Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 126
Filtrar
1.
Rev. méd. Urug ; 35(4): 267-280, dic. 2019. tab, fig
Artigo em Espanhol | LILACS | ID: biblio-1026117

RESUMO

Introduccción: en Uruguay, el cáncer de cuello uterino ocupó el tercer lugar con una incidencia promedio de 312 nuevos casos por año; fallecieron 134 mujeres promedio por año en el período 2010 - 2014. Objetivo: el objetivo de este trabajo fue analizar los primeros resultados de una experiencia piloto con la aplicación del test de HPV captura híbrida HC2 (QiagenR) como test de tamizaje primario del cáncer de cuello uterino en una zona del departamento de Canelones. Método: se estudiaron 1.010 mujeres asintomáticas entre 30 y 64 años que concurrieron a realizarse el test de PAP a dos unidades de toma de muestras del Programa de prevención del cáncer de cuello uterino. Se realizó la extracción conjunta de la muestra para PAP, que fue derivada a uno de los laboratorios de citología de la Red de Atención Primaria de Salud y la muestra de HPV que fue procesada con la técnica de captura híbrida en el laboratorio de biología molecular del Centro Hospitalario Pereira Rossell. Las usuarias con resultados HPV + y PAP anormales (ASC-US+) fueron derivadas a colposcopia, con biopsia y posterior tratamiento cuando correspondió. Resultados: el test de HPV fue positivo en 126/1.010 mujeres (12,5%) y el PAP anormal en 167/1.010 (16,5%). El test de HPV fue positivo en todos los casos CIN2+ 13/13 (100%) mientras que el PAP fue anormal (ASCUS+) en 7/13 (54%) para CIN2+ por biopsia. Conclusión: el test de HPV resultó más eficaz y eficiente que el PAP para la detección de lesiones precancerosas de cuello uterino.


Introduction: in Uruguay, cervical cancer occupied the third place with an average incidence of 312 new cases per year. 134 women died in the 2010 -2014 period. Objective: the study aims to analyse the first results in a pilot experience with the application of Hybrid Capture® 2 High-Risk HPV DNA Test™ (hc2) (QiagenR) as the primary screening test for cervical cancer, in the Department of Canelones. Method: 1.010 asymptomatic women whose ages ranged between 30 and 64 years old were studied when they requested a pap smear at two units of sample taking within the Cervical Cancer Prevention Program. Samples were taken along with the pap smear, and sent to one of the cytology labs in the primary health care network, the HPV sample being processed with the hybrid capture technique in the molecular biology laboratory of the Pereira Rossell Hospital Center. Users with abnormal HPV+ and abnormal pap smear results (ASCUS+) were referred to colposcopy, with subsequent biopsy and treatment if required. Results: HPV test was positive in 126/1010 women (12.5%) and PAP was abnormal in 167/1010 cases (16.5%). HPV test was positive in all cases CIN2+ 13/13 (100%) whereas PAP was abnormal (ASCUS+) in 7/13 54%) for CIN2+ in biopsy. Conclusion: HPV test was more effective and efficient than pap smear to detect pre-cancer lesions in the cervix.


Introdução: no Uruguai, no período 2010 - 2014, o câncer de colo do útero foi a terceira causa com uma incidência média de 312 novos casos por ano e uma média de 134 mortes por ano. Objetivo: o objetivo deste trabalho foi analisar os primeiros resultados de uma experiência piloto com a utilização do exame de HPV Captura Híbrida HC2 (QiagenR) na tamizagem primária do câncer de colo do útero em una zona do departamento de Canelones. Método: foram estudadas 1010 mulheres assintomáticas, com idades entre 30 e 64 anos que foram a duas unidades do Programa de Prevenção do Câncer do Colo do Útero para a coleta de amostra para exame de Papanicolau (PAP). Realizou-se uma única extração para duas amostras: uma para PAP, que foi encaminhada a um laboratório de citologia da rede de atenção primária de saúde e outra para o exame de HPV que foi processada com a técnica de captura híbrida no laboratório de biologia molecular do Centro Hospitalario Pereira Rossell. As usuárias com resultados HPV + e PAP anormais (ASCUS+) foram encaminhadas para realização de colposcopia, com biopsia e tratamento quando fosse necessário. Resultados: o exame de HPV foi positivo em 126/1010 mulheres (12.5%) e o PAP foi anormal em 167/1010 (16.5%). O exame de HPV foi positivo em todos los casos CIN2+ 13/13 (100%) e o PAP foi anormal (ASCUS+) em 7/13 (54%) para CIN2+ por biopsia. Conclusão: o exame de HPV foi mais eficaz e eficiente que o PAP para detecção de lesões pré-cancerosas de colo do útero.


