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Resumen: Objetivo: Identificar mediante un cuestionario de signos y síntomas vasovagales a donadores de sangre, con el fin de registrar los antecedentes que aumentan la probabilidad de presentar reacciones vasovagales. Materiales y Métodos: Se aplico un cuestionario a donadores de sangre, durante tres meses, en el banco de sangre en una institución de salud de tercer nivel. Resultados: El 100% de los donadores respondió negativamente a las preguntas del cuestionario, pero el 1.3% de ellos presentaron reacción vasovagal, siendo el mareo, palidez y náusea el signo y síntomas más frecuentemente mostrados. Al comparar dos grupos con y sin reacción vasovagal pareados por sexo, edad e índice de masa corporal, no hubo diferencias entre ellos. Conclusiones: Los donadores en nuestro país son fundamentalmente de reemplazo, por lo que se debe considerar esta circunstancia además de sus motivaciones, para el diseño de encuestas dirigidas a esta población.
Abstract: Objective: Identify, trough a vasovagal signs and symptoms questionnaire, blood donors in order to record the antecedents that increases the probability of presenting vasovagal reactions. Materials and Methods: A questionnaire was applied to blood donors, for three months, in the blood bank in a third-level health institution. Results: 100% of the donors answered negatively to the questions in the questionnaire, but 1.3% of them presented vasovagal reaction, with dizziness, pallor and nausea being the most frequently shown sing and symptoms. When comparing two groups with and without vasovagal reaction matched by sex, age and body mass index, there were no differences between them. Conclusions: Donors in our country are fundamentally replacement donors, so this circumstance plus their motivations should be considered for the design of surveys aimed at this population.
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Blood safety has been of paramount concern worldwide over the last decades, and Latin America and Mexico are no exception. Factors of utmost importance include the use of highly efficient screening tests and the encouragement of voluntary donation. This review summarizes the current situation in Latin America and particularly in Mexico with respect to these key issues. Except for some specific regions, there is a lack of progress of voluntary donation in Mexico compared with other Latin American countries. A more efficient voluntary donation system could provide donors with lower prevalence of infectious agents such as human immunodeficiency, hepatitis B, and hepatitis C viruses. In Latin America, and specifically in countries such as Argentina, Brazil and Nicaragua, voluntary donation and blood safety are strongly encouraged. However, to date, in Mexico there has not been a specific blood safety project because of fragmentation of the health system model with structural differences among organisations. Although national policies are established to grant health coverages in Mexico, blood safety is still limited and outdated because of oversights in technical fields and regulations. Individual molecular biological tests for donor screening have recently been incorporated into the Mexican national regulations. Although the routine use of these tests as part of effective donor screening is still not compulsory, it is enabling a progressive improvement of blood safety.
Assuntos
Segurança do Sangue , Doadores de Sangue , Infecções por HIV/epidemiologia , Hepatite B/epidemiologia , Hepatite C/epidemiologia , Humanos , América Latina/epidemiologia , México/epidemiologia , PrevalênciaRESUMO
BACKGROUND: Ischemic heart disease, cerebrovascular accident, and venous thromboembolism have the presence of a thrombotic event in common and represent the most common causes of death within the population. OBJECTIVE: Since Schiff base copper(II) complexes are able to interact with polyphosphates (PolyP), a procoagulant and potentially prothrombotic platelet agent, we investigated the antiplatelet aggregating properties of two novel tridentate Schiff base ligands and their corresponding copper( II) complexes. METHODS: The Schiff base ligands (L1) and (L2), as well as their corresponding copper(II) complexes (C1) and (C2), were synthesized and characterized by chemical analysis, X-ray diffraction, mass spectrometry, and UV-Visible, IR and far IR spectroscopy. In addition, EPR studies were carried out for (C1) and (C2), while (L1) and (L2) were further analyzed by 1H and 13C NMR. Tests for antiplatelet aggregation activities of all of the four compounds were conducted. RESULTS: X-ray diffraction studies show that (L1) and (L2) exist in the enol-imine tautomeric form with a strong intramolecular hydrogen bond. NMR studies show that both ligands are found as enol-imine tautomers in CDCl3 solution. In the solid state, the geometry around the copper(II) ion in both (C1) and (C2) is square planar. EPR spectra suggest that the geometry of the complexes is similar to that observed in the solid state by X-ray crystallography. Compound (C2) exhibited the strongest antiplatelet aggregation activity. CONCLUSION: Schiff base copper(II) complexes, which are attracting increasing interest, could represent a new approach to treat thrombosis by blocking the activity of PolyP with a potential anticoagulant activity and, most importantly, demonstrating no adverse bleeding events.
