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The abnormal biological activity of cytokines and their imbalance are implicated in developing rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). Cytokine levels were measured in RA and SLE patients and compared to healthy controls using the Wilcoxon rank sum test and Kruskal-Wallis test. The relationship between cytokine levels and blood and clinical parameters was assessed using Spearman's correlation test. Compared to healthy controls, both RA and SLE patients exhibited elevated levels of GM-CSF, CX3CL1, IFN-α2, IL-12p70, IL-17A, TNF-α, IL-1ß, and IFN-γ, which is evidence of their shared inflammatory signature. IL-2 levels were elevated exclusively in RA patients, while MCP-1 and IL-10 were uniquely increased in SLE patients. Notably, TNF-α showed the most significant increase in SLE patients. IL-4 was elevated in SLE patients with nephritis, correlating with IL-6, IL-10, sCD40L, and IL-8, suggesting B cell involvement in lupus nephritis. The negative correlation between CX3CL1 and TNF-α with HDL in RA and SLE respectively, highlights the potential association of these inflammatory markers with cardiovascular risk. These findings underscore the complex cytokine interplay in RA and SLE. CX3CL1 emerges as a potential therapeutic target for RA, while TNF-α and IL-4 show promise as therapeutic targets for SLE.
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Artrite Reumatoide , Citocinas , Lúpus Eritematoso Sistêmico , Humanos , Artrite Reumatoide/sangue , Lúpus Eritematoso Sistêmico/sangue , Feminino , Citocinas/sangue , Masculino , Adulto , Pessoa de Meia-Idade , Biomarcadores/sangue , Estudos de Casos e Controles , IdosoRESUMO
OBJECTIVE: To date, no data exist regarding the prevalence of integrase inhibitor (INSTI) resistance-associated mutations (HIVDRM) in HIV-infected pregnant women (HPW) in Latin America. We describe the prevalence and transmissibility of integrase HIVDRM in a historical cohort of INSTI-naïve HPW from Argentina (n=56) with Next Generation Sequencing (NGS). METHODS: Bioinformatics analysis was performed by HyDRA software for 20%, 10%, 5%, 2%, and 1% sensitivity thresholds. We calculated the mutational viral load for each INSTI-HIVDRM, considering those with >1000 c/mL as of high risk of transmissibility. RESULTS: The predominant HIV subtype was BF (78.5%). Major HIVDRM were not detected with the population sequencing 20% filter. With a 1% threshold, the prevalence increased to 8.9%; Y143C/S, E92G, E138K, and T66I mutations were found. The median (range) mutational load (expressed in c/mL) was: 355 (50.2-11705); with only 1 case >1000 c/mL Accessory mutations (G163R/K, T97A) were detected mostly with a 20% sensitivity threshold with an overall prevalence of 23.2%; the median (IQR) mutational load was: 23929 (4009-63158) c/mL; all of them above 1000 c/mL. CONCLUSIONS: Our results show evidence of the presence of major INSTI-HIVDRM as aleatory mutations and a high frequency of accessory mutations with potential transmissibility in HPW.
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BACKGROUND: The incidence of comorbidities is higher in HIV-positive patients than in the general population due to factors, such as HIV-related chronic inflammation. There is no consensus on whether a low CD4 lymphocyte count after virological suppression at long-term follow-up increases the risk of comorbidities. This study evaluates the association between CD4 lymphocyte count and the incidence of comorbidities during the first 5 years of virological suppression after highly active antiretroviral treatment. METHODS: We conducted a cohort study of HIV-positive adults who achieved virological suppression in an HIV program between 2002 and 2016 in Colombia. A generalized equation estimation model was used to estimate the association between CD4 lymphocyte count and the incidence of comorbidities. RESULTS: A follow-up period of at least 1 year was completed in 921 HIV-positive patients with virological suppression. We found 71 comorbidities during a maximum of 5 years of follow-up; 41 (59%) were AIDS-defining comorbidities and 19 (46%) of them occurred during the first semester. Thirty cases of non-AIDS- defining comorbidities were diagnosed.We did not find any association between CD4 lymphocyte count and the incidence of comorbidities (OR 0.92, CI 95% 0.45 -1.91 for CD4 201-499 cells/µL vs CD4 ≤200 cells/µL, and OR 0.55, 95% CI 0.21-1.44 for CD4 ≥500 cells/µL vs CD4 ≤200 cells/µL). CONCLUSION: No association was found between CD4 lymphocyte count and the incidence of AIDS-defining or non-AIDS-defining comorbidities in patients with virological suppression. Further studies are needed to assess the risk of comorbidities in this population to design interventions aimed at improving their prognosis.
