RESUMO
Familial Mediterranean Fever is a hereditary inflammatory disease of predominantly autosomal recessive inheritance, produced by mutations in the MEFV gene that is found on the short arm of chromosome 16, characterized by recurrent episodes of fever accompanied by peritonitis, pleuritis, arthritis or erysipelaslike erythema. An episode lasts from one to three days, and its frequency is very variable. This disease is more frequent among Mediterranean populations, Jews from North Africa (not Ashkenazi), Armenians, Turks and Arabs. However, in recent years more cases have been reported in countries not related to this area. There are no formal studies of epidemiology in Chile. We present the case of one patient of Egyptian/ Jewish ancestry, and the case of a family of German/Spanish ancestry, all Chileans with semiology and characteristic evolution of familial Mediterranean fever and heterozygous positive molecular study. The absence of diagnosis in non-Mediterranean countries may be due to the lack of awareness of this disease. In Chile there has been a rise in cases given by migrants and their offspring, so it is very important to keep in mind as possible diagnosis in case of pain and fever of unknown origin. On the other hand, the familial Mediterranean fever is mainly of autosomal recessive inheritance, but dominant variants have been described. Both cases described in this work present the variant in which the disease manifests itself in its heterozygous form, generating an autosomal dominant inheritance, which would increase the number of affected individuals in the population.
La fiebre mediterránea familiar es un trastorno auto inflamatorio hereditario de herencia predominantemente autosómica recesiva, producida por mutaciones en el gen MEFV que se encuentra en el brazo corto del cromosoma 16, y que se caracteriza por episodios recurrentes de fiebre acompañada de peritonitis, pleuritis, artritis o eritema tipo erisipela. Un episodio dura entre uno y tres días, y su frecuencia es muy variable. Esta enfermedad es más frecuente entre las poblaciones mediterráneas, judíos del norte de África (no ashkenazíes), armenios, turcos y árabes. Sin embargo, en los últimos años se han reportado más casos en países no relacionados con esta área. No hay estudios epidemiológicos formales en Chile. Presentamos el caso de una paciente de ascendencia egipcia/judía, y el caso de una familia de ascendencia alemana/española, todos chilenos con semiología y evolución característica de fiebre mediterránea familiar y estudio molecular positivo heterocigoto. La falta de diagnóstico en países no mediterráneos puede deberse a la falta de conocimiento de esta enfermedad. En Chile han aumentado los casos dado el aumento de migrantes y sus descendientes, por lo que es importante tener este diagnóstico como posibilidad en caso de dolor y fiebre de origen desconocido. Por otro lado, la fiebre mediterránea familiar es principalmente de herencia autosómica recesiva, pero se han descrito variantes dominantes. Los dos casos descritos en este trabajo presentan la variante en la que la enfermedad se manifiesta en su forma heterocigota, generando una herencia autosómica dominante, lo que aumentaría el número de individuos afectados en la población.
Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Pessoa de Meia-Idade , Febre Familiar do Mediterrâneo/diagnóstico , Febre Familiar do Mediterrâneo/genética , Febre Familiar do Mediterrâneo/tratamento farmacológico , Migrantes , Colchicina/uso terapêutico , Predisposição Genética para Doença , Pirina/genética , HeterozigotoRESUMO
Intestinal parasites are very common infections worldwide and they are responsible for significant public health problems. The World Health Organization estimates that one-third of the world population is infected and some epidemiologic factors related to the transmission have been identified. The purpose of this investigation was to study the prevalence of intestinal parasitic infections in people living in the rural community of "El Canal", Consolación del Sur municipality and the association with some epidemiologic risk factors. All participants were subjected to three methods of parasitological examinations on the stool samples and by immunodiagnostic tests which allow the detection of excretory-secretory antigens of adults with Fasciola hepatica. The global prevalence rate of intestinal parasitic infections (IPIs) was 18%, and 16.7% for protozoan infections, while the rate of helminth infection was lower (5.3%) in the population studied. The univariate analysis identified three factors associated with intestinal pathogenic protozoan infections which include livestock work, drinking water from well\river and eating unwashed fruits\vegetables. The multivariate analysis using introduction test logistic regression ratified the association of these risk factors. Contrary to what have been published in the majority of Cuban studies carried out in rural places, a higher prevalence of protozoan than helminth infection was found. This discrepancy may be explained because the majority of the workers in this rural community were stock-breeders and they are not involved in other agricultural work. The identification of risk factors is important in order to design appropriate strategies for control of IPIs in communities.
