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1.
Rev. medica electron ; 41(2): 397-409, mar.-abr. 2019. tab
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1004276

RESUMO

RESUMEN Introducción: la agitación durante la emergencia de la anestesia general es una complicación frecuente en pediatría que puede causar daños físicos, retrasar el alta y aumentar los costos. Objetivo: caracterizar los episodios anestesia general en el paciente pediátrico. Materiales y métodos: se realizó un estudio descriptivo, prospectivo, longitudinal de 246 pacientes que presentaron anestesia general en el Hospital "Eliseo Noel Caamaño" entre septiembre de 2015 y diciembre de 2018. Se estudiaron las variables: edad, género, ASA, tiempo quirúrgico y tiempo anestésico, tipo de cirugía, método de anestesia, agentes usados para la inducción y el mantenimiento, severidad de los episodios y necesidad de tratamiento. Resultados: la mayoría de los pacientes que presentaron anestesia general tenían entre 2 y 6 años (63,4%), eran masculinos (67,9%), ASA I (78,1%) y fueron operados de excéresis de lesiones de partes blandas (27,6%). El tiempo quirúrgico fue de 31,2 ± 10,4 minutos y el anestésico 43,5±8,8 minutos. El método anestésico más indicado fue la anestesia balanceada (84,2%), como inductor el propofol (86,2%) y para el mantenimiento isoflurano (34,1%) y sevoflurano (26,4%). Predominaron los episodios severos (51,2%) y el 56,9% necesitó intervención farmacológica. Conclusiones: esta anestesia fue más frecuente en los menores de seis años, masculinos, sanos, a los cuales se les realizaron procederes cortos, con anestesia balanceada, se usó propofol para la inducción e isoflurano y sevoflurano para el mantenimiento de la anestesia. Prevalecieron los episodios severos y la mayoría requirió tratamiento farmacológico.


ABSTRACT Introduction: agitation during the emergence from general anesthesia is a frequent complication in Pediatrics that can cause physical damages, delay discharge and increase costs. Objective: to characterize the episodes of general anesthesia in the pediatric patient. Materials and methods: a descriptive, prospective, longitudinal study was carried out with 246 patients who presented general anesthesia in the Hospital "Eliseo Noel Caamaño" from September 2015 to December 2018. The studied variables were age, gender, ASA, surgical time, anesthetic time, kind of surgery, anesthetic method, agents used for the induction and maintenance, episodes severity and treatment necessity. Results: most of patients treated with general anesthesia were aged 2-6 years (63.4 %), male (67.9 %), ASA I (78.1 %), and underwent the removal of soft parts lesions (27.6 %). The average surgical time was 31,2 ± 10,4 minutes and the anesthetics one was 43,5±8,8 minutes. The most used anesthetics method was balanced anesthesia (84.2 %), the most used inductor was propofol (86.2 %) and for the maintenance isoflurane (34,1%) and sevoflurane (26,4%). Severe episodes (51,2%) predominated, and 56.9 % needed pharmacologic intervention. Conclusions: this kind of anesthesia is more frequently used in children aged less than 6 years, male, healthy, who underwent short procedures with balanced anesthesia and the use of propofol for the induction and isoflurane and sevoflurane for maintaining it. Severe episodes predominated, and most of them required pharmacologic treatment.


Assuntos
Humanos , Masculino , Pré-Escolar , Criança , Delírio do Despertar/complicações , Delírio do Despertar/diagnóstico , Delírio do Despertar/tratamento farmacológico , Anestesia Geral/efeitos adversos , Anestesia Geral/métodos , Anestesia Geral/estatística & dados numéricos , Pediatria , Epidemiologia Descritiva , Estudos Prospectivos , Estudos Longitudinais
2.
Prog. obstet. ginecol. (Ed. impr.) ; 61(3): 261-263, mayo-jun. 2018. ilus
Artigo em Espanhol | IBECS | ID: ibc-174963

RESUMO

El embarazo ectópico en topografía ístmico-cervical y cicatriz de cesárea anterior es muy poco frecuente, por lo que no existe un tratamiento protocolizado estándar. Se presenta un caso clínico de una paciente con una gestación ectópica ístmico-cervical sobre la cicatriz de dos cesáreas previas. Se ingresa en el servicio de ginecología por el riesgo de ruptura uterina. La evolución se caracterizó por invasión trofoblástica de la histerorrafia y acretismo placentario, y culminó con la interrupción de la gestación. Sin complicaciones maternas. El tratamiento consistió en embrioscopia intervencionista uterina con extracción del disco embrionario e interrupción de la circulación placento-embrionaria, con resultado materno satisfactorio


