ABSTRACT
El síndrome de Swyer-James-Mac Leod es una entidad poco frecuente adquirida en la infancia, generalmente tras una infección pulmonar moderada a grave de tipo bronquiolitis o neumonía, generalmente virales. Ocasionalmente se tiene el antecedente de infecciones repetidas de este tipo. Consiste en el desarrollo de enfisema hipoplásico pulmonar unilateral, que puede a veces relacionarse con bronquiectasias ipsilaterales o bilaterales, obstrucción fija al flujo aéreo y puede también asociarse a reducción del flujo sanguíneo del pulmón hipoplásico, de manera focal o difusa, con o sin tortuosidad de la vascularización proximal y a veces con una compensación del pulmón contralateral, en forma de sobredistensión e hiperflujo vascular relativo. Presentamos el caso de un varón de 79 años de edad con antecedentes de infecciones tipo bronquiolitis virales repetidas en la infancia, obstrucción fija grave al flujo aéreo y hemoptisis masiva secundaria a una infección por Pseudomonas aeruginosa sensible a la terapia antibiótica habitual.
Swyer-James-Mac Leod syndrome is a rare condition acquired in childhood, usually after a moderate to severe lung infection such as bronchiolitis or pneumonia, usually viral. Occasionally there is a history of repeated infections of this type. It consists of the development of unilateral pulmonary hypoplastic emphysema, which can sometimes be related to ipsilateral or bilateral bronchiectasis, fixed airflow obstruction, and may also be associated with reduced blood flow in the hypoplastic lung, with or without tortuosity of the proximal vascular supply and sometimes with compensation from the contralateral lung, in the form of overdistension and relative vascular hyperflow. We present the case of a 79-year-old man with a history of recurrent viral bronchiolitis-type infections in childhood, severe fixed airflow obstruction, and massive hemoptysis secondary to a Pseudomonas aeruginosa infection sensitive to usual antibiotic therapy.
Subject(s)
Humans , Male , Aged , Pulmonary Emphysema/complications , Lung, Hyperlucent/complications , Hemoptysis/etiology , Pulmonary Emphysema/therapy , Pulmonary Emphysema/diagnostic imaging , Radiography, Thoracic , Lung, Hyperlucent/therapy , Lung, Hyperlucent/diagnostic imaging , Computed Tomography AngiographyABSTRACT
Abstract Background: Endotracheal intubation (ETI), which is the gold standard in coronary artery bypass grafting (CABG), may cause myocardial ischaemia by disturbing the balance between haemodynamic changes and oxygen supply and consumption of the myocardium as a result of sympathetic stimulation. In this study, we aimed to compare two different videolaryngoscopes (C-MAC and Airtraq) in the hemodynamic response to ETI. Methods: Fifty ASA II-III CABG surgery patients were randomly assigned to C-MAC or Airtraq. The hemodynamic data included arterial blood pressure [systolic (SAP), diastolic (DAP) and mean (MAP)] and heart rate (HR) and were recorded at six different points in time: before laryngoscopy-T1, during laryngoscopy-T2, immediately after intubation-T3, and 3 (T4), 5 (T5) and 10 (T6) minutes after intubation. Intraoperative complications were recorded. Patients were questioned about postoperative complications 2 and 24hours following extubation. Results: The hemodynamic response to ETI was significantly greater with C-MAC. The increase in HR started with the laryngoscopy procedure, whereas increases in SAP, DAP, and MAP started immediately after ETI (p = 0.024; p = 0.012; p = 0.030; p = 0.009, respectively). In group analyses, T1-T2, T2-T3 and T1-T3 comparisons did not show any significant differences in HR with Airtraq. However, with C-MAC, HR after intubation increased significantly compared to the pre-laryngoscopy values (T1-T3) (p = 0.004). The duration of laryngoscopy was significantly reduced with C-MAC (p < 0.001), but the duration of intubation and total intubation were similar (p = 0.36; p = 0.79). Conclusions: Compared to C-MAC, the hemodynamic response to ETI was less with Airtraq. Thus, Airtraq may be preferred in CABG patients for ETI.
