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The taeniasis/cysticercosis complex (TCC) belongs to the group of neglected infectious diseases with a multifactorial transmission that includes hosts such as humans and pigs of the parasitic tapeworm (Taenia solium) and environmental factors. This study represents the first phase of the National and Cross-sectoral Plan for TCC Elimination. OBJECTIVES: To obtain data about knowledge and practices in relation to the TCC from knowledge, attitudes, and practices (KAP) surveys applied in two pilot localities for building a baseline of the potential risk factors related to identification, prevention, and control of TCC in Colombia. METHODS: A descriptive cross-sectional survey from October to November in 2019 was carried out using a structured questionnaire and random sampling by single-stage conglomerates in the municipalities of Mahates, Bolívar (n = 152) (Atlantic Region) and Mercaderes, Cauca (n = 152) (Andean Region). RESULTS: Respondents in Mahates showed moderate knowledge about TCC compared to those in Mercaderes, however, risky practices were identified in both places (consumption of pork with cysts and defecation in places other than the bathroom or latrine). Deficiency in infrastructure and failure in basic services were observed as potential risk factors for TCC transmission in both municipalities. CONCLUSION: Based on the framework of the National and Cross-sectoral Plan for TCC Elimination, adequate knowledge on identification, prevention, and control of the disease must be reinforced; cultural and ecological differences should be considered when designing communication and knowledge transmission tools. We consider that major investment should be made in improving basic services and creating sustainable modernized pig farming in Mahates and Mercaderes.
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Cisticercose , Doenças dos Suínos , Taenia solium , Teníase , Humanos , Animais , Suínos , Colômbia , Estudos Transversais , Cisticercose/prevenção & controle , Teníase/parasitologia , Doenças dos Suínos/prevenção & controle , Doenças dos Suínos/parasitologiaRESUMO
PURPOSE: The selection of candidates for buccal fat pad (BFP) removal depends on the patient's requirements, the subjective surgeons' evaluation, and objective clinical factors. This cross-sectional observational study aimed to identify objective clinical and ultrasonographic parameters as indicators of cheek contouring with BFP excision. METHODS: Sixty-six patients with cheek fullness complaints were examined by two experienced surgeons to determine if they were good candidates for the procedure. Thereafter, participants underwent clinical and ultrasonographic assessments in a separate session to aid in the surgical decision-making. The association between the clinical judgment for BFP excision and the study variables was analyzed individually and adjusted for confounders using binary logistic regression and grouping analyses. RESULTS: Forty-nine participants were regarded as suitable and 17 as non-suitable for the procedure. After regression analysis, cheek skin-fold thickness > 6.00 mm, midfacial contour > 2.20 mm, ovoid/triangular facial form, and ultrasonographic BFP volume > 2.05 mL remained as robust individual indicators for the suitability for the procedure. However, the grouping analysis showed that patients having three-to-four significant criteria synchronously had significantly higher odds for eligibility with excellent discrimination capability. CONCLUSION: Although high values of cheek skin-fold thickness, midfacial contour, and ultrasonographic BFP volume, as well as an ovoid/triangular facial form, might be robust indicators for the suitability for BFP excision, the surgical decision-making should not be based on isolated parameters. Instead, those patients possessing a combination of at least three of these specific eligibility criteria above the threshold value might be considered the best candidates for the procedure.
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Tecido Adiposo , Estética Dentária , Humanos , Tecido Adiposo/cirurgia , Estudos Transversais , Face , Bochecha/diagnóstico por imagem , Bochecha/cirurgiaRESUMO
Resumen OBJETIVO: Describir las características sociodemográficas y clínicas y determinar los factores asociados con la hospitalización y la oportunidad de consulta en embarazadas notificadas con dengue en Cali, Colombia. MATERIALES Y MÉTODOS: Estudio observacional, analítico y retrospectivo de base poblacional. Descripción de las características sociodemográficas y clínicas de las embarazadas con dengue que se notificaron al Sistema de Vigilancia en Salud Pública (SIVIGILA). Para identificar los factores asociados con la hospitalización se aplicó un modelo de regresión logística y para el procesamiento estadístico se utilizó SPSS versión 26. RESULTADOS: Se estudiaron 674 embarazadas con dengue, 63.9% (n = 431) sin signos de alarma, 36.1% (n = 243) con signos de alarma y ningún caso de dengue grave. En cuanto a la conducta, el 42.3% ( n = 285) se trató de manera ambulatoria, 39.5% (n = 266) en el hospital;12.5% (n = 84) permaneció en observación, 1.9% (n = 13) requirió el envío a otro centro de salud para su hospitalización y el 3.9% (n = 26) requirió atención en cuidados intensivos. CONCLUSIONES: En las embarazadas, la infección por dengue aumenta la morbilidad; los principales factores asociados con la hospitalización fueron: trombocitopenia, hipotensión, dolor abdominal, erupción cutánea y vómito. Por parte de las entidades de salud y la comunidad se requieren intervenciones efectivas enfocadas a la manipulación de residuos y educación e insistencia en los principales signos de alarma por los que deben solicitar la consulta médica.
