RESUMO
Infections due to Ehrlichia, Anaplasma, Dirofilaria, Mycoplasma, Babesia and Hepatozoon continue to be highly prevalent in dogs, especially in tropical and subtropical areas, where vectors of many of them are present. However, many clinical aspects of dogs have not been characterized in detail, including assessing the haematological alterations associated with them, particularly in Colombia and Latin America. A group of 100 dogs with Ehrlichia, Anaplasma, Dirofilaria, Mycoplasma, Babesia and Hepatozoon infections/exposure were assessed by blood smear serology (SNAP4DX) and PCR in Pereira, Colombia. We performed blood counts to evaluate anaemia, leukopenia/leukocytosis, neutropenia, neutrophilia, lymphopenia/lymphocytosis, monocytosis, eosinophilia, and thrombocytopenia, among other alterations. Bivariate analyses were performed on Stata®14, with significant p < 0.05. From the total, 85% presented ≥1 infection (past or present), 66% with coinfections (≥2 pathogens) (Ehrlichia 75%), and 89% presented clinical alterations. A total of 100% showed anaemia, 70% thrombocytopenia, 61% monocytosis, and 47% neutropenia, among other alterations. Additionally, 11% presented pancytopenia and 59% bicytopenia. The median platelet count was lower in infected dogs (126,000 cells/µL) versus non-infected (221,000 cells/µL) (p = 0.003). Thrombocytopenia was higher among infected dogs (75%) versus non-infected (40%) (p = 0.006), with a 91% positive predictive value for infection. Median neutrophil count was lower in infected dogs (6591 cells/µL) versus non-infected (8804 cells/µL) (p = 0.013). Lymphocytosis occurred only among those infected (27%) (p = 0.022). Leukopenia was only observed among infected dogs (13%). Pancytopenia was only observed among infected dogs. Ehrlichiosis and other hematic infections have led to a significant burden of haematological alterations on infected dogs, including pancytopenia in a tenth of them, most with thrombocytopenia and all anemic.
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Pancreatite , Paniculite , Doença Aguda , Humanos , Pancreatite/diagnóstico , Paniculite/diagnóstico , PeleRESUMO
INTRODUCTION: Extracorporeal Shock Wave Lithotripsy (ESWL) is currently the recommended treatment for intra-renal calculi smaller than 2 cm. However the low Stone Free Rate (SFR) in lower pole calculi gives rise to new techniques, such us retrograde intrarenal surgery (RIRS), for improve the surgery outcomes. OBJECTIVE: To compare the efficacy of a treatment with ESWL with RIRS, in terms of SFR after surgery, in patients with kidney stones up to 15 mm in the lower pole. MATERIAL AND METHODS: A prospective study was carried out in order to assess the results of ESWL and RIRS in patients with lower pole stones less than 15 mm. Among a total of 55 patients, 31 were underwent to ESWL (Group 1) and the remaining 24 to RIRS (Group 2). Clinical data recorded, including general characteristics of each patient, were: calculi size, side, operative time, complications according to Clavien scale, SFR and the presence of residual fragments at 2 months post-treatment assessed by a CT scan. STATA 11 was used to perform the statistical analysis. RESULTS: There were no differences for general descriptors among groups with the exception of a significantly longer operative time for RIRS. The rates of SFR and residual fragments lesser than 3 mm. were lower in the RIRS group than in ESWL ones. RIRS also showed a lower rate of clinically significant fragments (0% vs 42.3%. P < .05). In the subgroup of patients with stones between 10/15 mm RIRS showed higher SFR (75% vs. 41.2%) and a lower rate of stones>3 mm (0% vs. 58.8%), being statistically significant (P < .05). Clavien III or higher complications were not reported in any of the groups. CONCLUSIONS: In the treatment of lower pole stone RIRS has the same results than ESWL in terms of SFR. Regarding absence of a clinically significant residual fragment, RIRS was superior to ESWL. A bigger sample size is required in order to confirm this results.
