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Sample records for dural tipo adulto

  1. Qualidade de vida em adultos com diabetes tipo 1 e validade do DQOL-Brasil

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    Fábio Brasil

    2014-01-01

    Full Text Available O objetivo deste estudo foi estabelecer validade de critério e construto, e também, avaliar qualitativamente a versão brasileira do Questionário de Medida da Qualidade de Vida em Diabetes (DQOL-Brasil, quando utilizado em pacientes adultos com diabete melito (DM tipo 1. O DQOL-Brasil foi autoadministrado a 150 indivíduos (63,3% mulheres com tempo diagnóstico médio de DM tipo 1 de 14,17 anos e na faixa etária de 18 a 56 anos. O escore médio obtido foi de 2,46 (IC 95% 2,35 - 2,56. Entre os itens, os melhores e piores escores foram obtidos nos domínios de impacto da doença e preocupações com o DM, respectivamente. O instrumento como um todo apresentou elevada consistência interna, alfa de Cronbach = 0,94. Constatou-se validade convergente ao se co-administrar o questionário genérico de avaliação da qualidade de vida: Perfil de Saúde de Nottingham. O DQOL-Brasil foi readministrado a 52 pacientes em um intervalo médio de 98,25 dias, e constatou-se reprodutibilidade aceitável, através de coeficientes de correlação intraclasse superiores a 0,7. Entretanto, a análise fatorial comprovou deficiências. Deste modo, o DQOL-Brasil é válido para medida da qualidade de vida em pacientes adultos com DM tipo 1 e útil para aplicação em pesquisas e comparações com dados internacionais. Porém, para a prática clínica, recomenda-se seleção criteriosa dos itens do instrumento que sejam mais relacionados às características específicas da enfermidade em brasileiros; uma seleção ponderada de itens provavelmente seria útil às versões do DQOL traduzidas e validadas em outras nações.

  2. Autopsia verbal en hombres adultos con diabetes tipo 2: estudio cualitativo

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    Geu Mendoza-Catalán

    2017-09-01

    Full Text Available Introducción: La diabetes mellitus tipo 2 (DMT2 es un padecimiento crónico cuya incidencia se incrementa en forma alarmante. El objetivo fue identificar los factores asociados al no autocuidado en hombres con muerte prematura y diagnóstico de DMT2. Materiales y Métodos: Se realizaron seis entrevistas cualitativas a familiares de hombres con DMT2 que fallecieron por complicaciones de su enfermedad, utilizando la metodología de la autopsia verbal. Los resultados se analizaron mediante el análisis de contenido. Resultados: Dentro de los factores que surgieron como limitantes para el autocuidado fueron: la negación de la DMT2, el trabajo, el machismo, preferencia en los alimentos, apoyo familiar, el consumo de alcohol, el consumo de tabaco y la depresión. Discusión: Los hombres con DMT2 se ven influenciados por diversas circunstancias que limitan cuidarse, atenderse y por consiguiente presentar desventajas de salud, complicaciones e incluso una muerte temprana. Conclusiones: Desde la perspectiva de enfermería los resultados ayudan a comprender el comportamiento de los hombres ante esta enfermedad en donde se requiere cuidado constante, a la par que una conciencia legítima de que no se deja de ser hombre por cuidarse.  Cómo citar este artículo: Mendoza-Catalán G, Gallegos-Cabriales EC, Figueroa-Perea JG. Autopsia verbal en hombres adultos con diabetes tipo 2: estudio cualitativo. Rev Cuid. 2017; 8(3: 1786-98. http://dx.doi.org/10.15649/cuidarte.v8i3.420

  3. Resgate vegetativo por alporquia de genótipos adultos de urucum (Bixa orellana L.

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    Nilton César Mantovani

    2010-09-01

    Full Text Available Este trabalho teve por objetivos avaliar a técnica de alporquia visando ao resgate vegetativo de genótipos de urucum (Bixa orellana L. e a obtenção de plantas fornecedoras de propágulos para processos de propagação clonal. Foram utilizadas dez plantas matrizes de urucum, com 12 anos de idade, obtidas partindo do cruzamento artificial entre os genótipos "Fruto Verde Piloso" X "Fruto Vermelho Liso". Os alporques foram realizados em ramos de 1 a 2 cm de diâmetro, utilizando-se como substrato uma mistura de vermiculita e musgo. Foi avaliado o efeito (1 do tipo de anelamento da casca dos ramos (total ou parcial, com 1 cm de comprimento, (2 do AIB (ácido indol-3-butírico a 0 e 4,92 mM aplicado em papel filtro e (3 do tipo de proteção dos alporques (filmes plásticos transparente ou preto ou tecido tencel, no enraizamento de alporque dos dez genótipos. A técnica de alporquia proporcionou o enraizamento de ramos dos dez genótipos avaliados, com eficiência variável de 20 a 100%, havendo efeito do genótipo sobre a frequência de enraizamento. A sobrevivência desses alporques foi de 100% após o plantio quando estes foram produzidos com anelamento total, tratados com AIB e protegidos com plástico transparente. Em casa de vegetação os alporques desenvolveram ramos partindo da brotação de gemas caulinares constituindo estoques de explantes apropriados para serem utilizados como estacas ou como fontes de segmentos nodais para a propagação in vitro desta espécie.

  4. Espiritualidad e incertidumbre ante la enfermedad: adultos diabéticos tipo 2

    OpenAIRE

    Gómez Palencia, Isabel Patricia; Durán de Villalobos, María Mercedes

    2013-01-01

    El objetivo principal de este artículo es determinar la relación entre espiritualidad e incertidumbre presente en personas con situación crónica por diabetes mellitus tipo 2 en instituciones de servicio de salud en Cartagena, Colombia. El estudio fue realizado con un método descriptivo transversal, correlacional.Asimismo, la muestra fue de 163 pacientes que tuvieran como mínimo dos meses de haber sido diagnosticados con diabetes mellitus tipo 2; los instrumentos utilizados fueron la escala de...

  5. Incertidumbre en adultos diabéticos tipo 2 a partir de la teoría de Merle Mishel

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    Isabel Patricia Gómez-Palencia

    2015-01-01

    Full Text Available Objetivo: describir el nivel de incertidumbre de adultos con diabetes mellitus tipo 2 atendidos en instituciones prestadoras de servi- cios de salud en Cartagena (Colombia. Materiales y métodos: estudio descriptivo a partir de una muestra de 163 pacientes que tuvieran como mínimo dos meses de haber sido diagnosticados con diabetes mellitus tipo 2. El instrumento utilizado fue la escala de la Incerti- dumbre ante la enfermedad de Mishel y para el análisis de los datos fue utilizado el paquete estadístico SPSS versión 20.0. Resultados: del total de participantes 76,1 % mostraron un nivel de incertidumbre regular. El fenómeno de la incertidumbre está más relacionado con la incapacidad para identificar si ha mejorado o no (86,5 % , de predecir o explicar la causa de un malestar físico (76,7 % o predecir el cambio de los síntomas (60,1 % . Conclusiones: para enfermería, abarcar este fenómeno permite una mejor aproximación al análisis de los desafíos y las expectativas de quienes viven con una enfermedad crónica y así proporcionar cuidados que permitan un proceso de adaptación óptimo, que apoyen y enriquezcan la práctica enfermera.

  6. Ejercicio de resistencia muscular en adultos con diabetes mellitus tipo 2 Exercício de resistência muscular em adultos com diabetes mellitus tipo 2 Endurance training in adults with diabetes mellitus type 2

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    Karina Asunción Muñoz Canché

    2005-02-01

    Full Text Available Objetivos. Probar la efectividad del ejercicio de resistencia muscular en las cifras de hemoglobina glucosilada (HbA1c, en la fuerza muscular y en la fortaleza muscular percibida; explorar la influencia de la dieta, otros ejercicios, hipoglucemiantes y manifestaciones asociadas a episodios de hipoglucemia o hiperglucemia sobre el control glucémico de adultos con diabetes mellitus tipo 2 provenientes de los consultorios de endocrinología de dos hospitales públicos de la Ciudad de Monterrey, México. Procedimientos básicos. Se usó un diseño de 12 semanas de grupo control no equivalente con dos grupos, experimental (n1 = 14 y control (n2 = 11. Los participantes contaron con la recomendación de su médico para participar. Las sesiones de ejercicio fueron de una hora, dos veces por semana. Resultados. El grupo experimental mostró decremento significativo en el porcentaje de HbA1c, e incremento en la fuerza muscular y fortaleza muscular percibida (p Objetivos: Provar a efetividade do exercício de resistência muscular nas taxas de hemoglobina A glicosilada (HbA1c, na força muscular e no fortalecimento muscular percebido, explorar a influência da dieta, outros exercícios, hipoglicemiantes e manifestações associadas a episódios de hipoglicemia ou hiperglicemia sobre o controle glicêmico de adultos com diabetes mellitus tipo 2, provenientes dos consultórios de endocrinologia de dois hospitales públicos da Cidade de Monterrey, México. Procedimentos básicos: Foi utilizado um desenho de 12 semanas de grupo controle não equivalente com dois grupos, experimental (n1=14 e controle (n2=11. Os participantes tiveram recomendação de seu médico para participar. As sessões de exercício foram de uma hora, duas vezes por semana. Resultados: O grupo experimental apresentou decréscimo significativo nas taxas de HbA1c, incremento na força muscular e fortalecimento muscular percebido (pObjectives. Test the effects of an endurance training

  7. Dural ectasia

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    Neha Gupta

    2014-01-01

    Full Text Available Dural ectasia is one of the likely causes of incomplete or failed spinal anaesthesia. Its association with diseases like Marfans syndrome, neurofibromatosis, osteogenesis imperfecta, vertebral fracture, postopertative adhesions, trauma etc., is often overlooked as a reason for inadequate spinal anaesthesia. Greater than normal volume of cerebrospinal fluid in the lumber theca in dural ectasia is postulated to restrict the spread of intrathecally injected Local anaesthetic. Here, we report a case of failed spinal anaesthesia but successful epidural anaesthesia in later setting in a patient with dural ectasia.

  8. Asociación entre el precio de los alimentos y la glucemia en adultos estadounidenses con diabetes de tipo 2

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    Tobenna D. Anekwé

    2015-06-01

    Full Text Available OBJETIVOS: Calculamos la asociación entre el precio de diversas categorías de alimentos saludables y menos saludables y la glucemia en adultos estadounidenses con diabetes de tipo 2. MÉTODOS: Vinculamos la información de salud contenida en la Encuesta Nacional de Salud y Nutrición 1999-2006 y el precio de los alimentos a partir de la base trimestral de datos de precios de los alimentos. Aplicamos una regresión de los valores de glucemia con respecto al precio de los alimentos en el trimestre anterior, con control de la región del mercado y otras covariables. Examinamos asimismo si la asociación entre el precio de los alimentos y la glucemia variaba entre distintos grupos de ingresos. RESULTADOS: Tanto el precio de las frutas y verduras como el precio de los productos lácteos magros se asocian a la glucemia en las personas con diabetes de tipo 2. En concreto, un precio mayor de las frutas y verduras y de los productos lácteos se asocia a valores más altos de glu-cohemoglobina y de glucemia en ayunas tres meses después. La asociación entre el precio de los alimentos y la glucemia es mayor en las personas de ingresos bajos que en las de ingresos elevados, en la dirección esperada. CONCLUSIONES: Un precio mayor de los alimentos saludables se asocia a cifras más elevadas de glucemia en las personas con diabetes de tipo 2. Esta asociación fue especialmente pronunciada en las personas con diabetes de tipo 2 con ingresos bajos.

  9. Diabetes autoinmune del adulto en diabéticos tipo 2: frecuencia y características LADA in type 2 diabetics: frequency and characteristics

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    Eduardo Cabrera-Rode

    2001-04-01

    Full Text Available Se realizó este trabajo para conocer frecuencia, características clínico-bioquímicas, inmunológicas y genéticas de la diabetes autoinmune en adultos (LADA en 1 000 diabéticos tipo 2 con edades ³ 35 años con distintos tiempos de duración de la diabetes. Se les determinó glucemia, anticuerpos antiislotes pancreáticos (ICA, anti-GAD65, anti-ICA512bdc/IA2, antimicrosomales tiroideos (AMT, antigástricos parietales (AGP, antinucleares (AN, microalbuminuria y péptido C en ayunas. Se encuestaron y se registraron algunas características clínicas. Se dividieron en 2 grupos según la presencia de ICA. Todos los diabéticos tipo 2 + para autoanticuerpos antiislotes (ICA y/o anti-GAD65 fueron identificados como LADA. Se detectó el 3,4 % de diabético tipo 2 con ICA +, en los diabéticos tipo 2 ICA- el 22,0 % presentó anticuerpos anti-GAD65. Se encontró que los diabéticos tipo 2 ICA+ eran más jóvenes, la duración de su diabetes era menor, presentaron menor IMC, disminución de los niveles de péptido C en ayunas, menos antecedentes familiares (padres de DM2, valores menores en las tensiones arteriales diastólicas y sistólicas, mayor presencia de anticuerpos anti-GAD65, AMT y AGP en comparación con los diabéticos tipo 2 ICA-. Se observó que los diabéticos tipo 2 ICA+ (LADA tienen características específicas que los asemejan a los diabéticos tipo 1, esto implicaría variaciones importantes en su tratamiento y evolución con respecto a los diabéticos tipo 2 ICA-. Se observó una baja frecuencia de ICA y alta de GAD en los diabéticos tipo 2 cubanos, las cuales fueron diferentes a la encontrada en poblaciones caucasianas. Los anticuerpos anti-GAD65 fueron superiores a los ICA para detectar los LADA. Las características clínicas e inmunológicas de estos pacientes muestran la lenta progresión de la destrucción autoinmune de las células b con implicaciones terapéuticas.This paper was aimed at knowing the frequency, clinico

  10. Nivel de conocimientos sobre la enfermedad en los adultos mayores con diabetes mellitus tipo 2 Level of knowledge concerning diabetes mellitus type-2 in the elderly

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    María de la C Casanova Moreno

    2011-06-01

    Full Text Available Se realizó una investigación epidemiológica, descriptiva y transversal, con el objetivo de determinar el nivel de conocimientos sobre diabetes mellitus en los adultos mayores con diabetes tipo 2 durante el año 2010, en el área de salud Hermanos Cruz de la provincia de Pinar del Río. Se incluyeron 91 pacientes diabéticos tipo 2 que recibieron el servicio de atención integral al diabético de ambos sexos y en las edades de 60 y más años (n=91. Para determinar el nivel de conocimientos se aplicó una encuesta diseñada por los especialistas del Centro Provincial de Promoción y Educación para la Salud de la provincia; con los datos obtenidos se confeccionó una base de datos utilizando el programa EpiInfo 2002. Se hizo uso de la estadística descriptiva, los datos para su análisis fueron reflejados en cuadros de distribución de frecuencias y gráficos. Predominó el sexo femenino, la enfermedad crónica no transmisible que más se asoció fue la hipertensión arterial. El nivel de conocimientos fue insuficiente en todos los grupos según el tiempo de evolución de la enfermedad, lo mismo sucedió con los pacientes con complicaciones crónicas. Los diabéticos adultos mayores necesitan fortalecer la educación diabetológica para mejorar los conocimientos sobre la enfermedad y tener una mejor calidad de vida.An epidemiological, descriptive and cross-sectional research was carried out in 2010 with the objective of determining the level of knowledge concerning diabetes mellitus type-2 in the elderly suffering from this disease at "Hermanos Cruz" health area, Pinar del Rio. Ninety one (91 diabetic- type-2 patients attended to the comprehensive care service for both sexes, ages of 60 years old and older (n=91 participated in the study. To determine the level of knowledge a survey was applied, this was prepared by the specialists of the Provincial Center for Health Promotion and Education, arranging a database supported on these results and

  11. Educación, actividad física y obesidad en adultos con diabetes tipo 2 desde la perspectiva del autocuidado de Orem

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    Lidia Guadalupe Compean-Ortiz

    2013-01-01

    Full Text Available Describir la relación de la actividad física (pasos/día/ejercicio con la obesidad (índice de masa corporal, circunferencia de cintura y grasa corporal en adultos con diabetes tipo 2. Se planteó además: 1 determinar la relación de la educación/comprensión en diabetes con la actividad física/ejercicio, y 2 establecer diferencias de actividad física/ejercicio y obesidad/sobrepeso de acuerdo con variables sociodemográficas. Materiales y métodos : diseño descriptivo correlacional, muestra aleatoria de 124 pacientes de 17 centros comunitarios de Tampico, Tamaulipas, México. Las mediciones incluyeron: podómetro New-Life Style 2000, cuestionarios de autocuidado y Perfil de Cuidado en Diabetes, IMC, CC y grasa corporal. Los datos se analizaron con medidas de tendencia central, correlación de Spearman, prueba U de Mann-Whitney y Kruskal Wallis. Resultados: el promedio de pasos/día mostró relación inversa con el IMC (r s = - 0,282, p < 0,01 y la CC (r s = - 0,300, p < 0,01. La comprensión en diabetes tuvo relación positiva con el ejercicio (r s = 0,179, p = 0,04. Las mujeres fueron quienes tuvieron mayor porcentaje de grasa corporal (p < 0,05. Conclusiones: los hallazgos tienen implicacio- nes importantes para el ejercicio práctico de la profesión de enfermería que juega un papel esencial en el fomento de la activi dad física y otros comportamientos básicos de autocuidado a través de la educación. La educación basada en teoría se hace necesaria para el avance en el conocimiento de la disciplina.

  12. Self-Care Behaviors and Health Indicators in Adults with Type 2 Diabetes Conductas de autocuidado e indicadores de salud en adultos con diabetes tipo 2 Condutas de autocuidado e indicadores de saúde em adultos com diabetes tipo 2

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    Lidia Guadalupe Compeán Ortiz

    2010-08-01

    Full Text Available This descriptive correlational study aimed to analyze self-care behaviors and their relationship with health indicators represented by glycemic control, lipid profile, Body Mass Index [BMI], waist circumference and body fat percentage in a sample of 98 adults with type 2 diabetes in an area of Nuevo Leon, Mexico (August 2005/May 2006. The results showed a low self-care behaviors index ( or = 36.94, SD=15.14. A significant relationship was found between self-care behaviors and glycosilated hemoglobin [HbA1c] (r s=-.379, pSe trata de un estudio descriptivo y correlacional que tuvo como objetivo analizar las conductas de autocuidado y su relación con indicadores de salud, representados por el control de la glucemia, perfil de lípidos, IMC, circunferencia de cintura y porcentaje de grasa corporal, en una muestra aleatoria de 98 adultos con diabetes tipo 2 de un zona periférica de la ciudad de Nuevo León, en México; los datos fueron recolectados entre agosto del 2005 y mayo del 2006. Los resultados mostraron un índice de autocuidado bajo (promedio= 36,94 y desvío estándar=15,14. Se encontró correlación significativa entre el autocuidado y la HbA1c (r s= 0,379, pEstudo descritivo correlacional que teve como objetivo analisar as condutas de autocuidado e a sua relação com indicadores de saúde, representados pelo controle glicêmico, perfil de lipídios, índice de massa corpórea (IMC, circunferência da cintura e porcentagem de gordura corporal, em amostra aleatória de 98 adultos com diabetes tipo 2, de uma zona conturbada em Nuevo León, México (agosto 2005/maio 2006. Os resultados mostraram índice de autocuidado baixo ( ou = 36,94, dp=15,14. Encontrou-se correlação significativa entre o autocuidado e a hemoglobina glicolisada (HbA1c (r s=0,379, p<0,001, triglicerídeos (r s=0,208, p=0,040, IMC (r s=0,248, p=0,014 e gordura corporal (r s=0,221, p=0,029. A análise multivariada revelou influência do autocuidado em HbA1c, IMC e

  13. Ortodoncia en adultos

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    Hidalgo B. Ester, Dra.M

    2013-11-01

    Full Text Available Existe la creencia de que los tratamientos de ortodoncia sólo se pueden realizar en adolescentes. Desde la década del 70, a nivel internacional y nacional cada vez más son los adultos que están dispuestos a tener frenillos para solucionar su problema. En este artículo se describe la motivación del paciente, indicaciones y contraindicaciones de tratamiento, limitación de los resultados, tipos de aparatos usados y se presentan casos clínicos. Se concluye que no existe límite de edad para realizar tratamientos de ortodoncia en adultos.

  14. Extrasinusal dural arteriovenous malformations

    International Nuclear Information System (INIS)

    Piske, R.L.; Lasjaunias, P.

    1988-01-01

    Of 60 cases of dural arteriovenous malformations (DAVM) explored and treated in the Vascular Neuroradiology Unit of the Hospital of Bicetre between 1980 and 1986, 3 presented in an extrasinusal location: intraorbital, middle cerebral fossa and the region of the superior orbital fissure. We have not found any prior description of DAVMs in these regions in the literature. The classic concept that DAVMs rise in direct relationship with the dural sinuses is limited. We believe that these lesions may also developed in relationship with the venous drainage system of the sinuses and the venous drainage of the peripheral nervous system. We note that the superior ophthalmic vein which drains DAVMs of the orbit and the olfactory vein which drains DAVMs of the anterior cranial fossa and other veins that accompany the cranial nerves through the skull base have the characteristics of emissary veins. It may be that DAVMs can develop wherever veins follow a transosseous trajectory. (orig.)

  15. DESENVOLVIMENTO DO PROTÓTIPO DE UM ALIMENTO A BASE DE AVEIA E SOJA ENRIQUECIDO COM PREBIÓTICOS, VITAMINAS E MINERAIS PARA ATENDER ÀS NECESSIDADES NUTRICIONAIS DE ADULTOS E IDOSOS BRASILEIROS

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    SARASPATHY NAIDOO TERROSO GAMA DE MENDONÇA

    2009-07-01

    Full Text Available

    Mediante a utilização de um questionário sobre hábitos de consumo e da técnica focal de entrevistas, obteve-se um perfil de comportamento de consumo de alimentos processados e in natura de duas amostras da população adulta e idosa brasileira. A primeira foi realizada com 73 voluntários do Núcleo de Estudos da Terceira Idade (NETI da Universidade Federal de Santa Catarina, em Florianópolis, estado de Santa Catarina e a segunda com 295 participantes, selecionados aleatoriamente na cidade de Serranópolis do Iguaçu, estado do Paraná. Os dados coletados revelaram que ambas as populações têm expectativas quanto a alimentos saudáveis e apresentaram dificuldades na leitura do texto de rotulagem dos alimentos. Face aos resultados apresentados, este trabalho visou o desenvolvimento do protótipo de um alimento a base de aveia e soja, enriquecido com minerais, vitaminas e prebióticos, de forma a atender não somente às expectativas apontadas mas também às necessidades fisiológicas e sensoriais desta população. Apresenta também como sugestão para o painel secundário do texto de rotulagem, um tamanho de fonte de letra acima de 10 para melhor visualização das informações nutricionais constantes nos rótulos dos alimentos. PALAVRAS-CHAVE: Expectativas de consumo; adultos; idosos; alimento enriquecido; prebióticos.

  16. Fat in the dural sinus

    International Nuclear Information System (INIS)

    Tokiguchi, S.; Ando, K.; Tsuchiya, T.; Ito, J.

    1986-01-01

    Fat density in the dural sinus on computed tomography (CT) is described in eight cases. Of the eight cases, five had fat deposit in the torcular Herophili, and three in the superior sagittal sinus. This finding was incidentally found by CT and there was no common underlying disease in these cases. It is suggested that this finding represents normal adipose tissue in the dural sinus. (orig.)

  17. DURAL CAROTID-CAVERNOUS FISTULAS

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    Barbara Cvenkel

    2002-12-01

    Full Text Available Background. Dural carotid-cavernous sinus fistulas (CCF are communications fed by meningeal branches of the intracavernous internal carotid artery (ACI or/and external carotid artery (ACE. In contrast to typical CCF, the arteriovenous shunting of blood is usually low flow and low pressure. Spontaneous dural CCF are more common in postmenopausal women. Aetiology is unknown, but congenital malformation or rupture of thin-walled dural arteries within venous sinuses is believed to be the cause.Case reports. 3 cases lacking the typical clinical signs of CCF who had been treated as chronic conjunctivitis, myositis of the extraocular muscle and orbital pseudotumour are presented. Clinical presentation depends on the direction and magnitude of fistular flow and on the anatomy of the collateral branches. If increased blood flow is directed anteriorly in ophthalmic veins the signs of orbito-ocular congestion are present (»redeyed shunt syndrome«. Drainage primarly in the inferior petrosal sinus may cause painful oculomotor and abducens palsies without signs of ocular congestion (»white-eyed shunt syndrome«. Also different therapeutic approaches as well as possible complications are described.Conclusions. For definite diagnosis angiography is obligatory and is also therapeutic as one third to one half of dural CCF close spontaneously. Because of potential severe eye and systemic complications, surgical intervention is indicated only in cases with uncontrolled secondary glaucoma and hypoxic retinopathy.

  18. Dural enhancement with primary calvarial lesions.

    Science.gov (United States)

    Arana, E; Martí-Bonmatí, L; Ricart, V; Pérez-Ebrí, M

    2004-11-01

    The purpose of this study was to relate the pathological and imaging features of dural enhancement and meningeal sign ("dural tail") on contrast-enhanced T1-weighted magnetic resonance (MR) images from patients with primary calvarial lesions as well to assess the accuracy of MR imaging in predicting dural invasion. Thirty-two calvarial tumors studied with contrast-enhanced MR imaging and histopathological examination of the dural specimens were reviewed. Sixteen patients presented dural enhancement, eight with tumor invasion. Tumoral invasion of the dura was observed in one case without enhancement. Malignant lesions showed enhanced dura more commonly than benign lesions (P=0.02). Nodular and discontinuous dural enhancement was statistically associated with dural invasion (P=0.05). Dural tail did not show a specific pathological association. Meningeal enhancement is a nonspecific reaction to calvarial lesions unless nodular and discontinuous. False-negative and -positive cases of dural invasion imply some limitation of contrast-enhanced MR imaging in predicting dural invasion by calvarial neoplasms.

  19. Dural enhancement with primary calvarial lesions

    Energy Technology Data Exchange (ETDEWEB)

    Arana, E. [Clinica Quiron, Department of Radiology, Valencia (Spain); Marti-Bonmati, L. [Clinica Quiron, Department of Radiology, Valencia (Spain); Hospital Universitario Dr. Peset, Department of Radiology, Valencia (Spain); Ricart, V. [Hospital de la Ribera, Department of Radiology, Valencia (Spain); Perez-Ebri, M. [Hospital Universitario Dr. Peset, Department of Pathology, Valencia (Spain)

    2004-11-01

    The purpose of this study was to relate the pathological and imaging features of dural enhancement and meningeal sign (''dural tail'') on contrast-enhanced T1-weighted magnetic resonance (MR) images from patients with primary calvarial lesions as well to assess the accuracy of MR imaging in predicting dural invasion. Thirty-two calvarial tumors studied with contrast-enhanced MR imaging and histopathological examination of the dural specimens were reviewed. Sixteen patients presented dural enhancement, eight with tumor invasion. Tumoral invasion of the dura was observed in one case without enhancement. Malignant lesions showed enhanced dura more commonly than benign lesions (P=0.02). Nodular and discontinuous dural enhancement was statistically associated with dural invasion (P=0.05). Dural tail did not show a specific pathological association. Meningeal enhancement is a nonspecific reaction to calvarial lesions unless nodular and discontinuous. False-negative and -positive cases of dural invasion imply some limitation of contrast-enhanced MR imaging in predicting dural invasion by calvarial neoplasms. (orig.)

  20. Dural sinus filling defect: intrasigmoid encephalocele

    Science.gov (United States)

    Karatag, Ozan; Cosar, Murat; Kizildag, Betul; Sen, Halil Murat

    2013-01-01

    Filling defects of dural venous sinuses are considered to be a challenging problem especially in case of symptomatic patients. Many lesions have to be ruled out such as sinus thrombosis, arachnoid granulations and tumours. Encephalocele into dural sinus is also a rare cause of these filling defects of dural sinuses. Here, we report an extremely rare case with spontaneous occult invagination of temporal brain tissue into the left sigmoid sinus and accompanying cerebellar ectopia. PMID:24311424

  1. Symptomatic hemorrhagic complications associated with dural substitutes

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    Po-Yuan Chen

    2018-01-01

    Conclusion: The increased risk of hemorrhagic complications associated with craniotomy is modified by choice of dural replacement. Our results could assist clinicians in their decision-making with respect to the optimal timing for synthetic dural substitutes in patients with tumor infiltration of the patient's dura, severe brain swelling in traumatic brain injury, or a result of shrinkage from exposure and electrocautery.

  2. Dural metastasis of Ewing's sarcoma.

    Science.gov (United States)

    Ben Nsir, Atef; Boughamoura, Mohamed; Maatouk, Mezri; Kilani, Mohamed; Hattab, Nejib

    2013-01-01

    Metastatic Ewing's sarcoma to the central nervous system is an uncommon condition and debate concerning the true origin of its metastases is still up to date. To the best of our knowledge, only two cases of dural metastatic Ewing's sarcoma have been published in the English medical literature. We present an additional case in a 24-year-old female and discuss the pathogenesis of these unusual tumors with review of the relevant literature concerning their treatment and outcome. A 24-year-old female with previous history of pelvis Ewing's sarcoma and recently discovered lung metastases, presented with moderate headache for the past 2 weeks and weakness in her left leg for the past 2 days. Computed tomography scan and magnetic resonance imaging revealed an extra-axial right frontoparietal mass invading the superior sagittal sinus but with clear delineation with brain parenchyma. Imaging features were suggestive of a meningioma as no abnormalities in the skull abutting to the tumor were noted. The patient underwent surgical removal of her tumor. Near total resection was achieved and histological examination showed evidence of metastatic Ewing's sarcoma. Postoperative adjuvant radiation and chemotherapy were administered. The patient improved well postoperatively with full recovery of her motor weakness. She is symptom free with no signs of progression, at most recent follow-up, 8 months after surgery. Despite its rarity, metastatic Ewing's sarcoma must be considered in the differential diagnosis of extra-axial dural masses particularly meningiomas.

  3. Neck massage induced dural sinus thrombosis

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    Verma Ashish

    2007-01-01

    Full Text Available Thrombosis of the intracranial dural sinuses and internal jugular veins may occur as a complication of head and neck infections, surgery, central venous access, local malignancy, polycythemia, hyperhomocysteinemia, neck massage and intravenous drug abuse. A high degree of clinical suspicion followed by adequate imaging is prerequisite to early diagnosis and management. We report a young man who had dural sinus thrombosis with jugular venous thrombosis following neck massage.

  4. Emotional dysfunction associated with diabetes in Mexican adolescents and young adults with type-1 diabetes Disfunción emocional asociada a diabetes en adolescentes y adultos jóvenes mexicanos con diabetes tipo 1

    Directory of Open Access Journals (Sweden)

    Israel Lerman-Garber

    2003-01-01

    Full Text Available OBJECTIVE: To assess the emotional dysfunction associated with diabetes in Mexican young individuals with type-1 diabetes. MATERIAL AND METHODS: A cross-sectional survey was conducted to perform a complete clinical and psychosocial evaluation of 93 consecutive type-1 diabetes patients, aged 14 to 30 years. RESULTS: Adolescents had higher scores of emotional dysfunction related to diabetes and a diminished knowledge in diabetes-related areas. A multivariate logistic regression model showed that an inadequate emotional response to diabetes (high problem areas in diabetes or PAID scores was mainly associated with a poor glycemic control (OR=2.9, 95% CI 0.9-9.7, p=0.09. Apprehension about the future and the possibility of serious complications had the highest mean PAID score in all age groups. CONCLUSIONS: New strategies should be developed to improve the routine care and support of young individuals with type-1 diabetes.OBJETIVO: Investigar la disfunción emocional asociada con la diabetes en jóvenes mexicanos con diabetes tipo 1. MATERIAL Y MÉTODOS: Estudio transversal que incluyó la evaluación clínica y psicosocial de 93 pacientes con diabetes tipo 1 con edades comprendidas entre los 14 y los 30 años. RESULTADOS: Los adolescentes como grupo presentaron mayor disfunción emocional asociada con la diabetes y menores conocimientos en las diferentes áreas de diabetes. En un análisis de regresión logística multivariado, una respuesta emocional inadecuada (calificación alta de áreas problema en diabetes o PAID, por sus siglas en inglés, se asoció principalmente con un mal control glucémico (OR=2.9; 95% CI 0.9-9.7 p=0.09. La preocupación acerca del futuro y la posibilidad de desarrollar complicaciones se asoció con las calificaciones más altas de PAID en todos los grupos de edad. CONCLUSIONES: Es una imperiosa necesidad desarrollar nuevas estrategias que permitan mejorar el cuidado y brindar más apoyo a los jóvenes con diabetes tipo

  5. Dural AVM supplied by the ophthalmic artery.

    LENUS (Irish Health Repository)

    Flynn, T H

    2012-02-03

    Dural arteriovenous malformations in the anterior cranial fossa are rare and are especially prone to haemorrhage. These lesions are usually treated by surgical excision. We report the embolization of an anterior cranial fossa DAVM using an endovascular approach via the ophthalmic artery.

  6. BIENESTAR PSICOLOGICO: ADULTOS MAYORES, ACTIVOS A TRAVES DEL VOLUNTARIADO

    OpenAIRE

    FERRADA MUNDACA; LESLIE ISABEL; FERRADA MUNDACA; LESLIE ISABEL

    2011-01-01

    El propósito del presente estudio fue establecer el grado de bienestar psicológico en adultos mayores voluntarios del programa "Asesores Seniors" de Senama Región Bio Bio y no voluntarios, usuarios del CESF AM San Pedro de la comuna de San Pedro de la Paz. Corresponde a un estudio cuantitativo, de tipo descriptivo, correlacional y comparativo. La muestra estuvo constituida por 60 adultos mayores, donde 30 de ellos corresponde al grupo de voluntarios y los otros 30 al grupo...

  7. Dural ectasia and conventional radiography in the Marfan lumbosacral spine

    International Nuclear Information System (INIS)

    Ahn, N.U.; Nallamshetty, L.; Ahn, U.M.; Buchowski, J.M.; Kebaish, K.M.; Sponseller, P.D.; Rose, P.S.; Garrett, E.S.

    2001-01-01

    Objective. To determine how well conventional radiographic findings can predict the presence of dural ectasia in Marfan patients.Design and patients. Twelve Marfan patients without dural ectasia and 21 Marfan patients with dural ectasia were included in the study. Five radiographic measurements were made of the lumbosacral spine: interpediculate distance, scalloping value, sagittal canal diameter, vertebral body width, and transverse process width.Results. The following measurements were significantly larger in patients with dural ectasia: interpediculate distances at L3-L4 levels (P 38.0 mm, sagittal diameter at S1 >18.0 mm, or scalloping value at L5 >5.5 mm.Conclusion. Dural ectasia in Marfan syndrome is commonly associated with several osseous changes that are observable on conventional radiographs of the lumbosacral spine. Conventional radiography can detect dural ectasia in patients with Marfan syndrome with a very high specificity (91.7%) but a low sensitivity (57.1%). (orig.)

  8. Dural arteriovenous fistula as a treatable dementia.

    Science.gov (United States)

    Enofe, Ikponmwosa; Thacker, Ike; Shamim, Sadat

    2017-04-01

    Dementia is a chronic loss of neurocognitive function that is progressive and irreversible. Although rare, dural arteriovenous fistulas (DAVFs) could present with a rapid decline in neurocognitive function with or without Parkinson-like symptoms. DAVFs represent a potentially treatable and reversible cause of dementia. Here, we report the case of an elderly woman diagnosed with a DAVF after presenting with new-onset seizures, deteriorating neurocognitive function, and Parkinson-like symptoms.

  9. Spinal endoscopy combined with selective CT myelography for dural closure of the spinal dural defect with superficial siderosis: technical note.

    Science.gov (United States)

    Arishima, Hidetaka; Higashino, Yoshifumi; Yamada, Shinsuke; Akazawa, Ayumi; Arai, Hiroshi; Tsunetoshi, Kenzo; Matsuda, Ken; Kodera, Toshiaki; Kitai, Ryuhei; Awara, Kousuke; Kikuta, Ken-Ichiro

    2018-01-01

    The authors describe a new procedure to detect the tiny dural hole in patients with superficial siderosis (SS) and CSF leakage using a coronary angioscope system for spinal endoscopy and selective CT myelography using a spinal drainage tube. Under fluoroscopy, surgeons inserted the coronary angioscope into the spinal subarachnoid space, similar to the procedure of spinal drainage, and slowly advanced it to the cervical spine. The angioscope clearly showed the small dural hole and injured arachnoid membrane. One week later, the spinal drainage tube was inserted, and the tip of the drainage tube was located just below the level of the dural defect found by the spinal endoscopic examination. This selective CT myelography clarifies the location of the dural defect. During surgery, the small dural hole could be easily located, and it was securely sutured. It is sometimes difficult to detect the actual location of the small dural hole even with thin-slice MRI or dynamic CT myelography in patients with SS. The use of a coronary angioscope for the spinal endoscopy combined with selective CT myelography may provide an effective examination to assess dural closure of the spinal dural defect with SS in cases without obvious dural defects on conventional imaging.

  10. Tentorial artery embolization in tentorial dural arteriovenous fistulas

    Energy Technology Data Exchange (ETDEWEB)

    Rooij, Willem Jan van; Sluzewski, Menno [St. Elisabeth Ziekenhuis, Department of Radiology, Tilburg (Netherlands); Beute, Guus N [St. Elisabeth Ziekenhuis, Department of Neurosurgery, Tilburg (Netherlands)

    2006-10-15

    The tentorial artery is often involved in arterial supply to tentorial dural fistulas. The hypertrophied tentorial artery is accessible to embolization, either with glue or with particles. Six patients are presented with tentorial dural fistulas, mainly supplied by the tentorial artery. Two patients presented with intracranial hemorrhage, two with pulsatile tinnitus and one with progressive tetraparesis, and in one patient the tentorial dural fistula was an incidental finding. Different endovascular techniques were used to embolize the tentorial artery in the process of endovascular occlusion of the fistulas. All six tentorial dural fistulas were completely occluded by endovascular techniques, confirmed at follow-up angiography. There were no complications. When direct catheterization of the tentorial artery was possible, glue injection with temporary balloon occlusion of the internal carotid artery at the level of the tentorial artery origin was effective and safe. Different endovascular techniques may be successfully applied to embolize the tentorial artery in the treatment of tentorial dural fistulas. (orig.)

  11. Tentorial artery embolization in tentorial dural arteriovenous fistulas

    International Nuclear Information System (INIS)

    Rooij, Willem Jan van; Sluzewski, Menno; Beute, Guus N.

    2006-01-01

    The tentorial artery is often involved in arterial supply to tentorial dural fistulas. The hypertrophied tentorial artery is accessible to embolization, either with glue or with particles. Six patients are presented with tentorial dural fistulas, mainly supplied by the tentorial artery. Two patients presented with intracranial hemorrhage, two with pulsatile tinnitus and one with progressive tetraparesis, and in one patient the tentorial dural fistula was an incidental finding. Different endovascular techniques were used to embolize the tentorial artery in the process of endovascular occlusion of the fistulas. All six tentorial dural fistulas were completely occluded by endovascular techniques, confirmed at follow-up angiography. There were no complications. When direct catheterization of the tentorial artery was possible, glue injection with temporary balloon occlusion of the internal carotid artery at the level of the tentorial artery origin was effective and safe. Different endovascular techniques may be successfully applied to embolize the tentorial artery in the treatment of tentorial dural fistulas. (orig.)

  12. Diabetes autoinmune latente del adulto o diabetes tipo 1 de lenta progresión: definición, patogenia, clínica, diagnóstico y tratamiento Latent autoimmune diabetes of the adult or type 1 diabetes of slow progression: definition, pathogeny, clinic, diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    Eduardo Cabrera Rode

    2002-04-01

    Full Text Available Se sabe que la diabetes mellitus es un síndrome heterogéneo que tiene como elemento común una hiperglucemia crónica, como consecuencia de una deficiencia de insulina o una insuficiente efectividad de su acción. Nos propusimos en este trabajo describir los aspectos más relevantes de la diabetes autoinmune del adulto (LADA y exponer el resultado de nuestra experiencia. Se considera que un sujeto la padece cuando es clasificado inicialmente como diabético tipo 2, el inicio es después de los 34 años, tiene generalmente peso corporal, normal o bajo y en un tiempo relativamente corto necesita tratamiento insulínico para lograr un buen control metabólico y presenta además una mayor asociación con la producción de anticuerpos antiislotes (ICA, antiglutámico descarboxilasa (AGAD65, microsomales tiroideos y antigástricos parietales, con una susceptibilidad genética por la presencia de haplotipos HLA-DR. Al momento del diagnóstico clínico puede presentar o no una insulinodeficiencia. Se ha demostrado que la insulinoterapia es el tratamiento ideal para los individuos con LADA, con el mismo se ha evidenciado una alta tasa de conversión negativa de los ICA con un incremento de los niveles de péptido C en el suero. Por el contrario, el tratamiento con sulfonilureas produce una persistencia de los ICA, los que probablemente sean responsables de una destrucción progresiva de las células b del páncreas. Por tanto, estas observaciones justifican la elección de la insulinoterapia desde el mismo momento del diagnóstico.It is known that diabetes mellitus is an heterogeneous syndrome that has as a common element a chronic hyperglycaemia resulting from an insulin deficiency or from an insufficient effectiveness of its action. It is our purpose to describe the most significant aspects of the autoimmune diabetes of the adult and to show the result of our experience. It is considered that subjects suffer from it when they are initially classified

  13. Radiographic anatomy of the distal dural SAC

    International Nuclear Information System (INIS)

    Larsen, J.L.; Olsen, K.O.

    1991-01-01

    A radio-anatomical study was performed of the distal dural sac (DS) in 121 patients subjected to myelography. In 83.4% the termination of the DS was located from the upper half of the S1-segment to the lower half of the S2-segment. In the remaining patients the dural terminations were more distally located. The average location of the DS-termination was higher than that found in a previous anatomic study. The inference is that in patients with low-back pain and sciatica, the DS tends to terminate at a higher spinal level than in a non-selected anatomic material. The caudal reduction in sagittal diameter of the DS was less than that of the frontal diameter of the sac. The linear diminution in cross-sectional area of the DS from the level of L3 towards the lumbosacral junction was not correlated with the degree of caudal extension of the DS into the sacrum. Thus the length of the DS and its transverse diameters are independent of each other. These results supported the view that the location of the termination of the DS (and hence that of the spinal cord) is not related to stenosis of the central spinal canal. (orig.)

  14. Dural ectasia and conventional radiography in the Marfan lumbosacral spine

    Energy Technology Data Exchange (ETDEWEB)

    Ahn, N U [Dept. of Orthopaedic Surgery, Johns Hopkins Univ. School of Medicine, Baltimore (United States); Johns Hopkins Outpatient Center, Dept. of Orthopaedic Surgery, Baltimore, MD (United States); Nallamshetty, L; Ahn, U M; Buchowski, J M; Kebaish, K M; Sponseller, P D [Dept. of Orthopaedic Surgery, Johns Hopkins Univ. School of Medicine, Baltimore (United States); Rose, P S [Dept. of Orthopaedic Surgery, Johns Hopkins Univ. School of Medicine, Baltimore (United States); National Human Genome Research Institute, National Institutes of Health, Bethesda, MD (United States); Garrett, E S [Dept. of Oncology, Division of Biostatistics, Johns Hopkins University School of Medicine, Baltimore (United States)

    2001-06-01

    Objective. To determine how well conventional radiographic findings can predict the presence of dural ectasia in Marfan patients.Design and patients. Twelve Marfan patients without dural ectasia and 21 Marfan patients with dural ectasia were included in the study. Five radiographic measurements were made of the lumbosacral spine: interpediculate distance, scalloping value, sagittal canal diameter, vertebral body width, and transverse process width.Results. The following measurements were significantly larger in patients with dural ectasia: interpediculate distances at L3-L4 levels (P<0.03); scalloping values at the L1 and L5 levels (P<0.05); sagittal diameters of the vertebral canal at L5-S1 (P<0.03); transverse process to width ratios at L2 (P<0.03). Criteria were developed for diagnosis of dural ectasia in Marfan patients. These included presence of one of the following: interpediculate distance at L4 >38.0 mm, sagittal diameter at S1 >18.0 mm, or scalloping value at L5 >5.5 mm.Conclusion. Dural ectasia in Marfan syndrome is commonly associated with several osseous changes that are observable on conventional radiographs of the lumbosacral spine. Conventional radiography can detect dural ectasia in patients with Marfan syndrome with a very high specificity (91.7%) but a low sensitivity (57.1%). (orig.)

  15. Traumatic dural venous sinus thrombosis: A Mini Review

    Directory of Open Access Journals (Sweden)

    Moscote-Salazar Luis Rafael

    2016-09-01

    Full Text Available The dural venous sinus thrombosis is a benign disease, representing about 1% of cerebral vascular events. In some cases the development of the disease increased intracranial pressure or symptomatic epilepsy. The development towards a dural venous sinus thrombosis is rare, but is a condition to be considered before the development of ischemic vascular events and a history of recent head trauma. Intracranial hematomas or skull fractures can lead to the establishment of obstructive pathology of the dural venous sinuses. The knowledge of this entity is necessary for the critical care staff and neurosurgery staff.

  16. La inflación de los adultos mayores en Colombia

    Directory of Open Access Journals (Sweden)

    Álvaro Montenegro

    2016-12-01

    Full Text Available Este artículo compara el comportamiento de la inflación para el hogar promedio y diversos tipos de hogares de adultos mayores en Colombia. Los resultados indican que, en promedio, los adultos mayores gastan una mayor proporción de su ingreso en vivienda y salud y una menor proporción en educación, y que experimentaron una mayor inflación que la población en general entre diciembre de 2008 y mayo de 2015. Los hogares de adultos mayores más pobres gastan una mayor proporción en vivienda y alimentación, y para estos la inflación fue mayor que para los de adultos mayores de altos ingresos.

  17. MR diagnosis of dural sinus thrombosis

    International Nuclear Information System (INIS)

    Rovira Canellas, A.; Turon Estrada, A.; Alvarez Sabin, J.; Lozano Sanchez, M.; Castano Duque, Ch.; Grive Isern, E.; Sumalla Sune, J.

    1994-01-01

    Four adult patients were diagnosed as having dural sinus thrombosis (DST) by means of magnetic resonance (MR). In the three cases of acute thrombosis, MR disclosed diffuse or segmental hyperintensity in the sinuses involved, which persisted regardless of the sequence and orientation of the plane selected. MR angiography (MRA) provided diagnostic information that proved useful in the chronic case, as well as in the two cases in which follow-up was carried out to determine the degree to which permeability was restored to the sinuses involved. MR diagnosis of DST can produce false positives and negatives, the causes of which should be known, as well as the ways to avoid them, in order to prevent diagnostic errors. MR, when applied and interpreted correctly, can be considered the first, and in many cases the only, choice as a diagnostic method in DST. (Author)

  18. Histology of the distal dural ring.

    Science.gov (United States)

    Graffeo, Christopher S; Perry, Avital; Copeland, William R; Raghunathan, Aditya; Link, Michael J

    2017-09-01

    The distal dural ring (DDR) is a conserved intracranial anatomic structure marking the boundary point at which the internal carotid artery (ICA) exits the cavernous sinus (CS) and enters the subarachnoid space. Although the CS has been well described in a range of anatomic studies, to our knowledge no prior study has analyzed the histologic relationship between the ICA and DDR. Correspondingly, our objective was to assess the relationship of the DDR to the ICA and determine whether the DDR can be dissected from the ICA and thus divided, or can only be circumferentially trimmed around the artery. The authors examined ten fresh-frozen, adult cadaveric specimens. A standard frontotemporal craniotomy, orbito-optic osteotomy, and extradural anterior clinoidectomy was performed bilaterally. The cavernous ICA, DDR, and supraclinoid ICA were harvested as an en bloc specimen. Specimens formalin-fixed and paraffin-embedded prior to routine histochemical staining with hematoxylin and eosin and Masson trichrome. In all specimens, marked microscopic investment of the DDR throughout the ICA adventitia was noted. Dural collagen fibers extensively permeated the arterial layers superficial to the muscularis propria, with no evidence of a clear separation between the DDR and arterial adventitia. Histologic analysis suggests that the ICA and DDR are highly interrelated, continuous structures, and therefore attempted intraoperative dissection between these structures may carry an elevated risk of injury to the ICA. We correspondingly recommend careful circumferential trimming of the DDR in lieu of direct dissection in cases requiring mobilization of the clinoidal ICA. Clin. Anat. 30:742-746, 2017. © 2017Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  19. A New Classification for Pathologies of Spinal Meninges, Part 1: Dural Cysts, Dissections, and Ectasias.

    Science.gov (United States)

    Klekamp, Jörg

    2017-07-01

    The clinical significance of pathologies of the spinal dura is often unclear and their management controversial. To classify spinal dural pathologies analogous to vascular aneurysms, present their symptoms and surgical results. Among 1519 patients with spinal space-occupying lesions, 66 patients demonstrated dural pathologies. Neuroradiological and surgical features were reviewed and clinical data analyzed. Saccular dural diverticula (type I, n = 28) caused by defects of both dural layers, dissections between dural layers (type II, n = 29) due to defects of the inner layer, and dural ectasias (type III, n = 9) related to structural changes of the dura were distinguished. For all types, symptoms consisted of local pain followed by signs of radiculopathy or myelopathy, while one patient with dural ectasia presented a low-pressure syndrome and 10 patients with dural dissections additional spinal cord herniation. Type I and type II pathologies required occlusion of their dural defects via extradural (type I) or intradural (type II) approaches. For type III pathologies of the dural sac no surgery was recommended. Favorable results were obtained in all 14 patients with type I and 13 of 15 patients with type II pathologies undergoing surgery. The majority of dural pathologies involving root sleeves remain asymptomatic, while those of the dural sac commonly lead to pain and neurological symptoms. Type I and type II pathologies were treated with good long-term results occluding their dural defects, while ectasias of the dural sac (type III) were managed conservatively. Copyright © 2017 by the Congress of Neurological Surgeons

  20. Llanto del adulto

    Directory of Open Access Journals (Sweden)

    Alegría Majluf

    2013-09-01

    Full Text Available Se presentan los resultados de un primer estudio transcultural del llanto del adulto que comprende 30 países, entre los que se encuentra el Perú. Vingerhoets et al. (1997 de la Universidad de Tilburg, Holanda, analizan las causas, tendencia y frecuencia del llanto, emociones y sentimientos que inducen al llanto, diferencias y similitudes entre los países y los sexos. Los autores encuentran que las mujeres tienden a llorar con más frecuencia e intensidad que los varones, advirtiendo que en algunos países las mujeres establecen mayor relación entre la tendencia al llanto y el ciclo menstrual que en otros. The results of a first cross-cultural study on adult crying in 30 countries including Peru are presented. Vingerhoets et al. (1997 from the University of Tilburg have analyzed motives, tendencies and frequency of crying, emotions and feelings that provoke crying, as well as differences and similarities among countries and sexes. Results show that women have a tendency to cry more frequently and intensively than men. It has also been noted that, in certain countries, there is a link between crying in women and their monthly period.

  1. Dermatomiositis en un adulto

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    Julio Rodríguez López

    2014-04-01

    Full Text Available Se presenta el caso clínico de un adulto de 37 años de edad, quien presentó, a finales del 2010, síntomas de debilidad muscular y fiebre, que se agravaron progresivamente al aumentar la fatiga y manifestar dificultad respiratoria. En el 2012 fue ingresado en estado crítico en la Unidad de Cuidados Intensivos del Hospital General Docente "Dr. Juan Bruno Zayas Alfonso", debido a daño multiorgánico. Se estudiaron los antecedentes epidemiológicos para determinar alguna causa infecciosa, y se aplicó el tratamiento con antimicrobianos, esteroides e inmunoglobulinas; posteriormente fue valorado por un equipo multidisciplinario que sugirió la presencia de lupus eritematoso sistémico. A pesar de que el paciente mostró mejoría, se mantuvo con fiebres periódicas; de manera que fue reevaluado y se le diagnosticó una dermatomiositis

  2. Prevalence of obesity and metabolic syndrome components in Mexican adults without type 2 diabetes or hypertension Prevalencia de obesidad y componentes del síndrome metabólico en adultos mexicanos sin diabetes tipo 2 o hipertensión arterial

    Directory of Open Access Journals (Sweden)

    Rosalba Rojas-Martínez

    2012-02-01

    Full Text Available OBJECTIVE: To describe the number of Mexican adults with undiagnosed diabetes and arterial hypertension and their association with obesity. MATERIAL AND METHODS: The study included a sub-sample of 6 613 subjects aged 20 years or more who participated in the 2006 National Health and Nutrition Survey (ENSANUT 2006. Subjects with a previous diagnosis of diabetes or hypertension (n=1 861 were excluded. Prevalences and standard errors were estimated, taking into account the complex sample design. RESULTS: 6.4 million adults have obesity and undiagnosed impaired fasting glucose. Almost two million more have fasting glucose levels diagnostic for diabetes. As for arterial blood pressure, 5.4 million adults had prehypertension. Another 5.4 million adults had blood pressure levels suggestive of probable hypertension. A total of 21.4 million Mexican adults with obesity had at least one further component of the metabolic syndrome. CONCLUSIONS: A large proportion of adults with obesity-related metabolic comorbidities remains undiagnosed in Mexico.OBJETIVO: Estimar el número de adultos mexicanos que tienen diabetes o hipertensión arterial no diagnosticadas y el riesgo de tales condiciones asociado a la obesidad. MATERIAL Y MÉTODOS: Se analiza una submuestra de 6 613 sujetos mayores de 20 años que participaron en la Encuesta Nacional de Salud y Nutrición 2006. Los sujetos con diagnóstico previo de diabetes o hipertensión arterial fueron excluidos (n=1 861. Las prevalencias y errores estándar fueron estimados considerando el diseño complejo de la muestra. RESULTADOS: 6.4 millones de adultos tienen obesidad y glucemia anormal de ayuno. Casi dos millones más tienen una glucemia de ayuno diagnóstica de diabetes En cuanto a la presión arterial, 5.4 millones tienen prehipertensión. El mismo número de casos tienen valores diagnósticos de hipertensión. Un total de 21.4 millones de adultos con obesidad tienen al menos un componente del síndrome metab

  3. Dural opening/removal for combined petrosal approach: technical note.

    Science.gov (United States)

    Terasaka, Shunsuke; Asaoka, Katsuyuki; Kobayashi, Hiroyuki; Sugiyama, Taku; Yamaguchi, Shigeru

    2011-03-01

    Detailed descriptions of stepwise dural opening/removal for combined petrosal approach are presented. Following maximum bone work, the first dural incision was made along the undersurface of the temporal lobe parallel to the superior petrosal sinus. Posterior extension of the dural incision was made in a curved fashion, keeping away from the transverse-sigmoid junction and taking care to preserve the vein of Labbé. A second incision was made perpendicular to the first incision. After sectioning the superior petrosal sinus around the porus trigeminus, the incision was extended toward the posterior fossa dura in the middle fossa region. The tentorium was incised toward the incisura at a point just posterior to the entrance of the trochlear nerve. A third incision was made longitudinally between the superior petrosal sinus and the jugular bulb. A final incision was initiated perpendicular to the third incision in the presigmoid region and extended parallel to the superior petrosal sinus connecting the second incision. The dural complex consisting of the temporal lobe dura, the posterior fossa dura, and the freed tentorium could then be removed. In addition to extensive bone resection, our strategic cranial base dural opening/removal can yield true advantages for the combined petrosal approach.

  4. Comparison of the efficiency, side effects and complications of the synthetic dural grafts: Beriplast and Tissudura

    OpenAIRE

    HAMZAOĞLU, Vural; ÖZALP, Hakan; KARKUCAK, Ahmet; ÇOKLUK, Cengiz

    2015-01-01

    The purpose of this study was to compare human fibrinogen-thrombin-based liquid dural graft; Beriplast® (Behring, Malburg, Germany) and collagen-based dural graft; Tissudura® (Baxter, Heidelberg, Germany) in terms of efficiency, side effects and complications. Thirty Spraque Dawley rats were used in this experimental study. A burrhole was opened on the left parietal bone of each subject and experimental dural defect was created. While 10 subjects were in sham group without any dural defect re...

  5. Meduloepitelioma en el adulto

    Directory of Open Access Journals (Sweden)

    Nelson Inzulza Barrientos

    2014-07-01

    Full Text Available El meduloepitelioma es un tumor muy poco frecuente en adultos, encontrándose descritos en la literatura solo una decena de casos. Se presenta la historia de un paciente sometido a enucleación de su ojo derecho por sospecha de melanoma coroideo. La biopsia informó neoplasia de estirpe neural de comportamiento biológico incierto, y el estudio inmunohistoquímico informó neoplasia neuroendocrina de bajo grado. Se realizó estudio de extensión sistémica que resultó negativo. El paciente no se somete a controles durante 6 años, volviendo a consultar por una gran ocupación orbitaria derecha, manejada mediante exenteración orbitaria. La biopsia informó neoplasia maligna de estirpe neural, y la histoquímica concluyó meduloepitelioma pigmentado maligno ocular con extensión a la órbita. El paciente evolucionó con signos de remisión completa de la lesión, sin embargo un año y medio después comenzó con un aumento de volumen rápidamente progresivo, que compromete toda la región orbitaria derecha. Se presenta el caso a comité oncológico, indicando estudio de extensión sistémica mediante citología de LCR, TAC de tórax, abdomen y pelvis que resultaron normales; el cintigrama óseo evidenció actividad osteoblástica patológica en macizo facial, y la RMN de cerebro evidenció invasión intra y extracraneal, con ocupación de los senos paranasales. Con estos antecedentes se le ingresó en el programa de cuidados paliativos y alivio del dolor, realizándose radioterapia paliativa, con remisión parcial de tamaño tumoral y sintomatología.

  6. Intracranial Dural Metastasis of Ewing's Sarcoma: a Case Report

    International Nuclear Information System (INIS)

    Kim, Eung Yeop; Lee, Seung Koo; Kim, Dong Joon; Kim, Jin Na; Lee, Kyu Sung; Jung, Woo Hee; Kim, Dong Ik

    2008-01-01

    Ewing's sarcoma is a malignant bone tumor that can occur anywhere in the body, but it is most commonly observed in the long bones of the arms and legs, the pelvis and in the chest. The predominant sites of metastasis include the lung (38%), bone (including the spine; 31%), and the bone marrow (11%). Metastasis of Ewing's sarcoma to the central nervous system (CNS) is relatively rare, and most of the previous reports have demonstrated involvement of the bony calvarium or brain parenchyma. We describe here the imaging findings of dural metastasis of Ewing's sarcoma, and these imaging findings have not been previously reported on in the medical literature. In conclusion, dural metastasis of Ewing's sarcoma is very rare and its imaging characteristics are similar to those of a primary tumor, which mimic the findings of a schwannoma or meningioma. Despite its rarity, secondary Ewing's sarcoma may be included in the differential diagnosis of extra-axial dural masses

  7. Cefalea secundaria a punción dural Headache as a result of dural puncture

    Directory of Open Access Journals (Sweden)

    Ariadna García Rodríguez

    2005-03-01

    Full Text Available Se realizó una revisión bibliográfica sobre cefalea pospunción en el Hospital "Abel Santamaría", de Pinar del Río, en el período comprendido de febrero a junio del 2004, con el objetivo de ampliar los conocimientos de los profesionales de la salud encargados de diagnosticar y tratar esta complicación. La cefalea secundaria a punción dural se debe al escape persistente de LCR (líquido cefalorraquídeo a través del desgarro hecho en la duramadre, causado por la penetración de la aguja; se presenta cuando el paciente adopta la posición erecta y se alivia con el decúbito, característica esta que de no aparecer debe hacer dudar el diagnóstico. La elección de un trocar fino para realizar la punción y la dirección del bisel paralelo a las fibras de la duramadre son los factores determinantes en la profilaxis de la cefalea. Aún existen controversias en cuanto a su tratamiento, pero si hay un consenso unido en que el parche de sangre epidural es el tratamiento definitivo de esta complicación.A review of the most updated literature on dural post-puncture headache was made at Abel Santamaría University Hospital in February - June 2004 aimed at spreading the awareness to health professionals at diagnosing and treating this condition. The headache secondary to dural puncture is caused by the persistent leakage of cerebrospinal fluid through the dura tear because of the needle insertion; it presents when the patient adopts the erect position and it alleviates with the supine position; if this characteristic is not present it may appear some doubts on diagnosis. The selection of a fine trocar for puncture and guiding the bevel parallel to the fibers of dura are the main factors for profilaxis of headache. Its treatment is controversial, but it does exist a consensus in that the epidural blood patch is the definitive treatment for this condition.

  8. Effectiveness of a new gelatin sealant system for dural closure.

    Science.gov (United States)

    Kawai, Hisashi; Nakagawa, Ichiro; Nishimura, Fumihiko; Motoyama, Yasushi; Park, Young-Su; Nakamura, Mitsutoshi; Nakase, Hiroyuki; Suzuki, Shuko; Ikada, Yoshito

    2014-10-01

    Watertight dural closure is imperative after neurosurgical procedures because inadequately treated leakage of cerebrospinal fluid (CSF) can have serious consequences. In this study, the authors test the use of a new gelatin glue as a dural sealant in in vitro and in vivo canine models of transdural CSF leakage. The in vitro model was sutured semicircles of canine dura mater and artificial dural substitute. The sutures were sealed with gelatin glue (n  =  20), fibrin glue (n  =  20), or a polyethylene glycol (PEG)-based hydrogel sealant (n  =  20). Each sample was set in a device to measure water pressure, and pressure was increased until leakage occurred. Bonding strength was subjectively evaluated. The in vivo model was dogs who underwent dural excision and received either no sealant (control group; n  =  5) or gelatin glue sealant (n  =  5) before dural closure. Twenty-eight days post-surgery, the maximum intracranial pressure was measured at the cisterna magna using Valsalva maneuver and tissue adhesion was evaluated. The water pressure at which leakage occurred in the in vitro model was higher with gelatin glue (76·5 ± 39·8 mmHg) than with fibrin glue (38·3 ± 27·4 mmHg, P control group (13·8 ± 4·0 mmHg, P control group (P  =  0·005). The new gelatin glue provides an effective watertight closure when used as an adjunct to sutured dural repair.

  9. MR diagnosis of dural sinus thrombosis. Diagnostico por RM de las trombosis de senos durales

    Energy Technology Data Exchange (ETDEWEB)

    Rovira Caellas, A.; Turon Estrada, A.; Alvarez Sabin, J.; Lozano Sanchez, M.; Castao Duque, Ch.; Grive Isern, E.; Sumalla Sue, J. (Hospital General Vall d' Hebron Barcelona (Spain))

    1994-01-01

    Four adult patients were diagnosed as having dural sinus thrombosis (DST) by means of magnetic resonance (MR). In the three cases of acute thrombosis, MR disclosed diffuse or segmental hyperintensity in the sinuses involved, which persisted regardless of the sequence and orientation of the plane selected. MR angiography (MRA) provided diagnostic information that proved useful in the chronic case, as well as in the two cases in which follow-up was carried out to determine the degree to which permeability was restored to the sinuses involved. MR diagnosis of DST can produce false positives and negatives, the causes of which should be known, as well as the ways to avoid them, in order to prevent diagnostic errors. MR, when applied and interpreted correctly, can be considered the first, and in many cases the only, choice as a diagnostic method in DST. (Author)

  10. Factores asociados al maltrato del adulto mayor de Antioquia, 2012

    Directory of Open Access Journals (Sweden)

    Sara M. Cano

    2015-07-01

    Full Text Available Objetivo: determinar los factores asociados al maltrato del adulto mayor del departamento de Antioquia en el año 2012. Metodología: mediante estudio descriptivo transversal, se caracterizaron los factores demográficos, económicos y de salud mental de la población adulta mayor de Antioquia para el año 2012, con el fin de aportar al análisis de la situación de salud y condiciones de vida del adulto mayor. El estudio se basó en los resultados del instrumento aplicado por la Universidad ces a 4.215 adultos de sesenta años y más de edad, en el cual se indagó sobre percepción de maltrato, funcionamiento cognitivo, nivel de depresión, nivel de ansiedad, apoyo social, escala de recursos sociales, entre otras; los resultados se expandieron a 654.473 adultos del departamento. Resultados: el 72,8% de adultos del departamento son mujeres, 53,7% vive en Medellín, 55% tiene primaria incompleta, 72,9% pertenece a estratos socioeconómicos 1 y 2, 45,1% no registraron ingresos en el último mes, 26,3% tiene riesgo de depresión y 34,4% tiene riesgo de ansiedad, 2,5% reportó haber sufrido descuido, 5,0% necesidades afectivas ignoradas, 1,7% algún caso de agresión física, 0,4% agresión sexual y 1,3%, afirmó haber sufrido maltrato económico. Las variables estrato socioeconómico, tipo de vivienda, etnia, riesgo de depresión, riesgo de ansiedad, riesgo de deterioro cognitivo y red de apoyo fueron las que más ayudaron a explicar la presencia de maltrato. Conclusión: enfrentar este problema requiere de una atención integral a las necesidades de los adultos mayores, participación de todos los sectores de la sociedad y conciencia transgeneracional.

  11. Expansión clónica y caracterización genómica del proceso de integración del virus linfotrópico humano tipo I en la leucemia/linfoma de células T en adultos

    Directory of Open Access Journals (Sweden)

    Mercedes Salcedo-Cifuentes

    2009-06-01

    Conclusiones. Los resultados permiten postular que la integración del virus linfotrópico humano tipo I se dirigiría hacia un ambiente genómico caracterizado por elevado contenido de C:G, genes de replicación temprana que regularían el ciclo celular y la transducción de señales.

  12. Dural diverticulum with a symptomatic cerebrospinal fluid leak

    Directory of Open Access Journals (Sweden)

    Nicholas Armstrong, MD

    2016-03-01

    Full Text Available A case report of a 63-year-old female patient with a cervical spinal dural diverticulum and intracranial hypotension secondary to a symptomatic CSF leak after minor trauma. The patient responded well after the cervical approach epidural blood patch procedure.

  13. Iatrogene duralæsioner ved dekompressionskirurgi i lumbalcolumna

    DEFF Research Database (Denmark)

    Thomsen, Frederik; Amtoft, Ole; Andersen, Mikkel

    2010-01-01

    at the Private Hospital Hamlet. The study covers cases from the 10-month period from September 1, 2007 to June 30, 2008. Data was collected after this period and consists of surgeon-documented dural tears. At the time of surgery, the surgeon was unaware that there would be a subsequent registration. A total...

  14. Bilateral subdural hematoma secondary to accidental dural puncture

    Directory of Open Access Journals (Sweden)

    Sofía Ramírez

    2015-07-01

    Full Text Available We report the case of a 25-year-old woman, who received epidural analgesia for labor pain and subsequently presented post-dural puncture headache. Conservative treatment was applied and epidural blood patch was performed. In the absence of clinical improvement and due to changes in the postural component of the headache, a brain imaging test was performed showing a bilateral subdural hematoma.The post-dural puncture headache is relatively common, but the lack of response to established medical treatment as well as the change in its characteristics and the presence of neurological deficit, should raise the suspicion of a subdural hematoma, which although is rare, can be lethal if not diagnosed and treated at the right time. Resumo: Apresentamos o caso clínico de uma paciente de 25 anos de idade, na qual uma técnica peridural foi realizada durante o trabalho de parto e posteriormente apresentou cefaleia com características de cefaleia pós-punção dural. Foi iniciado tratamento conservador e tampão de sangue peridural. Devido a ausência de melhora clínica e à mudança do componente postural da cefaleia, decidiu-se realizar um exame de imagem cerebral que demostrou a presença de hematoma subdural bilateral.A cefaleia pós-punção dural é relativamente frequente, mas a falta de resposta ao tratamento médico instaurado, assim como a mudança em suas características e a presença de foco neurológico, devem levantar a suspeita de presença de um hematoma subdural que, embora infrequente, pode chegar a ser devastador se não for diagnosticado e tratado oportunamente. Keywords: Accidental dural puncture, Epidural analgesia, Post-dural puncture headache, Subdural hematoma, Epidural blood patch, Palavras chave: Dura-Máter, Analgesia epidural, Cefaleia pós-punção dural, Hematoma subdural, Placa de sangue epidural

  15. Evaluation of three different measurement methods for dural ectasia in Marfan syndrome

    International Nuclear Information System (INIS)

    Weigang, E.; Ghanem, N.; Chang, X.-C.; Richter, H.; Frydrychowicz, A.; Szabo, G.; Dudeck, O.; Knirsch, W.; Samson, P. von; Langer, M.; Beyersdorf, F.

    2006-01-01

    Aim: Dural ectasia is a major diagnostic criterion for Marfan syndrome using the Ghent nosology. Our aim was to evaluate the efficacy of three different radiological methods previously proposed for the assessment of dural sac diameter in Marfan syndrome. Methods: Marfan syndrome was diagnosed in our study using the Ghent criteria, disregarding dural ectasia as a criterion. Three proposed radiological methods were applied to measure dural sac diameter, examined for 41 patients (18 patients with and 23 without Marfan syndrome) by computed tomography or magnetic resonance imaging. Results: Using Oosterhof's method, 94% of the patients with and 44% of the patients without Marfan syndrome fulfilled the criteria of dural ectasia. According to Villeirs, dural ectasia was diagnosed in 18% of the patients with and in none of the patients without Marfan syndrome. With Ahn's method, dural ectasia was found in 72% of the patients with and in 44% of the patients without Marfan syndrome. In only two patients with Marfan syndrome was dural ectasia diagnosed by all three methods. Conclusion: Our results reveal overt discrepancy between the three methods of assessing dural ectasia. Considering the key role played by dural ectasia in reinforcing the diagnosis of Marfan syndrome according to the Ghent nosology, a standardized and reliable method should be sought

  16. Evaluation of three different measurement methods for dural ectasia in Marfan syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Weigang, E.; Ghanem, N.; Chang, X.-C.; Richter, H.; Frydrychowicz, A.; Szabo, G.; Dudeck, O.; Knirsch, W.; Samson, P. von; Langer, M.; Beyersdorf, F

    2006-11-15

    Aim: Dural ectasia is a major diagnostic criterion for Marfan syndrome using the Ghent nosology. Our aim was to evaluate the efficacy of three different radiological methods previously proposed for the assessment of dural sac diameter in Marfan syndrome. Methods: Marfan syndrome was diagnosed in our study using the Ghent criteria, disregarding dural ectasia as a criterion. Three proposed radiological methods were applied to measure dural sac diameter, examined for 41 patients (18 patients with and 23 without Marfan syndrome) by computed tomography or magnetic resonance imaging. Results: Using Oosterhof's method, 94% of the patients with and 44% of the patients without Marfan syndrome fulfilled the criteria of dural ectasia. According to Villeirs, dural ectasia was diagnosed in 18% of the patients with and in none of the patients without Marfan syndrome. With Ahn's method, dural ectasia was found in 72% of the patients with and in 44% of the patients without Marfan syndrome. In only two patients with Marfan syndrome was dural ectasia diagnosed by all three methods. Conclusion: Our results reveal overt discrepancy between the three methods of assessing dural ectasia. Considering the key role played by dural ectasia in reinforcing the diagnosis of Marfan syndrome according to the Ghent nosology, a standardized and reliable method should be sought.

  17. Prevalencia de trastornos temporomandibulares en el adulto mayor institucionalizado

    Directory of Open Access Journals (Sweden)

    Zenia Masiel Criado Mora

    Full Text Available Introducción: los trastornos temporomandibulares (TTM son una serie de signos y síntomas buco faciales de etiología multifactorial. En Cuba existen varias investigaciones que tratan sobre los TTM %sobre todo en jóvenes dentados% no conociéndose amplias referencias de este tipo de estudio en el adulto mayor. Objetivo: identificar la prevalencia de TTM en los adultos mayores institucionalizados, los signos y síntomas más frecuentes según edad y sexo. Métodos: se realizó un estudio descriptivo transversal en 113 adultos mayores de ambos sexos, institucionalizados en dos hogares de ancianos de la Habana, de marzo a abril de 2012. Se aplicó una encuesta donde se recogió sexo, edad, signos y síntomas. Las manifestaciones clínicas evaluadas fueron: la presencia de dolor muscular, dificultad al movimiento de abertura y cierre, dolor articular, dolor muscular articular, ruidos articulares, limitación de la abertura bucal, limitación de los movimientos de lateralidad y propulsión, desviación de la mandíbula. Resultados: el 40,70 % de los adultos mayores estudiados, presentaron afectación en la articulación temporomandibular. Los ruidos articulares fue el síntoma con mayor predominio en todos los grupos etarios (76,08 %, afectando al 82,35 % de los hombres y al 72,41 % de las mujeres. Seguido por el dolor muscular que se manifestó en el 52,17 % de los afectados, con mayor porcentaje en mujeres (58,62 % que en hombres (41,17 %. La dificultad para realizar los movimientos de abertura y cierre se detectó en el 28,26 % de los afectados con mayor prevalencia en el sexo femenino (34,48 % que en el masculino (17,14 %. Conclusiones. se observó una elevada prevalencia de TTM en los adultos mayores estudiados. Los signos y síntomas más frecuentes por edad y sexo fueron los ruidos articulares y el dolor muscular y la dificultad para realizar los movimientos de abertura y cierre.

  18. NIVEL DE SATISFACCIÓN DEL PACIENTE ADULTO POSTOPERADO RESPECTO AL CUIDADO DE ENFERMERÍA EN SERVICIO DE CIRUGÌA DEL HOSPITAL REGIONAL DE LAMBAYEQUE

    OpenAIRE

    Oliva Ramos, Pamela; Universidad Señor de Sipán

    2014-01-01

     El presente estudio Nivel de Satisfacción del Paciente Adulto Postoperado Respecto al Cuidado de Enfermería en Servicio de Cirugía del Hospital Regional de Lambayeque Chiclayo 2013, tuvo como objetivo: Determinar el nivel de satisfacción en el paciente adulto postoperado respecto al cuidado de enfermería en servicio de cirugía del Hospital Regional de Lambayeque Chiclayo 2013. El diseño metodológico fue de tipo cuantitativo descriptivo simple, se utilizó como instrumento el cuestionario tipo...

  19. Uso regular de serviços odontológicos entre adultos: padrões de utilização e tipos de serviços Regular use of dental care services by adults: patterns of utilization and types of services

    Directory of Open Access Journals (Sweden)

    Maria Beatriz J. Camargo

    2009-09-01

    Full Text Available O objetivo deste estudo foi avaliar o uso regular de serviços odontológicos entre adultos, identificando grupos nos quais esse comportamento é mais freqüente. O estudo foi realizado em Pelotas, Rio Grande do Sul, Brasil, com desenho transversal de base populacional, envolvendo 2.961 indivíduos, que responderam um questionário estruturado. A prevalência de uso regular encontrada foi de 32,8%. Estiveram positivamente associadas ao uso de forma regular as seguintes características: ser do sexo feminino, ter idade The aim of this study was to estimate the prevalence of regular use of dental services by adults and identify groups where this behavior is more frequent. A cross-sectional population-based study was carried out in Pelotas, southern Brazil, including 2,961 individuals who answered a standardized questionnaire. Overall prevalence of regular use of dental services was 32.8%. The following variables were positively associated with regular use: female gender, age > 60 years, no partner, high educational level, high economic status, private service user, good/excellent self-rated oral health, and no perceived need for dental treatment. Those who had received orientation on prevention and expressed a favorable view towards the dentist had higher odds of being regular users. Especially among lower-income individuals, regular use was infrequent (15%. When restricting the analysis to users of public dental services, schooling was still positively associated with the outcome. Dental services, especially in the public sector, should develop strategies to increase regular and preventive use.

  20. Imaging diagnosis of dural and direct cavernous carotid fistulae

    Energy Technology Data Exchange (ETDEWEB)

    Santos, Daniela dos; Monsignore, Lucas Moretti; Nakiri, Guilherme Seizem; Cruz, Antonio Augusto Velasco e; Colli, Benedicto Oscar; Abud, Daniel Giansante, E-mail: danisantos2404@gmail.com [Universidade de Sao Paulo (HCFMRP/USP), Ribeirao Preto, SP (Brazil). Faculdade de Medicina. Hospital das Clinicas

    2014-07-15

    Arteriovenous fistulae of the cavernous sinus are rare and difficult to diagnose. They are classified into dural cavernous sinus fistulae or direct carotid-cavernous fistulae. Despite the similarity of symptoms between both types, a precise diagnosis is essential since the treatment is specific for each type of fistula. Imaging findings are remarkably similar in both dural cavernous sinus fistulae and carotid-cavernous fistulae, but it is possible to differentiate one type from the other. Amongst the available imaging methods (Doppler ultrasonography, computed tomography, magnetic resonance imaging and digital subtraction angiography), angiography is considered the gold standard for the diagnosis and classification of cavernous sinus arteriovenous fistulae. The present essay is aimed at didactically presenting the classification and imaging findings of cavernous sinus arteriovenous fistulae. (author)

  1. MR inflow angiography for the evaluation of dural sinus patency

    International Nuclear Information System (INIS)

    Poncelet, B.; Baleriaux, D.; Grand, C.; Van Dijk, P.; De Graaf, R.; Segebarth, C.

    1990-01-01

    This paper assesses dural sinus patency with two-dimensional inflow MR angiography. Twelve patients with potential dural sinus (superior sagittal and transverse sinus) involvement related to tumors of the falx or the convexity (meningiomas, metastasis) were examined with digital subtraction angiography (DSA), Mr imaging (1.5-T Gyroscan system), including T1-weighted (pre- and post-agadolinium) and T2-weighted spin-echo imaging, and MR angiography. For the MR angiographic study, a gradient-echo fast field echo sequence with flow compensation was used. Thin (2-mm), contiguous coronal or transverse sections were acquired sequentially. Three-dimensional reconstruction with MIP processing was then performed. CT, DSA, and MR imaging were performed for presurgical evaluation. Surgical confirmation of sinus patency was obtained for all patients

  2. Optimal cutoff points for the detection of undiagnosed type 2 diabetes, hypertension and metabolic syndrome in Mexican adults Puntos de corte óptimos para la detección de diabetes tipo 2, hipertensión y síndrome metabólico no diagnosticados en adultos mexicanos

    Directory of Open Access Journals (Sweden)

    Rosalba Rojas-Martínez

    2012-02-01

    Full Text Available OBJECTIVE: To compare the waist circumference cutoff points established by the American Heart Association and the National Heart, Lung and Blood Institute (AHA/NHLBI with those of the International Diabetes Federation (IDF for the screening of diabetes, hypertension, and metabolic syndrome in Mexican adults. MATERIAL AND METHODS: This study comprised a subsample of the ENSANUT 2006. Subjects without diabetes and hypertension and non-pregnant women were included. Sensitivity, specificity, and predictive values were compared using AUC and the positive likelihood ratio test [LR(+]. RESULTS: In subjects aged ≥40 years, sensitivity for detection of diabetes and hypertension was higher for the IDF thresholds (85.34 and 86.87%, respectively compared with those of the AHA/NHLBI (59.49 and 52.41%, respectively. LR(+ were higher for IDF thresholds compared with AHA/NHLBI. Similar results in subjects aged ≥65 years were observed. CONCLUSIONS: The measurement of abdominal obesity defined by the IDF was a better screening tool for diabetes and hypertension, considering that initially a high sensitivity and low cost tool at population level is required.OBJETIVO: Comparar los puntos de corte de circunferencia de cintura de la American Heart Association and the National Heart, Lung and Blood Institute (AHA/NHLBI y la International Diabetes Federation (IDF para escrutinio de diabetes, hipertensión arterial y síndrome metabólico en adultos mexicanos. MATERIAL Y MÉTODOS: Se analizó una submuestra de la ENSANUT 2006 incluyendo sujetos sin diabetes o hipertensión y mujeres no embarazadas. Se comparó la sensibilidad, especificidad y valores predictivos mediante AUC y la razón de verosimilitudes positiva [LR(+]. RESULTADOS: En personas ≥40 años, la sensibilidad para detección de diabetes e hipertensión usando el criterio de la IDF fue de 85.34% (LR(+=1.1 y 86.87% (LR(+=1.1; mientras que para el criterio de la AHA/NHLBI fue de 59.49% (LR(+=1.34 y 52

  3. A rare case of spinal dural arteriovenous fistula

    Directory of Open Access Journals (Sweden)

    Mariya Apostolova

    2012-12-01

    Full Text Available Spinal dural arteriovenous fistula (SDAVF is a rare vascular malformation of the spine. Only a limited number of cases of SDAVF have been reported in the current literature. We describe the case of a 74 year old male who presented with gradually progressive bilateral lower extremity weakness and bladder dysfunction and was subsequently diagnosed with SDAVF affecting both the thoracic and lumbar spine. The patient later underwent embolization with some improvement in his neurologic symptoms.

