RESUMO

Objetivo: Identificar los factores asociados a la adherencia al tratamiento farmacológico en pacientes con diabetes mellitus tipo 2 sin hipertensión arterial. Materiales y métodos: Estudio transversal y analítico en pacientes con diabetes mellitus tipo 2 sin hipertensión arterial. Se integraron el grupo con adherencia al tratamiento (n = 145) y el grupo sin adherencia al tratamiento (n = 49), determinado por la escala de adherencia a la medicación de Morisky de 4 ítems (MMAS-4). Como factores asociados, se estudiaron sexo, vida en pareja, escolaridad, ocupación, edad agrupada en decenios y tiempo de evolución de la diabetes agrupada en menos de un año, de 1 a 5 años, de 6 a 10 años y más de 10 años. El plan de análisis estadístico incluyó la prueba de ji al cuadrado. Resultados: Se identificaron el sexo (p = 0,045), la vida en pareja (p = 0,045), la edad (p = 0,001) y el tiempo de evolución de la enfermedad (p = 0,001) como factores asociados a la adherencia al tratamiento farmacológico. La escolaridad no se identificó como un factor asociado a la adherencia terapéutica en el paciente con diabetes mellitus tipo 2 (p = 0,289). A mayor edad, menor adherencia al tratamiento farmacológico en el paciente con diabetes: el punto de corte se presenta a los 60 años; después de esta edad, el porcentaje en el grupo no adherente es mayor que en el grupo con adherencia (p = 0,001). A mayor tiempo de evolución de la diabetes, menor probabilidad de adherencia; en el grupo no adherente, el porcentaje de pacientes con más de 10 años de evolución es 67,3 % y en el grupo con adherencia el porcentaje corresponde a 33,8 % (p = 0,001). Conclusiones: Se identificaron los factores asociados a la adherencia al tratamiento farmacológico en pacientes con diabetes mellitus tipo 2 sin hipertensión arterial.

Objective: To identify the factors associated with adherence to drug therapy among patients with type 2 diabetes mellitus without hypertension. Materials and methods: A cross-sectional, analytical study conducted with patients with type 2 diabetes mellitus without hypertension, divided into an adherent group (n = 145) and a non-adherent group (n = 49), determined by the 4-item Morisky Medication Adherence Scale (MMAS-4). The associated factors were sex, cohabitation, schooling, occupation, age in 10-year groups and diabetes progression time grouped in less than 1 year, from 1 to 5 years, from 6 to 10 years and more than 10 years. The statistical analysis plan included the chi-square test. Results: The factors associated with adherence to drug therapy were identified as sex (p = 0.045), cohabitation (p = 0.045), age (p = 0.001) and disease progression time (p = 0.001). Schooling was not identified as a factor associated with adherence to drug therapy among patients with type 2 diabetes mellitus (p = 0.289). The older the patient with diabetes, the lower the adherence to drug therapy; the cut-off point was 60 years of age, after which the percentage in the non-adherent group was higher than in the adherent group (p = 0.001). The longer the diabetes progression time, the lower the probability of adherence; in the non-adherent group the percentage of patients with more than 10 years of disease progression was 67.3 % and in the adherent group the percentage was 33.8 % (p = 0.001). Conclusions: The factors associated with adherence to drug therapy among patients with type 2 diabetes mellitus without hypertension were identified

RESUMO

Crop improvement efforts have exploited new methods for modeling spatial trends using the arrangement of the experimental units in the field. These methods have shown improvement in predicting the genetic potential of evaluated genotypes. However, the use of these tools may be limited by the exposure and accessibility to these products. In addition, these new methodologies often require plant scientists to be familiar with the programming environment used to implement them; constraints that limit data analysis efficiency for decision-making. These challenges have led to the development of Mr.Bean, an accessible and user-friendly tool with a comprehensive graphical visualization interface. The application integrates descriptive analysis, measures of dispersion and centralization, linear mixed model fitting, multi-environment trial analysis, factor analytic models, and genomic analysis. All these capabilities are designed to help plant breeders and scientist working with agricultural field trials make informed decisions more quickly. Mr.Bean is available for download at https://github.com/AparicioJohan/MrBeanApp.