Assuntos
Litotripsia , Ureteroscopia/métodos , Adulto , Feminino , Humanos , Cálculos Renais/cirurgia , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Estudos Prospectivos , Resultado do TratamentoRESUMO
AIM: The impetus of our study was to investigate the effects of a nutritional supplement Delphinol®, an extract of maqui berries (Aristotelia chilensis) standardised to ≥25% delphinidins and ≥35% total anthocyanins, on postprandial blood glucose and insulin levels and identify the physiologic mechanism involved. METHODS: Postprandial blood glucose and insulin were investigated in double-blind, placebo-controlled, cross-over fashion in ten volunteers with moderate glucose intolerance. Longer term effects on blood sugar levels were investigated in streptozotocin-diabetic rats over a four months period. Effects of maqui berry delphinidins on sodium-glucose symport were examined in rodent jejenum of the small intestine. RESULTS: Delphinol® intake prior to rice consumption statistical significantly lowered post prandial blood glucose and insulin as compared to placebo. We identified an inhibition of Na+-dependant glucose transport by delphinidin, the principal polyphenol to which Delphinol® is standardised. In a diabetic rat model the daily oral application of Delphinol® over a period of four months significantly lowered fasting blood glucose levels and reached values indistinguishable from healthy non-diabetic rats. CONCLUSION: Our results suggest a potential use of Delphinol® for naturally controlling post-prandial blood glucose owed to inhibition of sodium glucose co-transporter in small intestine.
Assuntos
Glicemia/efeitos dos fármacos , Elaeocarpaceae , Intolerância à Glucose/tratamento farmacológico , Hipoglicemiantes/uso terapêutico , Jejuno/efeitos dos fármacos , Extratos Vegetais/uso terapêutico , Proteínas de Transporte de Sódio-Glucose/antagonistas & inibidores , Animais , Antocianinas/análise , Antocianinas/uso terapêutico , Biomarcadores/sangue , Glicemia/metabolismo , Chile , Estudos Cross-Over , Diabetes Mellitus Experimental/sangue , Diabetes Mellitus Experimental/diagnóstico , Diabetes Mellitus Experimental/tratamento farmacológico , Método Duplo-Cego , Elaeocarpaceae/química , Feminino , Frutas , Intolerância à Glucose/sangue , Intolerância à Glucose/diagnóstico , Humanos , Hipoglicemiantes/efeitos adversos , Hipoglicemiantes/química , Insulina/sangue , Jejuno/metabolismo , Masculino , Camundongos Endogâmicos C57BL , Fitoterapia , Extratos Vegetais/efeitos adversos , Extratos Vegetais/química , Plantas Medicinais , Período Pós-Prandial , Ratos , Ratos Sprague-Dawley , Proteínas de Transporte de Sódio-Glucose/metabolismo , Fatores de Tempo , Resultado do TratamentoRESUMO
It has been shown that infection with high-risk human papillomaviruses (HR-HPV) is related to the development of cervical cancer. The persistence of the virus in intra-epithelial lesions of cervix uteri (SILs) is the basis for the application of HPV testing for screening and management of patients. Most infections by HR-HPVs resolve spontaneously, however, and do not progress to dysplasia or cancer. p16INK4a is a useful biomarker of cervical intra-epithelial neoplasia and could be a marker for the progression of low-grade squamous intra-epithelial lesions (LSILs) to high-grade squamous intra-epithelial lesions (HSILs), because it correlates independently with increasing SIL grade. We conducted a preliminary histological study of 28 patients diagnosed with LSIL, HSIL or nondysplastic epithelium (NDE) from whom 28 biopsies of uterine cervix and 28 endocervical brushed biopsies were taken. Argyrophilic nucleolar organizer region (AgNOR) and p16INK4a assays were performed on the biopsies, and endocervical brushings were used for HPV typing. The high risk HPV group showed that the number of patients with AgNOR areas greater than 3.3 µm(2) and with expression of p16INK4a were statistically greater than the number of lower risk patients. None of the biopsies of LR-HPV carriers expressed p16 and AgNOR areas> 3.3 µm(2) simultaneously. Four LSILs and the NDE of this group expressed neither of the two markers. If the correlation between AgNOR areas and p16INK4a is good, we may be able to develop a low cost simple technology for studying patients infected with HR-HPV and diagnosed with LSIL of uncertain behavior.
