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Neotrop Entomol ; 2020 Aug 19.
Artigo em Inglês | MEDLINE | ID: mdl-32813216


Lethal yellowing (LY) affects several palm species in the Americas. It is caused by 16SrIV group phytoplasmas. In Florida (USA), LY was shown to be transmitted by the planthopper Haplaxius crudus ( Van Duzee ) (Hemiptera, Cixiidae) to different palm species, including Pritchardia pacifica Seem . & H. Wendl . (Arecaceae) in insect-proof cage experiments in the 1980s, a result that had never been reproduced later. LY has destroyed many coconut plantations as well as other palm species in the Caribbean and Mexico. In order to evaluate if H. crudus is a vector of LY phytoplasmas in Mexico, experiments were carried out in Yucatan (Mexico). Several H. crudus from palms infected by LY in the field were introduced into cages containing young P. pacifica palms. These insects were able to transmit 16SrIV group phytoplasmas to P. pacifica palms. According to DNA sequences comparative analysis, virtual restriction fragment length polymorphism, and phylogenetic analysis, the phytoplasmas detected in these infected P. pacifica were of subgroups A and D. All of ten P. pacifica palms infected with the subgroup D phytoplasmas developed symptoms of LY and died, whereas only one of two palms infected with subgroup A developed LY symptoms and died. This is the first time, more than 30 years later, that the role of H. crudus as a vector of LY is confirmed.

Rev. toxicol ; 37(11): 11-16, 2020. tab, mapas, graf
Artigo em Espanhol | IBECS-Express | IBECS | ID: ibc-ET6-759


Estudios toxicológicos y epidemiológicos ponen de manifiesto que el material particulado (PM) específicamente el PM2.5 tiene efectos negativos significativos en la salud humana, asociado con mortalidad, insuficiencia cardíaca, trastornos respiratorios, enfermedades pulmonares y cáncer. La toxicidad y el efecto inflamatorio de estas partículas están relacionados con su tamaño y características químicas. En este estudio se determinaron las características químicas de las fracciones acuosas y orgánicas solubles del PM2.5 recolectado en tres sitios de monitoreo del área urbana de la ciudad de Cuenca-Ecuador y se evaluó su actividad genotóxica mediante el ensayo del cometa en la línea celular de ovario de hámster chino, CHO-K1. El análisis gravimétrico de las muestras reveló que dos de los sitios de estudio superaron el límite de 25 mig/m3 establecido por la Organización Mundial de la Salud. En la caracterización de las fracciones acuosas y orgánicas se determinó la presencia de metales como el hierro y zinc e hidrocarburos aromáticos tales como el benzo(a) antraceno respectivamente. Las células fueron expuestas a 3,26 m3 de aire /mL de los extractos acuosos y 1,63 m3 de aire/mL de los extractos orgánicos. Finalmente se observó que los extractos obtenidos de PM2.5 inducen daño genotóxico en la longitud del largo de cola medido mediante el ensayo del cometa; este tipo de daño pueden atribuirse a la combinación de las especies químicas detectadas

Toxicological and epidemiological studies have a manifesto that particulate matter (PM), specifically PM2.5 has negative effects on human health, associated with mortality, heart failure, respiratory disorders, lung diseases, and cancer. The toxicity and inflammatory effect of these particles are related to their size and chemical characteristics. The objective of this study was to determine the characteristics of the soluble aqueous and organic fractions of the particulate material PM 2.5 collected in the monitoring sites of the urban area of ​​the city of Cuenca-Ecuador and to evaluate its genotoxic activity by means of the test of the comet of in the Chinese hamster ovary cells line CHO-K1. The gravimetric analysis of the samples revealed that two of the study sites exceeded the limit of 25 ug / m3 established by the WHO. In the characterization of water and organic fractions, the presence of metals such as Fe and Zn and aromatic hydrocarbons such as benzo(a) anthracene determined, respectively. Cells were exposed to 3,26 m3 of air /mL of aqueous extracts and 1,63 m3 of air/ mL of organic extracts. Finally, it was observed that the extracts obtained from PM2.5 induce genotoxic in the length of tail length measured by the comet assay; this type of damage can be attributed to the combination of the detected chemical species

Rev Neurol ; 69(8): 317-322, 2019 Oct 16.
Artigo em Espanhol | MEDLINE | ID: mdl-31588985


INTRODUCTION: Epidemiological studies have described a high comorbidity of substance use disorders with another psychiatric disorder, which has been called dual pathology. However, the aetiological mechanisms underlying this association are still not fully understood. AIM: To carry out a preliminary study of the effect of polymorphism rs1051730 of the gene group CHRNA5-CHRNA3-CHRNB4 through a case-control study. SUBJECTS AND METHODS: A total of 225 subjects were selected and divided into three groups: those diagnosed with bipolar disorder, those with nicotine dependence, and subjects without nicotine dependence or any other psychiatric disorder. Genotyping was performed by real-time polymerase chain reaction. Genetic association analysis was performed using chi-square tests and multivariate logistic regressions. RESULTS: On comparing allelic frequencies with the control group, we found that polymorphism rs1051730 was associated with nicotine dependence (p = 0.03), but not with bipolar disorder (p = 0.94). CONCLUSION: Variant rs1051730 was associated with nicotine dependence in the Mexican population and showed the same effect in dual pathology. However, further studies are recommended to obtain conclusive results.

Rehabilitacion (Madr) ; 53(1): 43-55, 2019.
Artigo em Espanhol | MEDLINE | ID: mdl-30929831


INTRODUCTION: Intra-articular ozone infiltrations have been used as a therapeutic intervention in osteoarthritis of the knee with reports of favourable effects. However, this therapeutic procedure is still controversial due to the lack of scientific evidence to justify its use. OBJECTIVE: To evaluate the safety and efficacy of intra-articular ozone infiltrations in patients with knee osteoarthritis. MATERIAL AND METHODS: A systematic search was performed in electronic databases such as Pubmed, Dialnet, Scielo, Medigraphic and other electronic sources from January 1990 to January 2018. We included controlled clinical trials that used intra-articular ozone infiltrations as a therapeutic intervention in patients with knee osteoarthritis. The variables analysed were the study design, risk of bias, clinical configuration, characteristics of the participants, characteristics of the interventions, results, length of follow-up and adverse events. RESULTS: Ten studies with a total of 400 patients treated with ozone vs 381 controls were included in the systematic review. Most studies had a high risk of bias. Intra-articular ozone infiltrations were more effective than placebo and were as effective as other interventional treatments in short-term follow-up. No adverse effects or serious adverse reactions were reported in the treated patients. CONCLUSION: Intra-articular ozone infiltration appears to be an effective therapeutic intervention in the short term. However studies with better methodological quality are needed to confirm its efficacy and to analyze long-term safety.

