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The cattle tick Rhipicephalus microplus (Acari: Ixodidae) has demonstrated its ability to increase its distribution raising spatially its importance as a vector for zoonotic hemotropic pathogens. In this study, a global ecological niche model of R. microplus was built in different scenarios using Representative Concentration Pathway (RCP), Socio-Economic Pathway (SSP), and a climatic dataset to determine where the species could establish itself and thus affect the variability in the presentation of the hemotropic diseases they transmit. America, Africa and Oceania showed a higher probability for the presence of R. microplus in contrast to some countries in Europe and Asia in the ecological niche for the current period (1970-2000), but with the climate change, there was an increase in the ratio between the geographic range preserved between the RCP and SSP scenarios obtaining the greatest gain in the interplay of RCP4.5-SSP245. Our results allow to determine future changes in the distribution of the cattle tick according to the increase in environmental temperature and socio-economic development influenced by human development activities and trends; this work explores the possibility of designing integral maps between the vector and specific diseases.
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Doenças dos Bovinos , Ixodidae , Rhipicephalus , Infestações por Carrapato , Humanos , Bovinos , Animais , Mudança Climática , Infestações por Carrapato/veterináriaRESUMO
Resumen La leishmaniasis cutánea presenta una clínica muy característica de pápula eritemato-amarillenta con costra central, en regiones expuestas, que los profesionales de la salud podemos identificar y tratar sin necesidad de biopsia. En ocasiones, se presenta con una clínica atípica que puede conducir a un error diagnóstico, con su perpetuación y malestar en el paciente. Presentamos el caso de una mujer de 53 con una placa eritema-to-exudativa por toda la extensión del pabellón auricular izquierdo de varios meses de evolución. Había sido tratada desde el inicio con antibioterapia y corticoides, sin conseguir mejoría y con un claro empeoramiento, al haberse extendido por toda la oreja. Tras la realización de la biopsia, se llegó al diagnóstico de leishmaniasis cutánea erisipeloide. Se procedió a realizar tratamiento dirigido con fluconazol y posteriores infiltraciones de antimoniato de meglumina consiguiendo su completa resolución.
Abstract Cutaneous leishmaniasis presents a very characteristic clinic of erythematous-yellowish papule with central crust, in exposed regions, that we health professionals can identify and treat without the need for a biopsy. Sometimes, it presents with an atypical clinic that can lead to a diagnostic error, with its perpetuation and discomfort in the patient. We present the case of a 53-year-old woman with an erythematous-exudative plaque throughout the extension of the left atrial pavilion of several months of evolution. It had been treated from the start with antiobiotherapy and corticosteroids, without achieving improvement and with a clear worsening, as it had spread throughout the ear. After the biopsy was performed, the diagnosis of erysipeloid cutaneous leishmaniasis was reached. Directed treatment with fluconazole and subsequent infiltrations of meglumine antimoniate were made, achieving its complete resolution.
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Polycyclic aromatic hydrocarbons (PAHs) are organic compounds generated mainly by anthropogenic sources. They are considered toxic to mammals, since they have carcinogenic, mutagenic and genotoxic properties, among others. Although mycoremediation is an efficient, economical and eco-friendly technique for degrading PAHs, the fungal degradation potential of the phylum Ascomycota has not been widely studied. In this work, we evaluated different fungal strains from the polluted soil of 'La Escondida' lagoon in Reynosa, Mexico to know their potential to degrade phenanthrene (PHE). Forty-three soil isolates with the capacity to grow in the presence of PHE (0·1% w/v) were obtained. The fungi Aspergillus oryzae MF13 and Aspergillus flavipes QCS12 had the best potential to degrade PHE. Both fungi germinated and grew at PHE concentrations of up to 5000 mg l-1 and degraded 235 mg l-1 of PHE in 28 days, with and without an additional carbon source. These characteristics indicate that A. oryzae MF13 and A. flavipes QCS12 could be promising organisms for the remediation of sites contaminated with PAHs and detoxification of recalcitrant xenobiotics.
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Ascomicetos/metabolismo , Aspergillus oryzae/metabolismo , Aspergillus/metabolismo , Biodegradação Ambiental , Fenantrenos/metabolismo , Poluentes do Solo/metabolismo , Aspergillus/isolamento & purificação , Aspergillus oryzae/isolamento & purificação , México , Hidrocarbonetos Policíclicos Aromáticos/metabolismo , Solo/química , Microbiologia do Solo , Xenobióticos/metabolismoRESUMO
TITLE: Síndrome de Guillain-Barré en el embarazo.
Assuntos
Síndrome de Guillain-Barré , Complicações na Gravidez , Adulto , Feminino , Síndrome de Guillain-Barré/diagnóstico , Síndrome de Guillain-Barré/terapia , Humanos , Gravidez , Complicações na Gravidez/diagnóstico , Complicações na Gravidez/terapia , Adulto JovemRESUMO
AIMS: This study aimed to determine in vitro activity of copper nanoparticles and copper nanowires against Candida albicans strains and to assess their effects on morphology and submicron structure. METHODS AND RESULTS: The microdilution method determined the minimal inhibitory concentration (MIC) of copper nanoparticles (CuNPs) and copper nanowires (CuNWs) against three strains of C. albicans: ATCC 10231 and two clinical strains (C and E). Effects on the morphology and ultrastructure of C. albicans strains were examined by scanning electron microscopy and transmission electron microscopy. MIC for CuNPs was 129·7 µg ml-1 for strain ATCC 10231, 1037·5 µg ml-1 for strain C and 518·8 µg ml-1 for strain E. MIC for CuNWs was similar for all strains tested (260·3 µg ml-1 ). SEM and TEM studies showed alterations in morphology, cell wall and the complete collapse of the yeast after incubation with CuNPs. In contrast, most of the yeast cells maintained their structure with an intact cell wall, and only decreased the number and size of fimbriae when C. albicans was exposed to CuNWs. CuNPs and CuNWs formed hierarchical copper oxide nanostructures growing in situ in the culture medium. Results suggest a dual mechanism for antifungal activity: (i) free Cu2+ ions act as a biocide, (ii) sharp edges of marigold-like petal nanostructures could injure the cellular wall and membrane and cause the death of the yeast. CONCLUSIONS: CuNPs and CuNWs inhibited the growth of the three strains of C. albicans tested. Moreover, CuNPs disrupted cell wall with leakage of the cytoplasmic content. Each concentration of the series used for the determination of the activity of CuNPs and nanowires against C. albicans formed copper oxide marigold-like nanostructures. SIGNIFICANCE AND IMPACT OF THE STUDY: This study suggests that CuNPs and CuNWs are good candidates for formulating new therapeutic agents for candidiasis.
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Antifúngicos/farmacologia , Candida albicans/efeitos dos fármacos , Cobre/farmacologia , Nanoestruturas/química , Nanofios/química , Antifúngicos/química , Candidíase/tratamento farmacológico , Cobre/química , Testes de Sensibilidade Microbiana , Microscopia Eletrônica de Varredura , Microscopia Eletrônica de Transmissão , Nanoestruturas/ultraestrutura , Nanofios/ultraestruturaRESUMO
The relevance of tonsils lies not only in local but also in systemic immunity. One of the most common ailments afflicting the tonsils are palatine tonsilloliths (PT), dystrophic calcifications found in the tonsillar crypts. PT prevalence reports have been conducted for Caucasian and Asian patients, but not for black patients. The aim of this cross-sectional study is to gauge the prevalence of PT in patients who sought treatment at two university clinics in the Dominican Republic, and to analyze any links with the race of patients. Two hundred and nine consecutive patients attending the dental services of two clinics located in different cities in the Dominican Republic, from March 1 to April 30, 2019, were selected. Computed tomography scans of patients were evaluated for a PT diagnosis. Determined prevalence of PT in this population sample was 5.85%. A non-significant relationship between occurrence of PT and race or kind of health service utilized was found. Nonetheless, more white patients used private health clinics while more black patients used the public health system. Previous tonsillitis was the only factor showing a significant correlation with the occurrence of PT. Also, PT prevalence was significantly higher in patients under 40 years of age. General prevalence of PT was significantly lower than reported in previous studies involving other countries/races. Considering the limitations of this study, when comparing it to a previous similar study and taking into account the Asian- and Caucasian-centric results obtained, a race influence on prevalence of calcifications may be suggested. Despite our results showing no racial differences within the Dominican Republic, black patients appear to present a lower prevalence of PT than Caucasian and Asian patients.
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Doenças Linfáticas/epidemiologia , Tonsilite/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Povo Asiático , População Negra , Criança , Pré-Escolar , Estudos Transversais , Feminino , Hispânico ou Latino , Humanos , Masculino , Pessoa de Meia-Idade , Tonsila Palatina/patologia , Prevalência , Radiografia Panorâmica/métodos , Classe Social , Universidades , População Branca , Adulto JovemRESUMO
ABSTRACTAims: The main goal of the current study was to evaluate, on a commercial beef cattle farm, the impact of infection with gastrointestinal nematodes resistant to both ivermectin (IVM) and moxidectin (MXD) on the productivity of calves.Methods: Male Aberdeen Angus calves, aged 9-11 months, with faecal nematode egg counts (FEC) ≥200 epg and body weight ≥190â kg, were allocated to two herds. Herd A (n = 90) grazed a maize-winter forage crop rotation and Herd B (n = 90) grazed a 2-year-old Agropyrum pasture. On Day 0 in each herd, calves were randomly allocated into five groups (n = 18), which were treated with 0.2â mg/kg IVM; 0.2â mg/kg MXD; 3.75â mg/kg ricobendazole (RBZ), both IVM and RBZ, or remained untreated. Faecal samples collected on Days -1 and 19 were used to determine the percentage reduction in FEC, and genera of the nematodes were determined by the identification of the third-stage larvae recovered from faecal cultures. Total weight gain was determined from body weights recorded on Days -1 and 91.Results: Overall mean reduction in FEC was 42% for IVM, 67% for MXD, 97% for RBZ and 99% for IVM + RBZ. The reduction in FEC for Cooperia spp. was ≤78% for IVM and MXD, and for Haemonchus spp. was 0 and 36% for IVM and MXD, respectively, confirming the presence of parasites resistant to both anthelmintics. Only IVM + RBZ treatment resulted in 100% efficacy against Haemonchus spp. The overall estimated mean total weight gain for calves treated with IVM was 15.7 (95% CI = 11.9-19.7) kg and for calves treated with IVM + RBZ was 28.8 (95% CI = 25-32.5) kg (p < 0.001). Mean total weight gain for calves treated with MXD was 23.5 (95% CI = 19.7-27.2) kg.Conclusions and clinical relevance: In calves naturally infected with resistant nematodes, under the production system assessed here, weight gains were lower in calves treated with anthelmintics that were moderately or highly ineffective compared to those treated with highly effective anthelmintics. These results demonstrate to farmers and veterinarians the importance of a sustainable and effective nematode control under field conditions.
Assuntos
Albendazol/análogos & derivados , Antiparasitários/farmacologia , Doenças dos Bovinos/tratamento farmacológico , Ivermectina/farmacologia , Macrolídeos/farmacologia , Infecções por Nematoides/veterinária , Albendazol/farmacologia , Animais , Anti-Helmínticos/farmacologia , Antinematódeos/farmacologia , Argentina , Peso Corporal/efeitos dos fármacos , Bovinos , Doenças dos Bovinos/parasitologia , Doenças dos Bovinos/fisiopatologia , Resistência a Múltiplos Medicamentos , Quimioterapia Combinada/veterinária , Masculino , Infecções por Nematoides/tratamento farmacológico , Infecções por Nematoides/fisiopatologia , Contagem de Ovos de Parasitas/veterinária , Carne VermelhaRESUMO
PURPOSE: In this paper we study the quality of life (QoL) of elderly breast cancer patients receiving endocrine treatment (ET). More QoL data on elderly patients treated with ET are needed. Our aims are to study QoL in early-stage breast cancer patients throughout the treatment period and compare the QoL of ET groups. METHODS: 148 patients > 65 years who began ET with either tamoxifen or aromatase inhibitor (AI) completed the EORTC QLQ-C30 and QLQ-BR23 and the Interview for Deterioration in Daily Living Activities in Dementia (IDDD) questionnaires three times over 3 years of ET. Linear mixed-effect models were used to evaluate longitudinal QoL changes. ET group comparisons were conducted after 3 years of treatment via ANCOVA adjusted by basal QoL. RESULTS: QoL scores were high (> 80/100 points) in most QoL areas, with moderate limitations (> 30) in sexual functioning and enjoyment and in future perspective. After 3 years of ET, four QoL areas improved (< 6 points) compared to baseline and 3-month assessments. Hot flushes worsened (8 points) at the 3-month assessment but by 3 years had recovered. AI patients showed more hot flushes, pain and diarrhea and less sexual enjoyment than tamoxifen patients after 3 years of ET (differences 3-12 points). CONCLUSIONS: Results indicate that elderly early-stage breast cancer patients adapted well to their disease and ET treatment over the 3 years. Few QoL differences were observed between ET groups.
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Antineoplásicos Hormonais/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Qualidade de Vida , Tamoxifeno/uso terapêutico , Idoso , Feminino , Seguimentos , Humanos , Prognóstico , Estudos Prospectivos , Inquéritos e QuestionáriosRESUMO
OBJECTIVE: To analyze the utility of neutrophil-to-lymphocyte ratio (NLR) plus C-reactive protein (CRP) to differentiate between infection and active disease in patients with SLE. METHODS: A cross-sectional study of a cohort of patients with SLE was carried out. Blood samples from four groups (patients without infection or active disease, patients with infection, patients with active disease, and patients with both infection and active disease) before therapeutic interventions were analyzed. We excluded patients with current malignancy, pregnancy, ischemic heart disease or use of antimicrobials during previous 7 days. Hematological cell count, CRP and cultures were obtained. We constructed receiver operating characteristic curves; sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated. RESULTS: Forty patients were included. NLR cut-off ≥6.3 had sensitivity 70%, specificity 85%, PPV 83% and NPV 74% to detect patients with non-viral infections. A CRP cut-off ≥7.5 mg/L had sensitivity 90%, specificity 75%, PPV 78% and NPV 88% to detect infections regardless of SLE activity. Combination of CRP plus NLR improves the specificity to 90% and PPV to 88%. Excluding the group with both infection and active disease, CRP plus NLR expands specificity to 95% and NPV to 90%. CONCLUSION: In our experience, levels of CRP, particularly CRP plus NLR, were useful in differentiating patients with SLE from those with suspected non-viral infection regardless of the activity of the disease.
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Proteína C-Reativa/análise , Infecções/diagnóstico , Lúpus Eritematoso Sistêmico/sangue , Linfócitos , Neutrófilos , Adolescente , Adulto , Idoso , Biomarcadores , Estudos Transversais , Feminino , Humanos , Infecções/sangue , Infecções/complicações , Contagem de Leucócitos , Lúpus Eritematoso Sistêmico/complicações , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Curva ROC , Adulto JovemRESUMO
En este trabajo abordamos como la Historia se cruza con las pequeñas historias en cada restitución. La restitución es puesta en juego, cada vez, en ellas y la nominación que ha acontecido se conmueve al reanudarse el nudo de la filiación con cada restitución
In this essay we work on how History intersects small stories in each restitution. The filiation is put into play, and the nomination that has taken place is shaken when the knot of filiation is rearmed with each restitution
Assuntos
Humanos , Recém-Nascido , Lactente , História do Século XX , TerrorismoRESUMO
The use of radioactive emanations has been of great importance for the performance of endourology procedures, such as percutaneous nephrolithotomy (NLP). The damage to health caused by radiation has been a sensitive issue. The objective of this work was to determine the dose received by the surgeon during NLP and the total dose generated by the fluoroscope. A cross-sectional study was conducted with data from a cohort study with a duration of 18 months that included 101 patients. Radiation was measured with dosimeter during the last 6 months. During the last 6 months of the study, 34 patients were submitted to surgery. The average age was 47 years. Average fluoroscopy time was 58.3 second (24-122 seconds) in both male and female groups, with 57.16 seconds and 58.95 seconds per case, respectively (P = .6). Radiation emitted during 6 months for the 34 patients was 330.5 mGy. The total radiation measured by the dosimeter was 1 mSv, which is equivalent to 0.3% of the total radiation applied during the procedures. Doses measured by the dosimeter on the surgeon were within the recommended annual doses although dose received by the hands exceeds the authorized limits (500 mSv/y).
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Objetivo: Determinar los factores asociados al consumo de tabaco en los estudiantes de la Licenciatura en Enfermería de la Universidad Autónoma del Estado de Morelos. Métodos: Estudio transversal realizado en 481 estudiantes que completaron un cuestionario autoaplicado con características sociodemográficas, consumo de tabaco, actitudes y conocimientos acerca del tabaquismo. Los factores asociados se analizaron con un modelo de regresión logística múltiple. Resultados: La prevalencia de fumadores activos fue de 42.4%. Se presenta mayor prevalencia en estudiantes del primer año (44.3%), que en los de cuarto año (13.9%) de la carrera. Los factores asociados al consumo de tabaco fueron el ser hombre (OR = 1.7; IC 95% (1.0 - 3.0)), ver cigarros sueltos a la venta (OR = 9.4; IC 95% (3.8 - 23.0)), que todos los amigos fumen (OR = 6.0; IC 95% (1.3-27.7)), no estar de acuerdo con prohibiciones de publicidad, así como con lugares para no fumar (OR = 3.2; IC 95% (3.0-5.2)) y cuyos padres no saben si ellos fuman (OR = 6.9; IC 95% (3.2 - 14.6)). Conclusiones: Al avanzar el estudiante en su formación académica se disminuye el consumo de tabaco. Se recomienda la incorporación de temas específicos sobre los efectos del consumo de tabaco en la salud en los contenidos de las asignaturas del programa de Licenciatura en Enfermería, así como la capacitación de los estudiantes en programas de prevención, control y cesación del tabaquismo.
Objective: To determine factors associated with tobacco use among students in the baccalaureate nursing program of the State of Morelos Autonomous University. Methods: This a transversal study with 481 students who answered a self-administered questionnaire on issues of social and demographical characteristics and attitudes and knowledge towards tobacco use. Associated factors were analyzed through a multiple logistic regression model. Results: The overall active smoking prevalence was 42.2%. A higher figure was found in the first year students in comparison to senior students (44.3% vs 13.9%). Some associated factors were: being male (OR = 1.7; CI 95% (1.0 - 3.0)); watching cigarettes being sold (OR = 9.3; CI 95% (3.8 - 23.0)); having all friends being smokers (OR = 6.0; CI 95% (1.3 - 27.7)); being in disagreement with prohibition publicity and smoking-banned places (OR = 3.2; CI 95% (3.0 - 5.2)); and having parents unaware of their sons' smoking habits (OR = 6.9; CI 95% (3.3 - 14.6)). Conclusions: Although students tend to decrease their tobacco use while they progress along their careers, it is recommended to incorporate into nursing baccalaureate programs diverse topic discussions on the health impacts from tobacco smoking in order to train the students in its prevention, control, and withdrawal.
Objetivo: Determinar os fatores associados ao consumo de tabaco nos estudantes da Licenciatura de Enfermagem da Universidad Autónoma del Estado de Morelos. Métodos: Estudo transversal realizado em 481 estudantes que completaram um questionário auto-aplicado com caraterísticas sociodemográficas, consumo de tabaco, atitudes e conhecimentos acerca do tabagismo. Os fatores associados analisaram-se com um modelo de regressão logística múltipla. Resultados: A prevalência de fumadores ativos foi de 42.4%. Apresenta-se maior prevalência em estudantes do primeiro ano (44.3%), quanto nos de quarto ano (13.9%) da carreira. Os fatores associados ao consumo de tabaco foram: o ser homem (OR = 1.7; IC 95% (1.0-3.0)), ver cigarros fracionados à venda (OR = 9.3; IC 95% (3.8 - 23.0)), que todos os amigos fumem, (OR = 6.0; IC 95% (1.3-27.7)), não concordar com proibições de publicidade, assim como com lugares para não fumantes (OR = 3.2; IC 95% (3.0 - 5.2)) e cujos pais não sabem que eles fumam (OR = 6.9; IC 95% (3.3 - 14.6)). Conclusões: Ao avançar o estudante em sua formação académica diminui o consumo de tabaco. Recomenda-se a incorporação de temas específicos sobre os efeitos do consumo de tabaco na saúde dentro dos conteúdos das disciplinas do programa de Licenciatura em Enfermagem, assim como o treinamento dos estudantes em programas de prevenção, controle e suspensão de tabagismo.
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Humanos , Masculino , Feminino , Adolescente , Adulto , Estudantes de Enfermagem , Conhecimento , Uso de TabacoRESUMO
Water buffaloes (Bubalus bubalis) were introduced to Mexico at the end of the last century. In Mexico, buffaloes are commonly pastured together with cattle; however few studies have been done on buffalo herd health in Mexico. We hypothesized that a better knowledge of the epidemiology of infections shared between cattle and buffaloes may improve herd profitability and promote buffalo production in areas unsuitable to cattle farming. This study aimed to determine the prevalence of antibodies against bovine herpes virus - 1 (BoHV1) in water buffaloes raised on six farms from the state of Veracruz, Mexico. Of 368 buffaloes sampled, 217 (59%) were seropositive for BoHV-1. Age was identified as a risk factor for BoHV-1 infection with buffaloes older than 5 years being the most likely to be infected. Animals more than 7 years old had the highest prevalence (86.0%). Females and males had similar seroprevalence rates. Females with history of abortion had higher prevalence of antiBoHV-1 antibodies than those with no record of abortion. Buffaloes and cattle were raised together in only one of the six farms under study. Interaction with cattle was not a risk factor for BoHV-1 seropositivity. This study showed that BoHV-1 is prevalent among buffalo herds in the state of Veracruz, Mexico. Buffaloes appear to play an important role in the epidemiology of BoHV-1 infection in parts of Mexico when there is no apparent risk of interaction with cattle. Animal health programs established to mitigate the burden caused by BoHV-1 must take into consideration buffaloes when this bovid species is part of the agroecosystem shared with cattle.
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The goals of the current study were to evaluate the potential pharmacokinetic (PK) interactions and the clinical efficacy occurring after the subcutaneous (s.c.) administration of ricobendazole (RBZ) and levamisole (LEV) given both separately and co-administered to calves naturally infected with susceptible gastrointestinal nematodes. The clinical efficacy was shown in two seasons, winter and spring, with predominance of different nematode populations. Groups of 15 calves were treated with RBZ alone, LEV alone and RBZ + LEV combination, and an untreated group was kept as a Control. RBZ and LEV plasma concentrations were quantified by HPLC. The clinical efficacy was determined by the faecal egg count reduction test. RBZ and LEV have similar plasma persistence, being detected in plasma over 24 hr post-treatment. No PK interactions were observed after the combined treatment, with similar PK parameters (p > .05) obtained for the single-drug and the combination-based strategy. In winter, the observed clinical efficacies were 96%, 99% and 100% for groups treated with RBZ, LEV and RBZ + LEV, respectively; however, in spring, the efficacies were 95%, 93% and 96% for the same groups. Remarkably, the combination was the only treatment that achieved 100% clinical efficacy against both Haemonchus spp and Ostertagia spp in winter; but the increased presence of Ostertagia spp. in spring (28% in untreated group) determined a tendency to reduced efficacies compared to winter time (only 10% of Ostertagia spp. in untreated group), even for the combined treatment. Overall, in a scenario where the nematode population is susceptible, the RBZ + LEV treatment may be a valid combination in cattle to delay the development of resistance, especially in winter when this combination achieved 100% of efficacy. Thus, selection of anthelmintic resistance will never occur. In fact, this is one of the greatest challenges for the whole cattle production system: to be one step ahead of anthelmintic resistance.
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Albendazol/análogos & derivados , Antinematódeos/uso terapêutico , Levamisol/uso terapêutico , Albendazol/administração & dosagem , Albendazol/sangue , Albendazol/uso terapêutico , Animais , Antinematódeos/administração & dosagem , Bovinos , Doenças dos Bovinos/tratamento farmacológico , Doenças dos Bovinos/parasitologia , Quimioterapia Combinada/veterinária , Hemoncose/tratamento farmacológico , Hemoncose/veterinária , Haemonchus/efeitos dos fármacos , Injeções Subcutâneas/veterinária , Levamisol/administração & dosagem , Levamisol/sangue , Masculino , Ostertagia/efeitos dos fármacos , Ostertagíase , Contagem de Ovos de Parasitas/veterinária , Estações do AnoRESUMO
La hipertensión de la arteria pulmonar es una grave complicación que pueden presentar los pacientes con enfermedades autoinmunes del tejido conectivo Exis-ten distintas prevalencias reportadas según cada país. Por otro lado, la sobrevida de estos pacientes reportada al año y a los tres años, va desde 70-82% y 47-53% respectivamente dependiendo de cual es la enfermedad del tejido conectivo aso-ciada. En los últimos años se ha avanzado en la precocidad del diagnóstico y han aparecido nuevas terapias que han demostrado mejores resultados. Sin embargo, la respuesta al tratamiento sigue siendo mejor en pacientes con hipertensión pul-monar idiopática que en aquellas asociadas a enfermedad de tejido conectivo.
Pulmonary artery hypertension is a serious complication that may occur in pa-tients with autoimmune diseases of the connective tissue. There are different prevalence reported by country. On the other hand, the survival of these patients reported at one year and three years, going from 70-82% and 47-53% respec-tively, depending on which is the associated connective tissue disease. In recent years it has made progress in the precocity of diagnosis and new therapies have appearedthat have shown better results. However, the response to treatment is still better in patients with idiopathic pulmonary hypertension than in those associated with connective tissue disease.
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Humanos , Doenças Autoimunes/complicações , Doenças do Tecido Conjuntivo/complicações , Hipertensão Arterial Pulmonar/complicações , Escleroderma Sistêmico , Sobrevida , Doenças do Tecido Conjuntivo/terapia , Hipertensão Arterial Pulmonar/mortalidadeRESUMO
La hipertensión de la arteria pulmonar (HAP) es una grave complicación que pue-den presentar los pacientes con enfermedades autoinmunes del tejido conectivo de prevalencia variable según cada país. Habitualmente su diagnóstico es tardío lo que influye negativamente en su pronóstico y respuesta terapéutica. En el pre-sente trabajo se ha iniciado una revisión en conjunto entre la Unidad de Hemodi-namia y de Reumatología del Hospital San Juan de Dios, con el propósito de tener una caracterización de los pacientes con HAP y enfermedades autoinmunes del tejido conectivo y poder así elaborar planes de manejo de acuerdo a las caracte-rísticas clínicas de estos pacientes e intentar obtener un diagnostico precoz, para mejorar la sobrevida de los portadores de estas enfermedades.
High blood pressure in the pulmonary artery (HAP) is a serious complication that may occur in patients with autoimmune diseases of the connective tissue of vari-able prevalence according to each country. Diagnosis is usually late which affects negatively their prognosis and therapeutic response. In the present work has been initiated a review in conjunction between the unit of Hemodynamic and Rheumatology of the Hospital San Juan de Dios, with the purpose of having a characterization of patients with PAH and autoimmune diseases of the connective tissue and can thus develop management plans according to the clinical features of these patients and try to get an early diagnosis, to improve the survival of the carriers of these diseases.
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Humanos , Masculino , Feminino , Doenças Autoimunes/complicações , Doenças do Tecido Conjuntivo/complicações , Hipertensão Arterial Pulmonar/epidemiologia , Chile/epidemiologia , Epidemiologia Descritiva , Doenças Pulmonares Intersticiais/etiologia , Diagnóstico Precoce , Hipertensão Arterial Pulmonar/diagnóstico , Hipertensão Arterial Pulmonar/mortalidadeRESUMO
Amebiasis is the infection by Entamoeba histolytica, a protozoan capable of invading the colonic mucosa causing a diarrheic syndrome, although most of the time is mild, it can lead to a fulminating colitis. Sometimes it can spread to other organs; among extra-intestinal manifestations of this parasite, the most frequent is the amebic liver abscess. In the next pages, general aspects of this protozoan, its epidemiology, clinical findings, diagnosis and treatment are reviewed, emphasizing the possibilities of diagnosis and treatment available in Chile.
La amebiasis corresponde a la infección por Entamoeba histolytica, protozoo capaz de invadir la mucosa del colon provocando un cuadro diarréico que, si bien la mayoría de las veces es leve, puede llegar a una colitis fulminante. En algunas oportunidades puede diseminarse a otros órganos; dentro de las manifestaciones extra-intestinales de este parásito, la más frecuente es el absceso hepático amebiano. A continuación se revisan aspectos generales de este protozoo, su epidemiología, cuadro clínico, diagnóstico y tratamiento, destacando las posibilidades de diagnóstico y tratamiento disponibles en Chile.
Assuntos
Humanos , Disenteria Amebiana/diagnóstico , Disenteria Amebiana/tratamento farmacológico , Abscesso Hepático Amebiano/diagnóstico , Abscesso Hepático Amebiano/tratamento farmacológico , Diarreia/parasitologia , Disenteria Amebiana/parasitologia , Entamoeba histolytica/patogenicidade , Abscesso Hepático Amebiano/parasitologia , Metronidazol/uso terapêutico , Antiparasitários/uso terapêuticoAssuntos
Masculino , Feminino , Humanos , Adulto , Adulto Jovem , Pessoa de Meia-Idade , Idoso , Varizes Esofágicas e Gástricas/terapia , Hemorragia Gastrointestinal/terapia , Ligadura , Inibidores da Bomba de Prótons/uso terapêutico , Vasoconstritores/uso terapêutico , Terapia Combinada , Inibidores da Bomba de Prótons/efeitos adversos , Reprodutibilidade dos Testes , Vasoconstritores/efeitos adversosRESUMO
BACKGROUND: The diffusion tensor imaging technique (DTI) combined with tractography methods, has achieved the tridimensional reconstruction of white matter tracts in the brain. It allows their characterization in vivo in a non-invasive way. However, one of the largest sources of variability originates from the location of regions of interest, is therefore necessary schemes which make it possible to establish a protocol to be insensitive to variations in drawing thereof. The purpose of this paper is to stablish a reliable protocol to reconstruct ten prominent tracts of white matter and characterize them according to volume, fractional anisotropy and mean diffusivity. Also we explored the relationship among these factors with gender and hemispheric symmetry. METHODS: This study aims to characterize ten prominent tracts of white matter in a representative sample of Cuban population using this technique, including 84 healthy subjects. Diffusion tensors and subsequently fractional anisotropy and mean diffusivity maps were calculated from each subject's DTI scans. The trajectory of ten brain tracts was estimated by using deterministic tractography methods of fiber tracking. In such tracts, the volume, the FA and MD were calculated, creating a reference for their study in the Cuban population. The interactions between these variables with age, cerebral hemispheres and gender factors were explored using Repeated Measure Analysis of Variance. RESULTS: The volume values showed that a most part of tracts have bigger volume in left hemisphere. Also, the data showed bigger values of MD for males than females in all the tracts, an inverse behavior than FA values. CONCLUSIONS: This work showed that is possible reconstruct white matter tracts using a unique region of interest scheme defined from standard to native space. Also, this study indicates differing developmental trajectories in white matter for males and females and the importance of taking gender into account in developmental DTI studies and in underlie gender-related cognitive differences.
Assuntos
Imagem de Difusão por Ressonância Magnética/métodos , Imagem de Tensor de Difusão/métodos , Substância Branca/anatomia & histologia , Adulto , Cuba , Feminino , Voluntários Saudáveis , Humanos , Masculino , Pessoa de Meia-Idade , Substância Branca/diagnóstico por imagem , Adulto JovemRESUMO
BACKGROUND: Patients with systemic lupus erythematosus (SLE) have a higher risk for cardiovascular disease (CVD), not fully explained by the conventional risk factors. These patients have endothelial dysfunction (ED) as an early process of atherosclerosis, which can be reversed with therapy. OBJECTIVE: To determine the effect of ezetimibe plus pravastatin on endothelial function in patients with SLE after 12 months of treatment. PATIENTS AND METHODS: An open study, before and after, which assessed the effect of ezetimibe plus pravastatin treatment, was performed. Twenty two patients (21 women and one man) with diagnosis of SLE were studied, with a mean age 40 ± 5 years. Endothelial dysfunction was evaluated using vascular ultrasound of the brachial artery in order to measure the flow-mediated vasodilation (FMV) basal and after 12 months of treatment with pravastatin 40 mg/day plus ezetimibe 10 mg/day. In addition, a lipid profile: total cholesterol (TC), HDL-cholesterol (HDL-C), LDL-cholesterol (LDL-C), and serum C-reactive protein (CRP), was done. RESULTS: We found a basal FMV of 7.58% and 18.22% after 12 months of treatment, with an improvement of 10.64 points 95% CI (7.58-13.58), p < 0.001. TC decreased from 201.3 ± 58.9 mg/dL to 158.06 ± 50.13 mg/dL (p < 0.01); LDL-C from 125.78 ± 44.4 mg/dL to 78.8 ± 32.9 mg/dL (p < 0.001); HDL-C increased from 49.0 ± 16.8 mg/dL to 52.2 ± 13.8 mg/dL (p = 0.077). The basal and final concentrations of CRP were 4.49 and 2.8, respectively, with a mean decrease of 2.11 mg/dL, 95% CI (0.908-3.32), p < 0.002. Both drugs were well tolerated. CONCLUSION: Ezetimibe plus pravastatin significantly improved FMV in patients with SLE, decreasing ED and the lipid profile. This treatment ameliorated an early process of atherosclerosis and a risk factor for CVD.