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No Abstract Available.
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Medicina Basada en la Evidencia , Neoplasias , Evaluación del Resultado de la Atención al Paciente , Humanos , Neoplasias/terapiaRESUMEN
PURPOSE AND OBJECTIVES: Collaboration across multiple sectors is needed to bring about health system transformation, but creating effective and sustainable collaboratives is challenging. We describe outcomes and lessons learned from the Hearts of Sonoma County (HSC) initiative, a successful multi-sector collaborative effort to reduce cardiovascular disease (CVD) risk in Sonoma County, California. INTERVENTION APPROACH: HSC works in both clinical systems and communities to reduce CVD risk. The initiative grew out of a longer-term county-wide collaborative effort known as Health Action. The clinical component involves activating primary care providers around management of CVD risk factors; community activities include community health workers conducting blood pressure screenings and a local heart disease prevention campaign. EVALUATION METHODS: The impact of the clinical improvement efforts was tracked using blood pressure data from the 4 health systems participating in HSC. Descriptive information on the community-engagement efforts was obtained from program records. Lessons learned in developing and maintaining the collaborative were gathered through document review and interviews with key informants. RESULTS: Favorable trends were seen in blood pressure control among patients with hypertension in the participating health systems: patients with controlled blood pressure increased from 58% in 2014 to 67% in 2016 (P < .001). Between 2017 and 2019, the community engagement effort conducted 99 outreach events, reaching 1,751 individuals, and conducted 1,729 blood pressure screenings, with 441 individuals referred to clinical providers for follow-up care. HSC scored highly on 6 essential elements of an effective coalition and achieved a degree of sustainability that has eluded many other collaboratives. IMPLICATIONS FOR PUBLIC HEALTH: Factors contributing to the success of HSC include 1) starting small and focused to build trust among participants and demonstrate value, 2) working within the framework of a larger effort, and 3) providing long-term, open-ended backbone support.
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Enfermedades Cardiovasculares/prevención & control , Servicios de Salud Comunitaria , Promoción de la Salud , California , Enfermedades Cardiovasculares/epidemiología , Agentes Comunitarios de Salud , Atención a la Salud , Apoyo a la Planificación en Salud , Humanos , Hipertensión , Atención Primaria de Salud , Evaluación de Programas y Proyectos de SaludRESUMEN
Congenital hypothyroidism (CH) is one of the most frequent inherited-metabolic diseases in the world, and the main cause of treatable mental retardation in children. Because signs and symptoms of this disease are often scarce and not easily recognizable, newborns are screened for the early CH detection at birth. The Center of Immunoassay (CIE) has developed the UMELISA® TSH Neonatal and UMELISA® TSH to determine neonatal thyroid-stimulating hormone (TSH) levels in dried blood and serum samples. Both reagent kits use the same polystyrene plates coated with anti-ß-TSH monoclonal antibodies (MAbs), but one of these is commercially acquired. Obtaining appropriate anti-TSH MAbs at the CIE would guarantee economic independence and security in the production of these kits. Immunization of mice with TSH led to the generation of 7G11E3, an anti-ß-TSH IgG1-secreting hybridoma. The high affinity of 7G11E3 MAb and its characteristic epitopic recognition explain its better performance when adsorbed to UMELISA® plates for capturing low amounts of TSH in comparison with the studied MAbs. Performance of assays using polystyrene plates coated with 7G11E3 MAb was studied. Recovery percentages (100.0-106.7% for UMELISA® TSH NEONATAL and 97.3-99.0% for UMELISA® TSH) and intra (5.2-7.9% for UMELISA® TSH NEONATAL and 3.2-5.3% for UMELISA® TSH) and inter (6.6-7.7% for UMELISA® TSH NEONATAL and 5.2-8.0% for UMELISA® TSH) coefficients of variation were similar to the ones described for the commercial kits. Limits of detection and quantification were 1.0 and 3.8 mIU/L for UMELISA® TSH NEONATAL, and 0.3 and 0.6 mIU/L for UMELISA® TSH, respectively. The results also showed high overall concordance between assays (n = 2 019, ρc = 0.90 for UMELISA® TSH NEONATAL and n = 200, ρc = 0.94 for UMELISA® TSH). The 7G11E3 MAb meets the requirements for its use in the plates of UMELISA® TSH kits for CH newborn screening in Cuba. Abbreviations: CECMED, Center for the State Control of Medicaments and Medical Equipment and Devices; CH, congenital hypothyroidism; CIE, Center of Immunoassay; CLSI, Clinical and Laboratory Standards Institute; CV coefficient of variation; DBS, dried blood spots; LOB, limit of blank; LOD, limit of detection; LOQ, limit of quantitation; SD, standard deviation; Sr, repeatability standard deviation; SUMA, Ultra Micro Analytic System; UMELISA, ultramicro enzyme-linked immunosorbent assay.
