ABSTRACT
Introducción: La máscara laríngea es el equipamiento con el objetivo de aumentar la calidad, seguridad, cuidado, sin embargo, a pesar de tener uso universal y alta eficacia para la ventilación no está exenta de complicaciones. El objetivo de la presente Investigación fue identificar la frecuencia de complicaciones con el uso de mascara laríngea en los hospitales públicos Vicente Corral Moscoso y José Carrasco en la ciudad de Cuenca. Métodos: Es un estudio observacional, descriptivo, prospectivo, en 220 pacientes pediátricos, ASA I , II y III intervenidos en cirugías electivas y emergentes bajo anestesia general en un intervalo de tiempo de 30 a 240 minutos, de todas las especialidades médicas quirúrgicas del año 2018 ,se utilizaron los diferentes tipos de máscara. La muestra se obtuvo aplicando la fórmula para población desconocida (n = (Z2 x p x q)/ e2), nivel de confianza (Z): 95%. (1.96) Margen de error (e): 5% Probabilidad de ocurrencia del evento (p): 15% Probabilidad de no ocurrencia del evento (q): 85%. Resultados: 220 casos ingresados al estudio. El índice de complicaciones laríngeas es 5.9% , frecuentemente la tos y secreción sanguinolenta, asociándose factores como mascara clásica, edad (2-5 años), tiempo mayor de 60 minutos, mayor número de intentos, ASA> I, estado nutricional sobrepeso, e insertar en formación. Conclusión: La máscara laríngea es validada como dispositivo en anestesia pediátrica por aprendizaje rápido, baja tasa de fracaso, menores complicaciones y utilidad en vías aéreas difíciles, Es insuficiente la evidencia para respaldar el uso de un determinado dispositivo por encima de otro
Introduction: The laryngeal mask is the equipment with the aim of increasing quality, safety, care, however, despite having universal use and high efficacy for ventilation, it is not without complications. The objective of this research was to identify the frequency of complications with the use of a laryngeal mask in the Vicente Corral Moscoso and José Carrasco public hospitals in the city of Cuenca. Methods: It is an observational, descriptive, prospective study in 220 pediatric patients, ASA I, II and III who underwent elective and emergent surgeries under general anesthesia in a time interval of 30 to 240 minutes, of all surgical medical specialties of the year 2018, the different types of mask were used. The sample was obtained by applying the formula for unknown population (n = (Z2 x p x q) / e2), confidence level (Z): 95%. (1.96) Margin of error (e): 5% Probability of occurrence of the event (p): 15% Probability of non-occurrence of the event (q): 85%. Results: 220 cases entered the study. The rate of laryngeal complications is 5.9%, frequently cough and bloody discharge, associating factors such as classic mask, age (2-5 years), time greater than 60 minutes, greater number of attempts, ASA> I, nutritional status, overweight, and insert in formation. Conclusion: The laryngeal mask is validated as a device in pediatric anesthesia due to rapid learning, low failure rate, fewer complications and usefulness in difficult airways. The evidence is insufficient to support the use of a certain device over another.
