RESUMO
New perspectives arise in the therapeutic practice for cancer, with the objective to not only treat patients, but also improve their quality of life. Guarana, a plant from Brazilian Amazon presents a wide range of pharmacological actions. This study evaluated the effect of Guarana (Paullinia cupana) extract, pure and dry Guarana (PC-18) extract and magnesium chloride (MgCl2) in mice of the Balb/c strain inoculated with the Ehrlich tumor regarding gene expression of inflammatory markers transforming growth factor-ß1 and tumor necrosis factor alpha and oxidative stress (OS) and fatigue, superoxide dismutase, catalase, and glutathione peroxidase 4 and analyzed myelotoxicity and hepatotoxicity. After euthanasia, blood was collected to analyze the complete blood count and measured the levels of liver enzymes (alanine aminotransferase and aspartate aminotransferase). Hepatoprotective actions of the crude extract of P. cupana and PC-18 extract were noticed. The PC-18 and MgCl2 group showed the best result regarding animal welfare. There were no associations between compounds and gene expression regarding fatigue and OS. PC-18 reduced the tumor and may have an antitumor action. The crude extract of Guarana presented hepatoprotective action.
Assuntos
Neoplasias , Paullinia , Animais , Fadiga/tratamento farmacológico , Cloreto de Magnésio/uso terapêutico , Camundongos , Camundongos Endogâmicos BALB C , Neoplasias/tratamento farmacológico , Extratos Vegetais/farmacologia , Extratos Vegetais/uso terapêutico , Qualidade de VidaRESUMO
BACKGROUND: The three-way indwelling urinary catheter (IUC) is used for continuous bladder irrigation and is considered the cornerstone for clinical treatment of patients with macroscopic hematuria. Although there seems to be a logical relationship between catheter size and efficacy of irrigation and drainage, we often observe relevant variations in these parameters between different brands of catheters available on the market. The aim of this study was to compare the mechanical properties of different models of latex and silicone three-way catheters in an in vitro setting that resembles clinical use. METHODS: Three different three-way catheters were evaluated: Gold Silicone-Coated Rusch® (Model A), 100% Silicone Rusch® (Model B) and X-Flow Coloplast® (Model C). Irrigation channel, drainage channel, and overall cross-sectional areas were all digitally measured. Irrigation and drainage channel flow rates were measured and correlated with their corresponding catheter cross-sectional area values. RESULTS: Different catheter models of the same caliber have different internal irrigation port diameters, internal drainage port diameters and internal cuff port diameters. The Model C IUC internal irrigation port diameter is significantly larger than models A and B. When flows were evaluated, we found that in the same model, the increase in caliber of the IUC was related to an increased drainage flow, but not to an increased irrigation flow. CONCLUSION: Precise measurements of the internal architecture of the three-way catheter, rather than relying on the caliber itself, could assist surgeons in choosing the best product for each specific patient, while minimizing complications.
RESUMO
OBJECTIVE: To investigate the impacts of continuous venovenous hemodiafiltration on the microcirculation in patients with acute kidney injury. METHODS: A prospective observational pilot study conducted in a 40-bed, open clinical-surgical intensive care unit of a private tertiary care hospital located in the city of São Paulo (SP), Brazil. Microcirculation was assessed using near-infrared spectroscopy by means of a 15mm probe placed over the thenar eminence. Vascular occlusion test was performed on the forearm to be submitted to near-infrared spectroscopy by inflation of a sphygmomanometer cuff to 30mmHg higher than the systolic arterial pressure. The primary endpoint was the assessment of near-infrared spectroscopy-derived parameters immediately before, 1, 4 and 24 hours after the initiation of continuous venovenous hemodiafiltration. RESULTS: Nine patients were included in this pilot study over a period of 2 months. Minimum tissue oxygen saturation measured during the vascular occlusion test was the only near-infrared spectroscopy-derived parameter to differed over the time (decrease compared to baseline values up to 24 hours after initiation of continuous venovenous hemodiafiltration). CONCLUSION: The impacts of microcirculatory dysfunction on clinical outcomes of patients undergoing to continuous venovenous hemodiafiltration need to be further investigated.
