Efficacy of ERCP in Case of Choledocholithiasis and Incidence of Pancreatitis

ERCP has largely replaced open and laparoscopic surgery in management of common bile duct stones. After endoscopic procedure pancreatitis is the most common complication. The purpose of this study was to know effectiveness of ERCP and its complications. In this study, conducted at CIVIL Hospital Ahmedabad during May 2018 to October 2020, total 50 patients underwent ERCP with choledocholithiasis with or without gall stone disease. Out of 50 patients, number of females being 29(58%), maximum distribution found in age group 41 to 60. Out years of 50, successfully stone removed in 44(88%) patients and sphincterotomy done in 45(90%) patients and stenting done in all 50 patients. Out of 50, patients underwent ERCP 4(8%) developed pancreatitis. ERCP is important modality for diagnosis and removal of common bile duct stones and only few patients developed different complications including pancreatitis.

Life satisfaction mediates the association between childhood maltreatment and depressive symptoms: a study in a sample of Brazilian adolescents

Objective: To evaluate the interrelationships between childhood maltreatment, life satisfaction (LS), and depressive symptoms, and to investigate LS as a mediating factor in the association between childhood maltreatment and depressive symptoms. Methods: The sample consisted of 342 adolescents, aged 11 to 17 years (mean = 13.3, SD = 1.52 years), recruited from a public school in Salvador, Brazil. Participants filled out instruments for the collection of sociodemographic data and evaluation of childhood maltreatment, LS, and depressive symptoms. Structural equation modeling (SEM) was used to evaluate the mediating effect of LS. Results: We detected significant negative correlations between childhood maltreatment and LS and between LS and depressive symptoms. We observed a significant positive correlation between childhood maltreatment and depressive symptoms. LS partially mediated the association between childhood maltreatment and depressive symptoms, mitigating the impact of maltreatment. Conclusion: LS played an important mediating role in the association between childhood maltreatment and depressive symptoms. Longitudinal studies are recommended to fully elucidate these associations, reinforcing the need for attention and care of this vulnerable population.

Conocimiento, actitudes, prácticas y percepción sobre la Tuberculosis, en pacientes afectadas por la enfermedad / Knowledge, attitudes, practices and perception on tuberculosis, in patients affected by the disease

El objetivo de este estudio fue identificar el conocimiento, las actitudes, prácticas y percepción sobre la tuberculosis de Pacientes Afectadas por Tuberculosis (PATB) en la ciudad de Sucre. Se trata de un estudio de carácter cuali-cuantitativo no experimental, descriptivo, sincrónico o transversal, realizada con 28 PATB que realizan su tratamiento en centros de primer nivel de la ciudad de Sucre. Para la recolección de los datos se aplicó la encuesta con uso de cuestionarios previamente elaborados y validados. Entre los resultados se obtuvo que la mayoría de las personas afectas por TB eran del sexo masculino (53.6%), 35.1% casados, y la edad abarca de 18 a 86 años, siendo el promedio de edad de 42.8 años. El 33.8% concluyó la primaria, el 40.5% refirió trabajar. En lo que refiere al conocimiento la mayoría (65.5%) refiere conocer sobre la enfermedad, el 71.2% reconoce los síntomas de la enfermedad así como el 93.3% manifiesta la forma correcta de contagio. En cuanto al tratamiento, el 100% de las pacientes lo realizan en servicio público, de los cuales el 52% manifiestan hablar sobre su enfermedad con el personal de salud. El 44.8% de los pacientes percibe como muy buena la calidad de los servicios de apoyo, finalmente la mayoría (78.5%) de los pacientes se sienten bien informados a la hora de la encuesta.

The objective of this study was to identify the knowledge, attitudes, practices and perception regarding tuberculosis of Patients Affected by Tuberculosis (PATB) in the city of Sucre. This is a non-experimental qualitative, quantitative, descriptive, synchronous or cross-sectional study, conducted with 28 PATBs that perform their treatment in first level centers in the city of Sucre. To collect the data, the survey was applied using previously developed and validated questionnaires. Among the results it was obtained that the majority of people affected by TB were male (53.6%), 35.1% married, and the age ranges from 18 to 86 years, being the average age of 42.8 years. 33.8% finished primary school, 40.5% referred to work. With regard to knowledge, the majority (65.5%) report knowing about the disease, 71.2% recognize the symptoms of the disease as well as 93.3% state the correct form of infection. Regarding treatment, 100% of patients perform it in public service, of which 52% say they discuss their illness with health personnel. 44.8% of patients perceive the quality of support services as very good, finally most (78.5%) of patients feel well informed at the time of the survey.

Diagnóstico da Leishmaniose Visceral Canina pelas técnicas de imunoistoquímica e PCR em tecidos cutâneos em associação com a RIFI e ELISA-teste / Canine Visceral Leishmaniasis diagnosis by immunohistochemistry and PCR in skin tissues in association with RIFI and ELISA-test

O objetivo deste trabalho foi avaliar as técnicas de imunoistoquímica (IMIQ) e de PCR (Reação em Cadeia da Polimerase) em tecidos cutâneos para o diagnóstico da Leishmaniose Visceral Canina (LVC) e compará-los com os exames parasitológicos em tecidos corados histoquimicamente (hematoxilina-eosina, HE) e com testes sorológicos, como a Reação de Imunofluorescência Indireta (RIFI) e ensaio imunoenzimático (ELISA). Dos 34 cães naturalmente infectados, classificados em assintomáticos, oligossintomáticos e polissintomáticos, foram coletadas amostras de pele sadia ou com lesão para a realização da IMIQ, HE e PCR. Não somente peles lesionadas (56,5 por cento), mas também sadias (31,8 por cento) encontravam-se positivas pela IMIQ, confirmadas posteriormente pela PCR em 97,8 por cento das amostras. No grupo assintomático, 87,5 por cento estavam negativos pelos testes sorológicos, mas positivos em 50 por cento dos casos pela IMIQ e 100 por cento pela PCR. Entre os oligossintomáticos, 100 por cento, 85,7 por cento e 28,6 por cento encontravam-se positivos, respectivamente, pela PCR, sorologia e IMIQ. Os cães polissintomáticos eram 91,7 por cento soropositivos e tinham parasitas na pele. Em geral, a técnica PCR teve maior positividade (100 por cento). A eficiência dos testes variou de acordo com a evolução da doença, demonstrando a necessidade da associação de técnicas, usando-se IMIQ para confirmação da sorologia e a PCR apenas nos casos suspeitos após a IMIQ. Dessa forma, pode-se aumentar os níveis de positividade e contribuir para o controle desta zoonose.

The purpose of the present study was to evaluate the immunohistochemistry (IMHC) and PCR (Polymerase Chain Reaction) tests for Canine Visceral Leishmaniasis (CVL) diagnosis and compare the results with serological tests such as the indirect fluorescence antibody test (IFAT), ELISA and a parasitological test (microscopic direct examination of the parasite stained with haematoxylin and eosin - HE). For this study, samples of healthy or lesion skin tissues were obtained from 34 CVL naturally infected dogs classified in three groups: asymptomatic, oligosymptomatic and polisymptomatic. Not only lesion (56.5 percent) but also healthy skins (31.8 percent) were positives by IMHC and confirmed by PCR in 97.8 percent of skin samples. In asymptomatic group, 87.5 percent dogs were negatives by serological tests, but positives by IMHC in 50 percent and by PCR in 100 percent. In oligosymptomatic group, 100 percent, 85.7 percent and 28.6 percent of dogs were positives, respectively by PCR, serological and IMHC tests. In addition, 91.7 percent of polisymptomatic dogs were serum positive and had intact parasites in the skin. In general, PCR showed higher positivity (100 percent). The efficiency of each test varied with the evolution of the disease. IMHC may be used to confirm the results of the serology and PCR in inconclusive cases after HE and IMHC. The association of techniques proposed in this study may increase the positivity and contributed to the control of this canine disease.

Diagnóstico da Leishmaniose Visceral Canina pelas técnicas de imunoistoquímica e PCR em tecidos cutâneos em associação com a RIFI e ELISA-teste / Canine Visceral Leishmaniasis diagnosis by immunohistochemistry and PCR

O objetivo deste trabalho foi avaliar as técnicas de imunoistoquímica (IMIQ) e de PCR (Reação em Cadeia da Polimerase) em tecidos cutâneos para o diagnóstico da Leishmaniose Visceral Canina (LVC) e compará-los com os exames parasitológicos em tecidos corados histoquimicamente (hematoxilina-eosina, HE) e com testes sorológicos, como a Reação de Imunofluorescência Indireta (RIFI) e ensaio imunoenzimático (ELISA). Dos 34 cães naturalmente infectados, classificados em assintomáticos, oligossintomáticos e polissintomáticos, foram coletadas amostras de pele sadia ou com lesão para a realização da IMIQ, HE e PCR. Não somente peles lesionadas (56,5%), mas também sadias (31,8%) encontravam-se positivas pela IMIQ, confirmadas posteriormente pela PCR em 97,8% das amostras. Nogrupo assintomático, 87,5% estavam negativos pelos testes sorológicos, mas positivos em 50% dos casos pela IMIQ e 100% pela PCR. Entre os oligossintomáticos, 100%, 85,7% e 28,6% encontravam-se positivos, respectivamente, pela PCR, sorologia e IMIQ. Os cães polissintomáticos eram 91,7% soropositivos e tinham parasitas na pele. Em geral, a técnica PCR teve maior positividade (100%). A eficiência dos testes variou de acordo com a evolução da doença, demonstrando a necessidade da associação de técnicas, usando-se IMIQ para confirmação da sorologia e a PCR apenas nos casos suspeitos apos a IMIQ. Dessa forma, pode-se aumentar os níveis de positividade e contribuir para o controle desta zoonose.

The purpose of the present study was to evaluate the immunohistochemistry (IMHC) and PCR (Polymerase Chain Reaction) tests for Canine Visceral Leishmaniasis (CVL) diagnosis and compare the results with serological tests such as the indirect fluorescence antibody test (IFAT), ELISA and a parasitological test (microscopic direct examination of the parasite stained with haematoxylin and eosin - HE). For this study, samples of healthy or lesion skin tissues were obtained from 34 CVL naturally infected dogs classified in three groups: asymptomatic, oligosymptomatic and polisymptomatic. Not only lesion (56.5%) but also healthy skins (31.8%) were positives by IMHC and confirmed by PCR in 97.8% of skin samples. In asymptomatic group, 87.5% dogs were negatives by serological tests, but positivesby IMHC in 50% and by PCR in 100%. In oligosymptomatic group, 100%, 85.7% and 28.6% of dogs were positives, respectively by PCR, serological and IMHC tests. In addition, 91.7% of polisymptomatic dogs were serum positive and had intact parasites in the skin. In general, PCR showed higher positivity (100%). The efficiency of each test varied with the evolution of the disease. IMHC may be used to confirm the results of the serology and PCR in inconclusive cases after HE and IMHC. The association of techniques proposed in this study may increase the positivity and contributed to the control of this canine disease.

Criptococose disseminada em lúpus eritematoso sistêmico juvenil / Disseminated cryptococcosis in juvenile systemic erythematosus lupus

O lúpus eritematoso sistêmico (LES) é uma doença inflamatória multissistêmica, na qual as infecções são responsáveis por altos índices de morbimortalidade. Os usos de corticóide e imunossupressores contribuem para o aumento das infecções. Embora as bactérias sejam os agentes mais comuns, grande variedade de patógenos tem sido relatada. Este artigo descreve um caso de LES em um menino de 15 anos com criptococose disseminada (sistema nervoso central, pulmão e rim) e encefalite tuberculosa presumível. A coexistência de infecção por Cryptococcus e LES é descrita na literatura, mas a associação desta com encefalite tuberculosa é incomum. O risco potencial de infecções em pacientes lúpicos imunossuprimidos deve alertar o médico a adotar estratégias diagnósticas e terapêuticas precoces visando ao espectro ampliado de possíveis patógenos.

Systemic lupus erythematosus (SLE) is a multisystem inflammatory disease, in which infection is responsible for high rates of mortality. The use of corticosteroids and immunosuppressive therapy contributes to this high incidence of infections. Although bacteria are the most common agents, a wide variety of pathogens has been reported. This article reports a case of SLE in a 15 years-old boy with disseminated criptococosis (central nervous system, lungs and kidneys) and presumptive tuberculous encephalitis. The coexistence of infection by Cryptococcus and SLE is described in the literature, but the combination of this with tuberculous encephalitis is uncommon. The potential risk of infection in immunosuppressed SLE patients should alert the physician to adopt early diagnostic and therapeutic strategies aiming at an extended spectrum of pathogens.

An open label efficacy study of topical imiquimod 5% cream in the treatment of verruca vulgaris and verruca plana in Filipinos

BACKGROUND: Verrucae or warts, are benign epithelial growths caused by human papillomavirus (HPV) infection of the skin. They are unsightly and may affect a patient's quality of life, causing social embarrassment, discomfort, pain, and interference in certain activities. OBJECTIVE: To evaluate the efficacy and safety of imiquimod 5 percent cream for sixteen weeks in the treatment of verruca vulgaris and verruca plana in an open-label trial involving healthy immunocompetent Filipino patients of the Dermatology out-patient clinic of the Philippine General Hospital. METHODS: Imiquimod 5 percent cream was self-administered by patients with verruca vulgaris or verruca plana on their lesions, nightly for 16 weeks. Follow-up was done every two weeks to determine any change in size over time. Side effects were recorded. RESULTS: Complete clearance was seen in 31.8% of verruca vulgaris cases, with improvement seen in 59 percent of cases. Shorter duration of lesions was associated with clearance. Complete clearance was seen in only 1 out of 8 patients with verruca plana treated. Minor side effects were reported. CONCLUSION: Topical imiquimod 5 percent cream is a safe, well-tolerated, painless, convenient, patient-applied route which may be a preferred alternative treatment for verruca vulgaris.

In silico survey of resistance (R) genes in Eucalyptus transcriptome

A major goal of plant genome research is to recognize genes responsible for important traits. Resistance genes are among the most important gene classes for plant breeding purposes being responsible for the specific immune response including pathogen recognition, and activation of plant defence mechanisms. These genes are quite abundant in higher plants, with 210 clusters found in Eucalyptus FOREST database presenting significant homology to known R-genes. All five gene classes of R-genes with their respective conserved domains are present and expressed in Eucalyptus. Most clusters identified (93) belong to the LRR-NBS-TIR (genes with three domains: Leucine-rich-repeat, Nucleotide-binding-site and Toll interleucine 1-receptor), followed by the serine-threonine-kinase class (49 clusters). Some new combinations of domains and motifs of R-genes may be present in Eucalyptus and could represent novel gene structures. Most alignments occurred with dicots (94.3%), with emphasis on Arabidopsis thaliana (Brassicaceae) sequences. All best alignments with monocots (5.2%) occurred with rice (Oryza sativa) sequences and a single cluster aligned with the gymnosperm Pinus sylvestris (0.5%). The results are discussed and compared with available data from other crops and may bring useful evidences for the understanding of defense mechanisms in Eucalyptus and other crop species

Estudio comparativo del efecto antiinflamatorio del plantago major "Llantén" y del diclofenaco / Comparative study of the antiinflammatory effect of the plantago major

Se determinó la Dosis Letal 50(DL50) del extracto metanólico del Plantago major "Llantén" administrado por vía intraperitoneal, hallándose como resultado una DL50 equivalente a 4,000 mg/Kg de peso de animal utilizándose para ello 36 ratones divididos en 6 grupos de 6 animales cada uno. Se utilizarón 40 ratas albinas divididas en 4 grupos de 10 animales cada uno, a las cuales se les infiltró en el lomo 2 ml de carragenina al 1 por ciento a las bolsas de aire. Después de 30' de haber colocado la carragenina se administró los extractos y el diclofenaco. A las seis horas fueron sacrificados los animales. Del exudado obtenido se utilizó una parte para el recuento de Leucocitos en el Coulter Counter, el resto se centrifugó para determinar la concentración de proteínas totales por el método colorimétrico de Gornall utilizando el reactivo de Biuret y un patrón de proteína de 70 g/L. Se evidenció las propiedades antiinflamatorias significativas del extracto metanólico, administrado por vía intraperitoneal, a la dosis de 400 mg/Kg y 800 mg/Kg de peso frente al diclofenaco, utilizando la técnica estandarizada de Edwars (CYTED), del Granuloma de Pouche.

We have determined the 50 Lethal dose of the Metanolic extract of Plantago major "Llanten" given by intraperitoneal route. We have found that 50LD was 4000 mg/Kg. Of animal weigtht, using 36 mice divided in six groups with 6 animal s each one. 40 rats divided in four groups of ten animals each one received on the back 2 mI of carragenin 1 % to the air pouch. After 30 minutes, the extract and diclofenac were administered. Six hours afterwards the animal s were killed. The exudate obtained was used to find the leucocyte count in the Coulter Counter. The rest of the material was centrifuged to determine the concentracion of proteins with de Gornall colorimetric method using the Biuret reactive and a model of protein lof 70 g/L. We found the anti-inflammatory properties of the methanolic extract, administered by the intraperitoneal route 400 mg/Kg. and 800mg/Kg and with diclofenac using the standardized technique of Edwards (CYTED) from the granuloma of .. Pouche.

Soroprevalência da sífilis em gestantes HIV-negativas, obtida de três testes diagnósticos: VDRL, ELISA, TPHA / Syphilis seroprevalwence in HIV-negative pregnant women, using tree diagnostic tests: VDRL, ELISA M and TPHA

A sífilis é uma infecçäo crônica com diversas manifestaçöes clínicas que ocorrem ao longo de estágios variados. Apesar do seu declínio última década, tem sido, novamente, um importante problema de saúde pública. No Brasil, a média de prevalência é de 4 por cento pelo VDRL, em gestantes atendidas em serviços públicos. Na gestaçäo constitui problema importante, pela gravidade das lesöes e pela possiblidade real da profilaxia medicamentosa. É grande a dificuldade de se proceder ao diagóstico nesta fase, e ainda sim, mesmo com tratamento apropriado, durante a gestaçäo a infecçäo fetal poderá ocorrer em mais de 14,0 por cento dos casos. O presente trabalho objetiva determinar a soroprevalência da sífilis por meio da realizaçäo de prova de VDRL confirmada por teste específico

Producción y caracterización de un anticuerpo monoclonal que reconoce el fragmento 28-30 kDa de la proteína MSP-1 de Plasmodium falciparum / Production and characterization of a monoclonal antibody thar recognizes the fragment of 28-30 kDa of the protein MSP-1 from Plasmodium falciparum

Los merozoítos del parásito Plasmodium falciparum contienen en su superficie los fragmentos producidos por el primer procesamiento proteolítico de la proteína MSP-1 (merozoite surface protein-1). Dichos fragmentos tienen pesos moleculares relativos aproximados de 83, 42, 38 y 28-30 kDa, respectivamente. En este estudio se describe la producción y caracterización de un anticuerpo monoclonal, denominado 8F4, que reconoce la proteína MSP-1 dadas las siguientes características del antígeno: 1) localización subcelular, 2) peso molecular relativo, 3) período de expresión durante el ciclo eritrocítico, 4) tipo de asociación con la membrana plasmática del parásito y 5) presencia de epítopes compartidos con MSP-1. Adicionalmente, se estableció que 8F4 reconoce el fragmento de 28-30 kDa, producto del primer procesamiento proteolítico de MSP-1. Los análisis realizados permiten confirmar que MSP-1 subíndice 28-30 no permanece en la superficie del merozoíto después de ocurrida la invasión, lo cual sugiere que hace parte del complejo de polipéptidos que es liberado por el merozoíto previamente al evento de la invasión. 8F4 es el primer anticuerpo monoclonal reportado hasta el momento que reconoce específicamente este fragmento

Reemplazo total de cadera - Hospital Dr. Darío Contreras, 1988-1992 / Hip prosthesis - Hospital Dr. Dario Contreras; 1988-1992

Se realizó un estudio descriptivo de reemplazo total de cadera en el Hospital Dr. Darío Contreras, Santo Domingo, República Dominicana, durante el período 1988-1992. El estudio consistió en la revisión de los expedientes clínicos de los pacientes intervenidos a reemplazo total de cadera, para determinar su edad, sexo, causa etiológica y movimientos articulares. De los 27 casos encontrados el grupo de edad de más incidencia es 61-70 años, con 9 casos (33.3 por ciento ), el sexo femenino 17 casos (62.9), la causa etiológica más frecuente es osteoartritis primaria con 11 casos (40.7 por ciento ) y en los movimientos articulares hubo un aumento después de la cirugía, en especial en la dislocación traumática y fractura de cuello de fémur que casi se logró todos sus movimientos. En función de los resultados, recomendamos medidas preventivas

Estudo perinatal do polidramnio no Hospital Maternidade Escola de Vila Nova Cachoeirinha. / Perinatal study of polyhydromnio at the Hospital Maternidade Escola de Vila Nova Cachoeirinha

Foram estudados no periodo de julho de 1975 a julho de 1978, os casos de polidramnio ocorridos no HMEVNC.Foram observados 13 pacientes num total de 10.339 admissoes, com incidencia de 0,12%. No grupo estudado, em relacao a populacao atendida no HMEVNC, houve diferencas quanto a cor e grupo etario, chamando atencao a maior incidencia relativa de pacientes pardas entre 30 e 41 anos de idade. A patologia materna anterior mais encontrada foi a hipertensao. Houve 23% de natimortos macerados.Dos recem-nascidos, 84,6% eram do sexo feminino, 38,4% mal formados, e 38,4% normais. Os autores sugerem o estabelecimento de criterios de risco e uma rotina de atendimento a pacientes com polidramnio acentuando a importancia da acao conjunta de obstetras e neonatologistas face ao diagnostico precoce de recem-nascidos com possiveis malformacoes congenitas