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1.
Community Dent Health ; 40(3): 146-153, 2023 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-37067350

RESUMO

OBJECTIVE: We assessed the prevalence of moderate and severe periodontitis and its association with social determinants of health in rural and urban population from the State of Chiapas, in Southern Mexico. MATERIAL AND METHODS: A cross-sectional population-based study was conducted in 2013 comprising people 20 years and older. The determinants were categorized as proximal (age, sex, indigenous origin, diabetes, smoking, diet), intermediate (level of schooling, occupation, medical and dental care), and structural (type of institution of health care provision, residence area). Periodontal status was assessed using the Periodontal Screening and Recording (PSR) Index. RESULTS: In total, 467 persons (72.4% women; mean age 43.0 years [s.d 14.7]) participated. Of them, 76.5% lived in rural areas and 56.7% were of indigenous origin. Participants with moderate and severe periodontitis had a significantly lower toothbrushing frequency (44.1% and 44.8%, respectively), and poorer oral hygiene (90% and 90.3%, respectively) compared with people without periodontitis (29.4% for toothbrushing frequency and 74.5% for oral hygiene). Moderate periodontitis was associated with poor oral hygiene (OR=2.63) and no schooling (OR=1.86). Severe periodontitis was associated with age (OR=1.05), poor oral hygiene (OR=3.99), no schooling (OR=2.08), and the interaction term of rural area and indigenous origin (RM=5.23). CONCLUSIONS: Social determinants of health play an important role in the development of periodontitis. Preventive oral health programs should thus focus on the specific social, economic, and geographical context of the population.


Assuntos
Periodontite , Determinantes Sociais da Saúde , Humanos , Feminino , Adulto , Masculino , População Urbana , Estudos Transversais , Periodontite/epidemiologia , Higiene Bucal
2.
Eur J Pediatr ; 182(2): 957-964, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36459226

RESUMO

During the COVID-19 pandemic, children and adolescents with psychiatric disorders experienced an exacerbation of their symptoms with more access to the emergency department (ED). However, little is known about the experience of somatic symptom disorders (SSDs) during the COVID-19 pandemic in children. Therefore, we aimed to compare the rates of pediatric ED admissions for SSDs before and during the COVID-19 pandemic and to understand whether the relative risk of ED admissions for SSDs changed between the two periods. We retrospectively enrolled all children between 4 and 14 years admitted for SSDs in the pediatric ED of Santobono-Pausilipon Hospital, Naples, Italy, from March 11th, 2020, to March 11th, 2021 (pandemic period), and in the same time period of the previous year (pre-pandemic period). We identified 205/95,743 (0,21%) children with SSDs presenting in ED in the pre-pandemic year and 160/40,165 (0,39%) in the pandemic year (p < 0.05). Considering the accesses for age, we observed a relative decrease of the accesses for SSDs over 12 years old (IRR 0,59; CI 0,39-0,88), while we found no differences under 12 years old (IRR 0,87; CI 0,68-1,10).   Conclusion: In this study, we found that despite the massive decrease in pediatric admissions due to the COVID-19 pandemic, somatic symptom disorders' admissions to the pediatric ED increased, suggesting an impact of the pandemic also on pediatric psychiatric disorders. What is Known: • During the COVID -19 pandemic, children and adolescents with a psychiatric disorder experienced exacerbation of their symptoms with more accesses in Emergency Department. What is New: • We found that despite the massive decrease of the pediatric admissions due to the COVID-19 pandemic, somatic symptom disorders admissions in healthy children to the pediatric Emergency Department increased ,suggesting an impact of the pandemic also on the pediatric psychiatric disorders.


