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Methods for patterning biomolecules on a substrate at the single molecule level have been studied as a route to sensors with single-molecular sensitivity or as a way to probe biological phenomena at the single-molecule level. However, the arrangement and orientation of single biomolecules on substrates has been less investigated. Here, the arrangement and orientation of two rod-like coiled-coil proteins, cortexillin and tropomyosin, around patterned gold nanostructures is examined. The high aspect ratio of the coiled coils makes it possible to study their orientations and to pursue a strategy of protein orientation via two-point attachment. The proteins are anchored to the surfaces using thiol groups, and the number of cysteine residues in tropomyosin is varied to test how this variation affects the structure and arrangement of the surface-attached proteins. Molecular dynamics studies are used to interpret the observed positional distributions. Based on initial studies of protein attachment to gold post structures, two 31-nm-long tropomyosin molecules are aligned between the two sidewalls of a trench with a width of 68 nm. Because the approach presented in this study uses one of twenty natural amino acids, this method provides a convenient way to pattern biomolecules on substrates using standard chemistry.
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Ouro/química , Nanoestruturas/química , Tamanho da Partícula , Proteínas/química , Humanos , Simulação de Dinâmica Molecular , Nanoestruturas/ultraestrutura , Conformação Proteica , Temperatura , Tropomiosina/químicaRESUMO
We demonstrated a technique to control the placement of 6 nm-diameter CdSe and 5 nm-diameter CdSe/CdZnS colloidal quantum dots (QDs) through electron-beam lithography. This QD-placement technique resulted in an average of three QDs in each cluster, and 87% of the templated sites were occupied by at least one QD. These QD clusters could be in close proximity to one another, with a minimum separation of 12 nm. Photoluminescence measurements of the fabricated QD clusters showed intermittent photoluminescence, which indicates that the QDs were optically active after the fabrication process. This optimized top-down lithographic process is a step towards the integration of individual QDs in optoelectronic and nano-optical systems.
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Introduction: The severity of wheezing episodes is related with the need for health services, but the factors associated with health care utilization in preschool recurrent wheezers in underdeveloped regions are unclear. Objective: To evaluate the factors associated with health care utilization in preschool recurrent wheezers in Cartagena, Colombia. Methods: One hundred twenty-seven recurrent wheezers (age 2-6 years old) who were admitted to the emergency room (ER) due to wheezing in a Pediatric reference hospital in Cartagena were included. Children were evaluated by means of questionnaires and classified according to the number of ER visits, need for hospitalization and history of intensive care unit (ICU) admission due to wheezing within the last year. Total serum IgE and specific IgE to house dust mite allergens (HDM) were measured by ImmunoCAP® and allergen sensitization was evaluated by skin prick tests (SPT). Results: The maternal report of nocturnal cough without fever in their children increased the risk to have ≥5 ER visits in the last year due to wheezing. The use of montelukast was negatively associated with hospitalization, while a history of pneumonia and lack of tap water, increased the risk of hospitalization due to wheezing. A history of bronchiolitis, family history of asthma, cohabiting with two or more siblings, passive exposure to smoke and lack of sewage facilities increased the risk of ICU admission due to wheezing. The presence of atopy evaluated by SPT reactivity, total IgE levels or specific IgE to HDM were not associated with health care utilization. We also found that seroprevalence of positive IgE (≥0.35 kU/L) was 27% to B. tropicalis and 20.3% to D. pteronyssinus but the prevalence of positive IgE sensitization to these allergens was below 2% and 8% when evaluated by SPT, respectively. Conclusions: Poverty indicators are associated with ICU admission in a group of preschool recurrent wheezers and should be considered as aggravating factors for wheezing. These factors must be systematically assessed in the medical approach in underdeveloped regions in the tropics. Nocturnal cough without fever is a symptom associated with frequent ER visits while atopy was not associated with health care utilization in preschool recurrent wheezers.
