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1.
Surg Neurol Int ; 15: 143, 2024.
Article in English | MEDLINE | ID: mdl-38741983

ABSTRACT

Background: Primary central nervous system (CNS) lymphoma is a very rare extranodal non-Hodgkin lymphoma. The bilateral pattern, as we call it "mirror type", has been identified in other CNS lesions such as gliomas, metastases, and demyelinating lesions, so the differential diagnosis includes imaging studies such as magnetic resonance imaging contrasted with spectroscopy, ruling out immunodeficiency or metastatic disease. Case Description: A 65-year-old female presented progressing headache, loss of memory and language alterations, as well as sensory alterations. Neuroimaging showed the presence of two equidistant periventricular lesions at the level of both ventricular atria, a spectroscopy study suggestive of malignancy. Serological studies showed no evidence of immunodeficiency or the presence of positive tumor markers; however, a biopsy was performed, which revealed a histopathological result of primary lymphoma of the CNS. Conclusion: In neuro-oncology, primary CNS tumors with multiple lesions are rare, even more, the "mirror type" lesions. Lymphomas are lesions that can present in different ways on imaging and clinical presentation. These tumors that present a vector effect due to their size, perilesional edema, or that lead to loss of neurological function are highly discussed in diagnostic and surgical treatment. Due to their prognosis, action on diagnosis and treatment must be taken as quickly as hospital resources allow.

2.
Surg Neurol Int ; 13: 459, 2022.
Article in English | MEDLINE | ID: mdl-36324915

ABSTRACT

Background: During the past 2 years, the use of systemic corticosteroids has increased due to COVID-19 atypical pneumonia management. Similarly, an increase in mycotic infection cases has been reported during the same period as a consequence of immunosuppression caused by corticosteroid overuse. Mycotic clival osteomyelitis is a rare clinical entity which presumably has increased its incidence during the pandemic. Case Description: A 52-year-old woman who presented persistent headaches and unexplained weight loss after being hospitalized due to COVID-19 pneumonia treated with intravenous corticosteroids. Head computed tomography and magnetic resonance imaging showed extensive osteomyelitis at the clival region with no brain parenchyma involvement. Surgical excision through navigation-guided transnasal transclival endoscopic extended approach was performed for surgical debridement. Histopathological analysis revealed angulated hyphae, suggestive of Aspergillosis. Systemic antifungal treatment was administered for 30 consecutive days. Afterward, she was discharged without any remarkable neurological findings, reassessed during follow-up. Conclusion: The COVID-19 pandemic has had an effect on the reemergence of mycotic infections due to corticosteroid immunosuppression. Clival osteomyelitis secondary to mycotic infection is an exclusion diagnosis that we encourage to be highly suspected within the persisting COVID-19 pandemic.

3.
Math Biosci Eng ; 19(1): 918-935, 2022 01.
Article in English | MEDLINE | ID: mdl-34903019

ABSTRACT

In this paper we evaluate different models and constraints to define strategic planning approaches. In addition, we analyze the best models to meet the expectations generated by the organization. A forest company situated in the province of Misiones, Argentina, provided the data. Hence, forest growth was simulated and, ultimately, optimized planning was used to evaluate different scenarios with 50-year horizon. The best results to stabilize log production were obtained when the harvest is relaxed in ±2 years. Relaxing the clear-cut age leads to a better balance in planting, thinning (1, 2, 3 and 4) and clear felling operations. We found that when maximizing the economic benefit, the NPV is slightly higher, however, this is not significant. In this sense, the planner chooses an economic or volumetric objective function. Furthermore, we demonstrated that model 1 presented better results than model 2 because it manages to stabilize production in the planning horizon. The results allow forest companies to see the implication of choosing the model for strategic planning.


