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au:ROSA, MARIO M.
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1.
Caracterización de un bosque templado en un gradiente altitudinal en Oaxaca, México
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Velasco Luis, Mario Ubaldo
; Velázquez Martínez, Alejandro
; Hernández de la Rosa, Patricia
; Fierros González, Aurelio Manuel
; Gil Vera Castillo, José Amando
.
Resumen La caracterización de la vegetación sirve para generar directrices de manejo y conservación, sin embargo, pocos estudios en bosques templados integran a la vegetación del sotobosque. El objetivo del presente estudio fue describir la estructura, composición y diversidad florística arbórea, arbustiva y herbácea del bosque de pino-encino en un gradiente altitudinal en la comunidad de Miguel Hidalgo, San Antonio Huitepec, Oaxaca. Se tomaron variables dasométricas en 45 sitios distribuidos en tres intervalos altitudinales. Se estimaron la diversidad alfa y la beta, así como el índice de valor de importancia, y se compararonentre intervalos. Se identificaron 27 especies arbóreas, 25 arbustivas y 73 herbáceas. Se determinó una diversidad media, para arbóreas y herbáceas, y baja para arbustivas. La diversidad de las tres formas de vida no presentó un patrón de distribución definido; sin embargo, el intervalo altitudinal superior presentó el mayor valor promedio de área basal, altura y cobertura individual. Pinus oocarpa Schiede., Gaultheria erecta Vent. y Pteridium aquilinum var. feei (W. Schaffn. ex Fée) Maxon presentaron el valor más alto del índice de valor de importancia en el intervalo altitudinal inferior e intermedio y Pinus pseudostrobus Lindl. y Salvia cinnabarina M. Martens & Galeotti en el intervalo altitudinal superior. El intervalo altitudinal superior presentó mejor estado de conservación influenciado por una menor perturbación antropogénica. Considerar al sotobosque en estudios de caracterización mejora la comprensión de la dinámica de crecimiento y desarrollo de la vegetación forestal.
Abstract Characterization of the vegetation helps to generate management and conservation guidelines, however, few studies in temperate forests integrate the understory vegetation. The objective of this study was to describe the structure, composition, and tree, shrub, and herbaceous floristic diversity of the pine-oak forest in an altitudinal gradient in the community of Miguel Hidalgo, San Antonio Huitepec, Oaxaca. Dasometric variables were taken at 45 sites distributed in three altitudinal intervals. Alpha and beta diversity were estimated, as well as the importance value index, and compared among intervals. 27 tree species, 25 shrubs and 73 herbaceous were identified. A medium diversity was determined for trees and herbs, and low for shrubs. The diversity of the three life forms did not present a defined distribution pattern; however, the upper altitudinal interval presented the highest average value of basal area, height, and individual coverage. Pinus oocarpa Schiede., Gaultheria erecta Vent. and Pteridium aquilinum var. feei (W. Schaffn. ex Fée) Maxon presented the highest value of the importance value index in the lower and intermediate altitudinal range, and Pinus pseudostrobus Lindl. and Salvia cinnabarina M. Martens & Galeotti in the upper altitudinal range. The upper altitudinal interval presented a better state of conservation influenced by less anthropogenic disturbance. Considering the understory in characterization studies improves the understanding of the dynamics of growth and development of forest vegetation.
2.
Effect of dietary tryptophan on blood and plasma parameters of striped bass Morone saxatilis, exposed to acute stressors
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Cabanillas-Gámez, Miguel
; López, Lus M.
; Bardullas, Ulises
; Espinoza-Villegas, Rosa E.
; True, Conal D.
; Galaviz, Mario A.
.
ABSTRACT Striped bass, Morone saxatilis, is a marine species that belongs to the Moronidae family, which has great recreational and commercial importance and high production potential for human consumption. This research examines two acute stress factors that can be frequent in fish production units: a) handling is carried out constantly due to maintenance needs, size separation, growth evaluation, and health state, and b) hypoxia likely occur as the culture tank biomass, temperature, and fish metabolic rate increase. Juvenile fish (initial body weight 200 ± 3.0 g) were distributed in 110 L tanks and fed one week with different dietary tryptophan (Trp) levels: CD0.5 (0.5%), D1.0 (1.0%), D1.5 (1.5%) and D2.0 (2.0%). The fish were then exposed to stress by handling (5 min) or hypoxia (45 min). After that, blood hematocrit (Hct), hemoglobin (HB) and plasma cortisol, glucose (GLU), lactate (LACT), total protein (TP), albumin (AL), and globulin (GLOB) were analyzed, and AL/GLOB ratio was calculated. All analyzed parameters showed great sensitivity to acute stressors. Hypoxia increased Hct, cortisol, and GLU and decreased HB and LACT. Handling decreased HB and TP and increased GLU and LACT. D1.0 and D1.5 prevented Hct and LACT disturbance. D1.5 Trp prevented HB disturbance. All Trp supplemented diets prevented GLU change under hypoxia and TP change after handling. The results suggest that Trp played a role in M. saxatilis homeostasis restoration under acute stress.
https://doi.org/10.3856/vol50-issue4-fulltext-2929
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3.
Volviéndonos mejores: necesidad de acción inmediata ante el reto de la obesidad. Una postura de profesionales de la salud
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Barquera, Simón
; Véjar-Rentería, Lesly Samara
; Aguilar-Salinas, Carlos
; Garibay-Nieto, Nayely
; García-García, Eduardo
; Bonvecchio, Anabelle
; Perichart, Otilia
; Torres-Tamayo, Margarita
; Esquivias-Zavala, Héctor
; Villalpando-Carrión, Salvador
; García-Méndez, Rosalba Carolina
; Apolinar-Jiménez, Evelia
; Kaufer-Horwitz, Martha
; Martínez-Montañez, Olga Georgina
; Fajardo Niquete, Ileana
; Aguirre-Crespo, Alejandra
; Gómez-Álvarez, Enrique
; Hernández-Jiménez, Sergio C.
; Denova-Gutiérrez, Edgar
; Batis, Carolina
; Elías-López, Daniel
; Palos-Lucio, Ana Gabriela
; Vásquez-Garibay, Edgar M.
; Romero-Velarde, Enrique
; Ortiz-Rodríguez, María Araceli
; Almendra-Pegueros, Rafael
; Contreras, Alejandra
; Nieto, Claudia
; Hernández-Cordero, Sonia
; Munguía, Ana
; Rojas-Russell, Mario
; Sánchez-Escobedo, Samantha
; Delgado-Amézquita, Elvia
; Aranda-González, Irma
; Cruz-Casarrubias, Carlos
; Campos-Nonato, Ismael
; García-Espino, Fátima
; Martínez-Vázquez, Sophia
; Arellano-Gómez, Laura P.
; Caballero-Cantú, Idalia
; Hunot-Alexander, Claudia
; Valero-Morales, Isabel
; González-González, Lorena
; Ríos-Cortázar, Víctor
; Medina-García, Catalina
; Argumedo, Gabriela
; Calleja-Enríquez, Carmen Rosa
; Robles-Macías, Edna
; Nava-González, Edna J.
; Lara-Riegos, Julio
; Sánchez-Plascencia, Ana K.
