RESUMO
BACKGROUND: The bone nonunion is an important complication of bone fracture repair. The existing models developed on small animal species prevent using osteosynthesis materials designed to be implanted in human bones. The goal of this study was to develop a nonunion process in a noncritical segmental tibial defect in sheep, a species analogous in size to humans. MATERIALS AND METHODS: The animals were divided into two groups of four animals each. In Group 1 (experimental), the defect was created by surgically stripping the periosteum from the edges of a distal tibial osteotomy, keeping the edges 5 mm apart, and placing an incomplete O-shaped silicone ring in the gap. Group 2 (control) was intervened with a simple fracture at the distal end of the tibia. In both groups an interlocking nail was used as a fixation system. Over 8 wk after surgery, radiographs and histologic and histomorphometric analyses were performed. RESULTS: The control group showed a typical bone repair process. In contrast, the experimental group showed a fracture line with rounded edges and a scarce callus formation. The bone callus showed reduced amount of bone formation and large content of fibrous tissue (P=0.001). CONCLUSIONS: These results indicate that our model developed an atrophic nonunion in sheep, a species having multiple similarities to humans, such as weight, size, bone structure, and bone remodeling process.
Assuntos
Pinos Ortopédicos , Fixação Interna de Fraturas/instrumentação , Fixação Interna de Fraturas/métodos , Fraturas Mal-Unidas/cirurgia , Modelos Animais , Fraturas da Tíbia/cirurgia , Animais , Consolidação da Fratura , Fraturas Mal-Unidas/diagnóstico por imagem , Masculino , Osteogênese , Osteotomia , Periósteo/cirurgia , Radiografia , Ovinos , Tíbia/cirurgia , Fraturas da Tíbia/diagnóstico por imagemRESUMO
BACKGROUND: Mortality from colorectal cancer (CCR) in Chile has nearly doubled over the past 15 years. International studies have shown that CCR screening programs based on fecal occult blood test (FOBT) reduce CCR mortality. AIM: To analyze the results from a CCR screening model in people over 50 years. MATERIAL AND METHODS: Between 2007 and 2009, a prospective multicenter study was performed in seven major Chilean cities. FOBT using an immunological method, was measured in asymptomatic subjects aged 50 years or more, without risk factors. In patients with a positive FOBT, with symptoms or with family risk factors, a colonoscopy was indicated. RESULTS: A total of 6348 subjects were assessed, FOBT was performed in 4938 of them, with a compliance of 77%. The result was positive in 9.6%. A total of 2359 colonoscopies were ordered, with an overall compliance of 50.1%. Of the 1184 colonoscopies performed, adenomas and high risk adenomas were found in 304 (26%) and 75 (6%) patients, respectively. Thirteen patients were diagnosed with stage I and IICCR. Three of these lesions were excised endoscopically and 10 surgically. The detection rate of polyps, high risk adenomas and cancer was 75, 12 and 2 per 1000 screened individuals, respectively. CONCLUSIONS: This program allowed the early detection of an important number of high risk colon lesions, and all patients with CCR were diagnosed at early stages.
Assuntos
Pólipos Adenomatosos/diagnóstico , Neoplasias Colorretais/diagnóstico , Detecção Precoce de Câncer/métodos , Programas de Rastreamento/métodos , Sangue Oculto , Pólipos Adenomatosos/mortalidade , Fatores Etários , Chile/epidemiologia , Colonoscopia/estatística & dados numéricos , Neoplasias Colorretais/mortalidade , Humanos , Pessoa de Meia-Idade , Cooperação do Paciente , Avaliação de Programas e Projetos de Saúde , Estudos Prospectivos , Fatores de Risco , População UrbanaRESUMO
Background: Mortality from colorectal cancer (CCR) in Chile has nearly doubled over the past 15 years. International studies have shown that CCR screening programs based on fecal occult blood test (FOBT) reduce CCR mortality. Aim: To analyze the results from a CCR screening model in people over 50 years. Material and Methods: Between 2007 and 2009, a prospective multicenter study was performed in seven major Chilean cities. FOBT using an immunological method, was measured in asymptomatic subjects aged 50 years or more, without risk factors. In patients with a positive FOBT, with symptoms or with family risk factors, a colonoscopy was indicated. Results: A total of 6348 subjects were assessed, FOBT was performed in 4938 of them, with a compliance of 77%. The result was positive in 9.6%. A total of 2359 colonoscopies were ordered, with an overall compliance of 50.1%. Of the 1184 colonoscopies performed, adenomas and high risk adenomas were found in 304 (26%) and 75 (6%) patients, respectively. Thirteen patients were diagnosed with stage I and IICCR. Three of these lesions were excised endoscopically and 10 surgically. The detection rate of polyps, high risk adenomas and cancer was 75, 12 and 2 per 1000 screened individuals, respectively. Conclusions: This program allowed the early detection of an important number of high risk colon lesions, and all patients with CCR were diagnosed at early stages.
Assuntos
Humanos , Pessoa de Meia-Idade , Pólipos Adenomatosos/diagnóstico , Neoplasias Colorretais/diagnóstico , Detecção Precoce de Câncer/métodos , Programas de Rastreamento/métodos , Sangue Oculto , Pólipos Adenomatosos/mortalidade , Fatores Etários , Chile/epidemiologia , Colonoscopia , Neoplasias Colorretais/mortalidade , Cooperação do Paciente , Avaliação de Programas e Projetos de Saúde , Estudos Prospectivos , Fatores de Risco , População UrbanaRESUMO
La infección urinaria constituye la infección bacteriana más común, siendo los bacilos gram negativos(E. coli, P. mirabilis, Klebsiella) los patógenos más frecuentes. Esta enfermedad pese a los nuevos conocimientos tanto en factores relacionados con el huésped cómo en los relacionados con la biología de las bacterias, aún nos enfrenta a numerosos problemas no resueltos, cómo son la resistencia a los antibióticos y la recurrencia. La resistencia, de los patógenos, a los agentes antimicrobianos es un problema muy importante para la elección deun tratamiento de primera línea, por lo que nos parece necesario conocer sus cambios. El objetivo de este estudio es evaluar los cambios experimentados por la susceptibilidad de la E. Coli a los antibióticos de uso frecuente, en pacientes de consulta ambulatoria con ITU baja no complicada, en un período de 10 años. Realizamos unarevisión retrospectiva de los antecedentes, urocultivos y antibiograma de pacientes de sexo femenino que consultaron en nuestro centro en los años 1996 y 2005. Se registró la edad, bacteria y antibiograma de aquellas con urocultivos positivos, comparando las variaciones producidas en este período de tiempo. Se utilizó la prueba de Chi cuadrado para comparar la sensibilidad antibiótica. En el año 1996, durante el período enero a septiembre, se registraron 242 pacientes con urocultivos positivos, con una edad promedio de 46 años. En el 91,3 por ciento la bacteria responsable fue Escherichia coli. Durante el mismo período en el año 2005 registramos 296 pacientes con urocultivos positivos, con edad promedio de 52 años y Escherichia coli en el 88,5 por ciento. La resistencia de E. Coli a cotrimoxazol, sulbactam-ampicilina, Ac. Pipemídico, cefotaxima y cefradina aumentó significativamente. Por el contrario la resistencia a gentamicina disminuyó significativamente. El ciprofloxacino, norfloxacino, nitrofurantoina y amikacinano presentaron cambios significativos. Conclusiones: Los cambios en la...
The urinary tract infection (UTI) is the most common bacterial infection, caused by several germs like gramnegative bacillus ( E. Coli, P. Mirabilis, Klebsiella). This disease has a lot of non-resolved problems like resistance to the antibiotics and recurrence. The germ resistance is important at the moment to choose a first line antibiotic.The aim of the study was evaluate the evolution of E. Coli resistance to the frequent used antibiotics in female outpatients of our center with no complicate UTI in a 10 years period. We assessed retrospectively our database ofurine culture (UC) and antibiogram the years 1996 and 2005 from January to September using the Chi square test to compare the antibiotic sensitivity. In 1996 we found 242 patients with positive UC, the mean age was 46 years and E. Coli was responsible in 91,3 percent. In 2005 we had 296 patients with positive UC, the mean age was 52 years and E. Coli was responsible in 88,5 percent. We found a rise E. Coli resistance (statistically significant) to cotrimoxazol, sulbactam-ampicilin, pipemidic acid, cefotaxim and cefradin. Ciprofloxacin, norfloxacin, nitrofuranto in and amikacin present no significant changes. Gentamicin has an important increase of sensitivity.
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Antibacterianos/farmacologia , Escherichia coli , Infecções Urinárias/microbiologia , Estudos Retrospectivos , Testes de Sensibilidade MicrobianaRESUMO
A school-based, bilingual intervention was developed to increase seat belt use among families living along the Texas-Mexico border. The intervention sought to increase seat belt use by changing perceived norms within the community (i.e., making the nonuse of seat belts less socially acceptable). The intervention was implemented in more than 110 classrooms and involved more than 2100 children. Blind coding, validity checks, and reliability estimates contributed to a rigorous program evaluation. Seat belt use increased by 10% among children riding in the front seat of motor vehicles in the intervention community, as compared with a small but nonsignificant decline in use among control community children. Seat belt use among drivers did not increase.
Assuntos
Educação em Saúde/organização & administração , Conhecimentos, Atitudes e Prática em Saúde , Promoção da Saúde/organização & administração , Hispânico ou Latino/estatística & dados numéricos , Cintos de Segurança/estatística & dados numéricos , Criança , Feminino , Hispânico ou Latino/psicologia , Humanos , Masculino , México , Avaliação de Programas e Projetos de Saúde , Marketing Social , Serviços de Saúde para Estudantes/organização & administração , Estudantes/psicologia , Estudantes/estatística & dados numéricos , Texas , Fatores de TempoRESUMO
Se desarrolló un protocolo de impregnación rápida en parafina por medio de microondas, para muestras histológicas y de diagnóstico, con el propósito de que fueran observadas en microscopia de campo claro. Se procesaron muestras de hígado, papiloma, piel y pulmón de perro; cerebro y riñón de gato; ovario, cuerno uterino y arteria de rata. Se utilizó un horno de microondas casero (600 watts) a 75 por ciento de su potencia, con soluciones ascendentes de alcohol para deshidratar, mezclas de benceno-etanol para aclarar y parafina para embeber. Un grupo de especialistas revisó el material y fotografías de los diversos órganos procesados, con tres técnicas de inclusión distintas, con los resultados obtenidos a partir de las observaciones realizadas se concluye que no hay una diferencia significativa entre las muestras de histokinette (HK) y microondas (MO). Al comparar las técnicas de HK, MO con la de Robinson y Fayen (RF), se advierten diferencias morfológicas muy aparentes. Este método permite obtener diagnósticos patológicos y morfológicos 30 minutos después de que las muestras se reciben en el laboratorio. La morfología de las muestras procesadas por medio de microondas es mejor que las muestras procesadas por el método rápido de RF y no hay diferencias apreciables en comparación con el método de rutina por HK.
Assuntos
Parafina , Micro-Ondas , Técnicas In Vitro , Técnicas e Procedimentos Diagnósticos/veterináriaRESUMO
Se presentan 25 pacientes con el diagnóstico de hidronefrosis fetal in utero, tratados exitosamente en el período postnatal. Se concluye que con líquido amniótico normal, la hidronefrosis fetal no requiere cirugía de urgencia y la mayoría evoluciona favorablemente en forma espontánea
Assuntos
Humanos , Feminino , Gravidez , Hidronefrose , Ultrassonografia Pré-Natal , Doenças Fetais , Hidronefrose/classificação , Hidronefrose/terapia , Complicações na GravidezRESUMO
Entre 1979 y 1989 hemos tratado a 129 pacientes portadores de TBC génitourinaria, con 3 esquemas de quimioterapia acortada, con duración aproximada de 7-8 meses cada uno. Todos incluyen RMP, HIN, SM y PZ. Lográndose un 98% de éxito bacteriológico. El tiempo de seguimiento promedio fue de 3 años con un rango entre 3 meses y 6 años, 27 pacientes necesitaron algún tipo de cirugía: en 13 con fines diagnósticos antes del tratamiento y en 14 durante o luego de finalizada la quimioterapia; en 8 de ellos fue de tipo reparadora o conservadora y en 6 fue resectiva. En general los efectos adversos de la quimioterapia fueron menores, siendo los más frecuentes alergia a alguno de los fármacos, gastritis y ototoxicidad. Concluímos que con la quimioterapia acortada se pueden obtener buenos resultados, en tuberculosis génitourinaria, similares a los obtenidos previamente utilizando la quimioterapia clásica
Assuntos
Adolescente , Adulto , Pessoa de Meia-Idade , Humanos , Masculino , Feminino , Isoniazida/administração & dosagem , Pirazinamida/administração & dosagem , Rifampina/administração & dosagem , Estreptomicina/administração & dosagem , Tuberculose Urogenital/tratamento farmacológico , Esquema de Medicação , Tuberculose Urogenital/diagnóstico , Tuberculose/cirurgiaRESUMO
Los autores presentan su experiencia de 55 pacientes con complicaciones urológicas tratadas con el cateter ureteral doble pigtail. Las indicaciones para el empleo de este cateter fueron: la obstrucción ureteral por metástasis retroperitoneales, en cirugía ureteral compleja y en fístula de la vía urinaria alta. En general esta técnica endourológica no se asocia a complicaciones y ayuda al Urólogo a ser menos invasivo y mas conservador