ABSTRACT
Metronidazole can cause adverse effects both in the central and peripheral nervous system. We report a 34-year-old female who presented a reversible cerebellar syndrome and peripheral neuropathy as an adverse effect associated with the use of metronidazole. Brain magnetic resonance imaging (MRI) showed hyperintense T2 and FLAIR bilateral symmetrical cerebellar lesions, without contrast enhancement or mass effect, isointense in diffusion-weighted imaging and hypointense in apparent diffusion coefficient sequences. Also, electrophysiological evaluation was consistent with axonal polyneuropathy. She had received metronidazole for a liver abscess during 49 days. After discontinuation of metronidazole, she had rapid regression of cerebellar symptoms and normalization of MRI, with subsequent disappearance of peripheral symptoms. The brain MRI, electromyography and nerve conduction studies performed at 35 months later showed complete resolution of the lesions. Although metronidazole neurotoxicity is a rare event, it must be borne in mind because the prognosis is usually favorable after stopping the drug.
Subject(s)
Adult , Female , Humans , Antiprotozoal Agents/adverse effects , Cerebellar Diseases/chemically induced , Metronidazole/adverse effects , Peripheral Nervous System Diseases/chemically induced , Liver Abscess/drug therapy , Magnetic Resonance ImagingABSTRACT
We evaluated the sperm parameters such as cauda epididymis weight, sperm count, sperm morphology and sperm DNA stability of adult CF-1 male mice treated daily (oral exposure) with the toxic sodium arsenite (As, 7.0 mg/kg/body weight); Melatonin (Me, 10.0 mg/kg/bw), Me (10.0 mg/kg/bw) plus As (7.0 mg/kg/bw) and Negative Control (NaCl 0.9 percent) to assess acute (8.3 days), chronic (33.2 days) and recovery of testicular damage (66.4 days). Arsenic decreases the number of sperm from chronic treatment (33.2 days) and this effect continued until 66.4 days of treatment. The toxic effect of As also altered the morphology of spermatozoa in all treatment periods when compared to the negative control group. However, Metalonin induced protective effects in periods of 33.2 and 66.4 days of treatment. Additionally, the stability of DNA was significantly affected by arsenic in all periods, but the chronic treatment (33.2 days) in the AsMe revealed increased stability compared to the group treated with arsenic only. Melatonin partially protects sperm toxicity caused by Arsenic, especially during periods of 33.2 and 66.4 days.
Se evaluaron los parámetros espermáticos como peso de la cola del epidídimo, conteo de espermatozoides, morfología de los espermatozoides y estabilidad del ADN de espermatozoides de ratones machos adultos CF-1 tratados diariamente (exposición oral) con el tóxico arsenito de sodio (As, 7,0 mg/kg/peso corporal), melatonina (Me, 10,0 mg/kg/pc, Me (10,0 mg/kg/pc) más As (7,0 mg/kg/pc) y el Control Negativo (NaCl 0,9 por ciento) en evaluación aguda (8,3 días), crónica (33,2 días) y recuperación del daño testicular (66.4 días). El arsénico reduce el número de espermatozoides en el tratamiento crónico (33,2 días) y este efecto continuó hasta 66,4 días. El efecto tóxico de As también altero la morfología de los espermatozoides en todos los períodos de tratamiento cuando se compara con el grupo control negativo. Sin embargo, metalonina indujo efectos protectores en períodos de 33,2 y 66,4 días de tratamiento. La estabilidad del ADN se vio afectada significativamente por el arsénico en todos los periodos, pero en el tratamiento crónico (33,2 días) con AsMe se observa un aumento de la estabilidad em comparación com el grupo tratado con arsénico. Sin embargo, la melatonina protege parcialmente a los espermatozoides del daño causado por arsénico, especialmente durante los períodos de 33,2 y 66,4 días.
Subject(s)
Male , Animals , Mice , Antioxidants/pharmacology , Testicular Diseases/chemically induced , Spermatozoa , Spermatozoa/pathology , Melatonin/pharmacology , Arsenites/toxicity , Sodium Compounds/toxicity , Epididymis , Epididymis/pathology , Sperm Count , Protective Agents/pharmacologyABSTRACT
Arsenic is a testicular environmental toxic. Melatonin (Me), being a potent antioxidant, may reduce the damage caused by arsenic in male fertility. The effects of daily oral exposure of Sodium Arsenite (As; 7.0 mg/kg/bw); Melatonin (Me, 10.0 mg/kg/bw); Me (10.0 mg/kg/bw) plus As (7.0 mg/kg/bw), and Negative Control (NaCl 0.9 percent) in male CF-1 adult mice were assessed in acute (8.3 days), chronic (33.2 days) and recovery (66,4 days) of testicular damage. We evaluated changes in testicular weight and histopathological, morphometric measurements, expression of COX-2 and Androgen Receptor (AR) antigens and lipid peroxidation levels. Treatment resulted in decreased tubular diameter and AR expression, and increased: interstitial area, luminal diameter, COX-2 expression levels and of lipid peroxidation. Co-administration of As and Me partially decreased germ cell degeneration and AR expression levels, improving testicular histopathological parameters. These results indicate that As causes toxicity and testicular germ cell degeneration by induction of oxidative stress. Me partially protects from this damage in mouse testis, acting as scavenger of oxygen radical species.