Assuntos
COVID-19 , Serviços Médicos de Emergência , Sintomas Inexplicáveis , Transtornos Mentais , Adolescente , Criança , Humanos , Pandemias , Estudos Retrospectivos , COVID-19/epidemiologia , Serviço Hospitalar de Emergência , Transtornos Mentais/epidemiologia
3.
Nanotechnology ; 33(5)2021 Nov 12.
Artigo em Inglês | MEDLINE | ID: mdl-34678792

RESUMO

Nitrogen-doping of cadmium sulfide nanostructured compounds was carried out under a nitrogen plasma source to produce CdS-N compounds. Once prepared, it was supported on graphene oxide sheets for producing CdS-N/GO photocatalysts, which were tested in the degradation of lignin and methylene blue (MB) molecules. Photocatalytic reactions were carried out under UV and visible (vis) energy irradiation. To provide insight on the catalytic behavior the CdS, CdS-N, GO, and CdS-N/GO compounds were characterized using different techniques including x-ray diffraction, scanning electron microscopy, Raman, and UV-vis diffuse reflectance spectroscopy. X-ray photoelectron spectroscopy allowed determining the chemical composition in samples. It was observed an outstanding performance in photocatalytic activity tests, attributed to the extended response towards the visible light regime, and the synergistic effect between CdS-N and GO particles. The catalytic activity tests, reveal that the CdS-N/GO compound achieved over 90% lignin degradation and 100% of MB degradation. In addition, a remarkable performance is observed in the CdS-N/GO compound which exhibited stability after performing several reaction cycles.

4.
Acta Ortop Mex ; 35(1): 61-68, 2021.
Artigo em Espanhol | MEDLINE | ID: mdl-34480442

RESUMO

INTRODUCTION: At the national and international levels, there are few studies on early knee tumor periprosthetic infection. We present a review of patients operated by knee tumor arthroplasty, obtaining information on the clinical and bacteriological profile of early tumor periprosthetic infections. MATERIAL AND METHODS: Observational, retrospective and descriptive study, review of patient records with knee tumor replacement, from 1 January 2013, to 31 December 2017 and minimum follow-up of 2 years. RESULTS: 35 patients with average age 32. Left knee 71.4%, 77.1% distal femur, 54.2% was osteosarcoma. Complications in 82.8% of patients, prosthetic retention 62.8%; periprosthetic infection accounts for 34.2% of early complications in 90% of cases. Osteosarcomas and GCT had early infection in equal proportion (44%). The most common comorbidity was overweight/obesity at 66%, smoking by 55%. 55% of infected patients received chemotherapy. 58% of the isolated bacteria were Staphylococcus sp. 83.3% of bacteria showed antibiotic resistance. 66% of infected patients required radical management. CONCLUSIONS: Early periprosthetic infection represents a devastating pathology in our institution. Prosthetic retention is achieved at 66%. In our unit the bacteriological profile is resistant.


INTRODUCCIÓN: A nivel nacional e internacional son pocos los estudios sobre infección periprotésica tumoral temprana en rodilla. Presentamos una revisión de pacientes operados por artroplastía tumoral de rodilla, obteniendo información sobre el perfil clínico y bacteriológico de las infecciones periprotésicas tumorales tempranas. MATERIAL Y MÉTODOS: Estudio observacional, retrospectivo y descriptivo. Revisión de expedientes de pacientes operados con artroplastía tumoral de rodilla del 01 de Enero de 2013 al 31 de Diciembre de 2017 y seguimiento mínimo de dos años. RESULTADOS: 35 pacientes con edad promedio de 32 años, rodilla izquierda 71.4%, 77.1% afección en fémur distal, 54.2% reportado osteosarcoma. Complicaciones en 82.8% de pacientes, retención protésica 62.8%; la infección periprotésica representa 34.2% de las complicaciones de forma temprana en 90% de casos. Osteosarcomas y TCG presentaron infección temprana en igual proporción (44%). La comorbilidad más común fue sobrepeso/obesidad en 66%, tabaquismo en 55%; 55% de pacientes infectados recibió quimioterapia (neoadyuvante o adyuvante), 58% de las bacterias aisladas fueron Staphylococcus sp. 83.3% de bacterias mostraba resistencia, 66% de pacientes infectados requirió manejo radical. CONCLUSIONES: La infección periprotésica temprana representa una patología devastadora en nuestra institución. Se logra retención protésica en 66%. En nuestra unidad el perfil bacteriológico es resistente.


Assuntos
Artroplastia do Joelho , Osteossarcoma , Infecções Relacionadas à Prótese , Adulto , Artroplastia do Joelho/efeitos adversos , Fêmur/cirurgia , Humanos , Articulação do Joelho/cirurgia , Infecções Relacionadas à Prótese/epidemiologia , Reoperação , Estudos Retrospectivos
5.
Ann Coloproctol ; 37(Suppl 1): S58-S62, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34107598

RESUMO

A leiomyoma is a benign mesenchymal neoplasm that usually develops where smooth muscle is present. In this report, we present the case of a 75-year-old woman who sought medical attention due to pelvic organ prolapse and urinary incontinence, and without defecatory symptoms. Both pelvic floor ultrasound and magnetic resonance imaging (MRI) examination showed a well-defined mass in the ischioanal fossa, eventually diagnosed as a perianal leiomyoma. It is considered a rare entity because of its location involving the anal sphincter and clinical features. We describe the ultrasonographic and MRI findings of this perianal leiomyoma, together with differential diagnoses and immunohistochemical characterization.

6.
Ultrasound Obstet Gynecol ; 55(2): 257-263, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31332857

RESUMO

OBJECTIVE: To determine whether differences exist in the rate of levator ani muscle (LAM) avulsion between women who had undergone either Malmström vacuum delivery (MVD) or Kielland forceps delivery (KFD), allowing for potential confounding factors. METHODS: This was a prospective observational study of nulliparous women undergoing instrumental delivery using Malmström vacuum extractor or Kielland forceps, at two hospital centers in Spain. Fetal head position (anterior, posterior or transverse) and fetal head station (low or mid) were assessed by ultrasound and digital examination, respectively. Avulsion was defined on tomographic ultrasound imaging as an abnormal insertion of the LAM in the three central slices from the plane of minimal hiatal dimensions. RESULTS: In total, 414 patients were included in the study (212 MVD and 202 KFD). We observed a higher rate of LAM avulsion in the KFD group (KFD 49.5% vs MVD 32.5%; P = 0.001). When the results were evaluated according to fetal head position and station, we observed no differences in LAM avulsion. The crude odds ratio (OR) for the difference in avulsion between women in the KFD and MVD groups was 2.03 (95% CI, 1.36-3.03). However, when adjusted for duration of second stage of labor, fetal head circumference and fetal head station, the OR was no longer statistically significant (OR, 2.14 (95% CI, 0.95-4.85); P = 0.068). CONCLUSION: When potential confounding factors are taken into account, the rate of LAM avulsion does not differ between women according to whether they have undergone KFD or MVD. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.


Assuntos
Complicações do Trabalho de Parto/terapia , Forceps Obstétrico/efeitos adversos , Diafragma da Pelve/lesões , Vácuo-Extração/efeitos adversos , Adulto , Feminino , Feto/diagnóstico por imagem , Humanos , Apresentação no Trabalho de Parto , Complicações do Trabalho de Parto/diagnóstico por imagem , Razão de Chances , Gravidez , Estudos Prospectivos , Espanha , Ultrassonografia Pré-Natal
7.
Chemosphere ; 236: 124368, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31323553

RESUMO

In the present work, the photocatalytic efficiency of a novel system based on ZnO doped with nitrogen (ZT) and supported on graphene oxide (GO) is investigated. ZnO synthesis and their N doping were carried out in a microwave reactor using thiourea as nitrogen source, while the GO was prepared through a variation of the Hummers' method. Structural, morphological and photochemical characterization of the developed material was performed by X-ray diffraction (XRD), UV-Vis spectroscopy, energy dispersive spectroscopy (EDS), scanning electron microscopy (SEM), analysis by X-ray photoelectron spectroscopy (XPS) and Raman spectroscopy. The compounds were used to photodegrade the methylene blue molecule, which confirms the efficiency of nitrogen doped supported system compared to pristine ZnO. The degradation percentage of MB under UV energy using nitrogen-doped ZnO/GO, in a time of 35 min, reached 98% degradation; while using visible light 93% of degradation was reached.