Assuntos
Injúria Renal Aguda/diagnóstico por imagem , Hemodiafiltração/métodos , Microcirculação/fisiologia , Injúria Renal Aguda/fisiopatologia , Injúria Renal Aguda/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Estudos Prospectivos , Espectroscopia de Luz Próxima ao InfravermelhoRESUMO
ABSTRACT Objective To investigate the impacts of continuous venovenous hemodiafiltration on the microcirculation in patients with acute kidney injury. Methods A prospective observational pilot study conducted in a 40-bed, open clinical-surgical intensive care unit of a private tertiary care hospital located in the city of São Paulo (SP), Brazil. Microcirculation was assessed using near-infrared spectroscopy by means of a 15mm probe placed over the thenar eminence. Vascular occlusion test was performed on the forearm to be submitted to near-infrared spectroscopy by inflation of a sphygmomanometer cuff to 30mmHg higher than the systolic arterial pressure. The primary endpoint was the assessment of near-infrared spectroscopy-derived parameters immediately before, 1, 4 and 24 hours after the initiation of continuous venovenous hemodiafiltration. Results Nine patients were included in this pilot study over a period of 2 months. Minimum tissue oxygen saturation measured during the vascular occlusion test was the only near-infrared spectroscopy-derived parameter to differed over the time (decrease compared to baseline values up to 24 hours after initiation of continuous venovenous hemodiafiltration). Conclusion The impacts of microcirculatory dysfunction on clinical outcomes of patients undergoing to continuous venovenous hemodiafiltration need to be further investigated.
RESUMO Objetivo Avaliar o impacto da hemodiafiltração venovenosa contínua na microcirculação de pacientes com lesão renal aguda. Métodos Estudo piloto, prospectivo e observacional conduzido em uma unidade de terapia intensiva clínico-cirúrgica aberta, com 40 leitos, localizada em um hospital terciário, privado, na cidade de São Paulo (SP), Brasil. A microcirculação foi avaliada empregando-se a espectroscopia no infravermelho próximo, por meio de uma sonda de 15mm posicionada sobre a eminência tenar. O teste de oclusão vascular foi realizado no antebraço a ser submetido à espectroscopia no infravermelho próximo, inflando-se o manguito de um esfigmomanômetro a um valor 30mmHg acima da pressão arterial sistólica. O desfecho primário foi a avaliação dos parâmetros derivados por espectroscopia no infravermelho próximo imediatamente antes, 1, 4 e 24 horas após o início da hemodiafiltração venovenosa contínua. Resultados Foram incluídos nove pacientes neste estudo piloto ao longo de 2 meses. A saturação de oxigênio tecidual mínima mensurada durante o teste de oclusão vascular foi o único parâmetro derivado por espectroscopia no infravermelho próximo que diferiu ao longo do tempo, com queda em relação aos valores iniciais nas primeiras 24 horas após o início da hemodiafiltração venovenosa contínua. Conclusão A influência da disfunção microcirculatória sobre os desfechos clínicos de pacientes submetidos à hemodiafiltração venovenosa contínua precisa ser melhor investigada.
