RESUMEN
The continuous use of synthetic anthelmintics against gastrointestinal nematodes (GINs) has resulted in the increased resistance, which is why alternative methods are being sought, such as the use of natural products. Plant essential oils (EOs) have been considered as potential products for the control of GINs. However, the chemical composition and, consequently, the biological activity of EOs vary in different plant cultivars. The aim of this study was to evaluate the anthelmintic activity of EOs from cultivars of Ocimum basilicum L. and that of their major constituents against Haemonchus contortus. The EOs from 16 cultivars as well the pure compound linalool, methyl chavicol, citral and eugenol were used in the assessment of the inhibition of H. contortus egg hatch. In addition, the composition of three cultivars was simulated using a combination of the two major compounds from each. The EOs from different cultivars showed mean Inhibition Concentration (IC50) varying from 0.56 to 2.22 mg/mL. The cultivar with the highest egg-hatch inhibition, Napoletano, is constituted mainly of linalool and methyl chavicol. Among the individual compounds tested, citral was the most effective (IC50 0.30 mg/mL). The best combination of compounds was obtained with 11% eugenol plus 64% linalool (IC50 0.44 mg/mL), simulating the Italian Large Leaf (Richters) cultivar. We conclude that different cultivars of O. basilicum show different anthelmintic potential, with cultivars containing linalool and methyl chavicol being the most promising; and that citral or methyl chavicol isolated should also be considered for the development of new anthelmintic formulations.
Asunto(s)
Antihelmínticos , Haemonchus , Ocimum basilicum , Aceites Volátiles , Extractos Vegetales , Animales , Antihelmínticos/farmacología , Haemonchus/efectos de los fármacos , Ocimum basilicum/química , Aceites Volátiles/farmacología , Óvulo/efectos de los fármacos , Extractos Vegetales/farmacologíaRESUMEN
Eplingiella fruticosa (Salzm. ex Benth.) Harley & J.F.B. Pastore, ex Hyptis fruticosa Salzm. ex Benth. is an aromatic and medicinal plant of the family Lamiaceae, found mainly in regions with intense anthropic activity. Information on the genetic diversity of this species is scarce. However, it can be assessed using molecular markers that identify the level of diversity among phenotypically identical individuals. The present study aimed to characterize the genetic diversity of a native population of E. fruticosa from the State of Sergipe using ISSR molecular markers. Samples of 100 plants were collected in 11 municipalities of the State of Sergipe and analyzed using eight ISSR primers, resulting in 72 informative bands. The cluster analysis obtained using the neighbor joining method resulted in three groups: Group I consisted of 50 plants, mainly from the municipalities of Areia Branca, Estância, Japaratuba, Moita Bonita, Pirambu, and Salgado; Group II was formed by 21 plants, with nine representatives from the municipality of Itaporanga d'Ajuda and 13 representatives from other municipalities; Group III was composed by 29 plants, being represented mainly by the municipalities of Malhada dos Bois and São Cristóvão. The smallest genetic distance occurred between plants EPF94 and EPF96 (0.250), and the greatest distance occurred between plants EPF50 and EPF96 (0.9778). The Shannon index had a mean value of 0.42, and diversity was considered moderate. Heterozygosity had a mean value of 0.267 and was considered low. Polymorphic information content (0.253) was considered moderately informative. Genetic diversity of E. fruticosa plants was intermediate, and the results of the present study can assist in the conservation and use of the genetic resources of this species.
Asunto(s)
Lamiaceae/genética , Polimorfismo Genético , Ecosistema , Repeticiones de Microsatélite , Plantas Medicinales/genéticaRESUMEN
The conservation of plants in germplasm banks ensures the characterization and availability of these resources for future generations. The present study used DNA markers to obtain genetic information about germplasm collections of Lippia sidoides and L. gracilis, which are maintained in an Active Germplasm Bank (AGB). Genetic variability of samples in the AGB was assessed using 12 combinations of amplified fragment length polymorphism (AFLP) primers (EcoRI/MseI). Twenty simple sequence repeat primers designed for L. alba were tested to determine their transferability in L. sidoides and L. gracilis. The AFLP markers generated 789 markers. The assessed loci exhibited a moderate Shannon diversity index (I = 0.42) in both species, suggesting that the conserved accessions possess an intermediate level of genetic diversity. Twelve microsatellite loci amplified satisfactorily, and nine loci were polymorphic in each species. A total of 23, 22, and 36 alleles, with an average of 2.5, 2.4, and 3.27 alleles per locus were identified for L. sidoides and L. gracilis accessions in the AGB, and Lippia sp sampled plants, respectively. Analyses of genetic structure permitted the identification of three different groups using both sets of markers, of which two were representative of L. sidoides. The information generated in this study may help to create, expand, and maintain collections of these species and may assist in genetic-breeding programs.
