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1.
PeerJ ; 10: e13950, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36032955

RESUMO

Providing uncertainty estimates for predictions derived from species distribution models is essential for management but there is little guidance on potential sources of uncertainty in predictions and how best to combine these. Here we show where uncertainty can arise in density surface models (a multi-stage spatial modelling approach for distance sampling data), focussing on cetacean density modelling. We propose an extensible, modular, hybrid analytical-simulation approach to encapsulate these sources. We provide example analyses of fin whales Balaenoptera physalus in the California Current Ecosystem.


Assuntos
Ecossistema , Baleia Comum , Animais , Incerteza , Cetáceos , Simulação por Computador
2.
Mar Environ Res ; 168: 105305, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33773411

RESUMO

The Natura 2000 network is the centerpiece of the European Union conservation strategy to safeguard priority species and habitats. The question of whether other co-occurring species of conservation concern may also benefit from this network, however, remains largely unknown. Here, we used a systematic approach (MARXAN) for i) evaluating if the current Natura 2000 network in the Alboran Sea (western Mediterranean Sea), initially proposed to protect the common bottlenose dolphin (Tursiops truncatus) and priority habitats, is also spatially protecting the endangered common dolphin (Delphinus delphis), and ii) identifying additional marine areas that should be protected to reach adequate conservation targets for the common dolphin. While the current Natura 2000 network encompass ca. 22% of predicted abundances for common dolphins, this percentage might be enhanced by protecting coastal areas nearby the Strait of Gibraltar. However, dolphins and fisheries largely overlap spatially nearby the coastline, and only segregate in offshore areas that represent the marginal distribution of the species. Thus, conservation decision-makers must achieve a trade-off between cetacean conservation and fisheries by combining an area-based approach (i.e., new protected areas close to the Strait of Gibraltar) together with a basin-wide threat-based approach (e.g., regulation of fisheries).


Assuntos
Golfinho Nariz-de-Garrafa , Golfinhos Comuns , Animais , Pesqueiros , Gibraltar , Mar Mediterrâneo
3.
Vet Comp Oncol ; 17(4): 489-496, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31100200

RESUMO

E-cadherin is a cell adhesion molecule that participates in several cellular processes that guarantee the maintenance of structural and functional integrity of epithelial tissues. E-cadherin plays an important role in mammary carcinogenesis, and various studies have demonstrated the effect of CDH1 genetic variation in risk, progression and biological behaviour of human breast cancer. Although there are some recognized genetic variations in canine CDH1 gene, their influence in canine mammary tumour development and progression has not been previously evaluated. In this study, we aim to assess the influence of CDH1 SNPs rs850805755, rs852280880 and rs852639930 in the risk, clinicopathological features and clinical outcome of canine mammary tumours. A case-control study was conducted involving 206 bitches with mammary tumours and 161 bitches free of mammary neoplasia. CDH1 SNPs rs850805755 and rs852280880 were associated with a decreased risk and a later onset of mammary tumour development. Furthermore, these SNPs were related to the development of small size carcinomas, of low histological grade and low nuclear pleomorphism. SNP rs852639930 was associated with the development of small size tumours with a non-infiltrative, non-invasive growth pattern. Data from the present investigation demonstrate that these CDH1 genetic variants could have a protective role in canine mammary tumours, by being associated with low risk of tumour development, delayed onset of the disease and less aggressive clinicopathological features.


Assuntos
Caderinas/genética , Doenças do Cão/genética , Neoplasias Mamárias Animais/genética , Animais , Estudos de Casos e Controles , Doenças do Cão/metabolismo , Doenças do Cão/patologia , Cães , Feminino , Regulação Neoplásica da Expressão Gênica , Polimorfismo de Nucleotídeo Único
4.
Vet Comp Oncol ; 17(3): 394-406, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31025532

