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INTRODUCTION: Anaplastic lymphoma kinase (ALK) rearrangement located on the short arm of chromosome 2, region 2 and band 3 is frequent in lung cancer patients who respond to targeted therapies with ALK inhibitors Therefore, their identification has become a standard diagnostic test in patients with advanced NSCLS, as such chromosomal alterations may lead to the activation of important signalling pathways involved in cell survival and proliferation. METHODS: To investigate the ALK gene status, we performed FISH and IHC assays in 18 lung adenocarcinoma patients, 12 women and 6 men, aged between 29 and 85 years. Paraffin-embedded samples were analyzed in the Pathology Department of the Hospital Universitario San Ignacio. RESULTS: Results between the two techniques in 5 patients showed discordant patterns, being positive for FISH and negative for IHC. The borderline to define ALK positivity was set at 15%, These results present experimental evidence that the techniques differ in specific situations. CONCLUSIONS: Our findings show that it is advisable to investigate the ALK gene status in patients with suspected lung cancer using both FISH and IHC in combination.
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Adenocarcinoma de Pulmão , Adenocarcinoma , Neoplasias Pulmonares , Feminino , Humanos , Quinase do Linfoma Anaplásico/genética , Imuno-Histoquímica , Receptores Proteína Tirosina Quinases/genética , Receptores Proteína Tirosina Quinases/metabolismo , Hibridização in Situ Fluorescente/métodos , Adenocarcinoma/patologia , Adenocarcinoma de Pulmão/genética , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/patologiaRESUMO
INTRODUCTION: Mexico City has no endemic presence of Aedes aegypti, and it is therefore free of vector-borne diseases, such as dengue fever, Zika and chikungunya. However, evidence has shown the presence of Aedes aegypti eggs in the city since 2015. OBJECTIVE: To report the constant and increasing presence of Aedes aegypti eggs in Mexico City from 2015 to 2018. METHODS: Surveillance was carried out using ovitraps. Eggs were counted and hatched in order to determine the species. RESULTS: From 2015 to 2018, 378 organisms were identified as Ae. aegypti. In total, 76 Aedes aegypti-positive ovitraps were collected at 50 different places in 11 boroughs of the city. Northeastern Mexico City was the area with the highest number of positive traps. CONCLUSIONS: The results may be indicating a period of early colonization and the probable existence of cryptic colonies of the mosquito; Mexico City could be at risk of experiencing vector-borne epidemics.
INTRODUCCIÓN: La Ciudad de México no tiene presencia endémica de Aedes aegypti, por lo que está libre de enfermedades transmitidas por vector como dengue, Zika y chikunguña. Sin embargo, existe evidencia de la presencia de huevecillos en la urbe desde 2015. OBJETIVO: Reportar la presencia constante y en aumento de huevecillos de Aedes aegypti en la Ciudad de México de 2015 a 2018. MÉTODO: Se realizó vigilancia a través de ovitrampas; se contabilizaron y eclosionaron huevecillos para determinar la especie. RESULTADOS: De 2015 a 2018 fueron identificados 378 organismos como Aedes aegypti. En total fueron colectadas 76 ovitrampas positivas a Aedes aegypti en 50 sitios distintos de 11 alcaldías. El noreste de la Ciudad de México fue el área con mayor positividad. CONCLUSIONES: Los resultados pueden estar indicando un periodo de colonización incipiente y la probable la existencia de colonias crípticas del mosquito, por lo que la Ciudad de México podría estar en riesgo de presentar epidemias de enfermedades transmitidas por vector.
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Aedes/classificação , Dengue , Ovos , Mosquitos Vetores , Aedes/crescimento & desenvolvimento , Animais , Cidades , Larva/classificação , Larva/crescimento & desenvolvimento , México , Especificidade da EspécieRESUMO
Resumen Introducción: La Ciudad de México no tiene presencia endémica de Aedes aegypti, por lo que está libre de enfermedades transmitidas por vector como dengue, Zika y chikunguña. Sin embargo, existe evidencia de la presencia de huevecillos en la urbe desde 2015. Objetivo: Reportar la presencia constante y en aumento de huevecillos de Aedes aegypti en la Ciudad de México de 2015 a 2018. Método: Se realizó vigilancia a través de ovitrampas; se contabilizaron y eclosionaron huevecillos para determinar la especie. Resultados: De 2015 a 2018 fueron identificados 378 organismos como Aedes aegypti. En total fueron colectadas 76 ovitrampas positivas a Aedes aegypti en 50 sitios distintos de 11 alcaldías. El noreste de la Ciudad de México fue el área con mayor positividad. Conclusiones: Los resultados pueden estar indicando un periodo de colonización incipiente y la probable la existencia de colonias crípticas del mosquito, por lo que la Ciudad de México podría estar en riesgo de presentar epidemias de enfermedades transmitidas por vector.
