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1.
Nature ; 600(7890): 621-624, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34937892

RESUMO

Magnetars are strongly magnetized, isolated neutron stars1-3 with magnetic fields up to around 1015 gauss, luminosities of approximately 1031-1036 ergs per second and rotation periods of about 0.3-12.0 s. Very energetic giant flares from galactic magnetars (peak luminosities of 1044-1047 ergs per second, lasting approximately 0.1 s) have been detected in hard X-rays and soft γ-rays4, and only one has been detected from outside our galaxy5. During such giant flares, quasi-periodic oscillations (QPOs) with low (less than 150 hertz) and high (greater than 500 hertz) frequencies have been observed6-9, but their statistical significance has been questioned10. High-frequency QPOs have been seen only during the tail phase of the flare9. Here we report the observation of two broad QPOs at approximately 2,132 hertz and 4,250 hertz in the main peak of a giant γ-ray flare11 in the direction of the NGC 253 galaxy12-17, disappearing after 3.5 milliseconds. The flare was detected on 15 April 2020 by the Atmosphere-Space Interactions Monitor instrument18,19 aboard the International Space Station, which was the only instrument that recorded the main burst phase (0.8-3.2 milliseconds) in the full energy range (50 × 103 to 40 × 106 electronvolts) without suffering from saturation effects such as deadtime and pile-up. Along with sudden spectral variations, these extremely high-frequency oscillations in the burst peak are a crucial component that will aid our understanding of magnetar giant flares.


Assuntos
Astros Celestes , Atmosfera
2.
Parasitology ; 147(9): 949-956, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32234095

RESUMO

Cystic echinococcosis (CE) is a zoonotic disease caused by a complex of species known as Echinococcus granulosus sensu lato. CE is endemic in Argentina, Chile, Peru, Uruguay and the South part of Brazil. In contrast, little is known regarding the presence of CE in Bolivia. In this study, 35 cysts isolated from livestock (mostly from the Department of La Paz) and 3 from humans (La Paz, Oruro and Potosi) were genetically characterized analysing the sequence of the cox1 gene (1609 bp). In total, 30 cysts (from La Paz, Cochabamba and Beni) were characterized as E. granulosus sensu stricto (3 fertile and 4 non-fertile cysts from sheep, 8 fertile and 12 non-fertile cysts from cattle and 3 fertile cysts from humans). A detailed analysis of the cox1 haplotypes of E. granulosus s.s. is included. Echinococcus ortleppi (G5) was found in 5 fertile cysts from cattle (from La Paz and Cochabamba). Echinococcus intermedius (G7) was identified in 3 fertile cysts from pigs (from Santa Cruz). Additionally, E. granulosus s.s. was detected in 4 dog faecal samples, while E. ortleppi was present in other two dog faecal samples. The implications of these preliminary results in the future implementation of control measures are discussed.


Assuntos
Doenças dos Bovinos/parasitologia , Doenças do Cão/parasitologia , Equinococose/parasitologia , Equinococose/veterinária , Echinococcus/isolamento & purificação , Doenças dos Ovinos/parasitologia , Doenças dos Suínos/parasitologia , Animais , Bolívia , Bovinos , Cães , Fezes/parasitologia , Humanos , Ovinos , Carneiro Doméstico , Sus scrofa , Suínos
3.
Rev Med Chil ; 148(11): 1550-1557, 2020 Nov.
Artigo em Espanhol | MEDLINE | ID: mdl-33844760

