RESUMO
The difficulty to estimate the mechanical properties of the tympanic membrane (TM) is a limitation to understand the sound transmission mechanism. In this paper, based on finite element calculations, the sensitivity of the human hearing system to these properties is evaluated. The parameters that define the bending stiffness properties of the membrane have been studied, specifically two key parameters: Young's modulus of the tympanic membrane and the thickness of the eardrum. Additionally, it has been completed with the evaluation of the presence of an initial prestrain inside the TM. Modal analysis is used to study the qualitative characteristics of the TM comparing with vibration patterns obtained by holography. Higher-order modes are shown as a tool to identify these properties. The results show that different combinations of elastic properties and prestrain provide similar responses. The presence of prestrain at the membrane adds more uncertainty, and it is pointed out as a source for the lack of agreement of some previous TM elastic modulus estimations.
RESUMO
Bovine herpesvirus 4 (BoHV-4) is a gammaherpesvirus, belonging to the Rhadinovirus genus, which is increasingly associated with various problems of the reproductive tract of cattle. In Argentina, analysis of BoHV-4 strains isolated from cervico-vaginal mucus of aborted cows revealed a high genetic divergence among strains, which could be classified in three different groups: Genotype 1 comprises Movar-like strains (European prototype), Genotype 2 includes DN599-like strains (American prototype) and Genotype 3 corresponds to a novel genotype group. Understanding the replication behavior in cell cultures and the molecular characteristics of this pathogen of cattle is critical for the rational design of in vitro experiments. The aim of this work was to quantitatively evaluate the replication properties of different Argentinean BoHV-4 strains and to characterize their phylogenetic relationships. Significant differences were evident among the virus titers of the different BoHV-4 isolates in vitro. The most conserved gene was the major capsid protein (ORF25). The glycoprotein B (gB), glycoprotein H (gH), and thymidine kinsase (TK) genes displayed both synonymous and non-synonymous substitutions, with the highest diversity observed for gB, which displayed amino acid substitutions in 24 out of the 178 positions examined. Strains 09/759, 12/512, and 07/568 presented a deletion encompassing amino acid position 27 to 35, whereas strains 07/435 and 09/227 had a deletion from position 28 to 35. Two strains, 07/435 and 09/227, also displayed the highest divergence compared to the other strains analyzed. This study provides information about the in vitro replication and behavior of nine field isolates of BoHV-4. These findings are relevant since available information on the in vitro growth characteristics of BoHV-4 strains is scarce. The results from this study may also be useful for establishing comparisons with other related viruses.
Assuntos
Herpesvirus Bovino 4/isolamento & purificação , Herpesvirus Bovino 4/fisiologia , Replicação Viral/genética , Animais , Argentina , Bovinos , Doenças dos Bovinos/virologia , Linhagem Celular , DNA Viral/genética , Feminino , Variação Genética , Genótipo , Infecções por Herpesviridae/veterinária , Infecções por Herpesviridae/virologia , Herpesvirus Bovino 4/genética , Filogenia , Timidina Quinase/genética , Vagina/virologia , Esfregaço Vaginal/veterinária , Proteínas do Envelope Viral/genéticaRESUMO
INTRODUCTION. Pharmacological treatment is the first therapeutic step towards controlling pain in trigeminal neuralgia, but 25-50% of patients become medication resistant. There are currently several surgical alternatives for treating these patients. AIM. To evaluate the effectiveness and safety of stereotactic radiosurgery for the treatment of patients with trigeminal neuralgia. PATIENTS AND METHODS. A follow-up study was conducted on 30 patients who underwent radiosurgery using a Novalis linear accelerator. Eighty per cent of the dosage was calculated at the isocentre, the entry zone of the root of the trigeminal nerve. The mean follow-up time was 27.5 months (range: 1-65 months). RESULTS. The mean age was 66 years (range: 36-87 years), with a time to progression of 7.1 years (range: 4-27 years). The distribution of the pain was from the right side (63.3%). Of the 30 patients, 27 experienced an improvement (90%) 1.6 months (range: 1 week-4 months) after the treatment; 10 patients (33.3%) scored grade I, and 17 patients (56.6%) obtained a score of grade II. During the follow-up, four patients (14.2%) suffered a relapse; two underwent re-irradiation. Time without recurrence was 62.7 months (range: 54.6-70.8 months). The rate of side effects was 76.7% and only three patients developed facial anaesthesia with loss of the corneal reflex. CONCLUSIONS. The use of the linear accelerator is an effective therapeutic option in the treatment of trigeminal neuralgia, since it provides adequate long-term control of the pain, reduces the use of medication and improves the quality of life.
