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Introduction: Tuberculosis is endemic in Colombia, the prevalence of its pulmonary form in immunocompetent hosts is high, and peritoneal compromise instead is rare and difficult to diagnose. Case presentation: A 24-year-old female patient living in a rural area presented to the emergency department with constitutional and gastrointestinal symptoms, including bloating, diarrhea, significant weight loss, nocturnal diaphoresis, and gradual onset of ascites with abdominal pain. Diagnostic workup, including paracentesis, a transvaginal ultrasound, and an abdominal CT scan, did not suggest malignancy or portal hypertension. However, diagnostic laparoscopy revealed a miliary pattern comprising the parietal and pelvic peritoneum, uterus, fallopian tubes, and major omentum suggestive of peritoneal tuberculosis. Anti-tuberculosis therapy was initiated with subsequent microbiological confirmation. Conclusion: Abdominal compromise by tuberculosis is a diagnostic challenge, especially in patients with no apparent risk factors. The clinical manifestations and paraclinical data may be unspecific or inconclusive, requiring peritoneal biopsy and empirical treatment before definitive confirmation.
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Twelve 7-chloroquinoline derivatives were designed and synthesized using the principle of molecular hybridization through the coupling of 2-[2-(7-chloroquinolin-4-ylthio)-4-methylthiazol-5-yl]acetic acid 1 with various benzoyl hydrazines 2a-l. The synthetic compounds were tested as antimalarials. Some of them showed an efficient in vitro activity as inhibitors of ß-hematin formation and an in vivo activity in a murine model, resulting in compounds 8 and 9 as the most active ones with IC50 values of 0.65 ± 0.09 and 0.64 ± 0.16 µM, respectively. The effects of the compounds on the cell viability, cell cycle, and apoptosis induction of A549 and MCF-7 cancer cell lines were also examined. Our data showed that compounds 6 and 12 were the most active agents, decreasing the cell viability of MCF-7 cells with IC50 values of 15.41 and 12.99 µM, respectively. None of the compounds analyzed significantly affected the viability of peripheral blood mononuclear cells. Also, significant induction of apoptosis was observed when both cancer cell lines were incubated with compounds 6 and 12. In MCF-7 cells, treatment with these compounds led to cell cycle arrest in the G0/G1 phase. The results obtained suggest that these structures may be useful in developing new therapies for malaria and cancer treatment.
Assuntos
Antimaláricos/farmacologia , Antineoplásicos/farmacologia , Hidrazinas/farmacologia , Quinolinas/farmacologia , Células A549 , Ácido Acético/síntese química , Ácido Acético/química , Ácido Acético/farmacologia , Animais , Antimaláricos/síntese química , Antimaláricos/química , Antineoplásicos/síntese química , Antineoplásicos/química , Apoptose/efeitos dos fármacos , Pontos de Checagem do Ciclo Celular/efeitos dos fármacos , Sobrevivência Celular/efeitos dos fármacos , Modelos Animais de Doenças , Humanos , Hidrazinas/síntese química , Hidrazinas/química , Concentração Inibidora 50 , Células MCF-7 , Malária/tratamento farmacológico , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Quinolinas/síntese química , Quinolinas/química , Relação Estrutura-Atividade , Tiazóis/síntese química , Tiazóis/química , Tiazóis/farmacologiaRESUMO
Multiple perturbations of the immune response affecting a range of cells have been reported in Trypanosoma cruzi-infected individuals and associated to clinical manifestations of chronic Chagas disease. There is a paucity of knowledge about the role of T follicular helper (Tfh) cells in this infection. Here, we sought to characterize circulating Tfh (cTfh) cells in chronic Chagas disease patients and to identify potential associations with disease severity in humans. cTfh cells were characterized by flow cytometry in freshly isolated PBMCs from 7 T. cruzi-infected asymptomatic patients (ASYMP), 5 patients with chronic chagasic dilated cardiomyopathy (CCC) and 8 healthy controls, using antibodies against chemokine receptors CXCR5, CXCR3, CCR6, and CCR7. Our results showed significant expansion of CD4+CD45RO+CXCR5+CCR6+ cells in ASYMP and CCC patients, along with a contraction of CD4+CD45RO+CXCR5+CXCR3-CCR6- (cTfh2) cells. ASYMP patients further exhibited decreased CD4+CD45RO+CXCR5+CXCR3+CCR6- (cTfh1) cells and expanded CD4+CD45RO+CXCR5+CXCR3-CCR6+ (cTfh17) cells while CCC patients exhibited significantly increased frequencies of CD4+CD45RO+CXCR5+CCR7+ cells. Linear regression analysis revealed a positive trend of CD4+CD45RO+CXCR5+CXCR3+CCR6+ (cTfh1/17) cells and negative trends of cTfh1 and cTfh2 cells as disease was more severe. There was no correlation between the frequencies of cTfh cells and circulating CD19+IgD-IgG+ cells or serum levels of T. cruzi-specific IgG. These results demonstrate that the cTfh compartment of humans chronically infected with T. cruzi comprises expanded CCR6-expressing cells and reduced cTfh2 cells. The association of discrete phenotypic changes in cTfh subsets with different clinical forms suggests the potential contribution of T follicular helper cells to Chagas heart disease progression.
