ABSTRACT
Introducción: La coinfección de COVID-19 con otros patógenos respiratorios en pediatría ha sido poco estudiada. Resulta de interés conocer las características y cuadro clínico de pacientes que presenten coinfecciones con COVID-19. Objetivo: Estudiar la coinfección de SARS-CoV-2 con patógenos incluidos en el Panel RP 2.0 FilmArray® en muestras de pacientes pediátricos en un hospital del tercer nivel. Materiales y métodos: Durante abril a agosto de 2021 se realizó un estudio prospectivo descriptivo sobre 21 muestras de Hisopado Nasofaríngeo de pacientes pediátricos positivos para SARS-CoV-2 (iAMP® COVID-19 Detection Kit de Atila Biosystems). Se procesaron por PCR multiplex Filmarray® RP 2.0. Luego se describieron las características y síntomas de los pacientes. Resultados: 12/21 (60%) fueron pacientes ambulatorios y 8/21 (40%) internados. El 57% de los pacientes fueron mayores de 5 años, el 24% menores de 1 año y el 19% entre 1 y 5 años. El síntoma más frecuente fue fiebre 18/21 (86%). El 90,5% (19/21) de las muestras no mostraron detección de otros patógenos. En una muestra se detectó Rhino/enterovirus y en otra Coronavirus NL63; ambas pertenecieron a dos pacientes con enfermedades de base. Conclusión: La tasa de coinfecciones fue del 9,5%. Este número podría deberse a la baja circulación de patógenos respiratorios en un contexto con medidas de prevención de los contagios. En el estado actual de incremento de circulación de virus respiratorios endémicos, es de interés la búsqueda de coinfecciones con COVID-19
Introduction: The co-infection of COVID-19 with other respiratory pathogens in pediatrics has been little studied. It is of interest to know the characteristics and clinical picture of patients who present co-infections with COVID-19. Objective: To study the co-infection of SARS-CoV-2 with pathogens included in the RP Panel 2.0 FilmArray® in samples from pediatric patients in a third-level hospital. Materials and methods: During April to August 2021, a prospective descriptive study was conducted on 21 Nasopharyngeal Swab samples from pediatrics patients positive for SARS-CoV-2 (iAMP® COVID-19 Detection Kit from Attila Biosystems). They were processed by PCR multiplex Filmarray® RP 2.0. The characteristics and symptoms of the patients were then described. Results: 12/21 (60%) were outpatients and 8/21 (40%) were hospitalized. 57% of patients were older than 5 years, 24% under 1 year and 19% between 1 and 5 years. The most frequent symptom was fever 18/21 (86%). 90,5% (19/21) of the samples showed no detection of other pathogens. Rhino/enterovirus was detected in one sample and NL63 in another Coronavirus; both belonged to two patients with underlying diseases. Conclusion: The rate of co-infections was 9,5%. This number could be dueto the low circulation of respiratory pathogens in a context with measures to prevent contagion. In the current state of increased circulation of endemic respiratory viruses, the search for co-infections with COVID-19 is of interest
Subject(s)
Coinfection , SARS-CoV-2 , PediatricsABSTRACT
OBJECTIVES: To prospectively evaluate demographic, anthropometric and health-related quality of life (HRQoL) in pediatric patients with laboratory-confirmed coronavirus disease 2019 (COVID-19) METHODS: This was a longitudinal observational study of surviving pediatric post-COVID-19 patients (n=53) and pediatric subjects without laboratory-confirmed COVID-19 included as controls (n=52) was performed. RESULTS: The median duration between COVID-19 diagnosis (n=53) and follow-up was 4.4 months (0.8-10.7). Twenty-three of 53 (43%) patients reported at least one persistent symptom at the longitudinal follow-up visit and 12/53 (23%) had long COVID-19, with at least one symptom lasting for >12 weeks. The most frequently reported symptoms at the longitudinal follow-up visit were headache (19%), severe recurrent headache (9%), tiredness (9%), dyspnea (8%), and concentration difficulty (4%). At the longitudinal follow-up visit, the frequencies of anemia (11% versus 0%, p=0.030), lymphopenia (42% versus 18%, p=0.020), C-reactive protein level of >30 mg/L (35% versus 0%, p=0.0001), and D-dimer level of >1000 ng/mL (43% versus 6%, p=0.0004) significantly reduced compared with baseline values. Chest X-ray abnormalities (11% versus 2%, p=0.178) and cardiac alterations on echocardiogram (33% versus 22%, p=0.462) were similar at both visits. Comparison of characteristic data between patients with COVID-19 at the longitudinal follow-up visit and controls showed similar age (p=0.962), proportion of male sex (p=0.907), ethnicity (p=0.566), family minimum monthly wage (p=0.664), body mass index (p=0.601), and pediatric pre-existing chronic conditions (p=1.000). The Pediatric Quality of Live Inventory 4.0 scores, median physical score (69 [0-100] versus 81 [34-100], p=0.012), and school score (60 [15-100] versus 70 [15-95], p=0.028) were significantly lower in pediatric patients with COVID-19 at the longitudinal follow-up visit than in controls. CONCLUSIONS: Pediatric patients with COVID-19 showed a longitudinal impact on HRQoL parameters, particularly in physical/school domains, reinforcing the need for a prospective multidisciplinary approach for these patients. These data highlight the importance of closer monitoring of children and adolescents by the clinical team after COVID-19.
