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Introducción. Las neoplasias quísticas mucinosas del hígado son tumores poco frecuentes, equivalen a menos del 5 % de todas las lesiones quísticas hepáticas y se originan generalmente en la vía biliar intrahepática, con poco compromiso extrahepático. En la mayoría de los casos su diagnóstico es incidental dado que es una entidad generalmente asintomática con un curso benigno; sin embargo, hasta en el 30 % pueden ser malignas. En todos los casos se debe hacer una resección quirúrgica completa de la lesión. Caso clínico. Se presentan dos pacientes con diagnóstico de neoplasia quística mucinosa en la vía biliar intrahepática, así como sus manifestaciones clínicas, hallazgos imagenológicos y tratamiento. Discusión. Debido a su baja incidencia, esta patología constituye un reto diagnóstico, que se puede confundir con otro tipo de entidades más comunes. El diagnóstico definitivo se hace de forma histopatológica, pero en todos los casos, ante la sospecha clínica, se recomienda la resección completa. Conclusión. Se presentan dos pacientes con diagnóstico de neoplasias quísticas mucinosas del hígado, una entidad poco frecuente y de difícil diagnóstico
Introduction. Mucinous cystic neoplasms of the liver are rare tumors, accounting for less than 5% of all liver cystic lesions, and generally originate from the intrahepatic bile duct with little extrahepatic involvement. In most cases its diagnosis is incidental since it is a generally asymptomatic entity with a benign course; however, up to 30% can have a malignant course. In all cases, complete surgical resection of the lesion must be performed. Clinical case. Two patients with a diagnosis of mucinous cystic neoplasm in the intrahepatic bile duct are presented, as well as their clinical manifestations, imaging findings, and treatment. Discussion. Due to its low incidence, this pathology constitutes a diagnostic challenge, which can be confused with other types of more common entities. The definitive diagnosis is made histopathologically, but in all cases, given clinical suspicion, complete resection is recommended. Conclusion. Two patients with a diagnosis of mucinous cystic neoplasms of the liver are presented, a rare entity that is difficult to diagnose
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Humanos , Hepatectomia , Neoplasias Abdominais , Ductos Biliares , Colestase , FígadoRESUMO
La silicosis pulmonar es una enfermedad ocupacional que continúa ocasionando morbilidad en el mundo. Debido a que el sílice es el mineral más abundante en la tierra y en las rocas, son numerosas las fuentes de exposición laboral a la inhalación del polvo de sílice en varios sectores industriales. Por su parte, la silicoproteinosis pulmonar es una forma aguda muy rara de silicosis, que puede desarrollarse con un período de latencia más corto en comparación con la silicosis, luego de la primera exposición al sílice, y se caracteriza por un rápido deterioro de la función pulmonar, sin respuesta efectiva a ningún tratamiento. Por su forma de presentación tan atípica, reportamos el caso de un hombre de 58 años, con antecedente laboral de trabajo en mina de extracción de oro en socavón
Pulmonary silicosis is an occupational disease that continues to cause morbidity in the world. Because silica is the most abundant mineral in soil and rock, sources of occupational exposure to inhalation of silica dust are numerous in various industrial sectors. Alternately, pulmonary silicoproteinosis is a very rare acute form of silicosis, which can develop with a shorter latency period compared to silicosis after the first exposure to silica, and is characterized by a rapid deterioration of lung function, without effective response to any treatment. Due to its atypical form of presentation, we report the case of a 58-year-old man, with a history of working in a gold mine
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Humanos , Silicose , Pneumoconiose , Proteinose Alveolar Pulmonar , Riscos Ocupacionais , Dióxido de SilícioRESUMO
