Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 111
Filtrar
1.
Acta Neuropathol Commun ; 9(1): 21, 2021 02 04.
Artigo em Inglês | MEDLINE | ID: mdl-33541434

RESUMO

Amyotrophic lateral sclerosis (ALS) is a progressive fatal neurodegenerative disease that affects motoneurons. Mutations in superoxide dismutase 1 (SOD1) have been described as a causative genetic factor for ALS. Mice overexpressing ALS-linked mutant SOD1 develop ALS symptoms accompanied by histopathological alterations and protein aggregation. The protein disulfide isomerase family member ERp57 is one of the main up-regulated proteins in tissue of ALS patients and mutant SOD1 mice, whereas point mutations in ERp57 were described as possible risk factors to develop the disease. ERp57 catalyzes disulfide bond formation and isomerization in the endoplasmic reticulum (ER), constituting a central component of protein quality control mechanisms. However, the actual contribution of ERp57 to ALS pathogenesis remained to be defined. Here, we studied the consequences of overexpressing ERp57 in experimental ALS using mutant SOD1 mice. Double transgenic SOD1G93A/ERp57WT animals presented delayed deterioration of electrophysiological activity and maintained muscle innervation compared to single transgenic SOD1G93A littermates at early-symptomatic stage, along with improved motor performance without affecting survival. The overexpression of ERp57 reduced mutant SOD1 aggregation, but only at disease end-stage, dissociating its role as an anti-aggregation factor from the protection of neuromuscular junctions. Instead, proteomic analysis revealed that the neuroprotective effects of ERp57 overexpression correlated with increased levels of synaptic and actin cytoskeleton proteins in the spinal cord. Taken together, our results suggest that ERp57 operates as a disease modifier at early stages by maintaining motoneuron connectivity.

2.
Front Immunol ; 11: 611004, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33343585

RESUMO

Background: SARS-CoV-2 infection represents a global health problem that has affected millions of people. The fine host immune response and its association with the disease course have not yet been fully elucidated. Consequently, we analyze circulating B cell subsets and their possible relationship with COVID-19 features and severity. Methods: Using a multiparametric flow cytometric approach, we determined B cell subsets frequencies from 52 COVID-19 patients, grouped them by hierarchical cluster analysis, and correlated their values with clinical data. Results: The frequency of CD19+ B cells is increased in severe COVID-19 compared to mild cases. Specific subset frequencies such as transitional B cell subsets increase in mild/moderate cases but decrease with the severity of the disease. Memory B compartment decreased in severe and critical cases, and antibody-secreting cells are increased according to the severity of the disease. Other non-typical subsets such as double-negative B cells also showed significant changes according to disease severity. Globally, these differences allow us to identify severity-associated patient clusters with specific altered subsets. Finally, respiratory parameters, biomarkers of inflammation, and clinical scores exhibited correlations with some of these subpopulations. Conclusions: The severity of COVID-19 is accompanied by changes in the B cell subpopulations, either immature or terminally differentiated. Furthermore, the existing relationship of B cell subset frequencies with clinical and laboratory parameters suggest that these lymphocytes could serve as potential biomarkers and even active participants in the adaptive antiviral response mounted against SARS-CoV-2.


Assuntos
Subpopulações de Linfócitos B , Adulto , Idoso , Idoso de 80 Anos ou mais , Subpopulações de Linfócitos B/imunologia , Subpopulações de Linfócitos B/metabolismo , Subpopulações de Linfócitos B/patologia , /imunologia , Feminino , Citometria de Fluxo , Humanos , Masculino , Pessoa de Meia-Idade , /metabolismo , Índice de Gravidade de Doença
3.
Lancet ; 396(10257): 1071-1078, 2020 10 10.
Artigo em Inglês | MEDLINE | ID: mdl-32987008

RESUMO

BACKGROUND: Multiple major health organisations recommend the use of extracorporeal membrane oxygenation (ECMO) support for COVID-19-related acute hypoxaemic respiratory failure. However, initial reports of ECMO use in patients with COVID-19 described very high mortality and there have been no large, international cohort studies of ECMO for COVID-19 reported to date. METHODS: We used data from the Extracorporeal Life Support Organization (ELSO) Registry to characterise the epidemiology, hospital course, and outcomes of patients aged 16 years or older with confirmed COVID-19 who had ECMO support initiated between Jan 16 and May 1, 2020, at 213 hospitals in 36 countries. The primary outcome was in-hospital death in a time-to-event analysis assessed at 90 days after ECMO initiation. We applied a multivariable Cox model to examine whether patient and hospital factors were associated with in-hospital mortality. FINDINGS: Data for 1035 patients with COVID-19 who received ECMO support were included in this study. Of these, 67 (6%) remained hospitalised, 311 (30%) were discharged home or to an acute rehabilitation centre, 101 (10%) were discharged to a long-term acute care centre or unspecified location, 176 (17%) were discharged to another hospital, and 380 (37%) died. The estimated cumulative incidence of in-hospital mortality 90 days after the initiation of ECMO was 37·4% (95% CI 34·4-40·4). Mortality was 39% (380 of 968) in patients with a final disposition of death or hospital discharge. The use of ECMO for circulatory support was independently associated with higher in-hospital mortality (hazard ratio 1·89, 95% CI 1·20-2·97). In the subset of patients with COVID-19 receiving respiratory (venovenous) ECMO and characterised as having acute respiratory distress syndrome, the estimated cumulative incidence of in-hospital mortality 90 days after the initiation of ECMO was 38·0% (95% CI 34·6-41·5). INTERPRETATION: In patients with COVID-19 who received ECMO, both estimated mortality 90 days after ECMO and mortality in those with a final disposition of death or discharge were less than 40%. These data from 213 hospitals worldwide provide a generalisable estimate of ECMO mortality in the setting of COVID-19. FUNDING: None.