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Anticuerpos Monoclonales/inmunología , Hipotiroidismo Congénito/diagnóstico , Hipotiroidismo Congénito/inmunología , Tamizaje Neonatal , Tirotropina/inmunología , Animales , Reacciones Antígeno-Anticuerpo , Femenino , Humanos , Recién Nacido , Ratones , Ratones Endogámicos BALB C , Tirotropina/sangreRESUMEN
Glutaric Aciduria type I (GA-I) is caused by mutations in the GCDH gene. Its deficiency results in accumulation of the key metabolites glutaric acid (GA) and 3-hydroxyglutaric acid (3-OHGA) in body tissues and fluids. Present knowledge on the neuropathogenesis of GA-I suggests that GA and 3-OHGA have toxic properties on the developing brain. We analyzed morphological and biochemical features of 3D brain cell aggregates issued from Gcdh-/- mice at two different developmental stages, day-in-vitro (DIV) 8 and 14, corresponding to the neonatal period and early childhood. We also induced a metabolic stress by exposing the aggregates to 10â¯mM l-lysine (Lys). Significant amounts of GA and 3-OHGA were detected in Gcdh-/- aggregates and their culture media. Ammonium was significantly increased in culture media of Gcdh-/- aggregates at the early developmental stage. Concentrations of GA, 3-OHGA and ammonium increased significantly after exposure to Lys. Gcdh-/- aggregates manifested morphological alterations of all brain cell types at DIV 8 while at DIV 14 they were only visible after exposure to Lys. Several chemokine levels were significantly decreased in culture media of Gcdh-/- aggregates at DIV 14 and after exposure to Lys at DIV 8. This new in vitro model for brain damage in GA-I mimics well in vivo conditions. As seen previously in WT aggregates exposed to 3-OHGA, we confirmed a significant ammonium production by immature Gcdh-/- brain cells. We described for the first time a decrease of chemokines in Gcdh-/- culture media which might contribute to brain cell injury in GA-I.