RESUMO

BACKGROUND: Transmitted drug resistance (TDR) occurs in patients with HIV infection who are not exposed to antiretroviral drugs but who are infected with a virus with mutations associated with resistance. AIM: To determine the prevalence of TDR and characterize HIV reverse transcriptase and protease mutation patterns. MATERIAL AND METHODS: HIV infected antiretroviral treatment-naive patients treated in three centers between 2014 and 2018 were studied. A genotyping study was carried out. The HIVdb Program (Stanford University) and the World Health Organization (WHO) TDR surveillance mutation list were used to register resistance-associated mutations. RESULTS: We enrolled 220 patients aged a median of 29 (interquartile range (IQR) 24-34) years, 99% men. Median CD4 count was 365 cells/µL (IQR 250-499 cells/µL) and median viral load was 39.150 copies/mL (IQR 9,270 -120,000). The overall prevalence of RTD was 10.45% (95% CI 6.7-15.2, N = 23/220). The higher frequency of TDR was against non-nucleoside reverse transcriptase inhibitors, reaching 9.0% (95% CI 5.6-13.6), followed by nucleoside reverse transcriptase inhibitors reaching 1.8% (95% CI 0.49-4.5) and protease inhibitors reaching 0.45% (95% CI 0.01-2.5). The mutations in reverse transcriptase were M41L, L210W, D67N, K70E, M184V, K103N (6.36%, 95% CI 3.5-10.4), G190A, E138A, K101E, and I84V in protease. CONCLUSIONS: These results should prompt a change in recommendations for starting antiretoviral therapy, especially in first-line regimens that include non-nucleoside reverse transcriptase inhibitors.


Assuntos
Fármacos Anti-HIV , Infecções por HIV , HIV-1 , Idoso , Fármacos Anti-HIV/farmacologia , Fármacos Anti-HIV/uso terapêutico , Chile/epidemiologia , Farmacorresistência Viral/genética , Feminino , Genótipo , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , HIV-1/genética , Humanos , Masculino , Mutação , Prevalência
4.
Phys Rev Lett ; 123(22): 221101, 2019 Nov 29.
Artigo em Inglês | MEDLINE | ID: mdl-31868397

RESUMO

We perform numerical evolutions of the fully nonlinear Einstein (complex, massive) Klein-Gordon and Einstein (complex) Proca systems, to assess the formation and stability of spinning bosonic stars. In the scalar (vector) case these are known as boson (Proca) stars. Firstly, we consider the formation scenario. Starting with constraint-obeying initial data, describing a dilute, axisymmetric cloud of spinning scalar or Proca field, gravitational collapse toward a spinning star occurs, via gravitational cooling. In the scalar case the formation is transient, even for a nonperturbed initial cloud; a nonaxisymmetric instability always develops ejecting all the angular momentum from the scalar star. In the Proca case, by contrast, no instability is observed and the evolutions are compatible with the formation of a spinning Proca star. Secondly, we address the stability of an existing star, a stationary solution of the field equations. In the scalar case, a nonaxisymmetric perturbation develops, collapsing the star to a spinning black hole. No such instability is found in the Proca case, where the star survives large amplitude perturbations; moreover, some excited Proca stars decay to, and remain as, fundamental states. Our analysis suggests bosonic stars have different stability properties in the scalar (vector) case, which we tentatively relate to its toroidal (spheroidal) morphology. A parallelism with instabilities of spinning fluid stars is briefly discussed.

5.
Int J Biometeorol ; 60(11): 1753-1760, 2016 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-27094916

RESUMO

The incidence of geomagnetic storms may be associated with changes in circulatory physiology. The way in which the natural variations of the geomagnetic field due to solar activity affects the blood pressure are poorly understood and require further study in controlled experimental designs in animal models. In the present study, we tested whether the systolic arterial pressure (AP) in adult rats is affected by simulated magnetic fields resembling the natural changes of a geomagnetic storm. We exposed adult rats to a linear magnetic profile that simulates the average changes associated to some well-known geomagnetic storm phases: the sudden commencement and principal phase. Magnetic stimulus was provided by a coil inductor and regulated by a microcontroller. The experiments were conducted in the electromagnetically isolated environment of a semi-anechoic chamber. After exposure, AP was determined with a non-invasive method through the pulse on the rat's tail. Animals were used as their own control. Our results indicate that there was no statistically significant effect in AP when the artificial profile was applied, neither in the sudden commencement nor in the principal phases. However, during the experimental period, a natural geomagnetic storm occurred, and we did observe statistically significant AP increase during the sudden commencement phase. Furthermore, when this storm phase was artificially replicated with a non-linear profile, we noticed a 7 to 9 % increase of the rats' AP in relation to a reference value. We suggested that the changes in the geomagnetic field associated with a geomagnetic storm in its first day could produce a measurable and reproducible physiological response in AP.


