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1.
An. Fac. Cienc. Méd. (Asunción) ; 54(1): 93-100, 20210000.
Article in Spanish | LILACS | ID: biblio-1178639

ABSTRACT

El 15% de los individuos con DM2 presenta una úlcera en el pie y una fracción importante de ellos sufrirá en algún momento una amputación. Se realizó un estudio analítico, de corte trasversal retrospectivo de muestreo no probabilístico de casos consecutivos en pacientes con diagnóstico de pie diabético que acudieron al servicio de Urgencias del Hospital de Clínicas de San Lorenzo, en el periodo Enero ­ Diciembre del año 2019. Sobre un número total de 138 pacientes, se observa que el 51% recibió un manejo quirúrgico, con amputaciones de varios tipos. Se comparó el manejo instaurado en los pacientes, sea este quirúrgico o conservador según la presencia o no de ciertas comorbilidades, como edad mayor a 65 años, lugar de procedencia, glicemia capilar promedio del paciente e hipertensión arterial al ingreso; de estos existió una relación estadísticamente significativa (p<0,05) entre la necesidad de amputación y la glicemia capilar y la hipertensión arterial. El éxito de la intervención requiere un completo entendimiento de la patogénesis de las úlceras del pie diabético y una implementación rápida y estandarizada de un tratamiento efectivo. El manejo multidisciplinario puede lograr el salvataje de la extremidad, que conducirá a una mejor calidad de vida y sobrevida.


Among diabetic patients, 15% have a foot ulcer and a significant fraction of them will suffer an amputation at some point. An analytical, retrospective cross-sectional study of non-probabilistic sampling of consecutive cases was carried out in patients with a diagnosis of diabetic foot who attended the Emergency Service of the Clínicas Hospital in San Lorenzo, during January - December of the year 2019. In a total of 138 patients, the management established in the patients, whether surgical or. conservative, was compared according to certain comorbidities, such as age over 65 years, place of origin, average capillary glycemia and arterial hypertension on admission; Of these, there was a statistically significant relationship (p <0.05) between the need for amputation and capillary glycemia and arterial hypertension. Successful intervention requires a thorough understanding of the pathogenesis of diabetic foot ulcers and a rapid and standardized implementation of effective treatment. Multidisciplinary management can achieve limb salvage, leading to better quality of life and survival.


Subject(s)
Ulcer , Pathogenesis, Homeopathic , Foot Ulcer , Diabetic Foot , Amputation , Hypertension , Cross-Sectional Studies , Diagnosis
2.
Pesqui. vet. bras ; 41: e06927, 2021. tab, graf
Article in English | LILACS, VETINDEX | ID: biblio-1340346

ABSTRACT

Histopathology is an old science that is still currently utilized for disease diagnosis and research. The routinely processed histologic slides stained with hematoxylin and eosin are still used worldwide in most if not every histopathology laboratory. The technique is inexpensive, quick to perform, and allows the diagnosis of a fantastic variety of tissue changes and diseases. Skills in description and interpretation in histopathology are a craft that can be learned by repeatedly and systematically observing simple rules. In this article, we offer a few advices to help trainees in veterinary pathology at the start of their careers. Those advices are drawn from our experience in the diagnostic pathology routine and from the veterinary pathology literature. To enhance the understanding of these important steps in the histopathologic description of tissues, we decided to illustrate most concepts expressed here. We hope that our effort can add a bit to the development of future pathologists. Just like Alice, let us follow the White Rabbit into his burrow for this challenging experience!(AU)


A histopatologia é uma ciência antiga, mas ainda usada para diagnosticar e investigar a patogênese de doenças. As lâminas histológicas processadas rotineiramente e coradas por hematoxilina e eosina ainda são utilizadas em virtualmente todos os laboratórios de histopatologia do mundo. A técnica não é cara, é de execução rápida e permite o diagnóstico de uma fantástica variedade de doenças. As habilidades em descrever e interpretar os achados histopatológicos é um ofício que pode ser aprendido pela observação repetida e sistemática de regras simples. Para ajudar os estudantes de patologia no início de suas carreiras, abordamos aqui algumas dessas regras, extraídas tanto de nossa experiência quanto da literatura relacionada à patologia veterinária. Para aumentar a compreensão dos tópicos, decidimos ilustrar praticamente todos os conceitos expressados neste manuscrito. Esperamos que nosso esforço possa contribuir um pouco para o desenvolvimento de aspirantes a patologistas. Assim como Alice no País das Maravilhas, vamos seguir o coelho branco até a sua toca para essa aventura desafiadora.(AU)


Subject(s)
Animals , Rabbits , Rabbits/anatomy & histology , Pathogenesis, Homeopathic , Hematoxylin
3.
Rev. colomb. reumatol ; 27(supl.2): 4-14, oct.-dic. 2020. graf
Article in English | LILACS | ID: biblio-1341334

ABSTRACT

ABSTRACT Neutrophils play an important role in immune defence against several pathogens. These cells actively participate in the innate immune response through different functions, such as chemotaxis, phagocytosis, oxidative burst and degranulation, which have been widely studied. However, in the last few years, a new function has been described; activated neutrophils are able to release web-like chromatin structures known as neutrophil extracellular traps (NETs). These structures formed by DNA, histones, and proteins, immobilize and kill microorganisms. Disruption in NET formation is associated with the pathophysiology of several disorders, including the autoimmune diseases. NETs are an important source of the autoantigens involved in the production of autoantibodies and maintenance of the inflammatory milieu. This review provides a summary of the contribution of NETs to the pathogenesis of anti-neutrophil cytoplasmic antibodies-associated vasculitis, systemic lupus erythematosus, and rheumatoid arthritis. The preliminary findings on NETs components in Sjögren.'s syndrome will also be described.


RESUMEN Los neutrófilos juegan un papel muy importante en la defensa inmune contra diferentes patógenos. Estas células participan activamente en la respuesta inmune innata a través de diferentes funciones como quimiotaxis, fagocitosis, estallido oxidativo y degranulación, las cuales han sido estudiadas ampliamente. Sin embargo, en los últimos años se ha descrito una nueva función; los neutrófilos activados son capaces de liberar redes de cromatina llamadas trampas extracelulares de neutrófilos (NETs). Estas estructuras están formadas por ADN, histonas y proteínas capaces de inmovilizar y matar microorganismos. Alteraciones en la formación de estas NETs están asociadas con la fisiopatología de varios trastornos, incluyendo las enfermedades autoinmunes (EAI). Las NETs son consideradas una fuente de autoantígenos que ayudan a la producción de autoanticuerpos y al mantenimiento de un ambiente inflamatorio. Esta revisión resume la contribución de las NETs a la patogénesis de vasculitis asociada a anticuerpos contra el citoplasma de los neutrófilos, lupus eritematoso sistémico y artritis reumatoide. Adicionalmente, se describirán los resultados preliminares de la detección de componentes de las NETs en pacientes con síndrome de Sjögren.


Subject(s)
Humans , Autoimmune Diseases , Extracellular Traps , Neutrophils , Pathogenesis, Homeopathic , Immunity , Noxae
4.
Rev. cuba. hematol. inmunol. hemoter ; 36(3): e1218, jul.-set. 2020.
Article in Spanish | LILACS, CUMED | ID: biblio-1156437

ABSTRACT

Introducción: Las anemias diseritropoyéticas congénitas constituyen un grupo de trastornos hereditarios caracterizados por anemia refractaria, eritropoyesis ineficaz y alteraciones morfológicas de los eritroblastos. La anemia diseritropoyética congénita tipo I es la más frecuente, no obstante, constituye una rara enfermedad con particularidades morfológicas y moleculares. Objetivo: Analizar los aspectos más novedosos en cuanto a la patogenia molecular, el diagnóstico genético y el tratamiento de la anemia diseritropoyética congénita tipo I. Métodos: Se realizó una revisión de la literatura, en inglés y español. Se utilizaron motores de búsqueda como Google académico y Pubmed que permitió el acceso a artículos actualizados del tema. Se hizo un análisis y resumen de la bibliografía revisada. Análisis y síntesis de la información: La anemia diseritropoyética congénita tipo I es una enfermedad hereditaria autosómica recesiva. Se caracteriza por anemia de grado variable, reticulocitopenia, alteraciones morfológicas de la serie roja en la lámina periférica y un número elevado de eritroblastos binucleados conectados por puentes internucleares en el aspirado de médula ósea. Se han identificado múltiples alteraciones moleculares que involucran fundamentalmente a los genes CDAN1 y C15orf41. Las proteínas codificadas por estos genes participan en proceso vitales como el ciclo celular, la reparación del ADN y la transcripción de ARN. Conclusiones: El estudio de las bases moleculares de la anemia diseritropoyética congénita tipo I ha cambiado la perspectiva en el diagnóstico de esta enfermedad. Los protocolos de tratamiento son similares a otras anemias hemolíticas hereditarias aunque se destaca el uso del Interferón-α(AU)


Introduction: Congenital dyserythropoietic anemias belong to a group of hereditary disorders characterized by refractory anemia, ineffective erythropoiesis and morphological alterations of erythroblasts. Congenital dyserythropoietic anemia type I is the most frequent; however, it is a rare disease with morphological and molecular characteristics. Objective: To analyze the most updated aspects regarding molecular pathogenesis, genetic diagnosis and treatment of congenital dyserythropoietic anemia type I. Methods: A review of the literature in English and Spanish was carried out. Search engines such as Google Scholar and Pubmed were used, which allowed access to updated articles on the subject. An analysis and summary of the revised bibliography was carried out. Information analysis and synthesis: Congenital dyserythropoietic anemia type I is an autosomal recessive hereditary disease. It is characterized by anemia of variable degree, reticulocytopenia, morphological alterations of the red series in the peripheral lamina, and high number of binucleated erythroblasts connected by internuclear bridges in the bone marrow aspirate. Multiple molecular alterations have been identified, mainly involving the CDAN1 and C15orf41 genes. The proteins encoded by these genes participate in vital processes, such as the cell cycle, DNA repair, and RNA transcription. Conclusions: The study of the molecular bases of congenital dyserythropoietic anemia type I has changed the perspective concerning the diagnosis of this disease. Treatment protocols are similar to other hereditary hemolytic anemias, although the use of Interferon-α stands out(AU)


