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1.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1515143

ABSTRACT

Introducción: El virus SARS-Cov-2 se ha asociado a múltiples manifestaciones neurológicas, incluyendo accidente cerebrovascular agudo. La manifestación cerebrovascular reportada con mayor secuencia es accidente cerebrovascular secundario a trombosis de grandes vasos. La arteriopatía cerebral autosómica dominante con infartos subcorticales y leucoencefalopatía (CADASIL, por las siglas en inglés), es la enfermedad genética más frecuente asociada a lesiones de sustancia blanca e infartos lacunares múltiples. Se desconoce como el SARS-Cov-2 podría afectar en los pacientes con CADASIL. El objetivo de este trabajo es reportar la manifestación neurológica del COVID-19 en un paciente con CADASIL. Métodos: Se buscó información clínica y de laboratorio en los registros clínicos. Información adicional se obtuvo del informe de la evaluación de neuropsicología y de la entrevista con el paciente. Resultados: Paciente en la sexta década de la vida consulta a servicio de urgencias por confusión, desorientación, dificultad para expresarse y debilidad en su mano y pierna a derecha. La resonancia magnética cerebral demostró lesiones subcorticales múltiples agudas en áreas limítrofe y lesiones de sustancia blanca crónicas en capsula externa y polos de los lóbulos temporales, ambas típicas del CADASIL. El examen genético arrojó mutación sin sentido en el gen NOTCH3. El paciente fue seguido durante 10 meses, aunque presentó mejoría de su condición neurológica, persistió el déficit cognitivo con repercusión en sus actividades instrumentales de la vida diaria. Conclusión: Los pacientes con CADASIL que se infectan con SARS-Cov-2 pueden manifestarse con accidentes cerebrovasculares de zona limítrofe y encefalopatía. El COVID19 podría acelerar la declinación cognitiva descripta en los pacientes con CADASIL.


Introduction: The SARS-Cov-2 is associated with many neurological manifestations, including acute cerebrovascular disease. The most common reported stroke manifestation is ischemic stroke secondary to large vessels occlusion. The cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is the most frequent genetic disease associated with white matter disease and multiple lacunar strokes. How the SARS-Cov-2 could affect CADASIL patients is unknown. Our aim is to report the neurologic presentation of COVID19 in a CADASIL patient. Method: With searched laboratory data and patient history in clinical registers. Additional information was obtained from the neuropsychologic report and patient's family interview. Results: A patient on his fifties consulted to the emergency department for disorientation, difficulty with language and weakness of his right arm and leg. The magnetic resonance showed multiple acute subcortical border zone lesions and other chronic white matter lesions affecting the pole of the temporal lobes and external capsule, both typical of CADASIL. The genetic examination confirmed a missense mutation on the NOTCH3 gene. The patient was followed up for 10 months and although there was an improvement in his neurologic condition, he remained with cognitive deficits that impacted in his instrumental activities of daily living. Conclusion: CADASIL patients infected with SARS-Cov-2 can suffer of multiple border zone infarcts and encephalopathy. The COVID19 could accelerated the cognitive decline of CADASIL patients.

2.
Rev. chil. radiol ; 25(2): 67-70, jun. 2019. ilus
Article in Spanish | LILACS | ID: biblio-1013851

ABSTRACT

El tumor desmoides es un tumor benigno raro, de origen fibroblastico no inflamatorio, algunas veces referido como fibromatosis no agresiva. Su etiología aún no está completamente clara, sin embargo, se asocia habitualmente a trauma previo y/o procedimientos quirúrgicos. La ubicación más frecuente es abdominal, el cual posee características imagenologicas claras, al igual que su presentación musculo esquelética plantar. La presentación fuera de estos lugares es infrecuente y difícil de diagnosticar. Presentamos un caso de un tumor desmoides cervical que genero un gran desafío diagnóstico, identificando sus claves diagnósticas y realizando una revisión de la bibliografía al respecto para esta ubicación.


Desmoid tumours are a rare benign tumour of fibroblastic non inflammatory origin, sometimes referred as non aggressive fibromatosis.The etiology is not yet completely clear, however, it is usually associated with previous trauma and / or surgical procedures. The most frequent location is in the abdomen, which has typical images characteristics, as well as its skeletal muscle presentation at the plantar level. The presentation outside these places is infrequent and difficult to diagnose. We present a case of a cervical desmoid tumour that generated a great diagnostic challenge, identifying its key imaging characteristics and performing a literature review of the bibliography regarding this location.


