Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 26
Filtrar
Mais filtros











Intervalo de ano de publicação
1.
Int J Biol Macromol ; 270(Pt 2): 132393, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38761898

RESUMO

Light chain amyloidosis is a conformational disease caused by the abnormal proliferation and deposition of antibody light chains as amyloid fibers in organs and tissues. The effect of Cu(II) binding to the model recombinant protein 6aJL2-R24G was previously characterized in our group, and we found an acceleration of the aggregation kinetics of the protein. In this study, in order to confirm the Cu(II) binding sites, histidine variants of 6aJL2-R24G were prepared and the effects of their interaction with Cu(II) were analyzed by circular dichroism, fluorescence spectroscopy, isothermal calorimetry titrations, and molecular dynamics simulations. Confirming our earlier work, we found that His8 and His99 are the highest affinity Cu(II) binding sites, and that Cu(II) binding to both sites is a cooperative event.


Assuntos
Cobre , Histidina , Ligação Proteica , Cobre/metabolismo , Cobre/química , Histidina/química , Histidina/metabolismo , Humanos , Sítios de Ligação , Simulação de Dinâmica Molecular , Cadeias Leves de Imunoglobulina/metabolismo , Cadeias Leves de Imunoglobulina/genética , Cadeias Leves de Imunoglobulina/química , Amiloidose de Cadeia Leve de Imunoglobulina/metabolismo , Amiloidose de Cadeia Leve de Imunoglobulina/genética , Amiloidose/metabolismo , Amiloidose/genética , Cinética
2.
Vaccines (Basel) ; 11(12)2023 Nov 28.
Artigo em Inglês | MEDLINE | ID: mdl-38140183

RESUMO

BACKGROUND: Phase III clinical trials have documented the efficacy of the SARS-CoV-2 vaccines in preventing symptomatic COVID-19. Nonetheless, it is imperative to continue analyzing the clinical response to different vaccines in real-life studies. Our objective was to evaluate the effectiveness of five different vaccines in hospitalized patients with COVID-19 during the third COVID-19 outbreak in Mexico dominated by the Delta variant. METHODS: A test-negative case-control study was performed in nine tertiary-care hospitals for COVID-19. We estimated odds ratios (OR) adjusted by variables related a priori with the likelihood of SARS-CoV-2 infection and its severity. RESULTS: We studied 761 subjects, 371 cases, and 390 controls with a mean age of 53 years (SD, 17 years). Overall, 51% had a complete vaccination scheme, and an incomplete scheme (one dose from a scheme of two), 14%. After adjustment for age, gender, obesity, and diabetes mellitus, we found that the effectiveness of avoiding a SARS-CoV-2 infection when hospitalized with at least one vaccination dose was 71% (OR 0.29, 95% CI 0.19-0.45), that of an incomplete vaccination scheme, 67% (OR 0.33, 95% CI 0.18-0.62), and that of any complete vaccination scheme, 73% (OR 0.27, 95% CI 0.17-0.43). CONCLUSIONS: The SARS-CoV-2 vaccination program showed effectiveness in preventing SARS-CoV-2 infection in hospitalized patients during a Delta variant outbreak.

3.
Med Mycol Case Rep ; 42: 100615, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38022891

RESUMO

Surgical treatment of vertebral coccidioidomycosis presents a challenge, with an unpredictable course and uncertain results. We present a 52-year-old man with disseminated infection due to coccidioidomycosis in the thoracolumbar spine, with vertebral instability, and deferral surgical treatment due to SARS-CoV-2 contingency. Treatment with itraconazole was initiated, followed by liposomal amphotericin B and fluconazole due to a relapse. The patient was discharged long-term with voriconazole. The axial pain improved without neurological deficits. Surgical treatment was not required. 2012 Elsevier Ltd. All rights reserved.

4.
Life (Basel) ; 13(8)2023 Jul 27.
Artigo em Inglês | MEDLINE | ID: mdl-37629486

RESUMO

Canine monocytic ehrlichiosis (CME) is the most common tick-borne disease affecting domestic dogs and other wild canids. It has a worldwide distribution and is associated with the presence of the brown dog tick. Few studies have been conducted in Mexico to identify and characterize Ehrlichia canis genetic variability. In the present study, 111 dogs of different sex, breed, and age from three geographic regions in Mexico were included. All of them had a previous history of tick infestation and/or the presence of one or more clinical signs compatible with CME. All dogs were tested by a commercial ELISA and nested PCR assay for the detection of E. canis. In addition, we analyzed the E. canis genetic diversity from the 16S rRNA gene sequences obtained in this study, along with 15 additional sequences described for E. canis in Mexico and obtained from GeneBank. Serological detection by commercial ELISA results showed overall infection rates of 85.58% (95/111), including 73.1% (30/41) in samples from Guerrero state; 75% (15/20) in Morelos; and 100% (50/50) in Chihuahua. On the other hand, molecular detection (nPCR assay) showed 31.5% (35/111) overall infection rate, with 41.4% (17/41) in Guerrero state; 55% (11/20) in Morelos; and 14% (7/50) in Chihuahua. We observed a high 16S rRNA gene sequence conservancy in most of the E. canis isolates in the three geographical areas from Mexico, including those analyzed in this research, suggesting a common geographic origin among isolates.

