Programa de seguimiento al alta de la unidad de cuidados intensivos / Follow-up program after intensive care unit discharge

Introducción: El seguimiento de pacientes al alta de la unidad de cuidados intensivos (UCI) permite el reconocimiento precoz de las complicaciones asociadas al síndrome post terapia intensiva (SPTI). El objetivo de este estudio es la estandarización de medidas básicas de resultado incluidas en un programa de seguimiento de pacientes en riesgo de presentar SPTI. Métodos: El comité de Seguimiento y Rehabilitación luego de la Enfermedad Crítica de la Sociedad Argentina de Terapia Intensiva (SATI) convocó a diferentes comités para la redacción del presente documento. Se realizó una búsqueda bibliográfica, junto con reuniones y foros de discusión. Las recomendaciones incluidas en el programa de seguimiento según el sistema GRADE son: frecuencia de seguimiento, profesionales encargados del programa, dominios básicos a evaluar, herramientas recomendadas para su evaluación validadas al español y duración del programa. Conclusión: Las medidas recomendadas para el seguimiento de pacientes permiten establecer los lineamientos básicos para la identificación y tratamiento precoz de las complicaciones asociadas al SPTI

Introduction: Patient follow-up after intensive care unit (ICU) discharge allows the early recognition of complications associated to post-intensive care syndrome (PICS). The aim of this project is to standardize outcome variables in a follow-up program for patients at risk of suffering PICS. Methods: The Rehabilitation and Patient Follow-up Committee of the Argentine Society of Intensive Care Medicine (Sociedad Argentina de Terapia Intensiva, SATI) requested the collaboration of different committees to design the present document. A thorough search of the literature on the issue, together with pre-scheduled meetings and web-based discussion encounters were carried out. After comprehensive evaluation, the recommendations according to the GRADE system included in the follow-up program were: frequency of controlled visits, appointed healthcare professionals, basic domains of assessment and recommended tools of evaluation, validated in Spanish, and entire duration of the program. Conclusion: The measures herein suggested for patient follow-up after ICU discharge will facilitate a basic approach to diagnosis and management of the long-term complications associated to PICS

Follow-up program after intensive care unit discharge. / Programa de seguimiento al alta de la unidad de cuidados intensivos.

INTRODUCTION: Patient follow-up after intensive care unit (ICU) discharge allows the early recognition of complications associated to post-intensive care syndrome (PICS). The aim of this project is to standardize outcome variables in a follow-up program for patients at risk of suffering PICS. METHODS: The Rehabilitation and Patient Follow-up Committee of the Argentine Society of Intensive Care Medicine (Sociedad Argentina de Terapia Intensiva, SATI) requested the collaboration of different committees to design the present document. A thorough search of the literature on the issue, together with pre-scheduled meetings and web-based discussion encounters were carried out. After comprehensive evaluation, the recommendations according to the GRADE system included in the follow-up program were: frequency of controlled visits, appointed healthcare professionals, basic domains of assessment and recommended tools of evaluation, validated in Spanish, and entire duration of the program. CONCLUSION: The measures herein suggested for patient follow-up after ICU discharge will facilitate a basic approach to diagnosis and management of the long-term complications associated to PICS.

Genetic divergence and admixture of ancestral genome groups in the sugarcane variety 'RB867515' (Saccharum spp).

We analyzed 80 plants of the sugarcane (Saccharum spp) variety 'RB867515' in order to investigate its diversity and genetic structure at the molecular level. Four simple sequence repeat (SSR) loci (UGSM51, SMC1237, SEGMS1069, and UGSM38) and five expressed sequence tag (EST)-SSR loci (ESTA68, ESTB92, ESTB145, ESTC66, and ESTC84) were used as molecular markers. The polymorphic loci rate was 66.6%. A total of 17 alleles and an average of 1.88 alleles/locus were detected. The number of alleles in the EST-SSR loci was lower than the number of alleles in the SSRs of non-expressed loci. The mean observed heterozygosity among the nine SSR loci was 0.3291. Genetic structure analysis showed that 'RB867515' contains alleles from three ancestral groups (K = 3), but there is little admixing of alleles in the same plant (from 0.8 to 17.3%); only 1.88% of the plants shared alleles from two or three groups. ESTB92, ESTC84, and UGSM38 were monomorphic, but there was evidence of polymorphism in ESTA68, ESTB145, ESTC66, UGSM51, SMC1237, and SEGMS1069, indicating that 'RB867515' has variability at the molecular level and the potential to be used as a parent in breeding programs. The molecular variability observed in 'RB867515' indicates that the clone terminology that is used to identify this cultivar is inconsistent with the original meaning of "clone", which is defined as a sample of genetically identical plants.

