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Abstract The species formerly included in the Pertyella camposseabrai species-group are reviewed. The following two species are transferred from the genus Mutilla to Pertyella: P. angulosa (Burmeister, 1854) new combination, and P. carinigena (Cresson, 1902) new combination. The following new synonymies are proposed: P. mayri (Kohl, 1882); P. paulista Casal, 1964; P. viuva Casal, 1964; P. itinga Casal, 1964; P. camposseabrai Casal, 1964; P. uzai Fritz, 1990 and P. diasi Fritz, 1990 are jr. synonyms of P. angulosa; P. lenti Casal, 1964 is a jr. synonym of P. carinigena; P. aguaz Fritz, 1990 is a jr. synonym of P. cordoi Fritz, 1990. A new species in this group, Pertyella quirosae sp. nov., is described. Most characters that were formerly used to define this species-group are not consistent or exclusive to the group. Because the diagnostic features and component species in this species-group were changed, and because an older name is now available, this group of species is now called the P. angulosa species-group. Females of this group can be recognized by having the mesosoma with lateral stripes of dense silvery or whitish setae. A key to the species of the P. angulosa species-group and new distribution records are provided.
Resumen Se revisan las especies anteriormente incluidas en el grupo de especies de Pertyella camposseabrai. Las siguientes dos especies se transfieren del género Mutilla a Pertyella: P. angulosa (Burmeister, 1854) combinación nueva y P. carinigena (Cresson, 1902) combinación nueva. Se proponen las siguientes sinonimias nuevas: P. mayri (Kohl, 1882); P. paulista Casal, 1964; P. viuva Casal, 1964; P. itinga Casal, 1964; P. camposseabrai Casal, 1964; P. uzai Fritz, 1990 y P. diasi Fritz, 1990 son jr. sinónimos de P. angulosa; P. lenti Casal, 1964 es un jr. sinónimo de P. carinigena; P. aguaz Fritz, 1990 es un jr. sinónimo de P. cordoi Fritz, 1990. Se describe una especie nueva en este grupo, Pertyella quirosae sp. nov.. La mayoría de los caracteres que se usaban anteriormente para definir este grupo de especies no son consistentes o exclusivos del grupo. En virtud de que se cambiaron las características de diagnóstico y las especies componentes de este grupo de especies, y debido a que en este momento se dispone de un nombre más antiguo, ahora se denomina especies del grupo P. angulosa. Las hembras de este grupo pueden ser reconocidas por tener el mesosoma con franjas laterales de densas setas plateadas o blanquecinas. Se proporciona una clave para las especies del grupo P. angulosa y nuevos registros de distribución.
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Disseminated and recurrent infundibulofolliculitis is an uncommon non-infectious skin eruption characterized by recurrent, sometimes pruritic, follicular papules commonly seen on the trunk and proximal extremities. We describe the clinical, dermoscopic, and histopathologic characteristics of disseminated and recurrent infundibulofolliculitis in three young pediatric patients from the tropical regions of Mexico, Guerrero, and Chiapas.
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Exantema , Foliculite , Criança , Foliculite/diagnóstico , Humanos , México/epidemiologia , Recidiva , TroncoRESUMO
BACKGROUND: Providers of total hip and knee replacements are being judged regarding quality/cost by payers using competition-based performance measures with poor medical and no socioeconomic risk adjustment. Providers might assume that other providers shed risk and the perception of added risk can influence practice. A poll was collected to examine such perceptions. METHODS: In 2019 a poll was sent to the 2800 surgeon members of the American Association of Hip and Knee Surgeons using Survey Monkey while protecting respondent anonymity/confidentiality. The questions asked whether the perception of poorly risk-adjusted medical comorbidities and socioeconomic risk factors influence surgeons to selectively offer surgery. RESULTS: There were 474 surgeon responses. Prior to elective total hip arthroplasty/total knee arthroplasty, 95% address modifiable risk factors; 52% require a body mass index <40, 64% smoking cessation, 96% an adequate hemoglobin A1C; 82% check nutrition; and 63% expect control of alcohol 2. Due to lack of socioeconomic risk adjustment, 83% reported feeling pressure to avoid/restrict access to patients with limited social support, specifically the following: Medicaid/underinsured, 81%; African Americans, 29%; Hispanics/ethnicities, 27%; and low socioeconomic status, 73%. Of the respondents, 93% predicted increased access to care with more appropriate risk adjustment. CONCLUSION: Competition-based quality/cost performance measures influence surgeons to focus on medical risk factors in offering lower extremity arthroplasty. The lack of socioeconomic risk adjustment leads to perceptions of added risk from such factors as well. This leads to marginal loss of access for patients within certain medical and socioeconomic classes, contributing to existing healthcare disparities. This represents an unintended consequence of competition-based performance measures.