Abstract OBJECTIVE: To describe the sociodemographic and clinical characteristics and to determine the factors associated with hospitalization and timeliness of consultation in pregnant women notified with dengue fever in Cali, Colombia. MATERIALS AND METHODS: Observational, analytical and retrospective population-based study. Description of the sociodemographic and clinical characteristics of pregnant women with dengue reported to the Public Health Surveillance System (SIVIGILA). A logistic regression model was applied to identify factors associated with hospitalization and SPSS version 26 was used for statistical processing. RESULTS: A total of 674 pregnant women with dengue were studied, 63.9% (n = 431) without alarm signs, 36.1% (n = 243) with alarm signs and no cases of severe dengue. In terms of behavior, 42.3% ( n = 285) were treated on an outpatient basis, 39.5% (n = 266) in hospital;12.5% (n = 84) remained under observation, 1.9% (n = 13) required referral to another health center for hospitalization and 3.9% (n = 26) required intensive care. CONCLUSIONS: In pregnant women, dengue infection increases morbidity; the main factors associated with hospitalization were: thrombocytopenia, hypotension, abdominal pain, rash, and vomiting. On the part of the health entities and the community, effective interventions focused on waste handling and education and insistence on the main warning signs for which they should seek medical consultation are required.
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Resumen El coronavirus del Síndrome Respiratorio Agudo Grave 2 (SARS-CoV-2) posee diversas proteínas estructurales que incluyen la proteína spike (S), principal blanco de las vacunas actuales. Existen diversas metodologías para la medición de anticuerpos contra ésta que brindan información acerca de la respuesta inmune frente a la vacunación. El objetivo de este trabajo fue determinar la correlación entre quimioluminiscencia (CLIA) y enzimoinmunoanálisis de adsorción (ELISA) para la medición de anticuerpos IgG anti-proteína S (IgG anti-S). Se recolectaron resultados serológicos de 169 individuos y se determinaron los niveles de anticuerpos por ambas metodologías. Del total de muestras, 106 arrojaron un resultado positivo por ambas metodologías y 15 resultaron discordantes (CLIA+, ELISA-), con índice Kappa de 0,80. La correlación entre ambas metodologías fue buena. Este estudio podría aportar al manejo y seguimiento de la población vacunada, con la finalidad de obtener un valor de corte para evaluar la aplicación de una dosis adicional.
Abstract Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) has several structural proteins including the spike (S) protein, which is the main target of current vaccines. There are various methodologies for the measurement of antibodies against it that provide information about the immune response to vaccination. The objective of this study was to determine the correlation between chemiluminescence (CLIA) and enzyme-linked immunoassay (ELISA) for the measurement of IgG anti-S protein (IgG anti-S) antibodies. Serological results were collected from 169 individuals and antibody levels were determined by both methodologies. Out of the total samples, 106 were positive by both methodologies and 15 were discordant (CLIA+, ELISA-), with a Kappa index of 0.80. The correlation between both methodologies was good. This study could contribute to the management and follow-up of the vaccinated population, in order to obtain a cut-off value to evaluate the application of an additional dose.
Resumo O coronavírus da Síndrome Respiratória Aguda Grave 2 (SARS-CoV-2) possui várias proteínas estruturais, incluindo a proteína spike (S), principal alvo das vacinas atuais. Existem várias metodologias para medir anticorpos contra ela que fornecem informações sobre a resposta imune diante da vacinação. O objetivo deste trabalho foi determinar a correlação entre quimioluminescência (CLIA) e enzimoimunoanálise de absorção (ELISA) para a medição de anticorpos IgG anti-proteína S (IgG anti-S). Foram coletados resultados sorológicos de 169 indivíduos e os níveis de anticorpos foram determinados por ambas as metodologias. Do total de amostras, 106 deram resultados positivos nas duas metodologias e 15 foram discordantes (CLIA+, ELISA-), com índice Kappa de 0,80. A correlação entre as duas metodologias foi boa. Este estudo poderia contribuir para a gestão e seguimento da população vacinada, visando a obter um valor de corte para avaliar a aplicação de uma dose adicional.