Osteoartrite do Joelho/terapia , Ozônio/administração & dosagem , Humanos , Injeções Intra-Articulares , Osteoartrite do Joelho/patologia , Ozônio/efeitos adversos , Projetos de Pesquisa , Resultado do Tratamento
Neurologia ; 34(3): 159-164, 2019 Apr.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-28215911


INTRODUCTION: REM sleep behaviour disorder (RBD) is characterised by violent behaviours (screaming, kicking, vivid dreams) during REM sleep. It has a prevalence of 1% to 2% of the general population and is especially frequent in men and the population older than 60. In the last decade, RBD has been suggested to be a prodrome of neurodegenerative disease. We analysed associated neurological diseases and responses to drug treatment in 33 patients with RBD treated in the multidisciplinary sleep disorders unit at Hospital Infanta Sofía. PATIENTS AND METHODS: We conducted an observational descriptive retrospective analysis of patients diagnosed with RBD and treated in our multidisciplinary sleep disorders unit between October 2012 and December 2015. We recorded age, sex, associated diseases, and treatments administered to these patients. RESULTS: A total of 365 patients were attended at our unit, including 33 with RBD: 13 women (40%) and 20 men (60%). Mean age was 62.72 years. An associated disorder was identified in 48%, with the most common being mild cognitive impairment (69%). The percentage of patients with RBD and an associated disorder among patients older than 60 was 68%. Eighty-two percent of the patients required treatment. The most commonly used drug was clonazepam (76%), followed by melatonin (9%), gabapentin (6%), and trazodone (3%). DISCUSSION: In our series, 48% of the patients had an associated disorder. The likelihood of detecting an associated disorder increases with patients' age. The vast majority of patients required drug treatment due to symptom severity; the most frequently administered drug was clonazepam (76%).

Anticonvulsivantes/uso terapêutico , Clonazepam/uso terapêutico , Sintomas Prodrômicos , Transtorno do Comportamento do Sono REM/tratamento farmacológico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Neurodegenerativas , Polissonografia/métodos , Estudos Retrospectivos , Espanha
Rev Neurol ; 67(10): 373-381, 2018 Nov 16.
Artigo em Espanhol | MEDLINE | ID: mdl-30403280


INTRODUCTION: The risk of falls in older adults increases because of the decrease in strength, flexibility, balance and sensory changes affecting functionality and quality of life. For this reason, an integral system of evaluation of equilibrium is necessary, for preventive purposes or for early therapeutic interventions. AIM: To present the results of the transcultural translation and adaptation process of the Balance Evaluation Systems Test (BESTest) to Spanish language. SUBJECTS AND METHODS: The original version of the BESTest was translated into Spanish, following the process of retro-traduction and cultural adaptation considering the semantic, idiomatic, conceptual and experiential equivalences. Subsequently the version was reviewed by a panel of experts qualifying clarity, coherence, relevance and sufficiency. The pilot test included 32 adults between 50 and 80 years old. RESULTS: It was possible to carry out the complete translation of the instrument, the instructions for the subject and for the evaluator. Most items of the test reached the maximum score of 4.0 (100%), nine items achieved an average score of 3.9 (99%), one item got an average score of 3.8 (95%) and two items achieved an average score of 3.7 (92.5%). CONCLUSIONS: With this study the Spanish speakers community has a pertinent sufficient, coherent and clear instrument in order to identify the control postural system altered to focus treatment and to get better functional outcomes from balance evaluation in older adults.

Características Culturais , Avaliação Geriátrica/métodos , Equilíbrio Postural , Idoso , Idoso de 80 Anos ou mais , Humanos , Pessoa de Meia-Idade , Projetos Piloto , Traduções
Rev. colomb. gastroenterol ; 33(2): 103-110, abr.-jun. 2018. tab, graf
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-960047


Resumen Objetivo: este estudio caracteriza la diversidad de los genes de virulencia cagA (gen asociado con la citotoxina A) y vacA (citotoxina vacuolizante) en pacientes colombianos para determinar posibles asociaciones entre estos 2 genes y la severidad de los hallazgos endoscópicos teniendo en cuenta todos los genotipos reportados para el gen vacA (s, m e i). Materiales y métodos: Helicobacter pylori fue detectado por cultivo y por métodos moleculares en biopsias de 62 pacientes. Los genotipos de cagA y vacA (m/i/s) se determinaron por reacción en cadena de la polimerasa (PCR) y secuenciación. Resultados: se aislaron 124 cepas de 62 pacientes; de estas, el 48,5% (n = 48) fueron vacA s2/m2/i2-cagA (-) presente en su mayoría en pacientes con gastritis folicular; mientras el 32,3% (n = 32) fueron vacA s1/m1/i1-cagA (+) presentes mayormente en pacientes con gastritis folicular, gastritis crónica y posible metaplasia. Se encontró una asociación significativa entre la presencia de cagA y el genotipo vacA s1/m1/i1 y la ausencia de cagA y el genotipo vacA s2/m2/i2 (p <0,001). No se encontró una asociación significativa entre la severidad de los hallazgos endoscópicos y el estatus cagA-vacA de las cepas. Conclusión: se encontró una baja prevalencia de cepas cagA (+), el estatus cagA-vacA no es un predictor de riesgo en la población estudiada y la presencia de infecciones heterogéneas sin tropismo sugieren la necesidad de tomar biopsias tanto del cuerpo como del antro del estómago en la práctica clínica rutinaria.

