Eficacia de la insuflación con dióxido de carbono en enteroscopia de un solo balón para determinar profundidad de intubación y dolor posprocedimiento en pacientes referidos para evaluación del intestino delgado

ResumenIntroducciónLa intubación profunda del intestino delgado es limitada por la distensión debido a la insuflación con aire durante el procedimiento. El dióxido de carbono (CO2) es rápidamente absorbido de la luz intestinal previniendo la distensión abdominal.ObjetivoComparar el efecto de la insuflación con CO2 y aire en la intubación profunda durante enteroscopia de un solo balón (ESB) y dolor posprocedimiento.DiseñoEstudio descriptivo de las series de casos y comparación de los resultados de sus variables, en un hospital terciario.Pacientes y métodosCiento cuarenta y siete ESB fueron realizadas en 130 pacientes con sospecha de enfermedad del intestino delgado usando insuflación con CO2 en 65 procedimientos y 82 con aire. Enteroscopio Olympus SIF 180-Q y bomba CO2 UCR Olympus fueron usados. Intubación profunda fue medida usando una escala validada. El dolor fue evaluado post-ESB y a las 12 h.ResultadosCiento cuarenta y siete ESB fueron realizadas en 130 pacientes con una media de intubación en el grupo CO2 significativamente mayor que en el grupo aire (p = 0.008). Noventa y cinco ESB anterógrada y 52 ESB retrógrada fueron realizadas con una media de intubación significativamente mayor en el grupo CO2 (p = 0.035 y p= 0.004, respectivamente). El dolor fue significativamente menor en el grupo CO.LimitacionesDiseño descriptivo de dos series de casos.ConclusiónInsuflación con CO2 mejora significativamente la profundidad de intubación en ESB y reduce el dolor abdominal.AbstractIntroductionThe intubation depth of the small bowel is limited by distention due to air insufflation during the procedure. Carbon dioxide (CO2) is rapidly absorbed from the bowel lumen and prevents distention of abdomen.ObjectiveA comparison was made between the effects of CO2 and air insufflations on the intubation depth during single balloon enteroscopy (SBE), as well as post-procedure pain.DesignDescriptive case series study and comparison of the results in a tertiary care hospital.Patients and methodsA total of 147 SBE procedures were performed on 130 patients with suspected small bowel disease using CO2 insufflation in 65 procedures, and air insufflation in 82. Enteroscopy was performed using an Olympus SIF 180-Q and a UCR CO2 pump. Intubation depth was recorded using a validated form, and pos-procedure pain immediately after SBE and 12 hours later were evaluated.ResultsA total of 147 SBE procedures were performed on 130 patients with a mean small bowel intubation depth in the CO2 group significantly larger than the air group (p=.008). An oral approach was used in 95 procedures, and anal in 52 procedureswith a mean intubation depth significantly larger in the CO2 group (p=.035 and p=.004, respectively). Patient pain was significantly reduced in the CO2 group.LimitationsDescriptive study of two case series.ConclusionCO2 insufflation significantly improves intubation depth in SBE and reduces abdominal pain

Intestinal Parasitic Infections among Pregnant Women in Venezuela

Introduction. Intestinal parasitic infections, especially due to helminths, increase anemia in pregnant women. The results of this are low pregnancy weight gain and IUGR, followed by LBW, with its associated greater risks of infection and higher perinatal mortality rates. For these reasons, in the setting of no large previous studies in Venezuela about this problem, a national multicentric study was conducted. Methods. Pregnant women from nine states were studied, a prenatal evaluation with a coproparasitological study. Univariated and multivariated analyses were made to determine risk factors for intestinal parasitosis and related anemia. Results. During 19 months, 1038 pregnant women were included and evaluated. Intestinal parasitosis was evidenced in 73.9%: A lumbricoides 57.0%, T trichiura 36.0%, G lamblia 14.1%, E hystolitica 12.0%, N americanus 8.1%, E vermicularis 6.3%, S stercoralis 3.3%. Relative risk for anemia in those women with intestinal parasitosis was 2.56 (P < .01). Discussion. Intestinal parasitoses could be associated with conditions for development of anemia at pregnancy. These features reflect the need of routine coproparasitological study among pregnant women in rural and endemic zones for intestinal parasites. Further therapeutic and prophylactic protocols are needed. Additional research on pregnant intestinal parasitic infection impact on newborn health is also considered