Subject(s)
Coronary Artery Bypass , Intubation, IntratrachealABSTRACT
Introduction- Enterococci are part of normal intestinal flora of humans and animals but have also emerged as important pathogens responsible for serious infections in hospital and community acquired infections.it is second most common cause of nosocomial infections in gastrointestinal tract, wound and genitourinary tract. To process all the clinicalAim- samples from various department in our hospital, for isolation of Enterococci spp. To speciate the isolates & to have resistance pattern of the isolates of vancomycin total 926 sample were collected from both outMaterial & Methods- patients and in patient in all clinical departments and transported to microbiology laboratory. specimens were processed by inoculating on to blood agar, MacConkey Agar, nutrient agar, potassium tellurite agar and incubated at 37°C for24-48 hr. Enterococci were identified by their typical arrangement in and salt tolerance test Gram stain, bile esculin test and biochemical tests. Antimicrobial susceptibility patterns were determined by performing Kirby-Bauer disc diffusion method and Minimum inhibitory concentration (MIC) values were identified by tube dilution methods. Result- a total of 926 sample, 645 (69.72%) were culture positive and 281 (30.28%) were culture negative. Among 645 culture positive cases, 81(12.55%) were Enterococcus faecalis. Antimicrobial susceptibility & MIC done as per standard protocols. The E. Faecalis showed 99% sensitive to Vancomycin. the resistance to vancomycin was 1% & further confirmed by MIC via tube dilution methods. In which MIC was ?32 ?g/ml in one isolate. About 8 of Enterococcal strains showed MIC of 0.0125?g/ml. species level identification of Enterococcus is important forConclusions- epidemiological study and also for analysis of drug resistant pattern. Effective detection of vancomycin resistance helps in reducing the morbidity and mortality of VRE in hospitalized patients
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Objective:To systematically review the correlation between serum Mac-2-binding protein glycosylation isomer (M2BPGi) level and hepatocellular carcinoma (HCC).Methods:The PubMed, Embase, Ovid, CBM (China Biology Medicine), Wanfang Databases were searched for studies on the correlation between serum M2BPGi level and HCC. After the selection process, 16 papers were included in this systematic review. A total of 7 810 patients were enrolled in the study, including 629 patients with HCC. The RevMan 5.2 software and R 4.1.2 software were used for the meta-analysis.Results:The elevated level of M2BPGi was significant positively associated with the risk of HCC( HR=2.28, 95% CI: 1.82-2.86, P<0.01). In Japan and Chinese groups, the elevated level of M2BPGi was significantly associated with an increased risk of HCC, with HR of 4.77 (95% CI: 2.73-8.32, P<0.01) and 2.04 (95% CI: 1.38-3.03, P<0.01), respectively. The elevated level of M2BPGi in three subgroups of people with untreated hepatitis C virus (HCV) infection, during treatment of hepatitis B virus (HBV) infection, and after HCV virological cure predicted an increased risk of HCC, with HR of 3.14 (95% CI: 2.19-4.50, P<0.01), 2.09 (95% CI: 1.36-3.22, P<0.01) and 5.07 (95% CI: 1.57-16.42, P<0.01), respectively. Conclusion:The elevated level of M2BPGi can indicate the increased risk of HCC, which can be used as one of the early warning indicators of HCC.
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Resumen Entre la multitud de medicinas y terapias alternativas presentes en el mundo Occidental, el neochamanismo es una de las que, en la actualidad, ha despertado mayor interés y que se sitúa entre las nuevas formas espirituales y los procesos de patrimonialización fruto de la modernidad globalizada. En este artículo se muestra el proceso de reconfiguración de prácticas y conocimientos ancestrales, -etiquetados como chamánicos- y cómo éstos constituyen una respuesta adaptativa en la búsqueda de nuevos espacios vitales y de experiencias colectivas que den sentido a la existencia en el contexto occidental. Desde el caso español y tomando la Comunidad Valenciana como unidad de análisis, nos adentramos en el proceso de adaptación de distintas corrientes chamánicas que han llegado a nuestras tierras y en cómo, desde ellas, mostrando ejemplos concretos, se entiende la sanación como un proceso de recuperar la salud y el bienestar que incluye al ser humano en su totalidad, así como las relaciones que establece con los demás y con su entorno.
Abstract Amongst multitude of alternative medicines and therapies that are present in the western world, neo-shamanism is one that has awakened more interest and has been established between the new spiritual ways and the heritagisation of processes as a result of globalized modernity. In this article, we will show the process of reconfiguration of shamanic practices and knowledge and how they constitute an adaptive response in the search of new vital spaces and collective experiences that give meaning to existence in western context. From the Spanish case and using the Autonomous Community of Valencia as an analysis unit, we will go in depth into the adaptation process that different shamanic movements reaching our land have suffered and how one can understand healing as a process to regain health and wellbeing that includes the human being in entirety of bodies, as well as established relationships with others and with the environment.
Subject(s)
Humans , Male , Female , Complementary Therapies , Shamanism , Spirituality , Medicine, TraditionalABSTRACT
Caseous calcification of mitral annulus (CCMA) is rare variant of mitral annular calcification (MAC). There is no clear consensus on the optimal management for CCMA. However, patients with CCMA have high risk of embolic strokes. We performed drainage and debridement in 3-cases of CCMA. All patients had a history of chronic kidney disease (CKD), and two of the three patients were undergoing hemodialysis. If a calcified mass at the mitral valve annulus is observed, especially in hemodialysis patients, CCMA should be recognized.
ABSTRACT
The case was a 77-year-old woman with a history of coronary artery bypass surgery 9 years earlier. After the surgery, aortic stenosis appeared and gradually progressed. During follow-up, she presented with a high degree of mitral annular calcification (MAC). A mobile verrucous mass in the left ventricle attached to the calcified posterior mitral annulus. We replaced the aortic valve and resected the mass (size, 3×26 mm). The mass with a club-shape was hard but fragile. Pathological examination revealed that it was a calcified substance without cell components covered with a thin membrane. Immunostainings with CD31 and Factor VIII-related antigen, a vascular endothelial cell marker, were both positive. Thus, the resected mass was diagnosed as a detached calcified mitral annulus. In order to avoid embolic events, early resection would be appropriate for an MAC-related mobile mass.