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Compuestos de Amonio/análisis , Encéfalo/citología , Quimiocinas/análisis , Medios de Cultivo/análisis , Glutaril-CoA Deshidrogenasa/genética , Errores Innatos del Metabolismo de los Aminoácidos/genética , Compuestos de Amonio/metabolismo , Animales , Encéfalo/efectos de los fármacos , Encéfalo/patología , Encefalopatías Metabólicas/genética , Técnicas de Cultivo de Célula , Quimiocinas/metabolismo , Medios de Cultivo/metabolismo , Glutaril-CoA Deshidrogenasa/deficiencia , Lisina/farmacología , Ratones , Ratones Endogámicos C57BL , Ratones Noqueados , Andamios del TejidoAsunto(s)
Enfermedades Hereditarias del Ojo/diagnóstico , Ceguera Nocturna/diagnóstico , Fenómenos Fisiológicos Oculares , Células Fotorreceptoras Retinianas Bastones/patología , Adaptación a la Oscuridad , Electrorretinografía , Enfermedades Hereditarias del Ojo/fisiopatología , Femenino , Humanos , Persona de Mediana Edad , Ceguera Nocturna/fisiopatología , Células Fotorreceptoras Retinianas Conos/fisiología , Agudeza VisualRESUMEN
Introducción: los extractos de Calendula officinalis se utilizan como materia prima natural en diversidad de preparaciones farmacéuticas y cosméticas, sin embargo, no existen métodos oficiales para el control de calidad de dichos extractos. Objetivo: se validó una metodología analítica por HPLC para la cuantificación de quercetina total en extractos glicólicos e hidroalcohólicos de Calendula officinalis. Métodos: para cuantificar el contenido de quercetina total en las matrices, fue necesario hidrolizar los flavonoides glicósidos en condiciones óptimas. La separación cromatográfica se realizó en una columna SiliaChrom C-18 5 µm 4.6x150 mm, adaptada a una precolumna SiliaChrom C-18 5 µm 4.6x10 mm, con un sistema de detección UV a 370 nm. El sistema de elución fue en gradiente, donde la fase móvil se compuso de Metanol (MeOH) y ácido fosfórico (H3PO4) (0.08 por ciento p/v), la cuantificación se efectuó con el método de estándar externo y comparación con un estándar de quercetina de referencia. Resultados: la selectividad de la metodología frente los componentes del extracto y a los productos de degradación en condiciones de hidrólisis ácida - básica, oxidación y exposición a la luz, mostró que no hay señales que interfieran con la cuantificación de la quercetina. Se comprobó estadísticamente que el método es lineal entre 1,0 y 5,0 µg / mL. La precisión intermedia expresada como coeficiente de variación fue de 1,8 y 1,74 por ciento y el porciento de recuperación fue de 102.15 y 101.32 por ciento, para los extractos glicólico e hidroalcohólico, respectivamente. Conclusiones: la metodología propuesta cumple con los parámetros de calidad requeridos para la cuantificación de quercetina total, lo cual la convierte en una herramienta útil para el control de calidad de extractos glicólicos e hidroalcohólicos de C. officinalis(AU)
Introduction: calendula officinalis extracts are used as natural raw material in a wide range of pharmaceutical and cosmetic preparations; however, there are no official methods for quality control of these extracts. Objective: to validate an HPLC-based analytical method for quantification total quercetin in glycolic and hydroalcoholic extracts of Calendula officinalis. Methods: to quantify total quercetin content in the matrices, it was necessary to hydrolyze flavonoid glycosides under optimal conditions. The chromatographic separation was performed on a C-18 SiliaChrom 4.6x150 mm 5 µm column, adapted to a SiliaChrom 5 um C-18 4.6x10 mm precolumn, with UV detection at 370 nm. The gradient elution was performed with a mobile phase consisting of methanol (MeOH) and phosphoric acid (H3PO4) (0.08 percent w/v). The quantification was performed through the external standard method and comparison with quercetin reference standard. Results: the studied method selectivity against extract components and degradation products under acid/basic hydrolysis, oxidation and light exposure conditions showed no signals that interfere with the quercetin quantification. It was statistically proved that the method is linear from 1.0 to 5.0 mg/mL. Intermediate precision expressed as a variation coefficient was 1.8 and 1.74 percent and the recovery percentage was 102.15 and 101.32 percent, for glycolic and hydroalcoholic extracts, respectively. Conclusions: the suggested methodology meets the quality parameters required for quantifying total quercetin, which makes it a useful tool for quality control of C. officinalis extracts(AU)
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Humanos , Control de Calidad , Quercetina , Cromatografía Líquida de Alta Presión/métodos , Calendula , Estudios de Validación como Asunto , ColombiaRESUMEN
Teniendo en cuenta que no existe una normativa actualizada nacional para el control de calidad de los envases metálicos de aerosol que se utilizan en la industria farmacéutica y la cosmética, en este trabajo se desarrolló una guía de análisis para aplicarla de forma rutinaria a los envases con boca de 25,4 mm de diámetro. El primer paso consistió en realizar una revisión documental de las normativas del Instituto Colombiano de Normas Técnicas (Icontec), la Consumer Specialty Products Associations Aerosol Guide (CSPA), la Federación Europea de Aerosoles (FEA), la European Standards (EN) y el Instituto Argentino de Normalización (IRAM). Luego se seleccionaron los análisis de mayor criticidad y practicidad que fueran aplicables a la industria del llenado de aerosoles y se confirmó su viabilidad técnica en diferentes envases metálicos con un diámetro de boca de 25,4 mm, con el fin de desarrollar un protocolo unificado para llevar a cabo el control de calidad de estos envases metálicos.
