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1.
Artículo | IMSEAR | ID: sea-213033

RESUMEN

Restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) has become the standard surgical treatment for ulcerative colitis patients. Among others, it is important for clinicians to be aware of a rare, though urgent situation, the ileal pouch torsion. A high degree of suspicion is essential as obstruction due to pouch torsion is not likely to resolve conservatively. Delay in diagnosis and treatment can lead to pouch jeopardy and life-threatening complications. The aim of this study was to present a systematic review of the literature combined with the presentation of a case report of our department regarding this rare entity. A systematic literature review according to QUORUM guidelines was conducted in July 2019 using MEDLINE, SCOPUS, and COCHRANE databases. We included studies reporting pouch torsion after IPAA in English or German language with no restriction regarding publication time.  Outcomes after different treatment options, such as operative pouch detorsion, and/or pouchpexy, and/or pouch reconstruction, and/or end-ileostomy through laparoscopic or open procedures were evaluated. We identified 170 publications. After duplicates and irrelevant articles have been excluded, 25 publications remained for full-text review. Finally, 12 articles were included in this systematic review, concerning 14 cases. To the best of our knowledge, this is the first comprehensive systematic review on this topic to date.

2.
Artículo | IMSEAR | ID: sea-195974

RESUMEN

Background & objectives: Tyrosine kinase inhibitors (TKIs) targeting the epidermal growth factor receptor (EGFR) have been evaluated in patients with advanced non-small cell lung cancer (NSCLC). Erlotinib and gefitinib are the first-generation EGFR-TKIs for patients with NSCLC. However, there is a paucity of studies comparing the effectiveness of these two drugs. Hence, this study was aimed to compare the effectiveness and safety of erlotinib and gefitinib in NSCLC patients. Methods: This study included 71 NSCLC patients who received EGFR-TKIs between 2013 and 2016. Adverse drug reaction of both erlotinib (n=37) and gefitinib (n=34) was determined and graded according to Common Terminology Criteria for Adverse Events grading system. Effectiveness was measured using response evaluation criteria in solid tumours and progression-free survival (PFS). Pharmacoeconomic analysis was performed by cost-effective analysis. Results: When comparing safety profile, both the drugs had similar adverse events except for dermal side effects such as acneiform eruption (51.4%), rash (54.05%) and mucositis (59.5%) for erlotinib and 20.6, 26.5 and 29.4 per cent for gefitinib, respectively. The PFS of the two drugs was compared to differentiate the effectiveness of erlotinib and gefitinib. There was no significant difference between the effectiveness of the two drugs. The pharmacoeconomic analysis showed that gefitinib was more cost-effective than erlotinib. Interpretation & conclusions: This study showed that erlotinib and gefitinib had similar effectiveness but gefitinib had a better safety profile compared to erlotinib. Therefore, gefitinib could be considered a better option for NSCLC patients compared to erlotinib. However, further studies need to be done with a large sample to confirm these findings.

3.
Int. braz. j. urol ; 45(3): 468-477, May-June 2019. tab, graf
Artículo en Inglés | LILACS | ID: biblio-1012330

RESUMEN

ABSTRACT Introduction: To determine the impact of time from biopsy to surgery on outcomes following radical prostatectomy (RP) as the optimal interval between prostate biopsy and RP is unknown. Material and methods: We identified 7, 350 men who underwent RP at our institution between 1994 and 2012 and had a prostate biopsy within one year of surgery. Patients were grouped into five time intervals for analysis: ≤ 3 weeks, 4-6 weeks, 7-12 weeks, 12-26 weeks, and > 26 weeks. Oncologic outcomes were stratified by NCCN disease risk for comparison. The associations of time interval with clinicopathologic features and survival were evaluated using multivariate logistic and Cox regression analyses. Results: Median time from biopsy to surgery was 61 days (IQR 37, 84). Median follow-up after RP was 7.1 years (IQR 4.2, 11.7) while the overall perioperative complication rate was 19.7% (1,448/7,350). Adjusting for pre-operative variables, men waiting 12-26 weeks until RP had the highest likelihood of nerve sparing (OR: 1.45, p = 0.02) while those in the 4-6 week group had higher overall complications (OR: 1.33, p = 0.01). High risk men waiting more than 6 months had higher rates of biochemical recurrence (HR: 3.38, p = 0.05). Limitations include the retrospective design. Conclusions: Surgery in the 4-6 week time period after biopsy is associated with higher complications. There appears to be increased biochemical recurrence rates in delaying RP after biopsy, for men with both low and high risk disease.


