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This research communication paper addresses the hypothesis that the use of therapeutic alternatives for mastitis, such as intramammary ozone, can cure the disease with lower costs and without harmful residues for human consumption and without formation of microbial resistance like the ones caused by indiscriminate use of antibiotics in dairy farms. The study was performed in 36 mammary quarters from 12 dairy cows with subclinical mastitis grade three. The experimental units were randomly assigned into four groups and each group received a treatment. Treatments comprised (a) 20 µg/ml ozone gas; (b) 40 µg/ml ozone gas; (c) negative control treatment of 12.5 µg/ml ozonated saline and (d) positive control treatment of 100 mg of cephalexin + 100 mg of neomycin + 10 mg of prednisolone, all by intramammary injection. In all quarters, milk was collected before and after the application of treatments for California mastitis test and evaluation of milk composition, somatic cell count, and bacterial cultures. The results indicated that the use of intramammary ozone did have a therapeutic effect, and whilst this was less than that of antibiotics, ozone does confer some advantages. Treated milk had a good composition, the treatment cost was low, milk withdrawal may not be necessary and there is no risk of antibiotic resistance.
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Antibacterianos , Mastitis Bovina , Ozono , Animales , Bovinos , Femenino , Antibacterianos/administración & dosificación , Antibacterianos/efectos adversos , Antibacterianos/análisis , Recuento de Células/veterinaria , Lactancia , Glándulas Mamarias Animales/microbiología , Mastitis Bovina/microbiología , Mastitis Bovina/terapia , Leche/química , Ozono/uso terapéutico , Ozono/análisisRESUMEN
Background: Acupuncture (AP) has been empirically used to relieve post-canine distemper virus (CDV) infection neurological signs in veterinary clinics. Objectives: This clinical study aimed to investigate the effects of AP combined with electroacupuncture (EA) on neurological function in dogs infected by CDV. Methods: Twenty-four CDV-infected dogs with neurological sequelae were recruited to receive weekly AP/EA sections for 24 weeks. Neurological improvements were assessed before each AP/EA session using a modified scoring system. Data were analyzed using the McNemar test, Friedman test, Fisher's exact test, and Kaplan-Meier curves (p < 0.05). Results: Neurological scores improved from seven to 24 weeks after AP/EA treatment compared with pretreatment scores (p < 0.001). Significant improvements were recorded over time for functional limb recovery, cranial nerve deficits, mental status (p = 0.025 - 0.014), and urinary function (p < 0.001). Myoclonus was improved and entirely reversed in 75% and 25% of the dogs, respectively. At the end of treatment, the proportion of dogs with normal proprioception, posture, hopping (p < 0.001), and superficial pain sensation responses (p = 0.004) was greater than pretreatment values. Conclusion: AP/EA therapy promoted significant neurological recovery in CDV-infected dogs and may be considered within the chronic phase of the disease to improve motor and sensory rehabilitation. However, these results are preliminary and must be confirmed by further investigations.
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Terapia por Acupuntura , Virus del Moquillo Canino , Moquillo , Perros , Animales , Moquillo/terapia , Moquillo/diagnóstico , Terapia por Acupuntura/veterinariaRESUMEN
In this study, polypyrrole nanotubes (PPy-NT) and gold nanoparticles (AuNPs) were electrochemically synthesized to form a hybrid material and used as an electroactive layer for the attachment of proteins for the construction of a high-performance biosensor. Besides the enhancement of intrinsic conductivity of the PPy-NT, the AuNPs act as an anchor group for the formation of self-assembly monolayers (SAMs) from the gold-sulfur covalent interaction between gold and Mercaptopropionic acid (MPA). This material was used to evaluate the viability and performance of the platform developed for biosensing, and three different biological approaches were tested: first, the Avidin-HRP/Biotin couple and characterizations were made by using cyclic voltammetry (CV) and electrochemical impedance spectroscopy (EIS), wherein we detected Biotin in a linear range of 100-900 fmol L-1. The studies continued with folate group biomolecules, using the folate receptor α (FR-α) as a bioreceptor. Tests with anti-FR antibody detection were performed, and the results obtained indicate a linear range of detection from 0.001 to 6.70 pmol L-1. The same FR-α receptor was used for Folic Acid detection, and the results showed a limit of detection of 0.030 nmol L-1 and a limit of quantification of 90 pmol L-1. The results indicate that the proposed biosensor is sensitive and capable of operating in a range of clinical interests.
