ABSTRACT
The pancreatoduodenal groove is a small area where pathologic processes involving the distal bile duct, duodenum, pancreatic head, ampulla of Vater, and retroperitoneum converge. Despite great advances in imaging techniques, a definitive preoperative diagnosis is challenging because of the complex anatomy of this area. Therefore, surgical intervention is frequently required because of the inability to completely exclude malignancy. We report 3 cases of patients with different groove pathologies but similar clinical and imaging presentation, and show the essential role of endoscopic ultrasound (EUS) in making a specific preoperative diagnosis, excluding malignancy in the first case, changing diagnosis in the second case, and confirming malignancy in the third case. EUS was a fundamental tool in this cohort of patients, not only because of its ability to provide superior visualization of a difficult anatomical region, but because of the ability to guide precise, real-time procedures, such as fine-needle aspiration.
Subject(s)
Humans , Ampulla of Vater , Bile Ducts , Biopsy, Fine-Needle , Cohort Studies , Diagnosis , Duodenum , Head , Pancreatic Neoplasms , Pathologic Processes , Pathology , UltrasonographyABSTRACT
Resumo Objetivos Estabelecer a prevalência das crises febris e descrever o perfil clínico e epidemiológico dessa população. Métodos Estudo transversal de base populacional feito em Barra do Bugres (MT), de agosto de 2012 a agosto de 2013. Os dados foram coletados em duas etapas. Na primeira etapa usamos um questionário validado previamente em outro estudo brasileiro, para identificação de casos suspeitos de crises epilépticas. Na segunda etapa fizemos a avaliação neuroclínica para confirmação diagnóstica. Resultados A prevalência de crise febril foi de 6,4/1.000 habitantes (IC95% 3,8; 10,1). Não houve diferença entre os sexos. As crises febris simples foram encontradas em 88,8% dos casos. A história familiar de crise febril e epilepsia em parentes de primeiro grau esteve presente em 33,3% e 11,1% dos pacientes, respectivamente. Conclusões A prevalência da crise febril na Região Centro-Oeste foi menor do que a encontrada em outras regiões brasileiras, provavelmente relacionado à inclusão apenas das crises febris com manifestações motoras e as diferenças de fatores socioeconômicos entre as regiões pesquisadas.
Abstract Objectives To determine the prevalence of benign febrile seizures of childhood and describe the clinical and epidemiological profile of this population. Methods This was a population-based, cross-sectional study, carried out in the city of Barra do Bugres, MT, Brazil, from August 2012 to August 2013. Data were collected in two phases. In the first phase, a questionnaire that was previously validated in another Brazilian study was used to identify suspected cases of seizures. In the second phase, a neurological evaluation was performed to confirm diagnosis. Results The prevalence was 6.4/1000 inhabitants (95% CI: 3.8-10.1). There was no difference between genders. Simple febrile seizures were found in 88.8% of cases. A family history of febrile seizures in first-degree relatives and history of epilepsy was present in 33.3% and 11.1% of patients, respectively. Conclusions The prevalence of febrile seizures in Midwestern Brazil was lower than that found in other Brazilian regions, probably due to the inclusion only of febrile seizures with motor manifestations and differences in socioeconomic factors among the evaluated areas.
Subject(s)
Adolescent , Child , Child, Preschool , Female , Humans , Infant , Male , Seizures, Febrile/epidemiology , Brazil/epidemiology , Cross-Sectional Studies , Epilepsy/complications , Epilepsy/diagnosis , Epilepsy/epidemiology , Prevalence , Recurrence , Risk Factors , Socioeconomic Factors , Seizures, Febrile/etiologyABSTRACT
Objetivo: Verificar a prevalência de anemia e deficiência de ferro, analisar a correlação entre indicadores hematológicos e índice de massa corporal pré-gestacional/gestacional e o comportamento desses indicadores de acordo com a semana de gestação. Método: Estudo de corte transversal com 146 gestantes atendidas em ambulatório de pré-natal da rede pública de Cuiabá-MT, Centro-Oeste do Brasil, de maio de 2008 a maio de 2009. Os indicadores hematológicos foram coletados e relacionados entre si e com os índices de massa corporal. Analisou-se o comportamento dos indicadores hematológicos conforme a semana de gestação. O coeficiente de correlação de Pearson foi empregado para avaliar a associação entre as variáveis. Para estes testes, foi considerado o nível de significância menor que 5% (p < 0,05). Resultados: A prevalência de anemia variou de 3,4% a 4,8%, considerando-se os valores para hemoglobina, hematócrito e volume corpuscular médio. Entretanto, as prevalências das alterações nos indicadores de reservas de ferro variaram de 11,0% para transferrina a 39,0% paraferritina. As correlações positivas estatisticamente significantes foram: hemoglobina e hematócrito (0,85), ferro e índice de saturação de transferrina (0,75). Observou-se comportamento constante no volume corpuscular médio, hematócrito e hemoglobina, e queda nestes indicadores ao final da 27ª semana de gestação. O IMC mostrou correlação negativa com o ferro sérico. Conclusão: Foi baixa a prevalência de anemia pelos níveis de hemoglobina, mas os indicadores de reservas de ferro mostraram maior prevalência de deficiência de ferro. Os indicadores de reservas de ferro que tiveram correlação mais forte entre si foram o ferro sérico e o índice de saturação da transferrina, sugerindo que sua combinação com outros indicadores hematológicos poderia melhor caracterizar a anemia por carência de ferro. O IMC e o ferro apresentaram correlação negativa.
