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1.
J Vasc Access ; 24(4): 798-801, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34590510

RESUMO

We present the case of a patient with a brachio-basilic graft forearm loop with intractable edema and thrombosed central veins. She showed up with an important edema after some effort and a previously thrombosed pseudoaneurysm with significant growth. She refused angioplasty treatment for central veins, the graft had not been used for dialysis during the last year, so that arteriovenous graft (AVG) ligation was considered. Due to local conditions thrombin percutaneous embolization was performed to avoid possible complications of a conventional surgery approach. AVG occlusion was done in 10 min by fluoroscopy and ultrasound guidance. In 24 h the patient was significantly better and after 1 week she had no edema at all. There were no complications and no recanalization was observed after 3 months. Percutaneous thrombin embolization is a safe and effective technique for AVG occlusion in case of intractable arm edema with central vein thrombosis, and most likely to be considered in other situations where arteriovenous graft or fistula ligature is needed.


Assuntos
Falso Aneurisma , Derivação Arteriovenosa Cirúrgica , Trombose , Doenças Vasculares , Feminino , Humanos , Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/etiologia , Falso Aneurisma/terapia , Braço , Derivação Arteriovenosa Cirúrgica/efeitos adversos , Derivação Arteriovenosa Cirúrgica/métodos , Edema/complicações , Oclusão de Enxerto Vascular/diagnóstico por imagem , Oclusão de Enxerto Vascular/etiologia , Oclusão de Enxerto Vascular/terapia , Diálise Renal , Estudos Retrospectivos , Trombina , Resultado do Tratamento , Ultrassonografia de Intervenção , Doenças Vasculares/complicações , Grau de Desobstrução Vascular
2.
Enfermeria (Montev.) ; 11(2)dic. 2022.
Artigo em Inglês | LILACS-Express | LILACS, BDENF - Enfermagem | ID: biblio-1404687

RESUMO

Abstract: Introduction: Although the training of nurses in administration and leadership has an important repercussion on the present and the future of the profession, teaching methods are still traditional in many cases. Flipped classroom is a widely used method in nursing education but studies about its application to Nursing Administration and Management are limited. Method: Qualitative study by means of anonymous survey (dichotomous and open questions). Results: 92 % of students were shown to be satisfied with the teaching methodology and 92.9 % with the assessment. Only 31.5 % had used it previously but 83 % would like to use it in more subjects. The students showed that the methodology used had improved their opinion about the content and had increased their perception its usefulness. Conclusion: The participating students have been shown to be satisfied with flipped method and continuous assessment. These teaching strategies can help motivate nursing students towards the subject of Nursing Administration and Management, which can encourage them to pursue postgraduate training and professional practice in this area


Resumen: Introducción: Si bien la formación de enfermeros en Administración y Gestión tiene una importante repercusión en el presente y el futuro de la profesión, los métodos de enseñanza siguen siendo tradicionales en muchos casos. El aula invertida es un método ampliamente utilizado en la educación de enfermería, pero los estudios sobre su aplicación a la administración y gestión de enfermería son limitados. Método: Estudio cualitativo mediante cuestionario anónimo (preguntas dicotómicas y abiertas). Resultados: El 92 % de los estudiantes se mostró satisfecho con la metodología de enseñanza y el 92,9 % con la evaluación. Solo el 31,5 % lo había usado anteriormente, pero al 83 % le gustaría usarlo en más sujetos. Los estudiantes demostraron que la metodología utilizada había mejorado su opinión sobre el contenido y había aumentado su percepción útil del mismo. Conclusión: Los estudiantes participantes han demostrado estar satisfechos con el método de aula invertida. Estas estrategias de enseñanza pueden ayudar a motivar a los estudiantes de enfermería hacia la asignatura de Administración y Gestión de los Servicios de Enfermería, lo que puede animarlos a realizar una formación de posgrado y una práctica profesional en esta área.


