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We aimed to evaluate the facilitation effects of an aluminum (Al) hyperaccumulator species bearing cluster roots, Gevuina avellana, on the seedling growth and performance of an Al-intolerant and phosphorus (P)-deficient-sensitive plant, Vaccinium corymbosum. For this, seedlings of G. avellana and V. corymbosum were grown alone or together as follows: i) two G. avellana seedlings, ii) one G. avellana + one V. corymbosum and iii) two V. corymbosum, in soil supplemented with Al (as Al2(SO4)3) and in the control (without Al supplementation). We determined relative growth rate (RGR), photosynthetic rate, chlorophyll concentration, lipid peroxidation and Al and nutrient concentration [Nitrogen (N), P, potassium (K), calcium (Ca), magnesium (Mg), sodium (Na), manganese (Mn), iron (Fe), copper (Cu), zinc (Zn), and sulfur (S)] in leaves and roots of both species. The results showed that, in general, G. avellana did not assist V. corymbosum to enhance its RGR nor reduce its Al uptake. However, G. avellana assisted V. corymbosum in enhanced N acquisition and, consequently, to increase its chlorophyll concentration and photosynthetic rate. Besides, V. corymbosum had lower lipid peroxidation in leaves when grown in the soil with high Al supplementation in association with G. avellana. Our results suggest a facilitating effect of G. avellana to V. corymbosum when grown in soils with high Al concentration, by enhancing chlorophyll concentrations and photosynthetic rate, and decreasing the oxidative damage to lipids.
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INTRODUCCIÓN: En la mayoría de servicios de urgencia estatales no cuentan con un Urólogo de llamado, por lo que la mayoría de los pacientes que acuden al Servicio de Urgencia (SU) son evaluados por cirujanos generales. MATERIALES Y MÉTODO: Estudio observacional retrospectivo de corte transversal de la totalidad de ingresos al SU de nuestro centro entre enero de 2008 y diciembre de 2012, de los cuales se analizaron los pacientes con diagnósticos urológicos. Las variables estudiadas fueron: edad, sexo, diagnóstico determinado según la CIE-10 y si se realizó cirugía de urgencia. RESULTADOS: Media de edad: 48,5 años (D.E.:27,07), Sexo: Masculino 74 por ciento, Media de Consultas totales en SU: 142.138pacientes anuales, Media de consultas Urológicas en SU: 4.837 pacientes anuales, correspondientes al 3,4 por ciento del total. Las consultas más frecuentes fueron: ITU baja: 33,5 por ciento, Cólico Renal: 33,1 por ciento , ITU alta 15,6 por ciento, de los cuales un 0,6 por ciento correspondena Pionefrosis, Patología Genital Infecciosa: 4,7 por ciento, de los cuales un 76 por ciento, corresponden a Orquiepididimitis, Retención Aguda de Orina: 3,7 por ciento, Hematuria Persistente: 2,4 por ciento,, Trauma Urogenital: 1,86 por ciento,, Urgencias Genitales: 0,37 por ciento,. Pacientes que requirieron Cirugía de Urgencia: 1.02 por ciento, CONCLUSIONES: Si bien, el porcentaje de pacientes a los que se realizó una intervención quirúrgica de urgencia es bajo,sería importante implementar en los servicios de urgencia estatales Urólogos de llamado, ya que patologías altamente prevalentes, como la litiásica, podrían tener una mejor resolución. (AU)
Most of the public emergency services do not count with urologist and these patients are evaluated by general surgeons. MATERIALS AND METHODS: cross-section, retrospective study of all admissions in Emergency Services (ES) at our center between January 2008 and December 2012, of patients with urological diagnoses were analyzed. The variables studied were: age, sex, diagnosis determined according to the International Classification Diseases, 10th version and if emergency surgery was performed. RESULTS: Average age: 48.5 years (SD: 27.07), Gender: Male 74 pertcent Average Total consultations in