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1.
Front Pharmacol ; 14: 1175737, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37251329

RESUMO

Pharmacogenomics (PGx) is considered an emergent field in developing countries. Research on PGx in the Latin American and the Caribbean (LAC) region remains scarce, with limited information in some populations. Thus, extrapolations are complicated, especially in mixed populations. In this paper, we reviewed and analyzed pharmacogenomic knowledge among the LAC scientific and clinical community and examined barriers to clinical application. We performed a search for publications and clinical trials in the field worldwide and evaluated the contribution of LAC. Next, we conducted a regional structured survey that evaluated a list of 14 potential barriers to the clinical implementation of biomarkers based on their importance. In addition, a paired list of 54 genes/drugs was analyzed to determine an association between biomarkers and response to genomic medicine. This survey was compared to a previous survey performed in 2014 to assess progress in the region. The search results indicated that Latin American and Caribbean countries have contributed 3.44% of the total publications and 2.45% of the PGx-related clinical trials worldwide thus far. A total of 106 professionals from 17 countries answered the survey. Six major groups of barriers were identified. Despite the region's continuous efforts in the last decade, the primary barrier to PGx implementation in LAC remains the same, the "need for guidelines, processes, and protocols for the clinical application of pharmacogenetics/pharmacogenomics". Cost-effectiveness issues are considered critical factors in the region. Items related to the reluctance of clinicians are currently less relevant. Based on the survey results, the highest ranked (96%-99%) gene/drug pairs perceived as important were CYP2D6/tamoxifen, CYP3A5/tacrolimus, CYP2D6/opioids, DPYD/fluoropyrimidines, TMPT/thiopurines, CYP2D6/tricyclic antidepressants, CYP2C19/tricyclic antidepressants, NUDT15/thiopurines, CYP2B6/efavirenz, and CYP2C19/clopidogrel. In conclusion, although the global contribution of LAC countries remains low in the PGx field, a relevant improvement has been observed in the region. The perception of the usefulness of PGx tests in biomedical community has drastically changed, raising awareness among physicians, which suggests a promising future in the clinical applications of PGx in LAC.

2.
Rev. cuba. med ; 62(1)mar. 2023.
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1450009

RESUMO

Introducción: El uso clínico de la ozonoterapia se incrementa cada día. Abarca disímiles especialidades médicas como la oncología. En Cuba las investigaciones que evalúan el empleo de la ozonoterapia en pacientes con cáncer son escasas, se precisan estudios científicos que demuestren su eficacia clínica. Objetivo: Explicar los mecanismos farmacológicos y bioquímicos de la ozonoterapia y su uso en el cáncer como terapia complementaria. Métodos: Se consultaron bases de datos disponibles a través de la red de Infomed. Se utilizaron como palabras clave: cáncer, ozonoterapia y estrés oxidativo. Se seleccionaron artículos originales y de revisión sistemáticos de los últimos diez años que evaluaron la utilización de la ozonoterapia en el tratamiento del cáncer. Resultados: El cáncer es per se una enfermedad inductora de estrés oxidativo. La ozonoterapia respalda su utilización como una terapia adyuvante mediante el preacondicionamiento oxidativo que estimula los sistemas antioxidantes de la célula contra la acción de los radicales libres. Así, se logra neutralizar la acción nociva del estrés oxidativo. El ozono incrementa la eficacia de la radio - quimioterapia y ayuda a reducir los efectos secundarios de estos tratamientos al activar los sistemas antioxidantes de la célula. La ozonoterapia se caracteriza por la simplicidad de su aplicación, bajos costos, alta efectividad y prácticamente ausencia de efectos colaterales en comparación con otros tratamientos adyuvantes. Conclusiones: El uso de la ozonoterapia en oncología como una terapia adyuvante representó un recurso terapéutico de gran valor dado por su perfil de efectividad y seguridad. Su uso podría extenderse para disminuir los efectos secundarios y mejorar la calidad de vida de los pacientes(AU)