Resumo: Introdução: Embora a educação de Enfermagem em Administração e Gestão tenha um grande impacto no presente e futuro da profissão, os métodos de ensino continuam a ser tradicionais em muitos casos. A sala de aula invertida é um método amplamente utilizado na educação em Enfermagem, mas os estudos sobre a sua aplicação à Administração e Gestão de Enfermagem são limitados. Método: Estudo qualitativo utilizando um questionário anônimo (perguntas dicotômicas e abertas). Resultados: 92% dos estudantes ficaram satisfeitos com a metodologia de ensino e 92,9% com a avaliação. Apenas 31,5% já o tinha utilizado antes, mas 83% gostariam de utilizá-lo em mais assuntos. Os estudantes mostraram que a metodologia utilizada havia melhorado a sua opinião sobre o conteúdo e aumentado a sua percepção útil do conteúdo. Conclusão: Os estudantes participantes mostraram-se satisfeitos com o método invertido e com a avaliação contínua. Estas estratégias de ensino podem ajudar a motivar os estudantes de Enfermagem para a disciplina de Administração e Gestão de Enfermagem, o que pode encorajá-los a empreender uma educação de pós-graduação e prática profissional nesta área.

3.
Clin Transl Oncol ; 24(1): 112-126, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34363594

RESUMO

PURPOSE: Malnutrition is a common problem among pancreatic cancer (PC) patients that negatively impacts on their quality of life (QoL) and clinical outcomes. The main objective of this consensus is to address the role of Medical Nutrition Therapy (MNT) into the comprehensive therapeutic management of PC patients. METHODS: A Spanish multidisciplinary group of specialists from the areas of Medical Oncology; Radiation Oncology; Endocrinology and Nutrition; and General Surgery agreed to assess the role of MNT as part of the best therapeutic management of PC patients. RESULTS: The panel established different recommendations focused on nutritional screening and nutritional screening tools, MNT strategies according to PC status, and MNT in palliative treatment. CONCLUSIONS: There is an unmet need to integrate nutritional therapy as a crucial part of the multimodal care process in PC patients. Health authorities, health care professionals, cancer patients, and their families should be aware of the relevance of nutritional status and MNT on clinical outcomes and QoL of PC patients.


Assuntos
Desnutrição/dietoterapia , Desnutrição/etiologia , Terapia Nutricional , Neoplasias Pancreáticas/complicações , Procedimentos Clínicos , Humanos , Estado Nutricional
4.
Cir Cir ; 89(6): 811-817, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34851590

RESUMO

BACKGROUND: Post-intubation tracheoesophageal fistula is a severe complication in long-term mechanical ventilation patients with possible fatal consequences. OBJECTIVE: To describe a case of post-intubation tracheoesophageal fistula and its surgical management. In addition, a brief literature review was effectuated. CASE REPORT: 45-year-old female, suffers ischemic stroke with progressive neurological damage that requires long-term mechanical ventilation. During endoscopic gastrostomy tracheoesophageal fistula is shown. RESULTS: Undergoes surgery for esophageal repair and tracheal resection, through cervicosternotomy. Unfortunately died in the immediate postoperative period. CONCLUSIONS: This complex pathology requires structured protocols for its prevention in patients in whom long-term mechanical ventilation is expected.


ANTECEDENTES: La fístula traqueoesofágica es una complicación en pacientes con ventilación mecánica prolongada. La contaminación pulmonar permanente puede ser grave, con evolución fatal. OBJETIVO: Describir un caso de fístula traqueoesofágica posintubación y hacer una breve revisión de la literatura. CASO CLÍNICO: Mujer de 45 años que sufre un evento cerebrovascular isquémico que condiciona deterioro neurológico progresivo, ameritando ventilación mecánica prolongada. Durante la gastrostomía endoscópica se evidencia una fístula. RESULTADOS: Intervenida quirúrgicamente para reparación esofágica y resección traqueal mediante cervicoesternotomía, lamentablemente fallece en el posoperatorio inmediato. CONCLUSIONES: Esta patología es compleja. Deben implementarse protocolos enfocados en su prevención en pacientes en quienes se espera una ventilación mecánica prolongada.