Assuntos
Grafite/química , Nitrogênio/química , Óxido de Zinco/química , Catálise , Fotólise
9.
Eye (Lond) ; 32(1): 120-127, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-28799562

RESUMO

PurposeTo analyze the relation between ophthalmologic and motor changes in spinocerebellar ataxia type 7 (SCA7).Patients and methodsThis was a case series study. Sixteen SCA7 patients underwent a comprehensive ophthalmic examination, including ocular extrinsic motility testing, color vision test, and optical coherence tomography of the optic nerve and macula. Changes in the corneal endothelium, electroretinographic patterns, and a complete neurologic evaluation using the Scale for the Assessment and Rating of Ataxia (SARA) were evaluated. Correlations of endothelial cell density (ECD) with number of CAG repetitions and the SARA scores were estimated.ResultsAll patients showed various degrees of visual impairment mainly due to macular deterioration. Notably, they also presented decreased ECD. Pairwise correlations of ECD with number of CAG repeats and severity of motor symptoms quantified with the SARA scores were inverse (r=-0.46, P=0.083 and r=-0.64, P=0.009, respectively). Further analyses indicated an average ECD decrease of 48 cells/mm2 (P=0.006) per unit of change on the number of CAG repeats, and of 75 cells/mm2 (P=0.001) per unit of change on the SARA scores.ConclusionsThe results agree with previous ophthalmological findings regarding the widespread effect of SCA7 mutation on the patient's visual system. However, the results also show a significant negative correlation of decreased ECD with both CAG repetitions and SARA scores. This suggests that motor systems could degenerate in parallel with visual systems, although more research is needed to determine whether the degeneration is caused by the same mechanisms.


Assuntos
Segmento Anterior do Olho/diagnóstico por imagem , Visão de Cores , Oftalmopatias/diagnóstico , Ataxias Espinocerebelares/complicações , Acuidade Visual , Adulto , Idoso , Topografia da Córnea , Eletrorretinografia , Oftalmopatias/etiologia , Oftalmopatias/genética , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Ataxias Espinocerebelares/diagnóstico , Ataxias Espinocerebelares/genética , Tomografia de Coerência Óptica , Adulto Jovem
10.
Zootaxa ; 4178(1): 145-150, 2016 Oct 20.
Artigo em Inglês | MEDLINE | ID: mdl-27811734

RESUMO

Specimens of a deep-sea anemone were observed in photographs and video footage taken with the Remotely Operated Vehicle JASON (WHOI Deep Submergence Laboratory) in the Gulf of California, Mexico, in May 2008. Comparison of our material with photographs and description of this species available in literature indicate that the sea anemones filmed during the JASON survey are most likely to represent Phelliactis callicyclus Riemann-Zurneck, 1973. This species has previously been reported from a locality in the Gulf of California near the present record. During the JASON survey, 28 specimens of P. callicyclus were spotted in 27 locations during six dives. The specimens occurred on angular rock outcrops along the escarpments of the transform faults of the Gulf of California, between depths of 993-2543 m and at temperatures ranging from 2.3 to 4.5°C. Based on these new records, Phelliactis callicyclus appears to be widely spread in the Gulf of California.


Assuntos
Anêmonas-do-Mar/classificação , Distribuição Animal , Animais , México , Oceano Pacífico , Anêmonas-do-Mar/anatomia & histologia
11.
Bioprocess Biosyst Eng ; 39(7): 1151-61, 2016 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-27021346

RESUMO

Carbon-to-nitrogen ratio (CNR) has shown to be a relevant factor in microorganisms growth and metabolites production. It is usual that this factor compromises the productivity yield of different microorganisms. However, CNR has been rarely modeled and therefore the nature of its specific influence on metabolites production has not been understood clearly. This paper describes a parametric characterization of the CNR effect on the Escherichia coli metabolism. A set of parameters was proposed to introduce a mathematical model that considers the biomass, substrate and several byproducts dynamical behavior under batch regimen and CNR influence. Identification algorithm used to calculate the parameters considers a novel least mean square strategy that formalizes the CNR influence in E. coli metabolism. This scheme produced a step-by-step method that was suitable for obtaining the set of parameters that describes the model. This method was evaluated under two scenarios: (a) using the data from a set of numerical simulations where the model was tested under the presence of artificial noises and (b) the information obtained from a set of experiments under different CNR. In both cases, a leave-one-experiment-out cross-validation study was considered to evaluate the model prediction capabilities. Feasibility of the parametric identification method was proven in both considered scenarios.


