RESUMO
Introduction: New-onset super-refractory status epilepticus (NOSRSE) is a neurological emergency characterised by the development of status epilepticus in a patient without epilepsy or any known prior neurological disease and with no clear structural, toxic or metabolic cause, which recurs after 24 hours of induced coma. The most common identifiable cause is inflammatory-autoimmune. Consequently, we present a case of NOSRSE related to SARS-CoV-2 vaccination as an opportunity to investigate the dysimmune origin of this pathology. Case report: We report the case of a 40-year-old male who presented at the emergency department with fever and headache with no clear source of infection. His personal history included bacterial meningitis in childhood without any sequelae and protein S deficiency without treatment at the time, as well as vaccination with ChAdOx1 nCoV-19 21 days earlier. He was initially diagnosed with a urinary tract infection and treated with cefuroxime. Two days later, he was taken back to the emergency department with confusional symptoms and tonic-clonic seizures. He did not respond to midazolam and finally required sedation and orotracheal intubation for refractory status epilepticus. While in hospital, he required a number of lines of antiepileptic drugs, ketamine, a ketogenic diet, immunotherapy and plasmapheresis in order to successfully limit NOSRSE. The aetiological study offered normal results for serology, antineuronal antibodies in serum and cerebrospinal fluid, transthoracic echocardiography, testicular ultrasound and computed tomographic angiography. Only the control MRI scan showed a diffuse and bilateral alteration of the right hemispheric cortex and thalamic pulvinar as the only finding. Conclusion: It is crucial to report suspected adverse reactions associated with SARS-CoV-2 vaccination, thereby allowing continued monitoring of the risk/benefit ratio of vaccination.(AU)
Introducción: El estado epiléptico superrefractario de nueva aparición (NOSRSE) es una emergencia neurológica caracterizada por el desarrollo de estado epiléptico en un paciente sin epilepsia ni enfermedad neurológica previa conocida y sin clara causa estructural, tóxica o metabólica, que recurre tras 24 horas del coma inducido. La causa identificable más frecuente es la inflamatoria-autoinmune. En consecuencia, planteamos un caso de NOSRSE relacionado con la vacunación para el SARS-CoV-2 como una oportunidad de indagar el origen disinmune de esta patología. Caso clínico: Varón de 40 años que acude al servicio de urgencias refiriendo fiebre y cefalea sin claro foco infeccioso. Entre sus antecedentes personales destacamos una meningitis bacteriana en la infancia sin secuelas y un déficit de proteína S sin tratamiento en ese momento, así como vacunación con ChAdOx1 nCoV-19 21 días antes. Fue inicialmente diagnosticado de infección del tracto urinario y tratado con cefuroxima. Dos días después, se le llevó de nuevo a urgencias con cuadro confusional y crisis tonicoclónicas, sin respuesta al midazolam, y requirió finalmente sedación e intubación orotraqueal por estado epiléptico refractario. Durante su ingreso requirió múltiples líneas de antiepilépticos, quetamina, dieta cetógena, inmunoterapia y plasmaféresis para conseguir limitar el NOSRSE. El estudio etiológico ofrecía normalidad de los resultados de serología, anticuerpos antineuronales en el suero y líquido cefalorraquídeo, ecocardiografía transtorácica, ecografía testicular y angiotomografía computarizada. Únicamente la resonancia magnética de control mostró una alteración difusa y bilateral de la corteza hemisférica y pulvinar talámica derecha como único hallazgo. Conclusión: Es crucial notificar las sospechas de reacciones adversas asociadas a la vacunación frente al SARS-CoV-2, permitiendo así una supervisión continuada de la relación riesgo/beneficio de ésta.(AU)
Assuntos
Humanos , Masculino , Adulto , Estado Epiléptico/complicações , Estado Epiléptico/imunologia , Coronavírus Relacionado à Síndrome Respiratória Aguda Grave , Pandemias , Infecções por Coronavirus/epidemiologia , Vacinação/efeitos adversos , Neurologia , Doenças do Sistema Nervoso , Pacientes Internados , Exame Físico , Epilepsia , AutoimunidadeRESUMO
INTRODUCTION: New-onset super-refractory status epilepticus (NOSRSE) is a neurological emergency characterised by the development of status epilepticus in a patient without epilepsy or any known prior neurological disease and with no clear structural, toxic or metabolic cause, which recurs after 24 hours of induced coma. The most common identifiable cause is inflammatory-autoimmune. Consequently, we present a case of NOSRSE related to SARS-CoV-2 vaccination as an opportunity to investigate the dysimmune origin of this pathology. CASE REPORT: We report the case of a 40-year-old male who presented at the emergency department with fever and headache with no clear source of infection. His personal history included bacterial meningitis in childhood without any sequelae and protein S deficiency without treatment at the time, as well as vaccination with ChAdOx1 nCoV-19 21 days earlier. He was initially diagnosed with a urinary tract infection and treated with cefuroxime. Two days later, he was taken back to the emergency department with confusional symptoms and tonic-clonic seizures. He did not respond to midazolam and finally required sedation and orotracheal intubation for refractory status epilepticus. While in hospital, he required a number of lines of antiepileptic drugs, ketamine, a ketogenic diet, immunotherapy and plasmapheresis in order to successfully limit NOSRSE. The aetiological study offered normal results for serology, antineuronal antibodies in serum and cerebrospinal fluid, transthoracic echocardiography, testicular ultrasound and computed tomographic angiography. Only the control MRI scan showed a diffuse and bilateral alteration of the right hemispheric cortex and thalamic pulvinar as the only finding. CONCLUSION: It is crucial to report suspected adverse reactions associated with SARS-CoV-2 vaccination, thereby allowing continued monitoring of the risk/benefit ratio of vaccination.