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The purpose of the food industry is to ensure the availability of safe and nutritious food ingredients for human consumption. Sweet potato is a crop with excellent industrialization possibilities for human food due to its important nutrient content. The objective of this study was to evaluate the effect of an alginate-calcium sulfate-tripolyphosphate (PPTS) gelling system on the physicochemical and sensory characteristics of restructured sweet potato products. Fifteen formulations with varied concentrations of alginate, calcium sulfate, and PPTS were elaborated and subjected to a ordered-preference test. The physicochemical composition and color parameters of the preferred samples were determined, and the consumer acceptance, intention to purchase, and acceptability index (AI) were assessed. The preferred formulations (p ≤ 0.05) were F1, F6, F10, F11, and F14, and the gel formation was efficient at retaining water and preventing the restructured products from absorbing fat during frying. The restructured products with the highest water retention and lowest fat absorption were F11 (46.75%), F10 (44.53%), and F14 (43.29%). In the acceptance test, no differences (p ≥ 0.05) were found in the attributes softness, crunchiness, and sweet potato flavor. Formulations F6 and F14 obtained the highest acceptability index (AI), equal to or higher than 70%, indicating that they could represent viable alternatives for the industrial transformation of sweet potato for its possible commercialization.
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OBJECTIVE: Respiratory scleroma (RS) is a progressive, chronic, granulomatous disease caused by Klebsiella rhinoscleromatis. There is only one report of RS association with HLA-DQ3. In this study, molecular association of HLA class II and RS was determined. STUDY DESIGN AND SETTING: Nine RS patients and 163 healthy controls were compared. DQA1, DQB1, and DRB1 loci were typed. RESULTS: Statistical analysis demonstrated association between DQB1*0301 and susceptibility to RS (P(c) = 0.004). Haplotype analysis showed an association of DQA1*03011-DQB1*0301 (P = 1.21E-19) and DRB1*0407-DQA1*03011-DQB1*0301 (P = 0.0002). CONCLUSIONS: Results established that DQA1*03011-DQB1*0301 haplotype is a strong risk factor for development of RS.
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Antígenos HLA-DQ/genética , Rinoscleroma/genética , Adulto , Mapeamento Cromossômico , Feminino , Frequência do Gene/genética , Predisposição Genética para Doença/genética , Genótipo , Cadeias alfa de HLA-DQ , Cadeias beta de HLA-DQ , Antígenos HLA-DR/genética , Cadeias HLA-DRB1 , Haplótipos , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de RiscoRESUMO
INTRODUCTION: Pathology may affect the muscles that control vocal function directly by affecting peripheral function or indirectly by affecting the central nervous system. Clinically, muscle function can be assessed by observing the movements of the structures themselves or by recording the electrical activity of the muscles (electromyography, EMG). Since EMG is an invasive technique, it has enjoyed limited use in the diagnosis and management of voice disorders, especially in children. Laryngeal EMG may be helpful in those patients with voice problems of suspected neurological or neuromuscular etiology. OBJECTIVE: The purpose of this paper is to study the role of laryngeal EMG in the clinical evaluation of unilateral vocal fold immobility in children. MATERIALS AND METHODS: Twenty-five children with unilateral vocal fold paralysis were studied. Twenty-five patients with vocal pathologies secondary to vocal abuse and misuse were studied as controls. The sensitivity and specificity of the EMG as a diagnostic marker for vocal fold paralysis were obtained. Additionally, nine patients with traumatic arytenoid dislocation were also studied. All patients were subjected to laryngeal EMG. EMG showed a sensitivity of 100%, and specificity of 92%. Only two patients, present with a functional voice disorder, showed abnormalities in the EMG recordings. In the nine patients with arytenoid dislocation, EMG showed normal parameters. CONCLUSION: EMG seems a safe and reliable test for evaluating patients with vocal fold immobility. Moreover, the EMG recordings were helpful in differentiating vocal fold paralysis from arytenoid dislocation. EMG can provide useful data concerning muscle denervation, and more importantly, reinnervation. Besides its utility for the diagnosis, serial EMG can be useful for monitoring recovery and for establishing a reliable prognosis, and hence, an adequate treatment plan.
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Eletromiografia/métodos , Músculos Laríngeos/fisiopatologia , Paralisia das Pregas Vocais/diagnóstico , Adolescente , Cartilagem Aritenoide/lesões , Estudos de Casos e Controles , Criança , Diagnóstico Diferencial , Eletromiografia/estatística & dados numéricos , Feminino , Humanos , Luxações Articulares/diagnóstico , Luxações Articulares/fisiopatologia , Laringoscopia , Masculino , Valor Preditivo dos Testes , Traumatismos do Nervo Laríngeo Recorrente , Segurança , Sensibilidade e Especificidade , Paralisia das Pregas Vocais/fisiopatologia , Prega Vocal/inervação , Distúrbios da Voz/diagnóstico , Distúrbios da Voz/fisiopatologiaRESUMO
Frontal swelling can be due to multiple etiologies, including: mucocele, Pott's puffy tumor, fibro osseous lesions, benign and malignant neoplasms of the nose and paranasal sinuses, intracranial lesions, and metastasis. The objective of this study was to describe the clinical protocol used for the diagnosis of patients presented with frontal swelling and the proposal for staging of inflammatory lesions. We performed an observational retrospective analysis. We found 7 cases of patients with frontal swelling: 4 cases secondary to inflammatory pathology (3 Potts puffy tumors and one frontal mucocele), and 3 cases secondary to neoplasms (one benign and 2 malignant neoplasms). It's very important to consider the wide differential diagnosis that can present as frontal swelling, from inflammatory pathologies secondary to possible advanced infections of the paranasal sinuses to invasive malignant neoplasms. We propose a system of staging of frontal inflammatory lesions.
