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1.
J Hazard Mater ; 445: 130625, 2023 03 05.
Article in English | MEDLINE | ID: mdl-37056024

ABSTRACT

In this work, we used palladium-doped polystyrene NPLs (PS-NPLs with a primary size of 286 ± 4 nm) with an irregular surface morphology which allowed for particle tracking and evaluation of their toxicity on two primary producers (cyanobacterium, Anabaena sp. PCC7120 and green algae, Chlamydomonas reinhardtii) and one primary consumer (crustacean, Daphnia magna). the concentration range for Anabaena and C. reinhardtii was from 0.01 to 1000 mg/L and for D. magna, the range was from 7.5 to 120 mg/L.EC50 s ranged from 49 mg NPLs/L for D. magna (48hEC50 s) to 248 mg NPLs/L (72hEC50 s for C. reinhardtii). PS-NPLs induced dose-dependent reactive oxygen species overproduction, membrane damage and metabolic alterations. To shed light on the environmental fate of PS-NPLs, the short-term distribution of PS-NPLs under static (using lake water and sediments) and stirring (using river water and sediments) conditions was studied at laboratory scale. The results showed that most NPLs remained in the water column over the course of 48 h. The maximum percentage of settled particles (∼ 30 %) was found under stirring conditions in comparison with the ∼ 10 % observed under static ones. Natural organic matter increased the stability of the NPLs under colloidal state while organisms favored their settlement. This study expands the current knowledge of the biological effects and fate of NPLs in freshwater environments.


Subject(s)
Aquatic Organisms , Water Pollutants, Chemical , Animals , Microplastics/toxicity , Polystyrenes/metabolism , Fresh Water , Daphnia , Water/pharmacology , Water Pollutants, Chemical/metabolism
3.
Complex Psychiatry ; 7(3-4): 60-70, 2021 Dec.
Article in English | MEDLINE | ID: mdl-36017067

ABSTRACT

No large-scale genome-wide association studies (GWASs) of psychosis have been conducted in Mexico or Latin America to date. Schizophrenia and bipolar disorder in particular have been found to be highly heritable and genetically influenced. However, understanding of the biological basis of psychosis in Latin American populations is limited as previous genomic studies have almost exclusively relied on participants of Northern European ancestry. With the goal of expanding knowledge on the genomic basis of psychotic disorders within the Mexican population, the National Institute of Psychiatry Ramón de la Fuente Muñiz (INPRFM), the Harvard T.H. Chan School of Public Health, and the Broad Institute's Stanley Center for Psychiatric Research launched the Neuropsychiatric Genetics Research of Psychosis in Mexican Populations (NeuroMex) project to collect and analyze case-control psychosis samples from 5 states across Mexico. This article describes the planned sample collection and GWAS protocol for the NeuroMex study. The 4-year study will span from April 2018 to 2022 and aims to recruit 9,208 participants: 4,604 cases and 4,604 controls. Study sites across Mexico were selected to ensure collected samples capture the genomic diversity within the Mexican population. Blood samples and phenotypic data will be collected during the participant interview process and will contribute to the development of a local biobank in Mexico. DNA extraction will be done locally and genetic analysis will take place at the Broad Institute in Cambridge, MA. We will collect extensive phenotypic information using several clinical scales. All study materials including phenotypic instruments utilized are openly available in Spanish and English. The described study represents a long-term collaboration of a number of institutions from across Mexico and the Boston area, including clinical psychiatrists, clinical researchers, computational biologists, and managers at the 3 collaborating institutions. The development of relevant data management, quality assurance, and analysis plans are the primary considerations in this protocol article. Extensive management and analysis processes were developed for both the phenotypic and genetic data collected. Capacity building, partnerships, and training between and among the collaborating institutions are intrinsic components to this study and its long-term success.

4.
Rev. cuba. pediatr ; 92(2): e832, abr.-jun. 2020. graf
Article in Spanish | LILACS, CUMED | ID: biblio-1126752

ABSTRACT

Introducción: El carcinoma verrugoso es una variante inusual bien diferenciada del carcinoma epidermoide que tiende a aparecer en adultos de mediana edad o mayores. Se considera una neoplasia maligna de grado bajo con cuatro subtipos principales. Objetivo: Referir la infrecuente presentación del carcinoma verrugoso en un adolescente. Presentación de caso: Escolar masculino de 12 años de edad, de raza mestiza, que acude a Consulta Especializada de Dermatología en el Hospital Clínico Quirúrgico Docente Celia Sánchez Manduley con lesión vegetante localizada en planta de pie derecho; se realizan complementarios, biopsia excisional más injerto y se concluye el caso como epitelioma curriculatum. Conclusiones: A nivel clínico, los carcinomas verrugosos se presentan en forma de tumores exofíticos con una superficie papilomatosa o verrugosa. Se asocian con frecuencia a la infección por el virus del papiloma humano, y puede ser difícil distinguir entre un carcinoma verrugoso y una verruga. Es importante el reconocimiento temprano para guiar un diagnóstico preciso y tratamiento oportuno(AU)