Assuntos
Humanos , Feminino , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/prevenção & controle , Programas de Rastreamento/métodos , Infecções por Papillomavirus/diagnóstico , Teste de Papanicolaou
2.
Sci Rep ; 9(1): 9947, 2019 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-31289311

RESUMO

Bacterial/archaeal family X DNA polymerases (PolXs) have a C-terminal PHP domain with an active site formed by nine histidines and aspartates that catalyzes 3'-5' exonuclease, AP-endonuclease, 3'-phosphodiesterase and 3'-phosphatase activities. Multiple sequence alignments have allowed us to identify additional highly conserved residues along the PHP domain of bacterial/archaeal PolXs that form an electropositive path to the catalytic site and whose potential role in the nucleolytic activities had not been established. Here, site directed mutagenesis at the corresponding Bacillus subtilis PolX (PolXBs) residues, Arg469, Arg474, Asn498, Arg503 and Lys545, as well as to the highly conserved residue Phe440 gave rise to enzymes severely affected in all the nucleolytic activities of the enzyme while conserving a wild-type gap-filling activity, indicating a function of those residues in DNA binding at the PHP domain. Altogether, the results obtained with the mutant proteins, the spatial arrangement of those DNA binding residues, the intermolecular transference of the 3'-terminus between the PHP and polymerization active sites, and the available 3D structures of bacterial PolXs led us to propose the requirement to a great degree of a functional/structural flexibility to coordinate the synthetic and degradative activities in these enzymes.

3.
Br J Haematol ; 185(3): 480-491, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30793290

RESUMO

The use of immunochemotherapy has improved the outcome of follicular lymphoma (FL). Recently, complete response at 30 months (CR30) has been suggested as a surrogate for progression-free survival. This study aimed to analyse the life expectancy of FL patients according to their status at 30 months from the start of treatment in comparison with the sex and age-matched Spanish general population (relative survival; RS). The training series comprised 263 patients consecutively diagnosed with FL in a 10-year period who needed therapy and were treated with rituximab-containing regimens. An independent cohort of 693 FL patients from the Grupo Español de Linfomas y Trasplante Autólogo de Médula Ósea (GELTAMO) group was used for validation. In the training cohort, 188 patients were in CR30, with a 10-year overall survival (OS) of 53% and 87% for non-CR30 and CR30 patients, respectively. Ten-year RS was 73% and 100%, showing no decrease in life expectancy for CR30 patients. Multivariate analysis indicated that the FL International Prognostic Index was the most important variable predicting OS in the CR30 group. The impact of CR30 status on RS was validated in the independent GELTAMO series. In conclusion, FL patients treated with immunochemotherapy who were in CR at 30 months showed similar survival to a sex- and age-matched Spanish general population.

4.
Oncotarget ; 9(64): 32383-32399, 2018 Aug 17.
Artigo em Inglês | MEDLINE | ID: mdl-30190794

RESUMO

Diffuse large B-cell lymphoma (DLBCL) accounts for approximately 30% of non-Hodgkin lymphoma (NHL) cases in adult series. DLBCL is characterized by marked clinical and biological heterogeneity, encompassing up to 16 distinct clinicopathological entities. While current treatments are effective in 60% to 70% of patients, those who are resistant to treatment continue to die from this disease. An expert panel performed a systematic review of all data on the diagnosis, prognosis, and treatment of DLBCL published in PubMed, EMBASE and MEDLINE up to December 2017. Recommendations were classified in accordance with the Grading of Recommendations Assessment Development and Evaluation (GRADE) framework, and the proposed recommendations incorporated into practical algorithms. Initial discussions between experts began in March 2016, and a final consensus was reached in November 2017. The final document was reviewed by all authors in February 2018 and by the Scientific Committee of the Spanish Lymphoma Group GELTAMO.

5.
3 Biotech ; 8(8): 366, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30105191

RESUMO

The present study reports the effect of treatment of coconut embryogenic structure explants (derived from embryogenic callus) with the calcium ionophore A23187 (0, 1, 5, 10 µM) to promote somatic embryogenesis under in vitro conditions. The results showed no significant increase in the percentage of explants forming embryogenic callus, but with 1 µM ionophore there were significant increases in the formation of embryogenic structures per callus (2.8-fold), of somatic embryos per callus (1.5-fold) and also a greater absolute number (1.5-fold) of developing plantlets per callus. The ionophore treatment also promoted a change of pattern of the expression of the CnSERK gene during embryogenic callus formation. It is proposed that if the use of ionophore A23187 treatment is coupled with an embryogenic callus multiplication process there could be a potentially greater increase in the efficiency of the formation of somatic embryos and plantlets of coconut.

6.
Ginecol. obstet. Méx ; 86(9): 621-626, feb. 2018. tab, graf
Artigo em Espanhol | LILACS-Express | ID: biblio-984486

RESUMO

Resumen ANTECEDENTES: El nevo comedónico es un tumor benigno del aparato pilosebáceo. Puede aparecer en topografía poco habitual, como la región mamaria. Es de manifes-tación aislada o puede formar parte del síndrome de nevo comedónico. No precisa tratamiento, salvo por motivos estéticos o complicaciones. CASO CLINICO: Paciente de 45 años que acudió a consulta por una dermatosis locali-zada en el tronco, unilateral, dispuesta linealmente, que afectaba la línea axilar media y la región mamaria derecha. Caracterizada por una placa de 4 x 1 cm, conformada por comedones abiertos. El padecimiento se inició durante la infancia, asintomático, sin aumento de la dermatosis. En la dermoscopia se observaron tapones de queratina color negro de 3 mm de diámetro. La biopsia incisional reportó que se trataba de un nevo comedónico. CONCLUSION: El nevo comedónico es un tumor poco frecuente que puede aparecer en la región mamaria y debe reconocerse como padecimiento benigno.


