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BACKGROUND: Giant pituitary adenomas (GPAs) are defined as tumors with ≥40 mm in any maximum diameter, and these tend to invade multiple intracranial compartments. Hence, treatment remains a surgical challenge. OBJECTIVE: To describe the clinical and surgical outcomes of the endoscopic endonasal approach (EEA) for GPA in a pituitary referral center in Latin America and to analyze associated predictive factors. METHODS: 37 patients with histologically-confirmed GPA treated solely through the EEA between a 2-year period were included. Preoperative and postoperative clinical and neuroimaging findings; surgical morbidity and mortality; and binary logistic regression analysis to assess predictive factors were analyzed. RESULTS: Preoperative visual impairment prevalence was 97.3%. Mean tumor volume was 32 cc and gross total resection rate was 40.5%. Favorable visual acuity and visual fields outcome rate was 75% and 82.9%, respectively. In the multivariate analysis, bilateral cavernous sinus invasion (P = 0.018) and postoperative cerebrospinal fluid (CSF) leak (P = 0.036) were associated with an unfavorable visual acuity outcome, while radiation therapy (P = 0.035) was for visual fields. Similarly, intraoperative CSF leak was a predictive factor for postoperative CSF leak (10.8%) (P = 0.042) and vascular injury (13.5%) (P = 0.048). CONCLUSIONS: In this first Mexican clinical series, we demonstrated that the EEA is a safe and effective technique for GPA, although early diagnosis and prompt intervention may promote further visual function preservation without significant endocrine morbidity.
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Adenoma , Doenças da Hipófise , Neoplasias Hipofisárias , Humanos , Neoplasias Hipofisárias/diagnóstico por imagem , Neoplasias Hipofisárias/cirurgia , Neoplasias Hipofisárias/complicações , Adenoma/diagnóstico por imagem , Adenoma/cirurgia , Adenoma/complicações , Nariz/cirurgia , Complicações Pós-Operatórias/epidemiologia , Resultado do Tratamento , Estudos RetrospectivosRESUMO
A clear comprehension of the oscillatory nature of sound for acoustics undergraduate students is of paramount importance. In this paper, two online experiments were implemented to aid teaching of the oscillatory nature of sound through the analogy between a mechanical mass-spring model and a Helmholtz resonator. The study was conducted among undergraduate students taking a science course in the Electronic and Electrical Engineering career curriculum. These in-class experiments were conducted during the COVID-19 pandemic via the Zoom platform. Students measured the Helmholtz resonant frequency of a plastic bottle with a smartphone application and compared its oscillatory behavior with that of a conventional harmonic oscillator under a professor-student collaborative environment. The results of this study suggest that, with careful experiment design, students can effectively benefit from the use of common technology tools, which, in turn, poses these methodologies as a rather satisfactory alternative to face-to-face laboratory sessions.
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COVID-19 , Humanos , COVID-19/epidemiologia , Pandemias , Acústica , Som , CurrículoRESUMO
An 83-year-old Ecuadorian male, indigent with a history of malnutrition and chronic alcoholism, presented with a clinical feature characterized by progressive growth of larvae at the left eye level (LE), associated with areas of ocular tissue putrefaction. Upon admission, his vision in the right eye (RE) was of hand movement and no light perception in LE, the anterior segment of the RE showed a brunescent cataract, with no other alteration, while the LE presented edema, bipalpebral erythema and an abundant number of mobile larvae distributed throughout the orbit, associated with areas of necrosis, putrefaction and distortion of the anatomy of the ocular tissues. Orbital tomography showed a significant compromise of the orbit, indicating surgical management by left orbital exenteration with taxonomic identification of the larvae as Dermatobia hominis associated with it, antibiotic treatment was implemented and a frontal fasciocutaneous flap was performed by the plastic surgery department.