El arsénico es un tóxico testicular ambiental. La melatonina (Me), que es un potente antioxidante, puede reducir el daño causado por el arsénico en la fertilidad masculina. Se evaluaron los efectos de la exposición oral diaria de arsenito de sodio (As; 7,0 mg/kg/peso corporal), melatonina (Me, 10,0 mg/kg/p.c.); Me (10,0 mg/kg/p.c.) más As (7,0 mg/kg/pc) y el Control Negativo (NaCl 0,9 por ciento) en ratones adultos CF-1 machos, a los 8,3 días (exposición aguda), 33,2 días (crónica) y 66,4 días (recuperación) del daño testicular. Se evaluaron los cambios en el peso testicular y mediciones morfométricas, histopatológicas, expresión de COX-2, del receptor de andrógeno (AR) y los niveles de peroxidación de lípidos. El tratamiento con As resultó en disminución del diámetro tubular y la expresión de AR, y el aumento de: área intersticial, diámetro luminal, los niveles de expresión de COX-2 y peroxidación lipídica. La co-administración de As y Me disminuyó parcialmente la degeneración de células germinales, el aumento de los niveles de expresión de AR y hubo mejoría de los parámetros histopatológicos testiculares. Estos resultados indican que As es tóxico y causa degeneración de células germinales por inducción de estrés oxidativo. Me protege parcialmente este daño en los testículos de ratones, actuando como eliminador de especies radicalarias del oxígeno.
Subject(s)
Male , Animals , Mice , Antioxidants/administration & dosage , Arsenites/toxicity , Spermatogenesis , Infertility, Male/chemically induced , Melatonin/administration & dosage , Infertility, Male/prevention & control , Lipid Peroxidation , Oxidative Stress , Receptors, Androgen , TestisABSTRACT
Objetivo: Evaluar la gestión de los Hospitales de la Solidaridad y comparar los resultados con la satisfacción de los usuarios externos. Métodos: Se desarrolló un estudio aplicativo, de diseño observacional de corte transversal, se analizaron a los Hospitales de la Solidaridad mediante cuatro variables de evaluación del desempeño de la gestión hospitalaria (supervisión, producción, ingresos y perfil del gestor), el puntaje obtenido por los Hospitales fue contrastado con los resultados encontrados en las encuestas de satisfacción del usuario externo según la metodología del SERVQUAL de los años 2011 y 2012. Resultados: A) El Sistema Metropolitano de la Solidaridad en la variable supervisión tiene una calificación cualitativa "regular". B) Existe una tendencia creciente de la producción e ingresos. C) Existe una variación con tendencia decreciente de la satisfacción de los usuarios externos de 70 por ciento en el 2012 a 49 por ciento en el 2011. D) No existe relación entre los resultados de la evaluación del desempeño de la gestión hospitalaria y los resultados de las encuestas de satisfacción de los usuarios externos. Conclusiones: Los Hospitales de la Solidaridad consisten en un modelo de gestión, donde los servicios de salud se brindan con participación de asociados o microempresas de médicos, en ese sentido, es necesario adecuar o elaborar instrumentos de evaluación para este tipo de servicios de salud, de modo tal que se pueda efectuar estudios comparados entre este y otros prestadores de salud.
Subject(s)
Hospital Administration , Hospitals, Municipal/organization & administration , Observational Study , Cross-Sectional StudiesABSTRACT
La incorporación del marco teórico de la ciencia ocupacional en el abordaje de los conflictos emergentes que se presentan al desarrollo profesional del Terapeuta Ocupacional en el área de la psiquiatría y salud mental, brinda el fundamento para diagnosticar, evaluar, y restablecer las situaciones disfuncionales en que ven involucradas las personas. El estudio presentado describe las interferencias ocupacionales como consecuencia de un estrés post traumático, en mujeres que han sufrido un asalto en la vía publica. Se recuerda el evento, sucedido con anterioridad entre 3 y 6 meses, se analizan las acciones que ocasionan mayor impacto y se reflexiona sobre la directa proporcionalidad entre retomar las ocupaciones y la recuperación de la seguridad.
