Pesquisa | SciELO

Resumen Introducción. La vainilla se cultiva en agreoecosistemas bajo diversa intensidad de manejo, con características ambientales particulares que podrían ser desfavorables para la orquídea. Las condiciones atmosféricas son importantes, debido al cambio climático. Objetivo. Caracterizar las condiciones climáticas y microclimáticas de tres sistemas productivos de vainilla (Vanilla planifolia Jacks. ex Andrews). Materiales y métodos. El estudio se realizó en tres sistemas productivos de vainilla ubicados en Veracruz y Oaxaca, México. Se utilizaron tres intensidades de manejo: a) acahual, bajo sombra de diversas especies arbóreas; b) monocultivo, intercalado con una especie arbórea y c) malla sombra (con sombra artificial). Se abarcó un año de monitoreo (diciembre-2020 a noviembre-2021), que incluyó cuatro temporadas climáticas, dos frías y dos cálidas. Se midieron variables climáticas (de la región) y microclimáticas (de la parcela): temperatura (T), humedad relativa (HR) y radiación fotosintéticamente activa (RFA, solo en el microclima), con estaciones automatizadas; además se calculó el déficit de presión de vapor (DPV). Resultados. A escala diaria, las condiciones climáticas como microclimáticas en el acahual fueron más favorables para el cultivo de vainilla en las cuatro temporadas evaluadas; el monocultivo y la malla sombra experimentaron condiciones de humedad y temperatura fuera de los requerimientos agroclimáticos de la vainilla, principalmente en marzo-mayo (MAM), con Tmax >32 °C y HR <80 %. A escala horaria, las condiciones más cálidas y secas estuvieron en el monocultivo y la malla sombra en diciembre-febrero (DEF) y MAM; mientras que en junio-agosto (JJA) y septiembre-noviembre (SON) en acahual y malla sombra; el DPV (>2 kPa) indicó periodos más prolongados de estrés hídrico en estos sistemas. Conclusiones. El monocultivo y la malla sombra presentaron condiciones de humedad y temperatura desfavorables para la vainilla, con más periodos de estrés hídrico. El acahual presentó las condiciones climáticas y microclimáticas más convenientes para el cultivo de vainilla.

Abstract Introduction. Vanilla is grown in agroecosystems under varying management intensities, with particular environmental characteristics that could be unfavorable for the orchid. Atmospheric conditions are important due to climate change. Objective. To characterize the climatic and microclimatic conditions of three vanilla (Vanilla planifolia Jacks. ex Andrews) production systems. Materials and methods. The study was carried out in three vanilla production systems located in Veracruz and Oaxaca, Mexico. Three management intensities were used: a) acahual, under the shade of various tree species; (b) monoculture, interspersed with an arboreal species; and (c) shade mesh (with artificial shade). One year of monitoring was carried out (December-2020 to November-2021), which included four climatic seasons, two cold and two warm. Climatic variables (region) and microclimatic (plot) variables were measured: temperature (T), relative humidity (HR), and photosynthetically active radiation (PAR, only in the microclimate), with automated stations; in addition, the vapor pressure deficit (VPD) was calculated. Results. On a daily scale, climatic conditions as microclimatic in the acahual were more favorable for vanilla cultivation in the four seasons evaluated; the monoculture and the shade mesh experienced humidity and temperature conditions outside the agroclimatic requirements of vanilla, mainly in March-May (MAM), with Tmax >32 °C and RH <80 %. On an hourly scale, the warmest and driest conditions were in monoculture and shade mesh in December-February (DEF) and MAM; while in June-August (JJA) and September-November (SON) in acahual and shade mesh; VPD (>2 kPa) indicated longer periods of water stress in these systems. Conclusions. The monoculture and the shade mesh presented unfavorable humidity and temperature conditions for vanilla, with more periods of water stress. The acahual presented the most convenient climatic and microclimatic conditions for the cultivation of vanilla.

https://doi.org/10.15517/am.v33i2.48682

[SciELO Preprints] - Which lesions are at higher risk of developing colorectal carcinomas: superficially elevated serrated lesions or depressed lesions?
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Parada , Artur Adolfo Venco, Filadelfio Euclydes Varca-Neto, Miguel Reynaldo Degiovani, Matheus El Ibrahim, Roberto Polett, Paula Bechara Brito, Helcio Pedrosa Marchioro, Stella Karina Sare , Heloisa de Fátima Malafaia, Osvaldo

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Data de publicação: 2022-06-14

Resumo: En Pt

Background: There are lesions that are still being missed in colonoscopy. Many of those could be superficially elevated serrated lesions or depressed ones. Aim: Compare the histopathological characteristics of these lesions and their risks for submucosal carcinoma. Methods: Retrospective, cross-sectional and observational study comparing 217 superficially elevated serrated lesions larger than 5 mm resected by colonoscopies (G1) with 558 depressed lesions (G2). Results: In G1, 217 lesions were found in 12653 colonoscopies (1,7%); in G2, 558 lesions in 36174 colonoscopies (1.5%). In G1 there were 63.4% of women and in G2 no gender predominance. Average size was G1 with 16.2 mm and G2 with 9.2 mm (plt;0.001). G1 predominated on the proximal colon and G2 on the distal and rectum (plt;0.001). In G1 there were 214 low-grade intramucosal neoplasia (98,6%) and three high grade intramucosal neoplasia (1,4%). Excluding 126 hyperplastic polyps and considering 91 sessile serrated adenomas in G1, was observed 88 (96.7%) with low-grade intramucosal neoplasia and three (3.3%) high-grade intramucosal neoplasia; in G2, 417 low-grade intramucosal neoplasia (74,7%), 113 high-grade intramucosal neoplasia (20,3%) and 28 (5,0%) submucosal adenocarcinomas (plt;0.001). Conclusion: Depressed lesions significantly had more high-grade intramucosal neoplasia and more invasive carcinomas for the submucosal layer than superficially elevated serrated lesions and more than superficially elevated sessile serrated adenomas.