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Artroplastia de Quadril , Artroplastia do Joelho , Cirurgiões , Humanos , Articulação do Joelho , Percepção , Estados Unidos/epidemiologiaRESUMO
ABSTRACT The secondary metabolites of the aerial parts of Zornia brasiliensis Vogel, Fabaceae, and the biological activity of one of these secondary metabolites were characterized in this study. A phytochemical investigation was performed using chromatographic techniques including analytical and preparative reverse-phase HPLC column sequences, which resulted in the isolation of fourteen compounds: one previously undescribed C-glycosylated dihydrochalcone (zornioside), one cyclitol (D-pinitol), one glycosylated megastigmane (roseoside) and eleven phenolic compounds: 7-methoxyflavanone, 7,4'-dimethoxyisoflavone, medicarpin, 2'-4'-dihydroxychalcone, onionin, isoorientin-3'-O-methyl ether, isovitexin, glycosylated (Z)-O-coumaric acid, glycosylated (E)-O-coumaric acid, dihydromelilotoside, and isoorientin. The structures of the isolated compounds were determined based on 1D and 2D-NMR, HRESIMS, IR and CD spectroscopic analyses. The cytotoxic activity of zornoside was assessed against tumor cell lines (MCF-7, HCC1954, T-47D, 4T1, HL60), and a non-tumor cell line (RAW264.7) using MTT assay. The compound zornioside was selectively cytotoxic for HL60 leukemia cells (IC50: 37.26 µM).
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Anterocollis is a type of cervical dystonia characterized by simultaneous and repetitive antagonist muscles contractions, resulting in abnormal neck flexion. It was described with a frequency of 6.8% from 399 patients with diagnosis of cervical dystonia and usually coexists with torticollis and/or laterocollis, as mixed cervical dystonia patterns. Botulinum toxin is usually a practical and effective treatment for cervical dystonia. The target muscles to inject in anterocollis are usually sternocleidomastoid and scalene muscles. There is also a case report suggesting longus collis involvement. Nevertheless, the dosage of the medication in anterocollis is limited by frequent side effects of dysphagia. We described 2 cases of refractory anterocollis. They did not benefit from conventional bilateral upper portion of sternocleidomastoid muscle injections with OnabotulinumtoxinA, but notably improved their symptoms and clinical global impression after switching to injections into bilateral lower portion of sternocleidomastoid muscles, without significant side effects.
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Toxinas Botulínicas Tipo A/uso terapêutico , Músculos do Pescoço/efeitos dos fármacos , Fármacos Neuromusculares/uso terapêutico , Torcicolo/tratamento farmacológico , Idoso , Humanos , MasculinoRESUMO
Heterologous prime-boost vaccination using plasmid DNA followed by replication-defective adenovirus vector generates a large number of specific CD8⺠T effector memory (TEM) cells that provide long-term immunity against a variety of pathogens. In the present study, we initially characterized the frequency, phenotype, and function of these T cells in vaccinated mice that were subjected to infectious challenge with the human protozoan parasite Trypanosoma cruzi. We observed that the frequency of the specific CD8⺠T cells in the spleens of the vaccinated mice increased after challenge. Specific TEM cells differentiated into cells with a KLRG1(High) CD27(Low) CD43(Low) CD183(Low)T-bet(High) Eomes(Low) phenotype and capable to produce simultaneously the antiparasitic mediators IFNγ and TNF. Using the gzmBCreERT2/ROSA26EYFP transgenic mouse line, in which the cells that express Granzyme B after immunization, are indelibly labeled with enhanced yellow fluorescent protein, we confirmed that CD8⺠T cells present after challenge were indeed TEM cells that had been induced by vaccination. Subsequently, we observed that the in vivo increase in the frequency of the specific CD8⺠T cells was not because of an anamnestic immune response. Most importantly, after challenge, the increase in the frequency of specific cells and the protective immunity they mediate were insensitive to treatment with the cytostatic toxic agent hydroxyurea. We have previously described that the administration of the drug FTY720, which reduces lymphocyte recirculation, severely impairs protective immunity, and our evidence supports the model that when large amounts of antigen-experienced CD8⺠TEM cells are present after heterologous prime-boost vaccination, differentiation, and recirculation, rather than proliferation, are key for the resultant protective immunity.