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One of the major causes of morbidity and mortality in tropical and subtropical regions is Dengue viral infection. This virus belongs to family flaviviridae comprising of four antigenically distinct serotypes DENV 1 - 4. A small number of studies conducted in North Eastern (NE) Region of India reported Dengue cases in Assam, Meghalaya, Nagaland, Manipur and Arunachal Pradesh. However, no studies have been conducted in the state of Tripura, with regard to pattern of Dengue viral infection and its circulating serotypes. Therefore, this study was undertaken to identify the serotypes circulating in Tripura. MethodsPatients with acute febrile illness were tested for detecting Dengue viral infection by MAC ELISA and / or NS1 detection test at Viral Research and Diagnostic Laboratory (VRDL), of a tertiary care centre in Tripura for a period of 3 years. All NS1 positive samples were further tested for presence of viral RNA by Reverse Transcriptase –PCR (RT - PCR) and serotyping was done using serotype specific primers. ResultsA total of 2515 acute febrile cases seen over a period of 3 years from 2014 to 2017 was tested for Dengue virus infection by serology. Out of 2515 of cases, 405 cases tested for NS1 antigen, where 10.61 % (43 / 405) was NS1 positive. The remaining 2110 cases were tested for IgM antibody MAC ELISA and 15.68 % (331 / 2110) was MAC ELISA positive. Out of all NS1 antigen positive cases 34.88 % of PCR positive and serotype characterisation showed DENV - 1 was predominant serotype followed by DENV - 2 and DENV - 4 respectively. ConclusionsThere is a rising trend of Dengue virus infection in Tripura with circulation of multiple serotypes. Moreover, cocirculation of multiple serotypes is a risk to the emergence of recombinant strains and also heterotypic infection in the near future might lead to development of DHF and DSS. Hence, molecular characterization of circulating serotypes may be helpful in addressing the probabilities of Dengue outbreak and possibilities of complications.
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El rápido aumento de la obesidad infantil se ha asociado al elevado consumo de alimentos procesados de alta densidad energética e insuficiente actividad física. Chile el año 2016, implementó la Ley 20.606 sobre Composición Nutricional de los Alimentos y su Publicidad, que prohíbe la publicidad de alimentos altos en calorías, grasas saturadas, azúcares y sodio para los niños menores de 14 años y la venta de estos alimentos al interior de las escuelas. El objetivo de este trabajo fue identificar los cambios en la oferta y consumo de alimentos de los kioscos escolares en escuelas públicas de Chile con la implementación de la Ley 20.606 sobre Composición Nutricional de los Alimentos y su Publicidad. Se hizo so de un estudio longitudinal. La muestra provino del estudio "Efectividad de una intervención en alimentación y actividad física orientada a controlar la obesidad en niños pertenecientes a escuelas públicas en escuelas de tres regiones del país" (estudio KIND), alcanzando 351 escolares de 8 a 14 años pertenecientes a tres escuelas municipalizadas. Para analizar la oferta en el kiosco se registraron en una base Excel todos los alimentos junto a su aporte nutricional, para el consumo de alimentos, se aplicó la encuesta utilizada en el estudio KIND y la medición del estado nutricional fue realizada por nutricionistas previamente estandarizadas. Se utilizó de la línea base la información obtenida en el estudio KIND, obtenida el año 2015 y se comparó con el año 2017 a través de Test de Mac Nemar y Test de proporciones para una muestra. Todos los análisis se realizaron con STATA 15 (Copyright 1984-2009 StataCorp). Los alimentos procesados y ultra procesados (84,8%) siguen siendo los más ofertados dentro de los kioscos en donde destacan los snacks dulces y los caramelos, manteniéndose la oferta al interior y exterior de las escuelas. Los grupos de alimentos que los niños prefieren comprar y traer desde la casa en ambos periodos analizados son los snacks dulces y las bebidas y jugos azucarados. Con la implementación de la Ley 20.606, disminuyó la variedad de alimentos ofertados altos en nutrientes críticos, sin embargo, se mantiene la oferta de alimentos ultra procesados y procesados en los kioscos escolares.
The fast growth in childhood obesity has been linked to the increased intake of high energy density processed food and poor physical activity. In 2016 in Chile the law 20.606 about Food Nutritional Composition and Advertisement, forbids the advertising of food with high calories, saturated fats, sugars, and sodium for children younger than 14 years and the sale of these food products inside schools. This work aimed to identify changes in the food supply and consumption in public school kiosks from Chile with the addition of the law 20.606 about Food Nutritional Composition and Advertisement. A longitudinal study was performed. The sample came from the study "Effectiveness of a food and physical activity intervention oriented to control obesity in children belonging to public schools from three regions of the country" (KIND study), reaching 351 students from 8 to 14 years belonging to three municipal schools. To analyze the supply at the kiosk, every food product along with its nutritional content was registered in an Excel base, for the intake of food it was used the survey from the KIND study and the nutritional state measurement was made by nutritionist standardized in advance. We used the baseline of the data obtained from the KIND study, this data was gathered in 2015 and we compared it to the one from 2017 using the Mac Nemar Test and the Test for proportions of a sample. Every analysis was made with STATA 15 (Copyright 1984-2009 StataCorp). Processed and ultra-processed food (84.8%) still is the most offered in the kiosks where the sweet snacks and candy are featured, keeping the supply at the inside and outside of schools. The foods that children prefer to buy and bring from home in both analyzed periods are the sweet snacks and sugary drinks and juices. With the addition of the law 20.606, the variety of the high critical nutrient food decreased, however, the supply of processed and ultra-processed food in school kiosks still remains.