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Dípteros , Miíase , Animais , Humanos , Masculino , Idoso de 80 Anos ou mais , Equador , LarvaRESUMO
BACKGROUND: Previous studies have shown that multimorbidity is a risk factor for cognitive dysfunction (CD).Type 2 diabetes mellitus (T2DM) and hypertension (HT) are very common risk factors.The association between multimorbidity due to both diseases and CD has been understudied in low and middle-income countries, in which the strength of the association might be stronger. AIM: To evaluate the association between multimorbidity due to T2DM and HT with CD among adults ≥50 years in Tumbes. MATERIALS AND METHODS: A secondary analysis of a population-based cross-sectional study was conducted. The exposure variable was the presence of both T2DM and HT, split into categories: without HT or T2DM, only T2DM, only HT, and with T2DM and HT; whereas CD was the outcome variable, defined as a score ≤26 in the Leganes Cognitive Test. Crude and adjusted generalized linear models were used to estimate the association of interest, and prevalence ratio (PR) and 95% confidence interval (95%CI) were reported. RESULTS: 688 participants were analyzed. The prevalence of CD was 39.1%. There was a 56.1% of participants without TDM2 nor HT, 8.3% with T2DM, 28.9% with HT and 6.7% with both diseases. A significant association was found between multimorbidity and CD (PR = 1.43, 95%CI 1.04-1.97). Multimorbidity had a statistically significant association with CD in the group of participants with ≥7 years of education (PR = 2.56,95%CI 1.55-4.21), but no in the group with <7 years. CONCLUSIONS: There is association between the morbidity of T2DM and HT, and CD among adults ≥50 years of age in Tumbes. Education was an effect modifier of the association between HT and T2DM on the presence of CD.
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Disfunção Cognitiva , Diabetes Mellitus Tipo 2 , Hipertensão , Adulto , Humanos , Diabetes Mellitus Tipo 2/epidemiologia , Multimorbidade , Peru/epidemiologia , Estudos Transversais , Hipertensão/epidemiologia , Prevalência , Disfunção Cognitiva/epidemiologia , Disfunção Cognitiva/psicologiaRESUMO
Endemic species distributed in fragmented habitats are highly vulnerable to extinction because they may have low genetic diversity. However, some life-history traits can mitigate the effect of genetic drift on populations. We analysed the level and distribution of genetic variation and ancestral population size of Yucca capensis, a long-lived endemic plant of the Baja California Peninsula, Mexico. Its populations are scattered across a habitat that is suffering accelerated transformation. We used six nuclear microsatellites to genotype 224 individuals from 17 locations across the entire species' geographic range. We estimated polymorphisms, heterozygosity and genetic structure. We also evaluated the ancestral and recent effective size and time since the population started to change. We found high heterozygosity, high polymorphism and low differentiation among locations, suggesting a panmictic population across the range. We also detected a large ancestral effective population size, which suffered a strong reduction in the Mid-Holocene. Despite changes in environmental conditions caused by habitat modification, the high diversity and low differentiation in Y. capensis may result from its large ancestral effective size and life-history traits, such as plant longevity, clonal growth and mating system, which reduce the rate of loss of genetic variation. However, the dependence on a specialist pollinator that displays short flight range can reduce gene flow among the plant populations and could, shortly, lead them into an extinction vortex.
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Asparagaceae , Yucca , Ecossistema , Fluxo Gênico , Variação Genética , Genética Populacional , México , Repetições de Microssatélites/genética , Árvores/genéticaRESUMO
Neisseria gonorrhoeae is a nonmotile, sporulated, aerobic or facultative anaerobic gram-negative diplococcus, catalase and oxidase positive. Sexually transmitted infections caused by this microorganism were established as public health problem since the 19th century, representing a great threat to human health due to its high prevalence and multi-resistance to antimicrobials. In recent decades, reports of strains resistant to penicillin, fluoroquinolones, sulfonamides, tetracycline, macrolides, and more recently to cephalosporins and azithromycin have increased. Such a panorama has generated concern worldwide, due to the increase in cases of gonorrhea associated with multi-resistant strains. In Chile, from 2010 to 2018, the National Surveillance Program for N. gonorrhoeae was developed in order to characterize this infection in the regions and record antimicrobial resistance. This review presents an updated, systematic bibliographic analysis of the main aspects of this microorganism, its response to antimicrobials, and provides diagnostic and treatment guidelines, while waiting to advance in the understanding of the molecular mechanism and the metabolic and immunological interactions that determine infection, with a view to designing an effective vaccine.