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Terapia Antirretroviral de Alta Atividade , Comorbidade , Infecções por HIV , Carga Viral , Humanos , Masculino , Feminino , Contagem de Linfócito CD4 , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Infecções por HIV/virologia , Adulto , Incidência , Pessoa de Meia-Idade , Colômbia/epidemiologia , Fármacos Anti-HIV/uso terapêutico , Estudos de Coortes , Resposta Viral Sustentada , SeguimentosRESUMO
Introducción: La enfermedad de Parkinson es una afección neurológica progresiva caracterizada por la lentitud y la escasez de movimientos (bradicinesia), rigidez muscular, temblores en reposo y trastorno de la postura. Entre el período 1990-2016, las muertes atribuidas a enfermedad de Parkinson aumentaron en 16,5% y la prevalencia en 19,9%, situando a Chile como el país latinoamericano que registra el mayor aumento en la prevalencia de esta patología. Método: Se presenta estudio de carácter cuantitativo, observacional, descriptivo, ecológico y longitudinal retrospectivo relacionado a los ingresos de pacientes con un diagnóstico previo confirmado de enfermedad de Parkinson, con el objetivo general de describir los motivos de ingresos hospitalarios en pacientes con enfermedad de Parkinson en el Hospital Clínico Herminda Martín, Chillán, Chile, durante el período 2017-2021 a través de la descripción de esta población y sus complicaciones más frecuentes. Resultados y Conclusiones: La edad de presentación de complicaciones que requieren hospitalización más frecuente fue entre los 70 y 90 años, teniendo una distribución hombre: mujer de 3:2. La mediana de la duración de las hospitalizaciones fue de 8 días y el año en el que se presentaron mayor número de ingresos fue el 2019, con un 24% de los pacientes ingresados durante el período de estudio. En cuanto a los motivos de ingreso hospitalario más frecuente en pacientes con enfermedad de Parkinson fueron enfermedades cardiovasculares (30,2%), traumatismos (17,7%), descompensaciones de la enfermedad (10,4%), trastornos del tracto gastrointestinal (10,4%), neoplasias (8,3%), trastornos genitourinarios (8,3%), manifestaciones del sistema nervioso central no párkinson (7,3%), infecciones (3,1%) y Otros no clasificables (5%).
Introduction: Parkinson's disease is a progressive neurological condition characterized by slowness and scarcity of movement (bradykinesia), muscle stiffness, resting tremors, and postural impairment. Between 1990 and 2016, deaths attributed to Parkinson's increased by 16.5% and prevalence by 19.9%, making Chile the Latin American country with the highest increase in the prevalence of this pathology. Method: A quantitative, observational, descriptive, ecological, and retrospective longitudinal study is presented related to the admissions of patients with a previously confirmed diagnosis of Parkinson's disease, with the general objective of describing the reasons for hospital admissions in patients with Parkinson's disease at Herminda's Clinical Hospital, Martín, Chillán, Chile during the period 2017-2021 through the description of this population and its most frequent complications. Results and Conclusions: The age of presentation of complications requiring hospitalization was most frequent between 70 and 90 years, with a male:female distribution of 3:2. The average length of hospital stay was 9,8 days and the year with the highest number of admissions was 2019, with 24% of patients admitted during the study period. The most frequent reasons for hospital admission in patients with Parkinson's disease were cardiovascular diseases (30.2%), trauma (17,7%), disease decompensations (10.4%), gastrointestinal disorders (10.4%), neoplasms (8.3%), genitourinary disorders (8.3%), manifestations of the central nervous system not related to Parkinson's (7.3%), infections (3.1%) and others not classifiable (5%).
