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ABSTRACT: Aims: To identify the frequency in changes of bone metabolism, including below the average value for age, osteopenia, and osteoporosis, in people living with HIV/AIDS (PLWHA) and to compare the frequency of factors associated with bone mineral density (BMD) and body composition between sex. Methods: This observational study assessed 106 PLWHA (65 male) recruited from the University Hospital of Ribeirão Preto Medical School from 2013 to 2014. BMD was measured using Dual Energy X-ray Absorptiometry (DXA). Standard deviation values for Z- and T-score proposed by the International Society for Clinical Densitometry were adopted to classify participants below the average value for age, osteopenia, and osteoporosis. Qui-square and Fischer's exact tests were employed to compare males and females based on their factors associated with BMD reduction. Results: Fifty-two (49%) PLWHA presented at least one diagnosis for below the average value for age, osteopenia, and osteoporosis, being 37 (57%) and 15 (37%) male and female, respec-tively. Frequency of alcohol consumption was higher in males (n=20; 30.8%) than females (n=05; 12.2%) (p=0.028).Conclusions: A high rate of PLWHA showed changes in bone metabolism, with a higher frequency in males. The fre-quency of alcohol consumption was higher in males, and it may partially explain the possible causes of the increased rates of bone metabolism changes observed in this group. This information may help develop strategies for reducing the frequency of diagnosis for below the average value for age, osteopenia, osteoporosis improving quality of life in PLWHA. (AU)
RESUMO: Objetivos: Identificar a frequência de alterações no metabolismo ósseo, incluindo valores abaixo do estimado para idade, osteopenia e osteoporose, em pessoas vivendo com HIV/Aids (PVHA) e comparar a frequência de fatores associados à redução da densidade mineral óssea (DMO) e composição corporal entre sexos. Métodos: Estudo observacional que ava-liou 106 PVHA (65 do sexo masculino) recrutadas do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo entre os anos 2013 e 2014. A DMO foi medida utilizando a Absorciometria Radiológica de Dupla Energia (DXA). Valores de desvio padrão Z- e T- scores propostos pela Sociedade Internacional para Densitometria Clí-nica foram adotados para classificar os participantes em abaixo do valor estimado para idade, osteopenia e osteoporose. Os testes do qui-quadrado e exato de Fischer foram empregados na comparação entre os sexos baseado em seus respec-tivos fatores associados à redução da densidade mineral óssea. Resultados: Cinquenta e dois (49%) PVHA apresentaram ao menos um diagnóstico para abaixo do valor estimado para idade, osteopenia e osteoporose, sendo 37 (57%) do sexo masculino e 15 (37%) feminino. A frequência de consumo de álcool foi maior no sexo masculino (n=20; 30,8%) compara-do ao feminino (n=5; 12,2%) (p=0,028). Conclusões: Uma alta taxa de PVHA apresentaram alterações no metabolismo ósseo, com maior frequência no sexo masculino. A frequência no consumo de álcool foi maior no sexo masculino, podendo explicar parcialmente as possíveis causas para taxa aumentada de alterações no metabolismo ósseo observada nesse grupo. Essa informação pode contribuir no desenvolvimento de estratégias para redução da frequência do diagnóstico para valores abaixo do estimado para idade, osteopenia e osteoporose, melhorando a qualidade de vida em PVHA
Assuntos
Humanos , Masculino , Feminino , Osteoporose , Doenças Ósseas Metabólicas/diagnóstico , Doenças Ósseas Metabólicas/epidemiologia , Síndrome da Imunodeficiência Adquirida , HIV , Terapia Antirretroviral de Alta Atividade , DensitometriaRESUMO
BACKGROUND: The most frequent sequel to the ankle sprain is the instability of the lateral ligament complex; the results of surgical treatment have not been evaluated with multiple scales simultaneously. The objective of the study was to assess the clinical and functional results with three scales in patients with lateral instability of ankle undergoing Broström-Gould technique, using for fixation, anchors with suture to distal fibula. MATERIAL AND METHODS: The design of the study was cross-sectional and descriptive; we included patients with lateral instability of ankle and partial or complete rupture of the APA or CP ligament subject to repair with Broström-Gould technique. Magnetic resonance imaging was performed to confirm the diagnosis; clinical and functional outcomes were determined with three scales: EVA, SF-36 and AOFAS. Patients were evaluated at six months, or more, after the surgical procedure. RESULTS: We included 13 patients; quality of life (SF-36 questionnaire) showed a good result with average score of 90; 10 (77%) patients showed excellent results in function, absence of pain and alignment of the ankle (AOFAS 90-100). Also found significant improvement in pain (presurgical EVA: 6, compared with 1 in the postoperative period). CONCLUSIONS: The surgical procedure showed excellent results, in the short term with resolution of pain and ankle stability.
