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INTRODUCTION: Polyserositis is described as inflammation with effusion of more than one serous membrane. There is very little published literature linking it to COVID-19 as a late complication. OBJECTIVE: Present and describe a case of post-COVID-19 polyserositis. METHODS: Data were collected from the medical record of a female patient admitted for fainting spells and marked weakness. The patient underwent a clinical evaluation, additional hematology, imaging and histopathology tests, and a surgical procedure. The new index, called the abdominal adipose deposit index, was obtained by multiplying the subcutaneous fat thickness by visceral fat thickness, both measured by ultrasound. A cutoff point was established that facilitated discernment of an unhealthy phenotype: normal weight but metabolically obese, a cardiometabolic risk factor. RESULTS: We present the case of a 57-year-old female patient admitted to hospital for fainting spells and marked weakness, four months after COVID-19 infection. She also had a history of obesity, asthma, type 2 diabetes mellitus and a cholecystectomy in December 1992 for gallstones. Clinical assessment revealed pericardial effusion and bilateral pleural effusion, in addition to a tumor-like lesion outside the pericardium, proximal to the right ventricular wall. A surgical procedure and findings from additional tests led to diagnoses of thymic remnants and polyserositis. CONCLUSIONS: This is a case of polyserositis in a post-COVID-19 patient. After other causes of polyserositis were ruled out, and since there is a likely physiological and pathogenic mechanism operating between the two diseases, the polyserositis was determined to be a late complication of COVID-19. To date, it is the second case reported in the world and the first reported in Cuba.
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COVID-19 , Diabetes Mellitus Tipo 2 , Feminino , Humanos , COVID-19/complicações , Diabetes Mellitus Tipo 2/complicações , Cuba , Inflamação , Obesidade/complicações , Doença Crônica , SíncopeRESUMO
Aims The objective of the study was to assess whether changes in the volume of the thalamus during the onset of multiple sclerosis predict cognitive impairment after accounting for the effects of brain volume loss. Methods A prospective study included patients with relapsing-remitting multiple sclerosis less than 3 years after disease onset (defined as the first demyelinating symptom), Expanded Disability Status Scale of 3 or less, no history of cognitive impairment and at least 2 years of follow-up. Patients were clinically followed up with annual brain magnetic resonance imaging and neuropsychological evaluations for 2 years. Measures of memory, information processing speed and executive function were evaluated at baseline and follow-up with a comprehensive neuropsychological test battery. After 2 years, the patients were classified into two groups, one with and the other without cognitive impairment. Brain dual-echo, high-resolution three-dimensional T1-weighted magnetic resonance imaging scans were acquired at baseline and every 12 months for 2 years. Between-group differences in thalamus volume, total and neocortical grey matter and white matter volumes were assessed using FIRST, SIENA, SIENAXr, FIRST software (logistic regression analysis P < 0.05 significant). Results Sixty-one patients, mean age 38.4 years, 35 (57%) women were included. At 2 years of follow-up, 17 (28%) had cognitive impairment. Cognitive impairment patients exhibited significantly slower information processing speed and attentional deficits compared with patients without cognitive impairment ( P < 0.001 and P = 0.02, respectively). In the cognitive impairment group a significant reduction in the percentage of thalamus volume ( P < 0.001) was observed compared with the group without cognitive impairment. Conclusion We observed a significant decrease in thalamus volume in multiple sclerosis-related cognitive impairment.
