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1.
Lasers Med Sci ; 36(3): 657-665, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-32728814

RESUMEN

Either isotretinoin or intense pulsed light (IPL) proved to be effective to alleviate acne lesions, but the combined treatment has rarely been reported. The study aimed to evaluate the efficacy, safety, and patient satisfaction of isotretinoin and 420 nm IPL combined treatment. Forty-seven patients with facial acne with Global Evaluation Acne (GEA) graded 2-4 were randomized into study group and control group. The patients in the control group received oral isotretinoin for 8 weeks. The patients in the study group were treated with oral isotretinoin for 8 weeks, together with a biweekly 420 nm IPL treatment for 4 weeks. Topical agents included adapalene and fusidic acid. Efficacy was evaluated using digital photographies taken at baseline and week 12 by an independent dermatologist, including GEA grade, lesion count, lesion reduction percentage, and effective rate. All patients completed a questionnaire about dermatology life quality index (DLQI) and satisfaction visual analog scale (VAS) on week 12, and were followed up for another 2 months. Adverse events were recorded. The patients in the study group experienced significant reduction in GEA grade, total lesions, and inflammatory lesions on week 12, compared with the control group (p < 0.05). The patients in the study group reported lower DLQI and higher VAS satisfaction (p < 0.05) and experienced lower incidence of relapse (p < 0.05). No severe adverse event was identified in both groups. Compared with isotretinoin alone, isotretinoin and 420 nm IPL combined treatment proved to be more effective within limited treatment duration. It was well-tolerated and the patients' satisfaction was high.


Asunto(s)
Acné Vulgar/terapia , Grupo de Ascendencia Continental Asiática , Tratamiento de Luz Pulsada Intensa/efectos adversos , Isotretinoína/efectos adversos , Isotretinoína/uso terapéutico , Satisfacción del Paciente , China , Femenino , Estudios de Seguimiento , Humanos , Isotretinoína/administración & dosificación , Masculino , Índice de Severidad de la Enfermedad , Encuestas y Cuestionarios , Resultado del Tratamiento , Escala Visual Analógica , Adulto Joven
2.
Medicine (Baltimore) ; 99(12): e19562, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32195965

RESUMEN

It has been established that prediabetes can causes significant comorbidities, particularly in the elderly. The deterioration of glucose metabolism are generally considered to be results of the impairment of the 4 factors: first, second insulin secretion (FPIS, SPIS, respectively), glucose effectiveness (GE), and insulin resistance. In this study, we enrolled older women to investigate their relationships with prediabetes.Five thousand four hundred eighty-two nonobese, nondiabetic women were included. They were divided into normal glucose tolerance and prediabetes groups. Receiver operating characteristic curve was performed to investigate the effects on whether to have prediabetes for each factors. Two models were built: Model 1: FPIS + SPIS, and Model 2: model 1 + GE. The area under the receiver operating characteristic (aROC) curve was used to determine the predictive power of these models.The aROC curve of GE was significantly higher than the diagonal line followed by SPIS and FPIS accordingly. The aROC curve of Model 1 (0.611) was not different from GE. However, Model 2 improved significantly up to 0.663. Based on this model, an equation was built (-0.003 × GE - 212.6 × SPIS - 17.9 × insulin resistance + 4.8). If the calculated value is equal or higher than 0 (≥0), then the subject has higher chance to have prediabetes (sensitivity = 0.607, specificity = 0.635).Among the 4 factors, GE is the most important contributor for prediabetes in older women. By building a model composed of FPIS, SPIS, and GE, the aROC curve increased significantly. The equation built from this model could predict prediabetes precisely.


Asunto(s)
Grupo de Ascendencia Continental Asiática/etnología , Glucosa/metabolismo , Resistencia a la Insulina/fisiología , Secreción de Insulina/fisiología , Estado Prediabético/epidemiología , Anciano , Índice de Masa Corporal , Estudios Transversales , Diabetes Mellitus Tipo 2/epidemiología , Diabetes Mellitus Tipo 2/fisiopatología , Femenino , Prueba de Tolerancia a la Glucosa/métodos , Humanos , Persona de Mediana Edad , Estado Prediabético/fisiopatología , Prevalencia , Sensibilidad y Especificidad , Taiwán/epidemiología
3.
Rev. bras. med. esporte ; 26(1): 16-20, Jan.-Feb. 2020. tab, graf
Artículo en Inglés | LILACS-Express | LILACS | ID: biblio-1057899

RESUMEN

ABSTRACT Introduction: Nandrolone decanoate is a synthetic testosterone analogue considered one of the most widely used anabolic androgenic steroids (AAS) among adolescents and athletes. Chronic ingestion of AAS increases the incidence of cardiovascular abnormalities in athletes, but the mechanism that causes these changes remains unknown. Objectives: The purpose of this study is to verify the possible effects of the use of anabolic androgenic steroids (AAS) on the morphology and oxidative metabolism of the heart in exercised and sedentary rats. Methods: This is a comparative prospective level II study. Twenty-four Wistar rats were distributed in groups that performed voluntary (TG) and sedentary (SG) running exercises, and used AAS: the Anabolic Training Group (ATG), and the Anabolic Sedentary Group (ASG). During the three months of the running protocol, the animals received an intramuscular injection of 5 mg/kg b.p. of AAS. After the training period, the rats were euthanized and the hearts were removed for evaluation of lipid peroxidation and antioxidant capacity, and for morphometric analysis. Results: The anabolic groups, ASG (0.3072 ± 0.0531) and ATG (0.2732 ± 0.0413), presented higher lipid peroxidation when compared to the non-anabolic groups SG (0.1705 ± 0.0224) and TG (0.1785 ± 0.0340). Conclusion: There was no change in total antioxidant capacity or in the thickness of the interventricular septum and left ventricular wall. Thus, the use of anabolic androgenic steroids did not cause morphological changes in the myocardium. However it did alter the oxidative metabolism. It was also verified that aerobic exercise had no protective effect against lipid peroxidation in the myocardium caused by the use of AAS. Level of evidence II; Prospective comparative study.


RESUMO Introdução: O decanoato de nandrolona é um análogo sintético da testosterona, considerado um dos esteroides anabólicos androgênicos (EAA) mais utilizados entre adolescentes e atletas. Sua ingestão crônica aumenta a incidência de anormalidades cardiovasculares em atletas, porém o mecanismo que causa essas alterações ainda permanece desconhecido. Objetivos: O estudo teve como objetivo verificar os possíveis efeitos do uso de esteroides anabólicos androgênicos (EAA) na morfologia e no metabolismo oxidativo do coração de ratos treinados e sedentários. Métodos: Trata-se de um estudo prospectivo comparativo nível II. Vinte e quatro ratos Wistar foram distribuídos em grupos que realizaram exercícios de corrida voluntária (GT) e sedentários (GS) e faziam uso dos EAA, Grupo Treinado com Anabolizante (GTA) e Grupo Sedentário com Anabolizante (GSA). Durante os três meses do protocolo de corrida, os animais receberam injeção intramuscular de 5 mg/kg p.c. de EAA. Após o período de treinamento, houve a eutanásia e remoção do coração dos ratos para avaliação da peroxidação lipídica e capacidade antioxidante, além da análise morfométrica. Resultados: Verificaram-se que os grupos anabolizantes, GSA (0,3072 ± 0,0531) e GTA (0,2732 ± 0,0413), apresentaram maior peroxidação lipídica quando comparados aos grupos não anabolizantes GS (0,1705 ± 0,0224) e GT (0,1785 ± 0,0340). Conclusões: Não houve alteração na capacidade antioxidante total, assim como não houve alteração na espessura do septo interventricular e da parede ventricular esquerda. Portanto, o uso de esteroides anabólicos androgênicos não provocou alterações morfológicas no miocárdio, contudo alterou o metabolismo oxidativo. Verificou-se também que a prática de exercício aeróbico não teve efeito protetor contra a peroxidação lipídica no miocárdio provocada pelo uso dos EAA. Nível de evidência II; Estudo prospectivo comparativo.