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Introducción: Los macroinvertebrados son un componente biológico importante de los ecosistemas acuáticos al estar vinculados de forma activa en el flujo de materia y energía. Objetivo: Identificar los Grupos Funcionales Alimentarios (GFA) de macroinvertebrados bentónicos presentes en Caño Baranda. Materiales y métodos: Se midieron características físicas y químicas en 5 estaciones a lo largo de Caño Baranda en temporada de lluvia, así mismo se recolectaron macroinvertebrados acuáticos utilizando red Surber, red Tienneman, red de Patada y recolecta manual. Se obtuvieron muestras en cada estación para estimar la densidad de macroinvertebrados y se asignaron GFA por taxón. Resultados: Se recolectaron 251 organismos pertenecientes a 32 familias, distribuídas en 9 órdenes. Las familias más abundantes fueron Leptophlebiidae con 35% y Glossosomatidae con 12%. Se recolectaron organismos de cinco GFA donde los grupos dominantes fueron recolectores (45%) seguido por los depredadores (23%) presentando correlaciones positivas con el pH. Por su parte el grupo menos colectado fueron los trituradores (1%) donde su presencia se relacionó con el aumento de oxígeno disuelto. Conclusiones: La presencia de colectores y depredadores se relacionó con pH y temperaturas bajas; para los fragmentadores se relacionó con menores porcentajes de oxígeno disuelto; para los raspadores se relacionó con pH bajos y mayores caudales y para los trituradores se relacionó con una elevada concentración de oxígeno en el agua.
Introduction: Macroinvertebrates are an important biological component of aquatic ecosystems as they are actively linked in the flow of matter and energy. Objective: To identify the Functional Feeding Groups (FFG) of benthic macroinvertebrates present in Caño Baranda. Materials and method: Physical and chemical characteristics were measured in 5 sampling points along Caño Baranda during the rainy season, likewise aquatic macroinvertebrates were collected using Surber net, Tienneman net, Kick net and hand collection. Samples were obtained at each sampling point to estimate the density of macroinvertebrates and FFG per taxa. Results: 251 organisms belonging to 32 families were collected, sorted into 9 orders. The most abundant families were Leptophlebiidae (35%) and Glossosomatidae (12%). Collected organisms were associated to five FFG, the dominant being collectors (45%) followed by predators (23%) which presented positive correlations with pH. On the other hand, the least collected group was shredders (1%) whose presence was related to the increase in dissolved oxygen.
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Limnologia , EcologiaRESUMO
Bisphenols such as bisphenol A (BPA), S (BPS), C (BPC), F (BPF), AF (BPAF), tetrabromobisphenol, nonylphenol, and octylphenol are plasticizers used worldwide to manufacture daily-use articles. Exposure to these compounds is related to many pathologies of public health importance, such as infertility. Using a protector compound against the reproductive toxicological effects of bisphenols is of scientific interest. Melatonin and vitamins have been tested, but the results are not conclusive. To this end, this systematic review and meta-analysis compared the response of reproductive variables to melatonin and vitamin administration as protectors against damage caused by bisphenols. We search for controlled studies of male rats exposed to bisphenols to induce alterations in reproduction, with at least one intervention group receiving melatonin or vitamins (B, C, or E). Also, molecular docking simulations were performed between the androgen (AR) and estrogen receptors (ER), melatonin, and vitamins. About 1234 records were initially found; finally, 13 studies were qualified for review and meta-analysis. Melatonin plus bisphenol improves sperm concentration and viability of sperm and increases testosterone serum levels compared with control groups; however, groups receiving vitamins plus bisphenols had lower sperm concentration, total testis weight, and testosterone serum levels than the control. In the docking analysis, vitamin E had the highest negative MolDock score, representing the best binding affinity with AR and ER, compared with other vitamins and melatonin in the docking. Our findings suggest that vitamins could act as an endocrine disruptor, and melatonin is most effective in protecting against the toxic effects of bisphenols.
