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Aeroallergen sensitization patterns among patients with chronic rhinitis with or without concomitant asthma
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Souza, Tássia Milenna Oliveira de
; Fernandes, Jamille Souza
; Santana, Cinthia Vila Nova
; Lessa, Marcus Miranda
; Cruz, Álvaro A.
.
Abstract Objectives The aim of this study was to explore the differences in the pattern of allergen sensitization in CR individuals without or with asthma, according to asthma severity. Methods A total of 1066 adults were evaluated. Asthma and chronic⁄allergic rhinits were identified by specialists, questionnaries and skin-prick test. The phenotypic characterization was avaliable from skin-prick test to an aeroallergen extended panel, total IgE and pulmonary function. Using questionnaires and clinical evaluation, participants were classified into the groups: chronic rhinitis alone (CRA) and chronic rhinitis + asthma, the latter subdivided into CR + mild asthma (CRMA) and CR + moderate to severe asthma (CRMSA). Aerollergen sensitization was defined by a positive prick test to one or more allergens associated with nasal symptoms and/or asthma. The association between CR and asthma was evaluated by multivariable logistic regression. The evidence of effect modification of pattern of sensitization in CR on the association with asthma severity and outcomes was examined by introducing interactions terms in the logistic regression models adjusting for confounders. Results Frequency of sensitization to aeroallergens was higher in association with asthma in comparison to CRA (CRMA 70.4%; CRMSA 65.0%; CRA 47.0%; p= 0.000). Similarly, the presence of asthma was associated to aeroallergen multiple sensitization (51.5%) (OR = 2.10, 95% CI 1.27-3.50). Additionally, the sensitization to mites, cockroaches, animal epithelium, grasses, and molds, were higher in asthma (56.8%, 24.3%, 12%, 7.13% and 10.3%, respectively). Sensitization to Alternaria alternata, Cladosporium herbarum and dog epithelium was exclusive in asthma groups. A concomitant asthma diagnosis was directly associated with a positive allergen sensitization at least one allergen (62.7%, OR = 2.45, 95% CI 1.80-3.34) and polissensitization (51.5%, OR = 2.10, 95% CI 1.27-3.50). Conclusion Asthma is associated with multiple allergen sensitization among patients with CR. Some unique profiles of aeroallergen sensitization were observed in patients with CR and asthma. Nevertheless, no difference was found in the sensitization in relation to asthma severity, which suggest atopy is not the main underlying mechanism for asthma severity among patients with CR. Level of evidence: Level 3. 106 chronicallergic allergic specialists skinprick skin panel function evaluation groups (CRA CRMA CRMSA. . (CRMSA) andor confounders 70.4% 704 70 4 65.0% 650 65 0 47.0% 470 47 p 0.000. 0000 0.000 000 0.000) Similarly 51.5% 515 51 5 (51.5% 210 2 10 2.10 95 1.273.50. 127350 1.27 3.50 1 27 3 50 1.27-3.50) Additionally mites cockroaches grasses molds 56.8%, 568 56 8 (56.8% 243 24 24.3% 12 12% 713 7 13 7.13 103 10.3% respectively. respectively respectively) alternata 62.7%, 627 62 (62.7% 245 45 2.45 1.803.34 180334 1.80 3.34 80 34 1.80-3.34 51.5%, Nevertheless (CRMSA 70.4 65.0 6 47.0 0.00 00 51.5 (51.5 21 2.1 9 273 1.273.50 12735 127 1.2 350 3.5 1.27-3.50 56.8% (56.8 24.3 71 7.1 10.3 62.7% (62.7 2.4 803 1.803.3 18033 180 1.8 334 3.3 1.80-3.3 70. 65. 47. 0.0 51. (51. 2. 1.273.5 1273 1. 35 1.27-3.5 56.8 (56. 24. 7. 10. 62.7 (62. 1.803. 1803 18 33 1.80-3. 0. (51 1.273. 1.27-3. 56. (56 62. (62 1.803 1.80-3 (5 1.273 1.27-3 (6 1.80- ( 1.27-
2.
Catálogo Taxonômico da Fauna do Brasil: Setting the baseline knowledge on the animal diversity in Brazil Brasil
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Boeger, Walter A.
; Valim, Michel P.
; Zaher, Hussam
; Rafael, José A.
; Forzza, Rafaela C.
; Percequillo, Alexandre R.
; Serejo, Cristiana S.
; Garraffoni, André R.S.
; Santos, Adalberto J.
; Slipinski, Adam
; Linzmeier, Adelita M.
; Calor, Adolfo R.
; Garda, Adrian A.
; Kury, Adriano B.
; Fernandes, Agatha C.S.
; Agudo-Padrón, Aisur I.
; Akama, Alberto
; Silva Neto, Alberto M. da
; Burbano, Alejandro L.
; Menezes, Aleksandra
; Pereira-Colavite, Alessandre
; Anichtchenko, Alexander
; Lees, Alexander C.
; Bezerra, Alexandra M.R.
; Domahovski, Alexandre C.
; Pimenta, Alexandre D.
; Aleixo, Alexandre L.P.
; Marceniuk, Alexandre P.
; Paula, Alexandre S. de
; Somavilla, Alexandre
; Specht, Alexandre
; Camargo, Alexssandro
; Newton, Alfred F.
; Silva, Aline A.S. da
; Santos, Aline B. dos
; Tassi, Aline D.
; Aragão, Allan C.
; Santos, Allan P.M.
; Migotto, Alvaro E.
; Mendes, Amanda C.
; Cunha, Amanda
; Chagas Júnior, Amazonas
; Sousa, Ana A.T. de
; Pavan, Ana C.
; Almeida, Ana C.S.
; Peronti, Ana L.B.G.
; Henriques-Oliveira, Ana L.
; Prudente, Ana L.
; Tourinho, Ana L.
; Pes, Ana M.O.
; Carmignotto, Ana P.
; Wengrat, Ana P.G. da Silva
; Dornellas, Ana P.S.
; Molin, Anamaria Dal
; Puker, Anderson
; Morandini, André C.
; Ferreira, André da S.
; Martins, André L.
; Esteves, André M.
; Fernandes, André S.
; Roza, André S.
; Köhler, Andreas
; Paladini, Andressa
; Andrade, Andrey J. de
; Pinto, Ângelo P.
; Salles, Anna C. de A.
; Gondim, Anne I.
; Amaral, Antonia C.Z.
; Rondón, Antonio A.A.
; Brescovit, Antonio
; Lofego, Antônio C.
; Marques, Antonio C.
; Macedo, Antonio
; Andriolo, Artur
; Henriques, Augusto L.
; Ferreira Júnior, Augusto L.
; Lima, Aurino F. de
; Barros, Ávyla R. de A.
; Brito, Ayrton do R.
; Romera, Bárbara L.V.
; Vasconcelos, Beatriz M.C. de
; Frable, Benjamin W.
; Santos, Bernardo F.
; Ferraz, Bernardo R.
; Rosa, Brunno B.
; Sampaio, Brunno H.L.
; Bellini, Bruno C.
; Clarkson, Bruno
; Oliveira, Bruno G. de
; Corrêa, Caio C.D.
; Martins, Caleb C.
; Castro-Guedes, Camila F. de
; Souto, Camilla
; Bicho, Carla de L.
; Cunha, Carlo M.
; Barboza, Carlos A. de M.
; Lucena, Carlos A.S. de
; Barreto, Carlos
; Santana, Carlos D.C.M. de
; Agne, Carlos E.Q.
; Mielke, Carlos G.C.
; Caetano, Carlos H.S.
; Flechtmann, Carlos H.W.
; Lamas, Carlos J.E.
; Rocha, Carlos
; Mascarenhas, Carolina S.
; Margaría, Cecilia B.
; Waichert, Cecilia
; Digiani, Celina
; Haddad, Célio F.B.
; Azevedo, Celso O.
; Benetti, Cesar J.
; Santos, Charles M.D. dos
; Bartlett, Charles R.
; Bonvicino, Cibele
; Ribeiro-Costa, Cibele S.
; Santos, Cinthya S.G.
; Justino, Cíntia E.L.
; Canedo, Clarissa
; Bonecker, Claudia C.
; Santos, Cláudia P.
; Carvalho, Claudio J.B. de
; Gonçalves, Clayton C.
; Galvão, Cleber
; Costa, Cleide
; Oliveira, Cléo D.C. de
; Schwertner, Cristiano F.
; Andrade, Cristiano L.
; Pereira, Cristiano M.
; Sampaio, Cristiano
; Dias, Cristina de O.
; Lucena, Daercio A. de A.
; Manfio, Daiara
; Amorim, Dalton de S.
; Queiroz, Dalva L. de
; Queiroz, Dalva L. de
; Colpani, Daniara
; Abbate, Daniel
; Aquino, Daniel A.
; Burckhardt, Daniel
; Cavallari, Daniel C.
; Prado, Daniel de C. Schelesky
; Praciano, Daniel L.
; Basílio, Daniel S.
; Bená, Daniela de C.
; Toledo, Daniela G.P. de
; Takiya, Daniela M.
; Fernandes, Daniell R.R.
; Ament, Danilo C.
; Cordeiro, Danilo P.
; Silva, Darliane E.
; Pollock, Darren A.
; Muniz, David B.
; Gibson, David I.
; Nogueira, David S.
; Marques, Dayse W.A.
; Lucatelli, Débora
; Garcia, Deivys M.A.
; Baêta, Délio
; Ferreira, Denise N.M.
; Rueda-Ramírez, Diana
; Fachin, Diego A.
; Souza, Diego de S.
; Rodrigues, Diego F.
; Pádua, Diego G. de
; Barbosa, Diego N.
; Dolibaina, Diego R.
; Amaral, Diogo C.
; Chandler, Donald S.
