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Summary: The castor plant (Ricinus communis L.) is a plant that has dif ferent benefits, such as the production of biodiesel and soil bioremediation. Due to the above, the castor plant’s ability to extract arsenic (As) was evaluated. For this, a randomized block experimental design with four repetitions was carried out. The evaluated treatments consisted of two types of biosolids (oxidation lagoon biosolids (BLO) and activated sludge biosolids (BLA) and four doses of As (0, 25, 50, 100 mg kg-1), under greenhouse conditions. As concentration was determined by inductively coupled plasma mass spectrometry (ICP-MS). From the quantification of As, the translocation factor (TF) and the bioaccumulation factor (FB) were estimated. The total nitrogen (N) content was quantified by the combustion method. Phosphorus (P) was analyzed by colorimetry using the metavanadate method, and the content of potassium (K), calcium (Ca), magnesium (Mg), copper (Cu), manganese (Mn), iron (Fe) and zinc (Zn) was quantified by atomic absorption. For percentage of oil The Soxhlet method was used in the seed. The plant height and the dry weight of biomass did not vary due to the treatment ef fect (P ≤ 0.05). The Translocation Factor (TF) and the Bioconcentration Factor (BCF) registered ranges of 0.20 - 0.63 and 0.28 - 0.75, respectively. The applied doses of As did not af fect the biomass and nutrient absorption in the castor plant, which indicates that this plant species is tolerant to toxicity with productive potential in soils contaminated with this element, in concentrations up to 100 mg kg-1.

Resumen: La higuerilla (Ricinus communis L.) es una planta que tiene diferentes beneficios, como la producción de biodiesel y la biorremediación de suelo. Debido a lo anterior, se evaluó la capacidad de la higuerilla para extraer arsénico (As). Para ello, se realizó un diseño experimental de bloques al azar con cuatro repeticiones. Los tratamientos evaluados consistieron en dos tipos de biosólidos (biosólidos de lagunas de oxidación (BLO) y biosólidos de lodos activados (BLA) y cuatro dosis de As (0, 25, 50, 100 mg kg-1), bajo condiciones de invernadero. La concentración de As se determinó por espectrometría de masas por plasma acoplado inductivamente (ICP-MS). A partir de la cuantificación de As se estimó el factor de translocación (FT) y el factor de bioacumulación (FB). El contenido de nitrógeno (N) total se cuantifico por el método de combustión. El fósforo (P) se analizó por colorimetría por el método de metavanadato, y el contenido de potasio (K), calcio (Ca), magnesio (Mg), cobre (Cu), manganeso (Mn), hierro (Fe) y zinc (Zn) que se cuantificaron por absorción atómica. Para porcentaje de aceite en la semilla se utilizó el método Soxhlet. La altura de planta y el peso seco de biomasa no variaron por efecto de tratamiento (P ≤ 0.05). El Factor de translocación (FT) y el Factor de bioconcentración (FBC) registraron rangos de 0.20 - 0.63 y 0.28 - 0.75, respectivamente. Las dosis aplicadas de As no afectaron la biomasa y absorción de nutrientes en la planta de higuerilla, lo cual indica que esta especie vegetal es tolerante a la toxicidad con potencial productivo en suelos contaminados con este elemento, en concentraciones hasta de 100 mg kg-1.

https://doi.org/10.28940/terra.v42i0.1836

Distribution of coronary arteries and histopathological analysis of three-toed sloth (Bradypus variegatus) heart threetoed three toed Bradypus variegatus
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Albuquerque, Priscilla Virgínio de

; Torres, Sandra Maria de

; Mesquita, Emanuela Polimeni de

; Nascimento, Júlio Cézar dos Santos

; Ribeiro, Apolônio Gomes

; Evêncio Neto, Joaquim

; Andrade, Gilcifran Prestes de

; Amorim Júnior, Adelmar Afonso de

; Amorim, Marleyne José Afonso Accioly Lins

Ciência Animal Brasileira

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2024, Volume 25 elocation 76956E

Resumo: En Pt | Texto: En Pt | PDF: En | PDF: Pt

Abstract The three-toed sloth (Bradypus variegatus) has been a victim of disorderly human interventions, leading to an increase in accidents and diseases for the species. This study aimed to provide a description of the coronary arteries and to high light the histopathological findings in the sloth’s heart. This information should be beneficial for medical clinics dealing with these species. Eighteen B. variegatus specimens were dissected after natural death. Fifteen of them, comprising five adult males, nine adult females, and one juvenile, were fixed with formaldehyde and preserved in saline solution. In two males and one female, red-coloured latex was injected through the left common carotid artery to make the coronary arteries more visible. In the female, blue-coloured latex was also injected through the right external jugular vein to aid in arterial identification. The chests were opened to evaluate and extract the heart for a detailed description of the coronary arteries. For histopathological analysis, histological slides were prepared from four hearts collected from four animals (three adults and one juvenile). Arterial analyses revealed that sloths possess two coronary arteries: one on the right and one on the left side, each of which supplies blood to their respective surfaces. The heart is composed of the endocardium, myocardium, and epicardium, similar to mammals in general. However, necrosis of endocardial tissue and cardiac muscle fbres, as well as myxomatous degeneration of valves and thrombi in vascular lumens, were observed. These necrotic events, more extensive in nature, are related to infarctions, while the more subtle ones may be associated with stressful situations experienced by the individuals. threetoed three toed Bradypus interventions species s B death them females juvenile solution female redcoloured red coloured visible bluecoloured blue identification analysis juvenile. . juvenile) side surfaces endocardium myocardium epicardium general However fbres lumens observed events nature infarctions individuals