ANTECEDENTES: La secuela más frecuente del esguince de tobillo es la inestabilidad del complejo ligamentario lateral; los resultados del tratamiento quirúrgico no han sido evaluados con varias escalas simultáneamente. El objetivo del estudio fue evaluar los resultados clínicos y funcionales con tres escalas en pacientes con inestabilidad lateral de tobillo sometidos a plastía de Broström-Gould, utilizando para su fijación anclas con sutura al peroné distal. MATERIAL Y MÉTODOS: El diseño del estudio fue transversal y descriptivo; se incluyeron pacientes con inestabilidad lateral de tobillo y ruptura parcial o completa del ligamento PAA y/o PC, sometidos a reparación con plastía de Broström-Gould. Se realizó resonancia magnética nuclear para confirmar el diagnóstico; los resultados clínicos y funcionales se determinaron con tres escalas: EVA, SF-36 y AOFAS. Los pacientes fueron evaluados a los seis meses o más posteriores al procedimiento quirúrgico. RESULTADOS: Se incluyeron 13 pacientes; la calidad de vida (cuestionario SF-36) arrojó un resultado bueno con promedio de 90; 10 (77%) pacientes mostraron resultados excelentes en la función, ausencia de dolor y alineación del tobillo (AOFAS 90-100). Asimismo, se observó mejoría importante en el dolor (EVA prequirúrgico: 6, comparado con 1 en el período postquirúrgico). CONCLUSIONES: El procedimiento quirúrgico demostró excelentes resultados en el corto plazo con resolución del dolor y estabilidad del tobillo.
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Traumatismos do Tornozelo , Instabilidade Articular , Ligamentos Laterais do Tornozelo , Traumatismos do Tornozelo/complicações , Traumatismos do Tornozelo/diagnóstico por imagem , Traumatismos do Tornozelo/cirurgia , Articulação do Tornozelo , Estudos Transversais , Humanos , Instabilidade Articular/cirurgia , Qualidade de VidaRESUMO
OBJECTIVES: To propose objective ratios using anthropometry and dual-energy X-ray absorptiometry (DXA) and to suggest cutoff points for them in order to classify lipodystrophy in male patients. METHODS: It is a cross-sectional study. DXA was applied and anthropometric measurements were performed in 100 men on highly active antiretroviral therapy. Receiver operating characteristic curves were used to propose cutoffs. Individuals were divided in without (lipo-) or with (lipo+) lipodystrophy and their metabolic parameters were compared. RESULTS: The following ratios were proposed: fat mass ratio by DXA (FMR), waist thigh ratio (WTR), waist calf ratio (WCR), and arm to trunk ratio (ATR). The best cutoffs observed for FMR, WTR and ATR were 1.26, 1.74 and 2.08, respectively. Using the proposed cutoff for FMR, we observed worse metabolic profile, with increased tryglicerides, fasting serum glucose and more hypercholesterolemia in the lipo+ group. WTR and ATR showed a significant correlation with FMR. CONCLUSIONS: Anthropometric ratios (WTR/ATR) and FMR can be used to aid the diagnosis of lipodystrophy in order to contribute to a more accurate and earlier diagnosis permitting intervention and even preventing metabolic disturbances.
