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Positron Emission Mammography (PEM) is a valuable molecular imaging technique for breast studies using pharmaceuticals labeled with positron emitters and dual-panel detectors. PEM scanners normally use large scintillation crystals coupled to sensitive photodetectors. Multiple interactions of the 511 keV annihilation photons in the crystals can result in event mispositioning leading to a negative impact in radiopharmaceutical uptake quantification. In this work, we report the study of crystal scatter effects of a large-area dual-panel PEM system designed with either monolithic or pixelated lutetium yttrium orthosilicate (LYSO) crystals using the Monte Carlo simulation platform GATE. The results show that only a relatively small fraction of coincidences (~20%) arise from events where both coincidence photons undergo single interactions (mostly through photoelectric absorption) in the crystals. Most of the coincidences are events where at least one of the annihilation photons undergoes a chain of Compton scatterings: approximately 79% end up in photoelectric absorption while the rest (<1%) escape the detector. Mean positioning errors, calculated as the distance between first hit and energy weighted (assigned) positions of interaction, were 1.70 mm and 1.92 mm for the monolithic and pixelated crystals, respectively. Reconstructed spatial resolution quantification with a miniDerenzo phantom and a list mode iterative reconstruction algorithm shows that, for both crystal types, 2 mm diameter hot rods were resolved, indicating a relatively small effect in spatial resolution. A drastic reduction in peak-to-valley ratios for the same hot-rod diameters was observed, up to a factor of 14 for the monolithic crystals and 7.5 for the pixelated ones.
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Elétrons , Lutécio , Tomografia por Emissão de Pósitrons , Tomografia por Emissão de Pósitrons/métodos , Silicatos/química , Mamografia , FótonsRESUMO
Obesity is highly prevalent in breast cancer (BC) survivors. Adipose tissue promotes inflammation, affecting recurrence, morbidity, and quality of life. This study aimed to determine the relationship of body composition parameters with the levels of C-reactive protein (CRP) and interleukin 6 (IL-6) in female BC survivors. Additionally, we evaluated the association of log-transformed serum concentrations of CRP and IL-6 with the appendicular skeletal lean mass index (ASMI). The results showed that CRP was positively associated with body fat percentage (BFP; ß adjusted = .08, 95% CI: .02-.14) in all participants, and with fat mass index (FMI; ß = .24, 95% CI: .08-.40) only in premenopausal women. IL-6 was positively associated with FMI (ß adjusted = .16, 95% CI: .03-.29), while ASMI decreased as CRP levels increased (ß adjusted = -.30, 95% CI: -.53 to -.06). Interventions to improve body composition in BC survivors should also consider the role of inflammatory markers in changes in body composition to avoid sarcopenic obesity (SO) and the risk of BC recurrence.
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Neoplasias da Mama , Sobreviventes de Câncer , Humanos , Feminino , Interleucina-6 , Proteína C-Reativa , Neoplasias da Mama/complicações , Qualidade de Vida , Recidiva Local de Neoplasia/complicações , Composição Corporal , Obesidade/complicações , Sobreviventes , Índice de Massa CorporalRESUMO
Acute aortic syndromes (AAS) include a variety of overlapping anatomical and clinical conditions. Intramural hematoma (IMH), penetrating aortic ulcer, and aortic dissection occur in isolation or may coexist in the same patient. IMH represents 5-30% of all AAS and 60-70% of cases are located in the descending aorta. The diagnosis relies on a high index of clinical suspicion and on the use of complementary images. Management is conservative, but patients with some high-risk characteristics have a higher risk of mortality in the acute phase, so initial endovascular management should be considered. We present the case of a 69-year-old patient, in whom IMH was diagnosed in the course of a hypertensive emergency and who required hybrid management due to high-risk anatomical characteristics for endovascular management only.
