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1.
Farm. comunitarios (Internet) ; 14(Supl 1): 1, junio 2022. graf
Artigo em Espanhol | IBECS | ID: ibc-209285

RESUMO

JUSTIFICACIÓN: INDICA+PRO es un estudio de implantación que tiene como objetivo la incorporación del servicio de indicación farmacéutica (SIF) protocolizado en la práctica diaria de la farmacia comunitaria (FC). Se ha estimado que el 25 % del tiempo del farmacéutico en España se dedica a la atención del paciente con síntomas menores. Tras la evaluación de un estudio de impacto que mostró resultados clínicos, humanísticos y económicos positivos en Valencia, se llevó a cabo el estudio INDICA+PRO Implantación para incrementar dicho impacto a escala nacional.OBJETIVOS: desarrollar y evaluar los resultados de un programa de implantación del SIF en la farmacia comunitaria española.MATERIAL Y MÉTODOS: diseño híbrido de efectividad-implantación tipo 3 con una duración inicial de 14 meses. La intervención constaba de diferentes elementos: procedimiento general del SIF establecido por Foro de Atención Farmacéutica en Farmacia Comunitaria, protocolos consensuados entre sociedades médicas (Semergen y SemFyC), asociaciones farmacéuticas (SEFAC y MICOF) y universidad (GIAF-UGR) específicos para 31 síntomas menores incluidos en una plataforma digital (SEFAC e_XPERT®) y la formación de los farmacéuticos con el seguimiento de 33 farmacéuticos facilitadores del cambio de práctica. Los pacientes recibieron seguimiento tras 10 días de la consulta en farmacia. Se utilizó un marco teórico para la implantación de servicios en FC. (AU)


Assuntos
Humanos , Farmácias , Pacientes , Espanha
2.
Int. j. morphol ; 39(2): 463-468, abr. 2021. ilus, tab
Artigo em Inglês | LILACS | ID: biblio-1385367

RESUMO

SUMMARY: The aim of the study was to determine the number and anatomical configuration of roots and root canals of maxillary first and second premolars using cone-beam computed tomography scans. n273 CBCT scans were evaluated, obtaining a sample of 592 maxillary premolars. Root number and root canal anatomy were categorized using Ahmed´s classification. Data was analyzed using Pearson's Chi-squared test. Two roots were present on 157 first premolars, one root in 132 premolars and three roots in 17. Second premolars presented one root in 266 samples and two roots in 20; no second premolars presented three roots. Eight different configurations were found; the most frequent was 2MP B1 P1 in first premolars (51,3 %) and 1MP1 (63.6 %) in second premolars. The most frequent morphology found in maxillary premolars in Chilean population was two and three roots. The analysis of internal anatomy using CBCT revealed a highly variable distribution of root canals, generally of low to medium complexity, similar to what is found in other ethnic groups.


RESUMEN: El objetivo de este estudio fue determinar el número y la configuración de raíces y canales radiculares de primeros y segundos premolares maxilares utilizado tomografía computacional de haz cónico. 273 TCHC fueron evaluados, obtenido una muestra de 592 premolares maxilares. El número de raíces y la anatomía de los canales radiculares fueron categorizados utilizando la clasificación de Ahmed. Los datos fueron analizados con la prueba Chi- Cuadrado de Pearson. Dos raíces fueron observadas en 157 primeros presentaron una raíz en 266 muestras y dos raíces en 20; no se encontraron tres raíces en segundos premolares. Ocho diferentes configuraciones fueron encontradas; siendo la más frecuente 2MP B1 P1 en primeros premolares (51,3 %) y 1MP1 (63,6 %) en segundos premolares. La morfología radicular más frecuentemente encontrada en premolares de población Chilena fue de dos y tres raíces. El análisis de la anatomía interna usando TCHC mostró una gran variabilidad de en la distribución de los canales radiculares. Generalmente de mediana y baja complejidad como los encontrados en otros grupos etnicos.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Adulto Jovem , Raiz Dentária/diagnóstico por imagem , Dente Pré-Molar/diagnóstico por imagem , Tomografia Computadorizada de Feixe Cônico , Maxila/diagnóstico por imagem , Raiz Dentária/anatomia & histologia , Dente Pré-Molar/anatomia & histologia , Estudos Transversais , Maxila/anatomia & histologia
3.
Folia Morphol (Warsz) ; 79(2): 327-332, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31322722