The inclusion of Occupational Science as a theory to address new conflicts found in the course of professional development of occupational therapists in the area of mental health and psychiatry gives the foundation for diagnosis, evaluation, and recovery from dysfunctional circumstances in which people feel involved. This study describes the negative impact that Post Traumatic Stress Disorder had on occupational lives of women who were assaulted in public streets. These events are described after three to six month they took place. An analysis of the actions that produced more impact and a reflection about the direct relationship between engaging again in occupations and confidence recovery are highlighted in this paper.
Subject(s)
Humans , Female , Adolescent , Adult , Middle Aged , Adaptation, Psychological , Crime Victims , Women/psychology , Occupations , Stress Disorders, Post-Traumatic , Interviews as Topic , Qualitative Research , Social AdjustmentABSTRACT
Subacute sclerosing panencephalitis is an infrequent central nervous system viral disease and is a late manifestation of persistent infection by a mutant form of measles virus. Since it affects mainly children and teenagers, the diagnosis in older ages is difficult. Its main clinical symptoms are cognitive impairment, behavioral disturbances and myoclonia. We report two males, aged 21 and 22 years old, presenting with the disease with atypical manifestations. One had a catatonic syndrome and the other, amaurosis. The recognition of the different presentation forms of the disease, endemic in developing countries, allows an earlier diagnosis and a more efficient treatment, when available
Subject(s)
Humans , Male , Adult , Subacute Sclerosing Panencephalitis/etiology , SSPE Virus/pathogenicity , Subacute Sclerosing Panencephalitis/diagnosis , Subacute Sclerosing Panencephalitis/drug therapy , SSPE Virus/drug effects , Inosine Pranobex/therapeutic use , Myoclonus/etiology , Myoclonus/drug therapy , Valproic Acid/therapeutic use , Magnetic Resonance SpectroscopyABSTRACT
Background: The high costs of adequate pharmacological treatment for Parkinson disease preclude the universal access of patients to this medication. Aim: To assess the accessibility to pharmacological treatment of Chilean patients with Parkinson disease. Patients and methods: An inquiry about socioeconomic stratification, medical controls, disease features and costs of pharmacological therapy, was applied to 95 patients (56 male, aged 32 to 89 years old) attending the Chilean League Against Parkinson Disease. Results: Among studied patients, the disease had a mean duration of 7.9ñ6 years. There was a direct relationship between family income, the frequency of visits to physicians and the dose and cost of pharmacological therapy. Conclusions: The accessibility to pharmacological therapy among patients with Parkinson disease, depends on their socioeconomic level. Measures to correct this situation and improve the quality of life of these patients should be undertaken by health services
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Parkinson Disease/drug therapy , Parkinson Disease/epidemiology , Antiparkinson Agents/economics , Social Class , Levodopa/adverse effects , Drug Costs/statistics & numerical data , Cost of Illness , Income , Socioeconomic SurveyABSTRACT
The features of refractory epilepsies and the role of functional surgery and new antiepileptic drugs is reviewed. Among the latter, gabapentin, a drug with peculiar pharmacokinetic properties, is highlighted as a therapeutic alternative in refractory epilepsies and eventually for epileptic patients without previous treatment. A new type of relationship between the pharmaceutical industry and physicians, that privileges clinical research is discussed
Subject(s)
Humans , Epilepsy/drug therapy , Anticonvulsants/pharmacology , Drug Interactions/physiology , Epilepsy/surgery , gamma-Aminobutyric Acid/analogs & derivativesSubject(s)
Humans , Epilepsy/diagnosis , Anticonvulsants/administration & dosage , Diagnosis, Differential , Electroencephalography/methods , Epilepsy, Tonic-Clonic/diagnosis , Epilepsies, Partial/diagnosis , Epilepsy, Absence/diagnosis , Epilepsy, Generalized/diagnosis , Epilepsy/drug therapy , Epilepsy/physiopathologySubject(s)
Humans , Male , Female , Adult , Epilepsy/diagnosis , Anticonvulsants/administration & dosage , Diagnosis, Differential , Electroencephalography , Epilepsy, Tonic-Clonic/diagnosis , Epilepsies, Partial/diagnosis , Epilepsy, Absence/diagnosis , Epilepsy, Generalized/diagnosis , Epilepsy/therapy , Status Epilepticus/diagnosis , Phenytoin/pharmacokinetics , Seizures, Febrile/diagnosis , Seizures/diagnosis , Syncope/diagnosisSubject(s)
Adult , Humans , Female , Thrombosis , Cerebrovascular Disorders , Coronary Disease , Hypertension , Skin ManifestationsABSTRACT
Se revisan las características farmacológicas clínicas de la Carbamazepina y se hace hincapié en las dificultades de índole práctica que ocasiona el uso de este fármaco antiepiléptico