Utililzación de anestesia general en cesáreas de mujeres con parálisis cerebral: descripción de dos casos

SummaryTwo pregnant women with cerebral palsy were scheduled for cesarean section. Curvature of the spine and mental retardation make regional anestesia technically very difficult, so general anestesia was selected. Propofol were intravenouslsy administered for induction and isoflurane for maintenance. In both cases, healthy babies were delivered with good Apgar score and without maternal and neonatal complications

El factor socio económico y su repercusión en el sistema de ingreso en la Universidad Técnica de Manabí, Ecuador

Dropout in higher education refers to the premature abandonment of a study program caused by factors that are generated both within the educational system and by society, family and environment, considering sufficient time to rule out the possibility of reinstatement due to part of the student. The objective of this article is to analyze the socio-economic factor and its impact on the admission system at the Technical University of Manabí, Ecuador. The methodology used is descriptive with a mixed approach, aimed at analyzing the various demographic, social and economic aspects of the university population, it had a descriptive scope with a population that consisted of 75 people. The survey technique and the interview were applied, which were pre-designed under the parameters related to the established topic. As results of the research, it was obtained that student dropout affects both universities and the most identified causes are academic performance, motivation and academic and social integration. It is identified that the first- and third-year students are the ones with the highest dropout rates. In conclusion, among the main causes of dropout in higher education we have: failing subjects, lack of support, bad environment at the university, emotional factors, family problems, economic factor, poor teacher preparation, the role of the teacher in higher education and wrong career choice.    La deserción en la educación superior, hace referencia al abandono prematuro de un programa de estudios provocado por factores que se generan tanto al interior del sistema educativo como por la sociedad, familia y entorno, considerando un tiempo suficiente para descartar la posibilidad de una reincorporación por parte del estudiante. El objetivo de este articulo es analizar el factor socio económico y su repercusión en el sistema de ingreso en la Universidad Técnica de Manabí, Ecuador. La metodología empleada es de tipo descriptivo con enfoque mixto, orientado a analizar los diversos aspectos demográficos, sociales y económicos de la población universitaria, tuvo un alcance descriptivo con una población que estuvo constituida por 75 personas. Se aplicó la técnica de encuesta y la entrevista las cuales fueron prediseñadas bajo los parámetros relacionados al tema establecido. Como resultados de la investigación se obtuvo que la deserción estudiantil afecta tanto a las universidades y las causas más identificadas son el rendimiento académico, la motivación y la integración académica y social. Se identifica que son los estudiantes del primer año y tercero son los de mayor deserción. Como conclusión entre las principales causas de deserción en la educación superior tenemos: la reprobación de materias, falta de apoyo, mal ambiente en la universidad, factores emocionales, problemas familiares, factor económico, mala preparación docente, el rol del docente en la educación superior y elección errónea de la carrera. &nbsp

Anestesia para salpingectomia parcial bilateral em paciente com miocardiopatia hipertrófica idiopática: relato de um caso e revisão da literatura Anestesia para salpingectomía parcial bilateral en paciente con miocardiopatía hipertrófica idiopática: relato de un caso y revisión del literatura Anesthesia for partial bilateral salpingectomy in a patient with idiopathic hypertrophic cardiomyopathy: case report and review of the literature

JUSTIFICATIVA E OBJETIVOS: A miocardiopatia hipertrófica é uma doença cardíaca rara, com transmissão autossômica dominante e que se caracteriza pela hipertrofia do septo ventricular e pelas anormalidades da valva mitral. RELATO DO CASO: Paciente secundípara, de 25 anos, com diagnóstico de miocardiopatia hipertrófica há quatro anos e antecedente de asma leve intermitente controlada com inalações esporádicas de corticosteroides. Apresentava sopro holossistólico IV/VI plurifocal e importante escoliose, com os espaços intervertebrais palpáveis. Acusou palpitações esporádicas durante toda a gravidez e recebia medicação de 100 mg de atenolol por dia. Apresentava hemograma, creatinina e eletrólitos dentro dos limites normais, ecocardiograma com miocardiopatia hipertrófica de predomínio septal, com fração de ejeção sistólica de 0,76%. A paciente entrou em trabalho de parto de rápida evolução e nasceu criança viva, do sexo feminino, com APGAR 9/9 sem complicações maternas nem fetais. Foi realizada a programação para a realização de salpingectomia parcial bilateral. Em consulta, a paciente negou-se a receber anestesia para o procedimento. A técnica anestésica de eleição foi a regional combinada. O procedimento cirúrgico durou 20 minutos e as mudanças de pressão arterial junto com a frequência cardíaca foram 10% menores que as dos valores iniciais, sem complicações hemodinâmicas nem cirúrgicas imediatas. CONCLUSÕES: A mortalidade absoluta materna com miocardiopatia hipertrófica (MH) é muito baixa e costuma aparecer em mulheres com fatores de alto risco. Não há evidências de que a anestesia regional aumente o risco em mulheres com MH quando é utilizada para o parto vaginal. Tanto a anestesia geral como a regional foram utilizadas com sucesso e sem complicações em cesarianas de parturientes com MH.<br>JUSTIFICATIVA Y OBJETIVOS: La cardiomiopatía hipertrófica es enfermedad cardíaca rara, con transmisión autosómica dominante que se caracteriza por hipertrofia del septum ventricular y anormalidades de la válvula mitral. RELATO DEL CASO: Paciente segundigesta, 25 años con diagnóstico de cardiomiopatía hipertrófica hace 4 años e antecedente de asma bronquial leve intermitente controlada con inhalaciones esporádicas de corticoesteroides. Presentaba soplo holosistólico IV/VI plurifocal e importante escoliosis, con los espacios intervertebrales palpables. Refirió palpitaciones esporádicas durante todo el embarazo y se encontraba medicada con 100 mg de atenolol diarios. Presentaba hemograma, creatinina y electrolitos dentro de los límites normales, ecocardiograma que reportaba cardiomiopatía hipertrófica de predominio septal con fracción de eyección sistólica del 76%. La paciente entró en labor de parto de urgencia, obteniéndose producto femenino vivo, APGAR 9/9, sin complicaciones hemodinámicas maternas ni fetales. Se programa para la realización de salpingectomía parcial bilateral. Se entrevista a la paciente, la cual nos refirió que se rehusaba a recibir anestesia general para el procedimiento. La técnica anestésica elegida fue la regional combinada. El procedimiento quirúrgico duró 20 minutos, y los cambios de presión arterial y frecuencia cardíaca fue menos del 10% que el de los valores iniciales, sin complicaciones hemodinámicas ni quirúrgicas inmediatas. CONCLUSIONES: La mortalidad absoluta materna con cardiomiopatia hipertrófica (CH) es muy baja y suele estar confinada a mujeres con factores de alto riesgo. No hay evidencia que la anestesia regional aumenta el riesgo en mujeres con CH cuando se utiliza para el parto vaginal. Tanto la anestesia general como regional han sido utilizado con éxito y sin complicaciones en cesáreas de parturientas con CH.<br>BACKGROUND AND OBJECTIVES: Hypertrophic cardiomyopathy is a rare, autosomal dominant cardiac disorder characterized by hypertrophy of the interventricular septum and mitral valve abnormalities. CASE REPORT: A 25-year old female, second gestation, with a diagnosis of hypertrophic cardiomyopathy for four years and history of mild intermittent asthma controlled with sporadical use of corticosteroids. On physical exam, the patient had a IV/VI systolic and plurifocal heart murmur and accentuated scoliosis with palpable intervertebral spaces. She complained of occasional palpitations during pregnancy, and was treated with 100 mg of atenolol a day. Complete blood count, creatinine, and electrolytes were within normal limits; echocardiogram showed hypertrophic cardiomyopathy predominantly septal and ejection fraction of 0.76%. The patient underwent emergency labor giving birth to a live female fetus, Apgar 9/9, without maternal and fetal hemodynamic complications. The patient was scheduled for bilateral partial salpingectomy. During the interview, the patient refused general anesthesia for the procedure. A decision was made for combined regional blockade. The surgical procedure lasted 20 minutes during which changes in blood pressure and heart rate were up to 10% lower than baseline levels without immediate hemodynamic or surgical complications. CONCLUSIONS: Absolute maternal mortality in hypertrophic cardiomyopathy (HC) is very low and it is usually seen in patients with high risk factors. Evidence does not show an increased risk of regional blocks in females with HC when it is used for vaginal delivery. Both general anesthesia and regional blocks were successfully used without complication for cesarean sections in patients with HC

Flow cytometry TUNEL standardization for assaying sperm DNA fragmentation

We read with great interest Muratori's paper (Muratori et al, 2010), because we believe that terminal deoxynucleotidyl transferase–mediated dUTP nick end labeling (TUNEL) assay standardization is a matter of great concern and that there are certain steps that must be followed to achieve accurate results.Fil: Curi, Susana M.. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Departamento de Bioquímica Clínica; ArgentinaFil: Chenlo, Patricia H.. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Departamento de Bioquímica Clínica; ArgentinaFil: Billordo, Luis Ariel. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Departamento de Bioquímica Clínica; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Baz, Placida. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Departamento de Bioquímica Clínica; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Sardi, Melba L.. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Departamento de Bioquímica Clínica; ArgentinaFil: Ariagno, Julia Irene. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Departamento de Bioquímica Clínica; ArgentinaFil: Repetto, Herberto. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Departamento de Bioquímica Clínica; ArgentinaFil: Mendeluk, Gabriela Ruth. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Departamento de Bioquímica Clínica; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Pugliese, Mercedes Norma. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Departamento de Bioquímica Clínica; Argentin

Predominance of Rotavirus Genotype G9 during the 1999, 2000, and 2002 Seasons among Hospitalized Children in the City of Salvador, Bahia, Brazil: Implications for Future Vaccine Strategies

Two hundred eight of 648 (32%) diarrheal stool samples collected from hospitalized children under 5 years of age during a 3-year period (1999, 2000, and 2002) in the city of Salvador, in the state of Bahia, Brazil, were rotavirus positive. One hundred sixty-four of 208 (78.8%) rotavirus-positive samples had genotype G9 specificity, predominantly in association with P[8]. Other specificities detected were G1 (12.0%) and G4 (1.4%). Viruses with G2, G3, or P[4] specificity were not detected. Rotavirus genotype G9 predominated during each of the three seasons studied; it represented 89.2% of rotavirus strains detected in 1999, 85.3% in 2000, and 74.5% in 2002. G1 viruses (the globally most common G type) have a unique epidemiological characteristic of maintaining predominance during multiple consecutive rotavirus seasons. We have shown in this study for the first time that the G9 viruses also have a similar epidemiological characteristic, albeit for a shorter period of surveillance. The next generation of rotavirus vaccines will need to provide adequate protection against disease caused by G9 viruses

Molecular characterization of group A rotavirus isolates obtained from hospitalized children in Salvador, Bahia, Brazil

Rotavirus is a major cause of infectious diarrhea in infants and young children. The objective of this study was to characterize the genotypes of Human Rotavirus found in children hospitalized with acute diarrhea in the Pediatric Hospital Prof. Hosannah de Oliveira of the UFBA in Salvador, Bahia, Brazil, during the years of 1999, 2000 and 2002. Fecal samples were analyzed (n=358) by methods EIARA and SDS-PAGE for detection of Rotavirus. Positive samples of one or two of these methods (n=168) were submitted to RT-PCR and Multiplex-Nested PCR to determine genotypes G and P. A hundred sixty-eight (46.9%) samples were positive and 190 (53.1%) negative. Only 17 (4.7%) samples had divergent results. The distribution of genotypes G during the first year, showed that the genotype G9 was present in 96,8% of the analyzed samples, in the second year, it was responsible for 96% and in the third year, 88,1%. The characterization of genotypes P demonstrated that the genotype P1A[8] was the most outstanding in all years. In this study we discuss the benefit to control the genotypes of Rotavirus through the molecular characterization for the development of potential vaccines