El tumor fibroso solitario (TFS) es una neoplasia mesenquimatosa de tipo fibroblástico que, a pesar de ser localizado principalmente en pleura, se ha observado en otros órganos como la próstata. Por su parte, el tumor fibroso solitario de la próstata es una neoplasia de baja incidencia, crecimiento lento y potencial maligno incierto, que generalmente se compone de células fusiformes de apariencia citológicamente benignas, dispuestas en una arquitectura desorganizada, mezcladas con colágeno y pequeños vasos sanguíneos. Establecer su diagnóstico se ha vuelto más reproducible desde la identificación de la fusión de los genes NAB2-STAT6 por biología molecular, que lleva a la sobreexpresión de STAT6 por inmunohistoquímica, el cual es un marcador muy sensible y específico para TFS. Presentamos el caso clínico de un paciente que debutó con síntomas de compresión vesical, en quien se identificó una masa con epicentro en la próstata que infiltraba la vejiga y llegaba a la pared rectal, y que luego de estudios de patología, inmunohistoquímica y pruebas moleculares se clasificó como un TFS de la próstata, finalmente tratado con cistoprostatectomía radical más derivación urinaria
Solitary fibrous tumor (SFT) is a mesenchymal neoplasm of fibroblastic type, which despite being located mainly in the pleura, has been observed in other organs such as the prostate. On the other hand, solitary fibrous tumor of the prostate is a rare neoplasm, slow growing, and of uncertain malignant potential, which is generally composed of spindle cells of cytologically benign appearance, arranged in a disorganized architecture, mixed with collagen and small blood vessels. Establishing its diagnosis has become more reproducible since the identification of the NAB2-STAT6 gene fusion by molecular biology, leading to the overexpression of STAT6 by immunohistochemistry, a very sensitive and specific marker for SFT. We present a clinical report of a patient who consulted with symptoms of bladder compression, in whom a mass was identified with the epicenter in the prostate infiltrating into the bladder and reaching the rectal wall. Following histopathology study, immunohistochemistry and molecular tests it was classified as a SFT of the prostate, finally treated with radical cystoprostatectomy plus urinary shunt
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Humanos , Próstata , Prostatectomia , Neoplasias da Próstata , Fator de Transcrição STAT6 , Tumores Fibrosos SolitáriosRESUMO
Enteric duplication cysts (EDCs) are congenital anomalies. We report the case of a 5-day-old girl with a 2.0 cm congenital oral mass in the tongue, an extremely uncommon site of EDC. The tongue mass was resected without complication; microscopic findings were characteristic of an EDC, and the patient is doing very well. The English literature was researched for the cases of single congenital oral cavity masses diagnosed prenatally or at birth as EDC or EDC-like lesions. Cystic lesions of the oral cavity partially lined by gastrointestinal epithelium, without teratoma features, have received several names. Similarities between EDC and EDC-like lesions favor the idea of one lesion with several morphologies manifest along a spectrum and that the necessity for EDC diagnosis of the smooth muscle coat criteria could be re-evaluated to improve the categorization of these lesions and better understand the pathogenic mechanism.
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Los niveles de bilirrubina sérica normal en el adulto varían entre 0,3 mg/dL y 1,2 mg/dL, y su valor está determinado por la tasa de captación hepática, conjugación y excreción. La ictericia se hace evidente cuando los niveles de bilirrubina sérica se elevan por encima de 2,5 mg/dL a 3 mg/dL, siendo un indicador de enfermedad subyacente. La bilis es producida por los hepatocitos y fluye desde los canalículos, canales de Hering, conductos biliares intrahepáticos, conductos hepáticos derechos e izquierdos hasta llegar al duodeno. A nivel histopatológico, cualquier entidad que lleve a la acumulación intrahepática de bilis por disfunción hepatocelular u obstrucción biliar genera colestasis, que se observa en la biopsia hepática como la acumulación de tapones de color marrón verdoso de pigmento biliar en los hepatocitos, y secundariamente se observan los canalículos dilatados. Las causas de colestasis intrahepática son diversas e incluyen enfermedades como colangitis biliar primaria, colangitis esclerosante primaria, hepatitis autoinmune, hepatitis virales y toxicidad medicamentosa. Esta revisión tiene como objetivo analizar algunos tipos de hiperbilirrubinemia, resaltando sus características histopatológicas.