Racional: Há ainda lesões que podem ser perdidas nas colonoscopias. Muitas delas poderiam ser serrilhadas superficialmente elevadas ou deprimidas. Objetivo: Comparar as características histopatológicas destas lesões e seus riscos para carcinoma invasivo para a submucosa. Método: Estudo retrospectivo, transversal, observacional comparando 217 lesões serrilhadas superficialmente elevadas com mais de 5 mm e ressecadas por colonoscopias (G1) com 558 lesões deprimidas (G2). Resultados: As 217 lesões do G1 foram encontradas em 12653 colonoscopias (1,7%) enquanto as 558 do G2 ocorreram dentre 36174 colonoscopias (1,5%). No G1, 63,4% eram mulheres e no G2 não houve predominância de gênero. O tamanho médio foi no G1, 16,2 mm e no G2, 9,2 mm (plt;0,001). G1 predominaram no cólon proximal e G2, no distal e reto (plt;0,001). No G1, ocorreram 214 (98,6%) neoplasias mucosas de baixo grau e três de alto grau (1,4%). Excluídos 126 pólipos hiperplásicos e considerados os 91 adenomas sésseis serrilhados, no G1 observou- se 88 (96,7%) neoplasias mucosas de baixo grau e três (3,3%) de alto grau, e no G2, 417 (74,7%) neoplasias mucosas de baixo grau 113 (20,3%) de alto grau e 28 (5,0%) adenocarcinomas invadindo a submucosa (plt;0,001). Conclusões: As lesões deprimidas apresentaram significativamente mais neoplasias mucosas de alto grau e carcinomas invasivos para a submucosa do que as serrilhadas superficialmente elevadas e mais do que os adenomas sésseis serrilhados superficialmente elevados.

https://doi.org/10.1590/SciELOPreprints.4272

Rendimiento del sistema Bethesda en el diagnóstico citopatológico del nódulo tiroideo en un centro universitario (Hospital de Clínicas) de Uruguay, diez años de experiencia
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Guarneri, Carolina

; Parada, Ulises

; Fernández, Lucía

; Taruselli, Roberto

; Cazabán, Luis

Revista Médica del Uruguay

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Jun 2022, Volume 38 Nº 2 elocation e207

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

Resumen: Introducción: el estudio citológico por punción ecoguiada se caracteriza por ser rápido, confiable, mínimamente invasivo y rentable. Permite reducir procedimientos quirúrgicos innecesarios y clasifica apropiadamente a los pacientes con nódulos sospechosos o malignos para una intervención quirúrgica oportuna. Objetivo: el objetivo del presente estudio es evaluar la correlación citológica-anatomopatológica del sistema Bethesda en un centro universitario (Hospital de Clínicas) de Uruguay. Metodología: se realizó un estudio de tipo observacional, retrospectivo, descriptivo, basado el análisis de historias clínicas de pacientes sometidos a cirugía tiroidea en el Hospital de Clínicas, en el período comprendido entre enero de 2008 y diciembre de 2018. Resultados: del total inicial de 119 pacientes, 93 cumplieron los criterios de inclusión. El rango de edad de la muestra fue entre 15 y 79 años. Del total de puncionados 49,5% (46) fueron informados como benignos y 50,5% (47) como malignos. Se calculó en forma global una sensibilidad de 96% (0,96) con IC 1,0-0,90, especificidad de 98% (0,97) con IC 1,0-0,93, un VPP de 98% y VPN de 96%. La sensibilidad diagnóstica para la categoría IV, V y VI fue de 96%, con una especificidad de 100, 94 y 100% respectivamente. Conclusiones: el sistema Bethesda aplicado a las PAAF de nódulos tiroideos potencia la certeza diagnóstica y asiste en la decisión terapéutica. En nuestra institución contamos con una buena correlación citopatológica, similar a otros trabajos reportados en la literatura, lo que permite predecir adecuadamente el riesgo de malignidad y facilitar la toma de decisiones.

Summary: Introduction: the ultrasound-guided fine needle aspiration biopsy (FNAB) study is characterized by being fast, reliable, minimally invasive, and cost-effective. It reduces unnecessary surgical procedures and appropriately classifies patients with suspicious or malignant nodules for timely surgical intervention. Objective: the objective of this study is to evaluate the cytological-pathological correlation of the Bethesda System in a university center (Hospital de Clínicas) in Uruguay. Methodology: an observational, retrospective, descriptive study was carried out, based on the analysis of medical records of patients undergoing thyroid surgery at the Hospital de Clínicas, in the period between January 2008 and December 2018. Results: of the initial total of 119 patients, 93 met the inclusion criteria. The age range of the sample was between 15 and 79 years. Of the total of punctured, 49.5% (46) were reported as benign and 50.5% (47) as malignant. A sensitivity of 96% (0.96) with CI 1.0-0.90, specificity of 98% (0.97) with CI 1.0-0.93, a PPV of 98% and NPV of 96%. The diagnostic sensitivity for categories IV, V and VI was 96% with a specificity of 100, 94 and 100% respectively. Conclusions: the Bethesda system applied to FNA of thyroid nodules enhances diagnostic certainty and assists in the therapeutic decision. In our institution we have a good cytopathological correlation, similar to other works reported in the literature. This makes it possible to adequately predict the risk of malignancy and facilitate decision-making.