RESUMO

Resumen Este estudio propone un sistema de cribado primario para diagnosticar la sarcopenia en adultos mayores a través de medidas antropométricas. Esta investigación exploratoria involucró inicialmente a 150 personas de edad avanzada, de las cuales 122 fueron seleccionadas después de un proceso de depuración de datos. Empleando técnicas de aprendizaje automático como el agrupamiento jerárquico y los árboles de decisión, se redujeron las 13 medidas antropométricas originales a cinco características clave. Se crearon tres sistemas de clasificación: el primero basado en parámetros previamente establecidos (masa muscular apendicular, velocidad de marcha y fuerza de agarre); el segundo consideró medidas de las extremidades superiores (masa muscular promedio de ambos brazos, fuerza de agarre, velocidad de marcha y porcentaje de grasa corporal); y el tercero se centró en las medidas de las extremidades inferiores (masa muscular promedio de ambas piernas, fuerza de agarre, velocidad de marcha y porcentaje de grasa corporal). Estos sistemas de clasificación se validaron clínicamente en un grupo de 57 pacientes previamente diagnosticados por especialistas, de los cuales 10 recibieron un diagnóstico positivo de sarcopenia. Los resultados mostraron eficiencias similares en los tres sistemas, con ocho de los diez diagnósticos positivos conocidos clasificados en el mismo grupo. Además, el estudio proporciona puntos de corte específicos para cada sistema, facilitando así el diagnóstico clínico de la sarcopenia por parte de profesionales médicos.

Abstract This study proposes a primary screening system for diagnosing sarcopenia in older adults through anthropometric measures. This exploratory research initially involved 150 elderly individuals, of whom 122 were selected after a data purification process. Using machine learning techniques such as hierarchical clustering and decision trees, the original set of 13 anthropometric measures was reduced to five key features. Three classification systems were created: the first based on previously established parameters (appendicular muscle mass, walking speed, and grip strength); the second considered upper limb measures (average muscle mass of both arms, grip strength, walking speed, and body fat percentage); and the third focused on lower limb measures (average muscle mass of both legs, grip strength, walking speed, and body fat percentage). These classification systems were clinically validated in a group of 57 patients previously diagnosed by specialists, of which 10 received a positive sarcopenia diagnosis. The results showed similar efficiencies in all three systems, with eight of the ten known positive diagnoses classified in the same group. Additionally, the study provides specific cut-off points for each system, thus facilitating the clinical diagnosis of sarcopenia by medical professionals.

RESUMO

Negative numbers are central in math. However, they are abstract, hard to learn, and manipulated slower than positive numbers regardless of math ability. It suggests that confidence, namely the post-decision estimate of being correct, should be lower than positives. We asked participants to pick the larger single-digit numeral in a pair and collected their implicit confidence with button pressure (button pressure was validated with three empirical signatures of confidence). We also modeled their choices with a drift-diffusion decision model to compute the post-decision estimate of being correct. We found that participants had relatively low confidence with negative numerals. Given that participants compared with high accuracy the basic base-10 symbols (0-9), reduced confidence may be a general feature of manipulating abstract negative numerals as they produce more uncertainty than positive numerals per unit of time.

Assuntos

RESUMO

Resumen En los últimos 4 años, Uruguay ha experimentado una creciente demanda por el consumo de alimentos a base de pescado crudo, tales como sushi, sashimi y ceviche. Este escenario generó la necesidad de evaluar la presencia y concentración de parásitos zoonóticos (Nematoda: Anisakidae) en porciones comestibles de especies de pescado comercializadas en el mercado local. Se analizaron 233 ejemplares de tres especies de pescado comercializadas en Uruguay: Macrodon ancylodon, Micropogonias furnieri y Cynoscion guatucupa. Se cuantificaron e identificaron, a nivel de género, nematodos en cavidad celómica y músculo, estableciendo finalmente los descriptores ecológicos para cada género encontrado y para cada especie de pescado evaluada. Dos de las especies evaluadas se encontraban parasitadas a nivel de cavidad celómica y tejido muscular, M. ancylodon y C. guatucupa. Cynoscion guatucupa resultó la especie mayormente parasitada con una prevalencia de 46%, mientras que el género de anisákido más prevalente fue Contracaecum (prevalencia de 35,1% en C. guatucupa y 32,4% en M. ancylodon). El hallazgo de anisákidos en la especie M. ancylodon representa un nuevo registro de hospedador en Uruguay. Por otra parte, se reporta por primera vez en el país la presencia de estos parásitos zoonóticos en porciones comestibles (músculo).