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Antígenos Nucleares/metabolismo , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/virologia , Inibidor p16 de Quinase Dependente de Ciclina/metabolismo , Papillomaviridae/fisiologia , Displasia do Colo do Útero/patologia , Displasia do Colo do Útero/virologia , Biomarcadores Tumorais/metabolismo , Feminino , Humanos , Imuno-Histoquímica/economia , Papillomaviridae/isolamento & purificaçãoRESUMO
Introducción: El trauma renal está involucrado en 10 por ciento de los traumatizados, el estudio de imágenes nos ha permitido manejar más conservadoramente a estos pacientes, sin embargo los parámetros clínicos siguen siendo una valiosa herramienta de vigilancia que nos permitirá tomar una conducta quirúrgica oportuna. Objetivo: Análisis de la indicación quirúrgica tardía en pacientes con trauma renal en los últimos 15años en el Servicio de Urología del Hospital San Juan de Dios. Material y método: Estudio retrospectivo de pacientes hospitalizados en Servicio de Urología entre los años 1994 y 2008, se obtienen 70 fichas clínicas, se registra edad, sexo, mecanismo de lesión, estudio de imágenes y tratamiento. La edad promedio fue de 31 años, sexo masculino (85 por ciento), el mecanismo de lesión fue: agresión de terceros en 39 por ciento, caída de altura (22 por ciento), accidente de tránsito (20 por ciento), deportes 10 por ciento y otros 9 por ciento; traumatismo cerrado en 52 pacientes y penetrante en 18 casos ;Grado I: 40 por ciento; GII: 17 por ciento; GIII: 17 por ciento; GIV: 23 por ciento, GV: 3 por ciento. Se define como tardía a la exploración quirúrgica después de una semana ocurrido el accidente. Resultados: Catorce pacientes (20 por ciento) se intervinieron quirúrgicamente en forma tardía; se operaron8 de los 52 pacientes con trauma renal cerrado (15 por ciento), en 6 de ellos se realizó nefrectomía por riñones patológicos, 2 pacientes presentaron a la semana post accidente una caída del hematocrito asociado a hematuria severa, se realizó en uno de ellos drenaje más nefrorrafia y en otro nefrectomía simple. De los pacientes con trauma penetrante se operaron 4 pacientes (22 por ciento), en dos pacientes por un descenso del hematocrito en menos de 48 horas; un tercer paciente se exploró porque se detecta un crecimiento de la masa palpable al examen físico y un 4º paciente cuya indicación
Introduction: Renal trauma is involved in 10 percent of trauma cases, image studies have allowed us to handle these patients with more conservative criteria, and nevertheless clinical parameters continue being a valuable monitoring tool that allows us to take an opportune surgical conduct. Objective: Analysis of delayed surgical indication in patients with renal trauma in the last 15 years in the Service of Urology of the Hospital San Juan de Dios. Material and methods: Retrospective study of patients hospitalized in the Urology unit, between years 1994 and 2008. 70 clinical charts are obtained, and age, sex, mechanism of injury, image studies and treatment are registered. The age average was of 31 years, masculine sex (85 percent), the injury mechanism was: third party aggression in 39 percent, fallen of height (22 percent), traffic accident (20 percent), sports 10 percent and other 9 percent. Trauma was closed in 52 patients and penetrating in 18 cases. Grade I: 40 percent; GII: 17 percent; GIII: 17 percent; GIV: 23 percent, GV: 3 percent. Delayed surgical exploration is defined as the one performed after one week of the accident. Results: Fourteen patients (20 percent) had delayed surgery; 8 of the 52 patients with closed renal trauma were operated (15 percent), in 6 of them a nephrectomy was performed due to pathological kidneys, 2patients presented to the week post In 2 patients a hematocrit fall and severe hematuria was seen a week after the accident, in one of them a drainage and nephrorrafy was performed and in the other a simple nephrectomy.Of the patients with penetrating trauma 4 patients were operated (22 percent). In two patients because a fall of the hematocrit in less than 48 hours, a third patient was explored because of a growing mass detected at physical examination, and a 4th patient whose surgical indication was determined by clinical parameters of infection, in him an infected urinoma was drained...