Introduction: The clinical use of ozone therapy is increasing every day worldwide and it covers different medical specialties, including oncology. However, in Cuba, the investigations that evaluate the use of ozone therapy in cancer patients are scarce, so scientific studies are needed to demonstrate its clinical efficacy. Objective: To explain the pharmacological and biochemical mechanisms of ozone therapy and its use in cancer as a complementary therapy. Methods: Databases available through Infomed Network were consulted. Key words used were cancer, ozone therapy and oxidative stress. Original and systematic review articles from the last ten years that evaluated the use of ozone therapy in the treatment of cancer were selected. Results: Cancer is, as such, a disease that induces oxidative stress. Ozone therapy supports its use as an adjuvant therapy through oxidative pre-conditioning that stimulates the cell's antioxidant systems against the action of free radicals. Thus, it is possible to neutralize the harmful action of oxidative stress. Ozone increases the efficacy of radio-chemotherapy and helps reducing the side effects of these treatments by activating the cell's antioxidant systems. Ozone therapy is characterized by the simplicity of its application, low costs, high effectiveness and with practically no side effects, compared to other adjuvant treatments. Conclusions: The use of ozone therapy in oncology as an adjuvant therapy represented a therapeutic resource of great value given its effectiveness and safety profile. Its use could be extended to improve tissue oxygenation and thus enhance the efficacy of radiochemotherapy, reducing side effects and improving the patients's quality of life(AU)


Assuntos
Humanos , Masculino , Feminino , Qualidade de Vida , Radioterapia/métodos , Estresse Oxidativo , Tratamento Farmacológico/métodos , Ozonioterapia , Neoplasias/terapia
3.
Front Allergy ; 4: 1073430, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36793546

RESUMO

Background: Cow's milk protein allergy (CMPA) is the leading cause of food allergy in infants and young children. An extensively hydrolyzed formula (eHF) is the first choice of dietary management, however, not all of them have similar peptide profiles and degree of hydrolysis. The aim of this retrospective study was to investigate the use of two commercially available infant formulas in the clinical management of CMPA in Mexico in terms of symptoms' resolution and growth trajectories. Methods: Medical records of 79 subjects from four sites in Mexico were included to retrospectively evaluate the trajectory of atopic dermatitis, other symptoms of cow's milk protein allergy and growth outcomes. The study formulas were based on hydrolyzed whey protein (eHF-W) and hydrolyzed casein protein (eHF-C). Results: Medical records of 79 patients were enrolled, 3 were excluded from analysis based on previous formula consumption. Seventy-six children with confirmed CMPA based on skin prick test and/or serum specific IgE levels were included in the analysis. 82% of patients (n = 65) consumed the eHF-C, reflecting the doctors' preference for formulas with a higher grade of hydrolysis and the high incidence of positive reactions to beta-lactoglobulin amongst subjects. During their first visit to the doctors, 55% of the subjects consuming the casein-based formula and 45% of subjects consuming the whey-based formula presented with mild or moderate dermatological symptoms. Other frequently reported symptoms included respiratory issues, enteropathies and colitis which improved during the consumption of both formulas. All CMPA-related symptoms showed improvement during formula consumption. During the period of retrospective observation, growth significantly improved for both groups. Conclusion: Consumption of eHF-C and eHF-W effectively improved symptoms' resolution and growth outcomes among children with CMPA in Mexico. More preference was reported towards eHF-C due to its hydrolysate profile and lack of b-lactoglobulin. Trial registration: The study was registered at ClinicalTrials.gov: NCT04596059.

