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Sample records for formas evolutivas graves

  1. Dislexia evolutiva :

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    Bardají Castel, Beatriz

    2012-01-01

    Se exponen y analizan los procesos cognitivos que ponemos en marcha cuando leemos y escribimos y, qué ocurre, cuando dichos procesos no se adquieren correctamente o existe algún déficit que no permite desarrollarlos de manera óptima. Se realiza un breve recorrido por la historia de la dislexia evolutiva, para poder analizar el porqué entendemos la dislexia, a día de hoy, como un trastorno multifactorial. Se examinan las diferentes orientaciones de investigación y, dentro de ellas, las hipóte...

  2. Auto-estima na forma inativa da oftalmopatia de Graves Inactive Graves' ophthalmopathy and self-esteem

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    Carlos Henrique de Toledo Magalhães

    2008-04-01

    Full Text Available OBJETIVOS: Avaliar a auto-estima dos pacientes com oftalmopatia de Graves na fase inativa. MÉTODOS: Foram avaliados 30 pacientes portadores de oftalmopatia de Graves, eutireoideanos, na fase inativa, com idade variando entre 26 e 65 anos, média 43 ± 11,0 anos, denominado grupo estudo e 39 indivíduos que não apresentavam oftalmopatia de Graves, com idade variando entre 18 e 67 anos, média de 41 ± 13,4 anos, selecionados na população geral denominado grupo controle. Para avaliar a auto-estima foi utilizada a escala de auto-estima Rosenberg Unifesp-EPM aplicada por meio de entrevista. Os valores dos escores de auto-estima nos dois grupos estudados foram comparados pelo teste não paramétrico de Mann-Whitney. O mesmo teste foi aplicado com objetivo de comparar os resultados obtidos no grupo oftalmopatia de Graves considerando a gravidade da doença. RESULTADOS: Não foi observada alteração com significância estatística na auto-estima dos pacientes com oftalmopatia de Graves (p=0,057. O grupo estudo apresentou, em média, valores inferiores de auto-estima, comparado ao grupo controle. Não houve diferença da auto-estima entre os pacientes dos subgrupos leve e moderado-grave (P=0,2710. CONCLUSÃO: A oftalmopatia de Graves na fase inativa não afetou a auto-estima dos pacientes, no grupo estudado.PURPOSE: To assess the self-esteem of Graves' ophthalmopathy patients in the inactive phase. METHODS: Thirty euthyroid patients were evaluated in the inactive phase of disease with age ranging from 26 to 65 years, average of 43 ± 11,0 years, called study group and 39 individuals without Graves' ophthalmopathy with age ranging from 18 to 67 years, average of 41 ± 13,4 years, selected from the general population called control group. To evaluate the self-esteem the Rosenberg UNIFESP/EPM self-esteem scale, applied by means of an interview, was utilized. The self-esteem scores in the two studied groups were compared by means of the non

  3. Seasonal distribution and evolving forms of multiple sclerosis patients diagnosed from April 2004 to November 2007 Distribución estacional y formas evolutivas de esclerosis múltiple en pacientes diagnosticados entre Abril del 2004 y Noviembre del 2007

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    Hermes Fundora-Hernández

    2009-09-01

    Full Text Available BACKGROUND: Multiple sclerosis (MS was first reported in Cuba in 1965. The most frequent appearance is observed in the first six months of the year. OBJECTIVE: To determine the seasonal distribution and evolving forms of MS patients diagnosed with the disease between April 2004 and November 2007. METHOD: Twenty-one patients with suspected MS and 42 outbreaks were studied. Patients were classified according to Lublin and Revingold's criteria for clinical forms and according to McDonald. RESULTS: Most patients were classified in outbreak and remission and only two patients classified as primary-progressive multiple sclerosis. The higher number of outbreaks occurred in the first two quarters of the year. CONCLUSION: It is recommended to study further weather variables that may be related to the emergence of these outbreaks in our environment.INTRODUCCIÓN: La esclerosis múltiple (EM fue reportada en Cuba por primera vez en 1965. Se ha venido observando la aparición más frecuente en los primeros seis meses del año. OBJETIVO: Determinar la distribución estacional y formas evolutivas de EM en pacientes con diagnóstico de esta enfermedad entre abril 2004 y noviembre 2007. MÉTODO: Se estudiaron 21 pacientes con sospecha de EM y un total de 42 brotes. Los pacientes fueron clasificados según los criterios de Lublin y Revingold para las formas evolutivas y según los criterios de McDonald. RESULTADOS: Solo dos pacientes clasificaron en la forma evolutiva progresiva primaria; los primeros dos trimestres del año fueron los de mayor número de brotes. CONCLUSIÓN: Se recomienda profundizar en las variables climatológicas que pudieran tener vínculo con la aparición de estos brotes en nuestro medio.

  4. Formas graves de retinopatia predizem aterosclerose subclínica em indivíduos com diabetes tipo 1

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    Fernando K. Almeida

    2011-10-01

    Full Text Available FUNDAMENTO: Em pacientes com diabetes tipo 2, a presença de retinopatia está associada a doença cardiovascular aumentada, independentemente dos fatores de risco conhecidos para a doença vascular. OBJETIVO: Investigar a associação da retinopatia diabética (RD e seus graus com a presença de aterosclerose coronariana subclínica em pacientes com diabetes tipo 1. MÉTODOS: Um estudo transversal foi conduzido com 150 pacientes com diabetes tipo 1, assintomáticos para doença arterial coronariana. Foram submetidos à avaliação clínica para verificar complicações microvasculares e avaliação para a presença de calcificação arterial coronariana (CAC. RESULTADOS: Formas graves de RD (RD grave não proliferativa - RDNP - e RD proliferativa - RDP foram associadas à CAC (RC: 3,98; IC de 95%; 1,13-13,9, p = 0,03, de maneira independente dos fatores de risco conhecidos para a doença cardiovascular (idade, A1C, hipertensão, dislipidemia e sexo masculino. CONCLUSÃO: Os pacientes com formas graves de RD estão em risco de presença de doença arterial coronariana, de maneira independente dos tradicionais fatores de risco cardiovascular.

  5. La investigación etnográfica en psicología evolutiva : una forma de abordar la relación entre mente y cultura

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    Palomares Varela, Manuel; Departamento de Interfacultativo de Psicología Evolutiva y de la Educación

    2007-01-01

    Este texto se presentó como comunicación al II Congreso Internacional de Etnografía y Educación: Migraciones y Ciudadanías. Universidad Autónoma de Barcelona, Barcelona, 5-8 Septiembre 2008. Buena parte de la psicología evolutiva y de la educación que conocemos en España ha sido elaborada desde paradigmas de investigación de corte positivista. Esto se debe por una parte a la concepción individualista que la psicología experimental ha contribuido a crear del individuo, y por otra, a la adop...

  6. Severe forms of neurocysticercosis: treatment with albendazole Formas graves da neurocisticercose: tratamento com albendazol

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    Svetlana Agapejev

    1996-03-01

    Full Text Available Study of 22 patients with the severe form of neurocysticercosis treated with albendazole (ABZ administered in 6 different schedules ranging from 15 to 30 mg/kg/day for 21 to 60 days. Dextrochloropheniramine and ketoprofen were the adjuvant drugs. Multiple symptoms were observed in 90.9% of patients. Intracranial hypertension was manifested in 90.9%. Hydrocephaly occurred in 86.4%. Evolution was satisfactory in 10 patients, 8 died and 4 had sequelae. Tomographic studies showed the appearance of an isolated IVth ventricle in 9 patients, after ventriculoperitoneal shunt, before ABZ treatment in 3 of them, during in 5 and after treatment in one. Median clinical follow-up duration was 10 months for the patients who died and 3-4 years for survivors. In 3 patients there was an increase in cyst size during the administration of the 15 mg/kg/day ABZ dose, which was not observed in any patient when the 30 mg/kg/day dose was used.Estudo de 22 doentes, com a forma grave de neurocisticercose, tratados com albendazol (ABZ, administrado em 6 diferentes esquemas, que variaram de 15 a 30 mg/kg/dia, durante 21 a 60 dias. A dextroclorofeniramina e o cetoprofeno foram as drogas coadjuvantes. Múltiplos sintomas ocorreram em 20 doentes. Hipertensão intracraniana foi manifestação mais comum em 20. Hidrocefalia foi detectada em 19. A evolução foi satisfatória em 45,4%, faleceram 36,4% e 18,2% ficaram com sequelas. Na evolução tomográfica apareceu IVº ventrículo isolado em 40,9%, após derivação ventriculoperitoneal, em 3 deles antes do tratamento com ABZ, em 5 durante e, em um, após o tratamento. A mediana estatística do período de seguimento clínico foi 10 meses para aqueles que faleceram e 3-4 anos para os sobreviventes. Em 3 doentes houve aumento no tamanho dos cistos durante a dose de 15 mg/kg/dia de ABZ, não observado na vigência de 30 mg/kg/dia.

  7. Changing trends in the treatment of Graves' disease with radioiodine: a 12-year experience in a university hospital; Mudancas evolutivas no tratamento da doenca de Graves com iodo radioativo: 12 anos de experiencia em um hospital universitario

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    Souza, Marcus Vinicius Leitao de [Instituto Estadual de Diabetes e Endocrinologia (IEDE), Rio de Janeiro, RJ (Brazil)], e-mail: marcusleitao@gmail.com; Souza, Honomar Ferreira de [Universidade Federal Fluminense (UFF), Niteroi, RJ (Brazil). Faculdade de Medicina. Dept. de Endocrinologia; Buescu, Alexandru; Vaisman, Mario [Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ (Brazil). Faculdade de Medicina. Dept. de Endocrinologia

    2009-03-15

    Objective: To evaluate the changes in clinical parameters and in the approach to patients submitted to radioiodine therapy for Graves' disease. Materials and methods: Dossiers of 226 patients submitted to radioiodine therapy for Graves' disease in the period between January 1990 and December 2001 were retrospectively evaluated. For the purposes of statistical analysis, the 12-year period was subdivided into three periods of 4 years, with a comparison of clinical and laboratory variables in these periods. Results: The authors have observed that the total number of patients referred for radioiodine therapy as well as the percentage of female patients presented a significant increase (from 62% to 86%; p = 0.005). The percentage of patients pretreated with methimazole before radioiodine therapy increased significantly (from 9.1% to 35.6%; p = 0.03). The mean radioiodine dose delivered has also presented a significant increase (from 7.6 mCi to 12.7 mCi; p = 0.000003) with a direct reflection on a higher percentage of patients cured one year after the radioiodine therapy (from 55.6% to 83.7%; p = 0.004). Conclusion: Radioiodine therapy has increasingly been accepted for treatment of patients with Graves' disease and the doses delivered have increased to achieve a permanent cure as well as a reduction of the chances of recurrence. (author)

  8. PESQUISA DE FORMAS EVOLUTIVAS DE PARASITAS CAUSADORES DE ZOONOSES EM TANQUES DE AREIA DE ESCOLAS PÚBLICAS DE EDUCAÇÃO INFANTIL DE ESPÍRITO SANTO DO PINHAL - SP

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    Patrícia Franciscone Mendes

    2012-06-01

    Full Text Available As escolas de ensino infantil comumente apresentam tanques de areia que são utilizados pelas crianças como área de lazer. Nestes locais, cães e gatos muitas vezes têm acesso e eliminam fezes contendo ovos e larvas de parasitas. Entre os parasitas encontrados nestas áreas destacam-se os do gênero Toxocara sp. e Ancylostoma sp., causadores de enfermidades conhecidas como larva migrans visceral e larva migrans cutânea, respectivamente. Este trabalho teve como objetivo pesquisar as formas evolutivas destes parasitas em tanques de areia de 16 escolas públicas de educação infantil de Espírito Santo do Pinhal - SP. Amostras de areia foram coletadas e analisadas quanto à presença de ovos e larvas infectantes empregando-se o Método de Baermann Modificado e o Método de Flutuação com Solução Saturada de Sacarose. Detectou-se a presença de ovos de Toxocara sp. em 14 escolas e larvas do mesmo parasita foram encontradas em 11 escolas. Em relação ao Ancylostoma sp., foram encontrados ovos em 1 escola e em 100% das escolas analisadas observou-se a presença de larvas do mesmo parasita. Conclui-se que estas áreas de lazer representam importantes focos de transmissão de doenças parasitárias. Entre as medidas preventivas, podem ser consideradas a instalação de cercas e a cobertura dos tanques com lona plástica. A conscientização da população sobre essas parasitoses representa um importante meio de profilaxia para redução e controle destas doenças.Schools of infantile teaching usually have sand used by children as playground. In these places, dogs and cats often have acess and eliminate feces containing parasite eggs and larvae. The most common parasites found in these areas are of the genus Ancylostoma sp. and Toxocara sp. which cause diseases known as visceral larva migrans and cutaneous larva migrans, respectively. This study aimed to investigate the evolutive types of these parasites in sand of 16 public schools of infantile

  9. Hipercalcemia grave como forma de apresentação de leucemia linfoblástica aguda em crianças

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    Andreia Luís Martins

    2015-12-01

    Full Text Available RESUMO A hipercalcemia é um distúrbio metabólico raro em pediatria, potencialmente fatal, apresentando um vasto diagnóstico diferencial, incluindo neoplasias. Relatamos aqui o caso de uma criança de 3 anos, previamente saudável, admitida no serviço de urgência por fadiga, hiporreatividade, febre e claudicação da marcha com 5 dias de evolução, de agravamento progressivo. À observação, apresentava-se inconsciente (escore de coma Glasgow: 8. Laboratorialmente, apresentava hipercalcemia grave (cálcio total 21,39mg/dL, ionizado 2,93mmol/L e anemia microcítica. Iniciou hiper-hidratação e foi transferido para a unidade de cuidados intensivos pediátricos. Instituiu-se hemodiafiltração venovenosa contínua com soluto livre de cálcio, ocorrendo a progressiva normalização da calcemia, com melhoria do estado de consciência. Administrou-se zolendronato. Excluíram-se causas metabólicas, infecciosas e intoxicação. O mielograma permitiu o diagnóstico de leucemia linfoblástica aguda. A hipercalcemia associada à malignidade em pediatria é rara, ocorrendo como forma de apresentação da neoplasia ou na recorrência desta. Em situações com risco de vida iminente, deve se considerar hemodiafiltração venovenosa contínua.

  10. Contribuição ao levantamento da carta planorbídica do Estado de São Paulo: Pesquisa de focos com formas evolutivas do Schistosoma mansoni. II. Município de Peruibe (Litoral Sul do Estado de São Paulo Contribution to the survey of the planorbid chart of the State of São Paulo (Brazil: Investigation of foci with evolutive forms of Schistosoma mansoni. II. Peruibe county (Southern coast of the State of São Paulo

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    Mário Demar Perez

    1969-12-01

    Full Text Available Em levantamento realizado em Peruibe, em janeiro de 1966, foram identificados focos de Biomphalaria tenagophila infestados com formas evolutivas do Schistosoma mansoni.In this work the occurence of Biomphalaria tenagophila naturally parasited by evolutive forms of Schistosoma mansoni is registered in the city of Peruibe, situated in the Southern Littoral of the State of São Paulo (Brazil. Besides B. tenagophila, in the region it occurs also Drepanotrema cimex, a species not proved to be a host of Schistosoma mansoni and whose occurence had not yet been recorded in Peruibe.

  11. Hipercalcemia grave como forma de apresentação de leucemia linfoblástica aguda em crianças

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    Andreia Luís Martins; Marta Moniz; Pedro Sampaio Nunes; Clara Abadesso; Helena Cristina Loureiro; Ximo Duarte; Helena Isabel Almeida

    2015-01-01

    RESUMO A hipercalcemia é um distúrbio metabólico raro em pediatria, potencialmente fatal, apresentando um vasto diagnóstico diferencial, incluindo neoplasias. Relatamos aqui o caso de uma criança de 3 anos, previamente saudável, admitida no serviço de urgência por fadiga, hiporreatividade, febre e claudicação da marcha com 5 dias de evolução, de agravamento progressivo. À observação, apresentava-se inconsciente (escore de coma Glasgow: 8). Laboratorialmente, apresentava hipercalcemia grave (c...

  12. Clinicopathological and immunohistochemical featuresof the severe pulmonary form of leptospirosis Aspectos clínico-patológicos e imuno-histoquímicosda forma pulmonar grave da leptospirose

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    João José Pereira da Silva

    2002-08-01

    Full Text Available Four cases of severe pulmonary form of leptospirosis (SPFL are described. In all four of these blood culture proven cases, there was severe pulmonary injury characterized by alveolar hemorrhage and acute respiratory failure. Three patients died in less than 48 hours after onset of the first respiratory signs. Leptospiral antigen detection in lung tissues was positive by immunoperoxidase in all three of these cases, suggesting that the microorganism exerts a local direct destructive action. Patients with SPFL should be carefully monitored, as the abrupt onset of severe alveolar hemorrhage can lead to respiratory insufficiency and death. The authors emphasize the importance of radiological findings and blood gas analysis for prompt clinical diagnosis, and suggest that corticosteroids, associated with antibiotics, early respiratory support, and platelet transfusions are useful as an attempt to prevent further development of SPFL.São descritos quatro casos da forma pulmonar grave da leptospirose (FPGL. Nestes quatro casos confirmados por hemocultura, observou-se grave acometimento pulmonar, caracterizado por hemorragia alveolar e insuficiência respiratória aguda. Três pacientes evoluíram para o óbito em menos de 48 horas após a instalação do quadro respiratório. A detecção por imunoperoxidase de antígenos de leptospira no tecido pulmonar foi positiva nestes três pacientes, sugerindo ação lesiva direta deste microrganismo. Os autores destacam a importância do diagnóstico clínico precoce, baseado nos achados radiológicos e de gasometria arterial, e sugerem que os corticosteróides, associados à antibioterapia, à assistência ventilatória precoce e à transfusão de plaquetas, são úteis na tentativa de impedir a instalação de grave hemorragia alveolar seguida de insuficiência respiratória e morte.

  13. Formas graves de retinopatia predizem aterosclerose subclínica em indivíduos com diabetes tipo 1 Severe forms of retinopathy predict the presence of subclinical atherosclerosis in type 1 diabetes subjects

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    Fernando K. Almeida

    2011-10-01

    Full Text Available FUNDAMENTO: Em pacientes com diabetes tipo 2, a presença de retinopatia está associada a doença cardiovascular aumentada, independentemente dos fatores de risco conhecidos para a doença vascular. OBJETIVO: Investigar a associação da retinopatia diabética (RD e seus graus com a presença de aterosclerose coronariana subclínica em pacientes com diabetes tipo 1. MÉTODOS: Um estudo transversal foi conduzido com 150 pacientes com diabetes tipo 1, assintomáticos para doença arterial coronariana. Foram submetidos à avaliação clínica para verificar complicações microvasculares e avaliação para a presença de calcificação arterial coronariana (CAC. RESULTADOS: Formas graves de RD (RD grave não proliferativa - RDNP - e RD proliferativa - RDP foram associadas à CAC (RC: 3,98; IC de 95%; 1,13-13,9, p = 0,03, de maneira independente dos fatores de risco conhecidos para a doença cardiovascular (idade, A1C, hipertensão, dislipidemia e sexo masculino. CONCLUSÃO: Os pacientes com formas graves de RD estão em risco de presença de doença arterial coronariana, de maneira independente dos tradicionais fatores de risco cardiovascular.BACKGROUND: In patients with type 2 diabetes, the presence of retinopathy is associated with increased cardiovascular disease, regardless of known risk factors for vascular disease. OBJECTIVE: To investigate the association of diabetic retinopathy (DR and its grades with the presence of subclinical coronary atherosclerosis in patients with type 1 diabetes. METHODS: A cross-sectional study was conducted with 150 type 1 diabetes individuals asymptomatic for coronary artery disease. They underwent clinical evaluation for microvascular complications and for the presence of coronary artery calcification (CAC. RESULTS: Severe forms of DR (severe non-proliferative DR and proliferative DR were associated with CAC (OR: 3.98 95% CI 1.13-13.9, p = 0.03, regardless of known risk factors for cardiovascular disease (age, A

  14. PAX9 : uma ferramenta evolutiva?

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    Vanessa Rodrigues Paixão Côrtes

    2008-01-01

    Um dos maiores objetivos na ciência atual é poder relacionar alterações nos genes a mudanças nas morfologias de organismos multicelulares. Além disso, é importante poder determinar se estas modificações foram obras do acaso ou se a seleção natural teve um papel central moldando a forma e o tamanho das criaturas vivas. A busca por nutrientes e sua utilização é uma das questões mais básicas para a sobrevivência de uma espécie. Em mamíferos a diversificação e especialização dos dentes para tritu...

  15. [Graves' ophthalmopathy].

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    Badelon, Isabelle; Morax, Serge

    2005-01-31

    Graves' ophthalmopathy (GO) is a chronic autoimmune process that affects the retrobulbar tissue and has strong etiological links with graves' disease. Pathogenesis is incompletely understood. Symptoms include proptosis, extraocular muscle dysfunction, eyelid swelling and retraction. In its severe expression, it is a disfiguring and potentially sight threatening disease that profoundly influences and impairs the quality of life of affected individuals. Only a minority of patients develop severe expressions of the disease, requiring aggressive treatments. Glucocorticoids, orbital radiotherapy and decompressive orbital surgery represent a mainstay and a well established treatment for severe and active GO.

  16. [Graves' ophthalmopathy].

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    Eckstein, A; Dekowski, D; Führer-Sakel, D; Berchner-Pfannschmidt, U; Esser, J

    2016-04-01

    Graves' orbitopathy (GO) is the main extrathyroidal manifestation of Graves' disease and the full clinical picture can impair the quality of life of the patients considerably. Active inflammation can often be effectively treated by intravenous steroids/immunosuppression, however does not lead to full remission, since inflammation rather quickly results in irreversible fibrosis and increase of orbital fat. Very important is the control of risk factors (smoking cessation, good control of thyroid function, selenium supplementation) to prevent progression to severe stages. Treatment should rely on a thorough assessment of activity and severity of GO. Rehabilitative surgery (orbital decompression, squint surgery, eyelid surgery) is needed in many patients to restore function and appearance. Anti-thyroid-stimulating hormone (TSH) receptor antibodies do specifically occur in these patients and correlate to the course of thyroid and eye disease. The levels of these antibodies can be used for treatment decisions at certain time points of the disease.

  17. Fisiopatologia da asma grave

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    Todo-Bom, Ana; Mota-Pinto, Anabela

    2006-01-01

    Não tem resumo. Transcreve-se o primeiro parágrafo: A história natural da asma e os condicionalismos de uma evolução para formas moderadas ou graves não está completamente estabelecida. Contudo, quer os factores genéticos quer os factores ambientais, serão determinantes na fisiopatologia e no prognóstico da doença. A asma é, por definição, uma doença inflamatória crónica das vias aéreas caracterizada por uma obstrução brônquica generalizada mas variável que é, pelo menos parcialmente, reve...

  18. Simbiosis: Consideraciones terminológicas y evolutivas

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    Luko Hilje

    2016-01-01

    Se redefinen los tipos de asociaciones simbióticas más conocidas, a partir de consideraciones sobre su significado conceptual y biológico. Se plantea un esquema preliminar de clasificación, con dos categorías de simbiosis: recíproca y antagónica. La primera muestra una sola línea evolutiva, tendiente a mayor especificidad entre los organismos asociados, e  incluye al comensalismo, protocooperación y mutualismo. La segunda muestra tres líneas evolutivas separadas, con diferentes grados de espe...

  19. Multiple sclerosis outcome and morbi-mortality of a Brazilian cohort patients Caracteristicas clínico-evolutivas e morbi-mortalidade de uma coorte de pacientes brasileiros com esclerose múltipla

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    Soniza Vieira Alves-Leon

    2008-01-01

    Full Text Available We studied the clinical and evolution characteristics of multiple sclerosis (MS patients followed since the onset of HUCFF/UFRJ in 1978. The diagnosis of MS was based on Poser's et al. and MC Donald's et al. criteria. From 188 patients, 122 were included. Eighty-five were females. The mean age onset was 32.2 years-old (range 6.0 to 61.0±10.3, mainly Caucasians (82/67%. The relapsing-remitting course (MSRR was more frequent (106/86.8%. Monosymptomatic onset was significantly more frequent in Caucasians than in Afro-Brazilians (pEstudamos as características clínico-evolutivas de pacientes com esclerose múltipla (EM acompanhados no HUCFF-UFRJ desde 1978. Foram usados critérios de Poser et al. e MC Donald et al. para o diagnóstico de EM. De 188, 122 foram incluídos. Oitenta e cinco eram mulheres. A média de idade de início foi 32,2 anos (6,0-61,0±10,3, predominando caucasianos (n=82/67%. A forma recorrente-remitente (EMRR foi mais freqüente (n=106/86,8%. Formas mono-sintomáticas no primeiro surto foram significativamente mais freqüentes em caucasianos do que em afro-brasileiros (p<0,05. Dezessete pacientes apresentavam a forma benigna (13,9% e 43 a grave (35,2%. A forma benigna foi associada com a EMRR (p=0,01. A taxa de letalidade 2,12% (4 óbitos. Nossos resultados são semelhantes aos de outras séries brasileiras no que se refere ao sexo e idade, e falta de correlação entre EDSS e número de surtos; confirmamos gradiente sul-sudeste de distribuição afro-descendente, associação significativa entre primeiro surto mono-sintomático e caucasianos e menor freqüência de formas benignas.

  20. Crecimiento y desarrollo: una perspectiva evolutiva

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    Goikoetxea Zabaleta, I.

    2011-01-01

    Full Text Available El estudio del patrón de crecimiento y desarrollo en las distintas especies fósiles del linaje humano permite interpretar de forma correcta el modelo de historia biológica de los individuos adultos e inmaduros y, además, ayuda a los investigadores a comprender mejor la evolución de nuestra especie. Los patrones de crecimiento y desarrollo de los humanos actuales y de los chimpancés son los que a día de hoy mejor se conocen y por eso son usados como modelos. Los restos de los individuos inmaduros del registro fósil contienen información que permite hipotetizar sobre estos patrones a lo largo de la evolución humana. En este trabajo se reúnen datos de individuos subadultos del registro fósil y se realiza una puesta al día sobre las hipótesis que hasta ahora se han propuesto para el patrón de crecimiento y desarrollo de las especies de los géneros Australopithecus, Paranthropus y Homo.

  1. Critical Clinical forms of influenza AH1N1: What we have learned from assisting the ill in Cienfuegos. Formas clínicas graves de la influenza AH1N1: Lo que hemos aprendido de la atención a estos enfermos en Cienfuegos

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    Grupo Operativo Provincial de Atención Médica a los enfermos adultos hospitalizados

    2009-11-01

    Full Text Available We currently possess a growing information level on the effects of the influenza AH1N1epidemics in a range of countries in the world. Much of that information refers to statistical data and recommendations for dealing with it. Concerning the clinics of the infected, the existence of groups presenting risks of complications has been repeatedly noted in the international literature, as well as critical clinical findings, with unusual manifestations in other epidemics caused by influenza viruses. To that effect, an approach to characterize various clinical-radiological forms of that entity, as well as serious complication risk groups, may help in the early diagnose and appropriate treatment, which, undoubtedly, along with keeping preventive measures, constitute the best form of assisting the ill in the epidemic phase.
    Actualmente se cuenta con una información cada vez más abundante sobre la afectación de la epidemia de influenza A H1N1, en diversas regiones del mundo. Mucha de ella, se refiere a datos estadísticos y a recomendaciones para su enfrentamiento. En relación con la clínica de los enfermos, se ha notificado reiteradamente, en la literatura internacional, la existencia de grupos de riesgo de complicaciones, así como la presentación de cuadros clínicos graves, con manifestaciones clínicas no habituales en otras epidemias ocasionadas por los virus de la influenza. En ese sentido, una aproximación a caracterizar varias formas clínico-radiológicas de presentación de esta entidad, así como los grupos de riesgo de complicaciones graves, puede ayudar en el diagnóstico precoz y el tratamiento oportuno, que, sin dudas, junto al mantenimiento de las importantes medidas preventivas, constituyen el mejor abordaje de la asistencia a los enfermos, en la fase de la epidemia.

  2. Esquistossomose na área hiperendêmica de Taquarendi: I Infecção pelo Schistosoma mansoni e formas graves Schistosomiasis in hyperendemic area of Taquarendi: I- Schistosoma mansoni infection and severe clinical forms

    Directory of Open Access Journals (Sweden)

    José Carlos Bina

    2003-04-01

    Full Text Available A localidade de Taquarendi (Bahia está situada em zona de caatinga, porém com pequena faixa de terra irrigada, onde se encontram caramujos Biomphalaria glabrata. Dos 1.532 habitantes, 1.105 (72,1% submeteram-se ao exame clínico e, destes, 1.058 (95,7% fizeram exame parasitológico de fezes. A prevalência da esquistossomose foi de 73,1%, sendo que 16,2% destes eliminavam mais de 1.000 ovos por grama de fezes. O exame clínico mostrou que o lobo esquerdo do f��gado estava aumentado e/ou endurecido em 54% dos pacientes e o baço foi palpado em 21,8%. Foram classificados como hepatosplênicas 9,8% dos examinados e como portadores da forma hepatintestinal avançada 3,7%. Houve relação direta entre estas formas clínicas da doença e a intensidade da carga parasitária acima de 1.000 ovos de S. mansoni por grama de fezes.The study was carried out in Taquarendi (Bahia, a caatinga zone with a small irrigated strip of land, where Biomphalaria glabrata snails are found. From the 1,532 inhabitants, 1,105 (72.1% were submitted to clinical examination and 1058 out of them (95.7% made stool examinations. Prevalence of schistosomiasis was 73.1% and 16.2% of these patients eliminated more than 1,000 eggs per gram of stool. By clinical examination, the size and the consistency of the left liver lobe were increased in 54% of the individuals and the spleen was palpable in 21.8%. The diagnosis of hepatosplenomegaly and of the advanced hepatointestinal clinical form was made, respectively, in 9.8% and 3.7%. A direct relationship between such clinical forms of the disease and the worm load over 1.000 S. mansoni eggs/g of fezes was found.

  3. A ABORDAGEM DO PLURALISMO DE PROCESSOS E DA EVO-DEVO EM LIVROS DIDÁTICOS DE BIOLOGIA EVOLUTIVA E ZOOLOGIA DE VERTEBRADOS

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    Wellington Bittencourt-dos-Santos

    Full Text Available Este artigo relata os resultados de uma análise de conteúdo comparativa de três livros didáticos de biologia evolutiva e três livros didáticos de zoologia de vertebrados, muito adotados nos cursos de formação superior de biologia de diversas universidades de países de línguas latinas e anglosaxônicas. Usando técnicas de análise de conteúdo, realizamos uma análise documental quali-quantitativa dos livros, com o objetivo de investigar a abordagem e recontextualização de conteúdos relativos à biologia evolutiva do desenvolvimento (evo-devo e ao pluralismo de processos. Os nossos achados indicam que, nos livros de ambas as disciplinas, a recontextualização dos conteúdos vinculados ao pluralismo de processos ainda está em fase inicial, ainda que num estágio mais avançado nos livros de biologia evolutiva. Quanto aos conteúdos de evo-devo, a recontextualização já teve lugar de modo mais extensivo, particularmente nos livros de zoologia de vertebrados. Estes resultados mostram diferenças na construção do discurso pedagógico relacionadas com a estrutura do conhecimento acadêmico e os alvos da pesquisa nestas duas disciplinas.

  4. Um exame histórico-filosófico da biologia evolutiva do desenvolvimento

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    Ana Maria Rocha de Almeida

    2010-03-01

    Full Text Available O desenvolvimento tem papel central na compreensão da evolução dos organismos multicelulares, dado que é o processo que resulta na produção da forma orgânica adulta. Logo, toda inovação morfológica deve ser também o resultado de modificações no desenvolvimento. Entretanto, a biologia do desenvolvimento permaneceu à margem da síntese evolutiva e o desenvolvimento foi tratado por muito tempo como uma caixa preta entre o genótipo e o fenótipo. Somente a partir dos anos 1980, foi dada mais atenção ao papel do desenvolvimento na evolução, resultando daí avanços teóricos e empíricos inesperados. Tais avanços resultaram na emergência de um novo campo de investigação, a biologia evolutiva do desenvolvimento (evo-devo, que vem cumprindo papel importante na construção de uma nova compreensão da evolução das formas orgânicas. Argumentamos que este campo tem papel central em uma "nova síntese evolutiva", atualmente em construção, que está comprometida com um "pluralismo de processos", ou seja, com a ideia de que não somente a seleção natural, mas também diversos outros mecanismos têm papel causal e explicativo na evolução biológica. A partir da discussão de algumas dicotomias clássicas no pensamento evolutivo, principalmente aquelas entre estruturalismo e funcionalismo e entre processos transformacionais e variacionais, buscamos situar a evo-devo no panorama do pensamento evolutivo contemporâneo.Development has a central role in the understanding of the evolution of multi-cellular organisms mainly because it is the process that results in the adult organic form. Therefore, every morphological innovation is also a result of changes in development. However, developmental biology remained at the margin of the modern evolutionary synthesis and development has been treated for a long time as a black-box between genotype and phenotype. Only at the beginning of 1980s, the role of development received more attention

  5. Graves disease (image)

    Science.gov (United States)

    Graves disease is an autoimmune disorder that involves overactivity of the thyroid gland (hyperthyroidism). Hallmarks of the condition are bulging eyes (exophthalmos), heat intolerance, increased energy, difficulty sleeping, diarrhea, and anxiety.

  6. Graves' ophthalmopathy: interdisciplinary approach

    Directory of Open Access Journals (Sweden)

    O I Vinogradskaya

    2010-12-01

    Full Text Available Graves' ophthalmopathy constitutes a major therapeutic challenge, so specialists of various disci-plines have to combine their forces. According to the last consensus of EUGOGO (European Group On Graves' Orbitopathy the treatment of choice for Graves' ophthalmopathy is pulses of glucocorticoid (GC. Evidence for the superiority of any of the different intravenous (iv glucocorticoid schedules is lacking. Objective: to evaluate the efficacy of two different methylprednisolone pulse therapy schedules in Graves' ophthalmopathy. Materials and Methods: 30 Graves' patients with Graves' ophthalmopathy were subcategorized into two groups: Group A subjects (n = 14 were given iv glucocorticoid daily for 5 days (total 5 g and Group B patients (n = 16 were given iv glucocorticoid weekly for 5 weeks (total 5 g. All patients were examined by the ophthalmologist before and in 1 and 12 weeks after the treatment. Results: We found that in group A visual acuity was significantly higher than in group B at 12 weeks. By 12 week proptosis, diplopia had improved as well as CAS had fallen in two groups but there were no significant differences between the two groups. Conclusion: Both schedules are effective on proptosis, soft tissue swelling. Daily pulse therapy appeared to be more effective on visual acuity. Thereby in case of active Graves' ophthalmopathy associated with impairment of visual acuity, daily pulse therapy is a treatment of choice. But, in spite of improvement, strabismus, diplopia, proptosis have a marked negative effect on quality of life, disturb a lifestyle. In these cases surgery should be considered. After end of our research two patients (3 orbits had bone decompression with a good result. We consider that eye muscle surgery is next needed to restore their binocular vision.

  7. Modeling Graves' Orbitopathy in Experimental Graves' Disease.

    Science.gov (United States)

    Banga, J P; Moshkelgosha, S; Berchner-Pfannschmidt, U; Eckstein, A

    2015-09-01

    Graves' orbitopathy (GO), also known as thyroid eye disease is an inflammatory disease of the orbital tissue of the eye that arises as a consequence of autoimmune thyroid disease. The central feature of the disease is the production of antibodies to the thyrotropin hormone receptor (TSHR) that modulate the function of the receptor leading to autoimmune hyperthyroidism and GO. Over the years, all viable preclinical models of Graves' disease have been incomplete and singularly failed to progress in the treatment of orbital complications. A new mouse model of GO based upon immunogenic presentation of human TSHR A-subunit plasmid by close field electroporation is shown to lead to induction of prolonged functional antibodies to TSHR resulting in chronic disease with subsequent progression to GO. The stable preclinical GO model exhibited pathologies reminiscent of human disease characterized by orbital remodeling by inflammation and adipogenesis. Inflammatory lesions characterized by CD3+ T cells and macrophages were localized in the orbital muscle tissue. This was accompanied by extensive adipogenesis of orbital fat in some immune animals. Surprisingly, other signs of orbital involvement were reminiscent of eyelid inflammation involving chemosis, with dilated and congested orbital blood vessels. More recently, the model is replicated in the author's independent laboratories. The pre-clinical model will provide the basis to study the pathogenic and regulatory roles of immune T and B cells and their subpopulations to understand the initiation, pathophysiology, and progression of GO.

  8. Una mirada crítica a la psicología evolutiva

    OpenAIRE

    Tineo Deffitt, Evelina

    2007-01-01

    Basada en una investigación documental, este trabajo tiene como objetivo analizar las implicaciones de la investigación tradicional de la psicología evolutiva, enmarcada fundamentalmente, en el paradigma positivista.

  9. Una mirada crítica a la psicología evolutiva

    OpenAIRE

    Tineo Deffitt, Evelina

    2007-01-01

    Basada en una investigación documental, este trabajo tiene como objetivo analizar las implicaciones de la investigación tradicional de la psicología evolutiva, enmarcada fundamentalmente, en el paradigma positivista.

  10. A forma pseudomiopática tardia da atrofia muscular progressiva heredo-familial

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    Nunjo Finkel

    1962-12-01

    Full Text Available Sob o rótulo de "forma pseudomiopática tardia da atrofia muscular progressiva heredo-familial" são relatados 4 casos exibindo características clínico-evolutivas similares. A análise genética levou a admitir, para a enfermidade, um tipo de herança recessiva simples.

  11. Graves orbitopathy: a perspective.

    Science.gov (United States)

    Perros, Petros; Krassas, Gerasimos E

    2009-06-01

    Advances in the past few years have helped clinicians understand some of the pathogenetic mechanisms of Graves orbitopathy (GO), particularly the role of receptors for TSH and insulin-like growth factor I in the orbit. Optimal treatment strategies have been formulated and published by the European Group on Graves' Orbitopathy, which are hoped to improve the management of patients with this condition. The administration of intravenous pulses of steroids has been established as a superior treatment approach compared with other steroid regimens. In addition, orbital radiotherapy was effective in a subgroup of patients with GO who had eye dysmotility. The use of immunotherapies for the treatment of GO is currently being explored; of these, rituximab has emerged as a promising new agent.

  12. Højfolkets Grave

    DEFF Research Database (Denmark)

    2007-01-01

    For the special exhibition 'Højfolkets Grave - Oak Coffins from Borum Eshøj' on Moesgaard Museum in 2007: The development of 3D graphics which was displayed on a big screen in the exhibition. The animation shows - in a very stylistic way - the design principles behind the construction of Bronze Age...... burial mounds, based on the excavation results from the mound Skelhøj....

  13. Digging One's Own Grave

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    Arvo Krikmann

    2007-01-01

    Full Text Available The paper aims to demonstrate that some points in the explicationof the figurative expression digging one’s own grave via the concept of blending given by Gilles Fauconnier and Mark Turner are problematic: (1 Not understanding the consequences of one’s deeds is an almost universal presuppositionof and impulse or motivation for actualizing any utterance with a forewarning or gloating content (e.g., proverbs, not the singularity characterizing just the expression of grave-digging as such. (2 The inversion of causal and temporal structure is not the case because of metonymic association between the concepts of the grave and death, as a result of which specific causal and temporal order loses any significance. Many synonymous examples can be given in which the image refers to events before the death, between the death and funeral, as well as those after burial. (3 The source domain needs not to be restricted to natural death and modern civilized funerals but should include also the cases of violent deaths, e.g., the scenario of execution and the scenario of hunting and trapping. Preliminarily, a very brief synopsis of the main phases of development of cognitive linguistic theory of metaphor and some favourite examples of blends, used also in previous works, is provided.

  14. Fundamentos neuropsicológicos de la dislexia evolutiva

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    Jorge Alfredo Herrera Pino

    2007-01-01

    Full Text Available El siguiente artículo enmarca los principios de la neuropsicología de la dislexia evolutiva y realiza un recorrido desde su evolución histórica, en cuanto a su definición, hasta sus síntomas más característicos en los sujetos que la padecen. La dislexia se conoce como una alteración de la capacidad para aprender a leer que afecta un buen porcentaje de la población escolarizada. La dificultad se debe principalmente a una deficiencia en el desarrollo del lenguaje que se ve manifestado en sus síntomas iniciales en un retraso significativo del desarrollo de la conciencia fonológica que viene a ser un buen predictor de dicha alteración Mediante la revisión realizada para este artículo se da explicación al trastorno disléxico desde la neuropsicología, la que se ha encargado de exponer las características desde la relación cerebro-conducta y, además de la localización cerebral de la alteración, las perturbaciones visuales y auditivas y de las otras variables intervinientes en la aparición del trastorno como la genética y, más propiamente, la herencia. Por último, a manera de conclusión, se espera que con este artículo se abran nuevas líneas de investigación para el estudio del tema y contribuya al planteamiento de nuevas hipótesis sobre la neuropsicología de la dislexia.

  15. Estudios sobre la variación estructural de la sinflorescencia en el género Axonopus (Poaceae, Panicoideae, Paniceae: tipología y tendencias evolutivas

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    Diego Giraldo Cañas

    2000-01-01

    Full Text Available Giraldo-Cañas, D. 2000. Estudios sobre la variación estructural de la sinflorescencia en elgénero Axonopus (Poaceae, Panicoideae, Paniceae: tipología y tendencias evolutivas. Darwiniana 38(3-4: 209-218.Se estudió la tipología de la sinflorescencia del género neotropical Axonopus P. Beauv. utilizando lametodología y terminología de la escuela de Troll. Se analizaron representantes de 52 de las ca. 75 especiesdel género. En todas las especies la sinflorescencia es politélica y truncada. De acuerdo con este estudio,la unidad de floración plesiomórfica se encuentra en la serie Barbigeri G. A. Black. La sinflorescencia deAxonopus pudo derivarse de una forma ancestral a través de los siguientes pasos: 1.- truncamiento del ejeprincipal; 2.- homogeneización completa; 3.- reducción de los paracladios cortos; 4.- disminución delnúmero de paracladios largos y 5.- truncamiento de los paracladios largos. Se discuten las relacionesmorfológicas y se comentan algunas posibles tendencias evolutivas.

  16. Thymic hyperplasia in Graves' disease.

    Science.gov (United States)

    Kotwal, Narendra; Singh, Yashpal; Menon, Anil; Behera, Vineet

    2013-05-01

    Graves' disease is an autoimmune thyroid condition characterized by the production of autoantibodies against the thyrotropin receptor. It is known to be associated with autoimmune conditions such as myasthenia gravis, Addison's disease, type 1 diabetes mellitus, and vitiligo. We present a case of rare autoimmune association of Graves' disease with thymic hyperplasia which regressed after treatment with antithyroid drugs. Exact pathophysiology of thymic hyperplasia in Graves' is not well understood; it is likely to be the result of rather than the cause of Graves' disease.

  17. Esclerodermia, tireoidite e miastenia grave: estudo de um caso

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    Antonio L. dos Santos Werneck

    1993-11-01

    Full Text Available Uma paciente de 36 anos com miastenia grave desenvolveu após dois anos intolerância ao frio, o que conduziu ao diagnóstico de tireoidite de Hashimoto. Quatro anos mais tarde apresentou pele espessada nas mãos (esclerodermia limitada. O quadro clínico e os exames complementares encaminharam o diagnóstico para a forma CREST de esclerodermia sistêmica progressiva. Discute-se a dificuldade diagnóstica da esclerodermia, assim como suas síndromes de superposição. Doença de Hashimoto e miastenia grave constituem associação pouco frequente. A presença de esclerodermia e miastenia grave é rara. Não encontramos na literatura a coincidência destas três doenças.

  18. Mass Graves, Landscapes of Terror

    Directory of Open Access Journals (Sweden)

    Ferrándiz, Francisco

    2009-06-01

    Full Text Available The recent exhumation of mass graves from the Spanish Civil War and the Post-War years, mostly involving the largely abandoned graves of the Francoist rearguard, have become a central element in contemporary debates about the conflict and the regime following it. In this paper, the complexity and dynamism of this process is analysed, including from political and legal initiatives of great social and media impact to local actions on the ground, at times failed, ephemeral or almost imperceptible, but no less crucial. From the point of view of many of the people involved in the pro-exhumation associations, opening up the graves is part of a basic exercise in justice and ‘dignification’, showing the scope and systematic nature of repression while reverting the ‘infrahuman’ disposition of the executed corpses, a feeling crystallised in the common expression ‘thrown’ or ‘buried like dogs’, used very often to justify the need of carrying out exhumations. Politics of dignification and ‘rehumanization’ of these ‘incorrectly’ buried bodies are incorporating, in the last few months, elements drawn from international law, such as the concept of ‘crimes against humanity’.

    Las exhumaciones de fosas comunes de la Guerra Civil española y la posguerra de la última década, muy especialmente de fosas abandonadas de la retaguardia franquista, se han colocado en un lugar central de los debates contemporáneos sobre la naturaleza y alcance de la contienda y el régimen que surgió de ella. En este artículo, se analiza la complejidad y dinamismo del proceso, que incluye desde iniciativas políticas y judiciales de enorme proyección pública y mediática, como la Ley de la Memoria o el controvertido auto de Garzón sobre los crímenes del franquismo, hasta acciones locales a veces fallidas, imperceptibles o efímeras, pero no menos cruciales. Desde el punto de vista de muchos de los actores sociales implicados en las exhumaciones

  19. Diversificación craneofacial e integración evolutiva en poblaciones sudamericanas

    OpenAIRE

    2007-01-01

    El estudio de la integración morfológica tiene gran importancia para comprender los patrones y procesos de evolución morfológica. Las poblaciones del sur de Sudamerica representan un interesante caso para el estudio de la integración evolutiva debido a que las mismas han alcanzado una gran diversidad morfológica. El objetivo de esta ponencia es presentar los resultados del análisis de la variación craneofacial y la integración evolutiva en poblaciones humanas de esta región. Se definieron com...

  20. Pathophysiology of Graves' ophthalmopathy.

    Science.gov (United States)

    Stiebel-Kalish, Hadas; Robenshtok, Eyal; Gaton, Dan D

    2010-03-01

    Pathohistological characteristics of Graves' ophthalmopathy (GO) include glycosaminoglycan deposition in the orbit, active inflammatory process, fibrosis of the extra-ocular muscles and fat accumulation within the orbit. These processes lead to the clinical manifestations of proptosis, chemosis, periorbital edema, and altered ocular motility. Current evidence demonstrates that GO is not a result of hyperthyroidism but rather represents a second target of the underlying autoimmune process. The candidate orbital autoantigens and the cells involved in the development and progression of GO are reviewed. The initiation and propagation of the autoimmune process against such antigens involves a complex action of lymphocytes and auto-antibodies. At least three cell types are involved in the unique remodeling of orbital tissues of GO patients: T cells, orbital fibroblasts, and B cells through the production of autoantibodies. These are further discussed in this review. In Graves' hyperthyroidism, autoantibodies to TSH receptors (TSH-R) may affect thyroid function by stimulating TSH-R, promoting excessive thyroid growth, hormone production and secretion receptor which stimulates TSH receptor mRNA and expression. The correlation of TSH-Abs levels with GO activity is used clinically as a marker of disease activity, to aid prediction of the disease course, and to support GO diagnosis in patients with no clinically significant thyroid disease. Several future specific therapies under investigation are mentioned. These are aimed against the autoantibodies, the orbital fibroblasts or the peroxisome proliferator-activated receptor gamma (PPARgamma), which regulates fatty acid storage and glucose metabolism.

  1. Osteologia de Melanosuchus niger (Crocodylia: Alligatoridae e a evidência evolutiva

    Directory of Open Access Journals (Sweden)

    Lucélia G. Vieira

    Full Text Available RESUMO: O objetivo foi realizar a descrição anatômica do esqueleto de Melanosuchus niger, com o intuito de contribuir com informações evolutivas sobre a espécie. Utilizaram-se três espécimes adultos de M. niger, com comprimento médio de 2,40m, provenientes da coleção biológica do Lapas-UFU. Na cintura peitoral, a escápula é maior do que o coracóide. Já nos elementos da cintura pelvina, o púbis não participa da formação do acetábulo, o contato com o ilío, ocorre por ligamentos, e sua articulação com o ísquio, permite movimentos dorso-ventrais. Nos membros torácicos, o úmero figura como elemento do estilopódio, a ulna e rádio como elementos do zeugopódio. No carpo há o ulnar do carpo, fusão do radial+intermédio, fusão dos distais do carpo 3+4+5 e o pisiforme; possui cinco metacarpos, numerados lateromedialmente e a fórmula falângica 2:3:4:3:2. Nos membros pelvinos, o estilopódio é formado pelo fêmur e o zeugopódio pela tíbia e fíbula. No tarso há a fusão do intermédio+central, fibular do tarso, distal do tarso 3, distal do tarso 4; possui quatro metatarsos longos I, II, III e IV, sendo os metatarsos II e III maiores que os demais. O metatarso V é um osso bastante reduzido e o pé possui a fórmula falângica 2:3:4:4. No crânio, a abertura nasal é única, o palatino, vômer, pterigóide, pré-maxila e maxila formam a estrutura óssea do palato secundário; o osso parietal é o único elemento no teto craniano. No esqueleto pós- axial em pares de costelas distintas que se articulam com as vértebras cervicais, dorsais, lombares, sacrais e caudais. A gastrália é formada por sete fileiras de ossos finos localizados entre o púbis e a região caudal do esterno.

  2. [Radiotherapy for Graves' ophthalmopathy].

    Science.gov (United States)

    Kuhnt, T; Müller, A C; Janich, M; Gerlach, R; Hädecke, J; Duncker, G I W; Dunst, J

    2004-11-01

    Graves' ophthalmopathy (GO) is the most frequent extrathyroidal manifestation of Graves' disease, an autoimmune disorder of the thyroid, whereas the precise pathogenesis still remains unclear. In Hashimoto's thyroiditis the occurrence of proptosis is an extremely rare event. The therapy for middle and severe courses of GO shows in partly disappointing results, although several therapy modalities are possible (glucocorticoid therapy, radiotherapy, antithyroid drug treatment, surgery). All these therapies lead in only 40 - 70 % to an improvement of the pathogenic symptoms. An intensive interdisciplinary cooperation is necessary to satisfy the requirements for the treatment of Graves' ophthalmopathy. As a consequence of the very different results of the few of clinical studies that were accomplished with reference to this topic, treatment by radiotherapy in the management of the disease is presently controversially discussed. In the German-speaking countries the radiotherapy is, however, firmly established as a therapy option in the treatment of the moderate disease classes (class 2-5 according to NO SPECS), especially if diplopia is present. This article describes the sequences, dosages and fractionation schemes as well as the risks and side effects of the radiotherapy. Altogether, radiotherapy is assessed as an effective and sure method. The administration of glucocorticoids can take place before the beginning of or during the radiotherapy. For the success of treatment the correct selection of patients who may possibly profit from a radiotherapy is absolutely essential. By realising that GO proceeds normally over a period of 2-5 years, which is followed by a period of fibrotic alteration, the application of the radiotherapy in the early, active phase is indispensable. A precise explanation for the effects of radiotherapy in treatment of the GO does not exist at present. The determination of the most effective irradiation doses was made from retrospectively evaluated

  3. Epidemiology of Graves' orbitopathy.

    Science.gov (United States)

    Putta-Manohar, Sudeep; Perros, Petros

    2010-03-01

    Thyroid orbitopathy is a relatively rare disease. Prevalence data are lacking and can only be estimated. The incidence of thyroid orbitopathy has been documented in one American study (16 cases per 100,000 population per year for females and 2.9 cases per 100,000 population for males). Thyroid orbitopathy can affect every race and age group. The majority of patients present in middle age with concurrent thyrotoxicosis due to Graves' disease. The onset of orbitopathy usually coincides with the hyperthyroidism, though the two may be asynchronous by months or sometimes years. A small proportion of patients with thyroid orbitopathy have primary hypothyroidism or are euthyroid. Female patients outnumber males by 2-5 to 1. Smoking increases the risk of thyroid orbitopathy up to 8-fold.

  4. Hashimoto's thyroiditis following Graves' disease.

    Science.gov (United States)

    Umar, Husaini; Muallima, Nur; Adam, John M F; Sanusi, Harsinen

    2010-01-01

    Both Graves' disease and chronic thyroiditis (Hashimoto's thyroiditis) are autoimmune diseases of thyroid gland. Graves' disease is caused by stimulation of TSH receptor located on the thyroid gland by an antibody, which is known as TSH receptor antibody (TRAb). Furthermore, this may lead to hyperplasia and hyperfunction of the thyroid gland. On the contrary, the cause of Hashimoto's thyroiditis is thought due to a TSH stimulation-blocking antibody (TSBAb) which blocks the action of TSH hormone and subsequently brings damage and atrophy to thyroid gland. Approximately 15-20% of patients with Graves' disease had been reported to have spontaneous hypothyroidism resulting from the chronic thyroiditis (Hashimoto's disease). Pathogenesis for chronic thyroiditis following anti-thyroid drug treatment in patients with Graves' disease remains unclear. It has been estimated that chronic thyroiditis or Hashimoto's disease, which occurs following the Graves' disease episode is due to extended immune response in Graves' disease. It includes the immune response to endogenous thyroid antigens, i.e. thyroid peroxidase and thyroglobulin, which may enhance lymphocyte infiltration and finally causes Hashimoto's thyroiditis. We report four cases of chronic thyroiditis (Hashimoto's disease) in patients who have been previously diagnosed with Graves' hyperthyroidism. In three cases, Hashimoto's thyroiditis occurs in 7 to 25 years after the treatment of Grave's disease; while the other case has it only after few months of Grave's disease treatment. The diagnosis of Hashimoto's disease (chronic thyroiditis) was based on clinical manifestation, high TSHs level, positive thyroid peroxidase antibody and thyroglobulin antibody, and supported by positive results of fine needle aspiration biopsy. Moreover, the result of histopathological test has also confirmed the diagnosis in two cases. All cases have been successfully treated by levothyroxine treatment.

  5. SOME EVOLUTIONARY TENDENCIES OF NEOTROPICAL PRIMATES: Algunas tendencias evolutivas de los primates neotropicales

    Directory of Open Access Journals (Sweden)

    THOMAS R. DEFLER

    Full Text Available La evolución de los primates neotropicales ha transcurrido aislada o de forma independiente a la de otros primates del mundo, porque poseen una historia evolutiva diferente. Hay varias características de los primates neotropicales (Platirrinos que son bien distintas a las del viejo mundo (Catarrinos, incluyendo la fórmula dental, el arreglo de las placas craneales, la anatomía del aparato auditivo, pesos corporales menores, una menor adaptación a comportamientos terrestres, algunos poseen colas prensiles y baja diferenciación fenotípica. Formas monógamas de platirrinos comparten una tendencia de evolución cromosómica rápida con un grupo monógamo de Catarrinos (los Hilobátidos o gibones. La historia filogenética de platirrinos, contrasta con la de catarrinos debido a una división filética antigua (mioceno de los primates del nuevo mundo en dos grupos, con características filogenéticas expresadas en las especies actuales. En contraste, la diferenciación de catarrinos con características que se pueden identificar en especies actuales no sucedió sino hasta el Plio-Pleistoceno. Algunas de estas tendencias, pueden ser explicadas hipotéticamente teniendo en cuenta las características ecológicas planteadas en el nuevo continente; otras tendencias tal vez son el resultado de caminos evolutivos tomados al azar durante la evolución del grupo o, como resultado tanto de deriva genética como de un efecto fundador. Sin embargo, queda mucho trabajo para reconocer la totalidad de las singularidades de los platirrinos y poder apreciar los detalles de su evolución.The evolution of neotropical primates has occurred isolated from other primates of the world, resulting in a distinct evolutionary history. Various characteristics of neotropical primates (Platyrrhini are quite distinct from those of the Old World (Catarrhini, including the dental formula, the position of cranial plates, the anatomy of the auditory apparatus, much less average

  6. Graves opthalmopathy and psychoendocrinopathies

    Directory of Open Access Journals (Sweden)

    Ghanem Asaad

    2010-01-01

    Full Text Available Purpose: To assess the psychiatric and endocrinological changes in patients with Graves ophthalmopathy (GO. Design: A prospective, controlled, University Hospital based study Subjects and Methods: The current study comprised 60 patients diagnosed with GO at Mansoura Ophthalmic Center. Thirty five patients of them with moderate to severe GO formed the study group and twenty five patients with negligible to very mild GO formed the control group in the euthyroid state. The study group was further subdivided based on their predominant clinical signs into a proptosis subgroup and a muscle restriction subgroup . Psychiatric changes were assessed with the Middlesex Hospital Questionnaire (MHQ. Biochemical analyses included serum-free thyroxine and thyroid-stimulating hormone (TSH concentrations, TSH receptor antibody (TRAb activity and anti-thyroglobulin particle agglutination (TGPA and antithyroid microsomal particle agglutination (MCPA. Results: The proptosis group reported significantly higher scores on anxiety, depression, and phobia than the muscle restriction group (P< 0.0001. The proptosis and muscle restriction subgroups reported significantly higher scores on all subscales compared to the control group (P < 0.05. The scale scores of depression and phobia showed a positive correlation with scores of anxiety (P< 0.0001. The serum TRAb activity showed a significant correlation with anxiety, phobia and hysteria (P < 0.0001. Conclusion: The psychiatric aspect of GO should be evaluated during routine follow-up and should be considered when making management decisions. Thyroid specific antibodies may be useful in confirming the diagnosis of GO.

  7. Mass Graves, Landscapes of Terror

    OpenAIRE

    Ferrándiz, Francisco

    2009-01-01

    The recent exhumation of mass graves from the Spanish Civil War and the Post-War years, mostly involving the largely abandoned graves of the Francoist rearguard, have become a central element in contemporary debates about the conflict and the regime following it. In this paper, the complexity and dynamism of this process is analysed, including from political and legal initiatives of great social and media impact to local actions on the ground, at times failed, ephemeral or almost imperceptibl...

  8. Atractivo sexual femenino a lo largo del ciclo menstrual: análisis bajo la perspectiva de la psicología evolutiva

    Directory of Open Access Journals (Sweden)

    García López, Georgina I.

    2015-01-01

    Full Text Available Uno de los retos más importantes sobre los estudios en humanos es el de explicar los mecanismos fisiológicos que subyacen en el despliegue del comportamiento. La psicología evolutiva trata de establecer una relación de causa-efecto entre la forma en que se comporta el humano y los cambios fisiológicos que ocurren en él. A fin de darle una interpretación evolutiva a la conducta humana, en el presente trabajo se sometió a prueba la hipótesis que propone que los hombres perciben a la  mujer más atractiva durante la ovulación en función de ciertos cambios fenotípicos causados por las concentraciones de estrógenos, lo que les indica señales de su condición de fertilidad. Además, proponemos que otras mujeres también son capaces de discriminar la ovulación como un mecanismo de competencia femenina, dado que en ese periodo podrían ser más atractivas para sus parejas. Para poner a prueba la hipótesis se realizó un seguimiento de progesterona y estradiol a lo largo del ciclo menstrual a 50 mujeres, tomándoles fotos en cada una de las fases del ciclo (folicular temprana, folicular tardía, periovulatoria y fase lútea y se les preguntó a hombres y mujeres en qué foto  se veían más atractivas. Tanto los hombres como las mujeres respondieron que perciben a las mujeres como más atractivas en el periodo periovulatorio (folicular tardía y periovulatoria.

  9. La jurisdicción constitucional en la actual etapa evolutiva del Estado constitucional

    Directory of Open Access Journals (Sweden)

    Peter Häberle

    2014-01-01

    Full Text Available INTRODUCCIÓN PRIMERA PARTE: Etapas evolutivas históricas de la jurisdicción constitucional, la comparación judicial en el tiempo y el espacio 1. La etapa inicial antes de la segunda guerra mundial 2. La segunda etapa evolutiva 3. La etapa evolutiva de. La jurisdicción constitucional a partir del annus mirabilis 1989 4. Primeras deducciones teóricoconstitucionales SEGUNDA PARTE: Un marco teórico 1. El tipo de estado constitucional entre identidad y realidad: un «proyecto evolutivo» 2. Textos clásicos, como textos constitucionales en sentido amplio 3. Los tribunales constitucionales como participantes reales y ficticios en el contrato social 4. Tareas de la jurisdicción constitucional 5. El canon abierto de métodos: la comparación jurídica como «quinid» método de la interpretación 6. Los tribunales constitucionales nacionales como tribunal constitucional europeo 7. Los tribunales constitucionales entre el judicial activism y el judicial restraint 8. El derecho procesal constitucional como «derecho constitucional concretizado» TERCERA PARTE: Cuestiones de actualidad sobre la jurisdicción constitucional (selección. Consideraciones preliminares 1. La elección de los jueces constitucionales 2. El voto particular como «judicatura alternativa» 3. El recurso de amparo perspectiva y conclusión

  10. Immunological aspects of Graves' disease

    NARCIS (Netherlands)

    B.M. van Ouwerkerk (Marcel)

    1986-01-01

    textabstractAssuming an autoimmune interested to know whether apart from restoring the immunologic parameters. Freshly diagnosed hyperthyroid patients with Graves' disease were all similarly treated with MMI 10 mg t.i.d. and when euthyroidism was achieved, with substitution of thyroid hormone. At

  11. Esclerodermia, tireoidite e miastenia grave: estudo de um caso

    OpenAIRE

    Antonio L. dos Santos Werneck; Tamara Checcacci-Balod; Graça Tuma

    1993-01-01

    Uma paciente de 36 anos com miastenia grave desenvolveu após dois anos intolerância ao frio, o que conduziu ao diagnóstico de tireoidite de Hashimoto. Quatro anos mais tarde apresentou pele espessada nas mãos (esclerodermia limitada). O quadro clínico e os exames complementares encaminharam o diagnóstico para a forma CREST de esclerodermia sistêmica progressiva. Discute-se a dificuldade diagnóstica da esclerodermia, assim como suas síndromes de superposição. Doença de Hashimoto e miastenia gr...

  12. Clinical evaluation of Graves ophthalmopathy

    Directory of Open Access Journals (Sweden)

    Janićijević-Petrović Mirjana A.

    2012-01-01

    Full Text Available Introduction. Graves ophthalmopathy is an autoimmune disease, which is the consequence of thyroid dysfunction. Ocular manifestations occur in 50% of patients with Graves disease. The changes occur due to the inflammatory cell infiltration of retrobulbar fat tissue and extraocular muscles. Ultrasonography of eye orbit provides important information about the condition of retrobulbar adipose tissue and the thickness of extraocular muscles. Objective. The aim of our study was to show the clinical significance of orbital ultrasonography in the diagnostics and follow-up of patients with Graves disease. Methods. The authors examined 154 patients with Graves ophthalmopathy at the Clinic of Ophthalmology of the Clinical Centre in Kragujevac during the period 2008–2010. Ophthalmological examination included visual acuity testing (Snellen chart, biomicroscopy and applanation tonometry, direct and indirect ophthalmoscopy, dry eye testing and exophthalmometry (Hertel. Orbital ultrasonography examination and extraorbital muscle measurement was done by ultrasound B-scan. Results. The disease was more frequent in women (79.87% aged from 36–45 years. Most patients had hyperthyreoidism (54.55%. In relation to the duration of the disease, the most frequent clinical signs were bilateral ptosis, conjunctival chemosis and periorbital edema. According to our data the highest number of patients had enlarged medial straight muscle. Conclusion. Graves ophthalmopathy is the most frequent sign of thyroid disease. By orbital ultrasonography we detected extended echogram and measured the thickness of the extraocular muscle. Computerized tomography and magnetic resonance scan were utilized for cases of insufficiently manifested clinical signs of the disease. The advantages of ultrasonography lie in easy handling, patients’ comfort, short time of examination and possibilities of repetition.

  13. A short history of evolutionary theory Uma breve história da teoria evolutiva

    Directory of Open Access Journals (Sweden)

    Edson Perreira da Silva

    2001-12-01

    Full Text Available The history of the Theory of Evolution has been told a number of times by historians, philosophers, professors, writers, scientists and so on. However, many of these versions differ from or even contradict one another. In this article, the history of the Theory of Evolution is retold according to a dialectical-materialistic perspective. It analyzes the historical contradictions between Darwinian evolution theory and Mendel's model, the background that led to the synthetic theory of evolution, the debate carried out by classic schools and the result of synthesis, as well as the still current debate between Neutralism and Selectionism. Finally, it also discusses the interpretative model used ("an idiosyncratic dialectic materialism", mainly in relation with Popper's and Kuhn's models.A história da teoria evolutiva tem sito contada inúmeras vezes por historiadores, filósofos, professores, escritores, cientistas etc. Contudo, muitas destas versões diferem entre si ou mesmo se contradizem. Neste trabalho, a história da teoria evolutiva é recontada a partir de uma perspectiva materialista dialética. São analisadas as contradições históricas entre a teoria evolutiva darwiniana e o modelo mendeliano, o caminho para a teoria sintética da evolução, o debate entre as escolas clássica e do balanco que sucedeu a síntese, bem como o debate, ainda atual, entre neutralismo e selecionismo. Ao final, o modelo interpretativo utilizado ("um materialismo dialético idiossincrático" é discutido, principalmente, em relação aos modelos popperiano e kuhniano.