Subject(s)
Forests , Strategic Planning , Argentina
5.
Neurocirugía (Soc. Luso-Esp. Neurocir.) ; 32(4): 170-177, jul.- ago. 2021. ilus, tab
Article in Spanish | IBECS | ID: ibc-222728

ABSTRACT

Background Cavernous sinus (CS) invasion is found in 15–20% of pituitary adenomas; it represents a poor prognosis factor and a surgical challenge even in experienced pituitary centers. We present our experience and technical note description for surgical management of pituitary adenomas with CS invasion in acromegaly by the transsellar lateral approach with an endoscopic endonasal transsphenoidal route. Method prospective case series of patients who underwent endoscopic endonasal surgery for Growing Hormone (GH) producing adenomas with CS invasion treated at the Neurosurgery departments of National Institute of Neurology and Neurosurgery in Mexico City, and of Toluca Medical Center of Social Security Institute of the State of Mexico and Provinces between January 2014 and March 2019. Results Thirty-two of 94 patients with diagnosis of pituitary adenoma treated at our institutions (34%) had acromegaly; thirteen of patients with acromegaly diagnosis met the inclusion criteria for CS invasion. Postoperative images reported gross total resection in 10 patients (76.9%). Mean follow-up time was 28.3 months. Remission criteria were achieved in nine patients (69.2%), with one of these patients (11.1%) having recurrence during follow up. All patients with no biochemical remission had improvement in GH and IGF profiles. Three patients without remission underwent radiosurgery (14Gy), and one patient had remission after the procedure. Conclusions We consider this to be a safe and efficient approach for tumors invading CS, when surgical team have good experience in endoscopy of the skull base and reconstruction techniques, appropriate instruments are available, and tumor has soft consistency (AU)


Antecedentes Se encuentra invasión al seno cavernoso en el 15-20% de los adenomas hipofisiarios, y representa un factor de mal pronóstico, así como un reto quirúrgico en algunas series. En el presente trabajo describimos y evaluamos nuestra experiencia con una técnica quirúrgica para el manejo de adenomas hipofisiarios con invasión al seno cavernoso en pacientes con acromegalia a través de un abordaje transelar lateral por la vía endonasal endoscópica. Métodos Serie de casos prospectiva de pacientes tratados con cirugía endonasal endoscópica para pacientes con diagnóstico de acromegalia y adenomas hipofisiarios con invasión al seno cavernoso tratados en los Departamentos de Neurocirugía del Instituto Nacional de Neurología y Neurocirugía en la Ciudad de México y en el Centro Médico Toluca del Instituto de Seguridad Social del Estado de México y Municipios entre enero del 2014 y marzo del 2019. Resultados Treinta y dos pacientes de 94 con diagnóstico de adenoma hipofisiario fueron tratados en nuestras instituciones, cumplieron con criterios clínicos y bioquímicos para el diagnóstico de acromegalia (34%); de estos, 13 pacientes cumplieron con criterios por imagen y quirúrgicos de invasión al seno cavernoso (40,6%). Las imágenes postoperatorias mostraron resección completa en 10 pacientes (76,9%). El tiempo medio de seguimiento fue de 28,3 meses. Se alcanzó un índice de remisión bioquímica en el 69,2% de los casos, con un paciente presentando recurrencia durante el seguimiento. Tres de los pacientes sin remisión bioquímica fueron sometidos a radiocirugía, con respuesta terapéutica en uno de ellos (AU)


Subject(s)
Humans , Male , Female , Adult , Growth Hormone-Secreting Pituitary Adenoma/diagnostic imaging , Growth Hormone-Secreting Pituitary Adenoma/surgery , Adenoma/diagnostic imaging , Adenoma/surgery , Prospective Studies , Treatment Outcome , Natural Orifice Endoscopic Surgery
6.
Nat Med ; 27(8): 1385-1394, 2021 08.
Article in English | MEDLINE | ID: mdl-34272499

ABSTRACT

Widespread acceptance of COVID-19 vaccines is crucial for achieving sufficient immunization coverage to end the global pandemic, yet few studies have investigated COVID-19 vaccination attitudes in lower-income countries, where large-scale vaccination is just beginning. We analyze COVID-19 vaccine acceptance across 15 survey samples covering 10 low- and middle-income countries (LMICs) in Asia, Africa and South America, Russia (an upper-middle-income country) and the United States, including a total of 44,260 individuals. We find considerably higher willingness to take a COVID-19 vaccine in our LMIC samples (mean 80.3%; median 78%; range 30.1 percentage points) compared with the United States (mean 64.6%) and Russia (mean 30.4%). Vaccine acceptance in LMICs is primarily explained by an interest in personal protection against COVID-19, while concern about side effects is the most common reason for hesitancy. Health workers are the most trusted sources of guidance about COVID-19 vaccines. Evidence from this sample of LMICs suggests that prioritizing vaccine distribution to the Global South should yield high returns in advancing global immunization coverage. Vaccination campaigns should focus on translating the high levels of stated acceptance into actual uptake. Messages highlighting vaccine efficacy and safety, delivered by healthcare workers, could be effective for addressing any remaining hesitancy in the analyzed LMICs.


