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Rev. Soc. Odontol. La Plata ; 30(58): 13-17, jul. 2020. ilus, graf
Article in Spanish | LILACS (Americas) | ID: biblio-1119236


Las compresiones del maxilar superior son alteraciones transversales por discrepancia óseo-dentaria. .En la dentición mixta temprana puede establecerse la estrechez mediante índices que relacionan el tamaño dental con el ancho transversal del arco dentario. Se analizaron 33 modelos superiores de niños en el tercer período de desarrollo clínico según Barnett. Se estableció la estrechez realizando el análisis métrico del arco dental mediante el índice de Pont. Se describió la anomalía de posición anterior según las siguientes variables: A) Apiñamiento dentario: 1-Escalón de los dientes anterosuperiores; 2-Rotación mesial de los cuatro incisivos; 3-Rotación mesial de los incisivos centrales y rotación distal de los incisivos laterales y 4-Rotación distal de los incisivos centrales. B) Ausencia de apiñamiento: 1-Reabsorción atípica y 2- Ausencia de reabsorción atípica. Las anomalías de posición y/o reabsorciones atípicas anteriores en este período de desarrollo clínico se asocian a estrechez transversal del maxilar superior Siendo la malposición más frecuente la rotación mesial de los cuatro incisivos, siguiendo las reabsorciones atípicas y el escalón de los dientes anterosuperiores, luego la rotación mesial de los incisivos centrales y distal de los laterales y por último la rotación distal de los incisivos centrales (AU)

Inside the traverse alteration of the maxillary the compressions are described as uni or bilateral where an imbalance is settled down between the dental size and the size of the maxillary causing alterations in the position of the teeth. In the early mixed teething the narrowness of the maxillary can be settled by means of indexes that relate the dental size with the traverse width of the dental arch. Thirty models of the maxillary of children according to Barnett's third development period were analyzed. The metrical analysis of the dental arch form was carried out through Pont's index. The theoretic values were compared with the real ones establishing the deviations of the norm that is to say the narrow nest. Out of the 30 cases analyzed, 40% presented mesial rotation of the 4 incisors; 27% showed a stop of the front teeth; 27% atypical reabsorption; 20% mesial rotation of the central incisors and distal rotation of the lateral incisors and the 10% presented a distal rotation of the central incisors. With regard to the front atypical discrepancy 36.66% of the cases had a discrepancy above 6 mm and the 23.33% below 3 mm (AU)

Humans , Male , Female , Child , Dental Arch/abnormalities , Dentition, Mixed , Early Diagnosis , Jaw Abnormalities/diagnosis , Statistical Analysis , Incisor/abnormalities , Malocclusion/diagnosis , Maxilla/abnormalities
Article in English | WPRIM (Western Pacific) | ID: wprim-762461


BACKGROUND: Rapid and accurate diagnosis of acute myocardial infarction (AMI) is critical for initiating effective treatment and achieving better prognosis. We investigated the performance of copeptin for early diagnosis of AMI, in comparison with creatine kinase myocardial band (CK-MB) and troponin I (TnI). METHODS: We prospectively enrolled 271 patients presenting with chest pain (within six hours of onset), suggestive of acute coronary syndrome, at an emergency department (ED). Serum CK-MB, TnI, and copeptin levels were measured. The diagnostic performance of CK-MB, TnI, and copeptin, alone and in combination, for AMI was assessed by ROC curve analysis by comparing the area under the curve (AUC). Sensitivity, specificity, negative predictive value, and positive predictive value of each marker were obtained, and the characteristics of each marker were analyzed. RESULTS: The patients were diagnosed as having ST elevation myocardial infarction (STEMI; N=43), non-ST elevation myocardial infarction (NSTEMI; N=25), unstable angina (N=78), or other diseases (N=125). AUC comparisons showed copeptin had significantly better diagnostic performance than TnI in patients with chest pain within two hours of onset (AMI: P=0.022, ≤1 hour; STEMI: P=0.017, ≤1 hour and P=0.010, ≤2 hours). In addition, TnI and copeptin in combination exhibited significantly better diagnostic performance than CK-MB plus TnI in AMI and STEMI patients. CONCLUSIONS: The combination of TnI and copeptin improves AMI diagnostic performance in patients with early-onset chest pain in an ED setting.

Acute Coronary Syndrome , Angina, Unstable , Area Under Curve , Chest Pain , Creatine Kinase , Diagnosis , Early Diagnosis , Emergencies , Emergency Service, Hospital , Humans , Myocardial Infarction , Prognosis , Prospective Studies , ROC Curve , Sensitivity and Specificity , Troponin I
Article in English | WPRIM (Western Pacific) | ID: wprim-811442


Duodenal leiomyosarcoma is a rare condition with a poor prognosis. Early diagnosis of duodenal leiomyosarcoma is challenging because it presents with nonspecific symptoms and endoscopic biopsies usually do not enable a definitive diagnosis. Duodenal leiomyosarcomas are diagnosed on the basis of the histopathological identification of a mesenchymal lesion composed of malignant tumor cells that on immunohistochemical examination is positive for smooth muscle actin and desmin. We report the case of a 38-year-old man who presented with gastrointestinal bleeding and obstruction who was diagnosed with duodenal leiomyosarcoma after surgical resection.