  14. El concepto de desarrollo en psicología evolutiva: aspectos epistemológicos

    OpenAIRE

    Coll, César

    1981-01-01

    En el curso 1978/79, el Departamento de Psicología Evolutiva y Diferencial de la Universidad de Santiago de Compostela, en colaboración con diversas entidades científicas y culturales, en especial con el Instituto de Ciencias da Educación (ICE), ha venido celebrando seminarios, conferencias y reuniones científicas sobre “desarrollo Humano”. Participaron en las mismas, psicólogos, pedagogos, sociólogos, antropólogos, pediatras, psiquiatras y filósofos, en un número superior a una veintena, y ...

  15. Graves' disease associated with histologic Hashimoto's thyroiditis.

    Science.gov (United States)

    Falk, S A; Birken, E A; Ronquillo, A H

    1985-02-01

    The microscopic slides of 16 patients who underwent bilateral subtotal thyroidectomy for hyperthyroid Graves' disease were reviewed and classified into three groups: I, Hashimoto's thyroiditis; II, Graves' disease; and III, both Hashimoto's thyroiditis and Graves' disease. Three patients were classified as group I, 10 as group II, and three as group III. In 38% of the patients with clinical Graves' disease the histologic evidence of Hashimoto's thyroiditis could be found either alone or in combination with histologic evidence of Graves' disease (groups I and III). One patient in group I, four in group II, and three in group III had infiltrative ophthalmopathy (50% of total). Hyperthyroid Graves' disease, Graves' ophthalmopathy, and Hashimoto's thyroiditis can occur all together, in duads, or individually at a specific time in a patient's life.

  16. Forma grave da síndrome pulmonar e cardiovascular por hantavírus tratada com pressurização positiva através de máscara facial Severe form of hantavirus cardiopulmonary syndrome managed with continuous positive airway plessure through facial mask

    Directory of Open Access Journals (Sweden)

    Mariangela Pimentel Pincelli

    2004-06-01

    Full Text Available O primeiro surto no Brasil da síndrome pulmonar e cardiovascular por hantavírus foi descrito em Juquitiba (SP, em 1993. Desde então têm sido descritos novos casos, especialmente nos estados do sul e sudeste do país. Em 2002 ocorreu a observação dos primeiros três casos em São Carlos (SP. Um dos pacientes recebeu suporte respiratório sem intubação traqueal, utilizando-se pressão positiva contínua nas vias aéreas (CPAP através de máscara facial. Este é o primeiro caso grave descrito de insuficiência respiratória por hantavírus em que houve sucesso com essa terapêutica ventilatória.In 1993 the first Brazilian cluster of Hantavirus Cardiopulmonary Syndrome (HCPS was described in Juquitiba, SP. Since then, there have been descriptions of new cases specially on the southeast and south states of Brazil. Only in 2002 there were observed the first three cases of HCPS in our city: São Carlos. One of our patients was successfully supported with CPAP through facial mask. This is the first severe case of acute respiratory failure induced by Hantavirus that was successfully managed with this kind of respiratory strategy.

  17. etapas evolutivas

    Directory of Open Access Journals (Sweden)

    Adriana Cáceres

    2006-01-01

    Full Text Available En este estudio descriptivo mediante encuestas se analiza la frecuencia y la intensidad de violencia física, psicológica y sexual de la que manifiestan haber sido objeto hombres y mujeres (n = 60 en el contexto de una relación íntima. Se estudiaron las respuestas de dos tipos de parejas, los que inician su relación (“novios”, n = 30 y aquellos que llevan varios años en el contexto de una relación conflictiva (“matrimonios”, n = 30 a la Escala de Ajuste Diádico de Spanier y al Índice de Violencia en Pareja de Hudson y McIntosh. Un 3,3% de los novios supera el punto cutt-off del cuestionario en violencia física y psicológica, mientras que el 43% de los matrimonios lo hace en el caso de la violencia física y un 50% en violencia psicológica. Ningún sujeto denunció haber sido forzado/a a realizar actos sexuales no deseados, mientras que un 6,7% de los hombres y un 3,3% de las mujeres denuncian ser requeridos/as sexualmente, aún estando cansados. No existen diferencias entre ambos géneros en ninguna de las puntuaciones. La correlación entre el índice de violencia y la Escala de Ajuste Diádico es de -0,72 (p <0,01. Se concluye que, además de otras medidas, se han de potenciar habilidades de relación “democráticas” para erradicar este problema.

  18. La Constitución Evolutiva: perspectivas evolutivas desde la sociología política y la práctica constitucional

    Directory of Open Access Journals (Sweden)

    Eloy Fisher

    2012-08-01

    Full Text Available El presente trabajo presenta una interpretación de la constitución como un mecanismo adaptativo. Si bien Bowles (2004 distingue dos tradiciones —la constitucional y la adaptativa— para la organización de vida en sociedad, aquella distinción no debe sertaxativa y categórica. En efecto, existen presiones que retroalimentan dinámicas endógenas entre la arena constitucional y el ámbito político (a través de la lucha adaptativa por el poder. En ese sentido, se presenta un modelo teórico y computacional que define a la constitución evolutiva como un espacio de interacción entre los factores reales de poder y los mecanismos de decisión. Al mediar los procesos de variación y selección, el espacio constitucional evolutivo es la órbita de adaptación que permite la reproducción delsistema político. No obstante, el presente modelo distingue aquellas fuerzas que buscan aplanar estos espacios constitucionales y con ello, imponer una camisa de fuerza paralimitar su flexibilidad, de aquellos diseños liberales que incluyen fricciones en el sistema para garantizar su heterogeneidad en medio de fuertes presiones sociales disipativas.

  19. Ictericia febril colestásica como forma de presentación de linfoma de Hodgkin

    OpenAIRE

    Max Schindler; Nicolás Kreplak; Lucía Acevedo; Héctor Damis; Guillermo Márquez; María del Carmen Ardaiz

    2014-01-01

    La ictericia febril colestásica como forma de presentación de los linfomas de Hodgkin es un cuadro muy infrecuente. Describimos aquí un caso de síndrome febril prolongado asociado a ictericia progresiva, en el que el diagnóstico de la enfermedad se realiza a través de la biopsia hepática, dada la ausencia de afectación ganglionar que caracteriza a esta enfermedad. Destacamos asimismo el cuadro clínico avanzado y el compromiso multisistémico de una enfermedad rápidamente evolutiva.

  20. Ictericia febril colestásica como forma de presentación de linfoma de Hodgkin

    Directory of Open Access Journals (Sweden)

    Max Schindler

    2014-02-01

    Full Text Available La ictericia febril colestásica como forma de presentación de los linfomas de Hodgkin es un cuadro muy infrecuente. Describimos aquí un caso de síndrome febril prolongado asociado a ictericia progresiva, en el que el diagnóstico de la enfermedad se realiza a través de la biopsia hepática, dada la ausencia de afectación ganglionar que caracteriza a esta enfermedad. Destacamos asimismo el cuadro clínico avanzado y el compromiso multisistémico de una enfermedad rápidamente evolutiva.

  1. Making pro formas perform.

    Science.gov (United States)

    Bryan, Stephen; Lilien, Steven

    2003-10-01

    Regulators are trying to clear up the muddle created by earnings-report adjustments called "pro formas" that companies issue. Constraining such reporting, as the regulators seem bent on doing, isn't the solution. Firms should increase alternative reporting--and fully account for their accounting.

  2. Formas agudas de periodontitis

    National Research Council Canada - National Science Library

    Bascones Martínez, Antonio; Pérez Salcedo, L

    2008-01-01

    ..., diferenciándose entre Gingivitis Necrotizante y Periodontitis Necrotizante. Y se añade en la clasificación el grupo de abscesos periodontales. En este artículo de revisión vamos a profundizar acerca de las formas agudas de periodontitis

  3. La innovación tecnológica desde una perspectiva evolutiva

    Directory of Open Access Journals (Sweden)

    Benavides Óscar A.

    2004-12-01

    Full Text Available Este artículo analiza el proceso de innovación tecnológica desde la economía política, específicamente, desde la perspectiva evolutiva.
    Se adopta el enfoque schumpeteriano en el cual el proceso de innovación tecnológica puede ser visto como un proceso de aprendizaje. En ese sentido, la innovación tecnológica representa un cambio en el conocimiento y, por ende, tiene un carácter epistemológico. Esta conceptualización, junto con el análisis histórico del proceso de innovación tecnológica y su formalización, permite entender los cambios que se han presentado en el proceso de innovación tecnológica durante los últimos doscientos cincuenta años.

  4. Dermopathy of Graves' disease: Clinico-pathological correlation.

    Science.gov (United States)

    Reddy, Sagili Vijaya Bhaskar; Gupta, Sushil Kumar; Jain, Manoj

    2012-05-01

    Dermopathy of Graves' disease is a classical, but uncommon extrathyroidal manifestation of Graves' disease. The images of a typical case of dermopathy of Graves' disease are presented along with clinico-pathological correlation.

  5. Insuficiencia mitral grave posvalvuloplastia mitral percutánea

    Directory of Open Access Journals (Sweden)

    Julio C. Echarte Martínez

    2010-01-01

    Full Text Available RESUMENIntroducciónLa valvuloplastia mitral percutánea es en la actualidad el tratamiento de elección en pacientesportadores de estenosis mitral de etiología reumática si la anatomía es apropiada.La insuficiencia mitral grave posvalvuloplastia continúa siendo un desafío.ObjetivoDeterminar las causas de insuficiencia mitral grave posvalvuloplastia mitral.Material y métodosSe realizaron 110 valvuloplastias mitrales percutáneas en forma consecutiva en 107 pacientes(3 repetidas por reestenosis en el Instituto de Cardiología y Cirugía Cardiovascular deCuba, entre el 17 de junio de 1998 y el 30 de junio de 2004 (106 por el método de Inoue y 4por Multitrack; el tiempo de evolución promedio fue de 24,6 meses (máximo 72 y mínimo1,93 meses. La insuficiencia mitral se clasificó por ecocardiografía Doppler en leve si elárea regurgitante era menor de 4 cm2, moderada si era de 4-8 cm2. y grave si era > 8 cm2 ypor ventriculografía izquierda según los criterios de Sellers. Para lograr correlación entre laclasificación por ecocardiografía Doppler color de tres grados y la de Sellers (cuatro gradosla insuficiencia mitral 1+ se consideró leve, 2+ y 3+ moderada y 4+, grave.ResultadosSe produjeron cinco insuficiencias mitrales graves posprocedimiento (4,54% del total. Tresde ellas necesitaron reemplazo valvular mitral por rotura de la valva anterior. Las dos restantesse encuentran bajo tratamiento médico.ConclusiónLos mecanismos de producción de la insuficiencia mitral posvalvuloplastia mitral percutáneason multifactoriales. Puede ocurrir en manos expertas.REV ARGENT CARDIOL 2010;78:222-227.

  6. Diversificación craneofacial e integración evolutiva en poblaciones sudamericanas

    Directory of Open Access Journals (Sweden)

    Pérez, Sergio Iván

    2007-01-01

    Full Text Available El estudio de la integración morfológica tiene gran importancia para comprender los patrones y procesos de evolución morfológica. Las poblaciones del sur de Sudamerica representan un interesante caso para el estudio de la integración evolutiva debido a que las mismas han alcanzado una gran diversidad morfológica. El objetivo de esta ponencia es presentar los resultados del análisis de la variación craneofacial y la integración evolutiva en poblaciones humanas de esta región. Se definieron componentes morfogenéticos los cuales fueron descriptos mediante landmarks y semilandmarks. Los patrones de integración entre componentes fueron comparados con modelos basados en información del desarrollo, función y origen embriológico de los componentes, con el fin de estimar la importancia de estos factores en la integración craneofacial. Nuestros resultados muestran que en el nivel intra-poblacional los componentes del esqueleto facial y la calota presentan mayor integración y se encuentran relativamente disociados de los de la base, como es esperado por el tipo de osificación del cráneo. En cambio, la integración en elnivel inter-poblacional difiere de la del nivel intra-poblacional y se ajusta al patrón de crecimiento del cráneo. En conjunto estos resultados muestran que la integración entre componentes es flexible y que diferentes factores pueden modificar el patrón de integración.

  7. PREGO (presentation of Graves' orbitopathy) study

    DEFF Research Database (Denmark)

    Perros, Petros; Žarković, Miloš; Azzolini, Claudio

    2015-01-01

    BACKGROUND/AIMS: The epidemiology of Graves' orbitopathy (GO) may be changing. The aim of the study was to identify trends in presentation of GO to tertiary centres and initial management over time. METHODS: Prospective observational study of European Group On Graves' Orbitopathy (EUGOGO) centres...

  8. Biventricular Takotsubo cardiomyopathy in Graves hyperthyroidism.

    Science.gov (United States)

    Perkins, Matthew J; Schachter, David T

    2014-03-01

    Graves hyperthyroidism is commonly seen in clinical practice and Takotsubo stress cardiomyopathy is an increasingly recognized cardiac complication of physical or emotional stress. We report the rare case of a patient with Graves hyperthyroidism that was complicated by severe biventricular takotsubo cardiomyopathy, which was demonstrated on heart catheterization. After appropriate pharmacologic treatment of her hyperthyroidism, she had complete resolution of her cardiomyopathy.

  9. Formas obstrutivas da neurocisticercose ventricular

    Directory of Open Access Journals (Sweden)

    Sylvio de Vergueiro Forjaz

    1961-03-01

    Full Text Available A incidência da cisticercose cerebral entre os consulentes orientados para o Ambulatório de Neurologia da Faculdade de Medicina de Ribeirão Prêto é muito alta. Trata-se de moléstia que, pela gravidade de seus sintomas, pela facilidade de infestação e pela precariedade dos recursos terapêuticos, representa um probiema individual e social grave nesta região. Muitos aspectos da moléstia já foram esclarecidos, sendo grande a contribuição de autores brasileiros. Certas feições da moléstia, porém, ainda comportam maiores estudos. É nosso objetivo oferecer uma contribuição ao estudo das formas intraventriculares de neurocisticercose. Relatamos as observações de 4 pacientes com queixas de hipertensão intracraniana periódica e com achados liquóricos e radiológicos compatíveis com a suspeita de cisticercose cerebral. Exames subsidiários (pneumencefalografia ou ventriculografia mostraram que em dois dêstes pacientes havia bloqueio do aqueduto de Sylvius (casos 3 e 4 e que, nos outros dois, havia exclusão de um ventrículo lateral por bloqueio do buraco de Monro (caso 1 e da confluência dos cornos temporal e occipital (caso 2. Nos dois casos em que havia bloqueio na parte alta do aqueduto de Sylvius os pacientes acusavam dificuldade no olhar vertical (síndrome de Parinaud. O tratamento cirúrgico permitiu desfazer o bloqueio em 3 casos (casos 2, 3 e 4; no caso 1 as punções feitas após a intervenção cirúrgica parecem ter agido benèficamente no sentido de restabelecer o trânsito do liqüido cefalorraquidiano. Excluindo um paciente (caso 2 que faleceu em caquexia 3 meses após a operação e no qual o exame necroscópico mostrou lesões pregressas imputáveis apenas à hipertensão aguda sem lesões cisticercóticas, os outros casos evoluíram para a cura.

  10. Acercamiento a una perspectiva biosemiótica sobre la modificación evolutiva de los fenotipos

    Directory of Open Access Journals (Sweden)

    Andrade Pérez Luis Eugenio

    2007-04-01

    Full Text Available

    La etología ha recurrido a la psicología comparada y la genética para entender el comportamiento animal, sin
    embargo para poder contribuir a la teoría evolutiva debe enmarcarse dentro de una perspectiva biosemiótica.
    Este trabajo es un intento de interpretar la conducta animal en conjunción con las teorías “clásicas” -Niko
    Tinbergen y Konrad Lorenz-, la teoría de sistemas en desarrollo (TDS y la psicología comparada, para mostrar
    que la conducta es el agente por excelencia de la modificación evolutiva de los fenotipos. La perspectiva
    biosemiótica es compatible enteramente con la TSD e integra a todas las anteriores, genética, psicología, etología clásica. Una visión integrada, considera que la información presente en el ADN requiere de las dinámicas
    catalíticas celulares para poder ser leída e interpretada; convirtiéndose en la base de la organización fenotípica
    en la que convergen un conjunto de jerarquías autorreferentes que regulan, modulan y coordinan la expresión genética a lo largo de la ontogenia del individuo. La selección orgánica de Baldwin define la relación con el
    entorno y esta fundamentada en ajustes a nivel fisiológico-anatómico en acople con los sistemas metabólicos
    celulares. Estos niveles fenotípicos median las relaciones organismo-entorno a través del comportamiento, el
    cual hace que la información del medio ambiente se reciba, codifique e interprete para definir las acciones correspondientes que la devuelven al entorno. Estos procesos son indispensables para el mantenimiento de los organismos individuales que cooperan en la formación y selección de paisajes asimilativos/interpretativos
    (paisajes de Umwelt y asimilación genética, asegurando determinadas líneas de variación para las generaciones
    subsiguientes. En consecuencia, los organismos son codificadores y usuarios de información, a la vez
    que son capaces de

  11. [Differential diagnosis of Graves' orbitopathy. Case report].

    Science.gov (United States)

    Erdei, Annamária; Steiber, Zita; Gazdag, Annamária; Bodor, Miklós; Berta, Eszter; Szász, Róbert; Szántó, Antónia; Ujhelyi, Bernadett; Barna, Sándor; Berényi, Ervin; Nagy, V Endre

    2016-02-21

    Graves' orbitopathy is the extrathyroidal manifestation of Graves' disease, which is the most common cause of exophthalmos. As eye symptoms usually coincide with the development of thyrotoxicosis, the diagnosis of the disease is rarely difficult. The aim of the authors was to summarize the differential diagnosis of Graves' orbitopathy based on literature review and presentation of their own four problematic cases on this topic. They conclude that symptoms similar to endocrine orbitopathy are present in other disorders. Endocrinologists need to be aware of these other conditions to avoid treatment failures.

  12. Formas de Hispanidad

    OpenAIRE

    Acuña, Ruth Noemí; Alfonso Piña, William H.; Arévalo, Diego Fabián; Barrero, Mario; Becerra, Witton; Cabrera, Marta; Cano, María José; Castañeda, Felipe; Castillo, Mery; Colom, Francisco; Conforti, María Cristina; Esquivel, Ricardo; del Rosario García, María; Gaviria, Radamiro; López, Carlos Arturo

    2010-01-01

    Este texto presenta estudios sobre las múltiples formas de hispanidad, desarrollados en los últimos años por destacados investigadores del mundo hispánico que, poco a poco, han estado construyendo un nuevo espacio de investigación para una creciente y activa comunidad científica. En este libro el lector encontrará estudios con enfoques desde la ciencia política, la teoría política, la historia, la filosofía, la sociología, la economía, los estudios literarios y culturales, entre otras perspec...

  13. La tríada oscura de la personalidad: maquiavelismo, narcisismo y psicopatía. Una mirada evolutiva

    Directory of Open Access Journals (Sweden)

    Fernando Renee González Moraga

    2015-08-01

    Full Text Available Se aborda la denominada Tríada Oscura de la Personalidad -Tríada- (maquiavelismo, narcisismo subclínico y psicopatía subclínica desde una mirada evolutiva. El objetivo de esta investigación es revisar la evidencia que han presentado los teóricos evolucionistas sobre la Tríada, desde un acercamiento a la mirada evolutiva. Para esto, se indaga en las principales características de cada uno de estos rasgos, los instrumentos que se han utilizado para evaluarlos y las principales áreas en donde se han estudiado. La mirada evolutiva plantea que los rasgos de la Tríada son dimensionales y varían de acuerdo con las diversas estrategias que utilizan los sujetos para adaptarse a las características socioambientales en las que se desarrollan. Estos rasgos se caracterizan por presentar violencia psicológica, inhibición moral, manipulación, baja amabilidad, insensibilidad, egoísmo y dificultad para mentalizar en contextos de interacción interpersonal y social.

  14. Pneumonia grave por "Chlamydia psittaci"

    Directory of Open Access Journals (Sweden)

    MOSCHIONI CRISTIANE

    2001-01-01

    Full Text Available A psitacose, também conhecida como ornitose, é causada pela Chlamydia psittaci; caracteriza-se por doença de início insidioso, sintomas brandos e inespecíficos, lembrando infecção de vias aéreas superiores. Acomete principalmente o pulmão, sendo raramente doença sistêmica e fatal. Descreve-se um caso raro de pneumonia por Chlamydia psittaci que evoluiu para insuficiência respiratória aguda, necessitando de ventilação mecânica. Destaca-se a importância em considerar o diagnóstico, especialmente em casos de pneumonia comunitária que evolui de modo insatisfatório, que não responde à terapia antimicrobiana e cuja epidemiologia é positiva para exposição às aves. O diagnóstico precoce é fundamental devido à excelente resposta terapêutica. O diagnóstico tardio pode levar a curso grave e fatal da doença.

  15. Orbital Volumetry in Graves' Orbitopathy

    DEFF Research Database (Denmark)

    Al-Bakri, Moug; Rasmussen, Åse Krogh; Thomsen, Carsten

    2014-01-01

    .6 cm(3) in controls, 8.7 ± 8.0 cm(3) in GO without DON, and 9.4 ± 3.1 cm(3) in GO with DON. The muscle and fat volumes were higher in patients with GO than in controls (P orbits with and without DON were not significantly different. The volume of the optic nerve were...... similar in the 3 groups. The number of apical, coronal 2 mm thick slices with no fat was 2.9 ± 0.9 in normal orbits, it was 4.1 ± 1.0 in GO orbits without DON and 5.3 ± 0.8 in GO orbits with DON (P = 0.007). Conclusion. Apical muscle enlargement may be more important than orbital fat enlargement......Purpose. We wanted to investigate the relative significance of fat and muscle enlargement in the development of dysthyroid optic neuropathy (DON) in Graves' orbitopathy (GO). Methods. Preoperative coronal CT scans of 13 patients with and without DON who subsequently underwent orbital decompression...

  16. Dislexia Evolutiva: Un Modelo Exitoso de Neuropsicología Genética

    Directory of Open Access Journals (Sweden)

    Alberto Galaburda D.

    2006-07-01

    Full Text Available La neurosicología clásica ha tenido gran éxito en establecer asociaciones entre estructura y fisiología cerebrales y sus respectivas funciones perceptivas, cognicitivas, metacognicitivas y conductuales. Considerando los grandes avances de la genética molecular y de la neurociencia de sistemas, es posible pretender que uno de los objetivos importantes de la neurosicología moderna es encontrar los vínculos asociativos o causales que existen entre estructuras y funciones genéticas y las conductas que éstas apoyan, sea a través de sus efectos sobre la construcción y mantención de regiones cerebrales relevantes, o a través de proteínas funcionales que estos genes producen. La dislexia evolutiva representa un síndrome conductual complejo que ha comenzado a analizarse experimentalmente, logrando establecer un recorrido por lo menos aproximativo entre un gen específico y una función cognitiva puntual.

  17. Nuevas perspectivas de la tafonomía evolutiva: tafosistemas y asociaciones conservadas

    Directory of Open Access Journals (Sweden)

    Fernández López, S.

    1984-08-01

    Full Text Available Several basic concepts of the evolutionary Taphonomy are examinated in this papero There is a general discussion of the main processes controlling fossil preservation. Approaches for the aplication of communications theory to the fossil record are reviewed and summarized, . The problems of redeposition (Umlagerung vs reworking (Aufarbeitung receives special attention as taphonomical phenomena. Sme remarks on the concept of condensation are made.

    Varios conceptos básicos de la Tafonomía evolutiva son tratados en este artículo. Hay una discusión general de los procesos principales que controlan la conservación tafonómica. Diversos enfoques para la aplicación de la teoría de la comunicación al registro fósil han sido revisados y sintetizados. Los problemas de resedimentación versus retrabajamiento reciben especial atención como fenómenos tafonórnicos. Se hacen algunas observaciones sobre el concepto de condensación.

  18. Forma e performance

    Directory of Open Access Journals (Sweden)

    Patricia Elizabeth Easterling

    2014-09-01

    Full Text Available Este artigo propõe uma revisão da tragédia grega, chamando a atenção para a necessidade de se abandonar o modelo evolutivo tradicional e entendê-las como essencialmente uma forma performática, em que o texto atende às necessidades de palco, e, em um esforço imaginativo, se ler as peças a partir, também, de seus elementos dêiticos e meta-narrativos, operação ilustrada através de uma análise de Medeia e As Troianas. Tradução: Ricardo Pinto de Souza(publicado originalmente em The Cambridge COmpanion to Greek TragedyAbstract: This paper proposes a revision of the Greek Tragedy calling for the need of leave behind the traditional evolutive model and emphasize the performatic nature of Greek Tragedy. Tragedy is an art-form in which text must re-spond to stage and performatic needs and, as consequence, demands from its reader an imaginative effort to consider its deictic and meta-narrative elements of essence to its understanding.Keywords: Greek Tragedy; Deixis; Performance; Medea; The Trojan Women Patricia Elizabeth Easterling é fellow da Academia Britânica para Humanidades e Ciências Sociais e do Newham College, primeira mulher em 450 anos a receber a prestigiosa cátedra de Professor Régio de Grego da Universidade de Cambridge (de 1994 até sua aposentadoria, em 2001, especialista na obra de Sófocles e organizadora de The Cambridge History of Classical Literature (com E. J. Kenney e The Cambridge Companion to Greek Tragedy. Livros: Sophocles: Trachiniae, Cambridge, 1982; Greek Religion and Society, ed. com J. V. Muir, 1984; The Cambridge History of Classical Literature, ed. com E. J. Kenney, 1994; The Cambridge Companion to Greek Tragedy, ed. , 1997; Greek and Roman Actors: Aspects of an Ancient Profession, ed. com Edith Hall, 2002. Ricardo Pinto de Souza é professor de Teoria Literária na Faculdade de Letras da UFRJ, onde leciona também no Programa de Pós-Graduação em Ciência da Literatura. Coordena o Laborat

  19. [Neonatal hyperthyroidism and maternal Graves disease].

    Science.gov (United States)

    Ben Ameur, K; Chioukh, F Z; Marmouch, H; Ben Hamida, H; Bizid, M; Monastiri, K

    2015-04-01

    The onset of Graves disease during pregnancy exposes the neonate to the risk of hyperthyroidism. The newborn must be monitored and treatment modalities known to ensure early treatment of the newborn. We report on the case of an infant born at term of a mother with Graves disease discovered during pregnancy. He was asymptomatic during the first days of life, before declaring the disease. Neonatal hyperthyroidism was confirmed by hormonal assays. Hyperthyroidism was treated with antithyroid drugs and propranolol with a satisfactory clinical and biological course. Neonatal hyperthyroidism should be systematically sought in infants born to a mother with Graves disease. The absence of clinical signs during the first days of life does not exclude the diagnosis. The duration of monitoring should be decided according to the results of the first hormonal balance tests.

  20. HACIA UNA EPISTEMOLOGÍA EVOLUTIVA EXTENDIDA: LA RETROALIMENTACIÓN ENTRE VARIACIÓN Y SELECCIÓN

    Directory of Open Access Journals (Sweden)

    David VELÁSQUEZ CARVAJAL

    2016-01-01

    Full Text Available Este artículo se sitúa en la perspectiva de la naturalización del conocimiento científico, toda vez que es un intento por caracterizar y describir la evolución del conocimiento a partir de nociones de la biología. El objetivo principal es responder si es posible sostener la analogía que propone la epistemología evolutiva (EE: que la evolución del conocimiento científico (ECC es similar a la evolución orgánica (EO. La pregunta surge tras las críticas que han atacado el núcleo de la analogía. La respuesta es que la analogía sí se sostiene si se tienen en cuenta las relaciones de retroalimentación, y que es posible proponer a la luz de la síntesis extendida (SE, una teoría posterior que complementa la síntesis moderna (SM. Así, este trabajo comienza con una descripción del estado de la “epistemología evolutiva”, prosigue señalando por qué la síntesis moderna, que sirvió de base para su formulación, no es suficiente para fundamentar la epistemología evolutiva y finaliza proponiendo que es pertinente una modificación que puede describirse como “epistemología evolutiva extendida”.

  1. Neurofisiología de la ataxia espinocerebelosa tipo 2:biomarcadores y fases evolutivas de la enfermedad

    OpenAIRE

    2012-01-01

    Este trabajo integra los resultados de un grupo de investigaciones neurofisiológicas que se iniciaron hace más de 20 años. Se evaluaron sujetos enfermos, presintomáticos y controles con los objetivos de ampliar la caracterización electrofisiológica de la enfermedad desde estadios preclínicos y describir las etapas evolutivas de la misma. Las principales alteraciones detectadas en los enfermos fueron: una neuropatía periférica sensitiva, disfunción olfatoria, disminución del aprendizaje vis...

  2. Papel de las barreras biogeográficas e historia evolutiva en la estructura poblacional actual de especies marinas cosmopolitas

    OpenAIRE

    Miralles López, Laura

    2015-01-01

    Las especies son grupos de poblaciones naturales e intercruzables que están aislados reproductivamente de otros grupos análogos. En el medio marino, las barreras al flujo génico entre especies no son tan evidentes como en el terrestre. Es imprescindible identificarlas porque tanto la variabilidad genética de las especies como su estructura genética poblacional y por supuesto, la especiación están modeladas por barreras presentes y pasadas en la historia evolutiva de cualquier grupo taxonómico...

  3. Acercamiento a una perspectiva biosemiótica sobre la modificación evolutiva de los fenotipos

    OpenAIRE

    Andrade Pérez Luis Eugenio; Fierro Toscano Yusleni

    2007-01-01

    La etología ha recurrido a la psicología comparada y la genética para entender el comportamiento animal, sin
    embargo para poder contribuir a la teoría evolutiva debe enmarcarse dentro de una perspectiva biosemiótica.
    Este trabajo es un intento de interpretar la conducta animal en conjunción con las teorías “clásicas” -Niko
    Tinbergen y Konrad Lorenz-, la teoría de sistemas en desarrollo (TDS) y la psicología comparada, para mostrar
    que la co...

  4. Associação familiar de miastenia grave e síndrome miotônica

    Directory of Open Access Journals (Sweden)

    Sylvio Saraiva

    1969-12-01

    Full Text Available É relatada uma associação familiar incomum, incidindo em mãe e filha, a primeira com síndrome miotônica e, a segunda, com miastenia grave, forma ocular. Um terceiro membro da família, irmão da paciente com miotonia, teria também manifestações dessa síndrome. São comentados aspectos clínico-laboratoriais dos casos estudados.

  5. Polipose nasossinusal: doença inflamatória crônica evolutiva?

    OpenAIRE

    Souza Bruno Beltrão de; Serra Marcelo Fenile; Dorgam João Vicente; Sarreta Sabrina Maria de Castro; Melo Valder Rodrigues de; Anselmo-Lima Wilma T.

    2003-01-01

    INTRODUÇÃO: A polipose nasossinusal é uma doença degenerativa da mucosa onde há formação de múltiplas estruturas polipóides nas cavidades nasais e seios paranasais e cujos mecanismos fisiopatológicos ainda não são bem compreendidos. FORMA DE ESTUDO: Clínico prospectivo. OBJETIVO E MATERIAL e MÉTODO: Objetivando colaborar na compreensão dos fatores envolvidos na patogênese dos pólipos nasais, decidimos estudar a histologia e a ultraestrutura dos pólipos em dezessete pacientes portadores de pol...

  6. TEORÍA ECONÓMICA EVOLUTIVA DE LA EMPRESA: ¿UNA ALTERNATIVA A LA TEORÍA NEOCLÁSICA?

    OpenAIRE

    2009-01-01

    Este trabajo presenta una reflexión crítica sobre las aportaciones conceptuales de la teoría económica evolutiva de la empresa. Sus contribuciones se comparan con el limitado alcance de la teoría neoclásica al explicar los factores internos de desempeño de la empresa, ya que la consideran una función técnica de producción. Al mismo tiempo, el artículo se ocupa especialmente de exponer los puntos principales que definen la propuesta evolutiva de la empresa, discutiendo el progreso conceptual y...

  7. Bilateral carpal tunnel syndrome in Graves' disease.

    Science.gov (United States)

    Manganelli, P; Pavesi, G; Salaffi, F

    1987-01-01

    Carpal tunnel syndrome (CTS) may be associated with endocrinopathies, such as hypothyroidism and acromegaly. A direct relationship between CTS and hyperthyroidism has recently been suggested. We now report a case in which bilateral CTS developed after treatment of Graves' disease, thus, questioning the possibility of a relationship between these two disease processes.

  8. Pro Forma Registration of Companies

    DEFF Research Database (Denmark)

    Werlauff, Erik

    2010-01-01

    The article analyses the view taken by Community law on companies' pro forma registration in another EU or EEA country. Community law recognises pro forma registration under company law, i.e. a brass plate is sufficient, whereas it does not recognise pro forma registration under tax law, i.......e. a brass plate is not sufficient. The article provides reasons for the differential treatment of the two contexts and clarifies the difference on the basis of the Hubbard criterion, in which it was ruled that the effectiveness of Community law cannot vary according to the various branches of national law....

  9. Diagnosis and treatment of Graves disease.

    Science.gov (United States)

    Streetman, Darcie D; Khanderia, Ujjaini

    2003-01-01

    To review the etiology, diagnosis, and clinical presentation of Graves disease and provide an overview of the standard and adjunctive treatments. Specifically, antithyroid drugs, beta-blockers, inorganic iodide, lithium, and radioactive iodine are discussed, focusing on current controversies. Primary articles were identified through a MEDLINE search (1966-July 2000). Key word searches included beta-blockers, Graves disease, inorganic iodide, lithium, methimazole, and propylthiouracil. Additional articles from these sources and endocrinology textbooks were also identified. We agreed to include articles that would highlight the most relevant points, as well as current areas of controversy. Graves disease is the most common cause of hyperthyroidism. The 3 main treatment options for patients with Graves hyperthyroidism include antithyroid drugs, radioactive iodine, and surgery. Although the antithyroid drugs propylthiouracil (PTU) and methimazole (MMI) have similar efficacy, there are situations when 1 agent is preferred. MMI has a longer half-life than PTU, allowing once-daily dosing that can improve patient adherence to treatment. PTU has historically been the drug of choice for treating pregnant and breast-feeding women because of its limited transfer into the placenta and breast milk. Adjuvant therapies for Graves disease include beta-blockers, inorganic iodide, and lithium. beta-Blockers are used to decrease the symptoms of hyperthyroidism. Inorganic iodide is primarily used to prepare patients for thyroid surgery because of its ability to decrease the vascularity of the thyroid gland. Lithium, which acts in a manner similar to iodine, is not routinely used due to its transient effect and the risk of potentially serious adverse effects. In the US, radioiodine therapy has become the preferred treatment for adults with Graves disease. It is easy to administer, safe, effective, and more affordable than long-term treatment with antithyroid drugs. Hypothyroidism is an

  10. EJERCICIO Y LA DETECCION DEL MAL AGUDO DE MONTAÑA GRAVE

    Science.gov (United States)

    Garófoli, Adrián; Montoya, Paola; Elías, Carlos; Benzo, Roberto

    2012-01-01

    El Mal Agudo de Montaña (MAM) es un conjunto de síntomas inespecíficos padecidos por sujetos que ascienden rápidamente desde baja a alta altura sin adecuada aclimatación. Usualmente es autolimitado, pero las formas graves (edema pulmonar y cerebral) pueden causar la muerte. La hipoxemia exagerada en reposo está relacionada con el desarrollo de MAM pero su valor predictivo es limitado. Dado que el ejercicio en altura se acompaña de mayor hipoxemia y síntomas, postulamos el valor predictivo de un simple test de ejercicio para pronosticar MAM grave. Se estudió el valor predictivo de la saturación de oxígeno en reposo y ejercicio submáximo a 2 700m y 4 300m en 63 sujetos que ascendían al cerro Aconcagua (6 962m). Se consideró desaturación de oxígeno con ejercicio a una disminución >=5% respecto al reposo. Se utilizó la escala de Lake-Louise para establecer la presencia de MAM grave. 6 sujetos presentaron MAM grave (9.5%) y requirieron evacuación. La saturación de oxígeno en reposo a 2 700m no fue significativa para clasificar sujetos que luego desarrollaron MAM grave. Por el contrario, la asociación de desaturación durante el ejercicio a 2 700m más la saturación inapropiada en reposo a 4 300m fue significativa para clasificar a los sujetos que desarrollaron MAM grave con un valor predictivo positivo de 80% y un valor predictivo negativo del 97%. Nuestros resultados son relevantes para el montañismo y sugieren la adición de un simple test de ejercicio en la predicción del MAM grave. PMID:20228017

  11. ENSEÑAR Y APRENDER BIOLOGÍA EVOLUTIVA EN EL SIGLO XXI (Pag:80-88

    Directory of Open Access Journals (Sweden)

    Rosaura Ruiz Gutiérrez

    2013-01-01

    Full Text Available La biología evolutiva es una disciplina integradora; sin embargo, en los procesos de enseñanza-aprendizaje ha ocupado espacios curriculares exiguos, que se reducen a un tema o inciso de los programas de estudio, lo que resulta insuficiente para enseñar y aprender biología en la formación científica básica, media superior y superior. Ante esa situación, el objetivo de este escrito es plantear que en tanto los fenómenos biológicos se explican desde su funcionalidad e historia evolutiva, es necesario que los contenidos curriculares, la formación docente y los recursos didácticos den cuenta, al mismo tiempo, de la naturaleza histórica y funcional de lo vivo; solo así podrá lograrse la enseñanza y el aprendizaje del pensamiento biológico.

  12. Planning the expansion of transmission with evolutionary programming; Planeacion de la expansion de transmision con programacion evolutiva

    Energy Technology Data Exchange (ETDEWEB)

    Ceciliano Meza, Jose Luis; Nieva Gomez, Rolando [Instituto de Investigaciones Electricas, Temixco, Morelos (Mexico)

    1999-07-01

    A method of evolutionary programming for the planning of transmission networks in electrical power systems is presented. This is a whole problem mixed and nonlinear, with a combinatory nature that leads to a very large number of possible solutions for electrical systems of medium and large scale. The problem of transmission planning is described briefly and later it is formulated in mathematical terms. The proposed algorithm of evolutionary programming is applied to a large scale network that is representative of the Mexican electrical system. [Spanish] Se presenta un metodo de programacion evolutiva para la planeacion de redes de transmision en sistemas electricos de potencia. Este es un problema entero mixto y no lineal, con una naturaleza combinatoria que conduce a un numero muy grande de soluciones posibles para sistemas electricos de mediana y gran escala. Se describe brevemente el problema de planeacion de transmision y posteriormente se formula en terminos matematicos. El algoritmo propuesto de programacion evolutiva se aplica a una red electrica de gran escala que es representativa del sistema electrico Mexicano.

  13. Graves-Basedow disease and potential risk factors

    Directory of Open Access Journals (Sweden)

    Živanović Dušica

    2008-01-01

    Full Text Available Background/Aim. Graves-Basedow disease is a common multifactorial genetic syndrome, which is determined by several genes and environmental factors. The aim of the present study was to investigate the presence of risk factors for developing Graves-Basedow disease between the groups of individuals with and without Graves-Basedow disease, and to compare the presence of risk factors between the affected individuals with or without positive family history for Graves- Basedow disease. Methods. This cross-sectional study was conducted in Ćuprija (central Serbia during a period from December 2001 to April 2002. The case group comprised 132 individuals diagnosed with Graves-Basedow disease. The control group comprised 130 subjects without any of endocrine diseases. All participants were interviewed at the Medical Center Ćuprija using structural questionnaire. Data were collected on basic demographic characteristics, exposure to various chemical and physical agents, stress, smoking and family history of Graves-Basedow disease. In statistical analysis chi-square test was used. Results. The individuals with Graves-Basedow disease were statistically significantly older (above 50 (p = 0.020, exposed to stress (p = 0.024 and to physical agents (p = 0.031, and had significantly (p = 0.000 more relatives with Graves-Basedow disease than those without the disease. Among the affected individuals with positive family history of Graves-Basedow disease the number of women was significantly higher (p = 0.000, than the affected individuals without positive family history of Graves- Basedow disease. Conclusion. In our study, as in many other, gender, age, positive family history of Graves-Basedow disease and exposure to physical agents were identified as potential risk factors for the increased incidence of Graves- Basedow disease. Different risk factors are probably responsible for developing Graves-Basedow disease among the affected individuals with or without

  14. Tratamiento de la enfermedad de Graves Basedow

    Directory of Open Access Journals (Sweden)

    Hernando Vargas-Uricoechea

    2014-05-01

    Full Text Available Se realizó una revisión narrativa rigurosa de la literatura inglesa y en español sobre diferentes aspectos de la Enfermedad de Graves-Basedow e hipertiroidismo. Esta patología –parte de la llamada “enfermedad tiroidea autoinmune”- se produce como consecuencia de la presencia de anticuerpos circulantes que se unen y activan al receptor de tirotropina, desencadenándose generalmente el hipertiroidismo en asociación con un estrés agudo. En este artículo actualizamos tanto el manejo de hipertiroidismo como el de problemas especiales con el que puede estar asociado. La fisiopatología y el diagnóstico de la Enfermedad de Graves-Basedow son motivo de otra publicación.

  15. Diagnosis and classification of Graves' disease.

    Science.gov (United States)

    Menconi, Francesca; Marcocci, Claudio; Marinò, Michele

    2014-01-01

    Graves' disease (GD) is an autoimmune disorder involving the thyroid gland, typically characterized by the presence of circulating autoantibodies that bind to and stimulate the thyroid hormone receptor (TSHR), resulting in hyperthyroidism and goiter. Organs other than the thyroid can also be affected, leading to the extrathyroidal manifestations of GD, namely Graves' ophthalmopathy, which is observed in ~50% of patients, and Graves' dermopathy and acropachy, which are quite rare. Presumably, the extrathyroidal manifestations of GD are due to autoimmunity against antigens common to the thyroid and other affected organs. Although its exact etiology remains to be completely understood, GD is believed to result from a complex interaction between genetic susceptibility and environmental factors. Clinically, GD is characterized by the manifestations of thyrotoxicosis as well as by its extrathyroidal features when present, the latter making the diagnosis almost unmistakable. In the absence of ophthalmopathy, the diagnosis is generally based on the association of hyperthyroidism and usually diffuse goiter confirmed with serum anti-TSHR autoantibodies (TRAbs). Hyperthyroidism is generally treated with anti-thyroid drugs, but a common long term treatment strategy in patients relapsing after a course of anti-thyroid drugs (60-70%), implies the use of radioactive iodine or surgery.

  16. Graves' disease associated with alopecia areata developing after Hashimoto's thyroiditis.

    Science.gov (United States)

    Aşık, Mehmet; Binnetoğlu, Emine; Şen, Hacer; Tekeli, Zeliha; Uysal, Fatma; Ukinç, Kubilay

    2013-01-01

    Graves' disease and Hashimoto's thyroiditis are the most common autoimmune thyroid diseases. Hypothyroidism can develop in patients with Graves' disease, either spontaneously or as a result of radioactive iodine therapy or surgery. However, it is rare for patients with Hashimoto's thyroiditis to subsequently develop Graves' disease. We report a case of alopecia areata associated with Graves' disease in a 41-year-old woman who had previously been diagnosed with Hashimoto's disease. Alopecia areata is an autoimmune disease associated with other autoimmune diseases such as thyroid disorders, anemia, and other skin disorders.

  17. Tratamiento de la osteoporosis grave con teriparatide

    Directory of Open Access Journals (Sweden)

    Marcelo A. Sarli

    2013-10-01

    Full Text Available El objetivo de este trabajo retrospectivo fue evaluar el tratamiento de la osteoporosis grave con teriparatide (PTH y comparar nuestros resultados con los publicados en la literatura médica. Se incluyeron cuarenta y seis pacientes, cuarenta y dos mujeres y cuatro varones, edad: 69.15 ± 9.43 años. Seis eran vírgenes de tratamiento y cuarenta tratados previamente con bisfosfonatos. Treinta y dos pacientes habían tenido 93 fracturas de las cuales 86 vertebrales. Cuarenta y seis recibieron PTH 6 meses, 29 pacientes durante 12 meses y 20 completaron los 18 meses sugeridos. La densidad mineral ósea (DMO de columna lumbar aumentó significativamente desde el primer control a los 6 meses (p < 0.0001. La DMO de cuello de fémur alcanzó un incremento significativo al final del tratamiento (p = 0.002. La osteocalcina aumentó significativamente al mes, seguido por el ß crosslaps (beta-CTx, prueba en suero al tercer mes y la fosfatasa alcalina ósea, regresando los marcadores de recambio óseo a niveles basales a los 18 meses. Las calcemias y las calciurias no se modificaron significativamente, pero 8 pacientes tuvieron hipercalcemias leves y tres hipercalciurias asintomáticas. El tratamiento fue bien tolerado y no se registraron efectos adversos graves que requirieran suspender el tratamiento. En conclusión, la PTH es una alternativa útil y segura para el tratamiento de la osteoporosis grave. Nuestros resultados concuerdan con los previamente publicados en la literatura médica.

  18. Tratamiento de la enfermedad de Graves Basedow

    OpenAIRE

    Hernando Vargas-Uricoechea; Carlos Hernán Sierra-Torres; Ivonne Alejandra Meza-Cabrera

    2014-01-01

    Se realizó una revisión narrativa rigurosa de la literatura inglesa y en español sobre diferentes aspectos de la Enfermedad de Graves-Basedow e hipertiroidismo. Esta patología –parte de la llamada “enfermedad tiroidea autoinmune”- se produce como consecuencia de la presencia de anticuerpos circulantes que se unen y activan al receptor de tirotropina, desencadenándose generalmente el hipertiroidismo en asociación con un estrés agudo. En este artículo actualizamos tanto el manejo de hipertiroid...

  19. Polipose nasossinusal: doença inflamatória crônica evolutiva?

    Directory of Open Access Journals (Sweden)

    Souza Bruno Beltrão de

    2003-01-01

    Full Text Available INTRODUÇÃO: A polipose nasossinusal é uma doença degenerativa da mucosa onde há formação de múltiplas estruturas polipóides nas cavidades nasais e seios paranasais e cujos mecanismos fisiopatológicos ainda não são bem compreendidos. FORMA DE ESTUDO: Clínico prospectivo. OBJETIVO E MATERIAL e MÉTODO: Objetivando colaborar na compreensão dos fatores envolvidos na patogênese dos pólipos nasais, decidimos estudar a histologia e a ultraestrutura dos pólipos em dezessete pacientes portadores de polipose. Os pacientes foram divididos em 2 grupos: alérgicos (5 pacientes e não alérgicos (12 pacientes. RESULTADOS: Mucosa respiratória normal cobrindo a superfície do epitélio foi encontrada em oito casos; metaplasia escamosa em quatro casos; diferentes tipos epiteliais em três casos; epitélio respiratório atípico em um caso e ausência de mucosa em um caso. Foram observados quatorze casos de pólipo tipo fibro-inflamatório, um caso de hiperplasia de glândulas seromucinosas e dois casos de pólipos fibróticos. CONCLUSÕES: Os pacientes apresentaram índices de testes cutâneos positivos iguais ou maiores que a população geral, entretanto, não houve diferenças histológicas ou ultraestruturais entre os pólipos de pacientes alérgicos e dos não alérgicos, sugerindo ser a alergia um fator contribuinte mas não causal na fisiopatologia da polipose nasossinusal.

  20. 75 FR 65030 - Native American Graves Protection and Repatriation Review Committee: Nomination Solicitation

    Science.gov (United States)

    2010-10-21

    ... National Park Service Native American Graves Protection and Repatriation Review Committee: Nomination Solicitation AGENCY: National Park Service, Interior. ACTION: Native American Graves Protection and... nominations for two members of the Native American Graves Protection and Repatriation Review Committee....

  1. 75 FR 13140 - Native American Graves Protection and Repatriation Review Committee: Nomination Solicitation

    Science.gov (United States)

    2010-03-18

    ... National Park Service Native American Graves Protection and Repatriation Review Committee: Nomination Solicitation AGENCY: National Park Service, Interior. ACTION: Native American Graves Protection and... nominations for one member of the Native American Graves Protection and Repatriation Review Committee....

  2. Graves' orbitopathy as a rare disease in Europe

    DEFF Research Database (Denmark)

    Perros, Petros; Hegedüs, L; Bartalena, L.

    2017-01-01

    qualify as rare. Recent published data on the incidence of GO and Graves' hyperthyroidism in Europe were used to estimate the prevalence of GO. The position statement was developed by a series of reviews of drafts and electronic discussions by members of the European Group on Graves' Orbitopathy...

  3. TEORÍA ECONÓMICA EVOLUTIVA DE LA EMPRESA: ¿UNA ALTERNATIVA A LA TEORÍA NEOCLÁSICA?

    Directory of Open Access Journals (Sweden)

    Mario Alberto Morales Sánchez

    2009-01-01

    Full Text Available Este trabajo presenta una reflexión crítica sobre las aportaciones conceptuales de la teoría económica evolutiva de la empresa. Sus contribuciones se comparan con el limitado alcance de la teoría neoclásica al explicar los factores internos de desempeño de la empresa, ya que la consideran una función técnica de producción. Al mismo tiempo, el artículo se ocupa especialmente de exponer los puntos principales que definen la propuesta evolutiva de la empresa, discutiendo el progreso conceptual y explicativo de sus postulados y sus limitaciones intrínsecas. Se concluye con un balance conceptual entre los principales méritos de la teoría económica evolutiva de la empresa y los puntos débiles que exhibe esta corriente teórica.

  4. Sepsis y nutrición artificial en pacientes graves desnutridos

    Directory of Open Access Journals (Sweden)

    Pedro Alexei Bacardí-Zapata

    2016-05-01

    Full Text Available Objetivo: Relacionar la repercusión de las sepsis con la desnutrición y el soporte nutricional en pacientes gra-ves, conforme a variables epidemiológicas de interés. Método: Se realizó una investigación aplicada y descriptiva en el período comprendido desde marzo del año 2014 hasta enero del año 2015, en el Servicio de Cuidados Intermedios del Hospital Provincial Clínicoquirúrgico Docente “Saturnino Lora Torres” de la ciudad de Santiago de Cuba. La muestra la constituyeron 32 pacientes sépticos y desnutridos a quienes se les realizó una valoración nutricional a los siete días de estadía y se les aplicó Nutrición Artificial para evaluar la interrelación entre la sepsis, desnutrición y soporte nutricional. Resultados: Predominó el grupo de edades de 65 años y más en la investigación con 15 pacientes para un 46,9%; prevaleciendo la nutrición parenteral total con 14 casos para un 43,7%. En el estudio los pacientes con sepsis graves representaron el 46,9% y dentro de este grupo la mayoría de los enfermos se encontraron desnutridos de forma severa con siete individuos. Fueron las infecciones precedentes del sistema digestivo las más frecuente con un total de 11 enfermos para un 34,4%. Conclusiones: Existe una interrelación muy potente de forma negativa para el enfermo grave entre nutrición parenteral, gra-vedad de la sepsis y severidad de la desnutrición, de tal manera que mientras más intensa sea, más perpetúa de forma negativa a la otra desencadenando finalmente una mala evolución de estos individuos que incluso los pueden llevar a la muerte. Palabras clave: cuidados intensivos; estado nutricional; pacientes internos.

  5. Current insights into animal models of Graves' disease and orbitopathy.

    Science.gov (United States)

    Wiesweg, B; Johnson, K T M; Eckstein, A K; Berchner-Pfannschmidt, U

    2013-08-01

    Graves' disease (GD) is a systemic autoimmune disease that is characterized by hyperthyroidism, orbitopathy and in rare cases dermopathy. Graves' orbitopathy (GO) is an inflammatory disease of eye and orbit which occurs in about 30-60% of patients. Hyperthyroidism occurs due to the presence of stimulating TSHR-autoantibodies (TRAbs) leading to increased serum levels of thyroid hormones. Attempts to induce Graves' disease in mice by immunization against the hTSHR or its variants have resulted in production of TRAbs that stimulate thyroid follicular cells to increase thyroid hormone secretion. Graves' like orbital changes, such as inflammation, adipogenesis and muscle fibrosis are more difficult to induce. In this review we summarize different methods used to induce murine Graves'-like disease and their impact on murine orbits.

  6. Tratamiento de la hepatitis alcohólica grave corticoides frente a nutrición enteral : efectos a corto y largo plazo /

    OpenAIRE

    Rodríguez Iglesias, Pilar

    2002-01-01

    Antecedentes: El espectro clínico de la hepatitis alcohólica es muy variable, desde formas leves, que se recuperan fácilmente con la abstinencia enólica, hasta formas graves, en las que la tasa de mortalidad puede llegar hasta el 40%. En las últimas tres décadas se han ensayado numerosas estrategias terapéuticas, y los corticosteroides se han investigado ampliamente. A pesar de que algunos estudios no observan un efecto beneficioso, los corticoides continúan siendo el único tratamiento recome...

  7. Maltrato físico grave con ingreso en Cuidados Intensivos Pediátricos Severe physical abuse with admission to Pediatric Intensive Care Unit

    OpenAIRE

    2013-01-01

    Introducción. El maltrato infantil es un problema de salud pública. Varios estudios han señalado que este diagnóstico se incrementa de forma alarmante. El objetivo de este estudio es describir la forma de presentación de los casos de maltrato físico infantil que precisaron ingreso en una Unidad de Cuidados Intensivos Pediátricos (UCIP). Métodos. Estudio descriptivo retrospectivo (1995-2011). Se incluyeron los casos de maltrato físico grave que precisaron ingreso en la UCIP. Se analizaron dato...

  8. Outcome of Very Long-Term Treatment with Antithyroid Drugs in Graves' Hyperthyroidism Associated with Graves' Orbitopathy

    NARCIS (Netherlands)

    L. Elbers; M. Mourits; W. Wiersinga

    2011-01-01

    Background: It is still debated which treatment modality for Graves' hyperthyroidism (GH) is most appropriate when Graves' orbitopathy (GO) is present. The preference in our center has been always to continue antithyroid drugs for GH (as the block-and-replace [B-R] regimen) until all medical and/or

  9. Radiation therapy of Graves' ophthalmopathy

    Energy Technology Data Exchange (ETDEWEB)

    Kawamura, Toshiki; Koga, Sukehiko; Anno, Hirofumi; Komai, Satoshi (Fujita-Gakuen Health Univ., Toyoake, Aichi (Japan))

    1992-01-01

    During the decade from 1978 to 1987, 20 patients with Graves' ophthalmopathy were treated with irradiation of 2000 cGy to the orbital tissue. We examined the effects of the therapy on 17 such patients. Exophthalmos tended to decrease. When the degree of deviation of the exophthalmic eye was small, the effect of therapy tended to be better than when it was large. Two cases that showed an increase in retrobulbar fatty tissue without thickening of the extraocular muscles did not respond as well as those that had thickening of the extraocular muscles. Diplopia tended to improve both subjectively and objectively. Ocular movement improved in 11 of the 17 patients. There were no serious radiation injuries after the radiation therapy, except for some transient swelling of the eyelid. (author).

  10. Radiologia contrastada do timo na miastenia grave

    Directory of Open Access Journals (Sweden)

    José Lamartine de Assis

    1964-03-01

    Full Text Available Foram estudados 20 casos de miastenia grave mediante exame radiológico simples para evidenciar a persistência ou hipertrofia do timo e estudar, comparativamente, os resultados dêste método propedêutico com o uso do enfisema do mediastino seguido de pneumografia e/ou planigrafia. Com tal procedimento foi possível mostrar, em 18 dos casos, a persistência ou hipertrofia do timo. Em alguns casos foram analisados os diversos aspectos radiológicos do timo em suas relações com as medidas terapêuticas, adotadas em particular com o uso do ACTH, radioterapia e/ou timectomia; neste particular, os autores não puderam tirar conclusões definitivas por ser pequeno o número de casos estudados.

  11. Resultados do tratamento da Insuficiência Venosa Crônica grave com espuma de polidocanol guiada por ultrassom

    OpenAIRE

    Melissa Andreia de Moraes Silva; Marcelo Calil Burihan; Orlando da Costa Barros; Felipe Nasser; José Carlos Ingrund; Adnan Neser

    2012-01-01

    CONTEXTO: A insuficiência venosa crônica (IVC) em suas formas mais graves, com ulceração e lesões inflamatórias, associa-se a um tratamento cirúrgico convencional de difícil execução. A escleroterapia de veias tronculares com espuma de polidocanol é considerada uma alternativa terapêutica com resultados satisfatórios. OBJETIVO: Relatar os resultados da escleroterapia com espuma de polidocanol no tratamento de pacientes com IVC de membros inferiores com úlcera ativa. MÉTODOS: Em um período de ...

  12. Radiotherapy in the management of Graves` ophthalmopathy

    Energy Technology Data Exchange (ETDEWEB)

    Sakata, Koh-ichi; Hareyama, Masato; Oouchi, Atsushi; Shidou, Mitsuo; Nagakura, Hisayasu; Morita, Kazuo; Osanai, Hajime; Ohtsuka, Kenji; Hinoda, Yuji [Sapporo Medical Univ. (Japan). School of Medicine

    1998-06-01

    To report the results of radiotherapy for patients with failure, adverse reactions or relative contraindications to the use of steroids or immunosuppressants, by using newly developed quantitative indexes. Fourteen female and six male patients with Graves` ophthalmopathy were treated with radiotherapy between 1989 and 1996. Prior to radiotherapy, eight patients received treatment with prednisone, four received immunosuppressants and four received a combination of both. Four patients with contraindications to steroids were initially managed with radiotherapy. Most of the patients received a dose of 24-28 Gy in 2 Gy fractions. We used the newly developed motility limitation index to assess extraocular motility. Treatment was well tolerated. There have been no late complications. All 12 patients with soft tissue signs such as edema, irritation, tearing and pain were improved. Proptosis did not improve or improved only slightly, 3 mm at best. However, proptosis in all but two has been stabilized and has not deteriorated in the follow-up period. Most of the patients have experienced an improvement of eye-muscle motility. Extraocular muscles that work for elevation were impaired more severely than the other muscles and this tended to remain. Of the 16 patients using steroids before or when radiotherapy was initiated, 15 were tapered off and only one patient required additional steroids, thus sparing the majority from steroid adverse reactions. Radiotherapy was effective in preventing exacerbations of active inflammatory ophthalmopathy in patients with Graves` disease with minimal morbidity and thus eliminated the adverse reactions associated with protracted corticosteroid use. The newly developed motility limitation index was useful in detecting delicate changes in motility of individual extraocular muscles. (author)

  13. Programas de Investigación en Paleobiología y Teoría evolutiva

    Directory of Open Access Journals (Sweden)

    Rosas González, Antonio

    2002-05-01

    Full Text Available Not available

    Se presenta una discusión del papel actual de la paleontología en el estudio de la evolución orgánica. Diferentes descubrimientos, tanto teóricos como empíricos, están cuestionando algunos de los principios básicos del paradigma neodarvinista. La irrupción de la genética del desarrollo y la noción de procesos que limitan el potencial de variación del fenotipo han abierto nuevos programas de investigación. Desde la paleontología se desarrollan los fundamentos de una teoría macroevolutiva. El estudio de la morfología, un tema clásico de las ciencias naturales, vive un resurgir a la luz de los nuevos datos y enfoques. Quedan, no obstante, importantes incógnitas por resolver ante la pregunta de cómo y porqué cambian los organismos. La integración de los nuevos datos de la neontología en un contexto temporal amplio (tiempo geológico proporciona a la paleontología una función importante en el momento actual de la investigación en biología evolutiva.

  14. LA CONSERVACIÓN BIOLÓGICA Y SU PERSPECTIVA EVOLUTIVA Biological Conservation and its Evolutionary Perspective

    Directory of Open Access Journals (Sweden)

    OLGA L MONTENEGRO

    Full Text Available Este artículo revisa tres de las principales causas de amenaza a la diversidad biológica, como son la fragmentación y pérdida del hábitat, así como la invasión de especies exóticas, principalmente en lo que compete a sus implicaciones evolutivas. Los efectos de la fragmentación y/o pérdida del hábitat pueden revisarse a la luz de la sinergia entre factores demográficos y genéticos que moldean cambios evolutivos o que llevan a las poblaciones al vórtice de la extinción. Las invasiones biológicas, aunque han generado pérdidas considerables en la diversidad biológica, ofrecen un escenario interesante para estudiar procesos evolutivos contemporáneos.This paper reviews three of the main threats to biological diversity, such as habitat fragmentation /habitat loss, and invasion of exotic species, mainly from their evolutionary implications. Effects of habitat fragmentation/habitat loss could be addressed by looking at the synergy between demographic and genetic factors that together shape evolutionary changes or otherwise bring populations to extinction vortex. Biological invasions, in spite of their strong negative effects on biological diversity, offer an interesting scenario to study contemporary evolutionary processes.

  15. Retrovirus endógenos humanos: Significado biológico e implicaciones evolutivas

    Directory of Open Access Journals (Sweden)

    Sentís, Carlos

    2002-05-01

    Full Text Available El genoma humano contiene un importante número de retrovirus endógenos (HERVs, es decir, secuencias derivadas de pasadas infecciones retrovirales insertadas de forma permanente; y secuencias similares se pueden observar en prácticamente todos los organismos eucariontes. Muchos de estos HERVs se transcriben y traducen en condiciones fisiológicas normales, llegando a formar partículas virales completas, y participando en procesos tan complejos como la placentación. Por su capacidad de retrotransposición y recombinación entre ellos son una fuente importante de remodelación genómica y, junto con otros retroelementos, participan en la generación de retrogenes y retropseudogenes, que suponen un sustrato de variabilidad informacional fundamental para la aparición de nuevas estructuras y funciones. Puesto que su actividad responde también a las condiciones ambientales, los cambios genómicos generados por ellos no son graduales, sino que aparecen en oleadas, de modo que se puede producir una variedad fenotípica muy extensa en momentos evolutivos concretos, coincidiendo con situaciones ambientales críticas. La consideración de los HERVs como parte integral y consustancial de nuestro genoma obliga a replantearse la utilización de vectores retrovirales en protocolos de terapia génica, así como la utilización de órganos animales -con sus propios retrovirus endógenos- para xenotrasplantes.

  16. Hay que poner de su parte para afrontar una enfermedad grave

    Directory of Open Access Journals (Sweden)

    Óscar Alberto Beltrán-Salazar

    2010-01-01

    Full Text Available Objetivo: describir el significado de la experiencia de estar gravemente enfermo y hospitalizado en una Unidad de Cuidado Intensivo. Metodología: investigación cualitativa basada en la teoría fundada, realizada en Medellín, Colombia, de abril a octubre de 2006; incluyó a nueve personas adultas entre 24 y 80 años que estuvieron críticamente enfermas y hospitalizadas en UCI. La entrevista en profundidad se utilizó para la recolección de información. Los datos se analizaron según el esquema propuesto por Cohen, Kahan y Steeves. Resultados: poner de su parte es necesario para afrontar una enfermedad y hace referencia a los medios personales y externos que los participantes utilizaron para aceptar y adaptarse a la enfermedad y atenuar su condición amenazante. Discusión: vivir la experiencia de padecer una enfermedad grave significó que los participantes se valieran de recursos personales internos disponibles y de algunas formas de apoyo social como la familia, la religión, los enfermeros, los amigos y conocidos e incluso de personas desconocidas. Conclusión: los recursos personales y sociales ayudan a los pacientes a afrontar las emociones que despierta una situación que no pueden resolver por sí mismos como es el padecimiento de una enfermedad grave.