RESUMO

Acute phase proteins (APP) and biomarkers of oxidative status change in human and canine mammary tumours, however, they have not been studied in feline mammary tumours. The aims of this study were to investigate the APP and antioxidant responses in feline malignant mammary tumours, to evaluate their relation with tumour features, and to assess their prognostic value. Serum amyloid A (SAA), haptoglobin (Hp), albumin, butyrylcholinesterase (BChE), insulin-like growth factor1 (IGF1), paraoxonase1 (PON1), total serum thiols (Thiol), glutathione peroxidase (GPox) and total antioxidant capacity determined by different assays, including trolox equivalent antioxidant capacity assessed by two different methodologies (TEAC1/2), ferric reducing ability of plasma (FRAP), and cupric reducing antioxidant capacity (CUPRAC), were determined in serum of 50 queens with spontaneous mammary carcinomas and of 12 healthy female cats. At diagnosis, diseased queens presented significantly higher SAA and Hp, and lower albumin, BChE, GPox, TEAC1, TEAC2 and CUPRAC than controls. Different tumour features influenced concentrations of APP and antioxidants. Increases in serum Hp, and decreases in albumin, Thiol and FRAP were significantly associated with neoplastic vascular emboli, metastasis in regional lymph nodes and/or in distant organs. Distant metastasis development during the course of the disease was associated with increases in SAA and TEAC1. At diagnosis, decreased albumin was associated with a longer survival, and BChE <1.15 µmoL/mL.minute was associated with a shorter survival time on multivariate analysis. Feline malignant mammary tumours are associated with an APP response and oxidative stress, and different tumour features influence the inflammatory response and the oxidative damage. Furthermore, some of these analytes proved to have prognostic value.


Assuntos
Proteínas de Fase Aguda/metabolismo , Doenças do Gato/metabolismo , Neoplasias Mamárias Animais/metabolismo , Animais , Biomarcadores Tumorais , Gatos , Feminino , Neoplasias Mamárias Animais/patologia , Estresse Oxidativo , Taxa de Sobrevida
5.
Vet Clin Pathol ; 48(1): 50-60, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30865320

RESUMO

BACKGROUND: Cell blocks and immunohistochemistry (IHC) are increasingly recognized as being complementary tools for cytologic diagnostics, especially for neoplastic diseases. OBJECTIVES: The study aimed to evaluate the utility of cell tube block (CTB) IHC for refining the diagnosis of effusions in dogs and cats. METHODS: Cavitary effusions (n = 25) from dogs and cats classified by cytology as reactive, neoplastic, borderline (suspicious of neoplasia), and chylous were studied. CTB sections were stained with H&E, and immunostained with PAX-5, CD3, pancytokeratin (CK), vimentin, and Wilms tumor 1 protein (WT1) antibodies, according to the cytologic diagnoses. A histologic case series of confirmed normal, reactive, and neoplastic mesothelium and several different carcinomas were included to test the utility of WT1 as a marker of mesothelial cells. RESULTS: CTBs had a layered appearance with reduced background staining. CD3 and PAX5 immunolabeling allowed immunophenotype assessment in all of the lymphoma cases. In carcinomatous effusions, neoplastic cells were CK-positive, WT1-negative, and vimentin-negative (except for two cases). Wilms tumor 1 protein was positive in the nuclei of normal, reactive, and neoplastic mesothelial cells, and ovarian carcinomatous cells. Other carcinomas and lymphomas were negative. CONCLUSIONS: CTBs are valuable tools to assist in making a diagnosis of cavitary effusions in dogs and cats, and WT1 is a promising marker to differentiate mesothelial from carcinomatous cells.