; Hernández-Fernández, Mauricio
; Rodríguez-Núñez, Jose Luis
; Rangel-Quillo, Sarai
; Cancino-Marentes, Martha Edith
; Hernández-Viana, Mónica J.
; Saldivar-Frausto, Mariana
; Álvarez-Ramírez, Miriam
; Sandoval-Salazar, Cuauhtémoc
; Silva-Tinoco, Rubén Oswaldo
; Moreno-Villanueva, Mildred
; Villarreal-Arce, María Elena
; Barriguete, J. Armando
; White, Mariel
; Jauregui, Alejandra
; Tolentino-Mayo, Lizbeth
; López-Ridaura, Ruy
; Rivera-Dommarco, Juan
.
Abstract: In recent decades, the growing obesity epidemic in Mexico has become one of the most important public health challenges faced by the country. With support from the World Obesity Federation, we formed a working group in 2021 to identify and summarize priority actions that Mexico can take to face this epidemic. More than 1 000 health professionals joined the development and discussion process. Recommendations from previously published, high-level documents and guidelines were taken into account. In commemoration of World Obesity Day 2022, this statement is presented as input for health care professionals to develop actions to address obesity. The statement includes 10 recommendations that include population-level and individual-level actions. It emphasizes the importance of social participation, comprehensive interventions with a person- centered perspective, planetary sustainability, on improving education and communication campaigns, as well as fostering a built environment that promotes active living, and shielding prevention and control efforts from conflicts of interest. The statement calls for obesity to be treated seriously, based on scientific evidence, in a timely and comprehensive manner, employing a life-course and ethical approach that does not perpetuate weight stigma in society.
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4.
Recomendaciones de manejo de los anticoagulantes orales directos (DOACs) anti Xa y anti IIa
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Ceresetto, José M.
; Tajer, Carlos
; Duboscq, Cristina
; Bottaro, Federico
; Casais, Patricia
; Korin, Jorge
; Fondevila, Carlos
; Giumelli, Carla
; Scazziota, Alejandra
; Rossi, Andrea
; Botto, Fernando
; Ariscancela, Maria Ester
; Martinuzzo, Marta
; Zaidel, Ezequiel
; Fitz Maurice, Mario
; Bahit, Cecilia
; Vazquez, Fernando
; Molnar, Soledad
; Saizberg, Simón
; Negri Aranguren, Pedro
; Rosa, Claudio
; Fedele, José Luis
; Comignani, Pablo
; Pombo, Gonzalo
; Raña, Pablo
; Adamczuk, Yolanda
; Martí, Alejandra
; Charask, Adrián
; Penchasky, Diana
; Riveros, Dardo
; Mariani, Javier
; Puente, Dolores
; Celebrin, Lucia
; Bosio, Martín
; Brodsky, Andrés
; Sanchez Lucero, Analía
; Castillo Costa, Yanina
; Hirschson, Alfredo
; Arbesú, Guillermo
; Viñuales, Susana
; Kazelian, Lucía
; Maneyro, Alberto
; Gutierrez, Victoria
; Castro Rios, Miguel
; Gagliardi, Juan
; Lescano, Adrián
; Repetto, Fernanda
.
Abstract Direct oral anticoagulants have emerged as the drugs that have changed the man agement of the antithrombotic treatment in the last 15 years. Their advantages, like a more friendly way of anticoagulation and their lower risk of bleeding, especially in the brain, have positioned these new anticoagu lants as the first drug of choice in the two most frequent indications of anticoagulation, atrial fibrillation, and the venous thromboembolic disease. However, not all the patients can receive these agents, not all the direct oral anticoagulants have the same characteristics, and most importantly, not all the diseases with an indication of an anticoagulant drug can be treated with them. Therefore, it is mandatory that all the faculties involved in the management of these drugs must know them in depth, to decide the best treatment for the patient. This position paper, from a group of experts in anticoagulation in Argentina, can help the general practitioner in the daily use of direct oral anticoagulants based on the new evidence and the experience of a wide group of professionals. The way we relate to the anticoagulant treatment has changed in the last years. The doctors who work with them must also do so.
Resumen Los anticoagulantes orales directos han surgido como una de las herramientas que ha cambiado el manejo de la enfermedad trombótica en los últimos 15 años. Sus ventajas, desde el punto de vista de la facilidad de uso y menor riesgo de sangrado, especialmente de sangrado cerebral, han posicionado a estos nuevos anticoagulantes como la primera alternativa de tratamiento en las dos indicaciones más frecuentes en que necesitamos estas drogas, la fibrilación auricular y la enfermedad tromboembólica venosa. Sin embargo, no todos los pacientes pueden recibir estos agentes, no todos los anticoagulantes directos tienen las mismas pro piedades y fundamentalmente, no todas las enfermedades con indicación de un anticoagulante pueden tratarse con ellos;con lo cual es necesario que todos los profesionales que están involucrados en el manejo de estos medicamentos estén obligados a conocerlos en profundidad, para poder decidir el mejor tratamiento en cada caso particular. Este documento de posición de expertos de diferentes especialidades de Argentina, presenta lineamientos para el uso correcto de los anticoagulantes directos en base a nueva evidencia y a la experiencia de uso de un amplio grupo de profesionales. La forma de relacionarnos con el tratamiento anticoagulante ha cambiado. Los médicos que trabajamos con ellos también debemos hacerlo.
810 downloads
5.
Use of effluents from Oxidation Lagoons of the “Carlos Baliño” Complex as Organic Fertilizers
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Martínez-Hernández, Carlos M.
; Sánchez-Jassa, Jesús A.
; Reinoso-Pérez, Mario
; Rodríguez-Urrutia, Alianny
; Martínez-Flores, Nilda Rosa
.
ABSTRACT The work was carried out with the objective of determining the properties of the effluents of the oxidation lagoon of "Carlos Baliño" and "Melanio Hernández" sugar mills as organic fertilizer; as well as the possibility of their decontamination. The effluents were taken at the central region of Cuba (Santo Domingo, Villa Clara and Tuinicú, Sancti Spíritus). The decontamination effect of a slow filter of sand was proven in cascades before different dilutions in distilled water of the samples of the valued treatment T1 (10%), T2 (25%), T3 (50%), T4 (75%), T5 and T6 (not diluted). Physical-chemical and microbiologic characteristics of effluents were determined, before and after their passing through slow filters of sand; later on, their effect like organic bio fertilizer was valued. Corn (Zea mays) was taken as indicator cultivation whose morphological and physiological parameters were valued. Physical-chemical properties of the soil samples were also valued. The analysis of the effluents like bio-fertilizers showed that none of the valued treatments exceeded the control TO (93,33%) in the germination percent variable (mean value). Treatment T2 (86,66%) presented the best behavior compared to the control TO, while in treatments T3 (60%) and T6 (40%), a fall of this variable was presented. In the case of treatment T6, the abrupt fall of this variable, could be related to the aggressiveness of the non-dilute effluents of the sugar mill "Melanio Hernández" oxidation lagoon.
