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OALib Journal期刊

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Inflamación y Nutrición en la Enfermedad Renal Crónica
Puchulu,MB;
Diaeta , 2011,
Abstract: patients with chronic kidney disease may suffer from a chronic infammatory state reflected by the elevation of infammatory markers as c-reactive protein. there is a strong association between clinical complications, malnutrition and infammation in dialysis patients. the terms malnutrition, infammation and atherosclerosis and malnutrition-infammation complex syndrome (mics) have been proposed to indicate the combination of these conditions in these patients. in dialysis patients the protein-energy malnutrition and the infammation are associated with the increase of morbidity and mortality, including increased risk of cardiovascular disease. the subjective global assessment and the malnutrition-infammation score are two tools for assessing protein-energy malnutrition in hemodialysis patients. intradialytic parenteral nutrition is a strategy for safe and appropriate nutrition intervention.
Inflamación y Nutrición en la Enfermedad Renal Crónica Inflammation and Nutrition in Chronic Kidney Disease
MB Puchulu
Diaeta , 2011,
Abstract: Los pacientes con Enfermedad Renal Crónica pueden padecer un estado inflamatorio crónico reflejado por la elevación de marcadores inflamatorios como la Proteína C Reactiva. Existe una fuerte asociación entre las complicaciones clínicas, la malnutrición y la inflamación en los pacientes en diálisis. Los términos Malnutrición, Inflamación y Aterosclerosis y Síndrome-Complejo de Malnutrición Inflamación han sido propuestos para indicar la combinación de estas condiciones en estos pacientes. En los pacientes en diálisis la Malnutrición Energético-Proteica y la inflamación se asocian con el incremento de la morbilidad y la mortalidad, incluyendo el aumento del riesgo de enfermedad cardiovascular. La Valoración Global Subjetiva y el Score de Malnutrición-Inflamación son dos herramientas de valoración de la malnutrición energético-proteica en los pacientes en hemodiálisis. La Nutrición Parenteral Intradialítica es una estrategia de intervención nutricional segura y conveniente. Patients with Chronic Kidney Disease may suffer from a chronic infammatory state reflected by the elevation of infammatory markers as C-Reactive Protein. There is a strong association between clinical complications, malnutrition and infammation in dialysis patients. The terms Malnutrition, Infammation and Atherosclerosis and Malnutrition-Infammation Complex Syndrome (MICS) have been proposed to indicate the combination of these conditions in these patients. In dialysis patients the Protein-Energy Malnutrition and the infammation are associated with the increase of morbidity and mortality, including increased risk of cardiovascular disease. The Subjective Global Assessment and the Malnutrition-Infammation Score are two tools for assessing protein-energy malnutrition in hemodialysis patients. Intradialytic Parenteral Nutrition is a strategy for safe and appropriate nutrition intervention.
Existe el síndrome metabólico?
Jorge Lerman,Félix Puchulu
Revista Argentina de Cardiología , 2006,
Abstract:
Bioética en la relación equipo de salud-paciente
Espinosa,CV; Menoret,V; Puchulu,MB; Selios,MJ;
Diaeta , 2009,
Abstract: since the decade of the '60s, along with the technical and scientific revolution, changes can be seen in the relationship between health professionals and patients, as the latter are increasingly more aware of their rights as such and vindicate their autonomy. this also affects the traditional paternalistic attitude of the physician. additionally, the relationship has turned from a personal scheme to a multidisciplinary approach, where all members of the health team are involved with equal responsibility. contemporary changes have led health professionals to work under different pressures, which has resulted in a dehumanization of the relationship. this article describes the current situation of the health professional- patient relationship, analyzing the changes and factors involved in said relationship from a bioethical perspective.
Bioética en la relación equipo de salud-paciente Bioethics in the Health Team - Patient Relationship
CV Espinosa,V Menoret,MB Puchulu,MJ Selios
Diaeta , 2009,
Abstract: Desde los a os sesenta, paralelamente a la revolución técnicocientífica, se observan cambios en la relación entre los profesionales de la salud y los pacientes, ya que estos son cada vez más conscientes de sus derechos como tal y hacen valer su autonomía. Esto afecta la tradicional postura paternalista del médico. A su vez, la relación ha mutado de un esquema personal a la relación multidisciplinaria, donde todos los miembros del equipo de salud participan con igual consideración. Los cambios contemporáneos han llevado a que los profesionales de la salud trabajen hoy bajo distintas presiones, observándose en consecuencia, una deshumanización en la relación. El artículo plantea la situación actual de la relación profesional de la salud - paciente, analizando desde una perspectiva bioética los cambios y factores que intervienen en dicha relación. Since the decade of the '60s, along with the technical and scientific revolution, changes can be seen in the relationship between health professionals and patients, as the latter are increasingly more aware of their rights as such and vindicate their autonomy. This also affects the traditional paternalistic attitude of the physician. Additionally, the relationship has turned from a personal scheme to a multidisciplinary approach, where all members of the health team are involved with equal responsibility. Contemporary changes have led health professionals to work under different pressures, which has resulted in a dehumanization of the relationship. This article describes the current situation of the health professional- patient relationship, analyzing the changes and factors involved in said relationship from a bioethical perspective.