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Disruptores Endócrinos , Melatonina , Masculino , Ratos , Animais , Melatonina/farmacologia , Vitaminas , Simulação de Acoplamento Molecular , Sêmen/metabolismo , Compostos Benzidrílicos/toxicidade , Compostos Benzidrílicos/química , Reprodução , Receptores de Estrogênio , Vitamina A , Vitamina K , Testosterona/metabolismo , Disruptores Endócrinos/toxicidade , Disruptores Endócrinos/químicaRESUMO
INTRODUCTION AND AIMS: Capsule endoscopy is part of the diagnostic approach to patients with suspected small bowel bleeding and data on its clinical impact are still limited in developing countries. The primary aim of the present study was to determine its impact on subsequent diagnostic and therapeutic decisions. MATERIAL AND METHODS: A retrospective study was conducted that included all the patients that underwent capsule endoscopy with the PillCam™ SB 3 Capsule system due to suspected small bowel bleeding treated at the Hospital Universitario Fundación Valle del Lili between January 2011 and December 2020. RESULTS: A total of 158 patients met the inclusion criteria. Mean patient age was 63 years (interquartile range [IQR], 52-74), 53.6% of the patients were women, and high blood pressure was the most frequent comorbidity (43.7%). The main indication was overt bleeding (58.2%). Of all the capsule endoscopies carried out, 63.9% showed lesions that were potentially responsible for bleeding. Medical or surgical treatment was indicated in 63.3% of the case total. Rebleeding at 6 months occurred in 15 patients and there were 2 deaths due to gastrointestinal bleeding at 6 months. CONCLUSIONS: Capsule endoscopy has a high impact on patients with suspected small bowel bleeding, with respect to clinical decision-making, as well as rebleeding, hospitalization, and mortality outcomes. The positivity rate of lesions potentially responsible for bleeding was similar to that reported in developed countries.
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The activins and inhibins are glycoproteins with a role in the follicular development of vertebrates, that are found in follicular fluid and somatic follicular cells, with a different pattern among taxa. The principal function of activin (Act) is to modulate the follicle-stimulating hormone (FSH) synthesis and secretion, whereas inhibin (Inh) downregulates it. Both factors are modulators of intraovarian follicular recruitment, oocyte maturation, cell proliferation, and steroidogenic activity. Our aim was to characterize the immunolocalization of Act and Inh in the ovarian follicles during the reproductive cycle of the lizard Sceloporus torquatus. Act was detected in the granulosa cells and oocyte cortex in the different stages of follicular development. On the other hand, we identified Inh in the oocyte cortex and the cytoplasm of pyriform and small cells of previtellogenic follicles. Also, we found immunoreactivity in the oocyte cortex, theca, and small cells of vitellogenic and preovulatory follicles. Our data provide evidence that Act and Inh have changes related to the stage of follicular development. This dynamic appears to be conserved among vertebrates and is fundamental to ensure an adequate follicular development in this specie.
