ABSTRACT
RESUMEN INTRODUCCIÓN: El nacimiento por cesárea se encuentra en aumento en todo el mundo, con diferencias significativas entre regiones. El objetivo fue determinar la situación del porcentaje de cesárea en mujeres con parto en la provincia del Neuquén en 2000-2020, buscando diferencias entre subsectores, zonas sanitarias, localidades e instituciones de salud . MÉTODOS: Se analizaron las estadísticas del Sistema Informático Perinatal referentes a vía de parto, recién nacidos y mujeres con partos entre 2000 y 2020. Se realizó un análisis estratificado del porcentaje de cesáreas, describiendo medidas de tendencia central, de dispersión y velocidad promedio de incremento anual . RESULTADOS: Las características sociodemográficas de madres gestantes se han modificado, con un descenso del embarazo adolescente y un aumento de madres de más de 35 años. Se observó un mayor porcentaje de bajo peso al nacer en el subsector privado y una importante disminución de la tasa bruta de natalidad, con mayor descenso en el interior provincial. Se encontró un aumento sostenido, así como diferencias crecientes y muy significativas entre subsectores (y dentro de estos entre las distintas instituciones) . DISCUSIÓN: Existen diferencias muy significativas en los resultados si se comparan los diferentes subsectores e instituciones respecto al nacimiento por cesárea. Estos resultados son un aporte para la construcción de políticas acordes a la realidad epidemiológica de la provincia y de cada institución de salud.
ABSTRACT INTRODUCTION: Cesarean delivery is increasing all over the world, with significant differences between regions. The aim was to determine the cesarean section rate in women giving birth between 2000 and 2020 in Neuquén province, seeking for differences between sub-sectors, health zones, cities and health institutions . METHODS: Statistics from the Perinatal Information System were analyzed regarding type of delivery, newborns and women delivering between 2000 and 2020. A stratified analysis of the cesarean section rate was conducted, describing central tendency and dispersion measures, and the average annual rate of increase . RESULTS: Maternal sociodemographic characteristics have changed, with adolescent pregnancy decrease and a higher number of mothers older than 35 years of age. The percentage of low birth weight was higher in the private sub-sector, with a significant decrease of gross birth rate, mainly inside the province. There was a steady increase as well as growing and very significant differences between sub-sectors (and within them between the different institutions) . DISCUSSION: The results show very significant differences when comparing sub-sectors and institutions regarding cesarean birth, and contribute to building policies tailored to the epidemiological situation of the province and each health institution.
Subject(s)
Humans , Infant, Low Birth Weight , Cesarean Section/statistics & numerical data , Argentina , Information Systems/instrumentation , PrevalenceABSTRACT
El síndrome antifosfolipídico (SAF) es infrecuente en la edad pediátrica (3 %) y se presenta como eventos trombóticos de lechos vasculares y/o abortos espontáneos, asociado a la presencia de anticuerpos antifosfolipídicos (aFL). Este síndrome puede ser primario o asociado a alguna enfermedad sistémica subyacente. Se presenta el caso de una niña de 12 años con hemiparesia faciobraquiocrural derecha y alteración en la marcha de aparición aguda, en la cual se confirma un accidente cerebrovascular (ACV) isquémico por trombosis de la arteria cerebral media asociado a aFL positivos (anticuerpo anticardiolipina, anticoagulante lúpico y anticuerpo anti-ß2-glicoproteína). Cumple con los criterios para realizar diagnóstico de síndrome antifosfolipídico. Luego de iniciar el tratamiento, la paciente evoluciona de manera favorable. Se trata de una patología infrecuente y de presentación variable, por lo que requiere un alto sentido de alerta por parte del equipo de salud para evitar retrasos en el diagnóstico y el tratamiento, y disminuir su morbimortalidad
Antiphospholipid syndrome (APS) is infrequent at pediatric age (3 %) and is characterized by venous or arterial thrombosis and/or spontaneous abortions. APS occurs either as a primary condition or in the setting of an underlying disease. This is a case of a 12-year-old girl with a right hemiparesis and acute disturbance in gait, in which an ischemic cerebrovascular accident (CVA) due to middle cerebral artery thrombosis associated with positive antiphospholipid antibodies is confirmed (anticardiolipin antibody, lupus anticoagulant and anti-ß2-glycoprotein antibody), fulfilling the criteria for the diagnosis of antiphospholipid syndrome . After starting treatment accordingly, the patient evolves favorably. As this pathology is infrequent and of variable presentation, it requires a high sense of alert from the health team to avoid delays in diagnosis and treatment