Assuntos
Líquido Ascítico/citologia , Doenças do Gato/diagnóstico , Doenças do Cão/diagnóstico , Técnicas de Preparação Histocitológica/veterinária , Derrame Pericárdico/veterinária , Derrame Pleural/veterinária , Animais , Líquido Ascítico/patologia , Doenças do Gato/patologia , Gatos , Doenças do Cão/patologia , Cães , Técnicas de Preparação Histocitológica/métodos , Imuno-Histoquímica/veterinária , Neoplasias Renais/diagnóstico , Neoplasias Renais/patologia , Neoplasias Renais/veterinária , Derrame Pericárdico/citologia , Derrame Pericárdico/patologia , Derrame Pleural/patologia , Tumor de Wilms/diagnóstico , Tumor de Wilms/patologia , Tumor de Wilms/veterinária
6.
Vet Pathol ; 56(2): 208-219, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30381007

RESUMO

Histopathology remains the cornerstone for diagnosing canine mammary tumors (CMTs). Recently, 2 classification systems (the World Health Organization [WHO] classification of 1999 and the proposal of 2011) and 2 grading methods based on the human Nottingham grade have been used by pathologists. Despite some evidence that the histological subtype and grade are prognostic factors, there is no comprehensive comparative study of these classification and grading systems in the same series of CMTs. In this study, the 2 classifications and the 2 grading methods were simultaneously applied to a cohort of 134 female dogs with CMTs. In 85 animals with malignant tumors, univariable and multivariable survival analyses were performed. Using the 2 systems, the proportion of benign (161/305, 53%) and malignant (144/305, 47%) tumors was similar and no significant differences existed in categorization of benign tumors. However, the 2011 classification subdivided malignant tumors in more categories-namely, those classified as complex, solid, and tubulopapillary carcinomas by the WHO system. Histological subtype according to both systems was significantly associated with survival. Carcinomas arising in benign tumors, complex carcinomas, and mixed carcinomas were associated with a better prognosis. In contrast, carcinosarcomas and comedocarcinomas had a high risk of tumor-related death. Slight differences existed between the 2 grading methods, and grade was related to survival only in univariable analysis. In this cohort, age, completeness of surgical margins, and 2 index formulas adapted from human breast cancer studies (including tumor size, grade, and vascular/lymph node invasion) were independent prognostic factors.


Assuntos
Doenças do Cão/classificação , Neoplasias Mamárias Animais/classificação , Gradação de Tumores/veterinária , Animais , Doenças do Cão/diagnóstico , Doenças do Cão/mortalidade , Doenças do Cão/patologia , Cães , Feminino , Glândulas Mamárias Animais/patologia , Neoplasias Mamárias Animais/diagnóstico , Neoplasias Mamárias Animais/mortalidade , Neoplasias Mamárias Animais/patologia , Prognóstico , Análise de Sobrevida
7.
Vet Comp Oncol ; 16(4): 664-669, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30168237

RESUMO

The enzyme catechol-o-methyltransferase (COMT) is responsible for inactivation of catechol estrogens, which are well-recognized carcinogenic metabolites. Two single-nucleotide polymorphisms (SNPs) in canine COMT gene were previously associated with the age of onset of mammary tumours and with the clinical progression of the disease. However, no information is available regarding the impact of other known SNPs in COMT gene in canine mammary tumours. The aim of the present study is to evaluate the influence of COMT SNP in clinicopathological features and outcome of canine mammary tumours. A case series study was conducted involving 155 non-neutered bitches with mammary tumours submitted to follow-up for 24 months after surgery. Three genotypes were considered: Genotype 1 (rs853046495); Genotype 2 (rs23350589, rs23322686, rs23336579, and rs852564758); Genotype 3 (rs851328636 and rs853133060). Genotype 1 was associated to low degree of tubular differentiation. Genotype 2 was related to the development of intermediate/high-histological-grade carcinomas and to vascular invasion. Genotype 3 was associated to reduced nuclear pleomorphism and well-differentiated carcinomas. Data from the present investigation allowed the identification of COMT genetic profiles associated with pathological features of mammary tumours that constitute relevant prognostic factors. The assessment of the COMT genotypes may represent a helpful tool in the clinical management of canine mammary tumours, assisting in the selection of individualized preventive and therapeutic strategies, according to the animals' genetic profile.


