RESUMEN
We analysed the haemodynamic, metabolic and hormonal status at rest and in response to exercise, in young normotensive women with two hypertensive parents (FH++; n=17; 25.1±4.8 years), one hypertensive parent (FH+; n=18; 24.9±4.1 years) and normotensive parents (FH-; n=15; 25.3±3.8 years). Casual and ambulatorial blood pressure (BP), carotid-femoral pulse wave velocity (PWV) and biochemistry were analysed. BP, nor-epinephrine (NE), epinephrine (EPI), endothelin-1 (ET-1) and nitrite/nitrate (NOx) levels were also analysed during a graded exercise test (GXT). Casual and ambulatorial BP were not different between groups, but PWV was 7.5 and 12.6% higher in FH++ than FH+ and FH-, respectively, and 4.8% higher in FH+ than FH- (P≤0.01). Insulin and insulin-to-glucose ratio were increased in FH++ and FH+ (P<0.05), and low-density lipoprotein (LDL)-cholesterol tended to be higher only in FH++ (P=0.07). FH++ showed higher exercise and recovery diastolic BP and EPI levels, and increased resting, exercise and recovery NE, and ET-1 levels than FH- (P<0.05). FH+ showed only greater resting, exercise and recovery NE, and rest ET-1 (P<0.05). Resting, exercise and recovery NOx were lower in FH++ and FH+ than FH- (P<0.01). Haemodynamic, metabolic and hormonal abnormalities were presented in nonhypertensive young women offspring of hypertensive parents before any increase in BP. Greater abnormalities were observed in women with a strong family history of hypertension (FH++). These results suggest that there is an early vascular, metabolic and hormonal involvement in a familial hypertensive disorder.
Asunto(s)
Biomarcadores/sangre , Presión Sanguínea , Hipertensión/sangre , Hipertensión/fisiopatología , Sistema Nervioso Simpático/fisiopatología , Adulto , Glucemia/análisis , Presión Sanguínea/genética , Monitoreo Ambulatorio de la Presión Arterial , Brasil , Arteria Carótida Común/fisiopatología , Epinefrina/sangre , Prueba de Esfuerzo , Femenino , Arteria Femoral/fisiopatología , Predisposición Genética a la Enfermedad , Humanos , Hipertensión/genética , Insulina/sangre , Lípidos/sangre , Norepinefrina/sangre , Linaje , Medición de Riesgo , Factores de Riesgo , Sistema Nervioso Simpático/metabolismo , Adulto JovenRESUMEN
While many members of the black yeasts genus Cladophialophora have been reported to cause diseases in humans, understanding of their natural niche is frequently lacking. Some species can be recovered from the natural environment by means of selective isolation techniques. The present study focuses on a Cladophialophora strain that caused an interdigital tinea nigra-like lesion in a HIV-positive Brazilian child. The fungal infection was successfully treated with oxiconazole. Similar strains had been recovered from the environment in Brazil, Uruguay and the Netherlands. The strains were characterized by sequencing the Internal Transcribed Spacer (ITS) regions and the small subunit (SSU) of the nuclear ribosomal RNA gene, as well as the elongation factor 1-alpha (EF1alpha) gene. Since no match with any known species was found, it is described as the new species, Cladophialophora saturnica.
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Infecciones Oportunistas Relacionadas con el SIDA/microbiología , Ascomicetos/clasificación , Ascomicetos/genética , Dermatomicosis/microbiología , Infecciones por VIH/complicaciones , Infecciones Oportunistas Relacionadas con el SIDA/tratamiento farmacológico , Antifúngicos/uso terapéutico , Ascomicetos/aislamiento & purificación , Brasil , Preescolar , ADN de Hongos/análisis , Dermatomicosis/tratamiento farmacológico , Femenino , Humanos , Imidazoles/uso terapéutico , Filogenia , Análisis de Secuencia de ADN , Especificidad de la Especie , Resultado del TratamientoRESUMEN
An 8-year-old girl was seen in our outpatient clinic with a history of an angiomatous plaque on the chest since birth. She had complained of pain at the site of the lesion for 1 month. Histopathologic examination and immunohistochemical analysis led to the diagnosis of glomangioma, a rare congenital plaquelike glomus tumor. We review the literature and discuss the clinical presentation and evolution of this rare entity.
