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1.
Cureus ; 16(6): e61937, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38978888

RESUMO

Monoclonal gammopathy of undetermined significance (MGUS) is a premalignant condition characterized by monoclonal paraprotein production, with IgM and non-IgM variants. While IgM MGUS is often associated with lymphoid neoplasms, non-IgM MGUS can progress to multiple myeloma. Comorbidities include bone mineral density loss and renal complications, such as monoclonal gammopathy of renal significance (MGRS) and peripheral neuropathy. Cardiovascular risks are also elevated. Despite its significance, MGUS often goes undiagnosed due to its asymptomatic nature and overlap with age-related comorbidities. We present a case of IgM MGRS manifesting as rapidly progressive glomerulonephritis, highlighting the diagnostic challenges and clinical implications of MGUS-associated complications.

2.
Front Microbiol ; 15: 1361795, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38694798

RESUMO

Introduction: Antimicrobial resistance (AMR) is a global health problem that requires early and effective treatments to prevent the indiscriminate use of antimicrobial drugs and the outcome of infections. Mass Spectrometry (MS), and more particularly MALDI-TOF, have been widely adopted by routine clinical microbiology laboratories to identify bacterial species and detect AMR. The analysis of AMR with deep learning is still recent, and most models depend on filters and preprocessing techniques manually applied on spectra. Methods: This study propose a deep neural network, MSDeepAMR, to learn from raw mass spectra to predict AMR. MSDeepAMR model was implemented for Escherichia coli, Klebsiella pneumoniae, and Staphylococcus aureus under different antibiotic resistance profiles. Additionally, a transfer learning test was performed to study the benefits of adapting the previously trained models to external data. Results: MSDeepAMR models showed a good classification performance to detect antibiotic resistance. The AUROC of the model was above 0.83 in most cases studied, improving the results of previous investigations by over 10%. The adapted models improved the AUROC by up to 20% when compared to a model trained only with external data. Discussion: This study demonstrate the potential of the MSDeepAMR model to predict antibiotic resistance and their use on external MS data. This allow the extrapolation of the MSDeepAMR model to de used in different laboratories that need to study AMR and do not have the capacity for an extensive sample collection.

3.
Cancers (Basel) ; 14(19)2022 Sep 29.
Artigo em Inglês | MEDLINE | ID: mdl-36230681

RESUMO

(1) Background: Androgen deprivation therapy (ADT) and docetaxel (DX) combination is a standard therapy for metastatic hormone-sensitive prostate cancer (mHSPC) patients. (2) Methods: We investigate if tumor transcriptomic analysis predicts mHSPC evolution in a multicenter retrospective biomarker study. A customized panel of 184 genes was tested in mRNA from tumor samples by the nCounter platform in 125 mHSPC patients treated with ADT+DX. Gene expression was correlated with castration-resistant prostate cancer-free survival (CRPC-FS) and overall survival (OS). (3) Results: High expression of androgen receptor (AR) signature was independently associated with longer CRPC-FS (hazard ratio (HR) 0.6, 95% confidence interval (CI) 0.3-0.9; p = 0.015), high expression of estrogen receptor (ESR) signature with longer CRPC-FS (HR 0.6, 95% CI 0.4-0.9; p = 0.019) and OS (HR 0.5, 95% CI 0.2-0.9, p = 0.024), and lower expression of tumor suppressor genes (TSG) (RB1, PTEN and TP53) with shorter OS (HR 2, 95% CI 1-3.8; p = 0.044). ARV7 expression was independently associated with shorter CRPC-FS (HR 1.5, 95% CI 1.1-2.1, p = 0.008) and OS (HR 1.8, 95% CI 1.2-2.6, p = 0.004), high ESR2 was associated with longer OS (HR 0.5, 95% CI 0.2-1, p = 0.048) and low expression of RB1 was independently associated with shorter OS (HR 1.9, 95% CI 1.1-3.2, p = 0.014). (4) Conclusions: AR, ESR, and TSG expression signatures, as well as ARV7, RB1, and ESR2 expression, have a prognostic value in mHSPC patients treated with ADT+DX.

