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Rev. Soc. Argent. Diabetes ; 55(1): 13-20, ene. - abr. 2021. tab, graf
Article in Spanish | LILACS, BINACIS | ID: biblio-1248270


Introducción: en la provincia de La Pampa no hay registro del número de pacientes con diabetes gestacional (DG) que vuelve a control metabólico posparto, cuando se conoce el riesgo que evolucione a diabetes mellitus tipo 2 (DM2). Objetivos: analizar en el Hospital Público Interzonal (Dr. Lucio Molas) el porcentaje de mujeres con DG que volvió a control metabólico posparto y desarrolló DM2 durante seis años de seguimiento. Materiales y métodos: estudio descriptivo ambispectivo en 44 pacientes con DG diagnosticada en 2013 con seguimiento hasta el 31/12/2019. Se analizaron antecedentes previos de DG y familiares de diabetes (AFD), edad, semana de gestación del diagnóstico con glucemia/prueba de tolerancia oral a la glucosa (PTOG), índice de masa corporal (IMC), presión arterial, vía del parto, peso del recién nacido, HbA1c. Resultados: en 2013 se efectuaron 1.238 partos, 44 pacientes (3,7%) tenían DG diagnosticada, 68% mediante PTOG. Presentaban 43% AFD, 38,6% sobrepeso, 20,45% obesidad, 68,2% cesáreas y 11,4% recién nacidos con alto peso. En seis años de seguimiento, 54,5% de estas pacientes realizó control metabólico; este grupo, a diferencia del grupo sin control, presentó mayor IMC al inicio del embarazo (t:2,103; p<0,02), glucemia basal (t:10,59; p<0,001), presión arterial sistólica (t:2,629; p<0,01), diastólica (t:1,965; p<0,05) y macrosomía fetal (4 vs 1). El 33,3 % manifestó DM2 predominantemente a partir de tres años del posparto. Conclusiones: el 54,5% de las pacientes con DG concurrió a control metabólico posparto tardíamente, y el 33,3% evolucionó a DM2; incluso estas pacientes presentaron mayor número de factores de riesgo obstétricos y cardiometabólicos que el grupo sin control al inicio del embarazo.

Introduction: there is no register of the number of women with gestational diabetes (GD) that have undergone metabolic post-partum control in the province of La Pampa, even though it is well-known the increased associated risk of becoming a diabetes type 2 patient (T2DM). Objectives: to analyze at the Interzonal Public Hospital (Dr. Lucio Molas) the percentage of women with GD who returned to postpartum metabolic control and developed T2DM during six years of follow-up. Materials and methods: descriptive ambispective study in 44 patients with GD diagnosed in 2013 with follow-up until 31 December 2019. Different characteristics were analyzed in all participants: previous history of GD and family members of diabetes (FHD), age, gestational week of the diagnosis with fasting glucose or oral glucose tolerance test (OGTT), body mass index (BMI), blood pressure, delivery route, newborn weight, glycated hemoglobin (HbA1C). Results: a number of 1,238 of deliveries were performed in 2013, 44 women (3.7%) developed GD diagnosed by OGTT (68%), 43% presented FHD, 38.6% overweight, 20.45% obesity. Among the totality of deliveries 68.2% were by caesarea and 11.4% high birth weight newborns. In six years of follow-up, 54.5% of these patients underwent metabolic control, presenting this group, unlike the group without control, higher BMI at the beginning of pregnancy (t:2.103; p<0.02), fasting blood glucose (t:10 .59; p<0.001), systolic blood pressure (t:2.629; p<0.01), diastolic blood pressure (t; 1.965; p<0.05) and fetal macrosomia (4 vs 1). 33.3% developed T2DM predominantly from at three years postpartum. Conclusions: the present study reported that 54.5% of women with GD performed a late metabolic postpartum control evolving 33.3% developed T2DM presenting higher obstetric and cardiometabolic risk factors than the group without control at the beginning of pregnancy.

Humans , Diabetes, Gestational , Blood Glucose , Gestational Age , Diabetes Mellitus, Type 2
Article in Chinese | WPRIM | ID: wpr-906099