Actins , Adult , Biopsy , Desmin , Diagnosis , Duodenal Obstruction , Early Diagnosis , Gastrointestinal Hemorrhage , Hemorrhage , Humans , Leiomyosarcoma , Muscle, Smooth , Prognosis
Article in English | WPRIM (Western Pacific) | ID: wprim-811182


In terms of management of Paget's disease of bone (PDB), early diagnosis and proper management achieving remission is essential with lifelong specialist follow-up. We present the case of a 40-year-old woman with PDB affecting mainly the distal extremities (ankle and wrist). The patient visited our hospital in 2012 with heel pain. Plain radiography revealed osteoporosis, and a bone scan revealed hot uptake. Initial laboratory investigations showed normal serum calcium, 25-hydroxy-vitamin D, and parathyroid hormone levels; however, osteocalcin, C-terminal telopeptide of type I collagen, and bone alkaline phosphatase levels were elevated. A bone mineral density scan showed T- and Z-scores of −2.5 and −2.7, respectively, and bisphosphonate treatment was initiated. Biopsy performed on the calcaneal lateral wall revealed inconclusive findings. Follow-up biopsy on the left distal radius was performed 7 years later to investigate wrist pain, and this examination led to a final diagnosis as PDB. We suggest inconclusive biopsy result during the early phase of PDB and highly recommend follow-up evaluation in osteoporosis with atypical behavior.

Adult , Alkaline Phosphatase , Biopsy , Bone Density , Calcium , Collagen Type I , Diagnosis , Diphosphonates , Early Diagnosis , Extremities , Female , Follow-Up Studies , Heel , Humans , Osteitis Deformans , Osteocalcin , Osteoporosis , Parathyroid Hormone , Radiography , Radius , Specialization , Wrist
Article in English | WPRIM (Western Pacific) | ID: wprim-816637


Sexually transmitted infections (STIs) are caused by the spread of pathogens via sexual activity and can cause serious complications if left untreated, regardless of their symptoms. Therefore, early diagnosis of STI is important, and molecular diagnostic methods for rapid detection and monitoring are needed. In this study, we evaluated a multiplex polymerase chain reaction (PCR) kit for simultaneously detecting 13 different bacterial, fungal, and viral microorganisms that cause STIs. The kit performance was evaluated for its sensitivity, lot-to-lot variation, and interference in detecting different pathogens. Additionally, its clinical usefulness was evaluated by estimating its sensitivity and specificity for clinical samples. The limit of detection (LOD) was 0.021–50.104 copies for each pathogen. In the tests of lot-to-lot, 100% of positive samples were detected at low concentrations and negative samples all showed negative results. This result confirms that there is no the variation of lot-to-lot. In the test for interference between pathogens, the efficiency of amplification for each pathogen was not significantly reduced and no nonspecific amplification product was formed. We tested 322 vaginal swab samples using the multiplex PCR kit and confirmed that its clinical sensitivity and specificity were 100% for all pathogens. This multiplex PCR kit can be used widely for rapid diagnosis and monitoring of STIs.

Diagnosis , Early Diagnosis , Limit of Detection , Multiplex Polymerase Chain Reaction , Pathology, Molecular , Sensitivity and Specificity , Sexual Behavior , Sexually Transmitted Diseases
Rev. latinoam. enferm. (Online) ; 28: e3266, 2020. tab
Article in English | LILACS (Americas), BDENF | ID: biblio-1101728


Abstract Objective: To verify factors associated with early newborn access to biological neonatal screening. Method: A cross-sectional quantitative study was carried out with all newborns who underwent tests in healthcare units, hospitals, and laboratories of a city in the state of São Paulo, Brazil, with programs linking healthcare information. The following variables were investigated: child's age at collection (dependent); place of collection; date of collection; and type of user (independent). Descriptive and inferential statistics were applied. Results: Records of 15,652 screenings were found in the two years analyzed. In the first year analyzed, 7,955 births and 7,640 (96.0%) tests were recorded, of which 5,586 (73.1%) were undertaken with newborns between three and five days old. In the next year analyzed, 8,316 births and 8,012 (96.3%) screenings were recorded, of which 7,025 (87.6%) were undertaken with newborns in the same age group. A statistically significant association was found between the variables "child's age" and "type of user" in one year, and between the variables "child's age" and "place of collection" in both years. Conclusion: Early access to these tests enables the screening of diseases and referral for treatment. The present study contributes to the management of child care programs by presenting strategies linking data and actions to improve access to biological neonatal screening.

