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The effective relief of postsurgical pain in patients undergoing knee arthroscopy is important to allow the initiation of activities of daily living. The objective of this study is to demonstrate the analgesic efficacy of dexmedetomidine as an adjuvant added to ropivacaine by the intra-articular route. METHOD: Seventy patients underwent knee arthroscopy which were randomly assigned into two groups (n=35). The RD group received ropivacaine 1.5mg/kg plus dexmedetomidine 1µg/kg intra-articularly. Group R received ropivacaine 1.5mg/kg intra-articularly. The analgesic effect was evaluated by measuring the intensity of pain (VAS score) and the duration of analgesia. RESULTS: A longer duration of the analgesic effect was observed in the RD group (655min) compared to the R group (318min) being statistically significant (p=0.03). CONCLUSION: Dexmedetomidine as an adjuvant to intra-articular ropivacaine improves the quality and duration of postoperative analgesia in patients undergoing knee arthroscopy.
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INTRODUCTION: Infant feeding has specific qualitative and quantitative characteristics. The influence of parents on food intake is crucial in the development of habits and an adequate nutritional state. OBJECTIVE: To evaluate eating behavior, dietary characteristics, and nutritional status of children between 6 to 18 months. SUBJECTS AND METHOD: Cross-sectional descriptive study in 199 children. Using convenience sampling, demographic and anthropometric data were recorded for nutritional status, and dietary history, through a 24-hour reminder for dietary behavior and food sufficiency. The Student's t-test and one-way ANOVA were applied for continuous variables and the chi-square test for the categori cal ones. RESULTS: 54.8% were women. Regarding nutritional status, 21.1% were overweight and 7.6% obese. 56.8% of the children had meal numbers according to their age. The average energy intake was 652.9 ± 224.2 calories per day. The intake of energy and macronutrients was significantly higher in children not consuming breast milk and aged 12 to 18 months. The energy, lipids, and carbohydrates adequacy in girls was significantly higher than in boys. 83.1% of food consumption was habitual for this age group. CONCLUSION: In eating behavior, we observed that 4 out of 10 children have meal numbers higher than suggested for their ages. Regarding dietary sufficiency, there is a higher intake in children with normal nutritional status, without breastfeeding, and between 12 and 18 months. Despite the high prevalence of obesity, it was lower than that observed at the national level.
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Comportamento Alimentar , Estado Nutricional , Criança , Estudos Transversais , Dieta , Feminino , Humanos , Lactente , Masculino , Leite HumanoRESUMO
OBJETIVO: Describir y analizar la experiencia clínica, resultados y complicaciones según Clavien-Dindo de las histeroscopías quirúrgicas realizadas en pabellón. MÉTODOS: Estudio descriptivo retrospectivo de las histeroscopías quirúrgicas realizadas entre el 1 de enero de 2012 y 1 de enero de 2018 en el Hospital Clínico de la Universidad de Chile. RESULTADOS: Hubo 613 histeroscopías quirúrgicas en el período analizado, de las cuales 593 cumplieron con los requisitos para incluirse en este estudio. Las indicaciones para realizar el procedimiento fueron: pólipo endometrial (56,3%), miomas uterinos (22,1%), sangrado uterino anormal (4,3%) y otras (17,7%). Hubo un 89,2% de concordancia entre el diagnóstico intraoperatorio y el estudio histopatológico. Se pesquisaron 11 hiperplasias endometriales sin atipías, 3 con atipías y 10 neoplasias malignas. Cabe destacar que, del total de pólipos resecados, hubo 8 casos (2,5%) con potencial malignidad (atipías o neoplasia maligna). Según la clasificación Clavien Dindo, hubo 22 complicaciones intraoperatorias (3,7%) grado I o II, cuyo diagnóstico fue realizado en el acto quirúrgico. No hubo complicaciones grado III o más (severas, con reintervención). CONCLUSIÓN: La tasa de éxito, correlación histeroscópica - anatomopatológica final y complicaciones fue similar a lo publicado en la literatura disponible. El diagnóstico intraoperatorio de la lesión y su reparación en el mismo acto quirúrgico, disminuye el riesgo de morbimortalidad de las pacientes, haciéndolo similar al de una paciente sin complicación. Utilizar la clasificación Clavien Dindo para evaluar las complicaciones nos permitirá en adelante, objetivar, mejorar aspectos del procedimiento quirúrgico y plantear estrategias de prevención y manejo de dichos eventos adversos.