Assuntos
Betacoronavirus , Infecções por Coronavirus/terapia , Oxigenação por Membrana Extracorpórea , Pneumonia Viral/terapia , Insuficiência Respiratória/terapia , Adulto , Estudos de Coortes , Infecções por Coronavirus/complicações , Infecções por Coronavirus/mortalidade , Cuidados Críticos , Feminino , Mortalidade Hospitalar , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/complicações , Pneumonia Viral/mortalidade , Sistema de Registros , Insuficiência Respiratória/mortalidade , Insuficiência Respiratória/virologia , Resultado do Tratamento
4.
World J Plast Surg ; 9(2): 213-218, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32934935

RESUMO

BACKGROUND: Carpal tunnel syndrome is the most common peripheral neuropathy affecting patients at productive age and has an important economical impact on those who suffer it. This study assessed the diagnostic performance of carpal tunnel syndrome´s signs and described the epidemiology at a tertiary care center in Mexico City. METHODS: All patients diagnosed with carpal tunnel syndrome during a five-year period were included. Demographic data, electromyography results, positive clinical signs and the severity score according to the Italian scale were recorded. Diagnostic accuracy of Tinel and Phalen´s signs were calculated via odds ratio. RESULTS: Totally, 650 patients were diagnosed and treated during a five-year period, 84% were female and 16% male, and the mean age was 55.8 years. The associated comorbidities were trigger finger (36.1%), thyroid disease (25.6%) and diabetes (20%). Diagnosis yielded for Phalen and Tinel signs were variable in each of the study groups (males and females) and showed to be beneficial in diagnosis of the disease. CONCLUSION: Carpal tunnel syndrome is a complex disease in which clinical signs remain the cornerstone of diagnosis. Extension studies are useful to assess the severity of the disease.

5.
Rev Med Chil ; 148(3): 349-361, 2020 Mar.
Artigo em Espanhol | MEDLINE | ID: mdl-32730380

RESUMO

ECMO (Extracorporeal Membrane Oxygenation) is an extracorporeal life support system in catastrophic lung failure, shock and cardiopulmonary resuscitation, in different age groups, with multiple physiologic features. When the candidate to be submitted is too unstable to be transported to a hospital with ECMO, cannulation before transfer allows stabilization and subsequent transport. The aim of this article is to review the current concepts of extracorporeal support, its indications, national and international experience, and its possible role in the SARS-Cov2 pandemic.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/terapia , Oxigenação por Membrana Extracorpórea , Pneumonia Viral/epidemiologia , Pneumonia Viral/terapia , Adulto , Humanos , Pandemias
6.
Nature ; 583(7814): 39-42, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32612222

RESUMO

The interiors of giant planets remain poorly understood. Even for the planets in the Solar System, difficulties in observation lead to large uncertainties in the properties of planetary cores. Exoplanets that have undergone rare evolutionary processes provide a route to understanding planetary interiors. Planets found in and near the typically barren hot-Neptune 'desert'1,2 (a region in mass-radius space that contains few planets) have proved to be particularly valuable in this regard. These planets include HD149026b3, which is thought to have an unusually massive core, and recent discoveries such as LTT9779b4 and NGTS-4b5, on which photoevaporation has removed a substantial part of their outer atmospheres. Here we report observations of the planet TOI-849b, which has a radius smaller than Neptune's but an anomalously large mass of [Formula: see text] Earth masses and a density of [Formula: see text] grams per cubic centimetre, similar to Earth's. Interior-structure models suggest that any gaseous envelope of pure hydrogen and helium consists of no more than [Formula: see text] per cent of the total planetary mass. The planet could have been a gas giant before undergoing extreme mass loss via thermal self-disruption or giant planet collisions, or it could have avoided substantial gas accretion, perhaps through gap opening or late formation6. Although photoevaporation rates cannot account for the mass loss required to reduce a Jupiter-like gas giant, they can remove a small (a few Earth masses) hydrogen and helium envelope on timescales of several billion years, implying that any remaining atmosphere on TOI-849b is likely to be enriched by water or other volatiles from the planetary interior. We conclude that TOI-849b is the remnant core of a giant planet.