Subject(s)
Humans , Male , Female , Child , Adolescent , Schools , Eating , Food Composition , Food Services , Obesity/epidemiology , Chile , Nutritional Status , Surveys and QuestionnairesABSTRACT
Objective: To investigate the clinical characteristics and prognostic factors associated with appendix-derived high-grade mucinous adenocarcinoma. Methods: A retrospective analysis of clinical and follow-up data of 60 patients with appendix-derived high-grade mucinous adenocarcinoma admitted to Aerospace Central Hospital between January 2013 and December 2017 was carried out. Results: Of the patients, 48% (29 cases) were men and 52% (31 cases) were women. The median age of the patients at admission was 57 (38-74) years. CEA levels increased in serum in 65% patients (39 cases) before operation, and hyperthermic intraperitoneal chemotherapy after operation accounted for 80% of the patients (48 cases). The 1-, 2- and 3-year survival rates were 80%, 58%, and 30%, respectively. The median survival time was 29 months. Univariate analysis showed that a lower peritoneal cancer index (PCI) score (P= 0.039) and a lesser degree of completeness of cytoreduction (CC) (P=0.002) were statistically significant in prolonging survival time. Multivariate analysis showed that the degree of CC could be an independent prognostic factor for overall survival (P=0.037). Conclusions: Appendix-derived high-grade mucinous adenocarcinoma is highly invasive and features a poor prognosis, but radical tumor reduction has a positive effect on prolonging the survival of patients. Early detection and early intervention are of great significance for the prognostic outcome.
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Mitral valve surgeries for cases with mitral annular calcification (MAC) are challenging because of the operative complications. For a case of MS with MAC, we achieved mitral valve plasty by ultrasonic decalcification alone. An 82-year-old male with edema and dyspnea was diagnosed with AS and MS with MAC. MAC was so severe that MVR was challenging. There were calcifications at the anterior commissure and the anterior mitral leaflet (AML), and removal of them was expected to improve the valve function. Therefore, anterior commissurotomy and ultrasonic decalcification of the anterior commissural annulus was performed using cavitron ultrasonic surgical aspiration (CUSA). Following the resection of the aortic valve, we carried out decalcification of the AML through the aortic valve orifice. After AVR, a trans-esophageal echocardiogram showed MS was ameliorated. Two years after surgery, recurrence of MS was not recognized. Some mitral cases with MAC can be treated by only decalcification to avoid risky valve replacement.
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This study aimed to determine and evaluate whether there are differences in values of MAC in wildlife captured guan (Penelope obscura) under different conditions of social stress. This study used 27 bird species guan (P. obscura), divided into two groups: animals kept in the same enclosure (Collective Group) and animals kept in individual cages (Individual Group). The research was conducted at the Advanced Research Base of IBAMA, Painel/SC, and at the Clinical Veterinary Hospital of the "Universidade do Estado de Santa Catarina", Lages/SC. The birds were captured using network trap with manual disarmament and transported to the Veterinary Hospital in cages. The animals were fasted for 2 to 6 hours before the procedure; anesthetic induction was performed with isoflurane for instrumentation. The isoflurane CAM was placed in the target value 1.3v% in the first animal of each group, and waited 15 minutes for the nociceptive (electric) stimulus, in the value of 50 hertz and 50mA, held in faradic form (3 consecutive simple stimuli, followed by 2 continuous stimuli). The stimulus was performed on the lateral side of the left pelvic limb in the tibiotarsal region, and the electrodes were fixed with a 22G needle at a distance of 5cm between them. The bird's responses to the stimulus were considered positive (wing movements, head or vocalization) or negative (not presented movements of wings, head or vocalization) and the MAC value of the animal was recorded. Negative responses reduced next birds' MAC value by about 10%, and MAC positive responses increased by about 10%. Statistical analysis was done by methods up and down and analyze quantal for MAC and paired t-test for equivalent or t-test for variances not equal variances for the physiological variables. At the end of the experiment, the birds were reintroduced in the same capture area. The MAC value of isoflurane in the Collective Group was 1.4v% and the Individual Group 1.9v% to 0.903atm. It is observed that guan (P. obscura) in the Collective Group showed lesser anesthetic resistance to isoflurane than the birds in the Individual Group, showing that some levels of social stress can influence the MAC values of the isoflurane.(AU)
