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1.
Neumol. pediátr. (En línea) ; 16(1): 17-22, 2021. ilus
Article in Spanish | LILACS | ID: biblio-1284149

ABSTRACT

Duchenne muscular dystrophy (DMD) is one of the most common neuromuscular diseases. Its evolution with well-defined stages related to motor and functional alterations, allows easily establishing relationships with respiratory function through a simple laboratory assessment including vital capacity (VC) measurements as well as peak cough flows. Without any treatment with respiratory rehabilitation, the main cause of morbidity and mortality is ventilatory failure, secondary to respiratory pump muscles weakness and inefficient cough. The VC plateau is reached during the non-ambulatory stages, generally after 13 years old. Respiratory rehabilitation protocols, including air stacking techniques, manual and mechanical assisted coughing and non-invasive ventilatory support, can effectively addressed the VC decline as well as the decrease in peak cough flows, despite advancing to stages with practically non-existent lung capacity. Non-invasive ventilatory support may be applied after 19 years old, initially at night and then extending it during the day. In this way, survival is prolonged, with good quality of life, avoiding ventilatory failure, endotracheal intubation and tracheostomy. This article proposes staggered interventions for respiratory rehabilitation based on the functional stages expected in the patient with DMD who has lost ambulation.


La distrofia muscular de Duchenne (DMD) es una de las enfermedades neuromusculares más frecuentes. Su curso evolutivo con etapas de declinación en la funcionalidad motora bien definidas, permite fácilmente establecer relaciones con la función respiratoria a través de un laboratorio de evaluación sencilla, básicamente de la capacidad vital (CV) y la capacidad tusígena. Sin intervenciones en rehabilitación respiratoria, la principal causa de morbimortalidad es la insuficiencia ventilatoria secundaria a debilidad de músculos de la bomba respiratoria e ineficiencia de la tos. En las etapas no ambulantes, se alcanza la meseta de la CV, generalmente después de los 13 años, su declinación junto con la disminución de la capacidad tusígena puede ser enfrentada efectivamente con la utilización de protocolos de rehabilitación respiratoria. Estos deben considerar la restitución de la CV con técnicas de insuflación activa o apilamiento de aire, tos asistida manual y mecánica, más soporte ventilatorio no invasivo, inicialmente nocturno después de los 19 años y luego diurno, pese a avanzar a etapas con capacidad pulmonar prácticamente inexistente. De esta manera, se prolonga la sobrevida, con buena calidad de vida, evitando el fallo ventilatorio, eventos de intubación endotraqueal y traqueostomía. Este artículo, hace propuestas escalonadas de intervención en rehabilitación respiratoria basadas en las etapas funcionales esperables en el paciente con DMD que ha perdido la capacidad de marcha.


Subject(s)
Humans , Respiratory Therapy/methods , Muscular Dystrophy, Duchenne/rehabilitation , Scoliosis/rehabilitation , Vital Capacity , Noninvasive Ventilation
2.
Neumol. pediátr. (En línea) ; 16(1): 23-29, 2021. tab
Article in Spanish | LILACS | ID: biblio-1284182

ABSTRACT

Spinal Muscular Atrophy (SMA) is a disease of the anterior horn of the spinal cord, which causes muscle weakness that leads to a progressive decrease in vital capacity and diminished cough flows. Respiratory morbidity and mortality are a function of the degree of respiratory and bulbar-innervated muscle. The former can be quantitated by the sequential evaluation of vital capacity to determine the lifetime maximum (plateau) and its subsequent rate of decline, progressing to ventilatory failure. SMA types 1 and 2 benefit from non-invasive respiratory care in early childhood and school age, improving quality and life expectancy. This document synthesizes these recommendations with special reference to interventions guided by stages that include air stacking, assisted cough protocols, preparation for spinal arthrodesis and non-invasive ventilatory support, even in those patients with loss of respiratory autonomy, minimizing the risk tracheostomy. Failure to consider these recommendations in the regular assessment of patients reduces the offer of timely treatments.