4.
J Invasive Cardiol ; 33(3): E200-E205, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33600354

RESUMO

BACKGROUND: In high-expertise transradial (TR) centers, the radiation exposure to patients during coronary angiography (CAG) is equivalent to transfemoral use. However, there is no definitive information during TR-CAG regarding the use of a single, dedicated catheter to impart less radiation exposure to patients. OBJECTIVE: We compare the radiation exposure to patients during right TR-CAG with Tiger II catheter (Terumo Interventional Systems) vs Judkins right (JR) 4.0/Judkins left (JL) 3.5 catheters (Cordis Corporation). METHODS: This multicenter, randomized, and prospective trial included 180 patients submitted to right TR-CAG, with the primary objective of observing radiation exposure to patients through the measurement of fluoroscopy time, air kerma (AK), and dose-area product (DAP) using Tiger II (group 1) vs JR 4.0 and JL 3.5 Judkins catheters (group 2). Secondary outcomes included contrast volume usage and the need to use additional catheters to complete the procedure (the crossover technique). RESULTS: Group 1 demonstrated reduced fluoroscopy time (2.47 ± 1.05 minutes in group 1 vs 2.68 ± 1.26 minutes in group 2; P=.01) and non-significant reduction of AK (540.9 ± 225.3 mGy in group 1 vs 577.9 ± 240.1 mGy in group 2; P=.34) and DAP (3786.7 ± 1731.7 µGy•m² in group 1 vs 4058.0 ± 1735.4 µGy•m² in group 2; P=.12). Contrast volume usage (53.46 ± 10.09 mL in group 1 vs 55.98 ± 10.43 mL in group 2; P=.13) and the need for additional catheters (5.56% in group 1 vs 4.44% in group 2; P>.99) were similar between groups. CONCLUSION: The Tiger II catheter was able to reduce radiation exposure to patients submitted to TR-CAG through a significant reduction in fluoroscopy time.


Assuntos
Cateterismo Cardíaco , Exposição à Radiação , Cateterismo Cardíaco/efeitos adversos , Catéteres , Angiografia Coronária/efeitos adversos , Vasos Coronários , Humanos , Estudos Prospectivos , Artéria Radial , Doses de Radiação , Exposição à Radiação/prevenção & controle
5.
J Endourol Case Rep ; 6(4): 413-415, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33457688

RESUMO

Background: Ureteroiliac fistula is a rare cause of gross hematuria and lateralizing flank pain. Risk factors include previous pelvic surgery, pelvic radiotherapy, or chronic ureteral stentings. Diagnosis is challenging and requires arteriography and ureteroscopy. Management ranges from open surgery to minimally invasive means such as the use of an endovascular stent. Case Report: A 62-year-old man with postradical cystoprostatectomy and cutaneous ureterostomy presented an intermittent gross hematuria with anemia that required blood transfusions. Some CT arteriographies were performed but none of them could identify the bleeding origin. Therefore, a flexible ureteroscopy was performed that showed a left ureteroiliac fistula. Subsequently, an endovascular stent was placed in the left common iliac without complications. Conclusion: The ureteroiliac fistula is a life-threatening condition. CT arteriography or ureteroscopy might help in the diagnosis but the sensitivity is ∼64%. Arteriography with endovascular stenting is a viable and safe option. However, because of its rarity, long-term durable benefits still need to be documented.

6.
Cytometry A ; 97(3): 308-319, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31688997

RESUMO

Imaging flow cytometry (IFC) produces up to 12 spectrally distinct, information-rich images of single cells at a throughput of 5,000 cells per second. Yet often, cell populations are still studied using manual gating, a technique that has several drawbacks, hence it would be advantageous to replace manual gating with an automated process. Ideally, this automated process would be based on stain-free measurements, as the currently used staining techniques are expensive and potentially confounding. These stain-free measurements originate from the brightfield and darkfield image channels, which capture transmitted and scattered light, respectively. To realize this automated, stain-free approach, advanced machine learning (ML) methods are required. Previous works have successfully tested this approach on cell cycle phase classification with both a classical ML approach based on manually engineered features, and a deep learning (DL) approach. In this work, we compare both approaches extensively on the problem of white blood cell classification. Four human whole blood samples were assayed on an ImageStream-X MK II imaging flow cytometer. Two samples were stained for the identification of eight white blood cell types, while two other sample sets were stained for the identification of resting and active eosinophils. For both data sets, four ML classifiers were evaluated on stain-free imagery with stratified 5-fold cross-validation. On the white blood cell data set, the best obtained results were 0.778 and 0.703 balanced accuracy for classical ML and DL, respectively. On the eosinophil data set, this was 0.871 and 0.856 balanced accuracy. We conclude that classifying cell types based on only stain-free images is possible with all four classifiers. Noteworthy, we also find that the DL approaches tested in this work do not outperform the approaches based on manually engineered features. © 2019 International Society for Advancement of Cytometry.