Subject(s)
COVID-19 Vaccines/administration & dosage , COVID-19/prevention & control , Patient Acceptance of Health Care , COVID-19/virology , COVID-19 Vaccines/supply & distribution , Developing Countries , Humans , SARS-CoV-2/isolation & purification
7.
Neurocirugia (Astur : Engl Ed) ; 32(4): 170-177, 2021.
Article in English | MEDLINE | ID: mdl-34218877

ABSTRACT

BACKGROUND: Cavernous sinus (CS) invasion is found in 15-20% of pituitary adenomas; it represents a poor prognosis factor and a surgical challenge even in experienced pituitary centers. We present our experience and technical note description for surgical management of pituitary adenomas with CS invasion in acromegaly by the transsellar lateral approach with an endoscopic endonasal transsphenoidal route. METHOD: prospective case series of patients who underwent endoscopic endonasal surgery for Growing Hormone (GH) producing adenomas with CS invasion treated at the Neurosurgery departments of National Institute of Neurology and Neurosurgery in Mexico City, and of Toluca Medical Center of Social Security Institute of the State of Mexico and Provinces between January 2014 and March 2019. RESULTS: Thirty-two of 94 patients with diagnosis of pituitary adenoma treated at our institutions (34%) had acromegaly; thirteen of patients with acromegaly diagnosis met the inclusion criteria for CS invasion. Postoperative images reported gross total resection in 10 patients (76.9%). Mean follow-up time was 28.3 months. Remission criteria were achieved in nine patients (69.2%), with one of these patients (11.1%) having recurrence during follow up. All patients with no biochemical remission had improvement in GH and IGF profiles. Three patients without remission underwent radiosurgery (14Gy), and one patient had remission after the procedure. CONCLUSIONS: We consider this to be a safe and efficient approach for tumors invading CS, when surgical team have good experience in endoscopy of the skull base and reconstruction techniques, appropriate instruments are available, and tumor has soft consistency.


Subject(s)
Adenoma , Cavernous Sinus , Adenoma/surgery , Cavernous Sinus/surgery , Endoscopy , Growth Hormone , Humans , Mexico , Neoplasm Recurrence, Local , Prospective Studies
8.
Article in English, Spanish | MEDLINE | ID: mdl-32690399

ABSTRACT

BACKGROUND: Cavernous sinus (CS) invasion is found in 15-20% of pituitary adenomas; it represents a poor prognosis factor and a surgical challenge even in experienced pituitary centers. We present our experience and technical note description for surgical management of pituitary adenomas with CS invasion in acromegaly by the transsellar lateral approach with an endoscopic endonasal transsphenoidal route. METHOD: prospective case series of patients who underwent endoscopic endonasal surgery for Growing Hormone (GH) producing adenomas with CS invasion treated at the Neurosurgery departments of National Institute of Neurology and Neurosurgery in Mexico City, and of Toluca Medical Center of Social Security Institute of the State of Mexico and Provinces between January 2014 and March 2019. RESULTS: Thirty-two of 94 patients with diagnosis of pituitary adenoma treated at our institutions (34%) had acromegaly; thirteen of patients with acromegaly diagnosis met the inclusion criteria for CS invasion. Postoperative images reported gross total resection in 10 patients (76.9%). Mean follow-up time was 28.3 months. Remission criteria were achieved in nine patients (69.2%), with one of these patients (11.1%) having recurrence during follow up. All patients with no biochemical remission had improvement in GH and IGF profiles. Three patients without remission underwent radiosurgery (14Gy), and one patient had remission after the procedure. CONCLUSIONS: We consider this to be a safe and efficient approach for tumors invading CS, when surgical team have good experience in endoscopy of the skull base and reconstruction techniques, appropriate instruments are available, and tumor has soft consistency.

