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1.
Pediatr Cardiol ; 2023 Dec 13.
Artigo em Inglês | MEDLINE | ID: mdl-38093114

RESUMO

Vertical vein (VV) ligation during total anomalous pulmonary venous return (TAPVR) repair is controversial. While some surgeons prefer ligation of the VV to prevent adverse sequelae of shunting across it and to promote flow through the newly created anastomosis, others leave it to serve as a "pop off valve" to the left heart structures, which are believed to be hypoplastic and noncompliant, presumably contributing to a more favorable post-operative outcome. We report two patients post-Fontan procedure, who underwent cardiac catheterization to explore the etiology of hypoxia and were found to have a persistent VV responsible for right to left shunting. Both patients underwent closure of the VV with improvement in the cyanosis and clinical course. These cases provide evidence supporting surgical ligation of the VV at the time of TAPVR repair, especially in patients with single ventricle.

2.
Ann Thorac Surg ; 115(5): 1223-1228, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-36702292

RESUMO

BACKGROUND: Despite the demonstrated utility of surgeon-fashioned polytetrafluoroethylene (PTFE) valved conduits, methods for educating surgeons to reproducibly construct these conduits are lacking. We present a surgeon education process and early outcomes for children receiving surgeon-fashioned PTFE valved conduits during the initial learning curve. METHODS: The educational curriculum included 4 hours of proctored instruction/supervised valve construction, followed by 2 hours of individual practice. A surgeon with prior mastery of the technique provided templated designs, videos, and follow-up consultation. A retrospective medical record review (2017-2022) described early outcomes and valve function for patients receiving surgeon-fashioned PTFE right ventricle-to-pulmonary artery conduits. RESULTS: Two surgeons were educated using the method described. Fifteen valved conduits were implanted in 14 patients (median patient age, 38 months; conduit size range, 10-24 mm). At discharge, no patient had more than mild stenosis or regurgitation, and 12 of 15 valves (80%) had none or trivial regurgitation. Median follow-up was 14 months (range, 1-52 months). At the last follow-up, median peak conduit gradient of the 15 valves was low (18 mm Hg), 1 (7%) had moderate stenosis, and 1 (7%) had mild-moderate regurgitation. Two conduits were replaced concomitantly during repair of associated lesions at 14 and 38 months (sizes 10 and 12 mm, respectively). There were no deaths and no infectious complications. CONCLUSIONS: Four hours of proctored surgeon education plus deliberate practice is an effective method for teaching valved PTFE conduit construction and is associated with excellent early valve function. This study provides educational methods and initial evidence of safety for congenital surgeons wishing to learn and adopt this technique.


Assuntos
Cardiopatias Congênitas , Próteses Valvulares Cardíacas , Cirurgiões , Criança , Humanos , Pré-Escolar , Estudos Retrospectivos , Constrição Patológica/complicações , Cardiopatias Congênitas/cirurgia , Cardiopatias Congênitas/complicações , Politetrafluoretileno , Resultado do Tratamento
3.
Trop Med Infect Dis ; 8(12)2023 Dec 12.
Artigo em Inglês | MEDLINE | ID: mdl-38133448

RESUMO

BACKGROUND: Despite advances in diagnosis and treatment, the incidence and mortality of infective endocarditis (IE) have increased in recent decades. Studies on the risk factors for mortality in endocarditis in Latin America are scarce. METHODS: This retrospective cohort study included 240 patients diagnosed with IE according to the modified Duke criteria who were admitted to two university hospitals in Rio de Janeiro, Brazil from January 2009 to June 2021. Poisson regression analysis was performed for trend tests. The multivariate Cox proportional hazards model was used to estimate the hazard ratio (HR) of predictors of in-hospital mortality. FINDINGS: The median age was 55 years (IQR: 39-66 years), 57% were male, and 41% had a Charlson comorbidity index (CCI) score > 3. Healthcare-associated infective endocarditis (54%), left-sided native valve IE (77.5%), and staphylococcal IE (26%) predominated. Overall, in-hospital mortality was 45.8%, and mortality was significantly higher in the following patients: aged ≥ 60 years (53%), CCI score ≥ 3 (60%), healthcare-associated infective endocarditis (HAIE) (53%), left-sided IE (51%), and enterococcal IE (67%). Poisson regression analysis showed no trend in in-hospital mortality per year. The adjusted multivariate model determined that age ≥ 60 years was an independent risk factor for in-hospital mortality (HR = 1.9; 95% CI 1.2-3.1; p = 0.008). INTERPRETATION: In this 12-year retrospective cohort, there was no evidence of an improvement in survival in patients with IE. Since older age is a risk factor for mortality, consensus is needed for the management of IE in this group of patients.