Constipation is a common functional gastrointestinal disease with obstructive constipation, prolonged defecation time, or difficulty in defecation as the main symptoms, its prevalence is increasing year by year. Copying the animal model that is highly consistent with the clinical characteristics of traditional Chinese medicine (TCM) and western medicine is the basis for the related research on constipation. Based on the clinical characteristics, etiology and pathogenesis, clinical diagnostic criteria and TCM syndrome differentiation of constipation, a comparative analysis of the anastomosis between common animal models and clinical symptoms was carried out. Existing animal models of constipation were mostly drug induction and non-pharmaceutical intervention methods, and the modeling method was relatively simple, which was different from the multi-factors of constipation in clinical practice, and the evaluation indicators were mainly charcoal-powder propelling rate, defecation function, colon tissue and serum biochemical indicators. TCM syndrome differentiation lacked perfect evaluation system, such as laborious defecation, palpitation, shortness of breath, forgetfulness, cold pain in the abdomen, and other indicators that had not been embodied in the animal models, and the observation indicators were inconsistent with the diagnostic criteria of TCM. The same pathogenic factor could cause different syndromes, such as shortness of breath and fatigue, hot flashes and night sweats in the diagnostic criteria of TCM. Therefore, it is necessary to further explore the animal model of constipation that is highly consistent with the clinical characteristics of TCM and western medicine, in order to promote clinical treatment of constipation.

Chinese Journal of Geriatrics ; (12): 1194-1198, 2021.
Article in Chinese | WPRIM | ID: wpr-910990


Acute kidney injury(AKI)refers to a clinical syndrome in which the glomerular filtration rate decreases sharply in a short period of time due to various causes.Since elderly patients often have low renal functional reserve, complex underlying diseases, frequent acute events and various types of drug combinations, the incidence of AKI in elderly patients is significantly higher than that in the general population and trends upward each year.The prevention and treatment of elderly AKI should place an emphasis on the identification of risk factors and early diagnosis.There is considerable controversy over whether the existing real-world diagnostic criteria are clinically practical and appropriate.The application of novel diagnostic biomarkers for the diagnosis of AKI in the elderly population remains to be justified.This paper reviews considerations on the diagnostic criteria for AKI in the elderly and the clinical application of new biomarkers, in order to arrive at improved diagnosis and treatment recommendations.

Article in Chinese | WPRIM | ID: wpr-873712


@#With the broad application of high-resolution computed tomography (CT) and high rates of early lung cancer screening, the number of patients diagnosed with synchronous multiple primary lung cancer (sMPLC) has been increasing. It becomes of great prominence to distinct sMPLC from intrapulmonary metastases in clinical practice. An increasing number of studies have developed high-throughput sequencing based genetic approaches to specify the molecular characteristics of sMPLC, which contributes to a better understanding of its tumorigenesis. The genetic profile of sMPLC also benefits its diagnosis, which mainly relies on its clinicopathological criteria. Here, we summarize the progresses on the diagnostic criteria for sMPLC, and also molecular features of sMPLC from the perspective of clonality analysis.

Article in English | WPRIM | ID: wpr-888490


OBJECTIVES@#To study the clinical features and prognosis of children with acute leukemias of ambiguous lineage (ALAL) under different diagnostic criteria.@*METHODS@#A retrospective analysis was performed on the medical data of 39 children with ALAL who were diagnosed and treated from December 2015 to December 2019. Among the 39 children, 34 received treatment. According to the diagnostic criteria for ALAL by World Health Organization and European Group for the Immunological Characterization of Leukemias, the 39 children were divided into two groups: ALAL group (@*RESULTS@#The 34 children receiving treatment had a 3-year event-free survival (EFS) rate of 75%±9% and an overall survival rate of 88%±6%. The children treated with acute myeloid leukemia (AML) protocol had a 3-year EFS rate of 33%±27%, those treated with acute lymphoblastic leukemia (ALL) protocol had a 3-year EFS rate of 78%±10%, and those who had no remission after induction with AML protocol and then received ALL protocol had a 3-year EFS rate of 100%±0% (@*CONCLUSIONS@#ALL protocol has a better clinical effect than AML protocol in children with ALAL, and positive MRD after induction therapy suggests poor prognosis. Hyperleukocytosis and adverse genetic changes are not observed in children with myeloid expression, and such children tend to have a good prognosis, suggesting that we should be cautious to take it as ALAL in diagnosis and treatment.

Acute Disease , Child , Disease-Free Survival , Humans , Neoplasm, Residual , Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy , Prognosis , Retrospective Studies
Article in Chinese | WPRIM | ID: wpr-811715