5.
Horiz. sanitario (en linea) ; 22(1): 131-135, Jan.-Apr. 2023. tab, graf
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1528697

RESUMO

Resumen Objetivo: Identificar el nivel de conocimiento sobre bioética en el personal salud que labora en un hospital de tercer nivel de atención, para que los dilemas bioéticos se turnen al Comité Hospitalario de Bioética. Materiales y Métodos: Se realizó un estudio descriptivo, transversal y prospectivo. Mediante un muestreo probabilístico por estratos, se calculó el tamaño de muestra para una población finita n=302 con un 95% de nivel de confianza, se realizó una visita a las áreas por turnos, se aplicó un cuestionario obtenido de 2 cuestionarios validados por Lynch y cols, y Hernández y cols. Dentro de las consideraciones éticas se aplicó un consentimiento informado previo a contestar el cuestionario. Se realizó un análisis estadístico descriptivo. Resultados: Los principios bioéticos que revisa el cuestionario son: Autonomía la cual fue identificada de manera correcta en 17.2%, Justicia en 10.3% y Los principios bioéticos que revisa el cuestionario son: Autonomía la cual fue identificada de manera correcta en 17.2%, Justicia en 10.3% y Beneficencia en 14.6%. Con respecto al nivel de conocimiento se encontró un2% de conocimiento alto, 33% de conocimiento regular, 33% de conocimiento bajo y 32% de conocimiento nulo. Conclusiones: Todos los días se presentan dilemas éticos, el identificarse de manera adecuada por el personal de salud y canalizarlos al Comité Hospitalario de Bioética sería el ideal de todo hospital que permitiría coadyuvar de manera adecuada en una mejor toma de decisiones en la atención al paciente.


Abstract Objective: Identify the level of knowledge about Bioethics in the health care workers in a third level hospital, so that the bioethical dilemmas turn to the Hospital Committee of Bioethics. Materials and Methods A descriptive, cross-sectional and prospective study was conducted. By means of a probabilistic sampling by strata, the sample size was calculated for a finite population n = 302 with a 95% confidence level, a visit to the areas was made in shifts, a questionnaire obtained from 2 questionnaires validated by Lynch et al., and Hernández et al. was applied. Within the ethical considerations, a prior informed consent was applied to answer the questionnaire. A descriptive statistical analysis was performed. Results: The bioethical principles that the questionnaire reviews are autonomy which was correctly identified in 17.2%, justice in 10.3%and charity in 14.6%. With respect to the level of knowledge, a 2% high knowledge, 33% regular knowledge, 33% knowledge low and 32% of null knowledge was found. Conclusions: Ethical dilemmas are presented every day, identifying properly by health care workers and channeling them to the Bioethics Hospital Committee would be the ideal of every hospital that would allow us to properly contribute toa better decision -making in patient care.

6.
Rev. argent. radiol ; 86(2): 115-123, jun. 2022. graf
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1387609

RESUMO

Resumen Para la reconstrucción y el tratamiento de anomalías que comprometen la aorta torácica pueden emplearse diversas técnicas quirúrgicas abiertas, las cuales estarán determinadas por la patología que presente el paciente. La angiotomografía computada multicorte (ATCMC) es el método de elección para su control y seguimiento. El médico radiólogo debe estar familiarizado con las técnicas quirúrgicas empleadas (Wheat, Bentall de Bono, Cabrol, entre otras), con las reparaciones estructurales que se realizan y con los materiales protésicos utilizados con el fin de evitar una interpretación errónea de las imágenes. El fieltro espontáneamente hiperdenso, los conductos protésicos y sus anastomosis, tanto con la aorta como con los grandes vasos, puede generar errores en el informe final y en el diagnóstico.


Abstract Multiple surgical techniques can be used for the reconstruction and treatment of abnormalities that compromise the thoracic aorta, which will be determined by the patient’s pathology. Multislice computed tomography angiography is the method of choice for their control and monitoring. The radiologist should be familiar with the surgical techniques used (Wheat, Bentall de Bono, and Cabrol, among others), as well as with the structural repairs that are performed and the prosthetic materials used in order to avoid an erroneous interpretation of the images. Spontaneously hyperdense felt, the prosthetic ducts and their anastomosis, both with the aorta and the large vessels, can generate pitfalls in the final report and error in the diagnosis.