4.
Acta Med Colomb ; 43(4): 207-216, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-31285636

RESUMO

The wide range of scientific evidence supporting various clinical interventions is not sufficient for these interventions to be used in practice. For this reason, Evidence-Based Medicine must take the step towards Evidence-Based Practice, through implementation processes that allow deploying and contextualizing the health interventions supported by evidence. For this purpose, the Science of implementation has been developed, which investigates the factors that influence the effective and complete use of scientific innovations in practice, trying to maximize the benefits of health interventions. This science is defined as the study of methods that promote the systematic incorporation of research findings in the clinical routine, with the aim of improving the quality and effectiveness of health services and interventions. The purpose of this article is to introduce the concept of Implementation Science in relation to clinical epidemiology and establish the reasons by which there is an urgent need for its development. In addition, it has the purpose of explaining why the need to accelerate the effective application of Evidence-Based Medicine and define the main models that define the scope of work of this science, including: the particularities of implementation studies, their differences with the classic studies of clinical epidemiology, the implementation and evaluation models, as well as the definition of expected outcomes in an implementation study.


La amplia gama de evidencias científicas que respaldan diversas intervenciones clínicas no son suficientes para que dichas intervenciones se utilicen en la práctica. De tal modo que la Medicina Basada en la Evidencia debe dar el paso hacia la Practica Basada en la Evidencia, a través de procesos de implementación que permitan desplegar y contextualizar intervenciones en salud respaldadas por la evidencia. Para tal fin se ha desarrollado la Ciencia de la implementación, la cual investiga los factores que influencian el uso efectivo y completo de las innovaciones científicas en la práctica, intentando maximizar los beneficios de las intervenciones en salud.Esta ciencia se define como el estudio de los métodos que promueven la incorporación sistemática de hallazgos de investigación en la rutina clínica, con el objetivo de mejorar la calidad y efectividad de los servicios e intervenciones en salud.El propósito de este artículo es introducir el concepto de Ciencia de la Implementación en relación con la epidemiología clínica y establecer las razones por las cuales existe una imperiosa necesidad de su desarrollo.Además, tiene el propósito de explicar el porqué de la necesidad de acelerar la aplicación efectiva de la Medicina Basada en Evidencia y definir los principales modelos que precisan el ámbito de trabajo de esta ciencia, incluyendo: las particularidades de los estudios de implementación, sus diferencias con los estudios clásicos de la epidemiología clínica, los modelos de implementación y evaluación, así como la definición de los desenlaces esperados en un estudio de implementación.

5.
Plant Physiol Biochem ; 123: 170-179, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29247937

RESUMO

Ceratocystis wilt, caused by Ceratocystis fimbriata, is currently one of the most important disease in eucalypt plantations. Plants infected by C. fimbriata have lower volumetric growth, lower pulp yields and reduced timber values. The physiological bases of infection induced by this pathogen in eucalypt plant are not known. Therefore, this study aims to assess the physiological and metabolic changes in eucalypt clones that are resistant and susceptible to C. fimbriata. Once, we evaluated in detail their leaf gas exchange, chlorophyll a fluorescence, water potential, metabolite profiling and growth-related parameters. When inoculated, the susceptible clone displayed reduced water potential, CO2 assimilation rate, stomatal conductance, transpiration rate, photochemical quenching coefficient, electron transport rate, and root biomass. Inoculated resistant and susceptible clones both presented higher respiration rates than healthy plants. Many compounds of primary and secondary metabolism were significantly altered after fungal infection in both clones. These results suggest that, C. fimbriata interferes in the primary and secondary metabolism of plants that may be linked to the induction of defense mechanisms and that, due to water restrictions caused by the fungus in susceptible plants, there is a partial closure of the stomata to prevent water loss and a consequent reduction in photosynthesis and the transpiration rate, which in turn, leads to a decrease in the plant's growth-related. These results combined, allowed for a better understanding of the physiological and metabolic changes following the infectious process of C. fimbriata, which limit eucalypt plant growth.


