Asunto(s)
Infecciones Oportunistas Relacionadas con el SIDA/patología , Infecciones por Citomegalovirus/patología , Urgencias Médicas , Gastroscopía , Infecciones por VIH/patología , VIH-1 , Úlcera Péptica Hemorrágica/patología , Úlcera Gástrica/patología , Infecciones Oportunistas Relacionadas con el SIDA/tratamiento farmacológico , Anciano , Antiinfecciosos/administración & dosificación , Antiinfecciosos/efectos adversos , Biopsia , Candidiasis/tratamiento farmacológico , Candidiasis/patología , Infecciones por Citomegalovirus/tratamiento farmacológico , Diagnóstico Diferencial , Quimioterapia Combinada , Esófago/patología , Femenino , Mucosa Gástrica/patología , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/transmisión , Humanos , Infección por Mycobacterium avium-intracellulare/tratamiento farmacológico , Infección por Mycobacterium avium-intracellulare/patología , Úlcera Péptica Hemorrágica/tratamiento farmacológico , Neumonía por Pneumocystis/tratamiento farmacológico , Neumonía por Pneumocystis/patología , Úlcera Gástrica/tratamiento farmacológico , Toxoplasmosis Cerebral/tratamiento farmacológico , Toxoplasmosis Cerebral/patologíaRESUMEN
The differential diagnosis of pharyngeal tumors includes malignomas as well as chronic inflammatory processes. Squamous cell carcinoma is the most prevalent malignoma of the pharynx, representing about 90% of all malignomas of the head and neck. Malignant lymphomas, lymphoepithelial tumors (Schmincke's tumor) and anaplastic carcinomas are less prevalent. Amelanotic melanoma, rhabdomyosarcoma and extramedullary plasmocytoma are rare malignomas of the pharynx. Infectious diseases may also be a cause of pharyngeal tumors which have been reported to be associated with mycobacterial infections, syphilis, leproma, malleus and anthrax. Sarcoidosis and Wegener's granulomatosis are chronic inflammatory diseases of unknown etiology. We report a case of a 65-year-old female with an 11-year history of a slowly progressing tumor of the nasopharynx who had been admitted to hospital with suspicion of a malignoma.
Asunto(s)
Neoplasias Nasofaríngeas/diagnóstico , Enfermedades Faríngeas/diagnóstico , Tuberculosis/diagnóstico , Anciano , Técnicas Bacteriológicas , Biopsia , Diagnóstico Diferencial , Femenino , Humanos , Neoplasias Nasofaríngeas/patología , Enfermedades Faríngeas/patología , Faringe/patología , Tomografía Computarizada por Rayos X , Tuberculosis/patologíaRESUMEN
A modified Vásquez-Estévez protocol for prognostic appraisal of newborns with necrotizing enterocolitis was retrospectively applied to 23 confirmed cases from year 1987 throughout 1989 in general metropolitan hospital at Santiago, Chile. Cases were classified as low (0-12 points) or high (13-30) risk according to its corresponding score. Case fatality rates ranged from 7.1% to 77.7% in low and high risk groups, respectively. Sensibility was 87.5%, specificity 86.6% and efficiency 86.6%. Instrument application was easy. It concluded that this is a valuable tool for the prognostic evaluation of necrotizing enterocolitis. A wider and deeper prospective application would allow to measure more exactly its usefulness in other settings.
Asunto(s)
Enterocolitis Seudomembranosa/diagnóstico , Enterocolitis Seudomembranosa/etiología , Femenino , Humanos , Recién Nacido de Bajo Peso , Recién Nacido , Recien Nacido Prematuro , Masculino , Pronóstico , Estudios RetrospectivosRESUMEN
Some features as well as pathological findings in 63 infants born to diabetic mothers (IDM) under control in a diabetes unit of a general hospital at metropolitan Santiago, Chile, from 1985 through 1988 are presented. Out of 63 newborns, 22 came from mothers with pregestational diabetes mellitus (PGDM) and 41 were born to mothers with gestational diabetes mellitus (GDM). Significant differences were detected among PGDM and GDM groups of newborns in the following features: mean gestational age (GE) premature (54.5% vs. 26.8% 37 weeks GE or less), jaundice (40.9% vs. 17.1%) and congenital malformations (18.2% vs. 0%). No significant differences were found in fetal distress, hypoglycemia, respiratory distress syndrome and birth trauma although as a whole these last were more frequently recorded among infant born to insulin dependent diabetic mothers. It is concluded that in spite of an appropriate control, morbidity remains higher in IDM, particularly in IDM PGDM.