7.
Fungal Biol ; 124(5): 501-508, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32389313

RESUMO

Circadian clocks are autonomous timers that are believed to confer organisms a selective advantage by enabling processes to occur at appropriate times of the day. In the model fungus Neurospora crassa, 20-40 % of its genes are reported to be under circadian regulation, as assayed in simple sugar media. Although it has been well-described that Neurospora efficiently deconstructs plant cell wall components, little is known regarding the status of the clock when Neurospora grows on cellulosic material, or whether such a clock has an impact on any of the genes involved in this process. Through luciferase-based reporters and fluorescent detection assays, we show that a clock is functioning when Neurospora grows on cellulose-containing wheat straw as the only carbon and nitrogen source. Additionally, we found that the major cellobiohydrolase encoding gene involved in plant cell wall deconstruction, cbh-1, is rhythmically regulated by the Neurospora clock, in a manner that depends on cellulose concentration and on the transcription factor CRE-1, known as a key player in carbon-catabolite repression in this fungus. Our findings are a step towards a more comprehensive understanding on how clock regulation modulates cellulose degradation, and thus Neurospora's physiology.

8.
Rev Panam Salud Publica ; 44: e20, 2020.
Artigo em Espanhol | MEDLINE | ID: mdl-32256545

RESUMO

Objective: To identify the food industry's arguments against front-of-package nutrition labels in Uruguay. Methods: Content analysis and inductive coding were applied to the comments made by the food industry during the public consultation on the draft decree regulating the inclusion of front-of-package nutrition labels (warnings) in Uruguay. Results: Most of the comments expressed concern about the high prevalence of obesity and noncommunicable diseases in the country and emphasized a commitment to implementing actions to help combat these health problems. However, 81% of the comments disagreed with the draft decree presented for public consultation; these included general criticisms of its validity. The content of the comments related to seven areas: lack of rationale for the measure; violation of international commitments; criticisms of the warning system; discrimination against industrialized packaged food; criticisms of the nutrient profile model; other criticisms of aspects specific to the draft decree; and adverse economic effects. For each area, there is discussion of the technical and normative relevance and consistency of the content presented by the industry representatives. Conclusions: Despite apparent agreement about the need to adopt measures, it is clear that the food industry is strongly opposed to the policy and, in particular, to the warning system. The results of this analysis may help to facilitate the process of implementing similar regulations in other countries.

9.
Rev. méd. Chile ; 148(3): 349-361, mar. 2020. tab, graf
Artigo em Espanhol | LILACS | ID: biblio-1115799

RESUMO

ECMO (Extracorporeal Membrane Oxygenation) is an extracorporeal life support system in catastrophic lung failure, shock and cardiopulmonary resuscitation, in different age groups, with multiple physiologic features. When the candidate to be submitted is too unstable to be transported to a hospital with ECMO, cannulation before transfer allows stabilization and subsequent transport. The aim of this article is to review the current concepts of extracorporeal support, its indications, national and international experience, and its possible role in the SARS-Cov2 pandemic.


Assuntos
Humanos , Adulto , Pneumonia Viral/terapia , Pneumonia Viral/epidemiologia , Oxigenação por Membrana Extracorpórea , Infecções por Coronavirus/terapia , Infecções por Coronavirus/epidemiologia , Pandemias
10.
Artigo em Espanhol | PAHO-IRIS | ID: phr-51931

RESUMO

[RESUMEN]. Objetivo. Identificar los argumentos de la industria alimentaria en contra del etiquetado frontal de advertencias nutricionales en Uruguay. Métodos. Se realizó un análisis de contenido de los comentarios de la industria alimentaria recibidos durante la consulta pública implementada durante el proceso de diseño del decreto que reglamenta la inclusión de rotulación nutricional frontal basada en advertencias en Uruguay mediante una codificación inductiva. Resultados. La mayoría de los comentarios manifestaron la preocupación por la elevada prevalencia de obesidad y enfermedades no transmisibles en el país y destacaron el compromiso con la implementación de acciones que contribuyan a combatir esta problemática de salud. Sin embargo, 81% de los comentarios planteó desacuerdo con la propuesta de decreto elevada a consulta pública y realizó críticas generales sobre su validez. El contenido de los comentarios se relacionó con siete dimensiones: falta de justificación de la medida, violación de compromisos internacionales, críticas al sistema de advertencias, discriminación a alimentos industrializados envasados, críticas al modelo de perfil de nutrientes, otras críticas a aspectos específicos del proyecto de decreto y efectos económicos negativos. En cada dimensión se discute la pertinencia y consistencia técnica y normativa de los contenidos vertidos por los representantes de la industria. Conclusiones. Bajo un aparente acuerdo con la necesidad de adoptar medidas, se evidenció, sin embargo, una fuerte oposición a la política y en particular al sistema de advertencias por parte de la industria alimentaria. Los resultados del análisis aportan insumos para facilitar el proceso de implementación de regulaciones similares en otros países.


