RESUMO
BACKGROUND: Campylobacter fetus subsp. fetus is the causal agent of sporadic abortion and infertility in bovines that produces economic losses in livestock. AIMS: This study evaluates the capability of C. fetus subsp. fetus to invade and survive in bovine endometrial epithelial cells and attempts to describe a pathogenic mechanism of this microorganism. METHODS: Primary culture of bovine endometrial epithelial cells was challenged with C. fetus subsp. fetus. Intracellular bacteria, represented by the number of genomic copies (g.c.) were quantified at 0, 2, 4, 10, and 24 hours post-infection (h.p.i.), by quantitative polymerase chain reaction (qPCR). The presence of intracellular bacteria was evaluated by immunofluorescence and immunohistochemistry. RESULTS: The results showed that only viable C. fetus subsp. fetus could invade endometrial cells. The g.c. number in assays with viable C. fetus subsp. fetus reached an average value of 656 g.c., remained constant until 4 h.p.i., then decreased to 100 g.c, at 24 h.p.i. In assays with non-viable microorganisms, the average value of g.c. was less than 1 g.c. and never changed. The intracellular presence of this bacteria was confirmed at 2 h.p.i. by immunofluorescence and immunohistochemistry. CONCLUSION: The results suggest that only C. fetus subsp. fetus viable can invade bovine endometrial epithelial cells but will not replicate in them, indicating that the endometrial cells do not represent a replication niche for this pathogen. Nonetheless, this invasion capability suggests that this type of cell could be employed by the pathogen to spread to other tissues.
RESUMO
Introducción: Los meningiomas de la vaina del nervio óptico (MVNO) son tumores inusuales de la vía visual anterior. Sin tratamiento, el crecimiento del tumor lleva a pérdida visual progresiva hasta la ceguera debido a la compresión que ejerce sobre el nervio óptico. Presentación del caso: Paciente, sexo femenino, 42 años, sin antecedentes mórbidos, que en 1992, inicia cuadro de disminución de la agudeza visual del ojo izquierdo. La resonancia magnética (RM) cerebral informa una lesión expansiva fusiforme en relación a la vaina del nervio óptico izquierdo que lo engloba, altamente sugerente de MVNO. En esa ocasión se realiza exploración de órbita la cual resulta frustra, por lo que se decide observación con controles clínicos e imagenológicos anuales, permaneciendo estable. Aproximadamente diez años más tarde, en el lapso de un año, inicia agravación progresiva de la agudeza y campo visual, ptosis palpebral y alteraciones de la oculo-motilidad del ojo izquierdo, objetivadas por examen neuro-oftalmológico, por lo que se sospecha progresión de MVNO. Se solicita nueva RM que confirma crecimiento significativo del tumor. Se descarta nuevo abordaje quirúrgico por riesgo de mayor deterioro visual y se efectúa radioterapia conformacional con una dosis de 54 Gy. Actualmente, a la edad de 65 años, se cumplen 24 años de evolución, 13 post radioterapia, confirmándose estabilidad clínica y radiológica de MVNO. Discusión: La radioterapia, cuando se observa progresión de la enfermedad, ha demostrado ser una terapia eficaz para los MVNO, con menos complicaciones y con mejores resultados en la preservación de la función visual a largo plazo.
Introduction: Optic nerve sheath meningiomas (ONSM) are rare tumors of the anterior visual pathway. Without treatment, tumor growth leads to progressive loss of visual acuity and blindness due to optic nerve compression. Case report: Patient, female, 42 years without other morbility , begins in 1992 with decreased visual acuity of the left eye, magnetic resonance imaging (MRI) showed enlargement of the left optic nerve sheath, suggestive of ONSM. On that occasion, orbit exploration failed, so it was decided to follow up with annual clinical and imaging controls. About ten years later, begins with progressive deterioration of visual acuity and visual field , with ptosis and ocular motor palsy of the left eye, confirmed with neuro-ophtalmological examinations. MRI shows tumor progression. A new surgical approach was discarded by the risk of visual worsening. A conformal radiotherapy was performed with a fractionated 54 Gy dose. Today, at age 65, after 24 years of follow up,13 post radiation therapy. clinical and radiological stability of ONSM is confirmed. Discussion: Conformal radiotherapy has been shown as an effective therapy, with fewer complications and better outcomes in the preservation of visual function in the long term follow up.
