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Background: Acinetobacter baumannii-calcoaeticus complex is the leader pathogen for the World Health Organization's list due to the escalating prevalence of multidrug-resistant strains. Insights into the molecular characterization of carbapenemase genes in A. baumannii-calcoaceticus complex infections among children are scarce. To address this gap, we conducted a systematic review to describe the molecular epidemiology of the carbapenemase genes in A. baumannii-calcoaceticus complex infections in the pediatric population. Methods: Adhering to the PRISMA 2020 guidelines for reporting systematic reviews, we conducted a review of in chore bibliographic databases published in English and Spanish, between January 2020 and December 2022. All studies conducted in patients ≤6 years with molecular characterization of carbapenemase-encoding genes in A. baumannii-calcoaceticus infections were included. Results: In total, 1129 cases were reviewed, with an overall carbapenem-resistance rate of 60.3%. A. baumannii-calcoaceticus was isolated from blood cultures in 66.6% of cases. Regionally, the Eastern Mediterranean exhibited the highest prevalence of carbapenem resistance (88.3%). Regarding the carbapenemase genes, blaKPC displayed an overall prevalence of 1.2%, while class B blaNDM had a prevalence of 10.9%. Class D blaOXA-23-like reported a prevalence of 64%, blaOXA-48 and blaOXA-40 had a prevalence of 33% and 18.1%, respectively. Notably, the Americas region showed a prevalence of blaOXA-23-like at 91.6%. Conclusion: Our work highlights the high prevalence of carbapenem-resistant A. baumannii-calcoaceticus and class D carbapenemase genes in children. Of note the distribution of different carbapenemase genes reveals considerable variations across WHO regions. To enhance epidemiological understanding, further extensive studies in children are imperative.
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Fifty years ago, researchers discovered a link between ambient temperature and the sex of turtle embryos. More recently, significant progress has been made in understanding the influence of temperature on freshwater turtles. However, our understanding of the key genetic factors in other turtle groups, such as sea turtles, remains limited. To address this gap, we conducted RNA-seq analyses on embryonic tissues from the sea olive ridley turtle during the thermosensitive period (stages 21-26) at temperatures known to produce males (26 °C) and females (33 °C). Our findings revealed that incubation temperatures primarily influence genes with broad expression across tissues due to differential cell division rates and later have an effect regulating gonad-specific transcripts. This effect is mostly related to gene activation rather than transcription repression. We performed transcriptome analyses following shifts in incubation temperatures of bi-potential gonads. This approach allowed us to identify genes that respond rapidly and may be closer to the beginning of the temperature-sensing pathway. Notably, we observed swift adaptations in the expression levels of chromatin modifiers JARID2 and KDM6B, as well as the splicing factor SRSF5, and transcription regulators THOC2, DDX3X and CBX3, but little impact in the overall gonad-specific pathways, indicating that temperature-sensing genes may change rapidly but the rewiring of the gonad's developmental fate is complex and resilient. AUTHOR SUMMARY: Sea turtles, one of the most iconic creatures of our oceans, confront a troubling reality of endangerment, a peril magnified by the looming specter of climate change. This climatic shift is gradually increasing the temperature of the nesting beaches thus causing dramatic male/female population biases. Conservation efforts will need genetic and molecular information to reverse the negative effects of climate change on the populations. In this study, we conducted the first transcriptomic analysis of embryonic tissues, including gonads, brain, liver, and mesonephros, in the olive ridley sea turtle during the critical thermosensitive period spanning stages 21-26. We examined both male-producing (26 °C) and female-producing (33 °C) temperatures and found that incubation temperatures influence temperature-sensitive genes that are either expressed globally or specifically associated with the gonads. These findings indicate that incubation temperatures predominantly sway genes with broad expression patterns due to differential cell division rates. This natural process was opted in the gonads to drive sex determination. We also identified genes that are rapidly capable of sensing temperature changes and that could play a role in the activation of the sex determination pathway. Overall, our study sheds light on the intricate interplay between temperature and gene expression during sea turtle development, revealing dynamic changes in the transcriptome and highlighting the involvement of key genetic players in sex determination.
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Regulação da Expressão Gênica no Desenvolvimento , Gônadas , Processos de Determinação Sexual , Temperatura , Tartarugas , Animais , Tartarugas/embriologia , Tartarugas/genética , Processos de Determinação Sexual/genética , Masculino , Feminino , Gônadas/metabolismo , Gônadas/embriologia , Transcriptoma/genética , Perfilação da Expressão Gênica , Embrião não Mamífero/metabolismoRESUMO
In mammals, progesterone and estrogens affect the stress response. The study aimed to compare the physiological and behavioral responses to the social isolation of ewes during the estrus or luteal phase. Estrous and diestrous ewes (n = 10 and 8 respectively) were individually isolated in a novel place for 10 min. Ewes' behavior was recorded during the test. Cortisol, blood proteins and glucose concentrations, and the skin surface temperature were determined before and after the test. Cortisol increased immediately after the test ended (P = 0.02). Serum total protein (P = 0.02), globulin (P < 0.0001), and plasma glucose (P = 0.006) concentrations were greater in estrus than in the luteal phase. The abdominal skin surface temperature was greater during estrus than during the luteal phase (P = 0.02). Ewes in estrus spent more time standing up immobile than ewes in the luteal phase (P = 0.05). In conclusion, the physiological and behavioral responses changed according to the phase of the estrous cycle. These results highlight the need for future studies focusing on how reproductive status influences the stress response to different management practices in sheep.
