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1.
Rev. chil. enferm. respir ; 39(3): 226-232, 2023. tab, graf
Artigo em Espanhol | LILACS | ID: biblio-1521831

RESUMO

El asma se caracteriza por su impacto deletéreo que incluye gran coste económico para el sistema de salud. En pacientes con asma mal controlada a pesar del tratamiento, se propone un régimen de mantenimiento con corticoides inhalados y formoterol. El objetivo del presente estudio observacional retrospectivo fue evaluar las modificaciones espirométricas tras el cambio del medicamento controlador en pacientes con asma moderada a severa asistidos en el Hospital Clínico de Magallanes de Punta Arenas, así como también cuantificar la modificación en el número de exacerbaciones graves (consulta a un servicio de urgencia y/u hospitalización por asma). Participaron 61 adultos con asma moderada a severa (mediana de edad: 60 años [rango: 21-87], mujeres: 69,4%; comorbilidad atópica/alérgica: 79%; otras comorbilidades: 46,8%) en los que se cambió el tratamiento con fluticasona/salmeterol 250/25 μg por budesónida/formoterol 160/4,5 μg. No se observaron cambios significativos en los índices espirométricos tras el cambio. Con el tratamiento inicial, el 46,9% presentó ≥ 1 visita a urgencias (total: 50 consultas). Tras el cambio por budesonida/formoterol, el 21% requirió al menos una visita a urgencias (total: 14 consultas; p < 0,01). La proporción de pacientes con ≥ 2 consultas a urgencias fue de 19,7% con el tratamiento basal y de 1,6% tras el cambio a budesonida/formoterol (p < 0,01). No se observaron diferencias significativas en la cantidad de hospitalizaciones. En este estudio del mundo real de pacientes con asma moderada a grave, el cambio del tratamiento a budesonida/formoterol se asoció con reducción significativa de las consultas a urgencias, a pesar de no detectarse cambios de significación estadística en los índices espirométricos habituales.


Asthma is characterized by its deleterious impact, including a high cost to the healthcare system. In patients with poorly controlled asthma despite treatment, a maintenance regimen of inhaled corticosteroids and formoterol is proposed. The aim of this retrospective, observational study was to evaluate the spirometric changes after switching the controller medication in patients with moderate to severe asthma attended in our institution ("Hospital Clínico de Magallanes"), as well as the variation in the number of severe exacerbations (consultation to an emergency department and/or hospitalization for asthma). Sixty-one adults with moderate to severe asthma (median age: 60 years-old [range: 21-87], women: 69.4%; atopic/allergic comorbidity: 79%; other comorbidities: 46.8%) in whom treatment with fluticasone/salmeterol 250/25 μg was switched to budesonide/formoterol 160/4.5 μg participated in our study. No significant changes in spirometric parameters were observed after the replacement treatment. With the initial treatment, 46.9% patients presented ≥ 1 visit to the emergency department (total: 50 visits). After the switch to budesonide/formoterol, 21% required at least one emergency department visit (total: 14 consultations; p < 0.01). The proportion of patients with ≥ 2 emergency department visits was 19.7% with baseline treatment and 1.6% after switching to budesonide/formoterol (p < 0.01). No significant differences were observed in the number of hospitalizations. In this real-world study of moderate to severe asthma patients, switching to budesonide/formoterol was associated with a significant reduction in emergency department visits, despite no statistically significant changes in the usual spirometric parameters.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Adulto Jovem , Asma/tratamento farmacológico , Espirometria , Budesonida/administração & dosagem , Fumarato de Formoterol/administração & dosagem , Broncodilatadores/administração & dosagem , Esquema de Medicação , Volume Expiratório Forçado , Estudos Retrospectivos , Quimioterapia Combinada , Combinação Fluticasona-Salmeterol/administração & dosagem
2.
Rev. cir. (Impr.) ; 74(6)dic. 2022.
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1441431