Objective: To investigate the prevalence of anemia and iron deficiency, to analyze the correlation of hematological indices with pre-gestational / gestational body mass, and the behavior of these indices according to the gestational age. Method: Cross-sectional study with 146 pregnant women attending public prenatal care service in Cuiabá city, state of Mato Grosso, Midwest of Brazil, from May 2008 to May 2009. Hematological indices were collected and related to each other and with the body mass index. The behavior of hematological indices was analyzed according to the gestational age. Pearson's coefficient correlation was used to assess association between variables. For these tests, it was considered the significance level of 5% (p <0.05). Results: The prevalence of anemia ranged from 3.4% to 4.8%, considering the values for hemoglobin, hematocrit and mean corpuscular volume. However, the prevalence of changes in iron stores indices ranged from 11.0% for transferrin to 39.0% for ferritin. Statistically significant positive correlations were: hemoglobin and hematocrit (0.85), iron and transferrin saturation index (0.75). It was observed a constant mean corpuscular volume, hematocrit and hemoglobin, and decreasein these indices in the end of 27 weeks of gestation. BMI showed negative correlation with serum iron. Conclusion: The prevalence of anemia by hemoglobin levels was low, but indicators of iron stores showed higher prevalence of iron deficiency. Among the iron stores indexes were more strongly correlated with each other were serum iron and transferrin saturation index, suggesting that their combination with other hematological indices could better characterize the iron deficiency anemia. The BMI and iron were negatively correlated.
Subject(s)
Humans , Female , Pregnancy , Anemia/epidemiology , Prenatal Care , Hematology/statistics & numerical data , Hematology/trends , Body Mass Index , Cohort Studies , IncidenceSubject(s)
Humans , Female , Middle Aged , Dyspnea , Pneumonia, Pneumocystis/diagnosis , Pneumonia, Pneumocystis/drug therapy , Pneumocystis carinii/isolation & purification , Anti-Bacterial Agents/therapeutic use , Diagnosis, Differential , Sensitivity and Specificity , Spirometry , Tomography, X-Ray ComputedABSTRACT
Las hernias diafragmáticas consisten en la migración de estructuras abdominales hacia el tórax a través de un defecto del diafragma. Ellas pueden tener origen congénito (de Morgagni y de Bochdalek) o adquirido, incluyendo las traumáticas o no traumáticas (del hiato, defectos diafragmáticos posteriores). Debido a que en algunas hernias diafragmáticas está indicada la reparación quirúrgica, los métodos de diagnóstico por imágenes cumplen un rol fundamental. La TC multicorte, con su capacidad multiplanar y posibilidad de efectuar cortes finos, nos permite valorar y caracterizar adecuadamente el defecto diafragmático y sus complicaciones. En este ensayo iconográfico realizamos un breve repaso de la embriología y anatomía del diafragma, revisamos los distintos tipos de hernias diafragmáticas y la utilidad de la TC multicorte.
Diaphragmatic hernias are characterized by the migration of abdominal structures into the chest through a diaphragmatic defect. These may have either a congenital etiology (e.g., Morgagni and Bochdalek), or an acquired etiology, including traumatic and nontraumatic hernias (hiatal, posterior diaphragmatic defects). Since a surgical repair is indicated in certain types of hernias, imaging diagnostic methods play a key role. Multislice Computed Tomography (MSCT) allows multiplanar views and thin section evaluation, thus providing a useful tool for the assessment and characterization of the diaphragmatic defect and its complications. In this pictorial essay we briefly review the diaphragm anatomy and embryology, the different types of diaphragmatic hernias and the role of MSCT.
ABSTRACT
Cyclospora spp. is a protozoan parasite responsible for significant gastrointestinal disease in patients infected with the human immunodeficiency virus. We report the clinical features of two patients with chronic diarrhea and intestinal cyclosporosis caused by Cyclospora cayetanensis. The average value for CD4 count in these patients was lower than or equal to 100 cells/mm3. The oocysts were detected in smears from stool samples stained with modified acid-fast or safranin technique. Light microscopy revealed parasites in the enterocytes and these parasites were associated with villous atrophy. Cyclospora cayetanensis infection might be an important cause of diarrhea in patients with AIDS in Argentina.