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Técnicas Biosensibles , Nanopartículas del Metal , Nanotubos , Oro/química , Polímeros/química , Pirroles/química , Ácido Fólico , Biotina , Nanopartículas del Metal/química , Técnicas Biosensibles/métodos , Electrodos , Técnicas Electroquímicas , Límite de DetecciónRESUMEN
Olfactory neuroblastoma, or esthesioneuroblastoma, is an uncommon malignant tumor originating from the neural crest that commonly occurs in the upper nasal cavity. Its ectopic origin is extremely rare, especially when located in the optical pathways. This paper reports the case of a giant ectopic esthesioneuroblastoma of the optic pathways that were surgically treated through a cranio-orbital-zygomatic (COZ) craniotomy with extensive resection, in addition to a literature review. The patient is a 46-year-old female presenting with a 4-month history of visual loss in the left eye. Since she was previously blind in the right eye from a traumatic injury, it was evolving to loss of bilateral vision. Imaging depicted an expansive infiltrating lesion involving the entire path of the right optic nerve, extending to the optic chiasm, cisternal portion of the left optic nerve, bilateral optic tract, and hypothalamus. Investigation of pituitary function was unremarkable. Esthesioneuroblastoma is a rare tumor with poorly defined standard clinical management. Its ectopic presentation makes the diagnosis even more challenging, making it difficult to manage these cases properly. Surgeons should be aware of this rare possibility, as early aggressive treatment is likely to be associated with better results.
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BACKGROUND: On January 23, 2020, China imposed a quarantine on the city of Wuhan to contain the SARS-CoV-2 outbreak. Regardless of this measure, the new infection has spread to several countries around the world. OBJECTIVE: We developed a method to study the dissemination of this infection by airline routes and provide estimations of the time of arrival of the outbreak to different cities. METHODS: Using the Kermack and McKendrick model complemented with diffusion on a graph composed of nodes and edges, we made an analysis of COVID-19 dispersion to other cities by air travel. RESULTS: The estimation was accurate in that it was possible to predict in the middle of February 2020 the arrival of the first outbreak in Mexico, which eventually occurred between March 20 and 30. This estimation was robust with respect to small changes in epidemiological parameters at the other nodes. CONCLUSIONS: The estimation of the time of arrival of the outbreak from its epicenter, allows for a time period to implement and strengthen preventive measures aimed at the general population as well as to strengthen hospital infrastructure and training of human resources. In the present study, this estimation was accurate, as observed from the real data of the beginning of the outbreak in Mexico City up to April 6, 2020.
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Viaje en Avión , Betacoronavirus , Infecciones por Coronavirus/transmisión , Pandemias , Neumonía Viral/transmisión , Enfermedad Relacionada con los Viajes , COVID-19 , China/epidemiología , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Brotes de Enfermedades/prevención & control , Geografía Médica , Humanos , México/epidemiología , Modelos Teóricos , Pandemias/prevención & control , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , SARS-CoV-2 , Factores de Tiempo , Salud UrbanaRESUMEN
ABSTRACT Background: On January 23, 2020, China imposed a quarantine on the city of Wuhan to contain the SARS-CoV-2 outbreak. Regardless of this measure, the new infection has spread to several countries around the world. Objective: We developed a method to study the dissemination of this infection by airline routes and provide estimations of the time of arrival of the outbreak to different cities. Methods: Using the Kermack and McKendrick model complemented with diffusion on a graph composed of nodes and edges, we made an analysis of COVID-19 dispersion to other cities by air travel. Results: The estimation was accurate in that it was possible to predict in the middle of February 2020 the arrival of the first outbreak in Mexico, which eventually occurred between March 20 and 30. This estimation was robust with respect to small changes in epidemiological parameters at the other nodes. Conclusions: The estimation of the time of arrival of the outbreak from its epicenter, allows for a time period to implement and strengthen preventive measures aimed at the general population as well as to strengthen hospital infrastructure and training of human resources. In the present study, this estimation was accurate, as observed from the real data of the beginning of the outbreak in Mexico City up to April 6, 2020.