TITLE: Radiocirugia estereotactica con acelerador lineal para el tratamiento de la neuralgia trigeminal. Experiencia de nueve años en una sola institucion.Introduccion. El tratamiento farmacologico constituye el primer escalon terapeutico para el control del dolor en la neuralgia del trigemino, pero entre el 25-50% de los pacientes se hace farmacorresistente. Actualmente existen varias alternativas quirurgicas para tratar a estos pacientes. Objetivo. Evaluar la efectividad y seguridad de la radiocirugia estereotactica para el tratamiento de pacientes con neuralgia del trigemino. Pacientes y metodos. Se dio seguimiento a 30 pacientes que se sometieron a radiocirugia con acelerador lineal Novalis. Se calculo el 80% de la dosis en el isocentro, la zona de raiz de entrada del nervio trigemino. El tiempo medio de seguimiento fue de 27,5 meses (rango: 1-65 meses). Resultados. La edad media fue de 66 años (rango: 36-87 años), con un tiempo de evolucion de 7,1 años (rango: 4-27 años). La distribucion del dolor fue del lado derecho (63,3%). De los 30 pacientes, 27 tuvieron mejoria (90%) 1,6 meses (rango: 1 semana-4 meses) despues del tratamiento; 10 pacientes (33,3%) tuvieron una valoracion de grado I y 17 pacientes (56,6%) una valoracion de grado II. Durante el seguimiento, cuatro pacientes (14,2%) tuvieron recidiva; dos se sometieron a reirradiacion. El tiempo sin recurrencia fue de 62,7 meses (rango: 54,6-70,8 meses). La tasa de efectos secundarios fue del 76,7%, y solo tres pacientes desarrollaron anestesia facial con perdida del reflejo corneal. Conclusiones. El uso del acelerador lineal es una opcion terapeutica efectiva en el tratamiento de la neuralgia del trigemino, proporciona a largo plazo adecuado control del dolor, reduce el uso de medicamentos y mejora la calidad de vida.
Assuntos
Aceleradores de Partículas , Radiocirurgia/instrumentação , Neuralgia do Trigêmeo/cirurgia , Academias e Institutos/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Piscadela/efeitos da radiação , Feminino , Seguimentos , Humanos , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Qualidade de Vida , Lesões por Radiação/etiologia , Radiocirurgia/efeitos adversos , Radiocirurgia/estatística & dados numéricos , Recidiva , Reflexo Anormal , Estudos Retrospectivos , Transtornos de Sensação/etiologia , Zumbido/etiologia , Resultado do Tratamento , Neuralgia do Trigêmeo/epidemiologia , Neuralgia do Trigêmeo/psicologiaRESUMO
The sieving and immobilization of virus-host complexes using impact filtration (aka membrane co-immobilization or MCI) is a novel approach to the study of plankton viruses. One of the most interesting characteristics of the method is the possibility of generating data on potential viral hosts without the need of culturing hosts cells. MCI has demonstrated to be useful for studying viruses of picoalgae, but studies comparing data generated by MCI to data obtained by other techniques are lacking. In this work, Ostreococcus virus (OV) and Ostreococcus sp. sequences generated from virus-host complexes obtained by MCI were compared to sequences obtained from tangential filtration (TF) concentrates and virus cultures (VC). Statistical parsimony, phylogenetic analyses, pairwise distance comparisons, and analysis of molecular variance showed that the viral and host sequences obtained by the three methods were highly related to each other, indicating that MCI, TF, and VC produce equivalent results. Minor differences were observed among viral sequences obtained from VC and TF concentrates as well as among host sequences generated from VC and MCI. As discussed in the body of the paper, the divergence observed for cultured cells could be due to selective pressures exerted by culture conditions, whereas the correlate observed for the corresponding viral sequences could obey to a hitchhiking effect.