Resumo: Introdução: o estudo citológico por punção guiada por ultrassom caracteriza-se por ser rápido, confiável, minimamente invasivo e de baixo custo. Permite reduzir procedimentos cirúrgicos desnecessários e classificar adequadamente pacientes com nódulos suspeitos ou malignos para intervenção cirúrgica oportuna. Objetivo: avaliar a correlação citológico-patológica do Sistema Bethesda em um centro universitário (Hospital de Clínicas) no Uruguai. Metodologia: foi realizado um estudo observacional, retrospectivo, descritivo, baseado na análise de prontuários de pacientes submetidos à cirurgia de tireoide no Hospital de Clínicas, no período janeiro de 2008-dezembro de 2018. Resultados: do total inicial de 119 pacientes, 93 preencheram os critérios de inclusão. A faixa etária da amostra foi entre 15 e 79 anos. Do total de punções, 49,5% (46) foram relatadas como benignas e 50,5% (47) como malignas. No geral, uma sensibilidade de 96% (0,96) com IC 1,0-0,90, uma especificidade de 98% (0,97) com IC 1,0-0,93, um VPP de 98% e VPN de 96%. A sensibilidade diagnóstica para as categorias IV, V e VI foi de 96% com especificidade de 100, 94 e 100%, respectivamente. Conclusões: o sistema Bethesda aplicado à PAAF de nódulos tireoidianos aumenta a certeza diagnóstica e auxilia na decisão terapêutica. Em nossa instituição temos uma boa correlação citopatológica, semelhante a outros trabalhos relatados na literatura. Isso permite prever adequadamente o risco de malignidade e facilitar a tomada de decisão.

https://doi.org/10.29193/rmu.38.2.7

Aptitud climática para Coffea arabica L. ante eventos climáticos extremos: Importancia de la cobertura arbórea
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Parada-Molina, Paulo César

; Barradas-Miranda, Víctor Luis

; Ortiz Ceballos, Gustavo

; Cervantes-Pérez, Juan

; Cerdán Cabrera, Carlos Roberto

Scientia Agropecuaria

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Mar 2022, Volume 13 Nº 1 Páginas 53 - 62

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

Abstract Negative impacts of climate change are expected in the production of Coffea arabica L. one of the most commercialized tropical agroproducts in the world. However, most studies work with global circulation models, being of little use in making decisions on the scale of farm management. Given this, the objective of this study was to identify the suitability for the cultivation of C. arabica in the face of climate change and how tree cover mitigates the impacts of climate change in an agroforestry plot. The indices of climatic extremes were calculated (1961 to 2016 for Coatepec; 1985 to 2016 for Briones) and a trend analysis was carried out (Mann-Kendall). The temperature inside a plot, and on an open site, was monitored for two years (2017-2019). This was related to the climatic requirements of C. Arabica. Trends of increase (p < 0.05) of the minimum and minimum extreme annual temperatures were identified in the two stations near the plot (0.24 and 0.69 °C·decade-1 in Coatepec and 0.46 and 0.79 °C·decade-1 in Briones). The maximum temperature did not present significant increases, reducing the thermal amplitude. Both annual and seasonal precipitation shows trends of increase in intensity. All these conditions are still suitable for the cultivation of C. arabica. At the plot scale, the importance of tree cover is demonstrated, which in this agroforestry system allows to reduce the maximum temperature by 1.9 °C compared to an open site. Tree cover has also made it possible to mitigate extreme events.

Resumen Se prevén impactos negativos del cambio climático en la producción de Coffea arabica L. uno de los agroproductos tropicales más comercializados en el mundo. Sin embargo, la mayoría de los estudios trabajan con modelos de circulación global, siendo poco útiles en la toma de decisiones a escala de manejo de una finca. Ante ello, el objetivo de este estudio fue identificar la aptitud para el cultivo de C. arabica ante el cambio climático y cómo la cobertura arbórea mitiga los impactos del cambio climático en una parcela agroforestal. Se calcularon los índices de extremos climáticos (1961 a 2016 para Coatepec; 1985 a 2016 para Briones) y se realizó un análisis de tendencias (Mann-Kendall). Se monitoreó la temperatura en el interior de una parcela, y en un sitio abierto, durante dos años (2017-2019). Esto se relacionó con los requerimientos climáticos de C. arabica. Se identificaron tendencias de incremento (p<0,05) de las temperaturas mínima y mínima extrema anual en las dos estaciones cercanas a la parcela (0,24 y 0,69 °C·década-1 en Coatepec y 0,46 y 0,79 °C·década-1 en Briones). La temperatura máxima no presentó incrementos significativos, reduciendo la amplitud térmica. Tanto la precipitación anual y estacional muestran tendencias de incremento en intensidad. Todas estas condiciones siguen siendo aptas para el cultivo de C. arabica. A escala de parcela, se demuestra la importancia de la cobertura arbórea, que en este sistema agroforestal permite reducir la temperatura máxima 1,9 °C en comparación con un sitio abierto. Asimismo, la cobertura arbórea ha permitido mitigar eventos extremos.

