The constant updating in the field of liver transplant led to the holding of the III Consensus Meeting of the Spanish Liver Transplant Association. Three current topics of great clinical interest ...were debated during this meeting; transplant in patients with liver cirrhosis due to hepatitis C, live donor liver transplant and the evaluation of the quality of liver grafts. A subject of great interest to Liver Transplant Units was also discussed: the assessment of their quality.
Surgical care holds significant importance in healthcare, especially in low and middle-income countries, as at least 50% of the 4.2 million deaths within the initial 30 days following surgery take ...place in these countries. The Lancet Commission on Global Surgery proposed six indicators to enhance surgical care. In Colombia, studies have been made using secondary data. However, strategies to reduce perioperative mortality have not been implemented. This study aims to describe the fourth indicator, perioperative mortality ratio (POMR), with primary data in Colombia.
A multicentre prospective cohort study was conducted across 54 centres (hospitals) in Colombia. Each centre selected a 7-day recruitment period between 05/2022 and 01/2023. Inclusion criteria involved patients over 18 years of age undergoing surgical procedures in operating rooms. Data quality was ensured through a verification guideline and statistical analysis using mixed-effects multilevel modelling with a case mix analysis of mortality by procedure-related, patient-related, and hospital-related conditions.
3807 patients were included with a median age of 48 (IQR 32–64), 80.3% were classified as ASA I or II, and 27% of the procedures had a low-surgical complexity. Leading procedures were Orthopedics (19.2%) and Gynaecology/Obstetrics (17.7%). According to the Clavien–Dindo scale, postoperative complications were distributed in major complications (11.7%, 10.68–12.76) and any complication (31.6%, 30.09–33.07). POMR stood at 1.9% (1.48–2.37), with elective and emergency surgery mortalities at 0.7% (0.40–1.23) and 3% (2.3–3.89) respectively.
The POMR was higher than the ratio reported in previous national studies, even when patients had a low–risk profile and low-complexity procedures. The present research represents significant public health progress with valuable insights for national decision-makers to improve the quality of surgical care.
This work was supported by Universidad del Rosario and Fundación Cardioinfantil-Instituto de Cardiología grant number CTO-057-2021, project-ID IV-FGV017.
OBJETIVO: este trabalho tem por finalidade explicitar aspectos microscópicos relevantes da movimentação dentária induzida em murinos quanto aos: (1) diferentes períodos de observação e (2) planos dos ...cortes microscópicos transversais e longitudinais. Os estudos experimentais sobre a movimentação dentária induzida em murinos variam quanto aos períodos e planos de cortes microscópicos, mesmo os trabalhos que utilizam especificamente o modelo de Heller e Nanda, de 1979. Para contribuir (1) na escolha do melhor design experimental de movimentação dentária induzida em murinos em futuros trabalhos, e (2) no aperfeiçoamento dos critérios de análise por outros pesquisadores, propusemo-nos a publicar este artigo. MÉTODOS: Empregaram-se 50 ratos machos Wistar, com 90 dias de vida, submetidos à movimentação dentária induzida por períodos de 3, 5, 7 e 9 dias. Utilizou-se movimento de inclinação mesial no primeiro molar superior esquerdo, com uma força equivalente a 75cN. A análise microscópica qualitativa avaliou os fenômenos teciduais e celulares decorrentes da movimentação dentária induzida, nos diferentes períodos de observação e entre os cortes microscópicos transversais e longitudinais. RESULTADOS: dos fenômenos observados, as áreas hialinas tiveram expressão máxima no período de 5 dias e as reabsorções radiculares apresentaram-se exuberantes e bem demarcadas no período de 9 dias. Nos dois fenômenos, as raízes mais afetadas foram as distais, especialmente a raiz distovestibular. CONCLUSÃO: mediante o delineamento proposto, pode-se sugerir, para futuros trabalhos nesta linha de pesquisa, períodos de análise de 5 a 9 dias e cortes microscópicos transversais.
Se estudiaron 45 pacientes asmáticos adultos de difícil manejo, de más de 5 años de evolución, 37 de ellos esteroide dependientes y 8 no dependientes, con asma alérgica o intrínseca y algunos con ...Infecciones respiratorias recurrentes de predominio viral. Por nefelometría se midieron los niveles séricos de las IgsG, M y A, y por ELISA se determinó la IgE total. Se encontraron 4 pacientes con deficiencia de IgG total, en el grupo de los esteroide dependientes. Mediante ELISA tipo sandwich y con anticuerpos monoclonales específicos para las sub clases de IgG se investigaron los niveles sé ricos de IgG1, 2, 3 y 4. En el 55.6% de los enfermos se encontraron una O más deficiencias de sub clases. No hubo diferencias significativas entre los grupos esteroide y no esteroide dependientes, ni entre los asmáticos alérgicos e intrínsecos, ni entre los con infección recurrente o sin ella. predominó la deficiencia de IgG1; en total el 46.7% de los pacientes tenían deficiencia aislada o combinada de IgG1, el 31.1% de IgG2, el 24.4% de IgG3 y el 17.8% de Igd4. La alta incidencia de deficiencia de sub clases podría deberse a la acción de los esteroides o a una alteración en la regulación de la síntesis de Igs producida por un defecto Inmune primario. Esta deficien cia sería la responsable del comportamiento agresivo de la enfermedad.