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Adenoviridae/genética , Linfócitos T CD8-Positivos/imunologia , Doença de Chagas/imunologia , Vetores Genéticos/genética , Memória Imunológica , Trypanosoma cruzi/imunologia , Adenoviridae/imunologia , Animais , Animais Geneticamente Modificados , Linfócitos T CD8-Positivos/citologia , Linfócitos T CD8-Positivos/metabolismo , Diferenciação Celular , Doença de Chagas/prevenção & controle , Modelos Animais de Doenças , Feminino , Vetores Genéticos/imunologia , Humanos , Imunofenotipagem , Ativação Linfocitária/imunologia , Contagem de Linfócitos , Camundongos , Baço/imunologia , Especificidade do Receptor de Antígeno de Linfócitos T/imunologia , Vacinação , Vacinas Sintéticas/genética , Vacinas Sintéticas/imunologiaRESUMO
BACKGROUND: DYT-5 dystonia usually presents as a dopa-responsive dystonia (DRD) with early or late parkinsonian manifestations and/or dystonic features. Genetically, these patients have been described as having a wide array of independent mutations in the guanosine triphosphate cyclohydrolase 1 gene (GCH1), and these patients may also have a wide array of clinical manifestations. METHODS: A Colombian family with six affected female members was characterized. RESULTS: Three members, including the index case, revealed mild parkinsonism, whereas three granddaughters of the index case showed severe generalized dystonia. No men were affected. There was anticipation, and a female predominance was uncovered. Treatment with levodopa was generally effective except in a case with severe skeletal deformities and contractions. Detailed genetic analysis in the index case revealed a new mutation in exon 1 of GCH1 (c.159delG). DISCUSSION: This study revealed a new mutation of GCH1 that resulted in heterogeneous clinical presentations of DRD within a large family.
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OBJECTIVE: Data on the use of Imatinib (IM) in developing countries remain limited. A retrospective study was done to assess the efficacy and toxicity of IM in treating chronic myeloid leukaemia (CML) in Trinidad and Tobago. METHODS: Patients in all phases of CML who started IM therapy between February 2001 and February 2004 were included. All had received other previous therapy. They were assessed for haematological, cytogenetic and molecular response, overall survival (OS), event free survival (EFS) and adverse effects (AE). RESULTS: Twenty-five patients were followed-up for a median 61 months. At initiation ofIM, 18 were in the chronic phase (CP), 3 in accelerated phase (AP), 3 in blast crisis (BC) and one in myelofibrotic transformation (MF). Overall, 96% of patients achieved complete haematological remission (CHR). Among CP patients, 67% attained a major cytogenetic response (MCR) and 44% a complete cyto genetic response (CCR). Overall survival and event free survival in the CP group were 82% and 76% respectively. Overall survival for advanced phase patients was 14% at 61 months The adverse effects of IM were the same as previously described and generally tolerable. No patient opted to discontinue IM because ofside effects. CONCLUSION: After 5 years of follow-up, IM was found to induce favourable and durable survival responses with an acceptable side effect profile in CP-CML patients who had received prior treatment with alternative agents.