Subject(s)
Humans , Female , Child , Antiphospholipid Syndrome/complications , Antiphospholipid Syndrome/diagnosis , Lupus Coagulation Inhibitor , Antibodies, Antiphospholipid , beta 2-Glycoprotein IABSTRACT
Introducción: La infiltración de la rodilla es una labor cotidiana en la consulta ortopédica. Para alcanzar el mayor potencial terapéutico en la infiltración articular, es necesario inyectar directamente en el espacio articular y no en estructuras adyacentes. Objetivo: Determinar la exactitud y eficacia de los diferentes puntos de infiltración de la rodilla en pacientes con gonartrosis grado II III, considerando los portales de abordaje anterolateral (AL), anteromedial (AM), suprapatelar lateral (SPL), medio patelar lateral (MPL), medio patelar medial (MPM) y trans tendón (TT). Métodos: Estudio descriptivo y transversal. Se infiltraron 123 rodillas bajo control fluroscópico en las diferentes vías de acceso, teniendo como variables el sexo, artrografía positiva al primer intento, grado de dolor que presentan los pacientes durante la prueba así como complicaciones y efectos secundarios. Resultados: Se usó MPL en 20 rodillas teniendo una artrografía positiva en el 40%, 17 SPL con 70,5%, 20 MPM con 90%, 21 AL rodillas con 61,3%, 26 AM con 69,9%, 19 TT con 78,9%. Conclusión: El portal de abordaje MPM proporciona una mayor eficacia en comparación de los otros portales utilizados en este estudio. Siendo mayor el porcentaje de artrografías positivas en el primer intento de punción.
Introduction: Knee joint injection is a daily procedure in orthopedic outpatient visit. In order to obtain the maximum therapeutic benefit, it is necessary to perform the injection directly into the articular space and not into the adjacent structures. Objective: To establish the accuracy of the injection site into the knee joint in patients with grade II-III gonarthrosis. The portal approaches taken into consideration in this study were: Anterolateral (AL), Anteromedial (AM), Lateral Suprapatellar (LSP), Lateral mid-patellar (LMP), Medial mid-patellar (MMP) and Transtendinous (TT). Methods: A cross-sectional and descriptive study was conducted. A total of 123 knee joints were injected under fluoroscopy through the different approach portals. Variables: gender, positive arthrography at the first attempt, level of pain in patients during the procedure, as well as complications and side effects. Results: Lateral mid-patellar (LMP) approach was used on 20 knee joints with a 40% positive arthrography, 17 through LSP with 70.5%, 20 MMP with 90%, 21 AL with 61.3%, 26 M with 69.9%, 19 TT with 78.9% Conclusion: The medial mid-patellar approach portal provides the greatest effectiveness in comparison to the other portals used on this study. Additionally, a greater percentage of positive arthrography was achieved at the first attempt.
ABSTRACT
The genus Paxillus is characterized by the difficulty of species identification, which results in reproducibility problems, as well as the need for large quantities of fungal inoculum. In particular, studies of Paxillus ammoniavirescens have reported divergent results in the in vitro growth while little is known of its capacity to degrade organic matter. For all the above, and assuming that this variability could be due to an inappropriate culture media, the aim of this study was to analyse growth in different culture media (MMN, MS, and 1/2 MS) and in the case of MMN in presence/absence of two types of organic matter (fresh litter and senescence litter) to probe the saprophytic ability of P. ammoniavirescens . We also evaluated the effects of pH changes in the culture media. Growth kinetics was assessed by weekly quantification of the area of growth in solid culture media over 5 wk, calculating the growth curves and inflection points of each culture media. In addition, final biomass after 5 wk in the different culture media was calculated. Results showed that best culture media are MS and 1/2 MS. Moreover, an improvement in growth in culture media containing decomposing fall litter was observed, leading to confirm differences in the culture media of this species with others of the same genus. Further, we established that all growth media suffered a significant acidification after fungal growth.