RESUMO
Coronary artery dissection is a rare cause of acute coronary syndrome. Most cases occur in women during the peripartum period, most likely influenced by hormonal changes, hemodynamic stress and modifications in the immune system during pregnancy. The pathogenesis of coronary artery dissection is unknown, hence numerous theories have been postulated such as pregnancy-related conditions, the presence of connective tissue disorders, trauma, etc. The clinical presentation ranges from asymptomatic patients to the whole spectrum of acute coronary syndrome manifestations. The management of these patients requires a multidisciplinary approach, with two options: medical therapy or an invasive approach, with percutaneous coronary intervention or coronary artery bypass graft surgery. The choice of treatment options depends on the hemodynamic status of the patient, the extension of the dissection and the myocardial territory at risk. In this case report we present a 38-year-old female who had a coronary artery dissection seven days postpartum. Coronary catheterization showed dissection of the left main coronary artery that extended until the circumflex artery. An intra-aortic balloon pump was installed and the patient then underwent coronary artery bypass graft surgery, with satisfactory results.
Assuntos
Anomalias dos Vasos Coronários/cirurgia , Doenças Vasculares/congênito , Angioplastia Coronária com Balão , Anomalias dos Vasos Coronários/diagnóstico , Feminino , Humanos , Período Pós-Parto , Gravidez , Doenças Vasculares/diagnóstico , Doenças Vasculares/cirurgiaRESUMO
Coronary artery dissection is a rare cause of acute coronary syndrome. Most cases occur in women during the peripartum period, most likely influenced by hormonal changes, hemodynamic stress and modifications in the immune system during pregnancy. The pathogenesis of coronary artery dissection is unknown, hence numerous theories have been postulated such as pregnancy-related conditions, the presence of connective tissue disorders, trauma, etc. The clinical presentation ranges from asymptomatic patients to the whole spectrum of acute coronary syndrome manifestations. The management of these patients requires a multidisciplinary approach, with two options: medical therapy or an invasive approach, with percutaneous coronary intervention or coronary artery bypass graft surgery. The choice of treatment options depends on the hemodynamic status of the patient, the extension of the dissection and the myocardial territory at risk. In this case report we present a 38-year-old female who had a coronary artery dissection seven days postpartum. Coronary catheterization showed dissection of the left main coronary artery that extended until the circumflex artery. An intra-aortic balloon pump was installed and the patient then underwent coronary artery bypass graft surgery, with satisfactory results.
Assuntos
Feminino , Humanos , Gravidez , Anomalias dos Vasos Coronários/cirurgia , Doenças Vasculares/congênito , Angioplastia Coronária com Balão , Anomalias dos Vasos Coronários/diagnóstico , Período Pós-Parto , Doenças Vasculares/diagnóstico , Doenças Vasculares/cirurgiaRESUMO
Background: Chronic hepatitis C is an important health problem in Chile. In 2005, the Ministry of Health started a pilot treatment program with peg interferon and ribavirin, to be developed in public hospitals all over the country. Aim: To report the results ofhepatitis C treatment obtained at our institution. Patients and Methods: Between 2005 and 2009, 63 patients were referred for treatment. In all, the viral load and genotype were determined. Peg interferon alpha-2a or alpha-2b plus ribavirin were used for therapy for up to 48 weeks in genotypes (G) 1 or 4 or 24 weeks in genotypes 2 or 3. If at the end oftreatment, viral load measured by polymerase chain reaction (PCR) was negative, it was repeated 6 months later. A negative viral load at that time was considered a sustained viral response (SVR). Results: Among the 51 patients who started treatment, 42 (80.4%) were G1,1 was G2,1 was G4 and 7 were G3. A SVR was reached in 51.1% ofG 1 and 4 and in 87.5% in G 3 and 2. In a univariate analysis, the variables significantly associated with a positive viral response were the degree offibrosis and body mass index. Conclusions: These results are similar to those obtained in other international series, demonstrating that Hispanic ethnicity does not influence the response to treatment. Our good results could be explained by the excellent compliance of the patients to the treatment. A higher degree offibrosis and a higher BMI were associated with a poor response.