Assuntos
Ascomicetos/metabolismo , Eucalyptus/metabolismo , Eucalyptus/microbiologia , Doenças das Plantas/microbiologia
6.
Acta Cir Bras ; 22(4): 309-16, 2007.
Artigo em Inglês | MEDLINE | ID: mdl-17625670

RESUMO

PURPOSE: To compare the biocompatibility of ethyl-cyanoacrylate (ECA) and octylcyanoacrylate (OCA) wound closures to sutures in rat skin. METHODS: Twenty-four male Wistar rats were subjected to three incisions which were closed using ECA, OCA or sutures . Rats were divided into four groups which received biopsies on the 3rd, 7th, 14th or 21st post-operative days. Necrosis, inflammation, dermatitis, infection, dehiscence, cicatricial enlargement and costs were examined; the histopathology evaluated was epithelialization, deep openings, foreign substance reaction, residues of synthesis material, fibrosis, inflammation, dehiscence and necrosis. RESULTS: The tissue adhesives presented the largest dehiscence levels, and ECA the lowest cost while the other measures were similar. Regarding histopathology, deep openings were more common with OCA and granulomas were most frequently obtained with ECA. The two tissue adhesives produces less inflammation than the inicial suture from post-operative day 7, while ECA and OCA cause similar inflammatory reactions. ECA did not differ significantly from OCA and sutures on other measures. CONCLUSION: ECA was well tolerated in this study and did not induce necrosis, allergic reactions or infections, presenting several advantages in relation to OCA and sutures, including lower costs and fewer complications.


Assuntos
Cianoacrilatos/uso terapêutico , Técnicas de Sutura/normas , Adesivos Teciduais/uso terapêutico , Cicatrização/efeitos dos fármacos , Animais , Materiais Biocompatíveis , Avaliação Pré-Clínica de Medicamentos , Masculino , Teste de Materiais , Ratos , Ratos Wistar , Pele/patologia , Resistência à Tração
7.
Microsc Res Tech ; 80(8): 898-903, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28475269

RESUMO

The El Plomo mummy was a pre-Columbian Incan child who was found mummified in the Andes Mountains above an altitude of 17,700 feet. In the environment, natural mummification occurred due to low temperatures and strong winds. Dating measurements (relative dating) by experts from the National Museum of Natural History of Chile established that the mummified body corresponds the Inca period (1,450 to 1,500 AD). In 2003, the body was transferred to the University of Chile Medical School for exhaustive medical examination. Tissue samples from the right quadriceps muscle were extracted and fixed in glutaraldehyde and postfixed in osmium tetroxide to obtain ultrathin sections to be observed by transmission electron microscope. Images were recorded on photographic paper, digitalized and analyzed by experts on morphology. Results showed a preservation of cell boundaries in striated muscle cells, but specific subcellular organelles or contractile sarcomeric units (actin and myosin) were unable to be recognized. However, the classical ultrastructural morphology of the polypeptide collagen type I was preserved intact both in primary and secondary organization. Therefore, we concluded that the process of natural mummification by freezing and strong winds is capable of damaging the ultrastructure of muscle cells and preserving collagen type I intact.