La Atrofia Muscular Espinal (AME) es una enfermedad genética del asta anterior de la medula espinal, que cursa con debilidad muscular progresiva. La intensidad y precocidad de la debilidad muscular presenta diferentes grados de afectación de los grupos musculares respiratorios, determinando la meseta en la capacidad vital y progresión a la insuficiencia ventilatoria, como también el compromiso de los músculos inervados bulbares. Los AME tipo 1 y 2, se benefician con cuidados respiratorios no invasivos en la infancia temprana y edad escolar, mejorando la calidad y esperanza de vida. Este documento sintetiza dichas recomendaciones, con especial referencia a intervenciones guiadas por etapas, que incluyan apilamiento de aire, protocolos de tos asistida, preparación para la artrodesis de columna y soporte ventilatorio no invasivo, incluso en aquellos pacientes con pérdida de la autonomía respiratoria, minimizando el riesgo de traqueostomía. La no consideración de estas recomendaciones en la valoración regular de los pacientes resta la oferta de tratamientos oportunos.


Subject(s)
Humans , Respiratory Therapy/methods , Muscular Atrophy, Spinal/therapy , Muscular Atrophy, Spinal/physiopathology , Vital Capacity/physiology , Noninvasive Ventilation
3.
Rev. chil. obstet. ginecol. (En línea) ; Rev. chil. obstet. ginecol;85(supl.1): S111-S121, set. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1138656

ABSTRACT

INTRODUCCIÓN: La Organización Mundial de La Salud ha reportado recientemente que el nuevo foco de la pandemia global de la enfermedad Covid-19 es el continente americano. OBJETIVO: Realizar una revisión de la literatura sobre la experiencia internacional de la pandemia Covid 19 y embarazo. MÉTODO: Se realiza una búsqueda de la base de datos PubMed para las palabras clave Pregnancy / Pregnant / Novel Coronavirus / SARS-CoV-2 / Covid-19, desde el 1 de noviembre 2019 hasta el 21 de mayo 2020. RESULTADOS: Un total de 365 artículos fueron inicialmente seleccionados de acuerdo con la estrategia de búsqueda diseñada. El total de artículos revisados de acuerdo con los criterios fueron 42. Las series clínicas seleccionadas acumularon un total de 1098 embarazadas y enfermedad de Covid-19. Las co-morbilidades mas frecuentes fueron hipertensión arterial, diabetes mellitus, obesidad y asma. La mortalidad en relación con el total de pacientes fue de un 1,2 % y la transmisión al recién nacido de 1,7% (15 de 875). CONCLUSIÓN: La información obtenida permite inferir que la presentación clínica de la enfermedad es a lo menos equivalente a la de mujeres de la misma edad no embarazadas. Dada la severidad de la enfermedad por SARS-CoV-2 reportada, las lecciones aprendidas deben ser rápidamente asimiladas y utilizadas en el contexto de la situación nacional epidémica.


INTRODUCTION: The World Health Organization has recently reported that the new focus of the global pandemic of Covid-19 disease is the American continent. OBJECTIVE: To conduct a literature review on the international experience of the Covid 19 pandemic and pregnancy. METHOD: A PubMed database search is performed for the keywords Pregnancy / Pregnant / Novel Coronavirus / SARS-CoV-2 / Covid-19, from November 1, 2019 to May 21, 2020. RESULTS: A total of 365 articles were initially selected according to the designed search strategy. The total of articles reviewed according to the criteria was 42. The selected clinical series accumulated a total of 1098 pregnant women and Covid-19 disease. The most frequent comorbidities were hypertension, diabetes mellitus, obesity, and asthma. Mortality in relation to the total number of patients was 1.2% and transmission to the newborn was 1.7% (15 of 875). CONCLUSION: The information obtained allows us to infer that the clinical presentation of the disease is at least equivalent to that of non-pregnant women of the same age. Given the severity of the reported SARS-CoV-2 disease, the lessons learned must be quickly assimilated and used in the context of the national epidemic situation.


Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Pneumonia, Viral/epidemiology , Pregnancy Complications, Infectious/epidemiology , Coronavirus Infections/epidemiology , Betacoronavirus , Pneumonia, Viral/mortality , Pneumonia, Viral/transmission , Pregnancy Complications, Infectious/mortality , Pregnancy Complications, Infectious/virology , Comorbidity , Maternal Mortality , Global Health , Coronavirus Infections/mortality , Coronavirus Infections/transmission , Pandemics
4.
Clin Exp Immunol ; 202(3): 384-393, 2020 12.
Article in English | MEDLINE | ID: mdl-32639582

ABSTRACT

Takayasu arteritis (TAK) is a large-vessel granulomatous vasculitis; the inflammatory infiltration in arteries comprises macrophages, multi-nucleated giant cells, CD4+ and CD8+ T cells, γδ T cells, natural killer (NK) cells and neutrophils. However, it is unknown which subtype of macrophages predominates. This study aims to evaluate macrophages subpopulations in the aorta in TAK. Immunohistochemistry was performed in the aorta from TAK patients (n = 22), patients with atherosclerotic disease (n = 9) and heart transplant donors (n = 8) using the markers CD68, CD86, CD206, CD3, CD20 and CD56. Active disease was observed in 54·5% of patients and active histological lesions were found in 40·9%. TAK patients presented atherosclerotic lesions in 27·3% of cases. The frequency of macrophages, M1 macrophages, T, B and NK cells was higher in the aorta from TAK and atherosclerotic patients compared to heart transplant donors. In TAK, macrophages and T cells were the most abundant cells in the aorta, and the expression of CD206 was higher than CD86 (P = 0·0007). No associations were found between the expression of cell markers and active disease or with atherosclerotic lesions. In TAK patients, histological disease activity led to higher T cell counts than chronic fibrotic lesions (P = 0.030), whereas prednisone use was associated with lower T cell counts (P = 0·035). In conclusion, M1 macrophages were more frequent in TAK and atherosclerotic patients compared to heart transplant donors, while M2 macrophages dominated M1 macrophages in TAK. T cells were associated with histological disease activity and with prednisone use in TAK.


Subject(s)
Antigens, CD/immunology , Aorta/immunology , Lymphocytes/immunology , Macrophages/immunology , Takayasu Arteritis/immunology , Adult , Aged , Aorta/pathology , Cross-Sectional Studies , Female , Humans , Inflammation/drug therapy , Inflammation/immunology , Inflammation/pathology , Lymphocytes/pathology , Macrophages/pathology , Male , Middle Aged , Prednisolone/administration & dosage , Takayasu Arteritis/drug therapy , Takayasu Arteritis/pathology
6.
Rev. méd. Chile ; 145(10): 1276-1288, oct. 2017. tab, graf
Article in Spanish | LILACS | ID: biblio-902442

ABSTRACT

Background: Costs allocation methods are important for economic evaluation of health care. Aim: To evaluate the impact of overhead costs rates of different hospitals on the cost-effectiveness rankings of health programs. Material and Methods: Using the cost reports from eight hospitals, a Montecarlo simulation was implemented, programming the complete micro-costing algorithm to calculate the final cost of 47 health care interventions, from the health sector perspective. The independent variables considered were the overhead cost rates per establishment and the actual overhead costs. Changing these variables, resulted in changes of the final cost of interventions and cost-effectiveness ratios. Finally the probabilities of changes in the cost-effectiveness ranking of each intervention were calculated. Results: Thirteen programs did not change their ranking order. However, 34 interventions modified their position with different occurrence probabilities. In the new proposed ranking, 21 programs changed their position from one to six places. Conclusions: Different overhead cost rates, representing different assignation forms, have a relative impact in the cost-effectiveness order. Montecarlo simulation can help to improve the accuracy of ranking assignment.


Subject(s)
Cost-Benefit Analysis/economics , Hospital Costs , Hospitals, Public/economics , Chile , Cost Allocation/economics , Cost Allocation/methods
7.
Braz J Med Biol Res ; 50(10): e6225, 2017 Aug 17.
Article in English | MEDLINE | ID: mdl-28832763

ABSTRACT

Coronary allograft vasculopathy is an inflammatory-proliferative process that compromises the long-term success of heart transplantation and has no effective treatment. A lipid nanoemulsion (LDE) can carry chemotherapeutic agents in the circulation and concentrates them in the heart graft. The aim of the study was to investigate the effects of methotrexate (MTX) associated to LDE. Rabbits fed a 0.5% cholesterol diet and submitted to heterotopic heart transplantation were treated with cyclosporine A (10 mg·kg-1·day-1 orally) and allocated to treatment with intravenous LDE-MTX (4 mg/kg, weekly, n=10) or with weekly intravenous saline solution (control group, n=10), beginning on the day of surgery. Animals were euthanized 6 weeks later. Compared to controls, grafts of LDE-MTX treated rabbits showed 20% reduction of coronary stenosis, with a four-fold increase in vessel lumen and 80% reduction of macrophage staining in grafts. Necrosis was attenuated by LDE-MTX. Native hearts of both LDE-MTX and Control groups were apparently normal. Gene expression of lipoprotein receptors was significantly greater in grafts compared to native hearts. In LDE-MTX group, gene expression of the pro-inflammatory factors tumor necrosis factor-α, monocyte chemoattractant protein-1, interleukin-18, vascular cell adhesion molecule-1, and matrix metalloproteinase-12 was strongly diminished whereas expression of anti-inflammatory interleukin-10 increased. LDE-MTX promoted improvement of the cardiac allograft vasculopathy and diminished inflammation in heart grafts.