Subject(s)
Humans , Pathogenesis, Homeopathic/methods , Interferons/therapeutic use , Genetic Diseases, Inborn/epidemiology , Anemia, Dyserythropoietic, Congenital/diagnosis , Anemia, Dyserythropoietic, Congenital/therapy
5.
Rev. cuba. oftalmol ; 33(2): e855, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1139079

ABSTRACT

RESUMEN Los drusen de nervio óptico fueron descritos por primera vez por Liebreich en el año 1868. Otros términos para designar esta entidad incluyen cuerpos hialinos y cuerpos coloides del disco óptico. Tienen una prevalencia de 1 por 500 y el 60 por ciento de los casos se encuentran profundos en la cabeza del nervio óptico. La patogenia primaria de los drusen puede ser una displasia hereditaria del canal óptico del disco óptico y su vasculatura, lo que predispone a la formación de estos. La evolución natural de los drusen es un proceso dinámico que transcurre durante toda la vida. Entre las complicaciones asociadas se presentan defectos de campo visual, pérdida de visión central (rara pero bien documentada), neuropatía óptica isquémica, oclusiones vasculares retinales, pérdidas transitorias de la visión, neovascularización subretinal peripapilar, corioretinopatia serosa central peripapilar y hemorragias pre y peripapilares. Se presenta una paciente de 64 años de edad con antecedente de haber sido operada de desprendimiento de retina del ojo izquierdo, y en el ojo derecho presentaba una hemorragia peripapilar subretinal profunda asociada a drusen(AU)


ABSTRACT Optic nerve drusens were first described by Liebreich in the year 1868. Other terms to designate this condition are optic disc hyaline bodies and colloid bodies. They have a prevalence of 1 per 500 and 60 percent of the cases occur deep in the optic nerve head. The primary pathogenesis of drusens may be an inherited dysplasia of the optic canal of the disc and its vasculature, which leads to their formation. The natural evolution of drusens is a lifelong dynamic process. Associated complications include visual field defects, central vision loss (rare but well documented), ischemic optic neuropathy, retinal vascular occlusion, transient sight loss, peripapillary subretinal neovascularization, central serous peripapillary chorioretinopathy, and pre- and peripapillary bleeding. A case is reported of a 64-year-old female patient with a history of surgery for retinal detachment of the left eye. In the right eye the patient presented deep peripapillary subretinal bleeding associated to drusen(AU)


Subject(s)
Humans , Female , Middle Aged , Retinal Detachment/etiology , Pathogenesis, Homeopathic/epidemiology , Optic Neuropathy, Ischemic/diagnostic imaging , Optic Nerve Neoplasms/epidemiology
6.
Article in English | LILACS, BBO | ID: biblio-1056880

ABSTRACT

Abstract Objective: To compare soluble HLA-C and HLA-DR molecules present in the plasma of orofacial cleft and non-orofacial cleft populations. Material and Methods: Orofacial cleft patients were recruited using an accidental sampling approach (n=15). Peripheral blood was collected from the participants and processed for Enzyme Linked Immunosorbent Assay (ELISA) against HLA-C and HLA-DR with specific antibodies. The absorbance was calculated utilizing ELISA reader. Data were statistically analyzed using an independent t-test to compare the disease and control groups. Results: The levels of soluble HLA-C and HLA-DR were significantly higher in the diseased group compared to the control group (p<0.05). Conclusion: The role of HLA molecules in non-communicable disease and congenital anomalies, particularly orofacial cleft, remains speculative despite the positive results of this study and those of previous investigations. It suggests that the variables examined may affect specific pathways involved in the pathogenesis of orofacial cleft, and predispose the individuals concerned to the oral cleft.


Subject(s)
Humans , Female , Child , Adolescent , HLA-C Antigens , HLA-DR Antigens , Case-Control Studies , Pathogenesis, Homeopathic , Cleft Lip/pathology , Enzyme-Linked Immunosorbent Assay , Data Interpretation, Statistical , Indonesia
7.
Rev. colomb. reumatol ; 27(1): 50-60, 2020. tab, graf
Article in English | LILACS | ID: biblio-1144400

ABSTRACT

ABSTRACT Vogt Koyanagi Harada disease affects several parts of the body, such as eyes, meninges, ears, and skin. The progressive course of the disease can lead to blindness and deafness. The case is presented of a Hispanic woman (mixed-race) with visual alterations, headache, tinnitus, hearing loss, and posterior uveitis with serous detachments of the retina in both eyes, as well as lymphocytic meningitis. The aim of the present study is to review the literature, the diagnostic strategies, and the appropriate treatment, as well as to update the immunogenetic pathogenesis of the disease.


RESUMEN La enfermedad de Vogt Koyanagi Harada compromete múltiples órganos tales como ojos, meninges, oídos y piel. El curso progresivo de la enfermedad puede llevar a ceguera y cofosis. Se describe un caso de esta enfermedad en mujer hispana (mestiza) con alteraciones visuales, cefalalgia, tinnitus e hipoacusia a quien se le encuentra uveítis posterior con desprendimientos serosos de retina en ambos ojos y meningitis linfocitaria. El objetivo del presente estudio es, mediante una revisión de la literatura, actualizar la patogénesis inmunogenética, conocer las estrategias diagnósticas y el tratamiento apropiado.