RESUMO

BACKGROUND: The aim of the study was to assess the number and anatomical classification of roots and root canals of first and second mandibular molars using cone-beam computed tomography (CBCT) in a Chilean population. MATERIALS AND METHODS: This study evaluated the CBCT scans of 289 patients aged between 14 and 86 years, obtaining a sample of 1022 mandibular first and second molars. The number of roots and root canals was evaluated according to the anatomical classification proposed by Ahmed in 2016. Data were analysed using Pearson's chi-squared test and ANOVA. RESULTS: Nine hundred fifty-one (93.05%) molars had two roots, while the remaining 71 (6.95%) molars had one root. The most frequent root and root canal morphologies found were: ²MM M² D¹ (29.65%), ²MM M²â»¹ D¹ (22.3%) and ²MM M¹ D¹ (13.4%) (M - mesial, D - distal), with a total of 32 different anatomical distributions. C-shaped canals were present in 56 molars and were more frequently found in women than in men (7.1% vs. 3.88%; p = 0.024). CONCLUSIONS: The analysis of internal anatomy using CBCT revealed a highly variable distribution of root canals. The most frequent morphology found in mandibular molars in a Chilean population was two roots and three canals.


Assuntos
Cavidade Pulpar/anatomia & histologia , Dente Molar/anatomia & histologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Tomografia Computadorizada de Feixe Cônico , Feminino , Humanos , Masculino , Mandíbula , Pessoa de Meia-Idade , Adulto Jovem
4.
Eur Geriatr Med ; 9(1): 61-69, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34654269

RESUMO

OBJECTIVE: To derive a risk score to predict in-hospital mortality for very old patients with decompensated chronic heart failure (DCHF). METHODOLOGY: Retrospective cohort study that included patients ≥ 80 years admitted to a Geriatric Acute Care Unit with DCHF between January 2012 and December 2014. We analyzed 70 candidate risk factors and in-hospital mortality. We derived a risk model using multivariate logistic regression model and constructed a scale for scoring risk. We used bootstrapping techniques for the internal validation. RESULTS: We included 629 patients with mean age of 90 (SD5) years, 470 (73.1%) being women. Eighty-six (13.7%) patients died during the hospitalization. Factors included in the final risk model were NYHA class III-IV, severe functional dependence (Katz activities of daily living index < 2), infection as cause of exacerbation of heart failure, number of medications ≥ 8, albumin < 3 mg/dL, glomerular filtration rate < 60 mL/min, level of potassium in blood > 5.5 mEq/L and red blood cell distribution width (RDW) > 17%. In-hospital mortality in risk groups was 3.0, 4.6, 9.5, 15.1 and 36.3%, respectively. The area under ROC curve risk for score after bootstrapping was 0.77 (95%: CI 0.70-0.83). CONCLUSION: This risk score could be useful for stratifying risk for in-hospital mortality among very old patients admitted to hospital for DCHF.

5.
Int. j. morphol ; 33(4): 1333-1337, Dec. 2015. ilus
Artigo em Inglês | LILACS | ID: lil-772317

RESUMO

The aim of this study was to assess the morphology of the mesial root canal system of maxillary molars and the frequency of MB2 canals using cone-beam computed tomography (CBCT). A total of 1374 teeth, first maxillary (1MS, n= 802) and second maxillary molars (2SM, n= 572) of 508 Chilean patients between 8 to 77 years were evaluated through CBCT. The mesiobuccal root was evaluated in all three thirds. Root canal morphology was classified according to Vertucci's method. Data were analyzed by Pearson's Chi-square and Cuzick trend tests. MB2 canal frequency in 1MS was 73.44% and in 2MS 42.48%. The most frequent morphology in 1MS and 2MS were Vertucci type II and I, respectively. No statistically significant association was found between frequencies and side or according to gender (P>0.05). A positive association was found as the age increased in both 1MS and 2MS (P<0.001 and P= 0.023, respectively). Given the anatomical complexity of the mesiobuccal root and the frequent presence of the MB2 canal, the clinician must assume the existence of two canals in this root. CBCT scanning is a good way to initially identify this canal in the different root thirds.