Assuntos
Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Antivirais/uso terapêutico , Hepatite C Crônica/tratamento farmacológico , Interferon-alfa/uso terapêutico , Ribavirina/uso terapêutico , Antivirais/efeitos adversos , Índice de Massa Corporal , Chile , Protocolos Clínicos/normas , Quimioterapia Combinada , Genótipo , Hepatite C Crônica/patologia , Hepatite C Crônica/virologia , Hospitais Públicos , Interferon-alfa/efeitos adversos , Estudos Prospectivos , Ribavirina/efeitos adversos , Resultado do Tratamento , Carga ViralRESUMO
Introduction: Nowadays the laparoscopic approach is the procedure of choice in adrenal diseases, except malignant adrenal tumors. Methods: A descriptive and retrospective study of the first 55 cases of laparoscopic adrenalectomy performed in our hospital between 1998 and 2011, we reviewed the short and long term results. Results: We had one case of conversion to open surgery in a patient with accidental section of the right renal vein. One case of reoperation due to hepatic injury. One case of postoperative mortality in a 71 year old woman with high anesthetic risk operated for Cushing's syndrome. Other complications were a case of hydropneumothorax and three cases of abdominal wall hematoma in site of laparoscopic trocar. In the follow up at 45 months all the patients remain asymptomatic, except one with ectopic Cushing's syndrome due to bronchial carcinoid. Conclusions: Laparoscopic adrenalectomy has good results and is an easily reproducible procedure, but must be performed by expert laparoscopic surgeons with a good knowledge of adrenal anatomy and experience in open surgery which allow them to solve the complications that may arise during the laparoscopic procedure.
Introducción: Al día de hoy el abordaje laparoscópico es el procedimiento de elección en la mayoría de lesiones que asientan sobre la glándula suprarrenal, a excepción del tumor maligno suprarrenal. Material y Métodos: Estudio descriptivo y retrospectivo de los 55 primeros casos de adrenalectomía laparoscópica realizados en nuestro centro en el período comprendido entre 1998 y 2011, evaluando los resultados a corto y largo plazo. Resultados: Hubo un caso de conversión a cirugía abierta (1,8 por ciento) en un paciente con sección accidental de la vena renal derecha. Un caso de reintervención por laceración hepática que pasó inadvertida durante la cirugía. Un caso de mortalidad en el postoperatorio inmediato por parada cardiorrespiratoria en una paciente de 71 años con riesgo anestésico ASAIII, intervenida por síndrome de Cushing. Otras complicaciones menores fueron un caso de hidroneumotórax y 3 casos de hematoma parietal en el trayecto del trocar. Se consiguió el control de la enfermedad de base después de un seguimiento medio de 45 meses en todos los casos menos en un paciente con síndrome de Cushing ectópico por un carcinoide bronquial. Conclusiones: La adrenalectomía laparoscópica es una técnica con buenos resultados y fácilmente reproducible, pero ha de ser realizada por cirujanos laparoscopistas expertos con un buen conocimiento de la anatomía de las glándulas suprarrenales y con experiencia en la cirugía abierta que les permita resolver las complicaciones que puedan surgir durante el procedimiento laparoscópico.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Adrenalectomia/métodos , Laparoscopia/métodos , Neoplasias das Glândulas Suprarrenais/cirurgia , Tempo de Internação , Complicações Pós-Operatórias , Estudos Retrospectivos , Resultado do TratamentoRESUMO
Background: The transumbilical route can be used to perform sleeve gastrectomies. Aim: To report the experience with transumbilical sleeve gastrectomy. Material and Methods: A prospective protocol of transumbilical sleeve gastrectomy was applied among patients with a body mass index of 36 kg/m² or less, and a distance between the xiphoid process and the umbilicus of less than 22 cm. Results: Six female patients, with a body mass index between 32.5 and 35.3 kg/m² have been operated. The operative time ranged from 90 to 170 min. An additional 5 mm trochar was required in the first two patients. The postoperative barium swallow showed a good distal passage and the absence of stenosis, residual fundus or nitrations in all patients. No patient had complications. Conclusions: Transumbilical sleeve gastrectomy is feasible among patients with a body mass index of less than 36 kg/m².