Assuntos
Múmias/parasitologia , Fibras Musculares Esqueléticas/parasitologia , Trichinella/fisiologia , Triquinelose/parasitologia , Animais , Chile , Colágeno Tipo I/metabolismo , Colágeno Tipo I/ultraestrutura , História Antiga , Humanos , Múmias/história , Fibras Musculares Esqueléticas/metabolismo , Fibras Musculares Esqueléticas/ultraestrutura , Trichinella/ultraestrutura
9.
Arq Bras Cir Dig ; 27(4): 285-7, 2014.
Artigo em Inglês, Português | MEDLINE | ID: mdl-25626940

RESUMO

INTRODUCTION: Cholecystocolic fistula is a rare complication of gallbladder disease. Its clinical presentation is variable and nonspecific, and the diagnosis is made, mostly, incidentally during intraoperative maneuver. Cholecystectomy with closure of the fistula is considered the treatment of choice for the condition, with an increasingly reproducible tendency to the use of laparoscopy. AIM: To describe the laparoscopic approach for cholecystocolic fistula and ratify its feasibility even with the unavailability of more specific instruments. TECHNIQUE: After dissection of the communication and section of the gallbladder fundus, the fistula is externalized by an appropriate trocar and sutured manually. Colonic segment is reintroduced into the cavity and cholecystectomy is performed avoiding the conversion procedure to open surgery. CONCLUSION: Laparoscopy for resolution of cholecystocolic fistula isn't only feasible, but also offers a shorter stay at hospital and a milder postoperative period when compared to laparotomy.


Assuntos
Fístula Biliar/cirurgia , Doenças do Colo/cirurgia , Doenças da Vesícula Biliar/cirurgia , Fístula Intestinal/cirurgia , Laparoscopia , Humanos
10.
Korean Journal of Radiology ; : 1236-1245, 2019.
Artigo em Inglês | WPRIM | ID: wpr-760277

RESUMO

OBJECTIVE: Considering the different prevalence rates of diseases such as asthma and chronic obstructive pulmonary disease in Asians relative to other races, Koreans may have unique airway structure and lung function. This study aimed to investigate unique features of airway structure and lung function based on quantitative computed tomography (QCT)-imaging metrics in the Korean Asian population (Koreans) as compared with the White American population (Whites). MATERIALS AND METHODS: QCT data of healthy non-smokers (223 Koreans vs. 70 Whites) were collected, including QCT structural variables of wall thickness (WT) and hydraulic diameter (Dh) and functional variables of air volume, total air volume change in the lung (ΔVair), percent emphysema-like lung (Emph%), and percent functional small airway disease-like lung (fSAD%). Mann-Whitney U tests were performed to compare the two groups. RESULTS: As compared with Whites, Koreans had smaller volume at inspiration, ΔVair between inspiration and expiration (p < 0.001), and Emph% at inspiration (p < 0.001). Especially, Korean females had a decrease of ΔVair in the lower lobes (p < 0.001), associated with fSAD% at the lower lobes (p < 0.05). In addition, Koreans had smaller Dh and WT of the trachea (both, p < 0.05), correlated with the forced expiratory volume in 1 second (R = 0.49, 0.39; all p < 0.001) and forced vital capacity (R = 0.55, 0.45; all p < 0.001). CONCLUSION: Koreans had unique features of airway structure and lung function as compared with Whites, and the difference was clearer in female individuals. Discriminating structural and functional features between Koreans and Whites enables exploration of inter-racial differences of pulmonary disease in terms of severity, distribution, and phenotype.


Assuntos
Feminino , Humanos , Povo Asiático , Asma , Grupos Raciais , Volume Expiratório Forçado , Pulmão , Pneumopatias , Fenótipo , Prevalência , Doença Pulmonar Obstrutiva Crônica , Tórax , Traqueia , Capacidade Vital
11.
Rev Assoc Med Bras (1992) ; 58(3): 376-82, 2012.
Artigo em Inglês, Português | MEDLINE | ID: mdl-22735232

RESUMO

The increased knowledge regarding proteomic analysis techniques has allowed for better understanding of the molecular bases related to the identification of cell signaling, modifying protein, and post-translational modification pathways, in addition to the characterization of specific biological markers. Thus, documenting certain proteins expressed in sepsis is a promising approach to elucidate pathophysiological, diagnostic, therapeutic, and prognostic aspects in this condition with a purpose of applying them to clinical practice. Although the studies are still preliminary, proteomics may offer good benefits for the better management of septic patients. Thus, this article aims to introduce a short review of the applications of proteomic studies to sepsis.


