RESUMO
Autism spectrum disorder (ASD) is a group of complex multifactorial neurodevelopmental disorders characterized by a wide and variable set of neuropsychiatric symptoms, including deficits in social communication, narrow and restricted interests, and repetitive behavior. The immune hypothesis is considered to be a major factor contributing to autism pathogenesis, as well as a way to explain the differences of the clinical phenotypes and comorbidities influencing disease course and severity. Evidence highlights a link between immune dysfunction and behavioral traits in autism from several types of evidence found in both cerebrospinal fluid and peripheral blood and their utility to identify autistic subgroups with specific immunophenotypes; underlying behavioral symptoms are also shown. This review summarizes current insights into immune dysfunction in ASD, with particular reference to the impact of immunological factors related to the maternal influence of autism development; comorbidities influencing autism disease course and severity; and others factors with particular relevance, including obesity. Finally, we described main elements of similarities between immunopathology overlapping neurodevelopmental and neurodegenerative disorders, taking as examples autism and Parkinson Disease, respectively.
Assuntos
Transtorno do Espectro Autista , Transtorno Autístico , Doenças do Sistema Imunitário , Transtornos do Neurodesenvolvimento , Transtorno do Espectro Autista/etiologia , Transtorno Autístico/complicações , Humanos , Doenças do Sistema Imunitário/complicações , Transtornos do Neurodesenvolvimento/complicaçõesRESUMO
Aedes aegypti, the mosquito that transmits arboviral diseases such as dengue (DENV), chikungunya (CHIKV), and Zika viruses (ZIKV), is present in tropical and subtropical regions of the world. Individuals at risk of mosquito-borne disease (MBD) in the urban tropics face daily challenges linked to their socio-environment conditions, such as poor infrastructure, poverty, crowding, and limited access to adequate healthcare. These daily demands induce chronic stress events and dysregulated immune responses. We sought to investigate the role of socio-ecologic risk factors in distress symptoms and their impact on biological responses to MBD in Machala, Ecuador. Between 2017 and 2019, individuals (≥ 18 years) with suspected arbovirus illness (DENV, ZIKV, and CHIKV) from sentinel clinics were enrolled (index cases, N = 28). Cluster investigations of the index case households and people from four houses within a 200-m radius of index home (associate cases, N = 144) were conducted (total N = 172). Hair samples were collected to measure hair cortisol concentration (HCC) as a stress biomarker. Blood samples were collected to measure serum cytokines concentrations of IL-10, IL-8, TNF-α, and TGF-ß. Univariate analyses were used to determine the association of socio-health metrics related to perceived stress scores (PSS), HCC, and immune responses. We found that housing conditions influence PSS and HCC levels in individuals at risk of MBD. Inflammatory cytokine distribution was associated with the restorative phase of immune responses in individuals with low-moderate HCC. These data suggest that cortisol may dampen pro-inflammatory responses and influence activation of the restorative phase of immune responses to arboviral infections.
Assuntos
Infecções por Arbovirus/epidemiologia , Infecções por Arbovirus/psicologia , Doenças do Sistema Imunitário/complicações , Estresse Psicológico/complicações , Adulto , Animais , Infecções por Arbovirus/imunologia , Biomarcadores/análise , Biomarcadores/sangue , Estudos de Coortes , Citocinas/sangue , Ecossistema , Equador/epidemiologia , Características da Família , Feminino , Cabelo/química , Acessibilidade aos Serviços de Saúde , Habitação/classificação , Habitação/normas , Humanos , Hidrocortisona/análise , Hidrocortisona/metabolismo , Doenças do Sistema Imunitário/epidemiologia , Modelos Logísticos , Masculino , Estudos Retrospectivos , Fatores Sociodemográficos , Estresse Psicológico/imunologiaRESUMO