Subject(s)
Humans , Male , Child , Adolescent , COVID-19/complications , Quality of Life , Prospective Studies , Tertiary Care Centers , COVID-19 Testing , SARS-CoV-2 , Latin AmericaABSTRACT
RESUMEN Objetivo. Evaluar el efecto de dosis crecientes del glucósido cianogénico Linamarina, en la reducción de metano ruminal in vitro. Materiales y Métodos. Se empleó líquido ruminal de dos ovejas fistuladas de la raza Merino Precoz, con el que se inoculó un sustrato fermentativo constituido por heno de alfalfa (Medicago sativa) y grano de avena molido (Avena sativa L.), se adicionó solución buffer y Linamarina (pureza de ≥98%) en dosis crecientes, lo que se llevó a incubación por ocho horas in vitro. El metano se midió cada hora, con un monitor de gases infrarrojo. Resultados. De acuerdo con el incremento de las dosis de Linamarina (0, 6, 13, 20 y 26 mg/L), la concentración de metano disminuyó de forma lineal (p≤0.05) en (9.7, 9.2, 18.1 y 29.4%) respectivamente. Se observó una reducción significativa de metano con la dosis más alta de Linamarina. Conclusión. La Linamarina, en su estado puro, fue eficaz en la reducción de metano durante la fermentación ruminal in vitro. Por lo tanto, este estudio constituye una base para futuros experimentos que incluyan fuentes vegetales de Linamarina y otras variables ruminales, lo que puede conducir a encontrar estrategias para reducir los gases de efecto invernadero.
ABSTRACT Objective. To assess the effect of rising doses of the cyanogenic glucoside Linamarin on the reduction of in vitro rumen methane. Materials and methods. Rumen fluid from two fistulated Merino Precoz sheep, inoculated with a fermentation substrate comprising alfalfa hay (Medicago sativa) and ground oat grain (Avena sativa L.), and added with buffer solution and Linamarin (purity ≥98%) in rising doses, was incubated for eight hours in vitro. Methane was measured each hour with an infrared gas monitor. Results. According Linamarin doses were increased (0, 6, 13, 20 and 26 mg/L), the methane concentration fell in a linear manner (p≤0.05) by (9.7, 9.2, 18.1 and 29.4%), respectively. A significant reduction of methane was seen whit the highest dose of Linamarin. Conclusions. Linamarin, in pure state, was effective to reduce methane during in vitro ruminal fermentation. Therefore, this study constitutes a basis for future experiments including vegetable sources of Linamarin as well as other rumen variables, leading to find a strategy for reducing greenhouse gases.
Subject(s)
In Vitro Techniques , Food Additives , Glucosides , Methane , FermentationABSTRACT
Abstract Objective: To describe and analyze indicators of feeding practices related to breastfeeding and factors associated with exclusive breastfeeding (EBF) in a subnormal urban cluster (slums) in Pernambuco, Brazil. Methods: Four breastfeeding indicators were used to interview mothers of children under 3 years of age. An inventory of the families' socioeconomic and environmental factors, maternal obstetric history, and basic health care access was undertaken. The sample consisted of all 310 children under the age of 3 years from Coelhos, PE, Brazil. Spearman's correlation was carried out, as well as crude and adjusted prevalence ratios for a final statistical model that showed associated factors with the main outcome at a level of 0.05. Results: The prevalence of breastfeeding in the first hour of life, exclusive breastfeeding up to 6 months, continued breastfeeding at 1 year, and continued breastfeeding at 2 years were 60.2%, 32.9%, 45.9, and 35.9%, respectively. A correlation was observed between start of pacifier use and duration of either exclusive (r s = 0.358 [p < 0.001]) or non‐exclusive breastfeeding (r s = 0.248 [p = 0.006]). Maternal age over 35 years (p < 0.001), home visit in the first week after birth (p = 0.003), having had a male baby (p = 0.029), and not using a pacifier (p < 0.001) remained protective factors in the final model. Conclusion: The prevalence rates of exclusive breastfeeding at 6 months were well above the results obtained by other Brazilian authors. Home visit and maternal age prevailed as protective factors, while pacifier use was shown to be a discouraging practice.
Resumo Objetivo: Descrever e analisar indicadores das práticas relacionadas ao aleitamento materno e fatores associados ao aleitamento materno exclusivo em um aglomerado urbano subnormal (favela) em Pernambuco. Métodos: Foram usados quatro indicadores do aleitamento materno mediante entrevista com as mães de menores de três anos. Fez-se um inventário de fatores socioambientais das famílias, antecedentes obstétricos e acesso às ações básicas de saúde. A amostra inclui todas as 310 crianças da Comunidade de Coelhos, PE, Brasil. Feitas correlação de Spearman e razões de prevalências brutas e ajustadas que compuseram um modelo estatístico final que evidenciou os fatores associados ao principal desfecho ao nível de 0,05. Resultados: A prevalência do aleitamento materno na primeira hora de vida, aleitamento materno exclusivo aos 6 meses, amamentação continuada até um ano e dois anos foram, respectivamente, 60,2%, 32,9%, 45,9% e 35,9%. Na correlação entre o início do uso de chupeta e a duração do aleitamento, exclusivo ou não, obtiveram-se respectivamente os coeficientes rs = 0,358 (p < 0,001) e rs = 0,248 (p = 0,006). No modelo final permaneceram como fatores de proteção: a idade materna acima de 35 anos (p < 0,001), a visita domiciliar na primeira semana de vida (p = 0,003), o sexo masculino (p = 0,029) e o não uso da chupeta (p < 0,001). Conclusão: Os índices de prevalência do aleitamento materno exclusivo aos 6 meses foram bem superiores aos resultados obtidos por outras pesquisas nacionais. A visita domiciliar e a idade materna prevaleceram como fatores de proteção e o uso de chupeta como uma prática desestimulante.