Assuntos
Proteômica/métodos , Sepse/diagnóstico , Biomarcadores/metabolismo , Humanos , Prognóstico , Sepse/genética , Sepse/metabolismo
12.
Rev Col Bras Cir ; 39(3): 207-10, 2012.
Artigo em Inglês, Português | MEDLINE | ID: mdl-22836569

RESUMO

OBJECTIVE: To develop an experimental model of global normothermic ischemia able to demonstrate the transient ischemia and reperfusion periods required for development of ischemia/reperfusion injury in the small intestines of Wistar rats by clamping the abdominal aorta. METHODS: Twenty adult male Wistar rats weighing 250-350g were randomly divided into five groups with four rats each and submitted to increasing times of ischemia (0 - 30 - 45 - 60 - 90 minutes). Within each group, except the control one, two rats underwent 60 minutes of reperfusion and two 90 minutes. After the procedures, histological analysis was conducted by measurement of areas of necrosis. RESULTS: The degree of intestinal necrosis ranged from 15% to 54% (p = 0.0004). There was progressive increase in the degree of injury related to increase in ischemic time. However, greater degrees of injury were observed in the lowest times of reperfusion. The analysis of the coefficient of variation of necrosis among the ten groups of ischemia/reperfusion showed a statistically significant difference in 15 areas, 13 related to the control group. CONCLUSION: The model was able to show the periods required for the occurrence of ischemia/reperfusion injury by aortic clamping and can serve as a basis to facilitate the development of studies that aim at understanding this kind of injury.


Assuntos
Modelos Animais de Doenças , Isquemia , Mesentério/irrigação sanguínea , Animais , Aorta Abdominal , Constrição , Masculino , Ratos , Ratos Wistar , Reperfusão/métodos
13.
Rev Colomb Psiquiatr ; 41(4): 719-39, 2012 Dec.
Artigo em Espanhol | MEDLINE | ID: mdl-26572263

RESUMO

INTRODUCTION: Depression is an important cause of morbidity and disability in the world; however, it is under-diagnosed at all care levels. OBJECTIVE: The purpose here is to present recommendations based on the evidence gathered to answer a series of clinical questions concerning risk factors, screening, suicide risk diagnosis and evaluation in patients undergoing a depressive episode and recurrent depressive disorder. Emphasis has been made upon the approach used at the primary care level so as to grant adult diagnosed patients the health care guidelines based on the best and more updated evidence available thus achieving minimum quality standards. METHODOLOGY: A practical clinical guide was elaborated according to standards of the Methodological Guide of the Ministry of Social Protection. Recommendation from guides NICE90 and CANMAT were adopted and updated so as to answer the questions posed while de novo questions were developed. RESULTS: Recommendations 1-22 corresponding to screening, suicide risk and depression diagnosis were presented. The corresponding degree of recommendation is included.

14.
Rev Colomb Psiquiatr ; 41(4): 774-86, 2012 Dec.
Artigo em Espanhol | MEDLINE | ID: mdl-26572265

RESUMO

INTRODUCTION: This article presents recommendations based on the evidence gathered to answer a series of clinical questions concerning the depressive episode and the recurrent depressive disorder. Emphasis was given to general treatment issues of resistant depression and psychotic depression, occupational therapy and day hospital treatment so as to grant diagnosed adult patients the health care parameters based on the best and more updated evidence available and achieve minimum quality standards. METHODOLOGY: A practical clinical guide was elaborated according to standards of the Methodological Guide of the Ministry of Social Protection. Recommendation from NICE90 and CANMAT guides were adopted and updated so as to answer the questions posed while de novo questions were developed. RESULTS: Recommendations 23-25 corresponding to the management of depression are presented.