Assuntos
Doença de Chagas , Células T Auxiliares Foliculares , Linfócitos T CD4-Positivos , Humanos , Receptores CXCR5 , Linfócitos T Auxiliares-IndutoresRESUMO
Abscesso retroperitoneal é uma enfermidade infrequente e, muitas vezes, com sintomatologia inespecífica, o que torna difícil o diagnóstico. No presente trabalho é relatado o caso de um paciente masculino, 54 anos, previamente hígido, que apresentou lombociatalgia súbita, além de imagem suspeita na topografia de retroperitônio e, após piora clínica e laboratorial, necessitou-se de intervenção cirúrgica com o propósito diagnóstico e terapêutico (drenagem e retirada do corpo estranho descoberto no transoperatório). Objetivamos, com este relato, enfatizar é fundamental a suspeita clínica para se chegar ao diagnóstico e manejar corretamente essa patologia que, embora rara, deve ser reconhecida precocemente a fim de evitar desfechos fatais.
Retroperitoneal abscess is a rare disease, often with unspecific symptoms, which makes diagnosis difficult. In this paper we report the case of a previously healthy 54-year-old male patient who presented sudden low back pain, besides suspicious image on the retroperitoneal topography. After clinical and laboratory worsening, a surgical intervention was required for diagnostic and therapeutic purposes (drainage and removal of foreign body discovered trans-operatively). Our aim with this report is to stress that clinical suspicion is crucial to make the diagnosis and properly manage this condition which, although rare, should be recognized early in order to avoid fatal outcomes.
Assuntos
Humanos , Masculino , Abscesso Abdominal , Corpos Estranhos , Espaço Retroperitoneal/cirurgiaRESUMO
Numerous abnormalities of the peripheral blood T cell compartment have been reported in human chronic Trypanosoma cruzi infection and related to prolonged antigenic stimulation by persisting parasites. Herein, we measured circulating lymphocytes of various phenotypes based on the differential expression of CD19, CD4, CD27, CD10, IgD, IgM, IgG and CD138 in a total of 48 T. cruzi-infected individuals and 24 healthy controls. Infected individuals had decreased frequencies of CD19+CD27+ cells, which positively correlated with the frequencies of CD4+CD27+ cells. The contraction of CD19+CD27+ cells was comprised of IgG+IgD-, IgM+IgD- and isotype switched IgM-IgD- memory B cells, CD19+CD10+CD27+ B cell precursors and terminally differentiated CD19+CD27+CD138+ plasma cells. Conversely, infected individuals had increased proportions of CD19+IgG+CD27-IgD- memory and CD19+IgM+CD27-IgD+ transitional/naïve B cells. These observations prompted us to assess soluble CD27, a molecule generated by the cleavage of membrane-bound CD27 and used to monitor systemic immune activation. Elevated levels of serum soluble CD27 were observed in infected individuals with Chagas cardiomyopathy, indicating its potentiality as an immunological marker for disease progression in endemic areas. In conclusion, our results demonstrate that chronic T. cruzi infection alters the distribution of various peripheral blood B cell subsets, probably related to the CD4+ T cell deregulation process provoked by the parasite in humans.
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Anticorpos Antiprotozoários/sangue , Antígenos CD/sangue , Subpopulações de Linfócitos B/imunologia , Doença de Chagas/imunologia , Memória Imunológica/imunologia , Antígenos CD/biossíntese , Subpopulações de Linfócitos B/citologia , Linfócitos T CD4-Positivos/imunologia , Doença de Chagas/parasitologia , Doença Crônica , Humanos , Imunoglobulina D/sangue , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Imunofenotipagem , Plasmócitos/imunologia , Células Precursoras de Linfócitos B/imunologia , Trypanosoma cruzi/imunologiaRESUMO
Previously we found that the frequency of IFN-gamma-producing CD8(+) T cells specific for Trypanosoma cruzi inversely correlates with disease severity in chronic human Chagas disease along with low levels of IL-2-secreting CD8(+) T cells in all clinical stages. This impairment of the parasite-specific T cell responses was associated with phenotypic features of immune senescence of the CD8(+) T cell compartment. These data prompted us to address the question of whether the CD4(+) T cell compartment also experiences signs of exhaustion. Thus, we performed a functional and phenotypical characterization of T. cruzi-specific and overall CD4(+) T cells in chronically infected subjects with different degrees of cardiac dysfunction. The results show an inverse association between disease severity and the frequency of T. cruzi-specific IFN-gamma-producing CD4(+) T cells. The high expression of CD27 and CD28 with a relative low expression of CD57 found on CD4(+)IFN-gamma(+) T cells suggests that the effector T cell pool in chronic T. cruzi infection includes a high proportion of newly recruited T cells, but a low frequency of long-term memory cells. The total CD4(+) T cell compartment shows signs of senescence and later stages of differentiation associated with more severe stages of the disease. These findings support the hypothesis that long-term T. cruzi infection in humans might exhaust long-lived memory T cells.
Assuntos
Linfócitos T CD4-Positivos/patologia , Doença de Chagas/imunologia , Trypanosoma cruzi , Adulto , Idoso , Animais , Linfócitos T CD4-Positivos/imunologia , Linfócitos T CD4-Positivos/parasitologia , Diferenciação Celular , Senescência Celular , Doença de Chagas/complicações , Doença de Chagas/patologia , Doença Crônica , Feminino , Cardiopatias/etiologia , Cardiopatias/patologia , Humanos , Memória Imunológica , Imunofenotipagem , Interferon gama/biossíntese , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Fatores de TempoRESUMO
El estudio se realizó en diciembre y enero del 2001 y 2002 respectivamente, y se llevó a cabo en el Area de Salud de Goicoechea 1 y en la Clínica de San Marcos de Tarrazú. Objetivos: Conocer la percepción del usuario interno sobre el uso de tecnología computadorizada. Metodología: cualitativa, del tipo de etnografía rápida (conocida como Rapid Assessment Procedue-RAP en inglés), la cual incluye observación, encuesas y cuestionarios. La muestra total fue de 32 trabajadores del sector salud. Resultados y Discusión: el uso de este tipo de tecnología tiene tanto ventajas como desventajas las cuales varían de acuerdo al sujeto, dado en parte por su entorno y sus conocimientos. Conclusiones: Existe un ambiente general de aceptación hacia este tipo de tecnología, aunque se debe de hacer un proceso de educación para aprovecharla al máximo.
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Atitude Frente aos Computadores , Capacitação de Usuário de Computador , Computadores , Aplicações da Informática Médica , Opinião Pública , Costa RicaRESUMO
Se destaca la importancia de las diapositivas como medio audiovisual de uso frecuente durante las exposiciones orales, que se realizan en congresos, talleres, simposios, seminarios, así como en otras actividades científicas y académicas. Se trata la preparación, obtención y clasificación de las diapositivas. Se establecen los requerimientos para la elaboración de las diapositivas de texto, así como de aquellas que contienen figuras o ilustraciones. Se enfatiza en la adecuada utilización y combinación de los colores, las características de los diferentes tipos de gráficos y sobre los aspectos esenciales de la exposición, protección y conservación de las diapositivas. Finalmente, se destaca la influencia decisiva que ejerce la calidad de la presentación sobre la receptividad de los espectadores en el proceso de comunicación y en su valoración sobre la profesionalidad de su expositor
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Recursos AudiovisuaisRESUMO
En los diversos foros científico-técnicos los participantes pueden presentar sus trabajos en diferentes modalidades. A partir de la década del noventa, el empleo de la gráfica [cartel, póster, mural] comenzó a experimentar un crecimiento significativo. No obstante el valor otorgado a este tipo de presentación, una vez terminadas las reuniones científicas, en poder de los concurrentes quedan sólo algunas notas tomadas con prontitud, ineficaces para realizar estudios, consultas y citas posteriores con rigor profesional. El microcartel (forma gráfica correspondiente reducida) surgió para llenar este vacío. Con el fin de mostrar su importancia, proyección y repercusión en el campo de la comunicación y dentro del contexto de la comunidad científica, se exponen las experiencias de los investigadores del Centro Nacional de Investigaciones Científicas en presentaciones realizadas durante la celebración de encuentros científicos nacionales e internacionales. Tanto expositores como interlocutores han mostrado su complacencia con los microcarteles. Esta modalidad editorial y gráfica resulta de gran utilidad para los que participan en las actividades científicas pues cumple una función importante en el campo de la comunicación científica.
In the different scientific-technical events, participants can exhibit their papers in a number of modalities. From the 90´s, the use of graphics (signs, poster, mural) began to increase significantly. Despite the value granted to this type of presentation, once the scientific meeting are over, the participants only have in their hands some notes taken in a hurry, which are not effective to perform studies, make consultations and appointments with due professional rigor. The microposter (reduced graphical form) emerged to fill a vaccum. With the objective of showing the importance, projections and impact of this tool in the field of communication in the context of the scientific community, the experiences of researchers from the National Center of Scientific Research in presentations in various national and international scientific gatherings are set forth. Both exhibitors and interlocutors have expressed their satisfaction with microposters. This editorial and graphical modality is of great benefit for participants in scientific activities and can play an important role in the field of scientific communication.
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El objetivo de este trabajo fue analizar la respuesta al tratamiento quirúrgico de pacientes con cáncer de pulmón no oat cell, estadios IIIa y IIIb, tratados con neoadyuvancia. Entre enero de 1992 y enero de 1996 colocaron en protocolo de quimioterapia y/o radioterapia 39 pacientes, 12 (31 por ciento) de los cuales se rescataron para tratamiento quirúrgico. El 67 por ciento (8) de los pacientes se encuentran vivos, mientras que el 16,5 por ciento (2) no posee seguimiento desde el último control y el 16,5 por ciento restante (2) falleció. El promedio de supervivencia fue de 17,83 ñ 9,04 meses y no hubo diferencias significativas en las supervivencias correspondientes a las respuestas por estadio, por histología y por neoadyuvancia (quimioterapia, quimioterapia y radioterapia); (test de Mann-Whitney). La supervivencia obtenida está dentro del rango de 10 a 20 meses citado en la literatura actual; los pacientes mejoraron su calidad de vida y se reintegraron a sus tareas, constituyendo un paso importante en el tratamiento multidisciplinario de estadios avanzados de cáncer de pulmón
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Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Carcinoma Pulmonar de Células não Pequenas/cirurgia , Quimioterapia Adjuvante/estatística & dados numéricos , Neoplasias Pulmonares/tratamento farmacológico , Taxa de Sobrevida/tendências , Resultado do Tratamento , Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Carcinoma Pulmonar de Células não Pequenas/radioterapia , Cisplatino , Cisplatino/uso terapêutico , Neoplasias Pulmonares/cirurgiaRESUMO
El objetivo de este trabajo fue analizar la respuesta al tratamiento quirúrgico de pacientes con cáncer de pulmón no oat cell, estadios IIIa y IIIb, tratados con neoadyuvancia. Entre enero de 1992 y enero de 1996 colocaron en protocolo de quimioterapia y/o radioterapia 39 pacientes, 12 (31 por ciento) de los cuales se rescataron para tratamiento quirúrgico. El 67 por ciento (8) de los pacientes se encuentran vivos, mientras que el 16,5 por ciento (2) no posee seguimiento desde el último control y el 16,5 por ciento restante (2) falleció. El promedio de supervivencia fue de 17,83 ñ 9,04 meses y no hubo diferencias significativas en las supervivencias correspondientes a las respuestas por estadio, por histología y por neoadyuvancia (quimioterapia, quimioterapia y radioterapia); (test de Mann-Whitney). La supervivencia obtenida está dentro del rango de 10 a 20 meses citado en la literatura actual; los pacientes mejoraron su calidad de vida y se reintegraron a sus tareas, constituyendo un paso importante en el tratamiento multidisciplinario de estadios avanzados de cáncer de pulmón (AU)