Subject(s)
Humans , Laryngeal Masks , Airway Management , Anesthesia, General , ChildABSTRACT
Abstract: Background: Primary percutaneous coronary intervention (PPCI) is the treatment of choice for acute ST-elevation myocardial infarction (STEMI). The delays associated with PPCI reduce the benefits of this therapy. To minimize these delays, the pharmacoinvasive strategy (PS) was developed, consisting of applying thrombolytic therapy followed by coronary angioplasty 2 to 24 hours after. Objective: To compare the safety and efficiency of PPCI vs PS in STEMI. Methods: We included patients with STEMI who had emergency PCI. The primary endpoint was combined major adverse cardiac events (MACE), death, reinfarction, stroke, target vessel revascularization (TVR) during hospitalization. The secondary endpoints were the individual components of MACE, and major bleeding (Bleeding Academic Research Consortium: BARC ≥ 3). Results: A total of 400 patients, 263 (65.8%) for PPCI group, 114 (28.5%) for PS group and 23 (5.75%) for diagnostic group. The PS group, 79 (69.3%) were then categorized as systematic angioplasty having had a successful thrombolysis, and 35 (30.7%) were rescue angioplasty because they had a failed thrombolysis. There were no differences in MACE: 13 (9.5%) patients in PS and 27 (10.3%) patients in the PPCI (p = 0.806), there were no differences in the individual components of MACE. The rate of major bleeding was the same, 5 (3.6%) and 4 (1.5%) respectively (p = 0.173). The multivariate analysis did not show a relationship between MACE and the reperfusion strategy. Conclusions: The pharmacoinvasive strategy when compared to PPCI has a similar rate of primary and secondary endpoints. There is no increase in major bleeding therefore, it is an important strategy that offers a reperfusion therapy for patients with STEMI in a non-PCI capable hospital.(AU)
Resumen: Antecedentes: La intervención coronaria percutánea primaria (ICPP) es el tratamiento de elección en infarto agudo al miocardio con elevación del ST (IAMCEST). El retraso relacionado con ICPP disminuye el beneficio. Buscando una reperfusión oportuna se implementa la estrategia farmacoinvasiva (EFI), que consiste en realizar trombólisis seguido de ICP entre 2 a 24 horas después. Objetivo: Comparar la seguridad y eficacia en pacientes sometidos a ICPP contra EFI en IAMCEST. Métodos: Se incluyeron pacientes con IAMCEST sometidos a ICP emergente. El punto final primario son eventos cardiacos adversos mayores (ECAM), muerte, reinfarto, evento vascular cerebral y revascularización del vaso tratado, durante la hospitalización. Los puntos finales secundarios son la presencia de los componentes individuales del ECAM, y el sangrado mayor (BARC ≥ 3). Resultados: Se estudiaron 400 pacientes, 263 (65.8%) de ICPP, 114 (28.5%) a EFI y 23 (5.75%) angiografía diagnóstica. Del grupo EFI, 79 (69.3%) fueron angioplastia sistemática por trombólisis exitosa y 35 (30.7%) por angioplastia de rescate por trombólisis fallida. No se observó diferencia en la frecuencia de ECAM: EFI 13 (9.5%) contra ICPP 27 (10.3%) respectivamente (p = 0.806), tampoco hubo diferencia en los componentes individuales. No se observó diferencia en sangrado mayor, 5 (3.6%) vs 4 (1.5%), (p = 0.173). El análisis multivariado no relacionó la estrategia de reperfusión con los ECAM. Conclusiones: La EFI comparada con ICPP demuestra una tasa similar de ECAM, así como de sus componentes individuales. No se asocia con aumento de hemorragia mayor, concluyendo que ofrece el beneficio de una reperfusión oportuna sin aumento del riesgo en los hospitales que no tienen la capacidad para realizar ICPP.(AU)
Subject(s)
Humans , Thrombolytic Therapy/instrumentation , Angioplasty/instrumentation , Percutaneous Coronary Intervention/instrumentation , Myocardial Infarction/surgeryABSTRACT
Abstract Bioresorbable linear poly(ether-ester-urethane)s with different hydrophilic characteristics were synthesized from triblock copolymers of poly(ε-caprolactone)-poly(ethylene oxide)-poly(ε-caprolactone) (PCL-PEO) as macrodiols, and L-lysine diisocyanate (LDI) or hexamethylenediisocyanate (HDI) were used as the required diisocyanates. Macrodiols were obtained by ring-opening polymerization (ROP) of ε-caprolactone (CL). Polyurethanes were synthesized by the reaction of the triblock copolymers with LDI or HDI in solution using stannous 2-ethylhexanoate as catalyst. Polyurethane tablets were fabricated and investigated as prospective drug delivery systems. The effect of the PEO content on the polymers' performance as drug carriers was evaluated. It was found that water provoked more swelling and erosion of polymers with higher contents of PEO. The hydrocortisone release profiles were analyzed using the Ritger-Peppas approximation. An anomalous release behaviour (values of n higher than 0.5) was found for most of the analyzed samples.
Subject(s)
Tablets/pharmacokinetics , Hydrocortisone/pharmacokinetics , Polyurethanes/chemical synthesis , Drug LiberationABSTRACT
Knowledge of the enterobacteria present in the roadside hawk can bring about an understanding of infectious diseases that can affect this bird, as well as other animals and/or humans, while also adding information of great ecological importance. Thus, the aim of the study was to determine the enterobacteria present in the cloaca of captive roadside hawks and antimicrobial susceptibility profile. Initially, cloacal samples from nine specimens were collected with the aid of swabs. Samples were placed in petri dishes with MacConkey agar, Hektoen agar, EMB agar and Salmonella-Shigella (SS) agar and incubated for 24 h at 35C. After incubation, the microorganisms were submitted to biochemical testing to confirm the presence of enterobacteria. Thereafter, the susceptibility profile of bacteria to antimicrobial agents was evaluated by a disk diffusion test according to the Clinical and Laboratory Standards Institute (CLSI). Escherichia coli (77.8%), Klebsiella oxytoca (11.1%), Klebsiella pneumoniae (11.1%) and Salmonella spp. (55.6%) were isolated from the collected samples. Among the isolates, some bacteria showed resistance to up to three antimicrobial agents. This study has brought greater insight about the enterobacteria present in the roadside hawk (Rupornis magnirostris), exhibiting a significant percentage of enterobacteria important to public health; also, it showed the occurrence of strains with resistance profile to antimicrobial agents...
O conhecimento das enterobactérias presentes em Gavião-carijó pode trazer uma compreensão sobre as doenças infecciosas que podem acometer essa ave, como também outros animais e/ou humanos, além de trazer mais informações sobre essa espécie de grande importância ecológica. Desta forma, o objetivo do estudo foi determinar as enterobactérias presentes na cloaca de Gaviões-carijós cativos e seu perfil de susceptibilidade a antimicrobianos. Inicialmente, foram coletadas amostras cloacais de nove espécimes com o auxílio de swabs. As amostras foram plaqueadas em ágar MacConkey, ágar Hektoen, ágar EMB e ágar SS e incubadas por 24 h a 35C. Após incubação, as colônias foram submetidas às provas bioquímicas para confirmação da presença de enterobactérias. Posteriormente, o perfil de susceptibilidade das bactérias frente a agentes antimicrobianos foi avaliado através do teste da difusão em disco de acordo com o Clinical and Laboratory Standards Institute (CLSI). Escherichia coli (77,8%), Klebsiella oxytoca (11,1%), Klebsiella pneumoniae (11,1%) e Salmonella spp. (55,6%) foram isoladas das amostras coletadas. Dentre as cepas isoladas, algumas apresentaram resistência a até três antimicrobianos. O presente estudo trouxe um maior conhecimento sobre as enterobactérias presentes no Gavião-carijó (Rupornis magnirostris), mostrando um percentual significativo de enterobactérias de importância na saúde pública, evidenciando também a ocorrência de cepas com perfil de resistência a agentes antimicrobianos...
Subject(s)
Animals , Cloaca/microbiology , Enterobacteriaceae/isolation & purification , Hawks/microbiology , Bird Diseases/diagnosis , Bird Diseases/pathology , Disk Diffusion Antimicrobial Tests/veterinaryABSTRACT
Objective: To detect the presence and transmission of S. mutans carrier of the spaP gene in samples of bacterial plaque in mother/child pairs from municipal child education centers, and the possible association with dental caries. Methods: The sample comprised 56 mother/child pairs. For the evaluation of the prevalence and severity of caries, the DMFT and dmft indices were used, following World Health Organization criteria. The oral hygiene pattern was also evaluated using the Simplified Oral Hygiene Index and O?Leary?s plaque control index. Using DNA extracted from bacteria in the dental plaque of mother/child pairs, a sequence of the S. mutans spaP gene was amplified using PCR. The chi-squared test, Fisher?s exact test and Pearson?s correlation coefficient were applied, using a level of significance of p< 0.05.Results: The mothers presented a DMFT index of 11.02 (SD=6.3) while the children exhibited a dmft index of 2.09 (SD=3.2). Approximately 40% ofmother/child pairs had a good oral hygiene index. A higher percentage of children with caries had, in their dental plaque, S. mutans harboringthe spaP+ gene (p=0.03). No association was detected between the presence of S. mutans spaP+ in the dental plaque of mother and child.Conclusion: An association was found between experience of caries in the children and the presence of bacteria carrying the spaP+ gene. Our results did not detect vertical transmission.