Subject(s)
Graft Rejection/prevention & control , Heart Transplantation/adverse effects , Immunosuppressive Agents/administration & dosage , Lipids/administration & dosage , Methotrexate/administration & dosage , Nanoparticles/administration & dosage , Allografts , Animals , Immunosuppressive Agents/pharmacology , Methotrexate/pharmacology , Nanoparticles/chemistry , Rabbits
9.
Acta Virol ; 60(1): 49-54, 2016 Mar.
Article in English | MEDLINE | ID: mdl-26982467

ABSTRACT

Deep sequencing analysis of the transcriptome of a Solanum phureja cv. Criolla Colombia plant with symptoms typical of a virus disease revealed an infection with potato virus V (PVV). The PVV-phureja genome comprises 9904 nt, exhibits 83% nucleotide identity with currently fully sequenced PVV isolates and contains one large ORF that codes for a polyprotein of 3065 residues flanked by 5' and 3' UTR of 217 and 448 nt, respectively. Phylogenetic analysis of the PVV-phureja polyprotein indicates that it is divergent with respect to most PVV isolates. This is the first complete PVV genome of an isolate infecting a host different to S. tuberosum and, to this date, the only one from the South American Andes.


Subject(s)
Genome, Viral , Plant Diseases/virology , Potyvirus/isolation & purification , Solanum/virology , Base Sequence , Colombia , Molecular Sequence Data , Phylogeny , Potyvirus/classification , Potyvirus/genetics
10.
Rev. Inst. Nac. Hig ; 45(1): 92-98, jun. 2014. tab
Article in Spanish | LILACS, LIVECS | ID: lil-772707

ABSTRACT

El análisis polínico de las mieles proporciona información sobre las preferencias de las abejas y permiten determinar su origen botánico y geográfico. Por esta razón, el polen apícola por ser el segundo producto más consumido proveniente de la colmena, puede contener oligoelementos cuyas cantidades varían de una planta a otra, permitiéndole actuar como un bioindicador de contaminación ambiental, debido a que se puede determinar si existen trazas de minerales tóxicos como el plomo y el mercurio. En el presente trabajo se evaluó la concentración de plomo (Pb) en polen apícola producto de distintas colmenas del Municipio Pinto Salinas del estado Mérida. El análisis de Pb se realizó por espectroscopía de absorción atómica, con atomización electrotérmica (ETAAS). Se encontró una concentración promedio de Pb entre (0,198 -0,288) mg Pb /kg de polen apícola fresco. El método para el análisis de plomo fue realizado mediante estudios de recuperación, obteniéndose un valor de (97-104) %, con una desviación estándar relativa (DER %) < 3 % (n = 7), lo cual indica que el método empleado fue exacto y preciso. Lo que indica que la metodología aplicada en polen apícola podría ser utilizada como un método de rutina para evaluar la contaminación de plomo en el medio ambiente.


Pollen analysis of honey provides information about the preferences of bees and can determine its botanical and geographical origin. Therefore, bee pollen as the second most consumed product from the hive, which may contain trace amounts vary from one plant to another, enabling it to act as a biomarker of environmental pollution, because it can determine whether there are traces of toxic minerals such as lead and mercury. In this study we evaluated the concentration of Pb in bee pollen produced in different colonies of Pinto Salinas Municipality of the Mérida State. Pb analysis was performed by atomic absorption spectroscopy with electrothermal atomization (ETAAS). We found an average concentration of Pb from (0,198 -0,288) mg Pb / kg of fresh bee pollen The method for lead analysis was evaluated by recovery studies, obtaining a value of (97-104) %, with a standard relative standard (RSD%) < 3% (n=7), indicating that the method was accurate, precise. This indicates that the methodology used in bee pollen could be used as a routine method to assess lead contamination in the environment.


