RESUMO
Perivascular adipose tissue (PVAT) negatively regulates vascular muscle contraction. However, in the context of obesity, the PVAT releases vasoconstrictor substances that detrimentally affect vascular function. A pivotal player in this scenario is the peptide endothelin-1 (ET-1), which induces oxidative stress and disrupts vascular function. The present study postulates that obesity augments ET-1 production in the PVAT, decreases the function of the nuclear factor erythroid 2-related factor-2 (Nrf2) transcription factor, further increasing reactive oxygen species (ROS) generation, culminating in PVAT dysfunction. Male C57BL/6 mice were fed either a standard or a high-fat diet for 16 weeks. Mice were also treated with saline or a daily dose of 100 mg·kg-1 of the ETA and ETB receptor antagonist Bosentan, for 7 days. Vascular function was evaluated in thoracic aortic rings, with and without PVAT. Mechanistic studies utilized PVAT from all groups and cultured WT-1 mouse brown adipocytes. PVAT from obese mice exhibited increased ET-1 production, increased ECE1 and ETA gene expression, loss of the anticontractile effect, as well as increased ROS production, decreased Nrf2 activity, and downregulated expression of Nrf2-targeted antioxidant genes. PVAT of obese mice also exhibited increased expression of Tyr216-phosphorylated-GSK3ß and KEAP1, but not BACH1 - negative Nrf2 regulators. Bosentan treatment reversed all these effects. Similarly, ET-1 increased ROS generation and decreased Nrf2 activity in brown adipocytes, events mitigated by BQ123 (ETA receptor antagonist). These findings place ET-1 as a major contributor to PVAT dysfunction in obesity and highlight that pharmacological control of ET-1 effects restores PVAT's cardiovascular protective role.
Assuntos
Tecido Adiposo , Regulação para Baixo , Endotelina-1 , Camundongos Endogâmicos C57BL , Fator 2 Relacionado a NF-E2 , Obesidade , Espécies Reativas de Oxigênio , Animais , Endotelina-1/metabolismo , Obesidade/metabolismo , Obesidade/fisiopatologia , Masculino , Tecido Adiposo/metabolismo , Fator 2 Relacionado a NF-E2/metabolismo , Espécies Reativas de Oxigênio/metabolismo , Bosentana/farmacologia , Dieta Hiperlipídica , Camundongos , Estresse Oxidativo , Receptor de Endotelina A/metabolismo , Receptor de Endotelina A/genética , Enzimas Conversoras de Endotelina/metabolismo , Aorta Torácica/metabolismo , Aorta Torácica/efeitos dos fármacos , Aorta Torácica/fisiopatologiaRESUMO
A large-scale cross-sectional epidemiological study was conducted to evaluate prevalence, species diversity, and associated risk factors of Eimeria infections in 55 cattle farms across seven states of Colombia, including subtropical and tropical regions. In total, 1333 fecal samples from young animals (< 1 year of age) were examined at a single sampling date from August 2016 to December 2016. Flotation and McMaster techniques were conducted for parasitological investigation. Excreted Eimeria oocysts were allowed to sporulate in vitro and thereafter identified to species level based on morphological and morphometric characteristics. The overall Eimeria prevalence was 75.5% (1006/1333), with no difference observed between age categories. In total, 13 different Eimeria species were identified. The most prevalent species was E. bovis (33.5%), followed by E. auburnensis (12.5%) and E. zuernii (11.9%). Analysis of extrinsic associated risk factors revealed the floor type, feeding system, watering system, and herd size as significant (p < 0.05) risk factors for Eimeria spp. infections. Based on these data, it can be assumed that bovine coccidiosis infections occur ubiquitously in the country and might play an important role especially in its subclinical form by affecting production parameters in conventional cattle management systems.