Subject(s)
Humans , Animals , Male , Adult , Acquired Immunodeficiency Syndrome/parasitology , Cyclospora/isolation & purification , Cyclosporiasis/complications , Diarrhea/parasitology , Chronic Disease , Cyclosporiasis/diagnosis , Feces/parasitologyABSTRACT
O artigo não apresenta resumo.
ABSTRACT
O artigo não apresenta resumo.
ABSTRACT
Se presenta el caso de una un paciente de 36 años, cuyo motivo de consulta fue visión borrosa y dolor ocular severo de 5 semanas de evolución, en ojo izquierdo. La paciente tenia como hábito el uso de lentes de contacto blandas con higiene inadecuada. Fue sometida a exámenes bacteriológicos y virológicos con resultados negativos. Para el presente estudio se extrajo material obtenido a través de una biopsia de córnea. Se realizó observación microscópica en fresco y con colorantes permanentes. Por medio de cultivos xénicos, se obtuvo trofozoitos y quistes de Acanthamoeba spp: Las colonias fueron observadas con microscopía óptica en fresco y con contraste de fases. Por MET (microscopía electrónica de transmisión) se analizó la ultraestructura de la ameba.
Subject(s)
Humans , Adult , Female , Acanthamoeba , Acanthamoeba Keratitis , Contact Lenses, Hydrophilic/parasitology , Microscopy, ElectronABSTRACT
The aim of this study was to investigate the possible interactions between the nociceptive system, the sympathetic system and the inflammatory process. Thus, the superior cervical ganglion of rats was submitted to chronic inflammation and Fos expression was used as a marker for neuronal activity throughout central neurons following painful peripheral stimulation. The painful stimulus consisted of subcutaneously injected formalin applied to the supra-ocular region. Fos-positive neurons were identified by conventional immunohistochemical techniques, and analyzed from the obex through the cervical levels of the spinal cord. In the caudal sub-nucleus of the spinal trigeminal nuclear complex, the number of Fos-positive neurons was much higher in rats with inflammation of the superior cervical ganglion than in control rats, either sham-operated or with saline applied to the ganglion. There was a highly significant difference in the density of Fos-positive neurons between the inflamed and control groups. No significant difference was found between control groups. These results suggest that the inflammation of the superior cervical ganglion generated an increased responsiveness to painful stimuli, which may have been due to a diminished sympathetic influence upon the sensory peripheral innervation
Subject(s)
Animals , Rats , Male , Central Nervous System/physiopathology , Proto-Oncogene Proteins c-fos/metabolism , Superior Cervical Ganglion , Autonomic Nervous System/physiopathology , Biomarkers , Chronic Disease , Inflammation , Neurons/metabolism , Pain/physiopathology , Rats, Inbred Strains , Rats, Wistar , Stimulation, Chemical , Sympathetic Nervous System/physiopathology , Trigeminal Nucleus, SpinalABSTRACT
A cavidade natural da bexiga natatória de Oreochromis niloticus (Tilápia-do-Nilo), pesando entre 100 e 150g, foi utilizada para o estudo da cinética celular inflamatória induzida pela carragenina (n=42). A injeçäo de 0,1ml do irritante (0,5 por cento) na luz da bexiga natatória determinou um processo inflamatório caracterizado por congestäo e edema de sua parede e migraçäo de células, predominantemente mononucleares, para a cavidade. Este fenômeno teve início 3 horas após a injeçäo do irritante, atingindo um máximo às 24 horas. Para caracterizar as células inflamatórias que migraram para a cavidade do órgäo, foi realizada uma análise das células sangüíneas desses animais em nível de microscopia de luz comum e eletrônica. Pode-se demonstrar que as células que migraram para a luz da bexiga natatória após diferentes tempos da injeçäo do irritante eram predominantemente trombócitos. Poucos macrófagos, linfócitos, granulócitos e outras células näo caracterizadas morfofuncionalmente também faziam parte do exsudato
Subject(s)
Animals , Carrageenan/pharmacokinetics , Fishes/physiologyABSTRACT
A inflamacao glanulomatosa e o substrato morfologico de uma variedade de doencas infecciosas importantes tais como tuberculose, lepra, esquistossomose e outras. Embora muitos aspectos deste tipo especial de inflamacao sejam conhecidos, questoes fundamentais referentes a formacao do granuloma, persistencia, destino e significado da relacao hospedeiro-parasita permanecem para serem elucidados...