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Edema/etiologia , Testa , Osso Frontal/patologia , Mucocele/patologia , Neoplasias dos Seios Paranasais/patologia , Tumor de Pott/patologia , Algoritmos , Carcinoma Papilar/complicações , Carcinoma Papilar/diagnóstico por imagem , Carcinoma Papilar/patologia , Carcinoma Papilar/secundário , Celulite (Flegmão)/diagnóstico por imagem , Celulite (Flegmão)/etiologia , Estudos Transversais , Diagnóstico Diferencial , Edema/diagnóstico por imagem , Displasia Fibrosa Monostótica/complicações , Displasia Fibrosa Monostótica/diagnóstico por imagem , Displasia Fibrosa Monostótica/patologia , Testa/diagnóstico por imagem , Osso Frontal/diagnóstico por imagem , Humanos , Imageamento por Ressonância Magnética , Mucocele/complicações , Mucocele/diagnóstico por imagem , Neoplasias Nasais/complicações , Neoplasias Nasais/diagnóstico por imagem , Neoplasias Nasais/patologia , Papiloma Invertido/complicações , Papiloma Invertido/diagnóstico por imagem , Papiloma Invertido/patologia , Neoplasias dos Seios Paranasais/complicações , Neoplasias dos Seios Paranasais/diagnóstico por imagem , Tumor de Pott/complicações , Tumor de Pott/diagnóstico por imagem , Estudos Retrospectivos , Sinusite/complicações , Sinusite/diagnóstico por imagem , Neoplasias Cranianas/complicações , Neoplasias Cranianas/diagnóstico por imagem , Neoplasias Cranianas/patologia , Neoplasias da Glândula Tireoide/patologia , Tomografia Computadorizada por Raios XRESUMO
RESUMEN La hemorragia talámica pertenece al grupo de las hemorragias intracerebrales de etiología no traumática o quirúrgica. Es una entidad relativamente infrecuente y tiene una prevalencia de 6-15 % de los casos dentro de dicho grupo. El tálamo es una estructura anatómica donde convergen múltiples vías neuronales, por lo tanto, sus manifestaciones clínicas no están totalmente descritas. A pesar de ello, se conoce que su presentación clínica más frecuente está asociada al síndrome sensitivo de Déjerine-Roussy, caracterizado por intenso dolor neuropático, alodinia contralateral a la lesión, hemiparesia y hemiataxia. La hemorragia talámica también se puede presentar con alteraciones de la memoria, sueño, emociones y procesamiento de información sensitiva. Se presenta un caso de hemorragia talámica izquierda espontánea en un paciente de 71 años que debutó con cambios en su comportamiento, bradipsiquia y amnesia anterógrada, con posterior recuperación completa de su estado cognitivo y psicológico antes de los 8 días y con hallazgos normales en la panangiografía.
ABSTRACT Thalamic hemorrhage belongs to the group of intracerebral hemorrhages of non-traumatic or surgical etiology. It is relatively rare and has a prevalence of 6-15% of cases. The thalamus is an anatomical structure where multiple neural pathways converge; therefore, its clinical manifestations are not fully described. Despite this, it is known that its most frequent clinical presentation is associated with the Dejerine-Roussy sensory syndrome, characterized by intense neuropathic pain, allodynia contralateral to the lesion, hemiparesis and hemiataxia. Thalamic hemorrhage can also present with alterations in memory, sleep, emotions, and the processing of sensitive information. We present a case of spontaneous left thalamic hemorrhage in a 71-year-old patient who presented with changes in his behavior, bradypsy-chia, and anterograde amnesia, with subsequent complete recovery of his cognitive and psychological state before 8 days and with normal findings in the panangiography.