ES: 142,138 patients annually, Media of urological evaluations at ES: 4,837 patients annually, corresponding to 3.4 pertcent of the total. The most frequent diagnosis were: low UTI: 33.5 pertcent,Renal pain: 33.1 pertcent, 15.6 pertcent high UTI, of which 0.6 pertcent are to Pyonephrosis, Infectious Genital Pathology 4.7 pertcent, of which 76 pertcent are Epydidimo- Orchitis, Acute Urinary Retention: 3.7 pertcent, Persistent Hematuria 2.4 pertcent, Genitourinary Trauma: 1.86 pertcent Genital Emergencies: 0.37 pertcent. Patients requiring urgent surgery: 1.02 pertcent CONCLUSIONS: While the percentage of patients who performed an emergency surgical intervention is low, it would be important to implement Urologists in public Emergency Services as highly prevalent diseases such as urolithiasis, could have a better resolution.(AU)
Assuntos
Masculino , Unidade Hospitalar de Urologia , Serviços Médicos de EmergênciaRESUMO
Se describe la inusual evolución de fibroadenomas (FA) mamarios múltiples en una adolescente de 11 años en tratamiento con progestinas cíclicas por metrorragia disfuncional. Inicialmente la ecografía mamaria mostró más de 10 lesiones sólidas en cada mama de hasta 2,6 cm, compatibles con fibroadenomas. Al cabo de 13 meses las lesiones se redujeron en número y tamaño. Se discute la historia natural de los FA, la influencia hormonal en la etiología de los FA y finalmente el diagnóstico ecográfico y manejo de este cuadro en la adolescencia. Se plantea, a modo de hipótesis, que existe un desbalance estrógeno-progesterona (E-P) dado por ciclos anovulatorios en el periodo posmenárquico, que se manifestó con metrorragia disfuncional y la presencia de FA. Al administrar progesterona cíclica se reequilibra la relación E-P explicando el control del ciclo y la involución de las lesiones mamarias.
We describe the unusual evolution of multiple fibroadenomas (FA) in a 11-years old adolescent during treatment of an abnormal uterine bleeding with cyclic progestins. Inicially ultrasound demonstrated more than 10 masses in each breast, up to 2,6 cm diameter, compatible with fibroadenomas. After 13 month follow up lesions decreased in number and size. We discuss the natural history of FA, the hormonal influence in FA etiology, the ultrasound diagnosis and the managment of this pathology in adolescents. We hypothesized that there is an estrogen/progestin imbalance, due to the anovulatory cycles of the post menarche period that caused the AUB and FA. Cyclic progesterone balanced the E/P relation, thus managing both AUB and causing regression of the breast masses.
Assuntos
Humanos , Feminino , Criança , Fibroadenoma/diagnóstico , Fibroadenoma/etiologia , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/etiologia , Evolução Clínica , Fibroadenoma/tratamento farmacológico , Metrorragia/etiologia , Neoplasias da Mama/tratamento farmacológicoRESUMO
Objetivo: Evaluar la facilidad y efectividad de la reducción neumática de la invaginación intestinal en niños. Materiales y métodos: El grupo de estudio estuvo conformado por 14 niños y 6 niñas, entre un mes y tres años de edad, a quienes se les realizaron 21 reducciones neumáticas desde enero de 2006 a abril de 2009. La invaginación intestinal fue diagnosticada en todos los pacientes por los criterios ecográficos conocidos y a todos se les realizó la reducción bajo control fluoroscópico. Se mantuvo una presión de 120 mm Hg durante 30 segundos con guía fluoroscópica. Resultados: El índice de éxito fue del 95% (20 reducciones de 21), sin recurrencia inmediata. En un paciente no se logró la reducción por encontrársele un divertículo de Meckel, que requirió cirugía. No se presentaron perforaciones intestinales y un paciente tuvo una invaginación recurrente tardía. Conclusión: La reducción neumática de la invaginación intestinal es un método seguro y muy efectivo, con una alta tasa de éxito.
