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RESUMEN La hemobilia (HB) es la presencia de sangre en o a través del tracto biliar. Las causas más comunes son iatrogénica, traumática, neoplasias y fístulas colangiovenosas o arteriobiliares. Y los cálculos biliares representan del 5-15 % de las causas. Presentamos el caso de una mujer 28 años, sin antecedentes, ni uso de anticoagulantes, diagnosticada inicialmente de colecistitis aguda, que requirió colecistectomía abierta de emergencia. Durante la operación se evidencia un coágulo adherido a la luz de la vesícula y dos cálculos. Confirmando el diagnóstico con los hallazgos histopatológicos. Debido a su similitud clínica, debe considerarse en pacientes con antecedentes de terapia anticoagulante, trauma, malignidad, o hallazgos compatibles con colecistitis alitiásica. Pero puede presentarse en pacientes sin antecedentes y estar asociado a colelitiasis. El tratamiento depende del estado hemodinámico y la etiología. Requiriendo cirugía en caso de colecistitis, ya que conlleva una alta tasa de mortalidad, y perforación vesicular (2-15 %).
ABSTRACT Hemobilia (HB) is the presence of blood in or through the biliary tract. Its most common causes are iatrogenic, traumatic, neoplasms, and cholangiovenous or arterio-biliary fistulas. Also, gallstones account for 5-15% of such cases. We present the case of a 28-year-old woman, with no remarkable history or anticoagulant use, who was initially diagnosed with acute cholecystitis, and required emergency open cholecystectomy. During the operation, a clot adhered to the gallbladder lumen and two calculi were evidenced. The diagnosis was confirmed with histopathological findings. Due to its clinical similarity, HB should be considered in patients with a history of anticoagulant therapy, trauma, malignancy, or with findings consistent with alithiasic cholecystitis. HB may also occur in patients with no remarkable history, and it be associated with cholelithiasis. Treatment depends on the patient's hemodynamic status and etiology. Surgery is required in cholecystitis, because of its high mortality rate and occurrence of gallbladder perforation (2-15%).
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ABSTRACT: Objective: To identify environmental factors present in areas with high density of road traffic accidents (RTA) in Leon, Nicaragua. Methods: The analysis included all accidents recorded by the Police Department in León City, from January to June 2017. All crashes were georeferenced, and data were collected from the environment elements within a perimeter of 20 meters from the site in which accidents occurred with a pre-tested data collection instrument. We specified a Poisson regression model to estimate incidence rate ratios (IRR) and 95% confidence intervals (CI) to determine environmental factors associated with the event incidence. For the identification areas with high, medium, and low occurrences of crashes, kernel density around points in which RTA occurred were estimated. Results: Out of 667 recorded crashes, 90% involved men aged 15-40, and motorcycle accidents represented 60% of injuries or deaths. Environmental factors that were positively associated with RTA included good road conditions (adjusted IRR = 1.36, 95%CI 1.13 - 1.63) and the existence of bicycle lanes (adjusted IRR = 1.64, 95%CI 1.29 - 2.10). Environmental characteristics associated with higher speeds and heavier accidents can increase their incidence. Conclusion: We found that high-foot-traffic commercial or touristic centers are three areas with high density of crashes. Local authorities can use these findings to promote road safety measures in high-incidence areas in León City.
RESUMO: Objetivo: Identificar os fatores ambientais presentes em áreas com alta densidade de acidentes de trânsito rodoviário (ATR) em León, Nicarágua. Métodos: Foram incluídos na análise todos os acidentes registrados pelo Departamento de Polícia da cidade de León de janeiro a junho de 2017. Georreferenciamos todos os acidentes e coletamos dados dos elementos ambientais em um perímetro de 20 metros do local até os acidentes ocorridos por meio de um instrumento de coleta de dados pré-testado. Foi especificado um modelo de regressão de Poisson para estimar as razões das taxas de incidência (TI) e intervalos de confiança de 95% (IC95%) para determinar os fatores ambientais associados à incidência do evento. Para identificar áreas com alta, média e baixa ocorrência de acidentes, estimamos a densidade do núcleo em torno dos pontos onde o ATR ocorreu. Resultados: Dos 667 acidentes registrados, 90% envolveram homens com idades entre 15 e 40 anos, e os acidentes de motocicleta representaram 60% dos ferimentos ou mortes. Os fatores ambientais que foram associados positivamente aos ATR incluíram boas condições da estrada (TI ajustada = 1,36; IC95% 1,13 - 1,63) e a existência de ciclovias (TI ajustada = 1,64; IC95% 1,29 - 2,10). Características ambientais associadas a velocidades mais altas e acidentes mais pesados podem aumentar a incidência deles. Conclusão: Constatamos que os centros comerciais ou turísticos com tráfego intenso são três áreas com alta densidade de acidentes. As autoridades locais podem usar essas descobertas para promover medidas de segurança no trânsito em áreas de alta incidência na cidade de León.