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Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Ferimentos e Lesões/cirurgia , Ferimentos e Lesões/epidemiologia , Rim/lesões , Chile , Estudos Retrospectivos , Fatores de Tempo , Ferimentos e Lesões/classificação , Rim/cirurgia , Índice de Gravidade de DoençaRESUMO
In cyclosporine-based protocols, everolimus is more effective than azathioprine to reduce acute rejection. Ketoconazole may reduce cyclosporine and everolimus requirements. We compared kidney transplant patients treated with everolimus or azathioprine in a ketoconazole- and cyclosporine-based immunosuppressive regimen. This open-label, prospective trial of low immunologic risk patients. Included one group (n = 11) who received everolimus (target blood level, 3-8 ng/mL) and the other (n = 11) azathioprine (2.0-2.5 mg/kg/d). Both received steroids, ketoconazole, and cyclosporine with C(0) targets (ng/mL) in the everolimus group of 200-250, 100-125, and 50-65 for months 1 and 2 and thereafter and in the azathioprine group of 250-300 in month 1, 200-250 in month 2, 180-200 until month 6, and 100-125 thereafter. Their baseline characteristics were similar. Two biopsy-proven acute rejections occurred in each group. Three-year graft and patient survival in both groups was 100%. Creatinine clearances at months 6, 12, 24, and 36 were 63.7 +/- 25.4, 58.9 +/- 24.9, 56.0 +/- 22.9, and 57.0 +/- 27.6 in the everolimus group versus 72.6 +/- 20, 68.6 +/- 21.3, 71.4 +/- 23.2, and 68.4 +/- 19.2 in the azathioprine group (NS for every comparison). Major complications were rare and similar in both groups. Five patients in the everolimus group received simvastatin versus 4 in the azathioprine cohort (P = .53). The average cyclosporine doses to achieve targets were 0.8-1.2 mg/kg in the everolimus group and 1.6-2.2 mg/kg in the azathioprine group. The average everolimus dose after month 2 was 0.75-0.9 mg/d. We concluded that with cyclosporine, ketoconazole, and steroids, everolimus was as effective and safe as azathioprine. Cyclosporine reduction with everolimus did not influence graft survival or function at 3 years.
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Azatioprina/uso terapêutico , Ciclosporina/uso terapêutico , Cetoconazol/uso terapêutico , Transplante de Rim/imunologia , Sirolimo/análogos & derivados , Corticosteroides/uso terapêutico , Adulto , Colesterol/sangue , Creatinina/metabolismo , Quimioterapia Combinada , Everolimo , Feminino , Antígenos HLA-A/sangue , Antígenos HLA-B/sangue , Humanos , Imunossupressores/uso terapêutico , Masculino , Metilprednisolona/uso terapêutico , Pessoa de Meia-Idade , Estudos Prospectivos , Sirolimo/uso terapêutico , Triglicerídeos/sangueRESUMO
Renal grafts suffer a progressive decrease in glomerular filtration rate (GFR) because of several factors including calcineurin inhibitor (CNI) nephrotoxicity. Switching CNIs to sirolimus may improve this adverse prognosis. We performed a prospective, open-label clinical trial among 18 kidney transplant patients with more than 12 months of evolution (range, 385-1826 days), showing progressive GFR decreases and biopsies with interstitial fibrosis and tubular atrophy (IFTA). Immunosuppressive treatment included cyclosporine, ketoconazole, and steroids associated with azathioprine or mycophenolate mofetil. After signing an Institutional Review Board-approved written consent, cyclosporine was switched to sirolimus seeking to achieve a trough blood sirolimus concentration of 6-15 ng/mL. Wilcoxon and Student's t-tests were used to compare the values in the annual periods before and after the switch. GFR was estimated by the Modification of Diet in Renal Disease formula. There were no acute rejection episodes. Estimated GFR on the day of the switch was 38.0 +/- 12.1 mL/min. After CNI switch, the slope of the estimated GFR significantly improved from -6.5 +/- 9.2 to 8.1 +/- 14.0 mL/min/year (P < .01). The estimated GFR 1 year after the switch was 47.2 +/- 16.9 mL/min (P = .003 vs baseline). Total expenditures increased. The ratio of post-switch versus baseline total expenditures was 1.93 (95% confidence interval, 1.54-2.31) and the ratio of sirolimus to CNI cost was 2.16 (95% confidence interval, 1.53-2.78). Switching from CNI to sirolimus for kidney transplants with decreasing GFR and a biopsy with IFTA changes, suggesting progressive graft nephropathy, almost doubled total expenses. It is necessary to conduct trials using clinical end points to definitively validate this therapeutic intervention.