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This study investigated whether the coadministration of vitamin E (VitE) diminishes the harmful effects provoked by plasticizer bisphenol S (BPS) in the serum metabolites related to hepatic and renal metabolism, as well as the endocrine pancreatic function in diabetic male Wistar rats. Rats were divided into five groups (n = 5-6); the first group was healthy rats (Ctrl group). The other four groups were diabetic rats induced with 45 mg/kg bw of streptozotocin: Ctrl-D (diabetic control); VitE-D (100 mg/kg bw/d of VitE); BPS-D (100 mg/kg bw/d of BPS); The animals from the VitE + BPS-D group were administered 100 mg/kg bw/d of VitE + 100 mg/kg bw/d of BPS. All compounds were administered orally for 30 days. Body weight, biochemical assays, urinalysis, glucose tolerance test, pancreas histopathology, proximate chemical analysis in feces, and the activity of antioxidants in rat serum were assessed. The coadministration of VitE + BPS produced weight losses, increases in 14 serum analytes, and degeneration in the pancreas. Therefore, the VitE + BPS coadministration did not have a protective effect versus the harmful impact of BPS or the diabetic metabolic state; on the contrary, it partially aggravated the damage produced by the BPS. VitE is likely to have an additive effect on the toxicity of BPS.
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Daily, people are exposed to chemicals and environmental compounds such as bisphenols (BPs). These substances are present in more than 80% of human fluids. Human exposure to BPs is associated with male reproductive health disorders. Some of the main targets of BPs are intercellular junction proteins of the blood-testis barrier (BTB) in Sertoli cells because BPs alter the expression or induce aberrant localization of these proteins. In this systematic review, we explore the effects of BP exposure on the expression of BTB junction proteins and the characteristics of in vivo studies to identify potential gaps and priorities for future research. To this end, we conducted a systematic review of articles. Thirteen studies met our inclusion criteria. In most studies, animals treated with bisphenol-A (BPA) showed decreased occludin expression at all tested doses. However, bisphenol-AF treatment did not alter occludin expression. Cx43, ZO-1, ß-catenin, nectin-3, cortactin, paladin, and claudin-11 expression also decreased in some tested doses of BP, while N-cadherin and FAK expression increased. BP treatment did not alter the expression of α and γ catenin, E-cadherin, JAM-A, and Arp 3. However, the expression of all these proteins was altered when BPA was administered to neonatal rodents in microgram doses. The results show significant heterogeneity between studies. Thus, it is necessary to perform more research to characterize the changes in BTB protein expression induced by BPs in animals to highlight future research directions that can inform the evaluation of risk of toxicity in humans.
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Barreira Hematotesticular , Células de Sertoli , Animais , Recém-Nascido , Masculino , Humanos , Barreira Hematotesticular/metabolismo , Ocludina/metabolismo , Ocludina/farmacologia , Células de Sertoli/metabolismo , Junções IntercelularesRESUMO
In this work, a numerical analysis of three different flat plate solar collectors was conducted using their entropy generation rates. Specifically, the Computational Fluid Dynamics (CFD) technique was used to compare the detailed performance of conventional and zigzag tube geometries of flat plate solar collectors (FPCs) in terms of their entropy generation rates. The effects of fluid viscosity, heat transfer, and heat loss of the flat plate solar collectors were considered for the local and global entropy generation rate analyses. Variations on the inlet volumetric flow rate of the FPCs from 1.0 to 9.0 L/min were simulated under the average solar radiation for one year in the state of Guanajuato, Mexico. The results illustrate and discuss the temperatures, pressures, and global entropy generation rates for volumetric flow variations. The velocity, temperature, and pressure distributions and the maps of the local entropy generation rates inside the collectors are presented and analyzed for the case with a flow rate of 3.0 L/min. These results demonstrate that the zigzag geometries achieved higher outlet temperatures and greater entropy generation rates than the conventional geometry for all the volumetric flow rates considered.
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TITLE: Neurocisticercosis, correlación clínica y tomográfica.