RESUMO

Introducción: El conocimiento obtenido a partir de las experiencias de los pacientes favorece una atención de calidad. El objetivo de este estudio cualitativo es conocer la percepción de los pacientes sobre su realimentación tras una cirugía colorrectal, y los factores condicionantes en relación con dicho proceso. Material y Método: En base a la directriz de Standards for Reporting Qualitative Research, se realiza un estudio cualitativo a partir de una entrevista de 8 preguntas de término abierto realizada a 20 pacientes seleccionados por un método de variación máxima de muestreo. Se realizó análisis temático. Resultados: Se identificaron cuatro dimensiones principales (con subtemas respectivos) que condicionan la alimentación en el postoperatorio: 1. propósitos del paciente tras la alimentación (búsqueda de alta, hidratación, búsqueda de salud, finalizar ayuno, deambulación); 2. propiedades y características de los alimentos (sazón, presentación, temperatura, porciones, consistencia, favoritos); 3. factores del paciente (físicos, psicológicos); y 4. relación equipo de salud-paciente (confianza, complacencia, información, agradecimiento). Conclusión: El proceso de ingesta de alimentos en este contexto está condicionado por las cuatro dimensiones mencionadas. Sería importante considerarlas al momento de crear y ejecutar pautas y guías de alimentación adaptadas a los pacientes.


Introduction: Knowledge obtained from the experiences of patients favors quality care. The aim of this study is to know the perception of patients regarding refeeding after colorectal surgery, and particular factors that condition postoperative intake from their perspective. Materials and Method: Based on the guideline of Standards for reporting qualitative Research, a qualitative study was constructed from an interview with 8 open-ended questions to 20 patients selected by a maximum sampling variation method. Thematic analysis was carried out. Results: Four main dimensions were identified that determine feeding in the postoperative period: 1. patient's goals after feeding (search for discharge, hydration, search for health, end fasting, ambulation); 2. properties and characteristics of food (seasoning, presentation, temperature, portions, consistency, favorites); 3 patient factors (physical, psychological); and 4. health team-patient relationship (trust, complacency, information, gratitude). Conclusion: The process of food intake in this context is conditioned by the four dimensions mentioned. It would be important to consider them when creating and executing feeding guidelines adapted to patients.

3.
Rev. cir. (Impr.) ; 74(5)oct. 2022.
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1423767

RESUMO

Introducción: Los trabajos científicos permiten divulgar, compartir y contrastar resultados a terceros. Una de las formas de ver la actividad investigativa de cada especialidad es a través de las presentaciones que realizan en reuniones científicas. Objetivo: Describir el número de presentaciones de las distintas especialidades o áreas quirúrgicas en Chile en el principal congreso realizado a nivel nacional y evaluar si el comportamiento fue distinto durante los años de pandemia por coronavirus. Material y Método: Estudio bibliométrico del Congreso Chileno de Cirugía entre los años 2010 y 2021 evaluando el número total de presentaciones por área quirúrgica, año de presentación y período categorizado en 2010 a 2019 y 2020 a 2021. Se realiza estadística descriptiva y análisis de asociación de medias de publicaciones por área y período. Resultados: Se identificaron 4.462 presentaciones, incluyendo resúmenes orales, póster, videos y jornada de residentes. La media total fue 371,8 trabajos anuales. Coloproctología y Cirugía Gastroesofágica aportaron un total de 616 (13,8%) y 598 (13,4%) respectivamente. La media de presentaciones anuales previo a la pandemia por coronavirus fue de 414, en contraste a los 160 trabajos anuales durante ella, existiendo una disminución significativa de medias de presentaciones por área de 27,6 (± 18,8) a 10,7 (± 8,69) (p < 0,001), sin diferencias sus porcentajes de participación respecto del total (p = 0,776). Conclusión: Coloproctología y Cirugía Gastroesofágica son las áreas quirúrgicas más representadas. Si bien en el período contemporáneo a la pandemia por coronavirus significó una disminución en las presentaciones, no se observó una modificación en el porcentaje de participación de algún área en particular.