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Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Síndrome Respiratória Aguda Grave/complicações , SARS-CoV-2 , Anticorpos/análise , Imunoglobulina G , Vacinas/uso terapêuticoRESUMO
Introducción: La Hipercolesterolemia familiar (HF) es una enfermedad genética de carácter autosómico dominante, poco frecuente, generada por la mutación en el cromosoma 19. Es la primera causa de enfermedad cardiovascular prematura. Las mutaciones patogénicas que generan la HF se relacionan con el receptor de LDL (LDLr), la apolipoproteina B-100 (Apo- B100) y la proteína convertasa subtilisina / kexina tipo 9 (PCSK9), que produce elevación del colesterol y alteración de la vía del LDLr en el 80 % de los casos diagnosticados de HF (5). Presentamos un reporte de caso de cuatro pacientes que pertenecen a la misma familia, quienes presentan mutaciones patogénicas de diferente compromiso a nivel cardiovascular y sistémico que ha afectado de manera negativa su cotidianidad. El objetivo de este trabajo es realizar una correlación del hipercolesterolemia familiar de tipo genético a partir de la literatura, con respecto a la serie de casos presentada, y evaluar el impacto que este genera en los servicios de salud, en la vida del paciente y su familia. Discusión: El reporte de caso que presentamos se fundamenta en la sospecha de HF según los criterios de Holanda. En estos pacientes se reconoce mutación del gen LDLr que se relaciona con HF. Sin embargo, no ha sido ampliamente estudiada. Chmara realizó en Polonia por primera vez un estudio en el que reportó la variante ac 11G>T. En Colombia, el estudio de López encontró tres mutaciones, identificadas como variante a c.11G > A, n c.416A > G y c.1187G > A (8). Conclusión: La HF en nuestro medio es poco frecuente y con gran impacto social, en la mayoría de los casos genera síntomas clínicos y aumento del riesgo cardiovascular desde una edad temprana. Es importante resaltar el diagnóstico oportuno y el conocimiento por parte del personal de salud para generar una calidad de vida adecuada a los pacientes y evitar que aumente el riesgo cardiovascular.
Introduction: Familial hypercholesterolemia (FH) is a rare autosomal dominant genetic disease caused by a chromosome 19 mutation. It is the main cause of premature cardiovascular disease. Pathogenic mutations which cause FH are related to the LDL receptor (LDLr), B-100 apolipoprotein (Apo-B100) and type 9 subtilisin/kexin convertase protein (PCSK9), causing blood cholesterol increase and impairment of the LDLr pathway in up to 80% of patients diagnosed with FH. We present the case of 4 patients belonging to the same family and who present pathogenic mutations leading to diverse kinds of cardiovascular and systemic disease. Discussion: The case report we are presenting is based on the suspicion of FH according to the dutch criteria. These patients had the LDLr gene mutation related to FH. However, this mutation has not been thoroughly studied. The ac 11G>T variant was reported for the first time in Poland by Chmara. In Colombia, Lopez found 3 mutations identified as variant a c.11G > A, variant n c.416A > G and variant c.1187G > A. Conclusion: FH is rare in Colombia. Early diagnosis and healthcare worker awareness must be highlighted to improve the quality of life and decrease the cardiovascular risk of patients.
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The coronavirus disease-2019 (COVID-19) has spread globally and is considered a world health emergency. Healthcare professionals represent an important percentage of the infected population, with otolaryngologists and head and neck surgeons at particular risk. Elective procedures have been strongly discouraged, but urgent disorders still entail a hazardous setting. We performed a non-systematic review of the publications and guidelines regarding Head and Neck surgical emergencies management in the context of the COVID-19 pandemic. The literature describing management of the disease was also reviewed to adapt conventional treatment to the present circumstances. A concise and specific compilation of practical recommendations was made with the aim of improving management of emergencies involving the head and neck region, while offering a safe alternative for patients and healthcare providers. In addition, we have made a brief summary of how these recommendations were adapted based on our socio-economic background and available health resources.
La enfermedad del coronavirus-2019 (COVID-19) se ha extendido a nivel mundial y se considera una emergencia sanitaria mundial. Los profesionales sanitarios representan un porcentaje importante de la población infectada, y los otorrinolaringólogos y cirujanos de cabeza y cuello corren un riesgo especial. Se han desaconsejado enérgicamente los procedimientos electivos, pero los trastornos urgentes aún implican un entorno peligroso. Realizamos una revisión no sistemática de las publicaciones y guías sobre el manejo de emergencias quirúrgicas de cabeza y cuello en el contexto de la pandemia de COVID-19. También se revisó la literatura que describe el manejo de la enfermedad con el fin de adaptar el tratamiento convencional a las circunstancias actuales. Se realizó una recopilación concisa y específica de recomendaciones prácticas con el objetivo de mejorar el manejo de las emergencias que involucran la región de la cabeza y el cuello, al tiempo que ofrece una alternativa segura para los pacientes y los proveedores de atención médica. Además, hemos hecho un breve resumen de cómo se adaptaron estas recomendaciones en función de nuestros antecedentes socioeconómicos y los recursos de salud disponibles.