Assuntos
Complexos de Coordenação/química , Complexos de Coordenação/farmacologia , Cobre/química , Inibidores da Agregação Plaquetária/química , Inibidores da Agregação Plaquetária/farmacologia , Agregação Plaquetária/efeitos dos fármacos , Adulto , Humanos , Masculino , Pessoa de Meia-Idade , Bases de Schiff/química , Adulto JovemRESUMO
BACKGROUND: Postprandial triglyceridemia may transitory affect the structure of HDL subclasses and probably their antiatherogenic properties but little is known in this field. We analyzed the HDL subclasses lipid content along postprandial period. METHODS: Fifteen metabolic syndrome (MS) patients and 15 healthy controls were enrolled. HDL were isolated from plasma samples obtained at fasting and every 2-h up to 8-h, after a 75-g fat meal. Cholesterol (C), triglycerides (TAG), and phospholipid (Ph) plasma concentrations of five HDL subclasses were determined by densitometry of electrophoresis gels enzymatically stained. RESULTS: The increase of postprandial triglyceridemia expressed as the incremental area under the curve (iAUC) was twice in MS patients than in controls. Only large HDL2b-TAG were higher in MS than controls at 4, 6 and 8h after meal intake, whereas cholesterol of HDL2a, 3a and 3b were lower at 8h. HDL size distribution shifted towards large HDL and HDL3a-, 3b- and 3c-subclasses had a lower content of cholesterol (estimated by the C-to-Ph ratio) in subjects whose iAUC>289.5mgh/dl (n=15) in comparison with those subjects with iAUC below this cutoff point (n=15), independently of the MS status and fasting TAG. Triglycerides content of HDL subclasses changed only discreetly along the postprandial period, whereas paraoxonase-1 remained unchanged. CONCLUSIONS: A high postprandial triglyceridemia conditions the shift of HDL size distribution towards large particles and the decrease of cholesterol in HDL3 subclasses. These data demonstrate that postprandial hypertriglyceridemia contributes to a transitory hypoalphalipoproteinemia that may increase the risk of cardiovascular disease.
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Colesterol , Dieta Hiperlipídica , Hipertrigliceridemia/sangue , Lipoproteínas HDL/sangue , Lipoproteínas HDL/química , Período Pós-Prandial , Adulto , Idoso , Dieta Hiperlipídica/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
BACKGROUND: The origin (native or non-native) of Trypanosoma cruzi strains used as substrate for immunoassays may influence their performance. OBJECTIVE: To assess the performance of an immunoassay based on a native T. cruzi strain compared to another based on non-native T. cruzi strains, in asymptomatic blood donors from Mexico. METHODS: Serum samples from a tertiary referral center were tested by both ELISA-INC9 (native) and Chagatest (non-native) assays. All reactive serum samples were further analyzed by indirect immunofluorescence. RESULTS: Sera from 1,098 asymptomatic blood donors were tested. A 4.3 and 0.7% serum reactivity prevalence was observed using ELISA-INC9 and Chagatest, respectively (kappa = 0.13; -0.11 to 0.38). Subsequently, indirect immunofluorescence analyses showed higher positivity in serum samples reactive by ELISA-INC9 compared to those reactive by Chagatest (79 vs. 62.5%; p < 0.001). Furthermore, out of the 47 positive samples by both ELISA-INC9 and indirect immunofluorescence, only four (8.5%) were reactive in Chagatest assay. Meanwhile, four (80%) out of the five positive samples by both Chagatest and indirect immunofluorescence were reactive using ELISA-INC9. CONCLUSION: Immunoassays based on a native T. cruzi strain perform better than those based on non-native strains, highlighting the need to develop and validate screening assays in accordance to endemic T. cruzi strains.