Assuntos
Esofagoplastia , Fístula Traqueoesofágica , Feminino , Humanos , Doença Iatrogênica , Intubação Intratraqueal/efeitos adversos , Pessoa de Meia-Idade , Respiração Artificial , Fístula Traqueoesofágica/etiologia , Fístula Traqueoesofágica/cirurgia
5.
Arch Med Sci ; 17(6): 1766-1771, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34900058

RESUMO

INTRODUCTION: The CYP450 complex participates in the metabolism of ifosfamide, an antineoplastic drug used to treat solid tumors. CYP450 genes contain several single nucleotide polymorphisms (SNPs) that confer different activity towards the enzyme. The aim of our study was to analyze gene frequencies of allelic variants and their association with ifosfamide blood levels and patient prognosis. MATERIAL AND METHODS: 148 DNA samples from children were analyzed. Genotyping was performed by real-time PCR with TaqMan probes and ifosfamide levels were determined in dried blood drop by UPLCMS/MS. RESULTS: Ifosfamide levels increased according to the genotype, and patients with the variant rs1799853 in CYP2C9 genotype CC had lower levels of ifosfamide (median = 1.8 µmol/l, Q25 0.9-Q75 4.6) compared with patients with genotype TT + CT (median = 2.8 µmol/l, Q25 1.9-Q75 5.1), p < 0.001. In the case of the rs2740574 variant in the CYP3A4 gene, patients with normal genotype (TT) presented median = 1.4 µmol/l, (Q25 0.7-Q75 2.7), while patients with the CC + TC genotype had higher levels of ifosfamide (median = 2.0 µmol/l, Q25 1.0-Q75 4.3), p = 0.024. In addition, patients with CC + CT genotype of this variant had a higher risk of non-response to treatment compared to patients with TT genotype (RR = 1.3, 95% CI: 1.07-1.59, p = 0.03). CONCLUSIONS: Polymorphisms in CYP2C9 and CYP3A4 genes are associated with high levels of ifosfamide. In addition, the polymorphism rs2740574 in CYP3A4 was associated with a worse therapeutic response.

7.
Rev. Urug. med. Interna ; 6(2): 72-76, jul. 2021. tab
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1288125

RESUMO

Resumen: La anestesia regional es la técnica de elección debida a la menor morbimortalidad. Una de las complicaciones más temidas es el hematoma espinal, teniendo las pacientes que reciben antiagregantes y/o anticoagulantes mayor riesgo de desarrollarlo. El cuadro clínico es variable, y no siempre están todos los elementos presentes (dolor lumbar, déficit motor y/o sensitivo y/o vesical). El diagnóstico se realiza por resonancia nuclear magnética y el tratamiento es la descompresión por laminectomía. Estando el pronóstico neurológico vinculado al tiempo en que se realiza ésta. Se realiza una revisión sobre los distintos fármacos antiagregantes y anticoagulantes utilizados en el embarazo - puerperio y las recomendaciones necesarias para las pacientes que recibirán una anestesia regional.


Abstract: Regional anesthesia is the technique of choice due to lower morbidity and mortality. One of the most feared complications is spinal hematoma, with patients receiving antiplatelet and / or anticoagulants having a greater risk of developing it. The clinical picture is variable, and not all the elements are always present (lumbar pain, motor and / or sensory and / or bladder deficits). Diagnosis is made by magnetic resonance imaging and treatment is laminectomy decompression. Being the neurological prognosis linked to the time in which it is performed. A review is made of the different antiplatelet and anticoagulant drugs used in pregnancy - puerperium and the necessary recommendations for patients who will receive regional anesthesia.