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COVID-19 , Cirurgiões , Pessoal de Saúde , Humanos , Pandemias , SARS-CoV-2RESUMO
BACKGROUND: Disorders of the temporomandibular joint (TMJ) are frequent and are usually associated with other disorders of the facial skeleton. Surgery might be needed to correct TMJ anatomy and function and, in cases where pathologies coexist, a two-stage corrective surgery might be needed. However, the current fashion of single-stage procedures is feasible with the aid of new technologies such as computer-assisted surgery (CAS). This is a step forward toward performing complex procedures such as a TMJ replacement with simultaneous orthognathic surgery. CAS allows designing patient-fitted prosthesis and more predictable and accurate surgeries. Moreover, intraoperative development can be controlled in real time with intraoperative navigation, and postoperative results can be measured and compared afterwards. AIMS: The primary purpose of this article is to present the protocol used in our institution for orthognathic surgery associated with unilateral and bilateral TMJ replacement with patient-fitted prostheses guided with CAS. MATERIALS AND METHODS: We present two cases to illustrate our protocol and its results. RESULTS: In the first case, the difference in millimeters between planning and surgical outcomes was 1.72 mm for the glenoid component and 2.16 mm for the condylar prosthesis; for the second case, differences in the right side were 2.59 mm for the glenoid component and 2.06 mm for the ramus, and in the left side, due to the anatomy the difference was a little greater, without clinical significance. CONCLUSION: Combined surgery of the midface and mandible with total TMJ replacement is feasible and beneficial for the patient. CAS facilitates the planning and design of custom-fit prosthesis and execution of these procedures.
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RESUMEN El lupus eritematoso sistémico (LES) es una enfermedad autoinmune que afecta múltiples órganos; el compromiso renal se encuentra en el 50% de los pacientes y es variable de acuerdo con el grupo racial y étnico. Se estima que el 10% de los pacientes con nefritis lúpica (NL) desarrollan enfermedad renal terminal (ERT) y, una vez que se da la progresión, el 80% de los pacientes negativizan los marcadores de actividad. Sin embargo, aunque es inusual, la reactivación de la enfermedad puede presentarse en compromiso renal avanzado y es importante diagnosticarla oportunamente para definir la causa, tratarla y evitar complicaciones. Presentamos el caso clínico de una paciente de 45 arios, con ERT en diálisis peritoneal, que se encontraba en remisión de la enfermedad y posteriormente desarrolló actividad lúpica.
ABSTRACT Systemic lupus erythematosus (SLE) is an autoimmune disease that affects multiple organs, and renal involvement is found in 50% of patients and is variable according to racial and ethnic group. It is estimated that 10% of patients with lupus nephritis (NL) develop end-stage renal disease (ERT), and once progression occurs, 80% of patients are negative for activity markers. However, although it is rare, the reactivation of the disease can occur in advanced renal involvement, and it is important to diagnose it in a timely manner to define the cause and treat it, avoiding complications.
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Humanos , Feminino , Pessoa de Meia-Idade , Falência Renal Crônica , Lúpus Eritematoso Sistêmico , Doenças Autoimunes , Causalidade , DiagnósticoRESUMO
PURPOSE: To analyze the clinical findings, management, and results of oncological treatments and to identify prognostic factors in patients diagnosed with head and neck sarcoma. METHODS: We performed a retrospective analysis including 48 adult patients with primary head and neck sarcomas, treated between 2006 and 2018 in a referral center of Argentina. RESULTS: The median follow-up time was 44 months (range: 4-146 months). Five-year overall survival was 68%. On univariate analysis, radiation-induced sarcomas (p=0.038) had worse survival. Five-year disease-free survival was 58% and local recurrence at 2 years was 22.7%. On multivariate analysis, positive/close resection margins (p=0.031), radiation-induced sarcomas (p=0.037), and mandibular and oral cavity location (p=0.002) were independent prognostic factors associated to local recurrence and shorter disease-free survival. CONCLUSION: Head and neck sarcomas are a rare entity. Surgery is feasible in more than 80% of patients, with an acceptable overall and disease-free survival. Radiation-induced sarcomas, location in the mandible and oral cavity, and close margins were significant prognostic factors in our population.
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Neoplasias de Cabeça e Pescoço , Sarcoma , Adulto , Argentina , Neoplasias de Cabeça e Pescoço/terapia , Humanos , Recidiva Local de Neoplasia , Prognóstico , Estudos Retrospectivos , Sarcoma/terapia , Centros de Atenção Terciária , Resultado do TratamentoRESUMO
Histamine H1 receptor ligands used clinically as antiallergics rank among the most widely prescribed and over-the-counter drugs in the world. They exert the therapeutic actions by blocking the effects of histamine, due to null or negative efficacy towards Gαq-phospholipase C (PLC)-inositol triphosphates (IP3)-Ca2+ and nuclear factor-kappa B cascades. However, there is no information regarding their ability to modulate other receptor responses. The aim of the present study was to investigate whether histamine H1 receptor ligands could display positive efficacy concerning receptor desensitization, internalization, signaling through Gαq independent pathways or even transcriptional regulation of proinflammatory genes. While diphenhydramine, triprolidine and chlorpheniramine activate ERK1/2 (extracellular signal-regulated kinase 1/2) pathway in A549 cells, pre-treatment with chlorpheniramine or triprolidine completely desensitize histamine H1 receptor mediated Ca2+ response, and both diphenhydramine and triprolidine lead to receptor internalization. Unlike histamine, histamine H1 receptor desensitization and internalization induced by antihistamines prove to be independent of G protein-coupled receptor kinase 2 (GRK2) phosphorylation. Also, unlike the reference agonist, the recovery of the number of cell-surface histamine H1 receptors is a consequence of de novo synthesis. On the other hand, all of the ligands lack efficacy regarding cyclooxygenase-2 (COX-2) and interleukin-8 (IL-8) mRNA regulation. However, a prolonged exposure with each of the antihistamines impaires the increase in COX-2 and IL-8 mRNA levels induced by histamine, even after ligand removal. Altogether, these findings demonstrate the biased nature of histamine H1 receptor ligands contributing to a more accurate classification, and providing evidence for a more rational and safe use of them.
