RESUMO
La infección en las vías urinarias constituye una causa importante de morbilidad en el adulto y son particularmente frecuentes en el sexo femenino, donde las mujeres son más propensas a contraer una IU lo que facilita que los gérmenes del exterior lleguen hasta el sistema urinario por ejemplo las bacterias gram negativas y la Escherichia Coli tiene una elevada tendencia a recidivar y volverse resistente al uso de antimicrobianos, las IU constituye una de las 10 enfermedades más comunes en privados de libertad en Bolivia, debido a que no tienen una buena infraestructura, los servicios sanitarios no abastecen a los internos ya que no cuentan con una buena información y educación sobre IU ignorando los riesgos, complicaciones que puede causar. Este estudio tuvo como objetivo determinar la prevalencia, los factores más frecuentes de IU en internas del penal San Roque. Se realizó el 10 de julio de 2019 un estudio observacional transversal en el que participaron todas las internas del penal de 22 a 72 años (n= 43). Para la determinación de infecciones urinarias, se entregó frascos recolectores para orina con previa indicación para la correcta recolección de la muestra. Posteriormente se realizó un examen general de orina (EGO) (examen físico, químico, microscópico) y tinción de Gram, como procedimiento final se hizo el cultivo para determinar el germen causante. En este estudio se trabajó con 43 mujeres, con el 100 % de la población de los cuales se obtuvo 11.62% dio positivo a IU, el 88.38% resulto negativo
Infection in the urinary tract is an important cause of morbidity in the adult and they are particularly frequent in the female sex, where women are more likely to get an UI, which makes it easier for germs from outside to reach the urinary system such as Gram-negative bacteria and Escherichia Coli have a high tendency to recur and become resistant to the use of antimicrobials, UTIs is one of the 10 most common diseases deprived of liberty in Bolivia, because they do not have a good infrastructure, health services they do not supply the inmates since they do not have good information and education about UI ignoring the risks, complications that can cause. This study aimed to determine the prevalence, the most frequent factors of UI in San Roque prison inmates. A cross-sectional observational study was carried out on July 10, 2019, in which all inmates of the prison from 22 to 72 years old participated (n = 43). For the determination of urinary infections, urine collection bottles were delivered with prior indication for the correct collection of the sample. Subsequently, a general urine test (EGO) (physical, chemical, microscopic examination) and Gram stain was performed, as a final procedure the culture was done to determine the causative germ. In this study we worked with 43 women, with 100% of the population of which 11.62% were obtained, IU tested positive, 88.38% were negative.
Assuntos
Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Bactérias , Infecções Urinárias , Ego , Bactérias Gram-Negativas , Serviços de Saúde , Urina , Mulheres , Escherichia coli , Coleta de UrinaRESUMO
Temporomandibular disorder (TMD) is a musculoskeletal condition characterized by pain and reduced function in the temporomandibular joint and/or associated masticatory musculature. Prevalence in the United States is 5% and twice as high among women as men. We conducted a discovery genome-wide association study (GWAS) of TMD in 10,153 participants (769 cases, 9,384 controls) of the US Hispanic Community Health Study/Study of Latinos (HCHS/SOL). The most promising single-nucleotide polymorphisms (SNPs) were tested in meta-analysis of 4 independent cohorts. One replication cohort was from the United States, and the others were from Germany, Finland, and Brazil, totaling 1,911 TMD cases and 6,903 controls. A locus near the sarcoglycan alpha ( SGCA), rs4794106, was suggestive in the discovery analysis ( P = 2.6 × 106) and replicated (i.e., 1-tailed P = 0.016) in the Brazilian cohort. In the discovery cohort, sex-stratified analysis identified 2 additional genome-wide significant loci in females. One lying upstream of the relaxin/insulin-like family peptide receptor 2 ( RXP2) (chromosome 13, rs60249166, odds ratio [OR] = 0.65, P = 3.6 × 10-8) was replicated among females in the meta-analysis (1-tailed P = 0.052). The other (chromosome 17, rs1531554, OR = 0.68, P = 2.9 × 10-8) was replicated among females (1-tailed P = 0.002), as well as replicated in meta-analysis of both sexes (1-tailed P = 0.021). A novel locus at genome-wide level of significance (rs73460075, OR = 0.56, P = 3.8 × 10-8) in the intron of the dystrophin gene DMD (X chromosome), and a suggestive locus on chromosome 7 (rs73271865, P = 2.9 × 10-7) upstream of the Sp4 Transcription Factor ( SP4) gene were identified in the discovery cohort, but neither of these was replicated. The SGCA gene encodes SGCA, which is involved in the cellular structure of muscle fibers and, along with DMD, forms part of the dystrophin-glycoprotein complex. Functional annotation suggested that several of these variants reside in loci that regulate processes relevant to TMD pathobiologic processes.
