RESUMO
La sífilis es una enfermedad infectocontagiosa con afectación sistémica, de evolución aguda o crónica, cuyo agente causal es el Treponema pallidum. Su principal mecanismo de transmisión es el contacto sexual sin protección, seguida de riesgo de contagio por transfusión sanguínea. Objetivo: Determinar la seroprevalencia de sífilis en donantes del banco de sangre del Hospital Universitario de Maracaibo, periodo 2012-2014. Metodología: Se realizó un estudio descriptivo, de corte transversal, no experimental que incluyó encuestas con pruebas serológicas confidenciales basada en el principio de ELISA. Se procesaron un total de 45.356 unidades de sangre. El 84,7% (38.414) de los donantes eran hombres y el 15,3% (6.942) mujeres con una edad promedio de 31,1 años. Durante este periodo se observó que la seroprevalencia general de anticuerpos específicos anti- T. pallidum en estos donantes fue de 2,95% lo que equivale a 1.336 casos de serología positiva, representada por individuos en edades comprendidas entre 29-39 años con un 35,1 % (470). El sexo masculino muestra la mayor frecuencia de donantes positivos con un 87,7% (1.172). Todo esto indica la necesidad de hacer un seguimiento longitudinal a largo plazo y de implementar programas de vigilancia epidemiológica.
Syphilis is an infectious disease with systemic involvement, chronic or acute evolution, whose causal agent is Treponema pallidum. Its main mechanism of transmission is unprotected sexual contact, followed by risk of transmission by blood transfusion. Objective: To determine the seroprevalence associated with syphilis in blood bank donors at the Universitario Hospital of Maracaibo during the period 2012-12014. Methodology: A non-experimental descriptive study, cross-sectional surveys that included confidential serological tests based on the principle of ELISA to detect anti-T. pallidum antibodies was performed. A total of 45,356 units of blood were processed. 84.7% (38,414) of donors were men and 15.3% (6,942) women with an average age of 31.1 years. During this period it was observed that the specific overall seroprevalence of anti- T. pallidum in these donors was 2.95% which is equivalent to 1,336 cases of positive serology, represented by individuals 29-39 aged 35,1% (470). The male shows increased frequency of positive donors with 87.7% (1,172). All this indicates the need for a long-term longitudinal follow and implement epidemiological surveillance programs.
RESUMO
The association between vascular tumors and thrombocytopenia is rare. Kasabach-Merritt Syndrome is seen in childhood and is characterized by hemangiomas and thrombocytopenia. A 42 years-old man with a cerebellar hemangioblastoma and thrombocytopenia, admitted with a subarachnoid hemorrhage is reported. The patient was operated and required a splenectomy to manage the thrombocytopenia. After the splenectomy the patient developed a subdural hematoma that was operated. Despite the surgical treatment, the patient died.
Assuntos
Neoplasias Cerebelares/complicações , Hemangioblastoma/complicações , Trombocitopenia/complicações , Adulto , Neoplasias Cerebelares/patologia , Neoplasias Cerebelares/terapia , Diagnóstico Diferencial , Evolução Fatal , Hemangioblastoma/patologia , Hemangioblastoma/terapia , Hematoma Subdural/complicações , Hematoma Subdural/patologia , Humanos , Síndrome de Kasabach-Merritt/patologia , Imageamento por Ressonância Magnética , Masculino , Trombocitopenia/patologia , Trombocitopenia/terapia , Tomografia Computadorizada por Raios XRESUMO
The association between vascular tumors and thrombocytopenia is rare. Kasabach-Merritt Syndrome is seen in childhood and is characterized by hemangiomas and thrombocytopenia. A 42 years-old man with a cerebellar hemangioblastoma and thrombocytopenia, admitted with a subarachnoid hemorrhage is reported. The patient was operated and required a splenectomy to manage the thrombocytopenia. After the splenectomy the patient developed a subdural hematoma that was operated. Despite the surgical treatment, the patient died.