Asunto(s)
Humanos , Masculino , Anciano , Complicaciones Posoperatorias/etiología , Prostatectomía/efectos adversos , Neoplasias de la Próstata/cirugía , Neoplasias de la Próstata/patología , Tiempo de Tratamiento , Complicaciones Intraoperatorias/etiología , Prostatectomía/métodos , Factores de Tiempo , Biopsia , Modelos Logísticos , Estudios Retrospectivos , Factores de Riesgo , Análisis de Varianza , Resultado del Tratamiento , Antígeno Prostático Específico/sangre , Medición de Riesgo , Progresión de la Enfermedad , Clasificación del Tumor , Persona de Mediana Edad , Recurrencia Local de Neoplasia , Estadificación de Neoplasias
4.
Arch. endocrinol. metab. (Online) ; 62(4): 410-415, July-Aug. 2018. tab, graf
Artículo en Inglés | LILACS | ID: biblio-950086

RESUMEN

ABSTRACT Objective: The association between coronary artery disease (CAD) and thyroid function remains controversial. We evaluated the thyroid function and graduated well-defined CAD as confirmed by quantitative coronary angiography (CA). Subjects and methods: We evaluated the serum TSH, free thyroxine, free triiodothyronine and thyroid antibody levels in 300 consecutive patients (age 61.6 ± 9.9 years and 54% were male) undergoing CAD diagnosis as confirmed by CA. Plaques with ≥ 50% stenosis being indicative of obstructive CAD, and patients were divided into groups according to main epicardial coronary arteries with plaques (0, 1, 2, 3). Lipid profiles and a homeostasis model assessment (HOMA-IR) were determined. Results: Serum median (25% and 75% percentile) TSH levels in patients with group 2 and 3 (2.25; 1.66-3.12 mU/L and 4.99; 4.38-23.60 mU/L, respectively) had significantly higher TSH concentrations (p < 0.0001) than the group 0 (1.82; 1.35-2.51 mU/L). Furthermore, patients of group 3 had higher TSH concentration (p < 0.0001) than those of group 1 (1.60; 0.89-2.68 mU/L). Group 3 were older (64 ± 8.5 vs. 59 ± 9.5, p = 0.001), had more patients with dyslipidemia (84% versus 58%, p < 0.001), male (54% versus 44%, p = 0.01), hypertension (100% versus 86%, p < 0.001), and smoking (61% versus 33%, p < 0.001) than group 0. Multivariate stepwise logistic analysis showed TSH, age, HbA1c, and HOMA-IR were the CAD associated variables. Conclusions: In this cohort, elevated TSH levels in the high normal range or above are associated with the presence and severity of CAD besides may represent a weak CAD risk factor.


Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Anciano , Enfermedad de la Arteria Coronaria/sangre , Tirotropina/sangre , Pruebas de Función de la Tiroides , Tiroxina/sangre , Triyodotironina/sangre , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Hemoglobina Glucada/análisis , Resistencia a la Insulina , Colesterol/sangre , Estudios Transversales , Factores de Riesgo , Factores de Edad , Angiografía Coronaria , Estenosis Coronaria/diagnóstico por imagen
5.
The Korean Journal of Internal Medicine ; : 284-289, 2018.
Artículo en Inglés | WPRIM | ID: wpr-713546

RESUMEN

Systemic lupus erythematosus (SLE), an autoimmune disease of unknown etiology, is characterized by the production of autoantibodies and end-organ damage. Lupus nephritis affects up to 70% of patients with SLE and is the most critical predictor of morbidity and mortality. The immunopathogenesis of SLE is complex and most clinical trials of biologics targeting immune cells or their mediators have failed to show efficacy in SLE patients. It has therefore become increasingly clear that additional, local factors give rise to the inflammation and organ damage. In this review, we describe recent advances in the role of renal resident cells, including podocytes, mesangial cells, and epithelial cells, in the pathogenesis of lupus nephritis.