Subject(s)
Humans , Female , Adult , Uveitis, Posterior , Uveomeningoencephalitic Syndrome , Vision Disorders , Pathogenesis, Homeopathic
8.
Rev. baiana saúde pública ; 43(4): 107-118, 20191212.
Article in Portuguese | LILACS | ID: biblio-1343603

ABSTRACT

A partir de seu primeiro isolamento em Uganda, em 1937, até os dias de hoje, o vírus do Nilo Ocidental (WNV) tornou-se um alarmante agente etiológico em humanos e animais. O WNV é mantido e perpetuado na natureza através de um ciclo enzoótico, entre aves e mosquitos, e ocasionalmente causa surtos epizoóticos em razão de uma doença contagiosa em humanos e cavalos. Este vírus é amplamente difundido no mundo e, embora grande parte das infecções humanas causadas por WNV seja assintomática, a doença pode evoluir para um quadro neurológico grave, resultando em sequelas a longo prazo ou óbito do paciente. Este estudo tem por objetivo analisar a literatura específica sobre o WNV para apresentar uma revisão de artigos científicos, buscando explorar os aspectos mais importantes da doença. Foram realizadas buscas nas bases de dados PubMed e SciELO a partir dos seguintes descritores: "West Nile virus", "epidemiology" e "pathogenesi'". A linha temporal pesquisada abrange de 1998 a 2019, o que permitiu a localização de 293 artigos, dos quais, com base na leitura dos resumos, 88 foram selecionados para realização da leitura completa do artigo. Ao final da leitura dos artigos, 33 foram selecionados na análise final, tendo levado à conclusão de que a vigilância epidemiológica e as medidas preventivas são uma necessidade contínua para reduzir os impactos da doença na saúde pública.


From its first isolation in Uganda, in 1937, up to date, the West Nile virus (WNV) has become a major cause of disease in both humans and animals. Maintained in nature through an enzootic cycle involving birds and mosquitoes, the WNV is liable to occasional epizootic outbreaks, causing diseases in humans and horses. This virus is widely spread in the world and, although most human infections with WNV are asymptomatic, the disease may progress into a severe neurological disorder, resulting in long-term sequelae or death. This study comprises a literature review on scientific articles discussing the theme of WNV. For that, a search was conducted in the databases PubMed and Scientific Electronic Library Online (SciELO) for articles published between 1998 and 2019, using the following descriptors: "West Nile virus", "epidemiology", and "pathogenesis". From the 293 articles found, 88 were selected for full-text reading after abstract screening, 33 of which remained in the final analysis. To reduce the impact of the disease on public health, authorities must conduct epidemiological surveillance and develop preventive measures.


Desde su primer aislamiento en Uganda en 1937 hasta la actualidad, el virus del Nilo Occidental (WNV) se ha convertido en un importante agente etiológico en humanos y animales. El WNV es un virus mantenido y perpetuado en la naturaleza a través de un ciclo enzoótico, entre aves y mosquitos, y ocasionalmente ocurren brotes epizoóticos, causando enfermedad en humanos y caballos. Es un virus ampliamente difundido en el mundo, que causa infecciones asintomáticas en humanos en la mayoría de los casos, sin embargo, la enfermedad puede evolucionar a un cuadro neurológico grave, ocasionando secuelas a largo plazo o el óbito del paciente. Este estudio tiene por objetivo analizar la literatura específica sobre el WNV para presentar una revisión de artículos científicos referentes al tema. Se realizaron búsquedas en las bases de datos PubMed y SciELO a partir de los siguientes descriptores: "West Nilo virus", "epidemiology" y "pathogenesi". La línea temporal de estudio abarcaba de 1998 a 2019, en la cual se encontraron 293 artículos y con base en la lectura de los resúmenes se seleccionaron 88 para realizar la lectura completa. Al final de la lectura de los artículos, 33 artículos fueron seleccionados en el análisis final, lo que se concluye que la vigilancia epidemiológica y las medidas preventivas son una necesidad continua a fin de reducir los impactos de esa enfermedad en la salud pública.


Subject(s)
West Nile Fever , West Nile virus , Pathogenesis, Homeopathic , Public Health , Epidemiological Monitoring
10.
Infectio ; 22(4): 213-222, Oct.-Dec. 2018. tab, graf
Article in English | LILACS, COLNAL | ID: biblio-953995

ABSTRACT

Abstract Based on epidemiological associations and experimentation, relationships between viruses and cancer have been established. For more than 14 million new cases of cancer per year, it is estimated that 15% are related to viral agents. Epithelial, hematolymphoid and mesenchymal malignancies related to different viruses have been document such as Epstein Barr, Kaposi's sarcoma, hepatitis B and C, human lymphotropic type 1, Merkel's carcinoma and human papilloma. New virus with oncogenic potential such as cytomegalovirus, JC polyoma virus and BK have been described. The interaction of the viruses with the host induces oncogene activation, inhibition of tumor suppressor genes and activation of miRNAs, as determining factors in the development of cancer. The pathology is initiated with the infection that induces the deregulation of cell signaling. The Epstein Barr virus is the oncogenic prototype, with 1% of the human cancers related to it.


