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Introducción: la hipoglicemia neonatal es un trastorno metabólico frecuente en neonatos, con mayor incidencia en aquellos con factores de riesgo como ser hijos de madre diabética, pequeño para la edad gestacional y pretérmino tardíos. Material y métodos: se realizó un ensayo analítico aleatorizado, controlado por placebo para evaluar la eficacia de la administración de gel de dextrosa al 40% para la prevención de hipoglicemia neonatal en esta población. Se reclutaron un total de 120 pacientes. Resultados: se encontró una menor incidencia de hipoglicemia neonatal al compararla con la incidencia reportada en la literatura internacional. No se encontraron diferencias estadísticamente significativas en cuanto al número de ingresos a áreas de internación para tratamiento de hipoglicemia ni en la alimentación a pecho directo exclusivo al alta entre los grupos. Conclusiones: el gel de dextrosa al 40% en recién nacidos podría ser un tratamiento alternativo para profilaxis de hipoglicemia en recién nacidos con factores de riesgo.
Introduction: neonatal hypoglycemia is a frequent metabolic disorder in neonates, with a higher incidence in those with risk factors such as being children of diabetic mothers, small for gestational age, and late preterm. Methodology: a randomized, placebo controlled analytic trial was conducted to evaluate the efficacy of 40% dextrose gel administration for the prevention of neonatal hypoglycemia in this population. A total of 120 patients were recruited. Results: a lower incidence of neonatal hypoglycemia was found when compared to the incidence reported in the international literature. No statistically significant differences were found in terms of the number of admissions to inpatient areas for hypoglycemia treatment or exclusive direct breastfeeding at discharge between the groups. Conclusions: 40% dextrose gel in newborns could be an alternative treatment for hypoglycemia prophylaxis in newborns with risk factors.
Introdução: a hipoglicemia neonatal é um disturbio metabólico comum em neonatos, com maior incidencia naqueles que apresentam fatores de risco, tais como filhos de mães diabéticas, pequenos para a idade gestacional e prematuros tardios. Metodologia: foi realizado um ensaio analítico randomizado e controlado por placebo para avaliar a eficácia da administração de gel de dextrose a 40% para prevenção de hipoglicemia neonatal nesta população. Um total de 120 pacientes foram recrutados. Resultados: foi encontrada menor incidência de hipoglicemia neonatal quando comparada com a incidência relatada na literatura internacional. Não foram encontradas diferenças estatisticamente significativas relativas ao número de internações em áreas de internação para tratamento de hipoglicemia ou aleitamento materno direto exclusivo para descarga entre os grupos. Conclusões: o gel de dextrose a 40% em recém nascidos pode ser uma alternativa de tratamento para profilaxia de hipoglicemia em recém nascidos com fatores de risco.
Subject(s)
Humans , Male , Female , Infant, Newborn , Congenital Hyperinsulinism/prevention & control , Glucose/therapeutic use , Double-Blind Method , Risk Factors , Congenital Hyperinsulinism/bloodABSTRACT
RESUMEN Fundamento: el parto pretérmino es un problema de salud pública por las repercusiones sobre la vida del niño al causar el 75 % de la morbilidad y mortalidad neonatales. Objetivo: identificar factores de riesgo asociados al parto pretérmino. Métodos: estudio descriptivo, correlacional, de corte transversal de dos series de casos que incluyó 678 gestantes de la provincia de Cienfuegos durante el año 2012; de ellas un grupo de 226 con parto entre 28 y 36,6 s semanas y otro grupo de 452 con parto después de las 37 semanas. Se analizó la edad gestacional al ingreso, factores de riesgo de prematuridad, presencia de modificaciones cervicales al examen clínico y por ultrasonido transvaginal. Se calculó Chi cuadrado con una confiabilidad del 95 % y el cociente de posibilidades. Resultados: las edades extremas y el nivel de escolaridad entre séptimo y noveno grados influyeron de manera significativa a favor de las gestantes con parto pretérmino. Otros factores como el hábito de fumar, la ingestión de bebidas alcohólicas, embarazo pretérmino anterior (OR=2,32), pre-eclampsia (OR=6,31), crecimiento intrauterino retardado (OR=3,77), infecciones urinarias (OR=3, 41), y vaginales, la rotura prematura de membranas y las modificaciones cervicales (OR>2), mostraron diferencias altamente significativas en las gestantes con parto pretérmino. Conclusiones: la pre-eclampsia, el crecimiento intrauterino retardado y las infecciones urinarias fueron los factores de riesgo con mayor cociente de posibilidad para parto pretérmino, no obstante existen otros que también lo potencian. La modificación de estos factores constituye pilar para la disminución del parto pretérmino.