; Maccagnan, Douglas H.B.
; Caron, Edilson
; Carvalho, Edrielly
; Adriano, Edson A.
; Abreu Júnior, Edson F. de
; Pereira, Edson H.L.
; Viegas, Eduarda F.G.
; Carneiro, Eduardo
; Colley, Eduardo
; Eizirik, Eduardo
; Santos, Eduardo F. dos
; Shimbori, Eduardo M.
; Suárez-Morales, Eduardo
; Arruda, Eliane P. de
; Chiquito, Elisandra A.
; Lima, Élison F.B.
; Castro, Elizeu B. de
; Orlandin, Elton
; Nascimento, Elynton A. do
; Razzolini, Emanuel
; Gama, Emanuel R.R.
; Araujo, Enilma M. de
; Nishiyama, Eric Y.
; Spiessberger, Erich L.
; Santos, Érika C.L. dos
; Contreras, Eugenia F.
; Galati, Eunice A.B.
; Oliveira Junior, Evaldo C. de
; Gallardo, Fabiana
; Hernandes, Fabio A.
; Lansac-Tôha, Fábio A.
; Pitombo, Fabio B.
; Dario, Fabio Di
; Santos, Fábio L. dos
; Mauro, Fabio
; Nascimento, Fabio O. do
; Olmos, Fabio
; Amaral, Fabio R.
; Schunck, Fabio
; Godoi, Fábio S. P. de
; Machado, Fabrizio M.
; Barbo, Fausto E.
; Agrain, Federico A.
; Ribeiro, Felipe B.
; Moreira, Felipe F.F.
; Barbosa, Felipe F.
; Silva, Fenanda S.
; Cavalcanti, Fernanda F.
; Straube, Fernando C.
; Carbayo, Fernando
; Carvalho Filho, Fernando
; Zanella, Fernando C.V.
; Jacinavicius, Fernando de C.
; Farache, Fernando H.A.
; Leivas, Fernando
; Dias, Fernando M.S.
; Mantellato, Fernando
; Vaz-de-Mello, Fernando Z.
; Gudin, Filipe M.
; Albuquerque, Flávio
; Molina, Flavio B.
; Passos, Flávio D.
; Shockley, Floyd W.
; Pinheiro, Francielly F.
; Mello, Francisco de A.G. de
; Nascimento, Francisco E. de L.
; Franco, Francisco L.
; Oliveira, Francisco L. de
; Melo, Francisco T. de V.
; Quijano, Freddy R.B.
; Salles, Frederico F.
; Biffi, Gabriel
; Queiroz, Gabriel C.
; Bizarro, Gabriel L.
; Hrycyna, Gabriela
; Leviski, Gabriela
; Powell, Gareth S.
; Santos, Geane B. dos
; Morse, Geoffrey E.
; Brown, George
; Mattox, George M.T.
; Zimbrão, Geraldo
; Carvalho, Gervásio S.
; Miranda, Gil F.G.
; Moraes, Gilberto J. de
; Lourido, Gilcélia M.
; Neves, Gilmar P.
; Moreira, Gilson R.P.
; Montingelli, Giovanna G.
; Maurício, Giovanni N.
; Marconato, Gláucia
; Lopez, Guilherme E.L.
; Silva, Guilherme L. da
; Muricy, Guilherme
; Brito, Guilherme R.R.
; Garbino, Guilherme S.T.
; Flores, Gustavo E.
; Graciolli, Gustavo
; Libardi, Gustavo S.
; Proctor, Heather C.
; Gil-Santana, Helcio R.
; Varella, Henrique R.
; Escalona, Hermes E.
; Schmitz, Hermes J.
; Rodrigues, Higor D.D.
; Galvão Filho, Hilton de C.
; Quintino, Hingrid Y.S.
; Pinto, Hudson A.
; Rainho, Hugo L.
; Miyahira, Igor C.
; Gonçalves, Igor de S.
; Martins, Inês X.
; Cardoso, Irene A.
; Oliveira, Ismael B. de
; Franz, Ismael
; Fernandes, Itanna O.
; Golfetti, Ivan F.
; S. Campos-Filho, Ivanklin
; Oliveira, Ivo de S.
; Delabie, Jacques H.C.
; Oliveira, Jader de
; Prando, Jadila S.
; Patton, James L.
; Bitencourt, Jamille de A.
; Silva, Janaina M.
; Santos, Jandir C.
; Arruda, Janine O.
; Valderrama, Jefferson S.
; Dalapicolla, Jeronymo
; Oliveira, Jéssica P.
; Hájek, Jiri
; Morselli, João P.
; Narita, João P.
; Martin, João P.I.
; Grazia, Jocélia
; McHugh, Joe
; Cherem, Jorge J.
; Farias Júnior, José A.S.
; Fernandes, Jose A.M.
; Pacheco, José F.
; Birindelli, José L.O.
; Rezende, José M.
; Avendaño, Jose M.
; Duarte, José M. Barbanti
; Ribeiro, José R. Inácio
; Mermudes, José R.M.
; Pujol-Luz, José R.
; Santos, Josenilson R. dos
; Câmara, Josenir T.
; Teixeira, Joyce A.
; Prado, Joyce R. do
; Botero, Juan P.
; Almeida, Julia C.
; Kohler, Julia
; Gonçalves, Julia P.
; Beneti, Julia S.
; Donahue, Julian P.
; Alvim, Juliana
; Almeida, Juliana C.
; Segadilha, Juliana L.
; Wingert, Juliana M.
; Barbosa, Julianna F.
; Ferrer, Juliano
; Santos, Juliano F. dos
; Kuabara, Kamila M.D.
; Nascimento, Karine B.
; Schoeninger, Karine
; Campião, Karla M.
; Soares, Karla
; Zilch, Kássia
; Barão, Kim R.
; Teixeira, Larissa
; Sousa, Laura D. do N.M. de
; Dumas, Leandro L.
; Vieira, Leandro M.
; Azevedo, Leonardo H.G.
; Carvalho, Leonardo S.
; Souza, Leonardo S. de
; Rocha, Leonardo S.G.
; Bernardi, Leopoldo F.O.
; Vieira, Letícia M.
; Johann, Liana
; Salvatierra, Lidianne
; Oliveira, Livia de M.
; Loureiro, Lourdes M.A. El-moor
; Barreto, Luana B.
; Barros, Luana M.
; Lecci, Lucas
; Camargos, Lucas M. de
; Lima, Lucas R.C.
; Almeida, Lucia M.
; Martins, Luciana R.
; Marinoni, Luciane
; Moura, Luciano de A.
; Lima, Luciano
; Naka, Luciano N.
; Miranda, Lucília S.
; Salik, Lucy M.
; Bezerra, Luis E.A.
; Silveira, Luis F.
; Campos, Luiz A.
; Castro, Luiz A.S. de
; Pinho, Luiz C.
; Silveira, Luiz F.L.
; Iniesta, Luiz F.M.
; Tencatt, Luiz F.C.
; Simone, Luiz R.L.
; Malabarba, Luiz R.
; Cruz, Luiza S. da
; Sekerka, Lukas
; Barros, Lurdiana D.
; Santos, Luziany Q.
; Skoracki, Maciej
; Correia, Maira A.
; Uchoa, Manoel A.
; Andrade, Manuella F.G.
; Hermes, Marcel G.
; Miranda, Marcel S.
; Araújo, Marcel S. de
; Monné, Marcela L.
; Labruna, Marcelo B.
; Santis, Marcelo D. de
; Duarte, Marcelo
; Knoff, Marcelo
; Nogueira, Marcelo
; Britto, Marcelo R. de
; Melo, Marcelo R.S. de
; Carvalho, Marcelo R. de
; Tavares, Marcelo T.
; Kitahara, Marcelo V.
; Justo, Marcia C.N.
; Botelho, Marcia J.C.
; Couri, Márcia S.
; Borges-Martins, Márcio
; Felix, Márcio
; Oliveira, Marcio L. de
; Bologna, Marco A.
; Gottschalk, Marco S.
; Tavares, Marcos D.S.
; Lhano, Marcos G.
; Bevilaqua, Marcus
; Santos, Marcus T.T.
; Domingues, Marcus V.
; Sallum, Maria A.M.
; Digiani, María C.
; Santarém, Maria C.A.
; Nascimento, Maria C. do
; Becerril, María de los A.M.
; Santos, Maria E.A. dos
; Passos, Maria I. da S. dos
; Felippe-Bauer, Maria L.
; Cherman, Mariana A.
; Terossi, Mariana
; Bartz, Marie L.C.
; Barbosa, Marina F. de C.
; Loeb, Marina V.
; Cohn-Haft, Mario
; Cupello, Mario
; Martins, Marlúcia B.
; Christofersen, Martin L.
; Bento, Matheus
; Rocha, Matheus dos S.
; Martins, Maurício L.
; Segura, Melissa O.
; Cardenas, Melissa Q.
; Duarte, Mércia E.
; Ivie, Michael A.
; Mincarone, Michael M.
; Borges, Michela
; Monné, Miguel A.
; Casagrande, Mirna M.
; Fernandez, Monica A.
; Piovesan, Mônica
; Menezes, Naércio A.
; Benaim, Natalia P.
; Reategui, Natália S.
; Pedro, Natan C.
; Pecly, Nathalia H.
; Ferreira Júnior, Nelson
; Silva Júnior, Nelson J. da
; Perioto, Nelson W.
; Hamada, Neusa
; Degallier, Nicolas
; Chao, Ning L.
; Ferla, Noeli J.
; Mielke, Olaf H.H.
; Evangelista, Olivia
; Shibatta, Oscar A.
; Oliveira, Otto M.P.
; Albornoz, Pablo C.L.
; Dellapé, Pablo M.
; Gonçalves, Pablo R.
