RESUMEN
The failure of the internal fixation of an ankle fracture due to Charcot joint/ neuroarthropathy is rare; such occurred in the case of a 52-year-old woman with uncontrolled diabetes who sustained a right ankle fracture after falling from standing height. The patient was treated with the internal fixation of both malleoli, which procedure failed as the patient progressed, until she eventually was diagnosed with Charcot arthropathy. The post operative images were reviewed and showed a catastrophic fixation failure with a diagnosis of Charcot neuroarthropathy. At that point, we decided to treat the problem presented with salvage arthrodesis, combining hindfoot fusion nail with adjuvant external fixation. This treatment was selected to augment stability and achieve stable fixation. The post-operative visits showed wound healing without complications and painless weight bearing. The follow-up radiographs showed tibiotalar fusion with painless union of the subtalar joint at 48 weeks.
Asunto(s)
Fracturas de Tobillo/cirugía , Artropatía Neurógena/diagnóstico , Fijación de Fractura/métodos , Fracturas de Tobillo/etiología , Artrodesis/métodos , Artropatía Neurógena/complicaciones , Artropatía Neurógena/cirugía , Clavos Ortopédicos , Femenino , Estudios de Seguimiento , Fijación Interna de Fracturas , Humanos , Recuperación del Miembro/métodos , Persona de Mediana Edad , Radiografía , Resultado del TratamientoRESUMEN
The adsorption of the 5-Fluorouracil (5-FU) molecule on the pristine and Al-doped activated carbon (AC) was investigated by using the Vienna Ab-initio Simulation Package. It is found that the 5-FU molecule is only weakly adsorbed on the pristine AC with high adsorption energy and large surface distance. The adsorption of the 5-FU molecule on pristine AC is highly disfavored. In contrast, the molecule shows strong interactions with the Al-doped AC confirmed by the lesser adsorption energy, the charge transfers on the Al-modified zone and the significant changes in the DOS at the Fermi level. The results of our study suggest that the Al dopant increases the adsorption capacity of AC enhancing its interactions with polar atoms of the adsorbate, hence improving its adsorption properties.
Asunto(s)
Aluminio/química , Antineoplásicos/química , Carbón Orgánico/química , Fluorouracilo/química , Teoría Cuántica , Adsorción , Modelos Moleculares , Conformación MolecularRESUMEN
Introduction: Extended-spectrum-β-lactamases (ESBL) are plasmid-encoded enzymes that confer resistance to multiple antimicrobials. ESBL-producing enterobacteria that cause bacteremia limit therapeutic options and increase mortality. Objective: To perform a clinical and molecular description of bacteremia caused by ESBL-producing enterobacteria. Method: We retrospectively studied the cases of bacteremia due to ESBL-producing Escherichia coli, Klebsiella pneumoniae and Proteus spp in adults admitted to a university hospital during the years 2004-2007. We reviewed the clinical records and antimicrobial susceptibility patterns. Molecular typing was performed by polymerase chain reaction and study of clonality by pulsed-field electrophoresis. Results: We found a prevalence of 9.8 percent ESBL in enterobacteria causing bacteremia. Decreased susceptibility to quinolones and aminoglycosides was observed, without resistance to carbapenems. The predominant ESBL types were CTX-M (96 percent), TEM (62 percent) and GES (28 percent). 79 percent of the strains presented more than one type of ESBL. Clinical analysis revealed high prevalence of risk factors, previous use of antimicrobials and of invasive devices. There was no significant clonality. Conclusion: The presence of ESBLs in bloodstream infections is a clinical problem that must be considered when choosing empiric therapy.