Subject(s)
Humans , Female , Infant, Newborn , Infant , Breast Feeding/statistics & numerical data , Family Health , National Health Programs , Socioeconomic Factors , Urban Population , Brazil/epidemiology , Cluster Analysis , Prevalence , Cross-Sectional Studies , PacifiersABSTRACT
ABSTRACT Objective. Determine the presence of antibodies and viral genomes of EHV-1 and EHV-4, as well as to detect the presence of latency associated transcripts (LATs) in a selected population of Colombian horses. Materials and methods. Serum samples, submandibular lymph nodes and trigeminal ganglion were obtained from 50 horses and analyzed. Sera were evaluated for the presence of antibodies against EHV-1 and EHV-4 while tissues were initially evaluated for the presence of viral genome by nPCR. Finally, samples were used for the detection of LATs through RT-PCR. Results. In general, 6/50 samples showed antibodies to EHV-1 and 44/50 were positive for EHV-4. As for viral genome detection, 10/50 samples were positive for EHV-1 and 30/50 were positive for EHV-4; in addition, 22/35 horses positive for EHV DNA were positive for LATs. The use of these tests led to eight possible combinations of results. Conclusions. The evidence used shows that horses can have simple viral infection, co-infections with both viruses, latency due to the presence of LATs and the simultaneous presence of LATs and viral genome replication at a given time. It contributes to the understanding of the behavior of the disease in Colombia and calls attention to the importance of implementing complementary diagnoses to the serology for the control of these viruses.
RESUMEN Objetivo. Determinar presencia de anticuerpos y genoma viral de EHV-1 y EHV-4, como también detectar la presencia de transcriptos asociados a latencia (LATs) en una población seleccionada de caballos colombianos. Materiales y métodos. Muestras de suero, nódulos linfáticos submandibulares y ganglio trigémino se obtuvieron de 50 caballos y fueron analizadas. Los sueros se evaluaron para la presencia de anticuerpos contra EHV-1 y EHV-4 mientras que los tejidos se evaluaron inicialmente para la presencia de genoma viral por nPCR. Finalmente, las muestras se emplearon para la detección de LATs a través de RT-PCR. Resultados. En general, 6/50 muestras mostraron anticuerpos para EHV-1 y 44/50 fueron positivos para EHV-4. En cuanto a la detección del genoma viral, 10/50 muestras fueron positivas para EHV-1 y 30/50 fueron positivas para EHV-4; además, 22/35 caballos positivos para DNA de EHV fueron positivos para LATs. El empleo de estas pruebas llevó a ocho posibles combinaciones de resultados. Conclusiones. Se confirma la presencia de estos virus en la población equina colombiana. Las pruebas empleadas demuestran que los caballos pueden tener infección viral simple, co-infecciones con ambos virus, estado de latencia debido a la presencia de los LATs y presencia simultánea de LATs y de replicación de genoma viral en un momento dado. Se aporta al entendimiento del comportamiento de la enfermedad en Colombia y se llama la atención sobre la importancia de implementar diagnósticos complementarios a la serología para el control de estos virus.
Subject(s)
Animals , Polymerase Chain Reaction , Virus Latency , Herpesvirus 1, Equid , Herpesvirus 4, Equid , HorsesABSTRACT
@#Several challenges relating to the diagnosis and treatment of malaria led to the World Health Organization's (WHO) new initiative of Test, Treat and Track (T3). This study assessed adherence to the National Policy on Malaria T3 by workers in public and private hospitals in Abuja in North central Nigeria. This descriptive comparative cross-sectional study was carried out among 380 health care workers (HCW) selected using multi-stage sampling techniques. Of the 380 HCW, 206 (54.2%) and 174 (45.8%) were from the public and private health facilities respectively. Research instrument used were semi structure, self-administered questionnaire. Data was analyzed using the SPSS software version 17 .0. Sixty eight percent (140/206) of respondents from public facilities were aware of the malaria T3 policy compared to 49.4% (86/174) from the private facilities (p<0.05). In addition, 33.0% (68/206) and 29.9% (52/174) of HCW in the public and private health facilities respectively had been trained on the policy. Mean composite knowledge score of T3 policy was 23.8% for public and 27.0% for private health facilities. Using mean adherence scores, 49.4% of public and 45.0% of private facilities had good adherence to the malaria T3; a null hypothesis of no difference in their level of adherence was rejected (p 0.066). Availability of national guidelines (OR 2.2, 95% CI 1.200-4.000, p 0.01) and having been trained (OR 1.5, 95% CI 0.800-2.700, p 0.220) were predictors of adherence on logistic regression. Good awareness, poor knowledge and poor practice of adherence to malaria T3 policy was concluded, with knowledge and practice being more in the public than the private health facilities. The training gap underscores the need for in-depth training of health staff holistic implementation of the malaria T3 policy in Nigeria
ABSTRACT
El nifurtimox es un 5-nitrofurano sintético utilizado en el tratamiento dela enfermedad de Chagas. El objetivo de este estudio fue determinar la toxicidad celular y el daño del ADN causado por el nifurtimox en células Vero, J774, NIH/3T3 y THP-1. Se utilizó la coloración vital con azul tripan y elmétodo colorimétrico MTT para determinar la toxicidad y el ensayo cometa alcalino para determinar el daño al ADN. Los cometas fueron contadosen un microscopio de fluorescencia y el porcentaje de daño total del ADN fue calculado y clasificado de 0 (sin daño) a 4 (daño severo). En el ensayo de toxicidad, las células J774 fueron las líneas celulares más sensibles y las células THP-1 las menos sensibles al nifurtimox con valores de CC50 34,04-138,58 μg/ml y CC90 130,58->300 μg/ml de nifurtimox, respectivamente.En el ensayo cometa, el porcentaje de daño total de ADN a 100 μg/ml de nifurtimox fue 79,75%, 85,30% y 10,25% en células NIH/3T3, J774 y THP-1 respectivamente. En las células Vero el daño del ADN fue del 80% en células tratadas y no tratadas. El nifurtimox presentó toxicidad y genotoxicidad con actividades que dependieron del tipo de célula y de la concentración del medicamento utilizada. Es importante tomar en cuenta estas diferencias al realizar conclusiones finales de resultados obtenidos utilizando estos ensayos, especialmente el ensayo cometa...