15.
Rev Colomb Psiquiatr ; 41(4): 740-73, 2012 Dec.
Artigo em Espanhol | MEDLINE | ID: mdl-26572264

RESUMO

INTRODUCTION: This article presents recommendations based on evidence gathered to answer a series of clinical questions concerning the depressive episode and the recurrent depressive disorder, with emphasis on general treatment aspects, treatment in the acute phase and management of the continuation/maintenance, all intended to grant health care parameters based on the best and more updated available evidence for achieving minimum quality standards with adult patients thus diagnosed. METHODOLOGY: A practical clinical guide was elaborated according to standards of the Methodological Guide of the Ministry of Social Protection. Recommendation from NICE90 and CANMAT guides were adopted and updated so as to answer the questions posed while de novo questions were developed. RESULTS: Recommendations 5-22 corresponding to management of depression are presented.

16.
Rev Bras Ter Intensiva ; 23(2): 207-16, 2011 Jun.
Artigo em Inglês, Português | MEDLINE | ID: mdl-25299722

RESUMO

This paper aims to provide an update on the main aspects of sepsis, a very relevant health care issue. A number of hypotheses have been proposed to explain its origin, involving interactions between microorganisms and the innate immune system, inflammation/immune mediation and the coagulation system. The clinical features of sepsis are variable and depend on the primary site of infection. The identification of early signs and symptoms is crucial for starting therapeutic measures fundamentally based on volume resuscitation, antibiotic therapy, use of steroids, anticoagulant therapy, biologic viability maintenance interventions and nutritional support.

17.
ABCD (São Paulo, Impr.) ; 27(4): 285-287, Nov-Dec/2014. graf
Artigo em Inglês | LILACS | ID: lil-735697

RESUMO

INTRODUCTION: Cholecystocolic fistula is a rare complication of gallbladder disease. Its clinical presentation is variable and nonspecific, and the diagnosis is made, mostly, incidentally during intraoperative maneuver. Cholecystectomy with closure of the fistula is considered the treatment of choice for the condition, with an increasingly reproducible tendency to the use of laparoscopy. AIM: To describe the laparoscopic approach for cholecystocolic fistula and ratify its feasibility even with the unavailability of more specific instruments. TECHNIQUE: After dissection of the communication and section of the gallbladder fundus, the fistula is externalized by an appropriate trocar and sutured manually. Colonic segment is reintroduced into the cavity and cholecystectomy is performed avoiding the conversion procedure to open surgery. CONCLUSION: Laparoscopy for resolution of cholecystocolic fistula isn't only feasible, but also offers a shorter stay at hospital and a milder postoperative period when compared to laparotomy. .


INTRODUÇÃO: A fístula colecistocólica é rara complicação das doenças calculosas do trato biliar. Sua apresentação clínica é variável e inespecífica, sendo o diagnóstico realizado, na maioria das vezes, incidentalmente durante o intraoperatório de sua causa base. A colecistectomia com fechamento da fístula é considerada o tratamento de escolha para a condição, sendo a videolaparoscopia cada vez mais reprodutível. OBJETIVO: Descrever a abordagem laparoscópica da fístula colecistocólica e ratificar a sua factibilidade mesmo diante da indisponibilidade de instrumentos mais específicos. TÉCNICA: Após dissecção da comunicação e secção do polo vesicular, a fístula é exteriorizada por uma cânula adequada e rafiada manualmente. Reintroduzido o segmento colônico na cavidade, a colecistectomia é realizada evitando-se a conversão do procedimento para a operação aberta. CONCLUSÃO: A videolaparoscopia para resolução de fístula colecistocólica é viável, com menor tempo de internação hospitalar e melhor pós-operatório quando comparada à laparotomia. .


Assuntos
Humanos , Fístula Biliar/cirurgia , Doenças do Colo/cirurgia , Doenças da Vesícula Biliar/cirurgia , Fístula Intestinal/cirurgia , Laparoscopia
18.
Acta Cir Bras ; 24(2): 82-6, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19377774