Introducción: β-lactamasas de espectro extendido (BLEE) son enzimas plasmidiales que confieren resistencia a múltiples antimicrobianos. Las bacteriemias por enterobacterias productoras de BLEE restringen las opciones terapéuticas y aumentan la mortalidad. Objetivo: Realizar una descripción clínica y molecular de las bacteriemias causadas por enterobacterias productoras de BLEE. Método: Se estudiaron retrospectivamente los casos de bacteriemia por Escherichia coli, Klebsiella pneumoniae y Proteus spp. confirmadas para BLEE, en adultos ingresados en un hospital universitario durante los años 2004-2007. Se revisaron los registros clínicos y de susceptibilidad. Se realizó tipificación molecular por reacción de polimerasa en cadena y estudio de clonalidad por electroforesis de campo pulsado. Resultados: Se identificó una prevalencia de BLEE de 9,8 por ciento en enterobacterias causantes de bacteriemias. Se observó susceptibilidad disminuida a quinolonas y aminoglucósidos, sin resistencia a carbapenémicos. Los tipos de BLEE predominantes fueron CTX-M (96 por ciento), TEM (62 por ciento) y GES (28 por ciento). El 79 por ciento de las cepas presentó más de un tipo de BLEE. El análisis clínico reveló alta frecuencia de patologías de riesgo, uso previo de antimicrobianos y uso de dispositivos invasores. No se encontró clonalidad significativa. Conclusión: La presencia de BLEE en bacteriemias constituye un problema clínico que debe ser considerado al elegir la terapia empírica.
Asunto(s)
Adulto , Anciano , Humanos , Bacteriemia/microbiología , Infecciones por Escherichia coli/microbiología , Infecciones por Klebsiella/microbiología , Infecciones por Proteus/microbiología , beta-Lactamasas/metabolismo , Antibacterianos/farmacología , Electroforesis en Gel de Campo Pulsado , Escherichia coli/efectos de los fármacos , Escherichia coli/enzimología , Escherichia coli/genética , Hospitales Universitarios , Klebsiella pneumoniae/efectos de los fármacos , Klebsiella pneumoniae/enzimología , Klebsiella pneumoniae/genética , Pruebas de Sensibilidad Microbiana , Reacción en Cadena de la Polimerasa , Prevalencia , Proteus/efectos de los fármacos , Proteus/enzimología , Proteus/genética , Estudios Retrospectivos , beta-Lactamasas/genéticaRESUMEN
INTRODUCTION: Extended-spectrum-ß-lactamases (ESBL) are plasmid-encoded enzymes that confer resistance to multiple antimicrobials. ESBL-producing enterobacteria that cause bacteremia limit therapeutic options and increase mortality. OBJECTIVE: To perform a clinical and molecular description of bacteremia caused by ESBL-producing enterobacteria. METHOD: We retrospectively studied the cases of bacteremia due to ESBL-producing Escherichia coli, Klebsiella pneumoniae and Proteus spp in adults admitted to a university hospital during the years 2004-2007. We reviewed the clinical records and antimicrobial susceptibility patterns. Molecular typing was performed by polymerase chain reaction and study of clonality by pulsed-field electrophoresis. RESULTS: We found a prevalence of 9.8% ESBL in enterobacteria causing bacteremia. Decreased susceptibility to quinolones and aminoglycosides was observed, without resistance to carbapenems. The predominant ESBL types were CTX-M (96%), TEM (62%) and GES (28%). 79% of the strains presented more than one type of ESBL. Clinical analysis revealed high prevalence of risk factors, previous use of antimicrobials and of invasive devices. There was no significant clonality. CONCLUSION: The presence of ESBLs in bloodstream infections is a clinical problem that must be considered when choosing empiric therapy.
Asunto(s)
Bacteriemia/microbiología , Infecciones por Escherichia coli/microbiología , Infecciones por Klebsiella/microbiología , Infecciones por Proteus/microbiología , beta-Lactamasas/metabolismo , Adulto , Anciano , Antibacterianos/farmacología , Electroforesis en Gel de Campo Pulsado , Escherichia coli/efectos de los fármacos , Escherichia coli/enzimología , Escherichia coli/genética , Hospitales Universitarios , Humanos , Klebsiella pneumoniae/efectos de los fármacos , Klebsiella pneumoniae/enzimología , Klebsiella pneumoniae/genética , Pruebas de Sensibilidad Microbiana , Reacción en Cadena de la Polimerasa , Prevalencia , Proteus/efectos de los fármacos , Proteus/enzimología , Proteus/genética , Estudios Retrospectivos , beta-Lactamasas/genéticaRESUMEN
BACKGROUND: An alert value is a result suggesting that the patient is at imminent danger unless appropriate remedial actions begin promptly. Report of alert values (AV) by the clinical laboratories has taken special relevance in recent years due to its contribution to patient's care. AIM: To report results of AV informed during 2007 within the Health Network of the Pontificia Universidad Católica de Chile. MATERIAL AND METHODS: Analysis of AV recorded in a centralized database of the laboratories of the health network, between January and December, 2007. RESULTS: Total number of AV was 5.366, which represented 0.3% of total examinations and corresponded mainly to the clinical chemistry area. Potassium levels generated the higher number of AV detected, followed by positive blood cultures. Eighty two percent of AV corresponded to hospitalized patients. The greater number of AV was reported to intermediate and intensive care services. Thirty two percent of AV was informed to the physician or professional in charge of the patient within 5 minutes of obtaining the results and 79% within 30 minutes. CONCLUSIONS: To obtain a real impact on patient management, it is fundamental to shorten the lapse between the obtainment of tests results and the warning, supported on appropriate computerized systems, and to spread the procedure to all personnel involved in patient's care.