Asunto(s)
Humanos , Autoanticuerpos , Enfermedades Autoinmunes , Productos Biológicos , Células Epiteliales , Inflamación , Lupus Eritematoso Sistémico , Nefritis Lúpica , Células Mesangiales , Mortalidad , Podocitos
6.
Vascular Specialist International ; : 51-60, 2018.
Artículo en Inglés | WPRIM | ID: wpr-742478

RESUMEN

PURPOSE: There is currently debate if brachio-basilic vein fistula (BBVF) should be performed as a one-stage or two-stage procedure. The aim of the present study was to perform a systematic review and meta-analysis on BBVF staging. MATERIALS AND METHODS: On February 25, 2016, a search for randomized-controlled trials (RCTs) on BBVF procedures was performed in MEDLINE and Scopus databases. Meta-analyses were performed with fixed-effect or random-effects models as appropriate with risk ratios (RRs). The primary efficacy and safety outcome measures were BBVF maturation and development of complications, respectively. Specific types of complications, including loss of functional secondary patency and long-term complications were all secondary outcome measures. RESULTS: We identified three RCTs reporting on 126 patients. Maturation failure of two-stage BBVFs (3/47, 6.4%) was less frequent than one-stage BBVFs (16/79, 20.3%; RR, 0.27; P=0.02). Complication rates of two-stage and one-stage BBVFs were similar (RR, 0.80; P=0.54), but on sensitivity analysis these were less likely to occur with two-stage BBVFs (37% vs. 69% for one-stage BBVFs; RR, 0.57; P=0.03). Two-stage BBVFs were less likely to lose their functional secondary patency (21.3% vs. 31.6% for one-stage BBVFs; RR, 0.61; P=0.11). This non-significant trend became significant (RR, 0.36; P=0.02) on sensitivity analysis. There was no difference in specific complication rates of the two study groups. CONCLUSION: Among candidates for BBVF fistula, there is evidence to suggest that two-stage BBVFs achieve higher maturation rates compared to one-stage BBVFs. The evidence for difference in long-term secondary patency is less robust, calling for further research.


Asunto(s)
Humanos , Fístula Arteriovenosa , Fístula , Oportunidad Relativa , Evaluación de Resultado en la Atención de Salud , Diálisis Renal , Venas
8.
Rev. bras. entomol ; 60(4): 302-307, Oct.-Dec. 2016. tab
Artículo en Inglés | LILACS | ID: biblio-829865

RESUMEN

ABSTRACT A review of bee species used as hosts of mutillid wasps in the Neotropical region is presented. Three new confirmed host records are provided for the mutillid species Hoplomutilla biplagiata Mickel, 1939, Pappognatha limes Mickel, 1939, and Tallium aracati Casal, 1962. Two potential host records are provided for Euspinolia rufula Mickel, 1938 and Lophomutilla inca Fritz and Pagliano, 1993. Additionally, Mutilla hoplitiformis Strand, 1909, is transferred to the genus Darditilla. Correlations between host nesting habits and female mutillid morphology are discussed. Lastly, all known confirmed and potential host records in the Neotropical region are compiled.

9.
Rev. bras. cardiol. invasiva ; 22(4): 324-332, Oct-Dec/2015. tab, graf
Artículo en Portugués | LILACS | ID: lil-744581