  4. Violencia intrafamiliar en el adulto mayor que vive en el distrito de Breña, Perú

    OpenAIRE

    Jack Roberto Silva Fhon; Antonia Defilia del Río Suarez; Silvia Natividad Motta Herrera; Suzele Cristina Coelho Fabricio Webhe; Rosalina Aparecida Partezani Rodrigues

    2015-01-01

    Antecedentes: La violencia hacia el adulto mayor es un problema social que ocurre dentro de la familia y que por miedo no es denunciado dificultando el trabajo del personal multi-profesional de salud para la detección, denuncia y prevención de estos casos. Objetivo: Identificar la prevalencia, los tipos de violencia intrafamiliar e su asociación con variables socio demográficas y presencia de síntomas depresivos en el adulto mayor que vive en la comunidad. Método: Estudio cuantitativo...

  5. Violencia intrafamiliar en el adulto mayor que vive en el distrito de Breña, Perú

    OpenAIRE

    Jack Roberto Silva-Fhon; Antonia Defilia Del Río-Suarez; Silvia Natividad Motta-Herrera; Suzele Cristina Coelho Fabricio-Wehbe; Rosalina Aparecida Partezani-Rodrigues

    2015-01-01

    Antecedentes. La violencia hacia el adulto mayor es un problema social que ocurre dentro de la familia y que, por miedo, no es denunciado. Esto dificulta el trabajo del personal multiprofesional de salud para la detección, denuncia y prevención de estos casos. Objetivo. Identificar la prevalencia, los tipos de violencia intrafamiliar, su asociación con variables sociodemográficas y la presencia de síntomas depresivos en el adulto mayor que vive en la comunidad de estudio. Materiales y métodos...

  6. TIPOS DE DISCURSO

    OpenAIRE

    Garcia, Afrânio; UERJ

    2012-01-01

    O professor Adilson Citelli, em seu excelente livro Linguageme persuasão, apresenta cinco tipos de discurso:§ discurso dominante§ discurso autorizado§ discurso polêmico,§ discurso lúdico§ discurso autoritário.

  7. Phase-contrast MR angiography of intracranial dural arteriovenous fistulae

    International Nuclear Information System (INIS)

    Cellerini, M.; Mascalchi, M.; Mangiafico, S.; Ferrito, G.P.; Scardigli, V.; Pellicano, G.; Quilici, N.

    1999-01-01

    MRI and phase-contrast MR angiography (PC MRA) were obtained in 13 patients with angiographically confirmed intracranial dural arteriovenous fistulae (DAVF). Three- and two-dimensional PC MRA was obtained with low (6-20 cm/s) and high (>40 cm/s) velocity encoding along the three main body axes. MRI showed focal or diffuse signal abnormalities in the brain parenchyma in six patients, dilated cortical veins in seven, venous pouches in four with type IV DAVF and enlargement of the superior ophthalmic vein in three patients with DAVF of the cavernous sinus. However, it showed none of the fistula sites and did not allow reliable identification of feeding arteries. 3D PC MRA enabled identification of the fistula and enlarged feeding arteries in six cases each. Stenosis or occlusion of the dural sinuses was detected in six of eight cases on 3D PC MRA with low velocity encoding. In six patients with type II DAVF phase reconstruction of 2D PC MRA demonstrated flow reversal in the dural sinuses or superior ophthalmic vein. (orig.)

  8. Efficacy and safety of small intestinal submucosa in dural defect repair in a canine model

    Energy Technology Data Exchange (ETDEWEB)

    He, Shu-kun [Laboratory of Stem Cell and Tissue Engineering, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041 (China); Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041 (China); Guo, Jin-hai [Laboratory of Stem Cell and Tissue Engineering, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041 (China); Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041 (China); Department of Orthopedics, The Third People' s Hospital of Chengdu, Chengdu, Sichuan 610031 (China); Wang, Zhu-le [Laboratory of Stem Cell and Tissue Engineering, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041 (China); Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041 (China); Zhang, Yi [Laboratory of Stem Cell and Tissue Engineering, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041 (China); Tu, Yun-hu [Department of Neurosurgery, Chengdu Military General Hospital, Chengdu, Sichuan 610083 (China); Wu, Shi-zhou [Laboratory of Stem Cell and Tissue Engineering, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041 (China); Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041 (China); Huang, Fu-guo [Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041 (China); Xie, Hui-qi, E-mail: xiehuiqi@scu.edu.cn [Laboratory of Stem Cell and Tissue Engineering, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041 (China)

    2017-04-01

    Dural defects are a common problem, and inadequate dural closure can lead to complications. Several types of dural substitute materials have recently been discarded or modified owing to poor biocompatibility or mechanical properties and adverse reactions. The small intestinal submucosa (SIS) is a promising material used in a variety of applications. Based on the limitations of previous studies, we conducted an animal study to evaluate the efficacy and safety of the SIS in preclinical trials. Twenty-four male beagle dogs were subjected to surgical resection to produce dural defects. SIS or autologous dural mater was patched on the dural defect. Gross and histological evaluations were carried out to evaluate the efficacy and safety of the therapy. Our findings demonstrated that the SIS, which stimulated connective and epithelial tissue responses for dural regeneration and functional recovery without immunological rejection, could provide prolonged defect repair and prevent complications. The mechanical properties of the SIS could be adjusted by application of multiple layers, and the biocompatibility of the material was appropriate. Thus, our data suggested that this material may represent an alternative option for clinical treatment of dural defects. - Highlights: • SIS stimulates dura regeneration without immunological rejection. • SIS has adjustable mechanical properties and appropriate biocompatibility. • SIS may be an effective alternative option for clinical treatment of dural defects.

  9. Efficacy and safety of small intestinal submucosa in dural defect repair in a canine model

    International Nuclear Information System (INIS)

    He, Shu-kun; Guo, Jin-hai; Wang, Zhu-le; Zhang, Yi; Tu, Yun-hu; Wu, Shi-zhou; Huang, Fu-guo; Xie, Hui-qi

    2017-01-01

    Dural defects are a common problem, and inadequate dural closure can lead to complications. Several types of dural substitute materials have recently been discarded or modified owing to poor biocompatibility or mechanical properties and adverse reactions. The small intestinal submucosa (SIS) is a promising material used in a variety of applications. Based on the limitations of previous studies, we conducted an animal study to evaluate the efficacy and safety of the SIS in preclinical trials. Twenty-four male beagle dogs were subjected to surgical resection to produce dural defects. SIS or autologous dural mater was patched on the dural defect. Gross and histological evaluations were carried out to evaluate the efficacy and safety of the therapy. Our findings demonstrated that the SIS, which stimulated connective and epithelial tissue responses for dural regeneration and functional recovery without immunological rejection, could provide prolonged defect repair and prevent complications. The mechanical properties of the SIS could be adjusted by application of multiple layers, and the biocompatibility of the material was appropriate. Thus, our data suggested that this material may represent an alternative option for clinical treatment of dural defects. - Highlights: • SIS stimulates dura regeneration without immunological rejection. • SIS has adjustable mechanical properties and appropriate biocompatibility. • SIS may be an effective alternative option for clinical treatment of dural defects.

  10. Vida y salud con la gimnasia para adultos mayores

    Directory of Open Access Journals (Sweden)

    MSc. María Magdalena Rosado Álvarez

    2018-01-01

    Full Text Available El objetivo del trabajo es realizar una revisión metódica de las normas vigentes en la constitución de la República del Ecuador, el impacto de la gimnasia para disfrutar una vida saludable los adultos mayores el periodo mayo a septiembre de 2016. La investigación tuvo un enfoque cuantitativo, de alcance explicativo, con diseño experimental de tipo pre experimental con corte longitudinal, a través de una muestra de 20 pacientes, donde se implementó métodos para la recolección de datos demostrando su consistencia, tales como: historia clínica, encuesta, test de Tinetti, prueba de Romberg. Los resultados reflejan mejoría a la marcha y equilibrio pasando de un 15% a 10% de la población

  11. Pólipo fibroepitelial de uretra en un adulto

    OpenAIRE

    Lanzas Prieto, J.M.; Menéndez Fernández, C.L.; Pérez García, F.J.; Gutiérrez García, R.; González Tuero, J.; Guate Ortiz, J.L.

    2003-01-01

    Presentamos el caso de un pólipo fibroepitelial de uretra prostática en un paciente de cuarenta y cinco años. Este tipo de pólipos son poco frecuentes en el adulto. Los síntomas principales que manifestaba el paciente eran hematuria y disminución ocasional del chorro miccional. Mostramos las imágenes endoscópicas del tumor, así como detalles de su histología que corresponde a una lesión polipoide con un revestimiento urotelial típico sobre tejido conectivo laxo, con algún fascículo de músculo...

  12. Cobertura vacinal de adultos deficientes visuais e as características sociodemográficas

    Directory of Open Access Journals (Sweden)

    Lorita Marlena Freitag Pagliuca

    2014-01-01

    Full Text Available Se evaluaran la cobertura vacunal y las características sociodemográficas de adultos deficientes visuales. Investigación exploratoria, descriptiva y cuantitativa, con 41 adultos de asociación de ciegos de Fortaleza-CE, Brasil, de febrero a mayo/2011. Se realizó entrevista con instrumento semiestructurado con nombre, sexo, escolaridad y situación vacunal. Los resultados señalaron grupo predominante del sexo masculino (63,41%; edad entre 20-49 años (95,92% y escolaridad secundaria (79,92%. Recordaron tener recibido vacuna doble tipo adulto (82,93%, tríplice viral (51,22%, fiebre amarilla (21,95%, influenza según estaciones (29,27% e, no recibieron pneumocócica y hepatitis B. Intervalos de confianza señalaron que la mayoría de las personas con deficiencia, según recuerdo, se encontraba vacunada con doble adulto y tríplice viral. Las personas con deficiencia visual no reciben cartilla de vacunación adecuada para lectura, están parcialmente inmunizadas y susceptibles a enfermedades inmunoprevinibles. Medidas de intervención de enfermería son necesarias para planes de acciones a las principales medidas de prevención.

  13. ''Dural tail'' adjacent to acoustic neuroma on MRI: a case report

    International Nuclear Information System (INIS)

    Lunardi, P.; Mastronardi, L.; Nardacci, B.; Acqui, M.; Fortuna, A.

    1993-01-01

    A 'dural tail' on Gd-DTPA-enhanced MRI has been often observed adjacent to meningiomas and considered to be useful in distinguishing meningioma of the cerebellopontine angle from acoustic neuroma. However, demonstration of a dural tail adjacent to an acoustic neuroma indicates that this sign is not specific. (orig.)

  14. Prognosis of cerebral vein and dural sinus thrombosis - Results of the International Study on Cerebral Vein and Dural Sinus Thrombosis (ISCVT)

    NARCIS (Netherlands)

    Ferro, José M.; Canhão, Patrícia; Stam, Jan; Bousser, Marie-Germaine; Barinagarrementeria, Fernando

    2004-01-01

    Background and Purpose - The natural history and long-term prognosis of cerebral vein and dural sinus thrombosis (CVT) have not been examined previously by adequately powered prospective studies. Methods - We performed a multinational ( 21 countries), multicenter ( 89 centers), prospective

  15. Intracranial dural arterio-venous fistula presenting with progressive myelopathy.

    LENUS (Irish Health Repository)

    Ogbonnaya, Ebere Sunny

    2011-01-01

    Spinal dural arterio-venous fistula (DAVF) is rare and usually involves the thoracic segments. The classical presentation is a slowly progressive ataxia. Clinical presentation of intracranial DAVF depends on the site of the DAVF, as well as the vessels involved. Patients may present with pulsatile tinnitus, occipital bruit, headache, dementia, visual impairment as well as neurological deterioration distant from the DAVF as a result of venous hypertension and cortical haemorrhage. The authors present a rare case of progressive myelopathy secondary to an intracranial DAVF.

  16. Dural ectasia and FBN1 mutation screening of 40 patients with Marfan syndrome and related disorders: role of dural ectasia for the diagnosis.

    Science.gov (United States)

    Attanasio, Monica; Pratelli, Elisa; Porciani, Maria Cristina; Evangelisti, Lucia; Torricelli, Elena; Pellicanò, Giannantonio; Abbate, Rosanna; Gensini, Gian Franco; Pepe, Guglielmina

    2013-07-01

    Marfan syndrome is an autosomal dominant disorder of connective tissue caused by mutations in the gene encoding fibrillin-1 (FBN1), a matrix component of microfibrils. Dural ectasia, i.e. enlargement of the neural canal mainly located in the lower lumbar and sacral region, frequently occurs in Marfan patients. The aim of our study was to investigate the role of dural ectasia in raising the diagnosis of Marfan syndrome and its association with FBN1 mutations. We studied 40 unrelated patients suspected for MFS, who underwent magnetic resonance imaging searching for dural ectasia. In all of them FBN1 gene analysis was also performed. Thirty-seven patients resulted affected by Marfan syndrome according to the '96 Ghent criteria; in 30 of them the diagnosis was confirmed when revaluated by the recently revised criteria (2010). Thirty-six patients resulted positive for dural ectasia. The degree of dural ectasia was grade 1 in 19 patients, grade 2 in 11 patients, and grade 3 in 6 patients. In 7 (24%) patients, the presence of dural ectasia allowed to reach a positive score for systemic feature criterion. Twenty-four patients carried an FBN1 mutation, that were represented by 13 missense (54%), and 11 (46%) mutations generating a premature termination codon (PTC, frameshifts and stop codons). No mutation was detected in the remaining 16 (6 patients with MFS and 10 with related disorders according to revised Ghent criteria). The prevalence of severe (grade 2 and grade 3) involvement of dura mater was higher in patients harbouring premature termination codon (PTC) mutations than those carrying missense-mutations (8/11 vs 2/13, P = 0.0111). Our data emphasizes the importance of dural ectasia screening to reach the diagnosis of Marfan syndrome especially when it is uncertain and indicates an association between PTC mutations and severe dural ectasia in Marfan patients. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  17. Manifestaciones de violencia intrafamiliar hacia adultos mayores diabéticos. Pinar del Rio, 2012

    Directory of Open Access Journals (Sweden)

    María de la Caridad Casanova Moreno

    Full Text Available Introducción: la violencia contra el adulto mayor es un problema que requiere de sensibilización por parte del equipo de salud para ser visualizado. Objetivo: caracterizar las manifestaciones de violencia intrafamiliar hacia el adulto mayor diabético en un consultorio de la provincia de Pinar del Río. Métodos: se realizó un estudio descriptivo transversal durante el primer semestre del año 2012, en el Consultorio número 10 del Policlínico Universitario "Hermanos Cruz". El universo (U=86 estuvo constituido por el total de adultos mayores diabéticos; la muestra quedó conformada por 52 adultos mayores diabéticos. Las variables estudiadas fueron: edad, sexo, tipo de maltrato recibido, notificación, principal agresor e identificar la necesidad de información sobre el tema. Para la recolección de información se diseñó y aplicó un cuestionario por el equipo de investigación. Se utilizó el porcentaje como medida de resumen. Resultados: el grupo de edad más maltratado fue el de 60 a 69 años, predominando el sexo femenino. Los agresores más cercanos resultaron ser los hijos. La muestra estudiada manifestó que existe una insuficiente divulgación sobre el tema. Conclusiones: en el consultorio donde se realizó la investigación existen manifestaciones de violencia intrafamiliar en adultos mayores diabéticos, a pesar de que la comunidad no la reconoce como uno de sus problemas de salud.

  18. Valoración funcional del adulto mayor relacionado con el abandono familiar.

    Directory of Open Access Journals (Sweden)

    Jenny Fernanda Villarroel Vargas

    2017-03-01

    Full Text Available Introducción: Se estima que entre el 2000 al 2050 la población mundial envejecida ascenderá del 11% al 22 %, con ello el incremento de las diversas enfermedades o trastornos propios de la edad. Objetivo: Establecer la relación entre capacidad funcional del adulto mayor con el abandono familiar en el barrio La Calera Centro, Latacunga, 2015-2016. Métodos: Se realizó un estudio observacional descriptivo de corte trasversal, donde previo consentimiento informado participaron 70 adultos mayores, a quienes se les aplicó escalas para valoración de la capacidad funcional, así como la encuesta para valorar abandono familiar y aspectos sociodemográficos de la población. Para el análisis estadístico se utilizó el test de Chi Cuadrado de Pearson con un nivel de significancia del 0,05. Resultados: Se reportó el abandono en el 75,7% de los adultos mayores y tuvo significancia con respecto a la capacidad funcional y la estructura familiar (p=0,002. Hubo relación  entre capacidad funcional y abandono familiar, así como también predominio de los adultos mayores entre los 65 a 74 años, sexo femenino, sin ninguna actividad laboral y analfabetos. Hubo relación significativa entre capacidad funcional, edades geriátricas y ocupación; y de igual manera entre la estructura familiar y el abandono. La capacidad funcional y la estructura familiar fueron factores asociados al abandono.    Conclusiones: La dependencia del adulto mayor condicionó a diferentes tipos de maltrato, destacando el abandono familiar.

  19. Urticaria pigmentosa en el adulto

    Directory of Open Access Journals (Sweden)

    Jhon Alexander Ávila Rueda

    2012-08-01

    Full Text Available La urticaria pigmentosa es una de las formas más comunes de las mastocitosis, las cuales corresponden a una serie de procesos caracterizados por un aumento anormal de los mastocitos en diversos órganos y tejidos corporales. En la urticaria pigmentosa la manifestación es exclusiva de la piel, caracterizada por la presencia de lesiones maculopapulares de 2.5 a 5 mm de diámetro, de un color que puede oscilar entre rojo y café, distribuyéndose generalmente en tronco y extremidades respetando palmas y plantas. Cerca de la mitad de los lesiones presenta rubor localizado, prurito y ampollas. Su incidencia y prevalencia son desconocidas; sin embargo, su aparición es más común en niños que en adultos. El diagnóstico depende en gran manera de un adecuado examen físico complementado con estudios de laboratorio e histopatología. El tratamiento de elección constituye la administración de antihistamínicos orales.

  20. A dural metastatic small cell carcinoma of the gallbladder as the first manifestation: a case report.

    Science.gov (United States)

    Tonomura, Shuichi; Kitaichi, Tomoko; Onishi, Rina; Kakehi, Yoshiaki; Shimizu, Hisao; Shimada, Keiji; Kanemasa, Kazuyuki; Fukusumi, Akio; Takahashi, Nobuyuki

    2018-03-16

    A dural metastasis is one of the essential differential diagnoses of meningioma. In general, carcinomas of the breast and lung in females and prostate in males have been the most commonly reported primary lesions of dural metastases. However, dural metastasis of gallbladder carcinoma is extremely rare. Here, we report a unique case of a dural matter metastasis of gallbladder carcinoma as the first manifestation, which was autopsy-defined as small cell carcinoma. A 78-year-old man came to our hospital complaining of left hemianopia. Brain computed tomography (CT) revealed a sizeable parasagittal dural-based extra-axial tumor. However, the findings for meningioma were atypical by magnetic resonance imaging, suggesting a meningioma mimic. A contrast-enhanced CT scan of the abdomen revealed a large gallbladder carcinoma. The patient opted for the best supportive care and died 2 months later. The post-mortem examination revealed small cell carcinoma in gallbladder carcinoma. Moreover, an immunologically similar carcinoma was detected in the dural metastasis. To the best of our knowledge, this is the first case of a dural metastasis of gallbladder small cell carcinoma. A systemic examination is essential for clinicians when atypical findings of meningioma are observed, suggesting a meningioma mimic. We present this rare case with a review of the literature.

  1. A Multicenter Study of the Presentation, Treatment, and Outcomes of Cervical Dural Tears.

    Science.gov (United States)

    O'Neill, Kevin R; Fehlings, Michael G; Mroz, Thomas E; Smith, Zachary A; Hsu, Wellington K; Kanter, Adam S; Steinmetz, Michael P; Arnold, Paul M; Mummaneni, Praveen V; Chou, Dean; Nassr, Ahmad; Qureshi, Sheeraz A; Cho, Samuel K; Baird, Evan O; Smith, Justin S; Shaffrey, Christopher; Tannoury, Chadi A; Tannoury, Tony; Gokaslan, Ziya L; Gum, Jeffrey L; Hart, Robert A; Isaacs, Robert E; Sasso, Rick C; Bumpass, David B; Bydon, Mohamad; Corriveau, Mark; De Giacomo, Anthony F; Derakhshan, Adeeb; Jobse, Bruce C; Lubelski, Daniel; Lee, Sungho; Massicotte, Eric M; Pace, Jonathan R; Smith, Gabriel A; Than, Khoi D; Riew, K Daniel

    2017-04-01

    Retrospective multicenter case series study. Because cervical dural tears are rare, most surgeons have limited experience with this complication. A multicenter study was performed to better understand the presentation, treatment, and outcomes following cervical dural tears. Multiple surgeons from 23 institutions retrospectively identified 21 rare complications that occurred between 2005 and 2011, including unintentional cervical dural tears. Demographic data and surgical history were obtained. Clinical outcomes following surgery were assessed, and any reoperations were recorded. Neck Disability Index (NDI), modified Japanese Orthopaedic Association (mJOA), Nurick classification (NuC), and Short-Form 36 (SF36) scores were recorded at baseline and final follow-up at certain centers. All data were collected, collated, and analyzed by a private research organization. There were 109 cases of cervical dural tears among 18 463 surgeries performed. In 101 cases (93%) there was no clinical sequelae following successful dural tear repair. There were statistical improvements ( P < .05) in mJOA and NuC scores, but not NDI or SF36 scores. No specific baseline or operative factors were found to be associated with the occurrence of dural tears. In most cases, no further postoperative treatments of the dural tear were required, while there were 13 patients (12%) that required subsequent treatment of cerebrospinal fluid drainage. Analysis of those requiring further treatments did not identify an optimum treatment strategy for cervical dural tears. In this multicenter study, we report our findings on the largest reported series (n = 109) of cervical dural tears. In a vast majority of cases, no subsequent interventions were required and no clinical sequelae were observed.

  2. Prevalence of dural ectasia in Loeys-Dietz syndrome: comparison with Marfan syndrome and normal controls.

    Directory of Open Access Journals (Sweden)

    Atsushi K Kono

    Full Text Available BACKGROUND AND PURPOSE: Dural ectasia is well recognized in Marfan syndrome (MFS as one of the major diagnostic criteria, but the exact prevalence of dural ectasia is still unknown in Loeys-Dietz syndrome (LDS, which is a recently discovered connective tissue disease. In this study, we evaluated the prevalence of dural ectasia in LDS according by using qualitative and quantitative methods and compared our findings with those for with MFS and normal controls. MATERIAL AND METHODS: We retrospectively studied 10 LDS (6 males, 4 females, mean age 36.3 years and 20 MFS cases (12 males, 8 females, mean age 37.1 years and 20 controls (12 males, 8 females, mean age 36.1 years both qualitatively and quantitatively using axial CT images and sagittal multi-planar reconstruction images of the lumbosacral region. For quantitative examination, we adopted two methods: method-1 (anteroposterior dural diameter of S1> L4 and method-2 (ratio of anteroposterior dural diameter/vertebral body diameter>cutoff values. The prevalence of dural ectasia among groups was compared by using Fisher's exact test and the Tukey-Kramer test. RESULTS: In LDS patients, the qualitative method showed 40% of dural ectasia, the quantitative method-1 50%, and the method-2 70%. In MFS patients, the corresponding prevalences were 50%, 75%, and 85%, and in controls, 0%, 0%, and 5%. Both LDS and MFS had a significantly wider dura than controls. CONCLUSIONS: While the prevalence of dural ectasia varied depending on differences in qualitative and quantitative methods, LDS as well as MFS, showed, regardless of method, a higher prevalence of dural ectasia than controls. This finding should help the differentiation of LDS from controls.

  3. Clinical evolution of adult, elderly and very elderly patients admitted in Intensive Care Units Evolución clínica de adultos, ancianos y muy ancianos internados en Unidades de Terapia Intensiva Evolução clínica de adultos, idosos e muito idosos internados em Unidade de Terapia Intensiva

    Directory of Open Access Journals (Sweden)

    Verônica Cunha Rodrigues de Oliveira

    2011-12-01

    Full Text Available This study compared clinical outcomes among adult, elderly and very elderly patients admitted to Intensive Care Units (ICUs located in São Paulo, Brazil. This retrospective, longitudinal and comparative study included 279 adult (≥18 and El estudio comparó la evolución clínica de adultos, ancianos y muy ancianos internados en Unidades de Terapia Intensiva localizadas en Sao Paulo, Brasil. El estudio fue retrospectivo longitudinal, del tipo comparativo. Participaron 279 adultos (≥18 y O estudo comparou a evolução clínica de adultos, idosos e muito idosos, internados em Unidades de Terapia Intensiva, localizadas em São Paulo, Brasil. Trata-se de estudo retrospectivo-longitudinal, do tipo comparativo. Participaram 279 adultos (≥18 e <60 anos, 216 idosos (≥60 e <80 anos e 105 muito idosos (≥80 anos. Os adultos diferiram dos outros grupos em relação à unidade de destino e evolução da gravidade, segundo Simplified Acute Physiology Score II. Foi mais prevalente o encaminhamento dos adultos para unidades de internação, porém, os idosos e muito idosos, sobreviventes à internação na unidade crítica, apresentaram melhora mais acentuada antes da alta. Entre adultos e idosos ocorreu diferença em relação à mortalidade, com maior taxa no grupo mais velho; entretanto, a mortalidade dos muito idosos e adultos foi similar. Em geral, os resultados indicaram que a idade mais avançada não foi fator associado aos desfechos indesejáveis da assistência intensiva.

  4. Un estudio exploratorio de capacidades emocionales en adultos mayores

    Directory of Open Access Journals (Sweden)

    Zoe S. Bello Dávila

    2012-01-01

    Full Text Available Abstract The study of the emotional world of the elderly is a fundamental requisite for guaranteeing the well-being and health of this group. The objective of this research paper was to characterize a group of elderly people according to their motional capabilities. The group consisted of 122 elderly persons: 107 female, 15 male. All attendants participated in a “Círculo de Abuelos” (Circle of Grandparents. The study was descriptive, it sought to gather information about the responses of older adults in situations of emotional content by completing a questionnaire. The results provided a profile of capacities where areas of strength and weakness are clearly distinguished. Selfconfidence and the possibility of fulfilling projects are among the strengths while the weaknesses are found in interpersonal or intrapersonal managing of emotions. These results have led to a better understanding of the emotional world of the elderly and guide future educational activities. Resumen El estudio del mundo emocional de los adultos mayores es un requisito fundamental para garantizar el estado de bienestar y salud de los mismos. El presente artículo de investigación se fijó como objetivo caracterizar a un grupo de ancianos, en función de sus capacidades emocionales. Los participantes fueron 122 ancianos, en concreto 107 mujeres y 15 hombres, que asisten a un “Círculo de Abuelos”. El estudio fue de tipo descriptivo, pues pretendió recoger información acerca de las respuestas de los adultos mayores ante situaciones de contenido emocional que se exploran por medio de un cuestionario elaborado al efecto. Los resultados ofrecen un perfil de capacidades en que la autoconfianza y la posibilidad de elaborar proyectos se erigen como fortalezas, mientras que las debilidades se expresan en las dificultades para el manejo emocional tanto a nivel intra como interpersonal. Estos resultados han permitido lograr una mejor comprensión del mundo emocional del

  5. ACTIVIDAD FÍSICA EN UN GRUPO DE ADULTOS MAYORES QUE ACUDEN A CENTROS COMUNITARIOS

    OpenAIRE

    Abril Merizalde, Dennys Leonardo; Andrade Trujillo, Catherine Alexandra

    2017-01-01

    La esperanza de vida ha tenido un notable incremento en la actualidad y con ello el aumento de la prevalencia e incidencia de enfermedades como: diabetes tipo 2, enfermedades cardiovasculares, cerebrovasculares y pulmonares. De esta manera el adulto mayor es susceptible al deterioro de su estado nutricional y por lo tanto a una disminución de su funcionalidad e independencia lo que afecta directamente a su calidad de vida. El objetivo del presente estudio es realizar un análisis cuantitativo ...

  6. How I do it: surgical ligation of craniocervical junction dural AV fistulas.

    Science.gov (United States)

    Sorenson, Thomas J; La Pira, Biagia; Hughes, Joshua; Lanzino, Giuseppe

    2017-08-01

    Dural arteriovenous fistulas (DAVFs) of the craniocervical junction are uncommon vascular lesions, which often require surgical treatment even in the endovascular era. Most commonly, the fistula is placed laterally, and surgical ligation is performed through a lateral suboccipital craniotomy. After dural opening, the area is inspected, and the arterialized vein is identified emerging from the dura, often adjacent to the entry point of the vertebral artery, and ligated. A far lateral craniotomy is the authors' preferred surgical approach for accessing and treating dural arteriovenous fistulas of the craniocervical junction that cannot be reached endovascularly.

  7. Anterior dural ectasia mimicking a lytic lesion in the posterior vertebral body in ankylosing spondylitis.

    Science.gov (United States)

    Bele, Keerthiraj; Pendharkar, Hima Shriniwas; Venkat, Easwer; Gupta, Arun Kumar

    2011-12-01

    Anterior dural ectasia is an extremely rare finding in ankylosing spondylitis (AS). The authors describe a unique case of AS in which the patient presented with cauda equina syndrome as well as an unusual imaging finding of erosion of the posterior aspect of the L-1 (predominantly) and L-2 vertebral bodies due to anterior dural ectasia. Symptomatic patients with long-standing AS should be monitored for the presence of dural ectasia, which can be anterior in location, as is demonstrated in the present case.

  8. Cranial dural arteriovenous fistula as a rare cause of tinnitus – case report

    International Nuclear Information System (INIS)

    Kuśmierska, Małgorzata; Gać, Paweł; Nahorecki, Artur; Szuba, Andrzej; JaŸwiec, Przemysław

    2013-01-01

    Tinnitus, occurring at least once in a lifetime in about 10–20% of the population, is an important clinical problem with complex etiology. Rare causes of tinnitus include cranial dural arteriovenous fistulas (DAVFs), which are usually small lesions consisting of abnormal connections between branches of dural arteries and venous sinuses or veins. Authors present a case of a 44-year-old woman with persistent, unilateral, treatment-resistant pulsatile tinnitus caused by a small dural arteriovenous fistula revealed in computed tomography angiography. Computed tomography angiography is a useful diagnostic method that in some cases allows for establishing the cause of unilateral, pulsatile tinnitus

  9. Cranial dural arteriovenous fistula as a rare cause of tinnitus – case report

    Energy Technology Data Exchange (ETDEWEB)

    Kuśmierska, Małgorzata; Gać, Paweł [Department of Medical Radiology and Imaging Diagnostics, 4th Military Clinical Hospital, Wrocław (Poland); Nahorecki, Artur [Department of Internal Diseases, 4th Military Clinical Hospital, Wrocław (Poland); Szuba, Andrzej [Department of Internal Diseases, 4th Military Clinical Hospital, Wrocław (Poland); Medical University, Wrocław (Poland); JaŸwiec, Przemysław [Department of Medical Radiology and Imaging Diagnostics, 4th Military Clinical Hospital, Wrocław (Poland)

    2013-07-01

    Tinnitus, occurring at least once in a lifetime in about 10–20% of the population, is an important clinical problem with complex etiology. Rare causes of tinnitus include cranial dural arteriovenous fistulas (DAVFs), which are usually small lesions consisting of abnormal connections between branches of dural arteries and venous sinuses or veins. Authors present a case of a 44-year-old woman with persistent, unilateral, treatment-resistant pulsatile tinnitus caused by a small dural arteriovenous fistula revealed in computed tomography angiography. Computed tomography angiography is a useful diagnostic method that in some cases allows for establishing the cause of unilateral, pulsatile tinnitus.

  10. Massive granular cell ameloblastoma with dural extension and atypical morphology

    Directory of Open Access Journals (Sweden)

    Vandana Raghunath

    2014-01-01

    Full Text Available Ameloblastomas are rare histologically benign, locally aggressive tumors arising from the oral ectoderm that occasionally reach a gigantic size. Giant ameloblastomas are a rarity these days with the advent of panoramic radiography in routine dental practice. Furthermore, the granular cell variant is an uncommon histological subtype of ameloblastoma where the central stellate reticulum like cells in tumor follicles is replaced by granular cells. Although granular cell ameloblastoma (GCA is considered to be a destructive tumor with a high recurrence rate, the significance of granular cells in predicting its biologic behavior is debatable. However, we present a rare case of giant GCA of remarkable histomorphology showing extensive craniofacial involvement and dural extension that rendered a good prognosis following treatment.

  11. Management of intracranial dural arteriovenous shunts in adults

    International Nuclear Information System (INIS)

    Sarma, Dipanka; Brugge, Karel ter

    2003-01-01

    Dural arteriovenous shunts are abnormal arteriovenous communications within the dura. They are thought to be an acquired condition in adults and can present with a variety of clinical features, ranging from benign bruits to intracranial hemorrhage and neurological deficits. The presentation and natural history of these shunts is largely determined by the pattern of venous drainage. Knowledge of natural history and careful study of the angioarchitexture by angiography is therefore mandatory for correct management of these lesions. In this review, principles of management in adults and the various factors that influence treatment decisions are discussed, with a focus on endovascular therapy. Retrograde leptomeningeal or cortical venous drainage has a strong correlation with adverse clinical events and the requirement for aggressive management in this situation is highlighted. Indications for endovascular treatment, therapeutic goals, approaches and techniques are reviewed. The role of surgical treatment is also briefly discussed

  12. Dural arteriovenous fistula presenting with exophthalmos and seizures.

    Science.gov (United States)

    Feyissa, Anteneh M; Ponce, Lucido L; Patterson, Joel T; Von Ritschl, Rudiger H; Smith, Robert G

    2014-03-15

    Concomitant seizures and exophthalmos in the context of a temporal dural arteriovenous fistula (dAVF) has not been described before. Here, we report a 55-year-old-male who presented with an 8-month history of progressive painless exophthalmos of his left eye, conjunctival chemosis, reduced vision and new onset complex partial seizures. Cerebral angiography demonstrated Cognard Type IIa left cerebral dAVF fed by branches from the left occipital artery and an accessory meningeal artery, with drainage to the superior ophthalmic vein. Following surgical obliteration of dAVF feeding vessels, our patient had dramatic improvement in visual acuity, proptosis and chemosis along with cessation of clinical seizures. Published by Elsevier B.V.

  13. MELLITUS TIPO 1

    Directory of Open Access Journals (Sweden)

    Luciana Vládia Carvalhêdo Fragoso

    2010-01-01

    Full Text Available Investigación de carácter cualitativo, con el objetivo de comprender las experiencias cotidianas de los adolescentes con diabetes tipo 1. Los sujetos del estudio son 14 adolescentes atendidos en una clínica para la diabetes en Fortaleza, Ceará, Brasil, de junio a octubre de 2008. La recolección de los datos se hizo a través de entrevistas semi-estructuradas y se organizaron de acuerdo al análisis de contenido de Morse y Field. Se observó que el descubrimiento de la diabetes fue un momento difícil para los adolescentes debido a los cambios que tuvieron que hacer como el control terapéutico. Hacer una dieta adecuada es muy difícil como consecuencia de estímulos internos y externos a que están sometidos y a las dificultades financieras. Los adolescentes tienen el apoyo de la familia y amigos para su tratamiento diario. Además, les gusta el servicio realizado por los profesionales de salud de la clínica. Sin embargo, hay mucho que mejorar como enfermeras en la valorización de las experiencias de la vida de los adolescentes con diabetes, como la identificación de factores que interfieren en el control metabólico.

  14. Maltrato institucional a adultos mayores

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    Miriam Rubio Acuña

    Full Text Available El maltrato institucional se refiere a cualquier forma de abuso que ocurre en servicios dirigidos a los ancianos. Esta revisión bibliográfica muestra que el maltrato se presenta con mayor frecuencia en residencias de larga estadía y el tipo más frecuente es la negligencia. Los factores asociados son los que tienen relación con el residente y con el ambiente. Las principales estrategias son invertir recursos sociosanitarios, sensibilizar a la población respecto al maltrato de los ancianos, considerar las necesidades de estos, fortalecer la formación de pregrado de los profesionales de salud en este ámbito y realizar educación continua. El maltrato es un problema social que debe ser abordado de manera integral.

  15. Spontaneous Resolution of a Fetal Dural Sinus Thrombosis: One Case Report and Review of the Literatures

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    Chen Wang

    2012-01-01

    Full Text Available Fetal dural sinus thrombosis is a rare finding. Most cases have been terminated without long-term follow-ups. Recently some reports have indicated the potentially favorable evolution of fetal dural sinus thrombosis. Most of the fetuses showing symptoms have been delivered with normal neurologic outcome. We report a case of fetal dural sinus thrombosis. Serial ultrasound and magnetic resonance images (MRI showed the shrinkage of the thrombosis which indicated good prognosis. No physical or neurological abnormality was observed at 8-months follow-up. Conservative treatment is appropriate to prenatally diagnosed dural sinus thrombosis with favorable prognostic factors. Serial MRI or ultrasound should be taken every 1-2 months to monitor the thrombosis development and fetal well-beings.

  16. Abuso y Maltrato en el Adulto Mayor

    OpenAIRE

    Montero Solano, Gustavo; Vega Chaves, Juan Carlos; Hernández, Gabriel

    2017-01-01

    ResumenExiste incongruencia en las definiciones e interpretación del abuso en adultos mayores. Una definición apropiada y unificada es la dada por la Organización Mundial de la Salud, que indica que el abuso en adulto mayor es cualquier acto aislado o repetitivo o la falta de acción apropiada, ocurrida en cualquier relación de la que se espera confianza, que causa daño o malestar a la persona mayor.Este grupo poblacional es particularmente vulnerable, pues es muy probable que, en algún moment...

  17. Maltrato en el adulto mayor institucionalizado

    OpenAIRE

    Eu. Yuly Adams, C.

    2012-01-01

    El maltrato al adulto mayor es un fenómeno presente tanto en nuestro país como en el extranjero, del que no existen estadísticas claras y actualizadas que permitan evaluar su impacto personal ni social. No obstante, en Chile, en el actual escenario de transición demográfica, se presume su protagonismo. En los establecimientos de larga estadía para adultos mayores, el maltrato, es una situación real y recurrente. Si bien en este ámbito específico las estadísticas son aun más escasas, los me...

  18. RESGATE VEGETATIVO POR ALPORQUIA DE GENÓTIPOS ADULTOS DE URUCUM (Bixa orellana L.

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    Nilton César Mantovani

    2010-01-01

    Full Text Available This study aimed to evaluate the usefulness of an air layering technique for vegetative rescue of annatto (Bixa orellana L. genotypes and obtainment of propagules for vegetative propagation. Ten 12 year-old annatto stock plants, whose genotypes are derived from artificial crossing between "Hairy-green capsule" X "Smooth-red capsule" were used in this study. Air layering adventitious roots were induced in branches (1-2 cm diameter using as substrate a mixture of vermiculite and moss. The effects of (1 the type of girdling (total or partial, 1 cm in length, (2 IBA (indole-3-butyric acid at 0 and 4.92 mM solution in paper filter and (3 the covering with either transparent or dark plastic films and tencel were evaluated. The technique of air layering provided rooted branches for the 10 genotypes evaluated, with efficiency ranging from 20 to 100%, and a genotype effect was observed on rooting frequency. Under greenhouse conditions, the survival of layers derived from totally girdled stems treated with IBA and protected with transparent plastic was 100%. Established layers provided vigorous branching from which shoot apexes or nodal segment explants were obtained for in vitro establishment and propagation of this species.

  19. A case report of spinal dural arteriovenous fistula: origins, determinants, and consequences of abnormal vascular malformations

    OpenAIRE

    Zakhary, Sherry M.; Hoehmann, Christopher L.; Cuoco, Joshua A.; Hitscherich, Kyle; Alam, Hamid; Torres, German

    2017-01-01

    A spinal dural arteriovenous fistula is an abnormally layered connection between radicular arteries and venous plexus of the spinal cord. This vascular condition is relatively rare with an incidence of 5–10 cases per million in the general population. Diagnosis of spinal dural arteriovenous fistula is differentiated by contrast-enhanced magnetic resonance angiography or structural magnetic resonance imaging, but a definitive diagnosis requires spinal angiography methods. Here, we report a cas...

  20. Refractory seizures due to a dural-based cavernoma masquerading as a meningioma.

    Science.gov (United States)

    Zeng, Xianwei; Mahta, Ali; Kim, Ryan Y; Saad, Ali G; Kesari, Santosh

    2012-04-01

    A 37-year-old female presented with medically intractable complex partial seizures with secondary generalization. She was found to have a dural-based lesion with radiologic features of meningioma. A gross total resection was performed and pathology confirmed a diagnosis of cavernous angioma and she became seizure free after the surgical resection. Cavernous angioma should be considered in differential diagnosis of a dural-based lesion manifesting with refractory seizures.

  1. mellitus tipo 2

    Directory of Open Access Journals (Sweden)

    Margarita Lazcano-Ortiz

    2008-01-01

    Full Text Available Objetivo: valorar las propiedades psicométricas de la escala de afrontamiento y proceso de adaptación de Roy en población mexicana. Materiales y métodos: la escala se aplicó a 200 participantes con diabetes mellitus tipo 2. Para validar el constructo se realizó la extracción de factores con componentes principales y rotación Varimax, con Eigenvalores por arriba de 1 y cargas de factor mayores a ,30. Resultados: seis reactivos fueron eliminados del análisis por mostrar correlación negativa con la correlación total de la escala. El análisis de componentes principales inicial reveló nueve factores con una variación explicada de 65,29%. Sin embargo, no se consideraron tres factores por contener cada uno de ellos solamente un reactivo. Por tanto, la escala final se acepta con 38 reactivos. El coeficiente de confiabilidad Alfa de Cronbach fue de, 93. Discusión: el análisis reveló seis factores, uno más de lo reportado por Roy, y con mayor variación explicada. Algunos reactivos parecen no ser bien comprendidos por los participantes. Conclusiones: este artículo aporta una aproximación metodológica para explorar la adecuación de un instrumento a una población diferente para la que originalmente fue diseñado. Se concluye que la escala tiene consistencia interna y validez de constructo incipiente, los datos reportados en este estudio deben tomarse en cuenta con cautela. Es conveniente revisar de nuevo los reactivos y adecuarlos a la cultura particular, y probar la escala de nuevo con pacientes con enfermedades crónicas degenerativas a fin de contar con instrumentos culturalmente equivalentes.

  2. Hipoglicemias de Ayuno en el Adulto

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    Alfredo Jácome Roca

    1987-08-01

    Full Text Available

    Las hipoglicemias espontáneas (o no inducidas por medicamentos pueden presentarse bien en ayunas o en estados postprandiales (como reacción a la ingesta por lo que se han llamado también reactivas o funcionales. Las hipoglicemias que se observan en estado de ayuno se han denominado en su mayoría “orgánicas”, pues usualmente tienen relación con alguna lesión tisular (tumor, necrosis, atrofia en donde además puede haber exceso o deficiencia de una o varias hormonas (1.

    La hipoglicemia orgánica más común es la asociada con los insulinomas (tumores productores de insulina, tema que he revisado previamente con algún detalle (2; igual he hecho con las reactivas y las farmacotóxicas (3. En este artículo me ocuparé de las hipoglicemias de ayuno (observadas en el adulto distintas a las del insulinoma. Son éstas las asociadas a hipofunción endocrina, con deficiencia de las hormonas contrarreguladoras de la insulina (hipopituitarismos, insuficiencia suprarrenal crónica, supresión del eje hipófisis-suprarrenales postadministración de esteroides, hiperplasia suprarrenal congénita; cuando hay producción excesiva de factores insulinosímiles de crecimiento, consumo excesivo de glucosa o lesiones que interfieren con la gluconeogénesis (como en la neoplasia masiva; trastorno de la producción hepática de glucosa (como en la enfermedad hepato celular severa; falla en la producción de glucosa, aumento de la vida media de la insulina (insuficiencia renal crónica; falla relativa de producción, consumo o pérdidas excesivas de glucosa (como se observa en el ejercicio severo, glicosuria renal, embarazo y ayuno prolongado, donde los descensos de la glicemia son usualmente asintomáticos.

    No existe una cifra específica por debajo de la cual se produzcan siempre síntomas, pero un nivel que podría servir de referencia es el de 45 mgrs/dl. Algunos pacientes acostumbrados a hipoglicemia crónica (insulinomas, síndrome de

  3. Detector location selection based on VIP analysis in near-infrared detection of dural hematoma

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    Qiuming Sun

    2018-03-01

    Full Text Available Detection of dural hematoma based on multi-channel near-infrared differential absorbance has the advantages of rapid and non-invasive detection. The location and number of detectors around the light source are critical for reducing the pathological characteristics of the prediction model on dural hematoma degree. Therefore, rational selection of detector numbers and their distances from the light source is very important. In this paper, a detector position screening method based on Variable Importance in the Projection (VIP analysis is proposed. A preliminary modeling based on Partial Least Squares method (PLS for the prediction of dural position μa was established using light absorbance information from 30 detectors located 2.0–5.0 cm from the light source with a 0.1 cm interval. The mean relative error (MRE of the dural position μa prediction model was 4.08%. After VIP analysis, the number of detectors was reduced from 30 to 4 and the MRE of the dural position μa prediction was reduced from 4.08% to 2.06% after the reduction in detector numbers. The prediction model after VIP detector screening still showed good prediction of the epidural position μa. This study provided a new approach and important reference on the selection of detector location in near-infrared dural hematoma detection. Keywords: Detector location screening, Epidural hematoma detection, Variable importance in the projection

  4. Meningeal norepinephrine produces headache behaviors in rats via actions both on dural afferents and fibroblasts.

    Science.gov (United States)

    Wei, Xiaomei; Yan, Jin; Tillu, Dipti; Asiedu, Marina; Weinstein, Nicole; Melemedjian, Ohannes; Price, Theodore; Dussor, Gregory

    2015-10-01

    Stress is commonly reported to contribute to migraine although mechanisms by which this may occur are not fully known. The purpose of these studies was to examine whether norepinephrine (NE), the primary sympathetic efferent transmitter, acts on processes in the meninges that may contribute to the pain of migraine. NE was applied to rat dura using a behavioral model of headache. Primary cultures of rat trigeminal ganglia retrogradely labeled from the dura mater and of rat dural fibroblasts were prepared. Patch-clamp electrophysiology, Western blot, and ELISA were performed to examine the effects of NE. Conditioned media from NE-treated fibroblast cultures was applied to the dura using the behavioral headache model. Dural injection both of NE and media from NE-stimulated fibroblasts caused cutaneous facial and hindpaw allodynia in awake rats. NE application to cultured dural afferents increased action potential firing in response to current injections. Application of NE to dural fibroblasts increased phosphorylation of ERK and caused the release of interleukin-6 (IL-6). These data demonstrate that NE can contribute to pro-nociceptive signaling from the meninges via actions on dural afferents and dural fibroblasts. Together, these actions of NE may contribute to the headache phase of migraine. © International Headache Society 2015.

  5. Tipos especiales de niños

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    Mercedes Rodrigo Bellido

    1946-09-01

    Full Text Available En las tres últimas lecciones han sido expuestas algunas consideraciones referentes a niños y adolescentes desde el nacimiento hasta el dintel de la juventud. En todas ellas hemos procurado poner de relieve la necesidad de individualizar el conocimiento de cada niño para obtener mejores resultados en su adaptación a su futura vida de adultos, En todas ellas  nos hemos referido al llamado niño normal. Nos corresponde en la lección de hoy ocuparnos can la superficialidad característica de estas charlas tipo-muestrario, de otras categorías de niños muy dignos de interés.. quienes unas por exceso, otros por defecto, otros por dificultades de adaptación por diferentes causas, se desvían de la línea media de la normalidad. Consideramos que no está fuera del lugar, aquí, el tema de los niños excepcionales y por el contrario que es necesario intensificar el estudio de los trastornos de la vida mental y emocional de los niños en la preparación de los estudiantes de Medicina. Y no es nuestra solo esta opinión; no hace mucho tiempo en la Medical School de Ia Universidad de Minnessota hemos sabido que se ha hecho un intento de considerar y evaluar factores emocionales ambientales sobre las mismas bases que los descubrimientos fisiológicos.

  6. Diabetes mellitus en adultos mayores costarricenses

    Directory of Open Access Journals (Sweden)

    Rosero-Bixby, Luis

    2007-07-01

    Full Text Available El propósito del artículo es describir la prevalencia de la diabetes mellitus (DM entre los adultos mayores costarricenses. Se analiza la magnitud de la prevalencia, los problemas de medición de la misma, así como los factores asociados con la enfermedad, la enfermedad controlada, y el tener niveles altos de hemoglobina glicosilada (HbA1C entre la población sin diagnóstico previo de DM. Una cuarta parte de los adultos mayores de Costa Rica padecen de DM y cerca de la mitad de los que la padecen, no la tienen controlada. Los factores asociados con la prevalencia de la enfermedad son los usuales destacados por la literatura científica: actividad física, obesidad e historia familiar de DM. Se halla evidencia de un posible problema de acceso diferencial a servicios de control de DM, ya que los adultos mayores que habitan fuera de la gran área metropolitana de San José tienen un riesgo menor de tener controlada su enfermedad. Los adultos mayores sin pensión también tienen un riesgo mayor de tener niveles altos de HbA1C.

  7. Diabetes mellitus en adultos mayores costarricenses

    Directory of Open Access Journals (Sweden)

    Gilbert Brenes-Camacho

    2007-01-01

    Full Text Available El propósito del artículo es describir la prevalencia de la diabetes mellitus (DM entre los adultos mayores costarricenses. Se analiza la magnitud de la prevalencia, los problemas de medición de la misma, así como los factores asociados con la enfermedad, la enfermedad controlada, y el tener niveles altos de hemoglobina glicosilada (HbA1C entre la población sin diagnóstico previo de DM. Una cuarta parte de los adultos mayores de Costa Rica padecen de DM y cerca de la mitad de los que la padecen, no la tienen controlada. Los factores asociados con la prevalencia de la enfermedad son los usuales destacados por la literatura científica: actividad física, obesidad e historia familiar de DM. Se halla evidencia de un posible problema de acceso diferencial a servicios de control de DM, ya que los adultos mayores que habitan fuera de la gran área metropolitana de San José tienen un riesgo menor de tener controlada su enfermedad. Los adultos mayores sin pensión también tienen un riesgo mayor de tener niveles altos de HbA1C.

  8. Sobrecarga y calidad de vida del cuidador principal del adulto mayor

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    Jack Roberto Silva Fhon

    2016-09-01

    Full Text Available Objetivo: Determinar la sobrecarga de trabajo y la calidad de vida del cuidador principal del adulto mayor atendido en un consultorio de geriatría. Metodología: Estudio cuantitativo, descriptivo, de corte transversal, realizado con 183 adultos mayores y sus respectivos cuidadores atendidos en un consultorio de geriatría. Para la recolección de los datos, fueron utilizados los instrumentos de perfil demográfico para el adulto mayor y su cuidador Escala de Zarit y The Medical Outcomes Study 36-item (sf-36. El análisis se realizó por medio de la estadística descriptiva y de la prueba de correlación de Spearman, con un nivel de significancia de p ≤ 0,05. Resultados: En los adultos mayores, hubo predominio del sexo masculino; la edad promedio fue de 74,8 años y estaban casados/as. En los cuidadores, predominó el sexo femenino; la edad promedio fue de 44,3 años. El total de cuidadores tenían estudios superiores, estaban casados/as y eran hijos/as de los adultos mayores. Según la evaluación con la Escala de Zarit, el 18,1% presentó algún tipo de sobrecarga; en cuanto a la calidad de vida, las dimensiones con menor puntuación fueron Salud general, Salud mental y Vitalidad. Se obtuvo una correlación inversa entre la puntuación total de la Escala de Zarit y todas las dimensiones de la calidad de vida. Conclusión: Se observó que el desgaste de la calidad de vida se debe a la sobrecarga en el cuidado del adulto mayor. Por lo tanto, se hace necesario acompañar el estado de salud de los cuidadores con la finalidad de prevenir alteraciones físicas y mentales.

  9. Uso de medicamentos en adultos mayores de Bogotá, Colombia

    Directory of Open Access Journals (Sweden)

    Carlos Cano-Guitierrez

    Full Text Available Objetivos. Determinar la frecuencia y tipo de medicamentos que utiliza un grupo de adultos mayores que viven en lacapital colombiana, y cuáles son potencialmente inapropiados, con base en los criterios revisados de Beers. Materiales y métodos. Los datos fueron obtenidos del estudio SABE (estudio de salud, bienestar y envejecimiento que se llevó a cabo en áreas urbanas y rurales de Bogotá en el 2012. Se utilizó la prueba U de Mann-Whitney para analizar las diferencias por sexo en los diferentes grupo de edad con relación al número de medicamentos tomados. Resultados. Un total de 1268 (63,4% de los adultos mayores fueron mujeres; entre los participantes, 1514 (75,7% tenían 5 años de educación básica o menos. El promedio de medicamentos tomados en general fue de 3,24 siendo mayor en mujeres (3,50 que en hombres (2,79. Un total de 549 sujetos (27,4% reportaron recibir cinco medicamentos o más. De los medicamentos utilizados, 443 (6,9% eran potencialmente inapropiados de acuerdo con los criterios de Beers. La prevalencia autorreportada de hipertensión fue de 56,9% y para diabetes de 17,5%. Solo 311 sujetos (15,6% no tomaban ningún medicamento. Conclusiones. El uso de medicamentos inapropiados es un problema importante que afecta a los adultos mayores en Bogotá. Estudios adicionales deberán identificar factores que aumentan el riesgo de polifarmacia y uso inapropiado de medicamentos y diseñar intervenciones para prevenir el uso inapropiado de medicamentos entre adultos mayores.

  10. Estrategia educativa para incrementar el nivel de información sobre violencia intrafamiliar en los adultos mayores.

    Directory of Open Access Journals (Sweden)

    Yanelis Emilia Tabio Henry

    2015-09-01

    Full Text Available Se realizó una investigación cuasi experimental que comprendió de tres fases: la primera fase consistió en un estudio de tipo descriptivo longitudinal prospectivo a 32 adultos mayores que constituyen la muestra, que fueron atendidos en el Centro Comunitario de Salud Mental perteneciente al municipio de Jatibonico, provincia Sancti Spíritus. En la segunda fase se diseñó una estrategia educativa con participación comunitaria y en la tercera fase se realizó la evaluación de la estrategia, desde el 1ro de enero del 2010 al 31 de diciembre del 2012, con el objetivo de incrementar el nivel de información sobre violencia intrafamiliar en los adultos mayores. Los adultos mayores que fueron víctimas de violencia en su mayoría son mujeres, entre 70 -79 años, jubiladas, con vínculo conyugal. Los agresores fueron las hijas, que conviven con la víctima, siendo el maltrato psicológico el que predominó, el principal síntoma encontrado después del maltrato fue la insatisfacción con su vida. La estrategia educativa se caracterizó por elevar el nivel de información sobre la violencia intrafamiliar a los familiares de los adultos mayores violentados desde la perspectiva de trabajo educativo y comunitario.

  11. 231. Cirugía cardíaca en adultos con cardiopatías congénitas: ¿qué pacientes y patologías intervenimos actualmente?

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    E.C. Ruiz-Solano

    2012-04-01

    Conclusiones: La cirugía congénita sobre pacientes adultos representa una actividad de relevancia en la cirugía cardíaca de hoy día. Nuestros resultados evidencian que este tipo de intervenciones se puede llevar a cabo con una baja morbimortalidad.

  12. Tipos de parafasias que presentan un grupo de pacientes afásicos fluentes que acuden a un centro hospitalario

    OpenAIRE

    Aguilar, Angelica; Panaifo, Erika; Paredes, José Alberto

    2013-01-01

    El objetivo de la investigación fue conocer los tipos de parafasias en un grupo de pacientes adultos afásicos fluentes que acuden a un Centro Hospitalario, a través del Test de Boston. La metodología que se utilizó fue descriptivo simple, y el estudio tuvo una duración de 5 meses contando con la participación de 6 pacientes. A través de la presente investigación se logró conocer el tipo de parafasia que presenta cada paciente, encontrando en los resultados que existe una relación entre ...

  13. Prevalência da escoliose lombar em adultos Prevalencia de la escoliosis lumbar en adultos Prevalence of lumbar scoliosis in adults

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    Djalma Castro de Amorim Junior

    2011-01-01

    Full Text Available OBJETIVO: Avaliar a prevalência da escoliose degenerativa do adulto (tipo de novo em uma amostra da população brasileira. MÉTODOS: foram estudados 1149 exames radiográficos simples de abdome na incidência anteroposterior, realizados no Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, no período de julho de 2008 a fevereiro de 2009. RESULTADOS: a prevalência da escoliose do adulto na amostra da população estudada foi de 1,74%, sendo maior na faixa etária entre 60 e 69 anos. Não foi observada diferença estatisticamente significativa (p = 0,41 entre os sexos, e a medida média do ângulo da escoliose foi de 19,1º. CONCLUSÃO: A PREVAlência da escoliose do adulto na amostra da população estudada está dentro dos resultados já apresentados na literatura.OBJETIVO: Evaluar la prevalenciade la escoliosis degenerativa del adulto (tipo de 'novo' en una muestra de la población. MÉTODOS: Se estudiaron 1149 radiografías de abdomen simple en proyección anteroposterior; esto se realizó en el Hospital de la Facultad de Medicina de Ribeirão Preto de julio de 2008 a febrero de 2009. RESULTADOS: La preponderanciade la escoliosis en la población de la muestra de adultos estudiados fue de 1,74%, siendo mayor en el grupo entre 60 y 69 años. No hubo diferencias significativas (p = 0,41 entre los sexos, y la medida promediodel ángulo de la escoliosis fue de 19,1º. CONCLUSIÓN: La prevalencia de la escoliosis en la muestra de adultos de la población estudiada está de acuerdo con los resultados presentados en la literatura.OBJECTIVE: to evaluate the prevalence of adult degenerative scoliosis (de novo in a sample of the population. METHODS: We studied 1149 plain anteroposterior abdominal radiographs in achieved in the Hospital das Clínicas of the Faculty of Medicine of Ribeirão Preto from July 2008 to February 2009. RESULTS: The prevalence of scoliosis in the adult population sample studied was 1.74%, being higher in the

  14. Reversibility of cognitive disorder after treatment of dural arteriovenous fistulae

    International Nuclear Information System (INIS)

    Kai, Yutaka; Ito, Koichi; Kinjo, Tatsuya; Hokama, Youhei; Nagamine, Hideki; Kushi, Sukemitsu; Kinjo, Shigemasa; Tsuchida, Yukihiro; Sugimoto, Kouichi; Yoshii, Yoshihiko; Morioka, Motohiro; Yano, Shigetoshi; Ohmori, Yuki; Kawano, Takayuki; Nakamura, Hideo; Makino, Keishi; Kuratsu, Jun-ichi; Hamada, Jun-ichiro

    2009-01-01

    Dural arteriovenous fistulae (DAVF) occasionally lead to cognitive disorders whose reversibility after DAVF treatment remains unclear. We studied changes on pre- and post-treatment magnetic resonance imaging (MRI) and single photon emission computed tomography (SPECT) scans in ten patients with cognitive disorder due to DAVF. We studied the symptoms, pre- and post-treatment MRI scans, SPECT findings, and mini-mental state examination (MMSE) and treatment results in ten patients with cognitive disorder due to DAVF. They were divided into two groups; the post-treatment MMSE score exceeded 25 points in group 1 (n = 6) and was lower than 24 points in group 2 (n = 4). In the six group 1 patients, pretreatment diffusion-weighted images (DWI) showed hyperintense areas, and SPECT scans demonstrated the preservation of vasoreactivity after acetazolamide challenge. In the four group 2 patients, pretreatment SPECT demonstrated hypoperfusion areas that coincided with the hyperintense areas seen on DWI; there were areas with marked disturbance in vasoreactivity. The post-treatment MMSE score in groups 1 and 2 improved by 13.7 ± 2.4 and 3.8 ± 1.0 points, respectively; the difference was significant at p < 0.01. In patients with cognitive disorder due to DAVF, the preservation of vasoreactivity on SPECT after acetazolamide challenge indicates that their cognitive disorder may be reversible by DAVF treatment. (orig.)

  15. Screen for intracranial dural arteriovenous fistulae with carotid duplex sonography.

    Science.gov (United States)

    Tsai, L-K; Yeh, S-J; Chen, Y-C; Liu, H-M; Jeng, J-S

    2009-11-01

    Early diagnosis and management of intracranial dural arteriovenous fistulae (DAVF) may prevent the occurrence of stroke. This study aimed to identify the best carotid duplex sonography (CDS) parameters for screening DAVF. 63 DAVF patients and 170 non-DAVF patients received both CDS and conventional angiography. The use of seven CDS haemodynamic parameter sets related to the resistance index (RI) of the external carotid artery (ECA) for the diagnosis of DAVF was validated and the applicability of the best CDS parameter set in 20 400 patients was tested. The CDS parameter set (ECA RI (cut-off point = 0.7) and internal carotid artery (ICA) to ECA RI ratio (cut-off point = 0.9)) had the highest specificity (99%) for diagnosis of DAVF with moderate sensitivity (51%). Location of the DAVF was a significant determinant of sensitivity of detection, which was 70% for non-cavernous DAVF and 0% for cavernous sinus DAVF (pdetected abnormality in 92 of 20 400 patients. These abnormalities included DAVF (n = 25), carotid stenosis (n = 32), vertebral artery stenosis (n = 7), intracranial arterial stenosis (n = 6), head and neck tumour (n = 3) and unknown aetiology (n = 19). Combined CDS parameters of ECA RI and ICA to ECA RI ratio can be used as a screening tool for the diagnosis of DAVF.

  16. Intervenciones musicales para la ansiedad odontológica en pacientes pediátricos y adultos

    OpenAIRE

    Marta Sanjuán Navais

    2016-01-01

    La ansiedad odontológica ha sido identificada como un problema común tanto en niños como en adultos. La ansiedad odontológica se refiere a un estado de aprensión de que algo terrible va a suceder en relación con el tratamiento dental y se combina con una sensación de pérdida de control. Se informa que uno de cada seis adultos sufren algún tipo de ansiedad y en los niños entre un 5,7% y el 19,5%. Los pacientes con ansiedad odontológica tienden a descuidar el cuidado dental, lo cual plantea un ...

  17. Surgical management of dural arteriovenous fistulas with transosseous arterial feeders involving the jugular bulb.

    Science.gov (United States)

    Tirakotai, W; Benes, L; Kappus, C; Sure, U; Farhoud, A; Bien, S; Bertalanffy, H

    2007-01-01

    Dural arteriovenous fistulas located in the vicinity of the jugular foramen are complex vascular malformations and belong to the most challenging skull base lesions to treat. The authors comprehensively analyze multiple features in a series of dural arteriovenous fistulas with transosseous arterial feeders involving the jugular bulb. Four patients who underwent surgery via the transcondylar approach to treat dural arteriovenous fistulas around the jugular foramen were retrospectively reviewed. Previously, endovascular treatment was attempted in all patients. The success of the surgical treatment was examined with postoperative angiography. Complete obliteration of the dural arteriovenous fistulas (DAVFs) was achieved in three patients, and significant flow reduction in one individual. All patients had a good postoperative outcome, and only one experienced mild hypoglossal nerve palsy. Despite extensive bone drilling, an occipitocervical fusion was necessary in only one patient with bilateral lesions. The use of an individually tailored transcondylar approach to treat dural arteriovenous fistulas at the region of the jugular foramen is most effective. This approach allows for complete obliteration of the connecting arterial feeders, and removal of bony structures containing pathological vessels.

  18. Bacterial Cellulose Membranes Used as Artificial Substitutes for Dural Defection in Rabbits

    Directory of Open Access Journals (Sweden)

    Chen Xu

    2014-06-01

    Full Text Available To improve the efficacy and safety of dural repair in neurosurgical procedures, a new dural material derived from bacterial cellulose (BC was evaluated in a rabbit model with dural defects. We prepared artificial dura mater using bacterial cellulose which was incubated and fermented from Acetobacter xylinum. The dural defects of the rabbit model were repaired with BC membranes. All surgeries were performed under sodium pentobarbital anesthesia, and all efforts were made to minimize suffering. All animals were humanely euthanized by intravenous injection of phenobarbitone, at each time point, after the operation. Then, the histocompatibility and inflammatory effects of BC were examined by histological examination, real-time fluorescent quantitative polymerase chain reaction (PCR and Western Blot. BC membranes evenly covered the surface of brain without adhesion. There were seldom inflammatory cells surrounding the membrane during the early postoperative period. The expression of inflammatory cytokines IL-1β, IL-6 and TNF-α as well as iNOS and COX-2 were lower in the BC group compared to the control group at 7, 14 and 21 days after implantation. BC can repair dural defects in rabbit and has a decreased inflammatory response compared to traditional materials. However, the long-term effects need to be validated in larger animals.

  19. Comparison of dural puncture epidural technique versus conventional epidural technique for labor analgesia in primigravida

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    Pritam Yadav

    2018-01-01

    Full Text Available >Background: Dural puncture epidural (DPE is a method in which a dural hole is created prior to epidural injection. This study was planned to evaluate whether dural puncture improves onset and duration of labor analgesia when compared to conventional epidural technique.Methods and Materials: Sixty term primigravida parturients of ASA grade I and II were randomly assigned to two groups of 30 each (Group E for conventional epidural and Group DE for dural puncture epidural. In group E, epidural space was identified and 18-gauge multi-orifice catheter was threaded 5 cm into the epidural space. In group DE, dura was punctured using the combines spinal epidural (CSE spinal needle and epidural catheter threaded as in group E followed by 10 ml of injection of Ropivacaine (0.2% with 20 mcg of Fentanyl (2 mcg/ml in fractions of 2.5 ml. Later, Ropivacaine 10 ml was given as a top-up on patient request. Onset, visual analouge scale (VAS, sensory and motor block, haemodynamic variables, duration of analgesia of initial dose were noted along with mode of delivery and the neonatal outcome.Results: Six parturients in group DE achieved adequate analgesia in 5 minutes while none of those in group E (P 0.05.Conclusions: Both techniques of labor analgesia are efficacious; dural puncture epidural has the potential to fasten onset and improve quality of labor analgesia when compared with conventional epidural technique.

  20. Experimental inflammation following dural application of complete Freund's adjuvant or inflammatory soup does not alter brain and trigeminal microvascular passage

    DEFF Research Database (Denmark)

    Lundblad, Cornelia; Haanes, Kristian A; Grände, Gustaf

    2015-01-01

    , following dural application of complete Freund's adjuvant (CFA) or inflammatory soup (IS) on brain and trigeminal microvascular passage. METHODS: In order to address this issue, we induced local inflammation in male Sprague-Dawley-rats dura mater by the addition of CFA or IS directly on the dural surface...

  1. Crescimento de genótipos de frangos tipo caipira

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    R. C. Veloso

    2015-10-01

    Full Text Available RESUMOObjetivou-se com este trabalho comparar o padrão de crescimento, mediante ajustes das respectivas curvas de crescimento por modelos não lineares, bem como estudar o desenvolvimento de cortes de carcaça em relação ao peso da carcaça em diferentes genótipos de frangos tipo caipira. Foram utilizados 840 pintos de um dia, machos, distribuídos em delineamento inteiramente ao acaso, dos seguintes genótipos da linhagem Redbro: Caboclo, Carijó, Colorpak, Gigante Negro, Pesadão Vermelho, Pescoço Pelado e Tricolor. As aves foram alojadas em 28 boxes, sendo 30 aves/boxe, em galpão de alvenaria com acesso a um piquete de 45m², com quatro repetições. O peso corporal individual dos frangos foi medido ao nascer, aos 14, 28, 42, 56, 70 e 84 dias de idade. Para a determinação das curvas de crescimento do peso corporal das aves, os dados coletados foram avaliados por meio dos modelos não lineares: Brody, Gompertz, Logístico, Richards e von Bertalanffy. Foi empregado o PROC NLIN do SAS, utilizando-se o método interativo de Gauss-Newton. Os critérios usados para escolha do modelo de melhor ajuste da curva de crescimento foram o coeficiente de determinação, o desvio padrão assintótico, o desvio médio absoluto dos resíduos e o índice assintótico. As análises para obtenção dos coeficientes alométricos foram realizadas por meio do PROC GLM do SAS para os genótipos Carijó, Colorpak, Pesadão Vermelho, Pescoço Pelado e Tricolor. Foram avaliados os pesos da carcaça, do peito, das coxas, das sobrecoxas, das pernas e das asas das aves abatidas aos 85 dias de idade. Apenas as equações propostas por Gompertz, von Bertalanffy e Logístico atingiram a convergência, e o modelo proposto por von Bertalanffy foi o mais adequado para descrever o crescimento dos genótipos de frangos caipiras. Todos os cortes avaliados apresentaram crescimento tardio em relação ao peso da carcaça em genótipos de frangos tipo caipira.

  2. Spontaneous acute subdural hematoma: A rare presentation of a dural intracranial fistula.

    Science.gov (United States)

    de Aguiar, Guilherme Brasileiro; Veiga, José Carlos Esteves; Silva, João Miguel de Almeida; Conti, Mario Luiz Marques

    2016-03-01

    Dural arteriovenous fistulas are acquired lesions between the meningeal arteries and their associated draining veins. They may have highly variable clinical presentations and evolution, from severe neurological deficit to no or trivial symptoms. Intracranial hemorrhage occurs in less than 24% of all dural fistulas, and the bleeding is usually subarachnoid, more infrequently intracerebral, and rarely in the subdural space. Here, we present a rare case of a patient who presented with a subdural spontaneous hemorrhage. After investigation by cerebral angiography, the diagnosis of a dural arteriovenous fistula was made. The patient underwent uneventful endovascular treatment. As there are with only a few reports in the literature of such a presentation, we present this patient and perform a brief review of the literature. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. Preclinical characterization and safety of a novel hydrogel for augmenting dural repair

    International Nuclear Information System (INIS)

    Strong, Michael J; Carnahan, Michael A; D’Alessio, Keith; Butlin, Jared D G; Butt, Mark T; Asher, Anthony L

    2015-01-01

    Cerebrospinal fluid (CSF) leakage is a potentially serious complication in surgical procedures involving opening of the dura mater. Although several materials have been developed to help achieve watertight dural closures, CSF leakages persist. The goal of this study was to evaluate the performance of a novel hydrogel designed to provide augmentation to standard methods of dural repair. Performance measures such as polymerization time, dimensional swelling, burst strength, and elasticity were examined in laboratory situations. Additionally, biocompatibility in an in vivo rat model was examined. The results demonstrate that this novel hydrogel has superior mechanical strength and tissue adherence with enhanced flexibility, reduced swelling, and quicker set time compared with existing hydrogel dural sealants approved for intra-cranial use. Furthermore, biocompatibility studies demonstrate that this compound is both non-toxic and non-immunogenic. (paper)

  4. A case report of spinal dural arteriovenous fistula: origins, determinants, and consequences of abnormal vascular malformations

    Directory of Open Access Journals (Sweden)

    Sherry M. Zakhary, DO

    2017-06-01

    Full Text Available A spinal dural arteriovenous fistula is an abnormally layered connection between radicular arteries and venous plexus of the spinal cord. This vascular condition is relatively rare with an incidence of 5–10 cases per million in the general population. Diagnosis of spinal dural arteriovenous fistula is differentiated by contrast-enhanced magnetic resonance angiography or structural magnetic resonance imaging, but a definitive diagnosis requires spinal angiography methods. Here, we report a case of a 67-year-old female with a spinal dural arteriovenous fistula, provide a pertinent clinical history to the case nosology, and discuss the biology of adhesive proteins, chemotactic molecules, and transcription factors that modify the behavior of the vasculature to possibly cause sensorimotor deficits.

  5. A case report of spinal dural arteriovenous fistula: origins, determinants, and consequences of abnormal vascular malformations.

    Science.gov (United States)

    Zakhary, Sherry M; Hoehmann, Christopher L; Cuoco, Joshua A; Hitscherich, Kyle; Alam, Hamid; Torres, German

    2017-06-01

    A spinal dural arteriovenous fistula is an abnormally layered connection between radicular arteries and venous plexus of the spinal cord. This vascular condition is relatively rare with an incidence of 5-10 cases per million in the general population. Diagnosis of spinal dural arteriovenous fistula is differentiated by contrast-enhanced magnetic resonance angiography or structural magnetic resonance imaging, but a definitive diagnosis requires spinal angiography methods. Here, we report a case of a 67-year-old female with a spinal dural arteriovenous fistula, provide a pertinent clinical history to the case nosology, and discuss the biology of adhesive proteins, chemotactic molecules, and transcription factors that modify the behavior of the vasculature to possibly cause sensorimotor deficits.

  6. Endovascular and surgical treatment of spinal dural arteriovenous fistulas

    International Nuclear Information System (INIS)

    Andres, Robert H.; University of Berne; Stanford University Medical Center, Department of Neurosurgery, Stanford, CA; University of Berne; Barth, Alain; Medical University of Graz, Department of Neurosurgery, Graz; University of Berne; Guzman, Raphael; Stanford University Medical Center, Department of Neurosurgery, Stanford, CA; University of Berne; Remonda, Luca; El-Koussy, Marwan; Schroth, Gerhard; University of Berne; Seiler, Rolf W.; Widmer, Hans R.; University of Berne

    2008-01-01

    The aim of this retrospective study was to evaluate the clinical outcome of patients with spinal dural arteriovenous fistulas (SDAVFs) that were treated with surgery, catheter embolization, or surgery after incomplete embolization. The study included 21 consecutive patients with SDAVFs of the thoracic, lumbar, or sacral spine who were treated in our institution from 1994 to 2007. Thirteen patients were treated with catheter embolization alone. Four patients underwent hemilaminectomy and intradural interruption of the fistula. Four patients were treated by endovascular techniques followed by surgery. The clinical outcome was assessed using the modified Aminoff-Logue scale (ALS) for myelopathy and the modified Rankin scale (MRS) for general quality of life. Patient age ranged from 44 to 77 years (mean 64.7 years). Surgical as well as endovascular treatment resulted in a significant improvement in ALS (-62.5% and -31.4%, respectively, p<0.05) and a tendency toward improved MRS (-50% and -32%, respectively) scores. Patients that underwent surgery after endovascular treatment due to incomplete occlusion of the fistula showed only a tendency for improvement in the ALS score (-16.7%), whereas the MRS score was not affected. We conclude that both endovascular and surgical treatment of SDAVFs resulted in a good and lasting clinical outcome in the majority of cases. In specific situations, when a secondary neurosurgical approach was required after endovascular treatment to achieve complete occlusion of the SDAVF, the clinical outcome was rather poor. The best first line treatment modality for each individual patient should be determined by an interdisciplinary team. (orig.)

  7. A Rare Case of Composite Dural Extranodal Marginal Zone Lymphoma and Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma

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    Mark Bustoros

    2018-04-01

    Full Text Available BackgroundPrimary extranodal marginal zone lymphoma (MZL of the dura is a rare neoplastic entity in the central nervous system (CNS.MethodsWe used literature searches to identify previously reported cases of primary dural MZL. We also reviewed clinical, pathologic, and radiographic data of an adult patient with concurrent dural MZL and chronic lymphocytic leukemia (CLL/small lymphocytic lymphoma (SLL.ResultsWe identified 104 cases of dural MZL in the literature. None of them presented concurrently with another type of non-Hodgkin lymphoma. This is the first report of composite lymphoma consisting of dural MZL and CLL/SLL in the bone marrow and lymph nodes.ConclusionPrimary dural MZL is a rare, indolent low-grade CNS lymphoma, with a relatively good prognosis. Its treatment is multidisciplinary and often requires surgical intervention due to brain compression, along with low to moderate doses of radiotherapy and/or systemic chemotherapy.

  8. Evaluation of venous congestion in dural arteriovenous fistulae using the acetazolamide test

    International Nuclear Information System (INIS)

    Deguchi, Jun; Yamada, Makoto; Kobata, Hitoshi; Kuroiwa, Toshihiko

    2002-01-01

    The pattern of venous drainage determines the clinical presentation of dural arteriovenous fistulas (AVFs). We assessed the degree of venous congestion in dural AVFs using acetazolamide test and stable Xenon-CT. In 11 patients (8 sigmoid-transverse dural AVFs, 3 cavernous dural AVFs) before treatment and in 8 patients 6 months after treatment, cerebral hemodynamics were studied by stable Xenon-CT. Regions of interest (ROI) were placed in the temporo-occipital region in cases of sigmoid-transverse AVFs, and in the frontal operculum in cases of cavernous AVFs. Patients were classified into 5 groups according to Cognard's classification. In the groups without venous reflux (Cognard type I) and reflux only to the venous sinus (type IIa), regional cerebral blood flow (rCBF) at rest and after acetazolamide challenge were normal. In the group showing reflux to the cortical vein (type IIb), the increase in rCBF after acetazolamide challenge on the lesion side was less than that on the opposite side. In the group showing reflux to both cortical vein and sinus (type IIa+b), rCBF did not increase after acetazolamide challenge. The CBF and increase in rCBF after acetazolamide in the symptomatic group were significantly lower than those in the asymptomatic group. After embolization, the increase in rCBF by acetazolamide improved in all except for type III cases. Cerebral venous hypertension in dural AVFs causes weak response to acetazolamide challenge. The degree of venous hypertension can be evaluated quantitatively by acetazolamide challenge and stable Xenon-CT. Therefore acetazolamide challenge is useful for determination of the embolization of dural AVFs. (author)

  9. Evaluación de los estereotipos negativos hacia la vejez en jóvenes y adultos

    OpenAIRE

    Menendez Alvarez-Dardet, Susana; Cuevas Toro, Ana María; Pérez Padilla, Javier; Lorence Lara, Bárbara

    2016-01-01

    Introducción: Los estereotipos negativos hacia el envejecimiento y la vejez pueden influir negativamente en la relación y el trabajo con las personas mayores. El CENVE es una herramienta diseñada para evaluar este tipo de estereotipos viejistas, pero su estructura factorial no ha sido evaluada con jóvenes y adultos. En este trabajo se analiza la estructura factorial del CENVE con sujetos que aún no han llegado a la vejez, y se examinan las relaciones de los estereotipos edadistas con diversos...