Asunto(s)
Sistemas de Información en Laboratorio Clínico , Cuidados Críticos , Laboratorios de Hospital , Centros Médicos Académicos/organización & administración , Chile , Sistemas de Información en Laboratorio Clínico/normas , Técnicas de Laboratorio Clínico/clasificación , Técnicas de Laboratorio Clínico/estadística & datos numéricos , Cuidados Críticos/métodos , Cuidados Críticos/estadística & datos numéricos , Hospitales Universitarios , Humanos , Laboratorios de Hospital/organización & administración , Personal de Laboratorio Clínico/organización & administración , Estudios RetrospectivosRESUMEN
Background: An alert value is a result suggesting that the patient is at imminent danger unless appropriate remedial actions begin promptly. Report of alert values (AV) by the clinical laboratories has taken special relevance in recent years due to its contribution to patient's care. Aim: To report results of AV informed during 2007 within the Health Network of the Pontificia Universidad Católica de Chile. Material and methods: Analysis of AV recorded in a centralized database of the laboratories of the health network, between January and December, 2007. Results: Total number of AV was 5.366, which represented 0.3 percent of total examinations and corresponded mainly to the clinical chemistry area. Potassium levels generated the higher number of AV detected, followed by positive blood cultures. Eighty two percent of AV corresponded to hospitalized patients. The greater number of AV was reported to intermediate and intensive care services. Thirty two percent of AV was informed to the physician or professional in charge of the patient within 5 minutes of obtaining the results and 79 percent within 30 minutes. Conclusions: To obtain a real impact on patient management, it is fundamental to shorten the ¡apse between the obtainment of tests results and the warning, supported on appropriate computerized systems, and to spread the procedure to all personnel involved in patient's care (RevMéd Chile 2009; 137: 1137-44).
Asunto(s)
Humanos , Sistemas de Información en Laboratorio Clínico , Cuidados Críticos , Laboratorios de Hospital , Técnicas de Laboratorio Clínico , Centros Médicos Académicos/organización & administración , Chile , Sistemas de Información en Laboratorio Clínico/normas , Cuidados Críticos/métodos , Cuidados Críticos/estadística & datos numéricos , Hospitales Universitarios , Laboratorios de Hospital/organización & administración , Personal de Laboratorio/organización & administración , Estudios RetrospectivosRESUMEN
The primary target of this investigation was to determine the chemical and physical composition of the different varieties of barley that are cultivated in the states of Hidalgo and Tlaxcala, and based on their composition, consider their potential uses in the food industry. Seven varieties of barleys cultivated in the region before mentioned were analyzed. Proximal analysis showed that Esmeralda 1, M16 Hidalgo, Esmeralda Tlaxcala and Forrajera Tlaxcala are the most appropriate varieties for the elaboration of malts and beer due to their carbohydrate content. Due to their protein content, Esmeralda 2, Pastor Ortiz and M16 Tlaxcala varieties are apt for animal feeding and baking.
El objetivo principal de esta investigación fue determinar la composición fisicoquímica de las diferentes variedades de cebada que se cultivan en los estados de Hidalgo y Tlaxcala y a partir de su composición estimar sus usos potenciales en la industria de alimentos. Para lograrlo se utilizaron 7 variedades de cebadas cultivadas en la región antes mencionada. El análisis proximal mostró que Esmeralda 1, M16 Hidalgo, Esmeralda Tlaxcala y Forrajera Tlaxcala son las variedades más apropiadas para la elaboración de maltas y cerveza por su contenido de carbohidratos. Las variedades Esmeralda 2, Pastor Ortiz y M16 Tlaxcala por su alto contenido de proteínas son aptas para fines de alimentación animal y panificación.