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Humanos , Neumonía Viral/transmisión , Infecciones por Coronavirus/transmisión , Pandemias/prevención & control , Viaje en Avión , Betacoronavirus , Enfermedad Relacionada con los Viajes , Neumonía Viral/epidemiología , Factores de Tiempo , China/epidemiología , Salud Urbana , Brotes de Enfermedades/prevención & control , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/epidemiología , Geografía Médica , SARS-CoV-2 , COVID-19 , México/epidemiología , Modelos TeóricosRESUMEN
Tentorial meningiomas are challenging tumors because of its complex relationship with vital neurovascular structures. We present the case of a 41-yr-old female with a history of right-sided facial numbness associated with pain around the ear. Magnetic resonance imaging demonstrated a lesion in the right tentorium edge closely related with the porus trigeminus, suggestive of a meningioma. Because of worsening of symptoms the patient underwent surgery for tumor removal. A standard temporo-zygomatic craniotomy was performed, followed by an extradural peeling of the middle fossa; the petrous apex was drilled allowing access to the posterior fossa dura. Dural opening was carried connecting the temporal and posterior fossa, and the tentorium was then cut to the incisura. The tumor was identified and completely removed reaching Simpson grade I resection. Postoperatively, the patient presented a right dry eye in the first days that fully improved, and also a right-sided facial paralysis (House-Brackmann grade IV) and diplopia, both recovered completely after 4 mo. We believe that facial paralysis was the result of an undesired traction of the geniculate ganglion, or upon the nerve itself. To avoid such complication, dissection over the GSPN must be carried parallel to that nerve. Facial numbness and pain improved with no neurological other deficits. Tentorial meningiomas are complex deep-seated lesions that can be successfully approached through an anterior transpetrosal route in selected cases. Informed consent was obtained from the patient for publication of this operative video. Anatomical images were a courtesy of the Rhoton Collection, American Association of Neurological Surgeons/Neurosurgical Research and Education Foundation.
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Neoplasias Meníngeas , Meningioma , Adulto , Duramadre/diagnóstico por imagen , Duramadre/cirugía , Femenino , Humanos , Neoplasias Meníngeas/diagnóstico por imagen , Neoplasias Meníngeas/cirugía , Meningioma/diagnóstico por imagen , Meningioma/cirugía , Procedimientos Neuroquirúrgicos , Hueso Petroso/diagnóstico por imagen , Hueso Petroso/cirugíaRESUMEN
One of the greatest challenges is to reduce malnutrition worldwide while promoting sustainable agricultural and food systems. This is a daunting task due to the constant growth of the population and the increasing demands by consumers for functional foods with higher nutritional values. Cereal grains are the most important dietary energy source globally; wheat, rice, and maize currently provide about half of the dietary energy source of humankind. In addition, the increase of celiac patients worldwide has motivated the development of gluten-free foods using alternative flour types to wheat such as rice, corn, cassava, soybean, and pseudocereals (amaranth, quinoa, and buckwheat). Amaranth and quinoa have been cultivated since ancient times and were two of the major crops of the Pre-Colombian cultures in Latin- America. In recent years and due to their well-known high nutritional value and potential health benefits, these pseudocereals have received much attention as ideal candidates for gluten-free products. The importance of exploiting these grains for the elaboration of healthy and nutritious foods has forced food producers to develop novel adequate strategies for their processing. Fermentation is one of the most antique and economical methods of producing and preserving foods and can be easily employed for cereal processing. The nutritional and functional quality of pseudocereals can be improved by fermentation using Lactic Acid Bacteria (LAB). This review provides an overview on pseudocereal fermentation by LAB emphasizing the capacity of these bacteria to decrease antinutritional factors such as phytic acid, increase the functional value of phytochemicals such as phenolic compounds, and produce nutritional ingredients such as B-group vitamins. The numerous beneficial effects of lactic fermentation of pseudocereals can be exploited to design novel and healthier foods or grain ingredients destined to general population and especially to patients with coeliac disease.