  10. Descubriendo los sentimientos y comportamientos que experimenta el adulto mayor con dolor crónico benigno

    Directory of Open Access Journals (Sweden)

    Alejandra María Alvarado García

    Full Text Available Objetivo: Describir los comportamientos y sentimientos que experimentan los adultos mayores no institucionalizados frente al dolor crónico benigno. Métodos: Estudio cualitativo tipo teoría fundamentada a 25 adultos mayores con dolor crónico benigno residentes en las ciudades de Medellín y Bogotá. La técnica utilizada para recolectar la información fue la entrevista en profundidad. El análisis se hizo utilizando las herramientas de la teoría fundamentada bajo los lineamientos de Strauss y Corbin. Resultados: El estudio arrojó dos categorías principales, las cuales se nutren de códigos que dan muestra de los comportamientos y sentimientos percibidos por los adultos mayores. El adulto mayor decide expresar su comportamiento a través del llanto, la manipulación frente a los miembros de su familia, mientras que otros al contrario lo callan y esconden su dolor frente a la familia. Aparecen una serie de sentimientos y emociones como la angustia, la tristeza, el miedo, el estrés, la impotencia, la desesperanza y el aislamiento, los cuales dan cuenta de una nueva perspectiva que lleva a entender aún más cómo la experiencia del dolor crónico impacta en todas las dimensiones de los adultos mayores. Conclusiones: El estudio permitió describir los comportamientos y sentimientos de los adultos mayores no institucionalizados frente al dolor crónico benigno y a su experiencia con los servicios de salud. Esta mezcla de emociones sugiere un posterior agotamiento físico y mental en el adulto mayor despojándolo de toda su energía y arrastrándolo a experimentar emociones negativas que agudizarán sus síntomas y afectarán a otras funciones normales de su cuerpo.

  11. Caracterización de la familia del adulto mayor

    Directory of Open Access Journals (Sweden)

    Yahima Limia Núñez

    2014-08-01

    Full Text Available El envejecimiento en la familia constituye un problema mundial y nacional, teniendo en cuenta esa premisa se realizó un estudio de tipo descriptivo, con el uso de técnicas cuantitativas y cualitativas, para caracterizar las familias donde viven adultos mayores, pertenecientes al área de salud del policlínico docente Dr. Gustavo Aldereguía Lima. Se seleccionaron al azar diez familias del área incluida en el consultorio médico de la familia 94-01 que cumplieran con los criterios de inclusión, las que se caracterizaron a través de las variables socio-psicológicas: estructura, crisis, funcionamiento y percepción familiar; los datos se obtuvieron a partir de las técnicas de entrevista a la familia, la prueba de percepción de funcionamiento familiar (FF-SIL y la prueba de percepción de las relaciones familiares. En las familias estudiadas predominó la existencia de una estructura pequeña; nuclear y unigeneracional; multigeneracional. Las funciones que mejor cumplieron las familias fueron la económica y la educativo-cultural; y las crisis normativas que predominaron fueron la jubilación, el envejecimiento y la enfermedad. El funcionamiento familiar que prevaleció fue el funcional; los indicadores más afectados fueron los roles, la permeabilidad, la comunicación y la adaptabilidad; en la percepción familiar predominaron las familias armónicas, seguidas de las poco armónicas. Los indicadores más afectados fueron el sistema de apoyo, la comunicación y el desempeño de roles. Se concluyó que las familias presentaron fundamentalmente una estructura pequeña y nuclear, son funcionales y son armónicas

  12. [Feasibility and efficiency of embolization of spinal dural arteriovenous fistula].

    Science.gov (United States)

    Zhang, Hong-qi; Liu, Jiang; Wang, Jian-sheng; Zhi, Xing-long; Zhang, Peng; Bian, Li-song; He, Chuan; Ye, Ming; Wang, Zhi-chao; Li, Meng; Ling, Feng

    2013-03-01

    To evaluate the feasibility and efficiency of embolization of spinal dural arteriovenous fistula (SDAVF). From December 2010 to May 2012, there were 104 cases of SDAVF were treated, and 26 cases were selected to be treated with embolization. The inclusion criteria was as follows: (1) No anterior or posterior spinal artery originated from the fistula segment; (2) The segmental artery can be catheterized with guiding or micro catheter; (3) High flow in fistula; (4) Patient's situation was not suitable for surgery or general anesthesia. Among 26 cases, there were 22 male and 4 female patients, the average age was 55.9 years (ranged from 34 to 81 years). The locations of SDAVF were 10 cases in thoracic, 9 in lumbar and 7 in sacral segment. The main symptoms were progressive numbness and weakness in both lower extremities, most cases accompanied with difficulties in urination and defecation. The average history was 17.1 months (from 1 to 156 months). ONYX-18 liquid embolic agent or Glubran-2 surgical glue were used as embolic material. The patients not cured with embolization were treated with surgery in the following 1 - 2 weeks. Follow-up evaluation was done with MRI after 3 months and DSA after 6 months, besides physical examination. Fifteen from 26 cases achieved immediate angiographic cure results: 14 in 20 cases which embolized with ONYX-18; only 1 in 6 cases with Glubran-2. Three in 10 cases of thoracic SDAVF and 12 in 16 cases of lumbar/sacral SDAVF were cured with embolization. Partially embolized cases were treated with surgical obliteration of drainage veins within 2 weeks. Cured patients experienced immediate improvement after embolization and kept getting better in the follow-up. All the patients had MRI follow-up after 3 months and DSA follow-up after 6 months. In 6 month's follow-up, MRI showed the edema and flow void signal in the spinal cord disappeared. DSA showed no fistula recurrence or remnant. There was no deterioration case in all of the embolized

  13. O potencial evocado cognitivo em adultos normais

    Directory of Open Access Journals (Sweden)

    Franco Glaucio M.

    2001-01-01

    Full Text Available O objetivo deste estudo foi avaliar os resultados do potencial cognitivo auditivo em um grupo de adultos normais. Os testes foram realizados registrando-se a resposta evocada em Cz e Fz. Os dados obtidos foram analisados estatisticamente. São descritas neste trabalho as latências médias de N1, P2, P2AP, N2 e P3, a amplitude de P3, bem como o desvio padrão destas variáveis. Comentam-se algumas dificuldades encontradas na interpretação do teste destacando as limitações de seu uso clínico.

  14. EL SINDROME VESTIBULAR EN EL ADULTO MAYOR

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    Dr. Hamlet Suárez

    2016-11-01

    Full Text Available El vértigo, la inestabilidad y las caídas tienen una incidencia relevante en el adulto mayor, disminuye su calidad de vida y puede ser causa de muerte en esta población. Este artículo describe las presentaciones clínicas y el abordaje de la evaluación de la patología vestibular en este grupo de edad, utilizando diferentes instrumentos para el diagnóstico así como también las reglas generales del tratamiento.

  15. Enfermedades endocrinas en el adulto mayor

    Directory of Open Access Journals (Sweden)

    B. Carlos García, Dr.

    2013-09-01

    A pesar de la heterogeneidad, múltiple co morbilidad y escasa literatura en que se incluye adultos mayores, se proponen algunas recomendaciones para el tratamiento individual del paciente diabético anciano, se revisan las particularidades del diagnóstico y tratamiento del híper e hipotiroidismo, algunas ideas en relación al manejo de la osteoporosis en la mujer mayor y el hombre anciano. Finalmente se aborda la dificultad diagnóstica del hipogonadismo tardío con las indicaciones y contra indicaciones del uso de testosterona.

  16. Performance of a new quantitative method for assessing dural ectasia in patients with FBN1 mutations and clinical features of Marfan syndrome

    International Nuclear Information System (INIS)

    Soeylen, Bahar; Schmidtke, Joerg; Arslan-Kirchner, Mine; Hinz, Kerstin; Prokein, Jana; Becker, Hartmut

    2009-01-01

    This study presents a comparison of established methods for measuring dural ectasia with a new quantitative method of assessing this clinical feature. Seventeen patients with an identified mutation in FBN1 were examined for dural ectasia. The results were compared with 17 age- and sex-matched controls. Our images were also evaluated using the two methods of quantifying dural ectasia, namely those of Ahn et al. and of Oosterhof et al. With our method, 80% MFS1 patients and 7% controls fulfilled the criterion for dural ectasia. Using the method of Oosterhof et al., dural ectasia was found in 88% patients with MFS1 and in 47% controls. Using the method of Ahn et al. 76% patients with Marfan syndrome and 29% controls showed dural ectasia. We present a novel quantitative method of evaluating MRT images for dural ectasia, which, in our own patient cohort, performed better than those previously described. (orig.)

  17. Performance of a new quantitative method for assessing dural ectasia in patients with FBN1 mutations and clinical features of Marfan syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Soeylen, Bahar; Schmidtke, Joerg; Arslan-Kirchner, Mine [Hannover Medical School, Institute of Human Genetics, Hannover (Germany); Hinz, Kerstin [Hannover Medical School, Institute of Diagnostic and Interventional Neuroradiology, Hannover (Germany); Vivantes Klinikum Neukoelln, Institut fuer Radiologie und Interventionelle Therapie, Berlin (Germany); Prokein, Jana [Hannover Medical School, Institute for Biometrics, Hannover (Germany); Becker, Hartmut [Hannover Medical School, Institute of Diagnostic and Interventional Neuroradiology, Hannover (Germany)

    2009-06-15

    This study presents a comparison of established methods for measuring dural ectasia with a new quantitative method of assessing this clinical feature. Seventeen patients with an identified mutation in FBN1 were examined for dural ectasia. The results were compared with 17 age- and sex-matched controls. Our images were also evaluated using the two methods of quantifying dural ectasia, namely those of Ahn et al. and of Oosterhof et al. With our method, 80% MFS1 patients and 7% controls fulfilled the criterion for dural ectasia. Using the method of Oosterhof et al., dural ectasia was found in 88% patients with MFS1 and in 47% controls. Using the method of Ahn et al. 76% patients with Marfan syndrome and 29% controls showed dural ectasia. We present a novel quantitative method of evaluating MRT images for dural ectasia, which, in our own patient cohort, performed better than those previously described. (orig.)

  18. Prevalencia de polifarmacia en adultos mayores residentes de asilos de Hermosillo, Sonora

    Directory of Open Access Journals (Sweden)

    Andrés Canale Segovia

    2014-12-01

    Full Text Available El término polifarmacia se refiere a la utilización de múltiples fármacos por una persona, de manera constante. Debido a que los adultos mayores constituyen el grupo etario con mayor prevalencia de enfermedades crónico-degenerativas, la polifarmacia es un fenómeno común en poblaciones geriátricas. No se conoce con precisión cuál es la prevalencia en un grupo de ancianos asilados del estado de Sonora. Se realizó un estudio transversal, para estimar la prevalencia de polifarmacia en una muestra no probabilística de adultos mayores residentes de asilos de ancianos de Hermosillo, Sonora. La prevalencia de polifarmacia (definida como consumo concomitante de 4 o más fármacos fue de 36.1%, sin diferencias significativas respecto al tipo de enfermedades crónicas padecidas, así como a la edad y sexo de los ancianos asilados. Los sujetos con polifarmacia tuvieron un exceso de riesgo, superior a 10 veces, cuando la prescripción farmacológica era realizada por más de un médico, y tuvieron 5 veces más probabilidad de presentar algún efecto adverso a medicamentos respecto a los sujetos con ausencia de polifarmacia. La polifarmacia es un fenómeno que requiere mayor atención, control e investigación futura, toda vez que los adultos mayores son el grupo poblacional con mayor tendencia de crecimiento en México.

  19. Progressive subcortical calcifications secondary to venous hypertension in an intracranial dural arteriovenous fistula.

    Science.gov (United States)

    Pascoe, Heather M; Lui, Elaine H; Mitchell, Peter; Gaillard, Frank

    2017-05-01

    Intracranial dural arteriovenous fistulas (dAVF) are acquired lesions, with the most commonly reported findings on CT haemorrhage or focal oedema. We describe a case of progressive subcortical calcification on CT secondary to venous hypertension from a high grade dAVF. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. Utility of the magnetic resonance in the evaluation of the dural sinus occlusive disease

    International Nuclear Information System (INIS)

    Delgado, Jorge Andres; Toro, Nancy; Bolivar, Guillermo; Pulgarin, Luis German

    1998-01-01

    The dural sinus occlusive disease is potentially fatal (20-78% cases) and of unspecific clinical symptoms. CT sensibility is only 75% and angiography is invasive. The MRI offers several advantages in the diagnosis due to its high sensibility to flow, high intrinsic contrast and no invasively. The MRI findings in 7 cases are described

  1. Dural sinus thrombosis - A rare manifestation of internal jugular venous occlusion

    Directory of Open Access Journals (Sweden)

    Pooja Binnani

    2012-01-01

    Full Text Available The dural sinus thrombosis is an uncommon complication of a commonly done procedure of central venous catheterisation. We present a case of massive hemorrhagic venous infarct with gross cerebral edema due to dural sinus thrombosis along with right internal jugular vein thrombus. A 21-year-old male patient presented to the emergency department with fever and swelling of the right neck four days following discharge after his prior hospitalization two weeks ago for acute renal failure due to severe gastroenteritis, when he underwent hemodialysis through right internal jugular access. On presentation, he was conscious, with swelling on right side of the neck, which was diagnosed as right internal jugular vein occlusion. However, he rapidly dete-riorated and developed signs of raised intracranial pressure despite being on treatment with heparin. He was diagnosed as having massive hemorrhagic cerebral venous infarct with gross cerebral edema complicated with shift of the ventricles to the left due to dural sinus thrombosis. Despite emergency decompressive craniotomy, he succumbed in the next two days due to coning. Asymptomatic catheter-related thrombosis is frequent in the intensive care units, but major complications like retrograde extension into dural sinus causing thrombosis is rare. A high index of suspicion is required to diagnose this major catastrophe for an early and meaningful intervention.

  2. A dural lymphatic vascular system that drains brain interstitial fluid and macromolecules.

    Science.gov (United States)

    Aspelund, Aleksanteri; Antila, Salli; Proulx, Steven T; Karlsen, Tine Veronica; Karaman, Sinem; Detmar, Michael; Wiig, Helge; Alitalo, Kari

    2015-06-29

    The central nervous system (CNS) is considered an organ devoid of lymphatic vasculature. Yet, part of the cerebrospinal fluid (CSF) drains into the cervical lymph nodes (LNs). The mechanism of CSF entry into the LNs has been unclear. Here we report the surprising finding of a lymphatic vessel network in the dura mater of the mouse brain. We show that dural lymphatic vessels absorb CSF from the adjacent subarachnoid space and brain interstitial fluid (ISF) via the glymphatic system. Dural lymphatic vessels transport fluid into deep cervical LNs (dcLNs) via foramina at the base of the skull. In a transgenic mouse model expressing a VEGF-C/D trap and displaying complete aplasia of the dural lymphatic vessels, macromolecule clearance from the brain was attenuated and transport from the subarachnoid space into dcLNs was abrogated. Surprisingly, brain ISF pressure and water content were unaffected. Overall, these findings indicate that the mechanism of CSF flow into the dcLNs is directly via an adjacent dural lymphatic network, which may be important for the clearance of macromolecules from the brain. Importantly, these results call for a reexamination of the role of the lymphatic system in CNS physiology and disease. © 2015 Aspelund et al.

  3. Imaging findings in patients with ventral dural defects and herniation of neural tissue

    International Nuclear Information System (INIS)

    Baur, A.; Staebler, A.; Reiser, M.; Psenner, K.; Hamburger, C.

    1997-01-01

    The aim of this paper is to describe clinical and imaging findings in three patients with ventral dural defects and herniation of the spinal cord or cauda equina. The literature is reviewed and the clinical, radiological and operative findings are compared. Three patients with ventral dural defects of different etiologies are presented. One patient gave a longstanding history of ankylosing spondylitis, the second patient presents 37 years after spinal trauma, and the third patient presents with spontaneous spinal cord herniation. All patients had typically slowly progressive neurological symptoms with multiple hospitalizations until diagnosis was made. Characteristic findings in postmyelographic CT included a ventral or ventrolateral displacement with deformation of the spinal cord or the cauda equina. Sagittal MRI showed this abrupt and localized anterior deviation of the spinal cord or the cauda equina to the posterior portions of a vertebral body with or without a bony vertebral defect optimally. Additionally, due to the ventral displacement of the spinal cord, the dorsal subarachnoid space was relatively enlarged without evidence of an arachnoid cyst, in all patients. Magnetic resonance imaging and postmyelographic CT can diagnose ventral dural defects with spinal cord herniation or nerve root entrapment. Dural defects must be considered in the presence of neurological symptoms in cases of longstanding ankylosing spondylitis, late sequelae of fractures of vertebral bodies, and without history of spinal trauma or surgery. (orig.). With 3 figs

  4. Epistaxis caused by a dural AV-fistula at the cribriform plate

    NARCIS (Netherlands)

    van Dijk, J. Marc C.; Korsten-Meijer, Astrid G. W.; Mazuri, Aryan

    2014-01-01

    Objectives/HypothesisA dural arteriovenous fistula (DAVF) with cortical venous reflux (CVR) is a dangerous neurovascular entity. A DAVF at the cribriform plate is typically silent until its inevitable presentation with intracranial hemorrhage. Case SummaryA 67-year-old male presented with severe

  5. Contribution of dynamic contrast MR imaging to the differentiation between dural metastasis and meningioma

    International Nuclear Information System (INIS)

    Kremer, S.; Grand, S.; Le Bas, J.F.; Remy, C.; Pasquier, B.; Benabid, A.L.; Bracard, S.

    2004-01-01

    To determine the perfusion-sensitive characteristics of cerebral dural metastases and compare them with the data on meningiomas. Twenty-two patients presenting with dural tumor underwent conventional and dynamic susceptibility-contrast MR imaging: breast carcinoma metastases, two patients; colorectal carcinoma metastasis, one patient; lung carcinoma metastasis, one patient; Merkel carcinoma metastasis, one patient; lymphoma, one patient; meningiomas, 16 patients. The imaging characteristics were analyzed using conventional MR imaging. The cerebral blood volume (CBV) maps were obtained for each patient and the relative CBV (rCBV) in different areas was calculated using the ratio between the CBV in the pathological area (CBVp) and in the contralateral white matter (CBVn). The differentiation between a meningioma and a dural metastasis can be difficult using conventional MR imaging. The rCBVs of lung carcinoma metastasis (1 case: 1.26), lymphoma (1 case: 1.29), breast carcinoma metastasis (2 cases: 1.50,1.56) and rectal carcinoma metastasis (1 case: 3.34) were significantly lower than that of meningiomas (16 cases: mean rCBV = 8.97±4.34, range 4-18). Merkel carcinoma metastasis (1 case: 7.56) showed an elevated rCBV, not different from that of meningiomas. Dural metastases are sometimes indistinguishable from meningiomas using conventional MR imaging. rCBV mapping can provide additional information by demonstrating a low rCBV which may suggest the diagnosis of metastasis. (orig.)

  6. Prevalencia de los trastornos del sueño en el adulto mayor

    Directory of Open Access Journals (Sweden)

    Pando-Moreno Manuel

    2001-01-01

    Full Text Available El presente es un estudio realizado con adultos mayores de la Ciudad de Guadalajara, México, que viven en domicilios particulares. De ellos, el 58% de los hombres y el 76% de las mujeres presentaron al menos un síntoma de trastornos del sueño, según el "Cuestionario General de Salud de Goldberg"; el 8,5% registró positivo en el total de los reactivos. Conforme a los criterios del DSM IV, un 33,3% podría ser considerado "caso" de trastorno del sueño. Estos posibles casos estarían asociados al género, al grado de estudio y con la presencia de depresión; pero no con el estado civil ni la edad. Ante la gran cantidad de "posibles casos" encontrados, que no han sido previamente detectados ni se encuentran en ningún tipo de tratamiento ad hoc, se recomienda promover cursos de actualización en esta materia para los profesionales de la salud (principalmente médicos y enfermeras, de manera que se facilite la detección oportuna de los casos, así como incrementar y mejorar la accesibilidad de los servicios de salud mental para la población de la tercera edad, e incrementar las actividades de educación para la salud para el adulto mayor y los cuidadores de éstos.

  7. Prevalencia de los trastornos del sueño en el adulto mayor

    Directory of Open Access Journals (Sweden)

    Manuel Pando-Moreno

    Full Text Available El presente es un estudio realizado con adultos mayores de la Ciudad de Guadalajara, México, que viven en domicilios particulares. De ellos, el 58% de los hombres y el 76% de las mujeres presentaron al menos un síntoma de trastornos del sueño, según el "Cuestionario General de Salud de Goldberg"; el 8,5% registró positivo en el total de los reactivos. Conforme a los criterios del DSM IV, un 33,3% podría ser considerado "caso" de trastorno del sueño. Estos posibles casos estarían asociados al género, al grado de estudio y con la presencia de depresión; pero no con el estado civil ni la edad. Ante la gran cantidad de "posibles casos" encontrados, que no han sido previamente detectados ni se encuentran en ningún tipo de tratamiento ad hoc, se recomienda promover cursos de actualización en esta materia para los profesionales de la salud (principalmente médicos y enfermeras, de manera que se facilite la detección oportuna de los casos, así como incrementar y mejorar la accesibilidad de los servicios de salud mental para la población de la tercera edad, e incrementar las actividades de educación para la salud para el adulto mayor y los cuidadores de éstos.

  8. Cranial dural arteriovenous shunts. Part 4. Clinical presentation of the shunts with leptomeningeal venous drainage.

    Science.gov (United States)

    Baltsavias, Gerasimos; Spiessberger, Alex; Hothorn, Torsten; Valavanis, Anton

    2015-04-01

    Cranial dural arteriovenous fistulae have been classified into high- and low-risk lesions mainly based on the pattern of venous drainage. Those with leptomeningeal venous drainage carry a higher risk of an aggressive clinical presentation. Recently, it has been proposed that the clinical presentation should be considered as an additional independent factor determining the clinical course of these lesions. However, dural shunts with leptomeningeal venous drainage include a very wide spectrum of inhomogeneous lesions. In the current study, we correlated the clinical presentation of 107 consecutive patients harboring cranial dural arteriovenous shunts with leptomeningeal venous drainage, with their distinct anatomic and angiographic features categorized into eight groups based on the "DES" (Directness and Exclusivity of leptomeningeal venous drainage and features of venous Strain) concept. We found that among these groups, there are significant angioarchitectural differences, which are reflected by considerable differences in clinical presentation. Leptomeningeal venous drainage of dural sinus shunts that is neither direct nor exclusive and without venous strain manifested only benign symptoms (aggressive presentation 0%). On the other end of the spectrum, the bridging vein shunts with direct and exclusive leptomeningeal venous drainage and venous strain are expected to present aggressive symptoms almost always and most likely with bleeding (aggressive presentation 91.5%). Important aspects of the above correlations are discussed. Therefore, the consideration of leptomeningeal venous drainage alone, for prediction of the clinical presentation of these shunts appears insufficient. Angiographic analysis based on the above concept, offers the possibility to distinguish the higher- from the lower-risk types of leptomeningeal venous drainage. In this context, consideration of the clinical presentation as an additional independent factor for the prediction of their clinical

  9. Apoyos en los hogares con al menos un adulto mayor en el Estado de México

    Directory of Open Access Journals (Sweden)

    Lilian CERVANTES

    2013-01-01

    sus corresidentes y los que proporcionan algún tipo de ayuda a estos últimos. La fuente de información que se utiliza es la Encuesta sobre Envejecimiento Demográfico en el Estado de México (esedem 2008, realizada por el Centro de Investigación y Estudios Avanzados de la Población de la Universidad Autónoma del Estado de México (cieap-uaem. Los resultados muestran que los adultos mayores viven principalmente en hogares nucleares y desempeñan papeles en los cuales no solamente tienen que hacerse responsables de sí mismos, sino de otras personas. En la entidad, 42.2 por ciento de las personas mayores recibe algún tipo de ayuda informal y 16.3 por ciento la otorga; los intercambios de apoyos se efectúan con los hijos, la nuera y el yerno, los cónyuges, los nietos y los padres de los adultos mayores.

  10. LINFOMA CUTÁNEO DE CÉLULAS B TIPO CENTRO FOLICULAR CON INFILTRACIÓN A MÉDULA ÓSEA: REPORTE DE UN CASO

    OpenAIRE

    ARENAS SOTO, CLAUDIA MARCELA; MARIÑO ÁLVAREZ, MARÍA LILIANA; CALDERÓN GÓMEZ, JORGE ENRIQUE; GONZÁLEZ C, MARÍA ISABEL; ROBAYO, MARTHA PATRICIA

    2012-01-01

    Los linfomas cutáneos primarios de células B constituyen cerca del 2025% de todos los linfomas. El linfoma cutáneo primario de células B tipo centro folicular es el subtipo más frecuente y se manifiesta principalmente en pacientes adultos con una edad media de 58 años (1), la diseminación extracutánea es muy rara y se presenta con nódulos, tumores o placas solitarios o en grupo usualmente localizados en cabeza o tronco. Presentamos el caso de una paciente con un linfoma primario cutáneo tipo ...

  11. Incontinencia urinaria en el adulto mayor

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    Humberto Chiang, Dr.

    2018-03-01

    Full Text Available Resumen: La incontinencia urinaria (IU es una condición prevalente en la población de adultos mayores, afectando a ambos sexos. Con el envejecimiento de la población será un problema de salud de cada vez mayor relevancia. Su patogenia es compleja y multifactorial, por lo que es fundamental conocer los aspectos fisiopatológicos subyacentes para realizar un adecuado diagnóstico en base a la historia clínica, examen físico y exámenes complementarios solicitados de manera racional. El tratamiento de la IU para adultos mayores no difiere mayormente de los tratamientos utilizados en población más joven. Sin embargo, debe hacerse particular énfasis en identificar comorbilidades, fármacos, trastornos neurológicos y psiquiátricos que puedan estar contribuyendo a la IU. Debe sacarse el máximo provecho del manejo conservador, teniendo consideraciones especiales con el uso de algunos fármacos e indicando cuidadosamente tratamiento quirúrgico a pacientes seleccionados. Summary: Urinary incontinence (UI is a prevalent condition in the population of elderly adults, affecting both sexes. With the aging of the population it will be a health problem of increasing relevance. Its pathogenesis is complex and multifactorial, so it is essential to know the underlying pathophysiological aspects in order to make an adequate diagnosis based on the clinical history, physical examination and complementary tests requested in a rational manner. The treatment of UI for elderly adults does not differ much from the treatment of younger population. However, particular emphasis should be placed on identifying comorbidities, medications, neurological and psychiatric disorders that may be contributing to the UI. Full advantange of conservative management should be taken, having special considerations with the use of some drugs and carefully indicating surgical treatment to selected patients. Palabras clave: Incontinencia urinaria, adulto mayor, envejecimiento

  12. Violencia intrafamiliar en el adulto mayor que vive en el distrito de Breña, Perú

    Directory of Open Access Journals (Sweden)

    Jack Roberto Silva Fhon

    2015-07-01

    Full Text Available Antecedentes: La violencia hacia el adulto mayor es un problema social que ocurre dentro de la familia y que por miedo no es denunciado dificultando el trabajo del personal multi-profesional de salud para la detección, denuncia y prevención de estos casos. Objetivo: Identificar la prevalencia, los tipos de violencia intrafamiliar e su asociación con variables socio demográficas y presencia de síntomas depresivos en el adulto mayor que vive en la comunidad. Método: Estudio cuantitativo, descriptivo y transversal con 369 adultos mayores en el distrito de Breña, Lima – Perú. Se utilizó el instrumento de datos sociodemográficos, Canadian Task Force on the Periodic Health Examination y Escala de Depresión Geriátrica. Para el análisis de los datos se aplicó estadística descriptiva y regresión logística. Resultados: Predominó el sexo femenino, adulto mayor más joven, el estado civil casado y la conformación familiar por el cónyuge. La prevalencia de violencia intrafamiliar fue 79,7% y síntomas depresivos 48,2%. Prevaleció la violencia financiera. A la regresión se verificó que aquel que no trabaja tiene mayor chance de sufrir de violencia. Cuanto más son los años de estudio disminuye el riesgo de sufrir de violencia. Asimismo, aquel que no presenta síntomas depresivos no sufre de violencia. Conclusión: Se verificó que el adulto mayor necesita de atención permanente y que el personal de salud debe reconocer síntomas y señales en el adulto mayor que sufre de violencia y que presenta síntomas depresivos ofreciendo información con la importancia de denunciar estos casos favoreciendo un envejecimiento saludable y con calidad.

  13. Patrones de diseño para mejorar la accesibilidad y uso de aplicaciones sociales para adultos mayores

    Directory of Open Access Journals (Sweden)

    Huizilopoztli Luna García

    2015-07-01

    Full Text Available El objetivo de este artículo fue proponer una colección no exhaustiva de 36 patrones para el diseño de interacciones en aplicaciones sociales para adultos mayores. La propuesta representa un punto de partida confiable para facilitar, a diseñadores/desarrolladores, la integración de usabilidad en las interfaces de estas tecnologías con el fin de fomentar su aceptación, uso y adopción entre los adultos mayores. Esta propuesta se basa en esfuerzos previos comúnmente expresados como criterios y guías de diseño para definir los posibles problemas de usabilidad en este tipo de interfaces, y se concentra en reforzar estos enfoques mediante la integración de una mayor descripción de tales anomalías y alternativas de solución bajo una estructura de patrones útil para los diseñadores/desarrolladores. Se realizó un estudio de usabilidad con la técnica «evaluación heurística» (comúnmente utilizada en interacción hombre-máquina para obtener la percepción de los usuarios sobre un diseño particular. El trabajo se llevó a cabo desde dos perspectivas: el punto de vista de expertos técnicos y la percepción de un grupo social de adultos mayores. Los resultados reflejaron que los patrones propuestos propician la creación de interfaces bien diseñadas capaces de ofrecer una mejor experiencia de uso y promueven un impacto positivo en la calidad de vida de los adultos mayores.

  14. Cavernous sinus invasion by pituitary adenomas. Relationship between magnetic resonance imaging findings and histologically verified dural invasion

    Energy Technology Data Exchange (ETDEWEB)

    Daita, Go; Yonemasu, Yukichi; Nakai, Hirofumi; Takei, Hidetoshi; Ogawa, Katsuhiro [Asahikawa Medical Coll., Hokkaido (Japan)

    1995-01-01

    The relationship between magnetic resonance (MR) imaging findings and histologically verified invasion of the cavernous sinus by tumor cells was studied in 26 patients treated surgically for pituitary adenoma. Dural invasion of the sellar floor by tumor cells was found in 10 cases (38%). All patients were classified according to MR imaging findings into three types. Type I showed a gadolinium-enhanced stripe medial to the carotid artery (5 patients), none of which showed dural invasion. Type II showed no enhanced stripe (17 patients), six of which showed dural invasion. Within this type, tumor size and dural invasion showed no correlation. Type III showed displacement or encasement of the carotid artery by the tumor with or without extracranial extension (4 patients), all of which showed massive infiltration of the tumor cells into the dura mater. This study shows that preoperative MR imaging can provide information for assessment of invasion into the cavernous sinus in patients with pituitary adenoma. (author).

  15. A importância das aulas práticas para alunos jovens e adultos: uma abordagem investigativa sobre a percepção dos alunos do PROEF II

    Directory of Open Access Journals (Sweden)

    Adriana Cristina Souza LEITE

    Full Text Available Resumo: Este trabalho analisa a importância das aulas práticas no ensino de Ciências Naturais para os alunos de duas turmas, com perfis diferentes, do Segundo Segmento do Projeto de Ensino Fundamental de Jovens e Adultos da Universidade Federal de Minas Gerais (PROEF II. O trabalho analisa o conceito de aulas práticas para esses alunos, a aceitação e as impressões pessoais dos mesmos em relação a estas aulas na disciplina de Ciências Naturais. Os resultados demonstram que os alunos jovens e adultos gostam desse tipo de aula e se sentem motivados quando a mesma é proposta, principalmente quando elas ocorrem no laboratório e, desse modo, o desenvolvimento dessas aulas pode ser uma importante ferramenta no ensino de ciências para os alunos jovens e adultos.

  16. INTERVENCIÓN PSICOLÓGICA EN ADULTOS MAYORES

    Directory of Open Access Journals (Sweden)

    Ana Fernanda Rodríguez Uribe

    2010-01-01

    Full Text Available El objetivo de este artículo es plantear una propuesta de intervención psicológica dirigida a adultos mayores institucionalizados y no institucionalizados; para ello se tomó como referencia la situación actual del adulto, los estudios realizados entorno a esta etapa y específicamente lo relacionado con el diseño de programas de intervención, para finalmente exponer la propuesta de intervención psicológica que pretende no solo mejorar la calidad de vida del adulto mayor, sino abarcarlo desde sus diversas áreas de funcionamiento.

  17. Nivel de autotrascendencia en un grupo de adultos mayores mexicanos

    OpenAIRE

    Raúl Fernando Guerrero Castañeda; Ricardo Lara Pérez

    2017-01-01

    Introducción: La autotrascendencia es una expansión multidimensional personal, una conexión con los demás, el entorno y/o una entidad superior, está relacionada con el bienestar personal del adulto mayor. Objetivo: Determinar el nivel de autotrascendencia de un grupo de adultos mayores mexicanos. Materiales y Métodos: Estudio descriptivo de corte transversal; realizado en tres centros gerontológicos de Celaya, Guanajuato, México, muestra probabilística aleatoria n=118. Se incluyeron adultos m...

  18. Normal measurement of spinal cord and dural sac by CT myelography

    International Nuclear Information System (INIS)

    Yun, Ku Sub; Choi, Yo Won; Han, Moon Hee; Chang, Kee Hyun

    1988-01-01

    The data on the normal measurement of spinal cord are essential for an objective assessment of equivocal change of spinal cord size in the various clinical settings. The present study was therefore undertaken to evaluate normal range of spinal cord dimensions in Koreas. CT myelography of the cervical and thoracic region was performed in 60 patients who had symptoms referable to lumbosacral region and then computed tomographic measurement of spinal cord and dural sac was performed. The results are as follows: 1. The anteroposterior diameter of spinal cord was maximum at C1 level (8.6±1.4mm) and minimum at T6 level (6.4±1.7mm). 2. The transverse diameter of spinal cord was maximum at C4 and C5 levels (13.3±1.6mm) and minimum at T8 (8.1±1.9mm) and T10 (8.1±1.3mm) levels. 3. The area of spinal cord was maximum at C5 level (76±16mm 2 ) and minimum at T6 (40±24mm 2 ) and T8 (40±23mm 2 ) levels. 4. The ratio of anteroposterior diameter/transverse diameter of spinal cord was smallest at C4 (0.57±0.11) and C5 (0.57±0.09) levels and largest at T12 (0.9±0.17) level. 5. The ratio of anteroposterior diameter of spinal cord/dural sac was maximum at C4 level (0.73±0.14) and minimum at T12 level (0.52±0.15). The ratio of transverse diameter of spinal cord/dural sac was maximum at C3 (0.66±0.10) and C4 (0.66±0.14) levels and minimum at T12 level (0.46±0.18). The ratio of area of spinal cord/dural sac was maximum at C3 level (0.48±0.13) and minimum at T12 level (0.29±0.20). 6. The location of cervical cord in dural sac was mainly ventral (56%) at C1 level, middle (40-73%) from C2 to C6 level and dorsal (44%) at C7 level. The location of thoracic cord in dural sac was chiefly middle (61%) at T2 level and lower thoracic level (T10: 60% and T12: 51%) and mainly ventral (59-84%) at other levels.

  19. Transcutaneous Drainage of Gel-Like Substance after Application of Hydrogel Dural Sealant: Report of Two Cases

    OpenAIRE

    Siman, Homayoun; Techy, Fernando

    2015-01-01

    Study Design?Case report. Objective?Incidental durotomy (IDT) is a common complication of spinal surgery. The use of collagen matrix graft along with hydrogel dural sealant is a common method of IDT repair. With this method, there have been several reported cases of detrimental dural sealant expansion in the literature. One case study reported an expansion rate greater than 300%; many report neurologic damage. This article reports the clinical course of two patients who developed postoperativ...

  20. Comparison of Porcine and Bovine Collagen Dural Substitutes in Posterior Fossa Decompression for Chiari I Malformation in Adults.

    Science.gov (United States)

    Lee, Christine K; Mokhtari, Tara; Connolly, Ian D; Li, Gordon; Shuer, Lawrence M; Chang, Steven D; Steinberg, Gary K; Hayden Gephart, Melanie

    2017-12-01

    Posterior fossa decompression surgeries for Chiari malformations are susceptible to postoperative complications such as pseudomeningocele, external cerebrospinal fluid (CSF) leak, and meningitis. Various dural substitutes have been used to improve surgical outcomes. This study examined whether the collagen matrix dural substitute type correlated with the incidence of postoperative complications after posterior fossa decompression in adult patients with Chiari I malformations. A retrospective cohort study was conducted of 81 adult patients who underwent an elective decompressive surgery for treatment of symptomatic Chiari I malformations, with duraplasty involving a dural substitute derived from either bovine or porcine collagen matrix. Demographics and treatment characteristics were correlated with surgical outcomes. A total of 81 patients were included in the study. Compared with bovine dural substitute, porcine dural substitute was associated with a significantly higher risk of pseudomeningocele occurrence (odds ratio, 5.78; 95% confidence interval, 1.65-27.15; P = 0.01) and a higher overall complication rate (odds ratio, 3.70; 95% confidence interval, 1.23-12.71; P = 0.03) by univariate analysis. There was no significant difference in the rate of meningitis, repeat operations, or overall complication rate between the 2 dural substitutes. In addition, estimated blood loss was a significant risk factor for meningitis (P = 0.03). Multivariate analyses again showed that porcine dural substitute was associated with pseudomeningocele occurrence, although the association with higher overall complication rate did not reach significance. Dural substitutes generated from porcine collagen, compared with those from bovine collagen, were associated with a higher likelihood of pseudomeningocele development in adult patients undergoing Chiari I malformation decompression and duraplasty. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. In utero magnetic resonance imaging for diagnosis of dural venous sinus ectasia with thrombosis in the fetus

    Energy Technology Data Exchange (ETDEWEB)

    Fanou, Evgenia Maria [University Hospital of North Staffordshire, Stoke-on-Trent (United Kingdom); Reeves, Mike J.; Griffiths, Paul D. [Royal Hallamshire Hospital, University of Sheffield, Academic Unit of Radiology, Sheffield (United Kingdom); Howe, David T. [Princess Anne Hospital, Wessex Fetal Medicine Unit, Southampton (United Kingdom); Joy, Harriet [University Hospital of Southampton, Department of Radiology, Southampton (United Kingdom); Morris, Susan [University Hospital of Wales, Radiology Department, Cardiff, Wales (United Kingdom); Russell, Sarah [St. Mary' s Hospital, Radiology Department, Manchester (United Kingdom)

    2013-12-15

    Dural venous sinus ectasia with thrombosis (DVSET) in the fetus is a rare condition that can be diagnosed prenatally with the use of fetal MR imaging, yet with limited indication of long-term clinical significance. To describe and evaluate the diagnostic value of fetal MR imaging in the prenatal diagnosis of dural venous sinus ectasia with thrombosis and its clinical significance. We report a series of nine fetuses with dural venous sinus ectasia with thrombosis. The mothers, located in four feto-maternal centres, were referred for fetal MR imaging due to space occupying lesions identified on second-trimester antenatal ultrasound. In all but one case the dural venous sinus ectasia with thrombosis was in the vicinity of the venous confluence (VC) with various extension in the posterior dural sinuses. Antenatal follow-up imaging was performed in seven cases and showed progression in one, stable appearances in one and regression in five cases. Three pregnancies were terminated. In the remaining six cases there was no reported neurological deficit at up to 44 months of clinical follow-up. This is among the largest series of postnatal clinical follow-up in cases of prenatal diagnosis of dural venous sinus ectasia with thrombosis in the literature. Clinical follow-up suggests a good prognosis when antenatal follow-up shows partial or complete thrombus resolution. (orig.)

  2. Spinal movement and dural sac compression during airway management in a cadaveric model with atlanto-occipital instability.

    Science.gov (United States)

    Liao, Shiyao; Schneider, Niko R E; Weilbacher, Frank; Stehr, Anne; Matschke, Stefan; Grützner, Paul A; Popp, Erik; Kreinest, Michael

    2017-12-01

    To analyze the compression of the dural sac and the cervical spinal movement during performing different airway interventions in case of atlanto-occipital dislocation. In six fresh cadavers, atlanto-occipital dislocation was performed by distracting the opened atlanto-occipital joint capsule and sectioning the tectorial membrane. Airway management was done using three airway devices (direct laryngoscopy, video laryngoscopy, and insertion of a laryngeal tube). The change of dural sac's width and intervertebral angulation in stable and unstable atlanto-occipital conditions were recorded by video fluoroscopy with myelography. Three-dimensional overall movement of cervical spine was measured in a wireless human motion track system. Compared with a mean dural sac compression of - 0.5 mm (- 0.7 to - 0.3 mm) in stable condition, direct laryngoscopy caused an increased dural sac compression of - 1.6 mm (- 1.9 to - 0.6 mm, p = 0.028) in the unstable atlanto-occipital condition. No increased compression on dural sac was found using video laryngoscopy or the laryngeal tube. Moreover, direct laryngoscopy caused greater overall extension and rotation of cervical spine than laryngeal tube insertion in both stable and unstable conditions. Among three procedures, the insertion of a laryngeal tube took the shortest time. In case of atlanto-occipital dislocation, intubation using direct laryngoscopy exacerbates dural sac compression and may cause damage to the spinal cord.

  3. Evaluation of the effect of hemoglobin or hematocrit level on dural sinus density using unenhanced computed tomography.

    Science.gov (United States)

    Lee, Seung Young; Cha, Sang-Hoon; Lee, Sung-Hyun; Shin, Dong-Ick

    2013-01-01

    To identify the relationship between hemoglobin (Hgb) or hematocrit (Hct) level and dural sinus density using unenhanced computed tomography (UECT). Patients who were performed UECT and had records of a complete blood count within 24 hours from UECT were included (n=122). We measured the Hounsfield unit (HU) of the dural sinus at the right sigmoid sinus, left sigmoid sinus and 2 points of the superior sagittal sinus. Quantitative measurement of dural sinus density using the circle regions of interest (ROI) method was calculated as average ROI values at 3 or 4 points. Simple regression analysis was used to evaluate the correlation between mean HU and Hgb or mean HU and Hct. The mean densities of the dural sinuses ranged from 24.67 to 53.67 HU (mean, 43.28 HU). There was a strong correlation between mean density and Hgb level (r=0.832) and between mean density and Hct level (r=0.840). Dural sinus density on UECT is closely related to Hgb and Hct levels. Therefore, the Hgb or Hct levels can be used to determine whether the dural sinus density is within the normal range or pathological conditions such as venous thrombosis.

  4. Preservation of Frontal Sinus Anatomy and Outflow Tract Following Frontal Trauma with Dural Defect

    Directory of Open Access Journals (Sweden)

    James Wei Ming Kwek, MBBS, MRCS

    2015-02-01

    Full Text Available Summary: Our case report describes a young male mechanic who was hit in his face by a spring while repairing a car, resulting in traumatic injury to the frontal sinus, with fractures of both the anterior and the posterior tables with dural defect and cerebrospinal fluid leak. Current guidelines recommend that comminuted and/or displaced fractures of the posterior table of the frontal sinus with dural defects should be either cranialized or obliterated. In this patient, instead of cranializing or obliterating the frontal sinus, we managed to preserve the frontal sinus anatomy and its outflow tract using a combined open bicoronal and nasoendoscopic approach. This avoids the long-term complications associated with cranialization or obliteration including mucocele formation and frontocutaneous fistula.

  5. Embolization of intracranial dural arteriovenous fistulas using PHIL liquid embolic agent in 26 patients

    DEFF Research Database (Denmark)

    Lamin, S.; Chew, H. S.; Chavda, S.

    2017-01-01

    BACKGROUND AND PURPOSE: The introduction of liquid embolic agents has revolutionized endovascular approach to cranial vascular malformations. The aim of the study was to retrospectively assess the efficacy and safety of Precipitating Hydrophobic Injectable Liquid (PHIL), a new nonadhesive liquid......: This was a retrospective multicenter study. Twenty-six consecutive patients with dural arteriovenous fistulas (de novo or previously treated) treated by injection of PHIL only or with PHIL in combination with other embolization products (such as Onyx or detachable coils) were included in the study. Recruitment started......, 3 were retreated with PHIL and 1 achieved angiographic cure. An adverse event was seen in 1 patient who developed worsening of preexisting ataxia due to acute thrombosis of the draining vein. CONCLUSIONS: PHIL appears to be safe and effective for endovascular treatment of cranial dural arteriovenous...

  6. Dural metastases from prostate carcinoma: A systematic review of the literature apropos of six patients

    International Nuclear Information System (INIS)

    Vasconcelos Sobreira Guedes, Bruno de; Rocha, Antonio Jose da; Pereira Pinto Gama, Hugo; Silva, Carlos Jorge da

    2011-01-01

    Intracranial metastases are a rare manifestation of prostate carcinoma and the dura mater is the most affected site. We report a series of six patients with dural prostate metastases (DPM) and perform a systematic review of the current literature in order to depict imaging trademarks of this condition. This review points to a magnetic resonance imaging (MRI) pattern of meningeal involvement characterized by a diffuse smooth thickening, nodular appearance or dural-based masses. We also demonstrate an osteoblastic pattern of lesions, particularly in sphenoid wing, by computed tomography (CT) scans. We suggest that these imaging findings may support an elevated index of suspicion of DPM in elderly men, including those patients without urologic symptoms.

  7. Dural ectasia of the optic nerve sheath: is it always benign?

    Directory of Open Access Journals (Sweden)

    Berker Bakbak

    2009-11-01

    Full Text Available Berker Bakbak1, Hava Dönmez2, Tülay Kansu3, Hayyam Kiratli41Hacettepe University Institute of Neurological Sciences and Psychiatry, Neuro-ophthalmology Unit, Ankara, Turkey; 2Diskapi Yildirim Beyazid Education and Research Hospital Neurology Clinic, Ankara, Turkey; 3Hacettepe University Medical Faculty, Department of Neurology, Neuro-Ophthalmology Unit, Ankara, Turkey; 4Hacettepe University Medical Faculty, Department of Ophthalmology, Ocular Oncology Unit, Ankara, TurkeyAbstract: A 36-year-old woman with a 3-month history of progressive visual loss had papilledema, dilatation of the optic nerve sheaths and normal cerebrospinal fluid pressures. She was diagnosed as dural ectasia of the optic nerve sheaths and surgical decompression was performed. In this case report, severe visual loss is described as a serious complication of this rare disease and the importance of early surgical intervention is emphasized.Keywords: optic nerve, dural ectasia, meningocele

  8. Adultos mayores cuidadores: sobrecarga y dimensión afectiva

    Directory of Open Access Journals (Sweden)

    Serrana Banchero

    2017-05-01

    Full Text Available Este trabajo plantea la relación entre la sobrecarga del cuidador y la dimensión afectiva del cuidado en personas mayores cuidadoras. En la actualidad el cuidado es entendido como una problemática social pública, y por lo tanto objeto de políticas públicas. Uruguay es un país envejecido debido a los cambios socio-demográficos que han acontecido por lo que han aumentado las situaciones de dependencia y las demandas de cuidados. De este modo, las personas mayores no solo son receptores sino también proveedores de cuidados. El cuidado implica la dimensión material, económica y afectiva, y los cuidadores como consecuencia de su tarea de cuidar, pueden experimentar el síndrome de sobrecarga del cuidador. Se trata de un diseño cuali-cuantitativo y consiste en un estudio de caso utilizando entrevistas individuales con aplicación de instrumentos según la categorización de la muestra finalista que fue Personas Mayores Cuidadoras y no Cuidadoras. Se analizará la variable sobrecarga del cuidador con las características de la relación cuidador-cuidado. La muestra es finalista y se constituyó por 74 personas mayores usuarios regulares del Subprograma Adultos Mayores del Programa Apex-Cerro (UdelaR de la ciudad de Montevideo, Uruguay. Los resultados mostraron que aparece una visión totalizante del cuidado, así como relatos autorreferenciales. El 29,7% son personas mayores cuidadoras, de los cuales el 15,7% presentan el síndrome de sobrecarga del cuidador (siendo todas mujeres y la edad mediana de 65,5 años. En el análisis de la dimensión afectiva del cuidado se observan características de un tipo de vínculo co-dependiente entre el cuidador y el cuidado.

  9. Role of penumbra mechanical thrombectomy device in acute dural sinus thrombosis

    Directory of Open Access Journals (Sweden)

    Suraj Mammen

    2017-01-01

    Full Text Available Background: In dural venous sinus thrombosis (DVST, the mortality ranges 5–30%. Deep venous system involvement and septic dural sinus thrombosis have a higher mortality rate. In acute occlusion, collateral flow may not be established, which may result in significant edema and mass effect. Endovascular interventions may be considered as a treatment option in appropriate high-risk patients with DVST. Materials and Methods: Eight patients with magnetic resonance imaging (MRI-confirmed dural sinus thrombosis, who did not respond to the conventional standard medical treatment, were subsequently treated with mechanical thrombectomy using the Penumbra System®. In all cases, medical treatment including anticoagulants were continued following the procedure for a minimum period of 1 year. Results: Recanalization of the dural sinus thrombosis was achieved in all 8 cases. There were no immediate or late endovascular-related complications. One death occurred due to an unrelated medical event. At 6 months, there was notable improvement in the modified Rankin Score (mRS, with 5/8 (62% patients achieving mRS of 2 or less. The follow-up ranged between 3 months and 26 months (mean: 14.5 months, and there were no new neurological events during the follow-up period. Conclusion: Cerebral venous sinus thrombosis is a rare but life-threatening condition that demands timely diagnosis and therapy. In cases of rapidly declining neurological status despite standard therapy with systemic anticoagulation and anti-edema measures, mechanical thrombectomy could be a lifesaving and effective option. In this study, good outcomes were observed in the majority of patients at long-term follow up.

  10. The interperiosteo-dural concept applied to the perisellar compartment: a microanatomical and electron microscopic study.

    Science.gov (United States)

    François, Patrick; Travers, Nadine; Lescanne, Emmanuel; Arbeille, Brigitte; Jan, Michel; Velut, Stéphane

    2010-11-01

    The dura mater has 2 dural layers: the endosteal layer (outer layer), which is firmly attached to the bone, and the meningeal layer (inner layer), which directly covers the brain. These 2 dural layers join together in the middle temporal fossa or the convexity and separate into the orbital, lateral sellar compartment (LSC), or spinal epidural space to form the extradural neural axis compartment (EDNAC). The aim of this work was to anatomically verify the concept of the EDNAC by using electron microscopy. The authors studied the cadaveric heads obtained from 13 adults. Ten of the specimens (or 20 perisellar areas) were injected with colored latex and fixed in formalin. They carefully removed each brain to allow a superior approach to the perisellar area. The 3 other specimens were studied by microscopic and ultrastructural methods to describe the EDNAC in the perisellar area. Special attention was paid to the dural layers surrounding the perisellar area. The authors studied the anatomy of the meningeal architecture of the LSC, the petroclival venous confluence, the orbit, and the trigeminal cave. After dissection, the authors took photographs of the dural layers with the aid of optical magnification. The 3 remaining heads, obtained from fresh cadavers, were prepared for electron microscopic study. The EDNAC is limited by the endosteal layer and the meningeal layer and contains fat and/or venous blood. The endosteal layer and meningeal layer were not identical on electron microscopy; this finding can be readily related to the histology of the meninges. In this study, the authors demonstrated the existence of the EDNAC concept in the perisellar area by using dissected cadaveric heads and verified the reality of the concept of the meningeal layer with electron microscopy. These findings clearly demonstrated the existence of the EDNAC, a notion that has generally been accepted but never demonstrated microscopically.

  11. Significado de ser docente para el adulto mayor sanfernandino

    OpenAIRE

    Martina, Martha; Santos, Gladys; Lema, Julia

    2013-01-01

    Objetivos: Comprender el significado de ser docente para el adulto mayor de la Facultad de Medicina de San Marcos y describir las motivaciones que determinan, de alguna forma, su decisión de postergar su retiro, no obstante haber cumplido con los requisitos legales para la jubilación. Diseño: Estudio de caso cualitativo. Institución: Facultad de Medicina, UNMSM. Participantes: Docentes adulto mayores de la Facultad de Medicina. Intervenciones: Entrevista a profundidad. Principales medidas de ...

  12. Large capillary hemangioma of the temporal bone with a dural tail sign: A case report

    KAUST Repository

    YANG, GUANG

    2014-05-13

    The present study reports a rare case of large capillary hemangioma of the temporal bone with a dural tail sign. A 57-year-old female presented with pulsatile tinnitus and episodic vertigo associated with a ten-year history of an intermittent faint headache. Magnetic resonance imaging revealed a mass in the right petrous bone, which was hypointense on T1-weighted images and heterogeneously hyperintense on T2-weighted images, and showed a dural tail sign following gadolinium administration. Pre-operatively, this tumor was believed to be a meningioma. During surgery, the vascular tumor was removed by a modified pterional approach. A histopathological examination indicated that the tumor was a capillary hemangioma. Although intraosseous capillary hemangiomas are rare, they most frequently affect the temporal bone. Hemangiomas of the temporal bone may mimic other more common basal tumors. The diagnosis is most often made during surgical resection. The dural tail sign is not specific for meningioma, as it also occurs in other intracranial or extracranial tumors. The treatment of intratemporal hemangiomas is complete surgical excision, with radiotherapy used for unresectable lesions. To the best of our knowledge, the present study is the fourth case of intraosseous intracranial capillary hemangioma, but the largest intratemporal hemangioma to be reported in the literature to date.

  13. Use of collagen film as a dural substitute: preliminary animal studies.

    Science.gov (United States)

    Collins, R L; Christiansen, D; Zazanis, G A; Silver, F H

    1991-02-01

    Cadaver grafts, laminated metallic materials, and synthetic fabrics have been evaluated as dural substitutes. Use of cadaver tissues is limited by fear of transmission of infectious disease while use of synthetic materials is associated with implant encapsulation and foreign body reactions. The purpose of this study is to evaluate the use of collagen film as a dural substitute. Collagen films prepared from bovine skin were used to replace the dura of rabbits and histological observations were made at 16, 28, 42, and 56 days postimplantation. Controls consisted of dura that was removed and then reattached. Control dura showed no signs of inflammation or adhesion to underlying tissue at 16 and 28 days postimplantation. By 56 days postimplantation, extensive connective tissue deposition was observed in close proximity to adjacent bone as well as pia arachnoid adhesions. Implanted collagen film behaved in a similar manner to control dura showing minimal inflammatory response at all time periods. At 56 days postimplantation collagen film appeared strongly infiltrated by connective tissue cells that deposited new collagen. The results of this study suggest that a reconstituted type I collagen film crosslinked with cyanamide acts as a temporary barrier preventing loss of fluid and adhesion formation. It is replaced after approximately 2 months with host collagen with limited inflammatory and fibrotic complications. Further studies are needed to completely characterize the new connective tissue formed as well as long-term biocompatibility and functioning of a reconstituted collagen dural substitute.

  14. Four-dimensional computed tomography angiographic evaluation of cranial dural arteriovenous fistula before and after embolization.

    Science.gov (United States)

    Tian, Bing; Xu, Bing; Lu, Jianping; Liu, Qi; Wang, Li; Wang, Minjie

    2015-06-01

    This study aimed to evaluate the usefulness of four-dimensional CTA before and after embolization treatment with ONYX-18 in eleven patients with cranial dural arteriovenous fistulas, and to compare the results with those of the reference standard DSA. Eleven patients with cranial dural arteriovenous fistulas detected on DSA underwent transarterial embolization with ONYX-18. Four-dimensional CTA was performed an average of 2 days before and 4 days after DSA. Four-dimensional CTA and DSA images were reviewed by two neuroradiologists for identification of feeding arteries and drainage veins and for determining treatment effects. Interobserver and intermodality agreement between four-dimensional CTA and DSA were assessed. Forty-two feeding arteries were identified for 14 fistulas in the 11 patients. Of these, 36 (85.71%) were detected on four-dimensional CTA. After transarterial embolization, one patient got partly embolized, and the fistulas in the remaining 10 patients were completely occluded. The interobserver agreement for four-dimensional CTA and intermodality agreement between four-dimensional CTA and DSA were excellent (κ=1) for shunt location, identification of drainage veins, and fistula occlusion after treatment. Four-dimensional CTA images are highly accurate when compared with DSA images both before and after transarterial embolization treatment. Four-dimensional CTA can be used for diagnosis as well as follow-up of cranial dural arteriovenous fistulas in clinical settings. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  15. Large capillary hemangioma of the temporal bone with a dural tail sign: A case report

    KAUST Repository

    YANG, GUANG; LI, CHENGUANG; CHEN, XIN; LIU, YAOHUA; HAN, DAYONG; Gao, Xin; KAWAMOTO, KEIJI; ZHAO, SHIGUANG

    2014-01-01

    The present study reports a rare case of large capillary hemangioma of the temporal bone with a dural tail sign. A 57-year-old female presented with pulsatile tinnitus and episodic vertigo associated with a ten-year history of an intermittent faint headache. Magnetic resonance imaging revealed a mass in the right petrous bone, which was hypointense on T1-weighted images and heterogeneously hyperintense on T2-weighted images, and showed a dural tail sign following gadolinium administration. Pre-operatively, this tumor was believed to be a meningioma. During surgery, the vascular tumor was removed by a modified pterional approach. A histopathological examination indicated that the tumor was a capillary hemangioma. Although intraosseous capillary hemangiomas are rare, they most frequently affect the temporal bone. Hemangiomas of the temporal bone may mimic other more common basal tumors. The diagnosis is most often made during surgical resection. The dural tail sign is not specific for meningioma, as it also occurs in other intracranial or extracranial tumors. The treatment of intratemporal hemangiomas is complete surgical excision, with radiotherapy used for unresectable lesions. To the best of our knowledge, the present study is the fourth case of intraosseous intracranial capillary hemangioma, but the largest intratemporal hemangioma to be reported in the literature to date.

  16. Intracranial Dural Metastasis of Ewing's Sarcoma: a Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Eung Yeop; Lee, Seung Koo; Kim, Dong Joon; Kim, Jin Na; Lee, Kyu Sung; Jung, Woo Hee; Kim, Dong Ik [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2008-02-15

    Ewing's sarcoma is a malignant bone tumor that can occur anywhere in the body, but it is most commonly observed in the long bones of the arms and legs, the pelvis and in the chest. The predominant sites of metastasis include the lung (38%), bone (including the spine; 31%), and the bone marrow (11%). Metastasis of Ewing's sarcoma to the central nervous system (CNS) is relatively rare, and most of the previous reports have demonstrated involvement of the bony calvarium or brain parenchyma. We describe here the imaging findings of dural metastasis of Ewing's sarcoma, and these imaging findings have not been previously reported on in the medical literature. In conclusion, dural metastasis of Ewing's sarcoma is very rare and its imaging characteristics are similar to those of a primary tumor, which mimic the findings of a schwannoma or meningioma. Despite its rarity, secondary Ewing's sarcoma may be included in the differential diagnosis of extra-axial dural masses.

  17. The anterior medullary-anterior pontomesencephalic venous system and its bridging veins communicating to the dural sinuses: normal anatomy and drainage routes from dural arteriovenous fistulas

    International Nuclear Information System (INIS)

    Kiyosue, Hiro; Tanoue, Shuichi; Sagara, Yoshiko; Okahara, Mika; Kashiwagi, Junji; Mori, Hiromu; Hori, Yuzo; Nagatomi, Hirofumi

    2008-01-01

    We evaluated the normal venous anatomy of the anterior medullary/anterior pontomesencephalic venous (AMV/APMV) system and bridging veins connected to the dural sinuses using magnetic resonance (MR) imaging and demonstrated cases of dural arteriovenous fistulas (DAVFs) with bridging venous drainage. MR images obtained using a 3D gradient echo sequence in 70 patients without lesions affecting the deep or posterior venous channels were reviewed to evaluate the normal anatomy of the AMV/APMV system and bridging veins. MR images and digital subtraction angiography in 80 cases with intracranial or craniocervical junction DAVFs were reviewed to evaluate the bridging venous drainage from DAVFs. MR images clearly revealed AMV/APMV in 35 cases. Fifteen cases showed a direct connection between AMV and APMV, while 15 cases showed an indirect communication via the transverse pontine vein or the bridging vein. In the five remaining cases, the AMV and APMV end separately to the bridging vein or the transverse pontine vein. Bridging veins were identified in 34 cases, connecting to the cavernous sinus in 33, to the suboccipital cavernous sinus in 11, and the inferior petrosal sinus in five cases. In 80 DAVF cases, seven of 40 cavernous sinus DAVFs, two craniocervical junction DAVFs, and one inferior petrosal sinus DAVF drained via bridging veins to the brain stem. The AMV/APMV and bridging veins showed various anatomies and frequently showed a connection to the cavernous sinus. Knowledge of the venous anatomy is helpful for the diagnosis and intravascular treatment of DAVFs. (orig.)

  18. Inhibidores de la paraproteína convertasa subtilisina/kexina tipo 9: una alternativa de manejo para las dislipidemias

    OpenAIRE

    Beatriz Wills-Sanín; Alejandra Rincón; Ana Cristina Montenegro; Andrés F. Buitrago-Sandoval

    2017-01-01

    Las guías de la práctica clínica internacionales recomiendan a las estatinas como la terapia de elección para el manejo de la dislipidemia. No obstante, pese a la evidencia acerca de la importancia del manejo de esta condición, existe un porcentaje significativo de los adultos que no logran las metas en los lípidos con las estatinas. Lo anterior ha estimulado el desarrollo de anticuerpos monoclonales que inactivan la paraproteína convertasa subtilisina/kexina tipo 9. Estos medicamentos han si...

  19. Diabetes tipo 2, obesidad y cetoacidosis diabética en niños. Reporte de caso.

    OpenAIRE

    Manrique, Helard; Pinto, Miguel; Ramirez-Saba, Alfonso; Zapana, Alexander; Aro-Guardia, Pedro

    2011-01-01

    Se reporta el caso de una niña con obesidad que acudió a nuestro hospital por presentar cetoacidosis diabética. El manejo inicial incluyó hidratación enérgica e insulina endovenosa. El análisis de anticuerpos anti-GAD fue negativo y el péptido C fue normal. El control metabólico a largo plazo fue con metformina, dieta y ejercicio.Tradicionalmente, la diabetes tipo 2 ha sido considerada una enfermedad de adultos. Sin embargo, a medida que aumenta la prevalencia de obesidad en niños, aumenta el...

  20. Quantifying the Cerebral Hemodynamics of Dural Arteriovenous Fistula in Transverse Sigmoid Sinus Complicated by Sinus Stenosis: A Retrospective Cohort Study.

    Science.gov (United States)

    Guo, W-Y; Lee, C-C J; Lin, C-J; Yang, H-C; Wu, H-M; Wu, C-C; Chung, W-Y; Liu, K-D

    2017-01-01

    Sinus stenosis occasionally occurs in dural arteriovenous fistulas. Sinus stenosis impedes venous outflow and aggravates intracranial hypertension by reversing cortical venous drainage. This study aimed to analyze the likelihood of sinus stenosis and its impact on cerebral hemodynamics of various types of dural arteriovenous fistulas. Forty-three cases of dural arteriovenous fistula in the transverse-sigmoid sinus were reviewed and divided into 3 groups: Cognard type I, type IIa, and types with cortical venous drainage. Sinus stenosis and the double peak sign (occurrence of 2 peaks in the time-density curve of the ipsilateral drainage of the internal jugular vein) in dural arteriovenous fistula were evaluated. "TTP" was defined as the time at which a selected angiographic point reached maximum concentration. TTP of the vein of Labbé, TTP of the ipsilateral normal transverse sinus, trans-fistula time, and trans-stenotic time were compared across the 3 groups. Thirty-six percent of type I, 100% of type IIa, and 84% of types with cortical venous drainage had sinus stenosis. All sinus stenosis cases demonstrated loss of the double peak sign that occurs in dural arteriovenous fistula. Trans-fistula time (2.09 seconds) and trans-stenotic time (0.67 seconds) in types with cortical venous drainage were the most prolonged, followed by those in type IIa and type I. TTP of the vein of Labbé was significantly shorter in types with cortical venous drainage. Six patients with types with cortical venous drainage underwent venoplasty and stent placement, and 4 were downgraded to type IIa. Sinus stenosis indicated dysfunction of venous drainage and is more often encountered in dural arteriovenous fistula with more aggressive types. Venoplasty ameliorates cortical venous drainage in dural arteriovenous fistulas and serves as a bridge treatment to stereotactic radiosurgery in most cases. © 2017 by American Journal of Neuroradiology.

  1. FIBROSIS QUÍSTICA EN EL ADULTO

    Directory of Open Access Journals (Sweden)

    Joel Melo T., DR.

    2015-05-01

    Full Text Available La Fibrosis Quística (FQ es una enfermedad hereditaria autosómica recesiva. La detección precoz sumado a medidas de intervención temprana han modificado el curso de esta enfermedad con mejorías en su sobrevida, lo que ha llevado a una población creciente de pacientes de 18 años. La mutación genética determina una alteración en una Proteína Reguladora de Conductancia Transmembrana (CFTR que afecta a numerosos órganos y sistemas, pero el compromiso pulmonar es el que causa mayor morbimortalidad. El germen más frecuente que infecta a adultos es Pseudomonas aeruginosa y si bien hay una serie de medidas para el manejo de la infección crónica por Pseudomonas las terapia dirigida a la restauración de la función de la proteína CFTRhatomadorelevancia. Cuando la falla respiratoria progresa, la única alternativa disponible es el trasplante pulmonar que mejora la sobrevida y la calidad de vida en estos pacientes.

  2. Prevalencia del maltrato doméstico en adultos mayores. Policlínica "Alcides Pino". Holguín. 2009

    OpenAIRE

    Marcia Avila-Oliva; Libia Avila-Oliva; Sara Iris Rodríguez-Oliva

    2012-01-01

    Se realizó un estudio descriptivo con el objetivo de caracterizar el maltrato doméstico en adultos mayores de dos consultorios del área de salud "Alcides Pino" en el municipio de Holguín en el año 2009. De los seniles que percibieron maltrato estuvieron las edades de 60 a 74 años, predominando el sexo femenino, la escolaridad primaria y las mujeres sin vínculo conyugal, mientras que los mayoritarios estuvieron asociados a hombres casados. Otros aspectos analizados fueron, el tipo de familia o...

  3. Inclusión digital de los estudiantes adultos que acceden a la universidad: análisis de sus actitudes y competencias digitales

    OpenAIRE

    M. Teresa PADILLA-CARMONA; Magdalena SUÁREZ-ORTEGA; María Fe SÁNCHEZ-GARCÍA

    2016-01-01

    Esta investigación se propone identificar las actitudes y competencias de los estudiantes adultos en relación con el uso de las TIC, con especial atención al uso de plataformas digitales de aprendizaje y redes sociales (Web 2.0). Asimismo, evalúa la incidencia de algunas variables sociodemográficas (género y edad) en el uso estas herramientas y en la autopercepción de los estudiantes sobre sus competencias digitales. Se ha realizado un estudio tipo encuesta con una muestra de 3...

  4. Revisión sistemática sobre el impacto de la actividad física en los trastornos de la marcha en el adulto mayor

    OpenAIRE

    Salazar Pachón, Jeison Daniel; Ramírez Villada, Jhon F.; Chaparro, David; León, Henry H.

    2014-01-01

    Objetivos. 1) realizar una revisión sistemática de los estudios que examinan el impacto de la actividad física en los trastornos de la marcha del adulto mayor entre el periodo de 2003-2013, y 2) hacer recomendaciones basadas en el nivel y la fuerza de las evidencias. Método. La revisión fue limitada a: tipo de estudio, periodo de publicación, alteraciones de marcha, actividad física, frecuencia, duración, intensidad, protocolos de evaluación. En el proceso de adquisición de la información fue...

  5. Rasgos de la Personalidad de los Adultos de 25 – 35 Años de Edad y su Relacion con la Homofobia, Distrito de Tiabaya, Arequipa. 2015

    OpenAIRE

    Caceres Chavez, Erick Orlando

    2017-01-01

    RESUMEN El presente trabajo titulado: “Rasgos de la personalidad de los adultos de 25 á 35 años de edad y su relación con la Homofobia” tiene como fin u objetivo principal el establecer el tipo de relación entre la personalidad y la homofobia de un grupo de personas residentes en el área rural de Tiabaya en la ciudad de Arequipa. Es un estudio de campo, de nivel correlacional y de corte transversal. Se usó como técnica de investigación, la Encuesta en la modalidad de Cuestionario y com...

  6. Normal values of the sagittal diameter of the lumbar spine (vertebral body and dural sac) in children measured by MRI

    International Nuclear Information System (INIS)

    Knirsch, Walter; Kurtz, Claudia; Langer, Mathias; Haeffner, Nicole; Kececioglu, Deniz

    2005-01-01

    The definition of normal values is a prerequisite for the reliable evaluation of abnormality in the lumbar spine, such as spinal canal stenosis or dural ectasia in patients with Marfan syndrome. Values for vertebral body diameter (VBD) and dural sac diameter (DSD) for the lumbar spine have been published in adults. In children, normal values have been established using conventional radiography or myelography, but not by MRI. To define normal values for the sagittal diameter of the vertebral body and dural sac, and to calculate a dural sac ratio (DSR) in the lumbosacral spine (L1-S1) in healthy children using MRI. A total of 75 healthy children between 6 years and 17 years of age were examined using a sagittal T2-weighted sequence. Sagittal VBD and DSD were measured and a DSR was calculated. This was a retrospective and cross-sectional study. With increasing age there is a significant increase of VBD, a slight increase of DSD, and a slight decrease of DSR. There is no significant sex difference. DSR in healthy children is higher than in healthy adults. MRI is a reliable method demonstrating the natural shape of the lumbosacral spine and its absolute values. These normal values compare well with those established by conventional radiological techniques. Our data may serve as a reference for defining dural ectasia in children with Marfan syndrome. (orig.)

  7. Normal values of the sagittal diameter of the lumbar spine (vertebral body and dural sac) in children measured by MRI

    Energy Technology Data Exchange (ETDEWEB)

    Knirsch, Walter [University Children' s Hospital Freiburg, Department of Pediatric Cardiology, Freiburg (Germany); University Children' s Hospital Zurich, Division of Paediatric Cardiology, Zurich (Switzerland); Kurtz, Claudia; Langer, Mathias [University Hospital Freiburg, Department of Radiology, Freiburg (Germany); Haeffner, Nicole; Kececioglu, Deniz [University Children' s Hospital Freiburg, Department of Pediatric Cardiology, Freiburg (Germany)

    2005-04-01

    The definition of normal values is a prerequisite for the reliable evaluation of abnormality in the lumbar spine, such as spinal canal stenosis or dural ectasia in patients with Marfan syndrome. Values for vertebral body diameter (VBD) and dural sac diameter (DSD) for the lumbar spine have been published in adults. In children, normal values have been established using conventional radiography or myelography, but not by MRI. To define normal values for the sagittal diameter of the vertebral body and dural sac, and to calculate a dural sac ratio (DSR) in the lumbosacral spine (L1-S1) in healthy children using MRI. A total of 75 healthy children between 6 years and 17 years of age were examined using a sagittal T2-weighted sequence. Sagittal VBD and DSD were measured and a DSR was calculated. This was a retrospective and cross-sectional study. With increasing age there is a significant increase of VBD, a slight increase of DSD, and a slight decrease of DSR. There is no significant sex difference. DSR in healthy children is higher than in healthy adults. MRI is a reliable method demonstrating the natural shape of the lumbosacral spine and its absolute values. These normal values compare well with those established by conventional radiological techniques. Our data may serve as a reference for defining dural ectasia in children with Marfan syndrome. (orig.)

  8. Transcutaneous Drainage of Gel-Like Substance after Application of Hydrogel Dural Sealant: Report of Two Cases.

    Science.gov (United States)

    Siman, Homayoun; Techy, Fernando

    2016-02-01

    Study Design Case report. Objective Incidental durotomy (IDT) is a common complication of spinal surgery. The use of collagen matrix graft along with hydrogel dural sealant is a common method of IDT repair. With this method, there have been several reported cases of detrimental dural sealant expansion in the literature. One case study reported an expansion rate greater than 300%; many report neurologic damage. This article reports the clinical course of two patients who developed postoperative transcutaneous drainage of a gel-like substance after the use of a dural sealant, which is a previously unreported complication. Methods The clinical course and treatment outcome of two patients is presented. Results Both patients experienced postoperative transcutaneous drainage of a gel-like substance at the surgical site. Case one began draining this substance on postoperative day 14. This patient required no further intervention, and the drainage ended after 3 mL of a gel-like substance was expressed from his incision while in the clinic. Case two began draining the gel on postoperative day 16. This patient underwent two washout procedures and resolution of the drainage. No infection was ever detected. Conclusions To our knowledge, our patients are the first reported cases of transcutaneous drainage of expanded dural sealant. It is important to take into consideration the unexpected expansion of a dural sealant when using it for the repair of IDT.

  9. A method of posterior fossa dural incision to minimize hemorrhage from the occipital sinus: the "mosquito" method.

    Science.gov (United States)

    Lee, Hee Chang; Lee, Ji Yeoun; Ryu, Seul Ki; Lim, Jang Mi; Chong, Sangjoon; Phi, Ji Hoon; Kim, Seung-Ki; Wang, Kyu-Chang

    2016-12-01

    The posterior fossa dural opening requires the ligation of the occipital sinus to gain successful exposure. However, there could be a prominent occipital sinus which is functioning as the main drainage route and is harboring the risk of unpredictable massive hemorrhage during the dural opening. We introduce a safe method of posterior fossa dural incision to minimize hemorrhage from the occipital sinus using four curved hemostat clamps. For the dural incision at the midline part of the posterior cranial fossa, we used four curved hemostat clamps to occlude the prominent occipital sinus: one pair of clamps at the proximal part and the other pair at the distal part to occlude the occipital sinus. Dural incision was made between the two pairs of the curved hemostat clamps. By clamping of the sinus, it allows observation of possible brain swelling after occlusion of the occipital sinus as well as minimizes hemorrhage during incision of the midline dura of the posterior fossa. This method allows observation of brain swelling after occipital sinus occlusion and is an easy and safe incision of the midline dura minimizing hemorrhage in selected cases with a prominent occipital sinus.

  10. Hipnosis como complemento en la cirugía oral del adulto mayor

    Directory of Open Access Journals (Sweden)

    Elina Muñiz Manzano

    2013-03-01

    Full Text Available Introducción: el envejecimiento poblacional es un fenómeno mundial y la cirugía oral es compleja en los adultos mayores, por lo que la preparación preoperatoria es de vital importancia para una evolución satisfactoria. Este trabajo tiene como objetivo demostrar la eficacia de la hipnosis en pacientes con temor en la cirugía oral del adulto mayor. Métodos: se realizó un estudio descriptivo, transversal, con muestra de 20 pacientes de 60 años o más, atendidos en la consulta de Cirugía Maxilofacial del Hospital Universitario "Comandante Manuel Fajardo", en el año 2011, donde se analizaron las variables edad, sexo, número de sesiones de hipnosis, antecedentes patológicos, diagnósticos más frecuentes y temor. Resultados: el mayor número de pacientes se encontró entre 60-69 años de edad, (70 % y el menor en 70-79, (30 %. El sexo femenino prevaleció con 70 %. El número de sesiones fue en el grupo de 60-69 con 58, con un promedio total de 4 por pacientes. En los antecedentes patológicos más frecuentes fue la hipertensión arterial en 14 (70 % y le siguió la diabetes tipo II en 2 (10 % En los diagnósticos más frecuentes fue la caries de cuarto grado con 10 (50 % seguido por los dientes parodontósicos con 4 (20 %. El temor se midió en una escala confeccionada, en la que los pacientes con cifras de l0, 8 y 7 se redujeron a 4 y 5. Conclusiones: Se demuestra la efectividad de la terapia de hipnosis para disminuir el temor y realizar la cirugía oral en el adulto mayor.

  11. A Adaptação Psicológica à Diabetes dos Jovens Adultos com Diabetes Tipo 1

    OpenAIRE

    Nabais, Joao; Serrabulho, Lurdes; Gaspar de Matos, Margarida; Raposo, Joao

    2014-01-01

    Introduction: Quality of life of young adults can be affected by the social, occupational, familiar and emotional changes. Aims: Evaluation of life satisfaction, social support, treatment adherence and psychological adaptation of young adults with type 1 diabetes. Methods: Quantitative study with questionnaires Àlled by 278 young adults with type 1 diabetes (18-35 years). Results: Participants consider having good social support. Satisfaction with life was 6.6 ±1.7 (scale 0-10). Most...

  12. ''Dural tail'' adjacent to a giant posterior cerebral artery aneurysm: case report and review of the literature

    International Nuclear Information System (INIS)

    Good, C.D.; Kingsley, D.P.E.; Taylor, W.J.; Harkness, W.F.

    1997-01-01

    The ''dural tail'' sign on gadolinium (Gd-DTPA)-enhanced MRI has been described in association with meningiomas. Various series with histopathological correlation have shown that in some cases there is tumour invasion into the dura mater, but in the majority of cases it represents a hypervascular, non-neoplastic reaction. While this sign was originally thought to be specific for meningioma, subsequent case reports have described the presence of a dural tail in other intra- and extra-axial lesions. We present a patient with a giant aneurysm arising from the P2 segment of the right posterior cerebral artery, adjacent to the tentorium, with a prominent dural tail on Gd-DTPA-enhanced MRI. In this location, differentiation of an aneurysm from a meningioma was critical. (orig.). With 2 figs

  13. Relación del sentimiento de soledad y el estado de salud de los adultos mayores que acuden al Centro Médico Tierra Nueva, mediante la aplicación del cuestionario Sf 36 y escala este , periodo febrero-mayo del 2015”.

    OpenAIRE

    Cantuña Tapuyo, Cristina De Los Ángeles

    2015-01-01

    Antecedentes: Estudios revelan correlación de la soledad en el deterioro de salud. La presente investigación, tiene como objetivo general, analizar la relación del sentimiento de soledad y el estado de salud de los adultos mayores que acuden al Centro Médico Tierra Nueva, en los meses de Febrero a Mayo del 2015. Metodología: Es un estudio de tipo transversal analítico. Se estudió 165 adultos mayores, con la aplicación de la escala ESTE y cuestionario SF 36. Para el análisis de los datos se...

  14. Las alteraciones del lenguaje en el adulto

    OpenAIRE

    Pérez Restrepo, Ángela María; Fundación Valle de Lili

    2006-01-01

    ¿Qué partes del cuerpo se encargan del lenguaje?/¿Qué es afasia?/¿Quién puede presentar una afasia?/¿Cómo se alteran los diferentes niveles del lenguaje?/¿Qué tipos de afasia existen?/¿Cuáles son las manifestaciones de las afasias motoras?/¿Cuáles son las manifestaciones de las afasias de comprensión?/¿Qué es una afasia mixta?/¿Puede encontrarse dificultad en otra función psicológica superior en casos de afasia?/¿A quién consultar en estos casos?/¿Qué tratamientos se le pueden ofrecer a estos...