Subject(s)
Humans , Cytotoxicity, Immunologic , Genotoxicity , NifurtimoxABSTRACT
Este documento sistematiza la experiencia desarrollada por el equipo docente de la escuela de Terapia Ocupacional, los estudiantes y los equipos de salud mental del Servicio de Salud Talcahuano, en los cuales se han instalado Terapeutas Ocupacionales para desarrollar funciones docentes asistenciales, en el marco de un convenio Marco entre ambas instituciones. Desde una epistemología socioconstruccionista, se presentan los fundamentos de una Terapia Ocupacional Social, al mismo tiempo, se describe una metodología de trabajo, basada en un instrumento para la intervención social, denominado Diagnóstico situacional. En este caso aplicado al campo de la salud mental, desde la Terapia Ocupacional (TO) Social. La experiencia otorga una visión compleja sobre los desafíos que se presentan en el ejercicio de la Terapia Ocupacional Social, rescatando los elementos éticos-políticos de esta perspectiva y su materialización, en consideración a los diversos actores e intereses involucrados en la construcción y configuración de los problemas que los sujetos de intervención, equipos de trabajo y estudiantes deben enfrentar. Se concluye con algunos de los principales logros y metas alcanzados con esta propuesta, destacando la posibilidad de encontrar espacios de transformación social, cuando se articulan adecuadamente las miradas de los actores...
This document systematizes the experience developed by the faculty of the School of Occupational Therapy, students and mental health teams Talcahuano Health Service, in which are installed care Occupational Therapists to develop teaching duties as part of a Framework agreement between the two institutions. From a social constructionist epistemology, the foundations of Occupational Therapy Social occur at the same time, a methodology, based on an instrument for social intervention, called Situational diagnosis is described. In this case applied to the field of mental health, since the Occupational Therapy (OT) Social. The experience gives a complex insight into the challenges that arise in the exercise of Social Occupational Therapy, rescuing this ethical-political perspective and its realization, considering the various actors and interests involved in the construction and configuration of the elements problems that subjects intervention teams and students must face. It concludes with some major accomplishments and goals achieved with this proposal, noting the possibility of finding spaces for social transformation, when the eyes of the actors adequately articulated...
Subject(s)
Humans , Community Mental Health Services , Diagnosis of Health Situation , Occupational Therapy/methods , Social AdjustmentABSTRACT
Emphysematous cystitis is found in diabetic patients and in individuals with urinary stasis and immunosuppression. We report a 58-year-old male with hypertension, type 2 Diabetes on insulin treatment and central nervous system vasculitis on immunosuppressive therapy. He was admitted with weight loss and gait instability. A PET-CT showed a circumscribed image of air in the bladder contour without involving the upper urinary tract, suggesting emphysematous cystitis. Re-interrogated, the patient referred pneumaturia, dysuria and febrile sensation one week before admission. Urine culture showed Enterobacter aerogenes. He was treated with a urinary catheter, metabolic control and parenteral antimicrobials. The patient was discharged without symptoms 21 days after admission, with the bladder catheter.
Subject(s)
Humans , Male , Middle Aged , Cystitis/diagnosis , Emphysema/diagnosis , Enterobacter aerogenes/isolation & purification , Enterobacteriaceae Infections/drug therapy , Cystitis/complications , Dysuria/etiology , Emphysema/complications , Imipenem/therapeutic use , Treatment Outcome , Urinary Incontinence, Urge/etiologyABSTRACT
OBJECTIVES: This review aimed to organize and consolidate the latest knowledge about mutations and genetic polymorphisms related to hereditary thrombophilia and their potential association with pediatric stroke and cerebral palsy (CP). SOURCES: Scientific articles published from 1993 to 2013, written in Portuguese, English, French, and Spanish, were selected and reviewed. The publications were searched in electronic databases, and also in the collections of local libraries. The terms "hereditary thrombophilia", "polymorphisms", "mutation", "pediatric strokes", and "cerebral palsy" were used for the research. SUMMARY OF THE FINDINGS: The search in databases and in the bibliographic references retrieved 75 articles for inclusion in this review. Studies that investigated hereditary thrombophilias and their associations to CP and arterial and venous pediatric stroke presented contradictory results. The meta-analysis and case-control studies that showed positive results for this association described only slightly increased relative risks and sometimes had questionable conclusions. The association of two or more hereditary thrombophilias, or the association between thrombophilia and other specific clinical risk factors, suggest a higher risk of CP and pediatric stroke than isolated hereditary thrombophilia. CONCLUSIONS: Larger, multicenter studies should be developed in order to elucidate the role of mutations leading to hereditary thrombophilia and the development of CP and pediatric stroke. The complex and multifactorial etiology of CP and stroke makes this an arduous and difficult task; however, the benefits generated by these studies are immeasurable. .
OBJETIVO: Sistematizar e integrar os últimos conhecimentos sobre mutações e polimorfismos genéticos relacionados às trombofilias hereditárias e suas potenciais associações com acidentes vasculares cerebrais pediátricos (AVC) e paralisia cerebral (PC). MATERIAL: Artigos científicos publicados de 1993 a 2013, escritos em português, inglês, francês e espanhol foram selecionados e revisados. As publicações foram pesquisadas nas bases de dados eletrônicas, como também nos acervos das bibliotecas locais. Os termos mutação, polimorfismos, trombofilias hereditárias, acidentes vasculares cerebrais pediátricos e paralisia cerebral foram usados para a pesquisa. RESULTADOS: A pesquisa nas bases de dados e nas referências bibliográficas identificou 75 artigos para inclusão nesta revisão. Os estudos que investigaram as trombofilias hereditárias e suas associações à PC e aos AVC pediátricos arteriais e venosos apresentaram resultados contraditórios. As metanálises e os estudos caso-controle que demonstraram resultados positivos para essa associação descreveram riscos relativos discretamente aumentados e, algumas vezes, questionáveis. A associação de duas ou mais trombofilias hereditárias, ou a junção de trombofilias específicas com demais fatores de riscos clínicos, sugerem maior risco no aparecimento da PC e do AVC pediátrico do que as trombofilias hereditárias isoladas. CONCLUSÃO: Estudos multicêntricos de grande porte devem ser conduzidos para elucidar o papel real das mutações que levam às trombofilias hereditárias e ao aparecimento da PC e AVC pediátricos. A etiologia multifatorial e complexa da PC e dos AVC torna essa tarefa árdua e difícil, porém, os benefícios gerados por esses estudos são incalculáveis. .
Subject(s)
Child , Child, Preschool , Humans , Infant , Infant, Newborn , Cerebral Palsy/complications , Stroke/complications , Thrombophilia/complications , Thrombophilia/genetics , Case-Control Studies , Intracranial Thrombosis/complications , Meta-Analysis as Topic , Mutation , Polymorphism, Genetic , Risk FactorsABSTRACT
INTRODUCCIÓN: Los nevus melanocíticos son proliferaciones benignas de células névicas. Los nevus melanocíticos congénitos (NMC) representan el 1 por ciento del total y según su tamaño se clasifican en pequeños, medianos o gigantes. PRESENTACIÓN DEL CASO: Paciente de sexo masculino, 6 años de edad, con NMC gigante en forma de traje de baño. Controlado en policlínico de Dermatología desde su nacimiento, se mantuvo en observación realizándose exámenes imagenológicos, biopsias de piel y nódulos. En reunión multidisciplinaria respecto al caso, se plantea tratamiento quirúrgico incisional por etapas. DISCUSIÓN: El manejo de los NMC es controversial, se describen múltiples terapias que incluyen escisión, dermoabrasión, ablación con láser, etc. Pero para disminuir el riesgo de malignización la única efectiva es la escisión, no siempre posible en los NMC gigantes. Para los NMC de pequeño o mediano tamaño se recomienda un manejo individualizado con evaluaciones periódicas con dermatoscopía. En el caso de los NMC gigantes la mayoría de los autores concuerda en una extirpación temprana agresiva para disminuir el riesgo de malignización. En el caso clínico expuesto, el paciente presenta factores de riesgo para las dos principales complicaciones, por lo que se plantea el tratamiento quirúrgico. La remoción completa frecuentemente necesita de escisión por partes, usando expansores de piel e injertos dérmicos. Independiente de la terapia que se elija hay que considerar la necesidad del apoyo psicológico en este tipo de lesiones.
INTRODUCTION: Melanocytic nevi are benign proliferations of nevus cells. Represent 1 percent of all melanocytic nevi and are classified by size into small, medium or giant. CASE REPORT: Male patient, 6-year-old with giant congenital melanocytic nevi (CMN) as swimsuit. Controlled in the Department of Dermatology at birth, was kept under observation imaging tests, and skin biopsies performed nodules. In multidisciplinary meeting on the case, incisional surgical treatment arises in stages. DISCUSSION: The management of NMC is controversial; multiple therapies are described, including excision, dermabrasion, laser ablation, etc. But excision is the only way to reduce the risk of malignancy, not always possible in the giant NMC. NMC for small to medium size individualized management with periodic evaluations with dermoscopy is recommended. In the case of the giant NMC most authors agree on an aggressive early removal to reduce the risk of malignancy. In the case report, the patient had risk factors for the two major complications, so that surgical treatment is considered. Complete removal often requires cleavage by parts, using skin expanders and skin grafts. Independent of therapy you choose must consider the need for psychological support in this type of injury.
Subject(s)
Humans , Male , Skin Neoplasms/congenital , Skin Neoplasms/diagnosis , Skin Neoplasms/pathology , Nevus, Pigmented/congenital , Nevus, Pigmented/diagnosis , Nevus, Pigmented/pathology , Skin Neoplasms/surgery , Nevus, Pigmented/surgeryABSTRACT
El propósito de este estudio fue comparar la capacidad de sellado de tres técnicas de obturación con gutapercha termoplastificada, técnica de obturación vertical de Schilder, compactación termomecánica y Thermafil (Dentsply-Maillefer), en dientes con instrumentos fracturados en la región apical. Un total de 30 dientes unirradiculares extraídos fueron instrumentados con ProTaper (Dentsply-Maillefer), en cada uno de los mismos se fracturaron intencionalmente instrumentos rotatorios ProTaper F3 en el tercio apical. Los dientes fueron divididos aleatoriamente en tres grupos (n = 10) para ser obturados con la técnica correspondiente, para que, con la técnica de filtración de colorante y con la ayuda de la aclaración de los dientes fueran observados bajo microscopio para determinar la cantidad de microfiltración apical que permitía cada técnica. En todos los grupos, los especímenes presentaron alguna cantidad de microfiltración apical. Los dientes que fueron obturados con Thermafil presentaron una microfiltración promedio de 3,134 μm, resultando en significativamente mayor microfiltración que los obturados con la técnica termomecánica de McSpadden y de compactación vertical de Schilder, (p < 0.05) que obtuvieron un promedio de microfiltración de 1,934 μm y 2,083 μm respectivamente. Mientras que no existe diferencia estadísticamente significativa de microfiltración entre la técnica de McSpadden y la de Schilder (p > 0.05).
The purpose of the present study was to compare the sealing ability of three warm obturation techniques (thermo-plasticized gutta-percha): Schilders warm vertical compaction, McSpadden's thermo-mechanical compaction and Thermafil (Dentsply-Maillefer) in teeth fractured at the apical region. 30 extracted, single-rooted teeth were prepared with Pro-Taper (Dentsply-Maillefer). At the apical third of each of these teeth, ProTaper F3 rotary instruments were deliberately fractured. Teeth were randomly divided into three groups (n = 10) to be later filled with the selected technique, so that with dye penetration technique and with the aid of discoloring teeth technique, teeth could be microscopically assessed so as to determine the amount of apical microfiltration elicited in every technique. In all groups, specimens presented some degree of apical microfiltration. Teeth filled with Thermafil presented 3,134 µm average microfiltration. This microfiltration was significantly higher than the one observed with McSpadden thermo-mechanical technique and Schilder's vertical compaction technique (p < 0.05). These two techniques presented 1,934 µm and 2,083 µm respectively. McSpadden and Schilder's technique show no statistically significant microfiltration differences (p > 0.05).
