Pancreatite aguda grave em centro de terapia intensiva: análise de 10 anos

OBJECTIVE: To evaluate etiology, complications, treatment, hospital and intensive care unit stay and mortality in all patients hospitalized in the intensive care unit of Hospital de Clínicas de Porto Alegre with acute pancreatitis, from January 1st, 1990 to December 31st, 1999. MATERIALS AND METHODS: We performed a historical cohort study with 57 patients, 37% female and 63% male, with an age average of 48±17 years. Patients were classified in two groups – survivors (n=26, 45.6%) and non-survivors (n=31, 54.4%) – and compared considering hospital and intensive care unit stay, Ranson’s and modified Glasgow’s signs, APACHE II (acute physiology and chronic health evaluation), organ failure, surgery, parenteral nutrition and antibiotics.RESULTS: The most common causes of severe acute pancreatitis were alcohol (37%) and gallstones (31%). Mortality was 54.4 %. Hospital stays were longer for survivors than for non-survivors. Non-survivors presented more organ failures (respiratory, renaland cardiovascular failures) and more Ranson’s and modified Glasgow’s signs than survivors. Other parameters were similar in both groups.CONCLUSIONS: In order to better evaluate the reasons for the high rate of mortality identified in the present group in the studied period it would be necessary to perform a prospective study with stronger control of the interfering factors, including an evaluation of the cases of severe acute pancreatitis that are not admitted in the intensive care unit.OBJETIVO: Avaliar etiologia, complicações, tratamento, tempo de internação – hospitalar e em centro de terapia intensiva – e mortalidade de todos os pacientes internados por pancreatite aguda no centro de tratamento intensivo do Hospital de Clínicas de Porto Alegre, no período de janeiro de 1990 a dezembro de 1999.MATERIAIS E MÉTODOS: Realizamos um estudo de coorte histórico, no qual foram avaliados 57 pacientes, 37% do sexo feminino e 63% do sexo masculino, com média de idade de 48 ± 17 anos. Os pacientes foram divididos em dois grupos – sobreviventes (n=26;45,6%) e não-sobreviventes (n=31;54,4%) –, e foram comparados quanto a tempo de internação, critérios de Ranson e de Glasgow modificados, APACHE II (acute physiology and chronic health evaluation), falências orgânicas, procedimentos cirúrgicos, nutrição parenteral e antibióticos recebidos.RESULTADOS: As etiologias mais freqüentes foram alcoólica (37%) e biliar (31%). A mortalidade foi de 54,4%. Os sobreviventes apresentaram maior tempo de internação que os não-sobreviventes (47 ± 36 dias contra 21 ± 20 dias). Os não-sobreviventes apresentaram maiores taxas de falências orgânicas (respiratória, renal e cardiovascular) e maior número de critérios de Ranson e de Glasgow modificados, quando comparados aos sobreviventes. Os parâmetros restantes foram semelhantes entre os dois grupos.CONCLUSÕES: Para melhor avaliar os motivos da alta taxa de mortalidade identificada neste grupo, neste período, seria necessário um trabalho prospectivo com melhor controle dos fatores interferentes e que incluísse ainda a avaliação dos casos de pancreatite aguda com critérios de gravidade que não são admitidos no centro de tratamento intensivo