  15. Four-dimensional computed tomography angiographic evaluation of cranial dural arteriovenous fistula before and after embolization

    International Nuclear Information System (INIS)

    Tian, Bing; Xu, Bing; Lu, Jianping; Liu, Qi; Wang, Li; Wang, Minjie

    2015-01-01

    Highlights: • 4D CTA showed excellent agreement with DSA with regard to identification of feeding arteries and drainage veins. • The most important finding was 4D CTA in determining the impact of DAVF treatment with transarterial embolization. • 4D CTA provides images similar to those obtained with DSA both before and after treatment. - Abstract: Purpose: This study aimed to evaluate the usefulness of four-dimensional CTA before and after embolization treatment with ONYX-18 in eleven patients with cranial dural arteriovenous fistulas, and to compare the results with those of the reference standard DSA. Patients and Methods: Eleven patients with cranial dural arteriovenous fistulas detected on DSA underwent transarterial embolization with ONYX-18. Four-dimensional CTA was performed an average of 2 days before and 4 days after DSA. Four-dimensional CTA and DSA images were reviewed by two neuroradiologists for identification of feeding arteries and drainage veins and for determining treatment effects. Interobserver and intermodality agreement between four-dimensional CTA and DSA were assessed. Results: Forty-two feeding arteries were identified for 14 fistulas in the 11 patients. Of these, 36 (85.71%) were detected on four-dimensional CTA. After transarterial embolization, one patient got partly embolized, and the fistulas in the remaining 10 patients were completely occluded. The interobserver agreement for four-dimensional CTA and intermodality agreement between four-dimensional CTA and DSA were excellent (κ = 1) for shunt location, identification of drainage veins, and fistula occlusion after treatment. Conclusion: Four-dimensional CTA images are highly accurate when compared with DSA images both before and after transarterial embolization treatment. Four-dimensional CTA can be used for diagnosis as well as follow-up of cranial dural arteriovenous fistulas in clinical settings

  16. Endovascular management of dural carotid-cavernous sinus fistulas in 141 patients

    Energy Technology Data Exchange (ETDEWEB)

    Kirsch, M. [Alfried Krupp Krankenhaus, Klinik fuer Radiologie und Neuroradiologie, Essen (Germany); Universitaetsklinikum Greifswald, Institut fuer Diagnostische Radiologie und Neuroradiologie, Greifswald (Germany); Henkes, H.; Liebig, T.; Weber, W.; Golik, S.; Kuehne, D. [Alfried Krupp Krankenhaus, Klinik fuer Radiologie und Neuroradiologie, Essen (Germany); Esser, J. [Universitaetsklinikum Essen, Zentrum fuer Augenheilkunde, Essen (Germany)

    2006-07-15

    Introduction: The purpose of this study was to evaluate the single-centre experience with transvenous coil treatment of dural carotid-cavernous sinus fistulas. Methods: Between November 1991 and December 2005, a total of 141 patients (112 female) with dural carotid-cavernous sinus fistula underwent 161 transvenous treatment sessions. The patient files and angiograms were analysed retrospectively. Clinical signs and symptoms included chemosis (94%), exophthalmos (87%), cranial nerve palsy (54%), increased intraocular pressure (60%), diplopia (51%), and impaired vision (28%). Angiography revealed in addition cortical drainage in 34% of the patients. Partial arterial embolization was carried out in 23% of the patients. Transvenous treatment comprised in by far the majority of patients complete filling of the cavernous sinus and the adjacent segment of the superior and inferior ophthalmic vein with detachable coils. Complete interruption of the arteriovenous shunt was achieved in 81% of the patients. A minor residual shunt (without cortical or ocular drainage) remained in 13%, a significant residual shunt (with cortical or ocular drainage) remained in 4%, and the attempted treatment failed in 2%. There was a tendency for ocular pressure-related symptoms to resolve rapidly, while cranial nerve palsy and diplopia improved slowly (65%) or did not change (11%). The 39 patients with visual impairment recovered within the first 2 weeks after endovascular treatment. After complete interruption of the arteriovenous shunt, no recurrence was observed. The transvenous coil occlusion of the superior and inferior ophthalmic veins and the cavernous sinus of the symptomatic eye is a highly efficient and safe treatment in dural carotid-cavernous sinus fistulas. In the majority of patients a significant and permanent improvement in clinical signs and symptoms can be achieved. (orig.)

  17. The internal vertebral venous plexus prevents compression of the dural sac during atlanto-axial rotation

    Energy Technology Data Exchange (ETDEWEB)

    Reesink, E.M.; Lataster, L.M.A.; Mameren, H. van [Dept. of Anatomy/Embryology, Maastricht Univ. (Netherlands); Wilmink, J.T. [Dept. of Radiology, University Hospital Maastricht (Netherlands); Kingma, H. [Dept. of ENT, University Hospital Maastricht (Netherlands)

    2001-10-01

    Deformation of the extradural space and the possibility of impression upon the dural sac during atlanto-axial rotation are investigated. Atlanto-axial rotation leads to a reduction in the cross-sectional area of the bony spinal canal of approximately 40 %. Atlanto-axial rotation was recorded by endocanalar views from a video camera fixed inside the skull of six unembalmed cadavers. Axial thin-section T1-weighted MRI slice sets were acquired from three volunteers (mid-position and maximal left and right rotation of the head and cervical spine). The axial cross-sectional areas of the bony spinal canal, dural sac and spinal cord were measured. In two other persons post-gadolinium contrast-enhanced T1-weighted MRI volume scans with fat-suppression prepulse were acquired (mid-position and rotation) to determine venous contents of the extradural space. The 50:50 ratio between left and right extradural halves in mid-position changed to an ipsilateral:contralateral ratio of 20:80 in maximum rotation at the level just above the lateral C1-C2 joints. Directly below these joints the opposite occurred. The post-contrast studies showed an enhancing internal vertebral venous plexus (IVVP), which almost completely occupied the extradural space at the atlanto-axial level. This could not be shown in the cadaver experiments, because of absence of blood and cerebrospinal fluid (CSF) pressure. During atlanto-axial rotation blood displacement in the IVVP allows major deformations of the extradural space. This prevents dural sac impression. (orig.)

  18. Conduta na lesão dural intraoperatória em artrodese da coluna lombar Conducta en lesión de duramadre intraoperatoria en artrodesis de la columna lumbar Management of intraoperatory dural tear in lumbar spine arthrodesis

    Directory of Open Access Journals (Sweden)

    Fabiano de Mendonça Grandese

    2010-12-01

    Full Text Available OBJETIVO: estudo retrospectivo de pacientes com lesão dural intraoperatória de cirurgia da coluna vertebral lombar, conduzido por meio de um protocolo independente da extensão da lesão, complicações associadas e resultados após seguimento mínimo de um ano. MÉTODOS: um total de 10 pacientes com durotomia acidental em cirurgias de descompressão e artrodese da coluna vertebral lombar, no período de Janeiro de 2007 a Janeiro de 2009, para tratamento de doença degenerativa, tiveram seus prontuários revisados, após terem sido tratados por meio de um protocolo embasado em reparo primário da lesão, drenagem subaracnoidea fechada, subfascial e subcutânea aspirativa realizados por cirurgião experiente, associado a repouso relativo com mobilidade precoce e terapia medicamentosa. Suas anotações e exames radiológicos foram verificados com seguimento pós-operatório e direcionados para identificação de sintomas sugestivos de complicações. RESULTADOS: todos os pacientes apresentaram boa evolução, sem ocorrência de fístula liquórica ou infecção pós-operatória; três deles apresentaram cefaleia pós-operatória de leve intensidade. Não houve necessidade de reoperação em nenhum desses pacientes. CONCLUSÃO: concluiu-se que a conduta adotada é segura e de bom resultado para os pacientes quando ocorre esse tipo de lesão, independentemente da extensão da mesma.OBJETIVO: un estudio retrospectivo de pacientes con lesión de la duramadre intraoperatoria de cirugía en la columna lumbar, llevada a cabo por medio de un protocolo independiente de la extensión de la lesión, complicaciones asociadas y los resultados de seguimiento después de un mínimo de un año. MÉTODOS: 10 pacientes con durotomía accidental en la descompresión quirúrgica y artrodesis de la columna vertebral lumbar, en el período de enero de 2007 a enero de 2009, para el tratamiento de enfermedades degenerativas, tuvieron sus registros revisados después de

  19. Dural venous sinuses distortion and compression with supratentorial mass lesions: a mechanism for refractory intracranial hypertension?

    Science.gov (United States)

    Qureshi, Adnan I.; Qureshi, Mushtaq H.; Majidi, Shahram; Gilani, Waqas I.; Siddiq, Farhan

    2014-01-01

    Objective To determine the effect of supratentorial intraparenchymal mass lesions of various volumes on dural venous sinuses structure and transluminal pressures. Methods Three set of preparations were made using adult isolated head derived from fresh human cadaver. A supratentorial intraparenchymal balloon was introduced and inflated at various volumes and effect on dural venous sinuses was assessed by serial intravascular ultrasound, computed tomographic (CT), and magnetic resonance (MR) venograms. Contrast was injected through a catheter placed in sigmoid sinus for both CT and MR venograms. Serial trasluminal pressures were measured from middle part of superior sagittal sinus in another set of experiments. Results At intraparenchymal balloon inflation of 90 cm3, there was attenuation of contrast enhancement of superior sagittal sinus with compression visualized in posterior part of the sinus without any evidence of compression in the remaining sinus. At intraparenchymal balloon inflation of 180 and 210 cm3, there was compression and obliteration of superior sagittal sinus throughout the length of the sinus. In the coronal sections, at intraparenchymal balloon inflations of 90 and 120 cm3, compression and obliteration of the posterior part of superior sagittal sinus were visualized. In the axial images, basal veins were not visualized with intraparenchymal balloon inflation of 90 cm3 or greater although straight sinus was visualized at all levels of inflation. Trasluminal pressure in the middle part of superior sagittal sinus demonstrated a mild increase from 0 cm H2O to 0.4 cm H2O and 0.5 cm H2O with inflation of balloon to volume of 150 and 180 cm3, respectively. There was a rapid increase in transluminal pressure from 6.8 cm H2O to 25.6 cm H2O as the supratentorial mass lesion increased from 180 to 200 cm3. Conclusions Our experiments identified distortion and segmental and global obliteration of dural venous sinuses secondary to supratentorial mass lesion and

  20. Headache in the parturient: Pathophysiology and management of post-dural puncture headache

    Directory of Open Access Journals (Sweden)

    Gita Nath

    2011-01-01

    Full Text Available Headache in the postpartum period is common and multifactorial in origin. Apart from primary causes such as tension headaches and migraine, secondary headaches such as post-dural puncture headache (PDPH are increasingly common because of increasing use of regional anaesthesia and analgesia during childbirth. Preventive measures for PDPH include the use of smaller gauge pencil-point needles for spinal blocks; epidural needles of 18 G or less; using saline rather than air for epidural space identification and the use of ultrasound guidance, especially for difficult cases such as morbid obesity and spinal deformities. In case of accidental dural puncture (ADP, the choice is between inserting the catheter in an adjacent space or intrathecal catheterization. Current evidence seems to be in favour of inserting the epidural catheter into the subarachnoid space and using the intrathecal catheter for analgesia/anaesthesia after prominently labelling it as intrathecal, to prevent misuse. It should be removed after at least 24 hours and a 10 ml bolus of saline injected before removal of catheter may be helpful. Either way, having written protocols for the management of accidental dural puncture helps to reduce the incidence of PDPH. PDPH can be disabling in severity and can mar the whole experience of childbirth. In addition, severe untreated PDPH can cause complications such as nerve palsies, subdural hematoma and cerebral venous thrombosis. Conservative methods of treatment should be tried first such as adequate hydration, paracetamol, caffeine, sumatriptan or ACTH/hydrocortisone. Epidural blood patching is the most effective treatment for PDPH. It is more effective if done 24-48 hours after dural puncture. It is an invasive procedure with its own complications as well as a failure rate of up to 30%, so that a second or even third patch may be necessary. Both these facts should be intimated to the patient beforehand. Meticulous follow-up and evaluation

  1. Persistent dural cerebrospinal fluid leak shown by retrograde radionuclide myelography: case report

    International Nuclear Information System (INIS)

    Kadrie, H.; Driedger, A.A.; McInnis, W.

    1976-01-01

    Following inadvertent spinal anesthesia for delivery, a patient developed incapacitating post-lumbar puncture headache that persisted for 9 weeks. Scintigrams of the lumbar region, obtained after injection of /sup 99m/Tc-human serum albumin into the cisterna magna, showed the cerebrospinal fluid leak. Blood patch repair was carried out, with immediate relief of all symptoms. Because of subsequent atypical headaches, a second cisternogram was done by the same technique. This study confirmed that there was no further dural leak, and other evidence indicated that the recurrent headache was related to functional problems

  2. Conduta na lesão dural intraoperatória em artrodese da coluna lombar

    OpenAIRE

    Grandese, Fabiano de Mendonça; Yamazato, Clóvis; Oliveira, Fábio Mastromauro de; Ribeiro, Iberê; Bastos Júnior, José Olympio Catão; Kusabara, René

    2010-01-01

    OBJETIVO: estudo retrospectivo de pacientes com lesão dural intraoperatória de cirurgia da coluna vertebral lombar, conduzido por meio de um protocolo independente da extensão da lesão, complicações associadas e resultados após seguimento mínimo de um ano. MÉTODOS: um total de 10 pacientes com durotomia acidental em cirurgias de descompressão e artrodese da coluna vertebral lombar, no período de Janeiro de 2007 a Janeiro de 2009, para tratamento de doença degenerativa, tiveram seus prontuário...

  3. Dynamic subtraction magnetic resonance venography: a new real time imaging technique for the detection of dural sinus thrombosis

    International Nuclear Information System (INIS)

    Mandel, C.; Birchall, D.; Connolly, D.; English, P.

    2002-01-01

    Full text: Requests for imaging suspected dural sinus thrombosis are increasing. Conventional magnetic imaging (MRI) and magnetic resonance venography (MRV) are often used to detect venous sinus thrombosis, but these techniques are prone to technical problems. Catheter angiography is sometimes required as the final arbiter in the evaluation of the dural venous sinuses. Recent technical developments in MR scanning have allowed the development of dynamic subtraction MRA. This technique is beginning to be applied to the assessment of intracranial vascular malformations. We have recently applied the technique to the imaging of the dural venous sinuses, and describe our early experience with the technique. Imaging was performed on a Philips Intera 1.5T scanner with gradient strength 33 mT and slew rate 130 T/m/sec. T1-weighed fast field echo imaging was performed (flip angle 400, TR 1.5 msec) during bolus injection of gadolinium (5ml gadolinium followed by a 10 ml saline chaser) at 5-6 ml/sec using a MRI-compatible pump injector. Slice thickness depended on the plane of acquisition, but was between 100- 150 mm. Images were acquired in three orthogonal projections in each case, using 3 separate contrast injections. Mask images were obtained before the arrival of contrast, and subtracted reconstructed images were obtained in real time, providing a dynamic display of the intracranial circulation including the dural venous sinuses. Frame rate was 1 frame per 0.8 seconds. We will present dynamic MR angiographic images in a number of patients. Normal appearances and those seen in venous sinus thrombosis will be presented in the video display. Dynamic MR venography is a new technique for the imaging of dural venous sinuses. In our practice, it has proved a valuable adjunct for the imaging of patients with dural venous sinus thrombosis. Copyright (2002) Blackwell Science Pty Ltd

  4. NIVEL DE AUTOTRASCENDENCIA EN UN GRUPO DE ADULTOS MAYORES MEXICANOS

    OpenAIRE

    Guerrero Castañeda, Raúl Fernando; Lara Pérez, Ricardo

    2017-01-01

    RESUMEN Introducción: La autotrascendencia es una expansión multidimensional personal, una conexión con los demás, el entorno y/o una entidad superior, está relacionada con el bienestar personal del adulto mayor. Objetivo: Determinar el nivel de autotrascendencia de un grupo de adultos mayores mexicanos. Materiales y Métodos: Estudio descriptivo de corte transversal; realizado en tres centros gerontológicos de Celaya, Guanajuato, México, muestra probabilística aleatoria n=118. Se incluyero...

  5. Factores asociados al maltrato del adulto mayor de Antioquia, 2012

    OpenAIRE

    Sara M. Cano; María O. Garzón; Ángela M. Segura; Doris Cardona

    2015-01-01

    Objetivo: determinar los factores asociados al maltrato del adulto mayor del departamento de Antioquia en el año 2012. Metodología: mediante estudio descriptivo transversal, se caracterizaron los factores demográficos, económicos y de salud mental de la población adulta mayor de Antioquia para el año 2012, con el fin de aportar al análisis de la situación de salud y condiciones de vida del adulto mayor. El estudio se basó en los resultados del instrumento aplicado por la Universidad ces a 4.2...

  6. Apoyo social dignificante del adulto mayor institucionalizado. medellin, 2008

    OpenAIRE

    Cardona Arango, Doris; Segura Cardona, Angela María; Ordoñez Molina, Jaime Eduardo; Estrada Restrepo, Alejandro; Osorio Gómez, Jorge Julián; Chavarriaga Maya, Lina Marcela

    2011-01-01

    Objetivo Analizar el apoyo social del adulto mayor residente en los Centros de Bienestar del Anciano de Medellín registrados en la Secretaría de Bienestar Social en el año 2008. Materiales Estudio descriptivo transversal, que abordó algunas características relacionadas con el apoyo social recibido por 276 adultos mayores institucionalizados en 39 centros de protección social, con fuente de información primaria. El análisis de la información fue univariado y bivariado. Resultados Los institu...

  7. Intervenciones musicales para la ansiedad odontológica en pacientes pediátricos y adultos

    Directory of Open Access Journals (Sweden)

    Marta Sanjuán Navais

    2016-02-01

    Full Text Available La ansiedad odontológica ha sido identificada como un problema común tanto en niños como en adultos. La ansiedad odontológica se refiere a un estado de aprensión de que algo terrible va a suceder en relación con el tratamiento dental y se combina con una sensación de pérdida de control. Se informa que uno de cada seis adultos sufren algún tipo de ansiedad y en los niños entre un 5,7% y el 19,5%. Los pacientes con ansiedad odontológica tienden a descuidar el cuidado dental, lo cual plantea un problema, tanto para los pacientes como para los dentistas. Una relación dentista-paciente dominada por la ansiedad grave puede conducir a un mal diagnóstico y tratamiento inadecuado. Existen diferentes opciones de tratamiento para la ansiedad odontológica que pueden ir desde la explicación del proceso de tratamiento, estrategias farmacológicas, biofeedback, hipnosis e intervenciones conductuales. Se cree que la música reduce la ansiedad gracias a un efecto relajante o de distracción, que a su vez disminuye la actividad de los sistemas neuro-endocrino y sistema nervioso simpático.

  8. Factores de riesgo suicida en adultos

    Directory of Open Access Journals (Sweden)

    Sergio Pérez Barrero

    1997-02-01

    Full Text Available Se realiza un estudio descriptivo y poblacional en 833 adultos mayores de 15 años pertenecientes al Consultorio No. 3 del Policlínico "Bayamo Oeste", en Bayamo, Granma, entre noviembre de 1991 y octubre de 1992, para detectar la presencia de los siguientes factores de riesgo suicida: enfermedad médica crónica, enfermedad psiquiátrica, antecedentes de tratamiento e ingresos en salas de psiquiatría, ideación suicida, intento suicida previo, antecedentes familiares de conducta suicida y conflictos actuales. Se concluyó que el 39,1 % de la población estudiada poseía algún factor de riesgo suicida. La diabetes mellitus, la hipertensión arterial, el alcoholismo y la esquizofrenia, los antecedentes de tratamiento psiquiátrico, los antecedentes familiares de conducta suicida, la ideación suicida y el intento suicida previo fueron los factores de riesgo más frecuentes entre los individuos. Los conflictos de pareja y familiares, y la mala comunicación entre los miembros de las familias, fueron áreas conflictivas predominantes. Se recomienda realizar acciones de salud que disminuyan dichos factores de riesgo encontrados.A descriptive population study is carried out in 833 adults more than 15 years old, from the No.3 office of the "West Bayamo" policlinic at Bayamo, Granma province, between November 1991 and October 1992, in order to detect the appearance of the following suicidal risk factors: chronic medical disease, psychiatric disease, backgrounds of treatment and entrance in psychiatry rooms, suicidal ideation, previous suicidal attempt, family backgrounds of suiciddal behaviour, and current conflicts. It is concluded that 39,1 % of the studied population had some suicidal risk factor. The most frequent suicidal risk factors among individuals were diabetes mellitus, arterial hypertension. alcohol drinking, schizophrenia, backgrounds of psychiatric treatment, family backgrounds of suicidal behaviour, suicidal ideation, and previous

  9. Especificidad de la educación de adultos. b a s e s psicopedagógicas y señas de identidad

    Directory of Open Access Journals (Sweden)

    Óscar Medina Fernández

    2000-01-01

    Full Text Available Se plantean en este trabajo las bases psicopedagógicas de la educación de adultos y, a partir de ahí, se aborda el problema del carácter específico de este sector educativo. El autor trata de defender que, basándonos en la investigación psicológica que actualmente tenemos disponible, y haciendo uso de determinados conocimientos pedagógicos, existe base para fundamentar algunos aspectos del carácter específico de la educación de adultos como un tipo de educación propia que se diferencia de lo que habitualmente se realiza en las escuelas para niños y adolescentes. En la medida en que las señas de identidad de esa educación de adultos específica son eminentemente sociales, podemos afirmar que estamos ante un campo de la educación cuyo marco teórico más amplio es el de la Pedagogía Social

  10. Depresión en el adulto mayor: Estudio de una serie de pacientes de consultorio externo de medicina en el Hospital Nacional Cayetano Heredia

    Directory of Open Access Journals (Sweden)

    José Capuñay Chafloque

    1996-10-01

    Full Text Available Objetivo: Determinar la prevalencia de síntomas depresivos y de la depresión mayor en el adulto mayor. Material y métodos: Se realizó un estudio prospectivo y transversal tipo entrevista de carácter descriptivo en pacientes adultos mayores que acudieron a la consulta ambulatoria de medicina del Hospital Nacional Cayetano Heredia, entre abril y mayo de 1995. Resultados: Se encontró que 75% presentaba algún síntoma depresivo y el 8.3% de pacientes tenían depresión mayor según DSMIV. Los principales síntomas depresivos fueron estado de ánimo depresivo, trastorno del sueño y perdida de energía. Además se realizó revisión de la literatura sobre el tema de depresión en adultos mayores. (Rev Med Hered 1996; 7: 172-177.

  11. Las estrategias de afrontamiento frente a la percepción de apoyo social: Estudio Descriptivo-Comparativo con adultos mayores institucionalizados y no institucionalizados de la Región Metropolitana, considerando la variable género

    Directory of Open Access Journals (Sweden)

    Carolina Reyes Rasse

    2013-07-01

    Full Text Available La presente investigación estudió las estrategias de afrontamiento frente a la percepción de apoyo social en adultos mayores institucionalizados y no institucionalizados, considerando la variable género. Se utilizó una metodología de tipo descriptivo-comparativo de carácter cuantitativo. La muestra comprendió 100 adultos mayores, 25 hombres institucionalizados y no institucionalizados, 25mujeres institucionalizadas y no institucionalizadas. Los resultados señalan que las mujeres adultas mayores perciben mayor apoyo social familiar y de las amistades que los hombres; de igual manera, los no institucionalizados perciben mayor apoyo social que los institucionalizados. Comparando ambas escalas de apoyo social, los adultos mayores perciben mayor apoyo familiar que de las amistades. Con respecto a las estrategias de afrontamiento, entre hombres y mujeres adultos mayores existen diferencias significativas en la utilización de las estrategias: reinterpretación positiva y crecimiento, focalización y ventilación de emociones, siendo las mujeres quienes las despliegan más. Los hombres utilizan más las estrategias: afrontamiento activo, aceptación de responsabilidad y autocontrol, y las mujeres reinterpretación positiva y crecimiento, aceptación de responsabilidad y autocontrol. Los adultos mayores institucionalizados despliegan menos estrategias de afrontamiento que los no institucionalizados, existiendo diferencias significativas en las estrategias: planificación, búsqueda de apoyo social por motivos instrumentales, búsqueda de apoyo social por motivos afectivos y reinterpretación positiva y crecimiento. Las principales estrategias utilizadas por los adultos mayores institucionalizados son: afrontamiento activo, aceptación de la responsabilidad y autocontrol. Los no institucionalizados utilizan más las estrategias: afrontamiento activo, planificación, reinterpretación positiva y crecimiento y de autocontrol.

  12. Radiographic anatomy of the distal dural SAC; A myelographic investigation of dimensions and termination

    Energy Technology Data Exchange (ETDEWEB)

    Larsen, J.L.; Olsen, K.O. (Haukeland Sykehus, Bergen (Norway). Dept. of Diagnostic Radiology)

    1991-05-01

    A radio-anatomical study was performed of the distal dural sac (DS) in 121 patients subjected to myelography. In 83.4% the termination of the DS was located from the upper half of the S1-segment to the lower half of the S2-segment. In the remaining patients the dural terminations were more distally located. The average location of the DS-termination was higher than that found in a previous anatomic study. The inference is that in patients with low-back pain and sciatica, the DS tends to terminate at a higher spinal level than in a non-selected anatomic material. The caudal reduction in sagittal diameter of the DS was less than that of the frontal diameter of the sac. The linear diminution in cross-sectional area of the DS from the level of L3 towards the lumbosacral junction was not correlated with the degree of caudal extension of the DS into the sacrum. Thus the length of the DS and its transverse diameters are independent of each other. These results supported the view that the location of the termination of the DS (and hence that of the spinal cord) is not related to stenosis of the central spinal canal. (orig.).

  13. Spinal Dural Arteriovenous Fistula (SDAVF in a Patient with Progressive Paraparesia: A Case Report

    Directory of Open Access Journals (Sweden)

    Mehrdokht Mazdeh

    2016-07-01

    Full Text Available Background: Spinal dural arteriovenous fistula (SDAVF is a known cause of nontraumatic slow progressive araparesia and is frequently overlooked because its clinical features overlap with more common causes of myelopathy and also neuroimaging may be normal. Case Report: A 53 year-old man with developed weakness of both lower limbs had symptoms begun spontaneously 3.5 month before admission and progressed from 1 month ago with bowel and bladder incontinence. The patient's physical examination was normal and neurologic testing revealed lower extremity motor strength of 3/5. Deep tendon reflexes were decreased and superficial abdominal reflexes were absent. Sensation of pinprick and temperature was absent distal to the T4-T5 level. Vibration and proprioception were decreased to the ankle and saddle anesthesia and the patient was non ambulatory. Laboratory routine and specific tests for vitamin B12 level, hepatitis, HIV, HTLV1, 2 were negative. MRI of spine with and without contrast raised the possibility of dural arteriovenous malformation extended from T3 level to conus medullaris which was confirmed by angiography. The patient referred to neurosurgeon for deciding route of treatment. Conclusion: SDAVF can be a significant non traumatic slowly progressive cause of myelopathy. The majority of the affected patients are males older than 50 years of age. Rapid diagnosis in these patients leads to significant improvement.

  14. Indocyanine green videoangiography "in negative": definition and usefulness in intracranial dural arteriovenous fistulae.

    Science.gov (United States)

    Simal Julián, Juan Antonio; Miranda Lloret, Pablo; Aparici Robles, Fernando; Beltrán Giner, Andrés; Botella Asunción, Carlos

    2013-09-01

    Indocyanine green videoangiography (IGV) raises important limitations when we use it in vascular pathology, especially in cases with arterialization of the venous system such as arteriovenous malformations and fistulae. Our objective was to provide a simple procedure that overcomes the limitations of conventional IGV. We define IGV in negative (IGV-IN), so-called because, in its first phase, the vessel to analyze is clipped, and we report 3 cases of intracranial dural arteriovenous fistulae treated with this procedure. In 2011, we applied IGV-IN to 3 patients at our center with Borden type III intracranial arteriovenous fistulae. In all 3 cases, IGV-IN enabled both diagnosis and post-dural arteriovenous fistula exclusion control in 1 integrated procedure no longer than 1 minute, requiring only 1 visualization. IGV-IN is an improvement over the conventional IGV method and is able to provide more information in a shorter period of time. It is an intuitive and highly visual procedure, and, more importantly, it is reversible. Studies with larger samples are necessary to determine whether IGV-IN can further reduce the need for postoperative digital subtraction angiography.

  15. Widening of the spinal canal and dural ectasia in Marfan's syndrome: assessment by CT

    International Nuclear Information System (INIS)

    Villeirs, G.M.; Verstraete, K.L.; Kunnen, M.F.; Tongerloo, A.J. van; Paepe, A.M. de

    1999-01-01

    We describe a method for diagnosing dural ectasia (DE) and spinal canal widening (SCW) using CT. We examined 23 patients with Marfan's syndrome (MFS), 17 with Ehlers-Danlos syndrome (EDS) and 29 normal subjects, using six axial slices at the level of the L1-S1 pedicles. Transverse diameters of the vertebral bodies, spinal canal and dural sac were measured and indices were defined to differentiate patients with DE and SCW from normal. Statistical significance was assessed using Student's t -test, χ 2 -test and Pearson's correlation coefficient. DE and SCW occurred in 69.6 % and 60.9 % of cases of MFS and in 23.5 % and 35.3 % of EDS respectively. In MFS, prevalence was significantly higher than in the control group. DE was significantly more frequent in MFS than in EDS. A strong correlation existed between DE and SCW in MFS and the control group, but not in EDS. Our system enables quantitative assessment of SCW and DE. The latter is particularly important in subjects suspected of having MFS, in whom it is a common and characteristic sign. (orig.)

  16. Dural sinus malformation (DSM) in fetuses. Diagnostic value of prenatal MRI and follow-up

    Energy Technology Data Exchange (ETDEWEB)

    Merzoug, Valerie; Drissi, Cyrine; Adamsbaum, Catherine [Hopital Saint Vincent de Paul, Service de Radiopediatrie, Paris (France); Flunker, Sabrina; Couture, Alain [Hopital Arnaud de Villeneuve, Service de Radiopediatrie, Montpellier cedex 5 (France); Eurin, Danielle [Hopital Charles Nicolle, Service de Radiopediatrie, Rouen (France); Grange, Gilles [Hopital Cochin, Service de Gyneco-Obstetrique, Maternite Port-Royal, Paris (France); Garel, Catherine [Hopital Armand Trousseau, Service de Radiopediatrie, Paris (France); Richter, Brigitte [Hopital Clemenceau, Service de Radiopediatrie, Caen (France); Geissler, Frederic [Centre Hospitalier Universitaire, Service de Radiopediatrie, Clermont Ferrand (France)

    2008-04-15

    Dural sinus malformations (DSM) are rare malformations mainly reported after birth. The objectives of this study are to describe their prenatal patterns and to focus on their possible favorable outcome. This multicenter retrospective study reported 13 cases of DSM prenatally diagnosed. The admission criterion was a dural mass posterior to the vermis. In 12 patients, MRI was performed after US. Follow-up in 10 born babies (mean: 8 months) and three neuropathological examinations were available. In all fetuses, DSM presented as a well-delimited round mass involving the torcular. The follow-up examinations (n = 10) revealed progressive thrombosis of the DSM marked by a heterogeneous pattern (US and MRI) with concentric rings. The volume of the mass decreased, with complete regression in seven patients (five before and two after birth). One child died at the age of 5 months in the context of major hydrocephalus and another developed atrophy of the frontal lobes. The eight other babies were doing well (5 days to 3 years) without any treatment (n = 6) or following treatment for hydrocephalus (n = 2). Prenatal DSM may have a typical MR pattern, and the prognosis might not be as bad as has previously been reported. In the absence of criterion to predict the hydrovenous cerebral imbalance, it is mandatory to check the parenchyma and the ventricles during the pregnancy. (orig.)

  17. Dural sinus malformation (DSM) in fetuses. Diagnostic value of prenatal MRI and follow-up

    International Nuclear Information System (INIS)

    Merzoug, Valerie; Drissi, Cyrine; Adamsbaum, Catherine; Flunker, Sabrina; Couture, Alain; Eurin, Danielle; Grange, Gilles; Garel, Catherine; Richter, Brigitte; Geissler, Frederic

    2008-01-01

    Dural sinus malformations (DSM) are rare malformations mainly reported after birth. The objectives of this study are to describe their prenatal patterns and to focus on their possible favorable outcome. This multicenter retrospective study reported 13 cases of DSM prenatally diagnosed. The admission criterion was a dural mass posterior to the vermis. In 12 patients, MRI was performed after US. Follow-up in 10 born babies (mean: 8 months) and three neuropathological examinations were available. In all fetuses, DSM presented as a well-delimited round mass involving the torcular. The follow-up examinations (n = 10) revealed progressive thrombosis of the DSM marked by a heterogeneous pattern (US and MRI) with concentric rings. The volume of the mass decreased, with complete regression in seven patients (five before and two after birth). One child died at the age of 5 months in the context of major hydrocephalus and another developed atrophy of the frontal lobes. The eight other babies were doing well (5 days to 3 years) without any treatment (n = 6) or following treatment for hydrocephalus (n 2). Prenatal DSM may have a typical MR pattern, and the prognosis might not be as bad as has previously been reported. In the absence of criterion to predict the hydrovenous cerebral imbalance, it is mandatory to check the parenchyma and the ventricles during the pregnancy. (orig.)

  18. Effect of Hemoconcentration on Dural Sinus Computed Tomography Density in a Pediatric Population.

    Science.gov (United States)

    Yurttutan, Nursel; Kizildag, Betul; Sarica, Mehmet Akif; Baykara, Murat

    2016-10-01

    Unenhanced brain computed tomography (CT) is inexpensive, easily available, and the first-choice imaging modality for patients presenting with various neurologic symptoms. Venous thrombosis is not rare in childhood, but diagnosis can be difficult. In some cases, only denser vessels can be used to highlight an issue. The aim of this study was to retrospectively evaluate the relationship between X-ray attenuation and hemoconcentration in a pediatric population. This study enrolled 99 pediatric patients who had been referred radiology department for unenhanced brain CT. Images were retrospectively evaluated for measurement of dural sinus densities from four distinct dural sinus locations. Correlation between mean Hounsfield unit (HU) values and hemoglobin/hematocrit (Hb/Htc) levels, as well as age and gender were further analyzed. There was a strong correlation between mean HU and Hb levels (r = 0.411; standard deviation: 0.001) and also between mean HU and Htc levels (r = 0.393; p pediatric group. In conclusion, before deciding between a diagnosis of thrombosis and a determination of normal findings during an evaluation of unenhanced CT in a pediatric population, radiologists should consider complete blood count results as well as H:H ratios. Georg Thieme Verlag KG Stuttgart · New York.

  19. Standardization and validation of a novel and simple method to assess lumbar dural sac size

    International Nuclear Information System (INIS)

    Daniels, M.L.A.; Lowe, J.R.; Roy, P.; Patrone, M.V.; Conyers, J.M.; Fine, J.P.; Knowles, M.R.; Birchard, K.R.

    2015-01-01

    Aim: To develop and validate a simple, reproducible method to assess dural sac size using standard imaging technology. Materials and methods: This study was institutional review board-approved. Two readers, blinded to the diagnoses, measured anterior–posterior (AP) and transverse (TR) dural sac diameter (DSD), and AP vertebral body diameter (VBD) of the lumbar vertebrae using MRI images from 53 control patients with pre-existing MRI examinations, 19 prospectively MRI-imaged healthy controls, and 24 patients with Marfan syndrome with prior MRI or CT lumbar spine imaging. Statistical analysis utilized linear and logistic regression, Pearson correlation, and receiver operating characteristic (ROC) curves. Results: AP-DSD and TR-DSD measurements were reproducible between two readers (r = 0.91 and 0.87, respectively). DSD (L1–L5) was not different between male and female controls in the AP or TR plane (p = 0.43; p = 0.40, respectively), and did not vary by age (p = 0.62; p = 0.25) or height (p = 0.64; p = 0.32). AP-VBD was greater in males versus females (p = 1.5 × 10 −8 ), resulting in a smaller dural sac ratio (DSR) (DSD/VBD) in males (p = 5.8 × 10 −6 ). Marfan patients had larger AP-DSDs and TR-DSDs than controls (p = 5.9 × 10 −9 ; p = 6.5 × 10 −9 , respectively). Compared to DSR, AP-DSD and TR-DSD better discriminate Marfan from control subjects based on area under the curve (AUC) values from unadjusted ROCs (AP-DSD p < 0.01; TR-DSD p = 0.04). Conclusion: Individual vertebrae and L1–L5 (average) AP-DSD and TR-DSD measurements are simple, reliable, and reproducible for quantitating dural sac size without needing to control for gender, age, or height. - Highlights: • DSD (L1-L5) does not differ in the AP or TR plane by gender, height, or age. • AP- and TR-DSD measures correlate well between readers with different experience. • Height is positively correlated to AP-VBD in both males and females. • Varying

  20. Resultados de un programa de estrategias de aprendizaje en adultos

    OpenAIRE

    Puig Moratal, María Julia; Puig Moratal, Vicente

    2011-01-01

    Cómo aprende el adulto, diferentes métodos, técnicas y estrategias de aprendizaje, y su probada influencia sobre diferentes factores de orden personal y académico. Nos basamos en aprender estrategias de aprendizaje, a través de unidades didácticas.

  1. Prevalencia de anemia y factores asociados en adultos mayores peruanos

    Directory of Open Access Journals (Sweden)

    Carolina Tarqui-Mamani

    Full Text Available Objetivos. Determinar la prevalencia de anemia y factores asociados en los adultos mayores del Perú. Materiales y métodos. Se realizó un estudio transversal durante el año 2011. El muestreo fue probabilístico, estratificado y multietápico. La muestra de viviendas fue 5792 y se incluyó 2172 adultos mayores. Se definió anemia como hemoglobina 23 a 80 años (OR 2,1; IC 95%: 1,4-3,0 y la delgadez (OR 1,7; IC 95%:1,2-2,3 se asociaron con la anemia. Los departamentos con mayor prevalencia de anemia fueron Ayacucho (57,6%, Ancash (40,1%, Lambayeque (37,7% y Apurímac (36,9%. Conclusiones. Aproximadamente la cuarta parte de los adultos mayores tuvieron anemia, siendo más predominante en los analfabetos, procedentes de áreas rurales y pobres. La mayor edad y la delgadez se asocian con la presencia de anemia en los adultos mayores peruanos

  2. ¿Crisis de adolescentes o crisis de adultos?

    Directory of Open Access Journals (Sweden)

    Norman Darío Moreno Carmona

    2012-01-01

    Full Text Available Este artículo tiene como propósito la divulgación de una investigación cuyo objetivo fue caracterizar el significado contemporáneo del adulto en dos grupos etarios de la ciudad de Medellín (Colombia. Los tópicos centrales sobre los que se funda tal caracterización son la percepción sobre los adultos referentes, la manera como han vivido esa relación con sus adultos cercanos y la propia actitud frente a la adultez y su papel como referentes de las generaciones más jóvenes. La metodología del estudio fue cualitativa, las estrategias para la recolección de información fueron 20 entrevistas semiestructuradas y la aplicación de un test proyectivo. Los resultados muestran que hay un desdibujamiento de la adultez en la contemporaneidad, pues sus características cada vez resultan menos evidentes en los adultos.

  3. ¿Crisis de adolescentes o crisis de adultos?

    Directory of Open Access Journals (Sweden)

    Norman Darío Moreno Carmona

    2012-01-01

    Full Text Available Este artículo tiene como propósito la divulgación de una investigación cuyo objetivo fue caracterizar el significado con- temporáneo del adulto en dos grupos etarios de la ciudad de Medellín (Colombia. Los tópicos centrales sobre los que se funda tal caracterización son la percepción sobre los adultos referentes, la manera como han vivido esa relación con sus adultos cercanos y la propia actitud frente a la adultez y su papel como referentes de las generaciones más jóvenes. La metodología del estudio fue cualitativa, las estrategias para la recolección de información fueron 20 entrevistas semies- tructuradas y la aplicación de un test proyectivo. Los resultados muestran que hay un desdibujamiento de la adultez en la contemporaneidad, pues sus características cada vez resultan menos evidentes en los adultos. © Revista Colombiana de Ciencias Sociales.

  4. Nivel de autotrascendencia en un grupo de adultos mayores mexicanos

    Directory of Open Access Journals (Sweden)

    Raúl Fernando Guerrero Castañeda

    2017-01-01

    Full Text Available Introducción: La autotrascendencia es una expansión multidimensional personal, una conexión con los demás, el entorno y/o una entidad superior, está relacionada con el bienestar personal del adulto mayor. Objetivo: Determinar el nivel de autotrascendencia de un grupo de adultos mayores mexicanos. Materiales y Métodos: Estudio descriptivo de corte transversal; realizado en tres centros gerontológicos de Celaya, Guanajuato, México, muestra probabilística aleatoria n=118. Se incluyeron adultos mayores que acudían a los centros gerontológicos, hombres y mujeres, ≥ 60 años. Se utilizó la Escala de Autotrascendencia en español con valor resultante entre 15 y 60 (mayor puntaje = mayor autotrascendencia. Se realizó prueba piloto con 40 adultos mayores con Alpha de Cronbach de 0.80. Análisis estadístico descriptivo para variables categóricas (frecuencias y porcentajes, para variables numéricas: medidas de tendencia central y dispersión. Resultados: Media de Autotrascendencia fue 51.36. Se identificaron con “Encontrando significado en mis creencias espirituales” (85.6% y “Disfrutando mi ritmo de vida” (81.4%; hubo diferencia estadísticamente significativa en la media de Autotrascendencia (p˂0.05 por sexo, siendo mayor el nivel en las mujeres. No hubo diferencia entre grupos de edad. Discusión y Conclusiones: La media de autotrascendencia refleja un nivel alto, en comparación con otros estudios y se reportó entre 75-84 años una media mayor. Los adultos mayores se identifican con características como la religión y el disfrute de la vida. La Escala de Autotrascendencia se puede usar en adultos mayores mexicanos ya que demostró un buen nivel de consistencia interna. Cómo citar este artículo: Guerrero RF, Lara R. Nivel de autotrascendencia en un grupo de adultos mayores mexicanos. Rev Cuid. 2017; 8(1: 1476-87. http://dx.doi.org/10.15649/cuidarte.v8i1.354

  5. Miopericarditis en enfermedad de Still del adulto: Reporte de un caso

    Directory of Open Access Journals (Sweden)

    Carmen Eliana Peralta Vargas

    2008-10-01

    Full Text Available Varón de 22 años, admitido en el Hospital Nacional Cayetano Heredia, con un tiempo de enfermedad de diez días, manifestando fiebre, malestar general y diaforesis nocturna; se añade astenia, disnea a moderados esfuerzos y tos productiva. No tenía antecedentes personales ni familiares de enfermedad previa. En el Hospital, desarrolla Insuficiencia Cardiaca Aguda y efusión pericárdica, el estudio del líquido y la biopsia del pericardio fueron de tipo inflamatorio inespecífico. El paciente, inicialmente recibió antibióticos, sin mejoría de cuadro clínico; desarrolló rash dérmico y oligoartritis, con estudio de líquido articular no inflamatorio, con cultivos negativos. Se solicita ferritina sérica, resultado 95 873 ng/mL. Se obtuvo mejoría en el estado general y caída de la fiebre con prednisona 60mg/d. Al excluirse otras enfermedades, se sugiere el diagnóstico de enfermedad de Still de inicio del adulto, con miopericarditis como manifestación inicial. (Rev Med Hered 2008; 19:167-170.

  6. Características clínicas y comorbilidades de pacientes con lupus eritematoso sistémico en niños y adultos

    Directory of Open Access Journals (Sweden)

    Carlos Daniel Coronado Alvarado

    2018-01-01

    Full Text Available INTRODUCCIÓN: el lupus eritematoso sistémico es una enfermedad autoinmune crónica; se presenta mayormente en mujeres en etapa reproductiva y es menos frecuente en niños.   OBJETIVO: comparar las manifestaciones clínicas, comorbilidades y farmacoterapia en niños y adultos con lupus eritematoso sistémico (LES.   MATERIAL Y MÉTODOS: se seleccionaron 127 expedientes clínicos de pacientes con diagnóstico de LES; 36 menores de edad de un hospital pediátrico (grupo A y 91 adultos de un hospital general (grupo B. Recolectamos información respecto a las manifestaciones clínicas al diagnóstico en los niños y adultos, así como las comorbilidades relacionadas y mortalidad, atendiendo los criterios de la American College of Rheumatology, también del tipo de medicamentos empleados. Estadísticas utilizadas: cálculo de frecuencias, porcentajes, la prueba de ji cuadrada, prueba exacta de Fisher, razón de momios e intervalos de confianza.   RESULTADOS: en niños predominaron: eritema malar (p = < 0.01, vasculitis (p < 0.01, fotosensibilidad (p < 0.01, síndrome nefrítico (p < 0.01, alteraciones leucocitarias (p < 0.01, derrame pleural, anemia, derrame pericárdico, sepsis y hepatopatía; además, el número de medicamentos empleados fue mayor. En adultos predominaron: artralgia (p < 0.01, pancitopenia (p = 0.025, alopecia (p < 0.01, sinovitis (p = 0.044 y falla renal crónica (p = 0.04. Los fármacos usados en el grupo A fueron: hidroxicloroquina (p < 0.01, glucocorticoides (p = 0.14 y micofenolato (p = 0.28, la mortalidad en niños fue de 25% y en 91 adultos ocurrió en 5 (0.05%.   CONCLUSIONES: las manifestaciones clínicas en niños muestran mayor lesión cutánea inicial y vasculitis, daño renal, cardiovascular, pulmonar e infecciones; en los adultos predominan afecciones articulares y falla renal crónica. Los niños reciben mayor número de fármacos y su mortalidad es mayor.

  7. Instrumentos de avaliação de leitura em adultos: um estudo psicométrico

    Directory of Open Access Journals (Sweden)

    Natália Martins Dias

    Full Text Available RESUMO Objetivo: investigar as propriedades psicométricas de um teste de desempenho para avaliação de reconhecimento de palavras e de um checklist de autorrelato de dificuldades de leitura/indicadores de dislexia, em uma amostra de adultos. Métodos: foram avaliados 54 sujeitos, idades entre 18 e 57 anos (M=24,16; DP = 7,34, com Ensino Médio completo ou cursando a graduação. As avaliações foram realizadas utilizando o Teste Computadorizado de Competência de Leitura de Palavras para Adultos (TCLP-2 e o questionário de autorrelato Adult Dyslexia Checklist (ADC. Resultados: não foram observadas diferenças de desempenho em função da escolaridade e do gênero. O tempo de resposta foi menor no julgamento dos itens Corretos do TCLP-2 em relação aos itens incorretos (inversão, troca fonológica, erro ortográfico e pseudopalavra homófona. 18,5% dos participantes relataram dificuldades mais severas no ADC. Análise de grupos extremos mostrou que participantes com maiores pontuações/dificuldades no ADC tiveram pior desempenho nos itens Corretos do TCLP-2. Análise fatorial retornou solução com fator único para tipos de itens do TCLP-2. Dados de precisão se mostraram adequados para ambos os instrumentos, com valores de Spearman-Brown e alfa de Cronbach maiores que 0,70. Relações de baixa a moderadas foram observadas entre os dois instrumentos, provendo evidências de validade a ambos. Conclusão: o estudo apresentou dados psicométricos de dois instrumentos para avaliação de leitura em adultos. Ambos mostraram índices satisfatórios de precisão e evidências de validade por relação com outras variáveis. Frente à carência de instrumentos padronizados para avaliação de leitura em adultos no contexto nacional, o estudo estende sua contribuição à futura instrumentalização desta área.

  8. La calidad de vida del adulto mayor con Artritis Reumatoidea

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    Clara Gallardo

    2017-05-01

    Full Text Available Objetivo determinar la atención de Enfermería y su incidencia en la calidad de vida del adulto mayor con artritis reumatoidea atendidos en el subcentro de salud de Ambatillo en el período Julio – Diciembre 2013. Métodos y materiales: Estudio no experimental de diseño descriptivo aplicando técnicas de observación y cuestionario cuya población fue de 30 adultos mayores en los que se detectó la necesidad de investigar la problemática, cuyos resultados indican que los principales problemas que presentan los pacientes son: dolor e inflamación articular, incapacidad músculo esquelética, discapacidad etc. Re- sultados: La problemática que se aborda es la calidad de vida del adulto mayor con esta patología pues muchas veces no se da una atención basada en el estado emocional, respuesta fisiológica, aspecto físico al que se enfrenta tanto el paciente como su núcleo familiar.es asì que el 69% de adultos mayores con artritis reumatoidea , la misma manera el 75% del personal de enfermería que labora en el Subcentro de salud de Ambatillo Conclusiones: Una vez evidenciada la problemática de estudio se presenta como propuesta la elaboración de una Guía de Atención de Enfermería el mismo que permitirá valorar en forma integral, priorizar las necesidades de atención y brindar cuidados específicos en el adulto mayor con artritis reumatoidea.

  9. The entire dural sinus tree is compressed in patients with idiopathic intracranial hypertension: a longitudinal, volumetric magnetic resonance imaging study

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    Rohr, Axel; Bindeballe, Jan; Riedel, Christian; Jansen, Olav [University Clinic of Schleswig-Holstein Campus Kiel, Department of Neuroradiology, Kiel (Germany); Baalen, Andreas van [University Clinic of Schleswig-Holstein Campus Kiel, Department of Neuropediatrics, Kiel (Germany); Bartsch, Thorsten [University Clinic of Schleswig-Holstein Campus Kiel, Department of Neurology, Kiel (Germany); Doerner, Lutz [University Clinic of Schleswig-Holstein Campus Kiel, Department of Neurosurgery, Kiel (Germany)

    2012-01-15

    The objective of this study was to explore the volumetric alterations of dural sinuses in patients with idiopathic intracranial hypertension (IIH). Standardized cranial magnetic resonance imaging (MRI) was used in 17 patients prior to and following treatment of IIH and in seven controls. Magnetic resonance venographies (MRV) were employed for (a) judgement of circumscript dural sinus stenoses and (b) computation of sinus volumes. Cross-sectional areas (CSA) of the superior sagittal sinuses (SSS) were measured on T2-weighted images. Results of the initial MRIs were compared to those on follow-up MRIs and to results of controls. Stenoses of the transverse sinuses (TS) resulting in cranial venous outflow obstruction (CVOO) were present in 15/17 (88%) patients, normalizing in 7/15 cases (47%) after treatment of IIH. CVOO was not detected in the control group. Segmentation of MRV revealed decreased dural sinus volumes in patients with IIH as compared to controls (P = 0.018). Sinus volumes increased significantly with normalization of intracranial pressure independent from disappearing of TS stenoses (P = 0.007). The CSA of the SSS were normal on the initial MRIs of patients with IIH and increased on follow-up after treatment (P < 0.001). However, volumetries displayed overlap in patients and controls. Patients with IIH not only exhibit bilateral stenoses of the TS as has been reported, but volume changes of their entire dural sinus system also occur. The potential etiopathological and diagnostic roles of these changes are discussed. (orig.)

  10. Morbilidad cardiovascular en el adulto mayor

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    Rita Campillo Motilva

    2001-12-01

    Full Text Available Se realizó un estudio transversal y descriptivo, con el objetivo de definir la morbilidad por enfermedad cardiovascular en pacientes de 60 años y más, en un consultorio médico perteneciente al Policlínico Docente "Dr. Mario Escalona Reguera" del municipio Habana del Este, en el período entre marzo y diciembre del año 2000. Fueron incluidos 69 pacientes, 52 de los cuales (75,3 % presentó algún tipo de enfermedad cardiovascular, y fue el sexo femenino el más afectado (51,9 %. La enfermedad que se encontró con mayor frecuencia fue la hipertensión arterial (43 pacientes para un 62,3 %, observamos que la sistodiastólica (86,1 % y el estadio II (53,5 % fue donde se incluyeron mayor número de individuos. Otras enfermedades encontradas fueron los trastornos electrocardiográficos (33 pacientes para un 47,8 % y valvulopatías (18 pacientes para un 26 %.A cross-sectional and descriptive study was conducted in order to define morbidity due to cardiovascular disease in patients aged 60 and over in a family physician’s office of "Dr. Mario Escalona Reguera" Teaching Polyclinic, in Habana del Este municipality, from March to December, 2000. 69 patients were included. 52 of them (75.3 % had some type of cardiovascular disease and females were the most affected (51.9 %. Arterial hypertension was the most commonly found disease (43 patients for 62.3 %. Most of the individuals were included in the systodiastolic (86.1 % and in stage II (53.5 %. Electrocardiographic disorders (33 patients for 47.8 % and valvulopathies (18 patients for 26 % were other of the diseases detected.

  11. Use of computer-assisted design and manufacturing to localize dural venous sinuses during reconstructive surgery for craniosynostosis.

    Science.gov (United States)

    Iyer, Rajiv R; Wu, Adela; Macmillan, Alexandra; Musavi, Leila; Cho, Regina; Lopez, Joseph; Jallo, George I; Dorafshar, Amir H; Ahn, Edward S

    2018-01-01

    Cranial vault remodeling surgery for craniosynostosis carries the potential risk of dural venous sinus injury given the extensive bony exposure. Identification of the dural venous sinuses can be challenging in patients with craniosynostosis given the lack of accurate surface-localizing landmarks. Computer-aided design and manufacturing (CAD/CAM) has allowed surgeons to pre-operatively plan these complex procedures in an effort to increase reconstructive efficiency. An added benefit of this technology is the ability to intraoperatively map the dural venous sinuses based on pre-operative imaging. We utilized CAD/CAM technology to intraoperatively map the dural venous sinuses for patients undergoing reconstructive surgery for craniosynostosis in an effort to prevent sinus injury, increase operative efficiency, and enhance patient safety. Here, we describe our experience utilizing this intraoperative technology in pediatric patients with craniosynostosis. We retrospectively reviewed the charts of children undergoing reconstructive surgery for craniosynostosis using CAD/CAM surgical planning guides at our institution between 2012 and 2016. Data collected included the following: age, gender, type of craniosynostosis, estimated blood loss, sagittal sinus deviation from the sagittal suture, peri-operative outcomes, and hospital length of stay. Thirty-two patients underwent reconstructive cranial surgery for craniosynostosis, with a median age of 11 months (range, 7-160). Types of synostosis included metopic (6), unicoronal (6), sagittal (15), lambdoid (1), and multiple suture (4). Sagittal sinus deviation from the sagittal suture was maximal in unicoronal synostosis patients (10.2 ± 0.9 mm). All patients tolerated surgery well, and there were no occurrences of sagittal sinus, transverse sinus, or torcular injury. The use of CAD/CAM technology allows for accurate intraoperative dural venous sinus localization during reconstructive surgery for craniosynostosis and

  12. Retrograde flow in the dural sinuses detected by three-dimensional time-of-flight MR angiography

    International Nuclear Information System (INIS)

    Uchino, Akira; Nomiyama, Keita; Takase, Yukinori; Nakazono, Takahiko; Tominaga, Yukiko; Imaizumi, Takeshi; Kudo, Sho

    2007-01-01

    Retrograde flow in the left dural sinuses is sometimes detected by three-dimensional time-of-flight (3D-TOF) magnetic resonance (MR) angiography. The purpose of this study was to evaluate the incidence of this phenomenon and its characteristic features on 3D-TOF MR angiograms. We retrospectively reviewed cranial MR angiography images of 1,078 patients examined at our institution. All images were obtained by the 3D-TOF technique with one of two 1.5-T scanners. Maximum intensity projection (MIP) images in the horizontal rotation view were displayed stereoscopically. We reviewed the source images, inferosuperior MIP images, and horizontal MIP images and identified retrograde flow in the dural sinuses. We found retrograde flow in the dural sinuses of 67 patients on the source images from 3D-TOF MR angiography; the incidence was 6.2%. In 47 of the 67 patients, retrograde flow was identified in the left inferior petrosal sinus, in 13, it was seen in the left sigmoid sinus, and in 6, it was seen in the left inferior petrosal and left sigmoid sinuses. The remaining patient had retrograde flow in the left inferior petrosal and left and right sigmoid sinuses. The mean age of the patients with retrograde flow was slightly greater than that of the patients without this phenomenon (70 years vs 63 years). Retrograde flow in the dural sinuses frequently occurs on the left side in middle-aged and elderly patients during 3D-TOF MR angiography performed with the patient in the supine position. This phenomenon should not be misdiagnosed as a dural arteriovenous fistula. (orig.)

  13. Catarata e diabetes mellitus tipo 1

    OpenAIRE

    Pizzol,Melissa Manfroi Dal; Esteves,Jorge Freita; Sccoco,Caio Augusto; Roggia,Murilo Felix; Rosa,Carolina Maurente da; Lambert,José Humberto Franco; Canani,Luís Henrique

    2008-01-01

    OBJETIVO: Avaliar a prevalência de catarata e seus fatores de risco em uma população portadora de diabetes mellitus tipo 1 (DM1). MÉTODOS: Estudo de casos e controles de um banco de dados de 181 pacientes (362 olhos) com diagnóstico de diabetes mellitus tipo 1. Os pacientes foram classificados como casos quando apresentavam diagnóstico de catarata. As variáveis estudadas foram a presença ou não de retinopatia diabética, tratamento com panfotocoagulação, presença de hipertensão arterial sistêm...

  14. Endovascular management of sigmoid sinus dural arteriovenous fistula associated with sinus stenosis in an infant.

    Science.gov (United States)

    Cohen, José E; Gomori, John M; Benifla, Moni; Itshayek, Eyal; Moscovici, Samuel

    2013-01-01

    A 4-month-old female presented with a dural arteriovenous fistula (DAVF), which was successfully managed using endovascular techniques. There are very few case series reporting DAVF in infants younger than 12 months and, to our knowledge, only 60 pediatric patients with DAVF have been reported to date. Although most DAVF have a benign course, they can result in life-threatening hemorrhage. Endovascular therapies are usually indicated in the management of these neurosurgical vascular malformations. Endovascular therapy of DAVF in neonatal patients presents some major issues. Gaining arterial access may be problematic in femoral arteries too small for the introduction of a sizeable guiding catheter. The volumes of contrast and infused fluids must be carefully monitored to prevent fluid overload. Radiation exposure should be restricted as far as possible. This report contributes to the limited body of evidence on neonatal DAVF and its endovascular management. Copyright © 2012 Elsevier Ltd. All rights reserved.

  15. The MR imaging and DSA features and embolization therapy of spinal dural arteriovenous fistulae

    International Nuclear Information System (INIS)

    Zhang Hua; Hu Jinqing; Lin Dong; Wu Daming; Wang Dengbin; Yang Yanmin; Cheng Kemin

    2005-01-01

    Objective: To investigate the MR imaging and DSA features together with endovascular embolization of spinal dural arteriovenous fistulae (SDAVF). Methods: Twelve patients with SDAVF underwent both MR imaging and angiography of spinal cord, 4 of them received endovascular embolization. The imaging findings of MRI and angiography in all patients were analyzed. Results: Among 12 cases with SDAVF, 11 cases showed diffuse long T 2 signal, 2 cases demonstrated inhomogeneous maculate enhancement in the spinal cord and 6 cases revealed abnormal vessels in the dorsal spaces of spinal cord on MRI. Angiography of spinal cord showed orifices of all fistulae, draining veins, the extent of lesions, amount of feeding vessels and the angiographic features in all the 12 cases. 4 cases with embolization treatment showed improvement clinically. Conclusions: Angiography of spinal cord is the main method and MRI provides important assistance for diagnosing SDAVF while endovascular embolization is an effective method for the treatment. (authors)

  16. Dural carotid cavernous sinus fistula presenting as isolated oculomotor nerve palsy: Case report

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    Şehnaz Arıcı

    2015-04-01

    Full Text Available Indirect (dural carotid cavernous fistula is formed by the connection between meningeal branches of the internal carotid artery and the cavernous sinüs, and low flow circulation with low pressure is occured. Proptosis, ophtalmoplegia, headache, scleral and conjuctival hyperemia expanding around the eyeball can be observed. A forty-eight year old female patient with a background of diabetes mellitus and hypertension was admitted with complaints of double vision. Isolated oculomotor nerve palsy was found in neurological examination and an indirect carotid cavernous fistula was revealed by digital subtraction angiography. Our case with carotid cavernous fistula as a rare cause of isolated oculomotor nerve palsy is worth to be reported.

  17. FACTORES BIOPSICOSOCIALES ASOCIADOS A LAS ACTIVIDADES DE LA VIDA COTIDIANA DEL ADULTO MAYOR. CENTRO DE SALUD SAN JUAN DEL DISTRITO DE PAUCARPATA.AREQUIPA, 2012

    OpenAIRE

    MACEDO VALENCIA, HILDA EMILIANA

    2013-01-01

    EL ADULTO MAYOR ETAPA EVOLUTIVA DEL ADULTO MAYOR CARACTERÍSTICAS DEL ADULTO MAYOR QUE TIENEN UN ENVEJECIMIENTO SALUDABLE IMPACTO DE LAS CONDICIONES PSICOSOCIALES EN EL ADULTO MAYOR FACTORES BIO-PSICO-SOCIALES FACTORES BIOLÓGICOS FACTORES PSICOLÓGICOS FACTORES SOCIALES ACTIVIDADES DE LA VIDA COTIDIANA DEL ADULTO MAYOR

  18. Medio ambiente, comportamento y aprendizaje en ratones adultos

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    Luis Miguel Garcia-Segura

    1977-03-01

    Full Text Available Se analiza el efecto que tiene sobre el ratón adulto el ser sometido a diferentes situaciones ambientales. Para ello se colocan ratones adultos en grupos de 12 en cajas que contienen rampas, pasarelas, pasadizos y objetos diversos, que se cambiaban de posición relativa varias veces por semana. Otros ratones se colocaron en grupos de 4 en cajas más pequenas y sin ninguno de estos objetos. Despues de estar 60 dias en estas condiciones se estúdio el comportamiento explorador de los ratones y su capacidad de aprendizaje de un laberinto complejo. Se observó una diferencia significativa entre los dos grupos de ratones ,tanto en su comportamiento explorador como en el tiempo empleado en resolver el laberinto y el número de ratones que lo resolvian en cada una de 10 pruebas sucesivas.

  19. propiedades psicométricas en adultos mayores

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    Armando Rivera-Ledesma

    2013-01-01

    Full Text Available La presente investigación propone la adaptación al español y validación de la Escala de Soporte Social (ESS-AM de Tagaya, Okuno, Tamura y Davis (2000, conducida en cuatro muestras independientes de adultos mayores de la Ciudad de México. La escala, de ocho reactivos, mide la percepción de apoyo social mediante un solo factor que explica el 60,7% de la varianza, con una consistencia interna a de 0,84 y correlaciones negativas significativas con la variable soledad. Con base en ello, se concluye que la ESS-AM es un instrumento confiable, útil y sencillo en funciones de tamizaje para evaluar si el adulto mayor cuenta con adecuados niveles de apoyo social percibido.

  20. Documented development of a dural arteriovenous fistula in an infant subsequent to sinus thrombosis: case report and review of the literature

    International Nuclear Information System (INIS)

    Morales, Humberto; Jones, Blaise V.; Leach, James L.; Abruzzo, Todd A.

    2010-01-01

    Controversy exists as to whether sinus thrombosis is the cause or the result of dural arteriovenous fistula (DAVF) and to whether DAVF are congenital or acquired lesions, especially in children. An infant presented with rupture of an anterior communicating artery aneurysm diagnosed with computed tomography angiography and catheter angiography. Pretreatment hospital course was complicated by extensive dural sinus thrombosis. Subsequent arteriography showed a new adult-type dural arteriovenous fistula to the previously thrombosed right sigmoid sinus. This is the first report of definitive angiographic documentation of the development of an adult-type DAVF after recanalization of a thrombosed dural sinus in a child. This case confirms the acquired etiology of at least one type of DAVF in children, even at this young age. We review the previously documented cases of formation of DAVF subsequent to sinus thrombosis with serial angiography in adults. (orig.)

  1. Funcionalidad familiar y ansiedad en pacientes adultos con enfermedad crónica

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    Ma. del Refugio Zavala-Rodríguez

    2009-01-01

    Full Text Available Objetivo. Describir el grado de relación entre la funcionalidad familiar y el nivel de ansiedad en pacientes adultos con enfermedad crónica de una institución de salud de segundo nivel. Metodología. El diseño del estudio fue descriptivo, transversal, correlacional, se efectuó en una muestra de 97 pacientes y una misma cantidad de familiares; los primeros se seleccionaron mediante un análisis de potencia, cubriendo los siguientes criterios de inclusión: pacientes adultos, orientados, de los servicios de hospitalización y consulta externa de una institución de segundo nivel de atención. Se utilizó una cédula sociodemográfica, la Escala de Efectividad en el Funcionamiento Familiar de Friedemann (E-EFF, y la escala de ansiedad-rasgo de Spielberger, estos últimos con una consistencia interna de ,83 y ,75 respectivamente, determinada por el alpha de Cronbach. Los datos se analizaron a través de estadística descriptiva e inferencial. Resultados. El grupo de edad que predominó en los familiares fue de 33 a 47 años, con una media de 45,73, y en los pacientes predominó el grupo de 60 a 70 años, con una media de 65,05; en ambos grupos se destacó el género femenino. El 56% de los pacientes presenta diabetes mellitus tipo 2. En cuanto a los índices, la ansiedad-rasgo obtuvo una media de 51 (DE 10,7, en la E-EFF fue de 84 (DE 11,5. Por tanto, se detectó nivel moderado de ansiedad en el 92% de los pacientes, y el 91% integra una familia funcional. La correlación de Spearman no arrojó una asociación significativa entre las dos variables del estudio (rho= -,094, p= ,362. Conclusión. Las cuatro subescalas de la E-EFF obtuvieron una media significativa, con valores que fluctúan entre 77,0 a 92,0. Este último valor equivale a la subescala de coherencia que, de acuerdo con Friedemann, guía a la unidad y pertenencia familiar, y permite vínculos emocionales positivos.

  2. Intervención de trabajo social con adultos mayores

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    Yesica Rodríguez Montañez

    2003-01-01

    Full Text Available El artículo presenta las metodologías de intervención del Trabajo Social con adultos mayores realizando un recorrido por los términos envejecimiento y vejez, haciendo énfasis en la importancia de la pérdida en la concepción de la misma . Se realiza un aná

  3. Calidad de vida en adultos del Paraguay con enfermedad celiaca

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    Raúl Emilio Real-Delor

    2018-01-01

    Full Text Available La enfermedad celiaca altera el estado emocional, las relaciones sociales, la autonomía y la percepción de la salud, afectando la calidad de vida relacionada a la salud. Los objetivos fueron determinar la calidad de vida relacionada a la salud en adolescentes y adultos con enfermedad celiaca e investigar los factores que la afectan. Se realizó un estudio observacional, prospectivo, realizado en adolescentes y adultos del Paraguay portadores de enfermedad celiaca con al menos 6 meses en dieta sin gluten. Se aplicó el cuestionario CD-QOL. Fueron incluidos 114 sujetos, con edad media 30±10 años, siendo 58% del sexo femenino. La calidad de vida fue buena en 25%, regular en 49% y mala en 26%. Los factores asociados significativamente a mejor calidad de vida fueron el sexo femenino, el grupo etario >30 años y realizar actividades fuera del hogar. Se concluye que la calidad de vida de los celiacos adolescentes y adultos es regular en 49% de los encuestados.

  4. Resocialización en el Adulto Mayor

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    Zandra Liliana Cabara

    2004-11-01

    Full Text Available Este artículo plantea un estudio sobre la descripción de métodos de resocialización en el adulto mayor, evidenciando sus potencialidades como auto transformador de su mundo circundante dejando de Iado preconceptos sobre la vejez. Las reflexiones que se plantean en este articulo son producto de un estudio preliminar, don de se aplicó una prueba piloto a tres adultos mayores de diferentes niveles socioculturales pero pertenecientes al mismo estrato económico que se encuentran formando parte de un grupo organizado de atención integral al Adulto Mayor, coordinado por una Fundación Gerontológica en el municipio de Duitama. Se hace un análisis comparativo mediante un método de investigación cualitativa y descriptiva. Restaría, profundizar en la investigación e incluir un estudio comparativo de abuelos con características similares no pertenecientes a grupos organizados.

  5. Neural-Dural Transition at the Thoracic and Lumbar Spinal Nerve Roots: A Histological Study of Human Late-Stage Fetuses

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    Kwang Ho Cho

    2016-01-01

    Full Text Available Epidural blocks have been used extensively in infants. However, little histological information is available on the immature neural-dural transition. The neural-dural transition was histologically investigated in 12 late-stage (28–30 weeks fetuses. The dural sheath of the spinal cord was observed to always continue along the nerve roots with varying thicknesses between specimens and segments, while the dorsal root ganglion sheath was usually very thin or unclear. Immature neural-dural transitions were associated with effective anesthesia. The posterior radicular artery was near the dorsal root ganglion and/or embedded in the nerve root, whereas the anterior radicular artery was separated from the nearest nerve root. The anterior radicular artery was not associated with the dural sheath but with thin mesenchymal tissue. The numbers of radicular arteries tended to become smaller in larger specimens. Likewise, larger specimens of the upper thoracic and lower lumbar segments did not show the artery. Therefore, elimination of the radicular arteries to form a single artery of Adamkiewicz was occurring in late-stage fetuses. The epidural space was filled with veins, and the loose tissue space extended ventrolaterally to the subpleural tissue between the ribs. Consequently, epidural blocks in infants require special attention although immature neural-dural transitions seemed to increase the effect.

  6. Suitability of cerebrospinal fluid as a signal-intensity reference on MRI: evaluation of signal-intensity variations in the lumbosacral dural sac

    International Nuclear Information System (INIS)

    Luoma, E.K.; Luukkonen, R.; Riihimaeki, H.A.; Raininko, R.; Manninen, H.I.; Nummi, P.J.

    1997-01-01

    The suitability of the cerebrospinal fluid (CSF) in the lumbosacral dural sac as an internal signal-intensity reference was studied on magnetic resonance imaging (MRI) of the lumbar spine using a surface coil and motion artefact suppression technique. A signal-intensity reference is needed when signal is compared between images, studies or subjects. Homogeneity of the CSF was estimated visually on T2-weighted images of 60 subjects at 1.5 T and of another 60 subjects at 0.1 T. Spines with a severely narrowed dural sac or marked scoliosis were excluded from the study to avoid partial volume effect. CSF was homogeneous in 82% and 73% of the examinations at 1.5 T and 0.1 T, respectively. The type and location of the local inhomogeneities did not relate to local narrowings of the dural sac. The signal intensity of CSF was measured in 108 examinations at 0.1 T after correcting the spatially-dependent signal-intensity nonuniformities with a phantom-based method. The signal-intensity difference between the CSF in the upper and lower lumbar dural sac was less than 10% in 73% of the examinations. The CSF in the lumbosacral dural sac can be a useful signal-intensity reference for estimation of the signal of the adjacent structures in patients without severe narrowing of the dural sac or marked scoliosis. It may contribute to assessing spinal disease processes. (orig.). With 1 fig., 3 tabs

  7. Plano de amostragem do biótipo B de Bemisia tabaci na cultura do pepino

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    Moura Marcelo Fialho de

    2003-01-01

    Full Text Available A adoção de programas de manejo integrado de pragas permite reduzir a aplicação de inseticidas e os planos convencionais de amostragem representam o ponto inicial na geração desses programas. Assim, o objetivo deste trabalho foi determinar plano de amostragem convencional para o biótipo B da mosca-branca Bemisia tabaci Genn. (Hemiptera: Aleyrodidae na cultura do pepino. Foram avaliadas as densidades de ninfas e de adultos em dez lavouras comerciais de pepino, Tocantins, MG, estudando nove sistemas amostrais formados pela combinação de três técnicas (batida de folha em bandeja de plástico branco, contagem direta dos insetos na face inferior da folha e coleta de folha em sacola de plástico e três unidades amostrais (folha do terço apical, mediano ou basal do espaldeiramento. A contagem direta em folha do terço basal foi o sistema com maior precisão econômica na amostragem de ninfas, mas não possibilitou a geração de plano de amostragem praticável. As batidas, em bandeja, de folha dos terços apicais, medianos ou basais do espaldeiramento foram os sistemas economicamente mais precisos na amostragem de adultos. Desses, apenas a batida de folha do terço mediano em bandeja gerou plano de amostragem praticável, sendo que este plano é composto de 196 amostras/lavoura.

  8. BIENESTAR PSICOLÓGICO: ADULTOS MAYORES ACTIVOS A TRAVÉS DEL VOLUNTARIADO

    OpenAIRE

    FERRADA MUNDACA,LESLIE; ZAVALA GUTIÉRREZ,MERCEDES

    2014-01-01

    Objetivo: Comparar el nivel de bienestar psicológico de adultos mayores voluntarios del programa "Asesores Seniors" del Servicio Nacional del Adulto Mayor, Región del Bío-Bío, Chile, y adultos mayores no voluntarios, usuarios de un Centro de Salud Familiar de la misma región. Material y método: Corresponde a un estudio descriptivo - comparativo. La población del estudio corresponde a 60 adultos mayores, 30 voluntarios en un programa gubernamental y 30 no voluntarios usuarios de un Centro de S...

  9. Mejoramiento del cuidado de la salud de adultos mayores en una unidad de atención gerontológica

    Directory of Open Access Journals (Sweden)

    Rolando Jacinto Jijón Vásquez

    2018-03-01

    Full Text Available Introducción: Las personas de la tercera edad enfrentan múltiples enfermedades y disfunciones orgánicas propias del proceso natural de envejecimiento, además de los riesgos aumentados de afectación de su integridad física, psicológica, social y espiritual, incluyendo el abandono familiar. Objetivo: Fortalecer el cuidado de la salud de los adultos mayores de la unidad gerontológica Pimampiro, mediante la sensibilización y capacitación del personal y familiares. Se estableció como Fin el contribuir a mejorar la calidad de vida de los adultos mayores y como Propósito central, el mejoramiento del cuidado de la salud de este grupo poblacional. Métodos: El trabajo fue de tipo investigación acción, y se siguió la Metodología del Marco Lógico que implicó la construcción de un árbol de problemas y de objetivos, a partir de los cuales se planificaron las actividades requeridas. Participaron 60 adultos mayores; 1 fisioterapeuta, 1 nutricionista, 1 trabajadora social y 2 terapistas ocupacionales que desarrollan las actividades técnicas en el Centro, además de 60 familiares o cuidadores de los ancianos. Resultados: Se implementó una guía de atención al adulto mayor en el centro y los familiares fueron capacitados mediante talleres sobre estilos de vida saludable, constatándose que estas personas se encuentran brindando una atención digna e inclusiva a los ancianos en sus hogares y en el centro gerontológico. Conclusiones: La implementación de la guía de atención al adulto mayor y la capacitación a familiares y cuidadores fortalece la atención de este grupo poblacional, genera confiabilidad en la atención recibida y sensación de bienestar en los usuarios.

  10. Dural Ectasia of the Optic Nerve and Unilateral Proptosis-Two Rare Comorbidities Associated with Idiopathic Intracranial Hypertension

    Directory of Open Access Journals (Sweden)

    Serkan Dağdelen

    2013-08-01

    Full Text Available A 24-year-old woman with a recent history of visual abnormality (obscurations had bilateral optic disc swellings, dilatation of the optic nerve sheaths, monocular proptosis, and increased cerebrospinal fluid pressures. She was diagnosed as idiopathic intracranial hypertension (IIH. IIH can present with both papilledema and dural ectasia although the latter is usually seen as an isolated entity. Various conditions also have been implicated in IIH. However, apart from female sex, recent weight gain and obesity, there are no proven associations. In this case report, we present a case of IHH associated with two different pathologies: dural ectasia of the optic nerve sheaths and monocular proptosis. (Turk J Ophthalmol 2013; 43: 297-300

  11. Is there a dural wall between the cavernous sinus and the pituitary fossa? Anatomical and MRI findings

    International Nuclear Information System (INIS)

    Dietemann, J.L.; Diniz, R.; Reis, M. Jr.; Neugroschl, C.; Vinclair, L.; Maillot, C.

    1998-01-01

    We compared MRI studies of the sellar area and embryological and adult histological studies of the cavernous sinuses and pituitary fossa. MRI studies were performed in 50 normal subjects with coronal sections using a fast inversion-recovery sequence to demonstrate the dural walls of the cavernous sinus and pituitary fossa. With this sequence, dura mater appears as a high-signal linear structure. The lateral and superior walls of the cavernous sinus was easily identified on all studies, but demonstration of a dural wall separating the cavernous sinus from the pituitary fossa was not possible. These results correlated well with embryological and adult histological studies obtained from 14 specimens. The absence of a strong separation between the pituitary fossa and the cavernous sinus explains the high incidence of extension of pituitary tumours to the cavernous sinuses and vice versa. (orig.) (orig.)

  12. Acute Tetraparesis with Respiratory Failure after Steroid Administration in a Patient with a Dural Arteriovenous Fistula at the Craniocervical Junction

    Science.gov (United States)

    Takahashi, Hisashi; Ueshima, Taiki; Goto, Daiki; Kimura, Tadashi; Yuki, Natsuko; Inoue, Yasuo; Yoshioka, Akira

    2017-01-01

    A 63-year-old man developed vomiting, paraparesis, dysuria, bulbar palsy, and orthostatic hypotension over a period of 5 months. Neuroradiological examinations showed a swollen lower brainstem with a dural arteriovenous fistula at the craniocervical junction (DAVF-CCJ). A steroid was administered intravenously in the hospital to relieve brainstem edema. A few hours later, however, the patient developed acute tetraparesis with respiratory failure. Recently, there have been several reports describing the acute worsening of paraparesis in patients with a spinal dural arteriovenous fistula after steroid treatment. In addition to these reports, the present case suggests the risk of administering steroids to patients with DAVF-CCJ, especially those with brainstem dysfunction. PMID:29225249

  13. Dural arteriovenøs fistel er en sjælden, men behandlelig årsag til transversal myelopati

    DEFF Research Database (Denmark)

    Hansen, Julie Richter; Poulsgaard, Lars; Holtmannspötter, Markus

    2017-01-01

    This is a case report of a 60-year-old male admitted on suspicion of relapse of idiopathic transverse myelitis (TM), who after further diagnostic workup underwent successful closure of a dural arteriovenous fistula (DAVF). Magnetic resonance imaging in DAVF usually shows longitudinal TM, which, u......, unlike DAVF, is also seen with the more common inflammatory or infectious causes usually showing inflammation in the cerebrospinal fluid. The natural history of DAVF is progressive. Since curable options exist, timely diagnosis is most important....

  14. Fate of the three embryonic dural sinuses in infants: the primitive tentorial sinus, occipital sinus, and falcine sinus.