Abstract Introduction: Mexico City has no endemic presence of Aedes aegypti, and it is therefore free of vector-borne diseases, such as dengue fever, Zika and chikungunya. However, evidence has shown the presence of Aedes aegypti eggs in the city since 2015. Objective: To report the constant and increasing presence of Aedes aegypti eggs in Mexico City from 2015 to 2018. Methods: Surveillance was carried out using ovitraps. Eggs were counted and hatched in order to determine the species. Results: From 2015 to 2018, 378 organisms were identified as Ae. aegypti. In total, 76 Aedes aegypti-positive ovitraps were collected at 50 different places in 11 boroughs of the city. Northeastern Mexico City was the area with the highest number of positive traps. Conclusions: The results may be indicating a period of early colonization and the probable existence of cryptic colonies of the mosquito, and Mexico City could be therefore at risk of experiencing vector-borne epidemics.
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Animais , Aedes/classificação , Dengue , Ovos , Mosquitos Vetores , Especificidade da Espécie , Cidades , Aedes/crescimento & desenvolvimento , Larva/classificação , Larva/crescimento & desenvolvimento , MéxicoRESUMO
Thirteen cases of primary pulmonary adenofibromas are presented. The patients are 8 women and 5 men between the ages of 41 and 73 years (average: 57 y). The patients presented with nonspecific symptomatology or their tumor was identified during routine chest films. A wedge resection was performed in all cases with lymph node sampling. Grossly, the tumors varied in size from 1 to 2.5 cm in greatest dimension. The entire tumor was histologically evaluated in all cases. All the tumors shared similar histologic features namely leaf-like/phyllodes-like growth patterns with varying areas of sclerosis, focal inflammation, and entrapped epithelium. A wide panel of immunohistochemical studies was performed including epithelial, neural, muscle, and vascular markers, all of which showed negative staining. The tumors were positive only for vimentin in the stroma and keratin in the entrapped epithelium. Further evaluation in 6 cases using in situ hybridization for the solitary fibrous tumor was performed and was negative. Clinical follow-up in all the patients showed no evidence of recurrence or metastatic disease, during a period of 12 to 36 months. The current cases highlight the unusual occurrence of pulmonary adenofibromas and the importance of separating these tumors from other tumors that may have the potential to recur or metastasize. The use of proper immunohistochemical stains/molecular analysis aids in the proper classification of these tumors.
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Adenofibroma/diagnóstico , Adenofibroma/patologia , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/patologia , Adenofibroma/metabolismo , Adenofibroma/cirurgia , Adulto , Idoso , Biomarcadores Tumorais/metabolismo , Feminino , Seguimentos , Humanos , Imuno-Histoquímica , Neoplasias Pulmonares/metabolismo , Neoplasias Pulmonares/cirurgia , Masculino , Pessoa de Meia-Idade , Pneumonectomia , PrognósticoRESUMO
RESUMEN Introducción: En Cuba, los estudios descriptivos y experimentales que exploran los trastornos cardiovasculares secundarios a enfermedades neurológicas son escasos, tanto en el campo de la clínica como de la neurocardiología. Objetivos: Caracterizar los hallazgos electrocardiográficos en las primeras 72 horas de evolución de la enfermedad cerebrovascular y su relación con la mortalidad. Método: Se realizó un estudio observacional, descriptivo, de corte longitudinal prospectivo, en 166 pacientes ingresados en el Hospital Clínico-Quirúrgico Joaquín Albarrán, con el diagnóstico de enfermedad cerebrovascular de cualquier etiología y forma de presentación, durante el período de enero de 2015 a diciembre de 2016. Resultados: Los hallazgos electrocardiográficos estuvieron presentes en el 32,5% de los pacientes, fundamentalmente la taquicardia sinusal (27,7 %), la inversión de la onda T y las extrasístoles auriculares (13,3% cada uno). Se encontró una frecuencia significativamente mayor de cambios electrocardiográficos en los pacientes con hemorragia subaracnoidea (33,3% frente a 5,4%), menor puntuación en la escala de coma de Glasgow (29,7% frente a 5,4%) y localización a nivel de los ganglios basales (50,0%). La presencia de nuevos hallazgos electrocardiográficos se relacionó con una probabilidad 7,2 veces mayor de muerte intrahospitalaria (40,7% frente a 7,1%). Conclusiones: La presencia de nuevas alteraciones electrocardiográficas en pacientes con enfermedad cerebrovascular puede ser empleado como un marcador de riesgo de mortalidad intrahospitalaria.