Resumo: A anestesia regional é a técnica de escolha devido à menor morbimortalidade. Uma das complicações mais temidas é o hematoma espinhal, com pacientes em uso de antiagregantes plaquetários e / ou anticoagulantes com maior risco de desenvolvê-lo. O quadro clínico é variável e nem sempre os elementos estão presentes (dor lombar, déficits motores e / ou sensoriais e / ou vesicais). O diagnóstico é feito por ressonância magnética e o tratamento é a descompressão por laminectomia. Sendo o prognóstico neurológico ligado ao tempo em que é realizado. É feita uma revisão das diferentes drogas antiplaquetárias e anticoagulantes utilizadas na gravidez - puerpério e as recomendações necessárias para as pacientes que receberão anestesia regional.

8.
Clin Transl Oncol ; 23(2): 318-324, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32592157

RESUMO

BACKGROUND: Pancreatectomy plus celiac axis resection (CAR) is performed in patients with locally advanced pancreatic cancer. The morbidity rates are high, and no survival benefit has been confirmed. It is not known at present whether it is the type of pancreatectomy, or CAR itself, that is the reason for the high complication rates. METHODS: Observational retrospective multicenter study. INCLUSION CRITERIA: patient undergoing TP, PD or DP plus CAR for a pancreatic cancer. RESULTS: Sixty-two patients who had undergone pancreatic cancer surgery (PD,TP or DP) plus CAR were studied. Group 1: 17 patients who underwent PD/TP-CAR (13TP/4PD); group 2: 45 patients who underwent DP-CAR. Groups were mostly homogeneous. Operating time was longer in the PD/TP group, while operative complications did not differ statistically in the two groups. The number of lymph nodes removed was higher in the PD/TP group (26.5 vs 17.3), and this group also had a higher positive node ratio (17.9% vs 7.6%). There were no statistical differences in total or disease-free survival between the two groups. CONCLUSION: It seems that CAR, and not the type of pancreatectomy, influences morbidity and mortality in this type of surgery. International multicenter studies with larger numbers of patients are now needed to validate the data presented here.


Assuntos
Artéria Celíaca/cirurgia , Pancreatectomia/métodos , Neoplasias Pancreáticas/cirurgia , Índice de Massa Corporal , Intervalo Livre de Doença , Feminino , Humanos , Estimativa de Kaplan-Meier , Excisão de Linfonodo/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica/patologia , Duração da Cirurgia , Pancreatectomia/efeitos adversos , Pancreatectomia/mortalidade , Neoplasias Pancreáticas/mortalidade , Neoplasias Pancreáticas/patologia , Complicações Pós-Operatórias , Estudos Retrospectivos , Espanha , Resultado do Tratamento
10.
J Med Case Rep ; 14(1): 234, 2020 Dec 02.
Artigo em Inglês | MEDLINE | ID: mdl-33261664

RESUMO

BACKGROUND: Gastric carcinoma (GC) with second primary malignancy (SPM) is the most frequent combination within the multiple primary malignancies (MPM) group. The presentation of a GC associated with a synchronized SPM in the kidney is extremely rare and unusual. This study presents a rare case of synchronous tumors, describes the main associated risk factors, and emphasizes the need to rule out SPM. MAIN BODY: We present the case of a 63-year-old Hispanic woman with a history of smoking, weight loss, and gastrointestinal (GI) bleeding. GC was diagnosed by endoscopy, and during her workup for metastatic disease, a synchronous SPM was noted in the left kidney. The patient underwent resection of both tumors with a satisfactory postoperative course. A systematic review of the literature was performed using the Medline/PubMed, Science Direct, Scopus, and Google Scholar databases. A search of the literature yielded 13 relevant articles, in which the following main risk factors were reported: the treatment utilized, the grade and clinical stage, histopathological report, and in some cases survival. It is concluded that advanced age (> 60 years) and smoking are the main associated risk factors. CONCLUSION: Gastric carcinoma is the second most frequent neoplasm of the GI tract and the main neoplasm that presents a SPM. MPM screening is recommended in patients with gastric cancer. The clinical discovery of MPM of renal origin is rare and hence the importance of the current report.


