RESUMO
INTRODUCTION: Guillain-Barré syndrome, an acute polyradiculoneuropathy that presents with weakness and areflexia, is the most common cause of acute flaccid paralysis. In certain patients, respiratory failure is secondary to this disorder, eventually causing patients to require mechanical ventilation and experience additional complications due to diminished respiratory support and related mobility limitations. Prognoses for most of these cases are positive; treatment consists of basic support combined with plasmapheresis or administration of immunoglobulins. OBJECTIVE: This study sought to describe the socio-demographic, clinical, laboratory and neurophysiological characteristics of patients with Guillain-Barré syndrome who were hospitalised in the Intensive Care Unit of the Neurological Institute of Colombia between 2006 and 2012. METHODOLOGY: This study presents a case series. RESULTS: We surveyed 25 patients (32% female and 68% male) with Guillain-Barré syndrome and an average age of 54 years. Sixty per cent of these patients were admitted between days 3 and 7 after symptom onset; 64% had a history of respiratory infection and 20% had a history of intestinal infection. In addition, 84% of the patients presented with albuminocytological dissociation. We observed the following clinical subtypes of Guillain-Barré syndrome: inflammatory demyelinating polyneuropathy in 32%, acute motor-sensory axonal neuropathy in 28%, acute motor axonal neuropathy in 28%, and Miller Fisher syndrome in 12%. CONCLUSIONS: In this descriptive study of a group of critical care patients with GBS, results depended on patients' clinical severity at time of admission. Our findings are similar to results published in the international literature.
Assuntos
Cuidados Críticos/métodos , Síndrome de Guillain-Barré/terapia , Neurologia , Adulto , Idoso , Colômbia/epidemiologia , Feminino , Síndrome de Guillain-Barré/epidemiologia , Hospitalização/estatística & dados numéricos , Humanos , Unidades de Terapia Intensiva , Masculino , Pessoa de Meia-Idade , Plasmaferese , Estudos Retrospectivos , Fatores SocioeconômicosRESUMO
Objetivo: Adaptar culturalmente el cuestionario LINQ (Lung Information Needs Questionnaire) en pacientes con enfermedad pulmonar crónica. Métodos: Estudio descriptivo, después de la traducción del cuestionario por traductor certificado y de la adaptación cultural, se aplicó en ocho pacientes para identificar las dificultades y dudas relacionadas con el entendimiento de las preguntas, la terminología y para evaluar no solo la calidad de la traducción, sino también para verificar aspectos prácticos de su aplicación. Posteriormente, se realizó una segunda traducción al idioma inglés la cual fue enviada a los autores para asegurar el contenido original del cuestionario y conseguir el aval para su uso. Resultados: La muestra en la fase de adaptación cultural fue constituida por 6 hombres y 2 mujeres con una edad promedio de 61 años. La versión en español del LINQ y la adaptación cultural fue comprensible y fácil de usar y no presentó discrepancias con la versión original durante el proceso de retratraducción. Conclusiones: La traducción al español y la adaptación del LINQ fue adecuada pues los pacientes no manifestaron dificultades para entender y responder las preguntas. Esto podrá facilitar la realización de futuros estudios que evalúen el componente educativo en los programas de rehabiltación pulmonar.
Objective: To perform a cultural adaptation of the LINQ (Lung Information Needs Questionnaire) for patients with chronic pulmonary disease. Method: Descriptive study. After the translation of the questionnaire by a certified translator, and after its cultural adaptation, it was applied in eight patients in order to identify the difficulties and doubts related to an understanding of the questions and of its terminology, not only to evaluate the quality of the translation, but to verify practical aspects of its application, as well. Afterward, a second translation was done from Spanish to English, and sent back to the authors to ensure the original content of the questionnaire was maintained, and to obtain endorsement for its use. Results: During the cultural adaptation phase, the sample was constituted by 6 men and 2 women, with an average age of 61 years. The Spanish version of the LINQ, as well as the cultural adaptation, was easy to use and did not show any discrepancies with the original version during the re-translation process. Conclusions: The LINQ's translation to Spanish and the cultural adaptation proved to be adequate, because the patients did not express any difficulties in understanding and answering the questions. This will facilitate future studies that evaluate the educational component in the pulmonary rehabilitation program.