ABSTRACT Introduction: In Cuba, descriptive and experimental studies that explore cardiovascular disorders secondary to neurological diseases are scarce, both in the clinical and neurocardiology fields. Objectives: To characterize the electrocardiographic findings in the first 72 hours of evolution of the cerebrovascular disease and its relation to mortality. Method: An observational, descriptive, longitudinal prospective study was carried out in 166 patients admitted to the Hospital Clínico-Quirúrgico Joaquín Albarrán, with the diagnosis of cerebrovascular disease of any etiology and form of presentation, during the period of January 2015 to December 2016. Results: Electrocardiographic findings were present in 32.5% of patients, mainly sinus tachycardia (27.7%), T wave inversion and premature atrial contractions (13.3% each). A significantly higher frequency of electrocardiographic changes was found in patients with subarachnoid hemorrhage (33.3% vs. 5.4%), lower score on the Glasgow coma scale (29.7% vs. 5.4%) and location at the level of the basal ganglia (50.0%). The presence of new electrocardiographic findings was related to a 7.2 times greater probability of in-hospital death (40.7% vs. 7.1%). Conclusions: The presence of new electrocardiographic alterations in patients with cerebrovascular disease can be used as a marker of risk of in-hospital mortality.
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Acidente Vascular Cerebral , Arritmias Cardíacas , EletrocardiografiaRESUMO
Electrochemical treatment has been suggested as an effective alternative to local cancer therapy. Nevertheless, its effectiveness decreases when highly aggressive primary tumors are treated. The aim of this research was to understand the growth kinetics of the highly aggressive and metastatic primary F3II tumor growing in male and female BALB/c/Cenp mice under electrochemical treatment. Different amounts of electric charge (6, 9, and 18 C) were used. Two electrodes were inserted into the base, perpendicular to the tumor's long axis, keeping about 1 cm distance between them. Results have shown that the F3II tumor is highly sensitive to direct current. The overall effectiveness (complete response + partial response) of this physical agent was ≥75.0% and observed in 59.3% (16/27) of treated F3II tumors. Complete remission of treated tumors was observed in 22.2% (6/27). An unexpected result was the death of 11 direct current-treated animals (eight females and three males). It is concluded that direct current may be addressed to significantly affect highly aggressive and metastatic primary tumor growth kinetics, including the tumor complete response. Bioelectromagnetics. 39:460-475, 2018. © 2018 Wiley Periodicals, Inc.
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Neoplasias da Mama/terapia , Carcinoma/terapia , Terapia por Estimulação Elétrica , Animais , Linhagem Celular Tumoral , Terapia por Estimulação Elétrica/efeitos adversos , Terapia por Estimulação Elétrica/métodos , Feminino , Masculino , Camundongos Endogâmicos BALB C , Transplante de Neoplasias , Distribuição Aleatória , Análise de Sobrevida , Carga TumoralRESUMO
El pensamiento ético y bioético es una de las áreas de conocimiento recurrentes en el ejercicio reflexivo del profesional de la salud en Cuba; sin embargo, se detectan insuficiencias relacionadas con imprecisiones y falta de claridad en el pensamiento ético-moral por parte de este personal, según se observa en materiales evaluados para su publicación, en los ejercicios para el proceso de obtención de categorías docentes y en la presentación de las evaluaciones de posgrados. El artículo tiene el objetivo de argumentar precisiones teórico- metodológicas para la elaboración de trabajos en ética y bioética.
The ethical and bioethical thought is one of the recurrent areas of knowledge in the reflexive exercise of health professionals in Cuba. However, according to the observations of evaluated materials for their publication, in the exercises for the process of obtaining educational categories and in the presentation of postgraduate evaluations, inadequacies related with imprecision and lack of clarity are detected in the ethical-moral thought on the part of health professionals. The article has the objective of arguing theoretical- methodological precisions for the elaboration of works in ethics and bioethics.