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Resumen La amiloidosis constituye una complicación importante en los pacientes con enfermedad renal crónica que son sometidos a hemodiálisis durante extensos períodos de tiempo. Al igual que en otras amiloidosis sistémicas, en la amiloidosis asociada a hemodiálisis intervienen diferentes sustancias, algunas de ellas de carácter fibrilar, como la βeta-2-microglobulina, la cual representa una de las proteínas de mayor relevancia dada su implicación etiopatogénica. A pesar de que las técnicas de hemodiálisis han sido mejoradas con el paso de los años, dicha entidad continúa siendo una complicación relativamente frecuente; tal es que se puede presentar hasta en el 80 % de los pacientes con hemodiálisis prolongadas. Por lo tanto, se hizo imprescindible realizar una revisión narrativa partiendo de la literatura científica disponible en las diferentes bases de datos, con el objetivo de contribuir a mejorar y actualizar el conocimiento del médico en dicho tópico; al abarcar desde los aspectos generales y su fisiopatología, hasta su presentación clínica, diagnóstico y tratamiento.
Abstract Amyloidosis is a major complication in patients with chronic kidney disease who undergo hemodialysis for long periods of time. As in other systemic amyloidosis, different substances are involved in amyloidosis associated with different substances, some of them fibrillar in nature, such as βeta-2-microglobulin, which represents one of the most relevant proteins given its etiopathogenic involvement. Despite the fact that hemodialysis techniques have been improved over the years, this entity continues to be a frequent complication; such is that it can occur in up to 80% of patients with prolonged hemodialysis. Therefore, it was essential to carry out a narrative review based on the scientific literature available in the different databases with the aim of contributing to improve and update the doctor's knowledge on this topic; ranging from the general aspects and its pathophysiology, to its clinical presentation, diagnosis, and treatment.
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Los edulcorantes no calóricos surgieron como una opción segura y saludable en el marco de la alimentación y, por lo tanto, han sido de gran interés en la cultura dietética adquirida en la actualidad; es importante mencionar que en esta cultura adquirida el consumo de comida rápida y con altos niveles de azúcar ha tomado especial fuerza, lo que repercute negativamente en la incidencia de enfermedades metabólicas. En este orden de ideas, los edulcorantes no calóricos se convierten en una mejor opción para la salud en la que no es necesario hacer un cambio drástico en el estilo de vida. No obstante, los beneficios de los edulcorantes artificiales no calóricos no han sido estudiados a profundidad y no se ha evidenciado que una dieta a base de estos sustitutivos provoque un cambio significativo en el desarrollo de enfermedades metabólicas asociadas al consumo de azúcar, por el contrario, se han relacionado con enfermedades como obesidad, diabetes mellitus tipo 2 y síndrome metabólico. Asimismo, estos pueden provocar una serie de cambios metabólicos a través de distintos mecanismos que terminan en proteinuria progresiva y descenso de la tasa de filtrado glomerular. A partir de lo anterior, se hace necesario un análisis del riesgo que se corre al elegir esta opción alimenticia, para así no dejarse llevar por los procesos mediáticos que los promocionan, sino más bien, regirse por los hallazgos científicos.
Non-caloric artificial sweeteners have emerged to offer a safe and healthy option in the framework of food. They have received special attention in recent decades, precisely because of the current food culture, where fast food and high sugar consumption have taken on special strength, which has a negative impact on the incidence of metabolic diseases. In that order of ideas, non-caloric artificial sweeteners propose better health without the need for a drastic change in lifestyle. However, its benefits have not been studied in depth, in addition to the fact that there has been no significant change in the development of metabolic diseases associated with sugar consumption, on the contrary, they have been related to diseases such as obesity, type 2 diabetes mellitus and metabolic syndrome. Likewise, they cause a series of metabolic changes by different mechanisms that end in progressive proteinuria and a decrease in the glomerular filtration rate. In order with the above, an analysis of the risk to which one is subjected when choosing this food option is necessary, and not be deafened, much less dazzled by the media processes, if not rather, be governed by scientific findings.