RESUMEN El trabajo se realizó con el objetivo de determinar las propiedades de los efluentes de la laguna de oxidación de los CAI “Carlos Baliño” y “Melanio Hernández” como fertilizante orgánico; así como la posibilidad de su descontaminación. Los efluentes fueron tomados, en la región central del país (Santo Domingo, Villa Clara y Tuinicú, Sancti Spíritus). Se probó el efecto descontaminante de un filtro lento de arena en cascadas ante diferentes diluciones en agua destilada de las muestras de los efluentes evaluados T1(10%), T2(25%), T3 (50%), T4 (75%), T5 y T6 (no diluidos). En los efluentes, se determinaron: características físico-químicas y microbiológicas, anterior y posterior a su paso por biofiltros; se valoró su efecto como bioabono orgánico. Se tomó como cultivo indicador el maíz (Zea mays), evaluándose sus parámetros morfo fisiológicos; en las muestras de suelo, se valoraron sus propiedades físico-químicas. El análisis de los efluentes como bioabonos mostró que ninguno de los tratamientos evaluados, superan al control TO (93,33%) en la variable porcentaje de germinación (valor medio), el tratamiento T2, (86,66%) presentó el mejor comportamiento con respecto al control TO, mientras que en los tratamientos T3 (60%) y T6 (40%), se presentó una caída de esta variable, en el caso del tratamiento T6, la caída brusca de esta variable, pudiera estar relacionado con la agresividad del efluente no diluido del CAI “Melanio Hernández”.
6.
Las angiospermas epífitas de Puebla, México: riqueza y distribución
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Miguel-Vázquez, Mónica Isabel
; Espejo-Serna, Mario Adolfo
; Ceja-Romero, Jacqueline
; Cerros-Tlatilpa, Rosa
.
Abstract Background: Puebla state has great biodiversity as a result of its complex biogeographical history and its topographic and climatic heterogeneity. However, botanical exploration in the state has been scant and biased to certain regions, remaining great part of the territory undocumented. Questions: How many species of angiosperm epiphytes are in Puebla? How are distributed in the elevation range and by vegetation type? Studied species: The angiosperm epiphytes. Study site and dates: Data and specimens of angiosperm epiphytes from Puebla were compiled and examined from 2011 to 2019. Field work was performed in the state from 2012 to 2013. Methods: Literature was reviewed, databases were consulted, material from the collections AMO, ENCB, FCME, HUAP, MEXU, UAMIZ, XAL was examined and field work was made. Results: 18 families, 92 genera and 265 species of angiosperm epiphytes are reported for Puebla, 72 of these are endemic from Mexico. Seven species are recorded by first time for the state. The highest percentage of epiphytes is recorded in the cloud forest (50 %), followed by the Quercus forest (32 %); the largest number of species is reported at the elevation range between 1,090 to 1,700 m. Conclusions: Puebla has high diversity of angiosperm epiphytes; despite the vegetation is being fragmented, still there are favorable areas for development of epiphytes. It is important to explore and preserve those areas, before its biodiversity get lost without being documented.
Resumen Antecedentes: El estado de Puebla tiene gran biodiversidad, resultado de su compleja historia biogeográfica y de su heterogeneidad topográfica y climática. Sin embargo, la exploración botánica en la entidad ha sido escasa y sesgada a ciertas regiones, quedando aún buena parte del territorio sin documentar. Preguntas: ¿Cuántas especies de angiospermas epífitas hay en Puebla? ¿Cómo se distribuyen en el rango altitudinal y por tipo de vegetación? Especies estudiadas: Las angiospermas epífitas. Sitio de estudio y fechas: Se recopilaron datos y se revisaron especímenes de angiospermas epífitas de Puebla, de 2011 a 2019. Se realizó trabajo de campo en el estado de 2012 a 2013. Métodos: Se revisó literatura, se consultaron bases de datos, se revisaron las colecciones AMO, ENCB, FCME, HUAP, MEXU, UAMIZ, XAL y se hicieron viajes de recolección. Resultados: Se reportan 18 familias, 92 géneros y 265 especies de angiospermas epífitas para Puebla, 72 de las cuales son endémicas de México. Se registran siete especies por primera vez para el estado. El mayor porcentaje de epífitas se registró en el bosque mesófilo de montaña (50 %), seguido por el bosque de Quercus (32 %); el mayor número de especies se reporta en el rango altitudinal de 1,090 a 1,700 m. Conclusiones: Puebla tiene alta diversidad de angiospermas epífitas; a pesar de la velocidad a la que su vegetación está siendo fragmentada, aún hay zonas favorables para el desarrollo de epífitas. Es importante explorar y preservar dichas áreas, antes de que su biodiversidad se pierda sin haber sido documentada.
https://doi.org/10.17129/botsci.2540
314 downloads
7.
Efecto de los antimaláricos sobre los diferentes dominios del índice de daño SLICC en pacientes de la cohorte GLADEL
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Pons-Estel, Guillermo J.
; Quintana, Rosana
; Wojdyla, Daniel
; Alarcón, Graciela S.
; Serrano, Rosa María
; Ugarte-Gil, Manuel
; Pimentel-Quiroz, Víctor
; Soriano, Enrique R.
; Catoggio, Luis J.
; Scolnik, Marina
; Sacnun, Mónica
; Saurit, Verónica
; Caeiro, Francisco
; Alvarellos, Alejandro
; Sarano, Judith
; García, Mercedes
; Onetti, Laura
; Drenkard, Cristina
; Berbotto, Guillermo
; Scherbarth, Hugo R.
; Sato, Emilia
; Bonfa, Eloisa
; Ferreira Borba, Eduardo
; Costallat, Lilian
; Xavier, Ricardo
; Tavares Brenol, Joao C.
; Da Silva, Nilzio A.
; Cavalcanti, Fernando
; Massardo, Loreto
; Jacobelli, Sergio
; Neira, Oscar
; Molina, José F
; Vásquez, Gloria
; Gómez-Puerta, José A.
; Alonso Gonzalez, Luis
; Iglesias Gamarra, Antonio
; Guibert-Toledano, Marlene
; Reyes, Gil A.
; Cardiel, Mario H.
; Pascual-Ramos, Virginia
; García de la Torre, Ignacio
; Barile, Leonor
; Silveira, Luis H.
; Amigo, Mary-Carmen
; Sauza del Pozo, María Josefina
; Acevedo-Vásquez, Eduardo M.
; Alfaro-Lozano, José
; Segami, María Inés
; Chacón-Díaz, Rosa
; Abadi, Isaac
; Esteva Spinetti, María H
; Pons-Estel, Bernardo A.
.
Objective: To assess the effects of antimalarials (AM) over the items of the SLICC Damage Index (SDI). Methods: Patients with recent (≤2 years) diagnosis of systemic lupus erythematosus (SLE) from the GLADEL cohort were studied. End-point: increase in items SDI since cohort entry. Independent variables (socio-demographic, clinical, laboratory and treatment) were included. The effect of AM as a time dependent variable on most frequent SDI items (adjusting for potential confounders) was examined with a multivariable Cox regression model. Results: Of the 1466 patients included in this analysis, 1049 (72%) received AM with a median exposure time of 30 months (Q1-Q3: 11-57). Damage occurred in 665 (45%) patients during a median follow-up time of 24 months (Q1-Q3: 8-55). There were 301 integument, 208 renal, 149 neuropsychiatric, 98 musculoskeletal, 88 cardiovascular and 230 others less frequently represented damages. After adjusting for potential confounders at any time during follow-up, a lower risk of renal damage (HR 0.652; 95% CI: 0.472-0.901) and borderline for neuropsychiatric damage (HR 0.701, 95% CI: 0.481-1.024) was found. Conclusion: In the GLADEL cohort, after adjustment for possible confounding factors, AM were independently associated with a reduced risk of renal damage accrual.
