RESUMO
Administration of ethanol (8%) or acetone (1%) to nursing dams in the drinking water, for 10 days, increased the nephrotoxicity of paracetamol (APAP) in the 14-day-old lactating offspring. The percentage of proximal tubular cells with evidence of necrotic damage in male rats was higher in those animals that received APAP (500 mg/kg, i.p.) and whose nursing rats were exposed to ethanol (25. 0 +/- 8.4%) or acetone (17.2 +/- 1.2%), than in the group treated with APAP alone (10.6 +/- 1.6%). The activity of urinary N-acetylglucuronidase was also significantly higher in the rats exposed translactationally to ethanol or acetone than in animals treated with the APAP alone. Nephrotoxicity showed a sexual dimorphic pattern with a higher toxicity in male than in female rats. The percentage of necrotic tubules in the male rats not exposed to inductor was 10.6 +/- 1.6%, and in female rats 5.0 +/- 1.4% (p < 0. 05). Animals exposed to ethanol or acetone and treated with APAP showed less weight gain than the group treated only with APAP. Our results suggest that renal toxicity is enhanced in the nursing animals that were exposed, via maternal milk, to ethanol or acetone (inductors of cytochrome P4502E1), than in the control animals. This circumstance may be relevant in alcoholic women while they are lactating.
Assuntos
Acetaminofen/intoxicação , Etanol/administração & dosagem , Rim/efeitos dos fármacos , Lactação/fisiologia , Acetona/administração & dosagem , Acetona/farmacologia , Animais , Animais Lactentes , Sinergismo Farmacológico , Etanol/farmacologia , Feminino , Glucuronidase/urina , Rim/patologia , Masculino , Ratos , Ratos Wistar , Caracteres SexuaisRESUMO
The results of 114 fine-needle aspiration biopsies (FNAB) of the liver performed during six years (1987-1992) at the Departament of Pathology of the Instituto Nacional de la Nutrición Salvador Zubirán are presented. All were done by radiologists under ultrasonographic (three cases) or computerized tomographic guidance (111 cases). In order to determine the diagnostic accuracy, diagnoses made by FNAB were compared with those made by histological examination (coarse biopsies or surgical specimens) and/or by other diagnostic procedures including the clinical follow-up. Six cases were excluded because clinical information was not available. In 92 cases (85.2%) a correct diagnosis was made, in six (5.5%) the sample was inadequate and in 10 (9.3%) the diagnosis made by FNAB was incorrect. The diagnoses made were as follows: hepatocarcinoma 44, metastatic carcinoma 27, inflammatory lesions 12, regeneration 10, normal eight, unclassified carcinoma five, and lymphoma two. The sensitivity was 96.2, specificity 93.1, positive predictive value 97.4, negative predictive value 90.0, accuracy 95.3 and prevalence 73.1. There were three false negative and two false positive for carcinoma. These figures are similar to those found by other authors. No relevant complications were observed. It is concluded that FNAB of the liver is a safe, inexpensive and reliable method in the diagnoses of liver masses.
Assuntos
Biópsia por Agulha , Hepatopatias/patologia , Fígado/patologia , Humanos , Valor Preditivo dos TestesRESUMO
Solitary rectal ulcer syndrome (SRUS) is an unusual disorder which is seldom seen in our hospital. Considerable uncertainly remains concerning the cause, natural history, and management of this condition. During 1980-1992 period, 7 patients were seen at the Instituto Nacional de la Nutrición and the diagnosis was established on histological, sigmoidoscopic and clinical grounds. Most of the patients suffered rectal bleeding, abdominal pain, straining at defecation, tenemus and rectal mucus discharge. Laboratory results were non specific. Eighty-five percent has macroscopic ulcerations and these were found within 5.2 cm of the anal margin and usually situated anteriorly. Neither medical nor local surgical treatment consistently achieved relief of symptoms or healing of the lesion.
Assuntos
Doenças Retais/diagnóstico , Adolescente , Adulto , Biópsia , Criança , Colonoscopia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Sigmoidoscopia , Síndrome , Úlcera/diagnósticoRESUMO
Comparison of clinical and autopsy findings of the cases studied between 1984 and 1988, were made at the Department of Pathology of the Instituto Nacional de la Nutricion Salvador Zubiran in Mexico City. The goal was to determine the accuracy of clinical diagnoses. The total number of cases was 429. A decreasing number of autopsies as a function of time was observed. Thus, in 1985, 34.65% of the deaths was autopsied, whereas in 1988, the number dropped to 21.16%, overall mean of 27.31%. In 229 autopsies (53.8%), 353 findings of clinical significance were found; of these, 86 were in the main diagnoses and 267 in the causes of death. There were 171 overdiagnoses with therapeutic implications, 38 in the main diagnoses and 133 in the causes of death. Overdiagnoses and underdiagnoses were most common in infectious diseases, followed by respiratory and digestive diseases, while endocrinologic and rheumatologic diseases had the highest diagnostic concordance. It was also found that the diagnostic accuracy did not improve with time of hospitalization. A brief analyses of the probable causes of the decrease in the number of autopsies is made. It is concluded that, in spite of the great advances in clinical and technological knowledge, the high frequency of disagreements between clinical and anatomical diagnoses, indicate that autopsy continues playing a key role in the quality control of medical practice. This justifies by itself the performance of necropsies.
Assuntos
Autopsia , Diagnóstico , Academias e Institutos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Autopsia/estatística & dados numéricos , Causas de Morte , Criança , Pré-Escolar , Grupos Diagnósticos Relacionados , Erros de Diagnóstico , Estudos de Avaliação como Assunto , Feminino , Humanos , Lactente , Recém-Nascido , Tempo de Internação , Masculino , México , Pessoa de Meia-Idade , Estudos RetrospectivosAssuntos
Paralisia Facial/complicações , Granuloma/microbiologia , Hepatopatias/microbiologia , Linfoma Difuso de Grandes Células B/patologia , Adulto , Candidíase/complicações , Candidíase/patologia , Granuloma/complicações , Granuloma/patologia , Hepatite/complicações , Hepatite/patologia , Humanos , Hepatopatias/complicações , Hepatopatias/patologia , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/patologia , Linfoma Difuso de Grandes Células B/complicações , Masculino , Neoplasias Esplênicas/complicações , Neoplasias Esplênicas/patologia , Tuberculoma/complicações , Tuberculoma/patologia , Tuberculose Hepática/complicações , Tuberculose Hepática/patologiaRESUMO
Between 1978-1990 three patients were surgically treated with different kinds of intestinal endometriosis at the Instituto Nacional de la Nutrición Salvador Zubirán in Mexico City. The first patient had acute appendicitis without dysmenorrhea or pelvic endometriosis detected during laparotomy. The second patient had incomplete intestinal obstruction related to ileo-cecal involvement. She clinically had dysmenorrhea and were found multiple endometriosis implants during operation. After the ileocecal excision suppressive hormonal therapy was given, the patient developed side effects, then surgical resection of the uterus and ovaries were performed. The third patient was a 48-year-old woman who developed a progressive lower intestinal obstruction. She underwent a three-time operative procedure. Lower sigmoid resection was performed and no endometriosis implants or metastatic disease were found. Postoperative course was uneventful in all patients, no mucosal involvement or associated carcinoma was found. Surgical resection of the affected portions of the bowel was highly effective in each case.
Assuntos
Endometriose/cirurgia , Neoplasias Intestinais/cirurgia , Adulto , Neoplasias do Apêndice/patologia , Neoplasias do Apêndice/cirurgia , Endometriose/patologia , Feminino , Humanos , Neoplasias do Íleo/patologia , Neoplasias do Íleo/cirurgia , Valva Ileocecal , Neoplasias Intestinais/patologia , Metástase Linfática , Pessoa de Meia-Idade , Neoplasias do Colo Sigmoide/patologia , Neoplasias do Colo Sigmoide/cirurgiaRESUMO
A case of sensory neuropathy secondary to prolonged administration of metronidazole (MT) and tinidazole (TNZ) is reported. The patient received in the 6 months prior to admission, enough cumulative MT and TNZ to explain the development of a secondary neuropathy as reported in the literature. The present case is particularly interesting due to the length of evolution (38 months) which is the most prolonged reported up to now. It is also the first MT and TNZ neuropathy case reported in Spanish.