RESUMEN

Introdução: O stent farmacológico liberador de sirolimus Firebird® já demonstrou eficácia na inibição de hiperplasia neointimal em pacientes selecionados submetidos à intervenção coronária percutânea. Nosso objetivo foi avaliar o desempenho e o resultado clínico tardio do dispositivo Firebird® em pacientes submetidos à intervenção coronária percutânea na prática diária nacional. Métodos: O Registro CLARIFIRE foi um estudo prospectivo, não randomizado, multicêntrico, que incluiu 455 pacientes (536 lesões) em 14 centros no Brasil entre dezembro de 2008 e maio de 2011. O seguimento clínico foi realizado aos 1, 6, 12 e 24 meses, e os eventos adversos foram adjudicados por um Comitê de Eventos Clínicos independente. Resultados: A média das idades foi de 61,1 ± 10,4 anos, 30,8% eram do sexo feminino, 41,9% tinham diabetes e 58,2% apresentaram-se com angina estável. O vaso-alvo mais prevalente foi a artéria descendente anterior (46,5%), 29,9% eram lesões reestenóticas e 8% lesões em bifurcação. Foram implantados 613 stents e as médias de extensão e diâmetro nominal dos stents foram 22,0 ± 6,4 mm e 2,90 ± 0,40 mm, respectivamente. O sucesso do procedimento foi de 97,6%. A taxa cumulativa de eventos cardíacos adversos maiores aos 12 meses (desfecho primário) foi 8,1%. Considerando-se os eventos pós-hospitalização até 24 meses (409/455), observaram-se eventos cardíacos adversos maiores em 9,8%, morte cardíaca em 3,9% e revascularização do vaso-alvo em 7,6%. Já a trombose de stent (definitiva/provável) ocorreu em nove casos (2%) até 30 dias, sem ocorrências subsequentes. Conclusões: O stent farmacológico liberador de sirolimus Firebird ® demonstrou desempenho favorável, Além de segurança e eficácia sustentadas no tratamento de pacientes da prática diária, conforme evidenciado pela elevada taxa de sucesso do procedimento e pela ocorrência relativamente baixa de eventos adversos ao final de 2 anos...


Background: The Firebird™ sirolimus-eluting stent has proven to be effective in inhibiting neointimal hyperplasia in selected patients undergoing percutaneous coronary intervention. Our objective was to evaluate the performance and long-term outcomes of Firebird ™ in patients undergoing percutaneous coronary intervention in daily practice in Brazil. Methods: The CLARIFIRE Registry was a prospective, non-randomized, multicenter study enrolling 455 patients (536 lesions) in 14 Brazilian sites between December 2008 and May 2011. Clinical follow-up was performed at 1, 6, 12, and 24 months, and adverse events were adjudicated by the independent Clinical Events Committee. Results: Mean age was 61.1 ± 10.4 years, 30.8% were women, 41.9% had diabetes, and 58.2% had stable angina. The left anterior descending artery was the most prevalent target vessel (46.5%), 29.9% were restenotic lesions, and 8% were bifurcations. Six hundred and thirteen stents were implanted, and the mean nominal stent length and diameter were 22.0 ± 6.4 mm and 2.90 ± 0.40 mm, respectively. Procedural success was 97.6%. The cumulative major adverse cardiac events rate at 12 months (primary endpoint) was 8.1%. Considering post-discharge events up to 24 months (409/455), major adverse cardiac events were observed in 9.8%, cardiac death in 3.9%, and target vessel revascularization in 7.6% of the patients. Definite/probable stent thrombosis was observed in nine cases (2%) up to 30 days, and no further occurrences were found. Conclusions: The Firebird ™ sirolimus-eluting stent has demonstrated good performance and sustained safety and efficacy for patients treated in daily practice, as evidenced by the high procedural success rates and relatively low adverse event rates after 2 years...


Asunto(s)
Humanos , Masculino , Femenino , Anciano , Stents Liberadores de Fármacos , Enfermedad de la Arteria Coronaria/terapia , Sirolimus , Resultado del Tratamiento , Diabetes Mellitus , Electrocardiografía/métodos , Inhibidores de Agregación Plaquetaria/administración & dosificación , Intervención Coronaria Percutánea/métodos , Polímeros , Estudios Prospectivos , Vasos Coronarios/fisiopatología
10.
Frontiers in Biomedical Technologies. 2014; 1 (1): 35-41
en Inglés | IMEMR | ID: emr-191534