Normal serum bilirubin levels in adults range from 0.3 mg/dL to 1.2 mg/dL, and its value is determined by the rate of hepatic uptake, conjugation, and excretion. Jaundice becomes apparent when serum bilirubin levels rise above 2.5 mg/dL to 3.5 mg/dL and is an indicator of underlying disease. Bile is produced by hepatocytes and flows from the canaliculi, Hering's canals, intrahepatic bile ducts, and right and left hepatic ducts to the duodenum. Pathologically, any condition that leadsto intrahepatic accumulation of bile due to hepatocellular dysfunction or biliary obstruction, generates cholestasis, which is observed in liver biopsy as the accumulation of greenish-brown deposits of bile pigment in hepatocytes, with dilated canaliculi. The causes of intrahepatic cholestasis are diverse and include diseases such as primary biliary cholangitis and primary sclerosing cholangitis, autoimmune hepatitis, viral hepatitis, and drug toxicity. This review aims to analyze some types of hyperbilirubinemia, highlighting their histopathological characteristics.
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Humanos , Patologistas , Hiperbilirrubinemia , Icterícia , Bile , Ductos Biliares Intra-Hepáticos , Pigmentos Biliares , Bilirrubina , Biópsia , Colangite Esclerosante , Colestase , Colestase Intra-Hepática , Hepatite Autoimune , Hepatite , Fígado , Cirrose Hepática BiliarRESUMO
El cáncer de pulmón es la principal causa de muerte en el mundo por cáncer, y en Colombia es la segunda. Su pronóstico es pobre cuando se ha documentado enfermedad metastásica en el sistema nervioso central. El diagnóstico se basa en el resultado definitivo de patología. Aunque los hallazgos imagenológicos pueden ser muy sugestivos de malignidad, hay reportes de otras enfermedades que pueden imitar cáncer, tales como infecciones o tumores benignos, los cuales pueden llevar a adoptar conductas terapéuticas inapropiadas. Las infecciones fúngicas como las producidas por Criptococcus neoformans, son capaces de generar lesiones que pueden imitar neoplasias. El objetivo de esta publicación es reportar el caso de un hombre a quien inicialmente se le sospechó un carcinoma pulmonar metastásico al sistema nervioso central, y finalmente se le diagnosticó una criptococosis diseminada posterior a su fallecimiento
Lung cancer is the leading cause of death from cancer in the world and the second in Colombia, its prognosis is bad when the diagnosis of metastatic disease in the central nervous system is documented. The diagnosis is based on the definitive pathologic result. Although the imaging findings can be highly suggestive of malignancy, there are reports of other conditions that can mimic lung cancer, such as infections or benign tumors, which can lead to inappropriate treatment. Fungal infections such as those caused by Criptococcus neoformans are capable of generating lesions that can mimic neoplasms. The objective of this article is to report the case of a man who was initially diagnosed with metastatic lung carcinoma to the central nervous system, and was finally diagnosed with disseminated cryptococcosis after his death
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Humanos , Criptococose , Biópsia , Broncoscopia , Sistema Nervoso Central , Cryptococcus neoformans , Pneumopatias , Neoplasias PulmonaresRESUMO
The Peripampasic Arc is a set of low mountains / hills that connects the Andes, as it scatters to the East forming mountainous areas of lower heights in north-eastern Argentina, with the Atlantic coastal range of the Serra do Mar in Brazil. Numerous studies proved its important biogeographic connection for plant and animal phylogenies, but no information of this pattern is known to lichens. The aim of this work is to establish if the dispersion route of the lichenbiota follows the previously known Peripampasic Arc. For this reason, a comparative study of each area regarding its similarities was analyzed, with emphasis on the biota of the Buenos Aires' Sierras. We quantified the similarity and ß diversity of 104 saxicolous lichens species. There was a strong similarity between the Sierra de la Ventana and Tandil biota, which in turn is linked to the biotas of Uruguay, the Pampean Sierras and the northwest of Argentina. The lack of subgroups in the Peripampasic Arc implies the arc acts as a functional unit of dispersion, which is the most likely cause for the present lichens' distribution.