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The concentrations of trace elements including As, Zn, Cu, Se, Pb, Hg and Cd, were determined in the blood of nesting Kemp's ridley turtles (Lepidochelys kempii) at Rancho Nuevo sanctuary, Tamaulipas, Mexico during 2018-2020. The sequential concentrations analyzed were Zn> Se> Cu> As> Pb; while Cd and Hg concentrations were below the limits of detection (0.01 µg g-1). No significant differences were observed between the concentrations of trace elements (p> 0.05) by year, except Se levels, possibly resulting from recorded seasonal differences in turtle size. No relationships among turtle size vs elements concentration were observed. In conclusion, essential and toxic trace elements concentrations in the blood of nesting Kemp's ridley turtles may be a reflex of the ecosystem in which the turtles develop, that is, with low bioavailability of elements observed in the trophic webs in the Gulf of Mexico.
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Mercúrio , Oligoelementos , Tartarugas , Animais , Ecossistema , Cádmio , Chumbo , MéxicoRESUMO
We investigate the emergence of localization in a weakly interacting Bose gas confined in quasicrystalline lattices with three different rotational symmetries: five, eight, and twelve. The analysis, performed at a mean field level and from which localization is detected, relies on the study of two observables: the inverse participation ratio (IPR) and the Shannon entropy in the coordinate space. Those physical quantities were determined from a robust statistical study for the stationary density profiles of the interacting condensate. Localization was identified for each lattice type as a function of the potential depth. Our analysis revealed a range of the potential depths for which the condensate density becomes localized, from partially at random lattice sites to fully in a single site. We found that localization in the case of five-fold rotational symmetry appears for (6ER,9ER), while it occurs in the interval (12ER,15ER) for octagonal and dodecagonal symmetries.
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INTRODUCTION: Perianal fistulizing Crohn's disease (CD) is a phenotype with a poor prognosis. There are no studies in our country. Our objective is to determine the clinical, sociodemographic and treatment characteristics of perianal fistulizing CD in a Colombian multicenter registry. MATERIALS AND METHODS: A retrospective, multicenter observational study was carried out, with prospective data collection, in the main reference centers for inflammatory Bowel disease (IBD) in the country. Continuous variables were expressed as medians and interquartile ranges. The categorical outcome variables were compared by the Chi-square test. RESULTS: Sixty-five patients with perianal fistulizing CD were documented, with a median age of appearance of perianal fistula of 31.0 years (range: 24-42), predominantly in men (61.5%; H:M ratio: 1.4:1). Complex perianal fistulas were more frequent than simple ones (75.35 vs. 24.6%). Regarding medical treatment, 66.2% of the patients received antibiotics, 64.6% steroids, 78.5% biological therapy, 47.7% non-cutting setons, and 46.2% required surgical management, other than seton placement. Only 29.2% achieved complete remission of the fistula, and 9.2% of the patients ended up in a definitive colostomy. CD patients with complex fistulas received more biological therapy, compared to CD patients with simple fistulas (84.8 vs. 56.3%; P: 0.038). CONCLUSIONS: Perianal fistulizing CD has a poor prognosis in our setting, only 3 out of 10 patients achieve complete remission despite treatment. A multidisciplinary management is essential for the comprehensive management of this difficult pathology.