Assuntos
Tecido Adiposo , Composição Corporal , Pesos e Medidas Corporais , Soropositividade para HIV/complicações , Síndrome de Lipodistrofia Associada ao HIV/diagnóstico , Metabolismo dos Lipídeos , Absorciometria de Fóton/métodos , Adulto , Antropometria/métodos , Terapia Antirretroviral de Alta Atividade , Glicemia/metabolismo , Estudos Transversais , Infecções por HIV/complicações , Humanos , Hipercolesterolemia/complicações , Hipercolesterolemia/epidemiologia , Resistência à Insulina , Lipodistrofia/diagnóstico , Lipodistrofia/etiologia , Masculino , Pessoa de Meia-Idade , Curva ROC , Valores de Referência , Triglicerídeos/sangueRESUMO
This study was carried out to evaluate the performance of Brazilian Somalis sheep to natural infections by gastrointestinal nematodes. During 98 days, 75 weaned sheep, initially 3-4 months old, were kept on the same pasture and evaluated. Fecal and blood samples were collected for parasitological and hematological exams. After this period, the eight most resistant and the eight most susceptible animals were selected based on their individual averages of nematode fecal egg counts and were slaughtered for worm burden determination and nematodes identification. Abomasum and abomasum lymph nodes were also recovered for gene expression analysis. The animals selected as resistant had lower fecal egg counts during experimental period and smaller worm burdens than the susceptible ones (P < 0.05). The genus Haemonchus, followed by Trischostrongylus and Oesophagostomum, were identified in composite cultures. Haemonchus contortus was the specie identified in the abomasum. Packed cell volume and total plasma protein means were higher in the resistant group (27.2% and 6.1 g/dL) than in the susceptible one (22.5% and 5.3 g/dL), respectively. Regarding cytokine gene expression, IL-4 (P < 0.05) was up-regulated in the abomasum of resistant animals and TNF-α (P < 0.03) and IFN-γ (P < 0.03) in susceptible ones. In abomasum lymph nodes, IL-4 (P < 0.04) and IL-13 (P < 0.05) were up-regulated in the resistant animals and IFN-γ in the susceptible one (P < 0.01). This work provides further evidence that, within a given animal breed, individuals have different responses when infected by gastrointestinal nematodes. Resistant animals who responded more quickly and efficiently to these infections activated a TH2-type response.
Assuntos
Hemoncose/veterinária , Haemonchus , Doenças dos Ovinos/imunologia , Carneiro Doméstico/parasitologia , Abomaso/parasitologia , Animais , Brasil , Cruzamento , Resistência à Doença/genética , Fezes/parasitologia , Hemoncose/imunologia , Hematócrito/veterinária , Interferon gama/imunologia , Interleucina-13/imunologia , Interleucina-4/imunologia , Masculino , Contagem de Ovos de Parasitas/veterinária , Fenótipo , Ovinos/genética , Ovinos/parasitologia , Doenças dos Ovinos/parasitologia , Carneiro Doméstico/genética , Fator de Necrose Tumoral alfa/imunologiaRESUMO
En este trabajo se presenta un método para medir la variación del calcio intracelular en células foliculares. Esta propuesta consiste en dos etapas: (i) La detección de los núcleos de las células; y (ii) el análisis de las variaciones de fluorescencia. La primera etapa se realiza a través de la transformada modificada de líneas divisoras de agua controlada por marcadores (en inglés: Modified-Watershed Transformation) controlando el proceso de etiquetado de células por el establecimiento de criterios particulares. El proceso de detección homogeniza las condiciones de luminosidad a través de un filtro morfológico y utiliza como descriptores a los bordes de las células. En la segunda etapa, se asocia la variación de la fluorescencia con los cambios de Ca2+ intracelular donde la variación se modela como una función exponencial decreciente. Luego, se presenta un nuevo proceso morfológico, denominado proceso de reconstrucción medio, que permite suavizar los datos para el proceso de modelado. Este proceso utiliza la información del sub modelado y sobre modelado de la señal, mediante las propiedades de los operadores de reconstrucción, conservando la estructura interna de la señal original. Finalmente, en un proceso experimental utilizando células de anfibios, se muestran los resultados obtenidos después de aplicar la propuesta a un grupo de células.