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Introducción: los cambios del contexto de trabajo en los hospitales para los internistas exigen perfeccionar el funcionamiento de sus servicios. Objetivos: identificar problemas que afectan a la especialidad Medicina Interna y los cambios organizativos necesarios para su solución, en un hospital clínico-quirúrgico. Material y Métodos: se realizó investigación cualitativa, basada en la actividad de un grupo nominal que dio salida a tareas propias de la dirección estratégica. Resultados: se definió la misión, visión y líneas estratégicas de trabajo del Servicio de Medicina Interna, se caracterizó el contexto y definieron como problemas en orden de prioridad: Deterioro del método clínico; práctica de una Medicina biologicista; insuficiente disponibilidad de camas; limitaciones en los recursos humanos, materiales y financieros para la máxima calidad de la atención y sobrecarga de los servicios clínicos. Se definieron las fortalezas, debilidades, amenazas y oportunidades. De ellas se derivaron propuestas de acciones ofensivas, adaptativas, defensivas y de supervivencia para lograr un cambio positivo en el trabajo de esta especialidad. Conclusiones: la gestión del capital humano en Medicina Interna implica una estructura colaborativa más eficiente para el hospital, que depare mejor utilización de los internistas como médico generalista e integrador, lo que contribuiría a disminuir las fronteras físicas de las salas y centrar el trabajo en los enfermos.
Introduction: the work context changes of the internists demand to make perfect the functioning of their services. Objectives: identify problems that affect the Internal Medicine and the necessary organizative changes to solve them, at a clinical-surgical hospital. Material and Methods: it was a qualitative research based on the activity of a nominal group that gave vent to own tasks of the strategic direction. Results: the mission, vision and the Internal Medicine service's strategic lines of work were defined; the context was assigned priority to its problems: Deterioration of the clinical method; the practice of a biologist medicine; insufficient availability of beds; Limitations in human, materials and financiers resources for the maximum quality of attention; Overload of the clinical services. It was defined fortresses, weaknesses, threats and opportunities. The offensive, adjustatives, defensives and survival actions to achieve a positive change were derived. Conclusions: the management of the human capital in internal medicine implies a collaborative structure more efficient for the hospital, that better utilization of the internists like generalist and integrative doctor that would contribute to diminish the physical frontiers of the wards and centering the work in the sick persons.
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BACKGROUND: Primary neuroendocrine carcinoma of the breast is a heterogeneous group of rare tumors with positive immunoreactivity to neuroendocrine markers in at least 50% of cells. Diagnosis also requires that other primary sites be ruled out and that the same tumor show histological evidence of a breast in situ component. Primary neuroendocrine carcinoma of the breast rarely presents as locally advanced disease and less frequently with such widespread metastatic disease as described herein. The review accompanying this case report is the first to provide an overview of all the cases of primary neuroendocrine carcinoma of the breast published in the literature and encompasses detailed information regarding epidemiology, histogenesis, clinical and histologic diagnosis criteria, classification, surgical and adjuvant treatment, as well as prognosis. We also provide recommendations for common clinical and histologic pitfalls associated with this tumor. CASE PRESENTATION: We describe a case of a 51-year-old Hispanic woman initially diagnosed with locally-advanced invasive ductal carcinoma that did not respond to neoadjuvant treatment. After undergoing modified radical mastectomy the final surgical pathology showed evidence of alveolar-type primary neuroendocrine carcinoma of the breast. The patient was treated with cisplatin/etoposide followed by paclitaxel/carboplatinum. Thirteen months after surgery the patient is alive, but developed pulmonary, bone, and hepatic metastasis. CONCLUSION: The breast in situ component of primary neuroendocrine carcinoma of the breast may prevail on a core biopsy samples increasing the probability of underdiagnosing this tumor preoperatively. Being aware of the existence of this disease allows for timely diagnosis and management. Optimal treatment requires simultaneous consideration of both the neuroendocrine and breast in situ tumor features.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias da Mama/diagnóstico , Carcinoma Ductal de Mama/diagnóstico , Carcinoma Neuroendócrino/diagnóstico , Neoplasias Ósseas/secundário , Neoplasias Ósseas/terapia , Neoplasias da Mama/terapia , Carboplatina/administração & dosagem , Carcinoma Ductal de Mama/terapia , Carcinoma Neuroendócrino/terapia , Cisplatino/administração & dosagem , Terapia Combinada , Diagnóstico Diferencial , Etoposídeo/administração & dosagem , Feminino , Humanos , Neoplasias Hepáticas/secundário , Neoplasias Hepáticas/terapia , Neoplasias Pulmonares/secundário , Neoplasias Pulmonares/terapia , Imageamento por Ressonância Magnética , Mastectomia , Pessoa de Meia-Idade , Terapia Neoadjuvante , Estadiamento de Neoplasias , Paclitaxel/administração & dosagem , Prognóstico , Literatura de Revisão como AssuntoRESUMO