Objective@#To improve the diagnostic criteria of suspected cases through investigating the epidemiological and clinical manifestations of confirmed cases of new-type coronavirus infection in children.@*Methods@#We retrospective analyzed the epidemiological and clinical manifestations of 6 children with new coronavirus infection diagnosed in Chongqing Three Gorges Central Hospital from February 3, 2020 to February 15, 2020 . Compared with the diagnostic criteria of suspected cases,we summarized the problems encountered in the application of this standard in clinical work and try to put forward Suggestions for improvement.@*Results@#Among the 6 children with confirmed cases: 5 males and 1 female; 3 from Hubei Province and 3 from Wanzhou ; 6 cases of clustered onset of the family; Visiting nature: 3 cases of suspected case income, 3 cases of community or outpatient screening . Three cases with fever and / or respiratory symptoms, one of which had symptoms of diarrhea; all children's blood routine and lymphocyte counts were within the normal range; chest CT imaging except for cases No. 1 and No. 5 were in line with typical new coronavirus pneumonia signs. In addition, the remaining 3 patients had abnormal imaging but did not have the characteristics of new coronavirus pneumonia, and 1 case was normal. Comparison results:Only case 1 of all cases fully met the diagnostic criteria, and the remaining cases did not meet the diagnostic criteria of early suspected cases.@*Conclusion@#In order to improve the accuracy and practicality of the diagnosis of suspected cases in children, it is recommended to refine and standardize the diagnostic criteria of some suspected cases.

Article in Chinese | WPRIM | ID: wpr-857033


Alzheimer∗ s disease (AD) is a typical central nervous degenerative disease characterized by progressive cognitive impairment and behavioral damage, which is associated with the major pathological manifestations of extracellular amyloid deposition, intracellular neurofibrillary tangles, and neuron loss. Mild cognitive impairment ( MCI) is a kind of cognitive impairment status between normal cognition and AD, which is linked with a high risk of converting into AD. Previous studies mostly establish the animal models with clinical AD characteristics for mechanism research, drug screening, and new drug development. In recent years, researchers have attempted to establish animal models with clinical MCI characteristics, trying to intervene ear-ly at MCI stage to effectively prevent the occurrence of AD. There are many types of AD experimental animal models, and the MCI model should be distinguished from the AD model. Based on the systematic introduction of the characteristics of AD and MCI, this study aims to preliminarily evaluate the commonly used AD and MCI experimental animal models, providing sug-gestions for the research of AD and MCI.

Article in Chinese | WPRIM | ID: wpr-843816


Objective: To compare the diagnostic sensitivity of muscles in different regions on electromyography (EMG) to optimize and the muscle selection of needle electromyography in amyotrophic lateral sclerosis (ALS). To compare the diagnostic performance of revised El Escorial criteria (rEEC) and Awaji criteria (AwC) in ALS. Methods: Totally 198 ALS patients were recruited from ALS Clinic of The First Affiliated Hospital of Xi'an Jiaotong University and diagnosed with rEEC and AwC diagnostic criteria. Needle EMG was detected in muscles of bulbar, cervical, thoracal, and lumbosacral regions. Results: The muscle sensitivity in ALS regions (with or without clinical involvement) was consistent with that in the regions without clinical involvement. The diagnostic sensitivity of muscles were presented as follows: tongue (54.7% vs. 39.2%), trapezius (44.2% vs. 30.2%), lower orbicularis oris (33.2% vs. 20.7%), sternocleidomastoid (20% vs. 13.2%) in bulbar region, the first dorsal interosseus (93.8% vs. 77.3%), abductor pollicis brevis (92.8% vs. 72.7%), biceps (82% vs. 50%), deltoid (82% vs. 45.4%) in cervical region, thoracic paraspinal muscle 10 (86.5% vs. 85.3%) and rectus abdominis (49.5% vs. 49.3%) in thoracal region, the tibialis anterior (74.6% vs. 46.3%), and gastrocnemius (53.4% vs. 19.7%) in lumbosacral region. The diagnostic rate at AwC standard (75.3%) was significantly higher than that at rEEG standard (24.2%) (McNemar test P<0.001). Conclusion: The muscles of clinical affected region should be detected first, followed by the non-affected region in clinically suspected ALS. The tongue in bulbar region, the first dorsal interosseus in cervical region, thoracic paraspinal muscle 10 in thoracal region, tibialis anterior in lumbosacral region are recommended to detect in EMG protocol. The AwC criteria are suggested in ALS clinical diagnosis.

Organ Transplantation ; (6): 326-2020.
Article in Chinese | WPRIM | ID: wpr-821538


Liver transplantation, although recognized as the only effective radical treatment for severe liver disease, might be accompanied by high surgical risks, high perioperative mortality and high postoperative complications. Considering the shortage of donor liver and related surgical risks, it is necessary to strictly control the indication of operation and the opportunity of transplantation. Therefore, accurate diagnosis and comprehensive evaluation of the condition of patients with severe liver disease to be treated by liver transplantation is an important part in determining the treatment plan. At present, there are many evaluation criteria for severe liver disease. In addition to the classic ChildTurcotte-Pugh (CTP) score and model for end-stage liver disease (MELD) score, many other evaluation criteria have also been developed. All transplant centers have their own choices and thus there is no uniform diagnostic criterion, with disputes among various criteria, which is exactly what this paper aims to summarize.

Clinics ; 75: e1515, 2020. tab, graf
Article in English | LILACS | ID: biblio-1101095


This study aimed to systematically review neuropsychiatric lupus erythematosus (NPSLE) and establish a simplified diagnostic criterion for NPSLE. Publications from 1994 to 2018 in the database (Wanfang data ( and China National Knowledge Internet ( were included. In total, 284 original case reports and 24 unpublished cases were collected, and clinical parameters were analyzed. An attempt was made to develop a set of simplified diagnostic criteria for NPSLE based on cases described in the survey and literature; moreover, and pathophysiology and management guidelines were studied. The incidence rate of NPSLE was estimated to be 12.4% of SLE patients in China. A total of 408 NPSLE patients had 652 NP events, of which 91.2% affected the central nervous system and 8.8% affected the peripheral nervous system. Five signs (manifestations, disease activity, antibodies, thrombosis, and skin lesions) showed that negative and positive predictive values were more than 70%, included in the diagnostic criteria. The specificity, accuracy, and positive predictive value (PPV) of the revised diagnostic criteria were significantly higher than those of the American College of Rheumatology (ACR) criteria (χ2=13.642, 15.591, 65.010, p<0.001). The area under the curve (AUC) for revised diagnostic criteria was 0.962 (standard error=0.015, 95% confidence intervals [CI] =0.933-0.990), while the AUC for the ACR criteria was 0.900 (standard error=0.024, 95% CI=0.853-0.946). The AUC for the revised diagnostic criteria was different from that for the ACR criteria (Z=2.19, p<0.05). Understanding the pathophysiologic mechanisms leading to NPSLE is essential for the evaluation and design of effective interventions. The set of diagnostic criteria proposed here represents a simplified, reliable, and cost-effective approach used to diagnose NPSLE. The revised diagnostic criteria may improve the accuracy rate for diagnosing NPSLE compared to the ACR criteria.

Humans , Lupus Vasculitis, Central Nervous System/physiopathology , Lupus Vasculitis, Central Nervous System/psychology , Lupus Erythematosus, Systemic/physiopathology , Lupus Erythematosus, Systemic/psychology , Rheumatology , China , Surveys and Questionnaires
Clinics ; 75: e1894, 2020. graf
Article in English | LILACS | ID: biblio-1101090


This review aims to verify the main epidemiologic, clinical, laboratory-related, and therapeutic aspects of coronavirus disease 2019 (COVID-19) in critically ill pediatric patients. An extensive review of the medical literature on COVID-19 was performed, mainly focusing on the critical care of pediatric patients, considering expert opinions and recent reports related to this new disease. Experts from a large Brazilian public university analyzed all recently published material to produce a report aiming to standardize the care of critically ill children and adolescents. The report emphasizes on the clinical presentations of the disease and ventilatory support in pediatric patients with COVID-19. It establishes a flowchart to guide health practitioners on triaging critical cases. COVID-19 is essentially an unknown clinical condition for the majority of pediatric intensive care professionals. Guidelines developed by experts can help all practitioners standardize their attitudes and improve the treatment of COVID-19.

Humans , Male , Female , Child , Pneumonia, Viral/diagnosis , Pneumonia, Viral/therapy , Coronavirus Infections/diagnosis , Coronavirus Infections/therapy , Betacoronavirus , Time Factors , Severity of Illness Index , Positive-Pressure Respiration/methods , Critical Illness , Coronavirus Infections/metabolism , Clinical Laboratory Techniques , Reverse Transcriptase Polymerase Chain Reaction , Severe Acute Respiratory Syndrome/diagnosis , Severe Acute Respiratory Syndrome/therapy , Diagnosis, Differential , Pandemics , COVID-19 Testing , SARS-CoV-2 , COVID-19
Arch. cardiol. Méx ; 89(4): 360-368, Oct.-Dec. 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-1149094


Resumen La insuficiencia cardíaca (IC) es un problema de salud pública global con más de 37 millones de individuos afectados en el mundo. La insuficiencia cardíaca con fracción de expulsión preservada (ICFEp) representa una categoría cada vez más frecuente en la práctica clínica, constituye hasta el 60% de los casos y presenta diferencias importantes en el diagnóstico y tratamiento en comparación con la insuficiencia cardíaca y la fracción de expulsión reducida. Esta revisión de ICFEp expone la epidemiología, delimita los principales factores de riesgo y mecanismos fisiopatológicos, identifica las características clínicas/paraclínicas y los criterios diagnósticos, y finaliza con un llamado para realizar investigación en este país.