Clinical Study Intestinal Parasitic Infections Among Pregnant Women in Venezuela

Introduction. Intestinal parasitic infections, especially due to helminths, increase anemia in pregnant women. The results of this are low pregnancy weight gain and IUGR, followed by LBW, with its associated greater risks of infection and higher perinatal mortality rates. For these reasons, in the setting of no large previous studies in Venezuela about this problem, a national multicentric study was conducted. Methods. Pregnant women from nine states were studied, a prenatal evaluation with a coproparasitological study. Univariated and multivariated analyses were made to determine risk factors for intestinal parasitosis and related anemia. Results. During 19 months, 1038 pregnant women were included and evaluated. Intestinal parasitosis was evidenced in 73.9%: A lumbricoides 57.0%, T trichiura 36.0%, G lamblia 14.1%, E hystolitica 12.0%, N americanus 8.1%, E vermicularis 6.3%, S stercoralis 3.3%. Relative risk for anemia in those women with intestinal parasitosis was 2.56 (P &lt; .01). Discussion. Intestinal parasitoses could be associated with conditions for development of anemia at pregnancy. These features reflect the need of routine coproparasitological study among pregnant women in rural and endemic zones for intestinal parasites. Further therapeutic and prophylactic protocols are needed. Additional research on pregnant intestinal parasitic infection impact on newborn health is also considered. INTRODUCTION The soil-transmitted helminthiases are ancient diseases that continue to cause misery and disability in poor populations. The numbers affected are staggering. About 2 billion harbor these infections worldwide, of whom 300 million suffer associated severe morbidity. Of the total number infected, an estimated 400 millions are school-age children. In 1999, World Health Organization (WHO) estimated that schistosomiasis and soil-transmitted helminthiasis represented more than 40% of the disease burden due to all tropical diseases, excluding malaria Tropical diseases such as malaria, schistosomiasis, intestinal helminths, and filariasis have a dramatic impact on reproductive health. Many cases of unexplained pregnancy loss are due to undiagnosed tropical diseases. Malnutrition or anemia caused by intestinal worms may be worsened by pregnancy and make the pregnancy difficult In the developing world, young women, pregnant women, and their infants and children frequently experience a 2 Infectious Diseases in Obstetrics and Gynecology cycle, where undernutrition (macronutrient and micronutrient) and repeated infection, including parasitic infections, lead to adverse consequences that can continue from one generation to the next. Among parasitic infections, malaria and intestinal helminths coexist widely with micronutrient deficiencies and contribute importantly to anemia and this cycle of retarded growth and development. In somewhat more limited or focal geographic settings, other parasitic diseases (eg, schistosomiasis, filariasis) contribute similarly to this cycle. It is undoubtedly much better to enter a pregnancy free of infection and nutritionally replete than the various alternatives Intestinal parasitic infections, especially due to the helminths, increase anemia in pregnant women For these reasons, in the setting of no large previous studies in Venezuela about this problem, a national multicentric study was conducted with the objectives to describe preliminarily the epidemiological importance of intestinal parasitosis in pregnant women and its possible impacts. METHODS The study was a transversal analysis of pregnant women attending to prenatal control outpatient health care centers in Venezuela. Pregnant women from fifteen centers located in semi-urban and rural areas of nine states in the country were studied during the period January 2003-July 2004. All women accepted to be studied and included in this study. Women with previous diagnosis of infectious diseases as HIV/AIDS, HBV infection, syphilis, or toxoplasmosis were not enrolled. Evaluation of those women included, as a part of their routine prenatal control, an initial interrogation, physical examination, and laboratory studies: count of blood cells (CBC) (including thick and thin films, stained with Giemsa), serological screening studies for HIV-1 and -2 (ELISA), HBV (HbsAg and IgM anti-HBc), VDRL, and FTA-ABS, and toxoplasmosis (antibody titers by DAT). For this study, we considered as normal levels of Hb in women those between 12-16 g/dL, and between 37-48% for the hematocrit. An eosinophils proportion up to 4% was considered normal. All women were asked for a fresh stool sample each for coproparasitological study. The stool samples were masked, coded, and processed for parasitological examination. All stool samples were processed within 2 hours of collection. Isolation of enteric bacterial and viral pathogens was not studied in these samples. Different stool examinations were used for efficacy in detecting parasites. These were direct wet-mount, formaldehyde-ether sedimentation method and modified acid-fast staining techniques RESULTS One thousand thirty eight pregnant women were enrolled in this study. The mean age of this population was 25.5 ± 6.5 years old. The mean gestational age at enrollment moment was 28.5 ± 4.0 weeks (60% was on the 3rd trimester). At clinical evaluations, no apparent significant obstetrical alterations were observed. All women were asymptomatic. All serological studies were negative in all women (HIV, HBV, VDRL, Toxoplasmosis). Hematological evaluation showed that 65.1% of women presented anemia. The mean hemoglobin levels were 10.3 ± 0.4 g/dL, mean hematocrit was 30.6 ± 1.8%. Eosinophils relative mean proportion was 5.1 ± 4.2%. Eosinophilia was seen in 22.3% women. No other alterations were seen in these women. Intestinal parasitosis was seen in 767 women (73.9%). From this total, 360 (46.9 %) presented infections due to two simultaneous intestinal parasite species, 84 (10.9 %) with three intestinal parasite species, and only 2 women presented infections due to more than three intestinal parasite species (0.3 %). In this studied group of women, ten different species of intestinal parasites were found, 2 nonpathogenic protozoans, 3 pathogenic protozoans, and 5 helminths species Univariated and multivariated analyses made to assess risk factors for intestinal parasitosis and related anemia only found significance for the presence of intestinal parasitosis as a risk to have anemia during pregnancy, relative risk (RR) was 2.56 (95% CI 2.13-3.08)