Asunto(s)
Variación Genética , Lippia/genética , Semillas/genética , Alelos , Análisis del Polimorfismo de Longitud de Fragmentos Amplificados , Análisis por Conglomerados , Sitios Genéticos , Marcadores Genéticos , Geografía , Repeticiones de Microsatélite/genética , Filogenia , Análisis de Componente PrincipalRESUMEN
BACKGROUND: PIDs are a heterogeneous group of genetic illnesses, and delay in their diagnosis is thought to be caused by a lack of awareness among physicians concerning PIDs. The latter is what we aimed to evaluate in Brazil. METHODS: Physicians working at general hospitals all over the country were asked to complete a 14-item questionnaire. One of the questions described 25 clinical situations that could be associated with PIDs and a score was created based on percentages of appropriate answers. RESULTS: A total of 4026 physicians participated in the study: 1628 paediatricians (40.4%), 1436 clinicians (35.7%), and 962 surgeons (23.9%). About 67% of the physicians had learned about PIDs in medical school or residency training, 84.6% evaluated patients who frequently took antibiotics, but only 40.3% of them participated in the immunological evaluation of these patients. Seventy-seven percent of the participating physicians were not familiar with the warning signs for PIDs. The mean score of correct answers for the 25 clinical situations was 48.08% (±16.06). Only 18.3% of the paediatricians, 7.4% of the clinicians, and 5.8% of the surgeons answered at least 2/3 of these situations appropriately. CONCLUSIONS: There is a lack of medical awareness concerning PIDs, even among paediatricians, who have been targeted with PID educational programmes in recent years in Brazil. An increase in awareness with regard to these disorders within the medical community is an important step towards improving recognition and treatment of PIDs.
Asunto(s)
Competencia Clínica/estadística & datos numéricos , Síndromes de Inmunodeficiencia/epidemiología , Médicos/estadística & datos numéricos , Brasil , Estudios Transversales , Cirugía General , Hospitales Generales , Humanos , Síndromes de Inmunodeficiencia/diagnóstico , Medicina Interna , Pediatría , Rol del Médico , Práctica Profesional , Encuestas y CuestionariosRESUMEN
BACKGROUND: Severe combined immunodeficiency (SCID) is one of the most severe forms of primary immunodeficiency. The objectives of this study were to analyze the diagnosis, treatment, and prognosis of SCID in Brazil and to document the impact of BCG vaccine. METHODS: We actively searched for cases by contacting all Brazilian referral centers. RESULTS: We contacted 23 centers and 70 patients from 65 families. Patients were born between 1996 and 2011, and 49 (70%) were male. More than half (39) of the diagnoses were made after 2006. Mean age at diagnosis declined from 9.7 to 6.1 months (P = .058) before and after 2000, respectively, and mean delay in diagnosis decreased from 7.9 to 4.2 months (P = .009). Most patients (60/70) were vaccinated with BCG before the diagnosis, 39 of 60 (65%) had complications related to BCG vaccine, and the complication was disseminated in 29 of 39 (74.3%). Less than half of the patients (30, 42.9%) underwent hematopoietic stem cell transplantation (HSCT). Half of the patients died (35, 50%), and 23 of these patients had not undergone HSCT. Disseminated BCG was the cause of death, either alone or in association with other causes, in 9 of 31 cases (29%, no data for 4 cases). CONCLUSIONS: In Brazil, diagnosis of SCID has improved over the last decade, both in terms of the number of cases and age at diagnosis, although a much higher number of cases had been expected. Mortality is higher than in developed countries. Complications of BCG vaccine are an important warning sign for the presence of SCID and account for significant morbidity during disease progression.