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Amblyomin-X, a Kunitz-type protease inhibitor, is a recombinant protein that selectively induces apoptosis in tumor cells and promotes tumor reduction in vivo in melanoma animal models. Furthermore, Amblyomin-X was able to drastically reduce lung metastasis in a mice orthotopic kidney tumor model. Due to its antitumor activity, Amblyomin-X potential to become a new drug is currently under investigation, therefore the aim of the present study was to perform preclinical assays to evaluate Amblyomin-X toxicity in healthy mice. Exploratory toxicity assays have shown that treatment with 512 mg/kg of Amblyomin-X lead to animal mortality, therefore two groups of treatment were evaluated in the present work: in the acute toxicity assay, animals were injected once with doses ranging from 4 to 256 mg/kg of Amblyomin-X, while in the subacute toxicity assay, animals were injected with 0.25, 0.57 and 1 mg/kg of Amblyomin-X daily, during 28 days. Following this treatment regimens, Amblyomin-X did not cause any mortality; moreover, toxicity signs were discrete, reversible and observed only at the higher doses, thus establishing a safety profile for administration in mice, which can be further used to determine the dose translation of this novel drug candidate for treatment in other species.
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Introduction The management of petroclival meningiomas is among the most intimidating in neurosurgery, due to its difficult accessibility and close relationship with vital structures; therefore, an appropriate exposure is mandatory. We present a surgical video demonstrating a presigmoid transtentorial approach, associated with the opening of the retrosigmoid dura to a petroclival meningioma, performed by the senior surgeon (L.A.B.B.), along with its indications and pitfalls. Approach Decision The patient's clinical history is summed to the tumor's radiological features as its extension, vascularization, and venous drainage, when selecting the appropriate approach. The presigmoid transtentorial approach offers a wide exposure of the petroclival area along with the tumor's attachment. Its association with the retrosigmoid route allows the surgeon to freely work through multiple paths, and parallel to the skull base, reducing the traction in the temporal lobe. Clinical Case This is a 39-year-old female presenting with trigeminal neuralgia. Imaging depicted a petroclival meningioma, extending from the posterior aspect of the cavernous sinus to the cerebellopontine angle, extending inferiorly to the jugular bulb. A Simpson II resection was achieved through a combined presigmoid and retrosigmoid approach, and the patient was discharged with no complications or new deficits. Conclusion Petroclival meningiomas are a formidable and surgically treatable disease. The appropriate approach is design to each patient and should not be the limiting factor for total tumor removal, which is truly given by the absence of a dissection plane between the tumor and the brainstem, nerves and vascular structures of the skull base. The link to the video can be found at: https://youtu.be/MFjqZvElBSo .
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Recent studies have demonstrated that the oviductal environment plays an active role in modulating the epigenetic marks of the preimplantation embryo genome, but the molecular factors that mediate this epigenetic effect are unknown. Folate is a well-known epi-nutrient that can impact on cell epigenetic machinery during embryonic and fetal development. However, the study of this epi-nutrient in the oviduct is still limited. The present study was conducted to confirm the presence and physiological concentration of folate in bovine oviductal fluid (OF) and to determine if bovine oviduct epithelial cells (BOECs) are able to regulate the uptake of this micronutrient. Samples of OF from ipsi- and contralateral oviducts were collected at different stages of the estrous cycle and folate levels were determined using a competitive receptor binding immunoassay. In addition, gene expression of folate receptors (FOLR1, FOLR2) and transporters (SLC19A1, SLC46A1) were analyzed in BOECs from ampulla and isthmus regions during different stages of the estrous cycle using RT-qPCR. In vitro culture assays were also performed to evaluate whether expression of these genes responds to hormonal stimulation. Our results demonstrated presence of folate in the OF, showing changes of its concentration in the ipsilateral oviduct during the estrous cycle and significantly lower levels at the postovulatory stage. Moreover, gene expression of folate receptors and transporters was detected in BOECs, showing regional and cycle-dependent changes. In particular, differential expression of FOLR1 mRNA was observed in BOECs from the isthmus region, reaching significantly higher levels during the postovulatory stage. Under in vitro culture conditions, gene expression of folate receptors and transporters was maintained in BOEC explants and a particular susceptibility to steroid hormone stimulation was observed. In conclusion, the present study confirms the presence of folate in the bovine oviduct and proves the existence of a fine-tuned regulation of the expression of its receptors and transporters, highlighting the importance to expand the knowledge about this epi-nutrient in the oviductal context.