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Hidrocortisona , Fase Luteal , Feminino , Animais , Ovinos , Fase Luteal/fisiologia , Estro/fisiologia , Progesterona , MamíferosRESUMO
Six genome sequences for potato virus Y (PVY) recombinants are reported from two North American potato cultivars grown in China. The coding complete sequences encode a single open reading frame characteristic of potyviruses. The six sequenced PVY isolates represent three distinct recombinants of PVY, namely N-Wi, SYR-I, and SYR-II.
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Introducción: Para un buen profesional de la odontología es necesaria la ética en todas las actividades que realice. La ética establece lo que es y debe ser, buscando siempre el bien y no hacer el mal o causar daño, y el odontólogo debe tener una serie de cualidades y aptitudes con el fin de llevar a cabo todo el tratamiento que amerite el paciente de manera correcta, honesta y responsable sin escatimar esfuerzos para devolverle su salud oral. La COVID-19 es una enfermedad que se ha convertido en pandemia y está afectando al mundo de manera importante. Entre los más afectados se encuentran los profesionales de la salud que arriesgan sus vidas por sanar al enfermo. Dada la situación actual, a los odontólogos se les presenta la duda si atender a sus pacientes en este periodo cumple o no con los principios éticos de la profesión. Objetivo: El objetivo del presente artículo fue realizar una revisión sistemática de la literatura con el fin de identificar el rol bioético del odontólogo ante la pandemia de COVID-19. Material y métodos: Para realizar la recolección de la literatura se compilaron artículos de diferentes bases de datos: PubMed, Cochrane, Nature y Lilacs producidos entre los años 2012 y 2020 con las palabras clave: ética, odontología, pandemia, COVID-19 y bioética en los idiomas español, inglés y portugués. Resultados: Se localizaron 70 artículos, de los cuales se escogieron finalmente 10 correspondientes a los criterios de búsqueda. Los artículos presentaron homogeneidad sobre el rol del odontólogo en la situación actual y coinciden en la búsqueda de alternativas y métodos de atención lo más seguras posibles, dando prioridad a quienes requieren atención de urgencias (AU)
Introduction: For a good dental professional, ethics is necessary in all the activities performed. Ethics stablish what is and what should be, always looking for the good and not the bad, the dentist should have a series of qualities and skills in order to perform every treatment that the patient needs in a correct, honest and responsible way without sparing efforts to give them back their oral health. COVID-19 is a disease that has converted into a pandemic affecting the world in an important manner. And, between the most affected are the health providers and professionals that risk their lives to heal the people suffering this disease. Given the current situation, dentists have been found in doubt regarding if treating their patients in this period meets or not the ethical principles of their profession. Objective: The objective of this article is to perform a systematic review of literature in order to identify the bioethics role of the dentist in face of the COVID-19 pandemic. Material and methods: To carry out the collection of literature the procedure included compiling different articles from the databases: PubMed, Cochrane, Nature, and Lilacs produced between the years of 2012 and 2020 with the key words: ethics, dentistry, pandemic, COVID-19, bioethics in the languages of Spanish, English and Portuguese. Results: 70 papers were located from which only 10 were chosen meeting the searching criteria. The papers presented homogenous results about the role of dentists in the current situation and the all agree in the search of alternatives and methods of care that are as secure as possible, giving priority to those who are in need of urgent care (AU)
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Humanos , Bioética , Ética Odontológica , Papel do Dentista , COVID-19 , Bases de Dados Bibliográficas , Assistência Odontológica Integral/normas , Controle de Infecções Dentárias , PandemiasRESUMO