Objetivo: adaptar culturalmente o questionário LINQ (Lung Information Needs Questionnaire) em pacientes com doença pulmonar crônica. Métodos: Estudo descritivo, depois da tradução do questionário por tradutor certificado e da adaptação cultural, aplicou-se a oito pacientes para identificar as dificuldades e dúvidas relacionadas com o entendimento das perguntas, a terminologia e para avaliar não só a qualidade da tradução, más também para verificar aspectos práticos de sua aplicação. Posteriormente, realizou-se uma segunda tradução ao idioma inglês a qual foi enviada aos autores para assegurar o conteúdo original do questionário e conseguir o aval para seu uso. Resultados: a amostra na fase de adaptação cultural foi constituída por 6 homens e 2 mulheres com uma idade média de 61 anos. A versão em espanhol de LINQ e a adaptação cultural foram compreensíveis e fáceis de usar e não apresentaram discrepâncias com a versão original durante o processo de retradução. Conclusões: a tradução ao espanhol e a adaptação do LINQ foi adequada pois os pacientes não manifestaram dificuldades para entender e responder as perguntas. Isto poderá facilitar a realização de futuros estudos que avaliem o componente educativo nos programas de reabilitação pulmonar.
Assuntos
Humanos , Doença Pulmonar Obstrutiva Crônica , Reabilitação , Inquéritos e Questionários , Reprodutibilidade dos Testes , Adaptação a DesastresRESUMO
Se presenta el caso de Paciente femenina de 23 años de edad, II gesta, I Para, quien es referida a este centro por hallazgo ecográfico de malformación fetal y oligoamnios severo. Se le diagnóstico gastrosquisis a las 29 semanas a través de un ecograma pélvico. Al momento del ingreso se le realiza un nuevo ecograma, evidenciándose un embarazo de 35 semana por biometría fetal y 37 semanas por FUM, gastrosquisis con esas dilatadas (16 mm), RCF y liquido amniótico en suficiente cantidad; motivo por el cual la paciente es trasladada al servicio de obstetricia. Se planifica la intervención en conjunto con cirugía pediátrica e intensivista pediátrica. Se realiza cesárea segmentarea electiva, obteniéndose recién nacido de sexo femenino en con apgar de 7 pts al minuto y 9 pts a los 5 minutos, con liquido amniótico claro con grumos, se evidencio defecto de cierre de pared anterior con protusión de asas intestinales dilatadas. Se realiza de forma inmediata intervención de cirugía pediátrica, realizándose intento fallido de cierre de pared abdominal, y se coloca bolsa de bogota. Se mantiene en la unidad de cuidados intensivos por 3 días y fallece por sepsis fetal con punto de partida enteral. La madre evoluciona bien en su post operatorio y es dada de alta.
Assuntos
Humanos , Adulto , Feminino , Gravidez , Doenças Fetais/diagnóstico , Gastrosquise/diagnóstico , Gastrosquise/genética , Gastrosquise/patologia , Parede Abdominal/anormalidades , Ultrassonografia , Cesárea/métodos , Obstetrícia , Ultrassonografia Pré-Natal/métodosRESUMO
Genetically modified Vibrio cholerae strain 638 (biotype El Tor, serotype Ogawa) has previously been shown to be immunogenic in animal models and in human trials. Our objective in the work reported herein was to describe the process development methods for the production of the 638 attenuated cholera vaccine. Cell seed bank, culture of biomass, lyophilization and final formulation were processes were developed. The results show kinetics of culture that fulfils a logistical model. The microbiological properties, colonizing capability, immunogenicity and non-toxigenicity of the final product were indistinguishable from the properties of the working seed lot. We conclude that the non-reactogenic, immunogenic and protective strain 638 is robust and can withstand the fermentation processes required for large-scale production of a vaccine.