Asunto(s)
Vacuna BCG/efectos adversos , Inmunodeficiencia Combinada Grave/terapia , Adolescente , Brasil/epidemiología , Niño , Preescolar , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Pronóstico , Inmunodeficiencia Combinada Grave/complicaciones , Inmunodeficiencia Combinada Grave/epidemiologíaRESUMEN
BACKGROUND: Hereditary Angio-oedema (HAE) is a serious medical condition caused by a rare autosomal dominant genetic disorder, in which C1 inhibitor (C1-INH) function is reduced. There is no organized information on the HAE patient population in Brazil. OBJECTIVE: The Brazilian Registry was established to disseminate diagnostic access, and to better understand the main features of the disease in our country and its clinical impact. METHODS: A questionnaire was prepared and sent to specialists. The completed questionnaires were forwarded to the coordinating site and then entered into the Registry. Samples from patients with an unconfirmed diagnosis were tested for C1 inhibitor and C4 levels. RESULTS: From 2006 to 2010, 210 patients (133 females; mean age, 30 ±17 years) were included. The median age of onset of symptoms and age at diagnosis were 6.5 and 21 years, respectively; 80.9% of the patients had subcutaneous oedema, 54% gastrointestinal and 35.7% respiratory symptoms (21% had laryngeal oedema). Laparotomy due to the disease was performed in 6.2% of the patients. The majority of patients had Type I HAE of moderate severity. Twenty-seven per cent did not receive treatment; 53% were treated with danazol alone. CONCLUSION: A paucity of patients with Type II HAE and a high frequency of laparotomy were observed, highlighting the need for better diagnosis in Brazil. HAE related educational activities, improved diagnosis and access to available therapy are needed in Brazil.
Asunto(s)
Angioedemas Hereditarios/epidemiología , Sistema de Registros , Adolescente , Adulto , Brasil/epidemiología , Niño , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto JovenRESUMEN
The aim of this research was to perform in situ quantification, morphometry evaluation, and apoptosis analysis of ovarian follicular wall cells in mechanically isolated follicles obtained from ovaries of bovine fetuses (Bos taurus indicus) between 3 and 9 months of age. Apoptosis was evaluated using the terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling assay. The number of isolated follicles increased from 3 months onward (102.5 ± 141.1, mean ± SEM), peaked at 6 months (12855.0 ± 9030.1), and then decreased by 7 months (3208.7 ± 3249.5), consistent with atresia occurring at these stages. Follicular density was greatest at 4 months, consistent with a sudden boost in follicular activity independent of a corresponding increase in ovarian size. Antral follicles were first observed at 5 months. As fetal age increased, there was a tendency for the percentage of primordial and primary follicles to decrease, and the percentage of secondary follicles to increase. However, the high variability (P < 0.05) for all follicle populations up to 5 months of age precluded further interpretation of these results. Oocyte diameter increased from the primordial (23.6 ± 4.4 µm) to the secondary follicular stages (38.0 ± 14.9 µm). Apoptosis was observed in ovaries from all fetal ages analyzed. We concluded that preantral follicles could be isolated from bovine fetuses by 3 months of age, with apoptosis affecting ovarian follicular dynamics throughout fetal life.
Asunto(s)
Apoptosis , Bovinos/embriología , Folículo Ovárico/embriología , Ovario/embriología , Animales , Femenino , Edad Gestacional , Etiquetado Corte-Fin in Situ/veterinaria , Oocitos/citología , Tamaño de los Órganos , Folículo Ovárico/citologíaRESUMEN
In the past few years there has been increasing concern about the transmission of drug-resistant HIV. This study aimed to describe the frequency of primary mutations associated with HIV-1 drug resistance and the prevalence of genetic HIV subtypes in a population of vertically infected children before the initiation of HAART. At the time of genotypic testing, the median age was 6.0 years (IQR 25-75%: 3.8-9.2) and the median age at admission was 3.84 years (IQR 25-75%: 1.23-6.11). Antepartum maternal ARV exposure for PMTCT occurred for three (7.3%) mothers. According to the WHO criteria, primary ARV resistance mutations were detected in four out of 41 (9.8%) children. Subtype B was the most prevalent (63.4%). The relatively high prevalence of primary HIV-1 DRMs in this cohort of perinatally infected children in Brazil supports the local recommendation to perform resistance testing in all newly diagnosed children, regardless of age at diagnosis and antenatal ARV exposure.