Resumo Objetivo: verificar fatores associados ao acesso precoce de recém-nascidos à triagem neonatal biológica. Método: estudo transversal, quantitativo, com todos os bebês que realizaram exame em unidades de saúde, hospitais ou laboratórios de um município do estado de São Paulo, Brasil, com programas que vinculam informações de atenção à saúde. Foram investigadas as variáveis: idade da criança na coleta (dependente), local da coleta, data da coleta, tipo de usuário (independentes). Aplicou-se estatística descritiva e inferencial. Resultados: há registro de 15.652 triagens nos dois anos analisados. No primeiro ano analisado, ocorreram 7.955 nascimentos e 7.640 (96,0%) exames, 5.586 (73,1%) deles em recém-nascidos de três a cinco dias de vida. Para 8.316 bebês nascidos no ano seguinte, foram registradas 8.012 (96,3%) triagens, 7.025 (87,6%) delas na mesma faixa etária. Encontrou-se associação estatisticamente significativa entre as variáveis "idade da criança" e "tipo de usuário" em um ano, e entre "idade da criança" e "local da coleta" em ambos os anos. Conclusão: o acesso precoce ao exame oportuniza a triagem de doenças e o encaminhamento para tratamento. O estudo contribui com a gestão de programas de atenção à criança, ao apresentar estratégias que articulam informações e ações para melhoria do acesso à triagem neonatal biológica.

Resumo Objetivo: verificar factores asociados al acceso precoz del recién nacido al tamizaje neonatal biológico. Método: estudio transversal, cuantitativo, con todos los bebés examinados en unidades de salud, hospitales o laboratorios de un municipio del estado de São Paulo, Brasil; con programas integradores de información de atención de salud. Fueron investigadas las variables: edad del niño en la recolección (dependiente), lugar de recolección, fecha de recolección y tipo de usuario (dependientes). Se aplicó estadística descriptiva e inferencial. Resultados: existen registrados 15.652 triajes en los dos años estudiados. Durante el primero, ocurrieron 7.955 nacimientos y 7.640 (96,0%) análisis, 5.586 (73,1%) en recién nacidos de tres a cinco días de vida. Hubo 8.316 nacimientos en el año siguiente, se registraron 8.012 triajes, 7.025 (87,6%) para la misma faja etaria. Se encontró asociación estadísticamente significante entre las variables "edad del niño" y "tipo de usuario" en un año, y entre "edad del niño" y lugar de recolección" en ambos años. Conclusión: el acceso precoz al análisis permite el tamizaje de enfermedades y la derivación para tratamiento. El estudio contribuye a la gestión de programas de atención infantil, presentando estrategias que articulan información y acciones para mejorar el acceso al tamizaje neonatal biológico.

Humans , Infant, Newborn , Time Factors , Brazil , Child Health Services/statistics & numerical data , Neonatal Screening , Early Diagnosis , Health Services Accessibility , National Health Programs
Rev. argent. coloproctología ; 30(4): 88-92, dic. 2019. ilus
Article in Spanish | LILACS (Americas) | ID: biblio-1096793


Introducción: Las lesiones escamosas intraepiteliales de alto grado anales (H-ASIL) son consideradas el precursor del carcinoma escamoso anal. Es por esto que distintas Sociedades recomiendan su pesquisa y tratamiento en poblaciones de alto riesgo. El objetivo del trabajo es describir las manifestaciones de H-ASIL en la anoscopía de alta resolución (AAR) en nuestros pacientes. Diseño: Retrospectivo, descriptivo. Pacientes y métodos: Revisión de historias clínicas e imágenes de AAR de pacientes con diagnóstico de H-ASIL entre enero de 2016 y julio de 2017. La evaluación anoscópica incluyó la unión escamocolumnar, el conducto anal distal y el área perianal. Frente al hallazgo de una lesión sospechosa de ASIL, se tomaron biopsias. Resultados: Entre enero de 2016 y julio de 2017 se realizaron 184 AAR. Se biopsiaron 143 lesiones sospechosas de ASIL. Veintiséis de ellas, presentes en 13 pacientes fueron H-ASIL. Once hombres (diez hombres que tienen sexo con hombre (HSH) con infección por VIH). Todas las lesiones eran subclínicas y se encontraron a nivel endoanal; eran en su totalidad acetoblancas. Se buscaron áreas con puntillado y/o mosaico sugestivas de ASIL. El uso de Lugol nos permitió aumentar el grado de sospecha y delimitar las lesiones. Se tomaron biopsias para anatomía patológica bajo visión directa. Conclusiones: Las H-ASIL son consideradas en la actualidad las precursoras del carcinoma escamoso anal; su detección y tratamiento prevendrían su desarrollo. En nuestra casuística, todos los pacientes se encontraban en al menos un grupo de riesgo. Las lesiones fueron subclínicas y requirieron de la anoscopía de alta resolución para su hallazgo, lo que permitió realizar un tratamiento dirigido. Es importante que los profesionales de la salud consideren la pesquisa de H-ASIL en población de riesgo. (AU)

