RESUMO
Resumen La neuropatía laríngea es una condición de hipersensibilidad, hiperreactividad e hiper-función laríngea secundaria a un desequilibrio entre las aferencias y eferencias laríngeas. La respuesta individual y exagerada frente a diversos gatillantes específicos puede generar síntomas como tos crónica, parestesia laríngea, carraspera, disfonía, estridor, sensación de globus faríngeo, movimiento paradojal de las cuerdas vocales (también conocido como disfunción cordal) y/o laringoespasmo. Existe abundante literatura sobre neuropatía laríngea en adultos, sin embargo, en niños es limitada. El objetivo de este artículo es dar a conocer un caso de neuropatía laríngea en la edad pediátrica y la importancia de su consideración en el enfrentamiento de estos pacientes. Se presenta caso clínico de un paciente de 13 años, con antecedente de cirugía cardiaca reciente, evoluciona con disfonía severa evidenciándose aparente inmovilidad cordal bilateral con resultados discordantes entre nasofibrolaringoscopía y electromiografía laríngea. Posteriormente presenta mejorías en su voz, sin embargo, se agregan otros síntomas laringológicos como carraspera, globus faríngeo y estridor no explicados por causas anatómicas. Se expone la evaluación y abordaje otorrinolaringológico-fonoaudiológico para el caso. Se concluye que el diagnóstico de neuropatía laríngea requiere un alto índice de sospecha clínica ante signos laringológicos sugerentes, debiendo descartarse causas orgánicas y estructurales. El abordaje otorrinolaringológico-fonoaudiológico constituye el pilar terapéutico asociado al uso de neuromoduladores en casos seleccionados.
Abstract Laryngeal neuropathy is a condition of hypersensitivity, hyperresponsiveness and laryngeal hyperfunction secondary to an imbalance between laryngeal afferent and efferent information. The individual and exaggerated response to diverse specific triggers can lead to symptoms such as chronic cough, laryngeal paresthesia, throat clearing, dysphonia, stridor, globus pharyngeus, vocal cord dysfunction, and/or laryngospasm. There is plentiful literature on laryngeal neuropathy in adults, however, in children, it is limited. Here, we present a case report of laryngeal neuropathy in the pediatric age and discuss the importance of its consideration in the approach of these patients. A case of a 13-year-old patient, recently intervened with cardiac surgery that evolves with severe dysphonia is presented. Nasofibrolaryngoscopy shows apparent bilateral vocal fold immobility with discordant results in laryngeal electromyography. Later, his voice improves but other laryngological symptoms appeared, such as throat clearing, globus pharyngeus and stridor, not explained by anatomical causes. The otolaryngological-speech therapy evaluation and approach for the case is exposed. We conclude that for the diagnosis of laryngeal neuropathy, a high index of clinical suspicion is required in the presence of suggestive laryngological symptoms, and organic and structural causes must be previously ruled out. The otorhinolaryngological-logopedic approach constitutes the mainstay of treatment associated with the use of neuromodulators in selected cases.
Assuntos
Humanos , Masculino , Adolescente , Doenças da Laringe/diagnóstico , Doenças da Laringe/terapia , Prega Vocal/fisiopatologia , Sons Respiratórios , Tosse/diagnóstico , Disfonia/diagnóstico , Disfunção da Prega Vocal/fisiopatologia , Sensação de Globus/diagnósticoRESUMO
Resumen El trastorno del procesamiento sensorial (TPS) es una condición frecuente, pero poco conocida por muchos profesionales de la salud. El procesamiento sensorial se define como la capacidad que posee el sistema nervioso central de interpretar y organizar las sensaciones del propio cuerpo y del ambiente, para su uso efectivo en el entorno mediante respuestas adaptativas. Por lo tanto, cualquier disfunción en el procesamiento (registro, modulación y/o discriminación) de estos estímulos se expresa como una respuesta desadaptativa, siendo significativo cuando esta impacta en la vida diaria del paciente. Es deber del médico sospechar este trastorno, acogiendo al paciente y su familia, derivando oportunamente a terapia ocupacional para su correcta evaluación y eventual manejo de acuerdo con las necesidades de cada paciente.
Abstract Sensory processing disorder (SPD) is an unknown condition for many health care professionals. Sensory processing is defined as the capacity of the central nervous system to interpretate and organize sensations from our own body and from the environment, for their proper use by adaptive responses. Any dysfunction in this processing (registration, modulation and or discrimination) is expressed by a maladaptive response, being considered abnormal when this response has a negative impact in the patient's daily activities. Is our duty as health care workers to suspect this disorder, help our patients and their families by doing a proper referral to an occupational therapist for their evaluation and management, according to each patient needs.
