RESUMO
Necrotizing gastritis is an infrequent entity with unknown prevalence, the diagnosis is often incidental during exploratory laparotomy or autopsies of patients with acute abdomen. OBJECTIVE: To present a clinical case of necrotizing gastritis, a rare entity that should be taken into account in the context of immunocompromised patients with associated risk factors. CLINICAL CASE: 7-year-old male schoolboy diagnosed with T-precursor acute lymphoid leukemia, finishing induction chemotherapy cycle with PETHEMA 2013 protocol. He presented 12 days of symptoms characterized by epigastric abdominal pain and vomiting, initially acute pancreatitis was suspected, ruled out by normal pancreatic enzymes and abdominal computed tomography. Due to suspicion of acid peptic disease associated with steroids, treatment with proton pump inhibitors and prokinetics was started. Considering dyspepsia with alarm signs, such as progression of neutropenia, increased C-reactive protein and clinical deterioration, esophagogastroduodenoscopy (EGD) was performed, compatible with necrotizing gastritis, confirmed by histopathology. He received pharmacological management, zero regimen and parenteral support, and progressive improvement was evidenced in imaging controls. After fasting for 30 days, enteral nutrition was started, well tolerated, with ambulatory follow-up. After improvement, chemotherapy plan was completed, highlighting complete remission, without complications after 2 years. CONCLUSION: Necrotizing gastritis is a rare entity, in the case described the risk factors were immunocompromise, previous management with corticosteroids and cytotoxic therapy, and possibly, exposure to stressful situations during hospitalization. Early diagnosis and treatment determined a favourable prognosis.
Assuntos
Gastrite , Pancreatite , Leucemia-Linfoma Linfoblástico de Células Precursoras , Masculino , Humanos , Criança , Doença Aguda , Leucemia-Linfoma Linfoblástico de Células Precursoras/complicações , Leucemia-Linfoma Linfoblástico de Células Precursoras/diagnóstico , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamento farmacológico , Gastrite/complicações , Gastrite/diagnóstico , Fatores de RiscoRESUMO
Resumen Introducción: Los linfomas de células T son infrecuentes y se caracterizan por presentarse en la población de los adultos jóvenes. Además, suele acompañarse de patologías como la anemia moderada, hepatoesplenomegalia y trombocitopenia e infiltración sinusoidal por linfocitos T en células de médula ósea, bazo e hígado. Caso clínico: Se presenta un caso clínico de un adolescente que tiene los síntomas característicos de esta patología, con sospecha clínica y diagnóstico paraclínico confirmado con histoquímica de médula ósea. Conclusión: Es una entidad infrecuente de pronóstico desfavorable, hasta el momento el paciente está estable recibiendo tratamiento. Para utilizar el enfoque adecuado en el diagnóstico y brindar tratamiento, es necesario considerar todos los hallazgos clínicos.
Abstract Introduction: T-cell lymphomas are uncommon; these tend to be present in young adult patients. Additionally, this condition is characterized by the existence of pathologies like moderate anemia, hepatosplenomegaly disorder, thrombocytopenia and sinusoidal infiltration by T-Lymphocytes in bone marrow cells, spleen and liver. In this study a case of this rare lymphoma is going to be presented. Case report: A clinical case of an adolescent who presents the characteristic symptoms of this pathology is exposed. This clinical suspicion held a paraclinical diagnosis that was confirmed by histochemistry of bone marrow tests. Conclusion: It is an infrequent condition with an unfavorable prognosis. Until now the patient remains stable and is receiving treatment, the clinical findings of the disease raise awareness about the importance of carrying out the appropriate diagnosis procedures and providing treatment.
Assuntos
Humanos , Adolescente , Esplenomegalia , Trombocitopenia , Células da Medula Óssea , Linfócitos T , Linfoma de Células T , Hepatomegalia , Baço , Terapêutica , Medula Óssea , Anemia , FígadoRESUMO
OBJECTIVE: To consolidate and assess information on counterfeit medicines subject to pharmaceutical alerts issued by the Peruvian Medicines Regulatory Authority over 18â years (1997-2014) of health monitoring and enforcement. DESIGN: A retrospective review of drug alerts. SETTING: A search of the website of the General Directorate of Medicines, Supplies and Drugs (DIGEMID) of the Ministry of Health of Peru for drug alerts issued between 1997 and 2014. ELIGIBILITY CRITERIA: Drug alerts related to counterfeit medicines. RESULTS: A total of 669 DIGEMID alerts were issued during the study period, 354 (52.91%) of which cover 1738 cases of counterfeit medicines (many alerts deal with several cases at a time). 1010 cases (58.11%) involved pharmaceutical establishments and 349 (20.08%) involved non-pharmaceutical commercial outlets. In 126 cases (7.25%), counterfeit medicines were seized in an unauthorised trade (without any marketing authorisation); in 253 cases (14.56%) the type of establishment or business associated with the seized product was not identified. CONCLUSIONS: Counterfeit medicines are a serious public health problem in Peru. A review of the data cannot determine whether counterfeit medicines in Peru increased during the study period, or if monitoring by different government health agencies highlighted the magnitude of the problem by providing more evidence. The problem is clearly structural, since the majority of cases (58.11% of the total) were detected in legitimate supply chains. Most counterfeit medicines involve staple pharmaceutical products and common dosage forms. Considerable work remains to be done to control the serious problem of counterfeit medicines in Peru.