Introducción: La cirugía laparoscópica ha estado orientada los últimos años a buscar otras alternativas mínimamente invasivas de acceso abdominal. La transumbilical es una vía que ha comenzado a ser aplicada clínicamente, con o sin dispositivos de acceso único. Hemos comenzado a realizar la gastrectomía vertical laparoscópica (GVL) por vía transumbilical, en ciertos casos seleccionados. Objetivo: Evaluar la factibilidad de realizar la GVL por vía transumbilical, utilizando un dispositivo de acceso único y el resto del instrumental laparoscópico tradicional. Método: Protocolo prospectivo aplicado a pacientes que cumplan con criterios de inclusión como: ser candidato a GVL, tener IMC igual o menor a 36 kg/m², distancia entre apéndice xifoides y ombligo menor a 22 cm. El peso promedio de las pacientes operadas fue de 90,5 kg, (82,5-98), IMC promedio de 33,8 kg/m² (32,5-35,3). Se describe la técnica de inserción del dispositivo, de la gastrectomía y del manejo postoperatorio. Resultados: Se logró realizar GVL en las 6 pacientes en las que se intentó. El tiempo operatorio promedio fue de 127 min (90 a 170 min), en las dos primeras pacientes se requirió el uso de un trocar adicional de 5 mm. En todas las pacientes, la radiografía baritada de esófago, estómago y duodeno mostró buen paso a distal y ausencia de estenosis, fondo residual o filtraciones. No hubo morbilidad en este grupo. Conclusiones: La GVL es factible de realizar en pacientes portadores de obesidad menor a 36 kg/ m²de superficie corporal, usando un dispositivo de acceso único e instrumental laparoscópico tradicional.
Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Gastrectomia/métodos , Laparoscopia/métodos , Obesidade/cirurgia , Índice de Massa Corporal , Estudos de Viabilidade , Umbigo/cirurgia , Estudos ProspectivosRESUMO
A spread for the elderly with turkey, fibers (insulin and oligofructose), anti-oxidant vitamins (A and E) and minerals (selenium and zinc) has been developed. The methodology of Taguchi was used for the optimization of the formulation, considering control factors such as pig butter, hydrated insulin, lactonal, salt, oregano/pepper, garlic and ice. Experimental designs L8 (27) and L9 (34) were used, and sensorial assessments were made. The optimized formulation obtained a value of4.51 (greater than "good"). The low fat and calorie levels as well as the smooth and pleasant texture stand out in the product. Furthermore, it has been shown that the product is apt and safe for consumption. The spread maintained an optimal sensorial and sanitary quality during storage for 28 days under refrigeration. Elderly showed a 90 percent of acceptance and a high preference by the spread. Therefore, the methodology of Taguchi optimized the spread, making it a good alternative of food for the elderly.
Se desarrolló una pasta untable destinada al adulto mayor con pavo, fibras solubles (inulina y oligofructosa), vitaminas (A y E) y minerales antioxidantes (selenio y zinc). La formulación se optimizó con la metodología de Taguchi, considerando como factores de control: manteca de cerdo, inulina hidratada, emulsionante, sal, orégano/pimienta, ajo y hielo. Se utilizaron los diseños experimentales L8(27) y L9(34) y se realizaron evaluaciones sensoriales, obteniendo la formulación optimizada un puntaje de 4,51 (superior a "bueno"). Del producto destacó el bajo nivel de lípidos y calorías, la textura suave-agradable y se demostró que el producto es apto y seguro para el consumo, manteniendo su calidad sensorial y sanitaria durante 28 días de almacenamiento en refrigeración. El adulto mayor mostró un 90 por ciento de aceptación y alta preferencia por la pasta. Por lo tanto, la metodología de Taguchi logró optimizar la pasta untable, constituyendo una buena alternativa de alimento para el adulto mayor.