Introducción: Los criterios de calidad en la cirugía oncológica radical se basan en la extirpación completa del tumor, con márgenes libres, sin enfermedad macroscópica residual, con una linfadenectomía adecuada y mínima manipulación tumoral posible. A pesar de conseguir estos objetivos, puede quedar enfermedad residual no visible o micrometástasis, con potencial de crecimiento y diseminación dependiendo de la capacidad tumoral y de las defensas del huésped. Objetivos: Evaluar la influencia de los factores perioperatorios sobre la inmunidad del paciente oncológico intervenido quirúrgicamente y el efecto potencial de los fármacos anestésicos en la recurrencia, así como otros factores perioperatorios que pueden afectar la diseminación tumoral a largo plazo. Métodos: Se realizó una búsqueda bibliográfica electrónica de los artículos de los últimos 10 años que cumplieran con el objetivo trazado. Desarrollo: Durante el periodo perioperatorio la activación de la respuesta al estrés quirúrgico desencadena una serie de reacciones neuroendocrinas, humorales e inmunitarias complejas. La cirugía, con indudable potencial curativo, se relaciona con un estado de inmunosupresión por activación del eje HPA (hipotálamo- hipofisario- adrenal) y la inflamación. Por otro lado, la anestesia produce cambios biomoleculares que afectan la inmunidad celular y el número de NK (natural killer), que puede influir en la recurrencia del cáncer a largo plazo. Conclusiones: Disminuir el estrés quirúrgico y el psicológico, controlar el dolor quirúrgico, mantener normotermia, y una juiciosa transfusión sanguínea, además una técnica anestésica con disminución del consumo de opiáceos, puede resultar favorecedora para proteger la respuesta inmune antimetastásica del organismo y puede tener un efecto benéfico en la enfermedad oncológica(AU)
Introduction: The quality criteria in radical oncological surgery are based on complete tumor removal, with free margins, without residual macroscopic disease, with adequate lymphadenectomy and minimal possible tumor manipulation. Despite achieving these objectives, non-visible residual disease or micrometastasis may remain, likely to grow and spread depending on tumor capacity and the host's defenses. Objectives: To evaluate the influence of perioperative factors on the immunity of cancer patients operated on and the potential effect of anesthetic drugs on recurrence, as well as other perioperative factors that may affect long-term tumor spread. Methods: An electronic bibliographic search was carried out of the articles published in the last ten years and that fulfilled the established objective. Development: During the perioperative period, activation of the response to surgical stress triggers a series of complex neuroendocrine, humoral and immune reactions. Surgery, with unquestionable curative potential, is related to a state of immunosuppression due to activation of the hypothalamic-pituitary-adrenal axis and inflammation. On the other hand, anesthesia produces biomolecular changes that affect cellular immunity and the number of natural killers, which can influence cancer recurrence in the long term. Conclusions: To reduce surgical and psychological stress, to control surgical pain, to maintain normothermia, and a judicious blood transfusion, in addition to an anesthetic technique with reduced opiates usage, can be beneficial to protect the body's antimetastatic immune response and can have a beneficial effect on oncological disease(AU)
Assuntos
Humanos , Doenças do Sistema Imunitário/complicações , Recidiva Local de Neoplasia/complicações , Estudos Retrospectivos , Período Perioperatório/métodos , Micrometástase de Neoplasia/prevenção & controle , Anestésicos/efeitos adversosRESUMO
Introducción: en el síndrome de solapamiento o superposición existen simultáneamente manifestaciones clínicas o serológicas de dos o más enfermedades autoinmunes sistémicas. Afectan al 5 por ciento de la población con predominio en mujeres. Presentación del Caso: hombre de 48 años, sin antecedentes patológicos personales. Acude con dolor en ambas manos, inflamación en las articulaciones metacarpo e interfalángicas proximales, bilateral y simétrica, acompañada de rigidez matinal que duraba casi todo el día desde hace 4 meses. Se le diagnostica artritis reumatoidea y se inicia tratamiento que abandonó. Luego aparece un cuadro que es interpretado como un solapamiento por lo que es ingresado con un cuadro clínico florido. En los exámenes de laboratorio: las transaminasas, la creatín fosfoquinasa, el lactato deshidrogenasa, se encontraban elevadas. Por la clínica y los complementarios se diagnosticó Síndrome de Solapamiento de polimiosistis-esclerodermia. Se comenzó tratamiento con inmunosupesores. El paciente evolucionó desfavorablemente y falleció. Discusión: el diagnóstico de este caso se realizó por las manifestaciones clínicas como fascie esclerodérmica, signo de sal y pimienta, fibrosis de predominio distal en ambas manos, telangiectasias peribucales. Los diagnósticos diferenciales son las enfermedades autoinmunes sistémicas cuando se presentan como cuadros únicos. El tratamiento de primera línea y el pronóstico dependen de las enfermedades que se solapen(AU)