https://doi.org/10.17268/sci.agropecu.2022.005

WHICH LESIONS ARE AT HIGHER RISK OF DEVELOPING COLORECTAL CARCINOMAS: SUPERFICIALLY ELEVATED SERRATED LESIONS OR DEPRESSED LESIONS?
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PARADA, Artur Adolfo

; VENCO, Filadelfio Euclydes

; VARCA-NETO, Miguel Reynaldo

; EL IBRAHIM, Roberto

; POLETTI, Paula Bechara

; BRITO, Helcio Pedrosa

; SARE, Heloisa de Fátima

; MALAFAIA, Osvaldo

ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo)

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2022, Volume 35 elocation e1716

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

ABSTRACT BACKGROUND: There are lesions that are still being missed in colonoscopy. Many of those could be superficially elevated serrated lesions or depressed ones. AIMS: The aim of this study was to compare the histopathological characteristics of these lesions and their risks for submucosal carcinoma. METHODS: This is a retrospective, cross-sectional, and observational study comparing 217 superficially elevated serrated lesions larger than 5 mm resected by colonoscopies (G1) with 558 depressed lesions (G2). RESULTS: In G1, 217 lesions were found in 12,653 (1.7%) colonoscopies; in G2, 558 lesions were found in 36,174 (1.5%) colonoscopies. In G1, 63.4% were women and in G2, there was no gender predominance. The average size of G1 was 16.2 mm and G2 was 9.2 mm (p<0.001). G1 predominated on the proximal colon and G2 on the distal and rectum (p<0.001). In G1, there were 214 (98.6%) low-grade intramucosal neoplasia and 3 (1.4%) high-grade intramucosal neoplasia. Excluding 126 hyperplastic polyps and considering 91 sessile serrated adenomas in G1, we observed 88 (96.7%) low-grade intramucosal neoplasia and 3 (3.3%) high-grade intramucosal neoplasia; in G2, we observed 417 (74.7%) low-grade intramucosal neoplasia, 113 (20.3%) high-grade intramucosal neoplasia, and 28 (5.0%) submucosal adenocarcinomas (p<0.001). CONCLUSION: Depressed lesions significantly had more high-grade intramucosal neoplasia and more invasive carcinomas in the submucosal layer than superficially elevated serrated lesions and more than superficially elevated sessile serrated adenomas.

RESUMO RACIONAL: Há ainda lesões que podem ser perdidas nas colonoscopias. Muitas delas poderiam ser serrilhadas superficialmente elevadas ou deprimidas. OBJETIVO: Comparar as características histopatológicas destas lesões e seus riscos para carcinoma invasivo para a submucosa. MÉTODO: Estudo retrospectivo, transversal, observacional comparando 217 lesões serrilhadas superficialmente elevadas com mais de 5 mm e ressecadas por colonoscopias (G1) com 558 lesões deprimidas (G2). RESULTADOS: As 217 lesões do G1 foram encontradas em 12.653 colonoscopias (1,7%) enquanto as 558 do G2 ocorreram dentre 36.174 colonoscopias (1,5%). No G1, 63,4% eram mulheres e no G2 não houve predominância de gênero. O tamanho médio foi no G1, 16,2 mm e no G2, 9,2 mm (p<0,001). G1 predominaram no cólon proximal e G2, no distal e reto (p<0,001). No G1, ocorreram 214 (98,6%) neoplasias mucosas de baixo grau e três de alto grau (1,4%). Excluídos 126 pólipos hiperplásicos e considerados os 91 adenomas sésseis serrilhados, no G1 observou- se 88 (96,7%) neoplasias mucosas de baixo grau e três (3,3%) de alto grau, e no G2, 417 (74,7%) neoplasias mucosas de baixo grau 113 (20,3%) de alto grau e 28 (5,0%) adenocarcinomas invadindo a submucosa (p<0,001). CONCLUSÕES: As lesões deprimidas apresentaram significativamente mais neoplasias mucosas de alto grau e carcinomas invasivos para a submucosa do que as serrilhadas superficialmente elevadas e mais do que os adenomas sésseis serrilhados superficialmente elevados.

https://doi.org/10.1590/0102-672020220002e1716

Hemileia vastatrix: una prospección ante el cambio climático
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Parada-Molina, Paulo César

; Cerdán, Carlos Roberto

; Ortiz Ceballos, Gustavo

; Barradas Miranda, Víctor Luis

; Cervantes-Pérez, Juan

Ecosistemas y recursos agropecuarios

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2020, Volume 7 Nº 3 elocation e2507

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

ABSTRACT. Hemileia vastatrix, the fungus that causes the most devastating disease of Coffea arabica L. (coffee rust), could increase its altitude distribution due to climate change, causing adverse effects. Therefore, realized a prospecting of the effect of climate change on the incidence of H. vastatrix. This study was conducted out taking data from the coffee growing area of Coatepec, Veracruz, Mexico. The trends of maximum, minimum temperature and climatic extremes indexes (1961-2010) proposed by the Team of Experts on Climate Change Detection and Indices (ETCCDI) were analyzed. Trends were related to conditions suitable for the proliferation of Hemileia vastatrix. The area has experienced an increase in the maximum temperature (0.2 °C decade-1) and minimum (0.3 °C decade-1). Annual rainfall and daily intensity have increased, increasing the susceptibility to incidence and severity from coffee rust and other fungal diseases.