Abstract Heart failure is a global public health problem, with more than 37 million patients living with heart failure around the world. Heart failure with preserved ejection fraction is an increasingly common category (approximately 60% of the cases) and shows remarkable differences in diagnosis and treatment when compared with heart failure with reduced ejection fraction. The current review covers epidemiology, risk factors, pathophysiologic mechanisms, clinical and paraclinical characteristics and diagnostic criteria of heart failure with preserved ejection fraction and concludes with a plea for original research in our country.

Humans , Stroke Volume/physiology , Heart Failure/physiopathology , Public Health , Global Health , Risk Factors , Heart Failure/diagnosis , Heart Failure/epidemiology
Rev. cuba. reumatol ; 21(3): e114, sept.-dic. 2019.
Article in Spanish | LILACS, CUMED | ID: biblio-1093839


La artritis reumatoide es la enfermedad inflamatoria más común en adultos con una alta prevalencia en la población general, invocando para su diagnóstico la presencia de al menos cuatro criterios de los orientados por el Colegio Americano de Reumatología, teniendo un papel protagónico en los últimos años la presencia de anticuerpos anti proteína citrulinada, así como los estudios de imágenes, que ayudan al diagnóstico de la artritis reumatoide temprana en el curso de los dos primeros años de evolución y sus orientaciones terapéuticas adecuadas, aspecto fundamental en la actualidad para evitar las lesiones erosivas irreversibles, que resultan en un marcado compromiso de la calidad de vida de los pacientes que la sufren, elementos que revisamos en este artículo de opinión(AU)

Rheumatoid arthritis is the most common inflammatory disease in adults with a high prevalence in the general population, invoking for its diagnosis the presence of at least four criteria of those guided by the American College of Rheumatology, having a leading role in recent years the presence of anti-citrullinated protein antibodies, as well as imaging studies, which help the diagnosis of early rheumatoid arthritis in the course of the first two years of evolution and its appropriate therapeutic orientations, a fundamental aspect nowadays to avoid irreversible erosive lesions , which result in a marked commitment to the quality of life of patients who suffer from it, elements that we review in this opinion article(AU)

Humans , Arthritis, Rheumatoid/diagnosis , Arthritis, Rheumatoid/epidemiology , Arthritis, Rheumatoid/diagnostic imaging , Quality of Life , Anti-Citrullinated Protein Antibodies/analysis , Ecuador
Article | IMSEAR | ID: sea-204360


Benign neonatal sleep myoclonus (BNSM), is a disorder generally mistaken for seizures during the newborn period. Benign neonatal sleep myoclonus is featured by myoclonic "lightninglike" jerks of the extremities that exclusively occur during sleep; it is not associated with epilepsy that occur only during sleep and cease abruptly when the child is agitated. This case reported was a 50 days-old baby boy with a history suggestive of abnormal movements for limbs noted over the preceding 7 days. Diagnosis of BNSM in infant based on history taking, clinical manifestation, and with no electroencephalographic changes. BNSM is usually not associated with any other neurologic impairment and spontaneously subsides within the first year of life. Its importance lies in the differential diagnosis with the epileptic, especially myoclonic, seizures of infancy. BNSM can be misinterpreting for neonatal seizures or even neonatal status epilepticus, the recognition of benign sleep myoclonus of infancy is imperative to elude unnecessary diagnostic studies and treatments.

Rev. cuba. estomatol ; 56(3): e1904, jul.-set. 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-1093239


RESUMEN Introducción: La hemofilia es una enfermedad genética poco frecuente en la consulta odontológica. En algunas situaciones se presenta como una urgencia odonto-estomatológica, en la que el profesional debe relacionar las manifestaciones clínicas generales de la enfermedad, con una correcta semiología, paraclínicos y análisis genético-molecular, para diagnosticar y aplicar pertinentes terapéuticas dirigidas a resolver el motivo de consulta del paciente así como el manejo y control de sus complicaciones. Objetivo: Describir los principales aspectos fisiopatológicos generales y de importancia odontológica de la hemofilia, así como las herramientas diagnósticas desde el punto de vista clínico, paraclínico y genético-molecular. Métodos: Búsqueda bibliográfica en las bases de datos Pubmed, Proquest, Scielo y Elsevier, en idioma inglés y español, en las que se seleccionaron artículos publicados en un periodo de 13 años para un total de 50 (2005-2018), empleando los descriptores "hemophilia A, hemophilia B, diagnostic criteria, genetic, molecular, oral health, clinical diagnosis". Análisis e integración de la información: Los estudios han demostrado que la hemofilia, una condición genética y sistémica, tiene repercusiones bucales en el contexto de sus manifestaciones y complicaciones, lo que la hace importante para el odontólogo, debido a que debe ser diagnosticada desde el punto de vista genético-molecular y manejada interdisciplinariamente. Conclusiones: La implicación del diagnóstico genético-molecular por parte del genetista soporta la integración del hematólogo y el odontólogo para el manejo y control de la interconsulta cuando se trata de pautar procedimientos en pacientes con hemofilia(AU)