Assuntos
Humanos , Adulto , Feminino , Espectroscopia de Ressonância Magnética/métodos , Meningioma/diagnóstico , Meningioma/radioterapia , Neoplasias do Nervo Óptico , Radioterapia Conformacional , Radiocirurgia/instrumentação , Radiocirurgia/métodos , Diagnóstico por Imagem/métodos , Acuidade VisualRESUMO
El Traumatismo Raquimedular (TRM) implica todas las lesiones traumáticas que dañan los huesos, ligamentos, músculos, cartílagos, estructuras vasculares, radiculares o meníngeas a cualquier nivel de la médula espinal. Las consecuencias personales, familiares, sociales y económicas de esta enfermedad, hacen que sea un tema relevante en la actualidad. El propósito de esta revisión es entregar al lector las herramientas elementales sobre el TRM, y está principalmente enfocada en el tratamiento, el cual se aborda estrechamente relacionado con la fisiopatología para comprender los mecanismos moleculares y biomecánicos de trauma, incluyendo sus complicaciones y el manejo de éstas. Respecto al tratamiento del TRM, se aborda la evidencia que ofrecen las terapias actualmente validadas y las aún controversiales, incluyendo los glucocorticoides, la reducción cerrada y la cirugía precoz. Además las terapias emergentes como la hipotermia terapéutica, los nuevos agentes neuroprotectores que se encuentran en fases preclínicas y clínicas de estudio como el riluzol, la minociclina, el litio, los antagonistas opioides, entre otros, y los agentes neurorregenerativos como el Cethrin y el Anti-Nogo que han mostrado buenos resultados en la recuperación neurológica. Las recomendaciones actuales respecto a la terapia con células madre y subtipos de células madre en la actualidad, es que deben llevarse a cabo sólo en el contexto de ensayos clínicos. Aunque aún no existen terapias que permitan la recuperación neurológica completa en todos o la mayoría de los pacientes, las terapias emergentes prevén un futuro promisorio en los resultados clínicos de los pacientes con TRM.
The traumatic spinal cord injury (TSCI) involves all traumatic injuries that harm the bones, ligaments, muscles, cartilage, vascular, radicular or meningeal structures, at any level of the spinal cord. The personal, family, social and economic consequences of this disease, make it an important issue today. The purpose of this review is to provide the reader, the basic tools of the TRM, and it is mainly aimed at the treatment, which it approaches closely related to the pathophysiology, to understand the molecular and biomechanical mechanisms of trauma, including its complications and his management. Regarding treatment of TSCI, the evidence offered by currently validated and controversial therapies is discussed, including glucocorticoids, closed reduction and early surgery. Also emerging therapies such as therapeutic hypothermia, new neuroprotective agents currently in preclinical and clinical phases as riluzole, minocycline, lithium, opioid antagonists, among others, and neuroregenerative agents like Cethrin and Anti- Nogo that have shown good results in neurological recovery. Current recommendations for therapy with stem cells and subtype stem cell, is that only should be carried out in the context of clinical trials. Although there are not still therapies that allow full neurological recovery in all or most patients, emerging therapies provide a promising future in the clinical outcomes of patients with TRM.
Assuntos
Humanos , Canal Medular/fisiopatologia , Canal Medular/lesões , Fármacos Neuroprotetores/farmacologia , Hipotermia Induzida/métodos , Regeneração da Medula Espinal , Transplante de Células-Tronco , Traumatismo Múltiplo/epidemiologia , Traumatismos da Medula Espinal/complicações , Traumatismos da Medula Espinal/terapia , Glucocorticoides/administração & dosagem , Prognóstico , Redução Fechada/métodosRESUMO
El mucocele apendicular es un tipo de patología tumoral de baja incidencia. Su diagnóstico frecuentemente es incidental y su manejo es quirúrgico en base a la histología. CASO CLÍNICO: Paciente de sexo masculino, 83 años, diagnosticado de mucocele apendicular de presentación asintomática como hallazgo incidental en una Tomografía Computarizada (TC) de abdomen pelvis. Se realizó seguimiento radiológico cada 6 meses. Cuatro años más tarde, se vuelve sintomático con presencia de dolor en hemiabdomen inferior derecho, de intensidad moderada asociado a dificultad en la marcha y compromiso de estado general. Sele realizó una TC abdomen-pelvis que mostró una lesión quística retrocecal, de mayor tamaño con respecto al examen previo, que contacta con la corteza anterior del tercio inferior del riñón derecho. En el Hospital Clínico Universidad de Chile (HCUCh) se le realiza una hemicolectomía derecha, que requiere de nefrectomíaparcial debido a adhesión de la masa al riñón derecho. Post-cirugía, el paciente evoluciona con diversas complicaciones; entre ellas una sepsis de foco abdominal por un absceso perirrenal, un urinoma con fistula enteral e infecciones recurrentes que prolongaron la estadía hospitalaria. DISCUSIÓN: El mucocele apendicular carece de estudios en base a los que se pueda predecir como evolucionará al ser diagnosticado siendo asintomático. Debido a complicaciones el paciente es sometido a hemicolectomía en lugar de apendicectomía estándar que era la indicada según histología. Por esto, es necesario considerar en estos pacientes, controles radiológicos a menor intervalo de tiempo e incluso tratamiento quirúrgico precoz, con objetivo de evitar complicaciones propias del mucocele...