Assuntos
Pressão Arterial , Campos Magnéticos , Animais , Masculino , Ratos Wistar
6.
Horm Metab Res ; 47(4): 280-3, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25011019

RESUMO

Low vitamin D levels are associated with minority subjects, the metabolic syndrome, and inflammation. The effect of vitamin D supplementation on markers of inflammation has not been well studied. The aim of the study was to evaluate the effects of high doses of vitamin D supplementation for 1 year on serum biomarkers of inflammation in Latino and African-American subjects with pre-diabetes and hypovitaminosis D. Latino (n=69) and African-American (n=11) subjects who had both pre-diabetes and hypovitaminosis D with a mean age of 52.0 years, a BMI of 32.7 kg/m(2), and 70% of whom were females, were randomized to receive weekly doses (mean±SD) of vitamin D (85 300 IU±16 000) or placebo oil for 1 year. Serum levels of interleukin-6, tumor necrosis factor, highly sensitive C-reactive protein), plasminogen activator inhibitor 1, and insulin-like growth factor-1 were measured at baseline, 6, and 12 months. Serum 25-OH vitamin D levels of 22 ng/ml at baseline quickly rose to nearly 70 ng/ml in subjects receiving vitamin D and did not change in the placebo group. Two-way repeated measures ANOVA showed no differences between the 2 groups in any of the 5 selected parameters. High dose vitamin D supplementation for 1 year in minority subjects with pre-diabetes and hypovitaminosis D failed to affect serum biomarkers of inflammation.Clinical trial reg. no.: NCT00876928, clinicaltrials.gov.


Assuntos
Negro ou Afro-Americano , Hispânico ou Latino , Inflamação/sangue , Estado Pré-Diabético/sangue , Deficiência de Vitamina D/sangue , Vitamina D/administração & dosagem , Adulto , Biomarcadores/sangue , Índice de Massa Corporal , Proteína C-Reativa/análise , Suplementos Nutricionais , Feminino , Humanos , Fator de Crescimento Insulin-Like I/análise , Interleucina-6/sangue , Masculino , Pessoa de Meia-Idade , Placebos , Inibidor 1 de Ativador de Plasminogênio/sangue , Vitamina D/análogos & derivados , Vitamina D/sangue
7.
Int J Immunogenet ; 42(6): 469-78, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26441033

RESUMO

Molecular characterization of T-cell immunoglobulin mucin domain-3 (TIM-3) and Galectin-9 (GAL-9) genes of swamp- and riverine-type water buffaloes was conducted to compare these genes with other species; determine the unique characteristic specific in water buffalo; and provide baseline information for the assessment of disease progression in buffalo species. TIM-3 and GAL-9 genes were amplified, purified, sequenced and characterized. The sequence result of TIM-3 in both types of water buffaloes contained 843 nucleotides encoding to 280 amino acids while GAL-9 of swamp-type and riverine-type water buffaloes contained 1023 and 972 nucleotides encoding to 340 and 323 amino acids, respectively. Meanwhile, the nucleotide and amino sequence of TIM-3 in water buffalo were 83-98% and 94-97% identical with other artiodactyl species, respectively. On the other hand, GAL-9 nucleotide and amino acid sequence in water buffalo were 85-98% and 76-96% identical with other artiodactyl species. The tyrosine-kinase phosphorylation motif and potential glycosylation sites were conserved within the tribe Bovinae. It is imperative to have further studies in the assessment of the role of these genes in disease progression in water buffalo during chronic infection. The study is the first report that describes the genetic characteristic of TIM-3 and GAL-9 genes in water buffalo.