A cross-sectional survey was conducted in order to determine the seroprevalence and to identify some factors associated with the presence of antibodies against Salmonella enterica subsp. enterica serovar Gallinarum-Pullorum in white-winged (Zenaida asiatica) and mourning doves (Zenaida macroura) from hunting areas of Northeast Mexico. From September to October 2006, 201 serum samples were analyzed with the seroagglutination test. The overall seroprevalence of S. enterica subsp. enterica serovar Gallinarum-Pullorum was 26.3%, and was similar for white-winged doves (26.4%) and mourning doves (26.1%), but higher for juveniles (30.8%) and females (34.6%). Seroprevalence was associated with the weight of the doves (prevalence ratio [PR]=1.52, P<0.0001) and the municipality where the doves were hunted (PR=1.31, P<0.0001). This survey study emphasizes the need to conduct similar studies on wild birds to determine the risk of S. enterica subsp. enterica serovar Gallinarum-Pullorum to commercial flocks. In addition, to the best of our knowledge this is the first report of the serological evidence suggesting infection with S. enterica subsp. enterica serovar Gallinarum-Pullorum in wild white-winged and mourning doves.
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Anticorpos Antibacterianos/sangue , Doenças das Aves/epidemiologia , Columbidae/microbiologia , Salmonelose Animal/epidemiologia , Salmonella enterica/imunologia , Fatores Etários , Animais , Animais Selvagens/microbiologia , Estudos Transversais , Feminino , Masculino , México/epidemiologia , Estudos Soroepidemiológicos , Fatores SexuaisRESUMO
Melioidosis is an emerging infection in Brazil and neighbouring South American countries. The wide range of clinical presentations include severe community-acquired pneumonia, septicaemia, central nervous system infection and less severe soft tissue infection. Diagnosis depends heavily on the clinical microbiology laboratory for culture. Burkholderia pseudomallei, the bacterial cause of melioidosis, is easily cultured from blood, sputum and other clinical samples. However, B. pseudomallei can be difficult to identify reliably, and can be confused with closely related bacteria, some of which may be dismissed as insignificant culture contaminants. Serological tests can help to support a diagnosis of melioidosis, but by themselves do not provide a definitive diagnosis. The use of a laboratory discovery pathway can help reduce the risk of missing atypical B. pseudomallei isolates. Recommended antibiotic treatment for severe infection is either intravenous Ceftazidime or Meropenem for several weeks, followed by up to 20 weeks oral treatment with a combination of trimethoprim-sulphamethoxazole and doxycycline. Consistent use of diagnostic microbiology to confirm the diagnosis, and rigorous treatment of severe infection with the correct antibiotics in two stages; acute and eradication, will contribute to a reduction in mortality from melioidosis.
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Antibacterianos/administração & dosagem , Burkholderia pseudomallei , Melioidose , Guias de Prática Clínica como Assunto , Ceftazidima/administração & dosagem , Protocolos Clínicos , Doxiciclina/administração & dosagem , Humanos , Melioidose/diagnóstico , Melioidose/tratamento farmacológico , Meropeném , Tienamicinas/administração & dosagem , Combinação Trimetoprima e Sulfametoxazol/administração & dosagemRESUMO
Melioidose é uma infecção emergente no Brasil e em países vizinhos da América do Sul. O amplo espectro de apresentação clínica inclui pneumonia adquirida na comunidade, septicemia, infecção do sistema nervoso central e infecção de partes moles de menor severidade. O diagnóstico depende essencialmente da identificação microbiológica. Burkholderia pseudomallei, a causa bacteriana da melioidose, é facilmente cultivada em sangue, escarro e em outras amostras clínicas. Entretanto, B. pseudomallei pode ser difícil de identificar com segurança e também ser confundido com outras bactérias Gram negativas. Os exames sorológicos podem dar suporte a um diagnóstico de melioidose, mas não fornece um diagnóstico definitivo por si só. A realização de investigação laboratorial seqüenciada pode ajudar a reduzir o risco de não reconhecer isolados incomuns de B. pseudomallei. O tratamento antibiótico recomendado para infecção severa é Ceftazidima ou Meropenem endovenosos por várias semanas, seguido por um tratamento oral com uma combinação de Sulfametoxazol-Trimetopim e Doxiciclina por até 20 semanas. O uso consistente do diagnóstico microbiológico e o tratamento rigoroso da infecção severa com antibióticos adequados nas duas etapas, aguda e de erradicação, contribuirão para a redução da mortalidade por melioidose.