Assuntos
Humanos , Otorrinolaringopatias/terapia , Percepção , Terapia Ocupacional/métodos , Transtornos de Sensação/terapia , Transtornos de Sensação/epidemiologia , Qualidade de Vida , Sistema Nervoso Central , Prevalência , Inquéritos e Questionários , Transtornos de Sensação/diagnósticoRESUMO
AIMS: To evaluate the relationship between self-reported colour-race, genomic ancestry, and metabolic syndrome in an admixed Brazilian population with type 1 diabetes. METHODS: We included 1640 participants with type 1 diabetes. The proportions of European, African and Amerindian genomic ancestries were determined by 46 ancestry informative markers of insertion deletion. Two different sets of analyses were performed to determine whether self-reported colour-race and genomic ancestry were predictors of metabolic syndrome. RESULTS: Metabolic syndrome was identified in 29.8% of participants. In the first model, the factors associated with metabolic syndrome were: female gender (odds ratio 1.95, P < 0.001); diabetes duration (odds ratio 1.04, P < 0.001); family history of type 2 diabetes (odds ratio 1.36, P = 0.019); and acanthosis nigricans (odds ratio 5.93, P < 0.001). Colour-race was not a predictive factor for metabolic syndrome. In the second model, colour-race was replaced by European genomic ancestry. The associated factors were: female gender (odds ratio 1.95, P < 0.001); diabetes duration (odds ratio 1.04, P < 0.001); family history of type 2 diabetes (odds ratio 1.39, P = 0.011); and acanthosis nigricans (odds ratio 6.12, P < 0.001). Physical exercise (≥3 times a week) was a protective factor (odds ratio 0.77, P = 0.041), and European genomic ancestry was not associated with metabolic syndrome but showed an odds ratio of 1.77 (P = 0.05). CONCLUSIONS: Although a higher level of European genomic ancestry was observed among participants with metabolic syndrome in the univariate analysis, this association did not persist after multivariable adjustments. Further prospective studies in other highly admixed populations remain necessary to better evaluate whether the European ancestral component modulates the development of metabolic syndrome in type 1 diabetes.
Assuntos
Diabetes Mellitus Tipo 1/epidemiologia , Exercício Físico/estatística & dados numéricos , Síndrome Metabólica/etnologia , Acantose Nigricans/epidemiologia , Adolescente , Adulto , Indígena Americano ou Nativo do Alasca/genética , Indígena Americano ou Nativo do Alasca/estatística & dados numéricos , População Negra/genética , População Negra/estatística & dados numéricos , Brasil/epidemiologia , Criança , Estudos Transversais , Diabetes Mellitus Tipo 2 , Feminino , Genômica , Humanos , Masculino , Anamnese , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/genética , Pessoa de Meia-Idade , Fatores de Proteção , Fatores de Risco , Fatores Sexuais , População Branca/genética , População Branca/estatística & dados numéricos , Adulto JovemRESUMO
ABSTRACT In any broiler breeder flock, there is always some mortality that is considered to be normal during the life of the flock. The aim of this study is to summarize the prevalence and patterns of mortality during the production period. To evaluate the mortality, each dead hen was systematically and completely examined via necropsy. In addition to post mortem evaluation, weights (whole body, liver, spleen and heart) were recorded to correlate the birds physical condition with the mortality category or lesion. In general, the variation in mortality was not associated with the specific weight of the organs. However, for specific diseases like fatty liver, septicemia and ascites, there was a correlation with the organ weight of the liver, spleen and heart respectively. Ovaritis was observed to be the most prevalent lesion found in dead hens during the production period followed by ovarian regression (atrophy), peritonitis, internal lay and vent pecking. The two periods with the higher total percentage of morality were onset of lay (25-30 weeks) and end-stage of the production period (56-61 weeks). During the laying period, we mainly observed metabolic disorders followed by infectious lesions. Infectious lesions, including ovaritis and septicemia, were the predominant cause for mortality at the onset production. Vent and feather pecking were also primarily concentrated during the first weeks of the production period. Metabolic diseases were observed in higher prevalence during the latter half of the production period.