Assuntos
Imunossupressores/uso terapêutico , Cetoconazol/economia , Cetoconazol/uso terapêutico , Transplante de Rim/imunologia , Sirolimo/economia , Sirolimo/uso terapêutico , Anti-Hipertensivos/uso terapêutico , Azatioprina/economia , Azatioprina/uso terapêutico , Pressão Sanguínea , Chile , Colesterol/sangue , Análise Custo-Benefício , Custos e Análise de Custo , Ciclosporina/uso terapêutico , Taxa de Filtração Glomerular/efeitos dos fármacos , Humanos , Imunossupressores/economia , Ácido Micofenólico/análogos & derivados , Ácido Micofenólico/economia , Ácido Micofenólico/uso terapêutico , Proteinúria/epidemiologia , Insuficiência Renal/patologia , Triglicerídeos/sangueRESUMO
Introducción: La linfadenectomía en cáncer de pene cumple un importantísimo rol en la etapificación y tratamiento. Históricamente ha sido subutilizada por la morbilidad asociada al procedimiento quirúrgico. Objetivo: Análisis de la linfadenectomía inguinal modificada, su rol etapificador y el compromiso de la grasa periganglionar como factor de mal pronóstico. Material y método: Revisión retrospectiva de 40 linfadenectomías inguinales modificadas, realizadas en 20 pacientes con diagnóstico de cáncer de pene, entre los años 1995 y 2009. La edad promedio de los pacientes estudiados fue de 63,8 años, con un tiempo de evolución promedio de la lesión de 8,2 meses. La histología en la totalidad de los casos fue carcinoma escamoso, realizándose como primera aproximación quirúrgica 8penectomías parciales y 12 totales. Técnica quirúrgica utilizada: Linfadenectomía inguinal modificada. Resultados: Se realizaron 22 linfadenectomías profilácticas, obteniéndose ganglios inguinales superficiales (+) en 4 oportunidades y ganglios profundos (+) en 1 de ellas. Se realizaron 18 linfadenectomías terapéuticas, obteniéndose ganglios inguinales superficiales (+) en 12 procedimientos y ganglios profundos (+) en 4 de ellos. La sobrevida general a 5 años, fue de 15 por ciento y la específica de 10 por ciento.Los factores de mal pronóstico fueron la indiferenciación lesional, el compromiso de ganglios inguinales profundos y el compromiso de la grasa periganglionar. Discusión: No existiendo actualmente exámenes con adecuada sensibilidad y especificidad para detectar el compromiso ganglionar inguinal en el cáncer de pene, se plantea como rol primario de la Linfadenectomía, la etapificación; sin embargo, su rol terapéutico es el más importante, pudiendo ser curativo especialmente en pacientes con micrometástasis. Detectados factores de mal pronóstico, como el compromiso de la grasa periganglionar, se podría mejorar la sobrevida de la enfermedad en pacientes seleccionados con terapias...
Introduction: Lymphnode dissection (LND) in penile cancer (PC) plays an important role both in staging andtreatment. Historically, LND has been underused due to the morbidity associated to the surgical procedure. Objective: To study modified inguinal LND for staging and to evaluate involvement of the perinodal fat as a factor for poor prognosis. Material and method: A retrospective review of 40 modified inguinal LND performed in 20 patients with a diagnosis of PC between 1995 and 2009 was done. Mean age was 63.8 years. The lesion had been present an average of 8.2 month prior to the diagnosis. In all cases, the biopsy showed squamus cell carcinoma. Surgical procedure was partial penectomy in 8 patients and total penectomy in 12 cases. All patients underwent modified inguinal LND. Results: Twenty two prophylactic LND were performed. In 4 cases, (+) superficial lymphnodes were obtained and in 1 case, (+) deep lymphnodes were found. Eighteen therapeutic LND were done. In 12 LND, (+) superficial nodes were found and in 4 cases, deep (+) lymphnodes were found. Overall survival at 5 years was 15 percent, whereas the specific survival was 10 percent. Poor prognostic factors were the following: high histologic grade, involvement of deep inguinal nodes and involvement of the perinodal fat. Discussion: Currently, there are no tests with enough sensitivity and specificity to detect lymphnode involvement in PC. Therefore, LND has an important role in staging; however, its therapeutic role is even more important; the procedure might be curative in patients with micrometastases. When poor prognostic factors such as involvement of the perinodal fat are found, survival could be improved using adjuvant therapies like radiation therapy or combined chemotherapy.