RESUMEN. Hemileia vastatrix, hongo causante de la enfermedad más devastadora de Coffea arabica L. (roya del café), podría incrementar su distribución altitudinal debido al cambio climático, causando efectos adversos. Por ello, el objetivo fue se realizar una prospección del efecto del cambio climático en la incidencia de H. vastatrix. La investigación se realizó tomando datos de la zona cafetalera de Coatepec, Veracruz, México. Se analizaron las tendencias de temperatura máxima, mínima e índices de extremos climáticos de 1961 al 2010, propuestos por el Equipo de Expertos en Detección e Índices de Cambio Climático (ETCCDI). Las tendencias se relacionaron con las condiciones para la proliferación de H. vastatrix. La zona ha experimentado un aumento de temperatura máxima (0.2 °C década-1) y mínima (0.3 °C década-1); la precipitación y su intensidad diaria se han incrementado, aumentando la susceptibilidad a la incidencia y severidad de la roya del café y de otras enfermedades fúngicas.

https://doi.org/10.19136/era.a7n3.2507 35 downloads

Coma mixedematoso como presentación de hipotiroidismo
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Albín-Cano, Roberto Gabriel

; Parada-Valdés, Alexis

; Ramírez-Quintana, José O.

Acta Médica Costarricense

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Dez 2019, Volume 61 Nº 4 Páginas 187 - 189

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

Resumen Se presenta un caso de una paciente de 69 años de edad y sin antecedentes personales o familiares de patología tiroidea alguna, que asiste con un estado convulsivo de aparición súbita, de hemicuerpo derecho y relajación esfinteriana, asociado, además, a trastornos del estado de conciencia, bradicardia, bradipnea y edema de difícil Godet en miembros inferiores. Los exámenes complementarios mostraron acidosis respiratoria, hiposecreción de T4 y elevación de la hormona estimulante de la tiroides por retroalimentación negativa. Estos resultados corroboraron el diagnóstico presuntivo de coma mixedematoso. Se emprendió el tratamiento hormonal correspondiente con levotiroxina, al cual respondió satisfactoriamente y fue egresada a los 24 días de su ingreso, pendiente de valoración por el especialista de endocrinología.

Abstract We present the case of a 69-year-old female patient with no personal or family history of any thyroid disease, who attends with a convulsive state of sudden onset, right hemibody and sphincter relaxation, also associated with disorders of the state of consciousness, bradycardia, bradypnea and edema of difficult godet in lower limbs. Complementary analyses showed respiratory acidosis, hyposecretion of T4 and elevation of the thyroid stimulating hormone by negative feedback. These results corroborated the presumptive diagnosis of myxedema coma. The corresponding hormonal treatment with levothyroxine was undertaken, to which it responded satisfactorily and was discharged 24 days after admission, pending evaluation by the endocrinology specialist for an outpatient hormone replacement therapy.

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Respuestas cardiovasculares de mujeres con obesidad mórbida sometidas a un test ergoespirométrico con ergómetro de brazo
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Rosa, Felipe Monnerat Marino

; Linhares, Renato Vidal

; Martinez, Luiz Fernando Parada

; Quaresma, José Carlos do Valle

; Simão, Roberto Fares

; Carneiro, João Regis Ivar

; Braulio, Valéria Bender

; Fernandes Filho, José

Revista Colombiana de Cardiología

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Out 2017, Volume 24 Nº 5 Páginas 532 - 536

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

Resumen Introducción: la obesidad mórbida es una enfermedad de etiología multifactorial, de gran prevalencia en el mundo, que guarda relación directa con otras comorbilidades. Objetivo: analizar las respuestas cardiovasculares de pacientes mujeres con obesidad mórbida, a través de un test de esfuerzo máximo para la estratificación del riesgo y la prescripción de ejercicio. Método: se incluyeron trece pacientes con obesidad grado III, de sexo femenino, con edad entre 20 a 40 años, que fueron sometidas a un test ergoespirométrico en el cicloergómetro de miembros superiores para la verificación y el análisis de la frecuencia cardiaca, la presión arterial y el doble producto. Resultados: las pacientes con media de edad de 34,7 ± 5,1 años tenían índice de masa corporal de 46,5 ± 3,8 kg/m2. Alcanzaron una frecuencia cardíaca máxima de 168,2 ± 14,6 lpm, sin respuesta hipertensiva al esfuerzo, y presión arterial de 171,1 ± 22,2 mm Hg (sistólica) x 87,5 ± 4,2 mm Hg (diastólica). El doble producto máximo encontrado fue de 28.662,2 ±3.644,1 mm Hg.lpm. Conclusión: de acuerdo con los resultados de este estudio se observó una reducción de la frecuencia cardiaca, la presión arterial y el doble producto cardiaco, compatible con el esfuerzo esperado para el test.