Determinar la morfología del sistema de canales de la raíz mesial de molares maxilares y la frecuencia del canal MB2 usando tomografía computadorizada de haz cónico (TCHC). Un total de 1374 dientes, primeros molares maxilares (1MS, n= 802) y segundos molares maxilares (2MS, n= 572) de 508 pacientes Chilenos entre 8 y 77 años fueron evaluados a través de la TCHC. Se evaluó la raíz mesiobucal en todos sus tercio. La clasificación de Vertucci fue utilizada para determinar la morfología del sistema de canales. Los datos fueron analizados con los test Chi-Cuadrado de Pearson y la prueba de tendencia de Cuzick. La frecuencia del canal MB2 para el 1MS fue 73,44% y el 2MS 42,48%. La morfología mas frecuente en el 1MS y 2MS fueron el tipo II y I de Vertucci, respectivamente. No se encontró asociación significativa entre la frecuencia y el lado o sexo (p>0,005). Una asociación positive fue encontrada a medida que aumentaba la edad en ambos 1MS y 2MS (p<0,001 y p= 0,023, respectivamente). Dada la complejidad de la anatomía de la raíz mesiobucal y la frecuente presencia del canal MB2, el clínico debe asumir la existencia de dos canales en esta raíz. La TCHC es una buena manera de identificar tempranamente el canal en los diferentes tercio radiculares.


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Dente Molar/anatomia & histologia , Dente Molar/diagnóstico por imagem , Raiz Dentária/anatomia & histologia , Raiz Dentária/diagnóstico por imagem , Tomografia Computadorizada de Feixe Cônico , Maxila
6.
Orthop Traumatol Surg Res ; 100(5): 485-8, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-24947497

RESUMO

INTRODUCTION: Anterosuperior (AS) rotator cuff tear describes a combined tear of the subscapularis and the supraspinatus tendons. We hypothesized that results after AS tendon repairs might be influenced by the size of the subscapularis rupture and the preoperative subscapularis muscle fatty infiltration. METHODS: A prospective multicentric study of 53 AS rotator cuff tears from five centers was performed (January 2008-January 2009). Subscapularis tendon retraction and fatty infiltration were assessed preoperatively. An ultrasonographic healing control was performed 1 year after surgery. RESULTS: Patients were on average 60 years (range, 43-75 years) and were operated on average 16 months (range, 2-72 months) after the beginning of their symptoms. The incidence of AS tears was found to be 18%. Average follow-up was 15 months (range, 12-24). The Constant-Murley (CM) score for the patients with AS ruptures improved significantly from 49 points (range, 35-51 points) preoperatively to 73 points postoperatively (range, 50-95 points)(P=0.0205). CM score gains were 26 for Lafosse group 1 ruptures and 29 for Lafosse group 2 & 3 with pre- and postoperative P values at P<0.0000001 and P<0.000001, respectively. The last follow-up CM score according to the subscapularis fatty infiltration was 70 (range, 48-95) for groups 0-1, 70 (range, 56-87) for group 2, and 56 (range, 53-88) for groups 3-4 with pre- and postoperative P values at P<0.001, P<0.001, and P<0.004, respectively. The global retear rate was 6%. DISCUSSION: Our study showed that the CM score after repairs of AS rotator cuff tears was lower in advanced subscapularis fatty infiltration. However, gains in CM scores were similar whatever the initial subscapularis fatty infiltration. The rate of tendon healing was correlated with subscapularis fatty infiltration. Subscapularis tendon rupture size was not significantly correlated with outcomes. LEVEL OF EVIDENCE: Level III.


Assuntos
Tecido Adiposo/patologia , Músculo Esquelético/patologia , Manguito Rotador/cirurgia , Adulto , Idoso , Artroscopia , Feminino , Seguimentos , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Período Pré-Operatório , Estudos Prospectivos , Manguito Rotador/patologia , Lesões do Manguito Rotador , Tomografia Computadorizada por Raios X , Cicatrização
7.
Int. j. morphol ; 32(2): 671-677, jun. 2014. ilus
Artigo em Inglês | LILACS | ID: lil-714327