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Doença de Crohn , Fístula Retal , Humanos , Infliximab/uso terapêutico , Doença de Crohn/terapia , Doença de Crohn/tratamento farmacológico , Colômbia , Estudos Retrospectivos , Anticorpos Monoclonais/uso terapêutico , Resultado do Tratamento , Terapia Combinada , Fístula Retal/etiologia , Fístula Retal/terapia , Sistema de RegistrosRESUMO
In diabetes, obtaining optimal control is key to reducing chronic complications. Unfortunately, not all patients achieve the recommended goals. Therefore, the challenges to develop and evaluate comprehensive care models are enormous. In October 2008, the Diabetic Patient Care Program (DiabetIMSS) was designed and implemented in family medicine. Its principal component is the multidisciplinary team (doctor, nurse, psychologist, dietitian, dentist, and social worker) that offers coordinated health care; monthly medical consultation and individual, family and group education on self-care and prevention of complications for 12 months. Due to the COVID-19 pandemic, the percentage of attendance at the DiabetIMSS modules decreased significantly. This is how the Medical Director considered it necessary to strengthen them, and the Diabetes Care Centers (CADIMSS) arose. In addition to providing medical care with a comprehensive and multidisciplinary approach, the CADIMSS encourages the co-responsibility of the patient and his family. It consists of monthly medical consultation and nursing staff provides monthly educational sessions for 6 months. Pending tasks remain and there are still areas of opportunity to modernize and reorganize services that contribute to improving the health of the population with diabetes.
En un paciente con diabetes, la obtención de un control óptimo es clave para reducir las complicaciones crónicas. Desafortunadamente, no todos los pacientes logran las metas recomendadas. Por ello, son substanciales los desafíos para desarrollar y evaluar modelos de atención integral. En octubre del 2008, se diseñó e implementó el Programa de Atención al Paciente Diabético (DiabetIMSS) en medicina familiar. Su componente básico es el equipo multidisciplinario (médico, enfermera, psicólogo, dietista, dentista y trabajador social) que ofrece asistencia sanitaria coordinada, consulta médica mensual y educación individual, familiar y grupal sobre autocuidado y prevención de complicaciones durante 12 meses. Debido a la pandemia de COVID-19, el porcentaje de asistencia a los módulos DiabetIMSS disminuyó importantemente. Es así como la Dirección de Prestaciones Médicas consideró necesario su fortalecimiento, por lo que surgen los Centros de Atención a la Diabetes (CADIMSS). Además de proporcionar atención médico-asistencial con enfoque integral y multidisciplinario, en los CADIMSS se fomenta la corresponsabilidad del paciente y su familia, y se otorga consulta médica mensual y sesiones educativas a cargo de personal de enfermería durante 6 meses. Sin embargo, siguen tareas pendientes, y aún hay áreas de oportunidad para modernizar y reorganizar los servicios que contribuyan a mejorar la salud de la población con diabetes.
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COVID-19 , Diabetes Mellitus Tipo 2 , Humanos , Diabetes Mellitus Tipo 2/terapia , Diabetes Mellitus Tipo 2/complicações , Pandemias , Autocuidado , Medicina de Família e ComunidadeRESUMO
Twenty years after its launch, the most ambitious preventive program implemented at the institutional level in Mexico called PREVENIMSS focuses on new challenges and moves towards relaunching. This paper reviews the foundations and design of PREVENIMSS and its evolution throughout these two decades. The PREVENIMS coverage assessment through national surveys set a relevant precedent in evaluating programs at the Mexican Institute of Social Security. PREVENIMSS has shown progress in preventing vaccine-preventable diseases. However, given the current epidemiological profile, there is still a need to provide more effective primary and secondary prevention of chronic noncommunicable diseases. New digital resources and orientation of PREVENIMSS towards a more comprehensive approach that contemplates secondary prevention and rehabilitation can help to face the growing challenges that the program still faces.
A 20 años de su lanzamiento, el programa preventivo más ambicioso implementado a nivel institucional en México llamado PREVENIMSS se enfoca en nuevos desafíos y avanza hacia el relanzamiento. Este artículo hace un breve recorrido de sus fundamentos, diseño y evolución a lo largo de estas dos décadas. La estimación de las coberturas de PREVENIMSS a través de encuestas nacionales también marcó un precedente en la evaluación de programas en el Instituto Mexicano del Seguro Social. PREVENIMSS ha mostrado avances en prevención de enfermedades prevenibles por vacunación, pero aún existe la necesidad de brindar prevención primaria y secundaria más efectivos de las enfermedades crónicas no transmisibles ante el perfil epidemiológico actual. Nuevos recursos digitales y la orientación hacia un enfoque más integral que contemple la prevención secundaria y la rehabilitación pueden ayudar a enfrentar los crecientes desafíos que aún enfrenta el programa.
