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1.
Cir Cir ; 91(3): 388-396, 2023.
Article in English | MEDLINE | ID: mdl-37433151

ABSTRACT

BACKGROUND: The acquired brain damage is a common neurological disorder. OBJECTIVE: Determine the probabilistic intersections of variables related to acquired brain damage from the determination of a priori and a posteriori probabilities. METHOD: Analytical retrospective study. A descriptive analysis was carried out, confidence intervals were calculated to obtain the mean and the proportion with α = 0.05 considering the age of the patient and the diagnosis. An analysis of probabilistic intersection, a priori and a posteriori probability was performed considering diagnosis, sex and age decade; finally, chi squared was calculated. RESULTS: 736 patients were analyzed. The most frequent diagnosis was language disorder. The patients diagnosed with memory disorder were the youngest and those diagnosed with degenerative cognitive disorder the oldest. The probability that a patient with sequelae due to acquired brain damage arrives at the hospital, at the language pathology service, to be diagnosed with a language disorder and that this patient is also a man is 29.06%. CONCLUSIONS: The high prevalence of short and long-term disability generated by acquired brain damage highlights the importance of an early and timely detection and diagnosis so that it favors prompt and efficient specialized care.


ANTECEDENTES: El daño cerebral adquirido es un trastorno neurológico común. OBJETIVO: Determinar las intersecciones probabilísticas de variables relacionadas con daño cerebral adquirido a partir de la determinación de probabilidades a priori y a posteriori. MÉTODO: Estudio retrospectivo analítico. Se realizó análisis descriptivo y se calcularon intervalos de confianza para la media y para la proporción con α = 0.05 considerando la edad del paciente y el diagnóstico. Se realizó análisis de intersección probabilística, probabilidad a priori y a posteriori considerando el diagnóstico, el sexo y la década de edad; por último, se utilizó la prueba χ2. RESULTADOS: Se analizaron 736 pacientes. El diagnóstico más frecuente fue el trastorno del lenguaje. Los pacientes diagnosticados con trastorno de memoria fueron los más jóvenes y los diagnosticados con trastorno cognitivo degenerativo los más longevos. La probabilidad de que llegue al hospital, al servicio de patología de lenguaje, un paciente con secuelas por daño cerebral adquirido, sea diagnosticado con trastorno del lenguaje y sea hombre es del 29.06%. CONCLUSIONES: La alta prevalencia de discapacidad a corto y largo plazo generada por el daño cerebral adquirido indica la importancia de la detección y el diagnóstico temprano y oportuno que favorezcan una pronta y eficiente atención especializada.


Subject(s)
Brain Injuries , Cognition Disorders , Language Disorders , Male , Humans , Retrospective Studies , Brain Injuries/etiology , Disease Progression , Language Disorders/etiology
2.
Gac Med Mex ; 158(4): 222-228, 2022.
Article in English | MEDLINE | ID: mdl-36256575

ABSTRACT

INTRODUCTION: The prevalence of the different genotypes of human papillomavirus (HPV) varies depending on lesion severity and geographic region. OBJECTIVE: To identify multiple HPV infections in low- and high-grade cervical lesions in a group of women from the Mexican Bajío region referred with inconclusive cytology. METHODS: Pilot study of women referred from primary care units of Guanajuato, Mexico, with cytology suggestive of cervical lesion. Cervical smears were subjected to DNA extraction and HPV genotyping using microarrays. RESULTS: 100 consecutive cases were collected and 90 were analyzed; HPV positivity was observed in 26% of healthy women, and 62% had some degree of cervical lesion. The most common HPV genotypes were 59, 31, 16 and 51. Multiple infections were found in most samples. CONCLUSIONS: HPV heterogeneity was identified in the samples of the study population in contrast to worldwide reports; furthermore, multiple infections are common in precursor lesions and decrease in high-grade lesions. These data could have an impact on current HPV vaccination programs.


INTRODUCCIÓN: La prevalencia de los diferentes genotipos de virus del papiloma humano (VPH) varía dependiendo de la severidad de la lesión y región geográfica. OBJETIVO: Identificar infecciones múltiples de VPH en lesiones cervicales de bajo y alto grado en un grupo de mujeres del Bajío mexicano referidas con citología no concluyente. MÉTODOS: Estudio piloto de mujeres referidas de unidades del primer nivel de atención de Guanajuato, México, por citología sugerente de lesión cervical. Los raspados cervicales fueron sujetos a extracción de ADN y genotipificación del VPH mediante microarreglos. RESULTADOS: Se colectaron 100 casos consecutivos y fueron analizados 90; se observó 26 % de positividad a VPH en mujeres sanas y 62 % presentó algún grado de lesión. Los genotipos de VPH más frecuentes fueron 59, 31, 16 y 51. En la mayoría de las muestras se encontró infección múltiple. CONCLUSIONES: Se identificó heterogeneidad de VPH en las muestras de la población estudiada en contraste con los reportes internacionales; además, son comunes las infecciones múltiples en lesiones precursoras y disminuyen en las lesiones de alto grado. Estos datos podrían influir en los actuales programas de vacunación anti-VPH.