Resumo A preguiça-comum (Bradypus variegatus) tem sido vítima das investidas antrópicas desordenadas, o que tem elevado o número de acidentes e doenças para a espécie. Propôs-se com esse estudo, realizar uma descrição das artérias coronárias, assim como apontar os achados histopatológicos do coração do bicho-preguiça, a fim de favorecer o diagnóstico por imagem, semiologia e clínica médica das espécies. Foram dissecados 18 exemplares de B. variegatus obtidos após morte natural. Quinze deles, sendo 5 machos e 9 fêmeas adultas e 1 jovem, foram fixados com formaldeído e conservados em solução salina. Em 2 machos e 1 fêmea, foi injetado, a partir da artéria carótida comum esquerda, látex corado em vermelho, para tornar as coronárias mais evidentes. Na fêmea também foi injetado através da veia jugular externa direita, látex corado em azul, para evitar equívoco na identificação arterial. Os animais tiveram o tórax aberto a fim de avaliar e retirar o coração para descrição detalhada das artérias coronárias. Para análise histopatológica, foram confeccionadas lâminas histológicas oriundas de corações coletados de 4 animais (3 adultos e 1 jovem). Com base nas análises arteriais, as preguiças possuem duas coronárias: uma a direita e uma a esquerda, que irrigam suas respectivas faces. O coração é composto por endocárdio, miocárdio e epicárdio, semelhante aos mamíferos em geral. Todavia, observou-se necroses endocárdicas, de fibras musculares cardíacas, além de degenerações mixomatosas de válvulas e trombos no lúmen vascular. Esses eventos necróticos, mais extensos, estão relacionados a infartos, enquanto os mais discretos podem ser associados a situações de estresse vivenciadas pelos espécimes. preguiçacomum preguiça Bradypus desordenadas espécie Propôsse Propôs se estudo bichopreguiça, bichopreguiça bicho preguiça, bicho-preguiça imagem espécies B natural deles jovem salina esquerda vermelho evidentes azul arterial histopatológica 3 ( jovem. . jovem) arteriais faces endocárdio epicárdio geral Todavia observouse observou endocárdicas cardíacas vascular necróticos extensos infartos espécimes

https://doi.org/10.1590/1809-6891v25e-76956e

Adequação do Consumo de Ácidos Graxos entre Pacientes em Prevenção Cardiovascular Secundária
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Marcadenti, Aline

; Machado, Rachel H. Vieira

; Santos, Renato Hideo Nakagawa

; Kasai, Caio Cesar dos Santos

; Kovacs, Cristiane

; Bello, Annie

; de Matos, Cristina H.

; Bertacco, Renata Torres Abib

; Souza, Gabriela C.

; Schirmann, Gabriela da S.

; Nagano, Francisca Eugenia Zaina

; Poloni, Soraia

; Kik, Raquel Milani El

; Feres, Naoel Hassan

; Rodrigues, Isa G.

; Sousa, Antônio Carlos Sobral

; Pinheiro, Josilene M. F.

; Vasconcelos, Sandra Mary Lima

; Carlos, Daniele Maria de Oliveira

; Souza, Viviane Sahade

; Gomes, Adriana Barros

; Figueiredo Neto, José Albuquerque de

; Moriguchi, Emilio Hideyuki

; Izar, Maria Cristina

; Pinto, Sônia Lopes

; Bressan, Josefina

; de Souza, Simone Raimondi

; Kumbier, Magali C.

; de Araújo, Celme Barroncas Passos

; Torreglosa, Camila R.

; Weber, Bernardete

; Bersch-Ferreira, Ângela Cristine

Arquivos Brasileiros de Cardiologia

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2024, Volume 121 Nº 3 elocation e20230487

Resumo: En Pt | Texto: En Pt | PDF: En | PDF: Pt

Background: Adhering to a diet adequate in macronutrients is crucial for the secondary prevention of cardiovascular diseases. Objective: To assess the prevalence of adherence to recommendations for the consumption of dietary fatty acids for the prevention and treatment of cardiovascular diseases and to estimate whether the presence of certain cardiovascular risk factors would be associated with adherence. Methods: Cross-sectional study using baseline data from 2,358 participants included in the "Brazilian Cardioprotective Nutritional Program Trial". Dietary intake and cardiovascular risk factors were assessed. Adequate intake of polyunsaturated fatty acids (PUFA) was considered as ≥10% of total daily energy intake; for monounsaturated fatty acids (MUFA), 20%; and for saturated fatty acids (SFA), <7% according to the Brazilian Society of Cardiology. A significance level of 5% was considered in the statistical analysis. Results: No participant adhered to all recommendations simultaneously, and more than half (1,482 [62.9%]) did not adhere to any recommendation. Adherence exclusively to the SFA recommendation was the most prevalent, fulfilled by 659 (28%) participants, followed by adherence exclusively to the PUFA (178 [7.6%]) and MUFA (5 [0.2%]) recommendations. There was no association between the number of comorbidities and adherence to nutritional recommendations (p = 0.269). Participants from the Brazilian Northeast region showed a higher proportion of adherence to SFA consumption recommendations (38.42%) and lower adherence to PUFA intake (3.52%) (p <0.001) compared to other regions. Conclusions: Among the evaluated sample, there was low adherence to nutritional recommendations for dietary fatty acid consumption. Background Objective Methods Crosssectional Cross sectional 2358 2 358 2,35 Trial. Trial . Trial" assessed (PUFA 10 ≥10 MUFA, , (MUFA) 20% 20 SFA, (SFA) 7 <7 Cardiology 5 analysis Results simultaneously 1,482 1482 1 482 (1,48 62.9% 629 62 9 [62.9%] prevalent 65 28% 28 (28% 178 (17 7.6% 76 6 [7.6%] ( 0.2% 02 0 [0.2%] p 0.269. 0269 0.269 269 0.269) 38.42% 3842 38 42 (38.42% 3.52% 352 3 52 (3.52% <0.001 0001 001 regions Conclusions sample 235 35 2,3 ≥1 (MUFA (SFA < 1,48 148 48 (1,4 62.9 [62.9% (28 17 (1 7.6 [7.6% 0.2 [0.2% 026 0.26 26 38.42 384 4 (38.42 3.52 (3.52 <0.00 000 00 23 2, ≥ 1,4 14 (1, 62. [62.9 (2 7. [7.6 0. [0.2 38.4 (38.4 3.5 (3.5 <0.0 1, [62. [7. [0. 38. (38. 3. (3. <0. [62 [7 [0 (38 (3 <0 [6 [