RESUMEN Introducción: El decanoato de nandrolona es un análogo sintético de la testosterona considerado uno de los esteroides anabólicos androgénicos (EAA) más utilizados entre los adolescentes y atletas. Su ingestión crónica aumenta la incidencia de anomalías cardiovasculares en atletas, aunque el mecanismo que causa esas alteraciones sigue siendo desconocido. Objetivos: El estudio tuvo como objetivo verificar los posibles efectos del uso de esteroides anabólicos androgénicos (EAA) en la morfología y en el metabolismo oxidativo del corazón de ratones entrenados y sedentarios. Métodos: Se trata de un estudio prospectivo comparativo nivel II. Fueron distribuidos 24 ratones Wistar en grupos que realizaron ejercicios de carrera voluntaria (GE) y sedentarios (GS), y hacían uso de los EAA, Grupo Entrenado con Anabolizante (GEA) y Grupo Sedentario con Anabolizante (GSA). Durante los tres meses del protocolo de carrera, los animales recibieron inyección intramuscular de 5 mg/kg p.c. de EAA. Después del período de entrenamiento, hubo la eutanasia y remoción del corazón de los ratones, para evaluación de la peroxidación lipídica y capacidad antioxidante, además del análisis morfométrico. Resultados: Se verificó que los grupos anabolizantes, GSA (0,3072 ± 0,0531) y GEA (0,2732 ± 0,0413), presentaron mayor peroxidación lipídica cuando comparados a los grupos no anabolizantes GS (0,1705 ± 0,0224) y GE (0,1785 ± 0,0340). Conclusiones: No hubo alteración en la capacidad antioxidante total, así como no hubo alteración en el espesor del septo interventricular y de la pared ventricular izquierda. Por lo tanto, el uso de esteroides anabólicos androgénicos no provocó alteraciones morfológicas en el miocardio, aunque alteró el metabolismo oxidativo. Se verificó también que la práctica de ejercicio aeróbico no tuvo efecto protector contra la peroxidación lipídica en el miocardio provocada por el uso de EAA. Nivel de evidencia II; Estudio prospectivo comparativo.

4.
Fisioter. Mov. (Online) ; 33: e003332, 2020. tab
Artículo en Inglés | LILACS-Express | LILACS | ID: biblio-1133884

RESUMEN

Abstract Introduction: Loneliness interferes with the eating habits and functionality of the elderly, compromising their quality of life. Objective: This study aimed to evaluate the effects of eating and performing functional group-based exercises on depressive symptoms, loneliness and quality of life in patients with sarcopenia treated at a public health service. Method: This is a randomized clinical trial with a convenience sample of elderly women with sarcopenia according to the European Work Group of Sarcopenia on Older People (EWGSOP), divided into three groups of 20 subjects each: a control group (CG), functional exercise group (FEG), monitored using the Home-based Older People's Exercise (HOPE) program, and functional exercise and nutritional intervention group (NIG), which in addition to HOPE, received pre-training fruit juice (fast-absorbing carbohydrates) and post-training banana smoothie reinforced with peanut (leucine). These groups met twice a week for 12 weeks, the control group (CG) received health guidance at weekly meetings for 12 weeks. The results of the interventions were analyzed using the geriatric depression scale and UCLA loneliness scale, and quality of life using the EQ-5D. Results: Significant post-intervention differences were observed in the NIG group in depressive (p=0.008) and loneliness symptoms (0.04) and quality of life (0.009), demonstrating the effects of group exercise and eating as a social activity. Conclusion: Nutritional intervention and functional group-based exercises were effective at minimizing depressive symptoms, social isolation, and improving the quality of life of elderly women with sarcopenia.


Resumo Introdução: A solidão interfere na alimentação e funcionalidade de idosos comprometendo sua qualidade de vida. Objetivo: Analisar os efeitos da intervenção nutricional e exercícios funcionais nos sintomas depressivos, solidão e qualidade de vida de idosas sarcopênicas atendidas em serviço público de saúde. Método: Trata-se de ensaio clínico randomizado com amostra de conveniência, adotando os critérios do European Work Group of Sarcopenia on Older People (EWGSOP), em três grupos distintos com 20 idosas cada um: grupo de exercícios funcionais (GEF) que recebeu acompanhamento por meio do protocolo Home-based Older People's Exercises exercises (HOPE) e o grupo exercícios funcionais e intervenção alimentar (GEA), que além do HOPE recebia pré-treino por meio de suco de fruta integral (carboidratos de absorção rápida) e no pós-treino vitamina de banana acrescida de amendoim (leucina). Estes grupos se encontravam duas vezes por semana, por 12 semanas. O grupo controle (GC) recebeu orientações de saúde em encontros semanais durante 12 semanas e os resultados das intervenções foram analisadas por meio da escala de depressão geriátrica, escala de solidão de UCLA e a qualidade de vida por meio do EQ-5D. Resultados: Foram observadas diferenças significativas quando comparou-se os grupos após a intervenção no grupo GEA tanto nos sintomas depressivos (p=0,008), solidão (p=0,04) como na qualidade de vida (p=0,009), demonstrando os efeitos tanto do exercício em grupo como do comer como atividade social. Conclusão: A intervenção nutricional e exercícios funcionais em grupo foram efetivos em minimizar os sintomas depressivos, isolamento social e melhorar a qualidade de vida em idosas sarcopênicas.

5.
Bol. méd. Hosp. Infant. Méx ; 76(4): 176-181, jul.-ago. 2019. tab
Artículo en Español | LILACS-Express | LILACS | ID: biblio-1089127

RESUMEN

Resumen Introducción: Debido a la disponibilidad de técnicas moleculares en la atención clínica, las gastroenteritis agudas (GEA) por norovirus han retomado importancia como un agente causante de hospitalización. El objetivo de este estudio fue describir las características clínicas y evolutivas de pacientes menores de 16 años hospitalizados por GEA por norovirus. Métodos: Estudio retrospectivo. Se recabó información clínica de los pacientes atendidos en hospitalización del 1 de noviembre del 2016 al 28 de febrero del 2018 por GEA con detección de norovirus (genotipo I y II) en heces por medio de reacción en cadena de la polimerasa con transcriptasa inversa. Resultados: Estudiamos 103 pacientes; 96 (93.2%; intervalo de confianza del 95% [IC 95%]: 86.6-96.7%) con deteccion de genotipo II y 7 (6.8%; IC 95%: 5.3-8.7%) de genotipo I; 76 (73.8%) ≤5 anos. El 48.5% fueron atendidos durante el invierno. La evolucion fue a la autolimitacion en menos de 7 días en todos con manejo hidroelectrolitico. No hubo diferencias en la gravedad y sintomas segun el grupo viral: en ambos predominaron los vómitos (82%). Solo un paciente cursó con perforación intestinal por coinfección con Shigella sp.; tres pacientes (3.1%) manifestaron crisis convulsivas (dos febriles y una epiléptica). Conclusiones: La GEA por norovirus, a pesar de causar una enfermedad meritoria de hospitalización, tiene un pronóstico favorable con autolimitación rápida. Su detección por pruebas rápidas en heces podría evitar la prescripción injustificada de antibióticos.


Abstract Background: Because of the availability of molecular techniques in clinical care, acute gastroenteritis (AGE) due to norovirus has returned to importance as a causative agent of hospitalization. The aim of this study was to describe the clinical features and evolution of patients less than 16 years hospitalized for AGE associated with norovirus. Methods: Retrospective study. Clinical information of the patients attended from November 1, 2016 to February 28, 2018 by AGE with detection of norovirus (genotype I and II) in faeces by means of polymerase chain reaction with reverse transcriptase was collected. Results: We studied 103 patients; 96 (93.2%; 95% confidence interval [95% CI]: 86.6-96.7%) with genotype II detection and seven (6.8%; 95% CI: 5.3-8.7%) genotype I; 76 (73.8%) ≤5 years. 48.5% attended during the winter. The evolution was to self-limitation in less than 7 days in all with hydro electrolytic management. There were no differences in the severity and symptoms according to the viral group; in both cases the vomiting predominated (82%). Only one patient had intestinal perforation due to co-infection with Shigella sp.; three patients (3.1%) manifested seizures (two febrile and one epileptic convulsions). Conclusions: Despite causing a meritorious disease of hospitalization, GEA by norovirus has a favorable prognosis with rapid self-limitation. Its timely detection by rapid tests in feces could avoid the unjustified prescription of antibiotics.