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Medicina , Serviços Preventivos de Saúde , Humanos , México , Previdência SocialRESUMO
Wandering spleen is a rare condition, generally due to congenital abnormalities of the dorsal mesogastrium or splenic suspensory ligaments and not traumatic events. The most frequent complication is torsion of the splenic hilus with ischemia or splenic infarction and its association with pancreatic volvulus is extremely rare. There are no reported cases of wandering spleen with pancreatic volvulus in association with a post traumatic Grynfelt-Lesshaft haernia. We present a case of a 43-year-old female patient with an association of these three entities and a history of abdominal trauma.
El bazo errante es una afección rara que en general se debe a anomalías congénitas del mesogastrio dorsal o de los ligamentos suspensores esplénicos, y no a traumatismos. La complicación más frecuente es la torsión del hilio esplénico con isquemia o infarto esplénico, y su asociación a vólvulo pancreático es extremadamente rara. No existen ningún otro caso reportado de bazo errante con vólvulo pancreático en un paciente que presenta una hernia lumbar de Grynfelt-Lesshaft postraumática. Presentamos el caso de una paciente de 43 años con asociación de estas tres afecciones y antecedente de traumatismo abdominal.
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Volvo Intestinal , Infarto do Baço , Baço Flutuante , Adulto , Feminino , Humanos , Esplenectomia , Infarto do Baço/diagnóstico por imagem , Infarto do Baço/etiologia , Anormalidade Torcional , Baço Flutuante/complicações , Baço Flutuante/diagnóstico por imagem , Baço Flutuante/cirurgiaRESUMO
OBJECTIVE: To assess the effect of the adherence to medical treatment on urinary parameters in the 24-h metabolic study of patients with kidney stones. METHODS: A retrospective, longitudinal, descriptive, and observational study was carried out by reviewing the hospital electronic medical record from 2014 to 2018. The adherence to drug treatment was measured 6 months after its initiation, and the numerical values of the metabolic studies were compared. Wilcoxon tests were performed to compare the difference before and after treatment. RESULTS: Ninety patients were evaluated, with 73.3% of adherence. The 180-day overall adherence rate was 61.2% in patients treated with a single drug and 85.4% in patients treated with multiple drugs. There is a statistically significant increase in citrate levels in patients with good adherence in comparison with non-adherent patients (p=0.031 vs. p=0.528). CONCLUSIONS: Medical treatment and dietary measures in patients with kidney stones have an initial impact at 6 months on the values of the main urinary metabolic alterations that predispose to calculi formation; the most significant is seen in those patients with adherence to medical treatment for hypocitraturia.
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Resumen El quiste mesentérico es una patología intraabdominal poco frecuente, en su mayoría benigna. El tratamiento casi siempre es quirúrgico y consiste en la resección del quiste y de los órganos involucrados siempre que sea posible con el fin de reducir la tasa de recurrencia. Se presenta el caso de un paciente de 38 años con dolor abdominal inespecífico y diagnóstico ecográfico de masa retroperitoneal zona II izquierda gigante. Los estudios de extensión incluyeron tomografía axial computarizada, resonancia magnética y endoscopia de vías digestivas altas, cuyos hallazgos informaron una lesión quística gigante. Se realizó resección quirúrgica de la lesión por vía abierta, con diagnóstico histopatológico de quiste mesentérico.
Abstract A mesenteric cyst is a rare, mostly benign, intra-abdominal tumor. Treatment is almost always surgical and consists of removing the cyst and involved organs whenever possible to prevent recurrence. The following is the case of a 38-year-old patient with nonspecific abdominal pain and an ultrasound diagnosis of a giant retroperitoneal mass in the left medial paracolic gutter. The following imaging studies were performed: computed tomography, magnetic resonance, and endoscopy, finding a giant cystic lesion. An exploratory laparotomy was performed to remove the mass, and a histopathology report confirmed the diagnosis of mesenteric cyst.