TITLE: Estado epiléptico superrefractario de nueva aparición criptógeno tras vacunación contra el SARS-CoV-2. A propósito de un caso.Introducción. El estado epiléptico superrefractario de nueva aparición (NOSRSE) es una emergencia neurológica caracterizada por el desarrollo de estado epiléptico en un paciente sin epilepsia ni enfermedad neurológica previa conocida y sin clara causa estructural, tóxica o metabólica, que recurre tras 24 horas del coma inducido. La causa identificable más frecuente es la inflamatoria-autoinmune. En consecuencia, planteamos un caso de NOSRSE relacionado con la vacunación para el SARS-CoV-2 como una oportunidad de indagar el origen disinmune de esta patología. Caso clínico. Varón de 40 años que acude al servicio de urgencias refiriendo fiebre y cefalea sin claro foco infeccioso. Entre sus antecedentes personales destacamos una meningitis bacteriana en la infancia sin secuelas y un déficit de proteína S sin tratamiento en ese momento, así como vacunación con ChAdOx1 nCoV-19 21 días antes. Fue inicialmente diagnosticado de infección del tracto urinario y tratado con cefuroxima. Dos días después, se le llevó de nuevo a urgencias con cuadro confusional y crisis tonicoclónicas, sin respuesta al midazolam, y requirió finalmente sedación e intubación orotraqueal por estado epiléptico refractario. Durante su ingreso requirió múltiples líneas de antiepilépticos, quetamina, dieta cetógena, inmunoterapia y plasmaféresis para conseguir limitar el NOSRSE. El estudio etiológico ofrecía normalidad de los resultados de serología, anticuerpos antineuronales en el suero y líquido cefalorraquídeo, ecocardiografía transtorácica, ecografía testicular y angiotomografía computarizada. Únicamente la resonancia magnética de control mostró una alteración difusa y bilateral de la corteza hemisférica y pulvinar talámica derecha como único hallazgo. Conclusión. Es crucial notificar las sospechas de reacciones adversas asociadas a la vacunación frente al SARS-CoV-2, permitiendo así una supervisión continuada de la relación riesgo/beneficio de ésta.
Assuntos
COVID-19 , Estado Epiléptico , Masculino , Humanos , Adulto , Vacinas contra COVID-19/efeitos adversos , SARS-CoV-2 , ChAdOx1 nCoV-19 , COVID-19/complicações , Estado Epiléptico/etiologia , Vacinação/efeitos adversosRESUMO
Isolated limb perfusion (ILP) is a method for treating unresectable lesions of limbs in patients with melanoma or sarcoma by using high doses of tumor necrosis factor alpha and melphalan. These high doses can result in high systemic toxicity if there is a drug leak from the isolated circulation of the limb to the systemic. This makes it imperative to monitor the leakage rate (F[%]) during the infusion, currently performed with radiotracers. The objective of this work was to develop a leakage monitoring protocol as accurate as possible to ensure safe ILP. MATERIAL AND METHOD: We built a phantom with 3compartments (body, limb and precordial area) and a high sensitivity collimator fitted to a portable gammacamera. We simulate ILP with scheduled leaks every 10minutes from 1% to 9% (theorical F[%]). We mesured F(%) using 2equation: one is the proposed in the literature and another corrected by decay of the radioisotope. We test the optimal radiopharmaceutical doses to minimize the detector dead time error and compare F(%) mesured by both equations regarding the theoretical F(%). The leakage monitoring protocol was used in 17 ILP of 16 patients and an analysis of the recorded data was performed. RESULTS: We found significant differences between F(%) mesured using the first equation and theoretical F(%), obtaining results very adjusted to the theorical after applying the decay correction. CONCLUSIONS: The decay correction of the radioisotope is a simple manner to carry out the procedure more safely, reducing the error in the calculation of F(%).
RESUMO
BACKGROUND: Primary stability is an important key determinant of implant osseointegration. We investigated approaches to improve primary implant stability using a new drilling technique termed osseodensification (OD), which was compared with the conventional under-drilling (UD) method utilized for low-density bones. MATERIAL AND METHODS: We placed 55 conical internal connection implants in each group, in 30 low-density sections of pig tibia. The implants were placed using twist drill bits in both groups; groups Under Drilling (UD) and Osseodensification (OD) included bone sections subjected to conventional UD and OD drilling, respectively. Before placing the implants, we randomized the bone sections that were to receive these implants to avoid sample bias. We evaluated various primary stability parameters, such as implant insertion torque and resonance frequency analysis (RFA) measurements. RESULTS: The results showed that compared with implants placed using the UD technique, those placed using the OD technique were associated with significantly higher primary stability. The mean insertion torque of the implants was 8.87±6.17 Ncm in group 1 (UD) and 21.72±17.14 Ncm in group 2 (OD). The mean RFA was 65.16±7.45 ISQ in group 1 (UD) and 69.75±6.79 ISQ in group 2 (OD). CONCLUSIONS: The implant insertion torque and RFA values were significantly higher in OD group than in UD. Therefore, compared with UD, OD improves primary stability in low-density bones (based on torque and RFA measurements).
Assuntos
Implantes Dentários , Animais , Densidade Óssea , Implantação Dentária Endóssea , Retenção em Prótese Dentária , Osseointegração , Análise de Frequência de Ressonância , Suínos , TorqueRESUMO
La patología del pie y tobillo es una de las más frecuentes del sistema musculoesquelético y de gran repercusión en la calidad de vida de los pacientes. El diagnóstico preciso supone un desafío clínico importante debido a que la compleja anatomía y la función del pie dificultan la localización del origen del dolor por un examen clínico de rutina. En el estudio de la patología del pie se han utilizado técnicas anatómicas (radiografía, resonancia magnética [RM], ultrasonido y tomografía computarizada [TC]) y funcionales (gammagrafía ósea [GO], tomografía de emisión de positrones [PET] y RM). La imagen híbrida combina las ventajas de los estudios morfológicos y funcionales de forma sinérgica, ayudando al clínico en la gestión de problemas complejos. En este artículo profundizamos en la anatomía y en la biomecánica del pie y tobillo y describimos las indicaciones potenciales de las técnicas hibridas actuales disponibles para el estudio de la patología del pie y tobillo
Disorders of the foot and ankle are some of the most frequent ones affecting the musculoskeletal system and have a great impact on patients quality of life. Accurate diagnosis is an important clinical challenge because of the complex anatomy and function of the foot, that make it difficult to locate the source of the pain by routine clinical examination. In the study of foot pathology, anatomical imaging (radiography, magnetic resonance imaging [MRI], ultrasound and computed tomography [CT]) and functional imaging (bone scan, positron emission tomography [PET] and MRI) techniques have been used. Hybrid imaging combines the advantages of morphological and functional studies in a synergistic way, helping the clinician manage complex problems. In this article we delve into the anatomy and biomechanics of the foot and ankle and describe the potential indications for the current hybrid techniques available for the study of foot and ankle disease
Assuntos
Humanos , Imagem Multimodal/métodos , Doenças do Pé/diagnóstico por imagem , Fraturas Ósseas/diagnóstico por imagem , Traumatismos do Tornozelo/diagnóstico por imagem , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos , Fraturas do Tornozelo/diagnóstico por imagem , Ossos do Tarso/diagnóstico por imagem , Diagnóstico Precoce , Pé Diabético/diagnóstico por imagem , Doenças do Pé/fisiopatologia , Doenças do Pé/cirurgia , Imageamento por Ressonância Magnética , Dor Musculoesquelética/diagnóstico por imagem , Dor Musculoesquelética/etiologia , Tomografia Computadorizada de Emissão de Fóton Único/métodos , Tornozelo/diagnóstico por imagemRESUMO
Disorders of the foot and ankle are some of the most frequent ones affecting the musculoskeletal system and have a great impact on patients' quality of life. Accurate diagnosis is an important clinical challenge because of the complex anatomy and function of the foot, that make it difficult to locate the source of the pain by routine clinical examination. In the study of foot pathology, anatomical imaging (radiography, magnetic resonance imaging [MRI], ultrasound and computed tomography [CT]) and functional imaging (bone scan, positron emission tomography [PET] and MRI) techniques have been used. Hybrid imaging combines the advantages of morphological and functional studies in a synergistic way, helping the clinician manage complex problems. In this article we delve into the anatomy and biomechanics of the foot and ankle and describe the potential indications for the current hybrid techniques available for the study of foot and ankle disease.
Assuntos
Tornozelo/diagnóstico por imagem , Doenças do Pé/diagnóstico por imagem , Pé/diagnóstico por imagem , Imagem Multimodal , Traumatismos do Tornozelo/diagnóstico por imagem , Pé Diabético/diagnóstico por imagem , Diagnóstico Precoce , Ossos do Pé/diagnóstico por imagem , Doenças do Pé/fisiopatologia , Doenças do Pé/cirurgia , Traumatismos do Pé/diagnóstico por imagem , Fraturas Ósseas/diagnóstico por imagem , Humanos , Imageamento por Ressonância Magnética , Imagem Multimodal/métodos , Dor Musculoesquelética/diagnóstico por imagem , Dor Musculoesquelética/etiologia , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos , Sensibilidade e Especificidade , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único/métodos , Ossos do Tarso/diagnóstico por imagemRESUMO
The Erdheim-Chester disease (ECD) is an extremely rare form of non-Langerhans cell histiocytosis. The main difficulty for its diagnosis lies in the wide variety of non-specific symptoms and signs that can occur in the disease process, leading, therefore, to there being no clear-cut algorithm as a guide for an optimal biopsy to confirm the diagnosis. An 81-year-old male with history of diabetes insipidus was admitted due to non-specific respiratory signs. Imaging techniques revealed osteoblastic lesions in the lumbar spine. Whole-body bone-scintigraphy (BS) was performed, in which lesions involving the axial and appendicular skeleton, with different rates of osteoblastic activity, were observed. This highlighted a symmetrical severely intense uptake in the knees, leading to an accurate biopsy specimen that enabled making the definitive diagnosis. BS is a widely available, safe, and inexpensive technique that shows a characteristic pattern of uptake for ECD, thus its use is highly recommended for screening and guiding biopsy if clinical suspicion exists. Furthermore, when the scintigraphy pattern is incidentally observed, biopsy of increased uptake areas (tibia preferably) is mandatory in order to rule out the disease (AU)
La enfermedad de Erdheim-Chester es una histiocitosis no-Larngerhans extremadamente rara. La dificultad en su diagnóstico se debe a los signos y síntomas inespecíficos que presenta, que conlleva la ausencia de un claro algoritmo diagnóstico. Reportamos el caso de un varón de 81 años con diabetes insipidus en estudio por síntomas respiratorios inespecíficos. Lesiones osteoblásticas en la columna fueron referidas en técnicas radiológicas. Mediante gammagrafía ósea (GO) se observaron lesiones osteoblásticas con diferente actividad metabólica en esqueleto axial y apendicular, destacando una actividad muy elevada y simétrica en rodillas, cuya biopsia permitió el diagnóstico definitivo. La GO es una técnica disponible, segura y barata que muestra un patrón característico, por lo que recomendamos su realización como screening y guía para toma de biopsia. Ante el hallazgo incidental de dicho patrón debería realizarse biopsia (AU)
Assuntos
Humanos , Masculino , Idoso de 80 Anos ou mais , Cintilografia/instrumentação , Cintilografia/métodos , Doença de Erdheim-Chester/complicações , Doença de Erdheim-Chester , Histiocitose de Células não Langerhans/patologia , Histiocitose de Células não Langerhans , Algoritmos , Tomografia Computadorizada de Emissão/instrumentação , Tomografia Computadorizada de Emissão/métodos , Tomografia Computadorizada de Emissão , Tomografia Computadorizada de Emissão/tendênciasRESUMO
The Erdheim-Chester disease (ECD) is an extremely rare form of non-Langerhans cell histiocytosis. The main difficulty for its diagnosis lies in the wide variety of non-specific symptoms and signs that can occur in the disease process, leading, therefore, to there being no clear-cut algorithm as a guide for an optimal biopsy to confirm the diagnosis. An 81-year-old male with history of diabetes insipidus was admitted due to non-specific respiratory signs. Imaging techniques revealed osteoblastic lesions in the lumbar spine. Whole-body bone-scintigraphy (BS) was performed, in which lesions involving the axial and appendicular skeleton, with different rates of osteoblastic activity, were observed. This highlighted a symmetrical severely intense uptake in the knees, leading to an accurate biopsy specimen that enabled making the definitive diagnosis. BS is a widely available, safe, and inexpensive technique that shows a characteristic pattern of uptake for ECD, thus its use is highly recommended for screening and guiding biopsy if clinical suspicion exists. Furthermore, when the scintigraphy pattern is incidentally observed, biopsy of increased uptake areas (tibia preferably) is mandatory in order to rule out the disease.
Assuntos
Osso e Ossos/diagnóstico por imagem , Doença de Erdheim-Chester/diagnóstico por imagem , Idoso de 80 Anos ou mais , Biópsia , Osso e Ossos/patologia , Doença de Erdheim-Chester/patologia , Histiocitose de Células não Langerhans , Humanos , Masculino , Tíbia/diagnóstico por imagemRESUMO
El principal producto derivado de la yuca en Venezuela es el casabe, el cual es valorado por su contenido calórico, riqueza en Fibra Dietética (FD) y minerales. En este estudio se determinó el efecto del consumo de diferentes variedades de casabe venezolano sobre la absorción de hierro, cobre y zinc, en un modelo experimental, con 20 ratas machos adultas, cepa Sprague Dawley, las cuales fueron divididas en 4 grupos: un control sin fibra y tres grupos experimentales en los que se sustituyó el almidón de maíz por una variedad de casabe, identificados por su procedencia como: Casabe Miranda, Casabe Sucre y Casabe Amazonas. Las dietas con inclusión de casabe tuvieron un mayor contenido mineral, en comparación con la dieta control. El contenido de FD total y su fracción soluble fueron significativamente mayores en las variedades de casabe Sucre y Amazonas (p<0,05). La inclusión de casabe a las dietas produjo un incremento significativo en la excreción fecal de hierro y cobre(p<0,05). La absorción de los minerales se incrementó para el hierro en las variedades Miranda (3,5%) y Sucre (6%); para el cobre en el grupo Amazonas (32%); mientras que el Zinc fue menos afectado en su absorción a lo largo del ensayo. Los resultados de este estudio señalan que el efecto de la adición de casabe a las dietas sobre la absorción de hierro, cobre y zinc, fue diferente para cada mineral y estuvo relacionado con la dieta que consumieron los animales, dependiendo de la variedad de casabe utilizada.
The main product from cassava in Venezuela is the Casabe, which is valued for its caloric content, and rich in dietary fiber (DF) and minerals. This study determined the effect of consumption of different varieties of Venezuelan cassava on absorption of iron, cooper and zinc, in an experimental model, with 20 adult males rats, strain Sprague Dawley, which were divided into 4 groups: a control without fiber and three experimental groups with substitution of cornstarch by a variety of casabe, identified by their origin as: Casabe Miranda, Casabe Sucre y Casabe Amazonas. Casabe diets had a higher mineral content, compared to the control diet. Total and soluble dietary fiber content were significantly higher in Sucre and Amazonas casabe varieties(p<0,05). The inclusion of casabe to diets resulted in a significant increase in the fecal excretion of iron and copper (p<0,05).The mineral absorption increased for iron in Miranda (3.5%) and Sucre (6%) varieties; for copper in the Amazonas group (32%); while the zinc absorption was less affected throughout the trial. The results of this study indicates that the effect of adding casabe to diets on absorption of iron, copper and zinc, was different for each mineral and was related to the diet consumed by the animals, depending of casabe variety used.
Assuntos
Humanos , Masculino , Feminino , Minerais na Dieta/metabolismo , Fibras na Dieta/análise , Ferro da Dieta/uso terapêutico , Minerais , Zinco , Saúde Pública , CobreRESUMO
El propósito del estudio fue evaluar el estado del hierro y la vitamina A, en niños de la etnia Warao, perteneciente a las comunidades de María López y Los Barrancos, del estado Sucre. Se evaluó el consumo de alimentos,indicadores bioquímicos y antropométricos a 64 niños Warao en edades comprendidas entre los 3 y 10 años. Se encontró una adecuación deficiente del consumo de hierroen 56,8%,la mayoría provino defuentes no hem: cereales (37,8%), harina de maíz precocida fortificada (33,47%), harina de trigo (2,72%) y casabe (32,98%); el hierro hémico provino de pescados (37,49%). Se presentó déficit en la adecuación del consumo de la vitamina A en 97,3%, las fuentes fueron cereales (harina de maíz precocida), huevos y lácteos. El diagnóstico nutricional antropométrico por combinación de indicadores de dimensión corporal, arrojó que el 75,0% se encuentra en normalidad. Para los estudios bioquímicos: el 93,76% tiene deficiencia de retinol; 40,63% deficiencia severa. El 100% y 70,3% presentó niveles normales de hierro y ferritina sérica, respectivamente. La concentración de hemoglobina, reveló 70,3% de anemia. Existe prevalencia de 92,45% de parasitosis intestinal (Trichuristrichura, Ascarislumbricoides y Ancylostomideos). Se observaron diferencias estadísticamente significativas de niveles séricos de ferritina y asociaciones parasitarias. La alta prevalencia de anemia, deficiencia de vitamina A y parasitosis, indican la existencia de un déficit nutricional en cuanto al hierro y la vitamina A, que puede deberse a la baja disponibilidad de alimentos, el consumo insuficiente de nutrientes y un aprovechamiento biológico disminuido.
The purpose of this study was to assess the iron and vitamin A status in children of Warao ethnic group, belonging to communitiesMaríaLópez and Los Barrancos in Sucre State. We evaluated food intake, anthropometric and biochemical markers in 64 Warao children with ages between 3 and 10 years. A deficient consumption of iron was found in 56,8%, most from non-heme sources: cereals (37,8%), corn flour fortified (33,47%), wheat flour (2,72%) andcasabe (32,98%);heme iron came from fish(37,49%).In the intake of vitamin A the deficit was presented in97,3%,sources were cereals (corn flour fortified), eggs and dairy. The anthropometric-nutritional diagnosis by combination of body dimension indicators showed that 75.0% is in normality.For biochemical studies: 93.76% has retinol deficiency;40,63% severe deficiency. The 100% and 70.3% had normal levels of serum iron and ferritin, respectively. The hemoglobin concentration revealed 70.3% of anemia. There was a high prevalence (92,45%) of intestinal parasitosis (Trichuristrichura, Ascarislumbricoides y Ancylostomideos). There were statistically significant differences in serum ferritin and parasitic associations.The high prevalence of anemia, vitamin A deficiency and parasitosis,indicate the existence of nutritional deficit in iron and vitamin A,which may be due to the low availability of food, insufficient consumption of nutrients and biological utilization decreased.
Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Vitamina A/fisiologia , Avaliação Nutricional , Enteropatias Parasitárias/classificação , Ferro/análise , Etnicidade , Saúde Pública , Desnutrição , AnemiaRESUMO
El síndrome de neoplasia endocrina múltiple 2B (MEN 2B) es una entidad poco frecuente, que se caracteriza por la presencia de carcinoma medular de tiroides (CMT) en un 100% de los casos. El fenotipo de este síndrome incluye rasgos marfanoides y neuromas mucocutáneos. Describimos el caso de un paciente con un síndrome MEN 2B, al que se le diagnostica un cáncer medular de tiroides a partir del hallazgo de metástasis pulmonares y analizamos el papel del DMSA-V y de los nuevos sistemas híbridos SPECT-TAC en el estudio de extensión y seguimiento del CMT(AU)
Multiple endocrine neoplasia syndrome, type 2B (MEN 2B), is a rare entity characterized by the presence of medullary thyroid cancer in 100% of the cases. The phenotype of this syndrome consists in the presence of marfanoid features and mucocutaneous neuromas. We describe the case of a male patient with MEN 2B syndrome who was diagnosed with medullary thyroid cancer after lung metastases was found. We analyze the role of DMSA-V and the new hybrid SPECT-CT scan systems in the extension study and monitoring of medullary thyroid cancer(AU)
Assuntos
Humanos , Masculino , Adulto , Tomografia Computadorizada de Emissão de Fóton Único/instrumentação , Tomografia Computadorizada de Emissão de Fóton Único/métodos , Tecnécio Tc 99m Exametazima , Ácido Dimercaptossuccínico Tecnécio Tc 99m , Neoplasias da Glândula Tireoide , Tireoidectomia/métodos , Tireoidectomia , Octreotida/uso terapêutico , Tomografia Computadorizada de Emissão de Fóton Único/tendências , Tomografia Computadorizada de Emissão de Fóton Único , Ácido Dimercaptossuccínico Tecnécio Tc 99m/metabolismo , Ácido Dimercaptossuccínico Tecnécio Tc 99m/farmacocinética , Neoplasia Endócrina Múltipla Tipo 2a/complicações , Neoplasia Endócrina Múltipla Tipo 2a/diagnósticoRESUMO
Multiple endocrine neoplasia syndrome, type 2B (MEN 2B), is a rare entity characterized by the presence of medullary thyroid cancer in 100% of the cases. The phenotype of this syndrome consists in the presence of marfanoid features and mucocutaneous neuromas. We describe the case of a male patient with MEN 2B syndrome who was diagnosed with medullary thyroid cancer after lung metastases was found. We analyze the role of DMSA-V and the new hybrid SPECT-CT scan systems in the extension study and monitoring of medullary thyroid cancer.
Assuntos
Carcinoma Medular/secundário , Vértebras Lombares/diagnóstico por imagem , Imagem Multimodal , Neoplasia Endócrina Múltipla Tipo 2b/diagnóstico por imagem , Tomografia por Emissão de Pósitrons , Compostos Radiofarmacêuticos , Neoplasias da Coluna Vertebral/secundário , Ácido Dimercaptossuccínico Tecnécio Tc 99m , Vértebras Torácicas/diagnóstico por imagem , Neoplasias da Glândula Tireoide/patologia , Tomografia Computadorizada por Raios X , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Benzenossulfonatos/administração & dosagem , Carcinoma Medular/diagnóstico por imagem , Carcinoma Medular/tratamento farmacológico , Humanos , Neoplasias Hepáticas/secundário , Neoplasias Pulmonares/secundário , Masculino , Neoplasia Endócrina Múltipla Tipo 2b/genética , Esvaziamento Cervical , Niacinamida/análogos & derivados , Octreotida/administração & dosagem , Compostos de Fenilureia , Proteínas Proto-Oncogênicas c-ret/genética , Piridinas/administração & dosagem , Sorafenibe , Neoplasias da Coluna Vertebral/diagnóstico por imagem , Neoplasias da Coluna Vertebral/tratamento farmacológico , Neoplasias da Glândula Tireoide/cirurgia , Tireoidectomia , Adulto JovemAssuntos
Humanos , Masculino , Criança , Osteomielite , Doença de Legg-Calve-Perthes , Diagnóstico Diferencial , Imageamento por Ressonância Magnética/métodos , Espectroscopia de Ressonância Magnética/métodos , Osteomielite , Osteomielite/complicações , Osteomielite/terapia , Doença de Legg-Calve-Perthes , Biópsia/métodosRESUMO
Introducción. El objetivo de este trabajo es revisar los artículos decirugía oral publicados en el año 2005.Material y método. Tres revisores han realizado una búsqueda en las revistasindexadas en Medline, clasificando los artículos de acuerdo a diferentes temas.Los criterios de búsqueda fueron: artículos de especial interés publicadosen revistas de impacto nacional e internacional, que actualizaran cualquierade los temas señalados.Resultados. Los artículos más interesantes sobre cirugía bucal publicadosen el año 2005 son: 11 artículos sobre quistes, 35 de tumores de los maxilaresy tejidos blandos, 4 de infecciones de los maxilares, 11 de cirugía periapical,15 de patología del tercer molar, 5 de inclusiones dentarias, 11 detransplantes y reimplantes dentarios, 5 de fármacos y 3 artículos de otrostemas.Conclusión. Aportar a otros investigadores una rápida identificación de losartículos más importantes de cirugía bucal publicados en el año 2005(AU)
Introduction. Oral surgery articles published in 2005 werereviewed.Material and method. Three reviewers searched journals indexedin Medline and classified the articles by topic. The search criteriawere: articles of special interest, published in national andinternational impact journals, that updated any of the topics selected.Results. The most interesting articles on oral surgery published in2005 were: 11 articles on cysts, 35 on jaw and soft tissues tumors,4 jaw infections, 11 periapical surgery, 15 third molar pathology,5 dental impaction, 11 dental transplantation and reimplantation,5 drugs, and 3 articles on other topics.Conclusion. The authors offer other researchers a quick overview ofthe most important articles in oral surgery published in 2005(AU)
Assuntos
Publicações Periódicas como Assunto/estatística & dados numéricos , Procedimentos Cirúrgicos Bucais/tendências , Bibliometria , Bibliografias como Assunto , Bases de Dados BibliográficasRESUMO
OBJECTIVE: To assess the nutritional status, food consumption and physical activity (PA) habits of Chilean school children, as a baseline for developing an educational intervention. DESIGN: Cross-sectional study. SUBJECTS: A total of 1701 children from 3rd to 7th grade in nine schools located in three geographical regions. METHODS: We determined body mass index, food consumption (quantified FFQ which we categorised into five groups), PA in terms of TV viewing and frequency of after school PA. The data were analysed according to age, nutritional status and gender. A logistic regression analysis was performed using obesity as outcome. RESULTS: Obesity was higher among boys; younger children presented higher prevalence in both genders. Daily intake of dairy products varied between 240 and 308 g, fruits/vegetables, between 197 and 271 g, energy-dense foods between 343 and 460 g. In all, 22.3 and 47% of the children watched over 3 h of TV during the week and weekend, respectively. Older children watched significantly more TV during the week, while on weekends all children increased this time significantly. Boys were more active than girls after school. The logistic regression analysis showed a significant association between obesity and low intake of dairy products. CONCLUSIONS: Prevalence of obesity among Chilean children is high. Although TV time, intake of energy dense foods and fruits/vegetables appeared as risk factors for obesity, only dairy consumption was significantly associated with obesity. SPONSORSHIP: FAO
Assuntos
Laticínios , Exercício Físico/fisiologia , Comportamento Alimentar , Estado Nutricional , Obesidade/epidemiologia , Adolescente , Fatores Etários , Índice de Massa Corporal , Criança , Chile/epidemiologia , Estudos Transversais , Ingestão de Energia , Feminino , Frutas , Humanos , Atividades de Lazer , Modelos Logísticos , Masculino , Fatores Sexuais , Televisão , VerdurasRESUMO
La inmunohistoquímica (IHQ) constituye una herramienta para definir la etiología en el síndrome icterohemorrágico. Objetivo: Identificar mediante IHQ la presencia en hígado del antígeno de superficie de la Hepatitis B y del virus de la fiebre amarilla. Materiales y métodos: se incluyeron muestras de tejido hepático procedente de 55 fallecidos por sindrome icterohemorrágico, remitidos entre enero del 2000 y diciembre del 2001 al Instituto Nacional de Salud, (Lima, Perú). Resultados: La prueba se realizó unicamente en 46 muestras, 33 por ciento (15/46) fueron diagnosticados por histopatología como fiebre amarilla, de ellos, 9 casos fueron positivos por IHQ para fiebre amarilla, siendo 2 de ellos también positivos para HBsAg. Histológicamente se presentaron 6 casos como hepatitis con necrosis submasiva o masiva, que por IHQ fueron sólo dos casos positivos para fiebre amarilla. En 39 por ciento (18/46) no se llegó al diagnóstico etiológico de la Hepatitis, y finalmente hubo dos casos con siagnóstico histopatológico de ádenocarcinoma hepático y sólo se obtuvo positividad por IHQ para HBsAg en uno. Conclusiones: La IHQ es una alternativa para la confirmación diagnóstica de hepatitis B y fiebre amarilla
Assuntos
Febre Amarela , Hepatite B , Imuno-HistoquímicaRESUMO
In search for the vector of the recently recognized spotted fever rickettsiosis of the Yucatán, ticks, fleas, and lice were collected from vegetation and dogs in localities where seropositive persons had been found. The arthropods were examined by polymerase chain reaction (PCR) using primers for the genus-specific 17-kDa protein gene followed by restriction fragment length polymorphism (RFLP) and DNA sequencing. Eleven (20%) of 54 pools of Ctenocephalides felis fleas contained DNA of Rickettsia felis. None of 219 Amblyomma cajennense, 474 Rhiphicephalus sanguineus, 258 Boophilus sp. ticks, and 33 Poliplax species lice contained DNA of Rickettsia. The identity of the rickettsial DNA was confirmed as R. felis by PCR/RFLP for the citrate synthase and outer membrane protein A genes and by DNA sequencing. The results indicate that the host of R. felis in Yucatán is C. felis and suggest that the spotted fever rickettsiosis that has infected >5% of the population of the Yucatán and can present as a dengue-like illness is likely to be caused by R. felis.