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Ácido Fólico/farmacología , Regulación de la Expresión Génica/efectos de los fármacos , Oviductos/metabolismo , Animales , Líquidos Corporales/química , Bovinos , Células Epiteliales/metabolismo , Femenino , Ácido Fólico/química , Ácido Fólico/metabolismo , Transportadores de Ácido FólicoRESUMEN
BACKGROUND: Surgical access to the temporal horn is necessary to treat tumors and vascular lesions, but is used mainly in patients with mediobasal temporal epilepsy. The surgical approaches to this cavity fall into 3 primary categories: lateral, inferior, and transsylvian. The current neurosurgical literature has underestimated the interruption of involved fiber bundles and the correlated clinical manifestations. OBJECTIVE: To delineate the interruption of fiber bundles during the different approaches to the temporal horn. METHODS: We simulated the lateral (trans-middle temporal gyrus), inferior (transparahippocampal gyrus), and transsylvian approaches in 20 previously frozen, formalin-fixed human brains (40 hemispheres). Fiber dissection was then done along the lateral and inferior aspects under the operating microscope. Each stage of dissection and its respective fiber tract interruption were defined. RESULTS: The lateral (trans-middle temporal gyrus) approach interrupted "U" fibers, the superior longitudinal fasciculus (inferior arm), occipitofrontal fasciculus (ventral segment), uncinate fasciculus (dorsolateral segment), anterior commissure (posterior segment), temporopontine, inferior thalamic peduncle (posterior fibers), posterior thalamic peduncle (anterior portion), and tapetum fibers. The inferior (transparahippocampal gyrus) approach interrupted "U" fibers, the cingulum (inferior arm), and fimbria, and transected the hippocampal formation. The transsylvian approach interrupted "U" fibers (anterobasal region of the extreme capsule), the uncinate fasciculus (ventromedial segment), and anterior commissure (anterior segment), and transected the anterosuperior aspect of the amygdala. CONCLUSION: White matter dissection improves our knowledge of the complex anatomy surrounding the temporal horn. Identifying the fiber bundles at risk during each surgical approach adds important information for choosing the appropriate surgical strategy.
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Cuerpo Calloso/cirugía , Epilepsia del Lóbulo Temporal/patología , Lóbulo Temporal/cirugía , Sustancia Blanca/patología , Epilepsia del Lóbulo Temporal/diagnóstico por imagen , Epilepsia del Lóbulo Temporal/cirugía , Femenino , Humanos , Masculino , Fibras Nerviosas Mielínicas/patologíaRESUMEN
In plant-animal mutualisms, how an animal forages often determines how much benefit its plant partner receives. In many animals, foraging behaviour changes in response to foraging gene expression or activation of the cGMP-dependent protein kinase (PKG) that foraging encodes. Here, we show that this highly conserved molecular mechanism affects the outcome of a plant-animal mutualism. We studied the two PKG genes of Allomerus octoarticulatus, an Amazonian ant that defends the ant-plant Cordia nodosa against herbivores. Some ant colonies are better 'bodyguards' than others. Working in the field in Peru, we found that colonies fed with a PKG activator recruited more workers to attack herbivores than control colonies. This resulted in less herbivore damage. PKG gene expression in ant workers correlated with whether an ant colony discovered an herbivore and how much damage herbivores inflicted on leaves in a complex way; natural variation in expression levels of the two genes had significant interaction effects on ant behaviour and herbivory. Our results suggest a molecular basis for ant protection of plants in this mutualism.