ABSTRACT Introduction: Hemophilia is a genetic disease scarcely found in dental practice. On occasion it presents as a dental emergency in face of which the professional should relate the general clinical manifestations of the disease to an appropriate semiological, paraclinical and genetic-molecular analysis to diagnose the condition and apply relevant therapies aimed at solving the patient's main concern as well as managing and controlling its complications. Objective: Describe the main general pathophysiological features and aspects of dental interest of hemophilia, as well as the diagnostic tools related to the condition from a clinical, paraclinical and genetic-molecular perspective. Methods: A bibliographic search was conducted in the databases Pubmed, Proquest, Scielo and Elsevier of papers published in English and Spanish in a period of 13 years (2005-2018), using the search terms "hemophilia A", "hemophilia B", "diagnostic criteria", "genetic", "molecular", "oral health", "clinical diagnosis". A total 50 papers were selected. Data analysis and integration: Studies have shown that hemophilia, a genetic systemic condition, may have oral manifestations and complications. This makes it important to dentists, since the disease should be diagnosed from a genetic-molecular point of view and managed in an interdisciplinary manner. Conclusions: Genetic-molecular diagnosis by geneticists implies involvement of hematologists and dentists in the management and control of the condition via interconsultation, when it comes to deciding on procedures for hemophilic patients(AU)

Humans , Clinical Diagnosis , Oral Health/standards , Hemophilia A/epidemiology , Databases, Bibliographic
Rev. urug. cardiol ; 34(1): 284-306, abr. 2019. tab
Article in Spanish | LILACS-Express | LILACS | ID: biblio-991658


Resumen: La miocardiopatía no compactada es un trastorno caracterizado por una morfología anómala del miocardio, con una organización en dos capas diferenciadas: una capa fina epicárdica compactada y bien desarrollada, y otra capa endocárdica gruesa de aspecto esponjoso, con trabéculas y recesos intertrabeculares prominentes. En algunos casos se asocia a dilatación ventricular y disfunción sistólica, lo que conduce a insuficiencia cardíaca, arritmias cardíacas y complicaciones tromboembólicas. No está totalmente claro si se trata de una miocardiopatía definida como tal o si es un rasgo fenotípico compartido por muchas otras patologías subyacentes. Para su diagnóstico, la ecocardiografía representa la primera herramienta a emplear, utilizando varios criterios definidos hasta la fecha, aunque con escasa correlación entre ellos. La cardio-resonancia magnética (Cardio-RM), con criterios diagnósticos bien establecidos, trata de superar las limitaciones de la ecocardiografía. El tratamiento se basa en el manejo de las complicaciones según las guías de práctica general. Se han definido recomendaciones en cuanto al despistaje de la misma y el pronóstico es muy variable, si bien el conocimiento que tenemos de la patología hasta la fecha es aún muy limitado.

Summary: Non-compaction cardiomyopathy is a disorder characterized by an anomalous morphology of the myocardium, with an organization in two differentiated layers: a thin and well developed epicardial layer, and another thick endocardial layer of spongy appearance, with prominent trabeculae and intertrabecular recesses. In some cases, it is associated with ventricular dilatation and systolic dysfunction, which leads to heart failure, cardiac arrhythmias and thromboembolic complications. It is not entirely clear whether it is a cardiomyopathy per se or it is really a phenotypic trait shared by many other underlying pathologies. For its diagnosis, echocardiography represents the first tool to be used, with several diagnostic criteria defined to date, although they present little correlation. To help these limitations, cardiac magnetic resonance is also used, which has established criteria too. The treatment is based on the management of complications according to general practice guidelines. Recommendations have been defined regarding the screening of the pathology and the prognosis is very variable, even though the knowledge we have of the pathology to date is still very limited.