6.
Bol Med Hosp Infant Mex ; 76(4): 176-181, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31303655

RESUMEN

Background: Because of the availability of molecular techniques in clinical care, acute gastroenteritis (AGE) due to norovirus has returned to importance as a causative agent of hospitalization. The aim of this study was to describe the clinical features and evolution of patients less than 16 years hospitalized for AGE associated with norovirus. Methods: Retrospective study. Clinical information of the patients attended from November 1, 2016 to February 28, 2018 by AGE with detection of norovirus (genotype I and II) in faeces by means of polymerase chain reaction with reverse transcriptase was collected. Results: We studied 103 patients; 96 (93.2%; 95% confidence interval [95% CI]: 86.6-96.7%) with genotype II detection and seven (6.8%; 95% CI: 5.3-8.7%) genotype I; 76 (73.8%) ≤5 years. 48.5% attended during the winter. The evolution was to self-limitation in less than 7 days in all with hydro electrolytic management. There were no differences in the severity and symptoms according to the viral group; in both cases the vomiting predominated (82%). Only one patient had intestinal perforation due to co-infection with Shigella sp.; three patients (3.1%) manifested seizures (two febrile and one epileptic convulsions). Conclusions: Despite causing a meritorious disease of hospitalization, GEA by norovirus has a favorable prognosis with rapid self-limitation. Its timely detection by rapid tests in feces could avoid the unjustified prescription of antibiotics.


Asunto(s)
Infecciones por Caliciviridae/diagnóstico , Gastroenteritis/diagnóstico , Norovirus/aislamiento & purificación , Enfermedad Aguda , Adolescente , Infecciones por Caliciviridae/virología , Niño , Preescolar , Estudios Transversales , Femenino , Gastroenteritis/terapia , Gastroenteritis/virología , Genotipo , Hospitalización , Humanos , Lactante , Masculino , Norovirus/genética , Pronóstico , Estudios Retrospectivos , Vómitos/virología
7.
Med. interna Méx ; 35(1): 16-19, ene.-feb. 2019.
Artículo en Español | LILACS-Express | LILACS | ID: biblio-1056710

RESUMEN

Resumen: ANTECEDENTES: Las micosis superficiales se generan por contacto directo con el hongo o con una persona o animal infectado, y afectan la piel, los anexos y las mucosas; las pacientes embarazadas son susceptibles a cambios cutáneos fisiológicos y patológicos. OBJETIVO: Describir las micosis superficiales en pacientes embarazadas del Servicio de Obstetricia del Hospital General Dr. Manuel Gea González. MATERIAL Y MÉTODO: Estudio descriptivo, observacional, prospectivo y transversal realizado en pacientes embarazadas de la consulta externa del Servicio de Gineco-obstetricia del Hospital General Dr. Manuel Gea González de julio de 2016 a julio de 2017. RESULTADOS: Se incluyeron 23 pacientes que acudieron al Servicio de Micología; el grupo de edad más afectado fue de 21 a 40 años de edad (86.9%); 17 tuvieron tiña plantar (73.9%) y 4 (17.9%) tuvieron onicomicosis distrófica total. Dos cultivos fueron positivos para Trichophyton rubrum. CONCLUSIONES: Las micosis superficiales fueron poco frecuentes en el grupo estudiado: 17 pacientes con tiña de los pies y 4 con onicomicosis. El agente aislado fue Trichophyton rubrum.


Abstract: BACKGROUND: Superficial mycoses are generated by direct contact with the fungus or with an infected person or animal, and affect the skin, the attachments and mucous membranes; pregnant patients are susceptible to skin changes, both physiological and pathological. OBJECTIVE: To know the frequency of superficial mycoses in pregnant patients from the obstetrics service of the Hospital General Dr. Manuel Gea González. MATERIAL AND METHOD: A descriptive, observational, prospective and crosssectional study carried out in pregnant patients of the Gineco-Obstetrics Service of the Hospital General Dr. Manuel Gea González, Mexico City, from July 2016 to July 2017. RESULTS: Twenty-three patients were included in the mycology department for their physical examination; the most affected group was between 21 and 40 age years (86.9%); 17 patients presented tinea pedis (73.9%) and 4 (17.9%) onychomycosis. CONCLUSIONS: Superficial mycosis were not frequent in the group of study: 17 patients had tinea pedis and 4 onychomycosis. The causal agent isolated was Trichophyton rubrum.

8.
Rev Esp Salud Publica ; 932019 Jan 29.
Artículo en Español | MEDLINE | ID: mdl-30692506

RESUMEN

OBJECTIVE: Many parents visit paediatric health services due to unimportant reasons (ignorance of health problems of their children and psychosocial and emotional conditionings). The objective was to determine the effectiveness of a health education program, on the number and adequacy of pediatric consultations, in the first 6 months of the child´s life. METHODS: Quasi-experimental study of an educational intervention aimed at pregnant women in the last trimester of pregnancy and their partners. A simple random sampling of the health centers of the province of Valladolid was carried out, assigning four to the intervention group and two to the control group. The pregnant women were informed and participated voluntarily during the period from October 2016 to March 2017.The program consisted of six dynamic and participatory sessions of 90 minutes: rational use of paediatric services, fever, respiratory infec- tions (ARI), gastroenteritis (GEA), skin injuries, and accidents. The variables studies were: epidemiological data of the parents, number of consultations and their adequacy have been analyzed. Data analysis was performed using SPSS (v.20.0). Changes in participants before and after receiving workshops were analysed with Student's t test for related samples, or with its alternative test, Wilcoxon's non-parametric test. RESULTS: 191 pregnant woman were analyzed (101 control and 90 intervention). First-time pregnant women (62.3% intervention vs 54.1% control) with the high-school trained (59,1% intervention vs 44,2% control) were more participatory. The number of consultations for the reasons studied was reduced (3,5 in the control group vs 2,0 in the intervention group), and the level of adequacy improved in 16,3% (RR:1,62;95%CI:1,26-2,07;p<0,05). CONCLUSIONS: These positive results regarding the decrease in the number of consultations and the increase in their adequacy lead us to clearly recommend the establishment of prenatal interviews addressing most common health issues in children, in the Primary Care setting.


Asunto(s)
Uso Excesivo de los Servicios de Salud/prevención & control , Padres/educación , Educación Prenatal/métodos , Atención Primaria de Salud/estadística & datos numéricos , Adulto , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Uso Excesivo de los Servicios de Salud/estadística & datos numéricos , Evaluación de Resultado en la Atención de Salud , Pediatría , Embarazo , Atención Primaria de Salud/normas , Mejoramiento de la Calidad/estadística & datos numéricos , España
9.
CoDAS ; 31(4): e20170241, 2019. tab
Artículo en Inglés | LILACS-Express | LILACS | ID: biblio-1019726

RESUMEN

ABSTRACT Purpose This study investigated the effects of two levels of noise on the performance of young students of three educational levels and tested their ability to maintain attentional focus in reading and writing tasks. Methods 162 school children in the third, fourth and fifth grades were placed in three groups according to their educational level: Control Group (CG), Experimental Group A (GEA) and Experimental Group B (GEB). All groups were submitted to a Sustained Attention Test, Reading Assessment and Isolated Words Test and Writing Dictation Sub-test (part of the International Dyslexia Test). The GEA and GEB performed the tests in a noisy environment: 20dB and 40dB, respectively. The CG was assessed in the usual school environmental noise at the same time of the day. The data was submitted to an ANOVA, the Kruskal-Wallis test and Spearman correlation test. Results The higher the score on the Sustained Attention Test, the shorter the time spent reading and fewer errors in the dictation task. There were no differences across the three grades within the GEA (lower levels of noise) with regard to the effect of noise on attention and in the reading and writing task performance. The higher levels of noise for the GEB, however, decreased the attention levels, therefore increasing mistakes on the dictation test. Comparing the performance across educational levels on the reading tasks, the fourth grade presented decreased reading time, while the third and fifth grades spent more time reading. Conclusion Auditory interference can influence the ability to focus attention as well as worsen performance in reading and writing tasks at more intense noise levels.