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MAP Quinases Reguladas por Sinal Extracelular/metabolismo , Agonistas dos Receptores Histamínicos/farmacologia , Antagonistas dos Receptores Histamínicos H1/farmacologia , Receptores Histamínicos H1/efeitos dos fármacos , Células A549 , Sinalização do Cálcio/efeitos dos fármacos , Ciclo-Oxigenase 2/genética , Ciclo-Oxigenase 2/metabolismo , Agonismo Inverso de Drogas , Ativação Enzimática , Quinase 2 de Receptor Acoplado a Proteína G/genética , Quinase 2 de Receptor Acoplado a Proteína G/metabolismo , Subunidades alfa Gq-G11 de Proteínas de Ligação ao GTP/metabolismo , Humanos , Mediadores da Inflamação/metabolismo , Inositol 1,4,5-Trifosfato/metabolismo , Interleucina-8/genética , Interleucina-8/metabolismo , Ligantes , Fosforilação , Transporte Proteico , Receptores Histamínicos H1/metabolismo , Fosfolipases Tipo C/metabolismoRESUMO
Intracellular cAMP (i-cAMP) levels play an important role in acute myeloid leukemia (AML) cell proliferation and differentiation. Its levels are the result of cAMP production, degradation, and exclusion. We have previously described histamine H2 receptors and MRP4/ABCC4 as two potential targets for AML therapy. Acting through histamine H2 receptors, histamine increases cAMP production/synthesis, while MRP4/ABCC4 is responsible for the exclusion of this cyclic nucleotide. In this study, we show that histamine treatment induces MRP4/ABCC4 expression, augmenting cAMP efflux, and that histamine, in combination with MRP inhibitors, is able to reduce AML cell proliferation. Histamine, through histamine H2 receptor, increases i-cAMP levels and induces MRP4 transcript and protein levels in U937, KG1a, and HL-60 cells. Moreover, histamine induces MRP4 promoter activity in HEK293T cells transfected with histamine H2 receptor (HEK293T-H2 R). Our results support that the cAMP/Epac-PKA pathway, and not MEK/ERK nor PI3K/AKT signaling cascades, is involved in histamine-mediated upregulation of MRP4 levels. Finally, the addition of histamine potentiates the inhibition of U937, KG1a, and HL-60 cell proliferation induced by MRP4 inhibitors. Our data highlight that the use of a poly-pharmacological approach aimed at different molecular targets would be beneficial in AML treatment.
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Proteínas Quinases Dependentes de AMP Cíclico/genética , AMP Cíclico/metabolismo , Fatores de Troca do Nucleotídeo Guanina/genética , Histamina/farmacologia , Proteínas Associadas à Resistência a Múltiplos Medicamentos/genética , Receptores Histamínicos H2/genética , Benzotiazóis/farmacologia , Proliferação de Células/efeitos dos fármacos , Sobrevivência Celular/efeitos dos fármacos , Proteínas Quinases Dependentes de AMP Cíclico/metabolismo , Regulação Leucêmica da Expressão Gênica , Genes Reporter , Fatores de Troca do Nucleotídeo Guanina/metabolismo , Células HEK293 , Células HL-60 , Histamina/metabolismo , Humanos , Luciferases/genética , Luciferases/metabolismo , Terapia de Alvo Molecular/métodos , Proteínas Associadas à Resistência a Múltiplos Medicamentos/antagonistas & inibidores , Proteínas Associadas à Resistência a Múltiplos Medicamentos/metabolismo , Probenecid/farmacologia , Regiões Promotoras Genéticas , Propionatos/farmacologia , Quinolinas/farmacologia , Receptores Histamínicos H2/metabolismo , Transdução de Sinais , Triazóis/farmacologia , Células U937RESUMO
Resumen Objetivo: Identificar las principales manifestaciones y describir su ubicación en la cavidad oral en pacientes COVID-19. Métodos: Se utilizaron las bases de datos PubMed, Medline, LILACS, LIVIVO, Web of Science y SciELO; utilizando los términos de búsqueda oral mucosa, oral mucosa lesion, oral manifestations, COVID-19 y SARS-CoV-2. Se eliminaron duplicados, luego se realizó preselección de artículos, y finalmente se aplicaron los criterios de inclusión y exclusión. Resultados: Se seleccionaron 47 publicaciones, encontrando manifestaciones orales en pacientes COVID-19 tales como alteración en gusto, xerostomía, úlceras, vesículas, entre otras; ubicándose en diferentes áreas de la mucosa oral. Conclusiones: Se necesitan más estudios para vislumbrar la posible etiopatogenia a nivel oral del SARS-CoV-2. Además, se destaca el rol del odontólogo en el equipo multidisciplinario y en la teleconsulta.