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Doenças dos Bovinos/epidemiologia , Doenças dos Bovinos/parasitologia , Coccidiose/veterinária , Eimeria/isolamento & purificação , Animais , Bovinos , Coccidiose/epidemiologia , Coccidiose/parasitologia , Colômbia/epidemiologia , Estudos Transversais , Eimeria/classificação , Eimeria/citologia , Fazendas , Fezes/parasitologia , Oocistos/citologia , Oocistos/isolamento & purificação , Prevalência , Fatores de RiscoRESUMO
Imatinib mesylate and the newer BCR-ABL tyrosine kinase inhibitors are the standard therapy for chronic myeloid leukemia. Although these are remarkably effective drugs, some mechanisms of resistance have been identified including drug-to-drug interactions. Here we present the case of a chronic myeloid leukemia patient with an inadequate response to imatinib due to concurrent phenytoin administration. Conspicuously low imatinib plasma trough levels were documented. Imatinib dose was increased from 400 to 800 mg with good response. In conclusion, drug-to-drug interactions should be ruled out in cases of resistance to tyrosine kinase inhibitor treatment. Potent inducers of cytochrome P450 isoenzyme CYP3A4, as phenytoin, could induce inadequate responses due to increased imatinib clearance and low imatinib trough plasma levels. Thus, this interaction should be avoided. When this is not possible, dose escalation of imatinib and measurement of plasma levels, if available, is recommended.
Assuntos
Antineoplásicos/administração & dosagem , Mesilato de Imatinib/administração & dosagem , Leucemia Mielogênica Crônica BCR-ABL Positiva/tratamento farmacológico , Fenitoína/administração & dosagem , Idoso de 80 Anos ou mais , Citocromo P-450 CYP3A/metabolismo , Interações Medicamentosas , Resistencia a Medicamentos Antineoplásicos , Humanos , Masculino , Inibidores de Proteínas Quinases/administração & dosagemRESUMO
Marek's disease virus (MDV) is an immunosuppressive pathogen that can cause low production efficiency and high mortality rates in chickens. There is no current information on the MDV serotypes and pathotypes circulating in vaccinated commercial farms in Colombia where the birds are vaccinated in the incubator with Gallid herpesvirus (GaHV-2) and Meleagrid herpesvirus 1 (MeHV-1). Based on that, the main focus of this study was to understand the MDV's infection dynamics for the three known serotypes and to detect wild-virus pathogenic strains in 4-layer poultry farms in Antioquia. Samples of blood, feathers and spleens were collected from three randomly chosen animals according to age category: 1, 15, 30, 60, 90, and 120 days. Quantitative real-time PCR (qPCR) that differentiates between the three serotypes of MDV was used to assess viral loads over time, and phylogenetic analysis of the Meq oncogene was done to compare the strains of MDV with those of known pathogenicity. Meleagrid herpesvirus 1 (MeHV-1) was detected in all blood and feather follicle samples with an average number of genome copies (per 10,000 cells) of 31.44 in blood as expected as a result of vaccination. GaHV-2 was also detected in almost 100% of the blood and feather follicle samples throughout all defined age categories, with an average of 10.65 genome copies in blood samples. Gallid herpesvirus 3 (GaHV-3) was detected in 72% of blood and 84.61% of feather samples, with less than 1 copy per 10,000 cells. Based on the number of 132 bp repeats of the BamHI-H and BamHI-D regions in pooled feather samples, there were 70% (8/25) of attenuated MDV and 30% (17/25) of virulent MDV strains circulating in the farms. Virus isolation was performed successfully from every farm. In conclusion, different strains of MDV are circulating for up to 120 days in layers in Antioquia-Colombia and could be of major impact in poultry health. Keywords: Marek's disease virus (MDV); Antioquia-Colombia; qPCR; PCR; Meq gene phylogeny.
Assuntos
Galinhas , Plumas , Herpesvirus Galináceo 2 , Doença de Marek , Animais , Galinhas/virologia , Colômbia , Plumas/virologia , Feminino , Herpesvirus Galináceo 2/genética , Doença de Marek/diagnóstico , Doença de Marek/virologia , Filogenia , Doenças das Aves Domésticas/diagnóstico , Doenças das Aves Domésticas/virologiaRESUMO
The COVID-19 pandemic was initiated by the rapid spread of a SARS-CoV-2 strain. Though mainly classified as a respiratory disease, SARS-CoV-2 infects multiple tissues throughout the human body, leading to a wide range of symptoms in patients. To better understand how SARS-CoV-2 affects the proteome from cells with different ontologies, this work generated an infectome atlas of 9 cell models, including cells from brain, blood, digestive system, and adipocyte tissue. Our data shows that SARS-CoV-2 infection mainly trigger dysregulations on proteins related to cellular structure and energy metabolism. Despite these pivotal processes, heterogeneity of infection was also observed, highlighting many proteins and pathways uniquely dysregulated in one cell type or ontological group. These data have been made searchable online via a tool that will permit future submissions of proteomic data ( https://reisdeoliveira.shinyapps.io/Infectome_App/ ) to enrich and expand this knowledgebase.
