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Background and Aim: To develop species-specific probiotics for poultry, it is ideal to obtain these probiotic microorganisms directly from the intestinal tract of broiler and egg-laying chicks in production environments to ensure adaptation to actual conditions. This study aimed to isolate lactic acid bacteria (LAB) from the intestinal tract of broiler and egg-laying chicks to determine their probiotic potential. Materials and Methods: Twenty-five Ross-308 broilers and 25 Isa Brown egg-laying chicks were raised until days 42 and 120, respectively; they were housed in an individual poultry building. Lactic acid bacteria were isolated and identified from the small intestine mucus of broiler and layer chicks and then evaluated based on resistance to acidic pH levels, bile salt concentration, and antagonistic activity against wild strains of Escherichia coli and Salmonella spp. selected strains with probiotic potential were identified by polymerase chain reaction and confirmed by rDNA sequencing. Results: One hundred and fifty Gram-positive isolates were obtained; 28% (42) were catalase and oxidase negative and biochemical identification was made by crystal system: 76.2% (32) Enterococcus spp., 16.6% (7) Lactococcus spp., and 7.2% (3) Streptococcus spp.; and evaluated for hemolysin production; tolerance to low pH and bile salts, and antagonistic potential were carried out. Molecular characterization yielded 56% (24) Enterococcus faecium, and 44% (18) Enterococcus faecalis. About 81% (34) of strains were without vancomycin resistance genes criterion. Conclusion: This study isolated and characterized 36 strains of LAB with probiotic qualities, from the intestines of broiler and egg-laying chicks, selecting E. faecium, Enterococcus avium, and Enterococcus casseliflavus, Lactococcus garviae as promising strains for further in vitro and in vivo research.
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BACKGROUND: Creativity is a highly valued quality in different fields. Despite this, it is rarely included in the curricula of medical careers. AIM: To assess creative thinking among undergraduate medical students. MATERIAL AND METHODS: Sixty-seven students aged 18 to 31 years (45% women) from the first (16), third (26) and seventh year (25) of medical school answered a sociodemographic questionnaire and the Torrance Test of Creative Thinking (TTCT). RESULTS: Median creativity index according to age was in percentile 52 (range 2-99). Percentiles for fluency, originality, elaboration, abstraction of titles and resistance for premature closure were 31, 32, 79, 53 and 17 respectively. There were no significant differences between students of different levels (p = 0.73). CONCLUSIONS: In this group of students, there is a high performance in elaboration and a low score in Resistance to premature closure.
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Criatividade , Estudantes de Medicina , Adolescente , Adulto , Estudos Transversais , Educação Médica , Feminino , Humanos , Masculino , Inquéritos e Questionários , Adulto JovemRESUMO
INTRODUCCIÓN: El síndrome de apnea obstructiva del sueño (SAHOS) es más prevalente en hombres, los estudios poblacionales muestran una relación de 2:1, sin embargo, en los estudios clínicos la frecuencia llega a ser de hasta de 6:1. Estas diferencias en el ambiente clínico puede ser consecuencia de variaciones en el reporte de síntomas en hombres comparados con mujeres. OBJETIVO: Evaluar las diferencias de género en la presentación clínica de apnea obstructiva de sueño. Pacientes: Estudio transversal de pacientes sometidos a una poligrafía respiratoria (PR) con sospecha clínica de SAHOS. Se recolectaron datos demográficos, antropométricos, comorbilidades y las variables de la PR. Se realizó estudio t de student, Mann-Whitney y chi-cuadrado según correspondiera. RESULTADOS: Se incluyeron 1.044 pacientes: edad promedio 53,2 ± 14 años, 76% hombres. Las mujeres con SAHOS poseen mayor IMC (32,2 ± 6,1 vs 30,8 ± 5,0; p=0,002) y edad (61,4 ± 12,2 vs 52,6 ± 13,9; p < 0,001), pero menor circunferencia de cuello (CC) (38,1 ± 3,6 vs 43,2 ± 3,3; p < 0,001), además, presentan menor IA/H y menor duración de las apneas. No hubo diferencias en los síntomas clásicos de apneas presenciada y somnolencia diurna, sin embargo, describen más frecuentemente insomnio, cefalea matinal, depresión y uso de fármacos hipnóticos. CONCLUSIONES: Las mujeres al momento del diagnóstico son de mayor edad y más obesas, aunque presentan una CC menor, presentan una enfermedad más leve, pero refieren más fatiga, cansancio, cefalea e insomnio. Debemos estar alerta en la presentación clínica diferente de las mujeres para mejorar la sospecha diagnóstica.