Subject(s)
Papillomavirus Infections , Humans , Female , Papillomavirus Infections/diagnosis , Papillomavirus Infections/epidemiology , Pilot Projects , Papillomaviridae/genetics , Genotype , Prevalence , DNA
3.
Gac. méd. Méx ; Gac. méd. Méx;158(4): 231-237, jul.-ago. 2022. tab, graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1404845

ABSTRACT

Resumen Introducción: La prevalencia de los diferentes genotipos de virus del papiloma humano (VPH) varía dependiendo de la severidad de la lesión y región geográfica. Objetivo: Identificar infecciones múltiples de VPH en lesiones cervicales de bajo y alto grado en un grupo de mujeres del Bajío mexicano referidas con citología no concluyente. Métodos: Estudio piloto de mujeres referidas de unidades del primer nivel de atención de Guanajuato, México, por citología sugerente de lesión cervical. Los raspados cervicales fueron sujetos a extracción de ADN y genotipificación del VPH mediante microarreglos. Resultados: Se colectaron 100 casos consecutivos y fueron analizados 90; se observó 26 % de positividad a VPH en mujeres sanas y 62 % presentó algún grado de lesión. Los genotipos de VPH más frecuentes fueron 59, 31, 16 y 51. En la mayoría de las muestras se encontró infección múltiple. Conclusiones: Se identificó heterogeneidad de VPH en las muestras de la población estudiada en contraste con los reportes internacionales; además, son comunes las infecciones múltiples en lesiones precursoras y disminuyen en las lesiones de alto grado. Estos datos podrían influir en los actuales programas de vacunación anti-VPH.


Abstract Introduction: The prevalence of the different genotypes of human papillomavirus (HPV) varies depending on lesion severity and geographic region Objective: To identify multiple HPV infections in low- and high-grade cervical lesions in a group of women from the Mexican Bajío region referred with inconclusive cytology. Methods: Pilot study of women referred from primary care units of Guanajuato, Mexico, with cytology suggestive of cervical lesion. Cervical smears were subjected to DNA extraction and HPV genotyping using microarrays. Results: 100 consecutive cases were collected and 90 were analyzed; HPV positivity was observed in 26% of healthy women, 62% had some degree of cervical lesion. The most common HPV genotypes were 59, 31, 16 and 51. Multiple infections were found in most samples. Conclusions: HPV heterogeneity was identified in the samples of the study population in contrast to worldwide reports; furthermore, multiple infections are common in precursor lesions and decrease in high-grade lesions. These data could have an impact on current HPV vaccination programs.

4.
Cir Cir ; 90(3): 392-401, 2022.
Article in English | MEDLINE | ID: mdl-35636936

ABSTRACT

OBJECTIVE: Describes the economic effects on bio-psychosocial homeostasis from a three-dimensional analysis of the joint interaction of biological, psychological and economic-social comorbidities, in order to know the probabilities of occurrence of these conditions simultaneously. METHOD: It is a cross-sectional study and random quota sampling. 353 men and women over 20 years of age participated, and answered a 27 questions application (bio-psycho-economic-social), the data was analyzed three-dimensionally in order to know the probability of occurrence of the variables studied and their possible location in the probabilistic unit cube. RESULTS: Based on the unit cube proposal, it can be observed that in the block of people with incomes from 2200 to 6600 pesos in the group of men there is a probability of 12.9 per 1000 inhabitants of presenting debt problems, overweight and severe depression, while in the case of women, the probability is 2.08 per 1000 inhabitants. CONCLUSIONS: There is a priority axis that determines the change of the remaining variables, in this case it is the economic axis the one that determines the biological and psychological conditions.