Resumen Con base en asociaciones epidemiológicas y experimentación, se ha logrado establecer relaciones entre los virus y el cáncer. Para los más de 14 millones de casos nuevos de cáncer por año, se estima que el 15% se relacionan con agentes virales. Se han documentado malignidades epiteliales, hematolinfoides y mesenquimales, relacionadas con diferentes virus: Epstein Barr, sarcoma de Kaposi, hepatitis B y C, linfotrófico humano tipo 1, carcinoma de Merkel y papiloma humano; se plantean nuevos virus con potencial oncogénico como citomegalovirus, poliomavirus JC y BK. La interacción de los virus con el hospedero muestra activación de oncogenes, inhibición de supresores tumorales y activación de miRNAs, como factores determinantes en el desarrollo de cáncer. La patología se inicia con la infección que induce la desregulación de la señalización celular. El virus de Epstein Barr es el prototipo oncogénico, el 1% de los tipos de cáncer humanos se relacionan con él.


Subject(s)
Humans , Virology , Carcinogenesis , Neoplasms , Pathogenesis, Homeopathic , Hematologic Neoplasms
11.
Rev. colomb. psiquiatr ; 47(3): 155-164, jul.-set. 2018. tab
Article in Spanish | LILACS, COLNAL | ID: biblio-978316

ABSTRACT

RESUMEN Antecedentes: El trastorno conversivo es un reto para los clínicos por los vacíos conceptuales en lo que respecta a la patogenia y cómo confluyen otras entidades psiquiátricas y la falta de aproximaciones a las vivencias tanto de pacientes como de familiares con la enfermedad. Objetivo: Describir los modelos explicativos (ME) que utilizan los cuidadores de niños y adolescentes con trastorno conversivo que consultan al Hospital Pediátrico de La Misericordia. Métodos: Se realizó un estudio cualitativo con una muestra por conveniencia de 10 casos atendidos entre mayo de 2014 y abril de 2015. La herramienta usada fue una entrevista en profundidad con padres y/o cuidadores. Resultados: Los cuidadores tienen diversas creencias en torno al origen de los síntomas, y consideran principalmente enfermedad, factores mágicos místicos y factores psicosociales. Se explican los síntomas en cada caso de varias maneras, y no se encontró una relación directa entre estas creencias, el patrón de síntomas y los comportamientos de búsqueda de ayuda. La presentación sintomática es polimorfa y genera interferencia principalmente en la actividad escolar de los pacientes. La atención médica se percibe como pertinente y la atención psiquiátrica, como insuficiente. Entre los itinerarios terapéuticos, se describen consultas con diversos agentes, además de la atención médica, incluidas medicinas alternativas y enfoques mágico-religiosos. Conclusiones: Los ME en trastorno conversivo son variados, pero incluyen con frecuencia elementos mágico-religiosos y factores psicosociales. Las creencias subyacentes no se relacionan directamente con la búsqueda de ayuda u otras variables.


ABSTRACT Background: Conversion disorder is a challenge for clinicians due to the conceptual gaps as regards its pathogenesis, the way in which it converges with other psychiatric disorders, and the lack of approaches to the experiences of both patients and family members with the disease. Objective: To describe Explanatory Models (EM) offered to caregivers of paediatric patients with conversion disorder who attended the Hospital de la Misericordia. Methods: A qualitative study was conducted with a convenience sample of 10 patients who attended the Hospital de La Misericordia, ¿Bogotá? between May 2014 and April 2015. The tool used was an in-depth interview applied to parents and/or caregivers. Results: Caregivers have different beliefs about the origin of the symptoms, especially considering sickness, magical-mystical factors, and psychosocial factors. The symptoms are explained in each case in various ways and there is no direct relationship between these beliefs, the pattern of symptoms, and help-seeking behaviours. Symptomatic presentation is polymorphous and mainly interferes in the patient's school activities. The medical care is perceived as relevant, and psychiatric care as insufficient. Among the therapeutic routes, consultations with various agents are described, including medical care, alternative medicine, and magical-religious approaches. Conclusions: EMs in conversion disorder are varied, but often include magical-religious elements and psychosocial factors. The underlying beliefs are not directly related to help-seeking behaviours or other variables.


Subject(s)
Humans , Male , Female , Child , Adolescent , Adult , Therapeutics , Caregivers , Conversion Disorder , Psychology , Referral and Consultation , Stress, Psychological , Complementary Therapies , Pathogenesis, Homeopathic , Emergency Medical System , Medical Care , Help-Seeking Behavior , Mental Disorders
12.
Rev. colomb. cancerol ; 22(2): 76-83, abr.-jun. 2018. tab
Article in English | LILACS | ID: biblio-959886

ABSTRACT

Abstract Several autoimmune disorders have been associated with a variety of hematopoietic malignancies, particularly lympho-proliferative disorders. Multiple myeloma (MM) is one of the most common hematologic malignancies and has been described in the context of a variety of autoimmune conditions. Due to their diversity and rarity, the clinical features of autoimmune conditions associated with MM have not been elucidated and the pathogenesis remains unclear. In this report, we describe two cases of autoimmune conditions in the setting of MM and review the current literature.