Appendiceal mucocele is a low incidence tumor, being the cause of between 0.07 to 0.3 percent of all appendectomies. Its diagnosis is often incidental and surgical treatment is based on histology. CASE REPORT: Male patient, 83 years old, diagnosed of appendiceal mucocele presenting as asymptomat icincidental finding in abdominal - pelvic CT performed for other reason. Radiological follow-up was performed every 6 months. Four years later becomes symptomatic with presence of moderate intensity pain in lower right abdomen associated with difficulty in walking and overall commitment. Pelvis CT showed are trocecal cystic lesion, larger compared to the previous review, which contacts the anterior cortex of the lower third of the right kidney. In Clinical Hospital University of Chile (HCUCh) he underwent a right hemicolectomy, requiring partial nephrectomy due to the adhesion of the right kidney. Post- surgery, the patient evolved with various complications including abdominal sepsis for perirenal abscess, urinoma with enteral fistula and recurrent infections that prolonged hospital stay. DISCUSSION: As the mucocele low incidence pathology lacks studies based on that it can predict how it will envolve being asymptomatic. Due to complications, the patient is underwent to hemicolectomy instead of standard appendectomy indicated by histology. Therefore, it is necessary to consider in these patients, radiological controls shorter time interval and even early surgical treatment, in order to avoid complications of mucocele...
Assuntos
Humanos , Masculino , Idoso de 80 Anos ou mais , Apêndice/patologia , Doenças do Ceco/cirurgia , Doenças do Ceco/complicações , Mucocele/diagnóstico , Mucocele/terapia , Colectomia/métodos , Achados IncidentaisRESUMO
The therapeutic value of Florfenicol feed supplemented was evaluated in conventional pigs to eliminate consequences of chronic infection of Mycoplasma hyopneumoniae. The experimental animals were pigs with an average of 16 kg, after intratracheally inoculation with M. hyopneumoniae they were divided in two experimental groups: (a) the non-medicated; and (b) the feed supplemented group (20 g Florfenicol/ton of feed) during the ensuing 35 days. The average daily weight gain of the Florfenicol-treated pigs (0.33±0.14 kg/day) was significantly higher than that of the non-treated ones (0.21±0.10 kg/day). In medicated animals was still impaired relative to that of the uninfected ones control group (0.39±0.02 kg/day). The average percentage of pneumonic gross lesions extensions' of the pigs groups was: 13.99% for M. hyopneumoniae infected non-medicated group; 1.79% M. hyopneumoniae infected, Florfenicol-treated group and, 0.56% of the uninfected control group. M. hyopneumoniae; colonization was detected at these levels in 7 and 9 members of the respective infected groups. The extent of the pneumonic lesions and M. hyopneumoniae generally was greater in the non-medicated pigs. Therefore, oral administration of Florfenicol via feed ingestion seemed to be somewhat effective in ameliorating the clinical effects of M. hyopneumoniae infection of swine.
Assuntos
Antibacterianos/farmacologia , Suplementos Nutricionais , Mycoplasma hyopneumoniae/efeitos dos fármacos , Pneumonia Suína Micoplasmática/prevenção & controle , Doenças dos Suínos/prevenção & controle , Tianfenicol/análogos & derivados , Ração Animal , Animais , Imunidade Humoral/efeitos dos fármacos , Pulmão/patologia , México , Pneumonia Suína Micoplasmática/patologia , Suínos/crescimento & desenvolvimento , Suínos/microbiologia , Doenças dos Suínos/microbiologia , Tianfenicol/farmacologia , Aumento de Peso/efeitos dos fármacosRESUMO
This paper reports a study of the effects of exposure to cigarette smoke on osteogenesis and the mechanical strength of bone in rats. Twelve male rats were separated into two groups (n=6): CT (control) and CI (cigarette). All the animals had free access to rat chow and water throughout the experiment. Group CI was exposed to the smoke of 6 cigarettes/day for 12 weeks. After 6 weeks of exposure to cigarette smoke, a defect was produced on the parietal bone and dense hydroxyapatite (DHA) ceramic bodies were implanted into cavities made surgically in the tibia of the animals, in each group. After surgery, the CT and CI groups returned to normal experimental conditions and, at the end of 12 weeks, they were euthanized, and their tibiae and parietal bones removed for histological processing, while the femurs were subjected to biomechanical tests in a MTS TestStar II three-point flexion module. Consumption of solid and liquid diet was satisfactory in both groups, all animals gaining weight throughout the experiment. CI animals showed a smaller volume of newly formed bone in the parietal defect (8.l9±0.2) and around the DHA implant in the tibia (33±0.5) than the rats in the CT group (14.4±0.5 and 39±1 respectively). The maximum force needed to break the femur was smaller in CI (119±3.2) than in CT (140±6.5). The results of this study led to the conclusion that exposure to cigarette smoke interfered with osteogenesis in the bone defect and around the DHA implant and reduced the maximum force required to completely break the femur, revealing that bone fragility can be caused by tobacco smoke.