Introduction: Scientific studies allow the disclosure, sharing and comparison of results with third parties. One of the ways to see the investigative activity of each medical specialty is through the presentations they make at scientific meetings. Aim: To describe the number of presentations of the different surgical specialties or areas in Chile in the main congress held at a national level and to assess whether the behavior was different during the years of the coronavirus pandemic. Material and Method: Bibliometric study of the Chilean Congress of Surgery between 2010 and 2021, evaluating the total number of presentations by surgical area, year of presentation and two categorized periods (2010 to 2019 and 2020 to 2021). Descriptive statistics and association analysis of publication means by area and period are performed. Results: 4,462 presentations were identified, including oral summaries, posters, videos, and residents' sessions, with a mean of 371.8 per year. Coloproctology and Gastroesophageal Surgery contributed a total of 616 (13.8%) and 598 (13.4%) respectively. The mean number of annual presentations prior to the coronavirus pandemic was 414, in contrast to the 160 annual works during it, with a significant decrease in the mean number of presentations per area from 27.6 (± 18.8) to 10.7 (± 8.69) (p < 0.001), without differences in their percentages of participation with respect to the total (p = 0.776). Conclusion: Coloproctology and Gastroesophageal Surgery are the most represented surgical areas. Although the contemporary period of the coronavirus pandemic meant a decrease in presentations, no change was observed in the percentage of participation in any particular area.

4.
J Med Entomol ; 58(6): 2474-2478, 2021 11 09.
Artigo em Inglês | MEDLINE | ID: mdl-34197593

RESUMO

Mepraia spinolai, (Porter) 1934, is a diurnal triatomine endemic to Chile and a wild vector of the protozoan Trypanosoma cruzi, (Chagas) 1909, which causes Chagas disease. Behavioral changes in M. spinolai induced by this parasite have been reported previously, which include detection of a potential host, defecation latency, and some life history traits. In this study we assessed changes in locomotor and daily activity due to infection with T. cruzi. No difference was detected in distance traveled between infected and uninfected individuals. However, the groups differed in their daily activity patterns; infected individuals showed significant reduction of movements during the light phase and concentrated their activity in the dark phase. Uninfected individuals showed no differences in locomotor activity between the phases. The results suggest that T. cruzi induces a displacement in the activity of M. spinolai toward the dark phase of the circadian cycle, which may improve its vector competence.


Assuntos
Características de História de Vida , Triatominae/parasitologia , Trypanosoma cruzi/fisiologia , Animais , Comportamento Alimentar , Locomoção
5.
Gastroenterol. latinoam ; 31(1): 49-52, mayo 2020. ilus
Artigo em Espanhol | LILACS | ID: biblio-1103463

RESUMO

The presence of bezoars in daily clinical practice is a event that poses a challenge both diagnostic, due to the associated factors in its development, as well as therapeutic. The management of this entity is associated with medical, endoscopic and surgical procedures and it is necessary to know its usefulness in different clinical scenarios. The role of carbonated beverages is increasingly accepted given its low cost, wide availability and high efficiency. For the aforementioned, it seems important to report a series of cases and the management performed.


La presencia de bezoares en la práctica clínica diaria es un evento que establece un desafío diagnóstico, por los factores asociados en su desarrollo, como también terapéutico. El manejo de esta patología se asocia a procedimientos médicos, endoscópicos y quirúrgicos siendo necesario conocer su utilidad en distintos escenarios clínicos. El rol de las bebidas carbonatadas es cada vez más aceptado dado su bajo costo, amplia disponibilidad y alta eficacia. Por lo antes señalado, nos parece importante reportar una serie de casos y el manejo realizado.