Assuntos
Carcinoma de Células Renais , Neoplasias Renais , Neoplasias Primárias Múltiplas , Segunda Neoplasia Primária , Neoplasias Gástricas , Carcinoma de Células Renais/diagnóstico por imagem , Carcinoma de Células Renais/cirurgia , Feminino , Humanos , Neoplasias Renais/diagnóstico por imagem , Neoplasias Renais/cirurgia , Pessoa de Meia-Idade , Neoplasias Primárias Múltiplas/cirurgia , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/cirurgia
11.
Clin Transl Oncol ; 22(11): 1963-1975, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32318964

RESUMO

Pancreatic cancer (PC) remains one of the most aggressive tumors with an increasing incidence rate and reduced survival. Although surgical resection is the only potentially curative treatment for PC, only 15-20% of patients are resectable at diagnosis. To select the most appropriate treatment and thus improve outcomes, the diagnostic and therapeutic strategy for each patient with PC should be discussed within a multidisciplinary expert team. Clinical decision-making should be evidence-based, considering the staging of the tumor, the performance status and preferences of the patient. The aim of this guideline is to provide practical and evidence-based recommendations for the management of PC.


Assuntos
Consenso , Neoplasias Pancreáticas/terapia , Endossonografia , Humanos , Estadiamento de Neoplasias , Apoio Nutricional , Cuidados Paliativos , Pancreatectomia , Neoplasias Pancreáticas/diagnóstico , Neoplasias Pancreáticas/patologia
12.
Parasite Immunol ; 42(3): e12692, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31856305

RESUMO

The aim of this study was to evaluate the inflammation process that resulted from the inoculation of Wistar Rats with Acanthamoeba griffini, a virulent T3 Acanthamoeba genotype that produces keratitis. Haematoxylin and eosin, periodic acid stain, immunohistochemistry and morphometry were used to analyse tissues from rats of an Acanthamoeba keratitis (AK) model. Two weeks after inoculating the rats with A griffini trophozoites, the thickness of the stroma had diminished, followed by an increase in thickness at 4 weeks. At the latter time, an abundance of inflammatory infiltrate cells was observed, some found to express IL-1ß, IL-10 and/or caspase 3. Intercellular adhesion molecule-1 was expressed in corneal blood vessels amid the abundant vascularization characteristic of the development of AK. Through an immunohistochemical technique, trophozoites were detected at 2 and 4 weeks post-inoculation. By 8 weeks, there were a low number of trophozoites and cysts and the corneas of infected rats were similar in thickness to those of the controls. Thus, the rats were capable of healing experimental AK in the present rat model. Diverse immunological mechanisms regulated the inflammatory process in acute AK induced by A griffini in a murine model.


Assuntos
Ceratite por Acanthamoeba/patologia , Acanthamoeba/fisiologia , Acanthamoeba/classificação , Ceratite por Acanthamoeba/imunologia , Animais , Apoptose , Caspase 3/análise , Córnea/patologia , Modelos Animais de Doenças , Feminino , Humanos , Molécula 1 de Adesão Intercelular/análise , Interleucina-10/análise , Interleucina-1beta/análise , Camundongos , Ratos , Ratos Wistar , Trofozoítos/fisiologia
13.
Neuroinformatics ; 17(1): 5-25, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-29705977

RESUMO

This paper addresses the problem of obtaining new neuron features capable of improving results of neuron classification. Most studies on neuron classification using morphological features have been based on Euclidean geometry. Here three one-dimensional (1D) time series are derived from the three-dimensional (3D) structure of neuron instead, and afterwards a spatial time series is finally constructed from which the features are calculated. Digitally reconstructed neurons were separated into control and pathological sets, which are related to three categories of alterations caused by epilepsy, Alzheimer's disease (long and local projections), and ischemia. These neuron sets were then subjected to supervised classification and the results were compared considering three sets of features: morphological, features obtained from the time series and a combination of both. The best results were obtained using features from the time series, which outperformed the classification using only morphological features, showing higher correct classification rates with differences of 5.15, 3.75, 5.33% for epilepsy and Alzheimer's disease (long and local projections) respectively. The morphological features were better for the ischemia set with a difference of 3.05%. Features like variance, Spearman auto-correlation, partial auto-correlation, mutual information, local minima and maxima, all related to the time series, exhibited the best performance. Also we compared different evaluators, among which ReliefF was the best ranked.


