ABSTRACT
Vasculitic midline destructive lesions can be a complication of cocaine use. We report a 44-year-old man who presented with a two months history of left facial pain associated with ipsilateral facial paralysis and a cheek phlegmon. Magnetic resonance imaging showed broad soft tissue destruction linked to important cranial nerve involvement. Antibiotic and antifungal therapy was started and multiple surgical debridement procedures were performed, with no clinical improvement. Microbiological analysis was negative. Finally, thanks to the histologic findings corresponding to vasculitis and granuloma formation and the history of cocaine abuse, a cocaine induced midline destructive lesion was diagnosed.
Subject(s)
Humans , Male , Adult , Nose Diseases/diagnosis , Nose Diseases/chemically induced , Cocaine-Related Disorders/complications , Nasal Septum/drug effects , Magnetic Resonance Imaging , Tomography Scanners, X-Ray Computed , Granulomatosis with Polyangiitis/diagnosis , Nose Diseases/therapy , Diagnosis, Differential , Anti-Bacterial Agents/classification , Anti-Bacterial Agents/therapeutic useABSTRACT
Although gastrointestinal symptoms are not rare in Systemic lupus erythematosus, enteritis is an atypical manifestation of the disease. We report a 54 year-old woman who presented acute symptoms of diarrhea, fever and abdominal pain, receiving empiric antibiotic therapy for bacterial enteritis with no response. Computed tomography showed diffuse small intestine inflammation and serositis. Antinuclear antibodies, anti-Ro and anti-La were positive on blood tests. A lupic enteropathy was diagnosed and steroid treatment was initiated, with subsequent clinical improvement.
Subject(s)
Humans , Female , Middle Aged , Enteritis/etiology , Lupus Erythematosus, Systemic/complications , Prednisone/therapeutic use , Tomography, X-Ray Computed , Polymerase Chain Reaction , Treatment Outcome , Enteritis/diagnosis , Enteritis/drug therapy , Glucocorticoids/therapeutic use , Lupus Erythematosus, Systemic/diagnosis , Lupus Erythematosus, Systemic/drug therapyABSTRACT
Abstract Solid-state fermentation can be used to produce feeds for ruminants, which can provide an enriched population of yeasts to improve ruminal fermentation. Fermentation of apple bagasse was performed to obtain a yeast-rich product, with the objective of isolating, identifying, and characterizing yeast strains and testing their capability to enhance in vitro ruminal fermentation of fibrous feeds. Yeasts were isolated from apple bagasse fermented under in vitro conditions, using rumen liquor obtained from cannulated cows and alfalfa as a fibrous substrate. A total of 16 new yeast strains were isolated and identified by biochemical and molecular methods. The strains were designated Levazot, followed by the isolate number. Their fermentative capacity was assessed using an in vitro gas production method. Strain Levazot 15 (Candida norvegensis) showed the greatest increase in gas production (p < 0.05) compared with the yeast-free control and positively affected in vitro ruminal fermentation parameters of alfalfa and oat straw. Based on these results, it was concluded that the Levazot 15 yeast strain could be potentially used as an additive for ruminants consuming high-fiber diets. However, further studies of effects of these additives on rumen digestion, metabolism, and productive performance of ruminants are required.
Subject(s)
Animals , Yeasts/isolation & purification , Yeasts/classification , Cellulose , Malus , Food Additives , Animal Feed/microbiology , Phylogeny , Yeasts/genetics , Yeasts/metabolism , Ruminants , FermentationABSTRACT
La ultrasonografía se ha convertido en un examen muy útil para el estudio de artritis inflamatorias indiferenciadas, ya que posee mayor sensibilidad que el examen físico para detectar sinovitis y entesitis. La necesidad de realizar el diagnóstico de forma precoz, ha permitido que esta herramienta se vuelva un pilar fundamental en el enfrentamiento de estas patologías. Se presenta el caso de una paciente de 37 años que consulta por cuadro de seis meses de evolución de poliartralgias de distribución asimétrica en manos, hombros y codos. Al examen físico se detecta sinovitis en articulaciones metacarpofalángicas e interfalángicas proximales. Finalmente se solicita ultrasonografía de manos, la cual revela sinovitis activa en articulaciones interfalángicas distales. En base a esto se rescata antecedente familiar de psoriasis, se realiza HLA-B27 que resulta negativo y un TAC de sacroiliacas sugerente de sacroileítis bilateral. Por los hallazgos y el nuevo antecedente se diagnostica como Artritis Psoriática.