Objetivos: Estimar el efecto de los antimaláricos (AM) sobre los diferentes dominios del índice de daño SLICC (SDI). Métodos: Se estudiaron pacientes con diagnóstico clínico reciente (≤2 años) de lupus eritematoso sistémico (LES) de la cohorte GLADEL. Variable de estudio: aumento en los dominios del SDI desde el ingreso a la cohorte. Variables independientes: características sociodemográficas, clínicas, laboratorio y tratamientos. El efecto de los AM, como variable dependiente del tiempo, sobre los dominios más frecuentes del SDI (ajustado por factores de confusión) fue examinado con un modelo de regresión de Cox multivariado. Resultados: De 1466 pacientes estudiados, 1049 (72%) recibieron AM con un tiempo medio de exposición de 30 meses (Q1-Q3: 11-57) y 665 pacientes (45%) presentaron daño durante un seguimiento medio de 24 meses (Q1-Q3: 8-55); 301 eventos fueron cutáneos, 208 renales, 149 neuropsiquiátricos, 98 musculoesqueléticos, 88 cardiovasculares y 230 otros. Después de ajustar por factores de confusión, el uso de AM se asoció a un menor riesgo de daño renal (HR 0,652; IC 95%: 0,472-0,901) y en el límite de la significancia estadística (HR 0,701, IC 95%: 0,481-1,024) para el dominio neuropsiquiátrico. Conclusión: En GLADEL, el uso de AM se asoció independientemente a un menor riesgo de daño acumulado renal.
162 downloads
8.
Twenty-four hour Blood Pressure in Obese Patients with Moderate-to-Severe Obstructive Sleep Apnea
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Resumo Fundamentos: Obesidade, hipertensão arterial sistêmica (HAS) e apneia obstrutiva do sono (AOS) estão intimamente relacionados. Até 70% dos pacientes com AOS podem ser assintomáticos e há evidências que eles apresentam alterações cardiovasculares, em especial HAS noturna. Objetivos: O objetivo deste estudo foi avaliar o comportamento da pressão arterial nas 24 horas em indivíduos obesos assintomáticos com AOS moderada/grave comparando àqueles com AOS leve/ausente. Métodos: Foram selecionados 86 pacientes entre 30 e 55 anos, obesos (IMC 30-39,9 kg/m2), com pressão arterial casual < 140/90 mmHg e sem comorbidades, dos quais 81 foram submetidos à avaliação clínica, medidas antropométricas, monitorização ambulatorial da pressão arterial (MAPA) e Watch-PAT. Os participantes do estudo foram divididos em dois grupos com base no índice de apneia-hipopneia (IAH): grupo 1 com IAH < 15 eventos/h e grupo 2 com IAH ≥ 15 eventos/h. Resultados: Em comparação ao grupo 1, o grupo 2 apresentou maior circunferência de pescoço e maior relação cintura-quadril (40,5 ± 3,2 vs 38,0 ± 3,7 cm, p = 0,002, e 0,94 ± 0,05 vs 0,89±0,05cm, p = 0,001, respectivamente), maiores pressões arteriais sistólica e diastólica na MAPA-24h (122 ± 6 vs 117 ± 8 mmHg, p = 0,014, e 78 ± 6 vs 73 ± 7 mmHg, p = 0,008, respectivamente), bem como maior carga pressórica diastólica noturna (44,6 ± 25,9% vs 31,3 ± 27,3%, p = 0,041). Além disso, houve correlação positiva entre pressão arterial diastólica noturna e IAH (r = 0,43, p < 0,05). Conclusões: Indivíduos obesos assintomáticos com AOS de moderada a grave apresentam maiores valores de PA sistólica e diastólica nas 24 horas em comparação àqueles com AOS ausente/leve, apesar da PA casual normal. Esses resultados indicam que a MAPA pode ser útil na avaliação de pacientes obesos assintomáticos com AOS de moderada à grave.
Abstract Background: Obesity, systemic arterial hypertension (SAH) and obstructive sleep apnea (OSA) are closely related. Up to 70% of patients with OSA may be asymptomatic, and there is evidence that these patients have cardiovascular disease, especially nocturnal SAH. Objectives: The aim of this study was to evaluate 24-hour blood pressure circadian variation in asymptomatic, obese individuals with moderate-to-severe OSA and compare it with that in individuals with mild OSA or without OSA. Methods: Eighty-six obese subjects aged between 30 and 55 years (BMI 30-39 kg/m2), with casual blood pressure < 140/90 mmHg and without comorbidities were recruited. Eighty-one patients underwent clinical and anthropometric assessment, ambulatory blood pressure monitoring (ABPM), and Watch-PAT. Participants were divided into two groups, based on the apnea-hypopnea index (AHI): group 1, with AHI < 15 events/hour, and group 2 with AHI ≥ 15 events/hour. Results: Compared with group 1, group 2 had higher neck circumference and waist-hip circumference (40.5 ± 3.2 cm vs. 38.0 ± 3.7 cm, p = 0.002, and 0.94 ± 0.05 vs. 0.89 ± 0.05, p = 0.001, respectively), higher systolic and diastolic blood pressure measured by the 24-h ABPM (122 ± 6 vs 118 ± 8 mmHg, p = 0.014, and 78 ± 6 vs 73 ± 7 mmHg, p = 0.008, respectively), and higher nocturnal diastolic pressure load (44,6 ± 25,9% vs 31,3 ± 27,3%, p = 0,041). Moreover, there was a positive correlation between nocturnal diastolic blood pressure and AHI (r = 0.43, p < 0.05). Conclusions: Asymptomatic obese subjects with moderate-to-severe OSA have higher systolic and diastolic blood pressure at 24 hours compared with those with absent / mild OSA, despite normal casual blood pressure between the groups. These results indicate that ABPM may be useful in the evaluation of asymptomatic obese patients with moderate-to-severe OSA.
https://doi.org/10.5935/abc.20170130
1584 downloads
9.
Vigilancia en salud pública: una necesidad inaplazable
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Noguer, Isabel
; Alonso, Juan Pablo
; Arteagoitia, José M.
; Astray, Jenaro
; Cano, Rosa
; Pedro, Jesús de
; Gutiérrez, Gonzalo
; Hervada, Xurxo
; Margolles, Mario
; Nicolau, Antonio
; Núñez, Domingo
; Pollán, Marina
; Ramos, Julián Mauro
; Sierra, M. José
; Vanoclocha, Hermelinda
.
https://doi.org/10.1016/j.gaceta.2016.11.002
523 downloads
10.
Vigilancia en salud pública: una necesidad inaplazable
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Noguer, Isabel
; Alonso, Juan Pablo
; Arteagoitia, José M.
; Astray, Jenaro
; Cano, Rosa
; Pedro, Jesús de
; Gutiérrez, Gonzalo
; Hervada, Xurxo
; Margolles, Mario
; Nicolau, Antonio
; Núñez, Domingo
; Pollán, Marina
; Ramos, Julián Mauro
; Sierra, M. José
; Vanoclocha, Hermelinda
.
https://doi.org/10.1016/j.gaceta.2016.11.002
5 downloads
11.