  17. Miastenia grave tratamento clínico x cirúrgico

    Directory of Open Access Journals (Sweden)

    Lineu Cesar Werneck

    1991-12-01

    Full Text Available A indicação da timectomia na miastenia grave ainda é controversa e, na atualidade, é difícil encontrar séries comparando tratamento conservador, devido à indicação gene. ralizada da timectomia. Na presente série foram estudados 65 casos divididos em três grupos : (1 15 pacientes timectomizados e 50 com tratamento conservador; (2 15 pacientes timectomizados pareados com 15 pacientes semelhantes clinicamente, mas tratados conservadoramente; (3 49 pacientes tratados com corticosteróides, com 16 sem corticosteróides. Estes três grupos foram comparados quanto a idade, idade de início dos sintomas, tempo de doença, formas clinicas, escala funcional e intensidade dos sintomas, seguidos durante vários anos, estudando-se o número de remissões, melhora, estabilidade ou piora dos sintomas e número de óbitos. Somente tiveram melhora dos sintomas (p<0,05 os timectomizados do grupo 1; os demais parâmetros de todos os grupos não se mostraram estatisticamente significativos. Esses resultados sugerem que o tipo de tratamento pouco interferiu na evolução da miastenia grave neste grupo de pacientes.

  18. Graves' Disease that Developed Shortly after Surgery for Thyroid Cancer

    Directory of Open Access Journals (Sweden)

    Hea Min Yu

    2013-09-01

    Full Text Available Graves' disease is an autoimmune disorder that may present with various clinical manifestations of hyperthyroidism. Patients with Graves' disease have a greater number of thyroid nodules and a higher incidence of thyroid cancer compared with patients with normal thyroid activity. However, cases in which patients are diagnosed with recurrence of Graves' disease shortly after partial thyroidectomy for thyroid cancer are very rare. Here we report a case of hyperthyroid Graves' disease that occurred after partial thyroidectomy for papillary thyroid cancer. In this case, the patient developed hyperthyroidism 9 months after right hemithyroidectomy, and antithyroglobulin autoantibody and thyroid stimulating hormone receptor stimulating autoantibody were positive. Therefore, we diagnosed Graves' disease on the basis of the laboratory test results and thyroid ultrasonography findings. The patient was treated with and maintained on antithyroid drugs. The mechanism of the recurrence of Graves' disease in this patient is still unclear. The mechanism may have been the improper response of the immune system after partial thyroidectomy. To precisely determine the mechanisms in Graves' disease after partial thyroidectomy, further studies based on a greater number of cases are needed.

  19. Psychiatric manifestations of Graves' hyperthyroidism: pathophysiology and treatment options.

    Science.gov (United States)

    Bunevicius, Robertas; Prange, Arthur J

    2006-01-01

    Graves' disease is an autoimmune disorder that is the most common cause of hyperthyroidism. Other symptoms associated with the disease are goitre, ophthalmopathy, and psychiatric manifestations such as mood and anxiety disorders and, sometimes, cognitive dysfunction. Graves' hyperthyroidism may result in these latter manifestations via the induction of hyperactivity of the adrenergic nervous system. This review addresses the psychiatric presentations, and their pathophysiology and treatment, in patients with hyperthyroidism, based on literature identified by a PubMed/MEDLINE database search. Although the focus is on mental symptoms associated with Graves' disease, it is not always clear from the literature whether patients had Graves' disease: in some studies, the patients were thought to have Graves' disease based on clinical findings such as diffuse goitre or ophthalmopathy or on measurements of thyroid antibodies in serum; however, in other studies, no distinction was made between Graves' hyperthyroidism and hyperthyroidism from other causes. Antithyroid drugs combined with beta-adrenoceptor antagonists are the treatments of choice for hyperthyroidism, as well as for the psychiatric disorders and mental symptoms caused by hyperthyroidism. A substantial proportion of patients have an altered mental state even after successful treatment of hyperthyroidism, suggesting that mechanisms other than hyperthyroidism, including the Graves' autoimmune process per se and ophthalmopathy, may also be involved. When psychiatric disorders remain after restoration of euthyroidism and after treatment with beta-adrenoceptor antagonists, specific treatment for the psychiatric symptoms, especially psychotropic drugs, may be needed.

  20. Amnésia retrógrada funcional grave: relato de caso

    OpenAIRE

    Neves,Maila de Castro L.; Beato,Rogério Gomes; Girodo,Carla Monteiro; Lauar,Hélio; Nicolato,Rodrigo; Salgado,João Vinícius; Teixeira, Antônio Lúcio

    2008-01-01

    CONTEXTO: Uma síndrome amnésica clássica caracteriza-se por evidente prejuízo da memória anterógrada, variável e temporária amnésia retrógrada, sendo as formas não-declarativas da memória poupadas. Entretanto, publicações recentes relataram casos de prejuízo desproporcional da memória retrógrada em relação à anterógrada. OBJETIVOS: Relatar o caso de um paciente de 26 anos de idade com um quadro grave de amnésia retrógrada, aparentemente sem fatores desencadeantes. MÉTODOS: Entrevista psiquiát...

  1. Ciencia e Innovación. Una relación compleja y evolutiva

    Directory of Open Access Journals (Sweden)

    Fernández de Lucio, Ignacio

    2011-12-01

    Full Text Available The increasing importance of knowledge in contemporary societies is necessary to understand and analyze the relation between science and innovation today. This article is focused on how our conception of the processes of knowledge production and the process of innovation has evolved. The relation between science and innovation has changed compared to past decades, nowadays the concept of innovation and its’ relation with science goes beyond the application of the scientific method inside the scientific community. This relation extends itself into other spheres such as the cultural and the social where other applications are involved and where the development of public policy becomes crucial.

    La cada vez mayor importancia que está adquiriendo el conocimiento en las sociedades contemporáneas hace necesario profundizar en el análisis de la relación existente entre ciencia e innovación. Este artículo la aborda considerando como ha evolucionado nuestra concepción sobre los procesos de producción de conocimiento y el proceso innovador. La revisión bibliográfica realizada muestra que la emergencia de nuevos enfoques en estos campos ha generado una visión sobre la relación ciencia-innovación bastante diferente a la que predominaba hace algunas décadas. De esta forma, si bien por un lado se reconoce que el proceso innovador no depende exclusivamente del desarrollo de actividades científicas, por otro, se establece que el vínculo ciencia-innovación puede ser hoy mucho más estrecho, teniendo en cuenta que las actividades de investigación se desarrollan, cada vez más, en un contexto de aplicación. En el artículo se discute el alcance real de esta nueva visión y las implicaciones que tiene para el diseño de políticas públicas.

  2. Herramienta evolutiva para la planificación del mantenimiento de locaciones petroleras

    Directory of Open Access Journals (Sweden)

    Maria Azul Cossio

    2014-06-01

    Full Text Available El propósito de este documento es la presentación de una herramienta (PAE, Planificación basada en un Algoritmo Evolutivo que utiliza un algoritmo evolutivo generador de múltiples soluciones para la planificación dinámica del mantenimiento preventivo de locaciones petroleras. La explotación y el transporte de petróleo son actividades muy importantes para el desarrollo económico de la sociedad industrial moderna. Sin embargo, estas actividades son generadoras de riesgos que se traducen en contaminaciones accidentales o crónicas que afectan directamente al ecosistema. Es importante que las empresas petroleras realicen un correcto mantenimiento de sus locaciones. PAE es capaz de brindar en forma oportuna la planificación del recorrido. El beneficio debe observarse desde dos aspectos. Primero, una planificación es mejor que otra, si para un mismo número de locaciones a visitar el costo de recorrido e intervención planificada es menor. Segundo, si con un mismo tiempo de intervención es posible realizar el mantenimiento a más locaciones, reduciendo la probabilidad de caída al incrementar la cantidad de locaciones recorridas. Se han incorporado eventos externos que provocan la replanificación y restricciones al momento de la planificación, en estos casos los resultados obtenidos han sido satisfactorios ya que minimizan el tiempo total de una planificación y maximizan la cantidad de locaciones visitadas. Esta herramienta ha sido diseñada para operar a un bajo costo de desarrollo tanto desde el punto de vista de la tecnología hardware como la tecnología de software que la soporta, desarrollada por el Laboratorio de Tecnologías Emergentes de la Universidad Nacional de la Patagonia Austral Unidad Académica Caleta Olivia, utiliza un algoritmo evolutivo que es el generador de múltiples soluciones al problema.

  3. Concomitant Graves' disease and Hashimoto's thyroiditis, presenting as primary hypothyroidism.

    LENUS (Irish Health Repository)

    Cronin, C C

    2012-02-03

    Hypothyroidism in patients with Graves\\' disease is usually the result of ablative treatment. We describe a 58 year old man with Graves\\' ophthalmopathy and pre-tibial myxoedema, who presented with spontaneous primary hypothyroidism. Circulating TSH receptor antibody activity was increased, while thyroid microsomal antibody was detectable in titres greater than one in one hundred thousand. It is likely that the TSH receptor antibody of Graves\\' disease was ineffective in stimulating hyperthyroidism because of concomitant thyroid destruction due to Hashimoto\\'s disease. Alternatively, primary hypothyroidism could have resulted from the effects of a circulating TSH receptor blocking antibody.

  4. Uma nova forma de Coffea

    Directory of Open Access Journals (Sweden)

    C. A. Krug

    1950-01-01

    Full Text Available Nos extensos trabalhos de melhoramento do cafeeiro, há 18 anos em realização na Subdivisão de Genética do Instituto Agronômico, tem-se dedicado especial atenção à espécie C. arabica L., pelo fato de todos os nossos cafèzais pertencerem a esta espécie que, sem dúvida, fornece o produto de melhor qualidade. Nas regiões de terras extremamente cansadas, um dos principais fatôres levados em consideração no melhoramento é a rusticidade, caráter êsse, entretanto, encontrado de preferência em outras espécies, tais como o C. canephora e C. Dewevrei, cujos cafés são de má qualidade. A hibridação interespecífica, que poderia reunir em uma só planta caraterísticos de rusticidade e boa qualidade de bebida, tem o inconveniente de dar origem a plantas triplóides, que são estéreis. Daí se deduz que a obtenção artificial de formas que combinassem êsses caraterísticos constitui problema, cuja solução é extremamente demorada. No presente trabalho, apresentam-se os caracteres de uma nova forma de Coffea, encontrada em cafèzal da Fazenda Itaporã, em Terra Roxa, município de Viradouro, que, com algumas ressalvas, oferece a desejada combinação de caracteres. Trata-se, provàvelmente, de um híbrido espontâneo entre C. arabica e C. Dewevrei, com 2n = 44 cromosômios, extremamente rústico e produtivo, cujas sementes fornecem uma bebida que pode ser classificada como boa. Apenas apresenta, como principal defeito, uma auto-esterilidade quase completa. Os seus caraterísticos botânicos são descritos em detalhe. Devido ao seu porte elevado, ramos abundantes e folhas grandes e coriáceas, esse cafeeiro se assemelha ao C. Dewevrei. Os frutos são oval-elípticos, de um vermelho bem escuro quando maduros, e as sementes oblongas, constatan-do-se elevada percentagem do tipo "moca" e "chocha". Quanto à constituição citológica, as pesquisas conduziram à hipótese de este cafeeiro possuir 22 cromosômios de C. arabica e 22 (n

  5. Una introducción a la Computación Evolutiva y alguna de sus aplicaciones en Economía y Finanzas || An Introduction to Evolutionary Computation and some of its Applications in Economics and Finance

    Directory of Open Access Journals (Sweden)

    Coello Coello, Carlos A.

    2006-12-01

    Full Text Available Este artículo pretende proporcionar un panorama general de la computación evolutiva, sus orígenes, sus paradigmas principales y algunas de sus aplicaciones en Economía y Finanzas. Se discuten, entre otras cosas, los descubrimientos científicos más importantes que originaron el denominado Neo-Darwinismo, que es la teoría en la que se basa la computación evolutiva. También se proporciona una breve cronología de acontecimientos clave que desembocaron en los tres paradigmas en uso más común dentro de la computación evolutiva moderna: los Algoritmos Genéticos, la Programación Evolutiva y las Estrategias Evolutivas. En la segunda parte del artículose proporcionan algunas aplicaciones representativas del uso de algoritmos evolutivos en Economía y Finanzas, así como algunas de las tendencias de investigación en el Área.

  6. Successful treatment of Graves disease in pregnancy with Lugol's iodine.

    Science.gov (United States)

    Jamieson, A; Semple, C G

    2000-02-01

    We report a case of Grave's disease in pregnancy complicated by intolerance of standard antithyroid drug therapy. We describe the success of prolonged use of organic iodine as a primary treatment prior to surgical intervention.

  7. Historic Sites and Grave Markers at Litttle Bighorn Battlefield, Montana

    Data.gov (United States)

    National Park Service, Department of the Interior — This is a vector point file showing the historic sites and grave markers at Little Bighorn Battlefield National Monument (LIBI). The coordinates for this dataset...

  8. Paracentral Corneal Dellen:A Rare Sign of Graves Ophthalmopathy

    Institute of Scientific and Technical Information of China (English)

    Jianhua Yan; Zhongyao Wu

    2003-01-01

    Purpose: To report a rare sign, paracentral corneal dellen that developed in a middleaged female patient with Graves ophthalmopathy.Methods:A paracentral corneal dellen developed in the left eye in a 42-year-old woman who was diagnosed as Graves ophthalmopathy. The patient had remarkable upper eyelid retraction, upper eyelid lag and upward motility restriction. The Graves ophthalmopathy was classified as Grade V according to NOSPECS classification.Results:Local artificial tear film and 0.3% Tobramycin eye drops were administered to both eyes.Twenty-four hours later, the left corneal dellen disappeared.Conclusions:Graves ophthalmopathy can lead to paracentral corneal dellen because of severe upper eyelid retraction and upward motility restriction of the eye in spite of the lack of lagophthalmos. Artificial tear drop and antibiotic eye drop therapy helped even though the patient did not have corneal exposure.

  9. Anaesthetic Challenges In An Untreated Grave's Disease Parturient ...

    African Journals Online (AJOL)

    Alasia Datonye

    hyperthyroidism in pregnancy is challenging to perioperative care ... associated with untreated Graves ' disease in pregnancy. Method: .... pregnancy, symptoms of fatigue, heat intolerance, and. 7 ... Magnesium produces a dose-dependent.

  10. CASE REPORT : GRAVE'S DISEASE PRESENTING AS PARANOID SCHIZOPHRENIA

    OpenAIRE

    Singh, S. K.; Hatwal, A.; Agarwal, J.K.; Bajpai, H.S.; Sharma, I

    1989-01-01

    SUMMARY The case of a 37 year old male is described who initially presented as paranoid schizophrenia unresponsive to anti-psychotic drug treatment and subsequently developed features of Grave's disease. Treatment with carbimazole alone improved his psychiatric symptoms.

  11. Graves' Disease Associated with Cerebrovascular Disease and Antiphospholipid Antibody Syndrome

    Directory of Open Access Journals (Sweden)

    Ines Khochtali

    2010-01-01

    have increased risk for developing thromboembolic accidents, which are favoured by a simultaneous presence of antiphospholipid antibodies syndrome. in this paper, we describe the case of a patient with Graves' disease, who developed strokes with antiphospholipid antibodies syndrome.

  12. Orbital metastases from neuroendocrine carcinoma, masquerading as graves orbitopathy.

    Science.gov (United States)

    Sira, Mano; Clauss, Ralf P; Maclean, Chris; Rose, Geoffrey E

    2010-04-01

    We describe a patient with metastases from neuroendocrine carcinoma masquerading as Graves ophthalmopathy. This rare tumour possibly has a propensity for orbital spread, and we postulate a mechanism evoking the 'seed and soil' hypothesis.

  13. LOS NUEVOS PILARES DE LA TEORÍA EVOLUTIVA A LA LUZ DE LA GENÓMICA

    Directory of Open Access Journals (Sweden)

    López Camilo Ernesto

    2011-12-01

    Full Text Available La teoría de evolución de Darwin se ha constituido en uno de los pilares fundamentales de la biología. Algunos supuestos de dicha teoría han sido complementados con las bases genéticas de la herencia dando origen a la Teoría Moderna o Sintética de la Evolución. En los últimos años se han logrado grandes avances en el área de la secuenciación y análisis de genomas completos que han aportado elementos para debatir varios de los postulados darwinistas de la evolución. La evidencia de procesos de duplicación génica y de genomas completos, la transferencia horizontal de genes y la teoría endosimbiótica cuestionan la idea del cambio evolutivo como un proceso de acumulación de pequeños cambios a través del tiempo geológico. La evidencia de la selección neutral en el contexto genómico pone de manifiesto otros mecanismos de evolución que no necesariamente van acompañados de un programa adaptacionista ni con la idea de progreso. En este artículo se presentan estos y otros conceptos adicionales tales como la regulación génica y los mecanismos moleculares del desarrollo y del ambiente (epigénesis, plasticidad fenotípica como puntos de partida hacía la actualización de una teoría evolutiva actual, incluyente y acorde a los conocimientos actuales.

  14. LOS NUEVOS PILARES DE LA TEORÍA EVOLUTIVA A LA LUZ DE LA GENÓMICA

    Directory of Open Access Journals (Sweden)

    CAMILO ERNESTO LÓPEZ CARRASCAL

    2011-01-01

    Full Text Available La teoría de evolución de Darwin se ha constituido en uno de los pilares fundamentales de la biología. Algunos supuestos de dicha teoría han sido complementados con las bases genéticas de la herencia dando origen a la teoría moderna o sintética de la evolución. En los últimos años se han logrado grandes avances en el área de secuenciación y análisis de genomas completos que han aportado elementos para debatir varios de los postulados darwinistas de la evolución. La demostración de procesos de duplicación de genes y de genomas completos, la transferencia horizontal de genes y la teoría endosimbiótica cuestionan la idea de cambio evolutivo como un proceso de acumulación de pequeños cambios a través del tiempo geológico. La evidencia de la selección neutral en el contexto genómico pone de manifiesto otros mecanismos de evolución, que no necesariamente van acompañados de un programa adaptacionista ni con la idea de progreso. En este artículo se presentan estos y otros conceptos adicionales tales como la regulación génica y los mecanismos moleculares del desarrollo y del ambiente como puntos de partida para el planteamiento de una teoría evolutiva incluyente y acorde a los conocimientos actuales.

  15. Orbital dissection defatting technique for Graves disease.

    Science.gov (United States)

    Hecht, S D; Guibor, P; Wolfley, D; Wiggs, E O

    1984-04-01

    Five patients with Graves disease and bilateral proptosis were treated with different incisional approaches. They all underwent orbital decompression by removal of the anterior medial orbital walls, the anterior ethmoidal sinuses, the orbital floors, and multiple incisions of the orbital periosteums . The defatting technique, which consists of applying manual anterior orbital pressure with alternate removing of small lobules of fat, was added when it was intraoperatively decided by Hertel exophthalmometer measurement that more decompression was needed. It is estimated that one-third more reduction in proptosis resulted. An average total decrease in proptosis of 9 mm per orbit occurred. Both visual accuities and visual fields returned to normal. The only important complication was the development of hypertropia in down gaze in one patient. A potential value of this technique is its use with orbital floor decompression alone. It may be possible to avoid removing the medial and lateral walls of the orbit, thereby decreasing complications. Defatting may also be a valuable addition in those rare cases where all decompression techniques available are needed to affect an adequate decompression.

  16. Miastenia grave distal: relato de caso

    Directory of Open Access Journals (Sweden)

    Scola Rosana Herminia

    2003-01-01

    Full Text Available Relatamos o caso de uma mulher de 30 anos com quadro de fraqueza muscular nos membros inferiores com predomínio distal com início há 7 anos. Na evolução apresentou fraqueza muscular nos membros superiores. O exame físico mostrava nervos cranianos sem alterações, hipotrofia bilateral de quadriceps e interósseos dos pés, redução da força muscular mais intensa em tibiais anteriores e interósseos dorsais dos pés e reflexos tendinosos globalmente hipoativos. Foi realizado teste de estimulação repetitiva que mostrou decremento maior que 10% no nervo fibular e ulnar. A dosagem de anticorpos anti-receptor de acetilcolina foi positiva. Tomografia computadorizada de tórax foi normal. Dosagem de hormônios tireoidianos mostrou evidências laboratoriais de hipertireoidismo, porém sem manifestações clínicas. Foi iniciado tratamento com piridostigmina havendo melhora importante do quadro clínico. A fraqueza distal é um sintoma inicial raro na miastenia grave (MG. Contudo, a MG deve entrar no diagnóstico diferencial de doenças que cursam com fraqueza muscular distal de membros superiores ou inferiores.

  17. ENFERMEDADES GRAVES CON DIAGNÓSTICO PRENATAL

    Directory of Open Access Journals (Sweden)

    Carmen María Samaniego Fernández

    2012-01-01

    Full Text Available El objetivo de este artículo es presentar la información publicada hasta el momento sobre la supervivencia, las secuelas y la calidad de vida de las enfermedades mencionadas por la declaración de la Comisión de Bioética de la Sociedad Española de Ginecología y Obstetricia (SEGO como extremadamente graves e incurables, subsidiarias de interrupción voluntaria del embarazo más allá de las veintidós semanas de edad gestacional, según lo contemplado por la Ley Orgánica 2/2010 de Salud Sexual y Reproductiva y de la Interrupción Voluntaria del Embarazo. Los profesionales sanitarios deben conocer los aspectos médicos, los avances terapéuticos y el pronóstico de dichas enfermedades, siendo un deber ético transmitir dicha información a los progenitores.

  18. Lymphocyte-platelet crosstalk in Graves' disease.

    Science.gov (United States)

    Kuznik, Boris I; Vitkovsky, Yuri A; Gvozdeva, Olga V; Solpov, Alexey V; Magen, Eli

    2014-03-01

    Platelets can modulate lymphocytes' role in the pathophysiology of thyroid autoimmune diseases. The present study was performed to clarify the status of platelet-lymphocyte subpopulations aggregation in circulating blood in patients with Graves' disease (GD). One hundred and fifty patients with GD (GD group) and 45 hyperthyroid patients with toxic multinodular goiter (TMG group) were recruited in the study. Control group consisted 150 healthy subjects. Immunophenotyping of lymphocytes was performed by flow cytometry. Detection of lymphocyte-platelet aggregates (LPAs) was done using light microscope after Ficoll-gradient centrifugation. The group of GD patients exhibited reduced CD8 lymphocyte and higher CD19 cell counts compared with TMG group and healthy controls. A greater number of activated CD3, HLA-DR+ lymphocytes were observed in GD than in TMG group and control group. GD group was characterized by lower blood platelet count (232 ± 89 × 10 cells/µL) than TMG group (251 ± 97 × 10 cells/µL; P < 0.05) and control group (262 ± 95 × 10 cells/µL; P < 0.05). In GD group, more platelet-bound lymphocytes (332 ± 91 /µL) were found than that in TMG group (116 ± 67/µL, P < 0.005) and control group (104 ± 58 /µL; P < 0.001). GD is associated with higher levels of activated lymphocytes and lymphocyte-platelet aggregates.

  19. Delineation of graves using electrical resistivity tomography

    Science.gov (United States)

    Nero, Callistus; Aning, Akwasi Acheampong; Danuor, Sylvester K.; Noye, Reginald M.

    2016-03-01

    A suspected old royal cemetery has been surveyed at the Kwame Nkrumah University of Science and Technology (KNUST) campus, Kumasi, Ghana using Electrical Resistivity Tomography (ERT) with the objective of detecting graves in order to make informed decisions with regard to the future use of the area. The survey was conducted on a 10,000 m2 area. Continuous Vertical Electrical Sounding (CVES) was combined with the roll along technique for 51 profiles with 1 m probe separation separated by 2 m. Inverted data results indicated wide resistivity variations ranging between 9.34 Ωm and 600 Ωm in the near surface. Such heterogeneity suggests a disturbance of the soil at this level. Both high (≥ 600 Ωm) and low resistivity (≤ 74.7 Ωm) anomalies, relative to background levels, were identified within the first 4 m of the subsurface. These were suspected to be burial tombs because of their rectangular geometries and resistivity contrasts. The results were validated with forward numerical modeling results. The study area is therefore an old cemetery and should be preserved as a cultural heritage site.

  20. Preclinical models of Graves' disease and associated secondary complications.

    Science.gov (United States)

    Moshkelgosha, Sajad; So, Po-Wah; Diaz-Cano, Salvador; Banga, J Paul

    2015-01-01

    Autoimmune thyroid disease is the most common organ-specific autoimmune disorder which consists of two opposing clinical syndromes, Hashimoto's thyroiditis and Graves' (hyperthyroidism) disease. Graves' disease is characterized by goiter, hyperthyroidism, and the orbital complication known as Graves' orbitopathy (GO), or thyroid eye disease. The hyperthyroidism in Graves' disease is caused by stimulation of function of thyrotropin hormone receptor (TSHR), resulting from the production of agonist antibodies to the receptor. A variety of induced mouse models of Graves' disease have been developed over the past two decades, with some reproducible models leading to high disease incidence of autoimmune hyperthyroidism. However, none of the models show any signs of the orbital manifestation of GO. We have recently developed an experimental mouse model of GO induced by immunization of the plasmid encoded ligand binding domain of human TSHR cDNA by close field electroporation that recapitulates the orbital pathology in GO. As in human GO patients, immune mice with hyperthyroid or hypothyroid disease induced by anti-TSHR antibodies exhibited orbital pathology and chemosis, characterized by inflammation of orbital muscles and extensive adipogenesis leading to expansion of the orbital retrobulbar space. Magnetic resonance imaging of the head region in immune mice showed a significant expansion of the orbital space, concurrent with proptosis. This review discusses the different strategies for developing mouse models in Graves' disease, with a particular focus on GO. Furthermore, it outlines how this new model will facilitate molecular investigations into pathophysiology of the orbital disease and evaluation of new therapeutic interventions.

  1. Human lymphocyte antigens (HLA) and Graves' disease in Turkey.

    Science.gov (United States)

    Orhan, Y; Azezli, A; Carin, M; Aral, F; Sencer, E; Molvalilar, S

    1993-09-01

    To evaluate the association of HLA types with Turkish patients with Graves' disease, HLA typing, clinical findings, and thyroid antibodies were correlated. The HLA types, clinical findings (ophthalmopathy and age at onset), and thyroid stimulating hormone (TSH) receptor (TRAb) and antithyroid microsomal antibodies (MAb) were analyzed. Seventy Turkish patients with Graves' disease and 306 control subjects were assessed. Serological HLA typing was performed in HLA A, B, C, DR, and DQ loci. There was a significantly increased prevalence of HLA B8, B49, DR3, DR4, and DR10 in Graves' disease. The association of Graves' disease with HLA DR3 was found to be less strong than previously described. The HLA DR4 antigen may contribute to the predisposition of Graves' disease in Turkey. The results suggest that HLA B7, B13, DR7, DQw2, and DQw3 may confer a protective effect for Graves' disease in Turkey. Patients carrying HLA B12, B18, and B44 haplotypes had a tendency to develop the disease at a later age. The difference from the other studies may be the result of the selection of the controls; in part, of the variability in serological typing reagents; and, also, of the rather weak HLA associations with the disease.

  2. Corticosteroides no tratamento da miastenia grave. Estudo de 12 casos com revisão da literatura

    Directory of Open Access Journals (Sweden)

    José Lamartine de Assis

    1975-03-01

    Full Text Available Foram estudados os resultados do tratamento da miastenia grave em 12 pacientes, sendo 10 com a forma generalizada severa, um com a forma generalizada moderada e um com miastenia acentuada associada a polimiosite. Sete pacientes foram previamente timectomizados e somente um apresentava timoma. Todos estavam em uso de doses elevadas de drogas anticolinesterásicas com resposta terapêutica pobre ou nula. Um paciente foi tratado com dexametaxona, outro com dexametazona seguida de prednisona e os restantes com prednisona, sempre em doses altas inicialmente (100 mg por dia ou em dias alternados e com redução gradativa ulterior até doses de manutenção. Os corticosteróides foram administrados sempre pela via oral, por períodos que variaram de duas semanas até dois anos e meio. Em conclusão, 75% de 12 pacientes com miastenia grave generalizada foram influenciados favoravelmente com este método terapêutico. Deste grupo apenas um apresentava timoma e não respondeu a qualquer tratamento. Outro paciente apresentava polimiosite associada e teve excelente resposta terapêutica. Dois miastênicos sem timoma tiveram a sintomatologia exacerbada durante o tratamento. Nenhum efeito colateral importante foi observado, mesmo nos pacientes tratados a longo prazo.

  3. Hacia una epistemología evolutiva extendida: la retroalimentación entre variación y selección.

    Directory of Open Access Journals (Sweden)

    David Velásquez Carvajal

    2016-09-01

    Full Text Available Este artículo se sitúa en la perspectiva de la naturalización del conocimiento científico, toda vez que es un intento por caracterizar y describir la evolución del conocimiento a partir de nociones de la biología. El objetivo principal es responder si es posible sostener la analogía que propone la epistemología evolutiva (EE: que la evolución del conocimiento científico (ECC es similar a la evolución orgánica (EO. La pregunta surge tras las críticas que han atacado el núcleo de la analogía. La respuesta es que la analogía sí se sostiene si se tienen en cuenta las relaciones de retroalimentación que es posible proponer a la luz de la síntesis extendida (SE, una teoría posterior que complementa la síntesis moderna (SM. Así, este trabajo comienza con una descripción del estado de la “epistemología evolutiva”, prosigue señalando por qué la síntesis moderna, que sirvió de base para su formulación, no es suficiente para fundamentar la epistemología evolutiva y finaliza proponiendo que es pertinente una modificación que puede describirse como “epistemología evolutiva extendida”.

  4. Uma abordagem evolutiva para combina??o de fontes de evid?ncia de relev?ncia em m?quinas de busca

    OpenAIRE

    Silva, Thomaz Philippe Cavalcante

    2008-01-01

    M?quinas de busca modernas utilizam diferentes estrat?gias para melhorar a qualidade de suas respostas. Uma estrat?gia importante ? obter uma ?nica lista ordenada de documentos baseada em listas produzidas por diferentes fontes de evid?ncia. Este trabalho estuda o uso de uma t?cnica evolutiva para gerar boas fun??es de combina??o de tr?s diferentes fontes de evid?ncia: o conte?do textual dos documentos, as estruturas de liga??o entre os documentos de uma cole??o e a concatena??o dos textos...

  5. De la Teoría Fonológica a la Identificación Temprana y el Diagnóstico Diferencial de la Dislexia Evolutiva

    OpenAIRE

    Bordoy Castro, Soraya

    2016-01-01

    El objetivo general de este estudio consiste en contribuir a la construcción de un instrumento de diagnóstico diferencial de la dislexia evolutiva a partir del marco de la teoría fonológica. Para ello, validamos el procedimiento de evaluación de la Batería DIS-ESP, estudiando el valor predictivo de sus pruebas fonológicas con respecto a la adquisición de los mecanismos básicos de la lectura; pero también valoramos si DIS-ESP constituye un instrumento adecuado y preciso para realizar el diagnó...

  6. Repaso de las distintas concepciones y modelos de la inteligencia y del talento. Una perspectiva evolutiva desde el punto de vista de la Psicología Humanista

    OpenAIRE

    Hume Figueroa, Miriam

    2016-01-01

    En este artículo se repasan las distintas teorías sobre la inteligencia y los modelos de buena dotación que de ellas se derivan. Desde las perspectivas humanista, evolutiva y holista se defiende un concepto más amplio de inteligencia que aúna no sólo aspectos cognoscitivos sino también importantes factores personales que inciden en el florecimiento de las potencialidades. Se propugna un modelo mixto de intervención psicopedagógica y psicoterapéutica simultánea para el despliegue de las ...

  7. Miastenia grave ocular Severe ocular myastenia

    Directory of Open Access Journals (Sweden)

    Yaimir Estevéz Miranda

    2010-01-01

    Full Text Available La miastenia grave es una enfermedad autoinmune de la unión neuromuscular que se caracteriza por la variabilidad de la debilidad muscular, que empeora o está provocada por el ejercicio del músculo o de los grupos musculares implicados, mientras que el descanso la mejora. La primera descripción de la enfermedad data de 1672, su relación con una afección del timo no se estableció hasta 1901. La enfermedad es poco frecuente, afecta a todas las etnias por igual, y no tiene predilección geográfica. Se reporta un paciente masculino de 28 años de edad atendido en el Servicio de Oftalmología Pediátrica del Instituto Cubano de Oftalmología "Ramón Pando Ferrer" por presentar visión doble, ptosis palpebral ligera en ojo derecho que empeora con el transcurso del día. Por el interrogatorio y el cuadro clínico se sospecha de una miastenia grave, se remite al clínico y el neurólogo. En los estudios realizados de neuroimágenes, tomografía y electroencefalograma no se encontraron alteraciones. Se decide valorar el caso con el servicio de Neuroftalmología de nuestro centro y por el Instituto de Neurología y es confirmado el diagnóstico.Myasthenia gravis is an autoimmune illness of the neuromuscular joint that is characterized by the variability of the muscular weakness that worsens or caused by exercising of the muscle or the involved muscular groups; resting helps in improving the condition of the muscle. The first description of the illness dates back to 1672, but its linking to a thymus disorder was not discovered until 1901. This illness is not very frequent, affects equally to all the races, and it does not predominate in any particular geographic region. This paper presented a male patient aged 28 years who went to the Ophthalmologic Service at "Ramón Pando Ferrer" Cuban Institute of Ophthalmology because he suffered from double vision, slight palpebral ptosis in his right eye that became worse as the day went by. After the

  8. Necrose tubular aguda e anemia grave após uso intermitente de rifampicina

    Directory of Open Access Journals (Sweden)

    Eduardo Santos

    2013-03-01

    Full Text Available A rifampicina (RFP pode ser administrada diariamente ou num esquema intermitente. Quando é administrada de forma intermitente pode produzir reações imuno-alérgicas graves. Apresentamos o caso clínico de um pa-ciente que, após tratamento com RFP de forma intermitente para uma infeção por Mycobacterium intracellulare, desenvolveu quadro de necrose tubular aguda, anemia, prolongamento dos tempos de coagulação e citó-lise hepática ligeira. Após suspensão do fármaco houve recuperação em 24h das alterações da coagulação e da citólise hepática, tendo tido no entanto necessidade de hemodiálise por persistência de anúria e uremia, e transfusão de concentrados de eritrócitos pela gravidade da anemia. Teve alta com recuperação de todas as disfunções.

  9. Formas de la indefinicin (Gestaltwandel

    Directory of Open Access Journals (Sweden)

    Igncio Castro Rey

    2012-06-01

    Full Text Available Antes de la lengua natal y materna, existe un suelo de sentido (imgenes, ecos, rumores, sonidos rotos desde el cual el hombre habla, una zona cero de ruinas desde la cual el hombre reconstruye continuamente el lenguaje. Como si hablara su propia lengua estndar (castellano, portugus o ingls desde una lengua menor. La primera labor de traduccin ya est ah, al pasar la desarticulacin de lo vivido a la articulacin del sentido. Desde el punto de vista tico, ontolgico y poltico, la poesa y el arte se ocupan de esa inmediatez comn, de ese espectro de lo real. Si el arte comunica de una forma incomparable es precisamente porque afronta lo comn en la singularidad de un momento que junta (lejos de nuestra cultura de la separacin lo abstracto y lo concreto, la indefinicin y la definicin. J. Cage ha definido esta tarea tica as: Escuchar los sonidos del mundo antes de que se conviertan en signo, en cdigo general. Si esto es cierto, habra dos tipos de imgenes. Unas, las habituales (Studium, se presentan colgadas en la cronologa social, remitindose unas a otras a la manera de la mercanca informativa. Otras, a la fuerza ms escasas (Punctum, nos detienen porque, en vez de estar colgadas en el tiempo general de nuestra circulacin, acumulan el tiempo en un momento, en la fascinada quietud que condensa un infinito movimiento. Es el infinito el acto de algunas imgenes inolvidables, el absoluto local que logra la msica cuando consigue que se pare el tiempo. Para esta alta indefinicin de algunas obras del arte, la historia (informacin, contexto, conocimiento es slo el conjunto de mediaciones, prcticamente negativas, que son necesarias para que ocurra algo nuevo, que no tiene precedentes. Despus, todo el tiempo social vive a expensas de esos acontecimientos de lentitud fulminante, casi imperceptibles para vigilancia social ordinaria y el sistema informativo.

  10. Una introducción a la Computación Evolutiva y alguna de sus aplicaciones en Economía y Finanzas || An Introduction to Evolutionary Computation and some of its Applications in Economics and Finance

    OpenAIRE

    Carlos A. Coello Coello; Santana Quintero, Luis Vicente

    2006-01-01

    Este artículo pretende proporcionar un panorama general de la computación evolutiva, sus orígenes, sus paradigmas principales y algunas de sus aplicaciones en Economía y Finanzas. Se discuten, entre otras cosas, los descubrimientos científicos más importantes que originaron el denominado Neo- Darwinismo, que es la teoría en la que se basa la computación evolutiva. También se proporciona una breve cronología de acontecimientos clave que desembocaron en los tres paradigmas en uso más común dent...

  11. Inferência gramatical usando uma técnica evolutiva = Grammatical inference using an evolutionary technical

    Directory of Open Access Journals (Sweden)

    Sandra Mara Guse Scós Venske

    2011-04-01

    Full Text Available Num processo de inferência, busca-se encontrar uma resposta genéricabaseando-se na análise de uma amostra de fatos. A inferência gramatical visa obter uma gramática para uma determinada linguagem baseada em exemplos de cadeias que pertencem ou não à linguagem analisada. Neste trabalho propõe-se um algoritmo para o uso deinferência em gramáticas livres de contexto baseadas em uma cadeia exemplo não pertencente à linguagem. A técnica evolutiva de algoritmos genéticos foi aplicada no processo com o objetivo de auxiliar na criação das regras de produção para as gramáticas,atendendo às restrições impostas pela cadeia exemplo. Uma aplicação do algoritmo de inferência está relacionada a linguagens que possuem padrões específicos pré-definidos, como é o caso de documentos XML no contexto de esquemas. A eficiência do algoritmo proposto é mostrada através de pequenos testes onde são obtidas gramáticas geneticamentegeradas.Inference process try to find a generic answer based on a sample of facts. This process aims to achieve a grammar for a particular language based in string samples that belong or not belong to thespecific language. In this work we propose an algorithm for context-free grammars inference based in only one sample string that not belongs to the language. The genetic algorithm evolutive technical was applied in order to assist the generation of productionrules for grammars. This process must to validate the sample string restrictions. Inference algorithm proposed can be applied in computer languages that have specific pre-defined standards, like schemas for XML documents. Suitability of the proposed algorithm is shown by small experiments where grammars are genetically obtained and generated.

  12. Color-flow Doppler sonography in Graves disease: "thyroid inferno".

    Science.gov (United States)

    Ralls, P W; Mayekawa, D S; Lee, K P; Colletti, P M; Radin, D R; Boswell, W D; Halls, J M

    1988-04-01

    Graves disease is a common diffuse abnormality of the thyroid gland usually characterized by thyrotoxicosis. We performed color-flow Doppler sonography in 16 patients with Graves disease and compared the results with those in 15 normal volunteers and 14 patients with other thyroid diseases (eight with multinodular goiter, four with focal masses, and two with papillary thyroid carcinoma). All 16 Graves disease patients exhibited a pulsatile pattern we call "thyroid inferno." This pattern consists of multiple small areas of intrathyroidal flow seen diffusely throughout the gland in both systole and diastole. In systole, both high-velocity flow (color coded white) and lower velocity flow (color coded red and blue) were noted. In diastole, fewer areas of flow and lower velocity flow were noted. Patients with Graves disease also exhibited color flow around the periphery of the gland. The inferno pattern did not occur in normal subjects or in patients with other thyroid diseases. On occasion, focal areas of intrathyroidal flow were detected in patients with multinodular goiter and focal thyroid masses. High-resolution gray-scale images did not show the small vascular channels from which the flow signal originated. Color-flow Doppler sonography shows promise as a cost-effective, noninvasive technique for diagnosing Graves disease.

  13. Pengungkapan Pro Forma, Mendukung atau Menyesatkan Investor?

    Directory of Open Access Journals (Sweden)

    Yohanis Rura

    2010-12-01

    Full Text Available Pro forma is originated from Latin. It contains different meaning depends on which discipline it is used. In accounting, pro forma disclosure is used to show effect of important transaction which occurs after the end of periods, or which occurs during period but not fully reflected in historical cost financial statement of a firm. Pro forma disclosure has the objective to support (but might mislead investor in decision making focused on particular influence of important transaction. Company with low GAAP profit information; less profitable company and has higher level of debt but more liquid, whose P-E ratio and market to book is higher than other companies in the industry; has the tendency to do pro forma disclosure. Pro forma disclosure has been supported by several theories such as: efficient market theory, catering theory, agency theory, signaling theory, and stakeholder theory. However, there are problems in reporting pro forma figures. There is no standard to it. Therefore, information on pro forma disclosure might also mislead less sophisticated investor.

  14. An update on the medical treatment of Graves' hyperthyroidism.

    Science.gov (United States)

    Marinò, Michele; Latrofa, Francesco; Menconi, Francesca; Chiovato, Luca; Vitti, Paolo

    2014-11-01

    Medical treatment of Graves' hyperthyroidism is based on the use of thionamides; namely, methimazole and propylthiouracil. In the past, methimazole was preferred by European endocrinologists, whereas propylthiouracil was the first choice for the majority of their North American colleagues. However, because of the recent definition of a better side-effect profile, methimazole is nowadays the first choice world while. Although thionamides are quite effective for the short-term control of Graves' hyperthyroidism, a relatively high proportion of patients relapses after thionamide withdrawal. Other possible medical treatments, include iodine and compounds containing iodine, perchlorate, lithium (as an adjuvant in patients undergoing radioiodine therapy), β-adrenergic antagonists, glucocorticoids, and some new molecules still under investigation. Management of Graves' hyperthyroidism using thionamides as well as the other available medical treatments is here reviewed in detail, with a special mention of situations such as pregnancy and lactation, as well as neonatal and fetal thyrotoxicosis.

  15. Clinical experience of radiation therapy for Graves` ophthalmopathy

    Energy Technology Data Exchange (ETDEWEB)

    Takahashi, Takeo; Mitsuhashi, Norio; Nagashima, Hisako; Sakurai, Hideyuki; Murata, Osamu; Ishizeki, Kei; Shimaya, Sanae; Hayakawa, Kazushige; Niibe, Hideo [Gunma Univ., Maebashi (Japan). School of Medicine

    1996-11-01

    The effect of radiation therapy for Graves` ophthalmopathy was evaluated. Ten patients with Graves` ophthalmopathy were treated with radiation therapy between 1992 and 1993 in Gunma University Hospital. All patients had a past history of hyperthyroidism and received 2,000 cGy to the retrobulbar tissues in 20 fractions. Nine of ten patients were treated with radiation therapy after the failure of corticosteroids. Six patients (60%) showed good or excellent responses. The exophthalmos type was more responsive to radiation therapy than the double vision type in this series. Two of five patients with the exophthalmos type demonstrated excellent responses, and their symptoms disappeared almost completely. The improvement of symptoms appeared within 3-6 months, and obvious clinical effects were demonstrated after 6 months of radiotherapy. Radiation therapy was well tolerated, and we have not observed any side effects of radiation therapy. In conclusion, radiation therapy is effective treatment for Graves` ophthalmopathy. (author)

  16. Grupos de formação

    OpenAIRE

    2000-01-01

    Dissertação (mestrado) - Universidade Federal de Santa Catarina, Centro de Ciências da Educação. A proposta deste trabalho foi compreender os sentidos e significados formulados pelos professores da Educação Infantil da Rede Municipal de Florianópolis acerca de sua própria formação na experiência de formação em serviço por eles vivenciado nos Grupos de Formação, entre 1994 e 1996, no Governo da Frente Popular. Foram investigados os documentos gerados pela Secretaria Municipal de Educação re...

  17. Efeitos agudos laringológicos e vocais da radioiodoterapia em pacientes com hipertireoidismo por doença de Basedow Graves Acute effects of radioiodine therapy on the voice and larynx of Basedow-Graves patients

    Directory of Open Access Journals (Sweden)

    Roberta Werlang Isolan-Cury

    2008-04-01

    Full Text Available A Doença de Graves constitui a forma mais comum de hipertireoidismo e três abordagens terapêuticas são atualmente utilizadas: uso de medicamentos antitireoideanos, cirurgia e iodo radioativo (I 131. Os efeitos do o I 131 e a indução precoce de hipotireoidismo são conseqüências da destruição induzida do I131 sobre o parênquima tireoideano. São poucos relatos encontrados na literatura acerca dos efeitos da radioioterapia sobre a laringe e conseqüentemente na produção vocal. OBJETIVO: Avaliar os efeitos agudos sobre a voz da radioiodoterapia em pacientes com hipertireoidismo por Doença de Basedow Graves. MATERIAL E MÉTODO: Estudo de corte contemporâneo longitudinal, prospectivo. Procedimentos: Investigação vocal, mensuração do tempo máximo fonatório de /a/ e relação s/z, análise freqüência fundamental (Software Praat, laringoscopia e análise perceptivo-auditiva em três momentos: pré-dose, 4 dias e 20 dias pós dose. Momentos baseados no perfil inflamatório do tecido tireoideano. RESULTADOS: Não houve mudanças estatisticamente significantes nos aspectos vocais e laringológicos nos três momentos avaliados. CONCLUSÃO: A radioiodoterapia não afeta a qualidade vocal.Graves's disease is the most common cause of hyperthyroidism. There are three current therapeutic options: anti-thyroid medication, surgery, and radioactive iodine (I 131. There are few data in the literature regarding the effects of radioiodine therapy on the larynx and voice. The aim and the AIM: os this study was: to assess the effect of radioiodine therapy on the voice of Basedow-Graves patients. MATERIAL AND METHOD: A prospective study was done. Following the diagnosis of Grave's disease, patients underwent investigation of their voice, measurement of maximum phonatory time (/a/ and the s/z ratio, fundamental frequency analysis (Praat software, laringoscopy and (perceptive-auditory analysis in three different conditions: pre-treatment, 4 days, and

  18. Thyroid Ultrasonography in Differentiation between Graves' Disease and Hashimoto's Thyroiditis.

    Science.gov (United States)

    Pishdad, P; Pishdad, G R; Tavanaa, S; Pishdad, R; Jalli, R

    2017-03-01

    Graves' disease and Hashimoto's thyroiditis are the most common causes of hyper and hypothyroidism, respectively. Differentiation of these 2 diseases, if the patient is euthyroid, may sometimes be extremely difficult on the basis of clinical and laboratory findings. The purpose of this study was to determine the sensitivity and specificity of gray scale sonography in differentiation of Graves' disease from Hashimoto's thyroiditis. This study included 149 patients divided into three groups, patients with Graves' disease (34 patients, mean age = 36.8 ± 10.17 years), Patients with Hashimoto's thyroiditis (62 patients, mean age = 33.4 ± 12.16 years) and control group (53 healthy people, mean age = 34.74 ± 16.87 years). Members of all groups were referred to a single radiologist for thyroid sonography for evaluation of thyroid echogenicity pattern. A total of 117 women and 32 men were examined by sonography. The most common sonographic pattern in Hashimoto and Graves' was homogenous hypo-echogenicity which was observed in 45.2% and 47.1% of cases, respectively. Peripheral hypo-echogenicity pattern was seen in 40.3% of Hashimoto's group with 100% specificity and 40.3% sensitivity. Central-hypoechogenic pattern was observed in 17.6% of Graves' group with 100% and 17.6% specificity and sensitivity, respectively. Our findings indicate that sonography has high specificity but low sensitivity in the diagnosis of either Graves' disease or Hashimoto's thyroiditis. It is therefore not possible to differentiate between these two diseases using sonography alone. Confirmation by laboratory data is also needed.

  19. Comparative evaluation of oculometric variables in graves' ophthalmopathy

    Directory of Open Access Journals (Sweden)

    Hélio Amante Miot

    2009-01-01

    Full Text Available OBJECTIVES: To estimate oculometric parameters of Graves' ophthalmopathy in comparison to healthy eyes using digital photography and digital image analysis. INTRODUCTION: Graves' ophthalmopathy is the main cause of eye proptosis. Because these protrusions cause clinically perceived distortions in orbital architecture, digital photographs can be used to detect and quantify these changes. METHODS: We carried out a cross-sectional study comprising 12 healthy volunteers and 15 Graves' ophthalmopathy patients with the purpose of evaluating the use of simple, non-invasive digital photography to estimate oculometric parameters of Graves' ophthalmopathy and compare them with the parameters of unaffected eyes. Facial photographs of cases and controls were taken in a standardized manner. Oculometric parameters were compared between the groups and then correlated to proptometer measures. RESULTS: All estimated oculometric variables showed significant differences between the groups, in particular with regard to mediopupilar aperture, lateral height, distance from the iris edge to the lateral boundary of the palpebral fissure, and distance from the higher point of the iris to the lateral limit of the palpebral fissure. The product of medial aperture and horizontal palpebral fissure also revealed greater discrepancy between the groups. Proptometer measures showed significant linear correlation between the distance from the iris edge to the lateral boundary of the palpebral fissure and between the distance from the higher point of the iris to the lateral limit of palpebral fissure (p<0.05. CONCLUSIONS: Comparative analysis of oculometric parameters in Graves' ophthalmopathy suggests that eye proptosis is related to an asymmetric increase in lateral oculometric measures. Standardized digital photographs can be used in clinical practice to objectively estimate oculometric parameters of Graves' ophthalmopathy patients.

  20. Nutritional support in patients with severe acute pancreatitis Soporte nutricional en pacientes con pancreatitis aguda grave

    Directory of Open Access Journals (Sweden)

    Mónica Marcela Peláez Hernández

    2007-04-01

    Full Text Available Severe acute pancreatitis is associated with a systemic inflammatory response leading to a hypermetabolic, hypercatabolic condition; for those reasons, patients suffering from this disease require an excellent artificial nutritional support in order to maintain the structural integrity and the function of vital organs with minimal pancreatic secretion. Total parenteral nutrition has been the standard practice in the treatment of patients with severe acute pancreatitis because of the favorable outcomes of early nutritional support while avoiding pancreatic stimulation; however, recent evidence suggests there are potentially greater benefits with enteral as compared with parenteral nutrition, including fewer septic and metabolic complications and lesser costs. That is why present guidelines for the management of acute pancreatitis recommend that enteral instead of parenteral nutrition be used in patients with severe acute pancreatitis. La pancreatitis aguda, especialmente en su forma grave, está asociada con una respuesta inflamatoria sistémica que lleva a un estado de hipermetabolismo e hipercatabolismo, en el que se requiere un excelente soporte nutricional que permita mantener la integridad estructural y la función de los órganos vitales con un estímulo mínimo de la secreción pancreática. La nutrición parenteral total era el soporte de elección, que permitía obtener todos los beneficios de la nutrición temprana sin estimular la secreción pancreática; pero la evidencia actual muestra mayores beneficios con la nutrición enteral, porque se asocia con menos complicaciones infecciosas y metabólicas y con disminución en los costos. Por ello las guías actuales de tratamiento de la pancreatitis aguda grave recomiendan como primera elección el soporte nutricional enteral.

  1. O mosaico patogênico da pancreatite aguda grave The pathogenic mosaic of severe acute pancreatitis

    Directory of Open Access Journals (Sweden)

    Márcio Cavalcante Carneiro

    2004-12-01

    Full Text Available A pancreatite aguda tem sido alvo de grandes discussões que vão desde o entendimento de sua fisiopatologia até a investigação de novas modalidades terapêuticas. Reconhece-se que a necrose pancreática e a falência orgânica múltipla - mormente associadas à infecção - representam os principais fatores determinantes da evolução para o óbito, mas, apesar dos grandes avanços em seu estudo, a doença permanece como um desafio para o clínico e o cirurgião. Deste modo, um melhor conhecimento dos mecanismos envolvidos em sua fisiopatologia pode ser a chave para um tratamento mais eficaz, principalmente em relação às formas graves, cuja letalidade ainda encontra-se substancialmente elevada. Baseado nestas considerações, o presente trabalho tem por objetivo a revisão bibliográfica da fisiopatologia, dos fatores patogênicos envolvidos na história natural da pancreatite aguda grave e dos eventos associados à síndrome da resposta inflamatória sistêmica e à sepse, esboçando-se assim o mosaico patogênico desta importante condição.Acute pancreatitis has been the objective of discussion, principally regarding its physiopathology and treatment. It is recognized that pancreatic necrosis, infections and multiple organ dysfunction are associated with high mortality. This disease remains a challenge for physicians and surgeons. However, a better understanding of evolved mechanisms may be the key for an appropriated treatment, principally for severe forms of disease in which mortality remains elevated. This study reviews the physiopathology and natural history of severe acute pancreatitis, and its association to SIRS and sepsis.

  2. Artroscopia do quadril na epifisiólise grave Hip arthroscopy in severe epiphysiolisis

    Directory of Open Access Journals (Sweden)

    Eiffel Tsuyoshi Dobashi

    2010-12-01

    Full Text Available Apresenta-se o caso de um indivíduo de 12 anos de idade, do sexo masculino, com diagnóstico de epifisiólise femoral proximal grau III em sua forma crônica agudizada, associada à limitação funcional grave e restrição importante do arco de movimento do quadril. O paciente foi submetido à osteotomia de ressecção de uma cunha trapezoide do colo femoral tipo Dunn por via artroscópica, seguido da redução e fixação percutânea com parafuso de 6,5mm. Houve melhora significativa do quadro clínico logo no primeiro pós-operatório, o que permitiu a reabilitação precoce. Os autores apresentam uma breve revisão de literatura e propõem esta técnica como um método adjuvante viável no tratamento da epifisiólise femoral proximal grave, encorajando o desenvolvimento de estudos sobre o tema.We present a case report of a 12-year-old boy diagnosed with slipped capital femoral epiphysis grade III, with an acute-on-chronic presentation, associated with severe functional impairment and significant reduction in hip range of motion. The patient underwent a Dunn-type trapezoidal wedge femoral neck subtraction osteotomy by hip arthroscopy, followed by closed reduction and fixation with a 6.5mm percutaneous screw. There was significant improvement of the clinical picture on the first postoperative day, allowing for early rehabilitation. After a brief review of the literature, the authors propose this novel surgical technique as a viable method to treat severe slipped capital femoral epiphysis, encouraging the development of new studies on the subject.

  3. Hipertrigliceridemia familiar grave durante a gestação

    OpenAIRE

    Luiz Augusto Casulari; Myrian Wesgueber; Ricardo Cassiano B. Silva; Soares,Henrique F.; Lucilia Domingues

    2001-01-01

    A presença de hipertrigliceridemia grave durante a gravidez é rara, mas comporta grande possibilidade de desenvolver complicações, como a pancreatite aguda, que coloca em risco a mãe e o feto. Apresentamos o relato da evolução da gestação de uma paciente portadora de hipertrigliceridemia grave que havia apresentado pancreatite aguda dois meses antes da fecundação. Foi tratada durante o pré-natal com dieta e 3,0 g de ácidos graxos de cadeia ômega-3 (ácidos eicosapentaenóico 14% e docosahexaenó...

  4. Peripartum cardiomyopathy in a patient with Graves' disease.

    Science.gov (United States)

    Kajiya, Takashi; Lee, Souki; Yamashita, Makoto; Sasaki, Yuichi; Kamizono, Yusuke; Imamura, Masakazu; Toyonaga, Koichi; Toda, Hitoshi; Koriyama, Nobuyuki; Tei, Chuwa

    2010-11-05

    Peripartum cardiomyopathy (PPCM) is a rare life-threatening cardiomyopathy of unknown etiology that occurs during the peripartum period in previously healthy women. Autoimmune and viral factors have been suggested to be involved in PPCM. Here we describe a patient with Graves' disease, which is one of the organ-specific autoimmune diseases, who developed acute heart failure due to PPCM at 2 weeks after her first delivery. The patient recovered completely with conservative treatment for heart failure. An association between PPCM and Graves' disease has not been reported before. PPCM may be an organ-specific autoimmune disease, so the coexistence of other autoimmune diseases should be considered in PPCM patients.

  5. Dissociative disorder due to Graves' hyperthyroidism: a case report.

    Science.gov (United States)

    Mizutani, Kaoru; Nishimura, Katsuji; Ichihara, Atsuhiro; Ishigooka, Jun

    2014-01-01

    We report the case of a 20-year-old Japanese woman with no psychiatric history with apparent dissociative symptoms. These consisted of amnesia for episodes of shoplifting behaviors and a suicide attempt, developing together with an exacerbation of Graves' hyperthyroidism. Patients with Graves' disease frequently manifest various psychiatric disorders; however, very few reports have described dissociative disorder due to this disease. Along with other possible causes, for example, encephalopathy associated with autoimmune thyroid disease, clinicians should be aware of this possibility. Copyright © 2014 Elsevier Inc. All rights reserved.

  6. Thymic Hyperplasia Presenting as a Neck Mass in Graves Disease

    Directory of Open Access Journals (Sweden)

    Serkan Yener

    2009-06-01

    Full Text Available We describe a female patient who presented with Graves disease and a neck mass. Radiological characteristics of the mass suggested thymic hyperplasia. She was treated with methimazole, and because the mass did not regress after six months of therapy, the patient had total thyroidectomy and thymectomy. Pathological examination was consistent with chronic lymphocytic thyroiditis and thymic hyperplasia. Microscopic changes in the thymus can be detected in one third of patients with Graves disease, but massive enlargement is rare. It has been reported that regression occurs in most patients after a euthyroid state has been achieved; however, in some patients, thymectomy may be indicated. Turk Jem 2009; 13: 11-2

  7. Hipertrigliceridemia familiar grave durante a gestação

    OpenAIRE

    Casulari Luiz Augusto; Wesgueber Myrian; Silva Ricardo Cassiano B.; Soares Henrique F.; Domingues Lucilia

    2001-01-01

    A presença de hipertrigliceridemia grave durante a gravidez é rara, mas comporta grande possibilidade de desenvolver complicações, como a pancreatite aguda, que coloca em risco a mãe e o feto. Apresentamos o relato da evolução da gestação de uma paciente portadora de hipertrigliceridemia grave que havia apresentado pancreatite aguda dois meses antes da fecundação. Foi tratada durante o pré-natal com dieta e 3,0 g de ácidos graxos de cadeia ômega-3 (ácidos eicosapentaenóico 14% e docosahexaenó...

  8. Treating the thyroid in the presence of Graves' ophthalmopathy

    DEFF Research Database (Denmark)

    Hegedüs, Laszlo; Bonnema, Steen J; Smith, Terry J

    2012-01-01

    The etiology of Graves' orbitopathy (GO) remains enigmatic. Optimal therapeutic choices for the hyperthyroidism associated with Graves' disease (GD) in the presence of GO remain controversial. Whether antithyroid drugs (ATDs), radioiodine (RAI), or thyroidectomy should be favored in such patients...... - independent of extent - do not influence the natural course of GO. RAI can cause de novo development or progression of GO, which is largely preventable with oral steroid prophylaxis. In patients with mild GO, the thyroid treatment is largely independent of GO. Moderate to severe GO should be treated promptly...

  9. Graves' disease presenting as pseudotumor cerebri: a case report

    Directory of Open Access Journals (Sweden)

    Freitas Cláudia

    2011-02-01

    Full Text Available Abstract Introduction Pseudotumor cerebri is an entity characterized by elevated intracranial pressure with normal cerebrospinal fluid and no structural abnormalities detected on brain MRI scans. Common secondary causes include endocrine pathologies. Hyperthyroidism is very rarely associated and only three case reports have been published so far. Case presentation We report the case of a 31-year-old Luso-African woman with clinical symptoms and laboratory confirmation of Graves' disease that presented as pseudotumor cerebri. Conclusion This is a rare form of presentation of Graves' disease and a rare cause of pseudotumor cerebri. It should be remembered that hyperthyroidism is a potential cause of pseudotumor cerebri.

  10. Messiniense: compleja y grave crisis ecologica

    Directory of Open Access Journals (Sweden)

    Aguirre, E.

    2003-08-01

    yacimientos de mamíferos fósiles en España y otras regiones con importantes novedades, entre ellas diversos intercambios intercontinentales, en el mismo intervalo cronológico añaden cuestiones de interés además de obligar a la correlación entre la estratigrafía basada en series marinas y la biostratigrafía continental. A las singularidades de estas series se añade el descubrimiento reciente de homínidos fósiles con indicios de bipedia en edades comprendidas en este intervalo. En el mismo se han datado graves eventos paleogeográficos, geodinámicos, paleoambientales y paleoclimáticos, que empezaron a investigarse hace 40 años como la «Crisis de Salinidad del Mediterráneo*, y sobre cuyo desarrollo e interacciones se han publicado diversos modelos más o menos incompletos: aislamiento del mediterráneo, descenso global del nivel del mar, acreción continental y orogenia, glaciación, deterioro de la cubierta vegetal. Una interpretación de la secuencia de eventos en estos diversos campos de estudio de Historia de la Tierra y de la Vida, y sus interacciones, puede trazarse con una calibración del orden de los cien mil años.

  11. 78 FR 22292 - Native American Graves Protection and Repatriation Review Committee: Notice of Nomination...

    Science.gov (United States)

    2013-04-15

    ... National Park Service Native American Graves Protection and Repatriation Review Committee: Notice of.... SUMMARY: The National Park Service is soliciting nominations for one member of the Native American Graves... nominations submitted by Indian tribes, Native Hawaiian organizations, and traditional Native...

  12. 77 FR 65406 - Native American Graves Protection and Repatriation Review Committee: Notice of Nomination...

    Science.gov (United States)

    2012-10-26

    ... National Park Service Native American Graves Protection and Repatriation Review Committee: Notice of.... SUMMARY: The National Park Service is soliciting nominations for one member of the Native American Graves... nominations submitted by Indian tribes, Native Hawaiian organizations, and traditional Native...

  13. Pancreatite aguda grave: resultados do tratamento cirúrgico em 68 pacientes

    Directory of Open Access Journals (Sweden)

    Olívio Louro Costa

    Full Text Available OBJETIVO: Analisar os resultados do tratamento cirúrgico das formas necrosantes, ou graves, da pancreatite aguda e da forma crônica agudizada. MÉTODO: Foi preenchido um protocolo, de modo consecutivo e prospectivo, de 68 pacientes operados por pancreatite aguda grave e crônica agudizada, no período de 1982 a 2000. Os pacientes foram classificados em três categorias: 1. Pancreatite aguda biliar; 2. Pancreatite aguda de causa indeterminada; 3. Pancreatite crônica agudizada. RESULTADOS: As indicações para o tratamento cirúrgico foram: diagnóstico incerto (32,3%; necrose infectada (60,3% e para necrosectomia (7,4%. As operações realizadas foram: desbridamento de necrose infectada(70,6%; operações sobre as vias biliares (20,6% e desbridamento de grandes necroses (7,4%. Os óbitos hospitalares incidentes, por categoria foram: 1. Pancreatite aguda biliar (33,3%; 2. Pancreatite aguda indeterminada (45,0%; 3. Pancreatite crônica agudizada (37,0%. A média de óbitos foi de 38,2%. Vinte e cinco pacientes foram reoperados, uma ou várias vezes, e nestes a mortalidade foi de 40,0%. Os abscessos foram responsáveis por 52,0% dos óbitos e as outras complicações que resultaram em óbitos, sempre evoluiram para infecção. CONCLUSÕES: Ocorreu um alto índice de operações por diagnóstico incerto. Esta indicação deve se restringir aos casos onde não seja possível o diagnóstico diferencial com certas causas de abdome agudo. As indicações para tratar precocemente a litíase biliar devem ser evitadas ou reduzidas a situações específicas. As reoperações são freqüentemente indicadas nesses pacientes e a infecção foi a principal causa de morte.

  14. Evidence for a major role of heredity in Graves' disease

    DEFF Research Database (Denmark)

    Brix, T H; Kyvik, K O; Christensen, Kaare

    2001-01-01

    The etiology of Graves' disease (GD), affecting up to 2% of a population in iodine-sufficient areas, is incompletely understood. According to current thinking, the development of GD depends on complex interactions among genetic, environmental, and endogenous factors. However, the relative...

  15. A patient with Graves' disease, thrombocytopenia and chronic hepatitis B.

    OpenAIRE

    Szeto, C C; Chow, C C; Ko, G. T.; K. Y. LI; Yeung, V. T.; Cockram, C S

    1997-01-01

    A 22-year-old Chinese man, a HBsAg carrier, presented with relapse of thyrotoxic Graves' disease complicated by thrombocytopenia and hepatitis. Platelet count and liver enzymes gradually improved following successful treatment of the thyrotoxicosis with radioactive iodine. Possible pathogenetic links and therapeutic implications are discussed.

  16. [Central congenital hypothyroidism due to Graves' disease in the mother

    NARCIS (Netherlands)

    Liebrand, C.A.; Mol, A.C. de; Kempers, M.J.E.; Noordam, C.

    2006-01-01

    Two male twins were born at a gestational age of 30 weeks. Five days after delivery, the mother was diagnosed with Graves' disease. The thyroid function in the neonates was therefore evaluated, which led to the detection of central congenital hypothyroidism (central CHT), even though the neonatal

  17. Measuring disease activity to predict therapeutic outcome in Graves' ophthalmopathy

    NARCIS (Netherlands)

    Terwee, C.B.; Prummel, M.F.; Gerding, M.N.; Kahaly, G.J.; Dekker, F.W.; Wiersinga, W.M.