OBJETIVO: Describir los efectos económicos en la homeostasis biopsicosocial a partir de un análisis tridimensional de la interacción conjunta de la comorbilidad biológica, psicológica y económico-social, con la finalidad de conocer las probabilidades de ocurrencia a partir de estas condiciones de forma simultánea. MÉTODO: Estudio transversal y muestreo aleatorio por cuotas. Participaron 353 hombres y mujeres mayores de 20 años que contestaron un cuestionario con 27 preguntas (biopsicosociales-económicas). Se analizaron los datos tridimensionalmente con la finalidad de conocer la probabilidad de ocurrencia de las variables estudiadas y su posible localización en el cubo unitario probabilístico. RESULTADOS: Con base en la propuesta del cubo unitario se obtiene que, en las personas con ingresos de 2200 a 6600 pesos, en los hombres existe una probabilidad de 12.9 por cada 1000 habitantes de presentar deudas, sobrepeso y depresión grave; en las mujeres, la probabilidad es de 2.08 por cada 1000 habitantes. CONCLUSIONES: Existe un eje prioritario que determina el cambio de las variables restantes, en este caso el eje económico que determina las condiciones biológicas y psicológicas.


Subject(s)
Cross-Sectional Studies , Adult , Female , Homeostasis , Humans , Male , Probability
6.
J Environ Manage ; 300: 113659, 2021 Dec 15.
Article in English | MEDLINE | ID: mdl-34530366

ABSTRACT

The effectiveness of impact assessment (IA) methods has been a neglected topic in procedural effectiveness research, which has placed higher relevance on the quality of Environmental Impact Statements (EISs) and the environment impact assessment (EIA) process in general. This study analysed the effectiveness of methods used in IA in Colombia to demonstrate that they have been used in compliance with the Terms of Reference (ToR) but did not analyse their effectiveness. A total of 131 EIS were analysed using a revised version of the Effectiveness Index for Environmental Impact Assessment Methods (EIM) proposed by Caro and Toro (2016). It is concluded that, even if the environmental authority has accepted the EIS as a requirement for obtaining an environmental license, most of the methods that have been used in these technical documents, obtained a medium or low degree of effectiveness. The parameters regulated for the law have a higher percentage of compliance. The analysis suggests that the guidelines provided for the law, related to the design and implementation of the methods, should be improved to develop an effective EIA.


Subject(s)
Environment , Colombia
7.
Cir Cir ; 89(2): 223-232, 2021.
Article in English | MEDLINE | ID: mdl-33784272

ABSTRACT

OBJETIVO: Describir y analizar aspectos clínicos y sociodemográficos de una cohorte de pacientes con trastornos del lenguaje, del habla y del aprendizaje. MÉTODO: Estudio retrospectivo descriptivo. Se seleccionaron expedientes de 4632 pacientes (años 2011 a 2015). Se calcularon medias, desviaciones estándar, porcentajes y frecuencias, Con la finalidad de evaluar si existía diferencia significativa entre variables se utilizó la prueba de ji al cuadrado y se realizó un análisis de probabilidad condicional entre las variables para obtener la probabilidad a priori y a posteriori. RESULTADOS: Los trastornos del lenguaje, del habla y del aprendizaje se presentaron con mayor frecuencia en el sexo masculino, con 3358 pacientes (72.5%). El diagnóstico más frecuente fue el trastorno del lenguaje, diagnosticado en 2924 pacientes (63.1%). Se encontraron mayores incidencia y prevalencia de retraso del lenguaje en el sexo masculino (p < 0.05). CONCLUSIONES: De todas las variables estudiadas, solo la incidencia de retraso en el desarrollo del lenguaje con respecto al sexo masculino fue significativa; de cada cuatro pacientes, tres eran de sexo masculino y uno de sexo femenino. OBJECTIVE: To describe and analyze clinical and sociodemographic aspects of a cohort of patients with language, speech and learning disorder. METHOD: Descriptive retrospective study. Patient records (2011 to 2015) were selected, making up a total of 4632. Averages, standard deviations, percentages and frequencies were calculated; in order to assess whether there was a significant difference between variables, chi squared test and a conditional probability analysis was performed between the variables to obtain a priori and a posteriori probability. RESULTS: Disorders of language, speech and learning occurred more frequently in males, 3358 patients (72.5%). The most frequent diagnosis was language development disorder, diagnosed in 2924 patients (63.1%). A higher incidence and prevalence of language delay were found for the male sex (p < 0.05). CONCLUSIONS: Of all the variables studied, only the incidence of delay in language development with respect to the male sex was significant; three out of four patients were male and 1 female.