Assuntos
Búfalos/genética , Galectinas/genética , Proteínas de Membrana/genética , Sequência de Aminoácidos , Animais , Búfalos/classificação , Clonagem Molecular , DNA Complementar/química , DNA Complementar/genética , Galectinas/química , Proteínas de Membrana/química , Dados de Sequência Molecular , Filogenia , Alinhamento de Sequência , Análise de Sequência de DNA
9.
Front Plant Sci ; 15: 1371123, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38721332

RESUMO

We aimed to evaluate the facilitation effects of an aluminum (Al) hyperaccumulator species bearing cluster roots, Gevuina avellana, on the seedling growth and performance of an Al-intolerant and phosphorus (P)-deficient-sensitive plant, Vaccinium corymbosum. For this, seedlings of G. avellana and V. corymbosum were grown alone or together as follows: i) two G. avellana seedlings, ii) one G. avellana + one V. corymbosum and iii) two V. corymbosum, in soil supplemented with Al (as Al2(SO4)3) and in the control (without Al supplementation). We determined relative growth rate (RGR), photosynthetic rate, chlorophyll concentration, lipid peroxidation and Al and nutrient concentration [Nitrogen (N), P, potassium (K), calcium (Ca), magnesium (Mg), sodium (Na), manganese (Mn), iron (Fe), copper (Cu), zinc (Zn), and sulfur (S)] in leaves and roots of both species. The results showed that, in general, G. avellana did not assist V. corymbosum to enhance its RGR nor reduce its Al uptake. However, G. avellana assisted V. corymbosum in enhanced N acquisition and, consequently, to increase its chlorophyll concentration and photosynthetic rate. Besides, V. corymbosum had lower lipid peroxidation in leaves when grown in the soil with high Al supplementation in association with G. avellana. Our results suggest a facilitating effect of G. avellana to V. corymbosum when grown in soils with high Al concentration, by enhancing chlorophyll concentrations and photosynthetic rate, and decreasing the oxidative damage to lipids.

10.
Sci Total Environ ; 942: 173494, 2024 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-38810746

RESUMO

The soil is a vital resource that hosts many microorganisms crucial in biogeochemical cycles and ecosystem health. However, human activities such as the use of metal nanoparticles (MNPs), pesticides and the impacts of global climate change (GCCh) can significantly affect soil microbial communities (SMC). For many years, pesticides and, more recently, nanoparticles have contributed to sustainable agriculture to ensure continuous food production to sustain the significant growth of the world population and, therefore, the demand for food. Pesticides have a recognized pest control capacity. On the other hand, nanoparticles have demonstrated a high ability to improve water and nutrient retention, promote plant growth, and control pests. However, it has been reported that their accumulation in agricultural soils can also adversely affect the environment and soil microbial health. In addition, climate change, with its variations in temperature and extreme water conditions, can lead to drought and increased soil salinity, modifying both soil conditions and the composition and function of microbial communities. Abiotic stressors can interact and synergistically or additively affect soil microorganisms, significantly impacting soil functioning and the capacity to provide ecosystem services. Therefore, this work reviewed the current scientific literature to understand how multiple stressors interact and affect the SMC. In addition, the importance of molecular tools such as metagenomics, metatranscriptomics, proteomics, or metabolomics in the study of the responses of SMC to exposure to multiple abiotic stressors was examined. Future research directions were also proposed, focusing on exploring the complex interactions between stressors and their long-term effects and developing strategies for sustainable soil management. These efforts will contribute to the preservation of soil health and the promotion of sustainable agricultural practices.