Huelga de hambre en adolescentes: un desafío ético para el equipo de salud
Bórquez Polloni,Blanca; Montero Vega,Adela; Riquelme Gajardo,Eduardo; San Martín Toloza,Claudio; Valenzuela Puchulu,Sergio;
Revista de Bioética y Derecho , 2013,
Abstract: in 2011, chile was witnessed for first time the hunger strike as part of a group of young people, including adolescents, who in defense of protecting a right that felt violated, as is the right to education, believed be taken fasting as a pressure mechanism to encourage the government authority negotiations which until then they felt failed. under the eave of the department of bioethics, faculty of medicine, university of chile, the undersigned, regardless of personal conviction about the legitimacy or otherwise of the hh, we have carried out a work still developing, which seeks to reflect on ethical issues and the necessity of provide health professionals guides or guidelines to enable them to meet the care process adolescent striker from their particular development lifecycle.
Genotipificación del gen HLA DQB1 en diabetes autoinmune del adulto (lada)
Caputo,Mariela; Cerrone,Gloria E.; López,Ariel P.; Gónzalez,Claudio; Mazza,Carmen; Cedola,Norberto; Puchulu,Félix M.; Targovnik,Héctor M.; Frechtel,Gustavo D.;
Medicina (Buenos Aires) , 2005,
Abstract: autoimmune diabetes is a complex, multifactorial disease caused by the interaction of genetic and environmental factors. this autoimmune diabetes is commonly manifested in childhood and adolescence with a fast onset (type 1 diabetes, iddm) and it can occur in adult patients with a slow onset with delayed insulin requirement, (latent autoimmune diabetes in adults, lada ). autoimmune diabetes has strong class ii hla association mainly with dqb gene which constitutes the first susceptibility locus. however, association with the 5?ins- vntr and ctla-4 genes has been established. in this study, we analysed the polimorphic allele frequencies of dqb hla gene in 63 lada patients, 70 iddm and 79 control subjects. the hla dqb1 alleles typing was detected through olerup ssptm dq kit using sequence specific primers. we observed a positive association of *0201-*0302 and *0201-*0201 genotypes in both types of diabetic patients compared to the control group (p<0.05). moreover, *0201-*0302 genotype was higher in iddm than in lada (p<0.05). on the other hand, the *0602 protective allele analysis showed a high prevalence in the normal group compared to the diabetic population. in argentina, the most frequent allele of susceptibility in lada and iddm patients was the *0201. summing up, the finding of an increase in the *0201 allele, both in allelic and genotypic frequencies, allows the characterisation of our population of patients, lada and iddm, unlike other populations, in which the most frequent allele is *0302.
Experiencia clínica sobre 37 casos de insulinoma
Diaz,Adriana G.; Lucas,Sabrina; Ferraina,Pedro; Ferraro,Ariel; Puchulu,Felix; Paes De Lima,Andrea; Maselli,María Del Carmen; Gomez,Reynaldo M.; Bruno,Oscar D.;
Medicina (Buenos Aires) , 2006,
Abstract: insulinoma is the most frequent pancreatic islet cell tumor. clinical manifestations include adrenergic and neuroglycopenic symptoms. diagnosis is established through demonstration of inappropriately elevated insulin serum concentrations in the presence of hypoglycemia. the aim of this study is to show our experience in the management of insulinoma. since 1988, 23 women (48 ± 18 years) and 14 men (45 ± 19 years) were studied. seventy three percent of them suffered mainly from neuroglucopenic symptoms while 27% referred adrenergic signs. mean duration of symptoms before diagnosis was 2.7 ± 2 years. mean fasting serum glucose was 32.4 ± 8.7 mg/dl, insulin 38.2 ± 39.7 μu/ml (ria, n= 11) or 23.8 ± 18.1 μu/ml (chemoluminescence, n=26) and c-peptide 1.15 ± 1.60 nmol/l (n=14). twenty one patients developed clinical and/or biochemical hypoglycaemia within 9.0 ± 5.2 hours of supervised fast. preoperative localization was performed in 73% by imaging techniques, arterial calcium stimulation and/or intraoperative ultrasonography and palpation by the surgeon. thirty six patients were operated on by conventional surgery in 25, or laparoscopic approach in 11 cases. in 22 patients, a solitary tumor was excised (61.1%). six cases presented multiple insulinomas. five patients had malignant insulinomas. in one case, a pattern of nesidioblastosis was found and 2 patients presented unspecific findings. in 3 patients another tumour (glucagonoma) was found (1 of them with men 1). one patient was treated with verapamil with good clinical response. mean postoperative follow up was 60.4 ± 59.9 months.
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