Asunto(s)
Hordeum , Carbohidratos , Proteínas , Grano Comestible , Fenómenos Químicos , Composición de Alimentos , MéxicoRESUMEN
La calidad proteica de los cultivares de cebada Esmeralda 1, M16, Pastor Ortíz del Estado de Hidalgo y M16 del Estado de Tlaxcala fue evaluada por la determinación de la relación de eficiencia proteica (PER), basándose en el incremento de peso de ratas alimentadas con dietas bajo condiciones estandarizadas. Se observó que no existen diferencias significativas entre las cuatro variedades estudiadas, es decir, que las cuatro variedades proporcionan la misma calidad proteica al organismo, oscilando los valores de PER entre 2.4-2.2. Con relación a la caseína hubo una diferencia marcada, ya que dicha proteína produce mayor incremento de peso que las variedades de cebada. Esta diferencia entre las proteínas de caseína y las proteínas de cebada se debe al contenido de aminoácidos esenciales.
The protein quality of plantations of Esmeralda 1, M16, Pastor Ortíz barley varieties in Hidalgo state and M16 variety in Tlaxcala state were evaluated by means of the determination of protein efficiency relation (PER), being based on the increase of weight of rats fed with diets under standard conditions. It was observed that significant differences between the four varieties studied do not exist, that is to say, that the four varieties provide the same protein quality to the organism, having oscillated the values of PER between 2.4-2.2. In relation to the casein, there is a marked difference, since this protein provides greater increase of weight than the varieties of barley. This difference between casein proteins and barley proteins is due to the content of essential amino acids.
Asunto(s)
Animales , Ratas , Grano Comestible , Hordeum , Proteínas , Dieta/métodos , Calidad de los Alimentos , Tecnología de Alimentos , MéxicoRESUMEN
La cebada es el cuarto cereal de mayor importancia a nivel mundial, así como también a nivel nacional en México. Hidalgo y Tlaxcala son dos de los estados de mayor producción de cebada en grano de temporal. Entre los cereales existen variaciones en sus características y propiedades físicas, aún siendo de la misma variedad. Es por eso que existen sistemas de clasificación, para darle al grano de cebada determinada calidad y grado. Con la finalidad de determinar la calidad de siete variedades de cebada producidas en Hidalgo y Tlaxcala, las muestras se sometieron a diferentes análisis: sensorial y temperatura, impurezas y sanidad, densidad, dureza y selectivo. De los análisis mencionados se determinó que sólo la variedad Pastor Ortiz tiene el grado México de acuerdo a la norma mexicana NMX-FF-043-SCFI-2003, las otras seis variedades obtienen el grado México no clasificado.
Barley is the fourth cereal of greater importance at world-wide level, as well as at national level in México. Hidalgo and Tlaxcala are two of the states of greater production of barley. Between cereals, physical variations in their characteristics and properties exist, even in those of the same variety. A classification systems exist to give to the grain from certain barley regarding quality and degree. With the purpose of determining the quality of seven produced varieties of barley in Hidalgo and Tlaxcala, samples were put under different analyses: sensorial and temperature, impurities and sanitary, density, hardness and selectivity. From the analyses mentioned it was determined that only the Pastor Ortiz variety has the Mexico degree according to Mexican norm NMX-FF-043-SCFI-2003, the other six varieties received the Mexico rank of none classified.
Asunto(s)
Humanos , Análisis de los Alimentos/métodos , Hordeum/normas , Hordeum/química , Grano Comestible , Química de los Alimentos , Producción de Alimentos , Calidad de los Alimentos , Tecnología de Alimentos , MéxicoRESUMEN
Se realizó un estudio comparativo de las características físicoquímicas de tres variedades de cereales Kellogg's para desayuno, hojuelas de arroz (Special K), hojuelas de maíz (Zucaritas) y hojuelas de trigo (All Brand), y se compararon con las especificaciones dadas por el fabricante. Se constató que existen pequeñas diferencias que pueden ser debidas al tiempo transcurrido desde su elaboración. Se estudió por técnicas de difracción de rayos Lasser la distribución y tamaños de las partículas en suspención de estos cereales, correspondientes a los gránulos de almidón y partículas de grasas, denotándose una diferencia entre las variedades. Esto puede resultar efectivo para estudios posteriores por técnicas de análisis térmico, que permitan predecir de forma rápida y dinámica, tiempos de vida de estos productos y fechas de caducidad.