Abstract BACKGROUND: Comedonic nevus is a rare benign tumor of the pilo-sebaceous unit which can occur in unusual topography such as the mammary region. It can have an isolated presentation or as part of the nevus comedonic syndrome. There is no treat-ment except for aesthetic reasons or secondary complications. CLINICAL CASE: A 45- year-old patient presented with a unilateral, linearly arranged dermatosis located on the trunk, affecting the axillary midline and the right mam-mary region. Characterized by a plaque of 4 x 1 cm, formed by open comedons. Starts from childhood and referred as asymptomatic, it has not presented changes during life. By dermoscopy 3mm diameter black keratin plugs were observed. An incisional biopsy was performed and sent to a histopathological study, which reported as comedonic nevus. CONCLUSION: Comedonic nevus is a rare tumor that can occur in the mammary region and must be recognized as a benign entity.

7.
Educ. med. super ; 31(4): 1-15, oct.-dic. 2017.
Artigo em Espanhol | LILACS | ID: biblio-953122

RESUMO

Introducción: el proceso pedagógico de posgrado motiva el interés de muchos investigadores porque es mediante este que se da continuidad a la formación profesional de los egresados universitarios. Objetivos: presentar una visión teórica, renovada y crítica del proceso pedagógico de posgrado, de su esencia y estructura, así como de algunos de sus retos en la elevación, ampliación o reorientación de la superación de los profesionales de la salud. Métodos: se realizó un análisis de tipo histórico-lógico, de sistematización así como deductivo-inductivo. Se trabajó con el método general dialéctico-materialista. Resultados: se contribuyó a tener una mejor base para la didáctica y el diseño curricular del posgrado, así como sirvió de base para la elaboración de programas de superación profesional y de formación académica, la consulta para la elaboración de tesis de maestría y doctorado y para la preparación metodológica de profesores y tutores, también para la orientación y organización del aprendizaje en este nivel educacional sobre la base del enfoque histórico-cultural y el acervo cultural pedagógico cubano. Conclusiones: el análisis del proceso pedagógico de posgrado a partir de la actividad rectora del profesional universitario de la salud permite llegar a su esencia, el para qué del posgrado, y comprender los avances y perspectivas del posgrado en el sector de la salud en Cuba(AU)


Introduction: The postgraduate pedagogical process motivates the interest of many researchers because it gives continuity to the professional training of university graduates. For this article, the theoretical-practical systematization and the theoretical analysis of the postgraduate activity were used. Objective: To present a theoretical, renewed and critical vision of the postgraduate pedagogical process, its essence and structure, as well as some of its challenges in the progression, expansion or reorientation of the development of health professionals. Results: The contribution was having better foundations for the didactic and curricular design of the postgraduate courses, as well as for the elaboration of professional improvement and academic training programs, the consultation for the preparation of master's and doctoral degree theses and for the methodological training of teachers and tutors, also for the orientation and organization of learning at this educational level based on the historical-cultural approach and the Cuban pedagogical cultural heritage. Conclusions: The analysis of the postgraduate pedagogical process based on the governing activity of the university health professional allows us to reach the essence of postgraduate courses, and understand the advances and perspectives of postgraduate courses in the health sector in Cuba(AU)


Assuntos
Humanos , Educação de Pós-Graduação , Capacitação Profissional
8.
Educ. med. super ; 31(4): 1-15, oct.-dic. 2017.
Artigo em Espanhol | CUMED | ID: cum-72400

RESUMO

Introducción: el proceso pedagógico de posgrado motiva el interés de muchos investigadores porque es mediante este que se da continuidad a la formación profesional de los egresados universitarios. Objetivos: presentar una visión teórica, renovada y crítica del proceso pedagógico de posgrado, de su esencia y estructura, así como de algunos de sus retos en la elevación, ampliación o reorientación de la superación de los profesionales de la salud. Métodos: se realizó un análisis de tipo histórico-lógico, de sistematización así como deductivo-inductivo. Se trabajó con el método general dialéctico-materialista. Resultados: se contribuyó a tener una mejor base para la didáctica y el diseño curricular del posgrado, así como sirvió de base para la elaboración de programas de superación profesional y de formación académica, la consulta para la elaboración de tesis de maestría y doctorado y para la preparación metodológica de profesores y tutores, también para la orientación y organización del aprendizaje en este nivel educacional sobre la base del enfoque histórico-cultural y el acervo cultural pedagógico cubano. Conclusiones: el análisis del proceso pedagógico de posgrado a partir de la actividad rectora del profesional universitario de la salud permite llegar a su esencia, el para qué del posgrado, y comprender los avances y perspectivas del posgrado en el sector de la salud en Cuba(AU)


Introduction: The postgraduate pedagogical process motivates the interest of many researchers because it gives continuity to the professional training of university graduates. For this article, the theoretical-practical systematization and the theoretical analysis of the postgraduate activity were used. Objective: To present a theoretical, renewed and critical vision of the postgraduate pedagogical process, its essence and structure, as well as some of its challenges in the progression, expansion or reorientation of the development of health professionals. Results: The contribution was having better foundations for the didactic and curricular design of the postgraduate courses, as well as for the elaboration of professional improvement and academic training programs, the consultation for the preparation of master's and doctoral degree theses and for the methodological training of teachers and tutors, also for the orientation and organization of learning at this educational level based on the historical-cultural approach and the Cuban pedagogical cultural heritage. Conclusions: The analysis of the postgraduate pedagogical process based on the governing activity of the university health professional allows us to reach the essence of postgraduate courses, and understand the advances and perspectives of postgraduate courses in the health sector in Cuba(AU)