OBJECTIVE: To describe and analyze the clinical experience, results and complications according to Clavien-Dindo of surgical hysteroscopies performed in the ward. METHODS: Retrospective descriptive study of surgical hysteroscopies performed between January 1, 2012 and January 1, 2018 at the Hospital Clinico of the University of Chile. RESULTS: There were 613 surgical hysteroscopies in the analyzed period of which 593 fulfilled the requirements to be included in this study. The indications to perform the procedure were: endometrial polyp (56.3%), uterine fibroids (22.1%), abnormal uterine bleeding (4.3%) and others (17.7%). There was an 89.2% agreement between the intraoperative diagnosis and the histopathological study. Eleven endometrial hyperplasias without atypia, 3 with atypia and 10 malignant neoplasms were investigated. It should be noted that, of the total of resected polyps, there were 8 cases (2.5%) with potential malignancy (atypia or malignant neoplasm). According to the Clavien Dindo classification, there were 22 intraoperative complications (3.7%) grade I or II, the diagnosis of which was made during surgery. There were no grade III or more complications (severe, with reoperation). CONCLUSION: The success rate, final hysteroscopic-pathological correlation and complications was similar to that published in the available literature. The intraoperative diagnosis of the lesion and its repair in the same surgical act, reduces the risk of morbidity and mortality of the patients, making it similar to that of a patient without complication. Using the Clavien Dindo classification to assess complications will henceforth allow us to objectify, improve aspects of the surgical procedure and propose strategies for the prevention and management of such adverse events.
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Humanos , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Adulto Jovem , Histeroscopia/estatística & dados numéricos , Doenças dos Genitais Femininos/cirurgia , Complicações Pós-Operatórias/classificação , Índice de Gravidade de Doença , Histeroscopia/efeitos adversos , Epidemiologia Descritiva , Estudos Retrospectivos , Resultado do Tratamento , Seleção de Pacientes , Doenças dos Genitais Femininos/patologia , Tempo de InternaçãoRESUMO
The ability of lactobacilli isolated from feedlot cattle environment to differentially modulate the innate immune response triggered by Toll-like receptors (TLRs) activation in bovine intestinal epithelial (BIE) cells was evaluated. BIE cells were stimulated with Lactobacillus mucosae CRL2069, Lactobacillus acidophilus CRL2074, Lactobacillus fermentum CRL2085 or Lactobacillus rhamnosus CRL2084 and challenged with heat-stable pathogen associated molecular patterns (PAMPs) from enterotoxigenic Escherichia coli (ETEC) to induce the activation of TLR4 or with polyinosinic:polycytidylic acid (poly(I:C)) to activate TLR3. Type I interferons, cytokines, chemokines and negative regulators of TLR signalling were studied by RT-PCR. L. mucosae CRL2069 significantly reduced the expression of interleukin (IL)-8 and monocyte chemoattractant protein (MCP)-1 in BIE cells in the context of TLR3 activation. L. mucosae CRL2069 also reduced the expression of tumour necrosis factor-α, IL-ß, MCP-1, and IL-8 in heat-stable ETEC PAMPs-challenged BIE cells. In addition, reduced expressions of IL-6, MCP-1, and IL-8 were found in BIE cells stimulated with L. rhamnosus CRL2084, although its effect was significantly lower than that observed for the CRL2069 strain. The reduced levels of pro-inflammatory factors in BIE cells induced by the CRL2069 and CRL2085 strains was related to their ability of increasing the expression of TLR negative regulators. L. mucosae CRL2069 significantly improved the expression of A20-binding inhibitor of NFκ-B activation 3 (ABIN-3), interleukin-1 receptor-associated kinase M (IRAK-M) and mitogen-activated protein kinase 1 (MKP-1) while L. rhamnosus CRL2084 augmented ABIN-3 expression in BIE cells. The results of this work suggest that among the studied strains, L. mucosae CRL2069 was able to regulate TLR3-mediated innate immune response and showed a remarkable capacity to modulate TLR4-mediated inflammation in BIE cells. The CRL2069 strain induce the up-regulation of three TLR negative regulators that would influence nuclear factor kB and mitogen-activated protein kinases signalling pathways while reducing the expression of pro-inflammatory cytokines and chemokines. Therefore, L. mucosae CRL2069 is an interesting immunobiotic candidate for the protection of the bovine host against TLR-mediated intestinal inflammatory damage.