Subject(s)
Learning Disabilities , Speech , Child , Female , Humans , Incidence , Learning Disabilities/epidemiology , Male , Prevalence , Retrospective Studies
8.
Int J Mol Sci ; 22(4)2021 Feb 22.
Article in English | MEDLINE | ID: mdl-33671604

ABSTRACT

Phosphatases are hydrolytic enzymes that cleave the phosphoester bond of numerous substrates containing phosphorylated residues. The typical classification divides them into acid or alkaline depending on the pH at which they have optimal activity. The histidine phosphatase (HP) superfamily is a large group of functionally diverse enzymes characterized by having an active-site His residue that becomes phosphorylated during catalysis. HP enzymes are relevant biomolecules due to their current and potential application in medicine and biotechnology. Entamoeba histolytica, the causative agent of human amoebiasis, contains a gene (EHI_146950) that encodes a putative secretory acid phosphatase (EhHAPp49), exhibiting sequence similarity to histidine acid phosphatase (HAP)/phytase enzymes, i.e., branch-2 of HP superfamily. To assess whether it has the potential as a biocatalyst in removing phosphate groups from natural substrates, we studied the EhHAPp49 structural and functional features using a computational-experimental approach. Although the combined outcome of computational analyses confirmed its structural similarity with HP branch-2 proteins, the experimental results showed that the recombinant enzyme (rEhHAPp49) has negligible HAP/phytase activity. Nonetheless, results from supplementary activity evaluations revealed that rEhHAPp49 exhibits Mg2+-dependent alkaline pyrophosphatase activity. To our knowledge, this study represents the first computational-experimental characterization of EhHAPp49, which offers further insights into the structure-function relationship and the basis for future research.


Subject(s)
Entamoeba histolytica/enzymology , Phosphoric Monoester Hydrolases/chemistry , Phosphoric Monoester Hydrolases/metabolism , Structure-Activity Relationship , 6-Phytase/metabolism , Binding Sites , Catalytic Domain , Diphosphates/metabolism , Entamoeba histolytica/genetics , Humans , Molecular Docking Simulation , Phosphoric Monoester Hydrolases/genetics , Protein Conformation , Protozoan Proteins/chemistry , Protozoan Proteins/genetics , Protozoan Proteins/metabolism , Recombinant Proteins/genetics , Recombinant Proteins/metabolism
9.
Nanoscale ; 13(3): 1738-1744, 2021 Jan 28.
Article in English | MEDLINE | ID: mdl-33428700

ABSTRACT

Plasmonic reversible gas sensors are of paramount importance for the monitoring of indoor environments. Herein, we design and engineer a plasmonic foam, with a high surface area, confined inside a capillary glass tube for the live monitoring of carbon monoxide (CO) in closed environments using surface-enhanced resonance Raman scattering. The illumination of the sensor with light during the flow of air allows the live monitoring of the concentration of atmospheric CO through surface-enhanced resonance Raman scattering. The sensor was prepared with a detection range from 10 to 40 ppm, due to health needs. The results show a sensitive, selective, reversible and robust sensor applicable to the monitoring of CO levels but also to other gas species upon appropriate functionalization.

10.
J Immunol Res ; 2020: 9435030, 2020.
Article in English | MEDLINE | ID: mdl-33015199

ABSTRACT

CD47 is a cell surface protein in the immunoglobulin superfamily which is normally expressed at low levels in every healthy cell. It´s main physiologic function is to act as an inhibitor of phagocytosis; this occurs throughout interaction with SIRPa expressed on macrophages. Interaction between CD47 and SIRPa leads to activation of tyrosine phosphatases that inhibit myosin accumulation at the submembrane assembly site of the phagocytic synapse, resulting in phagocytosis blockade. In this way CD47 acts as a "don´t eat me signal" for healthy self-cells; accordingly, loss of CD47 leads to phagocytosis of aged or damaged cells. Taking advantage of this anti-phagocytic signal provided by CD47, many types of tumors overexpress this protein, thereby avoiding phagocytosis by macrophages and aiding in the survival of cancer cells. The aim of this review is to describe the physiologic the pathophysiologic role of CD47; summarize the available high-quality information about this molecule as a potential biomarker and/or therapeutic target in cancer; finally, we present an in-depth analysis of the available information about CD47 in association with nonsmall cell lung cancer, EGFR mutations, and tumor microenvironment.


Subject(s)
Antigens, Differentiation/metabolism , Biomarkers, Tumor , CD47 Antigen/metabolism , Carcinoma, Non-Small-Cell Lung/metabolism , Lung Neoplasms/metabolism , Receptors, Immunologic/metabolism , Carcinoma, Non-Small-Cell Lung/drug therapy , Carcinoma, Non-Small-Cell Lung/etiology , Carcinoma, Non-Small-Cell Lung/pathology , Disease Management , Disease Susceptibility , Humans , Lung Neoplasms/drug therapy , Lung Neoplasms/etiology , Lung Neoplasms/pathology , Molecular Targeted Therapy , Prognosis , Treatment Outcome
11.
Appl Biochem Biotechnol ; 192(4): 1255-1269, 2020 Dec.
Article in English | MEDLINE | ID: mdl-32715415