Introduction: The high-grade anal intraepithelial lesions (H-ASIL) are considered the precursor of the anal squamous cell carcinoma. This is why different societies recommend the screening and treatment in high-risk populations. The objective of this paper is to describe H-ASIL manifestations in the high resolution anoscopy (HRA) in our patients. Design: Retrospective, Descriptive Patients and Methods: Review of clinical histories and pictures of HRA of patients with H-ASIL diagnosis between January 2016 and July 2017. The anoscopic evaluation included the squamocolumnar junction, the distal anal duct and the perianal area. In case of the finding of a suspicious lesion of ASIL, biopsies were taken. Results: Between January 2016 and July 2017 184 HRA were performed. 143 ASIL suspicious lesion were biopsied. Twentysix of them, in 13 patients, were H-ASIL. Eleven were men (10 men who have sex with men with HIV infection). All lesions were subclinical and found at endoanal level. The totality of them were acetowhite. Areas with coarse punctation and a mosaic pattern were suggestive of ASIL. The use of lugol´s iodine allows us to increase the grade of suspect and delimit the lesions. Biopsies were taken for pathology under direct vision. Conclusion: The H-ASIL are considered at the present the precursors of the anal squamous carcinoma. Its development could be prevented with de proper detection and treatment of the H-ASIL. In our casuistic, all patients are in at least one risk group. The lesions were subclinical and required of the high resolution anoscopy for their finding, which allows to perform a directed treatment. It is important that health professionals consider the H-ASIL screening in risk population. (AU)

Humans , Male , Female , Anus Neoplasms/prevention & control , Precancerous Conditions/diagnosis , Carcinoma, Squamous Cell/prevention & control , Proctoscopy/methods , Papanicolaou Test/methods , Squamous Intraepithelial Lesions/diagnosis , Anal Canal/pathology , Precancerous Conditions/therapy , HIV Infections , Mass Screening , Retrospective Studies , Risk Factors , Homosexuality, Male , Papillomavirus Infections , Early Diagnosis , Squamous Intraepithelial Lesions/therapy
Rev. cuba. pediatr ; 91(4): e926, oct.-dic. 2019. tab, graf
Article in Spanish | LILACS (Americas), CUMED | ID: biblio-1093736


Introducción: la osteogénesis imperfecta es una rara enfermedad genética hereditaria caracterizada por su heterogeneidad causada por defectos del tejido conectivo con el rasgo de fragilidad ósea determinante de múltiples fracturas, incluso prenatales; deformidades de huesos largos y columna vertebral y otros síntomas extra-esqueléticos, como escleróticas de color azul, dentinogénesis imperfecta, trastorno de audición y afectación cardiovascular. Objetivo: Presentar un paciente con las características clínicas e imagenológicas de osteogénesis imperfecta de tipo III. Presentación del caso: Niño ecuatoriano de 4 años de edad de baja talla con antecedente de fracturas múltiples desde los 8 meses de nacido, con deformidad en columna vertebral demostrada por radiología por cifoescoliosis en forma de "S" y fracturas vertebrales, con deformidad progresiva en huesos largos; ha sufrido 16 fracturas, no deambula, sensorio presente, orientado en tiempo y espacio, desarrollo cognitivo normal para la edad. La fragilidad ósea del niño según el fenotipo clasifica al diagnóstico de tipo III de osteogénesis imperfecta, el cual es progresivo e invalidante por las deformidades óseas y múltiples fracturas demostradas en exámenes imagenológicos, sin modificaciones en el color de escleróticas, de herencia presumiblemente dominante. Conclusiones: La descripción clínica y radiológica de osteogénesis imperfecta, afección poco conocida, correspondiente al fenotipo III de la enfermedad, reportada en niño ecuatoriano de 4 años de edad, con talla baja que no deambula, expresión de la severidad de su afección genética, con severas alteraciones óseas por su fragilidad con fracturas múltiples en huesos largos y vértebras(AU)

Introduction: Osteogenesis imperfecta is a rare hereditary genetic disease characterized by its heterogeneity caused by connective tissue defects with the feature of bone fragility determining multiple fractures, even prenatal ones; also deformities of long bones and spine, and other extra-skeletal symptoms, such as blue sclerotic, dentinogenesis imperfecta, hearing disorder and cardiovascular affectations. Objective: To present a patient with clinical and radiological findings of osteogenesis imperfect type III. Case presentation: Ecuadorean male child of 4 years old, with a short height, history of multiple fractures from 8 months of age, with spinal deformity demonstrated by radiology due to "S" shaped kyphoscoliosis and vertebral fractures, with progressive deformity in long bones. The boy has suffered 16 fractures, he does not wander, and he is sensory present, oriented in time and space, with normal cognitive development for his age. The bone fragility of the child according to the phenotype classifies in the type III diagnosis of osteogenesis imperfecta, which is progressive and invalidating due to bone deformities and multiple fractures evidenced in imaging tests, without changes in the color of sclerotics and of presumably dominant inheritance. Conclusions: The clinical and radiological description of osteogenesis imperfecta, which is little-known pathology, corresponding to type III phenotype is reported in a 4-year-old boy who, due to his involvement, has a short height and does not wander as a consequence of the severity of bone affectations with fractures in long bones and vertebrae, mainly produced by the fragility of the bones due to his genetic disease(AU)