    2005-01-01

    OBJECTIVE: The concept of disease activity in Graves' ophthalmopathy (GO) might explain why as many as one-third of patients do not respond to immunosuppressive treatment, because only patients in the active stage of disease are expected to respond. The hypothesis was adopted that a parameter used

  18. Radiotherapy for Graves' orbitopathy : randomised placebo-controlled study

    NARCIS (Netherlands)

    Mourits, MP; van Kempen-Harteveld, ML; Garcia, MBG; Koppeschaar, HPF; Tick, L; Terwee, CB

    2000-01-01

    Background The best treatment (steroids, irradiation, or both) for moderately severe Graves' orbitopathy, a self-limiting disease is not known. We tested the efficacy of external beam irradiation compared with sham-irradiation. Methods In a double-blind randomised clinical trial, 30 patients with

  19. Treatment of Graves' hyperthyroidism: evidence-based and emerging modalities

    DEFF Research Database (Denmark)

    Hegedüs, Laszlo

    2009-01-01

    Currently there are three well-established treatment options for hyperthyroid Graves' disease (GD): antithyroid drug therapy with thionamides (ATD), radioactive iodine treatment with (131)I, and thyroid surgery. This article reviews the current evidence so the reader can evaluate advantages...

  20. Selenium and the Course of Mild Graves' Orbitopathy

    NARCIS (Netherlands)

    C. Marcocci; G.J. Kahaly; G.E. Krassas; L. Bartalena; M. Prummel; M. Stahl; M.A. Altea; M. Nardi; S. Pitz; K. Boboridis; P. Sivelli; G. von Arx; M.P. Mourits; L. Baldeschi; W. Bencivelli; W. Wiersinga

    2011-01-01

    Background Oxygen free radicals and cytokines play a pathogenic role in Graves' orbitopathy. Methods We carried out a randomized, double-blind, placebo-controlled trial to determine the effect of selenium (an antioxidant agent) or pentoxifylline (an antiinflammatory agent) in 159 patients with mild

  1. Radiotherapy for Graves' orbitopathy : randomised placebo-controlled study

    NARCIS (Netherlands)

    Mourits, MP; van Kempen-Harteveld, ML; Garcia, MBG; Koppeschaar, HPF; Tick, L; Terwee, CB

    2000-01-01

    Background The best treatment (steroids, irradiation, or both) for moderately severe Graves' orbitopathy, a self-limiting disease is not known. We tested the efficacy of external beam irradiation compared with sham-irradiation. Methods In a double-blind randomised clinical trial, 30 patients with mo

  2. Measuring disease activity to predict therapeutic outcome in Graves' ophthalmopathy

    NARCIS (Netherlands)

    Terwee, C.B.; Prummel, M.F.; Gerding, M.N.; Kahaly, G.J.; Dekker, F.W.; Wiersinga, W.M.

    2005-01-01

    OBJECTIVE: The concept of disease activity in Graves' ophthalmopathy (GO) might explain why as many as one-third of patients do not respond to immunosuppressive treatment, because only patients in the active stage of disease are expected to respond. The hypothesis was adopted that a parameter used t

  3. Graves' Disease Associated with Cerebrovascular Disease and Antiphospholipid Antibody Syndrome

    OpenAIRE

    2010-01-01

    Thyroid disorders are commonly associated with coagulopathy. Patients with hyperthyroidism have increased risk for developing thromboembolic accidents, which are favoured by a simultaneous presence of antiphospholipid antibodies syndrome. in this paper, we describe the case of a patient with Graves' disease, who developed strokes with antiphospholipid antibodies syndrome.

  4. Graves' disease: thyroid function and immunologic activity

    Energy Technology Data Exchange (ETDEWEB)

    Gossage, A.A.R.; Crawley, J.C.W.; Copping, S.; Hinge, D.; Himsworth, R.L.

    1982-11-01

    Patients with Graves' disease were studied for two years during and after a twelve-month course of treatment. Disease activity was determined by repeated measurements of thyroidal uptake of (/sup 9/-9..mu..Tc)pertechnetate during tri-iodothyronine administration. These in-vivo measurements of thyroid stimulation were compared with the results of in-vitro assays of Graves, immunoglobulin (TSH binding inhibitory activity - TBIA). There was no correlation between the thyroid uptake and TBIA on diagnosis. Pertechnetate uptake and TBIA both declined during the twelve months of antithyroid therapy. TBIA was detectable in sera from 19 of the 27 patients at diagnosis; in 11 of these 19 patients there was a good correlation (p<0.05) throughout the course of their disease between the laboratory assay of the Graves, immunoglobulin and the thyroid uptake. Probability of recurrence can be assessed but sustained remission of Graves' disease after treatment cannot be predicted from either measurement alone or in combination.

  5. Graves' disease: thyroid function and immunologic activity

    Energy Technology Data Exchange (ETDEWEB)

    Gossage, A.A.; Crawley, J.C.; Copping, S.; Hinge, D.; Himsworth, R.L.

    1982-11-01

    Patients with Graves' disease were studied for two years during and after a twelve-month course of treatment. Disease activity was determined by repeated measurements of thyroidal uptake of (/sup 99m/Tc)pertechnetate during tri-iodothyronine administration. These in-vivo measurements of thyroid stimulation were compared with the results of in-vitro assays of Graves, immunoglobulin (TSH binding inhibitory activity--TBIA). There was no correlation between the thyroid uptake and TBIA on diagnosis. Pertechnetate uptake and TBIA both declined during the twelve months of antithyroid therapy. TBIA was detectable in sera from 19 of the 27 patients at diagnosis; in 11 of these 19 patients there was a good correlation (p less than 0.05) throughout the course of their disease between the laboratory assay of the Graves, immunoglobulin and the thyroid uptake. Probability of recurrence can be assessed but sustained remission of Graves' disease after treatment cannot be predicted from either measurement alone or in combination.

  6. Formas asociativas: Una aproximación a las formas asociativas en el Reino Unido.

    Directory of Open Access Journals (Sweden)

    David Ricardo Sotomonte Mujica

    2004-01-01

    Full Text Available Este escrito se encuentra destinado a proporcionar al lector un acercamiento a las formas asociativas más importantes y utilizadas previstas dentro de la legislación del Reino Unido de La Gran Bretaña para la actividad empresarial. De igual forma es una guía para los estudiantes y profesionales del derecho, encaminada a facilitar la comprensión de las formas asociativas existentes en el sistema del common law.

  7. Formas asociativas: Una aproximación a las formas asociativas en el Reino Unido.

    Directory of Open Access Journals (Sweden)

    David Ricardo Sotomonte Mujica

    2004-12-01

    Full Text Available Este escrito se encuentra destinado a proporcionar al lector un acercamiento a las formas asociativas más importantes y utilizadas previstas dentro de la legislación del Reino Unido de La Gran Bretaña para la actividad empresarial. De igual forma es una guía para los estudiantes y profesionales del derecho, encaminada a facilitar la comprensión de las formas asociativas existentes en el sistema del common law.

  8. Mujer joven con hipertiroidismo asociado a insuficiencia tricuspídea grave Young woman with hyperthyroidism associated with severe tricuspid regurgitation

    OpenAIRE

    Ariel K. Saad; Ana A. Pisarevsky; Diego R. González; Manuel Vázquez Blanco; Enrique Petrucci

    2008-01-01

    Las manifestaciones cardiovasculares del hipertiroidismo son frecuentes, y en ocasiones dominan el cuadro clínico. Con frecuencia, la enfermedad se manifiesta por un estado circulatorio hiperdinámico, con disminución de la resistencia vascular periférica, aumento de la volemia y del volumen minuto cardíaco. La dilatación de las cavidades cardíacas con insuficiencia tricuspídea grave e insuficiencia cardíaca derecha sin hipertensión pulmonar constituye una forma inusual de presentación. Se pre...

  9. 78 FR 21410 - Native American Graves Protection and Repatriation Review Committee: Meetings

    Science.gov (United States)

    2013-04-10

    ... National Park Service Native American Graves Protection and Repatriation Review Committee: Meetings AGENCY... Federal Advisory Committee Act, 5 U.S.C. Appendix (1988), of two meetings of the Native American Graves... Advisory Committee Act, 5 U.S.C. Appendix (1988), of two meetings of the Native American Graves...

  10. 77 FR 23196 - Native American Graves Protection and Repatriation Act Regulations

    Science.gov (United States)

    2012-04-18

    ... Office of the Secretary 43 CFR Part 10 RIN 1024-AD99 Native American Graves Protection and Repatriation... Secretary of the Interior (Secretary) is responsible for implementation of the Native American Graves... implementing the Native American ] Graves Protection and Repatriation Act for purposes of factual accuracy...

  11. 77 FR 65407 - Native American Graves Protection and Repatriation Review Committee: Notice of Nomination...

    Science.gov (United States)

    2012-10-26

    ... National Park Service Native American Graves Protection and Repatriation Review Committee: Notice of.... SUMMARY: The National Park Service is soliciting nominations for one member of the Native American Graves... Review Committee was established by the Native American Graves Protection and Repatriation Act of...

  12. 77 FR 39406 - Safety Zone; Tom Graves Memorial Fireworks, Port Bay, Wolcott, NY

    Science.gov (United States)

    2012-07-03

    ... SECURITY Coast Guard 33 CFR Part 165 RIN 1625-AA00 Safety Zone; Tom Graves Memorial Fireworks, Port Bay... from a portion of Port Bay during the Tom Graves Memorial Fireworks display. This temporary safety zone... vessels during the Tom Graves Memorial Fireworks. This zone will be effective and enforced from 9:30 p.m...

  13. La teoría de juegos evolutivos (TJE y la economía evolutiva de Thorstein Veblen: ¿es vebleniana la TJE?

    Directory of Open Access Journals (Sweden)

    Villena Marcelo J.

    2005-08-01

    Full Text Available El objetivo de este artículo es ligar la obra de Veblen sobre economía evolutiva con el enfoque de la recientemente desarrollada teoría de juegos evolutivos (TJE. Este es el primer paso en la incorporación de la teoría de evolución socioeconómica de Veblen en la discusión sobre la aplicación de la TJE a los ambientes sociales. También investigamos hasta qué punto se pueden usar los elementos de la TJE para formalizar algunos de los principios evolutivos básicos propuestos por Veblen.

  14. LA TEORÍA DE JUEGOS EVOLUTIVOS (TJE Y LA ECONOMÍA EVOLUTIVA DE THORSTEIN VEBLEN: ¿ES VEBLENIANA LA TJE?

    Directory of Open Access Journals (Sweden)

    Mauricio G. Villena

    2005-06-01

    Full Text Available El objetivo de este artículo es ligar la obra de Veblen sobre economía evolutiva con el enfoque de la recientemente desarrollada teoría de juegos evolutivos (TJE. Este es el primer paso en la incorporación de la teoría de evolución socioeconómica de Veblen en la discusión sobre la aplicación de la TJE a los ambientes sociales. También investigamos hasta qué punto se pueden usar los elementos de la TJE para formalizar algunos de los principios evolutivos básicos propuestos por Veblen.

  15. Personalised immunomodulating treatments for Graves' disease: fact or fiction?

    Science.gov (United States)

    Struja, Tristan Mirko; Kutz, Alexander; Fischli, Stefan; Meier, Christian; Müller, Beat; Schütz, Philipp

    2017-08-14

    Although Graves' disease has been recognised for more than 100 years, its physiopathological mechanisms are incompletely understood. Treatment strategies today mainly focus on suppression of thyroid hormone production by use of antithyroid drugs or radio-iodine, but neglect the underlying immunological mechanisms. Although Graves' disease is often seen as a prototype for an autoimmune mechanism, it is more likely to be a heterogeneous syndrome showing characteristics of both autoimmunity and immunodeficiency. The interplay of these two mechanisms may well characterise the physiopathology of this disease and its complications. Immunodeficiency may be either genetically determined or secondarily acquired. Various triggering events lead to autoimmunity with stimulation of the thyroid gland resulting in the clinical syndrome of hyperthyroidism. Also, relapse risk differs from patient to patient and can be estimated from clinical parameters incorporated into the Graves' Recurrent Events After Therapy (GREAT) score. Accurate risk stratification may help to distinguish high-risk patients for whom a more definitive treatment approach should be used from others where there is a high probability that the disease will recover with medical treatment alone. Several smaller trials having found positive effects of immunosuppressive drugs on recurrence risk in Graves' disease; therefoore, there is great potential in the use of novel immunomodulating drugs in addition to the currently used antithyroid drugs for the successful treatment of this condition. Further in-depth exploration of susceptibility, triggering factors and immunological mechanisms has the potential to improve treatment of Graves' disease, with more personalised, risk-adapted treatment strategies based on the different physiopathological concepts of this heterogeneous condition.

  16. Esquistossomose pulmonar. II. Forma crônica reativada com hipertensão e Cor pulmonale

    Directory of Open Access Journals (Sweden)

    Jayme Neves

    1980-12-01

    Full Text Available Os Autores descrevem um caso grave de esquistossomose mansoni (forma hepática com hipertensão portal associada a forma pulmonar com hipertensão pulmonar e cor pulmonalej sobre o qual evoluiu uma sindrome toxi-infectuosa grave e de longa duração. Sucessivos exames radiológicos do tórax revelaram acometimento predominantemente arteriolar, ao lado de uma micronodulação pulmonar grosseira e difusa em ambos os hemitóraces e configuração de coração pulmonar. A histopatologia de material de biópsia pulmonar identificou basicamente uma arterite pulmonar característica, inflamação granulomatosa atípica provocada principalmente por vermes e raros ovos de S. mansoni envolvidos por escassa reação inflamatória. Para explicar a origem de constelação clínica toxi-infectuosa, foram afastadas as hipóteses de associação da esquistossomose a concausas infectuosas ou não, mas de curso febril, e a superposição de uma forma toxêmica sobre outra crônica pré-existente. Com base em dados clínicos, particularmente em subsídios da laparoscopia, e anatômicos, concluiu-se tratar o caso de uma forma crônica de esquistossomose reativada, provavelmente em virtude de alterações imunológicas inusitadas do hospedeiro. Ao que tudo parece indicar, o desvio de ovos e de vermes aos pulmões deveu-se à sindrome de hipertensão portal, cujos shunts entre a circulação portal e sistêmica determinaram a rota preferencial da migração.

  17. Estudio del genoma y del transcriptoma en las fases evolutivas de las gammapatías monoclonales

    OpenAIRE

    López Corral, Lucía

    2013-01-01

    [ES] Los estudios epidemiológicos han demostrado que la práctica totalidad de los mielomas múltiples están precedidos por una fase premaligna. En este sentido, la gammapatía monoclonal de significado incierto (GMSI) y el mieloma múltiple quiescente (MMQ) se consideran entidades premalignas y asintomáticas que difieren de forma significativa en la tasa de progresión a MM sintomático. A pesar de su comportamiento clínico radicalmente distinto, las tres entidades comparten aparentemente la misma...

  18. Amnésia retrógrada funcional grave: relato de caso Severe functional retrograde amnesia: case report

    OpenAIRE

    Neves,Maila de Castro L.; Rogério Gomes Beato; Carla Monteiro Girodo; Hélio Lauar; Rodrigo Nicolato; João Vinícius Salgado; Antônio Lúcio Teixeira

    2008-01-01

    CONTEXTO: Uma síndrome amnésica clássica caracteriza-se por evidente prejuízo da memória anterógrada, variável e temporária amnésia retrógrada, sendo as formas não-declarativas da memória poupadas. Entretanto, publicações recentes relataram casos de prejuízo desproporcional da memória retrógrada em relação à anterógrada. OBJETIVOS: Relatar o caso de um paciente de 26 anos de idade com um quadro grave de amnésia retrógrada, aparentemente sem fatores desencadeantes. MÉTODOS: Entrevista psiquiát...

  19. Future Prospects for the Treatment of Graves' Hyperthyroidism and Eye Disease.

    Science.gov (United States)

    Neumann, S; Place, R F; Krieger, C C; Gershengorn, M C

    2015-09-01

    Although there are adequate therapies for Graves' hyperthyroidism, mild to moderate Graves' orbitopathy (GO) is usually treated symptomatically whereas definitive therapy is reserved for severe, vision-threatening GO. Importantly, none of the treatment regimens for Graves' disease used today are directed at the pathogenesis of the disease. Herein, we review some aspects of what is known about the pathogenesis of these 2 major components of Graves' disease, specifically the apparent important roles of the TSH and IGF-1 receptors, and thereafter describe future therapeutic approaches directed at these receptors. We propose that targeting these receptors will yield effective and better tolerated treatments for Graves' disease, especially for GO.

  20. Nuevas formas organizacionales en la gobernabilidad transnacional

    OpenAIRE

    José Gpe. Vargas Hernández

    2008-01-01

    El objetivo de este trabajo es analizar las transformaciones que están teniendo las formas organizacionales para adaptarse a los requerimientos de una gobernabilidad transnacional que de respuesta a los cambios del medio ambiente creado por los procesos de globalización económica. A partir de un análisis de los elementos sobresalientes de las estructuras en las organizaciones, se determinan las tendencias en las nuevas formas organizacionales considerando las variables de un medio ambiente ca...

  1. Avaliação de antígenos do trypanosoma cruzi para a reação de hemaglutinação indireta: II. Antígenos de diferentes amostras e formas evolutivas

    Directory of Open Access Journals (Sweden)

    Ricardo Wagner de Almeida Vítor

    1987-06-01

    Full Text Available Para aprimorar a sensibilidade e a especificidade da reação de hemaglutina-ção indireta no diagnóstico da doença de Chagas, foram utilizados eritrocitos sensibilizados com antígeno de epimastigotas de diferentes amostras (clones Al.7, B12, Cl e cepas D150 e Y, de tripomastigotas metacíclicos de cultura (TMC e de tri-pomastigotas de cultura de células (TCC do Trypanosoma cruzi. Foram titulados 132 soros de indivíduos chagásicos e 161 soros de não chagásicos, diagnosticados pela reação de imunofluorescência indireta (RIFI, considerada como reação de referência no cálculo dos índices de co-positividade (i.c.p., co-negatividade (i.c.n. e concordância. Utilizando o título discriminante (T.D. de 1:40, os antígenos da cepa Y e do clone B12 apresentaram valores elevados para os três índices calculados, indicando boa sensibilidade e especificidade em relação à RIFI. Os antígenos dos clones Al .7 e Cl apresentaram baixa especificidade considerando o T.D. de 1:40, mas ocorreu um aumento acentuado para o i.c.n. considerando o T.D. de 1:80, indicando um aumento de especificidade relativa sem alteração significativa da sensibilidade relativa. Com os antígenos T.M.C, e T.C.C, foram observados títulos mais baixos e valores menores para o i.c.p., indicando pouca sensibilidade em relação à RIFI.

  2. 伊朗 Graves 眼病的临床特点%Clinical features of Graves' ophthalmopathy in Iran

    Institute of Scientific and Technical Information of China (English)

    Ali Sadeghi Tari; Mohammad Taher Rajabi; Khalil Hamzedust; Seyed Ziaeddin Tabatabaie; Abolfazl Kasai

    2007-01-01

    AIM:To determine the clinical characteristics of a prospective study of patients with Graves' ophthalmopathy.METHODS:We reviewed clinical manifestations,and medical records of 103 patients in whom Graves' ophthalmopathy WaS diagnosed between 2003 and 2005.RESULTS:Among 103 patients with Graves' ophthalmopathy,48(46.6%)male and 55(53.3%)female(F:M=1.1),with mean age of 45 (range;18-73) years,95 (92.2%)patients had Graves' hyperthyroidism,3(2.9%) had primary hypothyroidism,and 5 (4.8%) were euthyroid.The mean duration of ocular symptoms was 13.2 (range 2-95) months) while the mean duration of dysthyroid symptoms was 39.4(range 6-180) months.Unilaterality was occurred in 12 patients.Eyelid retraction was present in 90 patients (87%),whereas the approximate frequency of exophthalmos was 77.6%(80 patients);restrictive extraocular myopathy.29% (30 patients);evidence of extraocular enlargement on CT-scan in 52 patients of 70 patients (74%) that was evaluated,and optic nerve dysfunction,5.8%(6 patients).22(21%)patients hadglaucoma associated with Graves' ophthalmopathy that 7 (6.7%)of them were normal-tension glaucoma.CONCLUSION:Eyelid retraction Was the most common clinical sign of Graves' ophthalmopathy in our patients.Larger prospective studies are suggested to evaluate both the prevalenoe and possible racial difference in its dinical presentation in Iranian population.%目的:研究分析伊朗 Graves 眼病患者的临床特点.方法:回顾分析 2003/2005 年确诊为 Graves 眼病的103例患者临床资料.结果:在103例 Graves 眼病患者中,48例(46.6%)为男性,55例(53.3%)为女性(男女比例为1.1).年龄18-73(平均45)岁,95例(92.2%)表现为甲状腺机能亢进,3例(2.9%)表现为原发性甲状腺机能减退,5例(4.8%)甲状腺机能正常.出现眼部症状的时间为2~95 (平均3.2)mo,而表现出甲状腺功能障碍的时间为6~180(平均39.4)mo.12例患者单眼发病,90例(87%)患者有眼睑退缩,80例(77.6%)患者

  3. Malária grave em Palmas, Estado do Tocantins: relato de caso Severe malaria in Palmas, State of Tocantins: case report

    Directory of Open Access Journals (Sweden)

    Éldi Vendrame Parise

    2009-08-01

    Full Text Available Plasmodium falciparum causa a forma clínica mais grave da malária. Neste estudo, relatamos um caso de malária grave, através do acompanhamento do paciente e das anotações em prontuários médicos encontrados no Hospital Geral de Palmas. Discutimos o desfecho do caso e as complicações provocadas pela infecção, reconhecendo o risco potencial de ocorrência de malária grave em zona não endêmica, em consequência do retardo do tratamento e, a importância de intensificar medidas de vigilância que envolve todos os servidores das unidades de saúde, com ênfase para as áreas receptivas de migrantes oriundos de regiões endêmicas.Plasmodium falciparum causes the most severe clinical form of malaria. In this study, we report a severe case of malaria, through following up the patient and from notes in the medical files at the Palmas General Hospital. We discuss the outcome of this case and the complications caused by this infection, recognizing the potential risk of occurrences of severe malaria in not-endemic areas because of the delay in treatment, and the importance of intensifying surveillance measures involving all health unit employees, with emphasis on the reception areas for migrants from endemic regions.

  4. Subsídios para a diversificação de moradias destinadas a pessoas com transtorno mental grave no Brasil: uma revisão

    Directory of Open Access Journals (Sweden)

    Juarez Pereira Furtado

    2013-09-01

    Full Text Available Com as críticas ao chamado manicômio, diversas iniciativas de moradia para egressos de hospitais psiquiátricos precisaram ser implementadas em diferentes países. Neste artigo, a partir de revisão narrativa, analisamos os antecedentes e a constituição de moradias para pessoas com transtorno mental grave implementadas no Brasil, pelo Sistema Único de Saúde. Identificamos pouca discussão sobre os limites do programa de Serviços Residenciais Terapêuticos (SRTs e a quase inexistência de discussões sobre alternativas para as necessidades de moradia de pacientes graves ligados aos Centros de Atenção Psicossocial (Caps. Subsidiados por reflexões oriundas da experiência canadense, discutimos a necessidade e os caminhos possíveis de ampliação não só quantitativa, mas, sobretudo, qualitativa, das formas de apoio às moradias de pessoas com transtorno mental grave no Brasil.

  5. CRM+ severe Fletcher factor deficiency associated with Graves' disease.

    Science.gov (United States)

    Kyrle, P A; Niessner, H; Deutsch, E; Lechner, K; Korninger, C; Mannhalter, C

    1984-01-01

    A 59-year-old male patient with Graves' disease and severe hereditary Fletcher factor deficiency is described. PKK clotting activity as well as the activity by a chromogenic substrate method (Chromozym PK) was less then 0.01 U/ml. In contrast to functional tests, the immunological assay (Laurell method) showed a PKK antigen concentration of 0.25 U/ml, indicating the presence of an abnormal nonfunctional PKK molecule (CRM+ variant). An inhibitor was excluded since the patient plasma did not inactivate partially purified PKK. Investigation of 11 family members revealed a reduction of the PKK clotting activity in 9 relatives of the patient. Since Graves' disease is considered an autoimmune disease, our case represents an example of an association of a severe hereditary deficiency of a contact factor and an autoimmune disease.

  6. Doenças da tireoide e miastenia grave

    Directory of Open Access Journals (Sweden)

    J. Lamartine de Assis

    1984-09-01

    Full Text Available Os autores estudam o comportamento da tireóide em um grupo de 304 pacientes com miastenia grave, constatando 15 casos de tireopatias, sendo 9 de hipertireoidismo, um de hipotireoidismo e 5 de bócio sem alterações da função tireoidiana. Nenhum paciente era proveniente de região de bócio endêmico e não havia bócio familiar. A tireotoxicose, que foi a disfunção mais frequente, foi estudada quanto a sua prevalência em pacientes miastênicos, quanto a sua influência sobre os sintomas da miastenia grave e quanto à época do seu aparecimento.

  7. Habitat Evaluation Procedures Report; Graves Property - Yakama Nation.

    Energy Technology Data Exchange (ETDEWEB)

    Ashley, Paul; Muse, Anthony

    2008-02-01

    A habitat evaluation procedures (HEP) analysis was conducted on the Graves property (140 acres) in June 2007 to determine the number of habitat units to credit Bonneville Power Administration (BPA) for providing funds to acquire the property as partial mitigation for habitat losses associated with construction of McNary Dam. HEP surveys also documented the general ecological condition of the property. The Graves property was significantly damaged from past/present livestock grazing practices. Baseline HEP surveys generated 284.28 habitat units (HUs) or 2.03 HUs per acre. Of these, 275.50 HUs were associated with the shrubsteppe/grassland cover type while 8.78 HUs were tied to the riparian shrub cover type.

  8. Comparación de normo e hiperglucemia en sangre como factor pronóstico clínico de mortalidad en trauma craneoencefálico grave al ingreso en el servicio de emergencias del Hospital Eugenio Espejo. Enero 2010 - Diciembre 2011

    OpenAIRE

    Loor Zavala, Lynda Elizabeth; Villegas Terán, Marco Mauricio

    2015-01-01

    El trauma craneoencefálico grave es la principal causa de muerte en adultos jóvenes. En nuestro país según los últimos datos proporcionados por la Organización Mundial de la Salud (OMS 2009), la tasa de mortalidad por trauma en el Ecuador es de 16,9 por cada 100.000 habitantes, siendo en su mayor parte por trauma craneoencefálico grave. La hiperglucemia por estrés forma parte de la respuesta hormono-metabólica adaptativa a la injuria, y se le asocia con un aumento de la mortalidad en pacient...

  9. Hipertrigliceridemia familiar grave durante a gestação

    Directory of Open Access Journals (Sweden)

    Casulari Luiz Augusto

    2001-01-01

    Full Text Available A presença de hipertrigliceridemia grave durante a gravidez é rara, mas comporta grande possibilidade de desenvolver complicações, como a pancreatite aguda, que coloca em risco a mãe e o feto. Apresentamos o relato da evolução da gestação de uma paciente portadora de hipertrigliceridemia grave que havia apresentado pancreatite aguda dois meses antes da fecundação. Foi tratada durante o pré-natal com dieta e 3,0 g de ácidos graxos de cadeia ômega-3 (ácidos eicosapentaenóico 14% e docosahexaenóico 11,13%. Os níveis de triglicerídeos foram mantidos abaixo de 800 mg/dl, sendo este limite considerado seguro para evitar o desenvolvimento de pancreatite aguda. A gestação evoluiu, sem intercorrências, para parto vaginal, a termo. O recém-nato não apresentou alterações morfológicas ao nascimento. Concluímos que, nesta paciente grávida e portadora de hipertrigliceridemia grave, uma dieta adequada e o emprego de ácidos graxos de cadeia ômega-3 foram eficazes em prevenir a pancreatite aguda. Esta abordagem terapêutica pode ser uma alternativa para as gestantes portadoras de hipertrigliceridemia familiar.

  10. Mujer joven con hipertiroidismo asociado a insuficiencia tricuspídea grave Young woman with hyperthyroidism associated with severe tricuspid regurgitation

    Directory of Open Access Journals (Sweden)

    Ariel K. Saad

    2008-02-01

    Full Text Available Las manifestaciones cardiovasculares del hipertiroidismo son frecuentes, y en ocasiones dominan el cuadro clínico. Con frecuencia, la enfermedad se manifiesta por un estado circulatorio hiperdinámico, con disminución de la resistencia vascular periférica, aumento de la volemia y del volumen minuto cardíaco. La dilatación de las cavidades cardíacas con insuficiencia tricuspídea grave e insuficiencia cardíaca derecha sin hipertensión pulmonar constituye una forma inusual de presentación. Se presenta el caso de una joven paciente, portadora de enfermedad de Graves Basedow, sin antecedentes cardiovasculares, que evoluciona en el transcurso de un mes con edema de miembros inferiores, palpitaciones, diarrea, pérdida de peso y fiebre. Al examen clínico se evidencian taquicardia con pulso irregular, signos de insuficiencia cardíaca derecha acompañado de un intenso soplo regurgitante que aumentaba con la inspiración. Por radiografía de tórax y ecocardiograma se constata cardiomegalia e insuficiencia tricuspídea grave sin hipertensión pulmonar. El cuadro se resuelve en forma rápida luego del tratamiento con propranolol, corticoides y diuréticos, con reversión de la arritmia y franca mejoría de los signos y síntomas. Se analizan en forma breve los efectos de las hormonas tiroideas en el aparato cardiovascular y se postulan probables mecanismos fisiopatológicos de la insuficiencia cardíaca en el hipertiroidismo.Cardiovascular manifestations of hyperthyroidism are frequent and sometimes are relevant in the clinical picture. Usually an hyperdynamic circulatory state hallmarks the disease with low peripheral resistance, increased intravascular volume and cardiac output. However, right chamber dilatation with tricuspid valve regurgitation and cardiac failure are unusual. We present the case of a young woman with Graves-Basedow disease without cardiovascular history who complained about palpitations, peripheral edemas, weight loss and

  11. Formas duradouras e formas emergentes de trabalho precário entre os jornalistas brasileiros

    Directory of Open Access Journals (Sweden)

    Jeferson Bertolini

    2015-08-01

    Full Text Available Este artigo busca dimensionar o conceito de trabalho precário entre os jornalistas brasileiros. O texto indica que a categoria sempre esteve exposta a formas precárias de trabalho, mas que o problema se agravou nos últimos 10 anos, com as tecnologias digitais: elas redefiniram o perfil do profissional e reordenaram o modelo de negócio das empresas do setor. O manuscrito, baseado em levantamento bibliográfico e experiência de campo, lista oito formas duradouras e oito formas emergentes de trabalho precário no jornalismo.

  12. Comparative analysis of pubertal growth spurt predictors: Martins and Sakima method and Grave and Brown method Análise comparativa dos estimadores do surto de crescimento puberal: métodos de Martins e Sakima e Grave e Brown

    Directory of Open Access Journals (Sweden)

    Karina Emy Iguma

    2005-03-01

    Full Text Available The aim of this study was to evaluate whether Martins and Sakima and Grave and Brown methods are useful for the study of pubertal growth spurt in children with cleft lip and palate. A total of 132 hand-wrist radiographs of patients from HRAC/USP aged 7 to 17 years old were analyzed, including girls and boys. Six radiographs of each age and gender were employed. These methods were applied to evaluating the stages of the hand-wrist ossification and epiphyseal formation, by graphic representation. The Martins and Sakima and the Grave and Brown methods revealed that the initial, peak and final stages of pubertal growth spurt occurred between 9 to 10, 12 and 15 years old, respectively, in the female gender. Similarly, in the male gender, both Martins and Sakima and Grave and Brown methods showed similar mean ages: 12, 14 and 16 years old for initial, peak and final stages of pubertal growth spurt, respectively. The Pearson's correlation test showed high and significant correlation (r = 0.99 and p O objetivo deste trabalho foi avaliar se os métodos de Martins e Sakima e Grave e Brown são aplicáveis para o estudo do surto de crescimento puberal (SCP de crianças com fissuras lábio-palatais. Foram analisadas 132 radiografias carpais de pacientes do HRAC-USP, dos gêneros masculino e feminino, com a faixa etária de 7 a 17 anos, utilizando 6 radiografias de cada idade e gênero. Ambos os métodos estudam os estágios de ossificação dos ossos da mão e punho e os estágios que se encontram as epífises, através de gráficos. Com relação a este estudo, no gênero feminino, tanto para Martins e Sakima quanto para Grave e Brown, o início, pico e final do SCP ocorreram entre 9 e 10 anos, 12 anos e 15 anos, respectivamente. Da mesma forma, para o gênero masculino, Martins e Sakima e Grave e Brown mostraram médias de idade similares: 12, 14 e 16 anos para início, pico e final do SCP, respectivamente. O teste de correlação de Pearson mostrou uma

  13. New target for immunotherapy of Graves ophthalmopathy%Graves 眼病免疫治疗的新靶点

    Institute of Scientific and Technical Information of China (English)

    王坚

    2010-01-01

    @@ Graves 眼病(Graves ophthalmopathy,GO) 或称甲状腺相关性眼病(thyroid associated ophthalmopathy,TAO)是长期以来困扰内分泌医师的常见病症之一,目前尚无理想的治疗方法,常用免疫调节、球后放射照射、眼眶减压术等疗法.GO 的发病机制尚未完全明了,目前认为细胞免疫和体液免疫共同参与了GO 的发生和发展.

  14. Systematics and evolutionary biology: uneasy bedfellows? Sistemática y biología evolutiva: ¿compañeros incómodos?

    Directory of Open Access Journals (Sweden)

    Jeffrey H. Schwartz

    2011-03-01

    Full Text Available The history of systematics and evolutionary biology demonstrates how greatly the "modern evolutionary synthesis" instrumentally prevented, rather than facilitated, the intellectual growth and maturity of the diversity of evolutionary disciplines. In truth, the claim of the synthesis being synthetic is essentially without basis, indeed a myth. Instead, the "synthesis" had precisely the opposite effect: namely, squelching the arena of debate, disagreement, and diverse theorizing that had characterized the preceding decades. Although each of the 3 primary architects of the synthesis - Dobzhansky, Mayr, and Simpson - had his own agenda, they were united around the theme of population genetics and population thinking. When applied to systematics, especially by Mayr, the result can now be seen as confused at best. Perhaps this review will provoke a revival of earlier years of intellectual curiosity and fervor, and rekindle interest in systematic method and theory.La historia de la sistemática y de la biología evolutiva muestra el papel que tuvo la "síntesis evolutiva moderna" para impedir, en lugar de favorecer, el crecimiento intelectual y la maduración de la diversidad de disciplinas evolucionistas. En efecto, la pretensión de la "síntesis" de ser sintética carece de bases, y por ende, resulta un mito. En su lugar, la "síntesis" tuvo precisamente el efecto opuesto: suprimir escenarios de debate, acuerdos, y cancelar el desarrollo mismo de las teorías que caracterizaron las décadas precedentes. Aunque cada uno de los 3 estudiosos responsables de formular la síntesis -Dobzhansky, Mayr y Simpson- tenía su propia agenda, coincidían en torno al tema de la genética de poblaciones y el pensamiento poblacional. Sin embargo, el resultado del debate respecto a la sistemática, especialmente abordado por Mayr, es actualmente confuso en el mejor de los casos. Quizás esta revisión provoque un resurgimiento en el fervor y la curiosidad intelectual

  15. Forma de crecimiento en Leptochloa Chloridiformis (Poaceae

    Directory of Open Access Journals (Sweden)

    Mariel G. Perreta

    2000-01-01

    Full Text Available Perreta, M. G., Tivano, J. C. & Vegetti, A. C. 2000. Forma de crecimiento en Leptochloachloridiformis (Poaceae. Darwiniana 38(3-4: 219-226.El objetivo de este trabajo fue analizar la forma de crecimiento de Leptochloa chloridiformis (Hack.Parodi. En esta especie perenne la ramificación ocurre principalmente a través de yemas axilarespresentes en la zona de innovación. Este sistema de ramificación genera una planta cespitosa, en la cual lasconexiones entre unidades estructurales son rizomas cortos. Dependiendo de su posición estas conexio-nes muestran diferentes tendencias en relación a la desarticulación estructural. En algunas plantas seobservó ramificación en la zona de entrenudos largos posiblemente debido a cambios ambientalesrelacionados con las distintas estaciones

  16. Malária grave importada: relato de caso Severe imported malaria: case report

    Directory of Open Access Journals (Sweden)

    Alessandra Alves

    2007-06-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: A malária ainda representa um problema de saúde global. A forma grave da doença é causada principalmente por P. falciparum e pode cursar com complicações cerebrais, renais, pulmonares, hematológicas, circulatórias e hepáticas. O objetivo deste estudo foi relatar um caso de paciente portador de malária grave importada. RELATO DO CASO: Paciente do sexo masculino, 30 anos, pardo, filipino, marinheiro, proveniente de embarcação vinda da Nigéria, com história de dor abdominal no hipocôndrio direito, icterícia, febre e rebaixamento do nível de consciência. Os exames laboratoriais de admissão mostraram hiperbilirrubinemia de 50 mg/dL, acidose metabólica grave, trombocitopenia, creatinina de 5,6 mg/dL, leucocitose com desvio até metamielócitos. O escore APACHE II foi de 37, com risco de óbito de 88%. Durante a internação foi diagnosticada malária por P. falciparum pelo teste de gota espessa. Mesmo com tratamento antimalárico adequado, o paciente evoluiu com insuficiência renal aguda necessitando de hemodiálise e síndrome de angústia respiratória aguda (SARA, necessitando de ventilação mecânica (VM, choque refratário tratado com aminas vasoativas, além de quadro hematológico, configurando um caso grave de disfunção de múltiplos de órgãos. Ainda apresentou pneumonia associada à VM e sepse relacionada ao uso de cateteres. Após a alta hospitalar, o paciente não apresentou seqüelas cerebral, pulmonar ou renal. CONCLUSÕES: Dos critérios definidores de malária grave descritos na literatura, o paciente preenchia: insuficiência renal aguda, síndrome da angústia respiratória aguda (SARA, acidose metabólica, alteração do nível de consciência, hemoglobinúria macroscópica, hiperparasitemia e hiperbilirrubinemia, que se relaciona a uma mortalidade maior que 10%, na dependência do tratamento precoce e dos recursos disponíveis. A malária grave exige diagnóstico e tratamento

  17. El transporte, una forma de hacer ciudad

    OpenAIRE

    GARCÍA, LUIS Leonardo

    2010-01-01

    Históricamente se ha mirado la relación entre el transporte y la ciudad como tangencial, es decir un problema más de fondo que de forma, que ha sido estudiado y teorizado parcialmente, ya sea desde el punto de vista de los transportadores, desde el punto de vista de la ciudad o desde el punto de vista del usuario.

  18. GIROLAMO SAVONAROLA E AS FORMAS DE GOVERNO

    Directory of Open Access Journals (Sweden)

    Rafael Salatini

    2015-04-01

    Full Text Available O trabalho apresenta um estudo analítico do tema das formas de governo, no pensamento político de Girolamo Savonarola, a partir de Tratatto circa il regimento e governo dela città di Firenze (1498. Parte-se da metodologia bobbiana, analisando-se o tema sob três perspectivas simultâneas: sistemática, axiológica e teleológica.

  19. Las formas del recuerdo. La memoria colectiva

    Directory of Open Access Journals (Sweden)

    Jorge Mendoza García

    2004-11-01

    Full Text Available La memoria tiene una estructura narrativa. Sus contenidos, formas y maneras de expresión así lo ponen de manifiesto. Retomando planteamientos de los fundadores de la perspectiva de la memoria colectiva, Halbwachs, Blondel, Bartlett y Vygotsky, y reflexionando desde los postulados de Bruner, el presente trabajo argumenta que la memoria, incluso la denominada individual, se construye sobre la base de narraciones que constituyen formas de discursos y modos de organizar experiencias, por ejemplo las pasadas, que son culturalmente dotados de significado, y que para ser inteligibles a la persona, grupo, sociedad o colectividad a quien se presentan hay que expresarla en relatos lógicos que muestren la verosimilitud de lo que se está recordando o relatando. Ciertamente, en la vida cotidiana encontramos cantidad de narraciones sobre las experiencias colectivas, encontramos ?narradores de historias?, y como ocurre en la literatura no sólo vale lo que se cuenta sino cómo se cuenta. Así como hay convenciones de ideas sobre la realidad, las hay también para las narrativas: existen modelos narrativos que hacen más verosímil una narración que otra. Tales narraciones dotan de sentido al mundo. Las narraciones, asimismo, devienen marcos sociales de la memoria, como el tiempo y espacio de los que habló Halbwachs, la modalidad narrativa es un marco, una manera de enmarcar la experiencia, y lo que no se estructura de forma narrativa se pierde de la memoria. A esos marcos Bartlett los denomin esquemas, que son delineados por instituciones, costumbres y grupos, que dictan cómo hay que presentar los eventos pasados, es decir, cómo hay que narrarlos, y en tanto relatos, éstos dan forma a las realidades que crean y eso opera para las experiencias pasadas que el grupo guarda.

  20. Formação continuada e pós-graduação: introito retrospectivo do Serviço Social

    Directory of Open Access Journals (Sweden)

    Nilsen Aparecida Vieira Marcondes

    2012-06-01

    Full Text Available O assistente social na busca de efetivação das suas competências profissionais depara-se com a necessidade constante de atualizar-se, pois a amplitude e as dimensões que envolvem seu campo de intervenção demandam isso dele. A inexistência de dicotomia entre a natureza teórica e prática do Serviço Social reforça a importância desta análise. Portanto, sob o respaldo da Teoria Social Crítica, objetiva-se com este estudo contribuir para que as discussões em torno da formação continuada e consequentemente do exercício profissional constituam-se como centro das discussões. A análise bibliográfica, ora empreendida, materializa-se numa produção qualitativa e exploratória, ancorada na revisão da literatura sobre o tema Formação Continuada e Política Nacional de Pós-Graduação sob o enfoque do Serviço Social. A perspectiva analítica empreendida neste estudo permite apontar que, a questão da formação continuada e da Pós-Graduação, entremeadas pela conjuntura neoliberal, deve ser reforçada reiteradas vezes por parte de uma categoria profissional que busca constante sintonia com as alterações evolutivas que se verificam no interior da sociedade capitalista.

  1. Treatment of severe Graves eye disease%严重Graves眼病的治疗

    Institute of Scientific and Technical Information of China (English)

    吕新生

    2000-01-01

    @@ Graves眼病分型 Graves眼病是一种眼眶内的眼外肌和眶后脂肪结缔组织受累的自身免疫性疾病,是导致眼球突出的常见疾病.Hall等将Graves眼病分为Graves病眼型(Graves' ophthalmopathy)和眼型Graves病(ophthalmopathy Graves' disease,orbital Graves' disease).

  2. Inferência gramatical usando uma técnica evolutiva - doi: 10.4025/actascitechnol.v33i2.4799

    Directory of Open Access Journals (Sweden)

    Sandra Mara Guse Scós Venske

    2011-04-01

    Full Text Available Num processo de inferência, busca-se encontrar uma resposta genérica baseando-se na análise de uma amostra de fatos. A inferência gramatical visa obter uma gramática para uma determinada linguagem baseada em exemplos de cadeias que pertencem ou não à linguagem analisada. Neste trabalho propõe-se um algoritmo para o uso de inferência em gramáticas livres de contexto baseadas em uma cadeia exemplo não pertencente à linguagem. A técnica evolutiva de algoritmos genéticos foi aplicada no processo com o objetivo de auxiliar na criação das regras de produção para as gramáticas, atendendo às restrições impostas pela cadeia exemplo. Uma aplicação do algoritmo de inferência está relacionada a linguagens que possuem padrões específicos pré-definidos, como é o caso de documentos XML no contexto de esquemas. A eficiência do algoritmo proposto é mostrada através de pequenos testes onde são obtidas gramáticas geneticamente geradas.

  3. Avaliação dos indicadores de saúde bucal no Brasil: tendência evolutiva pró-equidade?

    Directory of Open Access Journals (Sweden)

    Juliana de Kássia Braga Fernandes

    2016-01-01

    Full Text Available Resumo Foi testada a hipótese de que os indicadores de saúde bucal, obtidos do Pacto da Atenção Básica de 2006, Pacto pela Saúde do biênio 2010/2011 e indicadores de transição entre o Pacto pela Saúde e Contrato Organizativo da Ação Pública em Saúde de 2012, não diferiam entre as Unidades Federativas (UF brasileiras com diferentes Índices de Desenvolvimento Humano (IDH. Para isso, foi realizado um estudo longitudinal ecológico comparando as UF do Brasil com extremos de IDH. Os dados foram obtidos dos sistemas de informação do SUS e do Programa das Nações Unidas para o Desenvolvimento, e submetidos à análise de regressão linear de efeitos mistos (alfa = 5%. Todos os indicadores de oportunidade de acesso foram associados negativamente com o IDH. Para os de utilização, a associação ocorreu para apenas dois indicadores. Os resultados evidenciaram uma tendência evolutiva pró-equidade para indicadores de oportunidade de acesso em relação à saúde bucal.

  4. Violencia en la pareja hacia mujeres con transtorno mental grave

    OpenAIRE

    González Cases, Juan Carlos

    2012-01-01

    Este estudio tiene como objetivo principal analizar la prevalencia y características de la violencia de pareja hacia mujeres con un trastorno mental grave. La muestra consta de 142 mujeres mayores de 18 años, que en algún momento de su vida adulta habían tenido una relación de pareja y que estaban en atención en recursos públicos de salud mental de la Comunidad de Madrid. A través de entrevista se aplicaron cuestionarios validados para la medición de violencia psicológica, sexual y física. Ad...

  5. Intoxicación grave por psicofármacos

    Directory of Open Access Journals (Sweden)

    Dr. B. Juan Pablo Acuña

    2011-05-01

    Los objetivos de este artículo son entregar nociones de las manifestaciones clínicas, del manejo inicial y de las complicaciones más frecuentes y graves del intoxicado por ingesta de psicofármacos. Serán agrupados por familia de acuerdo a su clase y uso terapéutico, describiendo los mecanismos de toxicidad. En algunos de ellos hay recomendaciones de consenso respecto del manejo prehospitalario y la derivación a centros de alta complejidad.

  6. Creativos, Precarios, y Nuevas Formas de Interculturalidad

    Directory of Open Access Journals (Sweden)

    Néstor García Canclini

    2016-05-01

    Full Text Available Quiero proponer explorar la fertilidad de un enfoque antropológico queconsiste en mirar como conversaciones los signos de lo que cuesta entender en elmundo contemporáneo. Con ese fin voy a contarles dos investigaciones en las quebuscamos cambiar algunas preguntas habituales sobre los comportamientos de losjóvenes creativos y sobre lo que hacemos hoy en las nuevas formas de leer, en papel y en pantallas. Ambos estudios surgieron del descontento con las fotos y los relatos que nos daban la sociología y la economía acerca de los jóvenes y la lectura.

  7. The utility of Pro Forma Income Statements.

    Science.gov (United States)

    Reiboldt, Max; Reiboldt, John

    2002-01-01

    Recent headlines surrounding the financial demise of the nation's seventh largest company, Enron, and its subsequent entanglements with its accounting and consulting firm, Arthur Andersen, have placed a cloud of suspicion upon many reasonable business practices that otherwise are considered standard procedure. The proforma income statement is one of those practices. An oft-used tool in financial management, pro formas play a useful role for projecting financial performance based on predictable forecasts or assumptions. Regardless of the current scrutiny, there is still a valid use for accurately prepared statements.

  8. Forma canónica de Kronecker

    OpenAIRE

    Gracia Melero, Juan Miguel; Ortiz de Elguea Ugartondo, Lourdes

    2011-01-01

    Este libro trata de explicar con claridad y sencillez la forma canónica de Kronecker de haces de matrices para la relación de equivalencia estricta. El tema es importante para los ingenieros, físicos, químicos, economistas y otros científicos que estudian sistemas lineales con control, por lo que una introducción asequible y rigurosa se echa de menos. También esperamos que el libro sea de utilidad para los matemáticos en un segundo curso de álgebra lineal como complemento natural del estudio ...

  9. Una forma de violencia: el acoso escolar

    OpenAIRE

    2014-01-01

    El presente trabajo ofrece una perspectiva del término “bullying” desde diversos puntos de vista como el aspecto jurídico o el tratamiento por parte de la prensa; manifestando las consecuencias que tuvo en la opinión pública un determinado caso que supuso un punto de inflexión en el interés general ante unos hechos que cambiaron la forma de percibir, manejar y enfrentarse a dicho fenómeno, así mismo crear unos protocolos para discernir entre las conductas propias de la convivencia escolar y e...

  10. Graves' orbitopathy as a rare disease in Europe: a European Group on Graves' Orbitopathy (EUGOGO) position statement.

    Science.gov (United States)

    Perros, P; Hegedüs, L; Bartalena, L; Marcocci, C; Kahaly, G J; Baldeschi, L; Salvi, M; Lazarus, J H; Eckstein, A; Pitz, S; Boboridis, K; Anagnostis, P; Ayvaz, G; Boschi, A; Brix, T H; Currò, N; Konuk, O; Marinò, M; Mitchell, A L; Stankovic, B; Törüner, F B; von Arx, G; Zarković, M; Wiersinga, W M

    2017-04-20

    Graves' orbitopathy (GO) is an autoimmune condition, which is associated with poor clinical outcomes including impaired quality of life and socio-economic status. Current evidence suggests that the incidence of GO in Europe may be declining, however data on the prevalence of this disease are sparse. Several clinical variants of GO exist, including euthyroid GO, recently listed as a rare disease in Europe (ORPHA466682). The objective was to estimate the prevalence of GO and its clinical variants in Europe, based on available literature, and to consider whether they may potentially qualify as rare. Recent published data on the incidence of GO and Graves' hyperthyroidism in Europe were used to estimate the prevalence of GO. The position statement was developed by a series of reviews of drafts and electronic discussions by members of the European Group on Graves' Orbitopathy. The prevalence of GO in Europe is about 10/10,000 persons. The prevalence of other clinical variants is also low: hypothyroid GO 0.02-1.10/10,000; GO associated with dermopathy 0.15/10,000; GO associated with acropachy 0.03/10,000; asymmetrical GO 1.00-5.00/10,000; unilateral GO 0.50-1.50/10,000. GO has a prevalence that is clearly above the threshold for rarity in Europe. However, each of its clinical variants have a low prevalence and could potentially qualify for being considered as a rare condition, providing that future research establishes that they have a distinct pathophysiology. EUGOGO considers this area of academic activity a priority.

  11. Craniotomia descompressiva bifrontal no tratamento do edema cerebral grave

    Directory of Open Access Journals (Sweden)

    Walter C. Pereira

    1977-06-01

    Full Text Available São apresentados os resultados obtidos com craniotomia descompressiva bifrontal ampla em 12 doentes com edema cerebral grave e irreversível com os métodos convencionais de tratamento, provocado em 10 por traumatismo crânio-encefálico. Todos os pacientes apresentavam quadro neurológico muito grave, com sinais de comprometimento do tronco cerebral superior. Angiografia caro-tídea bilateral foi praticada sistematicamente, tanto no pré como no pós-operatório, constituindo-se no fator decisivo para a indicação cirúrgica. Seis (50% dos doentes sobreviveram, apresentando 5 (41,6% recuperação neurológica e psíquica praticamente totais. Levando em conta estes resultados, consideramos esta técnica cirúrgica o melhor recurso de tratamento em tais casos, máxime se indicada precocemente. São necessários, contudo, cuidados pós-operatórios especiais com estes pacientes, que devem, sempre que possível, ser mantidos em unidade de terapia intensiva, em virtude da grande incidência de complicações, mormente respiratórias.

  12. Clinical update: treatment of hyperthyroidism in Graves' ophthalmopathy.

    Science.gov (United States)

    Azzam, Ibrahim; Tordjman, Karen

    2010-03-01

    The presence of thyroid eye disease (TED) may influence the treatment of hyperthyroidism in patients with Graves' disease. Moreover, treatment of hyperthyroidism may affect the course of Graves' ophthalmopathy (GO). We review the literature and summarise recent knowledge about the impact of treatment modality for hyperthyroidism in GO. Anti-thyroid drugs (ATDs) remain the simplest and safest way to treat hyperthyroidism in patients with GO, but they are associated with a high relapse rate of hyperthyroidism and they have no effect on the course of GO. Radioactive iodine (RAI) treatment may be associated with exacerbation of GO especially in high risk patients, when glucocorticoid prophylaxis may be indicated. Large prospective trials are still lacking to define the exact effect of RAI on the course of GO, particularly in relation to other known risk factors. Likewise, clear guidelines for prophylactic glucocorticoid therapy are needed. RAI should be cautiously used in patients with more severe ophthalmopathy and concomitant I.V glucocorticoids should be considered. Thyroid surgery, whether total or subtotal thyroidectomy, has no effect on the course of ophthalmopathy. However, total thyroid ablation that combines surgery with radioactive iodine, as a means of achieving thyroid antigen disappearance, is increasingly gaining attention for the treatment of patients with GO, especially those undergoing thyroid surgery, but also for those with severe unresponsive ophthalmopathy. Studies supporting this approach are awaited.

  13. Outcomes following surgical decompression for dysthyroid orbitopathy (Graves' disease).

    Science.gov (United States)

    Leong, Samuel C; White, Paul S

    2010-02-01

    Graves' disease is a multiorgan autoimmune disease of complex pathophysiology that primarily affects the thyroid gland and orbit. The ophthalmic manifestations of Graves' disease may vary from mild proptosis which causes minimal cosmetic embarrassment to subluxation of the globe, exposure keratitis, corneal abrasion and even blindness. This article focuses on outcomes following orbital decompression. Surgical techniques have evolved with improved understanding of sinonasal anatomy and being technology-driven with the use of the fiberoptic endoscope and image guidance. The most common surgical outcome reported in the literature is reduction in proptosis, followed by visual acuity and intraocular pressure. Quality-of-life assessments are not routinely measured. There are a myriad of surgical techniques currently in practice which underscores the fact that no single technique is clearly superior to another. Endoscopic decompression results in a mean reduction of 3.50 mm and is associated with a low complication rate. Nevertheless, the literature suggests that the best techniques are likely to be multiwall approaches such as combined medial and lateral wall decompression. Management of dysthyroid ophthalmopathy is clearly multidisciplinary. Future studies should consider a minimum data set for reporting outcome measures which should include a quality of life tool.

  14. Hyperthyroidism in Graves disease. Current trends in management and diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Haibach, H.

    1976-06-01

    The radioimmunoassay for T/sub 3/ is now widely available and is a useful diagnostic tool for hyperthyroidism, especially in T/sub 3/-thyrotoxicosis. It is an essential tool in the management of hyperthyroidism that persists after treatment with normal T/sub 4/ serum levels or, in euthyroid cases, with low T/sub 4/ serum levels. In these conditions, it reflects the metabolic state more accurately than serum levels of T/sub 4/. A promising new test is the response of radioimmunoassayable TSH to protirelin relin (TRH) administration. An absent response indicates pituitary suppression and thyroid autonomy as seen in frank hyperthyroidism or euthyroid Graves disease, treated or untreated. It is safer and quicker than the conventional T/sub 3/ suppression test of thyroid radioactive iodine uptake and may replace it at least partly in the future. The recently recognized sharp decline in the remission rate of patients subjected to thyroid drug therapy in the last decade has made this treatment much less efficacious. By necessity, it will probably lead to greater reliance on treatment with radioactive iodine in the majority of the patients with the hyperthyroidism of Graves disease.

  15. Nuevas formas organizacionales en la gobernabilidad transnacional

    Directory of Open Access Journals (Sweden)

    José Gpe. Vargas Hernández

    Full Text Available El objetivo de este trabajo es analizar las transformaciones que están teniendo las formas organizacionales para adaptarse a los requerimientos de una gobernabilidad transnacional que de respuesta a los cambios del medio ambiente creado por los procesos de globalización económica. A partir de un análisis de los elementos sobresalientes de las estructuras en las organizaciones, se determinan las tendencias en las nuevas formas organizacionales considerando las variables de un medio ambiente caracterizado por altos niveles de absorción de incertidumbre, complejidad de sistemas involucrados, flexibilidad de estructuras, comportamientos y procesos, interdependencia e interacciones de agentes económicos y actores políticos y sociales, incremento de la velocidad, cambios de poder y desmembramiento de fenómenos organizacionales. Finalmente, se hace una elaboración de las implicaciones del diseño organizacional e institucional bajo los diferentes modelos desde los enfoques del neoliberalismo, el intergubernamentalismo y las redes de gestión. A partir de este análisis se concluye con una delimitación de los principales retos.

  16. La imprescriptibilidad de la accion y la sancion disciplinaria por graves violaciones a los Derechos Humanos e infracciones graves al Derecho Internacional Humanitario

    National Research Council Canada - National Science Library

    Daza-Marquez, Tania-Milena

    2010-01-01

    El articulo presenta un analisis respecto a la problematica de la imprescriptibilidad de la accion y la sancion disciplinarias por graves violaciones e infracciones a los Derechos Humanos y el Derecho...

  17. Factores de riesgo para infección respiratoria aguda baja grave en Bogotá, 2001.

    Directory of Open Access Journals (Sweden)

    María Belén Jaimes

    2003-09-01

    Full Text Available La gravedad de la infección respiratoria aguda (IRA es mayor en países en desarrollo, sobre todo entre grupos social y económicamente pobres. Las neumonías virales son las más comunes, especialmente en niños. Con el fin de medir algunos factores asociados con formas graves de infección respiratoria baja realizamos un estudio de casos y controles prospectivo y de base hospitalaria en Bogotá entre noviembre de 2000 y agosto de 2001. Los casos fueron niños entre 2 meses y 5 años que llenaban los criterios de la OMS para IRA grave o muy grave. Los controles eran niños con IRA en el mismo rango de edad, que consultaban al mismo hospital y que no presentaban tirajes. Se estudiaron 638 niños entre los 2 meses y los 5 años de edad (277 casos y 361 controles. Los factores más importantes fueron: vivienda en préstamo (OR=2,7; IC95%: 1,06-7,07, compartir la cama (OR=1,88; IC95%: 1,0-3,7, más de 9 personas en la misma casa (OR=1,82; IC95%: 1,0-3,51 y fumadores en la vivienda (OR=1,4; IC95%: 1,0-2,05. Se tomaron 114 muestras nasofaríngeas (niños con 3 días de haber iniciado síntomas y se obtuvieron virus en 98 de ellas, y se identificó el virus sincitial respiratorio en 41,8%, virus influenza A en 3,1% y virus influenza B en 1%. El 100% de los aislamientos positivos para influenza A y B fueron enviados al CDC en Atlanta, donde fueron clasificados como influenza A/PANAMA/2007/99-like e influenza B/SICHUAN/379/99-like, respectivamente.

  18. Premature hair greying may predict reduced bone mineral density in Graves' disease.

    LENUS (Irish Health Repository)

    Leary, A C

    2012-02-03

    BACKGROUND: Premature hair greying has been associated with low bone mineral density (BMD), and it may be more frequent in Graves\\' disease. AIMS: To determine whether premature greying is associated with reduced BMD in women with Graves\\' disease and in control women, and to examine whether premature greying is more common in Graves\\' disease. METHODS: Premature greying (> 50% grey by 40 years) and BMD were determined in 44 women with a history of Graves\\' disease and 133 female controls referred for routine BMD measurement. Exclusion criteria included diseases or drugs known to affect BMD. RESULTS: Mean Z and T scores at the lumbar spine were significantly lower (P < 0.04) in subjects with premature greying than in those not prematurely grey among women with Graves\\' disease, but not among control women. Multiple regression confirmed this difference between Graves\\' and control women (P = 0.041). There were no differences at other measurement sites. Of Graves\\' patients, 36% were prematurely grey compared with 25% of control women (P = 0.14). CONCLUSION: Premature greying may be a weak marker for reduced BMD in women with a history of Graves\\' disease, but it is not a marker in normal women.

  19. 75 FR 12377 - Native American Graves Protection and Repatriation Act Regulations-Disposition of Culturally...

    Science.gov (United States)

    2010-03-15

    ... Interior 43 CFR Part 10 Native American Graves Protection and Repatriation Act Regulations-- Disposition of... Part 10 RIN 1024-AD68 Native American Graves Protection and Repatriation Act Regulations--Disposition... rule with request for comments. SUMMARY: This final rule implements the Native American...

  20. 78 FR 27078 - Native American Graves Protection and Repatriation Act Regulations

    Science.gov (United States)

    2013-05-09

    ... Government Relations with Native American Tribal Governments'' (59 FR 22951, April 29, 1994); Executive Order... Office of the Secretary of the Interior 43 CFR Part 10 RIN 1024-AD99 Native American Graves Protection.... SUMMARY: This final rule revises regulations implementing the Native American Graves Protection...

  1. 76 FR 69282 - Native American Graves Protection and Repatriation Review Committee: Meeting

    Science.gov (United States)

    2011-11-08

    ... National Park Service Native American Graves Protection and Repatriation Review Committee: Meeting AGENCY... Advisory Committee Act, 5 U.S.C. Appendix (1988), of a meeting of the Native American Graves Protection and... effect the agreed-upon disposition of Native American human remains determined to be...

  2. 75 FR 9429 - Native American Graves Protection and Repatriation Review Committee: Meetings

    Science.gov (United States)

    2010-03-02

    ... National Park Service Native American Graves Protection and Repatriation Review Committee: Meetings AGENCY... Advisory Committee Act, 5 U.S.C. Appendix (1988), of three meetings of the Native American Graves... agreement, of Native American human remains determined to be culturally unidentifiable; and presentations...

  3. 77 FR 7180 - Native American Graves Protection and Repatriation Review Committee: Meeting

    Science.gov (United States)

    2012-02-10

    ... National Park Service Native American Graves Protection and Repatriation Review Committee: Meeting AGENCY... Advisory Committee Act, 5 U.S.C. Appendix (1988), of two meetings of the Native American Graves Protection... of Native American human remains determined to be culturally unidentifiable; presentations by...

  4. 77 FR 53228 - Native American Graves Protection and Repatriation Review Committee: Meeting

    Science.gov (United States)

    2012-08-31

    ... National Park Service Native American Graves Protection and Repatriation Review Committee: Meeting AGENCY... Federal Advisory Committee Act, 5 U.S.C. Appendix (1988), of a meeting of the Native American Graves..., as required by law, in order to effect the agreed-upon disposition of Native American human...

  5. First reported case of unilateral Graves' disease in the left lobe of a bilobar thyroid gland.

    Science.gov (United States)

    Chen, Louis C; Green, Jennifer B

    2011-06-01

    Unilateral Graves' disease is a rare disease variant that can occur in a bilobar thyroid gland. We report the first documented case of unilateral Graves' disease in the left lobe of a bilobar thyroid gland and review the pertinent literature. A 48-year-old man presented in June 2010 with thyrotoxicosis. I-131 radioisotope uptake was elevated at 33.4%, and scintigraphy revealed that uptake of the radioisotope was uniformly increased in the left lobe of the thyroid gland. Ultrasonography of the thyroid gland revealed a non-nodular, enlarged, and heterogeneous left lobe; Doppler investigation of the lobe showed hypervascularity classically seen in Graves' disease. The right lobe of the thyroid, on the other hand, appeared homogeneous and hypovascular on ultrasonography. Thyroid-stimulating immunoglobulin was significantly elevated at 191% (reference range Graves' disease was the most likely diagnosis. As has occasionally been described in the literature, unilateral involvement of the thyroid gland is a rare presentation of Graves' disease. Pre-existing functional or structural differences (either congenital or acquired) between the two lobes may contribute to this rare presentation. To our knowledge, this is the first reported case of unilateral Graves' disease presenting in the left lobe of a bilobar thyroid gland. Although the pathophysiology of unilateral Graves's disease has not been clearly elucidated, clinicians should be aware that Graves' disease can present unilaterally in either lobe of the thyroid gland.