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Humanos , Antibacterianos/administração & dosagem , Burkholderia pseudomallei , Melioidose , Guias de Prática Clínica como Assunto , Protocolos Clínicos , Ceftazidima/administração & dosagem , Doxiciclina/administração & dosagem , Melioidose/diagnóstico , Melioidose/tratamento farmacológico , Tienamicinas/administração & dosagem , Combinação Trimetoprima e Sulfametoxazol/administração & dosagemRESUMO
The Gram-positive cocci (GPC), Staphylococcus aureus, Streptococcus pneumoniae, Enterococcus faecalis and Enterococcus faecium, have become important causes of community and nosocomial-acquired infections. The prevalence of multiple resistant isolates to standard antimicrobial drugs has significantly increased over the past decades. Few prospective studies have been performed in Puerto Rico (PR) concerning the GPC antimicrobial susceptibilities pattern. The purpose of this study was to evaluate the in vitro susceptibility of GPC clinical isolates from PR to selected standard antibiotics and to the new antimicrobial agents, linezolid (LZ), quinupristin/dalfopristin (Q/D) and gemifloxacin (GM). The in vitro susceptibility utilizing disk diffusion and Etest methods to selected antibiotics was determined for a total of 429 isolates obtained during a period of 5 months from the Puerto Rico Medical Center Bacteriology Laboratory. The distribution of GPC collected was as follows: 213 S. aureus isolates, 162 E. faecalis, 16 E. faecium and 38 S. pneumoniae. The results of the susceptibility test demonstrated: 1) that in S. aureus, 100% of the isolates were susceptible to vancomycin (VAN), LZ and Q/D; 93% to GM; and 61% to methicillin/oxacillin; 2) in S. pneumoniae, 100% were susceptible to LN and GM; 87% to Q/D; and 53% to penicillin; 3) in E. faecalis, 99% were susceptible to ampicillin; 93% to LZ; 79% to GM; 78.6% to VAN; and 0% to Q/D. Sixty eight and 66% of the E. faecalis isolates were susceptible to gentamicin and streptomycin respectively; and 4) in E. faecium, 100% were susceptible to LZ; 94% to Q/D; 69% to GM; 37.5% to VAN and 20% to ampicillin. In E. faecium isolates, 50% and 31% were susceptible to gentamicin and streptomycin, respectively. Of the vancomycin resistant enterococci, 88.9% and 21% of E. faecium and faecalis showed VanA phenotypic resistance, respectively. These results show that there is a significant degree of antimicrobial resistance in GPC, including 38% methicillin resistance in S. aureus, a near 50% penicillin resistant S. pneumoniae, and a significant resistance of enterococcal species to VAN. The new agents, LZ, Q/D and GM, proved to be effective against both, S. aureus and S. pneumoniae. For E. faecium, both, LZ and Q/D were active, while for E. faecalis, only LZ showed consistent activity.
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Cocos Gram-Positivos/efeitos dos fármacos , Testes de Sensibilidade Microbiana/métodos , Cocos Gram-Positivos/isolamento & purificação , Humanos , Estudos Prospectivos , Porto RicoRESUMO
BACKGROUND: In Puerto Rico, it has been established that although coronary heart disease is the leading cause of death, the population has a lower incidence of coronary disease than the continental United States. In addition, the severity of the disease is less aggressive in terms of a lower incidence of ventricular tachycardia and sudden death. A factor in the lower incidence of coronary disease in Puerto Rico could be a lower total plasma homocysteine concentration (tHcys) in our population. METHODS: We randomly measured tHcys concentrations in seventy-two Hispanic patients who were hospitalized for coronary angiography at the Cardiovascular Center of Puerto Rico and the Caribbean (UPR Division). RESULTS: The mean tHCys concentration in our patient population is similar than that reported for the Framingham study when adjusted by age (11.2 mumol/L vs. 11.8 mumol/L). In the Puerto Rican population, males had a higher tHcys concentration than females but this difference was not statistically significant (10.9 mumol/L vs. 9.4 mumol/L, p = 0.09). In addition, we did not see an increase of tHcys concentrations in diabetic patients when compared with nondiabetics (10.1 mumol/L vs. 10.3 mumol/L, p = 0.73). Neither we saw a direct correlation between tHcys concentrations and atherosclerosis as measured by coronary angiography (normal = 10.9 mumol/L, mild = 8.6 mumol/L, moderate = 10.9 mumol/L, severe = 10.5 mumol/L; ANOVA = 0.29). CONCLUSIONS: These results suggest that tHcys concentration is not a good predictor of atherosclerotic coronary disease in our patient population.