Introduction: Verrucous carcinoma is a well differentiated unusual variant of squamous cell carcinoma that tends to occur in middle-aged or older adults. It is considered a low-grade malignant tumour with four main subtypes. Objective: To explain the uncommon presentation of the verrucous carcinoma in a teenager and the importance of early recognition to guide an accurate diagnosis and a timely treatment. Case presentation: 12 years old, school age male, mixed race who attends to specialized consultation of Dermatology in Celia Sánchez Manduley Surgical Clinical Hospital presenting a vegetating lesion located in the right foot´s sole; there were made complementary blood tests, an excisional biopsy plus graft and the case was finally diagnoses as curriculatum epithelioma. Conclusions: At the clinical level, the verrucous carcinomas are presented in the form of exophytic tumors with a papillomatous or verrucous surface. They are often associated with the human papilloma virus infection, and it may be difficult to distinguish between a verrucous carcinoma and a wart(AU)


Subject(s)
Humans , Male , Child , Carcinoma, Squamous Cell/diagnosis , Carcinoma, Verrucous/pathology , Carcinoma, Verrucous/epidemiology
5.
Rev. cuba. pediatr ; 92(2): e923, abr.-jun. 2020. graf
Article in Spanish | LILACS, CUMED | ID: biblio-1126753

ABSTRACT

Introducción: La acrodermatitis enteropática es una dermatosis nutricional heredada o adquirida por deficiencia de zinc que clínicamente se caracteriza por eritema, escamocostras y erosiones, especialmente en la región perioral, en zonas acras y en la región anogenital. Además de una ingesta oral inadecuada, hay causas secundarias de esta deficiencia nutricional. Objetivo: Referir una dermatosis nutricional secundaria infrecuente en lactante femenina. Presentación de caso: Pequeñita de 6 meses de edad, fototipo III, alimentada con lactancia materna exclusiva, que acude a consulta especializada de dermatología en el hospital William Soler por cuadro clínico de 3 meses de evolución caracterizado por lesiones eritematocostrosas en regiónes acrales y periorificiales. Los padres refirieron lactancia materna exclusiva. Se realizaron complementarios Conclusiones: Las deficiencias de vitaminas y oligoelementos pueden ocasionar un amplio rango de hallazgos mucocutaneos. En el caso presentado diagnosticado como acrodermatitis enteropática adquirida, hay un aporte inadecuado de zinc en la leche materna(AU)


Introduction: Acrodermatitis enteropathica is an inherited or acquired nutritional dermatosis by zinc deficiency that is clinically characterized by erythema, squamous crusts and erosions, especially in the perioral region, in acral areas and in the anogenital region. In addition to inadequate oral intake, there are secondary causes of this nutritional deficiency. Objective: To refer a nutritional dermatosis uncommon in female infants. Case presentation: 6-months-old baby girl, skin phototype III, fed with exclusive breastfeeding whom was attended in the specialized consultation in Dermatology of William Soler Pediatric Hospital due to clinical framework of 3 months of evolution characterized by eritemato crusty lesions in acral and periorifices´ regions. Parents commented on exclusive breastfeeding. There were made complementary blood tests. Conclusions: The deficiencies of vitamins and trace elements may cause a wide range of mucocutaneous findings. In the presented case diagnosed as adquired acrodermatitis enteropathica, there is an inadequate intake of zinc in breast milk(AU)


Subject(s)
Humans , Female , Infant , Acrodermatitis/diagnosis , Acrodermatitis/epidemiology
6.
Rev. cuba. pediatr ; 92(1): e747, ene.-mar. 2020. graf
Article in Spanish | LILACS, CUMED | ID: biblio-1093751

ABSTRACT

Introducción: La incontinencia pigmentaria es una genodermatosis poco frecuente, con herencia dominante ligada al cromosoma X, que se presenta casi exclusivamente en mujeres. Objetivo: Informar un caso de incontinencia pigmentaria familiar (madre e hija), trastorno neuroectodérmico sistémico infrecuente. Presentación del caso: Lactante femenina remitida del servicio de neurología a la consulta especializada de dermatología en el Hospital William Soler, por alteraciones en el desarrollo psicomotor y crisis epilépticas con lesiones vegetantes hiperpigmentadas que siguen las líneas de Blaschko. En la madre se detectaron lesiones atróficas con una disposición similar. Conclusiones: Esta rara enfermedad debe sospecharse por erupción cutánea que sigue las líneas de Blaschko, habitualmente presentes en el nacimiento y que evoluciona en etapas consecutivas características. Resaltamos la importancia del asesoramiento genético, con el fin de prevenir futuras generaciones afectadas, así como el manejo multidisciplinario en esta genodermatosis(AU)