Introduction: In the syndrome of overlap or overlap there are simultaneously clinical or serological manifestations of two or more systemic autoimmune diseases. They affect 5 percent of the population with predominance in women. Case Presentation: A 48-year-old man with no personal pathological history. He came with pain in both hands, inflammation in the metacarpal and interphalangeal proximal joints, bilateral and symmetrical, accompanied by morning stiffness that lasted almost all day for 4 months. He was diagnosed with rheumatoid arthritis and started treatment that he abandoned. Then a picture appears that is interpreted as an overlap so it is entered with a florid clinical picture. In laboratory tests: transaminases, creatine phosphokinase, lactate dehydrogenase, were elevated. Clinical and complementary diagnosis of Polymyosis-Sclerosis Overlap Syndrome was diagnosed. Treatment with immunosupers was started. The patient evolved unfavorably and died. Discussion: The diagnosis of this case was made by clinical manifestations such as sclerodermic fascia, salt and pepper sign, predominantly distal fibrosis in both hands, perioral telangiectasias. Differential diagnoses are systemic autoimmune diseases when presented as single frames. First-line treatment and prognosis depend on overlapping diseases(AU)
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Artrite Reumatoide , Escleroderma Sistêmico/complicações , Telangiectasia , Polimiosite/complicações , Doenças do Sistema Imunitário/complicaçõesRESUMO
BACKGROUND: Celiac disease is described in association with several autoimmune diseases, but rarely with myasthenia gravis. CASE REPORT: We describe the case of a 31-year-old white woman with celiac disease who presented manifestations related to a hyperactive immune system, including macroamylasemia, false-positive anti-HCV, positive antinuclear antibody, and Raynaud's phenomenon. The introduction of a gluten-free diet (GFD) resolved these features, but myasthenia gravis (MG) symptoms unexpectedly occurred on that occasion. DISCUSSION: The role of a GFD in the course of autoimmune diseases has been studied and improvement has been reported in many diseases. However, there is no consensus in the literature regarding the course of neurological disorders associated with celiac disease. In the present case, a GFD did not prevent the appearance of symptoms related to myasthenia gravis. There are few reports on the association of celiac disease with myasthenia gravis and therefore little is known about the course and time of onset of myasthenia in celiac patients. The present case increases the knowledge about this unusual autoimmune neurological disease associated with celiac disease.
Assuntos
Doença Celíaca/complicações , Doenças do Sistema Imunitário/complicações , Miastenia Gravis/complicações , Adulto , Doença Celíaca/sangue , Doença Celíaca/dietoterapia , Dieta Livre de Glúten , Feminino , Humanos , Miastenia Gravis/dietoterapia , Miastenia Gravis/tratamento farmacológicoRESUMO
El síndrome de Roberts es una enfermedad genética de transmisión autosómica recesiva extremadamente rara. Se caracteriza clínicamente por retardo pre y posnatal del crecimiento, acortamiento severo de los miembros con defectos radiales, oligodactilia y anomalías craneofaciales, causada por mutación en el gen ESCO2, el cual codifica para una acetiltransferasa involucrada en la regulación de la cohesión de las cromátides hermanas. Hasta donde se conoce, no se ha descrito en este síndrome ningún déficit del sistema inmunológico. Se presenta el caso de un niño de 1 año y medio de edad, con síndrome de Roberts, con procesos infecciosos recurrentes, algunos severos, desde el primer año de vida. En los estudios inmunológicos se observó disminución de los niveles de IgA, del número de linfocitos T CD3 positivos y de los CD4 positivos, con cuantificación normal de células B, así como alteración de la función opsonofagocítica. Se diagnosticó una inmunodeficiencia combinada asociada con un defecto de la fagocitosis. La identificación de una inmunodeficiencia asociada con este síndrome genético sugiere que corresponde con una enfermedad genéticamente heterogénea y la utilidad de la valoración inmunológica en los pacientes con defectos genéticos e infecciones recurrentes