Resumen Varios trastornos autoinmunes se han asociado a una variedad de neoplasias malignas hematopoyéticas, particularmente trastornos linfoproliferativos. El mieloma múltiple (MM) es una de las neoplasias malignas hematológicas más comunes y ha sido descrito en el contexto de una variedad de condiciones autoinmunes. Debido a su diversidad y rareza, las características clínicas de las condiciones autoinmunes asociadas con el MM no han sido aclaradas y la patogénesis sigue siendo poco clara. En este artículo se describen dos casos de condiciones autoinmunes en el marco del MM y se realiza una revisión de la literatura actual.


Subject(s)
Humans , Hematologic Neoplasms , Multiple Myeloma , Pathogenesis, Homeopathic , Literature , Lymphoproliferative Disorders , Myasthenia Gravis
13.
Homeopatia Méx ; 87(712): 36-40, ene. - mar. 2018.
Article in Spanish | LILACS, HomeoIndex | ID: biblio-995357

ABSTRACT

Una amplia explicación acerca de las dosis homeopáticas, y la esencia sobre dicha temática dictada por el doctor Samuel Hahnemann, es lo que nos presenta el autor de este artículo, el cual pretende, además, colaborar para que cese la propagación de mentiras y datos inexactos que generan discordia entre la comunidad médica homeópata y desconfianza entre los pacientes. (AU)


A broad explanation about homeopathic doses, and the essence on this issue dictated by Dr. Samuel Hahnemann, is what the author of this article presents, which also aims to help stop the spread of lies and inaccurate data that generate discord among the homeopathic medical community and distrust among patients. (AU)


Subject(s)
Homeopathic Remedy , Pathogenesis, Homeopathic , Posology , Homeopathy
14.
Rev. med. Risaralda ; 23(2): 49-57, jul.-dic. 2017.
Article in Spanish | LILACS, COLNAL | ID: biblio-902081

ABSTRACT

La insuficiencia cardiaca es el resultado fisiopatológico de múltiples enfermedades. Además de la patologia isquémica, valvular, de la conducción o hipertensiva existen otras etiologías poco sospechadas. En la mayoría de ocasiones se realizan diagnósticos estructurales basados en la imagenologia como cardiomiopatía dilatada o cardiomiopatía restrictiva, lo que lleva al clínico a tratamientos sintomáticos, dejando de lado tratamientos etiológicos específicos que pudiesen preservar la función cardiaca, revertir el daño miocárdico y mejorar la calidad de vida de estos pacientes. Comprender y reconocer que existen factores nutricionales, hormonales, genéticos, infecciosos, medicamentosos, infiltrativos o autoinmunes en la patogénesis de la insuficiencia cardiaca permitirá optar por mejores tratamientos, mejorando las tasas de sobrevida.


Heart failure is a pathophysiologic result of several diseases and it's not only related to ischemic, valvular, arrhythmias or hypertensive. Most of the times structural diagnoses are made based on imaging, like dilated or restrictive cardiomyopathy, which leads to symptomatic treatments instead directed etiological therapies that could preserve heart function, reverse myocardial damage and improve life quality. Understands and recognize that there are nutritional, hormonal, genetic, infectious, drugs, infiltrative or autoimmune factors that could lead to heart failure would help clinicians to recognize them and propose targeted treatments, improving survival rates


Subject(s)
Humans , Male , Female , Cardiomyopathy, Restrictive , Cardiomyopathy, Dilated , Heart Diseases/etiology , Heart Failure , Quality of Life , Survival , Therapeutics , Pharmaceutical Preparations , Pathogenesis, Homeopathic , Heart/physiology
15.
Rev. colomb. cardiol ; 24(3): 298-298, mayo-jun. 2017. graf
Article in Spanish | LILACS, COLNAL | ID: biblio-900531

ABSTRACT

Resumen La enfermedad de Erdheim-Chester es una histiocitosis celular diferente a la histiocitosis de Langerhans, de origen incierto. Se caracteriza por una implicación multi-orgánica debida a la infiltración de los histiocitos CD68+/CD1a-, en forma de xantogranulomas, que afectan principal y comúnmente a la metáfisis y diáfisis de huesos largos. El diagnóstico se realiza mediante biopsia, donde se revelan histiocitos CD68+/CD1a-, carencia de proteína S, y presencia de gránulos de Birbeck. Se ha subestimado la implicación cardiovascular. Reportamos un caso de un varón de 67 años con la enfermedad de Erdheim-Chester e infarto de miocardio agudo, debido a implicación coronaria, además de enfermedad ósea, vascular, pituitaria y retroperitoneal. Revisamos la literatura relevante y describimos el tratamiento clínico de estos pacientes.