Assuntos
Catecol O-Metiltransferase/genética , Doenças do Cão/genética , Neoplasias Mamárias Animais/genética , Animais , Progressão da Doença , Doenças do Cão/enzimologia , Doenças do Cão/patologia , Cães , Feminino , Genótipo , Neoplasias Mamárias Animais/enzimologia , Neoplasias Mamárias Animais/patologia , Invasividade Neoplásica/genética , Polimorfismo de Nucleotídeo Único/genética
8.
PLoS One ; 13(9): e0203122, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30204764

RESUMO

There is worldwide concern about the status of elasmobranchs, primarily as a result of overfishing and bycatch with subsequent ecosystem effects following the removal of top predators. Whilst abundant and wide-ranging, blue sharks (Prionace glauca) are the most heavily exploited shark species having suffered marked declines over the past decades, and there is a call for robust abundance estimates. In this study, we utilized depth data collected from two blue sharks using pop-up satellite archival tags, and modelled the proportion of time the sharks were swimming in the top 1-meter layer and could therefore be detected by observers conducting aerial surveys. The availability models indicated that the tagged sharks preferred surface waters whilst swimming over the continental shelf and during daytime, with a model-predicted average proportion of time spent at the surface of 0.633 (SD = 0.094) for on-shelf, and 0.136 (SD = 0.075) for off-shelf. These predicted values were then used to account for availability bias in abundance estimates for the species over a large area in the Northeast Atlantic, derived through distance sampling using aerial survey data collected in 2015 and 2016 and modelled with density surface models. Further, we compared abundance estimates corrected with model-predicted availability to uncorrected estimates and to estimates that incorporated the average time the sharks were available for detection. The mean abundance (number of individuals) corrected with modelled availability was 15,320 (CV = 0.28) in 2015 and 11,001 (CV = 0.27) in 2016. Depending on the year, these estimates were ~7 times higher compared to estimates without the bias correction, and ~3 times higher compared to the abundances corrected with average availability. When the survey area contains habitat heterogeneity that may affect surfacing patterns of animals, modelling animals' availability provides a robust alternative to correcting for availability bias and highlights the need for caution when applying "average" correction factors.


Assuntos
Comportamento Animal , Modelos Biológicos , Tecnologia de Sensoriamento Remoto , Tubarões , Animais , Oceano Atlântico , Irlanda , Densidade Demográfica , Comunicações Via Satélite , Natação , Fatores de Tempo
9.
J Vet Diagn Invest ; 30(5): 733-738, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30027822

RESUMO

Cancer is a complex disease involving genetic and phenotypic changes. Several single nucleotide polymorphisms (SNPs) have been associated with the risk of breast cancer development in women; however, little is known regarding their influence on canine mammary tumor risk. We assessed the influence of SNPs in genes related to human breast cancer susceptibility, with respect to the risk of development of mammary tumors in dogs. Sixty-seven canine SNPs in proto-oncogenes, tumor suppressor genes, genes involved in DNA repair, and in hormonal metabolism were evaluated in 212 bitches with mammary tumors and in 161 bitches free of mammary neoplasia. A significant association with mammary neoplasia risk was identified for 2 SNPs in RAD51 ( rs23623251 and rs23642734) and one SNP in the STK11 gene ( rs22928814). None of the other SNPs were related to the risk of mammary tumor development. The identification of genetic profiles associated with risk of mammary neoplasia is of great importance, supporting the implementation of specific clinical management strategies in high-risk animals.


Assuntos
Suscetibilidade a Doenças/epidemiologia , Doenças do Cão/genética , Neoplasias Mamárias Animais/genética , Polimorfismo de Nucleotídeo Único , Proteínas Serina-Treonina Quinases/genética , Rad51 Recombinase/genética , Animais , Cães , Feminino , Proteínas Serina-Treonina Quinases/metabolismo , Rad51 Recombinase/metabolismo
11.
BMC Vet Res ; 14(1): 60, 2018 Feb 27.
Artigo em Inglês | MEDLINE | ID: mdl-29486759