A comparative study of physic and chemical characteristics of three varieties of Kellogg's cereals for breakfast, of rice (Special K), maize (Zucaritas) and wheat (All Brand) was made, and compared with the specifications given by the manufacturer. It was stated that small differences exist that can be due to the time passed from their elaboration. It was possible to be studied by techniques of diffraction Lasser ray the distribution and sizes of particles in suspension of these cereals, corresponding to grains of starch and fat particles, denoting itself a difference between the varieties. These, can be effective for later studies by techniques of thermal analysis, that allow to predict of fast and dynamic form, times of life of these products and dates of lapsing.
Asunto(s)
Humanos , Análisis de los Alimentos/métodos , Grano Comestible/química , Ingestión de Alimentos , Tabla de Composición de los Alimentos , Química de los Alimentos , Tecnología de Alimentos/métodosRESUMEN
It has been reported five cases of Castleman s disease. They were admitted at Hermanos Ameijeiras Surgical-Clinic Hospital. In four out of the five cases belonged to hyaline-vascular histological variety and one case to plasmacellular variety. All the cases which belonged hyaline-vascular variety were located and one of them was complicated with sarcoma of dendritic follicular cells. The plasmacellular variety was of the multicentric type. Of the four located cases two of them were retroperitoneals and they received surgical treatment only; the case of cervical location was treated with radiotherapy and steroids and the forth one of axillary location was treated with surgical removal followed of radiotherapy. The last one case, of plasma-cell and multicentric type, was only treated with prednisone. All the patients are still alive and only the one with plasmacellular variety has symptoms yet.
Asunto(s)
Enfermedad de Castleman/diagnóstico , Adulto , Enfermedad de Castleman/terapia , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
Estudios han mostrado que es inapropiado realizar coprocultivos (CP) en pacientes con más de tres días de hospitalización, dado que la causa de diarrea no es atribuible a los patógenos entéricos que habitualmente se buscan en este examen1-3. El objetivo de este trabajo es analizar el rendimiento de los CP realizados en pacientes hospitalizados en la Red de Salud UC desde enero a diciembre del 2002 y la proporción de resultados positivos obtenidos según los días de hospitalización, para así poder definir si las normas internacionales se adaptan a la realidad nacional. Se recibieron 3474 CP, de los cuales 458 (13,2%) provenían de pacientes hospitalizados. De éstos, 16 (3,5%) fueron positivos, 13 se tomaron el día del ingreso, 2 al segundo día y 1 al quinto día de hospitalización. El rendimiento de CP realizados en pacientes con más de dos días de hospitalización fue sólo de 0,5% (1/190). Los resultados encontrados reafirman la recomendación internacional de no solicitar CP en pacientes con más de tres días de hospitalización; e incluso, a la luz de los datos anteriores, se podría sugerir instaurar un punto de corte a los 2 días de hospitalización, ya que más allá de este tiempo no hay un impacto clínico significativo y podríamos ahorrar un 41% de estos exámenes, con los costos correspondientes.
Asunto(s)
Adolescente , Adulto , Anciano , Niño , Preescolar , Femenino , Humanos , Masculino , Persona de Mediana Edad , Diarrea/diagnóstico , Heces/microbiología , Bacterias Gramnegativas/aislamiento & purificación , Infecciones por Bacterias Gramnegativas/diagnóstico , Hospitalización , Diarrea/microbiología , Infecciones por Bacterias Gramnegativas/microbiología , Tiempo de Internación , Estudios Retrospectivos , Factores de TiempoRESUMEN
Cerebellar symptoms at onset are unusual in HTLV-I/II-associated tropical spastic paraparesis (TSP). A prospective study of neurological disorders in Panama (1985-1990) revealed 13 patients with TSP and 3 with HTLV-I/II-associated spinocerebellar syndrome (HSCS) presenting at onset loss of balance, wide-based stance and gait, truncal instability, and mild leg ataxia (vermian cerebellar syndrome), with absent upper limb dysmetria but with postural tremor, downbeat nystagmus, and dysarthria. In 4-5 years, spinal cord manifestations of TSP developed, including spastic paraparesis, pyramidal signs, bladder and sphincter disturbances. Two patients were infected with HTLV-I and another one, a Guaymi Amerindian woman, with HTLV-II. Magnetic resonance imaging (MRI) demonstrated cerebellar atrophy involving predominantly the superior vermis. Mild axonal peripheral neuropathy in the lower limbs, dorsal column involvement and inflammatory myopathy were found by neurophysiology studies. There are 14 similar cases reported in Japan and Canada, but to our knowledge these are the first documented cases of HSCS in the tropics. A cerebellar syndrome constitutes another form of presentation of HTLV-I/II infection of the nervous system.
