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INTRODUCTION: Surgical exploration in complete ureteropelvic-junction disruption (CUPJD) is still recommended by many authors. Conservative approach to pediatric renal trauma (RT) includes minimally invasive techniques such as nephrostomy, angioembolization or double-J stent placement. CASE REPORT: A 14-year-old patient with CUPJD was treated conservatively. CT-scan revealed active bleeding of the renal artery and significant urine extravasation. Coil angioembolization and nephrostomy placement were performed. An attempt to place a double-J stent was unsuccessful and surgical reconstruction was scheduled. Before surgery, methylene-blue was injected through the nephrostomy observing blue urine output through urethra. Antegrade pyelogram revealed drainage from the urinoma to the ureter. A new attempt to place an internal-external double-J-stent was successful. After 5 weeks, it was removed with total restoration of the urinary tract. CONCLUSION: Complete urinary tract restoration in some cases of CUPJD following RT is possible through a nonoperative approach. It can be safe and effective, reducing the risk of complications associated with complex surgeries.
INTRODUCCION: Muchos autores siguen recomendando la exploración quirúrgica en casos de avulsión completa de la unión pieloureteral (ACUPU). El abordaje conservador del traumatismo renal (TR) pediátrico incluye técnicas mínimamente invasivas como la nefrostomía, la angioembolización o el catéter doble J. CASO CLINICO: Paciente de 14 años con ACUPU tratada de forma conservadora. El escáner reveló la presencia de una hemorragia activa en la arteria renal, además de una importante extravasación urinaria. Se practicó angioembolización con bobinas y nefrostomía. Se intentó colocar un catéter doble J, sin éxito, por lo que se programó reconstrucción quirúrgica. Antes de la cirugía, se inyectó azul de metileno a través de la nefrostomía, observándose salida de orina azul a través de la uretra. La realización de una pielografía anterógrada reveló la presencia de drenaje desde el urinoma hacia el uréter. El segundo intento de colocar un catéter doble J interno-externo sí resultó fructífero, retirándose al cabo de 5 semanas, con restauración total del tracto urinario. CONCLUSION: La restauración completa del tracto urinario en algunos casos de ACUPU tras TR es factible sin necesidad de recurrir al abordaje quirúrgico. Se trata de un proceso seguro y eficaz que disminuye el riesgo de las complicaciones propias de las cirugías complejas.
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Tratamento Conservador , Ureter , Humanos , Adolescente , Ureter/lesões , Tratamento Conservador/métodos , Rim/lesões , Masculino , Tomografia Computadorizada por Raios X , Stents , Embolização Terapêutica/métodos , Pelve Renal/lesões , Artéria Renal/lesõesRESUMO
Introducción: El objetivo es lograr una plantilla de mapeo de activación cerebral promedio en niños sanos usando la resonancia magnética funcional (RMf), con paradigmas específicos para activar funciones de atención inhibitoria y de memoria de trabajo. Sujetos y métodos: Se realizó una evaluación nutricional y neuropsicológica a 87 niños diestros. Cumplieron los criterios de inclusión 30 (15 niños y 15 niñas) entre 9 y 11 años, a quienes se estudió con RMf con realización de dos pruebas de atención inhibitoria (Go/No Go), con letras e imágenes de alimentos, un test de memoria de trabajo (Test de Atención Continua-Pares Idénticos) y obtención de volúmenes anatómicos. Los datos posteriormente se procesaron con el programa FSL-v5 con un umbral de p < 0,05 (cluster-wise). Las áreas cerebrales activadas se localizaron utilizando una plantilla cerebral estándar del Montreal Neurological Institute y el atlas cortical estructural de Harvard-Oxford. Resultados: En las pruebas de atención inhibitoria hay activación en áreas frontales de predominio derecho, cíngulo, parietales y occipitales, con preponderancia en áreas occipitales en la prueba con alimentos. En la prueba Test de Atención Continua-Pares Idénticos se obtuvo activación de predominio en áreas occipitales, frontales y parietales. Conclusiones: Se obtienen plantillas de mapeo de actividad cerebral en niños sanos con test de atención inhibitoria, de alimentos y de memoria de trabajo. Las áreas de activación corresponden mayoritariamente a las descritas en la bibliografía. Esto nos permite tener patrones basales de activación cerebral para estudiar patologías relacionadas con la atención inhibitoria, la impulsividad y la memoria de trabajo.(AU)
Introduction: The objective is to produce an average brain activation mapping template in healthy children using functional magnetic resonance imaging (fMRI), with specific paradigms for activating inhibitory attention and working memory functions. Subjects and methods: A nutritional and neuropsychological evaluation was performed on 87 right-handed children. The inclusion criteria were met by 30 children (15 boys and 15 girls) between 9 and 11 years old, who were studied with fMRI in two inhibitory attention tests (Go/No Go), with food cues, a working memory test (Continuous Performance Test Identical Pairs) and measurement of anatomical volumes. These data were subsequently processed with the FSL-v5 program, with a threshold of p < 0.05 (cluster-wise). The brain areas activated were located using a standard Montreal Neurological Institute brain template and the Harvard-Oxford structural cortical atlas. Results: The inhibitory attention tests showed activation frontal areas predominantly on the right, and the cingulate, parietal and occipital areas, with preponderance in occipital areas in the food cues test. In the Continuous Performance Test-Identical Pairs test, activation was obtained predominantly in the occipital, frontal and parietal areas. Conclusions: Brain activity mapping templates are obtained in healthy children with tests for inhibitory attention, food cues and working memory. The activation areas are mostly those reported in the literature. This provides baseline brain activation patterns for studying pathologies related to inhibitory attention, impulsivity and working memory.(AU)
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Humanos , Masculino , Feminino , Criança , Espectroscopia de Ressonância Magnética , Função Executiva , Cognição , Transtorno do Deficit de Atenção com Hiperatividade , Memória , Neurologia , Doenças do Sistema Nervoso , Saúde da CriançaRESUMO
INTRODUCTION: The objective is to produce an average brain activation mapping template in healthy children using functional magnetic resonance imaging (fMRI), with specific paradigms for activating inhibitory attention and working memory functions. SUBJECTS AND METHODS: A nutritional and neuropsychological evaluation was performed on 87 right-handed children. The inclusion criteria were met by 30 children (15 boys and 15 girls) between 9 and 11 years old, who were studied with fMRI in two inhibitory attention tests (Go/No Go), with food cues, a working memory test (Continuous Performance Test Identical Pairs) and measurement of anatomical volumes. These data were subsequently processed with the FSL-v5 program, with a threshold of p < 0.05 (cluster-wise). The brain areas activated were located using a standard Montreal Neurological Institute brain template and the Harvard-Oxford structural cortical atlas. RESULTS: The inhibitory attention tests showed activation frontal areas predominantly on the right, and the cingulate, parietal and occipital areas, with preponderance in occipital areas in the food cues test. In the Continuous Performance Test-Identical Pairs test, activation was obtained predominantly in the occipital, frontal and parietal areas. CONCLUSIONS: Brain activity mapping templates are obtained in healthy children with tests for inhibitory attention, food cues and working memory. The activation areas are mostly those reported in the literature. This provides baseline brain activation patterns for studying pathologies related to inhibitory attention, impulsivity and working memory.