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Células Epiteliais/imunologia , Células Epiteliais/microbiologia , Imunidade Inata , Intestinos/imunologia , Lactobacillales/imunologia , Probióticos/administração & dosagem , Receptores Toll-Like/imunologia , Animais , Bovinos , Linhagem Celular , Quimiocinas/genética , Quimiocinas/imunologia , Citocinas/genética , Citocinas/imunologia , Inflamação , Mucosa Intestinal/imunologia , Intestinos/citologia , Lactobacillales/isolamento & purificação , Lactobacillus/imunologia , Lactobacillus acidophilus/imunologia , Lacticaseibacillus rhamnosus/imunologia , Transdução de Sinais , Receptor 3 Toll-Like/genética , Receptor 3 Toll-Like/imunologia , Receptor 4 Toll-Like/genética , Receptor 4 Toll-Like/imunologia , Receptores Toll-Like/genéticaRESUMO
TITLE: Sindrome de deficiencia de GLUT-1.
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Erros Inatos do Metabolismo dos Carboidratos/diagnóstico , Proteínas de Transporte de Monossacarídeos/deficiência , Ataxia/etiologia , Erros Inatos do Metabolismo dos Carboidratos/complicações , Erros Inatos do Metabolismo dos Carboidratos/dietoterapia , Erros Inatos do Metabolismo dos Carboidratos/genética , Criança , Doença Crônica , Diagnóstico Tardio , Deficiências do Desenvolvimento/etiologia , Diarreia/etiologia , Dieta Cetogênica , Epilepsia Resistente a Medicamentos/etiologia , Eletroencefalografia , Genes Dominantes , Transportador de Glucose Tipo 1/deficiência , Transportador de Glucose Tipo 1/genética , Heterozigoto , Humanos , Masculino , Proteínas de Transporte de Monossacarídeos/genéticaRESUMO
Previously, we reported that the non-viable immunomodulatory Bifidobacterium infantis MCC12 and Bifidobacterium breve MCC1274 strains (paraimmunobiotic bifidobacteria) were able to increase the protection against rotavirus infection in bovine intestinal epithelial (BIE) cells. In order to gain insight into the influence of paraimmunobiotic bifidobacteria on the innate antiviral immune response of BIE cells, their effect on the transcriptomic response triggered by Toll-like receptor 3 (TLR3) activation was investigated. By using microarray technology and qPCR analysis, we obtained a global overview of the immune genes involved in the innate antiviral immune response in BIE cells. Activation of TLR3 by poly(I:C) in BIE cells significantly increased the expression of interferon (IFN)-α and IFN-ß, several interferon-stimulated genes, cytokines, and chemokines. It was also observed that both paraimmunobiotic bifidobacteria differently modulated immune genes expression in poly(I:C)-challenged BIE cells. Most notable changes were found in genes involved in antiviral defence (IFN-ß, MX1, OAS1X, MDA5, TLR3, STAT2, STAT3), cytokines (interleukin (IL)-6), and chemokines (CCL2, CXCL2, CXCL6) that were significantly increased in bifidobacteria-treated BIE cells. B. infantis MCC12 and B. breve MCC1274 showed quantitative and qualitative differences in their capacities to modulate the innate antiviral immune response in BIE cells. B. breve MCC1274 was more efficient than the MCC12 strain to improve the production of type I IFNs and antiviral factors, an effect that could be related to its higher ability to protect against rotavirus replication in BIE cells. Interestingly, B. infantis MCC12 showed a remarkable anti-inflammatory effect. The MCC12 strain was more efficient to reduce the expression of inflammatory cytokines and chemokines (IL-16, IL-20, CX3CL1) when compared with B. breve MCC1274. These results provided valuable information for the deeper understanding of the antiviral immune response of intestinal epithelial cells as well as the host-paraimmunobiotic interaction in the bovine host.