Introduction: Incontinencia pigmenti is a rare genodermatoses with dominant inheritance linked to X chromosome that occurs almost exclusively in women. Objective: To report a case of family incontinentia pigmenti (mother and daughter), which is a systemic neuroectodermal disorder rare in pediatrics. Case presentation: Female infant referred from the neurology service to the dermatology specialist in William Soler Hospital due to alterations in the psychomotor development and epileptic seizures with hyperpigmented vegetative lesions that follow the Blaschko lines. In the mother, atrophic lesions were detected with a similar distribution. Conclusions: This rare disease should be suspected by rash that follows the Blaschko lines, usually present at birth and that develops in characteristic consecutive stages. We emphasize the importance of genetic counselling in order to prevent future generations to be affected, as well as the multidisciplinary management in this genodermatoses(AU)


Subject(s)
Humans , Female , Infant , Incontinentia Pigmenti/genetics , Incontinentia Pigmenti/epidemiology
7.
Int. braz. j. urol ; 46(1): 83-89, Jan.-Feb. 2020. tab, graf
Article in English | LILACS | ID: biblio-1056362

ABSTRACT

ABSTRACT Purpose: Obliterative urethral stenosis is a type of urethral lesion that compromises the whole corpus spongiosum's circumference. We present our experience in resolving complex long segment urethral obliteration in a single procedure using a combination of dorsal onlay oral mucosa graft (OMG) and ventral fasciocutaneous penile skin flap. Materials and methods: A prospectively maintained database was reviewed, which included data of men presenting long, obliterative strictures. Patients were excluded if they were lost to follow-up before one year. Failure was defined as need for further urethral instrumentation. The surgical technique used consisted on the fixation of OMG to the tunica albuginea of the corpus cavernosum, thus creating a new urethral plate. Penile or foreskin flaps were employed to complete the ventral aspect. Postoperative follow-up was done with a voiding cystourethrography at week 3. Results: A total of 21 patients were included with a median age of 49 years. Mean follow-up was 25 months. Failure was found for 3 patients (2 of them needing dilations and only one required a new urethral reconstruction). Conclusion: Single stage combination of dorsal OMG with ventral fasciocutaneous penile flap showed good results for selected patients affected with obliterative urethral stenosis.


Subject(s)
Humans , Male , Penis/surgery , Surgical Flaps/transplantation , Urethral Stricture/surgery , Plastic Surgery Procedures/methods , Mouth Mucosa/transplantation , Prospective Studies , Reproducibility of Results , Follow-Up Studies , Treatment Outcome , Kaplan-Meier Estimate , Operative Time , Middle Aged
8.
Int Braz J Urol ; 46(1): 83-89, 2020.
Article in English | MEDLINE | ID: mdl-31851463

ABSTRACT

PURPOSE: Obliterative urethral stenosis is a type of urethral lesion that compromises the whole corpus spongiosum's circumference. We present our experience in resolving complex long segment urethral obliteration in a single procedure using a combination of dorsal onlay oral mucosa graft (OMG) and ventral fasciocutaneous penile skin flap. MATERIALS AND METHODS: A prospectively maintained database was reviewed, which included data of men presenting long, obliterative strictures. Patients were excluded if they were lost to follow-up before one year. Failure was defined as need for further urethral instrumentation. The surgical technique used consisted on the fixation of OMG to the tunica albuginea of the corpus cavernosum, thus creating a new urethral plate. Penile or foreskin flaps were employed to complete the ventral aspect. Postoperative follow-up was done with a voiding cystourethrography at week 3. RESULTS: A total of 21 patients were included with a median age of 49 years. Mean follow-up was 25 months. Failure was found for 3 patients (2 of them needing dilations and only one required a new urethral reconstruction). CONCLUSION: Single stage combination of dorsal OMG with ventral fasciocutaneous penile flap showed good results for selected patients affected with obliterative urethral stenosis.