Assuntos
Algoritmos , Imageamento Tridimensional/métodos , Neurônios/classificação , Neurônios/citologia , Animais , Macaca mulatta , Ratos , Ovinos
15.
Rev. inf. cient ; 97(3): i:626-f:634, 2018.
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1005099

RESUMO

Introducción: la evaluación del proyecto educativo que se lleva a cabo actualmente en la Facultad de Ciencias Médicas de Guantánamo no es la más adecuada. Esto se evidencia en la participación poco activa y asistemática de los dirigentes de la FEU en la elaboración y evaluación del proyecto educativo a partir de indicadores, lo que influye en la calidad del proceso de integralidad de los estudiantes. Objetivo: elaborar un libro electrónico para la evaluación del proyecto educativo del año, que favorezca el perfeccionamiento del proceso de integralidad de los estudiantes de la Facultad de Ciencias Médicas Guantánamo. Método: se realizó un estudio tipo investigación acción en el período octubre de 2015 hasta junio de 2016 con 18 profesores guías y jefes de brigada y la jefa del colectivo de año de dicha facultad, donde se empleó una metodología para el diseño del material electrónico que consta de tres hojas de cálculo, que permite a partir de indicadores diseñados evaluar los resultados del proyecto educativo, además, de permitir determinar los posibles estudiantes integrales y el cumplimiento de los objetivos propuestos en el proyecto. Resultados: se obtuvo como principal resultado la transformación del personal pedagógico favoreciendo un nuevo estilo de trabajo en función de elevarla calidad del proceso y su impacto en la formación integral de los estudiantes. Conclusiones: contribuye a perfeccionar el proceso de integralidad a partir que propicia el empleo de métodos participativos, dinámicos, democráticos, a diferencia de los que se empleaban hasta el momento, con viejos estilos(AU)


Introduction: the evaluation of the educational project that is currently carried out in the Faculty of Medical Sciences of Guantanamo is not the most appropriate. This is evidenced by the active and unsystematic participation of the FEU leaders in the elaboration and evaluation of the educational project based on indicators, which influences the quality of the integrality process of the students. Objective: to prepare an electronic book for the evaluation of the educational project of the year, which favors the improvement of the integrality process of the students of the Faculty of Medical Sciences Guantanamo Method: an action research study was carried out in the period October 2015 to June 2016 with 18 teachers as guides, brigade chiefs and the head of the year collective of this faculty, where a methodology for the design of the electronic material was used. It consists of three spreadsheets, which allows from designed indicators to evaluate the results of the educational project, in addition, to determine the possible integral students and the fulfillment of the objectives proposed in the project. Results: the main result was the transformation of the pedagogical staff favoring a new style of work in order to raise the quality of the process and its impact on the integral formation of the students. Conclusions: it contributes to perfecting the integrality process from which it encourages the use of participatory, dynamic, democratic methods, unlike those used up to now, with old styles(AU)


Assuntos
Bases de Dados como Assunto , Educação Médica/métodos , Avaliação Educacional
16.
Anest. analg. reanim ; 30(2): 13-35, dic. 2017. tab, ilus
Artigo em Espanhol | LILACS | ID: biblio-887213

