ABSTRACT
La diverticulitis apendicular es una enfermedad poco frecuente, con una incidencia aproximada de 1%. Se define por la presencia de divertículos verdaderos o falsos en la pared del apéndice cecal. Durante la fase aguda posee una clínica indistinguible a la apendicitis, sin embargo en ocasiones presenta características clínicas particulares que la distinguen de la apendicitis aguda, tales como la presencia de dolor abdominal insidioso o intermitente y/o ausencia de sintomatología gastrointestinal (náuseas, vómitos o anorexia). En la diverticulitis apendicular las técnicas imagenológicas son de utilidad limitada al otorgar información inespecífica, por lo que el diagnóstico tiende a realizarse mediante el estudio anatomopatológico del apéndice posterior a una intervención quirúrgica en paciente con cuadro clínico compatible con apendicitis aguda. El tratamiento de elección corresponde a la apendicectomía, lo que permite evitar complicaciones futuras como por ejemplo perforación apendicular, neoplasias, entre otros. Se obtuvieron los datos de fuentes como Pubmed y Scielo. Específicamente la búsqueda de artículos originales y de revisiones sistemáticas, preferentemente menores a 15 años de publicación en revistas científicas de alto índice de impacto, con las palabras "diverticulitis apendicular", "diverticulosis" y "complicaciones diverticulares".
Appendiceal diverticulitis is a rare disease with an incidence of approximately 1%. It is defined by the presence of true or false diverticula in the wall of the cecal appendix. During the acute phase, it has symptoms that are indistinguishable from appendicitis, however, it sometimes presents particular clinical characteristics that distinguish it from acute appendicitis, such as the presence of insidious or intermittent abdominal pain and/or the absence of gastrointestinal symptoms (nausea, vomiting, or anorexia). In appendiceal diverticulitis, imaging techniques are of limited utility as they provide non-specific information, so the diagnosis tends to be made through the pathology study of the treatment after surgery in a patient with a clinical picture compatible with acute appendicitis. The treatment of choice corresponds to appendectomy, which allows avoiding future complications such as appendiceal perforation, neoplasms, among others. Data were obtained from sources such as Pubmed and Scielo, specifically searching for original articles and systematic reviews with the words "apendicular diverticulitis", "diverticulosis" and "diverticular complications". The criteria used were articles mainly under 5 years of publication in high-impact scientific journals.
ABSTRACT
In vitro modeling of neurodegenerative diseases is now possible by using patient-derived induced pluripotent stem cells (iPS). Through them, it is nowadays conceivable to obtain human neurons and glia, and study diseases cellular and molecular mechanisms, an attribute that was previously unavailable to any human condition. Amyotrophic lateral sclerosis (ALS) is one of the diseases that has gained a rapid advance with iPS technology. By differentiating motor neurons from iPS cells of ALS- patients, we are studying the mechanisms underlying ALS- disease onset and progression. Here, we introduce a cellular platform to help maintain longevity of ALS iPS-motor neurons, a cellular feature relevant for most late-onset human diseases. Long term cultures of patient-derived iPS cells might prove to be critical for the development of personalized-drugs.
Actualmente es posible modelar in vitro enfermedades neurodegenerativas humanas mediante el uso de células madre pluripotentes inducidas (iPS) derivadas del paciente. A través de ellas, es hoy concebible obtener neuronas y glía humanas, y estudiar mecanismos celulares y moleculares de enfermedades, un atributo que anteriormente no era posible para ninguna condición humana. La esclerosis lateral amiotrófica (ELA) es una de las enfermedades que se ha beneficiado con la tecnología de iPS. Al diferenciar neuronas motoras de células iPS obtenidas de pacientes con ELA, hemos iniciado estudios sobre los mecanismos que subyacen a la aparición y progresión de la enfermedad. Aquí, presentamos el desarrollo de una plataforma celular que permite extender la longevidad de las neuronas motoras derivadas de iPS, una característica relevante para la mayoría de las enfermedades humanas de inicio tardío. Los cultivos a largo plazo de células iPS provenientes de pacientes pueden ser determinantes en el desarrollo de terapias asociadas a la medicina de precisión.