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Neurocisticercose , Humanos , Neurocisticercose/diagnóstico por imagem , Tomografia Computadorizada por Raios XRESUMO
BACKGROUND AND OBJECTIVE: There are different methods for evaluating dry eye disease (DID), including questionnaires that analyze different aspects of its symptoms, which are important for its better understanding and therapeutic management. The Dry Eye Questionnaire 5 (DEQ-5), is unique in its kind, because in addition to its simplicity, it measures symptoms in 4 dimensions. The aim of this study is to adapt culturally and linguistically and validate this instrument to the Chilean population. MATERIAL AND METHODS: For the adaptation, the translation and retro-translation of the original version was carried out, its linguistic analysis, the pilot test and the expert panel review (which included a linguistics specialist) were used. For the validation, a psychometric analysis of reliability and validity of the construct was incorporated. The sample in which it was validated was constituted by 205 people with dry eye disease. RESULTS: 141 (69%) of the respondents were women, the mean of age was 48 years ±16,7, and the median of the total score DEQ-5 was 13 points (R.I 8-15 points). The adapted version resulted in a Cronbach alpha of 0.8085, scoring that classified it as good. DISCUSSION: The questionnaire DEQ-5, which was adapted and validated, was a good instrument to be used in populations with similar characteristics of those in the study. More so, the factor analysis enriched comprehension of the way in which people with dry eye disease relate their symptoms and which questions relate more between them, representing in a better way the aspects evaluated of the symptomatology of this disease.
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Comparação Transcultural , Síndromes do Olho Seco , Humanos , Feminino , Pessoa de Meia-Idade , Masculino , Inquéritos e Questionários , Chile , Reprodutibilidade dos Testes , Síndromes do Olho Seco/diagnósticoRESUMO
Resumen La pitiriasis liquenoide varioliforme aguda (PLEVA) pertenece a un grupo de enfermedades categorizadas como pitiriasis liquenoides, junto con la enfermedad febril úlcero-necrótica de Mucha-Habermann y la pitiriasis liquenoide crónica (PLC). Se caracteriza por la aparición aguda de múltiples pápulas eritemato-violáceas con posterior necrosis, discromía residual y cicatrices varioliformes. Dentro de las teorías patogénicas propuestas se encuentra el posible papel de agentes infecciosos, trastornos linfoproliferativos, complejos inmunes e incluso, asociación a medicamentos. Se presenta un casode una mujer adulta con un cuadro típico de PLEVA con confirmación histopatológica, cuyas lesiones aparecieron posteriormente al inicio de eritropoyetina.
Abstract Pityriasis lichenoides et varioliformes acuta (PLEVA) is part of a group of diseases clustered as pityriasis lichenoides, next to febrile ulceronecrotic Mucha-Habermann disease and pityriasis lichenoides chronica. It's characterized by a sudden onset of multiple erythematous and violaceous papules which develop necrosis, leaving residual dyschromia and varioliform scars. It's been hypothesized the possible role of infectious agents, lymphoproliferative diseases, immune complexes and drugs. We present the case of a woman with a typical PLEVA with histopathological confirmation, whose lesions appeared after therapy with erythropoietin.
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Introduction: The chin is one of the most visible facial structures. Chin surgery, was initially described, for, the treatment of facial abnormalities, advancing the mandibular symphysis; achieved anterior displacement of the base of the tongue showing some value in the treatment of snoring and obstructive sleep apnea, and achieved adequate lip competence. We designed the Basal Extended Mentoplasty (BEM) based on the needs of patients orthodontically compensated, but dissatisfied with the appearance of his face as well as upper airway problems looking for a solution to this, design and planning the advances of the chin. Materials and Methods: Patients operated in the service of Maxillofacial Surgery, Specialist Hospital, "Dr. Bernardo Sepulveda "XXI Century National Medical Center, during the period of 2015-2019, orthodontically compensated patients, with labial incompetence and Class II skeletal. Sixty-five patients were operated during this period, and eight cases are presented. Results: Lip competition, osseointegration of the segments is observed, with a proper projection of the lower third, no nerve or vascular damage in the area. Conclusions: The design of the osteotomy is for orthodontically compensated patients with labial incompetence and Class II skeletal, giving a result mandibular lengthening. The BEM achieved adequate lip competence demonstrated by an interlabial gap of 0 mm, achieved adequate osseous consolidation of the fracture site with a more harmonious facial balance and profile, without nerve or vascular damage with spectacular results.