Asunto(s)
Farmacorresistencia Viral , Infecciones por VIH/virología , VIH-1/genética , Transmisión Vertical de Enfermedad Infecciosa , Mutación Missense , Proteínas Virales/genética , Fármacos Anti-VIH/farmacología , Brasil , Niño , Preescolar , Estudios de Cohortes , Femenino , Genotipo , Infecciones por VIH/transmisión , VIH-1/clasificación , VIH-1/efectos de los fármacos , VIH-1/aislamiento & purificación , Humanos , Lactante , Masculino , Datos de Secuencia Molecular , Prevalencia , Análisis de Secuencia de ADNRESUMEN
Thirty silent lupus nephritis (SLN) patients were compared to 16 individuals bearing overt lupus nephritis (OLN). Results included: years of systemic lupus erythematosus (SLE) diagnosis were significantly earlier (4.6 +/- 2.8 years) in SLN than in OLN (7.18 +/- 3.61) (P < 0.05). Neurological compromise, hypertension, normocitic anemia and lymphopenia were significantly prevalent in OLN than in SLN (P < 0.05). Beside normal urinary sediment and renal function tests, the SLN group showed a moderate increase of both activity (AI) and chronicity (CI) renal pathology index when compared to highly increased AI and CI in OLN (P < 0.05). Seventy percent of SLN patients were ISN/RPS Classes I (6.6%) and II (63.3%) while 81% of OLN cases were Classes III, IV (37.5%) and V. IgG, IgA, IgM, lambda chain, C3 and fibrinogen immune deposits were found in 90% or over in both SLN and OLN individuals while in 60% or over, both groups also showed kappa chain, Clq and C4 deposits. While prevalence of ANA, anti-dsDNA and anti-C1q antibodies were similar in both groups, anti-histone, anti-RNP, CIC and CH50 serum levels were significantly different in OLN versus SLN (P < 0.05). We strongly suggest that indeed SLN is the earliest stage in the natural history of lupus nephritis.
Asunto(s)
Nefritis Lúpica/inmunología , Nefritis Lúpica/patología , Adulto , Autoanticuerpos/sangre , Biopsia , Complemento C1q/inmunología , Complemento C3/inmunología , ADN/inmunología , Diagnóstico Precoz , Femenino , Fibrinógeno/inmunología , Humanos , Riñón/patología , Nefritis Lúpica/epidemiología , Masculino , Persona de Mediana Edad , Estudios SeroepidemiológicosRESUMEN
El trasplante renal es el tratamiento sustitutivo de elección en todo el mundo, para pacientes con insuficiencia renal crónica terminal. Históricamente sus comienzos se sitúan a principios del siglo XX en Europa. Su éxito y permanencia como tratamiento electivo hasta ahora es la consecuencia principalmente de los adelantos de las técnicas quirúrgicas, del conocimiento de los fenómenos inmunológicos que se relacionan con la colocación de injertos y del descubrimiento de nuevas drogas inmunosupresoras, ya de uso corriente, como lo es la Ciclosporina A, que tiene gran efectividad en controlar los fenómenos de rechazo. La mejoría en la supervivencia de los injertos ha motivado también el desarrollo de una activa clínica de trasplante renal para encarar las alteraciones del funcionamiento de los injertos, cuyo diagnóstico definitivo descansa en el estudio morfológico de la biopsia renal, que se considera el estándar de oro y cuyos hallazgos histopatológicos fundamentales se muestran en la presente revisión
Asunto(s)
Insuficiencia Renal Crónica/terapia , Trasplante de Riñón/historia , Trasplante de Riñón/inmunología , Trasplante de Riñón , Nefrología , VenezuelaRESUMEN
This study was aimed at evaluating the immunogenicity of a vaccine composed of killed Leishmania amazonensis promastigotes using several different protocols in a randomized, double-blind and controlled trial design in order to select one of them for further efficacy trials. One hundred and fourteen leishmanin skin test (LST)-negative healthy volunteers were allocated into eight groups that received either two or three deep intramuscular injections of vaccine at doses of 180, 360 and 540 microg or similar injections of placebo. Cell-mediated immune responses were evaluated before and after vaccination by means of LST as well as proliferative responses and cytokine production in Leishmania antigen-stimulated peripheral blood mononuclear cell cultures. The majority of the subjects who actually received vaccine converted to positive LST (89.5%). On the other hand, none of the subjects who received placebo converted to positive LST. Proliferative responses and production of interferon-gamma and interleukin-2 were significantly higher after vaccination than before vaccination in all groups, including those that received placebo. The dose of 360 microg provided the highest LST conversion rate (100%), as well as the greatest increase in interferon-gamma and interleukin-2 production after vaccination.