9.
Rev. Asoc. Esp. Espec. Med. Trab ; 29(1): 42-56, mar. 2020. tab
Article in Spanish | IBECS | ID: ibc-192282

ABSTRACT

OBJETIVO: El estudio examina la relación entre estrés laboral y los factores de riesgo psicosociales intralaborales presente en trabajadores de una fundación de niños con discapacidad ubicada en el departamento del Atlántico, Colombia. MATERIAL Y MÉTODOS: Estudio descriptivo correlacional realizado en 35 trabajadores del centro de rehabilitación de niños con discapacidad, se aplicó el cuestionario del nivel estrés y factores de riesgo psicosociales intralaborales del ministerio de protección social en Colombia y la Universidad Javeriana. RESULTADOS: Entre la muestra de trabajadores estudiada, El 31,4% de los trabajadores tiene un alto nivel de estrés laboral, de igual manera identificamos una relación positiva entre los factores de riesgo psicosociales intralaborales y el nivel de estrés laboral en cada dominio. CONCLUSIÓN: Por lo tanto, concluimos que un alto nivel de riesgo psicosocial intralaboral incrementa el nivel de estrés laboral en los trabajadores del centro de discapacidad. En este caso la intervención por parte del programa de salud laboral ayudaría a reducir los factores de riesgo psicosociales intralaborales y el nivel de estrés en los trabajadores


OBJECTIVES: The study examined the relationship between work-related stress and psychosocial risk factors in the workplace of disability center employees working for a disability center located in Atlántico, Colombia. MATERIAL AND METHODS: The correlational descriptive study examined 35 employees working for a disability center. The employees were given a questionnaire produced by The Social Protection Ministry of Colombia and Javeriana University which measured work-related psychosocial risk factors and the employees’ level of work stress. RESULTS: Among the employee sample studied, 31.4% of the workers indicated a high level of work stress. We found a positive relationship between work-related psychosocial risk factors and the employees' level of work stress. CONCLUSION: We concluded that a high level of work-related psychosocial risk factors increases work stress in disability center employees. We recommend the intervention of the Occupational Health Department to help reduce work-related psychosocial risk factors to reduce disability center employees’ level of work-related stress


Subject(s)
Humans , Male , Female , Young Adult , Adult , Middle Aged , Health Services for Persons with Disabilities , Burnout, Professional/psychology , Psychosocial Impact , Disabled Children , 16360 , Surveys and Questionnaires , Socioeconomic Factors , Cross-Sectional Studies , Risk Factors , Colombia
12.
Ciênc. rural ; 46(7): 1185-1191, July 2016. tab, graf
Article in English | LILACS | ID: lil-780876

ABSTRACT

ABSTRACT: This study aimed to evaluate the evolution of stem taper of trees in Pinus taedastands using stem analysis data from 126 and 120 trees sampled from established stands in Paraná and Santa Catarina States, respectively. The integer and fractional power polynomial was fitted to estimate diameters inside bark along the stem and was used to construct taper curves by age class. The model identity test was applied to verify the change in stem form of trees. The evolution of natural and artificial form factors in the trees was also analyzed. The curves constructed from the fitted taper functions and form factors showed that the stems become more cylindrical with increasing age; the identity test indicated that, in general, the taper curves statistically differ between themselves. This showed that stratifying the data into age classes for fitting in taper functions can produce more accurate assortment estimates.


RESUMO: O objetivo desta pesquisa foi avaliar a evolução do afilamento dos fustes de árvores em povoamentos de Pinus taeda, utilizando dados de análise de tronco de 126 e 120 árvores amostradas, respectivamente, em plantios estabelecidos nos estados do Paraná e de Santa Catarina. O polinômio de potências inteiras e fracionárias foi ajustado para estimativa dos diâmetros sem casca ao longo do tronco e usado para construção de curvas de afilamento por classe de idade. O teste de identidade de modelos foi aplicado para verificar a mudança na forma do tronco das árvores. Foi analisada também, a evolução do fator de forma natural e artificial das árvores. As curvas construídas a partir das funções de afilamento ajustadas e os fatores de forma mostram que os troncos se tornam mais cilíndricos com o aumento da idade. O teste de identidade indicou que, em geral, as curvas de afilamento diferem estatisticamente entre si. Isso evidencia que a estratificação dos dados em classes de idades nos ajustes de funções de afilamento pode produzir estimativas mais acuradas do sortimento.