Assuntos
Humanos , Masculino , Feminino , Adulto , Idoso de 80 Anos ou mais , Bezoares/terapia , Bebidas Gaseificadas , Lavagem Gástrica/métodos , Bezoares/diagnóstico , Endoscopia do Sistema Digestório , Resultado do Tratamento
6.
Rev. chil. reumatol ; 34(2): 66-72, 2018. ilus, tab
Artigo em Espanhol | LILACS | ID: biblio-1254087

RESUMO

El síndrome de canal carpiano es una patología frecuente. Si bien el diagnóstico es clínico, la ecografía cumple un rol en caso de duda diagnóstica y como apoyo a proce-dimientos intervencionales.Existen variables anatómicas y distancias de estructuras vasculares útiles de conocer antes de planear un gesto quirúrgico o de infiltración para disminuir el riesgo de lesiones secundarias, en donde la ecografía podría tener un rol.Estudiamos una muestra de 267 ecografías de muñeca con especial hincapié en va-riantes neurogénicas, vasculares o tendinosas que podrían resultar lesionadas en relación a algún procedimiento.


Carpal tunnel syndrome is a frequent pathology. Although the diagnosis is clinical, ultrasound plays a role in case of diagnostic doubt and as support and guide for inter-ventional procedures.There are anatomical variants and distances of vascular structures that may be useful to know before planning a surgical or infiltration procedure to reduce the risk of iat-rogenic injuries, where ultrasound could play a role.We studied a sample of 267 wrists ultrasounds with special emphasis on neurogenic, vascular or tendinous variants that could be injured in relation to procedures.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Adulto Jovem , Síndrome do Túnel Carpal/cirurgia , Síndrome do Túnel Carpal/diagnóstico por imagem , Ultrassonografia de Intervenção/métodos , Nervo Mediano/anatomia & histologia , Nervo Mediano/diagnóstico por imagem , Infiltração-Percolação , Chile , Nervo Mediano/cirurgia
7.
J Affect Disord ; 215: 156-162, 2017 06.
Artigo em Inglês | MEDLINE | ID: mdl-28334676

RESUMO

BACKGROUND: Few studies have examined Manual Motor Speed (MMS) in bipolar disorder (BD). The aim of this longitudinal, family study was to explore whether dysfunctional MMS represents a neurocognitive endophenotype of BD. METHODS: A sample of 291 subjects, including 131 BD patients, 77 healthy first-degree relatives (BD-Rel), and 83 genetically-unrelated healthy controls (HC), was assessed with the Finger-Tapping Test (FTT) on three occasions over a 5-year period. Dependence of FTT on participants´ age was removed by means of a lineal model of HC samples, while correcting simultaneously the time and learning effect. Differences between groups were evaluated with an ANOVA test. RESULTS: The patients' performance was significantly worse than that of HC over time (p≤0.006), and these deficits remained when non-euthymic BD patients (n=9) were excluded from analysis. Some significant differences between BD patients and BD-Rel (p≤0.037) and between BD-Rel and HC (p≤0.033) were found, but they tended to disappear as time progressed (p≥0.057). Performance of the BD-Rel group was intermediate to that of BD and HC. Most sociodemographic and clinical variables did not affect these results in patients. (p≥0.1). However, treatment with carbamazepine and benzodiazepines may exert a iatrogenic effect on MMS performance (p≤0.006). LIMITATIONS: Only right-handed subjects were included in this study. Substantial attrition over time was detected. CONCLUSIONS: There were significant differences between the patients´ MMS performance and that of healthy relatives and controls, regardless of most clinical and sociodemographic variables. Dysfunctional MMS could be considered an endophenotype of BD. Further studies are needed to rule out possible iatrogenic effects of some psychopharmacological treatments.


Assuntos
Transtorno Bipolar/complicações , Endofenótipos , Transtornos das Habilidades Motoras/etiologia , Desempenho Psicomotor , Adolescente , Adulto , Idoso , Análise de Variância , Transtorno Bipolar/genética , Estudos de Casos e Controles , Família , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Destreza Motora , Transtornos das Habilidades Motoras/diagnóstico , Adulto Jovem
9.
Nanoscale ; 7(41): 17289-98, 2015 Nov 07.
Artigo em Inglês | MEDLINE | ID: mdl-26228582