Subject(s)
Humans , Male , Female , Pollen/immunology , Environment , Environmental Pollution/prevention & control , Lead/toxicity , Spectrophotometry, Atomic/methods , Public Health
11.
Neuropharmacology ; 79: 28-36, 2014 Apr.
Article in English | MEDLINE | ID: mdl-24212057

ABSTRACT

TASK channels belong to the family of K(+) channels with 4 transmembrane segments and 2 pore domains (4TM/2P) per subunit. These channels have been related to apoptosis in cerebellar granule neurons (CGN), as well as cancer in other tissues. TASK current is regulated by hormones, neurotransmitters, anesthetics and divalent cations, which are not selective. Recently, there has been found some organic compounds that inhibit TASK current selectively. In order to find other modulators, we report here a group of five dihydropyrrolo[2,1-a]isoquinolines (DPIs), four of them with putative anticancer activity, that were evaluated on TASK-1 and TASK-3 channels. The compounds 1, 2 and 3 showed IC50 < 320 µM on TASK-1 and TASK-3, intermediate activity on TASK-1/TASK-3 heterodimer, moderate effect over hslo and TREK-1 (500 µM), and practically not inhibition on Shaker-IR, herg and IRK2.1 potassium channels, when they were expressed heterologously in Xenopus laevis oocytes. In rat CGN, 500 µM of these three compounds induced a decrement by >39% of the TASK-carried leak current. Finally, only compound 1 showed significant protection (∼36%) against apoptotic death of CGN induced by K(+) deprivation. These results suggest that DPI compounds could be potential candidates for designing new selective inhibitors of TASK channels.


Subject(s)
Isoquinolines/pharmacology , Nerve Tissue Proteins/antagonists & inhibitors , Potassium Channel Blockers/pharmacology , Potassium Channels, Tandem Pore Domain/antagonists & inhibitors , Pyrroles/pharmacology , Animals , Apoptosis/drug effects , Apoptosis/physiology , Cells, Cultured , Cerebellum/drug effects , Cerebellum/physiology , ERG1 Potassium Channel , Ether-A-Go-Go Potassium Channels/antagonists & inhibitors , Ether-A-Go-Go Potassium Channels/metabolism , Isoquinolines/chemistry , Mice , Molecular Structure , Nerve Tissue Proteins/metabolism , Neurons/drug effects , Neurons/physiology , Potassium/metabolism , Potassium Channel Blockers/chemistry , Potassium Channels, Inwardly Rectifying/metabolism , Potassium Channels, Tandem Pore Domain/genetics , Potassium Channels, Tandem Pore Domain/metabolism , Potassium Channels, Voltage-Gated/metabolism , Pyrroles/chemistry , Rats , Rats, Wistar , Shaker Superfamily of Potassium Channels/metabolism , Xenopus laevis
12.
Rev. Hosp. Clin. Univ. Chile ; 25(1): 34-39, 2014.
Article in Spanish | LILACS | ID: lil-786966

ABSTRACT

Curricular innovation at the University of Chile Faculty of Medicine carries a considerable challenge to teaching practice and to all the “actors” involved in the educational process. It is essential to create the right conditions to perform the desired improvements; therefore, keeping this in mind, from the year 2012 we began to apply a model of Teachers’ Accompaniment, favouring their reflection capabilities through out a collaborative and participatory process for proper installation and implementation of the innovation process.


Subject(s)
Curriculum , Education, Medical , Schools, Medical , Chile
13.
Rev. chil. neuro-psiquiatr ; Rev. chil. neuro-psiquiatr;51(2): 115-125, abr. 2013. ilus, tab
Article in Spanish | LILACS | ID: lil-682330

ABSTRACT

Botulinum neurotoxin is widely used to treat a variety of movement disorders, especially dystonia and spasticity. There botúlica different preparations of botulinum type A, that because biologics are difficult to compare. AbobotulinumtoxinA (Dysport ®) has recently been introduced in Chile for treating dystonia and spasticity. The aim of this paper is to provide a review by experts on the existing evidence and propose a practical guide to the use of the drug. Methods and Results: A group of Chilean experts met on 6 and 7 July 2012 to review AbobotulinumtoxinA doses along with injection protocols for dystonia, spasticity and other movement disorders. We worked in two groups, one composed of neurologists who reviewed the on dystonias and other by physiatrists who reviewed the indications for spasticity. Conclusions: Finally, there is a proposal in terms of dose, injection points and recommendations for dystonia and spasticity...