Roberts syndrome is an extremely rare genetic disease of autosomal recessive. It is clinically characterized by pre and postnatal growth delaying, severe limb shortening, radial defects, oligodactyly, and craniofacial anomalies caused by mutation in the ESCO2 gene. This mutation encodes an acetyltransferase involved in regulating cohesion of sister chromatids. To our knowledge, no deficit of the immunological system has been described in this syndrome. We present here, a case of a one year and a half boy, with Roberts syndrome, recurrent infectious processes, some of them severe, since his first year of life. Immunological studies showed decreased levels of IgA, decreased number of CD3 positive T lymphocytes and decreased CD4 positive; they also showed cells with normal B quantification and opsonophagocytic function impairment. A combined immunodeficiency associated with defective phagocytosis was diagnosed. Identifying an immunodeficiency associated with this genetic syndrome suggests that it corresponds to a genetically heterogeneous disease. This also shows the usefulness of the immunological assessment in patients with genetic defects and recurrent infections
Assuntos
Humanos , Masculino , Pré-Escolar , Ectromelia/complicações , Ectromelia/genética , Doenças do Sistema Imunitário/complicações , Fagocitose/genética , Relatos de Casos , Levamisol/uso terapêuticoRESUMO
A histoplasmose é micose sistêmica causada por Histoplasma capsulatum. A infecção humana ocorre pela inalação de microconídios encontrados em solo contendo excretas de aves e/ou morcegos. Neste estudo foi enfatizado o potencial das atividades profissionais praticadas em cavernas em possibilitar risco de infecção por Histoplasma. Utilizando-se questionário semiestruturado, foram obtidas informações sobre o trabalho de campo executado por um grupo de 15 biólogos. A presença de anticorpos séricos anti-H. capsulatum foi avaliada em amostras de sangue coletadas desses profissionais. Na entrevista, 87% dos indivíduos relataram frequentes visitas a cavernas, 53% acampamento no interior das grutas; 33% capturade morcegos e 53% de coleta de amostras de solo. A maioria das cavernas situa-se nas regiões sudeste e centro-oeste do Brasil. A detecção de anticorpos por imunodifusão dupla demonstrou que 20% dos soros reagiram com o antígeno de H. capsulatum. Por immunoblotting, houve 94,1% de reconhecimento específico da fração de 94 kDa, sugerindo-se que os indivíduos entraram em contato com H. capsulatum. Este estudo sugere fortemente que a prática da espeleologia propicia a exposição dos indivíduos a espécies fúngicas que habitam saprofiticamente o meio ambiente, especialmente H. capsulatum, configurando-se como potencial fator de risco para infecções.(AU)
Histoplasmosis is a systemic mycosis caused by Histoplasma capsulatum. Human infection occurs by inhaling the microconidia found in soil contaminated with birds and/or bats excrements. In this study, the potential risk of infection with Histoplasma from practicing professional activities in caves was emphasized. Information on the fieldwork conducted by a group of 15 biologists were obtained through a semi-structuredquestionnaire; and the presence of antibodies anti-H. capsulatum was evaluated in their serum samples. The data analysis showed that 87% of subjects reported the frequent cave exploration, 53% camping inside the caves, 33% bats capturing activities, and 53% soil samples collection. The majority of the caves are located in the Southeast and Midwest regions of Brazil. By using double immunodiffusion assay, 20% of sera reacted with H. capsulatum antigen. By immunoblotting, it was found 94.1% of specific recognition of 94 kDa fraction, suggesting that the individuals had contact with the fungus. This study strongly suggests that the individuals practicing speleology were prone to fungal species exposure, which inhabit the environment as saprophytes, especially H. capsulatum, and it might characterize a potential risk factor for infections.(AU)
Assuntos
Humanos , Animais , Histoplasmose/patologia , Pesquisadores , Quirópteros/classificação , Aves/classificação , Doenças do Sistema Imunitário/complicações , Epidemiologia/tendênciasRESUMO
Miocardites são um grupo de doenças heterogêneas que podem ser compreendidas com uma fisiopatologia imunológica. Os autores discutem aspectos históricos e a imunologia dessas doenças, correlacionando o trabalho de cientistas como Carlos Chagas, Noel Rose e Nelson Vaz. Levam em consideração a evolução histórica do conhecimento científico e a mudança de paradigma em andamento na imunologia. Também analisam as principais manifestações clínicas e estratégias para o diagnóstico e abordam novas propostas para investigação clínica dessas síndromes.