RESUMO
Helicobacter pylori (H. pylori) eradication using standard triple therapy (STT) with proton pump inhibitors (PPI), amoxicillin and clarithromycin (CLA) has been the standard in Latin America. However, CLA resistance is a rising problem affecting eradication rates. Genetic polymorphisms of CYP2C19, a PPI metabolizer may also affect eradication. The primary aims of this study were to evaluate the effect of clarithromycin resistance on H. pylori eradication in a population from Santiago, and to establish the pooled clarithromycin resistance in Santiago, Chile. Symptomatic adult patients attending a tertiary hospital in Santiago were recruited for this study. CLA resistance and the polymorphisms of CYP2C19 were determined on DNA extracted from gastric biopsies, using PCR. The STT was indicated for 14 days and eradication was determined by a urea breath test 4-6 weeks after therapy. A meta-analysis of CLA resistance studies among adult residents in Santiago was performed. Seventy-three out of 121 consecutive patients had positive rapid urease test (RUT) and received STT. Sixty-nine patients (95%) completed the study. The H. pylori eradication rate was 63% and the prevalence of CLA resistance was 26%. According to the CYP2C19 polymorphisms, 79.5% of the RUT-positive patients were extensive metabolizers. Multivariable analyses showed that only CLA resistance was significantly and inversely associated with failure of eradication (OR: 0.13; 95% confidence interval [95% CI], 0.04-0.49). A meta-analysis of two previous studies and our sample set (combined n = 194) yielded to a pooled prevalence of CLA resistance of 31.3% (95% CI 23.9-38.7). Our study shows that CLA resistance is associated with failure of H. pylori eradication. Given the high pooled prevalence of CLA resistance, consideration of CLA free therapies in Santiago is warranted. We could recommend bismuth quadruple therapy or high-dose dual therapy, according to bismuth availability. Further studies need to evaluate the best therapy.
Assuntos
Antibacterianos/farmacologia , Claritromicina/farmacologia , Infecções por Helicobacter/tratamento farmacológico , Helicobacter pylori/efeitos dos fármacos , Adulto , Bismuto/uso terapêutico , Chile/epidemiologia , Estudos de Coortes , Farmacorresistência Bacteriana/efeitos dos fármacos , Feminino , Infecções por Helicobacter/epidemiologia , Infecções por Helicobacter/microbiologia , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos ProspectivosRESUMO
Abstract The present study assessed the percentage of survival and metamorphosis of larval stages of Caligus rogercresseyi (Boxshall and Bravo, 2000) nauplius I, nauplius II to and nauplius II to copepodite, conducting bioassays in triplicate with 50 larvae each, nauplius I or nauplius II, at temperature of 12 °C, 15 °C and 18 °C; salinity 20, 23, 25, 2729, 31, 33 and 35 g/L and oxygen saturation with ranges between 30-60%, 90-100% and 190 - 200%. Bioassays were performed in station Quillaipe of Fundación Chile, Puerto Montt, Chile. It is concluded that the temperature is inversely proportional to the time of metamorphosis and survival of the larvae of Caligus rogercresseyi . In salinity is observed that increased this, greater is the percentage of survival and metamorphosis is faster, while the larvae do not survive less than 20g/L. Oxygen saturation ranges indicate that the larvae do not survive at saturations between 30-60%, and it had no differences between 90-100% saturation and 190-200%.
Resumo O presente estudo avaliou a percentagem de sobrevivência e metamorfose dos estádios larvais de Caligus rogercresseyi (Boxshall and Bravo, 2000) nauplio I, nauplio II ae nauplio II a copepodita, realizando bioensaios em triplicado com 50 larvas cada, nauplio I ou nauplio II, À temperatura de 12 °C, 15 °C e 18 °C; Salinidade 20, 23, 25, 2729, 31, 33 e 35 g / L e saturação de oxigénio com variações entre 30-60%, 90-100% e 190-200%. Os bioensaios foram realizados na estação Quillaipe da Fundação Chile, Puerto Montt, Chile. Conclui - se que a temperatura é inversamente proporcional ao tempo de metamorfose e sobrevivência das larvas de Caligus rogercresseyi. Na salinidade observa-se que aumentou esta, maior é a percentagem de sobrevivência e metamorfose é mais rápida, enquanto as larvas não sobrevivem menos de 20g / L. Os intervalos de saturação de oxigénio indicam que as larvas não sobrevivem a saturações entre 30-60% e não têm diferenças entre 90-100% de saturação e 190-200%.
