RESUMEN
Introducción: el traumatismo encéfalo craneano es una de las principales causas de muerte en nuestro medio, El tratamiento médico y quirúrgico en la etapa inicial de un TEC severo se enfoca en evitar la elevación de la Presión Intracraneana. Objetivo : describir características asociados y sus principales complicaciones en aquellos pacientes sometidos a Craniectomía Descompresiva. Métodos : Estudio retrospectivo observacional descriptivo, realizado entre febrero de 2018 a julio de 2020 de pacientes operados de Craniectomía Descompresiva unilateral, admitidos por traumatismo encefalocraneano. Resultados : 66.7% fueron personas menores de 40 años; 87,5% fueron de sexo masculino; 16,7% de la población ingresaron con una ECG de 13-15, 37,5% de la población con una ECG de 9-12; 42.9% presentaron asimetría pupilar; 33,3% ingresaron por accidente de tránsito; 21,7% fueron Marshall II, 65,2% Marshall III y en 13,0% se halló un Marshall IV. Conclusiones : Los resultados sugieren que las características asociadas a la Craniectomía Descompresiva por TEC contribuyen en el manejo de esta patología.
Introduction: Head trauma is one of the main causes of death in Peru. Medical and surgical therapy during the initial stages of severe head trauma focus in preventing the elevation of intracranial pressure. Objective: To describe the associated characteristics and main complications in patients undergoing decompressive craniectomy. Methods: This is a retrospective observational study performed between February 2018 and July 2020 in patients who had been admitted because of head trauma and who had undergone unilateral decompressive craniectomy. Results: Two-thirds (66.7%) of patients were persons less than 40 years of age; 87.5% were males; 16.7% were admitted with Glasgow Coma Score (GCS) scores between 13 and 15; 37.5% were admitted with GCS between 9 and 12; 42.9% had asymmetric pupils; 33.3% were admitted because of traffic accidents; 21.7% were Marshall II, 65.2% were Marshall III, and 13.0% were Marshall IV. Conclusions: Our results suggest that characteristics associated to decompressive craniectomy because of head trauma contribute for its proper management.
RESUMEN
We have cloned and sequenced ten Helicobacter pylori genes from a Chilean strain (CH-CTX1) including: a cytotoxin VacA fragment, a CagA fragment (A17), a species-specific protein (TsaA), urease subunits (UreA, UreB), a flagellin subunit (FlaB), heat shock proteins (HspA and HspB), adhesin (HpaA) and a lipoprotein (Lpp20). We compared their deduced amino acid sequences with the corresponding sequences from three unrelated H. pylori strains, including fully sequenced strains 26695(UK) and J99(USA), and found that eight of them (UreA, UreB, FlaB, HspA, HspB, Lpp20, TsaA and HpaA) presented more than 97.3% identity. In contrast, VacA partial sequence showed lower identity values (93.2-94.9%). Moreover, we found major differences in the A17 region respect to the number and arrangement of the internal repeated elements when sequences from different strains were aligned. The A17 regions from strains CH-CTX1 and 26695 are very similar (91.8% identity) but lacked 6 repeated elements when compared to the Australian strains ATCC 43526 and NCTC 11637. The CCUG 17874 A17 region showed the largest deletion involving 9 repeats. A17 size differences between strains CCUG 17874 and CH-CTX1 were verified by PCR and polypeptide size. Such differences may explain variations in virulence among H. pylori strains as well as diversity in serum immunoreactivity.