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Rim , Laparoscopia , Humanos , Laparoscopia/economia , Rim/patologia , Biópsia/economia , Biópsia/efeitos adversos , Biópsia/métodos , Nefropatias/patologiaRESUMO
Milk is the natural food with the highest biological quality for the human population and its production can be affected by several sanitary factors and management conditions. With the objective of identifying influence factors on milk compositional and sanitary quality in a region with wide productive potential in the Colombian Orinoquia, an experiment was carried out in two contrasting climatic seasons. For the milk compositional analysis, samples of daily production from 30 dual-purpose systems were analyzed. Similarly, the udder sanitary status of 300 cows was studied using the California Mastitis Test (CMT). Data analysis included mixed models, Pearson correlations, frequency tables, and the Kruskal-Wallis test. The results showed that the total daily milk production of the farm and the season influenced the milk compositional quality. The farms with milk productions lower than 100 kg/day presented the highest levels of protein, lactose, solid non-fat (SNF), and density, while in the rainy season, the milk quality was higher compared to the dry season. The CMT test indicated that only 7.6% of the evaluated mammary quarters presented two or more degrees of positivity. There is an opportunity to improve the milk compositional quality by improving the nutritional offer for animals during the year. The low CMT positivity indicates that, in the calf-at-foot milking system, the presence of subclinical mastitis is not a determining variable in milk production.
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Introduction/Background The COVID-19 pandemic has resulted in a large number of deaths and has caused a significant increase in population morbidity. This viral infection has been associated with different neurological symptoms and complications that do not have a clear pathophysiological mechanism and exact implications for these patients. Case Presentation A 40-year-old man with COVID-19 and co-infection with Klebsiella pneumoniae KPC presented extensive pulmonary involvement and required comprehensive management in the intensive care unit (ICU). During his hospitalization, he developed neurological symptoms with evidence of involvement of the corpus callosum, which was attributed to the cytotoxic lesion of the corpus callosum (CLOCC). After several months of interdisciplinary management in the ICU, there was a progressive improvement in his general condition, with discharge from the hospital without significant sequelae, with follow-up images showing complete involvement of the corpus callosum due to what was considered an atypical cytotoxic lesion of the corpus callosum. Conclusion Imaging features of CLOCCs are known to be temporary, but in the setting of COVID-19, it has not yet been determined if this is true and further studies are needed. Nonetheless, the one-year follow-up of our patient makes us believe that this atypical involvement of the corpus callosum described in severe SARS-CoV-2 infections is not transitory, even if there are no neurologic sequelae.
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INTRODUCTION: Traumatic spinal root injury caused by shoulder dislocation may involve the brachial plexus or, in some cases, a single nerve. The degree of severity of the injury depends on many patient-specific factors as well as the mechanism of injury. It is essential to suspect this type of lesion by means of a thorough physical examination in order to have better patient outcomes. CASE PRESENTATION: We presented the subtle magnetic resonance imaging (MRI) findings in a 35-yearold male with left shoulder trauma and dislocation after falling off a bicycle. He complained of decreased muscle strength and sensitivity in the C8 dermatome. Atrophy of the hypothenar region and flexion deformity of the 4th and 5th digits were noted. Magnetic resonance imaging findings were consistent with a partial preganglionic C8 motor root lesion. We found T2 increased signal intensity and thinning of the intradural segment of the C8 motor nerve root and low signal in the sequence of a multi- echo gradient recalled echo (GRE). CONCLUSION: MRI is a noninvasive tool that allows a detailed anatomical characterization of the nerves. In brachial plexus injuries, the use of the GRE sequence is useful to identify the lesions, even if they are subtle; however, some lesions may go unnoticed. It is important to note that these patients require an interdisciplinary group to reach a correct diagnosis, which is vital to establish the appropriate treatment and follow-up.