This study was conducted with the objective of developing an analysis guide for quality control of metal containers used for filling of aerosols in the pharmaceutical and cosmetic industry, taking into account that at the national level there are no regulations for quality control of containers metal for aerosol. First, we conducted a literature review of the regulations of Instituto Colombiano de Normas Técnicas (Icontec), Consumer Specialty Products Association Guide (CSPA), European Aerosol Federation (FEA), European Standards EN, and Instituto Argentino de Normalización (IRAM). Subsequently, more critical analysis and practicality that are applicable to aerosol filling industry were selected and technical feasibility was confi rmed for various metal packaging with a mouth diameter of 25.4 mm, to develop a unified protocol quality control of these metal containers.
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En este trabajo, fue desarrollado y validado un método indicador de estabilidad por cromatografía líquida, para ser aplicado al estudio cinético de Rosuvastatina Cálcica en diferentes valores de pH y temperatura. Las condiciones cromatográficas seleccionadas fueron: columna C18, 50 x 4.6 mm y 3,5 µm de tamaño de partícula; fase móvil MeOH: Agua-0.1%TFA, temperatura de la columna de la columna 25 ° C, y velocidad de flujo 1 mL/min. El método validado presentó una adecuada repetibilidad y precisión intermedia y una recuperación superior al 98%. Por otra parte, el método fue lineal en el rango de 10 a 150 ppm. En condiciones ácidas, fueron identificados tres posibles productos de degradación como: Rosuvastatina Lactona, Rosuvastatina Anti-isómero y Rosuvastatina Lactona Anti-isómero y en condiciones de degradación con la luz se identificaron dos posibles productos mayoritarios. El método validado puede ser empleado en estudios de estabilidad y de degradación cinética del fármaco.
In this work, a liquid chromatography stability-indicating method was development and validated to be applied at study the hydrolytic behavior of Rosuvastatin Calcium in different pH values and temperatures. The selected chromatographic conditions were a column C18 50 x 4.6 mm and 3.5 µm. The mobile phase was Methanol: Water-1%TFA; 25°C column temperature and flow rate 1 mL/min. The validation method exhibited an adequate repeatability and intermediate precision and a recovery higher than 98%. Furthermore, the method was lineal in range of 10 to 150 ppm. Under acidic conditions, three degradation products possible were identified as Rosuvastatin lactone, Rosuvastatin anti-isomer and Rosuvastatin lactone anti-isomer, with light were identified two major decomposition products. The validated method can be used in the stability studies and drug degradation kinetics.
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El crecimiento progresivo de la industria de los aerosoles, se debe en gran medida a la efectividad de este tipo de envase para contener, proteger, conservar y dosificar el producto. Actualmente, se le han agregado algunos elementos que influyen notablemente en la decisión final, pues permiten que estos envases sean económicos, ergonómicos, amigables con el medioambiente y con buena apariencia. La tendencia del crecimiento de la industria del aerosol se ha extendido a todos los sectores de consumo, principalmente para el cuidado personal, el cuidado del hogar, productos farmacéuticos para uso humano y veterinario y productos alimenticios. Gracias al esfuerzo de empresas maquiladoras en búsqueda de nuevas oportunidades, hoy Colombia cuenta con maquinaria e insumos para producir aerosoles con calidad internacional. Dada la diversidad de proveedores de envases, necesarios para cubrir la demanda, es indispensable establecer pautas para el control de la calidad de los envases, pues ello incide directamente en la calidad del producto final. En el presente trabajo se revisaron y evaluaron las normas más representativas, del ámbito nacional e internacional, para el control de calidad de envases metálicos para aerosol, con el fin de identificar las pruebas aplicables al sector industrial tanto farmacéutico como cosmético.