O presente estudo teve como objetivo avaliar os efeitos da exposição à fumaça de cigarro sobre a osteogênese e a resistência mecânica do osso em ratos. Foram utilizados doze ratos machos, divididos em dois grupos (n=6): grupo CT (controle) e grupo CI (cigarro). Durante 12 semanas, os animais do grupo CI foram expostos à fumaça de seis cigarros/dia. Após seis semanas de exposição à fumaça de cigarro, uma falha óssea de 5mm foi produzida no osso parietal e corpos cerâmicos de hidroxiapatita densa (HAD) foram implantados em cavidade produzida cirurgicamente na tíbia dos animais do grupo CI e CT. Após as cirurgias, os animais retornaram aos protocolos experimentais e, ao término de doze semanas de experimentação, foram eutanasiados, as tíbias e os ossos parietais foram coletados para processamento histológico e os fêmures encaminhados para ensaio biomecânico em um módulo MTS TestStar II®. A exposição à fumaça do cigarro não interferiu no ganho de peso dos animais e os consumos de dieta líquida e sólida foram satisfatórios entre os grupos. Os animais do grupo CI apresentaram menor volume de osso neoformado na falha óssea (8,9±0,2) produzida no osso parietal e ao redor do implante de HAD na tíbia (33±0,5). A força máxima necessária para romper o fêmur dos animais foi menor no grupo CI (119±3,2) do que no grupo CT (140±6,5). Com bases nos resultados obtidos no presente trabalho, pôde-se concluir que a exposição à fumaça do cigarro interferiu na osteogênese da falha óssea e ao redor do implante de HAD, diminuiu a força máxima necessária para a ruptura completa dos fêmures e demonstrando a fragilidade óssea causada pelo hábito tabagista.
Assuntos
Animais , Masculino , Ratos , Osteogênese , Ratos Wistar , Nicotiana/toxicidadeRESUMO
Surface modification of natural fibers has been made using different methods. In this paper, cellulose fibers from sugarcane bagasse were bleached and modified by zirconium oxychloride in situ. The chemically modified cellulose fibers were compared to those of bleached ones. Cellulose fibers were modified with ZrO(2).nH(2)O nanoparticles through the use of zirconium oxychloride in acidic medium in the presence of cellulose fibers using urea as the precipitating agent. The spatial distribution characterization of hydrous zirconium oxide on cellulose fibers was carried out by combining both processing and image analyses obtained by SEM and statistical methodologies. Scanning electron microscopy (SEM), X-ray diffraction (XRD), and thermogravimetric analysis (TG) were also used to characterize the nanocomposite. Results indicated that ZrO(2).nH(2)O nanoparticles of about 30-80nm diameter deposited on cellulose fibers were heterogeneously dispersed.
Assuntos
Clareadores/farmacologia , Celulose/química , Processamento de Imagem Assistida por Computador , Saccharum/química , Zircônio/farmacologia , Microscopia Eletrônica de Varredura , Nanocompostos/química , Nanopartículas/química , Espectroscopia de Infravermelho com Transformada de Fourier , Propriedades de Superfície , Temperatura , Água/química , Difração de Raios XRESUMO
In this research the spatial distribution characterization of niobium phosphate into bleached cellulose was carried out combining processing and images analysis obtained by SEM and statistical methodologies. The objective is to investigate the deposit composition and phosphate morphology by using complementary analytical techniques. Based on the proposed methodology, parameters of niobium phosphate agglomerates (size and shape) and fiber morphology were evaluated depending on gray-levels (average luminance and fiber type): fiber characteristics (morphology) were measured. For the test method proposed, a specific region of cellulose/NbOPO(4) x nH(2)O composite was analyzed. This method involves area fraction measuring with a conditional probabilistic analysis. The analyzed fields were divided in different ways, called 'Scanning' and as a result, in quantitative terms, the phosphate deposition was described as spatial distribution homogeneous or inhomogeneous. The quantitative microscopy as a non-destructive testing provides relevant information when it is combined with statistic analysis.