Subject(s)
Mouth Mucosa/transplantation , Penis/surgery , Plastic Surgery Procedures/methods , Surgical Flaps/transplantation , Urethral Stricture/surgery , Follow-Up Studies , Humans , Kaplan-Meier Estimate , Male , Middle Aged , Operative Time , Prospective Studies , Reproducibility of Results , Treatment Outcome
9.
Multimed (Granma) ; 23(4): 758-774, jul.-ago. 2019. tab
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1091309

ABSTRACT

RESUMEN Se realizó un estudio cuasi experimental con Autohemoterapia menor a los pacientes con Psoriasis vulgar, en el hospital "Celia Sánchez Manduley" desde marzo 2016 - mayo 2018; con el objetivo de describir la respuesta de estos pacientes a dicho tratamiento. La población objeto de estudio quedó conformada por 71 pacientes que cumplieron con los criterios de inclusión/exclusión establecidos. Los datos se obtuvieron de las historias clínicas y encuestas realizadas a los pacientes y los resultados se presentaron en tablasde contingencias mediante el sistema Windows Vista. Se estudiaron las variables: respuesta clínica, tiempo de evolución de la enfermedad, número de sesiones, efectos adversos, tiempo de aparición de brotes. Se realizó el cálculo inicial del PASI y en cada consulta de evaluación y al final del tratamiento; se calculó el porciento del cambio del PASI, pues la respuesta clínica se realizó teniendo en cuenta las categorías de éste. Se concluyó que en el estudio predominaron los pacientes respondedores al tratamiento con Autohemoterapia menor, sin influir en la respuesta el tiempo de evolución de su enfermedad. Necesitó la mayoría de los psoriásicos la mayor cantidad de sesiones para la mejoría o desaparición de las lesiones y se logró con esta terapéutica espaciar los brotes sin efectos adversos en ningún enfermo.


ABSTRACT A quasi-experimental study with less autohemotherapy was performed on patients with vulgar Psoriasis, at the "Celia Sánchez Manduley" hospital from March 2016 - May 2018; with the objective of describing the response of these patients to said treatment. The study population consisted of 71 patients who met the established inclusion / exclusion criteria. The data were obtained from the clinical histories and surveys made to the patients and the results were presented in contingency tables using the Windows Vista system. The variables were studied: clinical response, time of disease evolution, number of sessions, adverse effects, time of appearance of outbreaks. The initial calculation of the PASI was performed and in each evaluation consultation and at the end of the treatment; the percentage of the PASI change was calculated, since the clinical response was made taking into account the categories of the latter. It was concluded that in the study the patients responding to treatment with minor autohemotherapy predominated, without influencing the response time of their disease evolution. The majority of psoriatics needed the most sessions for the improvement or disappearance of the lesions and this therapy was achieved by spacing the outbreaks without adverse effects in any patient.


RESUMO Um estudo quase experimental com menos auto-hemoterapia foi realizado em pacientes com psoríase vulgar, no hospital "Celia Sánchez Manduley", de março de 2016 a maio de 2018; com o objetivo de descrever a resposta desses pacientes ao referido tratamento. A população do estudo consistiu de 71 pacientes que preencheram os critérios de inclusão / exclusão estabelecidos. Os dados foram obtidos dos prontuários e levantamentos feitos aos pacientes e os resultados foram apresentados em tabelas de contingência utilizando o sistema Windows Vista. As variáveis ​​estudadas foram: resposta clínica, tempo de evolução da doença, número de sessões, efeitos adversos, tempo de aparecimento dos surtos. O cálculo inicial do PASI foi feito e em cada consulta de avaliação e no final do tratamento; o percentual de mudança do PASI foi calculado, uma vez que a resposta clínica foi feita levando-se em consideração as categorias deste último. Concluiu-se que o estudo predominou em pacientes que responderam ao tratamento com auto-hemoterapia menor, sem influenciar o tempo de resposta da evolução de sua doença. A maioria dos pacientes com psoríase precisou da maioria das sessões para a melhora ou desaparecimento das lesões e foi conseguida com essa terapia para espaçar os surtos sem efeitos adversos em nenhum paciente.

10.
Biomicrofluidics ; 13(2): 024111, 2019 Mar.
Article in English | MEDLINE | ID: mdl-31065310

ABSTRACT

Microfluidic devices provide a platform for analyzing both natural and synthetic multicellular systems. Currently, substantial capital investment and expertise are required for creating microfluidic devices using standard soft-lithography. These requirements present barriers to entry for many nontraditional users of microfluidics, including developmental biology laboratories. Therefore, fabrication methodologies that enable rapid device iteration and work "out-of-the-box" can accelerate the integration of microfluidics with developmental biology. Here, we have created and characterized low-cost hybrid polyethylene terephthalate laminate (PETL) microfluidic devices that are suitable for cell and micro-organ culture assays. These devices were validated with mammalian cell lines and the Drosophila wing imaginal disc as a model micro-organ. First, we developed and tested PETLs that are compatible with both long-term cultures and high-resolution imaging of cells and organs. Further, we achieved spatiotemporal control of chemical gradients across the wing discs with a multilayered microfluidic device. Finally, we created a multilayered device that enables controllable mechanical loading of micro-organs. This mechanical actuation assay was used to characterize the response of larval wing discs at different developmental stages. Interestingly, increased deformation of the older wing discs for the same mechanical loading suggests that the compliance of the organ is increased in preparation for subsequent morphogenesis. Together, these results demonstrate the applicability of hybrid PETL devices for biochemical and mechanobiology studies on micro-organs and provide new insights into the mechanics of organ development.