; Shimabukuro, Paloma H.F.
; Grossi, Paschoal
; Rodrigues, Patrícia E. da S.
; Lima, Patricia O.V.
; Velazco, Paul
; Santos, Paula B. dos
; Araújo, Paula B.
; Silva, Paula K.R.
; Riccardi, Paula R.
; Garcia, Paulo C. de A.
; Passos, Paulo G.H.
; Corgosinho, Paulo H.C.
; Lucinda, Paulo
; Costa, Paulo M.S.
; Alves, Paulo P.
; Roth, Paulo R. de O.
; Coelho, Paulo R.S.
; Duarte, Paulo R.M.
; Carvalho, Pedro F. de
; Gnaspini, Pedro
; Souza-Dias, Pedro G.B.
; Linardi, Pedro M.
; Bartholomay, Pedro R.
; Demite, Peterson R.
; Bulirsch, Petr
; Boll, Piter K.
; Pereira, Rachel M.M.
; Silva, Rafael A.P.F.
; Moura, Rafael B. de
; Boldrini, Rafael
; Silva, Rafaela A. da
; Falaschi, Rafaela L.
; Cordeiro, Ralf T.S.
; Mello, Ramon J.C.L.
; Singer, Randal A.
; Querino, Ranyse B.
; Heleodoro, Raphael A.
; Castilho, Raphael de C.
; Constantino, Reginaldo
; Guedes, Reinaldo C.
; Carrenho, Renan
; Gomes, Renata S.
; Gregorin, Renato
; Machado, Renato J.P.
; Bérnils, Renato S.
; Capellari, Renato S.
; Silva, Ricardo B.
; Kawada, Ricardo
; Dias, Ricardo M.
; Siewert, Ricardo
; Brugnera, Ricaro
; Leschen, Richard A.B.
; Constantin, Robert
; Robbins, Robert
; Pinto, Roberta R.
; Reis, Roberto E. dos
; Ramos, Robson T. da C.
; Cavichioli, Rodney R.
; Barros, Rodolfo C. de
; Caires, Rodrigo A.
; Salvador, Rodrigo B.
; Marques, Rodrigo C.
; Araújo, Rodrigo C.
; Araujo, Rodrigo de O.
; Dios, Rodrigo de V.P.
; Johnsson, Rodrigo
; Feitosa, Rodrigo M.
; Hutchings, Roger W.
; Lara, Rogéria I.R.
; Rossi, Rogério V.
; Gerstmeier, Roland
; Ochoa, Ronald
; Hutchings, Rosa S.G.
; Ale-Rocha, Rosaly
; Rocha, Rosana M. da
; Tidon, Rosana
; Brito, Rosangela
; Pellens, Roseli
; Santos, Sabrina R. dos
; Santos, Sandra D. dos
; Paiva, Sandra V.
; Santos, Sandro
; Oliveira, Sarah S. de
; Costa, Sávio C.
; Gardner, Scott L.
; Leal, Sebastián A. Muñoz
; Aloquio, Sergio
; Bonecker, Sergio L.C.
; Bueno, Sergio L. de S.
; Almeida, Sérgio M. de
; Stampar, Sérgio N.
; Andena, Sérgio R.
; Posso, Sergio R.
; Lima, Sheila P.
; Gadelha, Sian de S.
; Thiengo, Silvana C.
; Cohen, Simone C.
; Brandão, Simone N.
; Rosa, Simone P.
; Ribeiro, Síria L.B.
; Letana, Sócrates D.
; Santos, Sonia B. dos
; Andrade, Sonia C.S.
; Dávila, Stephane
; Vaz, Stéphanie
; Peck, Stewart B.
; Christo, Susete W.
; Cunha, Suzan B.Z.
; Gomes, Suzete R.
; Duarte, Tácio
; Madeira-Ott, Taís
; Marques, Taísa
; Roell, Talita
; Lima, Tarcilla C. de
; Sepulveda, Tatiana A.
; Maria, Tatiana F.
; Ruschel, Tatiana P.
; Rodrigues, Thaiana
; Marinho, Thais A.
; Almeida, Thaís M. de
; Miranda, Thaís P.
; Freitas, Thales R.O.
; Pereira, Thalles P.L.
; Zacca, Thamara
; Pacheco, Thaynara L.
; Martins, Thiago F.
; Alvarenga, Thiago M.
; Carvalho, Thiago R. de
; Polizei, Thiago T.S.
; McElrath, Thomas C.
; Henry, Thomas
; Pikart, Tiago G.
; Porto, Tiago J.
; Krolow, Tiago K.
; Carvalho, Tiago P.
; Lotufo, Tito M. da C.
; Caramaschi, Ulisses
; Pinheiro, Ulisses dos S.
; Pardiñas, Ulyses F.J.
; Maia, Valéria C.
; Tavares, Valeria
; Costa, Valmir A.
; Amaral, Vanessa S. do
; Silva, Vera C.
; Wolff, Vera R. dos S.
; Slobodian, Verônica
; Silva, Vinícius B. da
; Espíndola, Vinicius C.
; Costa-Silva, Vinicius da
; Bertaco, Vinicius de A.
; Padula, Vinícius
; Ferreira, Vinicius S.
; Silva, Vitor C.P. da
; Piacentini, Vítor de Q.
; Sandoval-Gómez, Vivian E.
; Trevine, Vivian
; Sousa, Viviane R.
; Sant’Anna, Vivianne B. de
; Mathis, Wayne N.
; Souza, Wesley de O.
; Colombo, Wesley D.
; Tomaszewska, Wioletta
; Wosiacki, Wolmar B.
; Ovando, Ximena M.C.
; Leite, Yuri L.R.
.
ABSTRACT The limited temporal completeness and taxonomic accuracy of species lists, made available in a traditional manner in scientific publications, has always represented a problem. These lists are invariably limited to a few taxonomic groups and do not represent up-to-date knowledge of all species and classifications. In this context, the Brazilian megadiverse fauna is no exception, and the Catálogo Taxonômico da Fauna do Brasil (CTFB) (http://fauna.jbrj.gov.br/), made public in 2015, represents a database on biodiversity anchored on a list of valid and expertly recognized scientific names of animals in Brazil. The CTFB is updated in near real time by a team of more than 800 specialists. By January 1, 2024, the CTFB compiled 133,691 nominal species, with 125,138 that were considered valid. Most of the valid species were arthropods (82.3%, with more than 102,000 species) and chordates (7.69%, with over 11,000 species). These taxa were followed by a cluster composed of Mollusca (3,567 species), Platyhelminthes (2,292 species), Annelida (1,833 species), and Nematoda (1,447 species). All remaining groups had less than 1,000 species reported in Brazil, with Cnidaria (831 species), Porifera (628 species), Rotifera (606 species), and Bryozoa (520 species) representing those with more than 500 species. Analysis of the CTFB database can facilitate and direct efforts towards the discovery of new species in Brazil, but it is also fundamental in providing the best available list of valid nominal species to users, including those in science, health, conservation efforts, and any initiative involving animals. The importance of the CTFB is evidenced by the elevated number of citations in the scientific literature in diverse areas of biology, law, anthropology, education, forensic science, and veterinary science, among others. publications problem uptodate up date classifications context exception (CTFB http//fauna.jbrj.gov.br/, httpfaunajbrjgovbr http //fauna.jbrj.gov.br/ , jbrj gov br (http://fauna.jbrj.gov.br/) 2015 Brazil 80 specialists 1 2024 133691 133 691 133,69 125138 125 138 125,13 82.3%, 823 82 3 (82.3% 102000 102 000 102,00 7.69%, 769 7 69 (7.69% 11000 11 11,00 . 3,567 3567 567 (3,56 2,292 2292 2 292 (2,29 1,833 1833 833 (1,83 1,447 1447 447 (1,44 1000 1,00 831 (83 628 (62 606 (60 520 (52 50 users science health biology law anthropology education others http//fauna.jbrj.gov.br/ faunajbrjgovbr //fauna.jbrj.gov.br (http://fauna.jbrj.gov.br/ 201 8 202 13369 13 133,6 12513 12 125,1 82.3% (82.3 10200 10 00 102,0 7.69% 76 6 (7.69 1100 11,0 3,56 356 56 (3,5 2,29 229 29 (2,2 1,83 183 83 (1,8 1,44 144 44 (1,4 100 1,0 (8 62 (6 60 52 (5 5 http//fauna.jbrj.gov.br (http://fauna.jbrj.gov.br 20 1336 133, 1251 125, 82.3 (82. 1020 0 102, 7.69 (7.6 110 11, 3,5 35 (3, 2,2 22 (2, 1,8 18 (1, 1,4 14 4 ( 82. (82 7.6 (7. 3, (3 2, (2 (1 7. (7
3.
Inoculación de Metarhizium anisopliae, Beaueria bassiana y bacterias BPCV combinada con fertilizantes orgánicos en el cultivo de melón
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Luna Fletes, Jonás Alan
; Ruiz Andalón, Carlos Alberto
; Mancilla Villa, Oscar Raúl
; Cruz Crespo, Elia
; Can Chulím, Álvaro
; Martínez Rodriguez, Oscar Germán
.
