Assuntos

Assuntos

RESUMO

INTRODUCTION: Neurocysticercosis (NCC), a possible cause of epilepsy with limited epidemiological data in the Dominican Republic, is endemic in four provinces in the country's south-western region. This study aimed to determine the association between NCC and epilepsy among people living in these endemic regions, and to obtain preliminary data on the prevalence of NCC in these provinces. PATIENTS AND METHODS: A case-control design was used, consisting of 111 patients with epilepsy with unknown causes, and 60 controls without epilepsy or NCC. The diagnosis of NCC was based on computed tomography and magnetic resonance imaging of the skull, as well as Western immunoblotting for serum antibodies using Taenia solium, following the criteria of Del Brutto et al. RESULTS. NCC was found in 27% of the epileptic patients (n = 30/111) and in 5% of the controls (n = 3/60); the probability of the epileptic patients having NCC was seven times higher than the controls (odds ratio = 7.04, 95% confidence interval: 2.04-24.18; p < 0.001). The participants' sociodemographic characteristics, including their age, sex, level of education, occupation, and province of residence presented no statistical significance in terms of their association with NCC. CONCLUSIONS: This study suggests that NCC is strongly associated with epilepsy in the south-western region of the Dominican Republic, and highlights the need for public health measures to improve the prevention, diagnosis and treatment of both diseases.

TITLE: Diagnóstico de neurocisticercosis en pacientes con epilepsia residentes en el suroeste de la República Dominicana.Introducción. La neurocisticercosis (NCC), una posible causa de epilepsia con datos epidemiológicos limitados en la República Dominicana, es endémica en cuatro provincias de la región suroeste. El objetivo de este estudio fue determinar la asociación entre la NCC y la epilepsia en personas que viven en estas regiones endémicas, así como obtener datos preliminares sobre la prevalencia de NCC en estas provincias. Sujetos y métodos. Se utilizó un diseño de casos y controles compuesto por 111 pacientes con epilepsia de causa desconocida y 60 controles sin epilepsia ni NCC. El diagnóstico de NCC se basó en la tomografía computarizada y la resonancia magnética del cráneo, así como en el inmunotransferencia de Western para anticuerpos séricos contra Taenia solium, siguiendo los criterios de Del Brutto et al. Resultados. Se encontró NCC en el 27% de los pacientes con epilepsia (n = 30/111) y en el 5% de los controles (n = 3/60); los casos de epilepsia tenían siete veces más probabilidades de tener NCC que los controles (odds ratio = 7,04, intervalo de confianza al 95%: 2,04-24,18; p < 0,001). Las características sociodemográficas de los participantes, como la edad, el sexo, el nivel de escolaridad, la ocupación y la provincia de residencia no mostraron significación estadística en cuanto a la asociación con NCC. Conclusiones. Este estudio sugiere que la NCC está fuertemente asociada con la epilepsia en la región suroeste de la República Dominicana, y destaca la necesidad de medidas de salud pública para mejorar la prevención, el diagnóstico y el tratamiento de ambas enfermedades.

Assuntos

RESUMO

Blood extraction is extremely important for the development of scientific research; however, the existing methods for amphibian´s blood sampling are invasive, mainly leading to the euthanasia of the animal. Therefore, less intrusive methods that allow the obtention of multiple samples from the same individual, are needed as an alternative to the common methods available. Hence, the aim of this study was to propose a minimally invasive method for obtaining blood from the hind leg of Xenopus laevis, that allows continuous sampling without compromising the wellbeing of the organisms. With this method, it was possible to extract blood and plasma from adults and juveniles, and the amount of sample was enough to perform biochemical and molecular assays to assess the viability of the blood. The results also revealed that this method is a convenient alternative to obtain blood without affecting the welfare of the experimental organisms, avoiding the cull of the animals, and the samples are viable for their use in follow up studies.