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Resumen La litiasis renal en la paciente gestante es una condición relativamente infrecuente; sin embargo, es la causa más común de dolor no obstétrico durante el embarazo. En el periodo de gestación se producen diversos cambios anatomofisiológicos en el tracto urinario, como la dilatación de los cálices renales, la pelvis renal y los uréteres por causa del efecto que ejerce la progesterona sobre el músculo liso uretral, y la compresión de los uréteres por el útero grávido. Estas modificaciones conducen a un aumento del flujo plasmático renal y de la tasa de filtrado glomerular, ocasionando hiperuricosuria e hipercalciuria. Del mismo modo, durante el embarazo también se produce un aumento de la secreción de inhibidores de cálculos, por lo cual la prevalencia de la formación de cálculos durante el embarazo es similar a la de las mujeres no embarazadas. El bajo índice de sospecha por parte del médico tratante puede entorpecer el diagnóstico y el tratamiento de esta patología, que también son limitados en la gestación debido a los potenciales riesgos teratogénicos. Se realiza una revisión narrativa de la literatura partiendo de la evidencia científica disponible en las diferentes bases de datos y de esta manera se pretende instruir al médico en los aspectos clave de dicho tema.
Abstract Renal lithiasis in pregnant women is a relatively rare condition. However, it is the most common cause of non-obstetric pain during pregnancy. During the gestation period, various anatomical-physiological changes occur in the urinary tract. These changes include dilation of the renal calyces, renal pelvis, and ureters due to the effect of progesterone on urethral smooth muscle and compression of the ureters by the gravid uterus. These modifications lead to an increase in renal plasma flow and glomerular filtration rate, thus causing hyperuricosuria and hypercalciuria. Similarly, during pregnancy there is also an increase in the secretion of stone inhibitors, therefore, the prevalence of stone formation during pregnancy is similar to non-pregnant women. The low index of suspicion on the part of the treating physician can hinder the diagnosis and treatment of this pathology, which is also limited in pregnancy due to teratogenic risks. A narrative review of the literature is carried out based on the scientific evidence available in the different databases and in this way it is intended to instruct the doctor in the key aspects of said topic.
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Humanos , Feminino , Gravidez , Complicações na Gravidez/diagnóstico , Complicações na Gravidez/terapia , Nefrolitíase/diagnóstico , Nefrolitíase/terapia , Complicações na Gravidez/etiologia , Algoritmos , Fatores de Risco , Nefrolitíase/etiologiaRESUMO
La enfermedad renal crónica es una afección que, dados sus altos niveles de incidencia y prevalencia, constituye un importante problema de salud pública a nivel mundial. Esta entidad se encuentra dentro de las principales causas de muerte tanto en Colombia como en el mundo y representa una gran carga social y económica, similar a la de otras enfermedades crónicas no trasmisibles como la hipertensión arterial y la diabetes mellitus. Actualmente, los gobiernos han realizado esfuerzos para moderar sus estadísticas; sin embargo, estos no han sido lo suficientemente sólidos para mantener bajo control el efecto que ejercen dichas patologías en la salud de las personas, por lo cual se hace imprescindible fortalecer las acciones que fomenten su prevención y control. En el presente artículo se realiza una revisión narrativa de la literatura, partiendo de la información disponible en las diferentes bases de datos, con el objetivo de resaltar la importancia de implementar un modelo de nefroprevención adaptado para Colombia que permita prevenir y detectar oportunamente los factores de riesgo cardiovasculares y renales, y que además facilite el diagnóstico precoz de la enfermedad renal crónica en aras de disminuir su progresión y sus consecuencias potencialmente letales.
Chronic kidney disease is a condition that, given its high levels of incidence and prevalence, constitutes a major public health problem worldwide. This entity is among the leading causes of death both in Colombia and in the world, and represents a great social an economic burden, similar to that of other chronic non-communicable diseases such as arterial hypertension and diabetes mellitus. Currently, governments have made efforts to moderate their statistics; however, these have not been solid enough to keep under control the effect that these pathologies have on the health of the individuals, for which it is indispensable to strengthen actions that promote their prevention and control. In the present article, a narrative literature review is carried out, based on the information available in the different databases, with the purpose of highlighting the importance of implementing a nephroprevention model adapted for Colombia that allows to timely prevent and detect the cardiovascular and renal risk factors, and also facilitate the early diagnosis of chronic kidney disease in order to slow its progression and its potentially lethal consequences.