Abstract Objective: This study characterizes the diversity of cagA and vacA virulence genes in Colombian patients to determine possible associations between them and the severity of endoscopic findings. It considers all four genotypes reported for the vacA gene (s, m and i). Materials and methods: Helicobacter pylori was detected in biopsies of 62 patients through culturing and by molecular methods. Genotypes of cagA and vacA (m/i/s) were determined by PCR and sequencing. Results: One hundred twenty four strains from 62 patients were isolated. Of these, 48.5% (n = 48) were vacA s2/m2/i2 - cagA (-) which were mostly found in patients with follicular gastritis; 32.3% (n = 32) were vacA s1/m1/i1-cagA (+) which were mostly found in patients with follicular gastritis, chronic gastritis and possible metaplasia. Significant associations were found between the presence of cagA and the vacA s1/m1/i1 genotype and the absence of cagA and the vacA s2/m2/i2 genotype (p <0.001). No significant association was found between the severity of endoscopic findings and the cagA-vacA status of the strains. Conclusion: We found a low prevalence of cagA (+) strains, the cagA-vacA status is not a predictor of risk in this population. Moreover, the presence of heterogenous infections without tropism suggests a need for biopsies from both the corpus and the antrum of the stomach in routine clinical practice.

Forensic Sci Int Genet ; 25: 63-72, 2016 11.
Artigo em Inglês | MEDLINE | ID: mdl-27500650


Since 1992, the Spanish and Portuguese-Speaking Working Group of the ISFG (GHEP-ISFG) has been organizing annual Intercomparison Exercises (IEs) coordinated by the Quality Service at the National Institute of Toxicology and Forensic Sciences (INTCF) from Madrid, aiming to provide proficiency tests for forensic DNA laboratories. Each annual exercise comprises a Basic (recently accredited under ISO/IEC 17043: 2010) and an Advanced Level, both including a kinship and a forensic module. Here, we show the results for both autosomal and sex-chromosomal STRs, and for mitochondrial DNA (mtDNA) in two samples included in the forensic modules, namely a mixture 2:1 (v/v) saliva/blood (M4) and a mixture 4:1 (v/v) saliva/semen (M8) out of the five items provided in the 2014 GHEP-ISFG IE. Discrepancies, other than typos or nomenclature errors (over the total allele calls), represented 6.5% (M4) and 4.7% (M8) for autosomal STRs, 15.4% (M4) and 7.8% (M8) for X-STRs, and 1.2% (M4) and 0.0% (M8) for Y-STRs. Drop-out and drop-in alleles were the main cause of errors, with laboratories using different criteria regarding inclusion of minor peaks and stutter bands. Commonly used commercial kits yielded different results for a micro-variant detected at locus D12S391. In addition, the analysis of electropherograms revealed that the proportions of the contributors detected in the mixtures varied among the participants. In regards to mtDNA analysis, besides important discrepancies in reporting heteroplasmies, there was no agreement for the results of sample M4. Thus, while some laboratories documented a single control region haplotype, a few reported unexpected profiles (suggesting contamination problems). For M8, most laboratories detected only the haplotype corresponding to the saliva. Although the GHEP-ISFG has already a large experience in IEs, the present multi-centric study revealed challenges that still exist related to DNA mixtures interpretation. Overall, the results emphasize the need for further research and training actions in order to improve the analysis of mixtures among the forensic practitioners.

Cromossomos Humanos X , Cromossomos Humanos Y , Impressões Digitais de DNA , DNA Mitocondrial/genética , Laboratórios/normas , Repetições de Microssatélites , Amelogenina/genética , Análise Química do Sangue , Feminino , Genética Forense , Marcadores Genéticos , Haplótipos , Humanos , Masculino , Saliva/química , Sêmen/química
Rev. mex. ing. bioméd ; 37(2): 101-114, May.-Aug. 2016. tab, graf
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-961316


Resumen: En la práctica clínica relacionada con la rehabilitación cognitiva, perceptual y del lenguaje, es habitual emplear como estímulos representaciones de objetos en dos dimensiones como dibujos o fotografías para que sean identificados por los pacientes. Ello supone una limitación, puesto que la presentación de objetos en tres dimensiones, dada su mayor riqueza visual, facilita su identificación y podría apoyar procesos de rehabilitación. Objetivo: Diseñar una configuración experimental para conocer el grado en que las modalidades de presentación de estímulos afectan el reconocimiento visual de objetos. Materiales y Métodos: Se diseñó un sistema de bajo costo para mostrar estímulos en tres modalidades: imágenes, videos y objetos reales. Fueron seleccionados 80 objetos, controlando las variables de manipulabilidad, edad de adquisición, familiaridad, complejidad visual y frecuencia léxica. Se realizó una prueba piloto utilizando el sistema con cinco personas sanas y se midieron los tiempos de reacción en la nominación de los objetos. Resultados: Las diferencias en los tiempos de reacción entre las modalidades observadas apoyan la influencia de la modalidad de presentación en el reconocimiento de objetos. Conclusiones: Las propiedades de volumen de los objetos permitirían la exploración de características que las fotografías no tendrían; razón por la cual, los tiempos de reacción para los objetos reales y los videos fueron menores. Son valiosos los aportes que ofrecen una alternativa de bajo costo para la visualización y el reconocimiento de objetos.

Abstract: A wide variety of stimuli or objects such as drawings or photographs are used in cognitive perceptual and language rehabilitation. However, the presentation of objects in three dimensions, due to the visual richness, facilitates the identification and could support the rehabilitation process. Objective: Design an experimental setup to determine the extent to which the modality of presentation of objects affects the visual recognition of objects. Materials and methods: A low-cost experimental system was designed in order to show the stimulus in three ways: images, videos and real objects. Eighty objects were selected and variables as manipulability, age of acquisition, familiarity, visual complexity, agreement on the label and lexical frequency were controlled. A pilot study was conducted using the system in five healthy participants and the reaction time to identify objects was measured. Results: The findings reveal that the differences in reaction times between the modalities of presentation support the influence of the mode of presentation in object recognition. Conclusions: The volume object properties could allow the exploration of characteristics that the photographs would not have. This may be why the reaction time to identify real objects or videos was lower. Low-cost alternatives for the visualization and object recognition are valuable in cognitive perceptual and language rehabilitation.