Assuntos
Humanos , Capacitação Profissional
9.
Br J Haematol ; 178(5): 699-708, 2017 09.
Artigo em Inglês | MEDLINE | ID: mdl-28782811

RESUMO

The diagnostic criteria for follicular lymphoma (FL) transformation vary among the largest series, which commonly exclude histologically-documented transformation (HT) mandatorily. The aims of this retrospective observational multicentre study by the Spanish Grupo Español de Linfoma y Transplante Autólogo de Médula Ósea, which recruited 1734 patients (800 males/934 females; median age 59 years), diagnosed with FL grades 1-3A, were, (i) the cumulative incidence of HT (CI-HT); (ii) risk factors associated with HT; and (iii) the role of treatment and response on survival following transformation (SFT). With a median follow-up of 6·2 years, 106 patients developed HT. Ten-year CI-HT was 8%. Considering these 106 patients who developed HT, median time to transformation was 2·5 years. High-risk FL International Prognostic Index [Hazard ratio (HR) 2·6, 95% confidence interval (CI): 1·5-4·5] and non-response to first-line therapy (HR 2·9, 95% CI: 1·3-6·8) were associated with HT. Seventy out of the 106 patients died (5-year SFT, 26%). Response to HT first-line therapy (HR 5·3, 95% CI: 2·4-12·0), autologous stem cell transplantation (HR 3·9, 95% CI: 1·5-10·1), and revised International Prognostic Index (HR 2·2, 95% CI: 1·1-4·2) were significantly associated with SFT. Response to treatment and HT were the variables most significantly associated with survival in the rituximab era. Better therapies are needed to improve response. Inclusion of HT in clinical trials with new agents is mandatory.


Assuntos
Antineoplásicos/uso terapêutico , Transformação Celular Neoplásica/patologia , Linfoma Folicular/tratamento farmacológico , Linfoma Folicular/patologia , Rituximab/uso terapêutico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Transformação Celular Neoplásica/efeitos dos fármacos , Progressão da Doença , Feminino , Humanos , Linfoma Folicular/mortalidade , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Prognóstico , Estudos Retrospectivos , Medição de Risco/métodos , Espanha/epidemiologia , Análise de Sobrevida , Adulto Jovem
10.
Sensors (Basel) ; 17(1)2017 Jan 19.
Artigo em Inglês | MEDLINE | ID: mdl-28106832

RESUMO

The number of elderly and chronically ill patients has grown significantly over the past few decades as life expectancy has increased worldwide, leading to increased demands on the health care system and significantly taxing traditional health care practices. Consequently, there is an urgent need to use technology to innovate and more constantly and intensely monitor, report and analyze critical patient physiological parameters beyond conventional clinical settings in a more efficient and cost effective manner. This paper presents a technological platform called PlaIMoS which consists of wearable sensors, a fixed measurement station, a network infrastructure that employs IEEE 802.15.4 and IEEE 802.11 to transmit data with security mechanisms, a server to analyze all information collected and apps for iOS, Android and Windows 10 mobile operating systems to provide real-time measurements. The developed architecture, designed primarily to record and report electrocardiogram and heart rate data, also monitors parameters associated with chronic respiratory illnesses, including patient blood oxygen saturation and respiration rate, body temperature, fall detection and galvanic resistance.


Assuntos
Assistência à Saúde , Frequência Cardíaca , Monitorização Fisiológica , Oximetria , Respiração , Software
11.
Rev. chil. obstet. ginecol ; 81(6): 520-525, dic. 2016. ilus
Artigo em Espanhol | LILACS | ID: biblio-844527

RESUMO

La miocardiopatía Takotsubo, o miocardiopatía por estrés, se define como una disfunción del segmento apical del ventrículo izquierdo, aguda, transitoria y reversible. Normalmente se relaciona con algún tipo de agente estresante, ya sea físico o emocional, pudiendo confundirse este cuadro con un síndrome coronario agudo. Se considera una patología rara, pero que es importante incluir en el diagnóstico diferencial de los trastornos cardiacos, sospechándolo previamente por la sintomatología. Está caracterizado por alteraciones en el electrocardiograma, como elevación del segmento ST en derivaciones precordiales e inversión de la onda T, elevación de las enzimas de necrosis miocárdica o patrones alterados en la ecocardiografía, como la disfunción ventricular apical con hiperquinesia de zonas basales. En cuanto a la fisiopatología, parece que la estimulación simpática juega un papel importante, en el que la disfunción ventricular se desencadena por algún tipo de estrés físico o emocional. Éste provoca una descarga de catecolaminas con un efecto cardiotóxico debido, en su mayor parte, al efecto del adenosín monofosfato cíclico. El tratamiento consiste en las medidas soporte de una miocardiopatía, evitando los fármacos teratogénicos o perjudiciales durante el periodo de lactancia. La evolución es favorable en la mayoría de los casos y el cuadro remite por completo, por lo que el pronóstico en líneas generales se considera bueno. En este trabajo se expone el caso de un parto instrumentado, en el que se manifiesta un cuadro compatible con una miocardiopatía Takotsubo, posiblemente relacionado con un procedimiento invasivo como factor desencadenante.