Introducción: La distrofia miotónica tipo 1 es la distrofia muscular más frecuente a nivel mundial. Progresa lentamente llevando al paciente a la pérdida de autonomía lo que implica la necesidad del cuidador, quien con frecuencia, también padece la enfermedad. El síndrome de sobrecarga, desgaste o burnout, término en inglés muy utilizado en la bibliografía médica, se ha descrito en los últimos años para los cuidadores y es el desgaste emocional una de sus particularidades. Objetivo: Evaluar la autonomía para la realización de actividades diarias de los pacientes con distrofia miotónica tipo 1 en referencia al tiempo de evolución de la enfermedad y determinar la magnitud de desgaste en los cuidadores. Metodología: Se aplicó la escala de autonomía de Barthel a 29 pacientes y el cuestionario de Maslach a sus cuidadores. Resultados: Se demostró que las mujeres cuidadoras resultaron más afectadas en el intercambio con el enfermo para el cuidado, en la subescala despersonalización del instrumento Maslach (U de Mann-Whitney p = 0,05). Conclusiones: Se sugiere que los cuidadores femeninos son el grupo de mayor riesgo de padecer el síndrome de sobrecarga(AU)
Introduction: Myotonic dystrophy type 1 is the most common muscular dystrophy worldwide. It progresses slowly, depriving patients of their autonomy, which implies the need for a caregiver, who would often suffer from the disease as well. The overload or burnout syndrome, an English term very often found in medical bibliography, has been described for caregivers in recent years, and emotional wear is one of its features. Objective: Evaluate the autonomy to perform activities of daily living of patients with myotonic dystrophy type 1 with reference to the time of evolution of the disease, and determine the extent of wear in caregivers. Methods: A study of a clinical case series was conducted for two years at the Institute of Neurology and Neurosurgery in Havana. Patients were evaluated with the Barthel autonomy scale and caregivers with the Maslach burnout syndrome inventory. Inclusion criteria admitted patients of both sexes clinically and neurophysiologically characterized for this diagnosis. It was also required to obtain the informed consent of patients and caregivers responding to the overload measuring tool. Exclusion criteria left out patients with a dystrophic condition other than Steinert type 1, inconclusive clinical and electromyographic evaluations, or not willing to participate in the study. Results: According to the depersonalization subscale in the Maslach tool (Mann-Whitney U p = 0.05), female caregivers are more often affected by the interaction with the person cared for. Conclusions: Results suggest that female caregivers are under a greater risk of overload syndrome(AU)
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Humanos , Masculino , Feminino , Adulto , Esgotamento Psicológico/psicologia , Sobrecarga do Cuidador/psicologia , Distrofia Miotônica , Mulheres Trabalhadoras/psicologiaRESUMO
Introducción:La hemorragia subaracnoidea espontánea (HSA) presenta aproximadamente el 5% de todos los ACV, siendo una patología de alto impacto en la sociedad por su elevada morbi-mortalidad. La clínica de presentación es variada, lo cual lleva múltiples veces a dificultades en el diagnóstico. El objetivo de este trabajo es analizar el error diagnóstico que existe en esta patología y evaluar si el mismo se vio modificado por la interposición de la Emergencia Sanitaria declarada en el país por la pandemia del SARS-Cov2. Materiales y Métodos: es un estudio prospectivo y multicéntrico, incluyendo a todos los pacientes que presentaron HSA en el Uruguay entre el 1 de noviembre del 2019 y el 31 de julio de 2020. Se analizaron acuerdo con 3 períodos: 1) pre-pandemia, 2) cuarentena general, y 3) nueva normalidad. Se incluyeron todos los pacientes mayores de 18 años que consultaron y se les diagnosticó una HSA espontánea aneurismática. Se definióÌ error diagnóstico a la imposibilidad de reconocer esta patología en la consulta médica inicial otorgándole el alta. El análisis se procesó utilizando el software SPSS versión 22. La investigación fue aprobada por todos los Comité de Ética de los diferentes centros que participaron del estudio. Resultados: de un total de 149 pacientes, la edad media fue de 57,23 años, con mayor frecuencia en el sexo femenino. Se constató error diagnóstico en 38 pacientes (25,5%), con mayor porcentaje durante la cuarentena general. El retraso en el diagnóstico por problemas asistenciales fue de un 2,6%. Se evidenció un 22,8% de complicaciones por el tratamiento indicado, y un 71,1% por la HSA, con una mortalidad global del 51,7%. Conclusiones: en el presente trabajo se observó un error diagnóstico elevado, evidenciando una relación directa y significativa con la cefalea y la HSA leve (HyH 1 y 2) como formas de presentación. Hubo un porcentaje mayor de HSA graves en comparación a la literatura, con una relación directa y significativa entre la presencia de vasoespasmo y la mortalidad con el error diagnóstico. También es claro que la crisis sanitaria determinó que ese error diagnóstico aumentara durante los primeros meses de la pandemia en Uruguay.