Ultrasonography has become a useful imaging test in the assessment of undifferentiated arthritis, due to its greater sensitivity in detecting synovitis and enthesitis in comparison with physical examination. In the need of making an early diagnosis, this exam has turn into a cornerstone when approaching certain arthritis. We present the case of a 37 years old women, with a six months history of asymmetric polyarthralgias in hands, shoulders and elbows. Synovitis is detected with physical exam in metacarpophalangeal and proximal interphalangeal joints. An ultrasonography is requested, revealing active synovitis in distal interphalangeal joints. Based on these information, the family background of psoriasis is obtained. HLA-B27 results negative and a sacroiliac CT suggests bilateral sacroiliitis. According to these findings the diagnosis of Psoriatic Arthritis is finally made.
Subject(s)
Humans , Adult , Female , Arthritis, Psoriatic , Synovitis , Arthralgia , Early DiagnosisABSTRACT
El manejo de las fracturas corono radiculares es un desafío clínico interdisciplinario, tanto en su atención de urgencia como en la planificación y ejecución del tratamiento definitivo. Se describen tres alternativas principales como terapia: tracción quirúrgica u ortodóncica del remanente corono radicular, gingivectomía y reimplante intencional dependiendo algunos factores como: edad del paciente, condición ligamento periodontal, longitud radicular, extensión del rasgo e fractura, entre otros. Paciente de sexo masculino de 10 años, con trauma dentoalveolar complejo, donde destaca la fractura corono radicular, diente 11, que presenta extensión subgingival mayor a 5 mm. Dada la complejidad de la situación clínica, se optó por el reimplante intencional, para permitir la reposición del fragmento con técnica adhesiva extra-oral. Luego de los primeros dieciséis meses de seguimiento se observa una adecuada cicatrización periodontal y un resultado estético aceptable. El reimplante intencional puede ser considerado un adecuado tratamiento en casos de fracturas corono radiculares complejas, cuando el rasgo de fractura se encuentra ubicado en zonas que impiden la utilización de otras técnicas, para su rehabilitación. De igual manera se permite la mantención de la altura y volumen del hueso alveolar de pacientes en crecimiento.
Crown root fracture management is a clinical and interdisciplinary challenge, either in its initial emergency care as in the definitive treatment planning and execution. Three main treatment alternatives are described: surgical and orthodontic extrusion of crown-root remnant, gingivectomy and intentional reimplantation, depending on factors such as: age of patient, clinical conditions of periodontal ligament and root length. This paper reports a clinical case of an adhesive fragment reattachment in a complicated crown root fracture in upper maxillary central incisor through intentional replantation. A 10 year-old male patient with complex dentoalveolar trauma, which highlights a complicated crown root fracture on tooth 11 with subgingival extension greater than 5 mm. Given the complexity of the clinical situation, we opted for intentional replantation, to allow reattachment of the crown fragment by adhesive technique. After the first sixteen months of follow-up, an adequate periodontal healing, acceptable aesthetic and functional outcome were observed. The intentional replantation can be considered adequate treatment in cases of complex crown root fractures when the fracture feature is located in areas that prevent the use of other techniques for rehabilitation. In the same way it allows the maintenance of the height and volume of the alveolar bone of growing patients.
ABSTRACT
Analisa a influência da infecção pelo HIV e o estágio clínico da doença sobre diferentes indicadores antropométricos do estado nutricional do indivíduo
Subject(s)
Humans , Male , Female , Adult , Acquired Immunodeficiency Syndrome , HIV , Nutritional Status , Sexually Transmitted Diseases , AnthropometryABSTRACT
Con el objetivo de analizar la influencia de la infección por el VIH y el estadio clínico de la enfermedad sobre indicadores bioquímicos del estado nutricional del individuo, se estudió un grupo de individuos infectados y clasificados en diferentes grupos clínicos, de acuerdo con los criterios propuestos en 1987 por el Centro de Control de Enfermedades de los Estados Unidos, así como un grupo control integrado por sujetos seronegativos al VIH y clasificados antropométricamente con un estado nutricional normal. Se analizaron las variaciones experimentadas por las proteínas totales, albúmina, colesterol, triacilglicéridos, urea, ácido úrico y creatinina, según sexo y grupo clínico, para lo cual se realizó la comparación de las medias obtenidas por medio de un análisis de la varianza. Al compararlos con los seronegativos, se encontró en los seropositivos asintomáticos un incremento no significativo de las proteínas totales con disminusión significativa de la albúmina y la creatinina; esta última sólo en el sexo masculino. En los pacientes del estadio IV se manifestó la disminución más importante del colesterol y un aumento significativo de los triglicéridos, así como los niveles más bajos de albúmina. La urea y el ácido úrico no experimentaron cambios con significación estadística. Se recomienda la determinación de indicadores bioquímicos en la detección de estados marginales de malnutrición por defecto en individuos VIH/SIDA