ABSTRACT

Poor solubility is the main drawback of the direct industrial exploitation of chitin, the second most abundant biopolymer after cellulose. Chemical methods are conventional to solubilize chitin from natural sources. Enzymatic hydrolysis of soluble chitinous substrates is a promising approach to obtain value-added by-products, such as N-acetylglucosamine units or low molecular weight chito-oligomers. Protein display on the bacterial membrane remains attractive to produce active enzymes anchored to a biological surface. The Lpp-OmpA system, a gene fusion of the Lpp signal sequence with the OmpA transmembrane region, represents the traditional system for targeting enzymes to the E. coli surface. EhCHT1, the amoebic chitinase, exhibits an efficient endochitinolytic activity and significant biochemical features, such as stability over a wide range of pH values. Using an extended Lpp-OmpA system as a protein carrier, we engineered E. coli to express the catalytic domain of EhCHT1 on the surface and assess the endochitinase activity as a trait. Engineered bacteria showed a consistent hydrolytic rate over a typical substrate, suggesting that the displayed enzyme has operational stability. This study supports the potential of biomembrane-associated biocatalysts as a reliable technology for the hydrolysis of soluble chitinous substrates.


Subject(s)
Amoeba/enzymology , Catalytic Domain , Chitinases/genetics , Chitinases/metabolism , Escherichia coli/genetics , Genetic Engineering , Chitin/metabolism , Chitinases/chemistry , Gene Expression , Hydrogen-Ion Concentration , Hydrolysis , Solubility
12.
J Crit Care ; 58: 41-47, 2020 08.
Article in English | MEDLINE | ID: mdl-32335494

ABSTRACT

PURPOSE: Our main objective was to use the Maximum Acute Gastrointestinal Injury Score (AGImax) to evaluate the prognostic capability of gastrointestinal dysfunction (GID), on hospital mortality in patients on mechanical ventilation (MV) requiring vasopressors. A secondary goal was to analyze the relationship between AGImax and vasopressor dosage with increasing caloric intake. MATERIALS AND METHODS: Prospective multicenter cohort study in ten ICUs across Argentina. Consecutive adult patients on MV, requiring vasopressors and receiving enteral nutrition (EN) were included. AGImax was identified (I-IV) using a modified AGI score. Comparisons of clinical and outcome variables were performed in 3 predetermined EN-groups: <10 kcal/kg/d, ≥10 to <20 kcal/kg/d, or ≥ 20 kcal/kg/d. RESULTS: A total of 494 patients met all inclusion criteria. Forty-four percent of patients had severe AGImax and 17% received <10 kcal/kg/day, indicating more severity and higher mortality. Notable independent predictors of mortality were AGImax, vasopressors, and caloric intake. PN was the only factor which had an inverse relationship to mortality. CONCLUSIONS: In this population, patients with AGImax III-IV were significantly associated with lower caloric intake and greater hospital mortality, highlighting the importance of AGI as a prognostic tool. As PN was linked with lower mortality, it could be an option to explore in further studies.


Subject(s)
Energy Intake , Gastrointestinal Tract/injuries , Injury Severity Score , Shock/therapy , Vasopressins/therapeutic use , Adult , Argentina , Cohort Studies , Female , Humans , Middle Aged , Predictive Value of Tests , Prognosis , Prospective Studies , Respiration, Artificial , Shock/mortality , Vasopressins/administration & dosage
13.
Cir Cir ; 88(2): 154-162, 2020.
Article in English | MEDLINE | ID: mdl-32116314

ABSTRACT

OBJECTIVE: Propose a system of multivariate multiple regression equations in order to establish a mathematical association that allows estimating the current units needed during the adjustment phase with respect to age and time that were used the implants. METHOD: Descriptive cross-sectional study. A total of 41 pediatric patients with a unilateral cochlear implant participated. Three groups were formed and multivariable multiple regression equations were constructed. RESULTS: For Group 1, in electrode Groups 3 and 4, there is a lower standard deviation and a similar index of asymmetry of the current units; in Group 2, the groups of electrodes with similar index of asymmetry were 2 and 4, while group of electrodes 3 presented average of 21.54 and dispersion smaller (16.25); in Group 3, groups of electrodes 3 and 4 presented similar standard deviation and average and smaller standard deviation. With respect to the standard estimation error, the lowest variability of current units was obtained in Group 2 for electrode Group 3. CONCLUSION: The proposed equations could be used in the clinical area by knowing the units current needed with respect to age and time of use the implant.