ABSTRACT Entomopathogenic fungi (EP) and plant growth-promoting bacteria (GBP) in combination with liquid organic fertilizers can be the ecological alternative to complement chemical fertilization, and improve the nutrition and yield of melon (Cucumis melo L.). The objective of the study was to evaluate Metarhizium anisopliae, Beauveria bassiana and a consortium of BPCV (P. flurescens, B. subtilis, A. brasilence and B. mucilaginosus) in combination with vermicompost leachate (LVE) and goat manure biol (BEC). ) in the foliar nutritional concentration, plant growth, fruit size, yield and colonization of these microorganisms in the melon rhizosphere. An experimental design was used in complete randomized blocks, with six treatments (HE + LVE, BPCV + LVE, HE + BEC, BPCV + BEC, LVE and BEC) and a control. It was found that with the BPCV + BEC treatment, leaf N and Ca concentration increased by 9.4% and 21.3%, respectively, root dry weight by 45.8%, fruit polar diameter by 20.3% and fruit weight in 31.2% in relation to the control. While plants treated with HE + BEC and BPCV + BEC, compared to the control, increased leaf P concentration from 9.8 to 10.2%, stem diameter from 27.2% to 28.5% and yield from 12.4% to 12.6%. Both HE and BPCV colonized soil particles from the plant rhizosphere, which positively influenced melon yield. These results are beneficial for melon producers, both to increase crop yield and to complement chemical fertilization in an ecological way in the production system.
RESUMEN Los hongos entomopatógenos (HE) y las bacterias promotoras del crecimiento vegetal (BPCV) en combinación con abonos orgánicos líquidos puede ser la alternativa ecológica para complementar la fertilización química, y mejorar la nutrición y rendimiento de melón (Cucumis melo L.). El objetivo del estudio fue evaluar Metarhizium anisopliae, Beauveria bassiana y un consorcio de BPCV (P. flurescens, B. subtilis, A. brasilence y B. mucilaginosus) en combinación con lixiviado de vermicompost (LVE) y biol de estiércol de cabra (BEC) en la concentración nutrimental foliar, crecimiento de planta, tamaño de fruto, rendimiento y colonización de estos microorganismos en la rizosfera de melón. Se utilizó un diseño experimental en bloques completos al azar, con seis tratamientos (HE + LVE, BPCV + LVE, HE + BEC, BPCV + BEC, LVE y BEC) y un testigo. Se encontró que con el tratamiento BPCV + BEC aumentó la concentración de N y Ca foliar en 9,4% y 21,3%, respectivamente, peso seco de raíz en 45,8%, diámetro polar de fruto en 20,3% y peso de fruto en 31,2% en relación con el testigo. Mientras que las plantas tratadas con HE + BEC y BPCV + BEC, en comparación con el testigo, incrementaron la concentración de P foliar de 9,8 a 10,2%, diámetro de tallo de 27,2% a 28,5% y rendimiento de 12,4% a 12,6%. Tanto los HE y BPCV colonizaron partículas de suelo de la rizosfera de la planta, lo que influyó positivamente en el rendimiento de melón. Estos resultados son beneficiosos para los productores de melón, tanto para aumentar el rendimiento del cultivo como para complementar la fertilización química de manera ecológica en el sistema productivo.
4.
Cognitive characteristics and quality of life in attention deficit hyperactivity disorder
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García-Galicia, Arturo
; Aréchiga-Santamaría, Alejandra
; Montiel-Jarquín, Álvaro J.
; Pulido-Morales, María I.
; Vázquez-Cruz, Eduardo
; Bertado-Ramírez, Nancy R.
; González-Martínez, Marco A.
; Loría-Castellanos, Jorge
.
Resumen Introducción: El Trastorno por Déficit de Atención e Hiperactividad es el desorden pediátrico del neurodesarrollo más frecuente. Los estudios en México que evalúan Calidad de vida y características cognitivas son escasos. Objetivo: Describir la relación entre las características cognitivas y la calidad de vida en niños con trastorno por déficit de atención e hiperactividad en Puebla, México. Método: Se realizó un estudio transversal, analítico en un Hospital de 2º nivel de atención en Puebla, México. Se incluyeron pacientes con Trastorno por Déficit de Atención e Hiperactividad de 6 a 12 años. Se excluyeron aquellos con discapacidad visual/auditiva y retraso severo del lenguaje. Se eliminaron quienes no completaron la información. Se les aplicó WISC-IV, Neuropsi y BMSLSS (como indicador de Calidad de Vida). Se utilizó Coeficiente de Spearman; p ≤ 0.05 se consideró significativa. Resultados: 104 niños reclutados, 71 hombres (68.26%), edad media 8.94 años (DE 1.83, mín. 6, máx. 12). Los dominios más afectados fueron Memoria de trabajo, Velocidad de procesamiento (WISC-IV), y Atención y memoria (Neuropsi). La Calidad de Vida fue mayoritariamente baja (60%). Coeficiente intelectual (WISC-IV) (r = 0.3962, p = 0.000) y Atención y memoria (Neuropsi) (r = 0.451, p = 0.018) reportaron correlación moderada significativa con Calidad de vida. Conclusión: Atención, Memoria y Velocidad de procesamiento son las características cognitivas más afectadas en niños con Trastorno por Déficit de Atención e Hiperactividad. La Calidad de vida es baja. Coeficiente intelectual y Atención y memoria reportaron correlación moderada significativa con Calidad de Vida.
Abstract Background: Attention deficit hyperactivity disorder (ADHD) is the most frequent pediatric neurodevelopmental disorder. Studies in Mexico about health-related quality of life (QOL) and cognitive characteristics in these patients are scarce. Objectives: The objective of this study is to describe the relationship between cognitive characteristics and health-related QOL in children with ADHD in Puebla, Mexico. Method: A cross-sectional, analytical study was carried out in a second-level care hospital in Puebla, Mexico. Both genders, from 6 to 12 years old patients with ADHD were included. Those with visual/hearing disabilities and/or severe language delays were excluded. Patients who did not complete the information were eliminated. The Wechsler Intelligence Scale for Children IV (WISC-IV), The Neuropsi and Brief Multidimensional Life Satisfaction Scale for Students (as health-related QOL indicator) scales were applied. Spearman test was used; p ≤ 0.05 was considered significant. Results: 104 children were recruited, 71 male (68.26%), medium age was 8.94 years old (SD = 1.83, min = 6, max = 12). Work memory and processing speed (WISC-IV), and memory and attention (Neuropsi) were the most affected domains. Health-related QOL was low at 60%. WISC-IVs intellectual quotient (r = 0.3962, p = 0.000), and Neuropsi's memory and attention (r = 0.451, p = 0.018) reported a significant moderated correlation with health-related QOL. Conclusion: Attention, memory, and processing speed were the most affected cognitive characteristics in children with attention deficit/hyperactivity disorder. Health-related QOL resulted low. Intellectual coefficient, as well as memory and attention, reported a significant moderated correlation with health-related QOL.
5.
Alternative methods of skull reconstruction for giant sarcomas
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Araujo-López, Adán
; Gónzalez-Rodríguez, Mónica
; Cruz-Hernández, Álvaro
; Nuñéz-Castillo, Joseph A.
; Tristán-Tenorio, Carlo Augusto
; Ríos-Lara, Rodolfo L.
; Ugalde-Vitelly, Juan A.
.
Revista médica del Hospital General de México
- Journal Metrics
Abstract Soft tissue sarcomas are malignant tumors derived from the mesoderm, the most frequent age of presentation is between the 5th and 7th decade of life, mostly in males, more frequent location in the extremities, leaving only 1% of presentation in skin hairy, and this is a new concept of treating big sarcomas. We present the case of a 45-year-old male with a diagnosis of soft tissue sarcoma on the frontal, parietal, and right occipital surface of approximately 35x28x25 cm, without involvement of adjacent organs, without adjuvant therapy. Performing an oncological resection, exposing the periosteum, performing fenetrations of the external table, covering the Dermal Matrix – Integra®, using a new concept to treat this large defects, after 3 weeks with complete neodermis, we cover it with a Partial Thickness Graft, achieving 100% integration. and proper follow-up. Sarcomas are an uncommon and heterogeneous group of neoplasms of mesenchymal origin. Standard use of Integra reconstruction requires two stages: Integra forms a neo dermis through ingrowth of host vessels, followed by application of a thin split-thickness skin graft at a later date <30 days, using this new concepts of treating large defects with no flap. Sarcomas are highly aggressive and have very varied symptoms depending on the tumor stage at the time of diagnosis. Timely and improved a new concept of treatment such as an Integra® dermal regenerator, not using a flap, shows adequate integration in the patient and survival.
6.
Valor do 18F-FDG PET/CT no Diagnóstico e Avaliação de Resposta ao Tratamento da Miocardite Lúpica
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Perazzo, Alvaro M.
; Andrade, Larissa G. F.
; Venancio, Leonardo G. A.
; Gouveia, Pedro Alves da Cruz
; Galvão, Mariana Feitosa Ramalho
; Lins, Esdras M.
; Moraes Neto, Fernando
; Brandão, Simone Cristina Soares
.
7.
Autoimagen, autoestima y depresión en escolares y adolescentes con y sin obesidad
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Sánchez-Rojas, Alma A.
; García-Galicia, Arturo
; Vázquez-Cruz, Eduardo
; Montiel-Jarquín, Álvaro J.
; Aréchiga-Santamaría, Alejandra
.
Resumen: Introducción: La obesidad infantil es un problema de salud pública mundial. En México, la prevalencia es de 35 % y continúa ascendiendo. Objetivo: Determinar la correlación entre autoimagen, autoestima y depresión en niños de ocho a 14 años con y sin obesidad. Métodos: Estudio transversal comparativo de 295 niños: 116 niños con sobrepeso u obesidad (grupo 1) y 179 sin obesidad (grupo 2). Se registró índice de masa corporal, escolaridad, aprovechamiento escolar, conflictos escolares, nivel socioeconómico, autoimagen (actual, deseada), satisfacción, autoestima y presencia de depresión. Se utilizó estadística descriptiva, rho de Spearman y U de Mann-Whitney; p ≤ 0.05 se consideró significativa. Resultados: En el grupo 1, 53.4 % de los niños se autopercibió con normopeso y en 77.6 % la autoimagen deseada era normopeso; 67.2 % deseaba ser más delgado; en 53.4 % la autoestima era elevada; 75.9 % se observó sin depresión. En el grupo 2, en 79.3 % la autoimagen actual era normopeso y la autoimagen deseada en 85.5 % fue normopeso; 35.2 % deseaba ser más delgado; la autoestima era elevada en 49.7 % y 77.1 % no presentaba depresión. Se identificaron correlaciones significativas en autoestima-depresión (r = 0.228) y autoestima-nivel socioeconómico (r = 0.130). Conclusiones: La autoimagen actual y la satisfacción corporal son diferentes en niños y adolescentes con y sin obesidad. La relación de la autoestima y síntomas depresivos inicia desde la edad escolar.