Assuntos
Mudança Climática , Nanopartículas Metálicas , Praguicidas , Microbiologia do Solo , Nanopartículas Metálicas/toxicidade , Poluentes do Solo , Solo/química , Ecossistema , Microbiota/efeitos dos fármacos , Agricultura/métodos
11.
Int J Surg Case Rep ; 122: 110017, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39032351

RESUMO

INTRODUCTION AND IMPORTANCE: Seat belt syndrome (SBS) is a rare condition described as injuries sustained due to thoracic, abdominal, and pelvic compression in the context of traffic accidents. These injuries can range from minor skin abrasions to large lesions of internal organs and spinal cord involvement. Traumatic abdominal wall hernias (TAWH) are one of the injuries that can be associated. CASE PRESENTATION: A 21-year-old male suffered a severe injury, resulting in complete transection of all abdominal wall musculature due to SBS, with associated visceral injury. Emergency surgery included intestinal and sigmoid colon resection, along with cava vein repair. After a prolonged recovery, a second-stage surgery for abdominal wall reconstruction was planned. Prehabilitation involved botulinum toxin and pneumoperitoneum, with surgical planning utilizing CT scan and 3D reconstruction. The second-stage surgery included transversus abdominis release and placement of double mesh. CLINICAL DISCUSSION: Managing traumatic abdominal wall hernias in polytrauma patients necessitates emergent surgery for vital injuries, while reconstructive surgery timing is crucial, with patient preparation being essential. Surgical planning, including 3D reconstructions, enhances accuracy, and safety, with repair technique selection depending on anatomical features. Given our patient's athletic background and preoperative vascular CT findings, flapless reconstructive surgery was chosen to mitigate vascular risks. CONCLUSION: The therapeutic approach to traumatic abdominal wall injuries should be individualized to each patient, with a focus on addressing vital injuries first and considering abdominal wall reconstruction surgery at a subsequent stage. Utilizing CT scan with 3D reconstruction can be a valuable tool for preoperative planning in cases involving significant abdominal wall defects.

12.
Histochem Cell Biol ; 139(1): 205-20, 2013 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-22878526

RESUMO

Ependymal cells form an epithelium lining the ventricular cavities of the vertebrate brain. Numerous methods to obtain primary culture ependymal cells have been developed. Most of them use foetal or neonatal rat brain and the few that utilize adult brain hardly achieve purity. Here, we describe a simple and novel method to obtain a pure non-adherent ependymal cell culture from explants of the striatal and septal walls of the lateral ventricles. The combination of a low incubation temperature followed by a gentle enzymatic digestion allows the detachment of most of the ependymal cells from the ventricular wall in a period of 6 h. Along with ependymal cells, a low percentage (less than 6 %) of non-ependymal cells also detaches. However, they do not survive under two restrictive culture conditions: (1) a simple medium (alpha-MEM with glucose) without any supplement; and (2) a low density of 1 cell/µl. This purification method strategy does not require cell labelling with antibodies and cell sorting, which makes it a simpler and cheaper procedure than other methods previously described. After a period of 48 h, only ependymal cells survive such conditions, revealing the remarkable survival capacity of ependymal cells. Ependymal cells can be maintained in culture for up to 7-10 days, with the best survival rates obtained in Neurobasal supplemented with B27 among the tested media. After 7 days in culture, ependymal cells lose most of the cilia and therefore the mobility, while acquiring radial glial cell markers (GFAP, BLBP, GLAST). This interesting fact might indicate a reprogramming of the cell identity.