Takotsubo cardiomyopathy or stress cardiomyopathy is defined as an acute, transient, and reversible dysfunction of the apical segment of the left ventricle. It is usually associated with some sort of stressor, whether physical or emotional, and could be confused with an acute coronary syndrome. It is considered a rare disease, so it is important to include it in the differential diagnosis, previously suspecting the symptoms. It is characterized by alterations in the electrocardiogram such as ST segment elevation and inversion of the T wave in precordial leads, elevation of myocardial necrosis enzymes, or altered patterns on echocardiography such as apical ventricular dysfunction with hyperkinesia of basal areas. Regarding the pathophysiology, it seems that sympathetic stimulation plays an important role, in which ventricular dysfunction is triggered by some kind of physical or emotional stress. This causes a release of catecholamines with cardiotoxic effects due, mostly, to the effect of cyclic AMP. Treatment involves cardiomyopathy supportive care, avoiding teratogenic or harmful drugs during lactation. The evolution is favorable in most cases and the clinical picture abates completely, so the prognosis is generally considered good. In this paper, we expose a case of an instrumental labor in which a clinical picture compatible with Takotsubo cardiomyopathy is presented, triggered by an invasive procedure.


Assuntos
Humanos , Feminino , Gravidez , Adulto , Estresse Psicológico/complicações , Cardiomiopatia de Takotsubo/etiologia , Eletrocardiografia , Complicações Cardiovasculares na Gravidez , Radiografia Torácica , Cardiomiopatia de Takotsubo/diagnóstico por imagem , Cardiomiopatia de Takotsubo/fisiopatologia
12.
BMC Musculoskelet Disord ; 17(1): 409, 2016 10 03.
Artigo em Inglês | MEDLINE | ID: mdl-27716217

RESUMO

BACKGROUND: Isolated gastrocnemius contracture is thought to lead to numerous conditions. Although many techniques have been described for gastrocnemius recession, potential anesthetic, cosmetic, and wound-related complications can lead to patient dissatisfaction. Open and endoscopic recession techniques require epidural anesthesia, lower limb ischemia, and stitches and may lead to damage of the sural nerve, which is not under the complete control of the surgeon at all stages of the procedure. The purpose of this study was to evaluate the safety and efficacy of a new technique based on ultrasound-guided ultra-minimally invasive gastrocnemius recession. METHODS: We performed a pilot study with 22 cadavers to ensure that the technique was effective and safe. In the second phase, we prospectively performed gastrocnemius recession in 23 patients (25 cases) with chronic non-insertional Achilles tendinopathy, equinus foot, and other indications. In the clinical study, we evaluated the range of dorsiflexion before and after the procedure, clinical outcomes with VAS and AOFAS scores, and potential complications, including neurovascular injuries. RESULTS: We achieved complete release of the gastrocnemius tendon in all cases in the cadaveric study, with no damage to the sural nerve or vessels and minimal damage to the underlying muscle fibers. Ankle dorsiflexion increased for every patient in the study (mean, 14°; standard deviation, 3°) and was maintained throughout follow-up. The mean preoperative VAS score was 7 (6-9), which improved to 0 (0-1). The AOFAS Ankle-Hindfoot Score improved from a mean of 30 (20-40) to 93 (85-100) at 6 months. No major complications were observed. All patients returned to their previous sports after 6 months. CONCLUSIONS: After cadaveric and clinical study, we considered the technique to be safe and effective to perform ultrasound-guided ultra-minimally invasive gastrocnemius recession using a 1-mm incision in vivo. This novel technique represents an alternative to open techniques, with encouraging results and with the advantages of reducing pain, obviating lower limb ischemia, deeper anaesthesia, thus decreasing complications and contraindications and accelerating recovery.


Assuntos
Tendão do Calcâneo/cirurgia , Contratura/cirurgia , Pé Equino/cirurgia , Pé/cirurgia , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Procedimentos Ortopédicos/métodos , Tendinopatia/cirurgia , Adolescente , Adulto , Feminino , Pé/irrigação sanguínea , Pé/inervação , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Minimamente Invasivos/efeitos adversos , Procedimentos Ortopédicos/efeitos adversos , Dor/cirurgia , Satisfação do Paciente , Projetos Piloto , Estudos Prospectivos , Amplitude de Movimento Articular , Recuperação de Função Fisiológica , Resultado do Tratamento , Ultrassonografia de Intervenção , Adulto Jovem
14.
Nutr. hosp ; 33(2): 345-350, mar.-abr. 2016. tab
Artigo em Inglês | IBECS | ID: ibc-153312

RESUMO

Introduction: Guatemala has been experiencing a lifestyle transition. While chronic malnutrition remains prevalent obesity, has increased substantially. Objective: The study aimed to provide current information on nutritional status trends in Guatemala. Methods: A cross-sectional study was conducted in two different regions of Guatemala. A random sample of 392 children and adolescents (aged 5-18 years), stratified by geographical location (rural and urban), sex and age, was selected. Results: Approximately 62% of the children and adolescents in the urban sample are overweight, whilst 13.8% are obese. Amongst urban participants the prevalence of overweight and obesity was higher in the 5-10 year age group. In the rural sample, the prevalence of overweight was 23.8% with 1.1% obesity. The highest prevalence of overweight and obesity was found in the 11-14 year age group. The urban group shows a higher prevalence of overweight and obesity compared to any of the age categories of the rural group (except in the 15-18 year age group where obesity in the rural group is slightly higer). A significantly higher prevalence of stunting was observed in the rural group than in the urban group, except in 15-18 year age group. Underweight was significantly higher in the 5-10 year age category of the rural group (25 vs. 1.2 %). The prevalence of thinness was also significantly higher in rural areas for all age groups except the 5-10 year age group. Conclusion: A double burden of malnutrition and a high prevalence of underweight and overweight exist among children and adolescents in Guatemala (AU)