Humans , Male , Child, Preschool , Osteogenesis Imperfecta/diagnosis , Osteogenesis Imperfecta/diagnostic imaging , Rare Diseases/prevention & control , Early Diagnosis , Ecuador
Ortodoncia ; 83(166): 14-23, jul.-dic. 2019. ilus
Article in Spanish | LILACS (Americas) | ID: biblio-1102095


La laterodesviación mandibular es una de las anomalías dentoesqueletales sobre las que hay que intervenir tempranamente, ya que, libradas a su evolución, desembocan en una asimetría facial que podría ser de resolución ortodóncicoquirúrgica. Dado que la población infantil puede estar expuesta a diferentes tipos de traumatismos en el área facial, es que se hace necesaria la evaluación exhaustiva del paciente con seguimiento a lo largo de su crecimiento y desarrollo. Se presenta un caso clínico de un paciente, a modo ilustrativo.(AU)

Mandibular laterognathia is one of dentofacial deformities which need an early diagnosis since if they evolve naturally, they lead to a facial asymmetry that could be of surgical-orthodontic solution. As pediatric population can be exposed to many different types of facial trauma, it becomes necessary a thorough examination of the patient with a follow up through out growth and development. A case report is presented for illustrative purposes.(AU)

Wounds and Injuries , Early Diagnosis , Orthodontic Appliances, Functional , Growth and Development , Facial Asymmetry , Mandibular Condyle/injuries
Prensa méd. argent ; 105(11): 816-826, dic2019. fig, tab, graf
Article in English | LILACS (Americas), BINACIS | ID: biblio-1049970


Background: To investigate the potential of the phage display-identified tumor cellbinding peptide as a biomarker of epithelial ovarian cancer using phage display technology. Method: The Ph.D.-7 Phage Display Peptide Library was used to identify the specific conjugated phages with SKOV3 epithelial ovarian cancer cells, while Chinese hamster ovary cells formed the basis. After employing the rapid differential screening method invitro, the enzyme-linked immunosorbent assay (ELISA), DNA sequencing, immunohistochemistry, immunofluorescence, and the competitive inhibition test of synthetic peptides were used to determine the affinity and specificity of the phages with SKOV3 cells. Results: Using bio panning, we screened the phages, showing a 3590-fold increase after the third round. A total of 61 titers of the phage were randomly selected for ELISA and 10 kinds of the phages with an optical density >0.5 were used for DNA sequencing. Clones of the phage TRRNIPN were derived from DNA sequencing based on ELISA, exhibiting both the brown granular phenomenon and green fluorescence. The specific targeted peptide TRRNIPN was incorporated in tumor cells through the competitive inhibition test. Conclusion: The results of our study indicate that the phage display identified polypeptide TRRNIPN may be an effective biomarker for the early diagnosis and targeted therapy of ovarian cancer

Humans , Female , Bacteriophages , DNA/analysis , Enzyme-Linked Immunosorbent Assay , Biomarkers, Tumor , Mass Screening/methods , Peptide Library , Early Diagnosis , Research Report , /therapy
J. bras. nefrol ; 41(4): 509-517, Out.-Dec. 2019. tab, graf
Article in English | LILACS (Americas) | ID: biblio-1056618


Abstract Introduction: Although microalbuminuria remains the gold standard for early detection of diabetic nephropathy (DN), it is not a sufficiently accurate predictor of DN risk. Thus, new biomarkers that would help to predict DN risk earlier and possibly prevent the occurrence of end-stage kidney disease are being investigated. Objective: To investigate the role of zinc-alpha-2-glycoprotein (ZAG) as an early marker of DN in type 2 diabetic (T2DM) patients. Methods: 88 persons were included and classified into 4 groups: Control group (group I), composed of normal healthy volunteers, and three patient groups with type 2 diabetes mellitus divided into: normo-albuminuria group (group II), subdivided into normal eGFR subgroup and increased eGFR subgroup > 120 mL/min/1.73m2), microalbuminuria group (group III), and macroalbuminuria group (group IV). All subjects were submitted to urine analysis, blood glucose levels, HbA1c, liver function tests, serum creatinine, uric acid, lipid profile and calculation of eGFR, urinary albumin creatinine ratio (UACR), and measurement of urinary and serum ZAG. Results: The levels of serum and urine ZAG were higher in patients with T2DM compared to control subjects and a statistically significant difference among studied groups regarding serum and urinary ZAG was found. Urine ZAG levels were positively correlated with UACR. Both ZAG levels were negatively correlated with eGFR. Urine ZAG levels in the eGFR ˃ 120 mL/min/1.73m2 subgroup were higher than that in the normal eGFR subgroup. Conclusion: These findings suggest that urine and serum ZAG might be useful as early biomarkers for detection of DN in T2DM patients, detectable earlier than microalbuminuria.