RESUMO Objetivo Investigar os efeitos de dois níveis de ruído sobre tarefas de atenção e de escrita e leitura em estudantes de três níveis de escolaridade. Método 162 sujeitos entre o 3º, 4º e 5º ano do Ensino Fundamental foram alocadas em três grupos conforme a escolaridade: controle (GC), experimental A (GEA) e experimental B (GEB). Todos os grupos foram submetidos aos testes de Atenção Concentrada de Cambraia; Avaliação de Leitura e Palavras Isoladas; Subteste Escrita sob Ditado do International Dyslexia Test. Os grupos GEA e GEB realizaram os testes em ambiente com ruídos de 20 dB e 40dB respectivamente. Os resultados foram analisados com teste de Kruskal-Wallis e correlação de Spearman com significância em 5%. Resultados Foi observado que quanto maior o escore no teste de atenção, menor o tempo gasto na leitura e menor o número de erros no ditado. Não houve diferenças nos três anos de escolaridade para o grupo GEA quanto à influência do ruído sobre a atenção e o desempenho de leitura e escrita. O grupo GEB apresentou decréscimo nos testes de atenção com aumento de erros no ditado. Comparando a escolaridade no teste de leitura, o 4º ano diminuiu o tempo de leitura enquanto os sujeitos dos 3º e 5º ano gastaram mais tempo de leitura. Conclusão A interferência auditiva é capaz de influenciar a capacidade de foco de atenção assim como o desempenho de leitura e de escrita em níveis de ruído mais intenso. Não foram observadas influências da escolaridade sobre os efeitos distratores.

10.
Rev. esp. salud pública ; 93: 0-0, 2019. tab, graf
Artículo en Español | IBECS | ID: ibc-189524

RESUMEN

OBJETIVO: Muchos padres acuden a la consultas de pediatría por motivos banales (desconocimiento de los problemas de salud de sus hijos, condicionantes psicosociales y emocionales, etc.). El objetivo de este estudio fue determinar la efectividad de un programa de educación para la salud sobre el número y la adecuación de las consultas pediátricas en los primeros 6 meses de la vida. MÉTODOS: Estudio cuasi experimental de una intervención educativa dirigida a gestantes en último trimestre de la gestación y sus parejas, comparando sus efectos con un grupo control. Se realizó un muestreo aleatorio simple de los centros de salud de la provincia de Valladolid, asignando cuatro al grupo de intervención y dos al de control. Las gestantes del grupo intervención fueron informadas y participaron de forma voluntaria durante el periodo de octubre de 2016 a marzo de 2017. El programa consistió en 6 sesiones dinámicas y participativas de 90 minutos, sobre uso racional de los servicios de urgencias pediátricos, fiebre, infecciones respiratorias agudas (IRA), gastroenteritis (GEA), lesiones de la piel y accidentes. Se analizaron datos epidemiológicos de los progenitores, número de consultas y su adecuación. El análisis de los datos se realizó mediante el programa estadístico SPSS (v.20.0). Los cambios en los participantes antes y después de recibir los talleres se analizaron con la prueba t de Student para muestras relacionadas, o con su prueba alternativa, la prueba no paramétrica de Wilcoxon. RESULTADOS: Se analizaron 202 gestantes (101 control y 101 intervención). Las gestantes primerizas (62.3% intervención vs 54.1% control) y de mayor nivel educativo (59,1% intervención vs 44,2% control) fueron las que más acudían a las sesiones. Se demostró una reducción en el número de consultas pediátricas por los motivos estudiados (en el grupo control fue de 3,5 frente a 2,0 en el grupo intervención) y mejoró el nivel de adecuación un 16,3% (RR: 1,62; 95% IC: 1,26-2,07; p<0,05). CONCLUSIONES: Estos resultados positivos con respecto a la disminución en el número de consultas y el aumento de su adecuación nos llevan a recomendar claramente el establecimiento de intervenciones grupales prenatales que aborden los problemas de salud más comunes en los niños, en el entorno de la Atención Primaria.


OBJECTIVE: Many parents visit paediatric health services due to unimportant reasons (ignorance of health problems of their children and psychosocial and emotional conditionings). The objective was to determine the effectiveness of a health education program, on the number and adequacy of pediatric consultations, in the first 6 months of the child's life. METHODS: Quasi-experimental study of an educational intervention aimed at pregnant women in the last trimester of pregnancy and their partners. A simple random sampling of the health centers of the province of Valladolid was carried out, assigning four to the intervention group and two to the control group. The pregnant women were informed and participated voluntarily during the period from October 2016 to March 2017.The program consisted of six dynamic and participatory sessions of 90 minutes: rational use of paediatric services, fever, respiratory infections (ARI), gastroenteritis (GEA), skin injuries, and accidents. The variables studies were: epidemiological data of the parents, number of consultations and their adequacy have been analyzed. Data analysis was performed using SPSS (v.20.0). Changes in participants before and after receiving workshops were analysed with Student's t test for related samples, or with its alternative test, Wilcoxon's non-parametric test. RESULTS: 191 pregnant woman were analyzed (101 control and 90 intervention). First-time pregnant women (62.3% intervention vs 54.1% control) with the high-school trained (59,1% intervention vs 44,2% control) were more participatory. The number of consultations for the reasons studied was reduced (3,5 in the control group vs 2,0 in the intervention group), and the level of adequacy improved in 16,3% (RR:1,62;95%CI:1,26-2,07;p<0,05). CONCLUSIONS: These positive results regarding the decrease in the number of consultations and the increase in their adequacy lead us to clearly recommend the establishment of prenatal interviews addressing most common health issues in children, in the Primary Care setting


Asunto(s)
Humanos , Masculino , Femenino , Embarazo , Recién Nacido , Lactante , Adulto , Uso Excesivo de los Servicios de Salud/prevención & control , Padres/educación , Educación Prenatal/métodos , Atención Primaria de Salud/estadística & datos numéricos , Uso Excesivo de los Servicios de Salud/estadística & datos numéricos , Evaluación de Resultado en la Atención de Salud , Pediatría , Atención Primaria de Salud/normas , Mejoramiento de la Calidad/estadística & datos numéricos
11.
Cir. plást. ibero-latinoam ; 44(3): 287-295, jul.-sept. 2018. ilus, tab, graf
Artículo en Español | IBECS | ID: ibc-180029