Assuntos
Separação Celular/métodos , Epêndima/citologia , Células Epiteliais/citologia , Animais , Técnicas de Cultura de Células , Sobrevivência Celular , Células Cultivadas , Cílios , Meios de Cultura/metabolismo , Epêndima/metabolismo , Células Epiteliais/metabolismo , Masculino , Camundongos , Peptídeo Hidrolases/metabolismo , Ratos , Ratos Wistar , Temperatura , Fatores de Tempo
13.
Nutr Metab Cardiovasc Dis ; 22(9): 756-62, 2012 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-21489765

RESUMO

BACKGROUND AND AIMS: APOA5, a key gene regulating triglyceride (TG) levels, is reported to be expressed exclusively in the liver where it may regulate TG-rich particle synthesis and secretion. Since the same lipoprotein processing occurs in the intestine, we have postulated that this organ would also express APOA5. METHODS AND RESULTS: We have detected the APOA5 gene expression in C57BL/6J mouse and in human small intestine samples. In humans, it is expressed mainly in the duodenum and colon, with messenger RNA (mRNA) levels four orders of magnitude lower than in the liver, and the protein product being one-sixth of the liver equivalent. Subsequently, we carried out in vitro experiments in TC-7/CaCo(2) human intestinal cells to analyse the expression of APOA5, APOC3, APOB and MTP genes after the incubation with long- and short-chain fatty acids, and a peroxisome proliferator-activated receptor alpha (PPARα) agonist (Wy 14643, a fibrate therapeutic agent). In the TC-7 cell line, APOA5 expression was significantly upregulated by saturated fatty acids. The short-chain fatty acid butyrate increased APOA5 expression almost fourfold while APOB was downregulated by increasing butyrate concentrations. When TC-7 cells were incubated with PPARα agonist, the APOA5 expression was increased by 60%, while the expression of APOB, MTP and APOC3 was decreased by 50%, 30% and 45%, respectively. CONCLUSION: Our results demonstrate that APOA5 is expressed in the intestine, albeit at a much lower concentration than in the liver. While it remains to be determined whether intestinal apo A-V is functional, our in vitro experiments show that its expression is modifiable by dietary and pharmacological stimuli.


Assuntos
Apolipoproteínas A/genética , Ácidos Graxos/farmacologia , Ácidos Fíbricos/farmacologia , Animais , Apolipoproteína A-V , Apolipoproteínas A/metabolismo , Apolipoproteínas B/genética , Apolipoproteínas B/metabolismo , Linhagem Celular Tumoral , Regulação da Expressão Gênica , Humanos , Mucosa Intestinal/metabolismo , Intestinos/citologia , Lipoproteínas/sangue , Fígado/metabolismo , Masculino , Camundongos , Camundongos Endogâmicos C57BL , PPAR alfa/agonistas , PPAR alfa/genética , PPAR alfa/metabolismo , Pirimidinas/farmacologia , Triglicerídeos/sangue
15.
Andes Pediatr ; 92(4): 617-625, 2021 Aug.
Artigo em Espanhol | MEDLINE | ID: mdl-34652382

RESUMO

Diabetes Technology refers to the software or hardware that is designed to facilitate and improve the quality of life of the patient with diabetes Mellitus. A non-systematic literature search was carried out which included articles in English and Spanish about the use of continuous glucose monitoring (CGM) in pediatric patients with Type 1 diabetes Mellitus. This review summarizes the performance of the CGM, its accuracy, and classification. A chronological synthesis of the general evidence up to June 2020 was done including both adult and pediatric studies. Aspects of metabolic control were specified on the use of real-time and intermittent / flash CGM, such as reduction of HbA1c levels, reduction in frequency and severity of hypoglycemia, decrease in episodes of ketoacidosis and well being, and variables such as the Frequency of CGM use, which have been related to the improvement of the objectives of diabetes control. This review presents a chronological summary of the evidence for flash glucose monitoring in studies where only pediatric population is included and provides an account of diabetes technology recommendations that apply to pediatric population from the Ame rican Diabetes Association 2020 guideline, the International Society for Pediatric and Adolescent Diabetes 2018 recommendations.