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Anti-Infecciosos , Gonorreia , Antibacterianos/farmacologia , Chile/epidemiologia , Farmacorresistência Bacteriana , Gonorreia/epidemiologia , Humanos , Testes de Sensibilidade Microbiana , Neisseria gonorrhoeaeRESUMO
BACKGROUND: HIV incidence can be estimated with cross-sectional studies using clinical, serological, and molecular data. Worldwide, HIV incidence data in only men who have sex with men (MSM) are scarce and principally focus on those with healthcare or under treatment. However, better estimates can be obtained through studies with national representativeness. The objective was to estimate the prevalence, incidence, and factors associated with acquiring HIV in a national sample of MSM who attend meeting places, considering geographical regions. METHODS: A nationally representative survey of MSM attending meeting places was performed in Mexico. Participants answered a questionnaire, and a dried blood spot (DBS) was collected. Samples were classified as recent infections using an algorithm with HIV status, antiretroviral therapy, and the result of BED-EIA assay. Parameters were analysed considering regions and demographic and sexual behaviour characteristics. RESULTS: The national HIV prevalence was 17.4% with regional differences; the highest prevalence (20.7%) was found in Mexico City, and the lowest prevalence was found in the West region (11.5%). The incidence was 9.4 per 100 p/y, with regional values from 6.2 to 13.2 for the Northeast and the Centre regions, respectively. Age, age at sexual debut, low wealth index, and rewarded sex were associated with HIV prevalence. Centre region, use of private clinics as health services, and having sex exclusively with men were associated with recent HIV infections. CONCLUSIONS: The incidence and prevalence showed regional differences, suggesting a difference in the dynamics of HIV transmission; some regions have a greater case accumulation, and others have a greater rate of new infections. Understanding this dynamic will allow developing health programs focused on HIV prevention or treating people already living with HIV.
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Infecções por HIV , Minorias Sexuais e de Gênero , Estudos Transversais , Infecções por HIV/epidemiologia , Homossexualidade Masculina , Humanos , Incidência , Masculino , Prevalência , Comportamento SexualRESUMO
Resumen Neisseria gonorrhoeae es un diplococo gramnegativo, no móvil, esporulado, aerobio o anaerobio facultativo, catalasa y oxidasa positivas. Las infecciones de transmisión sexual causadas por este microorganismo son un problema de salud pública definido como tal desde el siglo XIX, representando una gran amenaza para la salud humana debido a la su alta prevalencia y multirresistencia a antimicrobianos. En las últimas décadas han aumentado los reportes de cepas resistentes a penicilina, fluoroquinolonas, sulfonamidas, tetraciclina, macrólidos, y más recientemente a cefalosporinas y azitromicina. Tal panorama ha generado preocupación a nivel mundial, debido al aumento de casos de gonorrea asociados a cepas multirresistentes. En Chile se desarrolló desde el 2010 hasta el 2018 el Programa de Vigilancia de N. gonorrhoeae a nivel nacional con el objeto de caracterizar esta infección en las regiones y registrar la resistencia a los antimicrobianos. Esta revisión presenta un análisis sistemático bibliográfico, actualizado, de los principales aspectos de este microorganismo, su respuesta a antimicrobianos, y entrega pautas de diagnóstico y tratamiento, a la espera de avanzar en la comprensión del mecanismo molecular y las interacciones metabólicas e inmunológicas que determinan la infección, con miras a diseñar una vacuna efectiva.