11.
Rev Chil Pediatr ; 90(1): 69-77, 2019.
Article in English, Spanish | MEDLINE | ID: mdl-31095221

ABSTRACT

INTRODUCTION: Spirometry is the most commonly used test to evaluate lung function. Foreign refe rence standards are currently available for preschool children. OBJECTIVES: 1. To measure spirometric variables in healthy Chilean preschool children, 2. To compare these results with predictive ones according to GLI (Global Lung Initiative), Eigen (USA) and França (Brazil), and 3. If there is a sig nificant difference with these, to develop reference equations. SUBJECTS AND METHOD: Questionnaires were distributed to parents in several schools and kindergartens in Santiago. Children with a history of prematurity, asthmatic symptoms, chronic lung disease (including asthma), and chronic non respiratory disease were excluded. Spirometry was performed according to ATS/ERS 2007 guideli nes, with MedGraphics equipment, USA. Family and environmental background, weight and height were recorded, as well as values obtained in forced vital capacity (FVC), forced expiratory volume in 0.5, 0.75 and 1 second (FEV0.5, FEV0.75, and FEV1, respectively). RESULTS: 276 spirometries were performed, 202 met acceptability criteria, 112 girls, average age 5.01 ± 0.57 years, height 108.7 ± 5.6 cm. When comparing by gender, there was only a significant difference in FVC, which was higher in boys. The average values obtained in the total group were: FVC 1.22 ± 0.22 liters, FEV1 1.16 ± 0.18 liters, FEV0.75 1.07 ± 0.17 liters. These parameters were higher in percentage than the predictive ones according to GLI, Eigen, and França, except FVC with Eigen, therefore, predictive equations were de veloped. CONCLUSIONS: Spirometric values of preschoolers living in Santiago were higher than foreign reference values. We proposed these reference standards to be used in our country.


Subject(s)
Spirometry/standards , Child, Preschool , Chile , Female , Global Health , Healthy Volunteers , Humans , Male , Reference Standards , Reference Values
12.
Int. braz. j. urol ; 45(2): 253-261, Mar.-Apr. 2019. tab, graf
Article in English | LILACS | ID: biblio-1002195

ABSTRACT

ABSTRACT Purpose: To evaluate safety, efficacy and functional outcomes after open vesicourethral re - anastomosis using different approaches based on previous urinary continence. Materials and Methods: Retrospective study of patients treated from 2002 to 2017 due to vesicourethral anastomosis stricture (VUAS) post radical prostatectomy (RP) who failed endoscopic treatment with at least 3 months of follow-up. Continent and incontinent patients post RP were assigned to abdominal (AA) or perineal approach (PA), respectively. Demographic and perioperative variables were registered. Follow-up was completed with clinical interview, uroflowmetry and cystoscopy every 4 months. Success was defined as asymptomatic patients with urethral lumen that allows a 14 French flexible cystoscope. Results: Twenty patients underwent open re-anastomosis for VUAS after RP between 2002 and 2017. Mean age was 63.7 years (standard deviation 1.4) and median follow-up was 10 months (range 3 - 112). The approach distribution was PA 10 patients (50%) and AA 10 patients (50%). The mean surgery time and median hospital time were 246.2 ± 35.8 minutes and 4 days (range 2 - 10), respectively with no differences between approaches. No significant complication rate was found. Three patients in the AA group had gait disorder with favorable evolution and no sequels. Estimated 2 years primary success rate was 80%. After primary procedures 89.9% remained stenosis - free. All PA patients remained incontinent, and 90% AA remained continent during follow-up. Conclusion: Open vesicourethral re - anastomosis treatment is a reasonable treatment option for recurrent VUAS after RP. All patients with perineal approach remained incontinent while incontinence rate in abdominal approach was rather low.