Assuntos
Clorófitas/virologia , Filtração/métodos , Phycodnaviridae/isolamento & purificação , Virologia/métodos , Clorófitas/genética , Dados de Sequência Molecular , Phycodnaviridae/genética , Análise de Sequência de DNARESUMO
Bovine herpesvirus 4 (BoHV-4) is a γ-herpesvirus that has been isolated both from apparently healthy animals and from cattle with a variety of clinical signs, including post-partum endometritis and abortion. BoHV-4 causes either a persistent or a latent infection in cells of the monocyte/macrophage lineage. Two groups of BoVH-4 strains have been defined based on their restriction patterns: the Movar-like strains (European prototype) and the DN 599-like strains (American prototype). The purpose of the present study was to genetically characterize wild type BoHV-4 strains isolated from vaginal discharges of aborted cows in Argentina. The virus was identified by isolation and nested PCR in all vaginal discharge samples from aborted cows, either as a sole agent or in association with other pathogens. Restriction enzyme profiling and phylogenetic analysis demonstrated that there is a high genetic variability among the studied field isolates. The existence of three groups of strains, which were designated as genotypes 1, 2 and 3, is described. Genotypes 1 and 2 possibly correspond to the Movar-like and DN 599-like groups, respectively, whereas Genotype 3 corresponds to a novel group. Two viral strains did not cluster into any of these three groups, indicating that other genotypes could be circulating in Argentina. These results suggest a complex epidemiological background for the Argentinean BoHV-4 strains, probably influenced by independent events of genetic drift. This hypothesis cannot be rejected based on the available data. However, there is no direct evidence supporting this possibility. Thus, it seems speculative to suggest that interspecific jumps are responsible for the observed phylogenetic grouping. On the other hand, our analyses suggest a geographical structure for the observed viral genotypes, since genotypes 1 and 2 included the European (Movar-like) and American (DN599-like) reference strains, respectively. Geographic dispersion is known to be a driver of herpes viruses diversification, and independent evolution in geographical isolated places ensures the emergence of particular mutations in each location due to genetic drift (Compans, 2007; Zong et al., 1999). Therefore, at this point, the genetic drift hypothesis is the one that requires less ad-hoc considerations and thus, to our understanding, is the one that fits to the findings from this study. The involvement of this genetic variability in the detection and pathogenesis of BoHV-4 remains to be investigated.
Assuntos
Doenças dos Bovinos/virologia , Infecções por Herpesviridae/veterinária , Herpesvirus Bovino 4/genética , Aborto Animal/virologia , Animais , Argentina , Bovinos , Doenças dos Bovinos/genética , Linhagem Celular , Feminino , Infecções por Herpesviridae/genética , Infecções por Herpesviridae/virologia , Herpesvirus Bovino 4/isolamento & purificação , Filogenia , Reação em Cadeia da Polimerase/métodos , Reação em Cadeia da Polimerase/veterinária , Gravidez , Vagina/virologia , Esfregaço Vaginal/veterináriaRESUMO
BACKGROUND: An increase in asthma prevalence is reported from developed as well as developing nations, with rising costs from acute asthma and great expenditures to health care systems. Venezuela's Ministry of Health ambulatory facilities care for 80 % or more of a mostly urban and impoverished population of 26 million inhabitants, registering close to a million acute asthma visits per year; a nebulised fixed fenoterol-ipratropium bromide combination (Bero-dual, Boehringer-Ingelheim) in repeated dosing is the standard treatment. OBJECTIVES: to simplify acute asthma care and management in a cost effective manner employing Formoterol Fumarate powder, a long acting beta agonist with immediate bronchodilator effects. METHODOLOGY: Fifty acute asthmatic children (5-12 years old) were randomly assigned (25 patients in each group) to receive either a nebulised single dose (US $1.35) of two 12 microg Formoterol Fumarate capsules (Foradil 12 microg/cap, Novartis Pharma AG, Basel, Switzerland) diluted in 2.5 ml of sterile saline solution; or 3 doses of Albuterol (US $ 6.73) every twenty minutes for one hour (Glaxo Smith Kline Albuterol ampoules, 2.5 mg/2.5 ml, at a dose of 0.15 mg/kg/dose, maximum dose 2.5 mg). Symptoms score, oxygen saturation and lung function testing were recorded before and one hour after commencing treatments. RESULTS: Both groups improved significantly on all parameters, except for FEV(1) in the Albuterol group. CONCLUSIONS: Single dose nebulised Formoterol Fumarate (dry powder) in sterile saline solution, as depicted in this trial, is equivalent to three doses of Albuterol every twenty minutes for one hour in acute asthma in children, simplifying acute care management and at one fifth of medication costs. A pursuit of simpler and more cost effective approaches is found wanting in developing nations with depressed economies and unique cultural and socio-medical contexts; also, in countries where pharmaco-economics orients quality of health policies, novel approaches like this are worth exploring.