Introduction: Spontaneous subarachnoid hemorrhage (SAH) represents approximately 5% of all strokes, being a pathology of high impact in society, due to its high morbidity and mortality. The clinical presentation is varied, which leads many times to difficulties in diagnosis. The objective of this work is to analyze the diagnostic error that exists in this pathology, and to assess whether it was modified by the introduction of the Health Emergency declared in the country by the SARS-Cov2 pandemic. Materials and Methods: it is a prospective and multicenter study, including all patients who presented SAH in Uruguay between November 1, 2019 and July 31, 2020. They were analyzed according to 3 periods: 1) pre-pandemic, 2) general quarantine, and 3) new normality. All patients over 18 years of age who consulted and were diagnosed with spontaneous aneurysmal SAH were included. Diagnostic error was defined as the inability to recognize this pathology in the initial medical consultation and discharge. The analysis was processed using SPSS version 22 software. The research was approved by all the Ethics Committees of the different centers that participated in the study. Results: of a total of 149 patients, the mean age was 57.23 years, more frequently in the female sex. Diagnostic error was found in 38 patients (25.5%), with a higher percentage during general quarantine. The delay in diagnosis due to healthcare problems was 2.6%. There were 22.8% complications due to the indicated treatment, and 71.1% due to SAH, with an overall mortality of 51.7%. Conclusions: in the present work, a high diagnostic error was observed, showing a significant direct relationship with headache and mild SAH (HyH 1 and 2) as forms of presentation. There was a higher percentage of severe SAH compared to the literature, with a direct and significant relationship between the presence of vasospasm and mortality with diagnostic error. It is also clear that the health crisis determined that this diagnostic error increased during the first months of the pandemic in Uruguay
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Hemorragia Subaracnóidea , Acidente Vascular Cerebral , Síndrome Respiratória Aguda Grave , Diagnóstico , Erros de Diagnóstico , Pandemias , AneurismaRESUMO
ANTECEDENTES: Candida glabrata es un patógeno emergente con capacidad de desarrollar tolerancia y resistencia a los antifúngicos azólicos, lo que genera incertidumbre sobre la utilidad de la profilaxis antifúngica en recién nacidos. OBJETIVOS: El objetivo de este estudio fue describir los factores asociados a la infección por C. glabrata en una UCIN que utiliza la profilaxis con fluconazol. MÉTODOS: Se diseñó un estudio de casos y controles pareado por edad gestacional realizado en el Hospital Civil de Guadalajara Dr. Juan I. Menchaca. Se estudiaron los recién nacidos con infección por C. glabrata y para cada uno se seleccionó un control pareado por edad gestacional; se estimaron razones de momios (RM) con intervalos de confianza del 95% (IC 95%) y prueba de McNemar para contraste de hipótesis. RESULTADOS: Veintiún pacientes presentaron infección, con el 66,7% de ellos de género masculino; la mediana de edad gestacional fue de 31,5 semanas. Se observó mayor riesgo de infección por C. glabrata cuando hubo prescripción de más de un esquema antimicrobiano (RM 21, IC 95% 1,23 - 358,3; p = 0,006) y en pacientes con comorbilidades quirúrgicas (RM 8, IC 95% 1,01 - 63,9; p = 0,04). Durante el periodo de estudio el riesgo de infección no se vio aumentado por la exposición a fluconazol. CONCLUSIONES: Presentaron mayor riesgo de infección por C. glabrata los neonatos con más de un esquema antimicrobiano y aquellos con comorbilidades quirúrgicas
BACKGROUND: Candida glabrata is an emerging pathogen with the ability to develop tolerance and resistance to azole antifungals, which creates uncertainty about the usefulness of antifungal prophylaxis in newborns. AIMS: The aim of this study was to describe the factors associated with C. glabrata infection in a NICU that uses prophylaxis with fluconazole. METHODS: A case-control study paired by gestational age was designed and conducted at the Civil Hospital of Guadalajara Dr. Juan I. Menchaca. Newborns with C. glabrata infection were studied and for each one a matched control was selected by gestational age. Odds ratios (OR) were estimated with 95% confidence intervals (95% CI) and McNemar test for contrast of hypothesis was applied. RESULTS: Twenty-one infected patients were identified, from whom 66.7% were male; the median gestational age was 31.5 weeks. Increased risk of infection with C. glabrata was observed when there was a prescription of more than one antimicrobial scheme (OR 21, 95% CI, 1.23 - 358.3; p = 0.006) and also among patients with surgical comorbidities (OR 8, 95% CI 1.01 - 63.9; p = 0.04). During the study period, exposure to fluconazole showed no difference in the risk of infection. CONCLUSIONS: Neonates with more than one antimicrobial regimen and those with surgical comorbidities had a higher risk of C. glabrata infection
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Humanos , Candida glabrata , Antifúngicos/uso terapêutico , Fungemia/microbiologia , Fungemia/prevenção & controle , Profilaxia Pré-Exposição , Fluconazol/uso terapêutico , Unidades de Terapia Intensiva , Estudos de Casos e ControlesRESUMO
Resumen: La disección coronaria espontanea es una causa infrecuente de síndrome coronario agudo, representando 1-4 % de los síndrome coronario agudo. Entidad clínica muy infrecuente, constituyendo un desafío para el equipo de salud, su diagnóstico y tratamiento. Se presenta el caso de una paciente de sexo femenino 52 años que debuta con clínica de síndrome coronario agudo sin elevación del segmento ST. La cineangiocoronariografía evidenció disección espontanea del ramo posterolateral de la arteria circunfleja donde se planteó tratamiento médico conservador.
Abstract: Spontaneous coronary dissection is a rare cause of acute coronary syndrome, accounting for 1-4% of acute coronary syndrome. Very rare clinical entity, constituting a challenge for the health team, its diagnosis and treatment. The case of a 52-year-old female patient who debuts with acute coronary syndrome clinic without ST elevation. The cineangiocoronarygrafia showed spontaneous dissects the posterolateral bouquet of the circumflex artery where conservative medical treatment was planned
Resumo: A dissecção coronariana espontânea é uma causa rara de síndrome coronariana aguda, representando 1-4% da sindrome coronariana aguda. Entidade clínica muito rara, constituindo um desafio para a equipe de saúde, seus diagnóstico e tratamento. O caso de uma paciente de 52 anos que estreia na clínica sindrome coronariana aguda sem elevação de ST. A cinegicoronariografia apresentou dissecação espontânea do ramo posterolateral da artéria circumflexa onde foi proposto tratamento médico conservador.
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Desde su notificación a finales del 2019, la infección secundaria a coronavirus se ha difundido a nivel global hasta ser calificada como una pandemia. La respuesta inflamatoria generalizada que produce la infección por Sars-CoV-2, compromete múltiples órganos y sistemas, siendo el sistema respiratorio uno de los más afectados y con desenlace fatal, sin embargo, la afectación del sistema nervioso periférico puede implicar el desarrollo de déficits permanentes, con limitaciones en las actividades de la vida diaria y restricción en la participación, llevando a la pérdida de independencia y reducción de la calidad de vida. El médico rehabilitador debe estar enfocado al reconocimiento y detección temprana de la patología nerviosa periférica, así como a determinar la intervención de la cual se beneficia más el paciente, liderar el equipo interdisciplinario de salud y mantener un trabajo fluido con otras especialidades médicas.
Since its notification at the end of 2019, the infection secondary to coronavirus has spread globally to the point of being qualified as a pandemic. The generalized inflammatory response produced by Sars-CoV-2 infection involves multiple organs and systems, being the respiratory system one of the most affected and with fatal outcome, however, the involvement of the peripheral nervous system may involve the development of permanent deficits, with limitations in activities of daily living and restriction in participation, leading to loss of independence and reduced quality of life. The rehabilitation physician should be focused on the early recognition and detection of peripheral nerve pathology, as well as to determine the intervention from which the patient will benefit the most, lead the interdisciplinary health team and maintain a fluid work with other medical specialties.
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HumanosRESUMO
La infección por coronavirus Sars-CoV-2 desde su aparición en 2019, se ha manifestado con el compromiso multiorgánico y con la consecuente necesidad de un abordaje multidisciplinario que incluye a varios profesionales de la salud para la intervención aguda, la estabilización del paciente, la exploración neurológica y el proceso de rehabilitación. En conjunto las manifestaciones neurológicas, respiratorias y cardiovasculares son causa de discapacidad, alteración en la funcionalidad, de la participación y del entorno social en los pacientes con infección por Sars-CoV-2, por lo que requieren de una rehabilitación temprana como también de programas diseñados en torno a la pandemia y al compromiso neurológico, con el fin de prevenir complicaciones tempranas. Estas son razones por las que la presente revisión narrativa tiene como fin describir los principales compromisos del sistema nervioso central así como las secuelas neurológicas, basados en la búsqueda y referencia de diferentes tipos de artículos publicados hasta la fecha.
Sars-CoV-2 coronavirus infection since its emergence in 2019, has manifested with multiorgan involvement and the consequent need for a multidisciplinary approach that includes several health professionals for acute intervention, patient stabilization, neurological examination and rehabilitation process. As a whole, neurological, respiratory and cardiovascular manifestations are the cause of disability, alteration in functionality, participation and social environment in patients with Sars-CoV-2 infection, thus requiring early rehabilitation as well as programs designed around the pandemic and neurological involvement, in order to prevent early complications. These are the reasons why the present narrative review aims to describe the main central nervous system compromises as well as neurological sequelae, based on the search and reference of different types of articles published to date.