Abstract Introduction: Morbid obesity is a condition of multifactorial origin with a high prevalence worldwide, and has a direct relationship with other illnesses. Objective: To analyse the cardiovascular responses of morbid obese women using a máximum stress test for stratifying risk and the prescribing of exercise. Method: The study included 13 patients with Grade III obesity. All were women between 20 and 40 years of age. Their arms were subjected to an ergospirometry test on the cycle ergometry in order to check and analyse heart rate, blood pressure, and the double product. Results: The patients had a mean age of 34.7 ± 5.1 years, and a mean body mass index of46.5 ± 3.8 kg/m2. A maximum heart rate of 168.2 ± 14.6 bpm was achieved, with no hypertensive response to the stress, and blood pressure of 171.1 ± 22.2 mm Hg (systolic) x 87.5 ± 4.2 mm Hg (diastolic). The maximum double product found was 28,662.2 ±3,644.1 mm Hg.bpm. Conclusion: In the results of this study is observed reduction of heart rate, blood pressure, and the double cardiac product, compatible with the expected effort for the test.

https://doi.org/10.1016/j.rccar.2017.05.012 788 downloads

Estudio y manejo de nódulos tiroideos por médicos no especialistas. Consenso SOCHED
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Tala, Hernán

; Díaz, René E.

; Domínguez Ruiz-Tagle, José Miguel

; Sapunar Zenteno, Jorge

; Pineda, Pedro

; Arroyo Albala, Patricia

; Barberán, Marcela

; Cabané, Patricio

; Cruz Olivos, Francisco

; Gac, Patricio E.

; Glasinovic Pizarro, Andrea

; González, Hernán E.

; Grob, Francisca

; Hidalgo Valle, Maria Soledad

; Jaimovich, Rodrigo

; Lanas, Alejandra

; Liberman, Claudio

; Lobo Guiñez, Maite

; Madrid, Arturo

; Moreno Seguel, Marcela

; Mosso, Lorena

; Munizaga, Fernando C.

; Ortiz Parada, Eugenia

; Osorio Gonnet, Fernando

; Slater Morales, Jeannie

; Solar, Antonieta

; Stehr, Carlos

; Vásquez Rodríguez, Félix

; Véliz, Jesús

; Villaseca Najarian, Roberto

; Wohllk, Nelson

Revista médica de Chile

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Ago 2017, Volume 145 Nº 8 Páginas 1028 - 1037

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

The thyroid nodule is a frequent cause of primary care consultation. The prevalence of a palpable thyroid nodule is approximately 4-7%, increasing up to 67% by the incidental detection of nodules on ultrasound. The vast majority are benign and asymptomatic, staying stable over time. The clinical importance of studying a thyroid nodule is to exclude thyroid cancer, which occurs in 5 to 10% of the nodules. The Board of SOCHED (Chilean Society of Endocrinology and Diabetes) asked the Thyroid Study Group to develop a consensus regarding the diagnostic management of the thyroid nodule in Chile, aimed at non-specialist physicians and adapted to the national reality. To this end, a multidisciplinary group of 31 experts was established among university academics, active researchers with publications on the subject and prominent members of scientific societies of endocrinology, head and neck surgery, pathology and radiology. A total of 14 questions were developed with key aspects for the diagnosis and subsequent referral of patients with thyroid nodules, which were addressed by the participants. In those areas where the evidence was insufficient or the national reality had to be considered, the consensus opinion of the experts was used through the Delphi methodology. The consensus was approved by the SOCHED board for publication.

https://doi.org/10.4067/s0034-98872017000801028 28478 downloads

10.

Nondestructive characterization of epoxy matrix composites reinforced with Luffa lignocellulosic fibers
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Quinayá, Diana Carolina Parada

; D’almeida, Jose Roberto Moraes

Matéria (Rio de Janeiro)

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2017, Volume 22 Nº 2 elocation e11848

Resumo: En | Texto: En | PDF: En

ABSTRACT Luffa Cylindrica is a tropical plant from the Cucurbitaceae family, whose fruit becomes very fibrous when fully ripened. The lignocellulosic sponges of Luffa can be suitable for use as reinforcement of epoxy matrix composites, because they have a morphology with spatial 3-D arrangement as well as are eco-friendly materials (biodegradable, and high available) and have economic advantages compared to composites reinforced with synthetic fibers derived from non-renewable sources. Surface modification of the Luffa fibers was carried out by hornification and mercerization methods and was verified by Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), and X-Ray Diffraction (XRD). For the fabrication of non-biodegradable composites by hand layup technique, the sponges were impregnated with an epoxy resin based on bisphenol in a metallic mold with dimensions 150×200×3 mm3, followed by compression at 5 MPa. The dynamic modulus of the fabricated composites were measured using the nondestructive impulse excitation technique (IET), according to the ASTM E1876 standard. Bar specimens with dimensions 80×25×3 mm3 of the laminated composites were tested at room temperature, with Sonelastic® (ATCP) equipment and its associated software. Results showed that the Luffa/epoxy composites has higher loss factor and dynamic modulus when the Luffa fiber is treated before the composite fabrication. The highest Young's modulus obtained was 4.05±0.31 GPa for mercerized Luffa/epoxy. For hornificated Luffa/epoxy composite the highest loss factor and shear modulus values obtained, were 0.0337±0.003 and 1.46±0.13 GPa respectively.

https://doi.org/10.1590/s1517-707620170002.0181 1079 downloads

11.