Assuntos
COVID-19 , SARS-CoV-2 , Humanos , Proteômica , PandemiasRESUMO
Organic micropollutants (OMPs) in drinking water constitute a potential risk to human health; therefore, effective removal of these pollutants is required. Nanofiltration (NF) and reverse osmosis (RO) are promising membrane-based technologies to remove OMPs. In NF and RO, the rejection of OMPs depends on the properties and characteristics of the membrane, the solute, and the solution. In this review, we discuss how these properties can be included in models to study and predict the rejection of OMPs. Initially, an OMP classification is proposed to capture the relevant properties of 58 OMPs. Following the methodology described in this study, more and new OMPs can be easily included in this classification. The classification aims to increase the comprehension and mechanistic understanding of OMP removal. Based on the physicochemical principles used to classify the 58 OMPs, it is expected that other OMPs in the same groups will be similarly rejected. From this classification, we present an overview of the rejection mechanisms involved in the removal of specific OMP groups. For instance, we discuss the removal of OMPs classified as perfluoroalkyl substances (e.g., perfluorooctanoic acid, PFOA). These substances are highly relevant due to their human toxicity at extremely low concentration as well as their persistence and omnipresence in the environment. Finally, we discuss how the rejection of OMPs can be predicted by describing both the membrane-solution interface and calculating the transport of solutes inside the membrane. We illustrate the importance and impact of different rejection mechanisms and interfacial phenomena on OMP removal and propose an extended Nernst-Plank equation to calculate the transport of solutes across the membrane due to convection, diffusion, and electromigration. Finally, we show how the theory discussed in this review leads to improved predictions of OMP rejection by the membranes.
Assuntos
Água Potável , Poluentes Ambientais , Fluorocarbonos , Poluentes Químicos da Água , Purificação da Água , Humanos , Purificação da Água/métodos , Osmose , Filtração/métodos , Membranas Artificiais , Soluções , Poluentes Químicos da Água/análiseRESUMO
BACKGROUND: Healthcare providers previously using older electronic health records (EHRs) with electronic prescribing (e-prescribing) are transitioning to newer systems to be eligible for federal meaningful use incentives. Little is known about the safety effects of transitioning between systems. OBJECTIVE: To assess the effect of transitioning between EHR systems on rates and types of prescribing errors, as well as provider perceptions about the effect on prescribing safety. DESIGN, PARTICIPANTS: Prospective, case study of 17 physicians at an academic-affiliated ambulatory clinic from February 2008 through August 2009. All physicians transitioned from an older EHR with minimal clinical decision support (CDS) for e-prescribing to a newer EHR with more robust CDS. MAIN MEASUREMENTS: Prescribing errors were identified by standardized prescription and chart review. A novel survey instrument was administered to evaluate provider perceptions about prescribing safety. KEY RESULTS: We analyzed 1298 prescriptions at baseline, 1331 prescriptions 12 weeks post-implementation, and 1303 prescriptions one year post-implementation. Overall prescribing error rates were highest at baseline (35.7 per 100 prescriptions, 95% confidence interval (CI) 23.2-54.8) and lowest one year post-implementation (12.2 per 100 prescriptions, 95% CI 8.6-17.4) (p < 0.001). Improvement in prescribing safety was mainly a result of reducing inappropriate abbreviation errors. However, rates for non-abbreviation prescribing errors were significantly higher at 12 weeks post-implementation than at baseline (17.7 per 100 prescriptions, 95% CI 9.5-33.0 versus 8.5 per 100 prescriptions, 95% CI 4.6-15.9) (p <0.001) and no different at baseline than one year (10.2 per 100 prescriptions, 95% CI 6.2-18.6) (p = 0.337). Survey results complemented quantitative findings. CONCLUSIONS: Results from this case study suggest that transitioning between systems, even to those with more robust CDS, may pose important safety threats. Recognizing the challenges associated with transitions and refining CDS within systems may help maximize safety benefits.