Assuntos
Humanos , Masculino , Feminino , Idoso , Idoso/fisiologia , Alimentos Fortificados , Alimento Funcional , Paladar/fisiologia , Perus , Análise de Variância , Antioxidantes , Fibras na Dieta , Minerais na Dieta , Vitaminas na Dieta , Comportamento do ConsumidorRESUMO
The enhancer effect of glutamate monosodium (MSG) flavor was evaluated and its synergistic action with 5'-ribonucleotides: ionone rib nucleotides 5'-monophosphate (IMP) and guano sine monophosphate (GMP) in dehydrated soups consisting of lentils and peas. Four formulations were developed for both soups: the first was the target with the original level of MSG, the following had different concentrations and mixtures of these enhancers (6 percent MSG; 6 percent MSG and 0.26 percent IMP; 0.6 MSG and 0.12 percent IMP-GMP). A five-.point Graphic Hedonic Scale test was used, where 1 represented the most upset face and 5 represented the happiest face. The most accepted soup was selected by thirty elderly adults. The lentils soup with 0,6 MSG and 0J2 percent IMP-GMP and the pea's soup with 6 percent MSG and 0.26 percent IMP obtained the greatest level of acceptance. So, the effectiveness of the synergistic action between the MSG and 5'-ribonucleotides was demonstrated, because they can improve the acceptance of the evaluated formulation.
Se evaluó el efecto realzador del sabor del glutamato monosódico (GMS) y su acción sinergista con 5'-ribonucleótidos: inosinato monofosfato (IMP) y guanilato monofosfato (GMP), cuando se adicionaron a sopas deshidratadas de lentejas y arvejas. Se elaboraron 4 formulaciones para cada sopa, la primera formulación correspondió al control con su nivel de GMS original, las siguientes formulaciones contaron con distintas concentraciones y mezclas de estos realzadores (6 por ciento GMS; 6 por ciento GMS mas 0,26 por ciento IMP y 0,6 GMS mas 0,12 por ciento IMP-GMP). Se utilizó la evaluación sensorial de Escala Hedónica Gráfica, con una escala de 1 al 5, donde 1: representa "la carita más disgustada" y 5: "la más feliz". Treinta adultos mayores determinaron la formulación más aceptada. La sopa de lentejas con 6 por ciento de GMS mas 0,12 por ciento de IMP-GMP fue la que tuvo mayor aceptación, mientras que para la sopa de arvejas fue aquella que contenía 6 por ciento de GMS más 0,26 por ciento de IMP. Por tanto, se pudo demostrar la efectividad de la acción sinergista entre el GMS y los 5'-ribonucleótidos, al mejorar las aceptación de las formulaciones evaluadas.
Assuntos
Humanos , Aditivos Alimentares/farmacologia , Fabaceae , Glutamato de Sódio/farmacologia , Paladar , Ribonucleotídeos , Sopas , Sinergismo Farmacológico , Conservação de Alimentos , Paladar/fisiologia , Preferências Alimentares , Preferências Alimentares/fisiologiaAssuntos
Equinococose/diagnóstico , Equinococose/complicações , Humanos , Masculino , Dor/etiologia , Estômago , Adulto JovemRESUMO
UNLABELLED: Organ transplantation as a substitute for diseased organs in end-stage organ failure has led to a worldwide increase in this treatment modality, but donation has not kept pace with the demand, despite scientific, social, and government efforts. For many years, Hispanic donation in Puerto Rico was meager and lagged behind major centers in North America and Europe. Studies signaled mostly cultural factors in this limited donation. We report a 16-fold increase in organ donation with the development of a formal procurement organization tailored to a local culture. METHODS: The 30-year, 1400-transplant experience of the Puerto Rico Transplant Center was divided in three periods: 1977 through 1893, the latter signaling the approval of a transplant law; 1984 through 1995, signaling the commencement of a formal organ procurement organization; and 1996 through 2006. The subset of 2001 to 2006 was used in an additional calculation against 1984 to 1995. RESULTS: The comparison of the mean deceased donors from 1984 to 1995 with 1998 to 2006 shows a 12-fold increase; and the last 6 years versus 1984 to 1995, a 16.8-fold increase. CONCLUSION: Cultural and educational obstacles in a given country may be overridden by aggressive administrative and educational approaches and strategic planning tailored to local realities, with improvement in organ transplantation.