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Hormigas/genética , Cordia , Proteínas Quinasas Dependientes de GMP Cíclico/genética , Herbivoria , Simbiosis , Animales , Hormigas/enzimología , Genes de Insecto , PerúRESUMEN
This prospective study investigated the effects of acupuncture alone or combined with analgesics in chronic pain and quality of life assessed by owners for up to 24 weeks in 181 dogs with neurological and musculoskeletal diseases. The scores before and after the onset of treatment were evaluated using the Wilcoxon test and the evolution of success was evaluated by Kaplan-Meier curves. Differences were considered significant at P < 0.05. The success rates for Helsinki chronic pain index (HCPI), quality of life assessment, and visual analog scales (VAS) for pain and locomotion were 79%, 84%, 78%, and 78% of the animals, respectively, when both diseases and groups of treatment were combined. Dogs with musculoskeletal disorders had greater improvement in HCPI (P = 0.003) and VAS locomotion (P = 0.045) than those with neurological disorders. Use of acupuncture alone or in combination with analgesics reduced pain and improved quality of life in dogs with neurological and musculoskeletal diseases.
Effet de l'acupuncture dans la douleur et la qualité de vie dans les maladies neurologiques et musculo-squelettiques chez le chiens. Cette étude prospective a étudié les effets de l'acupuncture (AP) seul ou combinée avec des analgésiques pour traiter la douleur chronique et de la qualité de vie évaluée par les propriétaires pendant 24 semaines à 181 chiens atteints de maladies neurologiques et musculo-squelettiques. Les scores des animaux ont été évalués avant et après le début du traitement au moyen du test de Wilcoxon et l'évolution du succès par des courbes de Kaplan-Meier. Les différences ont été considérées comme significatives lorsque P < 0,05. Le taux de réussite pour l'indice de la douleur chronique de Helsinki (IDCH), évaluation de la qualité de vie et des échelles visuelles analogiques (EVA) pour la douleur et la locomotion étaient respectivement de 79 %, 84 %, 78 %, et 78 %. des animaux, respectivement, lorsque les deux types de maladies, et les deux groupes de traitement ont été combinés. Les chiens souffrant de maladies musculo-squelettiques ont une plus grande amélioration de IDCH (P = 0,003) et EVA locomotion (P = 0,045) scores que ceux souffrant de maladies neurologiques. Utilisation d'AP seul ou associé à traitements analgésiques réduite la douleur et meilleure qualité de vie chez les chiens atteints de maladies neurologiques et musculo-squelettiques.(Traduit par les auteurs).
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Terapia por Acupuntura/veterinaria , Enfermedades Musculoesqueléticas/veterinaria , Dimensión del Dolor/veterinaria , Calidad de Vida , Terapia por Acupuntura/métodos , Animales , Perros , Femenino , Masculino , Enfermedades Musculoesqueléticas/psicología , Enfermedades Musculoesqueléticas/terapia , Dolor , Estudios Prospectivos , Resultado del TratamientoRESUMEN
Tuberculosis (TB) remains a major threat throughout the world and in 2015 it caused the death of 1.4 million people. The Bacillus Calmette-Guérin is the only existing vaccine against this ancient disease; however, it does not provide complete protection in adults. New vaccines against TB are eminently a global priority. The use of bacteria as vehicles for delivery of vaccine plasmids is a promising vaccination strategy. In this study, we evaluated the use of, an engineered invasive Lactococcus lactis (expressing Fibronectin-Binding Protein A from Staphylococcus aureus) for the delivery of DNA plasmid to host cells, especially to the mucosal site as a new DNA vaccine against tuberculosis. One of the major antigens documented that offers protective responses against Mycobacterium tuberculosis is the Ag85A. L. lactis FnBPA+ (pValac:Ag85A) which was obtained and used for intranasal immunization of C57BL/6 mice and the immune response profile was evaluated. In this study we observed that this strain was able to produce significant increases in the amount of pro-inflammatory cytokines (IFN-γ, TNF-α, and IL-6) in the stimulated spleen cell supernatants, showing a systemic T helper 1 (Th1) cell response. Antibody production (IgG and sIgA anti-Ag85A) was also significantly increased in bronchoalveolar lavage, as well as in the serum of mice. In summary, these findings open new perspectives in the area of mucosal DNA vaccine, against specific pathogens using a Lactic Acid Bacteria such as L. lactis.