RESUMEN

Introducción y Objetivo: La posición expuesta del pabellón auricular lo predispone a una gran cantidad de lesiones. Su reconstrucción tras amputación traumática o laceración requiere una evaluación cuidadosa y experiencia en reconstrucción auricular para lograr un resultado exitoso. El tratamiento temprano de este tipo de lesiones previene la cicatrización defectuosa y por lo tanto mejores condiciones para una reconstrucción estética. El objetivo del presente estudio es conocer la población más afectada por el trauma del pabellón auricular y su etiología en nuestro medio. Material y Método: Realizamos un estudio retrospectivo de pacientes diagnosticados de trauma del pabellón auricular atendidos por la División de Cirugía Plástica y Reconstructiva del Hospital General Dr. Manuel Gea González de la Ciudad de México (México), durante un período de 5 años, con un total de 214 pacientes. Resultados: Dada la especial exposición del pabellón auricular en varones que usan pelo corto, la proporción en cuanto a sexo fue 4.5:1 en nuestra serie. La edad más frecuente fue los 33 años; entre los 0 y 40 años se encontró el 82% de los pacientes, con un promedio de 26 años de edad. El lado izquierdo fue el más afectado (54.6% de los casos). La mayoría de las lesiones fueron, de acuerdo a la clasificación de Weerda, de grado I (abrasiones o heridas sin compromiso del cartílago), con un 37.8% de los casos, seguidas por las de grado IV (lesiones por avulsión con pérdida de segmento o amputación total) con pérdida de cartílago en el 35.5%. El mecanismo más frecuente fue un traumatismo directo seguido por la mordedura humana. El área anatómica más afectada fue el hélix, seguramente por ser la estructura más externa. No hubo ningún caso candidato a reimplante. Conclusiones: Este trabajo nos permitió establecer el grupo de edad más afectado en nuestro medio por trauma auricular, así como las principales causas del mismo. Aportamos también 2 casos de lesión iatrogénica en pabellón auricular en pacientes pediátricos que nos ayudaran a prevenir o evitar dichas complicaciones El 59.3% de los casos se debió a riñas o agresión por tercera persona, cifra que refleja la problemática social de nuestro país


Background and Objective: The anatomical localization or the auricles make them susceptible of trauma. Reconstruction after traumatic amputation requires a careful evaluation and experienced surgeon in auricle reconstruction for a good result. Early treatment of this kind of lesions avoids pathologic wound healing and gets proper conditions for auricle reconstruction. The objective of our study is to know which is the most affected population by auricle trauma and the etiology of this lesions in our area. Methods: We realized a retrospective study analyzing clinical and photographic files of the patients attended by auricle trauma in a 5 years period at Hospital General Dr. Manuel Gea González in the City of México (México): a total of 214 patients. Results: Because of the exposed localization of the auricle in males with short hair, we found a rate 4.5:1 male/female in our study. The most frequent age was 33 years and 82% of the patients were between 10 and 40 years old, with a media of 26 years old. Left side was involved in 54.6%. Concerning Weerda classification 37.8% cases were I degree (wounds without cartilage compromise) followed by 35.5% cases in IV degree (avulsion with certain degree of cartilage lost). The most frequent mechanism of injury was by direct trauma followed by human bite. The most frequent localization was the helix that could be explained by being the most external part of the auricle. None of our patients were reimplantation candidate. Conclusions: Our study let us establish the most frequently affected age group in our area by auricle trauma, and its main etiology. Besides, we report two cases of iatrogenic auricle lesion in pediatric patients than can help us to prevent or avoid these complications. In our series, 59.3% of the cases was due to fights or aggressions for a third person, that reflect the social problematic in our country


Asunto(s)
Humanos , Masculino , Femenino , Recién Nacido , Lactante , Preescolar , Niño , Adolescente , Adulto Joven , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Pabellón Auricular/lesiones , Pabellón Auricular/cirugía , Heridas y Lesiones/cirugía , Mordeduras Humanas/cirugía , Estudios Retrospectivos , Quemaduras/cirugía
12.
Inmanencia (San Martín, Prov. B. Aires) ; 7(1): 95-99, 2018. tab., graf.
Artículo en Español | LILACS, BINACIS | ID: biblio-1016493

RESUMEN

Los niños con obesidad tienen mayor riesgo para desarrollar algunos o todos los factores individuales de Síndrome Metabólico (SM). Su prevención en la infancia podría no sólo disminuir el impacto en etapas tempranas de la vida, sino también disminuir la proporción de adultos que lo desarrollarán.Objetivo: Determinar la prevalencia de SM según Cook et al en niños de 2 a 13 años con IMC elevado para la edad y analizar la frecuencia de aparición de cada uno de los criterios en pacientes atendidos en el Consultorio de Nutrición del Servicio de Pediatría del HIGA Eva Perón, desde el 1 de Junio 2015 al 15 de Marzo 2016. Resultados: Se evaluaron 39 casos: 43,6% eran portadores deSM. De los 5 criterios evaluados, la circunferencia de cintura (CC) se encontró elevada en todos los casos y tanto los triglicéridos (TAG) como el HDL-colesterol (HDL-c), se vieron alterados en 1 de cada 2 niños. La glucemia en ayunas (GeA) fue el criterio de menor aparición (5,1%). Discusión: La alta prevalencia detectada podría deberse al persistente incremento de obesidad en la edad pediátrica.El parámetro de CC pareciera ser uno de los criterios más relevantes para su detección. No sucede lo mismo con GeA que se presentó con baja frecuencia, tanto en la totalidad de la muestra como en el grupo de niños portadores. Conclusión: La prevalencia de SM en niños con sobrepeso u obesidades elevada. Es importante detectarlo para intervenir tempranamente y prevenir la instauración definitiva de diabetes tipo 2 o eventos cardiovasculares en la edad adulta.


JObese children are in greater risk of developing some or all the individual factors of Metabolic Syndrome (MS). Its prevention in childhood could not only reduce the impact in early stages of life but also decrease the proportion of adults who will develop MS. Objective: To determine MS prevalence according to Cook et al. criteria in children aged 2 to 13 years with body mass index unappropriated to their age and to analyze the observed frequency in each of them in patients observed in Pediatrics' Nutrition outpatient office, between June 1 2015 to 1 March 2016. Results: 39 cases were evaluated: 43.6% showed MS. Out of the five criteria evaluated, waist circumference (WC) was elevated in every case and triglycerides as much as HDL-cholesterol appeared altered in 1 of 2 children. Fasting blood glucose test was the less frequent seen criterion (5.1%). Discussion: High prevalence detected may be attributed to persistent increase in pediatric obesity. WC appeared as one of the more relevant criteria to MS detection. (FBGT) was as much infrequent in total population as in MS bearing children. Conclusion: Prevalence of MS in overweighted children is high. It is important to try early detection to install preventive measures of Type 2 diabetes or cardiovascular events in adulthood.


As crianças obesas têm maior risco de desenvolver alguns, ou todos, os fatores individuais de Síndrome Metabólico (SM). Sua prevenção na infância poderia não apenas diminuir o impacto em etapas iniciais da vida, mas também diminuir a proporção de adultos que o desenvolverão. Objetivo: Determinar a prevalência de SM segundo Cook et alii em crianças de 2 a 13 anos com IMC elevado para a idade e analisar a frequência do aparecimento de cada um dos critérios em doentes atendidos no Consultório de Nutrição do Serviço de Pediatria do HIGA Eva Perón, desde 1° de Junho de 2015 até 15 de Março de 2016. Resultados: Avaliaram-se 39 casos: 43,6% eram portadores de SM. Dos 5 critérios avaliados, a circunferência de cintura (CC) achou-se elevada em todos os casos e tanto os triglicérides (TAG) como o HDL-colesterol (HDL-c), estavam alterados em 1 de cada 2 crianças. A glicemia em jejum foi o critério de menor aparecimento (5,1%). Discussão: A alta prevalência detectada poderia relacionar-se com o persistente incremento de obesidade na idade pediátrica. O parâmetro de CC pareceria ser um dos critérios mais relevantes para serem medidos. Isso não acontece com a glicemia em jejum, que se apresentou com baja frequência, tanto na totalidade da amostra quanto no conjunto das crianças portadoras. Conclusão: A maior incidência de SM em crianças com sobrepeso ou obesidade é elevada. Importa detectá-lo para intervir cedo e prever o aparecimento definitivo de diabetes tipo 2 ou eventos cardiovasculares na idade adulta


Asunto(s)
Preescolar , Niño , Síndrome Metabólico , Diabetes Mellitus Tipo 2 , Obesidad Pediátrica
13.
Rev Invest Clin ; 68(5): 262-268, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-27941962