RESUMO

BACKGROUND: In birds there are reports of intracranial lesions but not of the clinical, computed tomographic and histopathologic features of acute intraparenchymal cerebral haemorrhage in Iberian golden eagle. CASE PRESENTATION: The following report describes a case of a 30-year-old Iberian golden eagle (Aquila chrysaetos homeyeri) with no history of trauma, presented with acute opisthotonus, left head tilt and circling, anisocoria, positional nystagmus, and ataxia. The main differential diagnosis were hypovitaminosis B or E and intracranial disease due to trauma, infection, toxins or masses. A computed tomography (CT) of the head was performed with an 8-slices scanner and evidenced a hyperdense (63-65 HU) non-enhancing homogeneous well delineated round area in the midbrain, with 6 mm in its highest diameter. The attenuation values and the non-enhancing nature of the lesion strongly suggested the diagnosis of acute intraparenchymal haemorrhage, which was histologically confirmed after necropsy. CONCLUSIONS: In birds with a central neurological dysfunction, the diagnosis of acute brain haemorrhage should be considered when the CT evidences a non-enhancing, homogeneous, well circumscribed hyperattenuated round area.


Assuntos
Doenças das Aves/diagnóstico , Hemorragia Cerebral/veterinária , Águias , Animais , Animais de Zoológico , Doenças das Aves/diagnóstico por imagem , Doenças das Aves/patologia , Encéfalo/diagnóstico por imagem , Encéfalo/patologia , Hemorragia Cerebral/diagnóstico , Hemorragia Cerebral/diagnóstico por imagem , Hemorragia Cerebral/patologia , Neuroimagem/veterinária , Tomografia Computadorizada por Raios X/veterinária
12.
J Obstet Gynaecol ; 38(7): 979-984, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29553853

RESUMO

The use of long-acting contraceptive methods is on the rise. The aim of this study was to describe the main variables (effectiveness, tolerability, menstrual bleeding) associated with the use of subdermal contraceptive implants and to investigate the influence of age on these variables. This was a descriptive, retrospective, observational study of 221 cases of contraceptive implants inserted at a Spanish hospital between 2006 and 2015. The mean age of implant users was 31.2 ± 7.5 years. Effectiveness was 100% and good tolerability was recorded for 86.5%. Infrequent bleeding was the most common bleeding pattern, followed by amenorrhoea. Of the 221 implants inserted, 47.5% were removed. The main reasons were expiration (54.3%) and discomfort due to bleeding alterations and other adverse effects (25.7%). Nulliparity and weight gain were significantly associated with an increased probability of implant removal. This study shows that implants were highly effective, safe and well-tolerated in our population. The age of users had no influence on any of the study variables analysed. Impact Statement What is already known on this subject? Subdermal contraceptive implants are long-acting reversible contraceptives which are both safe and effective. What do the results of this study add? The age of users had no influence on any of the study variables analysed. Nulliparity and weight gain were significantly associated with an increased probability of implant removal. What are the implications of these findings for clinical practice and/or further research? Subdermal contraceptive implants were a safe and effective long-acting progestin contraceptive method for women from all age groups in our series because no significant age-related differences were observed for the tolerability, vaginal bleeding patterns, the effectiveness, the adverse effects or any other variables.


Assuntos
Anticoncepcionais Femininos/efeitos adversos , Desogestrel/efeitos adversos , Implantes de Medicamento/efeitos adversos , Levanogestrel/efeitos adversos , Contracepção Reversível de Longo Prazo/efeitos adversos , Adulto , Anticoncepcionais Femininos/administração & dosagem , Anticoncepcionais Femininos/farmacologia , Desogestrel/administração & dosagem , Desogestrel/farmacologia , Remoção de Dispositivo/estatística & dados numéricos , Implantes de Medicamento/administração & dosagem , Feminino , Humanos , Levanogestrel/administração & dosagem , Levanogestrel/farmacologia , Menstruação/efeitos dos fármacos , Estudos Retrospectivos , Adulto Jovem
14.
Sci Rep ; 8(1): 3126, 2018 02 15.
Artigo em Inglês | MEDLINE | ID: mdl-29449646