Assuntos
Albuterol/administração & dosagem , Asma/tratamento farmacológico , Broncodilatadores/administração & dosagem , Países em Desenvolvimento/economia , Etanolaminas/administração & dosagem , Doença Aguda , Administração por Inalação , Albuterol/economia , Asma/economia , Broncodilatadores/economia , Criança , Análise Custo-Benefício , Método Duplo-Cego , Esquema de Medicação , Etanolaminas/economia , Feminino , Fumarato de Formoterol , Humanos , Masculino , Pós/administração & dosagem , Pós/economia , Estudos Prospectivos , VenezuelaRESUMO
Multilayer immobilization of antibody and redox polymer molecules on a gold electrode was achieved, as a strategy for the potential development of an amperometric immunosensor. The step-by-step assembly of antibiotin IgG on Os(bpy)(2)ClPyCH(2)NH poly(allylamine) redox polymer (PAH-Os) adsorbed on thiolated gold electrodes was proved by quartz crystal microbalance (QCM) and atomic force microscopy (AFM) experiments, confirming the electrochemical evidence. The increase of redox charge during the layer-by-layer deposition demonstrated that charge propagation within the layers is feasible. The multilayer structure proved to be effective for the molecular recognition of horseradish peroxidase-biotin conjugate (HRP-biotin), as confirmed by the QCM measurements and the electrocatalytic reduction current obtained upon H(2)O(2) addition. The catalytic current resulting from PAH-Os mediation was shown to increase with the number of assembled layers. Furthermore, the inventory of IgG molecules on the supramolecular self-assembled structure and the specific and non-specific binding of HRP-biotin conjugate were confirmed by the QCM transient studies, giving information on the kinetics of IgG deposition and HRP-biotin conjugate binding to the IgG.