Assuntos
Estudo de Associação Genômica Ampla , Polimorfismo de Nucleotídeo Único , Transtornos da Articulação Temporomandibular/genética , Brasil/epidemiologia , Estudos de Casos e Controles , Distrofina , Feminino , Finlândia/epidemiologia , Loci Gênicos , Predisposição Genética para Doença , Genótipo , Alemanha/epidemiologia , Hispânico ou Latino , Humanos , Masculino , Fenótipo , Prevalência , Receptores Acoplados a Proteínas G , Sarcoglicanas , Fator de Transcrição Sp4 , Inquéritos e Questionários , Transtornos da Articulação Temporomandibular/epidemiologia , Transtornos da Articulação Temporomandibular/etnologia , Estados Unidos/epidemiologiaRESUMO
AIM: The aim of this study was to investigate changes in interocclusal distance (IOD) during pronunciation of /m/ and /s/ sounds in Brazilian Portuguese, in patients presenting dental wear due to bruxism, before and after placement of a stabilization appliance and restorative treatment. METHODS: Subjects were divided into a control group of 19 patients with no dental wear and an experimental group of 18 patients presenting dental wear on anterior teeth due to bruxism. A stabilization appliance was placed in each patient in the experimental group and anterior teeth were restored. A magnetic jaw-tracking device measured the interocclusal distance during pronunciation of /m/ and /s/ phonemes. Interocclusal distance for the experimental group was evaluated one week before and again immediately before the appliance was inserted and 24 hours, 7 days, 1 month and 2 months after appliance insertion. The same evaluation was performed 7 days and 1 month after restorative treatment. In the control group, the measurements were carried out at the same intervals. RESULTS: Comparison between groups revealed a significant difference (P<0.05) in interocclusal distance for the /m/ sound at all evaluation intervals. No differences were found before and after appliance insertion and restorative treatment with either phoneme. CONCLUSION: Stabilization appliance therapy and restorative treatment of subjects with dental wear did not change the interocclusal distance during speech of /m/ and /s/ sounds in the Brazilian Portuguese language, however, when compared with normal subjects, the IOD values were higher for the dental wear group during pronunciation of the /m/ sound.
Assuntos
Oclusão Dentária , Desgaste de Restauração Dentária , Restauração Dentária Temporária , Fala/fisiologia , Abrasão Dentária/fisiopatologia , Resinas Acrílicas , Adulto , Brasil , Bruxismo/complicações , Bruxismo/reabilitação , Feminino , Seguimentos , Humanos , Idioma , Masculino , Maxila , Pessoa de Meia-Idade , Fonética , Testes de Articulação da Fala , Abrasão Dentária/etiologiaRESUMO
We report a case of human monensin intoxication; to our knowledge, this is the first reported case in the medical literature. The patient took a dose of monensin three times higher than a dose considered lethal for cattle and developed a clinical picture similar to that reported in veterinary medicine. There was an early and extremely severe rhabdomyolysis followed by acute renal failure, heart failure, and death. The main changes observed at autopsy were extensive skeletal muscle necrosis, complement deposition at the myocardial level, pulmonary edema, and acute tubular damage.