Este estudo teve como objetivo determinar e avaliar se há diferença nos valores de CAM em jacus (Penelope obscura) capturados em vida livre e submetidos a diferentes condições de estresse social. Foram utilizadas 27 aves da espécie jacu (P. obscura) de vida livre, que depois de capturados foram alocados em dois grupos: 10 animais que permaneceram em grupo no mesmo recinto (Grupo Coletivo) e 17 animais que permaneceram em gaiolas individuais (Grupo Individual). A pesquisa foi realizada na Base de Pesquisa Avançada do IBAMA, Painel/SC, e no Hospital de Clínica Veterinária da Universidade do Estado de Santa Catarina, Lages/SC. A captura foi realizada utilizando armadilha de rede com desarmamento manual e as aves foram transportadas para o Hospital Veterinário em gaiolas. Os animais foram submetidos a um jejum alimentar de 2 a 6 horas antes do procedimento, a indução anestésica foi realizada com isoflurano para instrumentação. A CAM de isoflurano foi colocada no valor alvo 1,3v% no primeiro animal de cada grupo, e esperado 15 minutos para realização do estímulo nociceptivo (elétrico), no valor de 50 hertz e 50mA, realizado de forma farádica (3 estímulos simples consecutivos, seguidos de 2 estímulos contínuos). O estímulo foi realizado na face lateral do membro pélvico esquerdo na região tibiotársica, e os eletrodos fixados com agulha 22G a uma distância de 5cm entre elas. A resposta da ave ao estímulo foi considerada positiva (movimentos de asas, cabeça ou vocalização) ou negativa (não apresentou movimentos de asas, cabeça ou vocalização) e o valor de CAM do animal foi registrado. Para resultados negativos, a CAM da próxima ave foi reduzida em torno de 10%, para positivos a CAM foi aumentada em torno de 10%. A análise estatística foi feita pelos métodos up and down e análise quantal para a CAM e teste t de pareado para variâncias equivalentes ou teste t para variâncias não equivalentes para as variáveis fisiológicas. Ao final do experimento as aves utilizadas foram reintroduzidas na mesma área de captura. O valor da CAM de isoflurano no Grupo Coletivo foi de 1,4v% e no Grupo Individual a CAM de 1,9v% a 0,903atm, sendo o valor do Grupo Coletivo significativamente menor que o Grupo Individual. Observa-se assim que os jacus (P. obscura) que permaneceram em recinto coletivo apresentaram uma menor resistência anestésica ao isoflurano que as aves que permaneceram em recintos individuais, mostrando que alguns níveis de estresse social como os observados aqui podem influenciar sobre os valores da CAM do isoflurano.(AU)
Subject(s)
Animals , Stress, Psychological , Birds/physiology , Galliformes/physiology , Isoflurane/administration & dosage , Animals, WildABSTRACT
Introduction: Dengue virus transmitted by mosquitoes iswidely distributed throughout the tropics and subtropics. It isone of the most rapidly spreading mosquitos borne viraldisease in the world. In India specially, dengue has emergedas a matter of major concern because of its epidemicproportions. Therefore, early diagnosis for dengue is called for,to reduce the mortality and morbidity attributed to it.Aims and Objective: There are numerous methods for thediagnosis of dengue of which the serological tests play asignificant role. Various rapid ICT tests are being used in thelaboratories for the early diagnosis of dengue these days. Thepresent study aims to evaluate the performance of rapid ICTwith reference to MAC-ELISA for its role in diagnosis ofdengue.Methods and Materials: In the present study 305 suspectedsamples of dengue were collected during the month of October2017 to December 2017. All the samples were collected byaseptic techniques.Results: 92 samples were positive by Mac Elisa IgM Ab test.The prevalence of the disease was 30.16 %. When ICT IgM Abtest was compared with Elisa IgM capture Ab test a sensitivityof 95.65 % and specificity of 98.59 % was observed.Conclusion: The high sensitivity and specificity makes itsuitable to be used in acute diagnosis of dengue but Mac ElisaIgM capture Ab test combination will make it more reliable andconfirmatory.