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HumanosRESUMO
Resumen La familia es el sistema transmisor de comportamientos por excelencia y la pareja, en el momento de decidir tener un hijo, reflexiona acerca de ciertos ideales y expectativas con respecto a la forma de crianza que, en los hombres, determina el valor de la carga emocional y poder en el género masculino. Por lo anterior, el objetivo de este estudio fue diseñar y validar una escala para medir las actitudes hacia la paternidad, que delimitan aspectos comportamentales eficaces para una buena crianza. Para ello se realizó una tabla de especificaciones y se construyeron los reactivos, los cuales fueron sometidos a validación por jueces. Se realizó el ajuste de la escala, y fue aplicada a 240 hombres colombianos con edades comprendidas entre los 18 y 52 años (media=24,7). Tras hacer el análisis factorial exploratorio, se agruparon los reactivos con base a lo sugerido por el programa y se hizo la depuración pertinente según los resultados obtenidos. Ulteriormente, dichos resultados se sometieron a un análisis factorial confirmatorio, verificando el ajuste del modelo. Los índices de validez y concordancia indicaron que los ítems eran esenciales, el análisis de correlaciones indicó homogeneidad entre los ítems y el instrumento mostró tener alta fiabilidad. En conclusión, se puede afirmar que la Escala de actitudes hacia la paternidad es una escala válida y confiable para ser utilizada en población colombiana, recomendando repetir el estudio para replicar estos hallazgos y estimar la plausibilidad de ser extrapolada al género femenino.
Abstract The family is the main transmitting system of behaviors and a couple, when deciding to have a child, reflects on the ideals and expectations regarding the appropiate way of upbringing a child which in men, determines the value of the emotional load and power in the masculine gender. The present study had as main objective to design and validate a scale that measures attitudes toward parenthood which determine effective behavioral aspects for a suitable child rearing. In order to achieve this, a specification chart was designed and items were constructed and then submitted to be validated by judges. The scale was adjusted based on the judges opinions and applied to 240 Colombian men with an age range of 18-52 years old (media=24,7 years old). After conducting an exploratory factor analysis, the reactants were grouped according to what was suggested by the program and those which were not appropriate were extracted. Results were submitted to a confirmatory analysis verifying the model's adjustment. Ratings for validity and agreement showed that the items were essential, the correlation analysis showed homogeneity between them and the test showed high reliability. As a conclusion, it is said that the Attitudes toward parenthood scale is a valid and reliable scale to be used in Colombian population, suggesting to replicate the study in order to evaluate its generalizability and estimate the plausibility of extrapolating it to female gender.
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Paternidade , Comportamento , Adaptação Psicológica , Educação Infantil , Avaliação de Programas e Instrumentos de Pesquisa , População , Poder Psicológico , Família , Análise Fatorial , Identidade de Gênero , Homens , MotivaçãoRESUMO
RESUMEN Objetivo: Determinar el riesgo cardiovascular y la prevalencia de factores de riesgo cardiovascular (RCV) en los pacientes con artritis reumatoide. Materiales y métodos: Estudio observacional, descriptivo y transversal, realizado en el Hospital General de Ciudad Real, entre junio de 2013 y mayo de 2014. Se realizó una analítica completa, se elaboró un perfil clínico, se calculó el SCOREm y se estratificó el RCV. Finalmente, se determinó la presencia de aterosclerosis subclínica mediante la realización de una ecografía carotídea. Resultados: 119 pacientes aceptaron participar en el estudio. Hubo una prevalencia del 73,1% de los factores de riesgo tradicionales, 6,72% había presentado un evento cardiovascular al momento del estudio, 22,68% poseía un infradiagnóstico de diabetes mellitus o nefropatía. La distribución final del RCV fue: riesgo bajo 46 (38,7%), riesgo intermedio 33 (27,7%), riesgo alto 2 (1,7%), riesgo muy alto 38 (31,9%). Conclusiones: Existe una alta prevalencia de factores de RCV y riesgo elevado infradiagnosticado en esta población. Por lo que si bien la artritis reumatoide se manifiesta de forma más aparente a nivel articular, ha de considerarse una enfermedad sistémica asociada a una mayor incidencia de eventos cardiovasculares.
ABSTRACT Objective: To determine the cardiovascular risk and the prevalence of cardiovascular risk (CVR) factors in patients with rheumatoid arthritis. Material and methods: Observational, descriptive and cross-sectional study performed in the General Hospital of Ciudad Real from June 2013 to May 2014. A complete laboratory analysis was performed, a clinical profile was prepared, the Systematic Coronary Risk Evaluation (SCOREm) was calculated, and the CVR was stratified. Finally, the presence of sub-clinical atherosclerosis was determined by performing a carotid ultrasound. Results: 119 patients accepted to participate in the study. There was a prevalence of 73.1% of traditional risk factors; 6.72% having had a cardiovascular event at the time of the study, and 22.68% had an underdiagnosis of diabetes mellitus and/or nephropathy. The final distribution of the CVR was: Low risk 46 (38.7%), intermediate risk 33 (27.7%), high risk 2 (1.7%), very high risk 38 (31.9%). Conclusions: There is a high prevalence of CVR factors and an elevated risk of underdiagnosis in the rheumatoid arthritis population. Therefore, although rheumatoid arthritis manifests itself more in the joints, it should be considered a systemic disease associated with a higher incidence of cardiovascular events.