Subject(s)
Humans , Male , Prostatectomy/methods , Urethra/surgery , Urethral Stricture/etiology , Urinary Bladder/surgery , Postoperative Complications/etiology , Prostatectomy/adverse effects , Urethral Stricture/surgery , Urinary Incontinence/etiology , Urinary Bladder Neck Obstruction/surgery , Anastomosis, Surgical , Retrospective Studies , Follow-Up Studies , Treatment Outcome , Erectile Dysfunction/etiology , Middle Aged
13.
Medisan ; 23(1)ene.-feb. 2019. graf
Article in Spanish | CUMED | ID: cum-74727

ABSTRACT

Se presenta el caso clínico de un paciente de 57 años de edad, mestizo, con antecedentes de artritis reumatoidea y gota, quien acude a la consulta especializada de Dermatología del Hospital Clinicoquirúrgico Docente Celia Sánchez Manduley de Manzanillo, provincia de Granma, por presentar lesiones nodulares dolorosas diseminadas. Se realizaron estudios complementarios y biopsia de piel, cuyos resultados permitieron diagnosticar una gota tofácea crónica. El paciente llevaba tratamiento medicamentoso con prednisona, colchicina y metrotexate, pero luego de discutir el caso con los especialistas en medicina interna y reumatología se decidió sustituir la colchicina por el alopurinol(AU)


The case report of a 57 year-old mestizo patient, is presented with a history of rheumatoid arthritis and gout who visited the specialized Dermatology department of Celia Sánchez Manduley Teaching Clinical-Surgical Hospital in Manzanillo, Granma province, for presenting disseminated painful nodular lesions. Complementary studies and skin biopsy were carried out which results allowed to diagnose a chronic . The patient was under drugs treatment with prednisona, colchicina and metrotexate, but after discussing the case with the specialists in internal medicine and rheumatology it was decided to sustitute colchicina by alopurinol(AU)


Subject(s)
Humans , Male , Middle Aged , Humans , Arthritis, Gouty/diagnosis , Hyperuricemia , Gout , Uric Acid/metabolism , Secondary Care
14.
Medisan ; 23(1)ene.-feb. 2019. graf
Article in Spanish | LILACS | ID: biblio-990183

ABSTRACT

Se presenta el caso clínico de un paciente de 57 años de edad, mestizo, con antecedentes de artritis reumatoidea y gota, quien acude a la consulta especializada de Dermatología del Hospital Clinicoquirúrgico Docente Celia Sánchez Manduley de Manzanillo, provincia de Granma, por presentar lesiones nodulares dolorosas diseminadas. Se realizaron estudios complementarios y biopsia de piel, cuyos resultados permitieron diagnosticar una gota tofácea crónica. El paciente llevaba tratamiento medicamentoso con prednisona, colchicina y metrotexate, pero luego de discutir el caso con los especialistas en medicina interna y reumatología se decidió sustituir la colchicina por el alopurinol.


The case report of a 57 year-old mestizo patient, is presented with a history of rheumatoid arthritis and gout who visited the specialized Dermatology department of Celia Sánchez Manduley Teaching Clinical-Surgical Hospital in Manzanillo, Granma province, for presenting disseminated painful nodular lesions. Complementary studies and skin biopsy were carried out which results allowed to diagnose a chronic . The patient was under drugs treatment with prednisona, colchicina and metrotexate, but after discussing the case with the specialists in internal medicine and rheumatology it was decided to sustitute colchicina by alopurinol.


Subject(s)
Humans , Male , Middle Aged , Arthritis, Gouty/diagnosis , Hyperuricemia , Gout , Uric Acid/metabolism , Secondary Care
15.
Int Braz J Urol ; 45(2): 253-261, 2019.
Article in English | MEDLINE | ID: mdl-30325608

ABSTRACT

PURPOSE: To evaluate safety, efficacy and functional outcomes after open vesicourethral re - anastomosis using different approaches based on previous urinary continence. MATERIALS AND METHODS: Retrospective study of patients treated from 2002 to 2017 due to vesicourethral anastomosis stricture (VUAS) post radical prostatectomy (RP) who failed endoscopic treatment with at least 3 months of follow-up. Continent and incontinent patients post RP were assigned to abdominal (AA) or perineal approach (PA), respectively. Demographic and perioperative variables were registered. Follow-up was completed with clinical interview, uroflowmetry and cystoscopy every 4 months. Success was defined as asymptomatic patients with urethral lumen that allows a 14 French flexible cystoscope. RESULTS: Twenty patients underwent open re-anastomosis for VUAS after RP between 2002 and 2017. Mean age was 63.7 years (standard deviation 1.4) and median follow-up was 10 months (range 3 - 112). The approach distribution was PA 10 patients (50%) and AA 10 patients (50%). The mean surgery time and median hospital time were 246.2 ± 35.8 minutes and 4 days (range 2 - 10), respectively with no differences between approaches. No significant complication rate was found. Three patients in the AA group had gait disorder with favorable evolution and no sequels. Estimated 2 years primary success rate was 80%. After primary procedures 89.9% remained stenosis - free. All PA patients remained incontinent, and 90% AA remained continent during follow-up. CONCLUSION: Open vesicourethral re - anastomosis treatment is a reasonable treatment option for recurrent VUAS after RP. All patients with perineal approach remained incontinent while incontinence rate in abdominal approach was rather low.