    Science.gov (United States)

    Mizutani, Katsuhiro; Miwa, Tomoru; Akiyama, Takenori; Sakamoto, Yoshiaki; Fujiwara, Hirokazu; Yoshida, Kazunari

    2018-03-01

    The primitive tentorial, occipital, and falcine sinuses are thought to attain the adult pattern or regress between the fetal stage and adulthood. The anatomy of these three primitive dural sinuses has seldom been studied in the infant population, and it remains unclear when these dural sinuses reach the adult condition. Using computed tomography digital subtraction venography (CT-DSV), we analyzed the anatomy of these embryonic dural sinuses in infants. We included 13 infants who underwent CT-DSV prior to neurosurgery and 35 cases with unruptured cerebral aneurysms as normal adult controls. Three embryonic dural sinuses, i.e., the primitive tentorial, occipital, and falcine sinuses, were retrospectively analyzed in CT-DSV images of infants and adults. We also analyzed the drainage patterns of the superficial middle cerebral vein (SMCV), determined by the connection between the primitive tentorial sinus and the cavernous sinus. The primitive tentorial, occipital, and falcine sinuses were present in 15.4%, 46.2%, and none of the infants, respectively, and in 10.0, 8.6, and 2.9% of the adults, respectively. The difference in SMCV draining pattern between infants and adults was insignificant. The incidence of the occipital sinus was significantly higher in infants than in adults. The connection between the primitive tentorial sinus and the cavernous sinus appears to be established before birth. The occipital sinus is formed at the embryonic stage and mostly regresses after infancy. The falcine sinus is usually obliterated prenatally. Our findings form the basis for interventions by pediatric interventional neuroradiologists and neurosurgeons.

  15. Optic pathway glioma associated with orbital rhabdomyosarcoma and bilateral optic nerve sheath dural ectasia in a child with neurofibromatosis-1

    International Nuclear Information System (INIS)

    Nikas, Ioannis; Theofanopoulou, Maria; Lampropoulou, Penelope; Hadjigeorgi, Christiana; Pourtsidis, Apostolos; Kosmidis, Helen

    2006-01-01

    Neurofibromatosis-1 (NF-1) is a multisystem disorder presenting with a variety of clinical and imaging manifestations. Neural and non-neural tumours, and unusual benign miscellaneous conditions, separately or combined, are encountered in variable locations. We present a 21/2-year-old boy with NF-1 who demonstrated coexisting optic pathway glioma with involvement of the chiasm and optic nerve, orbital alveolar rhabdomyosarcoma and bilateral optic nerve sheath dural ectasia. (orig.)

  16. Educación emocional y satisfacción con la vida percibida en un grupo de adultos mayores

    Directory of Open Access Journals (Sweden)

    Adriana del Pilar Perugache Rodríguez

    2016-07-01

    Full Text Available La investigación tuvo como objetivo determinar el efecto de un Programa en Educación Emocional sobre la percepción de la satisfacción con la vida en un grupo de Adultos Mayores. Materiales y método: el trabajo realizado fue de tipo explicativo y empleó un diseño experimental. Se evaluó inicialmente el nivel de la variable dependiente, en los grupos experimental y control a través de la prueba Índice de Satisfacción Vital (ISV –A adaptación de la escala original validada por Zegers, Rojas y Förstein (2009; con una consistencia interna de 0, 80, y una validez de 0.84. Posteriormente se implementó el Programa de Educación Emocional en el grupo experimental y finalmente, se aplicó el pos-test en los dos grupos. El análisis de los datos se realizó con el paquete estadístico SPSS versión 0.20. Debido a que no se cumplió con el supuesto de normalidad se aplicó la prueba de Wilcoxon para muestras relacionadas y la U de Mann Whitney para las muestras independientes. Resultados: el programa mejoró los niveles de satisfacción con la vida percibida en el grupo experimental, obteniendo un p0,05. Conclusiones: El programa incrementa los niveles de satisfacción con la vida percibida en adultos mayores.

  17. Uso de medicamentos en adultos mayores no institucionalizados Use of medication in elderly people don’t institutionalized

    Directory of Open Access Journals (Sweden)

    Martín Regueiro

    2011-12-01

    Full Text Available El uso inadecuado de medicamentos en el adulto mayor representa un problema de salud pública en constante progresión. Realizamos un estudio de utilización de medicamentos de tipo transversal, empleando una encuesta autoadministrada para evaluar el uso de medicamentos y la prescripción inadecuada en adultos mayores ambulatorios de la ciudad de La Plata, Argentina, en 2009. El total de personas encuestadas fue de 215. El promedio de medicamentos usados por persona fue 3,19 ± 2,02, la polimedicación estuvo presente en 24,1 % de los sujetos. Recibieron medicamentos potencialmente inapropiados (MPI el 25,5 %, 31,9 % y 30,0 % de los pacientes, según los criterios Beers, lista PRISCUS, y criterios STOPP, respectivamente. Esta investigación constató que la prescripción potencialmente inapropiada es frecuente y que existe una necesidad creciente de contar con un listado de medicamentos potencialmente inapropiados, adecuada a cada realidad, que contemple aquellas situaciones donde el tratamiento es subóptimo.Misuse of drugs in the elderly is a rampant public health problem. We conducted a cross-sectional study using a self-administered survey to assess drug use and inadedequate prescription among noninstotunilazed elderly patients in the city of La Plata, Argentina in 2009. The total number of respondents was 215. The average number of drugs used per person was 3.19 ± 2.02, polypharmacy was present in 24.1 % of subjects. Potentially inappropriate medications (MPI were given in 25.5 %, 31.9 % and 30.0 % of the patients, according to Beers criteria, Priscus list, and STOPP criteria, respectively. This research found that potentially inappropriate prescribing is common and there is a growing need for a list of potentially inappropriate medications, as appropriate to each situation, that considers situations where treatment is suboptimal.

  18. Impacto de uma intervenção nutricional em pacientes adultos portadores de síndrome metabólica atendidos no Ambulatório de Nutrição do Hospital Escola/UFPel

    OpenAIRE

    Duval, Patrícia Abrantes

    2011-01-01

    A Síndrome Metabólica (SM) é um importante fator de risco independente para o desenvolvimento de Diabetes Mellitus tipo 2 e doença cardiovascular, sendo atribuído principalmente à presença de resistência à insulina. O rápido crescimento da SM tem sido atribuído às alterações do estilo de vida, principalmente, hábitos alimentares inadequados e sedentarismo. Os objetivos do estudo são avaliar o impacto de uma intervenção nutricional realizada em pacientes adultos portadores de Síndrome Metab...

  19. Diseño de cursos de inglés en un entorno de aprendizaje mixto e integración de la tecnología móvil en la educación de adultos

    OpenAIRE

    Prieto-Trigo, Carolina

    2013-01-01

    La enseñanza de idiomas dirigida a adultos en organismos públicos como la Escuela Oficial de Idiomas se suele considerar como un tipo de enseñanza tradicional en la que las nuevas tecnologías se incorporan, aunque de manera limitada, en las clases presenciales. Pero... ¿podría ser viable la implantación de un entorno mixto de aprendizaje en el que las nuevas tecnologías y el trabajo colaborativo fuesen un elemento fundamental en el proceso de enseñaza-aprendizaje? Esta es preci...

  20. La prevención del maltrato al adulto mayor, barrio Paraíso, parroquia José Luis Tamayo, cantón salinas, 2014-2016.

    OpenAIRE

    Martínez Salas, Letty J.

    2017-01-01

    El maltrato constituye un problema social que afecta al desarrollo humano del adulto mayor que habita en el barrio Paraíso de la parroquia José Luis Tamayo, limitando sus libertades y capacidades. El objetivo del presente trabajo consiste en analizar cómo prevenir el maltrato hacia estas personas. La metodología utilizada en este estudio es tipo cualitativo, efectuada a través de la entrevista con actores locales, consultas teóricas y bibliográficas, reportes estadísticos, complementadas con ...

  1. Induced dural lymphangiogenesis facilities soluble amyloid-beta clearance from brain in a transgenic mouse model of Alzheimer's disease

    Directory of Open Access Journals (Sweden)

    Ya-Ru Wen

    2018-01-01

    Full Text Available Impaired amyloid-β clearance from the brain is a core pathological event in Alzheimer's disease. The therapeutic effect of current pharmacotherapies is unsatisfactory, and some treatments cause severe side effects. The meningeal lymphatic vessels might be a new route for amyloid-β clearance. This study investigated whether promoting dural lymphangiogenesis facilitated the clearance of amyloid-β from the brain. First, human lymphatic endothelial cells were treated with 100 ng/mL recombinant human vascular endothelial growth factor-C (rhVEGF-C protein. Light microscopy verified that rhVEGF-C, a specific ligand for vascular endothelial growth factor receptor-3 (VEGFR-3, significantly promoted tube formation of human lymphatic endothelial cells in vitro. In an in vivo study, 200 μg/mL rhVEGF-C was injected into the cisterna magna of APP/PS1 transgenic mice, once every 2 days, four times in total. Immunofluorescence staining demonstrated high levels of dural lymphangiogenesis in Alzheimer's disease mice. One week after rhVEGF-C administration, enzyme-linked immunosorbent assay results showed that levels of soluble amyloid-β were decreased in cerebrospinal fluid and brain. The Morris water maze test demonstrated that spatial cognition was restored. These results indicate that the upregulation of dural lymphangiogenesis facilities amyloid-β clearance from the brain of APP/PS1 mice, suggesting the potential of the VEGF-C/VEGFR-3 signaling pathway as a therapeutic target for Alzheimer's disease.

  2. [Ropivacaine use in transnasal sphenopalatine ganglion block for post dural puncture headache in obstetric patients - case series].

    Science.gov (United States)

    Furtado, Inês; Lima, Isabel Flor de; Pedro, Sérgio

    2018-02-02

    Sphenopalatine ganglion block is widely accepted in chronic pain; however it has been underestimated in post dural puncture headache treatment. The ganglion block does not restore normal cerebrospinal fluid dynamics but effectively reduces symptoms associated with resultant hypotension. When correctly applied it may avoid performance of epidural blood patch. The transnasal approach is a simple and minimally invasive technique. In the cases presented, we attempted to perform and report the ganglion block effectiveness and duration, using ropivacaine. We present four obstetrics patients with post dural puncture headache, after epidural or combined techniques, with Tuohy needle 18G that underwent a safe and successful Sphenopalatine ganglion block. We performed the block 24-48h after dural puncture, with 4mL of ropivacaine 0.75% in each nostril. In three cases pain recurred within 12-48h, although less intense. In one patient a second block was performed with complete relief and without further recurrence. In the other two patients a blood patch was performed without success. All patients were asymptomatic within 7 days. The average duration of analgesic effect of the block remains poorly defined. In the cases reported, blocking with ropivacaine was a simple, safe and effective technique, with immediate and sustained pain relief for at least 12-24h. Copyright © 2017 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  3. Late-presenting dural tear: incidence, risk factors, and associated complications.

    Science.gov (United States)

    Durand, Wesley M; DePasse, J Mason; Kuris, Eren O; Yang, JaeWon; Daniels, Alan H

    2018-04-18

    Unrecognized and inadequately repaired intraoperative durotomies may lead to cerebrospinal fluid leak, pseudomeningocele, and other complications. Few studies have investigated durotomy that is unrecognized intraoperatively and requires additional postoperative management (hereafter, late-presenting dural tear [LPDT]), although estimates of LPDT range from 0.6 to 8.3 per 1,000 spinal surgeries. These single-center studies are based on relatively small sample sizes for an event of this rarity, all with <10 patients experiencing LPDT. This investigation is the largest yet conducted on LPDT, and sought to identify incidence, risk factors for, and complications associated with LPDT. This observational cohort study employed the American College of Surgeons National Surgical Quality Improvement Program dataset (years 2012-2015). Patients who underwent spine surgery were identified based on presence of primary listed Current Procedural Terminology (CPT) codes corresponding to spinal fusion or isolated posterior decompression without fusion. The primary variable in this study was occurrence of LPDT, identified as reoperation or readmission with durotomy-specific CPT or International Classification of Diseases, Ninth Revision, Clinical Modification codes but without durotomy codes present for the index procedure. Descriptive statistics were generated. Bivariate and multivariate analyses were conducted using chi-square tests and multiple logistic regression, respectively, generating both risk factors for LPDT and independent association of LPDT with postoperative complications. Statistical significance was defined as p<.05. In total, 86,212 patients were analyzed. The overall rate of reoperation or readmission without reoperation for LPDT was 2.0 per 1,000 patients (n=174). Of LPDT patients, 97.7% required one or more unplanned reoperations (n=170), and 5.7% of patients (n=10) required two reoperations. On multivariate analysis, lumbar procedures (odds ratio [OR] 2.79, p

  4. Ataxia espinocerebelar tipo 6: relato de caso

    Directory of Open Access Journals (Sweden)

    Bianca Simone Zeigelboim

    2014-10-01

    Full Text Available O objetivo deste estudo foi verificar as alterações vestibulococleares observadas em um caso de ataxia espinocerebelar tipo 6. O caso foi encaminhado do Hospital de Clínicas para o Laboratório de Otoneurologia de uma Instituição de Ensino e foi submetido aos seguintes procedimentos: anamnese, inspeção otológica, avaliações audiológica e vestibular. O caso retrata uma paciente com diagnóstico genético de ataxia espinocerebelar tipo 6, do sexo feminino, com 57 anos de idade, que referiu desequilíbrio à marcha com tendência a queda para a esquerda, disartria e disfonia. Na avaliação audiológica apresentou configuração audiométrica descendente a partir da frequência de 4kHz e curva timpanométrica do tipo "A" com presença dos reflexos estapedianos bilateralmente. No exame vestibular observou-se na pesquisa da vertigem posicional presença de nistagmo vertical inferior e oblíquo, espontâneo e semiespontâneo múltiplo com características centrais (ausência de latência, paroxismo, fatigabilidade e vertigem, nistagmooptocinético abolido e hiporreflexia à prova calórica. Constataram-se alterações labirínticas que indicaram afecção do sistema vestibular central evidenciando-se a importância dessa avaliação. A existência da possível relação entre os achados com os sintomas vestibulares apresentados pela paciente apontou a relevância do exame labiríntico neste tipo de ataxia uma vez que a presença do nistagmo vertical inferior demonstrou ser frequente neste tipo de patologia.

  5. Timing, severity of deficits, and clinical improvement after surgery for spinal dural arteriovenous fistulas.

    Science.gov (United States)

    Safaee, Michael M; Clark, Aaron J; Burkhardt, Jan-Karl; Winkler, Ethan A; Lawton, Michael T

    2018-04-20

    OBJECTIVE Spinal dural arteriovenous fistulas (dAVFs) are rare vascular abnormalities caused by arteriovenous shunting. They often form at the dural root sleeve between a radicular feeding artery and draining medullary vein causing venous congestion and edema, decreased perfusion, and ischemia of the spinal cord. Treatment consists of either surgical ligation of the draining vein or selective embolization via an endovascular approach. There is a paucity of data on which modality provides more durable and effective outcomes. METHODS The authors performed a retrospective review of a prospectively maintained database by the senior author to assess clinical outcomes in patients undergoing surgical treatment of spinal dAVFs. Preoperative and postoperative motor and Aminoff-Logue Scale (ALS) scores were collected. RESULTS A total of 41 patients with 44 spinal dAVFs were identified, with a mean patient age of 64 years. The mean symptom duration was 14 months, with weakness (82%), urinary symptoms (47%), and sensory symptoms (29%) at presentation. The fistula locations were as follows: 30 thoracic, 9 lumbar, 3 sacral, and 2 cervical. Five patients had normal motor and ALS scores at presentation. Among the remaining 36 patients with motor deficits or abnormal gait and micturition at presentation, 78% experienced an improvement while the remaining 22% continued to be stable. There was a trend toward improved outcomes in patients with shorter symptom duration; mean symptom duration among patients with clinical improvement was 13 months compared with 22 months among those without improvement. Additionally, rates of improvement were higher for lower thoracic and lumbosacral dAVFs (85% and 83%) compared with those in the upper thoracic spine (57%). No patient developed recurrent fistulas or worsening neurological deficits. CONCLUSIONS Surgery is associated with excellent outcomes in the treatment of spinal dAVFs. Early diagnosis and treatment are critical, with a trend toward

  6. Consumo de carnes por adultos do sul do Brasil: um estudo de base populacional

    Directory of Open Access Journals (Sweden)

    Bruna Celestino Schneider

    2014-08-01

    Full Text Available Estudo transversal de base populacional que avaliou indivíduos com 20 anos ou mais, residentes na zona urbana de Pelotas, Rio Grande do Sul, que objetivou descrever a frequência do consumo de carnes e o hábito de consumi-las com excesso de gordura. Foi avaliado, no último ano, o consumo de carnes vermelhas (com osso, bife e carne moída, brancas (frango e peixes, vísceras e embutidos. Dos 2,730 entrevistados, 99,1% (IC95%, 98,7 - 99,5 consumiu algum tipo de carne no último ano, sendo que, em torno de 32% referiu consumo diário. A prevalência do consumo de carnes vermelhas (99,3%, IC95%, 98,9 - 99,6 e brancas (99,4% IC95%, 99,1 - 99,7 foi semelhante. A carne de frango foi a mais consumida (98,0%, IC95%, 97,4 - 98,5, enquanto que as vísceras, as menos (59,1% IC95% 56,4 - 61,7. Os embutidos, consumidos por 85,5% (IC95%, 83,7 - 87,2 das pessoas, apresentaram a maior prevalência de consumo diário (16,6%. As carnes com excesso de gordura foram consumidas por 52,3% (IC95%, 49,8 - 54,8 dos adultos, principalmente homens, e pessoas de menor escolaridade e nível econômico.

  7. Intervención educativa en adultos mayores con diabetes mellitus en Guatemala

    Directory of Open Access Journals (Sweden)

    José Manuel Contreras Tejeda

    2014-08-01

    Full Text Available Se realizó un estudio de intervención comunitaria, con el objetivo de incrementar los conocimientos en pacientes diabéticos adultos mayores, pertenecientes al Departamento Alta Verapaz, Cobán, Guatemala; en el período comprendido desde junio de 2011 hasta junio de 2012. El universo de estudio estuvo constituido por los pacientes diabéticos dispensarizados por el médico y la enfermera en el área periférica, conformándose la muestra con 46 de ellos, a los cuales se les evaluó el grado de conocimientos previo y posterior a la aplicación de la intervención para modificar estilos de vida, empleando para ello técnicas participativas. Para obtener la información se revisaron las historias clínicas individuales, se realizaron entrevistas y se aplicaron cuestionarios a los pacientes, antes y después de aplicadas las técnicas educativas. Los resultados fueron procesados por métodos estadísticos. En la muestra predominaron los pacientes con diabetes mellitus tipo II. Después de la intervención hubo un incremento en las respuestas correctas en un 63.04%, haciéndose más marcado a medida que aumenta el nivel de escolaridad y en los que tienen más de diez años de evolución de la enfermedad. El estado nutricional se mejoró en un 50%. Se logró un mejor control de las complicaciones crónicas, así como del control metabólico en un 78.26%. Las charlas educativas en la comunidad resultaron efectivas para la incorporación de elementos educativos que incidieron en el mejor autocuidado de los pacientes diabéticos

  8. Factores relacionados al uso excesivo de alcohol en adultos jóvenes en Puerto Rico

    Directory of Open Access Journals (Sweden)

    David Pérez-Jiménez

    2018-05-01

    Full Text Available El propósito de este estudio fue identificar los factores relacionados con el uso excesivo de alcohol en personas jóvenes en Puerto Rico. Se realizó un estudio exploratorio de tipo cualitativo mediante el cual se entrevistaron de forma cualitativa a 20 adultos jóvenes (10 hombres y 10 mujeres, entre las edades de 21 a 29 años. Los datos fueron analizados mediante la técnica de análisis de contenido cualitativo. Los/as jóvenes identificaron más factores sociales y culturales que individuales. Algunos de los factores sociales más mencionados incluyen a la familia y a las campañas publicitarias que se transmiten por los medios de comunicación. Con respecto a la familia indicaron que en esta se comienza a transmitir valores de aceptación y uso del alcohol. Sobre las campañas publicitarias mencionaron que van dirigidas a resaltar la necesidad de consumir alcohol como una condición imprescindible para pasarla bien. También mencionaron que hay jóvenes que usan alcohol como un mecanismo para lidiar con los problemas que enfrentan. Esta investigación documenta algunos de los factores más relevantes relacionado con el uso de alcohol en jóvenes. Los esfuerzos de prevención deben ir dirigidos a minimizar esos factores de riesgo presentes en la cultura puertorriqueña y posiblemente latinoamericana

  9. Divergência genética entre genótipos de frangos tipo caipira

    Directory of Open Access Journals (Sweden)

    R. C. Veloso

    2015-10-01

    Full Text Available RESUMOObjetivou-se com este trabalho verificar a divergência genética entre sete genótipos de frangos tipo caipira da linhagem Redbro utilizando as características de desempenho por meio de técnicas de análise multivariada. Foram utilizados 840 pintos de um dia, machos, distribuídos em delineamento inteiramente ao acaso, dos seguintes genótipos: Caboclo, Carijó, Colorpak, Gigante Negro, Pesadão Vermelho, Pescoço Pelado e Tricolor. Após a consistência dos dados, foram avaliadas as seguintes variáveis: ganho em peso médio diário, consumo de ração médio diário e conversão alimentar, para os períodos: 1 a 28, 1 a 56, 1 a 70 e 1 a 84 dias de idade; peso corporal ao nascimento, aos 28, 56, 70 e aos 84 dias de idade. O desempenho dos genótipos foi avaliado por meio da análise de variância multivariada e da função discriminante linear de Fisher, usando os testes do maior autovalor de Roy e da união-interseção de Roy para as comparações múltiplas. O estudo da divergência genética foi feito por meio da análise por variáveis canônicas e pelo método de otimização de Tocher. Os genótipos Caboclo e Gigante Negro apresentaram médias canônicas diferentes dos demais genótipos. As duas primeiras variáveis canônicas explicaram 97,41% da variação entre os genótipos. A divergência genética entre os genótipos avaliados permitiu a formação de quatro grupos com os seguintes genótipos: grupo 1 - Colorpak; grupo 2 - Pesadão Vermelho e Pescoço Pelado; grupo 3 - Carijó e Tricolor; e grupo 4 - Caboclo e Gigante Negro.

  10. Prolongamentos na fala de adultos com e sem gagueira

    Directory of Open Access Journals (Sweden)

    Pâmila Bento da Silva

    Full Text Available RESUMO Objetivo: realizar uma análise quantitativa e qualitativa dos prolongamentos de adultos com e sem gagueira. Métodos: os participantes foram divididos em: Grupo de Pesquisa (GP, 15 adultos com gagueira e Grupo Controle (GC, 15 fluentes. Os procedimentos utilizados foram: avaliação da fluência, Instrumento de Gravidade da Gagueira e análises quantitativa e qualitativa dos prolongamentos. Resultados: GP mostrou maior número de prolongamentos não hesitativos, enquanto que GC mostrou maior ocorrência de prolongamentos hesitativos em relação ao total das disfluências. Prolongamentos não hesitativos ocorreram com maior frequência na palavra inicial e monossilábica, bem como na posição medial da frase para GP. Em relação à tensão muscular e duração, observou-se diferença apenas para a tensão muscular nos prolongamentos não hesitativos com maior média de ocorrência para GP. Conclusão: os prolongamentos não hesitativos ocorreram com maior frequência no GP, nas palavras iniciais, monossílabos e na posição medial da frase. Qualitativamente a tensão muscular foi uma característica típica dos prolongamentos não hesitativos no GP. Com relação aos prolongamentos hesitativos houve semelhança entre os adultos dos dois grupos quanto à frequência em relação ao total da fala, a posição dos prolongamentos nas palavras e nas frases e nos aspectos qualitativos, relacionados a tensão muscular e duração.

  11. Comportamiento de la violencia intrafamiliar en el adulto mayor

    OpenAIRE

    Docampo Santaló, Lourdes; Barreto Lacaba, Rita; Santana Serrano, Caridad

    2009-01-01

    Fundamento: la prevención de la violencia en su marco general y familiar es una prioridad que exige un conocimiento exhaustivo de su magnitud; ya que es observada como un asunto de salud pública por su impacto negativo en la sociedad. Objetivo: caracterizar el comportamiento de la violencia intrafamiliar contra el adulto mayor en el municipio de Nuevitas. Método: se realizó un estudio descriptivo retrospectivo durante el año 2006. De un universo de dos mil ciento seis, setenta y cinco fueron ...

  12. Costo de un sistema de atención de adultos mayores dependientes en Chile, 2012 - 2020

    Directory of Open Access Journals (Sweden)

    Mauricio Matus-López

    2014-07-01

    Full Text Available OBJETIVO: Obtener una estimación de los costos relativo y absoluto de un sistema de atención domiciliaria para los adultos mayores dependientes en Chile y reflexionar sobre las consideraciones metodológicas a tener en cuenta en estimaciones para otros modelos en otros países. MÉTODOS: Se utilizaron tasas de prevalencia por sexo y edad con base en los microdatos de la Encuesta Nacional de Dependencia (ENDPM 2009 y se proyectaron tres escenarios para 2012 - 2020. Se estimó la población beneficiaria y la demanda de 12 programas de servicios de atención domiciliaria. Las características de los programas, en horas y tipo de atención se obtuvieron del juicio de expertos, ajustados por la revisión bibliográfica. Se utilizaron salarios/hora del sistema público y privado. RESULTADOS: Entre los mayores de 65 años, 20,3% sería beneficiario del sistema; 21,7% sobre el total de mujeres y 18,4% sobre el total de hombres. Su número asciende a 336 874 personas para 2012. El costo anual del sistema alcanza los 1 214 millones de dólares para 2012. Esto equivale a 0,45% del PIB (producto interior bruto, que se podría incrementar entre 32,1% y 33,1% hasta 2020. CONCLUSIONES: El costo de un sistema inicial para adultos mayores dependientes en Chile es relativamente bajo en comparación con los modelos de los países industrializados. En términos metodológicos, se destaca la importancia de la discusión previa sobre el tipo de modelo que se desee implementar y las posibilidades financieras de llevarlo a cabo. Además, se valida la opción de utilizar juicios de expertos para la evaluación, aunque se aconseja ampliarla.

  13. Embolization of cranial dural arteriovenous fistulae with ONYX: Indications, techniques, and outcomes

    Directory of Open Access Journals (Sweden)

    Saraf Rashmi

    2010-01-01

    Full Text Available Objectives: The purpose of this study was to establish the role of the liquid embolic agent, ONYX, in the treatment of cranial dural arteriovenous fistulae (DAVFs and to redefine the indications, techniques and outcomes of treatment with ONYX. Materials and Methods: This is a retrospective study of 25 DAVF patients who underwent endovascular treatment with ONYX between February 2006 and July 2008. All patients of DAVF presenting in this period were treated with ONYX. Results: Anatomic cure (i.e., complete angiographic closure of the fistula was achieved in a single session and through a single arterial pedicle injection in 21 out of 25 patients (cure rate of 84%. Out of four patients with residual fistulae, one achieved cure that was evident on a control angiogram obtained at 3 months while three had no vascular access for further embolization and so were referred for radiosurgery. There was only one recurrence seen in angiograms obtained at the end of one year and this patient was re-embolized successfully with ONYX. Complications were seen in two patients. Conclusion: ONYX embolization of DAVFs has revolutionized the endovascular treatment of DAVFs, achieving high cure rates in a single session with minimal complications. Transarterial ONYX embolization should be the first option for all locations, except cavernous DAVFs.

  14. The accessory super-selective techniques in performing the transarterial embolization of intracranial dural arteriovenous fistulas

    International Nuclear Information System (INIS)

    Zhao Wenyuan; Liu Jianmin; Li Qiang; Fang Yibin; Xu Yi; Hong Bo; Huang Qinghai

    2010-01-01

    Objective: To evaluate the assistant techniques in performing transarterial embolization of intracranial dural arteriovenous fistulas (DAVF) when routine super-selective catheterization with microcatheter fails. Methods: Temporary balloon occlusion of the parent artery was adopted in 4 cases of anterior fossa DAVF and in one case of tentorial DAVF, and permanent occlusion of the distal main trunk with coils was carried out in one tentorial DAVF in order to help the super-selective catheterization. Results: The microcatheter was successfully advanced to, or near, the nidus with the help of these assistant techniques and all 6 cases were cured with single session. After the surgery no operation-related complications occurred. Conclusion: Our preliminary results indicate that the assistant techniques, including temporary balloon occlusion of the parent artery and permanent occlusion of the distal main trunk with coils, are a safe and effective method which can reliably help the successful performance of microcatheter catheterization, it can be safely used in complex cases when routine super-selective catheterization fails. (authors)

  15. Indocyanine green videoangiography "in negative": definition and usefulness in spinal dural arteriovenous fistulae.

    Science.gov (United States)

    Simal Julián, Juan Antonio; Miranda Lloret, Pablo; López González, Antonio; Evangelista Zamora, Rocío; Botella Asunción, Carlos

    2013-05-01

    Indocyanine green videoangiography (IGV) has proven its effectiveness in the field of exovascular neurosurgery, both in the intracranial and spinal compartment, but is necessary to define a systematic process for the performance of the IGV to facilitate its interpretation during the procedure. We have defined and applied the concept of videoangiography "in negative" (INIGV) to spinal dural arteriovenous fistulae (dAVF) for the detection and treatment of arteriovenous shunts, so called because the first phase is performed with the vessel suggestive of being pathological occluded. A Pentero-operating microscope with near-infrared IGV-integrated system (Carl Zeiss Co., Germany) was used. At our institution, 24 patients were treated for a spinal dAVF between 1995 and 2011, only in the last 4 cases, INIGV was performed. We describe the IGV in negative procedure and show the most illustrative cases. In all cases, the fistula occlusion was confirmed by postoperative selective digital subtraction angiography (DSA). INIGV demonstrate its capacity in detecting vessels not actually arterialized that should be respected and avoid some of the main limitations of the conventional IGV. This is a technical description about an Indocyanine green (ICG) videoangiographic procedure modification that is superior to merely performing ICG before and after clipping of a dAVF. The INIGV results are rapid and easy to interpret procedure and provide great advantages to the dAVF treatment. Nevertheless, further studies are needed with a larger sample size to determine if INIGV may reduce the need to perform immediate postoperative DSA.

  16. Superior cerebellar artery infarction in endovascular treatment for tentorial dural arteriovenous fistulas

    Energy Technology Data Exchange (ETDEWEB)

    Zhang Jingbo; Lv Xianli; Jiang Chuhan; Li Youxiang [Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, 6, Tiantan, Xili, Chongwen, 100050, Beijing (China); Wu Zhongxue, E-mail: ttyyzjb@sina.co [Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, 6, Tiantan, Xili, Chongwen, 100050, Beijing (China)

    2010-06-15

    Background: Superior cerebellar artery (SCA) syndrome shows ipsilateral cerebellar ataxia and Horner's syndrome, contralateral superficial sensory disturbance, as well as nystagmus toward the impaired side, vertigo, and nausea. Occasionally, unilateral lesions may produce bilateral hypogeusia and contralateral hypoacusia. Objective: To report 2 patients with unilateral lower midbrain ischemic lesions of the inferior colliculus level caused by transarterial embolization for tentorial dural arteriovenous fistulas (TDAVFs). Methods: Hospital records for 21 patients with TDAVFs mainly treated by endovascular techniques between 2005 and 2008 were reviewed. Two patients with MRI evidence of unilateral SCA territory infarction were investigated. Results: Of 21 patients, 2 treated transarterially with Onyx-18 (a nonahesive liquid embolic agent) developed infarctions in the territory of SCA. One patient had lateral SCA infarction characterized by ipsilateral gait ataxia, contralateral hemihypoesthesia, with additional ipsilateral ocular motor palsy and bilateral gustatory loss. And the other patient had medial SCA infarction characterized by ipsilateral ataxia contralateral hemihypoesthesia with additional contralateral hypoacusia. Conclusion: SCA infarction can be caused by transarterial injection of Onyx-18 via SCA or the posterior cerebral artery (PCA) for TDAVFs and additionally presented with gustatory loss and deafness, which is generally not a feature of the SCA syndrome.

  17. Management of a case with misdiagnosed spinal dural arterio-venous fistula.

    Science.gov (United States)

    Lien, Chia-Yi; Lui, Chun-Chung; Lu, Cheng-Hsien; Chang, Wen-Neng

    2014-03-01

    Spinal dural arterio-venous fistula (SDAVF) is an uncommon and easily misdiagnosed vascular malformation. We aimed to report the diagnosis and management of a case with SDAVF. A 62-year-old man suffered from acute paraparesis about 15 months before this study. He underwent a neurosurgical procedure for herniated discs of the cervical spine at that time but there was no relief and the symptoms worsened despite the surgery. Neurologically, he had spastic paraparesis and decreased vibration sensation of the lower limbs. Spinal magnetic resonance imaging (MRI) revealed intra-medullary hyper-intensity lesion at T8 to T10 levels and tubular-like signal void structures in the corresponding posterior sub-arachnoid space. Further trans-arterial angiography through right T6 intercostal artery catheterization revealed engorged veins, thereby confirming the diagnosis of SDAVF. The patient was treated via endovascular embolization (18% Onyx, EV3TM MIT, Bonn, Germany) through spinal angiography and the results showed a marked decrease in engorged veins. After a 4-month follow-up, the patient was symptomatic but stable. Follow-up MRI showed a complete disappearance of the hyper-intensity change of the spinal cord. Spinal MR angiography did not reveal any recurrence of SDAVF. This case study demonstrated the easily misdiagnosed state of SDAVF. Serial neuroimage studies including spinal MRI, endovascular embolization through spinal angiography and MR angiography can be useful tools for its diagnostic confirmation, management and follow-up study.

  18. Determining the Level of the Dural Sac Tip: Magnetic Resonance Imaging in an Adult Population

    International Nuclear Information System (INIS)

    Binokay, F.; Akgul, E.; Bicakci, K.; Soyupak, S.; Aksungur, E.; Sertdemir, Y.

    2006-01-01

    Purpose: To determine the variation in the location of the dural sac (DS) in a living adult population and to correlate this position with age and sex. Material and Methods: T2-weighted, midline, sagittal, spin-echo magnetic resonance imaging (MRI) studies of 743 patients were assessed to identify the tip of the DS. This location was recorded in relation to the upper, middle, or lower third of the adjacent vertebral body or the adjacent intervertebral disk. Results: Frequency distribution for levels of termination of the DS on MRI demonstrated that the end of the DS was usually located at the upper one-third of S2 (25.2%). The mean level in females was also the upper one-third of S2 (26.5%) and in males the lower one-third of S2 (24.1%). The overall mean DS position was mostly at the upper one-third of S2. No significant differences in DS position were seen between male and female patients or with increasing age. Conclusion: It is important to know the possible range for the termination level of the DS when performing caudal anesthesia and craniospinal irradiation in some clinical situations. The distribution of DS location in a large adult population was shown to range from the L5-S1 intervertebral disk to the upper third of S3 vertebrae

  19. Brain herniations into the dural venous sinus or calvarium: MRI findings, possible causes and clinical significance

    Energy Technology Data Exchange (ETDEWEB)

    Battal, Bilal; Hamcan, Salih; Akgun, Veysel; Sari, Sebahattin; Tasar, Mustafa [Gulhane Military Medical School, Department of Radiology, Ankara (Turkey); Oz, Oguzhan [Gulhane Military Medical School, Department of Neurology, Ankara (Turkey); Castillo, Mauricio [University of North Carolina School of Medicine, Division of Neuroradiology, Department of Radiology, Chapel Hill, NC (United States)

    2016-06-15

    To determine frequency, imaging features and clinical significance of herniations of brain parenchyma into dural venous sinuses (DVS) and/or calvarium found on MRI. A total of 6160 brain MRI examinations containing at least one high-resolution T1- or T2-weighted sequence were retrospectively evaluated to determine the presence of incidental brain herniations into the DVS or calvarium. MRI sequences available for review were evaluated according to their capability to demonstrate these herniations. Patients' symptoms and clinical findings were recorded. Twenty-one (0.32 %) brain parenchyma herniations into the DVS (n = 18) or calvarium (n = 3) in 20 patients were detected. The most common locations of the herniations were the transverse sinuses (n = 13) and those involving inferior gyrus of the temporal lobe (n = 9). High-resolution T1- and T2-weighted sequences were equally useful in the detection of these brain herniations. According to clinical symptoms, brain herniations were considered to be incidental but headaches were present in nine patients. Brain herniations with surrounding cerebrospinal fluid (CSF) into the DVS and/or calvarium are incidental findings and not proven to be associated with any symptoms. Although rare, these herniations are more common than previously recognized and should not be confused with arachnoid granulations, clots or tumours. (orig.)

  20. Medullary Venous Hypertension Secondary to a Petrous Apex Dural Arteriovenous Fistula: A Case Report

    Directory of Open Access Journals (Sweden)

    Meghan Murphy

    2012-11-01

    Full Text Available Background: Dural arteriovenous fistulae (dAVF are common intracranial vascular lesions typically becoming symptomatic with cortical venous hypertension and possible hemorrhage. Here, we present a case illustration of a petrous apex dAVF with marked medullary venous hypertension and a unique clinical presentation. Methods: Case report. Results: A 72-year-old female, whose clinical progression was significant for altered mental status and progressive weakness, presented with diplopia, right leg paresis, and ataxia. Magnetic resonance imaging revealed edema involving the medulla. On digital subtraction cerebral angiogram, the patient was found to have a petrous apex dAVF, Cognard type IV. Following treatment with Onyx embolization, her symptoms rapidly improved, with complete resolution of diplopia and drastic improvement of her ataxia. Conclusion: The importance of this case is in the presentation and deterioration of the clinical exam, resembling an acute ischemic event. Further, this case illustrates that dAVF may cause venous hypertension with rapid onset of focal neurologic symptoms not exclusive to cortical locations.

  1. Endovascular management of dural arteriovenous fistulas of the transverse and sigmoid sinus in 150 patients

    Energy Technology Data Exchange (ETDEWEB)

    Kirsch, M [Ernst-Moritz-Arndt-Universitaet Greifswald, Institut fuer Diagnostische Radiologie und Neuroradiologie, Greifswald (Germany); Liebig, T [TU Muenchen, Institut fuer Neuroradiologie, Klinikum Rechts der Isar, Munich (Germany); Kuehne, D [Klinik fuer Radiologie und Neuroradiologie, Alfried-Krupp-Krankenhaus, Essen (Germany); Henkes, H [Katharinenhospital-Klinikum Stuttgart, Klinik fuer Neuroradiologie, Stuttgart (Germany)

    2009-07-15

    This study aimed to evaluate the safety and efficiency of the endovascular treatment of transverse-sigmoid sinus dural arteriovenous fistulas (TS{sub d}AVF). A total of 150 consecutive patients and 348 procedures were evaluated. Pulsatile tinnitus (81%), headache (15%), and intracranial hemorrhage (10%) were the most frequent manifestations of the TS{sub d}AVFs. More than half of the affected sinuses were partially or completely thrombosed. Access-wise treatment was performed transarterial (n = 33), transvenous (n = 21), or a combination thereof (n = 96). A mean of 2.4 procedures per patient was required. Immediate postprocedural occlusion rate after transarterial embolization was 30% only. Transvenous treatment alone resulted in an early occlusion rate of 81%, with delayed complete obliteration of half of the remaining fistulas. After combined transarterial/transvenous treatment, the angiographic cure rate was 54%. At follow-up, 88% of patients with residual shunt after the treatment showed complete occlusion. The cumulative complication rate was 9% (n = 13), with minor adverse events in ten patients (7%) and major complications in three patients (2%). Transvenous coil occlusion of the sinus segment with the adjacent dAVF site, eventually combined with transarterial occlusion of supplying arteries, is a very effective and well-tolerated treatment method. In selected patients, variations of these methods (e.g., sinus stenting, compartmental sinus occlusion) can be useful. (orig.)

  2. Recovery of opthalmoplegia associated with cavernous sinus dural arteriovenous fistulas after transvenous cavernous sinus packing

    Energy Technology Data Exchange (ETDEWEB)

    Xianli, Lv; Chuhan, Jiang; Youxiang, Li; Xinjian, Yang [Beijing Neurosurgical institute, Beijing Tiantan Hospital, Capital Medical University, 6, Tiantan Xili, Chongwen, Beijing (China); Wu Zhongxue, E-mail: ttyyzjb@sina.co [Beijing Neurosurgical institute, Beijing Tiantan Hospital, Capital Medical University, 6, Tiantan Xili, Chongwen, Beijing (China)

    2010-08-15

    Background: We report the recovery of ophthalmoplegia in 11 patients with cavernous sinus dural arteriovenous fistula (CSDAVF) after sinus packing at follow-up. Methods: Of 18 patients with CSDAVF treated with transvenous cavernous sinus packing between August 2002 and December 2007 at Beijing Tiantan Hospital, there were 9 patients with initial CNIII or CNVI dysfunction and 2 patients with CNVI dysfunction immediately after cavernous sinus packing selected and reevaluated. Results: Of 11 patients with CNIII or CNVI palsy, recovery was complete in 10. In 1 patient, complete CNVI palsy was unchanged because the CSDAVF was not cured. There were 6 men and 5 women with a mean age of 52.9 years. In 5 patients, CNVI palsy was associated with chemosis, proptosis and pulsatile tinnitus. Timing of treatment after onset of symptoms was from 4 to 35 days in 9 patients. All CSDAVFs were Barrow type D. Mean follow-up after treatment was 17.7 months (range, 2-54 months). Conclusion: CSDAVF-induced CNIII or CNVI palsies can be cured after cavernous sinus packing transvenously in most patients.

  3. Recovery of opthalmoplegia associated with cavernous sinus dural arteriovenous fistulas after transvenous cavernous sinus packing

    International Nuclear Information System (INIS)

    Lv Xianli; Jiang Chuhan; Li Youxiang; Yang Xinjian; Wu Zhongxue

    2010-01-01

    Background: We report the recovery of ophthalmoplegia in 11 patients with cavernous sinus dural arteriovenous fistula (CSDAVF) after sinus packing at follow-up. Methods: Of 18 patients with CSDAVF treated with transvenous cavernous sinus packing between August 2002 and December 2007 at Beijing Tiantan Hospital, there were 9 patients with initial CNIII or CNVI dysfunction and 2 patients with CNVI dysfunction immediately after cavernous sinus packing selected and reevaluated. Results: Of 11 patients with CNIII or CNVI palsy, recovery was complete in 10. In 1 patient, complete CNVI palsy was unchanged because the CSDAVF was not cured. There were 6 men and 5 women with a mean age of 52.9 years. In 5 patients, CNVI palsy was associated with chemosis, proptosis and pulsatile tinnitus. Timing of treatment after onset of symptoms was from 4 to 35 days in 9 patients. All CSDAVFs were Barrow type D. Mean follow-up after treatment was 17.7 months (range, 2-54 months). Conclusion: CSDAVF-induced CNIII or CNVI palsies can be cured after cavernous sinus packing transvenously in most patients.

  4. Endovascular management of dural arteriovenous fistulas of the transverse and sigmoid sinus in 150 patients

    International Nuclear Information System (INIS)

    Kirsch, M.; Liebig, T.; Kuehne, D.; Henkes, H.

    2009-01-01

    This study aimed to evaluate the safety and efficiency of the endovascular treatment of transverse-sigmoid sinus dural arteriovenous fistulas (TS d AVF). A total of 150 consecutive patients and 348 procedures were evaluated. Pulsatile tinnitus (81%), headache (15%), and intracranial hemorrhage (10%) were the most frequent manifestations of the TS d AVFs. More than half of the affected sinuses were partially or completely thrombosed. Access-wise treatment was performed transarterial (n = 33), transvenous (n = 21), or a combination thereof (n = 96). A mean of 2.4 procedures per patient was required. Immediate postprocedural occlusion rate after transarterial embolization was 30% only. Transvenous treatment alone resulted in an early occlusion rate of 81%, with delayed complete obliteration of half of the remaining fistulas. After combined transarterial/transvenous treatment, the angiographic cure rate was 54%. At follow-up, 88% of patients with residual shunt after the treatment showed complete occlusion. The cumulative complication rate was 9% (n = 13), with minor adverse events in ten patients (7%) and major complications in three patients (2%). Transvenous coil occlusion of the sinus segment with the adjacent dAVF site, eventually combined with transarterial occlusion of supplying arteries, is a very effective and well-tolerated treatment method. In selected patients, variations of these methods (e.g., sinus stenting, compartmental sinus occlusion) can be useful. (orig.)

  5. Effectiveness of autologous epidural blood patch to relieve post dural puncture headache

    International Nuclear Information System (INIS)

    Iqbal, L.A.A.; Naqvi, E.H.

    2013-01-01

    Background: Post-dural puncture headache (PDPH) is a common problem in anaesthesia practice especially in obstetric anaesthesia. Autologous epidural blood patch (AEBP) is the main stay of treatment of PDPH when it is not relieved with conservative management. Objective: To describe the efficacy of AEBP in treatment of PDPH. Study Design: Prospective descriptive study. Setting and Duration: The study was conducted at departments of Anaesthesia and Intensive Care, Military Hospital, Rawalpindi and Combined Military Hospital, Malir, from July 2008 to July 2011. Methodology: All patients who received AEBP during study period secondary to PDPH were included. Up to 20 ml of autologous blood was injected in epidural space. Effectiveness of AEBP was judged by relief of symptom; any complications associated with AEBP i.e. backache and paresthesia were also noted. Data was interpreted as mean and percentages. Results: A total of 30 AEBP were performed during the study period in predominantly female patients (n=27) with mean age of 27.8 years. AEBP was performed after a mean 3.83 days of lumbar puncture. Complete relief was observed in 29 (96%) patients; one patient required a second patch. During the follow-up, 7 (23%) patients complained of backache and 2(6%) of paresthesias. conclusion: AEBP is an effective way of providing relief from PDPH. (author)

  6. O oraloma da diabetes melitos tipo 1 vs diabetes melitos tipo 2 - um estudo comparativo

    OpenAIRE

    Brás, Vítor Daniel Moreira

    2013-01-01

    A Diabetes Melitos é uma doença de grande prevalência a nível mundial e os seus mecanismos fisiopatológicos não são ainda totalmente conhecidos. Actualmente, a terapêutica seguida em casos de Diabetes Melitos é eminentemente sintomática consistindo na administração de insulina nos casos de Diabetes Melitos tipo 1 ou quando se verifica a falência das células beta do pâncreas de pacientes com Diabetes Melitos tipo 2, ou no controlo da glicemia nos casos de Diabetes Melitos ...

  7. ALGUNOS ASPECTOS A CONSIDERAR SOBRE LA SEXUALIDAD DEL ADULTO MAYOR

    Directory of Open Access Journals (Sweden)

    Zoila Edith Hernández Zamora

    2008-12-01

    Full Text Available La presente investigación expone, a partir de una serie de entrevistas realizadas a una muestra de adultos mayores, aspectos relativos a la satisfacción general en la vida, así como las actitudes, conocimientos y prácticas de la sexualidad de un grupo de adultos mayores que asisten regularmente a una estancia diurna de la ciudad de Xalapa, Veracruz, México, misma que fue diseñada especialmente para este grupo etario. Se encontraron diferencias estadísticamente significativas entre la actitud hacia el ejercicio de la sexualidad de las personas mayores entre los hombres y las mujeres de la muestra, y entre .las personas que tienen pareja con relación a las que no tienen; así como que hay una diferencia estadísticamente significativa entre aquellas personas que tiene una o ninguna enfermedad y las que tienen dos o más enfermedades con respecto a su frecuencia de actividad sexual. Es de resaltar la escasez de conocimientos sobre aspectos básicos de la sexualidad que poseen estas personas mayores, lo que hace necesario el establecimiento de programas educativos que incluyan al personal de salud y a los mismos senectos.

  8. O significado da morte para adolescentes, adultos e idosos

    Directory of Open Access Journals (Sweden)

    Caroline Garpelli Barbosa

    2011-08-01

    Full Text Available Apesar do aumento na quantidade de trabalhos que visam a abordar a morte como tema de investigação, observa-se que ainda prevalece a interdição do assunto morte, dificultando que ela seja abordada e discutida. Este estudo buscou ampliar a compreensão de como pessoas, em diferentes etapas desenvolvimentais, lidam com perdas e com a própria finitude. Para isso, 7 adolescentes, 14 adultos de meia-idade e 10 idosos foram entrevistados, e os dados foram compreendidos mediante análise de conteúdo. Entre os participantes, os adultos foram os que mostraram mais aflição e inquietação, ao falarem sobre a própria finitude e sobre a possibilidade da morte de pessoas queridas. Os adolescentes abordaram-na como um acontecimento distante e impessoal, enquanto os idosos se referiram a ela com maior proximidade e aceitação. Sugere-se a realização de estudos que aprofundem tais compreensões, relacionando-as às diferentes religiões, classes sociais e experiências com perdas.

  9. The dural entrance of cerebral bridging veins into the superior sagittal sinus: an anatomical comparison between cadavers and digital subtraction angiography

    International Nuclear Information System (INIS)

    Han, Hui; Tao, Wei; Zhang, Ming

    2007-01-01

    Intracranial venous structures have received increasing attention due to improved neuroimaging techniques and increased awareness of cerebral venous disease. To date, few studies have attempted to investigate the dural entrance of the cerebral bridging vein (BV). The aim of this study was to use the superior sagittal sinus (SSS) as an example to identify anatomical features of the dural entrance of the BVs into the SSS in both human cadavers and digital subtraction angiography (DSA) images. A total of 30 adult and 7 fetal human cadavers and 36 patients were examined with anatomical dissections, vascular casting and DSA. The number, diameter and angle of the BVs entering the SSS were measured and compared between the cadavers and DSA images. The results demonstrated that (1) the way a BV entered the SSS varied in three dimensions, and thus the BV dural entrance was difficult to precisely localize by DSA, (2) the distribution pattern of the dural entrance of the BVs into the SSS was relatively constant and a nontributary segment of the SSS was centered at the coronal suture and was identifiable by DSA, and (3) nearly all the BVs (97%, 561/581) entered the SSS at an angle opposite to the direction of blood flow. Unique anatomical features of the dural entrance of a BV into the SSS should be considered in neuroimaging interpretation of the sinus and its associated veins. (orig.)

  10. Percepción del estudiante de medicina de una universidad pública acerca del docente adulto mayor y del adulto mayor en general

    Directory of Open Access Journals (Sweden)

    Martha Martina

    2014-07-01

    Full Text Available Introducción: La mayoría de los estudios disponibles muestran que las imágenes que construyen los jóvenes sobre la vejez, en general, se asocian a una valoración negativa de esta etapa de la vida. Objetivos: Analizar la percepción de los estudiantes de Medicina Humana de la UNMSM acerca de la vejez, así como la existencia o no de estereotipos negativos acerca de la vejez y del docente adulto mayor. Diseño: Estudio transversal. Institución: Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Perú. Participantes: Estudiantes del primero, tercero y quinto año de la Escuela Académico Profesional de Medicina Humana. Intervenciones: Aplicación de una escala de diferencial semántico para medir la percepción de los estudiantes mediante un cuestionario autoadministrado. Principales medidas de resultados: De una muestra de 319 estudiantes, 54,2% fue del sexo masculino y el promedio de edad 21,7±2,6 años; 90,3% tuvo cercanía con profesores mayores de 70 años. Los alumnos del quinto año otorgaron menores puntuaciones a los docentes adultos mayores (p=0,003 y a los adultos mayores en general (p=0,045. Los estudiantes que en su familia convivían con personas mayores de 70 años tuvieron una percepción más positiva sobre los adultos mayores en general (p=0,037. Respecto a la percepción de los estudiantes acerca del docente adulto mayor destacaron cinco características que superaron el 70% del puntaje, tipificándolo como seguro de sí mismo (78%, organizado (73,9%, interesado en el aprendizaje del estudiante (72,8%, planificador (72,6% y emocionalmente estable (71,8%. Respecto al adulto mayor, los puntajes no superaron el 70%, y en general lo tipificaron como tratable, sociable y hábil. Conclusiones: Los estudiantes de medicina mostraron una percepción positiva hacia el docente adulto mayor y sobre el adulto mayor en general. Existieron diferencias estadísticamente significativas según el año de estudios. Los

  11. Conduta na lesão dural intraoperatória em artrodese da coluna lombar Conducta en lesión de duramadre intraoperatoria en artrodesis de la columna lumbar Management of intraoperatory dural tear in lumbar spine arthrodesis

    OpenAIRE

    Fabiano de Mendonça Grandese; Clóvis Yamazato; Fábio Mastromauro de Oliveira; Iberê Ribeiro; José Olympio Catão Bastos Júnior; René Kusabara

    2010-01-01

    OBJETIVO: estudo retrospectivo de pacientes com lesão dural intraoperatória de cirurgia da coluna vertebral lombar, conduzido por meio de um protocolo independente da extensão da lesão, complicações associadas e resultados após seguimento mínimo de um ano. MÉTODOS: um total de 10 pacientes com durotomia acidental em cirurgias de descompressão e artrodese da coluna vertebral lombar, no período de Janeiro de 2007 a Janeiro de 2009, para tratamento de doença degenerativa, tiveram seus prontuário...

  12. EFECTO DE DIETAS EN ADULTOS DE Spodoptera cosmioides (LEPIDOPTERA: NOCTUIDAE SOBRE LA FERTILIDAD, FECUNDIDAD Y LONGEVIDAD DEL ADULTO

    Directory of Open Access Journals (Sweden)

    M. C. CURIS

    2017-12-01

    Full Text Available La aparición de cultivares de soja Bt + RR2Y determinó la emergencia de una nueva plaga, Spodoptera cosmioides, una plaga altamente polífaga de amplia distribución. La cría de insectos en cámaras de cría es necesaria para estudios de investigación básica y aplicada. El objetivo del trabajo fue evaluar el efecto de tres dietas ricas en carbohidratos (solución de miel, de jarabe de glucosa y de jarabe de maíz en la alimentación de los adultos y determinar su efecto sobre la fecundidad, fertilidad y supervivencia de S. cosmioides. Se determinó que, si bien no se hallaron diferencias entre los tratamientos, la composición de los  azúcares de las dietas, puede afectar los parámetros reproductivos de esta plaga, ya que las hembras alimentadas con solución de miel natural, más rica en compuestos orgánicos, aumentaron la fecundidad, refl ejado en una mayor puesta y eclosión de huevos y la longevidad de los adultos.

  13. Inhibidores de la paraproteína convertasa subtilisina/kexina tipo 9: una alternativa de manejo para las dislipidemias

    Directory of Open Access Journals (Sweden)

    Beatriz Wills-Sanín

    2017-07-01

    Full Text Available Las guías de la práctica clínica internacionales recomiendan a las estatinas como la terapia de elección para el manejo de la dislipidemia. No obstante, pese a la evidencia acerca de la importancia del manejo de esta condición, existe un porcentaje significativo de los adultos que no logran las metas en los lípidos con las estatinas. Lo anterior ha estimulado el desarrollo de anticuerpos monoclonales que inactivan la paraproteína convertasa subtilisina/kexina tipo 9. Estos medicamentos han sido aprobados como adyuvantes a la dieta y a las dosis máximas toleradas de la estatina para la hipercolesterolemia familiar o la aterosclerosis clínica en pacientes que requieren disminución adicional de las lipoproteínas de baja densidad. En este artículo revisaremos la evidencia actual acerca de los anticuerpos anti-paraproteína convertasa subtilisina/kexina tipo 9 con el objetivo de optimizar el tratamiento clínico de nuestros pacientes.

  14. Automated Cross-Sectional Measurement Method of Intracranial Dural Venous Sinuses.

    Science.gov (United States)

    Lublinsky, S; Friedman, A; Kesler, A; Zur, D; Anconina, R; Shelef, I

    2016-03-01

    MRV is an important blood vessel imaging and diagnostic tool for the evaluation of stenosis, occlusions, or aneurysms. However, an accurate image-processing tool for vessel comparison is unavailable. The purpose of this study was to develop and test an automated technique for vessel cross-sectional analysis. An algorithm for vessel cross-sectional analysis was developed that included 7 main steps: 1) image registration, 2) masking, 3) segmentation, 4) skeletonization, 5) cross-sectional planes, 6) clustering, and 7) cross-sectional analysis. Phantom models were used to validate the technique. The method was also tested on a control subject and a patient with idiopathic intracranial hypertension (4 large sinuses tested: right and left transverse sinuses, superior sagittal sinus, and straight sinus). The cross-sectional area and shape measurements were evaluated before and after lumbar puncture in patients with idiopathic intracranial hypertension. The vessel-analysis algorithm had a high degree of stability with <3% of cross-sections manually corrected. All investigated principal cranial blood sinuses had a significant cross-sectional area increase after lumbar puncture (P ≤ .05). The average triangularity of the transverse sinuses was increased, and the mean circularity of the sinuses was decreased by 6% ± 12% after lumbar puncture. Comparison of phantom and real data showed that all computed errors were <1 voxel unit, which confirmed that the method provided a very accurate solution. In this article, we present a novel automated imaging method for cross-sectional vessels analysis. The method can provide an efficient quantitative detection of abnormalities in the dural sinuses. © 2016 by American Journal of Neuroradiology.

  15. Characteristics, diagnosis and treatment of hypoglossal canal dural arteriovenous fistula: report of nine cases

    Energy Technology Data Exchange (ETDEWEB)

    Manabe, Shinji; Satoh, Koichi; Matsubara, Shunji; Satomi, Junichiro; Hanaoka, Mami; Nagahiro, Shinji [University of Tokushima, Department of Neurosurgery, Tokushima (Japan)

    2008-08-15

    We report the characteristics, diagnosis and treatment of dural arteriovenous fistula (DAVF) of the hypoglossal canal in nine patients with this relatively rare vascular disorder. Of 248 patients with intracranial DAVFs managed at our institution, nine patients (3.6%; four men, five women; mean age 62 years) were diagnosed with hypoglossal canal DAVF. We investigated patient characteristics with respect to clinical symptoms, neuroradiological findings, efficacy and complications related to endovascular treatment. Seven patients had experienced head injury. All patients presented with pulsatile tinnitus. One patient displayed ipsilateral hypoglossal nerve palsy before treatment. MR angiography showed a 'magic wand' appearance between the affected hypoglossal canal and the internal jugular vein in four patients. Angiography demonstrated an AV fistula on the medial aspect of the superior jugular bulb, mostly arising from the bilateral occipital, ascending pharyngeal and vertebral arteries with drainage to the internal jugular vein via the anterior condylar vein. Contralateral carotid injection accurately clarified the shunting point. Five patients underwent endovascular treatment: transarterial embolization (TAE; n=2), transvenous embolization (TVE; n=2), and TAE/TVE (n=1). Complete shunt obliteration was achieved in four patients and shunt reduction in one. The remaining four patients were treated conservatively and the shunt had disappeared at follow-up. Postoperative hypoglossal nerve palsy occurred in one patient after TVE, possibly due to coil overpacking. The incidence of hypoglossal canal DAVF was not very low in our series. Contralateral carotid injection is an essential examination to provide an accurate diagnosis. TVE should be considered when access is available, although TAE is also appropriate for shunt reduction. (orig.)

  16. Long-term outcome of a multidisciplinary concept of spinal dural arteriovenous fistulae treatment

    International Nuclear Information System (INIS)

    Sherif, Camillo; Gruber, Andreas; Bavinzski, Gerhard; Standhardt, Harald; Widhalm, Georg; Knosp, Engelbert; Gibson, Daniel; Richling, Bernd

    2008-01-01

    The optimal treatment of spinal dural arteriovenous fistulae (SDAVF) remains controversial and long-term follow-up data, especially data from multidisciplinary treatment, are rarely available. Thus, long-term outcomes following a multidisciplinary approach to the treatment of SDAVF were investigated. The investigation included 26 patients with SDAVF treated at the authors' department over a 15-year period including a follow-up of more than 2 years. The treatment strategy when occlusion of the draining vein could be achieved was to embolize the fistula with Histoacryl, with surgery reserved for those patients unsuitable for embolization. Posttreatment angiography followed by MRI was performed in all patients. Clinical follow-up was performed using the gait and micturition Aminoff-Logue scale scores and the modified Rankin scale score. Embolization was performed in 19 patients (73.1%), and direct surgery in 7 patients (26.9%). Follow-up angiography (at a mean of 21.7 months) showed occlusion of the SDAVF in 24 patients (92.3%). Of the 19 embolized patients, 2 (10.5%) developed recurrence secondary to insufficient occlusion of the SDAVF draining vein, and one of these two patients underwent re-embolization and one re-operation. No negative effects of SDAVF recurrence on the final clinical outcome were identified in either patient. MRI after angiography (at a mean of 91.5 months) demonstrated occlusion of all SDAVFs. After a mean clinical follow-up of 103.4 months there was a statistically significant improvement in both the modified Rankin scale score and the Aminoff-Logue gait scale score (P < 0.05). The present multidisciplinary study showed for the first time that embolization leads to stable neuroradiological results and favourable clinical outcomes even for very long follow-up times of more than 100 months. Microsurgery remains the treatment of choice when safe embolization of the draining vein cannot be achieved. (orig.)

  17. Gamma Knife radiosurgery for the treatment of intracranial dural arteriovenous fistulas

    Science.gov (United States)

    Dmytriw, Adam A; Schwartz, Michael L; Cusimano, Michael D; Mendes Pereira, Vitor; Krings, Timo; Tymianski, Michael; Radovanovic, Ivan

    2016-01-01

    Background Intracranial dural arteriovenous fistulae (DAVF) may present a treatment challenge. Endovascular embolization is in most cases the first line of treatment but does not always achieve cure. Gamma Knife (GK) radiosurgery represents an alternative treatment option, and the purpose of this study was to further evaluate its utility. Methods We reviewed all cases of DAVF treated between 2009 and 2016 at our institution with GK radiosurgery independently, or following failed/refused endovascular or surgical management. Patients’ clinical files, radiological images, catheter angiograms, and surgical DAVF disconnection reports were retrospectively reviewed. Results Sixteen DAVF (14 patients) treated by GK radiosurgery were identified. Eleven fistulae were aggressive and five were benign. Marginal doses ranged from 15 to 25 Gy. Target volumes ranged from 0.04 to 4.47 cm3. In all symptomatic patients, GK treatment resulted in symptom palliation. In 13/15 lesions, cure of symptoms (86.0%) was reported. One lesion was asymptomatic. Angiographic cure was achieved in eight cases (50%), small residual DAVF occurred in four, and four were unchanged. One patient developed headache that resolved at one year. No hemorrhage occurred during the follow-up period. There was no significant association between Borden type and cure rate. Prior failed endovascular treatment and small target volume were associated with lower rates of cure. Conclusions Stereotactic radiosurgery is viable treatment for DAVF. It is very effective in palliating symptoms as a de novo approach or adjunctive to endovascular therapy. In our experience it is only somewhat effective in achieving complete angiographic cure. PMID:28156167

  18. Gamma Knife surgery for clival epidural-osseous dural arteriovenous fistulas.

    Science.gov (United States)

    Lee, Cheng-Chia; Chen, Ching-Jen; Chen, Shao-Ching; Yang, Huai-Che; Lin, Chung Jung; Wu, Chih-Chun; Chung, Wen-Yuh; Guo, Wan-Yuo; Hung-Chi Pan, David; Shiau, Cheng-Ying; Wu, Hsiu-Mei

    2018-05-01

    OBJECTIVE Clival epidural-osseous dural arteriovenous fistula (DAVF) is often associated with a large nidus, multiple arterial feeders, and complex venous drainage. In this study the authors report the outcomes of clival epidural-osseous DAVFs treated using Gamma Knife surgery (GKS). METHODS Thirteen patients with 13 clival epidural-osseous DAVFs were treated with GKS at the authors' institution between 1993 and 2015. Patient age at the time of GKS ranged from 38 to 76 years (median 55 years). Eight DAVFs were classified as Cognard Type I, 4 as Type IIa, and 1 as Type IIa+b. The median treatment volume was 17.6 cm 3 (range 6.2-40.3 cm 3 ). The median prescribed margin dose was 16.5 Gy (range 15-18 Gy). Clinical and radiological follow-ups were performed at 6-month intervals. Patient outcomes after GKS were categorized as 1) complete improvement, 2) partial improvement, 3) stationary, and 4) progression. RESULTS All 13 patients demonstrated symptomatic improvement, and on catheter angiography 12 of the 13 patients had complete obliteration and 1 patient had partial obliteration. The median follow-up period was 26 months (range 14-186 months). The median latency period from GKS to obliteration was 21 months (range 8-186 months). There was no intracranial hemorrhage during the follow-up period, and no deaths occurred. Two adverse events were observed following treatment, and 2 patients required repeat GKS treatment with eventual complete obliteration. CONCLUSIONS Gamma Knife surgery offers a safe and effective primary or adjuvant treatment modality for complex clival epidural-osseous DAVFs. All patients in this case series demonstrated symptomatic improvement, and almost all patients attained complete obliteration.

  19. Cranial Nerve Dysfunction Associated with Cavernous Dural Arteriovenous Fistulas After Transvenous Embolization with Onyx

    Energy Technology Data Exchange (ETDEWEB)

    Li, Chuanhui; Wang, Yang; Li, Youxiang; Jiang, Chuhan; Wu, Zhongxue; Yang, Xinjian, E-mail: yang-xj@163.net [Capital Medical University, Beijing Neurosurgical Institute and Beijing Tiantan Hospital (China)

    2015-10-15

    PurposeCranial nerve dysfunction (CND) is not uncommon in patients with cavernous dural arteriovenous fistulas (cDAVFs), and may represent an initial manifestation or a complication after endovascular treatment. This study evaluated the outcome of CND associated with cDAVFs after transvenous embolization (TVE) using Onyx.Materials and MethodsForty-one patients with cDAVFs were treated with TVE in our department between April 2009 and October 2013. For each patient, clinical and radiologic records were retrospectively reviewed and evaluated, with an emphasis placed on evaluating the outcomes of the pre-existing cDAVF-induced CND and the TVE-induced CND.ResultsOf the 41 cases, 25 had a history of preoperative CND. Postoperatively, gradual remission to complete recovery (CR) within 8 months was observed in 17 of these cases, transient aggravation in 7, and significant improvement to be better than preoperative function but no CR in 1. All aggravation of CND occurred immediately or within 1 day after TVE and resolved completely within 5 months. Nine patients developed new CND after TVE. New CND occurred during the perioperative period in 8 cases, but all cases resolved completely within 15 days–6 months. Delayed CND was observed in 3 cases with a time lag of 3–25 months after TVE. Two of these completely resolved within 20 days–1 month and the remaining case significantly improved.ConclusionBoth the pre-existing cDAVF-induced CND and the TVE-induced new or aggravated CND completely resolved in almost all cases after embolization with Onyx.

  20. Clinical presentation, imaging findings, and prognosis of spinal dural arteriovenous fistula.

    Science.gov (United States)

    Lee, Jookyung; Lim, Young-Min; Suh, Dae Chul; Rhim, Seung Chul; Kim, Sang Joon; Kim, Kwang-Kuk

    2016-04-01

    Spinal dural arteriovenous fistula (SDAVF) is a relatively common acquired vascular malformation of the spinal cord. Assessment of a SDAVF is often difficult because of non-specific findings on non-invasive imaging modalities. Diagnosis of a SDAVF is often delayed, and some patients receive unnecessary treatment and treatment delays, often resulting in a poor outcome. The aim of this study was to characterize the clinical presentation, typical imaging findings, and long-term outcome of SDAVF. Forty patients (13 women, 27 men; mean age 58.18 ± standard deviation 14.75 years) who were treated at our hospital from June 1992 to March 2014 were retrospectively reviewed. We investigated the baseline characteristics, clinical presentation, imaging findings, treatment modalities, and outcome of the patients. The most common clinical presentation was a sensory symptom (80%), followed by motor weakness (70%), and sphincter dysfunction (62.5%). Roughly one-third (32.5%) of patients had a stepwise progression of fluctuating weakness and sensory symptoms, but the most common presentation was chronic progressive myelopathic symptoms (47.5%). Thirty-four patients (85%) had T2 signal change on the spinal cord MRI, indicative of cord edema. Thirty-eight patients had typical perimedullary vessel flow voids on T2-weighted MRI. Twenty-eight patients were treated with endovascular embolization, five patients underwent surgery, and four patients underwent both. Clinical outcome was determined by severity of initial deficit (p=0.008), extent of cord edema (p=0.010), treatment failure (p=0.004), and a residual fistula (p=0.017). SDAVF causes a treatable myelopathy, so early diagnosis and intervention is essential. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. Diagnosis of spinal dural arteriovenous fistula using 3D T2-weighted imaging

    Energy Technology Data Exchange (ETDEWEB)

    Kralik, Stephen F.; Murph, Daniel; Mehta, Peter; O' Neill, Darren P. [Indiana University School of Medicine, Department of Radiology and Imaging Sciences, Indianapolis, IN (United States)

    2017-10-15

    To evaluate spinal MRIs without and with 3D T2W imaging among patients without and with spinal dural arteriovenous fistula (SDAVF) confirmed by spinal digital subtraction angiography (DSA). A retrospective case-control study was performed among patients without and with SDAVF who had both spinal MRIs and gold standard spinal DSA. Two neuroradiologists independently reviewed spinal MRIs that were performed with either sagittal T2W turbo spin echo (2D group) or sagittal 3D T2W sampling perfection with application-optimized contrasts using different flip-angle evolutions (SPACE) (3D group) and documented the presence or absence of SDAVF. Using spinal DSA diagnosis as a gold standard, the sensitivity, specificity, and interobserver agreement for the 2D-group and 3D-group MRI diagnosis were calculated. The 2D group consisted of 21 patients and the 3D group consisted of 16 patients. For both radiologists, the 2D group demonstrated a sensitivity of 100% and specificity of 100%. Interobserver agreement in the 2D group was perfect (k = 1.0). For both radiologists, the 3D group demonstrated sensitivity of 100.0% and specificity of 92.3%. Interobserver agreement in the 3D group was perfect (k = 1.0). While flow voids were considered more conspicuous, spinal cord signal abnormality was considered less conspicuous with 3D T2W SPACE compared with conventional 2D STIR sequence. 3D T2W SPACE should be used in conjunction with 2D T2W sequences to more accurately detect abnormal cord signal and determine when perimedullary flow voids are pathologically abnormal for the radiologic diagnosis of SDAVF. (orig.)

  2. Characteristics, diagnosis and treatment of hypoglossal canal dural arteriovenous fistula: report of nine cases

    Energy Technology Data Exchange (ETDEWEB)

    Manabe, Shinji; Satoh, Koichi; Matsubara, Shunji; Satomi, Junichiro; Hanaoka, Mami; Nagahiro, Shinji [University of Tokushima, Department of Neurosurgery, Tokushima (Japan)

    2008-08-15

    We report the characteristics, diagnosis and treatment of dural arteriovenous fistula (DAVF) of the hypoglossal canal in nine patients with this relatively rare vascular disorder. Of 248 patients with intracranial DAVFs managed at our institution, nine patients (3.6%; four men, five women; mean age 62 years) were diagnosed with hypoglossal canal DAVF. We investigated patient characteristics with respect to clinical symptoms, neuroradiological findings, efficacy and complications related to endovascular treatment. Seven patients had experienced head injury. All patients presented with pulsatile tinnitus. One patient displayed ipsilateral hypoglossal nerve palsy before treatment. MR angiography showed a 'magic wand' appearance between the affected hypoglossal canal and the internal jugular vein in four patients. Angiography demonstrated an AV fistula on the medial aspect of the superior jugular bulb, mostly arising from the bilateral occipital, ascending pharyngeal and vertebral arteries with drainage to the internal jugular vein via the anterior condylar vein. Contralateral carotid injection accurately clarified the shunting point. Five patients underwent endovascular treatment: transarterial embolization (TAE; n=2), transvenous embolization (TVE; n=2), and TAE/TVE (n=1). Complete shunt obliteration was achieved in four patients and shunt reduction in one. The remaining four patients were treated conservatively and the shunt had disappeared at follow-up. Postoperative hypoglossal nerve palsy occurred in one patient after TVE, possibly due to coil overpacking. The incidence of hypoglossal canal DAVF was not very low in our series. Contralateral carotid injection is an essential examination to provide an accurate diagnosis. TVE should be considered when access is available, although TAE is also appropriate for shunt reduction. (orig.)

  3. Characteristics, diagnosis and treatment of hypoglossal canal dural arteriovenous fistula: report of nine cases

    International Nuclear Information System (INIS)

    Manabe, Shinji; Satoh, Koichi; Matsubara, Shunji; Satomi, Junichiro; Hanaoka, Mami; Nagahiro, Shinji

    2008-01-01

    We report the characteristics, diagnosis and treatment of dural arteriovenous fistula (DAVF) of the hypoglossal canal in nine patients with this relatively rare vascular disorder. Of 248 patients with intracranial DAVFs managed at our institution, nine patients (3.6%; four men, five women; mean age 62 years) were diagnosed with hypoglossal canal DAVF. We investigated patient characteristics with respect to clinical symptoms, neuroradiological findings, efficacy and complications related to endovascular treatment. Seven patients had experienced head injury. All patients presented with pulsatile tinnitus. One patient displayed ipsilateral hypoglossal nerve palsy before treatment. MR angiography showed a ''magic wand'' appearance between the affected hypoglossal canal and the internal jugular vein in four patients. Angiography demonstrated an AV fistula on the medial aspect of the superior jugular bulb, mostly arising from the bilateral occipital, ascending pharyngeal and vertebral arteries with drainage to the internal jugular vein via the anterior condylar vein. Contralateral carotid injection accurately clarified the shunting point. Five patients underwent endovascular treatment: transarterial embolization (TAE; n=2), transvenous embolization (TVE; n=2), and TAE/TVE (n=1). Complete shunt obliteration was achieved in four patients and shunt reduction in one. The remaining four patients were treated conservatively and the shunt had disappeared at follow-up. Postoperative hypoglossal nerve palsy occurred in one patient after TVE, possibly due to coil overpacking. The incidence of hypoglossal canal DAVF was not very low in our series. Contralateral carotid injection is an essential examination to provide an accurate diagnosis. TVE should be considered when access is available, although TAE is also appropriate for shunt reduction. (orig.)

  4. Onyx embolization as a first line treatment for intracranial dural arteriovenous fistulas with cortical venous reflux

    International Nuclear Information System (INIS)

    Panagiotopoulos, V.; Forsting, M.; Wanke, I.; Moeller-Hartmann, W.; Asgari, S.; Sandalcioglu, I.E.

    2009-01-01

    Our purpose was to present our experience regarding embolization of intracranial dural arteriovenous fistulas (DAVFs) with cortical venous reflux using Onyx, a non-adhesive liquid embolic agent. From January 2006 to December 2007, 16 patients (12 men and 4 women) with a mean age of 61 years (range 42 - 78) with an intracranial DAVF with cortical venous reflux underwent at least one transarterial embolization using Onyx. According to the Cognard classification, 2 lesions were grade V, 5 were grade IV, 6 were grade III, 2 were grade IIa+b, and 1 was grade IIb. The clinical presentation included 5 hemorrhagic deficits, 10 non-hemorrhagic manifestations, and 1 patient was asymptomatic. Twenty-four embolization sessions were performed in 16 patients with an average of 3 arterial feeders (range 1 - 9) embolized per DAVF. Immediately after embolization, complete occlusion was achieved in 9 / 16 (56 %) patients after the first session. Further postembolization surgical treatment was performed in 3 patients. Partial reperfusion occurred in 1 patient at the time of mean follow-up of 3.7 months (range 0 - 12). Treatment has been completed for 11 / 16 patients with angiographic cure in 10 / 11 (91 %). An infratentorial bleeding complication related to embolization occurred in one patient with temporary worsening of the patient's gait disturbance. At the time of mean clinical follow-up of 4.5 months (range 0 - 12), no procedure-related permanent morbidity was added to our cohort. According to our experience, embolization of intracranial DAVFs with cortical venous drainage using Onyx is feasible with promising results, indicating stability at the time of mid-term follow-up. In very complex DAVFs additional embolization material might be necessary, and in some cases surgery is warranted. (orig.)

  5. Experimental inflammation following dural application of complete Freund's adjuvant or inflammatory soup does not alter brain and trigeminal microvascular passage.

    Science.gov (United States)

    Lundblad, Cornelia; Haanes, Kristian A; Grände, Gustaf; Edvinsson, Lars

    2015-01-01

    Migraine is a paroxysmal, disabling primary headache that affects 16 % of the adult population. In spite of decades of intense research, the origin and the pathophysiology mechanisms involved are still not fully known. Although triptans and gepants provide effective relief from acute migraine for many patients, their site of action remains unidentified. It has been suggested that during migraine attacks the leakiness of the blood-brain barrier (BBB) is altered, increasing the passage of anti-migraine drugs. This study aimed to investigate the effect of experimental inflammation, following dural application of complete Freund's adjuvant (CFA) or inflammatory soup (IS) on brain and trigeminal microvascular passage. In order to address this issue, we induced local inflammation in male Sprague-Dawley-rats dura mater by the addition of CFA or IS directly on the dural surface. Following 2, 24 or 48 h of inflammation we calculated permeability-surface area product (PS) for [(51)Cr]-EDTA in the trigeminal ganglion (TG), spinal trigeminal nucleus, cortex, periaqueductal grey and cerebellum. We observed that [(51)Cr]-EDTA did not pass into the central nervous system (CNS) in a major way. However, [(51)Cr]-EDTA readily passed the TG by >30 times compared to the CNS. Application of CFA or IS did not show altered transfer constants. With these experiments we show that dural IS/CFA triggered TG inflammation, did not increase the BBB passage, and that the TG is readily exposed to circulating molecules. The TG could provide a site of anti-migraine drug interaction with effect on the trigeminal system.

  6. Dural afferents express acid-sensing ion channels: a role for decreased meningeal pH in migraine headache.

    Science.gov (United States)

    Yan, Jin; Edelmayer, Rebecca M; Wei, Xiaomei; De Felice, Milena; Porreca, Frank; Dussor, Gregory

    2011-01-01

    Migraine headache is one of the most common neurological disorders. The pathological conditions that directly initiate afferent pain signaling are poorly understood. In trigeminal neurons retrogradely labeled from the cranial meninges, we have recorded pH-evoked currents using whole-cell patch-clamp electrophysiology. Approximately 80% of dural-afferent neurons responded to a pH 6.0 application with a rapidly activating and rapidly desensitizing ASIC-like current that often exceeded 20nA in amplitude. Inward currents were observed in response to a wide range of pH values and 30% of the neurons exhibited inward currents at pH 7.1. These currents led to action potentials in 53%, 30% and 7% of the dural afferents at pH 6.8, 6.9 and 7.0, respectively. Small decreases in extracellular pH were also able to generate sustained window currents and sustained membrane depolarizations. Amiloride, a non-specific blocker of ASIC channels, inhibited the peak currents evoked upon application of decreased pH while no inhibition was observed upon application of TRPV1 antagonists. The desensitization time constant of pH 6.0-evoked currents in the majority of dural afferents was less than 500ms which is consistent with that reported for ASIC3 homomeric or heteromeric channels. Finally, application of pH 5.0 synthetic-interstitial fluid to the dura produced significant decreases in facial and hind-paw withdrawal threshold, an effect blocked by amiloride but not TRPV1 antagonists, suggesting that ASIC activation produces migraine-related behavior in vivo. These data provide a cellular mechanism by which decreased pH in the meninges following ischemic or inflammatory events directly excites afferent pain-sensing neurons potentially contributing to migraine headache. Copyright © 2010 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  7. Valores postmaterialistas y aprendizaje político adulto. El cambio de valores intracohorte en Europa Occidental

    Directory of Open Access Journals (Sweden)

    Raül Tormos

    2012-01-01

    Full Text Available La investigación sobre estabilidad y cambio de valores tiende a subrayar la importancia de los efectos generacionales, siendo la teoría del postmaterialismo de Inglehart un ejemplo de ello. En su teoría, las experiencias formativas confi guran los valores de cada cohorte de edad, y el cambio social tiene lugar de forma gradual mediante el reemplazo generacional. En este artículo se analizan datos de encuestas que abarcan un período de tiempo más amplio que el que utilizó Inglehart para sacar sus conclusiones. Aplicando técnicas de series temporales se identifi can cambios relevantes en cada generación a lo largo del tiempo. Se demuestra que ha tenido lugar un importante proceso de aprendizaje adulto en el ámbito de los valores postmaterialistas, obviado en la literatura empírica. Contradiciendo a Inglehart, se concluye que los efectos del período no son sólo de carácter menor y cortoplacista, sino que toman la forma de una tendencia sistemática de tipo intracohorte. Esta tendencia se vincula a la creciente prosperidad económica europea de las últimas décadas.