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The recommendation for the great majority of high-grade brain arteriovenous malformations (bAVMs) is observation, except for those patients with recurrent hemorrhages, progressive neurological deficits, steal-related symptoms, or AVM-related aneurysms, for whom intervention should be considered. These are general recommendations, and the decision should be made on an individual basis. Surgical resection of an AVM in the central lobe may cause postoperative sensorimotor deficits since this anatomical region includes the pre- and postcentral gyri on the lateral surface and the paracentral lobule on the medial surface. The authors present a patient with a ruptured high-grade bAVM in the central lobe who underwent previous surgery for hematoma evacuation and previous radiosurgery, and whose indication for reoperation was proposed based on progressive hemiparesis. Microsurgical resection was possible after a wide frontoparietal craniotomy, which made all the nidus borders accessible. This case illustrates the anatomy and surgical technique for large nidus AVMs in eloquent areas, showing that complete microsurgical resection is possible with good clinical outcome. The video can be found here: https://youtu.be/Cpd1PK6BLIM .
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Corteza Cerebral/cirugía , Malformaciones Arteriovenosas Intracraneales/cirugía , Microcirugia/métodos , Reoperación/métodos , Adulto , Angiografía Cerebral , Femenino , Humanos , Malformaciones Arteriovenosas Intracraneales/complicaciones , Procedimientos Neuroquirúrgicos/métodos , Radiocirugia/efectos adversos , Resultado del TratamientoAsunto(s)
Atención a la Salud , Programas de Gobierno , Infecciones por VIH/tratamiento farmacológico , Salud Pública , Huelga de Empleados , Fármacos Anti-VIH/administración & dosificación , Atención a la Salud/normas , Atención a la Salud/tendencias , Programas de Gobierno/economía , Programas de Gobierno/organización & administración , Programas de Gobierno/tendencias , Infecciones por VIH/epidemiología , Haití/epidemiología , Humanos , Salarios y Beneficios , Recursos HumanosRESUMEN
OBJECTIVE: The objective of this study is to present a case series of nonmissile penetrating (NMP) injuries and to establish a workflow for an uncommon mechanism of traumatic head injury through the analysis of each case, classification of the type of lesion, management, and outcome score at follow-up. METHODS: From January 1991 to December 2008, 36,000 patients presenting with traumatic brain injury (TBI) were admitted in the Department of Neurosurgery, Hospital Antônio Targino, Campina Grande-PB, Brazil. From these patients, 11 presenting with lesions caused by NMP objects were selected. RESULTS: Among the 11 patients, 9 were men and 2 were women. Their ages ranged from 7 to 74 years old (mean age ± SD, 29.1 ± 22.99 years). All patients underwent neuroradiologic evaluation. The entry point was classified as natural (orbit) or artificial (skull transfixation), and we also divided the patients presenting with secondary parenchymal or vascular damage from those presenting with only lesions caused by the primary penetration into the cranium and meninges. All patients were neurosurgically treated with removal of the foreign body through craniotomy, except the patient whose object (pen) was removed without craniotomy with local anesthesia. Glasgow Coma Scale (GCS) score on admission was a statistically significant factor on prognosis, and any patient who presented with a GCS score of 15 evolved satisfactorily, and there were no deaths in this group of patients (P = 0.04). CONCLUSIONS: TBIs caused by NMP objects are unusual and caused by aggression, self-inflicted harm (in the case of psychiatric patients), and accident. The foreign body may enter into the skull through a natural hole (orbit, nose, mouth, or ear) or crosses the skull, causing a fracture and creating an artificial hole. Preoperative neuroradiologic assessment is paramount for the correct neurosurgical approach. The main prognostic factor for these patients is the GCS score at admission.