Assuntos
Humanos , Masculino , Feminino , Hemodiafiltração/métodos , Injúria Renal Aguda/diagnóstico por imagem , Microcirculação/fisiologia , Projetos Piloto , Estudos Prospectivos , Espectroscopia de Luz Próxima ao Infravermelho , Injúria Renal Aguda/fisiopatologia , Injúria Renal Aguda/terapia , Pessoa de Meia-IdadeRESUMO
BACKGROUND: Hypofractionated (HRT) prostate radiation therapy has the potential to deliver a higher biologically effective dose over a shorter time compared with conventional fractionation (CRT). HRT, giving fewer fractions each with higher dose, might improve the therapeutic ratio, resource use and patient convenience but the toxicity is still controversial. Our objective was to compare the gastroinstestinal (GI) and genitourinary (GU) toxicity of HRT versus CRT. METHODS: Systematic review and meta-analysis of randomized clinical trials studies in PubMed, Cochrane and EMBASE databases published through December 2016 was done. Only randomized trials that evaluated patients with localized prostate cancer (PCa) undergoing CRT or HRT were included. In these studies, the daily dose was 1.8 Gy or 2 Gy per day for CRT and 2.4 to 3.4 Gy for HRT. RESULTS: 7317 patients in nine studies were analyzed. Six studies included acute GU toxicity data which showed similar rates for both HRT and CRT (32.6vs. 31.9%; RD 0.00; 95% CI; -0.03,0.03; p = .81; I2 = 0%). Similarly, seven studies showed no difference in late GU toxicity based on treatment schedule (28.7 vs. 28.0%; RD -0.01; 95% CI; -0.04,0.03; p = .67; I2 = 52%). GI toxicity at three months after radiotherapy was higher in patients treated with HRT in six studies (27.5 vs. 21.9%; RD 0.06; 95% CI; 0.02,0.10; p = .004; I2 = 39%); however, eight studies showed GI toxicity 12 months or more after radiotherapy that was statistically the same (12.9 HRT vs. 16.2% CRT; RD -0.01; 95% CI; -0.04,0.02; p = .41; I2 = 58%). CONCLUSION: In meta-analysis of the available randomized trials on moderate HRT versus CRT for prostate cancer, acute and late GU toxicity were similar for both treatment schemes. While HRT was associated with higher acute GI toxicity, late toxicity was similar.
Assuntos
Gastroenteropatias/etiologia , Doenças Urogenitais Masculinas/etiologia , Neoplasias da Próstata/radioterapia , Radioterapia/efeitos adversos , Humanos , Masculino , Hipofracionamento da Dose de Radiação , Radioterapia/métodos , Ensaios Clínicos Controlados Aleatórios como AssuntoRESUMO
Parameters related to macrocirculation, such as the mean arterial pressure, central venous pressure, cardiac output, mixed venous saturation and central oxygen saturation, are commonly used in the hemodynamic assessment of critically ill patients. However, several studies have shown that there is a dissociation between these parameters and the state of microcirculation in this group of patients. Techniques that allow direct viewing of the microcirculation are not completely disseminated, nor are they incorporated into the clinical management of patients in shock. The numerous techniques developed for microcirculation assessment include clinical assessment (e.g., peripheral perfusion index and temperature gradient), laser Doppler flowmetry, tissue oxygen assessment electrodes, videomicroscopy (orthogonal polarization spectral imaging, sidestream dark field imaging or incident dark field illumination) and near infrared spectroscopy. In the near future, the monitoring and optimization of tissue perfusion by direct viewing and microcirculation assessment may become a goal to be achieved in the hemodynamic resuscitation of critically ill patients.
Parâmetros relacionados à macrocirculação, como pressão arterial média, pressão venosa central, débito cardíaco e saturação venosa mista e central de oxigênio, são comumente utilizados na avaliação hemodinâmica de pacientes graves. No entanto, diversos estudos demonstram que existe dissociação entre estes parâmetros e o estado da microcirculação neste grupo de pacientes. Técnicas que permitem a visualização direta da microcirculação não estão completamente difundidas e nem incorporadas ao manejo clínico dos pacientes em choque. Entre as inúmeras técnicas desenvolvidas para avaliação da microcirculação encontram-se: avaliação clínica (por exemplo: índice de perfusão periférica e gradiente de temperatura); fluxometria por laser Doppler; eletrodos de avaliação de oxigênio tecidual; videomicroscopia (imagem espectral por polarização ortogonal, análise em campo escuro de fluxo lateral, ou iluminação incidental em campo escuro); e espectroscopia no infravermelho próximo. A monitorização e a otimização da perfusão tecidual por meio da visualização direta e da avaliação da microcirculação pode, em um futuro próximo, tornar-se uma meta a ser atingida na ressuscitação hemodinâmica dos pacientes graves.