Subject(s)
Humans , Male , Adolescent , Adult , Young Adult , Accidents, Traffic/statistics & numerical data , Attention , Risk Factors , Geographic Information Systems , Environment , Nicaragua/epidemiologyABSTRACT
Resumen Se registra Neoraimondia arequipensis subesp. gigantea en los bosques secos de Tumbes, ampliándose su distribución geográfica en el norte del Perú. Se realizó la identificación fenotípica de 70 individuos y genotípica basada en la secuenciación del gen matK (Maturase K gene). El hábitat de esta especie se caracteriza por la presencia de suelo de tipo pedregoso y rocoso, ubicados aledaños a zonas de quebradas y altitudes entre 20 a 60 m. Además, se registran observaciones de interacciones biológicas de este cactus con fauna y flora endémica del departamento de Tumbes.
Abstract Neoraimondia arequipensis subsp. gigantea is registered in the dry forests of Tumbes, expanding its geographical distribution in northern Peru, based on the phenotypic identification of 70 individuals and genotypic by sequencing the matK gene (Maturase K gene). The habitat of this species is characterized by the presence of stony and rocky soil, located adjacent to areas of ravines and altitudes between 20 to 60 meters above sea level. In addition, we include the record of biological interactions of this cactus with endemic fauna and flora of the department of Tumbes.
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A propósito del artículo: "Conocimiento y uso de método anticonceptivo de emergencia en estudiantes universitarios, Pereira, Colombia"
Subject(s)
Letter , Contraceptive Agents , EducationABSTRACT
Resumen Introducción: Los métodos anticonceptivos de emergencia o también llamados contracepción poscoital, es una de las alternativas que pueden ser utilizadas para evitar un embarazo no deseado en mujeres que han tenido relaciones sexuales sin protección, hasta 72 horas después de la relación. Objetivo: Establecer el nivel de conocimiento y el uso de los métodos anticonceptivos de emergencia utilizados en estudiantes universitarios. Materiales y métodos: Estudio observacional, descriptivo y transversal. Se incluyeron estudiantes de 15 a 25 años de una Institución de Educación Superior en el Municipio de Pereira, Colombia con vida sexual activa. Con un total de 127 estudiantes donde se incluyeron variables sociodemográficas de conocimiento y uso de métodos. Resultados: Se encuestaron 127 estudiantes donde la mediana en la edad fue de 19 años en sexo femenino con un rango intercuartílico de 3 y el sexo masculino presento una mediana de 21 años con un rango intercuartílico de 5. El condón fue el método más utilizado por los encuestados con un 35,4%, seguido de las píldoras con un 26,8%. Conclusiones: El método de elección fue el condón y existe alta prevalencia de consumo de métodos anticonceptivos de emergencia, con desconocimiento frente a su uso.
Abstract Introduction: The emergency contraceptive method, also known as post-coital contraception, is one of the alternatives that can be used to avoid an unwanted pregnancy up to 72 hours after a woman has had unprotected sexual intercourse. Objective: To establish the level of awareness and practice of emergency contraceptive methods among university students. Materials and methods: An observational, descriptive and cross-sectional study. The sample included 15- to 25-year-old students of a Higher Education Institution from the Municipality of Pereira- Colombia, with an active sexual life. The study included sociodemographic variables with respect to awareness and practice of contraceptive methods. Results: 127 students were surveyed, where the median age for female students was 19 years (IQR of 3), whereas male students showed a median age of 21 years old (IQR of 5). The condom was the most commonly used contraceptive method, used by 35.4% of the students, followed by contraceptive pills, which was used by 26.8% of students. Conclusions: The birth control method of choice was condom and although there is a high prevalence of consumption of emergency contraceptive methods, students show little awareness of their use.