Objetivo: Detectar a presença e a transmissão de S. mutans portador do gene spaP em amostras de placa bacteriana em pares mãe/criança de centros municipais de educação infantil e possível associação com a cárie dentária. Métodos: A amostra foi composta por 56 pares mãe/criança. Para avaliação da prevalência e severidade de cárie foram utilizados os índices CPO-D e ceo-d seguindo critérios da Organização Mundial de Saúde. O padrão de higiene bucal foi avaliado através do Índice de Higiene Oral Simplificado e do índice de controle de placa O´Leary. Utilizando o DNA extraído das bactérias da placa dentária dos pares mãe/criança, uma seqüência do gene spaP de S. mutans foi amplificado pela PCR. Os testes de Qui-quadrado, exato de Fisher e correlação de Pearson foram realizados. Adotando-se significância de p?< 0,05. Resultados: As mães apresentaram índice CPO-D de 11,02 (DP=6,3) enquanto as crianças mostraram índice ceo-d de 2,09 (DP=3,2). Aproximadamente 40% dos pares mãe/criança tinham um bom índice de higiene bucal. Maior porcentagem das crianças com cárie apresentaram em sua placa dentária S. mutans abrigando o gene spaP+ (p=0,03). Não foi detectada associação entre a presença de S. mutans spaP+ na placa dentária da mãe e seu filho. Conclusão: Foi verificada a associação entre a experiência de cárie nas crianças e a presença da bactéria portadora do gene spaP+. Nossos resultados não detectaram a transmissão vertical.
Subject(s)
Child , Dental Caries , Polymerase Chain Reaction , Streptococcus mutansABSTRACT
Seventy-fi ve strains isolated from fecal samples of six children werestudied for their morphology and biochemical properties. Geneticdiversity of 30 strains was analyzed by using Random Amplifi ed Polymorphic DNA (RAPD). The intestinal isolates were grouped into four clusters. Some strains in group I were 100% similar (Lactobacillus reuteri) while high degree of genetic diversity was found in groups II (standard species), III and IV. Eight strains of group I and group III wereidentifi ed through biochemical identifi cation, as Lactobacillus reuteri,Lactobacillus acidophilus, Lactobacillus plantarum, Lactobacillus casei and Lactobacillus salivarius, and showed low genetic similarity with type strains. The fi ndings in this study provide a strong basis for exploring the potential of these eight selected lactobacilli strains foruse in fermented-milk based product.
Subject(s)
Bacteria , Fermentation , Food , Food Technology , Lactobacillus plantarum , ProbioticsABSTRACT
O presente trabalho teve como objetivo verificar a utilização de substratos prebióticos por seis cepas de lactobacilos de origem intestinal humana. Foi utilizado o caldo MRS isento de glicose e extrato de carne adicionado de 1,0% de oligofrutose, insulina ou goma acácia sendo as contagens determinadas após 24 horas de incubação. Avaliou-se também a resistência destes isolados a alguns antibióticos de uso restrito em humanos como penicilina, tetraciclina, eritromicina, cloranfenicol e estreptomicina, utilizando-se o método de difusão em placa. Os resultados obtidos evidenciaram que todas cepas foram capazes de utilizar os substratos testados. Os seis isolados testados foram resistentes a eritromicina, porém não se determinou se esta característica era intrínseca ou adquirida. Os isolados apresentam potencial de uso em produtos simbióticos, pois também mostraram, em ensaios anteriores, resistência às condições adversas do trato gastrointestinal.
Subject(s)
Drug Resistance, Bacterial , Lactobacillus/isolation & purification , ProbioticsABSTRACT
There are cells that suffer uncontrolled growth with loss of contact inhibition and alterations in the nucleus, affecting the maintenance of telomeres in the chromosomes, forming a tumor. Telomeres have a tendency to merge, making repairs of DNA impracticable, taking the loss of genetic information and producing chromosomal aberrations. In relation to telomeres, there is a protein known as telomerase, hyperactive in several neoplasms, such as melanoma. The integrity and stability of chromosomes is one of the key factors that must be maintained for good functioning and propagation of an organism. In this revision, only aspects related to melanoma, telomeres and telomerase are addressed, pointing to the contribution of genetic and mutagenic environmental factors for carcinogenic development.