RESUMEN

Purpose: Integrin alph beta is a promising imaging target of angiogenic activity which is up-regulated on activated but not on quiescent endothelial cells. Molecular imaging of alph beta integrin expression with the aid of a dedicated high resolution gamma camera, is a very sensitive imaging approach for the evaluation of angiogenesis in the rabbit hindlimb ischemia model. Furthermore, in order to evaluate the whole spectrum of endogenous process of collateralization after occlusion of an rtery, Digital Subtraction Angiography [DSA] was also used for the visualization of larger collaterals. Methods: The study included seven New Zealand White rabbits that underwent unilateral percutaneous endovascular embolization of the femoral artery, for the establishment of hindlimb ischemia that triggers the endogenous process of collateralization. The contralateral limb was not embolized and served as a control. The radiotracer that was employed for the angiogenesis imaging, was a 99 mTc labeled cyclic RGD peptide [[c RGDfk-His]-99mTc] that binds specifically to alph beta integrin via a three amino acid sequence [Arginine-Glycine-Aspartic acid or RGD]. Image acquisition was performed with a high resolution gamma camera and all animals underwent molecular imaging on the 3rd day and the 9th day post-embolization. In all animals DSA was performed on the 9th day post-embolization. Results: The acquired images demonstrated the retention of the radiotracer at the ischemic tissue is remarkably increased compared to the non-ischemic hindlimb [normal limb] [mean value 16020 +/- 2309 vs. 13139 +/- 2493 on day 3; p=0.0014 and 21616 +/- 2528 vs. 13362 +/- 2529 on day 9; p<0.0001, respectively. In addition, radiotracer retention in normal limbs seemeds to be increased at day 9 in normal limbs compared to day 3 [p=0.0112]. DSA demonstrated the mean vessel length detected was significantly superior in the normal compared to the ischemic limb at day 9 [mean value 3680 +/- 369.8 vs. 2772 +/- 267.7; p< 0.0001, respectively]. Conclusion: Angiogenesis was successfully detected using a 99 mTc labeled cyclic RGD peptide molecular imaging technique and was significantly more pronounced in the ischemic compared to normal limbs, both at 3rd and 9th days after embolization. The peak of the phenomenon was detected at 9?th days. Finally increased retention of radiotracer in normal limbs at day 9 indicates presence and gradual accumulation of activated endothelium in normal tissues as well

11.
Rev. Hosp. Clin. Univ. Chile ; 25(1): 54-60, 2014. tab
Artículo en Español | LILACS | ID: lil-786970

RESUMEN

Clinical simulation is a technique with multiple benefits. Supervised professional practice results the best predictor of performance quality of a determined clinical skill. The “Summary of Medical Knowledge” course considers within its objectives enhancing necessary clinical skills before graduating, which is done through clinical simulation. Materials and methods: Voluntary participating activity was developed, considering performance in 5 clinical stations, which were assessed by Objective Structured Clinical Examination (OSCE). This activity was held at the Clinical Skill Centre, Faculty of Medicine, University of Chile. The evaluated skills were chosen based on information provided by graduates 2010-2012 about their own perception of competences. Results: 89 students and 53 teachers participated voluntarily. Over 90 percent of respondents (both teachers and students) stated that the activity was a great contribution to become aware of their own skills and limitations, resulting relevant and essential for medical training. Discussion: Simulation is feasible as a method of training in undergraduates, with a high rate of satisfaction for both students and teachers, encouraging the acquisition of clinical skills.


Asunto(s)
Humanos , Competencia Clínica , Educación Médica , Conocimiento
12.
Rev. bras. cardiol. invasiva ; 21(4): 373-377, out.-dez. 2013. tab
Artículo en Portugués | LILACS, SES-SP | ID: lil-703690

RESUMEN

INTRODUÇÃO: Escassos são os estudos a respeito da Qualidade de Vida pós-intervenção coronária percutânea (ICP), pelas vias radial e femoral, e dos gastos comparando as duas vias de acesso. Comparamos os desconfortos relacionados ao procedimento e os custos da ICP pelos acessos radial e femoral na fase hospitalar. MÉTODOS: Registro prospectivo, unicêntrico, que incluiu pacientes submetidos à ICP eletiva. As queixas relacionadas ao procedimento foram avaliadas ao final do período de repouso no leito, por meio de um questionário específico. Foram computados os custos por unidade de todo o material utilizado na ICP. RESULTADOS: Os pacientes tratados por via radial eram mais jovens, do sexo masculino e a angina estável foi o quadro clínico mais frequentemente tratado nos dois grupos. O tempo de exame, o número de vasos tratados e stents por paciente foram semelhantes entre os grupos. Não ocorreram complicações vasculares maiores após a ICP. Observamos maior desconforto geral associado ao procedimento (60,3% vs. 81,0%; P = 0,01), dor nas costas (1,7% vs. 17,2%; P < 0,01), dificuldade para urinar (1,7% vs. 12,1%; P = 0,03) e dependência do paciente para desempenhar atividades básicas (70,7% vs. 98,3%; P < 0,01) durante o período de observação no grupo femoral. Na comparação dos gastos, não foram notadas diferenças significantes entre os grupos, com ou sem a inclusão dos custos dos stents. CONCLUSÕES: A ICP por via radial demonstrou trazer maior conforto para o paciente comparada à via femoral, durante a fase hospitalar. Os custos dos procedimentos pelas duas vias de acesso foram semelhantes.