Eur J Histochem ; 58(3): 2400, 2014 Jul 18.
Artigo em Inglês | MEDLINE | ID: mdl-25308843


Dopamine D1 and D2 receptor immunohistochemistry and Golgi techniques were used to study the structure of the adult rat arcuate-median eminence complex, and determine the distribution of the dopamine D1 and D2 receptor immunoreactivities therein, particularly in relation to the tubero-infundibular dopamine neurons. Punctate dopamine D1 and D2 receptor immunoreactivities, likely located on nerve terminals, were enriched in the lateral palisade zone built up of nerve terminals, while the densities were low to modest in the medial palisade zone. A codistribution of dopamine D1 receptor or dopamine D2 receptor immunoreactive puncta with tyrosine hydroxylase immunoreactive nerve terminals was demonstrated in the external layer. Dopamine D1 receptor but not dopamine D2 receptor immnunoreactivites nerve cell bodies were found in the ventromedial part of the arcuate nucleus and in the lateral part of the internal layer of the median eminence forming a continuous cell mass presumably representing neuropeptide Y immunoreactive nerve cell bodies. The major arcuate dopamine/ tyrosine hydroxylase nerve cell group was found in the dorsomedial part. A large number of tyrosine hydroxylase immunoreactive nerve cell bodies in this region demonstrated punctate dopamine D1 receptor immunoreactivity but only a few presented dopamine D2 receptor immunoreactivity which were mainly found in a substantial number of tyrosine hydroxylase cell bodies of the ventral periventricular hypothalamic nucleus, also belonging to the tubero-infundibular dopamine neurons. Structural evidence for projections of the arcuate nerve cells into the median eminence was also obtained. Distal axons formed horizontal axons in the internal layer issuing a variable number of collaterals classified into single or multiple strands located in the external layer increasing our understanding of the dopamine nerve terminal networks in this region.  Dopamine D1 and D2 receptors may therefore directly and differentially modulate the activity and /or Dopamine synthesis of substantial numbers of tubero-infundibular dopamine neurons at the somatic and terminal level. The immunohistochemical work also gives support to the view that dopamine D1 receptors and/or dopamine D2 receptors in the lateral palisade zone by mediating dopamine volume transmission may contribute to the inhibition of luteinizing hormone releasing hormone release from nerve terminals in this region.

Núcleo Arqueado do Hipotálamo/metabolismo , Neurônios/metabolismo , Receptores de Dopamina D1/metabolismo , Receptores de Dopamina D2/metabolismo , Animais , Imunofluorescência , Masculino , Ratos , Ratos Sprague-Dawley
Apuntes psicol ; 31(1): 11-20, ene.-abr. 2013. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-116742


El presente estudio se centra en analizar la calidad de sueño de pacientes con trastornos de la conducta alimentaria (TCA). Para ello se compararon las puntuaciones de 13 pacientes con dichos diagnósticos y 15 controles en el Inventario de Calidad de Sueño de Pittsburg (PSQI), la Escala de Somnolencia de Epworth (ESS), la Escala de Creencias y Actitudes Disfuncionales sobre el Sueño (DBAS-18) y un diario de sueño. Se encontraron diferencias significativas con respecto a calidad subjetiva de sueño, consumo de medicación hipnótica y problemas durante el sueño, en los niveles de somnolencia diurna en la ESS y con respecto a creencias disfuncionales sobre el sueño. En conclusión, los pacientes con TCA manifiestan peor calidad de sueño y más problemas de sueño que los controles sanos. Estos resultados ponen de manifiesto la conveniencia de atender a los problemas de sueño en los programas terapéuticos con este tipo de pacientes (AU)

The present research focuses on the analysis of the quality of sleep in eating disorder patients (EDs). For this purpose, scores of 13 EDs patients and 15 controls on the Pittsburg Sleep Quality Inventory (PSQI), the Epworth Somnolence Scale (ESS), the Dysfunctional Beliefs and Attitudes about Sleep Scale (DBAS-18) and a sleep diary were compared. Significant differences were found with regard to subjective quality of sleep, hypnotic medication use, and sleep problems in the PSQI; in addition significant differences were shown on daytime sleepiness levels in the ESS, and in relation to several dysfunctional beliefs about the sleep. In conclusion, EDs patients show less quality of sleep and more sleep problems than controls. These results show the need to be aware into to sleep problems in ED therapeutic interventions (AU)

Humanos , Transtornos do Sono-Vigília/epidemiologia , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Psicometria/instrumentação , Distúrbios do Sono por Sonolência Excessiva/epidemiologia , Fatores de Risco , Estudos de Casos e Controles
Rev. otorrinolaringol. cir. cabeza cuello ; 73(1): 51-56, abr. 2013. tab
Artigo em Espanhol | LILACS | ID: lil-679043


Introducción: La cirugía mayor ambulatoria confiere al sistema sanitario un modelo de gestión eficiente y de alta calidad. Objetivo: Conocer los resultados de la cirugía mayor ambulatoria en otorrinolaringología (ORL) en un hospital de baja complejidad. Material y método: Estudio descriptivo retrospectivo realizado en el Hospital Santo Tomás de Limache entre los años 2004 y 2009. La inclusión de pacientes sometidos a cirugía otorrinolaringológica bajo la modalidad de cirugía mayor ambulatoria. Se realizó análisis descriptivo en base a promedios, desviación estándary proporciones. En análisis bivariado, se emplearon las pruebas de chi cuadrado y t-student. Resultados: Se incorporó 815 pacientes. El 58% fue de sexo masculino, con edad promedio de 8,4 ±6,2 años. La adenoamigdalectomía sola o asociada a otras cirugías se efectuó en 54,2(0)% de los casos. La tasa de complicaciones posoperatorias fue de 1,22 %, la mitad de ella, la hemorragia. No hubo mortalidad. No se encontró asociación estadística entre la presencia de complicaciones y alguna variable en particular. Conclusiones: En pacientes de otorrinolaringología seleccionados, la cirugía mayor ambulatoria efectuada en un hospital de baja complejidad tiene buenos resultados, con una baja tasa de complicaciones.