The progressive growth of the aerosol industry is due largely to the effectiveness of this type of packaging to contain, protect, preserve and dispense the product. Currently, some elements have been added in order to influence the final decision, they allow these containers are economical, ergonomic, environmentally friendly and good looking. The growth trend of the aerosol industry has spread to all sectors of consumption, mainly for personal care, home care, pharmaceuticals for human and veterinary use, and food products. Thanks to the efforts of industries maquiladoras in search of new opportunities, Colombia currently has machinery and inputs to produce aerosols with international quality. Given the diversity of packaging suppliers, needed to meet demand, it is essential to establishing guidelines for quality control of packaging as this directly impacts the quality of the final product. In this paper we reviewed and assessed most representative standards, nationally and internationally, for the quality control of metal aerosol containers, in order to identify the tests applicable to both pharmaceutical industry as a cosmetic.
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Repeat cesarean delivery (CD) rates among US Hispanic women are the highest of all racial/ethnic groups (90%). Vaginal birth after cesarean (VBAC) is an alternative delivery method, but requires medical records documentation of a non-vertical incision and favorable conditions in the current pregnancy. VBAC rates for Hispanic women are extremely low. This study explores the birth histories and medical records access among Hispanic women in California, taking into account the potential role of immigration on access to VBAC. Study aims are to describe for a sample of Hispanic women: (1) CD and VBAC histories as well as history of vaginal delivery preceding CD; and (2) medical records access, among women who had previous births in Mexico. Chart review was conducted for prenatal patients from three safety net clinics in two California counties with large Mexican migrant populations between August, 2003 and February 2004--during which VBAC was widely available in these two counties to determine: obstetric histories, CD details, birthplace and whether or not medical records had been requested/obtained for CD. 355 multiparous Hispanic women were included. Thirty-three percent had a previous CD, almost two-thirds (64%) had only one CD. Over half of the women (55%) with 2+ births and CD history also reported a vaginal birth history. Medical records for CD were infrequently requested (29%). Of those requested, records were received for 77% of women with a US CD, compared with 13% of women with Mexican CD histories. Policies to address: (1) VBAC opportunities for low risk women, such as those with prior vaginal births and one CD, and (2) overcoming limited medical records access, could mitigate against unnecessary CD and associated medical expenditures and risks for future complications.
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Parto Obstétrico/estadística & datos numéricos , Emigrantes e Inmigrantes/estadística & datos numéricos , Hispánicos o Latinos/estadística & datos numéricos , Registros Médicos/estadística & datos numéricos , Atención Prenatal/estadística & datos numéricos , Adulto , California , Cesárea/estadística & datos numéricos , Femenino , Accesibilidad a los Servicios de Salud , Humanos , Parto Vaginal Después de Cesárea/estadística & datos numéricosRESUMEN
Muchos han sido los estudios realizados para determinar la prevalencia de los dolores faciales que afectan cada día a diversos pacientes en todo el mundo; En los diversos resultados se determina que los nervios más afectados son el V par craneal o nervio trigémino (Nervus trigeminus) y el VII par craneal o nervio facial (Nervus facialis), sin embargo, se ha demostrado que en los restantes pares craneales se manifiestan lesiones que deben tener igual importancia para el odontólogo, debido a que pertenecen al campo de trabajo del mismo. La presente revisión bibliográfica se lleva a cabo para dar a conocer una afección que se presenta a nivel de las zonas adyacentes al aparato bucal conocida como Neuralgia del glosofaríngeo (Nervus glossopharyngeus), en la cual el paciente refiere dolor en oído, zona posterior de la lengua, fosa amigdalina, ángulo de la mandíbula, presentándose como un dolor intenso, punzante que puede durar de segundos a minutos; éste se manifiesta generalmente al comer, hablar, toser, etc. Se deben realizar varios exámenes sanguíneos y de imagenología para determinar el origen de esta enfermedad y con ello conseguir erradicar la causa de dicha lesión.