Assuntos
Corantes , Aprendizado de Máquina , Diagnóstico por Imagem , Citometria de Fluxo , Humanos , Leucócitos
7.
Arch Esp Urol ; 72(10): 992-999, 2019 Dec.
Artigo em Espanhol | MEDLINE | ID: mdl-31823847

RESUMO

OBJECTIVES: Penile cancer is not very frequent. To control the disease oncologically, we must perform inguinal lymphadenectomy in cases of high-risk histology, poor prognosis and palpable lymph nodes. The open inguinal lymphadenectomy has a high rate of morbidity. Consequently, this systematic review intends to summarize the published literature regarding the oncologic and post-surgery outcomes in video-endoscopic inguinal lymphadenectomy (VEIL). METHODS: A literature search has conducted through Pubmed, EMBASE and Cochrane library for English and Spanish articles. RESULTS: Our literature search identified 12 articles. In total, 161 patients have been subjected to 226 VEIL. Their average age was 55.66 years. In the case of open inguinal lymphadenectomy, 90 patients have been subjected to 106 operations. The rate of cutaneous complications was 6% for VEIL and 55.6% for open lymphadenectomy. The rate of lymphatic complications was very similar in both types of lymphadenectomy. The average number of lymph nodes obtained was 9.12 for VEIL and 7.02 lymph nodes for the open approach. CONCLUSION: Video-endoscopic inguinal lymphadenectomy contributes to less morbidity with a lower- rate of cutaneous complications and less severity. Furthermore, VEIL gives lower hospital stay without changing in initial oncologic outcomes. Although we need longer series to stablish the oncologic long-term results.


OBJETIVO: El cáncer de pene es una entidad poco frecuente. Para realizar un buen control oncológico, se recomienda la realización de linfadenectomía inguinal en casos de factores de riesgo de mal pronóstico, grado histológico alto o ganglios palpables o positivos. La linfadenectomía inguinal abierta presenta una alta tasa de morbilidad, por lo que en esta revisión se pretende resumir la literatura publicada en cuanto a los resultados oncológicos y postquirúrgicos en la linfadenectomía inguinal videoendoscópica (VEIL).MATERIAL Y MÉTODOS: Se realiza revisión sistemática de la literatura obtenida en "Pubmed", "EMBASE" y Cochrane library para artículos en inglés y español. RESULTADOS: Se han analizado un total de 12 artículos, que globalmente incluyen a 161 pacientes con 226 VEIL y una edad media de 55,66 años y 90 pacientes a los que se les ha realizado 106 linfadenectomías abiertas. En el caso del VEIL se han presentado 6% de complicaciones cutáneas y del 55,6% en el caso de la vía abierta. En cuanto a las complicaciones linfáticas, no hay diferencias significativas. La media de ganglios extraídos en el caso de VEIL de 9,12 ganglios y de 7,09 ganglios en abordaje abierto. CCONCLUSIONES: La linfadenectomía inguinal videoendoscópica aporta una menor morbilidad, con una menor tasa de complicaciones cutáneas, y de menor gravedad. Asimismo, aporta menor estancia hospitalaria, sin afectación de los resultados oncológicos iniciales. Aunque se necesitan series con mayor tiempo de seguimiento para valoración de resultados oncológicos a largo plazo.


Assuntos
Excisão de Linfonodo , Neoplasias Penianas , Cirurgia Vídeoassistida , Endoscopia , Humanos , Canal Inguinal , Excisão de Linfonodo/métodos , Masculino , Pessoa de Meia-Idade , Neoplasias Penianas/cirurgia
8.
Arch. esp. urol. (Ed. impr.) ; 72(10): 992-999, dic. 2019. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-192765

RESUMO

OBJETIVO: El cáncer de pene es una entidad poco frecuente. Para realizar un buen control oncológico, se recomienda la realización de linfadenectomía inguinal en casos de factores de riesgo de mal pronóstico, grado histológico alto o ganglios palpables o positivos. La linfadenectomía inguinal abierta presenta una alta tasa de morbilidad, por lo que en esta revisión se pretende resumir la literatura publicada en cuanto a los resultados oncológicos y postquirúrgicos en la linfadenectomía inguinal videoendoscópica (VEIL). MATERIAL Y MÉTODOS: Se realiza revisión sistemática de la literatura obtenida en "Pubmed", "EMBASE" y Cochrane library para artículos en inglés y español. RESULTADOS: Se han analizado un total de 12 artículos, que globalmente incluyen a 161 pacientes con 226 VEIL y una edad media de 55,66 años y 90 pacientes a los que se les ha realizado 106 linfadenectomías abiertas. En el caso del VEIL se han presentado 6% de complicaciones cutáneas y del 55,6% en el caso de la vía abierta. En cuanto a las complicaciones linfáticas, no hay diferencias significativas. La media de ganglios extraídos en el caso de VEIL de 9,12 ganglios y de 7,09 ganglios en abordaje abierto. CONCLUSIONES: La linfadenectomía inguinal videoendoscópica aporta una menor morbilidad, con una menor tasa de complicaciones cutáneas, y de menor gravedad. Asimismo, aporta menor estancia hospitalaria, sin afectación de los resultados oncológicos iniciales. Aunque se necesitan series con mayor tiempo de seguimiento para valoración de resultados oncológicos a largo plazo


OBJECTIVES: Penile cancer is not very frequent. To control the disease oncologically, we must perform inguinal lymphadenectomy in cases of high-risk histology, poor prognosis and palpable lymph nodes. The open inguinal lymphadenectomy has a high rate of morbidity. Consequently, this systematic review intends to summarize the published literature regarding the oncologic and post-surgery outcomes METHODS: A literature search has conducted through Pubmed, EMBASE and Cochrane library for English and Spanish articles. RESULTS: Our literature search identified 12 articles. In total, 161 patients have been subjected to 226 VEIL. Their average age was 55.66 years. In the case of open inguinal lymphadenectomy, 90 patients have been subjected to 106 operations. The rate of cutaneous complications was 6% for VEIL and 55.6% for open lymphadenectomy. The rate of lymphatic complications was very similar in both types of lymphadenectomy. The average number of lymph nodes obtained was 9.12 for VEIL and 7.02 lymph nodes for the open approach. CONCLUSION: Video-endoscopic inguinal lymphadenectomy contributes to less morbidity with a lower-rate of cutaneous complications and less severity. Furthermore, VEIL gives lower hospital stay without changing in initial oncologic outcomes. Although we need longer series to stablish the oncologic long-term results


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Excisão de Linfonodo/métodos , Neoplasias Penianas/cirurgia , Cirurgia Vídeoassistida , Endoscopia , Canal Inguinal
9.
Acta Gastroenterol Latinoam ; 46(1): 18-21, 2016 Mar.
Artigo em Espanhol | MEDLINE | ID: mdl-29470879

RESUMO

INTRODUCTION: Colorectal cancer is a major health problem worldwide because it is the third most common cancer and the third leading cause of cancer mortality in western countries. Screening for colorectal cancer in asymptomatic patients is crucialfor reducing the incidence and colonoscopy is one of the methods of choice. The ability of colonoscopy in detecting small lesions is clearly influenced by the quality of the colonic preparation. OBJECTIVES: To know which are the variablesrelating to the patient and the type ofpreparation that affect the quality of colonic cleansing. MATERIALS AND METHODS: It was designed a cross-sectional study. It was administered a questionnaire for the enrolled subjects to assess the presence offactors that could affect the quality of colonic cleansing. Then they underwent a colonoscopy. The different variables between subjects with adequate or inadequate colonic cleansing were compared. RESULTS: We evaluated 277 subjects. In multivariate analysis the only variables that showed significant differences are split dose [OR 0.45 (0.21 to 0.99)] and age [OR 1.02 (1-1.05)]. Obesity showed no significant differences in multivariate analysis [OR 1.84 (0.9-3.78)]. CONCLUSIONS: Age and split-dose were the only variables significantly associated with the quality of bowel preparation prior to colonoscopy. Not so constipation or the presence ofdiverticula, so these patients do not require special preparation regimes.