Asunto(s)
Cerebelo/patología , Cerebelo/virología , Infecciones por Deltaretrovirus/complicaciones , Infecciones por Deltaretrovirus/patología , Virus Linfotrópico T Tipo 1 Humano/fisiología , Virus Linfotrópico T Tipo 2 Humano/fisiología , Degeneraciones Espinocerebelosas/patología , Degeneraciones Espinocerebelosas/virología , Cerebelo/fisiopatología , Infecciones por Deltaretrovirus/virología , Femenino , Humanos , Imagen por Resonancia Magnética , Persona de Mediana Edad , Panamá , Degeneraciones Espinocerebelosas/fisiopatologíaRESUMEN
UNLABELLED: Massive hepatobiliary fascioliasis. Report of two cases. INTRODUCTION: Liver fascioliasis is the most frequent parasitic disease of the biliary tract in Mexico. Massive infestation is common in sheep and bovines and rarely occurs in humans. Only two previous cases of massive fascioliasis has been reported and we present here in two additional cases. Case reports. Both cases presented in alcohol-related liver disease patients who had eaten watercress Nasturium officinalis. Upper abdominal pain, obstructive jaundice, and choledochal dilatation were the salient manifestations. Diagnosis was made by surgical exploration and adult fluke identification. One patient died due to progressive liver failure and the other, is alive and received praziquantel treatment. CONCLUSIONS: Since 1935, approximately fifty cases of massive hepatobiliary fascioliasis have been reported in Mexico, most misdiagnosed as cholelithiasis; however, a history of watercress ingestion has been recorded in most of these cases.
Asunto(s)
Fascioliasis/patología , Anciano , Anciano de 80 o más Años , Antihelmínticos/uso terapéutico , Colecistitis/complicaciones , Enfermedad Crónica , Terapia Combinada , Diabetes Mellitus Tipo 2/complicaciones , Fascioliasis/complicaciones , Fascioliasis/tratamiento farmacológico , Fascioliasis/epidemiología , Fascioliasis/cirugía , Resultado Fatal , Femenino , Contaminación de Alimentos , Parasitología de Alimentos , Humanos , Hipertensión/complicaciones , Cirrosis Hepática Alcohólica/complicaciones , Fallo Hepático/etiología , Masculino , Persona de Mediana Edad , Plantas Comestibles/parasitología , Praziquantel/uso terapéuticoRESUMEN
An interesting neurological syndrome, characterized by recurrent optic neuritis, cervical myelopathy from syringomyelia, paraparesis, amenorrhea-galactorrhea, and other endocrine problems, has been described among young black women in the French West Indies. The etiology remains unknown, but possible links with Devic's disease, acute disseminated encephalomyelitis, and neurotoxicity from quinolines in Annona muricata teas have been postulated. The largest epidemic of neuropathy in this century occurred in Cuba in 1991-1994. Clinical features and etiologic studies are reviewed. Its primary cause was nutritional. A similar epidemic was recently described in Tanzania. A number of infectious neuropathies and myopathies are reviewed, including leprosy, tuberculosis, hemorrhagic fevers (Ebola and Marburg filoviruses, Lassa, Argentinean and Bolivian arenaviruses), the human retrovirus human T-cell lymphotropic virus type I, Lyme disease and postimmunization neuropathies. The tropics continue to contribute interesting and important clinical conditions that may illuminate the etiopathiogenesis of other common disorders.
Asunto(s)
Neuritis Óptica/patología , Medicina Tropical , Cuba/epidemiología , Humanos , Neuritis Óptica/epidemiología , Neuritis Óptica/etiologíaRESUMEN
The phenomenon of massive migration is a true "natural experiment" that offers opportunities for the study of gene-environment interactions in disease pathogenesis. Comparison of disease incidence, prevalence and mortality in the original population and in the migrant group, exposed to vastly different environmental influences, may reveal the presence of either risk factors or protective influences in one of the groups. As part of the "Colombo 2000" project to study the large Italian migration to Argentina, differences in mortality for neurological diseases have been found. Higher mortality rates for brain tumors, psychiatric diseases, Parkinson's disease, Alzheimer's disease, and motor neuron diseases were found in Italy while Argentina had mortality rates five times higher than Italy for alcohol-related deaths and two times higher for hemorrhagic strokes. Further study of these areas of difference is suggested using case-control, genetic, and cross-sectional studies in Italy and Argentina.