ABSTRACT Foundation: preterm delivery is a public health problem due to the repercussions on the child´s life, causing 75% of neonatal morbidity and mortality. Objective: to identify risk factors associated with preterm delivery. Methods: descriptive, correlational, cross-sectional study of two case series that included 678 pregnant women from the Cienfuegos province during 2012; out of them a group of 226 who had deliveries between 28 and 36.6 s weeks and another group of 452 with delivery after 37 weeks. Gestational age at admission, risk factors for prematurity, presence of cervical changes to clinical examination and trans-vaginal ultrasound were analyzed. Chi- square was calculated with 95% reliability and the quotient of possibilities. Results: extreme ages and schooling level of between seventh and ninth grades influenced significantly in favor of pregnant women with preterm delivery. Other factors such as smoking, alcohol ingestion, previous preterm pregnancy (OR = 2.32), pre-eclampsia (OR = 6.31), delayed intrauterine growth (OR = 3.77), urinary infections ( OR = 3, 41), and vaginal, premature rupture of membranes and cervical changes (OR> 2), showed highly significant differences in pregnant women with preterm delivery. Conclusions: pre-eclampsia, delayed intrauterine growth and urinary tract infections were the risk factors with the highest possibility ratio for preterm delivery, however there are others that also enhance it. Modifying these factors is determinant for decreasing preterm deliveries.
ABSTRACT
Los espacios educativos de interacción social resultan excelentes ámbitos para explicitar contenidos y encontrarle significado, lo que constituye una verdadera toma de conciencia de su utilidad. El presente artículo tiene como objetivo ofrecer valoraciones acerca del papel de los talleres integradores interdisciplinarios en el tratamiento de los contenidos básicos biomédicos y clínicos. Las valoraciones ofrecidas se sustentan en tres aspectos medulares: la importancia que tienen los talleres como espacios de construcción del conocimiento interdisciplinar, el valor de los postulados socio-constructivistas para el sujeto que aprende en estos espacios y las experiencias prácticas de los autores. Se puede expresar que este tipo de talleres, desde la concepción asumida para su realización, posibilitan un adecuado tratamiento de los contenidos básicos biomédicos y clínicos en la carrera de Medicina, debido a que permiten conseguir objetivos específicos integradores en el aprendizaje de los contenidos (objeto de integración). Además, exigen el uso de tareas docentes integradoras para el logro de dichos objetivos y facilitan el empleo de procedimientos didácticos integradores en el tratamiento de los contenidos.
Educative spaces of social interaction result in excellent environments for explaining contents meaningfully, which generates true consciousness of its utility. The present article is aimed at offering assessments on the role of cross discipline integrating workshops for basic and clinical content treatment. The offered appraisals are based on three key elements: the importance of these workshops for constructing cross discipline knowledge, the value of socio-constructivist postulate for the subject who learns in these spaces and the authors' practical experience. It may be stated that from the conception assumed for their development, this type of workshop allows an adequate basic bio-medical and clinical content treatment in the Medicine career, since it is possible to achieve integrating specific objectives in learning new contents to be linked. In addition, they demand the use of teaching tasks for achieving these objectives and facilitate the use of didactic procedures for content treatment.
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O objetivo deste estudo foi o de avaliar a adesão a medidas preventivas em saúde bucal de crianças e adolescentes portadores de fissuras labiopalatinas. A amostra foi composta por crianças e adolescentes com idade entre 5 e 18 anos, portadores de fissura labiopalatina isolada, em tratamento em um hospital de referência para reabilitação de malformações craniofaciais no Rio de Janeiro, entre os meses de agosto e novembro de 2009. O responsável/paciente respondeu a um questionário composto por dados sócio-demográficos e hábitos de higiene bucal e dieta. Através do exame clínico e dos prontuários médico/odontológico, foi possível identificar o tipo de fissura oral: fissura de lábio isolada (FL); fissura de lábio associada ao palato (FLP) e fissura de palato isolada (FP). Cento e oito questionários foram respondidos, e a amostra final foi composta por 100 questionários correspondentes a 53 crianças e 47 adolescentes com a maior prevalência do gênero masculino (55,0%) e indivíduos caucasianos (46%). O tipo de fissura oral mais frequente foi a FLP (63%,0), seguida da fl(19,0%) e da FP (18,0%). A maioria dos participantes do estudo relatou que realizava a escovação dos dentes três vezes ao dia, não fazia uso do fio dental e do enxaguatório bucal. A ingestão de doces entre as refeições foi mais relatada pelas crianças (66,0%), sem diferença estatística entre crianças e adolescentes (p=0,08). Observou-se que 15 (27,3%) meninos e 19 (42,2%) meninas relataram usar fio dental, sem diferença entre os gêneros (p=0,11). De acordo com os resultados observados, a adesão de medidas preventivas em saúde bucal na população foi considerada parcial. Embora a maioria dos participantes realizasse a escovação dentária três vezes ao dia, o uso do fio dental foi negligenciado, e a ingestão de doces entre as refeições foi relatada por um grande número de participantes do estudo.