Pregnancy ectopic ístmico-cervical topography and previus c-section scar is very rare so it not existe standard protocololized treatment. It presents a clinical case of a patient witch an ectopic gestation istmico-cervical on two previous caesarean section scar. She was admited in the gynaecology service because of the risk of uterine rupture, the evolution is characterized by invasion. Trophoblastic of the histerorrafia and acretismo placental culmininating with interruption of gestation. Without maternal complications. The treatment consisted of uterine interventional embrioscopia witch extraction of the embryonic disc and interruption of the placenta-embryonic circulation, witch satisfactory maternal outcome


Assuntos
Humanos , Feminino , Gravidez , Adulto , Gravidez Ectópica/diagnóstico por imagem , Cesárea , Cicatriz , Placenta Acreta/diagnóstico por imagem , Doença Trofoblástica Gestacional/diagnóstico por imagem , Complicações na Gravidez/diagnóstico por imagem , Fetoscopia , Extração Obstétrica/métodos
3.
Rev. cuba. med. mil ; 44(1): 130-138, ene.-mar. 2015. ilus
Artigo em Espanhol | LILACS, CUMED | ID: lil-748799

RESUMO

Paciente masculino de 47 años de edad, con antecedentes de hipertensión arterial. En mayo de 2009 sufrió un accidente en su hogar con gasolina inflamada, lo que le produjo lesiones en cara, cuello anterior, tronco y extremidades. Estas alcanzaron el 67,7 % de la superficie corporal total, de ellas el 51,3 % fueron quemaduras hipodérmicas y el 16,4 % dérmicas AB, para un índice de gravedad de 59,5 y pronóstico de vida de crítico extremo. Se decide ingreso en régimen de terapia intensiva del Servicio de Caumatología del Hospital Militar Central “Dr. Luis Díaz Soto”, donde se le realizaron varios tratamientos quirúrgicos. Tuvo una estadía hospitalaria de 98 días. Al alta quedaron como secuelas posquemaduras, múltiples cicatrices hipertróficas y queloideas en todo su cuerpo, sindactilia en mano izquierda y microstoma. Regresó a nuestro servicio a los 2 años y 6 meses para tratamiento reconstructivo de cicatriz queloidea que interesaba mentón y labio superior, así como del microstoma. Se realizó la reconstrucción de la zona afectada mediante la combinación de plastias locales y a distancia. Se obtuvo satisfactorios resultados estéticos y funcionales, lo que demuestra que el tratamiento integral del paciente quemado garantiza la sobrevida, el control de la sepsis, la mejoría estética, funcional y de la esfera psíquica.


A 47 year-old male patient with a history of hypertension suffered an inflamed gasoline accident at home in May 2009. This accident produced lesions on his face, anterior neck, trunk and limps. These burns reached 67.7 % of the total body surface area, out of which 51.3 % were hypodermic burns, and 16.4 % dermal AB, for a 59.5 severity index and prognosis of extremely critical. His admission is decided in intensive care regimen of the Burn Therapy Service at the Central Military Hospital where various surgical treatments were performed. He had a hospital stay of 98 days. At discharge sequelae were left as post burns, multiple keloids and hypertrophic scars all over his body, syndactyly microstoma in his left hand. The patient returned to our service at 2 years and 6 months for reconstructive treatment of keloid scar affecting his chin and upper lip, and the microstoma. Reconstruction of the affected area was performed by combining local and distance plasty. Satisfactory aesthetic and functional results were obtained, demonstrating that comprehensive treatment of burn patients guarantees survival, sepsis control, aesthetic, functional and psychic sphere improvement.