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INTRODUCTION: Obstructive sleep apnea syndrome (OSAS) commonly appears in patients with Pierre Robin sequence (PR). Polysomnography (PS) is the gold standard for the diagnosis of OSAS. Videonasopharyngoscopy (VNP) is the best diagnostic tool for visualizing the vocal tract and detecting structural abnormalities which can be associated with OSAS. OBJECTIVE: The purpose of this paper is to study whether VNP can be useful for identifying severe OSAS in a population of children with PR. MATERIALS AND METHODS: Fifty-two children with PR who were present with sleep-disordered breathing were studied. All the parents completed a questionnaire concerning the children's sleeping habits and sleep complaints before consultation. Each child underwent a general pediatric examination and an evaluation of craniofacial features and upper airway permeability. In all children, a PS was performed. Also, all children underwent a VNP. RESULTS: The diagnosis of OSAS was confirmed by PS in 31 patients. VNP showed 87% sensitivity and 100% specificity for the detection of OSAS. VNP findings showed a significant correlation with apnea-hypopnea index, arousal index, snoring time, percentage of sleep time spent at saturation of oxygen <90% and a significant inverse correlation with total sleep time, sleep efficiency and the mean saturation of oxygen during sleep. CONCLUSION: This study shows that in children with PR, airway obstruction as detected by VNP seems to be a risk factor for OSAS. VNP appears to be a safe and reliable tool for the evaluation of sleep-disordered breathing in children with PR.
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Endoscopia/métodos , Síndrome de Pierre Robin/diagnóstico , Apneia Obstrutiva do Sono/diagnóstico , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Polissonografia , Estudos Prospectivos , Sensibilidade e Especificidade , Índice de Gravidade de Doença , Inquéritos e Questionários , Gravação de VideoteipeRESUMO
Se realizó un rastreo bibliográfico sobre la reacomodación de las dinámicas internas en familias que tienen un infante en cuidados paliativos, haciendo hincapié en la importancia de la terapia familiar para entender la enfermedad y resignificarla mediante la técnica narrativa de la metáfora. Teniendo en cuenta lo anterior, cuando llega una crisis significativa al núcleo familiar, como una enfermedad, esta cambia la dinámica familiar, puesto que obliga a movilizarse de manera inesperada para buscar posibles soluciones a la situación que aqueja. En muchos casos, la familia recurre a la terapia familiar como estrategia para fortalecer sus recursos, y la metáfora como herramienta narrativa, es uno de los recursos que se usa para ayudar a resignificar la enfermedad. Ahora bien, en cuanto al rastreo bibliográfico, fue la base del texto reflexivo construido, ya que en el rastreo se evidenció que en la terapia familiar no se encuentra un abordaje específico en los procesos de salud que requieren acompañamiento paliativo, por lo que se hace necesario visibilizar la utilidad de la terapia familiar en estos procesos. Como conclusión, se presenta el uso de la metáfora como posible vía de trabajo con las familias que están pasando por una situación de enfermedad, puesto que facilita la externalización del problema y logran así nuevas narrativas orientadas a la resignificación.
A literature review was carried out on the rearrangement of inner dynamics in families with an infant in palliative care, emphasizing the importance of family therapy to understand the disease and resignify it through the narrative technique of metaphor. Considering the above, when a significant crisis, such as a disease, reaches the family core, family dynamics change since it forces unexpected mobilization to find possible solutions to the situation. In many cases, the family uses family therapy as a strategy to strengthen their resources, and the metaphor, as a narrative tool, is one of the resources used to help resignify the disease. Bibliographic review was the basis of the reflexive text constructed, since the review showed that in family therapy there is no specific approach in health processes that require palliative accompaniment, reason why it is necessary to draw attention to the usefulness of family therapy in this type of processes. In conclusion, the use of metaphor is presented as a possible way of addressing families who are going through a situation of disease, since it facilitates the externalization of the problem and the achievement of new narratives aimed at redefinition of the disease.
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Humanos , Terapia Familiar , Cuidados Paliativos , Terapêutica , MetáforaRESUMO
RESUMEN El SARS-CoV-2 es el patógeno causante de una enfermedad altamente contagiosa y potencialmente mortal denominada COVID-19. Dicha patología se ha extendido rápidamente a nivel mundial, constituyendo un importante problema de salud pública. La infección por SARS-CoV-2 afecta principalmente al sistema respiratorio, pero también puede existir el compromiso de otros órganos. En población susceptible la enfermedad puede cursar con manifestaciones clínicas graves, aumentando la tasa de complicaciones y tornando sombrío el pronóstico de estos individuos. Actualmente, el tratamiento es sintomático, dado que no se cuenta con fármacos específicos que tengan evidencia sólida para combatir la infección por SARS-CoV-2. Es por ello que la piedra angular para evitar la propagación del nuevo coronavirus es la prevención. Esta revisión narrativa se realiza partiendo de la evidencia científica disponible en las diferentes bases datos, y de esta manera, además de instruir al público en los aspectos claves de esta entidad, despertará el interés por dilucidar los mecanismos y particularidades de la infección por SARS-CoV-2/COVID-19.