  6. Early medieval stone-lined graves in Southern Germany: analysis of an emerging noble class.

    Science.gov (United States)

    Rott, Andreas; Turner, Nils; Scholz, Ulrike; von Heyking, Kristin; Immler, Franziska; Peters, Joris; Haberstroh, Jochen; Harbeck, Michaela

    2017-04-01

    Stone-lined graves, which first appear in Bavarian territory during the 7(th) century AD, are assumed to be tombs of emerging nobility. While previous research on stone-lined grave goods supports their status as elite burials, an important factor defining nobility-kinship-has not been examined so far. Morphological analysis of the commingled skeletal remains of 21 individuals from three archaeological sites was carried out. Radiocarbon dating was conducted on these individuals to gain information on usage intervals of these graves. To test whether stone-lined graves can be considered family graves, analyses of mitochondrial HVR I, Y-chromosomal and autosomal STRs were carried out. Morphological examination revealed a surplus of males buried in stone-lined graves and radiocarbon dating points to usage of the tombs for several generations. According to aDNA analysis, kinship can be assumed both between and within stone-lined graves. Taken together, these results hint at burials of family members with high social status being inhumed at the same site, in some cases even the same grave, for several generations. They also suggest, for the first time, that an early medieval linear cemetery was structured according to biological kinship. © 2017 Wiley Periodicals, Inc.

  7. Reduced parietooccipital white matter glutamine measured by proton magnetic resonance spectroscopy in treated graves' disease patients

    DEFF Research Database (Denmark)

    Danielsen, Else Rubæk; Elberling, T.V.; Rasmussen, Åse Krogh

    2008-01-01

    CONTEXT: Graves' disease is an autoimmune disease of the thyroid gland. Patients often have affective and cognitive complaints, whether these disappear after treatment remains disputed. OBJECTIVE: Our objective was to evaluate cerebral biochemistry in acute and treated Graves' disease. DESIGN: We...

  8. The 2016 European Thyroid Association/European Group on Graves' Orbitopathy Guidelines for the Management of Graves' Orbitopathy.

    Science.gov (United States)

    Bartalena, Luigi; Baldeschi, Lelio; Boboridis, Kostas; Eckstein, Anja; Kahaly, George J; Marcocci, Claudio; Perros, Petros; Salvi, Mario; Wiersinga, Wilmar M

    2016-03-01

    Graves' orbitopathy (GO) is the main extrathyroidal manifestation of Graves' disease, though severe forms are rare. Management of GO is often suboptimal, largely because available treatments do not target pathogenic mechanisms of the disease. Treatment should rely on a thorough assessment of the activity and severity of GO and its impact on the patient's quality of life. Local measures (artificial tears, ointments and dark glasses) and control of risk factors for progression (smoking and thyroid dysfunction) are recommended for all patients. In mild GO, a watchful strategy is usually sufficient, but a 6-month course of selenium supplementation is effective in improving mild manifestations and preventing progression to more severe forms. High-dose glucocorticoids (GCs), preferably via the intravenous route, are the first line of treatment for moderate-to-severe and active GO. The optimal cumulative dose appears to be 4.5-5 g of methylprednisolone, but higher doses (up to 8 g) can be used for more severe forms. Shared decision-making is recommended for selecting second-line treatments, including a second course of intravenous GCs, oral GCs combined with orbital radiotherapy or cyclosporine, rituximab or watchful waiting. Rehabilitative treatment (orbital decompression surgery, squint surgery or eyelid surgery) is needed in the majority of patients when GO has been conservatively managed and inactivated by immunosuppressive treatment.

  9. Formas de autonomia da ciência

    Directory of Open Access Journals (Sweden)

    Marcos Barbosa de Oliveira

    2011-01-01

    Full Text Available Na primeira parte deste ensaio, distinguimos três formas que a autonomia da ciência assume ao longo de sua história: a galileana, a vannevariana e a neoliberal. A galileana foi reivindicada por Galileu em seu conflito com a Igreja Católica. O termo "vannevariana" vem de Vannevar Bush, responsável pelo relatório Science, the endless frontier, que teve um papel fundamental na conformação das práticas científicas no período pós Segunda Guerra. A autonomia vannevariana diz respeito aos rumos da pesquisa científica. A autonomia neoliberal consiste na liberdade de cada cientista procurar financiamento para as pesquisas que deseja realizar em qualquer fonte, pública ou privada, tendo em vista apenas seu auto-interesse (intelectual e/ou econômico. Na segunda parte do ensaio, utilizamos o arcabouço conceitual e histórico proporcionado por essas distinções para discutir a questão: que forma de autonomia deve ser reivindicada pela ciência nos dias de hoje? O procedimento consiste em determinar, para cada uma das três formas, o que deve ser mantido e o que deve ser abandonado. A conclusão a que se chega é a de que a autonomia neoliberal deve ser descartada, a vannevariana restringida, e a galileana preservada.In the first part of this article, three forms that the autonomy of science has assumed in the course of its history are distinguished: the Galilean one, the Vannevarian one, and the neoliberal one. The Galilean form was claimed by Galileo in his conflict with the Catholic Church. The term "Vannevarian" comes from Vannevar Bush, responsible for the report, Science, the endless frontier, which played a crucial role in the configuration of scientific practices in the post World War II period. Vannevarian autonomy has to do with the directions of scientific research. Neoliberal autonomy consists in each scientist's freedom to search for funds for the research he intends to carry out from any source, public or private, in view only

  10. Padrao epidemiologico das oclusopatias muito graves em adolescentes brasileiros

    Directory of Open Access Journals (Sweden)

    Karen Glazer Peres

    2013-12-01

    Full Text Available OBJETIVO: Descrever o padrão de distribuição das oclusopatias em adolescentes brasileiros e identificar fatores associados a esse agravo bucal. MÉTODOS: Foram analisados dados de 7.328 e 5.445 adolescentes de 12 e 15-19 anos, respectivamente, participantes da Pesquisa Nacional de Saúde Bucal (SBBrasil 2010. O desfecho foi oclusopatia muito grave segundo o índice de estética dental. As variáveis de exposição foram sexo, cor da pele, renda familiar mensal, número de bens, aglomeração no domicílio, cárie não tratada, perda dentária, uso, frequência e motivo da consulta odontológica. Foram conduzidas análises de regressão logística considerando a complexidade do desenho amostral, com base em modelo hierarquizado. RESULTADOS: Prevalência de oclusopatia muito grave foi observada em 6,5% e 9,1% nos jovens de 12 e 15-19 anos, respectivamente. Após análise ajustada, a chance do desfecho foi 1,59 (IC95% 1,08;2,34 vez maior nos pardos e pretos em relação aos brancos e 2,66 (IC95% 1,26;5,63 vezes maior dentre aqueles com perda de pelo menos um primeiro molar aos 12 anos. Jovens de 15-19 anos cuja renda familiar mensal foi de até R$ 1.500,00 (OR 2,69 [IC95% 1,62;4,47] e aqueles que consultaram o dentista para tratamento (OR 2,59 [IC95% 2,55;4,34] apresentaram maior chance de oclusopatia muito grave quando comparados aos de maior renda e que procuraram o dentista para prevenção. CONCLUSÕES: A distribuição das oclusopatias em adolescentes brasileiros segue o padrão de iniquidade social de outros agravos à saúde. Essas informações são úteis para a formulação de critérios relacionados tanto com a distribuição e provisão de recursos quanto com as prioridades de tratamento ortodôntico fundamentados no princípio da equidade da atenção à saúde bucal.

  11. Formação social indiana

    OpenAIRE

    Campos, Bruno

    2013-01-01

    Dissertação (mestrado) - Universidade Federal de Santa Catarina, Centro de Filosofia e Ciências Humanas, Programa de Pós-Graduação em Geografia, Florianópolis, 2013. Este trabalho tem por objetivo analisar o processo de desenvolvimento econômico e de industrialização da Índia, partindo de sua formação sócio-espacial, dos projetos e ações de caráter desenvolvimentistas após a independência em 1947 e dos atuais estágios do desenvolvimento econômico e industrial do país, consistindo principal...

  12. Mi forma de matar las pulgas

    Directory of Open Access Journals (Sweden)

    Eduardo Mejía Prado

    2009-01-01

    Full Text Available El autor ofrece un ensayo reflexivo sobre su experiencia investigativa en la realización del proyecto Historia de Bugalagrande . Describe la forma en que investigó y escribió la historia local de su terruño natal, un pueblo en el Valle del Cauca, desde el establecimiento de estancias a comienzo del siglo XVII, su transformación en hacienda y luego indivisos, hasta constituirse físicamente en un pueblo con sus calles y plazas a finales del siglo XIX. El texto referencia los apoyos teóricos, metodológicos, manejo de fuentes y la narrativa desarrollada por el autor. Las reflexiones desnudan la influencia de historiadores clásicos del marxismo inglés, la microhistoria italiana, la microhistoria mexicana e historiadores locales del Valle del Cauca. El proyecto y la experiencia se desarrollaron durante el periodo sabático del investigador.

  13. NUEVAS FORMAS ORGANIZACIONALES EN LA GOBERNABILIDAD TRANSNACIONAL

    Directory of Open Access Journals (Sweden)

    José Guadalupe Vargas Hernández

    2004-07-01

    Full Text Available El objetivo de este trabajo es analizar las transformaciones que están teniendo las formas organizacionales para adaptarse a los requerimientos de una gobernabilidad transnacional que dé respuesta a los cambios del medio ambiente creado por los procesos de globalización económica. Se tienen en consideración las variables de un medio ambiente caracterizado por altos niveles de absorción de incertidumbre, complejidad de sistemas, flexibilidad de estructuras, comportamientos y procesos, interdependencia e interacciones de agentes económicos y actores políticos y sociales, incremento de la velocidad, cambios de poder y desmembramiento de fenómenos organizacionales. Finalmente, se describen las implicaciones del diseño organizacional e institucional bajo los diferentes modelos desde los enfoques del neoliberalismo, el intergubernamentalismo y las redes de gestión.

  14. Leibniz e a retomada das formas substanciais

    Directory of Open Access Journals (Sweden)

    Dante Carvalho Targa

    2009-06-01

    Full Text Available Considerando o percurso total do pensamento de G. W. Leibniz, o presente trabalho remete ao período da escrita do Discurso de Metafísica (1686, que antecede ao estado final de sua filosofia, popularmente conhecido como o “sistema das mônadas”. Embora esta obra inaugure a maturidade do pensamento leibniziano, expondo boa parte dos pressupostos fundamentais de sua metafísica, a formulação do conceito de substância simples ou mônada ainda não se faz presente. Todavia, suas origens e a direção na qual avançam as indagações de Leibniz sobre a determinação ontológica do real são sugeridas pela restauração do conceito de forma substancial, que o autor retoma da filosofia escolástica num sentido específico, simultaneamente integrando-o à sua teoria da substância e convertendo-o num ícone de sua oposição à filosofia cartesiana. Tendo encontrado a ocasião oportuna para fazer chegar suas idéias ao afamado teólogo e intelectual francês Antonie Arnauld, Leibniz sintetiza nos artigos do Discurso os principais aspectos de sua filosofia, agregando às considerações sobre a fé, o bem e a liberdade algumas posições peculiares em relação ao contexto filosófico do final do séc. XVII. Dentre elas, a retomada do antigo conceito escolástico de forma substancial consistirá numa ousada reivindicação pela prioridade da metafísica frente à envolvente influência do mecanicismo nas modernas concepções filosóficas sobre a natureza e as substâncias corpóreas. Se, por um lado, Leibniz é conhecido pelo seu ímpeto de harmonização das diferentes tendências filosóficas de sua época, por outro, suas apropriações dos diferentes conceitos e pontos de vista oriundos destas vertentes sempre resultaram em algo novo e mais profundo, distinguindo-se por fim de sua origem. Com relação ao tema da forma substancial não é diferente, uma vez que, embora constitua um marco de sua oposição à primazia do mecanicismo na

  15. Tuberculose grave com necessidade de internação em UTI Severe tuberculosis requiring ICU admission

    Directory of Open Access Journals (Sweden)

    Denise Rossato Silva

    2012-06-01

    Full Text Available A tuberculose é uma doença curável que pode evoluir para formas graves com necessidade de tratamento dos pacientes em UTI, especialmente se essa não for diagnosticada em tempo ou se afetar pacientes idosos, aqueles em diálise e aqueles com infecção pelo HIV ou outros estados de imunossupressão, assim como nos casos de doença multirresistente. O conhecimento da apresentação radiológica dos casos pode auxiliar no diagnóstico dessas formas graves, assim como a introdução de novos testes, como a detecção rápida do agente por PCR e a TC de tórax, favorecendo o início precoce do tratamento. Além disso, o uso de esquemas sem isoniazida e rifampicina, a absorção entérica incerta e as baixas concentrações séricas das drogas antituberculose podem contribuir para a diminuição da eficácia do tratamento. O prognóstico desses pacientes geralmente é ruim, com elevadas taxas de mortalidade.Tuberculosis is a curable disease that can evolve to severe forms, requiring the treatment of the patients in an ICU, especially if there is a delay in the diagnosis or if it affects elderly patients, those on dialysis, or those with HIV infection or other states of immunosuppression, as well as in cases of multidrug resistant disease. Knowledge of the radiological presentation of the cases can help diagnose these severe forms, as can the introduction of new tests, such as the early detection of the etiological agent by PCR and chest CT, which favors the early initiation of treatment. In addition, the use of regimens without isoniazid and rifampin, as well as uncertain enteral absorption and low serum concentrations of antituberculosis drugs, can reduce the efficacy of treatment. For such patients, the prognosis is generally poor and mortality rates are high.

  16. [The necklace from the 660 grave in Megara Iblea].

    Science.gov (United States)

    Verger, Stéphane

    2011-01-01

    The article analyzes the 660 grave in Megara Iblea, a Greek colony in Sicily, in which a woman has been buried. On her breast a magnificent neckless was found, made of amulets recalling the travel of the sun during the summer solstice. Some objects allude to solar cults (a cock; round pendants), others seem to came from Gallia and Macedonia (summer far West and East), others recall archeological contexts such as tombs in Marvinci, in the Vardar Valley, and allude to relations with female practices of medicine and magic and to female roles characterized by extraordinary powers, due to being descendants of the Sun god. These solar symbols, joint with the discovery of many little objects, typical of children burials, allow to hypotize a relation with the cult of Mater Matuta and seem to point out a difficult or anomalous pregnancy or birth.

  17. Doença Pariodontal: fator associado à asma grave?

    OpenAIRE

    Marques, Kaliane Rocha Soledade

    2012-01-01

    A periodontite constitui-se uma doença crônica de grande prevalência na população, com repercussões imunológicas em todo o organismo. Estima-se que a periodontite pode influenciar na hiper-resposta inflamatória em indivíduos com asma, por meio de alterações imuno-inflamatórias, além de servirem como fontes de microrganismos para o desenvolvimento de infecções pulmonares. Objetivo: Avaliar a possível associação entre a presença periodontite e a asma grave. Método: Estudo caso-co...

  18. The story of the only (? megalith grave on Gotland Island

    Directory of Open Access Journals (Sweden)

    Helene Martinsson-Wallin

    2010-12-01

    Full Text Available In this paper, we discuss the easternmost material expression of the Funnel Beaker Culture – a megalith grave on the west coast of Gotland Island in the Baltic Sea. The people who built and used the megalith brought the Neolithic lifestyle to Gotland. The biography of this monument includes two excavations, of which we participated in the latest in 1984. Our osteological analysis confirms that some thirty individuals of both sexes and various ages were buried there. The structure of the monument is that of a rectangular dolmen. This paper discusses the discovery of this specific site, and explores the existence of this type of monument in a Gotland context. Furthermore, is this really the only megalith on Gotland, or are more of these structures yet to be recognised? Finally, one may ask if the Neolithic way of life really was successful on Gotland.

  19. Changes of Regulatory T Cells in Graves' Disease

    Institute of Scientific and Technical Information of China (English)

    WANG Hongxiang; ZHAO Shi; TANG Xiaoqiong; LI Jingyuan

    2006-01-01

    The immune mechanism of Graves' diseases (GD) and the roles of regulator T cells were investigated. In 32 patients with GD (GD group) and 20 healthy volunteers (control group), flow cytometry was used to detect the proportion of CD4+CD25+ cells, MACS to isolate CD4+ CD25+ cells,RT-PCR to assay the expression of FOXP3, and ELISA to test the level of IL-10, respectively. It was found that there was no significant change in the proportion of CD4+CD25+ T cells between GD group and control group (P>0.05), while secretion of IL-10 and expression of FOXP3 in GD group were lower than control group (P<0.01 and P<0.05, respectively). In conclusion, though the proportion of regulatory T cells of peripheral blood lymphocytes in the patients with GD, the functions of them were significantly weakened, which might be a pathogenic factor in GD.

  20. Doenças da tireoide e miastenia grave

    OpenAIRE

    1984-01-01

    Os autores estudam o comportamento da tireóide em um grupo de 304 pacientes com miastenia grave, constatando 15 casos de tireopatias, sendo 9 de hipertireoidismo, um de hipotireoidismo e 5 de bócio sem alterações da função tireoidiana. Nenhum paciente era proveniente de região de bócio endêmico e não havia bócio familiar. A tireotoxicose, que foi a disfunção mais frequente, foi estudada quanto a sua prevalência em pacientes miastênicos, quanto a sua influência sobre os sintomas da miastenia g...

  1. Management plan and delivery of care in Graves' ophthalmopathy patients.

    Science.gov (United States)

    Yang, Morgan; Perros, Petros

    2012-06-01

    Most patients with Graves' orbitopathy have mild disease that requires no or minimal intervention. For the minority of patients with moderate or severe disease, multiple medical and surgical treatments may be required at different stages. It is crucial that such patients are monitored closely and treatments applied with care in the right sequence. Medical treatments should be used as early as possible and only during the active phase of the disease. Rehabilitative surgery is indicated in the inactive phase of the disease and should follow the sequence: surgical decompression followed by eye muscle surgery, followed by lid surgery. Delivery of care in a coordinated fashion that makes use of best available expertise is important and best implemented through a Combined Thyroid Eye clinic.

  2. Association between polymorphisms in the TSHR gene and Graves' orbitopathy.

    Directory of Open Access Journals (Sweden)

    Beata Jurecka-Lubieniecka

    Full Text Available BACKGROUND: Graves' orbitopathy (GO as well as Graves' disease (GD hyperthyroidism originate from an autoimmune reaction against the common auto-antigen, thyroid-stimulating hormone receptor (TSHR. GO phenotype is associated with environmental risk factors, mainly nicotinism, as well as genetic risk factors which initiate an immunologic reaction. In some patients GO is observed before diagnosis of GD hyperthyroidism, while it can also be observed far after diagnosis. The intensity of GO symptoms varies greatly in these patients. Thus, the pathogenesis of GD and GO may correlate with different genetic backgrounds, which has been confirmed by studies of correlations between GO and polymorphisms in cytokines involved in orbit inflammation. The aim of our analysis was to assess genetic predisposition to GO in young patients (age of diagnosis ≤30 years of age, for whom environmental effects had less time to influence outcomes than in adults. METHODS: 768 GD patients were included in the study. 359 of them had clinically evident orbitopathy (NOSPECS ≥2. Patients were stratified by age at diagnosis. Association analyses were performed for genes with a known influence on development of GD - TSHR, HLA-DRB1, cytotoxic T-lymphocyte antigen 4 (CTLA4 and lymphoid protein tyrosine phosphatase (PTPN22. RESULTS: The rs179247 TSHR polymorphism was associated with GO in young patients only. In young GO-free patients, allele A was statistically more frequent and homozygous carriers had a considerable lower risk of disease incidence than patients with AG or GG genotypes. Those differences were not found in either elderly patients or the group analyzed as a whole. CONCLUSIONS: Allele A of the rs179247 polymorphism in the TSHR gene is associated with lower risk of GO in young GD patients.

  3. Atypical Clinical Manifestations of Graves' Disease: An Analysis in Depth

    Directory of Open Access Journals (Sweden)

    Mohamed Osama Hegazi

    2012-01-01

    Full Text Available Over the past few decades, there has been an increase in the number of reports about newly recognized (atypical or unusual manifestations of Graves' disease (GD, that are related to various body systems. One of these manifestations is sometimes the main presenting feature of GD. Some of the atypical manifestations are specifically related to GD, while others are also similarly seen in patients with other forms of hyperthyroidism. Lack of knowledge of the association between these findings and GD may lead to delay in diagnosis, misdiagnosis, or unnecessary investigations. The atypical clinical presentations of GD include anemia, vomiting, jaundice, and right heart failure. There is one type of anemia that is not explained by any of the known etiological factors and responds well to hyperthyroidism treatment. This type of anemia resembles anemia of chronic disease and may be termed GD anemia. Other forms of anemia that are associated with GD include pernicious anemia, iron deficiency anemia of celiac disease, and autoimmune hemolytic anemia. Vomiting has been reported as a presenting feature of Graves' disease. Some cases had the typical findings of hyperthyroidism initially masked, and the vomiting did not improve until hyperthyroidism has been detected and treated. Hyperthyroidism may present with jaundice, and on the other hand, deep jaundice may develop with the onset of overt hyperthyroidism in previously compensated chronic liver disease patients. Pulmonary hypertension is reported to be associated with GD and to respond to its treatment. GD-related pulmonary hypertension may be so severe to produce isolated right-sided heart failure that is occasionally found as the presenting manifestation of GD.

  4. Enhanced thyroid iodine metabolism in patients with triiodothyronine-predominant Graves' disease

    Energy Technology Data Exchange (ETDEWEB)

    Takamatsu, J.; Hosoya, T.; Naito, N.; Yoshimura, H.; Kohno, Y.; Tarutani, O.; Kuma, K.; Sakane, S.; Takeda, K.; Mozai, T.

    1988-01-01

    Some patients with hyperthyroid Graves' disease have increased serum T3 and normal or even low serum T4 levels during treatment with antithyroid drugs. These patients with elevated serum T3 to T4 ratios rarely have a remission of their hyperthyroidism. The aim of this study was to investigate thyroid iodine metabolism in such patients, whom we termed T3-predominant Graves' disease. Mean thyroid radioactive iodine uptake was 51.0 +/- 18.1% ( +/- SD) at 3 h, and it decreased to 38.9 +/- 20.1% at 24 h in 31 patients with T3-predominant Graves' disease during treatment. It was 20.0 +/- 11.4% at 3 h and increased to 31.9 +/- 16.0% at 24 h in 17 other patients with hyperthyroid Graves' disease who had normal serum T3 and T4 levels and a normal serum T3 to T4 ratio during treatment (control Graves' disease). The activity of serum TSH receptor antibodies was significantly higher in the patients with T3-predominant Graves' disease than in control Graves' disease patients. From in vitro studies of thyroid tissue obtained at surgery, both thyroglobulin content and iodine content in thyroglobulin were significantly lower in patients with T3-predominant Graves' disease than in the control Graves' disease patients. Thyroid peroxidase (TPO) activity determined by a guaiacol assay was 0.411 +/- 0.212 g.u./mg protein in the T3-predominant Graves' disease patients, significantly higher than that in the control Graves' disease patients. Serum TPO autoantibody levels determined by immunoprecipitation also were greater in T3-predominant Graves' disease patients than in control Graves' disease patients. Binding of this antibody to TPO slightly inhibited the enzyme activity of TPO, but this effect of the antibody was similar in the two groups of patients.

  5. Método de evaluación kinésica en educación especial en niños con encefalopatía crónica no evolutiva

    OpenAIRE

    2008-01-01

    El presente trabajo de investigación, se realiza con el propósito de mostrar el método de clasificación de Encefalopatía Crónica No Evolutiva, de acuerdo a su desempeño funcional, la misma se describe en cinco niveles. Este método tiene su origen en Canadá, requiere de una capacitación y autorización especifica para su utilización. En esta tesina se utilizan sus fundamentos teóricos y se realiza una tabla adaptada respetando los lineamientos para estudiar a la muestra median...

  6. Evaluación de la Atención a las Personas con Enfermedad Mental Grave y Persistente: la Experiencia de Madrid

    Directory of Open Access Journals (Sweden)

    Manuel Muñoz López

    2009-01-01

    Full Text Available En este artículo se presenta una experiencia de evaluación de programas de atención a las personas con enfermedad mental grave y persistente llevada a cabo en la Comunidad de Madrid: la evaluación del Plan de atención social para personas con enfermedad mental grave y crónica 2003-2007, de la Consejería de Familia y Asuntos Sociales. En este caso se aborda la evaluación de una forma global, abarcando los distintos aspectos del Plan, aunque prestando una atención especial a la red de recursos que se incluyen en el mismo. Se describe el proceso de evaluación global explicando los objetivos, metodología y procedimientos seguidos, así como las fases del proceso, las tareas y actividades desarrolladas, los instrumentos aplicados y los procedimientos de evaluación establecidos. Se presentan también algunos de los resultados obtenidos mediante dicha evaluación durante el año 2006.

  7. The Role of Oxidative Stress on the Pathogenesis of Graves' Disease

    Directory of Open Access Journals (Sweden)

    Miloš Žarković

    2012-01-01

    Full Text Available Graves' disease is a most common cause of hyperthyroidism. It is an autoimmune disease, and autoimmune process induces an inflammatory reaction, and reactive oxygen species (ROSs are among its products. When balance between oxidants and antioxidants is disturbed, in favour of the oxidants it is termed “oxidative stress” (OS. Increased OS characterizes Graves' disease. It seems that the level of OS is increased in subjects with Graves' ophthalmopathy compared to the other subjects with Graves' disease. Among the other factors, OS is involved in proliferation of orbital fibroblasts. Polymorphism of the 8-oxoG DNA N-glycosylase 1 (hOGG1 involved in repair of the oxidative damaged DNA increases in the risk for developing Grave's disease. Treatment with glucocorticoids reduces levels of OS markers. A recent large clinical trial evaluated effect of selenium on mild Graves' ophthalmopathy. Selenium treatment was associated with an improved quality of life and less eye involvement and slowed the progression of Graves' orbitopathy, compared to placebo.

  8. Associação familiar de miastenia grave e síndrome miotônica Familial association of myasthenia gravis and myotonic syndrome

    Directory of Open Access Journals (Sweden)

    Sylvio Saraiva

    1969-12-01

    Full Text Available É relatada uma associação familiar incomum, incidindo em mãe e filha, a primeira com síndrome miotônica e, a segunda, com miastenia grave, forma ocular. Um terceiro membro da família, irmão da paciente com miotonia, teria também manifestações dessa síndrome. São comentados aspectos clínico-laboratoriais dos casos estudados.An uncommon association of myasthenia gravis in a child and a myotonic syndrome in her mother is reported. A brother of the second patient probably had myotonic symptomatology. Clinical and laboratorial aspects are discussed.

  9. Ejercicio y la detección del mal agudo de montaña grave Exercise and the detection of severe acute mountain sickness

    Directory of Open Access Journals (Sweden)

    Adrián Garófoli

    2010-02-01

    Full Text Available El mal agudo de montaña (MAM es un conjunto de síntomas inespecíficos padecidos por sujetos que ascienden rápidamente desde baja a alta altura sin adecuada aclimatación. Usualmente es autolimitado, pero las formas graves (edema pulmonar y cerebral pueden causar la muerte. La hipoxemia exagerada en reposo está relacionada con el desarrollo de MAM pero su valor predictivo es limitado. Dado que el ejercicio en altura se acompaña de mayor hipoxemia y síntomas, postulamos el valor predictivo de un simple test de ejercicio para pronosticar MAM grave. Se estudió el valor predictivo de la saturación de oxígeno en reposo y ejercicio submáximo a 2.700 m y 4 300 m en 63 sujetos que ascendían al cerro Aconcagua (6 962 m. Se consideró desaturación de oxígeno con ejercicio a una disminución = 5% respecto al reposo. Se utilizó la escala de Lake-Louise para establecer la presencia de MAM grave. Seis sujetos presentaron MAM grave (9.5% y requirieron evacuación. La saturación de oxígeno en reposo a 2.700 m no fue significativa para clasificar sujetos que luego desarrollaron MAM grave. Por el contrario, la asociación de desaturación durante el ejercicio a 2.700 m más la saturación inapropiada en reposo a 4.300 m fue significativa para clasificar a los sujetos que desarrollaron MAM grave con un valor predictivo positivo de 80% y un valor predictivo negativo del 97%. Nuestros resultados son relevantes para el montañismo y sugieren la adición de un simple test de ejercicio en la predicción del MAM grave.Acute mountain sickness (AMS is a group of non-specific symptoms, seen in subjects that ascend from low to high altitude too quickly, without allowing sufficient time to acclimatize. Usually it is self-limiting, but the severe forms (pulmonary and cerebral edema can be fatal. Exaggerated hypoxemia at rest is related to later development of AMS but its predictive value is limited. Since exercise at altitude induces greater hypoxemia and

  10. HIPOGLICEMIA NEONATAL GRAVE – QUE DIAGNÓSTICO?

    Directory of Open Access Journals (Sweden)

    Joana Leite

    2016-07-01

    Discussão: A displasia septo-óptica é uma patologia rara (incidência de 1:10000, com heterogeneidade clínica e fenotípica. Existem várias formas de apresentação, que podem dificultar o seu diagnóstico, sendo que a tríade clássica verificada no presente caso clínico só se manifesta em cerca de 30% dos casos. O diagnóstico é clínico e pode ser estabelecido pela presença de pelos menos 2 dos critérios: hipoplasia do nervo óptico uni ou bilateral, defeitos da linha média cerebral e hipopituitarismo. O presente caso pretende alertar para a necessidade de diagnóstico e tratamento precoce, de forma a evitar a morbi-mortalidade associada à doença.

  11. Metal consumption in the Late Prehistory of the central Iberian Peninsula: an approach through the analysis of pit grave contexts

    Directory of Open Access Journals (Sweden)

    Carmona Ballestero, Eduardo

    2010-12-01

    Full Text Available This article is focused on the metal objects of the Chalcolithic and Bronze Age (3050-900 cal BC documented in the Submeseta Norte and Campiña Madrileña, with special attention given to those found in pit graves. The aim of this paper is to assess whether these objects are linked with social inequalities, and, therefore, with hierarchical forms of political organization (as has been traditionally interpreted, or with kinship-based societies. For doing so, we have only used contextualized data, which have been analyzed with different statistical procedures. The results show a scarcity of metal objects, which, are also not connected with hierarchical social structures. Consequently, we propose, as an alternative explanation, the persistence of kinship-based societies during the analyzed period.

    El presente texto toma como objeto de análisis los productos metálicos del Calcolítico y la Edad del Bronce (3050-900 cal. BC conocidos dentro de la Submeseta Norte y la Campiña Madrileña, con especial atención a los documentados en los enterramientos en fosa. A partir de esta base documental se ha pretendido evaluar si estos objetos están vinculados con desigualdades sociales permanentes y, por tanto, con formas de organización política jerarquizadas, tal y como se ha planteado tradicionalmente, o si se deben atribuir a comunidades de tipo segmentario. Para tal fin se han utilizado únicamente los datos contextualizados, que han sido sometidos a diversos procedimientos estadísticos. Los resultados muestran la escasez de objetos metálicos y la falta de conexión de éstos con estructuras sociales jerarquizadas. Se propone como alternativa explicativa la permanencia de las formas de organización social de tipo segmentario durante todo el tramo temporal analizado.

  12. Forma urbana en Castilla-La Mancha

    Directory of Open Access Journals (Sweden)

    Antonio Zárate Martín

    1998-01-01

    Full Text Available Las ciudades de Castilla-La Mancha muestran en su forma la fiuella de los diferentes procesos de urbanización que se tian sucedido a través del tiempo, destacando dentro de ellas sus centros históricos por la importancia del patrimonio urbanístico e histórico acumulado, la belleza y espectacularidad de sus emplazamientos. Muchas localidades, incluidas algunas de menor rango funcional y demográfico que las capitales, proporcionan un variado muestrario de respuestas urbanísticas a necesidades concretas de las sociedades del pasado y se singularizan con fuerza dentro del patrimonio urbano español.The cities of Castille-La Mancha show in their shape the trace of the different urbanization processes following one another in time, standing out among them their historie centers, due to the importance of the urban and historie heritage gathered through the years, and to the beauty and spectacular nature of their sites. Many towns, including some with a less functional and demographic rank than the capitals, provide a varied collection of samples of urban responses to particular needs of the oíd societies, distinguishing themselves strongly among the urban Spanish heritage.

  13. The Woodlands: Una forma diferente de gobernar

    Directory of Open Access Journals (Sweden)

    Raquel Insa-Ciriza

    2010-01-01

    Unidos de ciudad gobernada por asociaciones privadas. Estas asociaciones, representadas por un Consejo de Administración, proveen la mayoría de los servicios públicos a los ciudadanos. En este artículo se muestra lo que llamo «complicidad ciudadana» basada en lo que el Nuevo Servicio Público define como gobierno basado en la comunidad. Ellos no están reinventando ninguna clase de gobierno, lo que están haciendo es crear una nueva forma de gobierno en la que los ciudadanos prefieren tomar el mando que servir. El estudio del caso que muestro nos ayuda a entender cómo una mayor participación de los ciudadanos en las tareas de la administración local puede hacer disminuir visiblemente el poder del promotor en el desarrollo de una Nueva Ciudad. Esta complicidad ciudadana se traduce en términos de implicación de los miembros de la comunidad en el crecimiento y en el Gobierno de la ciudad. Clasificación JEL: H1, H11, H70.

  14. Radioiodine treatment of recurrent hyperthyroidism in patients previously treated for Graves' disease by subtotal thyroidectomy

    DEFF Research Database (Denmark)

    Vestergaard, H; Laurberg, P

    1992-01-01

    Radioiodine therapy is often employed for treatment of patients with relapse of hyperthyroidism due to Graves' disease, after previous thyroid surgery. Little is known about the outcome of this treatment compared to patients with no previous surgery. A total of 20 patients who had received surgical...... treatment for Graves' hyperthyroidism 1-46 years previously and with relapse of the hyperthyroidism, and 25 patients with hyperthyroidism due to Graves' disease and no previous thyroid surgery were treated with radioiodine, following the same protocol. Early after treatment the previously operated patients...

  15. Mechanisms in endocrinology. Role of emotional stress in the pathophysiology of Graves' disease.

    Science.gov (United States)

    Falgarone, Géraldine; Heshmati, Hassan M; Cohen, Régis; Reach, Gérard

    2013-01-01

    The role of stress in the pathophysiology of Graves' disease is suggested by several clinical observations, by recent advances in immunology and by better understanding of autoimmune diseases which provides new insights into potential effects of stress hormones on T helper cell imbalance involved in the pathogenesis of autoimmune diseases. Stress management should therefore be an important part of the treatment of Graves' disease, as stress reduction may improve the effect of therapy. However, this field still requires interventional data to support stress management in the treatment of Graves' disease.

  16. Mass graves gone missing: Producing knowledge in a world of absence

    Directory of Open Access Journals (Sweden)

    Douglas, Lee

    2014-12-01

    Full Text Available On May 1st, 2014 members of the historical memory team from the Aranzadi Sciences Society arrived in Oropesa de Toledo. The objective: to locate two mass graves containing the remains of Republicans killed in the weeks after Franco’s troops entered the town in 1936. Despite evidence regarding the mass graves’ existence, they were never found. Drawing on empirical, ethnographic data collected in the town of Oropesa in the months following this “unsuccessful” exhumation, this paper narrates the curious story of two graves that have “gone missing.” It considers the intellectual labor exerted to produce historical knowledge in a context where municipal archives remain inaccessible and family histories are marked by silence and dis-information. The author suggests that the absence of information –the dearth of historical, narrative evidence– regarding the lives of the defeated makes the production of historical and forensic knowledge a complicated affair. It tracks how kin-based knowledge and scarce archival documents are gathered and animated in order to make exhumations possible. Considering the forms of knowledge that are needed in order to engage techno-scientific expertise in meaningful ways, the paper attends to the important role that kin-based knowledge and seemingly “unimportant” documents play in processes of historical enunciation.El 1 de mayo de 2014, los miembros del equipo forense de la Sociedad de Ciencias Aranzadi llegaron a Oropesa de Toledo. El objetivo: localizar dos fosas comunes que contenían los restos de republicanos asesinados en las semanas posteriores a la llegada de las tropas de Franco en 1936. A pesar de la evidencia que apuntaba a la existencia de las dos fosas comunes, nunca se encontraron. Utilizando los datos empíricos y etnográficos recogidos en Oropesa en los meses posteriores a esta exhumación “fallida”, este trabajo narra la curiosa historia de dos tumbas que han “desaparecido”. El

  17. Trabalho e transtornos mentais graves: breve histórico e questões contemporâneas

    Directory of Open Access Journals (Sweden)

    Paulo César Zambroni-de-Souza

    Full Text Available Este artigo mostra que o nascimento da psiquiatria se insere em um processo de disciplinamento da sociedade; por isso, o asilo, ou hospício, originalmente seu lugar de exercício por excelência, guarda muitas semelhanças com outras estruturas disciplinares, como a prisão. Posteriormente, mostra como, a partir da Segunda Guerra Mundial, houve uma transformação nas sociedades ocidentais, onde aquelas estruturas disciplinares entraram em declínio e formas de controle social mais sutis ganharam força. Trabalha-se, ao lado disso, um processo de questionamento da própria psiquiatria e das estruturas manicomiais, o que genericamente se denominou reforma psiquiátrica, na qual o trabalho das pessoas com transtorno mental foi tomado como elemento essencial. Por fim, realiza-se uma breve contextualização das transformações recentes nos processos de produção para perguntar de que maneira as pessoas com transtornos mentais graves podem colocar-se no mundo do trabalho.

  18. ALCANCES E LIMITES DA PSICOLOGIA EVOLUTIVA PARA A COMPREENSÃO DA MENTE SCOPE AND LIMITS OF EVOLUTIONARY PSYCHOLOGY TO THE UNDERSTANDING OF MIND

    Directory of Open Access Journals (Sweden)

    Cleverson leite Bastos

    2011-03-01

    Full Text Available O que pretendemos, na extensão que um artigo permite, é convergir dois domínios de modelos contemporâneos para a compreensão da mente. Ambos são ferramentas heurísticas fundamentais que possibilitam, por um lado, a teoria da mente modular, entender aspectos importantes da cognição humana como linguagem, memória, aprendizagem (ciências cognitivas e, por outro, modelos advindos da psicologia evolutiva que explicam certos aparentes desperdícios comportamentais. Os pressupostos fundamentais de ambas as metáforas são distintos: o modelo modular é produto das ciências cognitivas e o modelo evolucionista é produto do princípio de seleção sexual. Basicamente, como ferramenta heurística a teoria modular demonstra ser a mente um cômputo, como produto da seleção (seleção natural, que processa informação; já a teoria da mente ornamental propõe uma ideia estranha que Amotz Zahavi chamou de princípio de handicap (seleção sexual.
    Our intent with this article, given its space limitations, is converging two contemporary models of mind domain. Both are fundamental heuristic tools, being the first, the modular theory of mind, which enables us to understand important aspects of human cognition such as language, memory, learning (cognitive sciences. The second, the ornamental mind theory, explains certain apparent wasteful behaviors. The fundamental presuppositions of both metaphors are distinct: whilst the modular model is a product of cognitive sciences, the ornamental model is the yield of the sexual selection principle. Basically, as heuristic tools, the modular theory demonstrates the mind as a computation, as a product of selection (natural selection which processes information; on its turn, the ornamental mind theory proposes an awkward idea, which Amotz Zahavi called the handicap principle (sexual selection.

  19. Strategies of radioiodine therapy for Graves' disease

    Energy Technology Data Exchange (ETDEWEB)

    Lind, P. [Department of Nuclear Medicine and Endocrinology, PET Center Klagenfurt, LKH Klagenfurt (Austria)

    2002-08-01

    Several therapeutic options are available for the treatment of Graves' disease (GD), including long-term antithyroid drug medication (ATD), near-total resection (NTR) and radioiodine therapy (RIT). These treatments are used with different frequencies depending on geographical location, size of the goitre, age of the patient and experience of the physician. It should be noted that RIT is still being applied more frequently in the United States than in Europe. Despite the fact that RIT was introduced as long ago as 1941, several questions are still the subject of debate: Should a fixed dose or a calculated dose be used. If the dose is calculated, how many Grays (Gy) should be delivered to the thyroid? What is the goal of RIT in GD? Which factors, including ATD, influence the outcome of RIT? Is RIT appropriate in GD with Graves' ophthalmopathy (GO)? Although not all these questions have been answered yet, conclusions can be derived regarding a general strategy for use of RIT in GD. As with surgery, the goal of RIT in GD is euthyroidism with or without L-thyroxine medication. There is a clear advantage of dose calculation over use of a fixed dose because the only factor influencing the outcome is the dose delivered to a certain thyroid volume. To minimise recurrent hyperthyroidism, an ablative approach using a delivered dose of 250 Gy is widely accepted. Beside pretherapeutic T{sub 3} levels, thyroid volume and 24-h thyroid uptake, ATD may influence the outcome of RIT. Today it is accepted by most thyroidologists that, if ATD medication is necessary in overt hyperthyroidism, it should be withdrawn at least 2 days before RIT. In patients with GD and GO, RIT may worsen GO. If RIT is performed in GO it should be done under a 3-month steroid medication regimen. In conclusion, RIT can be considered an appropriate and cost-effective therapy in GD, although the decision regarding treatment should be taken on an individual basis, paying due respect to the course and

  20. Agranulocitosis inducida por metimazol en pacientes con enfermedad de Graves

    Directory of Open Access Journals (Sweden)

    Helard Manrique-Hurtado

    2013-04-01

    Full Text Available Objetivo: Describir las características clínicas y epidemiológicas de los pacientes con enfermedad de Graves que presentaron agranulocitosis inducida por metimazol. Material y métodos: Estudio retrospectivo, tipo serie de casos. Se revisaron las historias clínicas de todos los pacientes con diagnóstico de agranulocitosis inducida por metimazol, atendidos en el Hospital Nacional Arzobispo Loayza, entre enero 2002 y diciembre 2008. Se buscó asociación entre las variables demográficas y clínicas con la mortalidad y el tiempo de recuperación. Resultados: Treinta (0,60% pacientes con enfermedad de Graves fueron hospitalizados con el diagnóstico de agranulocitosis inducida por metimazol. La mediana de la edad fue 33,5 años y 86,67% fueron mujeres. Al ingreso, todos los pacientes presentaron fiebre y dolor de garganta. El manejo incluyó aislamiento invertido, suspensión del metimazol, administración de antibióticos y glucocorticoides. Doce (40% pacientes recibieron GM-CSF. El número de granulocitos se normalizó después de 10,59 días y cuatro (13,33% pacientes murieron por infecciones bacterianas y sepsis. En todos los casos, el tratamiento definitivo fue yodo radioactivo. No hubo diferencia significativa en la edad, sexo, dosis de metimazol, duración del tratamiento y uso de factor estimulante colonia, entre los pacientes fallecidos y los sobrevivientes. Además, el uso de factor estimulante de colonia no redujo el tiempo de recuperación de la agranulocitosis. Conclusión: La agranulocitosis inducida por metimazol es un evento adverso serio y potencialmente mortal. En este grupo de pacientes, la mortalidad fue elevada y el uso de factor estimulante de colonia no disminuyó el tiempo de recuperación.

  1. Impacto de la "Ley de promoción de la autonomía personal y atención a las personas en situación de dependencia" en las personas con trastorno mental grave.

    Directory of Open Access Journals (Sweden)

    Teodosia Sobrino Calzado

    2012-01-01

    Full Text Available La Ley 39/2006, conocida como Ley de Dependencia, ha generado, desde su aprobación, desconfianza por estar orientada a la atención de la dependencia, siendo la promoción de la autonomía personal un elemento apenas desarrollado y secundario.
    En el caso de las personas con trastorno mental grave, lo que mayor preocupación ha causado a las organizaciones de profesionales de la salud mental y a las asociaciones de familiares ha sido la compatibilidad de dicha Ley con las prestaciones del Sistema Nacional de Salud y si el baremo establecido se ajustaba a las necesidades de este colectivo.
    Este artículo recoge el trabajo realizado desde diferentes comunidades autónomas por diferentes profesionales en un intento de, tras un análisis de la Ley, plantear a la administración responsable de la misma el necesario ajuste para adaptarla a las características de las personas con trastorno mental grave.
    Se analizan, en primer lugar, sus fortalezas y debilidades. Posteriormente se exponen tres formas diferentes de contrarrestar sus riesgos, en tres comunidades autónomas diferentes. Finalmente se dan las claves de los aspectos de la Ley sobre los que hay que seguir trabajando para que sea una oportunidad para las personas con trastorno mental grave, y no una barrera

  2. Development of Graves' ophthalmopathy and uveitis after radioiodine therapy for Graves' disease in a patient with HTLA-I associated myelopathy (HAM)

    Energy Technology Data Exchange (ETDEWEB)

    Ozawa, Yasunori; Migita, Masayoshi; Watanabe, Tomoji; Okuda, Itsuko; Takeshita, Akira; Takagi, Akio; Shishiba, Yoshimasa (Toranomon Hospital, Tokyo (Japan))

    1994-09-01

    HTLV-I carriers or patients with HTLV-I associated myelopathy (HAM) are prone to immune-mediated inflammatory disorders. We present a 44-year-old female with HAM who developed Graves' disease. She developed severe Graves' ophthalmopathy shortly after [sup 131]I therapy, concurrently with a remarkable increase in TSH-receptor antibody titer. Ophthalmopathy was aggravated in spite of prednisolone therapy and euthyroidism being maintained by thyroxine replacement. Uveitis also developed after [sup 131]I therapy and iridocyclitis finally required trabeculotomy. This case suggests that HAM patients may have a higher risk of immune-mediated Graves' ophthalmopathy after [sup 131]I therapy.(author).

  3. Transconjunctival orbital decompression in Graves' ophthalmopathy: lateral wall approach ab interno

    NARCIS (Netherlands)

    D.A. Paridaens; K. Verhoeff; D. Bouwens; W.A. van den Bosch (Willem)

    2000-01-01

    textabstractAIMS: A modified surgical technique is described to perform a one, two, or three wall orbital decompression in patients with Graves' ophthalmopathy. METHODS: The lateral wall was approached ab interno through a "swinging eyelid" approach (lateral canthotomy

  4. Outcome of orbital decompression for disfiguring proptosis in patients with Graves' orbitopathy using various surgical procedures

    NARCIS (Netherlands)

    Mourits, M. P.; Bijl, H.; Altea, M. A.; Baldeschi, L.; Boboridis, K.; Curro, N.; Dickinson, A. J.; Eckstein, A.; Freidel, M.; Guastella, C.; Kahaly, G. J.; Kalmann, R.; Krassas, G. E.; Lane, C. M.; Lareida, J.; Marcocci, C.; Marino, M.; Nardi, M.; Mohr, Ch; Neoh, C.; Pinchera, A.; Orgiazzi, J.; Pitz, S.; Saeed, P.; Salvi, M.; Sellari-Franceschini, S.; Stahl, M.; von Arx, G.; Wiersinga, W. M.

    2009-01-01

    Aim: To compare the outcome of various surgical approaches of orbital decompression in patients with Graves' orbitopathy (GO) receiving surgery for disfiguring proptosis. Method: Data forms and questionnaires from consecutive, euthyroid patients with inactive GO who had undergone orbital decompressi

  5. Disease Activity in Graves' Ophthalmopathy: Diagnosis with Orbital MR Imaging and Correlation with Clinical Score

    National Research Council Canada - National Science Library

    Tortora, Fabio; Cirillo, Mario; Ferrara, Marco; Belfiore, Maria Paola; Carella, Carlo; Caranci, Ferdinando; Cirillo, Sossio

    2013-01-01

    In Graves' ophthalmopathy (GO) it is important to distinguish acute inflammation at an early stage, responsive to immunosuppressive treatment, from inactive fibrotic end stage disease, unresponsive to the same treatment...

  6. Mechanisms in endocrinology. Role of emotional stress in the pathophysiology of Graves' disease

    National Research Council Canada - National Science Library

    Falgarone, Géraldine; Heshmati, Hassan M; Cohen, Régis; Reach, Gérard

    2013-01-01

    The role of stress in the pathophysiology of Graves' disease is suggested by several clinical observations, by recent advances in immunology and by better understanding of autoimmune diseases which...

  7. Affective symptoms and cognitive functions in the acute phase of Graves' thyrotoxicosis

    DEFF Research Database (Denmark)

    Vogel, Asmus; Elberling, Tina V; Hørding, Merete

    2007-01-01

    In the acute phase of Graves' thyrotoxicosis patients often have subjective cognitive complaints. Continuing controversy exists about the nature of these symptoms and whether they persist after treatment. This prospective study included 31 consecutively referred, newly diagnosed, and untreated pa...

  8. Tratamento da pneumonia grave adquirida na comunidade no Brasil: análise secundária de um inquérito internacional

    Directory of Open Access Journals (Sweden)

    Lígia Rabello

    2015-03-01

    Full Text Available Objetivo: Avaliar a percepção dos médicos brasileiros quanto ao diagnóstico, à avaliação de gravidade, ao tratamento e à estratificação de risco em pacientes com pneumonia grave adquirida na comunidade, e compará-la com as diretrizes atuais. Métodos: Estudo transversal realizado por meio da aplicação de um questionário anônimo a uma amostra de médicos brasileiros especialistas em cuidados intensivos, medicina de emergência, medicina interna e pneumologia. Entre outubro e dezembro de 2008, foram avaliadas as atitudes dos médicos no diagnóstico, a avaliação de risco e as intervenções terapêuticas para pacientes com pneumonia grave adquirida na comunidade. Resultados: Responderam ao questionário 253 médicos, sendo 66% da Região Sudeste do Brasil. A maioria (60% dos médicos que responderam tinha mais de 10 anos de experiência. Verificou-se que a avaliação de risco de pneumonia grave adquirida na comunidade foi muito heterogênea, sendo a avaliação clínica a forma de avaliação de risco mais frequente. As hemoculturas foram habitualmente realizadas por 75% dos médicos, entretanto, foi reconhecido seu fraco desempenho diagnóstico. Por outro lado, a pesquisa de antígenos urinários de Pneumococo e Legionella foi solicitada por menos de um terço dos médicos. A maioria (95% prescreveu antibióticos de acordo com as diretrizes. A combinação de uma cefalosporina de terceira ou quarta geração com um macrolídeo foi a escolha mais comum. Conclusão: Este inquérito brasileiro demonstrou diferenças entre as diretrizes publicadas e a prática clínica. Isso leva à necessidade de se desenvolverem programas educacionais e de adoção de protocolos para implementar estratégias baseadas em evidências no manejo da pneumonia grave adquirida na comunidade.

  9. Cradle-to-Grave Logistic Technologies for Exploration Missions

    Science.gov (United States)

    Broyan, James L.; Ewert, Michael K.; Shull, Sarah

    2013-01-01

    Human exploration missions under study are very limited by the launch mass capacity of exiting and planned vehicles. The logistical mass of crew items is typically considered separate from the vehicle structure, habitat outfitting, and life support systems. Consequently, crew item logistical mass is typically competing with vehicle systems for mass allocation. NASA is Advanced Exploration Systems (AES) Logistics Reduction and Repurposing (LRR) Project is developing four logistics technologies guided by a systems engineering cradle-to-grave approach to enable used crew items to augment vehicle systems. Specifically, AES LRR is investigating the direct reduction of clothing mass, the repurposing of logistical packaging, the processing of spent crew items to benefit radiation shielding and water recovery, and the conversion of trash to propulsion supply gases. The systematic implementation of these types of technologies will increase launch mass efficiency by enabling items to be used for secondary purposes and improve the habitability of the vehicle as the mission duration increases. This paper provides a description, benefits, and challenges of the four technologies under development and a status of progress at the mid ]point of the three year AES project.

  10. Special features of Graves' disease in early childhood.

    Science.gov (United States)

    Segni, M; Leonardi, E; Mazzoncini, B; Pucarelli, I; Pasquino, A M

    1999-09-01

    Graves' disease (GD) is extremely rare in children younger than 4 years of age, but if not recognized and treated it can seriously interfere with growth and development. We report three unrelated children, all females, in whom GD occurred before the age of 3. These children presented with goiter, exophthalmos, tachycardia, and hyperactivity. Moreover, one showed a severe psychomotor delay, and had previously undergone surgery due to craniosynostosis; the other two manifested a language delay. All had high thyroid hormones and thyrotropin receptor antibody (TRAb) serum levels that clearly indicated autoimmune hyperthyroidism. In all of them, the disease presumably had developed during the first or second year of life. No maternal history of GD was present in two. The third child was born to a mother affected with GD during pregnancy, but it is likely that her GD began to develop after 6 months of life. These children are being treated with methimazole, and treatment is still necessary after 32 months. TRAb levels were persistently high at follow-up. Psychological evaluation including language development at follow-up was appropriate for age in two children; the third child improved, but severe mental retardation is still evident. GD assessment in early childhood also needs to focus on psychological evaluation. Pediatricians should be aware of the possibility of permanent brain damage and craniosynostosis due to hyperthyroidism in infancy.

  11. [Graves' disease: ultrasonographic, color Doppler and histological aspects].

    Science.gov (United States)

    Messina, G; Viceconti, N; Trinti, B

    1997-11-01

    The aim of the present work was to study the relationship between thyroid low echogenicity, the thyroid blood flow by color-Doppler (CD) and histological features in patients with Graves' disease (GD). Thyroid ultrasonography and CD was performed on 28 patients with GD. In 5 patients has been compared CD with histology. The thyroid volume was higher in 100% of patients with GD at the onset rather than in euthyroidism. Diffuse hypoechogenicity of the thyroid was discovered in 100% of patients with GD at the onset and it persisted in 57.1% of patients that became euthyroid after therapy. Qualitative CD resulted in different patterns that were classified as follow: pattern A ("thyroid inferno") in 17 patients (60.7%); pattern B (mildly increased of parenchymal blood flow) in 11 patients (39.3%). In the 5 histological proven cases, in the pattern A (3 cases) there was a diffuse microfollicular hyperplasia with functional activation notes. There was lymphocytic infiltration. While in the pattern B (two cases) there were a non-follicular hypercellular nodule with pseudocapsule and rare colloid. We conclude that there are two different histological types with different CD patterns in GD.

  12. Sheehan's syndrome co-existing with Graves' disease.

    Science.gov (United States)

    Arpaci, D; Cuhaci, N; Saglam, F; Ersoy, R; Cakir, B

    2014-01-01

    Sheehan's syndrome (SS), which is an important cause of hypopituitarism, is common in developing countries. The most common presentation is the absence of lactation and amenorrhea. Hypothyroidism rather than hyperthyroidism is the usual expected phenomenon in SS. Postpartum hyperthyroidism is also common and Graves' disease (GD) is an important cause of postpartum hyperthyroidism. Here we report a case of a 22-year-old female patient in our clinic presented symptoms of amenorrhea, lack of lactation, palpitations and sweating. Her physical examination revealed goiter, moist skin and proptosis. Her laboratory evaluation showed suppressed thyroid stimulating hormone, elevated levels of free thyroxine and free triiodothyronine. Thyroid antibodies were positive. Tec 99m thyroid scintigraphy results were gland hyperplasia and increased uptake consistent with GD. She gave birth 7 months ago; after delivery she had a history of prolonged bleeding, amenorrhea and inability to lactate. She had hypogonadotropic hypogonadism, hyperprolactinemia and growth hormone deficiency. Serum cortisol and adrenocorticotropic hormone levels were normal. Her magnetic resonance imaging was empty sella. Our diagnosis was GD co-existing with SS. GD with concomitant hypopituitarism is rare but has been described previously, but there are no reports of GD occurring with SS. In this case study, we report a patient with GD associated with SS.

  13. 17 CFR 210.8-05 - Pro forma financial information.

    Science.gov (United States)

    2010-04-01

    ... balance sheet required by § 210.8-02 or § 210.8-03, a pro forma balance sheet giving effect to the combination as of the date of the most recent balance sheet. For a purchase, pro forma statements of income..., INVESTMENT ADVISERS ACT OF 1940, AND ENERGY POLICY AND CONSERVATION ACT OF 1975 Article 8...

  14. A narrativa audiovisual publicitária : a forma comercial e a forma social

    OpenAIRE

    Vieira, Claúdia Virgínia Fernandes

    2009-01-01

    Dissertação de Mestrado em Ciências da Comunicação - Área de Especialização em Audiovisual e Multimédia A publicidade audiovisual é geralmente considerada uma forma de vender produtos ou serviços e, na sua maioria, é o que os anúncios estão dispostos a fazer. Temos, no entanto um outro tipo de anúncio, o institucional, que aqui chamamos publicidade social, feita para advertir o público de situações de risco ou fazer apelos para o melhoramento de assuntos pertinentes à sociedade ...

  15. Mating systems in caridean shrimp (Decapoda: Caridea and their evolutionary consequences for sexual dimorphism and reproductive biology Sistemas de apareamiento en camarones carideos (Decapoda: Caridea y sus consecuencias evolutivas en el dimorfismo sexual y biología reproductiva

    Directory of Open Access Journals (Sweden)

    CRISTIÁN CORREA

    2003-06-01

    species with search & attend the situation is variable, and only some males benefit by acquiring large size while others do better by searching or changing sex. In contrast to other crustaceans free-living shrimp do not exhibit precopulatory mate guarding and they are relatively unaggressive. The characteristic and efficient escape behavior of shrimp using their contractile abdomen might be one important trait that has constrained the evolution of such behaviors. Our review indicates that the mating systems of caridean shrimp depend both on environmental and on biological characteristicsEn este articulo revisamos relaciones funcionales y evolutivas entre los sistemas de apareamiento de camarones carideos, y características específicas tales como biología/ecología general, sistemas sexuales, conducta y morfología. Basados en reportes bibliográficos se describió cuatro sistemas de apareamiento, y un quinto fue reconocido pero la informaci��n disponible fue insuficiente para describirlo en detalle. `Monogamia' ocurre en muchas especies que habitan en refugios monopolizables o huéspedes, especialmente cuando las condiciones ambientales restringen la probabilidad de encuentros entre conespecíficos. En contraste, las especies de vida libre experimentan encuentros más frecuentes y los machos pueden dominar o buscar: En el sistema de apareamiento `dominancia vecinal' los machos más grandes rinden mayor éxito reproductivo porque son los que tienen el mejor desempeño en la competencia agresiva por las hembras receptivas. En el sistema `pura búsqueda' son los machos pequeños los que lo hacen mejor porque su agilidad les permite buscar pareja eficazmente entre la población. El cuarto sistema de apareamiento es `búsqueda & compañía' que ocurre en simbiontes solitarios que experimentan condiciones demográficas y ecológicas variables: dependiendo de las condiciones ambientales y del estado ontogenético, puede ser conveniente para los machos buscar o permanecer

  16. Formas graves de leptospirose: aspectos clínicos, demográficos e ambientais Severe forms of leptospirosis: clinical, demographic and environmental aspects

    Directory of Open Access Journals (Sweden)

    Everaldo Costa

    2001-06-01

    Full Text Available São descritas as características de 1.016 pacientes internados com leptospirose no Hospital Couto Maia, Salvador, BA, entre 1993 e 1997. Aumento na precipitação pluviométrica mostrou relação com aumento do número de internamentos no mês subsequente. Sexo masculino correspondeu a 81,1% (824/1.016; a média da idade foi 35,7±15,4 anos. Quase 94% (778/829 dos 829 com informação sobre raça eram negros ou mulatos. Para idade igual ou superior a 18 anos, quase 93% não cursaram o segundo grau. A média do período de incubação foi estimado em 6,3±3,9 dias. A duração dos sintomas foi em média 6,1±2,4 dias. Episódios hemorrágicos corresponderam a 14,3% (145/1.016. A letalidade entre 1.009 pacientes não transferidos foi de 14,2% (143/1.009. Insuficiência renal foi a causa atribuída de morte em 76,2% (109/143. Os dados indicam que leptospirose é estreitamente relacionada com baixos níveis socioeconômicos e que aumento da precipitação pluviométrica precede surtos epidêmicos.Characteristics of 1,016 patients hospitalized with leptospirosis in the Hospital Couto Maia, Salvador, BA, Brazil, between 1993 and 1997 are described. Higher pluviometric precipitation was related to an increase in the number of hospitalizations during the following month. Males corresponded to 81.1% (824/1,016 of these; mean age was 35.7±15.4 years. Almost 94% (778/829 of the 829 patients with information about race were black or mulatto (mixed race. For ages 18 years or above, almost 93% had not completed high school level. The mean incubation period was estimated as 6.3±3.9 days. Average duration of symptoms was 6.1±2.4 days. Hemorrhagic events corresponded to 14.3% (145/1,016. The case-fatality rate among 1,009 patients that were not transferred was 14.2% (143/1,009. Renal failure was the attributable cause of death in 76.2% (109/143. The data indicate that leptospirosis is closely related to lower socioeconomic levels, and that higher pluviometric precipitation antecedes the outbreaks.

  17. Prognostic factors of the outcomes of subtotal thyroid resection in graves disease

    Directory of Open Access Journals (Sweden)

    A J Tsurkan

    2011-03-01

    Full Text Available The long-term results of subtotal resection of thyroid gland on 82 patients with Graves' disease were studied. There was analysed the influence of three factors on outcome at Graves' disease: volume of a thyroid gland before operation, morphological structure of thyroid tissue and volume of thyroid remnant. Outcomes of subtotal resection of thyroid gland were studied on the basis of thyrotropic hormone level of blood in 3, 6, 12 months, 2 and 3 years after operation. Based on research it has been established that the volume of thyroid gland before operation does not influence to outcome of subtotal resection of thyroid gland with Graves' disease. Morphological changes of removed thyroid tissue in the form of colloidal nodules at patients with Graves' disease statistically significantly raise risk of development of postoperative complications after subtotal resection of thyroid gland. The surgeon defining the volume of thyroid rem-nant durng the operation could be mistaken as towards it's increase so towards it's reduction, with an average deviation about 35%. Various outcomes of subtotal resection of thyroid gland at the same volume of thyroid remnant let us conclude that this out-come depends more on intensity of autoimmune process rather than on the volume of thyroid remnant. According modern views to aetiology and patogenesis of Graves' disease, the optimum volume of operation at Graves' disease is thyroidectomy.

  18. Radioiodine therapy for Graves' disease: case selection and restrictions recommended to patients in North America.

    Science.gov (United States)

    Wartofsky, L

    1997-04-01

    Each of the three major therapies for Graves' disease has its own advantages, disadvantages, indications, and contraindications. Today, radioactive iodine (RAI) therapy is the most commonly employed means of therapy for Graves' disease in the United States, with approximately 70% of patients so treated after initial presentation and an additional fraction of arguably 10-15% treated with RAI after failure of antithyroid drugs or surgery. RAI therapy is acknowledged to have the clear-cut advantage of being safe, with low morbidity and cost. The indications for RAI therapy are clear and noncontroversial for most patients with Graves' disease. Moreover, RAI treatment is employed by some thyroidologists for subclinical thyrotoxicosis (normal T4 or T3 but immeasurable TSH), particularly in patients > age 45 due to risks of atrial fibrillation. RAI therapy is not considered indicated or is contraindicated during breast feeding and in pregnancy, subacute thyroiditis, postpartum thyroiditis, struma ovarii, pituitary (TSH-driven) hyperthyroidism, euthyroid, hyperthyroxinemia, and thyroid hormone resistance. Opinions vary on the use of RAI therapy in children with Graves' disease; generally, a lower age cutoff of 17 years is acceptable in most clinics. Even more controversial is whether RAI therapy in the presence of Graves' ophthalmology constitutes a risk for worsening ophthalmopathy. Resolution of this latter issue awaits more definitive studies, but RAI therapy is likely to remain the first choice for most patients with Graves' disease.

  19. Refractory Graves' Disease Successfully Cured by Adjunctive Cholestyramine and Subsequent Total Thyroidectomy

    Directory of Open Access Journals (Sweden)

    Yeoree Yang

    2015-12-01

    Full Text Available The three major forms of treatment for Graves thyrotoxicosis are antithyroid drugs, radioactive iodine therapy and thyroidectomy. Surgery is the definitive treatment for Graves thyrotoxicosis that is generally recommended when other treatments have failed or are contraindicated. Generally, thyrotoxic patients should be euthyroid before surgery to minimize potential complications which usually requires preoperative management with thionamides or inorganic iodine. But several cases of refractory Graves' disease have shown resistance to conventional treatment. Here we report a 40-year-old female patient with Graves' disease who complained of thyrotoxic symptoms for 7 months. Her thyroid function test and thyroid autoantibody profiles were consistent with Graves' disease. One kind of thionamides and β-blocker were started to control her disease. However, she was resistant to nearly all conventional medical therapies, including β-blockers, inorganic iodine, and two thionamides. She experienced hepatotoxicity from the thionamides. What was worse is her past history of serious allergic reaction to corticosteroids, which are often used to help control symptoms. A 2-week regimen of high-dose cholestyramine improved her uncontrolled thyrotoxicosis and subsequent thyroidectomy was successfully performed. In conclusion, cholestyramine could be administered as an effective and safe adjunctive agent for preoperative preparation in patients with severe hyperthyroid Graves's disease that is resistant to conventional therapies.