Assuntos
Assistência Ambulatorial/tendências , Sistemas de Apoio a Decisões Clínicas/tendências , Registros Eletrônicos de Saúde/tendências , Prescrição Eletrônica , Segurança do Paciente , Adulto , Feminino , Inquéritos Epidemiológicos/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos ProspectivosRESUMO
Avian coccidiosis continues to be one of the costliest diseases of commercial poultry. Understanding the epidemiology of Eimeria species in poultry flocks and the resistance profile to common anticoccidials is important to design effective disease prevention and control strategies. This study examined litter samples to estimate the prevalence and distribution of Eimeria species among broiler farms in 4 geographic regions of Colombia. A total of 245 litter samples were collected from 194 broiler farms across representative regions of poultry production between March and August 2019. The litter samples were processed for oocysts enumeration and speciation after sporulation. End-point polymerase chain reaction (PCR) analysis was conducted to confirm the presence of Eimeria species. Anticoccidial sensitivity was determined with 160 Ross AP males in 5 treatment groups: noninfected, nonmedicated control (NNC), infected, nonmedicated control (INC), infected salinomycin treated (SAL, dose: 66 ppm), infected diclazuril treated (DIC, dose: 1 ppm), and infected methylbenzocuate-Clopidol treated (MET.CLO, dose: 100 ppm), All birds were orally inoculated with 1 × 106 sporulated oocysts using a 1 mL syringe, except for the NNC- group who received 1ml of water.Eimeria spp. were found in 236 (96.3%) out of 245 individual houses, representing 180 (92.8%) out of 194 farms. Eimeria acervulina was the most prevalent species (35.0%) followed by Eimeria tenella (30.9%), Eimeria maxima (20.4%), and other Eimeria spp. (13.6%). However, mixed species infections were common, with the most prevalent combination being mixtures of E. acervulina, E. maxima, E. tenella, and other species in 31.4% of the Eimeria-positive samples. PCR analysis identified E. acervulina, E. maxima, E. tenella, Eimeria necatrix, Eimeria mitis, and Eimeria praecox with variable prevalence across farms and regions. Anticoccidial sensitivity testing of strains of Eimeria isolated from 1 region, no treatment difference (P > 0.05) was observed in final weight (BW), weight gain (BWG) or feed conversion (FCR). For the global resistance index (GI) classified SAL and MET.CLO as good efficacy (85.79 and 85.49, respectively) and DIC as limited efficacy (74.52%). These results demonstrate the ubiquitous nature of Eimeria spp. and identifies the current state of sensitivity to commonly used anticoccidials in a region of poultry importance for Colombia.
Assuntos
Coccidiose , Coccidiostáticos , Eimeria , Doenças das Aves Domésticas , Animais , Galinhas , Coccidiose/tratamento farmacológico , Coccidiose/epidemiologia , Coccidiose/veterinária , Coccidiostáticos/uso terapêutico , Colômbia/epidemiologia , Fazendas , Masculino , Doenças das Aves Domésticas/tratamento farmacológico , Doenças das Aves Domésticas/epidemiologiaRESUMO
Climate change affects human health; however, there have been no large-scale, systematic efforts to quantify the heat-related human health impacts that have already occurred due to climate change. Here, we use empirical data from 732 locations in 43 countries to estimate the mortality burdens associated with the additional heat exposure that has resulted from recent human-induced warming, during the period 1991-2018. Across all study countries, we find that 37.0% (range 20.5-76.3%) of warm-season heat-related deaths can be attributed to anthropogenic climate change and that increased mortality is evident on every continent. Burdens varied geographically but were of the order of dozens to hundreds of deaths per year in many locations. Our findings support the urgent need for more ambitious mitigation and adaptation strategies to minimize the public health impacts of climate change.
RESUMO
We show the annealing effect on silver and Erbium-doped tellurite glasses in the formation of nanoparticles (NPs) of silver, produced by the reduction of silver (Ag+ â Ag0), aiming to an fluorescence enhancement. The absorption spectra show typical Localized Surface Plasmon Resonance (LSPR) band of Ag0 NP in addition to the distinctive absorption peaks of Er3+ ions. Both observations demonstrate that the photoluminescence enhancement is due to the coupling of dipoles formed by NPs with the Er3+ 4I(13/2) â 4I(15/2) transition. This plasmon energy transfer to the Er3+ ions was observed in the fluorescence spectrum with a blue-shift of the peaks.