Assuntos
Catárticos/administração & dosagem , Neoplasias do Colo/diagnóstico , Colonoscopia , Intestinos , Cooperação do Paciente , Neoplasias Retais/diagnóstico , Fatores Etários , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
10.
Arq Gastroenterol ; 52(2): 139-42, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26039833

RESUMO

BACKGROUND: Some previously published studies have suggested an inverse relationship between celiac disease and Helicobacter pylori, raising the possibility of the protective role Helicobacter pylori could have against celiac disease development. Nevertheless, this association is inconclusive. OBJECTIVES: To determine the prevalence of Helicobacter pylori infection in celiac subjects. METHODS: Between January 2013 and June 2014, patients over 18 years old undergoing upper endoscopy who required both gastric and duodenal biopsies were included for analysis. Enrolled subjects were divided in two groups: those with a diagnosis of celiac disease and those without a celiac disease diagnosis. Helicobacter pylori infection prevalence was compared between groups. Among celiac patients, endoscopic markers of villous atrophy as well as histological damage severity were compared between those with and without Helicobacter pylori infection. RESULTS: Overall, 312 patients were enrolled. Seventy two of them had a diagnosis of celiac disease. Helicobacter pylori infection prevalence among celiac disease patients was 12.5%, compared to 30% in non-celiac patients [OR=0.33 (0.15-0.71)]. There was not a significant difference in terms of the severity of villous atrophy in patients with Helicobacter pylori infection compared to those without it. There was a slight increase in the prevalence of endoscopic markers in those Helicobacter pylori-negative celiac subjects. CONCLUSION: Helicobacter pylori infection seems to be less frequent in celiac patients; among those celiac subjects with concomitant Helicobacter pylori infection, histological damage degree and presence of endoscopic markers suggesting villous atrophy seem to be similar to those without Helicobacter pylori infection.


Assuntos
Doença Celíaca/complicações , Infecções por Helicobacter/complicações , Helicobacter pylori , Adulto , Biópsia , Doença Celíaca/patologia , Estudos Transversais , Feminino , Gastroscopia , Infecções por Helicobacter/epidemiologia , Infecções por Helicobacter/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos
11.
Arq. gastroenterol ; 52(2): 139-142, Apr-Jun/2015. tab
Artigo em Inglês | LILACS | ID: lil-748163

RESUMO

Background Some previously published studies have suggested an inverse relationship between celiac disease and Helicobacter pylori, raising the possibility of the protective role Helicobacter pylori could have against celiac disease development. Nevertheless, this association is inconclusive. Objectives To determine the prevalence of Helicobacter pylori infection in celiac subjects. Methods Between January 2013 and June 2014, patients over 18 years old undergoing upper endoscopy who required both gastric and duodenal biopsies were included for analysis. Enrolled subjects were divided in two groups: those with a diagnosis of celiac disease and those without a celiac disease diagnosis. Helicobacter pylori infection prevalence was compared between groups. Among celiac patients, endoscopic markers of villous atrophy as well as histological damage severity were compared between those with and without Helicobacter pylori infection. Results Overall, 312 patients were enrolled. Seventy two of them had a diagnosis of celiac disease. Helicobacter pylori infection prevalence among celiac disease patients was 12.5%, compared to 30% in non-celiac patients [OR=0.33 (0.15-0.71)]. There was not a significant difference in terms of the severity of villous atrophy in patients with Helicobacter pylori infection compared to those without it. There was a slight increase in the prevalence of endoscopic markers in those Helicobacter pylori-negative celiac subjects. Conclusion Helicobacter pylori infection seems to be less frequent in celiac patients; among those celiac subjects with concomitant Helicobacter pylori infection, histological damage degree and presence of endoscopic markers suggesting villous atrophy seem to be similar to those without Helicobacter pylori infection. .