  20. Autoinmunidad tiroidea: Mecanismos patogénicos comunes y distintivos en tiroiditis de Hashimoto y enfermedad de Graves Thyroid Autoimmunity: Common and Distinctive Pathogenic Mechanisms in Hashimoto's Thyroiditis and Graves' Disease

    Directory of Open Access Journals (Sweden)

    G Astarita

    2012-09-01

    Full Text Available Las enfermedades tiroideas autoinmunes (ETA son los desórdenes más frecuentes que llevan a la disfunción de la glándula tiroidea. Incluyen varias formas clínicas como Tiroiditis de Hashimoto (TH y Enfermedad de Graves (EG. La relación entre TH y EG ha sido objeto de debate por décadas. Si bien, muy diferentes en su clínica, algunos las consideran los lados opuestos de una misma moneda. En su patogénesis tienen aspectos en común, como la predisposición genética demostrado por la ocurrencia en una misma familia y en un mismo individuo. Sin embargo, diferencias en el microambiente local determinan la diferente expresión fenotípica o el viraje de una a otra patología. El objetivo de esta monografía es investigar similitudes y diferencias entre TH y EG en las distintas etapas que llevan al desarrollo de autoinmunidad. Los autores declaran no poseer conflictos de interés.Autoimmune thyroid disease (ATD is the most common disorder that leads to thyroid gland dysfunction. ATD manifests in various clinical forms, such as Hashimoto's Thyroiditis (HT and Graves' Disease (GD. The relation between HT and GD has been discussed for decades. Even if they greatly differ in their clinical features and treatment, some people believe they are the opposite sides of the same coin. In their pathogenesis, they share some mechanisms, such as genetic susceptibility, shown by the fact that they tend to occur both in the same person and within the same family. However, differences in the local micro-environment can determine the distinct phenotypic expression or the switch from one disease to the other. The aim of this monograph was to investigate similarities and differences between HT and GD at the diverse stages leading to the development of autoimmunity. No financial conflicts of interest exist.

  1. Radioiodine therapy in patients with Graves' disease; Radioiodoterapia em pacientes com doenca de Basedow-Graves

    Energy Technology Data Exchange (ETDEWEB)

    Correa, Margarida Maria Galvao; Blum, Bernardo; Pellegrini, Paulo Martins [Instituto Brasileiro de Medicina Nuclear, Rio de Janeiro, RJ (Brazil); Corbo, Rossana [Universidade Federal, Rio de Janeiro, RJ (Brazil). Faculdade de Medicina. Dept. de Radiologia; Rebello, Ana Maria de Oliveira [Hospital Universitario Clementino Fraga Filho, Rio de Janeiro, RJ (Brazil). Servico de Medicina Nuclear

    2000-04-01

    We studied retrospectively 104 patients with Graves' disease who underwent radioiodine therapy between 1983 and 1993. The administered dose varied from 2.0 to 9.0 mCi (74 to 333 MBq). In 1994 and 1998 the patients were asked to answer a questionnaire and were considered to have hypothyroidism when receiving T4 therapy. The importance of radioiodine therapy, its indications and the different methods of calculating the administered activity were studied. The results were compared with the literature. At the end of the evaluation, 62,4% of the patients presented hypothyroidism and 37,6% euthyroidism. There was no significant difference regarding the development of hypothyroidism when sex, number of doses, total activity (mCi), effective radiation ({mu}Ci per gram of tissue) and use of antithyroid drugs were considered. In conclusion, the period of time of post-radioiodine therapy is the most important factor in the analysis of the results, which may interfere with the development of hypothyroidism. (author)

  2. Current trends in the management of Graves' disease

    Energy Technology Data Exchange (ETDEWEB)

    Solomon, B.; Glinoer, D.; Lagasse, R.; Wartofsky, L. (Walter Reed Army Medical Center, Washington, DC (USA))

    1990-06-01

    Members of the American Thyroid Association were invited to participate in a survey of the management of Graves' disease. One primary case and several variations were provided, which differed in respect to age, sex, goiter size, severity, etc. The questionnaire was based on the format used in a similar survey of members of the European Thyroid Association. The aim of the survey was to determine (1) how expert thyroidologist employ diagnostic procedures for this disorder, and (2) the choice of therapy of the three treatment options and its manner of implementation. Questionnaires were sent only to clinically active members. The overall response rate was 62%. Data analysis was possible on 52% of members surveyed and was performed using SPSS and a specific Fortran program. In the laboratory evaluation of the primary case a radioiodine uptake, scan, serum total T4, and basal TSH were requested by 92%, 47%, 83%, and 66%, respectively, with 84% of respondents using an ultrasensitive TSH assay. For management of the primary case, radioiodine treatment was the first choice of 69% of the respondents. Antithyroid drugs were used briefly (3-7 days) before 131I by 28%, whereas 41% said they would employ thioureas after 131I. Of those using 131I, 66% tailored the dose to achieve euthyroidism as the goal of therapy, while 34% aimed for hypothyroidism requiring T4 replacement. Only 30% of respondents chose thioureas as a first line of treatment (72% propylthiouracil; 28% tapazole). The duration of drug therapy was a predetermined fixed interval for 80% of the respondents, with 90% treating for 1-2 yr. Other specific trends in diagnostic approach and therapeutic preferences were identified for the eight variations on the primary case problem.

  3. Copy number variations exploration of multiple genes in Graves' disease.

    Science.gov (United States)

    Song, Rong-Hua; Shao, Xiao-Qing; Li, Ling; Wang, Wen; Zhang, Jin-An

    2017-01-01

    Few previous published papers reported copy number variations of genes could affect the predisposition of Graves' disease (GD). Herein, the aim of this study was to explore the association between copy number variations (CNV) profile and GD. The preliminary copy number microarray used to screen copy number variant genes was performed in 6 GD patients. Five CNV candidate genes (CFH, CFHR1, KIAA0125, UGT2B15, and UGT2B17) were then validated in an independent set of samples (50 GD patients and 50 matched healthy ones) by the Accucopy assay method. The CNV of the other 2 genes TRY6 and CCL3L1 was investigated in 144 GD patients and 144 healthy volunteers by the definitive genotyping technique using the Taqman quantitative polymerase-chain-reaction (Taqman qPCR). TRY6 gene-associated single nucleotide polymorphism (SNP), rs13230029, was genotyped by the PCR-ligase detection reaction (LDR) in 675 GD patients and 898 healthy controls. There were no correlation of the gene copy number (GCN) of CFH, CFHR1, KIAA0125, UGT2B15, and UGT2B17 with GD. In comparison with that of controls, the GCN distribution of TRY6 and CCL3L1 in GD patients did not show significantly differ (P > 0.05). Furthermore, TRY6-related polymorphism (rs13230029) showed no difference between GD patients and controls. No correlation was found between CNV or SNP genotype and clinical phenotypes. Generally, there were no link of the copy numbers of several genes, including CFH, CFHR1, KIAA0125, UGT2B15, UGT2B17, TRY6, and CCL3L1 to GD. Our results clearly indicated that the copy number variations of multiple genes, namely CFH, CFHR1, KIAA0125, UGT2B15, UGT2B17, TRY6, and CCL3L1, were not associated with the development of GD.

  4. Lithium as an Alternative Option in Graves Thyrotoxicosis

    Directory of Open Access Journals (Sweden)

    Ishita Prakash

    2015-01-01

    Full Text Available A 67-year-old woman was admitted with signs and symptoms of Graves thyrotoxicosis. Biochemistry results were as follows: TSH was undetectable; FT4 was >6.99 ng/dL (0.7–1.8; FT3 was 18 pg/mL (3–5; TSI was 658% (0–139. Thyroid uptake and scan showed diffusely increased tracer uptake in the thyroid gland. The patient was started on methimazole 40 mg BID, but her LFTs elevated precipitously with features of fulminant hepatitis. Methimazole was determined to be the cause and was stopped. After weighing pros and cons, lithium was initiated to treat her persistent thyrotoxicosis. Lithium 300 mg was given daily with a goal to maintain between 0.4 and 0.6. High dose Hydrocortisone and propranolol were also administered concomitantly. Free thyroid hormone levels decreased and the patient reached a biochemical and clinical euthyroid state in about 8 days. Though definitive RAI was planned, the patient has been maintained on lithium for more than a month to control her hyperthyroidism. Trial removal of lithium results in reemergence of thyrotoxicosis within 24 hours. Patient was maintained on low dose lithium treatment with lithium level just below therapeutic range which was sufficient to maintain euthyroid state for more than a month. There were no signs of lithium toxicity within this time period. Conclusion. Lithium has a unique physiologic profile and can be used to treat thyrotoxicosis when thionamides cannot be used while awaiting elective radioablation. Lithium levels need to be monitored; however, levels even at subtherapeutic range may be sufficient to treat thyrotoxicosis.

  5. [Efficacy of treatment with I(131) in paediatric Graves disease].

    Science.gov (United States)

    Enes Romero, P; Martín-Frías, M; de Jesús, M; Caballero Loscos, C; Alonso Blanco, M; Barrio Castellanos, R

    2014-01-01

    Radioiodine is an important therapeutic option in young patients with Grave's disease (GD). In the United States it is a widespread therapy, but in Europe its use in paediatrics is still controversial. To report our experience in radioiodine therapy of paediatric GD patients and analyse its effectiveness and safety. We retrospectively studied our paediatric population (<18 years of age) with GD, diagnosed from 1982 to 2012. A curative option was offered to patients who did not respond to anti-thyroid drug (AT) at puberty. We analysed, the patient characteristics, TSH, T4, T3 and thyroid antibodies levels, AT response, remission post I(131), side effects, and hypothyroidism rates. A total of 50 patients were diagnosed with GD from 1982 to 2012. All patients received AT as initial treatment (mean duration: 35.3±25.9 months). Permanent remission was achieved in 46%. Thyroidectomy was performed in 5 patients, and 14 patients received I(131) (mean dose: 10.9±1.09 mCi). Remission with I(131) was obtained in 100%. The rate of permanent hypothyroidism was 90%. There was no progression of ophthalmopathy or side effects in any patients treated with I(131.) Radioiodine treatment of paediatric GD patients is safe, leads to complete remission at the expense of hypothyroidism, and does not exacerbate ophthalmopathy. It can be considered in patients older than 5 years, who do no not respond to AT or with significant side effects with this medication. Copyright © 2012 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  6. Paisaje e imagen: formas y herencias en la construcción cultural del territorio agrario

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    Prada Llorente, Esther Isabel

    2013-12-01

    Full Text Available The history of rural areas gives rise, as a result of interaction between residents and the environment, to a dense network of permanencies, distributed along a scale ranging from the domestic to the territorial. This amounts to forms unfolding as landscape, both in terms of significant image and living heritage. Three municipalities in the Western Spanish Meseta are analyzed with the help of images, historical records and local enquiries. The cases selected show in different degrees the influence of land consolidation policies. The agrarian system, at the territorial, urban and architectonic scales, is scanned in search of the key elements of landscape character. Different tools are combined: direct questionnaires, archival research and a reflective form-interpretation by means of drawing, as well as advanced land mapping and photographing. The outcomes are a taxonomy of evolutive responses to land use, an array of detected landscape values and the determination of landscape character, leading to innovative proposals for rural land planning policy.La historia del espacio agrario, merced a la interacción entre pobladores y medio, genera una rica red de permanencias, en escalas que van de lo territorial a lo doméstico: un despliegue formal como paisaje, entendido como imagen significativa y patrimonio vivo. A través de la imagen, la documentación antigua y el estudio del territorio se analizan tres términos municipales del Occidente mesetario, Destriana, Escuadro y Brincones. Los casos elegidos muestran de forma diferenciada el influjo de la concentración parcelaria. El sistema agrario, en sus escalas territorial, urbana y arquitectónica, es escudriñado en busca de las claves del carácter paisajístico, mediante la encuesta oral, el registro documental, la interpretación reflexiva a través del dibujo, y las técnicas cartográficas y fotogramétricas avanzadas. La diversidad de respuestas evolutivas ante la gestión del medio, el

  7. REPOSIÇÃO VOLÊMICA EM CÃES PORTADORES DE SEPSE GRAVE: REVISÃO DE LITERATURA

    Directory of Open Access Journals (Sweden)

    Inajara Nakamura Hirota

    2013-06-01

    Full Text Available The water to be a vital component in all forms of life becomes an important tool in the therapy of various disorders. The use of volume replacement aims to restore losses and electrolyte homeostasis. When patients are under severe sepsis, a syndrome of emergency, there is the presence of hemodynamic instability leading to the picture of hypoperfusion and tissue hypoxia, which may progress to multiple organ dysfunction. However, a thorough physical examination associated with early diagnosis and the realization of fluid replacement therapy, may reduce the high mortality rate of these patients, which is a challenge for the veterinarian. Therefore, we attempted to perform an updated, highlighting key definitions, classifications, pathophysiology, clinical signs and causes of severe sepsis, emphasizing the need for therapy and fluid resuscitation protocols in this context, as well as the importance of monitoring patients' clinical.A água por ser um componente vital para todas as formas de vida torna-se uma ferramenta importante na terapia de várias afecções. A utilização da reposição volêmica visa restabelecer as perdas hidroeletrolíticas e a homeostase do organismo. Quando pacientes apresentam-se no quadro de sepse grave, uma síndrome complexa de caráter emergencial há a presença da instabilidade hemodinâmica levando ao quadro de hipoperfusão e hipóxia tecidual, podendo evoluir para a disfunção múltipla de órgãos. Contudo, um exame físico minucioso associado ao diagnóstico precoce e a realização da terapia de reposição volêmica, podem reduzir a alta taxa de mortalidade destes pacientes, sendo este um desafio para o médico veterinário. Com isso, buscou-se realizar uma atualização bibliográfica, destacando as principais definições, classificações, fisiopatogenia, sinais clínicos e causas de sepse grave, enfatizando a necessidade de terapia e protocolos de reposição volêmica neste contexto, bem como a import

  8. Efeito rebote dos fármacos modernos: evento adverso grave desconhecido pelos profissionais da saúde

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    Marcus Zulian Teixeira

    2013-12-01

    Full Text Available OBJETIVO: Apoiado no aforismo hipocrático primum non nocere, o princípio bioético da não maleficência roga que o ato médico cause o menor dano ou agravo à saúde do paciente, incumbindo ao médico avaliar os riscos de determinada terapêutica por meio do conhecimento dos possíveis eventos adversos das drogas. Dentre esses, o efeito rebote representa um efeito colateral comum a inúmeras classes de fármacos modernos, podendo causar transtornos graves e fatais nos pacientes. Esta revisão tem o objetivo de esclarecer os profissionais da saúde sobre os aspectos clínicos e epidemiológicos do fenômeno rebote. MÉTODOS: Uma revisão qualitativa, exploratória e bibliográfica foi realizada na base de dados PubMed utilizando os unitermos 'rebound', 'withdrawal', 'paradoxical', 'acetylsalicylic acid', 'anti-inflammatory', 'bronchodilator', 'antidepressant', 'statin', 'proton pump inhibitor' and 'bisphosphonate' RESULTADOS: O efeito rebote ocorre após a descontinuação de inúmeras classes de fármacos com ação contrária aos distúrbios da doença, exacerbando-os a níveis superiores aos anteriores do tratamento. Independente da doença,dadrogaedaduração do tratamento, o fenômeno se manifesta numa pequena proporção de indivíduos suscetíveis. No entanto, pode causar eventos adversos graves e fatais, devendo ser considerado um problema de saúde pública em vista do enorme consumo de fármacos pela população CONCLUSÃO: Reunindo um corpo de evidências crescente e inquestionável, o médico precisa ter conhecimento das consequências do efeito rebote e de como minimizá-lo, aumentando a segurança no manejo das drogas modernas. Por outro lado, este efeito rebote pode ser utilizado de forma curativa, ampliando o espectro da terapêutica moderna.

  9. Sustained long-term improvement with clozapine in schizophrenia Clozapina na esquizofrenia grave: melhora duradoura e sustentada

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    RICARDO DE OLIVEIRA-SOUZA

    1999-03-01

    Full Text Available The present paper reports the long-term use of clozapine in a prospective sample of 46 chronic schizophrenics. In six months, 21 subjects had been excluded for a number of reasons. In four of them the reasons for exclusion were related to lack of response or adverse effects. The median daily clozapine dose was 400 mg in the remaining 25 patients. As a whole, there were remarkable improvements in core dimensions of psychopathology, global cognitive status, and level of functioning. We confirmed that clozapine is effective in a subgroup of schizophrenics with the severest forms of the disease. If tolerated after the first few months it leads to progressive gains in several domains of behavior. Clozapine should be tried in every patient with schizophrenia in whom positive symptoms, disorganization, or bizarre behavior are a matter of incapacitation despite efforts to keep them under control with other drugs.O presente estudo, prospectivo, relata o uso de longo-prazo da clozapina em 46 esquizofrênicos graves, com mais de cinco anos de doença. Com seis meses de uso da droga, 21 indivíduos haviam sido excluídos por diversas razões. Em quatro, a exclusão se deveu a efeitos adversos ou ausência de resposta. A dose mediana de clozapina foi de 400 mg nos demais 25 pacientes. No todo, observamos melhora em dimensões de psicopatologia, estado cognitivo global, e nível funcional. Concluímos que a clozapina é eficaz em um subgrupo de esquizofrênicos com formas graves da doença. Se tolerada depois dos primeiros meses, produz benefícios progressivos em diversos domínios do comportamento. Clozapina deve ser tentada em todo paciente com esquizofrenia incapacitado por sintomas positivos, desorganização, e/ou comportamentos bizarros, que persistem a despeito de esforços para mantê-los sob controle com outras drogas.

  10. As formações em bolas argênticas do sistema nervoso simpático

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    José Fernandez

    1957-09-01

    Full Text Available Foram estudados, histològicamente, gânglios simpáticos provenientes de 40 pacientes portadores de enfermidades variadas e 40 gânglios tidos como normais, para pesquisar as formações cm bolas argênticas. As impregnações foram feitas pelos métodos de Cajal, Arteta, Castro, Gros, Bielschowsky e Agduhr. Foi verificado que a presença de bolas argênticas é mais constante nas doenças circulatórias periféricas; nestas afecções, foi verificada, também, a presença de um pigmento corável pelos tricrômios de Gomori e de Goldner e que, possìvelmente, tem o mesmo significado que os descritos por Fedorow 12 corados pelo vermelho neutro; tais pigmentos foram relacionados com as formações em bolas argênticas, levando em consideração os trabalhos experimentais dos autores da escola russa. A presença das formações em bolas argênticas, tanto nos casos normais como nos patológicos, é atribuída a uma hiperfunção, por excitação, do simpático, por serem mais numerosas nos casos de transtornos periféricos. Foi observado que os neurônios em íntimo contacto com as formações em bolas argênticas, apresentam sempre alterações que vão desde o grau mais leve (tumefação do soma celular, retificação dos prolongamentos, neurofibrilas mais fortemente impregnadas, até o mais grave (hiperplasia e hipertrofia dos dendritos, degeneração retrátil, degeneração pigmentar. Foi notado que as terminações das fibras pré-ganglionares e as próprias fibras apresentam, muitas vêzes, alterações (hipertrofia, sinuosidade e grande poder de impregnação; as bolas argênticas foram observadas tanto no final dos dendritos como no das fibras pré-ganglionares. Foram encontradas formações de bolas argênticas em rosário, concluindo-se que elas têm a mesma significação que as alterações claviformes. Conclui-se, finalmente, que as bolas argênticas são produtos patológicos.

  11. LA EXTENSIÓN DE LA SÍNTESIS EVOLUTIVA Y LOS ALCANCES SOBRE LA ENSEÑANZA DE LA TEORÍA DE LA EVOLUCIÓN (pag. 4-18

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    Guillermo Folgera

    2013-01-01

    Full Text Available Entre las décadas de 1930 y 1940 se generó el consenso que dio el origen a la denominada síntesis evolutiva. Este consenso presentaba un conjunto teórico de gran riqueza a la vez que se proponía como un programa de investigación para el estudio de la evolución de la vida. Sin embargo, en las últimas décadas algunos aspectos de este conjunto teórico fueron cuestionados, a la vez que otras áreas de investigación fueron incorporadas, dando lugar a una serie de complejos debates de orden diverso. Por otro lado, en relación con el ámbito educativo, existe un amplio acuerdo sobre la necesidad de que la enseñanza secundaria obligatoria garantice un sólido aprendizaje de los modelos y conceptos fundamentales de la biología evolutiva, al tiempo que se reconoce que los resultados, en términos de aprendizaje, son muy deficientes. En dicho contexto surge la cuestión de qué modelos de la biología evolutiva deberían servir como referencia para la enseñanza obligatoria. En este trabajo analizamos diferentes argumentaciones en relación con la inclusión o no de las últimas modificaciones teóricas en la enseñanza de la teoría de la evolución en algunos ámbitos educativos. Con este fin, en una primera instancia analizamos algunas de las principales modificaciones y propuestas teóricas que han tenido lugar en relación con la teoría de la evolución de las últimas décadas. Posteriormente, indagamos algunas de las argumentaciones sobre su posible inclusión en el ámbito educativo. Por último presentamos algunos apuntes finales que hacen más las veces de apertura que de una búsqueda de conclusiones.

  12. Comparative genetic structure in pines: evolutionary and conservation consequences Estructura genética comparada en pinos: consecuencias evolutivas y para la conservación

    Directory of Open Access Journals (Sweden)

    PATRICIA DELGADO

    2002-03-01

    historia evolutiva. Con estos antecedentes estudiamos comparativamente la estructura genética de pinos. La heterocigosis esperada es particularmente constante con límites de confianza al 99 % entre 0,19 y 0,23 en las especies que se han estudiado hasta ahora utilizando aloenzimas. Hay una proporción significativa de especies (9/41 que muestran estimados de diferenciación altos (Fst = o mayor que 0,15. De ellos cinco especies tienen semillas grandes y sin alas asociadas probablemente con bajas densidades, dispersión de semillas por aves y resistencia a sequía. Estas especies incluyen a los pinos piñoneros de Norteamérica. Las tasas de entrecruzamiento también son constantes entre especies tanto del subgénero Pinus como del subgénero Strobus que refleja probablemente un límite selectivo a la cantidad de alelos deletéreos que pueden ser mantenidos en las poblaciones y que afecta también el nivel de consanguinidad. También exploramos los datos publicados usando microsatélites en pinos, concluyendo que estos marcadores muestran una mayor cantidad de variación y diferenciación genética como es esperado y que los modelos de evolución molecular utilizados para derivar los estimadores de la estructura genética de la población deben de tomar en consideración otras fuentes de mutación (mutaciones puntuales, inserciones y deleciones de mayor tamaño y la existencia de duplicaciones para entender las aplicaciones que desde el punto de vista comparado se pueden hacer con este tipo de marcadores

  13. O PAPEL DAS MUDANÇAS CLIMÁTICAS DO QUATERNÁRIO SUPERIOR NA DINÂMICA EVOLUTIVA DE PALEOVALE DE SEGUNDA ORDEM (SUL DO BRASIL

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    Julio Cesar Paisani

    2013-12-01

    Full Text Available Este artigo traz resultados da aplicação simultânea das análises de isotópos do carbono do solo e de fitólitos na identificação de trocas de vegetação com inferências às mudanças climáticas do Quaternário tardio, associadas à dinâmica evolutiva de um dos paleovales das bacias de baixa ordem hierárquica da Superfície 2 do Planalto das Araucárias. A seção estratigráfica investigada se encontra entre os divisores de águas dos rios Iguaçú (PR e Uruguai (SC, em situação de inversão de relevo. O registro estratigráfico foi caracterizado utilizando-se dos critérios conjugados da lito-, pedo- e aloestratigrafia, cuja cronologia foi estabelecida pelo 14C (AMS. Os dados obtidos neste trabalho foram insuficientes para detectar a mudança climática do último interestádio (EIM 3 para o Último Máximo Glacial (EIM 2 globalmente atestada na literatura. Registrou-se apenas a continuidade da presença de Campo Cerrado entre 41.000 (45.582 a 44.133 anos cal. AP a 29.000 anos AP (34.249 a 33.243 anos cal. AP. O sistema geomorfológico manteve-se em equilíbrio dinâmico não alterando os processos erosivos de baixa energia nas encostas. Registra-se apenas mudança na dinâmica pedogenética de progressiva para regressiva em direção ao Último Máximo Glacial. Houve mudanças na dinâmica fluvial ao longo dos EIM 3 e 2 comandadas por eventos neotectônicos. As principais alterações no sistema geomorfológico ocorreram por conta da transição Pleistoceno/Holoceno (EIM 2/1 e durante o Holoceno. Na transição Pleistoceno/Holoceno a mudança na energia dos processos erosivos nas encostas, de baixa para alta foi abrupta, promovendo a colmatação do fundo de vale. A partir de então a área passa a apresentar morfologia de rampa de colúvios. Possivelmente entre Holocêno Inferior e Médio houve o estabelecimento de cobertura vegetal transicional de Campo Cerrado/FOM, indicando condições climáticas mais úmidas e quentes que o

  14. LOS NUEVOS PILARES DE LA TEORÍA EVOLUTIVA A LA LUZ DE LA GENÓMICA New Pillars of Evolutionary Theory in the Light of Genomics

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    CAMILO ERNESTO LÓPEZ CARRASCAL

    Full Text Available La teoría de evolución de Darwin se ha constituido en uno de los pilares fundamentales de la biología. Algunos supuestos de dicha teoría han sido complementados con las bases genéticas de la herencia dando origen a la teoría moderna o sintética de la evolución. En los últimos años se han logrado grandes avances en el área de secuenciación y análisis de genomas completos que han aportado elementos para debatir varios de los postulados darwinistas de la evolución. La demostración de procesos de duplicación de genes y de genomas completos, la transferencia horizontal de genes y la teoría endosimbiótica cuestionan la idea de cambio evolutivo como un proceso de acumulación de pequeños cambios a través del tiempo geológico. La evidencia de la selección neutral en el contexto genómico pone de manifiesto otros mecanismos de evolución, que no necesariamente van acompañados de un programa adaptacionista ni con la idea de progreso. En este artículo se presentan estos y otros conceptos adicionales tales como la regulación génica y los mecanismos moleculares del desarrollo y del ambiente como puntos de partida para el planteamiento de una teoría evolutiva incluyente y acorde a los conocimientos actuales.The evolutionist theory proposed by Darwin is one of the fundamental pillars in biology. Darwin’s theory was solidified with the Modern synthesis of evolutionary biology thanks to the rediscovery of Mendel’s work, which laid the genetic basis of heredity. In recent years, great progress has been acquired in the sequencing and analyses of complete genomes, which have provided several elements to discuss some Darwinists tenets of evolution. The evidence of gene duplication and whole-genome duplication, the horizontal gene transfer and the endosymbiosis process question the idea that evolution proceeds through the gradual accumulation of infinitesimally small random changes. The new evidence of neutral selection on the genomics

  15. Reflexiones en torno al estudio de las formas musicales

    OpenAIRE

    Balderrabano, Sergio

    2006-01-01

    Una primera aproximación a esta temática referida al estudio de las formas musicales nos puede remitir a la siguiente constatación general: cuando hablamos de forma hablamos de un conjunto de componentes y la interacción de dichos componentes entre ellos. La tarea de definir el concepto de forma musical en el campo de la música tonal ha sido realizada tanto por compositores como por teóricos. Dada la brevedad de este artículo, solamente citaremos a algunos de ellos a manera de una breve ejemp...

  16. Forma contemporánea de Esclavitud: Trata de Mujeres

    OpenAIRE

    Correa da Silva, Waldimeiry

    2011-01-01

    Se afirma que la Trata de seres humanos es una forma contemporánea de esclavitud, pero ¿por qué lo es? ¿Qué elementos la caracterizan como tal?, y por otra parte, si la TSH es una forma contemporánea de esclavitud, hemos de reconocer la existencia de un ... a práctica que ha sido objeto de prohibición, abolición, desde hace casi dos siglos: la esclavitud. Una práctica condenada por diversas normas internacionales, tanto a nivel universal como regional. Ante la innegable existencia de formas c...

  17. Long-term sequential monitoring of controlled graves representing common burial scenarios with ground penetrating radar: Years 2 and 3

    Science.gov (United States)

    Schultz, John J.; Walter, Brittany S.; Healy, Carrie

    2016-09-01

    Geophysical techniques such as ground-penetrating radar (GPR) have been successfully used for forensic searches to locate clandestine graves and physical evidence. However, additional controlled research is needed to fully understand the applicability of this technology when searching for clandestine graves in various environments, soil types, and for longer periods of time post-burial. The purpose of this study was to determine the applicability of GPR for detecting controlled graves in a Spodosol representing multiple burial scenarios for Years 2 and 3 of a three-year monitoring period. Objectives included determining how different burial scenarios are factors in producing a distinctive anomalous response; determining how different GPR imagery options (2D reflection profiles and horizontal time slices) can provide increased visibility of the burials; and comparing GPR imagery between 500 MHz and 250 MHz dominant frequency antennae. The research site contained a grid with eight graves representing common forensic burial scenarios in a Spodosol, a common soil type of Florida, with six graves containing a pig carcass (Sus scrofa). Burial scenarios with grave items (a deep grave with a layer of rocks over the carcass and a carcass wrapped in a tarpaulin) produced a more distinctive response with clearer target reflections over the duration of the monitoring period compared to naked carcasses. Months with increased precipitation were also found to produce clearer target reflections than drier months, particularly during Year 3 when many grave scenarios that were not previously visible became visible after increased seasonal rainfall. Overall, the 250 MHz dominant frequency antenna imagery was more favorable than the 500 MHz. While detection of a simulated grave may be difficult to detect over time, long term detection of a grave in a Spodosol may be possible if the disturbed spodic horizon is detected. Furthermore, while grave visibility increased with the 2D

  18. Reviews: Diccionario de nuevas formas de lectura y escritura

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    Enrico Bocciolesi

    2013-12-01

    Full Text Available Review of Martos Núñez Eloy & Campos Fernández-Fígares Mar (eds, Diccionario de nuevas formas de lectura y escritura. Madrid: Red Internacional de Universidades Lectoras-Santillana.

  19. Estudos da formação de planetas terrestres

    OpenAIRE

    Costa, André Izidoro Ferreira da [UNESP

    2013-01-01

    O estudo da formação de planetas terrestres no Sistema Solar, é crucial para compre- endermos como outros sistemas planetários formam e também inferir as condições que poderiam ter influenciado a origem e evolução de vida na Terra. Esta Tese de douto- rado apresenta um estudo numérico da formação de planetas terrestres. Nosso objetivo principal é analisar o último estágio da formação desses planetas no Sistema Solar, em particular, a formação de Marte e a origem da água da Terra. Esses dois p...

  20. Caracterização e dinâmica evolutiva de retrovírus endógenos da família K (ERV-K) em genomas de primatas.

    OpenAIRE

    Camila Malta Romano

    2009-01-01

    Retrovírus endógenos (ERVs) são vírus que infectaram células germinativas e proliferaram no genoma do hospedeiro. A família K está integrada apenas no genoma de primatas do Velho Mundo. Os ERVs promovem alterações estruturais nos genomas hospedeiros, sendo fundamentais para a sua evolução. Esse trabalho teve como objetivo realizar uma investigação da distribuição e dinâmica evolutiva de ERV-K nos diferentes hospedeiros. Foram identificados 58 ERV-K em humanos, 38 em chimpanzés, 35 em orangota...

  1. Morbidade Materna Grave e Near Misses em Hospital de Referência Regional

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    Márcia Lait Morse

    Full Text Available OBJETIVO: Analisar perfil epidemiológico da morbidade materna grave/near miss em uma maternidade pública de referência regional, utilizando diferentes critérios identificadores. MÉTODOS: Trata-se de um estudo descritivo de corte transversal dos casos de morbidade materna grave/near miss realizado em Hospital de referência regional entre junho e outubro de 2009, identificados a partir dos livros de registro de internação da maternidade e análise dos prontuários clínicos. Foram estudadas mulheres que, durante a gestação, parto ou puerpério, apresentaram qualquer quadro clínico compatível com os critérios definidores de morbidade materna grave/near miss de Waterstone et al., Mantel et al. e Organização Mundial de Saúde. RESULTADOS: Entre as 1.544 internações foram identificadas 89 mulheres com morbidade materna grave, considerando os critérios adotados. As razões de morbidade materna grave/near miss variaram entre 81,4 a 9,4 por 1.000 NV, dependendo do critério utilizado. O índice de Mortalidade foi de 3,2%, chegando a 23% no critério da OMS. Das 89 mulheres, apenas 40% fizeram mais de seis consultas de pré-natal e 10% não realizaram qualquer consulta. Os marcadores mais encontrados foram a pré-eclâmpsia grave seguida de hemorragia grave, internação em UTI, Síndrome HELLP e eclâmpsia. Ocorreram três mortes maternas por causas obstétricas com RMM de 280/100.000 NV e uma morte tardia. O critério da OMS se mostrou mais específico, identificando os casos mais graves, enquanto o de Waterstone foi mais sensível. CONCLUSÃO: O estudo da morbidade materna grave/near miss em um hospital de referência regional pode contribuir para o conhecimento da magnitude deste evento, como também identificar suas características e condições clínicas mais frequentes, sendo extremamente importante para o enfrentamento da morbi-mortalidade materna.

  2. Professional training Formação profissional

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    Vera Lúcia Lemos Basto Echenique

    1990-08-01

    Full Text Available This paper presents a disucssion about the professional training of qualified human resources and the role of the university in this kind of preparation considering the present developement reality.O testo apresenta uma discussão sobre a formação profissional, o preparo de mão-de-obra qualificada e o papel da universidade frente a essa formação, considerando a realidade desenvolvida atual.

  3. Induction of animal model of Graves' disease in BALB/c mice

    Institute of Scientific and Technical Information of China (English)

    Zhu-fang Tian; Bing-yin Shi; Xiao-yan Wu; Li Xu

    2009-01-01

    Objective To construct an animal model of Graves' disease (GD) by immunizing BALB/c mice with hM12 cells co-expressing major histocompatibility complex (MHC) class Ⅱ molecules and human thyrotropin receptor (TSHR) molecules. Methods BALB/c mice in experimental group (H-2d) were immunized with hM12 cells Intraper-itoncally every 2 weeks for six times, while mice in control group were immunized with M12 cells. Five weeks later, the thyroids were histologically examined, and serum samples were tested for thyroid-stimulating antibodies (TSAb) and thyroid hormone levels. Results One BALB/c mouse in experimental group developed Graves'-like disease. Total T4 and T3 levels in this mouse were above the upper limit of normal, TSAb activity was displayed in its serum. The thyroid histologically showed the features of thyroid hyperactivity including thyrocyte hypercellularity and colloid absorption.None of control mice developed Graves'-like disease. Conclusion An animal model with some characteristics of human Graves' disease was successfully induced and the model will facilitate studies aimed directly at understanding the patho-genesis of autoimmunity in Graves' disease.

  4. Severe gangrene by cold agglutinemia Gangrena grave causada por crioaglutinina

    Directory of Open Access Journals (Sweden)

    Perla Vicari

    2004-03-01

    crioaglutininemia deve ser confirmada e tratada prontamente em função da risco de possíveis complicações graves.

  5. Formas cocoides de Helicobacter pylori: viables o degenerativas

    Directory of Open Access Journals (Sweden)

    Felipe Cava

    2003-06-01

    Full Text Available De los trabajos presentados acerca de las formas cocoides de Helicobacter pylori se deduce una controversia mucho mayor que la resultante del mero estudio clínico de este microorganismo. Parece claro que existe una conversión tanto in vivo como in vitro de las formas espirales a las formas cocoides inducida por varios motivos, como cultivos prolongados, estrés físico y químico, y agentes antimicrobianos. En esta revisión repasamos los puntos de vista que han dividido a investigadores de esta área en dos grupos bien definidos: Los que consideran a estas formas cocoides como un producto no viable de degeneración celular y los que piensan que estas formas son estructuras viables,durmientes o de resistencia frente a condiciones ambientales adversas. Esta discrepancia conlleva a que interrogantes sobre la relación entre la transmisión de la enfermedad y estas formas cocoides permanezcan sin respuesta todavía.

  6. Is the evolutionary theory still useful?: A review with examples ¿Es todavía útil la teoría evolutiva?: Una revisión con ejemplos

    Directory of Open Access Journals (Sweden)

    ROBERTO F NESPOLO

    2010-12-01

    Full Text Available Evolutionary biology is experiencing an exceptional process of revisión and outreach because of the 200-anniversary if the birth of Charles Darwin. As a consequence, the study of organic evolution and also its teaching are being discussed at several levels, by evolutionary biologists, biologists and scholars outside evolutionary biology and by the general public. In this scenario, a didactic explanation of how biologists address evolutionary research in real populations seems to be useful. Using actual research examples, here I tried to outline how the classic theory (termed here as the "basic scheme" is useful to answer relevant questions in biology and how a less dogmatic paradigm (or a more versatile one would be needed when dealing with the most recent and extravagant cases of gene, genotype, phenotype and environment interactions. Specifically, I used three in-extenso examples of research driven by hypothesis-testing: (1 the changes in genetic architecture induced by sexuality in a cyclically parthenogenetic insect; (2 the test of the energetic definition of fitness through phenotypic selection studies; and (3 the assessment of the underlying causes of character displacement in Darwin finches. In the former two cases, it is argued that the basic scheme is useful and sufficient for testing relevant evolutionary hypotheses. In the third case, it is argued that something else is needed to explain the observed genetic variation that Geospiza species exhibit in Daphne major island (Galapagos. Finally, I outline some "extravagant" cases biological entities interacting, such as horizontal gene transfer, epigenetic inheritance, adaptive anticipatory conditioning, evolutionary capacitance and niche construction. This "post-modern" biology has been seriously proposed and demonstrated to be widespread in nature, which would justify an extended evolutionary synthesis.La biología evolutiva está experimentando un inédito proceso de revisión y difusi

  7. Image and Role of the Queen Mother of the West in Han Grave Art

    Directory of Open Access Journals (Sweden)

    Nataša VAMPELJ SUHADOLNIK

    2015-12-01

    Full Text Available The present article is a detailed study of the image of an ancient Chinese goddess, The Queen Mother of the West, called Xiwangmu 西王母 in Chinese. In the mythological tradition, Xiwangmu is a goddess who possesses the elixir of immortality and dwells in the western paradise, on the magic mountain Kunlun 崑崙. While her image can be found in mural paintings, and on lacquered objects and bronze mirrors, it appears primarily in the form of relief images on the stones and bricks of grave chambers and temples in the Han (206 BCE–220 CE grave complexes. The literary tradition reveals a multifunctional role of the mother, with her many attributes developing in accordance with the changing values of social and mythological concepts. The article concludes with a detailed discussion of her image and role within the wider cosmological context of Han grave art.

  8. Heterotopic relation between media and materiality in children's online memorials and on children's graves

    DEFF Research Database (Denmark)

    Sandvik, Kjetil; Christensen, Dorthe Refslund

    place across media. We show how the death of an infant can lead to mediation, remediation and mediatization strategies which involves both the uses and arrangement of objects on memorial pages and on children’s graves as well as uses of new social technologies, that produce, negotiate and develop social......In this paper we analyze how bereaved parents make use of various media-strategies on online memorial sites and on children’s graves when performing processes of grief and commemoration for their stillborns and infants, and how these processes are not just linked to one particular media but take...... relations with the dead child and the (re)negotiating of parenthood. We understand media as a function of an object reflected in human practices and embedded and structured by the different materialities they are intertwined with. We argue that the use of media and materiality online and on the graves are...

  9. Pollen studies of textile from an Iron Age grave at Hammerum, Denmark

    DEFF Research Database (Denmark)

    Enevold, Renée

    2013-01-01

    was rewarded with a set of results which permitted detailed interpretation. Large amounts of pollen of crops and associated anthropogenic plants in the textile sample suggest that agricultural work was the primary source of the pollen embedded in the clothing. In contrast, the pollen assemblages from......This article presents the methods employed and the results obtained in pollen studies of a prehistoric grave, identifying a fascinating and productive context for pollen analyses: prehistoric textiles. The methods involved direct sampling from the grave during excavation and various measures aimed...... at minimizing the risk of contamination, thereby maximising the information gained about various aspects of contemporary prehistoric life. The example used was an Iron Age grave from Hammerum, Denmark which was found to contain very well preserved clothing. The clothing and surrounding sediment were block...

  10. Mortality in Graves' orbitopathy is increased and influenced by gender, age and pre-existing morbidity

    DEFF Research Database (Denmark)

    Schwensen, Charlotte F; Hjelm Brandt Kristensen, Frans; Hegedüs, Laszlo

    2017-01-01

     = 3965) between 1995 and 2012 were matched for age and gender with four control subjects. Median follow-up time was 7.9 years (range 0-17.5). Mortality risk in GO patients compared to the control population and compared to GD patients was calculated using Cox regression analyses, adjusting for pre......INTRODUCTION: It is unclear whether the excess mortality associated with Graves' disease differs between individuals with Graves' orbitopathy (GO) or without (GD). SUBJECTS AND METHODS: A nationwide, register-based cohort study in which all adult Danes diagnosed with GD (n = 28 461) and GO (n......-existing morbidity using the Charlson score. RESULTS: Adjusted mortality in Graves' disease overall (GD + GO) was significantly increased compared to that in the background population (HR = 1.18 (95% confidence interval: 1.15-1.21)). In GD and GO separately, adjusted mortality was also significantly higher than...

  11. Reacciones adversas graves y mortales a los antimicrobianos. Sistema Cubano de Farmacovigilancia, 2003-2012

    Directory of Open Access Journals (Sweden)

    Ismary Alfonso Orta

    Full Text Available Introducción: las reacciones adversas a los antimicrobianos ocasionan más de 142 000 visitas a las salas de urgencias hospitalarias por año en los Estados Unidos. En Cuba han ocupado el primer lugar en el reporte, por ejemplo, en el año 2008 representaron el 31,4 % del total de las reacciones adversas graves y el 25 % de las reacciones adversas mortales. Objetivo: caracterizar las reacciones adversas graves y mortales a los antimicrobianos notificadas a la Unidad Nacional Coordinadora de Farmacovigilancia, durante el periodo 2003-2012. Métodos: se realizó un estudio de farmacovigilancia, observacional, descriptivo y transversal, utilizando la base de datos nacional de farmacovigilancia durante el periodo 2003-2012. Se trabajó con el total de reportes de reacciones adversas graves y mortales a los antimicrobianos. Las reacciones adversas se clasificaron según tipo de reacción, sistema de órgano afectado, imputabilidad y frecuencia. Se identificaron los principales antimicrobianos sospechosos y se estudiaron los pacientes que presentaron reacciones adversas según sexo y edad. Resultados: se detectaron 631 sospechas de reacciones adversas graves y mortales a los antimicrobianos, de ellas fueron 550 graves y 81 mortales. Predominaron el sexo femenino con 60,1 % y 405 adultos. Las reacciones adversas comprometieron los sistemas: general (30,4 %, respiratorio (25,2 % y cardiovascular (14,9 %. El shock anafiláctico fue la reacción más reportada y la penicilina el fármaco más relacionado con esta. El 73,5 % fueron probables y el 58,9 % ocasionales. Conclusiones: las reacciones adversas graves y mortales predominaron en el sexo femenino y en los adultos. La penicilina fue el fármaco más relacionado. Las reacciones adversas probables y ocasionales fueron la mayoría en el estudio.

  12. Mediastinal neoplasms in patients with Graves disease: a possible link between sustained hyperthyroidism and thymic neoplasia?

    Directory of Open Access Journals (Sweden)

    Boyd Jonathan D

    2012-07-01

    Full Text Available Abstract Background Anterior mediastinal masses are a rare but well documented finding in Graves disease. The vast majority of these lesions represents benign thymic hypertrophy and regress after treatment of the hyperthyroidism. A small percentage of these cases however represent neoplastic/malignant diseases which require further treatment. Cases 12 year old boy with one year history of refractory Graves disease was found to have an anterior mediastinal mass and underwent curative thyroidectomy for sustained hyperthyroidism. Cervical lymphadenopathy was detected during the procedure and biopsy was obtained. A 23 year old woman who presented with a one month history of hyperthyroid symptoms, was diagnosed with Graves disease and also was found to have an anterior mediastinal mass on imaging. Biopsy of the anterior mediastinal mass was obtained and subsequently the patient underwent robotic thymectomy. Histologic examination and immunophenotyping of the cervical lymph node in a 12 year old boy revealed neoplastic proliferation of T lymphoblasts diagnostic of T lymphoblastic leukemia/lymphoma. Examination of the anterior mediastinal mass biopsy in the 23 year old woman revealed type B1 thymoma which was confirmed after examination of the subsequent robotic thymectomy specimen. Conclusion This is the first reported case of T cell lymphoblastic lymphoma and the third reported case of thymoma associated with sustained hyperthyroidism due to Graves disease. These cases indicate that an anterior mediastinal mass in a patient with active Graves disease may be due to a neoplastic cause, which may require definitive treatment. Caution should be exercised when dismissing a mediastinal mass as benign thymic hyperplasia in patients with active Graves disease.

  13. Doença de Graves associada à artrite idiopática juvenil Graves' disease associated with juvenile idiopathic arthritis

    Directory of Open Access Journals (Sweden)

    Vanessa de Matos Santos Mendonça Marques

    2011-04-01

    Full Text Available Os autores relatam o caso de uma menina de 10 anos de idade com diagnóstico de doença de Graves (DG, em tratamento com propiltiouracil, que desenvolveu uveíte e artrite poliarticular e cuja mãe também tem DG e lúpus discoide. São discutidos os diagnósticos diferenciais de artrite inflamatória que surge em uma criança com doença tireoidiana autoimune medicada com drogas antitireóideas.The authors report the case of a 10-year-old girl with Graves' disease (GD, treated with propylthiouracil, who developed uveitis and polyarticular arthritis, and whose mother also had GD and discoid lupus. The differential diagnosis of inflammatory arthritis that appears in a child with autoimmune thyroid disease managed with antithyroid drugs is discussed.

  14. [Treatment of hyperthyroidism due to Graves' disease: what is the recommended antithyroid drug during pregnancy?].

    Science.gov (United States)

    Caron, P

    2013-05-01

    Clinical hyperthyroidism during the first trimester of pregnancy due to Graves' disease can be associated with maternal, obstetrical and fetal complications, indicating an active treatment to restore normal thyroid function. Antithyroid drugs are the first line treatment in pregnant women with hyperthyroidism. Due to the increased congenital malformations reported in neonates after first-trimester carbimazole/methimazole treatment and propylthiouracil associated hepatotoxicity, the recommended treatment for pregnant women with hyperthyroid Graves' disease is propylthiouracil during the first trimester of pregnancy and following the first trimester, consideration should be given switching to carbimazole/methimazole during the second part of gestation.

  15. Cuidados intensivos en peritonitis grave: análisis de 9 años

    OpenAIRE

    Avilés Cruz, Pura

    1990-01-01

    Se realizó un estudio perspectivo de los cuidados intensivos en los en los enfermos de peritonitis grave, ingresados en el Hospital V. I. Lenin desde enero de 1980 a septiembre de 1988. Se estudiaron 446 pacientes, con los siguientes objetivos: comportamiento de la peritonitis grave, los criterios de reintervención en aquellos pacientes en que persistía la sepsis intraabdominal y las experiencias con la técnica de abdomen abierto. La evolución fue satisfactoria en el 63, 63%, y no satisfac...

  16. Patogenia y tratamiento médico de la orbitopatía de graves

    OpenAIRE

    Soledad Hidalgo, V.

    2010-01-01

    La Orbitopatía de Graves se presenta clínicamente en aproximadamente 50% de los casos de Enfermedad de Graves. La mayoría de las veces es leve y sólo en menos del 5% pone en riesgo la visión, pese a lo cual deteriora significativamente la calidad de vida de los pacientes. Hasta el momento no se conoce totalmente la patogenia, siendo posiblemente el receptor de TSH el blanco de la autoinmunidad. En cuanto al tratamiento, las medidas preventivas como lograr el eutiroidismo y la suspensión de...

  17. Epidemiología del traumatismo torácico grave

    OpenAIRE

    Cordero Lorenzana, María Lourdes

    2016-01-01

    [Resumen] Objetivo: Características del traumatismo torácico grave en UCI. Mortalidad. Material y método: Análisis descriptivo retrospectivo, univariado y regresión de 100 variables en 1174 pacientes con traumatismo torácico grave (1993-2010). Resultados: Más varones (4:1) de 43,5±18,9 años. 96,5% de traumatismos torácicos cerrados y 89% asociado. Lesiones óseas frecuentes: fracturas costales (71,2%) y claviculares (17,9%). Otras: contusión pulmonar (44%), hemotórax (41,7...

  18. Postpartum thyrotoxicosis in a patient with Graves' disease. Association with low radioactive iodine uptake

    Energy Technology Data Exchange (ETDEWEB)

    Eckel, R.H.; Green, W.L.

    1980-04-11

    A patient with previously diagnosed Graves' hyperthyroidism had a transient episode of thyrotoxicosis three months postpartum. This was associated with a diffusely enlarged thyroid gland, a rise in antithyroid microsomal antibody titer, a 24-hour radioactive iodine uptake (RAIU) of 1%, and an aspiration biopsy specimen suggestive of chronic lymphocytic thyroiditis. An alternative cause for the depressed RAIU was not discovered. This case would suggest that patients with previously diagnosed Graves' disease can have thyrotoxicosis without an enhanced RAIU and that the postpartum thyrotoxin syndrome may involve an immunologic injury causing a release of performed thyroid hormone.

  19. Management of hyperthyroidism due to Graves' disease: frequently asked questions and answers (if any).

    Science.gov (United States)

    Bartalena, L; Chiovato, L; Vitti, P

    2016-10-01

    Graves' disease is the most common cause of hyperthyroidism in iodine-replete areas. Although progress has been made in our understanding of the pathogenesis of the disease, no treatment targeting pathogenic mechanisms of the disease is presently available. Therapies for Graves' hyperthyroidism are largely imperfect because they are bound to either a high rate of relapsing hyperthyroidism (antithyroid drugs) or lifelong hypothyroidism (radioiodine treatment or thyroidectomy). Aim of the present article is to offer a practical guidance to the reader by providing evidence-based answers to frequently asked questions in clinical practice.

  20. Variación morfológica de la lagartija partenogenética Aspidoscelis rodecki (Squamata: Teiidae: implicaciones evolutivas y de conservación

    Directory of Open Access Journals (Sweden)

    Sandra P Elizalde-Rocha

    2008-12-01

    Full Text Available La divergencia post-formación se ha utilizado para el reconocimiento de nuevas especies partenogenéticas. Actualmente, la lagartija partenogenética Aspidoscelis rodecki McCoy y Maslin 1962 es reconocida como una sola especie, que se originó de un híbrido partenogenético. Estudios previos han encontrado divergencia genética, en coloración y en características de historia de vida entre una población continental (Puerto Juárez y una insular (Isla Contoy en Quintana Roo, México. Se llevó a cabo un análisis merístico para evaluar la divergencia entre ambas poblaciones de A. rodecki. Se utilizaron 38 individuos de Puerto Juárez y 23 individuos de Isla Contoy. Se usaron nueve características merísticas y se realizaron análisis univariados (t de Student y multivariados (análisis de componentes principales y análisis de variación canónica. De acuerdo a ambos análisis, Puerto Juárez es merísticamente distinguible de Isla Contoy. Ambas poblaciones difieren en cinco características merísticas y presentaron un alto porcentaje de clasificación en el análisis de variación canónica: 97% para Puerto Juárez y 100% para Isla Contoy. Una pequeña muestra de Isla Mujeres y un solo individuo de Punta Sam (continente pueden representar otros grupos morfológicos. Con base en los patrones de variación fenotípica, A. rodecki es considerada como una sola especie partenogenética variable y prioritaria para la conservación. Debido a que cada población contiene una porción única de la variación de A. rodecki, Puerto Juárez e Isla Contoy merecen un manejo separado y se sugiere que cada una constituya una "Unidad Evolutiva Significativa" (ESU.Morphologic variation of the parthenogenetic lizard Aspidoscelis rodecki (Squamata: Teiidae: evolutionary and conservation implications. Post-formational divergence has been used for the recognition of new parthenogenetic species. Currently, the parthenogenetic lizard Aspidoscelis rodecki Mc

  1. ¿Hay diferencias entre la violencia grave y la violencia menos grave contra la pareja?: un análisis comparativo

    Directory of Open Access Journals (Sweden)

    Enrique Echeburúa

    2008-01-01

    Full Text Available En este estudio ex post facto se lleva a cabo una descripción de las características presentadas por 1.081 casos denunciados por violencia contra la mujer en las comisarías de la Ertzaintza del País Vasco. En primer lugar, se presentan las variables psicológicas y sociodemográficas del agresor y de la víctima, así como de la relación de pareja. Y en segundo lugar, se determinan las diferencias más significativas entre la violencia grave y la violencia menos grave en relación con esas mismas variables. Los resultados ponen de manifiesto que tanto los agresores como las víctimas tienden a ser jóvenes, con una sobrerrepresentación de agresores y víctimas extranjeros inmigrantes. En el caso de los maltratadores graves, tienden a ser celosos o posesivos, a sentirse humillados por la ruptura de la pareja, lo que redunda directamente en un descenso de su autoestima y a consumir abusivamente alcohol o drogas. Por lo que se refiere a las víctimas de la violencia grave, se suelen sentir con frecuencia en peligro de muerte y están más fácilmente en circunstancias de vulnerabilidad, como una edad muy joven, una personalidad muy dependiente, una situación de enfermedad crónica o de dependencia económica, un consumo de drogas o un entorno de soledad. Se comentan las implicaciones de este estudio para la investigación y para la práctica clínica.

  2. The Roma: People without a Home or Grave

    Directory of Open Access Journals (Sweden)

    Vera Klopčič

    2010-12-01

    Full Text Available Although the Roma have been living in Europe for centuries, they still face rejection by majority populations, being treated as undesirable strangers in almost all European countries. Written evidence of their arrival can be traced back to the fourteenth and fifteenth centuries. There are many legends and myths about their origins and reasons for emigrating from their country of origin. Until recently, the Roma transmitted their own history only as oral tradition. One of the best-known contemporary Roma intellectuals, journalist and writer Rajko Djurić, picturesquely explains the importance of the Romany language for further exploration of Roma culture and their origin: “Romany is the only book they brought from India; it constitutes their collective memory and reflects the views of this people, to themselves, to the world, and to other peoples. Their language is an inventory of the material and spiritual culture to which they once belonged, and contains elements of culture of other peoples that they came into contact with during their long and yet insufficiently studied journey.” When the Roma arrived in Europe, their lifestyle differed significantly from that of other European peoples. As a result, majorities and other groups in Europe intervened in their lives for centuries. They were forced to abandon their nomadic way of life. In the past, authorities often expelled them from their territory and they did not enjoy legal protection when violence or crimes were committed against them. Living in isolated settlements, excluded from social life, segregated, and discriminated against by others, they lived on the margins as a people without a home or a grave. At the same time, they established their parallel world as a system of social norms valid within their community, and within it all non-Roma were perceived as gadje ‘outsiders’. Roma legends explain the reasons for their nomadic way of life: they contain stories of persecution and

  3. 78 FR 31570 - Prospective Grant of a Start-Up Exclusive Patent License Agreement: Treatment of Graves' Disease...

    Science.gov (United States)

    2013-05-24

    ... a Start-Up Exclusive Patent License Agreement: Treatment of Graves' Disease, Hyperthyroidism and...' Disease, hyperthyroidism and thyroid cancer. DATES: Only written comments or applications for a license... useful in treating hyperthyroidism and Graves' disease, an autoimmune disease that is commonly...

  4. Symmetric increased skeletal muscular uptake of F-18 fluoro-deoxyglucose: A clue for the diagnosis of Graves' disease.

    Science.gov (United States)

    Santhosh, Sampath; Mittal, Bhagwant Rai; Kashyap, Raghava; Bhattacharya, Anish; Singh, Baljinder

    2011-07-01

    F-18 fluoro-deoxyglucose (FDG) uptake in the thyroid and thymus is well reported in patients with Graves' disease. Incidental skeletal muscle uptake has also been reported in other non-musculoskeletal (benign and malignant) pathologies. We report a patient of Graves' disease showing symmetrical skeletal muscle uptake but no thyroidal or thymus uptake of FDG.

  5. Esquistossomose pulmonar. II. Forma crônica reativada com hipertensão e Cor pulmonale

    Directory of Open Access Journals (Sweden)

    Jayme Neves

    1980-12-01

    Full Text Available Os Autores descrevem um caso grave de esquistossomose mansoni (forma hepática com hipertensão portal associada a forma pulmonar com hipertensão pulmonar e cor pulmonalej sobre o qual evoluiu uma sindrome toxi-infectuosa grave e de longa duração. Sucessivos exames radiológicos do tórax revelaram acometimento predominantemente arteriolar, ao lado de uma micronodulação pulmonar grosseira e difusa em ambos os hemitóraces e configuração de coração pulmonar. A histopatologia de material de biópsia pulmonar identificou basicamente uma arterite pulmonar característica, inflamação granulomatosa atípica provocada principalmente por vermes e raros ovos de S. mansoni envolvidos por escassa reação inflamatória. Para explicar a origem de constelação clínica toxi-infectuosa, foram afastadas as hipóteses de associação da esquistossomose a concausas infectuosas ou não, mas de curso febril, e a superposição de uma forma toxêmica sobre outra crônica pré-existente. Com base em dados clínicos, particularmente em subsídios da laparoscopia, e anatômicos, concluiu-se tratar o caso de uma forma crônica de esquistossomose reativada, provavelmente em virtude de alterações imunológicas inusitadas do hospedeiro. Ao que tudo parece indicar, o desvio de ovos e de vermes aos pulmões deveu-se à sindrome de hipertensão portal, cujos shunts entre a circulação portal e sistêmica determinaram a rota preferencial da migração.The Authors relate a case ofsevere schistosomiasis mansoni (hepatic form, with portal hypertension, associated with pulmonary form, with pulmonary hypertension and cor pulmonale, o ver which develloped a severe toxi-infectious syndrome of long duration. Serial chest X-rays showed that the arteriolae were predominantly affected, besides a gross and difuse pulmonary micronodulation in both hemithoraces, and pulmonary heart configuration. Histopathology of the pulmonary biopsy material identified basically a

  6. Anxiety and depression are more prevalent in patients with graves' disease than in patients with nodular goitre

    DEFF Research Database (Denmark)

    Bové, Kira Bang; Watt, Torquil; Vogel, Asmus

    2014-01-01

    ' disease compared to patients with another chronic thyroid disease, nodular goitre, and to investigate determinants of anxiety and depression in Graves' disease.METHODS: 157 cross-sectionally sampled patients with Graves' disease, 17 newly diagnosed, 140 treated, and 251 controls with nodular goitre......' disease versus 4% in nodular goitre (p = 0.038), anxiety was 18 versus 13% (p = 0.131). Symptoms of anxiety (p = 0.04) and depression (p = 0.01) increased with comorbidity. Anxiety symptoms increased with duration of Graves' disease (p = 0.04). Neither thyroid function nor autoantibody levels were...... associated with anxiety and depression symptoms.CONCLUSIONS: Anxiety and depression symptoms were more severe in Graves' disease than in nodular goitre. Symptoms were positively correlated to comorbidity and duration of Graves' disease but neither to thyroid function nor thyroid autoimmunity....

  7. De formas, formatos y fórmulas

    OpenAIRE

    Molina Mesa, María Verónica

    2011-01-01

    El propósito de este trabajo fue buscar, a través de la estética desde una estética expandida, las resonancias entre las formas en sentido abstracto de lo jurídico con las formas urbanas y arquitectónicas desde el punto de vista iconográfico, a su vez inspiradas en el lenguaje geométrico y cosmológico. Haciendo uso de la analogía, de los rasgos semejantes entre diferentes órdenes, se encuentra que hay modulaciones hacia cierto tipo de forma clásica, tanto en el espacio como en la construcción...

  8. Aspectos gerais da formação de professores

    Directory of Open Access Journals (Sweden)

    Edson do Carmo Inforsato

    1996-08-01

    Full Text Available Este artigo, ancorado em estudos recentes e antigos, mostra o afastamento dos cursos de formação de professores em relação aos elementos que compõem a prática profissional docente. Favorável a uma aproximação efetiva com o contexto das práticas de sala de aula, o autor defende a idéia de uma formação de professores atrelada aos problemas e necessidades da prática docente no ensino formal de 1º e 2º graus.

  9. Corticosteroides no tratamento da miastenia grave. Estudo de 12 casos com revisão da literatura Corticosteroids in the management of myasthenia gravis

    Directory of Open Access Journals (Sweden)

    José Lamartine de Assis

    1975-03-01

    Full Text Available Foram estudados os resultados do tratamento da miastenia grave em 12 pacientes, sendo 10 com a forma generalizada severa, um com a forma generalizada moderada e um com miastenia acentuada associada a polimiosite. Sete pacientes foram previamente timectomizados e somente um apresentava timoma. Todos estavam em uso de doses elevadas de drogas anticolinesterásicas com resposta terapêutica pobre ou nula. Um paciente foi tratado com dexametaxona, outro com dexametazona seguida de prednisona e os restantes com prednisona, sempre em doses altas inicialmente (100 mg por dia ou em dias alternados e com redução gradativa ulterior até doses de manutenção. Os corticosteróides foram administrados sempre pela via oral, por períodos que variaram de duas semanas até dois anos e meio. Em conclusão, 75% de 12 pacientes com miastenia grave generalizada foram influenciados favoravelmente com este método terapêutico. Deste grupo apenas um apresentava timoma e não respondeu a qualquer tratamento. Outro paciente apresentava polimiosite associada e teve excelente resposta terapêutica. Dois miastênicos sem timoma tiveram a sintomatologia exacerbada durante o tratamento. Nenhum efeito colateral importante foi observado, mesmo nos pacientes tratados a longo prazo.The results of treatment of myasthenia gravis in 12 patients are reported. There were 10 cases with severe generalized form and two cases with moderate generalized form, one of which associated with polymyositis. Seven patients had prior thymectomy and one of them had a thymoma. All the patients were receiving anticholinesterase drugs with poor response or without any response. One patient received a short, intensive course of dexametazone, and other patient used prednisone after a more prolonged dexametazone course. The remaining patients received prednisone, always beginning with high (100 mg alternate day oral single-doses. This therapy has been maintained for a period thought to be sufficient

  10. A Danish Early Germanic Iron Age Grave with Tablet Woven Cuffs

    DEFF Research Database (Denmark)

    Mannering, Ulla; Knudsen, Lise Ræder

    2007-01-01

    This article presents exciting new textile information from a Danish Early Germanic Iron Age grave at Broedbaek, North West Jutland, where tiny little fragments of textiles were found on metal clasps and brooches. Some of the textiles appeared to be made in a so far unknown tablet weaving technique....

  11. Outcome of inferior and superior rectus recession in Graves' orbitopathy patients

    NARCIS (Netherlands)

    Jellema, Hinke Marijke; Saeed, Peerooz; Groenveld, Linda; Kloos, Roel; Mourits, Maarten P

    2015-01-01

    PURPOSE: To evaluate the surgical effect of unilateral inferior rectus recession (IR-group) with or without a recession of contralateral superior rectus (IR-SR-group) on squint angle and motility restrictions in Graves' Orbitopathy (GO) patients. DESIGN: Retrospective case series. MATERIALS AND METH

  12. Graves' disease during immune reconstitution in HIV-infected patients treated with HAART.

    NARCIS (Netherlands)

    Vos, F.J.; Pieters, G.F.F.M.; Keuter, M.; Ven, A.J.A.M. van der

    2006-01-01

    Autoimmune phenomena after immune recovery due to HAART are not frequently described. Recently we found 3 patients with Graves' disease after starting HAART, outnumbering the expected incidence; 13 patients have been reported in the literature up to the present time.A probable relation between

  13. Characterization of Regulatory B Cells in Graves' Disease and Hashimoto's Thyroiditis

    DEFF Research Database (Denmark)

    Kristensen, Birte; Hegedüs, Laszlo; Lundy, Steven K

    2015-01-01

    A hallmark of regulatory B cells is IL-10 production, hence their designation as IL-10+ B cells. Little is known about the ability of self-antigens to induce IL-10+ B cells in Graves' disease (GD), Hashimoto's thyroiditis (HT), or other autoimmune disease. Here we pulsed purified B cells from 12 HT...