Resumo Fundamento: A adesão à uma alimentação adequada em macronutrientes é fundamental para a prevenção secundária de doenças cardiovasculares. Objetivo: Avaliar a prevalência de adesão às recomendações de consumo de ácidos graxos para prevenção e tratamento de doenças cardiovasculares, e estimar se a presença de determinados fatores de risco cardiovascular estaria associada à adesão. Métodos: Estudo transversal com os dados de linha de base de 2358 participantes do estudo "Brazilian Cardioprotective Nutritional Program Trial". Dados de consumo alimentar, e fatores de risco cardiovascular foram avaliados. Foi considerada, de acordo com a Sociedade Brasileira de Cardiologia, uma ingestão adequada de ácidos graxos poli-insaturados (AGPI) ≥10% do consumo total de energia diária, para ácidos graxos monoinsaturados (AGM), 20% e para ácidos graxos saturados (AGS), <7%. Na análise estatística foi considerando nível de significância de 5%. Resultados: Nenhum participante aderiu a todas as recomendações de forma simultânea e mais da metade (1482 [62,9%]) não aderiu a nenhuma recomendação. A adesão exclusivamente à recomendação de AGS foi a mais prevalente, sendo cumprida por 659 (28%) dos participantes, seguida da adesão exclusivamente à recomendação de AGP (178 [7,6%]) e de AGM (5 [0,2%]). Não houve associação entre o número de comorbidades e a adesão às recomendações nutricionais (p =0,269). Os participantes da região Nordeste do país apresentaram maior proporção de adesão às recomendações para consumo de AGS (38,42%), e menor para ingestão de AGPI (3,52%) (p <0,001) em comparação às demais. Conclusões: Na amostra avaliada, evidenciou-se baixa adesão às recomendações nutricionais para consumo de ácidos graxos. Fundamento cardiovasculares Objetivo Métodos 235 Brazilian Trial. Trial . Trial" alimentar avaliados considerada Cardiologia poliinsaturados poli insaturados (AGPI 10 ≥10 diária AGM, , (AGM) 20 AGS, (AGS) 7 <7% 5 5% Resultados 1482 (148 62,9% 629 62 9 [62,9%] prevalente 65 28% 28 (28% 178 (17 7,6% 76 6 [7,6%] ( 0,2%. 02 0,2% 0 2 [0,2%]) p =0,269. 0269 =0,269 269 =0,269) 38,42%, 3842 38,42% 38 42 (38,42%) 3,52% 352 3 52 (3,52% <0,001 0001 001 demais Conclusões avaliada evidenciouse evidenciou 23 1 ≥1 (AGM (AGS <7 148 (14 62,9 [62,9% (28 17 (1 7,6 [7,6% 0,2 [0,2%] 026 =0,26 26 384 38,42 4 (38,42% 3,52 35 (3,52 <0,00 000 00 ≥ < 14 62, [62,9 (2 7, [7,6 0, [0,2% =0,2 38,4 (38,42 3,5 (3,5 <0,0 [62, [7, [0,2 =0, 38, (38,4 3, (3, <0, [62 [7 [0, =0 (38, (3 <0 [6 [ [0 = (38

https://doi.org/10.36660/abc.20230487

Anti-inflammatory and anti-oxidant action of tadalafil in testicular regeneration process after heat stress Antiinflammatory Anti inflammatory antioxidant anti oxidant
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Silva, Fernando Leonel da

; Dias, Fernanda Carolina Ribeiro

; Torres, Sandra Maria

; Lorena, Virginia Maria Barros de

; Silva, Sebastião Rogerio de Freitas

; Oliveira, Vinicius Vasconcelos Gomes de

; Oliveira Filho, Emanoel Felipe de

; Soares, Pierre Castro

; Silva Junior, Valdemiro Amaro da

Animal Reproduction

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2024, Volume 21 Nº 2 elocation e20230095

Resumo: En | Texto: En | PDF: En

Abstract Tadalafil, a potent phosphodiesterase inhibitor 5 (PDE-5), is commonly used for the management of erectile dysfunction. However, its therapeutic potential extends beyond this indication. This study aimed to investigate the impact of tadalafil on the recovery of testicular parenchyma in male Wistar rats exposed to testicular thermal stress. Fifty-four Wistar rats were subjected to testicular thermal stress and randomly assigned to receive either tadalafil treatment (TAD) or no treatment (control). TAD was administered intraperitoneally at a dose of either 0.9 mg/kg or 1.8 mg/kg. Biometric parameters, histopathological assessment of the testis, serum testosterone levels, oxidative stress, and interleukin levels were evaluated on days 7, 15, and 30 after thermal shock. The animals were euthanized at the end of each experimental period, and samples were collected. TAD treatment maintained testicular weight and reduced the testicular degenerative process up to day 7 post-injury. However, despite TAD therapy, serum testosterone levels were decreased in the treated groups at days 7 and 15 post-thermal stress. TAD also decreased TNF-α and NO levels at different doses but had no effect on IL-6. The treatment with TAD after heat shock demonstrated anti-inflammatory and antioxidant properties but did not prevent the aggravation of testicular lesions in subsequent periods, even with the systematic reduction in TNF-α and NO levels. Therefore, this selective PDE-5 inhibitor, at the dosages used, did not have a positive impact on testosterone levels during the post-thermal stress period, which could compromise the resumption of the spermatogenic process. Tadalafil PDE5, PDE5 PDE , (PDE-5) dysfunction However indication Fiftyfour Fifty four (TAD control. control . (control) 09 0 9 0. mgkg mg kg 18 1 8 1. parameters testis 3 period collected postinjury. postinjury post injury. injury post-injury therapy postthermal TNFα TNF α IL6. IL6 IL 6. 6 IL-6 antiinflammatory anti inflammatory periods Therefore PDE- (PDE-5 (control IL- (PDE- (PDE

https://doi.org/10.1590/1984-3143-ar2023-0095

Características clínicas de pacientes con accidente cerebrovascular isquémico y fibrilación auricular internados en hospital de referencia durante el periodo 2021 a 2022
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Frutos Zenteno, María Eduarda

; Alvarenga Tanii, Amy Fabiola

; Cáceres Santacruz, Sandra Manuela

; Caballero Torres, Marlene Elizabeth

; Ocampos Mamani, Cinthia Carolina

; Solís Cantero, Luz María

; Zaputovich Filippi, Juan José

Revista Virtual de la Sociedad Paraguaya de Medicina Interna

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2024, Volume 11 Nº 1 elocation e11122415

Resumo: Es En | Texto: Es En | PDF: Es | PDF: En

RESUMEN Introducción: se ha demostrado que uno de cada tres accidentes cerebrovasculares (ACV) isquémicos es consecuencia de una fibrilación auricular (FA) no conocida y, por ende, no tratada. Por eso es de vital importancia el diagnóstico y tratamiento oportuno de la FA, ya que el ACV isquémico es un motivo frecuente de ingreso hospitalario. Objetivos: determinar las características clínicas de pacientes con ACV isquémico y FA internados en el Hospital XX, durante los años 2021 y 2022. Metodología: se realizó un estudio observacional, descriptivo, de corte transversal, retrospectivo. Se incluyeron pacientes de ambos sexos, mayores de edad, con FA y ACV isquémico confirmados por electrocardiograma y tomografía. Las variables se obtuvieron de los expedientes clínicos. La investigación fue aprobada por el comité de ética de la Universidad Nacional de Itapúa. Resultados: se estudiaron 113 pacientes. La edad media fue 69 ± 10 años, el 54,87% (62) fueron varones. Entre los factores de riesgo, 96,46% eran conocidos con hipertensión arterial y 61,06% con diabetes mellitus. En 24 (21%) pacientes se realizó ecocardiograma y 14 tenían dilatación auricular, con una media de 44 ± 8 mm, y 11 de éstos tenían estenosis mitral. La media de frecuencia cardiaca era 92 ± 18 latidos/min. El ictus isquémico se presentó como debut en 52,21% y de éstos solo 7,08% se conocían portadores de FA. Entre los portadores conocidos de FA 7,08% recibían anticoagulación con acenocumarol. No se encontraron pacientes en tratamiento con otros anticoagulantes. Conclusión: el 22,12% de los pacientes con ACV isquémico estaban diagnosticados con FA. Aproximadamente, un tercio de los pacientes con FA bajo el régimen de anticoagulación no alcanzaron rangos terapéuticos ni una frecuencia cardiaca controlada.