Resumo Introdução: Embora a microalbuminúria continue sendo o padrão ouro para a detecção precoce da nefropatia diabética (ND), ela não é um preditor suficientemente preciso do risco de ND. Assim, novos biomarcadores para prever mais precocemente o risco de ND e possivelmente evitar a ocorrência de doença renal terminal estão sendo investigados. Objetivo: Investigar a zinco-alfa2-glicoproteína (ZAG) como marcador precoce de ND em pacientes com debates mellitus tipo 2 (DM2). Métodos: Os 88 indivíduos incluídos foram divididos em quatro grupos: grupo controle (Grupo I), composto por voluntários saudáveis normais; e três grupos de pacientes com DM2 assim divididos: grupo normoalbuminúria (Grupo II), subdivididos em TFG normal e TFG > 120 mL/min/1,73 m2), grupo microalbuminúria (Grupo III) e grupo macroalbuminúria (Grupo IV). Todos foram submetidos a urinálise e exames para determinar glicemia, HbA1c, função hepática, creatinina sérica, ácido úrico, perfil lipídico, cálculo da TFG, relação albumina/creatinina (RAC) e dosagem urinária e sérica de ZAG. Resultados: Os níveis séricos e urinários de ZAG foram mais elevados nos pacientes com DM2 em comparação aos controles. Foi identificada diferença estatisticamente significativa entre os grupos estudados em relação aos níveis séricos e urinários de ZAG. Os níveis urinários de ZAG foram positivamente correlacionados com a RAC. Ambos os níveis de ZAG foram negativamente correlacionados com TFG. Os níveis urinários de ZAG no subgrupo com TFG ˃ 120 mL/min/1,73m2 foram maiores do que no subgrupo com TFG normal. Conclusão: Constatamos que a ZAG sérica e urinária pode ser um útil biomarcador precoce para detecção de ND em pacientes com DM2, sendo detectável mais precocemente que microalbuminúria.

Humans , Male , Female , Adult , Middle Aged , Biomarkers/analysis , Seminal Plasma Proteins/analysis , Diabetes Mellitus, Type 2/complications , Diabetic Nephropathies/physiopathology , Case-Control Studies , Predictive Value of Tests , Sensitivity and Specificity , Risk Assessment , Creatinine/blood , Early Diagnosis , Diabetes Mellitus, Type 2/urine , Diabetic Nephropathies/urine , Diabetic Nephropathies/blood , Albuminuria/urine , Glomerular Filtration Rate/physiology , Kidney Failure, Chronic/prevention & control
Rev. cuba. pediatr ; 91(3): e882, jul.-set. 2019. tab, graf
Article in Spanish | LILACS (Americas), CUMED | ID: biblio-1093717


Introducción: Los enfermos de fibrosis quística tienen mayor supervivencia y calidad de vida en las últimas décadas, debido fundamentalmente a un diagnóstico precoz. Objetivo: Describir las características de los pacientes con fibrosis quística y el seguimiento de los vivos durante 40 años. Métodos: Estudio descriptivo longitudinal retrospectivo en 96 pacientes diagnosticados con fibrosis quística en el Hospital Pediátrico Universitario William Soler (1977-2017). Los datos se obtuvieron de las historias clínicas. Se analizaron variables demográficas, temporales, clínicas, genéticas y microbiológicas. Resultados: De la muestra, actualmente se mantienen con seguimiento 27, mayores de 19 años enviados a consulta de neumología 9, fallecieron 30, no se siguen en el centro 30. El 60,4 por ciento se diagnosticó antes del primer año de vida, predominó el sexo masculino 62,5 por ciento y el color de la piel blanco 88,5 por ciento. Sugirió el diagnóstico la forma clínica respiratoria 39,6 por ciento, mixta 38,5 por ciento, digestiva 19,8 por ciento y perdedora de sal 2,1 por ciento. De los 27 casos seguidos actualmente 74,1 por ciento son eutróficos y no hay desnutridos. En el primer aislamiento microbiológico predominó la Pseudomona aeruginosa en el menor de 1 año y el Staphilococcus aureus entre 1 y 4 años. Más del 37.0 por ciento tuvo complicaciones respiratorias, el 14,8 por ciento hepática y el 40,7 por ciento sin complicaciones. La caracterización genética fue mayormente ∆F508 (70,3 por ciento). Conclusiones: Es frecuente el aislamiento de Pseudomona aeruginosa en el menor de 1 año. Casi la mitad de los pacientes no tienen complicaciones, se consiguió mejorar el estado nutricional y disminuir la mortalidad(AU)