RESUMO

Information regarding the anatomy of the physiological apical foramen is limited. Knowing its diameter and shapes contributes to clinical work, specifically to the cleaning and shaping of the apical third. The aim of this ex vivo study was to determine the minimum and maximum diameters and shape of the physiological apical foramen in the roots of maxillary and mandibular first molars. A descriptive study was conducted on 89 recently extracted first molars. Roots 3-5 mm from the apex were sectioned and prepared for analysis at 40x magnification. The minimum and maximum diameters of each physiological foramen were measured using the program Motic Images plus 2.0 ML. The shape of the foramina, classified as round, oval or irregular, was determined by the difference between the maximum and minimum diameters. A total of 174 physiological foramina were analyzed. The average of the minimum and maximum diameters was between 0.24-0.33 mm in maxillary first molars and between 0.25-0.33 mm in mandibular first molars. In maxillary molars, the most common shape of the foramen was oval (50%), then irregular (32%), then round (18%). In mandibular molars, the oval shape was also the most frequent (59%), followed by irregular (23%) and round (18%). The findings of this study regarding the morphology of physiological apical foramina in first molars make it easier for the operator to choose the appropriately-sized instruments to perform endodontic therapy successfully.


La información relacionada a la anatomía del foramen fisiológico apical es limitada. Conocer su diámetro y forma contribuye al trabajo clínico, específicamente en los procedimientos de limpieza y conformación del tercio apical. El objetivo de este estudio ex vivo fue determinar los diámetros menor, mayor y la forma del foramen fisiológico apical en las raíces de primeros molares maxilares y mandibulares. Se realizó un estudio descriptivo sobre 89 primeros molares recientemente extraídos. Se seccionaron las raíces a 3­5 mm del ápice y fueron preparadas para su análisis bajo magnificación de 40X. Se midieron los diámetros mayor y menor de cada foramen fisiológico mediante el programa Motic Images plus 2.0 ML. La forma de los forámenes fue determinada de acuerdo a la diferencia entre diámetro mayor y menor, clasificándose como redondo, oval o irregular. Un total de 174 forámenes fisiológicos fueron analizados. El promedio del diámetro menor y mayor fue entre 0,24­0,33 mm en primeros molares maxilares y entre 0,25­0,33 mm en primeros molares mandibulares. En molares maxilares, la forma del foramen más común fue la oval (50%), luego irregular (32%) y redonda (18%). En molares mandibulares, la forma oval también fue la más frecuente (59%), seguida por la irregular (23%) y redonda (18%). Los hallazgos de este estudio en relación a morfología de los forámenes fisiológicos apicales en primeros molares, permite al operador facilitar la elección de instrumentos del calibre adecuado para realizar con éxito la terapia endodóntica.


Assuntos
Humanos , Ápice Dentário/anatomia & histologia , Dente Molar/anatomia & histologia , Mandíbula , Maxila
8.
Int J Morphol ; 32(2): 671-677, 2014 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25937698

RESUMO

Information regarding the anatomy of the physiological apical foramen is limited. Knowing its diameter and shapes contributes to clinical work, specifically to the cleaning and shaping of the apical third. The aim of this ex vivo study was to determine the minimum and maximum diameters and shape of the physiological apical foramen in the roots of maxillary and mandibular first molars. A descriptive study was conducted on 89 recently extracted first molars. Roots 3-5 mm from the apex were sectioned and prepared for analysis at 40× magnification. The minimum and maximum diameters of each physiological foramen were measured using the program Motic Images plus 2.0 ML. The shape of the foramina, classified as round, oval or irregular, was determined by the difference between the maximum and minimum diameters. A total of 174 physiological foramina were analyzed. The average of the minimum and maximum diameters was between 0.24-0.33 mm in maxillary first molars and between 0.25-0.33 mm in mandibular first molars. In maxillary molars, the most common shape of the foramen was oval (50%), then irregular (32%), then round (18%). In mandibular molars, the oval shape was also the most frequent (59%), followed by irregular (23%) and round (18%). The findings of this study regarding the morphology of physiological apical foramina in first molars make it easier for the operator to choose the appropriately-sized instruments to perform endodontic therapy successfully.

9.
Injury ; 44(3): 283-7, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23352678

RESUMO

Midclavicular fracture is one of the most common injuries of the skeleton, representing 3-5% of all fractures and 45% of all shoulder injuries. The recurrent failure of clavicular fracture treatment, whether conservative or surgical, could give rise to multiple surgeries, ultimately leading to a painful nonunion. The aim of the article is to address the indications, surgical technique and results of clavicular reconstruction using vascularised fibular flaps based on 4 cases reports.