Abstract Introduction: In Mexico, the prevalence of childhood obesity is 35%, and it continues to increase Objective: To determine the correlation between self-image, self-esteem and depression in children aged 8 to 14 years with and without obesity. Methods: Cross-sectional, comparative study of 295 children: 116 with overweight/obesity (group 1) and 179 with normal weight (group 2). Body mass index, scholarship, school achievement, school problems, socioeconomic status, self-image (current, desired), satisfaction, self-esteem and presence of depression were recorded. Descriptive statistics, Spearman’s rho and Mann-Whitney’s U-test were used; a p-value ≤ 0.05 was considered significant. Results: In group 1, 53.4% perceived themselves as with normal weight, and in 77.6%, the desired self-image was normal weight; 67.2% wanted to be slimmer; in 53.4%, self-esteem was high, and 75.9% had no depression. In group 2, current self-image was normal weight in 79.3%, and the desired self-image was normal weight in 85.5%; 35.2% wanted to be slimmer; self-esteem was high in 49.7% and 77.1% had no depression. Significant correlations were observed for self-esteem-depression (r = 0.228) and self-esteem-socioeconomic status (r = 0.130). Conclusions: Current self-image and body satisfaction are different with and without obesity. The relationship between self-esteem and depressive symptoms begins at school age.
https://doi.org/10.24875/gmm.21000817
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8.
GASTRIC TWIST AFTER SLEEVE GASTRECTOMY: A PROPOSAL FOR ENDOSCOPIC CLASSIFICATION
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SIQUEIRA, Luciana T.
; SANTA-CRUZ, Fernando
; PONTUAL, João Paulo
; AQUINO, Maria Amélia R.
; DOMPIERI, Luca T.
; KREIMER, Flávio
; FERRAZ, Álvaro A. B.
.
ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo)
- Journal Metrics
RESUMO - RACIONAL: A torção do tubo gástrico ou twist é uma das principais causas de refluxo persistente e intolerância alimentar após a gastrectomia vertical (GV). Até o momento, não há uma classificação proposta para a torção gástrica após GV. OBJETIVO: Propor uma classificação endoscópica para essa condição e descrever o perfil clínico desses pacientes. MÉTODOS: Pacientes no pós-operatório de GV apresentando achados endoscópicos de twist foram incluídos. Os pacientes foram submetidos a uma esofagogastroduodenoscopia 12 meses após a cirurgia. A classificação consiste em três graus. Grau I: rotação leve da linha de grampos, sem redução relevante do lúmen gástrico. Grau II: rotação moderada da linha de grampos, levando a uma área de estreitamento focal que requer manobras adicionais para a progressão do aparelho. Grau III: rotação severa da linha de grampos, levando à estenose, com grande dificuldade de progressão ou obstrução completa. RESULTADOS: Dos 2.723 pacientes que foram submetidos à GV, 45 (1,6%) apresentaram twist. A maioria dos pacientes era do sex feminino (85%), com idade média de 39±10.4 anos. Quarenta e um (91,1%) apresentaram twist grau I, 3 (6,7%) apresentaram twist grau II e apenas 1 (2,2%) apresentou twist grau III. A maioria dos pacientes eram assintomáticos (n=26). O sintoma mais prevalente foi vômito (15,5%). Não foi observada correlação estatisticamente significante entre o grau de twist e a presença de sintomas ou esofagite. CONCLUSÃO: Twist após GV é raro e geralmente assintomático. A classificação endoscópica proposta não foi estatisticamente relacionada com apresentação clínica, porém estabelece um referencial para análises futuras.
ABSTRACT - BACKGROUND: The twisting of the gastric tube is one of the main causes of persistent reflux and food intolerance after sleeve gastrectomy (SG). To date, there is no classification for gastric twist after SG. OBJECTIVE: This study aimed to propose an endoscopic classification for this condition and outline the clinical profile of these patients with sleeve gastrectomy. METHODS: Patients in the postoperative period of SG presenting endoscopic findings of gastric twist were included. All patients underwent an esophagogastroduodenoscopy 12 months after SG. The classification proposed consists of three degrees: degree I: mild rotation of the staple line without relevant shrinkage of the gastric lumen; degree II: moderate rotation of the staple line, leading to a focal area of fixed narrowing that requires additional maneuvers for its transposition; and degree III: severe rotation of the staple line leading to stenosis, with increased difficulty for transposition or complete blockage. RESULTS: Out of 2,723 patients who underwent SG, 45 (1.6%) presented gastric twist. Most patients were female (85%), with mean age of 39±10.4 years. In all, 41 (91.1%) presented degree I, 3 (6.7%) presented degree II, and 1 (2.2%) had degree III. Most patients were asymptomatic (n=26). Vomiting was the most prevalent symptom (15.5%). Statistically significant correlation of twisting degrees was not observed for both the presence of symptoms and the degrees of esophagitis. CONCLUSION: Gastric twist after SG is rare, with generally mild and asymptomatic presentation. The endoscopic classification was not statistically related to clinical presentation but set the ground for further analysis.
9.
Consenso de leucemia mieloide aguda en México
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Arana-Luna, Luara L.
; Alvarado-Ibarra, Martha
; Silva-Michel, Luis G.
; Morales-Maravilla, Adrián
; González-Rubio, María del C.
; Chávez-Aguilar, Lénica A.
; Tena-Iturralde, María Fernanda
; Mojica-Balceras, Liliana
; Zapata-Canto, Nidia
; Galindo-Delgado, Patricia
; Miranda-Madrazo, María Raquel
; Morales-Hernández, Alba E.
; Silva-Vera, Karina
; Grimaldo-Gómez, Flavio A.
; Hernández-Caballero, Álvaro
; Bates-Martin, Ramón A.
; Álvarez-Vera, José L.
; Tepepa-Flores, Fredy
; Teomitzi-Sánchez, Óscar
; Fermín-Caminero, Denisse J.
; Peña-Celaya, José A. de la
; Salazar-Ramírez, Óscar
; Flores-Villegas, Luz V.
; Guerra-Alarcón, Lidia V.
; Leyto-Cruz, Faustino
; Inclán-Alarcón, Sergio I.
; Milán-Salvatierra, Andrea I.
; Ventura-Enríquez, Yanet
; Pérez-Lozano, Uendy
; Báez-Islas, Pamela E.
; Tapia-Enríquez, Ana L.
; Palma-Moreno, Orlando G.
; Aguilar-Luévano, Jocelyn
; Espinosa-Partida, Arturo
; Pérez-Jacobo, Luis F.
; Rojas-Castillejos, Flavio
; Ruiz-Contreras, Josué I.
; Loera-Fragoso, Sergio J.
; Medina-Coral, Jesús E.
; Acosta-Maldonado, Brenda L.
; Soriano-Mercedes, Emely J.
; Saucedo-Montes, Erick E.
; Valero-Saldana, Luis M.
; González-Prieto, Susana G.
; Nava-Villegas, Lorena
; Hernández-Colin, Ana K.
; Hernández-Alcántara, Areli E.
; Zárate-Rodríguez, Pedro A.
; Ignacio-Ibarra, Gregorio
; Meillón-García, Luis A.
; Espinosa-Bautista, Karla A.
; Ledesma de la Cruz, Cindy
; Barbosa-Loría, Diego M.
; García-Castillo, Carolina
; Balderas-Delgado, Carolina
; Cabrera-García, Álvaro
; Pérez-Zúñiga, Juan M.
; Hernández-Ruiz, Eleazar
; Villela-Peña, Atenas
; Gómez Cortés, Sue Cynthia
; Romero-Rodelo, Hilda
; Garzón-Velásquez, Katheryn B.
; Serrano-Hernández, Cristina
; Martínez-Ríos, Annel
; Pedraza-Solís, María Luisa
; Martínez-Coronel, Jorge A.
; Narváez-Davalos, Iris M.
; García-Camacho, Alinka S.
; Merino-Pasaye, Laura E.
; Aguilar-Andrade, Carolina
; Aguirre-Domínguez, Juan A.
; Guzmán-Mera, Pedro G.
; Delgado-de la Rosa, Elizabeth
; Flores López, Perla E.
; González-Aguirre, Lilia L.
; Ramírez-Alfaro, Edgar M.
; Vera-Calderón, Heidi
; Meza-Dávalos, María Lizeth
; Murillo-Cruz, Juan
; Pichardo-Cepín, Yayra M.
; Ramírez-Romero, Eva F.
.
Abstract Acute myeloid leukemia (AML) comprises a heterogeneous group of hematopoietic cell neoplasms of myeloid lineage that arise from the clonal expansion of their precursors in the bone marrow, interfering with cell differentiation, leading to a syndrome of bone marrow failure. AML is a consequence of genetic and epigenetic changes (point mutations, gene rearrangements, deletions, amplifications, and arrangements in epigenetic changes that influence gene expression) in hematopoietic precursor cells, which create a clone of abnormal cells that are capable of proliferating but cannot differentiate into mature hematopoietic cells or undergo programmed cell death. The diagnosis requires more than 20% myeloid blasts in the bone marrow and certain cytogenic abnormalities. Treatment will depend on age, comorbidities, and cytogenetic risk among the most frequent.
resumen está disponible en el texto completo
https://doi.org/10.24875/gmm.m21000597
895 downloads
10.
