RESUMO
Anterior cruciate ligament reconstruction is a demanding procedure; complications may arise at any of its stages. This is the report of three cases in which the tibial fixation devices (IntraFix and Bio-IntraFix) led to intraarticular lesions. The complications were detected in one of the cases while the patient was still in the operating room and in the remaining two during the follow-up. All the patients had a stable knee, but all of them sustained chondral lesions resulting from the inadequate placement of the implants used for tibial fixation. Several suggestions to avoid the complications stemming from these devices are provided.
La reconstrucción del ligamento cruzado anterior es un procedimiento exigente; las complicaciones pueden presentarse en cualquiera de sus etapas. Presentamos tres casos en los cuales los dispositivos para la fijación tibial (IntraFix y Bio-IntraFix) condicionaron lesiones intraarticulares. Las complicaciones fueron detectadas, en uno de los casos, mientras el paciente se encontraba aún en la sala de operaciones, y en los otros dos, durante el seguimiento. Todos los pacientes contaban con una rodilla estable, pero tuvieron lesiones condrales causadas por la inadecuada colocación de los implantes para la fijación tibial. Se exponen algunas sugerencias para evitar complicaciones con estos dispositivos.
Assuntos
Lesões do Ligamento Cruzado Anterior , Reconstrução do Ligamento Cruzado Anterior , Lesões do Ligamento Cruzado Anterior/cirurgia , Humanos , Articulação do Joelho/cirurgia , Tendões , Tíbia/cirurgiaRESUMO
AIM: Protein-energy malnutrition as well as systemic inflammation and metabolic disorders are common in patients with chronic kidney failure, who require renal replacement therapy (haemodialysis). Such malnutrition is a factor that significantly contributes to their morbidity and mortality. This study evaluated the nutritional status of haemodialysis patients by assessing biochemical and anthropometric parameters in order to determine whether these patients suffered disorders reflecting nutritional deterioration directly related to time on haemodialysis. SUBJECTS AND METHOD: This research comprised 90 patients of both genders with chronic kidney failure, who regularly received haemodialysis at our unit over a period of ten years. The patients' blood was tested quarterly for plasma albumin, total cholesterol and total proteins, and tested monthly for transferrin. The patients' weight, height and body mass index (BMI) were monitored. Body mass index was calculated using the formula: weight (kg)/height (m2 ) and classified in one of the following categories defined in the World Health Organization (WHO) Global Database on Body Mass Index: (i) underweight [BMI < 18.50], (ii) normal [BMI 18.50 - 24.99], (iii) overweight [BMI 25 - 29.99], (iv) obese [BMI > 30]. RESULTS: In the ten-year period of the study, the patients experienced a substantial decline in their biochemical parameters. Nevertheless, their BMI did not show any significant changes despite the patients' state of malnutrition. CONCLUSIONS: The prevalence of malnutrition in haemodialysis patients was evident. Nevertheless, the BMI of the subjects did not correspond to the biochemical parameters measured. Consequently, the results showed that the nutritional deterioration of these patients was mainly reflected in their biochemical parameters rather than in their anthropometric measurements.