TITLE: Mapeo neuroanatómico de atención inhibitoria y memoria de trabajo con resonancia magnética funcional en niños sanos.Introducción. El objetivo es lograr una plantilla de mapeo de activación cerebral promedio en niños sanos usando la resonancia magnética funcional (RMf), con paradigmas específicos para activar funciones de atención inhibitoria y de memoria de trabajo. Sujetos y métodos. Se realizó una evaluación nutricional y neuropsicológica a 87 niños diestros. Cumplieron los criterios de inclusión 30 (15 niños y 15 niñas) entre 9 y 11 años, a quienes se estudió con RMf con realización de dos pruebas de atención inhibitoria (Go/No Go), con letras e imágenes de alimentos, un test de memoria de trabajo (Test de Atención Continua-Pares Idénticos) y obtención de volúmenes anatómicos. Los datos posteriormente se procesaron con el programa FSL-v5 con un umbral de p < 0,05 (cluster-wise). Las áreas cerebrales activadas se localizaron utilizando una plantilla cerebral estándar del Montreal Neurological Institute y el atlas cortical estructural de Harvard-Oxford. Resultados. En las pruebas de atención inhibitoria hay activación en áreas frontales de predominio derecho, cíngulo, parietales y occipitales, con preponderancia en áreas occipitales en la prueba con alimentos. En la prueba Test de Atención Continua-Pares Idénticos se obtuvo activación de predominio en áreas occipitales, frontales y parietales. Conclusiones. Se obtienen plantillas de mapeo de actividad cerebral en niños sanos con test de atención inhibitoria, de alimentos y de memoria de trabajo. Las áreas de activación corresponden mayoritariamente a las descritas en la bibliografía. Esto nos permite tener patrones basales de activación cerebral para estudiar patologías relacionadas con la atención inhibitoria, la impulsividad y la memoria de trabajo.
Assuntos
Encéfalo , Memória de Curto Prazo , Masculino , Feminino , Criança , Humanos , Memória de Curto Prazo/fisiologia , Encéfalo/fisiologia , Mapeamento Encefálico , Atenção/fisiologia , Imageamento por Ressonância Magnética/métodos , Testes NeuropsicológicosRESUMO
Introducción: La Enfermedad Renal Crónica (ERCR), puede tener un impacto significativo en la salud mental de los pacientes adultos mayores (AM), en diálisis, lo que hace que el diagnóstico y tratamiento oportuno de la depresión sea un aspecto crucial para considerar en este grupo etario. La alta incidencia de patologías mentales en los pacientes en diálisis puede condicionarse por la alta carga emocional y física de la ERCR, los cambios en la imagen corporal que genera esta condición, además de los efectos químicos y hormonales que implica esta enfermedad. La depresión no solo afecta el bienestar emocional, sino que también puede tener un impacto negativo en la adherencia al tratamiento de diálisis y en la toma de decisiones de salud. Un estudio reciente realizado en Brasil, demostró una prevalencia de depresión del 22.5% en AM en diálisis. Actualmente resulta desconocida la relevancia del problema en nuestro medio. Objetivos: Determinar la prevalencia de Depresión en AM y sus factores asociados en pacientes en hemodiálisis en el Hospital de Angol. Población: AM en diálisis que aceptaron ingresar al estudio. Método: Aplicación de test de Yesavage para detección de depresión en AM y del Edmonton Symptom Assessment System Revised Renal (ESAS-r), un método validado de autorreporte de 11 ítems destinados a evaluar la carga de síntomas físicos y psicosociales en pacientes en terapia dialítica. Además, se tomó registro de los parámetros biodemográficos y de laboratorio asociados a la positividad del test de Yesavage. Resultados: Se estudió al 100% de los AM de la unidad (n:27), edad promedio de 69,85 años (DE+/- 6,22), y una permanencia promedio en diálisis de 26 meses. El 52% de los participantes fueron de sexo femenino (Tabla 1). La prevalencia de depresión fue de un 56%, siendo un 60% de los casos leves y un 40% severos. Un ESAS-r ≥ 22 puntos (Puntaje máximo del test 110), conllevó un OR 13.75 (95% IC 1.6-162.8, p: 0.0034), para depresión. En este último test, los sub-ítems dolor, cansancio, disnea, malestar general y tristeza alcanzaron significación estadística (p < 0.05), para correlacionarse con el diagnóstico de depresión (Tabla 2). Conclusiones: La prevalencia de depresión en AM en diálisis crónica es superior a la descrita en la literatura, guarda relación con un deterioro global de la calidad de vida medida por ESAS-r y parece estar vinculada a una fuerte base orgánica derivada de la sintomatología propia de la ERCR.