RESUMO

Electrostatics is one of the fundamental driving forces of the interaction between biomolecules in solution. In particular, the recognition events between viruses and host cells are dominated by both specific and non-specific interactions and the electric charge of viral particles determines the electrostatic force component of the latter. Here we probe the charge of individual viruses in liquid milieu by measuring the electrostatic force between a viral particle and the Atomic Force Microscope tip. The force spectroscopy data of co-adsorbed ϕ29 bacteriophage proheads and mature virions, adenovirus and minute virus of mice capsids is utilized for obtaining the corresponding density of charge for each virus. The systematic differences of the density of charge between the viral particles are consistent with the theoretical predictions obtained from X-ray structural data. Our results show that the density of charge is a distinguishing characteristic of each virus, depending crucially on the nature of the viral capsid and the presence/absence of the genetic material.


Assuntos
Adenoviridae , Fagos Bacilares , Vírus Miúdo do Camundongo , Vírion , Adenoviridae/química , Adenoviridae/ultraestrutura , Animais , Fagos Bacilares/química , Fagos Bacilares/ultraestrutura , Camundongos , Microscopia de Força Atômica , Vírus Miúdo do Camundongo/química , Vírus Miúdo do Camundongo/ultraestrutura , Eletricidade Estática , Vírion/química , Vírion/ultraestrutura
10.
Rev. chil. neuro-psiquiatr ; 53(2): 93-99, jun. 2015. ilus
Artigo em Espanhol | LILACS | ID: lil-753502

RESUMO

Aim: Case report of association between diastematomyelia and medulloepithelioma. Method: 14-year-old patient with lower back pain and recent neurological deficit in extremities. CT and MRI scans of the thoracolumbar spine revealed a diastematomyelia. Intraoperative examination confirmed the presence of a spinal dysraphism and associated tumor, which was almost completely resected. Result: Histopathological and immunohistochemical findings were consistent with medulloepithelioma. Her postoperative course was uneventful. Conclusion: Diastematomyelia may manifest during adolescence as lower back pain and neurological deficit. The association of this malformation with a neoplasia is extremely rare; the present case describes concomitance with medulloepithelioma.


Reporte de un caso de asociación de diastematomielia y meduloepitelioma. Método: Paciente de 14 años con dolor lumbar y déficit neurológico en extremidades de reciente instalación. En TAC y RNM de columna dorsolumbar se pesquisa una diastematomielia. La exploración intraoperatoria, comprueba la presencia de una disrafia espinal y un tumor asociado al defecto, que se reseca casi en su totalidad. Resultado: Los hallazgos histopatológicos e inmunohistoquímicos son concordante con meduloepitelioma. La paciente tuvo un postoperatorio satisfactorio. Conclusión: La diastematomielia se puede manifestar durante la adolescencia como dolor lumbar y déficit neurológico. La asociación de esta malformación, con una neoplasia es muy poco frecuente, el presente caso describe la concomitancia con un meduloepitelioma.


Assuntos
Humanos , Adolescente , Feminino , Defeitos do Tubo Neural/complicações , Defeitos do Tubo Neural/diagnóstico , Neoplasias da Medula Espinal/cirurgia , Neoplasias da Medula Espinal/complicações , Tumores Neuroectodérmicos Primitivos/cirurgia , Tumores Neuroectodérmicos Primitivos/complicações , Dor Lombar/etiologia , Neoplasias da Medula Espinal/diagnóstico , Disrafismo Espinal , Tumores Neuroectodérmicos Primitivos/diagnóstico
11.
Rev. argent. mastología ; 33(120): 257-268, Sept. 2014. graf
Artigo em Espanhol | LILACS | ID: lil-777873