Assuntos
Injúria Renal Aguda/induzido quimicamente , Ionóforos/efeitos adversos , Monensin/efeitos adversos , Rabdomiólise/induzido quimicamente , Injúria Renal Aguda/patologia , Adolescente , Complemento C9/análise , Evolução Fatal , Humanos , Imuno-Histoquímica , Rim/química , Rim/efeitos dos fármacos , Rim/patologia , Masculino , Músculo Esquelético/efeitos dos fármacos , Músculo Esquelético/patologia , Miocárdio/química , Miocárdio/patologia , Mioglobina/análise , Rabdomiólise/patologiaRESUMO
We assessed the contributions of particulate matter with aerodynamic diameters < or =10 and < or =2.5 microm (PM2.5 and PM10) and ozone (O3) to peak expiratory flow (PEF) and respiratory symptoms in 40 schoolchildren 8-11 years of age for 59 days during three periods in 1991 at a school in southwest Mexico City. We measured peak expiratory flow in the morning on the children's arrival at school and in the afternoon before their departure from school. Separately for morning and afternoon, we normalized each child's daily measurement of peak flow by subtracting his or her mean peak flow from the daily measurement. Child-specific deviations were averaged to obtain a morning and afternoon mean deviation (APEF) for each day. Mean 24-hour O3 level was 52 parts per billion (ppb; maximum 103 ppb); mean 24-hour PM2.5 and PM10 were 30 microg/m3 (maximum 69 microg/m3) and 49 microg/m3 (maximum 87 microg/m3), respectively. We adjusted moving average and polynomial distributed lag multiple regression analyses of APEF vs pollution for minimum daily temperature, trend, and season. We examined effects of PM2.5, PM10, and O3, on deltaPEF separately and in joint models. The models indicated a role for both particles and O3 in the reduction of peak expiratory flow, with shorter lags between exposure and reduction in peak expiratory flow for O3 than for particle exposure (0-4 vs 4-7 days). The joint effect of 7 days of exposure to the interquartile range of PM2.5 (17 microg/m3) and O3 (25 ppb) predicted a 7.1% (95% confidence interval = 11.0-3.9) reduction in morning peak expiratory flow. Pollutant exposure also predicted higher rates of phlegm; colinearity between pollutants limited the potential to distinguish the relative contribution of individual pollutants. In an area with chronically high ambient O3 levels, school children responded with reduced lung function to both O3 and particulate exposures within the previous 1 to 2 weeks.
Assuntos
Poluição do Ar/efeitos adversos , Ozônio , Pico do Fluxo Expiratório , Doenças Respiratórias/etiologia , Criança , Humanos , México/epidemiologia , Modelos Estatísticos , Análise de Regressão , Testes de Função Respiratória , Smog , Tempo (Meteorologia)RESUMO
OBJECTIVES: Determine which factors were associated with mortality in our patients, specifically whether ventilatory parameters and arterial blood gas could be used to predict outcome. The role of delaying surgery and the presence of contra lateral pneumothorax were also assessed. BACKGROUND: Mortality among babies born with congenital diaphragmatic hernia remains high. The associated pulmonary hypoplasia and hypertension account for most of the overall mortality. There is no uniform consensus as to which parameters predict outcome. METHOD: Study population consisted of thirty-two patients with CDH managed during a ten-year period. Retrospective data obtained included: perinatal data, postnatal complications, ventilatory parameter data, arterial blood gas, type and age of surgery. Ventilatory index, oxygenation index and arterial to alveolar oxygen difference (A-aDO2) within the first 24 hours of life and after surgical correction were compared among the 23 patients who underwent surgical correction. Timing of surgery and frequency of pneumothorax were compared between survivors and non-survivors. Epi-Info Software Package was used for statistic analysis. RESULTS: Overall survival was 40%. Survival of surgically corrected infants was 61%. Non-survivors had significantly higher A-aDO2 than survivors (p < 0.05). No significant differences in pCO2, ventilatory index, or oxygenation index were identified between survivors and non survivors. Surgical repair performed after the first twenty-four hours of life, was associated with a higher survival rate (p < 0.05). Fourteen patients (39%) developed contralateral pneumothorax, eleven (79%) of these died. CONCLUSIONS: (1) contralateral pneumothorax was associated with higher mortality, 2) A-aDO2 was a better prognostic indicator than pCO2, ventilatory index, or oxygenation index, 3) delaying surgical repair was associated with better survival rate.