Introduction: Chronic Kidney Disease (CKD), can have a significant impact on the mental health of older adults (OAs), patients on dialysis. The high incidence of mental pathologies in dialysis patients may be conditioned by the emotional and physical impact of CKD, the changes in body image that this condition generates and the chemical and hormonal effects that this disease implies. The relevance of the problem in our country is unknown. Objectives: Determine the prevalence of Depression in OAs in patients on hemodialysis at the Angol Hospital. Method: Application of the Yesavage test to detect depression in OAs and the Edmonton Symptom Assessment System Revised Renal (ESAS-r), a test for evaluating the burden of physical and psychosocial symptoms. Results: 100% of the unit's OAs were studied (n:27), average age of 69.85 years (SD+/- 6.22) and an average stay on dialysis of 26 months. The prevalence of depression was 56%, with 60% mild cases and 40% severe. An ESAS-r ≥ 22 points (maximum test score 110) carried an OR 13.75 (95% CI 1.6-162.8, p: 0.0034) for depression. In this test, the sub-items pain, fatigue, dyspnea, general malaise and sadness reached statistical significance (p < 0.05), to correlate with the diagnosis of depression. Conclusions: The prevalence of depression in OAs on chronic dialysis is higher than that described in the literature, is related to a global deterioration in quality of life measured by ESAS-r and seems to be linked to a strong organic basis derived from the symptoms themselves of the CKD.
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BACKGROUND: In 2017, 69 108 work-related traffic injuries with medical leave were documented, constituting 12% of all occupational injuries (OI) in Spain. AIMS: The aim of this study was to describe OI within a Spanish bank company during 2017. METHODS: A cross-sectional analysis was conducted using the company's mandatory OI records, presenting data in both absolute (n) and relative (%) frequencies. The chi-square test was employed for comparisons. RESULTS: Among the company's 10 399 employees, 176 OI cases were recorded. Most were minor musculoskeletal incidents, with one severe myocardial infarction and one mild anxiety episode. Lower limb injuries were the most prevalent. Injuries of the trunk (Pâ <â 0.001), neck (Pâ <â 0.05), and upper limbs (Pâ <â 0.001) were linked to workplace factors. Approximately 62% of OI occurred outside the workplace and resulted in more extended medical leave (Pâ <â 0.01). Traffic-related injuries accounted for 39% of OI cases and caused 49% of days lost due to OI (Pâ <â 0.001).Female gender (Pâ <â 0.001) and age over 40 years (Pâ <â 0.05) were significantly associated with OI. CONCLUSIONS: In our study, musculoskeletal injuries were the most common, with a single cardiovascular event being the most severe. OI occurring outside the workplace was more frequent and led to longer medical leaves. Notably, traffic-related injuries were especially significant, exceeding official statistics 4-fold.
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Infarto do Miocárdio , Traumatismos Ocupacionais , Humanos , Feminino , Adulto , Traumatismos Ocupacionais/epidemiologia , Traumatismos Ocupacionais/etiologia , Estudos Transversais , Local de Trabalho , Infarto do Miocárdio/complicações , Espanha/epidemiologiaRESUMO
RESUMEN Las parasitosis gastrointestinales en bovinos de producción son uno de los problemas sanitarios más importantes a nivel mundial. Estos nematodos ocasionan problemas gastroentéricos que se caracterizan clínicamente por diarrea, debilidad, hemorragias y deshidratación. Entre las parasitosis gastrointestinales causadas por nematodos en ganado bovino, se destacan las familias: Trichuridae, Trichostrongylidae, Ancylostomidae, Ascaridae y Strongyloididae. El propósito de esta investigación fue determinar la eficacia de las distintas técnicas coproparasitológicas cualitativas y cuantitativas para la detección de nematodos gastrointestinales en ganado bovino. Para este estudio se utilizaron 250 muestras de vacas de raza carnicera, divididos en diferentes grupos, para la aplicación de las técnicas coproparasitológicas de tipo cualitativo y cuantitativo, los cuales fueron escogidos específicamente teniendo en cuenta criterios de inclusión y exclusión para cada animal. Los resultados entregados por este estudio indicaron que el mayor porcentaje en la identificación de estados infectantes parasitarios fue por medio de las técnicas coproparasitologicas de tipo cualitativo, principalmente aquellas de flotación de sulfato de zinc y magnesio con un 50%.
ABSTRACT Gastrointestinal parasites in production cattle are one of the most important health problems worldwide. These nematodes cause gastroenteric problems that are clinically characterized by diarrhoea, weakness, bleeding and dehydration. Within the gastrointestinal parasites caused by nematodes in cattle, the following families stand out: Trichuridae, Trichostrongylidae, Ancylostomidae, Ascaridae and Strongyloididae. The purpose of this research was to determine the efficacy of the different qualitative and quantitative coproparasitological techniques for the detection of gastrointestinal nematodes in cattle. For this study, 250 samples of beef breed cows were used, divided into different groups, for the application of qualitative and quantitative coproparasitological techniques, which were specifically chosen taking into account inclusion and exclusion criteria for each animal. The results delivered by this study indicated that the highest percentage in the identification of parasitic infective states was through qualitative coproparasitological techniques, focused mainly on zinc and magnesium sulfate flotation techniques with 50%.