Assuntos
Hispânico ou Latino/estatística & dados numéricos , Obtenção de Tecidos e Órgãos/estatística & dados numéricos , Transplante/estatística & dados numéricos , Cadáver , Cultura , Educação , Humanos , Porto Rico , Estudos Retrospectivos , Fatores de Tempo , Doadores de Tecidos/estatística & dados numéricos , Obtenção de Tecidos e Órgãos/legislação & jurisprudênciaRESUMO
To assess nutritional adherence to treatment among obese or overweight patients and to examine the relationship between anthropometrical variables, 94 subjects between 20-50 years old randomly selected were recruited at two nutritional health centers in Medellin-Colombia. Nutritional adherence to treatment was evaluated using a questionnaire, with a total score above 24 considered as adherent to the treatment. In addition, socio-demographic information was obtained and anthropometrical variables were measured. We used descriptive statistical, Kolmogorov-Smirnov test, Chi-square for proportions comparison, and Student T test or U Mann Whitney for means comparison. A 68% of the patients were classified as no adherent to the nutritional treatment, with significant differences found according to physical activity (p= 0,013). Mean weight (p= 0,014), BMI (p= 0,026), waist circumference (p= 0,005) and waist-hip ratio (p= 0,022) differed according to adherence, being significantly higher in non adherent patients. Percent body fat did not change by degree of adherence. However when controls were separated by gender the results were significant for both men and women. Nutritional adherence to treatment in patients on a diet for weight reduction produces significant changes in body composition.
Se determinó la adherencia al tratamiento nutricional en pacientes con obesidad o sobrepeso y se examinó la relación entre ésta y variables antropométricas, mediante un estudio transversal en 94 sujetos entre 20 y 50 años seleccionados de forma aleatoria en dos centros de atención nutricional de Medellín. La adherencia al tratamiento nutricional se evaluó aplicando un cuestionario, donde puntajes mayores o iguales a 24 se consideraron como adherentes. Además, se obtuvo información socio-demográfica y antropométrica, previa estandarización de los evaluadores. Se utilizaron medidas descriptivas, prueba de Kolmogorov-Smirnov, Chi-cuadrado para comparación de proporciones, T de Student o U Mann Whitney para comparación de promedios. El 68% de los pacientes fueron clasificados como no adherentes al tratamiento nutricional, encontrando diferencias según actividad física (p=0,013). El peso promedio (p=0,014), Indice de Masa Corporal (p=0,026), perímetro de cintura (p=0,005) y relación cintura cadera (p=0,022), difirieron de acuerdo a la clasificación de adherencia, siendo significativamente más altos en los no adherentes. No hubo diferencias en el porcentaje de masa grasa según adherencia (p=0,690), pero se hallaron al controlar por sexo, p=0,009 mujeres y p=0,026 hombres. La adherencia al tratamiento nutricional en pacientes en dieta para reducir de peso, produce cambios significativos en la composición corporal.