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Humanos , Masculino , Adulto , Dor Abdominal , Cisto Mesentérico , Pacientes , Espectroscopia de Ressonância Magnética , Tomografia , Endoscopia , Relatório de PesquisaRESUMO
In this work, micro-XRF was considered as a possible technique for monitoring the rate of incorporation of Cu and Zn into aquatic plants of a laboratory-scale phytofiltration system. This system employed Salvinia biloba Raddi under controlled conditions of light and nutrients. This aquatic plant is being considered as an efficient hyperaccumulator of Cu and Zn and is widely spread in South American lakes and rivers. One set of plants was exposed to 40 ppm w/w of Cu and another to 40 ppm w/w of Zn. The analytical procedure was based on the periodic in vivo quantitative analysis of Cu and Zn at selected points in the plants using micro-XRF. The accuracy of this quantification was effectively improved with the assistance of the Monte Carlo XMI-MSIM simulation code. In order to establish the input parameters of this software, careful measurements of the experimental parameters necessary for the correct modeling of the micro-XRF spectrometer were performed. After that, specially manufactured standards made of tissue equivalent material were employed to validate the configuration of the simulation code and input parameters. It was fulfilled by the comparison of measured and simulated micro-XRF spectra of these standards. Once the configuration code and input parameters were verified, two strategies were considered for the application of Monte Carlo simulation for elemental quantification in plants: an iterative process and inverse method established with external virtual standards. Benefits and drawbacks of both approaches to improve the monitoring of phytofiltration systems were carefully discussed.
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Metais , Traqueófitas , Simulação por Computador , Método de Monte Carlo , SoftwareRESUMO
The therapeutic potential of IgM-enriched immunoglobulin preparations (IgGAM) in sepsis remains a field of debate. The use of polyclonal immunoglobulins as adjuvant therapy (Esen & Tugrul, 2009; Kaukonen et al., 2014; Molnár et al., 2013; Taccone et al., 2009) has been shown to improve clinical outcomes in terms of mortality. This study analyze the impact of IgM-enriched IgG (IgGM) as additional immunomodulation. Patients and methods: This is a retrospective registry of 1196 patients with severe sepsis and septic shock from nine Intensive Care Units in Colombia, from routine clinical practice; 220 patients treated with IgGAM were registered. Fully matched comparators for severity and type of infection selected among patients non-treated with IgGAM. Mortality after 28 days was 30.5% among IgGAM-treated patients and 40.5% among matched comparators. Results: Multivariate Cox regression analysis showed IgGAM treatment to be the only variable protective from death after 28 days (hazard ratio 0.62; 0.45-0.86; p: 0.004). Results reinforce the importance of IgGAM treatment for favorable outcome after septic shock and are in line with recent published meta-analyses. This study showed that treatment with IgGM in patients with sepsis was an independent modulator of the 28-day associated with a lower mortality.