Assuntos
Estado Terminal , Microcirculação/fisiologia , Sistemas Automatizados de Assistência Junto ao Leito , Hemodinâmica/fisiologia , Humanos , Monitorização Fisiológica/instrumentação , Monitorização Fisiológica/métodos , Ressuscitação/métodosRESUMO
RESUMO Parâmetros relacionados à macrocirculação, como pressão arterial média, pressão venosa central, débito cardíaco e saturação venosa mista e central de oxigênio, são comumente utilizados na avaliação hemodinâmica de pacientes graves. No entanto, diversos estudos demonstram que existe dissociação entre estes parâmetros e o estado da microcirculação neste grupo de pacientes. Técnicas que permitem a visualização direta da microcirculação não estão completamente difundidas e nem incorporadas ao manejo clínico dos pacientes em choque. Entre as inúmeras técnicas desenvolvidas para avaliação da microcirculação encontram-se: avaliação clínica (por exemplo: índice de perfusão periférica e gradiente de temperatura); fluxometria por laser Doppler; eletrodos de avaliação de oxigênio tecidual; videomicroscopia (imagem espectral por polarização ortogonal, análise em campo escuro de fluxo lateral, ou iluminação incidental em campo escuro); e espectroscopia no infravermelho próximo. A monitorização e a otimização da perfusão tecidual por meio da visualização direta e da avaliação da microcirculação pode, em um futuro próximo, tornar-se uma meta a ser atingida na ressuscitação hemodinâmica dos pacientes graves.
ABSTRACT Parameters related to macrocirculation, such as the mean arterial pressure, central venous pressure, cardiac output, mixed venous saturation and central oxygen saturation, are commonly used in the hemodynamic assessment of critically ill patients. However, several studies have shown that there is a dissociation between these parameters and the state of microcirculation in this group of patients. Techniques that allow direct viewing of the microcirculation are not completely disseminated, nor are they incorporated into the clinical management of patients in shock. The numerous techniques developed for microcirculation assessment include clinical assessment (e.g., peripheral perfusion index and temperature gradient), laser Doppler flowmetry, tissue oxygen assessment electrodes, videomicroscopy (orthogonal polarization spectral imaging, sidestream dark field imaging or incident dark field illumination) and near infrared spectroscopy. In the near future, the monitoring and optimization of tissue perfusion by direct viewing and microcirculation assessment may become a goal to be achieved in the hemodynamic resuscitation of critically ill patients.
Assuntos
Humanos , Estado Terminal , Sistemas Automatizados de Assistência Junto ao Leito , Microcirculação/fisiologia , Ressuscitação/métodos , Hemodinâmica/fisiologia , Monitorização Fisiológica/instrumentação , Monitorização Fisiológica/métodosRESUMO
Cd(1-x)Mn(x)S nanocrystals (NCs) were successfully grown in a glass matrix and investigated by photoluminescence (PL), electron paramagnetic resonance (EPR) and magnetic force microscopy (MFM). We verified that the luminescent properties of these NCs can be controlled both by changing the x concentration and by thermal annealing of the samples. The EPR and PL data showed that the characteristic emission of Mn(2+) ions ((4)T(1)-(6)A(1)) is only observed when this magnetic impurity is substitutionally incorporated in the Cd(1-x)Mn(x)S NC core (site S(I)). Besides, it was observed that the emission ((4)T(1)-(6)A(1)) suppression, caused by the Mn(2+) ion presence near the surface (site S(II)) of the Cd(1-x)Mn(x)S NCs, is independent of the host material. The MFM images also confirmed the high quality of the Cd(1 - x)Mn(x)S NC samples, showing a uniform distribution of total magnetic moments in the nanoparticles.