Assuntos
Humanos , Masculino , Adulto , Trombocitopenia/complicações , Neoplasias Cerebelares/complicações , Hemangioblastoma/complicações , Trombocitopenia/patologia , Trombocitopenia/terapia , Imageamento por Ressonância Magnética , Tomografia Computadorizada por Raios X , Neoplasias Cerebelares/patologia , Neoplasias Cerebelares/terapia , Hemangioblastoma/patologia , Hemangioblastoma/terapia , Evolução Fatal , Diagnóstico Diferencial , Síndrome de Kasabach-Merritt/patologia , Hematoma Subdural/complicações , Hematoma Subdural/patologiaRESUMO
Objetivo: Presentar el electrocardiograma de un paciente con hallazgos múltiples en el síndrome coronario agudo y la enfermedad coronaria grave. Métodos: Presentación de un caso con antecedentes y el cuadro clínico de ingreso, el manejo instaurado y el desenlace. Resultados y conclusiones: Las manifestaciones electrocardiográficas del síndrome coronario agudo y la enfermedad coronaria grave van más allá de los cambios en el segmento ST y la T; cambios en la onda P y en la morfología del QRS también son indicativos de mal pronóstico.
Aim: To present the electrocardiogram of a patient with multiple manifestations in the context of acute coronary syndrome and severe coronary heart disease. Methods: Case report including past history, clinical presentation, treatment and outcome. Results and conclusions: Electrocardiographic manifestations in acute coronary syndrome and severe coronary heart disease is beyond ST and T changes; P wave changes and in the QRS wave morphology are indicative of worst prognosis.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Bloqueio de Ramo , Doença das Coronárias , Infarto do MiocárdioRESUMO
BACKGROUND: Tumor necrosis factor-alpha (TNF-alpha) has an increased expression in the adipose tissue of obese subjects and is involved in insulin resistance. AIM: To screen for associations between -308G/A, -238G/A, -376G/A and -163G/A genetic variants of the TNF-alpha gene, diabetes and obesity-related variables. MATERIAL AND METHODS: A group of 263 elderly women aged 60-90 years were recruited. Among them, an oral glucose tolerance test was performed and serum lipids measured in 100 women. TNF-alpha genotypes were determined by polymerase chain reaction (PCR) and analysis of restriction fragment length polymorphisms. RESULTS: No significant differences were found when comparing allele frequencies in TNF-alpha polymorphisms of normal subjects with those having impaired glucose tolerance or type 2 diabetes. After excluding patients with previous diagnosis of diabetes, no significant differences by polymorphism carrier status were found for plasma levels of lipids, glucose and insulin. Additionally, no significant differences were found for the association between variables related to adiposity and the -308G/A polymorphisms. CONCLUSIONS: It is unlikely that polymorphisms in the promoter region of the TNF-alpha gene have a major influence in obesity and diabetes phenotypes in Chilean elderly women.
Assuntos
Diabetes Mellitus Tipo 2/genética , Obesidade/genética , Polimorfismo Genético/genética , Regiões Promotoras Genéticas , Fator de Necrose Tumoral alfa/genética , Adulto , Idoso , Glicemia , Índice de Massa Corporal , Chile , Estudos Transversais , Feminino , Frequência do Gene , Genótipo , Teste de Tolerância a Glucose , Humanos , Resistência à Insulina , Lipídeos/sangue , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Polimorfismo de Fragmento de RestriçãoRESUMO
Background : Tumor necrosis factor-alpha (TNF-alpha) has an increased expression in the adipose tissue of obese subjects and is involved in insulin resistance. Aim: To screen for associations between -308G/A, -238G/A, -376G/A and -163G/A genetic variants of the TNF-alpha gene, diabetes and obesity-related variables. Material and methods: A group of 263 elderly women aged 60-90 years were recruited. Among them, an oral glucose tolerance test was performed and serum lipids measured in 100 women. TNF-alpha genotypes were determined by polymerase chain reaction (PCR) and analysis of restriction fragment lenght polymorphisms. Results: No significant differences were found when comparing allele frequencies in TNF-alpha polymorphisms of normal subjects with those having impaired glucose tolerance or type 2 diabetes. After excluding patients with previous diagnosis of diabetes, no significant differences by polymorphism carrier status were found for plasma levels of lipids, glucose and insulin. Additionally, no significant differences were found for the association between variables related to adiposity and the ¡308G/A polymorphisms. Conclusions: It is unlikely that polymorphisms in the promoter region of the TNF-alpha gene have a major influence in obesity and diabetes phenotypes in Chilean elderly women.
