RESUMEN
Introducción: la Rinosinusitis Crónica se define como la inflamación crónica de la nariz y los senos paranasales por más de 12 semanas. La prevalencia varía entre el 5% - 30% de acuerdo con la zona geográfica según un estudio de carga de enfermedad (2012-2014), la prevalencia de las enfermedades respiratorias crónicas (rinitis y sinusitis crónica) varió entre el 10% y el 25%. Objetivo: establecer un conjunto de consideraciones basadas en consenso de expertos, para el diagnóstico y el tratamiento de la rinosinusitis crónica en pacientes adultos, en el contexto colombiano. Métodos: se llevó a cabo un consenso formal (Delphi y nominal). Se conformó un grupo de expertos, se definieron el alcance y las preguntas. Se realizaron dos rondas de calificación anónimas, y una discusión para las preguntas sin consenso. En las preguntas con opciones de uno a nueve, se consideró consenso con una mediana de uno a tres o de siete a nueve. En las preguntas tipo Likert, se consideró consenso un porcentaje igual o superior al 80% en acuerdos o desacuerdos. Resultados: se definieron y calificaron 18 preguntas, con la participación de 17 otorrinolaringólogos, de 8 ciudades colombianas, todos miembros de la Asociación Colombiana de Otorrinolaringología y con un promedio de experticia de 19.2 años (Desviación estándar [DE]: 10,2). Se obtuvieron 18 recomendaciones para el diagnóstico y el tratamiento de esta patología. Conclusiones: las recomendaciones emitidas por los expertos permiten orientar y estandarizar el diagnóstico y el tratamiento de la rinosinusitis crónica en adultos, en el contexto de los servicios de salud en Colombia.
Introduction: Chronic Rhinosinusitis is defined as chronic inflammation of the nose and paranasal sinuses for more than 12 weeks. The prevalence varies between 5% - 30% depending on the geographical area according to a disease burden study (2012-2014), the prevalence of chronic respiratory diseases (rhinitis and chronic sinusitis) varied between 10% - 25%. Objective: To establish a set of considerations based on expert consensus, for the diagnosis and treatment of chronic rhinosinusitis in adult patients, in the Colombian context. Methods: A formal consensus (Delphi and nominal) was carried out. A group of experts was formed, the scope and questions were defined. Two anonymous grading rounds were conducted, and a discussion for questions without consensus. In the Questions with options from one to nine were considered consensus with a median of one to three or seven to nine. In the Likert-type questions, a percentage equal to or greater than 80% in agreements or disagreements was considered consensus. Results: 18 questions were defined and scored, with the participation of 17 otorhinolaryngologists, from eight Colombian cities, all members of the Colombian Association of Otorhinolaryngology and with an average experience of 19.2 years (Standard desviation [SD]: 10.2). 18 recommendations were obtained for the diagnosis and treatment of this pathology. Conclusions: The recommendations issued by the experts allow to guide and standardize the diagnosis and treatment of chronic rhinosinusitis in adults, in the context of health services in Colombia.
Asunto(s)
Humanos , Sinusitis , Terapéutica , DiagnósticoRESUMEN
Abscisic acid (ABA) is associated with bud dormancy, leaf abscission, and germplasm growth inhibition in in vitro conservation. We evaluated the effects of ABA in four wild Manihot accessions and one cassava accession (M. esculenta Crantz) to refine in vitro conservation methods for these species. The experiment was performed at the Laboratory for Tissue Culture from Embrapa, Cruz das Almas, Bahia State, Brazil. The statistical design was completely random in a 5 × 5 factorial scheme [(5 ABA dosages (0, 0.25, 0.50, 0.75, and 1 mg L-1) and 5 Manihot species (M. pseudoglaziovii, M. tristis, M. flabellifolia, M. chlorosticta, and M. esculenta)], with 15 replicates. Mini-cuttings of 1 cm were used, each inoculated in 10 mL of modified Murashige and Skoog medium, solidified with Phytagel® (2.4 g L-1) containing the respective ABA dosages. Tubes containing these mini-cuttings were placed in a germplasm conservation room with an irradiance of 30 µmol m-2 s-1, temperature of 22 ± 1°C, and photoperiod of 12 hours. Plant height (cm), the number of living and senescent leaves, shoots, and mini-cuttings (1 cm), and fresh and dry weights of shoots and roots (mg) were evaluated after 150 days. Growth reduction was prominent in M. pseudoglaziovii, M. tristis, and M. flabellifolia during the in vitro conservation period. In the present study, the addition of ABA did not promote the expected re
Abscisic acid (ABA) is associated with bud dormancy, leaf abscission, and germplasm growth inhibition in in vitro conservation. We evaluated the effects of ABA in four wild Manihot accessions and one cassava accession (M. esculenta Crantz) to refine in vitro conservation methods for these species. The experiment was performed at the Laboratory for Tissue Culture from Embrapa, Cruz das Almas, Bahia State, Brazil. The statistical design was completely random in a 5 × 5 factorial scheme [(5 ABA dosages (0, 0.25, 0.50, 0.75, and 1 mg L-1) and 5 Manihot species (M. pseudoglaziovii, M. tristis, M. flabellifolia, M. chlorosticta, and M. esculenta)], with 15 replicates. Mini-cuttings of 1 cm were used, each inoculated in 10 mL of modified Murashige and Skoog medium, solidified with Phytagel® (2.4 g L-1) containing the respective ABA dosages. Tubes containing these mini-cuttings were placed in a germplasm conservation room with an irradiance of 30 µmol m-2 s-1, temperature of 22 ± 1°C, and photoperiod of 12 hours. Plant height (cm), the number of living and senescent leaves, shoots, and mini-cuttings (1 cm), and fresh and dry weights of shoots and roots (mg) were evaluated after 150 days. Growth reduction was prominent in M. pseudoglaziovii, M. tristis, and M. flabellifolia during the in vitro conservation period. In the present study, the addition of ABA did not promote the expected re