RESUMO
BACKGROUND: Academic centers are among the health care organizations that have used consolidation as a strategy to improve efficiency and reduce costs. In 1997, the New York Hospital and The Presbyterian Hospital underwent a full-asset merger to become New York City's largest medical center, known as the New York-Presbyterian Hospital (NYPH). In 2006, recognition of the challenges of the Children's Service Line at NYPH led to the formation of a Patient Safety and Quality Program to deliver consistently safe and effective health care. CREATING A BICAMPUS PEDIATRIC QUALITY AND SAFETY TEAM: Each campus has a children's quality council, an interdisciplinary group that discusses and prioritizes safety and quality issues. The quality councils from each campus report directly to a bicampus children's quality steering committee formed to ensure that similar safety practices and standards are implemented across both children's hospitals. A safety subcommittee, which primarily coordinates and follows up on leadership safety walk rounds, and a significant-events subcommittee, which reviews morbidities and mortalities, report to each hospital's quality council. PROGRAM PRIORITIES AND INITIATIVES: The bicampus pediatric quality and safety program is organized around five broad themes: improving the culture of safety, reducing the frequency of health care-acquired infections, reducing harm in the health care setting, using information technology to improve the quality and safety of care provided to patients and families, and measuring the effectiveness of care in key areas. Two sample initiatives--building family engagement and prevention of adverse medication events--illustrate the program's successes and challenges. CONCLUSIONS: Developing a pediatric safety and quality program across two campuses has been challenging but has led to important improvements at both organizations.
Assuntos
Centros Médicos Acadêmicos/normas , Instituições Associadas de Saúde , Pediatria/normas , Garantia da Qualidade dos Cuidados de Saúde , Gestão da Segurança/métodos , Centros Médicos Acadêmicos/organização & administração , Implementação de Plano de Saúde/organização & administração , Implementação de Plano de Saúde/normas , Humanos , Erros Médicos/prevenção & controle , Cidade de Nova Iorque , Estudos de Casos Organizacionais , Cultura Organizacional , Gestão de Riscos , Gestão da Segurança/organização & administraçãoRESUMO
Detection and management of posterior approximal caries lesions are still problematic. Inspection of approximal surfaces is challenging, and bitewing radiographs are used when direct vision is not possible. Unfortunately, there is no definite radiographic appearance to identify lesion cavitation with absolute certainty. Many lesions detected radiographically within the outer half of dentin are not cavitated, often resulting in unnecessary restorative treatment. Our study compared radiographic depth of approximal caries lesions with presence of cavitation in adults using visual inspection following temporary tooth separation (TTS). We conducted this observational descriptive cross-sectional study at two dental schools in two cities in Chile. Clinicians were unaware of radiographic depths of lesions and examined 147 participants (57.3% female and 42.7% male) following TTS. Using the common classification system that consists of E0 (no lesion), E1 (lesion within the outer half of enamel), E2 (lesion within the inner half of enamel), D1 (lesion within the outer third of dentin), D2 (lesion within the middle third of dentin), and D3 (lesion within the inner third of dentin), a trained dentist evaluated all the processed films. Cavitation was detected in only three sites (0.22%) within the E0 category, seven sites (3.41%) in E1, five sites (14.8%) in E2, four sites (14.8%) in D1, six sites (50%) in D2, and eight sites (61.5%) in D3. Considering that restorative treatment should be indicated strictly for cavitated lesions, our findings support indication for restorative treatment for D3 lesions and the rationale for TTS for D1-D2 caries lesions to allow direct visual inspection to determine whether there is surface cavitation.
Assuntos
Cárie Dentária , Adulto , Estudos Transversais , Esmalte Dentário , Dentina , Feminino , Humanos , Masculino , Radiografia InterproximalAssuntos
Astenia/etiologia , Inativadores do Complemento/uso terapêutico , Hemoglobinúria Paroxística/diagnóstico , Oclusão Vascular Mesentérica/etiologia , Trombose/etiologia , Abdome Agudo/etiologia , Anticorpos Monoclonais Humanizados/uso terapêutico , Duodeno/irrigação sanguínea , Hemoglobinúria Paroxística/complicações , Humanos , Isquemia/etiologia , Masculino , Oclusão Vascular Mesentérica/cirurgia , Pessoa de Meia-Idade , Qualidade de VidaRESUMO
UNLABELLED: The association of HIV infection and lymphoma in patients attending at the South Health Metropolitan Reference Centre is presented. OBJECTIVE: To analyse its incidence, clinical and pathologic manifestations, treatment and outcome. PERIOD OF STUDY: January 1990 to December 2002. RESULTS: 14 cases were detected, 10 non Hodgkin lymphoma patients (7 with high malignancy and 50% in stages III-IVB) and 4 with Hodgkin lymphoma (3 with mixed cellularity, 2 in stage IVB). The annual incidence was 0.68%. Ten patients were classified under stage C3 of AIDS CDC criteria, the mean CD4 count was 139 cells/mm3 and mean CV was 5,32 log. Eighty six percent of patients presented with unique or multiples lymphonodes, with predominance of advanced lymphoma stage. Conventional CHOP chemotherapy was the treatment for high risk and extended non Hodgkin lymphomas and for extended Hodgkin lymphomas the ABVD protocol was administered. Six patients received antiretroviral therapy, 4 simultaneously with chemotherapy. Global mortality in this series was 71%, attributable to tumor disease per se or to sepsis. Four patients survived (18 to 50 months) in complete remission, 2 non Hodgkin lymphomas and 2 Hodgkin lymphomas. The low incidence of lymphoma and AIDS association and the high frequency of lymphomas with localized or generalized lymphonodes in this series are remarkable.