Many had been the studies maked for determinate the prevalence of the facials pains that affect each day diverses patients in the world. In results its determined that one of the nerve most affected is the cranial V Pair or Trigeminal Nerve (Nervus trigeminus) and the Cranial XII Pair or Facial Nerve (Nervus facialis), however, have been demostrated that in the rest of cranials pairs lesions have been manifestations that should have the same importance for the dentist, because they belong to their work camp. The present bibliographic review is maked for given to know an affection that presents in adjacent zones of the bucal aparate knowing like Glossopharyngeal (Nervus glossopharyngeus) Neuralgy, where the patients refiere pain in the ear, posterior zone of the tongue, tonsil fosse, mandibule angle, presenting as an intensive pain, shooting that would endure seconds to minutes. This makes clear generally on eating, talking, coughing, etc. Its necessary to realize some bloods test and imagenology to determinate the origin of the disease and with that to obtain delete the cause of that lesion.
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El gastrinoma es un tumor predominantemente maligno pancreático o extrapancreático (duodeno, yeyuno, proximal, estómago), el cual causa una hipergastrinemia, no regulada y el síndrome de Zollinger-Ellison. Se presenta un caso de un Paciente masculino de 58 años de edad, con antecedentes de gastritis erosiva diagnósticada un año previo a su ingreso, es hospitalizado en agosto del 2001 por episodio de Hemorragía Digestiva Superior originada por ulcera gástrica, es controlado mediante tratamiento médico y tres días despues reingresa con cuadro clínico de ulcuspeptico perforado resolviendose quirúrgicamente con estudio anatomopatológico e inmuno-histoquímico posterior a la intervención de gastrinoma gástrico
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Humanos , Masculino , Persona de Mediana Edad , Gastrinoma , Tumores Neuroendocrinos , Páncreas , Úlcera Gástrica/complicaciones , Úlcera Gástrica/diagnóstico , Síndrome de Zollinger-Ellison , Gastroenterología , VenezuelaRESUMEN
Se prtesenta un caso de un paciente con hemorragia digestiva superior recurrente masiva, diagnosticandose lesión de Dieulafoy en la segunda endoscopia superior, el cual inicialmente tratado con dos sesiones de escleroterapia con Polidocanol al 2 por ciento y una sesión de termocoagulación con carácter Heat Probe, sin mejoría clínica del mismo, lo cual motivo la Ligadura de la lesión con banda elástica, la fue precedida de tatuaje de la zona con tinta china. El control clínico del paciente a las 48 horas, a la semana y 9 meses después, ha demostrado ausencia de recurrencias
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Humanos , Masculino , Adulto , Traumatismos Abdominales , Endoscopía Gastrointestinal , Hemorragia Gastrointestinal , Escleroterapia , Gastroenterología , VenezuelaRESUMEN
This report describes the first isolation of the ameba Balamuthia mandrillaris from an environmental soil sample associated with a fatal case of amebic encephalitis in a northern California child. Isolation of the ameba into culture from autopsied brain tissue confirmed the presence of Balamuthia: In trying to locate a possible source of infection, soil and water samples from the child's home and play areas were examined for the presence of Balamuthia: The environmental samples (plated onto nonnutrient agar with Escherichia coli as a food source) contained, in addition to the ameba, a variety of soil organisms, including other amebas, ciliates, fungi, and nematodes, as contaminants. Presumptive Balamuthia amebas were recognized only after cultures had been kept for several weeks, after they had burrowed into the agar. These were transferred through a succession of nonnutrient agar plates to eliminate fungal and other contaminants. In subsequent transfers, axenic Naegleria amebas and, later, tissue cultures (monkey kidney cells) served as the food source. Finally, the amebas were transferred to cell-free axenic medium. In vitro, the Balamuthia isolate is a slow-growing organism with a generation time of approximately 30 h and produces populations of approximately 2 x 10(5) amebas per ml. It was confirmed as Balamuthia by indirect immunofluorescence staining with rabbit anti-Balamuthia serum and human anti-Balamuthia antibody-containing serum from the amebic encephalitis patient. The environmental isolate is similar in its antimicrobial sensitivities and identical in its 16S ribosomal DNA sequences to the Balamuthia isolate from the deceased patient.