RESUMO

Heterogeneous data collection in the marine environment has led to large gaps in our knowledge of marine species distributions. To fill these gaps, models calibrated on existing data may be used to predict species distributions in unsampled areas, given that available data are sufficiently representative. Our objective was to evaluate the feasibility of mapping cetacean densities across the entire Mediterranean Sea using models calibrated on available survey data and various environmental covariates. We aggregated 302,481 km of line transect survey effort conducted in the Mediterranean Sea within the past 20 years by many organisations. Survey coverage was highly heterogeneous geographically and seasonally: large data gaps were present in the eastern and southern Mediterranean and in non-summer months. We mapped the extent of interpolation versus extrapolation and the proportion of data nearby in environmental space when models calibrated on existing survey data were used for prediction across the entire Mediterranean Sea. Using model predictions to map cetacean densities in the eastern and southern Mediterranean, characterised by warmer, less productive waters, and more intense eddy activity, would lead to potentially unreliable extrapolations. We stress the need for systematic surveys of cetaceans in these environmentally unique Mediterranean waters, particularly in non-summer months.

15.
Sci Rep ; 7(1): 2025, 2017 05 17.
Artigo em Inglês | MEDLINE | ID: mdl-28515419

RESUMO

The ocean sunfish, Mola mola, is the largest teleost fish in the world. Despite being found in all oceans of the world, little is known about its abundance and factors driving its distribution. In this study we provide the first abundance estimates for sunfish in offshore waters in the northeast Atlantic and the first record of extensive sunfish presence in these waters year-round. Abundance estimates and predictive distributions for sunfish in approximately 300,000 km² of the northeast Atlantic were derived from large scale offshore aerial surveys in 2015-2016 using distance sampling techniques. Generalized additive models of sunfish density were fitted to survey data from 17,360 km of line transect effort resulting in minimum abundance estimates of 12,702 (CI: 9,864-16,357) in the summer (Density = 0.043 ind/km²) and 8,223 individuals (CI: 6,178-10,946) (Density = 0.028 ind/km²) in the winter. Density surface models predicted seasonal shifts in distribution and highlighted the importance of the mixed layer depth, possibly related to thermoregulation following deep foraging dives. The abundance estimate and estimated daily consumption of 2,600 tonnes of jellyfish in the northeast Atlantic highlights the need to re-assess the importance of this species in the pelagic ecosystem, and its role in top-down control of jellyfish blooms.


Assuntos
Perciformes , Densidade Demográfica , Estações do Ano , Animais , Oceano Atlântico , Ecossistema , Modelos Teóricos
17.
PLoS One ; 10(11): e0141189, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26580814

RESUMO

The giant devil ray Mobula mobular, the only Mediterranean mobulid, is subject to mortality caused by directed and accidental captures in fisheries throughout the region. Whilst the combination of human impacts, limited range and a low reproductive potential is not inconsistent with its endangered listing, there are insufficient data to enable a quantitative assessment of trends. Without this, it is difficult to assess and prioritise threats and develop effective conservation actions. Using results from aerial surveys conducted between 2009 and 2014 over the Ligurian, Corsican, Sardinian, northern and central Tyrrhenian seas (626,228 km2), this study provides the first quantitative information on giant devil ray abundance and habitat choice in the western Mediterranean. Devil rays were observed in all seasons except winter, with their estimated abundance in the study area peaking in summer. The overall uncorrected mean density in the study area during summer was estimated at 0.0257 individuals km-2 (range: 0.017-0.044), resulting in a total abundance estimate of 6,092 (12.7%CV) individuals at the surface; once corrected for availability bias, this estimate indicates a summer presence of >12,700 devil rays in the study area. Rays were mostly observed alone even if occasionally, larger aggregations up to a maximum of 18 individuals were observed. Although observed throughout the study area, spatial modelling identified their preferred habitat to be over a broad strip connecting the Tuscan Archipelago to Eastern Sardinia, over a wide range of water depths ranging from 10 to 2000m. The observed seasonal changes in giant devil ray distribution in this study, combined with similar evidence from other areas in the Mediterranean, support the hypothesis that the species undertakes latitudinal migrations across the region, taking advantage of highly productive waters in the north during summer, and warmer southern waters during winter.