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Doadores de Sangue , Doença de Chagas/diagnóstico , Imunoensaio/métodos , Trypanosoma cruzi/isolamento & purificação , Doença de Chagas/parasitologia , Ensaio de Imunoadsorção Enzimática/métodos , Técnica Indireta de Fluorescência para Anticorpo/métodos , Humanos , México , Testes Sorológicos/métodos , Especificidade da EspécieRESUMO
BACKGROUND AND AIMS: Secreted frizzled-related protein 5 (SFRP5) was recently described as a new adipokine protective for hepatic steatosis and other obesity-related complications in the mouse model. To date, SFRP5 expression in non-alcoholic fatty liver disease (NAFLD) has not been fully assessed in humans. We measured circulating SFRP5 levels and its expression in liver and adipose tissue, and evaluated its association with NAFLD in morbidly obese women. MATERIAL AND METHODS: Fifty-four morbidly obese women undergoing bariatric surgery were included in the study. Liver biopsies were used for histology and hepatic triglyceride content quantification. Circulating SFRP5 levels were measured through enzyme-linked immunoabsorbent assay, and SFRP5 expression was performed in hepatic and adipose tissue (subcutaneous and visceral). RESULTS: Although circulating SFRP5 levels showed a tendency to decrease with NAFLD progression, no significant differences were observed among non-alcoholic steatosis, steatohepatitis, and control subjects. Hepatic SFRP5 expression showed a negative correlation with hepatic triglyceride content (r = -0.349, P = 0.016 for mRNA and r = -0.291, P = 0.040 for SRFP5 protein) and ALT serum levels (r = -0.437, P = 0.001 for SRFP5 protein). In addition, hepatic SFRP5 protein levels were significantly lower in NASH than in control subjects (P = 0.006). CONCLUSION: This is the first study reporting an association of hepatic SFRP5 expression with NAFLD in humans.
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Proteínas do Olho/análise , Fígado/química , Proteínas de Membrana/análise , Hepatopatia Gordurosa não Alcoólica/etiologia , Obesidade Mórbida/complicações , Proteínas Adaptadoras de Transdução de Sinal , Adulto , Cirurgia Bariátrica , Biópsia , Estudos Transversais , Regulação para Baixo , Ensaio de Imunoadsorção Enzimática , Proteínas do Olho/sangue , Proteínas do Olho/genética , Feminino , Humanos , Imuno-Histoquímica , Gordura Intra-Abdominal/química , Proteínas de Membrana/sangue , Proteínas de Membrana/genética , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/diagnóstico , Hepatopatia Gordurosa não Alcoólica/genética , Hepatopatia Gordurosa não Alcoólica/metabolismo , Obesidade Mórbida/diagnóstico , Obesidade Mórbida/cirurgia , Reação em Cadeia da Polimerase , RNA Mensageiro/genética , Índice de Gravidade de Doença , Gordura Subcutânea/química , Triglicerídeos/análise , Adulto JovemRESUMO
Acute coronary syndromes (ACS) may be triggered by acute infections. Systemic production of interferon gamma (IFN-γ) is induced during infection and regulates the production of matrix metalloproteinases (MMPs) and their inhibitors (TIMPs), both important in plaque stability. This study evaluates the effect of IFN-γ on the MMPs/TIMP-1 ratio in cultured monocytes from 30 patients with stable coronary artery disease (CAD), 30 with unstable angina (UA) or non-ST-segment elevation myocardial infarction (NSTEMI), and 30 healthy blood donors. Supernatant concentrations of MMP-1, -2, -9, and TIMP-1 were measured by enzyme-linked immunoassays. Basal concentration of MMP-1 and TIMP-1 was similar between groups, while MMP-2 was higher in healthy individuals and MMP-9 in patients with UA/NSTEMI. Upon IFN-γ stimulation, MMP-9 secretion increased in all groups, while TIMP-1 decreased only in patients with CAD, which in turn result in a strikingly elevation in their mean MMP-9/TIMP-1 ratio. MMP-1/TIMP-1 and MMP-2/TIMP-1 ratios were <1.0 in basal conditions and after stimulation in all groups. Our results suggest that nonstimulated monocytes from patients with stable CAD show a similar behavior than those from healthy individuals. However, stimulation with IFN-γ induces an increase on the MMP-9/TIMP-1 ratio as high as that found in patients with ACS. Thus, it may bring biological plausibility to the association between acute infections and the development of ACS.