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RESUMEN Se analizaron los niveles de lactato sérico y de frecuencia cardiaca (FC) en 15 perros clinicamente sanos que fueron sometidos a pruebas de esfuerzo en trotadora motorizada, buscando verificar un grado de fatiga muscular frente a una prueba de esfuerzo intenso. Se consideraron pacientes con morfologia craneana de tipo braquicefálico, mesocefálico y dolicocefálico. Las mediciones séricas de lactato fueron conseguidas por medio de un medidor portátil, mientras que las frecuencias cardiacas se obtuvieron a través de un oximetro portátil a los tiempos 0, 10, 20 y 30 minutos, en los diferentes momentos de esfuerzo fisico en la trotadora motorizada, la cual fue adaptada en su inclinación en 15% y a un máximo de velocidad de 10 km/h. Las medias de los niveles séricos entre perros mesocefálicos y dolicocefálicos fueron significativas, a diferencia de los perros braquicefálicos los cuales resultaron no significativos. Las medias de las frecuencias cardiacas no tuvieron diferencia significativa bajo un 95% de confianza.
ABSTRACT Serum lactate and heart rate (HR) levels were analyzed in 15 clinically healthy dogs that were subjected to stress tests on a motorized treadmill, seeking to verify a degree of muscle fatigue compared to an intense exercise test. Patients with brachycephalic, mesocephalic and dolichocephalic type cranial morphology were considered. Serum lactate measurements were procured by means of a portable meter, while heart rates were obtained through a portable oximeter at the times 0, 10, 20, and 30 minutes at different moments of physical effort on the motorized treadmill, which was adapted in its inclination by 15% and at a maximum speed of 10 km/h. Mean serum levels between mesocephalic and dolichocephalic dogs were significant, unlike brachycephalic dogs, which were not significant. The mean heart rates did not have a significant difference under 95% confidence.
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Biomarcadores , Cães , Teste de Esforço , Ácido Láctico , Soro , Fadiga , Frequência CardíacaRESUMO
Resumen Los tumores cerebrales se caracterizan por su gran morbilidad y mortalidad. La gran mayoría corresponde a tumores secundarios (metástasis). Dentro de los tumores primarios del sistema nervioso central, los gliomas corresponden al 30% de éstos. En EEUU, entre el 2007-2011, se estima una incidencia aproximada de 21,4 casos por 100.000 habitantes. Los recientes avances en la comprensión molecular de la biología de estos tumores han permitido mejorar sustancialmente su clasificación, posibilitando realizar un mejor correlato con los desenlaces clínicos y el pronóstico. En esta línea, hoy en día es posible estratificar a los pacientes por riesgo y entregar tratamientos capaces de prolongar la sobrevida global entre 5-7 años, para los gliomas grado II y III. El presente consenso, elaborado por un panel multidisciplinario de expertos de diversas sociedades científicas chilenas y, por tanto, de todas las especialidades involucradas en el manejo médico-quirúrgico de las personas portadoras de gliomas cerebrales. A la luz de este nuevo conocimiento desarrollado al alero de la oncología molecular, esta propuesta ofrece un insumo de utilidad clínica real, que, articulado a una revisión actualizada en relación con el tratamiento y seguimiento de estos pacientes, permite entender la relevancia de estos biomarcadores en el manejo de precisión de la enfermedad. Cabe señalar que, este manuscrito emerge de la misma fuerza de trabajo, que elaboró el Protocolo Clínico de Gliomas del Adulto 2019, publicado por el Ministerio de Salud, y que ha diferencia de esta, que ofrece los detalles clínicos-operativos, como flujogramas y dosis, nuestra revisión intenta relevar los avances imagenológicos y moleculares y como estos impactan en el manejo actual de la enfermedad.
Brain tumors are characterized by high morbidity and mortality. The vast majority correspond to secondary tumors (metastasis). On the other hand, within the primary tumors of the central nervous system, gliomas correspond to 30% of these. In the US, between 2007-2011, an approximate incidence of 21.4 cases per 100,000 inhabitants was estimated. Recent advances in the molecular understanding of the biology of these tumors have made it possible to substantially improve their classification, allowing a better correlation with clinical outcomes and prognosis. Along these lines, today, it is possible to stratify patients by risk and deliver treatments capable of prolonging global survival between 5-7 years, for grade II and III gliomas. The present consensus, prepared by a multidisciplinary panel of experts from various Chilean scientific societies and, therefore, from all the specialties involved in the medical and surgical therapy. Enlightened from the molecular oncology, this proposal offers an input of clinical utility, which, together with an updated review in relation to the treatment and follow-up of these patients, allows us to understand the relevance of these biomarkers in precision disease management. It should be noted that this manuscript emerges from the same work force, which prepared the Clinical Protocol for Adult Gliomas 2019, published by the Ministry of Health, and that differs from it, which offers clinical-operative details, such as flowcharts and dose, our review attempts to reveal imaging and molecular advances and how they impact the current management of the disease.
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Humanos , Neoplasias Encefálicas/diagnóstico , Neoplasias Encefálicas/terapia , Glioma/diagnóstico , Glioma/terapia , Chile , ConsensoRESUMO
Portal vein thrombosis (PVT) still remains a major challenge in managing liver transplant recipients. The aim of this study was to describe PVT prevalence in our health district and identify potential risk factors involved. Although further research is needed to make some general appointments, we identified anticoagulation therapy before transplant as a potential protective factor against PVT.