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Amebiasis/parasitología , Amoeba/clasificación , Amoeba/aislamiento & purificación , Encefalitis/parasitología , Suelo/parasitología , Amoeba/genética , Animales , Antiprotozoarios/farmacología , Encéfalo/parasitología , California , Infecciones Protozoarias del Sistema Nervioso Central/parasitología , Preescolar , Resultado Fatal , Femenino , Humanos , Datos de Secuencia Molecular , Pruebas de Sensibilidad Parasitaria , ARN Ribosómico 16S/genética , Análisis de Secuencia de ADNRESUMEN
A propósito de un paciente con tumor submucoso en primera porción del duodeno, con diagnóstico histológico de Lipoma. Se realiza revisión de la literatura sobre su presentación más frecuente y sus complicaciones, así como de los métodos diagnósticos utilizados y su indicación quirúrgica
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Humanos , Masculino , Persona de Mediana Edad , Neoplasias Duodenales , Duodenitis , Úlcera Péptica , Gastroenterología , VenezuelaRESUMEN
The aim of this study was to analyze the incidence and risk factors of bacteremia after a febrile episode in uncomplicated pediatric recipients more than 2 months after liver transplantation, which has not previously been studied. This cross-sectional study was conducted over a 4-year period. Patients with known risk factors for sepsis at the time of admission were excluded from the study. Seventy-one patients were hospitalized on 128 occasions, with bacteremia occurring in the case of 11 admissions (8.6%). No laboratory tests were predictive of bacteremia. The bacteremic group most frequently presented with ill appearance ( P<0.001), lethargy ( P<0.01), decreased physical activity, and a history of early-onset bacteremia after transplantation and segmental graft ( P<0.05). This study identified a significant incidence of bacteremia in uncomplicated patients many months after liver transplantation.
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Bacteriemia/epidemiología , Fiebre/etiología , Trasplante de Hígado/fisiología , Complicaciones Posoperatorias/microbiología , Bacteriemia/fisiopatología , Preescolar , Estudios Transversales , Femenino , Estudios de Seguimiento , Humanos , Masculino , Anamnesis , Selección de Paciente , Complicaciones Posoperatorias/fisiopatología , Grupos Raciales , Factores de Tiempo , Virosis/epidemiologíaRESUMEN
El documento es un estudio realizado en el período de mayo de 1994 a junio de 1995 en Managua Nicaragua, se plasman testimonios de mujeres lesbianas que hablan sobre su experiencia sexual, lo que han sufrido o sufren discriminación de culpa por no querer a un hombre, sino a una mujer. Se pretende conocer cómo se manifiesta la autoestima de las mujeres lesbianas, poder identificar algunos elementos psicociales, históricos y culturales que inciden en ellas y establecer si existen variaciones en la autoestima de las mujeres lesbianas organizadas y no organizadas. Esta entrevista presentada por mujeres lesbianas que sin tapujos, sin disfraces hablan de sus emociones, alegrías y conflictos que tiene ante la sociedad que las ha descriminado y donde tienen los mismos derechos de todas las mujeres
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Testimonio de Experto , Homosexualidad Femenina , Derechos Humanos , Entrevistas como Asunto , MujeresRESUMEN
Estudio cuyo tema central es la autoestima de las mujeres lesbianas del sector urbano de Nicaragua que partiendo de la experiencia llega a la conceptualización. El trabajo fue presentado inicialmente como tesis a la Universidad Centroamericana y con su publicación se pretende formular un debate de altura.