The aim of this study was to assess the adherence to preventive oral health measures of children and adolescents with cleft lip and palate. The sample was composed of children and adolescents aged varied 5 to 18 years, with isolated cleft lip and palate in treatment at a referral hospital for rehabilitation of craniofacial malformations in Rio de Janeiro, between August and November 2009. The guardian/patient answered a questionnaire comprising socio-demographic data and oral hygiene habits and diet. Through clinical records and medical/dental care, it was possible to identify the type of oral clefts: cleft lip (CL), cleft lip with cleft palate (CLP) and cleft palate alone (CP). One hundred and eight questionnaires were completed and the final sample consisted of 100 questionnaires corresponding to 53 children and 47 adolescents with a higher prevalence of males (55%) and caucasians (46%). The most common type of oral cleft was CLP (63.0%), followed by CL (19.0%) and CP (18.0%). Almost all participants reported that they brushed their teeth three times a day; on the other hand, they did not use dental floss and mouthwash. The intake of sweets between meals was reported more frequently by children (66.0%), no statistical diff erence between children and adolescents (p=0.08) was observed. It was observed that 15 (27.3%) boys and 19 (42.2%) girls reported using dental floss, there was no diff erence between genders (p=0.11). According to the results, adherence to preventive measures in oral health in this population was considered partial. Although most participants to perform the tooth brushing three time a day, flossing has been neglected and eating sweets between meals was reported by a large number of study participants.
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La preparación de derivados de glucosa marcados con 99mTc reviste gran interés para la evaluación del consumo de glucosa in vivo en oncología y cardiología nuclear. Este trabajo presenta la marcación de un análogo de glucosa (GLU-DTC) mediante la formación de un complejo Tc(V)-nitruro simétrico. Para ello se incorporó a la biomolécula un grupo ditiocarbamato capaz de coordinar al metal. La marcación fue realizada mediante sustitución de ligandos, obteniéndose una única especie con pureza radioquímica superior al 90 por cientp, la que se mantuvo durante al menos 4 hs. La caracterización fisicoquímica y biológica muestra que el complejo 99mTc(V)-nitruro(GLU-DTC)2 es un compuesto estable y altamente hidrofílico, aunque su unión a proteínas plasmáticas es mayor a la esperada, hecho que justificaría la alta actividad retenida en sangre y en hígado durante la evaluación biológica en ratones CD1 normales. Estos resultados indican que la marcación con 99mTc de este derivado de glucosa produce una alteración significativa de su comportamiento biológico.
The preparation of 99mTc-labeled glucose derivatives is of great interest to evaluate the in vivo glucose uptake in nuclear oncology and cardiology. This paper presents the labelling of a glucose analogue (GLU-DTC) through the formation of a Tc(V)-nitride symmetrical complex. For this purpose, a dithiocarbamate group was incorporated to the biomolecule, in order to coordinate the metal. The labelling reaction was carried out by substitution yielding a single complex with radiochemical purity above 90 percent. This complex was stable for at least 4 hours. The physicochemical and biological characterization shows that the 99mTc(V)-nitride(GLU-DTC)2 complex is a stable and highly hydrophilic compound, although its plasma protein binding is greater than expected, a fact which justifies the high activity retained in blood and liver during the biological evaluation in normal CD1 mice. These results indicate that 99mTc labelling of this glucose derivate alters significantly its biological behaviour.
Subject(s)
Animals , Rats , Organotechnetium Compounds/chemical synthesis , Glucose/chemistry , Isotope Labeling/methods , Radiopharmaceuticals/chemical synthesis , Cardiology/methods , Organotechnetium Compounds/pharmacokinetics , Tissue Distribution , Time Factors , Glucose/analogs & derivatives , Ligands , Nuclear Medicine/methods , Medical Oncology/methods , Radiopharmaceuticals/pharmacokinetics , Technetium/pharmacokineticsABSTRACT
Objetivo: caracterizar el consumo de sustancias psicoactivas en adolescentes judicializados bajo el Sistema de Responsabilidad Penal entre 2009 y 2010 pertenecientes a una fundación de rehabilitación de Calarcá, Quindío. Métodos: se sistematizaron las historias psicosociales de los 66 adolescentes institucionalizados y posteriormente se llevó a cabo un análisis descriptivo de las variables. Resultados: se encontró mayor prevalencia del género masculino con un 97%, la edad promedio de inicio de consumo de SPA fue 12,8 años, el 30% ingresaron por fabricación, tráfico o porte de estupefacientes, el 21% pertenece a una familia extensa, el 18% iniciaron el consumo con marihuana. Conclusiones: teniendo en cuenta que se ha encontrado que el consumo de SPA y las conductas delictivas suelen darse a edades muy tempranas y la importancia de algunas dinámicas familiares que actúan como factor de riesgo. Se evidencia la necesidad de crear programas de apoyo en el que tanto adolescentes como familias se vean involucrados.
Objective: to characterize the consumption of psychoactive substances in adolescents prosecuted under the Criminal Responsibility System between 2009 and 2010 belonging to a rehabilitation foundation in Calarcá, Quindío. Methods: the psychosocial histories of the 66 institutionalized adolescents were systematized and a descriptive analysis of the variables was subsequently carried out. Results: a higher prevalence of the male gender was found with 97%, the average age of initiation of SPA consumption was 12.8 years, 30% were admitted due to manufacture, trafficking or carrying narcotic drugs, 21% belonged to an extended family , 18% started using marijuana. Conclusions: taking into account that it has been found that the consumption of SPA and criminal behaviors usually occur at very young ages and the importance of some family dynamics that act as a risk factor. The need to create support programs in which both adolescents and families are involved is evident.