Asunto(s)
Diabetes Mellitus/congénito , Embarazo en Diabéticas , Adulto , Femenino , Edad Gestacional , Humanos , Recién Nacido , Masculino , Edad Materna , EmbarazoRESUMEN
A retrospective clinical description of 7 newborn infants with adrenal haemorrhage. All patients were born at term by vaginal delivery. Their birth weights ranged between 2,550 and 3,950, and only one was small for gestational age. Two patients had Apgar scores less than 6 at one minute and both were born by forceps delivery. The first symptom of adrenal haemorrhage was an abdominal mass. Diagnosis was confirmed by ultrasonography demonstrating a right adrenal echogenic mass which displaced the Kidney which disappeared along a few and all patients survived.
Asunto(s)
Enfermedades de las Glándulas Suprarrenales/congénito , Hemorragia/congénito , Enfermedades de las Glándulas Suprarrenales/diagnóstico por imagen , Glándulas Suprarrenales/diagnóstico por imagen , Femenino , Edad Gestacional , Hemorragia/diagnóstico por imagen , Humanos , Recién Nacido , Masculino , Estudios Retrospectivos , UltrasonografíaRESUMEN
Isolates from 100 monomicrobial Staphylococcus aureus infections were tested for the production of TSST-1 and the enterotoxins A, B and C, which were found to be synthesized as a single toxin in 34 strains, or in combination of two or more toxins in 26. Acute phase sera and one or two further serum samples from 60 patients with toxigenic (either enterotoxins and/or TSST-1) S. aureus isolates were tested for humoral immune responses. Such immune responses occurred more frequently in septicemic than in localized staphylococcal infections, and more frequently against TSST-1 and the other enterotoxins than against enterotoxin A. Furthermore, the data suggest an immunological non-responsiveness to enterotoxin A in a considerable portion of the patients. The retrospective screening of the records of 15 selected patients for symptoms of Toxic-Shock-Syndrome revealed one case of probable TSS.
Asunto(s)
Anticuerpos Antibacterianos/biosíntesis , Toxinas Bacterianas , Enterotoxinas/inmunología , Infecciones Estafilocócicas/inmunología , Staphylococcus aureus/inmunología , Superantígenos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Humanos , Persona de Mediana Edad , Prevalencia , Estudios Retrospectivos , Choque Séptico/epidemiología , Choque Séptico/inmunología , Infecciones Estafilocócicas/epidemiología , Staphylococcus aureus/metabolismoRESUMEN
Necrotizing enterocolitis (NEC) is an extremely severe clinical entity in whose pathogenesis at least two of the following factors are involved: intestinal ischaemia, pathogenic bacterial colonization and excessive substrate in the intestinal contents. Common risk factors are prematurity, rapid increase of feeding volume, polycythemia and perinatal asphyxia. Clinical features are abdominal distention, gastric retention, bloody stools and intestinal wall pneumatosis; while its complications are bowel perforation, peritonitis and shock. Early diagnosis allows prompt medical treatment based upon intestinal rest, no oral feeding, parenteral hydration and nutrition, nasogastric intubation, broad spectrum antibiotics and close surveillance. Surgery is kept to treat complications. Prevention includes feeding with human milk in prematures with slow increase of partial and total volumes, early initial fastening in cases of asphyxia and careful and close surveillance of high-risk newborns.
Asunto(s)
Enterocolitis Seudomembranosa/diagnóstico , Enterocolitis Seudomembranosa/terapia , Humanos , Recién Nacido , Factores de RiesgoRESUMEN
The susceptibilities of conventional and germ-free miniature pigs to staphylococcal toxic shock syndrome toxin 1 (TSST-1) were studied and compared. TSST-1 at doses of 100 micrograms/kg evoked reactions similar to those observed in rabbits, i.e., hyperthermia, diarrhea, apathy, conjunctival hyperemia, and various changes indicating toxic damage of different organs, but it was never lethal at this dose. Germ-free piglets were less susceptible than were corresponding conventional animals, a finding that may support the concept that endogenous endotoxin is involved in the pathogenesis of toxic shock syndrome.
Asunto(s)
Toxinas Bacterianas , Enterotoxinas/toxicidad , Staphylococcus aureus , Superantígenos , Porcinos Enanos , Animales , Plaquetas , Temperatura Corporal , Vida Libre de Gérmenes , Recuento de Leucocitos , Hepatopatías/etiología , Enfermedades Pulmonares/etiología , Masculino , Enfermedades del Bazo/etiología , PorcinosRESUMEN
A total of 174 sera from healthy Polish individuals of different age groups were tested for TSST-1 antibody by the micro-ELISA method. Over 90% of sera contained the antibody with titres equal to above 1:10(2), even in children and adolescents. The data suggest that the majority of the Polish population acquires TSST-1-antibody during early childhood, whereas a small portion of the population seems to remain anti-TSST-1-negative.