13.
Pharm Biol ; 54(12): 2791-2801, 2016 Dec.
Article in English | MEDLINE | ID: mdl-27256704

ABSTRACT

CONTEXT: Biofilm formation is an important problem, since this growth mode confers resistance to drugs usually used in therapeutics. OBJECTIVE: In vitro antifungal activity of extracts obtained from Heterophyllaea pustulata Hook f. (Rubiaceae) were studied against Candida tropicalis biofilms, evaluating the effect of irradiation and the oxidative and nitrosative stresses as possible mechanisms of action. MATERIALS AND METHODS: Hexane, benzene, ethyl acetate and ethanol extracts were evaluated at three concentrations (0.2, 0.1 and 0.05 mg/mL) over mature biofilm, under darkness and irradiation. After 48 h of incubation, biofilm quantitation was performed by the O'Toole and Kolter method. Reactive oxygen species (ROS) was measured by nitro-blue tetrazolium (NBT) reaction and reactive nitrogen intermediates (RNI) by the Griess reagent. Superoxide dismutase activation (SOD, NBT assay) and total antioxidant system (FRAP test) were studied. RESULTS: Only the benzene extract at 0.2 mg/mL reduced the biofilms formation. The slight decrease achieved in darkness (17.06 ± 2.80% reduction) was increased by light action (39.31 ± 3.50% reduction), clearly observing a photostimulation. This great reduction was confirmed by confocal microscopy. In darkness, biofilm reduction was mediated by an increase in RNI, whereas under irradiation, the ROS action was most important. Although no SOD activation was observed, a strong stimulation of the total antioxidant system was detected. HPLC analysis established a high content of several anthraquinones in this extract. DISCUSSION AND CONCLUSION: Biofilm reduction by benzene extract was mainly mediated by oxidative stress triggered under light action, confirming a photodynamic sensitization, which could be attributed to its high content of photosensitizing anthraquinones.


Subject(s)
Antifungal Agents/pharmacology , Biofilms/drug effects , Candida tropicalis/drug effects , Photosensitizing Agents/pharmacology , Plant Extracts/pharmacology , Rubiaceae , Antifungal Agents/isolation & purification , Biofilms/growth & development , Candida tropicalis/growth & development , Dose-Response Relationship, Drug , Humans , Photic Stimulation/methods , Photosensitizing Agents/isolation & purification , Plant Extracts/isolation & purification , Reactive Oxygen Species/antagonists & inhibitors , Reactive Oxygen Species/metabolism
14.
Ars pharm ; 55(2): 32-41[2], abr.-jun. 2014. tab, graf, ilus
Article in Spanish | IBECS | ID: ibc-125919

ABSTRACT

Objetivo: El objetivo de este trabajo fue analizar la oferta, demanda y costos de los anticonceptivos orales disponibles en Argentina, así como también caracterizar la población usuaria y la forma de uso de los anticonceptivos parte de los mismos. Material y Método: Se realizó un estudio descriptivo y observacional donde se trabajó con un procedimiento normalizado analizando dispensaciones en un total de 42 farmacias comunitarias de Córdoba (Argentina). Resultados: 90 son los anticonceptivos hormonales orales disponibles, 81 % de los cuales son combinados. Más del 80% de las ventas se concentren solo en 3 laboratorios productores siendo paradójicamente la combinación más costosa (Drospirenona-Etinil Estradiol) la más dispensada. En más del 60% de los casos el anticonceptivo fue adquirido sin receta médica y sin cobertura de la seguridad social, lo cual fue, generalmente, compensado con descuentos adicionales que provenían en su mayoría de la farmacia. A pesar de contar la población en estudio, en su mayoría, con un nivel educativo medio-alto y experiencia en el uso de anticonceptivos, se detectó desconocimiento en los parámetros de uso y actitudes a tomar ante olvidos. Conclusiones: A pesar de la amplia oferta de anticonceptivos orales, la demanda de los mismos en farmacias comunitarias de la ciudad de Córdoba está fuertemente concentrada en los anticonceptivos orales combinados de mayor precio de venta en el mercado, existiendo deficiencias en el conocimiento por parte de los paciente respecto al modo adecuado de uso, con una fuerte tendencia a la repetición de una prescripción o automedicación a utilizar combinaciones de 3ra o 4ta generación sin que las mismas sean las más recomendadas