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Previous studies have reported on the phytotherapeutic potential of propolis from southern Brazil (Urupema, Santa Catarina State), in particular, its efficacy in the treatment of bovine mastitis. The present study evaluates the effect of seasonal variation on the chemical composition of propolis from southern Brazil and its resultant antimicrobial and cytotoxic activities in the context of treating bovine mastitis. Antimicrobial activity against Staphylococcus aureus was assessed, along with the cytotoxicity and induction of apoptosis in MAC-T bovine mammary epithelial cells. With the exception of spring propolis, the flavonoid quercetin was the main compound present in all samples. The minimum inhibitory concentration (MIC) of propolis against S. aureus from mastitic milk was 140 µg/mL for samples collected during the spring, autumn, and winter seasons, but 280 µg/mL for samples collected in summer. For MAC-T cells, the spring propolis extract was more toxic with an IC50 of 120 µg/mL. However, for 120 µg/mL of spring propolis extract, only 0.77% of necrotic and 37% of apoptotic MAC-T cells were found, respectively. Nonetheless, the induction of cell death through apoptosis by propolis extract suggests less severe damage to bovine mammary glands. Moreover, only negligible seasonal variation was found in the chemical composition of propolis from southern Brazil, and no biological activities were determined to be harmful. Therefore, this propolis shows promise as an alternative to commercial antimicrobials in the control of bovine mastitis, offering support for organic milk production.(AU)
Estudos prévios tem demonstrado o potencial terapêutico da propolis do Sul do Brasil (Urupema, Santa Catarina), em particular no tratamento da mastite bovina. O presente estudo tem como objetivo avaliar o efeito da variação sazonal sobre a composição química da própolis de Urupema do Sul do Brasil e suas atividades antimicrobiana e citotóxica visando o tratamento da mastite bovina. A atividade antimicrobiana contra Staphylococcus aureus foi avaliada, juntamente com a citotoxicidade e indução de apoptose em células epiteliais mamárias bovina da linhagem MAC-T. Com exceção da própolis da primavera, o flavonóide quercetina foi o composto majoritário em todas as amostras. A concentração inibitória mínima (CIM) da propolis contra S. aureus de leite mastítico foi 140 µg/mL para as amostras de primavera, outono e inverno e 280 µg/mL para a amostra coletada no verão. Para as células MAC-T, o extrato de própolis da primavera foi o mais tóxico, sendo a IC50 120 µg/mL. Entretanto, com 120 µg/mL do extrato de própolis primaveril, somente 0,77% de células MAC-T necróticas e 37% apoptóticas foram encontradas. Portanto, a indução da morte celular por apoptose pelo extrato de própolis sugere danos possivelmente menos graves a glândula mamária bovina. Além disso, somente uma pequena variação sazonal foi encontrada para a composição química da propolis do Sul do Brasil, a qual não prejudicou suas atividades biológicas. Portanto, esta própolis mostra como uma alternativa promissora ao uso de antimicrobianos comerciais no controle da mastite bovina e uma opção para subsidiar a produção orgânica de leite.Palavras-chave: Células MAC-T. Mastite bovina. Propolis brasileira. Staphylococcus aureus.(AU)
Subject(s)
Animals , Female , Cattle , Staphylococcus aureus/pathogenicity , Mastitis, Bovine , Propolis , SeasonsABSTRACT
A 78-year-old woman was referred to our hospital because of progressive exertional dyspnea due to nonrheumatic severe aortic valve stenosis and moderate mitral valve stenosis with mitral annular calcification. We subsequently performed aortic valve replacement and mitral anterior leaflet decalcification. During surgery, we found that the cause of mitral valve stenosis was calcification of A2 aortic curtain-medial trigon through aortic valve annulus and resected calcification with SONOPET. The postoperative echocardiography revealed good mitral valve motion with mild mitral valve stenosis.
ABSTRACT
Introducción: En la Argentina, hay 754.600 nacimientos por año, de los cuales el 15% proviene de madres adolescentes de entre 15 a 19 años. Este porcentaje varía en las diferentes provincias, siendo mayor en el Noreste y Noroeste argentino. El 65.5% de ellas no usaba ningún método anticonceptivo al momento de la concepción, muchas de ellas por desconocimiento sobre salud reproductiva. La alta frecuencia de embarazos en la población adolescente, muchos de ellos no planeados, aumenta el riesgo de exposición a un aborto inseguro, abandono escolar y de limitaciones en el acceso al mercado laboral, condicionando así las perspectivas de desarrollo personal. Es evidente que la diversidad de manifestaciones clínicas de esta entidad hace que ante la consulta del adolescente no siempre se lo tenga presente como posible diagnóstico diferencial en primera instancia. Considerar el embarazo a tiempo optimizaría la atención al brindar información a la paciente y al realizar la derivación a un centro especializado para su seguimiento. Asimismo también se evitaría la utilización de métodos diagnósticos o terapéuticos que resulten nocivos para el producto de la gestación. Objetivos: Describir los motivos de consulta realizados por pacientes adolescentes menores de 19 años, en el Hospital Garrahan durante el período comprendido entre 2012 y 2016, que concluyeron con el diagnóstico de embarazo. Describir el número de consultas, y exámenes complementarios solicitados hasta que se arribó al diagnóstico. Metodología: estudio retrospectivo, descriptivo observacional, a través del análisis de las historias clínicas (HC) y base de datos del laboratorio de todas las pacientes femeninas menores de 19 años, que hayan consultado en el periodo comprendido entre 2012 a 2016. Resultado: Se obtuvo un total de 46 pacientes adolescentes con diagnóstico de embarazo. Si bien el síntoma más frecuente fue la alteración del ciclo menstrual, sólo en el 50% fue lo que motivó la consulta. En el 74% de los casos el diagnóstico se realizó en la primera atención. En el 33% de las pacientes no se registró en la HC el uso de MAC (Métodos Anti Conceptivos). En los casos que se interrogó acerca del uso de MAC, sólo el 55% lo hacía en forma correcta. Conclusión: El diagnóstico de embarazo debe considerarse frente a la consulta de pacientes adolescentes. Es necesario pesquisar la existencia de alteraciones en el ciclo menstrual y el uso de MAC en esta población (AU)