  14. Incidence of vitiligo in children with Graves' disease and Hashimoto's thyroiditis

    Directory of Open Access Journals (Sweden)

    Prindaville Brea

    2011-11-01

    Full Text Available Abstract Background Limited data are available on the association between vitiligo and autoimmune thyroid disease in pediatric patients. In addition, reported studies of pediatric patients have been based on a population known to have vitiligo and subsequently evaluated for the presence of thyroid function abnormalities. Methods A retrospective chart review was performed on 333 children who had been followed for thyroid disorders by endocrinologists at the Yale Pediatric Thyroid Center over the last 5 years for autoimmune thyroid disease. Demographical and clinical features of patients found to have thyroid disease and vitiligo were recorded. These studies were approved by the Yale Human Investigation Committee. Results Of the total 333 children and adolescents, 9 (2.7% were noted to have vitiligo. Four patients (44% had Graves' disease and 5 patients (66% had Hashimoto's thyroiditis. For patients with Graves' disease and vitiligo, the average age of onset of thyroid disease was young at 4 ± 0.7 years, and the diagnosis of vitiligo usually preceded that of thyroid disease. For children with Hashimoto's thyroiditis and vitiligo, thyroid disease was diagnosed at an average age of 13.25 ± 2.8 years. Conclusion In our population, 4.6% of children with Graves' disease and 2.0% of children with Hashimoto's thyroiditis had vitiligo. Interestingly, when vitiligo presents with Graves' disease, it occurs in younger rather than older children.

  15. Graves, Ancestors and Cement in Land disputes in Acholi and Ikland, Uganda

    DEFF Research Database (Denmark)

    Meinert, Lotte; Willerslev, Rane; Seebach, Sophie Hooge

    2017-01-01

    The paper explores the roles of graves, ancestors and concrete pillars in disputes over land across different land-systems, -conflicts, and territory making in northern Uganda by comparing extended cases between Acholi in Gulu district and Ik in Kaabong district . In the post-conflict Acholi region...

  16. T-cell prolymphocytic leukaemia (T-PLL): a rare disease with a grave prognosis.

    Science.gov (United States)

    Vivekanandarajah, Abhirami; Atallah, Jean Paul; Gupta, Shilpi

    2013-05-02

    T-cell prolymphocytic leukaemia (T-PLL) is an extremely uncommon haematological malignancy that has an aggressive course and a grave prognosis. We describe a patient who presented with lymphocytosis, scalp erythema, ascites and splenomegaly and was diagnosed with T-PLL. He was treated with alemtuzumab with a good response and was referred for allogeneic stem cell transplantation.

  17. Subclinical Hypothyroidism after 131I-Treatment of Graves' Disease: A Risk Factor for Depression?

    Directory of Open Access Journals (Sweden)

    Jing Yu

    Full Text Available Although it is well accepted that there is a close relationship between hypothyroidism and depression, previous studies provided inconsistent or even opposite results in whether subclinical hypothyroidism (SCH increased the risk of depression. One possible reason is that the etiology of SCH in these studies was not clearly distinguished. We therefore investigated the relationship between SCH resulting from 131I treatment of Graves' disease and depression.The incidence of depression among 95 patients with SCH and 121 euthyroid patients following 131I treatment of Graves' disease was studied. The risk factors of depression were determined with multivariate logistic regression analysis. Thyroid hormone replacement therapy was performed in patients with thyroid-stimulating hormone (TSH levels exceeding 10 mIU/L.Patients with SCH had significantly higher Hamilton Depression Scale scores, serum TSH and thyroid peroxidase antibody (TPOAb levels compared with euthyroid patients. Multivariate logistic regression analysis revealed SCH, Graves' eye syndrome and high serum TPO antibody level as risk factors for depression. L-thyroxine treatment is beneficial for SCH patients with serum TSH levels exceeding 10 mIU/L.The results of the present study demonstrated that SCH is prevalent among 131I treated Graves' patients. SCH might increase the risk of developing depression. L-thyroxine replacement therapy helps to resolve depressive disorders in SCH patients with TSH > 10mIU/L. These data provide insight into the relationship between SCH and depression.

  18. A randomized controlled trial of orbital radiotherapy versus sham irradiation in patients with mild Graves' ophthalmopathy

    NARCIS (Netherlands)

    Prummel, MF; Terwee, CB; Gerding, MN; Baldeschi, L; Mourits, MP; Blank, L; Dekker, FW; Wiersinga, WM

    2004-01-01

    Radiotherapy is often used in Graves' ophthalmopathy, but its efficacy has been doubted. We compared its efficacy with sham irradiation in mild ophthalmopathy. In a double-blind randomized trial, 44 patients received orbital irradiation, and 44 were sham-irradiated. The primary outcome was assessed

  19. 78 FR 16295 - Native American Graves Protection and Repatriation Review Committee: Meeting

    Science.gov (United States)

    2013-03-14

    ... National Park Service Native American Graves Protection and Repatriation Review Committee: Meeting AGENCY... the Federal Advisory Committee Act, 5 U.S.C. Appendix (1988), of a meeting of the Native American... the Federal Advisory Committee Act, 5 U.S.C. Appendix (1988), of a meeting of the Native...

  20. 77 FR 74874 - Native American Graves Protection and Repatriation Review Committee: Meeting

    Science.gov (United States)

    2012-12-18

    ... National Park Service Native American Graves Protection and Repatriation Review Committee: Meeting AGENCY... Federal Advisory Committee Act, 5 U.S.C. Appendix (1988), of a telephonic meeting of the Native American... Advisory Committee Act, 5 U.S.C. Appendix (1988), of a telephonic meeting of the Native American...

  1. A refined study of FCRL genes from a genome-wide association study for Graves' disease

    National Research Council Canada - National Science Library

    Zhao, Shuang-Xia; Liu, Wei; Zhan, Ming; Song, Zhi-Yi; Yang, Shao-Ying; Xue, Li-Qiong; Pan, Chun-Ming; Gu, Zhao-Hui; Liu, Bing-Li; Wang, Hai-Ning; Liang, Liming; Liang, Jun; Zhang, Xiao-Mei; Yuan, Guo-Yue; Li, Chang-Gui; Chen, Ming-Dao; Chen, Jia-Lun; Gao, Guan-Qi; Song, Huai-Dong

    2013-01-01

    To pinpoint the exact location of the etiological variant/s present at 1q21.1 harboring FCRL1-5 and CD5L genes, we carried out a refined association study in the entire FCRL region in 1,536 patients with Graves' disease (GD...

  2. Too early to dismiss Yersinia enterocolitica infection in the aetiology of Graves' disease

    DEFF Research Database (Denmark)

    Brix, Thomas H; Hansen, Pia S; Hegedüs, Laszlo

    2008-01-01

    BACKGROUND: Yersinia enterocolitica (YE) infection has long been implicated in the pathogenesis of Graves' disease (GD). The association between YE and GD could, however, also be due to common genetic or environmental factors affecting the development of both YE infection and GD. This potential...

  3. Miastenia grave induzida por D-penicilamina em paciente com esclerose sistêmica progressiva

    Directory of Open Access Journals (Sweden)

    Paulo E. Marchiori

    1984-12-01

    Full Text Available Relato de caso de miastenia grave induzida por D-penicilamina. São descutidos os possíveis mecanismos etiopatogênicos envolvidos no desencadeamento da doença e é salientada a presença de anticorpo anti-receptor de acetilcolina e hiperplasia tímica na DPA-MG.

  4. Educational Interventions Targeted at Minors in Situations of Grave Social Vulnerability and Their Families

    Science.gov (United States)

    de la Caba Collado, Mariangeles; Rojas, Isabel Bartau

    2010-01-01

    The aim of this article is to outline and assess an educational intervention programme targeted at improving the skills of families and the personal and social development of children living in situations of grave social vulnerability. The sample comprised 10 families during the first phase of the intervention and six during the second. The…

  5. Eyelid retraction, lid lag, lagophthalmos, and von Graefe's sign quantifying the eyelid features of Graves' ophthalmopathy.

    Science.gov (United States)

    Gaddipati, Ramakrishna V; Meyer, Dale R

    2008-06-01

    To report the frequency and relationship of eyelid retraction, lid lag, lagophthalmos, and von Graefe's sign in a group of patients with Graves' ophthalmopathy and compare these findings to those in a group of normal individuals. Retrospective comparative cohort study. Fifty consecutive Graves' ophthalmopathy patients were compared to a control group of 50 normal individuals. Measurements were made of eyelid position in primary gaze and downgaze to assess eyelid retraction and lid lag, and the presence of lagophthalmos and von Graefe's sign was noted when present. Eyelid position in primary gaze and downgaze and presence of lagophthalmos and von Graefe's sign. In the Graves' group, eyelid retraction (38%), von Graefe's sign (36%) and lagophthalmos (16%) were observed at a significantly greater frequency (P<0.01) than in normals, whereas true eyelid lag was observed in only 8% (P = 0.67). The terms lid lag and von Graefe's sign have been used interchangeably in the past; however, they are distinct signs of downgaze-related upper eyelid static position and dynamic movement, respectively. Although von Graefe's sign was commonly exibited in Graves' patients, the relatively low frequency of lid lag suggests that factors other than restriction/fibrosis are likely responsible for the etiology of eyelid retraction in many cases.

  6. /sup 131/I-therapy of Graves' disease and non-immunogenic thyrotoxicosis

    Energy Technology Data Exchange (ETDEWEB)

    Hoeschel, M.; Heinze, H.G.

    1984-06-01

    From 1977 to 1982, 315 patients suffering from thyrotoxicosis with diffuse and/or nodular goitre or Graves' disease were treated with /sup 131/I. In 246 patients, the results of treatment after 7 months to 5 1/2 years could be evaluated. After a single treatment with /sup 131/I, 72% of the patients with hyperthyroid nodular goitre and 61% of those with diffuse goitre, but only 36% of the patients with Graves' disease showed normal thyroid function. By repeated /sup 131/I treatments - as many as 5 for those with Graves' disease - normal thyroid function could be achieved in nearly all patients examined. Patients with immune thyrotoxicosis, type Graves' disease, showed a high resistance to therapy. A dependence was found between the results of these treatments and previous antithyroidal drug therapy or surgery. The rate of hypothyroidism varied between 4 and 15%. The highest rate of hypothyroidism was observed in operated patients with persistent or recurring thyrotoxicosis.

  7. Reporte de cinco casos de malaria neonatal grave por Plasmodium vivax en Urabá, Colombia

    Directory of Open Access Journals (Sweden)

    Juan Gabriel Piñeros

    2008-12-01

    Conclusión. Se trata de un reporte de cinco casos de malaria neonatal grave por P. vivax, especie que habitualmente no se relaciona con complicaciones, sin que existiera en ningún caso la sospecha clínica y con tratamiento inadecuado.

  8. B lymphocyte depletion with the monoclonal antibody rituximab in Graves' disease: a controlled pilot study

    DEFF Research Database (Denmark)

    El Fassi, Daniel; Nielsen, Claus H; Bonnema, Steen J

    2007-01-01

    Graves' disease (GD) is a common TSH receptor autoantibody (TRAb)-mediated disorder. Because B lymphocytes are important self-antigen presenting cells and precursors for antibody-secreting plasma cells, temporary B-lymphocyte depletion with the monoclonal antibody rituximab (RTX) might be of bene...

  9. Educational Interventions Targeted at Minors in Situations of Grave Social Vulnerability and Their Families

    Science.gov (United States)

    de la Caba Collado, Mariangeles; Rojas, Isabel Bartau

    2010-01-01

    The aim of this article is to outline and assess an educational intervention programme targeted at improving the skills of families and the personal and social development of children living in situations of grave social vulnerability. The sample comprised 10 families during the first phase of the intervention and six during the second. The…

  10. Neurocisticercose: formas clínicas pouco frequentes. II - formas do ângulo pontocerebelar

    Directory of Open Access Journals (Sweden)

    Horácio M. Canelas

    1962-06-01

    Full Text Available A localização de cisticercos no recesso lateral da cisterna pontina poderá levar à constituição de uma síndrome do ângulo pontocerebelar, simulando eventualmente um neurinoma do acústico. São revistos os casos dessa forma clínica de neurocisticercose descritos na literatura. O problema do diagnóstico diferencial com os tumores (neurinomas do acústico é discutido sob os pontos de vista clínico e radiológico. Os autores apresentam 7 casos de cisticercose do ângulo pontocerebelar. O diagnóstico etiológico foi estabelecido pela positividade da reação de fixação do complemento para cisticercose no liqüido cefalorraqueano em 5 casos e, em 2, pela cirurgia e/ou necropsia. Em todos os pacientes havia sintomas de lesão coclear, bilaterais em 2; lesão vestibular foi comprovada em 4 casos. Em 6 pacientes ocorreram sinais indicativos de lesão unilateral do nervo trigêmeo. Comprometimento do nervo facial foi observado em 4 casos. Existia faringoplegia em 3 casos e estrabismo interno em 2. Em 3 casos não foram observados sinais cerebelares, o que faria com que o diagnóstico propendesse para o de tumor do acústico, não fôssem outras características clínicas e subsidiárias. A síndrome de hipertensão intracraniana era nítida em 5 pacientes. Convulsões ocorreram em 2 casos. A propósito do resultado dos exames radiológicos, os autores salientam que, num dos casos, foi verificada amputação da ponta do rochedo ipsolateral à síndrome do ângulo pontocerebelar; outros comemorativos do caso levaram, porém, a rejeitar a hipótese de tumor (neurinoma do acústico, tendo a cirurgia comprovado o acêrto do diagnóstico clínico.

  11. Fadiga na forma remitente recorrente da esclerose múltipla Fatigue in multiple sclerosis relapsing-remitting form

    Directory of Open Access Journals (Sweden)

    MARIA FERNANDA MENDES

    2000-06-01

    Full Text Available Foram avaliados 95 pacientes com forma remitente-recorrente da esclerose múltipla quanto à presença de fadiga. A Escala de Severidade de Fadiga foi aplicada em todos os pacientes. Em 64 pacientes (67,4% a fadiga foi encontrada. Não observamos diferenças clínicas quanto ao gênero, idade, grau de incapacidade funcional e depressão, nos pacientes com e sem fadiga. Foi encontrada correlação entre ansiedade e tempo de doença com a presença de fadiga. Ao analisarmos estas variáveis quanto à intensidade da fadiga, observamos haver associação entre fadiga grave e maior incapacidade funcional.In 95 patients with the remitting-relapsing form of multiple sclerosis we investigated fatigue. All of them were evaluated with the Fatigue Severity Scale and we found it in 64 patients (67.4%. Gender, age, depression and fuctional incapacity was not predictive of fatigue occurrence, while anxiety and time of disease seems to be correlated with it. When we analysed the fatigue severity, a correlation between the EDSS and the increasing fatigue severity was found.

  12. Tratamento cirúrgico da laringomalácia grave: estudo retrospectivo de 11 casos

    Directory of Open Access Journals (Sweden)

    José Antonio Pinto

    2013-10-01

    Full Text Available A laringomalácia é a anomalia congênita da laringe mais frequente, sendo responsável por cerca de 60% a 75% dos casos de estridor congênito. Apesar de seu curso benigno e autolimitado, 10% dos casos necessitam de intervenção. Atualmente, as supraglotoplastias são consideradas o tratamento padrão da laringomalácia grave. OBJETIVO: Descrever a experiência adquirida pelos autores no tratamento cirúrgico dos pacientes com laringomalácia grave. Metodologia: Estudo retrospectivo. MÉTODO: Os prontuários de 11 casos consecutivos de laringomalácia grave, submetidos ao tratamento cirúrgico entre 2003 e 2012, foram analisados quanto à idade, gênero, sintomas, doenças associadas, técnica cirúrgica adotada, tempo de extubação, complicações cirúrgicas, tempo de internação e evolução clínica. RESULTADOS: Dos 11 casos de laringomalácia grave, seis pacientes (54,5% foram operados com o uso do laser de CO2 e em cinco pacientes (45,5% foram realizadas a técnica a frio. Apenas um paciente (9,1% necessitou reabordagem cirúrgica. Não foram observados casos de complicações cirúrgicas. Todos os pacientes apresentaram melhora clínica importante. CONCLUSÃO: A supraglotoplastia mostrou-se um procedimento eficaz e seguro no tratamento da laringomalácia grave.

  13. The thickness of the retrobulbar portion of the optic nerve in Graves ophthalmopathy measured by ultrasound

    Directory of Open Access Journals (Sweden)

    Stefanović Ivan

    2009-01-01

    Full Text Available Introduction. The clinical diagnostic of Graves ophthalmopathy is based on the association of ocular signs and the disease of the thyroid gland. The evolution of the disease involves the development of eye globe protrusion, extraocular muscle thickening pressuring the optic nerve, which can result in its thickness. Objective. The aim of the paper is to find whether the retrobulbar optic nerve thickened and if there was a correlation between its possible thickening and the thickness of the muscles in Graves ophthalmopathy. We also wished to test the theory of compressive aetiology of such thickening using a 30-degree test. Methods. We examined 28 patients with Graves ophthalmopathy. The thickness of the retrobulbar optic nerve was measured by ultrasound on a B-scan using the Schraeder's method and by the largest thickness of the internal muscle. Results. The thickness of the retrobulbar portion of the optic nerve in the 52 analyzed eyes with signs of the disease ranged between 3.24 mm to 6.30 mm, with median of 5.13 mm, indicating that the majority of the patients had optic nerve thickening rating at this value. Forty-eight eyes had a marked retrobulbar optic nerve thickening, with the thickening over 4 mm, while in 4 eyes with signs of Graves ophthalmopathy the thickness of the optic nerve was within normal limits. We detected that 92.3% of the patients with muscular thickening also had a directly proportional thickening of the retrobulbar optic nerve. By using the 30-degree test we confirmed the diagnosis of compressive neuropathy. Conclusion. Patients with Graves ophthalmopathy and thickened muscles, also have a thickening of the retrobulbar optic nerve; the rate of the thickness directly depends on the degree of the muscular thickness. The word is of compressive neuropathy, i.e. the thickness of the optic nerve is the result of subarachnoid fluid stasis caused by the compression on the optic nerve.

  14. A Pro-Forma approach to Car-Carrier Design

    CSIR Research Space (South Africa)

    Benade, R

    2016-11-01

    Full Text Available In this work a pro-forma approach is developed for assessing truck and centre-axle tag-trailer or 50/50 car-carrier designs in terms of their compliance with the South African Performance-Based Standards (PBS) pilot project requirements. First...

  15. Formação inovadora em Terapia Ocupacional

    Directory of Open Access Journals (Sweden)

    Patrícia Carla de Souza Della Barba

    2012-09-01

    Full Text Available As instituições de Ensino Superior enfrentam o desafio de implementarem propostas pedagógicas traduzidas no desempenho satisfatório do estudante para uma formação de qualidade. Ainda, as políticas públicas ressaltam a necessidade de mudança na formação de profissionais de saúde voltada para as necessidades da população. Descreve-se a construção do projeto pedagógico do curso de Terapia Ocupacional (TO da Universidade Federal de São Carlos, no qual se propõe a formação reflexiva, levando o formando a interagir com o conhecimento de forma autônoma, flexível e criativa. O currículo é integrado, interdisciplinar e orientado por competência, no qual a prática profissional é fundamentada em capacidades voltadas para o enfrentamento de situações em diferentes contextos. A concepção pedagógica adotada é a socioconstrutivista, e são utilizadas metodologias ativas de ensino-aprendizagem, tais como a aprendizagem baseada em problemas e problematização.

  16. 19 CFR 122.74 - Incomplete (pro forma) manifest.

    Science.gov (United States)

    2010-04-01

    ... 19 Customs Duties 1 2010-04-01 2010-04-01 false Incomplete (pro forma) manifest. 122.74 Section 122.74 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT...; Electronic Manifest Requirements for Passengers, Crew Members, and Non-Crew Members Onboard...

  17. Effector profiles distinguish formae speciales of Fusarium oxysporum.

    Science.gov (United States)

    van Dam, Peter; Fokkens, Like; Schmidt, Sarah M; Linmans, Jasper H J; Kistler, H Corby; Ma, Li-Jun; Rep, Martijn

    2016-11-01

    Formae speciales (ff.spp.) of the fungus Fusarium oxysporum are often polyphyletic within the species complex, making it impossible to identify them on the basis of conserved genes. However, sequences that determine host-specific pathogenicity may be expected to be similar between strains within the same forma specialis. Whole genome sequencing was performed on strains from five different ff.spp. (cucumerinum, niveum, melonis, radicis-cucumerinum and lycopersici). In each genome, genes for putative effectors were identified based on small size, secretion signal, and vicinity to a "miniature impala" transposable element. The candidate effector genes of all genomes were collected and the presence/absence patterns in each individual genome were clustered. Members of the same forma specialis turned out to group together, with cucurbit-infecting strains forming a supercluster separate from other ff.spp. Moreover, strains from different clonal lineages within the same forma specialis harbour identical effector gene sequences, supporting horizontal transfer of genetic material. These data offer new insight into the genetic basis of host specificity in the F. oxysporum species complex and show that (putative) effectors can be used to predict host specificity in F. oxysporum. © 2016 Society for Applied Microbiology and John Wiley & Sons Ltd.

  18. Affordance, Learning Opportunities, and the Lesson Plan Pro Forma

    Science.gov (United States)

    Anderson, Jason

    2015-01-01

    This article argues that the most commonly used lesson plan pro formas in language teacher education are inappropriately premised on an outcomes-based approach to teaching, one that is in conflict with what we know about how languages are learnt and how experienced teachers teach. It proposes an alternative, affordance-based approach to lesson…

  19. Affordance, Learning Opportunities, and the Lesson Plan Pro Forma

    Science.gov (United States)

    Anderson, Jason

    2015-01-01

    This article argues that the most commonly used lesson plan pro formas in language teacher education are inappropriately premised on an outcomes-based approach to teaching, one that is in conflict with what we know about how languages are learnt and how experienced teachers teach. It proposes an alternative, affordance-based approach to lesson…

  20. Forma central da moléstia nervosa de Recklinghausen

    Directory of Open Access Journals (Sweden)

    L. C. Mattosinho França

    1958-06-01

    Full Text Available Os autores apresentam uma sistematização das lesões que podem ser encontradas na moléstia de Recklinghausen. Foram observados 4 casos de forma nervosa central da moléstia. Em todos existiam tumores bilaterais nos ângulos pontocerebelares, constituindo uma das manifestações mais importantes da doença, sendo mesmo a única em um dos casos (forma central pura. Nos demais, portadores de formas mistas, além de outras lesões centrais (neurofibromas, meningeomas, ninhos de células atípicas, havia lesões periféricas discretas. Tumores intrarraquidianos originados nas bainhas radiculares foram os causadores da sintomatologia inicial em 3 pacientes. Em dois casos em que o córtex foi examinado histológicamente, foram encontrados ninhos de células gliais atípicas, característicos da forma central da neurofibromatose. Duas lesões relativamente raras foram encontradas no segundo caso: angioma cortical e neurite intersticial hipertrófica do plexo braquial. Em pacientes portadores de neurofibromatose periférica ou raquídea, como também em seus familiares, devem ser sempre procuradas lesões centrais, principalmente tumores do nervo acústico. O exame neuro-radiológico de escolha para confirmar o diagnóstico dêstes tumores é a iodoventriculografia.

  1. Tratamento das formas severas de miastenia pelo ACTH por via intravenosa

    Directory of Open Access Journals (Sweden)

    José Lamartine de Assis

    1960-12-01

    caso 2, por exemplo, somente na terceira série de ACTH, foi conseguida remissão da sintomatologia acentuada para leve. Dos 10 casos relatados neste trabalho, em 6 houve agravação dos sintomas miastênicos nos primeiros 10 dias de tratamento. O autor considera o ACTH, utilizado por via intravenosa, como importante contribuição na terapêutica da miastenia grave, sendo especialmente indicado nas formas severas que não regridem mediante o emprego dos medicamentos anticolinesterásicos habitualmente usados.

  2. Inserção social e habitação: um caminho para a avaliação da situação de moradia de portadores de transtorno mental grave no Brasil

    Directory of Open Access Journals (Sweden)

    Juarez Pereira Furtado

    2010-06-01

    Full Text Available No que concerne às suas necessidades de moradias, os portadores de transtorno mental grave no Brasil possuem duas perspectivas: os Serviços Residenciais Terapêuticos (SRTs ou formas alternativas, como o apoio de familiares e/ou da rede de saúde mental do SUS, sobretudo os Centros de Atenção Psicossocial (Caps. Parece fundamental avaliar como os portadores de sofrimento mental grave constituem suas habitações (habitus e inserção social nessas experiências, a partir dos elementos estruturais da moradia (abrigo, privacidade, segurança e conforto e de suporte (rede social e de serviços, bem como o acompanhamento ofertado pelos serviços, em um contexto de desinstitucionalização. Para isso, são discutidos pressupostos, categorias de análise e possíveis contribuições de um método de investigação avaliativa qualitativa e interdisciplinar, elaborado por pesquisadores de distintas áreas do saber (antropologia, arquitetura, psicanálise e saúde coletiva, de modo a propiciar uma aproximação mais sistemática acerca dessa importante temática.

  3. Derrame isquêmico como a primeira manifestação de hipertrabeculação/não-compactação ventricular grave Ischemic stroke as the first manifestation of severe ventricular hypertrabeculation/non-compaction

    OpenAIRE

    Arturo Jaramillo; Alfredo Ramírez; Lorna Galleguillos; José Vallejos; Sergio Illanes

    2010-01-01

    Um raro defeito congênito do miocárdio, conhecido como hipertrabeculação/não-compactação do ventrículo esquerdo (HTVE/NCVE) tem sido ocasionalmente descrito em associação com a formação de trombos com um potencial risco embólico sistêmico, mas sua associação com derrames isquêmicos permanece controversa. Reportamos o caso de um derrame isquêmico em paciente com grave (HTVE/NCVE) e disfunção ventricular como uma possível associação sinérgica etiológica. Na ausência de outras fontes embólicas, ...

  4. Nascer é envelhecer: uma perspetiva demográfica evolutiva e territorial na construção do futuro de Portugal

    Directory of Open Access Journals (Sweden)

    Teresa Marques

    2016-12-01

    Full Text Available A evolução da população é atualmente considerada como um dos principais desafios dos países europeus. Esta análise retrata uma visão temporal e geográfica da demografia, de forma a refletirmos os desafios ancorados no tempo e no território. Portugal sempre superou as tendências demográficas ao longo da sua história, as mudanças em termos reprodutivos e os efeitos das migrações (internas e externas. A nível local o que mais explica a situação demográfica não é a dinâmica natural, mas a mobilidade, e isso será ainda mais evidente nos próximos anos. O país superou as altas taxas de mortalidade e os ciclos de vida ficaram mais longos, aumentou a eficiência produtiva e passou a necessitar de menos nascimentos para obter o mesmo stock populacional, teve de suportar os impactos da emigração e agora necessita de apostar na atratividade se pretender manter a sua dimensão populacional.

  5. La normalización científica del amor. A propósito de la perspectiva evolutiva en psicología

    Directory of Open Access Journals (Sweden)

    Adriana García Andrade

    2011-05-01

    Full Text Available En este escrito asumimos que la ciencia, tal y como Foucault lo propone, es un discurso capaz de normalizar, que sin embargo puede ser deconstruido. Lo que se plantea aquí sigue esa dirección: es posible des-normalizar el discurso sin apelar a una crítica normativa y utilizando los mismos elementos de la ciencia. En ese sentido, asumimos que la ciencia no es un discurso monolítico sino compuesto por diversas formas de observación –que podemos catalogar como disciplinas. En este artículo se presentan una serie de indicadores de delimitación disciplinar y de supuestos subyacentes a la misma que permiten mostrar lo que se ha dejado fuera y que no es visible en la presentación científica; en suma, lo que se excluye para poder establecer normalidad. Todo esto lo mostraremos utilizando el caso de una vertiente de la psicología que estudia las relaciones amorosas y la elección de pareja.

  6. Modelo de Negócio: Uma Abordagem Evolutiva no Setor de SVA sob a Ótica do Método Canvas.

    Directory of Open Access Journals (Sweden)

    Fábio Luiz Zandoval Bonazzi

    2015-11-01

    Full Text Available Este estudo objetivou analisar e descrever o modelo de negócios da empresa Movile e sua forma de criação e captura de valor. Trata-se de uma pesquisa qualitativa com foco empírico, baseada em um estudo de caso único realizado por meio de entrevista, análise documental e observações indiretas da empresa. O estudo permitiu analisar a concepção do modelo de negócio atual da empresa com base em todo em seu processo evolutivo delineado pelas alterações vivenciadas pelo segmento de serviço de valor agregado – SVA na última década, além de inferir sobre sua participação na cadeia de valor no setor de telecomunicações e descrever as nove dimensões de seu modelo de acordo com o Business Model Canvas – BMC (OSTERWALDER E PIGNEUR, 2010. Como contribuição teórica destaca-se a aproximação de antigos autores como Penrose (2006 e Chandler Jr. (2000 com o tema modelo de negócio, bem como o dinamismo que os mesmos puderam fornecer à ferramenta CANVAS, essencialmente caracterizada como um método estático, a partir da discussão do processo evolutivo organizacional.

  7. La normalización científica del amor. A propósito de la perspectiva evolutiva en psicología

    Directory of Open Access Journals (Sweden)

    Roberta Priscila Cedillo

    2011-08-01

    Full Text Available En este escrito asumimos que la ciencia, tal y como Foucault lo propone, es un discurso capaz de normalizar, que sin embargo puede ser deconstruido. Lo que se plantea aquí sigue esa dirección: es posible des-normalizar el discurso sin apelar a una crítica normativa y utilizando los mismos elementos de la ciencia. En ese sentido, asumimos que la ciencia no es un discurso monolítico sino compuesto por diversas formas de observación –que podemos catalogar como disciplinas. En este artículo se presentan una serie de indicadores de delimitación disciplinar y de supuestos subyacentes a la misma que permiten mostrar lo que se ha dejado fuera y que no es visible en la presentación científica; en suma, lo que se excluye para poder establecer normalidad. Todo esto lo mostraremos utilizando el caso de una vertiente de la psicología que estudia las relaciones amorosas y la elección de pareja.

  8. Infección odontogénica grave: Posibles factores predictores

    Directory of Open Access Journals (Sweden)

    Oscar García-Roco Pérez

    2003-04-01

    Full Text Available Se analizaron factores que pudieran predisponer a una infección odontogénica grave que requiera cuidados intensivos. Se realizó un estudio observacional descriptivo a 100 pacientes ingresados consecutivamente con infección odontogénica severa en el Hospital "Manuel Ascunce Domenech" de Camagüey desde 1999 al 2001. A partir de las historias clínicas se estudiaron diferentes variables que incluyeron parámetros médicos, sociales y procedimientos dentales previos. Se prestó particular atención al resultado de los cultivos bacterianos. La edad media de los 59 pacientes masculinos y 41 femeninos fue de 41 ± 15,8 años; 18 pacientes requirieron cuidados intensivos. El 41 % de los pacientes era de bajo nivel de escolaridad; 11 pacientes graves (61,1 % y 42 no graves (51,2 % eran fumadores. Dos pacientes (11,1 % de los graves y 8 (9,8 % de los no graves referían consumo excesivo de bebidas alcohólicas. La prevalencia de enfermedades crónicas fue mayor entre los no graves (31,7 %. La afección subyacente más común fue la osteítis periapical (70 % de los episodios infecciosos, seguido por la extracción dental en el 27,5 % de los graves y 10,9 % de los no graves. Ninguno de estos factores predijo la necesidad de cuidados intensivos. No existieron diferencias significativas en cuanto a síntomas, demora en solicitar atención médica, procedimientos dentales previos o terapéutica antimicrobiana. Predominaron los estreptococos aerobios (grupo S. milleri asociados con bacterias anaerobias variadas. No se encontraron variables sociales o clínicas predictoras de un curso grave en infecciones odontogénicas. Todos los pacientes deben ser cuidadosamente monitoreados para evitar complicaciones severas.Those factors that may predispose to a severe odontogenic infection requiring intensive care were analyzed. An observational descriptive study was conducted among 100 patients that were consecutively admitted with severe odontogenic infection at

  9. Formação continuada: a importância da formação docente

    Directory of Open Access Journals (Sweden)

    Maria Helena Biazi

    2011-12-01

    Full Text Available A formação continuada de professores é uma temática importante e necessária, haja vista os desafios que se apresentam à escola e aos educadores. As instituições e os educadores têm uma imensa tarefa no que se refere aos imperativos desafios advindos da rápida evolução da ciência e das tecnologias. Desafios estes que exigem de nós, educadores, flexibilidade e abertura para novas relações que necessitam ser engendradas no contexto educacional. A pesquisa foi realizada no Colégio Alternativo, e verificamos junto aos professores quais são as expectativas dos professores com referência à Formação Continuada e se a mesma contribui com o desenvolvimento, colaborando com a teoria e prática em sala de aula. Desta forma, a pesquisa justifica-se, pois é necessário que a escola acompanhe como se dá o processo de formação continuada na escola e se posteriormente, se estes saberes são construídos com os alunos em sala de aula. Dentre os autores estudados, citaremos Francisco Imbernón, Antonio Nóvoa e Paulo Freire. Durante a realização da escrita, optamos por fazer uma abordagem teórica e prática entrelaçada à análise da pesquisa. Finalmente, constatamos que é de suma importância que o profissional da educação tenha uma sólida formação epistemológica para refletir, analisar e entender sobre a concepção de aprendizagem e conhecimento que, determina o seu fazer pedagógico. É importante que entendamos que a forma como se concebe o aprender e o conhecer determina e orienta o seu trabalho em sala de aula e sua identidade.Palavras-chave: professores; formação continuada; Colégio Alternativo.

  10. Book review. La forma degli animali. Adolf Portmann

    Directory of Open Access Journals (Sweden)

    Manuel Graziani

    2013-09-01

    Full Text Available Nel 1931 il biologo Adolf Portmann era già talmente noto a livello internazionale per le sue ricerche da guadagnarsi la cattedra in zoologia nell'università della sua città natale, Basilea, all'età di appena 34 anni. All'attività di docente universitario ha sempre affiancato un'originale riflessione sul significato delle scienze della vita, imponendosi come una delle figure chiave nel dibattito tra biologia teoretica, estetica e antropologia filosofica. La forma degli animali, la sua opera più celebre, si pone al confine tra varie discipline e conserva un grande interesse ancora oggi che il dialogo tra estetica e biologia si è fatto nuovamente intenso. Pubblicata nel 1948 e in forma ampliata nel 1960 (da cui deriva questa prima edizione italiana a cura di Pietro Conte l'opera rappresenta il frutto più maturo delle sue ricerche "interdisciplinari".Un saggio che nasce dall'insoddisfazione nei confronti dei paradigmi scientifici consolidati e che ripropone l'idea morfologica in biologia sulla scorta del pensiero di J. W. Goethe il quale affermava che "tutto ciò che è deve anche dar cenno di sé e mostrarsi". Adolf Portmann è un convinto sostenitore che dalla forma si possano dedurne le complessive caratteristiche interne ed esterne degli animali. Secondo questa prospettiva la peculiare fisionomia dell'organismo dipende dalla congiunzione delle sue parti e dalle loro reciproche funzioni. Tuttavia l'autore non vede nello studio della forma l'alternativa al funzionalismo quanto, piuttosto, il suo necessario bilanciamento come dichiara nell'introduzione: "… per giungere alla conoscenza della vita animale di strade ce ne sono molte, e tutte possono contribuire ad arricchire la nostra esperienza. Questo lavoro si occupa della forma degli animali e si propone di mettere in luce la peculiare natura dell'aspetto visibile. Ci sono persone che si dedicano allo studio degli animali, conoscono moltissime specie, hanno imparato centinaia di nomi e

  11. Relato de um caso de neutropenia congênita grave em um lactente jovem A case report of severe congenital neutropenia in a young infant

    Directory of Open Access Journals (Sweden)

    Lucas Fadel M. dos Santos

    2011-12-01

    Full Text Available OBJETIVO: Relatar um caso de neutropenia congênita grave e alertar os pediatras sobre tal diagnóstico em pacientes jovens, com infecções recorrentes. DESCRIÇÃO DO CASO: Lactente jovem com 45 dias de vida, com história de febre alta, letargia, recusa alimentar e hemogramas repetidos com leucopenia importante à custa de polimorfonucleares. A hipótese diagnóstica foi confirmada pelo aspirado de medula óssea, que mostrou hipoplasia de série granulocítica e completa ausência de neutrófilos maduros. Foi introduzida antibioticoterapia de largo espectro e estimulador da formação de colônias de granulócitos. O paciente evoluiu para óbito em decorrência de complicações infecciosas após 21 dias de internação. COMENTÁRIOS: Trata-se de um lactente jovem, portador de uma rara desordem congênita que leva à intensa neutropenia, deixando-o vulnerável a infecções graves e potencialmente fatais. À internação, o paciente apresentava sinais e sintomas sugestivos de sepse, sendo introduzido antibioticoterapia de amplo espectro, necessária por se tratar de lactente jovem, neutropênico e febril. A hipótese diagnóstica se baseou na história clínica e nos leucogramas alterados, sendo posteriormente confirmada pelo aspirado de medula óssea. Foi introduzido o estimulador da formação de colônias de granulócitos, que geralmente é efetivo, porém, nesse caso, não houve sucesso e o paciente evoluiu para óbito devido à grave infecção.OBJECTIVE: To report a case of severe congenital neutropenia and alert pediatricians about its diagnosis in young patients with recurrent infectious diseases. CASE DESCRIPTION: Young infant with 45 days of life, with a history of high fever, lethargy, poor feeding and repeated blood counts showing significant leucopenia due to a significant decrease of polymorphonuclear cells. The diagnosis was confirmed by bone marrow aspirate showing hypoplasia of the granulocytic series and complete absence of

  12. B-cell depletion with rituximab in the treatment of autoimmune diseases. Graves' ophthalmopathy the latest addition to an expanding family

    DEFF Research Database (Denmark)

    Nielsen, Claus H; El Fassi, Daniel; Hasselbalch, Hans C;

    2007-01-01

    of 10 Graves' disease patients remained in remission 400 days after rituximab treatment versus none in the control group, and remarkable improvements in the eye symptoms of patients with Graves' ophthalmopathy were observed. This supports a role for B cells in the pathogenesis of Graves' ophthalmopathy......In this review, the authors summarise the clinical results obtained after therapy with rituximab in autoimmune diseases, including Graves' disease and Graves' ophthalmopathy. On the basis of qualitative and quantitative analyses of B- and T-cell subsets, and autoantibody levels obtained in other...... diseases before and after rituximab therapy, the authors interpret the results of the only two clinical investigations of the efficacy of rituximab in the treatment of Graves' disease and Graves' opthalmopathy reported so far. No significant effect on autoantibody levels was observed. Nonetheless, 4 out...

  13. Evaluación de un programa de tratamiento en prisión de hombres condenados por violencia grave contra la pareja

    Directory of Open Access Journals (Sweden)

    Enrique Echeburúa

    2009-01-01

    Full Text Available En este estudio cuasi-experimental se ha puesto a prueba la efectividad de un programa de tratamiento psicológico para hombres encarcelados por haber cometido un delito grave de violencia de pareja. La muestra constó de 148 hombres que cumplían condena en 18 cárceles españolas. El tratamiento psicológico consistió en un programa cognitivo-conductual, con 20 sesiones de periodicidad semanal, que duró aproximadamente 8 meses. Según los resultados obtenidos, hubo una modificación significativa de los sesgos cognitivos tanto sobre la inferioridad de la mujer como sobre la violencia como forma válida de afrontar las dificultades cotidianas. Asimismo los sujetos tratados experimentaron una reducción de los síntomas psicopatológicos, de la impulsividad y de la ira, así como un aumento significativo en la autoestima. Por otra parte, la única diferencia entre los sujetos que abandonaron el tratamiento y los que lo completaron fue la ausencia de antecedentes penales. La alta impulsividad y los síntomas depresivos antes del tratamiento fueron predictores de unos resultados terapéuticos más pobres. Se comentan las implicaciones de este estudio para investigaciones futuras.

  14. O uso do conhecimento como técnica evolutiva voltada à melhoria dos processos e de tomada de decisão

    Directory of Open Access Journals (Sweden)

    Liane Mahlmann Kipper

    2013-01-01

    Full Text Available No atual cenário das organizações, a Gestão por Processos tem como foco realizar processos de forma organizada, priorizando ações por meio de técnicas e métodos que estejam vinculados à melhoria da organização no segmento de mercado onde atua. Como fator determinante para atingir metas com sucesso, a memória organizacional é de total importância no gerenciamento dos processos, possibilitando atender a todas as áreas de forma sistêmica, creditando suas informações aos diversos setores organizacionais e, assim, utilizando o conhecimento para dirigir uma ação com foco no planejamento para alcançar um objetivo estratégico organizacional. A memória organizacional pode ser registrada por meio do desenvolvimento de uma base de conhecimento. O trabalho em questão tem como objetivo permitir uma melhor compreensão sobre a importância da base de conhecimento em uma organização, para realizar ações apropriadas, planejando, simulando e alcançando uma decisão através de dados significativos. Logo após o desenvolvimento de uma pesquisa bibliográfica, um estudo bibliométrico sobre o tema proposto foi realizado junto aos principais eventos científicos brasileiros das áreas de engenharia de produção, analisando-se como o assunto tem sido abordado por autores das áreas da Gestão por Processos e Base de Conhecimento. Nos principais resultados encontrados até o momento, observou-se a necessidade da implantação de modelos baseados em conhecimento, em sistemas que buscam a melhoria na execução dos processos e consequente diminuição de falhas e processos de tomada de decisão mais adequados.Abstract In the current scenario of organizations Process Management aims to perform process in an organized, prioritizing actions through techniques and methods that are linked to the improvement of the organization in the market segment it operates. As a determinant for achieving goals successfully, organizational memory is all

  15. Fenomenología y formas de vida

    OpenAIRE

    María del Carmen PAREDES MARTÍN

    2015-01-01

    os artículos de Husserl en la revista japonesa Kaizo contienen muchas claves sugerentes e importantes sobre su filosofía práctica. Su visión de las “formas de vida” (Lebensformen) humanas y sobre todo su concepción de la “forma de vida ética” muestran su preocupación por el significado de la fenomenología para la vida y para la búsqueda de la responsabilidad. Husserl articula el problema ético sobre la base de su concepción de la “esencia” del ser humano y la lucha o el afán de la vi...

  16. FORMAS CONTEMPORÁNEAS DE ESCLAVITUD: TRATA DE MUJERES

    OpenAIRE

    da Silva, Waldimeiry Correa

    2013-01-01

    Afirma-se que o Tráfico de seres humanos é una forma contemporânea de escravidão, com base em que fundamento? Que elementos caracterizam o tráfico como escravidão contemporânea? Por outro lado, se o Tráfico é uma forma contemporânea de escravidão, temos de reconhecer a existência de uma prática que foi objeto de “proibição”, “abolição”, há mais de 150 anos: a escravidão. Uma prática condenada por diversas normas internacionais, tanto a nível universal quanto regional e nacional. Diante da ine...

  17. El lenguaje simbólico de las formas precolombinas

    Directory of Open Access Journals (Sweden)

    Luz Helena Ballestas Rincón

    1999-09-01

    Full Text Available A través del estudio de las formas precolombinas es posible aproximarnos a la mitología, la magia y la cotidianidad del individuo prehispánico. Estas formas revelan toda una simbología, aunque difícil de comprender, pues se dio en otro tiempo y en diversos lugares. No por pertenecer al orden de lo racional sino por constituir la representación de mitos y leyendas mediante la asociación de imágenes, denotan la capacidad de síntesis y la creatividad, presentes en la arquitectura, la orfebrería, la alfarería, la talla en piedra y la labor textil.

  18. Review of Novum Inventorium Sepulchrale: Kentish Anglo-Saxon Graves and Grave Goods in the Sonia Chadwick Hawkes Archive (Online Digital Corpus

    Directory of Open Access Journals (Sweden)

    Tara-Jane Sutcliffe

    2008-02-01

    Full Text Available In 2007, the year in which the Society of Antiquaries of London celebrated its tercentenary, what more fitting tribute to those industrious individuals than that their work be made accessible to a new generation of students. One means was by a celebratory exhibition hosted by the Royal Academy, Making History: Antiquaries in Britain, 1707-2007, which showcased a treasure-trove of art, antiquities and manuscripts (for review, see Mount 2007. Structured display is one thing: scholarly use or re-use of antiquarian data is, however, quite another matter. Indeed, therein arguably lays one of the more pressing challenges facing the practice of 'modern' archaeology (see Jones et al. 2001. A timely response was the online publication in October 2007 of the Novum Inventorium Sepulchrale (NIS, a digital corpus of Kentish Anglo-Saxon graves and grave goods. Through this project a wealth of primary data has been made accessible as never before. This resource will be of interest to all those researching Anglo-Saxon Archaeology, particularly material culture and mortuary practices. Whilst the editors express the hope that the NIS will 'enable future generations of researchers to gain a better understanding of the origins of the Anglo-Saxon kingdoms', users will find themselves both delighted and frustrated by the quantity and format of the data presented in it.

  19. 白细胞介素-4基因多态性与Graves'病的关系%Association of Interleukin-4 gene polymorphisms with Graves' disease

    Institute of Scientific and Technical Information of China (English)

    龚莹; 蒋玲; 江维岩; 张晓黎; 武传龙

    2003-01-01

    目的:探讨白细胞介素-4(Interleukin-4,IL-4)基因多态性与Graves'病(Graves'Disease GD)发病易感性的关系.方法:选择汉族GD患者和正常人各100例,采用序列特异性引物聚合酶链反应(PCR-SSP)检测等位基因和基因型.结果:GD组IL-4启动子区-590位置t等位基因频率明显低于对照组(8%对15.5%;P<0.05).GD组IL-4(-590)c/t杂合子基因型频率显著低于对照组(12%对25%;P<0.05).结论:在中国汉族人群中,GD患者和正常人之间存在IL-4(-590)等位基因和基因型频率分布的差异.GD患者IL-4启动子区-590位置t等位基因频率下降,可能使IL-4总的转录活性减低,通过免疫炎症反应导致GD发病.

  20. Breaking the glass ceiling: an interview with Dr. Shirley Graves, a pioneering woman in medicine.

    Science.gov (United States)

    Ahmed, Zulfiqar; Mai, Christine L; Elder, Badrea; Rodriguez, Samuel; Yaster, Myron

    2014-04-01

    Shirley Graves M.D., D.Sc. (honorary) (1936), Professor Emeritus of Anesthesiology and Pediatrics at the University of Florida, was one of the most influential women in medicine in the 1960 and 1970s, a time when the medical profession was overwhelmingly male-dominated. In today's society, it is hard to believe that only 50 years ago, women were scarce in the field of medicine. Yet Dr. Graves was a pioneer in the fields of pediatric anesthesia and pediatric critical care medicine. She identifies her development of the pediatric intensive care unit and her leadership in the Division of Pediatric Anesthesia at the University of Florida as her defining contributions. Through her journal articles, book chapters, national and international lectures, and leadership in the American Society of Anesthesiology and the Florida Society of Anesthesiology, she inspired a generation of men and women physicians to conquer the unthinkable and break through the glass ceiling.

  1. Hot and cold: coexistent Graves' disease and Hashimoto's thyroiditis in a patient with Schmidt's syndrome.

    Science.gov (United States)

    Dasari, Sowjanya; Naha, Kushal; Hande, Manjunath; Vivek, Ganapathiraman

    2014-05-21

    A 37-year-old housewife presented with generalised fatigue, palpitations and weight loss over the past 3 months. Physical examination revealed signs of hyperthyroidism. Thyroid function tests confirmed the presence of thyrotoxicosis. Pertechnetate radionuclide imaging of the thyroid showed diffusely increased radiotracer uptake consistent with Graves' disease and a cold nodule in the right lobe. Needle aspiration from the nodule yielded evidence of Hashimoto's thyroiditis. The patient also tested strongly positive for antithyroid peroxidase antibodies. Simultaneous laboratory evaluation revealed primary adrenal failure and probable pernicious anaemia, thus producing a diagnosis of Schmidt's syndrome. The patient was initiated on appropriate medical therapy for endocrinopathy. Graves' disease was treated with radioablation. 2014 BMJ Publishing Group Ltd.

  2. GO-QOL--disease-specific quality of life questionnaire in Graves' orbitopathy.

    Science.gov (United States)

    Sawicka-Gutaj, Nadia; Bednarczuk, Tomasz; Daroszewski, Jacek; Waligórska-Stachura, Joanna; Miśkiewicz, Piotr; Sowiński, Jerzy; Bolanowski, Marek; Ruchała, Marek

    2015-01-01

    The main goal of therapy for Graves' orbitopathy (GO) is to restore visual function and to improve quality of life (QOL); therefore, the idea of self-assessment of eye changes by the patient has been developed. We developed a validated Polish version of the GO-QOL questionnaire (GO-QOLpl). As an original version we used the English version of GO-QOL, which consists of 15 questions summarised in two subscales. GO-QOLpl was translated and validated in accordance with standard principles for translation of patient-reported outcomes (PRO). GO-QOLpl is a linguistically validated version of the original GO-QOL questionnaire, which is recommended by the European Group of Graves' Orbitopathy (EUGOGO). We strongly support the use of GO-QOLpl for the assessment of QOL among Polish patients with GO in clinical practice.

  3. Scientific studies on pottery and pro-porcelain from group of graves in Henglingshan, Guangdong Province

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    The findings of the Henglingshan group of graves, Guangdong Province, were appraised as one of the ten major archaeological excavations in 2000. The pottery and proto-porcelain samples excavated from the group of graves in Henglingshan are very important for studying the development history of Guang-dong ceramics. In this paper, the chemical compositions, micro-structure and physical properties of the samples were systematically analyzed. The results were subjected to multivariate statistical analysis. Different compositional patterns were found for specimens from different periods. The reasons for these variations were discussed. In addition, compared with the pottery and proto-porcelain samples from different production sites in other provinces of China, the obvious regional characters and unique law of the development for ancient ceramics of Guangdong were also discussed.

  4. Concurrent reactive arthritis, Graves' disease, and warm autoimmune hemolytic anemia: a case report.

    Science.gov (United States)

    Chiang, Elizabeth; Packer, Clifford D

    2009-08-13

    Warm antibody autoimmune hemolytic anemia is due to the presence of warm agglutinins that react with protein antigens on the surface of red blood cells causing premature destruction of circulating red blood cells. We report the first case of concurrent reactive arthritis, Graves' disease, and autoimmune hemolytic anemia. A 40-year-old man with reactive arthritis, Graves' disease, type 2 diabetes mellitus, mitral valve prolapse, and Gilbert's disease presented with a one month history of jaundice, fatigue, and black stools. After diagnosis of warm autoimmune hemolytic anemia, the patient was started on prednisone 1 mg/kg with rapid improvement in his anemia and jaundice. Our subject's mother and possibly his maternal grandmother also had autoimmune hemolytic anemia, which raises the possibility of hereditary autoimmune hemolytic anemia, a rarely reported condition.

  5. Unilateral gynecomastia and hypokalemic periodic paralysis as first manifestations of Graves' disease.

    Science.gov (United States)

    Wang, Yufan; Zhao, Li; Li, Fan; Chen, Hai-xi; Fang, Fang; Peng, Yong-de

    2013-06-01

    A 39-year-old Chinese man presented to the study hospital with right-sided gynecomastia. Underlying Graves' disease was not diagnosed until recurrent episodes of hypokalemic periodic paralysis were observed. The estradiol (E2) and progesterone levels and the E2-to-testosterone (T) (E2/T) ratio of the patient were elevated before treatment. Immediate intravenous potassium supplementation was started to reverse the paralysis. Additionally, antithyroid drugs were administered to restore a euthyroid state. After treatment, the patient gained strength. Gynecomastia regressed with a return to the euthyroid state; the E2 and progesterone levels normalized and the plasma E2/T ratio declined. In addition to the classic symptoms, some atypical symptoms of Graves' disease may also occur. One of the challenges lies in recognizing the underlying etiology. Early diagnosis and appropriate treatment can avoid unnecessary investigations and serious cardiopulmonary complications.

  6. FORMAS ORGANIZACIONAIS NO SETOR DE INTERMEDIAÇÃO FINANCEIRA

    Directory of Open Access Journals (Sweden)

    Ricardo presz Palmaka

    2011-12-01

    Full Text Available Considerado o primeiro passo numa análise demográfica organizacional, a caracterização da forma organizacional define os limites entre as várias populações e permite compreender a dinâmica competitiva intra e interpopulações. De acordo com a literatura de Ecologia Organizacional, ao observar os tipos de empresas selecionadas numa determinada população organizacional, é possível identificar os critérios de seleção em funcionamento no ambiente competitivo. Em algumas populações de empresas, a própria legislação define os contornos das formas organizacionais, como é o caso das populações de empresas de intermediação financeira, foco deste artigo. Todavia, a legislação não é explícita no que diz respeito às dimensões da forma organizacional. Identificaram-se quatro aspectos da legislação (denominação social; objeto social; capital e patrimônio mínimo; natureza da propriedade e sociedade correspondentes às seguintes dimensões: identidade, objetivos, recursos, controle e autoridade.

  7. Application of new therapies in Graves' disease and thyroid-associated ophthalmopathy: animal models and translation to human clinical trials

    DEFF Research Database (Denmark)

    Banga, J Paul; Nielsen, Claus H; Gilbert, Jacqueline A

    2008-01-01

    immunosuppression. The recent development of an induced model of experimental Graves' disease, although incomplete as it lacks the extrathyroidal manifestations, provided opportunities to investigate immune intervention strategies, including influence upon the autoreactive B and T cell players in the autoimmune...

  8. The influence of position deviation on RAIU and,the corresponding therapeutic dose calculations in patients with Graves hyperthyroidism

    Institute of Scientific and Technical Information of China (English)

    李从心

    2013-01-01

    Objective To evaluate the influence of inappropriate position deviation on radioactive iodine uptake(RAIU),effective half-life(Teff)and the corresponding dose variances in patients suffering from Graves hyperthyroidism.Methods RAIU was examined in 20 patients with

  9. Application of new therapies in Graves' disease and thyroid-associated ophthalmopathy: animal models and translation to human clinical trials

    DEFF Research Database (Denmark)

    Banga, J Paul; Nielsen, Claus H; Gilbert, Jacqueline A;

    2008-01-01

    Most current approaches for treating Graves' disease are based essentially upon regimes developed nearly 50 years ago. Moreover, therapeutic approaches for complications such as thyroid-associated ophthalmopathy (TAO) and dermopathy are singularly dependent on conventional approaches of nonspecif...

  10. O ofício do procurador geral das missões e a formação de redes sociais da Companhia de Jesus nas missões do Grão-Pará e Maranhão =The office of the attorney general of missions and the formation of networks of the Society of Jesus in missions of the Grão-Pará and Maranhão

    Directory of Open Access Journals (Sweden)

    Joaquim, Mariana Alliatti

    2014-01-01

    Full Text Available O presente artigo tem como foco de investigação a função exercida por um ex-missionário da Companhia de Jesus no Brasil, integrante do grupo de jesuítas expulsos da Vice-Província do Grão Pará e Maranhão encarcerado na prisão de São Julião da Barra, a partir da expulsão em 1759. O Padre Bento da Fonseca, neste momento, atuava em Lisboa como procurador geral das missões da Vice-Província do Grão-Pará e Maranhão, junto a autoridades civis e eclesiásticas. Desta forma, objetiva-se enquadrar o cargo do procurador geral das missões da Companhia de Jesus na formação e consolidação de redes socioeconômicas e de poder entre os jesuítas e os vários setores da sociedade lusitana. A partir do conceito de redes sociais, conforme definiram Barnes (1987, Castells (2011 e Elias (1994, far-se-á uma seleção e análise evolutiva da correspondência e de outros escritos de Bento da Fonseca, complementada com a análise sincrônica de outros textos produzidos.

  11. Treatment of Graves' disease and the course of ophthalmopathy

    Energy Technology Data Exchange (ETDEWEB)

    Sridama, V.; DeGroot, L.J.

    1989-07-01

    Contradictory results have been obtained with regards to the effect of various treatment modes on the exacerbation of Graves' ophthalmopathy, probably because the number of patients in each study was small and some studies were analyzed only in relation to one type of treatment. To circument these problems, we studied the course of Graves' ophthalmopathy after various modes of therapy for thyrotoxicosis among 537 patients with Graves' disease. A total of 537 patients with Graves' disease were prospectively studied over an 11-year period. Thirty-one patients were lost to follow-up during the first six months after treatment and were excluded from the study. Of those remaining, 426 received one form of treatment, 79 received two kinds of therapy, and one received three kinds of therapy. Thus, surgical treatments numbered 164, radioactive iodine-131 (/sup 13/1I) treatments numbered 241, and medical treatments numbered 182. Ocular signs were considered improved or exacerbated by the following criteria: decrement or increment of the exophthalmos of 2 mm or more, improvement or deterioration of visual acuity, and regression or progression of extraocular muscle involvement causing diplopia. Among patients who did not have infiltrative ophthalmopathy before treatment, there was no difference in the occurrence of posttreatment exophthalmos in the surgically, medically, and 131I-treated patients (7.1%, 6.7%, and 4.9%, respectively). The incidence and the degree of progression of ophthalmopathy in patients who already had exophthalmos before treatment were similar in the medically, surgically, and 131I-treated groups (19.2%, 19.8%, and 22.7%, respectively). Most of the progression occurred in the posttreatment euthyroid stage. The incidence of improvement of ophthalmopathy was also similar 14.1%, 12.6%, and 12.3% in the medically, surgically, and 131I-treated patients.

  12. Seasonal changes in calcium homeostasis affect the incidence of postoperative tetany in patients with Graves' disease.

    Science.gov (United States)

    Yamashita, H; Noguchi, S; Murakami, T; Watanabe, S; Uchino, S; Ohshima, A; Kawamoto, H; Toda, M; Yamashita, H

    2000-04-01

    We have found that postoperative tetany occurs in patients with Graves' disease who have secondary hyperparathyroidism caused by a deficiency in calcium and vitamin D concomitant with transient hypoparathyroidism after surgery. There are seasonal variations in serum 25-hydroxyvitamin D (25[OH]D) concentrations. The purpose of this study was to investigate the effects of seasonal changes in calcium homeostasis on the incidence of postoperative tetany in patients with Graves' disease who undergo subtotal thyroidectomy. A prospective study was carried out to investigate sequential changes in serum levels of intact parathyroid hormone (iPTH), calcium and other electrolytes, 25(OH)D, and 1,25-dihydroxyvitamin D (1,25[OH]2D) in female patients with Graves' disease who underwent subtotal thyroidectomy during the summer (n = 89) and during the winter (n = 89). The serum levels of calcium, magnesium, and 25(OH)D were significantly higher, but iPTH levels and 1,25(OH)2D levels were lower in summer than in winter. The percentage of vitamin D deficiency (25(OH)D tetany developed in only 4 of 15 patients and in one patient whose iPTH level was below normal (incidence of tetany, 5.6%). In winter, however, tetany developed in 6 of 13 patients and in 4 patients whose iPTH level was below normal (incidence of tetany, 11.2%). Patients with Graves' disease are more susceptible to calcium and vitamin D deficiency during the winter than during the summer, resulting in the tendency toward a higher incidence of postoperative tetany in winter.

  13. Nutrición por sonda nasogástrica en la pancreatitis aguda grave

    National Research Council Canada - National Science Library

    García de Casasola, Gonzalo; Cacho Acosta, Guillermo; Gonzálvez-Gasch, Asunción; Barba Martín, Raquel; Herreros Valdepeñas, Benjamín; Barbado Cano, Ana

    2008-01-01

    ... alternativa a la nutrición parenteral es la nutrición enteral por sonda nasoyeyunal. Se han efectuado varios ensayos clínicos controlados y aleatorizados en los que se compara la nutrición parenteral total con la nutrición enteral por sonda nasoyeyunal en la pancreatitis aguda grave 2–4 . A pesar de las limitaciones de estos estudios, en la mayoría de ellos se...

  14. Incidental Visualization of Thyroid Gland on Bone Scan Caused by Graves' Hyperthyroidism

    Energy Technology Data Exchange (ETDEWEB)

    Sohn, Myung Hee; Jeong, Hwan Jeong; Kim, Dong Wook; Lim, Seok Tae [Chonbuk National University Medical School, Jeonju (Korea, Republic of)

    2009-04-15

    A 45-year-old man presented with fatigue and weight loss underwent a Tc-99m MDP bone scan because of increased serum alkaline phosphatase. Delayed images at 4 hours demonstrated diffuse increased activity throughout both lobes of the thyroid in the absence of activity of the stomach and salivary glands. Thyroid laboratory indices and a Tc-99m pertechnetate thyroid scan suggested Graves' hyperthyroidism

  15. Socioeconomic Disparities in the Presentation and Treatment of Graves' Disease and Thyroid Eye Disease.

    Science.gov (United States)

    Vargason, Caroline W; Chelnis, James G; Barahimi, Behin I; Mawn, Louise A

    2016-01-01

    Thyroid eye disease (TED) is an inflammatory, autoimmune orbitopathy with multifactorial etiology. Clinical presentation of TED spans a range from mild surface irritation to vision threatening compressive optic neuropathy. Potential vision loss underscores the importance of understanding genetic and environmental factors influencing the severity of TED presentation. This review will describe the classic risk factors for TED, outline treatments for Graves' disease (GD) and TED, and describe newer evidence of socioeconomic disparities in TED presentation.

  16. Cradle-to-Grave Nuclear Fuel Supply Assurance Workshop: Industry’s Potential Role

    Energy Technology Data Exchange (ETDEWEB)

    Bengelsdorf, Harold (Hal); Hund, Gretchen; Kessler, Carol E.; Mahy, Heidi A.; McGoldrick, Fred; Seward, Amy M.

    2007-09-30

    The Pacific Northwest Center for Global Security hosted a workshop on June 6, 2007 in Washington D.C. to discuss the feasibility, merits and implications of the United States offering cradle-to-grave nuclear fuel cycle services to other countries. The workshop consisted of a small group of senior individuals from the private sector, government and the national laboratories. The workshop is summarized and recommendations given.

  17. Cradle-to-Grave Nuclear Fuel Supply Assurance Workshop: Industry’s Potential Role

    Energy Technology Data Exchange (ETDEWEB)

    Bengelsdorf, Harold (Hal); Hund, Gretchen; Kessler, Carol E.; Mahy, Heidi A.; McGoldrick, Fred; Seward, Amy M.

    2007-09-30

    The Pacific Northwest Center for Global Security hosted a workshop on June 6, 2007 in Washington D.C. to discuss the feasibility, merits and implications of the United States offering cradle-to-grave nuclear fuel cycle services to other countries. The workshop consisted of a small group of senior individuals from the private sector, government and the national laboratories. The workshop is summarized and recommendations given.

  18. Graves' disease in two pregnancies complicated by fetal goitrous hypothyroidism: successful in utero treatment with levothyroxine

    DEFF Research Database (Denmark)

    Bliddal, Sofie; Rasmussen, Åse Krogh; Sundberg, Karin Milner

    2011-01-01

    Treatment of Graves' disease during pregnancy with antithyroid drugs (ATDs) poses a risk of inducing hypothyroidism and, thus, development of a goiter to the fetus. PATIENT FINDINGS: We report two patients referred to our department after discovery of a fetal goiter by ultrasound examination in t...... hypothyroidism as the cause of goiter development. Reduction of maternal ATD dose and injection of levothyroxine intra-amniotically quickly reduced the goiter size, and both babies were born euthyroid and without goiters....

  19. Management of patients with Graves' orbitopathy: initial assessment, management outside specialised centres and referral pathways.

    Science.gov (United States)

    Perros, Petros; Dayan, Colin M; Dickinson, A Jane; Ezra, Daniel; Estcourt, Stephanie; Foley, Peter; Hickey, Janis; Lazarus, John H; MacEwen, Caroline J; McLaren, Julie; Rose, Geoffrey E; Uddin, Jimmy; Vaidya, Bijay

    2015-04-01

    Graves' orbitopathy (GO) is uncommon, but responsible for considerable morbidity. A coordinated approach between healthcare professionals is required in order to meet the needs of patients. Early diagnosis can be achieved by a simple clinical assessment. Low-cost effective interventions can be initiated by generalists, which may improve outcomes. Moderate-to-severe GO should be referred to specialised centres. Recommendations for clinical diagnosis, initial management and referral pathways are highlighted.

  20. The philosopher Socrates had exophthalmos (a term coined by Plato) and probably Graves' disease.

    Science.gov (United States)

    Papapetrou, Peter D

    2015-01-01

    According to a previously published theory, Socrates was afflicted with temporal lobe epilepsy since his childhood. Plato, Xenophon, and Aristoxenus described Socrates as having exophthalmos, probably diplopia, and some symptoms compatible with hyperthyroidism. Using these data, we theorize that Socrates had Graves' disease. In order to determine a cause of his temporal lobe epilepsy, we speculate that the philosopher also had autoimmune thyroiditis and Hashimoto encephalopathy during his childhood and his epilepsy may have been a sequel to this hypothesized encephalopathy.