Abstract Erdheim-Chester disease is a non-Langerhans cell histiocytosis of uncertain origin. It is characterized by multiorgan involvement due to infiltration of CD68+/CD1a- histiocytes, in the form of xantogranulomas, most commonly affecting the metaphysis and diaphysis of long bones. The diagnosis is made by biopsy showing CD68+/CD1ahistiocytes, lack of S protein and Birbeck granules. Cardiovascular involvement is underestimated. We report a case of a 67 year-old man with Erdheim-Chester disease and acute myocardial infarction due to coronary involvement, in addition to bone, vascular, pituitary and retroperitoneal disease. We review relevant literature and describe the clinical management of these patients.


Subject(s)
Aged , Coronary Disease/drug therapy , Angiography , Pathogenesis, Homeopathic , Erdheim-Chester Disease
16.
Rev. homeopatia (Säo Paulo) ; 80(3/4): 151-171, 2017. tab, ilus
Article in English | LILACS | ID: biblio-973278

ABSTRACT

Homeopathic pathogenetic trials (HPT) are designed to identify specific and characteristic symptoms in apparently health individuals exposed to homeopathic medicines, so that the latter might be indicated following comparison to the patient’s symptoms. The original methodological guidelines for HPTs were established by Hahnemann, who advocated rigorous methods likely to lead to conclusions free from any conjecture. With the advances in scientific methods, new guidelines were formulated to improve the methodological quality of HPT. Relevant scientific contributions were made by Brazilian researchers in this field, resulting in original studies or innovations in methods. The validity and reliability of the clinical information acquired from HPT are fundamental for the success of homeopathic clinical practice.


Subject(s)
Humans , Homeopathy , Pathogenetic Symptoms , Materia Medica , Pathogenesis, Homeopathic , Experiment of Substances
17.
Arq. Inst. Biol ; 84: e0392015, 2017. tab
Article in Portuguese | LILACS, VETINDEX | ID: biblio-887873

ABSTRACT

A encefalopatia espongiforme bovina (EEB), causada por um príon infectante, surgiu na década de 1980 na Europa como uma nova doença nos rebanhos bovinos e, desde então, estão sendo tomadas várias ações para sua prevenção e controle. A restrição da alimentação de ruminantes com subprodutos de origem animal e a remoção e destruição dos materiais de risco específico para a doença das carcaças em frigoríficos se mostraram efetivas medidas para o controle da doença, além de reduzirem a exposição humana ao agente, pois se trata de uma importante zoonose. No entanto, em 2004 os primeiros casos atípicos de EEB foram diagnosticados, nos quais os agentes causais apresentavam alterações de peso molecular na prova de Western blot, em relação ao agente da forma clássica. Além das diferenças moleculares dos agentes, as apresentações clínicas mostraram-se diferenciadas nas formas atípicas, acometendo principalmente bovinos com idade superior a oito anos. Por se tratar de uma nova forma da doença, muitos estudos estão sendo conduzidos buscando elucidar a patogenia, epidemiologia e seu potencial zoonótico. Objetivou-se neste estudo revisar os principais aspectos relacionados às EEB atípicas enfatizando sua etiologia, epidemiologia, sinais clínicos, diagnóstico e medidas de controle.(AU)


Bovine spongiform encephalopathy (BSE), caused by an infectious prion, emerged in the 1980s in Europe as a new disease in cattle and, since then, several actions are being taken for its prevention and control. Restricting the feeding of ruminants with animal by-products and the removal and destruction of specific risk materials (SRM) for the condition of carcasses in slaughterhouses have been proven effective to control the disease, in addition to the reduction of human exposure to the agent, as this is an important zoonosis. However, in 2004 the first atypical cases of BSE were diagnosed, in which the causative agents showed different molecular weights in Western blot (WB), compared to the classical form of the agent. In addition to the molecular differences, clinical presentations proved to be differentiated in atypical forms, affecting mainly cattle older than eight years. Because it is a new form of the disease, many studies are being conducted to elucidate the pathogenesis, epidemiology and zoonotic potential of atypical BSE. The aim of this study was to review the main aspects of atypical BSE emphasizing its etiology, epidemiology, clinical signs, diagnosis and control and prevention measures.(AU)


Subject(s)
Animals , Cattle , Prions , Encephalopathy, Bovine Spongiform , Pathogenesis, Homeopathic , Diagnosis
18.
Homeopatia Méx ; 86(706): 13-24, 2017.
Article in Spanish | LILACS, CidSaude, HomeoIndex, MTYCI | ID: biblio-880109

ABSTRACT

Desde los años sesenta, los homeópatas, junto con los físicos biomédicos, generalmente han reconocido al ensayo de control doble ciego aleatorio (ECA) como el "estándar de oro" para establecer la eficacia en una intervención clínica. Sin embargo, la profesión homeopática se ha mostrado ambivalente respecto a la incorporación del modelo ECA para la validación interna de los medicamentos homeopáticos. Este texto muestra importantes elementos del ECA, como la evaluación ciega, la aleatoriedad y la inferencia estadística, examinando algunos de los elementos históricos y científicos acerca de su inclusión en las experimentaciones homeopáticas.


