ABSTRACT
Resumen Introducción El AR de causa no precisada es un problema de salud reproductiva que impacta importantemente a las parejas. En casi el 50% de los casos de AR no se encuentra una etiología clara, por lo que es necesario lograr encontrar estrategias de tratamiento que puedan ayudar a mejorar las probabilidades de lograr un embarazo de término. Objetivo analizar la bibliografía existente en cuanto a la utilidad de la progesterona para reducir tasa de aborto en las parejas con AR de causa no precisada en ciclos naturales Métodos: Revisión sistemática cualitativa respecto al uso de progesterona en casos de aborto recurrente de causa no precisada. Resultados Se encontraron 3 artículos. Todos usaron progesterona vaginal, 2 desde el inicio de la fase lútea con disminución de los abortos, uno no demostró este efecto con inicio más tardío de la intervención. Conclusiones Los estudios encontrados orientan a que el uso de progesterona vaginal podría ser de utilidad para disminuir abortos en pacientes con AR iniciando la suplementación al comienzo de la fase lútea.
Subject(s)
Humans , Female , Pregnancy , Abortion, Habitual , Abortion, Induced/methods , Progesterone/administration & dosage , Recurrence , Vagina/drug effects , Administration, Intravaginal , Pregnancy OutcomeABSTRACT
Background: The incidence oflymphoma increases enormously inpatients infecten with the human immunodeficiency virus (HIV). Aim: To describe the incidence, clinical and histológica! characteristics, treatments and survival of lymphomas associated with HTV infection. Material and Methods: Retrospective review of medical records ofpatients with HIV and lymphoma, treated in a public hospital, between January 2001 and June 2009. Results: Twenty-two mole patients were included but 14 had immunohistochemical confirmation ofthe lymphoma. The accumulated incidence for thisperiod was 2.8 percent. The median age at lymphoma diagnosis was 39.5 years. Twelvepatients (86 percent) had non-Hodgkin lymphoma (NHI) and two (14 percent) Hodgkin lymphoma. The main pathological type of non-Hodgkin lymphomas was diffuse large B cell in seven cases (50 percent). The mean CD4 cell count and viral load were 83 cell/mm³ (33.5-113.5) and 26.000 RNA copies/ml (1210-196500), respectively Twelve patients (86 percent) had B type symptoms of lymphoma at the moment of diagnosis. Eleven patients (29 percent) received chemotherapy with or without radiotherapy, onepatient (7 percent) received radiotherapy alone and two patients (14 percent) received palliative symptomatic treatment. Six cases (43 percent) received highly active antiretroviral therapy simultaneously with chemotherapy. Global mortality in this series was 57 percent (8patients) with a median survival time of 5.8 months (2.6-26.2). Conclusions: In this series ofpatients infected with HIV, a predominance of aggressive histológica! subtypes of lymphomas and low complete remission rates, were observed.
Subject(s)
Adult , Female , Humans , Male , Hodgkin Disease , Lymphoma, AIDS-Related , Chile/epidemiology , Epidemiologic Methods , Hodgkin Disease/classification , Hodgkin Disease/epidemiology , Hodgkin Disease/therapy , Lymphoma, AIDS-Related/diagnosis , Lymphoma, AIDS-Related/epidemiology , Lymphoma, AIDS-Related/therapyABSTRACT
La respuesta inmunitaria frente a microbacterias es de tipo celular, existiendo en pacientes VIH (+) un riesgo elevado de infecciones diseminadas. Se presenta caso de hombre de 46 años, que presenta infección por VIH de 16 años de evolución sin control. Ingresa presentando síntomas sistémicos, y desarrolla 3 adenopatías cervicales fistulizadas, adenopatía torácicas y abdominales, y masa suprarrenal izquierda. Institulo de Salud Pública confirma Mycobacterium intracellulare. Completa 1 año de tratamiento con claritromicina, etambutol y rifampicina, asintomático en controles a 2 años. Se describe diagnóstico, manejo y evolución, y se revisa historia, epidemiología, presentación y tratamiento de micobacteriosis en pacientes VIH.
The immune response to mycobacterium infection is of cellular type, existing in HIV (+) patients a higher risk of disseminated infections. We present a 46 years old male patient, that presents HIV infection of 16 years of evolution without control. He was admitted presenting systemic symptoms, and developed 3 cervical fistulized lynephadenopathies, thoracic and abdominal lymphadenopathies, and left adrenal mass. Institute of Public Health confirms Mycobacterium intracellulare. Patient completes 1 year of treatment with claritromicin, ethambutol and rifampicin, asymtomatic in controls for 2 years. We describe the diagnosis, clinical managment and evolution, and a review of the history, epidemiology, presentation and treatment of mycobacteriosis in HIV patients.