Abstract Neisseria gonorrhoeae is a nonmotile, sporulated, aerobic or facultative anaerobic gram-negative diplococcus, catalase and oxidase positive. Sexually transmitted infections caused by this microorganism were established as public health problem since the 19th century, representing a great threat to human health due to its high prevalence and multi-resistance to antimicrobials. In recent decades, reports of strains resistant to penicillin, fluoroquinolones, sulfonamides, tetracycline, macrolides, and more recently to cephalosporins and azithromycin have increased. Such a panorama has generated concern worldwide, due to the increase in cases of gonorrhea associated with multi-resistant strains. In Chile, from 2010 to 2018, the National Surveillance Program for N. gonorrhoeae was developed in order to characterize this infection in the regions and record antimicrobial resistance. This review presents an updated, systematic bibliographic analysis of the main aspects of this microorganism, its response to antimicrobials, and provides diagnostic and treatment guidelines, while waiting to advance in the understanding of the molecular mechanism and the metabolic and immunological interactions that determine infection, with a view to designing an effective vaccine.
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Humanos , Gonorreia/epidemiologia , Testes de Sensibilidade Microbiana , Chile/epidemiologia , Farmacorresistência Bacteriana , Fatores de Virulência , Monitoramento Epidemiológico , Antibacterianos/farmacologia , Neisseria gonorrhoeae/efeitos dos fármacos , Neisseria gonorrhoeae/patogenicidadeRESUMO
Solar drying is a sustainable process that may impact the quality of dried food. This is because, pigments contained in food are sensitive to sunlight, and exposure to ultraviolet radiation can affect them. We applied biopolymer-based coatings on strawberry, from hydro-colloidal solutions of Opuntia ficus indica-mucilage, fenugreek, xanthan gum, gum Arabic, and guar gum to evaluate their potential use as UV filters for solar drying of food. Thermal properties and the optical transmittance, absorbance and reflectance of the coatings were measured to assess their influence on food-sunlight interaction. During the drying experiments, the moisture content, total anthocyanins (TA), and total phenolic compounds (TPC) were measured. Optical and thermal properties are influenced by the biopolymer-based coatings. Also, the optical properties are influenced by the coating thickness. The differences in optical and thermal properties influence the drying process. Differences exist in the drying rate for strawberry slices with coating, compared with those without the coatings. In general, the TA and TPC content in the product are better preserved under solar drying than in control experiments done in a drying oven. A partial transmittance of solar UV radiation is recommended to obtain increased TA and TPC contents in the dried product.
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Day by day, the health and economical burden of cancer increases globally. Indeed it can be considered that there is ''cancer pandemic''. Blocking the renin-angiotensin system (RAS) by angiotensin-converting enzyme (ACE) inhibitors (ACEI) or angiotensin-receptor blockers (ARB) are widely used measures to treat hypertension and heart failure. It has been recently suggested the activation and blocking of RAS has been associated with various types of cancer in epidemiological and experimental studies. Various studies have shown that RAS blockage is protective in some cancers. However, although fewer, contradictory data also showed that RAS blockage is either not related or adversely related to cancer. Although the reasons for these findings are not exactly known, different types of receptors and effectors in RAS may account for these findings. In the current review, we summarize the different RAS receptors and cancer development with regard to epidemiology, and pathogenesis including cell signaling pathways, apoptosis, genetic and epigenetic factors.