Assuntos
Humanos , Pacientes , Composição Corporal , Redução de Peso , Dietoterapia , Sobrepeso , Cooperação e Adesão ao Tratamento , Obesidade , Estudos TransversaisRESUMO
La patogenia de la infecciones del pie diabético involucra la polineuropatía, la enfermedad macro y microvascular y el déficit funcional de los neutrófilos. La vasodilatación dependiente del endotelio, relacionada con el Oxido Nítrico (NO), está comprometida en diabéticos predispuestos a ulceración del pie. El NO, es producido también por neutrófilos y macrófagos estimulados por citoquinas o lipopolisacáridos bacterianos mediante la sintetasa de NO inducible (iNOS), ejerciendo actividad microbicida. La peroxidación lipídica reflejada por la producción de malondialdehido (MDA), está implicada en el desarrollo de microangiopatía diabética. Para comparar los niveles séricos de NO y MDA en pacientes con pie diabético con o sin infección, se estudiaron 27 individuos diabéticos tipo 2 con edades entre 38 y 65 años divididos en 3 grupos: 8 controles sin afección de los pies (A), 10 con pie diabético sin infección (B) y 9 con pie diabético infectado (C). El NO fué determinado mediante ensayo de diazotización y el MDA mediante la relación de Acido Thiobarbitúrico. B y C mostraron niveles de NO menores (p= 7.636 x 10-5 y p= 0,006) que A. El NO fue mayor en el grupo infectado que en el grupo sin infección (p=0,05), sin embargo los valores obtenidos no coinciden con lo esperado teniendo en cuenta las grandes cantidades de NO producido mediante iNOS, sugiriendo un defecto más del leucocito del diabético. No hubo diferencia significativa en el MDA entre los grupos, indicando ausencia de stress oxidativo relevante
Assuntos
Humanos , Masculino , Adulto , Feminino , Pessoa de Meia-Idade , Infecções , Malondialdeído , Biomarcadores , Óxido Nítrico , Pé Diabético/classificação , VenezuelaRESUMO
Se reporta un caso ilustrativo de un paciente de 77 años con lesión nodular pigmentada que apareció sobre una mácula color cafe de 15 años de evolución. La biopsia reporta melanoma maligno Clark IV, Breslow de 4mm. Se revisa el riesgo de trasformación del léntigo maligno a léntigo maligno melanoma
Assuntos
Lentigo , MelanomaRESUMO
The paper presents the case of a female patient who was admitted to "Calixto García" General Hospital with respiratory distress and hypovolemic or septic shock. She was diagnosed with viral hemorrhagic pneumonia. From the endotracheal secretion taken as a sample, the influenza virus was isolated as etiological agent, which, through the hemaglutination inhibition technique, was characterized as a strain belonging to H3N2 subtype, very similar to strain A/Johannesburg/33/94 from the antigenic viewpoint. The patient recovered satisfactorily after being treated with rivabirin.
Assuntos
Vírus da Influenza A , Influenza Humana/complicações , Pneumonia Viral/etiologia , Adulto , Antivirais/uso terapêutico , Feminino , Técnica Indireta de Fluorescência para Anticorpo , Hemorragia/etiologia , Humanos , Vírus da Influenza A/isolamento & purificação , Influenza Humana/tratamento farmacológico , Influenza Humana/virologia , Pneumonia Viral/tratamento farmacológico , Pneumonia Viral/virologia , Ribavirina/uso terapêuticoRESUMO
Durante los años 1995 a 1999 fueron atendidos en el servicio de dermatología del CES en promedio 6870 pacientes por año, de los cuales el 70 por ciento de ellos fueron mujeres. La procedencia de los pacientes fue constante en los diferentes centros de atención siendo la mitad de los pacientes de Medellín y luego en su orden de Envigado, Itaguí, Sabaneta y otros municipios. Las primeras cinco causas de consultas fueron acné, melasma, verrugas, insuficiencia venosa y en quinto lugar otras como dermatitis atópica, psoriasis, nevus y carcinoma basocelular.
Assuntos
Dermatologia , Epidemiologia Descritiva , Estatísticas de Serviços de Saúde , Encaminhamento e Consulta , EstatísticaRESUMO
Nine Adenovirus (Ad) strains isolated in Cuba, from 128 nasopharingeal swab specimens of children below five years old, with acute respiratory diseases, during 1996 and 1997, were studied by restriction enzyme analysis of genomic DNA with two endonucleases BamH I and Sma I. All different fragment patterns were compared with the respective prototypes. The identified adenoviruses were Ad 1 (n=4), Ad 2 (n=1) and Ad 6 (n=4). Males were more frequently infected than females. The analysis of the occurrence of these Adenovirus strains of subgenus C revealed that Ad 1 and Ad 6 were the predominant serotypes in 1996 and in 1997, respectively.