INTRODUCTION: Obstructive sleep apnea (OSA) is more prevalent in men, population studies show a ratio of 2:1, however in clinical studies the frequency is as high as 6:1. These differences in the clinical setting may be a consequence of variations in the reporting of symptoms in men compared to women. OBJECTIVE: To evaluate gender differences between women and men with recent diagnosis of OSA. Patients: A cross-sectional, study of patients undergoing home sleep apnea testing (HSAT) with clinical suspicion of OSA. Demographic, anthropometric, comorbidities and HSAT variables were collected. We performed t student analysis, Mann-Whitney test or chi square test as appropriate. RESULTS: 1,044 patients were included: mean age 53.2 ± 14 years, 76% men. Women with OSA have a higher BMI (32.2 ± 6.1 vs 30.8 ± 5.0, p = 0.002), were older (61.4 ± 12.2 vs 52.6 ± 13.9, p <0.001), but have a lower neck circumference (NC) (38.1 ± 3.6 vs. 43.2 ± 3.3, p <0.001). The women presented lower AHI and shorter duration of apneas. Although the classic symptoms of apnea and daytime sleepiness showed no differences, women reported more frequently insomnia, morning headache, depression and use of hypnotic drugs. CONCLUSIONS:: Clinical differences between gender are present at time of diagnosis. Woman are older and more obese, although they have a lower NC. They have a milder disease, but they refer to be more tired, headache, insomnia and depression. We must be alert in the different clinical presentation of women to improve the diagnostic suspicion.
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Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Polissonografia/métodos , Apneia Obstrutiva do Sono/epidemiologia , Índice de Massa Corporal , Distribuição de Qui-Quadrado , Comorbidade , Fatores Sexuais , Antropometria , Estudos Transversais , Estudos Retrospectivos , Estatísticas não Paramétricas , Apneia Obstrutiva do Sono/diagnóstico , Apneia Obstrutiva do Sono/fisiopatologiaRESUMO
Background: Creativity is a highly valued quality in different fields. Despite this, it is rarely included in the curricula of medical careers. Aim: To assess creative thinking among undergraduate medical students. Material and Methods: Sixty-seven students aged 18 to 31 years (45% women) from the first (16), third (26) and seventh year (25) of medical school answered a sociodemographic questionnaire and the Torrance Test of Creative Thinking (TTCT). Results: Median creativity index according to age was in percentile 52 (range 2-99). Percentiles for fluency, originality, elaboration, abstraction of titles and resistance for premature closure were 31, 32, 79, 53 and 17 respectively. There were no significant differences between students of different levels (p = 0.73). Conclusions: In this group of students, there is a high performance in elaboration and a low score in Resistance to premature closure.
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Humanos , Masculino , Feminino , Adolescente , Adulto , Adulto Jovem , Estudantes de Medicina , Criatividade , Estudos Transversais , Inquéritos e Questionários , Educação MédicaRESUMO
BACKGROUND: Cerebral ptosis is understood as the bilateral paralysis of eyelid elevation linked to a stroke or hemorrhage of the middle cerebral artery (MCA). It is a transient condition, independent of the evolution of the lesion. AIM: To analyze six patients with the condition. PATIENTS AND METHODS: Report of five women and one male aged 42 to 72 years. RESULTS: All suffered an infarction or hemorrhage in the territory of the middle cerebral artery of the non-dominant hemisphere and developed a bilateral palpebral ptosis. The recovery started after the fourth day. At the tenth day, eye opening was effortless and did not require frontal help, despite the persistence of hemiplegia. CONCLUSIONS: Cerebral ptosis is a mimetic dysfunction of a specific non-injured area of the cerebral cortex, originated from a nearby parenchymal damage such as the middle cerebral artery of the same hemisphere. Cerebral ptosis expresses the inhibition of the voluntary eyelid elevation center, of prefrontal location in the non-dominant hemisphere.
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Blefaroptose/diagnóstico por imagem , Infarto Cerebral/diagnóstico por imagem , Artéria Cerebral Média/diagnóstico por imagem , Adulto , Idoso , Blefaroptose/fisiopatologia , Blefaroptose/terapia , Infarto Cerebral/fisiopatologia , Infarto Cerebral/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Artéria Cerebral Média/fisiopatologia , Tomografia Computadorizada por Raios XRESUMO
Background: Cerebral ptosis is understood as the bilateral paralysis of eyelid elevation linked to a stroke or hemorrhage of the middle cerebral artery (MCA). It is a transient condition, independent of the evolution of the lesion. Aim: To analyze six patients with the condition. Patients and Methods: Report of five women and one male aged 42 to 72 years. Results: All suffered an infarction or hemorrhage in the territory of the middle cerebral artery of the non-dominant hemisphere and developed a bilateral palpebral ptosis. The recovery started after the fourth day. At the tenth day, eye opening was effortless and did not require frontal help, despite the persistence of hemiplegia. Conclusions: Cerebral ptosis is a mimetic dysfunction of a specific non-injured area of the cerebral cortex, originated from a nearby parenchymal damage such as the middle cerebral artery of the same hemisphere. Cerebral ptosis expresses the inhibition of the voluntary eyelid elevation center, of prefrontal location in the non-dominant hemisphere.