Análisis sensorial de leche de vacas suplementadas con un alimento fermentado a base de pollinaza
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Citalan Cifuentes, Luis Humberto
; Ramos Juárez, Jesús Alberto
; Salinas Hernández, Rosa
; Bucio Galindo, Adolfo
; Osorio Arce, Mario M.
; Herrera Haro, José G.
; Orantes Zebadua, Miguel A.
.
Abstract: The objective of this study was to evaluate the sensory, nutritional and sanitary quality of milk from cows fed on fermented fed based on poultry litters. Treatments were: T1, fermented feed based on poultry litter (AFBP) and T2 (control), unfermented feed based on grain (ASFBG). Ten cows were assessed a Latin rectangle randomized cross over design. Both treatments were tested in all cows in two periods of time. Each period lasted 30 d. Analysis of nutritional composition and sanitary quality of raw milk were carried out. For sensory analysis, two discriminative tests (triangular and duo-trio) and a Quantitative Descriptive Analysis (QDA) were used, milk was pasteurized before analysis. The sanitary quality of milk in both treatments was within the range allowed by Mexican Official Standards. For the two treatments; no significant differences (p > 0.05) were found either for the nutritional composition of milk or the sensory quality. A sensory perceptible difference (p < 0.05) was only found for the triangle test in the second period. It was concluded that the AFBP can be used in the supplement of dual purpose cows without causing unpleasant effects on the milk.
Resumen: El objetivo del trabajo fue evaluar el efecto de un alimento fermentado con pollinaza en las características sensoriales, calidad sanitaria y composición nutricional de la leche de vaca. Los tratamientos (T) evaluados fueron: T1, alimento fermentado con pollinaza (AFBP) y T2 (control), alimento sin fermentar con grano (ASFBG). Se utilizaron 10 vacas, las cuales se aleatorizaron en un diseño rectángulo Latino cross over de forma que los tratamientos se probaron en todas las vacas en dos periodos de tiempo, con lapso de 30 d para cada periodo. Se realizaron análisis de composición nutricional y de calidad sanitaria de la leche cruda. Antes del análisis sensorial la leche se pasteurizó para este análisis se utilizaron las pruebas discriminativas triangular y dúo-trío, y una prueba de análisis descriptivo cuantitativo. La calidad sanitaria de la leche en ambos tratamientos estuvo dentro de los rangos permitidos por las Normas Oficiales Mexicanas. No se encontró diferencia significativa (p > 0.05) entre los tratamientos estudiados en composición nutricional y características sensoriales. Solo se observó diferencia significativa (p < 0.05) en la prueba discriminativa tipo triangular en el segundo periodo de muestreo. Se concluye que el AFBP puede utilizarse en la suplementación de vacas de doble propósito sin causar efectos negativos en la leche.
8321 downloads
12.
Action verbal fluency in Parkinson’s patients
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Rodrigues, Inês Tello
; Ferreira, Joaquim J.
; Coelho, Miguel
; Rosa, Mario M.
; Castro-Caldas, Alexandre
.
Este estudo comparou o desempenho em provas de fluência verbal semântica, fonêmica e de ação, em 31 pacientes com doença de Parkinson (DP), sem demência, e 61 controlos saudáveis. As funções executivas e comportamentais foram igualmente avaliadas. O tempo de evolução foi de 9,8 anos (DP = 6,13). Não foram encontradas diferenças de idade (U = 899,5, p = 0,616), género (X2= 0,00, p = 1,00) ou literacia (U = 956, p = 0,96) entre os dois grupos. Diferenças significativas foram encontradas na prova de fluência verbal de ação (U = 406,5, p < 0,01) que não se verificaram nas restantes provas. O nível educacional foi a única variável biográfica que influenciou o desempenho das tarefas, independentemente do tempo de evolução da doença. Os resultados sugerem uma correlação entre os mecanismos patológicos da DP e um déficit específico para a evocação de verbos e que a prova de fluência de ação providencia uma informação importante que não é detectada pelos restantes testes executivos.
We compared the performance of 31 non-demented Parkinson´s disease (PD) patients to 61 healthy controls in an action verbal fluency task. Semantic and phonemic fluencies, cognitive impairment and behavioural dysfunction were also assessed. The mean disease duration of PD was 9.8 years (standard deviation (SD) = 6.13). There were no age (U = 899.5, p = 0.616), gender(chi-square = 0.00, p = 1.00) or literacy (U = 956, p = 0.96) differences between the two groups. A significant difference was observed between the two groups in the action verbal fluency task (U = 406.5, p < 0.01) that was not found in the other fluency tasks. The education level was the only biographical variable that influenced the action (verb) fluency outcomes, irrespective of disease duration. Our findings suggest a correlation between the disease mechanisms in PD and a specific verb deficit, support the validity of the action (verb) fluency as an executive function measure and suggest that this task provides unique information not captured with traditional executive function tasks.
https://doi.org/10.1590/0004-282X20150056
4932 downloads
13.
Growing knowledge: an overview of Seed Plant diversity in Brazil
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Zappi, Daniela C.
; Filardi, Fabiana L. Ranzato
; Leitman, Paula
; Souza, Vinícius C.
; Walter, Bruno M.T.
; Pirani, José R.
; Morim, Marli P.
; Queiroz, Luciano P.
; Cavalcanti, Taciana B.
; Mansano, Vidal F.
; Forzza, Rafaela C.
; Abreu, Maria C.
; Acevedo-Rodríguez, Pedro
; Agra, Maria F.
; Almeida Jr., Eduardo B.
; Almeida, Gracineide S.S.
; Almeida, Rafael F.
; Alves, Flávio M.
; Alves, Marccus
; Alves-Araujo, Anderson
; Amaral, Maria C.E.
; Amorim, André M.
; Amorim, Bruno
; Andrade, Ivanilza M.
; Andreata, Regina H.P.
; Andrino, Caroline O.
; Anunciação, Elisete A.
; Aona, Lidyanne Y.S.
; Aranguren, Yani
; Aranha Filho, João L.M.
; Araújo, Andrea O.
; Araújo, Ariclenes A.M.
; Araújo, Diogo
; Arbo, María M.
; Assis, Leandro
; Assis, Marta C.
; Assunção, Vivian A.
; Athiê-Souza, Sarah M.
; Azevedo, Cecilia O.
; Baitello, João B.
; Barberena, Felipe F.V.A.
; Barbosa, Maria R.V.
; Barros, Fábio
; Barros, Lucas A.V.
; Barros, Michel J.F.
; Baumgratz, José F.A.
; Bernacci, Luis C.
; Berry, Paul E.
; Bigio, Narcísio C.
; Biral, Leonardo
; Bittrich, Volker
; Borges, Rafael A.X.
; Bortoluzzi, Roseli L.C.
; Bove, Cláudia P.
; Bovini, Massimo G.
; Braga, João M.A.
; Braz, Denise M.
; Bringel Jr., João B.A.
; Bruniera, Carla P.
; Buturi, Camila V.
; Cabral, Elza
; Cabral, Fernanda N.
; Caddah, Mayara K.
; Caires, Claudenir S.
; Calazans, Luana S.B.
; Calió, Maria F.
; Camargo, Rodrigo A.
; Campbell, Lisa
; Canto-Dorow, Thais S.