4.
Rev. cuba. med. mil ; 51(1)mar. 2022.
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1408790

RESUMO

RESUMEN Introducción: El cáncer de pulmón es uno de los principales problemas de salud en Cuba y el mundo. Las diferencias genéticas a causa de polimorfismos de un solo nucleótido, son factores importantes involucrados en la susceptibilidad genética a esta enfermedad. En Cuba son escasos los datos disponibles sobre los polimorfismos de un solo nucleótido y su posible influencia sobre la aparición y pronóstico del cáncer. Objetivo: Exponer la importancia del estudio de los polimorfismos de un solo nucleótido en genes de la reparación del daño al ADN en el cáncer de pulmón. Desarrollo: El tabaquismo es el principal factor de riesgo para desarrollar cáncer de pulmón, sin embargo, aproximadamente el 15 % de los fumadores desarrollará la enfermedad. Los polimorfismos de un solo nucleótido son factores involucrados en la predisposición genética a las enfermedades. La presencia de variantes polimórficas puede modificar la eficacia de los sistemas de reparación, favoreciendo la aparición de genotoxicidad y/o mutagénesis. También pueden modificar la respuesta a los tratamientos oncológicos y la supervivencia de los pacientes. Por consiguiente, además de ser marcadores de susceptibilidad, los polimorfismos se consideran marcadores de pronóstico individual de respuesta a la terapia. Este trabajo enfatiza la utilidad de su evaluación como biomarcadores clínicos y de susceptibilidad genética a enfermedades en la población cubana. Conclusiones: El estudio de polimorfismos de un solo nucleótido permitirá el abordaje personalizado de enfermedades oncológicas, lo cual podría contribuir a su detección temprana y a definir grupos de individuos con alto riesgo de padecer cáncer de pulmón.


ABSTRACT Introduction: Lung cancer is one of the main health problems in Cuba and worldwide. Genetic differences due to single nucleotide polymorphisms are important factors involved in the genetic susceptibility to this disease. In Cuba, there are scarce data available on single nucleotide polymorphisms and their possible influence on the incidence and prognosis of cancer. Objective: To expose the importance of the study of single nucleotide polymorphisms in DNA damage repair genes in lung cancer. Results: Smoking is the main risk factor for developing lung cancer, however, approximately 15 % of smokers will develop the disease. Single nucleotide polymorphisms are important factors involved in genetic predisposition to diseases. The presence of polymorphic variants can modify the efficacy of repair systems, favoring the occurrence of genotoxicity and/or mutagenesis. They can also modify the response to oncological treatments and patient´s survival. Therefore, in addition to being susceptibility markers, polymorphisms are considered individual prognostic markers of response to therapy. This work emphasizes the usefulness of evaluating single nucleotide polymorphisms as clinical and susceptibility biomarkers in the Cuban population. Conclusions. The study of single nucleotide polymorphisms will allow a personalized approach to oncological diseases, which could contribute to define groups of individuals at high risk of getting lung cancer, therefore, early disease detection.

5.
Biomedica ; 41(4): 756-772, 2021 12 15.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-34936259

RESUMO

Introduction: Endoparasites and ectoparasites in dogs are of global distribution. The close relationship between dogs and man implies a risk for the transmission of zoonotic parasites. Therefore, it is necessary to determine the parasites hosted by dogs in specific areas and the factors associated with their presence. Objectives: To identify and to estimate the prevalence of endoparasites and ectoparasites in domiciled dogs in the Metropolitan area of Toluca, México, and the prevalence of D. caninum in fleas of the genus Ctenocephalides spp. Materials and methods: We collected samples from 402 domiciled dogs in four reference hospitals in the area in Toluca. We diagnosed endoparasites using direct smear, flotation, and sedimentation techniques and we performed the taxonomic identification of ectoparasites. Finally, the molecular diagnosis of D. caninum in fleas was made using the polymerase chain reaction technique (PCR). Results: A total of 37.2% of dogs were positive for endoparasites; the genera or species identified were Toxocara spp., Giardia spp., Ancylostoma spp., Cystoisospora spp., D. caninum, Taenia spp., and Trichuris vulpis; the prevalence of ectoparasites was 13.13%. We identified fleas of the species Ctenocephalides felis, Ctenocephalides canis; only one animal was parasitized with Rhipicephalus sanguineus and another one with Trichodectes canis; the prevalence of D. caninum in fleas was 9.5%. Conclusion: The prevalence of endoparasites was 37.2% while that of ectoparasites was 13.1%; this is the first analysis of endoparasites and ectoparasites conducted in the same population of dogs in México together with the molecular diagnosis of D. caninum in fleas.