ABSTRACT Introduction: It has been shown that one in three ischemic cerebrovascular accidents (CVA) is a consequence of unknown and, therefore, untreated atrial fibrillation (AF). That is why timely diagnosis and treatment of AF is of vital importance since ischemic stroke is a frequent reason for hospital admission. Objectives: To determine the clinical characteristics of patients with ischemic stroke and AF hospitalized at Hospital XX, during 2021 and 2022. Methodology: An observational, descriptive, cross-sectional, retrospective study was carried out. Male and female adult patients, with AF and ischemic stroke confirmed by electrocardiogram and tomography were included. The variables were obtained from the clinical records. The research study was approved by the ethics committee of the National University of Itapúa. Results: One hundred thirteen patients were studied. The mean age was 69 ± 10 years, and 54.87% (62) were men. Among the risk factors, 96.46% were known to have arterial hypertension, and 61.06% were known to have diabetes mellitus. An echocardiogram was performed in 24 (21%) patients, 14 had atrial dilation, with a mean of 44 ± 8 mm, and 11 of these had mitral stenosis. The mean heart rate was 92 ± 18 beats/min. Ischemic stroke occurred as a debut in 52.21% and of these, only 7.08% were known to have AF. Among known AF carriers, 7.08% received anticoagulation with acenocoumarol. No patients were found being treated with other anticoagulants. Conclusion: AF was diagnosed in 22.12% of patients with ischemic stroke. Approximately one-third of AF patients on anticoagulation regimens did not achieve therapeutic ranges or a controlled heart rate.

https://doi.org/10.18004/rvspmi/2312-3893/2024.e11122415

Resultados de un programa educativo orientado a la promoción de la independencia y autonomía funcional
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Pérez García, María Belén

; Valdés González, Elda María

; Molina Rosero, Sandra Mónica

; Torres Jara, Andrea Cristina

; Dillon Cacuango, María Eugenia

Revista Cubana de Medicina Militar

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Dez 2023, Volume 52 Nº 4 elocation e10784

Resumo: Es En | Texto: Es En | PDF: Es | PDF: En

RESUMEN Introducción: El envejecimiento es un proceso fisiológico que genera cambios en la salud de los adultos mayores. Una de las esferas que con mayor frecuencia se afecta es la psicosocial, en la cual se presenta pérdida de la independencia y autonomía funcional. Objetivo: Evaluar los resultados de un programa educativo orientado a la promoción de la independencia y autonomía funcional. Métodos: Se realizó un estudio cuasiexperimental de intervención antes - después. El universo fue de 697 adultos mayores residentes en las parroquias rurales del cantón Penipe, en la provincia Chimborazo. La muestra quedó conformada por 249 ancianos. Se aplicó un programa educativo durante 8 meses que incluyó como variable el nivel de conocimiento sobre hábitos y estilos de vida saludables y la dependencia. Se utilizó la prueba de McNemar para identificar cambios en el nivel de conocimiento sobre hábitos y estilos de vida. Resultados: Promedio de edad de 68,32 años, predominio del sexo femenino (55,02 %) y con comorbilidades (73,49 %). En el 42,97 % de los sujetos se identificó algún tipo de dependencia, con predominio de la dependencia escasa (45,79 %). Durante el pretest se identificó un nivel de conocimiento bajo en el 63,05 %, durante el postest solo el 15,66 % mantenía un nivel bajo (p= 0,02). Conclusiones: El programa educativo mejora el nivel de conocimiento sobre la importancia de adoptar hábitos y estilos de vida saludables para promocionar la independencia y la autonomía funcional.

ABSTRACT Introduction: Aging is a physiological process that generates changes in the health of people over 60 years of age. One of the spheres that is most frequently affected is psychosocial, in which there is loss of independence and functional autonomy. Objective: To evaluate the results of an educational program aimed at promoting independence and functional autonomy. Methods: A quasi-experimental before-after intervention study was carried out. The universe was 697 older adults residing in the rural parishes of the Penipe canton in the Chimborazo province. The sample was made up of 249 elderly people. An educational program was applied for 8 months that included as a variable the level of knowledge about healthy habits and lifestyles and dependency. The McNemar test was used to identify changes in the level of knowledge about habits and lifestyles. Results: Average age of 68.32 years, predominance of female sex (55.02%) and with associated comorbidities (73.49%). Some type of dependency was identified in 42.97% of the subjects, with a predominance of low dependency (45.79%). During the pretest, older adults with a low level of knowledge about healthy habits and lifestyles predominated (63.05%). During the posttest, the average level of knowledge predominated (51.81%). Conclusions: The educational program improves the level of knowledge about the importance of adopting healthy habits and lifestyles to promote independence and functional autonomy.

Validación de clasificaciones de pie diabético en Argentina
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Carro, Gabriela Verónica

; Saurral, Rubén Nicolás

; Issa, Claudia Marcela

; Witman, Érica Lorena

; Braver, José Daniel

; Casen, María Alejandra

; David, Raúl Alejandro

; Dituro, Claudio Fabián

; Torres, Julio César

; Illuminati, Gabriela Silvana

; Alterini, Pablo

; Losada, María Victoria Dicatarina

; Badías, Florencia

; Romero, Élida Beatriz

; Kremer Sendros, Sandra Aixa

; Vega, Walter Agustín

; Méndez, Elizabet

; Carrió, Luisa Mabel

Revista de la Sociedad Argentina de Diabetes

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Ago 2023, Volume 57 Nº 2 Páginas 84 - 94