Assuntos
Automonitorização da Glicemia , Diabetes Mellitus Tipo 1 , Hipoglicemia/prevenção & controle , Adolescente , Adulto , Glicemia , Criança , Diabetes Mellitus Tipo 1/tratamento farmacológico , Hemoglobinas Glicadas , Humanos , Qualidade de Vida
16.
Semergen ; 47(3): 189-196, 2021 Apr.
Artigo em Espanhol | MEDLINE | ID: mdl-33509725

RESUMO

Patent foramen ovale (FOP) is the most prevalent cause of cryptogenic strokes in people under 60 years old. Although it is usually asymptomatic, it has a high risk of producing paradoxical embolism and, therefore, stroke with indeterminate outcomes. The study should be started based on clinical suspicion, and includes a multidisciplinary assessment and a determination of the type of treatment to be performed. The therapeutic possibilities range from conservative treatment (indefinite antithrombotic treatment), to its percutaneous closure (currently the most widely used). The first objective is to decrease the number of stroke recurrences. Conservative treatment should be reserved for those cases of low embolic risk. The risk assessment must be individualised, fundamentally based on the anatomical characteristics of the FOP and the patient clinic picture. The use of the RoPE risk scale (The Risk of Paradoxical Embolism) should be a tool to consider.


Assuntos
Forame Oval Patente , Atenção Primária à Saúde , Embolia , Embolia Paradoxal , Humanos , Pessoa de Meia-Idade , Fatores de Risco , Acidente Vascular Cerebral , Resultado do Tratamento
17.
Rev Esp Anestesiol Reanim ; 57(4): 214-9, 2010 Apr.
Artigo em Espanhol | MEDLINE | ID: mdl-20499799

RESUMO

BACKGROUND AND OBJECTIVE: Thoracic epidural analgesia and patient-controlled analgesia (PCA) with intravenous fentanyl have both been shown to be effective in pediatric patients treated surgically for pectus excavatum using the Nuss procedure. We compare the efficacy and safety of these techniques. METHODS: Retrospective study of pediatric cases in which the Nuss procedure was used to treat pectus excavatum between October 1997 and February 2009. Weight, age, sex, and Haller index were analyzed. Pain was assessed every 8 hours on a visual analog scale of 0 to 10 or on a scale based on observation of distress (LLANTO scale). Daily use of analgesics was also recorded. The incidence of catheter-related complications or adverse events of treatment such as nausea, vomiting, and respiratory depression were also noted. RESULTS: We identified 31 patients in 2 groups: the epidural group (n=22) and the PCA group (n=9). Demographic characteristics, the incidences of complications or adverse events, and mean (SD) pain scores (epidural group, 1.8 [3.8]; PCA group, 2.1 [3.4]; P = .775) were statistically similar in the 2 groups. However, analgesic requirements and the duration of analgesic use in days differed significantly, at 2.9 (1.1) days in the epidural group and 5.9 (1.4) days in the PCA group (P =.001). CONCLUSIONS: The efficacy and safety of thoracic epidural analgesia is similar to that of PCA with intravenous fentanyl, although the use of epidural analgesia is associated with a markedly shorter duration of requirement for postoperative analgesia.


Assuntos
Analgesia Controlada pelo Paciente , Analgésicos Opioides/administração & dosagem , Cardioversão Elétrica , Fentanila/administração & dosagem , Tórax em Funil/cirurgia , Criança , Feminino , Humanos , Infusões Intravenosas , Masculino , Procedimentos Ortopédicos/métodos , Estudos Retrospectivos
18.
J Sci Med Sport ; 12(2): 323-31, 2009 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-18396101