RESUMO

La estrategia terapéutica para los tumores de mama en estadios tempranos ha sido establecida desde fines del siglo XX; es entonces que al tratamiento quirúrgico conservador y la radioterapia se sumó el ganglio centinela y el tratamiento adyuvante, de acuerdo a parámetros pre- y posoperatorios. Sin embargo, existe en todas las series una tasa de recurrencia local, y se ha podido determinar en parte cuáles son los factores de la paciente, anatómicos e histológicos, que predisponen a tal evento, a partir de hallazgos posoperatorios.También existe una tasa de enfermedad regional y a distancia, derivando en la necesidad de identificar factores de predicción que puedan sugerir la necesidad de una terapéutica más agresiva en pacientes susceptibles. Por otra parte, la clasificación molecular de los tumores de mama descripta por Perou y cols. pone en evidencia características inherentes a cada tumor, permitiendo establecer subtipos con implicancia clínica. A partir del análisis de nuestra estadística, en la que presentamos pacientes con cáncer de mama inicial que han recibido un tratamiento conservador, los objetivos planteados son: Presentar las tasas de eventos locales, regionales, a distancia y sobrevida luego de 15 años de experiencia en tratamiento conservador, y determinar si existe en nuestra serie una relación entre estos eventos, la edad de las pacientes y la clasificación molecular de los tumores. Establecer a partir de los resultados su implicancia a nivel asistencial.


Assuntos
Neoplasias da Mama , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/imunologia
12.
Sci Rep ; 3: 1434, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23486377

RESUMO

The standard pathway for virus infection of eukaryotic cells requires disassembly of the viral shell to facilitate release of the viral genome into the host cell. Here we use mechanical fatigue, well below rupture strength, to induce stepwise disruption of individual human adenovirus particles under physiological conditions, and simultaneously monitor disassembly in real time. Our data show the sequence of dismantling events in individual mature (infectious) and immature (noninfectious) virions, starting with consecutive release of vertex structures followed by capsid cracking and core exposure. Further, our experiments demonstrate that vertex resilience depends inextricably on maturation, and establish the relevance of penton vacancies as seeding loci for virus shell disruption. The mechanical fatigue disruption route recapitulates the adenovirus disassembly pathway in vivo, as well as the stability differences between mature and immature virions.


Assuntos
Adenovírus Humanos/fisiologia , Estresse Mecânico , Adenovírus Humanos/química , Capsídeo/química , Capsídeo/fisiologia , Proteínas do Capsídeo/metabolismo , Humanos , Microscopia de Força Atômica , Simulação de Dinâmica Molecular , Montagem de Vírus
13.
Int J Impot Res ; 24(6): 234-41, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22717763

RESUMO

The European Sexual Confidence Survey examined the opinions of men and women on the link between a man's sexual confidence and functional (erectile and orgasmic) and emotional (satisfaction and self-confidence) aspects of sex and life in general. The online survey of sexually active adults (25-64 years of age) was conducted in 12 European countries using multiple-choice questions and predefined statements on sexual confidence. Erectile function was assessed by erection hardness score (EHS). Of 8576 respondents (4246 men, 4330 women), 23.9% reported non-optimal erectile hardness (EHS3) for themselves or their partners. 79.0% believed that an ability to sexually satisfy their partner is most closely linked to a man's sexual confidence. One in three linked a man's sexual confidence to erection hardness and ability to reach orgasm. The majority (∼94.0%) believed that it is important for a man to be sexually confident for good sex and that being able to have good sex enables men to have greater satisfaction with life overall. Lack of sexual confidence due to insufficient erection rigidity was considered by most respondents (∼65.0%) to reduce a man's confidence about the next sexual encounter and also his self-confidence and self-esteem overall.


Assuntos
Atitude , Disfunção Erétil/psicologia , Ereção Peniana/psicologia , Autoimagem , Comportamento Sexual/psicologia , Adulto , Europa (Continente) , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação Pessoal , Personalidade , Parceiros Sexuais/psicologia , Inquéritos e Questionários
14.
Ultramicroscopy ; 114: 56-61, 2012 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-22356789

RESUMO

Control and minimization of tip-sample interaction forces are imperative tasks to maximize the performance of atomic force microscopy. In particular, when imaging soft biological matter in liquids, the cantilever dragging force prevents identification of the tip-sample mechanical contact, resulting in deleterious interaction with the specimen. In this work we present an improved jumping mode procedure that allows detecting the tip-sample contact with high accuracy, thus minimizing the scanning forces (-100 pN) during the approach cycles. To illustrate this method we report images of human adenovirus and T7 bacteriophage particles which are prone to uncontrolled modifications when using conventional jumping mode.