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Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Blefaroptose/diagnóstico por imagem , Infarto Cerebral/diagnóstico por imagem , Artéria Cerebral Média/diagnóstico por imagem , Blefaroptose/fisiopatologia , Blefaroptose/terapia , Tomografia Computadorizada por Raios X , Infarto Cerebral/fisiopatologia , Infarto Cerebral/terapia , Artéria Cerebral Média/fisiopatologiaRESUMO
Spinal cord injury (SCI) is a pathology that generates great personal, family, economic and social impact. There are two main etiologies that are traumatic (T-SCI) and non-traumatic (NTSCI). These patients receive their rehabilitation in specialized hospital services in the acute and sub-acute phase. A retrospective, descriptive, observational study was designed, reviewing the clinical records of patients diagnosed with SCI at discharge, hospitalized in the Physical Medicine and Rehabilitation Service of the Clinical Hospital of the University of Chile. The general profile of admission of patients with SCI was a young men with NT- SCI, with higher education, paid work and incomplete injury (ASIA B, C, D). An improvement was observed for all patients for the severity of the injury, neurological level, motor level, sensory level and functionality. This is the first study conducted nationwide that provides epidemiological data and functional evolution of patients with SCI and are comparable to those found in the international literature. (AU)
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Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Reabilitação/métodos , Traumatismos da Medula Espinal/reabilitação , Reabilitação/tendências , Traumatismos da Medula Espinal/epidemiologiaRESUMO
Although inflammatory bowel disease (IBD) etiology is still unknown, genetic, environmental and immunological factors are implicated. Studies have considered quality of sleep as a risk factor in IBD course. Objective: To determine sleep quality in IBD patients, irritable bowel syndrome (IBS) patients and healthy controls (HC). Methods: Cross sectional study assessing sleep quality in adult patients with IBD, IBS and HC. All patients answered a validated Spanish version of the Pittsburgh Sleep Quality Index (PSQI) questionnaire in order to evaluate sleep quality. A PSQI global score > 5 is indicative of poor sleep quality. Demographic and clinical variables were assessed. Results: The study included 276 patients, 111 with IBD, 85 with IBS and 80 HC. A PSQI score > 5 was observed in 67 percent of IBD and IBS patients and 55 percent of HC. IBD and IBS patients exhibited poorer sleep quality than HC, although results did not reach statistical significance (p = 0.069 and p = 0.076, respectively). In IBD patients, an association between disease activity and sleep quality was observed (p = 0.025). However, when analyzing separately patients with ulcerative colitis (UC) and Crohn ́s Disease (CD), only in UC patients sleep quality was related with disease activity. The use of sleep medications was significantly higher in IBD and IBS patients compared with healthy controls (p = 0.021 and p = 0.009, respectively). Conclusion: Sleep disturbances are frequent in IBD, IBS patients and even healthy controls. Additionally, IBD patients with active disease, particularly those with UC, exhibit worse sleep quality.
Aunque la etiología de la enfermedad inflamatoria intestinal (EII) es aún desconocida, factores genéticos, ambientales e inmunológicos estarían implicados. Estudios han considerado la calidad del sueño como un factor de riesgo en la evolución de la EII. Objetivo: Determinar la calidad del sueño en pacientes con enfermedad inflamatoria intestinal (EII), síndrome intestino irritable (SII) y controles sanos (CS). Métodos:Estudio transversal en pacientes adultos con EII, SII y CS. Se evaluó la calidad del sueño mediante el Índice de Calidad del Sueño de Pittsburgh (ICSP), siendo una puntuación global > 5 indicativa de mala calidad del sueño. Variables demográficas y clínicas fueron evaluadas. Resultados:Se incluyeron 276 pacientes, 111 con EII, 85 SII y 80 CS. ICSP > 5 fue observado en 67 por ciento de los pacientes con EII y SII, y 55 por ciento de los CS. Los pacientes con EII y SII mostraron una peor calidad del sueño comparado con CS sin alcanzar significancia estadística (p: 0,069 y p: 0,076, respectivamente). En los pacientes con EII, se observó una asociación entre actividad de la enfermedad y calidad del sueño (p: 0,025). Sin embargo, al analizar por diagnóstico específico, sólo pacientes con colitis ulcerosa (CU) presentaron esta asociación. El uso de medicamentos para dormir fue significativamente mayor en los pacientes con EII y SII comparado con CS (p: 0,021 y p: 0,009, respectivamente). Conclusión:Los trastornos del sueño son frecuentes en pacientes con EII, SII e incluso CS. Pacientes con EII activa, en particular aquellos con CU, presentaron una peor calidad del sueño.
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Masculino , Feminino , Humanos , Adolescente , Adulto , Adulto Jovem , Pessoa de Meia-Idade , Idoso , Doenças Inflamatórias Intestinais/fisiopatologia , Sono , Transtornos do Sono-Vigília/epidemiologia , Estudos Transversais , Colite Ulcerativa/complicações , Colite Ulcerativa/fisiopatologia , Doença de Crohn/complicações , Doença de Crohn/fisiopatologia , Doenças Inflamatórias Intestinais/complicações , Qualidade de Vida , Inquéritos e QuestionáriosRESUMO
The present study is a non-inferiority study based on a descriptive and comparative case series for comparison of generic vs. original intravenous antimicrobials in septic oncology patients at an oncology private ICU. 1906 cancer patients admitted to Arturo Lopez Perez Foundation, Chile, were included in this study. After recruitment, a first retrospective group of 206 septic cancer patients recorded from 1st January, 2008 until July 14th, 2010, treated with original antibiotics (cefoperazone-sulbactam, imipenem-cilastatin, piperacillin-tazobactam) were included for analyses and a second prospective group of 143 septic cancer patients recorded from July 15th, 2010 until January 02, 2013, treated with the same but generic antibiotics were also included for comparisons. The trial protocol was developed in accordance with Helsinki and Good Clinical Practices recommendations. The results of this study showed no significant differences between the 2 groups in days of treatment, rate of success and lab test determinations (white cell count, PCR and procalcitonin), with lower, but not significant, total bed days and CPU bed days for generic antibiotics. Therefore, we conclude that the safety and efficacy of the generic antibiotics cefactam®, imipen® and Piperazam® are not inferior to original antibiotics for the treatment of severe sepsis in hospitalised patients at the Arturo Lopez Perez Foundation.
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Antibacterianos/efeitos adversos , Antibacterianos/uso terapêutico , Cefoperazona/uso terapêutico , Cilastatina/uso terapêutico , Imipenem/uso terapêutico , Serviço Hospitalar de Oncologia , Ácido Penicilânico/análogos & derivados , Sepse/tratamento farmacológico , Sulbactam/uso terapêutico , Administração Intravenosa , Antibacterianos/administração & dosagem , Cefoperazona/efeitos adversos , Cilastatina/efeitos adversos , Combinação Imipenem e Cilastatina , Combinação de Medicamentos , Medicamentos Genéricos/efeitos adversos , Medicamentos Genéricos/uso terapêutico , Feminino , Humanos , Imipenem/efeitos adversos , Masculino , Pessoa de Meia-Idade , Ácido Penicilânico/efeitos adversos , Ácido Penicilânico/uso terapêutico , Projetos Piloto , Piperacilina/efeitos adversos , Piperacilina/uso terapêutico , Combinação Piperacilina e Tazobactam , Estudos Prospectivos , Estudos Retrospectivos , Sulbactam/efeitos adversos , Resultado do TratamentoRESUMO
Carpal tunnel syndrome (CTS) is the most common peripheral neuropathy in the general population. In pregnant women the prevalence increases to 31-62 percent probably by edema secondary to the hormonal changes of pregnancy. The definitive treatment is surgical decompression, but in pregnant reserves only in exceptional cases where other treatments have failed. This population receives mainly conservative therapy consisting of splints, physical therapy and infiltration. Objective: To review the management of CTS in pregnant about a case. Methods: The clinical case of a pregnant patient with CTS managed conservatively was revised, based on this existing literature was reviewed. Results: 32 years old woman, studying 18 weeks pregnancy, consultation by paresthesia and loss of strength of both hands since1.5 months, more than right. Physical examination was consistent with bilateral CTS. Use of night splint is indicated. The electrodiagnostic evaluation reporting neuropathic sensitive-motor commitment severe intensity, subacute bilateral median nerve, with moderate denervation. Patient with symptoms persist, it is decided to perform infiltration of carpal tunnel steroid with good clinical and electrophysiological response. Conclusions: This case exemplifies the conservative treatment of CTS in pregnancy delivered good results. The literature supports the use of splints and steroid injections in this population...