Assuntos
Animais , Copépodes/fisiologia , Larva/fisiologia , Metamorfose Biológica/fisiologia , ChileRESUMO
Lettuce (Lactuca sativa L.) constitutes one the most important vegetable crops worldwide. Poultry litter is being applied as an economically suitable alternative to nitrogen fertilizers in lettuce cultivation. However, little is known about the effects of this practice over this fresh product safety that is usually consumed as a salad. The aim of this work was to determine the microbiological quality and the nitrate content in lettuce produced, under field conditions, using either raw or composted poultry litter, coming from the same original batch. Two experiments were conducted in the experimental field of Facultad de Ciencias Agrarias (UNL, Santa Fe, Argentina) to assess the effects of recently extracted poultry litter that consisted of broiler chicken manure plus rice husk, or composted for 12 mo. The application amounts were: 20 T ha-1 (T1); 40 T ha-1 (T2); and no application of manure (T). Increasing the applied quantities had also increased the health risk associated with lettuce consumption, due to higher nitrate levels and microbial contamination. However, these risks were reduced by composting the material. Even when lettuce contamination with faecal bacteria was mainly due to the use of poultry litter, the number and incidence of pathogens were reduced when properly composted manure was applied instead of raw one. Increasing the dose of poultry litter applied also increases the health risk in lettuce. Though, when the material is properly composted, its fertilizing capacity is maintained, giving proper yields with lower nitrate levels and microbial contamination by enterobacteria.
Assuntos
Compostagem , Contaminação de Alimentos/análise , Lactuca/microbiologia , Esterco/microbiologia , Animais , Argentina , Galinhas , Produção Agrícola/métodos , Enterobacteriaceae/isolamento & purificação , Fertilizantes/efeitos adversos , Lactuca/química , Esterco/análise , Nitratos/análise , Fatores de RiscoRESUMO
The present study assessed the percentage of survival and metamorphosis of larval stages of Caligus rogercresseyi (Boxshall and Bravo, 2000) nauplius I, nauplius II to and nauplius II to copepodite, conducting bioassays in triplicate with 50 larvae each, nauplius I or nauplius II, at temperature of 12 °C, 15 °C and 18 °C; salinity 20, 23, 25, 2729, 31, 33 and 35 g/L and oxygen saturation with ranges between 30-60%, 90-100% and 190 - 200%. Bioassays were performed in station Quillaipe of Fundación Chile, Puerto Montt, Chile. It is concluded that the temperature is inversely proportional to the time of metamorphosis and survival of the larvae of Caligus rogercresseyi . In salinity is observed that increased this, greater is the percentage of survival and metamorphosis is faster, while the larvae do not survive less than 20g/L. Oxygen saturation ranges indicate that the larvae do not survive at saturations between 30-60%, and it had no differences between 90-100% saturation and 190-200%.
Assuntos
Copépodes/fisiologia , Larva/fisiologia , Metamorfose Biológica/fisiologia , Animais , Chile , Oxigênio/análise , Salinidade , Água do Mar/química , TemperaturaRESUMO
The present study assessed the percentage of survival and metamorphosis of larval stages of Caligus rogercresseyi (Boxshall and Bravo, 2000) nauplius I, nauplius II to and nauplius II to copepodite, conducting bioassays in triplicate with 50 larvae each, nauplius I or nauplius II, at temperature of 12 °C, 15 °C and 18 °C; salinity 20, 23, 25, 2729, 31, 33 and 35 g/L and oxygen saturation with ranges between 30-60%, 90-100% and 190 - 200%. Bioassays were performed in station Quillaipe of Fundación Chile, Puerto Montt, Chile. It is concluded that the temperature is inversely proportional to the time of metamorphosis and survival of the larvae of Caligus rogercresseyi . In salinity is observed that increased this, greater is the percentage of survival and metamorphosis is faster, while the larvae do not survive less than 20g/L. Oxygen saturation ranges indicate that the larvae do not survive at saturations between 30-60%, and it had no differences between 90-100% saturation and 190-200%.(AU)
O presente estudo avaliou a percentagem de sobrevivência e metamorfose dos estádios larvais de Caligus rogercresseyi (Boxshall and Bravo, 2000) nauplio I, nauplio II ae nauplio II a copepodita, realizando bioensaios em triplicado com 50 larvas cada, nauplio I ou nauplio II, À temperatura de 12 °C, 15 °C e 18 °C; Salinidade 20, 23, 25, 2729, 31, 33 e 35 g / L e saturação de oxigénio com variações entre 30-60%, 90-100% e 190-200%. Os bioensaios foram realizados na estação Quillaipe da Fundação Chile, Puerto Montt, Chile. Conclui - se que a temperatura é inversamente proporcional ao tempo de metamorfose e sobrevivência das larvas de Caligus rogercresseyi. Na salinidade observa-se que aumentou esta, maior é a percentagem de sobrevivência e metamorfose é mais rápida, enquanto as larvas não sobrevivem menos de 20g / L. Os intervalos de saturação de oxigénio indicam que as larvas não sobrevivem a saturações entre 30-60% e não têm diferenças entre 90-100% de saturação e 190-200%.(AU)