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Transplante de Fígado , Trombose Venosa , Humanos , Cirrose Hepática/patologia , Veia Porta/diagnóstico por imagem , Veia Porta/patologia , Estudos Retrospectivos , Trombose Venosa/etiologia , Trombose Venosa/patologiaRESUMO
RESUMEN El objetivo principal de este estudio fue caracterizar el nivel ético en estudiantes y docentes de la carrera de medicina veterinaria de la Universidad Santo Tomás, sede de Puerto Montt, Chile. Para esto, se aplicó una encuesta dilemática a 3 grupos de estudio conformados por estudiantes de primer y quinto año, además de docentes que imparten asignaturas de formación profesional de la sede Puerto Montt. La creación de la encuesta fue por medio de la contratación de especificaciones éticas de la carrera con los diles de juicio moral en Kohlberg. De los resultados obtenidos se pudo concluir que las especificaciones de la carrera de medicina veterinaria solo contemplan el 20% de 59 artículos estudiados del Código de Ética profesional. Además, es posible decir que los estudiantes de primero y quinto año, y los docentes no conocen a cabalidad los artículos del Código de Ética según la clasificación de la teoría de Kohlberg.
ABSTRACT The main objective of this study was to characterize the ethical level in students and teachers of the veterinary medicine career of the Santo Tomás University, Puerto Montt headquarters, Chile. For this a dilemmatic survey was applied to 3 study groups, made up of students from the first and fifth years, in addition to teachers who teach professional training subjects at the Puerto Montt campus. The survey was created by contracting ethical specifications of the career with the moral judgment diles in Kohlberg. From the results obtained, it was possible to conclude that the specifications of the veterinary medicine career only contemplate 20% of the 59 articles studied of the professional code of ethics. In addition, it was possible to say that the first and fifth year students, and teachers do not fully know the articles of the code of ethics according to the classification of Kohlberg's theory.
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Humanos , Estudantes , Medicina Veterinária , Códigos de Ética , Ética Profissional , Capacitação Profissional , Docentes , Inquéritos e Questionários , Princípios MoraisRESUMO
INTRODUCTION: COVID-19 pandemic has meant adapting to a different reality, with long-term lockdowns that might cause an increase of burns in children at home. OBJECTIVE: To compare the epidemiological situation of patients admitted to the Corporación de Ayuda al Niño Quemado (COANIQUEM) due to out patient burn injuries management at the beginning of COVID-19 lockdown with the same period the year before. PATIENTS AND METHODS: Analytical and cross-sectional study. A population of 2,027 patients under the age of 20, who were admitted to COANIQUEM for the first time with burn inju ries, between April and July of 2019 and 2020 was analyzed. The number of patients admitted each month was registered as well as their demographic, social, and clinical characteristics. The monthly percentage variation was calculated by comparing patient data in both years. RESULTS: During 2020, there was a 48.7% decrease in overall outpatient admissions. There was a relative increase of 10.5% in burns in patients under 5 years old, 18.3% in scalds, 33.1% in the number of burns in 3 or more body locations, and 16.8% in burns occurring at home. These parameters were not influenced by geographic location, sex, or socioeconomic level. CONCLUSIONS: In the first period of the COVID-19 pandemic, with strict lockdown strategies, there was a decrease in the demand for burn care, affecting both outpatients with acute burns and those who were admitted for sequelae rehabilitation, as a result of the effective decrease in the burns incidence and the reduced access to health care.
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Queimaduras , COVID-19 , Adolescente , Distribuição por Idade , Queimaduras/epidemiologia , Queimaduras/etiologia , Queimaduras/terapia , COVID-19/epidemiologia , COVID-19/prevenção & controle , Criança , Pré-Escolar , Chile/epidemiologia , Controle de Doenças Transmissíveis , Estudos Transversais , Atenção à Saúde , Humanos , Pacientes Ambulatoriais , Pandemias/prevenção & controleRESUMO
Objetivos: La balanitis xerótica obliterante (BXO) es una enferme-dad crónica inflamatoria de incidencia poco conocida en la población pediátrica. El objetivo de este trabajo es describir nuestra experiencia en el tratamiento de las BXO. Material y métodos: Estudio retrospectivo de 419 pacientes intervenidos de circuncisión en el periodo comprendido entre enero de 2014 y enero de 2017. Analizamos variables demográficas, clínicas, anatomopatológicas, terapéuticas y complicaciones durante el seguimiento. Resultados: De los 419 pacientes, 41 fueron diagnosticados de BXO (9,78%). Seis pacientes fueron excluidos por falta de seguimiento, por lo que se analizaron 35 pacientes. La media de edad al diagnóstico fue de 8,6 años. El diagnóstico de sospecha fue clínico durante la exploración física en 17 pacientes (48,6%) y durante la intervención en 18 (51,4%), realizando la confirmación anatomopatológica en un total de 35 pacientes (100%). Durante el seguimiento 6 pacientes (17,14%) presentaron lesiones en glande, 3 (8,57%) en uretra y 9 (25,71%) en ambas localizaciones, siendo necesaria la realización de 6 meatotomías (17,14%) y de nueva circuncisión en 5 (14,28%). El tiempo medio de recidiva fue de 32,43 meses. En 19 pacientes (54,28%) se aplicaron corticoides tópicos en pomada y en 1 paciente inmunosupresores tópicos (2,85%). Conclusiones: Es necesario un seguimiento estrecho de los pacientes con diagnóstico clínico o anatomopatológico de BXO dada su elevada morbilidad. Las principales complicaciones descritas en la población pediátrica son la estenosis meatal y uretral, así como la recidiva de la fimosis si no se reseca el prepucio suficientemente