Assuntos
Distribuição Animal/fisiologia , Reprodução/fisiologia , Rajidae/fisiologia , Animais , Conservação dos Recursos Naturais , Ecossistema , Espécies em Perigo de Extinção , Feminino , Masculino , Mar Mediterrâneo , Densidade Demográfica , Estações do Ano
18.
Prog. obstet. ginecol. (Ed. impr.) ; 58(8): 368-372, oct. 2015. ilus
Artigo em Espanhol | IBECS | ID: ibc-141297

RESUMO

Introducción. La muerte fetal intrauterina es una de las situaciones más difíciles de enfrentar en la práctica obstétrica diaria. Esta condición es bien caracterizada como un duelo. Especial énfasis debe ser otorgado al apoyo psicológico brindado especialmente a la madre. Sujetos y métodos. Se presenta el caso clínico de una primigesta de 40 semanas diagnosticada de muerte fetal anteparto. Ilustramos las etapas del duelo y su manejo clínico. Conclusiones. Consideramos interesante establecer protocolos y directrices bien planificadas sobre el cuidado de la madre y de la pareja durante la pérdida gestacional (AU)


Introduction. Intrauterine fetal death is one of the most difficult situations to face in daily obstetric practice. This condition is well characterized as a bereavement. Special emphasis should be given to the provision of psychological support, especially to the mother. Subjects and methods. We report the case of a primigravida at 40 weeks of pregnancy who was diagnosed with an antepartum stillbirth. We illustrate the stages of grief and their clinical management. Conclusions. Protocols and guidelines should be designed for the care of the mother and her partner during pregnancy loss (AU)


Assuntos
Feminino , Humanos , Gravidez , Morte Fetal/etiologia , Morte Fetal/prevenção & controle , Cardiotocografia/instrumentação , Cardiotocografia/métodos , Cardiotocografia , Cesárea/métodos , Cesárea/psicologia , Morte Perinatal , Mortalidade Perinatal , Pesar , Psicologia Clínica , Apoio Social , Estresse Psicológico/psicologia , Consentimento Livre e Esclarecido/ética , Consentimento Livre e Esclarecido/psicologia , Consentimento Livre e Esclarecido/normas
19.
Med. clín (Ed. impr.) ; 143(12): 521-529, dic. 2014. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-130281

RESUMO

Fundamento y objetivo: Realizar la validación psicométrica en la población española de la escala Overactive Bladder Awareness Tool (OAB-V8), y de su versión abreviada, OAB-V3, para la detección de pacientes con probable vejiga hiperactiva (VH). Pacientes y método: Estudio transversal en población general > 18 años realizado por vía telemática (Internet) sobre una población representativa de la prevalencia de VH en la población española. Las propiedades evaluadas incluyeron factibilidad, fiabilidad y validez. Los sujetos incluidos fueron clasificados según la probabilidad de VH usando un algoritmo automatizado validado previamente. Se realizó análisis de curvas ROC y se determinaron sensibilidad, especificidad, y valores predictivos positivo y negativo. Resultados: Se incluyeron 2.035 sujetos, con una edad media + DE de 52,7 + 12,1 años (50,8% varones). El 13,7% fue clasificado como «Probable»; el 27,9% como «Posible» y el 58,3% como «No» VH. La consistencia interna para las escalas OAB-V8 y OAB-V3 fue alta (0,894 y 0,851 respectivamente), con correlaciones ítem-total asimismo elevadas en ambos casos (0,87-0,88 y 0,71-0,83 respectivamente). Ambas escalas fueron fiables con coeficientes de correlación intraclase de 0,826 (intervalo de confianza del 95%: 0,695-0,901) y 0,828 (intervalo de confianza del 95%: 0,623-0,922), respectivamente. El punto de corte óptimo en la escala OAB-V8 para identificar probable VH fue ≥ 8 puntos (área bajo la curva 0,895; sensibilidad 0,875 y especificidad 0,735), mientras que en la OAB-V3 fue ≥ 3 (área bajo la curva 0,910, sensibilidad 0,828 y especificidad 0,825). Conclusión: Las escalas OAB-V8 y OAB-V3 resultaron ser herramientas útiles de cribado autoadministrado por vía telemática, factibles, fiables y válidas para la detección de pacientes con probable VH en la población general en España (AU)