Assuntos
Clavícula/cirurgia , Fraturas Ósseas/cirurgia , Fraturas Mal-Unidas/cirurgia , Retalhos de Tecido Biológico/irrigação sanguínea , Procedimentos de Cirurgia Plástica , Idoso , Transplante Ósseo , Clavícula/lesões , Clavícula/fisiopatologia , Feminino , Fíbula , Consolidação da Fratura , Fraturas Ósseas/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/fisiopatologia , Resultado do Tratamento
10.
Eur J Cancer ; 45(11): 2050-60, 2009 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-19427195

RESUMO

BACKGROUND: Aberrant activation of oncogenes, such as Ras, likely contributes to the development of hepatocarcinoma (HCC). AIMS/METHODS: We evaluated in vivo the effect of intraperitoneal injections of the Ras inhibitor S-trans, trans-farnesylthiosalicyclic acid (FTS) on Ras activation and the development of preneoplastic liver lesions in rats receiving weekly diethylnitrosamine (DEN) injections for 16weeks. Western blotting, quantitative PCR, immunohistochemistry, Tunel and caspase activity assays were used. RESULTS: FTS prevents liver nodule formation and reduces foci expressing the tumour marker GSTp. FTS abrogates DEN-induced Ras membrane activity, increases Tunel positive cells in transformed, GSTp-expressing hepatocytes, up-regulates caspase 3 and 8 activity, induces Fas, Fas ligand and JNK phosphorylation that occurs independently of TNFalpha and Trail. Cytochrome C release, Bax, Bcl2, Bcl-xl, Ki67 and nuclear cyclin D expression is not affected by FTS. CONCLUSIONS: FTS inhibits Ras activation and prevents preneoplastic liver nodule development by inducing apoptosis in transformed hepatocytes through activation of the Fas/Fas ligand system. FTS might be new molecule for HCC treatment.


Assuntos
Antineoplásicos/uso terapêutico , Farneseno Álcool/análogos & derivados , Regulação Neoplásica da Expressão Gênica/efeitos dos fármacos , Genes ras , Hepatócitos/patologia , Salicilatos/uso terapêutico , Animais , Apoptose/efeitos dos fármacos , Biomarcadores/análise , Western Blotting/métodos , Carcinoma Hepatocelular/patologia , Carcinoma Hepatocelular/prevenção & controle , Caspase 3/análise , Caspase 8/análise , Dietilnitrosamina , Farneseno Álcool/uso terapêutico , Hepatócitos/efeitos dos fármacos , Imuno-Histoquímica , Neoplasias Hepáticas/patologia , Neoplasias Hepáticas/prevenção & controle , Masculino , Modelos Animais , Ratos , Ratos Wistar
11.
Rev. chil. neuropsicol. (En línea) ; 3(1): 7-14, jul. 2008. ilus, tab
Artigo em Espanhol | LILACS | ID: lil-523020

RESUMO

Los estudios epidemiológicos muestran una clara relación entre el nivel educativo y la presencia de deterioro cognitivo en poblaciones envejecidas. En nuestro medio no existen investigaciones que aborden esta problemática por lo que pretendemos realizar una primera aproximación a las consecuencias del envejecimiento y el bajo nivel educativo sobre los procesos cognitivos. Para esto evaluamos a 280 sujetos adultos mayores de tres distritos de la ciudad Arequipa con el Examen Mental Abreviado (Mini Mental) y un cuestionario de variables sociodemográficas. Nuestros resultados muestran una relación significativa entre la edad y el deterioro cognitivo observándose puntajes más bajos en sujetos con mayor edad; además observamos que los sujetos con mayor nivel educativo muestran puntajes más altos. Estas primeras aproximaciones al deterioro cognitivo en nuestro medio ponen de relieve la importancia de la implementación de políticas socioeducativas eficaces que permitan el acceso a la educación a la mayoría de nuestra población.


The epidemiologic studies of cognitive decline show a clear relationship between the educational level and the presence of cognitive deterioration in aged populations. In our city there are not investigations that approach this problem for what we try to carry out a first approach to the consequences of the aging and the educational low-level on the cognitive processes. For this we evaluated 280 old age fellows of three districts of the city of Arequipa with the Mini Mental State Examination and a questionnaire of sociodemographic variables. Our results show a significant relationship between the age and the cognitive deterioration being observed in lower score in subject with more age; we also observe that those subject with more educational level show higher score. These first approaches to the cognitive deterioration in our city put of relief the importance of the implementation of effective political programs that allow the access to the education to most of our population.


Assuntos
Humanos , Masculino , Feminino , Idoso , Envelhecimento , Demência/epidemiologia , Transtornos Cognitivos/epidemiologia , Escolaridade , Entrevista Psiquiátrica Padronizada , Peru/epidemiologia , Inquéritos e Questionários
12.
Neurochem Res ; 30(4): 567-76, 2005 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-16076026

RESUMO

The expression of mesencephalic brain derived neurotrophic factor (BDNF) has been shown to be regulated by dopaminergic neuronal functioning and glutamate receptors (GluRs). In turn, BDNF participates in the regulation of mesencephalic GluRs' expression. In the present study we analyzed, using semi-quantitative RT-PCR, the effect of BDNF as well as of the GluRs agonists NMDA and trans-(+/-)-1-Amino-(1S,3R)-cyclopentane dicarboxylic acid (t-ACPD), on the expression levels of the NMDA GluR subunit 1 (NR1) mRNA, using rat cultured mesencephalic neurons. In the course of this study, a novel rat mRNA splice variant of NR1 was identified. This new NR1 mRNA isoform is characterized by the insertion of an 82 base pair intron containing an inframe stop codon, thus predicting the expression of a putative truncated protein of 465 amino acids. The RT-PCR and in situ hybridization reveals that the novel NR1 mRNA is expressed in various brain regions of the rat embryo, whereas no expression was detected in the adult rat brain. The modulation of the novel NR1 mRNA isoform by both BDNF and the metabotropic GluR agonist t-ACPD, suggests that the resulting putative NR1 truncated protein may be relevant in the regulatory network of glutamatergic neurotransmission in the developing central nervous system.


Assuntos
Processamento Alternativo/genética , Química Encefálica/genética , Encéfalo/embriologia , Receptores de N-Metil-D-Aspartato/genética , Sequência de Aminoácidos , Animais , Sequência de Bases , Fator Neurotrófico Derivado do Encéfalo/farmacologia , Sobrevivência Celular/efeitos dos fármacos , Células Cultivadas , Clonagem Molecular , Cicloleucina/análogos & derivados , Cicloleucina/farmacologia , Feminino , Hibridização In Situ , Mesencéfalo/citologia , Mesencéfalo/efeitos dos fármacos , Mesencéfalo/metabolismo , Dados de Sequência Molecular , Gravidez , RNA Mensageiro/biossíntese , RNA Mensageiro/isolamento & purificação , Ratos , Receptor trkB/agonistas , Receptores de N-Metil-D-Aspartato/agonistas , Reação em Cadeia da Polimerase Via Transcriptase Reversa
13.
Transplant Proc ; 36(6): 1673-4, 2004.
Artigo em Inglês | MEDLINE | ID: mdl-15350448

RESUMO

INTRODUCTION: Since the early days, liver transplantation (OLT) has conquered several barriers worldwide to become a proven therapy. We assessed the evolution of our adult liver transplant program. METHODS: We studied all adult patients who underwent OLT since the inception from November 1993 through May 2003. Donor data, recipient pretransplantation evaluation, surgical technique, results, and costs were examined over our evolution, stratifying 3 groups over time, based on the number of adult OLT per year. RESULTS: Between November 1993 and May 2003, 70 OLT were performed in 64 patients older than 15 years of age. Preoperative Child score, preoperative creatinine level, donor and recipient age, and proportion of emergencies were similar in the 3 groups. Over time, the predominant surgical technique was the piggyback technique (97% of OLT) with a decrease in the use of bypass from 63% to 5% during the last time period. Over the 10 years of our program's existence, warm ischemia time has been reduced to less than 1 hour, whereas cold ischemia time has remained constant at around 5 hours. Biliary and vascular complications decreased over time to around 10%. The mean length of hospital stay (LOS) decreased to 12 days (excluding emergencies). Since inception, our 1-year patient survival rate average is 91%; however, in just the last 3 years of our program (2000 through 2003), the 1-year patient survival rate is 97%. CONCLUSIONS: In summary, our surgical technique has evolved toward piggyback use without veno-venous bypass with a significant decrease in warm ischemia times. As expected, our results have improved over time and our LOS and costs have decreased. Finally, our current results are similar to the best ones reported in the medical literature today.