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Traumatismos Penetrantes de la Cabeza/cirugía , Accidentes , Adolescente , Adulto , Anciano , Niño , Femenino , Cuerpos Extraños/diagnóstico por imagen , Cuerpos Extraños/patología , Cuerpos Extraños/cirugía , Escala de Coma de Glasgow , Traumatismos Penetrantes de la Cabeza/diagnóstico por imagen , Traumatismos Penetrantes de la Cabeza/etiología , Traumatismos Penetrantes de la Cabeza/patología , Humanos , Masculino , Persona de Mediana Edad , Procedimientos Neuroquirúrgicos , Pronóstico , Conducta Autodestructiva/diagnóstico por imagen , Conducta Autodestructiva/patología , Conducta Autodestructiva/cirugía , Violencia , Adulto JovenRESUMEN
OBJECTIVES: To analyze the clinical presentation and outcome of nontraumatic spontaneous acute spinal subdural hematoma by observing the predictors of outcome. METHODS/RESULTS: This study was based on a case report and systematic review of the international literature. Among the 151 patients, 80 were female and 65 were male (1.25 female/1.0 male). The age distribution ranged from 6 months to 87 years, with a small increase in incidence between the first and second decade of life and a major peak at age 60 years. The difference of proportion of good results between patients with and without established neurologic deficits was: 0.488, 95% confidence interval (95% CI) 0.237-0.648, P = 2.71e-08; coagulopathy was 0.335, 95% CI 0.163-0.508, P = 0.0002; SAH was 0.0539, 95% CI -0.119 to 0.226, P = 0.6529; lumbar puncture/associated diseases was 0.149 95% CI -0.032 to 0.330, P = 0.1171; surgery was 0.0593, 95% CI -0.114 to 0.233, P = 0.5838; and hematoma extension equal or longer than 5 levels was 0.010 95% CI -0.178 to 0.197, P = 1. CONCLUSIONS: Although mortality and morbidity associated with nontraumatic spontaneous acute spinal subdural hematoma has decreased during the last 2 decades, the disease still carries a mortality rate of approximately1.3% and a morbidity (permanent neurologic deficits) rate of 28%. The main factors affecting the outcome are neurologic status at presentation and coagulopathies.
Asunto(s)
Hematoma Subdural Espinal , Adolescente , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Bases de Datos Bibliográficas/estadística & datos numéricos , Femenino , Hematoma Subdural Espinal/diagnóstico , Hematoma Subdural Espinal/epidemiología , Hematoma Subdural Espinal/mortalidad , Humanos , Lactante , Masculino , Persona de Mediana Edad , Adulto JovenRESUMEN
Genetic susceptibility factors, parasite strain, and an adequate modulation of the immune system seem to be crucial for disease progression after Trypanosoma cruzi infection. HLA-G and its murine functional homolog Qa2 have well-recognized immunomodulatory properties. We evaluated the HLA-G 3' untranslated region (3'UTR) polymorphic sites (associated with mRNA stability and target for microRNA binding) and HLA-G tissue expression (heart, colon, and esophagus) in patients presenting Chagas disease, stratified according to the major clinical variants. Further, we investigated the transcriptional levels of Qa2 and other pro- and anti-inflammatory genes in affected mouse tissues during T. cruzi experimental acute and early chronic infection induced by the CL strain. Chagas disease patients exhibited differential HLA-G 3'UTR susceptibility allele/genotype/haplotype patterns, according to the major clinical variant (digestive/cardiac/mixed/indeterminate). HLA-G constitutive expression on cardiac muscle and colonic cells was decreased in Chagasic tissues; however, no difference was observed for Chagasic and non-Chagasic esophagus tissues. The transcriptional levels of Qa2 and other anti and proinflammatory (CTLA-4, PDCD1, IL-10, INF-γ, and NOS-2) genes were induced only during the acute T. cruzi infection in BALB/c and C57BL/6 mice. We present several lines of evidence indicating the role of immunomodulatory genes and molecules in human and experimental T. cruzi infection.