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Doença da Artéria Coronariana/metabolismo , Interferon gama/farmacologia , Metaloproteinase 9 da Matriz/metabolismo , Monócitos/efeitos dos fármacos , Monócitos/metabolismo , Inibidor Tecidual de Metaloproteinase-1/metabolismo , Adulto , Idoso , Idoso de 80 Anos ou mais , Doença da Artéria Coronariana/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
BACKGROUND AND AIMS: Non-alcoholic fatty liver disease (NAFLD) and elevated alanine transaminase (ALT) levels are common in obese Hispanic adults and children. Recently, a PNPLA3 gene variant (I148M) was strongly associated with NAFLD and higher ALT levels in obese adults, including Hispanics. The aims of this study were to estimate the frequency of elevated ALT levels, and to address the influence of obesity and PNPLA3/I148M on ALT levels in a general population sample of Mexican school-aged children. METHODS: A total of 1037 non-related Mexican children aged 6 to 12 years were genotyped for the I148M variant. Anthropometric, clinical and metabolic parameters were collected from all participants. RESULTS: Elevated ALT levels (>35 U/L) were more frequent in obese (26.9%) and overweight (9.3%) than in normal weight children (2.2%). The M148M genotype was significantly associated with elevated ALT levels in this population (OR=3.7, 95% CI 2.3-5.9; P=3.7×10(-8)), and children carrying the M148M genotype showed significantly lower HDL cholesterol levels and BMI z-core (P=0.036 and 0.015, respectively). On stratifying by BMI percentile, this genotype conferred a much greater risk of elevated ALT levels in normal weight (OR=19.9, 95% CI 2.5-157.7; P=0.005) than overweight and obese children (OR=3.4, 95% CI 1.3-8.9; P=0.014 and OR=3.1, 95% CI 1.7-5.5; P=1.4 x10(-4), respectively). CONCLUSIONS: The I148M PNPLA3 variant is strongly associated with elevated ALT levels in normal weight and overweight/obese Mexican children. Thus, the M148M genotype may be considered as an important risk factor for liver damage in this population.
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Alanina Transaminase/sangue , Peso Corporal Ideal , Lipase/genética , Proteínas de Membrana/genética , Obesidade/genética , Sobrepeso/genética , Polimorfismo de Nucleotídeo Único/fisiologia , Idade de Início , Alanina Transaminase/análise , Substituição de Aminoácidos/genética , Estudos de Casos e Controles , Criança , Feminino , Estudos de Associação Genética , Humanos , Peso Corporal Ideal/genética , Peso Corporal Ideal/fisiologia , Isoleucina/genética , Hepatopatias/sangue , Hepatopatias/epidemiologia , Hepatopatias/genética , Masculino , Metionina/genética , México/epidemiologia , Obesidade/sangue , Obesidade/epidemiologia , Obesidade/etnologia , Sobrepeso/sangue , Sobrepeso/epidemiologia , Sobrepeso/etnologiaRESUMO
MicroRNAs have emerged as key regulators of immune responses. They influence immune cells' function and probably the outcome of several infections. Currently, it is largely unknown if helminth parasites and their antigens modify host microRNAs expression. The aim of this study was to explore if excreted/secreted antigens of Taenia crassiceps regulate LPS-induced miRNAs expression in human dendritic cells. We found that these antigens repressed LPS-let-7i induction but not mir-146a or mir-155 and this correlates with a diminished inflammatory response. This let-7i downregulation in dendritic cells constitutes a novel feature of the modulatory activity that helminth-derived antigens exert on their host.