Introducción: Guatemala ha estado experimentando una transición en sus estilos de vida. Mientras que la desnutrición crónica sigue siendo prevalente, se ha experimentado un aumento sustancial de los casos de obesidad. Objetivo: proporcionar información actualizada sobre las nuevas tendencias en cuanto al estado nutricional en Guatemala. Métodos: se diseñó un estudio transversal con una muestra de 392 niños y adolescentes (5-18 años) seleccionados de manera aleatoria. El muestreo fue estratificado según su ubicación geográfica (rural y urbana), sexo y edad. Resultados: alrededor del 62% de la muestra urbana presentó problemas de sobrepeso y un 13,8 de obesidad. Entre los participantes urbanos, la prevalencia de sobrepeso/obesidad fue mayor en el grupo de 11-14 años. El grupo urbano presentó una mayor prevalencia de sobrepeso/ obesidad que el grupo rural para todos los grupos de edad (excepto en el grupo de 15-18 años que presentó unos índices de obesidad ligeramente más elevados en el grupo rural). Se observó una mayor prevalencia de retraso en el crecimiento en el grupo rural, excepto para el grupo de edad de 15-18 años. La prevalencia de bajo peso fue significativamente mayor en el grupo rural (25% vs. 1,2%) así como la prevalencia del delgadez, excepto para el grupo de edad de 5-10 años. Conclusión: la alta prevalencia de bajo peso y la de sobrepeso/obesidad coexisten en los niños y adolescentes en Guatemala (AU)


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Desnutrição/epidemiologia , Obesidade Pediátrica/epidemiologia , Sobrepeso/epidemiologia , População Urbana/estatística & dados numéricos , População Rural/estatística & dados numéricos , Guatemala/epidemiologia
15.
Rev. méd. Urug ; 31(4): 231-240, dic. 2015. tab
Artigo em Espanhol | LILACS | ID: lil-778609

RESUMO

En Uruguay se registran 351 nuevos casos de cáncer de cuello uterino y mueren en promedio 140 mujeres por esta causa. Se dispone de un Programa de Prevención Secundaria del Cáncer de Cuello Uterino cuyo test de tamizaje es el Papanicolaou convencional, que ofrece la disponibilidad del test para las usuarias de la Administración de los Servicios de Salud del Estado y existen también normas estatales que obligan a los prestadores del sistema de salud privada a brindarlo sin costo a sus usuarias. No obstante ello, se comprueba un importante número de mujeres que consultan en estadios avanzados de la enfermedad, con pocas posibilidades de curación. Objetivo: determinar los conocimientos, las actitudes, las prácticas y el estadio de la enfermedad en usuarias del Centro Hospitalario Pereira Rossell y del Hospital de Clínicas con el diagnóstico de cáncer cuello uterino invasor realizado durante el año 2009. Material y método: estudio observacional, descriptivo, aplicado a todas las mujeres con diagnóstico de cáncer de cuello uterino invasor a través de una encuesta y revisión de historias clínicas, realizado entre junio de 2010 y setiembre de 2011. Resultados: se entrevistaron 68 pacientes, el 75% de las usuarias contestó en forma adecuada sobre la utilidad del test, el mismo porcentaje declaró que no se hacía el test por falta de motivación. En la práctica solo 13% de las pacientes se realizó el Papanicolaou por control. Las principales barreras declaradas fueron las demoras en la sala de espera y en acceder a la fecha y hora para realizarse el estudio en los servicios de salud. El 47% de los casos encuestados iniciaron su tratamiento en estadios avanzados de la enfermedad. Conclusión: se determina que las usuarias no asumen una conducta preventiva a pesar de tener el conocimiento adecuado. El sistema de salud debería implementar estrategias de información adecuadas para que utilicen en el momento oportuno y frecuencia recomendada los exámenes de tamizaje.


Abstract In Uruguay there are 351 new cases of cervical cancer and an average of 140 women die from this disease. Today, there is a Program for the Secondary Prevention of Cervical Cancer, the screening of which is done with the conventional Pap test for users of the Public Health System. Likewise, there are national provisions that oblige private health providers to offer it for free. Notwithstanding this, a large number of women consult with advanced stages of the disease, with little possibilities for cure. Objective: to determine awareness, attitudes, practices and stage of the disease for users of the Pereira Rossell Hospital Center and the University Hospital with an invasive cervical cancer diagnosis during 2009. Method: observational, descriptive study applied to all women with a diagnosis of invasive cervical cancer through survey and the review of medical histories, performed from June, 2010 through September 2011. Results: 68 patients were interviewed, 75% of whom proved they knew about the test’s usefulness, although the same percentage of women declared they failed to have it due to lack of motivation. As a matter of fact, only 13% of women sought a Pap smear test for control. According to what they stated, the main barriers were delays in the waiting room and in access to an appointment to have the test done hospital in the health systems. 47% of surveyed patients initiated treatment in advanced stages of the disease. Conclusion: the study reveals users fail to undertake a preventive behavior in spite of their being aware of the test and its usefulness. The health system should implement appropriate information strategies so that the screening tests are timely and frequently used.