OBJETIVO: Proponer un sistema de ecuaciones de regresión múltiple multivariable para establecer una asociación matemática que permita estimar las unidades de corriente necesarias durante la fase de ajuste con respecto a la edad y el tiempo de uso del implante coclear. MÉTODO: Estudio transversal descriptivo. Participaron 41 pacientes pediátricos con implante coclear unilateral. Se conformaron tres grupos y se construyeron ecuaciones de regresión múltiple multivariable. RESULTADOS: Para el grupo 1 se observa en los grupos de electrodos 3 y 4 menor desviación estándar y similar índice de asimetría de las unidades de corriente; en el grupo 2, los grupos de electrodos con similar índice de asimetría fueron el 2 y el 4, y el grupo de electrodos 3 presentó un promedio de 21.54 y una dispersión más pequeña (16,25); en el grupo 3, los grupos de electrodos 3 y 4 presentaron similar desviación estándar y promedio y desviación estándar más pequeños. Con respecto al error estándar de estimación, se obtuvo una menor variabilidad de unidades de corriente en el grupo 2 para el grupo de electrodos 3. CONCLUSIÓN: Las ecuaciones propuestas son de utilidad clínica al conocer las unidades de corriente necesarias considerando la edad y el tiempo de uso del implante coclear.


Subject(s)
Cochlear Implants/statistics & numerical data , Age Factors , Child , Child, Preschool , Cross-Sectional Studies , Female , Humans , Male , Mathematical Concepts , Regression Analysis , Time Factors
14.
Cir Cir ; 87(6): 640-644, 2019.
Article in English | MEDLINE | ID: mdl-31631183

ABSTRACT

OBJECTIVE: To compare the amplitude of potentials by acoustic stimulation at 500 Hz versus 1000 Hz in healthy subjects. METHODS: 25 subjects; potentials were performed with acoustic stimuli burst-type at 500 and 1000 Hz with a stimulation rate of 5.1 at 100 dB in both ears. Descriptive statistics tests were performed, confidence intervals were calculated for the mean with 95% reliability, standard error graphs and t-test for related samples. RESULTS: The values obtained in amplitude when performing an acoustic stimulus at 1000 Hz show a faster response compared to that obtained in the frequency of 500 Hz. The t-test showed a significant difference in the amplitude in the 1000 Hz frequency between ears with a significance value of p < 0.025. CONCLUSIONS: It is strengthened the hypothesis that in the amplitude of potentials by aerial acoustic stimulation in the frequency of 1000 Hz a greater amplitude is generated in relation to the one generated in the frequency of 500 Hz.


OBJETIVO: Comparar la amplitud de los potenciales miogénicos vestibulooculares por estimulación acústica a 500 y 1000 Hz en sujetos sanos. MÉTODO: Se estudiaron 25 sujetos y se realizaron potenciales con estímulos acústicos tipo burst a 500 y 1000 Hz con una tasa de estimulación de 5.1 a 100 dB en ambos oídos. Se realizaron pruebas de estadística descriptiva y se calcularon los intervalos de confianza para la media con un 95% de confiabilidad, las gráficas de error estándar y la prueba t para muestras relacionadas. RESULTADOS: Los valores obtenidos en amplitud al realizar estímulo acústico a 1000 Hz muestran una respuesta más rápida en comparación con la obtenida en la frecuencia de 500 Hz. La prueba t mostró una diferencia significativa en la amplitud en la frecuencia 1000 Hz entre oídos, con un valor de significancia p < 0.025. CONCLUSIONES: Se fortalece la hipótesis de que en los potenciales por estimulación acústica aérea en la frecuencia de 1000 Hz se genera una mayor amplitud en relación con la generada en la frecuencia de 500 Hz.


Subject(s)
Acoustic Stimulation/methods , Vestibular Evoked Myogenic Potentials/physiology , Adult , Cross-Sectional Studies , Female , Humans , Male , Middle Aged
15.
Medicina (B Aires) ; 78(3): 163-170, 2018.
Article in Spanish | MEDLINE | ID: mdl-29940542

