RESUMO
INTRODUCTION: Neurotoxoplasmosis (NTX) is one of the commonest opportunist infections in patients infected by the human immunodeficiency virus. It presents with a variety of clinical features in the immunocompromised patient. PATIENTS AND METHODS: We made a horizontal retrospective descriptive study of 88 patients with a diagnosis of NTX treated in the Pedro Kour Institute during a three years period. Our aim was to find which were the most common forms of clinical presentation in our setting and to evaluate the use of paraclinical examinations in reaching the presumptive diagnosis. The patients had clinical examinations, CSF studies, detection of indirect immunofluorescence titres (IFI) for Toxoplasma, imaging studies (CAT) and lymphocyte counts. RESULTS: The commonest symptoms were: headache in 79%, fever in 55.68%, motor defect in 44.31% and disorders of consciousness in 29.54% of the patients. The IFI titres were negative in 31.54% of the patients, between 1/16 and 1/32 in 38.34% and between 1/64 and 1/1,024 in only 30.07% of cases. The T CD4+ lymphocyte count was less than 200 cells in 66.7% of the patients; 72% of imaging studies showed typical lesions, in association with other disorders in 38% of the cases (lymphomas, cryptococcosis, tuberculous meningoencephalitis and cytomegalovirus encephalitis). CONCLUSIONS: NTX in a patient with AIDS often presents in our setting with headache and fever, motor deficit and alterations of consciousness. The diagnosis should be confirmed by immunological or imaging studies since in this disease serology and CSF studies are less specific.
Assuntos
Síndrome da Imunodeficiência Adquirida/epidemiologia , Toxoplasmose Cerebral/epidemiologia , Adulto , Animais , Transtornos da Consciência/diagnóstico , Transtornos da Consciência/epidemiologia , Cuba/epidemiologia , Ensaio de Imunoadsorção Enzimática , Feminino , Febre/diagnóstico , Febre/epidemiologia , Técnica Indireta de Fluorescência para Anticorpo , Cefaleia/diagnóstico , Cefaleia/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos Psicomotores/diagnóstico , Transtornos Psicomotores/epidemiologia , Estudos Retrospectivos , Índice de Gravidade de Doença , Toxoplasma/isolamento & purificação , Toxoplasmose Cerebral/diagnóstico , Toxoplasmose Cerebral/parasitologiaRESUMO
Resumen. Introducción. La neurotoxoplasmosis (NTX) es una de las infecciones oportunistas más frecuentes en el paciente infectado por el virus de inmunodeficiencia humana y se presenta con diversidad de manifestaciones clínicas en el huésped inmunoafectado. Pacientes y métodos. Realizamos un estudio descriptivo horizontal, retrospectivo, en 88 pacientes atendidos en el Instituto Pedro Kourí, durante un período de 3 años, con el diagnóstico clínico de NTX, con el propósito de describir qué formas clínicas de presentación en nuestro medio son las más frecuentes, así como evaluar la utilidad de los exámenes paraclínicos en el diagnóstico presumible. Se les realizó examen clínico, estudio del LCR, detección de los títulos de la inmunofluorescencia indirecta (IFI) para Toxoplasma, estudios imaginológicos (TAC), así como recuento de poblaciones linfocitarias. Resultados. Los síntomas que sepresentaron con mayor frecuencia fueron: cefalalgia en un 79 por ciento, fiebre en un 55,68 por ciento, defecto motor en el 44,31 por ciento y trastornos de la concienciaen el 29,54 por ciento de los pacientes. Los títulos de IFI estaban negativos en el 31,54 por ciento de los pacientes, entre 1/16 y 1/32 en el 38,34 por ciento, y entre1/64 y 1/1.024 en sólo el 30,07 por ciento de los casos. El recuento de linfocitosT CD4+ se encontraba por debajo de 200 células en el 66,7 por ciento de los pacientes; el 72 por ciento de los estudios imaginológicos evidenciaron lesiones típicas, y se asociaron a otras entidades en el 38 por ciento de los casos (linfomas, criptococosis, meningoencefalitis tuberculosa y encefalitis por citomegalovirus). Conclusiones. La NTX en el paciente con sida se presenta frecuentemente en nuestro medio con cefalalgia, asociada a fiebre, déficit motor y trastornos de conciencia, y su diagnóstico debecomplementarse con el estudio inmunológico e imaginológico, pues los resultados de los estudios serológicos y del LCR son más inespecíficos en esta enfermedad(AU)
Assuntos
Humanos , Síndrome da Imunodeficiência AdquiridaRESUMO