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Líquens , Mariposas , Animais , Argentina , Biota , Filogenia , PlantasRESUMO
Erythrodiplax nataliae sp. nov. (5 males), collected in Vereda wetlands (a unique Neotropical savanna environment) in Mato Grosso, Brazil is described and illustrated. The new species fits in Borror's Juliana Group, and can be distinguished from other species by the combination of the following traits: blue pruinosity on thorax (more dense dorsally); sides of the pterothorax yellowish, darkening dorsally; face ivory, dorsally black with a metallic blue reflection; wings hyaline with a small basal brown spot; vesica spermalis with long lateral lobes, enclosing the median process and median process elongated with a pair of conspicuous rectangular and elongated lateral lobes, with a middle dorso-ventral furrow.
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Odonatos , Animais , Brasil , Cor , Masculino , Fenótipo , Áreas AlagadasRESUMO
The Level of Traffic Stress (LTS) is an indicator that quantifies the stress experienced by a cyclist on the segments of a road network. We propose an LTS-based classification with two components: a clustering component and an interpretative component. Our methodology is comprised of four steps: (i) compilation of a set of variables for road segments, (ii) generation of clusters of segments within a subset of the road network, (iii) classification of all segments of the road network into these clusters using a predictive model, and (iv) assignment of an LTS category to each cluster. At the core of the methodology, we couple a classifier (unsupervised clustering algorithm) with a predictive model (multinomial logistic regression) to make our approach scalable to massive data sets. Our methodology is a useful tool for policy-making, as it identifies suitable areas for interventions; and can estimate their impact on the LTS classification, according to probable changes to the input variables (e.g., traffic density). We applied our methodology on the road network of Bogotá, Colombia, a city with a history of implementing innovative policies to promote biking. To classify road segments, we combined government data with open-access repositories using geographic information systems (GIS). Comparing our LTS classification with city reports, we found that the number of bicyclists' fatal and non-fatal collisions per kilometer is positively correlated with higher LTS. Finally, to support policy making, we developed a web-enabled dashboard to visualize and analyze the LTS classification and its underlying variables.
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The larva of Zenithoptera lanei Santos, 1941 is described and illustrated based on three exuviae of reared larvae collected in Misiones, Argentina, Roraima and Amazonas, Brazil. A comparison with the larva of Z. anceps Pujol-Luz, 1993 is included.
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Besouros , Odonatos , Animais , LarvaRESUMO
El leiomioma primario de pulmón es un tumor benigno raro, de origen mesodérmico, que representa aproximadamente el 2 % de todos los tumores benignos de pulmón. Desde que fue descrito por primera vez por Forkel en 1910, se han reportado al menos 150 casos en la literatura. Se hace una revisión del tema a propósito del caso de una mujer posmenopáusica oligosintomática, con hallazgo de una lesión pulmonar sólida, asociada a una malformación vascular, en quien la biopsia inicial reportó un tumor fusocelular, por lo que fue llevada a lobectomía superior del pulmón derecho, y cuyo diagnóstico patológico definitivo fue leiomioma pulmonar primario. Este caso se presenta por su baja incidencia y la poca literatura sobre este tipo de lesiones tumorales benignas
Primary lung leiomyoma is a rare benign tumor of mesodermal origin, that accounts for approximately 2% of all benign lung tumors. Since it was first described by Forkel in 1910, at least 150 cases have been reported in the literature. A review of the subject is made regarding the case of an oligosymptomatic postmenopausal woman, with the finding of a solid lung lesion, associated with a vascular malformation, in whom the initial biopsy reported a spindle cell tumor, for which she was taken for a right upper lung lobectomy and whose definitive pathological diagnosis was primary pulmonary leiomyoma. This case is presented due to its low incidence and the little literature on this type of benign tumor lesions
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Humanos , Leiomioma , Toracoscopia , Cirurgia Torácica Vídeoassistida , Neoplasias PulmonaresRESUMO
The American genus Argia, with more than 100 species described, is the most speciose genus of Odonata in the world. In this contribution, the final stadium larva of Argia serva, the southernmost distributed species of Argia, is described and diagnosed based on reared material from Martín García island, Buenos Aires, Argentina. The larva of this species can be easily separated from the other Argentinean Argia by the following combination of characters: sternum of S8 covered with spines (bare in A. translata); antennal segment 3 longer than 1+2 (equal to or shorter than 1+2 in A. joergenseni and A. jujuya); palpal setae absent (present in A. croceipennis). A key to the known larvae of Argia of the Southern Cone is provided.