; Carauta, Jorge P.P.
; Cardiel, José M.
; Cardoso, Domingos B.O.S.
; Cardoso, Leandro J.T.
; Carneiro, Camila R.
; Carneiro, Cláudia E.
; Carneiro-Torres, Daniela S.
; Carrijo, Tatiana T.
; Caruzo, Maria B.R.
; Carvalho, Maria L.S.
; Carvalho-Silva, Micheline
; Castello, Ana C.D.
; Cavalheiro, Larissa
; Cervi, Armando C.
; Chacon, Roberta G.
; Chautems, Alain
; Chiavegatto, Berenice
; Chukr, Nádia S.
; Coelho, Alexa A.O.P.
; Coelho, Marcus A.N.
; Coelho, Rubens L.G.
; Cordeiro, Inês
; Cordula, Elizabeth
; Cornejo, Xavier
; Côrtes, Ana L.A.
; Costa, Andrea F.
; Costa, Fabiane N.
; Costa, Jorge A.S.
; Costa, Leila C.
; Costa-e-Silva, Maria B.
; Costa-Lima, James L.
; Cota, Maria R.C.
; Couto, Ricardo S.
; Daly, Douglas C.
; De Stefano, Rodrigo D.
; De Toni, Karen
; Dematteis, Massimiliano
; Dettke, Greta A.
; Di Maio, Fernando R.
; Dórea, Marcos C.
; Duarte, Marília C.
; Dutilh, Julie H.A.
; Dutra, Valquíria F.
; Echternacht, Lívia
; Eggers, Lilian
; Esteves, Gerleni
; Ezcurra, Cecilia
; Falcão Junior, Marcus J.A.
; Feres, Fabíola
; Fernandes, José M.
; Ferreira, D.M.C.
; Ferreira, Fabrício M.
; Ferreira, Gabriel E.
; Ferreira, Priscila P.A.
; Ferreira, Silvana C.
; Ferrucci, Maria S.
; Fiaschi, Pedro
; Filgueiras, Tarciso S.
; Firens, Marcela
; Flores, Andreia S.
; Forero, Enrique
; Forster, Wellington
; Fortuna-Perez, Ana P.
; Fortunato, Reneé H.
; Fraga, Cléudio N.
; França, Flávio
; Francener, Augusto
; Freitas, Joelcio
; Freitas, Maria F.
; Fritsch, Peter W.
; Furtado, Samyra G.
; Gaglioti, André L.
; Garcia, Flávia C.P.
; Germano Filho, Pedro
; Giacomin, Leandro
; Gil, André S.B.
; Giulietti, Ana M.
; A.P.Godoy, Silvana
; Goldenberg, Renato
; Gomes da Costa, Géssica A.
; Gomes, Mário
; Gomes-Klein, Vera L.
; Gonçalves, Eduardo Gomes
; Graham, Shirley
; Groppo, Milton
; Guedes, Juliana S.
; Guimarães, Leonardo R.S.
; Guimarães, Paulo J.F.
; Guimarães, Elsie F.
; Gutierrez, Raul
; Harley, Raymond
; Hassemer, Gustavo
; Hattori, Eric K.O.
; Hefler, Sonia M.
; Heiden, Gustavo
; Henderson, Andrew
; Hensold, Nancy
; Hiepko, Paul
; Holanda, Ana S.S.
; Iganci, João R.V.
; Imig, Daniela C.
; Indriunas, Alexandre
; Jacques, Eliane L.
; Jardim, Jomar G.
; Kamer, Hiltje M.
; Kameyama, Cíntia
; Kinoshita, Luiza S.
; Kirizawa, Mizué
; Klitgaard, Bente B.
; Koch, Ingrid
; Koschnitzke, Cristiana
; Krauss, Nathália P.
; Kriebel, Ricardo
; Kuntz, Juliana
; Larocca, João
; Leal, Eduardo S.
; Lewis, Gwilym P.
; Lima, Carla T.
; Lima, Haroldo C.
; Lima, Itamar B.
; Lima, Laíce F.G.
; Lima, Laura C.P.
; Lima, Leticia R.
; Lima, Luís F.P.
; Lima, Rita B.
; Lírio, Elton J.
; Liro, Renata M.
; Lleras, Eduardo
; Lobão, Adriana
; Loeuille, Benoit
; Lohmann, Lúcia G.
; Loiola, Maria I.B.
; Lombardi, Julio A.
; Longhi-Wagner, Hilda M.
; Lopes, Rosana C.
; Lorencini, Tiago S.
; Louzada, Rafael B.
; Lovo, Juliana
; Lozano, Eduardo D.
; Lucas, Eve
; Ludtke, Raquel
; Luz, Christian L.
; Maas, Paul
; Machado, Anderson F.P.
; Macias, Leila
; Maciel, Jefferson R.
; Magenta, Mara A.G.
; Mamede, Maria C.H.
; Manoel, Evelin A.
; Marchioretto, Maria S.
; Marques, Juliana S.
; Marquete, Nilda
; Marquete, Ronaldo
; Martinelli, Gustavo
; Martins da Silva, Regina C.V.
; Martins, Ângela B.
; Martins, Erika R.
; Martins, Márcio L.L.
; Martins, Milena V.
; Martins, Renata C.
; Matias, Ligia Q.
; Maya-L., Carlos A.
; Mayo, Simon
; Mazine, Fiorella
; Medeiros, Debora
; Medeiros, Erika S.
; Medeiros, Herison
; Medeiros, João D.
; Meireles, José E.
; Mello-Silva, Renato
; Melo, Aline
; Melo, André L.
; Melo, Efigênia
; Melo, José I.M.
; Menezes, Cristine G.
; Menini Neto, Luiz
; Mentz, Lilian A.
; Mezzonato, A.C.
; Michelangeli, Fabián A.
; Milward-de-Azevedo, Michaele A.
; Miotto, Silvia T.S.
; Miranda, Vitor F.O.
; Mondin, Cláudio A.
; Monge, Marcelo
; Monteiro, Daniele
; Monteiro, Raquel F.
; Moraes, Marta D.
; Moraes, Pedro L.R.
; Mori, Scott A.
; Mota, Aline C.
; Mota, Nara F.O.
; Moura, Tania M.
; Mulgura, Maria
; Nakajima, Jimi N.
; Nardy, Camila
; Nascimento Júnior, José E.
; Noblick, Larry
; Nunes, Teonildes S.
; O'Leary, Nataly
; Oliveira, Arline S.
; Oliveira, Caetano T.
; Oliveira, Juliana A.
; Oliveira, Luciana S.D.
; Oliveira, Maria L.A.A.
; Oliveira, Regina C.
; Oliveira, Renata S.
; Oliveira, Reyjane P.
; Paixão-Souza, Bruno
; Parra, Lara R.
; Pasini, Eduardo
; Pastore, José F.B.
; Pastore, Mayara
; Paula-Souza, Juliana
; Pederneiras, Leandro C.
; Peixoto, Ariane L.
; Pelissari, Gisela
; Pellegrini, Marco O.O.
; Pennington, Toby
; Perdiz, Ricardo O.
; Pereira, Anna C.M.
; Pereira, Maria S.
; Pereira, Rodrigo A.S.
; Pessoa, Clenia
; Pessoa, Edlley M.