Background: Major ambulatroy surgery provide to public health and efficient and high quality model. Aim: To know teh results in patient underwent Otorrinolaringologic surgery in a low complexity hospital. Material and method: Date from 815 who underwent Otorrinolaringologic surgery carried on a major ambulatory surgery basis in Hospital Santo Tomás de Limache, between 2004 and 2009 where retrospectively reviewed. Analysed date included sex, age, type of conducted surgery, type of complications and the period of time in which patients were discharged. Averages, standard deviation and proportions were used. In bivariate analysis, chi square and t-student were used. Results: 58% of enrolled patients were males with age average of 8.4 ±6.2 years. Adenotonsillectomy single or associated to other surgeries took place in 54,2% of the cases. The rate ofpostoperation side effects was 1.22%%, And half of these patient presented postoperatory bleeding. There was no mortality. There was not statistical association between the presence of complications and some variable in particular. Conclusions: Major ambulatory surgery In selected patients who need otorrinolaringologic surgery in a low complexity hospital is safe whith low rate of complication.

Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Otorrinolaringológicos/métodos , Procedimentos Cirúrgicos Otorrinolaringológicos/estatística & dados numéricos , Procedimentos Cirúrgicos Ambulatórios/métodos , Procedimentos Cirúrgicos Ambulatórios/estatística & dados numéricos , Complicações Pós-Operatórias , Estudos Retrospectivos , Resultado do Tratamento
GEN ; 65(3): 234-236, sep. 2011.
Artigo em Espanhol | LILACS | ID: lil-664153


Introducción: Recientemente se ha desarrollado un accesorio para la disección submucosal endoscópica (DSE) que combina un jet de agua ultrafino de alta presión para la hidrodisección submucosal con un electrocauterio. Objetivo: Mostrar la experiencia inicial con el uso del ERBE Hybrid Knife para la DSE. Materiales y pacientes: Se incluyen 2 pacientes con adenomas planos extendidos lateralmente de colon y recto, a quienes se les realizó DSE con el ERBE Hybrid Knife como instrumento único y la fuente electroquirúrgica ERBE VIO-200 D. Se marcó el área utilizando coagulación (FORCED COAG). El jet de agua de alta presión se usó en forma intermitente para elevar la submucosa durante el proceso de disección a una presión entre 45 y 60 bar. Luego se hizo una incisión circunferencial en la mucosa y se realizó la disección submucosal usando los modos FORCED COAG Y ENDOCUT D del mismo accesorio. Resultados: Las lesiones estaban localizadas en sigmoides y recto bajo, de 1,5 y 3 cm de diámetro respectivamente, las cuales fueron resecadas en su totalidad en un solo segmento. El tiempo promedio utilizado fue de 65 minutos. Los procedimientos fueron realizados con sedación profunda asistida por anestesiólogo. No hubo complicaciones mayores. La histología de las lesiones fue adenoma tubulovelloso de colon con displasia leve y adenoma plano de recto. Conclusión: El ERBE Hybrid Knife es una alternativa para realizar la DSE, simplificando la técnica al usar un solo instrumento. Se deben hacer estudios prospectivos para medir el impacto en la estandarización de la técnica.

Introduction: Recently there has been developed an accessory for endoscopic submucosal dissection (ESD) that combines an ultra-thin water jet high pressure for a submucosal hydrodissection with an electrocautery. Aim: initial experience with the use of ERBE Hybrid Knife for the DSE. Materials and patients: The study included 2 patients with laterally spreading flat adenomas of the colon and rectum, who underwent ESD with ERBE Hybrid Knife as a single instrument and ERBE VIO electrosurgical source-200 D. It was marked the area using coagulation (FORCED COAG). The jet of high pressure water was used intermittently to raise the submucosa during the dissection at a pressure between 45 and 60 bar. Then, a circumferential incision in the mucosa and the submucosal dissection were performed with modes ENDOCUT D and FORCED COAG of the same accessory. Results: The lesions were located in lower rectum and sigmoid colon, 1.5 and 3 cm in diameter respectively, which were resected in its entirety as a single segment. The mean time spent was 65 minutes. The procedures were performed with deep sedation assisted by an anesthesiologist. There were no major complications. The histology of the lesions was tubulovillous adenoma with mild dysplasia colon and rectal adenoma plane. Conclusion: The ERBE Hybrid Knife is an alternative for the ESD, simplifying the technique of using a single instrument. Prospective studies should be made to measure the impact on the standardization of the technique.

Humanos , Adenoma/cirurgia , Adenoma , Colo/cirurgia , Colo/lesões , Colo/ultraestrutura , Dissecação/métodos , Endossonografia/métodos , Gastroenterologia
GEN ; 64(3): 200-205, sep. 2010. ilus, tab
Artigo em Espanhol | LILACS | ID: lil-664496


El desarrollo reciente de la cápsula endoscópica (CE) y la enteroscopia asistida por balones (EAPB) ha cambiado el algoritmo diagnóstico de la patología del intestino delgado. La combinación de ambos métodos parece ser una herramienta útil. Mostrar la experiencia con el uso combinado de CE y EAPB en pacientes con sospecha de enfermedades del intestino delgado. 34 pacientes a quienes se les realizó CE y EAPB. El endoscopista conocía el resultado de la CE. Equipos: CE M2A, PillCam SB (Given Imaging), videoenteroscopios doble balón Fujinon EN-450P5, EN-450T5, enteroscopio balón único Olympus SIG Q-180. Se registraron datos demográficos, indicaciones, segmentos evaluados, hallazgos y complicaciones. 34 pacientes (19 mujeres, 15 hombres), edad promedio: 57,67 años. Principales indicaciones: sangrado digestivo oscuro evidente 67,64 %, anemia 11,76%, enfermedad de Crohn 5,88%. La EAPB se realizó por vía anterógrada en 25 pacientes, retrógrada en 4 y combinada en 5. Se detectaron lesiones con CE en 85,29% pacientes, con EAEAPB en 67,64% y con ambos métodos en 52,9%. En 11 pacientes se detectaron lesiones por CE y la EAPB fue normal. En 2 pacientes hubo hallazgos en la EAPB no vistos por la cápsula. Hallazgos mas frecuentes: CE: angioectasias 11, tumor subepitelial ulcerado 2, presencia de sangre 4, úlceras 3. EAPB: angioectasias 9, tumor subepitelial ulcerado 1, ulceras 3, divertículo de Meckel, 1. Terapéutica endoscópica en 13 pacientes y cirugía en 4 con sangrado digestivo. CE y EBU combinadas permiten mejorar el diagnóstico y orientar la conducta terapéutica en pacientes con sospecha de patología del intestino delgado...

