ABSTRACT
El síndrome de Forestier es una enfermedad reumatológica, de origen desconocido, que consiste en la calcificación de diferentes zonas del cuerpo, predominantemente a nivel del ligamento vertebral común anterior, donde se forman osteofitos capaces de producir sintomatología variada y de intensidad variable. Normalmente asintomática, aunque, cuando afecta la columna cervical, el síntoma más común es la disfagia. Se presenta un caso de Síndrome de Forestier que consultó por disfagia en la Unidad de Cirugía de Cabeza y Cuello del Servicio de Otorrinolaringología del Instituto de Previsión Social de Asunción, Paraguay. La semiología permitió observar un abombamiento submucoso en la pared posterior de la orofaringe de 1,5 cm de diámetro, que pudo ser evaluado y confirmado por tomografía. Debido a poca intensidad de la sintomatología y escasa repercusión en el estado general se decidió realizar un tratamiento conservador con buenos resultados, tras dos años de seguimiento clínico. En estos casos la cirugía ocupa un lugar secundario, ya sea ante el fracaso de esta conducta conservadora o ante la progresión de los síntomas
Forestier Syndrome is a rheumatological disease of unknown origin, which consist in calcification of different areas of the body, predominantly at the level of the anterior common vertebral ligament, where osteophytes capable of producing varied symptoms of variable intensity are formed. Normally asymptomatic, although, when it affects the cervical spine, the most common symptom is dysphagia.A case of Forestier syndrome is presented who consulted for dysphagia in the Head and Neck Surgery Unit of the Otolaryngology Service of the Institute of Social Prevision, Asuncion, Paraguay. The semiology allowed to observe a submucosal bulge in the posterior wall of the oropharynx of 1,5 cm in diameter, which could be evaluated and confirmed by tomography.Due to the low intensity of the symptoms and little impact on the general state, it was decided to carry out a conservative treatment with good results, after two years of clinical follow-up. In these cases, surgery occupies a secondary place, either before the failure of this conservative behavior or the progression of the symptoms.
Subject(s)
Humans , Female , Middle Aged , Hyperostosis, Diffuse Idiopathic Skeletal/diagnostic imaging , Paraguay , Tomography, X-Ray ComputedABSTRACT
Essential gene functions underpin the core reactions required for cell viability, but their contributions and relationships are poorly studied in vivo. Using CRISPR interference, we created knockdowns of every essential gene in Bacillus subtilis and probed their phenotypes. Our high-confidence essential gene network, established using chemical genomics, showed extensive interconnections among distantly related processes and identified modes of action for uncharacterized antibiotics. Importantly, mild knockdown of essential gene functions significantly reduced stationary-phase survival without affecting maximal growth rate, suggesting that essential protein levels are set to maximize outgrowth from stationary phase. Finally, high-throughput microscopy indicated that cell morphology is relatively insensitive to mild knockdown but profoundly affected by depletion of gene function, revealing intimate connections between cell growth and shape. Our results provide a framework for systematic investigation of essential gene functions in vivo broadly applicable to diverse microorganisms and amenable to comparative analysis.
Subject(s)
Bacillus subtilis/genetics , Genes, Bacterial , Genes, Essential , CRISPR-Cas Systems , Gene Knockdown Techniques , Gene Library , Gene Regulatory Networks , Molecular Targeted TherapyABSTRACT
Quorum sensing by farnesol in Candida albicans inhibits filamentation and may be directly related to its ability to cause both mucosal and systemic diseases. The Ras1-cyclic AMP signaling pathway is a target for farnesol inhibition. However, a clear understanding of the downstream effectors of the morphological farnesol response has yet to be unraveled. To address this issue, we screened a library for mutants that fail to respond to farnesol. Six mutants were identified, and the czf1Δ/czf1Δ mutant was selected for further characterization. Czf1 is a transcription factor that regulates filamentation in embedded agar and also white-to-opaque switching. We found that Czf1 is required for filament inhibition by farnesol under at least three distinct environmental conditions: on agar surfaces, in liquid medium, and when embedded in a semisolid agar matrix. Since Efg1 is a transcription factor of the Ras1-cyclic AMP signaling pathway that interacts with and regulates Czf1, an efg1Δ/efg1Δ czf1Δ/czf1Δ mutant was tested for filament inhibition by farnesol. It exhibited an opaque-cell-like temperature-dependent morphology, and it was killed by low farnesol levels that are sublethal to wild-type cells and both efg1Δ/efg1Δ and czf1Δ/czf1Δ single mutants. These results highlight a new role for Czf1 as a downstream effector of the morphological response to farnesol, and along with Efg1, Czf1 is involved in the control of farnesol-mediated cell death in C. albicans.
Subject(s)
Candida albicans/metabolism , DNA-Binding Proteins/metabolism , Farnesol/pharmacology , Fungal Proteins/metabolism , Quorum Sensing , Transcription Factors/metabolism , Candida albicans/drug effects , Candida albicans/genetics , Candida albicans/physiology , DNA-Binding Proteins/genetics , Fungal Proteins/genetics , Hot Temperature , Mutation , Transcription Factors/geneticsABSTRACT
A aspergilose broncopulmonar alérgica é uma doença pulmonar que ocorre em pacientes com asma ou fibrose cística, desencadeada pela reação de hipersensibilidade à presença do fungo Aspergilus fumigatus nas vias aéreas. Relatamos aqui um caso em que uma paciente com quadro clínico sugestivo de asma apresentou critérios clínicos, laboratoriais e radiológicos compatíveis com o diagnóstico de aspergilose broncopulmonar alérgica. A importância de tais achados deve-se ao fato de que quanto mais precocemente for feito o diagnóstico, menores serão os riscos de agravamento do quadro respiratório e de aparecimento de fibrose.