Background and objective: To perform the psychometric validation in the Spanish population of the Overactive Bladder Awareness Tool (OAB-V8) scale and its abbreviated version OAB-V3 for screening patients with probable overactive bladder (OAB). Patients and methods: A cross-sectional study was conducted in a population aged over 18 years, which was representative of the prevalence of OAB in Spain using an online methodology (Internet survey). Psychometric properties included feasibility, reliability, and validity. Subjects were classified according to the likelihood of OAB, using an automated algorithm validated previously. ROC curve analysis was performed, and the sensitivity, specificity, and positive and negative predictive values were also assessed. Results: A total of 2,035 subjects with a mean + SD age of 52.7 + 12.1 years were included (50.8%) men. In total 13.7% were classified as «Probable», 27.9% «Possible», and 58.3% «No» OAB. The internal consistency of both OAB-V8 and OAB-V3 scales was high (0.894 and 0.851, respectively). The item-total correlation coefficients were high; 0.87-0.88 and 0.71-0.83, respectively. Intraclass correlation coefficient for OAB-V8 was 0.826 (confidence interval 95% 0.695-0.901) and it was 0.828 (confidence interval 0.623-0.922) for OAB-V3. The optimum cut-off value of OAB-V8 for detecting probable OAB was ≥ 8 points (AUC = 0.895, sensitivity 0.875, specificity 0.735), while for the OAB-V3 it was ≥ 3 (AUC = 0.910, sensitivity 0.828, specificity 0.825). Conclusion: Both OAB-V8 and OAB-V3 scales were considered useful online self-administered screening tools, which were also feasible, reliable and valid for the detection of patients with probable OAB in the general population in Spain (AU)


Assuntos
Humanos , Psicometria/instrumentação , Bexiga Urinária Hiperativa/epidemiologia , Reprodutibilidade dos Testes , Programas de Rastreamento/métodos , Qualidade de Vida
20.
Ginecol Obstet Mex ; 82(10): 688-96, 2014 Oct.
Artigo em Espanhol | MEDLINE | ID: mdl-25510060

RESUMO

Acquired hemophilia A is a truly exceptional hemorrhagic diathesis, that consists of the emergence of polyclonal autoantibodies (inhibitor) IgG-type (subclasses 1 and 4, in most cases) against the coagulant function of the circulating factor VIII, which acts in the domains C2, A2 and A3 of the molecule, thus interfering their interaction with the factor IXa, the phospholipids and the Von Willebrand factor. Its morbidity and mortality are high, but nevertheless its low incidence (1-1.5 cases per million population per year) is the most frequent autoimmune disorder. This paper reports the clinical case of two patients; the first one, 36 years old, who the tenth day of postpartum required re-entry due to a diagnosis of hematoma of the abdominal wall that was surgically drained twice. The patient of case 2 was 39 years old and at six days of postpartum went to the emergency room due to bleeding, she was underwent to curettage and therapeutic transfusion of 3 UCH. Because of the persistence of bleeding, which was not possible to control with medical treatment and conservative measures, therapeutic hysterectomy was performed, with blood transfusion later. Due to the hemorrhagic complications of this condition and the serious clinical consequences derived from them, it is important to establish an early diagnosis; it is therefore critical to know the existence of this very rare disease to be able to avoid its consequences.


Assuntos
Hemofilia A/diagnóstico , Hemofilia A/terapia , Transtornos Puerperais/diagnóstico , Transtornos Puerperais/terapia , Adulto , Feminino , Humanos
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