Introduction: Patients with cystic fibrosis have had a greater survival and life quality in the last decades; this is due to a precocious diagnostic, a better nutrition state, and diminution of respiratory infections. Objective: To describe the characteristics of cystic fibrosis patients and follow up process to survivors for the last 40 years. Methods: Descriptive, longitudinal and retrospective study in 96 patients diagnosed with cystic fibrosis in William Soler Pediatric University Hospital (1977-2017). Data was obtained from clinical records. Demographic, temporary, clinical, genetic and microbiological variables were analized. Results: From the sample, 27 patients keep under medical follow up; 9 patients older than 19 years old were remitted to the Neumology consultation; 30 died; and 30 patients are not followed up at the hospital. 60.4 percent of the patients was diagnosed before the first year of life, t was predominant the male sex (62.5 percent) and most of them were white skin (88.5 percent). Diagnosis suggested; the respiratory clinical symptoms, 39.6 percent; mixed, 38.5 percent; digestive symptoms, 19.8 percent; salt lost, 2.1 percent. Out of the 27 cases followed at present, 74.1 percent are eutrophics, and there are not patients with malnutrition. In the first microbiological isolation, Pseudomonas aeruginosa prevailed in patients under 1-year-old and Staphilococcus aureus in patients between 1 and 4 years old. More than 37.0 percent of patients had respiratory complications, 14.8 percent had hepatic complications, and 40.7 percent had no complications. The genetic characterization was mostly of ∆F508 (59.2 percent). Conclusions: Pseudomonas aeruginosa is frequently in patients under 1-year-old. Almost half of the patients has no complications; and it is improved their nutritional state and mortality decreased(AU)

Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Cystic Fibrosis/prevention & control , Early Diagnosis , Nutritional Status/physiology , Epidemiology, Descriptive , Retrospective Studies , Follow-Up Studies , Longitudinal Studies
Rev. Asoc. Méd. Argent ; 132(3): 34-38, sept. 2019.
Article in Spanish | LILACS (Americas) | ID: biblio-1045903


El objetivo de este trabajo es difundir la Ley Nº 2578 de la Ciudad Autónoma de Buenos Aires (CABA) del 06/12/07, promulgada por decreto N° 09/008 del 07/01/08, publicada en BOCBA N° 2.850 del 15/01/08, relativa a la creación del "Programa de Prevención, Detección Precoz y Rehabilitación del Estrés Laboral Crónico de los Trabajadores de la Salud". También hacer algunas consideraciones sobre esta enfermedad y destacar al síndrome de Burn-Out como resultado de un estrés laboral crónico que se desarrolla en los ambientes laborales del equipo de la salud

The purpose of this work is to spread Law C.A.B.A. N° 2.578 regarding the creation of the Program for the Prevention, Early Detection and Rehabilitation of Chronic Labor Stress of Health Care Workers of Autonomous City of Buenos Aires. Also make some considerations about this disease and highlight Burn Out syndrome as result of chronic work stress that develops in the work environment of the health team.

Burnout, Professional/prevention & control , Health Personnel , Occupational Stress/prevention & control , Argentina , Early Diagnosis , Legislation, Medical
Rev. cuba. oftalmol ; 32(3): e770, jul.-set. 2019. tab
Article in Spanish | LILACS (Americas), CUMED | ID: biblio-1099085


RESUMEN Se realiza una actualización sobre el diagnóstico y tratamiento del glaucoma infantil primario, considerando la importancia que tiene un diagnóstico precoz y un tratamiento oportuno para obtener los mejores resultados posibles. Actualmente, a pesar del surgimiento de nuevos fármacos y de técnicas quirúrgicas para tratar esta afección, aún existen discrepancias sobre cómo debemos realizar el diagnóstico positivo; qué tratamiento o técnica quirúrgica emplear; cuándo y cuál sería la mejor. Cuando se trata de glaucoma pediátrico (primario o secundario), presente en etapas tan tempranas de la vida -incluso al nacimiento, donde la cirugía está indicada lo más precozmente posible, con la disyuntiva de cuáles medicamentos podemos emplear o no, por desconocimiento de qué efectos indeseables pudieran presentarse en estas edades y además, teniendo en cuenta que estos niños serán nuestros pacientes para toda la vida- es necesario conocer y repasar una vez más este tema. Se recomienda instruir a pediatras y oftalmólogos generales para lograr la remisión adecuada y precoz del niño a un centro especializado para su tratamiento quirúrgico, y mejorar así su pronóstico visual(AU)

ABSTRACT Updated information is provided about the diagnosis and treatment of primary childhood glaucoma, given the importance of early diagnosis and timely treatment to obtain the best possible results. Despite the emergence of new drugs and surgical techniques to treat this disorder, there is still controversy about how we should perform the positive diagnosis, what treatment or surgical technique should be used and when, and which would be the best. When childhood glaucoma (whether primary or secondary) presents at early stages of life - even at birth -, in which case surgery should be indicated as soon as possible, we are faced with the dilemma of what drugs we may or may not use, due to lack of knowledge about undesirable effects which could appear at these ages, and bearing in mind that these children will be our patients for a lifetime. It is thus necessary to be informed about this topic and go over it once again. It is recommended to instruct pediatricians and ophthalmologists to ensure timely, appropriate referral of the child patient to a specialized center where they will receive surgical treatment, thus improving their visual prognosis(AU)

Humans , Infant , Child, Preschool , Tonometry, Ocular/methods , Trabeculectomy/methods , Ocular Hypertension/etiology , Early Diagnosis , Gonioscopy/methods
An. bras. dermatol ; 94(4): 473-475, July-Aug. 2019. graf
Article in English | LILACS (Americas) | ID: biblio-1038301


Abstract: Atrophoderma of Pasini and Pierini is a skin disorder affecting dermal collagen and is clinically characterized by well-defined plaques of depressed skin. Histopathological changes are subtle, and in most cases, the diagnosis requires a comparative study with healthy skin from the same anatomical site. High frequency ultrasound is a useful imaging method for diagnosis of atrophic skin changes. A case is presented in which ultrasound can support the clinical and the histopathological diagnosis of atrophoderma of Pasini and Pierini.