Assuntos
Linfoma Relacionado a AIDS , Linfoma não Hodgkin , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Contagem de Linfócito CD4 , Chile/epidemiologia , Feminino , Doença de Hodgkin/diagnóstico , Doença de Hodgkin/tratamento farmacológico , Doença de Hodgkin/epidemiologia , Humanos , Incidência , Linfoma Relacionado a AIDS/diagnóstico , Linfoma Relacionado a AIDS/tratamento farmacológico , Linfoma Relacionado a AIDS/epidemiologia , Linfoma não Hodgkin/diagnóstico , Linfoma não Hodgkin/tratamento farmacológico , Linfoma não Hodgkin/epidemiologia , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Estudos Retrospectivos , Análise de Sobrevida , Carga ViralRESUMO
OBJECTIVES: To provide more reliable data on the epidemiology of chronic myeloid leukaemia (CML) in Spain than are currently available. MATERIAL AND METHODS: The EUTOS population-based project of European LeukemiaNet is a population registry of new CML cases in patients 18 years of age or older from 22 European areas. The Spanish section included the autonomous communities of Madrid, Castilla-La Mancha and Aragon, from 1-2-2010 to 31-12-2012. RESULTS: A total of 250 cases were recorded in 35 months. The overall incidence was 1.08 cases/10(5) inhabitants-year, with a predominance of men (58%) and clear differences among the communities. The incidence standardised by age was similar (overall, 1.04; men, 1.31; women, 0.81). The median age was 54 years. The incidence increased with age, reaching a peak at>65 years, although 31.7% of cases appeared between the ages of 20 and 44 years. Four percent of cases were diagnosed in advanced stages (2.4% in accelerated phase, 1.6% in blast crisis), 56% were asymptomatic, 38% had splenomegaly, and the Sokal score was high in 11% (lower than what was previously reflected in the literature). CONCLUSIONS: The current incidence of CML in Spain is higher than previously reported and similar to that of the European studies. Unlike the classical descriptions, CML presented mostly in asymptomatic form, with no splenomegaly, less leucocytosis and in stages with better prognosis.
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Objetivo: Revisar las metodologías y los materiales utilizados en la enseñanza de técnicas quirúrgicas para personal de la salud, publicados durante los últimos siete años. Metodología: Se realizó una revisión bibliográfica en la base de datos PubMed sobre materiales y metodologías utilizados en educación quirúrgica determinando criterios de inclusión y exclusión para filtrar los diferentes artículos. Resultados: Se encontraron 1190 artículos, de los cuales se descartaron 826 por no cumplir con el rango de la revisión sistemática. Se utilizaron 59 artículos que cumplieron los criterios de inclusión y de exclusión para la revisión. Conclusiones: El entrenamiento para obtener habilidades en técnicas quirúrgicas a través de la simulación es una oportunidad para estudiantes y maestros de avanzar en el saber y el hacer; se deben acoplar los materiales con el espacio para obtener resultados esperados. La investigación continúa con el fin de encontrar mejores opciones para la adquisición de las destrezas y habilidades quirúrgicas.
Objective: To review the methodologies and materials used in the teaching of surgical techniques for health personnel, which have been published over the last seven years. Methodology: A literature review was carried out in the PubMed database on materials and methodologies used in surgical education, based on inclusion and exclusion criteria to filter the different articles. Results: A total of1 190 articles were found, of which 826 were discarded for not meeting the range of the systematic review.59 articles that did meet the inclusion and exclusion criteria were used for the review. Conclusions: Training to obtain skills in surgical techniques through simulation is an opportunity for students and teachers to advance in knowing and doing; materials must be matched with the circumstances to obtain expected results. New research must be carried out in order to find better options for the acquisition of surgical skills and abilities.