Asunto(s)
Leishmania/inmunología , Leishmaniasis Cutánea/inmunología , Leishmaniasis Cutánea/prevención & control , Vacunas Antiprotozoos/inmunología , Adolescente , Adulto , Animales , Antígenos de Protozoos/inmunología , Células Cultivadas , Citocinas/biosíntesis , Método Doble Ciego , Femenino , Humanos , Leucocitos Mononucleares/inmunología , Activación de Linfocitos , Masculino , Persona de Mediana Edad , Vacunas Antiprotozoos/administración & dosificación , Pruebas Cutáneas , VacunaciónRESUMEN
In this study, we evaluated the immune response of patients suffering from cutaneous leishmaniasis treated with two distinct protocols. One group was treated with conventional chemotherapy using pentavalent antimonium salts and the other with immunochemotherapy where a vaccine against cutaneous leishmaniasis was combined with the antimonium salt. Our results show that, although no differences were observed in the necessary time for complete healing of the lesions between the two treatments, peripheral blood mononuclear cells from patients treated by chemotherapy showed smaller lymphoproliferative responses at the end of the treatment than those from patients in the immunochemotherapy group. Furthermore, IFN-gamma production was also different between the two groups. While cells from patients in the chemotherapy group produced more IFN-gamma at the end of treatment, a significant decrease in this cytokine production was associated with healing in the immunochemotherapy group. In addition, IL-10 production was also less intense in this latter group. Finally, an increase in CD8+ -IFN-gamma producing cells was detected in the chemotherapy group. Together these results point to an alternative treatment protocol where healing can be induced with a decreased production of a potentially toxic cytokine.
Asunto(s)
Antiprotozoarios/uso terapéutico , Citocinas/biosíntesis , Leishmania/inmunología , Leishmaniasis Cutánea/inmunología , Leishmaniasis Cutánea/terapia , Meglumina/uso terapéutico , Compuestos Organometálicos/uso terapéutico , Vacunas Antiprotozoos/uso terapéutico , Adulto , Animales , Antígenos de Protozoos/inmunología , Antimonio/uso terapéutico , Método Doble Ciego , Ensayo de Inmunoadsorción Enzimática , Femenino , Humanos , Inmunidad Celular , Interferón gamma/biosíntesis , Interleucina-10/biosíntesis , Masculino , Antimoniato de MegluminaRESUMEN
In this study, we evaluated the immune response of patients suffering from cutaneous leishmaniasis treated with two distinct protocols. One group was treated with conventional chemotherapy using pentavalent antimonium salts and the other with immunochemotherapy where a vaccine against cutaneous leishmaniasis was combined with the antimonium salt. Our results show that, although no differences were observed in the necessary time for complete healing of the lesions between the two treatments, peripheral blood mononuclear cells from patients treated by chemotherapy showed smaller lymphoproliferative responses at the end of the treatment than those from patients in the immunochemotherapy group. Furthermore, IFN-gamma production was also different between the two groups. While cells from patients in the chemotherapy group produced more IFN-gamma at the end of treatment, a significant decrease in this cytokine production was associated with healing in the immunochemotherapy group. In addition, IL-10 production was also less intense in this latter group. Finally, an increase in CD8+ -IFN-gamma producing cells was detected in the chemotherapy group. Together these results point to an alternative treatment protocol where healing can be induced with a decreased production of a potentially toxic cytokine
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Antiprotozoarios/uso terapéutico , Interferón gamma/biosíntesis , Leishmaniasis Cutánea/tratamiento farmacológico , Leishmania/inmunología , Vacunas Antiprotozoos/uso terapéutico , Antígenos de Protozoos/inmunología , Antimonio/uso terapéutico , Citocinas/biosíntesis , Método Doble Ciego , Quimioterapia Combinada , Ensayo de Inmunoadsorción Enzimática , Interleucina-10/biosíntesisRESUMEN
The authors discuss the relative importance of the livestock sector in South America, in developing countries and in countries world-wide. The development of animal health services is highlighted and the new challenges which these services must meet, with respect to the restructuring of international trade, are described. The economic impact of animal diseases and of disease control is evaluated by taking a regional approach and by analysing production systems. A classification of production systems is accompanied by case studies on the economics of animal health. Emphasis is placed on national control programmes, diseases which affect reproduction, parasitic diseases and mastitis, with particular reference to the livestock sector of Colombia. The authors suggest that integrated livestock development programmes include the management of animal health and production information. A change of attitude is also recommended with greater participation of those involved. The need to co-ordinate sustained research initiatives is stressed.