Resumo: Es En | Texto: Es En | PDF: Es | PDF: En

Resumen Introducción: las clasificaciones de pie diabético (PD) son una herramienta que tienen el objetivo de mejorar la comunicación entre los profesionales, la referencia y contrarreferencia; proporcionar un pronóstico; ayudar en la valoración de las lesiones, y contribuir con fines estadísticos. Objetivos: describir las características de los pacientes que se presentaron al consultorio o a la guardia con un PD durante un período de 3 meses, determinar el riesgo según cinco clasificaciones (Texas, IDSA, San Elián, WIfI y SINBAD) y evaluar su evolución a 6 meses en relación con el grado de gravedad determinada por cada clasificación. Materiales y métodos: se analizaron 312 pacientes de 15 instituciones en Argentina. Para el análisis se utilizó la calculadora de clasificaciones de pie diabético/score de riesgo del Comité de Pie Diabético de la Sociedad Argentina de Diabetes. Resultados: el 43% de los pacientes (n=133) requirió internación al momento de la primera consulta y el 61% (n=189) había consultado previamente. El porcentaje de amputación mayor total fue de 8,33% (IC 95%; 5,5-11,9) (n=26) y el de amputación menor de 29,17% (IC 95%; 24,2-34,6) (n=91). A los 6 meses, el porcentaje de muerte fue de 4,49% (IC 95%; 2,5-7,4) (n=14), el 24,3% (IC 95%;19,6-29,5) presentaba la herida aún abierta (n=76), el 58,0% (IC 95%; 52,3-66,5) (n=181) cicatrizó y el 7,37% se perdió del seguimiento (n=23). Las clasificaciones de San Elián y WIfI se relacionaron con amputación mayor, cicatrización y muerte. En relación a la clasificación de Texas, el 49% de los pacientes presentó herida penetrante a hueso o articulación (Texas 3), con o sin infección. El 65,3% de las amputaciones mayores y el 78,6% de las muertes se produjeron en pacientes con isquemia. El punto de corte de San Elián para amputación mayor fue 20. Conclusiones: conocer los datos locales permite organizar los recursos para mejorar la atención de los pacientes.

Abstract Introduction: the classifications of diabetic foot (DF) are a tool that aims to improve communication between professionals, referral and counter-referral, provide a prognosis, help in the assessment of lesions, and contribute to statistical purposes. Objectives: to describe the characteristics of patients who presented to the clinic or emergency department with DF over a period of 3 months, determine the risk according to 5 classifications (Texas, IDSA, SEWSS, WIfI, and SINBAD), and evaluate their evolution at 6 months in relation to the severity degree determined by each classification. Materials and methods: 312 patients from 15 institutions in Argentina were analyzed. The Diabetic Foot Classification Calculator/Risk Score from the Diabetic Foot Committee of the Argentina Argentina Diabetes Society was used for the analysis. Results: 43% of patients (n=133) required hospitalization at the time of the first consultation and 61% (n=189) had previously consulted. The total major amputation percentage was 8.33% (95%CI; 5.5-11.9) (n=26), and the minor amputation percentage was 29.17% (95% CI; 24.2-34.6) (n=91). At 6 months, the death rate was 4.49% (95% CI; 2.5-7.4) (n=14), 24.3% (95% CI; 19.629.5) had an open wound (n=76), 58.0% (95% CI; 52.3-66.5) (n=181) had healed, and 7.37% were lost to follow-up (n=23). The SEWSS and WIfI classifications were related to major amputation, healing, and death. Regarding the Texas classification, 49% of patients had a penetrating wound to bone or joint (Texas 3), with or without infection. 65.3% of major amputations and 78.6% of deaths occurred in patients with ischemia. The SEWSS cut-off point for major amputation was 20. Conclusions: knowing local data allows organizing resources to improve patient care.

Travestis, transgender women and young MSM are at high risk for PrEP early loss to follow-up in Rio de Janeiro, Brazil Travestis followup follow up Janeiro
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Echeverría-Guevara, Amanda

; Coelho, Lara E.

; Veloso, Valdiléa G.

; Pimenta, Maria C.

; Hoagland, Brenda

; Moreira, Ronaldo I.

; Leite, Iuri

; Jalil, Emília M.

; Cardoso, Sandra W.

; Torres, Thiago S.

; Grinsztejn, Beatriz

Brazilian Journal of Infectious Diseases

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2023, Volume 27 Nº 1 elocation 102733

Resumo: En | Texto: En | PDF: En

Abstract Introduction Oral pre-exposure prophylaxis (PrEP) with emtricitabine/tenofovir (FTC/TDF) is highly effective in preventing HIV infection. This study aimed to identify factors associated with PrEP early loss to follow-up (ELFU) among gay, bisexual and other men who have sex with men (MSM), travestis and transgender women (TGW). Methodology This was a prospective cohort study evaluating TGW and MSM who initiated PrEP at the Evandro Chagas National Institute of Infectious Diseases (INI-Fiocruz) from 2014 to 2020. ELFU was defined as not returning for a PrEP visit within 180 days after first dispensation. Exposure variables included age, gender, race, education, transactional sex, condomless anal intercourse [CAI] (both in the past six months), binge drinking and substance use (both in past three months) and syphilis diagnosis at baseline. Multilevel logistic regression models with random intercepts and fixed slopes were used to identify factors associated with ELFU accounting for clustering of participants according to their PrEP initiation study/context (PrEP Brasil, PrEParadas, ImPrEP and PrEP SUS). Results Among 1,463 participants, the median age was 29 years (interquartile range 24-36), 83% self-identified as MSM, 17% as TGW, 24% were black, 37% mixed-black/pardo and 30% had < 12 years of education. Fifteen percent reported transactional sex, 59% reported CAI, 67% binge drinking, 33% substance use, and 15% had a syphilis diagnosis. Overall, 137 participants (9.7%) had ELFU. Younger age (18-24 years) (adjusted odds ratio [aOR] 1.9, 95%CI:1.2-3.2), TGW (aOR 2.8, 95%CI:1.6-4.8) and education < 12 years (aOR 1.9, 95%CI:1.2-2.9) were associated with greater odds of ELFU. Conclusion TGW, young individuals and those with lower education were at higher risk of PrEP ELFU. Our results suggest that the development of specific strategies targeting these populations should be a priority, through policies that aim to reduce the incidence of HIV infection. preexposure pre exposure emtricitabinetenofovir emtricitabine tenofovir FTC/TDF FTCTDF FTC TDF (FTC/TDF infection followup follow up (ELFU gay , (MSM) TGW. . (TGW) INIFiocruz INI Fiocruz (INI-Fiocruz 201 2020 18 dispensation gender race CAI [CAI both months, months baseline studycontext context Brasil PrEParadas SUS. SUS SUS) 1463 1 463 1,46 2 interquartile 2436, 2436 24 36 24-36) 83 selfidentified self identified 17 black 37 mixedblack/pardo mixedblackpardo mixed black/pardo pardo 30 59 67 33 15 Overall 13 9.7% 97 9 7 (9.7% 1824 (18-2 adjusted aOR [aOR 19 1.9 95%CI1.23.2, 95CI1232 CI 95%CI 1.2 3.2 95 3 95%CI:1.2-3.2) 28 8 2.8 95%CI1.64.8 95CI1648 1.6 4.8 6 4 95%CI:1.6-4.8 95%CI1.22.9 95CI1229 2.9 95%CI:1.2-2.9 priority (MSM (TGW 20 202 146 46 1,4 243 24-36 mixedblack blackpardo 5 9.7 (9.7 182 (18- 1. CI1 23 95%CI1.23.2 95CI123 95CI 32 3. 95%CI:1.2-3.2 2. 64 95%CI1.64. 95CI164 16 48 4. 95%CI:1.6-4. 22 95%CI1.22. 95CI122 95%CI:1.2-2. 14 1, 24-3 9. (9. (18 95%CI1.23. 95CI12 95%CI:1.2-3. 95%CI1.64 95CI16 95%CI:1.6-4 95%CI1.22 95%CI:1.2-2 24- (9 (1 95%CI1.23 95CI1 95%CI:1.2-3 95%CI1.6 95%CI:1.6- 95%CI1.2 95%CI:1.2- ( 95%CI1. 95%CI:1.6 95%CI:1.2 95%CI1 95%CI:1. 95%CI:1 95%CI:

https://doi.org/10.1016/j.bjid.2022.102733

The first case of acute HIV and monkeypox coinfection in Latin America
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Silva, Mayara Secco Torres

; Santos, Desiree Gomes dos

; Coutinho, Carolina

; Ribeiro, Maria Pia Diniz

; Cardoso, Sandra Wagner

; Veloso, Valdilea Gonçalves

; Grinsztejn, Beatriz

Brazilian Journal of Infectious Diseases

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2023, Volume 27 Nº 2 elocation 102736

Resumo: En | Texto: En | PDF: En

ABSTRACT Monkeypox (MPX) transmission outside non-endemic countries has been reported since May 2022, rapidly evolving into a multi-country outbreak. A potential role of sexual contact in transmission dynamics, as well as a predominance of anogenitallesions, are remarkable features of current cases. Screening for sexually transmitted infections (STIs) plays an important role in the evaluation of patients with suspected MPX infection. Herein we report the first case of a patient diagnosed with both MPX and acute HIV infection in Latin America. He had no major complications during his clinical course, and antiretroviral therapy was promptly initiated. Diagnosis of acute HIV requires a high level of suspicion and appropriate laboratory investigation. Health practitioners need to consider this diagnosis while evaluating patients with suspected MPX with a recent unprotected sexual contact. (MPX nonendemic non endemic 2022 multicountry multi country outbreak dynamics anogenitallesions cases STIs (STIs America course initiated investigation 202 20 2

https://doi.org/10.1016/j.bjid.2022.102736

10.

Demografía y COVID-19: Diferenciales sociales y epidemiológicos
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Aja Díaz, Antonio

; Molina Cintra, Matilde de la Caridad

; Trinquete Díaz, Dixie Edith

; Barros Díaz, Otilia Zenaida

; Rodríguez García, Arianna

; Orbea López, Marbelis

; Mora Pérez, Arelis Rosalen

; Araujo González, Rafael

; Farnós Morejón, Alfonso

; Martin Fernández, Consuelo M.

; Dujarric Bermúdez, Gabriela

; Rodríguez Javiqué, Daylin Cecilia

; Terrero Trinquete, Amanda

; Díaz Fernández, Marta

; Benítez Jiménez, Iliana

; Bourzac Macia, Lisset

; Oliveros Domínguez, Eloy Rafael

; Alfonso de Armas, Marisol

; Quintana Llanio, Livia

; Rodríguez Gómez, Grisell

; Castellanos Cabrera, Roxanne

; Bárcenas Alfonso, Jany

; López Bauta, Adis Aymee

; Oroza Fraíz, Teresa

; Cancio-Bello Ayes, Claudia

; Pérez León, Marta Valeria

; Vera Vergara, Vivian

; Llantá Abreu, María del C.

; Lozano Pérez, Teresa Isabel

; Zas Ros, Bárbara

; Gener Serralta, Sandra

; Rivera Fernández, Rosa M.

; Martínez Debs, Leyti

; Quintosa Puebla, Yissel

; Pérez Rodríguez, Nancy

; Oviedo Álvarez, Vivian

; Fernández Lorenzo, Juan Manuel

; Remond Noa, Ricardo

; Torres Reyes, Antonio

; Veranes Miranda, Alejandro

; de la Garma García, Lic. Diana

Anales de la Academia de Ciencias de Cuba

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Dez 2022, Volume 12 Nº 3 elocation e1115

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

ABSTRACT Introduction. The behavior of COVID-19 is influenced by diverse social differentials that transcend demographic variables and include morbidity, the conditions of their homes, family dynamics, job performance, gender roles and stereotypes, care tasks, habits, and behaviors of life and consumption, among others. Methods. Statistical and demographic analysis and tools of metric studies of the information were used. Results and Discussion. The research showed the importance of incorporating into the analysis of the behavior of COVID-19 in Cuba the influence of social and epidemiological differentials determined by skin color, marital status, employment status, income levels, types of families, mobility, hygienic environmental conditions, access to health services, among others, which can place populations in greater or lesser conditions of vulnerability. Conclusions: The composition and dynamics of the population together with other social differentials are determinants of the behavior and expression of the pandemic. The crossing of epidemiological factors with the analysis of containment measures and the composition and structure of the affected population allows for the design of health policies that are more adjusted to the needs of the pandemic. Distance psychological counseling makes it possible to identify and deal with situations related to confinement and changes in life routines that affect the mental health of different groups of people.

RESUMEN Introducción. El comportamiento de la COVID-19 está influenciado por diferenciales sociales que trascienden las variables demográficas e incluyen la morbilidad, las condiciones de sus viviendas, las dinámicas familiares, el desempeño laboral, los roles y estereotipos de género, las tareas de cuidado, los hábitos y comportamientos de vida y consumo, entre otros. Métodos. Se empleó el análisis estadístico y demográfico y herramientas de los estudios métricos. Resultados y Discusión. La investigación mostró la importancia de incorporar a los análisis del comportamiento de la COVID-19 en Cuba la influencia de diferenciales sociales y epidemiológicos determinados por el color de la piel, el estado conyugal, la situación laboral, los niveles de ingreso, los tipos de familias, la movilidad, las condiciones higiénico ambientales, el acceso a los servicios de salud, entre otros, que pueden ubicar a las poblaciones en mayores o menores condiciones de vulnerabilidad. Conclusiones, la composición y la dinámica de la población junto a otros diferenciales sociales son determinantes del comportamiento de la pandemia. El cruzamiento de los factores epidemiológicos con el análisis de las medidas de contención y la composición y estructura de población afectada permite diseñar políticas sanitarias más ajustadas a las necesidades de la pandemia. La orientación psicológica a distancia permite identificar y atender situaciones vinculadas al confinamiento y los cambios en las rutinas de vida que afectan la salud mental de diferentes grupos de personas.