Introducción. Los endoparásitos y ectoparásitos en perros son de distribución mundial. La estrecha relación entre los perros y el hombre implica un riesgo de transmisión de parasitosis zoonóticas, por lo cual es necesario conocer las especies que parasitan a los perros de esta zona y determinar los factores asociados. Objetivos. Estimar la prevalencia de endoparásitos y ectoparásitos, identificarlos en perros domiciliados de la zona metropolitana de Toluca, México, y determinar la prevalencia de Dipyilidium caninum en pulgas del género Ctenocephalides spp. Materiales y métodos. Se recolectaron muestras de 402 perros que fueron llevados a consulta en cuatro hospitales de referencia de Toluca. En el diagnóstico de endoparásitos, se utilizaron las técnicas coproparasitoscópicas de frotis directo, flotación y sedimentación; además, se recolectaron ectoparásitos para su identificación taxonómica. Por último, la detección de D. caninum en pulgas se hizo mediante la reacción en cadena de la polimerasa (PCR). Resultados. El 37,2 % de los perros resultó positivo para endoparásitos. Los géneros o especies identificados fueron Toxocara spp., Giardia spp., Ancylostoma spp., Cystoisospora spp., D. caninum, Taenia spp. y Trichuris vulpis. Se determinó una prevalencia de ectoparásitos de 13,13 %. Se identificaron pulgas de las especies Ctenocephalides felis y C. canis, en tanto que solo un animal presentó parasitosis por Rhipicephalus sanguineus y otro por Trichodectes canis. La prevalencia de D. caninum en pulgas fue del 9,5 %. Conclusión. La prevalencia de endoparásitos fue de 37,2 % y, la de ectoparásitos, de 13,1 %. Por primera vez en México se hizo un análisis de endoparásitos y ectoparásitos en una misma población de perros, así como el diagnóstico molecular de D. caninum.


Assuntos
Doenças do Cão , Parasitos , Sifonápteros , Animais , Doenças do Cão/epidemiologia , Cães , Fezes , México/epidemiologia , Reação em Cadeia da Polimerase , Prevalência
6.
Drug Metab Pers Ther ; 37(2): 141-148, 2021 12 06.
Artigo em Inglês | MEDLINE | ID: mdl-34860473

RESUMO

OBJECTIVES: ABCB1 gene polymorphisms can modify P-glycoprotein function with clinical consequences. METHODS: The 3435C>T polymorphism prevalence was analyzed using oligonucleotide probes and next-generation sequencing in 421 unrelated healthy individuals living in Cuba. Data were stratified by gender, ethnic background and residence. The genotype and allelic frequencies were determined. RESULTS: The genotype distribution met the Hardy-Weinberg equilibrium assumption. The allelic frequency was 63.5% for the 3435C variant. The genotype frequencies were 41.1% for CC, 44.9% for CT and 14.0% for TT. The allele and genotype distributions differed between individuals living in La Habana and Santiago de Cuba (p<0.05) when ethnic background was analyzed. The allelic distribution was similar among Admixed and Black subjects, and they differed from Caucasians. The CC genotype was equally distributed among Admixed and Black subjects, and they differed from Caucasians. The TT genotype frequency differed between Caucasians and Admixed. The CT genotype was distributed differently among the three groups. Similar distribution was obtained in Brazilians, whereas some similarities were observed in African, Spanish and Chinese populations, consistent with the mixed Cuban ethnic origin. CONCLUSIONS: This is the first report on allele and genotype frequencies of the 3435C>T polymorphism in Cuba, which may support personalized medicine programs.