Asunto(s)
Enfermedades de los Animales/economía , Enfermedades de los Animales/prevención & control , Crianza de Animales Domésticos/economía , Animales Domésticos , Países en Desarrollo/economía , Crianza de Animales Domésticos/métodos , Animales , Comercio , Salud Global , Cooperación Internacional , América del SurRESUMEN
A via de acesso de Cincinnati foi utilizada em 111 pacientes (164 pés) portadores de pé torto eqüinovaro congênito (PTC) no período de 1985 a 1994. Os autores descrevem a técnica cirúrgica empregada e as facilidades que envolvem a abordagem das regiöes medial, posterior e lateral através dessa via de acesso. Os resultados säo analisados por um sistema de avaliaçäo funcional que permite, por meio de exame clínico e radiográfico, classificá-los em excelentes, bons, regulares e ruins. Os autores, entretanto, sugerem que os resultados excelentes e bons sejam denominados satisfatórios e os regulares e ruins, insatisfatórios. A análise comparativa entre duas faixas etárias é submetida ao estudo estatístico. Dessa forma, foi possível concluir que a idade influenciou significantemente os resultados obtidos.
Asunto(s)
Humanos , Masculino , Femenino , Lactante , Preescolar , Pie Zambo/cirugía , Procedimientos Ortopédicos/métodos , Factores de Edad , Periodo PosoperatorioRESUMEN
Este artigo destina-se a informaçäo do cirurgiäo dentista, em particular do ortodontista, a respeito de uma nova síndrome que desperta interesse no meio médico e que em seu tratamento e o ortodontista terá importante participaçäo
Asunto(s)
Humanos , Adulto , Persona de Mediana Edad , Mandíbula/cirugía , Osteotomía , Síndromes de la Apnea del Sueño/diagnóstico , Cefalometría , Hipoxia/complicaciones , Polisomnografía , Ronquido/etiologíaRESUMEN
METHODS: From June 1989 to April 1991, 394 adolescents aged 10-18 years randomly selected upon admission at a state shelter in Belo Horizonte, Brazil underwent health history interview, physical examination, serology for HIV, hepatitis B, and syphilis, and stool examination. Participants were classified as street-based youths (n = 195) or home-based youths (n = 199). The age distribution was similar in both groups, although males were overrepresented among street-based youths (79.5% versus 62.3%). RESULTS: Compared with home-based youths, street-based youths reported earlier onset (p = 0.009) and higher rates of sexual activity (odds ratio [OR], 2.1; 95% confidence interval [CI], 1.4-3.3), sexual abuse (OR, 3.7; 95% CI, 1.2-10.1), and sexually transmitted diseases (OR, 2.9; 95% CI, 1.3-6.6). Overall condom use was low in both groups. Street-based youths were 7.8 times more likely to use drugs than home-based youths (95% CI, 4.9-12.7). Inhalants and marijuana were the more commonly used drugs. Intravenous drug use was low. CONCLUSIONS: Although chronic malnutrition and multiple parasitosis were common findings in both groups, street-based youths were more likely to present disorders related to trauma and poor hygienic conditions. Antibodies to HIV were detected in four (2%) street-based youths and in none of the home-based youths. This study confirms that street youths are at higher risk for HIV infection than their home-based peers and indicates a need for HIV prevention programs targeting this population.
Asunto(s)
Conducta del Adolescente , Infecciones por VIH/epidemiología , Conductas Relacionadas con la Salud , Estado de Salud , Personas con Mala Vivienda , Pobreza , Asunción de Riesgos , Adolescente , Distribución por Edad , Brasil/epidemiología , Niño , Intervalos de Confianza , Femenino , Infecciones por VIH/prevención & control , Infecciones por VIH/transmisión , Necesidades y Demandas de Servicios de Salud , Encuestas Epidemiológicas , Humanos , Masculino , Morbilidad , Oportunidad Relativa , Factores de RiesgoAsunto(s)
Neoplasias de Cabeza y Cuello/terapia , Escisión del Ganglio Linfático , Neoplasias Faríngeas/terapia , Neoplasias de Cabeza y Cuello/patología , Humanos , Neoplasias Hipofaríngeas/patología , Neoplasias Hipofaríngeas/terapia , Metástasis Linfática , Cuello , Neoplasias Faríngeas/patología , Pronóstico , Factores de TiempoRESUMEN
Bilateral auricular inflammation with histological changes of relapsing polychondritis was observed in a female patient with primary Sjögren's syndrome. This was accompanied by rapidly progressive renal insufficiency due to diffuse proliferative glomerulonephritis. To our knowledge this is the first well documented case of primary Sjögren's syndrome associated with chondritis and glomerulonephritis, further emphasising the wide spectrum of extraglandular manifestations in this autoimmune disorder.