Subject(s)
Prostatectomy/methods , Urethra/surgery , Urethral Stricture/etiology , Urinary Bladder/surgery , Anastomosis, Surgical , Erectile Dysfunction/etiology , Follow-Up Studies , Humans , Male , Middle Aged , Postoperative Complications/etiology , Prostatectomy/adverse effects , Retrospective Studies , Treatment Outcome , Urethral Stricture/surgery , Urinary Bladder Neck Obstruction/surgery , Urinary Incontinence/etiology
16.
Rev. chil. pediatr ; 90(1): 69-77, 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-990888

ABSTRACT

INTRODUCCIÓN: La espirometría es el examen más utilizado para evaluar función pulmonar. Para niños pre-escolares actualmente se cuenta con patrones de referencia extranjeros. OBJETIVOS: 1. Medir variables espirométricas en pre-escolares chilenos sanos, 2. Comparar estos resultados con predictivos según GLI (Global Lung Initiative), Eigen (USA) y França (Brasil) y 3. De haber diferencia significativa con éstos, elaborar ecuaciones de referencia. SUJETOS Y MÉTODO: Se distribuyeron encuestas a apoderados de colegios y jardines infantiles de Santiago. Se excluyeron niños con antecedente de prematurez, síntomas asmáticos, enfermedad pulmonar crónica (incluida asma) y enfermedad crónica no respiratoria. La espirometría se realizó según guías ATS/ERS 2007, con equipo MedGraphics, USA. Se registraron antecedentes familiares, ambientales, peso y talla y los valores obtenidos en capacidad vital forzada (CVF), volumen espirado forzado en 0,5, 0,75 y 1 segundo (VEF 05, VEF0 75 y VEFj, respectivamente). RESULTADOS: Se realizaron 276 espirometrías, de las cuales 202 cumplieron criterios de aceptabilidad, 112 mujeres, edad promedio 5,01 ± 0,57 años, talla 108,7 ± 5,6 cm. Al comparar por género, solo hubo diferencia significativa en CVF, siendo superior en hombres. Los valores promedio obtenidos en el grupo total fueron: CVF 1,22 ± 0,22 litros, VEF1 1,16 ± 0,18 litros, VEF075 1,07 ± 0,17 litros. Nuestros parámetros fueron porcentualmente mayores que los predictivos según GLI, Eigen y França, excepto CVF con Eigen, motivo por el cual se construyeron ecuaciones predictivas. CONCLUSIONES: Los valores espirométricos de pre-escolares residentes en Santiago fueron superiores a los valores de referencia extranjeros. Se proponen patrones de referencia que podrían ser utilizados en nuestro medio.


INTRODUCTION: Spirometry is the most commonly used test to evaluate lung function. Foreign refe rence standards are currently available for preschool children. OBJECTIVES: 1. To measure spirometric variables in healthy Chilean preschool children, 2. To compare these results with predictive ones according to GLI (Global Lung Initiative), Eigen (USA) and França (Brazil), and 3. If there is a sig nificant difference with these, to develop reference equations. SUBJECTS AND METHOD: Questionnaires were distributed to parents in several schools and kindergartens in Santiago. Children with a history of prematurity, asthmatic symptoms, chronic lung disease (including asthma), and chronic non respiratory disease were excluded. Spirometry was performed according to ATS/ERS 2007 guideli nes, with MedGraphics equipment, USA. Family and environmental background, weight and height were recorded, as well as values obtained in forced vital capacity (FVC), forced expiratory volume in 0.5, 0.75 and 1 second (FEV0.5, FEV0.75, and FEV1, respectively). RESULTS: 276 spirometries were performed, 202 met acceptability criteria, 112 girls, average age 5.01 ± 0.57 years, height 108.7 ± 5.6 cm. When comparing by gender, there was only a significant difference in FVC, which was higher in boys. The average values obtained in the total group were: FVC 1.22 ± 0.22 liters, FEV1 1.16 ± 0.18 liters, FEV0.75 1.07 ± 0.17 liters. These parameters were higher in percentage than the predictive ones according to GLI, Eigen, and França, except FVC with Eigen, therefore, predictive equations were de veloped. CONCLUSIONS: Spirometric values of preschoolers living in Santiago were higher than foreign reference values. We proposed these reference standards to be used in our country.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Spirometry/standards , Reference Standards , Reference Values , Chile , Global Health , Healthy Volunteers
17.
Rev. chil. dermatol ; 35(4): 146-149, 2019. ilus
Article in Spanish | LILACS | ID: biblio-1120285