Assuntos
Polimorfismo de Nucleotídeo Único , Subfamília B de Transportador de Cassetes de Ligação de ATP/genética , Frequência do Gene/genética , Genótipo , Humanos , Polimorfismo de Nucleotídeo Único/genética , Prevalência
7.
Biomédica (Bogotá) ; 41(4): 756-772, oct.-dic. 2021. tab, graf
Artigo em Espanhol | LILACS | ID: biblio-1355748

RESUMO

Resumen | Introducción. Los endoparásitos y ectoparásitos en perros son de distribución mundial. La estrecha relación entre los perros y el hombre implica un riesgo de transmisión de parasitosis zoonóticas, por lo cual es necesario conocer las especies que parasitan a los perros de esta zona y determinar los factores asociados. Objetivos. Estimar la prevalencia de endoparásitos y ectoparásitos, identificarlos en perros domiciliados de la zona metropolitana de Toluca, México, y determinar la prevalencia de Dipyilidium caninum en pulgas del género Ctenocephalides spp. Materiales y métodos. Se recolectaron muestras de 402 perros que fueron llevados a consulta en cuatro hospitales de referencia de Toluca. En el diagnóstico de endoparásitos, se utilizaron las técnicas coproparasitoscópicas de frotis directo, flotación y sedimentación; además, se recolectaron ectoparásitos para su identificación taxonómica. Por último, la detección de D. caninum en pulgas se hizo mediante la reacción en cadena de la polimerasa (PCR). Resultados. El 37,2 % de los perros resultó positivo para endoparásitos. Los géneros o especies identificados fueron Toxocara spp., Giardia spp., Ancylostoma spp., Cystoisospora spp., D. caninum, Taenia spp. y Trichuris vulpis. Se determinó una prevalencia de ectoparásitos de 13,13 %. Se identificaron pulgas de las especies Ctenocephalides felis y C. canis, en tanto que solo un animal presentó parasitosis por Rhipicephalus sanguineus y otro por Trichodectes canis. La prevalencia de D. caninum en pulgas fue del 9,5 %. Conclusión. La prevalencia de endoparásitos fue de 37,2 % y, la de ectoparásitos, de 13,1 %. Por primera vez en México se hizo un análisis de endoparásitos y ectoparásitos en una misma población de perros, así como el diagnóstico molecular de D. caninum.


Abstract | Introduction: Endoparasites and ectoparasites in dogs are of global distribution. The close relationship between dogs and man implies a risk for the transmission of zoonotic parasites. Therefore, it is necessary to determine the parasites hosted by dogs in specific areas and the factors associated with their presence. Objectives: To identify and to estimate the prevalence of endoparasites and ectoparasites in domiciled dogs in the Metropolitan area of Toluca, México, and the prevalence of D. caninum in fleas of the genus Ctenocephalides spp. Materials and methods: We collected samples from 402 domiciled dogs in four reference hospitals in the area in Toluca. We diagnosed endoparasites using direct smear, flotation, and sedimentation techniques and we performed the taxonomic identification of ectoparasites. Finally, the molecular diagnosis of D. caninum in fleas was made using the polymerase chain reaction technique (PCR). Results: A total of 37.2% of dogs were positive for endoparasites; the genera or species identified were Toxocara spp., Giardia spp., Ancylostoma spp., Cystoisospora spp., D. caninum, Taenia spp., and Trichuris vulpis; the prevalence of ectoparasites was 13.13%. We identified fleas of the species Ctenocephalides felis, Ctenocephalides canis; only one animal was parasitized with Rhipicephalus sanguineus and another one with Trichodectes canis; the prevalence of D. caninum in fleas was 9.5%. Conclusion: The prevalence of endoparasites was 37.2% while that of ectoparasites was 13.1%; this is the first analysis of endoparasites and ectoparasites conducted in the same population of dogs in México together with the molecular diagnosis of D. caninum in fleas.


Assuntos
Zoonoses/epidemiologia , México , Toxocara canis , Ctenocephalides , Giardia , Ancylostoma
8.
Multimed (Granma) ; 24(1): 200-209, ene.-feb. 2020. graf
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1091376