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Bifidobacterium/imunologia , Células Epiteliais/imunologia , Perfilação da Expressão Gênica , Imunidade Inata , Mucosa Intestinal/imunologia , Probióticos/metabolismo , Rotavirus/imunologia , Animais , Bovinos , Linhagem Celular , Fatores Imunológicos/metabolismo , Modelos Biológicos , Reação em Cadeia da Polimerase em Tempo RealRESUMO
Helicobacter pylori infection is associated with important gastric pathologies. An aggressive proinflammatory immune response is generated in the gastric tissue infected with H. pylori, resulting in gastritis and a series of morphological changes that increase the susceptibility to cancer development. Probiotics could present an alternative solution to prevent or decrease H. pylori infection. Among them, the use of immunomodulatory lactic acid bacteria represents a promising option to reduce the severity of chronic inflammatory-mediated tissue damage and to improve protective immunity against H. pylori. We previously isolated Lactobacillus fermentum UCO-979C from human gastric tissue and demonstrated its capacity to reduce adhesion of H. pylori to human gastric epithelial cells (AGS cells). In this work, the ability of L. fermentum UCO-979C to modulate immune response in AGS cells and PMA phorbol 12-myristate 13-acetate (PMA)-differentiated THP-1 (human monocytic leukaemia) macrophages in response to H. pylori infection was evaluated. We demonstrated that the UCO-979C strain is able to differentially modulate the cytokine response of gastric epithelial cells and macrophages after H. pylori infection. Of note, L. fermentum UCO-979C was able to significantly reduce the production of inflammatory cytokines and chemokines in AGS and THP-1 cells as well as increase the levels of immunoregulatory cytokines, indicating a remarkable anti-inflammatory effect. These findings strongly support the probiotic potential of L. fermentum UCO-979C and provide evidence of its beneficial effects against the inflammatory damage induced by H. pylori infection. Although our findings should be proven in appropriate experiments in vivo, in both H. pylori infection animal models and human trials, the results of the present work provide a scientific rationale for the use of L. fermentum UCO-979C to prevent or reduce H. pylori-induced gastric inflammation in humans.
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Infecções por Helicobacter/tratamento farmacológico , Infecções por Helicobacter/imunologia , Helicobacter pylori/fisiologia , Imunidade Inata/efeitos dos fármacos , Limosilactobacillus fermentum/fisiologia , Probióticos/farmacologia , Animais , Citocinas/genética , Citocinas/imunologia , Células Epiteliais/efeitos dos fármacos , Células Epiteliais/imunologia , Células Epiteliais/microbiologia , Infecções por Helicobacter/microbiologia , Helicobacter pylori/imunologia , Humanos , CamundongosRESUMO
INTRODUCCIÓN: La incontinencia urinaria es un problema muy frecuente. El diagnóstico diferencial incluye varias condiciones. La Incontinencia Urinaria de Esfuerzos es la más común y su tratamiento es fundamentalmente quirúrgico. Debido a que el diagnóstico de Incontinencia Urinaria de Esfuerzo no es confiable cuando se basa en la historia y las complicaciones asociadas a la cirugía son potencialmente complejas de manejar, se vuelve imperativo objetivar el diagnóstico. MÉTODO: Se presenta un descripción retrospectiva de los resultados obtenidos de la examinación de pacientes con incontinencia urinaria mediante evaluación urodinámica simple y estandarizada. RESULTADOS: Se evaluó a 303 pacientes, de las cuales el 75,3% finalmente fue sometida a cirugía antiincontinencia. En el resto de las pacientes se encontró desde evaluación normal a variadas disfunciones miccionales. CONCLUSIONES: Es importante la implementación de herramientas de evaluación objetivas y estandarizadas como medida de seguridad y de gestión de listas de espera. Nuestros resultados son similares a los reportados en la literatura.