Subject(s)
Granulomatous Disease, Chronic/immunology , Granuloma/pathology , Macrophages/immunology , Granulomatous Disease, Chronic/etiology , Granulomatous Disease, Chronic/immunology , Macrophages/physiologyABSTRACT
Lactentes desnutridos com diarréia apresentam balanço energético negativo nos primeiros dias de internaçäo. A estimativa da energia ingerida, da energia fecal e do gasto energético de repouso tornam-se extremamente úteis no planejamento do fornecimento calórico diário para essas crianças. Estudaram-se 13 lactentes(10 do sexo masculino) com idades inferiores a 12 meses, desnutridos com diarréia, em 3 ocasiöes durante a internaçäo: no período inicial (PI), na recuperaçäo (PR) e no período de alta (PA). As ingestöes e perdas, diárias de energia foram calculadas a partir dos conteúdos energéticos de leite, urina e fezes que foram determinadas por bomba calorimétrica. O gasto energético de repouso (GER) foi medido por calorimetria indireta. No PI a ingestäo diária correspondeu à metade do PA (59,7 ñ 12,2 vs. 132,9 ñ 27,9 Kcal/Kg, -p (menor que) 0,05). O GER aumentou no PR significativamente (71,1 ñ 11.4 vs. 58,3 ñ 10,9 Kcal/kg, p (menor que) 0.05). Os balanços médicos de energia foram significativamente diferentes nos 3 períodos: PI= -21 ñ 20; pr= 29 ñ 22; PA 29ñ 22; PA= 52 ñ 21 Kcal/Kg/dia, p (menor que) 0,01. Em conclusäo pode-se afirmar que o balanço negativo de energia no PI foi consequente a menor ingestäo e a maior perda fecal (proporcionalmente ao ingerido) de energia. Os balanços efetuados durante a recuperaçäo hospitalar desses pacientes foram úteis como fonte de informaçöes para um adequado tratamento nutricional
Subject(s)
Humans , Male , Female , Infant , Energy Metabolism , Infant Nutrition Disorders/complications , Calorimetry , Diarrhea, Infantile/complicationsSubject(s)
Mice , Animals , Macrophages/physiology , Mycobacterium leprae/physiology , Phagocytosis/physiology , Cell Count , Mice, Inbred BALB CABSTRACT
After inflammation was induced in the foot-pad of rats with nistatin or BCG, injection of "non-activated" homologous plasma at the inflamed site caused a significant increase in the vascular permeability of the lesions (Evans blue test), which was more intense in older lesions, increasing from 7.83 + or - 1.11 to 8.70 + or - 1.18 (nistatin, 4 and 21 days) and 7.30 + or - 0.66 to 7.54 + or - 0.80 (BCG, 4 and 21 days). Steroidal (acetyltriamcinolone, 25 mg/kg) and non-steroidal (indomethacin, 2 mg/kg) anti-inflammatory drugs markedly decreased this effect on 14-day old lesions induced by nistatin plus "non-activated" plasma (2.37 + or - 0.10 for acetyltriamcinolone treatment vs 8.15 + or - 1.22 for untreated animals; 3.34 + or - 0.41 for indomethacin treatment vs 8.15 + or - 1.22 for untreated animals) and BCG plus "non-activated" plasma (1.67 + or - 0.11 for acetyltriamcinolne treatment vs 10.27 + or - 0.52 for untreated animals; 5.87 + or - 0.35 for indomethacin treatment vs 9.14 + or - 0.23 for untreated animals). These data suggest that an increase in exudation in chronic lesions might result in "reactivation" of the process as observed clinically, for example, in rheumatoid arthritis in man
Subject(s)
Anti-Inflammatory Agents/therapeutic use , Capillary Permeability/drug effects , Inflammation/etiology , Mycobacterium bovis , Mycobacterium bovis/immunology , Plasma , Evans Blue , Inflammation/pathology , Nystatin/pharmacology , Rats, Inbred StrainsABSTRACT
Hamsters inoculated with BCG become responsive to dead Mycobacterium leprae. The response is characerized by a typical perineural granulomatous reaction, observed 16 days after the injection of a suspension of dead M. leprae into the foot pad of animals previously sensitized with BCG
Subject(s)
Cricetinae , Animals , Antigens, Bacterial/immunology , Leprosy/immunology , Mycobacterium bovis/immunology , Mycobacterium leprae/immunology , Granuloma/pathology , Intradermal TestsABSTRACT
1. this oaoer describes the effect if homologous plasma in contact with connective tissue on vascular perveability, edema and cell migration. 2. The contact of "non-activated"plasma with connective tissue structures does not tesults in generation of mediators responsible for increase in vascular premeability or in edema. 3. "Activated" plasma is able to induce vascular permeability and edema when in contact with connective tissue components. 4. Injection of "non-activated" or "activated" plasma induced a mild inflammatory cell migration