Assuntos
Medicamentos Falsificados , Fraude/tendências , Humanos , Peru , Saúde Pública , Estudos RetrospectivosRESUMO
La leucemia/linfoma de células T del adulto ( Adult T-Cell Leukemia/Lymphoma , ATLL) es una neoplasia maligna de los linfocitos T CD4 maduros, que resulta de la infección con el virus T-linfotrópico humano de tipo 1 (HTLV-1), con varias manifestaciones sistémicas y cutáneas. Se presentan dos casos de leucemia/linfoma de células T del adulto en pacientes del suroccidente de Colombia, cuyos diagnósticos fueron confirmados por histología, inmunohistoquímica, citometría de flujo y pruebas ELISA y Western blot. También, se discute acerca del virus y cómo hacer el diagnóstico en países como el nuestro.
Adult T-cell leukemia/lymphoma (ATLL) is a malignant neoplasia of mature CD4+ T lymphocytes,resulting from infection with human T-lymphotropic virus type 1 (HTLV-1), with several systemic and cutaneous manifestations. We present two cases of adult T-cell leukemia/lymphoma, in patients from the Colombian Southwestern region, whose diagnoses were confirmed by histology, immunohistochemistry, flow cytometry, ELISA and Western blot tests. We also discuss about the virus and how to make this diagnosis in countries like Colombia.
Assuntos
Idoso , Feminino , Humanos , Pessoa de Meia-Idade , Leucemia-Linfoma de Células T do Adulto/diagnóstico , ColômbiaRESUMO
Adult T-cell leukemia/lymphoma (ATLL) is a malignant neoplasia of mature CD4+ T lymphocytes,resulting from infection with human T-lymphotropic virus type 1 (HTLV-1), with several systemic and cutaneous manifestations. We present two cases of adult T-cell leukemia/lymphoma, in patients from the Colombian Southwestern region, whose diagnoses were confirmed by histology, immunohistochemistry, flow cytometry, ELISA and Western blot tests. We also discuss about the virus and how to make this diagnosis in countries like Colombia.
Assuntos
Leucemia-Linfoma de Células T do Adulto/diagnóstico , Idoso , Colômbia , Feminino , Humanos , Pessoa de Meia-IdadeRESUMO
Las neoplasias del oído medio son lesiones raras que, generalmente, plantean retos diagnósticos por la escasa información existente sobre su biología y la carencia de uniformidad de criterios para su análisis. Se presenta el caso de un tumor de oído observado clínicamente en el canal auditivo externo, el cual protruía del oído medio a través del tímpano, y en cuyo espécimen de resección se encontró un tumor epitelial benigno con una de sus superficies revestida por epitelio escamoso. La escasa información clínica inicial incrementó la dificultad diagnóstica y para su diagnóstico se requirió apoyo en técnicas de histoquímica e inmunohistoquímica. El diagnóstico definitivo fue adenoma del oído medio. Además, se hace una revisión del tema y se plantean algunas claves diagnósticas sobre este tipo de lesiones.
Middle ear neoplasms are rare lesions and difficult to diagnose due to limited information about their biology and the lack of standard criteria for their analysis. Herein, a middle ear neoplasm is described that became apparent because of its appearance in the external ear duct as it protruded from the middle ear through the eardrum. Following resection, the specimen was determined to be a benign epithelial tumor. Absence of adequate clinical information complicated the diagnosis; therefore, histochemistry and immunohistochemistry analyses were necessary to reach the final diagnosis of middle ear adenoma. Diagnostic criteria are proposed to properly diagnose these types of lesions.
Assuntos
Adenoma/patologia , Tumor Carcinoide , Diagnóstico Diferencial , Orelha Média , Imuno-HistoquímicaRESUMO
Middle ear neoplasms are rare lesions and difficult to diagnose due to limited information about their biology and the lack of standard criteria for their analysis. Herein, a middle ear neoplasm is described that became apparent because of its appearance in the external ear duct as it protruded from the middle ear through the eardrum. Following resection, the specimen was determined to be a benign epithelial tumor. Absence of adequate clinical information complicated the diagnosis; therefore,histochemistry and immunohistochemistry analyses were necessary to reach the final diagnosis of middle ear adenoma. Diagnostic criteria are proposed to properly diagnose these types of lesions.
Assuntos
Adenoma , Neoplasias da Orelha , Orelha Média , Adenoma/patologia , Adulto , Neoplasias da Orelha/patologia , Feminino , HumanosRESUMO
Introducción: El síndrome de muerte súbita en los deportistas de alto rendimiento es una situación de rara presentación, con alto impacto social, que plantea muchos interrogantes sobre los conceptos de salud y enfermedad.Objetivo: Revisar la literatura relacionada con el síndrome de muerte súbita en deportistas buscando generar algunas recomendaciones útiles para detectar condiciones patológicas que amenazan la vida de los atletas. Resultado: Se identificó una lista extensa de condiciones relacionadas principalmente con alteraciones cardíacas que pueden desencadenar la muerte al ejecutar ejercicios de alta exigencia. Del mismo modo, otras condiciones igualmente importantes inherentes a la actividad física o las características medioambientales en que se practica deporte pueden desencadenar el síndrome de muerte súbita. Conclusión: La muerte súbita en deportistas es una condición modificable con el conocimiento de las causas predisponentes en cada atleta y con la implementación de políticas de salud pública que mejoren el acceso a medidas de salvamento ante la presencia de colapso cardiovascular.
Introduction: The sudden death syndrome in high-performance athletes is a rare condition, highly worrisome,which asks lots of questions about health and illness concepts. Objetive: To review relevant literature about sudden death syndrome in athletes looking for suggesting some recommendations to detect diseases that threat the life. Results: It was identified a list of diseases related to the heart that can trigger deaths when high-demanding exercises are performed. Furthermore, other important issues related to the physical activity or environmental factors can set off the sudden death syndrome. Conclusions: The sudden death in athletes is a modifiable situation through knowing predisposing causes in everyone and implementing public health policies that improve the access to salvage equipment when cardiac arrests occur.