Assuntos
Anticorpos , Eletroquímica/instrumentação , Ouro , Polímeros , Eletrodos , Imunoensaio/instrumentação , Cinética , Microscopia de Força Atômica , OxirreduçãoAssuntos
Humanos , Bioética , Ética Médica , Assistência ao Paciente/normas , Ética , Direito à Saúde , Defesa do Paciente , Setor de Assistência à Saúde , Diagnóstico da Situação de Saúde , Fatores de Risco , Risco à Saúde Humana , Responsabilidade Legal , Política de Saúde , Pacientes , Setor Público , Setor Privado , Necessidades e Demandas de Serviços de Saúde , Avaliação das NecessidadesAssuntos
Humanos , Assistência ao Paciente/normas , Bioética , Diagnóstico da Situação de Saúde , Ética , Ética Médica , Setor de Assistência à Saúde , Risco à Saúde Humana , Defesa do Paciente , Fatores de Risco , Direito à Saúde , Política de Saúde , Necessidades e Demandas de Serviços de Saúde , Responsabilidade Legal , Avaliação das Necessidades , Pacientes , Setor Privado , Setor PúblicoRESUMO
Antecedentes: los Comités de Bioética (CBE) ingresaron al imaginario hospitalario mundial hace 30 años. Su historia en la Argentina es más corta. La experiencia de uno de ellos puede resultar importante para los interesados en el tema. Objetivos: analizar la gestión del CBE y estudiar la valoración que mereció por parte de la comunidad hospitalaria. Lugar de aplicación: Hospital General de Agudos. Diseño: revisión de las actividades del período 1997-2000. Distribución aleatoria de encuesta dirigida al personal. Población: Comunidad hospitalaria (1300 agentes). Métodos: revisión del libro de actas. Análisis de las opiniones recogidas. Resultados: en 1996, de acuerdo con la Ley Provincial 11044, la Dirección del Hospital designó un Coordinador, encargado de constituir un CBE. Convocó a representantes de varias disciplinas. Redactó el Estatuto que rige su funcionamiento. Actúa como asesor de la Dirección. Propone utilizar mecanismos de acción optativo-optativo para docencia y práctica asistencial e imperativo-imperativo para la investigación. Desde abril de 1997 se realizaron 150 sesiones. Se diseñaron y redactaron circuitos para presentación de casos y protocolos de investigación, documentos sobre derechos del paciente, ingreso de personal minusválido, consentimiento informado, uso de medios de contraste iodados y derechos del animal. Se efectuaron ateneos conjuntos con diversos Servicios. Se estudió y dictaminó sobre 10 solicitudes de ligadura tubaria, 2 de aborto terapéutico y sobre opción quirúrgica en un neonato polimalformado. Se analizaron y observaron 30 protocolos de investigación. Se concretaron tres Ciclos de Reuniones sobre Bioética, cuya transcripción se publicó con el título de "Discutiendo Bioética". En octubre de 1999, se distribuyeron al azar 550 encuestas entre el personal del hospital. Fueron respondidas 110 (20 por ciento): 9 por ciento dice conocer las funciones del CBE, 86 por ciento considera que la existencia tiene sentido, 82 por ciento que es útil, 38 por ciento que logró cambios de conducta y 34 por ciento que trajo beneficios. Le reconoce labores docentes 48 por ciento, 87 por ciento la cree interesante y sólo 35 por ciento ha concurrido a alguna actividad. La producción fue calificada como mala o regular por 13,5 por ciento y como buena por 27 por ciento. El resto (60 por ciento) no respondió la pregunta. Conclusiones: la actividad del CBE generó resistencias y no contó con aceptación masiva en la institución...(AU)
Assuntos
Humanos , Comissão de Ética/organização & administração , Hospitais , Argentina , Comissão de Ética/normas , Bioética , Ética MédicaRESUMO
Antecedentes: los Comités de Bioética (CBE) ingresaron al imaginario hospitalario mundial hace 30 años. Su historia en la Argentina es más corta. La experiencia de uno de ellos puede resultar importante para los interesados en el tema. Objetivos: analizar la gestión del CBE y estudiar la valoración que mereció por parte de la comunidad hospitalaria. Lugar de aplicación: Hospital General de Agudos. Diseño: revisión de las actividades del período 1997-2000. Distribución aleatoria de encuesta dirigida al personal. Población: Comunidad hospitalaria (1300 agentes). Métodos: revisión del libro de actas. Análisis de las opiniones recogidas. Resultados: en 1996, de acuerdo con la Ley Provincial 11044, la Dirección del Hospital designó un Coordinador, encargado de constituir un CBE. Convocó a representantes de varias disciplinas. Redactó el Estatuto que rige su funcionamiento. Actúa como asesor de la Dirección. Propone utilizar mecanismos de acción optativo-optativo para docencia y práctica asistencial e imperativo-imperativo para la investigación. Desde abril de 1997 se realizaron 150 sesiones. Se diseñaron y redactaron circuitos para presentación de casos y protocolos de investigación, documentos sobre derechos del paciente, ingreso de personal minusválido, consentimiento informado, uso de medios de contraste iodados y derechos del animal. Se efectuaron ateneos conjuntos con diversos Servicios. Se estudió y dictaminó sobre 10 solicitudes de ligadura tubaria, 2 de aborto terapéutico y sobre opción quirúrgica en un neonato polimalformado. Se analizaron y observaron 30 protocolos de investigación. Se concretaron tres Ciclos de Reuniones sobre Bioética, cuya transcripción se publicó con el título de "Discutiendo Bioética". En octubre de 1999, se distribuyeron al azar 550 encuestas entre el personal del hospital. Fueron respondidas 110 (20 por ciento): 9 por ciento dice conocer las funciones del CBE, 86 por ciento considera que la existencia tiene sentido, 82 por ciento que es útil, 38 por ciento que logró cambios de conducta y 34 por ciento que trajo beneficios. Le reconoce labores docentes 48 por ciento, 87 por ciento la cree interesante y sólo 35 por ciento ha concurrido a alguna actividad. La producción fue calificada como mala o regular por 13,5 por ciento y como buena por 27 por ciento. El resto (60 por ciento) no respondió la pregunta. Conclusiones: la actividad del CBE generó resistencias y no contó con aceptación masiva en la institución...