Assuntos
Escherichia coli/crescimento & desenvolvimento , Nitrogênio/metabolismo , Escherichia coli/metabolismo , Modelos Teóricos
12.
Org Biomol Chem ; 14(6): 2015-24, 2016 Feb 14.
Artigo em Inglês | MEDLINE | ID: mdl-26754878

RESUMO

Herein, we disclose a general and flexible access to spirocyclopropyl oxindoles by a domino Michael/intramolecular nucleophilic substitution pathway with variously substituted vinyl selenones and enolizable oxindoles in aqueous sodium hydroxide solution. The spirocyclopropyl oxindole being a privileged scaffold, some of the synthesized compounds were selected for biological evaluation. Compound showed selective anti-HIV-1 activity thanks to its ability to inhibit the reverse transcriptase.


Assuntos
Fármacos Anti-HIV/farmacologia , Transcriptase Reversa do HIV/antagonistas & inibidores , HIV/efeitos dos fármacos , HIV/enzimologia , Inibidores da Transcriptase Reversa/farmacologia , Fármacos Anti-HIV/síntese química , Fármacos Anti-HIV/química , Linhagem Celular Tumoral , Sobrevivência Celular/efeitos dos fármacos , Ciclopropanos/síntese química , Ciclopropanos/química , Ciclopropanos/farmacologia , Transcriptase Reversa do HIV/metabolismo , Humanos , Indóis/síntese química , Indóis/química , Indóis/farmacologia , Testes de Sensibilidade Microbiana , Conformação Molecular , Compostos Organosselênicos/química , Compostos Organosselênicos/farmacologia , Inibidores da Transcriptase Reversa/síntese química , Inibidores da Transcriptase Reversa/química , Compostos de Espiro/síntese química , Compostos de Espiro/química , Compostos de Espiro/farmacologia , Compostos de Vinila/química , Compostos de Vinila/farmacologia , Replicação Viral/efeitos dos fármacos
13.
J Matern Fetal Neonatal Med ; 29(14): 2368-72, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26381595

RESUMO

OBJECTIVES: The objective of our study was to compare the theoretical concept of the accoucheur in our institution with regard to the characteristics of the mediolateral episiotomy (MLE), with a crowning head and after a delivery. METHODS: We devised two simple pictorial questionnaires (one with a crowning head and the other in rest after a delivery) in order to explore possible differences in clinical practice between the accoucheurs of our institution with respect to the MLE characteristics. RESULTS: With a crowning head, we found more acute angles when the age of accoucheurs was greater than 35 years old and more than 15 years of experience, but no with the perineum at rest. No difference was found between doctors and midwives, nor between males and females. 28.1% of accoucheurs indicated an acuter episiotomy angle with a crowning head. CONCLUSION: This study confirmed that the individual interpretation of MLE differed widely among professionals at the same hospital. These differences which have been shown could predispose women to a greater risk of anal sphincter injuries. For this reason, there is a need to standardize this practice, to make the technique more homogeneous, particularly in the context of future research into the risks and benefits of episiotomy with respect to major perineal trauma.


Assuntos
Episiotomia/métodos , Padrões de Prática em Enfermagem/estatística & dados numéricos , Padrões de Prática Médica/estatística & dados numéricos , Adulto , Feminino , Humanos , Apresentação no Trabalho de Parto , Masculino , Enfermeiros Obstétricos , Gravidez , Espanha , Inquéritos e Questionários
14.
Odontol. pediatr. (Lima) ; 14(2): 150-157, jul.-dic.2015. ilus
Artigo em Espanhol | LILACS, LIPECS | ID: lil-790539