RESUMEN

BACKGROUND: Microalbuminuria is an early marker of atherosclerosis. Ethnic differences for both conditions have been reported. We studied microalbuminuria prevalence and its association with coronary artery calcification as an early atherosclerosis marker in a Mexican-Mestizo population free of diabetes and hypertension (healthy), as well as in hypertensive and diabetic subjects. METHODS: In 1,472 adults (53.3 ± 9.4 years old, 50.3% women), anthropometric measurements, fasting blood glucose, and lipid profile were determined. A spot urine sample was used to quantify the albumin-to-creatinine ratio and to define microalbuminuria (20-200 mg/g in men, and 30-300 mg/g in women). A coronary artery calcification score was obtained by electron-beam computed tomography and subclinical atherosclerosis was defined as a score > 0. RESULTS: Overall microalbuminuria prevalence was 9.3% (5.4% in healthy, 11.6% in obese, 12% in hypertensive, and 25% in diabetic subjects). Compared to "healthy" subjects without microalbuminuria, those with microalbuminuria had a ∼3-fold higher prevalence of coronary artery calcification > 0, while normal-high albumin-to-creatinine ratio (OR: 1.8; p < 0.05) and microalbuminuria (OR: 2.6; p < 0.001) was independently associated with coronary artery calcification > 0 only among diabetic subjects. CONCLUSIONS: Microalbuminuria and high-normal albumin-to-creatinine ratio were independently associated with subclinical atherosclerosis, suggesting that they may confer a higher risk of future cardiovascular events.


Asunto(s)
Albuminuria/etiología , Aterosclerosis/patología , Enfermedad de la Arteria Coronaria/patología , Grupos Étnicos , Adulto , Anciano , Albuminuria/epidemiología , Albuminuria/etnología , Aterosclerosis/epidemiología , Aterosclerosis/etnología , Estudios de Casos y Controles , Enfermedad de la Arteria Coronaria/epidemiología , Enfermedad de la Arteria Coronaria/etnología , Creatinina/orina , Diabetes Mellitus/epidemiología , Femenino , Humanos , Hipertensión/epidemiología , Masculino , México , Persona de Mediana Edad , Prevalencia , Tomografía Computarizada por Rayos X
14.
Arq. bras. med. vet. zootec ; 68(2): 387-396, mar.-abr. 2016. tab, graf
Artículo en Portugués | LILACS | ID: lil-779781

RESUMEN

Os hormônios esteroides presentes em várias gerações de contraceptivos orais combinados (COC) podem se apresentar como disruptores endócrinos, produzindo alterações no comportamento e na fisiologia de peixes. Diante disso, o objetivo deste trabalho foi avaliar os efeitos de hormônios esteroides presentes em COC sobre os parâmetros comportamentais de Betta splendens, um peixe ornamental usado na aquariofilia e bastante agressivo. Machos adultos foram observados pelo método ad libitum para confecção do etograma e divididos em cinco grupos, controle e expostos aos hormônios: 17β-estradiol (E2); levonorgestrel e etinilestradiol (LEA - segunda geração de COC); gestodeno e etinilestradiol (GEA - terceira geração de COC); e drospirenona e etinilestradiol (DEA - quarta geração de COC). Os peixes foram expostos por 30 dias à concentração final de 10ng/L. Foram avaliados os comportamentos pelos métodos de varredura instantânea e animal-focal, bem como o consumo de ração. No método varredura, o comportamento descansar apresentou o maior valor (54,4±10,1%) no grupo E2 (P<0,05). Os comportamentos agressivos de carga (16,1±3,6%) e recuar e carga (16,4±5,1%) apresentaram os maiores valores no grupo controle em relação aos demais grupos (P<0,05). Os animais do grupo E2 apresentaram maior frequência de comportamentos inativos (76,1%) comparados aos de outros grupos. O comportamento atípico natação errática não foi observado no grupo controle, mas foi observado nos grupos experimentais. Os grupos E2, LEA, GEA e DEA apresentaram redução nos comportamentos agressivos (10%) quando comparados ao grupo controle pelo método animal-focal. Não foram observadas diferenças na exibição desses comportamentos ao se compararem os animais expostos às diferentes gerações de contraceptivos e no consumo de ração. Pode-se concluir que 17β-estradiol causou mais efeitos aos peixes e que diferentes gerações de COC apresentaram efeitos tóxicos semelhantes em relação aos comportamentos observados.


The steroid hormones present in many generations of combined oral contraceptives (COC) can act as endocrine disruptors inducing changes in the behavior and physiology of fish. In this context, the aim of this work was to evaluate the effects of steroid hormones present in COC on behavioral parameters of Betta splendes, an aggressive ornamental fish used in the aquariophily. Adult males were observed with the ad libitum method to develop an ethogram and were divided into five groups, Control and exposed to hormones: 17β-estradiol (E2), levonorgestrel and ethinylestradiol (LEA - 2nd COC generation), gestodene and ethinylestradiol (GEA - 3rd COC generation) and drospirenone and ethinylestradiol (DEA - 4th COC Generation). Fish were exposed for 30 days to a final concentration of 10ng/L. The behavior was evaluated by scan sampling and animal-focal methods, and feed intake. In the scan sampling method, the Resting behavior showed the highest value (54.4±10.1%) in E2 group (P<0.05). The aggressive behavior Rush (16.1±3.6%) and Back and Rush (16.4±5.1%) showed the highest values in the control group, compared to the other groups (P<0.05). Animals in the E2 group showed higher frequency of inactive behaviors (76.1%) compared to other groups. Furthermore, the atypical behavior Erratic swimming was not observed in the control group, but it was observed in the experimental groups. The E2, LEA, GEA and DEA groups showed reduction in aggressive behavior (10%) compared to the control group by the animal-focal method. Moreover, no difference was observed in the exhibition of these behaviors and feed intake comparing animals exposed to the different generations of contraceptives. It can be concluded that 17β-estradiol has caused more effects on fish and different generations of COC showed similar toxic effects in the observed behaviors.


Asunto(s)
Animales , Anticonceptivos Orales Combinados/efectos adversos , Hormonas Esteroides Gonadales/administración & dosificación , Peces/fisiología , Conducta Animal/fisiología , Estradiol/efectos adversos , Estradiol/toxicidad , Etinilestradiol/efectos adversos , Etinilestradiol/toxicidad
15.
Rev. esp. quimioter ; 29(2): 91-98, abr. 2016. tab, graf
Artículo en Español | IBECS | ID: ibc-150931

RESUMEN

Introducción. En España no abundan estudios poblacionales actualizados sobre salmonelosis, a pesar de ser una de las etiologías de gastroenteritis agudas (GEAs) bacterianas más habituales en el mundo. El objetivo fue conocer los rasgos epidemiológicos más relevantes de las GEAs producidas por Salmonella spp. entre 2005-2014 en Salamanca (España). Métodos. Estudio descriptivo transversal realizado a partir del archivo informático del Servicio de Microbiología del Complejo Asistencial Universitario de Salamanca. El cultivo, aislamiento, identificación y serotipificación se realizaron según la metodología habitual. Resultados. Salmonella se aisló en 1.477 pacientes, representando el 47,7% del total de coprocultivos positivos y el 53,3% de todos los ingresos por GEA bacteriana. La prevalencia media fue de 42,1 casos/100.000 habitantes y año. La media de edad fue de 23 ± 28 años y la mediana 7 años. El 40,2% de todos los aislamientos se produjo en menores de 5 años, con una prevalencia media de 45,1 casos/10.000 habitantes y año. Globalmente, el serotipo aislado con más frecuencia fue S. Typhimurium con un 57%, seguido por S. Enteritidis con un 35,8%. Conclusiones. La prevalencia de Salmonella disminuyó a lo largo del tiempo. El grupo entre 0-4 años presentó la tasa más alta durante todo el periodo. Sin embargo, produjo el mayor porcentaje de hospitalizaciones por GEA bacteriana. El serotipo S. Typhimurium ha reemplazado en los últimos años al serotipo S. Enteritidis y predomina en pacientes de menor edad. Se aprecia una infranotificación de los casos de salmonelosis producidos en Salamanca a pesar de ser obligatoria su declaración desde 2007 (AU)