Assuntos
Humanos , Masculino , Choque Traumático/diagnóstico , Queimaduras/diagnóstico , Queimaduras/terapia , Sindactilia/cirurgia , Procedimentos Cirúrgicos Reconstrutivos/estatística & dados numéricos , Queloide/cirurgia
4.
Rev. cuba. med. mil ; 44(1)ene.-mar. 2015. ilus
Artigo em Espanhol | CUMED | ID: cum-66966

RESUMO

Paciente masculino de 47 años de edad, con antecedentes de hipertensión arterial. En mayo de 2009 sufrió un accidente en su hogar con gasolina inflamada, lo que le produjo lesiones en cara, cuello anterior, tronco y extremidades. Estas alcanzaron el 67,7 por ciento de la superficie corporal total, de ellas el 51,3 por ciento fueron quemaduras hipodérmicas y el 16,4 por ciento dérmicas AB, para un índice de gravedad de 59,5 y pronóstico de vida de crítico extremo. Se decide ingreso en régimen de terapia intensiva del Servicio de Caumatología del Hospital Militar Central Dr Luis Díaz Soto, donde se le realizaron varios tratamientos quirúrgicos. Tuvo una estadía hospitalaria de 98 días. Al alta quedaron como secuelas posquemaduras, múltiples cicatrices hipertróficas y queloideas en todo su cuerpo, sindactilia en mano izquierda y microstoma. Regresó a nuestro servicio a los 2 años y 6 meses para tratamiento reconstructivo de cicatriz queloidea que interesaba mentón y labio superior, así como del microstoma. Se realizó la reconstrucción de la zona afectada mediante la combinación de plastias locales y a distancia. Se obtuvo satisfactorios resultados estéticos y funcionales, lo que demuestra que el tratamiento integral del paciente quemado garantiza la sobrevida, el control de la sepsis, la mejoría estética, funcional y de la esfera psíquica(AU)


A 47 year-old male patient with a history of hypertension suffered an inflamed gasoline accident at home in May 2009. This accident produced lesions on his face, anterior neck, trunk and limps. These burns reached 67.7 percent of the total body surface area, out of which 51.3 percent were hypodermic burns, and 16.4 percent dermal AB, for a 59.5 severity index and prognosis of extremely critical. His admission is decided in intensive care regimen of the Burn Therapy Service at the Central Military Hospital where various surgical treatments were performed. He had a hospital stay of 98 days. At discharge sequelae were left as post burns, multiple keloids and hypertrophic scars all over his body, syndactyly microstoma in his left hand. The patient returned to our service at 2 years and 6 months for reconstructive treatment of keloid scar affecting his chin and upper lip, and the microstoma. Reconstruction of the affected area was performed by combining local and distance plasty. Satisfactory aesthetic and functional results were obtained, demonstrating that comprehensive treatment of burn patients guarantees survival, sepsis control, aesthetic, functional and psychic sphere improvement(AU)


Assuntos
Humanos , Masculino , Adulto , Queimaduras/diagnóstico , Queimaduras/terapia , Choque Traumático/diagnóstico , Queloide/cirurgia , Procedimentos Cirúrgicos Reconstrutivos , Sindactilia/cirurgia
5.
J Sci Food Agric ; 90(6): 1089-97, 2010 Apr 30.
Artigo em Inglês | MEDLINE | ID: mdl-20355151

RESUMO

BACKGROUND: Alternative techniques for cultivation of leafy vegetables such as a floating tray system and unconventional gas mixtures for post-harvest active modified atmosphere packaging (MAP) could be of interest in the minimally processed vegetable industry. RESULTS: The combined effect of three pre-harvest fertilisation doses (8, 12 or 16 mmol N L(-1)) and three post-harvest MAP conditions (passive, super-atmospheric or N2O-enriched) on the main quality attributes of fresh-cut baby spinach leaves throughout 10 days at 5 degrees C was studied. After 8 days of shelf life, spinach leaves fertilised with 8 and 16 mmol N L(-1) and stored under N2O-enriched MAP showed the lowest microbial growth, with good sensory quality. Such combined treatments also preserved the total antioxidant capacity sampled at harvest (8 g ascorbic acid equivalent antioxidant capacity kg(-1) f.w.). A decrease of 10-20% in total vitamin C content regardless of N fertilisation and packaging treatment was found during shelf life. Total phenolics content at harvest was 2 g gallic acid equivalents kg(-1) f.w., which was slightly decreased or preserved during shelf life while total chlorophylls were preserved for all treatments assayed around 550 mg kg(-1) f.w. CONCLUSION: No clear effect of fertilisation doses was observed during post-harvest storage on overall quality of fresh-cut baby spinach leaves, while N2O-enriched atmospheres seems to be a promising alternative to passive MAP for extending shelf life.