[ABSTRACT]. Objective. To identify the food industry’s arguments against front-of-package nutrition labels in Uruguay. Methods. Content analysis and inductive coding were applied to the comments made by the food industry during the public consultation on the draft decree regulating the inclusion of front-of-package nutrition labels (warnings) in Uruguay. Results. Most of the comments expressed concern about the high prevalence of obesity and noncommunicable diseases in the country and emphasized a commitment to implementing actions to help combat these health problems. However, 81% of the comments disagreed with the draft decree presented for public consultation; these included general criticisms of its validity. The content of the comments related to seven areas: lack of rationale for the measure; violation of international commitments; criticisms of the warning system; discrimination against industrialized packaged food; criticisms of the nutrient profile model; other criticisms of aspects specific to the draft decree; and adverse economic effects. For each area, there is discussion of the technical and normative relevance and consistency of the content presented by the industry representatives. Conclusions. Despite apparent agreement about the need to adopt measures, it is clear that the food industry is strongly opposed to the policy and, in particular, to the warning system. The results of this analysis may help to facilitate the process of implementing similar regulations in other countries.


[RESUMO]. Objetivo. Identificar os argumentos da indústria alimentícia contra a rotulagem frontal de advertência nutricional no Uruguai. Métodos. Realizou-se uma análise do conteúdo dos comentários de representantes da indústria alimentícia obtidos em uma consulta pública conduzida no Uruguai durante o processo de elaboração do decreto para regulamentar a inclusão de rotulagem frontal de advertência nutricional com uso de códigos indutivos. Resultados. Os comentários, na sua maioria, revelaram preocupação com a alta prevalência de obesidade e doenças crônicas não transmissíveis no país e destacaram o compromisso com a implementação de ações para combater estes problemas de saúde. No entanto, verificou-se que, em 81% dos comentários, os participantes discordavam da proposta do decreto apresentada na consulta pública e teceram críticas gerais quanto à sua validade. Observaram-se sete dimensões distintas no conteúdo dos comentários: falta de justificação da medida, descumprimento de compromissos internacionais, críticas ao sistema de advertência, discriminação de alimentos industrializados em embalagens, críticas ao modelo de perfil nutricional, outras críticas relativas a aspectos específicos do projeto do decreto e repercussão econômica negativa. Para cada dimensão, foram discutidas a relevância e a coerência técnica e normativa do conteúdo dos comentários feitos pelos representantes da indústria. Conclusões. Apesar de uma suposta concordância quanto à necessidade de adotar medidas, observou-se uma firme oposição da indústria alimentícia à política e, em particular, ao sistema de advertência nutricional propostos. Os resultados desta análise servem para facilitar o processo de implementação de regulamentações semelhantes em outros países.


Assuntos
Rotulagem Nutricional , Rotulagem de Alimentos , Política Pública , Programas e Políticas de Nutrição e Alimentação , Informação Nutricional , Uruguai , Rotulagem Nutricional , Rotulagem de Alimentos , Política Pública , Programas e Políticas de Nutrição e Alimentação , Informação Nutricional , Rotulagem Nutricional , Rotulagem de Alimentos , Programas e Políticas de Nutrição e Alimentação , Informação Nutricional , Uruguai
11.
FEBS J ; 287(16): 3449-3471, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31958362

RESUMO

B lymphocytes are a leukocyte subset capable of developing several functions apart from differentiating into antibody-secreting cells. These processes are triggered by external activation signals that induce changes in the plasma membrane properties, regulated by the formation of different lipid-bilayer subdomains that are associated with the underlying cytoskeleton through different linker molecules, thus allowing the functional specialization of regions within the membrane. Among these, there are tetraspanin-enriched domains. Tetraspanins constitute a superfamily of transmembrane proteins that establish lateral associations with other molecules, determining its activity and localization. In this study, we identified TSPAN33 as an active player during B-lymphocyte cytoskeleton and plasma membrane-related phenomena, including protrusion formation, adhesion, phagocytosis, and cell motility. By using an overexpression model of TSPAN33 in human Raji cells, we detected a specific distribution of this protein that includes membrane microvilli, the Golgi apparatus, and extracellular vesicles. Additionally, we identified diminished phagocytic ability and altered cell adhesion properties due to the aberrant expression of integrins. Accordingly, these cells presented an enhanced migratory phenotype, as shown by its augmented chemotaxis and invasion rates. When we evaluated the mechanic response of cells during fibronectin-induced spreading, we found that TSPAN33 expression inhibited changes in roughness and membrane tension. Contrariwise, TSPAN33 knockdown cells displayed opposite phenotypes to those observed in the overexpression model. Altogether, our data indicate that TSPAN33 represents a regulatory element of the adhesion and migration of B lymphocytes, suggesting a novel implication of this tetraspanin in the control of the mechanical properties of their plasma membrane.