RESUMO

PURPOSE: To improve the measurement system, during a research for the prevention of adhesions, we explored the feasibility of introducing three continuous numeric variables to quantify the intensity of pericardial adhesions. METHODS: To validate these three new numeric variables - time spent to dissect the adhesions (Deltat), the amount of sharp dissection (ShpD) and the adhesion's collagen area (ACA) - as useful tools in measuring the severity of pericardial adhesions, data from a randomized study on adhesion prevention enrolling twenty-four swine, were analysed. A statistical Spearman's test and regressions models were applied to verify the correlation and the relationship between the results of a standard severity score (SS) and Deltat, between SS and ShpD used in adhesiolysis and, also, between SS and ACA. RESULTS: There was a statistically significant correlation between SS and Deltat, between SS and ShpD, as well as between SS and ACA, all measured by the Spearman's test (r=0.897, r=0.932, r=0.66; p<0.01, respectively). Through a non-linear regression, an exponential relation of SS with ShpD (R(2)=0.915) and SS with Deltat (R(2)= 0.917) was found. CONCLUSION: The time spent to dissect the adhesions (Deltat) and the amount of sharp dissection (ShpD) are new powerful measurement tools in evaluating outcomes of the methods used to prevent pericardial adhesions.


Assuntos
Pericárdio/cirurgia , Complicações Pós-Operatórias/prevenção & controle , Procedimentos Cirúrgicos Torácicos/métodos , Aderências Teciduais/prevenção & controle , Análise de Variância , Animais , Modelos Animais de Doenças , Complicações Pós-Operatórias/diagnóstico , Distribuição Aleatória , Suínos , Aderências Teciduais/diagnóstico , Resultado do Tratamento
19.
Rev. colomb. psiquiatr ; 41(4): 719-739, oct. 2012. ilus, tab
Artigo em Espanhol | LILACS | ID: lil-675291

RESUMO

Guía de atención integral para la detección temprana y diagnóstico del episodio depresivo y trastorno depresivo recurrente en adultos. Atención integral de los adultos con diagnóstico de episodio depresivo o trastorno depresivo recurrente Parte I: Factores de riesgo, tamización, diagnóstico y evaluación de riesgo de suicidio en pacientes con diagnóstico de depresión...


Integral care guide for early detection and diagnosis of depressive episodes and recurrent depressive disorder in adults. integral attention of adults with a diagnosis of depressive episodes and recurrent depressive disorderpart i: risk factors, screening, suicide risk diagnosis and assessment in patients with a depression diagnosis...


Assuntos
Transtorno Depressivo , Guias de Prática Clínica como Assunto , Fatores de Risco , Peneiramento de Líquidos
20.
Rev. Assoc. Med. Bras. (1992, Impr.) ; 58(3): 376-382, May-June 2012. tab
Artigo em Português | LILACS | ID: lil-639564

RESUMO

A ampliação do conhecimento das técnicas de análise proteômica tem permitido maior compreensão das bases moleculares relacionadas à identificação de vias de sinalização celular, de proteínas modificadoras, de modificações pós-traducionais, além de caracterizar marcadores biológicos específicos. Desta feita, a documentação de determinadas proteínas expressas na sepse constitui uma promissora abordagem para elucidação dos aspectos fisiopatológicos, diagnósticos, terapêuticos e prognósticos dessa condição, com a finalidade de aplicação na prática clínica. Embora os resultados sejam ainda preliminares, a proteômica poderá oferecer bons subsídios para o melhor manejo dos pacientes sépticos. Dessa feita, o objetivo do presente artigo é apresentar uma breve revisão das aplicações dos estudos proteômicos na sepse.


The increased knowledge regarding proteomic analysis techniques has allowed for better understanding of the molecular bases related to the identification of cell signaling, modifying protein, and post-translational modification pathways, in addition to the characterization of specific biological markers. Thus, documenting certain proteins expressed in sepsis is a promising approach to elucidate pathophysiological, diagnostic, therapeutic, and prognostic aspects in this condition with a purpose of applying them to clinical practice. Although the studies are still preliminary, proteomics may offer good benefits for the better management of septic patients. Thus, this article aims to introduce a short review of the applications of proteomic studies to sepsis.


Assuntos
Humanos , Proteômica/métodos , Sepse/diagnóstico , Biomarcadores/metabolismo , Prognóstico , Sepse/genética , Sepse/metabolismo
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