ABSTRACT SARS-CoV-2 is the pathogen that causes a highly contagious and life-threatening disease, called COVID-19. This pathology has quickly spread worldwide posing a major public health problem. SARS-CoV-2 infection mainly affects the respiratory system, but it could also impact other organs. In susceptible population, the disease can occur with severe clinical manifestations, increasing the rate of complications and making the prognosis of these individuals difficult. Currently, treatment is symptomatic since there are no specific drugs that have concrete evidence to combat SARS-CoV-2 infection. Therefore, prevention is the cornerstone to stop the spread of the new coronavirus. This narrative is developed based on the scientific evidence available in different databases. In addition to informing the public on the key aspects of this pandemic, it will awaken interest in elucidating the mechanisms and particularities of SARS-CoV-2 infection.
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Resumen Aunque es evidente el compromiso de los sistemas respiratorio y digestivo en los pacientes infectados por el nuevo coronavirus (SARS-CoV-2), también puede existir compromiso de otros sistemas importantes, como lo es el sistema renal. En este sentido, se hace imprescindible que el clínico no olvide que los pacientes renales muchas veces concomitan con enfermedades cardiovasculares, ya que en ambas patologías se torna sombrío el pronóstico de la enfermedad infectocontagiosa causada por este nuevo coronavirus. Aún no existen fármacos efectivos y aprobados para enfrentar este virus, pero se presume el posible efecto benéfico de los antimaláricos (hidroxicloroquina y cloroquina) y se espera que a través de las propiedades antivirales que exhiben estos fármacos se mejore el pronóstico y la mortalidad asociada a la enfermedad; al respecto se adelantan un número considerable de ensayos que escudriñan y discuten la viabilidad de este tratamiento. En el presente artículo se realiza una revisión narrativa de la evidencia científica disponible hasta el 15 de abril de 2020 en las bases de datos acerca del uso de este grupo de fármacos contra la COVID-19.
Abstract Although compromise of the respiratory and digestive systems is evident in patients infected with the new coronavirus (SARS-CoV-2), there may also be compromise of other important systems, such as the renal system. In this sense, it is essential that the clinician does not forget that kidney patients often coexist with cardiovascular diseases, since in both pathologies the prognosis of the infectious contagious disease caused by this new coronavirus becomes bleak. There are still no effective and approved drugs to face this virus, but the possible beneficial effect of antimalarials (hydroxychloroquine and chloroquine) is presumed and it is expected that the prognosis and mortality associated with these drugs will improve through the antiviral properties that these drugs exhibit. the illness; In this regard, a considerable number of trials are being conducted that scrutinize and discuss the feasibility of this treatment. This article makes a narrative review of the scientific evidence available until April 15, 2020 in the databases about the use of this group of drugs against COVID-19.
Assuntos
Humanos , Masculino , Feminino , COVID-19 , Antimaláricos , Antivirais , Pacientes , Terapêutica , ColômbiaRESUMO
Abstract Objective: To identify predisposing factors to developing severe pneumonia in hospitalized children diagnosed with community-acquired pneumonia hospitalized in Cartagena's Napoleón Franco Pareja children's Hospital. Methods: Analytical observational cross-sectional study performed in patients under 18 years. Data from surveys and records were analyzed. Univariate and bivariate analysis was performed. The variables are grouped according to the presence or absence of complications and analyzed by jisquare test. We calculated OR of each of the dummy variables to evaluate their association with complications. A P < 0.05 was considered statistically significant for all analyses. Results: 301 patients with severe pneumonia were included. Riskfactors related to severity: age less than 3 months (OR: 4.86; CI 95%: 1,5 -14.3; p = 0.004); exclusive breastfeeding for less than 6 months (CI:95% 7,7-1,4; p = 0.0019); heart disease (OR: 5.37; CI 95%: 1,28-19,88, p = 0.010); prematurity (OR: 1.62, CI 95%: 0.93- 6.69, p = 0.034); Incomplete vaccination (OR: 2.32; CI: 95% 1.07 - 5.10; p = 0.015). Conclusions: It was found increased severity risk, statistically significant, in patients less than 6 months breastfeeding, prematurity, heart disease, incomplete vaccination scheme, and positive blood culture with Sp. pneumonia