ABSTRACT
Chronic kidney disease (CKD) is frequently observed in cats and it is characterized as a multisystemic illness, caused by several underlying metabolic changes, and secondary renal hyperparathyroidism (SRHPT) is relatively common; usually it is associated with the progression of renal disease and poor prognosis. This study aimed at determining the frequency of SRHPT, and discussing possible mechanisms that could contribute to the development of SRHPT in cats at different stages of CKD through the evaluation of calcium and phosphorus metabolism, as well as acid-base status. Forty owned cats with CKD were included and divided into three groups, according to the stages of the disease, classified according to the International Renal Interest Society (IRIS) as Stage II (n=12), Stage III (n=22) and Stage IV (n=6). Control group was composed of 21 clinically healthy cats. Increased serum intact parathyroid hormone (iPTH) concentrations were observed in most CKD cats in all stages, and mainly in Stage IV, which hyperphosphatemia and ionized hypocalcemia were detected and associated to the cause for the development of SRHPT. In Stages II and III, however, ionized hypercalcemia was noticed suggesting that the development of SRHPT might be associated with other factors, and metabolic acidosis could be involved to the increase of serum ionized calcium. Therefore, causes for the development of SRHPT seem to be multifactorial and they must be further investigated, mainly in the early stages of CKD in cats, as hyperphosphatemia and ionized hypocalcemia could not be the only factors involved.
A doença renal crônica (DRC) em gatos é frequentemente observada e caracteriza-se como alteração multissistêmica, causada por alterações metabólicas, e o hiperparatireoidismo secundário renal (HPTSR) seria o mais comum e usualmente está associada com progressão da doença renal e mau prognóstico. Esse estudo teve como objetivo determinar a frequência do HPTSR, e discutir os possíveis mecanismos que podem contribuir para o desenvolvimento de SRHPT em gatos em diferentes estágios de DRC, pela avaliação do metabolismo do cálcio e fósforo, bem como do equilíbrio ácido-base. Quarenta gatos com DRC foram divididos em três subgrupos, de acordo com a classificação proposta pela International Renal Interest Society (IRIS), Estágio II (n=12), Estágio III (n=22) e Estágio IV (n=6). O grupo-controle foi composto por 21 gatos clinicamente saudáveis. O aumento das concentrações séricas de paratormônio intacto (PTHi) foi observado na maioria dos casos, mas principalmente no Estágio IV, no qual a hiperfosfatemia e a hipocalcemia ionizada parecem estar associadas ao desenvolvimento do HPTSR. No entanto, nos Estágios II e III, observou-se hipercalcemia ionizada, sugerindo que, nestes estágios, o desenvolvimento do HPTSR possa estar associado a outros fatores, e a acidose metabólica pode estar envolvida com o desenvolvimento de hipercalcemia ionizada. Assim, outros fatores, além da hiperfosfatemia e da hipocalcemia ionizada, possam estar envolvidos com o desenvolvimento do HPTSR, principalmente nos estágios iniciais da DRC. Futuros estudos são necessários para uma melhor compreensão da fisiopatologia do HPTSR em gatos.
Subject(s)
Animals , Cats , Ketosis/veterinary , Kidney Failure, Chronic/veterinary , Cats/metabolism , Hyperphosphatemia/veterinary , Hyperparathyroidism, Secondary/veterinary , Metabolic Diseases/veterinary , Parathyroid HormoneABSTRACT
Canine distemper virus (CDV) is a pathogen which affects dogs and causes severe disease leading to death. Dogs infected with CDV can be diagnosed by RNA detection by Nested PCR technique. The following study proposed to evaluate CDV RNA in blood, urine and saliva samples. The Nested-PCR technique was able to detect CDV RNA in different types of biologic samples. The higher number of positive results was obtained in urine samples.
vírus da cinomose canina (CDV) é um patógeno que afeta cães, causando doença grave e que pode levar a morte. Os cães infectados pelo CDV podem ser diagnosticados pela detecção do RNA utilizando-se a técnica de Nested-PCR. O presente estudo teve como objetivo avaliar o RNA do CDV no sangue, urina e saliva em cães com diagnóstico clínico de cinomose. A técnica de Nested-PCR foi capaz de detectar o RNA em diferentes tipos de amostras biológicas. Obteve-se um maior número de resultados positivos em amostras de urina.
Subject(s)
Animals , Distemper/pathology , Diagnosis , Dogs , Polymerase Chain ReactionABSTRACT
El cáncer de mama inflamatorio es una patología poco frecuente, sin embargo, su importancia radica en la agresividad de su evolución. A nivel nacional no existe estadística certera respecto al porcentaje del cáncer inflamatorio de mama como tal. En el Hospital Base de Valdivia, constituye el 3,3 por ciento de los carcinomas mamarios invasores según una revisión de los últimos 3 años. El diagnóstico de esta patología está basado en la sospecha clínica, en pacientes que presenten eritema, edema, piel de naranja, nódulos y/o induración mamaria. La histopatología del tumor primario y de la piel permite la confirmación diagnóstica. En cuanto al tratamiento, en la actualidad existe consenso de que las pacientes deben ser sometidas a un tratamiento multimodal, éste consiste en quimioterapia neoadyuvante, para luego efectuar la terapia locorregional. Lo particular de este tipo de cáncer, es que posee características biológicas intrínsecas de rápida progresión y alto poder de diseminación, lo que le confiere un mal pronóstico.
Inflammatory breast cancer is a rare disease, but its importance lies in the aggressiveness of its evolution. At the national level there is no accurate statistics on the percentage of inflammatory breast cancer as such. In the Base Hospital of Valdivia, constitute 3.3 percent of invasive breast carcinomas according to a review of the past 3 years. The diagnosis of this disease is based on clinical suspicion in patients presenting with erythema, edema, cellulitis, nodules, and / or breast induration. The histopathology of the primary tumor and skin allows diagnostic confirmation. As for treatment, there is now consensus that patients should be subjected to a multimodal treatment, starting with neoadjuvant chemotherapy and then perform locoregional therapy. The particularity of this type of cancer is that it has intrinsic biological characteristics of rapid progression and high power spread, which gives a poor prognosis.