La neurotoxina botulínica es ampliamente usada para tratar una variedad de trastornos del movimiento, especialmente la distonía y la espasticidad. Existen diferentes preparados de toxina botúlica tipo A, que por ser productos biológicos resultan difícilmente comparables. La abobotulinumtoxinA (Dysport®) ha sido introducida en Chile recientemente para el tratamiento de la distonía y la espasticidad. El objetivo de este trabajo es entregar una revisión hecha por expertos sobre la evidencia existente y plantear una guía práctica para el uso del medicamento. Métodos y Resultados: Un grupo de expertos chilenos se reunieron el 6 y 7 julio de 2012 para revisar las dosis abobotulinumtoxin A, junto con los protocolos de inyección para la distonía, la espasticidad y otros trastornos del movimiento. Se trabajó en dos grupos, uno compuesto por neurólogos que revisaron las indicaciones en distonías y otro por fisiatras que revisaron las indicaciones para espasticidad. Conclusiones: Finalmente, se realiza una propuesta en cuanto a dosis, puntos a inyectar y recomendaciones para la distonia y espasticidad...


Subject(s)
Humans , Dystonia/drug therapy , Muscle Spasticity/drug therapy , Neuromuscular Agents/administration & dosage , Botulinum Toxins, Type A/administration & dosage , Chile , Consensus , Evidence-Based Medicine , Neuromuscular Agents/adverse effects , Practice Guidelines as Topic , Botulinum Toxins, Type A/adverse effects
14.
Acta Ortop Mex ; 27(2): 128-32, 2013.
Article in Spanish | MEDLINE | ID: mdl-24701766

ABSTRACT

The total shoulder prosthesis in reverse was designed as a treatment for patients with arthropathy deficiency rotator cuff because the conservative treatment failed. The indications for its use have evolved; these include arthropathy deficient rotator cuff, reconstruction humeral head fractures, hemiarthroplasties revision and reconstruction after tumor resection. Successful placement depends on the patient having a function adequately and good quality deltoid in the glenoid bone and in the proximal humerus. Until a few years ago data was no clear on the success of this procedure, currently encouraging results have been reported, however, they have had a high cost due to the high rate of complications, which are divided into specific and common to the prosthesis shoulder surgeries. The primary objective of this review is to assess the most common complications of the prosthesis in reverse, how to treat them and how we can avoid them.


Subject(s)
Arthroplasty/methods , Postoperative Complications/etiology , Prosthesis Design , Shoulder Joint/surgery , Bone Screws , Device Removal , Humans , Joint Instability/etiology , Joint Instability/prevention & control , Patient Selection , Postoperative Complications/epidemiology , Postoperative Complications/prevention & control , Prosthesis Failure/etiology , Prosthesis-Related Infections/etiology , Prosthesis-Related Infections/prevention & control , Treatment Outcome
15.
Cuad. cir ; 26(1): 48-54, 2012.
Article in Spanish | LILACS | ID: lil-721847

ABSTRACT

Son muchas las patologías que producen defectos de piel. El método de elección para la cobertura cutánea de estos defectos es el injerto de piel parcial, sin embargo, en algunos casos sus resultados no son adecuados. Los sustitutos dérmicos son una alternativa de cobertura cutánea, que existen en la actualidad y que permiten obtener mejores resultados funcionales y estéticos. Existen muchos sustitutos dérmicos en el mercado, cada uno con distintas características, beneficios y complicaciones. Esta revisión logra agrupar los aspectos más relevantes de los sustitutos dérmicos para poder tener una base teórica sobre estos productos que son de gran ayuda para poder tratar a pacientes con distintas patologías.


Many are the pathologies that cause skin defects. The gold standard for skin coverage of these defects is the partial skin graft, but in some cases the results are not appropiate. Dermal substitutes are an alternative for skin coverage that exists today and allow get better functional and aesthetic results. There are many dermal substitutes in the pharmaceutical industry, each one with different characteristics, benefits and complications. This review brings together the most important aspects of dermal substitutes to have a theoretical background on these products that are helpful to treat patients with different pathologies.