RESUMO

RESUMEN Se presenta el caso de un paciente masculino, de 4 años de edad, producto de parto distócico (por cesárea), gestación a término, (41.0 semana), con un peso al nacer de 7.10 libras (normopeso) procedencia urbana, con antecedentes de haber sido sometido a tratamiento quirùrgico por una Obstrucción de vías lagrimales, a la edad de un año. Al examen oftalmológico se constata, caída de ambos párpados superiores a nivel del tercio medio del área pupilar; inserción baja del borde cantal superior externo de ambos párpados superiores, abundante lagrimeo y secreciones oculares; miopía pequeña y ambliopía bilateral ligera. Se observó además, trastornos posturales por elevación del mentón para mirar. Valorado por Neurología, se descartó causa neurológica de la ptosis. Estudiado por Oculoplastia, se decide tratamiento quirúrgico, consistente en acortamiento del músculo elevador de ambos parpados, por vía anterior y excursión de dicho músculo, en 6 mm. El resultado postquirúrgico fue satisfactorio.


ABSTRACT We present the case of a male patient, 4 years old, product of dystocic delivery (by caesarean section), term gestation, (41.0 weeks), with a birth weight of 7.10 pounds (normal weight) urban origin, with a history of having undergone surgical treatment for a tear duct obstruction, at the age of one year. At the ophthalmological examination, it is noted that both upper eyelids fall at the level of the middle third of the pupil area; low insertion of the upper outer canthal edge of both upper eyelids, abundant tearing and ocular secretions; Small myopia and slight bilateral amblyopia. It was also observed postural disorders due to elevation of the chin to look. Valued by Neurology, neurological cause of ptosis was ruled out. Studied by Oculoplasty, surgical treatment is decided, consisting of shortening of the elevating muscle of both eyelids, by anterior route and excursion of said muscle, in 6 mm. The post-surgical result was satisfactory.


RESUMO Apresentamos o caso de um paciente do sexo masculino, 4 anos, produto de parto distócico (por cesariana), gestação a termo (41,0 semanas), com peso ao nascer de 7,10 libras (peso normal) origem urbana, com histórico de tratamento cirúrgico para obstrução do canal lacrimal, com um ano de idade. No exame oftalmológico, nota-se que ambas as pálpebras superiores caem para o terço médio da área pupilar; baixa inserção da borda cantal externa superior de ambas as pálpebras superiores, lacrimejamento abundante e secreções oculares; Miopia pequena e ambliopia bilateral leve. Também foram observados distúrbios posturais devido à elevação do queixo para olhar. Avaliada pela Neurologia, a causa neurológica da ptose foi descartada. Estudado por oculoplastia, o tratamento cirúrgico é decidido, consistindo em encurtamento do músculo elevador de ambas as pálpebras, por via anterior e excursão do referido músculo, em 6 mm. O resultado pós-cirúrgico foi satisfatório.

9.
Arch. méd. Camaguey ; 23(2): 256-263, mar.-abr. 2019. graf
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1001235

RESUMO

RESUMEN Fundamento: el leiomiosarcoma de la vena cava superior es una enfermedad rara y más cuando se extiende a las cavidades cardíacas. Objetivo: presentar una paciente con leiomiosarcoma de la vena cava superior que se extendió de forma intraluminal a las cavidades derechas del corazón lo que provocó obstrucción de las mismas y choque cardiogénico. Caso clínico: paciente de 45 años de edad, blanca, femenina sin antecedentes mórbidos de salud, la cual presentó enrojecimiento del rostro y agotamiento de las extremidades al peinarse. Se le realiza tomografía axial computarizada donde se identificó una lesión sugestiva de trombosis, se decide su traslado hacia un centro especializado, se llega a la conclusión de que la paciente era portadora de una lesión tumoral no trombótica, la cual resultó ser benigna en una biopsia realizada por lo cual se decide seguimiento. La paciente reingresa en estado de shock cardiogénico por progresión de la enfermedad y se decide su tratamiento quirúrgico de emergencia, durante la cirugía fallece. Conclusiones: el leiomiosarcoma de la vena cava superior es una enfermedad rara, existen pocos reportes en la literatura sobre este padecimiento. Se presentó un caso en el cual el tumor se extendía de forma intraluminal a las cavidades cardíacas derechas (aurícula y ventrículo).