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Antagonistas de Receptores de Angiotensina/farmacologia , Inibidores da Enzima Conversora de Angiotensina/farmacologia , Epigênese Genética , Neoplasias/epidemiologia , Sistema Renina-Angiotensina/fisiologia , Transdução de Sinais , Apoptose/fisiologia , Carcinógenos/toxicidade , Proliferação de Células/fisiologia , Contaminação de Medicamentos , Insuficiência Cardíaca/tratamento farmacológico , Humanos , Hipertensão/tratamento farmacológico , MicroRNAs/fisiologia , Neoplasias/etiologia , Peptidil Dipeptidase A/genética , Sistema Renina-Angiotensina/efeitos dos fármacosRESUMO
OBJECTIVE: To report the ocular manifestations in patients with leukaemia. METHODS: This is a retrospective, descriptive and observational study in patients with ocular manifestations of leukaemia. RESULTS: A total of 14 eyes were evaluated corresponding to 8 patients (5 women and 3 men) with ocular manifestations of leukaemia. The mean age at diagnosis was 43 years (31-76 years). Six eyes corresponded to patients with acute myeloid leukaemia (AML), four eyes to acute lymphoid leukaemia (ALL), two eyes to chronic myeloid leukaemia (CML), and the remaining two belonged to patients with hairy cell leukaemia (HCL). The primary ocular findings were choroidal invasion in 12 eyes (85.7%), retinal infiltration in 4 eyes (28.6%), and neuro-ophthalmic disorders in 4 eyes (28.6%). The mean visual acuity improved from 0.689 to 0.449 (logMAR) (P=.012) after the systemic and intrathecal chemotherapy. Of the eight patients, four died from systemic complications of the underlying disease. CONCLUSIONS: This is the first report of multiple ocular manifestations secondary to leukaemia in a Colombian population. It is important to keep in mind that this disease is included within the masquerade syndromes and that the ophthalmological findings that, while subtle, can also be devastating and be signs of a life-threatening disease.
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Se comunica una serie de casos, multicéntricos de la cual participaron cinco instituciones. La muestra fue de 17 pacientes, de los cuales 11 pertenecían al Hospital Dr. J.M. Cullen. Todos consultaron por compromiso orbitario y/o periorbitario. El compromiso en hombres fue de 23.4% y un 76.6% en mujeres. La edad media en años fue de 45.4 (17-69 años). Dentro de los diagnósticos encontrados, cinco casos fueron Enfermedad Relacionada con IgG4 (ER-IgG4), dos casos de Enfermedad de Erdheim Chester (EEC), dos Xantogranuloma, dos xantelasmas, un caso de metástasis de cáncer de mama, un caso de orbitopatía tiroidea, un caso de Amiloidosis con mieloma múltiple, y tres sin diagnóstico. Se revisan los diagnósticos diferenciales encontrados.
A series of multicentric cases is reported, of which five institutions participated. The sample was of 17 patients, of which 11 belonged to our Hospital, the Dr. J.M. Cullen Hospital. All consulted for orbital and/or periorbital commitment. The commitment in men was 23.4% and 76.6% in women. The average age in years was 45.4 (17-69 years). Among the diagnoses found, five cases were IgG4-Related Disease, two cases of Erdheim Chester Disease, two Xantogranuloma, two xanthelasmas, a case of breast cancer metastases, a case of thyroid orbitopathy, a case of Amyloidosis with multiple myeloma, and three without diagnosis. Differential diagnoses found are reviewed.
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Olho , Doença de Erdheim-Chester , Oftalmopatia de Graves , Doença Relacionada a Imunoglobulina G4 , AmiloidoseRESUMO
Presentamos el caso de un paciente de 56 años con antecedente de Mieloma Múltiple, que evoluciona con inflamación periorbitaria de ambos parpados, bilateral, de coloración amarillenta-violácea, ulcerada e indolora. Se planteó el diagnóstico diferencial con las enfermedades xantogranulomatosas orbitarias del adulto, en especial con su asociación con Mieloma Múltiple (MM). Al realizar biopsia de la lesión, se observan en la histología fragmentación de haces de colágeno dérmico y alrededor de vasos un material amorfo acelular eosinófilo pálido, rojo congo positivo y coloración verde manzana con luz polarizada, llegando al diagnóstico de Amiloidosis y Xantogranuloma Orbitario del Adulto.
We present the case of a 56-year-old patient with a history of Multiple Myeloma, who evolves with periorbital inflammation of both eyelids, bilateral, yellowish-violet, ulcerated and painless. The differential diagnosis with the adult orbital xanthogranulomatous diseases was raised, especially XN due to its association with MM. When performing a biopsy of the lesion, fragmentation of dermal collagen bundles and around vessels a pale eosinophilic acellular material, positive congo red and apple-green color with polarized light are observed in the histology, reaching the diagnosis of Amyloidosis and Orbital Xantogranuloma of the Adult.