RESUMO

The factors responsible for the acute effects of exercise on blood lipids are not well known, and there have been few studies comparing different kinds of exercise in the same population. The concentration of blood lipids was evaluated in this study at the end and at post-24h of two 14km/90min single exercise sessions: continuous exercise (CE) at 44.5+/-5.6% VO(2max) and intermittent exercise (IE) at 39-72% VO(2max), in subjects with high levels of aerobic training. Fourteen male athletes (endurance runners) took part in this study and each completed a 24h dietary record. The O(2) uptake and CO(2) production were recorded, and blood lactate and blood lipids were measured. The results showed that triacylglycerols were not modified by any kind of exercise. Total cholesterol was increased at the end of both exercises: 7.04% for CE (p<0.001) and 4.23% for IE (p=0.001). High-density lipoprotein cholesterol was increased at the end of IE: 11.38% (p=0.03) and low-density lipoprotein cholesterol was increased only at the end of CE: 7.45% (p=0.006). The increase of lipids for CE was negatively correlated with aerobic fitness indicators (heart rate and %HRmax at lactate threshold), and was positively associated with energy expenditure. For IE, %HRmax and lactate were negatively correlated, and the respiratory exchange ratio was positively correlated, with the lipid increase. We conclude that in trained male athletes, a 14km run in 90min induced different changes of lipid profile if the exercise was done continuously or intermittently, and that in CE the extent of these increases was influenced by aerobic fitness.


Assuntos
Limiar Anaeróbio/fisiologia , HDL-Colesterol/sangue , LDL-Colesterol/sangue , Exercício Físico/fisiologia , Corrida/fisiologia , Triglicerídeos/sangue , Adolescente , Adulto , Desempenho Atlético/fisiologia , Humanos , Masculino , Adulto Jovem
19.
Actas Urol Esp ; 32(9): 888-93, 2008 Oct.
Artigo em Espanhol | MEDLINE | ID: mdl-19044298

RESUMO

INTRODUCTION AND OBJECTIVES: The radical prostatectomy is a technique that has shown competitive oncological and functional results, that is why it has become to be a routine procedure in many leading centers. Nevertheless, the difficulty of learning and its initial cost, could question its implantation as a routine technique in centers that are not a point of reference. We have carried out a descriptive study of our initial series analyzing the surgical technique, post surgical immediate results, and oncological and functional short-term outcomes, comparing them with other series in national and international centers. METHODS: From February, 2006 to August, 2007 we performed 69 laparoscopical procedures in our center, of which 34 were radical prostatectomies. The average age of the series were 63 years (50-72), with a prostate average weight by transrectal ultrasound of 35 gr. (17-72), and a median PSA of 6ng/ml (4-35). The clinical stages were: T1c 59%, T2a 12%, T2b 17%, T2c 12%; with Gleason combined of: 2+2 in 3%, 3+3 in 35%, 3+4 in 15%, 4+3 in 44%, 4+5 in 3%. RESULTS: Out of the 34 cases initiated by laparoscopy, 30 were concluded laparoscopically, with a surgical average time of 261 minutes (150-380). The pathological stages were: pT2a 3%, pT2b 18%, pT2c 41%, pT3a 32%, pT3b 6%. With Gleason of: 3+3 in 26%, 3+4 in 14%, 4+3 in 47%, 4+4 in 9%, 4+5 in 3%. We obtained 29% of positive margins (50% pT3a, 20% pT3b, 20% pT2b, 10% pT2c). Four cases were converted to open surgery, one due to subcutaneous emphysema, one to enlarged surgical time, one bleeding, and one rectal injury. The continence (0-1 pads) at the first month was 62%, reaching 84% at 6 months. The erection, remained in 50% of the patients at the first month, in the four cases of intrafascial dissection. CONCLUSIONS: Laparoscopic radical prostatectomy is a technique of difficult learning, and initially requires higher surgical time than open surgery. Nevertheless, we prove that it is a reliable technique with competitive oncological and functional results, early recovery and little bleeding even in the initial series. Therefore, it should be considered an option for the treatment of prostate cancer also in not leading centers.


Assuntos
Prostatectomia , Neoplasias da Próstata/cirurgia , Idoso , Hospitais Gerais , Humanos , Internacionalidade , Masculino , Pessoa de Meia-Idade , Prostatectomia/métodos , Prostatectomia/tendências , Espanha , Fatores de Tempo
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