Assuntos
Humanos , Comissão de Ética/organização & administração , Argentina , Bioética , Comissão de Ética/normas , Ética Médica , HospitaisRESUMO
The mechanism by which lentivirus envelope (Env) glycoproteins are packaged into budding virions is poorly understood. Simian immunodeficiency virus (SIV) contains an Env protein with an unusually long cytoplasmic tail. To investigate the role of this domain in the incorporation of the SIV Env into virions, we generated a series of SIV Env mutants carrying small in-frame deletions within the cytoplasmic domain. The effects of these mutations on Env synthesis, processing, and association with Gag particles were analyzed by means of the vaccinia virus expression system. All of the mutant Env glycoproteins were synthesized and processed in a manner similar to that of the wild-type Env. However, deletions affecting domains C-terminal to residue 832 in the SIV Env protein significantly impaired Env incorporation into particles. Cell surface biotinylation assays showed that this phenotype could not be attributed to inefficient cell surface expression of the Env mutants. Furthermore, when the Env deletion mutants were tested for their ability to mediate virus entry in single-cycle infectivity assays, those mutations that impaired Env incorporation also caused a severe defect in virus infectivity. Our results suggest that domains in the C-terminal third of the SIV Env protein are required for Env incorporation into particles and Env-mediated virus entry.
Assuntos
Glicoproteínas de Membrana/química , Glicoproteínas de Membrana/metabolismo , Proteínas dos Retroviridae/química , Proteínas dos Retroviridae/metabolismo , Síndrome de Imunodeficiência Adquirida dos Símios/virologia , Vírus da Imunodeficiência Símia/patogenicidade , Vírion/metabolismo , Animais , Células Cultivadas , Chlorocebus aethiops , Citoplasma/química , Glicoproteínas de Membrana/genética , Estrutura Terciária de Proteína , Ratos , Proteínas dos Retroviridae/genética , Deleção de Sequência , Vírus da Imunodeficiência Símia/genética , Vírus da Imunodeficiência Símia/metabolismo , Vaccinia virus/genéticaRESUMO
Simian immunodeficiency viruses (SIVs) have an envelope (Env) glycoprotein with an unusually long cytoplasmic domain of 164 amino acids. In this article, we have characterized a series of SIV Env truncation mutants in which the cytoplasmic domain was progressively shortened from its carboxyl terminus by 20 amino acids. Expression by means of the vaccinia virus system showed that all of the SIV Env mutants were expressed and processed into the surface and transmembrane (TM) subunits. When the ability of the Env mutants to associate with SIV Gag particles was examined, we found that deletion of 20 to 80 residues from the carboxyl terminus of the SIV TM cytoplasmic tail abrogated the incorporation of the Env glycoprotein into particles. By contrast, further truncation of the SIV TM protein by 100 to 140 amino acids restored the ability of the Env protein to associate with Gag particles. Interestingly, mutants bearing a 44- or 24-amino acid cytoplasmic domain were incorporated at levels significantly higher than those of the wild-type Env. Single-cycle infectivity assays showed that Env mutants bearing cytoplasmic tails of 144 to 64 amino acids were highly inefficient at mediating virus entry. By contrast, truncation of the cytoplasmic domain to 44 or 24 amino acids drastically enhanced virus infectivity with respect to that conferred by the full-length Env protein. Our results demonstrate that small variations in the length of the SIV Env cytoplasmic domain dramatically influence Env-mediated viral functions.