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Sepse , Choque Séptico , Humanos , Imunoglobulina M , Unidades de Terapia Intensiva , Estudos Retrospectivos , Sepse/tratamento farmacológicoRESUMO
Resumen El bazo errante es una entidad clínica muy poco frecuente en niños, representando menos del 0.25% de todas las esplenectomías. Puede ocurrir por la ausencia congénita de ligamentos suspensorios del bazo, o debido a una laxitud adquirida de los mismos. El espectro clínico va desde condición asintomática con hallazgo incidental, hasta presentación de abdomen agudo. El conocimiento de esta condición y de sus hallazgos radiológicos, juegan un papel esencial para lograr un diagnóstico correcto y tratamiento quirúrgico oportuno. La preservación del bazo más esplenopexia es el procedimiento de elección. Se presenta un paciente de 4 años con antecedente de cirugía antirreflujo, en quien se encontró bazo ectópico errante con torsión esplénica, que fue manejado exitosamente con conservación del bazo y esplenopexia. MÉD.UIS.2021;34(1): 113-18
Abstract Wandering spleen is an uncommon clinical entity in children, representing less than 0,25% of all splenectomies. It is caused by laxity or absence of the supporting splenic ligaments. Its clinical spectrum varies from asymptomatic disease with incidental finding to acute abdominal pain due to torsion. The knowledge of this condition and its radiological findings plays a crucial role in reaching the correct diagnosis and timely surgical treatment. Spleen preservation with splenopexy is recognized as the procedure of choice. We report a case of a four year old patient with a history of anti-reflux surgery, with a wandering spleen and splenic torsion, successfully managed with spleen conservation and splenopexy. MÉD.UIS.2021;34(1): 113-18
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Humanos , Masculino , Pré-Escolar , Baço FlutuanteRESUMO
Energy Dispersive Inelastic X-ray Scattering (EDIXS) is a reliable technique for the discrimination and characterization of local chemical environments. By means of this methodology, the speciation of samples has been attained in a variety of samples and experimental conditions, such as total reflection, grazing incidence, and confocal setups. Until now, due to the requirement of a monochromatic and intense exciting beam, this tool had been applied using exclusively synchrotron radiation sources. We present, for the first time, results of test measurements using EDIXS for chemical characterization implemented in a conventional x-ray tube based laboratory. The results show good discrimination between different iron compounds under study, suggesting the real possibility of rutinary chemical state characterizations of samples by means of EDIXS using a conventional x-ray tube.
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In this work the scintillation energy spectra originating from the background radioactivity from polished monolithic lutetium yttrium oxyorthosilicate coupled to position-sensitive silicon photomultipliers (SiPM) was studied using the open source Monte Carlo simulation package ANTS2. Two crystal sizes, fully and partially covering the photosensor area, three surface crystal wrappings (black, specular or diffuse) and the full signal formation process in the photosensor were considered. The simulation results were validated with experimental data acquired under the same geometric and detector operating conditions. In all cases ANTS2 simulated spectra have very good agreement with experimental results, reproducing the expected shape, with correct onset and end at 88 and 1190 keV, respectively, as well as sharp edges at the reference energies of 88, 88 + 202, 88 + 307 and 88 + 202 + 307 keV. The normalized root-mean square error between simulated and measured spectra varied between 4.3% and 10.4%.
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Fótons , Tomografia por Emissão de Pósitrons , Simulação por Computador , Método de Monte CarloRESUMO
PURPOSE: Most detectors in current positron emission tomography (PET) scanners and prototypes use lutetium oxyorthosilicate (LSO) or lutetium yttrium oxyorthosilicate (LYSO) scintillators. The aim of this work is to provide a complete set of background energy spectra, due to the scintillator intrinsic radioactivity, for a wide range of crystal sizes. METHODS: An analytical model, developed and validated in a previous work, was used to obtain the background energy spectra of square base cuboids of different dimensions. The model uses the photon absorption probabilities of the three gamma rays (88, 202, and 307 keV) emitted following the beta decay of 176 Lu to 176 Hf excited states. These probabilities were obtained for each crystal size considered in this work from Monte Carlo simulations using the PENELOPE code. The probabilities are then used to normalize and shift the beta spectrum