Asunto(s)
Tumor Glómico/congénito , Neoplasias Cutáneas/congénito , Actinas/análisis , Niño , Femenino , Tumor Glómico/química , Tumor Glómico/patología , Humanos , Inmunohistoquímica , Piel/patología , Neoplasias Cutáneas/química , Neoplasias Cutáneas/patología , Tórax , Vimentina/análisisRESUMEN
OBJECTIVES: To present the case of a patient with an epidermal nevus since birth and its relationship to neurologic signs and symptoms, emphasizing the importance of cutaneous manifestations as early markers of syndromes involving the Central Nervous System. METHODS: Clinical, radiological and histopathological data were analyzed. RESULTS: We report the case of a boy with an erythematous lesion on the neck and cheek since birth. At 9 months the lesion was velvety and slightly brown in color, with associated hemihypertrophy of the face. After 3 months he was hospitalized for having seizures. Computerized tomography of the brain disclosed hemimegalencephaly ipsilateral to the cutaneous lesions. DISCUSSION: The cutaneous findings can be an indicator of neurologic disease since both tissues have the same embryological origin: the neural crest. Thus, the Pediatrician must recognize these cutaneous signs which appear early in life and characterize some of the Neurocutaneous Syndromes so that a proper diagnosis and follow-up can be made.
RESUMEN
A total of 11 patients with listeriosis wereadmited to the Hospital Emilio Ribas - Säo Paulo, Brasil. The etiology Listeria monocytogenes in 2 Aids and Listeria spp in underlying conditions was established in the other patients. The age ranged from 20 to 60 years old and white: black; male:famele ratio was 3:1 for all them. Acute meningoencephalitis in 11; renal failure in 2; acute respiratory failure, septicemia and AIDS with drug multiform exantema, respectively in 1 were observed. Leukocytosis > 500 cells/mm elevado ao cubo; glucose < 45 mg/dl; protein > 90 mg/dl and Gram-positive rod strains with positive culture to Listeria spp were revealed in the cerebrospinal fluid study. These strains were resistant to betalactamin; colistin; streptomycin and amikacin and sensitive to kanamicin; gentamicin; tetracicline; erytromicin and chloramphenicol. Monotherapy (ampicillin) or associate (ampicillin/chloramphenicol) had not influence on death or improvement during the follow-up of patients. Listeral meningoencephalitis is similar to tuberculosis or other bacterial meningitis include in cerebrospinal fluid chemistries data
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Síndrome de Inmunodeficiencia Adquirida , Listeriosis , Meningoencefalitis/tratamiento farmacológico , Lesión Renal Aguda , Hiperpotasemia , LeucocitosisRESUMEN
UNLABELLED: A total of 112 AIDS and no AIDS cryptococcosis patients admitted at Emílio Ribas Hospital--São Paulo, Brazil, were treated with amphotericin B (AMB) or amphotericin B and 5 fluorocytosine (5FC). Age, race, predisposing and epidemiological factors, respiratory symptoms were evaluated. Goodman tests applied in three patients groups (I, II and III) with associate or unique therapy revealed: 1. prognostic factors: leukocytes ang glucose showed similar response in groups I, II and III and protein spinal fluid after 1.5g/AMB; 2. India ink tests and Cryptococcus culture were often positive until 1.0g/AMB; 3. significant hypokalemia during monotherapy. Hypo and hyperkalemia had similar data in associate therapy; 4. significant difference in adverse reactions often appeared above 0.7g AMB/250g 5FC; 5. early and late death were common in group III (unique) and group I (no AIDS) and III (2.5 to 4.0g) respectively; 6. similar remission and deaths were verified in AIDS/cryptococcosis. CONCLUSIONS: adverse reactions were observed above 0.75g/AMB plus 250g 5FC. Association was important in initial therapy and AMB maintenance permitted late relapses.