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Larva/anatomia & histologia , Larva/classificação , Odonatos/anatomia & histologia , Odonatos/classificação , Animais , Argentina , Larva/ultraestrutura , Microscopia Eletrônica de Varredura , Odonatos/ultraestruturaRESUMO
Resumen Introducción: En la práctica clínica las infecciones de piel y tejidos blandos son frecuentes y pueden ser responsables de sepsis y complicaciones graves. Objetivo: Determinar las variables asociadas con la prescripción de antimicrobianos en pacientes con diagnóstico de infecciones de piel y tejidos blandos en un hospital de primer nivel de atención. Métodos: Estudio de corte transversal, en pacientes hospitalizados por infecciones de piel entre el 1 enero y 31 diciembre de 2014 en Hospital de La Virginia, Risaralda. Se realizó un muestreo aleatorio simple. Se incluyeron variables sociodemográficas, clínicas, farmacológicas a partir de las historias clínicas. Se definió que el tratamiento era adecuado cuando había correlación entre el diagnóstico de cada paciente registrado según la Clasificación Internacional de las Enfermedades -10 como infección purulenta o no purulenta, severidad y el medicamento prescrito. Se realizó análisis multivariado. Resultados: Se identificaron 309 pacientes en quienes las penicilinas fueron los antibióticos iniciales más formulados (81,7 %); el 74,8 % recibió tratamiento antibiótico indicado. La comedicación más frecuentemente encontrada fue con antiinflamatorios no esteroideos (61,2 %). Recibir el primer antibiótico por vía oral tuvo menor probabilidad de que la prescripción fuese inadecuada (OR: 0,2; IC95 %:0,1-0,4). Conclusión: Los datos obtenidos deben ser destinados para mejorar las prescripciones y permitir la implementación de planes de capacitación que contribuyan a que la terapia sea más efectiva y segura.
Abstract Introduction: Infections of skin and soft tissues are common in clinical practice, which may even be responsible for sepsis and severe complications. Objective: To describe the prescription of antimicrobials and variables associated with their use in patients with diagnosis of infections of skin and soft tissues in a primary care hospital. Materials and Methods: Cross-sectional study in patients hospitalized for infections of the skin between 1 January and 31 December 2014. A simple random sampling was performed. Were included sociodemographic, clinical and pharmacological variables from medical records. Treatment was defined as adequate when there was a correlation between the diagnosis of each patient according to the International Classification of Diseases (ICD-10) as purulent or non-purulent infection, severity (mild, moderate or severe) and prescribed medication. Multivariate analysis using. SPSS 22.0. Results: A total of 309 patients were included, and the penicillins corresponded to the initial most formulated antibiotics (81.7 % of cases); 231patients (74.8 %) had well indicated antibiotic treatment. Comorbid conditions most frequently found in patients of this cohort were antiinflammatory drugs (NSAIDs) (61.2 %). Receiving the first oral antibiotic was less likely that the prescription was inadequate (OR:0.215;IC95 %:0.115-0.400). Conclusion: The data obtained should be aim to improving prescriptions and should allow implement training plans that contribute to therapy more effective and safe.