OBJETIVO: Los datos sobre el uso de imatinib (IM) en los países en vías de desarrollo, siguen siendo limitados. Se hizo un estudio retrospectivo con el fin de evaluar la eficacia y toxicidad de IM en el tratamiento de la leucemia mieloide crónica (LMC) en Trinidad y Tobago. MÉTODOS: Se incluyeron todos los pacientes -en todas las fases de LMC - que empezaron la terapia de IM entre febrero de 2001 y febrero de 2004. Todos habían recibido otra terapia previamente. Se les evaluó con respecto a su respuesta hematológica, citogenética y molecular, supervivencia global (SG), supervivencia libre de eventos (SLE), y efectos adversos (EA). RESULTADOS: Veinticinco pacientes tuvieron seguimiento por espacio de 61 meses como promedio. En la iniciación de IM, 18 estaban en fase crónica (FC), 3 en la fase acelerada (FA), 3 en crisis blástica (CB) y uno en transformación mielofibrótica (MF). En general, 96% de los pacientes lograron la remisión hematológica completa (RHC). Entre los pacientes de CF, 67% lograron una repuesta citogénica mayor (RCM) y 44% una respuesta citogénica completa (RCC). La supervivencia global (SG) y la supervivencia libre de eventos (SLE) en el grupo FC fueron 82% y 76% respectivamente. La supervivencia global para los pacientes en fase avanzada fue de 14% en 61 meses. Los EA de IM fueron los mismos previamente descritos, y eran generalmente tolerables. Ningún paciente optó por discontinuar IM debido a efectos adversos. CONCLUSIÓN: Después de 5 años de seguimiento, se halló que IM induce respuestas de supervivencia favorables y duraderas en los pacientes de LMC-FC previamente tratados, con un perfil aceptable de efectos colaterales.
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Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Antineoplásicos/uso terapêutico , Leucemia Mielogênica Crônica BCR-ABL Positiva/tratamento farmacológico , Piperazinas/uso terapêutico , Proteínas Tirosina Quinases/antagonistas & inibidores , Pirimidinas/uso terapêutico , Seguimentos , Estimativa de Kaplan-Meier , Leucemia Mielogênica Crônica BCR-ABL Positiva/mortalidade , Resultado do Tratamento , Trinidad e TobagoRESUMO
OBJECTIVE: Data on the use of Imatinib (IM) in developing countries remain limited. A retrospective study was done to assess the efficacy and toxicity of IM in treating chronic myeloid leukaemia (CML) in Trinidad and Tobago. METHODS: Patients in all phases of CML who started IM therapy between February 2001 and February 2004 were included. All had received other previous therapy. They were assessed for haematological, cytogenetic and molecular response, overall survival (OS), event free survival (EFS) and adverse effects (AE). RESULTS: Twenty-five patients were followed-up for a median 61 months. At initiation of IM, 18 were in the chronic phase (CP), 3 in accelerated phase (AP), 3 in blast crisis (BC) and one in myelofibrotic transformation (MF). Overall, 96% of patients achieved complete haematological remission (CHR). Among CP patients, 67% attained a major cytogenetic response (MCR) and 44% a complete cytogenetic response (CCR). Overall survival and event free survival in the CP group were 82% and 76% respectively. Overall survival for advanced phase patients was 14% at 61 months. The adverse effects of IM were the same as previously described and generally tolerable. No patient opted to discontinue IM because of side effects. CONCLUSION: After 5 years of follow-up, IM was found to induce favourable and durable survival responses with an acceptable side effect profile in CP-CML patients who had received prior treatment with alternative agents.
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Antineoplásicos/uso terapêutico , Leucemia Mielogênica Crônica BCR-ABL Positiva/tratamento farmacológico , Piperazinas/uso terapêutico , Proteínas Tirosina Quinases/antagonistas & inibidores , Pirimidinas/uso terapêutico , Adolescente , Adulto , Idoso , Benzamidas , Feminino , Seguimentos , Humanos , Mesilato de Imatinib , Estimativa de Kaplan-Meier , Leucemia Mielogênica Crônica BCR-ABL Positiva/mortalidade , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Trinidad e Tobago , Adulto JovemRESUMO
We describe two adult cases of neurologic complications occurring after the administration of the influenza vaccine. The first case described is a 68 year-old man who experienced paresthesias of the upper and lower extremities two weeks after vaccination, and the second case was a 64 year-old female who exhibited paraplegia eighteen days after vaccination. Diagnosis of acute idiopathic demyelinating polyradiculopathy (Guillain-Barré syndrome) was made for both patients, and intravenous gammaglobulin therapy was given with marked improvement of the first case, but poor response on the second case. Although the efficacy of influenza vaccination has been widely accepted, such neurologic complications might occur in the elderly and adult population. Even if Guillain-Barré syndrome was a true side effect of vaccination, the risk is substantially lower than is the risk for complications following influenza. The rare occurrence of neurological complications after influenza vaccine should not discourage against the vaccination.