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Antígenos de Helmintos/imunologia , Células Dendríticas/metabolismo , Equinococose/imunologia , Regulação da Expressão Gênica , MicroRNAs/metabolismo , Taenia/imunologia , Animais , Citocinas/imunologia , Células Dendríticas/imunologia , Inativação Gênica , Humanos , Lipopolissacarídeos , MicroRNAs/genética , Monócitos/imunologiaRESUMO
Transfusion-related acute lung injury (TRALI) is a syndrome characterized by acute respiratory distress following the transfusion of blood components. The pathophysiological hallmark of TRALI is increased pulmonary microvascular permeability. Several reports demonstrate that the majority of TRALI cases are precipitated by transfusion of donor antibodies directed against HLA (human leukocyte antigens) or HNA (human neutrophil antigens) expressed on the neutrophils' surface of the recipient. This antibody-antigen interaction is thought to directly cause neutrophils activation and release of cytotoxic agents, with subsequent endothelial damage and capillary leak. Following plasma transfusion is an important and underreported adverse event. Some blood centers have limited the collection of plasma from female donors due to their propensity for developing anti HLA antibodies after pregnancy.
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Reação Transfusional , Lesão Pulmonar Aguda/etiologia , Feminino , Humanos , Masculino , Fatores de Risco , Fatores SexuaisRESUMO
Thirteen Trypanosoma cruzi isolates from different geographic regions of Mexico and Guatemala belonging to discrete typing unit (DTU) I and a reference CL-Brener (DTU VI) strain were used to perform enzyme-linked immunosorbent assay (ELISA) and polymerase chain reaction (PCR). A panel of 57 Mexican serum samples of patients with chronic chagasic cardiopathy and asymptomatic infected subjects (blood bank donors) were used in this study. DNA from the above 14 T. cruzi strains were extracted and analyzed by PCR using different sets of primers designed from minicircle and satellite T. cruzi DNA. The chronic chagasic cardiopathy serum samples were easily recognized with ELISA regardless of the source of antigenic extract used, even with the CL-Brener TcVI, but positive serum samples from blood bank donors in some cases were not recognized by some Mexican antigenic extracts. On the other hand, PCR showed an excellent performance despite the set of primers used, since all Mexican and Guatemalan T. cruzi strains were correctly amplified. In general terms, Mexican, Guatemalan, and CL-Brener T. cruzi strains are equally good sources of antigen when using the ELISA test to detect Mexican serum samples. However, there are some strains with poor performance. The DTU I strains are easily detected using either kinetoplast or satellite DNA target designed from DTU VI strains.