Asunto(s)
Anticuerpos Antibacterianos/análisis , Toxinas Bacterianas , Enterotoxinas/inmunología , Choque Séptico/epidemiología , Staphylococcus aureus/inmunología , Superantígenos , Adolescente , Adulto , Factores de Edad , Donantes de Sangre , Niño , Preescolar , Ensayo de Inmunoadsorción Enzimática , Femenino , Humanos , Lactante , Masculino , PoloniaRESUMEN
Sera of 152 healthy blood donors and 43 infants 9 to 12 months of age were tested for serum antibodies to TSST-1 and staphylococcal enterotoxins A, B and C by a microtiter ELISA assay. Only 50% of the adult population had detectable antibody-titers to enterotoxin A, whereas 80% to enterotoxin C and 90% to enterotoxin B and TSST-1, which is very similar to the prevalence of TSST-1 antibodies among USA-residents. The "protective" titer of TSST-1-antibodies can be estimated to be 1:100 in the test system used by comparison with anti-TSST-1-titers in five acute phase sera from confirmed menstrual TSS cases.
Asunto(s)
Anticuerpos Antibacterianos/análisis , Toxinas Bacterianas , Enterotoxinas/inmunología , Choque Séptico/epidemiología , Staphylococcus aureus/inmunología , Superantígenos , Adulto , Donantes de Sangre , Ensayo de Inmunoadsorción Enzimática , Alemania Occidental , Humanos , Lactante , Persona de Mediana EdadRESUMEN
Three strains of vancomycin-resistant Gram-positive cocci, belonging to the family Streptococcaceae, were isolated from patient samples. Two were identified as Leuconostoc species, the other one as Enterococcus (Streptococcus) faecium. The clinical significance of vancomycin-resistant Gram-positive bacteria is discussed.
Asunto(s)
Streptococcaceae/efectos de los fármacos , Vancomicina/farmacología , Farmacorresistencia Microbiana , Humanos , Leuconostoc/efectos de los fármacos , Streptococcus/efectos de los fármacosAsunto(s)
Candidiasis/diagnóstico , Recien Nacido Prematuro , Anfotericina B/uso terapéutico , Candidiasis/tratamiento farmacológico , Ecocardiografía , Endocarditis/microbiología , Endocarditis/cirugía , Flucitosina/uso terapéutico , Humanos , Recién Nacido , Hígado/diagnóstico por imagen , Hepatopatías/microbiología , Masculino , Cintigrafía , UltrasonografíaRESUMEN
The in-vitro activity of ticarcillin with and without clavulanic acid was investigated against 285 freshly isolated clinical strains of Gram-positive and Gram-negative bacteria by the agar-dilution technique on Mueller-Hinton-agar. Clavulanic acid had an excellent or moderate potentiating effect on the in-vitro activity of ticarcillin against staphylococci, Escherichia coli, Klebsiella spp., Enterobacter aerogenes, Proteus mirabilis, Citrobacter spp., Acinetobacter, Haemophilus influenzae and Bacteroides spp. No effect was seen against enterococci, indole-positive Proteus spp., Ent. cloacae, Serratia marcescens and Pseudomonas aeruginosa. The effect of clavulanic acid was dose- and inoculum-dependent.
Asunto(s)
Ácidos Clavulánicos/farmacología , Bacterias Gramnegativas/efectos de los fármacos , Bacterias Grampositivas/efectos de los fármacos , Penicilinas/farmacología , Ticarcilina/farmacología , Infecciones Bacterianas/microbiología , Ácido Clavulánico , Sinergismo Farmacológico , Bacterias Gramnegativas/aislamiento & purificación , Bacterias Grampositivas/aislamiento & purificación , Humanos , Pruebas de Sensibilidad Microbiana , Resistencia a las Penicilinas , Especificidad de la EspecieRESUMEN
In a seventeen-year old female patient fever, vomiting, conjunctivitis, pharyngitis, hypotension, exanthema, disorientation and severe myalgia were observed on the second day of menstruation. The typical symptoms suggested the clinical diagnosis of toxic shock syndrome (TSS). During the period of reconvalescence desquamations on hands and feet occurred. From vaginal swabs and the tampons Staphylococcus aureus was recovered. In supernatants from cultures the strain was found to produce toxic shock toxin (TST). Antibodies against TST in the patients serum were not detectable for a period of 70 days after onset of the disease. The patient recovered within three weeks, relapses were not observed.