Humans , Female , Adult , Skin Diseases/pathology , Skin Diseases/diagnostic imaging , Ultrasonography, Doppler, Color/methods , Dermis/pathology , Dermis/diagnostic imaging , Atrophy/pathology , Atrophy/diagnostic imaging , Biopsy , Early Diagnosis
Rev. Asoc. Argent. Ortop. Traumatol ; 84(3): 265-272, jun. 2019.
Article in Spanish | LILACS (Americas) | ID: biblio-1020342


Introducción: La prevalencia del dolor de hombro oscila entre el 6,7% y el 66,7%; los trastornos del manguito rotador y especialmente la ruptura pueden alcanzar una prevalencia del 22,1%. Debido a los importantes avances y estudios en la reparación de esta lesión, la cirugía artroscópica ha permitido una mejor identificación, visualización y clasificación, y un mejor manejo de los pacientes. Además, la ruptura del manguito rotador o la fractura de la tuberosidad mayor del húmero incrementan el riesgo de lesión nerviosa (riesgo relativo -1,9), más significativa en pacientes >60 años. Se presenta a un paciente con ruptura postraumática del manguito rotador, quien requirió reparación artroscópica mínimamente invasiva, con evolución posoperatoria estacionaria y diagnóstico de lesión del nervio axilar, sin recuperación autolimitada atribuida a luxación anterior e inestabilidad secundaria al trauma inicial. Conclusiones: La lesión del nervio axilar es más frecuente que lo esperado y, en muchas ocasiones, la identificación temprana se pasa por alto debido a la alta asociación con otras lesiones. Por lo tanto, el diagnóstico y el manejo oportunos requieren mucho cuidado por parte del médico tratante. Nivel de Evidencia: IV

Introduction: The prevalence of shoulder pain varies between 6.7% and 66.7%; whereas rotator cuff disorders-especially rupture-can reach a prevalence of 22.1%. Due to the important advances and studies in the repair of this injury, arthroscopic surgery has allowed a better identification, visualization and classification, as well as a better handling of the patients. In addition, rotator cuff ruptures or greater tuberosity fractures increase the risk of nerve injury (relative risk -1.9), which is more significant in patients >60 years old. We discuss the case of a patient with post-traumatic rotator cuff rupture who required minimally invasive arthroscopic repair. No weight-bearing was allowed during the postoperative period. Patient presented a non-self-limited axillary nerve injury secondary to anterior dislocation and resulting instability after the original trauma. Conclusions: Axillary nerve injuries are more common than expected and, in many cases, early identification is not possible due to its high rate of association with other injuries. Therefore, treating physicians must be very careful in order to achieve a timely diagnosis and management of the patient. Level of Evidence: IV

Middle Aged , Shoulder Joint/injuries , Axillary Artery/injuries , Rotator Cuff/surgery , Rotator Cuff Injuries/diagnosis , Postoperative Complications , Early Diagnosis
Rev. Fac. Cienc. Méd. Univ. Cuenca ; 37(1): 65-73, Junio 2019. ilus
Article in Spanish | LILACS (Americas) | ID: biblio-1004999


La Leishmaniasis es una enfermedad parasitaria catalogada como emer-gente y sin control debido al cambio en el perfil epidemiológico por el sur-gimiento de nuevos focos y urbanización del ciclo de transmisión. Se des-cribe el caso de un adolescente de la Comunidad Dos Ríos, del Cantón Taisha, quien presentó varias lesiones ulceradas, confirmándose diagnós-tico de Leishmaniasis Cutáneamediante estudio histológico, iniciándose tratamiento con sales de antimonio pentavalentes, logrando una resolución progresiva y paulatina de las lesiones. Destacándose la importancia del diagnóstico temprano, tratamiento supervisado, y seguimiento para preve-nir complicaciones.

Leishmaniasis is a parasitic, emergent and uncontrolled disease due to the change in the epidemiological profile for the appearance of new outbreaks and urbanization of the transmission cycle. A case of a 15-years-old ado-lescent, who is resident of the Community Dos Ríos located on the Taisha Canton, was described. The patient presented ulcerated lesions, confir-ming the diagnosis of Cutaneous Leishmaniasis through the histological study of the lesions, and starting intramuscular treatment with pentavalent antimony salts observing healing with a progressive and gradual resolution of the lesions and emphasizing the importance of early diagnosis, supervi-sed treatment, and monitoring to prevent complications.

Humans , Male , Adolescent , Parasitic Diseases , Health Profile , Leishmaniasis, Cutaneous , Skin Ulcer , Antimony Sodium Gluconate , Early Diagnosis