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Antígenos de Protozoários/sangue , Cardiomiopatia Chagásica/diagnóstico , Ensaio de Imunoadsorção Enzimática/normas , Reação em Cadeia da Polimerase/normas , Trypanosoma cruzi/imunologia , Doadores de Sangue , Cardiomiopatia Chagásica/sangue , Primers do DNA , DNA de Protozoário/sangue , Guatemala , Humanos , México , Trypanosoma cruzi/isolamento & purificaçãoRESUMO
Background. Previous reports have shown that undernourished children with acute lymphoblastic leukemia (ALL) have a poorer long-term survival as compared withchildren with normal nourishment status. It has been shown that both the relapse and mortality rates of undernourished children with ALL are higher during the continuation phase of the chemotherapy and are apparently related to a poor tolerance of ablative chemotherapy. No previous artichles have analyzed the aerly mortality rate of these patients. Methods. We carried out a case-control study, and have studied the effect of severe malnutrition on the mortality of 17 children with ALL during the initial induction-to-remission phase of the treatment. These 17 cases were compared with 76 controls who had survived at least the phases of induction and consolidation. Results. It was found that the chance of dying during the initial phase of the treatment was 2.6 times higher (confidence interval 95 percent: 0.55-11.89) in undernourished children with ALL than in those children with normal nourishment status. The risk of death increades with the severity of undernorisment (p= 0.04). Conclusions. These data confirm the prognostic value of malnutrition in children with ALL and suggest that undernourishment may also influence aerly mortality during the induction-to-remission phase of the treatment
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Humanos , Masculino , Feminino , Pré-Escolar , Adolescente , Leucemia-Linfoma Linfoblástico de Células Precursoras/complicações , Progressão da Doença , Indução de Remissão , Transtornos da Nutrição Infantil/etiologia , Estudos de Casos e Controles , PrognósticoRESUMO
Background. The aim of this paper is to present the epidemiological characteristics of time, subject and place of lymphomas in children residing in Mexico City, Mexico (MC). Methods. The type of study was a retrospective hospital survey. All records of children with lymphomas registered between 1982 and 1991 at the main hospitals that treat children with cancer in MC were reviewed. Neoplasms were classified into Hodgkin's disease (HD) and non-Hodgkin's lymphomas (NonHL). Trend and incidence by sex, age and area of residence in MC were evaluated. Time of diagnosis, as well as parental occupation and educational level, were registered. Results. A trend was only observed for HD in the total group (r:0.62; P=0.05). In 1991, incidence for HD was 6.12 (rates x 10 at 6) and 3.87 for NonHL. The highest average incidence was found in children 5-9 years of age (5.40= for HD, and in the age groups of 1-4 and 5-9 (3.10 and 3.33, respectively), for NonHL. Incidence was higher among boys for both lymphoma categories, but the male-to-female ratio was much higher in HD. Time of diagnosis, incidence in terms of place of residence, and parental educational level and occupation also differed from one lymphoma category to the other. Conclusion. The epidemiology of HD is different from that of NonHL, both showing a pattern similar to that of Latin American children
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Humanos , Masculino , Feminino , Pré-Escolar , Diretório , Incidência , Linfoma/epidemiologia , Estudos Retrospectivos , México/epidemiologiaRESUMO
La anemia es un problema frecuente en la consulta diaria. Se presenta cuando el nivel de hemoglobina es inferior al considerado como límite normal, de acuerdo a: edad, sexo y altura sobre el nivel del mar. La medición de la hemoglobina y el examen del frotis de sangre periférica proporciona información necesaria para identificar los principales tipos de anemia. El conocer las causas prevalentes de la anemia puede ayudar a simplificar el estudio y establecer las causas en los grupos de población vulnerable. Fisiopatogenia de la anemia. La constancia en la cifra de hemoglobina dentro de los límites de variación en personas sanas, alimentadas adecuadamente, implica la existencia de un