Resumo: A cardiomiopatia não compactada é um distúrbio caracterizado por morfologia anômala do miocárdio, com organização em duas camadas diferenciadas: camada fina epicárdica bem desenvolvida e compacta, e outra camada endocárdica espessa de aspecto esponjoso, com trabéculas e recessos intertrabeculares proeminentes. Em alguns casos está associada à dilatação ventricular e disfunção sistólica, o que leva à insuficiência cardíaca, arritmias cardíacas e complicações tromboembólicas. Não está completamente claro se é uma cardiomiopatia definida como tal ou se é um traço fenotípico compartilhado por muitas outras patologias subjacentes. Para o seu diagnóstico, a ecocardiografia representa a primeira ferramenta a ser utilizada, com vários critérios diagnósticos definidos até o momento, embora com pouca correlação entre eles. Ressonância Cardio-Magnética, com critérios diagnósticos bem estabelecidos, tenta superar as limitações da ecocardiografia. O tratamento baseia-se no manejo das complicações de acordo com as diretrizes da prática geral. Definimos recomendações quanto à triagem das mesmas e o prognóstico é muito variável, embora o conhecimento que temos da patologia até o momento ainda seja muito limitado.

Medicina (B.Aires) ; 79(1): 1-5, feb. 2019. ilus, tab
Article in Spanish | LILACS | ID: biblio-1002580


La leucemia aguda es la enfermedad oncológica más frecuente en la infancia. La leucemia linfoblástica aguda representa el 75% y la mieloblástica aguda el 25% de ellas. La eritroleucemia es una entidad infrecuente, representando menos del 5% de las leucemias mieloblásticas agudas. Su definición ha variado a lo largo del tiempo. La OMS en 2017 define el subtipo de eritroleucemia cuando el porcentaje de eritroblastos representa el 80% de la celularidad total de la médula ósea. El presente trabajo, de tipo analítico, retrospectivo, tuvo como finalidad revisar los hallazgos de morfología, citometría de flujo, citogenética, respuesta al tratamiento y evolución de los casos previamente definidos como eritroleucemia, en nuestro centro, en los últimos 25 años y reclasificar aquellos que no cumplían con los nuevos criterios de la OMS 2017. Entre enero de 1990 y diciembre de 2015, se diagnosticaron 576 casos de leucemia mieloblástica aguda siendo 11 (1.9%) de ellos clasificados como eritroleucemia. Resultaron evaluables 10 casos. La distribución por sexo fue 1:1 y la edad mediana fue 5 (rango: 0.9-14) años. Seis pacientes presentaban antecedentes de síndrome mielodisplásico. Según los nuevos criterios, ninguno de los casos analizados puede ser actualmente definido como eritroleucemia. De acuerdo a la recategorización, fueron definidos como leucemias de subtipos de mal pronóstico, como leucemia aguda indiferenciada, sin diferenciación y megacarioblástica. Solo dos pacientes se encuentran libres de enfermedad, probablemente debido a estos subtipos desfavorables, sumado al antecedente frecuente de mielodisplasia.

Acute leukemia is the most frequent malignant disease in childhood. Acute lymphoblastic leukemia represents 75% and acute myeloblastic leukemia 25% of them. Erythroleukemia is a rare entity, corresponding to less than 5% of acute myeloblastic leukemia. Its definition has changed over the time. WHO in 2017 defines erythroleukemia when the percentage of erythroblasts represent 80% of the total cellularity of the bone marrow aspirate. This analytical and retrospective study was performed with the aim of reviewing morphology, flow cytometry and cytogenetic features, response to treatment and outcome of cases previously defined as erythroleukemia in our center during the last 25 years and, in addition to reclassify those cases which do not meet the new WHO 2017 criteria. From January 1990 to December 2015, 576 patients were diagnosed as acute myeloblastic leukemia and 11 (1.9%) of them were classified as erythroleukemia. Ten cases were evaluable. Sex distribution was 1:1 and the median age at diagnosis was 5 (range: 0.9-14) years. Six of them had presented with previous myelodysplastic syndrome. None of the analyzed cases can be currently defined as erythroleukemia, according to the new criteria. When reclassified, the cases were defined as leukemias of subsets with poor prognosis such as acute undifferentiated leukemia, without differentiation and megakaryoblastic leukemia. Only 2 patients remain leukemia-free and this could be explained both by the unfavorable prognosis of these leukemia subtypes, and the antecedent of myelodysplastic syndrome in most of the cases.

Humans , Female , Infant , Child, Preschool , Child , Adolescent , World Health Organization , Leukemia, Erythroblastic, Acute/classification , Leukemia, Erythroblastic, Acute/diagnosis , Argentina , Leukemia, Erythroblastic, Acute/therapy , Retrospective Studies , Treatment Outcome , Practice Guidelines as Topic , Disease Progression , Cytogenetic Analysis/methods , Flow Cytometry/methods
China Occupational Medicine ; (6): 345-348, 2019.
Article in Chinese | WPRIM | ID: wpr-881803


OBJECTIVE: To explore the 2014 edition of the diagnostic criteria of occupational noise-induced deafness on the assessment of hearing loss in occupational health examination. METHODS: A total of 835 noise-exposed workers were selected as study subjects by cluster sampling method. The hearing threshold results were compared through two different editions of criteria: GBZ 49-2007 Diagnostic Criteria of Occupational Noise-induced Deafness( GBZ 49-2007) and GBZ 49-2014 Diagnosis of Occupational Boise-induced Deafness( GBZ 49-2014). RESULTS: The binaural high frequency threshold average calculated by GBZ 49-2007 was lower than that of GBZ 49-2014 [( 46. 8 ± 8. 1) vs( 49. 2 ± 8. 0) d B,P < 0. 01].The speech frequency threshold average of the good ear calculated by GBZ 49-2007 was lower than the monaural threshold of weighted value of the good ear of GBZ 49-2014 [( 18. 8 ± 3. 6) vs( 22. 0 ± 3. 3),P < 0. 01]. The speech frequency threshold average of the good ear and the monaural threshold of weighted value of the good ear calculated after age and sex correction using GBZ 49-2007 were lower than that calculated by using GBZ 49-2014 [( 18. 8 ± 3. 6) vs( 19. 4 ± 3. 6),( 21. 5 ±3. 4) vs( 22.0 ±3.3),P <0.05]. The detection rate of suspected occupational noise-induced deafness GBZ 49-2014 was higher than that of GBZ 49-2007( 6. 35% vs 2. 87%,P < 0. 01). CONCLUSION: In occupational health examination,the diagnostic criteria of GBZ 49-2014 can diagnose patients as suspected occupational noise-induced deafness easier than that of GBZ 49-2007.

Article in Chinese | WPRIM | ID: wpr-805587


Objective@#To characterize the features of human brucellosis from national reports of occupational diseases and infectious diseases in China during 2006-2016, and explore the correlations between human brucellosis with the livestock and their products.@*Methods@#From January to October 2018, the data of human brucellosis were extracted from China's annual national reports of occupational diseases and infectious diseases from government circulars during 2006-2016. The data on the number of livestock and the output of livestock products were obtained from China Statistical Yearbook, China Animal Industry Yearbook and China Animal Industry and Veterinary Yearbook. The standards of Diagnosis of occupational infectious disease (GBZ 227-2017) and Diagnostic criteria for brucellosis (WS 269-2007) were compared. The statistics were analyzed using Excel 13.0 and SPSS software 22.0. The linear regression and multiple regression were used to explore the relationships between human brucellosis with the number of livestock and the output of livestock products.@*Results@#The diagnosis of human brucellosis in national reports of occupational diseases was based on GBZ 227-2017, which referred to WS 269-2007. There is an increasing trend from 2006 to 2009, and then declined to 2011, but rebounded from 2012 onwards in human brucellosis in national reports of occupational diseases. The general trend showed an increase during the 2006-2014 period, and then a decrease onwards in human brucellosis in national reports of infectious diseases. The Spearman correlation from SPSS showed the rs value of 0.936 (P<0.001) between human brucellosis cases in national reports of occupational diseases and infectious diseases in China from 2006 to 2016. Human brucellosis had a seasonal and periodic trend, and the cases revealed an epidemic period from April to August, with a peak in June. Human brucellosis cases were positively correlated with the number of cattle and buffaloes, hogs, sheep and goats (P<0.05) , and the output of pork, beef and mutton (P<0.05) . And human brucellosis cases in national reports of infectious diseases were positively associated with the output of sheep wool (β=0.814) , goat wool (β=0.603) , and cashmere (β=0.562) .@*Conclusion@#Human brucellosis both in national reports of occupational diseases and infectious diseases remain severe in China. There are relationships between human brucellosis with the number of livestock and the output of livestock products.

Article in Chinese | WPRIM | ID: wpr-804802


Objective@#To determine the weight coefficients of the diagnostic index system for occupational chronic obstructive pulmonary disease (COPD), and to provide a reference for the determination of diagnostic indices.@*Methods@#The analytic hierarchy process was performed to establish the hierarchical structure of diagnostic indices for occupational COPD, construct a pairwise comparison judgment matrix, and conduct a consistency test on the judgment matrix, in order to determine the weight of each index.@*Results@#The weight coefficients of six first-level indices and 27 second-level indices were determined based on the analytic hierarchy process.All these index weights satisfied the consistency test.@*Conclusion@#The analytic hierarchy process uses expert experience knowledge to set up the index system, then judges the consistency of expert opinions through the consistency test, and effectively combines qualitative analysis with quantitative analysis, which may provide a scientific and feasible idea for establishing the diagnostic index system for COPD caused by occupational irritant chemicals.