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INTRODUCTION AND AIMS: Epstein-Barr virus (EBV) infection is an etiologic factor in EBV-associated gastric carcinoma (EBVaGC). The aim of our study was to describe the clinical and histopathologic characteristics of EBV infection in intestinal-type gastric adenocarcinoma samples. MATERIAL AND METHODS: Of 180 paraffin-embedded gastrectomy samples, 28 were studied. Chromogenic in situ hybridization was performed to detect EBV. Sociodemographic and histopathologic data were obtained from the patients' clinical histories. RESULTS: A total of 21.4% of the samples were positive for EBV. The predominant morphologic characteristic was the lace pattern, with dense inflammatory infiltration. Fifty percent of the EBVaGC+ patients were men, and the median age of the positive patients was 59 years (range: 50-75); 77.2% of the EBVaGC- patients were men, and the median age of the negative patients was 66 years (range: 34-89). Helicobacter pylori infection was associated with 10.7% of the EBVaGC+ patients and 53.6% of the EBVaGC- patients. In the EBVaGC+ patients, the cardia was the most frequent tumor location (17.9%), 7.1% had histologic grades 2 and 3, and 17.9% presented with Borrmann classification type III. In the EBVaGC- patients, the cardia and fundus were the most frequent tumor locations (71.4%), 35.7% had histologic grade 2, and 39.3% and 21.4% presented with Borrmann classification type III and IV, respectively. CONCLUSIONS: The present study describes the clinical and histopathologic characteristics associated with EBVaGC positivity. Those data may aid in the selection of cases that are candidates for analysis through molecular methods aimed at identifying EBV infection in intestinal-type gastric adenocarcinoma.
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INTRODUCTION AND AIM: Graft-versus-host disease (GvHD) is a complication of hematopoietic cell transplantation, and the small bowel is one of the main targets in the gastrointestinal tract. Capsule endoscopy is a safe procedure and can be useful in the diagnosis of GvHD. The aim of the present study was to compare the diagnostic yield of capsule endoscopy with the histopathologic findings in GvHD. MATERIALS AND METHODS: A retrospective diagnostic test study included all the patients with suspected GvHD that underwent gastroscopy and colonoscopy, with histopathologic evaluation of the biopsies taken, and capsule endoscopy, within the time frame of July 2015 and July 2019. Capsule endoscopy findings were compared with the histopathologic diagnosis, considered the gold standard. RESULTS: Twenty-one patients with GvHD (7 [33%] women; 37 ± 11.9 years of age) were included, 20 (95%) of whom had acute GvHD. The median gastric transit time of the capsule was 55 minutes (20-113) and the median small bowel transit time was 261 minutes (238-434). The entire small bowel was visualized through capsule endoscopy in 17 cases (80.95%). The histopathologic findings and capsule endoscopy findings resulted in the diagnosis of GvHD in 17 and 16 cases, respectively. There was agreement between the histopathologic and capsule endoscopy findings in 18 cases (15 positive and 3 negative). Sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic yield of capsule endoscopy were 88%, 75%, 94%, 60%, and 85%, respectively. CONCLUSIONS: Capsule endoscopy is a safe tool for the diagnosis of GvHD, with high sensitivity and positive predictive value, as well as moderate agreement with histopathologic findings.
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Endoscopia por Cápsula , Doença Enxerto-Hospedeiro , Transplante de Células-Tronco Hematopoéticas , Feminino , Doença Enxerto-Hospedeiro/diagnóstico , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Humanos , Intestino Delgado/diagnóstico por imagem , Estudos RetrospectivosRESUMO
The application of sodium cyanide (NaCN) to the carotid body receptors (CBR) (CBR stimulation) induces rapid blood hyperglycemia and an increase in brain glucose retention. The commissural nucleus tractus solitarius (cNTS) is an essential relay nucleus in this hyperglycemic reflex; it receives glutamatergic afferents (that also release brain derived neurotrophic factor, BDNF) from the nodose-petrosal ganglia that relays CBR information. Previous work showed that AMPA in NTS blocks hyperglycemia and brain glucose retention after CBR stimulation. In contrast, BDNF, which attenuates glutamatergic AMPA currents in NTS, enhances these glycemic responses. Here we investigated the combined effects of BDNF and AMPA (and their antagonists) in NTS on the glycemic responses to CBR stimulation. Microinjections of BDNF plus AMPA into the cNTS before CBR stimulation in anesthetized rats, induced blood hyperglycemia and an increase in brain arteriovenous (a-v) of blood glucose concentration difference, which we infer is due to increased brain glucose retention. By contrast, the microinjection of the TrkB antagonist K252a plus AMPA abolished the glycemic responses to CBR stimulation similar to what is observed after AMPA pretreatments. In BDNF plus AMPA microinjections preceding CBR stimulation, the number of c-fos immunoreactive cNTS neurons increased. In contrast, in the rats microinjected with K252a plus AMPA in NTS, before CBR stimulation, c-fos expression in cNTS decreased. The expression of AMPA receptors GluR2/3 did not change in any of the studied groups. These results indicate that BDNF in cNTS plays a key role in the modulation of the hyperglycemic reflex initiated by CBR stimulation.
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Fator Neurotrófico Derivado do Encéfalo/metabolismo , Corpo Carotídeo/efeitos dos fármacos , Corpo Carotídeo/metabolismo , Hiperglicemia/metabolismo , Núcleo Solitário/metabolismo , Ácido alfa-Amino-3-hidroxi-5-metil-4-isoxazol Propiônico/metabolismo , Animais , Fator Neurotrófico Derivado do Encéfalo/administração & dosagem , Ensaio de Imunoadsorção Enzimática , Glucose/metabolismo , Hiperglicemia/induzido quimicamente , Hiperglicemia/patologia , Imuno-Histoquímica , Masculino , Microinjeções , Neurotransmissores/farmacologia , Proteínas Proto-Oncogênicas c-fos/metabolismo , Distribuição Aleatória , Ratos Wistar , Receptor trkB/agonistas , Receptor trkB/antagonistas & inibidores , Receptor trkB/metabolismo , Receptores de AMPA/agonistas , Receptores de AMPA/antagonistas & inibidores , Receptores de AMPA/metabolismo , Cianeto de Sódio/farmacologia , Núcleo Solitário/citologia , Núcleo Solitário/efeitos dos fármacos , Ácido alfa-Amino-3-hidroxi-5-metil-4-isoxazol Propiônico/administração & dosagemRESUMO
A survey is conducted of the way difficult-to-control epileptic seizures are currently managed in paediatric practice. We also highlight the alternative means of therapy available, such as epilepsy surgery, a ketogenic diet, the use of hormones, steroids, gamma globulin and the stimulation of the vagal nerve, together with their indications, their efficiency in the different types of epilepsy and their contraindications. Mention is also made of the new antiepileptic drugs that have appeared since the nineties, as well as the reappearance of others that had fallen into disuse.
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Epilepsia/terapia , Criança , HumanosRESUMO
OBJECTIVE: We describe our experience in the study of active cerebral cysticercosis in paediatrics over a period of 6 years, involving a total of 85 cases, which were studied from the clinical, immunological and radiological points of view. The aim of this communication is to present the clinical characteristics of the disorder and its course when symptomatic treatment is given. DEVELOPMENT: The commonest age of presentation was school age. However, we had a large number of children under 4 years old. This shows that there is considerable endemicity in a group in which the disorder is considered to be less frequent. There were slightly more females than males, which is in accordance with another Mexican series. The predominant socio-economic level was poor (59%). The patients come from urban areas more and more frequently. The commonest signs were: convulsive crises, intracranial hypertension and headache without intracranial hypertension. The commonest type of crisis was partial, in its different forms. CONCLUSIONS: The course was mild and satisfactory in 90% of the patients. The good clinical progress was independent of the use of antiparasitic treatment.
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Encéfalo/parasitologia , Neurocisticercose , Adolescente , Albendazol/uso terapêutico , Anti-Helmínticos/uso terapêutico , Criança , Pré-Escolar , Progressão da Doença , Eletroencefalografia , Feminino , Cefaleia/diagnóstico , Cefaleia/etiologia , Honduras/epidemiologia , Humanos , Recém-Nascido , Hipertensão Intracraniana/diagnóstico , Hipertensão Intracraniana/etiologia , Masculino , Neurocisticercose/complicações , Neurocisticercose/diagnóstico , Neurocisticercose/epidemiologia , Neurocisticercose/prevenção & controle , Convulsões/diagnóstico , Convulsões/etiologia , Fatores Socioeconômicos , Tomografia Computadorizada por Raios XRESUMO
La enuresis es un problema cotidiano de salud en un número importante de niños mayores de 3 años de edad, aunque su frecuencia y prevalencia reales se desconozcan en nuestro país. Su importancia se incrementa debido a la gran vinculación que tiene con los padres de familia y, además, porque su manejo es aún tema de controversia. En la presente revisión bibliográfica se describen los principales aspectos clínicos de esta anomalía; se incluye un cuadro de facíl manejo sobre el criterio diagnóstico en la enuresis funcional, y se hace énfasis en la vigilancia que debe ejercer el médico cuando instituye tratamiento farmacológico. En especial, se destaca la trascendencia que ofrece educar al paciente y a sus padres o cuidadores, a través de instituir, a la brevedad posible, la práctica cotidiana del manejo de los esfínteres vesicales al aportador al niño cantidades generosas de líquidos durante el día. Insistiéndole en la necesidad imperiosa que existe en su caso, de que concientice las sensaciones de la necesidad de miccionar y la conveniencia de controlar los esfinteres mencionados
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Humanos , Masculino , Feminino , Desempenho Psicomotor/fisiologia , Diagnóstico Diferencial , Enurese/diagnóstico , Enurese/epidemiologia , Enurese/etiologia , Enurese/terapia , PrognósticoRESUMO
Trichinellosis in pigs in Bolivia was first documented in 1993 following a small abattoir survey in a rural community in the Bolivian Altiplano. The present study investigated the presence of antibodies to Trichinella spiralis in pigs in the 2 largest departments in terms of pig production in Bolivia. Three geographically separate abattoir surveys were conducted to cover the major production areas in the Departments of Santa Cruz and Chuquisaca. Sera were tested using an enzyme-linked immunosorbent assay. Of the 1,327 sera analysed from the 3 areas, 13.4% overall tested positive. Results from the 3 individual surveys varied from 10.2% seropositivity to 17.1 per cent. However, within each of the 3 sample areas, highly significant variation in seropositivity was encountered, with those areas with the most extensive production systems having the highest percentage of positive sera. Such variation is probably due to differences in nutrition with foraging and household waste being important components of pig diets in extensive production systems. The results of this study were similar to those obtained from the previous survey in the Altiplano and indicate that trichinellosis is present throughout Bolivia and is a potentially important public health problem.
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Anticorpos Anti-Helmínticos/sangue , Doenças dos Suínos/epidemiologia , Trichinella spiralis/imunologia , Triquinelose/veterinária , Matadouros , Criação de Animais Domésticos/métodos , Animais , Bolívia/epidemiologia , Ecologia , Feminino , Masculino , Suínos , Triquinelose/sangue , Triquinelose/epidemiologiaRESUMO
The case of a 35 years old female patient is here reported. Her previous medical records included repeated miscarriages and ischaemic ulcers in the right leg. She developed thrombosis at the left common femoral artery with serum antiphospholipid antibodies. The patient was treated with anticoagulants and two months later developed multiorganic failure. She was successfully managed with plasmapheresis, high dose prednisone, and anticoagulants. The clinical picture was considered to be a catastrophic antiphospholipid syndrome.