Objective: To assess the feasibility and effectiveness of pneumatic reduction as a non surgical treatment of intussusception in children. Materials and Methods: We studied retrospectively 20 consecutive patients (aged 1 month to 3 years; 14 boys, 6 girls) who underwent pneumatic reduction of intussusception from January 2006 to April 2009. Previous abdominal sonography was performedand confirmed the diagnosis of intussusception in all of them. All patients underwent pneumaticreduction under fluoroscopic guidance using the standard technique. Results: The overall success rate of pneumatic reduction in intussusception was of 95% (20 of 21 reductions), with no cases of immediate recurrence. In a patient who had a Meckels diverticulum, the intussusception could not be reduced. There were no cases of intestinal perforation or other complications and recurrence of intussusception occurred only in one patient. Conclusion: Pneumatic reduction is a safe, feasible and highly effective method for treatment of intussusception in children.
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Obstrução Intestinal , Perfuração Intestinal , IntussuscepçãoRESUMO
La enfermedad de injerto contra huésped es un síndrome que ocurre en pacientes inmuno-deprimidos generalmente post-trasplante de médula ósea, caracterizado en su etapa aguda por manifestaciones dermatológicas, hepáticas y gastrointestinales. El diagnóstico oportuno es fundamental, ya que puede disminuir significativamente la morbimortalidad. Dentro del diagnóstico diferencial de las manifestaciones gastrointestinales se incluye enterocolitis neutropénica y colitis pseudomembranosa. Mediante tomografía computada, hay signos que apuntan a su diagnóstico, como dilatación focal de asas, y refuerzo significativo de la mucosa enterocólica.
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Humanos , Doença Enxerto-Hospedeiro/complicações , Doença Enxerto-Hospedeiro/diagnóstico , Enterocolite/diagnóstico , Enterocolite/etiologia , Colonoscopia , Diagnóstico Diferencial , Doença Enxerto-Hospedeiro/patologia , Gastroenteropatias/diagnóstico , Gastroenteropatias/etiologia , Hospedeiro Imunocomprometido , Neutropenia , Síndrome , Tomografia Computadorizada por Raios X , Transplante de Medula Óssea/efeitos adversosRESUMO
The agar dilution method was used to test the activity of ampicillin, benzylpenicillin, cefoxitin, imipenem, clindamycin, metronidazole, chloramphenicol, gentamicin, methicillin and vancomycin against 241 anaerobic and 227 aerobic bacteria isolated from 136 patients with intraabdominal infections and 49 with nonintraabdominal infections. Beta-lactamase production was tested in all strains. Overall, imipenem, metronidazole and chloramphenicol were the most active antimicrobial agents against anaerobic bacteria followed by clindamycin. Only the Bacteroides fragilis group was shown to be less susceptible to clindamycin (MIC90 8 mg/l). Ampicillin and cefoxitin were the least active beta-lactam antibiotics against the most common isolated B. fragilis group strains (MIC(90) >1024 and 64 mg/l, respectively) and against Escherichia coli strains (MIC(90) >1024 and >1024 mg/l, respectively). Chloramphenicol showed low activity against the Gram-negative aerobic bacteria, while gentamicin had good activity against the aerobic bacteria tested, except for E. coli and Pseudomonas. Among the Gram-positive aerobic and anaerobic bacteria tested, Staphylococcus aureus was shown to be less susceptible to beta-lactam antibiotics (29% were methicillin resistant). No vancomycin-resistant S. aureus strains were found. A good correlation between beta-lactamase production and beta-lactam resistance was observed.
