ABSTRACT
RESUMEN Introducción: Las fracturas vertebrales por compresión han sido tratadas usando cemento óseo en su interior, con técnicas como la cifoplastia y vertebroplastia. Sin embargo, son conocidos los potenciales efectos adversos, principalmente la fuga del cemento a los tejidos aledaños y, en la mayoría de los casos, la consiguiente afección a la altura vertebral. Es importante lograr una adecuada reducción de la fractura, ya que la esta influye directamente en la calidad de vida de los pacientes. Objetivo: Describir la aplicación, por primera vez, del implante intramedular expandible SpineJack® como método para el tratamiento de fracturas vertebrales por compresión. Presentación del caso: Se presenta una paciente de 65 años que sufrió un traumatismo en su columna lumbar a nivel de L1, con fractura tipo burst, a la que, en junio de 2016, se le realizó un acceso transpedicular percutáneo con guía fluoroscópica con el propósito de insertar el dispositivo SpineJack® en el cuerpo vertebral. Se utilizaron expansores del implante especialmente diseñados para este dispositivo, los cuales abrieron los extremos y desplegaron el componente central de titanio; esto facilitó la inyección de polimetilmetacrilato, el cual finalmente envolvió a los implantes, lo que garantizó la estabilización de la fractura. Resultados: La tomografía de control permitió observar una adecuada reducción del declive central de la vértebra L1 de la paciente y una recuperación de la altura del cuerpo vertebral con valores similares a los reportados por otros investigadores que han trabajado con este método en otros países. Conclusiones: La capacidad anátomo-funcional de la vértebra fracturada, así como la mejoría clínica de la paciente. y su calidad de vida fueron notables. No se observaron complicaciones. El seguimiento del empleo de este dispositivo en otros pacientes en Ecuador, permitirá profundizar en su evaluación(AU)
ABSTRACT Introduction: Vertebral compression fractures have been treated using internal bone cement, using techniques such as kyphoplasty and vertebroplasty. However, the potential adverse effects are known, mainly the leakage of cement to the surrounding tissues and, in most cases, the consequent affection at the vertebral level. Achieving adequate reduction of the fracture is important since it directly influence on the quality of life of patients. Objective: To describe the application, for the first time, of SpineJack® expandable intramedullary implant as a method for treating vertebral compression fractures. Case report: We report a 65-year-old female patient who suffered trauma to her lumbar spine at L1 level, a burst-type fracture, who, in June 2016, underwent percutaneous transpedicular access with fluoroscopic guidance with the purpose of inserting SpineJack® device into her vertebral body. Specially designed implant expanders were used for this device, which opened the ends and deployed the central titanium component. This facilitated the injection of polymethylmethacrylate that eventually enveloped the implants, ensuring stabilization of the fracture. Results: The control tomography allowed to observe adequate reduction of the central decline of the L1 vertebra of this patient and the recovery of the vertebral body height with values similar to those reported by other researchers who have worked with this method in other countries. Conclusions: The anatomy-functional capacity of the fractured vertebra, as well as the clinical improvement of this patient, and her quality of life were remarkable. No complications were observed. Following up the use of this device in other patients in Ecuador will allow to deepen its evaluation(AU)
Subject(s)
Humans , Female , Aged , Spinal Fractures/surgery , Vertebroplasty/methods , Fracture Fixation, Intramedullary/methods , EcuadorABSTRACT
A comparative study of antioxidant properties, platelet antiaggregation activity and transcriptional analysis of flavonoid biosynthesis genes were performed in Fragaria x ananassa, F. vesca and F. chiloensis subsp chiloensis f. chiloensis and f. patagonica. Furthermore, differences in flavonoid content were found by UHPLC-MS. The highest free radical scavenging activity by DPPH assay was observed in F. chiloensis f. chiloensis, meanwhile, F. vesca presented the highest antioxidant capacity by FRAP. Biosynthetic flavonoids- related transcripts were higher abundant in F. x ananassa and lower in F. vesca. Additionally, all strawberry extracts showed antiaggregant effect (1 mg mL-1), but F. vesca and F. chiloensis subsp. chiloensis f. patagonica were still active at lower concentration. This study suggests that platelet antiaggregation effect of different strawberries could be due to isoflavones and flavonoids precursors in addition to anthocyanins. Results could usefully to take decisions in future breeding programs to improve the content of healthy compounds in strawberry fruits.