Pancreatite aguda grave em centro de terapia intensiva: análise de 10 anos

OBJECTIVE: To evaluate etiology, complications, treatment, hospital and intensive care unit stay and mortality in all patients hospitalized in the intensive care unit of Hospital de Clínicas de Porto Alegre with acute pancreatitis, from January 1st, 1990 to December 31st, 1999. MATERIALS AND METHODS: We performed a historical cohort study with 57 patients, 37% female and 63% male, with an age average of 48±17 years. Patients were classified in two groups – survivors (n=26, 45.6%) and non-survivors (n=31, 54.4%) – and compared considering hospital and intensive care unit stay, Ranson’s and modified Glasgow’s signs, APACHE II (acute physiology and chronic health evaluation), organ failure, surgery, parenteral nutrition and antibiotics.RESULTS: The most common causes of severe acute pancreatitis were alcohol (37%) and gallstones (31%). Mortality was 54.4 %. Hospital stays were longer for survivors than for non-survivors. Non-survivors presented more organ failures (respiratory, renaland cardiovascular failures) and more Ranson’s and modified Glasgow’s signs than survivors. Other parameters were similar in both groups.CONCLUSIONS: In order to better evaluate the reasons for the high rate of mortality identified in the present group in the studied period it would be necessary to perform a prospective study with stronger control of the interfering factors, including an evaluation of the cases of severe acute pancreatitis that are not admitted in the intensive care unit.OBJETIVO: Avaliar etiologia, complicações, tratamento, tempo de internação – hospitalar e em centro de terapia intensiva – e mortalidade de todos os pacientes internados por pancreatite aguda no centro de tratamento intensivo do Hospital de Clínicas de Porto Alegre, no período de janeiro de 1990 a dezembro de 1999.MATERIAIS E MÉTODOS: Realizamos um estudo de coorte histórico, no qual foram avaliados 57 pacientes, 37% do sexo feminino e 63% do sexo masculino, com média de idade de 48 ± 17 anos. Os pacientes foram divididos em dois grupos – sobreviventes (n=26;45,6%) e não-sobreviventes (n=31;54,4%) –, e foram comparados quanto a tempo de internação, critérios de Ranson e de Glasgow modificados, APACHE II (acute physiology and chronic health evaluation), falências orgânicas, procedimentos cirúrgicos, nutrição parenteral e antibióticos recebidos.RESULTADOS: As etiologias mais freqüentes foram alcoólica (37%) e biliar (31%). A mortalidade foi de 54,4%. Os sobreviventes apresentaram maior tempo de internação que os não-sobreviventes (47 ± 36 dias contra 21 ± 20 dias). Os não-sobreviventes apresentaram maiores taxas de falências orgânicas (respiratória, renal e cardiovascular) e maior número de critérios de Ranson e de Glasgow modificados, quando comparados aos sobreviventes. Os parâmetros restantes foram semelhantes entre os dois grupos.CONCLUSÕES: Para melhor avaliar os motivos da alta taxa de mortalidade identificada neste grupo, neste período, seria necessário um trabalho prospectivo com melhor controle dos fatores interferentes e que incluísse ainda a avaliação dos casos de pancreatite aguda com critérios de gravidade que não são admitidos no centro de tratamento intensivo

NEOTROPICAL XENARTHRANS: a data set of occurrence of xenarthran species in the Neotropics

Xenarthrans—anteaters, sloths, and armadillos—have essential functions for ecosystem maintenance, such as insect control and nutrient cycling, playing key roles as ecosystem engineers. Because of habitat loss and fragmentation, hunting pressure, and conflicts with domestic dogs, these species have been threatened locally, regionally, or even across their full distribution ranges. The Neotropics harbor 21 species of armadillos, 10 anteaters, and 6 sloths. Our data set includes the families Chlamyphoridae (13), Dasypodidae (7), Myrmecophagidae (3), Bradypodidae (4), and Megalonychidae (2). We have no occurrence data on Dasypus pilosus (Dasypodidae). Regarding Cyclopedidae, until recently, only one species was recognized, but new genetic studies have revealed that the group is represented by seven species. In this data paper, we compiled a total of 42,528 records of 31 species, represented by occurrence and quantitative data, totaling 24,847 unique georeferenced records. The geographic range is from the southern United States, Mexico, and Caribbean countries at the northern portion of the Neotropics, to the austral distribution in Argentina, Paraguay, Chile, and Uruguay. Regarding anteaters, Myrmecophaga tridactyla has the most records (n = 5,941), and Cyclopes sp. have the fewest (n = 240). The armadillo species with the most data is Dasypus novemcinctus (n = 11,588), and the fewest data are recorded for Calyptophractus retusus (n = 33). With regard to sloth species, Bradypus variegatus has the most records (n = 962), and Bradypus pygmaeus has the fewest (n = 12). Our main objective with Neotropical Xenarthrans is to make occurrence and quantitative data available to facilitate more ecological research, particularly if we integrate the xenarthran data with other data sets of Neotropical Series that will become available very soon (i.e., Neotropical Carnivores, Neotropical Invasive Mammals, and Neotropical Hunters and Dogs). Therefore, studies on trophic cascades, hunting pressure, habitat loss, fragmentation effects, species invasion, and climate change effects will be possible with the Neotropical Xenarthrans data set. Please cite this data paper when using its data in publications. We also request that researchers and teachers inform us of how they are using these data