Comparative analysis of endoscopic and histopathological features of superficial elevated lesions resected by endoscopic mucosal resection in the distal and proximal colon
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PARADA, ARTUR ADOLFO

; RIBAS, CARMEN AUSTRALIA PAREDE MARCONDES

; VENCO, FILADELFIO EUCLYDES

; ARDENGH, JOSÉ CELSO

; REIS, MARIANA AMARAL

; DEGIOVANI, MATHEUS

; VARCA-NETO, MIGUEL REYNALDO

; DIGER, NILDEDE RODRIGUES

; IBRAHIM, ROBERTO EL

; CORDOVA, KASSIA FERNANDA

; FAGUNDES, MARÍLIA DA CRUZ

; MOREIRA, HAMILTON

; KUBRUSLY, LUIZ FERNANDO

Revista do Colégio Brasileiro de Cirurgiões

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Jun 2016, Volume 43 Nº 3 Páginas 178 - 184

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

RESUMO Objetivo: comparar aspectos endoscópicos e histopatológicos de lesões superficialmente elevadas, com um ou mais centímetros de diâmetro, diagnosticadas por videocolonoscopias e ressecadas por mucosectomias do cólon distal com as do cólon proximal. Métodos: estudo foi retrospectivo, transversal, observacional, envolvendo 8075 videocolonoscopias. Avaliou-se 166 mucosectomias em 145 pacientes com lesões superficialmente elevadas com diâmetro igual ou maior do que 1cm. Resultados: a prevalência de lesões foi menor no G1 do que no G2 (34,9% x 65%). A média de idade, a distribuição por sexo e o tamanho (1,9cm no G1 e 2cm no G2, p=0,921) foram semelhantes. Não houve diferenças das superfícies em relação à localização (p=0,575). Considerando neoplasia intraepitelial de baixo grau, neoplasia intraepitelial de alto grau (incluindo carcinomas) e hiperplásicas, não houve diferença (p=0,527), assim como quando foram divididas as lesões neoplásicas em serrilhadas e não serrilhadas (p=0,124). Excluindo-se 13 lesões hiperplásicas e duas com carcinomas, 124 (82,1%) foram não serrilhadas e 27 (17,9%) serrilhadas. Conclusão: não foram observadas diferenças significativas entre os aspectos endoscópicos e os histopatológicos das lesões superficialmente elevadas, com 1cm ou mais de diâmetro, ressecadas por mucosectomia do cólon distal em relação ao proximal. Embora não significante, há tendência à associação entre a localização da lesão e a presença de características serrilhadas.

ABSTRACT Objective: to compare endoscopic and histopathologic features of superficial, elevated lesions with one or more centimeters in diameter, diagnosed by videocolonoscopy on the distal and proximal colon, and subjected to mucosal resection. Methods: we conducted a retrospective, cross-sectional, observational study involving 8,075 videocolonoscopies. From this total, we evaluated 166 mucosectomies in 145 patients with superficial, elevated lesions with a diameter equal to or greater than 1cm. Results: the lesion prevalence was lower in G1 than in G2 (34.9% vs. 65%). The mean age, gender distribution and size (1.9cm in G1 versus 2.0cm in G2, p=0.921) were similar. There was no difference of mucosal surfaces in relation to the location (p=0.575). Considering Intraepithelial neoplasias, both the low grade, high grade (including carcinomas) and hyperplasic ones showedd no difference (p=0.527), nor did the neoplastic lesions when divided into serrated and non-serrated (p=0.124). Excluding 13 hyperplastic lesions and two carcinomas, 124 (82.1%) were non-serrated and 27 (17.9%), serrated. Conclusion: were found no significant differences between endoscopic and histopathological aspects of superficial, elevated lesions of 1cm or more in diameter in distal colon compared with the proximal, when resected by mucosectomy. Although not significant, there was a tendency of association between the location of the lesion and the presence of serrated features.

https://doi.org/10.1590/0100-69912016003010 5485 downloads

12.

Prevalence of Patients With Cleft Lip and Palate who were Treated at the San Borja Arriarán Clinical Hospital in Santiago Chile, within the AUGE Healthcare Plan
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Cordero Carrasco, Erita

; Correa Hernández, Sebastián

; Pantoja Parada, Roberto

International journal of odontostomatology

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Dez 2015, Volume 9 Nº 3 Páginas 469 - 473

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

Cleft lip and palate (CLP) are congenital defects caused by faulty fusion of the embryonic processes that participate in the formation of oral and nasal cavities, this leads to a number of functional, social and psychological alterations. The incidence is estimated at 1/700 live birth, resulting in a high cost to the public health system. In 2005 these malformations were incorporated in the Regime of Explicit Health Guarantees (Garantías Explícitas en Salud GES), also known as Plan AUGE, a health program developed in Chile, that has been conceived and implemented to guarantee access, quality, protection and recovery for certain pathologies. To determine which clefts are more prevalent in patients who were treated in the Hospital and compare these results are consistent with international literature, along with which gender is more affected and their association with other syndromes. Medical records of 169 patients with CLP were reviewed. Their gender, type of cleft according to its anatomical classification and their association with other syndromes were recorded. Ten percent of the CLP were associated with syndromes, there being a higher prevalence among male infants (56.8%) than females (43.2%). Incidence of cleft lip, with or without cleft palate, was higher than the incidence of isolated cleft palate. CLP has a heterogeneous distribution. This creates the need to know, which clefts are more prevalent in our patients and to compare with other results.