Recomendações para o diagnóstico de alergia ao látex / Recommendations for the diagnosis of latex allergy

Objetivo: Fornecer uma atualização das condutas atuais baseadas em evidências, no que diz respeito à abordagem da alergia ao látex, de forma prática e objetiva. Fontes de dados: Foram utilizados os bancos de dados: Pubmed e Lilacs; artigos de revisão, manuais de conduta prática e atualizações no tema. Síntese de dados: Este artigo enfoca os parâmetros práticos da conduta em pacientes com história de alergia ao látex. Conclusões: A alergia ao látex constitui um grande desafio na prática diária do médico alergista, especialmente no que se refere ao diagnóstico diferencial das reações de hipersensibilidade aos medicamentos. Desta forma, é importante abordar este tópico de forma clara e prática, a fim de auxiliar o médico especialista a conduzir de forma correta a investigação dos casos suspeitos

Objective: This document was developed as an updated practice parameter to improve the care of patients by providing the practicing physician with an evidence-based approach in the management of latex allergy. Sources: Medline and Lilacs databases; review papers, practice parameters and updates in beta lactam allergy management. Data synthesis: This is a practice parameter review on latex allergy management. Conclusions: Latex allergy results in major health problems for allergists, especially regarding the differential diagnosis in drug hypersensitivity. Knowledge of the latex allergic patient management is very important in the investigation of suspected subjects.

Evaluación del Sequential Organ Failure Assessmente (SOFA) score para predecir mortalidad en los pacientes críticos, y comparación con los scores APACHE II Y SAPS II / Sequential Organ Failure Assessment Assessed (SOFA) score to predict mortality in critically ill patients, and comparison with APACHE II scores and SAPS II

Objetivos: 1) Determinar la utilidad del SOFA score y sus variables derivadas como predictores de mortalidad 2) correlacionar la mortalidad estmada por el SOFA score y derivadas, con la predicha por APACHE II y SAPS II. Materiales y métodos: Diseño: cohorte prospectiva. Lugar UTI polivalente de un hospital escuela. Pacientes: los ingresados desde el 1/5/01 al 14/4/03. Al ingreso se calcularon los scores pronósticos APACHE II y SAPS II y SOFA inicial, y diariamente (hasta 30 días de internación), el score SOFA con los peores valores del día anterior. Adicionalmente se calcularon las siguintes variables derivadas: SOFA medio: valor promedio de la internación; SOFA total: suma de todos los valores diarios; delta SOFA 48hs: diferencia entre el SOFA inicial y a las 48 hs del ingreso; y SOFA máximo: el valor más alto registrado. Análisis estadístico: primeramente, se calculó el área bajo la curva ROCd (AUC) correspondiente a las 5 variables citadas, a APACHE IIy a SAPS II, y luego se compararon con refencia a la que presentó mayor AUC en el procedimeinto anterior...

Cytogenetic studies on Choeroniscus minor (Chiroptera, Phyllostomidae) from the Amazon region.

The Choeroniscus genus (Glossophaginae, Phyllostomidae) has five monotypic species: C. minor, C. godmani, C. intermedius, C. inca and C. periosus. This paper analyses the karyotype of a female C. minor, collected close to the Guama river (Belém, Para, Brazil). G-, C-banding and NOR-staining were performed. This species has 2n = 20 chromosomes, where there are two bi-armed pairs (numbers 1 and 9) and seven subtelocentric pairs (2, 3, 4, 5, 6, 7 and 8). The probable X chromosome is a submetacentric. The constitutive heterochromatin can be found in the short arm of five subtelocentric pairs (4, 5, 6, 7 and 8) and is centromeric in the bi-armed pairs numbers 1 and 9, and the X chromosome. The heterochromatic bands are heteromorphic in three pairs (1, 2 and 3). Active NOR were observed in the short arms of eight subtelocentric chromosomes, suggesting that at least four pairs are nucleolar organizers. This paper describes for the first time the karyotype of C. minor from the Amazon region.