Objectives. Balanitis xerotica obliterans (BXO) is a chronic inflam-matory disease with a little known incidence in pediatric population. The objective of this work was to describe our experience in the treatment of BXO. Materials and methods: Retrospective study carried out in 419 patients undergoing circumcision surgery between January 2014 and January 2017. Demographic, clinical, therapeutic, and anatomical and pathological variables, as well as complications during follow-up, were analyzed. Results: Of the 419 patients, 41 (9.78%) were diagnosed with BXO. 6 patients were excluded owing to lack of follow-up, so 35 patients were analyzed. Mean age at diagnosis was 8.6 years. Suspicion diagnosis was clinical at physical exploration in 17 patients (48.6%), and at surgery in 18 patients (51.4%). Anatomical and pathological confirmation was performed in a total 35 patients (100%). During follow-up, 6 patients (17.14%) had lesions in the glans, 3 (8.57%) in the urethra, and 9 (25.71%) in both. 6 meatotomies (17.14%) and 5 new circumcisions (14.28%) had to be carried out. Mean recurrence time was 32.43 months. In 19 patients (54.28%), topical corticoids - ointment - were applied, and 1 patient (2.85%) received topical immunosuppressants. Conclusions: A close follow-up of patients with clinical or anatomical and pathological diagnosis of BXO is required given its high morbidity. The complications described in pediatric population include meatal and urethral stenosis, as well as recurrent phimosis, unless a sufficient amount of foreskin is resected
Assuntos
Humanos , Masculino , Pré-Escolar , Criança , Adolescente , Balanite Xerótica Obliterante/cirurgia , Complicações Pós-Operatórias , Resultado do Tratamento , Estudos Retrospectivos , SeguimentosRESUMO
OBJECTIVES: Balanitis xerotica obliterans (BXO) is a chronic inflammatory disease with a little known incidence in pediatric population. The objective of this work was to describe our experience in the treatment of BXO. MATERIALS AND METHODS: Retrospective study carried out in 419 patients undergoing circumcision surgery between January 2014 and January 2017. Demographic, clinical, therapeutic, and anatomical and pathological variables, as well as complications during follow-up, were analyzed. RESULTS: Of the 419 patients, 41 (9.78%) were diagnosed with BXO. 6 patients were excluded owing to lack of follow-up, so 35 patients were analyzed. Mean age at diagnosis was 8.6 years. Suspicion diagnosis was clinical at physical exploration in 17 patients (48.6%), and at surgery in 18 patients (51.4%). Anatomical and pathological confirmation was performed in a total 35 patients (100%). During follow-up, 6 patients (17.14%) had lesions in the glans, 3 (8.57%) in the urethra, and 9 (25.71%) in both. 6 meatotomies (17.14%) and 5 new circumcisions (14.28%) had to be carried out. Mean recurrence time was 32.43 months. In 19 patients (54.28%), topical corticoids - ointment - were applied, and 1 patient (2.85%) received topical immunosuppressants. CONCLUSIONS: A close follow-up of patients with clinical or anatomical and pathological diagnosis of BXO is required given its high morbidity. The complications described in pediatric population include meatal and urethral stenosis, as well as recurrent phimosis, unless a sufficient amount of foreskin is resected.
OBJETIVOS: La balanitis xerótica obliterante (BXO) es una enfermedad crónica inflamatoria de incidencia poco conocida en la población pediátrica. El objetivo de este trabajo es describir nuestra experiencia en el tratamiento de las BXO. MATERIAL Y METODOS: Estudio retrospectivo de 419 pacientes intervenidos de circuncisión en el periodo comprendido entre enero de 2014 y enero de 2017. Analizamos variables demográficas, clínicas, anatomopatológicas, terapéuticas y complicaciones durante el seguimiento. RESULTADOS: De los 419 pacientes, 41 fueron diagnosticados de BXO (9,78%). Seis pacientes fueron excluidos por falta de seguimiento, por lo que se analizaron 35 pacientes. La media de edad al diagnóstico fue de 8,6 años. El diagnóstico de sospecha fue clínico durante la exploración física en 17 pacientes (48,6%) y durante la intervención en 18 (51,4%), realizando la confirmación anatomopatológica en un total de 35 pacientes (100%). Durante el seguimiento 6 pacientes (17,14%) presentaron lesiones en glande, 3 (8,57%) en uretra y 9 (25,71%) en ambas localizaciones, siendo necesaria la realización de 6 meatotomías (17,14%) y de nueva circuncisión en 5 (14,28%). El tiempo medio de recidiva fue de 32,43 meses. En 19 pacientes (54,28%) se aplicaron corticoides tópicos en pomada y en 1 paciente inmunosupresores tópicos (2,85%). CONCLUSIONES: Es necesario un seguimiento estrecho de los pacientes con diagnóstico clínico o anatomopatológico de BXO dada su elevada morbilidad. Las principales complicaciones descritas en la población pediátrica son la estenosis meatal y uretral, así como la recidiva de la fimosis si no se reseca el prepucio suficientemente.