7.
Isr Med Assoc J ; 24(5): 299-305, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35598053

RESUMO

BACKGROUND: Patients with autoimmune disease (AID) and coronavirus disease 2019 (COVID-19) could have higher mortality due to the co-morbidity and the use of immunosuppressive therapy. OBJECTIVES: To analyze the risk factors and outcomes of patients with AID and COVID-19 versus a control group. METHODS: A prospective cohort study included patients with and without AID and COVID-19. Patients were paired by age and sex. Clinical, biochemical, immunological treatments, and outcomes (days of hospital stay, invasive mechanical ventilation [IMV], oxygen at discharge, and death) were collected. RESULTS: We included 226 COVID-19 patients: 113 with AID (51.15 ± 14.3 years) and 113 controls (53.45 ± 13.3 years). The most frequent AIDs were Rheumatoid arthritis (26.5%), systemic lupus erythematosus (21%), and systemic sclerosis (14%). AID patients had lower lactate dehydrogenas, C-reactive protein, fibrinogen, IMV (P = 0.027), and oxygen levels at discharge (P ≤ 0.0001) and lower death rates (P ≤ 0.0001). Oxygen saturation (SaO2) ≤ 88% at hospitalization provided risk for IMV (RR [relative risk] 3.83, 95% confidence interval [95%CI] 1.1-13.6, P = 0.038). Higher creatinine and LDH levels were associated with death in the AID group. SaO2 ≤ 88% and CO-RADS ≥ 4 were risk factors for in-hospital mortality (RR 4.90, 95%CI 1.8-13.0, P = 0.001 and RR 7.60, 95%CI 1.4-39.7, P = 0.016, respectively). Anticoagulant therapy was protective (RR 0.36, 95%CI 0.1-0.9, P = 0.041). CONCLUSIONS: Patients with AID had better outcomes with COVID-19 than controls. Anticoagulation was associated with a lower death in patients with AID.


Assuntos
Doenças Autoimunes , COVID-19 , Doenças Autoimunes/epidemiologia , Doenças Autoimunes/terapia , COVID-19/epidemiologia , COVID-19/terapia , Humanos , Oxigênio , Pandemias , Estudos Prospectivos , Respiração Artificial , Fatores de Risco , SARS-CoV-2
8.
Ann Glob Health ; 88(1): 24, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35481980

RESUMO

Background: In the movement for global health equity, increased research and funding have not yet addressed a shortage of evidence on effectively implementing context-specific interventions; one unmet need is facilitating access to specialty care within the public health sector in Mexico. Compañeros en Salud has been piloting a novel program, called Right to Healthcare (RTHC), to increase access to specialty care for the rural poor in Chiapas, Mexico. The RTHC program incorporates social work, patient navigation, referrals, direct economic support, and accompaniment for patients. Objectives: This study evaluates the effectiveness of the RTHC program. Primary outcomes analyzed included acceptance of any referral and attendance of any appointment. Secondary outcomes included acceptance of the first referral and rate of appointment attendance for patients with an accepted referral. Methods: Using referral process data for the years 2014 to 2019 from a public tertiary care hospital in Chiapas, 91 RTHC patients were matched using 2:1 optimal pair matching with a control cohort balancing covariates of patient age, sex, specialty referred to, level of referring hospital, and municipality. Findings: RTHC patients were more likely to have had an accepted referral (OR 17.42, 95% CI 3.68 to 414.16) and to have attended an appointment (OR 5.49, 95% CI 2.93 to 11.60) compared to the matched control group. RTHC patients were also more likely to have had their first referral accepted (OR 2.78, 95% CI 1.29 to 6.73). Among patients with an accepted referral, RTHC patients were more likely to have attended an appointment (OR 3.86, 95% CI 1.90 to 8.57). Conclusions: The results demonstrate that the RTHC model is successful in increasing access to specialty care by both increasing referral acceptance and appointment attendance.


Assuntos
Agendamento de Consultas , Encaminhamento e Consulta , Humanos , México , Serviço Social , Atenção Terciária à Saúde
9.
Clin Immunol ; 238: 108990, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35395388

RESUMO

HLA is a polymorphic antigen presenter which has provided valuable information on the susceptibility of populations to viruses. Therefore, the study of HLA can reveal specific susceptibility or resistance alleles to severe COVID-19 in an ethnically dependent manner. This pilot study investigated HLA alleles associated with COVID-19 severity in Tapachula, Chiapas, Mexico. A total of 146 Mexican Mestizos were typed for HLA class I and II using PCR-SSP. The patients were classified according to the outcome (death or improvement) and the infection's severity (mild or severe). In addition, a group of exposed uninfected individuals was included. HLA-A*68 was found to be a protective allele against the severe infection and fatal outcome; pC = 0.03, OR = 0.4, 95% CI =0.20-0.86, and pC =0.009, OR = 0.3, 95% CI =0.13-0.71 respectively. HLA-DRB1*03 also appears to be a protective factor against fatal outcome pC = 0.009, OR = 0.1, 95%IC = 0.01-0.66; however, the low frequency of this allele in the studied population limits the statistical power. The severity and fatal outcome of COVID-19 patients in Tapachula, Chiapas depend more on the lack of resistance than susceptibility HLA alleles.