Allergic bronchopulmonary aspergillosis is a lung disease occurring in patients with asthma or cystic fibrosis, triggered by a hypersensitivity reaction to the presence of Aspergillus fumigatus in the airways. We report herein the case of a patient presenting a clinical profile suggestive of asthma and meeting the clinical, laboratory testing and radiological criteria for a diagnosis of allergic bronchopulmonary aspergillosis. The importance of such findings is that early diagnosis can reduce the risk of respiratory exacerbations and fibrosis.
Subject(s)
Adult , Female , Humans , Albuterol/therapeutic use , Aspergillosis, Allergic Bronchopulmonary/diagnosis , Aspergillus fumigatus/immunology , Bronchodilator Agents/therapeutic use , Prednisolone/therapeutic use , Aspergillosis, Allergic Bronchopulmonary/drug therapy , Immunoglobulin E/immunology , Tomography, X-Ray ComputedABSTRACT
Allergic bronchopulmonary aspergillosis is a lung disease occurring in patients with asthma or cystic fibrosis, triggered by a hypersensitivity reaction to the presence of Aspergillus fumigatus in the airways. We report herein the case of a patient presenting a clinical profile suggestive of asthma and meeting the clinical, laboratory testing and radiological criteria for a diagnosis of allergic bronchopulmonary aspergillosis. The importance of such findings is that early diagnosis can reduce the risk of respiratory exacerbations and fibrosis.
Subject(s)
Albuterol/therapeutic use , Aspergillosis, Allergic Bronchopulmonary/diagnosis , Aspergillus fumigatus/immunology , Bronchodilator Agents/therapeutic use , Prednisolone/therapeutic use , Adult , Aspergillosis, Allergic Bronchopulmonary/drug therapy , Female , Humans , Immunoglobulin E/immunology , Tomography, X-Ray ComputedABSTRACT
Foram estudados 24 casos de pacientes portadores de carcinoma epidermóide da hipofaringe, sendo 13 deles sem metástase linfática (pN0) e 11 com metástase linfática sem ruptura (pN+RC-), tratados no Serviço de Cirurgia de Cabeça e Pescoço do Hospital Heliópolis, São Paulo, no período de janeiro de 1977 a janeiro de 1993. Foram comparados parâmetros clínico-histopatológicos dos dois grupos com a sobrevida. As informações clínicas foram obtidas através da revisão dos prontuários dos pacientes, e as informações histológicas foram obtidas através da revisão das lâminas. Quando relacionadas às variáveis idade, sexo, categoria N, estadiamento clínico e recorrência cervical, não foi observada piora estatisticamente significativa no prognóstico dos pacientes com linfonodos positivos sem ruptura capsular (pN+RC-) comparados aos pacientes com linfonodos negativos (pN). Quando os tipos de reações linfonodais foram agrupados em estimulados e não estimulados, foi observado que o grupo com linfonodos positivos sem ruptura capsular (pN+RC-) apresentou maior porcentagem de linfonodos estimulados (Predomínio Linfocitário e de Centros Germinativos) que o grupo sem metástase linfonodal (pN0), tendo sido estatisticamente significativo (p=0,0333)
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Carcinoma, Squamous Cell , Hypopharyngeal Neoplasms , Lymphatic MetastasisABSTRACT
El propósito de esta investigación es el de llamar la atención a las autoridades administrativas y enfatizar en el hecho de que la evaluación de las metas anuales de un programa de salud determinado, no son suficientes para mejorar el servicio; sino que gran parte de las respuestas en este sentido las encontramos en la evaluación de la calidad de la atención ofrecida en el mismo. En este trabajo evaluamos la calidad del control prenatal en dos instituciones de salud de asistencia social, la policlínica Alejandro De La Guardia, hijo de Bethania y el Centro de Salud Rómulo Roux de Pueblo Nuevo. Para ello, se utilizó un instrumento tipo hoja-cotejo dividido en cinco partes que evalúan a los diferentes elementos que incluye la calidad del control prenatal: estructura física-administrativa, aplicación de normas en el proceso de atención, satisfacción del usuario, resultados alcanzados y el impacto logrado. Se encuestaron 60 embarazadas; 30 en cada uno de los dos centros de salud, quienes se siguieron desde su tercer trimestre de gestación hasta su primera cita puerperal y de crecimiento y desarrollo del recién nacido. Se plantearon seis hipótesis que se probaron a través de la prueba estadística del (Chí Cuadrado) y se clasificó el grado de la calidad de ambas instituciones por medio de una escala valorativa establecida en el instrumento. Se concluye que una de las dos instituciones ofrece un control prenatal de buena calidad, en tanto que la otra alcanza calificación de regular alto en la calidad del mismo; que este grado de calidad se ve mayormente afectado por la falta de información en el expediente lo que no permite establecer la aplicación o no de las normas en el proceso de atención; y que en menor grado afectan aspectos como la enseñanza brindada a la paciente, satisfacción del ususario y otros. No obstante, la mayoría de las correcciones a las desviaciones encontradas pueden implementarse con los recursos existentes en la actualidad (INV)
Subject(s)
Humans , Prenatal Care , Quality ControlABSTRACT
Os autores relatam estudo comparativo da concentraçäo sérica de ácido úrico em pacientes portadores de tuberculose pulmonar ativa com e sem manifestaçöes reumáticas, em tratamento com pirazinamida. Näo encontram diferença significante, em relaçäo às médias da concentraçäo sérica de ácido úrico, entre os grupos estudados. Concluem näo haver indicaçöes que a hiperuricemia, induzida por pirazinamida, seja fator determinante das manifestaçöes articulares observadas em pacientes com tuberculose