Assuntos
Vacinas contra Cólera , Tecnologia Farmacêutica , Vibrio cholerae/imunologia , Animais , Cólera/prevenção & controle , Toxina da Cólera/análise , Vacinas contra Cólera/efeitos adversos , Vacinas contra Cólera/imunologia , Indústria Farmacêutica , Fermentação , Humanos , Camundongos , Camundongos Endogâmicos BALB C , Modelos Animais , Vacinas Atenuadas/efeitos adversos , Vacinas Atenuadas/imunologia , Vibrio cholerae/genética , Vibrio cholerae/patogenicidade , Vibrio cholerae/fisiologiaRESUMO
BACKGROUND: Studies in developed countries have shown that reduced fetal growth is related to raised blood pressure in childhood and adult life. Little is known about this association in developing countries, where fetal growth retardation is common. METHODS: In 1994-1995, we measured blood pressure in 1570 3-6-year-old children living in China, Guatemala, Chile, Nigeria and Sweden. We related their blood pressure to patterns of fetal growth, as measured by body proportions at birth. The children were all born after 37 weeks gestation and weighed more than 2.5 kg at birth. RESULTS: In each country, blood pressure was positively related to the child's current weight. After adjusting for this and gender, systolic pressure was inversely related to size at birth in all countries except Nigeria. In Chile, China and Guatemala, children who were proportionately small at birth had raised systolic pressure. For example, in Chile, systolic pressure adjusted for current weight increased by 4.9 mmHg (95% CI : 2.1, 7.7) for every kilogram decrease in birthweight, by 1 mmHg (95% CI : 0.4, 1.6) for every centimetre decrease in birth length, and by 1.3 mmHg (95% CI : 0.4, 2.2) for every centimetre decrease in head circumference at birth. In Sweden, systolic pressure was higher in children who were disproportionately small, that is thin, at birth. Systolic pressure increased by 0.3 mmHg (95% CI : 0.0, 0.6) for every unit (kg/m3) decrease in ponderal index at birth. These associations were independent of the duration of gestation. CONCLUSIONS: Raised blood pressure among children in three samples from China, Central and South America is related to proportionate reduction in body size at birth, which results from reduced growth throughout gestation. The relation between fetal growth and blood pressure may be different in African populations. Proportionately reduced fetal growth is the prevalent pattern of fetal growth retardation in developing countries, and is associated with chronic undernutrition among women. Improvement in the nutrition and health of girls and young women may be important in preventing cardiovascular disease in developing countries.
Assuntos
Peso ao Nascer , Pressão Sanguínea/fisiologia , Estatura , Desenvolvimento Embrionário e Fetal/fisiologia , Criança , Pré-Escolar , Chile , China , Países em Desenvolvimento/estatística & dados numéricos , Guatemala , Humanos , Pessoa de Meia-Idade , Nigéria , SuéciaRESUMO
In August 2001, the XVII Meeting of the Health Sector in Central America and the Dominican Republic (RESSCAD) was held in Managua, Nicaragua. At the meeting, a resolution was adopted in support of strengthening and furthering the Central American initiative for the Promotion of Food and Nutritional Security. This paper examines the conceptual framework behind the initiative, which was approved by the XIV Central American Presidents Summit Meeting (Guatemala City, Guatemala) and launched in 1994 at the regional, national, and municipal levels (Guacimo, Costa Rica, 1994). It focuses on the accomplishments attributable to this initiative, the challenges it has faced over 2001 and those it will be facing over the next biennium, and the measures taken or recommended so far in order to ensure its long-term success.
Assuntos
Alimentos , Fenômenos Fisiológicos da Nutrição , Agricultura , América Central , Desastres , Alimentos/normas , Previsões , Humanos , Cooperação Internacional , População Rural , Fatores SocioeconômicosRESUMO
To evaluate whether milk production can be improved by increasing food intake, a randomized, double-blind, supplementation trial was completed among 102 lactating Guatemalan women. The subjects were undernourished, as indicated by their low values for calf circumference (CC) and the small size of their infants at birth. A high-energy (2.14 MJ/d, HES) and a low-energy (0.50 MJ/d, LES) supplement were distributed 6 d/wk from wk 5 to 25 of lactation. Data were evaluated using repeated-measures analysis of variance on the increments from initial values for each outcome variable with one-tailed tests of statistical significance. The maternal energy intake increased 1.18 MJ/d (P < 0.01) more among the HES than the LES women. Benefit from supplementation was more evident among the more undernourished (CC
Assuntos
Aleitamento Materno , Dieta , Suplementos Nutricionais , Ingestão de Energia , Lactação/fisiologia , Adulto , Análise de Variância , Método Duplo-Cego , Ingestão de Alimentos , Feminino , Guatemala , Humanos , Recém-Nascido , Modelos Logísticos , Masculino , Distúrbios Nutricionais/dietoterapia , Distúrbios Nutricionais/fisiopatologia , População RuralRESUMO
There have been 2521 articles published on cysticercosis between 1965 and 1995. An analysis of these articles is presented in this paper and includes the subjects, grouped in 61 descriptors and the frequency of each one, the number of articles published each year, which has increased, the journals used, in total 663, 7% of which include 42% of the articles, the parameters used to measure the quality and importance of the main journals used for cysticercosis, for example, 56% have impact factor, the authors and co-authors which add 4848, of these, 59 have published between 9 and 79 articles each one, the analysis of their frequency of publication indicates that once they start publishing on cysticercosis they follow on in this area. Of the most productive authors 58% are Latinoamerican, 22 of which are Mexican.