The recent development of capsule endoscopy (CE) and balloon-assisted enteroscopy (BAE) has changed the diagnostic algorithm of small bowel pathology. The combination of both methods seems to be a useful tool. To show the experience with the combined use of CE and BAE in patients with suspected small bowel diseases. 34 patients who underwent CE and BAE. The endoscopist knew the outcome of the CE. We used the CE M2A, Pillcam (Given Imaging), double balloon videoenteroscopy Fujinon EN-450P5, EN-450T5, single balloon enteroscopy GIS Olympus Q-180. Demographic data, indications, segments evaluated, findings and complications were recorded. 34 patients (19 women, 15 men), average age: 57.67 years. Main indications: evident obscure gastrointestinal bleeding 67.64%, anemia 11, 76%, Crohn’s disease 5.88%. Anterograde BAE was performed in 25 patients, retrograde in 4 and combined in 5 patients. CE lesions were detected in 85.29% patients with BAE in 67.64% and 52.9% in both methods. In 11 patients lesions were detected by CE and the BAE was normal. In 2 patients there were findings in the BAE, not seen by the capsule. Most common finding: CE: 11 angiodysplasia, 2 subepithelial ulcerated tumor, 4 blood presence, 3 ulcers. BAE: 9 angiodysplasia, 1 subepithelial ulcerated tumor, 3 ulcers, 1 Meckel diverticulum. Therapeutic endoscopy was performed in 13 patients and surgery in 4 patients with digestive bleeding. Combined CE and BAE allow improving the diagnostic and orientate the therapeutic behavior in patients with suspected small bowel pathology...

Humanos , Masculino , Adulto , Feminino , Pessoa de Meia-Idade , Endoscopia por Cápsula/métodos , Intestino Delgado/anormalidades , Intestino Delgado , Diagnóstico por Imagem , Enteroscopia de Duplo Balão , Gastroenterologia
J Physiol Pharmacol ; 61(1): 59-65, 2010 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-20228416


Oxytocin (OT) is a peptide involved in several physiological functions in the central nervous system including central cardiovascular regulation. To clarify the role of endogenous OT in cardiovascular control, one group of anesthetized rats received unilateral microinjections of the OT receptor antagonist [d(CH(2))(5),Tyr(Me)(2),Orn(8)]-vasotocin (OTA) in the nucleus tractus solitarii (NTS) and a second group was injected with specific OT antiserum (Anti-OT). Moreover, the modulation of the cardiovascular effect of L-glutamate (GLU) by OT was also evaluated by cardiovascular analysis using effective and threshold doses of GLU. Mean arterial pressure (MAP) and heart rate (HR) were measured from a femoral catheter. OTA significantly (p<0.01) decreased the vasopressor and tachycardiac long-lasting response elicited by an effective dose of OT. Microinjections of Anti-OT antibody did not modify the values of MAP and HR compared with the control group. With regard to the OT/GLU coinjections, a subthreshold dose of OT significantly (p<0.001) counteracted the vasodepressor and bradycardiac responses induced by GLU. The coinjection of subthreshold doses of OT and GLU did not produce a change in MAP or in HR. These findings seem to exclude an endogenous tonic action of OT on central regulation of MAP and HR, although they confirm the significant role of OT on central cardiovascular control within the NTS. In fact, the modulation of GLU responses by OT supports the importance of OT on the central cardiovascular adjustments likely acting on the baroreceptor reflex sensitivity.

Pressão Sanguínea/fisiologia , Ácido Glutâmico/metabolismo , Frequência Cardíaca/fisiologia , Ocitocina/fisiologia , Núcleo Solitário/fisiologia , Animais , Barorreflexo/efeitos dos fármacos , Barorreflexo/fisiologia , Pressão Sanguínea/efeitos dos fármacos , Frequência Cardíaca/efeitos dos fármacos , Soros Imunes/administração & dosagem , Masculino , Microinjeções , Ocitocina/administração & dosagem , Ocitocina/análogos & derivados , Ocitocina/imunologia , Ratos , Ratos Sprague-Dawley , Receptores de Ocitocina/antagonistas & inibidores , Núcleo Solitário/efeitos dos fármacos , Núcleo Solitário/metabolismo , Vasotocina/farmacologia
GEN ; 64(1): 14-18, mar. 2010. tab
Artigo em Espanhol | LILACS | ID: lil-664456


Colangiopancreatografía Retrógrada Endoscópica (CPRE), es un método endoscópico avanzado que posibilita el estudio y tratamiento de la vía biliar y pancreática. Este procedimiento requiere alto nivel de conocimientos y destrezas técnicas para garantizar mínimas complicaciones en el paciente. En nuestro país, existen pocos centros para la formación de gastroenterólogos para desarrollar habilidad en la realización de CPRE. Determinar la casuística en procedimientos de CPRE en un centro privado para proveer los estándares más altos en la capacitación teórica y práctica en las técnicas avanzadas de este procedimiento. Estudio retrospectivo, descriptivo, que incluyó pacientes con patologías bilio-pancreáticas que acudieron a la Policlínica Metropolitana y se les realizó CPRE. Durante el período de estudio se realizaron 815 procedimientos, 486 (59,6%) y 329 (40,36%) eran del sexo femenino y masculino respectivamente. La edad promedio de los pacientes fue 53,34 años, con edades comprendidas entre 2 y 98 años, con 18 menores de 12 años. Las indicaciones más frecuentes: colestasis, litiasis biliar, pancreatitis aguda y crónica. Otras indicaciones: fístula biliar, recambio de prótesis, colangitis y pacientes con tumor bilio-pancreático. Los procedimientos terapéuticos abarcaron desde esfinterotomía hasta ampulectomía, toma de biopsia, colocación de prótesis tanto en vía biliar como pancreática, con resolución del problema en la mayoría de los pacientes. Hubo complicaciones en 36 pacientes (4,17%), las más frecuentes fueron hemorragia (16) y pancreatitis post-CPRE (7), de los cuales 3 fueron severas. No se reportaron muertes debido al procedimiento. En nuestro estudio demostramos que estamos dentro de lo que realiza cualquier centro de entrenamiento reportado en la literatura mundial (número de procedimientos, indicaciones, hallazgos, procedimientos terapéuticos y tasa de éxito...