Assuntos
Balanite Xerótica Obliterante/terapia , Adolescente , Balanite Xerótica Obliterante/complicações , Balanite Xerótica Obliterante/diagnóstico , Balanite Xerótica Obliterante/patologia , Betametasona/uso terapêutico , Criança , Pré-Escolar , Circuncisão Masculina/estatística & dados numéricos , Dexametasona/uso terapêutico , Seguimentos , Glucocorticoides/uso terapêutico , Humanos , Masculino , Pênis/cirurgia , Fimose/cirurgia , Recidiva , Reoperação , Estudos Retrospectivos , Tacrolimo/uso terapêuticoRESUMO
Hidradenitis suppurativa (HS) is a chronic inflammatory disease associated with insulin resistance (IR), metabolic syndrome and increased cardiovascular risk. Adipokines are biologically active, pleotropic molecules which have been involved in the development of IR and in the pathogenesis of several chronic inflammatory conditions. The aim of the present study was to analyze serum concentrations of adiponectin, leptin, resistin and visfatin in patients with HS, and investigate their possible associations with IR, HS risk and disease severity. This case-control study enrolled 137 non-diabetic individuals (76 HS-patients and 61 age and sex-matched controls). Serum concentrations of adiponectin, leptin, resistin and visfatin, and the homeostasis model assessment of IR (HOMA-IR) were measured in all the participants. Serum adiponectin concentrations were found to be significantly lower, and leptin, resistin and visfatin levels were significantly higher in HS-patients than in controls. These differences remained significant even after adjusting for age, sex and body mass index, except for leptin. In a multivariate regression analysis, HOMA-IR was inversely correlated with adiponectin and positively associated with resistin levels. Furthermore, serum levels of resistin and visfatin were independently associated with HS risk. However, we found no association between serum levels of adipokines and HS severity. Our results suggest that reduced adiponectin and increased resistin serum levels may be surrogate biomarkers for IR in patients with HS. Moreover, resistin and visfatin might be independent risk factors for the development of HS.
Assuntos
Hidradenite Supurativa/diagnóstico , Resistência à Insulina , Adiponectina/sangue , Adulto , Biomarcadores/sangue , Estudos de Casos e Controles , Estudos Transversais , Citocinas/sangue , Feminino , Hidradenite Supurativa/sangue , Hidradenite Supurativa/metabolismo , Humanos , Leptina/sangue , Masculino , Pessoa de Meia-Idade , Nicotinamida Fosforribosiltransferase/sangue , Resistina/sangue , Fatores de Risco , Índice de Gravidade de DoençaRESUMO
BACKGROUND: The malignant mechanisms that control the development of cutaneous T-cell lymphoma (CTCL) are beginning to be identified. Recent evidence suggests that disturbances in specific intracellular signalling pathways, such as RAS-mitogen-activated protein kinase, T-cell receptor (TCR)-phospholipase C gamma 1 (PLCG1)-nuclear factor of activated T cells (NFAT) and Janus kinase (JAK)-signal transducer and activator of transcription (STAT), may play an essential role in the pathogenesis of CTCL. OBJECTIVES: To investigate the mechanisms controlling disease development and progression in mycosis fungoides (MF), the most common form of CTCL. METHODS: We collected 100 samples that were submitted for diagnosis of, or a second opinion regarding, MF between 2001 and 2018, 80% of which were in the early clinical stages of the disease. Formalin-fixed paraffin-embedded tissues were used for histological review and to measure the expression by immunohistochemistry of surrogate markers of activation of the TCR-PLCG1-NFAT, JAK-STAT and NF-κB pathways. Folliculotropism and large-cell transformation were also examined. RESULTS: NFAT and nuclear factor kappa B (NF-κB) markers showed a comparable activation status in early and advanced stages, while STAT3 activation was more frequent in advanced stages and was associated with large-cell transformation. Consistently with this observation, STAT3 activation occurred in parallel with MF progression in two initially MF-negative cases. A significant association of NFAT with NF-κB markers was also found, reflecting a common mechanism of activation in the two pathways. Genomic studies identified nine mutations in seven genes known to play a potential role in tumorigenesis in T-cell leukaemia/lymphoma, including PLCG1, JAK3 and STAT3, which underlies the activation of these key cell-survival pathways. A higher mutational allele frequency was detected in advanced stages. CONCLUSIONS: Our results show that STAT3 is activated in advanced cases and is associated with large-cell transformation, while the activation of NFAT and NF-κB is maintained throughout the disease. These findings could have important diagnostic and therapeutic implications. What's already known about this topic? Mycosis fungoides is characterized by a clonal expansion of T cells in the skin. The mechanisms controlling disease development and progression are not fully understood. What does this study add? An association of the nuclear factor of activated T cells and nuclear factor kappa B pathways was found, which could reflect a common mechanism of activation. These pathways were activated in early and advanced stages at the same level. Signal transducer and activator of transcription 3 activation was associated with large-cell transformation and was more frequent in advanced stages. A genomic analysis of cutaneous T-cell lymphoma-associated genes was performed. Nine mutations were detected. What is the translational message? These results could have important implications for the treatment of MF in the near future.
Assuntos
Linfoma Cutâneo de Células T , Micose Fungoide , NF-kappa B , Fatores de Transcrição NFATC , Fator de Transcrição STAT3 , Neoplasias Cutâneas , Humanos , Micose Fungoide/genética , Fator de Transcrição STAT3/genética , Fator de Transcrição STAT3/metabolismo , Neoplasias Cutâneas/genética , Linfócitos T/metabolismoRESUMO
A study was conducted to determine the effects of flaxseed supplementation on performance, carcass traits, and hindleg fatty acid composition of guinea pigs. Sixty male and female weaned guinea pigs (1 month old, five animals/cage) were blocked by sex and bodyweight and randomly fed 0 (control) or 100 g/kg flaxseed concentrate diets (15 g/animal) plus ad libitum fresh alfalfa for 30 days. Results showed that flaxseed supplementation had no influence on animal performance. However, final body weight (P = 0.035), total feed intake (P = 0.019), and body weight gain (P < 0.001) were higher in male than female guinea pigs. Similar results were also observed for carcass composition (i.e., hot, chilled, and reference carcass weights). Inclusion of flaxseed reduced saturated (P < 0.001), mono-unsaturated (P = 0.004), and increased (P < 0.001) polyunsaturated (PUFA) fatty acid concentrations in hindlegs. Concentrations of linolenic acid and n-3 PUFA increased (P < 0.001) by 49.7 and 37.1%, respectively as a result of flaxseed inclusion. It was concluded that feeding flaxseed to guinea pigs at 100 g/kg of the concentrate diets improves meat PUFA concentrations with no adverse effects on performance or carcass composition.