11.

Predictors of poor outcomes in young non-comorbid patients with COVID-19
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Martínez-Guerra, Bernardo A.

; Medrano-Borromeo, Carla

; González-Lara, María F.

; Román-Montes, Carla M.

; Tamez-Torres, Karla M.

; Rajme-López, Sandra

; Salgado-Guízar, Karla D.

; Juárez-Menéndez, Noe A.

; Ramos-Cervantes, Pilar

; Ruiz-Palacios, Guillermo M.

; Ponce-de-León, Alfredo

; Sifuentes-Osornio, José

Revista de investigación clínica

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Out 2022, Volume 74 Nº 5 Páginas 268 - 275

Resumo: En | Texto: En | PDF: En

ABSTRACT Background: Prognostic factors in previously healthy young patients with COVID-19 remained understudied. Objective: The objective of the study was to identify factors associated with in-hospital death or need for invasive mechanical ventilation (IMV) in young (aged ≤ 65 years) and previously healthy patients with COVID-19. Methods: We conducted a prospective cohort study that included patients admitted with COVID-19. The primary outcome was in-hospital death/need for IMV. Secondary outcomes included need for IMV during follow-up, days on IMV, length of stay (LOS), hospital-acquired pneumonia/ventilator-associated pneumonia (HAP/VAP), and pulmonary embolism (PE). Bivariate and multivariate analyses were performed. Results: Among 92 patients, primary outcome occurred in 16 (17%), death in 12 (13%), need for IMV in 16 (17%), HAP/VAP in 7 (8%), and PE in 2 (2%). Median LOS and IMV duration were 7 and 12 days, respectively. Independent associations were found between the primary outcome and male sex (Adjusted odds ratio [aOR] 7.1, 95%CI 1.1-46.0, p < 0.05), D-dimer levels > 1000ng/mL (aOR 9.0, 95%CI 1.6-49.1, p < 0.05), and RT-PCR Ct-value ≤ 24 on initial swab samples (aOR 14.3, 95%CI 2.0-101.5, p < 0.01). Conclusions: In young and non-comorbid COVID-19 patients, male sex, higher levels of D-dimer, and low SARS-CoV-2 RT-PCR Ct-value on an initial nasopharyngeal swab were independently associated with increased in-hospital mortality or need for IMV.

https://doi.org/10.24875/ric.22000162

12.

Neumotórax espontáneo bilateral en primigestante adolescente, reporte de un caso
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Beltrán-Acosta, Sandra L.

; Bandera-Barros, Liliana M.

; Torres-Berra, Katerin C.

; Fuentes-Sandoval, María A.

; Ortiz-Ávila, María A.

Revista chilena de obstetricia y ginecología

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Out 2022, Volume 87 Nº 5 Páginas 360 - 364

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

Abstract Spontaneous pneumothorax is an extremely rare pathology during pregnancy. It is defined as the presence of air inside the pleural cavity that can mainly generate chest pain and dyspnea. This pathology has a low incidence and prevalence in pregnancy, but a high rate of recurrence with a good prognosis for the mother and the fetus if it is diagnosed early and managed early. It is related to risk factors such as Valsalva maneuvers performed during labor, in addition to comorbidities such as smoking, longilinear biotype, among others, so it is very important to have an adequate history and evaluation of the physical examination. The obstetrician must be attentive to chest pain symptoms associated with dyspnea in pregnant women during labor and delivery, suspect this pathology and take it into account as a differential diagnosis. It is vitally important to have a multidisciplinary management composed of the gynecologist-obstetrician, internist, pulmonologist, neonatologist, including the support of an intensive care unit to avoid maternal-perinatal complications that may be associated with spontaneous pneumothorax.

Resumen El neumotórax espontáneo es una patología extremadamente rara durante la gestación. Se define como la presencia de aire dentro de la cavidad pleural que puede generar principalmente dolor torácico y disnea. Esta patología tiene unas bajas incidencia y prevalencia en el embarazo, pero es relevante por una alta tasa de recurrencia, con un buen pronóstico para la madre y el feto si es tempranamente diagnosticada y oportunamente manejada. Se relaciona con factores de riesgo como las maniobras de Valsalva efectuadas durante el trabajo de parto, además de con comorbilidad como el tabaquismo, y con el biotipo longilíneo, entre otros, por lo que son muy importantes una adecuada anamnesis y la evaluación de la exploración física. El obstetra debe sospecharlo ante la clínica de dolor torácico asociado a disnea en gestantes en el trabajo de parto y el parto, y tenerlo en cuenta como diagnóstico diferencial. Es de vital importancia tener un manejo multidisciplinario compuesto por ginecoobstetra, internista, neumólogo y neonatólogo, incluido el apoyo por una unidad de cuidado intensivo para evitar complicaciones materno-perinatales que se puedan asociar al neumotórax espontáneo.

https://doi.org/10.24875/rechog.22000046

13.

Comparación de los resultados funcionales post operatorios en enucleación prostática con láser holmio, fotovaporización prostática con láser verde y resección transuretral de próstata en el tratamiento de la hiperplasia prostática obstructiva
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Cruz-Ordoñez, Sandra Xochiquetzal

; Chein-Vázquez, María Fernanda

; Victorio-Vargas, Omar Dimas

; Cervantes-Palma, César

; Lemus-Hernández, Luis Alberto

; Toledo-Díaz, Mario Alberto

; Torres-Gómez, Jesús Javier

; Bravo-Castro, Edgar Iván

; Díaz-Gómez, Cristóbal

; Martínez-Alonso, Iván Azael

; Campos-Salcedo, José Gadú

Revista mexicana de urología

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Jun 2022, Volume 82 Nº 3 elocation e07

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

Abstract Objective: To compare the functional results in patients undergoing transurethral resection of the prostate (TURP), photovaporization of the prostate with GreenLight ® laser (FTV) and prostate enucleation with Holmium laser (HOLEP), for the treatment of benign prostatic obstruction at the Central Military Hospital. Material and methods: The international index of prostate symptomatology questionnaire (IPSS), Uroflowmetry (Qmax), pre and post void ultrasonography (PVR) were applied to patients undergoing TURP, VTF and HOLEP pre and postoperatory from January 2018 to March 2019. Shapiro-Wilks tests were analyzed for quantitative variables; parametric behavioral data were analyzed with ANOVA tests, and non-parametric data were analyzed with Mann-Whitney and Kruskal-Wallis U tests. GraphPad PRISM v7.0 statistical package was used. Results: 46 patients underwent to TURP, 62 to HOLEP and 17 to VFT were evaluated, removing those who did not achieve complete postoperative follow-up; describing the demographic characteristics, the most frequent comorbidities and the parameters evaluated preoperatively. At follow-up, HOLEP was slightly better than FTV or TURP; without finding statistical significance between the groups, observing an important improvement in the reference values of IPSS, Qmax and PVR after surgery in all populations. Conclusions: No superiority of any technique was proven in short-term postoperative functional results, so we propose to perform long-term studies, considering adding trans and postoperative parameters in order to demonstrate superiority of these techniques.