Contexto Alguns estudos publicados anteriormente sugerem uma relação inversa entre a doença celíaca e Helicobacter pylori, levantando a possibilidade do papel protetor que o Helicobacter pylori poderia ter contra o desenvolvimento de doença celíaca. No entanto, esta associação é inconclusiva. Objetivos Determinar a prevalência da infecção por Helicobacter pylori em indivíduos celíacos. Métodos Entre janeiro de 2013 e de 2014 junho, foram incluídos para análise pacientes com mais de 18 anos de idade submetidos a endoscopia para necessárias biópsias gástricas e duodenais. Os pacientes foram divididos em dois grupos: aqueles com diagnóstico de doença celíaca e aqueles sem um diagnóstico de doença celíaca. A prevalência da infecção por Helicobacter pylori foi comparada entre os grupos. Entre os pacientes celíacos, os marcadores endoscópicos de atrofia das vilosidades, bem como a gravidade do dano histológico foram comparados entre aqueles com e sem infecção pelo Helicobacter pylori. Resultados De um total de 312 pacientes, 72 deles tiveram diagnóstico da doença celíaca. A prevalência de infecção pelo Helicobacter pylori entre pacientes com doença celíaca foi de 12,5%, em comparação com 30% em pacientes não-celíacos [OR=0,33 (0,15-0,71)]. Não houve diferença significativa em termos da gravidade da atrofia das vilosidades em pacientes com infecção pelo Helicobacter pylori em comparação com aqueles sem ele. Houve um ligeiro aumento na prevalência de marcadores endoscópicos nos indivíduos celíacos com Helicobacter pylori-negativo. Conclusão A infecção pelo Helicobacter pylori parece ser menos frequente em pacientes celíacos; entre esses indivíduos celíacos com concomitante infecção por Helicobacter pylori, o grau de dano histológico e a presença de marcadores endoscópicos sugerindo atrofia vilosa, parecem ser semelhantes com os sem infecção. .


Assuntos
Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doença Celíaca/complicações , Helicobacter pylori , Infecções por Helicobacter/complicações , Biópsia , Estudos Transversais , Doença Celíaca/patologia , Gastroscopia , Infecções por Helicobacter/epidemiologia , Infecções por Helicobacter/patologia , Prevalência , Estudos Retrospectivos
13.
Acta Gastroenterol Latinoam ; 44(3): 205-9, 2014.
Artigo em Espanhol | MEDLINE | ID: mdl-26742290

RESUMO

INTRODUCTION: Proton pump inhibitors could have an impact on the results of breath tests performed in patients with irritable bowel syndrome. This impact could be due to the development of small intestine bacterial overgrowth. OBJECTIVE: To compare the prevalence of fermentative profile alterations of irritable bowel syndrome patients exposed and not-exposed to proton pump inhibitor therapy. MATERIAL AND METHODS: Subjects with irritable bowel syndrome were enrolled. A validated questionnaire assessing symptom severity as well as proton pump inhibitor treatment was delivered. A lactulose breath test was undertaken by each enrolled subject. Fermentative profile (area under the curve of hydrogen excretion/time) was compared between proton pump inhibitors consumers and non-consumers. Furthermore, small intestine bacterial overgrowth prevalence was compared. RESULTS: Two hundred and twenty five patients were enrolled. No significant differences were found on the fermentative profile between groups [AUC mediana 3,776 (rango 2,124-5,571) vs 4,347 (rango 2,038-5,481), P = 0.3]. Small intestine bacterial overgrowth prevalence was similar as well [33% vs 27.5%]. These differences remained non-significant after adjusting for proton pump inhibitor dose and treatment time. Surprisingly, symptom score was significantly higher in those patients under proton pump inhibitor therapy [28.5 (23-26) vs 23 (15-29), P = 0.01]. CONCLUSION: Proton pump inhibitors have no significant influence on lactulose breath tests, regardless of the dosage and time of administration.


Assuntos
Fermentação/efeitos dos fármacos , Microbioma Gastrointestinal/efeitos dos fármacos , Síndrome do Intestino Irritável/tratamento farmacológico , Inibidores da Bomba de Prótons/administração & dosagem , Idoso , Área Sob a Curva , Testes Respiratórios , Estudos de Casos e Controles , Feminino , Humanos , Síndrome do Intestino Irritável/microbiologia , Lactulose/metabolismo , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Inquéritos e Questionários
18.
Artigo em Espanhol | LILACS | ID: lil-686316

RESUMO

El objetivo de este trabajo es analizar nuestra experiencia en artritis séptica luego de la reconstrucción artroscópica del LCA. Nive! 4 de evidencia. Se realizó la revisión retrospectiva de las reconstrucciones de ligamento cruzado anterior (LCA) por via artroscópica realizadas en nuestros servicios. Se incluyeron todos los casos diagnosticados como artritis sépticas con un seguimiento mínimo de 1 año. Entre los años 1999 y 2008 se realizaron 1088 reconstrucciones artroscópicas de LCA. Se registraron 12 casos de artritis séptica, lo que implica una incidencia de 1,1 por ciento (IC95 0.6 por ciento - 2 por ciento), los pacientes eran todos de sexo masculino. La edad promedio fue de 27 años (rango entre 21-47). Luego de obtenido el material para cultivo por punción se realizó lavado artroscópico. Se comenzó con terapia antibiótica intravenosa empírica con vancomicina más ciprofloxacina. Al obtener la tipificación se rotó al antibiótico específico endovenoso durante 6 semanas. Se logró conservar el neoligamento en 11 casos (IC95 0,5 por ciento - 1,9 por ciento) y en 1 se perdió. En el seguimiento todos los pacientes presentaron rodillas estables a excepción de un caso. Es de fundamental importancia el trabajo interdisciplinario con el sector de infectología para determinar el tratamiento antibiótico definitivo. La artritis séptica post-reconstrucción de! LCA con diagnóstico precoz y tratamiento efectivo tiene resultados satisfactorios


Assuntos
Adulto , Artrite Infecciosa/diagnóstico , Artrite Infecciosa/terapia , Ligamento Cruzado Anterior/cirurgia , Procedimentos de Cirurgia Plástica/efeitos adversos , Traumatismos do Joelho/complicações , Antibacterianos/uso terapêutico , Complicações Pós-Operatórias , Incidência , Resultado do Tratamento
19.
Artigo em Espanhol | BINACIS | ID: bin-131036

RESUMO

El objetivo de este trabajo es analizar nuestra experiencia en artritis séptica luego de la reconstrucción artroscópica del LCA. Nive! 4 de evidencia. Se realizó la revisión retrospectiva de las reconstrucciones de ligamento cruzado anterior (LCA) por via artroscópica realizadas en nuestros servicios. Se incluyeron todos los casos diagnosticados como artritis sépticas con un seguimiento mínimo de 1 año. Entre los años 1999 y 2008 se realizaron 1088 reconstrucciones artroscópicas de LCA. Se registraron 12 casos de artritis séptica, lo que implica una incidencia de 1,1 por ciento (IC95 0.6 por ciento - 2 por ciento), los pacientes eran todos de sexo masculino. La edad promedio fue de 27 años (rango entre 21-47). Luego de obtenido el material para cultivo por punción se realizó lavado artroscópico. Se comenzó con terapia antibiótica intravenosa empírica con vancomicina más ciprofloxacina. Al obtener la tipificación se rotó al antibiótico específico endovenoso durante 6 semanas. Se logró conservar el neoligamento en 11 casos (IC95 0,5 por ciento - 1,9 por ciento) y en 1 se perdió. En el seguimiento todos los pacientes presentaron rodillas estables a excepción de un caso. Es de fundamental importancia el trabajo interdisciplinario con el sector de infectología para determinar el tratamiento antibiótico definitivo. La artritis séptica post-reconstrucción de! LCA con diagnóstico precoz y tratamiento efectivo tiene resultados satisfactorios (AU)


Assuntos
Adulto , Artrite Infecciosa/terapia , Artrite Infecciosa/diagnóstico , Ligamento Cruzado Anterior/cirurgia , Traumatismos do Joelho/complicações , Procedimentos de Cirurgia Plástica/efeitos adversos , Incidência , Complicações Pós-Operatórias , Antibacterianos/uso terapêutico , Resultado do Tratamento
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