Assuntos
Celulose/química , Celulose/isolamento & purificação , Nióbio/análise , Fosfatos/análise , Saccharum/química , Processamento de Imagem Assistida por Computador , Microscopia Eletrônica de Varredura , Modelos EstatísticosRESUMO
OBJECTIVE: The aim of the study was to evaluate clinical and laboratorial features of 1234 patients with different etiologies of hyperprolactinemia, as well as the response of 388 patients with prolactinomas to dopamine agonists. DESIGN, SETTING, AND PATIENTS: A total of 1234 hyperprolactinemic patients from 10 Brazilian endocrine centers were enrolled in this retrospective study. MAIN OUTCOME MEASURE: PRL measurement, thyroid function tests, and screening for macroprolactin were conducted. RESULTS: Patients were subdivided as follows: 56.2% had prolactinomas, 14.5% drug-induced hyperprolactinemia, 9.3% macroprolactinemia, 6.6% non-functioning pituitary adenomas, 6.3% primary hypothyroidism, 3.6% idiopathic hyperprolactinemia, and 3.2% acromegaly. Clinical manifestations were similar irrespective of the etiology of the hyperprolactinemia. The highest PRL levels were observed in patients with prolactinomas but there was a great overlap in PRL values between all groups. However, PRL>500 ng/ml allowed a clear distinction between prolactinomas and the other etiologies. Cabergoline (CAB) was more effective than bromocriptine (BCR) in normalizing PRL levels (81.9% vs 67.1%, p<0.0001) and in inducing significant tumor shrinkage and complete disappearance of tumor mass. Drug resistance was observed in 10% of patients treated with CAB and in 18.4% of those that used BCR (p=0.0006). Side-effects and intolerance were also more common in BCR treated patients. CONCLUSION: Prolactinomas, drug induced hyperprolactinemia, and macroprolactinemia were the 3 most common causes of hyperprolactinemia. Although PRL levels could not reliably define the etiology of hyperprolactinemia, PRL values >500 ng/ml were exclusively seen in patients with prolactinomas. CAB was significantly more effective than BCR in terms of prolactin normalization, tumor shrinkage, and tolerability.
Assuntos
Agonistas de Dopamina/uso terapêutico , Hiperprolactinemia/diagnóstico , Hiperprolactinemia/tratamento farmacológico , Adolescente , Adulto , Idoso , Brasil , Bromocriptina/uso terapêutico , Feminino , Humanos , Hiperprolactinemia/sangue , Hiperprolactinemia/etiologia , Masculino , Pessoa de Meia-Idade , Prolactina/sangue , Estudos Retrospectivos , Resultado do TratamentoRESUMO
BACKGROUND: In Brazil hospital malnutrition is highly prevalent, physician awareness of malnutrition is low, and nutrition therapy is underprescribed. One alternative to approach this problem is to educate health care providers in clinical nutrition. The present study aims to evaluate the effect of an intensive education course given to health care professionals and students on the diagnosis ability concerning to hospital malnutrition. MATERIALS AND METHODS: An intervention study, based on a clinical nutrition educational program, offered to medical and nursing students and professionals, was held in a hospital of the Amazon region. Participants were evaluated through improvement of diagnostic ability, according to agreement of malnutrition diagnosis using Subjective Global Assessment before and after the workshop, as compared to independent evaluations (Kappa Index, k). To evaluate the impact of the educational intervention on the hospital malnutrition diagnosis, medical records were reviewed for documentation of parameters associated with nutritional status of in-patients. The SPSS statistical software package was used for data analysis. RESULTS: A total of 165 participants concluded the program. The majority (76.4%) were medical and nursing students. Malnutrition diagnosis improved after the course (before k = 0.5; after k = 0.64; p < 0.05). A reduction of false negatives from 50% to 33.3% was observed. During the course, concern of nutritional diagnosis was increased (chi2 = 17.57; p < 0.001) and even after the course, improvement on the height measurement was detected (chi2 = 12.87; p < 0.001). CONCLUSIONS: Clinical nutrition education improved the ability of diagnosing malnutrition; however the primary impact was on medical and nursing students. To sustain diagnostic capacity a clinical nutrition program should be part of health professional curricula and be coupled with continuing education for health care providers.