Resumen Objetivo: Comparar los resultados funcionales en pacientes operados de resección transuretral de próstata (RTUP), fotovaporización prostática con láser GreenLight ® (FTV) y enucleación prostática con láser Holmio (HOLEP), en el tratamiento de la obstrucción prostática benigna en el Hospital Central Militar. Material y métodos: Se aplicó cuestionario de índice internacional de sintomatología prostática (IPSS), Uroflujometría (Qmax), ultrasonografía vesical pre y postmiccional (PVR) a los pacientes llevados a RTUP, FTV y HOLEP de manera pre y post operatoria de enero del 2018 a marzo del 2019. Se analizaron las pruebas descriptivas y de normalidad de Shapiro-Wilks para las variables cuantitativas; los datos de comportamiento paramétrico se analizaron con pruebas de ANOVA, y los no paramétricos se analizaron con pruebas de U de Mann-Whitney y Kruskal-Wallis. Se utilizó paquete estadístico GraphPad PRISM v7.0. Resultados: Se evaluaron 46 pacientes de RTUP, 62 de HOLEP y 17 de FTV, eliminando aquellos que no lograron seguimiento postoperatorio completo; describiendo las características demográficas, las comorbilidades más frecuentes y los parámetros evaluados de manera preoperatoria. En el seguimiento, HOLEP fue ligeramente mejor que FTV o RTUP; sin encontrar significancia estadística entre los grupos, observando mejoría marcada de los valores de referencia de IPSS, Qmax y PVR pre y post operatorios en todas las poblaciones. Conclusiones: No se comprobó superioridad de alguna de las técnicas en cuanto a resultados funcionales postoperatorios a corto plazo, por lo que se propone realizar estudios a largo plazo, considerando agregar parámetros trans y postoperatorios a fin de demostrar superioridad de estas técnicas.

https://doi.org/10.48193/revistamexicanadeurologa.v82i3.743

14.

Recomendaciones de práctica clínica: diagnóstico de osteomielitis en pie diabético
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Carro, Gabriela Verónica

; Saurral, Rubén Nicolás

; Méndez, Elizabet Gladys

; Dituro, Claudio Fabián

; Varela, Cristina

; David, Raúl Alejandro

; Witman, Érica Lorena

; Torres, Julio Cesar

; Iluminati, Gabriela Silvana

; Casen, María Alejandra

; Alterini, Pablo

; Losada, María Victoria Dicatarina

; Kremer Sendros, Sandra Aixa

; Issa, Claudia

; Badías, Florencia

; Braver, José Daniel

; Romero, Elida

; Vega, Walter Agustín

; Carrió, Luisa Mabel

Revista de la Sociedad Argentina de Diabetes

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Mai 2022, Volume 56 Supl. 1 Páginas 36 - 39

Resumo: Es En | Texto: Es En | PDF: Es | PDF: En

Resumen La osteomielitis (OM) es una complicación de las úlceras en pie diabético que habitualmente es subdiagnosticada y tratada en forma tardía e inadecuada. La demora en el tratamiento de estos pacientes aumenta el riesgo de amputación. En esta revisión, se analiza la bibliografía actual acerca del diagnóstico de OM y se realizan recomendaciones en base a la misma, y a las características de los pacientes, los insumos y las posibilidades en nuestro medio.

Abstract Diabetic foot osteomyelitis (OM) is a diabetic foot ulcer complication. Usually, it is misdiagnosed and the treatment is delayed and inadequate. Delaying the treatment of these patients rises the risk of amputation. In this revision, current bibliography about this topic is updated and clinical practice recommendations are done, based on the publications and adapted to the characteristics of our country.

15.

Effect of Tocilizumab in Mortality among Patients with Severe and Critical Covid-19: Experience in a Third-Level Medical Center
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Martínez-Guerra, Bernardo A.

; de-León-Cividanes, Nereyda A.

; Tamez-Torres, Karla M.

; Román-Montes, Carla M.

; Rajme-López, Sandra

; Ortiz-Brizuela, Edgar

; Aguilar-Salinas, Carlos A.

; Sierra-Madero, Juan

; Sifuentes-Osornio, José

; Ponce-de-León, Alfredo

; González-Lara, María F.

Revista de investigación clínica

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Fev 2022, Volume 74 Nº 1 Páginas 40 - 50

Resumo: En | Texto: En | PDF: En

ABSTRACT Background: Trials evaluating safety and efficacy of tocilizumab in coronavirus disease 19 (COVID-19) show contradictory results. Objective: The objective of the study was to evaluate the effect of tocilizumab in hospital mortality among patients with severe COVID-19 in a third-level medical center. Methods: This prospective cohort study included patients with severe and critical COVID-19. Primary outcome was death during hospitalization. Secondary outcomes included invasive mechanical ventilation (IMV), days on IMV, ventilator-free days (VFDs), length of hospital stay (LOS), and development of hospital-acquired infections (HAIs). Bivariate, multivariate, and propensity score matching analysis were performed. Results: During the study period, 99/794 (12%) patients received tocilizumab. Male patients, health care workers, and patients with increased inflammatory markers received tocilizumab more frequently. No difference in hospital mortality was observed between groups (34% vs. 34%, p = 0.98). Tocilizumab was not independently associated with mortality. No significant treatment effects were observed in propensity score analysis. IMV was more frequent (46% vs. 11%, p < 0.01) and LOS was longer (12 vs. 7 days, p < 0.01) in the tocilizumab group, reflecting increased severity. Although HAIs were more frequent in the tocilizumab group (22% vs. 10%, p < 0.01), no difference was seen after adjusting for IMV (38% vs. 40%, p = 0.86). Conclusions: In our study, tocilizumab was not associated with decreased hospital mortality among patients with severe COVID-19.

https://doi.org/10.24875/ric.21000404 27 downloads

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