ABSTRACT

Congestion in heart failure patients with reduced ejection fraction (HFrEF) is relevant and closely linked to the clinical course. Bedside blood pressure measurement during the Valsalva maneuver (Val) added to clinical examination may improve the assessment of congestion when compared to NT-proBNP levels and left atrial pressure (LAP) estimation by Doppler echocardiography, as surrogate markers of congestion in HFrEF. A clinical examination, LAP and blood tests were performed in 69 HFrEF ambulatory patients with left ventricular ejection fraction ≤ 40% and sinus rhythm. Framingham Heart Failure Score (HFS) was used to evaluate clinical congestion; Val was classified as normal or abnormal, NT-proBNP was classified as low (< 1000 pg/ml) or high (≥ 1000 pg/ml) and the ratio between Doppler early mitral inflow and tissue diastolic velocity was used to estimate LAP and was classified as low (E/e'< 15) or high (E/e' ≥ 15). A total of 69 patients with HFrEF were included; 27 had a HFS ≥ 2 and 13 of them had high NT-proBNP. HFS ≥ 2 had a 62% sensitivity, 70% specificity and a positive likelihood ratio of 2.08 (p=0.01) to detect congestion. When Val was added to clinical examination, the presence of a HFS ≥ 2 and abnormal Val showed a 100% sensitivity, 64% specificity and a positive likelihood ratio of 2.8 (p = 0.0004). Compared with LAP, the presence of HFS = 2 and abnormal Val had 86% sensitivity, 54% specificity and a positive likelihood ratio of 1.86 (p = 0.03). In conclusion, an integrated clinical examination with the addition Valsalva maneuver may improve the assessment of congestion in patients with HFrEF.


Subject(s)
Biomarkers/analysis , Heart Failure/diagnosis , Natriuretic Peptide, Brain/analysis , Peptide Fragments/analysis , Valsalva Maneuver , Echocardiography, Doppler , Female , Humans , Male , Middle Aged , Prospective Studies , ROC Curve , Sensitivity and Specificity , Severity of Illness Index
16.
Medicina (B.Aires) ; Medicina (B.Aires);78(3): 163-170, jun. 2018. graf, tab
Article in Spanish | LILACS | ID: biblio-954972

ABSTRACT

La evaluación de la congestión en pacientes con insuficiencia cardíaca y fracción de eyección reducida (ICFEr) resulta relevante y estrechamente vinculada al curso clínico. El agregado del comportamiento de la presión arterial durante la maniobra de Valsalva en la cabecera del paciente (VAL) podría mejorar la evaluación clínica de congestión cuando la comparamos con los niveles de NT-proBNP y la estimación de la presión media en la aurícula izquierda por Doppler cardíaco, como subrogantes de congestión. Se realizó un examen clínico con el VAL, un examen de laboratorio y un Doppler cardíaco en 69 pacientes ambulatorios con insuficiencia cardíaca y fracción de eyección ≤ 40% en ritmo sinusal. El score de Framingham ≥ 2 (SFr ≥ 2) se empleó para evaluar congestión clínica. VAL fue clasificado como normal o anormal, el NT-proBNP como bajo (< 1000 pg/ml) o alto (≥ 1000 pg/ml) y la relación entre la velocidad del llenado ventricular rápido y la velocidad del Doppler tisular (E/e') como baja < 15 o alta ≥ 15. Se halló que 13/27 pacientes con SFr ≥ 2 tenían NT-proBNP alto (sensibilidad 62%, especificidad 70% y razón de verosimilitud positiva [LR+] de 2.08, p = 0.01). El agregado del VAL al SFr ≥ 2 mejoró la exactitud diagnóstica (sensibilidad 100%, especificidad 64% y LR+ 2.8 p = 0.0004). Comparado con la E/e', SFr ≥ 2 con VAL anormal mostró sensibilidad 86%, especificidad 56% y LR + 1.86 (p = 0.03). En conclusión, el agregado del comportamiento de la presión durante la maniobra de Valsalva podría mejorar la evaluación clínica de la congestión en la insuficiencia cardíaca.


Congestion in heart failure patients with reduced ejection fraction (HFrEF) is relevant and closely linked to the clinical course. Bedside blood pressure measurement during the Valsalva maneuver (Val) added to clinical examination may improve the assessment of congestion when compared to NT-proBNP levels and left atrial pressure (LAP) estimation by Doppler echocardiography, as surrogate markers of congestion in HFrEF. A clinical examination, LAP and blood tests were performed in 69 HFrEF ambulatory patients with left ventricular ejection fraction ≤ 40% and sinus rhythm. Framingham Heart Failure Score (HFS) was used to evaluate clinical congestion; Val was classified as normal or abnormal, NT-proBNP was classified as low (< 1000 pg/ml) or high (≥ 1000 pg/ml) and the ratio between Doppler early mitral inflow and tissue diastolic velocity was used to estimate LAP and was classified as low (E/e'< 15) or high (E/e' ≥ 15). A total of 69 patients with HFrEF were included; 27 had a HFS ≥ 2 and 13 of them had high NT-proBNP. HFS ≥ 2 had a 62% sensitivity, 70% specificity and a positive likelihood ratio of 2.08 (p=0.01) to detect congestion. When Val was added to clinical examination, the presence of a HFS ≥ 2 and abnormal Val showed a 100% sensitivity, 64% specificity and a positive likelihood ratio of 2.8 (p = 0.0004). Compared with LAP, the presence of HFS ≥ 2 and abnormal Val had 86% sensitivity, 54% specificity and a positive likelihood ratio of 1.86 (p = 0.03). In conclusion, an integrated clinical examination with the addition Valsalva maneuver may improve the assessment of congestion in patients with HFrEF.