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Amiloidose , Xantogranuloma Necrobiótico , Mieloma MúltiploRESUMO
RESUMEN Se presenta caso de paciente masculino de 9 años de edad, fototipo VI acude a consulta especializada de Dermatología en el Hospital pediátrico William Soler por lesiones eritematoescamosas dispuestas en placas localizadas en ambas rodillas, acompañadas de queratodermia palmo plantar. Se realizan exámenes complementarios y biopsia de piel concluyéndose caso como pitiriasis rubra pilaris circunscrita juvenil. Esta dermatosis es de infrecuente presentación, desafío terapéutico por ausencia de estandarización internacional y cursa con una evolución impredecible.
ABSTRACT We present the case of a 9-year-ol, phototype 3, who attended a specialized dermatology consultation at the William Soler pediatric hospital due to erythematosquamous lesions arranged in plaques located on both knees accompanied by palmoplantar keratoderma. Laboratory tests and skin biopsies were carried out, concluding case as a juvenile and circumscribed pityriasisrubra pilaris. This is an infrequent dermatosis, a therapeutic challenge because of the absence of international standardized treatments and it has an unpredictable evolution.
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AIM: To determine whether intermediate hyperglycaemia, defined by fasting plasma glucose and HbA1c criteria, is associated with mortality in a 10-year cohort of people in a Latin American country. METHODS: Analysis of the PERU MIGRANT Study was conducted in three different population groups (rural, rural-to-urban migrant, and urban). The baseline assessment was conducted in 2007/2008, with follow-up assessment in 2018. The outcome was all-cause mortality, and the exposure was intermediate hyperglycaemia, using three definitions: (1) impaired fasting glucose, defined according to American Diabetes Association criteria [fasting plasma glucose 5.6-6.9 mmol/l (100-125 mg/dl)]; (2) intermediate hyperglycaemia defined according to American Diabetes Association criteria [HbA1c levels 39-46 mmol/mol (5.7-6.4%)]; and (3) intermediate hyperglycaemia defined according to the International Expert Committee criteria [HbA1c levels 42-46 mmol/mol (6.0-6.4%)]. Crude and adjusted hazard ratios and 95% CIs were estimated using Cox proportional hazard models. RESULTS: At baseline, the mean (sd) age of the study population was 47.8 (11.9) years and 52.5% of the cohort were women. The study cohort was divided into population groups as follows: 207 people (20.0%) in the rural population group, 583 (59.7%) in the rural-to-urban migrant group and 198 (20.3%) in the urban population group. The prevalence of intermediate hyperglycaemia was: 6%, 12.9% and 38.5% according to the American Diabetes Association impaired fasting glucose definition, the International Expert Committee HbA1c -based definition and the American Diabetes Association HbA1c -based definition, respectively, and the mortality rate after 10 years was 63/976 (7%). Intermediate hyperglycaemia was associated with all-cause mortality using the HbA1c -based definitions in the crude models [hazard ratios 2.82 (95% CI 1.59-4.99) according to the American Diabetes Association and 2.92 (95% CI 1.62-5.28) according to the International Expert Committee], whereas American Diabetes Association-defined impaired fasting glucose was not [hazard ratio 0.84 (95% CI 0.26-2.68)]. In the adjusted model, however, only the American Diabetes Association HbA1c -based definition was associated with all-cause mortality [hazard ratio 1.91 (95% CI 1.03-3.53)], whereas the International Expert Committee HbA1c -based and American Diabetes Association impaired fasting glucose-based definitions were not [hazard ratios 1.42 (95% CI 0.75-2.68) and 1.09 (95% CI 0.33-3.63), respectively]. CONCLUSIONS: Intermediate hyperglycaemia defined using the American Diabetes Association HbA1c criteria was associated with an elevated mortality rate after 10 years in a cohort from Peru. HbA1c appears to be a factor associated with mortality in this Peruvian population.