Resumen Objetivo: Identificar factores predisponentes a desarrollar neumonía severa en niños hospitalizados con diagnóstico de NAC en el Hospital Infantil Napoleón Franco Pareja de Cartagena Colombia. Materiales y métodos: Estudio observacional transversal analítico en pacientes menores de 18 años hospitalizados con neumonía adquirida en la comunidad. Se analizaron datos obtenidos de encuestas y registros clínicos. Se realizó un análisis descriptivo univariado y bivariado. Las variables se agruparon según la presencia o no de complicación y se analizaron a través de la prueba ji cuadrado. Se realizó el cálculo de OR de cada una de las variables dicotómicas para evaluar su asociación a complicaciones. Una P<0,05 fue considerada como estadísticamente significativa para todos los análisis. Resultados: Se incluyeron 301 pacientes con neumonía grave. Los factores de riesgo más relacionados con severidad fueron: edad menor de 3 meses (OR: 4,86; IC 95%: 1,5-14,3; p 0,004); la lactancia materna exclusiva menor a 6 meses (IC 95%: 1,4- 7,7; p 0,0019); cardiopatía (OR: 5,37; IC 95%: 1,28-19,88; p: 0,010); prematurez (OR: 1,62; IC: 0,93-6,69; p: 0,034); esquema incompleto de vacunación (OR: 2,32; IC 95%: 1,07-5,10: p: 0,015). Conclusiones: Se encontró aumento de riesgo de severidad en pacientes con lactancia materna menor de 6 meses, prematurez, cardiopatía, esquema de vacunación incompleto, y hemocultivo con Sp. Neumoniae positivo.
RESUMO
RESUMEN Objetivo Evaluar la resistencia a la compresión en restauraciones de ionómero de vidrio y de resina compuesta en cavidades clase I en premolares. Material y métodos Un estudio experimental in vitro, para evaluar la resistencia a la compresión de dos tipos de materiales restaurador estomatológico, utilizando como objeto de estudio 52 dientes premolares birradiculares. Las muestras fueron distribuidas en cuatro grupos con diferencias en sus características, como fueron el material restaurador y la profundidad de la cavidad (2-4 mm). Se empleó como material restaurador ionómero de vidrio y resina compuesta. Las muestras grupales fueron sometidas a una fuerza vertical compresiva utilizando un texturómetro EZ-S SHIMADZU hasta lograr producir la fractura del material. Para evaluar la normalidad los datos obtenidos se sometieron a la prueba Shapiro-Wilk que rechazó la hipótesis nula. El análisis de los datos totales se realizó a través del test t-Student para muestras independientes. Resultados Los resultados obtenidos al evaluar la dureza superficial de los diferentes materiales restauradores, muestran que existen diferencias estadísticas a favor de la resina compuesta en comparación con el ionómero de vidrio en ambas profundidades (p = 6.908 × 10-11 y p = 0.000), y en la comparación intragrupal se aprecia una diferencia significativa entre los dos grupos de resina e ionómeros a distinta profundidad (p = 0.000155887 y p = 0.00257443). Conclusión Al evaluar las cavidades de los órganos dentarios de 4 mm de profundidad, que fueron restaurados con resina Tetric N-Ceram, éstas presentan mayor dureza en comparación con los que fueron restaurados con resina VitremerTM a 2 y 4 mm y que la misma resina a 2 mm de profundidad.
ABSTRACT Objective To assess compressive strength of glass ionomer and composite resin restorations in premolar class I cavities. Material and methods In vitro experimental study to assess compressive strength of two types of stomatological restoration materials, using as object of study 52 bi-radicular premolars. Samples were distributed into four groups with different characteristics such as restorative material and cavity depth (2-4 mm). Glass ionomer and composite resins were the used restorative materials. Grouped samples were subjected to a compressive vertical force using a EZ-S SHIMADZU texturometer, until achieving the material's fracture. Obtained data were subjected to the Shapiro-Wilk test in order to assess data normalcy, null hypothesis was rejected. Total data analysis was conducted with t-Student test for independent samples. Results Data obtained after assessing superficial hardness of different restorative materials showed the existence of statistical differences which favored composite resin when compared to glass ionomer at both depths (p = 6.908 × 10-11 and p = 0.000). In intra-group comparison, a significant different was found between both groups (resin and glass ionomer) at different depths (p = 0.000155887 and p = 0.00257443). Conclusion Assessment of 4 mm tooth cavities restored with Tetric N-Ceram resin revealed greater hardness than those accomplished with Vitremer® resin at 2 and 4 mm and with the same resin at 2 mm depth.