Assuntos
Hérnia Diafragmática/mortalidade , Hérnias Diafragmáticas Congênitas , Fatores Etários , Índice de Apgar , Peso ao Nascer , Interpretação Estatística de Dados , Feminino , Idade Gestacional , Hérnia Diafragmática/cirurgia , Hispânico ou Latino , Humanos , Hipertensão/complicações , Recém-Nascido , Pulmão/anormalidades , Masculino , Pneumotórax/complicações , Prognóstico , Porto Rico/etnologia , Testes de Função Respiratória , Estudos Retrospectivos , Taxa de SobrevidaRESUMO
To evaluate methods of reducing exposure of school children in southwest Mexico City to ambient ozone, outdoor ozone levels were compared to indoor levels under three distinct classroom conditions: windows/doors open, air cleaner off; windows/doors closed, air cleaner off; windows/doors closed, air cleaner on. Repeated two-minute average measurements of ozone were made within five minutes of each other inside and outside of six different school classrooms while children were in the room. Outdoor ozone two-minute average levels varied between 64 and 361 ppb; mean outdoor levels were above 160 ppb for each of the three conditions. Adjusting for outdoor relative humidity, for a mean outdoor ozone concentration of 170 ppb, the mean predicted indoor ozone concentrations were 125.3 (+/- 5.7) ppb with windows/doors open; 35.4 (+/- 4.6) ppb with windows/doors closed, air cleaner on. The mean predicted ratios of indoor to outdoor ozone concentrations were 0.71 (+/- 0.03) with windows/doors open; 0.18 (+/- 0.02) ppb with windows/doors closed, air cleaner off; and 0.15 (+/- 0.02) ppb with windows/doors closed, air cleaner on. As outdoor ozone concentrations increased, indoor ozone concentrations increased more rapidly with windows and doors open than with windows and doors closed. Ozone exposure in Mexican schools may be significantly reduced, and can usually be kept below the World Health Organization (WHO) guideline of 80 ppb, by closing windows and doors even when ambient ozone levels reach 300 ppb or more.
Assuntos
Poluição do Ar/análise , Exposição Ambiental , Oxidantes Fotoquímicos/análise , Ozônio/análise , Poluição do Ar em Ambientes Fechados/análise , Criança , Humanos , México , Oxidantes Fotoquímicos/efeitos adversos , Ozônio/efeitos adversosRESUMO
The acute effects of ozone (O3) on the change in lung function before and after exercise was assessed in 22 boys and 18 girls from 7 1/2 to 11 yr of age tested up to eight times over a 1 1/2-yr period outdoors (under a tarpaulin) at a school in Mexico City. Ozone and particulates were monitored at an adjacent government station, in the school yard, and under the tarp. Subjects were selected to oversample children with chronic respiratory symptoms, although children with active asthma under regular medication or FEV1 < 80% predicted were excluded. Of the participants, 21 had chronic cough, chronic phlegm, or ever wheeze with colds or apart from colds. Children performed two cycles of treadmill exercise (15 min) and rest (15 min) for a total of 1 h of intermittent exercise. Most subjects attained the target minute ventilation of 35 L/min/m2. Subjects exercised alternately during low ozone hours (8:00-10:00 A.M.) and during peak O3 hours (12:00-2:00 P.M.), to assure a range of exposures. On 85% of exercise days, the maximum daily 1-h average for ambient O3 exceeded the Mexican guideline of 110 parts per billion (ppb). O3 exposure during the hour of exercise was divided into quintiles, and the response was adjusted for repeated measures, subject having a cold, and prior outdoor exercise. Ambient O3 in the fifth quintile (mean = 229 ppb) was associated with a percentage change in FVC (-1.43% +/- 0.70), FEV1 (-2.85% +/- 0.79), FEF25-75% (-6.32 +/- 1.87) and FEV1 (-1.41% +/- 0.46).(ABSTRACT TRUNCATED AT 250 WORDS)
Assuntos