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Glicemia/metabolismo , Intolerância à Glucose/metabolismo , Hemoglobinas Glicadas/metabolismo , Hiperglicemia/metabolismo , Mortalidade , Estado Pré-Diabético/metabolismo , Adulto , Causas de Morte , Feminino , Recursos em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Peru , Modelos de Riscos Proporcionais , População Rural/estatística & dados numéricos , Migrantes/estatística & dados numéricos , População Urbana/estatística & dados numéricosRESUMO
Background: Inflammation is a condition that jeopardizes the continuity of pregnancy because it increases the secretion of chemokines that favor the migration of leukocytes from maternal and fetal circulations to the cervix, placenta, and the chorioamniotic membranes. During pregnancy, the level of prolactin (PRL) in the amniotic fluid is high; there is evidence to suggest that PRL contributes to maintain a privileged immune environment in the amniotic cavity. We test the effect of prolactin on the secretion profile of chemokines in human fetal membranes.Methods: Nine fetal membranes collected from healthy nonlabouring cesarean deliveries at term. We placed whole membrane explants in a two-chamber culture system. Choriodecidua and amniotic chambers were pretreated with 250, 500, 1000, or 4000 ng/ml of PRL for 24 h, then choriodecidua was cotreated with 500 ng/ml of lipopolysaccharide (LPS) and PRL for 24 h. We used ELISA to measure secreted levels of four chemokines (RANTES, monocyte chemoattractant protein 1 (MCP-1), MIP-1α, and IL-8) in both amnion and choriodecidua regions.Results: In comparison with basal conditions, LPS treatment induced significantly higher secretion of RANTES, MCP-1, and MIP-1α, but not of IL-8. RANTES was mainly produced by choriodecidua and cotreatment with PRL significantly decreased its LPS-induced secretion. MCP-1 was primarily produced by the amnion and its secretion was only inhibited by 4000 ng/ml of PRL. Both membrane regions produced MIP-1α, which was significantly inhibited at 1000 and 4000 ng/ml PRL concentrations. IL-8 showed no significant changes regardless of PRL concentration.Conclusion: PRL inhibits the differential secretion of proinflammatory chemokines by human fetal membranes.
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Membranas Extraembrionárias , Lipopolissacarídeos , Prolactina , Âmnio , Quimiocinas , Feminino , Humanos , Gravidez , Prolactina/fisiologiaAssuntos
Infecções Oportunistas Relacionadas com a AIDS/etiologia , Aspergilose/microbiologia , Coccidioidomicose/microbiologia , Entamebíase/parasitologia , Infecções por HIV/complicações , Aspergilose/etiologia , Aspergilose/patologia , Aspergillus/isolamento & purificação , Coccidioides/isolamento & purificação , Coccidioidomicose/etiologia , Coccidioidomicose/patologia , Entamoeba histolytica/isolamento & purificação , Entamebíase/etiologia , Entamebíase/patologia , Evolução Fatal , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
RESUMEN El trauma laríngeo constituye un grupo de lesiones infrecuentes, pero de gran importancia clínica dada su alta morbimortalidad. Requiere un alto nivel de sospecha, puesto que muchas de estas lesiones pueden pasar desapercibidas en la evaluación inicial. Se debe sospechar en todo paciente que se presenta con traumatismo cervical y síntomas que van desde la disfonía y el dolor cervical anterior, a la disnea e incluso el compromiso respiratorio severo por obstrucción de la vía aérea. El abordaje de estos pacientes debe iniciar con la evaluación de la vía aérea y asegurar su estabilidad, para luego enfocarse en el diagnóstico y manejo específico de las lesiones. Presentamos a continuación una revisión bibliográfica en cuanto a los mecanismos de trauma, presentación clínica, diagnóstico, clasificación y manejo.
ABSTRACT The laryngeal trauma constitutes a group of infrequent lesions, but with great clinical importance, given its high morbidity and mortality. It requires a high level of suspicion, since many of these injuries may go unnoticed at the initial evaluation. It should be suspected in every patient presenting with cervical trauma and symptoms ranging from dysphonia and anterior cervical pain, to dyspnea or even severe respiratory distress, due to obstruction of the airway. The approach of these patients should begin with the evaluation of the airway and ensure its stability, to then focus on the diagnosis and specific management of the lesions. We present an updated literature review regarding the mechanisms of trauma, clinical presentation, diagnosis, classification and management.