Background. In Spain there are not many updated population studies about salmonellosis, despite being one of the most common etiologies of acute gastroenteritis (AGEs) caused by bacteria in the world. The aim of the study was to know the most relevant epidemiological features of AGEs produced by Salmonella spp. between 2005 and 2014 in Salamanca (Spain). Methods. Descriptive cross-sectional study carried out through review of the clinical microbiologic records at Complejo Asistencial Universitario de Salamanca. Culture, isolation, identification and serotyping were performed according to standard methodology. Results. Salmonella was isolated in 1,477 patients, representing 47.7% of all positive stool cultures and 53.3% of all income bacterial AGE. The average prevalence was 42.1 cases/100,000 people per year. The mean age was 23 ± 28 years and the median 7 years. 40.2% of all isolates occurred in children under 5 years, with an average prevalence of 45.1 cases/ 10,000 people per year. Overall, the most frequently isolated serotype was S. Typhimurium with 57%, followed by S. Enteritidis with 35.8%. Conclusions. The prevalence of Salmonella decreased over time. The group aged 0-4 years had the highest rate throughout the period. However, Salmonella produced the highest percentage of hospitalizations for bacterial AGE. In recent years, S. Typhimurium serotype has replaced S. Enteritidis serotype and predominates in younger patients. It is observed under-reporting of cases of salmonellosis produced in Salamanca despite being mandatory notification of these since 2007 (AU)


Asunto(s)
Humanos , Masculino , Femenino , Recién Nacido , Lactante , Preescolar , Niño , Adolescente , Adulto Joven , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Gastroenteritis/tratamiento farmacológico , Gastroenteritis/epidemiología , Serotipificación/métodos , Serotipificación/normas , Salmonella/aislamiento & purificación , Infecciones por Salmonella/tratamiento farmacológico , Infecciones por Salmonella/epidemiología , Estudios Transversales/métodos , Estudios Transversales/tendencias , Calidad de Vida
16.
São José dos Campos; s.n; 2016. 68 p. ^etab., graf.68 ilus.
Tesis en Portugués | BBO - Odontología | ID: biblio-848174

RESUMEN

O objetivo deste estudo foi avaliar o efeito do etanol na longevidade de união de diferentes modos de aplicação do sistema adesivo ao substrato dentinário bovino, através do teste de microtração. Foram utilizados 80 incisivos bovinos, os quais tiveram a superfície dentinária da face vestibular exposta e a padronização da smear layer. Após a padronização, os espécimes foram divididos aleatoriamente em 2 grupos, Grupo Com Etanol (GE) e Grupo Sem Etanol (GS) e após, subdivididos de acordo com a forma de aplicação do sistema adesivo, Condicionamento Ácido Convencional (GEC, GSC) e Autocondicionante (GEA, GSA). Sobre a superfície tratada foram confeccionados blocos de resina com auxílio de matriz de silicone e armazenados em água deionizada a 37 ºC, por um período de 48 h. Após a cura da resina, metade dos espécimes foi submetida ao envelhecimento termomecânico resultando nos seguintes grupos (n= 10): GEC sem Envelhecimento (GECSE), GEC Envelhecido (GECE), GSC Sem Envelhecimento (GSCSE), GSC Envelhecido (GSCE), GEA Sem Envelhecimento (GEASE), GEA Envelhecido (GEAE), GSA Sem Envelhecimento (GSASE) e GSA Envelhecido (GSAE). Foram obtidos palitos resina/dentina com área adesiva medindo aproximadamente 1x1 mm, e submetidos ao teste de microtração em máquina de ensaios Universal DL- 200MF (EMIC). Os dados foram analisados pelos testes ANOVA a três fatores e Tukey (α = 5%). Houve interação entre os três fatores (p = 0,0003). O modo de aplicação foi semelhante, exceto para o GSAE que foi maior que o GSCE. A utilização do etanol resultou em valores superiores de microtração, exceto para GECSE que foi similar a GSCSE. Para os grupos envelhecidos, os valores foram inferiores, exceto quando da utilização do etanol, no qual os resultados não foram influenciados pelo envelhecimento. Conclui-se que utilização do etanol resultou em valores de microtração superiores, principalmente quando associado ao envelhecimento. O modo de aplicação do adesivo de forma geral não influenciou nos resultados(AU)


The aim of this study was to evaluate the effect of ethanol on the longevity on adhesion by different application ways of adhesive system to bovine dentin substrate, through the microtensile test. Eighty bovine incisors were used, which had buccal dentin exposed and the standardization of smear layer obtained by sandpaper polishing (600 SiC, Fepa-P). After standardization, the specimens were randomly divided into 2 groups, With Ethanol Group (GE) and No Ethanol Group (GS) and further, subdivided according to the application ways into: Conventional Acid conditioning (GEC, GCH) and self-etching (GEA, GSA). Resin blocks were built over the treated surface using a silicon mold and specimens were stored in deionized water at 37ºC for 48 hours. After resin lightcuring, half of the specimens was subjected to thermomechanical aging resulting in the following groups (n = 10): GEC No Aging (GECSE), GEC Aged (GECE), GSC No Aging (GSCSE), GSC Aged (GSCE), GEA No Aged (GEASE), GEA Aged (GEAE), GSA No Aging (GSASE) e GSA Aged (GSAE). Resin/Dentin sticks measuring approximately 1x1 mm were obtained and subjected to microtensile test in universal testing machine Universal DL-200MF (EMIC). Data were analyzed by three-way ANOVA and Tukey tests (α = 5%). There was interaction between the three factors (p = 0.0003). The application way was similar except for GSAE which was highest than GSCE. The use of ethanol resulted in higher values of microtensile except for GECSE which was similar to GSCSE. For the aged group, the values were below, except when the use of ethanol, in which the results were not affected by aging. It is concluded that use of ethanol resulted in higher microtensile bond strength values, especially when associated with aging. The application way of universal adhesive system did not influence the results(AU)


Asunto(s)
Humanos , Dentina , Envejecimiento , Etanol
17.
Arq. bras. med. vet. zootec ; 67(6): 1554-1562, nov.-dez. 2015. graf
Artículo en Portugués | LILACS | ID: lil-768152

RESUMEN

Objetivou-se com este estudo avaliar o efeito analgésico trans e pós-operatório da eletroacupuntura em onda denso-dispersa e frequências 3 e 200Hz, nos pontos E44, R3 e BP4, compará-lo com a analgesia promovida pelos pontos BP6, E36 e VB 34, e pela morfina, em cadelas submetidas à ovariosalpingohisterectomia (OSH). Teve-se como hipótese que a eletroacupuntura nos pontos E44, R3 e BP4 resultaria em controle da dor trans e pós-operatória melhor ou igual àquele promovido pela eletroacupuntura nos pontos BP6, E36 e VB34 e pela morfina. Trinta e seis cadelas submetidas à cirurgia eletiva de OSH foram distribuídas em blocos ao acaso em três grupos com 12 animais. Em dois grupos foi realizada eletroacupuntura denso-dispersa, com frequência de 3 e 200Hz, sendo que, no primeiro grupo (GEA), foram estimulados os pontos BP4, E44, R3 e, no segundo grupo (GEB), os pontos BP6, E36, VB34...


Thirty-six dogs undergoing elective ovariohysterectomy surgery were randomly distributed into 3 groups of 12 animals each. In the first group, dense-dispersed electroacupuncture was performed with a frequency of 3-200 Hz in SP4, ST44, KID3 points and 1.5mL of saline was given intramuscularly (GEA group). For the second group, dense-dispersed electroacupuncture was performed with a frequency of 3-200 Hz in SP6, ST36, GB34 points and 1.5mL of saline given intramuscularly (GEB group)...