RESUMO

Cuando una necrosis pulpar se instala en dientes jóvenes que aún no han completado el cierre apical o no han terminado el desarrollo radicular, la apexificacion es el tratamiento indicado, el cual induce la formación de una barrera calcificada que oblitere el orificio apical 0 que permita el desarrollo radicular completo. La mezcla del hidróxido de calcio Ca(OH)2 con suero fisiológico es la forma más deseable y sencilla de inducir la apexificacion con pronóstico exitoso. El caso clínico que se presenta es un paciente masculino de 10 años de edad, al cual se diagnostica necrosis pulpar en O.D.36, radiográficamente con zona radiohicida en ápices y furca, retracción pulpar y falta de cierre apical al cual se realiza el tratamiento de apexificacion con hidroxido de calcio, mostrando en el control radiográfico disminución de la lesión en furca y ápices, lográndose el cierre apical permitiendo el tratamiento de endodoncia con gutapercha y finalmente la rehabilitación con corona de acero cromo...


When a pulp necrosis it's established in young teeth that have not developed an apical seal or the incomplete development of the root, an apexitication is the election treatment, because it inducts the formation of a calcified barrier that obliterates the apical foramen or allows the complete radicular development. The mixture of Calcium Hydroxide with physiological serum is the most simple technique of inducting apexification. The case report presents a 10 year old male, with necrotic pulp in O.D 36, in the x-ray can be observed radiolucent zone in apex and furcation, pulp retraction and lack of apical seal; in this teeth apexification was performed with calcium hydroxide, and it shows a correct evolution in decrasing of lesion in furcation and seal in apex; that permits the obturation or radicular system and finally the rehabilitation with a steel crown...


Assuntos
Humanos , Masculino , Criança , Apexificação , Hidróxido de Cálcio/uso terapêutico , Necrose da Polpa Dentária/terapia
15.
Acta Naturae ; 7(3): 113-5, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26483967

RESUMO

Several 5-aminouracil derivatives that have previously been shown to inhibit Mycobacterium tuberculosis growth at concentrations of 5-40 µg/mL are demonstrated to act also as noncompetitive non-nucleoside inhibitors of HIV-1 reverse transcriptase without causing toxicity in vitro (MT-4 cells) and ex vivo (human tonsillar tissue).

16.
Cell Death Differ ; 22(8): 1287-99, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-25571973

RESUMO

Vasculogenesis, the establishment of the vascular plexus and angiogenesis, branching of new vessels from the preexisting vasculature, involves coordinated endothelial differentiation, proliferation and migration. Disturbances in these coordinated processes may accompany diseases such as cancer. We hypothesized that the p53 family member p73, which regulates cell differentiation in several contexts, may be important in vascular development. We demonstrate that p73 deficiency perturbed vascular development in the mouse retina, decreasing vascular branching, density and stability. Furthermore, p73 deficiency could affect non endothelial cells (ECs) resulting in reduced in vivo proangiogenic milieu. Moreover, p73 functional inhibition, as well as p73 deficiency, hindered vessel sprouting, tubulogenesis and the assembly of vascular structures in mouse embryonic stem cell and induced pluripotent stem cell cultures. Therefore, p73 is necessary for EC biology and vasculogenesis and, in particular, that DNp73 regulates EC migration and tube formation capacity by regulation of expression of pro-angiogenic factors such as transforming growth factor-ß and vascular endothelial growth factors. DNp73 expression is upregulated in the tumor environment, resulting in enhanced angiogenic potential of B16-F10 melanoma cells. Our results demonstrate, by the first time, that differential p73-isoform regulation is necessary for physiological vasculogenesis and angiogenesis and DNp73 overexpression becomes a positive advantage for tumor progression due to its pro-angiogenic capacity.


Assuntos
Diferenciação Celular/genética , Proteínas de Ligação a DNA/metabolismo , Células Endoteliais/metabolismo , Proteínas Nucleares/metabolismo , Transdução de Sinais/genética , Fator de Crescimento Transformador beta/farmacologia , Proteínas Supressoras de Tumor/metabolismo , Fator A de Crescimento do Endotélio Vascular/farmacologia , Animais , Diferenciação Celular/efeitos dos fármacos , Proteínas de Ligação a DNA/genética , Células Endoteliais/efeitos dos fármacos , Células Endoteliais da Veia Umbilical Humana , Imuno-Histoquímica , Camundongos , Camundongos Endogâmicos C57BL , Proteínas Nucleares/genética , RNA Interferente Pequeno/genética , Reação em Cadeia da Polimerase em Tempo Real , Retina/metabolismo , Proteína Tumoral p73 , Proteínas Supressoras de Tumor/genética
17.
Int Urogynecol J ; 26(2): 235-42, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25227745