This paper presents a method for the measurement of the variation of intracellular calcium in follicular cells. This proposal consists in two stages: (i) The detection of the cell's nuclei, and (ii) the analysis of the fluorescence variations. The first stage is performed with the modified-watershed transformation, where the marker process is controlled by establishing own criterion. The detection process homogenizes the luminance conditions through a morphological filter and uses as descriptors the edges of the cells. In the second stage, the variations of fluorescence are associated with changes in intracellular Ca2+, which are modeled as an exponential decay function. Then, we present a new morphological process called medium reconstruction process, that smoothes the data in the process of model creation. This process uses the information of under and over model of the signal, through the properties of reconstruction operators, keeping the internal structure of the original signal. Finally, using amphibian cells in an experimental process, the results obtained are showed after applying the proposal to a group of cells.
RESUMO
The development of anthelmintic resistance has made the search for alternatives to control gastrointestinal nematodes of small ruminants imperative. Among these alternatives are several medicinal plants traditionally used as anthelmintics. This work evaluated the efficacy of Cocos nucifera fruit on sheep gastrointestinal parasites. The ethyl acetate extract obtained from the liquid of green coconut husk fiber (LGCHF) was submitted to in vitro and in vivo tests. The in vitro assay was based on egg hatching (EHT) and larval development tests (LDT) with Haemonchus contortus. The concentrations tested in the EHT were 0.31, 0.62, 1.25, 2.5 and 5 mg ml(-1), while in the LDT they were 5, 10, 20, 40 and 80 mg ml(-1). The in vivo assay was a controlled test. In this experiment, 18 sheep infected with gastrointestinal nematodes were divided into three groups (n=6), with the following doses administered: G1-400 mg kg(-1) LGCHF ethyl acetate extract, G2-0.2 mg kg(-1) moxidectin (Cydectin) and G3-3% DMSO. The worm burden was analyzed. The results of the in vitro and in vivo tests were submitted to ANOVA and analyzed by the Tukey and Kruskal-Wallis tests, respectively. The extract efficacy in the EHT and LDT, at the highest concentrations tested, was 100% on egg hatching and 99.77% on larval development. The parameters evaluated in the controlled test were not statistically different, showing that despite the significant results of the in vitro tests, the LGCHF ethyl acetate extract showed no activity against sheep gastrointestinal nematodes.
Assuntos
Anti-Helmínticos/farmacologia , Cocos/química , Hemoncose/tratamento farmacológico , Haemonchus/efeitos dos fármacos , Fitoterapia/veterinária , Extratos Vegetais/farmacologia , Doenças dos Ovinos/tratamento farmacológico , Análise de Variância , Animais , Anti-Helmínticos/uso terapêutico , Relação Dose-Resposta a Droga , Hemoncose/parasitologia , Hemoncose/veterinária , Haemonchus/crescimento & desenvolvimento , Enteropatias Parasitárias/tratamento farmacológico , Enteropatias Parasitárias/veterinária , Larva/efeitos dos fármacos , Larva/crescimento & desenvolvimento , Contagem de Ovos de Parasitas/veterinária , Testes de Sensibilidade Parasitária , Extratos Vegetais/uso terapêutico , Plantas Medicinais/química , Ovinos , Doenças dos Ovinos/parasitologia , Estatísticas não ParamétricasRESUMO
Medicinal plants have been investigated for their anthelmintic properties and shown to be effective against eggs and larvae of gastrointestinal nematodes. The aim of this study was to evaluate the efficacy of the Lippia sidoides essential oil (LsEO) on sheep gastrointestinal nematodes. Initially, 44 naturally infected sheep were divided and treated with 200 microg kg(-1) ivermectin and 230 and 283 mg kg(-1) LsEO, respectively, plus the control. Fecal samples were collected from each animal to determine epg at 7, 14 and 21 days after treatment. In another test, 21 sheep were distributed and treated with 200 microg kg(-1) ivermectin, 283 mg kg(-1) LsEO and the control, respectively. Seven days after treatment, they were euthanized and necropsied to count and identify the nematodes from the abomasum, small and large intestines. In the first test, the efficacy of 230 and 283 mg kg(-1) LsEO and ivermectin was 38%, 45.9% and 40.2%, respectively, 7 days after treatment, and 30%, 54% and 39.6%, respectively, 14 days after treatment. In the second experiment, the respective efficacy of 283 mg kg(-1) LsEO and ivermectin was 56.9% and 34.4% against Haemonchus spp., and 39.3% and 63.6% against Trichostrongylus spp.