We studied 45 adult asthmatic patients with difficult to care disease and who had more than five years of evolution; they suffered from elther allergic or intrinsic asthma and some had experienced recurrent respiratory tract infections. predominantly of viral etiology. Serum levels of IgA, IgG and IgM were measured by nephelometry and total lgE was determined by an Enzyme-Linked immunosorbent Assay (ELISA). Total lgG deficiency was found in four steroid. dependent patients. Serum levels of IgG subclasses 1 to 4 were measured by means of a sandwich-like ELISA with specific monoclonal antibodies. One or more subclass deficiencies were present In 55.6% of the patients. Significant differences were not found between the following groups: steroid and nonsteroid dependent patients; allergic or intrinsic, asthma; and individuals with or without history of infection. IgG 1 deficiency was the most commonly found: It was present in 46.7% of the patients, either as an isolated disorder or combined with alteration of other subclasses. Deficiency of other subclasses was present in the following proportions: 31.1% for IgG2; 24.4% for IgG3 and 17.8 for IgG4. The high incidence of subclass deficiency may be due to steroid action or to primary Immune defects leading to disorders of IgG synthesis. Such situation might be responsible for the aggressive behavior of the disease.
Asma y deficiencia de subclases de IgG Montoya Maya, Fernando; Toro Castaño, María Fabiola; García de Olarte, Diana ...
Iatreia (Medellín, Colombia),
04/1995
Journal Article
Recenzirano
Se estudiaron 45 pacientes asmáticos adultos de difícil manejo, de más de 5 años de evolución, 37 de ellos esteroide dependientes y 8 no dependientes, con asma alérgica o intrínseca y algunos con ...Infecciones respiratorias recurrentes de predominio viral. Por nefelometría se midieron los niveles séricos de las IgsG, M y A, y por ELISA se determinó la IgE total. Se encontraron 4 pacientes con deficiencia de IgG total, en el grupo de los esteroide dependientes. Mediante ELISA tipo sandwich y con anticuerpos monoclonales específicos para las sub clases de IgG se investigaron los niveles sé ricos de IgG1, 2, 3 y 4. En el 55.6% de los enfermos se encontraron una O más deficiencias de sub clases. No hubo diferencias significativas entre los grupos esteroide y no esteroide dependientes, ni entre los asmáticos alérgicos e intrínsecos, ni entre los con infección recurrente o sin ella. predominó la deficiencia de IgG1; en total el 46.7% de los pacientes tenían deficiencia aislada o combinada de IgG1, el 31.1% de IgG2, el 24.4% de IgG3 y el 17.8% de Igd4. La alta incidencia de deficiencia de sub clases podría deberse a la acción de los esteroides o a una alteración en la regulación de la síntesis de Igs producida por un defecto Inmune primario. Esta deficiencia sería la responsable del comportamiento agresivo de la enfermedad.
OBJETIVO: este trabalho tem por finalidade explicitar aspectos microscópicos relevantes da movimentação dentária induzida em murinos quanto aos: (1) diferentes períodos de observação e (2) planos dos ...cortes microscópicos transversais e longitudinais. Os estudos experimentais sobre a movimentação dentária induzida em murinos variam quanto aos períodos e planos de cortes microscópicos, mesmo os trabalhos que utilizam especificamente o modelo de Heller e Nanda, de 1979. Para contribuir (1) na escolha do melhor design experimental de movimentação dentária induzida em murinos em futuros trabalhos, e (2) no aperfeiçoamento dos critérios de análise por outros pesquisadores, propusemo-nos a publicar este artigo. MÉTODOS: Empregaram-se 50 ratos machos Wistar, com 90 dias de vida, submetidos à movimentação dentária induzida por períodos de 3, 5, 7 e 9 dias. Utilizou-se movimento de inclinação mesial no primeiro molar superior esquerdo, com uma força equivalente a 75cN. A análise microscópica qualitativa avaliou os fenômenos teciduais e celulares decorrentes da movimentação dentária induzida, nos diferentes períodos de observação e entre os cortes microscópicos transversais e longitudinais. RESULTADOS: dos fenômenos observados, as áreas hialinas tiveram expressão máxima no período de 5 dias e as reabsorções radiculares apresentaram-se exuberantes e bem demarcadas no período de 9 dias. Nos dois fenômenos, as raízes mais afetadas foram as distais, especialmente a raiz distovestibular. CONCLUSÃO: mediante o delineamento proposto, pode-se sugerir, para futuros trabalhos nesta linha de pesquisa, períodos de análise de 5 a 9 dias e cortes microscópicos transversais.
AIM: This study aims to elucidate the relevant microscopic aspects of induced tooth movement in murines with regard to: (1) different study periods; and (2) transverse and longitudinal directions of microscopic sections. Experimental studies on induced tooth movement in murines use variable study periods and directions of microscopic sections, including those studies that specifically use the model adopted by Heller and Nanda in 1979. This manuscript was prepared in order to contribute to: (1) selection of the best study design for future studies on induced tooth movement in murines, and (2) improve the analysis criteria to be used by other investigators. METHODS: The study was conducted on 50 male Wistar rats with 90 days of age, submitted to induced tooth movement for periods of 3, 5, 7 and 9 days. The maxillary left first molar was submitted to mesial inclination by application of 75cN of force. Qualitative microscopic analysis evaluated the tissue and cellular phenomena secondary to induced tooth movement, at the different study periods and on transverse and longitudinal sections. RESULTS: Among the phenomena investigated, hyaline areas of periodontal ligament were mostly observed at 5 days, and root resorptions were remarkable and well delineated at 9 days. Both phenomena affected mainly the distal roots, especially the distobuccal root. CONCLUSION: Considering the present objective, study periods of 5 to 9 days and transverse microscopic sections may be suggested for future studies on this subject.
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