RESUMO
Blends of L-alanine (85% weight proportion) with KI (10%) and with PbI2 (10%), these last two compounds acting as dopants, and with PVA (5%) acting as binder, were prepared in water at 80 degrees C. A blend of pure L-alanine (95%) with PVA (5%) was also prepared. The three blends were irradiated with photon beams of different energies (120 kV, Co, and 10 MV) to a unique dose of 30 Gy to compare their sensitivities for those three energies. EPR spectra of the three irradiated blends were recorded in a K-Band spectrometer (24 GHz) taking aliquots of about 4 mg for each blend. The energy sensitivity of a blend was defined as the peak-to-peak amplitude of its EPR spectrum central line. For the Co energy (1.25 MeV) the blends presented practically the same sensitivity, indicating that the presence of the dopants does not affect the sensitivity of L-alanine. For 10 MV x-rays, there was an increment (around 10%-20%) in sensitivity for the two L-alanine doped blends compared with the pure L-alanine blend (not doped). In the case of 120 kV x-rays, the blends ala+KI and ala+PbI showed increments of 10 and 20 times more sensitivity than the pure L-alanine blend. It is concluded that the dopants KI and PbI2 produce a great enhancement of the L-alanine sensitivity to low-energy photons. For the same dopant's content (10%) in the blend, PbI2 showed a better performance. Increasing the PbI2 proportion (30%) in the blend allows the detection of radiation dose as low as 10 mGy for 120 kV x-rays. These results encourage the authors to try to enhance the sensitivity of L-alanine even more by increasing the dopant's content in the blend and diminishing the lower limit detection. Application of these L-alanine doped blends in the dosimetry in diagnostic radiology could be possible.
Assuntos
Alanina/química , Alanina/efeitos da radiação , Algoritmos , Espectroscopia de Ressonância de Spin Eletrônica/métodos , Radiometria/métodos , Relação Dose-Resposta à Radiação , Transferência de Energia , Fótons , Doses de Radiação , Reprodutibilidade dos Testes , Sensibilidade e EspecificidadeRESUMO
The use of small-size alanine dosimeters presents a challenge because the signal intensity is less than the spectrometer sensitivity. K-band (24 GHz) EPR spectrometer seems to be a good compromise between size and sensitivity of the sample. Miniature alanine pellets were evaluated for small-field radiation dosimetry. Dosimeters of DL-alanine/PVC with dimensions of 1.5 mm diameter and 2.5 mm length with 5 mg mass were developed. These dosimeters were irradiated with 10 MV X-rays in the dose range 0.05-60 Gy and the first harmonic (1h) spectra were recorded. Microwave power, frequency and amplitude of modulation were optimized to obtain the best signal-to-noise ratio (S/N). For beam profile determination, a group of 25 dosimeters were placed in an acrylic device with dimensions of (7.5 x 2.5 x 1)cm3 and irradiated with a (3 x 3)cm2 10 MV X-rays beam field size. The dose at the central region of the beam was 20 Gy at a depth of 2.2 cm (build up for acrylic). The acrylic device was oriented perpendicular to the beam axis and to the gantry rotation axis. For the purposes of comparison of the spatial resolution, the beam profile was also determined with a radiographic film and 2 mm aperture optical densitometer; in this case the dose was 1 cGy. The results showed a similar spatial resolution for both types of dosimeters. The dispersion in dose reading was larger for alanine in comparison with the film, but alanine dosimeters can be read faster and more directly than film over a wide dose range.