Assuntos
Tumores Neuroendócrinos/secundário , Neoplasias Pancreáticas/diagnóstico , Neoplasias de Tecidos Moles/secundário , Tela Subcutânea/patologia , Adenocarcinoma de Células Claras/diagnóstico , Idoso , Antimetabólitos Antineoplásicos/uso terapêutico , Braço , Biomarcadores/análise , Biomarcadores Tumorais/análise , Desoxicitidina/análogos & derivados , Desoxicitidina/uso terapêutico , Erros de Diagnóstico , Feminino , Humanos , Queratinas/análise , Proteínas de Neoplasias/análise , Neprilisina/análise , Tumores Neuroendócrinos/química , Tumores Neuroendócrinos/diagnóstico , Tumores Neuroendócrinos/tratamento farmacológico , Neoplasias Pancreáticas/tratamento farmacológico , Fosfopiruvato Hidratase/análise , Neoplasias de Tecidos Moles/química , Vimentina/análise , GencitabinaRESUMO
OBJECTIVE: Increase the awareness about the importance of Diabetes mellitus (DM) management and assess the educational and monitoring needs of patients visiting a community pharmacy in Puerto Rico. METHODS: A community service activity focusing on DM was held in a community pharmacy. The educational and monitoring needs of the participants were assessed using a questionnaire. Glucose tests were conducted in the pharmacy by medical technologists. Educational activities consisted of presentations and printed materials. RESULTS: Two-thirds of the fasting people had blood glucose levels higher than 140 mg/dl. Seventy-nine percent of the patients with diabetes were not aware of the glycosilated hemoglobin test. Most of the patients were interested in learning more about how to manage their condition. CONCLUSION: A greater understanding is needed among patients with DM that blood glucose control decreases diabetes related complications. Community pharmacists are in an excellent position to collaborate with other health professionals in screening, monitoring and educating patients with DM to prevent long-term complications.
Assuntos
Automonitorização da Glicemia , Diabetes Mellitus/sangue , Educação de Pacientes como Assunto/métodos , Farmácias , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Coleta de Amostras Sanguíneas/métodos , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Porto RicoRESUMO
OBJECTIVES: Study the percentage of clinical successes which have been confirmed by percutaneous hepatic biopsy guided by echography (PHBE) in those diseases which can affect the liver in an Internal Medicine service. PATIENTS AND METHODS: 78 patients were chosen for this study. All of them were admitted to hospital during the last eight years. Each patient had had a PHBE made regarding clinical, analytical and echographic criteria that were necessary to conclude their diagnostic studies. They were distributed into different groups. RESULTS: Patients could be distributed into five different groups. There was a higher percentage of clinical successes on those who suffered from chronic hepatopathy derived from alcohol-addiction and on those with carcinomatous hepatopathies. When corroborating the diagnosis of clinical suspect, the diagnostic profitability of the biopsy proved to get down in the others groups, depending on it was the group of miscellaneous, dissociate cholestasis and, in the last place, unknownly originated fever. CONCLUSIONS: The diversity of diseases which can affect the liver in an Internal Medicine service gives PHBE a particular diagnostic character. The diagnosis of clinical suspect was confirmed in 78.2% of the total of cases that made up the different groups. Therefore, PHBE plays a main role in a large amount of hepatic repercussive diseases that are treated in Internal Medicine services where, despite the clinical suspect, a diagnostic corroboration is often required for a right treatment.
Assuntos
Biópsia por Agulha , Hepatopatias/patologia , Fígado/patologia , Humanos , Neoplasias Hepáticas/patologia , Ultrassonografia de IntervençãoRESUMO
Intracerebral hemorrhages represent about 10% of the whole of vascular cerebral accidents. According to different authors, the incidence of cerebral amyloid angiopathy varies between 5-10% and up to 20-30% of all primary non-traumatic intracerebral hemorrhages. This incidence was analyzed in our environment. A retrospective study was carried out on 403 patients, 203 of them were analyzed between 1990-91 and the other 200 between 1992-3. Age, arterial tension, relapses and localization were taken as criteria for a diagnosis. For the statistical analysis, Student's T-test was used for quantitative variables, while square Chi with Yates' correction was used for qualitative variables. Ischemic cerebral accidents (90.5% of the total) are more frequent than hemorrhagic cerebral accidents, which represent 5.7%. 3.7% were not registered. Therefore, it was suspected cerebral amyloid angiopathy in 1.4% of all vascular cerebral accidents. This represents 26.1% of the total of hemorrhagic patients. Different variables from groups of hemorrhagic vascular cerebral accidents were compared to those caused by amyloid cerebral angiopathy and significant statistics were found with respect to localization in the cerebral hemispheres (p < 0.01). Neither age, nor arterial tension or relapses were significant. Amyloid cerebral angiopathy as a cause of hemorrhagic cerebrovascular accident is and entity to be considered in the diagnosis of these patients. By using clinical criteria and others of localization through complementary explorations, a diagnosis for guessing such a process can be determined.