12.
Aesthet Surg J ; 40(5): 551-559, 2020 04 14.
Artigo em Inglês | MEDLINE | ID: mdl-30957144

RESUMO

BACKGROUND: Hyaluronic acid fillers are the second-most commonly performed nonsurgical procedure. Arterial thrombosis is their most devastating complication. Recent research shows that along hyaluronic acid thrombi, a platelet/fibrin thrombus forms in the site of injection. This is not addressed by current management protocols, which focus on perivascular hyaluronidase plus adjuvant strategies to increase blood flow. We experimented with an animal model utilizing both hyaluronidase and a thrombolytic agent for treatment of occlusion. OBJECTIVES: The authors sought to evaluate the efficacy of a combined treatment of hyaluronidase with a thrombolytic agent applied perivascularly to an artery occluded with hyaluronic acid. METHODS: After direct intravascular injection into the femoral artery, rats were randomized to receive one of the following perivascular solutions: saline, hyaluronidase, alteplase, or hyaluronidase + alteplase. Reperfusion, distal bleeding, and microscopic findings were evaluated 4 hours after intervention. RESULTS: None of the subjects in the control group showed signs of reperfusion. In the hyaluronidase group, 60% reperfused, 10% completely, the rest only partially. In the alteplase group, 50% reperfused partially. In the hyaluronidase + alteplase group, 50% had partial and 50% complete prepermeabilization. Kruskal-Wallis test showed a P < 0.0001 favoring hyaluronidase + alteplase. Microscopic findings were compatible with bleeding rates. CONCLUSIONS: Both hyaluronic acid and red thrombi play a role in the occluded vessel. Perivascular application of hyaluronidase with a thrombolytic agent seems to achieve greater reperfusion rates than either one alone. If proven safe in humans, this strategy could make treatment more effective while still being suitable for an outpatient setting.

13.
Crit Care Med ; 48(3): 406-414, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31833901

RESUMO

OBJECTIVES: The purpose of this position paper is two-fold: first, to describe the state of extracorporeal membrane oxygenation education worldwide, noting current limitations and challenges; and second, to put forth an educational agenda regarding opportunities for an international collaborative approach toward standardization. DESIGN: Relevant medical literature was reviewed through literature search, and materials from national organizations were accessed through the Internet. Taskforce members generated a consensus statement using an iterative consensus process through teleconferences and electronic communication. SETTING: In 2018, the Extracorporeal Life Support Organization convened the ECMOed Taskforce at two structured, face-to-face meetings of 40 healthcare practitioners and educators with expertise in caring for the extracorporeal membrane oxygenation patient and in extracorporeal membrane oxygenation education. PATIENTS: None. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The ECMOed Taskforce identified seven educational domains that would benefit from international collaborative efforts. Of primary importance, the Taskforce outlined actionable items regarding 1) the creation of a standardized extracorporeal membrane oxygenation curriculum; 2) defining criteria for an extracorporeal membrane oxygenation course as a vehicle for delivering the curriculum; 3) outlining a mechanism for evaluating the quality of educational offerings; 4) utilizing validated assessment tools in the development of extracorporeal membrane oxygenation practitioner certification; and 5) promoting high-quality educational research to guide ongoing educational and competency assessment development. CONCLUSIONS: Significant variability and limitations in global extracorporeal membrane oxygenation education exist. In this position paper, we outline a road map for standardizing international extracorporeal membrane oxygenation education and practitioner certification. Ongoing high-quality educational research is needed to evaluate the impact of these initiatives.


Assuntos
Oxigenação por Membrana Extracorpórea/educação , Oxigenação por Membrana Extracorpórea/normas , Internacionalidade , Certificação/normas , Comportamento Cooperativo , Currículo , Humanos , Avaliação de Processos em Cuidados de Saúde , Estudos Retrospectivos
14.
Haemophilia ; 26(1): 97-105, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31823446

RESUMO

INTRODUCTION: Postpartum haemorrhage (PPH) is the main cause of maternal morbidity and mortality globally, but it is far more important in non-developed countries. PPH represents 25% of all maternal deaths worldwide. Women with von Willebrand disease (VWD) and other inherited haemorrhagic disorders are at increased risk of PPH. Our aim was to establish a probable association of severe PPH in women with a history of haemostatic abnormalities. METHODS: An observational, controlled study of adult women with a one or more episodes of severe PPH requiring treatment in an intensive care unit or >10 units of blood products during the 24-hour period after diagnosis and their controls. The tests performed were blood cell count, blood group, renal, viral, liver function and haemostatic tests, fibrinogen, activity of the plasma factors and specific test to diagnose and classify VWD. RESULTS: We included 124 women with 133 PPH events and their controls. The median age at the first event was 25.5 years old. Results were significantly different between the groups in terms of fibrinogen concentration, VWF:Ag, VWF:RCo and FVIII. A specific diagnosis was established in 69 (55.6) and 4 (3.2%) patients in the PPH group and controls, respectively. Of 61 patients with VWD, 57 had type 1, two had type 2A, and another two had type 2B. CONCLUSION: Our results show a relationship between PPH and inherited haemostatic disorders. VWD was the most frequent diagnosis. Appropriate and opportune diagnosis before pregnancy of inherited haemostatic disorders may be important to effectively prevent and treat PPH.