Assuntos
Alanina/química , Alanina/efeitos da radiação , Espectroscopia de Ressonância de Spin Eletrônica/instrumentação , Micro-Ondas , Radiometria/instrumentação , Relação Dose-Resposta à Radiação , Espectroscopia de Ressonância de Spin Eletrônica/métodos , Desenho de Equipamento , Análise de Falha de Equipamento , Miniaturização , Doses de Radiação , Radiometria/métodos , Reprodutibilidade dos Testes , Sensibilidade e EspecificidadeRESUMO
The use of polyvinyl chloride (PVC) as a binder to 2-methylalanine (2MA) dosimeters was investigated. It was recently shown by Olsson et al. (Radiat. Res. 157 (2002) 113), that 2MA is approximately 70% more sensitive than L-alanine which makes this substance a good candidate to replace alanine in ESR dosimetry. PVC is a low yield material for free radical production by ionizing radiation and a good binding material easily processed and widely available. PVC can be prepared at room temperature and mixed up to 50% in weight with 2MA to produce a pellet stable in mass and physical dimensions, in large quantities and with low background signal. Pure PVC pellet irradiated at 50 Gy gave weaker ESR signals compared to 2MA at the region of spectral interest. Spectrometer settings such as microwave power, and modulation amplitude were optimized for the measurements. This dosimeter production scheme allows the addition of Mn2+ ions for an internal reference signal, leading to a self-calibrated dosimeter (J. Radional. Nucl. Chem. 240 (1999) 215).
Assuntos
Ácidos Aminoisobutíricos/química , Ácidos Aminoisobutíricos/efeitos da radiação , Espectroscopia de Ressonância de Spin Eletrônica/instrumentação , Micro-Ondas , Cloreto de Polivinila/química , Radiometria/instrumentação , Relação Dose-Resposta à Radiação , Espectroscopia de Ressonância de Spin Eletrônica/métodos , Desenho de Equipamento , Análise de Falha de Equipamento , Cloreto de Polivinila/efeitos da radiação , Doses de Radiação , Radiometria/métodos , Reprodutibilidade dos Testes , Sensibilidade e EspecificidadeRESUMO
The usefulness of a direct detection scheme of the second harmonic (2h) overmodulated signal from irradiated alanine in EPR dosimetry was studied. For this purpose, a group of DL-alanine/paraffin cylindrical pellets was produced. The dosimeters were irradiated with a 60Co radiotherapy gamma source with doses of 0.05, 0.1, 0.5, 1 and 5 Gy. The EPR measurements were carried out in a VARIAN-E4 spectrometer operating in X-band with optimized parameters to obtain highest amplitude signals of both harmonics. The 2h signal was detected directly at twice the modulation frequency. In preliminary results, the 2h showed some advantages over the 1 h such as better resolution for doses below 1 Gy, better repeatability results and better linear behaviour in the dose range indicated.
Assuntos
Alanina , Espectroscopia de Ressonância de Spin Eletrônica/métodos , Radiometria , Radioisótopos de Cobalto/química , Campos Eletromagnéticos , Fatores de TempoRESUMO
La tuberculosis mamaria es considerada como una rara entidad en el mundo. Se describe un caso de mastitis tuberculosa en una paciente femenina de 39 años, quien presentó una masa tumoral mamaria con diagnóstico inicial de carcinoma. Se realizó una revisión de la comunidad en la literatura mundial
Assuntos
Adulto , Humanos , Feminino , Doenças Mamárias/diagnóstico , Doenças Mamárias/tratamento farmacológico , Neoplasias da Mama/diagnóstico , Diagnóstico Diferencial , Mycobacterium tuberculosis/isolamento & purificação , Tuberculose/diagnóstico , Tuberculose/tratamento farmacológicoRESUMO