Subject(s)
Humans , Animals , Mice , Induced Pluripotent Stem Cells/cytology , Amyotrophic Lateral Sclerosis/metabolism , Immunohistochemistry , Cell Line , Coculture Techniques , Amyotrophic Lateral Sclerosis/pathology , Amyotrophic Lateral Sclerosis/therapyABSTRACT
Background: In conditions that may change red blood cell survival, such as hemodialysis, the accuracy of A1c glycosylated hemoglobin (HbA1c) to assess metabolic control can be hampered. Other glycosylated proteins such as fructosamine, could accomplish the role of HbA1c. Aim: To assess if HbA1c is a good metabolic control parameter in diabetic patients on chronic hemodialysis. To compare fructosamine, HbA1c and serial capillary glucose levels in the same patients. Material and Methods: Patients on hemodialysis three times per week were studied. Twenty one subjects with diabetes mellitus and 10 non-diabetic patients were included (70 percent were male). During a period of 14 days, fasting and post prandial capillary glucose levels were measured. Venous glucose, HbA1c and fructosamine were measured at the onset and completion of the monitoring period. Results: Diabetic patients were older than their non-diabetic counterparts (65 and 47 years respectively, p < 0.04). In diabetic and non-diabetic patients respectively, capillary blood glucose levels were 161 +/- 22 and 104 +/- 51 mg/dl, HbA1c levels were 6.8 +/- 1.2 and 5.4 +/- 0.4 percent and fructosamine levels were 282.0 +/- 126.6 and 154.6 +/- 73 umol/L. In all patients there was a positive correlation between blood glucose, HbA1c (r = 0.78 p < 0.01) and fructosamine (r = 0.52, p 0.02). There was a positive correlation between mean capillary glucose, HbA1c (r = 0.77, p < 0.01) and fructosamine (r = 0.69, p < 0.02). Among diabetic patients, the correlation coefficients between mean capillary glucose levels, HbA1c and fructosamine levels were 0.67 (p < 0.01) and 0.51 (NS), respectively. Conclusions: Among diabetic patients on hemodialysis fructosamine levels are not a better indicator of metabolic control than HbA1c.
Subject(s)
Humans , Male , Female , Middle Aged , Diabetes Mellitus/blood , Fructosamine/analysis , Glycated Hemoglobin/analysis , Renal Dialysis , Blood Glucose , Body Mass Index , Diabetes Mellitus/diagnosis , Kidney Failure, Chronic/blood , Prospective StudiesABSTRACT
Alterations in plasma osmolality are related to changes in cell volume, which are the pathophysiological substrate of serious diseases. Under normal conditions sodium is the main determinant of plasma osmolality, and its homeostasis depends primarily on water balance. Hyponatremia is common in clinical practice, and is associated with morbidity and mortality by itself or in relation to its treatment. Despite this, sodium disorders are underdiagnosed, undertreated, and often handled improperly. Because multiple conditions with different treatments can be manifested through hyponatremia, the clear understanding of the pathophysiologic condition of each patient is essential for proper management. This review will discuss the pathophysiology, diagnostic approaches and current therapies of hyponatremia (AU)
Subject(s)
Humans , Hyponatremia/diagnosis , Hyponatremia/physiopathology , Hyponatremia/therapy , Water-Electrolyte ImbalanceABSTRACT
La pandemia de influenza del 2009 afectó a las pacientes gineco-obstétricas del Paraguay. Se incluyeron mujeres gestantes y 2 pacientes ginecológicas Los motivos de consulta fueron síntomas respiratorios, trabajo de parto y síntomas respiratorios, patologías obstétricas, patologías ginecológicas. Las principales comorbilidades fueron pre-eclampsia severa y asma. El manejo obstétrico más frecuente fue interrupción del embarazo. Todas fueron dadas de alta en buenas condiciones. Impactó en mujeres con complicaciones maternas y fetales de relevancia...
Subject(s)
Humans , Pregnancy Complications/epidemiology , Influenza, Human , Influenzavirus A , Pregnancy Outcome , Influenza A virus , Paraguay/epidemiologyABSTRACT
A 32 years old female was admitted to hospital due to acute abdominal pain, nausea, vomiting and liquid stools. Physical examination was normal except for pain on her left inferior abdominal quadrant without peritoneal irritation signs. An abdominal CAT-scan suggested thrombosis at celiac trunk, although the echo Doppler showed no alterations except for signs of ischemia in the distal branch of the superior mesenteric artery. An exploratory laparotomy was performed disclosing a necrosis of the distal ileum and cecum, diffuse peritonitis and thrombosis of the ileocecoapendiculocolic artery. No vasculitis lesions were found in the arteries of medium size examined. A history of intermittent claudication for the past 3 years as well as acrocyanosis, asymmetry of pulses and blood pressure in the superior extremities was ascertained after the surgery. A MRI angiogram showed multiple stenoses and irregularities at the celiac trunk, hepatic, superior mesenteric and fibular arteries. No abnormalities at the aortic arch and its main branches were documented. A sepsis due to Candida sp complicated her postoperatory period. After recovery, prednisone 1 mg/kg/day was started and the anticoagulation continued. The abdominal pain, intermittent claudication and superior limb acrocyanosis disappeared. This is an unusual case of type IV Takayasu's arteritis with acute abdominal signs as the first manifestation
Subject(s)
Humans , Adult , Female , Takayasu Arteritis , Intestines , Necrosis , Adrenal Cortex Hormones , Thrombophilia , Ischemia , Intermittent Claudication/etiologyABSTRACT
The proteolytic activity (PA) of some microorganisms is an important pathogenic factor during tissue invasion. However, its role in Helicobacter pylori infection is not clear. Due to the importance of the immunological response to inhibit pathogenic factors of microorganisms, this study aims to establish an in vitro system to detect inhibitory antibodies to the PA of H. pylori in mouse serum. We obtained mouse sera from animals immunized by oral and intraperitoneal inoculations with the raw bacterial extract (BE) of H. pylori, in which we had previously detected PA. The degradation of azocasein subtract for BE was inhibited in 49.23 and 22.6 using 5 micrograms/ml of serum proteins (SP) from oral and intraperitoneal inoculation, respectively. However, when using more than 25 micrograms/ml of SP of immune serum, PA was inhibited in a similar way than with control serum. In conclusion we present a methodology for the detection of inhibitory antibodies to PA of H. pylori in the serum of the immunized mouse.