Assuntos
Transtornos de Proteínas de Coagulação/complicações , Hemostáticos/metabolismo , Hemorragia Pós-Parto/etiologia , Doenças de von Willebrand/complicações , Adulto , Feminino , Humanos , Gravidez , Adulto Jovem
15.
Rev. panam. salud pública ; 44: e20, 2020. tab
Artigo em Espanhol | LILACS | ID: biblio-1101767

RESUMO

RESUMEN Objetivo. Identificar los argumentos de la industria alimentaria en contra del etiquetado frontal de advertenciasnutricionales en Uruguay. Métodos. Se realizó un análisis de contenido de los comentarios de la industria alimentaria recibidos durante la consulta pública implementada durante el proceso de diseño del decreto que reglamenta la inclusión de rotulación nutricional frontal basada en advertencias en Uruguay mediante una codificación inductiva. Resultados. La mayoría de los comentarios manifestaron la preocupación por la elevada prevalencia de obesidad y enfermedades no transmisibles en el país y destacaron el compromiso con la implementación de acciones que contribuyan a combatir esta problemática de salud. Sin embargo, 81% de los comentarios planteó desacuerdo con la propuesta de decreto elevada a consulta pública y realizó críticas generales sobre su validez. El contenido de los comentarios se relacionó con siete dimensiones: falta de justificación de la medida, violación de compromisos internacionales, críticas al sistema de advertencias, discriminación a alimentos industrializados envasados, críticas al modelo de perfil de nutrientes, otras críticas a aspectos específicos del proyecto de decreto y efectos económicos negativos. En cada dimensión se discute la pertinencia y consistencia técnica y normativa de los contenidos vertidos por los representantes de la industria. Conclusiones. Bajo un aparente acuerdo con la necesidad de adoptar medidas, se evidenció, sin embargo, una fuerte oposición a la política y en particular al sistema de advertencias por parte de la industria alimentaria. Los resultados del análisis aportan insumos para facilitar el proceso de implementación de regulaciones similares en otros países.(AU)


ABSTRACT Objective. To identify the food industry's arguments against front-of-package nutrition labels in Uruguay. Methods. Content analysis and inductive coding were applied to the comments made by the food industry during the public consultation on the draft decree regulating the inclusion of front-of-package nutrition labels (warnings) in Uruguay. Results. Most of the comments expressed concern about the high prevalence of obesity and noncommunicable diseases in the country and emphasized a commitment to implementing actions to help combat these health problems. However, 81% of the comments disagreed with the draft decree presented for public consultation; these included general criticisms of its validity. The content of the comments related to seven areas: lack of rationale for the measure; violation of international commitments; criticisms of the warning system; discrimination against industrialized packaged food; criticisms of the nutrient profile model; other criticisms of aspects specific to the draft decree; and adverse economic effects. For each area, there is discussion of the technical and normative relevance and consistency of the content presented by the industry representatives. Conclusions. Despite apparent agreement about the need to adopt measures, it is clear that the food industry is strongly opposed to the policy and, in particular, to the warning system. The results of this analysis may help to facilitate the process of implementing similar regulations in other countries.(AU)


RESUMO Objetivo. Identificar os argumentos da indústria alimentícia contra a rotulagem frontal de advertência nutricional no Uruguai. Métodos. Realizou-se uma análise do conteúdo dos comentários de representantes da indústria alimentícia obtidos em uma consulta pública conduzida no Uruguai durante o processo de elaboração do decreto para regulamentar a inclusão de rotulagem frontal de advertência nutricional com uso de códigos indutivos. Resultados. Os comentários, na sua maioria, revelaram preocupação com a alta prevalência de obesidade e doenças crônicas não transmissíveis no país e destacaram o compromisso com a implementação de ações para combater estes problemas de saúde. No entanto, verificou-se que, em 81% dos comentários, os participantes discordavam da proposta do decreto apresentada na consulta pública e teceram críticas gerais quanto à sua validade. Observaram-se sete dimensões distintas no conteúdo dos comentários: falta de justificação da medida, descumprimento de compromissos internacionais, críticas ao sistema de advertência, discriminação de alimentos industrializados em embalagens, críticas ao modelo de perfil nutricional, outras críticas relativas a aspectos específicos do projeto do decreto e repercussão econômica negativa. Para cada dimensão, foram discutidas a relevância e a coerência técnica e normativa do conteúdo dos comentários feitos pelos representantes da indústria. Conclusões. Apesar de uma suposta concordância quanto à necessidade de adotar medidas, observou-se uma firme oposição da indústria alimentícia à política e, em particular, ao sistema de advertência nutricional propostos. Os resultados desta análise servem para facilitar o processo de implementação de regulamentações semelhantes em outros países.(AU)