Subject(s)
Humans , Homeopathy Foundation , Homeopathic Remedy , Pathogenesis, Homeopathic , Double-Blind Method
19.
Rev. homeopatia (Säo Paulo) ; 80(1/2,supl): 151-171, 2017. tab, ilus
Article in Portuguese | LILACS | ID: biblio-973265

ABSTRACT

Os ensaios patogenéticos homeopáticos buscam descobrir sintomas específicos e característicos que se manifestam em indivíduos aparentemente sadios, expostos a medicamentos homeopáticos, para que possam ser utilizados na comparação com os sintomas dos pacientes. Ao definir as diretrizes metodológicas para sua realização, Hahnemann deixou claro que deveriam ser o produto de estudos rigorosos para evitar qualquer conjectura em seus resultados. Com o avanço nos métodos científicos, também têm sido propostas novas diretrizes para sua realização, que são incorporadas aos estudos atuais. Autores brasileiros têm oferecido valiosas contribuições científicas para o desenvolvimento dos ensaios patogenéticos homeopáticos, com realização de estudos originais ou inovações na área metodológica. A validade e a confiabilidade das informações produzidas a partir de ensaios patogenéticos homeopáticos são fundamentais para o êxito da prática clínica em homeopatia.


Homeopathic pathogenetic trials (HPTs) are designed to identify specificand characteristic symptoms in apparently health individuals, afterhaving been exposed to homeopathic medicines, so that the lattermight be indicated following comparison to the patient’s symptoms.The original methodological guidelines for HPTs were defined byHahnemann, who advocated rigorous methods likely to lead to conclusionsfree from any conjecture. With the advances in scientific methods,new guidelines were also proposed to improve the methodologicalquality of HPTs. Relevant scientific contributions were made byBrazilian researchers to develop this field, resulting in the publicationof original studies or innovations on its methods. The validity and reliabilityof the clinical information acquired from HPTs are fundamentalfor the success of homeopathic clinical practice.


Subject(s)
Humans , Homeopathy , Materia Medica , Pathogenesis, Homeopathic , Pathogenetic Symptoms , Experiment of Substances
20.
Rev. colomb. cardiol ; 23(6): 568-575, nov.-dic. 2016. tab, graf
Article in Spanish | LILACS, COLNAL | ID: biblio-959933

ABSTRACT

Resumen La cardiopatía chagásica crónica se presenta en un 30% de las personas infectadas con Trypanosoma cruzi. Aunque el parásito puede ser controlado por la respuesta inmune después de la fase aguda, su detección se hace difícil en la fase crónica a pesar de la persistencia de éste en los tejidos de los individuos infectados. Dado que solo un porcentaje de estos individuos crónicamente infectados desarrolla el daño tisular, se sugiere la existencia de factores asociados que predicen la aparición de la sintomatología crónica: a) la genética del hospedero (moléculas del HLA), cuyo papel aún no se ha dilucidado, b) factores dependientes del parásito cómo la variabilidad de los genotipos (TcI a TcVI), su asociación con tropismo y daño tisular; y c) otros factores como la cantidad del inóculo, la reexposición constante a vectores infectados, las diferentes vías de infección y el estado inmunológico del hospedero. Varias teorías han sido implicadas en el compromiso cardiaco, como la persistencia del T. cruzi en los tejidos, la autoinmunidad inducida y el daño tisular producido por la respuesta inmune. En esta revisión se pretende emitir una hipótesis respecto a la disfunción celular inmune producida por la persistencia parasitaria en los tejidos y su papel en la patogénesis de la enfermedad. Se consideran aspectos como el pronóstico de los pacientes con cardiopatía chagásica llevados a trasplante de corazón por falla cardiaca avanzada comparado con otras causas de falla que conducen a trasplante y la posible organización de los infiltrados inflamatorios en el tejido cardiaco, el cual podría funcionar como un tejido linfoide terciario.


Abstract Chronic Chagas cardiomyopathy is present in 30% of people infected with Trypanosoma cruzi. Even though the parasite can be controlled by immune response after the acute phase, its detection is hard in the chronic phase despite its persistence in the tissues of infected individuals. Since only a fraction of these chronically infected individuals develop tissue damage, the existence of associated predictive factors for appearance of chronic symptoms is suggested: a) host's genetics (HLA molecules) whose role has not yet been clarified; b) parasitedependent factors such as genotype variability (TcI to TcVI), their association with tropism and tissue damage; and c) other factors like the amount of inoculum, the constant reexposure to infected vectors, the different infection routes and the host's immune status. Several theories have been put forward with regard to cardiac compromise, such as T. cruzi persistence in tissues, induce autoimmunity and tissue damage caused by immune response. This review intends to propose a hypothesis on cellular immune dysfunction produced by parasite persistence in tissues and their role in the pathogenesis of the disease. Aspects such as prognosis of patients with Chagas cardiomyopathy who undergo heart transplant due to advanced heart failure are taken into consideration and compared to other failure causes that lead to transplants, and also the possibly organisation of inflammatory infiltrates in heart tissue, which could function as a tertiary lymphoid tissue.


Subject(s)
Humans , Male , Female , Chagas Cardiomyopathy , Chagas Disease , T-Lymphocytes , Pathogenesis, Homeopathic , Immunity , Immunity, Cellular
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