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Anisopterous odonate male's secondary genitalia is a complex of several structures, among them the vesica spermalis is the most informative with important specific characters. The observation of those characters, mostly of membranous nature, is difficult in the Scanning Electron Microscope due to dehydration and metallization processes. In this contribution, we discuss a new and low cost procedure for the observation of these characters in the SEM, compatible with the most common agents used for preserving specimens.
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Microscopia Eletrônica de Varredura/métodos , Odonatos/ultraestrutura , Manejo de Espécimes/métodos , Animais , Masculino , Microscopia Eletrônica de Varredura/economia , Microscopia Eletrônica de Varredura/instrumentação , Odonatos/anatomia & histologia , Preservação BiológicaRESUMO
Una de las principales limitaciones que presentan las personas con discapacidad auditiva está directamente relacionada con su dificultad para interactuar con otras personas, ya sea de forma verbal o a través de sistemas auxiliares basados en la voz y el audio. En este artículo se presenta el desarrollo de un sistema integrado de hardware y software, para el reconocimiento automático del lenguaje dactilológico de señas utilizado por personas con este tipo de discapacidad. El hardware está compuesto por un sistema inalámbrico adherido a un guante, el cual posee un conjunto de sensores que capturan una serie de señales generadas por los movimientos gestuales de la mano, y un modelo por adaptación basado en los principios de la computación neuronal, el cual permite su reconocimiento en términos de un lenguaje dactilológico en particular. Los resultados arrojados por el sistema integrado mostraron gran efectividad en el reconocimiento de las vocales que conforman el lenguaje dactilológico en español, esto gracias a la capacidad que posee el modelo de asociar un conjunto de señales de entrada, con un movimiento dactilológico en particular.
One of the main limitations of the people with hearing impairment is directly related to their difficulty interacting with others, either verbally or through auxiliary systems based on voice and audio. This paper presents the development of an integrated system of hardware and software for automatic fingerspelling sign language used by people with this type of disability. The hardware system comprises a glove which has a set of wireless sensors that capture a series of signals generated by the hand gestures, and a adaptive model based on the principles of neural computation, that allows recognition of a particular dactilologic language. Results from the integrated system showed great effectiveness in recognizing vowels from the dactilologic Spanish language. This recognition was influenced by the dimensionality reduction made by the neural model of the input signals representing movements, and the sensitivity factor that sets the limit between recognition and learning.
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La enfermedad de células falciformes, aunque infrecuente, es una patología con una alta comorbilidad; el ataque cerebrovascular (ACV) y las malformaciones vasculares por deformidad endotelial, son complicaciones mayores y catastróficas en las pacientes con alteraciones falciformes, es por esto que el adecuado seguimiento de estos pacientes permite prevenir la alta tasa de complicaciones que esta enfermedad conlleva. Se presenta el caso de una mujer de raza negra de 24 años con enfermedad de células falciformes, con infartos cerebrales en la adolescencia y quien durante su gestación se complica con hemorragia intraventricular secundaria a múltiples malformaciones vasculares tipo Moyamoya, desarrollando un estado epiléptico convulsivo y deterioro neurológico irreversible.
Sickle cell disease, although infrequent, is a disease with high comorbidity, stroke and vascular malformations by endothelial deformity are major and catastrophic complications in patients with sickle cell disease, which is why proper monitoring of these patients can prevent the high rate of complications that this disease leads. The situation of a 24 years old african-american woman with sickle cell disease and several strokes during adolescence is exposed. The patient had a complicated pregnancy due to secondary intraventricular hemorrhage and multiple vascular malformations type Moyamoya. She developed a convulsive status epilepticus and an irreversible neurological impairment.