Las Fisuras Labio Palatinas (FLP) son defectos congénitos causados por una mala fusión de los procesos embrionarios que participan en la formación de las cavidades oral y nasal, que generan una seria de alteraciones funcionales, sociales y pscicológicas. La incidencia de las FLP se estima en 1/700 nacidos vivos, lo que genera un importante gasto a nivel de salud pública. En el 2005 éstas malformaciones fueron incorporadas al "Régimen de Garantías Explícitas en Salud (GES)", también conocido como Plan AUGE, éste es un programa de salud concebido y creado para garantizar el acceso, calidad, protección y recuperación de ciertas patologías. Determinar que fisuras con más prevalentes en pacientes que han sido tratados en el Hospital y comparar estos resultados con la literatura internacional, además determinar que género se ve más afectado y si existe asociación con síndromes. Se revisaron las fichas clínicas de 169 pacientes con FLP. Registrándose el género, el tipo FLP de acuerdo a su clasificación anatómica y la asociación con otros síndromes. Resultados: 10% de las FLP presentaban otro síndrome asociado. Hay una mayor incidencia en el género masculino (56,8%) que en el femenino (43.2%). Las fisuras de labio, con o sin compromiso del paladar, son más frecuentes que las fisuras labiales aisladas. Las FLP tienen una distribución heterogénea. Esto crea la necesidad de conocer que fisuras son más prevalentes en nuestros pacientes con el objetivo de compararlos con otros resultados.

2024 downloads

13.

ENCOMS: Argentinian survey in cost of illness and unmet needs in multiple sclerosis
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Ysrraelit, Celica

; Caceres, Fernando

; Villa, Andres

; Marcilla, Marcela Parada

; Blanche, Jorge

; Burgos, Marcos

; Parera, Ignacio Casas

; Colombo, Oscar

; Crespo, Ernesto

; Deri, Norma

; Labal, Patricio

; Maluendez, Monica

; Martinez, Alejandra

; Melcon, Mario

; Nofal, Pedro

; Reich, Edgardo

; Sinay, Vladimiro

; Tarulla, Adriana

; Vetere, Santiago

; Barboza, Andres

; Rey, Roberto

; Moreno, Margarita

; Bacile, Alejandra

; Rojas, Juan I.

; Kuperman, Gaston

; Resk, Mercedes

; Seifer, Gustavo

; Machinicki, Gerardo

; Cuneo, Jorge

Arquivos de Neuro-Psiquiatria

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Mai 2014, Volume 72 Nº 5 Páginas 337 - 343

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

The objective of the study was to assess the cost of multiple sclerosis (MS) patients in Argentina categorized by disease severity using a societal perspective.Method:Cross-sectional study including MS patients from 21 MS centers in 12 cities of Argentina. Patients were stratified by disease severity using the expanded disability status scale (EDSS) (group 1 with EDSS score between 0 and 3; group 2 with EDSS >3 and <7; group 3 with EDSS ≥7). Direct and indirect costs were analyzed for the second quarter of 2012 from public sources and converted to US Dollars.Results:266 patients were included. Mean annual cost per MS patient was USD 36,025 (95%CI 31,985-38,068) for patients with an EDSS between 0-3; USD 40,705 (95%CI 37,199-46,300) for patients with EDSS >3 and <7, and USD 50,712 (95%CI 47,825-62,104) for patients with EDSS ≥7.Conclusions:This is the first Argentine study evaluating the costs of MS considering disease severity.

El objetivo del estudio fue evaluar el costo de los pacientes con esclerosis múltiple (EM) en Argentina categorizados por severidad de la enfermedad.Método:Estudio de corte transversal que incluyó pacientes con EM en 12 ciudades de Argentina. Los pacientes se estratificaron según expanded disability status scale (EDSS) (grupo 1 EDSS entre 0 y 3; grupo 2 EDDS >3 y <7; grupo 3 EDSS ≥7). Los costos directos e indirectos fueron analizados para el segundo trimestre de 2012 y convertidos a dólares estadounidenses.Resultados:266 pacientes fueron incluidos. El coste medio anual por paciente con EM fue de USD 36,025 (31,985-38,068 IC95%) para los pacientes con un EDSS entre 0-3; USD 40,705 (37,199-46,300 IC95%) para los pacientes con EDSS >3 y <7 y USD 50,712 (47,825-62,104 IC95%) para los pacientes con EDSS ≥7.Conclusiones:Primer estudio argentino evaluar los costes de la EM considerado la gravedad de la enfermedad.

https://doi.org/10.1590/0004-282X20140016 5177 downloads

14.

O limite da ação setorial: federalismo, saúde e vigilância sanitária
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Parada, Roberto

Ciência & Saúde Coletiva

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Nov 2010, Volume 15 Supl. 3 Páginas 3318 - 3328

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1401 downloads

15.

O limite da ação setorial: federalismo, saúde e vigilância sanitária
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Parada, Roberto

Ciência & Saúde Coletiva

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Nov 2010, Volume 15 Supl. 3 Páginas 3318 - 3328

Resumo: Pt | Texto: Pt | PDF: Pt

490 downloads

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