Assuntos
Angiopatia Amiloide Cerebral/complicações , Hemorragia Cerebral/etiologia , Distribuição por Idade , Idoso , Isquemia Encefálica/epidemiologia , Angiopatia Amiloide Cerebral/diagnóstico , Angiopatia Amiloide Cerebral/epidemiologia , Hemorragia Cerebral/epidemiologia , Comorbidade , Demência/epidemiologia , Diagnóstico Diferencial , Diagnóstico por Imagem , Feminino , Humanos , Hipertensão/epidemiologia , Incidência , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Espanha/epidemiologiaRESUMO
A case of laryngeal fibrolipoma, a rare tumor, is presented. The histopathology, symptoms, diagnosis, treatment, and related literature are reviewed.
Assuntos
Neoplasias Hipofaríngeas/patologia , Hipofaringe/patologia , Lipoma/patologia , Feminino , Humanos , Neoplasias Hipofaríngeas/diagnóstico , Neoplasias Hipofaríngeas/cirurgia , Hipofaringe/cirurgia , Laringoscopia , Lipoma/diagnóstico , Lipoma/cirurgia , Pessoa de Meia-IdadeRESUMO
The present clinical and pathological study describes the cases of two patients having infiltrate and ulcerous lesions of the nose, hard palate and rhinopharynx clinically consistent with a malignant midline granuloma. Histologically, infiltrates presented atypical lymphoid cells around small vessels and damage of the vascular wall. Immunohistologic study, using monoclonal antibodies on both fresh and paraffin embedded tissues, led to the positive diagnosis of peripheral lymphoma of T cells.
Assuntos
Neoplasias Faciais/patologia , Doença de Hodgkin/patologia , Linfoma de Células T Periférico/patologia , Neoplasias Primárias Múltiplas/patologia , Adulto , Humanos , Pessoa de Meia-IdadeRESUMO
OBJECTIVE: To determine the prevalence of gestational diabetes (GD) in an outpatient clinic in northeastern Mexico. PATIENTS: 732 consecutive pregnant women referred for prenatal care during a two-year period. INTERVENTION AND OUTCOME MEASURE: A 100 g glucose tolerance test was performed in the patients with sampling at 1, 2 and 3 hours postchallenge. The patients were classified according to the criteria of the American Diabetes Association as normal, abnormal, and a third category of those showing a single abnormal value in the tolerance test. RESULTS: Six percent of the women (44/732) had GD and 1.4% (10/732) had one abnormal value. A comparison group was made with a subset of 44 of the 678 women who showed a normal tolerance test. No group differences were seen in parity, and age, nor in body weight gain or changes in body mass index, the latter measured in the initial and final weeks of pregnancy. Significant differences versus the normal women were seen in the GD group for cesarean births (43% vs 30%) and in macrosomy (25% vs 7%). The group with one abnormal test showed high values in cesareans (50%) and macrosomy (10%) but did not reach significant difference with the other groups. CONCLUSIONS: GD was higher in our study than in the only paper on GD prevalence reported in Mexico (3.9%). The higher incidence of cesareans and macrosomy in GD makes it necessary to consider therapeutic interventions in these cases.
Assuntos
Diabetes Gestacional/epidemiologia , Programas de Rastreamento , Adulto , Peso ao Nascer , Cesárea/estatística & dados numéricos , Feminino , Teste de Tolerância a Glucose , Humanos , México/epidemiologia , Gravidez , Resultado da Gravidez , Prevalência , Avaliação de Programas e Projetos de SaúdeRESUMO
Report about 2 children affected with the cat scratch disease or lymphoreticulosis. The AA. discuss some etiological and clinic features of the malady, especially emphasizing the typical anatomopathological findings, which in the majority of the occurrences, allow the actual diagnosis. This is a disease of low incidence, but must be bear in mind when dealing with any cervical lump.