RESUMO

INTRODUCTION AND HYPOTHESIS: The objective of this study was to investigate the association between the trigonometric properties of episiotomy in operative vaginal delivery (OVD) and obstetric anal sphincter injuries (OASIS). METHODS: The study included 72 primiparous women who had an OVD and episiotomy. Cases (n = 36) had sustained OASIS at birth, while controls (n = 36) had not. The groups were matched for instrumental delivery. The episiotomy scar was identified and its trigonometric characteristics were measured at 8-12 weeks postpartum. Data were analysed using conditional logistic analysis. RESULTS: The angle of episiotomy behaves as a factor associated with anal sphincter injury, so women with a mediolateral episiotomy and an angle greater than 20° have an 87% less risk of having an OASIS (odds ratio 0.13, 95% confidence interval 0.03-0.58). The study showed that scarred episiotomies at 8-12 weeks after OVD with an angle ≤ 20°, depth and distance between the episiotomy and anus ≤ 15 mm, total upper triangle perimeter ≤ 75 mm, para-anal triangle perimeter ≤ 15 mm and areas between scar and midline ≤ 250 mm(2) were significantly associated with higher risk of OASIS. CONCLUSIONS: When a mediolateral episiotomy is performed in OVD the technique has a strong effect on the occurrence of OASIS. Additional research is needed to determine if the optimal technique for mediolateral episiotomies produces less OASIS than deferring the performance of episiotomy.


Assuntos
Canal Anal/lesões , Episiotomia/métodos , Lacerações/etiologia , Conceitos Matemáticos , Complicações do Trabalho de Parto/etiologia , Adulto , Cicatriz/etiologia , Cicatriz/patologia , Episiotomia/efeitos adversos , Feminino , Humanos , Gravidez , Fatores de Risco , Índices de Gravidade do Trauma
18.
Minerva Anestesiol ; 81(7): 713-22, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-25384690

RESUMO

BACKGROUND: Studies on pregnant women undergoing cesarean delivery or elderly men scheduled for prostate brachytherapy have demonstrated the predictive value of heart rate variability (HRV) analysis for hypotension during spinal anesthesia. We conducted a prospective observational study to investigate if preoperative HRV analysis may have a role in identifying the risk of hypotension following spinal anesthesia in otherwise healthy patients. METHODS: The study investigated 47 ASA physical status I-II patients aged between 18-50 years that underwent subarachnoid anesthesia for lower abdominal or orthopedic scheduled surgery. ECG was recorded from all subjects before the subarachnoid block. We analysed the autonomic nervous system modulation, measured by HRV analysis. The variables that were be considered were preoperative HRV total power, low frequency (LF) and high frequency (HF) heart beat oscillations and LF/HF ratio. The LF/HF ratio was dichotomized according to the median for sensitivity analysis. The lowest arterial pressure value between spinal anesthesia and the end of surgery was recorded. RESULTS: The median LF/HF before anesthesia was 2.3. We considered two groups of 23 (LF/HF<2.3, group LOW) and 24 (LF/HF>2.3, group HIGH) patients respectively. Both groups had similar baseline demographic and hemodynamic variables. A high preoperative sympathetic outflow and loss of vagal modulation, as stated by LF/HF>2.3, was correlated with a relative risk of 7.7 (95%CI 1.04 to 56.6, p=0.023) of post-spinal hypotension. CONCLUSIONS: Preoperative analysis of autonomic nervous system modulation might be useful to stratify the risk of post-spinal hypotension and it might indicate the need for careful monitoring or prophylactic fluids.