equilibrio entre la remoción diaria de glóbulos rojos que alcanzaron el límite de su vida y la formación de la misma cantidad por día en la médula ósea. Este equilibrio depende de los requerimientos de oxígeno a nivel de los tejidos y de la acción de la eritropoyetina, a condición desde luego de que la médula sea normal, anatómica y funcionalmente, que se cuente con los nutrientes requeridos y que la persona no padezca una condición patológica que interfiera con la eritropoyesis. La clasificación fisiopatogénica es útil y permite determinar el origen de la anemia, tomando en cuenta el aspecto etiológico. La anemia por deficiencia de hierro se desarrolla en pacientes quienes se han agotado previamente las reservas de hierro; es la causa más común de anemia en el mundo. Etiopatogenia: a) ingesta inadecuada; b) disminución en la absorción y en su utilización y c) sangrado crónico. Tratamiento de anemia: identificar y corregir la causa, transfundir paquete globular ante cifra de hemoglobina menor a 5 g/dL
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Anemia/classificação , Anemia/diagnóstico , Anemia/etiologia , Anemia/fisiopatologia , Anemia/terapia , Hemoglobinas , Hemoglobinas/análise , /etiologiaRESUMO
Las histiocitosis son un grupo de desórdenes clínicos que se presentan en los niños que desde las primeras publicaciones han representado dificultad para el diagnóstico y tratamiento y que hasta la fecha se ha superado al aplicar mejor tecnología para su estudio. El término de malignidad se ha dado por el conocimiento de clonalidad y curso clínco agresivo. El histiocito forma parte del sistema fagocítico mononuclear y del sistema efecto de inmunorregulación (monocito-macrófago y células dendríticas-células de Langerhans). Por tanto, los criterios de clasificación de los síndromes histiocíticos están caracterizados por proliferación reactiva o neoplásica tanto de la línea de los macrófagos como de las células dendríticas/células de Langerhans; tal clasifiación es propuesta por el grupo de estudio de la Sociedad Internacional de Histiocitosis. La anterior denominación de histiocitosis X era relacionada a entidades clínicas y la letra X fue usada como un distintivo de desconocimiento. Los avances en el estudio de las histiocitosis de células de Langerhans fueron la demostración de gránulos de Birbeck que son cuerpos de inclusión visibles (ME) y la positividad al antígeno CD1a. Otro aspecto es la extensión: limitado y extensa o multisistémico; en el pronóstico interviene la edad, el comportamiento progresivo y disfunción orgánica. La estrategia de tratamiento es de acuerdo a la extensión y si presenta disfunción orgánica se debe evaluar si pertence al grupo de alto riesgo para lo cual existen diversos protocolos de quimioterapia. Otro avance en la histiocitosis de células de Langerhans es el posible papel del sistema inmune, la clonalidad, las citoquinas y los virus en su etiopatogenia
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Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Histiocitose de Células de Langerhans/classificação , Histiocitose de Células de Langerhans/patologia , Histiocitose de Células de Langerhans/tratamento farmacológico , PediatriaAssuntos
Criança , Adulto , Humanos , Feminino , Doxorrubicina/administração & dosagem , Doxorrubicina/toxicidade , Cardiopatias/induzido quimicamente , Cardiopatias/complicações , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamento farmacológico , Sarcoma/tratamento farmacológico , Ventrículos do CoraçãoRESUMO
Introducción. La tiflitis es una colitis necrozante con inflamación del ciego en pacientes neutropénicos, usualmente diagnosticada en la autopsia. Material y métodos. identificamos 18 niños hospitalizados en el Hospital Infantil de México Federico Gómez en un período de 10 años, con presencia de fiebre, dolor e hipersensibilidad abdominal sugestiva de tiflitis neutropénica. Resultados. Ocho de los 18 pacientes tenían evidencia radiológica de tiflitis en las radiografías de abdomen. Todos los pacientes presentaron neutropenia al momento del diagnóstico y 9 tenían bacteriemia documentada. Los 18 pacientes fueron tratados con diversos antibióticos, 4 de ellos sometidos a cirugía y 1 a colonoscopia. Once pacientes murieron, 10 se mejoraron médicamente y 1 quirúrgicamente. En orden de frecuencia, la tiflitis fue