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Síndrome de Guillain-Barré/induzido quimicamente , Vacinas contra Influenza/efeitos adversos , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
BACKGROUND: Nearly 10% of patients with an actual acute coronary syndrome (ACS) are discharged with an inadequate diagnosis. AIM: To select clinical and laboratory predictors to identify patients with a high likelihood of ACS in the Chest Pain Unit. MATERIAL AND METHODS: Prospective evaluation of patients consulting in a Chest Pain Unit of a University Hospital. Initial assessment was standardized and included evaluation of pain characteristics, electrocardiogram and Troponin I. Independent predictors of ACS were identified with a multiple logistic regression. RESULTS: In a four years period, 1,168 patients aged 62+/-23 years (69% males), were studied. After initial evaluation, 62% of the patients were admitted to the hospital for further testing and in 71% of them, a definite diagnosis of ACS was made. No events were reported by patients directly discharged from the Chest Pain Unit. Independent predictors associated with a higher likelihood of ACS were an abnormal electrocardiogram at the initial evaluation (Odds ratio (OR) 5.37, 95% confidence intervals (CI) 3.61-7.99), two or more cardiovascular risk factors (OR 2.16, 95% CI 1.21-2.84), cervical irradiation of the pain (OR 1.84, 95% CI 1.25-2.69), age over 65 years (OR 1.73, 95% CI (1.32-2.27) and a Troponin I above the upper normal limit (OR: 5.68, 95% CI 3.72-8.29). CONCLUSIONS: Simple clinical findings allow an appropriate identification of patients with a high likelihood of ACS without specialized methods for myocardial ischemia detection.
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Síndrome Coronariana Aguda/diagnóstico , Dor no Peito/diagnóstico , Síndrome Coronariana Aguda/sangue , Biomarcadores/sangue , Dor no Peito/sangue , Eletrocardiografia , Serviço Hospitalar de Emergência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Alta do Paciente , Valor Preditivo dos Testes , Estudos Prospectivos , Medição de Risco , Troponina I/sangueRESUMO
Background: Nearly 10 percent of patients with an actual acute coronary syndrome (ACS) are discharged with an inadequate diagnosis. Aim To select clinical and laboratory predictors to identify patients with a high likelihood of ACS in the Chest Pain Unit. Material and methods: Prospective evaluation of patients consulting in a Chest Pain Unit of a University Hospital. Initial assessment was standardized and included evaluation of pain characteristics, electrocardiogram and Troponin I. Independent predictors of ACS were identified with a multiple logistic regression. Results: In a four years period, 1,168 patients aged 62±23 years (69 percent males), were studied. After initial evaluation, 62 percent of the patients were admitted to the hospital for further testing and in 71 percent of them, a definite diagnosis of ACS was made. No events were reported by patients directly discharged from the Chest Pain Unit. Independent predictors associated with a higher likelihood of ACS were an abnormal electrocardiogram at the initial evaluation (Odds ratio (OR) 5.37, 95 percent confidence intervals (CI) 3.61-7.99), two or more cardiovascular risk factors (OR 2.16, 95 percent CI 1.21-2.84), cervical irradiation of the pain (OR 1.84, 95 percent CI 1.25-2.69), age over 65years (OR 1.73, 95 percent CI (1.32-2.27) and a Troponin I above the upper normal limit (OR: 5.68, 95 percent CI 3.72-8.29). Conclusions: Simple clinical findings allow an appropriate identification of patients with a high likelihood of ACS without specialized methods for myocardial ischemia detection.
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Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Síndrome Coronariana Aguda/diagnóstico , Dor no Peito/diagnóstico , Síndrome Coronariana Aguda/sangue , Biomarcadores/sangue , Dor no Peito/sangue , Eletrocardiografia , Serviço Hospitalar de Emergência , Razão de Chances , Alta do Paciente , Valor Preditivo dos Testes , Estudos Prospectivos , Medição de Risco , Troponina I/sangueRESUMO
The occurrence of Physoclypeus farinosus Hendel in flowerheads of Asteraceae from different Brazilian localities is presented. The use of this resource by this fly is discussed.
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Asteraceae/parasitologia , Dípteros/fisiologia , Flores/parasitologia , Animais , BrasilRESUMO
The occurrence of Physoclypeus farinosus Hendel in flowerheads of Asteraceae from different Brazilian localities is presented. The use of this resource by this fly is discussed.
É apresentada a ocorrência de Physoclypeus farinosus Hendel em capítulos de Asteraceae de várias localidades brasileiras. Discute-se brevemente o uso desse recurso por essa mosca.