Impact of bariatric surgery in elderly patients with obesity
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PEREIRA, ADRIANO F.
; SANTA-CRUZ, FERNANDO
; COUTINHO, LUCAS R.
; VIEIRA-DE-MELO, MARIA CLARA P. T.
; HINRICHSEN, EDUARDA A.
; SIQUEIRA, LUCIANA T.
; FIGUEIREDO, JOSÉ-LUIZ
; FERRAZ, ÁLVARO A. B.
.
RESUMO Introdução: avaliar o impacto da cirurgia bariátrica na população idosa no longo prazo. Métodos: estudo retrospectivo que incluiu todos os pacientes com mais de 60 anos submetidos ao Bypass gástrico em Y de Roux (BGYR) em nosso centro e que mantiveram seguimento superior a 1 ano. Foram estudadas variáveis clínicas e laboratoriais para avaliação da remissão da obesidade e suas comorbidades, além de variáveis diretamente relacionados ao procedimento cirúrgico em si, incluindo complicações precoces e tardias. Resultados: foram estudados 56 pacientes, a maioria do sexo feminino (76,8%), com idade média de 64,02 ± 3,34. Foi observada uma taxa de complicações de 37,5%, com 10,7% requerendo internamento hospitalar e cirurgia de urgência. A média geral da perda do excesso de peso (%PEP) foi de 74,22% ± 26,76. As taxas de remissão de hipertensão e diabetes mellitus foram de 26,08% e 54,54%, respectivamente. Houve variação significativa no IMC (12,25 ± 5,42, p<0,001), colesterol total (31,37 ± 38,89 p<0,001), colesterol LDL (23,45 ± 34,9, p=0,002), colesterol HDL (5,14 ± 11,13, p=0,024), triglicerídeos (48,85 ± 56,15 p<0,001), HbA1C (1,81 ± 1,97, p<0,001) e PCR (1,43 ± 1,96, p<0,001). Conclusão: a cirurgia bariátrica se mostrou eficaz na perda de peso e na remissão de comorbidades na população de idosos com obesidade no longo prazo..
ABSTRACT Introduction: to evaluate the long-term impact of bariatric surgery in the elderly population. Methods: a retrospective study including all patients older than 60 years who underwent Roux-en-Y gastric bypass (RYGB) at our center and maintained a follow-up longer than 1 year. Clinical and laboratory variables were studied to assess remission of obesity and its comorbidities, as well as variables directly related to the surgical procedure itself, including early and late complications. Results: fifty-six patients were studied, mostly female (76,8%), with a mean age of 64.02 ± 3.34. A rate of complications of 37,5% was observed, with 10,7% requiring hospital admission and emergency surgery. The mean excess weight loss (%EWL) was 74.22% ± 26.76. The remission rates of hypertension and diabetes mellitus were 26.08% and 54.54%, respectively. There was significant difference in BMI reduction (12.25 ± 5.42, p<0.001), total cholesterol (31.37 ± 38.89 p<0,001), LDL cholesterol (23.45 ± 34.9, p=0.002), HDL cholesterol (5.14 ± 11.13, p=0,024), triglycerides (48.85 ± 56.15 p<0.001), HbA1C (1,81 ± 1,97, p<0,001) e PCR (1.43 ± 1.96, p<0.001). Conclusion: bariatric surgery was effective in weight loss and remission of comorbidities in the elderly obese population within the long term.
11.
Outcome of the treatment of hydronephrosis due to congenital ureteropelvic stenosis according to age at surgery
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Zaragoza-Torres, Raúl I.
; Cruz-Méndez, Álvaro de la
; Baltazar-González, Juan A.
; Venegas-Vázquez, Edgar
; Sánchez Martínez, Ricardo B.
; Barrera-de León, Juan C.
.
Boletín médico del Hospital Infantil de México
- Journal Metrics
Abstract Background: Congenital kidney and urinary tract anomalies are the most common cause of chronic kidney disease in the first three decades of life. Stenosis of the ureteropelvic junction may cause dilation of the collecting system in the fetal kidney. This study aimed to determine hydronephrosis due to congenital ureteropelvic stenosis treatment outcome according to the age of the intervention. Methods: We conducted a retrospective descriptive study that included pediatric patients with hydronephrosis secondary to ureteropelvic junction stenosis operated by the Anderson-Hynes open pyeloplasty method from 2010 to 2016. Patients were divided into two groups: group A, children < 1 year of age, and group B, children > 1 year of age. We analyzed ultrasonographic parameters, renal function, and clinical data. Inferential statistics were used with the Mann-Whitney U-test and X2 test. Intra-group data were assessed with the Wilcoxon test. Results: We included 52 patients: group A (n = 16, 30%) and group B (n = 36, 70%). The male sex predominated, and mainly the left renal unit. The most important surgical finding was stenotic segment. The median right glomerular filtration rate was 24.1 mL/min (19.0-34.5) pre-surgical and 38.2 mL/min (35.9-41.09) post-surgical in group A (p = 0.028), and 28.4 mL/min (18.5-35.0) pre-surgical and 37 mL/min (35.7-46.0) post-surgical in group B (p = 0.003). The median left glomerular filtration rate was 30 mL/min (21.4-39.0) pre-surgical and 40.0 mL/min (37.7-44.6) post-surgical in group A (p = 0.005) and 18.4 mL/min (14.2-29.2) pre-surgical and 37 mL/min (33.1-38.5) post-surgical in group B (p < 0.001). Conclusions: Correction of ureteropelvic stenosis before one year of age results in better renal function than a later correction.
Resumen Introducción: Las anormalidades congénitas del riñón y del tracto urinario son la causa más frecuente de enfermedad renal crónica en las primeras décadas de la vida. La estenosis de la unión ureteropiélica puede ocasionar restricción del flujo urinario desde la pelvis renal hacia el uréter, y es la causa más común de dilatación del sistema colector en el riñón fetal. El objetivo de este estudio fue determinar los resultados del tratamiento de la hidronefrosis por estenosis ureteropiélica congénita según la edad de la intervención. Métodos: Se llevó a cabo un estudio retrospectivo descriptivo incluyendo pacientes pediátricos con hidronefrosis secundaria a estenosis de la unión ureteropiélica sometidos a pieloplastia abierta de Anderson-Hynes en el periodo 2010-2016. Se formaron dos grupos: A, pacientes < 1 año, y B, pacientes > 1 año. Se analizaron parámetros clínicos, ecosonográficos y de función renal. Se utilizó estadística inferencial con las pruebas U de Mann Whitney, χ2 y Wilcoxon. Resultados: Se incluyeron 52 pacientes: 16 en el grupo A (30%) y 36 en el grupo B (70%). Predominó el sexo masculino, y principalmente la unidad renal izquierda. El hallazgo quirúrgico más importante fue el segmento estenótico. La mediana de la tasa de filtración glomerular derecha prequirúrgica fue de 24.1 ml/min (19.0-34.5) y la posquirúrgica fue de 38.2 ml/min (35.9-41.09) en el grupo A (p = 0.028), frente a 28.4 ml/min (18.5-35.0) y 37 ml/min (35.7-46.0), respectivamente, en el grupo B (p = 0.003). La mediana de la tasa de filtración glomerular izquierda prequirúrgica fue de 30 ml/min (21.4-39.0) y la posquirúrgica fue de 40.0 ml/min (37.7-44.6) en el grupo A (p = 0.005), frente a 18.4 ml/min (14.2-29.2) y 37 ml/min (33.1-38.5), respectivamente, en el grupo B (p < 0.001). Conclusiones: La corrección de la estenosis ureteropiélica antes de 1 año de edad resulta en una mejor función renal que la corrección tardía.
https://doi.org/10.24875/bmhim.20000359
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12.
Práticas de ressuscitação volêmica em unidades de terapia intensiva brasileiras: uma análise secundária do estudo Fluid-TRIPS
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Freitas, Flavio Geraldo Rezende de
; Hammond, Naomi
; Li, Yang
; Azevedo, Luciano Cesar Pontes de
; Cavalcanti, Alexandre Biasi
; Taniguchi, Leandro
; Gobatto, André
; Japiassú, André Miguel
; Bafi, Antonio Tonete
; Mazza, Bruno Franco
; Noritomi, Danilo Teixeira
; Dal-Pizzol, Felipe
; Bozza, Fernando
; Salluh, Jorge Ibrahin Figueira
; Westphal, Glauco Adrieno
; Soares, Márcio
; Assunção, Murillo Santucci César de
; Lisboa, Thiago
; Lobo, Suzana Margarete Ajeje
; Barbosa, Achilles Rohlfs
; Ventura, Adriana Fonseca
; Souza, Ailson Faria de
; Silva, Alexandre Francisco
; Toledo, Alexandre
; Reis, Aline
; Cembranel, Allan
; Rea Neto, Alvaro
; Gut, Ana Lúcia
; Justo, Ana Patricia Pierre
; Santos, Ana Paula
; Albuquerque, André Campos D. de
; Scazufka, André
; Rodrigues, Antonio Babo
; Fernandino, Bruno Bonaccorsi
; Silva, Bruno Goncalves
; Vidal, Bruno Sarno
; Pinheiro, Bruno Valle
; Pinto, Bruno Vilela Costa
; Feijo, Carlos Augusto Ramos
; Abreu Filho, Carlos de
; Bosso, Carlos Eduardo da Costa Nunes
; Moreira, Carlos Eduardo Nassif
; Ramos, Carlos Henrique Ferreira
; Tavares, Carmen
; Arantes, Cidamaiá
; Grion, Cintia
; Mendes, Ciro Leite
; Kmohan, Claudio
; Piras, Claudio
; Castro, Cristine Pilati Pileggi
; Lins, Cyntia
; Beraldo, Daniel
; Fontes, Daniel
; Boni, Daniela
; Castiglioni, Débora
; Paisani, Denise de Moraes
; Pedroso, Durval Ferreira Fonseca
; Mattos, Ederson Roberto
; Brito Sobrinho, Edgar de
; Troncoso, Edgar M. V.