; Pessoa, Maria C.R.
; Pinto, Luiz J.S.
; Pinto, Rafael B.
; Pontes, Tiago A.
; Prance, Ghillean T.
; Proença, Carolyn
; Profice, Sheila R.
; Pscheidt, Allan C.
; Queiroz, George A.
; Queiroz, Rubens T.
; Quinet, Alexandre
; Rainer, Heimo
; Ramos, Eliana
; Rando, Juliana G.
; Rapini, Alessandro
; Reginato, Marcelo
; Reis, Ilka P.
; Reis, Priscila A.
; Ribeiro, André R.O.
; Ribeiro, José E.L.S.
; Riina, Ricarda
; Ritter, Mara R.
; Rivadavia, Fernando
; Rocha, Antônio E.S.
; Rocha, Maria J.R.
; Rodrigues, Izabella M.C.
; Rodrigues, Karina F.
; Rodrigues, Rodrigo S.
; Rodrigues, Rodrigo S.
; Rodrigues, Vinícius T.
; Rodrigues, William
; Romaniuc Neto, Sérgio
; Romão, Gerson O.
; Romero, Rosana
; Roque, Nádia
; Rosa, Patrícia
; Rossi, Lúcia
; Sá, Cyl F.C.
; Saavedra, Mariana M.
; Saka, Mariana
; Sakuragui, Cássia M.
; Salas, Roberto M.
; Sales, Margareth F.
; Salimena, Fatima R.G.
; Sampaio, Daniela
; Sancho, Gisela
; Sano, Paulo T.
; Santos, Alessandra
; Santos, Élide P.
; Santos, Juliana S.
; Santos, Marianna R.
; Santos-Gonçalves, Ana P.
; Santos-Silva, Fernanda
; São-Mateus, Wallace
; Saraiva, Deisy P.
; Saridakis, Dennis P.
; Sartori, Ângela L.B.
; Scalon, Viviane R.
; Schneider, Ângelo
; Sebastiani, Renata
; Secco, Ricardo S.
; Senna, Luisa
; Senna-Valle, Luci
; Shirasuna, Regina T.
; Silva Filho, Pedro J.S.
; Silva, Anádria S.
; Silva, Christian
; Silva, Genilson A.R.
; Silva, Gisele O.
; Silva, Márcia C.R.
; Silva, Marcos J.
; Silva, Marcos J.
; Silva, Otávio L.M.
; Silva, Rafaela A.P.
; Silva, Saura R.
; Silva, Tania R.S.
; Silva-Gonçalves, Kelly C.
; Silva-Luz, Cíntia L.
; Simão-Bianchini, Rosângela
; Simões, André O.
; Simpson, Beryl
; Siniscalchi, Carolina M.
; Siqueira Filho, José A.
; Siqueira, Carlos E.
; Siqueira, Josafá C.
; Smith, Nathan P.
; Snak, Cristiane
; Soares Neto, Raimundo L.
; Soares, Kelen P.
; Soares, Marcos V.B.
; Soares, Maria L.
; Soares, Polyana N.
; Sobral, Marcos
; Sodré, Rodolfo C.
; Somner, Genise V.
; Sothers, Cynthia A.
; Sousa, Danilo J.L.
; Souza, Elnatan B.
; Souza, Élvia R.
; Souza, Marcelo
; Souza, Maria L.D.R.
; Souza-Buturi, Fátima O.
; Spina, Andréa P.
; Stapf, María N.S.
; Stefano, Marina V.
; Stehmann, João R.
; Steinmann, Victor
; Takeuchi, Cátia
; Taylor, Charlotte M.
; Taylor, Nigel P.
; Teles, Aristônio M.
; Temponi, Lívia G.
; Terra-Araujo, Mário H.
; Thode, Veronica
; Thomas, W.Wayt
; Tissot-Squalli, Mara L.
; Torke, Benjamin M.
; Torres, Roseli B.
; Tozzi, Ana M.G.A.
; Trad, Rafaela J.
; Trevisan, Rafael
; Trovó, Marcelo
; Valls, José F.M.
; Vaz, Angela M.S.F.
; Versieux, Leonardo
; Viana, Pedro L.
; Vianna Filho, Marcelo D.M.
; Vieira, Ana O.S.
; Vieira, Diego D.
; Vignoli-Silva, Márcia
; Vilar, Thaisa
; Vinhos, Franklin
; Wallnöfer, Bruno
; Wanderley, Maria G.L.
; Wasshausen, Dieter
; Watanabe, Maurício T.C.
; Weigend, Maximilian
; Welker, Cassiano A.D.
; Woodgyer, Elizabeth
; Xifreda, Cecilia C.
; Yamamoto, Kikyo
; Zanin, Ana
; Zenni, Rafael D.
; Zickel, Carmem S
.
Resumo Um levantamento atualizado das plantas com sementes e análises relevantes acerca desta biodiversidade são apresentados. Este trabalho se iniciou em 2010 com a publicação do Catálogo de Plantas e Fungos e, desde então vem sendo atualizado por mais de 430 especialistas trabalhando online. O Brasil abriga atualmente 32.086 espécies nativas de Angiospermas e 23 espécies nativas de Gimnospermas e estes novos dados mostram um aumento de 3% da riqueza em relação a 2010. A Amazônia é o Domínio Fitogeográfico com o maior número de espécies de Gimnospermas, enquanto que a Floresta Atlântica possui a maior riqueza de Angiospermas. Houve um crescimento considerável no número de espécies e nas taxas de endemismo para a maioria dos Domínios (Caatinga, Cerrado, Floresta Atlântica, Pampa e Pantanal), com exceção da Amazônia que apresentou uma diminuição de 2,5% de endemicidade. Entretanto, a maior parte das plantas com sementes que ocorrem no Brasil (57,4%) é endêmica deste território. A proporção de formas de vida varia de acordo com os diferentes Domínios: árvores são mais expressivas na Amazônia e Floresta Atlântica do que nos outros biomas, ervas são dominantes no Pampa e as lianas apresentam riqueza expressiva na Amazônia, Floresta Atlântica e Pantanal. Este trabalho não só quantifica a biodiversidade brasileira, mas também indica as lacunas de conhecimento e o desafio a ser enfrentado para a conservação desta flora.
Abstract An updated inventory of Brazilian seed plants is presented and offers important insights into the country's biodiversity. This work started in 2010, with the publication of the Plants and Fungi Catalogue, and has been updated since by more than 430 specialists working online. Brazil is home to 32,086 native Angiosperms and 23 native Gymnosperms, showing an increase of 3% in its species richness in relation to 2010. The Amazon Rainforest is the richest Brazilian biome for Gymnosperms, while the Atlantic Rainforest is the richest one for Angiosperms. There was a considerable increment in the number of species and endemism rates for biomes, except for the Amazon that showed a decrease of 2.5% of recorded endemics. However, well over half of Brazillian seed plant species (57.4%) is endemic to this territory. The proportion of life-forms varies among different biomes: trees are more expressive in the Amazon and Atlantic Rainforest biomes while herbs predominate in the Pampa, and lianas are more expressive in the Amazon, Atlantic Rainforest, and Pantanal. This compilation serves not only to quantify Brazilian biodiversity, but also to highlight areas where there information is lacking and to provide a framework for the challenge faced in conserving Brazil's unique and diverse flora.
https://doi.org/10.1590/2175-7860201566411
33340 downloads
14.