Se realizó un estudio retrospectivo, observacional y analítico acerca de la histerectomía obstétrica en pacientes del Hospital General de México durante un periodo de estudio de tres años. El objetivo principal es analizar la histerectomía en el estado grávido puerperal (histerectomía obstétrica), durante la resolución de los problemas que la patología del embarazo, parto y puerperio determinan, así como la asociación de las diversas complicaciones que durante el estado grávido puerperal condicionan la realización de dicho procedimiento, para sí poder disminuir la morbimortalidad. Se analizaron las siguientes variables: edad, antecedentes ginecoobstétricos, indicación quirúrgica, omisión diagnóstica, tipo de cirugía efectuada, cirujanos, tiempo quirúrgico, turno en que se efectuó, reintervención, complicaciones operatorias y transquirúrgicas, utilización de sangre y antibióticos, días de estancia intrahospitalaria y mortalidad. Concluimos que existe la necesidad de identificar una incidencia nacional, conocer las indicaciones más frecuentes, así como la morbimortalidad para poder establecer factores que determinen la disminución de las complicaciones y su mortalidad, además de conocer las pautas a seguir en dicho procedimiento
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Humanos , Feminino , Gravidez , Adolescente , Adulto , Histerectomia , Incidência , Estudos RetrospectivosRESUMO
La ruptura hepática espontánea durante el embarazo o puerperio, se ha comunicado como una complicación rara pero de extraordinaria gravedad. Usualmente se presenta como complicación de los trastornos hipertensivos del embarazo. Hasta el año de 1990 de han informado en la literatura mundial 120 casos de esta patología. Se presenta el caso de un paciente que presentó ruptura hepática espontánea durante el puerperio mediato y una revisión de la literatura mundial
Assuntos
Gravidez , Adulto , Humanos , Feminino , Hepatopatias/etiologia , Hepatopatias/mortalidade , Período Pós-Parto , Pré-Eclâmpsia/complicações , Complicações na Gravidez/mortalidade , Complicações na Gravidez/patologia , Ruptura Espontânea/etiologia , Ruptura Espontânea/mortalidadeRESUMO
Se presenta el caso clínico de una paciente de 16 años de edad, con diagnóstico histopatológico de sarcoma mulleriano mixto heterólogo, entidad poco frecuente en la adolescencia. Asimismo se realiza una revisión de sarcomas del útero, su epidemiología, clasificación, perfil clínico, pronóstico y tratamiento
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Adolescente , Humanos , Feminino , Adenossarcoma/diagnóstico , Adenossarcoma/fisiopatologia , Sarcoma , Tumor Mulleriano Misto/diagnóstico , Tumor Mulleriano Misto/fisiopatologia , Neoplasias Uterinas/diagnóstico , Neoplasias Uterinas/fisiopatologiaRESUMO
Se presenta el caso de una mujer joven la cual cursó con la asociación de meningioma y embarazo. Dicha neoplasia es poco frecuente durante la gestación, pero cuando se presenta asociado a la misma se observa un crecimiento rápido debido a la presencia de receptores estrogénicos. Además se observa la evolución tanto de la madre como del producto durante la gestación. Además se observa la evolución tanto de la madre como del producto durante la gestación y el puerperio. Se realiza una revisión del tema de la literatura
Assuntos
Gravidez , Adulto , Humanos , Feminino , Neoplasias Encefálicas , Neoplasias Encefálicas/patologia , Neoplasias Encefálicas/cirurgia , Cesárea , Complicações Neoplásicas na Gravidez/cirurgia , Complicações Neoplásicas na Gravidez/patologia , Craniotomia , Trabalho de Parto Induzido , Meningioma , Meningioma/patologia , Meningioma/cirurgiaRESUMO
La muerte intrauterina de un producto en un embarazo gemelar es una complicación poco común con una incidencia de 0.5 a 6.8 por ciento de todos los embarazos gemelares, siendo la mejor elección, el manejo conservador tanto para la madre como para el producto sobreviviente. Las complicaciones que se presentan se deben al paso de sustancias tromboplásticas procedentes del feto muerto al producto sobreviviente,a través de comunicaciones intravasculares, sobre todo en placentas de tipo monocoríonico, produciéndose alteraciones en el sistema nervioso central, riñones y piel principalmente en el producto sobreviviente, y alteraciones del sistema de coagulación en la madre. Se presenta el caso de un embrazo gemelar con la pérdida de un producto in utero con repercusiones en el producto sobreviviente a nivel del sistema nervioso central, y a la vez se hace una revisión de la literatura