RESUMO

Introducción: Las crisis en la atención de la paciente obstétrica son eventos pocos frecuentes, pero de presentarse requieren de un manejo rápido y adecuado. Actualmente hay evidencia que las listas de chequeo pueden contribuir a un mejor desenlace. Objetivo: Confeccionar una herramienta adaptada a la realidad del Uruguay que nos sirva de ayuda cognitiva frente a una situación de crisis en la población obstétrica. Métodos: El grupo de trabajo decidió cuáles era las listas de chequeo que iban a conformar el manual. Para las confección de las mismas se tuvo en cuenta las realizadas por Ariadne Labs. En cada uno de los temas se valoró la bibliografía actualizada y la evidencia de la misma. Resultados: Se realizaron 11 listas de chequeo de crisis en obstetricia, las cuales se adaptaron a los tratamientos y fármacos disponibles en nuestro país. Las mismas pueden ser descargadas en forma gratuita. Discusión y conclusiones: Luego de analizar la literatura disponible que apoya el uso de las listas de chequeo y concluye que su uso permite un mejor desenlace frente a una crisis. Dicha herramienta es una más junto con las ya existentes que puede ser de gran ayuda en una situación de crisis, pero que por sí sola no cambia el desenlace. Se presentó un manual de emergencias obstétricas con contenido claro, actualizado y adaptado a nuestro país.


Introduction: Crisis in patients in obstetrical care are unlikely events. If they occur, it is required to deal with them promptly and skillfully. Nowadays, there is evidence that checklists can help to achieve a better outcome. Objective: To create a tool suitable for the Uruguayan circumstances. This tool will provide cognitive aid in situations of crisis in the obstetric population. Methods: The work group decided on the checklists to be included in the handbook. Checklists made by Ariadne Labs were taken into consideration. Throughout all stages of this work, updated bibliography and scientific evidence were considered. Results: Eleven checklists were made on patients with obstetric crisis. These were created given the treatments and drugs available in Uruguay, moreover, they can be downloaded free of charge. Discussion and conclusions: After careful study of the available papers that supports the use of checklists, they conclude that the use of these, provide a better outcome when dealing with a crisis. In addition, there are many existing tools extremely beneficial in this situation. However, the use of checklist in isolation is not enough to guarantee a positive result. A handbook of obstetric emergency was presented featuring a clear and updated content, which is suitable to this country reality.


Assuntos
Humanos , Complicações na Gravidez/prevenção & controle , Lista de Checagem , Complicações do Trabalho de Parto
17.
Sci Rep ; 7(1): 6276, 2017 07 24.
Artigo em Inglês | MEDLINE | ID: mdl-28740236

RESUMO

Qa-2 is believed to mediate a protective immune response against cancer; however, little is known about the role of Qa-2 in tumorigenesis. Here, we used 4T1 breast cancer cells to study the involvement of Qa-2 in tumor progression in a syngeneic host. Qa-2 expression was reduced during in vivo tumor growth and in cell lines derived from 4T1-induced tumors. Tumor-derived cells elicited an epithelial-mesenchymal transition associated with upregulation of Zeb1 and Twist1/2 and enhanced tumor initiating and invasive capacities. Furthermore, these cells showed increased stem characteristics, as demonstrated by upregulation of Hes1, Sox2 and Oct3/4, and enrichment of CD44high/CD24median/low cells. Remarkably, Qa-2 cell-surface expression was excluded from the CD44high/CD24median/low subpopulation. Tumor-derived cells showed increased Src activity, and treatment of these cells with the Src kinase inhibitor PP2 enhanced Qa-2 but reduced Sox2 and CD44high/CD24median/low expression levels, suggesting that Src signaling, while positively associated with stemness, negatively regulates Qa-2 expression in breast cancer. Finally, overexpression of the Qa-2 family member Q7 on the cell surface slowed down in vivo tumor growth and reduced the metastatic potential of 4T1 cells. These results suggest an anti-malignant role for Qa-2 in breast cancer development, which appears to be absent from cancer stem cells.