Assuntos
Humanos , Masculino , Adulto , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Excisão de Linfonodo , Neoplasias Penianas/cirurgiaRESUMO
OBJECTIVE: To evaluate the lidocaine gel's application effect versus the periprostatic placement of lidocaine to manage the pain in patients who go through a prostate biopsy. MATERIALS AND METHOD: We took the patients who entered the FCI-IC to effectuate a prostate biopsy with an echographic guideline. The patients were split in two groups of 22 people with each one bearing similar characteristics. One of these groups experimented the previous prostate biopsy with 10cc of intrarectal lidocaine gel and the other group experimented 10 cc of lidocaine to 1% in the vesic-prostatic through echographic guidelines. To evaluate the pain, we used the visual analogue scale to gauge the pain during and after the procedure in both groups. The daily procedure to do biopsies by octants and their subsequent preparation remained the same and never changed. RESULTS: The average scale of pain during the procedure was 2.0 for the group with injected anaesthesia and 4.77 for the group who used gel. After the procedure the average of pain was 0.77 and 3.14 respectively. Some complications as bacteremy were present in 3 patients (6.8%) of the total, who were in the gel group and none were found in the group of injected anestesia. No significant relation was found with respect to other variables. CONCLUSIONS: the application of periprostatic lidocaine is efficient to control the pain in patients who go through a prostate biopsy. Besides, it is a safe procedure which can be easily reproduce in our environment.
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Anestésicos Locais/administração & dosagem , Lidocaína/administração & dosagem , Dor/etiologia , Dor/prevenção & controle , Próstata/patologia , Adulto , Idoso , Biópsia/efeitos adversos , Géis , Humanos , Injeções/métodos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Próstata/diagnóstico por imagem , UltrassonografiaRESUMO
This research expresses the potential of the bacterial activity present in the organic extracts obtained from Penicillium sp., isolated from the esponge Irciniafelix. This activity was evaluated through agar diffusion test and Minimal Inhibitory Concentration (MIC). The susceptibility trials of organic fractions were carried out against Staphylococcus aureus, S. epidermidis, Bacillus cereus and B. subtilis. The use of the chromatographic techniques (CLV and TLC), permitted to obtain bioactive organic extracts of different polarities, of which only the EtOAc and MeOH fractions inhibited the growth of the bacteria used. Of the EtOAc fractionation, only fraction number 3 EtOAc/Hex presented greatest activity against the Gram-positive bacteria. Number 1 EtOAc/Hex fraction increased its activity against S. aureus (24 mm) and S. epidermidis (25 mm), which can be explained by the loss of possible antagonistic effect during the fractionation process. The CMI trials were carried out for the EtOAc number I subfraction against S. aureus, S. epidermidis, B. cereus and B. subtilis, wich was clinical interest, and shows the potential of this organic extract as antimicrobial agent.
Assuntos
Animais , Antibacterianos , Bactérias Gram-Positivas , Penicillium , Poríferos , Testes de Sensibilidade Microbiana , PenicilliumRESUMO
This research expresses the potential of the bacterial activity present in the organic extracts obtained from Penicillium sp., isolated from the esponge Irciniafelix. This activity was evaluated through agar diffusion test and Minimal Inhibitory Concentration (MIC). The susceptibility trials of organic fractions were carried out against Staphylococcus aureus, S. epidermidis, Bacillus cereus and B. subtilis. The use of the chromatographic techniques (CLV and TLC), permitted to obtain bioactive organic extracts of different polarities, of which only the EtOAc and MeOH fractions inhibited the growth of the bacteria used. Of the EtOAc fractionation, only fraction number 3 EtOAc/Hex presented greatest activity against the Gram-positive bacteria. Number 1 EtOAc/Hex fraction increased its activity against S. aureus (24 mm) and S. epidermidis (25 mm), which can be explained by the loss of possible antagonistic effect during the fractionation process. The CMI trials were carried out for the EtOAc number I subfraction against S. aureus, S. epidermidis, B. cereus and B. subtilis, wich was clinical interest, and shows the potential of this organic extract as antimicrobial agent.