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Resumen El milium coloide (MC) es un trastorno de depósito cutáneo poco común, asociado a cambios degenerativos secundarios a la radiación ultravioleta, que provoca degeneración de las fibras elásticas en la dermis. Tiene dos formas de presentación definidas como juvenil y del adulto. Es más común en hombres que realizan oficios al aire libre. Clínicamente se caracteriza por numerosas y pequeñas pápulas de distintos colores (amarillo, ámbar, café) o translúcidas, que suelen agruparse y se localizan en zonas fotoexpuestas. El diagnóstico se confirma mediante el estudio histopatológico y pudiera requerir tinciones especiales para diferenciar la mucina y el amiloide. Para su tratamiento se han empleado técnicas como dermoabrasión mecánica, láseres, terapia fotodinámica, entre otros.
Abstract Colloid milium is a rare skin deposition disorder associated with degenerative changes secondary to ultraviolet radiation, which causes degeneration of elastic fibers in the dermis. It has two forms of presentation defined as juvenile and adult. It is more common in men who work outdoors. Clinically it is characterized by numerous small yellow, brown, amber or translucent papules that are usually grouped together, located over photo-exposed areas. The diagnosis is confirmed by histopathological study and may require special stains to differentiate mucin and amyloid. Techniques such as mechanical dermabrasion, lasers, photodynamic therapy, among others, have been used for its treatment.
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OBJECTIVE: This study aimed to fill the current knowledge gap in the literature by identifying the demographic and clinical characteristics of patients with epilepsy attending primary health care (PHC). PATIENTS AND METHODS: This was a cross-sectional study involving adults (= 18 years of age) with epilepsy attending PHC from a developing country between 2015 and 2019. Demographic information and epilepsy-related data were collected. RESULTS: A total of 140 patients (51.4% male; mean [± SD] age 44.9 ± 17.8 years) were evaluated. The mean age at onset of seizures was 29.9 ± 22.9 years, with a mean evolution of 14.3±15.4 years. Focal seizures accounted for 88.57% of cases and evolved into bilateral tonic-clonic attack (45.16%). Of those that were generalized, motor seizures accounted for 81.82%, absence 9.09%, and motor + absence 9.09%. Among generalized onset motor seizures, tonic-clonic was predominant, accounting for 55.56%. Among types, focal epilepsy predominated (88.57%). The primary etiologies were unknown (62.14%), structural causes (27.85%) and infectious (9.28%). Patients undergoing monotherapy accounted for 66.1%, with epilepsy control in 92.4%. The most commonly used antiepileptic drugs were carbamazepine (33.1%), valproic acid (28.2%), and phenobarbital (10.4%). CONCLUSIONS: Male sex, seizures, and focal epilepsy were prevalent. Magnetic resonance imaging was more useful than computed tomography. Most etiologies were unknown; however, mesial temporal sclerosis and neurocysticercosis were the most prevalent known causes. Most patients were controlled using a monotherapy regimen. The implementation of International League Against Epilepsy classifications and definitions was feasible and useful.