Subject(s)
Humans , Male , Female , Middle Aged , Peptide Fragments/analysis , Biomarkers/analysis , Valsalva Maneuver , Natriuretic Peptide, Brain/analysis , Heart Failure/diagnosis , Severity of Illness Index , Echocardiography, Doppler , Prospective Studies , ROC Curve , Sensitivity and Specificity
17.
J Crit Care ; 30(5): 1049-54, 2015 Oct.
Article in English | MEDLINE | ID: mdl-26105747

ABSTRACT

PURPOSE: Our goal was to describe the evolution of selected physical and psychologic symptoms and identify the determinants of health-related quality of life (HRQOL) after intensive care unit (ICU) discharge. METHODS: The study is a prospective cohort of consecutive adult patients admitted to a mixed ICU in a university-affiliated hospital, mechanically ventilated for more than 48 hours. During ICU stay, epidemiological data and events probably associated to worsening outcomes were recorded. After discharge, patients were interviewed at 1, 3, 6, and 12 months. Health-related quality of life was assessed with EuroQoL Questionnaire-5 Dimensions, which includes the EQ-index and EQ-Visual Analogue Scale. RESULTS: One hundred twelve patients were followed up, aged 33 [24-49] years, 68% male, 76% previously healthy, and cranial trauma was the main diagnosis. Physical and psychologic symptoms and moderate/severe problems according to the EQ index progressively decreased after discharge, yet were still highly prevalent after 1 year. EQ index improved from 0.22 [0.01-0.69] to 0.52 [0.08-0.81], 0.66 [0.17-0.79], and 0.68 [0.26-0.86] (P < .001, for all vs month 1). EQ-Visual Analogue Scale remained stable, within acceptable values. Independent determinants of EQ-index were time, duration of mechanical ventilation, shock, weakness, and return to study/work. CONCLUSIONS: Determinants of HRQOL after ICU discharge were both related to late sequelae of critical illness and to some events occurring in the ICU. Notwithstanding the high symptom burden, patients still perceived their HRQOL as good.


Subject(s)
Critical Illness/therapy , Quality of Life , Adult , Argentina , Brain Injuries/psychology , Cost of Illness , Critical Care , Female , Hospitalization , Humans , Intensive Care Units , Male , Middle Aged , Patient Discharge , Prospective Studies , Respiration, Artificial , Surveys and Questionnaires , Survivors , Young Adult
18.
Oxid Med Cell Longev ; 2012: 907162, 2012.
Article in English | MEDLINE | ID: mdl-22685624

ABSTRACT

Aged garlic extract (AGE) is an odorless garlic preparation containing S-allylcysteine (SAC) as its most abundant compound. A large number of studies have demonstrated the antioxidant activity of AGE and SAC in both in vivo--in diverse experimental animal models associated to oxidative stress--and in vitro conditions--using several methods to scavenge reactive oxygen species or to induce oxidative damage. Derived from these experiments, the protective effects of AGE and SAC have been associated with the prevention or amelioration of oxidative stress. In this work, we reviewed different antioxidant mechanisms (scavenging of free radicals and prooxidant species, induction of antioxidant enzymes, activation of Nrf2 factor, inhibition of prooxidant enzymes, and chelating effects) involved in the protective actions of AGE and SAC, thereby emphasizing their potential use as therapeutic agents. In addition, we highlight the ability of SAC to activate Nrf2 factor--a master regulator of the cellular redox state. Here, we include original data showing the ability of SAC to activate Nrf2 factor in cerebral cortex. Therefore, we conclude that the therapeutic properties of these molecules comprise cellular and molecular mechanisms at different levels.


Subject(s)
Antioxidants/pharmacology , Cysteine/analogs & derivatives , Garlic/chemistry , Plant Extracts/pharmacology , Animals , Cysteine/chemistry , Cysteine/pharmacokinetics , Humans , NF-E2-Related Factor 2/metabolism , Neuroprotective Agents/pharmacology , Oxidative Stress/drug effects , Oxidoreductases/metabolism , Plant Extracts/chemistry , Reactive Oxygen Species/metabolism , Time Factors
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