Assuntos
Antibacterianos/farmacologia , Bactérias Gram-Positivas/efeitos dos fármacos , Penicillium/isolamento & purificação , Poríferos/microbiologia , Animais , Testes de Sensibilidade Microbiana , Penicillium/químicaRESUMO
Introducción: Los textos y descripciones clásicas señalan patrones diferentes de presentación del cáncer broncogénico según el tipo celular, que han comenzado a ser cuestionados. Objetivo: Identificar los patrones del cáncer broncogénico en la radiografía del tórax de acuerdo con el tipo celular y compararlos con las descripciones usuales. Tipo de Estudio: Serie de casos. Lugar de Estudio: Cuatro hospitales en Bogotá: Hospital Central de la Policía, Instituto Nacional de Cancerología, Hospital Santa Clara, Hospital de la Samaritana. Pacientes y Métodos: En pacientes con diagnóstico histológico de cáncer broncogénico y clasificación precisa del tipo celular se revisaron en forma estándar las principales características radiológicas al momento del diagnóstico y se compararon con las series más conocidas (Clínica Mayo y Marshfield). Resultados: En 236 pacientes (edad promedio 61 años, 39 por ciento mujeres), la mayoría escamocelular (37 por ciento ) o adenocarcinoma (36 por ciento ), la localización de los adenos en general sigue la tendencia reciente (predominio central: 60 por ciento ) al igual que los escamocelulares (72 por ciento ) y las características radiológicas generales son similares entre estos tipos celulares más frecuentes. En etapas tempranas del adeno tiende a localizarse más hacia la periferia y los escamocelulares son tanto centrales como periféricos. En etapas avanzadas todos los tipos celulares predominan en localización central. Conclusión: En esta serie de casos no se encuentra diferencia significativa en la localización entre escamo y adenocarcinoma, siendo estos resultados diferentes a los de las descripciones clásicas. Es probable que la presentación radiológica del tumor esté cambiando y que parte de los hallazgos se expliquen por el estado al momento del diagnóstico
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Carcinoma Broncogênico/diagnóstico , Carcinoma Broncogênico/patologia , Carcinoma BroncogênicoRESUMO
Presentamos los resultados parciales del estudio que actualmente se lleva a cabo en el Instituto Nacional de Cancerología en el manejo paliativo de fístulas traqueoesofágicas y disfagia en pacientes con cáncer esofágico avanzado mediante la colocación de endoprótesis esofágicas autoexpandibles de nitinol cubiertas. Comentamos la técnica, materiales empleados, complicaciones y resultados obtenidos en los pacientes tratados entre junio de 2000y abril de 2001
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Neoplasias Esofágicas , Fístula Traqueoesofágica/cirurgia , Fístula TraqueoesofágicaRESUMO
OBJECTIVE: To evaluate the utility of the substituted judgement standard in terminally ill patients by determining agreement between patients, family proxies and physicians. BACKGROUND: Several studies have addressed the utility of substituted judgement, showing conflicting data whether surrogates are accurate predicting patient's wishes. METHODS: Patients with acquired immunodeficiency syndrome, congestive heart failure, chronic liver disease admitted to the San Juan Veterans Affairs Medical Center in Puerto Rico from November 1997 to February 1998 were evaluated. A questionnaire presented three hypothetical situations on withholding and withdrawal of life-support and CPR. The percent agreement was used as a measure of concordance between choices made by physician, surrogate and patients. RESULTS: Twenty patients met inclusion criteria (5 chronic liver disease, 9 heart failure, 6 AIDS). Relatives had a higher percent of agreement as compared to physicians in all vignettes. Even though, none did better than chance in predicting patient's wishes (k < 0.4). There was a tendency for relatives not to provide a wanted life-support measure, and for physicians to provide an unwanted life-support measure. CONCLUSION: The poor agreement between patients and surrogates suggests that substituted judgement is not an accurate tool to make end-of-life decisions. These findings, although similar to previous published studies, are unique because the direction of discrepant responses is opposite to the findings of studies published elsewhere. These results could reflect religious, cultural and socioeconomic differences.