Assuntos
Transplante de Fígado/estatística & dados numéricos , Doadores de Tecidos/estatística & dados numéricos , Adulto , Chile , Creatinina/sangue , Humanos , Transplante de Fígado/métodos , Transplante de Fígado/fisiologia , Resultado do Tratamento
14.
Transplant Proc ; 36(6): 1683-4, 2004.
Artigo em Inglês | MEDLINE | ID: mdl-15350452

RESUMO

INTRODUCTION: Some groups have reported early extubation post-liver transplantation in patients with previously defined criteria, in an attempt to shorten the ICU stay and decrease costs. We review our experience with trends in mechanical ventilation and resource utilization. METHODS: We retrospectively reviewed the length of mechanical ventilation, ICU stay, hospital stay, transfusions, and costs of liver transplants performed since the program's inception in 1993 and 2002 including 82 OLT in 71 patients. We also report our experience with immediate postoperative extubation, which we have done from October to December of 2002. We compare different periods: the early days (1993 to 1997), namely, fewer than 10 OLT per year, with the subsequent years assessed individually. RESULTS: There has been a progressive decrease over time in the length of mechanical ventilation, ICU stay, hospital stay, and costs. Since the program's inception actuarial adult patient 1- and 5-year survival rates were 88.7% and 78%, respectively. The 1-year survival rate increased to 97% during the period of 2000 to 2002 (n = 30). From October to the present, we extubated four of seven adult patients who met criteria with none of them requiring reintubation. CONCLUSIONS: We demonstrate improved results, decreased length of mechanical ventilation, ICU, and hospital stay, and costs. The immediate postoperative extubation may be feasible for patients who meet previously defined criteria.


Assuntos
Transplante de Fígado/métodos , Respiração Artificial/tendências , Transfusão de Sangue/estatística & dados numéricos , Chile , Humanos , Tempo de Internação , Respiração Artificial/métodos , Estudos Retrospectivos
17.
Rev. chil. urol ; 66(2): 172-174, 2001.
Artigo em Espanhol | LILACS | ID: lil-389300

RESUMO

La vasectomía es una técnica simple y eficiente en el objetivo de controlar la natalidad por medios quirúrgicos en el varón. Nosotros estudiamos a pacientes fértiles que deseaban ser sometidos a esta técnica con el fin de regular su natalidad en forma definitiva. Los espermiogramas post operatorios a la semana, dos semanas y al mes, demostraron presencia de espermios pero de escasa motilidad con lo cual concluimos que el efecto esterilizador de la vasectomía es inmediato, independientemente del número de espermios encontrados.


Assuntos
Humanos , Masculino , Vasectomia/estatística & dados numéricos , Vasectomia/tendências , Fertilidade
18.
Brain Res Mol Brain Res ; 79(1-2): 150-5, 2000 Jun 23.
Artigo em Inglês | MEDLINE | ID: mdl-10925152

RESUMO

By using non-isostopic in situ hybridization we have demonstrated a transient increase of BDNF mRNA in the lateral subregion of the substantia nigra pars reticulata 1 week after intrastriatal application of 6-OH-DA. These changes correlate with a partial reduction of dopamine (DA) content in the striatum but with a normal tyrosine hydroxylase immunoreactivity in substantia nigra pars compacta. Our data suggest that non-DA, BDNF expressing cells in substantia nigra pars reticulata may play a role in neuronal protection after partial lesions of the DA nigrostriatal pathway.


Assuntos
Fator Neurotrófico Derivado do Encéfalo/genética , Corpo Estriado/fisiologia , Substância Negra/fisiologia , Transcrição Gênica , Animais , Dopamina/metabolismo , Lateralidade Funcional , Regulação da Expressão Gênica , Masculino , Oxidopamina , RNA Mensageiro/genética , Ratos , Ratos Sprague-Dawley , Substância Negra/metabolismo , Fatores de Tempo , Tirosina 3-Mono-Oxigenase/metabolismo
19.
Neurochem Int ; 35(1): 19-33, 1999 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-10403427