BACKGROUND: There are few studies on quality of life and costs after percutaneous coronary intervention (PCI) using different vascular accesses. We have compared procedure-related discomforts and costs of PCI using the radial or femoral approaches during hospital stay. METHODS: Prospective, single center registry, including patients undergoing elective PCI. Procedure related complaints were assessed at the end of bed rest using a specific questionnaire. Costs per unit of all the materials used in PCI were taken into account. RESULTS: Patients treated by the radial approach were younger, male, and stable angina was the most common clinical presentation in both groups. Procedural duration, number of vessels treated and stents per patient were similar in both groups. There were no major vascular complications after PCI. We observed greater overall discomfort associated with the procedure (60.3% vs. 81.0%; P = 0.01), back pain (1.7% vs. 17.2%; P < 0.01), difficult urination (1.7% vs. 12.1%; P = 0.03) and patient's dependence to carry on basic activities (70.7% vs. 98.3%; P < 0.01) during the post-procedural observation period in the femoral group. No significant differences were observed between groups when costs were compared, with or without taking into account stent-related costs. CONCLUSIONS: PCI using the radial approach demonstrated to provide greater comfort for patients when compared to the femoral approach during hospitalization. Costs of the procedure using the two accesses were similar.


Asunto(s)
Humanos , Masculino , Femenino , Persona de Mediana Edad , Arteria Femoral/cirugía , Arteria Radial/cirugía , Intervención Coronaria Percutánea/efectos adversos , Intervención Coronaria Percutánea/métodos , Análisis de Varianza , Estudios Prospectivos , Calidad de Vida , Stents
13.
West Indian med. j ; 62(2): 122-126, Feb. 2013. ilus, tab
Artículo en Inglés | LILACS | ID: biblio-1045604

RESUMEN

OBJECTIVE: To analyse the sensitivity of Mycobacterium tuberculosis by nitrate reductase assay (NRA) and the Hain molecular line probe assay (LPA) in sputa of tuberculosis (TB)/HIV co-infected patients in Guyana. DESIGN: Sputum samples were collected from known TB patients at Georgetown Chest Clinic and were analysed at the Reference Laboratory, Guyana, over the period April 2010 to April 2011. RESULTS: Both methods recorded greater sensitivity for rifampin (RIF) than of isoniazid (INH). Both methods detected four RIF resistant, two INH resistant and two multi-drug resistant (MDR) strains and they had greater negative agreement indices than positive agreement indices. CONCLUSION: It was established that the sensitivity of Mycobacterium tuberculosis by the NRA and Hain LPA in TB/HIV co-infected patients has acceptable correlation and that HIV infection does not affect drug susceptibility testing.


OBJETIVO: Analizar la sensibilidad de Mycobacterium tuberculosis por medio del ensayo de nitrato reductasa (NRA) y el ensayo de sonda lineal (LPA) molecular de Hain en esputos de pacientes co-infectados TB/VIH en Guyana. DISEÑO: Muestras de esputo de pacientes de la Clínica del Tórax en Georgetown diagnosticados con tuberculosis, fueron analizadas en el Laboratorio de Referencias, en Guyana, en el período de abril de 2010 a abril de 2011. RESULTADOS: Ambos métodos registraron una mayor sensibilidad a la rifampicina (RIF) que a la isoniacida (INH). Ambos métodos detectaron cuatro cepas resistentes a RIF, dos resistentes a INH, y dos resistentes a mútiples medicamentos (RMM). Asimismo, presentaban mayores índices de concordancia negativa que de concordancia positiva. CONCLUSIÓN: Se estableció que la sensibilidad de Mycobacterium tuberculosis por medio del ensayo de NRA y el LPA de Hain en pacientes co-infectados TB/VIH, guarda una correlación aceptable, y que la infección por VIH no afecta la prueba de susceptibilidad a los medicamentos.