Resumo No Uruguai são registrados 351 novos casos de câncer de colo de útero y morrem em média 140 mulheres por ano por essa causa. Existe um Programa de Prevenção Secundaria de Câncer de Colo de Útero que emprega o exame de Papanicolaou convencional para tamizagem de paciente; este programa oferece este exame gratuitamente às usuárias de ASSE (Administración de los Servicios de Salud del Estado) existindo ademais normas governamentais que obrigam os prestadores do sistema de saúde privada a oferecê-lo sem custo às suas usuárias. No entanto, um número significativo de mulheres consultam em estádios avançados da doença, com poucas possibilidades de cura. Objetivo: determinar os conhecimentos, atitudes, práticas e o estádio da doença em usuárias do CHPR (Centro Hospitalario Pereira Rossell) e do HC (Hospital de Clínicas) com diagnóstico de câncer de colo de útero invasor realizado durante o ano 2009. Material e método: estudo observacional, descritivo, incluindo todas as mulheres com diagnóstico de câncer de colo útero invasor através de entrevistas e revisão de prontuário de paciente, realizado entre junho de 2010 e setembro de 2011. Resultados: 68 pacientes foram entrevistadas; 75% das usuárias respondeu adequadamente sobre a utilidade do exame; a mesma porcentagem declarou que não fazia o exame por falta de motivação. Na prática somente 13% das pacientes fez o exame de Papanicolaou por controle. As principais barreiras declaradas foram as demoras na sala de espera e conseguir dia e hora para a realização do exame nos serviços de saúde. 47% das entrevistadas iniciou seu tratamento em estádios avançados da doença. Conclusão: as usuárias não assumem uma conduta preventiva apesar de ter conhecimento adequado. O sistema de saúde deveria implementar estratégias adequadas de informação para que realizem os exames de tamizagem no momento oportuno e com a frequência recomendada.


Assuntos
Feminino , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/prevenção & controle , Teste de Papanicolaou/estatística & dados numéricos
16.
Br J Nutr ; 114(10): 1604-11, 2015 Nov 28.
Artigo em Inglês | MEDLINE | ID: mdl-26346647

RESUMO

Hidden hunger occurs in the presence of an otherwise nutritionally or energetically appropriate diet that is deficient in essential vitamins and minerals. Guatemala has the highest rate of child malnutrition in Latin America and the prevalence of hidden hunger is high. The aim of this study was to determine the Mn, Se and Cr dietary intakes in Guatemalan institutionalised children (4-14 years), a population group at high risk of mineral deficiency. For this purpose, the contents of Mn, Se and Cr were analysed in a duplicate diet (for 7 consecutive days) by electrothermal atomisation-atomic absorption spectrophotometry following acid digestion. Mn, Se and Cr intakes from the duplicate diets were in the range of 1·3-2·31 mg/d, 58·7-69·6 µg/d and 6·32-27·57 µg/d, respectively. Mn and Cr values were below current recommended daily intakes. A cereal- and legumes-based diet is habitually consumed by this population. Local vegetables, fruits and nutritional supplements are included daily, but the consumption of fish, meat, eggs and dairy products is very infrequent or negligible. Mean daily energy intake from the 7-d diet was 8418·2 kJ (2012 kcal), with a macronutrient energy distribution of carbohydrates 69·4 %, proteins 12·3 % and fats 18·3 %. Correlations between Mn, Se and Cr intakes and energy and other nutrient intakes were also evaluated. The present findings will help establish new nutritional strategies for this and similar population groups.


Assuntos
Adolescente Institucionalizado , Criança Institucionalizada , Cromo/administração & dosagem , Dieta , Manganês/administração & dosagem , Selênio/administração & dosagem , Adolescente , Criança , Pré-Escolar , Cromo/deficiência , Cultura , Suplementos Nutricionais , Ingestão de Energia , Feminino , Guatemala/epidemiologia , Humanos , Fome , Masculino , Desnutrição/epidemiologia , Manganês/deficiência , Orfanatos , Pobreza , Recomendações Nutricionais , Fatores de Risco , Selênio/deficiência
17.
J Sex Med ; 12(8): 1837-45, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-26139337

RESUMO

BACKGROUND: Patients with male-to-female gender dysphoria (GD) require multidisciplinary assessment and management. Nowadays, more and more patients decide to undergo genital reassignment surgery (GRS) to have aesthetic and functional external female genitalia. Different techniques of this procedure have been described. Orchiectomy, penile disassembly, creation of a neovaginal cavity, repositioning of urethral meatus, and clitorolabioplasty may be identified as the five major steps in all of these techniques. METHODS: We conducted a retrospective study of 60 patients who underwent genital reassignment procedure for male-to-female GD at our department between November 2008 and August 2013 with a minimum follow-up of 1 year. Data were collected on surgical technique, postoperative dilations protocol, complications, and functional and aesthetic outcomes. We describe and critically evaluate the surgical technique used in our department. RESULTS: Follow-up ranged from 14 to 46 months. Two patients developed late neovaginal stricture, and two patients experienced rectovaginal fistulae (one required surgical revision with dermal porcine graft placement). Minor complications occurred in 13 patients and included urethral stenosis, partial wound dehiscence, and minor bleeding. Secondary aesthetic revision surgery was performed in 13 cases. CONCLUSIONS: GRS can provide good functional and aesthetic outcomes in patients with male-to-female GD. However, despite a careful planning and meticulous surgical technique, secondary procedures are frequently required to improve the function and appearance of the neovagina.