Assuntos
Adulto , Idoso , Feminino , Humanos , Pessoa de Meia-Idade , Regiões Promotoras Genéticas , /genética , Obesidade/genética , Polimorfismo Genético/genética , Fator de Necrose Tumoral alfa/genética , Glicemia , Índice de Massa Corporal , Chile , Estudos Transversais , Frequência do Gene , Genótipo , Teste de Tolerância a Glucose , Resistência à Insulina , Lipídeos/sangue , Reação em Cadeia da Polimerase , Polimorfismo de Fragmento de RestriçãoRESUMO
Objetivo: determinar el número de niños y niñas entre 4 y 12 de la consulta pediátrica que ameritaban una consulta psiquiátrica. Conclusiones: una quinta parte de niños y niñas de la consulta pediátrica necesita evaluación pediátrica
Assuntos
Humanos , Criança , Psiquiatria Infantil , Serviço Social em PsiquiatriaRESUMO
Al resistance of signalgrass (Brachiaria decumbens Stapf cv Basilisk), a widely sown tropical forage grass, is outstanding compared with the closely related ruzigrass (Brachiaria ruziziensis Germain and Evrard cv Common) and Al-resistant genotypes of graminaceous crops such as wheat, triticale, and maize. Secretion of organic acids and phosphate by root apices and alkalinization of the apical rhizosphere are commonly believed to be important mechanisms of Al resistance. However, root apices of signalgrass secreted only moderately larger quantities of organic acids than did those of ruzigrass, and efflux from signalgrass apices was three to 30 times smaller than from apices of Al-resistant genotypes of buckwheat, maize, and wheat (all much more sensitive to Al than signalgrass). In the presence, but not absence, of Al, root apices of signalgrass alkalinized the rhizosphere more than did those of ruzigrass. The latter was associated with a shortening of the alkalinizing zone in Al-intoxicated apices of ruzigrass, indicating that differences in alkalinizing power were a consequence, not a cause of, differential Al resistance. These data indicate that the main mechanism of Al resistance in signalgrass does not involve external detoxification of Al. Therefore, highly effective resistance mechanisms based on different physiological strategies appear to operate in this species.
Assuntos
Alumínio/toxicidade , Raízes de Plantas/metabolismo , Poaceae/efeitos dos fármacos , Alumínio/farmacocinética , Resistência a Medicamentos/genética , Genótipo , Inativação Metabólica , Poaceae/fisiologia , Especificidade da EspécieRESUMO
Background: The cytosolic protein p47-phox (phagocyte oxidase) is one of the essential components of the superoxide generating system in phagocytes and its defect causes approximately 30 percent of the chronic granulomatous disease (CGD) cases. Aim: Two patients were studied, belonging to the same family, without a consanguinous background, in which deficiency or absence of superoxide generation was found together with recurrent and severe infections in one case and benign infections in the second. Methods: The presence of gp91-, p67- and p47-phox in patients and controls was determined by Western Blot analysis of granulocytes. Sequencing of PCR amplified DNA was performed by an enzimatic method. Results: Western Blot analysis showed normal expression of gp91 and p67 and absence of p47-phox. The molecular genetic study demonstrated a homocygotic dinucleotide GT (GT) deletion at the beginning of exon 2 of the p47-phox gene. The same mutation has been found in European, American and Japanese patients. Conclusions: The molecular characterization of this pathology done for the first time in Chile is important for diagnostic classification, patient prognosis, and adequate genetic advice and a possible future therapy
Assuntos
Humanos , Masculino , Adolescente , Adulto , Doença Granulomatosa Crônica/genética , Proteínas Quinases/deficiência , Western Blotting , Reação em Cadeia da Polimerase , Éxons/genética , NADPH Oxidases/genética , Leucócitos/imunologia , Nitroazul de Tetrazólio , Amplificação de Genes/métodos , Análise Mutacional de DNARESUMO