; Rodrigues Filho, Edison Moraes
; Nogueira, Eduardo Enrico Ferrari
; Ferreira, Eduardo Leme
; Pacheco, Eduardo Souza
; Jodar, Euzebio
; Ferreira, Evandro L. A.
; Araujo, Fabiana Fernandes de
; Trevisol, Fabiana Schuelter
; Amorim, Fábio Ferreira
; Giannini, Fabio Poianas
; Santos, Fabrício Primitivo Matos
; Buarque, Fátima
; Lima, Felipe Gallego
; Costa, Fernando Antonio Alvares da
; Sad, Fernando Cesar dos Anjos
; Aranha, Fernando G.
; Ganem, Fernando
; Callil, Flavio
; Costa Filho, Francisco Flávio
; Dall´Arto, Frederico Toledo Campo
; Moreno, Geovani
; Friedman, Gilberto
; Moralez, Giulliana Martines
; Silva, Guilherme Abdalla da
; Costa, Guilherme
; Cavalcanti, Guilherme Silva
; Cavalcanti, Guilherme Silva
; Betônico, Gustavo Navarro
; Betônico, Gustavo Navarro
; Reis, Hélder
; Araujo, Helia Beatriz N.
; Hortiz Júnior, Helio Anjos
; Guimaraes, Helio Penna
; Urbano, Hugo
; Maia, Israel
; Santiago Filho, Ivan Lopes
; Farhat Júnior, Jamil
; Alvarez, Janu Rangel
; Passos, Joel Tavares
; Paranhos, Jorge Eduardo da Rocha
; Marques, José Aurelio
; Moreira Filho, José Gonçalves
; Andrade, Jose Neto
; Sobrinho, José Onofre de C
; Bezerra, Jose Terceiro de Paiva
; Alves, Juliana Apolônio
; Ferreira, Juliana
; Gomes, Jussara
; Sato, Karina Midori
; Gerent, Karine
; Teixeira, Kathia Margarida Costa
; Conde, Katia Aparecida Pessoa
; Martins, Laércia Ferreira
; Figueirêdo, Lanese
; Rezegue, Leila
; Tcherniacovsk, Leonardo
; Ferraz, Leone Oliveira
; Cavalcante, Liane
; Rabelo, Ligia
; Miilher, Lilian
; Garcia, Lisiane
; Tannous, Luana
; Hajjar, Ludhmila Abrahão
; Paciência, Luís Eduardo Miranda
; Cruz Neto, Luiz Monteiro da
; Bley, Macia Valeria
; Sousa, Marcelo Ferreira
; Puga, Marcelo Lourencini
; Romano, Marcelo Luz Pereira
; Nobrega, Marciano
; Arbex, Marcio
; Rodrigues, Márcio Leite
; Guerreiro, Márcio Osório
; Rocha, Marcone
; Alves, Maria Angela Pangoni
; Alves, Maria Angela Pangoni
; Rosa, Maria Doroti
; Dias, Mariza D’Agostino
; Martins, Miquéias
; Oliveira, Mirella de
; Moretti, Miriane Melo Silveira
; Matsui, Mirna
; Messender, Octavio
; Santarém, Orlando Luís de Andrade
; Silveira, Patricio Júnior Henrique da
; Vassallo, Paula Frizera
; Antoniazzi, Paulo
; Gottardo, Paulo César
; Correia, Paulo
; Ferreira, Paulo
; Torres, Paulo
; Silva, Pedro Gabrile M. de Barros e
; Foernges, Rafael
; Gomes, Rafael
; Moraes, Rafael
; Nonato filho, Raimundo
; Borba, Renato Luis
; Gomes, Renato V
; Cordioli, Ricardo
; Lima, Ricardo
; López, Ricardo Pérez
; Gargioni, Ricardo Rath de Oliveira
; Rosenblat, Richard
; Souza, Roberta Machado de
; Almeida, Roberto
; Narciso, Roberto Camargo
; Marco, Roberto
; waltrick, Roberto
; Biondi, Rodrigo
; Figueiredo, Rodrigo
; Dutra, Rodrigo Santana
; Batista, Roseane
; Felipe, Rouge
; Franco, Rubens Sergio da Silva
; Houly, Sandra
; Faria, Sara Socorro
; Pinto, Sergio Felix
; Luzzi, Sergio
; Sant’ana, Sergio
; Fernandes, Sergio Sonego
; Yamada, Sérgio
; Zajac, Sérgio
; Vaz, Sidiner Mesquita
; Bezerra, Silvia Aparecida Bezerra
; Farhat, Tatiana Bueno Tardivo
; Santos, Thiago Martins
; Smith, Tiago
; Silva, Ulysses V. A.
; Damasceno, Valnei Bento
; Nobre, Vandack
; Dantas, Vicente Cés de Souza
; Irineu, Vivian Menezes
; Bogado, Viviane
; Nedel, Wagner
; Campos Filho, Walther
; Dantas, Weidson
; Viana, William
; Oliveira Filho, Wilson de
; Delgadinho, Wilson Martins
; Finfer, Simon
; Machado, Flavia Ribeiro
.
RESUMO Objetivo: Descrever as práticas de ressuscitação volêmica em unidades de terapia intensiva brasileiras e compará-las com as de outros países participantes do estudo Fluid-TRIPS. Métodos: Este foi um estudo observacional transversal, prospectivo e internacional, de uma amostra de conveniência de unidades de terapia intensiva de 27 países (inclusive o Brasil), com utilização da base de dados Fluid-TRIPS compilada em 2014. Descrevemos os padrões de ressuscitação volêmica utilizados no Brasil em comparação com os de outros países e identificamos os fatores associados com a escolha dos fluidos. Resultados: No dia do estudo, foram incluídos 3.214 pacientes do Brasil e 3.493 pacientes de outros países, dos quais, respectivamente, 16,1% e 26,8% (p < 0,001) receberam fluidos. A principal indicação para ressuscitação volêmica foi comprometimento da perfusão e/ou baixo débito cardíaco (Brasil 71,7% versus outros países 56,4%; p < 0,001). No Brasil, a percentagem de pacientes que receberam soluções cristaloides foi mais elevada (97,7% versus 76,8%; p < 0,001), e solução de cloreto de sódio a 0,9% foi o cristaloide mais comumente utilizado (62,5% versus 27,1%; p < 0,001). A análise multivariada sugeriu que os níveis de albumina se associaram com o uso tanto de cristaloides quanto de coloides, enquanto o tipo de prescritor dos fluidos se associou apenas com o uso de cristaloides. Conclusão: Nossos resultados sugerem que cristaloides são usados mais frequentemente do que coloides para ressuscitação no Brasil, e essa discrepância, em termos de frequências, é mais elevada do que em outros países. A solução de cloreto de sódio 0,9% foi o cristaloide mais frequentemente prescrito. Os níveis de albumina sérica e o tipo de prescritor de fluidos foram os fatores associados com a escolha de cristaloides ou coloides para a prescrição de fluidos.
Abstract Objective: To describe fluid resuscitation practices in Brazilian intensive care units and to compare them with those of other countries participating in the Fluid-TRIPS. Methods: This was a prospective, international, cross-sectional, observational study in a convenience sample of intensive care units in 27 countries (including Brazil) using the Fluid-TRIPS database compiled in 2014. We described the patterns of fluid resuscitation use in Brazil compared with those in other countries and identified the factors associated with fluid choice. Results: On the study day, 3,214 patients in Brazil and 3,493 patients in other countries were included, of whom 16.1% and 26.8% (p < 0.001) received fluids, respectively. The main indication for fluid resuscitation was impaired perfusion and/or low cardiac output (Brazil: 71.7% versus other countries: 56.4%, p < 0.001). In Brazil, the percentage of patients receiving crystalloid solutions was higher (97.7% versus 76.8%, p < 0.001), and 0.9% sodium chloride was the most commonly used crystalloid (62.5% versus 27.1%, p < 0.001). The multivariable analysis suggested that the albumin levels were associated with the use of both crystalloids and colloids, whereas the type of fluid prescriber was associated with crystalloid use only. Conclusion: Our results suggest that crystalloids are more frequently used than colloids for fluid resuscitation in Brazil, and this discrepancy in frequencies is higher than that in other countries. Sodium chloride (0.9%) was the crystalloid most commonly prescribed. Serum albumin levels and the type of fluid prescriber were the factors associated with the choice of crystalloids or colloids for fluid resuscitation.
https://doi.org/10.5935/0103-507x.20210028
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13.
THE ROUTINE USE OF THE METHYLENE BLUE TEST IN SLEEVE GASTRECTOMY: WHY NOT?
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FERRAZ, Álvaro A. B.
; SANTA-CRUZ, Fernando
; BELFORT, João Victor
; SÁ, Vladimir C. T.
; SIQUEIRA, Luciana T.
; ARAÚJO-JÚNIOR, José Guido C.
.
ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo)
- Journal Metrics
RESUMO Racional: Embora considerada procedimento seguro, a gastrectomia vertical (GV) apresenta risco não desprezível de complicações pós-operatórias importantes relacionadas a ela, com atenção especial para fístulas gástricas Objetivo: Avaliar a aplicabilidade clínica do teste do azul de metileno (TAM) na predição da ocorrência de fístulas após a GV. Método: Estudo retrospectivo que incluiu 1136 pacientes operados entre 2012 e 2016 com aplicação do TAM intraoperatório. Sensibilidade, especificidade, valor preditivo positivo (VPP) e valor preditivo negativo (VPN) foram calculados na tentativa de determinar a correlação clínica entre os resultados do TAM e a ocorrência de fístulas pós-operatórias. Sobressutura da linha de grampos foi realizada em todos os pacientes que apresentaram TAM positivo. Resultados: GV laparoscópica foi realizada em 97,0% dos casos; por laparotomia em 2,3% e roboticamente em 0,7%. TAM foi positivo em 19 casos (1,67%). Um dos casos positivos ocorreu na laparotomia e os outros 18 na laparoscopia. Ainda, houve nove casos (0,8%) de fístulas pós-operatórias, dentre os quais, apenas dois apresentaram TAM positivo. O valor diagnóstico do TAM foi avaliado através dos cálculos de sensibilidade (22,0%), especificidade (98,0%), VPP (11,0%) e VPN (99,0%). Não houve casos de reação alérgica ou qualquer outro efeito colateral advindo do uso da solução de azul de metileno. Conclusão: TAM mostrou alta especificidade e VPN, apresentando importância em descartar a ocorrência de fístulas pós-operatórias.
ABSTRACT Background: Although considered a safe procedure, sleeve gastrectomy (SG) has a non-negligible risk of major postoperative complications related to it, with special attention to gastric leaks. Aim: Evaluate the clinical value of the methylene blue test (MBT) in predicting the occurrence of post-SG leaks. Methods: Retrospective study that included 1136 patients who underwent SG with intraoperative MBT between 2012 and 2016. Sensitivity, specificity, positive predictive value (PPV) and negative predicted value (NPV) were calculated to determine the clinical correlation between the MBT and the occurrence of postoperative leaks. Staple line oversewing was performed in all patients who presented positive MBT. Results: Laparoscopic SG was performed in 97.0% of cases; open in 2.3%, and robotic in 0.7%. MBT was positive in 19 cases (1.67%). One positive MBT occurred during an open SG and the other 18 at laparoscopy. Moreover, there were nine cases (0.8%) of postoperative leaks, among which, only two presented positive MBT. MBT diagnostic value was evaluated through the calculation of sensitivity (22.0%), specificity (98.0%), PPV (11.0%) and NPV (99.0%). There were no cases of allergic reaction or any other side effect with the use of the methylene blue solution. Conclusion: MBT showed high specificity and negative predictive value, thus presenting an important value to rule out the occurrence of postoperative leaks.
14.
Atención integral y manejo del paciente con hemofilia en el contexto de la pandemia de COVID-19
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Lozano-Garcidueñas, Mónica
; Martínez-Murillo, Carlos
; Sánchez-Jara, Berenice
; Leyto-Cruz, Faustino
; Reyes-Espinoza, Elio A.
; Soto-Padilla, Janet M.
; Moreno-González, Aida M.
; Ventura-Enríquez, Yanet
; Campos-Cortés, Alvaro
; González-Pedroza, Lourdes L.
; Flores-Villegas, Victoria
; Ortiz-Torres, María Guadalupe
; López-Arroyo, José L.
; Villareal-Martínez, Laura
; Cruz-Hernández, Victor
; Trejo-Gómora, Jorge
.
Abstract The clinical spectrum of severe hemophilia has evolved throughout history from a catastrophic and highly fatal condition in the early 20th century to a chronic and “manageable” disorder in recent decades, thanks to the remarkable advances in treatment achieved. in the last 40 years, advances driven and reinforced by some past catastrophic experiences, such as the biological disaster in the 1980s due to fatal viral infections transmitted by transfusion, such as hepatitis and HIV/AIDS, from which, the appearance of new infectious agents are an ongoing concern for the hemophilia community, as is currently the case facing us with the coronavirus disease 2019 pandemic, which has created an extremely challenging situation for members of the global bleeding disorders community. Faced with this pandemic, questions have arisen regarding the possibility of whether patients with hemophilia will have a higher risk of infection and whether factor deficiency and its treatment could influence the manifestations of the infection, its natural course, treatment and complications; coupled with the concern that it seems clear that the current pandemic will have definitive consequences on the management of hemophilia around the world. Such questions have led to a review of the literature, guidelines, and expert consensus, including the recommendations of the World Federation of Hemophilia, in an attempt to answer these questions, thus generating both guidelines for care, and expanding some of them, promoting the development of new research protocols.
Resumen El espectro clínico de la hemofilia severa ha evolucionado a lo largo de la historia desde una condición catastrófica y altamente fatal a principios del siglo xx, hasta un trastorno crónico y «manejable» en las últimas décadas, gracias a los notables avances en el tratamiento alcanzados en los últimos 40 años, avances impulsados y reforzados por algunas experiencias catastróficas pasadas, como lo fue el desastre biológico en la década de 1980 debido a infecciones virales fatales transmitidas por trasfusión, como hepatitis y virus de la inmunodeficiencia humana/sida, a partir de lo cual la aparición de nuevos agentes infecciosos son una preocupación constante para la comunidad de hemofilia, como lo es actualmente el caso al que nos enfrentamos con la pandemia de enfermedad por coronavirus 2019, que ha creado una situación extremadamente desafiante para los miembros de la comunidad mundial de trastornos hemorrágicos. Ante esta pandemia han surgido interrogantes sobre la posibilidad de si los pacientes con hemofilia tendrán mayor riesgo de infección y si la deficiencia de factor y su tratamiento podrían influir en las manifestaciones de la infección, su curso natural, tratamiento y complicaciones; aunado a la preocupación de que parece claro que la pandemia actual tendrá consecuencias definitivas sobre el manejo de la hemofilia en todo el mundo. Tales interrogantes han dado lugar a la revisión de la literatura, guías, consensos de expertos, incluyendo las recomendaciones de la Federación Mundial de Hemofilia, en un intento de responder a dichas interrogantes, generando así tanto pautas para la atención como ampliando algunas de ellas, impulsando el desarrollo de nuevos protocolos de investigación.
https://doi.org/10.24875/gmm.m21000484
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15.
Diseño y validación de la escala pronóstica cubana PREDICMED para estratificar el riesgo de mediastinitis postoperatoria
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Bermúdez Yera, Gustavo de J.
; Barreto Fiu, Eligio E.
; Chaljub Bravo, Ernesto
; López de la Cruz, Yoandy
; Naranjo Ugalde, Alfredo M.
; Rabassa López-Calleja, Magda A.
; Lagomasino Hidalgo, Álvaro L.
; Mirabal Rodríguez, Roger
; Lastayo Casanova, Ramona G.
; Iturralde Espinosa, Arturo V.
; Allende González, Alain
; Quintero Fleties, Yolepsis F.
.
ABSTRACT Introduction: Phenomena prediction through prognostic scales is a valuable tool in medical sciences nowadays and it should be included in the decision-making process. Predicting postoperative mediastinitis allows to count on resources for its prevention. Objective: To build a prognostic scale to stratify the risk of suffering from postoperative mediastinitis. Method: A case-control study for the risk factors of postoperative mediastinitis was carried out at the Cardiocentro Ernesto Guevara from Santa Clara, Cuba. After the logistic regression, the model was obtained and from it, the predictors to obtain the Cuban prognostic scale of postoperative mediastinitis PREDICMED were included and weighted, which was validated through several methods. Results: This scale was obtained, counting on six predictors and two risk strata. Its performance was analyzed through adjustment, calibration and determination of its discriminating capacity, showing good results. Internal validation was carried out through the data division method and its capacity was compared in both subsets (development and validation) showing no differences. Its good construct validity was demonstrated, since there were no differences between the predicted and the observed probabilities. Its contents validity was also analyzed by experts. Finally, its criteria validity was determined when compared with another similar scale (Medscore). PREDICMED showed a very good discriminatory capacity (area under the curve 0.962) as well as high values of sensitivity (84.62%) and specificity (92.31%). Conclusions: The Cuban prognostic scale PREDICMED, to stratify the risk of postoperative mediastinitis showed good validation parameters and it was able to stratify the risk in not high and high.
RESUMEN Introducción: La predicción de fenómenos en las ciencias médicas mediante escalas pronósticas constituye una herramienta valiosa en la actualidad y deben incluirse en el proceso de toma de decisiones. Pronosticar la mediastinitis postoperatoria permite disponer de recursos para su prevención. Objetivo: Construir una escala pronóstica para estratificar el riesgo de padecer mediastinitis postoperatoria. Método: Se realizó un estudio de casos y controles para los factores de riesgo de mediastinitis postoperatoria en el Cardiocentro Ernesto Guevara de Santa Clara, Cuba. Luego de la regresión logística se obtuvo el modelo y, a partir de este, se incluyeron y ponderaron los predictores para obtener la escala cubana pronóstica de mediastinitis postoperatoria: PREDICMED, que se validó por diversos métodos. Resultados: Esta escala se obtuvo con seis predictores y dos estratos de riesgo. Se analizó su rendimiento mediante ajuste, calibración y determinación de su poder discriminante, con buenos resultados. Se realizó validación interna por el método de división de datos y se comparó su capacidad en ambos subconjuntos (desarrollo y validación) sin diferencias. Se probó su buena validez de constructo, al no existir diferencias entre las probabilidades predichas y las observadas. También se analizó su validez de contenido mediante expertos. Por último, se determinó su validez de criterio al comparar con otra escala similar (MEDSCORE). PREDICMED presentó muy buena capacidad discriminatoria (área bajo la curva 0,962) y elevados valores de sensibilidad (84,62%) y especificidad (92,31%). Conclusiones: La escala pronóstica cubana PREDICMED, para estratificar el riesgo de mediastinitis postoperatoria, mostró buenos parámetros de validación y logró estratificar el riesgo en no alto y alto.
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