Subject(s)
Humans , Female , Inflammatory Breast Neoplasms/diagnosis , Inflammatory Breast Neoplasms/therapy , Diagnosis, Differential , Neoplasm Staging , PrognosisABSTRACT
El virus de influenza ha sido reconocido como un importante patógeno en poblaciones humanas y animales, ya que es el principal causante de enfermedades respiratorias. Muchas vacunas y aislamientos de virus de influenza humana y animal son realizadas actualmente en huevos embrionados, siendo este el método usado tradicionalmente por décadas. Sin embargo, se han encontrado inconvenientes en la elaboración de vacunas ya que el proceso de fabricación es de capacidad limitada (se requiere aproximadamente un huevo para generar una dosis vacunal) y alta demanda tiempo, disminuyendo su habilidad para generar biológicos rápidamente en el caso de una pandemia. El empleo de líneas celulares continuas para la producción de vacunas virales nace como alternativa que ofrece diversas ventajas: (i) oportunidad de emplear células completamente caracterizadas y estandarizadas, (ii) producción y planeación permanente de vacunas y (iii) los biológicos pueden ser producidos de forma más rápida. El objetivo de esta revisión es analizar las diferentes alternativas empleadas en el cultivo y/o aislamiento de virus de influenza, enfatizando en el uso de cultivos celulares como sustrato para el aislamiento y la producciónc de biológicos destinados a la salud humana y animal.
Subject(s)
Virus Cultivation , Orthomyxoviridae , Orthomyxoviridae/growth & development , Influenza VaccinesABSTRACT
La influenza A (H1N1) se ha identificado como la causa de epidemia de Infección Respiratoria Aguda en Paraguay y en el mundo. Se analizaron los factores de riesgo asociados a la morbimortalidad en embarazadas con sospecha de infección por H1N1 notificadas a la Dirección General de Vigilancia de la Salud (DGVS) del MSPBS durante los primeros cuatro meses de la pandemia, en comparación con mujeres en edad fértil no embarazadas con sospecha de infección por H1N1. A partir del 28 de abril de 2009, la DGVS comenzó sistemáticamente la vigilancia de H1N1 en todas sus unidades notificadoras, siendo la notificación inmediata y por planilla individual basándose la notificación en la definición de casos confirmado establecidas por el país. Hasta el 25 de agosto del 2009 fueron notificadas 2268 mujeres con sospecha de H1N1, de las cuales 1120 tenían entre 15 a 40 años, y de ellas 117 estaban embarazadas. El 68% (79/117)de las embarazadas requirió hospitalización y la mortalidad fue de 21% (25/117), mientras que en grupo de las no embarazadas el 21% se hospitalizó (288 /1003) y la mortalidad fue de 1,5% (16/1003). Todos los casos fallecidos desarrollaron Infección Respiratoria Aguda Grave caracterizado por un síndrome de distrés respiratorio que en algunos casos requirieron asistencia respiratoria mecánica (ARM). Ninguna de las embarazadas refirió antecedente de co-morbilidad. El 22% (26/117) de las embarazadas y 2,9% (30/1003) de las no embarazadas recibieron Oseltamivir como tratamiento. Se evidencian que la infección produce alta morbimortalidad en embarazadas en comparación con mujeres del mismo grupo de edad, los cuales apoyan la recomendación de un tratamiento antiviral precoz en gestantes, así como un seguimiento clínico cercano.
Influenza A (H1N1) has been identified as the cause of the Acute Respiratory Infection epidemic in Paraguay and the world. Risk factors associated to morbid-mortality in cases of pregnant women with suspicion of H1N1 infection and notified to the General Direction of Health Surveillance (DGVS in Spanish) of the Ministry of Public Health and Social Welfare (MSPBS in Spanish) during the fourth first months of the pandemic were analyzed in comparison to non-pregnant fertile women with suspicion of H1N1 infection. From April28, 2009 the DGVS started a systematic surveillance of H1N1 in all its notifying units, being the notification immediate and by individual spreadsheet basing the notification inthe case definition established by the country. Until August 25, 2009 2,268 cases of women with suspicion of H1N1 were notified, 1,120 of them were between 15 to 40 years and from them 117 were pregnant. Sixty eight percent (79/117) of the pregnant women required hospitalization and mortality was 21% (25/117) while in the non-pregnant women, 21% were hospitalized (288 /1003) and mortality was 1.5% (16/1003). All deceased cases developed Serious Acute Respiratory Infection characterized by a respiratory distress syndrome that, in some cases, required mechanical respiratory assistance (MRA). None of the regnant women referred history of co-morbidity. Twenty two percent (26/117) of the pregnant women and 2.9% (30/1003) of the non-pregnant women received Oseltamivir as treatment. These results show that the infection produces high morbid-mortality in pregnant women in comparison to women of the same age group, supporting the recommendation of an early antiviral treatment in pregnant women as well as a close clinical follow-up.