Poluentes Atmosféricos/efeitos adversos , Exercício Físico/fisiologia , Pulmão/efeitos dos fármacos , Ozônio/efeitos adversos , População Urbana , Poluentes Atmosféricos/análise , Criança , Doença Crônica , Resfriado Comum/fisiopatologia , Tosse/fisiopatologia , Teste de Esforço/métodos , Teste de Esforço/estatística & dados numéricos , Feminino , Volume Expiratório Forçado/efeitos dos fármacos , Humanos , Modelos Logísticos , Pulmão/fisiologia , Masculino , México , Ozônio/análise , Sons Respiratórios/fisiopatologia , Capacidade Vital/efeitos dos fármacosRESUMO
The syndrome known as migraine with cerebrospinal fluid (CSF) pleocytosis is a clinical syndrome of controversial pathogenesis characterized by typical migraine headaches occurring in a fixed period of time along with lymphocyte pleocytosis in CSF which persists during intercritical periods. We present four new cases of this syndrome diagnosed in our service and we review those cases published in the literature in which there were no personal headache antecedents, attempting in this way to separate this syndrome from other types of migraine as included in the present classification. There also exists the possibility that it might be a question of a secondary process, the pathogenesis of which may play a part in the activation of the humoral immune system, given the frequent existence of immunogenic antecedents the previous days as well as that of a humoral reaction expressed as an increase in IgG levels in CSF with normal blood electrophoresis.
Assuntos
Linfócitos , Meningoencefalite/líquido cefalorraquidiano , Transtornos de Enxaqueca/líquido cefalorraquidiano , Humanos , Imunoglobulina G/líquido cefalorraquidiano , MasculinoRESUMO
We present the association of a distrophinopathy with a case of facioscupulohumeral dystrophy in two individuals belonging to the same family. The discrepancy in the seric creatinphosphokinase (CPK) of the two patients together with certain clinical data suggests the possibility that it is a question of two different processes. This impression was confirmed later through dystrophine analysis and genetic examination techniques. This case drew attention to the vital need today to insist on a combination of genetic examinations and dystrophine analysis when diagnosing muscular dystrophies, thus avoiding mistakes derived from diagnostic assumptions made on the basis of antecedents in the family involving neuromuscular disorders and the consequences that this might have regarding vital prognosis and advice to the family. This is the first case of coincidental association of these two processes within one family that has so far come to our knowledge.
Assuntos
Distrofina/análise , Face/fisiopatologia , Úmero/fisiopatologia , Músculos/química , Músculos/fisiopatologia , Distrofias Musculares/genética , Distrofias Musculares/fisiopatologia , Escápula/fisiopatologia , Anticorpos Monoclonais , Criança , Aberrações Cromossômicas , Transtornos Cromossômicos , Creatina Quinase/sangue , Distrofina/sangue , Humanos , Masculino , Distrofias Musculares/sangue , Cromossomo XRESUMO
La ascaris es una enfermedad parasitaria por Ascaris Lumbricoides. Se caracteriza por ser un gusano redondo, grande, nematodo intestinal blanquecino; la hembra es de mayor dimensión que el macho; particularmente abunda en los trópicos y lugares con malas condiciones de salubridad. Uno de cada 4 habitantes en el mundo está infectado por áscaris. Este reporte describe a una paciente de 25 años y otra de 58 años, que presentaron similar evolución clínica. Es importante saber diagnosticar, puesto que la clínica depende del número de vermes y su localización; en la infestación leve es posible el curso asintomático o solo ligeros síntomas abdominales. Las cargas mayores inclusive ocasionan obstrucción intestinal, puede migrar y llegar al exterior por la boca o la nariz, otras veces obstruye el conducto biliar (25xciento), páncreas o apéndice (5). Se diagnostica mediante la identificación de huevos de áscaris en las heces, eosinofilia, colangiografía intravenosa, ecosonografía, observándose claramente áscaris en vías biliares...