Subject(s)
Animals , Female , Mice , Antibodies, Bacterial/pharmacology , Endopeptidases , Gastritis, Atrophic/microbiology , Helicobacter pylori , In Vitro Techniques , Helicobacter Infections/microbiology , Bacterial Proteins/antagonists & inhibitors , Administration, Oral , Antibodies, Bacterial/immunology , Antigens, Bacterial/administration & dosage , Antigens, Bacterial/immunology , Enzyme-Linked Immunosorbent Assay , Helicobacter pylori , Immune Sera , Immunization , Mice, Inbred BALB C , Specific Pathogen-Free OrganismsABSTRACT
Legionella pneumophila is the second cause of severe community acquired pneumonia. In Chile, however, there are few reports of pneumonia caused by Legionella. We report eight patients (6 men, aged 42 to 72 years old) with community-acquired pneumonia caused by Legionella pneumophila serogroup 1, confirmed by the measurement of urinary antigen. Clinical presentation was characterized by fever or hypothermia (in one case), cough, dyspnea and neurological abnormalities in four patients. Cigarette smoking was the most frequently identified risk factor. All patients had at least one American Thoracic Society severity criteria. Complications observed were acute hypoxemic respiratory failure in seven patients, shock in four, renal failure in four and need for mechanical ventilation in three. No patient died
Subject(s)
Humans , Male , Adult , Female , Middle Aged , Legionnaires' Disease , Legionella pneumophila , Pneumonia, Bacterial/etiology , Legionnaires' Disease , Legionella pneumophila , Antigens, Bacterial/urine , Antigens, BacterialABSTRACT
La insuficiencia renal aguda es una complicación excepcional de la hepatitis A no fulminante. Esta asociación ha sido comunicada en alrededor de 30 casos en la literatura, la mayoría proveniente de pacientes japoneses. El proceso exacto a través del cual el virus de la hepatitis A (VHA) produce daño renal es incierto, pero se han postulado varios mecanismos patogénicos, como glomerulonefritis por complejos inmunes, toxicidad por hiperbilirrubinemia, síndrome hepatorrenal, nefritis intersticial aguda y necrosis tubular aguda isquémica, siendo este último el más frecuentemente demostrado en los casos en que se ha realizado biopsia renal. Nosotros reportamos el primer caso en Chile de insuficiencia renal aguda no oligúrica, en un paciente hombre de 16 años, cursando una hepatitis no fulminante por el VHA, de muy buena evolución espontánea, sin requerir diálisis, y en el que no se realizó biopsia renal, por coagulación incompatible y rápida mejoría
Subject(s)
Humans , Male , Adolescent , Acute Kidney Injury , Hepatitis A , Acute Kidney Injury , Diuretics/therapeutic use , Hepatovirus , Remission, Spontaneous , Vitamin KSubject(s)
Humans , Female , Adult , Chylous Ascites/surgery , Abdomen, Acute/etiology , Chylous Ascites/diagnosis , Chylous Ascites/etiologyABSTRACT
Se ensayo el empleo de melaza y suero de queso en la formulacion de medios para el desarrollo y produccion de toxina de una cepa de Clostridium perfringens tipo D y se comparan los resultados con el medio de Gordon modificado mencionado en la bibliografia. Las experiencias realizadas demuestram que empleando medio de melaza se alcanzan rendimientos de toxina similares a los obtenidos con el medio de Gordon modificado, con lo cual se concluye que la melaza puede ser un componente basico economico para la produccion de toxina del microorganismo citado. Con respecto al suero de queso como componente de medios puede concluir-se que debe descartarse su empleo en procesos de tipo discontinuo como el empleado en el presente trabajo, para la produccion de toxina de Clostridium perfringens tipo D