Subject(s)
Influenza in Birds , Epidemiological Monitoring , Risk Factors , Surveillance in DisastersABSTRACT
En Chile el consumo de EPA y DHA es mucho menor a las recomendaciones internacionales. Para mejorar el aporte de omega-3 en el embarazo y lactancia desarrollamos una bebida láctea fortificada con 60 mg de DHA y 14 mg de EPA por 200/ml. El objetivo del estudio fue evaluar su efecto en embarazo, parto y recién nacido, composición lipídica de los glóbulos rojos y de la leche materna. Se estudió una cohorte de embarazadas que recibieron dos Kg/mes del nuevo producto (GE n = 175) o la misma cantidad de la leche en polvo que distribuye el Ministerio de Salud (GC n =177). Se analizó consumo de la bebida láctea y otros alimentos fuentes de EPA y DHA y las características del embarazo, parto y recién nacido. En una submuestra de cada grupo se analizó al ingreso y a los 60 días la composición de los ácidos grasos de membranas del glóbulo rojo de la madre y de la leche materna a los 2 meses post parto. El 16 y 53 por ciento de la muestra no consumía pescado o mariscos respectivamente y menos del 25 por ciento consumía pescado en forma semanal. La intervención aumentó el aporte diario de DHA de 48,8 mg (IC 38,7 - 57,5) a 147,8 mg (IC 128,4 - 167,9) (p < 0,001). El GE tuvo mayores niveles de DHA en los fosfolípidos de la membrana del glóbulo rojo materno: 17,9 por ciento (IC 12,9 - 23,0) versus 11,1 por ciento (IC10,2 - 13,0) p < 0,002 y aumentó en 50 por ciento la concentración de ácidos grasos omega-3 en la leche materna (p 0,06). Se observó menor prevalencia de partos pretérminos en el GE (2,8 vs 10,6 por ciento), aunque sin significación estadística. La bebida láctea logró un aumento significativo del consumo de DHA en el embarazo y lactancia y una mejoría de la composición de ácidos grasos en el glóbulo rojo y leche materna, sugiriendo que es una buena estrategia de intervención en esta población.
EPA and DHA consumption in Chile is markedly below international daily intake recommendations. For improvement of such low intake level, we developed a fortified powdered dairy drink, containing 60 mg/serving of DHA and 14 mg/serving of EPA. Objectives: to evaluate the effects of DHA consumption during pregnancy, parturition, and in the newborn, on lipid composition of red blood cell membranes and levels of DHA and EPA on human milk during lactation. One hundred and seventy five (175) pregnant women received 2 kg/month of the fortified powdered dairy drink (GE), and 177 received the regular milk provided by the Ministry of Health (GC). We monitored daily intake of the dairy drink and all other sources of DHA and EPA in the diet, and measured general biological indicators during pregnancy, parturition, and in the new born. On a subsample of 14 women on each group (GE and GC), we measured fatty acid composition of red blood cell membranes after 0 and 60 days of consumption with the fortified dairy drink, and levels of DHA and EPA on human milk after 2 months of lactation. Of all women in the study, 16 percent had no consumption of fish, and 53 percent had no consumption of sea food. Less than 25 percent of all women had fish on a weekly basis. Consumption of the fortified dairy drink tripled intake of DHA, from 48.8 mg/day (CI 38.7-57.5) to 147.8 mg/day (CI 128.4-167.9) (p<0.001). The GE group had a higher content of DHA on the phospholipids of red blood cell membranes: 11.1 percent (CI 10.2- 13.0) versus 17.9 percent (CI 12.9-23.0) (p<0.002). Concentration of DHA and w-3 fatty acids increased 50 percent in milk of women consuming the fortified dairy drink (p<0.06). There was a lower incidence of preterm parturitions on the GE group (2.8 vs 10.6 percent), but without statistical significance. The consumption of the fortified dairy drink produced a significant increase of DHA consumption during pregnancy and lactation, and an improved composition...
Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Erythrocytes , Fatty Acids , Milk, HumanABSTRACT
Although pain is not an inevitable consequence of cancer, it remains the most feared. At present we have an importante accumulation of knowledge related to the prevention, early detection and management of the different types of cancer. It has been estimated that as many as 25 of patients with cancer through the world die without receiving adequate relief of pain. The major reason these patients continue to suffer is simply that available pain-relieving therapies are applied inadequately or inappropriately...The goal of pain management in patients with advanced disease is to provide control of pain that permits them to die in relative comfort. Narcotic analgesics with potentiating agents are generally necessary to achieve adequate control of severe cancer pain. The adjuvant therapy empoyed includes selective antidepressants, local anesthetics and anticonvulsant drugs...Also patients with cancer and a history of both alcohol and drugs-abuse, show a special differentiation against pain control. It is concluded that the prevalence of both neuropathic or mixed pain is high in the population of oncologic patients, where most of them can control the sympotoms with only opiates, even with a history of alcohol abuse. These aspects are detailed in the article.
Subject(s)
Humans , Adolescent , Adult , Middle Aged , Antineoplastic Agents/therapeutic use , Analgesics, Opioid/therapeutic use , Palliative Care , Neoplasms , Neuralgia/therapy , Pharmacokinetics , Retrospective Studies , Central Nervous SystemABSTRACT
The natural resistance of plants to disease is based not only on preformed mechanisms, but also on induced mechanisms. The defense mechanisms present in resistant plants may also be found in susceptible ones. This study attempted to analyze the metabolic alterations in plants of the potato Solanum tuberosum L. cv. Agata that were inoculated with the incompatible plant-pathogenic bacteria X. axonopodis and R. solanacearum, and the compatible bacterium E. carotovora. Levels of total phenolic compounds, including the flavonoid group, and the activities of polyphenol oxidase (PPO) and peroxidase (POX) were evaluated. Bacteria compatibility was evaluated by means of infiltration of tubers. The defense response was evaluated in the leaves of the potato plants. Leaves were inoculated depending on their number and location on the stem. Multiple-leaf inoculation was carried out on basal, intermediate, and apical leaves, and single inoculations on intermediate leaves. Leaves inoculated with X. axonopodis and with R. solanacearum showed hypersensitive responses within 24 hours post-inoculation, whereas leaves inoculated with E. carotovora showed disease symptoms. Therefore, the R. solanacearum isolate used in the experiments did not exhibit virulence to this potato cultivar. Regardless of the bacterial treatments, the basal leaves showed higher PPO and POX activities and lower levels of total phenolic compounds and flavonoids, compared to the apical leaves. However, basal and intermediate leaves inoculated with R. solanacearum and X. axonopodis showed increases in total phenolic compounds and flavonoid levels. In general, multiple-leaf inoculation showed the highest levels of total phenolics and flavonoids, whereas the single inoculations resulted in the highest increase in PPO activity. The POX activity showed no significant difference between single- and multiple-leaf inoculations. Plants inoculated with E. carotovora showed no significant increase ...