Assuntos
Neoplasias da Mama/patologia , Transição Epitelial-Mesenquimal , Antígenos de Histocompatibilidade Classe I/metabolismo , Células-Tronco Neoplásicas/patologia , Animais , Apoptose , Neoplasias da Mama/metabolismo , Carcinogênese , Movimento Celular , Proliferação de Células , Feminino , Humanos , Camundongos , Camundongos Endogâmicos BALB C , Células-Tronco Neoplásicas/metabolismo , Células Tumorais Cultivadas , Ensaios Antitumorais Modelo de Xenoenxerto
18.
Clin Transl Oncol ; 19(11): 1303-1311, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-28646282

RESUMO

Surgical resection is the only potentially curative option in the treatment of pancreatic ductal adenocarcinoma. Preoperative radiological imaging allows to rule out the presence of metastases. Three resectability categories are established based on the radiological findings depending on the degree of contact between the tumor and the blood vessels. Histological confirmation of malignancy is only required in cases of borderline or non-resectable tumors, prior to neoadjuvant treatment initiation. Diagnostic laparoscopy is recommended in the presence of large tumors of the body or tail and in borderline tumors to explore the possibility of resection and to apply treatment with curative intent, as well as in those cases with high level of biomarkers to rule out peritoneal involvement. Prior to surgery preoperative nutritional measures as well as endoscopic biliary drainage can be applied to optimize patient's conditions. Cephalic pancreaticoduodenectomy is the recommended surgical technique in tumors located in the head of the pancreas. The benefits from pyloric preservation, type or reconstruction (one vs. two loops), type of anastomosis (pancreaticojejunostomy vs. pancreaticogastrostomy), intraoperative biopsy of the pancreatic resection margin or the use of intraperitoneal drainages are inconclusive. Total pancreatectomy and/or portal resection should only be performed in particular cases; however, arterial resections have shown no benefits. Radical antegrade modular pancreaticosplenectomy, that can be performed laparoscopically, is the technique used for those tumors located in the pancreatic body-tail.


Assuntos
Adenocarcinoma/cirurgia , Carcinoma Ductal Pancreático/cirurgia , Neoplasias Pancreáticas/cirurgia , Qualidade de Vida , Humanos
20.
Gac. méd. espirit ; 18(1): 64-75, ene.-abr. 2016.
Artigo em Espanhol | LILACS | ID: lil-780685

RESUMO

Fundamento: En la actualidad existen deficiencias en el proceso de formación posgraduada del docente universitario. Objetivo: Proponer un modelo para el proceso de formación estadística investigativa en el posgrado. Desarrollo Se sustenta en la teoría holístico configuracional, y en consecuencia, parte de las contradicciones que se manifiestan entre los pares de categorías comprensión de variables de investigación y la interpretación cuantitativa cualitativa de la realidad investigada, así como desde aplicación de técnicas de análisis de datos y la valoración estadística descriptiva y/o inferencial, relaciones dialécticas que dinamizan en todo momento la modelación y a la vez le dan coherencia e integración, y desde las cuales se originan los movimientos y transformaciones en la sistematización del contenido estadístico investigativo. Conclusiones: El modelo además de su relevancia, tiene una estructuración coherente y lógica en el tramado de relaciones que se establecen entre sus categorías, así como fundamentos teóricos bien argumentados.


Background: At the present time there are some deficiencies in the process of formation of the postgraduate university students. Objective: To propose a model for the process of investigative statistical formation in the postgraduate. Development: It is sustained in the holistic configurationally theory , and in consequence parts of the contradictions that are manifested between the pairs of categories understanding of variables investigation and the qualitative quantitative interpretation of the investigated reality, as well as from application of analysis techniques of data and the descriptive statistical valuation and/or inferential, dialectical relationships that energize in all moment the modulation and at the same time give them coherence and integration, and from which originate the movements and transformations in the systematizing of the investigative statistical content. Conclusions: The pattern besides its relevance, has a coherent structuring and logic in the schemed of relationships that are settled down among its categories, as well as well-argued theoretical foundations.


Assuntos
Universidades , Educação Profissionalizante/estatística & dados numéricos , Educação de Pós-Graduação/estatística & dados numéricos , Estatística
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