Assuntos
Anti-Helmínticos/uso terapêutico , Lippia/química , Infecções por Nematoides/veterinária , Óleos Voláteis/farmacologia , Óleos de Plantas/farmacologia , Doenças dos Ovinos/tratamento farmacológico , Animais , Fezes/parasitologia , Gastroenteropatias/tratamento farmacológico , Gastroenteropatias/parasitologia , Gastroenteropatias/veterinária , Ivermectina/uso terapêutico , Infecções por Nematoides/tratamento farmacológico , Infecções por Nematoides/parasitologia , Óleos Voláteis/química , Contagem de Ovos de Parasitas , Óleos de Plantas/química , OvinosRESUMO
Gastrointestinal nematodes are becoming increasingly resistant to the commercial products used to control them. The cost of routine vermifuge applications on herds and the problem of residues in animal products and the environment have prompted research on the anthelmintic activity of plant extracts. This work examines the anthelmintic action of neem and the homeopathic product Fator Vermes in sheep kept in a pasture for 18 months. Forty sheep of the Morada Nova breed were divided into four treatments and the control, according to the EPG. During the experiment, each animal received 100 g/day of shredded corn and did not receive protein supplementation. In treatment 1 (control), the animals received only shredded corn. Treatment 2 received 1.6 g/(animal day) of the homeopathic product mixed with the shredded corn, and treatments 3, 4 and 5 received, respectively, 12.5, 25.0 and 37.5 g/(animal day) of dried Azadirachta indica leaves mixed with the shredded corn. The neem was administered for alternating 15-day periods and the homeopathic product daily for 18 months. There were 39 fortnightly fecal collections made to count the EPG, and fecal cultures were performed monthly. The following genera, in percentage, were identified: Haemonchus: 65.58+/-3.27, Trichostrongylus: 15.92+/-7.38 and Oesophagostomum: 18.50+/-6.22. The treatments evaluated were not effective in controlling gastrointestinal nematodes (P>0.05), whose mean log(10) counts (EPG +1) and standard errors for treatments 1-5 were respectively 3.55+/-0.28; 3.48+/-0.31; 3.90+/-0.29; 2.78+/-0.29 and 3.48+/-0.30. A significant effect (P<0.0001) was observed of the periods of the year when the 39 collections occurred. Because of the diet deficient in raw protein, the sheep had higher average EPG counts, for all the treatments, at the end of the dry season, and the opposite occurred in the middle of the rainy season.
Assuntos
Anti-Helmínticos/uso terapêutico , Azadirachta/química , Infecções por Nematoides/veterinária , Fitoterapia , Extratos Vegetais/uso terapêutico , Doenças dos Ovinos/tratamento farmacológico , Animais , Relação Dose-Resposta a Droga , Fezes/parasitologia , Feminino , Hemoncose/tratamento farmacológico , Hemoncose/veterinária , Haemonchus/efeitos dos fármacos , Nematoides/efeitos dos fármacos , Infecções por Nematoides/tratamento farmacológico , Testes de Sensibilidade Parasitária/veterinária , Fitoterapia/veterinária , Folhas de Planta/química , Distribuição Aleatória , Estações do Ano , Ovinos , Fatores de Tempo , Resultado do TratamentoRESUMO
Completeness of tuberculosis case reporting in Puerto Rico was assessed. Cases diagnosed among hospitalized, tuberculosis, and human immunodeficiency virus clinic patients during 1992 were retrospectively reviewed. Hospital discharge diagnoses, pharmacy listings of patients receiving anti-tuberculous medications, laboratory and acquired immunodeficiency syndrome registry data were used for case finding in selected hospitals and clinics. Identified cases were matched to the health department TB case registry to determine previous reporting through routine surveillance. Records of unreported cases were reviewed to verify tuberculosis diagnoses. Of 159 patients with tuberculosis, 31 (19.5%) were unreported. A case was defined according to the Centers for Disease Control and Prevention definition. Unreported cases were less likely than previously reported cases to have specimens that were culture positive for M. tuberculosis, 14 of 31 (45.2%) compared with 111 of 128 (86.7%). Excluding the laboratory, tuberculosis diagnoses in acquired immunodeficiency syndrome registry patients had the highest predictive value of finding tuberculosis (94.1%), followed by tuberculosis clinic records (71.7%), and pharmacy listings (45.6%). Tuberculosis discharge diagnoses, however, yielded the largest number of unreported cases (14). Health care providers should be educated regarding the importance of promptly reporting all suspected TB cases regardless of results of laboratory testing.