In Argentina, there are 754,600 births yearly, of which 15% are to adolescent mothers between 15 and 19 years of age. This percentage varies according to the different provinces, and is higher in the north-east and north-west of the country. Of the mothers, 65.5% did not use any contraceptive method at the moment of conception, in many of them due to lack of knowledge of reproductive health. The high rate of teenage pregnancies, many of them unplanned, increases the risk of exposure to unsafe abortions, school drop-out, limitation to access to the labor market thereby reducing perspectives of personal development. Clearly, the variability of clinical manifestations associated with this entity, in an adolescent pregnancy is not always considered as an early differential diagnosis. Early awareness of pregnancy would improve care by providing information to the patient and referral to a specialized center for follow-up. Additionally, the use of diagnostic or therapeutic methods that are harmful for the fetus are avoided. Objectives: To describe the reasons for consultation of teenage patients under 19 years of age at Garrahan Hospital between 2012 and 2016, in whom finally the diagnosis was pregnancy and to describe the number of consultation and complementary exams previous to the diagnosis. Methodology: A retrospective, descriptive, observational study was conducted through the analysis of clinical charts (CC) and laboratory data base of all female patients younger than 19 years of age that consulted between 2012 and 2016. Results: 46 teenage patients with the diagnosis of pregnancy were identified. Although the most frequent symptom was alteration of the menstrual cycle, this was the reason for consultation in only 50%. In 74% of the cases the diagnosis was made in the first visit. In 33% of the patients the use of methods of contraception (MOC) was not recorded in the CC. When the patient was asked about the use of MOC, only 55% used them correctly. Conclusion: The diagnosis of pregnancy should be considered in teenage patients. Screening for alterations in the menstruation and the use of MOC is necessary in this population (AU)
Subject(s)
Humans , Female , Adolescent , Argentina/epidemiology , Contraceptive Agents, Female , Pregnancy in Adolescence/statistics & numerical data , Pregnancy, Unwanted , Signs and Symptoms , Retrospective StudiesABSTRACT
Background: In anesthetic practice, the introduction of multiple novel laryngoscopes has simplified visualization of the vocal cords and has reduced the complications arising due to difficult or failed tracheal intubation Both Truview scope and C-Mac video laryngoscope have been reported to provide a comparable or superior glottic view on comparison with conventional Macintosh laryngoscope Materials and methods: A randomized controlled study was conducted in 100 subjects scheduled for elective surgery equally divided into 2 groups Conventional Macintosh laryngoscopy was done initially in all subjects enrolled for the study For the Glottic view, One Group (n=50) underwent Truview laryngoscopy while the other (n=50) underwent C-Mac video laryngoscopy Results: The improvement in glottic view from original MCL (Modified Cormack & Lehane) grading obtained from Macintosh laryngoscope was 40% (n=23) in Truview compared to 46% (n=23) in CMac video laryngoscope while downgrading of view was observed in 10% (n=5) in group– T compared to none in C-Mac video laryngoscope There were no statistically significant difference in Intubation Difficulty Scale (IDS) scores between the groups (P = 0072) The mean duration of time R Vimal, A Sivanoli Comparison of Truviewscope and C-Mac Video Laryngoscope with the Conventional Macintosh Laryngoscope in Improving the Glottic View during Endotracheal Intubation IAIM, 2018; 5(12): 125-133 Page 126 for endotracheal intubation with C-Mac video laryngoscope (2310 seconds) was significantly shorter compared with Truview laryngoscope (3126 seconds) Conclusions: There was an improvement in view of the glottis in both Truview and C-Mac video laryngoscope from the initial Macintosh laryngoscope view But C-Mac video laryngoscope offered better view improvement and also required a shorter time for intubation compared to Truview laryngoscope
ABSTRACT
BACKGROUND: Wisteria floribunda agglutinin-positive Mac-2 binding protein (WFA-M2BP) is a protein with altered glycosylation that reacts with lectin, and was recently identified as a useful non-invasive biomarker for the diagnosis of liver fibrosis in patients with hepatitis C virus infection.This study aimed to evaluate the diagnostic efficacy of WFA-M2BP for liver fibrosis in the context of hepatitis B virus (HBV). METHODS: We enrolled 151 patients infected with HBV. Liver biopsy and elastography (Fibroscan) were performed during the initial visit. Fibrosis was graded according to the Knodell histologic activity index (F0–3). WFA-M2BP levels were determined with an automated immunoassay analyzer (M2BPGi, HISCL-5000, Sysmex, Japan). The diagnostic efficacy of WFA-M2BP was compared with those of various conventional or composite biomarkers, including enhanced liver fibrosis (ELF) score, Fibroscan, aspartate transaminase (AST)-to-platelet ratio index (APRI), and FIB-4, based on the area under the ROC curve (AUC) value. RESULTS: The majority of patients were at fibrosis stages F1 and F2. The F2 and F3 AUC values for WFA-M2BP were similar to those for FIB-4, APRI, ELF, and Fibroscan, although the latter showed the best diagnostic efficacy. The diagnostic accuracy of all tested biomarkers for F2 and F3 was 60–70%. In multivariate analysis, WFA-M2BP, ELF, and platelet count significantly predicted stage ≥F2, whereas only platelet count significantly predicted F3. CONCLUSIONS: WFA-M2BP can support a diagnosis of liver fibrosis with similar diagnostic efficacy to other biomarkers, and predicted liver fibrosis stage ≥2 among patients with chronic hepatitis B.