Assuntos
Miocardite/diagnóstico , Miocardite/fisiopatologia , Miocardite/terapia , Sistema Imunitário/patologia , Doenças do Sistema Imunitário/complicações , Doenças do Sistema Imunitário/etiologiaRESUMO
Con el objeto de conocer las especies causantes de candidosis humanas en pacientes HIV positivos o con otras inmunodeficiencias secundarias y la incidencia de especies con capacidad de resistencia a antifúngicos, se estudiaron 76 aislamientos de Candida procedentes de 61 casos de candidosis superficiales y profundas de niños y adultos. Obtenidas desde piel, anexos, mucosas, abscesos, catéteres y secreciones diversas, entre otras. La identificación de las especies fue realizada por estudios de características morfológicas, cromogénicas y bioquímicas (CHROMagar , Candifast, API 20 y API 32). Los resultados revelan predominio de especies noalbicans (52.7 por ciento), obteniéndose las siguientes frecuencias de aislamientos: C.albicans (47,3 por ciento), C. parapsilosis: 15,8 por ciento, C. glabrata: 13,2 por ciento, C. krusei: 11,8 por ciento, C. tropicalis: 10,6 por ciento y C. dubliniensis: 1,3 por ciento. Algunas de ellas pueden presentar resistencia primaria o secundaria a algunos antifúngicos de uso habitual, por lo cual es necesario incluir estudios de sensibilidad a estos, para una mejor conducta terapéutica.
In order to find out species causing human candidosis in positive HIV patients or in individuals suffering from other secondary immunodeficiencies and the incidence of species bearing a resistance ability to antifungal agents, 76 Candida isolations obtained from 61 cases of superficial and deep candidosis in children and adults were studied. Samples were collected from skin, annexa, mucosities, abscesses, catheters and diverse secretions, among others. The identification of species was carried out through studies on morphological, chromogenic and biochemical characteristics (CHROMagar, Candifast, API 20 and API 32). Results reveal a predominance of non-albican species (52,7 percent), and the following frequencies of isolation: C.albicans (47.3 percent), C. parapsilosis: 15.8 percent, C.glabrata: 13.2 percent, C. krusei: 11.8 percent, C. tropicalis: 10.6 percent and C. dubliniensis: 1.3 percent. Some of them may exhibit some primary or secondary resistance to certain antifungal agents of common use, this is why it is necessary to include studies on sensitivity of them so as to attain a better therapeutical behaviour.
Assuntos
Humanos , Masculino , Adulto , Feminino , Criança , Infecções Oportunistas Relacionadas com a AIDS , Antifúngicos/antagonistas & inibidores , Antifúngicos/uso terapêutico , Candidíase/classificação , Candidíase/etiologia , Candidíase/genética , Candidíase/microbiologia , Candidíase/prevenção & controle , Candidíase/terapia , Candidíase/transmissão , Argentina , Doenças do Sistema Imunitário/complicaçõesRESUMO
BACKGROUND: The mechanisms underlying inappropriate sinus tachycardia are not fully known. An autonomic imbalance seems to play a role, but no attempts have been made to investigate a relationship between this arrhythmia and the antiautonomic membrane receptor antibodies found in other heart disorders and arrhythmias. OBJECTIVE: The purpose of this study was to investigate the prevalence and the functional and biochemical effects of circulating antiautonomic receptor antibodies in patients with inappropriate sinus tachycardia. METHODS: We studied 21 patients with inappropriate sinus tachycardia and 15 healthy volunteers. The chronotropic effects of the IgG fractions (also of affinity-purified anti-beta1 adrenergic receptor antibodies in selected cases) were assessed on cultured cardiomyocytes before and after exposure to atropine and propranolol. The effects of the IgG fractions from five patients and five healthy volunteers on cAMP production were evaluated in COS-7 cells transfected with genes encoding for beta1 or beta2 adrenergic receptor. RESULTS: The IgG fractions from patients with inappropriate sinus tachycardia exerted a positive chronotropic action with a high prevalence of anti-beta receptor antibodies (52%) and induced a clear-cut and long lasting increment of cAMP. No anti-M2 cholinergic receptor antibodies were found. The IgG fractions from healthy volunteers did not contain antiautonomic receptor antibodies. CONCLUSIONS: Our results suggest, for the first time, a link between inappropriate sinus tachycardia and circulating anti-beta adrenergic receptor antibodies that induce a persistent increment in cAMP production. This finding offers new insight into the physiopathology of inappropriate sinus tachycardia with potential therapeutic consequences.