Se realizo un estudio descriptivo, retrospectivo para evaluar la incidencia de ruptura uterina en el Hospital General de Medellin, en un periodo de 10 anos. Se presentaron 42 casos para una proporción acumulada de 1:4466 partos y una tasa de incidencia de 26.59 casos por 100.000 partos. Los 2 principales factores de riesgo fueron el antecedente de cicatriz uterina en el 50% de las pacientes y el uso de oxitocina exogena en el 30.9%. El 73.8% de las pacientes presento algunos de los factores de riesgo estudiados y entre las posibles causas, el trabajo de parto prolongado y la distocia mecanica, fueron las dos mas importantes en su orden. El tratamiento consistio en histerectomia total en le 47.6% e histerorrafia en una proporción igual de las pacientes. Dos pacientes (4.7%) fueron solamente observadas. Como tratamiento complementario se realizo hemotransfusion en el 73.8% de los casos. entre otros. No hubo muertes maternas; sin embargo, la mortalidad fetal fue de 64.2% y la perinatal del 69%. Solo el 27.5% de las muertes perinatales ocurrieron en el grupo de bajo peso (2.500 gr.) El 95% de los casos ocurrieron despues del inicio del trabajo de parto y el 4.7% ( dos casos) antes; ambos causados por acretismo placentario con perforación del peritoneo visceral
Assuntos
Humanos , Feminino , Ruptura Uterina , Colômbia , Ruptura Uterina/complicações , Ruptura Uterina/epidemiologia , Ruptura Uterina/mortalidade , Ruptura Uterina/terapiaRESUMO
Se comunica el caso de una mujer de 44 años con cuadro clínico-histopatológico de una linfangiomiomatosis. Presentaba además lesiones cutáneas y estigmas neurológicos de esclerosis tuberosa. Desarrolló quilotorax recurrente y peoría progresiva que no pudieron ser controladas mediante tratamiento con dieta, broncodilatadores, corticoides y progesterona. La búsqueda de receptores estrogénicos en una biopsia pulmonar a cielo abierto fue positiva. Tal hallazgo representa una evidencia importante para establecer una asociación entre esclerosis tuberosa y linfangiomiomatosis. El tratamiento con tamoxifeno y la pleurodesis con tetraciclina fueron medidas terapéuticas satisfactorias para detener el curso progresivo de la enfermedad y controlar el quilotorax (AU)
Assuntos
Adulto , Humanos , Feminino , Esclerose Tuberosa/complicações , Linfangiomioma/complicações , Músculo Liso/patologia , Pulmão/patologia , Quilotórax/terapia , Tamoxifeno/uso terapêuticoRESUMO
Se comunica el caso de una mujer de 44 años con cuadro clínico-histopatológico de una linfangiomiomatosis. Presentaba además lesiones cutáneas y estigmas neurológicos de esclerosis tuberosa. Desarrolló quilotorax recurrente y peoría progresiva que no pudieron ser controladas mediante tratamiento con dieta, broncodilatadores, corticoides y progesterona. La búsqueda de receptores estrogénicos en una biopsia pulmonar a cielo abierto fue positiva. Tal hallazgo representa una evidencia importante para establecer una asociación entre esclerosis tuberosa y linfangiomiomatosis. El tratamiento con tamoxifeno y la pleurodesis con tetraciclina fueron medidas terapéuticas satisfactorias para detener el curso progresivo de la enfermedad y controlar el quilotorax
Assuntos
Adulto , Humanos , Feminino , Linfangiomioma/complicações , Esclerose Tuberosa/complicações , Músculo Liso/patologia , Pulmão/patologia , Quilotórax/terapia , Tamoxifeno/uso terapêuticoRESUMO
Se estudio la influencia de la edad y el sexo en la excrecion de leucocitos y eritrocitos en la orina de 177 ninos sanos, los que se dividieron en tres grupos segun la edad: de dos a cinco, de seis a 11 y de 12 a 16 anos. El grupo de 12 a 16 anos excreto mayor cantidad de leucocitos y eritrocitos que los grupos de menor edad. La excrecion de leucocitos en las minas fue ligeramente mayor que en los ninos.Las cifras de excrecion de leucocitos obtenidos en la percentila 97 fueron de 500, 600 y 1000 por minuto en ninos; de eritrocitos de 1000, 850 y 1100 por minuto en ninas;de eritrocitos de 800, 800 y 950 por minuto en ninos y de 700, 800 y 850 por minuto en ninas, respectivamente por grupo de edad