INTRODUCTION: Urinary incontinence is a very frequent problem. The differential diagnosis includes some conditions. Stress urinary incontinence is the most common condition and its treatment is primarily surgical. Because the diagnosis of stress urinary incontinence is not reliable when it is based on the history and the complications associated with surgery are potentially complex to manage, it becomes imperative to objectively demonstrate the diagnosis. METHODS: We present a retrospective description of the results obtained from the examination of patients with urinary incontinence through simple and standardized urodynamic evaluation. RESULTS: A total of 303 patients were evaluated, of whom 75,25% were finally submitted to anti-incontinence surgery. In the rest of the patients it was found from normal evaluation to varied voiding dysfunctions. CONCLUSIONS: It is important to implement objective and standardized evaluation tools as a safety measure and management of the waiting lists. Our results are similar to those reported by literature.
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Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Incontinência Urinária por Estresse/diagnóstico , Incontinência Urinária por Estresse/fisiopatologia , Urodinâmica , Estudos RetrospectivosRESUMO
Hyperadrenocorticism (HAC) and diabetes mellitus (DM) are two diseases that can occur concurrently in dogs. The objective of this study was to evaluate the coexistence of HAC and DM, and the risk factors involved that could contribute to the development of DM in dogs with HAC. A total of 235 dogs with HAC were studied and, according to their fasting glycemia, they were divided into three groups: <5.6mmol/L, between 5.6 and 10.08mmol/L and >10.08mmol/L. The following parameters were evaluated: age, gender, cause of HAC, body condition, glycemia, total cholesterol, triglycerides, urinary cortisol:creatinin ratio (UCCR) and survival time. A 13.61% concurrence of HAC and DM was observed. Dogs with a fasting glycemia >5.6mmol/L, with dislipemia, with Pituitary-Dependent Hyperadrenocorticism, UCCR >100×10-6 and non-castrated females showed a higher risk of developing DM. The development of DM in dogs with HAC reduces the survival time.
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Hiperfunção Adrenocortical/veterinária , Diabetes Mellitus/veterinária , Doenças do Cão/patologia , Hiperfunção Adrenocortical/complicações , Hiperfunção Adrenocortical/patologia , Animais , Glicemia , Diabetes Mellitus/patologia , Cães , Feminino , Masculino , Fatores de RiscoRESUMO
Resumen ANTECEDENTES: en 80% de las ocasiones el cáncer de ovario epitelial se diagnostica en etapas III y IV, la recurrencia locorregional es una característica frecuente en esta neoplasia maligna. La mortalidad asociada es una de las más importantes de todas las neoplasias malignas en la mujer, en todo el mundo. OBJETIVO: documentar las metástasis de cáncer de ovario a piel, la incidencia, presentación clínica, y pronóstico. CASO CLÍNICO: paciente de 67 años, con un carcinoma seroso papilar etapa IIIC de ovario; se efectuaron cirugía óptima y cuatro ciclos de quimioterapia (carboplatino y paclitaxel), con 21 meses de intervalo libre de enfermedad. La paciente tenía: pápulas y nódulos inexplicables en la piel del abdomen y las piernas. La biopsia incisional documentó la recaída a la piel, sin otro sitio de metástasis a distancia. La paciente recibió tratamiento sistémico paliativo. CONCLUSIONES: las metástasis cutáneas de cáncer de ovario tienen una presentación clínica pleomórfica y distribución amplia en todo el organismo, con frecuencia afectan la región abdominal o torácica; las metástasis cutáneas de ovario tienen una expectativa de vida limitada, a pesar del tratamiento sistémico.
Abstract BACKGROUND: 80% of the cases of epithelial ovarian cancer are diagnosed in stages III and IV, locoregional recurrence is a frequent feature of this malignant neoplasm. Associated mortality is one of the most important of all malignant neoplasms in women, all over the world. OBJECTIVE: To document the metastasis of ovarian cancer to skin, incidence, clinical presentation, and prognosis. CLINICAL CASE: 67-year-old patient with papillary serous carcinoma stage IIIC of ovary; Optimal surgery and four cycles of chemotherapy (carboplatin and paclitaxel) were performed, with a 21-month disease-free interval. The patient had unexplained papules and nodules on the skin of the abdomen and legs. Incisional biopsy documented relapse to the skin, with no other site of distant metastases. The patient received systemic palliative treatment. CONCLUSIONS: Cutaneous metastases from ovarian cancer have a pleomorphic clinical presentation and widespread distribution throughout the body, often affecting the abdominal or thoracic region; cutaneous ovarian metastases imply a limited life expectancy, despite systemic treatment.