Assuntos
Raquianestesia/efeitos adversos , Sistema Nervoso Autônomo/fisiopatologia , Hipotensão/fisiopatologia , Adolescente , Adulto , Pressão Arterial , Feminino , Frequência Cardíaca , Humanos , Pessoa de Meia-Idade , Gravidez , Estudos Prospectivos , Medição de Risco , Adulto Jovem
19.
Minerva Anestesiol ; 81(8): 837-45, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-25375311

RESUMO

BACKGROUND: Surgical noxious stimuli generate a stress response with an increased sympathetic activity, potentially affecting the perioperative outcome. Surgical Pleth Index (SPI), derived from the pulse plethysmogram, has been proposed as a tool to assess nociception-antinociception balance. The relationship between SPI and autonomic nervous system (ANS) during general anesthesia is poorly understood and it is doubtful if SPI-guided analgesia may offer advantages over the standard clinical practice. The study was designed to evaluate if SPI-guided analgesia leads to a lower sympathetic modulation compared with standard clinical practice. METHODS: Electrocardiographic wave, non-invasive blood pressure and SPI were recorded in ASA I-II patients undergoing elective laparoscopic cholecystectomy, randomized to receive SPI-guided analgesia or standard analgesia. Hemodynamic parameters, SPI, mean and variance of heart rate, low (LF) and high frequency (HF) spectral components of heart rate variability were measured at four time points: (T0) baseline, (T1) after induction of general anesthesia, (T2) after pneumoperitoneum insufflation and (T3) after pneumoperitoneum withdrawal. RESULTS: SPI, hemodynamic and ANS parameters changed significantly in both groups during the study period (P<0.0001). At T2 SPI and markers of sympathetic modulation were significantly lower in SPI group (mean [SD] SPI 38.1 [15.3] vs. 48.1 [16.2] normalized units, P<0.05; LF 38 [8.6] vs. 56.2 [20.6] normalized units, P<0.01; LF/HF 1.01 [1.1] vs. 2.68 [2.07], P<0.01). There was no difference in remifentanil consumption, recovery time from anesthesia, or postoperative pain and complications. CONCLUSION: SPI-guided analgesia led to a more stable sympathetic modulation but didn't seem to offer clinically relevant advantages over the standard clinical practice for laparoscopic cholecystectomy.


Assuntos
Analgesia/métodos , Colecistectomia Laparoscópica/métodos , Pletismografia/métodos , Sistema Nervoso Simpático/efeitos dos fármacos , Adolescente , Adulto , Anestesia Geral , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Monitorização Intraoperatória , Estudos Prospectivos , Resultado do Tratamento , Adulto Jovem
20.
J Environ Radioact ; 136: 131-9, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-24953228

RESUMO

Fossil bones are often the only materials available for chronological reconstruction of important archeological sites. However, since bone is an open system for uranium, it cannot be dated directly and therefore it is necessary to develop models for the U uptake. Hence, a radial diffusion-adsorption (RDA) model is described. Unlike the classic diffusion-adsorption (D-A) model, RDA uses a cylindrical geometry to describe the U uptake in fossil bones. The model was applied across a transverse section of a tibia of an extinct megamammal Macrauchenia patachonica from the La Paz Local Fauna, Montevideo State, Uruguay. Measurements of spatial distribution of Na, K, Ca, and Mg were also performed by neutron activation analysis (NAA). Gamma-ray spectrometric U-series dating was applied to determine the age of the bone sample. From U concentration profile, it was possible to observe the occurrence of a relatively slow and continuous uranium uptake under constant conditions that had not yet reached equilibrium, since the uranium distribution is a ∪-shaped closed-system. Predictions of the RDA model were obtained for a specific geochemical scenario, indicating that the effective diffusion coefficient D/R in this fossil bone is (2.4 ± 0.6)10(-12) cm(2)s(-1). Mean values of Na, K, Ca, and Mg contents along the radial line of the fossil tibia are consistent with the expected behavior for spatial distributions of these mineral elements across a modern bone section. This result indicates that the fossil tibia may have its mineral structure preserved.


Assuntos
Arqueologia/métodos , Fósseis , Modelos Teóricos , Paleontologia/métodos , Tíbia/química , Urânio/química , Adsorção , Animais , Cálcio/química , Difusão , Mamíferos , Metais Leves/química , Análise de Ativação de Nêutrons , Espectrometria gama , Urânio/análise
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