Assuntos

RESUMO

Consumption of wild mushrooms has increased in recent years; however, not all of them are edible and there is no precise information on those that may cause poisoning. Therefore, studies to obtain data about their toxicity are needed. For this purpose, we used the brine shrimp Artemia franciscana, a crustacean employed in toxicity tests and with wide application in the toxin detection, including mycotoxins. Mushrooms were collected in the state of Jalisco, Mexico, with which aqueous extracts were prepared. Dilutions of the stock solution of each extract were made to final concentrations of 50, 100, 250, 500, and 1000 µg/mL. Potassium dichromate (PD) was used as positive control and artificial seawater as negative control. The median lethal dose (LD50) of extracts on nauplii of A. franciscana was calculated. The aqueous extracts obtained from Amanita amerivirosa, A. muscaria, Chlorophyllum molybdites, and Leucopaxillus amarus showed a LD50 < 70 µg/mL, similar to PD (LD50 = 37 µg/mL). This is the first indication of the probable toxicity of Leucopaxillus amarus in humans. Cantharellus cibarius and Scleroderma texense caused the lower toxicity to the nauplii. The brine shrimp bioassay was effective in evaluating the toxicity of Basidiomycota. Scleroderma texense has been reported to be toxic, but it was not for this crustacean nauplii, and probably not to humans either, as recent literature has reported.

Assuntos

RESUMO

BACKGROUND: Long-term outcomes of Off-Pump Coronary Artery Bypass Grafting (OPCAB) as an alternative to the traditional Coronary Artery Bypass Grafting (CABG) technique with cardiopulmonary bypass (CPB) are not well defined. AIM: To compare 10-year survival of isolated OPCAB versus CABG with CPB. MATERIAL AND METHODS: Analysis of information obtained from databases, clinical records and surgical protocols of patients treated with isolated CABG between January 2006 and November 2008 at a Regional Hospital. Of 658 isolated CABG, 192 (29.2%) were OPCAB and 466 (79.9%) CPB. Propensity Score Matching (PSM) was performed to compare both groups. After PSM, two groups of 192 cases were obtained. Mortality data was obtained from the Chilean public identification service. Ten-year survival was calculated and compared with Kaplan-Meier and log-rank methods. RESULTS: Follow-up data was obtained in all cases. No statistically significant differences were found when comparing 10-year survival between OPCAB versus CPB (78.6% and 80.2% respectively, p 0.720). There was also no statistical difference in cardiovascular death free survival (90.1% with CPB versus 89.1% OPCAB, p 0.737). Survival was comparable when analyzing subgroups with diabetes mellitus, left ventricular dysfunction or chronic kidney disease, among others. CONCLUSIONS: In our series, OPBAB has a comparable 10-year survival with CABG with CPB.

Assuntos

RESUMO

In Chilean children and adolescents, human papillomavirus (HPV) infection prevalence is unknown. In 2014, the HPV vaccine was incorporated into the National Immunization Program for girls, and since 2019 for boys. OBJECTIVE: To determine the prevalence, genotypes, and characteristics of HPV infection in children and adolescents with anogenital lesions not vaccinated against HPV. PATIENTS AND METHOD: Children and adolescents with anogenital lesions who consulted at the Luis Calvo Mackenna Children's Hospital between 2013 and 2017 were studied. The reason for consultation, age, sex, family history of HPV lesions, history of sexual abuse, and consensual sexual activity were recorded. HPV was detected by PCR and typification by reverse hybridization of the L1 gene. The samples were analyzed in the Oncogenic Virus Section of the Institute of Public Health. RESULTS: 110 patients were studied; 44.5% were children. HPV was detected in 34 cases (30.9% [CI95% 22.4- 40.4]), 22 (44.9%) were children and 12 (19.7%) adolescents. Eleven (91.7%) adolescents had a history of sexual con tact (p < 0.005); 4 (18.2%) children disclosed sexual abuse. HPV was found in 25% of patients with genital lesions and 50% with perianal lesions (p < 0.015). The most frequent genotypes were 59, 58, 16, 18, 6, and 11. Only low-risk genotypes were detected in children and high-risk genotypes were detected in 11/12 (91.7%) of HPV (+) adolescents. CONCLUSION: The prevalence of HPV infection was 30%. In adolescents, the infection was related to sexual contact and high-risk HPV. In children, it was associated with low-risk genotypes. Perianal lesions are more frequently associated with HPV infec tion than genital lesions in children and adolescents. The visual inspection does not allow to specify the etiology of the genital lesions, so it is necessary to perform a PCR test for HPV.

Assuntos

RESUMO

Introducción y objetivos: Describir los cambios en las características clínicas de los pacientes operados por endocarditis infecciosa (EI) en el centro-sur de Chile durante las últimas cuatro décadas. Métodos: Estudio retrospectivo de la serie de pacientes con diagnóstico de EI con indicación de cirugía de un hospital público chileno entre 1983 y 2020. La cohorte (n = 306) se dividió en cuatro grupos según el periodo de la cirugía: 1983-1990 (n = 50), 1991-2000 (n = 53), 2001-2010 (n = 44) y 2011-2020 (n = 159). Se compararon variables sociode-mográficas y clínicas entre los grupos utilizando la prueba de Kruskal-Wallis e independencia de Chi-cuadrado. Se calcularon supervivencias acumuladas que se compararon con la prueba de Gehan-Breslow-Wilcoxon. Resultados: Se observó un aumento de la edad al momento del diagnóstico (p < 0,001), de la frecuencia de comorbilidades (p < 0,001), de la presentación clínica compatible con lesión renal aguda (p < 0,001), de la afectación independiente de la válvula mitral (p < 0,001), de la positividad de los cultivos (p < 0,012) y de la supervivencia acumulada (p = 0,015). Hubo una disminución del tiempo desde el inicio de síntomas hasta el diagnóstico (p = 0,003), en la presentación clínica compatible con insuficiencia cardíaca (p < 0,001), la afectación independiente de la válvula aórtica (p < 0,001) y la indicación quirúrgica por gran vegetación (p < 0,001). Conclusiones: El perfil de la EI de los pacientes atendidos en un hospital público del centro-sur de Chile ha experimentado cambios significativos durante las últimas cuatro décadas.

Aim: To describe the changes observed in operated patients with infective endocarditis (IE) in the south-central region of Chile during the last four decades. Methods: Case series study. The target population was patients diagnosed with IE and indication for valve surgery between 1983 and 2020 from a Chilean public hospital. The universe (n = 306) was divided into four groups according to the period of valve surgery. Sociodemographic and clinical variables between these groups were compared using the Kruskal-Wallis and Chi-square tests for independence. Cumulative survivals were calculated and compared using the Gehan-Breslow-Wilcoxon test. Results: Age at diagnosis (p < 0.001), frequency of comorbidities (p < 0.001), clinical presentation compatible with acute kidney injury (p < 0.001), independent mitral valve involvement (p < 0.001), positivity of microbiological cultures (p < 0.012) and cumulative survival (p = 0,015) increased. The delay from symptom onset to diagnosis (p = 0.003), clinical presentation compatible with heart failure (p < 0.001), independent involvement of the aortic valve (p < 0.001), and surgical indication for large vegetation (p < 0.001) decreased. Conclusions: The IE profile of patients seen in a public hospital in the south-central region of Chile has undergone significant changes during the last four decades.

RESUMO

Introducción: En la evolución de las características de la cirugía coronaria (CC) intervienen factores como cambios demográficos, técnica quirúrgica y cuidados perioperatorios. Nuestro objetivo es analizar la evolución de las características de la enfermedad coronaria en pacientes tratados con CC y sus resultados inmediatos. Material y Método: Estudio analítico. Cohorte de pacientes operados con CC aisladas entre enero de 2006 y diciembre de 2008, y entre enero de 2016 y diciembre de 2018 en Hospital Clínico Regional de Concepción, Chile. Revisión bases datos y protocolos quirúrgicos, previa autorización comité de ética. Se utilizó SPSSv25® y pruebas estadísticas Chi-cuadrado y U Mann-Whitney, considerando significativo p < 0,05. Resultados: Total 1.400 CC aisladas, 658 primer período y 742 segundo período. Edad promedio: 62,0 ± 8,7 y 64,6 + 9,3 años según períodos (p < 0,001). Aumentaron significativamente en el segundo período: diabetes mellitus, enfermedad pulmonar obstructiva crónica, infarto agudo al miocardio (IAM), disfunción ventricular grave dentro de subgrupo con disfunción ventricular. Disminución significativa de la cirugía sin circulación extracorpórea, y aumento significativo del uso ≥ 2 puentes arteriales en el segundo período. EuroSCORE I aditivo aumentó de 3,6 ± 2,5 a 4,4 ± 2,7 (p = 0,001). Subgrupo de alto riesgo: 137 (20,8%) a 236 (31,8%), p < 0,001. Mortalidad de 13 (1,98%) y 16 (2,2%) según períodos, p = 0,813. Discusión: Se observó aumento significativo del riesgo operatorio estimado, sin embargo, la mortalidad se mantuvo sin variación. El aumento del riesgo operatorio se condice con el aumento de la edad promedio y de la prevalencia de comorbilidades, así como del aumento de disfunción ventricular grave dentro del grupo de pacientes con disfunción ventricular e IAM reciente en el segundo período.