Assuntos
Programas e Políticas de Nutrição e Alimentação , Informação Nutricional , Rotulagem Nutricional , Rotulagem de Alimentos/normas , Uruguai
16.
J Knee Surg ; 2019 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-31639849

RESUMO

Unicompartmental knee arthroplasty (UKA) represents 10% of knee arthroplasties. Advantages are better functional results, quicker recovery, shorter hospitalization time, and lower blood loss, among others. However, revision rates are larger than total knee arthroplasty. Among the most important factors that explain this are the implant position and alignment, and the correct surgical indication. Greater accuracy in the implant placement may improve clinical results and increase the rate of implant survival. The objective of this study is to evaluate the precision of the Navio robot-assisted system in the position and alignment of medial UKA compared with the conventional technique. This is an experimental pilot study. Twenty-six cadaveric models were randomized into 2 groups: Robot-Assisted surgery (R) and Conventional Surgery (C). Radiological study was performed pre- and post-surgery, evaluating the medial distal femoral angle (MDFA), medial proximal tibial angle (MPTA), tibial slope, tibiofemoral angle (TFA), sagittal femoral angle (SFA), and size of the femoral and tibial components. The main result measurement was the change in postoperative angulation. The results of this study are MDFA median of 1.07° (0.19-4.5) for group R and 0.12° (0.03-10.4) with a significant difference in variances; a Welch t-test of p = 0.013; and an MPTA of 1.28° (0.05-5.87) for R and 1.3°(0.08-14.1) for C with significantly different variances (p = 0.0064). Size of the femoral component has a difference of p < 0.05 between groups. No differences for dispersion of TFA nor for the size of the tibial component were observed. In conclusion, using robot-assisted UKA allows for greater accuracy in the positioning of the implants and in the prediction of the size of the femoral component.

17.
Rev. chil. ortop. traumatol ; 60(2): 67-76, oct. 2019. ilus
Artigo em Espanhol | LILACS | ID: biblio-1095956

RESUMO

La cirugía protésica de rodilla es un procedimiento ampliamente aceptado como etapa final del tratamiento de la artrosis de rodilla, con sobrevida que supera el 90% a 10­15 años. Dentro de las principales causas de fallo, se encuentran la infección (20,4%) y el aflojamiento mecánico (20,3%). El uso de ayudas tecnológicas en cirugía está en constante desarrollo, con el objetivo de mejorar la precisión del acto quirúrgico. En ese escenario, la Cirugía Asistida por Computador (CAS) en artroplastia de rodilla, crece de forma exponencial, y apunta a mejorar el posicionamiento y selección del tamaño de los componentes protésicos, aumentar la precisión de las resecciones óseas y mejorar el balance de los tejidos blandos, logrando así una mayor sobrevida del implante. En comparación a las técnicas convencionales, la cirugía robótica ha mostrado mejores resultados funcionales, al primer año de seguimiento, en términos de rango articular, menor dolor post-operatorio y menor tiempo de estadía hospitalaria. Pero todavía es necesario establecer si, a largo plazo, esas diferencias funcionales se traducirán en mejores resultados clínicos que permitan, de forma consistente, inclinar la balanza en favor de la técnica asistida por robot por sobre las técnicas tradicionales.


Prosthetic knee surgery is a widely accepted procedure as the final stage in the treatment of knee osteoarthritis, with survival rate over 90% at 10 - 15 years. Among the main causes of failure are infection (20.4%) and mechanical loosening (20.3%). The use of technological aids in surgery is in constant development, with the aim of improving the accuracy of the surgical act. In this scenario, Computer-Aided Surgery (CAS) in knee arthroplasty grows exponentially, and aims to improve the positioning and selection of the size of the prosthetic components, increase the accuracy of bone resections and improve the balance of soft tissues, thus achieving a greater survival of the implant. Compared to conventional techniques, robotic surgery has shown better functional results at the first year of follow-up, in terms of joint range, less post-operative pain and shorter hospital stay. It is still necessary to establish whether, in the long term, these functional differences will result in better clinical results that will allow - in a consistent manner - to tip the balance in favor of robot-assisted technique over traditional techniques.