Resumo Objetivo: Identificar as principais manifestações e descobrir sua ubiquação na cavidade oral em pacientes com COVID-19. Método: Foram utilizadas as bases de dados PubMed, Medline, LILACS, LIVIVO, Web of Science e SciELO; utilizando os termos de pesquisa oral mucosa, oral mucosa lesion, oral manifestations, COVID-19 e SARS-CoV-2. Duplicadas foram removidas, depois uma pré-seleção de artigos foi feita, e finalmente os critérios de inclusão e exclusão foram aplicados. Resultados: Foram selecionadas 47 publicações, encontrando manifestações orais em pacientes com COVID-19, tais como alterações no paladar, xerostomia, ulcerações, vesículas, entre outros; localizando-as em diferentes áreas da mucosa oral. Conclusão: São precisos mais estudos pra vislumbrar a possível etiopatogenia a nível oral do SARS-CoV-2. Ademais, destaca-se o role do odontólogo na equipe multidisciplinar e na tele consulta.
Abstract Objective: Identify the main oral manifestations associated with COVID19 and describe their location in the oral cavity. Methods: The literature search was conducted in PubMed, Medline, LILACS, LIVIVO, Web of Science, and SciELO. The following words were searched for: oral mucosa, oral mucosa lesion, oral manifestations, COVID-19, and SARS-CoV-2. Duplicate articles were eliminated, and the pieces were shortlisted. Finally, inclusion and exclusion criteria were applied. Results: This study included 47 articles. The main oral manifestations in patients with COVID-19 are taste disorders, xerostomia, ulcers, vesicles, and others located in different areas of the oral mucosa. Conclusions More studies are needed to determine the potential oral etiopathogenesis of SARS-CoV-2. Moreover, dentists play a significant role in the multidisciplinary and telemedicine team.
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Gallbladder stones (cholecystolithiasis) are the main risk factor for gallbladder cancer (GBC), a lethal biliary malignancy with poor survival rates worldwide. Gallbladder stones are thought to damage the gallbladder epithelium and trigger chronic inflammation. Preneoplastic lesions that arise in such an inflammatory microenvironment can eventually develop into invasive carcinoma, through mechanisms that are not fully understood. Here, we developed a novel gallbladder preneoplasia mouse model through the administration of two lithogenic diets (a low- or a high-cholesterol diet) in wild-type C57BL/6 mice over a period of 9 months. Additionally, we evaluated the chemopreventive potentials of the anti-inflammatory drug aspirin and the cholesterol absorption inhibitor ezetimibe. Both lithogenic diets induced early formation of gallbladder stones, together with extensive inflammatory changes and widespread induction of metaplasia, an epithelial adaptation to tissue injury. Dysplastic lesions were presented only in mice fed with high-cholesterol diet (62.5%) in late stages (9th month), and no invasive carcinoma was observed at any stage. The cholesterol absorption inhibitor ezetimibe inhibited gallbladder stone formation and completely prevented the onset of metaplasia and dysplasia in both lithogenic diets, whereas aspirin partially reduced metaplasia development only in the low-cholesterol diet setting. This model recapitulates several of the structural and inflammatory findings observed in human cholecystolithiasic gallbladders, making it relevant for the study of gallbladder carcinogenesis. In addition, our results suggest that the use of cholesterol absorption inhibitors and anti-inflammatory drugs can be evaluated as chemopreventive strategies to reduce the burden of GBC among high-risk populations.
Assuntos
Aspirina/uso terapêutico , Quimioprevenção , Ezetimiba/uso terapêutico , Neoplasias da Vesícula Biliar/tratamento farmacológico , Neoplasias da Vesícula Biliar/prevenção & controle , Lesões Pré-Cancerosas/tratamento farmacológico , Lesões Pré-Cancerosas/prevenção & controle , Animais , Colecistolitíase/complicações , Colesterol/metabolismo , Colesterol na Dieta , Doença Crônica , Dieta , Modelos Animais de Doenças , Progressão da Doença , Fígado Gorduroso/patologia , Comportamento Alimentar , Neoplasias da Vesícula Biliar/patologia , Cálculos Biliares/etiologia , Cálculos Biliares/patologia , Inflamação/patologia , Masculino , Metaplasia , Camundongos Endogâmicos C57BL , Lesões Pré-Cancerosas/patologia , Baço/patologiaRESUMO
Resumen La infección aguda por parvovirus B19 es una enfermedad autolimitada en pacientes sin trastornos inmunitarios. Sin embargo, en pacientes con discrasias sanguíneas pueden manifestarse con una crisis aplásica. Presentamos el caso de un varón de 48 años, con una esferocitosis hereditaria no diagnosticada previamente, la cual debutó con una crisis aplásica inducida por una infección aguda de parvovirus B19. La sospecha clínica se planteó luego del análisis histopatológico de la médula ósea, en el que se observó una hiperplasia eritroblástica, con precursores eritroides gigantes e inclusiones nucleares virales, y cuyo análisis inmunohistoquímico fue positivo para la proteína de la cápside viral VP1 y VP2 de parvovirus B19 en células infectadas. Se confirmó la sospecha diagnóstica con la detección de anticuerpos IgM de parvovirus B19. De acuerdo a nuestra revisión, este es el primer reporte de un adulto en Latinoamérica que debutó con una crisis aplásica inducida por una infección aguda por parvovirus B19, como primera manifestación de una esferocitosis hereditaria.
Abstract Acute parvovirus B19 infection is a self-limiting disease in patients with normal immune response. However, in patients with blood dyscrasias, it is possible to present with an aplastic crisis. We present the case of a 48-year-old man who had developed an aplastic crisis as a result of an acute parvovirus B19 infection with an undiagnosed hereditary spherocytosis. Suspicions of the parvovirus infection began to arise after a routine bone marrow histopathological analysis which showed erythroblastic hyperplasia with giant erythroid precursor and viral inclusions. A subsequent immunohistochemical analysis tested positive for VP1 and VP2 capsid proteins of parvovirus B19 in infected cells. The diagnostic suspicion was later confirmed with the presence of anti-parvovirus B19 IgM. According to our review, this is the first published case in Latin America that documents an adult patient with normal immune response whose first symptom of hereditary spherocytosis was an aplastic crisis induced by an acute parvovirus B19 infection.
Assuntos
Adulto , Humanos , Masculino , Pessoa de Meia-Idade , Esferocitose Hereditária , Parvovirus B19 Humano , Eritema Infeccioso , Infecções por Parvoviridae , Infecções por Parvoviridae/complicações , Infecções por Parvoviridae/diagnóstico , HiperplasiaRESUMO
Gastrointestinal tuberculosis is a rare extrapulmonary manifestation, it represents 3% of cases and mainly involves the ileocecal region; appendiceal involvement is rare. Tuberculous appendicitis can present as an acute condition indistinguishable from other causes of appendicitis and the diagnosis is generally made by histopathological finding, which delays treatment and can lead to complications. The postpartum period is at risk of a reactivation of tuberculosis, due to changes in the immune system that manifests as an immune reconstitution syndrome. We present the case of a postpartum patient admitted for septic shock secondary to perforated appendicitis, the pathology reported chronic granulomatous inflammation and subsequent confirmation by molecular technique of pulmonary tuberculosis.
Assuntos
Apendicite , Apêndice , Perfuração Intestinal/etiologia , Tuberculose Gastrointestinal , Apendicectomia , Apendicite/complicações , Feminino , Humanos , Período Pós-Parto , Tuberculose Gastrointestinal/complicaçõesRESUMO
Kidney cancer accounts for 2.5% of all cancers, with an annual global incidence of almost 300,000 cases leading to 111,000 deaths. Approximately 85% of kidney tumors are renal cell carcinoma (RCC) and their major histologic subtype is clear cell renal cell carcinoma (ccRCC). Although new therapeutic treatments are being designed and applied based on the combination of tyrosine kinase inhibitors and immunotherapy, no major impact on the mortality has been reported so far. MRP4 is a pump efflux that transporters multiple endogenous and exogenous substances. Recently it has been associated with tumoral persistence and cell proliferation in several types of cancer including pancreas, lung, ovary, colon, ostesarcoma, etc. Herein, we demonstrate for the first time, that MRP4 is overexpressed in ccRCC tumors, compared to control renal tissues. In addition, using cell culture models, we observed that MRP4 pharmacological inhibition produces an imbalance in cAMP metabolism, induces cell arrest, changes in lipid composition, increase in cytoplasmic lipid droplets and finally apoptosis. These data provide solid evidence for the future evaluation of MRP4 as a possible new therapeutic target in ccRCC.