Subject(s)
Humans , Skin Diseases/therapy , Skin, Artificial
16.
J Epidemiol Community Health ; 65(8): 715-21, 2011 Aug.
Article in English | MEDLINE | ID: mdl-20724286

ABSTRACT

INTRODUCTION: Consistent evidence has shown a positive association between air pollution and daily mortality among adults. Less is known about its effect on infant mortality and the modification of this association by socioeconomic status (SES). OBJECTIVE: To assess the association of particulate matter with an aerodynamic diameter of ≤10µm (PM(10)) and ozone (O(3)) on infant mortality and its modification by SES. METHODS: We evaluated the relationship of 24 h mean PM(10) and 1h daily maximum O(3) levels with 12 079 all-cause deaths (3903 respiratory deaths) among 1- to 11-month-old infants residing in the Mexico City Metropolitan Area between January 1997 and December 2005 using a case-crossover approach. The data were analysed using conditional logistic regression models, controlling for weather conditions and day of the week. RESULTS: Single-effect models showed, for all-cause mortality, increases of 5.5% (95% CI 1% to 10%) at lag1 and 6.6% (2% to 11.4%) at lag2; cumulative exposure models (0-2 days) showed an increase of 6.3% (0.01% to 32.7%). Respiratory mortality increased marginally at 5.3% (-0.02% to 13.2%) with a 1-day lag and 10% (2.1% to 18%) with a 2-day lag per increase of 38.7 µg/m(3) (IQR) in PM(10) levels. When data were stratified by SES (low, medium, and high), only infants with low and medium SES presented a significant increase in risk of all-cause mortality and respiratory mortality in relation to PM(10). O(3) was only significantly related to respiratory mortality in low SES. CONCLUSION: Our results suggest that in the Mexico City Metropolitan Area, infants with lower SES (low to medium) are at higher risk of mortality when exposed to ambient PM(10) and O(3).


Subject(s)
Air Pollutants/toxicity , Cities/epidemiology , Infant Mortality/trends , Ozone/toxicity , Particle Size , Cause of Death/trends , Cross-Over Studies , Environmental Exposure/adverse effects , Female , Humans , Infant, Newborn , Logistic Models , Male , Mexico/epidemiology , Social Class
17.
Phys Rev E Stat Nonlin Soft Matter Phys ; 80(1 Pt 1): 011914, 2009 Jul.
Article in English | MEDLINE | ID: mdl-19658736

ABSTRACT

The origin of stochastic fluctuations in gene expression has received considerable attention recently. Fluctuations in gene expression are particularly pronounced in cellular systems because of the small copy number of species undergoing transitions between discrete chemical states and the small size of biological compartments. In this paper, we propose a stochastic model for gene expression regulation including several binding sites, considering elementary reactions only. The model is used to investigate the role of cooperativity on the intrinsic fluctuations of gene expression by means of master-equation formalism. We found that the Hill coefficient and the level of noise increase as the interaction energy between activators increases. Additionally, we show that the model allows one to distinguish between two cooperative binding mechanisms.


Subject(s)
Gene Expression Regulation , Models, Biological , Binding Sites , Kinetics , Protein Binding , Transcription, Genetic
18.
Rev. Méd. Clín. Condes ; 19(3): 185-195, jul. 2008. ilus, tab
Article in Spanish | LILACS | ID: lil-503388

ABSTRACT

El hidrops fetal es una seria condición, la que tiene una compleja fisiopatología y se asocia a una variada gama de etiologías y un incierto pronóstico perinatal (mortalidad entre 60-90%). Pese a los avances en el campo de la Medicina Fetal, sólo existe posibilidad terapéutica en no más del 30% de los casos. Es necesario seguir investigando en las bases fisiopatológicas de la enfermedad, así como también estimular el diagnóstico precoz, especialmente de las causas relacionadas con malformaciones cardíacas y de paso, favorecer el asesoramiento genético a las parejas en riesgo.


Hydrops fetalis is a serious condition due to a complex pathophysiology, which is associated with a wide range of etiologic mechanisms leading to a poor pregnancy outcome (mortality of 60-90% of the cases). Management and therapeutic options are limited and can only be offered to one third of the cases. Investigation of the pathophysiologic basis as well as an early diagnosis would probably help in improving the outcome and genetic counseling of parents at risk for this condition.