Assuntos
Humanos , Artroplastia do Joelho/métodos , Osteoartrite do Joelho/cirurgia , Procedimentos Cirúrgicos Robóticos/instrumentação , Análise Custo-Benefício , Curva de Aprendizado , Procedimentos Cirúrgicos Robóticos/economia , Procedimentos Cirúrgicos Robóticos/educação
18.
Environ Entomol ; 48(3): 641-648, 2019 06 07.
Artigo em Inglês | MEDLINE | ID: mdl-30859190

RESUMO

Physiological limits of non-native species to environmental factors are critical for their establishment and spread in the adventive range. The crapemyrtle bark scale, Acanthococcus lagerstroemiae (Kuwana), is a major pest of crapemyrtles. Despite concerns on its rapid spread, there is a lack of information on potential distribution range of this scale in the United States. To understand this scale's distribution potential, its thermal tolerance was evaluated using higher and lower thermal limits. Exposure time leading to 50 and 90% mortality (Lt50 and Lt90) at extreme low or high temperatures were measured under controlled conditions. A model was then built to fit temperature data of cold fronts from 2001 to 2016 and to calculate potential mortalities along latitudes. Isothermal lines delineated at 90% mortality were defined as the northern limits. Modeling results suggested that A. lagerstroemiae nymphs collected in summer could tolerate heat; however, they were more susceptible to cold temperatures. Laboratory assays suggested that cold tolerance of A. lagerstroemiae nymphs varied from summer to winter. For example, SCP of nymphs collected in summer was higher than those collected in fall (-21 vs. -27°C), and the exposure time leading to Lt90 at 0°C was also different, which were 8 versus 50 h comparing nymphs collected in summer versus fall. Our prediction suggested that A. lagerstroemiae is likely to be limited by cold temperatures along the 43° N latitude. Based on these results, integrated management strategies can be developed for A. lagerstroemiae within the predicted range.


Assuntos
Hemípteros , Animais , Temperatura Baixa , Temperatura Alta , Ninfa , Casca de Planta
19.
Crit Care ; 23(1): 36, 2019 Feb 08.
Artigo em Inglês | MEDLINE | ID: mdl-30736845

RESUMO

BACKGROUND: The Extracorporeal Life Support Organization (ELSO) Maastricht Treaty for Nomenclature in Extracorporeal Life Support (ECLS) established consensus nomenclature and abbreviations for ECLS to ensure accurate, concise communication. METHODS: We build on this consensus nomenclature by layering a framework of precise and efficient abbreviations for cannula configuration that describe flow direction, number of cannulae used, any additional ECLS-related catheters, and cannulation sites. This work is a consensus of international representatives of the ELSO, including those from the North American, Latin American, European, South and West Asian, and Asian-Pacific chapters of ELSO. RESULTS: The classification increases in descriptive capability by introducing a third (cannula tip position) and fourth (cannula dimension) level to those provided in the previous consensus on ECLS cannulation configuration nomenclature. This expansion offers the simplest level needed to convey cannulation information yet allows for more details when required. CONCLUSIONS: A complete nomenclature for ECLS cannulation configurations accommodating future revisions was developed to facilitate ability to compare practices and results, to promote efficient communication, and to improve quality of registry data.


Assuntos
Oxigenação por Membrana Extracorpórea/métodos , Oxigenação por Membrana Extracorpórea/tendências , Sociedades/tendências , Cateterismo/métodos , Cateterismo/tendências , Oxigenação por Membrana Extracorpórea/classificação , Humanos , Terminologia como Assunto
20.
J Insect Physiol ; 112: 1-8, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30445022

RESUMO

Temperature is one of the most important abiotic factors influencing the adaptation and diversification of insects. Diverse and complex physiological mechanisms have evolved to help insects adapt to seasonal changes in temperature and prevent cold injury. Although the mechanisms of seasonal adaptation to low temperatures have been studied for insects in different taxa, none of these mechanisms have been investigated in scale insects in the superfamily Coccoidea. The crapemyrtle bark scale, Acanthococcus lagerstroemiae (Kuwana) (Hemiptera: Eriococcidae), is a newly introduced scale pest of crapemyrtles, Lagerstroemia spp. (Myrtales: Lythraceae). Our previous study concerning the cold tolerance of this pest suggested that, from summer to winter, A. lagerstroemiae seasonally adapted to lower temperature with a 5 °C reduction of supercooling points. In addition, time required to achieve the same levels of mortality at lower temperatures also increased. In this study, we used A. lagerstroemiae as a model system to investigate the physiological mechanisms correlated with changes in cold tolerance in scale insects, by measuring water content, lipid content and fatty acid composition, and cryoprotective polyols and sugars every other month. Results suggested that water content was lower in winter and early spring than in summer and early fall (40.8% vs. 63.3%). The proportions of the fatty acids in PL were similar over seasons, but in TAG, shorter chain fatty acids (from C6:0 to C10:0) increased in winter as longer chain fatty acids (from C14:0 to C18:0) decreased. Among all measured polyols and sugars, including glycerol, d-mannitol, myo-inositol, and d-trehalose, the levels of d-mannitol were the highest in January 2016, which were 19-times of those in March 2016 and 4.5-times of those in September 2016. Results from this study provide a better understanding on how A. lagerstroemiae overwinters, which may give insights into the overwintering strategies of other scale insects.


Assuntos
Aclimatação , Hemípteros/metabolismo , Metabolismo dos Lipídeos , Álcoois Açúcares/metabolismo , Animais , Temperatura Baixa , Ninfa/metabolismo , Estações do Ano , Trealose/metabolismo , Água/metabolismo
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...