Subject(s)
Humans , Male , Adult , Fibroma/surgery , Fibroma/diagnostic imaging , Head and Neck Neoplasms/surgery , Head and Neck Neoplasms/diagnostic imaging , Tomography, X-Ray Computed , Fibroma/pathology , Head and Neck Neoplasms/pathology
3.
Rev. chil. radiol ; 22(1): 39-46, 2016. ilus
Article in Spanish | LILACS | ID: lil-782655

ABSTRACT

Abstract. The objective of this article is to describe the multiple entities that can affect and invade the inferior vena cava. These can be either benign entities, but with an aggressive behaviour, or malignancies that originate in the organs adjacent to this vascular structure, or in itself as a leiomyosarcoma. The present review shows different examples in Computed Tomography and Magnetic Resonance, with cases of angiomyolipoma, phaeochromocytoma, adrenal cortical carcinoma, renal cell carcinoma, hepatocellular carcinoma, a retroperitoneal sarcoma and a leiomyosarcoma originating in the inferior vena cava. Besides these, there are situations that may lead to diagnostic errors, such as the flow artefacts and pseudolipoma.


El objetivo de este artículo es describir las múltiples entidades que pueden afectar e invadir la vena cava inferior. Entre ellas podemos enumerar tanto entidades benignas, pero con un comportamiento agresivo, como procesos malignos que se originan en órganos adyacentes a esta estructura vascular o en ella misma como el leiomiosarcoma. En la presente revisión se exponen diferentes ejemplos en tomografía computarizada y resonancia magnética con casos de angiomiolipoma, feocromocitoma, carcinoma suprarrenal, carcinoma de células renales, hepatocarcinoma, sarcoma retroperitoneal y leiomiosarcoma originado en la vena cava inferior. Además se exponen situaciones que pueden inducir a errores diagnósticos como los artefactos de flujo y el pseudolipoma.


Subject(s)
Humans , Pheochromocytoma/diagnostic imaging , Vena Cava, Inferior/diagnostic imaging , Carcinoma, Renal Cell/diagnostic imaging , Angiomyolipoma/diagnostic imaging , Carcinoma, Hepatocellular/diagnostic imaging , Vena Cava, Inferior/pathology , Magnetic Resonance Imaging , Tomography, X-Ray Computed , Venous Thrombosis/diagnostic imaging
4.
PLoS One ; 10(5): e0127262, 2015.
Article in English | MEDLINE | ID: mdl-25978357

ABSTRACT

Probiotics can modulate the immune system, conferring beneficial effects on the host. Understanding how these microorganisms contribute to improve the health status is still a challenge. Previously, we have demonstrated that Enterococcus faecalis CECT7121 implants itself and persists in the murine gastrointestinal tract, and enhances and skews the profile of cytokines towards the Th1 phenotype in several biological models. Given the importance of dendritic cells (DCs) in the orchestration of immunity, the aim of this work was to elucidate the influence of E. faecalis CECT7121 on DCs and the outcome of the immune responses. In this work we show that E. faecalis CECT7121 induces a strong dose-dependent activation of DCs and secretion of high levels of IL-12, IL-6, TNFα, and IL-10. This stimulation is dependent on TLR signaling, and skews the activation of T cells towards the production of IFNγ. The influence of this activation in the establishment of Th responses in vivo shows the accumulation of specific IFNγ-producing cells. Our findings indicate that the activation exerted by E. faecalis CECT7121 on DCs and its consequence on the cellular adaptive immune response may have broad therapeutic implications in immunomodulation.


Subject(s)
Dendritic Cells/drug effects , Dendritic Cells/immunology , Enterococcus faecalis/immunology , Immunomodulation/drug effects , Immunomodulation/immunology , Interferon-gamma/immunology , Probiotics/administration & dosage , Animals , Gastrointestinal Tract/drug effects , Gastrointestinal Tract/immunology , Gastrointestinal Tract/microbiology , Immunity/drug effects , Immunity/immunology , Interleukin-10/immunology , Interleukin-12/immunology , Interleukin-6/immunology , Mice , Mice, Inbred BALB C , Mice, Inbred C57BL , T-Lymphocytes/drug effects , T-Lymphocytes/immunology , Tumor Necrosis Factor-alpha/immunology
8.
Indian J Surg ; 75(Suppl 1): 227-9, 2013 Jun.
Article in English | MEDLINE | ID: mdl-24426573

ABSTRACT

Multiple primary gastrointestinal stromal tumors (GIST) are an infrequent finding. Benign and malignant tumors could coexist in the same patient. We discuss one case of a benign jejunal GIST and a malignant ileal GIST coexisting in the same patient and present their radiological characteristics.

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