Assuntos
Cuidados para Prolongar a Vida , Procurador , Ordens quanto à Conduta (Ética Médica) , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Porto RicoRESUMO
An immortal, cloned cell line (RCMH), obtained from human skeletal muscle was established in our laboratory and shown to express muscle specific proteins. We measured ligand binding to ion channels, ion currents using whole cell patch clamp and intracellular calcium both in cells grown in complete media and in cells grown for 4-40 days in media supplemented with hormones and nutrients (differentiating media). Markers for differentiated muscle, such as the muscle isoform of creatine kinase and the cytoskeletal proteins alpha-actinin, alpha-sarcomeric actin, myosin and titin were present in early stages. Receptors for gamma toxin from Tityus serrulatus scorpion venom, a specific modulator for voltage dependent sodium channels, were present (0.9-1.0 pmol mg-1 protein) during stage 1 (0-6 days in culture with differentiating media) and increased by 50% in stage 3 (more than 10 days in differentiating media). High and low affinity dihydropyridine receptors present in stage 1 convert into a single type of high affinity receptors in stage 3. Both intracellular calcium release and InsP3 receptors were evident in stage 1 but ryanodine receptors were expressed only in stage 3. RCMH cells showed no voltage sensitive currents in stage 1. Between 7 and 10 days in differentiating media (stage 2), an outward potassium current was observed. Small inward currents appeared only in stage 3; we identified both tetrodotoxin sensitive and tetrodotoxin resistant sodium currents as well as calcium currents. This pattern is consistent with the expression of voltage dependent calcium release before appearance of both the action potential and ryanodine receptors.
Assuntos
Canais Iônicos/biossíntese , Músculo Esquelético/citologia , Músculo Esquelético/fisiologia , Biomarcadores , Cálcio/metabolismo , Diferenciação Celular , Linhagem Celular Transformada , Membrana Celular/fisiologia , Creatina Quinase/metabolismo , Proteínas do Citoesqueleto/análise , Humanos , Canais Iônicos/fisiologia , Isoenzimas , Potenciais da Membrana/efeitos dos fármacos , Potenciais da Membrana/fisiologia , Proteínas Musculares/análise , Técnicas de Patch-Clamp , Venenos de Escorpião/metabolismo , Canais de Sódio/biossíntese , Tetrodotoxina/farmacologiaRESUMO
Cultured hind limb skeletal muscle cells from newborn rats were used to study the effect of caffeine and tetracaine upon intracellular Ca2+ release under voltage or current clamp conditions. Free [Ca2+]i was measured using the fluorescent calcium-sensitive dye Fluo-3. A field containing one or several myotubes was observed with a video camera and image analysis of fluorescence changes was performed. Addition of 100-500 microM tetracaine to the external saline elicited strong fluorescence responses in non-clamped cells, but significantly lower responses in cells clamped at -90 mV. At the same time, tetracaine inhibited voltage induced calcium release. Voltage and tetracaine modulation over the action of caffeine (500 microM) was also observed. Pretreatment of cells with 10 microM nifedipine abolished the caffeine induced fluorescence response in non-clamped cells. These findings suggest that, in cultured muscle cells, calcium release through the caffeine and tetracaine sensitive pathways is controlled by both membrane potential and the dihydropyridine receptor.
Assuntos
Cafeína/farmacologia , Cálcio/metabolismo , Potenciais da Membrana , Músculo Esquelético/metabolismo , Tetracaína/farmacologia , Animais , Bloqueadores dos Canais de Cálcio/farmacologia , Células Cultivadas , Microscopia de Fluorescência , Modelos Biológicos , Músculo Esquelético/citologia , Músculo Esquelético/efeitos dos fármacos , Nifedipino/farmacologia , Técnicas de Patch-Clamp , Perfusão , Ratos , Sarcolema/metabolismoRESUMO
Sampling of Fossaria cubensis, main host of Fasciola hepatica in Cuba was carried out in 3 transmission sites. A higher mollusk density was found in dairies numbers 6 and 9, coinciding with the higher values of total hardness and carbonate hardness. Ammonium, nitrite, and nitrite ions showed lower values in dairy number 6. Temperature and pH did not show significant differences in the 3 biotopes. The mollusks of dairy number 6 began to emit cercarias on the 26th day after being collected; they showed an emission peak at 9 a.m. and an average of 60 cercarias emitted by each mollusk at that time of the day.