Assuntos
Antioxidantes/análise , Microbiologia de Alimentos , Embalagem de Alimentos/métodos , Conservação de Alimentos/métodos , Nitrogênio , Spinacia oleracea/normas , Agricultura/métodos , Ácido Ascórbico/análise , Bactérias/crescimento & desenvolvimento , Clorofila/análise , Fertilizantes , Fungos/crescimento & desenvolvimento , Óxido Nitroso/farmacologia , Valor Nutritivo , Odorantes , Fenóis/análise , Folhas de Planta/microbiologia , Sensação , Spinacia oleracea/química , Spinacia oleracea/microbiologia , Paladar
6.
Toxicon ; 46(4): 418-29, 2005 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-16026809

RESUMO

From the venom of the Mexican scorpion Centruroides elegans Thorell five peptides were isolated to homogeneity by chromatographic procedures and their full amino acid sequence was determined by automatic Edman degradation. They all belong to the Noxiustoxin subfamily of scorpion toxins and were given the systematic names alpha-KTx 2.8 to 2.12, with trivial names Ce1 to Ce5, respectively. They have 39 amino acid residues, except for Ce3 which has only 38, but all of them have three disulfide bridges, and have molecular weights of 4255, 4267, 4249, 4295 and 4255 atomic mass units, respectively for Ce1 to Ce5. The C-terminal residues of Ce2, Ce4 and Ce5 were found to be amidated. The electrophysiological assay (whole-cell patch-clamp) showed that out of the five peptides, Ce1 (alpha-KTx 2.8), Ce2 (alpha-KTX2.9) and Ce4 (alpha-KTx 2.11) were effective blockers of Kv1.3 channels of human T lymphocytes, whereas these peptides did not inhibit the Ca2+-activated K+ channels (IKCa1) of the same cells. The equilibrium dissociation constants of these peptides for Kv1.3 were 0.70, 0.25 and 0.98nM for Ce1, Ce2 and Ce4, respectively. Furthermore, toxins Ce1, Ce2 and Ce4 practically did not inhibit the related voltage gated Shaker K+ channels, and rKv2.1 channels of the Shab family. The high affinity blockage of Kv1.3 channels by these peptides and their selectivity for Kv1.3 over IKCa1 may have significance in the development of novel tools for suppressing the function of those T cell subsets whose proliferation critically depends on the activity of Kv1.3 channels.


Assuntos
Canais de Potássio Ativados por Cálcio de Condutância Intermediária/metabolismo , Canal de Potássio Kv1.3/antagonistas & inibidores , Peptídeos/genética , Peptídeos/metabolismo , Venenos de Escorpião/química , Escorpiões , Linfócitos T/metabolismo , Sequência de Aminoácidos , Animais , Teorema de Bayes , Linhagem Celular , Cromatografia Líquida de Alta Pressão , Eletrofisiologia , Ensaio de Imunoadsorção Enzimática , Humanos , Espectrometria de Massas , México , Modelos Genéticos , Dados de Sequência Molecular , Compostos Organofosforados , Peptídeos/toxicidade , Filogenia , Venenos de Escorpião/toxicidade , Análise de Sequência de Proteína
7.
Gac Sanit ; 18(4): 335-7, 2004.
Artigo em Espanhol | MEDLINE | ID: mdl-15324645

RESUMO

OBJECTIVE: To describe the health resources used in patients hospitalized with Legionella pneumonia during an outbreak of Legionnaire's disease in Alcoy (Spain), and to compare them with those used in other forms of pneumonia. METHODS AND RESULTS: Using a clinical protocol, 177 Legionella pneumonia patients were compared with 180 patients hospitalized for other types of pneumonia. Data on therapy and the resources used were collected. The most common antibiotic treatment in both groups was clarithromycin, but intensive care and mechanical ventilation requirements were greater in Legionella pneumonia. Home-based hospital care was successfully used in 15.6% of patients with Legionella pneumonia and in 11.3% of those with other types of pneumonia. Home oxygen therapy after discharge was less frequent in the Legionella pneumonia group (7.8%) than in the group with non-Legionella pneumonia (16.7%). CONCLUSIONS: Notable results were the greater requirement for mechanical ventilation in Legionella pneumonia and the good results obtained by home-based hospital care within current health care management.


Assuntos
Surtos de Doenças , Doença dos Legionários/epidemiologia , Idoso , Feminino , Serviços de Assistência Domiciliar , Hospitalização , Humanos , Doença dos Legionários/terapia , Masculino , Pneumonia Bacteriana/epidemiologia , Pneumonia Bacteriana/terapia , Estudos Prospectivos , Espanha/epidemiologia
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