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Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Doença da Artéria Coronariana/sangue , Homocisteína/sangue , Angiografia , Doença da Artéria Coronariana/diagnóstico , Doença da Artéria Coronariana/epidemiologia , Área Programática de Saúde , Cromatografia Líquida de Alta Pressão , Incidência , Valor Preditivo dos Testes , Porto Rico/epidemiologia , Índice de Gravidade de DoençaRESUMO
Se analizaron los resultados del tratamiento quirúrgico electivo de la úlcera duodenal con la vagotomía altamente selectiva (VAS) y la vagotomía troncular más piloroplastia (VT + P) en el Hospital Militar Central "Dr. Carlos J. Finlay", durante un período de 10 años. Se sometieron 36 pacientes a VAS y 67 a VT + P y se halló un mayor número de complicaciones trans y posoperatorias con esta última. Las recidivas se presentaron con pocas diferencias entre ambas técnicas (16,4 porciento para la VT + P y 13, 9 porciento para la VAS), pero en la VAS el 80 porciento resolvió con tratamiento médico, mientras que en la VT + P sólo el 36,4 porciento curó por esta vía. El costo por estadía fue menor en la VAS (80 porciento menos de 7 días) con una mejor aptitud para el trabajo en este mismo grupo (83,3 porciento) después de operados y con resultados finales satisfactorios superiores (80,6 porciento) a la VT + P(AU)
The results of the elective surgical treatment of duodenal ulcer with highly selective vagotomy (HSV) and truncal vagotomy plus pyloro-plasty (TV+P) at the Dr. "Carlos J. Finlay" Central Military Hospital during 10 years were analyzed. 36 patients underwent HSV and 67 TV+P. A higher number of transand postoperative complications were found in the latter. Relapses showed little differences between both techniques (16. 4 percent) for TV+P and 13. 9 percent for HSV). 80 percent of those who underwent HSV resolved with medical treatment, whereas only 36.4 percent of the patients that in HSV (80 percent less than 7 days) with a better aptitude for work in this same group (83.3 percent) after being operated on and with higher final satisfactory results ( 80. 6 percent) than TV+P(AU)
Assuntos
Humanos , Complicações Pós-Operatórias , Vagotomia Troncular/métodos , Vagotomia Gástrica Proximal/métodos , Úlcera Duodenal/cirurgiaRESUMO
Glutathione (GSH) is the primary antioxidant in humans. Oxidative cellular injury is postulated to be centrally involved in diverse processes including ging, cancer, cardiovascular disease, and Human Immunodeficiency Virus (HIV) disease progression. Normal plasma GSH concentrations have been well haracterized in healthy children and adults, but not during infant development. The objectives of this study were to: a) measure plasma GSH concentrations in non-infected infants born from HIV-infected mothers, to b) assess the developmental ariations with age and gender, and c) evaluate for possible associations with growth, anemia, and other maternal and infant variables. One hundred and seventy (170) plasma samples from 44 HIV-uninfected infants (birth to 18 mos.) born to HIV-infected mothers from the Women and Infant Transmission Study (Puerto Rico site) were analyzed. The total plasma GSH geometric mean concentration for all samples analyzed was 1.94 (1.06) mumoles/L. A developmental effect of age was seen with lower concentrations in younger infants (0-2 months) than in older infants 4-18 months. There was no significant effect of gender, anemia, zidovudine exposure, maternal age, maternal CD4 cell percent, or infant growth, although a trend towards increasing GSH concentration was seen with increasing weight for height z-score. These findings have multiple clinical ramifications including prediction of capacity to detoxify oxidants at different ages, and partial explanation for the increased viral loads seen in HIV-infected infants