Asunto(s)
Humanos , Esputo/microbiología , Pruebas de Sensibilidad Microbiana , Infecciones por VIH , Mycobacterium tuberculosis/efectos de los fármacos , Antituberculosos/farmacología , Rifampin/farmacología , Población Rural , Tuberculosis Pulmonar/microbiología , Tuberculosis Resistente a Múltiples Medicamentos/microbiología , Farmacorresistencia Bacteriana Múltiple , Coinfección/microbiología , Guyana , Isoniazida/farmacología , Nitratos
15.
Artículo en Inglés | IMSEAR | ID: sea-156282

RESUMEN

Background. Availability of doctors at primary health centres (PHCs) is a major concern. We measured the operational availability of doctors in PHCs and examined the effect of residential distance and private practice. Methods. Thirty-six health centres, consisting of six randomly selected PHCs from six purposively chosen districts in Andhra Pradesh were studied. Cross-sectional data on residential distance, private practice and attendance pattern of 38 operationally available medical officers were analysed. Results. About 80% of doctors residing within 20 km attended their PHC on all 6 days of a week, compared with only 33% for those staying >40 km away. Among those staying >20 km away from their PHC, the odds of absenteeism by privately practising doctors was 3–24 times more than for those not practising privately. Conclusion. Residential distance seems to affect the operational availability of doctors. Private practice by doctors living within 20 km from the PHC does not seem to affect their operational availability. However, private practice by doctors staying >20 km away from their PHC may affect their availability.


Asunto(s)
Absentismo , Instituciones de Atención Ambulatoria , Estudios Transversales , Humanos , India , Médicos/provisión & distribución , Atención Primaria de Salud , Práctica Privada , Características de la Residencia
16.
International Eye Science ; (12): 1-4, 2010.
Artículo en Chino | WPRIM | ID: wpr-641469

RESUMEN

AIM: To study the effects of naringenin eye drops on NaIO3-induced retinal pigment epithelium (RPE) degeneration and laser-induced choroidal neovascularization (CNV) in rat eyes.METHODS: The 35mg/kg NaIO3-induced RPE degeneration was prevented by 10g/L naringenin eye drops 3 times a day for 7 days in advance of NaIO3 injection, and then 2 to 4 weeks thereafter, RPE function was measured with C-wave of electroretinogram (ERG). The laser-induced CNV rats were treated with laser to break the Bruchs membrane and the CNV formation was prevented by 10g/L naringenin eye drops instilled 3 times a day for 2 to 4 weeks. The CNV formation was measured with fluorescein angiography (FA) and flat mount. RESULTS: Two weeks after NaIO3 injection, the amplitude of ERG C-wave fell markedly in NaIO3 group to 53% of normal group (P<0.01). No apparent difference was observed in naringenin+ NaIO3 group. Four weeks later, the NaIO3 group fell to 37% of normal group (P<0.01), while the naringenin+ NaIO3 group fell to only 57% of normal group (P<0.01). There is a 52% reversal of the ERG C-wave by naringenin as compared to NaIO3 treated group (P<0.05). Two weeks and four weeks after laser treatment, naringenin reduced the CNV formation to 53% and 49% of control group (100%) measured by FA (P<0.01). Four weeks after laser treatment, naringenin reduced the CNV formation by 47% as compared to control group measured with flat mount (P<0.01).CONCLUSION: Naringenin significantly protected RPE from NaIO3 induced degeneration and can also prevent CNV formation.

17.
International Eye Science ; (12): 1455-1458, 2010.
Artículo en Chino | WPRIM | ID: wpr-641424

RESUMEN

AIM:To investigate the effect of flavone on ocular blood flow in rabbit eyes and the formation of choroidal neovascularization(CNV)in rat model of age-related macular degeneration(AMD).METHODS:In in vivo studies,colored microsphere technique was used to determine the ocular blood flow in ocular hypertensive rabbit eyes.The rat eyes were treated with 5g/L flavone eye drops 3 times a day for 1 week before and 4 weeks after laser-induced injury of Bruch's membrane.The development of CNV was determined by fluorescein angiography(FA)performed on weeks 2 and 4.In in vitro studies,the effect of flavone on the viability of HUVECs was measured by MTT assay.RESULTS:The ocular blood flow in rabbit eyes was significantly increased after flavone instillation.Flavone significantly inhibited the formation of laser induced CNV.In vitro resultsshowedthat fiavoneinhibited the proliferation of HUVECs.CONCLUSION:Flavone could increase ocular blood flow and inhibit the formation of CNV.