Assuntos
Adenoviridae/ultraestrutura , Bacteriófago T7/ultraestrutura , Microscopia de Força Atômica/métodos , Humanos
15.
Rev. chil. neurocir ; 37: 19-22, jul. 2011. tab
Artigo em Espanhol | LILACS | ID: lil-708071

RESUMO

La hidrocefalia es una complicación frecuente de la hemorragia subaracnoídea (HSA); se ha propuesto la fenestración de la lamina terminalis en el momento del clipaje aneurismático como un medio de facilitar la dinámica del flujo de líquido cefaloraquídeo (LCR) y de reducción de la incidencia de HCF dependiente de shunt. Realizamos un analisis retrospectivo para probar la hipótesis de que la fenestración de la lamina terminalis efectivamente reduce la incidencia de HCF dependiente de shunt y de complicaciones isquémicas en pacientes con hemorragia subaracnoídea aneurismática (grado de Fisher modificado III o IV). Las fichas clínicas de 145 pacientes con hemorragia subaracnoídea aneurismática fueron analizadas; 48 de estos pacientes recibieron tratamiento con coiling endovascular y 97 fueron tratados con clipaje microquirúrgico. De estos últimos, 9 pacientes fueron sometidos a fenestración de la lamina terminalis. En los 9 pacientes con fenestración de la lamina terminalis. No hubo ningún caso de HCF dependiente de shunt. En los 104 pacientes con HSA grado 3 o 4 en los cuales el aneurisma fue tratado pero la lamina terminalis no fue fenestrada, la incidencia de HCF dependiente de shunt fue de 5,3 por ciento; esta diferencia no fue estadísticamene significativa (p=0,378). Pese a que los resultados de este estudio no apoyan la real efectividad de la FLT en la reducción de la incidencia de HCF dependiente de shunt, la tasa de complicaciones isquémicas o la mortalidad a 6 meses en pacientes con HAS aneurismática, observamos una tendencia en el grupo con FLT a mostrar una menor incidencia de HCF post HAS. No hubo en esta casuística complicaciones directamente atribuíbles a la FLT. El bajo riesgo de la FLT la convierte en una opción válida como parte del manejo integral de la HAS aneurismática, a la espera de estudios prospectivos que clarifiquen el rol de esta intervención.


Assuntos
Humanos , Hemorragia Subaracnóidea/cirurgia , Hemorragia Subaracnóidea/complicações , Hemorragia Subaracnóidea/líquido cefalorraquidiano , Hemorragia Subaracnóidea/mortalidade , Hemorragia Subaracnóidea/terapia , Derivação Ventriculoperitoneal , Hidrocefalia/cirurgia , Hidrocefalia/etiologia , Hidrocefalia/prevenção & controle
16.
Gene Ther ; 18(11): 1025-33, 2011 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-21525953

RESUMO

Standard methods for producing high-capacity adenoviral vectors (HC-Ads) are based on co-infection with a helper adenovirus (HV). To avoid HV encapsidation, its packaging signal (Ψ) is flanked by recognition sequences for recombinases expressed in the producing cells. However, accumulation of HV and low yield of HC-Ad are frequently observed, due in part to insufficient recombinase expression. We describe here a novel HV (AdTetCre) in which Ψ is flanked by loxP sites that can be excised by a chimeric MerCreMer recombinase encoded in the same viral genome. Efficient modulation of cleavage was obtained by simultaneous control of MerCreMer expression using a tet-on inducible system, and translocation to the nucleus by 4-hydroxytamoxifen (TAM). Encapsidation of AdTetCre was strongly inhibited by TAM plus doxycicline. Using AdTetCre and 293Cre4 cells for the production of HC-Ads, we found that cellular and virus-encoded recombinases cooperate to minimize HV contamination. The method was highly reproducible and allowed the routine production of different HC-Ads in a medium-scale laboratory setting in adherent cells, with titers >10¹° infectious units and <0.1% HV contamination. The residual HVs lacked Ψ and were highly attenuated. We conclude that self-inactivating HVs based on virally encoded recombinases are promising tools for the production of HC-Ads.