Subject(s)
Humans , Area Under Curve , Aspartate Aminotransferases , Biomarkers , Biopsy , Carrier Proteins , Diagnosis , Elasticity Imaging Techniques , Fibrosis , Glycosylation , Hepacivirus , Hepatitis B , Hepatitis B virus , Hepatitis B, Chronic , Hepatitis, Chronic , Immunoassay , Liver Cirrhosis , Liver , Multivariate Analysis , Platelet Count , ROC Curve , WisteriaABSTRACT
Huge goitor can lead to tracheal compression and hence difficulty in intubation. This is compounded by severe obesity. Failed tracheal intubation in difficult intubation is a serious event that may lead to increased patient morbidity and mortality. Current intubation rescue techniques and combination of different rescue techniques may increase the success rate of difficult intubation. In a 47-year-old female patient, with severe obesity and a huge goiter, our attempts at intubation using direct laryngoscope, video laryngoscope, and awake fiberoptic bronchoscope had failed. We succeeded by applying video laryngoscope to improve visualization of the airway and fiberoptic bronchoscope as a stylet for endotracheal tube.
Subject(s)
Female , Humans , Middle Aged , Airway Management , Bronchoscopes , Goiter , Intubation , Laryngoscopes , Mortality , Obesity, MorbidABSTRACT
Introducción Las roturas masivas del manguito de los rotadores representan una de las lesiones más complejas a las cuales se puede enfrentar el ortopedista especialista en hombro y son un gran reto cuando se desean lograr resultados clínicos satisfactorios. El objetivo del trabajo es describir los resultados clínicos de una nueva técnica quirúrgica para la reparación artroscópica de lesiones grandes y masivas del manguito de los rotadores (MR) utilizada en una clínica ortopédica especializada durante un período de 3 años. Materiales y métodos Se realizó un estudio descriptivo de una cohorte de pacientes con lesiones grandes y masivas del MR, diagnosticados mediante artrorresonancia directa y que cumplían criterios para reparación artroscópica, a los cuales se les realizó la reparación mediante una nueva técnica denominada doble MAC. Se analizaron como desenlaces la escala de Constant postoperatoria, la existencia de complicaciones y el grado de satisfacción de los pacientes con el procedimiento. Resultados Se evaluó a 21 pacientes (10 hombres y 11 mujeres) con una media de edad de 59,4 años (DE: 8,2) en el momento de la cirugía. Las roturas comprometieron el músculo supraespinoso en todos los casos y en el 42,8% el infraespinoso con un tamaño medio de rotura de 34,5 mm (DE: 11,2). El tiempo entre la cirugía y la evaluación fue, por término medio, de 9 meses. La escala de Constant postoperatoria fue, por término medio, de 77,4 (DE: 9,0). No se presentaron complicaciones en la cirugía o falla de los anclajes. Solo un paciente presentó capsulitis adhesiva temprana, que se trató con movilización articular, con la cual se logró normalizar todos los arcos de movilidad. Discusión La técnica doble MAC para la reparación artroscópica de las lesiones grandes y masivas del manguito de los rotadores es una técnica segura y efectiva, con buenos resultados funcionales evaluados a medio plazo y un porcentaje de satisfacción superior al 90%. Nivel de evidencia clínica Nivel IV.
Background Massive ruptures of the rotator cuff represent one of the most complex lesions that can be faced by the orthopaedic shoulder surgeon, and pose a great challenge to achieve satisfactory clinical results. The aim of this study is to describe the clinical outcomes of a new surgical technique for the repair of large and massive rotator cuff injuries used in a specialised orthopaedic clinic during a period of 3 years. Materials and methods A descriptive study was carried out on a cohort of patients with large and massive lesions of the rotator cuff, diagnosed by direct arthro-resonance, and who met criteria for arthroscopic repair. They underwent repair using a new technique called double MAC (Mason-Allen configuration). The post-surgical outcomes were measured using the Constant scale, and the presence of complications and the level of patient satisfaction with the procedure were analysed as outcomes. Results There were 21 patients (10 men and 11 women) with mean age of 59.4 (SD: 8.2) years at the time of surgery. A supraspinatus rupture was present in all (100%) of patients, and an infraspinatus rupture was present in 42.8%.. The mean size of the tear was 34.5 mm (SD: 11.2). Mean time between surgery and assessment was 9 months. Mean post-operative Constant score was 77.4 (SD: 9.0). There were no surgical complications or anchor failure. An early adhesive capsulitis was diagnosed and managed with articular mobilisation, with subsequent improvement in range of motion. Discussion Double MAC technique for arthroscopic repair of large and massive RCT is a safe and effective technique, with good clinical outcomes in the medium term and a patient satisfaction of over 90%. Evidence Level IV.