to the corresponding energy value of the simultaneous detection of one, two, or three gamma rays in the scintillator. The simulated cuboids had side lengths of 5, 10, 20, 30, 40, 50, and 60 mm and crystal thickness T = 2.5, 5, 10, 15, and 20 mm. From these results a complete set of energy spectra, including intermediate dimensions, were obtained. In addition, LYSO and LSO were compared in terms of their analytical background energy spectra for two crystal sizes. The analytical spectra were convolved using a variable Gaussian kernel to account for the energy resolution of a typical detector. A parameterization of the photon absorption probabilities for each gamma ray energy as a function of the cuboid volume to surface area ratio was obtained. RESULTS: A data set of L(Y)SO background energy spectra was obtained and is available for the reader as 2D histograms. The model accurately predicts the structure of the energy spectra including the relative peak and valley intensities. The data allow visualizing how the structure evolves with increasing crystal length and thickness. Lutetium yttrium oxyorthosilicate and LSO present very similar background energy spectra for the range of sizes studied in this work and therefore the data generated can be confidently used for both scintillator materials. The filtered spectra showed a variable shift in the main peaks, depending on crystal size, alerting that to achieve a correct detector calibration using the background spectrum is not straight forward and requires precise data analysis and measurements. In addition, we found that square base L(Y)SO cuboids with same volume to surface area ratio have background spectra with the same structure. CONCLUSIONS: We present the energy spectra of L(Y)SO crystal of different sizes which will be very useful for industry and research groups developing and simulating detectors for positron imaging applications in terms of calibration, quality assurance, crystal maps, detector fine gain tuning, background reduction and other applications using the long-lived 176 Lu source. We analyzed the data produced in this work and found that crystal cuboids with equal volume to surface area ratio produce the same background energy spectra, a conclusion that simplifies its calculation and clarifies why the same energy spectrum is observed under different experimental setups.
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Lutécio , Ítrio , Tomografia por Emissão de Pósitrons , Silicatos , Tomografia Computadorizada por Raios XRESUMO
Recombinant hybrid antibodies are commonly used in antigen-targeting assays to reduce the immunogenic potential associated with using classic mouse antibodies in other species. The DEC205 receptor has become an attractive target due to its effectiveness in activating the immune response and is considered a promising vaccination target. The aim of this study was to produce a fully chimeric mouse x pig anti-porcine DEC205 recombinant antibody (rAb). Based on a mouse anti-porcine DEC205 monoclonal antibody (mAb), we designed and expressed a chimeric mouse x pig rAb using the Expi293f system. The resulting rAb maintained the recognition capacity of the native mouse mAb toward the porcine DEC205 receptor, as evidenced by western blot analysis. By using flow cytometry, we evaluated the ability of the rAb to recognize DEC205+ dendritic cells. In conclusion, the chimeric mouse x pig anti-DEC205 rAb can be used in antigen-targeting assays as a vaccination strategy in pigs.
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Anticorpos Monoclonais/biossíntese , Antígenos CD/imunologia , Lectinas Tipo C/imunologia , Antígenos de Histocompatibilidade Menor/imunologia , Receptores de Superfície Celular/imunologia , Animais , Anticorpos Monoclonais/imunologia , Camundongos , Proteínas Recombinantes/biossíntese , Proteínas Recombinantes/imunologia , SuínosRESUMO
Resumen Se presenta un caso de áscaris de la vía biliar (AB), cuya manifestación clínica fue ictericia obstructiva, acompañada de dolor abdominal causado por un cuadro de pancreatitis aguda. Inicialmente, se sospechó de etiología litiásica, por lo cual se realizaron estudios de imágenes diagnósticas y se evidenció la presencia de AB como hallazgo incidental, diagnosticado por ultrasonografía endoscópica biliopancreática (UEB), que fue confirmado y tratado mediante colangiopancreatografía retrógrada endoscópica (CPRE).
Abstract The following is a case of biliary ascariasis (BA), whose clinical presentation was obstructive jaundice, accompanied by abdominal pain due to acute pancreatitis. At first, clinical suspicion led to consider a stone etiology, for which diagnostic imaging studies were performed, evidencing BA as an incidental finding diagnosed by endoscopic biliopancreatic ultrasonography (EBU), which was confirmed and treated using endoscopic retrograde cholangiopancreatography (ERCP).