Assuntos
COVID-19 , Antígenos HLA-A , Alelos , COVID-19/genética , Frequência do Gene , Predisposição Genética para Doença , Antígenos HLA-A/genética , Cadeias HLA-DRB1/genética , Humanos , México/epidemiologia , Projetos Piloto
10.
Front Neurol ; 12: 631801, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33828518

RESUMO

Zika has been associated with a variety of severe neurologic manifestations including meningitis and encephalitis. We hypothesized that it may also cause mild to subclinical neurocognitive alterations during acute infection or over the long term. In this observational cohort study, we explored whether Zika cause subclinical or mild neurocognitive alterations, estimate its frequency and duration, and compare it to other acute illnesses in a cohort of people with suspected Zika infection, in the region of Tapachula in Chiapas, Mexico during 2016-2018. We enrolled patients who were at least 12 years old with suspected Zika virus infection and followed them up for 6 months. During each visit participants underwent a complete clinical exam, including a screening test for neurocognitive dysfunction (Montreal Cognitive Assessment score). We enrolled 406 patients [37 with Zika, 73 with dengue and 296 with other acute illnesses of unidentified origin (AIUO)]. We observed a mild and transient impact over cognitive functions in patients with Zika, dengue and with other AIUO. The probability of having an abnormal MoCA score (<26 points) was significantly higher in patients with Zika and AIUO than in those with dengue. Patients with Zika and AIUO had lower memory scores than patients with dengue (Zika vs. Dengue: -0.378, 95% CI-0.678 to -0.078; p = 0.014: Zika vs. AIUO 0.264, 95% CI 0.059, 0.469; p = 0.012). The low memory performance in patients with Zika and AIUO accounts for most of the differences in the overall MoCA score when compared with patients with dengue. Our results show a decrease in cognitive function during acute illness and provides no evidence to support the hypothesis that Zika might cause neurocognitive alterations longer than the period of acute infection or different to other infectious diseases. While effects on memory or perhaps other cognitive functions over the long term are possible, larger studies using more refined tools for neurocognitive functioning assessment are needed to identify these. Trial Registration: NCT02831699.

11.
Medisur ; 19(2): 220-227, tab
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1279437

RESUMO

RESUMEN Fundamento: La infección por el virus de la Hepatitis C ha sido reconocida como problema de salud a nivel mundial. Objetivo: Determinar las características de los pacientes con Hepatitis C que reciben tratamiento en el servicio de hemodiálisis del Centro Especializado Ambulatorio de Cienfuegos, en el periodo de enero a agosto del 2019. Metodología Se realizó un estudio observacional, descriptivo, longitudinal retrospectivo con los 54 pacientes en hemodiálisis portadores de Hepatitis C. Las variables utilizadas fueron: edad, sexo, lugar de procedencia, tipo de acceso vascular y tiempo en tratamiento. Se utilizó como fuente de información la base de datos del Centro Provincial de Higiene, Epidemiología y Microbiología en Cienfuegos. Resultados: El mayor porcentaje de personas con Hepatitis C se concentró entre los 50 a 54 años; siendo la edad promedio 53 años, sobresalió el sexo masculino para un 84.93%, y predominó el municipio de Cienfuegos como lugar de residencia. En relación al tipo de acceso vascular, la fístula arterio -venosa aportó el 98.14%, mientras el tiempo de tratamiento que prevaleció fue de más de 3 años para un 77.8%. Conclusiones La Hepatitis C en el servicio de hemodiálisis mostró un comportamiento similar a lo descrito en la literatura.


ABSTRACT Background Infection by the hepatitis c virus has been recognized as a health problem worldwide. Objective: To determine the characteristics of patients with hepatitis C receiving treatment in the Hemodialysis Service of the Cienfuegos Specialized Outpatient Center from January 2019 to August 2019. Methodology An observational, descriptive, longitudinal retrospective study was carried out with the 54 Hemodialysis patients with Hepatitis C. The variables used were: age, sex, place of origin, type of vascular access and time in treatment. The database of the Provincial Center for Hygiene, Epidemiology and Microbiology in Cienfuegos was used as a source of information. Results The highest percentage of people with hepatitis C was concentrated between 50 to 54 years old; The average age being 53 years, the male sex stood out for the 84.93%, with the municipality of Cienfuegos predominating as the place of residence. Regarding the type of vascular access, the arterio-venous fistula contributed the 98.14%, while the treatment time that prevailed was more than 3 years for the 77.8%. Conclusions: Hepatitis C in the hemodialysis service showed a similar behavior as described in the literature.

12.
Clin Rheumatol ; 40(8): 3095-3103, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33575923

RESUMO

INTRODUCTION: Systemic lupus erythematosus (SLE) is the prototypic autoimmune disease that disrupts numerous immunity mechanisms with the potential to exert damage to any organ or tissue. Its etiology remains uncertain; however, genetic and environmental factors that differ between populations strongly influence its development. Among the physiopathogenic factors, the genetic ones predominate, notably the major histocompatibility complex (MHC) loci. A high degree of ethnical admixture makes Mexican Mestizos a thoroughly genetically heterogeneous population. Therefore, this study aimed to identify the MHC polymorphisms associated with SLE development in Mexican Mestizos from Southern Mexico and compare them with patients from Mexico City. METHOD: A transversal study in SLE patients from Tapachula, Chiapas, was conducted. DNA typing of human leukocyte antigens (HLA) classes I and II was performed using single specific primers (SSP). Admixture analysis was performed using the population genetics LEADMIX software. RESULTS: The frequencies of HLA-DRB1*16 and HLA-DQB1*05 were found to have a tendency towards increase in SLE patients, compared to ethnically matched healthy controls. The allele HLA-DRB1*03 seemed to be less associated with SLE in this group of Mexican Mestizos, opposed to other more Caucasian populations. Admixture analysis showed a higher Mayan genetic component in these patients from Chiapas. CONCLUSIONS: The genetic susceptibility for SLE differed in two populations of Mexican Mestizos with dissimilar ethnic ancestries. Autochthonous Amerindian alleles, and not the more widely known Caucasian alleles, might be associated with the susceptibility to SLE in Mexican Mestizos from Tapachula, Chiapas. Key Points • Autochthonous Amerindian alleles, such as HLA-DRB1*16, had a tendency to be increased in SLE patients, compared to healthy controls. • SLE susceptibility alleles vary considerably among regions in Mexico, according to the distribution of the indigenous groups. • Ethnic admixture is a key determinant in the genetic susceptibility of SLE.


Assuntos
Predisposição Genética para Doença , Cadeias HLA-DRB1 , Lúpus Eritematoso Sistêmico , Alelos , Frequência do Gene , Predisposição Genética para Doença/etnologia , Cadeias HLA-DRB1/genética , Haplótipos , Humanos , Lúpus Eritematoso Sistêmico/etnologia , Lúpus Eritematoso Sistêmico/genética , Complexo Principal de Histocompatibilidade , México
13.
Bol. méd. Hosp. Infant. Méx ; 77(6): 337-340, Nov.-Dec. 2020. tab
Artigo em Espanhol | LILACS | ID: biblio-1142485

RESUMO

Resumen Introducción: El síndrome de hipertermia maligna es un trastorno farmacogenético del músculo esquelético de carácter hereditario, que se caracteriza por un estado hipermetabólico relacionado con la exposición a anestésicos inhalatorios o relajantes musculares despolarizantes. Se trata de una afección infrecuente en individuos genéticamente predispuestos, con una incidencia muy baja en pediatría (1 de cada 10,000-15,000 procedimientos anestésicos). Caso clínico: Se presenta un caso de hipertermia maligna relacionado con la exposición a sevoflurano durante una cirugía de adenoidectomía en un paciente de sexo femenino de 6 años de edad. La paciente presentó taquicardia, hipercapnia e hipertermia, que precisaron la administración de dos dosis sucesivas de dantroleno sódico. La evolución posterior fue buena. Conclusiones: El síndrome de hipertermia maligna es un cuadro poco frecuente en la edad pediátrica. Se debe sospechar de forma precoz, ya que es fundamental su detección temprana para iniciar el tratamiento.


Abstract Background: Malignant hyperthermia syndrome is a hereditary pharmacogenetic disorder of skeletal muscle characterized by hypermetabolic state related to the exposure of volatile anesthetic gases or depolarizing muscle relaxants. It is an infrequent entity that occurs in genetically predisposed individuals, with a very low incidence in pediatrics (1 in 10,000-15,000 anesthetic procedures). Case report: We report a case of malignant hyperthermia related to exposure to sevoflurane during adenoidectomy surgery in a 6-year-old female. The patient presented with tachycardia, hypercapnia, and hyperthermia, requiring two successive doses of dantrolene sodium administration, with an adequate response to the treatment. Conclusions: Malignant hyperthermia syndrome is a rare condition in pediatric patients that should be detected in early stages since it is essential to initiate the treatment as soon as possible.


Assuntos
Criança , Feminino , Humanos , Anestésicos Inalatórios , Sevoflurano , Hipertermia Maligna , Adenoidectomia , Anestésicos Inalatórios/efeitos adversos , Dantroleno/uso terapêutico , Sevoflurano/efeitos adversos , Hipertermia Maligna/etiologia , Hipertermia Maligna/tratamento farmacológico
14.
Bol Med Hosp Infant Mex ; 77(6): 337-340, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33186346

RESUMO

Background: Malignant hyperthermia syndrome is a hereditary pharmacogenetic disorder of skeletal muscle characterized by hypermetabolic state related to the exposure of volatile anesthetic gases or depolarizing muscle relaxants. It is an infrequent entity that occurs in genetically predisposed individuals, with a very low incidence in pediatrics (1 in 10,000-15,000 anesthetic procedures). Case report: We report a case of malignant hyperthermia related to exposure to sevoflurane during adenoidectomy surgery in a 6-year-old female. The patient presented with tachycardia, hypercapnia, and hyperthermia, requiring two successive doses of dantrolene sodium administration, with an adequate response to the treatment. Conclusions: Malignant hyperthermia syndrome is a rare condition in pediatric patients that should be detected in early stages since it is essential to initiate the treatment as soon as possible.


Background: Introducción">El síndrome de hipertermia maligna es un trastorno farmacogenético del músculo esquelético de carácter hereditario, que se caracteriza por un estado hipermetabólico relacionado con la exposición a anestésicos inhalatorios o relajantes musculares despolarizantes. Se trata de una afección infrecuente en individuos genéticamente predispuestos, con una incidencia muy baja en pediatría (1 de cada 10,000-15,000 procedimientos anestésicos). Caso clínico: Se presenta un caso de hipertermia maligna relacionado con la exposición a sevoflurano durante una cirugía de adenoidectomía en un paciente de sexo femenino de 6 años de edad. La paciente presentó taquicardia, hipercapnia e hipertermia, que precisaron la administración de dos dosis sucesivas de dantroleno sódico. La evolución posterior fue buena. Conclusiones: El síndrome de hipertermia maligna es un cuadro poco frecuente en la edad pediátrica. Se debe sospechar de forma precoz, ya que es fundamental su detección temprana para iniciar el tratamiento.


Assuntos
Anestésicos Inalatórios , Hipertermia Maligna , Sevoflurano , Adenoidectomia , Anestésicos Inalatórios/efeitos adversos , Criança , Dantroleno/uso terapêutico , Feminino , Humanos , Hipertermia Maligna/tratamento farmacológico , Hipertermia Maligna/etiologia , Sevoflurano/efeitos adversos
15.
Clin Rheumatol ; 37(6): 1441-1448, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29619588

RESUMO

Autoimmune/inflammatory syndrome induced by adjuvant (ASIA) includes the following conditions: siliconosis, Gulf War syndrome, macrophagic myofasciitis syndrome, and post-vaccination phenomena. Afterward, other syndromes have been recognized, such as in ASIA by mineral oil (ASIA-MO). These conditions are triggered by adjuvants and they are the result of the interplay of genetic and environmental factors. ASIA-MO is defined as the infiltration of oily type modeling substances for cosmetic purposes. It has been reported in many countries and used surreptitiously. Pathogenesis of ASIA-MO is not clear, but is characterized by chronic granulomatous inflammation, like the pristane model in mice, with increase of proinflammatory cytokines: type I interferons (IFNα and IFNß), systemic lupus erythematosus (SLE), and erosive arthritis. In humans, an increase of interleukin 1 (IL-1) has been found. Clinical spectrum of ASIA-MO is heterogeneous, varying from mild to severe and being local and systemic. The systemic manifestations can be non-specific and specific, meeting criteria for any autoimmune disease (AID), i.e., SLE, rheumatoid arthritis, and systemic sclerosis, among others. The areas of the body where the mineral oil is mostly applied include the following: buttocks (38-72%), breasts (12-16%), lower extremities (18-22%), and face (6-10%). The penis augmentation is also common. Treatment is focused on local and systemic manifestations and requires medical and surgical management representing a challenge for the physician.


Assuntos
Doenças Autoimunes/induzido quimicamente , Técnicas Cosméticas/efeitos adversos , Óleo Mineral/efeitos adversos , Animais , Doenças Autoimunes/diagnóstico , Doenças Autoimunes/terapia , Humanos
16.
Reumatol Clin (Engl Ed) ; 14(4): 230-232, 2018.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-28065485

RESUMO

Systemic sclerosis sine scleroderma (ssSSc) is a form of systemic sclerosis that is characterized by Raynaud's phenomenon (RP), visceral involvement without thickening of skin and anticentromere antibodies (ACA). We studied 10 ssSsc patients with a prevalence of 2%. The clinical signs were: RP 9/10, esophageal manifestations 8/10, pulmonary arterial hypertension 4/10, interstitial lung disease 4/10, cardiac signs 3/10 and ACA 8/10. CONCLUSION: In patients with RP, esophageal dysmotility, interstitial lung disease and pulmonary arterial hypertension should be tested for ACA in order to establish a prompt diagnosis and treatment of ssSSc.


Assuntos
Escleroderma Sistêmico/diagnóstico , Adulto , Idoso , Feminino , Humanos , Masculino , México , Pessoa de Meia-Idade , Estudos Retrospectivos , Escleroderma Sistêmico/complicações , Escleroderma Sistêmico/patologia
17.
Rev. biol. trop ; Rev. biol. trop;65(4): 1419-1427, Oct.-Dec. 2017. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-897631

RESUMO

Abstract The inhibition of infanticide can be considered a prerequisite for the onset of paternal behavior. Thus, hormones such as testosterone (T) would be expected to mediate the inhibition of aggression toward pups and the onset of paternal care. However, the effect of T in onset of this behaviorseems to depend of sexual experience. The aim of this study was to determine whether T induces paternal behavior in sexually inexperienced males of the Mexican volcano mouse (Neotomodon alstoni). For this, 33 non-paternal males were selected based on paternal behavior tests. These non-paternal mice were organized in three groups: 10 males were castrated, 10 subjected to sham procedure, and 13 underwent castration and T replacement. After of these treatments, the males were again evaluated by a second paternal behavior test, and blood samples were obtained to measure plasma T levels by radioimmunoassay. Castrated males with T replacement changed their behavior; 46.2 % of these males displayed paternal behavior despite 92.3 % of these males having previously displayed aggressive behavior in the selection test. An increase in T facilitates the onset of paternal behavior in sexually inexperienced males of Mexican volcano mouse, as occurs in sexual experience males. These results support the hypothesis that an increase in T levels would be involved in the neuroendocrine mechanisms that suppress infanticide and promote the onset of parental behavior in Mexican volcano mice males. Future studies in this mouse will investigate whether T regulates the onset of paternal behavior via conversion to estradiol or whether both T metabolites are involved in its onset.


Resumen La inhibición del infanticidio es necesaria en el inicio de la conducta paterna, así hormonas como la testosterona (T) pueden mediar la transición de machos agresivos a paternales. Sin embargo, el efecto de la T en el inicio de la conducta paterna parece depender de la experiencia sexual. El objetivo de este estudio fue determinar si T induce la conducta paterna en machos sin experiencia sexual del ratón Neotomodon alstoni. A través de pruebas de conducta paterna fueron seleccionados 33 machos no paternales; 23 fueron castrados bilateralmente, de los cuales a 13 se les colocó implante de T y 10 no recibieron ningún tratamiento. Otros 10 machos fueron sometidos a simulación del procedimiento. Después de los tratamientos, se realizaron nuevamente pruebas de conducta paterna para determinar cambios en la conducta de los machos hacia las crías. Enseguida se extrajeron muestras sanguíneas, para cuantificar los niveles de T en plasma, por radioinmuensayo. El 46.2 % de los machos castrados que recibieron implantes de T exhibieron conducta paterna, a pesar de que antes de la administración de esta hormona, el 92.3 % fueron agresivos con las crías. Los machos que transitaron a paternales tuvieron concentraciones de T significativamente más altas que los machos con castración simulada. Un incremento en T facilita el inicio de la conducta paterna en machos sexualmente inexpertos del ratón Neotomodon alstoni.Estos resultados apoyan la hipótesis que un incremento en T está involucrado en los mecanismos neuroendócrinos que inhiben la agresión hacia las crías y facilitan el inicio de la conducta paterna. Investigaciones futuras deben enfocarse a establecer la función de ambos metabolitos de la T en la regulación de la conducta paterna de este ratón.

18.
PLoS One ; 12(10): e0186923, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29065182

RESUMO

BACKGROUND: The emerging chikungunya virus (CHIKV), is an arbovirus causing intense outbreaks in North America. The situation in Mexico is alarming, and CHIKV threatens to spread further throughout North America. Clinical and biological features of CHIKF outbreaks in Mexico have not been well described; thus, we conducted a cross sectional study of a CHIKV outbreak in Chiapas, Southern Mexico to further characterize these features. METHODOLOGY/PRINCIPAL FINDINGS: We collected blood samples from patients suspected of having chikungunya fever (CHIKF) who presented to Clinical Hospital ISSSTE Dr. Roberto Nettel in Tapachula, Chiapas, Mexico. In addition to the clinical examination, real-time polymerase chain reaction (PCR) standardized for the Asian Chikungunya lineage and/or enzyme-linked immunosorbent assay for immunoglobulin M (IgM) were used to confirm CHIKV diagnosis. Of a total of 850 patients who presented with probably CHIKV at Hospital "Dr. Roberto Nettel", 112 probable CHIKF cases were enrolled in this study from November 2014- June 2015, of which 95 patients (84.8%) were CHIKV positive and 17 were negative (15.2%). Of these 95 CHIKV positive patients, 62 were positive by real-time reverse transcriptase PCR (+qRT-PCR); and 33 were seropositive to +IgM with a negative qRT-PCR. The most frequent symptoms reported were fever (100%), headache (82.3%), polyarthralgia (72.1%), and exanthem (82.3%). Biological abnormalities observed during CHIKV infection were lymphopenia (41.1%), leukopenia (51.6%), elevated transaminases (30.5%-46.3%) and high LDH (46.3%) and CRP (60.0%). CONCLUSION: Clinical and biological data obtained from this study is providing more useful information for benchmarking purposes with outbreaks from different parts of the world and would be helpful for better patient care and treatment.


Assuntos
Febre de Chikungunya/patologia , Febre de Chikungunya/epidemiologia , Estudos Transversais , Ensaio de Imunoadsorção Enzimática , Humanos , México/epidemiologia , Reação em Cadeia da Polimerase em Tempo Real
19.
Invest. clín ; Invest. clín;58(1): 44-55, mar. 2017. ilus, graf
Artigo em Espanhol | LILACS | ID: biblio-841136

RESUMO

La proteína C-reactiva ultrasensible (PCR-us) es un marcador de riesgo cardiovascular. En niños mexicanos sanos hay escasa evidencia que asocie los niveles séricos de este marcador con la dieta. El objetivo fue asociar los niveles séricos de PCR-us con la composición de la dieta en niños escolares mexicanos. El estudio fue transversal e incluyó 300 niños aparentemente sanos de 10 a12 años de edad. La cuantificación de PCR-us se realizó mediante nefelometría. La dieta se cuantificó con un cuestionario validado de frecuencia de consumo alimentos. Mediante el paquete estadístico SPSS v18, se realizaron pruebas de estadística descriptiva, correlación y modelos de regresión multivariada. El 53,7% fueron niñas y el 46,3% niños. La mediana de la PCR-us fue de 0,3 mg/L (rango: 0,3-6,8 mg/L). Se observó una correlación directa significativa entre la concentración sérica de la PCR-us con la ingesta de proteínas (rho= 0,126, p= 0,029), ácidos grasos totales (rho= 0,128, p= 0,027), ácidos grasos saturados (rho= 0,159, p= 0,006). Mediante el análisis de regresión múltiple se asoció la PCR-us con la ingesta de proteínas (β= 0,203, p=0,037) e inversamente con los granos enteros (β=-0,175, p= 0,002). Con el resto de las variables no se observó asociación significativa. La concentración sérica de la PCR-us se asoció directamente con el consumo de proteínas, ácidos grasos totales y saturados e indirectamente con el consumo de granos enteros.


The high-Sensitivity C-Reactive Protein (hs-CRP) is a cardiovascular risk marker. In healthy Mexican children, there islittle evidence that shows any relationship between serum levels of this marker with diet. The objective of this studywas to associate serum levels of hs-CRP with the diet composition in Mexican school children. The cross-sectional study included 300 seemingly healthy children of 10 to 12 years of age, 53.7% were girls and 46.3% boys.hs-CRP quantification was determined by nephelometry. The diet was quantified with a validated food frequency questionnaire. A descriptive statistical analysis, correlation and multivariate regression models were performed by using the SPSS v18 statistical software. The median of the hs-CRP was 0.3 mg / L (range: 0.3 to 6.8 mg / L). A significant direct correlation was found between serum hs-CRP with protein intake (rho=0.126, p=0.029), total fatty acids (rho = 0.128, p = 0.027) and saturated fatty acids (rho = 0.159, p = 0.006). hs-CRP was associated with the intake of protein (β = 0.203, p = 0.037) by multiple regression analysis, and inversely with whole grains (β = -0.175, p = 0,002). No significant association was found with the rest of the other variables. The serum concentration of hs-CRP was directly associated with the consumption of protein, total and saturated fatty acids and was indirectly proportional with the consumption of whole grains.


Assuntos
Criança , Feminino , Humanos , Masculino , Proteína C-Reativa/análise , Dieta , Alimentos , Estudos Transversais , Estudos Prospectivos , México
20.
Rev Biol Trop ; 57(1-2): 433-9, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19637720

RESUMO

Paternal behavior and testosterone plasma levels in the Volcano Mouse Neotomodon alstoni (Rodentia: Muridae). Although initially it was thought that testosterone inhibited the display of paternal behavior in males of rodents, it has been shown that in some species high testosterone levels are needed for exhibition of paternal care. In captivity, males of Volcano Mouse (Neotomodon alstoni) provide pups the same care provided by the mother, with the exception of suckling. Here we measured plasmatic testosterone concentrations 10 days after mating, five and 20 days postpartum, and 10 days after males were isolated from their families in order to determine possible changes in this hormone, associated to the presence and age of pups. Males of Volcano Mouse exhibited paternal behavior when their testosterone levels were relatively high. Although levels of this hormone did not change with the presence or pups age, males that invested more time in huddling showed higher testosterone levels. It is possible that in the Volcano Mouse testosterone modulates paternal behavior indirectly, as in the California mouse.


Assuntos
Muridae/sangue , Muridae/psicologia , Comportamento Paterno , Testosterona/sangue , Animais , Masculino , Camundongos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA