RESUMO
BACKGROUND: Alopecia areata (AA) is an autoimmune disease characterized by non-scaring hair loss and preservation of hair follicles. The information available on disease course, and clinical features of AA is scarce worldwide, and almost nonexistent in Colombia. OBJECTIVE: To determine the clinical and sociodemographic characteristics of patients diagnosed with AA who presented to a dermatology consultation in five Colombian cities. MATERIAL AND METHODS: This was a retrospective and multicenter study on data from an ongoing National Registry of Alopecia Areata in Colombia (RENAAC) collected in Bogota, Cali, Cartagena, Barranquilla, and Medellin, Colombia from March 2022 through April 2023. Data was recorded in a standardized form by trained physicians. The variables were expressed as measures of central tendency and dispersion, and absolute and relative frequencies. RESULTS: A total of 562 patients were included, 59.4% of whom were women, aged between 15 and 49 years (63.9%) with a mean disease course of 1.7 years. The most common finding was multiple plaque (53.2%), the predominant AA subtype was patchy (71.4%), and 29.5% of the patients had a past dermatological history, 18.3% had a past endocrinological history, and 8.9% had a past psychiatric history. The treatments most widely used were steroid injections (76.4%), 5% topical minoxidil (46.4%), followed by high-potency corticosteroids (42.5%). STUDY LIMITATIONS AND CONCLUSIONS: AA was slightly predominant in women. As seen in other populations, this disease had an earlier onset in men vs women. Presentation in pediatric age was uncommon. The previous history of other dermatological diseases was checked in almost one third of the patients. Analysis of the co-presentation of AA with other autoimmune diseases is biased due to excluding patients with systemic erythematous lupus from the study.
Assuntos
Alopecia em Áreas , Sistema de Registros , Humanos , Alopecia em Áreas/epidemiologia , Colômbia/epidemiologia , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem , Criança , Pré-Escolar , Fatores Sociodemográficos , Saúde da População Urbana/estatística & dados numéricos , LactenteRESUMO
Immunocastration (ImC) has been proposed as an animal welfare-friendly alternative to reduce sexual and aggressive behavior and to increase carcass fat deposition with positive effects on meat quality. The ß-adrenergic agonists (ß-AA) are known as repartitioning agents that acts increasing lean tissue deposition. The combined use of these technologies can positively affect meat quality and increase retail cuts yield. Thus, this research was conducted to evaluate the combined effects of ImC and ß-AA (zilpaterol hydrochloride (ZH) and ractopamine hydrochloride (RH)) on retail cuts, bones, and fat trim of feedlot finished Bos indicus (Nellore) cattle. No interaction was observed between sexual condition and diet for any trait. The ImC decreased cold carcass, hindquarter (HQ), forequarter (FQ) and combined brisket, short ribs and flank (BSF) weights. The ImC also showed smaller weights of retail cuts and bones on the HQ and on the FQ than non-castrated (NoC). Fat trim weights did not differ from ImC and NoC. The most of subprimal cuts were heavier in NoC than in ImC. Feeding ß-AA did not affect cold carcass weight; however, animals fed ZH had higher weights of HQ and retail cuts in HQ when compared with RH and control (CO) group, with no differences between RH and CO for both traits. The weights of FQ, BSF, retail cuts in FQ, as well as bones and fat trimmings were not affected by ß-AA. In summary, ImC decreases carcass and retail cut weights, whereas ZH supplementation leads to an improvement in carcass lean tissue and retail cuts.
Assuntos
Agonistas Adrenérgicos beta , Composição Corporal , Castração , Carne , Agonistas Adrenérgicos beta/farmacologia , Animais , Castração/veterinária , Bovinos , DietaAssuntos
Doença de Tay-Sachs/diagnóstico , Gânglios da Base/diagnóstico por imagem , Gânglios da Base/patologia , Pré-Escolar , Colômbia , Feminino , Hexosaminidase A/sangue , Hexosaminidases/sangue , Humanos , Lactente , Imageamento por Ressonância Magnética , Bainha de Mielina/patologia , Doença de Tay-Sachs/sangue , Doença de Tay-Sachs/diagnóstico por imagem , Doença de Tay-Sachs/patologiaRESUMO
ß-Adrenergic agonists (ß-AA) are non-hormonal growth promoters which promote muscle hypertrophy in supplemented animals. The effects of two ß-AA in combination with the immunocastration technique on the performance and carcass traits were evaluated using 96 feedlot Nellore males in a randomized complete block design with two sex conditions (immunocastrated (IC) v. non-castrated (NC)) and three treatments: CON (no ß-agonists added), RH (300 mg of ractopamine hydrochloride/day, for 33 days) or ZH (80 mg of zilpaterol·hydrochloride animal/day for 30 days, removed 3 days for required withdrawal period). The trial was carried for 100 days where in the first 70 days animals did not receive ß-AA (phase 1) and during the last 30 days they were treated with ß-AA (phase 2). The performance and ultrasound measurements of longissimus muscle area (LMA), backfat thickness (BFT) and rump fat thickness (RFT) were evaluated in both phases. No sex condition v. treatment interactions were observed for any trait. The NC animals had higher average daily gain (ADG) and final BW than the IC animals, but they did not differ in dry matter intake (DMI) and feed efficiency (gain to feed). The NC animals showed greater LMA (P=0.0001) and hot carcass weight (P=0.0006), and smaller BFT (P=0.0007), RFT (P=0.0039) and percentage of kidney, pelvic and heart fat (P<0.0001) when compared with IC animals. The animals fed ZH showed greater ADG (P=0.0002), G : F (P<0.0001) and dressing per cent (P=0.0136) than those fed RH and CON diets. No differences in BW and DMI were observed. A interaction between treatment and time on feed was observed for LMA and BFT, in which the animals fed ZH diet showed greater LMA (P<0.01) and lower BFT (P<0.01) at 100 days than the animals fed RH and CON diets, whereas RH and CON diets did not differ. Immunocastration decreases muscle development and increases carcass finishing. In contrast, ß-AA increases muscle and decreases fat deposition. The ZH has a higher action on the muscle metabolism than animals fed RH diet. However, RH diet achieves a better balance because it has an intermediary performance between non-supplemented and ZH animals and does not decrease the carcass fat.
Assuntos
Agonistas Adrenérgicos beta/administração & dosagem , Bovinos/fisiologia , Hormônio Liberador de Gonadotropina/administração & dosagem , Carne/análise , Orquiectomia/veterinária , Animais , Composição Corporal/efeitos dos fármacos , Masculino , Fenetilaminas/administração & dosagem , Compostos de Trimetilsilil/administração & dosagemRESUMO
La estrategia de atención primaria de la salud (APS) promueve fuertemente el rol del primer nivel de atención (PNA) como puerta de entrada al sistema; siendo su utilización un indicador de importancia que tiene dentro del sistema. A fin de evaluar la tendencia y distribución de demanda ambulatoria del subsector público en la ciudad de Corrientes (CCtes.), se analizaron las consultas externas del período 1991-2013 según los Anuarios de Estadísticas de la Provincia. Se utilizaron datos censales y proyecciones de población. Se evaluó la tendencia de utilización mediante el número de consultas en ambos niveles y tasas poblacionales. En el período la población de la CCtes. creció un 81,20 %; en tanto, el incremento de las consultas fue del 51,66 %: un 99,27 % las hospitalarias y 21,55 % las del PNA. En el primer trienio del período las consultas fueron superiores en el PNA. Luego la relación se invirtió y sólo volvió a superar el PNA al hospital en dos oportunidades: en el año 1998 y el período 2004-2007. Finalmente, se observa una recuperación en los últimos cuatro años observados. Las tasas provinciales pasaron de 3,5 a 5,0 consultas/habitantes/año; en tanto en la CCtes. pasó de 5,0 a 5,2 consultas/habitantes/año. Se concluye que en la CCtes., según las tasas, la utilización no ha variado y que el PNA no ha ocupado un lugar de relevancia en la atención ambulatoria
The strategy of primary health care strongly promotes the rol of the first level of attention (FLA) as an entrance door to the system. In order to evaluate the ambulatory demand's tendencies and distribution of the public subsector in the city of Corrientes (CCtes), were analyzed the external consultations from the 1991-2013 period, according to the Anuary of Statistics of the Province. Were used the population's census data and projections. It was evaluated the use's tendency by the consulting number in both levels and population rate. In this period the population of Corrientes grew 81,20%, while the consultation increased a 51,66%: 99,27% in hospitals and 21,55% in FLA. Then the proportion reverts and only surpassed the FLA at hospitals in two periods: in 1998, and between 2004 and 2007. Finally, it was observed a recovery in the last four years considered. The province's rates went from 3,5 to 5,0 consultants/habitants/year, while in CCtes went from 5,0 to 5,2. In concludes that in CCtes, according to rates, the use haven't changed and FLA wasn't relevant in the ambulatory attention
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Humanos , Atenção Primária à Saúde , Acessibilidade aos Serviços de Saúde , Assistência Ambulatorial/estatística & dados numéricosRESUMO
La integración entre servicios de salud del primer nivel de atención (PNA) y la comunidad es una de las características de la calidad de la atención; y para que ella se concrete es menester que exista satisfacción de la atención por parte de los usuarios. El solo hecho de indagar sobre la misma promueve la inclusión activa de los sujetos al sistema, condición necesaria para el desarrollo de Atención Primaria de la Salud como estrategia. El objetivo del trabajo, aquí reportado, fue explorar la satisfacción de usuarios del PNA de Salas de Atención Primaria de la Salud de la Ciudad de Corrientes (SAPS). Mediante una encuesta estructurada, se entrevistaron a usuarios de dichos servicios indagando sobre: razones de concurrencia a la SAPS y servicios requeridos, opinión sobre la atención recibida de los profesionales y administrativos, y opinión respecto al espacio físico y horarios de atención. El estudio abarcó al 10% de las SAPS, con una muestra de 105 usuarios. Como resultados, se pudo observar satisfacción con la atención recibida de los profesionales y administrativos, aunque con variaciones entre las SAPS. Es destacable el hecho que el 35% de los encuestados no pertenecían al área de referencia de las SAPS; sin embargo, adujeron su desplazamiento por la buena atención de los servicios. Respecto al espacio físico y horarios de atención, un 72% de los encuestados manifestó estar conforme. Un reclamo mayoritario fue que se aumentara la cantidad de profesionales. Las conclusiones de este trabajo fueron: 1) los encuestados están satisfechos con los servicios recibidos y en confianza con el personal (dos condiciones necesarias para el acercamiento de la comunidad a los servicios); 2) existen condiciones funcionales que facilitan la integración entre comunidad y servicios de salud; 3) se observa la necesidad de capacitar al personal en atención al usuario
The integration between first level of attention of health care service (FLA) and the community is one of the characteristics of the attention's quality, and in order for it to happen, the users of the service must be satisfied with it. Just inquiry about this promotes the active inclusion of the subjects to the system, necessary condition for the FLA development as a strategy. The objective of this work was explore the FLA user's satisfaction from the Rooms of Primary Health Care (RPHC) in the city of Corrientes (CCtes).The users were asked through a structured survey about: reasons of consultation to the RPHC and required services, opinion about the attention received from professionals and administrative personnel, opinion about the physical space and opening hours. The study included 10% of the RPHC, with a sample of 105 users. As a result, it was observed satisfaction with the attention received from professionals and administrative personnel, although with some variations between RPHC. It is remarkable the fact that 35% of the surveys didn't belong to the area of reference of the respective RPC, awarding this behavior to the nice attention perceived in those services. In reference to the physical space and opening hours, about 72% manifest agreement. A pronounced complain was the increase of professionals available. The conclusions of this work were: 1) the consulted were satisfied with the received services and with the relationship with the personnel (tow necessary conditions for the approach of the community to the services); 2) there are functional conditions that facilitates the integration between community and health care services; 3) it's observed the necessity to capacitate the personnel in customer care.Key words: satisfaction of attention, quality of attention, integration
Assuntos
Humanos , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Atenção Primária à Saúde/ética , Qualidade da Assistência à Saúde/estatística & dados numéricos , Satisfação do Paciente/estatística & dados numéricos , Integração Comunitária/estatística & dados numéricosRESUMO
OBJECTIVES: To present the study design and baseline results of the longitudinal International Mobility in Aging Study (IMIAS) on gender differences in physical performance and mobility disability prevalence in five diverse societies. METHODS: Data are from surveys on random samples of people aged 65-74 years at Canadian (Kingston, Ontario; Saint-Hyacinthe, Quebec), Mediterranean (Tirana, Albania) and Latin American sites (Natal, Brazil; Manizales, Colombia) (N=1995). Mobility disability was defined as reporting difficulty in walking 400m or climbing stairs. Activities of daily living (ADL) disability was based on any self-reported difficulty in five mobility-related ADLs. The short physical performance battery (SPPB) was used to assess physical performance. Poisson regression models were fitted to estimate prevalence ratios. RESULTS: Age-adjusted prevalence of low SPPB, mobility disability and ADL disability were higher in women than in men in all sites except for Kingston. After adjustment for education and income, gender differences in SPPB and ADL disability attenuated or disappeared in Saint-Hyacinthe and Manizales but remained large in Tirana and Natal and mobility disability remained more frequent in women than in men at all sites except Kingston. After further adjustment by chronic conditions and depressive symptoms, gender differences in mobility remained large at all sites except Kingston but only in Tirana did women have significantly poorer physical performance than men. DISCUSSION: Results provide evidence for gender as a risk factor to explain poorer physical function in women and suggest that moving toward gender equality could attenuate the gender gap in physical function in old age.
Assuntos
Atividades Cotidianas , Envelhecimento , Pessoas com Deficiência/estatística & dados numéricos , Avaliação Geriátrica/estatística & dados numéricos , Limitação da Mobilidade , Idoso , Idoso de 80 Anos ou mais , Brasil , Canadá , Avaliação da Deficiência , Feminino , Identidade de Gênero , Avaliação Geriátrica/métodos , Humanos , Modelos Logísticos , Estudos Longitudinais , Masculino , Prevalência , Quebeque , Fatores de Risco , Autorrelato , Fatores Sexuais , Caminhada/fisiologiaRESUMO
The current paradigm of star formation through accretion disks, and magnetohydrodynamically driven gas ejections, predicts the development of collimated outflows, rather than expansion without any preferential direction. We present radio continuum observations of the massive protostar W75N(B)-VLA 2, showing that it is a thermal, collimated ionized wind and that it has evolved in 18 years from a compact source into an elongated one. This is consistent with the evolution of the associated expanding water-vapor maser shell, which changed from a nearly circular morphology, tracing an almost isotropic outflow, to an elliptical one outlining collimated motions. We model this behavior in terms of an episodic, short-lived, originally isotropic ionized wind whose morphology evolves as it moves within a toroidal density stratification.
RESUMO
BACKGROUND AND PURPOSE: Carotid cavernous fistulas (CCF) can be effectively treated by using different therapeutic alternatives such as detachable balloons and detachable coils, alone or in combination with N-butyl-2-cyanoacrylate (n-BCA) or Onyx. Stents have also been used in an attempt to improve preservation of the parent artery while still occluding the fistula. We present our experience using balloon-expandable covered stents to treat CCF, focusing on arterial wall reconstruction. To our knowledge, this is the first series with midterm follow-up between 3 months and 3.5 years. MATERIALS AND METHODS: From the 46 CCF treated at our institution between November 1998 and September 2006, a total of 7 posttraumatic direct CCF were treated using polytetrafluoroethylene (PTFE)-covered stents between April 2003 and September 2006. Five were treated with covered stents alone. One patient with transection of the internal carotid artery (ICA) first underwent bare stent placement to provide support for the covered stent. One patient had to be treated with coils and n-BCA. RESULTS: Control angiograms obtained in the 7 patients demonstrated occlusion of the fistula and preservation of the ICA in all cases. There was no mortality and no immediate postprocedural morbidity. There was 1 case of morbidity identified at 1-month follow-up with asymptomatic occlusion of the ICA; the other 6 patients had angiographic follow-up between 3 and 42 months (mean, 18.4 months), with persistent occlusion of the fistulas, patent stent grafts, and no significant intimal hyperplasia. CONCLUSIONS: PTFE-covered stents are evolving as a promising intracranial therapeutic alternative to treat CCF and preserve the parent artery by reconstructing the arterial wall. They should be considered in patients in whom fistulas cannot be successfully occluded with detachable balloons or detachable coils. More investigation is required to further develop their specifications and indications.
Assuntos
Prótese Vascular , Fístula Carótido-Cavernosa/diagnóstico por imagem , Fístula Carótido-Cavernosa/cirurgia , Cateterismo/instrumentação , Stents , Adulto , Cateterismo/métodos , Desenho de Equipamento , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Radiografia , Resultado do TratamentoRESUMO
BACKGROUND: Psoriasis is recognized as the most prevalent T-cell-mediated inflammatory disease in humans, with predominantly activated T-helper (Th) 1 cell effectors. Leflunomide exerts its anti-inflammatory activities by preventing the generation of proinflammatory Th1 effectors and promoting Th2 cell differentiation. OBJECTIVES: To determine the safety and efficacy of leflunomide in patients with moderate to severe plaque-type psoriasis. METHODS: In an open-label phase II trial, eight patients with psoriasis received oral leflunomide 20 mg daily for 12 weeks. Patients were evaluated for improvement in psoriasis, quality of life, histological changes and toxicity. RESULTS: Antipsoriatic effects were obtained in all but two patients. A significant decrease was observed in the mean +/- SD Psoriasis Area and Severity Index score, from 20.08 +/- 6.85 before treatment to 12.51 +/- 11.83 after (P = 0.03). The antipsoriatic efficiency was confirmed histologically, with a significant mean +/- SD decrease in epidermal thickness, from 0.73 +/- 0.19 micro m before to 0.31 +/- 0.16 microm after (P = 0.01). The quality of life score showed an improvement, from 8.58 +/- 2.38 (mean +/- SD) before to 5.33 +/- 1.95 after (P = 0.02). The treatment was well tolerated; adverse reactions primarily consisted of transitory gastrointestinal events. CONCLUSIONS: Our data suggest that leflunomide for plaque-type psoriasis is a safe and clinically effective option as monotherapy. However, double-blind, placebo-controlled studies are needed.
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Imunossupressores/uso terapêutico , Isoxazóis/uso terapêutico , Psoríase/tratamento farmacológico , Adolescente , Adulto , Idoso , Feminino , Humanos , Imunossupressores/efeitos adversos , Isoxazóis/efeitos adversos , Leflunomida , Masculino , Pessoa de Meia-Idade , Psoríase/patologia , Qualidade de Vida , Índice de Gravidade de Doença , Resultado do TratamentoRESUMO
Objetivos: (1) diseñar y evaluar una técnica de angiorresonancia 3D contrastada (ARM 3D) para el diagnóstico de la estenosis carotídea y compararla con la ecografía triplex (eco triplex) y la arteriografía por sustracción digital (ASD), esta última como estándar de referencia. (2) Evaluar la factibilidad de adicionar a la técnica anterior secuencias anatómicas y angiográficas del cerebro. Materiales y métodos: en 39 pacientes (78 carótidas) se estudió la bifurcación carotídea con ASD, angiorresonancia 3D con doble inyección y eco triplex. Se utilizó el método descrito en el estudio NASCET para cuantificar el grado de estenosis. Cada examen fue evaluado por observadores diferentes que no conocían el resultado de los otros métodos. Adicionalmente, se obtuvieron imágenes del cerebro y se describieron dichos hallazgos. Resultados: la angiorresonancia 3D con técnica de doble inyección detectó el 98 por ciento del grupo de carótidas clasificadas como normal-leves, el 83 por ciento de las estenosis moderadas, el 88 por ciento de las estenosis graves y el 100 por ciento de las oclusiones. Adicionalmente, dos errores diagnósticos (oclusiones falsas) de la ASD fueron identificados efectivamente por la ARM 3D. La eco triplex detectó el 92 por ciento del grupo normal-leve, el 33 por ciento de las estenosis moderadas, el 86 por ciento de las graves y todas las oclusiones encontradas con la ASD, pero la ecografía sobrestimó una estenosis leve a oclusión (falsa oclusión). La correlación estadística entre el estándar de referencia ASD y la ARM 3D fue buena a excelente, para los diferentes grados de estenosis (K>0,7 y K>0,9, respectivamente). En todos los pacientes se logró una evaluación adecuada del cerebro con resonancia. Conclusión: esta investigación sugiere que la ARM 3D con técnica de doble inyección tiene el potencial para remplazar la ASD en el diagnóstico y seguimiento de la enfermedad carotídea
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Espectroscopia de Ressonância Magnética/métodos , Espectroscopia de Ressonância Magnética , Trombose das Artérias Carótidas/diagnóstico , Trombose das Artérias CarótidasRESUMO
Exophiala spinifera is reported as a newly recognized agent of chromoblastomycosis. This case demonstrates that infections caused by dematiaceous fungi may be variable and that a single fungus may cause more than one type of infection. Chromoblastomycosis and phaeohyphomycosis represent extremes of a continuum of infections.
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Cromoblastomicose/microbiologia , Exophiala , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Se estudiaron diversas constantes inmunologicas en dos grupos de pacientes con lepra lepromatosa nodular del Instituto Dermatologico de Guadalajara. El grupo I consto de 50 pacientes y el grupo II de 20 pacientes. Al primer grupo se le estudio la inmunidad humoral por medio de la valoracion de las inmunoglobulinas G, A, M, D, E y el componente C3 del complemento; se investigaron ademas proteinas anormales por electroforesis y proteina G-reactiva (PCR). Al grupo II se le valoro la inmunidad celular por medio de la respuesta de los linfocitos T al estimularse con fitohemaglutinina. En 70% de los pacientes del grupo I presentaron hipergammaglobulinemia de tipo IgG, IgA o IgM. El 34% de los pacientes del grupo II presentaron factores plasmaticos depresores de la transformacion blastoide, tanto de los linfocitos propios como de los alogenicos