Assuntos
Pênis/cirurgia , Complicações Pós-Operatórias/cirurgia , Cirurgia de Readequação Sexual , Transexualismo/cirurgia , Procedimentos Cirúrgicos Urogenitais/métodos , Vagina/cirurgia , Adulto , Estética , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Pênis/inervação , Períneo/cirurgia , Fístula Retovaginal/cirurgia , Estudos Retrospectivos , Cirurgia de Readequação Sexual/métodos , Estruturas Criadas Cirurgicamente , Uretra/cirurgia , Estreitamento Uretral/cirurgia , Vagina/inervação
18.
BMC Microbiol ; 15: 91, 2015 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-25925400

RESUMO

BACKGROUND: Legionella testing conducted at environmental laboratories plays an essential role in assessing the risk of disease transmission associated with water systems. However, drawbacks of culture-based methodology used for Legionella enumeration can have great impact on the results and interpretation which together can lead to underestimation of the actual risk. Up to 20% of the samples analysed by these laboratories produced inconclusive results, making effective risk management impossible. Overgrowth of competing microbiota was reported as an important factor for culture failure. For quantitative polymerase chain reaction (qPCR), the interpretation of the results from the environmental samples still remains a challenge. Inhibitors may cause up to 10% of inconclusive results. This study compared a quantitative method based on immunomagnetic separation (IMS method) with culture and qPCR, as a new approach to routine monitoring of Legionella. RESULTS: First, pilot studies evaluated the recovery and detectability of Legionella spp using an IMS method, in the presence of microbiota and biocides. The IMS method results were not affected by microbiota while culture counts were significantly reduced (1.4 log) or negative in the same samples. Damage by biocides of viable Legionella was detected by the IMS method. Secondly, a total of 65 water samples were assayed by all three techniques (culture, qPCR and the IMS method). Of these, 27 (41.5%) were recorded as positive by at least one test. Legionella spp was detected by culture in 7 (25.9%) of the 27 samples. Eighteen (66.7%) of the 27 samples were positive by the IMS method, thirteen of them reporting counts below 10(3) colony forming units per liter (CFU l(-1)), six presented interfering microbiota and three presented PCR inhibition. Of the 65 water samples, 24 presented interfering microbiota by culture and 8 presented partial or complete inhibition of the PCR reaction. So the rate of inconclusive results of culture and PCR was 36.9 and 12.3%, respectively, without any inconclusive results reported for the IMS method. CONCLUSION: The IMS method generally improved the recovery and detectability of Legionella in environmental matrices, suggesting the possibility to use IMS method as valuable indicator of risk. Thus, this method may significantly improve our knowledge about the exposure risk to these bacteria, allowing us to implement evidence-based monitoring and disinfection strategies.


Assuntos
Carga Bacteriana/métodos , Separação Imunomagnética/métodos , Legionella/isolamento & purificação , Microbiologia da Água , Humanos , Reação em Cadeia da Polimerase em Tempo Real/métodos
20.
Invest Clin ; 55(2): 142-54, 2014 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-24974630

RESUMO

In Latin America, people have largely abandoned the practice of wearing hats and traditional clothing that provided skin protection. Sunscreen application has therefore become essential to protect against the increased sun exposure. The physician-prescribed medical-grade sunscreens provide sufficient sun protection but the requirement for regular use puts a financial burden on the patient that is often not sustainable. An appropriate sunscreen should provide a high and broad ultraviolet (UV) protection against UVB and UVA. Several over-the-counter (OTC) sunscreens have been developed for sale at affordable prices and are available for purchase in convenient locations, such as local grocery stores. The aim of this study was to assess the in vitro UV protection of 34 popular OTC sunscreens found in the Latin American market. UV absorbance/transmittance was quantified by diffusion transmission spectroscopy using coarse silica plaques. Photostability was tested by irradiating them with simulated solar light and calculating the sun protection factor (SPF), critical length of absorption (C lambda ), UVA/UVB ratio, and the spectral uniformity index (SUI). The results indicated that the in vitro SPFs were significantly lower than the value declared on the labels, particularly for those claiming high SPF values; however, the majority of these sunscreens offered high levels of UV protection. Considering the advantages of low cost and ample accessibility, we concluded that this sample of OTC sunscreens can be beneficial to the general public by providing some level of skin protection from solar radiation, and may be promoted to improve compliance with recommended photoprotection behavior.


Assuntos
Fator de Proteção Solar , Protetores Solares/química , Raios Ultravioleta , Absorção , Avaliação Pré-Clínica de Medicamentos/instrumentação , Avaliação Pré-Clínica de Medicamentos/métodos , Técnicas In Vitro , América Latina , Fotoquímica , Quartzo , Espectrofotometria , Protetores Solares/efeitos da radiação , Propriedades de Superfície
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA