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4.
Gac Med Mex ; 157(1): 41-46, 2021.
Article in English | MEDLINE | ID: mdl-34125823

ABSTRACT

INTRODUCTION: Mycosis fungoides (MF) is the most common primary skin T-cell lymphoma, which is characterized for a heterogeneous clinical expressivity. OBJECTIVE: To report clinical variants and sociodemographic characteristics in patients with MF under the care of a dermatological hospital. METHODS: 290 patients with MF clinical and histopathological diagnosis attended to over the course of 11 years were included. Sociodemographic description of patients was made, who were classified according to clinical and histopathological variants. RESULTS: MF was recorded in 57.9 % of women and 42 % of men. The most common clinical variant was the classic type in 46.2 %; dyschromic variants accounted for 35.2 %, out of which hypopigmented MF was the most representative (17.6 %); poikilodermatous MF accounted for 4.1 %, and folliculotropic, for 3.1%. The papular variant occurred in six patients (2.1 %), the single-plaque variety in three (1%), and the ichthyosiform, syringotropic and granulomatous slack skin varieties occurred in one patient each. The granulomatous variant was found in 0.7 %, and 1.4 % had erythroderma. CONCLUSIONS: The most common MF clinical variant was classic plaque stage, followed by dyschromic variants. Other clinical variants accounted for 18.6 %.


INTRODUCCIÓN: La micosis fungoide es el linfoma primario de células T en piel más frecuente, con expresividad clínica heterogénea. OBJETIVO: Reportar las variedades clínicas y las características sociodemográficas en pacientes con micosis fungoide tratados en un hospital dermatológico. MÉTODOS: Se incluyeron 290 pacientes con diagnóstico clínico e histopatológico de micosis fungoide atendidos en el transcurso de 11 años. Se realizó descripción sociodemográfica de los pacientes, quienes se clasificaron conforme las variantes clínicas e histopatológicas. RESULTADOS: La micosis fungoide se presentó en 57.9 % mujeres y 42 % hombres. La variedad clínica más común fue la clásica en 46.2 %; la discrómica representó 35.2 %, del cual la hipopigmentada fue la más representativa (7.6 %); la poiquilodérmica constituyó 4.1 % y la foliculotrópica, 3.1 %. La variedad papular se presentó en seis pacientes (2.1 %), la de placa única en tres (1 %) y la ictiosiforme, siringotrópica y la piel laxa granulomatosa, en un paciente cada una. La variedad granulomatosa se encontró en 0.7 % y 1.4 % presentó eritrodermia. CONCLUSIONES: La variedad clínica más frecuente de micosis fungoide fue la clásica en fase de placa, seguida de las variedades discrómicas. Otras variedades clínicas representaron 18.6 %.


Subject(s)
Mycosis Fungoides/pathology , Skin Neoplasms/pathology , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Cohort Studies , Female , Humans , Male , Middle Aged , Mycosis Fungoides/classification , Mycosis Fungoides/therapy , Retrospective Studies , Skin Neoplasms/classification , Skin Neoplasms/therapy , Treatment Outcome , Young Adult
5.
Gac. méd. Méx ; 157(1): 43-49, ene.-feb. 2021. tab, graf
Article in Spanish | LILACS | ID: biblio-1279072

ABSTRACT

Resumen Introducción: La micosis fungoide es el linfoma primario de células T en piel más frecuente, con expresividad clínica heterogénea. Objetivo: Reportar las variedades clínicas y las características sociodemográficas de pacientes con micosis fungoide tratados en un hospital dermatológico. Métodos: Se incluyeron 290 pacientes con diagnóstico clínico e histopatológico de micosis fungoide atendidos en el transcurso de 11 años. Se realizó descripción sociodemográfica de los pacientes, quienes se clasificaron conforme las variantes clínicas e histopatológicas. Resultados: 58 % de los casos de micosis fungoide se presentó en mujeres y 42 % en hombres. La variedad clínica más común fue la clásica en 46.2 %; la discrómica representó 35.2 %, del cual la hipopigmentada fue la más representativa (7.6 %); la poiquilodérmica constituyó 4.1 % y la foliculotrópica, 3.1 %. La variedad papular se presentó en seis pacientes (2.1 %), la de placa única en tres (1 %) y la ictiosiforme, siringotrópica y la piel laxa granulomatosa, en un paciente cada una. La variedad granulomatosa se encontró en 0.7 % y 1.4 % presentó eritrodermia. Conclusiones: La variedad clínica más frecuente de micosis fungoide fue la clásica en fase de placa, seguida de las variedades discrómicas. Otras variedades clínicas representaron 18.6 %.


Abstract Introduction: Mycosis fungoides (MF) is the most common primary skin T-cell lymphoma, which is characterized for a heterogeneous clinical expressivity. Objective: To report clinical variants and sociodemographic characteristics in patients with MF under the care of a dermatological hospital. Methods: 290 patients with MF clinical and histopathological diagnosis attended to over the course of 11 years were included. Sociodemographic description of patients was made, who were classified according to clinical and histopathological variants. Results: MF was recorded in 57.9 % of women and 42 % of men. The most common clinical variant was the classic type in 46.2 %; dyschromic variants accounted for 35.2 %, out of which hypopigmented MF was the most representative (17.6 %); poikilodermatous MF accounted for 4.1 %, and folliculotropic, for 3.1%. The papular variant occurred in six patients (2.1 %), the single-plaque variety in three (1%), and the ichthyosiform, syringotropic and granulomatous slack skin varieties occurred in one patient each. The granulomatous variant was found in 0.7 %, and 1.4 % had erythroderma. Conclusions: The most common MF clinical variant was classic plaque stage, followed by dyschromic variants. Other clinical variants accounted for 18.6 %.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Skin Neoplasms/pathology , Mycosis Fungoides/pathology , Skin Neoplasms/classification , Skin Neoplasms/therapy , Retrospective Studies , Cohort Studies , Mycosis Fungoides/classification , Mycosis Fungoides/therapy , Treatment Outcome
8.
Lupus ; 27(14): 2181-2189, 2018 Dec.
Article in English | MEDLINE | ID: mdl-30282560

ABSTRACT

The importance of the immunomodulatory effects of vitamin D has recently been associated with autoimmune and chronic inflammatory diseases. Vitamin D deficiency has been linked to the development of autoimmune conditions. Antiphospholipid syndrome is an autoimmune disease characterized by thrombotic events and obstetric complications in patients with antiphospholipid antibodies. Current data show that patients with antiphospholipid syndrome have a high prevalence of vitamin D deficiency even without classic risk factors. Several studies have suggested vitamin D may have anti-thrombotic functions. In antiphospholipid syndrome, low vitamin D serum levels have been associated with thrombotic manifestations, suggesting a possible protective role of vitamin D in antiphospholipid syndrome. This literature review presents current evidence on the haemostatic functions of vitamin D and their possible relationship with the clinical manifestations of antiphospholipid syndrome.


Subject(s)
Antiphospholipid Syndrome/complications , Vitamin D Deficiency/complications , Vitamin D/metabolism , Antibodies, Antiphospholipid/blood , Anticoagulants/therapeutic use , Female , Humans , Pregnancy , Pregnancy Complications, Hematologic/etiology , Thrombosis/drug therapy , Thrombosis/etiology , Vitamin D Deficiency/drug therapy
9.
Actas dermo-sifiliogr. (Ed. impr.) ; 108(7): 637-642, sept. 2017. tab
Article in Spanish | IBECS | ID: ibc-166919

ABSTRACT

Introducción y objetivo: El vitíligo es una dermatosis autoinmune crónica causada por la destrucción de los melanocitos. Aunque la calidad de vida en pacientes con vitíligo se ha estudiado en diferentes poblaciones, hasta el momento no existen estudios previos sobre el tema en nuestra población. El objetivo de este estudio era determinar la calidad de vida de pacientes con vitíligo mexicanos. Material y método: Se realizó un estudio transversal en la Unidad de Investigación del Centro Dermatológico Dr. Ladislao de la Pascua en la ciudad de México. Se reclutaron adultos con vitíligo, se excluyeron los individuos con otras alteraciones de la pigmentación, diagnóstico de enfermedad neurológica y/o psiquiátrica y en tratamiento farmacológico con sustancias que afectaran su estado mental. Todos los pacientes contestaron los cuestionarios DLQI y VitiQoL y los inventarios de depresión y ansiedad de Beck. Resultados: Se reclutaron 150 pacientes con vitíligo, 68,7% (103) mujeres y 31,3% (47) hombres. La mediana de edad fue de 38 años ± 20 años. En nuestros pacientes el promedio de la puntuación del DLQI fue de 5,2 ± 5,4 y el del VitiQoL fue de 32,1 (DE: 22,7), de los 30 y 90 puntos posibles de cada instrumento, respectivamente. La correlación de los resultados de ambos cuestionarios fue de 0,675, p<0,001. Los pacientes con afectación de genitales reportaron una puntuación mayor en el cuestionario de calidad de vida VitiQoL que aquellos sin afectación de esa zona corporal, 43,5 (DE: 28,4) vs. 28,98 (DE: 20,08), p<0,001. La prevalencia de depresión y ansiedad fue del 34% y 60%, respectivamente. Conclusión: El impacto del vitíligo en la calidad de vida de nuestra muestra de pacientes fue mínimo. El vitíligo en los genitales se asocia a un deterioro de la calidad de vida (AU)


Introduction and objective: Vitiligo is a chronic autoimmune skin disease caused by the destruction of melanocytes. Although quality of life (QOL) in vitiligo has been studied in different countries, it has not yet been investigated in Mexico. The aim of this study was to assess the QOL of Mexican patients with vitiligo. Material and method: We conducted a cross-sectional study at the research unit of Centro Dermatológico Dr. Ladislao de la Pascua in Mexico City. We included adults with vitiligo and excluded those with other pigmentation disorders or a neurological or psychiatric disorder. Patients on psychoactive medications were also excluded. All the patients were administered the Dermatology Life Quality Index (DLQI), a vitiligo-specific quality of life instrument (the VitiQoL), and the Beck Depression and Anxiety Inventories. Results: We studied 150 patients with vitiligo (103 women [68.7%] and 47 men [31.3%]). The median (interquartile range) age was 38 (20) years. The mean (SD) scores on the DLQI and VitiQoL were 5.2 (5.4) and 32.1 (22.7) out of total possible scores of 30 and 90, respectively. The correlation between questionnaire scores was 0.675 (P<.001). Patients with genital involvement scored significantly worse on the VitiQoL than those without lesions in this area (43.95 [28.4]) vs. 28.98 [20.08], P<.001). The prevalence of depression and anxiety was 34% and 60%, respectively. Conclusion: Vitiligo has a minimal impact on the QOL of our patients. QOL was worse in patients with genital lesions (AU)


Subject(s)
Humans , Vitiligo/psychology , Anxiety/epidemiology , Depression/epidemiology , Quality of Life , Sickness Impact Profile , Psychometrics/statistics & numerical data , Cross-Sectional Studies , Calcineurin Inhibitors/therapeutic use , Adrenal Cortex Hormones/therapeutic use , Furocoumarins/therapeutic use
10.
An. Fac. Cienc. Méd. (Asunción) ; 50(2): 51-66, may-ago. 2017.
Article in Spanish | LILACS | ID: biblio-884517

ABSTRACT

Introducción: Los objetivos de este trabajo son: presentar los métodos de estudio de las infecciones urinarias actualmente disponibles en el Laboratorio de Microbiología del Hospital de Clínicas y mostrar los datos de los urocultivos evaluados en forma retrospectiva. Materiales y Métodos: Para estudiar los métodos de estudio de los urocultivos disponibles en el Laboratorio hemos recurrido al archivo del Laboratorio cuyos datos fueron consecutivamente cargados en una planilla de procesamiento de datos Excel de Microsoft Office ®. Los resultados de los urocultivos fueron evaluados de enero de 2015 a agosto de 2016, en forma retrospectiva, observacional, en corte transverso, de los adultos de ambos sexos. Las muestras para urocultivo son recibidas y procesadas en el laboratorio, siguiendo pasos preestablecidos. Resultados: El microorganismo preponderante de los urocultivos fue Escherichia coli (60% de las mujeres y 32% de los varones) seguido por Klebsiella pneumoniae (19% de los varones, 14% de las mujeres). Otros microorganismos aislados fueron Candida sp., Enterococcus faecalis, Enterobacter cloacae, Pseudomona aeruginosa, Proteus mirabilis, Staphylococcus aureus, Acinetobacter baumanii. La resistencia de Escherichia Coli a nitrofurantoína fue del 6% en los varones y 1% en las mujeres. La resistencia de E.Coli a meropenen fue también escasa. En cuanto a Klebsiella pneumoniae en las mujeres, la resistencia fue del 3%. En los hombres, los antibióticos testados para Klebsiella pneumoniae mostraron una resistencia superior al 30%, con excepción del meropenem. Uropatógenos productores de betalactamas de espectro extentido (BLEE) y de carbapenemasas fueron detectados en el presente estudio. Discusión: La toma de la orina para el urocultivo se efectúa siguiendo pautas claras, emanadas del laboratorio. Con la utilización de medios actualmente disponibles en el laboratorio, es posible tipificar el género y la especie tanto de bacterias Gram negativas y positivas como de hongos. Conclusión: La estructura del Laboratorio de Microbiología ha tenido avances que permiten la identificación precisa de los gérmenes de los urocultivos, así como la prevalencia y la resistencia que presentan a ciertos antibióticos. Estos aportes son particularmente útiles para los casos de Escherichia coli y Klebsiella pneumoniae debido a su alta prevalencia. También fue factible constatar la emergencia de gérmenes productores de betalactamasas de espectro extendido (BLEE) y carbapenemasas.


Introduction: The objectives of this work are: to present the methods of study of urinary infections currently available in the Laboratory of Microbiology of the Hospital de Clínicas and to show the data of the urine cultures evaluated retrospectively. Material and method: in order to study the available methods in urine cultures in the Laboratory, we have used the laboratory file whose data were consecutively loaded in an Excel data processing form of Microsoft Office ®. The results of the urine cultures were evaluated from January 2015 to August 2016, in a retrospective, observational, cross-sectional study of adults of both sexes. Samples for urine culture are received and processed in the laboratory, following pre-established steps. Results: The predominant microorganisms were Escherichia coli in 60% of women and 32%of men, Klebsiella pneumonia 19% of men and 14% of women. Other isolated organisms were Candida sp., Enterococcus faecalis, Enterobacter cloacae, Pseudomonas aeruginosa, Proteus mirabilis, Staphylococcus aureus, and Acinetobacter baumanii. Escherichia coli resistance to nitrofurantoin was seen in 6% of men and 1% of women and meropenem resistance to E. coli was also low. As for Klebsiella pneumoniae in women, resistance to meropenem was seen in 3% of cases. In men, the antibiotics tested for Klebsiella pneumoniae showed resistance greater than 30% except for meropenem. Uropathogens producing Extended-Spectrum -lactamase (ESBL ) and Carbapenemase were found. Discussion: Urine collection for urine culture is done following clear guidelines emanating from the laboratory. With the use of media currently available in the laboratory, it is possible to typify the genus and species of both Gram negative and positive bacteria as well as fungi. Conclusion: The structure of the Laboratory of Microbiology has had advances that allow the precise identification of the germs of the urine cultures, as well as the prevalence and resistance to certain antibiotics. These contributions are particularly useful for the cases of Escherichia coli and Klebsiella pneumoniae due to their high prevalence. It was also possible to verify the emergence of spread spectrum beta-lactamases (ESBL) and carbapenemases.

11.
Actas Dermosifiliogr ; 108(7): 637-642, 2017 Sep.
Article in English, Spanish | MEDLINE | ID: mdl-28456327

ABSTRACT

INTRODUCTION AND OBJECTIVE: Vitiligo is a chronic autoimmune skin disease caused by the destruction of melanocytes. Although quality of life (QOL) in vitiligo has been studied in different countries, it has not yet been investigated in Mexico. The aim of this study was to assess the QOL of Mexican patients with vitiligo. MATERIAL AND METHOD: We conducted a cross-sectional study at the research unit of Centro Dermatológico Dr. Ladislao de la Pascua in Mexico City. We included adults with vitiligo and excluded those with other pigmentation disorders or a neurological or psychiatric disorder. Patients on psychoactive medications were also excluded. All the patients were administered the Dermatology Life Quality Index (DLQI), a vitiligo-specific quality of life instrument (the VitiQoL), and the Beck Depression and Anxiety Inventories. RESULTS: We studied 150 patients with vitiligo (103 women [68.7%] and 47 men [31.3%]). The median (interquartile range) age was 38 (20) years. The mean (SD) scores on the DLQI and VitiQoL were 5.2 (5.4) and 32.1 (22.7) out of total possible scores of 30 and 90, respectively. The correlation between questionnaire scores was 0.675 (P<.001). Patients with genital involvement scored significantly worse on the VitiQoL than those without lesions in this area (43.95 [28.4]) vs. 28.98 [20.08], P<.001). The prevalence of depression and anxiety was 34% and 60%, respectively. CONCLUSION: Vitiligo has a minimal impact on the QOL of our patients. QOL was worse in patients with genital lesions.


Subject(s)
Quality of Life , Vitiligo/psychology , Adolescent , Adult , Anxiety/etiology , Cross-Sectional Studies , Depression/etiology , Female , Humans , Male , Mexico , Socioeconomic Factors , Surveys and Questionnaires , Symptom Assessment , Vitiligo/drug therapy , Young Adult
14.
Arch. Soc. Esp. Oftalmol ; 91(4): 160-169, abr. 2016. tab, graf
Article in Spanish | IBECS | ID: ibc-150683

ABSTRACT

OBJETIVO: En el presente trabajo hemos analizado, desde un enfoque bibliométrico, las publicaciones científicas de los investigadores españoles en el área de la Optometría, desde que se tienen datos de publicaciones (1974) hasta el año 2013. MÉTODO: Para realizar el estudio se utilizó la base de datos EMBASE, y se utilizaron los descriptores «optomtr*», «optic*», «visual», «vision», «eye*» y «ophthalm*». Sobre los documentos seleccionados, hemos aplicado los indicadores bibliométricos más usuales. RESULTADOS: El número de documentos recopilados para España en el periodo 1974-2013 fue de 1.055. El crecimiento de las publicaciones se adapta más a un ajuste exponencial (R = 0,93) que del lineal (R = 0,71). El tiempo de duplicación de la producción científica es de 3,63 años. El nivel de productividad corresponde mayoritariamente a pequeños productores (índice de transitoriedad del 64%). El índice de coautoría es de 4,4 firmas por artículo. La mayoría de producción se produce en el ámbito de la universidad, con el 62,27%. El núcleo de Bradford lo forman 4 revistas, siendo la que cuenta con mayor número de publicaciones Optometry and Vision Science, que aglutina el 11,85% de los artículos. CONCLUSIONES: La situación de la investigación en Optometría en España se encuentra en una fase de crecimiento exponencial, con un alto grado de autores ocasionales, que puede indicar una baja productividad o la presencia de investigadores de otras especialidades relacionadas, que de forma esporádica han publicado en esta área. Un pequeño grupo de equipos e investigación es responsable de una gran parte de las aportaciones, produciéndose la mayoría de la investigación en la universidad. Existe una alta concentración de publicaciones en un número reducido de revistas


OBJECTIVE: Using a bibliometric approach an analysis was made of the scientific publications of Spanish investigators in the area of optometry, from 1974 until 2013. METHODS: The EMBASE database was used for this study, employing optomtr*, optic*, visual, vision, eye*, and ophthalm* as search terms. The most common bibliometric indicators were applied for the selected publications. RESULTS: The number of published articles retrieved for Spain from 1974-2013 was 1,055. The growth of publications was more exponential (R = 0.93) than linear (R= 0.71). The doubling time of scientific production was 3.63 years. The level of productivity primarily corresponded to small producers (Transience index of 64%). The collaboration index was 4.4 authors per paper. The majority of the output was generated in academic settings (62.27%). The Bradford core was formed by four journals, in which Optometry and Vision Science accounted for the majority of publications, with 11.85%. CONCLUSIONS: Research in the area of optometry in Spain is in a phase of exponential growth, containing a high level of transient authors, which may indicate either a low productivity or the presence of investigators from other related fields that have published in a sporadic manner in this area. A small number of research groups are responsible for producing the majority of articles, primarily in an academic setting. There is a high concentration of publications in a few journals


Subject(s)
Humans , Male , Female , Optometry/history , Optometry/instrumentation , Optometry/statistics & numerical data , Bibliometrics/history , Spain , Optometry/trends , Science/classification , Science/statistics & numerical data , Science/trends
15.
Arch Esp Urol ; 69(1): 24-31, 2016.
Article in English, Spanish | MEDLINE | ID: mdl-26856735

ABSTRACT

UNLABELLED: Urethral stenosis is a common disease in the clinical practice of urology, with a major impact on the quality of life of patients. The anastomotic urethroplasty is a technique with very precise indications usually membranous or bulbar urethra stenosis with a length of 3 cm or up to 7 cm when it is secondary to urethral disruptions (no stenosis) after pelvic trauma. OBJECTIVE: We review anastomotic urethroplasty performed in our department between 2002 and 2015. METHODS: A retrospective, descriptive and inferential analysis on 107 patients out of 482 treated with Anastomotic urethroplasty by urethral strictures at the Urology Department of the Hospital "Virgen de la Victoria" (Malaga) from January 2002 to September 2015, establishing effectiveness and safety of the technique, as well as factors that might influence the results. The main diagnostic method was retrograde urethrography and voiding cystourethrography in 100% of patients undergoing surgery, using voiding uroflowmetry for subsequent monitoring. The definition of success was a postoperative flowmetry with Qmax>15 ml/s, and in case of lower flow, we perform a cystoscopy to verify recurrence of stenosis or exclude other pathology. RESULTS: The median age was 42 years, with a mean follow up of 59 months. The length of stenosis valued by retrograde urethrography and voiding cystourethrography was in 91.6% of cases of >1 cm and <2 cm. The most common etiology was idiopathic in 72.9%, followed by iatrogenic with 15.9%. Regarding the location, it was observed that the area most often affected was the bulbar urethra with 82.2%, with the membranous urethra in second place. In 77.6% of patients anastomotic urethroplasty was the initial treatment, followed in frequency by direct vision internal urethrotomy 9.3%. In the case of comorbidities associated with treatment with anastomotic urethroplasty it was observed that only Diabetes Mellitus had a tendency to statistical significance, with p=0.092, not demonstrating such significance in the case of hypertension or when the subject presented Diabetes Mellitus together with hypertension. Finally, the intervention was successful in 102 cases (95.3%), with only 5 cases (4.7%) where it failed, 4 of them treated with a new Anastomotic urethroplasty, with resolution of the stricture. CONCLUSIONS: Anastomotic urethroplasty is the treatment of choice for short bulbar urethral stricture, with high success rate and low complication rate, as well as low recurrence of these.


Subject(s)
Urethra/physiopathology , Urethra/surgery , Urethral Stricture/surgery , Urologic Surgical Procedures/methods , Adult , Anastomosis, Surgical , Humans , Quality of Life , Retrospective Studies , Urology
16.
Arch Soc Esp Oftalmol ; 91(4): 160-9, 2016 Apr.
Article in English, Spanish | MEDLINE | ID: mdl-26706776

ABSTRACT

OBJECTIVE: Using a bibliometric approach an analysis was made of the scientific publications of Spanish investigators in the area of optometry, from 1974 until 2013. METHODS: The EMBASE database was used for this study, employing optomtr*, optic*, visual, vision, eye*, and ophthalm* as search terms. The most common bibliometric indicators were applied for the selected publications. RESULTS: The number of published articles retrieved for Spain from 1974-2013 was 1,055. The growth of publications was more exponential (R=0.93) than linear (R= 0.71). The doubling time of scientific production was 3.63 years. The level of productivity primarily corresponded to small producers (Transience index of 64%). The collaboration index was 4.4 authors per paper. The majority of the output was generated in academic settings (62.27%). The Bradford core was formed by four journals, in which Optometry and Vision Science accounted for the majority of publications, with 11.85%. CONCLUSIONS: Research in the area of optometry in Spain is in a phase of exponential growth, containing a high level of transient authors, which may indicate either a low productivity or the presence of investigators from other related fields that have published in a sporadic manner in this area. A small number of research groups are responsible for producing the majority of articles, primarily in an academic setting. There is a high concentration of publications in a few journals.


Subject(s)
Bibliometrics , Optometry , Databases, Factual , Humans , Periodicals as Topic , Publishing , Spain , Vision, Ocular
18.
Clin Exp Dermatol ; 37(6): 599-609, 2012 Aug.
Article in English | MEDLINE | ID: mdl-22731679

ABSTRACT

BACKGROUND: Localized scleroderma (LS) is a disfiguring inflammatory autoimmune disease of the skin and underlying tissue. As in systemic sclerosis, a key feature is the presence of T cells in inflammatory lesions. AIM: To evaluate the effect of polymerized type I collagen vs. methylprednisolone (MP) in LS, and to determine the influence of this polymerized collagen (PC) on CD4+ peripheral T cells expressing interleukin (IL)-4, IL-17A, interferon-γ and Forkhead box protein (Foxp)3, and on cells expressing transforming growth factor (TGF)-ß1, IL-17A, IL-22 and Foxp3 in the skin. METHODS: In total, 16 patients with LS were treated for 3 months with monthly subcutaneous intralesional injections of 0.1 mL MP (giving a total dose of 20 mg/mL each month) and 15 patients were treated, with weekly subcutaneous intralesional injections of PC, ranging from 0.2 mL (equivalent to 1.66 mg collagen) for a lesion of 50 mm in size, up to a maximum of 1.0 mL (8.3 mg collagen) for a lesion > 100 mm in size, and followed up for a further 6 months. Skin biopsies were obtained from lesions at baseline (before treatment) and 9 months later (6 months after treatment end). Tissue sections were evaluated by histology and immunohistochemistry (IL-17A, IL-22, TGF-ß1 and Foxp3). CD4+ T-cell subsets were determined in peripheral blood by flow cytometry. RESULTS: Abnormal tissue architecture was seen in the biopsies taken from patients treated with MP, whereas the PC treatment restored normal skin architecture. PC downregulated pro-inflammatory/profibrotic cytokine expression in peripheral cells, and upregulated the number of regulatory T cells (Tregs) in skin. PC was safe and well tolerated. CONCLUSIONS: PC is not only an antifibrotic/fibrolytic agent but also an immunomodulator biodrug that restores the balance between T helper (Th)1, Th2, Th17 and Tregs, downregulates production of pro-inflammatory or profibrogenic cytokines (IL-17A, IL-22 and TGF-ß1), and renews skin architecture, without adverse effects.


Subject(s)
Collagen Type II/administration & dosage , Forkhead Transcription Factors/metabolism , Interleukin-17/metabolism , Interleukins/metabolism , Scleroderma, Localized/drug therapy , Transforming Growth Factor beta1/metabolism , Adolescent , Adult , Aged , Collagen Type II/pharmacology , Double-Blind Method , Down-Regulation , Female , Flow Cytometry , Humans , Immunohistochemistry , Injections, Subcutaneous , Male , Middle Aged , Prospective Studies , Scleroderma, Localized/metabolism , Scleroderma, Localized/pathology , T-Lymphocytes/metabolism , Young Adult , Interleukin-22
19.
Arch Esp Urol ; 65(4): 502-4, 2012 May.
Article in English, Spanish | MEDLINE | ID: mdl-22619144

ABSTRACT

OBJECTIVE: To describe one case of syringocele in an adult patient. METHODS/RESULTS: We report the case of a 26 year old man who presented frequency, hematuria and fever during one year, mictional cystourethrography showed a syringocele. Treatment consisted in endoscopic surgery, with good results in the follow-up. CONCLUSIONS: The syringocele is a relatively infrequent entity, that is necessary to study in a young patient with voiding symptoms, accompanied or not of haematuria and fever. The diagnosis is based on the cystourethrography, and treatment consisted, usually, in endoscopic surgery.


Subject(s)
Hernia/diagnostic imaging , Spinal Cord/diagnostic imaging , Urethral Diseases/diagnostic imaging , Adult , Humans , Male , Radiography
20.
Arch. esp. urol. (Ed. impr.) ; 65(4): 502-504, mayo 2012. ilus
Article in Spanish | IBECS | ID: ibc-99387

ABSTRACT

OBJETIVO: Presentación de un caso de siringocele en la edad adulta. MÉTODO/RESULTADO: Describimos el caso de un paciente que consultó en nuestro centro por un síndrome irritativo vesical, hematuria y fiebre de un año de evolución, que en el seguimiento se objetiva mediante cistouretrografía miccional un siringocele simple. El tratamiento consistió en una marsupialización endoscópica, presentando buenos resultados en el seguimiento. CONCLUSIONES: El siringocele es una entidad relativamente infrecuente, pero que es necesaria tenerla en cuenta ante un paciente joven con clínica miccional, acompañada o no de hematuria y fiebre. El diagnóstico se basa en la uretrografía, y como modalidad terapéutica más habitual destaca la marsupialización endoscópica(AU)


OBJECTIVE: To describe one case of syringocele in an adult patient. METHODS/RESULTS: We report the case of a 26 year old man who presented frequency, hematuria and fever during one year, mictional cystourethrography showed a syringocele. Treatment consisted in endoscopic surgery, with good results in the follow-up. CONCLUSIONS: The syringocele is a relatively infrequent entity, that is necessary to study in a young patient with voiding symptoms, accompanied or not of haematuria and fever. The diagnosis is based on the cystourethrography, and treatment consisted, usually, in endoscopic surgery(AU)


Subject(s)
Humans , Hematuria/etiology , Urinary Bladder Neoplasms/diagnosis , Urination , Urography
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