Assuntos
Autoanticorpos/imunologia , Doenças do Sistema Imunitário/complicações , Miocárdio/metabolismo , Receptores Adrenérgicos beta/metabolismo , Taquicardia Sinusal/etiologia , Adolescente , Adulto , Animais , Anticorpos Anti-Idiotípicos/imunologia , Biomarcadores/metabolismo , Feminino , Humanos , Doenças do Sistema Imunitário/imunologia , Doenças do Sistema Imunitário/metabolismo , Técnicas Imunoenzimáticas , Imunoglobulina G/imunologia , Masculino , Pessoa de Meia-Idade , Miocárdio/patologia , Ratos , Receptores Adrenérgicos beta/imunologia , Taquicardia Sinusal/imunologia , Taquicardia Sinusal/metabolismoRESUMO
En relación al uso de terapia antiretroviral (TAR) en pacientes con VIH, se ha descrito un síndrome clínico tras el inicio o cambio de la terapia, denominado Síndrome de Reconstitución Inmune (SRI). Se trata de un cuadro caracterizado por el deterioro inesperado en el estado clínico de los pacientes, producto de una respuesta inflamatoria exagerada en contra de patógenos oportunistas, tumores o antígenos propios del paciente. El manejo del SRI, incluye uso de antimicrobianos específicos y/o terapia antiinflamatoria, sin ser necesaria la descontinuación de la TAR. Es prioritario en la investigación del SRI, el desarrollo de estrategias de prevención, métodos de pesquisa de factores de riesgo y criterios diagnósticos.
Related to the antiretroviral therapy in HIV infected persons, it has been described a clinical syndrome called the Immune Restoration Disease (IRD). It appears after the initiation or switching of the therapy and is characterized by an exaggerated inflammatory response after the improvement of the immune system, which leads to an unexpected worsening of the clinical condition of the patient. This inflammatory response is presented against opportunist pathogens, tumors or the patients own antigens. The management of IRD often requires the use of anti-microbial and/or anti-inflammatory therapy, without interruption of the antiretroviral therapy. It is a priority for future research, to develop strategies to prevent IRD, risk assessment methods and diagnostic criteria.
Assuntos
Humanos , Antirretrovirais/efeitos adversos , Doenças do Sistema Imunitário/complicações , Infecções Oportunistas Relacionadas com a AIDS/imunologia , Infecções Oportunistas Relacionadas com a AIDS/tratamento farmacológico , Infecções por HIV/imunologia , Infecções por HIV/tratamento farmacológico , Anti-Inflamatórios/uso terapêuticoRESUMO
OBJECTIVE: To investigate clinical features and to establish optimal management in children with primary immunodeficiency (PID) and liver disease. Study design A retrospective analysis of medical records of 147 children with PID who presented with abnormal liver tests to a tertiary center. RESULTS: Clinical evidence of liver disease was documented in 35 (23.8%) patients. Of these, 22 (63%) had hepatomegaly and 14 (40%) had splenomegaly. Sclerosing cholangitis (SC) was diagnosed in 21 children (60%), based on radiological and histological criteria; 4 patients with SC on cholangiography had no biliary changes in the liver biopsy. Ultrasonography demonstrated a dilated biliary system in 14 (67%) children with SC. Of 27 children investigated for Cryptosporidium parvum (CSP), 12 (44%) were positive, including 9 of 12 with SC. Overall, 7 (20%) patients died, including 3 boys with disseminated recurrent CSP infection after successful liver transplantation (LT). Temporary deterioration of liver injury was observed in 2 CSP-positive boys with CD40 ligand deficiency (CD40LD) who were undergoing nonmyeloablative hematopoietic stem cell transplantation (HSCT). Successive liver and HSCT was curative in 1 patient with CD40LD and end-stage liver disease. CONCLUSION: SC is the most common hepatic complication of PID. Mild liver involvement could be arrested by early nonmyeloablative HSCT, whereas advanced disease may warrant combined liver and HSCT.