Asunto(s)
Consumo de Bebidas Alcohólicas/mortalidad , Infarto Cerebral/mortalidad , Predisposición Genética a la Enfermedad/epidemiología , Enfermedades Neurodegenerativas/epidemiología , Argentina/epidemiología , Comparación Transcultural , Métodos Epidemiológicos , Femenino , Humanos , Incidencia , Italia/epidemiología , Masculino , Prevalencia , Estudios Prospectivos , Tasa de Supervivencia , Migrantes/estadística & datos numéricosRESUMEN
In 1992, the USA embargo on Cuba was tightened through the passage of the Cuban Democracy Act (CDA) that explicitly restricts food and medical supplies. The embargo has contributed to cause a number of public health problems in Cuba including: (1) an epidemic of more than 50,000 cases of optic and peripheral neuropathies in 1992-1993, resulting from dietary deficiency; (2) an epidemic of esophageal stenoses in toddlers who inadvertently drank liquid lye as a result of a soap shortage for which liquid lye was substituted; (3) an outbreak of Guillain-Barré syndrome in Havana, in June and July 1994, resulting from water contamination due to lack of chemicals for water treatment to eliminate Campylobacter sp.; (4) outbreaks of self-inflicted disease and injuries caused by rioting among Cubans detained at the US Naval base at Guantánamo Bay, and (5) a decline in medical practice standards and public health indicators in Cuba resulting from the enactment of the CDA, documented by the American Public Health Association in 1993 and confirmed in March 1997 by the American Association for World Health. Despite this evidence, the Cuban embargo remains a politically sensitive subject in the USA, resistant to public health concerns, as evidenced by the recent passage of the Helms-Burton Act. The public health effects of the CDA need to be reviewed with possible revocation or at least modification.
Asunto(s)
Brotes de Enfermedades/legislación & jurisprudencia , Enfermedades del Sistema Nervioso/epidemiología , Salud Pública/legislación & jurisprudencia , Adolescente , Adulto , Anciano , Infecciones por Campylobacter/complicaciones , Infecciones por Campylobacter/epidemiología , Niño , Cuba/epidemiología , Estenosis Esofágica/epidemiología , Estenosis Esofágica/etiología , Femenino , Humanos , Lactante , Masculino , Persona de Mediana Edad , Enfermedades del Sistema Nervioso/dietoterapia , Enfermedades del Sistema Nervioso/etiología , Estado Nutricional , Enfermedades del Sistema Nervioso Periférico/epidemiología , Enfermedades del Sistema Nervioso Periférico/etiología , Polirradiculoneuropatía/epidemiología , Embarazo , Política Pública , Factores Socioeconómicos , Estados Unidos , Deficiencia de Vitamina B/epidemiologíaRESUMEN
At this study we analyzed morphologic relation with vaginal ephitelium, in women with bacterial vaginosis, in pre-treatment; first post-treatment and second post-treatment using metronidazol (oral), and clindamycine (intra-vaginally). From 20 patients with bacterial vaginosis, 10 received oral metronidazol, 500 mg/b.i.d. during seven days; the other patients received, clindamycine 2% intravaginal, once a day, during seven days. Couples received metronidazol. In pre-treatment, cellular prolongations produced greater adhesion of bacteria, and rests of cellular unions with adhered bacteria. There was penetration of some bacteria to epithelial cells, confirming this with serial cuts and discarding superposition in the cells. This penetration was found in five cases y persisted during the first and second post-treatment. In the first post-treatment, cellular groups without bacteria, were found. The presence of lactobacillus was low, increasing afterwards. The presence of yeasts was in the first post-treatment, and in some cases persisted. It is important to differentiate intracellular bacteria and to know the related characteristics with bacterial penetration, for an adequate prescription and a better use of medication, avoiding possible damage. The presence of bacteria may be one of the causes for bacterial vaginosis reincidence.