Assuntos
Pacientes Internados , Desnutrição/diagnóstico , Desnutrição/terapia , Avaliação Nutricional , Ciências da Nutrição/educação , Brasil , Distribuição de Qui-Quadrado , Estudos Transversais , Interpretação Estatística de Dados , Humanos , Tempo de Internação , Prontuários Médicos , Estado Nutricional , Recursos Humanos em Hospital , Desenvolvimento de Programas , Avaliação de Programas e Projetos de Saúde , Redução de PesoRESUMO
UNLABELLED: Data concerning the effects of GnRHa on weight gain are scarce. OBJECTIVE: To assess the variation of the body mass index (BMI) in girls during GnRHa treatment for idiopathic central precocious puberty (CPP). PATIENTS AND METHODS: Semestral anthropometric data from 176 girls treated with goserelin or leuprorelin were analyzed. RESULTS: BMI z-score increased from 1.5 +/- 0.1 SD before treatment (n = 176) to 1.7 +/- 0.2 SD after 24 months (n = 61, p = 0.008). In girls with normal weight before treatment, this variation was greater (n = 112, 0.2 +/- 0.1 SD, p = 0.01) than in those who were overweight (n = 63, -0.9 +/- 0.2 SD, p = 0.7). In the goserelin group the weight change adjusted for bone age was greater (n = 28, 0.4 +/- 0.1 SD) than in the leuprorelin group (n = 5, 0.04 +/- 0.1 SD, p = 0.05). CONCLUSIONS: A slight increase in BMI was noted, mainly in girls with normal weight before treatment. The influence of different GnRHa on weight must be further investigated.
Assuntos
Peso Corporal/fisiologia , Hormônio Liberador de Gonadotropina/análogos & derivados , Gosserrelina/uso terapêutico , Leuprolida/uso terapêutico , Puberdade Precoce/tratamento farmacológico , Estatura/efeitos dos fármacos , Estatura/fisiologia , Índice de Massa Corporal , Peso Corporal/efeitos dos fármacos , Criança , Pré-Escolar , Feminino , Gosserrelina/farmacologia , Humanos , Leuprolida/farmacologia , Estudos Longitudinais , Puberdade Precoce/fisiopatologia , Estudos RetrospectivosRESUMO
OBJECTIVE: To show the results of Radioimmunodetection (RID) using Cuban monoclonal antibody (MoA) anti-egf-ior-egf-r3 labeled with 99mTc for the detection of primary tumors and/or metastases of head and neck epithelial malignant tumors. MATERIAL AND METHODS: Thirteen patients aged from 16-62 years (mean: 54.8 years) with primary tumors and metastases in the regional cervical lymph nodes were retrospectively evaluated. The labelling dose was 1480-2220 MBq (40-60 mCi). Planar images were performed after 10 minutes and together with SPECT images after 18-24 hours following MoA administration. The matrix was 128 x 128. SPECT images were reconstructed using the Butterworth 4/16 filter. A positive result was defined when the lesions were visualized. RESULTS: RID localized 11 of the known primary tumors in the 13 patients studied. In the two other patients, in whom the primary tumor site was unknown, cervical lymph node metastases were found. The results of 3 of the RID were false negative but in the other 10, RID was able to localize the primary tumor and cervical lymph node metastases. Sensitivity was 77 % and the predictive positive value was 100 %. CONCLUSIONS: The results of this study show that the Cuban MoA ior-egf-r3 can be employed for RID of primary head and neck tumors and their metastases. The radiation dose is adequate for RID.
Assuntos
Anticorpos Monoclonais , Receptores ErbB/imunologia , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Humanos , Masculino , Pessoa de Meia-Idade , Cintilografia , Estudos RetrospectivosRESUMO
UNLABELLED: Changes in nutritional status are related to an increase in morbidity and mortality. It is well established that health care professionals, particularly physicians, lack formal education to recognize nutritional disorders, which malnutrition may worsen in the hospital, and that appropriate education could effectively correct this problem. AIM: To evaluate the awareness of the health care university students and professionals about the nutrition disorders in Amazon region hospitalized patients before and after a specific education program. STUDY DESIGN: An intensive Course on Clinical Nutrition, given in three weekly classes was offered to the multidisciplinary health care students and professionals of the health care tem. CASES AND METHODS: 195 participants started the course. They were 97 students of nursing, 52 students of medicine, 20 nurses, 15 resident physicians, 3 physicians, 3 dietitians, 2 others, 1 no answer. 165 participants concluded it. Precourse and postcourse tests were answered. The results of these tests are presented in this study. RESULTS AND DISCUSSION: 76.4% of the participants were graduation students. 40% of participants had no contact with patients yet. When the exposure of the participants of the course to the theme Nutrition was analyzed, 46.7% of the resident physicians considered
Assuntos
Centros Médicos Acadêmicos , Educação Médica , Pessoal de Saúde/educação , Ciências da Nutrição/educação , Adolescente , Adulto , Brasil , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação Nutricional , Distúrbios Nutricionais/prevenção & controle , Inquéritos e Questionários , Recursos HumanosRESUMO
The aim of this study was characterize the positivity of the bovine leukosis virus in the Microregion of the Serra de Botucatu. Sera from 1193 bovine from 65 properties of the Microregion of the Serra de Botucatu were evaluated throught ELISA test. All the evaluated animals were adult and 16 of them only were male; 85.5 percent were crossbred, 6.45 percent Nellore and 8 percent dutch. Of the analyzed samples, 618 sera had resulted positive to the test. In only one flock it was not found seroreagents animals, the regional positivity was 52 percent (the seropositivity in the properties varied of 10 percent to 67 percent), the higher the percentage of positivity was in the animals of the dutch race (94.7 percent), followed for the crossbred (43.7 percent). The high percentage of positivity of the disease in our region is distinguished.(AU)
Assuntos
Animais , Masculino , Feminino , Adulto , Leucose Enzoótica Bovina , BovinosRESUMO
The aim of this study was characterize the positivity of the bovine leukosis virus in the Microregion of the Serra de Botucatu. Sera from 1193 bovine from 65 properties of the Microregion of the Serra de Botucatu were evaluated throught ELISA test. All the evaluated animals were adult and 16 of them only were male; 85.5 percent were crossbred, 6.45 percent Nellore and 8 percent dutch. Of the analyzed samples, 618 sera had resulted positive to the test. In only one flock it was not found seroreagents animals, the regional positivity was 52 percent (the seropositivity in the properties varied of 10 percent to 67 percent), the higher the percentage of positivity was in the animals of the dutch race (94.7 percent), followed for the crossbred (43.7 percent). The high percentage of positivity of the disease in our region is distinguished.
Assuntos
Animais , Masculino , Feminino , Adulto , Bovinos , Leucose Enzoótica BovinaRESUMO
UNLABELLED: Changes in nutritional status are important in clinical practice because they relate to an increase in morbidity and mortality. Studies about nutritional problems in hospitalized adults have been reported since the 1970s. The prevalence of malnutrition has varied from 10 to 70%, depending on the diagnostic criteria used. The hospital studied and the duration of admission. AIM: To assess, in the first day of hospital stay, the nutritional status of adults admitted to undergo elective surgery in a public hospital of the State of Acre, Amazon Region, Brazil. STUDY DESIGN: Sectional study from April 7 to May 22, 2002. PATIENTS AND METHODS: 155 consecutive nutritional evaluations were performed using several parameters-global subjective assessment (GSA), anthropometric measurement and some laboratory tests. For the diagnosis of malnutrition the Index Suggestive of Malnutrition (ISM), as proposed by Waitzberg, was adopted. In the evaluation of obesity the BMI (Body Mass Index), with cutoffs suggested by WHO was used. RESULTS: 75.2% were women. Average age was 34.4 +/- 10.1 years. Mulatto (63.1%) was the prevailing racial group. Gynecological (43.6%) was the most frequent surgery. ISM disclosed a 12.1% prevalence of malnutrition. BMI classified 2.0% of the patients as grade I overweight and 15.4% as being obese. Among 76 patients classified as normal by BMI, 15 (19.7%) were considered malnourished by ISM criteria. Concordance between ISM and BMI was weak (k = 0.07). GSA classified 100% of the cases as well nourished. CONCLUSION: Lack of a golden standard to make the diagnosis of changes in nutritional status has been one of the determinants of the wide variations observed in the pertinent literature and it has hindered valid comparisons. The present study suggests that BMI should be used as an indicator of proportion and not of nutritional status. GSA underestimates the diagnosis of malnutrition. This paper concludes that establishing uniform standards for diagnostic criteria for malnutrition is urgently required and suggests preferring IMS (Index Suggestive of Malnutrition) because of its easy use, low coast and high sensitivity.
Assuntos
Avaliação Nutricional , Distúrbios Nutricionais/epidemiologia , Adulto , Antropometria , Brasil/epidemiologia , Estudos Transversais , Feminino , Hospitais Públicos , Humanos , Pacientes Internados , Masculino , Pessoa de Meia-Idade , Estado NutricionalRESUMO
Infection with human herpesvirus type 8 and with human T-cell leukaemia virus type-1 shows strong geographic variations. We conducted this study to assess prevalence and risk factors for human herpesvirus type 8 infection in Havana City, Cuba. Information and residual serum samples already collected for a hospital based case-control study were used. A total of 379 individuals (267 males and 112 females; median age=63 years) were evaluated. Antibodies to the lytic antigen of human herpesvirus type 8 were detected by using an immunofluorescence assay, while human T-cell leukaemia virus type-1 serology was performed by means of an ELISA test (alpha Biotech). Overall, 64 subjects (16.9%, 95% confidence interval: 13.1-20.0) were positive for human herpesvirus type 8 antibodies. Human herpesvirus type 8 seroprevalence significantly increased with age (odds ratio=1.9 for >/=65 vs <55 years), and was twice as frequent in blacks than in whites. No association emerged with gender, socio-economic indicators, family size, history of sexually transmitted disease, sexual behaviour. Overall, 16 persons had anti-human T-cell leukaemia virus type-1 antibodies (4.2%, 95% confidence interval: 2.2-6.4). No relationship emerged between human T-cell leukaemia virus type-1 and human herpesvirus type 8 serostatus. The study findings indicate that human herpesvirus type 8 infection is relatively common in Havana City, Cuba, suggesting that Cuba may represent an intermediate endemical area. Sexual transmission does not seem to play a major role in the spread human herpesvirus type 8 infection.
Assuntos
Infecções por HTLV-I/epidemiologia , Infecções por Herpesviridae/epidemiologia , Herpesvirus Humano 8/patogenicidade , Vírus Linfotrópico T Tipo 1 Humano/patogenicidade , Sarcoma de Kaposi/virologia , Fatores Etários , Idoso , Anticorpos Antivirais/análise , Estudos de Casos e Controles , Cuba/epidemiologia , Ensaio de Imunoadsorção Enzimática , Feminino , Infecções por HTLV-I/etiologia , Infecções por Herpesviridae/etiologia , Herpesvirus Humano 8/imunologia , Vírus Linfotrópico T Tipo 1 Humano/imunologia , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Prevalência , Fatores de Risco , Sarcoma de Kaposi/epidemiologia , Sarcoma de Kaposi/etiologia , População UrbanaRESUMO
INTRODUCTION: Infection by Angiostrongylus cantonensis is caused by eating snails and slugs or contaminated vegetables, and is the commonest cause of eosinophilic meningoencephalitis throughout the world. OBJECTIVES: To make a further study of this condition, analyze the clinical behaviour and evaluate the cerebrospinal fluid findings and response to treatment. PATIENTS AND METHODS: We made a retrospective, descriptive study by reviewing the clinical histories of a series of 17 adult patients attended in two university hospitals in the province of Villa Clara (Cuba), between December 1991 and January 2000. We recorded the characteristics of the clinical picture, results of the complementary investigations, treatment given and clinical course and the necropsy findings of the three patients who died. The data was collected from questionnaires. RESULTS: Headache was a constant symptom. Twelve patients had high temperatures and seven had stiff necks. Motor deficit and coma were seen in the three patients who died. In two patients the cranial nerves were involved. Spinal fluid pleocytosis varied between 48 and 2570 cells/mm3. Initially there was lymphocyte predominance in 10 patients and subsequently eosinophil conversion. The peripheral eosinophilia, seen in all patients, varied between 7% and 61%. Of the 14 patients cured, eight received symptomatic treatment and six antihelminth drugs. Steroids were given to only one patient. Of the three patients who died, two had received antihelminth drugs. CONCLUSIONS: Motor deficit and coma worsen the prognosis, which is generally good. There is no relation between cerebrospinal fluid pleocytosis and raised protein levels in the cerebrospinal fluid, nor between blood eosinophilia and prognosis. The most difficult differential diagnosis in our patients was with leptospirosis. No differences were seen in clinical evolution in relation to the treatment given.
Assuntos
Eosinofilia/epidemiologia , Meningoencefalite/epidemiologia , Adulto , Angiostrongylus cantonensis/imunologia , Angiostrongylus cantonensis/isolamento & purificação , Animais , Anticorpos Monoclonais/imunologia , Área Programática de Saúde , Cuba/epidemiologia , Diagnóstico Diferencial , Ensaio de Imunoadsorção Enzimática , Eosinofilia/complicações , Eosinofilia/parasitologia , Humanos , Imunoglobulina E/imunologia , Leucocitose/líquido cefalorraquidiano , Meningoencefalite/complicações , Meningoencefalite/parasitologia , Transtornos Psicomotores/diagnóstico , Transtornos Psicomotores/etiologia , Infecções por Strongylida/líquido cefalorraquidiano , Infecções por Strongylida/imunologia , Infecções por Strongylida/parasitologia , Inquéritos e QuestionáriosRESUMO
Autoimmune thyroiditis has been frequently reported during interferon monotherapy for hepatitis C, but there are few reports concerning subacute thyroiditis. Recently, combination therapy of IFN plus ribavirin has become the preferred therapeutic schedule for chronic hepatitis C. Similarly to interferon monotherapy, there are no reports concerning subacute thyroiditis during combination therapy. We described four episodes of subacute thyroiditis occurring in three patients during antiviral combination therapy. All patients had symptoms compatible with hyperthyroidism, which could be misdiagnosed as IFN side-effects. The antiviral treatment was continued in all three patients and thyroid function increased progressively with pharmacological treatment for hyperthyroidism. We concluded that subacute thyroiditis may be a complication of combination antiviral therapy and should be investigated in patients presenting with compatible symptoms, in order to differentiate from IFN side-effects.