Asunto(s)
Animales , Femenino , Perros , Analgesia por Acupuntura/veterinaria , Electroacupuntura , Electroacupuntura/veterinaria , Histerectomía/veterinaria , Ovariectomía/veterinaria , Estimulación Eléctrica Transcutánea del Nervio/veterinaria , Morfina/administración & dosificación , Periodo Posoperatorio
18.
J Crit Care ; 30(5): 901-7, 2015 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-26004031

RESUMEN

PURPOSE: Patients recovering from critical illness may be left with significant muscle mass loss. This study aimed to evaluate whether a 6-week program of enhanced physiotherapy and structured exercise (PEPSE) and an essential amino acid supplement drink (glutamine and essential amino acid mixture [GEAA]) improves physical and psychological recovery. MATERIALS AND METHODS: Intensive care patients aged 45 years or older, with a combined intensive care unit stay/pre-intensive care unit stay of 5 days or more were recruited to a randomized controlled trial examining the effect of PEPSE and GEAA on recovery. The 2 factors were tested in a 2 × 2 factorial design: (1) GEAA drink twice daily for 3 months and (2) 6-week PEPSE in first 3 months. Primary efficacy outcome was an improvement in the 6-minute walking test at 3 months. RESULTS: A total of 93 patients were randomized to the study. Patients receiving the PEPSE and GEA had the biggest gains in distance walked in 6-minute walking test (P < .0001). There were also significant reductions in rates of anxiety in study groups control supplement/PEPSE (P = .047) and GEAA supplement/PEPSE (P = .036) and for GEAA supplement/PEPSE in depression (P = .0009). CONCLUSION: Enhanced rehabilitation combined with GEAA supplement may enhance physical recovery and reduce anxiety and depression.


Asunto(s)
Atención Ambulatoria/métodos , Aminoácidos Esenciales/administración & dosificación , Enfermedad Crítica/rehabilitación , Modalidades de Fisioterapia , Análisis de Varianza , Ansiedad/prevención & control , Cuidados Críticos/métodos , Depresión/prevención & control , Suplementos Dietéticos , Método Doble Ciego , Terapia por Ejercicio/métodos , Femenino , Glutamina/administración & dosificación , Humanos , Unidades de Cuidados Intensivos , Masculino , Persona de Mediana Edad , Calidad de Vida , Caminata/fisiología
19.
Popul Health Manag ; 18(5): 373-82, 2015 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-25714906

RESUMEN

Cost-effectiveness modeling studies of global endometrial ablation (GEA) for treatment of abnormal uterine bleeding (AUB) from a US perspective are lacking. The objective of this study was to model the cost-effectiveness of GEA vs. hysterectomy for treatment of AUB in the United States from both commercial and Medicaid payer perspectives. The study team developed a 1-, 3-, and 5-year semi-Markov decision-analytic model to simulate 2 hypothetical patient cohorts of women with AUB-1 treated with GEA and the other with hysterectomy. Clinical and economic data (including treatment patterns, health care resource utilization, direct costs, and productivity costs) came from analyses of commercial and Medicaid claims databases. Analysis results show that cost savings with simultaneous reduction in treatment complications and fewer days lost from work are achieved with GEA versus hysterectomy over almost all time horizons and under both the commercial payer and Medicaid perspectives. Cost-effectiveness metrics also favor GEA over hysterectomy from both the commercial payer and Medicaid payer perspectives-evidence strongly supporting the clinical-economic value about GEA versus hysterectomy. Results will interest clinicians, health care payers, and self-insured employers striving for cost-effective AUB treatments.


Asunto(s)
Costos Directos de Servicios , Técnicas de Ablación Endometrial/economía , Histerectomía/economía , Seguro de Salud , Medicaid , Hemorragia Uterina/cirugía , Análisis Costo-Beneficio , Árboles de Decisión , Femenino , Humanos , Estados Unidos , Hemorragia Uterina/economía
20.
Nefrología (Madr.) ; 34(4): 477-482, jul.-ago. 2014. tab
Artículo en Español | IBECS | ID: ibc-129628

RESUMEN

Objetivo: Determinar si la utilización de sueros hipotónicos supone un riesgo en la aparición de hiponatremia iatrogénica en los niños hospitalizados por gastroenteritis aguda (GEA). Pacientes y método: Estudio prospectivo realizado con 205 pacientes de edades comprendidas entre 1 y 28 meses e ingresados con diagnóstico de deshidratación leve o moderada por GEA para recibir sueroterapia en la sección de lactantes de un hospital pediátrico de Madrid (España). El grado de deshidratación inicial se estimó con mediciones clínicas estándar. El suero administrado fue glucosalino 0,3 % en 198 casos y en los 7 casos restantes, todos con hipernatremia inicial, se administró suero glucohiposalino 0,2 %. Se analizó la respuesta a los líquidos intravenosos según si el niño se hallaba normo, hipo o hipernatrémico antes de iniciar el tratamiento. Las cifras de sodio en sangre y la excreción fraccional de sodio (EFNa) se consideraron como medidas de resultado. Resultados: Los 205 pacientes incluidos en el estudio se distribuyeron en tres grupos según el resultado inicial de la natremia. En 37 casos se detectó hiponatremia (18,04 %), en 133 niños isonatremia (64,87 %) y en 35 niños hipernatremia (17,07 %). Después de administrar soluciones hipotónicas encontramos en todos los grupos diferencia significativa entre el sodio sérico inicial y el final; en el grupo con hiponatremia el sodio subió y en los grupos con iso e hipernatremia el sodio descendió ligeramente. Se evidenció correlación significativa entre la EFNa y la evolución de la natremia (Na sérico inicial - Na sérico final). No se detectó ningún caso de hiponatremia posinfusión y tampoco se encontró correlación entre el agua libre administrada y la evolución de la natremia. Conclusiones: En lactantes con funcionamiento renal normal no se ha encontrado hiponatremia como resultado de la administración de sueros hiposalinos intravenosos, hallándose diferencias significativas en la EFNa que indican el ajuste renal de la natremia (AU)


Objective: The purpose of this study is to analyse whether the use of hypotonic fluids increases the risk of iatrogenic hyponatraemia in children hospitalised with acute gastroenteritis (AGE). Patients and methods: Prospective study carried out on 205 patients with ages ranging from 1 to 28 months and admitted with a diagnosis of mild or moderate dehydration due to AGE and treated with intravenous hypotonic fluids in a paediatric department in Madrid (Spain). The degree of dehydration at presentation was estimated using standard clinical measures. 198 children received 0.3 % glucosaline solution and in 7 patients, with baseline hypernatraemia, 0.2 % gluco-hyposaline solution was administered. We analysed the results according to whether children were hyponatraemic, normonatraemic or hypernatraemic at presentation. The blood and urine samples were analysed and the concentration of sodium and fractional sodium excretion (EFNa) before and after intervention were considered as outcome measures. Results: The 205 patients included in the study were distributed in 3 groups according to the baseline natraemia results. In 37 cases we detected hyponatraemia (18.04%), in 133 cases isonatraemia (64.87%) and in 35 children hypernatraemia (17.07%). After administering hypotonic fluids we detected a significant difference between initial and final natraemia in all groups; in the group with hyponatraemia, sodium increased and in the groups with iso and hypernatraemia, sodium slightly decreased. A significant correlation between the EFNa and the evolution of natraemia was found. No cases of hyponatraemia post-infusion were seen and there was no correlation between free water administered and natraemia evolution. Conclusions: Results show that the use of hypotonic fluids does not increase the risk of hospital acquired hyponatraemia in hospitalised children with normal renal function. Our children with gastroenteritis did not develop hyponatraemia even though they were all treated with hypotonic intravenous solutions (AU)


Asunto(s)
Humanos , Masculino , Femenino , Lactante , Gastroenteritis/complicaciones , Hiponatremia/prevención & control , Solución Salina Hipertónica/efectos adversos , Estudios Prospectivos , Niño Hospitalizado/estadística & datos numéricos , Fluidoterapia/métodos , Soluciones Hipotónicas/uso terapéutico
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