RESUMO
INTRODUCTION: Infection by Angiostrongylus cantonensis is caused by eating snails and slugs or contaminated vegetables, and is the commonest cause of eosinophilic meningoencephalitis throughout the world. OBJECTIVES: To make a further study of this condition, analyze the clinical behaviour and evaluate the cerebrospinal fluid findings and response to treatment. PATIENTS AND METHODS: We made a retrospective, descriptive study by reviewing the clinical histories of a series of 17 adult patients attended in two university hospitals in the province of Villa Clara (Cuba), between December 1991 and January 2000. We recorded the characteristics of the clinical picture, results of the complementary investigations, treatment given and clinical course and the necropsy findings of the three patients who died. The data was collected from questionnaires. RESULTS: Headache was a constant symptom. Twelve patients had high temperatures and seven had stiff necks. Motor deficit and coma were seen in the three patients who died. In two patients the cranial nerves were involved. Spinal fluid pleocytosis varied between 48 and 2570 cells/mm3. Initially there was lymphocyte predominance in 10 patients and subsequently eosinophil conversion. The peripheral eosinophilia, seen in all patients, varied between 7% and 61%. Of the 14 patients cured, eight received symptomatic treatment and six antihelminth drugs. Steroids were given to only one patient. Of the three patients who died, two had received antihelminth drugs. CONCLUSIONS: Motor deficit and coma worsen the prognosis, which is generally good. There is no relation between cerebrospinal fluid pleocytosis and raised protein levels in the cerebrospinal fluid, nor between blood eosinophilia and prognosis. The most difficult differential diagnosis in our patients was with leptospirosis. No differences were seen in clinical evolution in relation to the treatment given.
Assuntos
Eosinofilia/epidemiologia , Meningoencefalite/epidemiologia , Adulto , Angiostrongylus cantonensis/imunologia , Angiostrongylus cantonensis/isolamento & purificação , Animais , Anticorpos Monoclonais/imunologia , Área Programática de Saúde , Cuba/epidemiologia , Diagnóstico Diferencial , Ensaio de Imunoadsorção Enzimática , Eosinofilia/complicações , Eosinofilia/parasitologia , Humanos , Imunoglobulina E/imunologia , Leucocitose/líquido cefalorraquidiano , Meningoencefalite/complicações , Meningoencefalite/parasitologia , Transtornos Psicomotores/diagnóstico , Transtornos Psicomotores/etiologia , Infecções por Strongylida/líquido cefalorraquidiano , Infecções por Strongylida/imunologia , Infecções por Strongylida/parasitologia , Inquéritos e QuestionáriosRESUMO
Malignant tumors of the oral cavity rebound on the organism of the affected patients, because it is the open door of the digestive apparatus and any alteration of it, involves nutritional status. Besides oral cavity is easy to approach for its examination, importance of early detection of such neoplasias for the patient moves us to review 13,267 reports of biopsies from the Department of Pathologic Anatomy, "Celia S++ánchez" Clinicosurgical Hospital; 50 of such biopsies present diagnosis of malignant neoplasia of the oral cavity and are selected in order to know prevalence (0.37%), the most frequent locations (tongue, 50%), most affected age (sixth to seventh decades of life), sex (prevalence of male sex, 80%), and also to contribute to the widest knowledge and to the development of the plan for the early detection of oral cancer carried out by the Ministry of Public Health.
Assuntos
Neoplasias Bucais/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia , Cuba/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores SexuaisRESUMO
One-hundred-and-ten children between the ages of two months and 14 years with the following liver diseases were studied: 16 with acute viral hepatitis, 8 with persistent chronic hepatitis, 31 with active chronic hepatitis, 5 with hepatic steatosis, 11 with cirrhosis of the liver, 24 with newborn cholestasis, 3 with Wilson's disease, 2 with congenital hepatic fibrosis, 5 with metabolic diseases and 5 due to other causes. These children presented Pi system phenotypes in isoelectric focus using ultrafine polyacrylamide gels according to Kuepper's method, with modifications incorporated to determine Alpha-1-antitrypsin (A1-AT) serum level deficiencies in those presenting the Pi ZZ phenotype, a liver biopsy with P.A.S. coloration on digestion of diastase and a family history of the phenotype. Four (3.6%) of the children with Pi ZZ phenotypes showed a decrease of serum A1-AT and the presence of positive P.A.S. inclusions resistant to diastase in the cytoplasm of hepatocytes. Three had a history of postnatal icterus and the fourth presented hepatomegaly. The phenotypic study of the parents showed their being heterozygous (MZ), while siblings were normal (MM). The importance of the diagnosis of A1-AT deficiency and the diagnostic value of detecting Pi system phenotypes in every case of liver disease in children and adolescents is stressed.
Assuntos
Hepatopatias/genética , Deficiência de alfa 1-Antitripsina , Adolescente , Criança , Pré-Escolar , Feminino , Frequência do Gene , Humanos , Lactente , Focalização Isoelétrica , Masculino , FenótipoRESUMO
One-hundred-and-ten children between the ages of two months and 14 years with the following liver diseases were studied: 16 with acute viral hepatitis, 8 with persistent chronic hepatitis, 31 with active chronic hepatitis, 5 with hepatic steatosis, 11 with cirrhosis of the liver, 24 with newborn cholestasis, 3 with Wilsons disease, 2 with congenital hepatic fibrosis, 5 with metabolic diseases and 5 due to other causes. These children presented Pi system phenotypes in isoelectric focus using ultrafine polyacrylamide gels according to Kueppers method, with modifications incorporated to determine Alpha-1-antitrypsin (A1-AT) serum level deficiencies in those presenting the Pi ZZ phenotype, a liver biopsy with P.A.S. coloration on digestion of diastase and a family history of the phenotype. Four (3.6
) of the children with Pi ZZ phenotypes showed a decrease of serum A1-AT and the presence of positive P.A.S. inclusions resistant to diastase in the cytoplasm of hepatocytes. Three had a history of postnatal icterus and the fourth presented hepatomegaly. The phenotypic study of the parents showed their being heterozygous (MZ), while siblings were normal (MM). The importance of the diagnosis of A1-AT deficiency and the diagnostic value of detecting Pi system phenotypes in every case of liver disease in children and adolescents is stressed.