Assuntos
Carcinoma de Células Renais/genética , Proliferação de Células/genética , Neoplasias Renais/genética , Proteínas Associadas à Resistência a Múltiplos Medicamentos/genética , Apoptose/genética , Carcinoma de Células Renais/metabolismo , Linhagem Celular , Linhagem Celular Tumoral , AMP Cíclico/genética , Células HCT116 , Humanos , Rim/metabolismo , Neoplasias Renais/metabolismoRESUMO
Resumen La tuberculosis gastrointestinal es una manifestación extrapulmonar poco frecuente, correspondiendo al 3% de los casos y que compromete principalmente la región ileocecal; la afectación apendicular es poco frecuente. La apendicitis tuberculosa se puede presentar como un cuadro agudo indistinguible de las otras causas de apendicitis y el diagnóstico generalmente se hace por el hallazgo histopatológico, lo que retrasa el tratamiento y puede llevar a complicaciones. El período posparto es de riesgo de una reactivación de una tuberculosis, debido a cambios en el sistema inmunológico que se manifiestan como un síndrome de reconstitución inmune. Se presenta el caso de una paciente puérpera que ingresa por un choque séptico secundario a una apendicitis perforada. La histopatología demostró una inflamación granulomatosa crónica, con posterior confirmación por biología molecular de una tuberculosis pulmonar.
Abstract Gastrointestinal tuberculosis is a rare extrapulmonary manifestation, it represents 3% of cases and mainly involves the ileocecal region; appendiceal involvement is rare. Tuberculous appendicitis can present as an acute condition indistinguishable from other causes of appendicitis and the diagnosis is generally made by histopathological finding, which delays treatment and can lead to complications. The postpartum period is at risk of a reactivation of tuberculosis, due to changes in the immune system that manifests as an immune reconstitution syndrome. We present the case of a postpartum patient admitted for septic shock secondary to perforated appendicitis, the pathology reported chronic granulomatous inflammation and subsequent confirmation by molecular technique of pulmonary tuberculosis.
Assuntos
Humanos , Feminino , Apendicite/complicações , Apêndice , Tuberculose Gastrointestinal/complicações , Perfuração Intestinal/etiologia , Apendicectomia , Período Pós-PartoRESUMO
RESUMEN Introducción: Las lesiones cervicales por arma de fuego en pediatría tienen baja incidencia, aproximadamente a 5 a 10%, con una mortalidad de 0 a 11%. Objetivo: Describir un caso de politraumatismo por arma de fuego, su manejo multidisciplinario y las consecuencias de la imprudencia a la exposición de niños a las mismas. Caso Clínico: Paciente de sexo masculino, de 13 años de edad, con traumatismo de cara, cuello y tórax por herida accidental por arma de fuego (escopeta) con diagnósticos: Trauma Facial: fractura de maxilar superior e inferior; Trauma de cuello: lesión en cuerpo vertebral C4/C7 con perdigones incrustados; Trauma de tórax: contusión pulmonar derecha; Trauma de partes Blandas: con perdigones incrustados en celular subcutáneo. Ingresa al hospital de Trauma en choque hipovolémico presentando casi inmediatamente paro cardiorespiratorio, respondiendo a reanimación cardiopulmonar avanzada. TAC de cráneo al ingreso normal; al 8vo día se evidencia esquirla en sistema venoso de la base; TAC de cuello: se evidencia desplazamiento de tráquea y aire peri tráquea; AgioTAC: pseudoaneurisma en carótida interna izquierda. Fibrobroncospcopía: contusiones a nivel de tráquea; EDA: esófago y estómago con erosiones cubiertas por fibrina sin evidencia de fístula o perforación de víscera hueca. Tratamiento: en Asistencia Mecánica Respiratoria (ARM) por 10 días; inotrópicos por 72 hs, se realiza reparación de arteria carótida interna; colocación de arco de Erich por cirujanos maxilofaciales. Alta a sala de pediatría con buena evolución.
ABSTRACT Introduction: Pediatric cervical gun injuries have a low incidence, approximately 5 to 10%, with a mortality of 0 to 11%. Clinical Case: a 13-year-old male patient who presented with trauma to the face, neck and thorax due to accidental firearm injury (shotgun) with the following diagnoses: Facial trauma: fracture of the upper and lower jaw; Neck trauma: C4 / C7 vertebral body injury with embedded pellets; Chest trauma: right pulmonary contusion; Soft tissue trauma: embedded pellets in subcutaneous soft tissue. He was admitted to the Trauma hospital in hypovolemic shock, presenting almost immediate cardiorespiratory arrest, which responded to advanced cardiopulmonary resuscitation. CT scan of the skull was normal at admission; on the 8th day it showed evident splintering in the basal venous system; CT of the neck: tracheal displacement and evident peri-tracheal air; Angio CT: pseudoaneurysm in left internal carotid artery. Fibrobronchoscopy: bruises at the tracheal level; EDA: esophagus and stomach with fibrin-covered erosions without evidence of fistula or hollow viscera perforation. Treatment: on Mechanical Respiratory Assistance (MRA) for 10 days; inotropes for 72 hours, internal carotid artery repair was performed, Erich arch placement by maxillofacial surgeons. He was discharged to the pediatric ward with favorable evolution.