Subject(s)
Humans , Male , Female , Infant, Newborn , Hydrops Fetalis/diagnosis , Hydrops Fetalis/etiology , Hydrops Fetalis/therapy , Risk Factors
19.
Rev. MVZ Córdoba ; 12(2): 985-995, dic. 2007. tab, graf
Article in Spanish | LILACS | ID: lil-498547

ABSTRACT

Objetivo. Evaluar el efecto del cobre en vacas gestantes sobre el comportamiento reproductivo posparto y la salud del ternero. Materiales y métodos. Se estudiaron 80 vacas divididas en dos grupos de 40 animales cada uno. El grupo A fue tratado con 2 ml de CuSO4 (2.5%) subcutáneamente. El tratamiento se inició a los 8 meses de gestación, y se repitió a los 30 y 90 días post parto. El grupo B, se uso como control. A las vacas se les analizó el perfil hematoquímico, intervalo parto primer servicio (IPPS), intervalo parto concepción (IPC), intervalo parto-parto (IPP), índice de natalidad (IN), índice de inseminación (II) y la eficiencia en la detección de la hembra en estro (EDHE) y a los terneros los parámetros hematoquímicos. Los datos se procesaron mediante Statgraphics Plus 5.0, para las diferencias entre medias de los datos hemoquímicos y reproductivos se aplicó (ANOVA) y comparaciones de proporciones IN y EDHE. Se empleó la correlación y regresión simple para demostrar la relación del cobre con las demás parámetros estudiados. Resultados. La administración subcutánea de cobre incrementó los niveles de dicho elemento en sangre, hierro y hemoglobina (p< 0.001); así como la disminución del IPPS, IPC, IPP, IN, EDHE, e II (p< 0.05). En los terneros se aumentó la cupremia (p< 0.001), la hemoglobina (p< 0.01) y las proteínas totales (p< 0.05). Conclusiones. El tratamiento aplicado incrementó los indicadores hematoquímicos y reproductivos en los animales tratados.


Subject(s)
Copper , Insemination , Dietary Supplements , Insemination, Artificial, Homologous/veterinary
20.
Braz J Med Biol Res ; 40(4): 467-73, 2007 Apr.
Article in English | MEDLINE | ID: mdl-17401489

ABSTRACT

The relationship between lipid serum levels and coronary atherosclerotic plaque fat content was studied in 51 necropsy patients. Serum lipids were measured by standard techniques, during life, in the absence of lipid-lowering drugs. Intima, intimal fat and media areas were measured using a computerized system in cryosections of the odd segments of the right, anterior descending and circumflex coronary arteries stained with Sudan-IV. Mean intimal and lipid areas were 5.74 +/- 1.98 and 1.22 +/- 0.55 mm2 (22.12 +/- 8.48%) in 26 cases with high cholesterol (>or=200 mg/dL) and 4.98 +/- 1.94 and 1.16 +/- 0.66 mm2 (22.75 +/- 9.06%) in 25 cases with normal cholesterol (<200 mg/dL; P > 0.05). Patients with high levels of low-density lipoprotein (>or=130 mg/dL, N = 15) had a higher intima/media area ratio than those with normal levels of low-density lipoprotein (<130 mg/dL, N = 13, P < 0.01). No significant difference in the morphometrical variables was found in groups with high or low serum levels of triglycerides (>or=200 mg/dL, N = 13 vs <200 mg/dL, N = 36) or high-density lipoprotein (>or=35 mg/dL, N = 11 vs <35 mg/dL, N = 17). The association between the morphological measurements and serum levels of cholesterol, its fractions, and triglycerides was also tested and the correlation coefficients were low. Although high cholesterol is a risk factor, we show here that in patients with severe atherosclerosis blood cholesterol and triglyceride levels seem to have little influence on coronary lipid content, indicating that other factors may contribute to arterial lipid deposition and plaque formation.


Subject(s)
Atherosclerosis/blood , Atherosclerosis/pathology , Coronary Vessels/pathology , Lipids/blood , Adult , Aged , Aged, 80 and over , Coronary Vessels/chemistry , Female , Humans , Male , Middle Aged , Risk Factors , Severity of Illness Index
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