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Plexo Braquial , Ombro , Humanos , Masculino , Adulto , Ombro/diagnóstico por imagem , Ombro/inervação , Plexo Braquial/diagnóstico por imagem , Plexo Braquial/lesões , Plexo Braquial/patologia , Imageamento por Ressonância MagnéticaRESUMO
BACKGROUND: Persistent sciatic artery (PSA) is a congenital malformation due to incomplete involution during the embryonic period. Its etiology is unknown, with an estimated incidence of 0.02 - 0.04% in the whole population and a mean age of 60-65 years. Its presentation can be bilateral. It is asymptomatic in most cases and is usually detected accidentally; however, some symptoms may appear, such as claudication, sciatic neuralgia, and pain in the affected limb. It can also manifest as an aneurysmal dilatation or thrombosis that can generate distal embolism with ischemia. CASE REPORT: In this case study, a patient in her 90s with a suspected peripheral arterial disease, which required an angiotomography of the lower limb, showing a superficial femoral artery running to the middle and distal third of the thigh and a vascular structure running in the sciatic neurovascular bundle corresponding to a persistent sciatic artery presenting atherosclerotic changes and extensive occlusion, was presented. The patient's treatment was clinical with dual antiplatelet therapy and prophylactic anticoagulation. This was due to comorbidities and age. Moreover, the PSA occlusion was not critical and did not significantly impact the patient's quality of life. CONCLUSION: Most patients with this anatomical variant are asymptomatic all their lives, but some of them may present symptoms with serious consequences. It is important to suspect it by clinical presentation and perform diagnostic confirmation by angiotomography. Treatment has yielded excellent results with endovascular techniques. Certain patients only require conservative treatment with anticoagulants and antiplatelet agents.
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Aneurisma , Doença Arterial Periférica , Feminino , Humanos , Pessoa de Meia-Idade , Idoso , Qualidade de Vida , Extremidade Inferior/irrigação sanguínea , Aneurisma/terapia , Artéria Femoral , Doença Arterial Periférica/diagnóstico por imagemRESUMO
BACKGROUND: Paliperidone palmitate is a long-acting, second-generation antipsychotic (SGA) indicated for the treatment of acute exacerbations and maintenance treatment of adults with schizophrenia. This study addressed the response to paliperidone palmitate in Latin American patients with acute symptoms and recently diagnosed schizophrenia. OBJECTIVE: Explore the efficacy and tolerability of paliperidone palmitate administered once a month for 4 months in patients with acute phase and recent diagnosis (within 1-6 years) of schizophrenia in 3 Latin American countries. METHODS: This was a non-randomized, open-label, multicenter study with paliperidone palmitate injected intramuscularly in the deltoid muscle at an initial loading dose of 150 mg eq. (234 mg) on day 1 and 100 mg eq. (156 mg) on day 8 (± 4 days). The recommended maintenance dose was 75 mg eq. (117 mg) from day 36 to day 92. Efficacy was evaluated with PANSS and CGI-S. The last observation carried forward (LOCF) was used for efficacy analysis for imputation of missing data; no adjustments were made for multiplicity. Adverse events were evaluated during treatment. RESULTS: The patient retention rate was 84.0% (144 patients received study drug; 121 finished the study). The percentage of patients with a reduction of at least 30% in PANSS total score compared to baseline gradually increased during the study, and at the end, 78.4% of patients showed response. The PANSS total score and CGI-S scores decreased significantly from baseline to LOCF endpoint (P <0.0001 for both); significant reduction in PANSS total score was observed at day 8 and persisted to the end of the study. Most common adverse events were muscle rigidity (11.8%), akathisia (11.1%), injection-site pain (7.6%), weight gain (7.6%), and insomnia (7.6%). CONCLUSION: Paliperidone palmitate was efficacious in Latin American patients studied with an acute exacerbation and recent diagnosis of schizophrenia, and no new safety signals were identified.
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Objetivo: Presentar la historia un hombre joven que desde la infancia ha mostrado rasgos de trastorno de personalidad depresiva. Método: Reporte de caso. Resultados y conclusión: Si bien el trastorno de personalidad depresiva tan sólo figura en el anexo del DSM-IV, ha sido ampliamente discutido en diversas publicaciones. En el presente caso clínico, a partir de la narración en primera persona, se emplea una aproximación de tipo fenomenológico que destaca el ámbito de las vivencias predominantes de alguien con este trastorno de personalidad; las principales son el sinsentido de la vida, el aburrimiento y la sensación de vacío.
Objective: To present the story of a young man who has shown depressive personality traits since infancy. Methods: Case report. Results and conclusion: Even though depressive personality disorder is described only in the annex of DSM-IV, it has been widely discussed in various publications. In this clinical case with a first person narration, a phenomenological approach is used that highlights the environment of the predominant experiences of someone with this personality disorder; namely the senselessness of life, boredom and a sensation of emptiness