The link between excessive consumption of dietary saturated fats and coronary heart disease (CHD) is now well established. Because of its high content of saturated fatty acids, the consumption of foods containing coconut oil may therefore be a risk factor for CHD. While the fatty acid composition of coconut oil is well established, relatively little is known about the other constituents of coconut: the milk, water, cream and meat fractions. In this study, we show that while the water fraction is low in lipid content, the milk contains about 24% of the fat content of oil and the cream and meat fractions about 34%. The other coconut constituents contain significant amounts of medium-chain triglycerides that are formed from fatty acids of chain length 8:0 to 14:0. It is these fatty acids, primarily 14:0, that are thought to be atherogenic. On the other hand, medium-chain triglycerides may be advantageous under some circumstances in that they are absorbed intact and do not undergo degradation and re-esterification processes. As a result, medium-chain triglycerides provide a ready source of energy and may be useful in baby foods or in diet therapy. Nevertheless, the possible negative effects of the saturated fatty acids and the absence of the essential fatty acid linolenic acid from all coconut constituents suggest that the coconut milk, oil and cream should not be used on a regular basis in adults.
Assuntos
Cocos/química , Doença das Coronárias/etiologia , Ácidos Graxos/análise , Doença das Coronárias/epidemiologia , Gorduras na Dieta/análise , Gorduras Insaturadas na Dieta/classificação , Humanos , Lipídeos/análise , Lipídeos/sangue , Fatores de Risco , Trinidad e TobagoRESUMO
The link between excessive composition of dietary saturated fats and coronary heart disease (CHD) is now well established. Because of its high content of saturated fatty acids, the composition of foods containing coconut oil may therefore be a risk factor for CHD. While the fatty acid composition of coconut oil is well established, relatively little is known about the other constituents of coconut: the milk, water, cream and meat fractions. In this study, we show that while the water fraction is low in lipid content, the milk contains about 24 percent of the fat content of oil and the cream and meat fractions about 34 percent. The other coconut constituents contain significant amounts of medium-chain triglycerides that are formed from fatty acids of chain length 8:0 to 14:0. It is these fatty acids, primarily 14:0, that are thought to be atherogenic. On the other hand, medium-chain triglycerides provide a ready source of energy and may be useful in baby foods or in diet therapy. Nevertheless, the possible negative effects of the saturated acids and the absence of the essential fatty acid linolenic acid from all coconut constituents suggest that the coconut milk, oil and cream should not be used on a regular basis in adults. (AU)
Assuntos
Humanos , Cocos/química , Doença das Coronárias/etiologia , Ácidos Graxos/análise , Doença das Coronárias/epidemiologia , Gorduras na Dieta/análise , Gorduras Insaturadas na Dieta/classificação , Lipídeos/análise , Lipídeos/sangue , Fatores de Risco , Trinidad e TobagoRESUMO
The link between excessive composition of dietary saturated fats and coronary heart disease (CHD) is now well established. Because of its high content of saturated fatty acids, the composition of foods containing coconut oil may therefore be a risk factor for CHD. While the fatty acid composition of coconut oil is well established, relatively little is known about the other constituents of coconut: the milk, water, cream and meat fractions. In this study, we show that while the water fraction is low in lipid content, the milk contains about 24 percent of the fat content of oil and the cream and meat fractions about 34 percent. The other coconut constituents contain significant amounts of medium-chain triglycerides that are formed from fatty acids of chain length 8:0 to 14:0. It is these fatty acids, primarily 14:0, that are thought to be atherogenic. On the other hand, medium-chain triglycerides provide a ready source of energy and may be useful in baby foods or in diet therapy. Nevertheless, the possible negative effects of the saturated acids and the absence of the essential fatty acid linolenic acid from all coconut constituents suggest that the coconut milk, oil and cream should not be used on a regular basis in adults.