Abstract In the last 4 years, Uruguay has experienced a growing demand of raw fish-based foods, such as sushi, sahimi and ceviche. This scenario generated the need to assess the presence and concentration of zoonotic parasites (Nematodoes: Anisakidae) in edible parts of fish species traded in the local market. 233 fish specimens of 3 species commercialized in Uruguay were analyzed: Macrodon ancylodon, Micropogonias furnieri and Cynoscion guatucupa. The nematodes were quantified and identified at genus level, from coelomic cavity and muscle of the fishes, to finally stablish the ecological descriptors for each genus founded and for each fish species evaluated. Two of the three species of fish were parasitized with anisakids in both location (coelomic cavity and muscle), M. ancylodon and C. guatucupa. C. guatucupa was the most parasitized with a prevalence of 46%, while, the anisakid genus most prevalente was Contracaecum (prevalence of 35,1% in C. guatucupa and 32,4% in M. ancylodon). The finding of anisakids in M. ancylodon represents a report of a new host in Uruguay. Moreover, the finding for the first time in the country of these zoonotic parasites in edible parts of fish (muscle) is highlighted.

RESUMO

Common bean (Phaseolus vulgaris L.) is the most important legume for direct human consumption worldwide. It is a rich and relatively inexpensive source of proteins and micronutrients, especially iron and zinc. Bean is a target for biofortification to develop new cultivars with high Fe/Zn levels that help to ameliorate malnutrition mainly in developing countries. A strong negative phenotypic correlation between Fe/Zn concentration and yield is usually reported, posing a significant challenge for breeders. The objective of this study was to investigate the genetic relationship between Fe/Zn. We used Quantitative Trait Loci (QTLs) mapping and Genome-Wide Association Studies (GWAS) analysis in three bi-parental populations that included biofortified parents, identifying genomic regions associated with yield and micromineral accumulation. Significant negative correlations were observed between agronomic traits (pod harvest index, PHI; pod number, PdN; seed number, SdN; 100 seed weight, 100SdW; and seed per pod, Sd/Pd) and micronutrient concentration traits (SdFe and SdZn), especially between pod harvest index (PHI) and SdFe and SdZn. PHI presented a higher correlation with SdN than PdN. Seventy-nine QTLs were identified for the three populations: 14 for SdFe, 12 for SdZn, 13 for PHI, 11 for SdN, 14 for PdN, 6 for 100SdW, and 9 for Sd/Pd. Twenty-three hotspot regions were identified in which several QTLs were co-located, of which 13 hotpots displayed QTL of opposite effect for yield components and Fe/Zn accumulation. In contrast, eight QTLs for SdFe and six QTLs for SdZn were observed that segregated independently of QTL of yield components. The selection of these QTLs will enable enhanced levels of Fe/Zn and will not affect the yield performance of new cultivars focused on biofortification.

RESUMO

BACKGROUND: Common bean is an important staple crop in the tropics of Africa, Asia and the Americas. Particularly smallholder farmers rely on bean as a source for calories, protein and micronutrients. Drought is a major production constraint for common bean, a situation that will be aggravated with current climate change scenarios. In this context, new tools designed to understand the genetic basis governing the phenotypic responses to abiotic stress are required to improve transfer of desirable traits into cultivated beans. RESULTS: A multiparent advanced generation intercross (MAGIC) population of common bean was generated from eight Mesoamerican breeding lines representing the phenotypic and genotypic diversity of the CIAT Mesoamerican breeding program. This population was assessed under drought conditions in two field trials for yield, 100 seed weight, iron and zinc accumulation, phenology and pod harvest index. Transgressive segregation was observed for most of these traits. Yield was positively correlated with yield components and pod harvest index (PHI), and negative correlations were found with phenology traits and micromineral contents. Founder haplotypes in the population were identified using Genotyping by Sequencing (GBS). No major population structure was observed in the population. Whole Genome Sequencing (WGS) data from the founder lines was used to impute genotyping data for GWAS. Genetic mapping was carried out with two methods, using association mapping with GWAS, and linkage mapping with haplotype-based interval screening. Thirteen high confidence QTL were identified using both methods and several QTL hotspots were found controlling multiple traits. A major QTL hotspot located on chromosome Pv01 for phenology traits and yield was identified. Further hotspots affecting several traits were observed on chromosomes Pv03 and Pv08. A major QTL for seed Fe content was contributed by MIB778, the founder line with highest micromineral accumulation. Based on imputed WGS data, candidate genes are reported for the identified major QTL, and sequence changes were identified that could cause the phenotypic variation. CONCLUSIONS: This work demonstrates the importance of this common bean MAGIC population for genetic mapping of agronomic traits, to identify trait associations for molecular breeding tool design and as a new genetic resource for the bean research community.

Assuntos

RESUMO

RESUMEN El embolismo por cristales de colesterol (ECC) es una complicación de la enfermedad arterioesclerótica en la que el desprendimiento de fragmentos de placa de ateroma, principalmente de grandes arterias, provoca oclusión de pequeños vasos. Esta entidad, también llamada ateroembolia o síndrome de los dedos del pie azules, es más frecuente en pacientes de edad avanzada y después de procedimientos invasivos intravasculares. Se manifiesta con cianosis, livedo reticularis, necrosis y úlceras asociado a manifestaciones renales y gastrointestinales. Se presenta un paciente trasplantado renal y portador de fístula arteriovenosa trombosada izquierda con ateroembolia localizada en mano homolateral.

ABSTRACT The cholesterol crystal embolism (ECC) is a complication of arteriosclerotic disease in which the detachment of fragments of atheromatous plaque mainly from large arteries, causes occlusion of small vessels. This entity, also called atheroembolism or blue toe syndrome, is more common in elderly patients and after intravascular invasive procedures. It manifests with cyanosis, livedo reticularis, necrosis and ulcers associated with renal and gastrointestinal manifestations. We present a renal transplant patient with a left thrombosed arteriovenous fistula with atheroembolism located in homolateral hand.

Assuntos

RESUMO

Cooking time of the common bean is an important trait for consumer preference, with implications for nutrition, health, and environment. For efficient germplasm improvement, breeders need more information on the genetics to identify fast cooking sources with good agronomic properties and molecular breeding tools. In this study, we investigated a broad genetic variation among tropical germplasm from both Andean and Mesoamerican genepools. Four populations were evaluated for cooking time (CKT), water absorption capacity (WAC), and seed weight (SdW): a bi-parental RIL population (DxG), an eight-parental Mesoamerican MAGIC population, an Andean (VEF), and a Mesoamerican (MIP) breeding line panel. A total of 922 lines were evaluated in this study. Significant genetic variation was found in all populations with high heritabilities, ranging from 0.64 to 0.89 for CKT. CKT was related to the color of the seed coat, with the white colored seeds being the ones that cooked the fastest. Marker trait associations were investigated by QTL analysis and GWAS, resulting in the identification of 10 QTL. In populations with Andean germplasm, an inverse correlation of CKT and WAC, and also a QTL on Pv03 that inversely controls CKT and WAC (CKT3.2/WAC3.1) were observed. WAC7.1 was found in both Mesoamerican populations. QTL only explained a small part of the variance, and phenotypic distributions support a more quantitative mode of inheritance. For this reason, we evaluated how genomic prediction (GP) models can capture the genetic variation. GP accuracies for CKT varied, ranging from good results for the MAGIC population (0.55) to lower accuracies in the MIP panel (0.22). The phenotypic characterization of parental material will allow for the cooking time trait to be implemented in the active germplasm improvement programs. Molecular breeding tools can be developed to employ marker-assisted selection or genomic selection, which looks to be a promising tool in some populations to increase the efficiency of breeding activities.

RESUMO

El hipotiroidismo congénito es la enfermedad endocrina más frecuente en neonatos y puede ser de manifiesto clínico o subclínico. Es la principalcausa de retraso mental tratable y su pronóstico radica en el tamizajetemprano y la instauración oportuna del tratamiento, por lo cual en Colombia se considera necesaria la implementación de un esquema de tamizaje neonatal con una técnica apropiada y de cobertura nacional, equiparable al de otros países. El objetivo de este artículo es realizar una revisión y análisis de la literatura médica existente sobre el hipotiroidismo congénito centrado en la definición, epidemiología, factores etiológicos, tamizaje, diagnóstico y tratamiento; mediante la búsqueda de artículos en las bases de datos PUBMED, EMBASE, REDALYC, OVID, MEDLINE,DYNAMED y CLINICAL KEY (acceso: mayo 2015). Además se realizó revisiónde los informes del Instituto Nacional de Salud en el año 2013 y 2014, de las guías europeas de la sociedad de endocrinología pediátrica 2014, de laguía mexicana de hipotiroidismo congénito neonatal 2008 y del consensocolombiano para el diagnóstico y manejo de enfermedades tiroideas...

Congenital hypothyroidism is the most common endocrine disease innewborns and can be clinical or subclinical. It is the leading cause oftreatable mental retardation and its prognosis is in the early screening andtimely initiation of treatment; this is the reason why in Colombia theimplementation of a neonatal screening with appropriate nationalcoverage technique, comparable to those in other countries, is considerednecessary. The aim of this article is to review and analyse the literature oncongenital hypothyroidism focused on the definition, epidemiology,etiological factors, screening, diagnosis and treatment; by search inPubMed, EMBASE, REDALYC, OVID, MEDLINE, and CLINICAL KEY Dynameddata (access: May 2015). Besides reviewing the reports of the NationalInstitute of Health in 2013 and 2014, the European guidelines for pediatricendocrinology society of 2014, Mexico’s 2008 guide neonatal congenitalhypothyroidism and Colombian consensus for the diagnosis andmanagement of thyroid diseases...

Assuntos

RESUMO

El presente trabajo es un modo de conjugar la potencia activa del pensamiento estético deleuziano en relación con el arte, el teatro y la escritura. El cuerpo se presenta como el espacio privilegiado de creación y exploración de las sensibilidades, como un campo de batalla estético-político de las subjetividades. Así, el pensamiento corporante sería una cartografía estética de las sensaciones, donde el cuerpo conjura desde la crítica, lo lúdico y lo perverso, las insistentes formas de la identidad, de la mismidad, su armonía y su condición dogmática de capturar las fuerzas creativas.

The present work is a way of conjugating the effective power of Deleuzian aesthetic thought in relation to art, theater and writing. The body is presented as the privileged space of creation and exploration of sensitivities, as a field of battle of aesthetic-political subjectivities. Thus the corporealizing thought would be a cartography of aesthetic sensations, where the body conjures from critical, playful and perverse, insistent forms of identity, of sameness, its harmony and its dogmatic condition of capturing the creative forces.

Assuntos

RESUMO

El presente trabajo es un modo de conjugar la potencia activa del pensamiento estético deleuziano en relación con el arte, el teatro y la escritura. El cuerpo se presenta como el espacio privilegiado de creación y exploración de las sensibilidades, como un campo de batalla estético-político de las subjetividades. Así, el pensamiento corporante sería una cartografía estética de las sensaciones, donde el cuerpo conjura desde la crítica, lo lúdico y lo perverso, las insistentes formas de la identidad, de la mismidad, su armonía y su condición dogmática de capturar las fuerzas creativas.(AU)

The present work is a way of conjugating the effective power of Deleuzian aesthetic thought in relation to art, theater and writing. The body is presented as the privileged space of creation and exploration of sensitivities, as a field of battle of aesthetic-political subjectivities. Thus the corporealizing thought would be a cartography of aesthetic sensations, where the body conjures from critical, playful and perverse, insistent forms of identity, of sameness, its harmony and its dogmatic condition of capturing the creative forces.(AU)

Assuntos

RESUMO

Introducción: La Cineantropometría estudia la forma y composición del deportista con el objeto de mejorar su rendimiento, el cual está vinculado con la nutrición. Esto implicaría una asociación entre la valoración cineantropométrica y el consumo de energía y nutrientes. Objetivo: Determinar la relación entre la valoración cineantropométrica y el consumo de energía y nutrientes en futbolistas peruanos de alto rendimiento. Diseño: Descriptivo de asociación cruzada, transversal, Ambispectivo. Institución: Universidad Nacional Mayor de San Marcos. Escuela Académico Profesional de Nutrición. Lima, Perú. Participantes: 44 futbolistas varones de alto rendimiento con edades entre los 18 y 35 años. Intervenciones: Las medidas antropométricas se realizaron en junio del 2011 en base al protocolo de la Sociedad Internacional Para el Avance de la Cineantropometría (ISAK). El somatotipo se calculó con el modelo propuesto por Heath y Carter (1990) y la composición corporal con el propuesto por Ross y Kerr (1993). Se aplicó un cuestionario de frecuencia de consumo de alimentos semicuantitativo para la estimación del consumo de energía y nutrientes. Principales medidas de resultados: Correlación entre el consumo de energía, lípidos, proteínas, carbohidratos, calcio, hierro y vitamina C con los valores de endomorfismo, mesomorfismo, ectomorfismo, porcentaje de masa muscular, porcentaje de masa adiposa y porcentaje de masa ósea. Resultados: El somatotipo promedio de los futbolistas fue mesoendomórfico (3.0-4.8-2.1). Los porcentajes promedio de tejido adiposo, muscular y óseo fueron 24.2 por ciento, 46.7 por ciento y 12 por ciento respectivamente. El consumo promedio de energía fue de 3661.3 kcal/día siendo el consumo de lípidos, proteínas y carbohidratos del 27.0 por ciento, 14.1 por ciento y 58.8 por ciento del valor calórico total respectivamente. Existió asociación directa y estadísticamente significativa entre el consumo de energía y lípidos con el porcentaje (...)

Introduction: Kineanthropometry studies the shape and composition of the athlete in order to improve performance which is linked to nutrition. This implies that kineanthropometric assessment would be related to the consumption of energy and nutrients. Objetive: To determine the relationship between kineanthropometric assessment and use of energy and nutrients in Peruvian high performance players. Design: Descriptive cross-association, cross ambispective. Setting: Universidad Nacional Mayor de San Marcos. Professional Academic School of Nutrition. Lima, Peru. Participants: 44 high-performance male players aged between 18 and 35. Interventions: Anthropometric measurements were performed in June 2011 based on the protocol of the International Society for the Advancement of Kineanthropometry (ISAK). The somatotype was calculated with the model proposed by Heath and Carter (1990) and body composition proposed by Ross and Kerr (1993). Also applied a semiquantitative questionnaire of frequency of food intake, for the calculation of energy and nutrients. Main outcome measurements: Correlation between the values of endomorphism, mesomorphism, ectomorphism, percentage of muscle mass, percentage fat mass and bone mass percentage of energy consumption, lipids, proteins, carbohydrates, calcium, iron and vitamin C. Results: The average somatotype of the players was mesomorphic (3.0-4.8-2.1). The average percentages of fat, muscle and bone were 24.2 per cent, 46.7 per cent and 12 per cent respectively. The average energy intake was 3661.3 kcal / day, with an intake of lipids, proteins and carbohydrates 27.0 per cent, 14.1 per cent and 58.8 per cent of Total Calories respectively. The percentage body fat and endomorphism were statistically significant direct association with the intake of energy and lipids. Also, the percentage of muscle mass and mesomorphy were associated with the intake of protein, iron and vitamin C. Conclusions: The Peruvian player has high levels (...)

Assuntos

Assuntos

RESUMO

La tuberculosis es un problema de salud pública, prevalente en México, las manifestaciones extrapulmonares son frecuentes. El psoas se afecta cuando hay ruptura de abscesos de columna toracolumbar (mal de Pott); la afección primaria es rara. Presentamos el caso clínico de un paciente joven, en quien se encontró por cirugía un absceso solitario, granulomatoso primario del psoas derecho, sin lesiones en otro sitio. La etiología tuberculosa fue la más probable, dado los datos clínicos, epidemiológicos, histopatológicos y de imágenes (ultrasonido, tomografía computada, resonancia magnética y gammagrafía). Se inició tratamiento con rifampicina, pirazinamida, etambutol e isoniacida, con buena respuesta durante el seguimiento

Assuntos

Assuntos

RESUMO

La reciente epidemia de cólera se extendió en la mayor parte del país lo que motivó a proporcionar al personal médico y paramédico una capacitación y actualización en los conocimientos que se tenían de la enfermedad. En epidemias pasadas no se tiene conocimiento de casos atendidos en el HCM, fue en noviembre de 1991 cuando se presentó el primer caso de los pacientes que se atendieron hasta junio de 1995. A través de un estudio observacional, descriptivo y retrospectivo se llevó a cabo la revisión de los casos diagnosticados como cólera, la información se recabó de los expedientes en el archivo clínico de la institución. Se encontraron 38 pacientes del sexo masculino y 22 del sexo femenino. El 100 por ciento de los casos ingresó a la unidad hospitalaria con diversos grados de deshidratación y del total de pacientes el 12 por ciento tenía antecedente de diabetes mellitus. El 67 por ciento habían consumido alimentos en la vía pública. Todos recibieron solución de Ringer lactado, el medicamento utilizado fue trimetropim-sulfametoxazol; el 100 por ciento respondió favorablemente al tratamiento en un periodo de 3 a 5 días. El tratamiento oportuno disminuye la letalidad

Assuntos

RESUMO

Background: Neuroendocrine factors play an important role in the expression of autoimmune disease. Proclatin (PRL) can induce T-cell proliferation and macrophage activation. Elevated PRL levels have been described in patients with rheumatoid arthritis and (RA). Aim and Methods: We studiend immunological and clinical effects of PRL suppression in 9 RA patients with active disease, treated for 3 months with bromocriptiner (BRC), an inihibitor of PRL secretion. Results: BRC induced a significant depression of the peripheral blood mononuclear cells response to antigen (p=0.008) and mitogen (p=0.008) which was significantly correlated with improvements in the HAQ disability index (r=0.68; p=0.04) and grip strength (r=0.7; p=0.02). Also, the in-vitro production of IL-2, nitric oxide and poliamines -that are critical for the proliferative response of lymphoid cells- decreased significantly. The group experienced significant improvement of grip strength (p=0.028) and the HAQ disability index (p=0.025), whereas 4 individuals archieved clinical improvement according to the American College of Rheumatology preliminary definition. We conclude that BRC treatment induces a significant depression of in-vitro immune function in RA patients and these changes are related to parameters of disease activity. The effects of BRC on immune function and disease activity in RA patients warrant further investigation

Assuntos

RESUMO

Seronegative arthritides are a heterogeneous group of diseases that includes rheumatoid arthritis with negative rheumatoid factor. Between 1980 and 1984 we studied 38 patients with seronegative arthritis. Thirty of these patients were reassessed in 1994 after 9 or 20 years of evolution. Seventeen patients had a diagnosis of seronegative rheumatoid arthritis; this diagnosis was maintained in 12, changed to seropositive rheumatoid arthritis in 3, to psoriatic arthritis in 1 and connective tissue disease in 1. Thirteen patients had a diagnosis of undifferentiated arthritis; in 1994 the diagnosis was maintained in 3, 7 patients were diagnosed as having a sppondyloarthropathy, 2 as having a reactive arthritis and 1 as having a connective tissue disease. In 1994, nine patients fulfilled the 1991 criteria for spondyloarthritis and 6 of these did so on admission. Six of 12 patients with seronegative rheumatoid arthritis had an active disease or used antiinflammatory drugs and 64 percent had erosions on hand X ray examination. These figures are in contrast with the enigm evolution classically attributed to this disease and agree with recent reports. The usefulness of classification criteria for rheumatoid arthritis and spondyloarthritis in the initial assessment of patients with seronegative arthritis is emphasized

Assuntos

RESUMO

The aim of this study was to search infections that trigger reactive arthritis. Eigthy-six patients with seronegative arthritis (SNA) were studied; 32 had reactive arthritis, 21 ankylosing spondylitis, 7 psoriatic arthritis and 26 undifferentiated seronegative oligoarthritis. As controls, 70 patients with connective tissue diseases (CTD) and 55 healthy volunteers (HV) were studied. Serological evidence for infection with Chlamydia trachomatis was studied with micro immunofluorescence, looking for L2 and BED serotypes and serological evidence for Yersinia infection, using a commercial kit. Stool cultures were done in seven patients with recent diarrhea and endourethral or endocervical cultures in 35 individuals. Serotypes L2 or BED were positive in 23 of 83 patients with SNA, 3 of 39 patients with CTD and 4 of 55 HV (p<0.03). IgG class antibodies against L2 were detected in 17 percent of SNA patients, 2.6 percent of CTD patients and 5.4 percent of HV (p<0.05). IgM class antibodies were detected in 6 SNA patients, 0 CTD patients and 2 HV (NS). 12 of 35 cultures were positive for Chlamydia. As a whole 30 percent of SNA patients has serological or bacteriological evidence for Chlamydia infection. Serology for Yersinia was positive in 39 of 81 SNA patients, 1 of 54 CTD patients and 3 of 51 HV (p<0.01). Rates of infections were similar among male, female, HLA B27 positive and HLA negative subjects. It is concluded that SNA patients have a high prevalence of infections by Chlamydia trachomatis or Yersinia enterocolitica

Assuntos