Fracturas por armas de fuego

Se expone una d&eacute;cada, 1980-90, de las lesiones &oacute;seas producidas por armas de fuego, present&aacute;ndose una visi&oacute;n de los diferentes proyectiles de las armas de fuego ligeras que determinan la lesi&oacute;n corporal producida, debido a su caracter&iacute;stica y composici&oacute;n particular, incidiendo en los graves da&ntilde;os que producen al contacto con el organismo

Invasive bladder cancer in the eighties: transurethral resection or cystectomy?

PURPOSE: Describe morbidity and survival in patients older than 80 years with muscle invasive bladder cancer (MIBC) treated with radical cystectomy (RC) or transurethral resection (TUR) in our institution. MATERIALS AND METHODS: We reviewed our database of all patients older than 80 years treated with RC and TUR for MIBC between 1993 and 2005 in our institution. Twenty-seven patients were submitted to RC, with mean age of 82 years and mean follow-up of 16.4 months. RC was carried out following diagnosis of previous MIBC in 14 cases (51.9%). The American Society of Anesthesiology (ASA) score was III or IV in 23 patients (85.1%). Seventy-two patients with a mean age of 84 years and mean follow-up of 33 months, diagnosed with MIBC, were managed by means of TUR. The ASA score was III-IV in 64 (88.8%) patients. RESULTS: Pathological stage of the RC specimen was pT3 in 18 cases (66.7%). Mean hospital stay was 16 days. Early complications were assessed in 8 patients (29.6%), with an overall survival (OS) of 42.94%, and cancer-specific survival (CSS) of 60.54%. In patients submitted to TUR, clinical stage was T2 in 36 cases (50%). The mean hospital stay was 7 days, with a readmission rate (RR) of 87.5%. OS and CSS was less than 20%. CONCLUSIONS: RC in octogenarian patients is a safe procedure, with complication and survival rates comparable to RC series in general population. Transurethral resection (TUR) for patients with MIBC within this age range is a much less morbid procedure, but disease specific survival is lower

Measurement of brand personality in the automotive market.

Editorial.Una puerta abierta a la excelencia.Molina de Paredes, Olga R.Caracterización de las pequeñas empresas de confección de ropa y su incidencia en las relaciones laborales.Characterization of the small clothing companies and its incidence in work relationships.Añez Hernández, CarmenLa servucción y la calidad en la fabricación del servicio.The servuction and the quality in the service's fabrication.Briceño de Gómez, María Ysabel y García de Berrios, OmairaEvaluación de la iluminación en los puestos de trabajo de una empresa petrolera.Evaluation of lighting at workplaces in an oil company.Cabeza R., María Alejandra.; Cabeza, María E.; Corredor, EdwinLos equipos de trabajo: una práctica basada en la gestión del conocimiento.The work teams: a practice based on knowledge management.García Fernández, Francisco y Cordero Borjas, Ana EmiliaEl agroturismo en los municipios de la Zona Metropolitana de Mérida. Realidad y posibilidades.The agrotourism in the municipalities of Mérida Metropolitan Zone . Reality and possibilities.Duque Brito, AhidéLa percepción de la responsabilidad social empresarial por parte del consumidor.The consumer's perception of corporate social responsibility.León, FatimaAnálisis de la competitividad como elemento de sostenibilidad y eficiencia en las cooperativas agrícolas.Analysis of the competitiveness as sustainability and efficiency element in the agricultural cooperatives.Linares Morales, Yuraima y Colmenares, LoydaEmpleo de la red social como alternativa para la obtención de recursos en el proceso de creación de empresas.The social network as an alternative to obtain resources in the business startup process.López, Walevska N.; Montilla, Morelia; Girondo, Antonio¿Cómo determinar costos en la industria de la construcción?. Estudio de un caso.Parte II: Líneas maestras para la acumulación y determinación de los costos de producción.How to determine costs in the construction industry? A study case.Part II: Guidelines for the accumulation and determination of production costs.Noguera López, María Yohana y Rincón de Parra, HaydeéRelación en el ámbito macroeconómico entre Índice Bursátil Caracas y el precio del petróleo venezolano.Relation in the macroeconomic scope between Caracas Stock Exchange and the Venezuelan oil price.Pérez Araujo, Víctor RafaelEvaluación del sistema de acumulación de costos de la industria panadera en el Municipio Barinas, Estado Barinas.Evaluation of costs accumulation system in bakery industry of Barinas Municipality, Barinas State.Pulido, Dianosky y Morillo Moreno, Marysela C.Ideas iniciales para una construcción onto-epistemológica de la producción y gerencia del conocimiento en la universidad.Preliminary ideas for an ontoepistemological construction of knowledge's production and management in the university.Rincón de Parra, HaydeéMedición de la personalidad de marca en el mercado automotriz.Measurement of brand personality in the automotive market.Saavedra Torres, José Luis; Urdaneta, Daniel; Pirela, José Luis; Colmenares, OscarDesarrollo y fortalecimiento de las PyMIs y cooperativas por medio de las compras del sector público (mecanismos).Development and strengthening of SMIs and cooperatives by means of mechanisms implemented in public sector purchases.Sánchez, NormaViabilidad de la solidaridad organizacional como herramienta de supervivencia en la realidad actual.Viability of organizational solidarity as a survival skill in nowadays reality.Sumoza Matos, RolandoRelatoriaMemorias de las III Jornadas de Investigación del Centro de Investigaciones y Desarrollo EmpresarialContreras, Ismaira y León, FatimaEl CIDE por dentro.Inside the CIDE.Rivas Torres, Frank Eduardo; Briceño, María [email protected] analíticosemestra

Medición de la personalidad de marca en el mercado automotriz

El presente artículo tiene como objetivo explorar el modelo de Personalidad de Marca específicamente en el sector automotriz para 1) determinar la personalidad de cada una de las marcas que integran el sector, y 2) comparar los resultados provistos por Pirela et al (2004). El trabajo de campo arrojó información de 400 individuos por medio de un muestreo no probabilístico accidental. Se aplicó un análisis de Confiabilidad vía Alfa de Cronbach obteniéndose las Dimensiones de Marca: Emocionante, Pacífico, Pasional y Sincero, con sus respectivos rasgos. Los resultados del estudio sectorial y los llevados a cabo a escala nacional mostraron consistencia entre ellos, lo que indica la posibilidad de obtener dimensiones de personalidad para marcas estadísticamente válidas. Este hallazgo permite confirmar que, si bien el modelo original de Aaker (1997) no es generalizable mundialmente, estudios nacionales individuales si representan un marco teórico y metodológico válido para determinar la personalidad en sectores e incluso marcas específicas