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Humanos , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Artrite Reumatoide , Sistema Cardiovascular , Fatores de RiscoRESUMO
ABSTRACT: In order to use and study minimally invasive techniques to reduce side effects of ovarian-hysterectomy (OHE) in bitches, the aim of this study was to compare time, surgical complications, pain and postoperative inflammatory response, caused by single port videolaparoscopic OHE and traditional miniceliotomy with snook hook. Twenty-four healthy bitches were randomly divided in two groups: videolaparoscopy (Video) and miniceliotomy (MiniLap). Surgical time and complications, pain, need for analgesic rescue, C-reactive protein concentration, glycaemia and voluntary food ingestion were evaluated during 24 hours following the procedure and compared statistically. Surgical time (38±7min), surgical complications (17%), postoperative pain intensity, need for analgesic rescue and C-reactive protein concentration were similar between groups (P>0.05). Glycaemia was lower in Video group (P=0.03), animals fed faster and in greater proportion (P=0.02). Thus, it is concluded that both OHE techniques result in similar complications, surgical time and inflammatory response; however, animals on Video group fed more readily and presented lower glycaemia, which point to lower stress levels. These findings validated the indication of this technique.
RESUMO: Com o intuito de utilizar e estudar técnicas minimamente invasivas que permitam reduzir os efeitos adversos da ovário-histerectomia (OVH) em cadelas objetivou-se comparar: o tempo, as complicações cirúrgicas, a dor e a resposta inflamatória pós-operatória, resultantes da OVH laparoscópica por único portal e a miniceliotomia tradicional com gancho de Snook. Vinte e quatro cadelas hígidas foram aleatoriamente divididas em dois grupos e realizadas a OVH por videolaparoscopia (Vídeo) ou miniceliotomia (MiniLap). Avaliaram-se e compararam-se estatisticamente: o tempo e intercorrências cirúrgicas, a dor, necessidade de resgate analgésico, concentração sérica de proteína C reativa, glicemia e o consumo voluntário de alimento durante as 24 horas subsequentes ao procedimento. O tempo operatório (38±7min), as intercorrências cirúrgicas (17%), a intensidade de dor pós-operatória, a necessidade de resgate analgésico e a concentração sérica de proteína C reativa foram similares entre os grupos (P>0,05). A glicemia foi menor nos animais do grupo Vídeo (P=0,03) e estes se alimentaram mais rapidamente e em maior proporção (P=0,02). Assim, conclui-se que as técnicas de OVH por videolaparoscopia, miniceliotomia resultam em complicações, tempos cirúrgicos e respostas inflamatórias similares, no entanto, os animais submetidos à videolaparoscopia se alimentam mais prontamente e apresentam menor índice glicêmico indicando um nível de estresse menor e este resultado considera-se válido para a indicação desta técnica.
RESUMO
Las alopecias cicatrizales secundarias pueden tener distintos orígenes, entre ellos quemaduras, traumatismos y cirugías. Se caracterizan por la destrucción y ausencia permanente de folículos pilosos, lo que las hace estables en el tiempo. Se proponen distintos tratamientos quirurgicos, como por ejemplo resección de la cicatriz o también trasplante capilar. En este artículo mostramos la reparación de 3 casos de pacientes con alopecias cicatrízales posquirúrgicas mediante trasplantes capilar con técnica FUE (follicular unit extraction), atentidos en el Servicio de Dermatología del Hospital F. J. Muñiz, Secció Dermatología Quirúrgica. Consideramos que los resultados son altamentes satisfechos...