  8. Efecto de las isoflavonas de la soja en la salud ósea de adultos y niños

    Directory of Open Access Journals (Sweden)

    Dary Luz Mendoza Meza

    2015-01-01

    Full Text Available Las isoflavonas de la soja son metabolitos secundarios conocidos como fitoestrógenos por su similitud estructural con el 17b-estradiol. La daidzeina y la genisteina son las principales isoflavonas de la soja. Debido a su capacidad de unión a los receptores de estrógeno (RE son consideradas moduladores selectivos de los receptores de estrógenos (MSRE. El consumo dietario de isoflavonas es relacionado con la disminución de los síntomas de la menopausia, prevención de enfermedades cardiovasculares y de otras enfermedades crónicas como la diabetes mellitus. Las isoflavonas han sido propuestas también para el tratamiento de algunos tipos de cáncer y la prevención de la osteoporosis; sin embargo, existe gran controversia sobre los posibles efectos estrogénicos en niños púberes y prepúberes alimentados con fórmulas a base de proteína de soja. El objetivo de este trabajo es presentar una revisión sistemática de la química de las isoflavonas de la soja y sus efectos sobre la salud del hueso en adultos y niños.

  9. Diabetes tipo II e resolvinas D1

    OpenAIRE

    Silva, Isabel Alexandra Marques Batista da

    2015-01-01

    Dissertação para obtenção do grau de Mestre no Instituto Superior de Ciências da Saúde Egas Moniz A diabetes é um problema de saúde pública crescente com o envelhecimento da população, os maus hábitos alimentares e o sedentarismo. A obesidade poderá ser causa ou consequência da diabetes tipo II, sendo também um problema crescente de saúde pública. Esta monografia tem como objetivo estudar, com base no conhecimento atual, se as resolvinas D1 são uma alternativa viável na terapêutica da diab...

  10. Oviposição e dispersão de ninfas de Bemisia tabaci biótipo B em genótipos de tomateiro Oviposition and nymphal dispersion of Bemisia tabaci biotype B on tomato genotypes

    Directory of Open Access Journals (Sweden)

    Marilene Fancelli

    2008-12-01

    Full Text Available Diversos métodos têm sido empregados para avaliar a resistência de plantas a moscas-brancas. Todavia, poucos trabalhos têm sido realizados visando determinar a dispersão de ninfas desses insetos sobre as plantas. O objetivo do presente trabalho foi avaliar a oviposição de B. tabaci biótipo B e a dispersão de suas ninfas em folíolos com e sem exsudatos de genótipos de tomateiro. Foram utilizados sete genótipos de tomateiro: LA716, LA1739, PI134417, LA462, LA1584, 'Santa Clara' e P25 (controle suscetível. A oviposição de B. tabaci biótipo B foi avaliada em gaiolas plásticas (2,8 cm² fixadas na face abaxial dos folíolos, nas quais foram inseridos dez casais do inseto. Para avaliação da dispersão das ninfas, considerou-se o deslocamento dos insetos além do limite da área ocupada pelas gaiolas. As variáveis observadas foram: mortalidade de adultos 24 horas após a liberação, número de ovos, viabilidade da fase de ovo, período de incubação, número de ninfas e dispersão. Em folíolos com exsudato, LA716, LA1739 e PI134417 provocaram as maiores mortalidades. Adultos mortos nos folíolos desses genótipos ficaram aderidos aos tricomas glandulares, o que provocou redução na oviposição do inseto. Para dispersão, nos folíolos com exsudato, os máximos valores ocorreram nos genótipos LA716, LA462 e P25. Na condição sem exsudato, LA716 promoveu a menor dispersão das ninfas. A presença do exsudato influencia negativamente a sobrevivência e oviposição do inseto. A dispersão das ninfas também é afetada pelo exsudato, embora outros fatores possam ser importantes para o deslocamento do inseto.Several methods have been employed for evaluating plant resistance to whiteflies. Although, a few researches have been conducted aiming to determine the whitefly nymphal dispersion on crops. The objective of this work was to evaluate the oviposition of B. tabaci biotype B and nymphal dispersion in leaflets with and without

  11. The influence of age on positions of the conus medullaris, Tuffier's line, dural sac, and sacrococcygeal membrane in infants, children, adolescents, and young adults.

    Science.gov (United States)

    Jung, Ji-Yun; Kim, Eun-Hee; Song, In-Kyung; Lee, Ji-Hyun; Kim, Hee-Soo; Kim, Jin-Tae

    2016-12-01

    The purpose of this study was to analyze the distances between the conus medullaris and the Tuffier's line, and between the dural sac and the sacrococcygeal membrane (SCM) in the same pediatric population. Spinal magnetic resonance images and simple X-ray images of 350 patients aged from 1 month to 20 years were reviewed. Positions of the conus medullaris, Tuffier's line, the dural sac, and the SCM were identified. Each position was recorded in relation to the corresponding vertebral body segments. The distances between the conus medullaris and Tuffier's line, and between the dural sac and the SCM, were measured and then assessed according to age using an analysis of variance and a linear regression analysis. The median levels of the conus medullaris and Tuffier's line were in the lower third of L1 [the first lumbar vertebral body] and the middle third of L5, respectively. The levels of the conus medullaris and Tuffier's line were lower in younger populations. The distance between the conus medullaris and Tuffier's line ranged from 1.5 to 4.75 vertebral body height. However, a narrow range of 1.5-2.5 vertebral height was observed only in children younger than 2 years. The level of the dural sac did not differ greatly by age, but the upper limit of the SCM was lower in older populations. The distance between the dural sac and the upper limit of the SCM increased with age. In children, there is a distance of 1.5-4.75 vertebral body height between the conus medullaris and the Tuffier's line. However, these distances were narrower among younger populations. The distance between the dural sac and the upper limit of the SCM increased with age. © 2016 John Wiley & Sons Ltd.

  12. Análisis del bienestar de los adultos mayores en México

    OpenAIRE

    García Benítez, Julio César

    2008-01-01

    Esta tesis analiza el bienestar de los adultos mayores en México a partir de la teoría de los funcionamientos y capacidades de Amartya Sen. La investigación tiene dos objetivos principales: el primero es medir el bienestar del adulto mayor con una visión más amplia, en el sentido de incluir tanto indicadores objetivos como subjetivos; y el segundo objetivo es demostrar que este bienestar depende tanto de los recursos, como de los factores de conversión con los que cuenta el adulto mayor, los ...

  13. Competencias socio-emocionales en adultos mayores de la ciudad de Buenos Aires

    OpenAIRE

    Mikulic, Isabel M.; Caballero, Romina; Aruanno, Yanina

    2014-01-01

    Con el aumento de la población de adultos mayores, se plantean importantes retos a nivel internacional. Los estudios se focalizaron en factores demográficos, cognitivos y físicos, en cambio, los emocionales fueron escasamente investigados en esta etapa vital. El objetivo de este estudio es evaluar el patrón de competencias socioemocionales en 53 adultos mayores (M =69; DE =4.2), de ambos sexos, y comparar sus diferencias con 53 jóvenes adultos. A todos los participantes se les administró el I...

  14. Estereótipos e mulheres na cultura marroquina

    OpenAIRE

    Sadiqi,Fatima

    2008-01-01

    Estereótipos sobre as mulheres no Marrocos podem ser caracterizados como crenças culturais incompletas e inexatas mantidas por algumas pessoas e que se encontram inscritos em expressões lingüísticas ou em discursos subliminares. A cultura popular marroquina emprega representações poderosas para transmitir e sustentar tais estereótipos. Embora existam alguns estereótipos positivos, a maioria dos estereótipos sobre as mulheres no Marrocos é negativa e reflete ditames patriarcais subliminares qu...

  15. Actitud y miedo ante la muerte en adultos mayores

    Directory of Open Access Journals (Sweden)

    Ana Fernanda Uribe Rodríguez

    2007-01-01

    Full Text Available A través de los años el tema de la muerte se ha conceptualizado de diversas maneras. En la actualidad las personas evitan hablar del tema y se observa conductas evitativas, de miedo y ansiedad. El presente artículo tiene como objetivo evaluar la actitud y miedo ante la muerte en una muestra de 170 adultos mayores ( X :71,02; DT=5,946 de la ciudad de Cali-Colombia por medio del Perfil Revisado de Actitudes hacia la Muerte (PAM-R y la Escala de Collet-Lester (1969; se tuvo en cuenta las variables sexo, religión y estrato socioeconómico. Los resultados muestran diferencias significativas en función del sexo en las escalas de miedo a la propia muerte, evitación de la muerte, aceptación de acercamiento. Con relación al estrato socioeconómico se encontraron diferencias significativas en las escalas de miedo a la muerte y aceptación de acercamiento y en función de la religión sólo hay diferencias significativas en la evitación a la muerte. Se concluye la importancia de contribuir desde la psicología, al mejoramiento en los procesos de adaptación a los duelos y disminuir la presencia de duelos patológicos que se generan ante situaciones inesperadas y mal elaboradas en este caso, en los adultos mayores.

  16. Condicoes dentarias entre adultos brasileiros de 1986 a 2010

    Directory of Open Access Journals (Sweden)

    Sergio do Nascimento

    2013-12-01

    Full Text Available OBJETIVO: Identificar tendências do padrão da cárie dentária em adultos brasileiros. MÉTODOS: Foram utilizados dados provenientes de levantamentos epidemiológicos realizados pelo Ministério da Saúde nos anos de 1986, 2003 e 2010. A experiência de cárie, expressa pelo índice CPOD (dentes permanentes cariados, perdidos e obturados, e a saúde dentária, expressa pelo índice OH-D (dentes hígidos + obturados relativo ao número de dentes funcionais, foram comparadas em amostras aleatórias de residentes de 35 a 44 anos de idade em cada região brasileira. As diferenças nas condições dentárias entre os anos foram estimadas por meio da razão dos valores dos índices, empregando-se análise de regressão de Poisson ajustada pela idade. RESULTADOS: Houve reduções no índice CPOD e aumento no índice OH-D em todas as regiões no período de 1986 a 2010. A região Norte, que tinha o pior padrão em 1986, apresentou o maior ganho em termos de dentição funcional. CONCLUSÕES: Tem ocorrido uma transição da saúde bucal para melhor nos adultos brasileiros. É plausível que a adição de flúor à água e ao creme dental, maior incorporação de serviços restauradores e a melhoria nos indicadores de desenvolvimento humano decorrentes de políticas públicas estejam relacionados a essa melhora.

  17. Meningitis y artritis por Haemophilus influenzae en un adulto

    Directory of Open Access Journals (Sweden)

    Javier Molina

    1988-02-01

    Full Text Available Tradicionalmente el Haemophilus influenzae ha sido considerado un germen causante de infecciones en niños; en adultos se lo ha relacionado con Infecciones respiratorias, pero en los últimos tiempos se han descrito en ellos infecciones severas cuando hay algunos factores predisponentes. Se describe un paciente drogadicto de 30 años con cuadro de meningitis y artritis y prueba de látex y cultivo de LCR positivos para HaemophiIus influenzae, quien recibió tratamiento con ampicilina, 2 gramos Intravenosos cada 4 horas y evolucionó a la mejoría sin secuelas. Se plantea la necesidad de tener en cuenta al Haemophilus influenzae como patógeno del adulto y más en aquellas personas con factores predisponentes.

    Haemophilus influenzae has traditionally been considered as an infectious agent that predominantly affects children; instead, in adults It has been Linked either to respiratory infections or to gevere infections occurring when predisposing factors are present. We describe a 30 year-old drug adict patient that presented with meningitis and arthritis; both latex test and cerebrospinal fluid culture were positive for Haemophilus influenzae. He was treated with ampicilin 2 gm, I. V. every four hours and improved without sequelae. This microorganism must be considered among those affecting adult patients specially when predisposing factors for infection are present.

  18. Dural invasion of meningiomas adjacent to the tumor margin on Gd-DTPA-enhanced MR images: histopathologic correlation

    International Nuclear Information System (INIS)

    Hutzelmann, A.; Palmie, S.; Freund, M.; Heller, M.; Buhl, R.

    1998-01-01

    In intracranial meningiomas a flat, contrast-enhancing, dural structure adjacent to the tumor can occasionally be observed on gadolinium-DTPA-enhanced MR images. We wished to evaluate whether there is a correlation between MR images and meningeal invasion of intracranial meningiomas. The study included 54 patients with intracranial meningioma and the meningeal sign. MR studies included T2-weighted and gadolinium-DTPA-enhanced T1-weighted images in axial, coronal, and sagittal planes. Histopathologic examinations were done on the meningiomas adjacent to the dura mater. The meningeal sign on MRI was observed from 2 up to 35 mm from the main tumor mass in 31 (57 %) of the 54 patients. In 20 of these 31 the histopathologic examination showed tumor invasion, while 11 patients had no tumor invasion but tissue proliferation, hypervascularity, and vascular dilatation. Seven of the 23 meningiomas without the meningeal sign had histologically proven infiltration of the adjacent dura. MR imaging is not able to determine definitive whether or not there is dural infiltration of the meningiomas. In conclusion, resection of the tumor with a wide margin is necessary to achieve complete excision of meningioma and to avoid recurrence. (orig.)

  19. Widening of the spinal canal and dural ectasia in Marfan's syndrome: assessment by CT

    Energy Technology Data Exchange (ETDEWEB)

    Villeirs, G.M.; Verstraete, K.L.; Kunnen, M.F. [Dept. of Radiology, Univ. Hospital, Gent (Belgium); Tongerloo, A.J. van; Paepe, A.M. de [Dept. of Medical Genetics, Univ. Hospital, Gent (Belgium)

    1999-11-01

    We describe a method for diagnosing dural ectasia (DE) and spinal canal widening (SCW) using CT. We examined 23 patients with Marfan's syndrome (MFS), 17 with Ehlers-Danlos syndrome (EDS) and 29 normal subjects, using six axial slices at the level of the L1-S1 pedicles. Transverse diameters of the vertebral bodies, spinal canal and dural sac were measured and indices were defined to differentiate patients with DE and SCW from normal. Statistical significance was assessed using Student's t -test, {chi} {sup 2}-test and Pearson's correlation coefficient. DE and SCW occurred in 69.6 % and 60.9 % of cases of MFS and in 23.5 % and 35.3 % of EDS respectively. In MFS, prevalence was significantly higher than in the control group. DE was significantly more frequent in MFS than in EDS. A strong correlation existed between DE and SCW in MFS and the control group, but not in EDS. Our system enables quantitative assessment of SCW and DE. The latter is particularly important in subjects suspected of having MFS, in whom it is a common and characteristic sign. (orig.)

  20. Single-Session Hematoma Removal and Transcranial Coil Embolization for a Cavernous Sinus Dural Arteriovenous Fistula: A Technical Case Report.

    Science.gov (United States)

    Akamatsu, Yosuke; Sato, Kenichi; Endo, Hidenori; Matsumoto, Yasushi; Tominaga, Teiji

    2017-08-01

    Patients with cavernous sinus dural arteriovenous fistulas (CS dAVFs) with cortical venous varix are indicated for aggressive treatment because of the associated risk for intracranial hemorrhage. We present a case of surgical transvenous embolization in an 84-year-old woman with CS dAVF who presented with massive intracerebral hematoma. Cerebral angiograms revealed the dural AVF drained only into the superficial middle cerebral vein. Because an emergent mass reduction and prevention of rebleeding were necessary, single-session hematoma removal and transcranial embolization of a CS dAVF were performed in the neurosurgical operating room, using a mobile C-arm fluoroscopy. After the right frontotemporal craniotomy, intracerebral hematoma was removed and coil packing of the affected cavernous sinus was successfully performed via the dilated superficial middle cerebral vein. The transcortical vein approach enables occlusion of CS dAVF with isolated cortical venous drainage and may be a valuable alternative approach for some cases needed emergency craniotomy. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. The effect of intravenous propofol on the incidence of post-dural puncture headache following spinal anesthesia in cesarean section

    Directory of Open Access Journals (Sweden)

    Parisa Golfam

    2016-09-01

    Full Text Available Introduction: Post Dural puncture headache is still a common complication among young women undergone cesarean section, although use of small size spinal needles reduced its prevalence. Several methods have been suggested for prevention and treatment of this side effect; such as complete bed rest, hydration, non-opioid analgesics, caffeine, codeine, which none of them proved to be totally effective. The last option would be epidural blood patch, if headache persist. The aim of this study was evaluation the efficacy of intravenous propofol on post dural puncture headache incidence after cesarean section. Methods: In a randomized clinical trial 120 patients aged 18-45 years old in American Society of Anesthesiologist (ASA class I or II, who had no history of headache, analgesic consumption, substance abuse and drug addiction, candidate for elective cesarean section, were randomly assigned into intervention (propofol and control groups. The anesthesia method for both groups was precisely the same. After spinal anesthesia in the first group 30µg/kg/min of intravenous propofol have been infused slowly. Then at 1, 6, 18, 24 hours and 2nd to 7th days after surgery, anesthesiologist asked groups for presence or absence of headache. The data analyzed with SPSS 16.0 software. Results: Headache incidence rate in the group who receiving propofol was significantly reduced (P.V=0.001. Conclusion: This study showed that 30µg/kg/min of intravenous propofol caused reduced the incidence of post spinal headache in young women undergone elective cesarean section.

  2. CT and MR imaging of non-cavernous cranial dural arteriovenous fistulas: Findings associated with cortical venous reflux

    Energy Technology Data Exchange (ETDEWEB)

    Letourneau-Guillon, Laurent; Cruz, Juan Pablo; Krings, Timo, E-mail: Timo.Krings@uhn.ca

    2015-08-15

    Highlights: • The conventional neuroimaging manifestations of dural arteriovenous fistulas are highly variable. • Identification of cortical venous reflux is important to prevent complications. • Tortuous and dilated vessels without a nidus are associated with cortical venous reflux. • Digital subtraction angiography remains the gold standard for DAVF diagnosis. - Abstract: Purpose: To compare the conventional CT and MR findings of DAVFs in relation to the venous drainage pattern on digital subtraction angiography (DSA). Materials and Methods: Cross-sectional imaging findings (CT and/or MR) in 92 patients were compared to the presence of cortical venous reflux (CVR) on DSA. Results: Imaging features significantly more prevalent in patients with CVR included: abnormally dilated and tortuous leptomeningeal vessels (92% vs. 4%, p < 0.001) or medullary vessels (69% vs. 0%, p < 0.001), venous ectasias (45% vs. 0%, p < 0.001) and focal vasogenic edema (38% vs. 0%, p < 0.001). The following findings trended towards association but did not reach the p value established following Bonferroni correction: dilated external carotid artery branches (71% vs. 38%, p = 0.005), cluster of vessels surrounding dural venous sinus (50% vs. 19%, p = 0.009), presence of hemorrhage (33 vs. 12%, p = 0.040), and parenchymal enhancement (21% vs. 0%, p = 0.030). Conclusion: In the appropriate clinical setting, recognition of ancillary signs presumably related to venous arterialization and congestion as well as arterial feeder hypertrophy should prompt DSA confirmation to identify DAVFs associated with CVR.

  3. Morphological analysis of the cervical spinal canal, dural tube and spinal cord in normal individuals using CT myelography

    International Nuclear Information System (INIS)

    Inoue, H.; Ohmori, K.; Takatsu, T.; Teramoto, T.; Ishida, Y.; Suzuki, K.

    1996-01-01

    To verify the conventional concept of ''developmental stenosis of the cervical spinal canal'', we performed a morphological analysis of the relations of the cervical spinal canal, dural tube and spinal cord in normal individuals. The sagittal diameter, area and circularity of the three structures, and the dispersion of each parameter, were examined on axial sections of CT myelograms of 36 normal subjects. The spinal canal was narrowest at C4, followed by C5, while the spinal cord was largest at C4/5. The area and circularity of the cervical spinal cord were not significantly correlated with any parameter of the spinal canal nor with the sagittal diameter and area of the dural tube at any level examined, and the spinal cord showed less individual variation than the bony canal. Compression of the spinal cord might be expected whenever the sagittal diameter of the spinal canal is below the lower limit of normal, that is about 12 mm on plain radiographs. Thus, we concluded that the concept of ''developmental stenosis of the cervical spinal canal'' was reasonable and acceptable. (orig.). With 2 figs., 3 tabs

  4. Total dural irradiation: RapidArc versus static-field IMRT: A case study

    Energy Technology Data Exchange (ETDEWEB)

    Kelly, Paul J., E-mail: paulj.kelly@hse.ie [Department of Radiation Oncology, Dana Farber/Brigham and Women' s Cancer Center, Harvard Medical School, Boston, MA (United States); Mannarino, Edward; Lewis, John Henry; Baldini, Elizabeth H.; Hacker, Fred L. [Department of Radiation Oncology, Dana Farber/Brigham and Women' s Cancer Center, Harvard Medical School, Boston, MA (United States)

    2012-07-01

    The purpose of this study was to compare conventional fixed-gantry angle intensity-modulated radiation therapy (IMRT) with RapidArc for total dural irradiation. We also hypothesize that target volume-individualized collimator angles may produce substantial normal tissue sparing when planning with RapidArc. Five-, 7-, and 9-field fixed-gantry angle sliding-window IMRT plans were generated for comparison with RapidArc plans. Optimization and normal tissue constraints were constant for all plans. All plans were normalized so that 95% of the planning target volume (PTV) received at least 100% of the dose. RapidArc was delivered using 350 Degree-Sign clockwise and counterclockwise arcs. Conventional collimator angles of 45 Degree-Sign and 315 Degree-Sign were compared with 90 Degree-Sign on both arcs. Dose prescription was 59.4 Gy in 33 fractions. PTV metrics used for comparison were coverage, V{sub 107}%, D1%, conformality index (CI{sub 95}%), and heterogeneity index (D{sub 5}%-D{sub 95}%). Brain dose, the main challenge of this case, was compared using D{sub 1}%, Dmean, and V{sub 5} Gy. Dose to optic chiasm, optic nerves, globes, and lenses was also compared. The use of unconventional collimator angles (90 Degree-Sign on both arcs) substantially reduced dose to normal brain. All plans achieved acceptable target coverage. Homogeneity was similar for RapidArc and 9-field IMRT plans. However, heterogeneity increased with decreasing number of IMRT fields, resulting in unacceptable hotspots within the brain. Conformality was marginally better with RapidArc relative to IMRT. Low dose to brain, as indicated by V5Gy, was comparable in all plans. Doses to organs at risk (OARs) showed no clinically meaningful differences. The number of monitor units was lower and delivery time was reduced with RapidArc. The case-individualized RapidArc plan compared favorably with the 9-field conventional IMRT plan. In view of lower monitor unit requirements and shorter delivery time, Rapid

  5. A microcontroller-based simulation of dural venous sinus injury for neurosurgical training.

    Science.gov (United States)

    Cleary, Daniel R; Siler, Dominic A; Whitney, Nathaniel; Selden, Nathan R

    2018-05-01

    OBJECTIVE Surgical simulation has the potential to supplement and enhance traditional resident training. However, the high cost of equipment and limited number of available scenarios have inhibited wider integration of simulation in neurosurgical education. In this study the authors provide initial validation of a novel, low-cost simulation platform that recreates the stress of surgery using a combination of hands-on, model-based, and computer elements. Trainee skill was quantified using multiple time and performance measures. The simulation was initially validated using trainees at the start of their intern year. METHODS The simulation recreates intraoperative superior sagittal sinus injury complicated by air embolism. The simulator model consists of 2 components: a reusable base and a disposable craniotomy pack. The simulator software is flexible and modular to allow adjustments in difficulty or the creation of entirely new clinical scenarios. The reusable simulator base incorporates a powerful microcomputer and multiple sensors and actuators to provide continuous feedback to the software controller, which in turn adjusts both the screen output and physical elements of the model. The disposable craniotomy pack incorporates 3D-printed sections of model skull and brain, as well as artificial dura that incorporates a model sagittal sinus. RESULTS Twelve participants at the 2015 Western Region Society of Neurological Surgeons postgraduate year 1 resident course ("boot camp") provided informed consent and enrolled in a study testing the prototype device. Each trainee was required to successfully create a bilateral parasagittal craniotomy, repair a dural sinus tear, and recognize and correct an air embolus. Participant stress was measured using a heart rate wrist monitor. After participation, each resident completed a 13-question categorical survey. CONCLUSIONS All trainee participants experienced tachycardia during the simulation, although the point in the simulation

  6. The road less traveled: transarterial embolization of dural arteriovenous fistulas via the ascending pharyngeal artery.

    Science.gov (United States)

    Gross, Bradley A; Albuquerque, Felipe C; Moon, Karam; McDougall, Cameron G

    2017-01-01

    With the introduction of Onyx, transarterial embolization has become the most common endovascular approach to treating dural arteriovenous fistulas (dAVFs), often via the middle meningeal or occipital arteries. The ascending pharyngeal artery (APA) is a less frequently explored transarterial route because of its small caliber, potential anastomoses to the internal carotid and vertebral arteries, and vital supply to lower cranial nerves. To review our institutional experience and highlight the prevalence of APA supply to dAVFs and cases where it is a safe and effective pedicle for embolization. We reviewed our endovascular database (January 1, 1996 to March 1, 2016) for cranial dAVFs, evaluating dAVF characteristics and embolization results for those treated transarterially via the APA. Of 267 endovascularly treated dAVFs, 68 had APA supply (25%). Of these 68 dAVFs, embolization was carried out via this pedicle in 8 (12%) and 7 were ultimately occluded. No complications, including post-treatment cranial neuropathies or radiographic evidence of non-target embolization, were found. For 5 dAVFs, the APA was selected as the initial pedicle for embolization (two marginal sinus, one distal sigmoid, one cavernous, one tentorial). In four of these five cases, dAVF occlusion was achieved via the initial APA feeding artery pedicle. In one case, near-complete, stagnant occlusion was achieved after APA embolization; complete occlusion was achieved after adjunctive embolization of a single additional middle meningeal artery pedicle. In three other cases of complex transverse/sigmoid dAVFs, the APA was used after multiple attempts via middle meningeal and occipital artery pedicles. Occlusion was not achieved transarterially; two of these three dAVFs were ultimately occluded transvenously. In rare, select cases, the APA is an excellent route for transarterial embolization of cranial dAVFs. Published by the BMJ Publishing Group Limited. For permission to use (where not already

  7. Perfil clínico del adulto mayor atendido ambulatoriamente en un hospital general

    Directory of Open Access Journals (Sweden)

    Paola Casas

    2012-10-01

    Full Text Available Objetivo: Describir el perfil clínico del adulto mayor atendido ambulatoriamente en un hospital general. Material y métodos: Estudio descriptivo, transversal, realizado a través de encuestas aplicadas a pacientes en la consulta ambulatoria de geriatría del Hospital Nacional Cayetano Heredia (HNCH, entre agosto de 2011 y enero 2012. Resultados: Se evaluaron 290 pacientes, el 69,3% fueron mujeres; el 65,5% tenía entre 60 y 79 años. La hipertensión arterial fue el diagnóstico más frecuente (55,5%. El 83,1% consumía algún tipo de medicamento y el 45% más de 3 fármacos. En la valoración por esferas: el 83,5% era autónomo, el 18,1% tenía deterioro cognitivo, el 7,7% depresión, el 79,3% riesgo social, el 23,8% disfunción familiar, el 31,4% riesgo de malnutrición, el 23,4% obesidad, el 96% mala higiene del sueño y el 4,9% riesgo de caídas. El síndrome geriátrico más frecuente fue caídas en 23,8% y de los problemas geriátricos, el edentulismo en 77,6%; 17,4% eran frágiles según la velocidad de la marcha; se encontró asociación entre fragilidad y edad avanzada, género femenino y la presencia de riesgo social. Conclusión: Los pacientes que acuden a la consulta externa de Geriatría fueron mayoritariamente mujeres, funcionalmente autónomos, sin deterioro cognitivo, con riesgo social y adecuada funcionalidad familiar, prefrágiles y con enfermedades crónicas no transmisibles principalmente.

  8. Comprometimento medular por linfoma tipo Burkitt: relato de um caso

    Directory of Open Access Journals (Sweden)

    Murillo Côrtes Drummond

    1985-06-01

    Full Text Available Registro de caso de linfoma tipo Burkitt com comprometimento intrarraqueano em criança de três anos de idade. Considerações sobre esse tipo de tumor são feitas em função do caso observado e de dados da literatura.

  9. EDUCAÇÃO DE ADULTOS: DE ONDE VIEMOS E PARA ONDE VAMOS?

    Directory of Open Access Journals (Sweden)

    Carine Schenekenberg Guedes

    2016-02-01

    Full Text Available Este artigo tem como escopo apresentar uma abordagem histórica da educação dando destaque às iniciativas da UNESCO diante da realização das Conferências Internacionais de Educação de Adultos, as CONFINTEAS. Partindo do princípio de que para entendermos a história da educação de adultos faz-se necessário refletir sobre o conceito que lhe é atribuído, o texto que ora apresentamos está organizado da seguinte forma: de início procuramos refletir sobre o conceito de educação de adultos e as dimensões que esse abarca. Na sequência abordamos a história da educação de adultos desde a antiguidade até o período que antecede a Segunda Guerra Mundial. Em seguida, abordamos os diferentes contornos que a educação de adultos assume dentro dos documentos resultantes as CONFINTEAS. Encerramos não com uma conclusão, mas com algumas indagações no sentido de provocar reflexões sobre as perspectivas da educação de adultos neste início do século XXI.

  10. La educación de los adultos mayores en TICs

    Directory of Open Access Journals (Sweden)

    Boarini, Mauricio Nazareno

    2006-01-01

    Full Text Available El siguiente trabajo pretende mostrar una propuesta de educación destinada a la capacitación de Adultos Mayores en TICs, teniendo en cuenta el contexto sociocultural actual que originan estas prácticas, su adecuación a los destinatarios y el reconocimiento que las mismas tienen por parte de los Adultos Mayores, quienes enfrentan el desafío de llevar adelante nuevos aprendizajes para sentirse integrados al grupo social con el que conviven. Atendiendo a este propósito, el trabajo se divide en tres partes; en primer lugar se incluyen diferentes proyecciones poblacionales que muestran el crecimiento de la población de Adultos Mayores a nivel mundial, y se caracteriza a la sociedad, donde la integración de las Tecnologías de la Información y la Comunicación cambia las formas de vida. En segundo lugar, se caracteriza al Adulto Mayor como sujeto destinatario de los diferentes cambios que se deben proponer desde el sistema educativo. Por último se describe la propuesta de educación de Adultos Mayores en TICs del Programa Educativo de Adultos Mayores de la Universidad Nacional de Río Cuarto y la valoración de la misma por parte de los alumnos y sociedad en general.

  11. Dural attachment of intracranial meningiomas: evaluation with contrast-enhanced three-dimensional fast imaging with steady-state acquisition (FIESTA) at 3 T

    Energy Technology Data Exchange (ETDEWEB)

    Yamamoto, Junkoh; Takahashi, Mayu; Aoyama, Yuichi; Soejima, Yoshiteru; Saito, Takeshi; Akiba, Daisuke; Nishizawa, Shigeru [University of Occupational and Environmental Health, Department of Neurosurgery, Kitakyusyu (Japan); Kakeda, Shingo; Korogi, Yukunori [University of Occupational and Environmental Health, Department of Radiology, Kitakyusyu (Japan)

    2011-06-15

    The purpose of this study was to evaluate the role of contrast-enhanced fast imaging with steady-state acquisition (CE-FIESTA) for assessing whether dural attachment in intracranial meningiomas is adhesive or not by correlation with intraoperative findings. Fourteen consecutive patients who were candidates for surgical treatment of meningiomas were prospectively analyzed with preoperative magnetic resonance imaging, including CE-FIESTA at 3 T. First, two neuroradiologists assessed several characteristics of the attachment of the meningioma to the dura mater or skull base on CE-FIESTA images. Second, the surgical findings of adhesion at the dural attachment of meningiomas were evaluated by two neurosurgeons. Finally, the CE-FIESTA findings were correlated with the surgical findings by one neurosurgeon and one neuroradiologist by consensus. CE-FIESTA clearly depicted a hypointense marginal line at the attachment site of the meningioma. When CE-FIESTA revealed smooth marginal lines or hyperintense zones along the marginal lines, tumors were detached easily from the dura mater. On the contrary, when CE-FIESTA showed an irregularity, such as partial disruption of the marginal lines, vessels, or bony hyperostosis, the tumors tended to adhere firmly to the dura mater, which was found to contain small vessels and fine fibrous tissues. There seems to be an excellent correlation between the characteristics of dural attachment of meningiomas on CE-FIESTA images and intraoperative findings. Therefore, for operative planning, CE-FIESTA may provide useful information regarding the adhesiveness of dural attachment. (orig.)

  12. Dural attachment of intracranial meningiomas: evaluation with contrast-enhanced three-dimensional fast imaging with steady-state acquisition (FIESTA) at 3 T

    International Nuclear Information System (INIS)

    Yamamoto, Junkoh; Takahashi, Mayu; Aoyama, Yuichi; Soejima, Yoshiteru; Saito, Takeshi; Akiba, Daisuke; Nishizawa, Shigeru; Kakeda, Shingo; Korogi, Yukunori

    2011-01-01

    The purpose of this study was to evaluate the role of contrast-enhanced fast imaging with steady-state acquisition (CE-FIESTA) for assessing whether dural attachment in intracranial meningiomas is adhesive or not by correlation with intraoperative findings. Fourteen consecutive patients who were candidates for surgical treatment of meningiomas were prospectively analyzed with preoperative magnetic resonance imaging, including CE-FIESTA at 3 T. First, two neuroradiologists assessed several characteristics of the attachment of the meningioma to the dura mater or skull base on CE-FIESTA images. Second, the surgical findings of adhesion at the dural attachment of meningiomas were evaluated by two neurosurgeons. Finally, the CE-FIESTA findings were correlated with the surgical findings by one neurosurgeon and one neuroradiologist by consensus. CE-FIESTA clearly depicted a hypointense marginal line at the attachment site of the meningioma. When CE-FIESTA revealed smooth marginal lines or hyperintense zones along the marginal lines, tumors were detached easily from the dura mater. On the contrary, when CE-FIESTA showed an irregularity, such as partial disruption of the marginal lines, vessels, or bony hyperostosis, the tumors tended to adhere firmly to the dura mater, which was found to contain small vessels and fine fibrous tissues. There seems to be an excellent correlation between the characteristics of dural attachment of meningiomas on CE-FIESTA images and intraoperative findings. Therefore, for operative planning, CE-FIESTA may provide useful information regarding the adhesiveness of dural attachment. (orig.)

  13. Gamma Knife radiosurgery for intracranial meningiomas : Do we need to treat the dural tail? A single-center retrospective analysis and an overview of the literature

    NARCIS (Netherlands)

    Bulthuis, Vincent J; Hanssens, Patrick E J; Lie, Suan Te; van Overbeeke, Jacobus J

    2014-01-01

    BACKGROUND: The dural tail (DT) has been described as a common feature in meningiomas. There is a great variation of tumor invasion and extent of tumor cells in the DT. Therefore, the necessity to include the whole DT in Gamma Knife radiosurgery is not clear, since inclusion increases the target

  14. Measurement of the cross-sectional area of the dural tube in the lumbar spine on magnetic resonance imaging. Comparison between normal, pre- and post-discectomy conditions

    International Nuclear Information System (INIS)

    Matsubayashi, Yasutomo

    1997-01-01

    This study evaluated the usefulness of pre- and postoperative magnetic resonance imaging (MRI) of lumbar disc hernia with special attention to measurement of the cross-sectional area of the dural tube. Twenty-five patients (20 men and 5 women; 25 discs) who underwent posterior lumbar discectomy and 73 normal individuals (44 men and 29 women; 219 discs) of a similar age distribution were studied. Axial MRI was mainly used for the measurement of the dural tube. In the patient group, MRI examination was performed 1, 3, 6, and 12 months postoperatively. Assessment of the clinical symptoms was also included and used for comparison with the MRI evaluation. The cross-sectional area was significantly reduced to about 50% of the normal preoperatively. One month postoperatively, there was no significant increase in the size of the area, but after three months, the area increased significantly and progressed to the normal size within a year. One-month postoperatively, MRI examination was not considered useful because of postoperative hematoma and/or edema at the surgical site. The increase in the size of the cross-sectional area of the dural tube correlated well with the improvement in clinical symptoms. Three-months postoperatively, MRI evaluation of the lumbar disc seemed useful and measurement of the cross-sectional area of the dural tube appeared to serve as an indicator of the effectiveness of the surgery. (author)

  15. Measurement of the cross-sectional area of the dural tube in the lumbar spine on magnetic resonance imaging. Comparison between normal, pre- and post-discectomy conditions

    Energy Technology Data Exchange (ETDEWEB)

    Matsubayashi, Yasutomo [Juntendo Univ., Tokyo (Japan). School of Medicine

    1997-07-01

    This study evaluated the usefulness of pre- and postoperative magnetic resonance imaging (MRI) of lumbar disc hernia with special attention to measurement of the cross-sectional area of the dural tube. Twenty-five patients (20 men and 5 women; 25 discs) who underwent posterior lumbar discectomy and 73 normal individuals (44 men and 29 women; 219 discs) of a similar age distribution were studied. Axial MRI was mainly used for the measurement of the dural tube. In the patient group, MRI examination was performed 1, 3, 6, and 12 months postoperatively. Assessment of the clinical symptoms was also included and used for comparison with the MRI evaluation. The cross-sectional area was significantly reduced to about 50% of the normal preoperatively. One month postoperatively, there was no significant increase in the size of the area, but after three months, the area increased significantly and progressed to the normal size within a year. One-month postoperatively, MRI examination was not considered useful because of postoperative hematoma and/or edema at the surgical site. The increase in the size of the cross-sectional area of the dural tube correlated well with the improvement in clinical symptoms. Three-months postoperatively, MRI evaluation of the lumbar disc seemed useful and measurement of the cross-sectional area of the dural tube appeared to serve as an indicator of the effectiveness of the surgery. (author)

  16. Prevalencia de los trastornos del sueño en el adulto mayor Prevalence of sleep disorders in the elderly

    Directory of Open Access Journals (Sweden)

    Manuel Pando-Moreno

    2001-02-01

    Full Text Available El presente es un estudio realizado con adultos mayores de la Ciudad de Guadalajara, México, que viven en domicilios particulares. De ellos, el 58% de los hombres y el 76% de las mujeres presentaron al menos un síntoma de trastornos del sueño, según el "Cuestionario General de Salud de Goldberg"; el 8,5% registró positivo en el total de los reactivos. Conforme a los criterios del DSM IV, un 33,3% podría ser considerado "caso" de trastorno del sueño. Estos posibles casos estarían asociados al género, al grado de estudio y con la presencia de depresión; pero no con el estado civil ni la edad. Ante la gran cantidad de "posibles casos" encontrados, que no han sido previamente detectados ni se encuentran en ningún tipo de tratamiento ad hoc, se recomienda promover cursos de actualización en esta materia para los profesionales de la salud (principalmente médicos y enfermeras, de manera que se facilite la detección oportuna de los casos, así como incrementar y mejorar la accesibilidad de los servicios de salud mental para la población de la tercera edad, e incrementar las actividades de educación para la salud para el adulto mayor y los cuidadores de éstos.This study was performed with senior citizens in Greater Metropolitan Guadalajara, Mexico, who live in private homes, alone, or with family. Of these, 58% of men and 76% of women showed at least one symptom of sleep disorder according to the Goldberg General Health Questionnaire, while 8.5% were positive for all survey items. According to DSM IV criteria, 33.3% could be considered "cases" of sleep disorder, and none were under any type of treatment at the time of the study. These possible cases were apparently associated with gender and educational level, but not with marital status or age. In addition, no strong association was detected with the presence of depression, established according to Brink's Geriatric Depression Scale. Given the large amount of "possible cases" found that

  17. Lesao óssea em leucemias agudas linfoblásticas tipo T e TIPO nao T / nao B

    OpenAIRE

    Martins, Fernando Lopes

    2013-01-01

    Resumo: O AUTOR APRESENTA OS RESULTADOS DO ESTUDO RADIOLÓGICO DE ESQUELETO DE 61 PACIENTES PORTADORES DE LEUCEMIA AGUDA LINFOBLÁSTICA, CORRELACIONANDO A PRESENÇA OU NÃO DE Lesões ÓSSEAS COM A CLASSIFICAÇÃO IMUNOLÓGICA DE LAL TIPO T E TIPO não T / não B

  18. Beneficios percibidos por adultos mayores incorporados al ejercicio

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    René Barrios Duarte

    2003-04-01

    Full Text Available El propósito del trabajo es conocer los beneficios que perciben los adultos mayores del sexo femenino, con larga permanencia en el ejercicio, y las relaciones que se establecen entre estos y las variables edad, nivel cultural, tiempo de permanencia y ocupación anterior. Se tomó una muestra de 75 personas pertenecientes a 5 círculos de abuelos de Ciudad de La Habana, con edades entre 56 y 90 años, a los cuales se les aplicó un cuestionario de datos sociodemográficos y una entrevista. Los beneficios percibidos se agruparon en 4 categorías principales: salud, aptitud, psicológicos y sociales. No se encontró relación de dependencia con ninguna de las variables analizadas, aunque sí se encontraron diferencias en categorías específicas. El estudio detalla los beneficios que se pueden percibir con la práctica sistemática en programas destinados al adulto mayor, así como su carácter multidimensional, físico, psicológico y social. Se confirma la importancia del ejercicio y se ofrecen razones para su fomento.The objective of the paper is to find out the benefits that older females receive from practicing exercises for a long time and the relations that are established between these benefits and the variables age, educational level, length of practice and former occupation. A sample of 75 persons from 5 grandfather´s clubs in the City of Havana, aged 56-60 years was administered a socio-demographic questionnaire and an interview. Received benefits were grouped into 4 main categories: health, aptitude, psychological and social. There was no dependence relation with any of the analyzed variables, although differences were found in specific categories. The study detailed the benefits that may be received from systematic physical exercising in programs devoted to older people as well as their multidimensional, physical, psychological and social character. The paper confirmed the importance of exercising and provided reasons for encouraging

  19. Fatores associados as dificuldades de adultos na mastigacao

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    Daniela de Rossi Figueiredo

    2013-12-01

    Full Text Available OBJETIVO : Estimar a prevalência de dificuldade de adultos na mastigação, segundo sexo, e analisar os fatores associados. MÉTODOS : Estudo transversal de base populacional com adultos de 20 a 59 anos de idade (n = 2.016, de Florianópolis, SC, em 2009, por meio de amostragem em dois estágios, setores censitários e domicílios. A dificuldade na mastigação foi investigada por meio de pergunta sobre dificuldade de mastigação devida a problemas com os dentes ou dentadura. Analisaram-se os fatores  demográficos, socioeconômicos, utilização dos serviços de saúde para consulta odontológica e condição bucal autorreferida. Foi realizada regressão logística multivariável, estratificada por sexo. RESULTADOS : A taxa de resposta foi de 85,3% (n = 1.720. A prevalência de dificuldade na mastigação foi de 13,0% (IC95% 10,3;15,8 e 18,0% (IC95% 14,6;21,3 em homens e em mulheres, respectivamente. Mulheres e homens com 50 anos ou mais, aqueles com dez dentes naturais ou menos e os que manifestaram dor dentária tiveram mais chance de apresentar dificuldade na mastigação. O efeito conjunto da perda e da dor na dificuldade na mastigação foi cerca de quatro vezes maior entre as mulheres. CONCLUSÕES : A magnitude das associações entre variáveis socioeconômicas, demográficas e de condição bucal autorreferidas foi diferente para homens e mulheres, em geral maiores para as mulheres, destacando-se a dor dentária. Os resultados sugerem que o impacto das condições bucais varia segundo o sexo.

  20. Desigualdades na autoavaliacao da saude bucal em adultos

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    Carla Antoni Luchi

    2013-08-01

    Full Text Available OBJETIVO Analisar a associação entre autoavaliação da saúde bucal em adultos e desigualdades sociodemográficas. MÉTODOS Estudo transversal com 2.016 adultos de 20 a 59 anos de idade, de Florianópolis, SC, em 2009. A amostra foi obtida por duplo estágio (setores censitários e domicílios. Os dados foram coletados por entrevistas domiciliares face a face. O desfecho foi autoavaliação da saúde bucal. As variáveis exploratórias foram caracterizadas em blocos demográficos, socioeconômicos, de utilização de serviços e de condições bucais autorreferidas. Foi realizada análise de regressão multivariável de Poisson e estimadas as razões de prevalências e respectivos intervalos de 95% de confiança. RESULTADOS A prevalência de autoavaliação negativa da saúde bucal foi de 33,2% (IC95% 29,8;36,6. Idade avançada, referir-se como pardo, possuir menor escolaridade, ter consultado o dentista há três anos ou mais, ter realizado a última consulta em consultório público, possuir menos de dez dentes naturais presentes em pelo menos um arco, perceber necessidade de tratamento odontológico, apresentar sensação de boca seca e dificuldade de alimentação em virtude dos dentes foram associados à autoavaliação negativa da saúde bucal na análise ajustada. CONCLUSÕES A autoavaliação da saúde bucal reflete as desigualdades em saúde e está relacionada às piores condições socioeconômicas, menor uso de serviços de saúde e pior condição bucal autorreferida.

  1. Fetal MR imaging of posterior intracranial dural sinus thrombosis: a report of three cases with variable outcomes

    International Nuclear Information System (INIS)

    Byrd, Sharon E.; Elias, Dean; Abramowicz, Jacques S.; Kent, Paul; Kimura, Robert E.; Heydeman, Peter T.

    2012-01-01

    Thrombosis of fetal intracranial dural sinuses is a rare entity. A specific type of midline dural sinus thrombosis (DST) at the torcular Herophili with extension into the superior sagittal sinus (SSS) was initially seen on fetal US and was referred to fetal MRI for definite diagnosis and better delineation. Retrospective comparison to medical literature of three cases, diagnosed at our institution, of midline fetal DST with MR imaging findings and clinical outcomes. We reviewed MRI findings on T2-weighted images of our three cases of fetal midline DST and clinical outcomes of these fetuses and compared our findings to medical literature. The MR imaging and clinical findings of our cases extend over 6 years. They consist of three pregnant women, 31-39 years of age each with a single fetus, with fetal MR imaging performed at different gestational ages (GA). Case 1 the MR imaging was performed at 21 5/7 weeks' GA, case 2 at 24 and 33 4/7 weeks' GA, and case 3 at 22 and 25 weeks' GA. Postnatal MRI was performed in case 2 at 6 months of life and case 3 at 1 day of life. Clinical follow-up occurred during the last 6 years. In all of our cases, T2-W MR imaging demonstrated ballooned midline torcular Herophili with iso- to hypointense mass with or without focal eccentric area of greater hypointensity occupying the torcular Herophili with extension into the SSS. Case 3 had associated leptomeningeal dural vascular malformation overlying the left cerebral hemisphere with development of migrational disorder in the left cerebral hemisphere. Clinical outcome consisted of fetal demise in case 1, normal postnatal outcome in case 2 and severe brain damage with poor postnatal outcome in case 3. Our findings of large iso-hypointense thrombus with or without a focal eccentric area more hypointense to thrombus in a dilated torcular Herophili with extension into the SSS on T2-W images corresponds to the majority of cases of this rare type of DST in the medical literature. (orig.)

  2. Fetal MR imaging of posterior intracranial dural sinus thrombosis: a report of three cases with variable outcomes

    Energy Technology Data Exchange (ETDEWEB)

    Byrd, Sharon E.; Elias, Dean [Rush Medical College and Rush University Medical Center, Department of Diagnostic Radiology and Nuclear Medicine Section of Neuroradiology, Chicago, IL (United States); Abramowicz, Jacques S. [Rush Medical College and Rush University Medical Center, Department of Obstetrics and Gynecology, Rush Fetal and Neonatal Medicine Center, Chicago, IL (United States); Kent, Paul [Rush Medical College and Rush University Medical Center, Department of Pediatrics, Division of Hematology and Oncology, Chicago, IL (United States); Kimura, Robert E. [Rush Medical College and Rush University Medical Center, Department of Pediatrics, Division of Neonatology, Chicago, IL (United States); Heydeman, Peter T. [Rush Medical College and Rush University Medical Center, Department of Pediatrics, Division of Pediatric Neurology, Chicago, IL (United States)

    2012-05-15

    Thrombosis of fetal intracranial dural sinuses is a rare entity. A specific type of midline dural sinus thrombosis (DST) at the torcular Herophili with extension into the superior sagittal sinus (SSS) was initially seen on fetal US and was referred to fetal MRI for definite diagnosis and better delineation. Retrospective comparison to medical literature of three cases, diagnosed at our institution, of midline fetal DST with MR imaging findings and clinical outcomes. We reviewed MRI findings on T2-weighted images of our three cases of fetal midline DST and clinical outcomes of these fetuses and compared our findings to medical literature. The MR imaging and clinical findings of our cases extend over 6 years. They consist of three pregnant women, 31-39 years of age each with a single fetus, with fetal MR imaging performed at different gestational ages (GA). Case 1 the MR imaging was performed at 21 5/7 weeks' GA, case 2 at 24 and 33 4/7 weeks' GA, and case 3 at 22 and 25 weeks' GA. Postnatal MRI was performed in case 2 at 6 months of life and case 3 at 1 day of life. Clinical follow-up occurred during the last 6 years. In all of our cases, T2-W MR imaging demonstrated ballooned midline torcular Herophili with iso- to hypointense mass with or without focal eccentric area of greater hypointensity occupying the torcular Herophili with extension into the SSS. Case 3 had associated leptomeningeal dural vascular malformation overlying the left cerebral hemisphere with development of migrational disorder in the left cerebral hemisphere. Clinical outcome consisted of fetal demise in case 1, normal postnatal outcome in case 2 and severe brain damage with poor postnatal outcome in case 3. Our findings of large iso-hypointense thrombus with or without a focal eccentric area more hypointense to thrombus in a dilated torcular Herophili with extension into the SSS on T2-W images corresponds to the majority of cases of this rare type of DST in the medical literature

  3. Sensitization of dural afferents underlies migraine-related behavior following meningeal application of interleukin-6 (IL-6

    Directory of Open Access Journals (Sweden)

    Yan Jin

    2012-01-01

    Full Text Available Abstract Background Migraine headache is one of the most common neurological disorders, but the pathophysiology contributing to migraine is poorly understood. Intracranial interleukin-6 (IL-6 levels have been shown to be elevated during migraine attacks, suggesting that this cytokine may facilitate pain signaling from the meninges and contribute to the development of headache. Methods Cutaneous allodynia was measured in rats following stimulation of the dura with IL-6 alone or in combination with the MEK inhibitor, U0126. The number of action potentials and latency to the first action potential peak in response to a ramp current stimulus as well as current threshold were measured in retrogradely-labeled dural afferents using patch-clamp electrophysiology. These recordings were performed in the presence of IL-6 alone or in combination with U0126. Association between ERK1 and Nav1.7 following IL-6 treatment was also measured by co-immunoprecipitation. Results Here we report that in awake animals, direct application of IL-6 to the dura produced dose-dependent facial and hindpaw allodynia. The MEK inhibitor U0126 blocked IL-6-induced allodynia indicating that IL-6 produced this behavioral effect through the MAP kinase pathway. In trigeminal neurons retrogradely labeled from the dura, IL-6 application decreased the current threshold for action potential firing. In response to a ramp current stimulus, cells treated with IL-6 showed an increase in the numbers of action potentials and a decrease in latency to the first spike, an effect consistent with phosphorylation of the sodium channel Nav1.7. Pretreatment with U0126 reversed hyperexcitability following IL-6 treatment. Moreover, co-immunoprecipitation experiments demonstrated an increased association between ERK1 and Nav1.7 following IL-6 treatment. Conclusions Our results indicate that IL-6 enhances the excitability of dural afferents likely via ERK-mediated modulation of Nav1.7 and these responses

  4. Rendimiento en pruebas cognitivas breves, de adultos mayores con demencia en estadios avanzados, residentes de una comunidad urbana de Lima, Perú

    Directory of Open Access Journals (Sweden)

    Nilton Custodio

    Full Text Available Objetivos. Evaluar el rendimiento de la prueba de dibujo de reloj en versión de Manos (PDR-M y Mini Mental State Examination (MMSE en su versión peruana, para detectar demencia de cualquier tipo en adultos mayores residentes de una comunidad urbana de Lima, Perú. Materiales y métodos. Análisis secundario de base de datos, de tipo observacional, analítico y transversal; con diseño de prueba diagnóstica, teniendo como prueba estándar a las evaluaciones clínica y neuropsicológica en conjunto. Se evaluó el rendimiento de las pruebas individualmente, así como de forma combinada. Resultados. El rendimiento de MMSE para la evaluación de pacientes con demencia de cualquier tipo presentó sensibilidad de 64,1%, especificidad de 84,1%, VPP de 24,4%, VPN de 96,7%, LR (+ de 4,03 y LR (- de 0,43. La PDR-M presentó sensibilidad de 89,3%, especificidad de 98,1%, VPP de 79,3%, VPN de 99,1%, LR (+ de 47,79 y LR (- de 0,11. Cuando se aplicaron ambas pruebas, y al menos una de ellas fue positiva, presentaron sensibilidad de 98,1%, especificidad de 84,1%, VPP de 33,1%, VPN de 99,8%, LR (+ de 6,17 y LR (- de 0,02. Al realizar el análisis, por separado, de demencia tipo alzhéimer y no alzhéimer, los valores de los parámetros no se diferencian sustancialmente de los obtenidos para demencias de cualquier tipo. Conclusiones. La combinación de MMSE y PDR-M demuestran un buen rendimiento para detectar demencia en estadios moderado y severo en población residente de una comunidad urbana de Lima.

  5. Novos acessos de tomateiro resistentes à mosca-branca biótipo B New accessions of tomato resistant to whitefly biotype B

    Directory of Open Access Journals (Sweden)

    Maria Elisa de Sena Fernandes

    2009-11-01

    Full Text Available O objetivo deste trabalho foi selecionar novas fontes de resistência a Bemisia tabaci biótipo B, entre 34 acessos de tomateiro (Lycopersicon esculentum, do Banco de Germoplasma de Hortaliças da UFV. Avaliaram-se os números de adultos, ovos e ninfas por planta, além da densidade de tricomas. Detectaram-se diferenças entre os acessos nas variáveis avaliadas. Os acessos BGH-166, BGH-616, BGH-850, BGH-990, BGH-2102 e BGH-2125 apresentaram menor número de adultos, ovos e ninfas por planta e tiveram menor densidade de tricomas. A resistência dos acessos de tomate à mosca-branca foi associada a uma menor densidade de tricomas.The objective of this work was to evaluate resistance to Bemisia tabaci biotype B in 34 tomato (Lycopersicon esculentum accessions from the Banco de Germoplasma de Hortaliças of UFV. The number of adults, eggs and nymphs per plant besides of trichome density were evaluated. Differences between accessions were found for the evaluated variables. Accessions BGH-166, BGH-616, BGH-850, BGH-990, BGH-2102 and BGH-2125 presented less infestation of adults, eggs and nymphs per plant and showed lower trichome density. The resistance of these tomato accessions to whitefly was associated to a lower trichome density.

  6. Calidad de vida de cuidadores de adultos con accidente cerebrovascular

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    INNA ELIDA FLÓREZ TORRES

    2010-10-01

    Full Text Available Objetivo: describir la calidad de vida de los cuidadores familiares de adultos con secuelas de accidente cerebrovascular, en Cartagena, Colombia. Método: estudio descriptivo cuantitativo realizado durante el segundo semestre de 2008. Muestra no probabilística por conveniencia de 97 cuidadores. Se empleó el instrumento propuesto por Ferrell et ál. Para valorar cada uno de los bienestares que integran la calidad de vida se utilizaron medidas de tendencia central y coeficiente de variación. Resultados: el grupo de cuidadores presentó en el bienestar físico un promedio de 11,1 con relación al máximo puntaje, lo que indica el peor estado de salud; los bienestares psicológico y social tuvieron promedios de 48,8 y 21,9, respectivamente, con menor afectación. El mejor estado se halló en el bienestar espiritual, con promedio de 22,6. Conclusiones: la experiencia de ser cuidador modifica de manera importante la calidad de vida de las personas; los cuidadores, como fuente importante de cuidado informal, requieren apoyo de los sistemas de salud y, como parte de este, de los profesionales de enfermería.

  7. Líquen estriado no adulto Lichen striatus on adult

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    Leticia Fogagnolo

    2011-02-01

    Full Text Available Líquen estriado é uma erupção inflamatória incomum, de etiologia desconhecida. Raramente acomete adultos, e é caracterizada pelo surgimento abrupto de pápulas coalescentes, em arranjo linear, usualmente em extremidades. A histopatologia mostra reação liquenóide envolvendo folículos e glândulas. Ocasionalmente há sobreposição com líquen plano linear e "blaschkitis", seus principais diagnósticos diferenciais. Relata-se um caso de mulher adulta com pápulas eritematovioláceas em região cervical e hemiface direitas, cuja correlação clínico-histopatológica permitiu o diagnóstico de líquen estriado. Os achados atípicos e a dificuldade diagnóstica são discutidos.Lichen Striatus is an uncommon inflammatory skin eruption of unknown etiology. It rarely affects adults, and it is characterized by abrupt onset of coalescent papules, in a linear disposition, usually on the extremities. Histopathology shows lichenoid reaction involving follicles and glands. Occasionally, there is overlap with linear lichen planus and "blaschkitis", the main differential diagnoses. It is reported here the case of an adult woman with erythematous violaceous papules on the right side of the neck and face, diagnosed with lichen striatus by clinical and histopathological correlation. The atypical findings and the diagnostic difficulty are discussed.

  8. Nuevo tipo de apoyos y articulaciones

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    Andrä, Fritz Leonhardt

    1963-11-01

    of theoretical and technical difficulties inherent in these bearings: they also express acknowledgement to German individuals and institutions, for their contribution to this investigation.Las tendencias actuales son funciones que dependen directamente de la presencia creciente y mejorada de los materiales de construcción que se ofrecen al comercio. En el campo de los materiales cabe una marcada subdivisión en naturales y preparados o sintéticos; estos últimos constituyen la preocupación de los autores para su aprovechamiento y adecuada aplicación. De entre ellos, las resinas sintéticas o caucho artificial, dentro de las distintas especies de la extensa familia han gozado de un lugar preferente en este estudio de nuevos tipos de apoyos que presentan los notables ingenieros alemanes Wolfhart Andrä y Fritz Leonhardt. En los ensayos de laboratorio y a escala natural, las variedades comerciales de estas resinas, conocidas con los nombres de «neopreno» y «Teflon», han sido elegidas por presentar, por lo menos actualmente, características marcadamente apropiadas a la finalidad perseguida en este estudio, del que se confía ulterior desarrollo y mejor acogida, por las importantes aplicaciones que de él se derivan en el campo de la ingeniería y construcción. Los autores estudian con detenimiento y sobrado rigor para las aplicaciones prácticas las deformaciones que de estos materiales se espera al someterlos a fuerzas de gran concentración. En los apoyos juega particular interés la distribución de la carga siempre concentrada en superficies relativamente pequeñas, lo que exige elevadas cargas unitarias y, con ello, la utilización de materiales extremadamente nobles para resistirlas con la resistencia que las deformaciones instantáneas requieren para recobrar rápidamente la posición de estabilidad perdida momentáneamente. La fatiga en el ciclo de deformaciones relaja los materiales, y ha de tenerse presente al considerar las características que los

  9. Diagnósticos de enfermagem em adultos em tratamento de hemodiálise Diagnósticos enfermería en adultos en tratamiento de hemodiálisis Nursing diagnosis in adults on hemodialysis

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    Aline Gozzi Braga Lata

    2008-01-01

    Full Text Available OBJETIVO: Analisar a distribuição dos diagnósticos de enfermagem presentes em adultos de uma clínica de hemodiálise de Petrópolis - Rio de Janeiro. MÉTODOS: Estudo quantitativo do tipo transversal, de caráter exploratório e descritivo. Foram avaliados 20 pacientes nos meses de abril e maio de 2006. Os instrumentos de coleta de dados foram: roteiro de entrevista e exame físico. RESULTADOS: Verificou-se que metade eram mulheres, sendo a maioria casada, com média de 2 filhos. Foram identificados 16 diagnósticos de enfermagem, quatro desses acima do percentil 75, são eles: Risco de infecção; Perfusão tissular ineficaz: renal; Padrão de sono perturbado e Intolerância à atividade. CONCLUSÃO: O estudo proporcionou maior conhecimento da realidade desses pacientes, contribuindo para uma possível implementação de ações de enfermagem mais eficientes para a solução dos problemas identificados.OBJETIVO: Analizar la distribución de los diagnósticos de enfermería presentes en adultos de una clínica de hemodiálisis de Petrópolis - Rio de Janeiro. MÉTODOS: Se trata de un estudio cuantitativo de tipo transversal, de carácter exploratorio y descriptivo. Fueron evaluados 20 pacientes en los meses de abril y mayo del 2006. Los instrumentos de recolección de datos fueron: una guía de entrevista y examen físico. RESULTADOS: Se verificó que la mitad eran mujeres, siendo la mayoría casadas, con un promedio de 2 hijos. Se identificaron 16 diagnósticos de enfermería, cuatro de ellos encima del percentil 75, que son: Riesgo de infección; Perfusión tisular ineficaz: renal; Patrón de sueño perturbado e Intolerancia a la actividad. CONCLUSIÓN: El estudio proporcionó mayor conocimiento de la realidad de esos pacientes, contribuyendo a una posible implementación de acciones de enfermería más eficientes para la solución de los problemas identificados.OBECTIVE: to analyze the nursing diagnoses present in adults from a

  10. Angio-Architectural Features of High-Grade Intracranial Dural Arteriovenous Fistulas: Correlation With Aggressive Clinical Presentation and Hemorrhagic Risk.

    Science.gov (United States)

    Della Pepa, Giuseppe Maria; Parente, Paolo; D'Argento, Francesco; Pedicelli, Alessandro; Sturiale, Carmelo Lucio; Sabatino, Giovanni; Albanese, Alessio; Puca, Alfredo; Fernandez, Eduardo; Olivi, Alessando; Marchese, Enrico

    2017-08-01

    High-grade dural arteriovenous fistulas (dAVFs) can present shunts with very different angio-architectural characteristics. Specific hemodynamic factors may affect clinical history and determine very different clinical courses. To evaluate the relationship between some venous angio-architectural features in high-grade dAVFs and clinical presentation. Specific indicators of moderate or severe venous hypertension were analyzed, such as altered configurations of the dural sinuses (by a single or a dual thrombosis), or overload of cortical vessels (restrictions of outflow, pseudophlebitic cortical vessels, and venous aneurysms). The institutional series was retrospectively reviewed (49 cases), and the pattern of venous drainage was analyzed in relationship with clinical presentation (benign/aggressive/hemorrhage). Thirty-five of 49 cases displayed cortical reflux (high-grade dAVFs). This subgroup displayed a benign presentation in 31.42% of cases, an aggressive in 31.42%, and hemorrhage in 37.14%. Our data confirm that within high-grade dAVFs, 2 distinct subpopulations exist according to severity of clinical presentation. Some indicators we examined showed correlation with aggressive nonhemorrhagic manifestations (outflow restriction and pseudophlebitic cortical vessels), while other showed a correlation with hemorrhage (dual thrombosis and venous aneurysms). Current classifications appear insufficient to identify a wide range of conditions that ultimately determine the organization of the cortical venous drainage. Intermediate degrees of venous congestion correlate better with the clinical risk than the simple definition of cortical reflux. The angiographic aspects of venous drainage presented in this study may prove useful to assess dAVF hemodynamic characteristics and identify conditions at higher clinical risk. Copyright © 2017 by the Congress of Neurological Surgeons

  11. [Dural arteriovenous fistula involving the superior sagittal and transverse-sigmoid sinuses, treated by thrombolysis: case report].

    Science.gov (United States)

    Arai, T; Ohno, K; Yoshino, Y; Tanaka, Y; Nariai, T; Hirakawa, K; Nemoto, S

    1997-07-01

    A rare case of dural arteriovenous fistula (DAVF) in the superior sagittal sinus (SSS), the transverse sinus and the sigmoid sinus is reported. A 64-year-old man, who had had an episode of temporary visual disturbance after moderate fever for a week about 20 years before, was aware of loss of visual acuity and reduced field of view in the right eye. When he was introduced to our outpatient service, increased intracranial pressure (ICP) was detected by lumbar puncture. Cerebral angiograms showed bilateral DAVFs both in the posterior fossa and the SSS concomitant with thrombosis in the transverse sinus, sigmoid sinus and SSS. Afterwards, endovascular transarterial embolization through bilateral occipital, posterior auricular and left middle meningeal, superior temporal arteries was carried out. In addition, transvenous thrombolytic therapy using a catheter inserted into SSS resulted in the improvement of his visual problems. Although he was discharged at once, he was readmitted to our department with Foster Kennedy syndrome and increased ICP. Cerebral angiograms showed recurrence of both DAVF and sinus thrombosis. Transarterial embolization was performed again resulting in a significant reduction of DAVF, and his visual acuity was recovered to a moderate degree. The origin of DAVF is still controversial. Although two theories, "congenital" and "acquired", are put forward, it has been thought that both factors play important roles. In our case, the patient had stenosis in the jugular canal portions of the sigmoid sinus. In addition, sinus thrombosis seemed to have occurred. It is thought that increased intrasinus pressure may have lead to communication with surrounding arteries through existing dural vessels. We applied transvenous thrombolytic therapy in this case. Our result suggests that we should consider this therapy for some cases of DAVF.

  12. Linfangioma bucal del tipo capilar: Reporte de un caso en un paciente adulto Capillary buccal lymphangioma: Case report in adult patient

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    Fabiano Gonzaga Rodrigues

    2007-03-01

    Full Text Available Se describe un caso clínico de linfangioma localizado en la mucosa bucal de un paciente de 68 años de edad, tratado con eletrocauterización. La presentación del caso comprende una breve revisión de la literatura; se aborda el diagnóstico y las características clínico-patológicas en el tratamiento del linfagioma bucal.In this paper, the authors describe a case report of a buccal lymphangioma localizeted in jugal mucosa of a sixty eight years old patient, treated by the electrocauterization. Also, they present a literature revision approaching the diagnosis, the clinical and histopathological characteristics, and the different types of treatment of the buccal lymphangioma.

  13. Relación entre tipo y cantidad de carbohidratos dietarios con el perfil lipídico y ApoB100 en adultos

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    Martha Guerra

    2010-08-01

    Full Text Available Relationship between the type and quantity of dietary carbohydrates, and the lipid profile and ApoB100 in adults. Objective.To establish if there is any relationship between the type and amount of dietary carbohydrates commonly consumed and the plasmaticlevels of lipids, lipoproteins and apolipoprotein B100 (ApoB100. Materials and methods. The final sample was conformed by thedatabase of 144 lecturers of the Pontificia Universidad Javeriana who had previously participated in another survey and from which weused information on their food habits, plasmatic lipid levels, lipoproteins and ApoB100. To determine the relationship between thedependent and independent variables, simple and multiple correlation analyses were done. In the cases of no correlation we applied theindependence Chi2 test to find the relationship with the consumption of total carbohydrates, sugars and total fiber. Additionally, with aone-factor analysis of variance we compared plasmatic levels of lipids, lipoproteins and ApoB100 with the consumption of totalcarbohydrates, sugars and fiber. Results. Most of the population consumes above the daily total carbohydrate recommendation, menpresented greater carbohydrate consumption of the type of sugars and more elevated plasmatic levels of triglycerides and lipoproteins of investiverylow density (VLDL, whereas women presented higher levels of their high density lipoproteins (HDL. When relating grams ofeach type of carbohydrates with the levels of lipids, lipoproteins and ApoB100, no significant correlation was found for any of the cases(p>0,05. Conclusion. There was no significant relationship between the type and amount of carbohydrates consumed with theplasmatic levels of lipids, lipoproteins and Apo B100.

  14. Associação entre nível de atividade física habitual e qualidade de vida em adulto com diabetes melito tipo2

    OpenAIRE

    Silva, Cacio Costa da

    2012-01-01

    Introdução: O diabetes melito é um grupo de doenças metabólicas caracterizadas por hiperglicemia e associadas a complicações em vários órgãos, especialmente olhos, rins, nervos, cérebro, coração e vasos sanguíneos. A atividade física (AF) é definida como qualquer movimento corporal realizado pelos músculos esqueléticos que resulta em gasto energético acima dos níveis de repouso. A qualidade de vida (QV) é definida como a percepção do indivíduo sobre a sua posição na vida, no co...

  15. Trastornos del sueño en el adulto mayor en la comunidad Sleeping disturbances in aged within the community

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    Ernesto Cruz Menor

    2008-12-01

    Full Text Available La Edad es un factor determinante en el sueño y son los adultos mayores una población muy afectada por trastornos de la cantidad y la calidad del sueño. Fueron objetivos de esta investigación determinar la Prevalencia de Trastornos de sueño en 116 adultos mayores en régimen ambulatorio, pertenecientes a dos consultorios médicos del Policlínico Hermanos Cruz, así como la asociación de estos trastornos a algunos factores. Los Ancianos fueron encuestados sobre si tenían o no trastornos del sueño, sus tipos, si ingerían café y horario de la ingesta evaluándose su estado psicológico según Escala de depresión geriátrica. Los resultados muestran que un 52,6 % de los ancianos tenían trastornos de sueño, de ellos, el sexo femenino fue el más afectado triplicando el riesgo de padecerlo. Además, se comprobó una asociación significativa de los trastornos de sueño con el estado psicológico. El tipo más frecuente de Trastorno de sueño resultó ser el insomnio y entre ellos el mixto. Concluyendo que alrededor de la mitad de la población anciana en régimen ambulatorio padece de trastornos de sueño muy en relación a trastornos psicoafectivos y al sexo de los pacientes.Age is a significant factor in sleeping and the aged is a very affected population due to the quantity and quality of sleeping.The purpose of this research is to determine the prevalence of the sleeping disturbances in 116 adults in ambulatory setting attending to two Family Medical Offices in "Hermanos Cruz "Policlinic, as well as the association of these disturbances to some factors. The aged were surveyed for knowing if they had or not sleeping disturbances, its types , if they drink coffe and time of the drinking and it is assessed the psychological condition according to the geriatric depression scale.Results show that 52,6% of them had sleeping disturbances being female the most affected sex (3 times over, likewise it was proved a significant association

  16. OTROS TIPOS ESPECÍFICOS DE DIABETES MELLITUS

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    DRA. M. Gabriela Sanzana G.

    2016-03-01

    En las “Diabetes Atípicas” (no incluidas en la clasificación ADA, se mencionan la DM tipo 2 en niños y adolescentes, favorecida por el aumento de la obesidad y del sedentarismo; la diabetes propensa a la cetosis, que debutan en cetoacidosis, con etiopatogenia y evolución de DM2; los Latent Autoinmune Diabetes of Adults (LADA, DM tipo 1 de lenta aparición y la diabetes postrasplante.

  17. Preparación de los adultos mayores en los Estados Unidos para hacer frente a los desastres naturales: encuesta a escala nacional

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    Tala M. Al-rousan

    2014-12-01

    Full Text Available OBJETIVOS: Nos propusimos determinar el grado de preparación frente a los desastres naturales de los adultos mayores en los Estados Unidos y evaluar los factores que pueden afectar negativamente la salud y la seguridad durante este tipo de incidentes. MÉTODOS: Obtuvimos una muestra de adultos de 50 años en adelante (n = 1 304 de la encuesta del 2010 del Estudio de la Salud y la Jubilación (HRS por su sigla en inglés. La encuesta recogió datos sobre las características demográficas generales, el estado de discapacidad o las limitaciones funcionales, y también sobre factores y comportamientos relacionados con la preparación frente a los desastres. Calculamos una puntuación global de preparación mediante indicadores individuales a fin de evaluar el grado de preparación general. RESULTADOS: La media de la edad de los participantes (n = 1 304 fue de 70 años (desviación estándar [DE] = 9,3. Solo 34,3% informaron que habían participado en un programa formativo o que habían leído materiales sobre la preparación para los desastres. Casi 15% indicaron que usaban dispositivos médicos eléctricos que podían correr riesgo de no funcionar si se interrumpiera el suministro eléctrico. La puntuación de preparación indicó que la edad más avanzada, la discapacidad física y el menor nivel de escolaridad y de ingresos se asociaban independiente y significativamente a un grado de preparación general inferior. CONCLUSIONES: A pesar de la mayor vulnerabilidad ante los desastres y del número cada vez mayor de adultos mayores en los Estados Unidos, muchos de los problemas sustanciales que encontramos son remediables y requieren atención en los sectores de la sociedad dedicados a la atención clínica, a la salud pública y al manejo de situaciones de emergencia.

  18. Preparación de los adultos mayores en los Estados Unidos para hacer frente a los desastres naturales: encuesta a escala nacional*

    Science.gov (United States)

    Al-rousan, Tala M.; Rubenstein, Linda M.; Wallace, Robert B.

    2015-01-01

    Objetivos. Nos propusimos determinar el grado de preparación frente a los desastres naturales de los adultos mayores en los Estados Unidos y evaluar los factores que pueden afectar negativamente la salud y la seguridad durante este tipo de incidentes. Métodos. Obtuvimos una muestra de adultos de 50 años en adelante (n = 1 304) de la encuesta del 2010 del Estudio de la Salud y la Jubilación (HRS por su sigla en inglés). La encuesta recogió datos sobre las características demográficas generales, el estado de discapacidad o las limitaciones funcionales, y también sobre factores y comportamientos relacionados con la preparación frente a los desastres. Calculamos una puntuación global de preparación mediante indicadores individuales a fin de evaluar el grado de preparación general. Resultados. La media de la edad de los participantes (n = 1 304) fue de 70 años (desviación estándar [DE] = 9,3). Solo 34,3% informaron que habían participado en un programa formativo o que habían leído materiales sobre la preparación para los desastres. Casi 15% indicaron que usaban dispositivos médicos eléctricos que podían correr riesgo de no funcionar si se interrumpiera el suministro eléctrico. La puntuación de preparación indicó que la edad más avanzada, la discapacidad física y el menor nivel de escolaridad y de ingresos se asociaban independiente y significativamente a un grado de preparación general inferior. Conclusiones. A pesar de la mayor vulnerabilidad ante los desastres y del número cada vez mayor de adultos mayores en los Estados Unidos, muchos de los problemas sustanciales que encontramos son remediables y requieren atención en los sectores de la sociedad dedicados a la atención clínica, a la salud pública y al manejo de situaciones de emergencia.

  19. Significado de la calidad de vida del adulto mayor para sí mismo y para su familia

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    Martha Vera

    2007-09-01

    Full Text Available Objetivo: Comprender el significado que la expresión lingüística ‘calidad de vida del adulto mayor’ tiene para el adulto mayor y para su familia. Diseño: Estudio cualitativo, descriptivo, interpretativo - comprensivo, fundamentado en la Teoría de las Representaciones Sociales. Lugar: Asentamiento Humano Laura Caller, en Los Olivos. Participantes: Adultos mayores y sus respectivos grupos familiares. Métodos: Las técnicas e instrumentos utilizados fueron la observación, entrevista a profundidad y grupos focales; guía de observación y dos cuestionarios con ocho preguntas norteadoras, previamente validados. Principales medidas de resultados: Significado de calidad de vida para el adulto mayor y para la familia. Resultados: Participaron dieciséis adultos mayores con sus respectivos grupos familiares, entre 2004 y 2006. Los discursos a través de la ‘objetivación’ y el ‘anclaje’ y los análisis general, ideográfico-axial y nomotético-selectivo permitieron la emergencia de cuatro representaciones sociales: a conocimiento sobre la vejez y ser un adulto mayor; b elementos principales y secundarios del significado de calidad de vida del adulto mayor; c valores y actitudes del adulto mayor y familia sobre la calidad de vida; y, d necesidades del adulto mayor como ser social y la calidad de vida. Conclusiones: Para el adulto mayor, calidad de vida significa tener paz y tranquilidad, ser cuidado y protegido por la familia con dignidad, amor y respeto, y tener satisfechas como ser social sus necesidades de libre expresión, decisión, comunicación e información. Para la familia, que el adulto mayor satisfaga sus necesidades de alimentación, vestido, higiene y vivienda.

  20. AVALIAÇAO DO ENSINO-APRENDIZAGEM NA EDUCAÇÃO DE JOVENS E ADULTOS: UMA ANALISE CURRICULAR

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    Esequias Rodrigues da Silva

    2016-01-01

    Full Text Available Os Centros de Educação de Jovens e Adultos (CEJAs, pela especificidade do público alvo, funcionam com o sistema semipresencial de atendimento, do tipo de regime modular, onde os conteúdos das disciplinas são apresentados ao aluno por módulo. Analisamos a estrutura curricular de uma escola da rede estadual de ensino que funciona nestes moldes, com vistas discutir uma nova proposta de trabalho docente, com ênfase no sistema de avaliação do rendimento escolar. A abordagem teórica-metodológica de cunho qualitativa e dados coletados por meio da pesquisa documental e entrevista semi-estruturada, analisados face ao modelo de avaliação formativa (Bloom, 1983; Hadji, 2001; Perrenoud, 1999, de acordo com a perspectiva de teorização em avaliação (Bonniol e Vial, 2001. Os resultados apontam para o comprometimento de três componentes essenciais do trabalho docente: o currículo, as estratégias de ensino-aprendizagem e a avaliação do rendimento escolar. A avaliação, meramente classificatória e pontual. O estudo mostrou a viabilidade, dentro do sistema semipresencial da implementação de um novo entendimento do conceito de currículo – currículo real; da diversificação das estratégias de ensino-aprendizagem e o uso de diversos elementos, o modelo de avaliação processual – avaliação diagnóstica, formativa e somativa.

  1. Teorías de la educación de adultos que subyacen en el uso de videojuegos

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    Laura ALONSO DÍAZ

    2015-01-01

    Full Text Available La sociedad actual crece en edad y en tecnología, requiriendo de investigaciones en las que la educación permanente se convierta en su principal objeto de estudio. En este contexto comienzan a surgir tendencias en las que se promueve el uso de tecnologías lúdicas con objetivos pedagógicos y formativos a través de los videojuegos, pero los esfuerzos se están centrando en una etapa muy concreta de la vida, la infantil y la juvenil, habiendo apenas estudios en la edad adulta. En este artículo presentamos el proceso de validación de un cuestionario que nos permitirá conocer los rasgos propios de las teorías de educación de adultos que subyacen a los videojuegos a los que juegan las personas adultas, concretamente principios andragógicos, heutagógicos, del modelo social del aprendizaje y del modelo de formación basado en competencias. Se realizaron tres tipos de validaciones: de contenido, a través de juicio de expertos; de criterio, a través de entrevistas abiertas; y de constructo, mediante una prueba piloto. En total participaron doce expertos internacionales y 93 personas mayores de 16 años. Finalmente, hemos obtenido una prueba consistente y fiable que se estructura en seis dimensiones y 50 ítems, las dimensiones de la prueba son: datos del jugador, datos del videojuego, tecnológico-descriptiva, personal y contextual, interacción social, y desarrollo de competencias.

  2. Cansancio, cuidados y repercusiones en cuidadores informales de adultos mayores con enfermedades crónico degenerativas

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    María Asunción Vicente Ruiz

    2016-08-01

    Full Text Available Las enfermedades crónicas como diabetes, hipertensión, enfermedad cardiovascular, cáncer, pueden limitar la habilidad de los adultos mayores para ejecutar actividades de la vida diaria, generando cansancio o sobrecarga en los cuidadores. Objetivo: Determinar la relación que existe entre el cansancio, el cuidado y los efectos a la salud del cuidador. Metodología: Estudio cuantitativo y analítico. La muestra se conformó con 123 cuidadores familiares y 123 personas adultas con enfermedad crónico degenerativa. El tipo de muestreo fue no probabilístico. Resultados y Discusión: Se encontró asociación entre el cansancio y las repercusiones del cuidado (r=.438, p<.01, lo que sugiere que mayor cansancio en los cuidadores, mayores serán las repercusiones en la salud. Además correlación de los cuidados que presta el cuidador con las repercusiones en la salud del cuidador (r=.546, p<.01, así a mayor cantidad y complejidad de los cuidados, mayores serán las repercusiones que afecten el bienestar del cuidador. Los cuidados se relacionaron con el cansancio, se afirma que a mayor cantidad y complejidad del cuidado mayor cansancio percibe el cuidador (r=.109, p<.01. Conclusión: El cansancio en los cuidadores es elevado, está asociado a la sobrecarga del cuidado con serias repercusiones en la salud o bienestar y fundamenta las intervenciones interdisciplinarias futuras.

  3. Anormalidades urinarias en pacientes adultos infectados por VIH

    Directory of Open Access Journals (Sweden)

    Luis Estremadoyro S

    1996-07-01

    Full Text Available Objetivo: Determinar la frecuencia de anormalidades urinarias en pacientes adultos infectados con el virus de la inmunodeficiencia humana (VIH y los factores de riesgo asociados. Materiales y métodos: Se examinaron muestras de la primera orina matutina de 61 pacientes seropositivos (Western-Blot atendidos en el consultorio externo del Instituto de Medicina Tropical Alexander von Humboldt entre noviembre 1993 y diciembre de 1994. Se determinó: osmolidad, pH, examen bioquímico por tira reactiva, proteinuria en 24 horas (para pacientes con albuminuria > o = 1+ y sedimento urinario. Resultados: La edad promedio fue de 32,4 ± 8,1 años, 58% eran homosexuales, no hubieron adictos a drogas endovenosas y sólo un paciente era de raza negra. El 84% tenía SIDA al momento del estudio. Se encontró por lo menos una alteración en el 27,9% de los pacientes. El porcentaje de pacientes con incapacidad de concentración urinaria fue de 16,0% y de acidosis tubular renal 13,3%. Ningún paciente presentó proteinuria significativa, 3,3% presentó hematuria glomerular y 4,9% hematuria no glomerular. En ningún paciente se encontró glucosuria y se detectó leucocituria sólo en 3.3% de ellos. No se encontró ningúna relación significativa entre variables clínicas y las alteraciones urinarias. Conclusión: La frecuencia de alteraciones urinarias asociadas a daño túbulo inetersticial fue de 29,7%. La ausencia de proteinuria significativa obedece probablemente al escaso porcentaje de pacientes de raza negra y de adictos endovenosos. (Rev Med Hered 1996; 7: 108-112.

  4. Doença Renal Policística do Adulto: uma atualização

    Directory of Open Access Journals (Sweden)

    Vagner Milani

    2007-03-01

    Full Text Available A doença renal policística do adulto é uma desordem genética de caráter autossômico dominante, caracterizada por progressivo desenvolvimento e crescimento de cistos renais, que culminam com a falência renal terminal na meia-idade. Outras manifestações clínicas associadas incluem cistos hepáticos e pancreáticos, hipertensão, aneurismas cerebrais e defeitos cardiovasculares. Aspectos celulares e moleculares dos mecanismos de cistogênese envolvem proliferação e apoptose celular, remodelamento da matriz extracelular, secreção e acúmulo de fluidos. Geneticamente heterogênea, na maioria dos casos (aproximadamente 85% são mutações no gene PKD1, localizado no cromossomo 16p13.3, com o segundo gene, PKD2, localizado nos intervalos do cromossomo 4q13-q23, respondendo por 15% das mutações, ambos já seqüenciados e caracterizados. Existem evidências da interação comum das proteínas policistinas 1 e 2 em rotas de eventos de adesão extracelular e transporte iônico, possibilitando a regulação do fluxo de Ca2+ transmembrana. Inúmeros trabalhos vêm tentando correlacionar o genótipo mutado ao fenótipo expresso em termos da progressão e severidade da autosomal dominant polycystic kidney disease. A análise das mutações autosomal dominant polycystic kidney disease é fundamental para a compreensão dos mecanismos de atuação envolvidos na doença. Métodos de detecção baseados na reação em cadeia da polimerase têm sido amplamente empregados, como a reação em cadeia da polimerase via transcriptase reversa, protein truncation test, single-strand conformational polymorphism e denaturing high performance liquid chromatography, importantes ferramentas que auxiliam no seqüenciamento e caracterização dessas mutações.

  5. Proximal-type epithelioid sarcoma - Case report Sarcoma epitelióide tipo proximal - Relato de caso

    Directory of Open Access Journals (Sweden)

    Luciana Mendes dos Santos

    2013-06-01

    Full Text Available Epithelioid sarcoma, first described by Enzinger in 1970, is a rare soft-tissue sarcoma typically presenting as a subcutaneous or deep dermal mass in distal portions of the extremities of adolescents and young adults. In 1997, Guillou et al. described a different type of epithelioid sarcoma, called proximal-type epithelioid sarcoma, which is found mostly in the pelvic and perineal regions and genital tracts of young to middle-aged adults. It is characterized by a proliferation of epithelioid-like cells with rhabdoid features and the absence of a granuloma-like pattern. In this paper we present a case of proximal-type epithelioid sarcoma with an aggressive clinical course, including distant metastasis and death nine months after diagnosis.O sarcoma epitelióide, primeiramente descrito por Enzinger, em 1970, é uma neoplasia de partes moles que ocorre principalmente nas extremidades distais de adolescentes e adultos jovens. Em 1997, Guillou e cols. descreveram um tipo diferente de sarcoma epitelióide, que afetava frequentemente a região pélvica, períneo e áreas genitais de pacientes de média idade, com exame histológico caracterizado pela proliferação de células com aspecto epitelióide. Neste trabalho, descreve-se caso de paciente que apresentava há três meses duas lesões na região glútea, cujo exame histológico confirmou diagnóstico de sarcoma epitelioide do tipo proximal, já com presença de metástases pulmonares e cerebrais e que foi a óbito nove meses após o diagnóstico.

  6. 184. Unidad de cardiopatías congénitas del adulto: Experiencia quirúrgica inicial

    Directory of Open Access Journals (Sweden)

    J.L. Reyes-Juárez

    2010-01-01

    La complejidad y número de pacientes adultos afectos de CC ha aumentado en los últimos años. La formación de unidades de CC del adulto permiten reunir experiencia, casos y obtener buenos resultados. Los resultados de nuestro centro son similares a los comunicados.

  7. Efectos contextuales asociados a la variabilidad del riesgo de depresión en adultos mayores, Antioquia, Colombia, 2012

    Directory of Open Access Journals (Sweden)

    Doris Cardona

    2015-03-01

    Conclusiones. El municipio y la manzana de residencia aportaron 10 % de la variabilidad total del riesgo de depresión en los adultos mayores. Esta información es importante para fomentar la participación y adhesión de los adultos mayores a grupos comunitarios.

  8. Valoración funcional del adulto mayor relacionado con el abandono familiar.

    OpenAIRE

    Jenny Fernanda Villarroel Vargas; Vicente Hernán Cárdenas Naranjo; Josefa Margarita Miranda Vázquez

    2017-01-01

    Introducción: Se estima que entre el 2000 al 2050 la población mundial envejecida ascenderá del 11% al 22 %, con ello el incremento de las diversas enfermedades o trastornos propios de la edad. Objetivo: Establecer la relación entre capacidad funcional del adulto mayor con el abandono familiar en el barrio La Calera Centro, Latacunga, 2015-2016. Métodos: Se realizó un estudio observacional descriptivo de corte trasversal, donde previo consentimiento informado participaron 70 adultos m...

  9. Desenho do adulto: possibilidades para uma educação inclusiva

    OpenAIRE

    Silva, Priscyla Raquel da

    2012-01-01

    O objetivo desta dissertação foi investigar por que, o que e como os adultos desenham. Para isso foram coletados desenhos a partir de dois grupos: vinte professores da Educação Básica e vinte adultos não-professores de mesma faixa etária. O protocolo utilizado integrou a proposta de desenho elaborada por Bernard Darras e aplicada em pesquisa que envolveu alunos e professores não-iniciados em arte de uma escola francesa (1998), com a produção de um desenho livre e o preenchimento de um questio...

  10. Aspectos metodológicos e constitutivos do pensando do adulto

    OpenAIRE

    Silva, João Alberto da; Frezza, Júnior Saccon

    2011-01-01

    O estudo do pensamento do adulto apresenta algumas particularidades metodológicas que dificultam a investigação. Para a análise das estruturas e dos processos mentais, os pesquisadores da Epistemologia Genética têm por referência o Método Clínico-Crítico ou, simplesmente, Método Clínico. Todavia, os estudos de Piaget e da Escola de Genebra se ocupam, principalmente, do desenvolvimento em termos psicogenéticos, isto é, da evolução intelectual a partir da criança. No caso dos adultos, o ...

  11. INCREMENTO DE LA AUTOESTIMA EN LOS ADULTOS MAYORES DE UN HOGAR DE JUBILADOS

    OpenAIRE

    Teresa de Jesús Mazadiego Infante; Janeth Calderón Reyes; Claudia Solares Mejía; Maribel Zárate Moreno; Lisseth Torres Vargas; Ángel de Jesús Coto Sampayo

    2011-01-01

    El objetivo de este trabajo fue probar la efectividad de las técnicas de relajación, terapia ocupacional y dinámicas grupales para mejorar la autoestima de los adultos mayores de una casa-hogar para jubilados. Al efecto, se trabajó con una muestra de 17 adultos mayores, a quienes se asignaron diversas actividades, como ejercicios musicales, juegos de mesa, manualidades y sesiones de intercambio de experiencias y expresión de sentimientos. Los resultados obtenidos muestran un incremento consid...

  12. Estrategias orientadoras apara la elaboración de proyectos de adultos mayores

    OpenAIRE

    Ciano, Natalia

    2011-01-01

    En este trabajo se presenta el proyecto de investigación "estrategias orientadoras para la elaboración de proyectos en adultos mayores" que se propone aplicar las estrategias orientadoras diseñadas en un proyecto anterior a los efectos de analizar el impacto de las mismas en la elaboración de proyectos de adultos mayores. Articula el Modelo de Envejecimiento Activo y el Modelo Teórico Operativo en Orientación. Se parte de los principales resultados obtenidos en la investigación anterior, los ...

  13. ACTIVIDADES DE LA VIDA DIARIA EN ADULTOS MAYORES: LA EXPERIENCIA DE DOS GRUPOS FOCALES

    OpenAIRE

    Christian Oswaldo Acosta Quiroz; Ana Luisa Mónica González-Celis Rangel

    2010-01-01

    El presente estudio tuvo como objetivo obtener una muestra de ejemplos de actividades recreativas físicas y mentales, sociales, de independencia y de protección a la salud, como propuesta inicial de un inventario de actividades de la vida diaria en adultos mayores, a través del desarrollo de dos grupos focales organizados alrededor del tema de actividades cotidianas en ancianos, con ocho y quince adultos mayores, respectivamente. Los resultados reflejan una amplia variedad de actividades de l...

  14. Factores asociados al riesgo nutricional del adulto mayor no institucionalizado, Pasto, Colombia

    OpenAIRE

    Hernández Rangel, Juanita del Pilar

    2017-01-01

    Objetivo: determinar los factores sociales, demográficos, y de salud que se asocian al riesgo nutricional de los adultos mayores no institucionalizados de la ciudad de Pasto en el año 2016. Metodología: estudio de prevalencia analítico a partir del análisis secundario de los datos para la ciudad de Pasto de la encuesta “Índice de vulnerabilidad de los adultos mayores, en tres ciudades de Colombia, 2016”. Se utilizó la Iniciativa del Tamizaje Nutricional (NSI) con la escala DETERMINE para l...

  15. Estudio sobre la pertinencia del uso de las normas disponibles del Raven en adultos mayores chilenos

    OpenAIRE

    Alarcón Paz,Cristina; Díaz Valenzuela,Vanessa; Hernández Rosales,Jacqueline; Estrada Goic,Claudia

    2012-01-01

    La evaluación de la inteligencia en población adulto mayor ha aumentado su relevancia debido al incremento de la esperanza de vida. Este estudio centra su interés en la pertinencia de normas disponibles para el Test de Matrices Progresivas de Raven para dicha población. Se utilizaron normas de Colchester (1942, en Raven, Court y Raven, 2008), las más completas existentes. Participaron 102 adultos mayores voluntarios (más de 60 años). El diseño fue no experimental transversal correlacional. Lo...

  16. A traumatic dural arteriovenous fistula between the inferolateral trunk of the internal carotid artery and the ophthalmic vein: A case of transvenous coil embolization via the facial vein

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jun Young; Hong, Chang Ki; Suh, Sang Hyun [Dept. of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); Kim, Dong Ik [Dept. of of Radiology, CHA Bundang Medical Center, CHA University, Seongnam (Korea, Republic of)

    2017-05-15

    A 31-year-old man was admitted with exophthalmos. He suffered from progressive exophthalmos, bruit and conjunctival chemosis 7 days after head trauma caused by falling down. Cerebral angiography showed a dural arteriovenous fistula (DAVF) draining into the ophthalmic vein caused by tear in the inferolateral trunk, which is a rare presentation of traumatic DAVF. Selective transvenous coil embolization was performed via the facial vein without neurologic complications.

  17. Endovascular treatment of a cavernous sinus dural arteriovenous fistula by transvenous embolisation through the superior ophthalmic vein via cannulation of a frontal vein

    International Nuclear Information System (INIS)

    Venturi, C.; Bracco, S.; Cerase, A.; Gennari, P.; Lore, F.; Polito, E.; Casasco, A.E.

    2003-01-01

    We describe a new approach for transvenous embolisation of cavernous sinus dural arteriovenous fistulae through the superior ophthalmic vein (SOV), i.e., via percutaneous cannulation of a frontal vein. Modern neurointerventional angiographic materials make it possible to reach the SOV in this way without puncturing it in the orbit or a surgical exposure. Orbital phlebography should still be in the repertoire of interventional neuroradiology units in large centres. (orig.)

  18. Capacidad funcional y salud: orientaciones para cuidar al adulto mayor

    Directory of Open Access Journals (Sweden)

    CLARA INÉS GIRALDO M

    2008-07-01

    Full Text Available Objetivo: valorar la salud y la capacidad funcional de ancianos con dependencia funcional para el autocuidado, como elementos para orientar el cuidado de enfermería y el cuidado familiar en casa. Metodología: estudio descriptivo transversal en 40 personas de 65 y más años con dependencia funcional, cuidados por familiar, en Envigado Colombia; muestreo por conveniencia. Valoración de la capacidad funcional con el índice de Katz y la escala de Lawton y Brody, ajustados según grupo de Neurociencias, Universidad de Antioquia. Hallazgos: población entre 67 y 98 años, edad promedio 84,08 años; 82,5% mujeres. Sistemas orgánicos más afectados: cardiovascular, osteomuscular y neurológico; entre 47,5% y 27,5% de los ancianos los tenían comprometidos. Se identificaron dos comportamientos: los hombres, y las personas de edad más avanzada, con mayores grados de dependencia en las actividades básicas e instrumentales; no se determinó asociación estadística por el pequeño tamaño muestral. Las actividades básicas estaban afectadas así: entre el 67,5% y el 55% de los ancianos requería ayuda; y las actividades instrumentales estuvieron comprometidas: entre el 95% y el 75% de los ancianos son totalmente dependientes en ellas. Conclusiones: Enfermería ha de considerar la valoración de la capacidad funcional articulada al estado de salud integral de los ancianos, para orientar su cuidado y apoyar a los cuida-dores familiares. Esto además previene dependencias de cuidado innecesarias que estarían en contra de las aspiraciones del adulto mayor como individuo autónomo e independiente. Es tarea de profesionales en enfermería capacitar a cuidadores familiares sobre valoración de la capacidad funcional.

  19. Metabolismo posprandial en adultos mayores normales de nivel del mar

    Directory of Open Access Journals (Sweden)

    Fausto Garmendia

    2003-06-01

    Full Text Available Objetivo: Determinar las modificaciones normales del metabolismo después de la ingestión de alimentos. Material y Métodos: Se ha estudiado a 33 personas de ambos géneros, adultos mayores, de nivel del mar, tanto en ayunas como después de la ingesta de una mezcla alimenticia consistente en 730 kcal, con 55,4% de grasas, 37,2% de hidratos de carbono y 7,4% de proteínas. Se ha medido el perfil metabólico en ayunas y luego de la ingesta alimentaria, la glucosa, triglicérido (Tg, ácidos grasos no esterificados (AGNE, insulina por métodos convencionales hasta la 6a hora; se ha calculado las concentraciones de colesterol LDL y VLDL utilizando la fórmula de Friedewald; el colesterol no-HDL, mediante la sustracción del valor del colesterol HDL al valor de colesterol total (CT. Resultados: La glicemia se elevó discretamente, regresando a valores basales a la 2a hora; la insulinemia se incrementó durante 4 horas; los triglicéridos comenzaron a elevarse en sangre a partir de la 2a hora y llegaron al máximo a la 4a hora, para luego iniciar el descenso no completo en la 6a hora. Los AGNE disminuyeron a partir de los 30 minutos, llegando al máximo de caída a las 2 horas; luego se apreció un rebote máximo a la 6a hora, inclusive mayor al valor basal. Conclusiones: Estos resultados demuestran que no es suficiente obtener información del metabolismo intermediario en ayunas, sino que el estudio posprandial permite mayor información. Es la primera vez en nuestro país que se obtiene información sobre el metabolismo intermediario en fase posprandial en una muestra de la población normal que se encuentra en una edad de mayor riesgo cardiovascular.

  20. Método predictivo de volatilidad tipo cambio

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    Jeffrey Viales Abellán

    2011-01-01

    Full Text Available Las series temporales descritas por precios de ciertos activos financieros tales como el de las acciones y divisas presentan dos principales características, excesos de kurtosis y clustering de volatilidad. Para recoger estas características se han utilizado modelos no lineales tales como los modelos Garch o Volatilidad Condicionada y los modelos de Volatilidad Estocástica, ambos tipos de modelo son empleados para la gestión del riesgo cambiario a corto plazo; el primer tipo de modelos definen la volatilidad en función de la misma volatilidad rezagada y de los shocks (innovaciones de volatilidad; el segundo tipo de modelos son similares a los modelos Garch con la variante de que la volatilidad incluye por si misma un término aleatorio de tipo proceso Wienner2; estos modelos son empleados para simular caminatas aleatorias del tipo de cambio con volatilidades simuladas por las ecuación estocásticas de volatilidad.En el presente trabajo se analizará el desempeño del modelo Garch en comparación a las medidas de volatilidad utilizadas actualmente para la gestión del riesgo cambiario; sus implicaciones para la gestión de riesgos.

  1. Diagnóstico y manejo de litiasis renales en adultos y niños

    Directory of Open Access Journals (Sweden)

    Ricardo Susaeta, Dr.

    2018-03-01

    Full Text Available Resumen: La litiasis urinaria representa una patología importante en la práctica urológica y requiere de un abordaje multidisciplinario. Su incidencia es del 10%, afecta a un grupo etario extenso, con factores que pueden influir en su aumento en determinados lugares.Su diagnóstico aparece como hallazgo en controles rutinarios de salud o a través del sindrome de cólico renal, cuadro característico y de consulta frecuente en los servicios de urgencia. Su etiología no está del todo definida, siendo las hipótesis más aceptadas, las alteraciones excretoras del riñón sumada a factores ambientales y hábitos. El estudio incluye exámenes de laboratorio para descartar complicaciones como infecciones e insuficiencia renal. Las imágenes determinan el volumen de la litiasis, su ubicación y densidad, para decidir de qué manera resolver el caso, ya sea de manera espontánea o activa mediante distintos tipos de intervenciones quirúrgicas.La tomografía computarizada sin contraste se considera como el estándar de oro para el diagnóstico por imágenes de la litiasis urinaria.Los tratamientos se plantean según las distintas situaciones clínicas: manejo médico del cólico renal y terapia expulsiva para resolución espontánea del cuadro; manejo quirúrgico, cuyas técnicas más frecuentes son la nefrolitectomía o ureterolitectomía endoscópica rígida o flexible, litotripcia extracorpórea (LEC, nefrolitectomía percutánea (NLP, y finalmente el estudio etiológico de la litiasis urinaria y medidas de prevención.En niños, la incidencia de litiasis urinaria es menor que en adultos, sin embargo, las consecuencias de esta enfermedad pueden ser desastrosas. La etiología es fuertemente asociada a factores genéticos. Actualmente los tratamientos quirúrgicos son similares a los practicados en pacientes adultos. Summary: Urinary stones represent an important pathology in urological practice and requires a multidisciplinary approach. Its

  2. Propiedades psicométricas de la Escala de Locus de Control de la Salud en Dios en una muestra de mexicanos con diabetes mellitus tipo 2

    Directory of Open Access Journals (Sweden)

    Vianey Guadalupe Argüelles Nava

    2017-12-01

    Full Text Available En este estudio se obtuvo evidencia de validez y confiabilidad de la escala de Locus de Control de la Salud en Dios (GLHC en una muestra de 539 adultos mexicanos con diabetes mellitus tipo 2. El análisis de validez se basó en el análisis del contenido de los ítems y de la estructura interna del GLHC. El primer procedimiento estuvo a cargo de seis expertos, quienes evaluaron la pertinencia de la adaptación de los ítems. El segundo procedimiento fue un análisis factorial confirmatorio de grupo múltiple, de acuerdo al sexo y edad, a fin de evaluar la invarianza de medición del GLHC. Finalmente, la confiabilidad fue calculada mediante los coeficientes ω y H. El análisis factorial confirmatorio demostró una estructura de un solo factor con seis ítems, interpretable para la población de estudio con invarianza de medición por sexo, aunque deben tomarse precauciones al interpretar comparaciones por grupos de edad. La confiabilidad del constructo obtuvo magnitudes elevadas (>.90. Los resultados indican que la GLHC puede brindar información válida y confiable para valorar el locus de control de la salud en Dios para mexicanos con diabetes mellitus tipo 2.

  3. Fibrose quística em adultos

    Directory of Open Access Journals (Sweden)

    C. Damas

    2007-05-01

    Full Text Available Resumo: Os autores efectuaram uma revisão de doentes adultos com fibrose quística (FQ, seguidos na consulta de Pneumologia no período de 1994-2004 (n=8: cinco mulheres e três homens, com idades compreendidas entre 20 e 34 anos (mediana=27 anos, cuja idade de diagnóstico variou entre os 18 meses e os 31 anos. O diagnóstico foi obtido por prova de suor (positiva em seis doentes e estudo genético (homozigotia para a mutação ΔF508 em quatro doentes. O atingimento respiratório traduziu-se por sinusite e bronquiectasias, acompanhando-se o envolvimento pulmonar por alterações funcionais e também gaso-métricas na maioria dos doentes, ainda que de gravidade variável e não relacionada com a idade de diagnóstico. Verificou-se colonização da árvore brônquica em cinco doentes: Pseudomonas aeruginosa em quatro e Staphilococcus aureus em quatro (verificando-se coloni-zação concomitante por estes agentes em três. As principais causas de exacerbação foram infecções res-piratórias e hemoptises. Quanto ao atingimento não respiratório, quatro doentes apresentavam envolvimento digestivo (com cirrose hepática num caso, um insuficiência renal em hemo-diálise, e em apenas um foi efectuado espermograma para documentação de infertilidade. Quatro doentes tinham osteopenia documentada por densitometria óssea. As medidas terapêuticas mais utilizadas foram a cine-siterapia, os broncodilatadores, a alfa-dornase, muco-líticos, suplementos vitamínicos e enzimáticos, antibio-terapia e oxigenoterapia. Relativamente à evolução, uma doente abandonou a consulta, uma doente faleceu, um doente aguardava transplante pulmonar e os restantes mantiveram as suas características clínicas habituais. Neste grupo, a gravidade da doença pulmonar não se relacionou com o diagnóstico mais tardio, o que se pode dever à diversidade de apresenta

  4. Uso de videojuegos, agresión, sintomatología depresiva y violencia intrafamiliar en adolescentes y adultos jóvenes

    Directory of Open Access Journals (Sweden)

    Patricia Martínez Lanz

    2013-12-01

    Full Text Available El objetivo de la presente investigación fue determinar las diferencias en sintomatología depresiva, violencia intrafamiliar y agresión en 801 adolescentes y jóvenes con diferentes niveles de exposición a videojuegos con y sin contenidos violentos. La media de edad de los participantes fue de 17.5 años, el 55.4% eran hombres y 44.6% mujeres. Para evaluar la sintomatología depresiva se utilizó la cédula del centro de estudios epidemiológicos, para la violencia intrafamiliar, se diseñó una escala de 16 reactivos que miden: agresión verbal, agresión física, humillación y respeto; en cuanto a la agresión, se diseñó una escala tipo likert de 13 reactivos con cuatro opciones de respuesta: nunca a siempre. Respecto al uso de videojuegos, se preguntó si los utilizan o no, motivo por el cual los juegan, el tiempo aproximado a la semana que pasan jugándolos, si los videojuegos que utilizan tienen contenido violento y de qué tipo. Los resultados mostraron diferencias significativas en las variables evaluadas respecto al nivel de exposición de videojuegos con contenido violento, donde de manera general los adolescentes y adultos jóvenes que reportaron una mayor exposición (de 11 horas o más por semana presentaron mayor sintomatología depresiva, agresión y violencia intrafamiliar que aquellos con un menor nivel de exposición.

  5. La Planta única como tipo resistente a la escala

    OpenAIRE

    Colmenares Vilata, Silvia

    2014-01-01

    El sistema capitalista ha generado dos de los modelos espaciales de indiferencia funcional más extremos: por un lado, el espacio tecnificado y repetido del edificio de oficinas en altura, encarnado por la ?planta tipo? y, por otro, el espacio diáfano y extenso del gran contendor, que responde a la lógica de lo que llamaremos ?planta única?. En los edificios construidos para la industria automovilística y bélica americana se encuentra el germen de un tipo que servirá de modelo para los nuevos ...

  6. Maltrato institucional a adultos mayores Institutional elder abuse

    Directory of Open Access Journals (Sweden)

    Miriam Rubio Acuña

    2012-12-01

    Full Text Available El maltrato institucional se refiere a cualquier forma de abuso que ocurre en servicios dirigidos a los ancianos. Esta revisión bibliográfica muestra que el maltrato se presenta con mayor frecuencia en residencias de larga estadía y el tipo más frecuente es la negligencia. Los factores asociados son los que tienen relación con el residente y con el ambiente. Las principales estrategias son invertir recursos sociosanitarios, sensibilizar a la población respecto al maltrato de los ancianos, considerar las necesidades de estos, fortalecer la formación de pregrado de los profesionales de salud en este ámbito y realizar educación continua. El maltrato es un problema social que debe ser abordado de manera integral.Institutional abuse refers to any form of abuse that occurs in services for the elderly. This literature review indicates that abuse occurs more frequently in nursing homes and the most frequent type of neglect. The factors that may relate to the relationship with the resident and the environment. The main strategies relate to social and health invest resources, raising awareness about the abuse of the elderly, consider their needs, strengthen undergraduate education of health professionals in this field and make continuing education. Abuse is a social problem so this must be addressed holistically.

  7. Las posibilidades de internet en la reconfiguración de la red social primaria del adulto mayor, fracturada por efecto de la migración: El caso de los adultos mayores con parientes migrantes en 6 municipios del departamento del Quindío

    Directory of Open Access Journals (Sweden)

    Lucero Giraldo Marín

    2016-05-01

    Full Text Available El presente artículo muestra cómo Internet se convierte en una herramienta de comunicación importante para reconfigurar la red social primaria del adulto mayor, fracturada por efecto de la migración. En la investigación que le da origien, se pudo constatar que hoy esta red se encuentra dividida en red primaria natural, conformada por los parientes y amigos con los que comparte el día a día, y red primaria virtual, integrada por los parientes migrantes. El escrito centra su interés en presentar las características de la red primaria virtual en la que el adulto mayor se vio impelido a participar para satisfacer sus necesidades comunicacionales. Esta red cumple la función de mantener, pero no de extender, su red social primaria. Los resultados dan cuenta de 4 aspectos: las competencias digitales desarrolladas por el adulto mayor, la estructura, las funciones y los atributos de vínculo de la red primaria virtual. Para ello se acudió a autores como Cabrera, Castell; Madarriaga, Abello & Sierra; Narváez A.; Soto, Navarro & Sánchez; Tovar & Villarraga. La investigación fue de tipo etnográfico, con enfoque cualitativo. Se aplicaron entrevistas semi-estructuradas. Para el tratamiento de la información se utilizó la teoría Fundamentad, de Strauss & Corbin(2002 This article shows how Internet becomes an important communication tool for reconfiguring the primary social network of the elderly, which is fractured due to the effect of migration. In the research that generates this article it was possible to confirm that this network is currently divided into the primary natural network, formed by the relatives and friends with whom they share their daily life, and the primary virtual network, which is formed by the migrant relatives. The paper focuses its interest on presenting the characteristics of the primary virtual network, in which the elderly found themselves impelled to participate in order to satisfy their communicational needs

  8. Tele-asistencia y tele-alarma para adultos mayores: experiencias preliminares en Mexico

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    Liliana Giraldo-Rodriguez

    2013-08-01

    Full Text Available OBJETIVO Analizar el efecto de un programa piloto de tele-asistencia y tele-alarma en la autopercepción del estado de salud de los adultos mayores y conocer la satisfacción y aceptación del programa. METODOS Estudio transversal que incluyó entrevistas a 378 adultos mayores, 294 cuidadores/familiares y 53 profesionales de la salud, realizado en la Ciudad de México en 2010. Variables sociodemográficas, de autopercepción del estado de salud, satisfacción y aceptación del programa se obtuvieron por medio de cuestionario estandarizado. Se realizó análisis descriptivo y se utilizaron pruebas no paramétricas. RESULTADOS Se observaron efectos significativos en la autopercepción del estado de salud, 6,17 (DE 17,9 p < 0,05 puntos por encima de la media. El programa tuvo una buena aceptación por parte de los adultos mayores, de sus cuidadores familiares y de los profesionales de la salud. CONCLUSIONES El programa contribuye a mantener o mejorar la calidad de vida, permite la atención preventiva y es un medio ideal para dar apoyo psicosocial a los adultos mayores.

  9. Revista Interamericana de Educacion de Adultos, 1999 (Interamerican Review of Adult Education, 1999).

    Science.gov (United States)

    Soberanes, Juan F. Millan, Ed.

    1999-01-01

    This journal, written in Spanish, is a publication of the Centro de Cooperacion Regional para la Educacion de Adultos en America Latina y el Caribe (CREFAL), published in conjunction with the OAS. Its main objective is the dissemination of information on research and theoretical and methodological innovation in the field of adult education.…

  10. Revista Interamericana de Educacion de Adultos, 2003 (Interamerican Review of Adult Education, 2003).

    Science.gov (United States)

    Guerra, Alfonso Rangel, Ed.

    2003-01-01

    This journal offers a collection of Spanish-language articles, including: "Educacion a Distancia y Uso de las Tecnologias: Experiencias Desafios y Oportunidades Educativas para Jovenes y Adultos" (Ma. Mercedes Ruiz); "Volver a a Educacion Fundamental? Notas para una Arquelogia de los Mandatos Fundacionales del CREFAL" (Jorge…

  11. Funcionalidad y grado de dependencia en los adultos mayores institucionalizados en centros de bienestar

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    Elveny Laguado Jaimes

    Full Text Available RESUMEN Introducción: La funcionalidad en el adulto mayor constituye un eje principal para los programas orientados a fortalecer el envejecimiento activo; ante el incremento de este grupo poblacional, las enfermedades como factor que limita la capacidad física, mental y social requieren acciones de control que disminuyan la dependencia que contribuye a un deterioro mayor. Objetivo: Determinar la funcionalidad y grado de dependencia en el adulto mayor institucionalizado como información básica para el diseño de un programa de intervención específica. Metodología: estudio descriptivo retrospectivo con una muestra de 60 adultos mayores institucionalizados y seleccionados por muestreo no probabilístico. Resultados: predomina el rango de edad de 75-84 años, un 26,66% de 60 adultos mayores y el género masculino con mayor frecuencia (53,33%. Por lo que respecta a la escolaridad, el 53,3% estudiaron primaria. Contacto familiar con la familia, el 70%; tiempo de institucionalización de los adultos mayores, el mayor tiempo (55% de 1 a 5 años. Predominan los problemas cardiovasculares en el 34% de los adultos mayores. Valoración funcional: predomina el género masculino con dependencia leve (26,66% y como independiente un 25% del género femenino. La valoración del grado de autonomía en el género masculino evidencia un grado de autonomía 1, con un 30% con respecto al género femenino, que tiene un grado de autonomía 3, con el 16,66%, sin significación estadística. Conclusiones: Se observa el predominio del género masculino en los adultos mayores institucionalizados y con dependencia leve, y al contrario en las mujeres, donde la frecuencia de independencia es mayor. En la autonomía predomina un grado mayor en los hombres que en las mujeres.

  12. Moral no mundo adulto: a visão dos jovens sobre os adultos de hoje Morals in the adult world: how youth see their contemporary elders

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    Helena Amstalden Imanishi

    2011-12-01

    Full Text Available A pergunta central desta pesquisa é: como os adolescentes da atualidade julgam os adultos no que se refere essencialmente a critérios morais? Responder a essa indagação possui relevância para a formação ética e moral dos alunos devido a duas razões principais: a primeira refere-se ao desenvolvimento moral do adolescente; a segunda, à aparente deserção do espaço público por parte dos jovens em favor do espaço privado. Nesse sentido, o objetivo do presente trabalho foi verificar como os jovens julgam moralmente os adultos e se, de fato, eles operam uma clara cisão entre as esferas privada e pública. Foram realizadas separadamente duas pesquisas: no estudo 1 (E1, utilizou-se um questionário fechado de 24 questões e duas questões abertas; no estudo 2 (E2, além da aplicação de um questionário com 14 perguntas, foi realizado um debate em grupo acerca delas. É importante ressaltar que, neste artigo, são analisadas tanto questões presentes nos dois estudos, quanto algumas presentes apenas no E1. Os resultados obtidos mostram certa desconfiança dos jovens em relação à moralidade dos adultos. A maioria não os considera pessoas éticas e, de forma geral, critica sua condução da esfera pública. Além disso, os jovens questionam as virtudes dos adultos e consideram o egoísmo como o maior defeito deles, associando-o a uma preocupação exclusiva com a esfera privada. Dividem-se quanto à sabedoria, à responsabilidade e à confiança atribuída aos adultos de hoje. Os dados apontam, ainda, que a imagem do adulto apresentada é relativizada a partir da distinção entre os adultos da esfera pública e aqueles da esfera privada.The present study core issue is, how do today's youth judge adults concerning their moral criteria? The issue is twofold relevant for the ethical and moral education of adolescents, both for knowledge on their moral development and for their apparent desertion from the public sphere, favouring the

  13. Polifarmacia en los adultos mayores Polypharmacy in the older adults

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    César Martínez Querol

    2005-04-01

    Full Text Available Se realizó un estudio descriptivo de corte transversal con 118 senescentes de la población de adultos mayores del consultorio del Médico de la Familia 80.1 del Policlínico "Ana Betancourt", en el municipio Playa. A todos se les llenó una encuesta formulario que contemplaba sus datos generales, así como las enfermedades crónicas y los trastornos de los órganos de los sentidos que padecía. Se enumeraron los medicamentos que ingieren, con la dosis y periodicidad, tanto los prescritos como los autoprescritos, y se consignaron las reacciones adversas atribuidas a los fármacos consumidos. Se revisaron los controles de dispensarización y sus historias clínicas individuales.La prevalencia de polifarmacia detectada fue de 46 casos (39 %. El total de preparados prescritos fue de 303, con un promedio de 3,1 por paciente, la cifra de autoprescripciones fue 49 casos (41 % con 113 fármacos, y un promedio de preparados autorrecetados por anciano de 2,3, siendo los fármacos más indicados por los facultativos los hipotensores, los diuréticos, los psicofármacos, los analgésicos y los antidiabéticos; y entre los autorrecetados se encontraban las vitaminas, los analgésicos, los laxantes, los antihistamínicos y los psicofármacos. Las reacciones adversas se presentaron en 36 casos (37,2 %, señalándose que todas fueron ligeras y atribuidas a fármacos prescritos por los facultativos.A descriptive cross-sectional study was conducted among 118 senescents from the population of older adults of the family physician office 80.1 of "Ana Betancourt" Polyclinic, in Playa municipality. All of them answered a questionnaire to collect their general data, as well as information about the chronic diseases and disorders of the sense organs they suffered from. The drugs they were taking, both prescribed and self-prescribed, with their doses and periodicity were related, and the adverse reactions attributed to the drugs consumed were also exposed. The

  14. Morfologia externa de espécimes adultos de Paratanaisia bragai (Santos, 1934 (Digenea: Eucotylidae External morphology of the adults specimens of Paratanaisia bragai (Santos, 1934(Diginea; Eucotylidae

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    Solange V.P.B. Brandolini

    2007-09-01

    Full Text Available Espécimes adultos de Paratanaisia bragai foram coletados de ductos renais de Columba livia infectados naturalmente, fixados em glutaraldeído 2,5% e processados para microscopia eletrônica de varredura. Foram identificados dois tipos distintos de escamas, escamas bífidas e simples, dispostas em fileiras transversais no tegumento das faces dorsal e ventral do corpo. Também mostrando em detalhes a ventosa oral subterminal, bem desenvolvida e acetábulo de tamanho reduzido, localizado no terço médio do corpo, circundado por pequenas protuberâncias e quatro papilas dispostas regularmente na sua margem.Adult specimens of Paratanaisia bragai collected from renal ducts of Columba livia naturally infected, were fixed in glutaraldehyde 2.5% and processed for scanning electron microscopy. Two distinct types of scales had been identified, bifid and simple scales, disposed in transversal rows, on the tegument of dorsal and ventral face of the body. Also show in details the oral sucker subterminal, well developed and acetabulum of size reduced, located in third medium of the body, surrounded for small protuberance and four papillae on its edge.

  15. Diagnósticos de enfermagem de familiares de pacientes adultos queimados no período próximo à alta hospitalar

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    Goyatá Sueli Leiko Takamatsu

    2006-01-01

    Full Text Available O objetivo deste estudo foi identificar os diagnósticos de enfermagem de familiares de pacientes adultos queimados no período próximo à alta hospitalar. Dez membros das famílias de pacientes queimados foram avaliados por meio de entrevista e observação. Os diagnósticos de enfermagem foram estabelecidos com base na Taxonomia II da NANDA e na interpretação da Taxonomia I da NANDA realizada por Carpenito. Foram identificadas 11 diferentes categorias diagnósticas, todas do tipo real. Conhecimento deficiente e ansiedade foram os diagnósticos que apresentaram maior freqüência entre os familiares avaliados. O primeiro caracterizou-se pela necessidade de informação dos familiares sobre os cuidados com as áreas queimadas e a prevenção de infecção. O sentimento de ansiedade estava relacionado, principalmente, às mudanças ocorridas na aparência, estrutura ou função do corpo do paciente queimado e às expectativas de familiares em relação ao retorno do paciente ao ambiente familiar e ocupacional, apresentando alguma seqüela física, psico-emocional ou social.

  16. Planes de atención de enfermería para pacientes adultos en post-operatorio inmediato de cirugía cardiovascular

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    Parra Vargas Myriam

    1992-06-01

    Full Text Available

    En la Fundación Clínica Shaio de Santafé de Bogotá, se realizó este estudio de tipo descriptivo, utilizando la técnica de seguimiento de casos durante las primeras 24 horas del post-operatorio de cirugía cardíaca sobre ''modelo de planes de atención de enfermería estandarizados y basados en diagnósticos de enfermería prioritarios para el paciente en post-operatorio inmediato de cirugía cardíaca". Para ello se realizó observación directa y valoración seriada (tres en promedio para cada paciente seleccionado a 35 pacientes adultos sometidos a cirugía cardíaca con circulación extracorpórea, atendidos en la unidad de cuidado intensivo quirúrgico durante los cuatro meses dedicados a la recolección de la información y que cumplían con los criterios de selección establecidos. Además de la investigadora principal participaron en esta investigación un grupo de seis (6 estudiantes del programa de especialización en enfermería cardiorespiratorio, quienes se vincularon al estudio como coinvestigadores.

     

  17. Escenarios evolutivos en larvas y adultos de Hydrophiloidea (Coleoptera analizados en función de diferentes hipótesis filogenéticas

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    Miguel ARCHANGELSKY

    2007-01-01

    Full Text Available Se comparan cinco hipótesis filogenéticas de las relaciones, a nivel de familia, de la superfamilia Hydrophiloidea (s.str. en función de la evolución de cuatro caracteres bionómicos y morfológicos: hábitat de adultos (acuático o ripario, hábitat de larvas (terrestre, acuático o ripario, tipo de sistema respiratorio en larvas (holopnéustico o metapnéustico y número de segmentos abdominales en larvas (décimo segmento no reducido o décimo segmento reducido. Si bien no se favorece una hipótesis sobre la otra, éstas se evalúan por el nivel explicativo de la secuencia de cambios de estado de los caracteres de interés, y se destaca cuáles de ellas explican de forma más parsimoniosa la secuencia de cambios.

  18. Reconstructive treatment of dural arteriovenous fistulas of the transverse and sigmoid sinus: transvenous angioplasty and stent deployment

    International Nuclear Information System (INIS)

    Liebig, T.; Henkes, H.; Brew, S.; Miloslavski, E.; Kuehne, D.; Kirsch, M.

    2005-01-01

    Various techniques for the endovascular treatment of dural arteriovenous fistulas (dAVFs) of the transverse and sigmoid sinus have recently evolved. Transvenous coil occlusion of the involved segment and transarterial embolization of the feeding arteries with liquid agents are the commonest treatments utilized. However, with respect to venous hypertension as the probable pathogenic cause of this disorder, a nonocclusive or remodeling technique might be preferable. We will present a series involving four patients, treated with transvenous angioplasty and stent deployment as a definitive treatment of dAVFs of the transverse and sigmoid sinus. This method was used as a primary treatment or as an adjunct to previous noncurative transarterial n-butyl cyanoacrylate and particle embolization. In three of the four cases, complete occlusion of the fistula was achieved with confirmation of occlusion seen on follow-up angiographical studies. In one case a negligible and nonsymptomatic remnant of the fistula fed by the tentorial artery was left untreated. From our experience, we conclude that transvenous stent deployment is an alternative to traditional concepts. Additionally, the pathological theory of dAVFs in this region located in venous pouches of the sinus wall is supported by the fact that they can be occluded by mechanical compression during angioplasty and subsequently maintained by a stent. (orig.)

  19. The accuracy and utility of contrast-enhanced MR angiography for localization of spinal dural arteriovenous fistulas: the Toronto experience

    Energy Technology Data Exchange (ETDEWEB)

    Lindenholz, Arjen [University Medical Center Groningen, Department of Neurosurgery AB71, PO Box 30001, Groningen (Netherlands); Toronto Western Hospital, Department of Medical Imaging, Division of Neuroradiology, Toronto, ON (Canada); TerBrugge, Karel G.; Farb, Richard I. [Toronto Western Hospital, Department of Medical Imaging, Division of Neuroradiology, Toronto, ON (Canada); Dijk, J.M.C. van [University Medical Center Groningen, Department of Neurosurgery AB71, PO Box 30001, Groningen (Netherlands)

    2014-11-15

    The purpose of this study was to determine the accuracy and utility of contrast-enhanced MR angiography (CE-MRA) in spinal dural arteriovenous fistulas (SDAVF). A retrospective analysis from 1999-2012 identified 70 patients clinically suspected of harboring a SDAVF. Each patient underwent consecutive conventional MR-imaging, CE-MRA, and digital subtraction angiography (DSA). The presence or absence of serpentine flow voids, T2-weighted hyperintensity, and cord enhancement were evaluated, as well as location of the fistula as predicted by CE-MRA. DSA was used as the reference standard. Of the 70 cases, 53 were determined to be a SDAVF, 10 cases were shown to be other forms of vascular malformation, and 7 were DSA-negative. On MRI, all reported cases of SDAVF showed serpentine flow voids (100 %). T2-weighted hyperintensity was seen in 48 of 50 cases (96 %), extending to the conus in 41 of 48 cases (85 %). Cord enhancement was seen in 38 of 41 cases (93 %). CE-MRA correctly localized the SDAVF in 43 of the 53 cases (81 %). CE-MRA is a useful non-invasive examination for the detection and localization of SDAVF. CE-MRA facilitates but does not replace DSA as confirmation of location, fistula type, and arterial detail, which are required before treatment. (orig.)

  20. Predictability of the future development of aggressive behavior of cranial dural arteriovenous fistulas based on decision tree analysis.

    Science.gov (United States)

    Satomi, Junichiro; Ghaibeh, A Ammar; Moriguchi, Hiroki; Nagahiro, Shinji

    2015-07-01

    The severity of clinical signs and symptoms of cranial dural arteriovenous fistulas (DAVFs) are well correlated with their pattern of venous drainage. Although the presence of cortical venous drainage can be considered a potential predictor of aggressive DAVF behaviors, such as intracranial hemorrhage or progressive neurological deficits due to venous congestion, accurate statistical analyses are currently not available. Using a decision tree data mining method, the authors aimed at clarifying the predictability of the future development of aggressive behaviors of DAVF and at identifying the main causative factors. Of 266 DAVF patients, 89 were eligible for analysis. Under observational management, 51 patients presented with intracranial hemorrhage/infarction during the follow-up period. The authors created a decision tree able to assess the risk for the development of aggressive DAVF behavior. Evaluated by 10-fold cross-validation, the decision tree's accuracy, sensitivity, and specificity were 85.28%, 88.33%, and 80.83%, respectively. The tree shows that the main factor in symptomatic patients was the presence of cortical venous drainage. In its absence, the lesion location determined the risk of a DAVF developing aggressive behavior. Decision tree analysis accurately predicts the future development of aggressive DAVF behavior.

  1. Reação de resistência tipo I e tipo II a Giberela em cultivares de trigo

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    Rafael Hansen Alves

    2013-09-01

    Full Text Available O objetivo deste trabalho foi avaliar as reações de resistência tipo I e tipo II à giberela em 28 cultivares de trigo em casa de vegetação. A inoculação de Fusarium graminearum foi realizada no estádio de florescimento. Para a resistência tipo I, a avaliação foi feita 21 dias após a inoculação. Foi determinada a severidade no estádio de espiga seca e a porcentagem de grãos giberelados. A avaliação da severidade foi feita pela porcentagem de espiguetas infectadas, no estádio de espiga verde atribuindo-se uma nota em uma escala linear de zero (nenhuma infecção a 100 (100% de espiguetas infectadas. Para a resistência tipo II, as avaliações foram realizadas aos 7, 14 e 21 dias após a inoculação, contando-se as espiguetas com sintomas da doença, excluindo as duas espiguetas que foram inoculadas. As cultivares Frontana, BRS 177, BRS 179, BRS Umbu, BRS Camboim, Abalone, Ônix, Pampeano e Fundacep 30 apresentaram menor severidade da doença e menor porcentagem de grãos giberelados, demonstrando serem fontes de resistência tipo I. As cultivares BRS Guamirim, CD 120, Onix, Rubi, Fundacep 50, BRS 179, Pampeano, Abalone, CD 114, IPR 85, Safira, BRS Louro, CD 117, CDF 2002116, CD 115, BRS 177, CD 0529 e BRS Camboim apresentaram a menor área abaixo da curva de progresso da doença, demonstrando a presença da resistência do tipo II.

  2. Tipos de pasteurização e agentes coagulantes na fabricação do queijo tipo prato

    OpenAIRE

    Ramos, Thaís de Melo

    2013-01-01

    O presente trabalho foi realizado com os objetivos de avaliar a influência do tipo de pasteurização pelos sistemas de aquecimento indireto high temperature short time, ou HTST, e injeção direta de vapor (IDV), e avaliar a influência de duas diferentes enzimas coagulantes na fabricação do queijo tipo prato. O delineamento experimental utilizado neste experimento foi um fatorial 2 x 2 x 5 inteiramente casualizado, sendo dois sistemas de pasteurização (HTST e IDV), duas enzimas coagulantes e cin...

  3. Diabetes mellitus tipo 2 y osteoartritis primaria de rodilla

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    Rubén Daniel Arellano-Pérez Vertti

    2017-07-01

    Full Text Available Señor editor: Es nuestro interés dar a conocer los resultados del estudio sobre la asociación entre diabetes tipo 2 y osteoartritis primaria de rodilla en una población del norte de México.

  4. Peso corporal y depresión en adultos mayores de comunidad urbano marginal en México - Tamaulipas.

    OpenAIRE

    Duran-Badillo, Tirso; Martínez Aguilar, Ma. de la Luz; Gutiérrez Sánchez, Gustavo; Rosa Ma., Rosa Ma.; Guevara-Valtie, Milton Carlos

    2016-01-01

    El peso corporal inadecuado y la depresión son factores que alteran la calidad de vida del adulto mayor. Objetivos: identificar asociación existente entre peso corporal y depresión en el adulto mayor. Material y Metodos: estudio descriptivo y correlacional, se realizó en una población urbano-marginal de Tamaulipas, México. Participaron 252 adultos mayores de 60 años y que tuvieran la capacidad física para mantenerse de pié al momento de medir el peso corporal y talla. El muestreo fue no proba...

  5. Maltrato intrafamiliar hacia el adulto mayor en el del Policlínico Reynold García de Versalles

    OpenAIRE

    García Rosique, Regla Mercedes; Guisado Zamora, Katia; Torres Triana, Adelaida

    2016-01-01

    Introducción: el maltrato al adulto mayor emerge como problema social, desde hace pocos años, y no porque antes no existiera, sino porque muchas veces existe en las familias y no sale a la luz pública. Objetivo: identificar maltrato intrafamiliar hacia los adultos mayores. Materiales y Métodos: se realizó un estudio descriptivo, de corte transversal en 60 adultos mayores de 60 años, pertenecientes al Consultorio Médico de Familia No. 87, del Policlínico Reynold García, área de Versalles de la...

  6. CARACTERIZAÇÃO PÓS-COLHEITA E SENSORIAL DE GENÓTIPOS DE BANANEIRAS TIPO PRATA

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    ARIANE CASTRICINI

    2015-03-01

    Full Text Available RESUMO O norte de Minas Gerais é grande produtor de banana ‘Prata-Anã’ irrigada, cultura altamente suscetível ao Mal-do-Panamá. O uso de genótipos resistentes é uma alternativa, mas os frutos devem apresentar características pós-colheita o mais próximo possível da ‘Prata-Anã’, para melhor aceitação pelos consumidores. O objetivo do trabalho foi caracterizar frutos em pós-colheita, identificar a preferência e a intenção de compra de diferentes genótipos de bananeira tipo Prata. Os genótipos Prata-Anã, BRS Platina e Fhia-18. foram caracterizados no ponto de colheita (verdes e maduros (estádio seis de maturação, por avaliações químicas, físicas e sensoriais. Quando verde, ‘BRS Platina’ apresentou maior massa fresca e tamanho que ‘Fhia-18’ e ‘Prata-Anã’. ‘Fhia-18.’ teve a tonalidade verde da casca mais intensa que a dos demais genótipos. Madura, ‘BRS Platina’ foi mais firme, mas com a mesma resistência ao despencamento que ‘Fhia-18’ e superior à ‘Prata-Anã’. ‘Fhia-18’ apresentou cor da casca com amarelo mais clara e tão brilhante quanto da ‘Prata-Anã’, mas ‘BRS Platina’ teve a tonalidade de amarelo mais intensa. Bananas ‘Fhia-18’ foram mais ácidas, ‘BRS Platina’, com menor acidez titulável, e ‘Prata-Anã’, o maior teor de sólidos solúveis. Os genótipos Prata-Anã e BRS Platina tiveram maior preferência e intenção de compra pelos consumidores, sendo as bananas ‘Prata-Anã’ em dedos e ‘BRS Platina’ e ‘Fhia-18’ em dedos, buquê e penca, as mais preferidas. Entretanto, a maioria compraria bananas ‘Prata-Anã’ em buquê e ‘BRS Platina’ e ‘Fhia-18’ em penca. Enquanto verdes, os genótipos foram semelhantes à ‘Prata-Anã’, e maiores diferenças químicas e físicas ocorreram quando maduros.

  7. Parâmetros de desempenho e carcaça de genótipos de frangos tipo caipira

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    R.C. Veloso

    2014-08-01

    Full Text Available Objetivou-se com este trabalho avaliar as características de desempenho e de carcaça de sete genótipos de frangos tipo caipira da linhagem Redbro. Foram utilizados 840 pintos de um dia, machos, distribuídos em delineamento inteiramente ao acaso, dos seguintes genótipos: Caboclo, Carijó, Colorpak, Gigante Negro, Pesadão Vermelho, Pescoço Pelado e Tricolor. Os frangos foram alojados em 28 boxes, sendo 30 frangos por boxe, em galpão de alvenaria com acesso a um piquete de 45m², em quatro repetições. As características de desempenho (conversão alimentar, ganho em peso médio diário, consumo de ração médio diário foram avaliadas nos períodos: um a 28, um a 56, um a 70 e um a 84 dias de idade. O peso corporal foi avaliado aos 28, 56, 70 e 84 dias de idade. As características de carcaça (peso e rendimento de carcaça, peito e pernas foram obtidas a partir do abate de dois frangos por boxe, aos 85 dias de idade. As análises estatísticas foram realizadas utilizando-se o "proc glm" do SAS. Verificou-se que, em todos os períodos, os frangos do genótipo Colorpak apresentaram maior peso corporal, consumo de ração médio diário, ganho em peso médio diário e melhor conversão alimentar. Entretanto, os genótipos Caboclo e Gigante Negro apresentaram menores consumo de ração médio diário, ganho de peso médio diário e pior conversão alimentar. Quanto ao rendimento de cortes, observou-se que os genótipos Caboclo e Gigante Negro apresentaram os menores valores, e o Carijó, Colorpak, Pesadão Vermelho, Pescoço Pelado e Tricolor obtiveram os melhores rendimentos de pernas. Para o rendimento de peito, o Carijó e o Pesadão Vermelho obtiveram os maiores valores. A escolha do genótipo deve ser feita de acordo com o interesse do mercado, pois há diferenças no desempenho e no rendimento de carcaça e dos cortes.

  8. Relacionamentos pessoais e sociais: amizade em adultos Relacionamientos personales y sociales: amistad en adultos Personal and social relationships: friendship in adults

    Directory of Open Access Journals (Sweden)

    Luciana Karine de Souza

    2008-06-01

    Full Text Available A amizade é um relacionamento importante para o desenvolvimento social, emocional e cognitivo; no entanto a maioria dos estudos trata da amizade na infância e na adolescência, havendo pouca ênfase na investigação de adultos. O presente trabalho apresenta uma revisão da literatura sobre relacionamentos de amizade na adultez, procurando descrever criticamente a produção científica na área. Estudos brasileiros indicam que relacionamentos de amizade no nosso país podem ser comparados aos de outras culturas e discutidos com base nos modelos teóricos existentes. Não obstante, há algumas diferenças que requerem mais estudo, inclusive para verificar se os modelos internacionais correntes são satisfatórios para explicar adequadamente relações de amizade entre adultos na cultura brasileira.La amistad es un relacionamiento importante para el desarrollo social, emocional y cognitivo, pero la mayor parte de los estudios trata de la amistad en la niñez y en la adolescencia, habiendo poca énfasis en la investigación con adultos. El estudio en cuestión presenta una revisión de la literatura sobre relacionamentos de amistad en la edad adulta, buscando describir críticamente la producción científica en el área. Estudios brasileños indican que relacionamientos de amistad en ese país pueden ser comparados a los de otras culturas y discutidos en base a los modelos teóricos existentes. Sin embargo, hay algunas diferencias que requieren más estudio incluso para averiguar si los modelos internacionales actuales son satisfactorios para explicar adecuadamente relaciones de amistad entre adultos en la cultura brasileña.Friendship is an important relationship for social, emotional and cognitive development. However, most empirical studies investigate friendship in childhood and adolescence, with little emphasis in adulthood. Current analysis presents a critical review of the literature on friendship among adults, describing the major

  9. Factores asociados a la no adherencia al tratamiento antirretroviral de gran actividad en adultos infectados con el VIH-sida

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    Óscar Alvis

    2009-12-01

    Full Text Available Introducción: La no adherencia al tratamiento antirretroviral de gran actividad (Targa es la principal causa de fracaso terapéutico. Objetivos: Determinar la prevalencia y los factores asociados a la no adherencia al Targa en adultos infectados con el VIH-sida. Diseño: Estudio transversal. Institución: Servicio de Infectología, Hospital Nacional Arzobispo Loayza. Participantes: Pacientes infectados con el VIH que se encontraban recibiendo tratamiento antirretroviral. Intervenciones: A pacientes infectados con el VIH que se encontraban recibiendo tratamiento antirretroviral en el hospital, se aplicó un cuestionario estructurado, elaborado en función a instrumentos que evalúan la adherencia y factores asociados. Para determinar la asociación, se empleó las pruebas de chi cuadrado y t de student, se estableció un nivel de significación estadística p<0,05, y para calcular el riesgo se utilizó el OR, con intervalos de confianza de 95%. Se realizó análisis de regresión logística. Principales medidas de resultados: No adherencia al tratamiento antirretroviral de gran actividad. Resultados: Se encuestó 465 personas; la edad promedio fue 36,8±9,1 años; 64,1% era varón. El 35,9% de los encuestados resultó ser no adherente. Los factores independientemente asociados a la no adherencia fueron: ser homosexual/bisexual (OR: 3,85, IC95% 1,98 a 7,51, tener una baja calidad de vida relacionada a la salud (OR: 6,22, IC95% 3,47 a 11,13, poco apoyo social (OR: 5,41, IC95% 3,17 a 9,22, no tener domicilio fijo (OR 3,34, IC95% 1,93 a 5,79, tener morbilidad psíquica (OR 2,93, IC95% 1,78 a 4,82 y tener mayor tiempo en tratamiento (OR 1,04, IC95% 1,02 a 1,07. Conclusiones: La prevalencia de no adherencia fue mayor a la reportada previamente en este mismo hospital, pero similar a la encontrada en diferentes estudios, pese a la heterogeneidad de los mismos. Los factores de tipo psicosocial fueron los que influyeron de forma más importante en la

  10. Clinical and radiological profile of Hirayama disease: A flexion myelopathy due to tight cervical dural canal amenable to collar therapy

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    K M Hassan

    2012-01-01

    Full Text Available Background: Hirayama disease (HD is benign focal amyotrophy of the distal upper limbs, often misdiagnosed as motor neuron disease. Routine magnetic resonance imaging (MRI is often reported normal. Objective: To study the clinicoradiological profile of hand wasting in young males. Materials and Methods: Patients presenting with insidious-onset hand wasting from March 2008 to May 2011 were evaluated electrophysiologically. Cervical MRI in neutral position was done in 11 patients and flexion contrast imaging was done in 10 patients. Results: All patients were males less than 25 years of age, with median age 23 years, except one patient who was 50 years old. Duration of illness was 3 months to 3 years. All (100% had oblique amyotrophy, four (36% cold paresis, 10 (91% minipolymyoclonus and three (27% had fasciculations. Regional reflexes were variably absent. Two patients (18% had brisk reflexes of lower limbs with flexor plantars. Electromyography (EMG showed chronic denervation in the C7-T1 myotomes. Neutral position MRI showed loss of cervical lordosis in 10/11 (91%, localized lower cervical cord atrophy in 9/11 (82%, asymmetric cord flattening in 11/11 (100% and intramedullary hyperintensity in 2/11 (18%; flexion study showed loss of dural attachment, anterior displacement of dorsal dura, epidural flow voids in 9/10 (90% and enhancing epidural crescent in 10/10 (100%. Clinical profile, imaging and electrophysiological findings of the patient aged 50 years will be described in detail as presentation at this age is exceptional. Collar therapy slowed progression in most cases. Conclusion: Clinical features of HD corroborated well with electrophysiological diagnosis of anterior horn cell disease of lower cervical cord. While dynamic contrast MRI is characteristic, routine studies have a high predictive value for diagnosis. Prompt diagnosis is important to institute early collar therapy.

  11. MR imaging of the lumbar disk herniation : relationship between the direction of herniated disc and pressure effect on nerve root and dural sac

    International Nuclear Information System (INIS)

    Cha, B. H.; Shon, M. Y.; Kim, K. W.; Lim, M. A.; Kwon, K. R; Kim, S. S.

    1996-01-01

    To evaluate the relationship between the direction of herniated disc and pressure effect on nerve root and dural sac, as seen on MRI. We retrospectively reviewed lumbar spine MR images of 122 cases of lumbar disk herniation 75 patients MRI findings were analyzed with regard to the relationship between the direction of the herniated disc and pressure effect on nerve root and dural sac. Pressure effect on nerve root and dural sac was arbitrarily divided into three types. Type I was defined as zero or minimal compression of nerve roots or thecal sac by the herniated disc ; type II was defined as mild to moderate compression, while III was defined as severe compression or displacement of nerve roots and/or thecal sac. Of the 122 cases seen in these 75 patients, 97(80%) were observed at L4-5 and L5-S1. The central type(71cases ; 58%) was more frequently observed than the posterolateral type(48cases ; 40%) or lateral type(3cases ; 2%). The totals of types I, II, and III were 44(36%), 43(35%) and 35 cases(29%), respectively. Seventy-seven %(34/44) of type I and 65%(28/43) of type II were of the central type but for type III, the corresponding figure was only 26%(9/35). On MR imaging, most of lumbar disk herniations were observed at L4-5 and L5-S1, with a predominance of the central type rather than the posterolateral one. Most of the central types were either type I or type II

  12. Riesgo de tipo de cambio: cobertura con instrumentos financieros

    OpenAIRE

    Gutiérrez Blanco, Vidal

    2017-01-01

    RESUMEN: En el siguiente trabajo se hace una pequeña aproximación al mercado de divisas, explicando qué es el tipo de cambio y cuál es el riesgo que conlleva operar con monedas de diferentes países. En primer lugar, se define el mercado de divisas, poniendo énfasis sobre el hecho de que es el mercado más grande y líquido del mundo, y se identifican cuáles son las principales operaciones llevadas a cabo en este mercado. Seguidamente, se ha explicado lo que es el tipo de cambio, cuáles son l...

  13. El Enigma de las Causas de la Diabetes Mellitus Tipo 2 El Enigma de las Causas de la Diabetes Mellitus Tipo 2

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    Juan Manuel Malacara

    2012-02-01

    Full Text Available Type 2 diabetes mellitus the most frequent metabolic disease, is induced by factors so far largely unknown. Genetic and environmental causes are implicated, among the latter obesity and sedentary life are the most important. The discovery of new hormones controlling food intake such as leptin, ghrelin and the YY3-36 peptide, are expected to provide new tools to reduce overfeeding. The genes associated with type 2 diabetes are intensively sought without success.It is possible that the genetic transmission is more complex than suppossed. The theory of the thrifty gene proposes an explanation for the increased obesity and diabetes in ethnic groups in transition from preindustrial to industrialized cultures. The theory of the fetal origins of adult disease, proposes that in the fetal life there is a window for metabolic programming under stress or caloric restriction. If the subject, however, at the adult life consumes excessive caloric intake, has a high risk for the metabolic syndrome. The mechanisms involved in insulin resistance are complex, and several molecules are under study as candidates to explain it. The diminution in insulin secretion is an other important factor for the initiation of type 2 diabetes. Glucotoxicity and lipotoxicity are factors that further reduce insulin secretion. Recent evidence indicates that inflammation is implicated in the onset of both diabetes and atherosclerosis. The elucidation of the nature of this process, as well as the pathways involved will be another important tool for a better management of this disease.La causa de la diabetes mellitus tipo 2, la enfermedad metabólica más frecuente, no es bien conocida. Tiene un componente genético y otro ambiental, en éste destacan la obesidad y el sedentarismo. El conocimiento de las nuevas hormonas que controlan la alimentación: la leptina, la ghrelina y el péptido YY3-36, es una esperanza para el control de la obesidad. No se han identificado los genes

  14. The Termination Level of the Dural Sac Relevant to Caudal Epidural Block in Lumbosacral Transitional Vertebrae: A Comparison between Sacralization and Lumbarization Groups.

    Science.gov (United States)

    Jeon, Ji Young; Jeong, Yu Mi; Lee, Sheen-Woo; Kim, Jeong Ho; Choi, Hye-Young; Ahn, Yong

    2018-01-01

    Lumbosacral transitional vertebrae (LSTV) are a relatively common variant and have been considered as one of the reasons for back pain. It is not unusual for clinicians to encounter patients with LSTV who require caudal epidural block (CEB) for pain management. We investigated the termination level of the dural sac (DS) and anatomical features of the lumbosacral region relevant to CEB in patients with LSTV and compared these findings between sacralization and lumbarization groups. A retrospective evaluation. A university hospital with inpatient and outpatient LSTV cases presenting low back pain. Four hundred ninety-four LSTV patients were included and categorized into sacralization (n = 201) or lumbarization groups (n = 293). Magnetic resonance imaging (MRI) of all of the LSTV patients were reviewed to determine the level of DS termination, the shortest distance between the apex of the sacral hiatus and DS, and the presence and the caudal level of sacral perineural cysts. Each lumbosacral vertebra column was divided into 3 equal portions (upper, middle, and lower thirds). The MRI findings in both of the groups were compared and analyzed. The distribution frequency of the levels of DS termination demonstrated a significant difference between the 2 groups. The mean caudal DS level in the lumbarization group was significantly lower than the sacralization group (lower third of the S2 [131 {44.7%} of 293 patients] vs. lower third of the S1 [78 {38.8%} of 201 patients]). The DS terminated at the S3 in more than 19% of the lumbarization group, whereas in only one case of the sacralization group. Although the incidence of perineural cysts was not significantly different between the 2 groups, the mean level of caudal margin of perineural cysts in the lumbarization group was significantly lower than the sacralization group (middle third of the S3 [10 {35.7%} of 28 cases] vs. middle third of the S2 [11 {44%} of 25 cases]). This study reveals several limitations including the

  15. The importance of venous hypertension in the formation of dural arteriovenous fistulas: a case report of multiple fistulas remote from sinus thrombosis

    International Nuclear Information System (INIS)

    Kusaka, N.; Sugiu, K.; Katsumata, A.; Nakashima, H.; Tamiya, T.; Ohmoto, T.

    2001-01-01

    Various hypotheses have been reported concerning the pathogenesis of dural arteriovenous fistulas (DAVFs). However, it is still controversial whether sinus thrombosis or venous hypertension has a greater influence on the formation of DAVFs. We present a rare case of multiple DAVFs that developed after sinus thrombosis. Chronic venous hypertension secondary to sinus thrombosis in the left transverse-sigmoid sinus induced the multiple DAVFs, including one in the right cavernous sinus, which was remote from the occluded sinus. This case indicates the importance of venous hypertension in the formation of DAVFs. (orig.)

  16. Chronic changes in pituitary adenylate cyclase-activating polypeptide and related receptors in response to repeated chemical dural stimulation in rats.

    Science.gov (United States)

    Han, Xun; Ran, Ye; Su, Min; Liu, Yinglu; Tang, Wenjing; Dong, Zhao; Yu, Shengyuan

    2017-01-01

    Background Preclinical experimental studies revealed an acute alteration of pituitary adenylate cyclase-activating polypeptide in response to a single activation of the trigeminovascular system, which suggests a potential role of pituitary adenylate cyclase-activating polypeptide in the pathogenesis of migraine. However, changes in pituitary adenylate cyclase-activating polypeptide after repeated migraine-like attacks in chronic migraine are not clear. Therefore, the present study investigated chronic changes in pituitary adenylate cyclase-activating polypeptide and related receptors in response to repeated chemical dural stimulations in the rat. Methods A rat model of chronic migraine was established by repeated chemical dural stimulations using an inflammatory soup for a different numbers of days. The pituitary adenylate cyclase-activating polypeptide levels were quantified in plasma, the trigeminal ganglia, and the trigeminal nucleus caudalis using radioimmunoassay and Western blotting in trigeminal ganglia and trigeminal nucleus caudalis tissues. Western blot analysis and real-time polymerase chain reaction were used to measure the protein and mRNA expression of pituitary adenylate cyclase-activating polypeptide-related receptors (PAC1, VPAC1, and VPAC2) in the trigeminal ganglia and trigeminal nucleus caudalis to identify changes associated with repetitive applications of chemical dural stimulations. Results All rats exhibited significantly decreased periorbital nociceptive thresholds to repeated inflammatory soup stimulations. Radioimmunoassay and Western blot analysis demonstrated significantly decreased pituitary adenylate cyclase-activating polypeptide levels in plasma and trigeminal ganglia after repetitive chronic inflammatory soup stimulation. Protein and mRNA analyses of pituitary adenylate cyclase-activating polypeptide-related receptors demonstrated significantly increased PAC1 receptor protein and mRNA expression in the trigeminal ganglia, but not

  17. Vitamina B12, Acido Fólico y Función Mental en Adultos Mayores

    OpenAIRE

    Meertens-R, Lesbia; Solano-R, Liseti

    2005-01-01

    Los adultos mayores constituyen un grupo de población vulnerable a cuadros de deficiencias de nutrientes específicos como la vitamina B12 y el ácido fólico, íntimamente ligados al deterioro de las funciones mentales, en especial, del área cognitiva. El objetivo de este estudio fue determinar indicadores del estado de vitamina B12 y ácido fólico y asociarlos a la evaluación de la función mental de 53 adultos mayores de 60 años de edad, residenciados en un hogar geriátrico. Se evaluó consumo di...

  18. RELACIÓN MÉDICO PACIENTE: DERECHOS DEL ADULTO MAYOR

    Science.gov (United States)

    Barrantes-Monge, Melba; Rodríguez, Eduardo; Lama, Alexis

    2009-01-01

    Existen prejuicios en relación con la vejez, incluso entre los profesionales que se dedican a la gerontología. Uno común y peligroso es considerar que los viejos son todos enfermos o discapacitados. La relación médico-paciente es la piedra angular de la práctica y ética médicas. Para alcanzar el respeto por los adultos mayores es necesaria una medicina prudente, basada en una práctica en la cual la reflexión ética y clínica pueda contribuir. Esto último es posible si se hacen valer los derechos del adulto mayor, en particular como paciente para la toma de decisiones. PMID:20379380

  19. Tratamiento del adulto mayor con síndrome coronario agudo

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    Carolina Pemberthy-López

    2016-11-01

    Full Text Available El adulto mayor se encuentra en una etapa de la vida con cambios fisiológicos importantes que posee repercusiones directas e indirectas sobre su estado clínico, es así como el enfoque diagnóstico y terapéutico de sus patologías debe ser abordado desde una perspectiva diferente, con consideraciones especiales para este grupo poblacional. Lamentablemente, este grupo no ha sido bien representado en los diferentes estudios y por tanto, es mucho lo que desconocemos; su comportamiento y la eficacia de las distintas terapias no están bien establecidos. Teniendo de referencia el síndrome coronario agudo como principal causa de mortalidad en pacientes mayores de 65 años de edad, abordaremos esta entidad desde la evidencia que nos aportan algunos de los registros más importantes al respecto en adultos mayores.

  20. FREQUÊNCIA DE USO DE PARQUES E PRÁTICA DE ATIVIDADES FÍSICAS EM ADULTOS DE CURITIBA, BRASIL

    Directory of Open Access Journals (Sweden)

    Rogério César Fermino

    Full Text Available RESUMO Introdução: A visitação de parques está associada com maiores níveis de atividades físicas, no entanto as evidências são limitadas a países de renda elevada. Objetivo: Verificar a associação entre a frequência de uso de parques e a prática de diferentes tipos, volumes e intensidades de atividades físicas de lazer em adultos de Curitiba-PR. Métodos: Em 2009 foi realizado um estudo transversal, com inquérito domiciliar, em uma amostra representativa de 1.461 adultos que residiam no entorno de oito parques da cidade. A frequência de uso dos parques foi avaliada em uma escala ordinal de quatro níveis e os diferentes volumes de caminhada, atividade física moderada, vigorosa e total foram avaliados com o International Physical Activity Questionnaire. A associação foi testada com a regressão de Poisson. Resultados: Foi verificado tendência de associação positiva entre o uso de parques e a prática de caminhada, atividade física moderada e total para homens (p<0,05. Para as mulheres esta tendência ocorreu na caminhada e na atividade física total (p<0,05. O uso dos parques em uma frequência ≥4 vezes/sem pode aumentar em aproximadamente três vezes (RP: 2,96; IC95%: 1,92-3,66 a probabilidade dos indivíduos a atingirem as recomendações de atividade física total (≥150 min/sem. Conclusão: O uso dos parques está associado com a atividade física, com efeitos mais consistentes entre os homens. Estes resultados podem auxiliar os gestores a direcionarem ações específicas para promover o uso e a prática de atividade físicas nos locais.

  1. A asma agudizada em adultos. Revisão do tema

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    G.J. Rodrigo

    2004-09-01

    Full Text Available RESUMO: Todos os doentes com asma podem sofrer exacerbações da sua doença. Os internamentos e as idas ao serviço de urgência contribuem para uma larga proporção dos custos em cuidados de Saúde dirigidos a estes doentes. Desta forma, a prevenção, bem como o tratamento adequado dos episódios de agudização da asma, representam uma área com um elevado potencial para uma redução substancial dos custos em cuidados de Saúde. As exacerbações podem apresentar uma gravidade que varia de ligeira até potencialmente fatal. A mortalidade associa-se frequentemente a uma incapacidade para reconhecer a gravidade da exacerbação, resultando num tratamento inadequado e num atraso em referenciar o doente para a urgência hospitalar. Nesta revisão temática, os autores descrevem a epidemiologia, os custos, a fisiopatologia, a mortalidade e o tratamento da asma agudizada do adulto no serviço de urgência e na unidade de cuidados intensivos.A asma representa a 11.º diagnóstico mais frequente que motiva a ida ao serviço de urgência nos EUA, afectando sobretudo os grupos etários da adolescência e adultos jovens. As mulheres recorrem à urgência e são internadas duas vezes mais do que os homens1. Na última década tem-se assistido a um declínio do número de doentes com exacerbações graves de asma requerendo internamento em unidades de cuidados intensivos. Uma meta-análise recente atribui aos corticosteróides inalados, quando comparados com o placebo, a redução das taxas de internamento hospitalar em doentes com asma agudizada2. Provavelmente, a maior parte dos internamentos, incluindo os que requerem cuidados intensivos, podem ser evitados.Apenas cerca de 20% dos asmáticos recorreram alguma vez a um serviço de urgência. Contudo, estes doentes contribuem para mais de 80% dos custos directos totais. O internamento e as idas à urg

  2. A asma agudizada em adultos. Revisão do tema

    Directory of Open Access Journals (Sweden)

    G.J. Rodrigo

    2003-05-01

    Full Text Available RESUMO: Todos os doentes com asma podem sofrer exacerbações da sua doença. Os internamentos e as idas ao serviço de urgência contribuem para uma larga proporção dos custos em cuidados de Saúde dirigidos a estes doentes. Desta forma, a prevenção, bem como o tratamento adequado dos episódios de agudização da asma, representam uma área com um elevado potencial para uma redução substancial dos custos em cuidados de Saúde. As exacerbações podem apresentar uma gravidade que varia de ligeira até potencialmente fatal. A mortalidade associa-se frequentemente a uma incapacidade para reconhecer a gravidade da exacerbação, resultando num tratamento inadequado e num atraso em referenciar o doente para a urgência hospitalar. Nesta revisão temática, os autores descrevem a epidemiologia, os custos, a fisiopatologia, a mortalidade e o tratamento da asma agudizada do adulto no serviço de urgência e na unidade de cuidados intensivos.A asma representa a 11.º diagnóstico mais frequente que motiva a ida ao serviço de urgência nos EUA, afectando sobretudo os grupos etários da adolescência e adultos jovens. As mulheres recorrem à urgência e são internadas duas vezes mais do que os homens1. Na última década tem-se assistido a um declínio do número de doentes com exacerbações graves de asma requerendo internamento em unidades de cuidados intensivos. Uma meta-análise recente atribui aos corticosteróides inalados, quando comparados com o placebo, a redução das taxas de internamento hospitalar em doentes com asma agudizada2. Provavelmente, a maior parte dos internamentos, incluindo os que requerem cuidados intensivos, podem ser evitados.Apenas cerca de 20% dos asmáticos recorreram alguma vez a um serviço de urgência. Contudo, estes doentes contribuem para mais de 80% dos custos directos totais. O internamento e as idas à urg

  3. Comportamientos y capacidad de agencia de autocuidado de adultos con insuficiencia cardiaca

    Directory of Open Access Journals (Sweden)

    EDITH ARREDONDO HOLGUÍN

    2010-06-01

    Full Text Available Este estudio tiene como objetivo describir comportamientos y capacidad de agencia de autocuidado de pacientes con insuficiencia cardiaca de una clínica cardiovascular de Medellín entre noviembre de 2007 y mayo de 2008. Es un estudio descriptivo con abordaje cuantitativo. La muestra fue de 206 adultos con insuficiencia cardiaca diagnosticados por sintomatología clínica, fracción de eyección menor o igual a 40%. Se usaron para la recolección de datos la Escala Capacidad de Agencia de Autocuidado desarrollada por Isemberg y Evers et ál. (1993, traducida por Gallego, que mide el nivel de agencia de autocuidado, y la Escala Comportamientos de Autocuidado validada en Colombia en 2007 por Arredondo, que mide la frecuencia de comportamientos de autocuidado de adultos con insuficiencia cardiaca en la solicitud de ayuda, adaptación a vivir con la enfermedad y el régimen terapéutico, modificación del autoconcepto y aceptación de sí mismo, vivir con efectos de la insuficiencia cardiaca y el tratamiento. Concluye que el mayor número de pacientes eran hombres; que factores básicos condicionantes como el apoyo de la familia, desempeño de un trabajo, afiliación al sistema de salud, nivel socioeconómico y acceso a un nivel educativo fueron importantes para los pacientes. La frecuencia de comportamientos de autocuidado fue media en los adultos en la mayoría de las dimensiones y el nivel de agencia fue alto y muy alto. Igualmente se concluyó que no hay una correlación entre agencia y comportamientos de autocuidado. Lo que plantea que los adultos tienen el conocimiento pero no han tomado la decisión de realizar acciones de autocuidado.

  4. Cierre percutáneo de fístulas coronario-pulmonares en el adulto

    Directory of Open Access Journals (Sweden)

    Pedro Trujillo, MD

    2014-01-01

    Full Text Available El cierre percutáneo de las fístulas coronario-pulmonares con implante de “coils” es eficaz y pueden realizarlo los cardiólogos intervencionistas de adultos. Se presentan tres casos clínicos de cierre percutáneo exitoso de fístulas coronario-pulmonares con implante de “coils”.

  5. Prevalencia de hipertensión en adultos mayores de Costa Rica

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    Rosero-Bixby, Luis

    2007-07-01

    Full Text Available Este artículo estima la prevalencia de hipertensión (controlada y con o sin diagnóstico previo entre los adultos mayores costarricenses. Valora los problemas de medición y explora los factores asociados con la enfermedad. Se utilizan datos de una muestra nacional representativa del proyecto CRELES: “Costa Rica: Estudio de Longevidad y Envejecimiento Saludable”. Se realizaron dos mediciones de la presión arterial con monitores digitales a una muestra de 3000 adultos y se registró el auto reporte de la enfermedad y el uso de medicamentos antihipertensivos. La segunda medición resultó en valores significativamente menores tanto para la presión diastólica como para la sistólica. No se detectaron sesgos en la medición realizada por entrevistador ni por trimestre de trabajo de campo. El 59% de los adultos mayores del país sufre de hipertensión (HTA. La prevalencia es mayor entre las mujeres que entre los hombres. El 16% de todos los adultos mayores no tenían diagnóstico previo de HTA pero en nuestras mediciones resultaron con HTA. Los principales co-factores de HTA identificados en este artículo son: edad, estar asegurado, el índice de masa corporal, los antecedentes familiares, tener menos de 6 años de educación formal, ser fumador activo y consumir más de 3000 calorías al día.

  6. Posterolateral Bochdalek diaphragmatic hernia in adults Hernia diafragmática posterolateral de Bochdalek en el adulto

    Directory of Open Access Journals (Sweden)

    José Maximiliano Garófano-Jerez

    2011-09-01

    ía, nuestros pacientes no han sido tratados quirúrgicamente. La exploración mediante tomografía computarizada multicorte, con posibilidad de realizar reconstrucciones coronales y sagitales, debería ser considerada el método estándar para diagnosticar esta entidad. La resonancia magnética en T1 es muy valiosa en la evaluación de lesiones torácicas que contienen grasa. Para concluir, debemos resaltar que las hernias de Bochdalek en el adulto, asintomáticas, descubiertas de forma incidental, están siendo diagnosticadas cada vez con una mayor frecuencia gracias a los avances en las nuevas técnicas de imagen, permitiendo el diagnóstico correcto del tipo y localización de la hernia, lo cual facilitará su manejo y la elección del tratamiento.

  7. Fatores associados à atividade física em adultos, Brasília, DF Factores asociados con la actividad física en adultos, Brasilia, Brasil Factors associated with physical activity in adults in Brasília, Central-West Brazil

    Directory of Open Access Journals (Sweden)

    Priscilla Marcondelli Dias Thomaz

    2010-10-01

    Full Text Available OBJETIVO: Descrever a prática de atividade física por adultos e identificar fatores associados. MÉTODOS: Estudo transversal com amostragem por conglomerados das quatro regiões de Brasília, DF, em 20062007. A amostra de 469 adultos foi obtida em 250 domicílios selecionados aleatoriamente. Dados sociodemográficos, peso e altura foram obtidos durante uma entrevista no domicílio. O questionário internacional de atividade física (Ipaq, versão curta, foi utilizado para a mensuração da atividade física. Para se avaliar o efeito do sexo, índice de massa corporal (IMC, classificação socioeconômica e estado civil sobre o escore de atividade física, foi realizada uma análise de regressão linear multivariável. RESULTADOS: A maioria da amostra era composta por mulheres (57%. O percentual de indivíduos que atingiu 150 minutos semanais de prática de atividade física foi de 52% (IC 95%: 47; 56 e de inativos de 21,5% (IC 95%: 17,8;25,3. Somente nos homens foi observada uma associação inversa entre atividade física e IMC. Os tipos de atividades físicas relatados diferiram entre os sexos: entre mulheres, caminhar e fazer serviços domésticos; entre os homens, pedalar, correr, nadar e fazer exercícios com pesos. Houve uma forte interação entre sexo masculino e IMC para a associação com o escore de atividade física: quanto maior o IMC, menor o escore de atividade física. CONCLUSÕES: A parcela de indivíduos inativos em Brasília pode ser considerada baixa, em contraste com estimativas de outras cidades brasileiras. Diferenças entre sexos em relação a IMC e escore de atividade física estão associadas ao tipo de atividade física praticada.OBJETIVO: Describir la práctica de actividad física por adultos e identificar factores asociados. MÉTODOS: Estudio transversal con muestreo por conglomerados de las cuatro regiones de Brasilia, Centro Oeste de Brasil, en 2006-2007. La muestra de 469 adultos fue obtenida en 250 domicilios

  8. Cuidado popular de familias con un adulto mayor sobreviviente del primer accidente cerebrovascular

    Directory of Open Access Journals (Sweden)

    Lucero López-Díaz

    2016-01-01

    Full Text Available Introducción: el accidente cerebrovascular afecta a numerosas personas en el mundo y se constituye en la principal causa de muer- te. Los sobrevivientes pueden padecer discapacidad y sufrir modificaciones en las actividades cotidianas. La familia es el principal apoyo del sobreviviente y al ser parte de una misma cultura, construye acciones de cuidado en búsqueda del bienestar. Objetivo: describir las acciones del cuidado popular de las familias con un adulto mayor sobreviviente del primer accidente cerebrovascular. Método: estudio etnográfico, con observación participante y entrevistas en profundidad. Participaron siete familias bogotanas (siete adultos mayores entre los dos y diez meses posteriores al primer accidente cerebrovascular y los siete cuidadores principales respectivos. Resultados: cuidadores y adulto mayor comparten acciones de cuidado para la recuperación, relacionadas con la alimentación, el cuidado personal y la ingesta de medicamentos permeadas por la creencia religiosa, fuente de soporte y vínculo afectivo. Conclusión: conocer el cuidado popular de esta población posibilita proponer acciones culturalmente congruentes con sus valores y creencias para potencializar las ca- pacidades familiares e intermediar en los procesos de tratamiento.

  9. ¿Estamos preparados para la atención primaria del adulto mayor?

    Directory of Open Access Journals (Sweden)

    Marco Zelada R

    Full Text Available RESUMEN El Ministerio de Salud ha implementado el Modelo de Atención Integral en Salud enfocado por etapas de vida,siendo parte de este,el Programa de Atención al Adulto Mayor.Con el objetivo de conocer el nivel de conocimientos previos sobre geriatría,se realizó una encuesta a los responsables y miembros del equipo interdisciplinario a cargo de dicho programa.Se entrevistó a 73 profesionales de los cuales el 30%recibió conocimientos en el pregrado,y de éstos, 59%la considero como regular o mala;sólo 10%manifestó que basado en sus conocimientos y experiencia tiene la capacidad para manejar problemas de un adulto mayor.Todos consideraron necesaria la capacitación,para ello prefe- rían talleres teórico-prácticos,con pasantías en servicios de geriatría.Los temas de mayor interés fueron hipertensión arterial (84%,depresión (73%,osteoporosis (66%y diabetes (56%.En conclusión,existe una deficiente formación en geriatría entre los responsables de la atención al adulto mayor,debido a una falta de enseñanza en las universidades y pobre capacitación a los profesionales.

  10. El mundo afectivo de adultos mayores en situación de dependencia y sus cuidadores

    Directory of Open Access Journals (Sweden)

    Juana Rosa Hidalgo-Martinola

    2015-12-01

    Full Text Available El objetivo del presente trabajo es caracterizar la relación interpersonal entre cuidadores informales primarios y adultos mayores en situación de dependencia, a partir, de un estudio de casos múltiples. Se empleó la metodología cualitativa y el método etnometodológico. Se seleccionaron tres casos, por la presencia de diferentes grados de dependencia en los adultos mayores. Las técnicas empleadas fueron: entrevista en profundidad, escala de evaluación funcional y la observación abierta.Los principales resultados muestran que las relaciones interpersonales entre un cuidador informal primario y un adulto mayor en situación de dependencia, actualizan la historia de la relación anterior, generando vivencias de frustración y/o satisfacción en función de la dinámica pasada. Este proceso primario adquiere más trascendencia que las propias habilidades comunicativas en la relación y marcan una vivencia de la relación, que en algunos casos, se diferencia de la vivencia de la labor del cuidado.

  11. Familias con Adultos Quirúrgicos: Riesgo y Salud Familiar. 2007-2010

    Directory of Open Access Journals (Sweden)

    Luz Amparo Leyva Morales

    2013-06-01

    Full Text Available Estudio descriptivo cuantitativo que caracterizó familias con adultos quirúrgicos en la Unidad Hospitalaria "Clínica San Pedro Claver", apoyado en la Teoría de Riesgo Familiar Total (1 y Organización Sistémica de Friedman (2 Utilizó los instrumentos: Riesgo Familiar Total RFT: 6-69 y Salud Familiar General ISF: GEN 25, diseñados, validados para población colombiana por Amaya P. con validez y confiabilidad comprobados internacionalmente. La muestra de 202 familias residentes en Bogotá con adultos quirúrgicos institucionalizados, total 928 personas que fueron en 65% adultos. Predominó familia nuclear (43% con promedio cuatro personas por familia en la vivienda. El Riesgo Familiar Total fue riesgo bajo en un 88% y el 12% fue de familias amenazadas: 11% riesgo medio y solo 1% alto. La categoría de mayor riesgo corresponde a Servicios y Prácticas de Salud, en donde riesgo medio y alto suman 46%. Las categorías Condiciones de Vivienda y Vecindario y Condición Socioeconómica el riesgo medio y alto suman respectivamente 7% y 8%. La medición de la salud familiar fue Poco Organizada (49%, aunque Satisfecha (84%. Todas las familias requieren intervención en promoción de la salud, prevención y control del riesgo familiar total y salud familiar.

  12. Fatores de risco cardiovascular em adultos jovens de um município do Nordeste brasileiro

    Directory of Open Access Journals (Sweden)

    Emiliana Bezerra Gomes

    2012-08-01

    Full Text Available Objetivou-se averiguar fatores de risco cardiovasculares em adultos jovens num interior do Nordeste brasileiro. Estudo quantitativo realizado com 351 escolares adultos jovens de 12 escolas públicas em Juazeiro do Norte, Ceará, selecionados aleatoriamente e estratificados por escola e turno. Os resultados apresentaram maioria feminina, mestiça, conciliando estudo e trabalho, sem companheiro(a e morando com os pais. Houve sedentarismo (57,3%, obesidade/sobrepeso (19,4%, adição de sal à comida (54,4%, ingestão alcoólica (76,1%, hipertensão arterial (1,1% com 50% de não adesão ao tratamento, diabetes mellitus (0,6% e antecedentes familiares de doenças cardiovasculares (86,3%. Caracterizar os riscos cardiovasculares entre os adultos jovens direciona ações de saúde e potencialidades nas parcerias com as escolas.

  13. Efecto del tipo de sangre en la supervivencia y fecundidad del flebotomino Lutzomyia ovallesi Ortiz (Diptera: Psychodidae vector de Leishmania

    Directory of Open Access Journals (Sweden)

    Pedro Noguera

    2006-10-01

    Full Text Available Introducción. El potencial reproductivo de los flebotominos depende de varios factores, unode los cuales es el tipo de hospedador disponible como fuente sanguinea, este es importanteen determinar su capacidad de servir como vectores. Objetivo. Se estudia el efecto de la fuente de alimentación sanguínea sobre varios parámetrosbiológicos de L. ovallesi en condiciones de laboratorio. Materiales y métodos. Se utilizaron hembras de dos días de edad de L. ovallesi de colonia,alimentadas artificialmente a repleción usando membrana de pollo, con sangre de sietehospedadores vertebrados, caballo, perro, vaca, gallina, chivo, cochino y humano. Se determinóel tiempo de vida, tiempo de oviposición, tiempo de digestión sanguínea, número de huevospuestos, número de huevos retenidos y número de huevos totales. Resultados. Los resultados muestran la influencia de la fuente sanguínea sobre diferentesparámetros biológicos de L. ovallesi estudiados. Los resultados demuestran que con la sangrede gallina se obtienen mayor tiempo de oviposición (5,88 días, digestión más rápida (3,34días, mayor número de huevos retenidos (10,20 huevos por hembra y mayor fecundidad(30,80 huevos por hembra en comparación con los otros tipos de sangre. La sangre más satisfactoria fue la de gallina seguida, en orden descendente, por las de chivo, vaca, cochino,humano, perro y caballo. Conclusión. Los datos muestran que la sangre de gallina es la mejor fuente sanguínea entérminos bio-ecológicos para L. ovallesi, y la sangre de caballo la menos adecuada. Losresultados contribuyen al entendimiento de los mecanismos que influyen en las condicionesde cría en el laboratorio del flebotomino L. ovallesi y también de cómo ciertos factores de ladieta en los adultos afectan el potencial biológico y que podrían tener importante consecuenciasen la transmisión de Leishmania.

  14. A IDENTIFICAÇÃO DE TIPOS DE LIDERANÇA A PARTIR DE ARQUÉTIPOS

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    Adriana Nunes Lacerda e Prestupa

    2009-09-01

    junguianos analisados por Moore e Gillette (1993 foram relacionados com características de líderes dentro do contexto organizacional. Desta forma foi possível apresentar uma tipologia rica e aplicável, onde o individuo pode se identificar e também entender o processo e a maturação das características dos arquétipos estudados para melhor desempenho dentro das organizações.

  15. Perfil de los adultos mayores usuarios de atención primaria

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    Fabianne de Jesus Dias de Sousa

    2017-05-01

    Full Text Available Introducción: Las proyecciones indican que Brasil será el sexto país del mundo con el mayor número de adultos mayores. El objetivo de este estudio fue caracterizar las condiciones de perfil y de vida socio-demográficos y de salud de los usuarios adultos mayores de la atención primaria de un municipio en la región amazónica del Brasil. Es oportuno porque el envejecimiento de la población está creciendo rápidamente, especialmente en países en desarrollo como el Brasil. Materiales y Métodos: Estudio transversal con una muestra de 441 individuos con edad inferior a 60 años de la población de usuarios de la atención básica en el municipio de Benevides, en la Amazonia brasileña. Os datos fueron obtenidos a través del Elder notebook, un protocolo clínico del Ministerio de la Salud. La prueba del chi-cuadrado con un nivel de significancia de 5% para explorar fue utilizada las asociaciones entre las variables de las condiciones de salud y de vida, y las variables socio-demográficas. Resultados: Se presentaron un perfil predominantemente joven adultos mayores (46.0%, que no practican actividad física (p<0.02, con condiciones crónicas y uso de drogas para inducir el sueño (p<0.05. Discusión y Conclusiones: El perfil de vida desfavorable y de salud encontrados en adultos mayores exige la adopción de medidas reforzadas, sobre la salud y los presupuestos de atención integral como un desafío para efectuar la colocación de sus necesidades, principalmente por la enfermería, en la Atención Básica de Salud en áreas más necesitadas de la región amazónica. Cómo citar este artículo: Sousa FJD, Andrade FS. Perfil de los adultos mayores usuarios de atención primaria. Rev Cuid. 2017; 8(2: 1573-81. http://dx.doi.org/10.15649/cuidarte.v8i2.376

  16. Dynamic changes in the dural space and spinal cord cross-sectional area during flexion and extension in patients with cervical spondylotic myelopathy

    International Nuclear Information System (INIS)

    Machino, Masaaki; Yukawa, Yasutsugu; Ito, Keigo; Nakashima, Hiroaki; Kato, Fumihiko

    2009-01-01

    The number of patients with cervical spondylotic myelopathy (CSM) is increasing with the aging of the population. The patients' during spinal cord tends to be compressed neck extension, because the yellow ligaments and intervertebral discs protrude into the spinal canal during neck extension (pincer mechanism). A total of 100 patients with CSM were prospectively enrolled in this study. After preoperative myelography, multi-detector-row CT (MDCT) scans were acquired in flexion and extension, and the dural space and spinal cord cross-sectional area at each disc level from C2/3 to C7/Th1 were measured by using Scion imaging software. The average dural space and average spinal cord cross-sectional area were smaller in extension than in flexion from the C3/4 to C7/Th1 disc level, and the greatest dynamic changes were seen at the C5/6 level. MDCT demonstrated dynamic factors in patients with CSM. The spinal cord cross-sectional area became narrower during extension in patients with CSM. (author)

  17. Resolution of clinical symptoms after reopening of an occluded inferior petrosal sinus in a patient with a cavernous sinus dural arteriovenous fistula. A case report.

    Science.gov (United States)

    Kojima, A; Onozuka, S; Kinoshita, Y

    2013-03-01

    We describe a rare case with a cavernous sinus (CS) dural arteriovenous fistula (DAVF) in which the clinical symptoms disappeared after the patient underwent reopening of an occluded inferior petrosal sinus (IPS). A 66-year-old woman presented with increased intraocular pressure, chemosis, and proptosis on the left side. Angiography demonstrated a left CS DAVF supplied by the dural branches of bilateral internal carotid arteries. The shunt flow was directed to the superior and inferior ophthalmic veins, while the bilateral IPSs were not opacified. Accordingly, a transvenous embolization of the fistula was attempted. Although the microcatheter was navigated to the cavernous sinus through the occluded left IPS, obliteration of the fistula was unsuccessful because of the failure of superselective catheterization at the fistulous point. However, the final image demonstrated the development of an antegrade shunt flow through the left IPS to the internal jugular vein and disappearance of the retrograde reflux to the superior and inferior ophthalmic veins. The patient's clinical symptoms immediately resolved after the operation, and the symptoms have not recurred during a one-year follow-up period. Inappropriate transvenous embolization of CS DAVFs can result in vascular complications arising from the unintentional redistribution of shunt flow. The present case illustrates that the disappearance of retrograde shunt flow to the ophthalmic veins after reopening of the occluded IPS may be sufficient if a superselective approach fails or is anticipated to result only in an incomplete embolization of the fistulous point.

  18. Diagnostic performance of CT and MRI on the detection of symptomatic intracranial dural arteriovenous fistula: a meta-analysis with indirect comparison

    Energy Technology Data Exchange (ETDEWEB)

    Lin, Yen-Heng [National Taiwan University, Institute of Epidemiology and Preventive Medicine, Taipei (China); National Taiwan University Hospital in Taipei and Yuan-Lin Branch, Department of Medical Imaging and Radiology, Hospital and Medical College, Taipei (China); Lin, Hsien-Ho [National Taiwan University, Institute of Epidemiology and Preventive Medicine, Taipei (China); Liu, Hon-Man; Lee, Chung-Wei; Chen, Ya-Fang [National Taiwan University Hospital in Taipei and Yuan-Lin Branch, Department of Medical Imaging and Radiology, Hospital and Medical College, Taipei (China)

    2016-08-15

    This study aims to review the diagnostic performance of computed tomography (CT) and magnetic resonance imaging (MRI) in symptomatic dural arteriovenous fistula (DAVF). EMBASE, PubMed, and Cochrane Library were searched until April 2015 for studies which compared CT, MRI, or both with angiography for the detection of DAVF. The diagnostic performances of MRI and CT were indirectly compared using modality as a covariate in the analysis. Thirteen studies met our inclusion criteria. MRI had a sensitivity of 0.90 (95 % confidence interval (CI) = 0.83-0.94) and specificity of 0.94 (95 % CI = 0.90-0.96). CT had a sensitivity of 0.80 (95 % CI = 0.62-0.90) and specificity of 0.87 (95 % CI = 0.74-0.94). MRI showed better diagnostic performance than CT (p = 0.02). Contrast medium use and time-resolved MR angiography did not improve MRI diagnostic performance (p = 0.31 and 0.44, respectively). Both CT and MRI had good diagnostic performance. MRI was better than CT on the detection of symptomatic intracranial dural arteriovenous fistula in the indirect comparison. (orig.)

  19. Differences between pediatric and adult celiac disease Diferencias entre la enfermedad celiaca infantil y del adulto

    Directory of Open Access Journals (Sweden)

    Luis Rodrigo Sáez

    2011-05-01

    Full Text Available Introduction: celiac disease (CD is a common autoimmune condition (involves 1-2% of the general population that develops at any age in life but manifests differently in children and adults. Objectives: to analyze clinical differences in disease expression between both groups, as well as findings at the time of diagnosis. Methods: a retrospective study of a series of patients diagnosed with CD during childhood ( 14 years. Results: a total of 187 patients were included, of which 43 were children and 144 were adults. Among clinical manifestations in children classic presentation forms predominated -34 patients (79% versus 20 adult patients (14% (p Introducción: la enfermedad celiaca (EC es un proceso frecuente (afecta al 1-2% en población general, de naturaleza autoimmune, que aparece a cualquier edad de la vida, pero que se presenta de forma diferente en el niño que en el adulto. Objetivos: analizar las diferencias clínicas en las formas de expresión de la enfermedad entre ambos grupos, así como los hallazgos al momento del diagnóstico. Métodos: estudio retrospectivo de una serie de pacientes diagnosticados, en la infancia ( 14 años. Resultados: se incluyeron un total de 187 pacientes, de los cuales 43 eran niños y 144 adultos. En las manifestaciones clínicas de los niños, predominaron las formas de presentación clásicas, 34 casos (79% frente a los adultos 20 casos (14% (p < 0,001 (OR = 23,4; IC-95%: 9,8-56,1. Por el contrario, en estos predominaron las formas atípicas, siendo la anemia el hallazgo más frecuente en 61 casos (42% frente a 8 casos (19% en los niños (p < 0,01. En los adultos existía un mayor retraso diagnóstico con una media de 10 ± 9 años, frente a los niños, que es de 1 ± 2 años (p < 0,001. Encontramos en los adultos una mayor frecuencia de enfermedades autoinmunes asociadas (24,3%, frente al 9,3% en niños (p < 0,05. Respecto a los marcadores serológicos, la TGt-2 fue más frecuentemente positiva en los ni

  20. Perfil antropométrico en adultos del noroeste argentino: comparación con una referencia internacional

    Directory of Open Access Journals (Sweden)

    Lomaglio, Delia Beatriz

    2015-01-01

    Full Text Available Desde una perspectiva bioantropológica las mediciones antropométricas en adultos son exhaustivamente utilizadas en la evaluación morfológica de poblaciones argentinas extintas. La mayoría de los estudios antropométricos en adultos argentinos contemporáneos se limitan a la evaluación de talla, peso e IMC. El objetivo de este trabajo fue describir otras variables antropométricas en adultos del Noroeste argentino (NOA y compararlas con una referencia internacional. Los datos de peso, talla, perímetros (brazo, muslo, pierna, cintura y pliegues (tríceps, subescapular proceden de 881 individuos (526 mujeres; 355 varones sanos de 20-60 años de edad de distintas localidades de Catamarca y Jujuy. Se calcularon estadísticos descriptivos (media y DS por sexo y dos PALABRAS CLAVE adultos; Noroeste Argentino; perímetros; pliegues; antropometría grupos de edad: 20-39 y 40-60 años. Las comparaciones se establecieron con adultos de EEUU de origen mejicano (Centers for Disease Control, CDC 2003-2006 con la prueba t. Se calcularon los percentilos con el método LMS. En ambos sexos y grupos de edad los adultos del NOA presentaron valores significativamente inferiores a los de la referencia en todas las variables consideradas, excepto para pliegues tricipital y subescapular en varones de 40-60 años. No se han encontrado antecedentes antropométricos comparables semejantes para poblaciones argentinas y del NOA. El perfil antropométrico de los adultos del NOA difiere significativamente con respecto a la población de referencia con un origen étnico afín.

  1. Hipnosis como complemento en la cirugía oral del adulto mayor Hypnosis as a complement to oral surgery in elderly persons

    Directory of Open Access Journals (Sweden)

    Elina Muñiz Manzano

    2013-03-01

    Full Text Available Introducción: el envejecimiento poblacional es un fenómeno mundial y la cirugía oral es compleja en los adultos mayores, por lo que la preparación preoperatoria es de vital importancia para una evolución satisfactoria. Este trabajo tiene como objetivo demostrar la eficacia de la hipnosis en pacientes con temor en la cirugía oral del adulto mayor. Métodos: se realizó un estudio descriptivo, transversal, con muestra de 20 pacientes de 60 años o más, atendidos en la consulta de Cirugía Maxilofacial del Hospital Universitario "Comandante Manuel Fajardo", en el año 2011, donde se analizaron las variables edad, sexo, número de sesiones de hipnosis, antecedentes patológicos, diagnósticos más frecuentes y temor. Resultados: el mayor número de pacientes se encontró entre 60-69 años de edad, (70 % y el menor en 70-79, (30 %. El sexo femenino prevaleció con 70 %. El número de sesiones fue en el grupo de 60-69 con 58, con un promedio total de 4 por pacientes. En los antecedentes patológicos más frecuentes fue la hipertensión arterial en 14 (70 % y le siguió la diabetes tipo II en 2 (10 % En los diagnósticos más frecuentes fue la caries de cuarto grado con 10 (50 % seguido por los dientes parodontósicos con 4 (20 %. El temor se midió en una escala confeccionada, en la que los pacientes con cifras de l0, 8 y 7 se redujeron a 4 y 5. Conclusiones: Se demuestra la efectividad de la terapia de hipnosis para disminuir el temor y realizar la cirugía oral en el adulto mayor.Introduction: population aging is a worldwide phenomenon, and oral surgery is complex in elderly patients. Therefore, preoperative preparation is vital to their satisfactory evolution. The purpose of the present paper is to show the efficacy of hypnosis in elderly patients who fear oral surgery. Methods: a descriptive cross-sectional study was conducted with a sample of 20 patients aged 60 or over, cared for at the maxillofacial surgery service of Comandante Manuel

  2. Análisis estadístico exploratorio de dos tipos de secado de quinua

    OpenAIRE

    Mena Reinoso, Angel Patricio

    2015-01-01

    El presente trabajo “Análisis Estadístico Exploratorio de dos Tipos de Secado de Quinua” permite realizar una validación estadística del tipo de secador que posea una alta eficiencia, rendimiento en el secado de este tipo de cereal (Chenopodium quinoa Willd). Para el efecto se empleó el secador de bandejas y un secador solar tipo invernadero, el experimento se llevó a cabo con tres tipos de muestras, una con cascara y las otras escarificadas. La quinua fue sometida a un secado ...

  3. Síndrome de Waardenburg tipo I: relato de caso

    Directory of Open Access Journals (Sweden)

    Patricia Capua Vieira da Silva

    2011-06-01

    Full Text Available A síndrome de Waardenburg tipo I é uma desordem auditivo-pigmentária que inclui, entre outros, perda auditiva neurossensorial congênita não progressiva, telecanto, distúrbios pigmentares de íris, cabelo e pele. Indivíduos afetados podem ter maior risco de: defeitos no tubo neural, fendas labial e palatina, anormalidades nos membros e doença de Hirschsprung. O diagnóstico é clínico, sendo necessários dois critérios maiores ou um maior e dois menores. PAX3 é o único gene conhecido associado à síndrome, sendo, entretanto, mais usado no aconselhamento genético. Quanto ao diagnóstico diferencial, podemos citar: outras causas de perda auditiva neurossensorial congênita não progressiva, outros tipo de síndrome de Waardenburg, piebaldismo, albinismo, vitiligo e síndrome de Teitz. Neste trabalho, apresenta-se um paciente masculino de 11 anos com diagnóstico de síndrome de Waardenburg tipo I. Ressalta-se a importância do oftalmologista no auxílio do diagnóstico deste raro quadro sistêmico, uma vez que inclui algumas alterações oftalmológicas. O diagnóstico precoce da síndrome permite estimulação adequada para a perda auditiva, assim como medidas preventivas em caso de gestantes afetadas no aconselhamento genético.

  4. Tipos do Herbário Prisco Bezerra - EAC

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    Maria Stela Bezerra da Silva

    1990-01-01

    Full Text Available Com o presente trabalho pretende-se contribuir para a divulgação dos tipos do Herbário Prisco Bezerra - EAC. Um levantamento realizado no acervo do Herbário revelou o registro de dez tipos. Sete deles pertencentes à família Leguminosae distribuídas entre as subfamilias Caesalpinioideae: Peltogyne crenulata, Sentia dardanoi, Moldenhawera acuminata, Chamaecrista duckeana, Papilionoideae: Aeschynomene monteiroi, Cranocarpus gracilis e Mimosoideae: Mimosa niomarlei; dois, pertencentes à família Erythroxylaceae. As espécies Erythroxylum tianguanum e Erythroxylum bezerrae e um à família Euphorbiaceae: Dalechampia fernandesii recentemente descrita por G. Webster. Os tipos são apresentados na seqüência das indicações: nome das famílias, seguido do epíteto específico, habitat, com a transferência de todas as informações mencionadas na ficha de exsicata do material, bem como, a fotografia correspondente. Citam-se também alguns aspectos característicos das espécies, para melhor visualização dos detalhes fotográficos.The present paper repasts the type specimens in the Herbário Prisco Bezerra (University of Ceará. The Herbário has ten type, of which seven are Leguminosae: Peltoqyne crenulata, Senna dardanoi, Moldenhawera acuminata Chamaecrista duckeana, Aeschynomene monteiroi, Cranocarpus gracilis, Mimosa niomarlei, two the Erythroxylaceae: Erythroxylum tianquanum and Erythroxylum bezerrae and one Euphorbiaceae: Dalechampia fernandesii. Additional informations for these exsicata is presented.

  5. A retrospective study of pediatric endoscopy as performed in an adult endoscopy unit Estudio retrospectivo sobre la endoscopia pediátrica desarrollada en un servicio de endoscopias de adultos

    Directory of Open Access Journals (Sweden)

    L. Julián-Gómez

    2010-02-01

    Full Text Available Gastrointestinal endoscopy is a safe, efficient technique with minimal complications, and a useful diagnostic tool for the pediatric population. Under ideal conditions endoscopies for children should be performed by experienced pediatric endoscopists. In this study we report our experience with pediatric endoscopy at the general adult endoscopy unit in our hospital. Our goal is to quantify the number of endoscopies performed in children, as well as their indications and findings, the type of sedation or anesthesia used, and the time waiting for the test to occur. Our experience demonstrates that endoscopists in a general adult gastroenterology department, working together with pediatricians, may perform a relevant number of endoscopies in children in a fast, safe, effective manner.La endoscopia gastrointestinal es una técnica segura y eficiente con mínimas complicaciones, así como una útil herramienta diagnóstica en la población pediátrica. En condiciones ideales, las endoscopias en niños deberían ser realizadas por endoscopistas pediátricos experimentados. En este estudio reportamos nuestra experiencia en la realización de endoscopias pediátricas en la Unidad de Endoscopias general de adultos de nuestro hospital. El objetivo es cuantificar la cantidad de endoscopias realizadas en niños, así como las indicaciones y hallazgos de las mismas, el tipo de sedación o anestesia empleado y el tiempo de espera para la realización de la prueba. Nuestra experiencia demuestra que los endoscopistas de un servicio de gastroenterología general de adultos, en colaboración con pediatras, pueden realizar un número importante de endoscopias a niños, de forma rápida, segura y eficaz.

  6. Estresse em mulheres com Diabetes mellitus tipo 2

    OpenAIRE

    Lessmann, Juliana Cristina; Silva, Denise Maria Guerreiro Vieira da; Nassar, Silvia Modesto

    2011-01-01

    OBJETIVO: O objetivo do estudo foi investigar a relação entre estresse e Diabetes Mellitus Tipo 2 em mulheres. MÉTODO: Estudo transversal prospectivo, desenvolvido com 147 mulheres, utilizando a Escala de Estresse Percebido (PSS). RESULTADOS: Houve associação entre as variáveis testadas, sendo possível inferir que as mulheres com estresse elevado são as que vivenciaram sofrimento e apresentam controle glicêmico alterado, ou seja, com valores superiores a 180 mg/dL. A maioria relatou sofriment...

  7. Diabetes tipo 2 y obesidad leve: tratamiento quirúrgico

    OpenAIRE

    Lanzaren S,Enrique

    2013-01-01

    Introducción: En la actualidad la diabetes mellitus tipo 2 (DM2) y la obesidad representan un serio problema de salud, comportándose como enfermedades epidémicas. Existe un gran interés en explorar distintas opciones de tratamiento de la DM2 en pacientes que no tienen obesidad mórbida. Objetivo: Reportar los parámetros de control glicémico en pacientes con DM2 y obesidad leve sometidos a bypass gástrico (BPG) a 3 años de seguimiento. Metodología: Estudio clínico prospectivo que incluye pacien...

  8. Tipos de Tiempo en el periodo de Semana Santa Vallisoletana.

    OpenAIRE

    Miranda Martín, Javier

    2017-01-01

    El propósito del proyecto es el análisis y la caracterización de ciertos tipos de tiempo a partir de los datos observados de la Base de Datos Climatológica del Observatorio de Valladolid. Los datos analizados corresponden a los ocho días de Semana Santa de un periodo de 37 años que comprenden entre los años 1981 y 2017. Grado en Geografía y Ordenación del Territorio

  9. Atrofia muscular espinal tipo 1: enfermedad de Werdnig-Hoffmann

    OpenAIRE

    Zárate-Aspiros, Romeo; Rosas-Sumano, Ana Beatriz; Paz-Pacheco, Alberto; Fenton-Navarro, Patricia; Chinas-López, Silvet; López-Ríos, José Antonio

    2013-01-01

    Introducción. Las atrofias musculares espinales de la infancia son enfermedades neuromusculares hereditarias, autosómicas, recesivas, caracterizadas por la degeneración de las neuronas motoras del asta anterior de la médula espinal. La atrofia muscular espinal tipo I (enfermedad de Werdnig-Hoffmann) es la forma más severa. Se inicia in útero o durante los primeros meses de vida. La muerte suele ocurrir antes de los dos años de edad. Caso clínico. Lactante de 6 meses de edad que ingresa al Ser...

  10. Fundamentos del Tipo de Cambio Real en Chile

    OpenAIRE

    Rodrigo Cerda; Alvaro Donoso; Aldo Lema

    2003-01-01

    Un modelo basado en la relación gasto-producto (efecto Salter-Swan) y los términos de intercambio, habría predicho un incremento más pronunciado del tipo de cambio real (TCR) en Chile durante la segunda mitad de los '80, una caída menos acentuada entre 1990 y 1997, y un aumento más fuerte a partir de 1998 cuando irrumpió la crisis financiera internacional. Este trabajo incorpora en forma exhaustiva otros factores en la determinación de largo plazo del TCR, tanto de oferta como de demanda. Usa...

  11. Propiedades y aplicaciones de piezocomposites tipo címbalo

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    Ochoa, P.

    2001-08-01

    Full Text Available The metal-ceramic composite actuators, moonies and cymbals consist in capped piezoceramic disks with metallic endcaps having cavities inside. These cavities favour the amplification of direct and reverse piezoelectric effects. These actuators fill the gap between high displacement low generative force bimorph actuators and low displacement high generative force multilayer ceramic actuators. The moonie actuator can give displacements greater than 100 mm, maximum generative force of 3N to several N´s, response time of 20 to 100 ms, and low fatigue test response for more than 107 cycles. Cymbals actuators shows twice as big as displacement than moonie for the studied size, much higher generative force and the possibility to avoid the temperature dependence of the displacement for selected materials. Properties of cymbal actuators can be tailored trough the selection of materials. Also, cymbal actuators can be tuned to adopt different resonance frequencies.

    Los composites metal-cerámica tipo luna y címbalo consisten en discos piezoeléctricos encapsulados con cápsulas metálicas que poseen una cavidad. Esta cavidad favorece la amplificación de los efectos piezoeléctricos directo e inverso. Estos actuadores llenan el escalón entre actuadores multicapa, con desplazamientos pequeños y fuerzas generativas elevadas, y actuadores bimorfos, con desplazamientos grandes y fuerzas generativas pequeñas. El actuador tipo luna alcanza desplazamientos de más de 100mm, fuerzas generativas máximas de hasta varios N´s, tiempos de respuesta desde 20 hasta 100ms, y baja respuesta en ensayos de fatiga a más de 107 ciclos. Los actuadores tipo címbalo muestran desplazamientos dos veces mayores que los obtenidos con actuadores tipo luna para el mismo tamaño, fuerzas generativas mucho mayores y la posibilidad de eliminar la dependencia del desplazamiento con la temperatura mediante selección de los materiales. Además poseen unas caracter

  12. Apoyo social y condiciones de vida de adultos mayores que viven en la pobreza urbana en México Social support and living conditions in poor elderly people in urban Mexico

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    Blanca Estela Pelcastre-Villafuerte

    2011-03-01

    Full Text Available El objetivo del artículo fue analizar el apoyo social y las condiciones de vida de adultos mayores en zonas urbanas empobrecidas. Estudio cualitativo con 8 grupos focales, realizado en Guerrero, Jalisco, Morelos y Sinaloa, México, durante 2005-2006. Participaron 40 varones y 63 mujeres. El principal apoyo para la vida cotidiana y la condición de salud de los adultos mayores proviene de los familiares cercanos, en algunos casos de vecinos. Los apoyos de los adultos mayores son básicamente materiales y económicos, así como cierto tipo de acompañamiento y traslado a consultas médicas. El apoyo emocional es mínimo o inexistente, igual la compañía cotidiana y la integración en la vida familiar. Se identificó una ausencia significativa de apoyo por parte del gobierno o de organizaciones religiosas o civiles. La familia continúa siendo la fuente fundamental de apoyo. Es necesario incrementar las acciones gubernamentales para la población adulta mayor y transformar la idea de que las necesidades de esta población es una responsabilidad individual más que colectiva.The aim of this paper was to analyze social support and living conditions among poor elderly people in Mexican cities. A qualitative study with eight focus groups was carried out in Guadalajara, Cuernavaca, Chilpancingo, and Culiacan, Mexico, in 2005. Forty men and 63 women participated in the study. The main support for the elderly in daily living came from their immediate family and in some cases from neighbors. Social support was basically material and economic, in addition to providing company and transportation for medical appointments. Daily emotional support, companionship, and social inclusion were minimal or absent. The study identified a significant lack of support from government and religious or civil society organizations. The family is still the main source of support for the elderly. Increased government collaboration is dramatically needed to combat the

  13. Características del consumo de medicamentos de venta libre en una población de adultos de la ciudad de Medellín (Colombia

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    Gloria Inés Martínez-Domínguez

    2013-01-01

    Full Text Available Objetivos: Describir las características del consumo de medicamentos de venta libre en una población de adultos de la ciudad de Medellín (Colombia. Materiales y métodos: En 2011 se realizó un estudio descriptivo de tipo trasversal. Se tomó una muestra por conveniencia de 351 personas de población general que asistieron a actividades de capacitación en una institución universitaria de Medellín. Después de aceptar el consentimiento informado verbal, los participantes respondieron una encuesta adaptada del instrumento para la realización de estudios de utilización de medicamentos de prescripción y consumo del Ministerio de la Protección Social. Resultados: La prevalencia anual de consumo de medicamentos no prescritos por un médico fue de 73 % y la mensual de 55 %. Los principales síntomas que motivaron el consumo fueron: dolor de cabeza (64.4 % y síntomas gripales (40.5 %. El consumo de medica- mentos para el tratamiento de los síntomas referidos anteriormente se hizo principalmente por automedicación (64 %. Los criterios para consumir o comprar un medicamento son: la recomendación médica (77 %, el precio, la experiencia de uso (76 % cada uno y la publicidad (22 %. Las fuentes de información sobre los medicamentos más utilizadas son el médico (73 %, la internet (44 % y el farmaceuta (43 %. Conclusión: La automedicación es una práctica frecuente en los participantes de este estudio. Los criterios importantes para el consumo o compra de un medicamento son: la experiencia personal previa, la publicidad y la promoción farmacéutica.

  14. Inclusión digital de los estudiantes adultos que acceden a la universidad: análisis de sus actitudes y competencias digitales

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    M. Teresa PADILLA-CARMONA

    2016-09-01

    Full Text Available Esta investigación se propone identificar las actitudes y competencias de los estudiantes adultos en relación con el uso de las TIC, con especial atención al uso de plataformas digitales de aprendizaje y redes sociales (Web 2.0. Asimismo, evalúa la incidencia de algunas variables sociodemográficas (género y edad en el uso estas herramientas y en la autopercepción de los estudiantes sobre sus competencias digitales. Se ha realizado un estudio tipo encuesta con una muestra de 382 estudiantes que acceden a la Universidad de Sevilla a través de las vías establecidas para mayores de 25, de 40 y 45 años. Los resultados ponen de manifiesto una actitud generalmente positiva ante las TIC que puede calificarse como de pragmática, ya que estas herramientas se valoran positivamente en función de sus potenciales beneficios en los procesos de aprendizaje. Se constata a la vez que no han recibido formación específica en el uso de las TIC. El nivel de competencia que este alumnado percibe tener en el uso de estos recursos es medio-bajo. Además, el grupo de estudiantes mayores de 45 años se considera menos competente que los mayores de 25 y de 40 años. En consecuencia, se realizan algunas propuestas para mejorar la participación de los estudiantes maduros en la enseñanza universitaria.

  15. Cuadro clínico patológico y factores pronósticos de sobrevida en adultos con sarcomas de partes blandas

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    Juan Díaz-Plasencia

    1997-10-01

    Full Text Available Objetivo: Identificar el cuadro clínico - patológico y algunos factores pronósticos que influyen en la sobrevida actuarial a 5 años. Material y métodos: Analizamos retrospectivamente información de 44 adultos portadores de sarcomas de partes blandas tratados en el Hospital Belén, Perú, desde 1967 a 1994. La estimación de la sobrevida fue hecha por el método de Kaplan - Meier y en el análisis univariado utilizamos el test de log - rank. Resultados: La edad promedio fue de 46 ± 19 años (límites, 16 a 85 años. Hubo 21 hombres y 23 mujeres (H:M, 0,9:1. Las molestias más frecuentes fueron tumor y dolor local. Las localizaciones más afectadas fueron las extremidades inferiores (52% y superiores (21%. De acuerdo a la clasificación UICC, 48% de los casos estuvieron en estadio II. 23 % en estadio III, 18 % en estadio IV y 11 % en estadio I. Los tipos histológicos predominantes fueron: Fibrosarcoma (34 %, liposarcoma (16 % y rabdomiosarcoma (14 %. Trece tumores (30 % fueron clasificados como grado 3, 24 (55% como grado 2 y 7 (16 % como grado 1. La sobrevida a 5 años fue de 54 % con cirugía sola (n=27, 11 % con cirugía más radioterapia y/o quimioterapia (n=13 y 0% con radioterapia y /o quimioterapia (n=4 (p< 0.01. La sobrevida a 5 años en la serie total fue 38 %. Fueron factores que influyeron en la sobrevida: Edad (p< 0.001, tiempo de enfermedad (p <0.001, estado ganglionar regional (p <0.001, grado histológico (p < 0.01, estadio clínico (p <0.001 y tipo de tratamiento (p <0.001. Conclusión: El tratamiento de elección para los sarcomas de partes blandas es la cirugía de amplio margen. (Rev Med Hered 1997; 8: 129-141.

  16. TERMOMETRIA TIMPÂNICA E TEMPORAL NA AVALIAÇÃO DA HIPOTERMIA NO INTRAOPERATÓRIO DE CIRURGIA ABDOMINAL EM ADULTOS

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    Rutes de Fatima Terres Danczuk

    2016-01-01

    Full Text Available Objetivo: analizar la asociación entre las características sociodemográficas, clínicas, operatorias y ambientales con la ocurrencia de hipotermia medida por medio de termómetros timpánicos y temporales, en pacientes adultos en el trans-operatorio sometidos a cirugías abdominales electivas con exposición visceral. Métodos: estudio observacional, prospectivo, cuantitativo, correlacional. Los datos fueron recolectados mediante instrumento estructurado conteniendo las variables: edad; Índice de Massa Corporal; clasificación American Society of Anesthesiologists ; tipo de anestesia; tiempo de la cirugía; temperatura timpánica y temporal; temperatura y humedad relativa a la sala quirúrgica. Fueron medidas las temperaturas por los métodos de afección timpánico y temporal en 63 pacientes. En el análisis de los datos se buscó la asociación de la hipotermia con las características de los pacientes, del tipo de anestesia, del ambiente quirúrgico segundo el método de afección y del tiempo quirúrgico. Resultado: de los 63 pacientes, 15 (23,8% presentaron hipotermia. Del total (n=15; 100% de pacientes hipotérmicos, 13 (80% presentaron hipotermia leve. La hipotermia moderada fue identificada apenas por la termometría temporal, en tres (20% pacientes. No hubo hipotermia grave y en dos (13,3% pacientes a la hipotermia ocurrió apenas en la medida de la termometría temporal. En la relación de las variables, identificación que la hipotermia tuvo asociación estadísticamente significante solamente con la edad (p=0,0027 y el sexo (p=0,015, en la afección de la temperatura timpánica. Conclusión: apenas el sexo y la edad interfirieron en la hipotermia en el trans-operatorio por la termometría timpánica y ninguna variable influenció por la termometría temporal.

  17. Diabetes mellitus tipo 2 y resistencia a la insulina

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    Enrique Cipriani-Thorne

    2010-07-01

    Full Text Available Se analizó la literatura de los últimos 15 años para poder objetivar los temas que son materia de esta comunicación. En primer lugar se analiza en qué consiste el llamado Síndrome Metabólico, sus características; a continuación se resume la historia natural de la Diabetes Mellitus tipo II y su patogenia. Se revisa la importancia de la resistencia a la insulina en el músculo estriado principal órgano de combustión de la glucosa y el factor mitocondrial de la resistencia a la insulina. Se analiza además la importancia de resistencia a la insulina con respecto al metabolismo del hígado y en particular a las alteraciones del metabolismo del colesterol y de los triglicéridos. Se hace un comentario extenso de cómo así la Diabetes Mellitus Tipo II es considerada en la actualidad como una enfermedad de origen inflamatorio y por último se discuten las consecuencias de la hiperinsulinemia, dado que el exceso de insulina es producido por el bloqueo en la línea metabólica de su acción más no en su línea de producir proliferación tisular.(Rev Med Hered 2010;21:160-170.

  18. INCIDENCIA DEL TIPO DE PROGRAMA DE ACTIVIDAD FÍSICA EN LA CONDICIÓN FÍSICA DE MUJERES ADULTAS

    Directory of Open Access Journals (Sweden)

    J. P. Núñez Roca

    2010-10-01

    Full Text Available

     

    El objetivo de nuestro estudio es comprobar la influencia de un programa de actividad física en la condición física de mujeres adultas (fuerza del tren superior e inferior, equilibrio estático, consumo máximo de oxígeno y la movilidad articular de tronco y ver si el tipo de programa condiciona la mejora de las variables analizadas. La muestra la componen 20
    mujeres de 30-50 años, formando un grupo de n =10 para la actividad de natación y un grupo de n =10 para la actividad de mantenimiento. Los programas de actividad física de mantenimiento y natación de 2 sesiones semanales, son suficientes para mantener la condición física general, pero no para mejorarla significativamente. El programa de actividad física de natación, produce incrementos significativos en el consumo máximo de oxigeno en
    las mujeres de mediana edad (30-50 años.
    PALABRAS CLAVES: natación, mantenimiento, adultos, condición física.

  19. O acesso a informacao sobre higiene bucal e as perdas dentarias por carie entre adultos

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    Desiree Sant'Ana Haikal

    2014-01-01

    Full Text Available Objetivou-se testar a associação entre perdas dentárias por cárie (PDC e variáveis relativas ao acesso a informações em saúde bucal. Foram analisados dados de 780 adultos (35-44 anos participantes de um estudo epidemiológico. A variável dependente foi o total de PDC e as independentes foram reunidas em blocos de variáveis: demográficas e socioeconômicas; utilização dos serviços odontológicos; acesso a informações em saúde bucal (informações sobre como evitar problemas bucais, sobre higiene bucal e sobre dieta e; comportamentais. Conduziu-se regressão linear múltipla hierarquizada. O número médio de PDC foi de 7,03 (EP= 0,31 e 83% dos adultos haviam perdido algum dente por cárie. As PDC foram maiores entre os mais velhos, os com menor escolaridade, as mulheres, os que raramente ou nunca receberam informações sobre higiene bucal, os que escovavam os dentes uma vez ou menos ao dia e entre os que não usavam fio dental. Adultos que raramente/nunca receberam informações dos serviços odontológicos sobre higiene bucal perderam 2,15 dentes a mais por cárie que aqueles que sempre/frequentemente receberam tais informações (p = 0,000. Assim, sugere-se que a garantia do acesso à informação deva ser incentivada a fim de contribuir com maior equidade em saúde bucal.

  20. Diferencias relacionadas con la salud de mujeres y hombres adultos mayores

    Directory of Open Access Journals (Sweden)

    Ileana E Castañeda Abascal

    Full Text Available Introducción: la humanidad se enfrenta a la elevación del número de ancianos(as. Cuba no es una excepción. La salud en ancianos(as es diferente, debido a los factores biológicos, psicológicos y culturales a que están expuestos a lo largo de la vida, de ahí la necesidad de su estudio. Objetivos: identificar las diferencias relacionadas con la salud de mujeres y hombres adultos mayores en el área de salud Cuatro Caminos, durante el año 2009. Métodos: se realizó una investigación descriptiva y transversal. El universo estuvo constituido por los 1 562 ancianos (761 mujeres y 801 hombres residentes en el área de salud Cuatro Caminos. La información se recolectó a través de los registros de adultos mayores, hojas de cargo de los consultorios médicos de la familia, y una entrevista semiestructurada aplicada a la totalidad del universo. Resultados: las edades más representadas para ambos sexos estuvieron entre 60 y 79 años. Tanto mujeres como hombres padecían enfermedades crónicas, destacándose la hipertensión arterial. Las féminas fueron más frecuentes en los ancianos frágiles y en estado de necesidad. Los ancianos solos fueron mayoritariamente hombres. Las mujeres se realizaron más los exámenes periódicos de salud y recibieron atención domiciliaria. Conclusiones: la salud, las actividades que realizan y la atención geriátrica son diferentes en mujeres y hombres adultos mayores.

  1. Calidad de vida en adultos mayores del hogar de ancianos del municipio Cruces

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    María del Carmen Corugedo Rodríguez

    Full Text Available Introducción: el proceso de envejecimiento es un hecho relevante para todos los sistemas de salud en el mundo debido a la transición demográfica. Cuba no está exenta de esta realidad, por lo que la calidad de vida del adulto mayor es un tema de gran importancia. Objetivo: caracterizar la calidad de vida percibida en los adultos mayores del Hogar de Ancianos del municipio Cruces. Métodos: se realizó un estudio observacional descriptivo de corte transversal durante el periodo de febrero de 2012 a febrero de 2013. El universo estuvo constituido por los 28 ancianos que viven en el hogar de ancianos del municipio Cruces. La información se obtuvo con la aplicación de la Escala M.G.H. Se aplicaron técnicas estadísticas. Resultados: de forma general los ancianos perciben baja calidad de vida, independientemente de las variables sociodemográficas (edad, sexo y nivel de escolaridad. La dimensión de resultados más bajos fue la satisfacción por la vida. El 82 % de los adultos mayores perciben una baja calidad de vida en relación con la misma, seguida por la dimensión socioeconómica. Conclusiones: casi todos los ancianos de la investigación perciben una baja calidad de vida, debido al predominio de estados de displacer y pobres vínculos o mala calidad en las relaciones con sus familiares.

  2. Trato digno proporcionado por enfermería en unidades para adultos de un hospital general

    OpenAIRE

    Beltrán López, María Luisa

    2016-01-01

    El trato digno: Es la percepción que tiene el paciente o familiar del trato y atención proporcionada por el personal de enfermería durante su estancia hospitalaria, se mide a través de indicadores de calidad. Objetivo: Analizar el trato digno que proporciona el personal de enfermería a usuarios adultos hospitalizados en unidades de medicina interna y cirugía de un hospital general. Metodología: Estudio descriptivo transversal, realizado en los servicios de cirugías hombres, mujeres, m...

  3. Perfil clínico del adulto mayor atendido ambulatoriamente en un hospital general.

    OpenAIRE

    Casas, Paola; Varela, Luis; Tello, Tania; Ortiz, Pedro; Chávez, Helver

    2012-01-01

    Objetivo: Describir el perfil clínico del adulto mayor atendido ambulatoriamente en un hospital general. Material y métodos: Estudio descriptivo, transversal, realizado a través de encuestas aplicadas a pacientes en la consulta ambulatoria de geriatría del Hospital Nacional Cayetano Heredia (HNCH), entre agosto de 2011 y enero 2012. Resultados: Se evaluaron 290 pacientes, el 69,3% fueron mujeres; el 65,5% tenía entre 60 y 79 años. La hipertensión arterial fue el diagnóstico más frecuente (55,...

  4. Virus de rabia en cultivos de neuronas sensoriales de ratón adulto

    OpenAIRE

    H. Hurtado; Jaime E. Castellanos; R. Pérez

    2000-01-01

    Introducción: Las neuronas sensoriales de los ganglios de la raíz dorsal (GRD) del ratón adulto, son un modelo interesante en el estudio de la infección in vitro por virus de rabia. Su importancia radica puesto que es una de las vías que tiene el virus para llegar a sistema nervioso central. El virus de la rabia usualmente entra por la mordedura de un animal infectado, inicialmente llega al músculo, replicándose localmente, pasa a terminales nerviosas adyacentes, sube a través del sistema ner...

  5. Niveles de bienestar espiritual y de fortaleza relacionados con la salud en adultos mayores

    OpenAIRE

    Martha V. Whetsell; Keville Frederickson; Paulina Aguilera; Juan Luis Maya

    2005-01-01

    Este estudio investigó la relación entre niveles de bienestar espiritual y fortaleza relacionada con la salud en una población mexicana de adultos mayores de 65 años. El proyecto se basó en el Modelo de Adaptación de Roy, el Modelo de Pollock (fortaleza relacionada con la salud) y el de Reed (bienestar espiritual). El diseño fue descriptivo correlacional, la muestra fue probabilística y se hizo al azar. La muestra (n=160) tuvo un nivel de significancia de 0,05 para una di...

  6. Síndrome del cuidador de adultos mayores discapacitados y sus implicaciones psicosociales

    OpenAIRE

    Eliana Dueñas; María Anggeline Martínez; Benjamín Morales; Claudia Muñoz; Ana Sofía Viáfara; Julián A. Herrera

    2006-01-01

    Objetivo: Describir la prevalencia del síndrome del cuidador y las características psicosociales de los cuidadores de adultos mayores discapacitados. Materiales y métodos: Se realizó un estudio piloto de casos y controles en el Valle del Cauca durante el 2003-2004 para evaluar la funcionalidad familiar (APGAR familiar), la ansiedad y depresión (escala de Goldberg), la presencia de enfermedades (cuidadores y no cuidadores), y la prevalencia del síndrome del cuidador (escala de Zarit). Resul...

  7. Síndrome del cuidador de adultos mayores discapacitados y sus implicaciones psicosociales

    OpenAIRE

    Dueñas, Eliana; Martínez, María Anggeline; Morales, Benjamín; Muñoz, Claudia; Viáfara, Ana Sofía; Herrera, Julián A

    2006-01-01

    Objetivo: Describir la prevalencia del síndrome del cuidador y las características psicosociales de los cuidadores de adultos mayores discapacitados. Materiales y métodos: Se realizó un estudio piloto de casos y controles en el Valle del Cauca durante el 2003-2004 para evaluar la funcionalidad familiar (APGAR familiar), la ansiedad y depresión (escala de Goldberg), la presencia de enfermedades (cuidadores y no cuidadores), y la prevalencia del síndrome del cuidador (escala de Zarit). Resultad...

  8. El conocimiento escolar y la educación de adultos: Perspectivas psicológicas

    OpenAIRE

    Mata Benítez, Manuel de La

    1987-01-01

    Se plantea el problema de la falta de transferencia de los aprendizajes escolares a contextos cotidianos extraescolares. Para explicarlo, se baraja el concepto de encapsulación del conocimiento, muy relacionado con el modo en que se enseñan las destrezas básicas en la escuela. Este fenómeno reviste una especial gravedad en el ámbito de la educación de adultos, dadas las características del individuo sujeto de este nivel educativo. Para superar el problema, se propone un enfoque del proceso de...

  9. Estudio epidemiológico de salud oral en adultos. Comunidad Valenciana, 2006

    OpenAIRE

    Eustaquio Raga, Mª Vicenta

    2008-01-01

    RESUMEN En las últimas dos décadas se han venido realizando estudios epidemiológicos de salud oral en adultos en las diferentes comunidades autónomas españolas. Así la ausencia de dicho estudio de ámbito autonómico valenciano justifica plenamente su realización. En la realización del presente estudio nos hemos propuesto como objetivo general el evaluar el estado de salud bucodental de la población adulta y mayor de la Comunidad Valenciana. Se ha diseñado un estudio transversal o de p...

  10. Impacto da alfabetização de adultos sobre salário e emprego

    OpenAIRE

    Rocha, Maúna Soares de Baldini; Ponczek, Vladimir Pinheiro

    2010-01-01

    Neste trabalho apresentamos evidência sobre os efeitos da alfabetização de adultos na renda e probabilidade de empregos dos indivíduos. Os dados longitudinais disponibilizados pela Pesquisa Mensal de Emprego (PME) permitem controlar os efeitos fixos não-observáveis dos indivíduos gerando uma estimação mais robusta e consistente dos efeitos analisados. De modo geral, os resultados deste trabalho indicam retorno de 9,3% em rendimentos para indivíduos que se alfabetizam. Mostramos...

  11. Volumen de grasa visceral como indicador de obesidad en hombres adultos

    OpenAIRE

    Ana I. García; Laura Niño-Silva; Katherine González-Ruiz; Robinson Ramírez-Vélez

    2016-01-01

    Objetivo: Determinar la prevalencia del volumen de grasa visceral estimado por ecuación predictiva en un grupo de adultos de Bogotá, Colombia, además de evaluar la relación de la grasa visceral con factores de riesgo asociados a enfermedad cardiovascular. Materiales y métodos: Estudio transversal en 413 hombres voluntarios del sector educativo y automotriz de Bogotá, Colombia. El volumen de grasa visceral fue estimado por ecuación predictiva y los resultados fueron divididos por terciles d...

  12. Cateterismo diagnóstico en cardiopatías congénitas del adulto

    OpenAIRE

    García Montes,José Antonio

    2006-01-01

    Los métodos no invasivos en la actualidad son de elección para el diagnóstico en pacientes adultos con cardiopatía congénita. La tendencia del cateterismo cardíaco en la actualidad es el tratamiento intervencionista de algunas cardiopatías, sin embargo, en algunos casos, sobre todo en cardiopatías complejas el cateterismo diagnóstico puede ser necesario como complemento de otros métodos no invasivos. La medición de presiones, toma de oximetrías y angiografías continúa siendo fundamental en el...

  13. Curvas de car?ncias nutricionais em adultos quilombolas de ?reas ribeirinhas do baixo Amazonas

    OpenAIRE

    Silva, Lu?sa Margareth Carneiro da

    2013-01-01

    INTRODU??O: A Pol?tica Nacional de Alimenta??o e Nutri??o 2012 assegura: A alimenta??o e nutri??o constituem requisitos b?sicos para a promo??o e a prote??o da sa?de, possibilitando a afirma??o plena do potencial de crescimento e desenvolvimento humano, com qualidade de vida e cidadania . OBJETIVO: Elaborar curvas de car?ncias nutricionais atrav?s da investiga??o das tend?ncias de consumo, padr?o alimentar e nutricional de adultos quilombolas de ?reas ribeirinhas do Baixo Amazonas no Munic?p...

  14. Percepción de algunos estilos de crianza y el episodio depresivo en el adulto.

    OpenAIRE

    Salirrosas-Alegría, Cristopher; Saavedra-Castillo, Javier

    2014-01-01

    Objetivos: Evaluar la relación entre la percepción de algunos estilos de crianza y el episodio depresivo en el adulto. Método: Se trata de un estudio descriptivo y transversal donde se usó la base de datos del Estudio Epidemiológico de Salud Mental de la Costa Peruana que incluyó 6555 personas adultas, relacionando los estilos de crianza con el episodio depresivo mediante pruebas de independencia para muestras complejas, ajustando modelos de regresión logística múltiple. Resultados: Se encont...

  15. La intervención grupal en pacientes adultos con retraso mental

    OpenAIRE

    Avilés, Fabián

    2007-01-01

    La temática principal es plantear cómo se puede trabajar la subjetividad en pacientes adultos, con diferentes niveles de retraso mental, internados como pacientes crónicos en una institución hospitalaria. Se delimita el problema a partir de describir los imaginarios institucionales existentes en el hospital (el profesional y el de las personas que cuidan cotidianamente a los pacientes )y cómo dentro de estas dos formas de pensar a los internados no se contempla el trabajo de la subjetividad d...

  16. Prevalencia de obesidad en adultos del municipio de Soledad (Atlántico, Colombia), 2010

    OpenAIRE

    Edgar Navarro Lechuga; Rusvelt Vargas Moranth

    2012-01-01

    Objetivo: Determinar la prevalencia de obesidad en adultos del municipio de Soledad (Atlántico, Colombia) según diferentes consensos de clasificación. Materiales y métodos: Estudio descriptivo, transversal. Se calculó una muestra de 790 individuos (N=103731; prevalencia esperada: 22%; error: 3%; nivel de confianza: 95%). Previo consentimiento informado, se aplicó una encuesta sobre factores de riesgo cardiovascular, y a los individuos también se les tomó el peso, la talla y el perímetro de ci...

  17. Representaciones sociales del matrimonio en el adulto joven de la ciudad de Santa Marta

    OpenAIRE

    Otero Díaz, Javier

    2017-01-01

    Las representaciones sociales del matrimonio son una construcción social donde se configura el bagaje de conocimientos que tienen las personas sobre el concepto del matrimonio, las cuales establecen desde estas construcciones, una cosmovisión sobre el mundo y ellos mismos. Desde una mirada sistémica este estudio analizó las representaciones sociales que sobre el matrimonio poseen los jóvenes adultos de la ciudad de Santa Marta. Se trató de una investigación cualitativa de diseño fenomenológic...

  18. PACIENTE ADULTO MAYOR Y CIRUGÍA NO CARDÍACA: ¿QUÉ DEBEMOS SABER?

    OpenAIRE

    Nazar J,Claudio; Zamora H,Maximiliano; Fuentes H,Ricardo; Lema F,Guillermo

    2015-01-01

    Los procedimientos quirúrgicos en pacientes adultos mayores son cada vez más frecuentes. Se caracterizan por tener mayor morbimortalidad que los realizados en pacientes más jóvenes, por lo que es esencial una apropiada evaluación preoperatoria, una acuciosa monitorización intraoperatoria y un adecuado manejo del período postoperatorio. La edad conlleva una serie de cambios fisiológicos y una mayor incidencia de enfermedades crónicas, que en conjunto determinan una disminución de las reservas ...

  19. Desarrollo en planta piloto de una bebida de lacto suero y fruta natural para adultos mayores /

    OpenAIRE

    Villarreal Arizpe, Beatriz,

    2017-01-01

    Departament responsable de la tesi: Departament de Ciència Animal i dels Aliments. México es el 18 país a nivel mundial, de los mayores productores de leche, el 55% se destina a la producción de los quesos frescos, el subproducto principal es el lacto suero. Los adultos mayores, ocupan gran porcentaje de los habitantes del país, grupo con alta prevalencia de enfermedades relacionadas con estilos de vida no saludables. La innovación de productos en base a subproductos, con adición de ingred...

  20. Perfil lipídico em pacientes adultos com artrite idiopática juvenil

    Directory of Open Access Journals (Sweden)

    Thelma Larocca Skare

    2013-08-01

    Full Text Available O processo inflamatório articular de uma criança com artrite idiopática juvenil (AIJ pode persistir na vida adulta. A inflamação tem sido ligada a distorções do perfil lipídico e à aterogênese acelerada. Neste trabalho, estudou-se o perfil lipídico de indivíduos adultos com AIJ, comparando-o ao de pessoas saudáveis. Foram recrutados 54 adultos com AIJ (57,3% poliarticular, 37% oligoarticular, 1,9% do subtipo entesítica e 3,7% do subtipo sistêmica e 54 indivíduos saudáveis para comparação de perfil lipídico. Nos adultos AIJ, coletaram-se dados sobre sexo, idade e idade de início da doença, presença de fator reumatoide (FR e fator antinuclear (FAN, HAQ (Health Assessment Questionnaire e tempo de doença. Observou-se que hipercolesterolemia, aumento de LDL e diminuição de HDL foram mais comuns em pacientes com AIJ do que nos controles (com P = 0,016; P < 0,0001 e P = 0,0008, respectivamente. Alterações no colesterol total (CT e no LDL foram mais comuns em indivíduos com início de doença mais tardio (P = 0,0017 para CT e P = 0,023 para LDL. Em todo o grupo de pacientes com AIJ nenhuma outra variável pode ser ligada à dislipidemia tal como presença de FR, FAN, duração de doença e HAQ (P = ns. Concluiu-se que pacientes adultos com AIJ apresentam um perfil lipídico com aumento de CT e de LDL, e diminuição de HDL em relação aos controles. Nenhuma característica clínica pode ser ligada a essa alteração, exceto idade de início da doença.

  1. Estenosis aórtica pura y resonancia magnética en el adulto

    OpenAIRE

    Meave-González, Aloha; Alexánderson, Erick; Hernández-González, Martha A; Siu, Silvia; Soto, Ma. Elena; Solorio, Sergio; Espínola-Zavaleta, Nilda

    2007-01-01

    Objetivos: Evaluar la utilidad de la resonancia magnética cardiovascular (RMC) para la cuantificación del área valvular aórtica en pacientes adultos con estenosis aórtica pura (EA). Método: Estudio transversal comparativo, cegado, en pacientes con estenosis aórtica, sin otra patología valvular asociada, en quienes se realizó ecocardiograma transtorácico bidimensional (ETT) y resonancia magnética. Los resultados se analizaron mediante t de Student, ji cuadrada considerando como significativos ...

  2. Autopercepción de salud general y mortalidad en adultos mayores

    Directory of Open Access Journals (Sweden)

    Ximena Moreno

    2014-05-01

    Conclusiones: Los resultados apoyan los hallazgos previos respecto a que la autopercepción de la salud general negativa predice la mortalidad. Es necesario dilucidar los mecanismos por los que este indicador puede predecir la mortalidad en los adultos mayores, que pueden ser diferentes para hombres y mujeres. Se sugiere investigar el papel de la depresión, considerando que el efecto de la autopercepción de la salud sobre la mortalidad no estaba presente en los estudios que la incluían.

  3. El desarrollo psicosocial de Eric Erikson. El diagrama epigenético del adulto

    OpenAIRE

    Bordignon, Nelso Antonio

    2005-01-01

    This work shows a brief on the psychosocial development theory of Erik Erikson, and the epigenetic diagram of adults. It makes a brief of the content of each psychosocial stage and shows the diagram of adults, according to the VIII stages of the whole life cycle. El trabajo presenta una síntesis de la teoría del desarrollo psicosocial de Erik Erikson y el diagrama epigenético del adulto. Hace un resumen del contenido de cada estadío psicosocial y presenta el Diagram...

  4. Marketing esportivo: propostas de ações para o voleibol adulto em Joinville

    OpenAIRE

    Silva, Joffran Guilherme da

    2007-01-01

    Esta dissertação que recebe o nome de Marketing Esportivo - propostas para o voleibol adulto em Joinville, aborda o papel que o esporte desempenha na vida das pessoas e visa demonstrar que, ao longo do tempo, as relações com o mundo empresarial merecem atenção especial. A consulta à literatura demonstrou que o esforço acadêmico evoluiu ao longo dos anos, porém ainda guarda espaço para novos estudos. Este estudo pretende contribuir na definição do marketing esportivo, percorrendo além das fron...

  5. Intervención educativa en adultos mayores con diabetes mellitus en Guatemala

    OpenAIRE

    José Manuel Contreras Tejeda; Arely Díaz Cifuentes; Mayda Díaz Pérez; Aurora Seara Cifuentes

    2014-01-01

    Se realizó un estudio de intervención comunitaria, con el objetivo de incrementar los conocimientos en pacientes diabéticos adultos mayores, pertenecientes al Departamento Alta Verapaz, Cobán, Guatemala; en el período comprendido desde junio de 2011 hasta junio de 2012. El universo de estudio estuvo constituido por los pacientes diabéticos dispensarizados por el médico y la enfermera en el área periférica, conformándose la muestra con 46 de ellos, a los cuales se les evaluó el grado de conoci...

  6. Redução fechada e fixação esquelética externa tipo I para tratamento de fraturas de tibiotarso em pombos domésticos (Columba livia

    Directory of Open Access Journals (Sweden)

    Alievi M.M.

    2002-01-01

    Full Text Available Estudaram-se a redução fechada e a fixação esquelética externa tipo I para o tratamento de fraturas de tibiotarso em 10 pombos domésticos (Columba livia adultos. As aves foram anestesiadas com a associação de xilazina e cetamina e em seguida foi realizada fratura do tibiotarso direito por pressão digital sobre a diáfise do membro. Quatro pinos de Kirschner, dois proximais e dois distais à linha da fratura, foram inseridos percutaneamente através de ambas as corticais ósseas e, após redução fechada da fratura, conectados externamente por uma barra de acrílico autopolimerizável na face lateral do membro. Em três aves foi observado radiograficamente desvio ósseo angular, porém, a função do membro não foi afetada. O tempo médio e o desvio-padrão para a cicatrização óssea foram 23,4± 3,0 dias. Os resultados demonstram que a redução fechada e a aplicação de fixador esquelético externo tipo I é um método efetivo para o tratamento de fraturas de tibiotarso em pombos domésticos (Columba livia.

  7. Homocisteína, acido fólico y vitamina B12 en adultos mayores venezolanos

    OpenAIRE

    Meertens G, Lesbia; Díaz W, Nayka; Solano R, Liseti; Baron, Maria Adela; Rodríguez M, Adelmo

    2007-01-01

    Los cambios anatomo-fisiológicos propios del envejecimiento hacen de los adultos mayores un grupo vulnerable a los estados de malnutrición y deficiencias específicas de nutrientes como la vitamina B12 y el folato. El objetivo de este estudio fue establecer la relación existente entre la vitamina B12, folato, homocisteína y el consumo y adecuación de estos nutrientes. Se evaluaron 55 adultos mayores de 60 años de edad, de ambos sexos, no institucionalizados, a quienes se les determinó homocist...

  8. Salud oral y déficit nutricional en adultos mayores no institucionalizados en Londrina, Paraná, Brasil

    OpenAIRE

    Mesas,Arthur Eumann; Andrade,Selma Maffei de; Cabrera,Marcos Aparecido Sarria; Bueno,Vera Lúcia Ribeiro de Carvalho

    2010-01-01

    OBJETIVO: Examinar la asociación entre el déficit nutricional y problemas de salud oral en adultos mayores no institucionalizados de una comunidad en Brasil. MÉTODOS: En este estudio transversal fueron obtenidos datos de 267 adultos mayores (160 mujeres y 107 hombres) con edad entre los 60 y 74 años provenientes del censo del área de cobertura de un Equipo del Programa Salud de la Familia de Londrina, Brasil. El déficit nutricional fue identificado con la Mini Evaluación Nutricional (< 24 pun...

  9. El sufrimiento del adulto abusado sexualmente en la infancia. Una aproximación clínica

    Directory of Open Access Journals (Sweden)

    Liudmila Santana Romero

    Full Text Available La clínica con los adultos abusados sexualmente en la infancia, pudiera ser una de las líneas de investigación de mayor importancia en los estudios sobre Abuso Sexual Infantil (ASI. Su abordaje es relevante no sólo en el tratamiento del paciente adulto que sufre, sino que hecha luz sobre el conocimiento de las consecuencias a largo plazo del ASI. Estos temas son abordados empírica y teóricamente en este trabajo ilustrado a través de tres casos clínicos.

  10. Conocimiento sobre el maltrato al adulto mayor por un grupo de ancianos del Policlínico Bernardo Posse

    OpenAIRE

    Martínez Muñoz, Lidiana; Cruz Sánchez, Leticia; Martínez Iglesias, Ivonne; González Carrodeguas, Kenia; Terry Pérez, Emilio

    2013-01-01

    Introducción: la violencia contra el adulto mayor es un fenómeno mundial que también afecta a los hogares cubanos. Las personas comentan, acerca del maltrato infantil y el maltrato femenino pero se olvidan del maltrato que sufren los ancianos en el vecindario, en las instalaciones de salud y en los hogares, en la actualidad. Objetivo: valorar el conocimiento que posee un grupo de adultos mayores, correspondientes a tres consultorios médicos del Policlínico Bernardo Posse, sobre la violencia a...

  11. O marketing dos «social media» na perspetiva do consumidor pré-adulto

    OpenAIRE

    Simões, Dora; Filipe, Sandra

    2014-01-01

    O objetivo deste estudo é avaliar a utilização e recetividade do marketing dos social media por pré-adultos, partindo de um estudo de caso de estudantes de diferentes cursos de uma instituição de ensino superior portuguesa. Os dados foram recolhidos através da disponibilização de um questionário online e foram analisados estatisticamente. Os principais resultados mostram que os pré-adultos são fãs de várias marcas, apesar de não as seguirem continuamente ou seguirem apenas aquelas nas quais e...

  12. Aspectos biopsicosociales que inciden en la salud del adulto mayor Bio-psycho social aspects shattering elderly health

    OpenAIRE

    Aida Chong Daniel

    2012-01-01

    El presente trabajo trata acerca de algunos factores biosicosociales que inciden en la salud del adulto mayor, se parte del concepto de que el envejecimiento no es un proceso de causa única, sino el resultado de una compleja asociación de interacciones y modificaciones estructurales y funcionales, entre lo biológico, lo psicológico y lo socio-ambiental. Teniendo en cuenta estos elementos el objetivo de este trabajo es exponer algunos aspectos que inciden en la salud del adulto mayor, para que...

  13. Vivências em espaços educativos: constituição de identidades homossexuais em homens adultos

    OpenAIRE

    Cechin, Andréa Forgiarini

    2006-01-01

    Esta pesquisa problematiza a relação entre a constituição das identidades homossexuais de homens adultos e suas vivências em espaços educativos formais, não formais e informais. Como ponto de partida para desenvolver o estudo, foram formuladas questões que focalizam percepções e sentimentos desses homens adultos em relação a si próprios e aos outros, tendo em vista suas vivências nesses espaços educativos e, especialmente, suas experiências de discriminação e resistência. Apoia-se teoricament...

  14. Reminiscencia en adultos mayores no institucionalizados de República Dominicana: seguimiento de una intervención

    OpenAIRE

    Fortuna Terrero, Flor Berenice

    2016-01-01

    Es de interés tener en cuenta los aspectos que influyen en la calidad de vida del adulto mayor y como optimizar su desarrollo. Es por ello que surgen intervenciones no farmacológicas que pretende facilitar la adaptación del adulto mayor a los cambios que se producen tanto a nivel intrapersonal como en los diferentes contextos de desarrollo donde el sujeto interactúa, suministrándole mecanismos para que adquieran estrategias compensatorias que les ayuden a dar respuestas eficaces ante las dema...

  15. Autopercepção da mastigação e fatores associados em adultos brasileiros

    OpenAIRE

    Ana Paula Gasparini Braga

    2011-01-01

    INTRODUÇÃO: A mastigação é uma das funções mais importantes do sistema estomatognático, relaciona-se: à nutrição, ao crescimento e desenvolvimento craniofacial, à maturação da musculatura orofacial, à estabilidade oclusal e à estabilidade da articulação temporomandibular. Existem poucos estudos populacionais sobre o tema em adultos. OBJETIVOS: Estimar a prevalência da autopercepção da mastigação como boa, regular e ruim em adultos brasileiros e investigar os fatores associados à autopercepção...

  16. KYNA analogue SZR72 modifies CFA-induced dural inflammation- regarding expression of pERK1/2 and IL-1β in the rat trigeminal ganglion

    DEFF Research Database (Denmark)

    Lukács, M; Warfvinge, K; Kruse, L S

    2016-01-01

    modify the neurogenic inflammatory response in the trigeminal ganglion. METHODS: Inflammation in the trigeminal ganglion was induced by local dural application of Complete Freunds Adjuvant (CFA). Levels of phosphorylated MAP kinase pERK1/2 and IL-1β expression in V1 region of the trigeminal ganglion were...... investigated using immunohistochemistry and Western blot. FINDINGS: Pretreatment with one dose of SZR72 abolished the CFA-induced pERK1/2 and IL-1β activation in the trigeminal ganglion. No significant change was noted in case of repeated treatment with SZR72 as compared to a single dose. CONCLUSIONS......: This is the first study that demonstrates that one dose of KYNA analog before application of CFA can give anti-inflammatory response in a model of trigeminal activation, opening a new line for further investigations regarding possible effects of KYNA derivates....

  17. formales o categorías tipo interfase?

    Directory of Open Access Journals (Sweden)

    Julio Alfonso Piña López

    2011-01-01

    Full Text Available Se analiza la relación entre los fenómenos básicos y los fenómenos del desarrollo y la personalidad, en términos de si los primeros deberían concebirse como condición de existencia necesaria y suficiente de los segundos, y, a su vez, si los unos y los otros lo son de los últimos. Se concluye que dependiendo de cómo se plantee dicha relación, es que eventualmente tendrá sentido la construcción de teorías formales sobre el desarrollo y la personalidad, o bien caracterizar ambos fenómenos como categorías tipo interfase con fines de predicción.

  18. Terapêutica da diabetes mellitus tipo 1

    OpenAIRE

    Antunes, Ana Luisa Lopes

    2009-01-01

    Introdução: Diabetes Mellitus (DM) é uma doença metabólica de etiologia múltipla caracterizada por hiperglicemia crónica com distúrbios no metabolismo dos hidratos de carbono, lípidos e proteínas, por deficiências na secreção e/ou acção da insulina. A descoberta da insulina em 1921, foi um grande marco na sua terapêutica, aumentando a esperança e qualidade de vida dos doentes, nomeadamente na DM tipo 1. Tornou-se um fármaco salvador de vidas (life saving). A primeira a ser comercializad...

  19. Tipo abstracto de datos "Biblioteca" Library Abstract data type

    Directory of Open Access Journals (Sweden)

    Silvana Temesio Vizoso

    2010-12-01

    Full Text Available Análisis de la descripción bibliográfica desde un punto de vista conceptual a partir de la especificación formal: tipo abstracto de datos "biblioteca". Se detallan otros abordajes usando el modelo entidad-relación y el lenguaje XML. Se concluye la relevancia del enfoque abstracto y su aplicabilidad genérica en un sujeto de cambio permanente.Analysis of bibliographic description from a conceptual point of view from the formal specification: "library" abstract data type. Other approaches are detailed using the entity-relationship model and XML language. We conclude the relevance of abstract approach and its general applicability in a subject of constant change.

  20. Tipos de socialización y desesperanza aprendida

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    Sandro Macassi

    1988-12-01

    Full Text Available Las nociones de alienación, falta de poder y desesperanza aprendida son revisadas. Sesenta obreros de una empresa limeña fueron evaluados en términos del tipo de socialización dominante (SD y desesperanza aprendida (DA en sus tres áreas: falta de motivación, falta de control y expectativas de no-control en el futuro. Las escalas SD y DA resultaron consistentes. El análisis de regresión múltiple con las variables grado de división del trabajo, el grado de instrucción y –en migrantes- edad de arribo y permanencia en la capital, evidenció que el único predictor de DA es el grado de instrucción, correlacionándose negativamente. Los resultados se discuten a la luz de la realidad peruana.