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Animais , Asteraceae/parasitologia , Dípteros/fisiologia , Flores/parasitologia , BrasilAssuntos
Antineoplásicos/efeitos adversos , Conservadores da Densidade Óssea/efeitos adversos , Difosfonatos/efeitos adversos , Imidazóis/efeitos adversos , Doenças Mandibulares/induzido quimicamente , Doenças Maxilares/induzido quimicamente , Osteonecrose/induzido quimicamente , Idoso , Idoso de 80 Anos ou mais , Processo Alveolar/patologia , Antineoplásicos/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Neoplasias da Mama/tratamento farmacológico , Difosfonatos/administração & dosagem , Feminino , Humanos , Imidazóis/administração & dosagem , Doenças Mandibulares/diagnóstico por imagem , Doenças Mandibulares/cirurgia , Doenças Maxilares/diagnóstico por imagem , Doenças Maxilares/cirurgia , Pessoa de Meia-Idade , Mieloma Múltiplo/tratamento farmacológico , Osteonecrose/diagnóstico por imagem , Osteonecrose/cirurgia , Radiografia , Índice de Gravidade de Doença , Ácido ZoledrônicoRESUMO
OBJECTIVES: To measure the changes in median nerve conduction parameters at various angles of wrist flexion and extension. DESIGN: We studied 8 patients with carpal tunnel syndrome (CTS) and 4 subjects (5 hands) without the condition (controls). Conduction parameters were measured with the wrist in neutral position and at different wrist angles. RESULTS: Onset motor latency increased in both groups with wrist extension and decreased with wrist flexion. Sensory onset latency decreased in both groups with wrist flexion. Compound Muscle Action Potential (CMAP) amplitude increased with wrist flexion for both groups. Wrist extension resulted in reduction of the CMAP amplitude in controls; however, for the CTS group it increased for the first 30 degrees and then decreased. Sensory Nerve Action Potential (SNAP) amplitude increased with wrist flexion and decreased with wrist extension in both groups. CONCLUSION: Median nerve conduction parameters improve with wrist flexion and generally worsen with extension.
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Síndrome do Túnel Carpal/fisiopatologia , Síndrome do Túnel Carpal/terapia , Nervo Mediano/fisiologia , Condução Nervosa , Punho , Adulto , Idoso , Fenômenos Biomecânicos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Aparelhos Ortopédicos , Punho/fisiologiaRESUMO
A review of the history and pharmacology of the botulinum neurotoxins is presented. Established mechanisms of action are discussed as well as preliminary evidence of other potential mechanisms, as related to botulinum toxins' antinociceptive properties. Methods of administration, including reconstitution, dilution, and basic injection techniques/principles are reviewed. Safety concerns are also addressed. Various applications relevant to the field of Physical Medicine & Rehabilitation are reviewed, specifically uses in the management of muscle over activity syndromes such as upper motor neuron-related spasticity, dystonias, and painful syndromes including Myofascial Pain Syndromes and headaches. Relevant literature related to these applications is reviewed and discussed. Botulinum toxin therapeutic efficacy and possible reasons for treatment failure (including development of antibody-mediated resistance) are discussed.
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Toxinas Botulínicas/uso terapêutico , Toxinas Botulínicas/administração & dosagem , Toxinas Botulínicas/farmacologia , Distonia/tratamento farmacológico , Distonia/reabilitação , Cefaleia/tratamento farmacológico , Cefaleia/reabilitação , Humanos , Espasticidade Muscular/tratamento farmacológico , Espasticidade Muscular/reabilitação , Síndromes da Dor Miofascial/tratamento farmacológico , Síndromes da Dor Miofascial/reabilitação , Modalidades de Fisioterapia , Reabilitação/métodosAssuntos
Humanos , Bactérias/patogenicidade , Infecções Bacterianas/etiologia , Insuficiência de Múltiplos Órgãos/etiologia , Infecções Bacterianas/microbiologia , Infecções Bacterianas/terapia , Terapia Combinada , Estado Terminal , Resumo em Inglês , Intestinos/imunologia , Intestinos/microbiologia , Insuficiência de Múltiplos Órgãos/microbiologia , Insuficiência de Múltiplos Órgãos/terapiaRESUMO
Presentamos un caso de una patología poco común y sobre la cual existe poca literatura