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Disfunção Cognitiva/diagnóstico por imagem , Disfunção Cognitiva/etiologia , Esclerose Múltipla Recidivante-Remitente/diagnóstico por imagem , Esclerose Múltipla Recidivante-Remitente/psicologia , Tálamo/diagnóstico por imagem , Adulto , Disfunção Cognitiva/patologia , Disfunção Cognitiva/fisiopatologia , Avaliação da Deficiência , Progressão da Doença , Feminino , Seguimentos , Humanos , Processamento de Imagem Assistida por Computador , Modelos Logísticos , Masculino , Esclerose Múltipla Recidivante-Remitente/patologia , Esclerose Múltipla Recidivante-Remitente/fisiopatologia , Testes Neuropsicológicos , Tamanho do Órgão , Estudos Prospectivos , Tálamo/patologia , Tálamo/fisiopatologiaRESUMO
INTRODUCTION: The Montreal Cognitive Assessment (MoCA) test is a brief tool for neuropsychological assessment. OBJECTIVE: to validate the MoCAin the population of Buenos Aires, Argentina, to allow for the use of the test for the detection of Mild Cognitive Impairment (MCI). METHODS: The sample consisted of 269 adults over 60 years old and of schooling of more than 6 years (healthy adults n = 115 and MCIn = 154). Receiver operating characteristic (ROC) analysis was used to establish the relationship between the diagnoses of the patients and the scores obtained at MoCA. The optimal cut-off points were selected, and the positive and negative predictive value were calculated for them. RESULTS: The area under the curve (AUC) was 0,741 (p <0001, 95% CI:.682 -.800) for the MMSE and 0.810 (p <0001, 95% CI:.759 -. 861) for the MoCA test. The cut point suggested using the MoCA test is 26 points, which throws .727 of sensitivity and a specificity of. 748. CONCLUSION: The MoCA test is a useful test for clinical consultation. Its brevity and simplicity place it as an interesting instrument for neuropsychological screening in the Argentinian population.
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Disfunção Cognitiva , Testes de Estado Mental e Demência , Idoso , Argentina , Disfunção Cognitiva/diagnóstico , Humanos , Pessoa de Meia-Idade , Testes Neuropsicológicos , Sensibilidade e EspecificidadeRESUMO
Cardiovascular risk factors (CRF) were widely described as related to dementia. There are very few studies regarding this association in FTD. The objective of the study was to compare the frequency of CRF in our population with FTD and controls. 100 consecutive subjects with FTD diagnosis according to Lund-Manchester clinical criteria and 200 controls matched by age and sex were included between January 2003 to February 2007 at the Cognitive and Behavior Unit of Hospital Italiano de Buenos Aires. Clinical evaluation, laboratory tests, brain images (CT/MRI), neuropsychological and neuropsychiatric assessment were performed. Multiple regression analysis was performed to analyze the association in CRF between FTD patients vs. controls. The mean age in FTD was 69.7 ± 0.9 vs. 70.1 ± 0.8 in controls (p 0.12). No difference in gender was observed between cases and controls. No differences were identified between patients and controls regarding hypertension (HTA) (65% vs. 67,3% p 0.44); dyslipidemia (57% vs. 54.7% p 0.74); obesity (39% vs. 27.6% p 0.14) and hypothyroidism (26% vs. 17.1% p 0.1). A significant difference was observed for Diabetes Mellitus (39% vs. 22.6% p 0.001). In our population, Diabetes Mellitus was associated as an independent risk factor for FTD. To our knowledge this is the first report in which CRF were evaluated prospectively in FTD patients. More studies are needed to confirm this finding in larger populations.
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Neurodevelopmental disorders are the result of a disturbance of brain function. They are frequent, with varied symptomatology, manifest themselves at different times of life and tend to be persistent with impact at the individual, family and social level. The association of these disorders with genetic entities is low. Although the research supports a mode of genetic inheritance, epigenetic factors and environmental factors can play an important role. In recent years there was a striking increase of these disorders especially attention deficit hyperactivity disorders and pervasive development disorder. Environmental factors such as the intoxication of the fetus by especially heavy metals lead and mercury are to blame in some children, of these disorders. Other substances of wide use, little degradation and maintenance in the food chain as pesticides, polychlorinated biphenyls and now the recycling of electronic waste put especially infants and children at risk, and even more so in the developing countries.
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Doenças do Sistema Nervoso Central/induzido quimicamente , Deficiências do Desenvolvimento/induzido quimicamente , Exposição Ambiental/efeitos adversos , Substâncias Perigosas/toxicidade , Arsênio/toxicidade , Sistema Nervoso Central/efeitos dos fármacos , Criança , Resíduo Eletrônico/efeitos adversos , Feminino , Humanos , Masculino , Praguicidas/toxicidade , Bifenilos Policlorados/toxicidadeRESUMO
Neurodevelopmental disorders are the result of a disturbance of brain function. They are frequent, with varied symptomatology, manifest themselves at different times of life and tend to be persistent with impact at the individual, family and social level. The association of these disorders with genetic entities is low. Although the research supports a mode of genetic inheritance, epigenetic factors and environmental factors can play an important role. In recent years there was a striking increase of these disorders especially attention deficit hyperactivity disorders and pervasive development disorder. Environmental factors such as the intoxication of the fetus by especially heavy metals lead and mercury are to blame in some children, of these disorders. Other substances of wide use, little degradation and maintenance in the food chain as pesticides, polychlorinated biphenyls and now the recycling of electronic waste put especially infants and children at risk, and even more so in the developing countries.
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Deficiências do Desenvolvimento/induzido quimicamente , Doenças do Sistema Nervoso Central/induzido quimicamente , Exposição Ambiental/efeitos adversos , Substâncias Perigosas/toxicidade , Arsênio/toxicidade , Bifenilos Policlorados/toxicidade , Criança , Feminino , Humanos , Masculino , Praguicidas/toxicidade , Resíduo Eletrônico/efeitos adversos , Sistema Nervoso Central/efeitos dos fármacosRESUMO
Neurodevelopmental disorders are the result of a disturbance of brain function. They are frequent, with varied symptomatology, manifest themselves at different times of life and tend to be persistent with impact at the individual, family and social level. The association of these disorders with genetic entities is low. Although the research supports a mode of genetic inheritance, epigenetic factors and environmental factors can play an important role. In recent years there was a striking increase of these disorders especially attention deficit hyperactivity disorders and pervasive development disorder. Environmental factors such as the intoxication of the fetus by especially heavy metals lead and mercury are to blame in some children, of these disorders. Other substances of wide use, little degradation and maintenance in the food chain as pesticides, polychlorinated biphenyls and now the recycling of electronic waste put especially infants and children at risk, and even more so in the developing countries.
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Doenças do Sistema Nervoso Central/induzido quimicamente , Deficiências do Desenvolvimento/induzido quimicamente , Exposição Ambiental/efeitos adversos , Substâncias Perigosas/toxicidade , Arsênio/toxicidade , Sistema Nervoso Central/efeitos dos fármacos , Criança , Resíduo Eletrônico/efeitos adversos , Feminino , Humanos , Masculino , Praguicidas/toxicidade , Bifenilos Policlorados/toxicidadeAssuntos
Hepatite Autoimune/diagnóstico , Hepatite Autoimune/tratamento farmacológico , Poliendocrinopatias Autoimunes/tratamento farmacológico , Poliendocrinopatias Autoimunes/imunologia , Azatioprina/uso terapêutico , Pré-Escolar , Seguimentos , Doenças Genéticas Ligadas ao Cromossomo X/complicações , Doenças Genéticas Ligadas ao Cromossomo X/tratamento farmacológico , Doenças Genéticas Ligadas ao Cromossomo X/imunologia , Hepatite Autoimune/complicações , Humanos , Masculino , Poliendocrinopatias Autoimunes/complicações , Prednisona/uso terapêutico , Síndrome , Resultado do TratamentoRESUMO
C3H/HeN male mice were infected with a lethal population of Trypanosoma cruzi and treated with benznidazole (Bz). Parasitemia, body weight and survival rate were registered during the therapy with significant improvement for T. cruzi-infected Bz-treated animals. Besides, flow cytometry resulted a useful method to discriminate between cured animals from those not cured by monitoring IgG(1) bound to live trypomastigotes levels. At the end of Bz therapy, the LT splenocyte compartment was studied for activation/memory cell surface markers (CD(69)(+) and CD(44)(+)). Cytofluorometric analysis showed that T. cruzi-infected untreated mice increased their activated LT numbers and this effect was completely abolished only in cured mice at the end of Bz administration. The same behavior was observed for the memory LT subpopulation correlating to an effector memory (CD(62L)(-)) displayed by T. cruzi infection. Bz treatment was able to modulate the immunological response by reducing the deleterious effect of the acute phase in all T. cruzi-infected mice.
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Doença de Chagas/tratamento farmacológico , Nitroimidazóis/uso terapêutico , Tripanossomicidas/uso terapêutico , Trypanosoma cruzi/efeitos dos fármacos , Animais , Anticorpos Antiprotozoários/sangue , Antígenos CD/análise , Antígenos de Diferenciação de Linfócitos T/análise , Contagem de Linfócito CD4 , Linfócitos T CD8-Positivos/imunologia , Doença de Chagas/imunologia , Doença de Chagas/parasitologia , DNA de Protozoário/análise , DNA de Protozoário/sangue , Ensaio de Imunoadsorção Enzimática , Citometria de Fluxo , Imunofluorescência , Receptores de Hialuronatos/análise , Imunoglobulina G/sangue , Imunofenotipagem , Lectinas Tipo C , Masculino , Camundongos , Camundongos Endogâmicos C3H , Músculo Esquelético/parasitologia , Nitroimidazóis/farmacologia , Parasitemia/tratamento farmacológico , Parasitemia/imunologia , Parasitemia/parasitologia , Reação em Cadeia da Polimerase , Baço/citologia , Baço/imunologia , Linfócitos T/imunologia , Tripanossomicidas/farmacologia , Trypanosoma cruzi/genética , Trypanosoma cruzi/imunologiaRESUMO
UNLABELLED: Post-Transplant Lymphoproliferative Disorder (PTLD) is a life threatening complication in organ transplant recipients. Risk factors include primary Epstein-Barr virus infection, intensity of immunosupression and cytomegalovirus infection. OBJECTIVES: To evaluate the incidence, clinical presentation, risk factors, histopathologic appearance and outcome of pediatric liver recipients with PTLD at our institution. METHOD: Retrospective, descriptive and observational analysis. Between November 1992 and December 2005, 383 liver transplants were performed. The diagnosis of PTLD was based on clinical history and physical examination and confirmed by histologic appearance and immunohistologic staining. Knowles' classification was used for histopathologic diagnosis. RESULTS: The incidence of PTLD was 5.7% (n: 22p). The average onset after tansplantation (OLT) was 24.9 months. Clinical manifestations were malaise, anorexia, fever of more than 3 days, peripheral adenopathy, tonsillar hypertrophy, abdominal mass, hepatosplenomegaly, snoring, interstitial pulmonary infiltrate, G.T.-tract bleeding, rash, submaxilar mass. Histopathologic diagnosis were Plasmocytic Hyperplasia (n: 10), Polymorphic Lymphoproliferative Disorder (n: 8), Non-Hodgkin Lymphoma (n: 4). Mortality was 18%. CONCLUSION: The clinical presentations were protean and not specific. A high index of suspicion is important for early diagnosis as it correlates with more benign lesions and more favorable outcume. The lower mortality rate in our series is concordant with that reported in more recent articles.
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Hepatopatias/cirurgia , Transplante de Fígado/efeitos adversos , Transtornos Linfoproliferativos/diagnóstico , Transtornos Linfoproliferativos/epidemiologia , Adolescente , Criança , Pré-Escolar , Humanos , Incidência , Lactente , Transtornos Linfoproliferativos/etiologia , Transtornos Linfoproliferativos/patologia , Prognóstico , Estudos Retrospectivos , Fatores de RiscoRESUMO
A precise assessment of bone mineral density (BMD) and body composition can be performed using dual-energy X-ray absorptiometry (DXA). Values of body composition for males would be useful to evaluate the occurrence of alterations in body composition in a number of diseases. The objectives of this study were to establish BMD and body composition values in healthy men and to analyze age-related changes. BMD and body composition of total body and subareas were determined in 116 healthy men (aged 20-79 yr) using DXA. Comparison between 20-29- and 70-79-yr-old men showed that older subjects were shorter (p<0.03), and had a higher body mass index (p<0.01). Fat mass increased (+46.7%; p<0.001) especially in the trunk. Lean mass (LM) decreased (-9.4%; p<0.05) mainly in the arms and legs. Bone mineral content (BMC) and BMD decreased (-15.3% [p<0.001], -6.3% [p<0.05], respectively). Correlation was observed between BMC and LM (r=0.7, p<0.01). Values of BMD and body composition in healthy men were obtained. A relation was observed between bone mass and body composition, suggesting that the age-related decrease in LM may be associated to bone mass loss. Further studies should be conducted to elucidate the role of body composition in the occurrence of osteoporosis in men.
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Absorciometria de Fóton/métodos , Tecido Adiposo , Adulto , Fatores Etários , Idoso , Argentina , Composição Corporal , Índice de Massa Corporal , Densidade Óssea , Humanos , Masculino , Pessoa de Meia-Idade , Osteoporose/diagnóstico , Osteoporose/patologia , Projetos Piloto , Valores de Referência , Análise de Regressão , Fatores de TempoRESUMO
The impact of body composition on bone and mineral metabolism in Parkinson's disease (PD) was evaluated. Body fat mass, lean mass, bone mineral content, and bone mineral density (BMD) were measured by DXA in 22 PD patients and 104 controls. Female patients exhibited reduced body mass index, fat mass, and BMD compared to controls (p<0.05). Significant positive correlation was found between 25 OHD levels and BMC. Diminished bone mass in women with PD was found to be associated with alterations in body composition and low 25 OHD levels.
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Composição Corporal , Osso e Ossos/metabolismo , Doença de Parkinson/metabolismo , Doença de Parkinson/patologia , Absorciometria de Fóton , Tecido Adiposo/metabolismo , Idoso , Índice de Massa Corporal , Densidade Óssea/fisiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doença de Parkinson/fisiopatologia , Projetos Piloto , Estatísticas não ParamétricasRESUMO
The authors undertook this study to describe Latina mothers' professional help seeking for their young children's disruptive behaviors. They interviewed 62 Cuban, Puerto Rican, and Dominican first-time help seekers and found four modes of entry: (a) coercion, (b) acceptance of offered referral, (c) responsive and resourceful help seeking subsequent to school reports of behavior problems, and (d) a laborious and convoluted path that was characteristic of 52% of the sample. Schools, maternal and child characteristics, and social network forces played significant roles for all mothers, but the final determinants of service entry varied by the mode of entry followed. Findings suggest that problem labeling is not a necessary precursor to service entry and that direct referrals might effectively shortcut the help-seeking process. Finally, the process that underlies service entry would be described more aptly as a Theory of Affective Action than a Theory of Reasoned Action.
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Transtorno do Deficit de Atenção com Hiperatividade/terapia , Transtornos do Comportamento Infantil , Transtornos do Comportamento Infantil/terapia , Serviços de Saúde da Criança/estatística & dados numéricos , Hispânico ou Latino/psicologia , Mães/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Adulto , Transtorno do Deficit de Atenção com Hiperatividade/etnologia , Criança , Transtornos do Comportamento Infantil/etnologia , Estudos Transversais , Cuba/etnologia , República Dominicana/etnologia , Feminino , Humanos , Entrevistas como Assunto , Porto Rico/etnologia , Estados UnidosAssuntos
Pré-Escolar , Criança , Transplante de Fígado/classificação , Transplante de Fígado , PediatriaAssuntos
Pré-Escolar , Criança , Transplante de Fígado/classificação , Transplante de Fígado , PediatriaRESUMO
BACKGROUND: Carotenoids in serum vary between countries and within populations with evidence suggesting a qualitative relationship to diet. Breast milk carotenoids furnish a source of vitamin A and potentially provide immunoprotection and other health benefits for infants. There have been numerous studies of milk carotenoid concentrations in undernourished populations; however, carotenoid concentrations have not previously been compared in populations of well-nourished mothers. AIM OF STUDY: To compare concentrations of five major carotenoid groups: alpha-carotene, beta-carotene, beta-cryptoxanthin, lutein/zeaxanthin, and lycopene in breast milk of healthy women from Australia, Canada, Chile, China, Japan, Mexico, the Philippines, the United Kingdom, and the United States, and to qualitatively compare patterns of dietary intake with milk carotenoid concentrations. METHODS: Breast milk collected from healthy lactating women was analyzed for concentrations of five carotenoids and retinol and quantitated relative to total milk lipid. All determinations were performed in a single research laboratory using standardized methodology. Mothers consumed their usual diets and provided a single 24-h dietary recall. RESULTS: Breast milk carotenoid concentrations varied greatly among countries, with the greatest differences in beta-cryptoxanthin (approximately 9-fold) and the least in alpha-carotene and lycopene (approximately 3-fold). Breast milk retinol concentrations varied approximately 2-fold across countries. The provitamin A carotenoids alpha-carotene, beta-carotene, and beta-cryptoxanthin as a group accounted for > 50 % of the carotenoids measured. Total breast milk carotenoids were highest in Japanese and lowest in Philippine mothers. Breast milk beta-carotene concentrations were highest in Chile and lowest in the Philippines. CONCLUSIONS: Patterns of breast milk carotenoids were unique to each country and qualitative patterns reflected the dietary carotenoid supply.