Assuntos
Humanos , Ascaríase , PacientesRESUMO
At present, evidence has been accumulating that point out that some central nervous structures, of oblongata to the limbic system, are primarily involved in the control of systemic arterial pressure (AP). In agreement with several experimental and clinical works, a hypothesis has been suggested that a functional defect of the central dopaminergic system could be involved in the etiopathogenesis of essential hypertension (EH). With the objective of analyzing this hypothesis, the effect of dopamine (DA) agonist, amantadine (Am) on heart rate (HR), AP, plasma catecholamines (CA, PCA), urinary DA, noradrenaline (NA), adrenaline (A), vanilmandelic acid (VMA) and homovanillic acid (HVA), was studied in 19 females with established EH. The study included 2 periods: "placebo" and "drug", each one lasting 22 days, with a register of HR and AP in clino and orthostatism, taken every 3-4 days; at the end of each period, CA and their metabolites were measured. During the drug period, oral Am clorhidrate (300 mg/day, t.i.d.) was administered. With the drug, HR was not change with respect to the placebo period; but the AP in both positions, just as PCA, DA, NA and HVA, showed a highly significant decrease; A and VMA displayed a less significant decrease from the statistical point of view. The obtained results and literature data support the hypothesis that in EH there probably exists a genetic disfunction of the inhibitory central dopaminergic receptor of peripheral sympathetic activity, which is susceptible to compensation by use of several dopaminergic agonists, such as Am.
Assuntos
Amantadina/uso terapêutico , Catecolaminas/metabolismo , Hipertensão/tratamento farmacológico , Receptores Dopaminérgicos/efeitos dos fármacos , Pressão Sanguínea/efeitos dos fármacos , Feminino , Humanos , Hipertensão/metabolismo , Postura , Receptores Dopaminérgicos/fisiologiaRESUMO
The usefulness of fluorimetric techniques in the diagnosis of pheochromocytoma was investigated. In the 63 cases studied during 25 years by measuring simultaneously various aminergic parameters, including plasma catecholamines and urinary adrenaline (A), noradrenaline (N) and vanilmandelic acid (VMA), we were able to establish the diagnosis of pheochromocytoma in all cases. Adrenaline excretion was found to be higher in patients with tumors located on the adrenal region, whereas N excretion was predominantly increased in patients with extra-adrenal tumors. In patients having tumors smaller than 50 g, A + N excretion was higher and VMA was lower than in those whose tumors were heavier; therefore in cases with small tumors the ratio VMA/A + N was lower than in those with larger tumors. It is concluded that simultaneous measurements of PC, A, N and VMA allow the diagnosis to be made in the most patients with this tumor. On the other hand, the predominant increase in A excretion is suggestive of adrenal pheochromocytoma.
Assuntos
Neoplasias das Glândulas Suprarrenais/metabolismo , Catecolaminas/análise , Feocromocitoma/metabolismo , Adolescente , Neoplasias das Glândulas Suprarrenais/diagnóstico , Adulto , Catecolaminas/sangue , Catecolaminas/urina , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Feocromocitoma/diagnósticoRESUMO
The response of arterial blood pressure, plasma renin activity (PRA) and plasma (PA) or urinary aldosterone (UA) concentrations to the administration of captopril, was studied in patients with established essential hypertension. Captopril was effective in lowering significantly the blood pressure (189.4/111.2 +/- 23.9/9.7 to 163.4/98.1 +/- 20.7/8.6 mmHg. mean +/- SD, p less than 0.01/0.001). Normal arterial blood pressure values (140.4/86.5 +/- 20.7/10.8 mmHg, were achieved by the addition of hydrochlorothiazide. Captopril administration was followed by a decrease in PA and in UA and an increase in PRA, suggesting the inhibition of angiotensin II formation. Captopril attenuated hypokalemia and hyperaldosteronism produced by the simultaneous administration of hydrochlorothiazide.