ABTRACT Background: the leiomyosarcoma of the superior cava vein is a rare illness and more when it extends to the cardiac cavities. Objective: to present to the medical community a female patient with leiomyosarcoma of the superior cava vein that extended intraluminal form to the right cavities of the heart causing obstruction and cardiogenic shock. Clinical case: a 45-year-old white female patient with no morbid health history, who presented redness of the face and exhaustion of the extremities when combing. A computerized axial tomography was performed where a lesion suggestive of thrombosis was identified. It was decided to transfer her to a specialized center, in which it is concluded that the patient was a carrier of a non-thrombotic tumor lesion, which turned out to be benign in a biopsy done for which follow-up is decided. The patient reenters in a state of cardiogenic shock due to progression of the disease, which is why her emergency surgical treatment is decided and die during surgery. Conclusions: the leiomyosarcoma of the superior vena cava is a rare illness, with few reports in the literature. A case in which the tumor extended intraluminally to the right cardiac cavities (atrium and ventricle) is presented.

10.
Rev. cuba. cir ; 58(1): e718, ene.-mar. 2019. tab
Artigo em Espanhol | LILACS | ID: biblio-1093142

RESUMO

RESUMEN Introducción: La presencia de aire dentro de la cavidad pleural es definida como neumotórax. El tratamiento quirúrgico inicial es la pleurostomía, que puede acarrear complicaciones, relacionadas con varios factores, entre los cuales se encuentra el diámetro de la sonda intratorácica utilizada. Objetivo: Evaluar los resultados del tratamiento con pleurostomía en pacientes con neumotórax espontáneo en el Hospital Universitario Manuel Ascunce Domenech. Método: Se realizó un estudio descriptivo longitudinal retrospectivo desde septiembre de 2012 hasta septiembre de 2017. Se estudiaron 63 pacientes afectos de neumotórax espontáneos que recibieron pleurostomía como tratamiento inicial. Resultados: Los neumotórax espontáneos primarios representaron 56 por ciento de los casos. Del total de pacientes, 82 por ciento eran fumadores. En todos los pacientes el síntoma predominante fue el dolor. Las complicaciones fueron más frecuentes con el uso de sondas pleurales de menor diámetro (86 por ciento). Conclusiones: El neumotórax espontáneo primario fue el de mayor frecuencia. Las causas predominantes en el neumotórax secundario fueron las bulas de enfisema y la enfermedad pulmonar obstructiva crónica. En la totalidad de los casos, estuvo presente algunos de los síntomas del síndrome pleural con predominancia absoluta del dolor. El mayor número de complicaciones se presentó en pacientes fumadores(AU)


ABSTRACT Introduction: The presence of air within the pleural cavity is defined as pneumothorax. The initial surgical treatment is pleurostomy, which can lead to complications associated with several factors, among which is the diameter of the intrathoracic probe that is used. Objective: To evaluate the outcomes of the treatment with pleurostomy in patients with spontaneous pneumothorax at Manuel Ascunce Domenech University Hospital. Method: A retrospective, longitudinal, descriptive study was conducted from September 2012 to September 2017. We studied 63 patients affected by spontaneous pneumothorax who received pleurostomy as initial treatment. Results: Primary spontaneous pneumothorax accounted for 56 percent of the cases. From the total amount of patients, 82 percent were smokers. In all patients, the predominant symptom was pain. Complications were more frequent with the use of pleural probes of smaller diameter (86 percent). The primary spontaneous pneumothorax was the most frequent. The predominant causes of secondary pneumothorax were bullous emphysema and chronic obstructive pulmonary disease. In all the cases, some of the symptoms of pleural syndrome with absolute predominance of pain were present. The greatest number of complications occurred in smoking patients. Conclusions: Pleurostomy, with the use of the drainage catheter, is the initial treatment for all patients with spontaneous pneumothorax in our hospital, regardless of the diameter of the probe to be used according to the type of pneumothorax (primary or secondary)(AU)


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Pneumotórax/etiologia , Pneumotórax/terapia , Dor no Peito/epidemiologia , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Epidemiologia Descritiva , Estudos Retrospectivos , Estudos Longitudinais , Fumantes/estatística & dados numéricos
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