Introduction: Several factors intervene in the evolution of the characteristics of Coronary artery bypass grafting (CABG), such as demographic changes, surgical technique, and perioperative care. Our objective was to analyze the evolution of the characteristics of coronary artery disease in patients treated with CABG and its immediate results. Methods: In an analytical study, we analyzed a cohort of patients with isolated CABG from January 2006 to December 2008 and from January 2016 to December 2018 in Hospital Clínico Regional Concepción, Chile. After the ethics committee's approval, we reviewed the database and surgical protocols. We used Chi-square and U Mann Whitney tests for statistical analysis (SPSSv25®), considering significant p < 0,05. Results: We analyzed 1,400 isolated CABG, 658 from the first period and 742 from the second, with a mean age of 62.0 ± 8.7 and 64.6 ± 9.3 respectively (p < 0.001). The subgroup with ventricular dysfunction in the second period showed a significant increase in diabetes mellitus, chronic obstructive pulmonary disease, acute myocardial infarction (AMI), and severe ventricular dysfunction. The second group decreased off-pump surgery and increased the use of ≥ 2 arterial grafts (p < 0.05). The Additive EuroSCORE I increased from 3.6 ± 2.5 to 4.4 ± 2.7 (p = 0.001). High-risk subgroup: 137 (20.8%) to 236 (31.8%), p < 0.001. Mortality of 13 (1.98%) and 16 (2.2%) in the first and second group respectively, p = 0.813. Conclusion: There was a significant increase in the estimated surgical risk; however, mortality remained unchanged. The increase in surgical risk is consistent with the increase in mean age and prevalence of comorbidities, as well as the increase in severe ventricular dysfunction in the group ofpatients with ventricular dysfunction and recent AMI in the second period.

RESUMO

BACKGROUND: Long-term outcomes of Off-Pump Coronary Artery Bypass Grafting (OPCAB) as an alternative to the traditional Coronary Artery Bypass Grafting (CABG) technique with cardiopulmonary bypass (CPB) are not well defined. AIM: To compare 10-year survival of isolated OPCAB versus CABG with CPB. MATERIAL AND METHODS: Analysis of information obtained from databases, clinical records and surgical protocols of patients treated with isolated CABG between January 2006 and November 2008 at a Regional Hospital. Of 658 isolated CABG, 192 (29.2%) were OPCAB and 466 (79.9%) CPB. Propensity Score Matching (PSM) was performed to compare both groups. After PSM, two groups of 192 cases were obtained. Mortality data was obtained from the Chilean public identification service. Ten-year survival was calculated and compared with Kaplan-Meier and log-rank methods. RESULTS: Follow-up data was obtained in all cases. No statistically significant differences were found when comparing 10-year survival between OPCAB versus CPB (78.6% and 80.2% respectively, p 0.720). There was also no statistical difference in cardiovascular death free survival (90.1% with CPB versus 89.1% OPCAB, p 0.737). Survival was comparable when analyzing subgroups with diabetes mellitus, left ventricular dysfunction or chronic kidney disease, among others. CONCLUSIONS: In our series, OPBAB has a comparable 10-year survival with CABG with CPB.

Assuntos