Assuntos
Adenoviridae/genética , Terapia Genética/métodos , Vetores Genéticos/síntese química , Vírus Auxiliares/genética , Integrases/administração & dosagem , Doxiciclina/farmacologia , Tamoxifeno/análogos & derivados , Tamoxifeno/farmacologia
17.
J Struct Biol ; 167(3): 252-60, 2009 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-19555764

RESUMO

The 3D reconstruction of biological specimens using Electron Microscopy is currently capable of achieving subnanometer resolution. Unfortunately, this goal requires gathering tens of thousands of projection images that are frequently selected manually from micrographs. In this paper we introduce a new automatic particle selection that learns from the user which particles are of interest. The training phase is semi-supervised so that the user can correct the algorithm during picking and specifically identify incorrectly picked particles. By treating such errors specially, the algorithm attempts to minimize the number of false positives. We show that our algorithm is able to produce datasets with fewer wrongly selected particles than previously reported methods. Another advantage is that we avoid the need for an initial reference volume from which to generate picking projections by instead learning which particles to pick from the user. This package has been made publicly available in the open-source package Xmipp.


Assuntos
Algoritmos , Inteligência Artificial , Imageamento Tridimensional/métodos , Adenoviridae/química , Antígenos Virais de Tumores/química , Microscopia Eletrônica , Tamanho da Partícula , Proteína de Replicação A/química
18.
Rev. chil. ortop. traumatol ; 46(1): 27-32, 2005. tab
Artigo em Espanhol | LILACS | ID: lil-410363

RESUMO

Se presenta la experiencia de los 13 primeros alargamientos óseos realizados en el Hospital de Puerto Montt entre los años 1996 y 2001. Se revisa la evolución histórica del procedimiento y sus resultados, con énfasis en el ánalisis de sus complicaciones. Se incluyeron 10 casos de niños y 3 de adultos. La etiología fue congénita en el 54 por ciento. Se operaron 9 tibias y 4 fémures. Las complicaciones globales totalizan 41 sobre 13 casos, constituyendo un 315 por ciento. Se intenta identificar las causas de las complicaciones para que en los sucesivos alargamientos, éstas se minimicen o resuelvan en forma precoz.


Assuntos
Humanos , Masculino , Feminino , Criança , Adulto , Alongamento Ósseo , Fêmur/cirurgia , Tíbia/cirurgia , Chile , Fixadores Externos
20.
Rev. méd. Chile ; 131(7): 711-718, jul. 2003.
Artigo em Espanhol | LILACS | ID: lil-356069

RESUMO

BACKGROUND: Type I human immunodeficiency virus (HIV) is characterized by a great genetic variability. There are three groups of virus throughout the world: O, N and M. Group M is responsible for AIDS pandemic and is subdivided in 9 genetic subtypes. Most viral strains in South America are subtype B. AIM: To determine the frequency of HIV subtypes in Chilean patients. MATERIAL AND METHODS: Genetic analysis of C2-V3-C3 region of the gene env in HIV strains coming from 77 Chilean subjects infected by different means. DNA heteroduplex mobility assay was used to determine HIV subtypes. RESULTS: Sixty eight cases were infected with subtype B (88.3 per cent) and nine cases were infected with subtype F (11.7 per cent). CONCLUSIONS: Subtype B is the predominant HIV in Chile, but subtype F is also present.


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adolescente , HIV-1 , Infecções por HIV/virologia , HIV-1 , Chile/epidemiologia , DNA Viral/análise , Eletroforese em Gel de Poliacrilamida , /genética , Reação em Cadeia da Polimerase , Sorodiagnóstico da AIDS
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