Subject(s)
Humans , Male , Middle Aged , HIV , Mycobacterium avium-intracellulare Infection , Chile , Macrolides/therapeutic useABSTRACT
La profilaxis en cirugía se define como la administración de antibióticos con el fin de prevenir infecciones asociadas a procedimientos quirúrgicos. La comprensión de la fisiopatología de la infección de la herida operatoria es la clave de los principios básicos de la antibioprofilaxis. Ella nos enseña cómo se produce la contaminación bacteriana durante el acto quirúrgico, cómo está constituida la flora endógena removida según el tipo de cirugía y la importancia que tiene la existencia de un período vulnerable en el momento de administración de los antimicrobianos. Estos principios básicos son: la administración del antibiótico previa al inicio del acto quirúrgico para cubrir el período vulnerable; la elección del antibiótico que cubra la mayor cantidad de especies de la flora bacteriana contaminante; que sea poco tóxico; que no se use en infecciones severas; y la administración del fármaco en dosis plena. Las indicaciones más aceptadas de antiprofilaxis en cirugía son: las heridas limpias-contaminadas (cuyo beneficio ha sido documentado estadísticamente) y las heridas limpias donde la infección pudiera tener consecuencias catastróficas (por ejemplo cirugía cardíaca)
Subject(s)
Humans , Surgical Wound Infection/drug therapy , Antibiotic Prophylaxis/methods , Anti-Bacterial Agents/administration & dosage , Anti-Bacterial Agents/therapeutic use , Surgical Wound Infection/physiopathology , Surgical Wound Infection/prevention & control , Postoperative Complications/drug therapy , Postoperative Complications/prevention & control , Risk Factors , Surgical Procedures, OperativeABSTRACT
Los linfomas son tumores malignos originados en el tejido linfatico, en ocasiones con localizaciones extraganglionares. Tal es el caso de los linfomas no hodkigs. Los linfomas primarios del tracto gastrointestinal corresponden solamente del 1 al 4 por ciento de todas las neoplasias malignas gastrointestinales, observandose una localizacion mas frecuente en estomago seguida por el intestino delgado y el colon. A pesar de su baja frecuencia han concitado la atencion de muchos autores por los avances en citogenetica, histologia, funcion y caracteres inmunoenzimaticos de las celulas linfoideas, y debido a su curabilidad potencial. En el presente trabajo se exponen la experiencia relativa a los linfomas primarios intestinales, tratados en el Departamento de cirugia del Hospital Clinico de la Universidad de Chile.
Subject(s)
Humans , Male , Female , Lymphoid Tissue/physiopathology , Lymphoma/physiopathology , Biopsy/statistics & numerical data , Drug Therapy/statistics & numerical data , Endoscopy/statistics & numerical data , Intestines/cytology , Intestines/physiopathology , Laparotomy/statistics & numerical data , Mortality/trends , Pathology, Clinical/trendsABSTRACT
One hundred and thirteen children suffering from tubercular lymphadenitis proven histopathologically, were studied for clinical and laboratory features. Age distribution was equal in all age groups except during infancy when it was rare. Sex ratio indicates a male preponderance with male to female in the ratio of 1.5:1 (67:46). Family history of contact with known tuberculous patient was positive in 19 (17%) children, 44 (40%) had received BCG, and 98 (88%) were either normal nourished or had mild malnutrition. Cervical, axillary and inguinal nodes were found in 90 (80%), 14 (12%), and 8 (7%) children respectively. Epitrochlear node was found in only 1 child. 11 (10%) children had discharging sinus, all being in cervical group. The consistency of nodes was firm in 98 (87%), fluctuation was present in 15 (13%). In 87 (77%) lymph nodes were matted. Hepatomegaly of more than 2 cm was present in 13 (11%) and spleen was enlarged (> 2 cm) in 4 (4%) only: Mantoux test was positive in 96 (85%) children and chest X-ray was abnormal in 25 (22%) cases. Findings suggest that tubercular adenitis occurs in all age groups with equal frequency. It can occur in vaccinated children also. It may be a sole manifestation of tubercular infection. The cervical nodes are predominantly involved. There is no typical location of nodes in individual groups but multiplicity and matting of nodes are characteristic features of tubercular adenitis in children.
Subject(s)
Child , Child, Preschool , Cross-Sectional Studies , Developing Countries , Female , Humans , Incidence , India/epidemiology , Infant , Male , Tuberculosis, Lymph Node/diagnosisSubject(s)
Middle Aged , Humans , Female , Hemoptysis/complications , Critical Care , Hemoptysis/diagnosis , Hemoptysis/drug therapy , Hemoptysis/etiology , Hemoptysis/therapyABSTRACT
A maioria das comissöes de corridas proíbem a presença de qualquer substância estranha na saliva, no sangue e na urina na amostragem feita após a corrida. A identificaçäo de uma substância proibida resulta normalmente na perda de prêmios e suspensäo do treinador. Proprietários, treinadores e veterinários necessitam orientaçäo para o momento certo de interromper a medicaçäo. Vários fatores podem influenciar este momento. O presente estudo investiga a importância da idade e o nível de exercício na eliminaçäo de flunixina meglumine, medicamento näo esteróide comumente usado na terapêutica eqüina.