Subject(s)
Aging , Biomass , Culture Media , Hydrogen-Ion Concentration , In Vitro Techniques , KineticsABSTRACT
<p><b>OBJECTIVE</b>To identify the landmarks of transpterygoid approach and to report its application in a series of cases.</p><p><b>METHODS</b>Two silicon-injected adult cadaveric heads(4 sides) were dissected by performing an endoscopic endonasal transpterygoid approach after CT scanning for imaging guidance. High-quality pictures were obtained. This approach was used to treat twelve patients with skull base lesions including 3 spontaneous cerebrospinal fluid (CSF) leaks in the lateral recess of the sphenoid sinus, 2 neurofibromas and 2 Schwannomas involving the pterygopalatine fossa and infratemporal fossa, 1 dermoid cyst involving the middle fossa and infratemporal fossa, 1 invasive fungal sinusitis invading the middle fossa base, 1 basal cell adenoma in the upper parapharyngeal space, 1 chondrosarcoma in the parasellar region and 1 adenoid cystic carcinoma. Clinical records were reviewed.</p><p><b>RESULTS</b>In terms of approach dissection, important landmarks, such as the sphenopalatine foramen and artery, vidian canal and nerve, foramen rotundum and maxillary branch of trigeminal nerve, foramen ovale and mandibular branch of trigeminal nerve, as well as pterygoid segment of Eustachian tube were identified. In terms of clinical data, three patients with spontaneous CSF leak underwent repair. Six patients with benign lesions underwent complete tumor resection. In the patient with invasive fungal disease, thorough debridement was undertaken and antifungal drug was administered for one month. For these benign skull base lesions, there was no recurrence during the follow-up period. In the patient with chondrosarcoma, most of the tumor was removed in the first operation, and was followed by two endoscopic operations because of fast growth of the tumor. Final control was achieved with chemotherapy and radiation. In the patient with adenoid cystic carcinoma, tumor recurred five years after surgery, and was reoperated.</p><p><b>CONCLUSION</b>An understanding of the landmarks of the transpterygoid approach is paramount for surgically dealing with disease located within and adjacent to the region of the pterygoid process of the sphenoid bone. The endoscopic endonasal transpterygoid approach is feasible and safe in selected patients with skull base lesions.</p>
Subject(s)
Adult , Humans , Cerebrospinal Fluid Leak , General Surgery , Cranial Fossa, Middle , Pathology , Dissection , Endoscopy , Eustachian Tube , Nasal Cavity , General Surgery , Neoplasm Recurrence, Local , Orbit , Otorhinolaryngologic Surgical Procedures , Methods , Pterygopalatine Fossa , Pathology , Skull Base , General Surgery , Skull Base Neoplasms , General Surgery , Sphenoid Bone , Tomography, X-Ray Computed , Trigeminal NerveABSTRACT
OBJECTIVE@#In-depth understanding of endoscopic anatomy of the skull base is the cornerstone of the development of endoscopic endonasal skull base surgery. The purpose of this study is to explore the anatomical landmarks of the clivus for endoscopic endonasal skull base surgery.@*METHOD@#Eight silicon-injected adult cadaveric heads (16 sides) were dissected performing endoscopic endonasal approach. The clivus and adjacent structures were exposed; and their anatomy shown in detail. High-quality pictures were produced.@*RESULT@#The clivus was subdivided into the upper, the middle and the lower clivus. Extracranial soft tissue landmarks and bony landmarks were presented. Intradural landmarks of the upper clivus were the interpeduncular cistern, posterior cerebral artery, posterior communicating artery, superior cerebellar artery, cranial nerve III and cerebral peduncle; intradural landmarks of the middle clivus were the prepontine cistern, basilar artery, cranial nerve VI and pons; intradural landmarks of lower clivus were premedullary cistern, vertebral artery, cranial nerve XI and medulla oblongata. Surgical routes to the clivus were the upper clivus approach, middle clivus approach, lower clivus approach and panclival approach.@*CONCLUSION@#An understanding of the complex anatomy of the clivus is paramount for surgically dealing with the disease involved clivus and adjacent region.