Aim: The aim of this study was to describe the supply and demand of oral contraceptives available in Argentina, characterize the user population and how the patients use contraceptives. Materials and Methods: We worked with a normalized procedure, analyzing 713 dispensations in 42 community pharmacies in Córdoba (Argentina). Results: The 90 oral contraceptives available in the Argentine pharmaceutical market, 81% of which correspond to combined oral contraceptive. More than 80% of the sales are concentrated in only 3 laboratories. Among combined oral contraceptive, the combinations of Drosperinone-Ethinylestradiol, those with the highest average price, were also the ones most chosen by the users. In over 60% of the cases they were purchased without a prescription and without social security coverage. This was offset by additional discounts coming mostly from the pharmacy outlets. Although most of the study population had an acceptable level of education and experience in the use of contaceptives, a certain lack of knowledge in the parameters of use and in the attitude to adopt when missing the daily dose was detected. Conclusions: Despite the broad range of oral contraceptives, the demand in community pharmacies is heavily concentrated in the combined oral contraceptive with higher price in the market, existing deficiencies in the knowledge from the patient regarding the proper way to use and there is a strong trend self-medication and use combinations of 3rd or 4th generation without the appropriate indications


Subject(s)
Humans , Female , Contraceptives, Oral/therapeutic use , Community Pharmacy Services/statistics & numerical data , Family Development Planning , Contraception Behavior/statistics & numerical data , Drug Utilization Review/statistics & numerical data , Self Medication/statistics & numerical data
15.
Acta amaz ; 39(2): 305-314, 2009. graf, tab
Article in Portuguese | LILACS | ID: lil-522377

ABSTRACT

O objetivo do presente estudo foi o de comparar a acuracidade e a precisão das estimativas de área basal obtidas de processos, intensidades e métodos amostrais com valores obtidos pelo censo, numa floresta ecotonal de 120 hectares na região norte matogrossense, para oito grupos de espécies e para espécies individuais para árvores com DAP ≥ 30 centímetros. Aplicaram-se os processos: aleatório e o sistemático, com uma intensidade amostral de 5 e 10 por cento para 22 tamanhos e formas de parcelas variando de 400 m² a 10000 m². A área basal média por hectare foi de 11,08 m². As parcelas de 2500 m² (125 m x 20 m) apresentaram erros reais e de amostragem sempre inferiores a 10 por cento na estimativa de área basal para os grupos de todas as espécies e para as 15 de maiores valores de importância (VI). Para os demais grupos os erros aumentam na medida em que decresce a quantidade de árvores por hectare. Para as espécies, individualmente, os erros variaram de 28,7 por cento (Vochysia sp.) a 250,59 (Hymenaeae courbaril), respectivamente, para a mais e a menos freqüente, mostrando inviabilidade na aplicação de processos estimativos tradicionalmente empregados nos inventários florestais, notadamente para estimar parâmetros específicos de espécies raras (baixa freqüência por hectare).


The objective of this research was to compare the accuracy and the precision of estimates from basal area obtained by processes, intensities and methods of sampling with true values gotten from the census, in an ecotonal forest of 120 hectares in the northern region of Matogrosso, for eight groups of species and for individual tree species with dbh ≥ 30 centimeters. The applied processes were: random and the systematic, with a sampling intensity of 5 percent and 10 percent for 22 sizes and forms of plots ranging from 400 m to 10000 m². The average basal area per hectare was 11.08 m². The 2500 m² (125 m x 20 m) plots presented actual and sampling errors always inferior to 10 percent in estimating basal area for all species and for the 15 of greater importance values (VI). For the other groups the errors increase accordance to the decrease of tree density. For the species, individually, the errors varied from 28.7 percent (Vochysia sp.) to 250.59 percent (Courbaril hymenaeae), respectively, for the most and the least dense, thus showing the unfeasibility of applying traditional estimative processes to estimate specific parameters of species with low frequency by hectare (rare species).