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Humanos , Cartilagem Tireóidea/lesões , Laringe/lesões , Ferimentos e Lesões , Fraturas Ósseas/mortalidade , Fraturas Ósseas/terapia , Laringe/cirurgia , Laringe/diagnóstico por imagemRESUMO
RESUMO O Tumor Venéreo Transmissível Canino (TVTC) é uma neoplasia de células redondas que tem a particularidade de se implantar em mucosas que tenham perdido a sua integridade. Nesse local o tumor prolifera e ocasionalmente origina metástase. Em geral, o tumor responde ao tratamento com sulfato de vincristina, porém a resistência quimioterápica associada ao fenótipo tumoral tem sido documentada. Objetivou-se relatar um caso de TVTC genital de fenótipo citológico misto com metástase esplênica e o insucesso da quimioterapia com sulfato de vincristina, em uma fêmea canina, da raça Australian Cattle Dog, de cinco anos de idade. Após diagnóstico citológico e histológico, o tumor primário foi ainda caracterizado em fase de progressão e mostrou baixa expressão de moléculas do complexo principal de histocompatibilidade (MHC) (4,4 ± 2% classe I e 11 ± 4,1% classe II). A cadela foi submetida à ovariohisterectomia e esplenectomia terapêutica e não apresentou recidiva do tumor após 12 meses de acompanhamento clínico.
ABSTRACT The canine transmissible venereal tumor is a type of round cell cancer that have the particularity of implanting in mucous tissue, when they lose their integrity, at which point the tumour proliferates and may even develop metastases. The tumor typically responds well to vincristine sulfate chemotherapy, although there are cases of resistance to the drug correlated with the tumoral phenotype. We describe herein a genital mixed TVTC case with metastases at spleen and failure at vincristine sulfate chemotherapeutic treatment in a five years old Australian Cattle Dog female. After the cytological, histological and cytogenetic diagnostic, the primary tumor was still characterized in progression phase and showed low major histocompatibility complex expression MHC (4,4 ± 2% class I e 11 ± 4,1% class II. The dog underwent therapeutic splenectomy and ovariohysterectomy and did not present tumor recurrence within 12 months of clinical follow-up.
Assuntos
Animais , Tumores Venéreos Veterinários , Vincristina , Cães , Genitália , Histerectomia , Mucosa , Metástase Neoplásica , Neoplasias , Recidiva , Esplenectomia , Sulfatos , Terapêutica , Tecidos , Preparações Farmacêuticas , Tratamento Farmacológico , HistocompatibilidadeRESUMO
OBJECTIVE: To perform an epidemiologic profile of pancreatic cancer (PC) in Puerto Rico (PR) with data gathered from 2001 to 2015. METHODS: Using data from the PR Central Cancer Registry we estimated incidence and mortality rates and trends of PC in PR, and performed survival analyses. We also compared the age-standardized incidence and mortality rates of PC in people in PR with those of Hispanics, non-Hispanic whites, and non Hispanic blacks in the United States (US). RESULTS: From 2011 to 2015, 7.8 per 100,000 persons were diagnosed with PC in PR; higher rates were observed in men than in women (9.2 vs. 6.7 per 100,000, respectively) and in persons 65 years old and older (42.7 per 100,000 persons). For the same period, 6.7 per 100,000 persons died from PC; men and persons 65 years and older had higher mortality rates. Incidence and mortality trends of PC in PR increased from 2001-2015 (annual percent change [APC] = 3.8% and 1.9%, respectively (p<0.05). Lower risk of being diagnosed with and dying from PC was seen in PR than in members of several racial/ethnic groups in the US. The median survival time for PC cases diagnosed in PR during the period of 2008 to 2012 was 5.3 months. CONCLUSION: We observed increasing mortality rates and low survival in PC patients in PR. Research on access and response to treatment is needed to elucidate the reasons for the observed results and have a positive impact on PC burden and survival.