identificada en 9 pacientes con leucemia aguda no linfoide, en 6 con leucemia aguda linfoide; en 1 con anemia aplásica, neutropenia cíclica y carcinoma renal, respectivamente. Sólo 4 pacientes recibieron factor estimulador de colonias de granulocitos; y en todos los pacientes que sobrevivieron se observó un aumento de leucocitos polimorfonucleares a más de 500/mm3 documentado entre el cuarto y el décimosexto día de manejo médico y/o quirúrgico. Conclusiones. Recomendamos que ante un paciente con fiebre y neutropenia, con dolor e hipersensibilidad abdominal, además de datos como diarrea hematemesis se debe plantear como diagnóstico tiflitis neutropénia e instaurarse el manejo general y específico que incluye la valoración quirúrgica
Assuntos
Criança , Adolescente , Humanos , Masculino , Feminino , Anemia Aplástica/complicações , Bacteriemia/complicações , Bacteriemia/etiologia , Doenças do Ceco/etiologia , Doenças do Ceco/mortalidade , Doenças do Ceco/fisiopatologia , Enterocolite/diagnóstico , Enterocolite/mortalidade , Enterocolite/terapia , Leucemia/complicações , Necrose/etiologia , Necrose/fisiopatologia , Neutropenia/complicações , Neutropenia/fisiopatologiaRESUMO
Se diseñó un estudio comparativo entre niños con anemia aplástica y pacientes con otro tipo de padecimiento, encamados en el hospital. En el estudioo, fue posible observar, que los niños con anemia aplástica procedian de zonas rurales a diferencia de los niños controles que procedian de zonas urbanas marginales. Los resultados en las pruebas señalaron la presencia de un daño y/o disfunción cerebral en los niños con anemia aplástica, además de un cociente intelectual menor en la prueba de Weschler en relación al grupo testigo. Fue posible observar una menor sintomatología de tipo psicológico antes del padecimiento, así como una mejor autoimagen del niño con anemia aplástica en relación al grupo testigo. Sin embargo, no es posible decir si las alteraciones neurológicas observadas en el grupo con anemia aplástica, se presentaron antes o después del padecimiento y si las diferencias en el cociente intelectual entre los grupos son el resultado de las diferencias entre los ambientes socioeconómicos a los que pertenecen cada grupo
Assuntos
Criança , Humanos , Masculino , Feminino , Sintomas Afetivos , Anemia Aplástica/psicologia , Características da Família , Fatores SocioeconômicosRESUMO
En un estudio previo se encontró en las familias de los niños con anemia aplástica, predominio de hogares no integrados, pobreza y alimentación deficiente, por lo que se planteó confirmar o rechazar estos hallazgos mediante un muestro más adecuado, de las familias testigo. Por cada paciente que ingresó al hospital con anemia aplástica, se eligió uno por azar que hubiera ingresado al mismo tiempo, con otro diagnóstico y que comparable en cuanto a sexo y edad. Se explicó a las dos familias el objeto del estudio y los autores investigaron en las dos, características de residencias respectivas, de los padres y de su unión, de la alimentación y de los enfermos desde el punto de vista nutricional. Se estudiaron 30 familias de cada grupo y en los de anemia aplástica se encontró predominio significativo de: residencia proletaria en área no urbana; ausencia de drenaje y de baño individual; fecalismo y convivencia con animales; padres analfabetos; padres que trabajan como campesinos o albañiles; ingestión deficiente de carne, leche, huevo, plátano, naranja, otras frutas y verduras; retraso en la edad ósea y albúmina sérica baja; calificaciones inferiores a 8 y frecuencia de reprobados (paciente y hermanos) y exposición a agentes químicos. Estos datos sugieren que la anemia aplástica en México tiene una etiología multifactorial
Assuntos
Humanos , Anemia Aplástica , Família , Habitação , Ciências da Nutrição , Fatores SocioeconômicosRESUMO
Se presentan dos hermanas con antecedentes de consaguinidad en los padres. Ingresaron al hospital por presentar hepatosplenomegalia y se les efectuó el diagnóstico de linfohistiocitosis hemofagocítica familiar. La primera de las pacientes falleció antes de recibir tratamiento y la segunda recibió tratamiento con vincristina, metrotrexate y prednisona. Se hace una revisión del cuadro clínico e histológico, así como una discusión del diagnóstico diferencial de esta rara enfermedad con otros desórdenes del sistema macrofágico