Subject(s)
Data Interpretation, Statistical , Models, Statistical , Censuses , Basal Forebrain
18.
Rev cuba med int emerg ; 5(4)2006. tab
Article in Spanish | CUMED | ID: cum-34071

ABSTRACT

Se realizó un estudio descriptivo de carácter retrospectivo con los pacientes sometidos a cirugía electiva de tórax admitidos en la Unidad de Cuidados Intensivos del Hospital Docente Dr Miguel Enríquez durante el período comprendido de Enero del año 2000 a Diciembre del 2004, excluyendo los pacientes con historia clínica incompleta. La muestra quedó conformada por 26 pacientes, los cuales se dividieron en tres grupos, según el tipo de cirugía realizada: a) resección pulmonar por neoplasia de pulmón, b) esofagogastrectomía de Ivor Lewis por tumores del tercio inferior del esófago y c) reducción de volumen pulmonar en pacientes con enfisema buloso uni o bilateral. Para cada grupo se analizaron variables como: sexo, edad, PFV pre-operatorias, complicaciones, causas de ventilación mecánica y causas de fallecimiento; llegándose a la conclusión de que predominó la cirugía de resección pulmonar en edades comprendidas entre 30 y 64 años; las principales complicaciones se presentaron en los pacientes con reducción de volumen pulmonar y fueron: la agudización de insuficiencia respiratoria crónica y ECV isquémica, a su vez estas complicaciones fueron las principales causas de ventilación mecánica, pero no se relacionaron con los fallecimientos, siendo el TEP la principal causa de muerte con dos casos; uno en el grupo de resección pulmonar y otro en el grupo con esofagogastrectomía(AU)


Subject(s)
Humans , Thoracic Surgery , Postoperative Care/methods
19.
Arch. med. deporte ; 22(109): 397-405, sept.-oct. 2005. ilus, tab
Article in Es | IBECS | ID: ibc-040967

ABSTRACT

De forma tradicional, se explica el estado ácido-base en términos cuantitativos de la variable dependiente pH y dos variables elementales independientes, lactato y bicarbonato, en relación a la intensidad del ejercicio. Cuando la intensidad del ejercicio alcanza un valor determinado, el incremento de la concentración de ácido láctico en plasma determina un aumento de la concentración de protones ([H+]), con un descenso de la concentración de bicarbonato ([HC03-]). Sin embargo, la explicación dada al estado ácido-básico durante el ejercicio, aunque sencilla y de fácil compresión, tiene considerables limitaciones, que han hecho necesario dar una visión físico-química. Esta nueva concepción indica que los factores que afectan a la [H +) se pueden agrupar en una expresión polinómica de cuarto grado: A[H+)4 + B[H+P + C[H+]2 + D[H+) + E = O Los coeficientes de esta expresión dependen principalmente de la diferencia de iones fuertes (DIF), la presión parcial de dióxido de carbono (PpC02) y de la concentración de aniones totales (AT-). Por tanto, para conocer el estado ácido-básico en ejercicio de intensidad progresiva en términos físico-químicos es necesario conocer la concentración de las tres variables inde pendientes (DIF, PpC02 y AT -). Partiendo de la situación de reposo, el organismo "reordena" las variables independientes al objeto de mantener estable la concentración de protones. Es objetivo de esta revisión analizar, desde el punto de vista físico químico la regulación del estado ácido-base en esfuerzos de resistencia


Tradicionally, the state is explained acid-bases on quantitative terms of the dependent variable pH and two independent elementary variables, lactate and bicarbonate, in relation to the intensity of the exercise. When the intensity of the exercise reaches a determined value, the increase of lactic acid concentration in plasma determines an increase of the proton concentration ([H+]), with a reduction of the bicarbonate concentration ([HC03-]). However, the explanation given to the acid-basic state during the exercise, although simple and of easy compression, has considerable limitations, which have done necessary to give to a physicalchemistry point of view. This new conception indicates, that the factors that affect to [ H + ) can group in a polinómic expression of fourth degree: A[H+)4 + B[H+P + C[H+]2 + D[H+) + E = O The coefficients of this expression depend mainly on the strong ion difference (DIF), the partial dioxide pressure of carbon (PpCO) and the total anion concentration (AT -). Therefore, to know the acid-basic state in incremental exercise in terms physical-chemistries it is necessary to know the concentration the three independent variables (DIF, PpC02 and AT -). Starting off of the rest situation, the organism "rearranges" the independent variables to maintain the proton concentration stable. He is objective of this revision to analyze, from the physical-chemestry point of view, the regulation of the state acid-bases on endurance exercise


Subject(s)
Humans , Exercise/physiology , Hydrogen-Ion Concentration , Bicarbonates/analysis , Bicarbonates/metabolism , Water-Electrolyte Balance/physiology , Lactic Acid/blood , Lactic Acid/metabolism , 24965 , Bicarbonates/blood , Physical Exertion , Lactic Acid/analysis
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