Assuntos
Humanos , Alopecia , Folículo Piloso , TransplanteRESUMO
INTRODUCCIÓN: Los mecanismos de contratación y pago en salud generan un impacto diverso en la cantidad y calidad de los servicios médicos, en la transferencia de riesgo entre actores y en la eficiencia de la utilización de los recursos. OBJETIVO: Analizar la estructura del mercado de servicios de salud en las provincias de Córdoba, Salta y Tucumán durante los últimos cinco años. MÉTODO: Se consideraron las condiciones socio-económico-sanitarias locales, el marco institucional, la historia de los actores más relevantes del sector y las conductas adquiridas como respuesta a la estructura. La metodología incluyó un mapeo de los actores claves del sector salud cada provincia así como la administración de un cuestionario a una muestra de establecimientos públicos y privados de cada jurisdicción. RESULTADOS: Los ministerios de salud provinciales son los principales financiadores del sistema público de salud y el Instituto Nacional de Servicios Sociales para Jubilados y Pensionados (PAMI) y las obras sociales provinciales lo son del sistema privado. CONCLUSIONES: PAMI tiene una política nacional que lo torna menos flexible para contemplar las particularidades locales, mientras que las obras sociales provinciales se presentan como los actores idiosincrásicos, siendo más permeables a las demandas locales. En la medida en que el PAMI coordine con los ministerios y la obra social provincial, se podría converger a modelos más homogéneos de atención y mecanismos de pago, generando incentivos para una mayor eficiencia en la asignación de recursos y una mayor equidad en salud
INTRODUCTION: The contracting and payment mechanisms in health generate different impact on the quantity and quality of medical services, the transfer of risk among actors and the efficient use of resources. OBJECTIVES: To analyze the market structure of health services in the provinces of Cordoba, Salta and Tucuman during the past five years. We considered the local socioeconomic and health conditions, institutional framework, the history of the most relevant actors, and their behaviour in response to the structure. The methodology included a mapping of key actors in the health sector in each province and the administration of a questionnaire to a sample of local public and private health institutions. RESULTS: The results show that the provincial ministries of health are the primary funders of the public services and the national insurance for retired people (PAMI) and the provincial social insurances are the primary funders of the private system. CONCLUSION: PAMI has a national policy which makes it self less flexible to consider the local particularities,while the provincial social insurances present themselves as idiosyncratic actors, being more receptive to local demands. If PAMI were coordinated with the structure of the local social insurance and the ministries of health, it could beachieved homogeneous models of health care and payment mechanisms, generating incentives for a more efficient resources allocation and equity in health
Assuntos
Humanos , Qualidade da Assistência à Saúde/organização & administração , Equidade na Alocação de Recursos , Financiamento Governamental , Alocação de Recursos para a Atenção à Saúde , Serviços Contratados/organização & administração , Sistema de Fonte Pagadora Única/organização & administraçãoRESUMO
Distribution of potentially nitrogen-fixing bacteria and its relationship with physicochemical parameters in soils with three vegetation types in the southern Colombian Amazon region. Potentially nitrogen-fixing microaerobic and aerobic bacteria were isolated from several Colombian Amazon soils (forest, pastures and chagras) and two landscapes (floodable and non floodable areas). The abundance and distribution of bacteria were evaluated, as well as their relationship with soil physical and chemical characteristics. Landscape had a direct influence on the abundance of the microaerobic bacteria, with higher numbers in forest and pasture soils in non- floodable zones. The aerobic isolates (N=51) were grouped into 19 morphologies, with the highest numbers found in forest soil in floodable zones. A higher number of aerobic morphologies was shared among forest sites (Nonmetric Multidimensional Scaling and Analysis of Similarity p<0.05), and 40% of the distribution was explained by lime percentage and Al concentration. Rev. Biol. Trop. 57 (4): 915- 927. Epub 2009 December 01.
Se evaluó la abundancia y distribución de bacterias microaerófilas y aerobias potencialmente fijadoras de nitrógeno aisladas a partir de suelos bajo coberturas de bosque, pastizal y chagra en dos paisajes, terraza y llanura inundable, en el sur de trapecio amazónico. Se relacionó el recuento en placa en el medio Ashby de estas bacterias aerobias con las características físicas y químicas del suelo. Se encontró mayor abundancia de bacterias aerobias y microaerofilas en suelos bajo cobertura de pastizal. Se observó influencia directa del paisaje sobre la abundancia de bacterias microaerófilas registrando mayores recuentos los suelos bajo terraza en las coberturas de bosque y pastizal. Los aislamientos aerobios obtenidos (51) se agruparon en 19 morfologías, de las cuales se obtuvo mayor número en suelos bajo bosque y en el paisaje de llanura inundable. A través del análisis multidimensional no métrico (NMDS) y análisis de similaridades (ANOSIM) (p<0.05) se comprobó que entre los sitios de muestreo bajo la cobertura de bosque se comparten mayor número de morfologías de bacterias aerobias que bajo las demás coberturas. El programa BIOENV indicó que esta distribución fue explicada en un 40% por las variables % limo y Al (meq/100 g).
Assuntos
Bactérias Aeróbias/metabolismo , Fixação de Nitrogênio , Microbiologia do Solo , Solo/análise , Árvores , Bactérias Aeróbias/classificação , Bactérias Aeróbias/isolamento & purificação , Colômbia , Contagem de Colônia MicrobianaRESUMO
Contenido: Acciones del organismo sobre el medio externo. Regulación del medio interno. Nutrición. Relación y biodiversidad. Reproducción y biodiversidad. El ambiente en el espacio. El ambiente en el tiempo...
Assuntos
Disciplinas das Ciências Biológicas , BiologiaRESUMO
Contenido: Acciones del organismo sobre el medio externo. Regulación del medio interno. Nutrición. Relación y biodiversidad. Reproducción y biodiversidad. El ambiente en el espacio. El ambiente en el tiempo...