RESUMO

The in vivo microdialysis methodology was used to assess the effect of N-methyl-D-aspartate (NMDA) receptor ligands on glutamate (GLU), aspartate (ASP) and gamma-aminobutyrate (GABA) extracellular levels in the striatum of anaesthetized rats, after damage to the dopamine (DA) nigrostriatal pathway by injections of different doses of 6-hydroxydopamine (6-OH-DA) seven days earlier. The 6-OH-DA treated rats were divided into two groups, corresponding to animals with 20-80% (partial) and 85-99% (extensive) striatal DA tissue depletion, respectively. In rats with partial DA depletion, the striatal extracellular ASP levels significantly increased after intrastriatal dialysis perfusion with MK-801 (100 microM), an antagonist of NMDA receptors. In addition, a change in the pattern of local NMDA (500 microM)- induced efflux of ASP was observed in the striatum of these rats. However, in these partially DA-depleted striata no changes were found in basal extracellular levels of GLU, ASP and GABA or in NMDA- and MK-801-mediated effluxes of GLU and GABA relative to striata from sham rats. In contrast, rats with extensive striatal DA depletion exhibited a significant increase in ASP and GABA extracellular striatal levels, after intrastriatal dialysis perfusion with NMDA. In addition, the MK-801-mediated stimulation of extracellular ASP levels was accentuated along with the appearance of a MK-801 mediated increase in extracellular striatal GLU. Finally, basal extracellular levels of ASP, but not of GLU and GABA, were found to increase in extensive DA-depleted striata when compared to sham and partially DA-depleted striata. Thus, a differential regulation of basal and NMDA receptor-mediated release of transmitter amino acids occur seven days after partial and extensive DA-depleted striatum by 6-OH-DA-induced lesions of the nigrostriatal DA pathway. These findings may have implications as regards the participation of NMDA receptors in the compensatory mechanisms associated with the progress of Parkinson's disease, as well as in the treatment of this neurological disorder.


Assuntos
Ácido Aspártico/metabolismo , Corpo Estriado/fisiologia , Maleato de Dizocilpina/farmacologia , Dopamina/metabolismo , Ácido Glutâmico/metabolismo , Receptores de N-Metil-D-Aspartato/fisiologia , Substância Negra/fisiologia , Ácido gama-Aminobutírico/metabolismo , Animais , Corpo Estriado/efeitos dos fármacos , Antagonistas de Aminoácidos Excitatórios/farmacologia , Homeostase , Cinética , Masculino , Microdiálise , Oxidopamina/farmacologia , Prosencéfalo/efeitos dos fármacos , Prosencéfalo/fisiologia , Ratos , Ratos Sprague-Dawley , Receptores de N-Metil-D-Aspartato/efeitos dos fármacos , Substância Negra/efeitos dos fármacos
20.
Arch Med Res ; 30(2): 132-7, 1999.
Artigo em Inglês | MEDLINE | ID: mdl-10372448

RESUMO

BACKGROUND: The purpose of this work was to evaluate the effect of superoxide dismutase (SOD) on primary swelling, lipoperoxidation, body thymus, and spleen weight in the adjuvant-induced arthritis (AIA) model in rats. METHODS: Orally and intraperitoneally administered SOD (100 U/kg) from bovine erythrocytes, as well as naproxen (40 mg/kg) and dexamethasone (25 mg/kg), were evaluated against placebo. RESULTS: Primary edema was not decreased by SOD; in contrast, naproxen and dexamethasone showed good anti-inflammatory activity. Lipoperoxidation increased 1.8, 2.5, and 2.8 times with intraperitoneal SOD, naproxen, and dexamethasone administration, respectively, while oral SOD decreased lipoperoxidation levels to approximately one-half of that found in the control group. Body weight increased with SOD but decreased with dexamethasone. Naproxen did not change the animal weight. Thymus weight remained unchanged with SOD and naproxen, while it decreased with dexamethasone. Spleen weight remained the same with SOD, but increased with naproxen and decreased with dexamethasone. No side effects were observed in the SOD group, whereas 20% of the rats in the naproxen group died of gastrointestinal hemorrhage, and 50% of the rats in the dexamethasone group, of pulmonary infection. CONCLUSIONS: In conclusion, SOD showed no anti-inflammatory activity but decreased lipoperoxidation when administered orally. No deleterious effects in primary and secondary immunologic organs were observed with this agent.


Assuntos
Artrite Experimental/metabolismo , Eritrócitos/enzimologia , Superóxido Dismutase/sangue , Animais , Anti-Inflamatórios não Esteroides/farmacologia , Bovinos , Dexametasona/farmacologia , Peroxidação de Lipídeos , Masculino , Naproxeno/farmacologia , Tamanho do Órgão/efeitos dos fármacos , Ratos , Ratos Wistar , Baço/efeitos dos fármacos , Timo/efeitos dos fármacos
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