Objetivo: Revisar as metodologias e materiais utilizados no ensino de técnicas cirúrgicas para profissionais de saúde, publicados nos últimos sete anos. Metodologia: Foi realizada uma revisão bibliográfica na base de dados PubMed sobre materiais e metodologias utilizadas na educação cirúrgica, determinando critérios de inclusão e exclusão para filtrar os diferentes artigos. Resultados: foram encontrados 1190 artigos, dos quais 826 foram descartados por não atenderem à abrangência da revisão sistemática. 59 artigos que atenderam aos critérios de inclusão e exclusão foram utilizados para a revisão. Conclusões: O treinamento para obtenção de habilidades em técnicas cirúrgicas por meio de simulação é uma oportunidade para alunos e professores avançarem no saber e no fazer; os materiais devem ser combinados com a lacuna para obter os resultados esperados. A pesquisa continua a fim de encontrar melhores opções para a aquisição de habilidades e habilidades cirúrgicas.
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Humanos , Animais , Exercício de Simulação , Cirurgia Geral , Pessoal de Saúde , Métodos , DocentesRESUMO
Lung abscess is a rare entity in pediatric age, but it generates significant morbidity. Even less frequent is the presence of this with spontaneous drainage to the skin, generating an abscess in the chest wall, reason for consultation, of the present clinical case. Subsequently, the presence of lung abscess with extension to the chest wall without pleural involvement was documented by imaging studies, an extremely rare and unusual entity, with only one case described in the world literature within our reach and in an adult patient.
El absceso pulmonar es una entidad infrecuente en la edad pediátrica, pero que genera una morbilidad importante. Aún menos frecuente es la presencia de este con drenaje espontáneo a piel, generando un absceso en pared torácica, motivo de consulta, del presente caso clínico. Posteriormente y por estudios imagenológicos se documentó la presencia de absceso pulmonar con extensión a pared torácica sin afectación pleural, una entidad extremadamente rara e inusual, con un solo caso descrito en la literatura mundial a nuestro alcance y en un paciente adulto.
Assuntos
Humanos , Masculino , Pré-Escolar , Fístula/complicações , Fístula/diagnóstico por imagem , Abscesso Pulmonar/complicações , Abscesso Pulmonar/diagnóstico por imagem , Radiografia Torácica , Tomografia Computadorizada por Raios X , Drenagem , Parede TorácicaRESUMO
We report a patient with progressive multifocal leukoencephalopathy (PML) after autologous stem cell transplantation (SCT) for non-Hodgkin's lymphoma (NHL). This is an unusual association, and to date only seven cases have been reported. This is the first case of PML after SCT treated with cidofovir, and the fifth case treated with this drug in a patient without human immunodeficiency virus (HIV) infection. In the previous four patients treated with cidofovir the outcome was discouraging, as was the case in this patient.
Assuntos
Antivirais/uso terapêutico , Citosina/análogos & derivados , Citosina/uso terapêutico , Leucoencefalopatia Multifocal Progressiva/tratamento farmacológico , Organofosfonatos , Compostos Organofosforados/uso terapêutico , Transplante de Células-Tronco de Sangue Periférico/efeitos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Encéfalo/virologia , Cidofovir , Terapia Combinada , Evolução Fatal , Soronegatividade para HIV , Humanos , Hospedeiro Imunocomprometido , Vírus JC/isolamento & purificação , Leucoencefalopatia Multifocal Progressiva/etiologia , Leucoencefalopatia Multifocal Progressiva/virologia , Linfoma de Célula do Manto/complicações , Linfoma de Célula do Manto/tratamento farmacológico , Linfoma de Célula do Manto/terapia , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Transplante Autólogo/efeitos adversos , Falha de TratamentoRESUMO
Treatment of common diseases were analyzed for a rural community--Guacarhue (Chile). This community has ancient hispanic roots. The main objective was to find if the hispanic elements ar e still alive. The sample was representative: 42 house-keepers; 50% of the sample were aged over 50 years and 50% were aged under 35 years. A semi-structured interview was applied at home. Results show the existence of hispanic elements especially in the treatment of folk and common illnesses.