Assuntos
Mutação , Vírus da Imunodeficiência Símia/patogenicidade , Proteínas do Envelope Viral/química , Proteínas do Envelope Viral/genética , Animais , Linhagem Celular , Membrana Celular/metabolismo , Produtos do Gene gag/metabolismo , Humanos , Síndrome de Imunodeficiência Adquirida dos Símios/virologia , Vírus da Imunodeficiência Símia/química , Vírus da Imunodeficiência Símia/genética , Proteínas do Envelope Viral/metabolismo , Vírion/metabolismoRESUMO
One hundred cases of upper gastrointestinal hemorrhage in peruvian highlanders were studied at a hospital in La Oroya (3850 meters above the sea level). On admission in all of them an esophagogastroduodenal fiberscope was performed to establish the diagnosis. Most of them were males (98%), between 30-39 years of age (38%) and presented at the same time hematemesis and melena (64%). After bleeding in 72% the hemoglobin was over 14 g%. As a whole the most frequent diagnosis were: gastric ulcer (33%). duodenal ulcer (23%) and erosive gastritis (23%). In those living between 3000-3500 m.a.s.l. duodenal ulcer had the highest incidence. At 3500 m.a.s.l. was gastric ulcer more frequent, followed by erosive gastritis. In 11% surgery was required and only in 27% it was necessary a blood transfusion. After bleeding 10% had an hemoglobin level over 20 g% and because of this they were considered as having Chronic Mountain Sickness, 4 of them with severe cardiorespiratory and consciousness disturbances required after the gastrointestinal hemorrhage, an immediate bleeding in order to compensate the patient, a completely unusual occurrence in general pathology but a peculiar treatment in these patients living at high altitudes of the peruvian Andes.
Assuntos
Altitude , Hemorragia Gastrointestinal , Hemorragia Gastrointestinal/diagnóstico , Adulto , Distribuição por Idade , Idoso , Feminino , Hemorragia Gastrointestinal/epidemiologia , Hemorragia Gastrointestinal/etiologia , Hematemese/diagnóstico , Hematemese/epidemiologia , Hematemese/etiologia , Humanos , Masculino , Melena/diagnóstico , Melena/epidemiologia , Melena/etiologia , Pessoa de Meia-Idade , Peru/epidemiologia , Estudos Retrospectivos , Distribuição por SexoRESUMO
In order to know the frequency and distribution of the histologic types of Hodgkin disease (HD) in the general Hospital of Mexico City and to compare the results with those of other countries; 96,909 surgical specimens were reviewed; 422 were of HD, from which only 309 (0.31%) could be reclassified according to the modified Rye classification, 214 (69%) were male and 95 (31%) female (M:F = 1:2.25). The mean age for the group was 26 years, for females was 30 and for males 24. The graphic for age and sex showed a unimodal curve in both sexes. The most frequent histologic type was mixed cellularity with 175 cases (56.6%), followed by the NE type with 83 (26.9%), the DL with 26 (8.4%) and finally the PL type with 25 (8.1%). In all the groups predominated the males as reported by other authors, but they reported a bimodal curve of age distribution and ours was unimodal as reported in Peru, Colombia, Uganda. The mean age is also one decade younger than in other countries, probably because almost 50% of the Mexican population are youngsters. The distribution of histologic types is similar to those of South Africa, Colombia, Uganda, Zambia and to the poor black population from USA, where the most frequent type is the mixed cellularity. The frequency of the other histologic types differs from the reports of Denmark Sweden, USA and England were the NE type predominates.(ABSTRACT TRUNCATED AT 250 WORDS)