Estudio prospectivo de las complicaciones asociadas a la biopsia percutánea en riñón nativo: experiencia en un centro
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Pendón-Ruiz de Mier, M. Victoria
; Espinosa-Hernández, Mario
; Rodelo-Haad, Cristian
; Esquivias-de Motta, Elvira
; Gómez-Carrasco, José
; Ortega, Rosa
; Aljama, Pedro
.
Background: Percutaneous renal biopsy (PRB) is a key invasive technique in the study of kidney disease and it is associated with considerable morbidity. Retrospective studies have shown minor complications in 10%-20% and major complications in 1.2%-6.6% of cases. However, this aspect has not been studied prospectively. Objective: The aim of our study was to prospectively assess complications related to PRB in the native kidney. Methods: From January 2009 to May 2013, we prospectively analysed PRB performed by nephrologists in native kidneys under ultrasound guidance. We analysed clinical and laboratory variables. We defined minor complications as the decrease in haemoglobin (Hb) of more than 1g/dL and major complications as the need for a transfusion or invasive technique. Results: 241 PRB were performed over this period. The mean patient age was 49 years (±17), the majority (56%) were male and 58.1% had high blood pressure. In 51% of cases, we carried out 2 punctures. There were minor complications in 46 patients (19.1%) and major complications in 9 patients (3.7%). In the univariate analysis, pre-PRB Hb was 10.3g/dL (±1.3) in patients with major complications and 12.3g/dL (±2.2) in the remaining patients (p=.003); in the multivariate analysis: OR 0.51, 95% CI (0.2-0.9), p<.05. Conclusions: PRB is a procedure that is not without risk, since minor complications occurred in 19.1% and major complications in 3.7% of cases. Pre-PRB Hb is an independent risk factor for the development of major complications.
Introducción: La biopsia renal percutánea (BRP) es una exploración invasiva fundamental para el estudio de enfermedades renales que lleva asociada una apreciable morbilidad. Estudios retrospectivos han mostrado que el 10-20 % de los casos presentan complicaciones menores y el 1,2-6,6 % complicaciones consideradas mayores. Sin embargo, este aspecto no ha sido examinado prospectivamente. Objetivo: El objetivo del estudio fue evaluar prospectivamente las complicaciones asociadas a la BRP en el riñón nativo. Métodos: Estudio prospectivo desde enero de 2009 hasta mayo de 2013 de las BRP realizadas por nefrólogos en riñón nativo bajo control ecográfico. Se analizaron variables clínicas y analíticas. Definimos complicación menor como la caída de la hemoglobina (Hb) de más de 1 g/dl y complicación mayor la necesidad de transfusión o técnica invasiva. Resultados: En este período se han realizado 241 BRP. La edad media de los pacientes fue de 49 años (± 17), la mayoría eran varones (56 %) y el 58,1 % padecían hipertensión arterial. Se realizaron dos punciones en el 51 %. Se observaron complicaciones menores en 46 pacientes (19,1 %) y mayores en 9 pacientes (3,7 %). En el análisis univariante, la Hb pre-BRP fue 10,3 g/dl (± 1,3) en aquellos que desarrollaron complicaciones mayores y 12,3 g/dl (± 2,2) en los demás (p = 0,003); en el análisis multivariante: OR 0,51, IC 95 %(0,2-0,9), p < 0,05. Conclusiones: La BRP es un procedimiento no exento de riesgos, ya que las complicaciones menores se presentaron en el 19,1 % y las mayores en el 3,7 % de los casos. La Hb pre-BRP es un factor de riesgo independiente para el desarrollo de complicaciones mayores.
https://doi.org/10.3265/Nefrologia.pre2014.Jan.12323
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15.
C4d como herramienta diagnóstica en la nefropatía membranosa
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Espinosa-Hernández, Mario
; Ortega-Salas, Rosa
; López-Andreu, María
; Gómez-Carrasco, José M.
; Pérez-Sáez, M. José
; Pérez-Seoane, Carlos
; Aljama-García, Pedro
.
Introduction: membranous nephropathy (MN) is the most common cause of nephrotic syndrome in adults. The diagnosis is based on typical findings observed using electron microscope (EM) and immunofluorescence (IF) studies. On some occasions, tissues are only available for analysis using an optical microscope (OM); in these cases, it can be difficult to differentiate between MN and minimal change disease (MCD). Recently, the use of C4d immunohistochemical staining has spread. Very little information is available regarding C4d deposits in MN. Our study consisted of analysing whether C4d staining of samples embedded in paraffin could be useful for diagnosing MN. Material and Method: Ours was a retrospective study including all patients diagnosed with MN by renal biopsy in our unit between January 2001 and October 2008. We only included adult patients with a definitive diagnosis of MN or idiopathic MCD by OM, IF, and ME studies. In October 2008, 3µm sections of renal tissue fixed in formaldehyde were removed from paraffin and rehydrated. The samples were then stained for C4d immunohistochemical analysis using anti-human polyclonal antibodies obtained from rabbits. Results: Our study included a final sample of 19 patients with MCD and 21 with MN. No C4d deposits were observed in any of the glomeruli in patients with MCD, and 100% of these patients were classified as negative. However, C4d deposits were detected in 100% of patients with MN, and were observable in all glomeruli with a uniform granular distribution, demarcating all capillary loops. Conclusions: C4d immunohistochemical staining is a very useful tool for diagnosing MN.
Introducción: La nefropatía membranosa (NM) es la causa más frecuente de síndrome nefrótico en adultos. El diagnóstico se basa en los hallazgos típicos observados con el microscopio electrónico (ME) y el estudio de inmunofluorescencia (IF). En algunas ocasiones, sólo se dispone de tejido para estudio de microscopio óptico (MO); en estos casos puede ser complicado diferenciar entre una NM y una enfermedad por cambios mínimos (ECM). Recientemente se está extendiendo el estudio con C4d por inmunohistoquímica. Existe muy poca información sobre el depósito de C4d en la NM. Nuestro estudio consistió en analizar si el depósito de C4d realizado en la muestra en parafina podría ser útil en el diagnóstico de NM. Material y métodos: Estudio retrospectivo que incluyó a todos los pacientes diagnosticados de NM mediante biopsia renal en nuestra unidad entre enero de 2001 y octubre de 2008. Se incluyeron sólo adultos con un diagnóstico certero de NM y ECM idiopática que dispusieran de estudios con MO, IF y ME. En octubre de 2008, secciones de 3 µm de tejido renal fijado en formaldehído fueron deparafinadas y rehidratadas. Después se tiñeron mediante inmunohistoquímica con C4d usando un anticuerpo policlonal antihumano obtenido de conejo. Resultados: Se incluyeron finalmente 19 pacientes con ECM y 21 con NM. Ningún depósito de C4d fue observado en ninguno de los glomérulos de los pacientes con ECM y el 100% de estos pacientes fueron clasificados como negativos. Sin embargo, el depósito de C4d se detectó en el 100% de los pacientes con NM y en todos los glomérulos con una distribución uniforme y granular dibujando todas las asas capilares. Conclusiones: El depósito de C4d mediante inmunohistoquímica es una herramienta muy útil en el diagnóstico de NM.
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