RESUMO
The agar dilution method was used to test the activity of ampicillin, benzylpenicillin, cefoxitin, imipenem, clindamycin, metronidazole, chloramphenicol, gentamicin, methicillin and vancomycin against 241 anaerobic and 227 aerobic bacteria isolated from 136 patients with intraabdominal infections and 49 with nonintraabdominal infections. Beta-lactamase production was tested in all strains. Overall, imipenem, metronidazole and chloramphenicol were the most active antimicrobial agents against anaerobic bacteria followed by clindamycin. Only the Bacteroides fragilis group was shown to be less susceptible to clindamycin (MIC90 8 mg/l). Ampicillin and cefoxitin were the least active beta-lactam antibiotics against the most common isolated B. fragilis group strains (MIC(90) >1024 and 64 mg/l, respectively) and against Escherichia coli strains (MIC(90) >1024 and >1024 mg/l, respectively). Chloramphenicol showed low activity against the Gram-negative aerobic bacteria, while gentamicin had good activity against the aerobic bacteria tested, except for E. coli and Pseudomonas. Among the Gram-positive aerobic and anaerobic bacteria tested, Staphylococcus aureus was shown to be less susceptible to beta-lactam antibiotics (29% were methicillin resistant). No vancomycin-resistant S. aureus strains were found. A good correlation between beta-lactamase production and beta-lactam resistance was observed.
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Bactérias Aeróbias/efeitos dos fármacos , Bactérias Anaeróbias/efeitos dos fármacos , Infecções Bacterianas/tratamento farmacológico , Resistência Microbiana a Medicamentos , Humanos , Testes de Sensibilidade Microbiana , NicaráguaRESUMO
A case of primary squamous-cell carcinoma (epidermoid carcinoma) of the colon is presented located in the hepatic flexure. It seems to be the first case registered in Latin America. The pathogenesis, natural history, and treatment of the disease are reviewed.
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Carcinoma de Células Escamosas/diagnóstico , Neoplasias do Colo/diagnóstico , Idoso , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/cirurgia , Colectomia , Colo/patologia , Neoplasias do Colo/patologia , Neoplasias do Colo/cirurgia , Humanos , MasculinoRESUMO
The clinical course of infection by Salmonellae was compared between patients who had been vaccinated against typhoid fever using the Ty21a vaccine and those who had not. Of 2566 bacteriological confirmed cases 84% were infected with S typhi, 14% with S paratyphi B and 2% with S paratyphi A. Among patients with typhoid fever, 34% were treated in hospital, 3.5% had relapses, 5.4% developed complications and 1 patient died (0.05%). Among patients with paratyphoid fever, 18% were treated in hospital, 0.6% had relapses, 1.4% developed complications and there were no deaths. These figures were similar among vaccinated and non-vaccinated cases. A slightly greater proportion of vaccinated cases were treated in hospital (38 vs 30%). Thus, use of oral vaccination against typhoid fever does not alter the clinical course of infection with Salmonellae.
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Febre Paratifoide/fisiopatologia , Febre Tifoide/fisiopatologia , Vacinas Tíficas-Paratíficas , Administração Oral , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Febre Paratifoide/epidemiologia , Febre Paratifoide/prevenção & controle , Salmonella paratyphi A , Salmonella paratyphi B , Febre Tifoide/epidemiologia , Febre Tifoide/prevenção & controle , Vacinas Tíficas-Paratíficas/administração & dosagemRESUMO
We evaluated the anti Vi test to detect S typhi carriers in 1006 food handlers of 65 locations in central Santiago (Chile): 710 males and 296 females, age range 17 to 67. Positive reactions were found in 27 subjects, titers varying from 1/40 in 9 to 1/160 in 1 subject. Culture of feces, along with urine and bile cultures in those with very high titers allowed isolation of S typhi in 2 subjects, one with a 1/40 titer, the other 1/160. None had clinical history of typhoid fever, both had received parenteral vaccination. These results compare favorably with the classic technique which would have required 3018 fecal cultures (vs 108 in the present study) and a total cost of US$ 1730 vs US$ 364. In addition, anti-Vi detection is readily accepted by the subjects. Therefore, we recommend this technique as a screening prior to culture techniques in the identification of chronic S typhi carriers.