Endoscopic Retrograde Cholangiopancreatography (ERCP) is an advanced endoscopic procedure that allows the study and treatment of biliary and pancreatic ducts. This procedure requires a higher level of knowledge and technical skills, to ensure a minimal complications outcome of the patient. In our country there are few training centers for gastrointestinal specialists for developing the necessary skills for performing ERCP. To asses the statistics of ERCP procedures that were performed in our private hospital between January 2005 until January 2009, to demonstrate that we possessed the high standars on capacitation, both theorical and practical on performing ERCP. ItÊs a descriptive and retrospective study, including all patients that came to our center with pancreatic or billiary pathology and underwent the procedure. 815 ERCP were performed during the time of the study, 486 (59.6%) were female and 329 (40, 36%) were male. The mean age was 53, 34 years, with range between 2 and 98 years, and 18 patients were younger than 12 years. The main indications for the procedure were cholestasis, billiary litiasis, acute and chronic pancreatitis. Also other indications were billiary fistulae, billiary prothesis placement and replacement, cholangitis and tumors of the pancreas and billiary ducts. The therapeutics procedures performed were sphinctectomy, ampullectomy, biopsy, billiary and pancreatic prothesis placement. In most of the cases the problem was solved. There were complications in 36 patients (4, 17%), the most common being bleeding 16 and post ERCP acute pancreatitis 7 there were no deaths attributed to the procedure. In our study we show that our statistics are well placed among the standards of any reported trainning center in the world, regarding number of procedures, indications for the procedure, findings, therapeutic procedures and a very low morbility/mortality rate...

Humanos , Masculino , Adolescente , Adulto , Feminino , Colangiografia/métodos , Pâncreas , Sistema Biliar , Técnicas e Procedimentos Diagnósticos , Endoscopia/instrumentação , Genética
Actas Esp Psiquiatr ; 37(3): 153-7, 2009.
Artigo em Espanhol | MEDLINE | ID: mdl-19533428


INTRODUCTION: Teacher's rating scales for the evaluation of attention deficit and superactivity disorder (TDAH) and conduct disorders have been shown to be useful and valid tools. The Child Psychiatric Hospital Teacher Questionnaire (CPHTQ) of the Hospital Psiquiátrico Infantil Dr. Juan N. Navarro was designed for the assessment of ADHD symptoms, externalizing symptoms and school functioning difficulties of children and adolescents. METHODS: Internal consistency, criterion validity, construct validity and sensitivity of the scale to changes in symptom severity were evaluated in this study. RESULTS: The scale was administered to 282 teachers of children and adolescents aged 5 to 17 years who came to a unit specialized in child psychiatry. The validity analysis of the instrument showed that the internal consistency measured by Cronbach's alpha was 0.94. The factorial analysis yielded 5 factors accounting for 59.1% of the variance: hyperactivity and conduct symptoms, predatory, conduct disorder, inattentive, poor functioning and motor disturbances. The CPHTQ scores on the scale showed positive correlation with the Clinical Global impression (CGI) scale in the patients' response to drug treatment. CONCLUSIONS: The CPHTQ shows adequate validity characteristics that demonstrate its utility in the evaluation of patients with ADHD and its comorbidity with other behavior disorders.

Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Inquéritos e Questionários , Adolescente , Criança , Pré-Escolar , Docentes , Feminino , Humanos , Masculino , Índice de Gravidade de Doença
GEN ; 62(4): 256-288, dic. 2008. ilus, tab
Artigo em Espanhol | LILACS-Express | LILACS | ID: lil-664372


La enfermedad de reflujo gastroesofágico (ERGE) es una enfermedad recurrente relacionada con el flujo retrógrado del contenido gástrico al esófago, con o sin daño tisular a dicho nivel. La Hernia Hiatal (HH) se asocia con ERGE, y se ha relacionado con grados severos de la enfermedad (Esofagitis Erosiva Severa y Esófago de Barrett). Objetivo: Describir la presencia y las alteraciones a nivel de la mucosa esofágica reportadas endoscópicamente en los pacientes que consultan con síntomas de ERGE al servicio de Gastroenterología del Hospital Vargas. Pacientes y métodos: estudio descriptivo de corte transversal, en el cual se evaluaron hallazgos endoscópicos de pacientes que acudieron con síntomas de ERGE a las consultas del servicio de gastroenteologia del Hospital Vargas entre enero-mayo de 2007. Resultados: de 674 pacientes encuestados, 204 pacientes (59 hombres y 145 mujeres)presentaron síntomas de ERGE, a 60 de ellos se les realizó videogastroscopia de manera aleatoria, reportando 23,33% (14 pacientes) con ERGE erosiva, 1,66% (1paciente) con tu submucoso de esófago, 6,66% con esófago Barret y 75% (45 pacientes) sin alteraciones esofágicas. 23 (38,33%) con hernia hiatal, 8 de ellos con esofagitis erosiva. Conclusiones: Nuestro trabajo confirma el valor de la endoscopia digestiva superior en la evaluación de pacientes con síntomas cardinales de ERGE.