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Sistema de Registros , Tuberculose/epidemiologia , Síndrome da Imunodeficiência Adquirida/complicações , Síndrome da Imunodeficiência Adquirida/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Notificação de Doenças/estatística & dados numéricos , Métodos Epidemiológicos , Estudos de Avaliação como Assunto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Porto Rico/epidemiologia , Distribuição Aleatória , Estudos Retrospectivos , Tuberculose/complicações , Tuberculose/diagnósticoAssuntos
Anemia Refratária/complicações , Coma/etiologia , Icterícia/complicações , Hepatopatias/complicações , Acetaminofen/efeitos adversos , Infecções Bacterianas/complicações , Doença Hepática Induzida por Substâncias e Drogas , Hepatomegalia/complicações , Humanos , Masculino , Pessoa de Meia-Idade , NecroseRESUMO
Os autores relatam caso de ulcera peptica no estomago transposto ao torax em um doente com megaesofago grau IV, submetido a esofagectomia subtotal pela tecnica de Ferreira. O aparecimento da ulcera ocorreu no terceiro ano de pos-operatorio. A secrecao gastrica basal e estimulada pelo Histalog, assim como a dosagem da gastrina serica, foram considerados normais. O esvaziamento gastrico, prejudicado pelo mau funcionamento da piloroplastia, determinando estase foi considerado fator causal da ulcera gastrica e a realizacao de piloroctomia, melhorando a drenagem, levou a cicatrizacao da ulcera
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Adulto , Humanos , Masculino , Esofagoplastia , Úlcera PépticaRESUMO
The results of treatment with cimetidine in 12 patients with postoperative peptic ulcer are presented. Anterior surgical procedures were: Billroth II gastrectomy (8 cases), proximal selective vagotomy (1 case), truncal vagotomy plus pyloroplasty (1 case), gastroenteroanastomosis (1 case) and intrathoracic esophagogastric anastomosis (1 case). Clinical diagnosis was confirmed by radiology and endoscopy. Gastric secretion, both, basal and stimulated by Histalog was considered high (basal from 0,82 to 4,68 mEq/1 stimulated from 6,06 to 54,1 mEq/1). The patients were treated with 1,0 g of cimetidine daily, divided in four dosis. Healing assessed endoscopically, was seen in 75%. Treatment with cimetidine failed in three patients (25%) who were submitted to selective vagotomy and their ulcers healed. The authors conclude that treatment with cimetidine in postoperative peptic ulcer is effective and should be the first choice before surgical reoperation.
Assuntos
Cimetidina/uso terapêutico , Guanidinas/uso terapêutico , Úlcera Péptica/tratamento farmacológico , Adulto , Ácido Gástrico/metabolismo , Humanos , Masculino , Pessoa de Meia-Idade , Úlcera Péptica/cirurgia , Complicações Pós-Operatórias , RecidivaRESUMO
E apresentado o resultado do tratamento com a cimetidina em 12 doentes com ulcera peptica pos-operatoria. Os procedimentos cirurgicos anteriores foram: gastrectomia a BII (oito casos), vagotomia gastrica proximal (1 caso), vagotomia troncular mais piloroplastia (1 caso). O diagnostico clinico foi confirmado pela radiologia e endoscopia. A secrecao gastrica basal e estimulada pelo Histalog foi considerada elevada(basal de 0,82 a 4,68 mEq/ 1 e estimulada de 6,06 a 54,1 mEq/1).Os doentes foram tratados com 1,0 g de cimetidina diarias, divididas em quatro doses. A cicatrizacao foi comprovada endoscopicamente em 75% dos casos. O tratamento com a cimetidina falhou em tres doentes (25%) que, submetidos posteriormente a uma vagotomia seletiva, tiveram suas ulceras cicatrizadas. Concluem que o tratamento da ulcera peptica pos-operatoria com a cimetidina e eficaz e deve ser tentado como primeira opcao, antes de se indicar tratamento cirurgico