Assuntos
Doença da Arranhadura de Gato/diagnóstico , Vértebras Cervicais/fisiopatologia , Doença da Arranhadura de Gato/microbiologia , Doença da Arranhadura de Gato/fisiopatologia , Criança , Diagnóstico Diferencial , Epitélio , Bacilos Gram-Positivos/isolamento & purificação , Granuloma de Células Gigantes/diagnóstico , Granuloma de Células Gigantes/cirurgia , Humanos , Osso Hioide/cirurgia , Masculino , Doenças Mandibulares/diagnóstico , Doenças Mandibulares/fisiopatologia , Neutrófilos/citologiaRESUMO
This study report 3 cases of nodal cystic metastasis in the neck. One of them was diagnosed as an epidermoid carcinoma of unknown origin and the other 2 were an epidermoid carcinoma and an mucoepidermoid carcinoma respectively, arising in the larynx. Treatment of these patients included removal of the cystic metastasis with or without neck dissection and irradiation. Cystic metastasis from squamous cell carcinoma have often been mistaken for primary squamous cell carcinoma of branchiogenic origin. The distinctive histological features of cystic metastasis reviewed after its correct identification, can lead to the discovery of an unsuspected primary lesion and result in specific treatment options.
Assuntos
Branquioma/diagnóstico , Carcinoma de Células Escamosas/diagnóstico , Vértebras Cervicais/patologia , Adulto , Idoso , Branquioma/patologia , Carcinoma de Células Escamosas/patologia , Feminino , Humanos , Neoplasias Laríngeas/diagnóstico , Neoplasias Laríngeas/patologia , Neoplasias Laríngeas/cirurgia , Laringectomia , Laringe/patologia , Laringe/cirurgia , Masculino , Pessoa de Meia-Idade , Metástase NeoplásicaRESUMO
By multiple linear regression the authors show a closed relationship between survival and conventional anatomopathologic data as grade of differentiation and of lymphoid infiltration of the primary tumor. This retrospective pathological study showed that various degrees of squamous cell differentiation may be recognized for malignant laryngeal lesions and that such distinction may be of prognostic significance.
Assuntos
Carcinoma de Células Escamosas/patologia , Neoplasias Laríngeas/patologia , Linfócitos do Interstício Tumoral , Carcinoma de Células Escamosas/mortalidade , Humanos , Neoplasias Laríngeas/mortalidade , Prognóstico , Análise de Regressão , Análise de SobrevidaRESUMO
At the moment the use of quantitative techniques in anatomopathology is more and more frequent. In this study the authors use for the first time the morpho-photometry approach in epidermoid carcinomas of the larynx coming from filed material. In this way they are checking if this method adds anything to conventional anatomopathology.
Assuntos
Carcinoma de Células Escamosas/patologia , Neoplasias Laríngeas/patologia , Fotometria/métodos , Núcleo Celular/patologia , Humanos , Laringe/patologia , Fotometria/instrumentaçãoRESUMO
At the moment the use of quantitative techniques is not very frequent in standard anatomopathologic studies of epidermoid carcinoma of the larynx. By "multiple linear regression" the authors show a closed relationship between survival and conventional anatomopathologic data as grade of differentiation and of lymphoid infiltration of the primary tumor.
Assuntos
Carcinoma de Células Escamosas/patologia , Neoplasias Laríngeas/patologia , Carcinoma de Células Escamosas/epidemiologia , Carcinoma de Células Escamosas/mortalidade , Humanos , Neoplasias Laríngeas/epidemiologia , Neoplasias Laríngeas/mortalidade , Laringe/patologia , Metástase Linfática , Prognóstico , Análise de RegressãoRESUMO
The anatomopathologic study of epidermoid carcinoma of the larynx is a reason for many publications in the international scientific community in spite of the apparent histologic similarity of this type of tumor. After a careful review from wide material the authors make reference to the prognostic value of certain anatomopathologic finding.