Assuntos
Humanos , Cocos/química , Doença das Coronárias/etiologia , Ácidos Graxos/análise , Trinidad e Tobago , Gorduras Insaturadas na Dieta/classificação , Gorduras na Dieta/análise , Fatores de Risco , Doença das Coronárias/epidemiologia , Lipídeos/análise , Lipídeos/sangueRESUMO
The tuberous roots of the Mexican yam bean, jicama, (Pachyrhizus erosus L. Urban) contained large quantities of two acidic glycoproteins which accounted for more than 70% of the total soluble proteins (about 3 g per 100 g of tuber on a dry weight basis). The two major proteins, tentatively named YBG1 and YBG2, had apparent M(r)s of 28,000 and 26,000, respectively, by SDS-PAGE. A third protein named YBP22 which accounted for 2-5% of the total soluble proteins had an M(r) of 22,000. YBG1 and YBG2 exhibited great similarity on the basis of their amino acid composition and had identical N-terminal amino acid sequences. The first 23 amino acids in the N-terminal region of YBG2 were DDLPDYVDWRDYGAVTRIKNQGQ which showed strong homology with the papain class of cysteine proteases. YBG1 and YBG2 were found to bind to a Concanavalin A-Sepharose column and were also stained positively by a sensitive glycoprotein stain. Both glycoproteins exhibited cysteine proteolytic activity. In contrast, YBP22 showed sequence homology with several known protease inhibitors, and a polyclonal antibody raised against this protein cross reacted with soybean trypsin inhibitor.
Assuntos
Fabaceae/química , Glicoproteínas/química , Proteínas de Plantas/química , Plantas Medicinais , Sequência de Aminoácidos , Glicoproteínas/isolamento & purificação , Dados de Sequência Molecular , Proteínas de Plantas/isolamento & purificação , Raízes de Plantas/química , Homologia de Sequência de AminoácidosRESUMO
Calmodulin is an ubiquitous, malfunctional 17kDa, acidic protein which is activated by Ca2+ and regualates the function of many enzymes and other cellular proteins. A novel bovine heart high molecular weight Ca2+ /Calmodulin-binding protein was recently reported by Sharma (J.Biol. Chem. 265, 1152-1157, 1990) and Barnes and Sharma (Faseb J. 5 449, 1991). In this work, we have investigated the distribution of this 175 kDA protein (Mr 140 000) in various bovine tissues. The polyclonal antibody to the protein was used to show its presence in the heart, lung, brain and pancreas but not in spleen, Kidney, uterus and skeletal muscles. The protein was phosphorylated by a novel endogenous protein kinase with a stoichiometry of 1 mole of phosphate incorporated per mole of protein in a Ca2+ /Calmodulin-dependant manner(AU)
Assuntos
Proteínas de Ligação a Calmodulina/imunologia , FosforilaçãoRESUMO
The Myelodysplastic Syndromes (MDS) are a group of hematologic disorders that resemble hematologic malignancies but are often treated much differently. These syndromes result from a clonal disorder of certain stem cells in the bone marrow. Treatment can range from simple supportive care to new and innovative approaches such as immunotherapy. In general, treatment is dictated by the severity of the presenting disease. Oncology nurses, because of their familiarity with the manifestations of cancer, are particularly qualified to intervene for the patient and family experiencing MDS. Nursing interventions, based on a firm understanding of the underlying disease, include patients and family education. In addition, emotional support and symptom management are important nursing roles.