Assuntos
Doenças do Sistema Imunitário/complicações , Hepatopatias/complicações , Adolescente , Criança , Pré-Escolar , Colangiografia , Colangiopancreatografia Retrógrada Endoscópica , Feminino , Transplante de Células-Tronco Hematopoéticas , Humanos , Doenças do Sistema Imunitário/fisiopatologia , Lactente , Hepatopatias/mortalidade , Hepatopatias/fisiopatologia , Masculino , Prontuários Médicos , Estudos Retrospectivos , Resultado do TratamentoRESUMO
The incidence of progressive nephropathies and, consequently, the population suffering from end-stage renal disease have increased steadily in recent years, posing an ever-growing cost, in both human and financial terms, to society. There is mounting evidence that, in both immune-mediated and nonimmune-mediated chronic nephropathies, renal inflammatory events are key to the propagation and perpetuation of renal injury. Mycophenolate mofetil (MMF) is an antilymphocyte agent recently introduced in clinical practice for the prevention of allograft rejection. The present review discusses clinical and experimental evidence that the anti-inflammatory action of MMF can be advantageously used to arrest immune- and nonimmune-mediated progressive injury of native kidneys as well.
Assuntos
Imunossupressores/uso terapêutico , Nefropatias/tratamento farmacológico , Nefropatias/fisiopatologia , Ácido Micofenólico/uso terapêutico , Progressão da Doença , Quimioterapia Combinada , Humanos , Doenças do Sistema Imunitário/complicações , Nefropatias/imunologia , Ácido Micofenólico/análogos & derivadosRESUMO
Bajo diferentes modelos de asociación, la periodontitis de tipo crónico puede mostrar una interrelación con la aparición y curso de enfermedades generales. En este estudio de pacientes mayores de 40 años, se encontró que de manera significativa, existe diferencia en la incidencia de periodontitis crónica en pacientes que sufren padecimientos sistémicos metabólicos, cardiovasculares e inmunopatológicos, al compararla con la observada en sujetos sanos. La frecuencia de periodontitis crónica inicial, periodontitis crónica severa y edentulismo total, fue mayor en pacientes con diabetes, hipertensión arterial y artritis reumatoidea, que en aquellos que no declararon antecedentes sistémicos (x2 < 0.005)
Assuntos
Humanos , Masculino , Adulto , Feminino , Pessoa de Meia-Idade , Doença Crônica , Periodontite , Fatores Etários , Artrite Reumatoide , Doenças Cardiovasculares , Distribuição de Qui-Quadrado , Diabetes Mellitus , Doenças do Sistema Imunitário/complicações , Doenças Metabólicas/complicações , Epidemiologia Descritiva , Hipertensão/complicações , Hipertensão/epidemiologia , México , Boca Edêntula , Osteoartrite , Periodontite , Estudos Retrospectivos , Interpretação Estatística de DadosRESUMO
El objetivo del trabajo es describir los resultados del cintigrama óseo en niños con síndrome febril prolongado y correlacionarlos con aspectos clínicos y con otros estudios de imagen. Para ello, se revisan los cintigramas óseos de 37 niños con síndrome febril prolongado correlacionando sus resultados con la ocurrencia de dolor óseo y las informaciones proporcionadas por otros exámenes de imagen. Los pacientes fueron separados en grupos según la etiología del cuadro febril. El cintigrama óseo resultó positivo en 21,6 por ciento de los pacientes, de los cuales 75 por ciento eran de causa infecciosa. La mitad de las lesiones cintigráficas detectadas fueron indoloras y en el 80 por ciento de ellas el estudio radiográfico contemporáneo fue negativo. En 56,8 por ciento de los pacientes la etiología de la fiebre fue infecciosa, y en 24,3 por ciento de ellos la causa no fue aclarada. Se concluye que el cintigrama óseo es una valiosa herramienta en el estudio de niños con síndrome febril prolongado siendo, en el grupo estudiado, la manera más sensible de detección de focos óseos en forma precoz
Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Adolescente , Osso e Ossos , Febre de Causa Desconhecida/etiologia , Doenças Transmissíveis/complicações , Doenças do Sistema Imunitário/complicações , Neoplasias/complicações , CintilografiaRESUMO
Se revisan brevemente los principales tipos de lesiones vesiculosas y ulcerosas de la cavidad orofaríngea. Según su etiopatogenia se distinguen lesiones virales, bacterianas, micóticas, inmunológicas y hematológicas. En general forman parte de un cortejo sintomático que incluye manifestaciones cutáneas (síndromes mucocutáneos), articulaciones y/o viscerales, así como fiebre y compromiso del estado general. Las lesiones más frecuentes son las virales y las de naturaleza inmunológica