Subject(s)
Adult , Humans , Cadaver , Cranial Fossa, Posterior , General Surgery , Endoscopy , Nose , Skull BaseABSTRACT
Introducción: la traquelectomía radical (TR) es una técnica quirúrgica utilizada en estadios precoces del cáncer de cérvix en aquellas mujeres que desean conservar la capacidad reproductiva. Los embarazos posteriores a esta técnica quirúrgica pueden desencadenar complicaciones obstétricas. El presente artículo tiene como objetivo hacer una revisión de la literatura en relación al pronóstico obstétrico de estas pacientes. Metodología: en este estudio se presenta un caso clínico. Posteriormente, se realiza una búsqueda en las bases de datos MEDLInE, vía PubMed, y Cochrane con las palabras clave cáncer de cérvix, traquelectomía radical, embarazo y complicaciones obstétricas. Resultados: se evaluó un total de 17 artículos que comprendieron revisiones, artículos de opinión y casos clínicos. Conclusión: la preservación de la fertilidad en estadios precoces del cáncer de cérvix mediante la traquelectomía radical está adquiriendo cada vez mayor aceptación a medida que se publican más casos en la literatura. Los resultados obstétricos parecen ser cada vez más favorables aunque son más numerosas las complicaciones en comparación con la población general.
Introduction: radical trachelectomy (TR) is a surgical technique which is used in the early stages of cervical cancer in females wishing to conserve their reproductive ability. Pregnancies following this surgical technique having been applied could trigger obstetric complications. This article was thus aimed at reviewing the literature related to these patients obstetric prognosis. Methodology: a clinical case is presented. A literature search was made in MEDLInE databases, via PubMed and Cochrane, using the following key words: cervical cancer, radical trachelectomy, pregnancy, obstetric complications. Results: 17 articles were evaluated, covering review articles, articles expressing opinion and clinical cases. Conclusion: preserving fertility in early stages of cervical cancer by radical trachelectomy is increasingly acquiring more acceptance as more cases are published in the literature. Obstetric results seem to be becoming more favorable even though complications are becoming more numerous compared to incidence in the general population.
Subject(s)
Humans , Adult , Female , Pregnancy , Uterine Cervical NeoplasmsABSTRACT
La hemocromatosis neonatal es una enfermedad hepática muy severa del recién nacido y se asocia a una alta mortalidad. Se cree que su etiología es de tipo aloinmune, debido a la presencia de un anticuerpo materno hasta ahora desconocido que interfiere con el metabolismo férrico del feto, llegando a producir gran morb i mortal ¡dad. Basándonos en esta teoría, el tratamiento materno con inmunoglobulinas intravenosas en gestaciones sucesivas podría prevenir el desarrollo de un nuevo cuadro de hemocromatosis neonatal. Se describe el caso de una gestante con un hijo anterior diagnosticado y fallecido neonatalmente por hemocromatosis, a la que en el embarazo actual se le trató con inmunoglobulinas intravenosas consiguiendo un hijo sano y vivo. Es el primer caso descrito en España y demuestra el éxito de esta terapia, tal como describe la literatura.
Neonatal hemochromatosis is a severe neonatal liver disease with a high mortality and recurrence rate. It is supposed to be a gestational alloimmune disease because of the existence of maternal antibodies against fetal hepatic metabolism. On the basis of this hypothesis, the administration of intravenous immunoglobulin has been reported as a successful treatment during the following pregnancy. We describe the first case of this treatment in Spain which confirms the data available in the literature.
Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Hemochromatosis/drug therapy , Immunoglobulins, Intravenous/therapeutic use , Hemochromatosis/pathology , Liver/pathology , Treatment OutcomeABSTRACT
Se estudió la factibilidad del proceso de radiodescontaminación de polen de abejas, el cual posibilita la obtención de un polen acto para la producción de apiterapéuticos. La irradiación con rayos gamma permitió lograr la descontaminación sin pérdida de la calidad del polen. Se aplicó el proceso a la materia prima para la fabricación del apiterapéutico y al producto final, como un eslabón más de la cadena de producción. Como resultado en este trabajo se estableció una metodología para la aplicación de la irradiación gamma en la producción de apitrrapéuticos
Subject(s)
Drug Contamination/economics , Drug Contamination/prevention & control , Gamma Rays , Pollen/radiation effectsABSTRACT
Se investigaron los cambios del contenido de vitamina C, sólidos solubles, acidez y ph en mandarinas de la variedad "Dancy", irradiadas a 5 dosis diferentes de 0,25 a 1,5 kGy y almacenadas durante 21 días de 12 a 15 -C aproximadamente, con el objetivo de establecer el grado de afectación de esas variables. Se observó una tendencia a la disminución del contenido de vitamina C, sólidos solubles y el porcentaje de acidez con el incremento de la dosis recibida; el ph se mantuvo estable para todas las dosis. En todos los grupos estudiados se observaron diferencias significativas entre el contenido inicial de vitamina C y los contenidos a los 10 y 21 dias de almacenamiento