Gastro-esophageal reflux disease (GERD) is a recurrent disease related with retrograde progression of gastric contents to the esophagus with or without mucosal damage at this level. Hiatal hernia is associated with GERD and it has been related with severe grades of the disease (severe erosive esophagitis and BarrettÊs esophagus). Aims: to describe the presence of endoscopic features in GERD patientss with cardinals symptoms attended at the Gastroenterology Division of the Vargas Hospital in Caracas. Patients and Methods: this was a descriptive, transversal cohort study in which endoscopic findings in patients with GERD symptoms were evaluated, at the Gastroenterology Service, between January and May 2007. Results: of 674 patients interviewed, 204 patients (59 men and 145 women) presented GERD symptoms; to 60 of them an upper endoscopy randomly was performed. 23,33% (14 patients) had erosive GERD, 1,66% (1 patient) a submucous esophageal tumor, 6,66 % with BarrettÊs esophagus and 75% (45 patients) without esophageal changes, 23 (38,33%) with hiatal hernia, 8 of them with erosive esophagitis. Conclusion: our study supports the importance of performing an upper endoscopy in patients with cardinals symptoms of GERD.

GEN ; 62(3): 182-185, sep. 2008. ilus, tab
Artigo em Espanhol | LILACS-Express | LILACS | ID: lil-664353


Desde hace dos décadas esta descrita la utilidad de las prótesis endoscópicas, en patología biliopancreática. Objetivo: Mostrar la experiencia del Servicio de Gastroenterología del Hospital Vargas de Caracas en la colocación de prótesis endoscópicas en la patología biliopancreática, describiendo características demográficas, patologías más frecuentes, tasa de éxito en su colocación y complicaciones. Pacientes y Métodos: Estudio descriptivo, retrospectivo. Se revisaron datos de los informes de CPRE de pacientes hospitalizados y ambulatorios evaluados en la institución desde enero 1998 hasta abril 2007. Resultados: Se incluyeron 248 procedimientos de 110 mujeres y 73 hombres, 242 correspondieron a colocación de prótesis biliares (234 de teflón o plástico y 8 autoexpansibles metálicas) y 6 prótesis pancreáticas. Las indicaciones mas frecuentes para la colocación de prótesis fueron: patologías neoplásicas (47%), lesiones de la vía biliar post-quirúrgicas o traumáticas (22%) y litiasis biliar (17%). El éxito de la colocación de la prótesis fue del 99,1%. Se reportaron complicaciones en 4% de los procedimientos, con mayor frecuencia la colangitis (2%) y una mortalidad del 0%. Conclusión: La colocación de prótesis endoscópicas en patologías biliopancreáticas es un procedimiento seguro, con un bajo porcentaje de complicaciones y mortalidad.

The utility of the endoscopic stent have been described for two decades in the biliopancreatic diseases. Aims: To show the Gastroenterology Division of the Hospital Vargas de Caracas experience in placing endoscopic stents in biliopancreatic diseases, describing demographic characteristics more frequent diseases, success rates and complications. Patients and Methods: descriptive and retrospective trial. Features of the reports of PEPR of hospitalized and ambulatory patients seen in the institution from January 1998 to april 2007 were reviewed. Results: 248 procedures from 110 women and 73 men were included, 242 had a biliar stent (234 of Teflon or plastic and 8 metallic selfexpanded) and 6 had pancreatic stents. The more frequent indications for placing the stents were: Tumoral disease, (47%), traumatic or post-surgical lesions of the biliary tract (22%) and biliary stones (17%). The success rate of the placing of stents was 99.1%. The procedureÊs complication rate reported was 4%, being colangitis the most frequent with 2% and a 0% mortality. Conclusion: the placing of endoscopic stents in biliopancreatic diseases is a safe procedure, with a low rate of complications and mortality.

GEN ; 62(2): 109-113, jun. 2008. ilus, tab
Artigo em Espanhol | LILACS-Express | LILACS | ID: lil-664333


La enfermedad por reflujo gastroesofágico (ERGE) es uno de los trastornos gastrointestinales con mayor prevalencia; afecta del 10 a 15% de la población general constituyendo una causa frecuente de consulta. Sin embargo, existen pocos reportes acerca de la prevalencia de ERGE en la población general. Objetivos: Determinar la prevalencia de ERGE en la población general adulta del área metropolitana de Caracas y estudiar algunos factores asociados a esta enfermedad. Materiales y métodos: Estudio de corte transversal, realizado en la población general adulta del área metropolitana de Caracas en abril de 2007. Se utilizó una encuesta basada en criterios clínicos epidemiológicos de acuerdo a consensos latinoamericanos y europeos sobre la ERGE. Para el análisis de los resultados se calcularon promedios, medianas y porcentajes. Resultados: De 389 sujetos encuestados, 223 fueron mujeres (57,3%) y 166 hombres (42,7%). El promedio de edad fue 33,89 años. La prevalencia de síntomas cardinales en la ERGE fue 19,02%. En los sujetos con ERGE encontramos que 47,3% ingerían licor al menos un vez al mes, y 21,6% referían hábitos tabáquicos. Conclusión: Se determinó que la prevalencia de la ERGE en la población general adulta del área Metropolitana de Caracas fue de 19,02% encontrándose asociación con el hábito alcohólico.

Gastroesophageal reflux disease (GERD) is one of the gastrointestinals problems with higher prevalence; it affects 10 to 15% of the general population being a frequent cause of medical visit. Nevertheless, there is low number of reports about GERD prevalence. Objectives: to determine GERD prevalence in adult population of the Caracas Metropolitan Area and study some related factors to this disease. Materials and methods: Study of transversal cut, made in adult population in Caracas Metropolitan Area in April 2007. A poll based in clinical and epidemiological criteria in accordance with a Latin- American and European consensus about GERD was used. To analize the results averages, medians and percentages were calculated. Results: of 389 subjects surveyed, 223 were women (57,3%) and 166 were men (42,7%). The mean age of the patients was 33 years old. The cardinals symptoms prevalence was 19,02%. In subjects with GERD we found that 47,3% drank alcohol at least once a week, and 21,6% were smokers. In Conclusion, we found that GERD prevalence in adult population of the Caracas Metropolitan Area was 19, 02% finding a relationship with alcoholic habit.