TITLE: Características clínicas de pacientes con epilepsia atendidos en la atención primaria.Objetivo. Este estudio tuvo como objetivo llenar el vacío de conocimiento actual en la bibliografía mediante la identificación de las características demográficas y clínicas de los pacientes con epilepsia que asisten a la atención primaria de salud. Pacientes y métodos. Éste fue un estudio transversal que involucró a adultos (18 años o mayores) con epilepsia que asistieron a atención primaria de salud de un país en desarrollo entre 2015 y 2019. Se recopilaron información demográfica y datos relacionados con la epilepsia. Resultados. Se evaluó a un total de 140 pacientes 51,4%, varones; edad media (± desviación estándar), 44,9 ± 17,8 años. La edad media de inicio de las crisis fue de 29,9 ± 22,9 años, con una evolución media de 14,3 ± 15,4 años. Las crisis focales presentes en el 88,57% de los casos y evolucionaron a crisis tonicoclónicas bilaterales (45,16%). De las generalizadas, las crisis motoras predominaron con el 81,82%; las ausencias, el 9,09%; y las motoras + ausencias, el 9,09%. Entre las crisis motoras de inicio generalizado, predominó la tonicoclónica, con un 55,56%. Entre los tipos, predominó la epilepsia focal (88,57%). Las etiologías primarias fueron desconocidas (62,14%), causas estructurales (27,85%) e infecciosas (9,28%). Los pacientes en monoterapia representaron el 66,1%, con control de la epilepsia en el 92,4%. Los fármacos antiepilépticos más utilizados fueron la carbamacepina (33,1%), el ácido valproico (28,2%) y el fenobarbital (10,4%). Conclusiones. Predominaron el sexo masculino, las convulsiones y la epilepsia focal. La resonancia magnética fue más útil que la tomografía computarizada. La mayoría de las etiologías se desconocían; sin embargo, la esclerosis temporal mesial y la neurocisticercosis fueron las causas conocidas más prevalentes. La mayoría de los pacientes se controlaron con un régimen de monoterapia. La implementación de las clasificaciones y definiciones de la Liga Internacional contra la Epilepsia fue factible y útil.
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Epilepsias Parciais , Epilepsia , Adulto , Estudos Transversais , Epilepsias Parciais/tratamento farmacológico , Epilepsias Parciais/epidemiologia , Epilepsia/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Atenção Primária à Saúde , Convulsões/tratamento farmacológico , Convulsões/epidemiologia , Convulsões/etiologiaRESUMO
Resumen El neurofibroma laríngeo es poco frecuente, representa menos del 0,1% de las neoplasias benignas de la laringe. Puede presentarse aislado, o más comúnmente asociado a neurofibromatosis tipo I. Se presenta el caso de un paciente varón de 40 años, ya diagnosticado de neurofibromatosis tipo I, que presenta masa supraglótica submucosa asintomática, diagnosticada como hallazgo casual en una intubación por una cirugía previa programada.
Abstract Laryngeal neurofibroma is rare, representing less than 0.1% of benign tumors of the larynx. It can occur in isolation or more commonly associated with type I neurofibromatosis. The case of a 40-year-old male patient, already diagnosed with type I neurofibromatosis, is presented with an asymptomatic submucosal supraglottic mass, diagnosed as a chance finding in intubation due to a previous scheduled surgery.
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Humanos , Masculino , Adulto , Neoplasias Laríngeas/cirurgia , Neoplasias Laríngeas/diagnóstico por imagem , Neurofibromatose 1/diagnóstico por imagem , Laringe/cirurgia , Imageamento por Ressonância Magnética/métodos , Terapia a Laser/métodosRESUMO
The growing use of biomaterials with different therapeutic purposes increases the need for their physiological understanding as well as to seek its integration with the human body. Chronic inflammatory local pathologies, generally associated with infectious or autoimmunity processes, have been a current therapeutic target due to the difficulty in their treatment. The recent development of biomaterials with immunomodulatory capacity would then become one of the possible strategies for their management in local pathologies, by intervening in situ, without generating alterations in the systemic immune response. The treatment of periodontal disease as an inflammatory entity has involved the use of different approaches and biomaterials. There is no conclusive, high evidence about the use of these biomaterials in the regeneration of periodontitis sequelae, so the profession keeps looking for other different strategies. The use of biomaterials with immunomodulatory properties could be one, with a promising future. This review of the literature summarizes the scientific evidence about biomaterials used in the treatment of periodontal disease.