Se realizoÌ un estudio comparativo de propiedades antioxidantes, actividad de antiagregacion plaquetaria, anaÌlisis transcripcional de genes de biosiÌntesis de flavonoides y contenido de estos en Fragaria x ananassa, F. vesca and F. chiloensis subsp chiloensis f. chiloensis and f. patagonica. La mayor actividad removedora de radicales libres por DPPH se observoÌ en F. chiloensis f. chiloensis, mientras F. vesca presentoÌ la mayor capacidad antioxidante mediante FRAP. Transcritos relacionados con biosiÌntesis de flavonoides fueron mas abundantes en F. x ananassa y menores en F. vesca. Adicionalmente, todos los extractos de frutillas mostraron efectos antiagregante (1 mg mL-1), pero F. vesca and F. chiloensis subsp. chiloensis f. patagonica fueron activos a concentraciones menores. Este estudio sugiere que efectos de antiagregacioÌn plaquetaria en distintas frutillas podriÌa deberse a isoflavonas y precursores de flavonoides ademaÌs de antocianinas. Los resultados podriÌan ser uÌtiles en programas de mejoramiento geneÌtico para mejorar el contenido de compuestos saludables en frutilla.
Subject(s)
Plant Extracts/chemistry , Fragaria/chemistry , Antioxidants/chemistry , Flavonoids/analysis , Flavonoids/genetics , Flavonoids/metabolism , Platelet Aggregation Inhibitors/pharmacology , Plant Extracts/pharmacology , Gene Expression , Free Radical Scavengers , Chromatography, High Pressure Liquid/methods , Fluorescence Recovery After Photobleaching , Real-Time Polymerase Chain Reaction , Antioxidants/pharmacologyABSTRACT
O trabalho discute a função da assistência ambulatorial regida pelos princípios da Reforma Psiquiátrica a partir da experiência de uma equipe interdisciplinar do ambulatório infantojuvenil de Nova Iguaçu, Rio de Janeiro, Brasil. O objetivo é relatar uma experiência pautada na lógica de uma assistência ambulatorial ampliada em articulação com o campo da educação. O matriciamento foi a metodologia utilizada nesta experiência. Trata-se de uma forma de produzir saúde pela construção do compartilhamento de responsabilidade entre duas equipes; neste caso, a equipe de saúde mental infantojuvenil e a equipe de agentes pedagógicos de educação especial da Secretaria Municipal de Educação de Nova Iguaçu.(AU)
This paper discusses the role of ambulatory health care governed by the principles of psychiatric reform based on theexperience of an interdisciplinary team caring for children and teen outpatients in Nova Iguaçu, Rio de Janeiro, Brazil. Its objective is to report an experience guided by the logic of an expanded ambulatory care in related to the educational domain. The matrix support was the methodology used in the reported experience as a way to produce health through the construction of shared responsibility between two teams, in this case the child and youth mental health ambulatory team and the team of pedagogical agents of special education of the correspondent Municipal Department of Nova Iguaçu.(AU)
El trabajo discute la función de la asistencia ambulatorial regida por los principios de la Reforma Psiquiátrica a partir de la experiencia de un equipo interdisciplinario del ambulatorio infanto-juvenil de Nova Iguaçu, Rio de Janeiro, Brasil. El objetivo es relatar una experiencia pautada en la lógica de una asistencia ambulatoria ampliada en articulación con el campo de la educación. La matriciación fue la metodología utilizada en esta experiencia. Se trata de una forma de producir salud por la construcción de compartir responsabilidad entre los dos equipos; en este caso el equipo de salud mental infanto-juvenil y el equipo de agentes pedagógicos de educación especial de la Secretaría Municipal de Educación de Nova Iguaçu.(AU)
Subject(s)
Humans , Male , Female , Mental Health , Health Policy , Ambulatory Care , Mental Health ServicesABSTRACT
O artigo é parte da Dissertação de Mestrado "O sujeito abusado da psicanálise". A partir de uma revisão crítica da bibliografia sobre o tema do abuso sexual, enfatiza a questão do manejo psicanalítico nesses casos e pretende sustentar um diálogo da psicanálise com outros campos de saber, diferenciando a proposta psicanalítica das demais abordagens encontradas na literatura. A tendência contemporânea de normalização e patologização dos casos é outro ponto de questionamento. Tendo como premissa que o manejo clínico não se define previamente à escuta do sujeito, sem levar em conta sua responsabilidade pelo que lhe ocorreu, verificamos que, muitas vezes, em nome de uma "cientificidade" e do "bem-estar" da criança, corre-se o risco de reforçar uma dimensão policial, de vigilância administrativa, e deixar de lado a implicação subjetiva de cada um.
The article is part of the Master's degree Dissertation "The abused subject of psychoanalysis". From a critical review of the literature on the topic of sexual abuse, it poses questions regarding the psychoanalytic management of these cases, and intends to support a dialog between psychoanalysis and other fields of knowledge, distinguishing the psychoanalytic proposal from other approaches found in the literature. The contemporary trend of normalization and pathologisation of sexual abuse cases is another point of questioning. Our premise is that the clinical management is not defined previously to the listening of the subject, without taking into account his responsibility for what happened. In many cases, in the name of "science" and "child welfare", we can reinforce a police dimension, of administrative vigilance, setting aside the subjective implication of the individual.