ABSTRACT

Se presenta caso de paciente masculino de 67 años de edad, fototipo III, con antecedentes patológicos personales de lepra lepromatosa en tratamiento, que acude a consulta especializada de Dermatología en el Hospital Guillermo Fernández Baquero (La Habana, Cuba) por lesiones ulcerosas diseminadas. Se realizan complementarios y se concluye caso como fenómeno de Lucio. Resaltando la infrecuencia de este eritema necrosante y la severidad de los estados reactivos de la lepra pues son procesos distintos pero destructores de los tejidos, supuestamente dirigidos por el sistema inmunológico que aumentan en gran medida la morbimortalidad de esta enfermedad


A case of a 67 year old male patient, phototype III, with a personal pathological history of lepromatous leprosy in treatment is presented at a specialized dermatology clinic at Guillermo Fernández Vaquero hospital for disseminated ulcerative lesions. Complementary are performed and case is concluded as a phenomenon of Lucio. Highlighting the infrequency of this necrotizingerythema and the severity of the reactive states of leprosy are different but destructive processes of the tissues, supposedlydirected by the immune system that greatly increase the morbidity and mortality of this disease.


Subject(s)
Humans , Male , Aged , Skin Ulcer/diagnosis , Skin Ulcer/etiology , Leprosy, Lepromatous/complications , Skin Ulcer/pathology , Erythema , Necrosis
18.
MULTIMED ; 22(6)2018. ilus
Article in Spanish | CUMED | ID: cum-75015

ABSTRACT

Se presenta paciente masculino de 27 años de edad, de raza mestiza, con antecedentes de queratodermia plantar, que acude a consulta especializada de dermatología en el hospital clínico quirúrgico docente Celia Sánchez Manduley por exacerbación de las lesiones, acompañadas de dolor intenso al caminar; evidenciándose al examen físico la presencia de lesiones quísticas diseminadas, hipertrofia ungueal y alopecia. Se concluye caso como síndrome de Jackson-Lawler, resaltando su infrecuencia en el medio, la afectación de calidad de vida e impacto psicológico generada al paciente y la importancia del asesoramiento genético al mismo, con el fin de prevenir futuras generaciones afectadas(AU)


We present a 27-year-old male patient of mixed race, with a history of plantar keratoderma, who attended a specialized in the Celia Sánchez Manduley clinical teaching hospital due to exacerbation of the lesions, accompanied by severe pain when walking; the physical examination revealed the presence of disseminatedcystic lesions, nail hypertrophy and alopecia. The case is concluded as a Jackson-Lawler syndrome, highlighting its infrequence in the environment, the impact on the quality of life and the psychological impact generated on the patient and the importance of genetic counseling to them, in order to prevent future generations affected(EU)


Subject(s)
Humans , Male , Adult , Pachyonychia Congenita/diagnosis , Keratoderma, Palmoplantar/diagnosis , Ectodermal Dysplasia/diagnosis , Steatocystoma Multiplex/diagnosis
19.
Curr Diab Rep ; 17(10): 93, 2017 08 24.
Article in English | MEDLINE | ID: mdl-28836097

ABSTRACT

PURPOSE OF REVIEW: Diabetic retinopathy (DR) is one of the most common complications associated with chronic hyperglycemia seen in patients with diabetes mellitus. While many facets of DR are still not fully understood, animal studies have contributed significantly to understanding the etiology and progression of human DR. This review provides a comprehensive discussion of the induced and genetic DR models in different species and the advantages and disadvantages of each model. RECENT FINDINGS: Rodents are the most commonly used models, though dogs develop the most similar morphological retinal lesions as those seen in humans, and pigs and zebrafish have similar vasculature and retinal structures to humans. Nonhuman primates can also develop diabetes mellitus spontaneously or have focal lesions induced to simulate retinal neovascular disease observed in individuals with DR. DR results in vascular changes and dysfunction of the neural, glial, and pancreatic ß cells. Currently, no model completely recapitulates the full pathophysiology of neuronal and vascular changes that occur at each stage of diabetic retinopathy; however, each model recapitulates many of the disease phenotypes.


Subject(s)
Diabetic Retinopathy/pathology , Disease Models, Animal , Animals , Cytokines/metabolism , Diabetes Mellitus, Experimental/pathology , Diabetic Retinopathy/genetics , Diabetic Retinopathy/physiopathology , Humans , Hypoxia/pathology , Models, Genetic
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