18.
International Eye Science ; (12): 1843-1847, 2010.
Artículo en Chino | WPRIM | ID: wpr-641410

RESUMEN

AIM: To study the effects of Tetramethylpyrazine (TMP) on retinal pigment epithelium (RPE) degeneration, choroidal blood flow and oxidative stress of RPE cells.METHODS: The 35mg/kg NaIO3-induced RPE degeneration rat eyes was given 25μg 1% TMP eye drops 3 times a day for 7 days before NaIO3 injection, and then 2 to 4 weeks after NaIO3 injection. RPE function was measured with c-wave of electroretinogram (ERG). Colored microsphere technique was used for in vivo experiments to determine the choroidal blood flow in ocular hypertensive (40mmHg) rabbit eyes. Methylthiazoltetrazolium (MTT) assay was used to study in vitro effect of TMP on various oxidants induced injury in the hRPE (ARPE-19 (ATCC, Manassas, VA, USA)) . RESULTS: Two weeks after NaIO3 injection, the amplitude of ERG c-wave fell markedly in NaIO3 group to 36% of control group (P<0.01). No apparent difference was observed in TMP+NaIO3 group. Four weeks later, the NaIO3 group fell to 46% of control group (P<0.01), while the TMP+NaIO3 group fell to only 77% of control group (P<0.01). There was a 67% reversal of the ERG c-wave by TMP as compared to NaIO3 group (P<0.01). The choroidal blood flow was significantly increased at all time points (at 30, 60 and 120 minutes after TMP instillation) as compared with corresponding controls. TMP had no effect on hypoxia-(1%O2), t-BHP- and H2O2-induced damage in RPE cells. 10μg/mL TMP could reverse 1 and 3mmol/L NaN3-induced loss of viability of RPE by 18.5% (P<0.01) and 23% (P<0.01), respectively. 30μg/mL TMP could reverse 30 and 100mmol/L NaIO3 induced loss of viability of RPE by 18.1% (P<0.05) and 16.8% (P<0.01), respectively.CONCLUSION: TMP can significantly protect RPE from NaIO3 induced degeneration in vivo and oxidative stress in vitro and can increase choroidal blood flow markedly in vivo .

19.
International Eye Science ; (12): 1641-1644, 2010.
Artículo en Chino | WPRIM | ID: wpr-641409

RESUMEN

AIM: To investigate the effect of flavone on oxidation-induced injury in retinal pigment epithelium(RPE) cells. METHODS: In in vivo studies, NaIO3-induced RPE degeneration in rat eyes were treated with 5g/L flavone eye drops 3 times a day for 1 week before and 4 weeks after NaIO3injection. At the end of 2 and 4 weeks, all rats were measured c-wave by electroretinogram(ERG). In in vitro studies,ARPE-19 cells were treated with hypoxia, H2O2, NaN3and t-BHP to induce cell damages. MTT assay was used to measure the viable cells. RESULTS: The ERG c-wave results showed that flavone reversed NaIO3-induced injury at the end of 4 weeks. In vitro results showed flavone reversed the various oxidants-induced injuries in RPE cells.CONCLUSION: Flavone could prevent the RPE from oxidation-induced injury both in vivo and in vitro.

20.
Salud pública Méx ; 51(supl.4): S657-S674, 2009. tab
Artículo en Español | LILACS | ID: lil-556076

RESUMEN

Se presentan los resultados de un estudio nutriológico en grupos de indígenas otomíes del Valle del Mezquital de México. La región es árida, estéril y económica y culturalmente una de las más deprimidas del país. Los habitantes comían muy pocos de los alimentos considerados comúnmente como esenciales para lograr una buena nutrición. Su consumo de carne, leche y sus derivados, frutas y verduras es extremadamente bajo. Sin embargo, por el consumo de tortillas, pulque y todas las plantas disponibles que se pueden considerar comestibles, se logra una dieta suficientemente adecuada.


Asunto(s)
Historia del Siglo XX , Humanos , Conducta Alimentaria , Indígenas Norteamericanos , Estado Nutricional , México
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