Assuntos
Ingestão de Alimentos , Ácidos Graxos/análise , Linho/metabolismo , Cobaias/fisiologia , Membro Posterior , Carne/análise , Aumento de Peso , Ração Animal/análise , Animais , Dieta/veterinária , Suplementos Nutricionais/análise , Ingestão de Alimentos/efeitos dos fármacos , Feminino , Linho/química , Cobaias/crescimento & desenvolvimento , Membro Posterior/química , Membro Posterior/efeitos dos fármacos , Masculino , Peru , Distribuição Aleatória , Sementes/química , Aumento de Peso/efeitos dos fármacosRESUMO
INTRODUCCIÓN: Los carcinomas adenoneuroendocrinos mixtos (MANEC) son tipos de tumores bifásicos, reconocidos morfológicamente ante la presencia de una formación neoplásica constituida de manera simultánea por epitelio glandular y células neuroendocrinas. Dentro del tracto gastrointestinal, estas neoplasias predominan en el estómago o el colon. Solo 19 casos localizados en la ampolla de Vater han sido reportados por la literatura. OBJETIVO: Reportar un caso de MANEC; revisar la epidemiología, pronóstico y tratamiento de estos tumores. MATERIALES Y MÉTODO: Presentación de caso clínico de una paciente con diagnóstico de adenocarcinoma neuroendocrino mixto de la región ampular. DISCUSIÓN: La presentación clínica, el manejo y el pronóstico son similares al del adenocarcinoma ampular. Se diagnostican con el examen histopatológico de la muestra resecada. Ambos componentes deben ser histológicamente malignos, y cada uno de ellos debe representar al menos el 30% de la lesión. CONCLUSIÓN: Los MANEC ampulares son tumores poco comunes a nivel mundial, siendo éste el primer caso reportado en nuestro instituto.
INTRODUCTION: Mixed adenoneuroendocrine carcinomas (MANEC) are types of biphasic tumors, morphologically recognized in the presence of a neoplastic formation constituted simultaneously by glandular epithelium and neuroendocrine cells. Only 19 cases located in the ampulla of Vater have been reported in the literature. Within the gastrointestinal tract, these neoplasms predominate in the stomach or colon. AIM: Report a case of MANEC; review of the epidemiology, prognosis and treatment of these tumors. MATERIALS AND METHOD: Case presentation of a patient diagnosed with mixed adeno-neuroendocrine carcinoma of the ampullary region. DISCUSSION: The clinical presentation, management and prognosis are similar to ampullary adenocarcinoma. These tumors are diagnosed with a histopathological examination of the resected specimen. Both components must be histologically malignant, and each of them must represent at least 30% of the lesion. CONCLUSION: MANEC of the ampulla are rare tumors worldwide, being this case the first reported in our institute.
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Ampola Hepatopancreática/cirurgia , Adenocarcinoma/cirurgia , Carcinoma Neuroendócrino/cirurgia , Ampola Hepatopancreática/diagnóstico por imagem , Adenocarcinoma/diagnóstico por imagem , Colangiopancreatografia Retrógrada Endoscópica , Pancreaticoduodenectomia , Carcinoma Neuroendócrino/diagnóstico por imagemRESUMO
Wastewater treatment is an important source of methane (CH4) emissions. In most large-size aerobic treatment plants, the excess sludge is digested in anaerobic reactors (AD), with the concomitant CH4 emissions. The guidelines of the Intergovernmental Panel on Climate Change (IPCC) have been adopted worldwide for quantifying the national emission inventories, which include wastewater treatment plants (WWTP) as a key category. The IPCC recommends using default emission factors (Tier 1) for countries with limited available data (such as Mexico and most developing countries). However, these estimates have a high degree of uncertainty, owing to the lack of reliable information about the operation process and local environmental conditions. In order to reduce uncertainty in the estimation of CH4 emission from WWTP in Mexico, a country-specific emission factor was determined for AD associated with activated sludge process. This was accomplished with on-site data obtained from the AD of six activated sludge WWTP. In addition, the measured CH4 emissions were compared to those resulting from the application of the IPCC Tier 1 method, using the recommended default methane correction factor (MCF: 0.8) as well as alternate values (0.32 and 0.26) recently proposed by the authors. Results show that the IPCC Tier 1 method, using the recommended MCF, highly overestimate CH4 emissions compared with the values obtained on-site. In contrast, the alternate MCF achieved better estimations than the IPCC-recommended MCF, much closer to the observed emission values. The CH4 emission factor proposed as country (Mexico) specific value is 0.49â¯kgâ¯CH4/kgâ¯BODrem, which would allow the application of IPCC Tier 2 method. By doing so, the uncertainty associated with CH4 emission from aerobic treatment plants with AD would be reduced. This, in turn, would provide important information for implementing appropriate CH4 mitigation strategies for the water sector.
Assuntos
Poluentes Atmosféricos/análise , Reatores Biológicos , Monitoramento Ambiental/métodos , Metano/análise , Eliminação de Resíduos Líquidos , Anaerobiose , Monitoramento Ambiental/instrumentação , México , EsgotosRESUMO
Se presenta el caso de una paciente de sexo femenino, de 69 años, que refiere tinnitus pulsátil de dos meses de evolución percibido en la región retroauricular derecha. Se presentan los hallazgos en estudios de imágenes, diagnóstico y se presenta una corta revisión del tema.
We present the case of a female patient, 69 years old, who reported pulsatile tinnitus since two months ago perceived in the right retroauricular region. We present the findings in image studies, diagnosis and a short review about the topic.