  1. Graves' disease: measurement of the extraocular muscle thickness with the echobiometer.

    Science.gov (United States)

    Schenome, M; Polizzi, A; Buono, C; Ciurlo, C; Ciurlo, G

    1998-01-01

    The authors measured extraocular muscle thickness in normal subjects and in patients affected by Graves' disease, using a Sonomed A-2000 echobiometer (probe with 10-MHz frequency); Hertel's exophthalmometry was also performed. Statistically significant differences in muscle thickness between normals and patients were found. This technique seems to be sufficiently useful and reliable in extraocular thickness evaluation, showing data similar to those of the recent literature.

  2. Combination of Cerebral Demyelination and Graves Disease in a Case with Miller Fisher Syndrome

    OpenAIRE

    Sibel Güler; Levent Sinan Bir

    2010-01-01

    A 44-year-old male patient with a diagnosis of Miller Fisher syndrome, Graves disease and central nervous system demyelination is presented. Clinical and laboratory findings supported the diagnosis of Miller Fisher syndrome. On T2-weighted sections of cranial magnetic resonance imaging, many ovoid-shaped, hyperintense lesions in bilateral deep white matter were detected. Magnetic resonance imaging spectroscopy demonstrated low N-acetylaspartate to creatine (NAA/Cr) ratio consistent with demye...

  3. Does radioiodine cause the ophthalmopathy of Graves' disease; Editorial

    Energy Technology Data Exchange (ETDEWEB)

    McDougall, I.R. (Stanford Univ., CA (United States). Medical Center)

    1993-02-01

    This editorial briefly reviews studies which might answer the question as to whether radioiodine treatment causes the ophthalmopathy of Graves' disease. However, the data do not allow any conclusion one way or the other. Other possible causal factors are discussed. Further studies are required to define whether treatment of hyperthyroidism aggravates the ophthalmopathy and whether one thereby is worse than the others and by how much. (UK).

  4. Três formas de violência, três formas de paz. A paz, a guerra e a formação social indo-europeia

    Directory of Open Access Journals (Sweden)

    Johan Galtung

    2012-10-01

    Full Text Available Nas formações sociais, as formas de violência coexistem com as formas de paz. O presente artigo analisa a coexistência, na formação social indo-europeia, da violência cultural (produção de ideias justificativas das demais violências com a paz cultural (cooperação e comiseração com todas as formas de vida; da violência directa (eliminação física do outro com a paz directa (formas de controlo não-violentas, com sanções positivas; e da violência estrutural (mecanismos sistémicos de injustiça e morte com a paz estrutural (satisfação das necessidades básicas e distribuição de bens e serviços.

  5. A study of the effect of seasonal climatic factors on the electrical resistivity response of three experimental graves

    Science.gov (United States)

    Jervis, John R.; Pringle, Jamie K.

    2014-09-01

    Electrical resistivity surveys have proven useful for locating clandestine graves in a number of forensic searches. However, some aspects of grave detection with resistivity surveys remain imperfectly understood. One such aspect is the effect of seasonal changes in climate on the resistivity response of graves. In this study, resistivity survey data collected over three years over three simulated graves were analysed in order to assess how the graves' resistivity anomalies varied seasonally and when they could most easily be detected. Thresholds were used to identify anomalies, and the ‘residual volume' of grave-related anomalies was calculated as the area bounded by the relevant thresholds multiplied by the anomaly's average value above the threshold. The residual volume of a resistivity anomaly associated with a buried pig cadaver showed evidence of repeating annual patterns and was moderately correlated with the soil moisture budget. This anomaly was easiest to detect between January and April each year, after prolonged periods of high net gain in soil moisture. The resistivity response of a wrapped cadaver was more complex, although it also showed evidence of seasonal variation during the third year after burial. We suggest that the observed variation in the graves' resistivity anomalies was caused by seasonal change in survey data noise levels, which was in turn influenced by the soil moisture budget. It is possible that similar variations occur elsewhere for sites with seasonal climate variations and this could affect successful detection of other subsurface features. Further research to investigate how different climates and soil types affect seasonal variation in grave-related resistivity anomalies would be useful.

  6. Myasthenia gravis and thymoma: evaluation of 41 patients Miastenia grave e timoma: avaliação de 41 pacientes

    Directory of Open Access Journals (Sweden)

    JOSÉ LAMARTINE DE ASSIS

    1999-03-01

    Full Text Available We evaluated the epidemiological, clinical, laboratory and therapeutical aspects of 41 patients with thymomatous myasthenia gravis. Thirty five patients (85.36% were submitted to thymectomy. Follow-up ranged from two to 18 years. Diagnosis of thymoma was based upon clinical investigations and CT scan of the anterior mediastinum and in 11 patients supported by immunological tests of anti-striated muscle antibodies with a positive result in more than 80% of cases. Histopathologic examination of all thymomectomized patients confirmed the diagnosis of thymoma. There was a significant predominance of benign over malignant thymoma. Occurred higher prevalence of male patients and of patients over 40 years of age. The therapeutical strategy to control myasthenic clinical findings was the same as that for non-thymomatous myasthenia gravis. The corticosteroids associated to cytotoxic drugs were less often used. Radiotherapy of the anterior mediastinum was more often used in patients having invasive tumors submitted to surgery or not. With regard to survival and control of myasthenia gravis, especially in younger patients and in those submitted to early surgery, results of treatment were surprisingly favorable.Avaliamos 41 pacientes com miastenia grave timomatosa sob os aspectos epidemiológico, clínico e terapêutico. Trinta e cinco pacientes (85,36% foram timectomizados. O seguimento clínico variou de dois meses até 18 anos. O diagnóstico do timoma foi fundamentado no estudo de imagem do mediastino (tomografia axial computadorizada e, em 11 pacientes, complementado com a determinação sérica de anticorpos para músculo estriado com resultado positivo em mais de 80% dos casos e confirmado pelo exame anátomo-patológico do timo realizado em todos os pacientes operados. Ocorreu predomínio significante de timomas benignos sobre timomas malignos, forma clínica generalizada severa, frequente envolvimento do sexo masculino e, em pacientes com mais de

  7. James George Frazer’s Anthropologic Heritage in the Work of Robert Graves

    Directory of Open Access Journals (Sweden)

    Tomislav M. Pavlović

    2016-02-01

    Full Text Available The works of Sir James George Frazer had an outstanding influence on the literature of modernism. Among those who benefited from Frazer’s ritualism were W. B. Yeats, T. S. Eliot. James Joyce, Ernest Hemingway, D. H. Lawrence, Ezra Pound, Mary Renault, Joseph Campbell, Robert Graves and many others. Robert Graves was known for his famous adaptation of Frazer’s concept of the sacred king who is sacrificed for the benefit of his subjects thus forming the narrative frame for the one of his most controversial novels. The dying king is also identified with the poet striving to attain the favour of the Triple Muse Goddess - who represents the embodiment of true poetic inspiration. The aforementioned concept is not the only thing that Graves inherited from his famous ancestor. In our analysis we laid stress on the customs, rituals, magic symbols and deities both authors dealt with. We also observed a striking resemblance of the style Greves and Frazer developed and their euchemeristic approach to myths as well.

  8. Preserved brains from the Spanish Civil War mass grave (1936) at La Pedraja1, Burgos, Spain.

    Science.gov (United States)

    Serrulla, Fernando; Herrasti, Lourdes; Navarro, Carmen; Cascallana, Jose Luis; Bermejo, Ana Maria; Marquez-Grant, Nicholas; Etxeberria, Francisco

    2016-12-01

    During the excavation of the Spanish Civil War mass grave at La Pedraja (Burgos, Spain), 104 individuals were found interred within it, 45 of which displayed brains that were preserved but dehydrated and reduced in size. This exceptional finding has resulted in the formation of a multidisciplinary team, with the aim of obtaining as much information as possible and to primarily understand the taphonomic phenomena that has led to the preservation of these brains. The following types of analyses were undertaken on three of these brains: macroscopy, histology, radiology, chemical-toxicology, genetics, chemical analysis of the soil and 3D modelling for stereolithography. The historical context was considered, plus all archaeological and other forensic data provided by the investigation of the mass grave. The results of the analyses on these morphologically identifiable human brains confirmed the presence of nerve structures, fatty acids, and in one case ante-mortem evidence for an intracranial haemorrhage. The fatty acid profile corresponds to the process of saponification. Therefore, the interpretation is that the preservation of these brains at the mass grave of La Pedraja was due to the saponification process, which was influenced by the manner and cause of death, the chemical composition of the brain, the physicochemical properties of the soil and the meteorological conditions at the time.

  9. Avaliação e tratamento da hiperglicemia em pacientes graves

    Directory of Open Access Journals (Sweden)

    Marina Verçoza Viana

    2014-03-01

    Full Text Available A hiperglicemia é um problema frequentemente encontrado em pacientes graves em ambiente de terapia intensiva. Sua presença se associa ao aumento da morbidade e da mortalidade, independentemente da causa da admissão (infarto agudo do miocárdio, condição após cirurgia cardiovascular, acidente vascular cerebral e sepse. Entretanto, permanecem muitas dúvidas com relação à fisiopatologia e, particularmente, em relação ao tratamento da hiperglicemia no paciente graves. Na prática clínica, devem ser levados em consideração diversos aspectos para o controle desses pacientes, inclusive os alvos de glicemia, o histórico de diabetes mellitus, a via de nutrição (enteral ou parenteral e o equipamento de monitoramento disponível, o que aumenta substancialmente a carga de trabalho dos profissionais envolvidos nesse tratamento. Esta revisão descreveu a epidemiologia, a fisiopatologia, o tratamento e o monitoramento da hiperglicemia no paciente adulto grave.

  10. Randomized double-blind trial of prednisone versus radiotherapy in Graves' ophthalmopathy

    Energy Technology Data Exchange (ETDEWEB)

    Prummel, M.F.; Mourits, M.; Blank, L.; Berghout, A.; Koornneef, L.; Wiersinga, W.M. (Univ. of Amsterdam (Netherlands))

    1993-10-16

    Corticosteriods are usually given for management of Graves' ophthalmopathy, but they have many and serious side-effects. By comparison, retrobulbar irradiation is well tolerated, although its efficacy has been evaluated only in uncontrolled studies. Therefore, the authors did a double-blind randomized trial, in which 28 patients with moderately severe Graves' ophthalmopathy were treated with a 3-month course of oral prednisone and sham irradiation, and 28 received retrobulbar irradiation (20 Gy) and placebo capsules. Therapeutic outcome, assessed twenty-four weeks after the start of treatment, was determined by the change in the highest NOSPECS class. A successful outcome was observed in 14 prednisone-treated and in 13 irradiated patients. Responders to treatment (but not nonresponders) in both groups showed improvements in total and subjective eye score and a decrease in eye-muscle volume. Response to either treatment was due largely to changes in soft-tissue involvement and eye-muscle motility. Radiotherapy and oral prednisone appear to be equally effective as initial treatment in patients with moderately severe Graves' ophthalmopathy. In view of its better tolerability, radiotherapy should be considered the treatment of first choice.

  11. Enfoque terapéutico de los traumatismos graves de los miembros

    Directory of Open Access Journals (Sweden)

    Roberto Joaquín del Gordo D´Amato

    2013-12-01

    Full Text Available Los traumatismos graves de miembros representan un porcentaje importante dentro de las patologías que consultan los servicios de urgencias de diversos centros hospitalarios. En la actualidad las estadísticas mundiales, nacionales y locales guardan unas proporciones similares en cuanto a frecuencia de presentación, sin embargo en países desarrollados la infraestructura en atención prehospitalaria con personal altamente calificado, permite obtener mejores resultados con respecto a atención y pronóstico de paciente politraumatizados, logrando en los últimos años una disminución significativa en cuanto a frecuencia de mortalidad. En todo traumatismo grave de miembros se requiere un manejo cuidadoso y ordenado a fin de disminuir complicaciones que en muchas ocasiones resultan verdaderamente catastróficas. Al considerar el tratamiento de traumatismos graves de miembros la amputación representa en algunas ocasiones una alternativa, sobre todo en aquellos pacientes con patologías asociadas que contribuyen a una evolución tórpida cuando se realiza reconstrucción.

  12. Efficacy of (99m)Tc-EDDA/HYNIC-TOC SPECT/CT scintigraphy in Graves' ophthalmopathy.

    Science.gov (United States)

    Zhao, Rong; Wang, Jiang; Deng, Jinglan; Yang, Weidong; Wang, Jing

    2012-01-01

    The aim of this study was to investigate the predictive role of the orbital somatostatin receptor scintigraphy with (99m)Tc-EDDA/HYNIC-TOC ((99m)Tc-TOC) to detect clinical stage of Graves' ophthalmopathy and the response to corticosteroid therapy. The subjects of the experiment were 46 patients with Graves' ophthalmopathy (GO) and four volunteers without eye disease or GO as the normal group (NG). Single photon emission computed tomography (SPECT), computed tomography (CT) and the left and right lateral position planar imaging of the heads of the all subjects were obtained 4 h after the intravenous injection of 555 MBq of (99m)Tc-TOC. The (99m)Tc-TOC SPECT/CT was repeated 3 months later. 35 (35/46) patients were received corticosteroid therapy (prednisolone, 10 mg po tid ) for 3 months, however, the other 11 patients as control groups did not receive any treatment. The treatment effect was evaluated both by the orbital (99m)Tc-TOC uptake and NOSPECS. A significant decrease in the O/OC ratio was observed in 22 GO patients between pre- and post-treatment (1.64 ± 0.13 vs. 1.21 ± 0.09, P TOC scintigraphy is a feasible technique to estimate the Graves' ophthalmopathy activity and predict the response to subsequent corticosteroid therapy in GO patients. The technique could be a useful tool for physicians not familiar with CAS determination.

  13. Acute effects of radioiodine therapy on the voice and larynx of basedow-Graves patients

    Energy Technology Data Exchange (ETDEWEB)

    Isolan-Cury, Roberta Werlang; Cury, Adriano Namo [Sao Paulo Santa Casa de Misericordia, SP (Brazil). Medical Science School (FCMSCSP); Monte, Osmar [Sao Paulo Santa Casa de Misericordia, SP (Brazil). Physiology Department; Silva, Marta Assumpcao de Andrada e [Sao Paulo Santa Casa de Misericordia, SP (Brazil). Medical Science School (FCMSCSP). Speech Therapy School; Duprat, Andre [Sao Paulo Santa Casa de Misericordia, SP (Brazil). Medical Science School (FCMSCSP). Otorhinolaryngology Department; Marone, Marilia [Nuclimagem - Irmanity of the Sao Paulo Santa Casa de Misericordia, SP (Brazil). Nuclear Medicine Unit; Almeida, Renata de; Iglesias, Alexandre [Sao Paulo Santa Casa de Misericordia, SP (Brazil). Medical Science School (FCMSCSP). Otorhinolaryngology Department. Endocrinology and Metabology Unit

    2008-07-01

    Graves's disease is the most common cause of hyperthyroidism. There are three current therapeutic options: anti-thyroid medication, surgery, and radioactive iodine (I 131). There are few data in the literature regarding the effects of radioiodine therapy on the larynx and voice. The aim of this study was: to assess the effect of radioiodine therapy on the voice of Basedow-Graves patients. Material and method: A prospective study was done. Following the diagnosis of Grave's disease, patients underwent investigation of their voice, measurement of maximum phonatory time (/a/) and the s/z ratio, fundamental frequency analysis (Praat software), laryngoscopy and (perceptive-auditory) analysis in three different conditions: pre-treatment, 4 days, and 20 days post-radioiodine therapy. Conditions are based on the inflammatory pattern of thyroid tissue (Jones et al. 1999). Results: No statistically significant differences were found in voice characteristics in these three conditions. Conclusion: Radioiodine therapy does not affect voice quality. (author)

  14. Transcaruncular Medial Wall Orbital Decompression: An Effective Approach for Patients with Unilateral Graves Ophthalmopathy

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    Robert H. Hill

    2012-01-01

    Full Text Available Purpose. To evaluate the reduction in proptosis, incidence of postoperative diplopia, and postoperative globe symmetry after transcaruncular medial wall decompression in patients with unilateral Graves ophthalmopathy. Methods. Retrospective review of 16 consecutive patients who underwent unilateral transcaruncular medial wall orbital decompression from 1995 to 2007. The diagnosis of Graves ophthalmopathy was based on history and clinical findings including proptosis, lagophthalmos, lid retraction, motility restriction, and systemic thyroid dysfunction. Results. The mean reduction in proptosis was 2.3 mm. The mean difference in exophthalmometry preoperatively between the two eyes in each patient was 3.1 mm whereas postoperatively the mean difference was 1.1 mm (P=0.0002. Eleven of 16 patients (69% had 1 mm or less of asymmetry postoperatively. There was no statistically significant difference in the incidence of diplopia pre- and postoperatively (P=1.0. Conclusions. Medial wall orbital decompression is a safe and practical surgical approach for patients with unilateral Graves orbitopathy. The procedure carries a low risk of morbidity and yields anatomic retrusion of the globe that is comparable to other more invasive methods and may yield more symmetric postoperative results.

  15. Is Graves' disease a primary immunodeficiency? New immunological perspectives on an endocrine disease.

    Science.gov (United States)

    Struja, Tristan; Kutz, Alexander; Fischli, Stefan; Meier, Christian; Mueller, Beat; Recher, Mike; Schuetz, Philipp

    2017-09-25

    Uncertainty about factors influencing the susceptibility and triggers for Graves' disease persists, along with a wide variation in the response to anti-thyroid drugs, currently at approximately 50% of non-responders. The aim of this narrative review is to summarize immunological concepts, with a combined endocrine and immunological perspective, to highlight potential new areas of research. Relevant studies were identified through a systematic literature search using the PubMed and EMBASE databases in March 2016. No cut-offs regarding dates were imposed. We used the terms "Graves' Disease" or "Basedow" or "thyrotoxicosis" together with the terms "etiology", "pathophysiology", "immunodeficiency", "causality", and "autoimmunity". The terms "orbitopathy", "ophthalmopathy", and "amiodarone" were excluded. Articles in English, French, German, Croatian, Spanish, and Italian were eligible for inclusion. While concepts such as the impact of iodine, smoking, human leucocyte antigen, infections, and ethnicity are established, new ideas have emerged. Pertaining evidence suggests the involvement of autoimmunity and immunodeficiency in the pathophysiology of Graves' disease. Recent studies point to specific immunological mechanisms triggering the onset of disease, which may also serve as targets for more specific therapies.

  16. Chronology of the Third – Fifth Centuries Male Graves from the Tarasovo Burial Ground

    Directory of Open Access Journals (Sweden)

    Goldina Rimma D.

    2016-09-01

    Full Text Available The article focuses on the chronological attribution of male graves from the late Mazunino stage of the Tarasovo burial ground and is a sequel to an earlier article about dating of the early Nyrgynda stage (1st – 2nd centuries of the same site. The three main methods employed in this research include those of formal typology, cultural stratigraphy and the nearest neighbor method. Eighty-six male graves of the third-fifth centuries were analyzed, with 12 identified as a result: first half of the 3rd c. AD (group 1, second half of the 3rd c. AD (2; 3rd c. (3; first half of the 4th c. (group 4; second half of the 3rd – 4th c. (5; third quarter of the 4th c. (6; fourth quarter of the 4th c. (group 7; second half of the 4th c. (8; second half of the 4th – 5th c. (9; 4th – 5th cc. (10; second half of the 3rd – 5th cc. (11 and 3rd – 5th cc. (12. This article minutes investigates the first six groups, while the rest will be covered in the next publication. Artifacts form the third – fifth century female graves of the Tarasovo burial ground will be studied separately.

  17. [A case of membranous nephropathy with ANCA-associated necrotizing glomerulonephritis during oral administration of PTU for Graves' disease].

    Science.gov (United States)

    Fujii, Takayuki; Kawamata, Toyotaka; Ueda, Shiro; Akikusa, Bunshiro; Hasegawa, Shigeru; Tsukahara, Tsunemichi; Iesato, Kenji; Ogawa, Makoto; Saisho, Hiromitsu

    2003-01-01

    We experienced a coincidental case of two types of glomerulopathy associated with Graves' disease. A 64-year-old man, who had been treated with propylthiouracil(PTU) for Graves' disease for 15 years, was admitted to our hospital for macroscopic hematuria and rapidly progressive deterioration of renal function. Although his thyroid function had been within the normal range during treatment, the level of thyrotropin receptor antibody(TRAb) gradually increased from a year before admission. Serological tests revealed that he was positive for myeloperoxidase-antineutrophil cytoplasmic antibody(MPO-ANCA). The renal biopsy specimen showed necrotizing and crescentic glomerulonephritis(GN) superimposed on membranous nephropathy(MN). This is a rare case of MN complicated with ANCA associated crescentic GN in a Graves' disease patient. Association of these two renal alterations was not clearly defined. MN involved with Graves' disease also has been rarely reported. Some reports demonstrated deposition of thyroglobulin and other thyroid related antigens in the glomeruli. In the present case, long-term impairment of Graves' disease and elevation of TRAb might have been responsible for the formation and deposition of thyroid-associated immune complex in the glomeruli. As for crescentic GN, PTU might have induced ANCA-associated GN independently of MN. This case is instructive for considering the relation between Graves' disease and renal injury.

  18. Morbidade materna extremamente grave: uso do Sistema de Informação Hospitalar

    Directory of Open Access Journals (Sweden)

    Maria da Consolação Magalhães

    2012-06-01

    Full Text Available OBJETIVO: Estimar a prevalência da morbidade materna extremamente grave e identificar procedimentos hospitalares associados. MÉTODOS: Foram utilizados dados do Sistema de Informação Hospitalar fornecidos pela Secretaria de Saúde de Juiz de Fora, MG, de 2006 a 2007. Foram selecionadas as internações para procedimentos obstétricos (n = 8.620 mulheres cujo diagnóstico principal compreendia todo o capítulo XV, gravidez, parto e puerpério, da Classificação Estatística Internacional de Doenças e Problemas Relacionados à Saúde, Décima Revisão. Foram identificados os códigos dos procedimentos realizados, procedimentos especiais e atos profissionais que pudessem contemplar o critério de morbidade materna extremamente grave da Organização Mundial da Saúde e outros procedimentos não habitualmente utilizados no período gravídico-puerperal. A análise de regressão logística foi utilizada para identificar associações entre desfecho e variáveis selecionadas. RESULTADOS: A prevalência de morbidade materna foi 37,8/1000 mulheres e a proporção de mortalidade foi 12/100.000 mulheres. O tempo de internação > 4 dias foi 13 vezes mais alto entre as mulheres que apresentaram alguma morbidade. Após análise ajustada, os fatores preditores de morbidade materna extremamente grave foram: tempo de internação, número de internações e filhos natimortos, e os procedimentos/condições mais frequentes foram a transfusão de hemoderivados (15,7/1.000, "permanência a maior" (9,5/1.000 e pré-eclâmpsia grave/eclâmpsia (8,2/1.000. CONCLUSÕES: Foi alta a prevalência de morbidade materna extremamente grave, associada principalmente às internações e variáveis relacionadas ao recém-nascido. O critério para identificação dos casos e o uso do Sistema de Informações Hospitalares mostraram-se úteis para a vigilância da morbimortalidade materna e para ampliar o conhecimento sobre os aspectos que a envolvem, contribuindo para a

  19. Intoxicaciones agudas graves en un servicio de medicina intensiva durante doce años

    Directory of Open Access Journals (Sweden)

    Palazón Sánchez C

    2000-01-01

    Full Text Available Fundamento: Conocer la epidemiología de las intoxicaciones agudas graves en un servicio de medicina intensiva y evaluar el pronóstico de la PCR y mortalidad asociada a los distintos tóxicos Métodos: Estudio retrospectivo realizado en el servicio de medicina intensiva polivalente de 10 camas, ubicado en un Hospital General de adultos. Período de estudio 12 años. Revisión de las historias clínicas de las personas ingresadas en el servicio de medicina intensiva por intoxicaciones agudas graves. Se recogieron datos demográficos, existencia de PCR al ingreso, necesidad de VM, complicaciones de las intoxicaciones agudas graves y mortalidad de la serie. Se realizó un análisis global y por año de estudio. El tratamiento estadístico de los datos se realizó con el paquete SPSS mediante la "t" de Student o la "chi" cuadrado, considerando valores significativos si p<0,05 Resultados: Se han incluido 233 sujetos, de los que 130 fueron varones. La estancia media fue de 4 días. El 63% de los pacientes fueron menores de 40 años (p<0,05. La intoxicación más frecuente fue la medicamentosa debida a un solo producto (72%. La supervivencia tras la PCR fue del 40% (4/10. La mortalidad global se situó en el 5,6% (n=13, habiendo precisado el 92% de los sujetos que posteriormente murieron, VM en algún momento de su ingreso en la unidad de cuidados intensivos. Conclusiones: En nuestro medio, la intoxicación más frecuente es la medicamentosa. La mortalidad se muestra dependiente del carácter de voluntariedad, pero independiente del tipo de tóxico (medicamentoso o no. La PCR asociada a las intoxicaciones agudas graves tiene, en nuestra serie, un mejor pronostico que la asociada a otras patologías. La VM asociada a las intoxicaciones agudas graves tiene una mortalidad baja (15,7%

  20. Is severe visceral leishmaniasis a systemic inflammatory response syndrome? A case control study A leishmaniose visceral grave é uma síndrome da resposta inflamatória sistêmica? Um estudo caso-controle

    Directory of Open Access Journals (Sweden)

    Carlos Henrique Nery Costa

    2010-08-01

    número de leucócitos aumentados, enquanto outros seis foram exclusivos para morte por sangramento (icterícia, neutropenia relativa grave, trombocitopenia grave, lesão hepática, insuficiência renal, maior carga de parasitas na medula óssea. Entre os pacientes tratados com sucesso, as principais síndromes de leishmaniose visceral foram infecções bacterianas, sangramento, anemia grave, diarreia, dispneia, edema, icterícia e carga de parasitas na medula óssea. CONCLUSÕES: Os dados apoiam a ideia de que as infecções bacterianas são secundárias a imunoparalisia. O amplo envolvimento de órgãos e sistemas é de forma plausível devido a elevada produção de citocinas pró-inflamatórias, cujas ações se encaixam com a leishmaniose visceral. As síndromes e os mediadores causais são típicos da síndrome de resposta inflamatória sistêmica, desenrolando-se lentamente.

  1. Identidade docente em formação

    Directory of Open Access Journals (Sweden)

    Patrícia Trindade Nakagome

    2012-06-01

    Full Text Available Neste artigo, discutimos a importância de que aidentidade docente seja objeto de reflexão e discussão nos cursos de formação continuada de professores, que muitas vezes ainda pecam por limitar-se a uma transmissão de novas metodologias, novos conceitos, novas técnicas, desconsiderando a experiência pessoal e profissional dos sujeitos. A identidade deve ser valorada junto a outros aspectos mais diretamente relacionados à prática docente, pois é fundamental para significar a responsabilidade do professor de modo mais amplo: como formador e membro de um grupo de pesquisa e trabalho. Para a realização de nossa análise, baseamo-nos na experiência com professores de Português Língua Estrangeira (PLE na Nicarágua, mais especificamente na oficina de escrita autobiográfica desenvolvida com eles durante um ano e meio. A escrita de si é uma forma de autocompreensão e, sendo realizada em grupo, é um caminho para maior entendimento entre os membros da equipe, algo indispensável para a consolidação de novas metodologias. Além disso, a autobiografia leva os professores a assumirem a função de autoria, o que lhes permite compreender as dificuldades dos alunos diante do texto e refletir sobre aspectos da língua que vão além de conteúdos a serem ensinados. O trabalho reflexivo sobre a identidade, realizado em grupo ematerializado num trabalho concreto com/sobre a linguagem, exerce influência positiva sobre a forma de se compreender a língua e o seu ensino.

  2. Las formas del crecimiento urbano y las variantes de carretera

    OpenAIRE

    Herce, Manuel

    1995-01-01

    El objeto de la tesis fue comprobar como la continua construcción de variantes de las carreteras que anteriormente atravesaban ciudades ha afectado a la organización de éstas, a la disposición de las actividades sobre el espacio y a la evolución del precio del suelo en la ciudad.La hipótesis de partida era que la forma de la ciudad, la disposición de las actividades urbanas sobre el territorio, deriva de la organización de sus redes de infraestructuras, entre las que las más importantes son l...

  3. La forma de la información en arquitectura

    Directory of Open Access Journals (Sweden)

    Antonio Yemail

    2006-01-01

    Full Text Available En una serie de conversaciones discontinuas a lo largo de veinte días, entre un diseñador industrial/arquitecto y un filósofo, maestro en medios interactivos, se confrontaron ideas acerca de las dinámicas del flujo de información y sus implicaciones en las posibles formas de los espacios contemporáneos, que se presentan aquí a manera de párrafos que pueden ser leídos siguiendo la insinuación de un hilo argumentativo, o por separado.

  4. Estudo teórico de formas condensadas de polianilinas

    OpenAIRE

    Liliana Yolanda Ancalla Dávila

    2005-01-01

    Neste trabalho estudamos o efeito de empacotamento, em diferentes formas condensadas, sobre as propriedades estruturais e eletrônicas de um polímero orgânico conjugado, a polianilina, através de simulações teóricas. A metodologia teórica empregada depende do número de átomos nos sistemas escolhidos, e das propriedades investigadas. Assim, para os filmes com milhares de átomos, utilizamos métodos clássicos para a obtenção das propriedades estruturais. Já para o estudo das propriedades eletrôni...

  5. Tres aspectos del deporte como forma de ocio

    OpenAIRE

    Munné i Matamala, Frederic

    1989-01-01

    Este trabajo parte de la con>ideración del deporte como una actividad psi- cológica y social, que constituye una de las principales formas contemporáneas del ocio. solo indirectamente se refiere al deporte como actividad profesional. Como ocio, el deporte es muy peculiar y asi lo revelan al menos tres de sus carac- teristicas actuales. El analisis critico de las mismas, a la luz del tiempo libre, per- mite atisbar en el futuro del deporte como hecho psicológico a la vez que social.

  6. Tipos de interacciones, formas de confianza y relaciones

    OpenAIRE

    Degenne, Alain

    2009-01-01

    Existe una distancia importante entre la complejidad de las relaciones sociales, que son historias compuestas de interacciones múltiples, y la pobreza de los modelos de relación de los que se ocupa el análisis de las redes sociales. Volviendo a partir de las interacciones reconoceremos cuatro grandes categorías de formas fundadas en el análisis del modo de regulación. Examinaremos, entonces, una hipótesis sobre la distribución de las interacciones en las relaciones. There is an important g...

  7. Formas predominantes de hormona de crecimiento humana (hgh en sueros

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    Martha L. Pinzón

    2010-07-01

    Full Text Available En este trabajo se compararon las formas predominantes de la Hormona de Crecimiento Humana (hGH, proveniente de sueros de pacientes con hipersecreción hormonal, para determinar los cambios que presenta en ellas y que puedan servir de diagnóstico para la detección de patologías, tales como acromegalia, como también alteraciones en el metabolismo degradativo de la proteína o en la unión a sus receptores específicos.

  8. FORMAS ORGANIZACIONAIS NO SETOR DE INTERMEDIAÇÃO FINANCEIRA

    OpenAIRE

    Ricardo presz Palmaka; Eliana da Cruz Yoshida; Dimária elles

    2011-01-01

    Considerado o primeiro passo numa análise demográfica organizacional, a caracterização da forma organizacional define os limites entre as várias populações e permite compreender a dinâmica competitiva intra e interpopulações. De acordo com a literatura de Ecologia Organizacional, ao observar os tipos de empresas selecionadas numa determinada população organizacional, é possível identificar os critérios de seleção em funcionamento no ambiente competitivo. Em algumas populações de empresas, a p...

  9. DOCUMENTO: FORMAS DE EVALUACIÓN DEL APRENDIZAJE

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    Marcela Currea Galvis

    2004-08-01

    Full Text Available Las notas de seguimiento (usadas por casi todos los docentes y educadores se constituyen en lo que se conoce (en muchas instituciones cómo evaluaciones parciales y finales, y permiten utilizar diferentes tipos y esquemas para laevaluación del aprendizaje y del desarrollo de competencias, es decir, la articulacióny uso de saberes, las formas de razonar y proceder para comprender situaciones, solucionar problemas y hacer en contexto, lográndose con aquéllas notas establecer diferenciaciones significativas de los múltiples procesos y conductas pertenecientes alos campos cognoscitivo, afectivo y psicomotor de cada uno de los estudiantes.

  10. FORMAS DIFERENCIALES Y ALGUNAS APLICACIONES A LA RELATIVIDAD GENERAL

    OpenAIRE

    Flores Tinoco, Alma Lilia Deni

    2012-01-01

    En esta tesis introducimos la teoría básica de formas diferenciales y discutimos algunas aplicaciones de esta teoría en el contexto de relatividad general. En el capítulo 1 introducimos el algebra exterior de Grassmann basandose en el espacio tangente Tx M de una variedad M diferenciable de dimM = n, (pero nuestro anáisis es válido si Tx M se reemplaza por un espacio vectorial real E, dimE = n). También en el mismo capítulo introducimos el operador de Hodge, la operación produc...

  11. Cocinando el cuerpo: la cocina tradicional como forma de resistencia

    OpenAIRE

    Escobar Rivera, Juan Carlos

    2014-01-01

    En la cocina tradicional, el cuerpo se involucra profundamente con los alimentos y abarca el espacio y tiempo de la cocina. La experiencia, la historia, los saberes culinarios de los cocinero/as están encarnados físicamente en sus cuerpos. Ello/as reproducen/producen sus prácticas alimentarias en forma de habitus(Bourdieu 1991, 1999). En contraposición, la cocina “gourmet” instaura otros usos y sentidos sobre el cuerpo, unos más disciplinados y que actúan como dispositivo. Legitima un sabe...

  12. Uso de hierro en forma de medicamento en gestantes colombianas

    OpenAIRE

    2013-01-01

    Objetivo Caracterizar el consumo de hierro en forma de medicamento en un grupo de embarazadas colombianas. Metodología Estudio observacional descriptivo, se obtuvo información de mujeres en control prenatal y/o atención del parto en 4 ciudades de Colombia. Las fuentes de información fueron entrevistas a gestantes y registros de historia clínica. Resultados La muestra fue de 1 637 mujeres en 15 instituciones. A 1 396 mujeres (85,3 %) les recomendaron consumir hierro, recomendación realizada po...

  13. Formas generalizadas de la entropía

    OpenAIRE

    Mesón, Alejandro

    2000-01-01

    El presente trabajo consta de tres capítulos, cada uno de ellos dedicado a una forma particular de generalizar la entropía. En el capítulo 2 se consideran familias dependientes de un parámetro y se muestran resultados acerca de su invarianza y otras propiedades. Se pondrá especial énfasis en analizar si los miembros de la familia proveen nueva información. La respuesta en el caso ergódico es negativa. Esta afirmación, como veremos, no contradice los resultados de la literatura físi...

  14. Processo de formação esportiva

    OpenAIRE

    Folle,Alexandra

    2014-01-01

    Tese (doutorado) - Universidade Federal de Santa Catarina, Centro de Desportos, Programa de Pós-Graduação em Educação Física, Florianópolis, 2014. O objetivo deste estudo foi analisar o processo de formação esportiva em ambiente de sucesso no desenvolvimento de talentos do basquetebol feminino. Esta investigação, pautada na Teoria Bioecológica do Desenvolvimento Humano, caracteriza-se como um estudo de caso do tipo descritivo, com abordagem qualitativa das informações. O contexto esportivo...

  15. Forma + color = significado : Percepción + conocimiento = pensamiento

    OpenAIRE

    Tapia, Andrea

    2001-01-01

    Se habla de Arquitectura, Forma, Color, Lenguaje, Percepción, Pensamiento, Semiótica, para poder ubicar este análisis en un contexto diferente, el de la "Teoría Interpretativa" de Umberto Eco. Se puede hacer esta analogía por entender que la Arquitectura es un hecho cultural, que comunica, por ende susceptible de interpretación. Para ello se desarrolla una metodología con la introducción de instrumentos semióticos. El Lenguaje es, como en una poesía, el flujo vital que guí...

  16. Las formas de enajenación en Marcuse

    OpenAIRE

    Jaimes Cienfuegos, Javier

    2016-01-01

    El objetivo del presente trabajo es establecer un proceso analítico y sintético de los estados de enajenación expresados en la obra de Herbert Marcuse. Permitiendo entender el concepto de dominación en el hombre del siglo XX al igual las nuevas formas de control que traen como consecuencia sociedades sin oposición y critica. Realizar una comparativa de los conceptos de enajenación y represión que se expresan en la obra de Marcuse con base en los autores Marx y Freud. Es nece...

  17. Impacto de la craniectomía descompresiva precoz en los resultados del tratamiento del trauma craneoencefálico grave

    Directory of Open Access Journals (Sweden)

    Henry Lopez Jimenez

    2016-01-01

    Full Text Available Fundamento: el trauma craneoencefálico (TCE constituye la primera causa de muerte y morbilidad en personas jóvenes. Actualmente es difícil conocer el real rendimiento de las craniectomías descompresivas y, el momento oportuno no está definido con claridad, especialmente en pacientes que han sufrido traumatismo craneoencefálico.Objetivo: evaluar el impacto de la craniectomía descompresiva precoz en el control de la presión intracraneal (PIC, la calidad de vida, y la mortalidad en los pacientes con trauma craneoencefálico grave, atendidos en el Hospital General Docente “Dr. Ernesto Guevara de la Serna”, en la provincia de Las Tunas, en el período comprendido entre enero de 2008 y diciembre de 2013.Métodos: se realizó un estudio analítico, longitudinal y prospectivo, en el referido hospital y período de tiempo. La investigación tuvo dos momentos, el primero del 2008 al 2011 con 202 pacientes y el segundo del 2012 al 2013 con 38 pacientes. El grupo I, de estudio, constituido por 120 casos, al que se les ofreció una Craniectomía Descompresiva como tratamiento inicial. El grupo II, control, estuvo formado por 120 pacientes que recibieron tratamiento convencional inicialmente.Resultados: en el grupo de estudio predominaron cifras de presión intracraneal por debajo de 20 mmHg (72,5%, fallecidos (17,5%, las secuelas moderadas (40,83% y la buena recuperación funcional (18,3%. En el grupo de control predominaron valores de presión intracraneal por encima de 20 mmHg, los fallecidos (35% y las secuelas graves (41,6%. El tratamiento quirúrgico precoz no tuvo un impacto significativo en la mortalidad de los pacientes.Conclusiones: la craniectomía descompresiva precoz fue eficaz para el control de la presión intracraneal (PIC, se mejoró la calidad de vida de los pacientes, y la técnica quirúrgica realizada de forma precoz no influyó en la mortalidad de los pacientes.

  18. PREGO (presentation of Graves' orbitopathy) study: changes in referral patterns to European Group On Graves' Orbitopathy (EUGOGO) centres over the period from 2000 to 2012.

    Science.gov (United States)

    Perros, Petros; Žarković, Miloš; Azzolini, Claudio; Ayvaz, Göksun; Baldeschi, Lelio; Bartalena, Luigi; Boschi, Antonella; Bournaud, Claire; Brix, Thomas Heiberg; Covelli, Danila; Ćirić, Slavica; Daumerie, Chantal; Eckstein, Anja; Fichter, Nicole; Führer, Dagmar; Hegedüs, Laszlo; Kahaly, George J; Konuk, Onur; Lareida, Jürg; Lazarus, John; Leo, Marenza; Mathiopoulou, Lemonia; Menconi, Francesca; Morris, Daniel; Okosieme, Onyebuchi; Orgiazzi, Jaques; Pitz, Susanne; Salvi, Mario; Vardanian-Vartin, Cristina; Wiersinga, Wilmar; Bernard, Martine; Clarke, Lucy; Currò, Nicola; Dayan, Colin; Dickinson, Jane; Knežević, Miroslav; Lane, Carol; Marcocci, Claudio; Marinò, Michele; Möller, Lars; Nardi, Marco; Neoh, Christopher; Pearce, Simon; von Arx, George; Törüner, Fosun Baloş

    2015-11-01

    The epidemiology of Graves' orbitopathy (GO) may be changing. The aim of the study was to identify trends in presentation of GO to tertiary centres and initial management over time. Prospective observational study of European Group On Graves' Orbitopathy (EUGOGO) centres. All new referrals with a diagnosis of GO over a 4-month period in 2012 were included. Clinical and demographic characteristics, referral timelines and initial decisions about management were recorded. The data were compared with a similar EUGOGO survey performed in 2000. The demographic characteristics of 269 patients studied in 2012 were similar to those collected in the year 2000, including smoking rates (40.0% vs 40.2%). Mild (60.5% vs 41.2%, p<0.01) and inactive GO (63.2% vs 39.9%, p<0.01) were more prevalent in 2012. The times from diagnosis of thyroid disease to being seen in EUGOGO centres (6 vs 16 months) and from first symptoms of GO (9 vs 16 months) or from diagnosis of GO (6 vs 12 months) to first consultation in EUGOGO centres were shorter in 2012 (p<0.01). The initial management plans for GO were no different except surgical treatments for patients with mild inactive disease were more frequently offered in the 2012 cohort than in 2000 (27.3% vs 17%, p<0.05), and selenium supplements were offered only in the 2012 cohort (21.2% vs 0%, p<0.01). These findings suggest that the clinical manifestations of patients with GO may be changing over time in Europe. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  19. Persistent remission of Graves` disease or evolution from Graves' disease to Hashimoto's thyroiditis in childhood - a report of 6 cases and clinical implications.

    Science.gov (United States)

    Smyczńyska, Joanna; Cyniak-Magierska, Anna; Stasiak, Magdalena; Karbownik-Lewińska, Małgorzata; Lewiński, Andrzej

    2014-01-01

    The main clinical manifestations of autoimmune thyroid diseases are Graves' disease (GD) and Hashimoto's thyroiditis (HT). Graves' disease is the cause of most cases of hyperthyroidism in childhood. Indications for radical therapy (surgery or 131I treatment) in children are still a matter of discussion, as sustained (sometimes very long) remission of GD is possible, while the radical therapy almost always leads to hypothyroidism. Spontaneous evolution from GD with hyperthyroidism to HT with hypothyroidism may also be observed. The aim of the study was to analyze the clinical course of 6 cases of hyperthyroid girls with GD in whom a normalization of previously increased autoantibodies against thyrotropin (TSH) receptor (anti-TSHR) was observed together with a significant increase in autoantibodies against thyroid peroxidase (anti-TPO) and thyroglobulin (anti-Tg), with concomitant hypo- or euthyroidism but no recurrence of hyperthyroidism. Patients' age at diagnosis ranged from 5.0 to 16.5 years. Two (2) patients had Turner syndrome, another one (1), diabetic, was on insulin therapy. In all the girls, antithyroid drugs were administered and euthyroid state was achieved during the first 2.0-3.5 months of the treatment. Mild side effects were observed in only one case. The therapy was continued up to 1.5-4.0 years. Relapses during the therapy were observed in 2 cases. Up to now, no relapses have been observed for 0.5-7.5 years since the therapy withdrawal in 5 patients (1 patient was lost to follow-up), 2 patients are currently treated with levothyroxine due to hypothyroidism. It seems that the prolonged pharmacotherapy with antithyroid drugs, followed by observation after remission of hyperthyroidism, may be an appropriate therapeutic option at least in some children with GD as they can be cured without radical therapy and the potential risks of such treatment.

  20. Occurrence of Type 1 Diabetes in Graves' Disease Patients Who Are Positive for Antiglutamic Acid Decarboxylase Antibodies: An 8-Year Followup Study

    Directory of Open Access Journals (Sweden)

    Matsuo Taniyama

    2011-01-01

    Full Text Available Glutamic acid decarboxylase antibodies (GADAs are one of the markers of islet cell autoimmunity and are sometimes present before the onset of type 1 diabetes (T1D. GADA can be present in Graves' patients without diabetes; however, the outcome of GADA-positive Graves' patients is not fully understood, and the predictive value of GADA for the development of T1D in Graves' patients remains to be clarified. We investigated the prevalence of GADA in 158 patients with Graves' disease and detected GADA in 10 patients. They were followed up to discover whether or not T1D developed. In the course of eight years, 2 patients with high titers of GADA developed T1D, both had long-standing antithyroid drug-resistant Graves' disease. Thus, Graves' disease with high GADA titer seems to be at high risk for T1D.

  1. Hermenéutica de una filosofia de las formas simbólicas

    OpenAIRE

    Mario Ariel González Porta

    2010-01-01

     Resumo: Nesta exposiçáo proponho efetuar uma apresentaçáo dos problemas interpretativos fundamentais e das diferentes leituras que se tem realizado em relaçáo à filosofia das formas simbólicas cassireriana. Palabvas chaves: Cassirer. Filosofia das formas simbólicas. Formas simbólicas

  2. Common genetic variants associated with thyroid function may be risk alleles for Hashimoto's disease and Graves' disease.

    Science.gov (United States)

    Campbell, Purdey; Brix, Thomas H; Wilson, Scott G; Ward, Lynley C; Hui, Jennie; Beilby, John P; Hegedüs, Laszlo; Walsh, John P

    2015-02-14

    Recent studies have identified common genetic variants associated with TSH, free T4 and thyroid peroxidase antibodies, but it is unclear whether these differ between patients with Hashimoto's disease and Graves' disease. To examine whether 11 common genetic variants differ between Graves' disease and Hashimoto's disease. We genotyped 11 common variants in a discovery cohort of 203 Australian patients with autoimmune thyroid disease (AITD). Two variants with significant or suggestive associations were analysed in a replication cohort of 384 Danish patients. For rs753760 (PDE10A), the minor allele frequency in Graves' disease and Hashimoto's disease was 0·38 vs. 0·23, respectively, (P = 6·42 × 10(-4) ) in the discovery cohort, 0·29 vs. 0·24 (P = 0·147) in the replication cohort and 0·32 vs. 0·24 in combined analysis (P = 0·0021; all analyses adjusted for sex). In healthy controls from Busselton, the frequency was 0·29, significantly different from Hashimoto's disease but not Graves' disease. For rs4889009 (MAF gene region), the frequency of the minor G-allele in Graves' disease and Hashimoto's disease was 0·48 vs. 0·36 (P = 0·0156) in the discovery cohort, 0·48 vs. 0·34 (P = 1·83 × 10(-4) ) in the replication cohort and 0·48 vs. 0·35 in the combined analysis (P = 7·53 × 10(-6) ); in controls, the frequency was 0·38, significantly different from Graves' disease but not Hashimoto's disease. After further adjustment for smoking, associations with rs4889009 remained significant, whereas those with rs753760 were not. Common variants in PDE10A and MAF gene regions may influence whether patients with AITD develop Graves' disease or Hashimoto's disease. © 2015 John Wiley & Sons Ltd.

  3. Repertorio de formas imaginarias de lidiar con la urbe

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    Luis Campos Medina

    2016-10-01

    Full Text Available Mediante el análisis temático de un conjunto de microrrelatos publicados por el concurso literario “Santiago en 100 palabras”, realizado en Santiago de Chile desde 2001, en este artículo abordamos las maneras en que los habitantes de la ciudad hacen frente a la vida urbana contemporánea. La idea de lidiar con la urbe resulta propicia para describir la relación problemática que mantienen los urbanitas con su ciudad y la noción de repertorio posibilita una comprensión de conjunto de las distintas expresiones que esta experiencia adopta. Como conclusión proponemos, primero, que las formas de lidiar con la urbe adoptan tres modos típicos en los microrrelatos. Segundo, que los microrrelatos dejan ver una secuencia causal en la manera como se experimentan subjetivamente los problemas de la vida urbana. Tercero, que la producción de representaciones e imaginarios urbanos adopta una forma agregativa que parece plausible extrapolar a otros ámbitos.

  4. A formação humana em debate

    Directory of Open Access Journals (Sweden)

    Sandra Soares Della Fonte

    2014-06-01

    Full Text Available Este artigo aborda a questão da formação humana a partir do conflito entre formulações educacionais pós-críticas e críticas. De modo mais preciso, problematiza a perspectiva de formação humana das teorizações educacionais pós-críticas, ao mesmo tempo em que sinaliza um possível caminho a ser explorado e desenvolvido pela pedagogia histórico-crítica no enfrentamento das limitações que lhe são impostas. Conclui que a compreensão de omnilateralidade em Marx pode contribuir para inspirar formulações pedagógicas críticas na consolidação de uma concepção humana que supere, de um lado, tendências racionalistas ou cognitivistas e, de outro, perspectivas estetizantes.

  5. TEMPORAL RELATIONSHIP BETWEEN THE ONSET OF THYROID DERMOPATHY AND GRAVES' OPHTHALMOPATHY

    Directory of Open Access Journals (Sweden)

    Mohammad Pajhouhi

    1993-06-01

    Full Text Available Pretibial myxedema is an uncommon manifestation of Graves' disease and because of its rarity, information regarding its natural course and its relationship with other manifestations of Graves' disease is not sufficient."nWe reviewed 150 consecutive cases diagnosed as having pretibial myxedema in a twenty-year period in a tertiary care center. Only one patient in this group did not have ophthalmopathy, and the majority of cases had significant proptosis and ophthalmopathy, 30% required orbital decompression surgery. Dermopathy is a late manifestation of the Graves' disease and its onset is usually after the diagnosis of hyperthyroidism and ophthalmopathy. In a few patients, dermopathy preceded diagnosis of hyperthyroidism or the onset of ophthalmopathy. Fourteen patients have never had hyperthyroid, eleven patients in this group had developed spontaneous hypothyroidism."nAll cases showed the involvement of the lower extremities, and only one patient showed to have combined upper and lower extremities involvement. The most common form of thyroid dermopathy was non-pitting edema. Nodular and plaque forms were also relatively common and occurred with equal frequency. Polypoid form occurred in one patient and elephantiatic form in another. There was no consistent correlation among different types of dermopathy and severity of eye disease."nDuring a three-month to nineteen-year follow up in 120 patients, complete remission was observed only in twelve patients. Partial remission was more common and occurred more frequently in patients who had local steroid therapy. it is possible that patients with remission might have been excluded of the follow up program.Thus, the remission data should be interpreted cautiously.

  6. POTENTIALLY GRAVE GASTRO-INTESTINAL TRACT PROBLEMS IN PREGNANCY - A CHALLENGE TO THE OBSTETRICIAN!

    Directory of Open Access Journals (Sweden)

    Chaitra

    2016-02-01

    Full Text Available CONTEXT Acute surgical pathology may be overlooked in pregnancy. Despite advances in medical technology, preoperative diagnosis of potentially grave pathologies of the gastrointestinal tract (GIT is often delayed due to overlap with symptoms of pregnancy non-specific elevation of some laboratory parameters due to pregnancy and a dilemma for obstetricians and surgeons in ordering radiological imaging modalities given the risk associated with fetal exposure to ionizing radiation and contrast. AIMS The aim of this study is to analyse the cases of gastrointestinal tract problems encountered in pregnancy so that increasing awareness can be created among obstetricians. This is important because early diagnosis and timely intervention can significantly improve maternal and fetal outcome in these cases. SETTINGS AND DESIGN There is a retrospective case study of potentially grave GIT problems encountered at Vanivilas hospital, Bangalore, a tertiary referral institute wherein the clinical presentation was confounded by pregnancy. MATERIALS AND METHODS All the included cases were analysed for age of the patient, pre-existing gastrointestinal tract disorders, gestational age at diagnosis, maternal and fetal outcome. RESULTS A total of 8 cases of GIT problems in pregnancy were studied. Though acute appendicitis is the most common cause of GIT emergency in pregnancy as quoted in literature 5, we did not encounter any case of acute appendicitis in pregnancy in the study period. Other conditions which were encountered were small bowel obstruction, stomach and bowel perforation and bleeding oesophageal varices. Whilst few of the conditions could be managed conservatively without harm to the pregnancy, others required a laparotomy and reparative procedures. Delay in diagnosis and intervention proved to be fatal in some of these women. CONCLUSIONS Knowledge about potentially grave gastrointestinal tract problems during pregnancy, high index of clinical suspicion

  7. Current perspectives on the role of orbital fibroblasts in the pathogenesis of Graves' ophthalmopathy.

    Science.gov (United States)

    Dik, Willem A; Virakul, Sita; van Steensel, Leendert

    2016-01-01

    Graves' ophthalmopathy (GO) is an extra-thyroidal complication of Graves' disease (GD; Graves' hyperthyroidism) characterized by orbital tissue inflammation, expansion, remodeling and fibrosis. Although the initiating trigger of GO is still indistinct, excessive orbital fibroblast activity is at the heart of its pathogenesis. Orbital fibroblasts are activated by cellular interactions with immune cells and the soluble factors they secrete. Orbital fibroblasts, especially from GO patients, express the thyrotropin receptor (TSH-receptor; TSHR), and activation of the orbital fibroblast population by stimulatory autoantibodies directed against the TSHR may provide an important link between GD and GO. Furthermore, stimulatory autoantibodies directed against the insulin-like growth factor-1 receptor have been proposed to contribute to orbital fibroblast activation in GO. Activated orbital fibroblasts produce inflammatory mediators thereby contributing to the orbital inflammatory process in GO. Moreover, orbital fibroblasts exhibit robust proliferative activity and extracellular matrix (especially hyaluronan) synthesizing capacity and can differentiate into adipocytes and myofibroblasts with disease progression, thereby contributing to tissue expansion/remodeling and fibrosis in GO. Orbital fibroblasts, especially those from GO patients, exhibit a hyper-responsive phenotype when compared to fibroblasts from other anatomical regions, which may further contribute to GO pathogenesis. Fibrocytes have been identified as additional source of orbital fibroblasts in GO, where they may contribute to orbital tissue inflammation, adipogenesis and remodeling/fibrosis. This review addresses our current view on the role that orbital fibroblasts fulfill in GO pathogenesis and both established as well as less established not fully crystallized concepts that need future studies will be discussed.

  8. Use of corticosteroids to prevent progression of Graves' ophthalmopathy after radioiodine therapy for hyperthyroidism

    Energy Technology Data Exchange (ETDEWEB)

    Bartalena, L.; Marcocci, C.; Bogazzi, F.; Panicucci, M.; Lepri, A.; Pinchera, A. (Univ. of Pisa (Italy))

    1989-11-16

    We studied the effects of radioiodine treatment of hyperthyroidism due to Graves' disease on Graves' ophthalmopathy and the possible protective role of corticosteroids. Between June 1985 and June 1988, 26 patients were randomly assigned to treatment with radioiodine alone (group 1) and 26 to treatment with this agent and concomitant administration of systemic prednisone for four months (group 2). The initial dose of prednisone was 0.4 to 0.5 mg per kilogram of body weight for one month; the drug was gradually withdrawn over the next three months. All patients were evaluated at 3-month intervals for 18 months after they underwent radioiodine therapy. Ocular changes were assessed with the ophthalmopathy index; patients with moderate-to-severe changes (scores greater than or equal to 4) were excluded from the study. Before treatment, 10 patients in group 1 and 5 in group 2 had no evidence of ophthalmopathy: in none of them did ocular symptoms appear after radioiodine therapy. Among the patients in group 1 with an initial ophthalmopathy index greater than or equal to 1, ocular disease worsened in 56 percent (mostly involving soft-tissue changes and extraocular-muscle function) and did not change in 44 percent. In contrast, ophthalmopathy improved in 52 percent and did not change in 48 percent of group 2. The mean ophthalmopathy index increased from 1.5 to 3.0 in group 1 (P less than 0.005) and decreased from 2.2 to 1.3 in group 2 (P less than 0.05). We conclude that systemic corticosteroid treatment prevents the exacerbations of Graves' ophthalmopathy that occur after radioiodine therapy in a substantial proportion of patients with hyperthyroidism who have some degree of ocular involvement before treatment.

  9. Discordant hypothyroxinemia and hypertriiodothyroninemia in treated patients with hyperthyroid Graves' disease

    Energy Technology Data Exchange (ETDEWEB)

    Chen, J.J.; Ladenson, P.W.

    1986-07-01

    Hypothyroxinemia and hypertriiodothyroninemia may occur in the course of antithyroid drug or /sup 131/I treatment for hyperthyroid Graves' disease. To determine the frequency of combined high serum T3 and low serum T4 concentrations during such treatment and to assess the clinical significance of its recognition, we reviewed 60 patients treated for hyperthyroid Graves' disease with antithyroid drugs (n = 43) or radioactive iodine (n = 17). Six of these patients (10%) were found to have high serum T3 and low serum T4 concentrations during therapy. Four were receiving antithyroid drugs, and 2 had received radioactive iodine. At the time this abnormality occurred, 4 patients were euthyroid, 1 was hypothyroid, and 1 was hyperthyroid. The serum TSH concentration was increased in 2, at the upper limit of normal in 1, and undetectable in 3 patients. After discontinuation or reduction in the dose of antithyroid drug, clinical and chemical euthyroidism was restored in 2 additional patients with previously elevated TSH levels. In 2 patients, both of whom previously had undetectable serum TSH levels, clinical hyperthyroidism persisted or recurred, and additional therapy was required. No patient developed permanent hypothyroidism during the period of follow-up (1-22 months). An additional 19 of the 60 patients (32%) had an elevated serum T3 level with a normal serum T4 concentration during the course of follow-up. Among the 19 patients, the magnitude of serum T3 elevation was not different between clinically euthyroid (n = 13) and hyperthyroid (n = 6) patients. We conclude that discordance of serum T4 and T3 concentrations is frequently encountered in patients with hyperthyroid Graves' disease during or after therapy. The low serum T4 level does not predict hypothyroidism, nor does a high serum T3 level predict hyperthyroidism.

  10. Incorporación de situaciones de aprendizaje auténtico en la clase magistral : incidencias metodológicas e impacto en la motivación para aprender. Valoración de la experiencia docente en la asignatura "Psicología evolutiva y de la educación"

    OpenAIRE

    Álvarez Valdivia, Ibis Marlene

    2006-01-01

    El objetivo de esta comunicación es comentar los fundamentos y el impacto de cambios introducidos en el diseño de las actividades docentes de la asignatura “Psicología Evolutiva y de la Educación” para estudiantes de la licenciatura en Pedagogía (UAB), a propósito de dificultades encontradas para conseguir la motivación de los estudiantes en la clase magistral. Las innovaciones docentes se refieren a procedimientos de la enseñanza activa, con énfasis en la creación de experiencias de aprendiz...

  11. Samantha Matthews. Poetical Remains – Poets’ Graves, Bodies, and Books in the Nineteenth Century

    Directory of Open Access Journals (Sweden)

    Marc PORÉE

    2005-10-01

    Full Text Available What is left of poets after they have passed away? Graves and books, answers Samantha Matthews in Poetical Remains, a study which capitalizes on body-oriented essays, while threatening to drive the trend into the ground, since it offers the ultimate take on poets—viewing them as terminal cases, but assessing their books as open-ended. The work purports to examine what it views as the particular affinity between poets' physical and literary “remains” in the Romantic to late Victorian period. B...

  12. Peritonitis secondary to ruptured splenic abscess:A grave complication of typhoid fever

    Institute of Scientific and Technical Information of China (English)

    Peter George; Ashfaq Ahmed; Roshan Maroli; Leo Francis Tauro

    2012-01-01

    Splenic abscesses are increasingly being identified, possibly due to widespread use of imaging modalities in clinical practice. The commonest clinical features are high grade fever and exclusively localised left upper quadrant abdominal pain. These symptoms are similar to most infectious diseases prevalent in the tropics, making imaging by ultrasonography or computer tomography a necessity in the diagnosis. There are reports from different geographic areas on splenic abscesses associated with typhoid fever. We reported ruptured splenic abscess presenting with peritonitis as a rare and grave complication of typhoid fever.

  13. The impact of graves' disease and its treatment on handwriting characteristics

    DEFF Research Database (Denmark)

    Papi, Giampaolo; Botti, Cristina; Corsello, Salvatore Maria

    2014-01-01

    handwriting, although this has not been studied yet. The aim of this study was to evaluate handwriting characteristics before and after therapy for hyperthyroid Graves' disease (GD). METHODS: Twenty-two patients (15 women, 7 men) with untreated GD (median age: 44 years; range: 20-70 years) were asked to write...... observation. Graphological examination showed statistically significant changes after patients become euthyroid, in the following parameters: size of letters (4.5±1.1 vs. 5.9±1.3 mm; p

  14. Walter Miles, Pop Warner, B. C. Graves, and the psychology of football.

    Science.gov (United States)

    Baugh, Frank G; Benjamin, Ludy T

    2006-01-01

    In 1926-1927, a graduate student, B. C. Graves, working with Stanford University psychologist Walter Miles and legendary football coach Pop Warner, conducted an investigation of variations in signal calling as they affected the charging times of football players. The study was one of two that involved Miles and the ingenious multiple chronograph that he had invented to time the reactions of seven players simultaneously. These studies represented a brief digression in the career of Miles, who certainly was no sport psychologist. They tell of an interesting collaboration between scientist and coaches that produced one of the richest studies in sport psychology in the first half of the twentieth century.

  15. Tratamento cirúrgico da laringomalácia grave: estudo retrospectivo de 11 casos

    OpenAIRE

    2013-01-01

    A laringomalácia é a anomalia congênita da laringe mais frequente, sendo responsável por cerca de 60% a 75% dos casos de estridor congênito. Apesar de seu curso benigno e autolimitado, 10% dos casos necessitam de intervenção. Atualmente, as supraglotoplastias são consideradas o tratamento padrão da laringomalácia grave. OBJETIVO: Descrever a experiência adquirida pelos autores no tratamento cirúrgico dos pacientes com laringomalá...

  16. A female burial with grave goods at the Roman villa of Almenara de Adaja (Valladolid

    Directory of Open Access Journals (Sweden)

    C. GARCÍA MERINO

    2012-03-01

    Full Text Available Recent works in an area placed North from the pars urbana of the late imperial roman villa at Almenara de Adaja (Valladolid, Spain have uncovered a female burial with grave goods. These finds suggest the likely situation of a necropolis corresponding to the villa lifetime period. We study the artifacts found in the burial. Results of an analysis on the content of a ceramic vessel found there are also given. This finding complements the available data on the distribution and organization of contemporary habitat and adds up to the known information on cemeteries dating from this time period in the Spanish north inner plateau.

  17. Complicaciones hemorrágicas graves en las gestantes quirúrgicas

    OpenAIRE

    Yamila Zayas Nápoles; Dunior Peláez Rodríguez; Miladis Justo Hernández; Leticia Fernández Álvarez; Marjuris Arias Pérez

    2015-01-01

    Las hemorragias obstétricas ocurren aproximadamente en un tres a un cinco porciento de los embarazos y son responsables del 75 % de las complicaciones durante la gestación y del 25 % de la mortalidad materna. Se realizó un estudio descriptivo de corte transversal en 58 pacientes ingresadas en la Unidad de Cuidados Intensivos del Hospital General Docente “Dr. Ernesto Guevara de la Serna”, con el diagnóstico de hemorragia obstétrica grave; en el período de enero de 2010 a abril de 2013, con el ...

  18. Tratamiento quirúrgico del estrabismo en la enfermedad de graves

    OpenAIRE

    Iván Villaseca, C.

    2010-01-01

    El estrabismo en la Oftalmopatía (Orbitopatía) de Graves se origina en la fibrosis post inflamatoria de uno o varios músculos, en uno o ambos ojos. Esto provoca un desalineamiento de los ejes visuales con diplopia que puede llegar a ser invalidante. Los músculos más frecuentemente comprometidos son los Rectos Inferiores y Medios. Algunos pacientes compensan su diplopia con posiciones anómalas de la cabeza. La cirugía se plantea en la etapa inactiva de la inflamación orbitaria, con ángulos est...

  19. Coincidence of remission of postpartum Graves' disease and use of omega-3 fatty acid supplements

    Directory of Open Access Journals (Sweden)

    Breese McCoy Sarah J

    2011-11-01

    Full Text Available Abstract I developed Graves' Disease four months postpartum. After one year on propylthiouracil, I learned that omega-3 fatty acids may reduce inflammation associated with certain autoimmune disorders, although no investigations for thyroiditis have been reported. Within eight weeks of beginning flaxseed oil supplements, TSH levels normalized, but fell somewhat when flaxseed was decreased and PTU discontinued. During another pregnancy, plasma TSH normalized, but was again suppressed by four weeks postpartum, then undetectable by four months. This time, flaxseed supplementation alone coincided with TSH normalization. Omega-3 fatty acids should be investigated as a potential treatment for autoimmune thyroid disease.

  20. Progressive bilateral ophthalmoparesis--a case of simultaneous autoimmunity: balancing Graves' ophthalmoparesis and ocular myasthenia.

    Science.gov (United States)

    Canepa, Carlo; Venu, Maya

    2016-01-04

    A 44-year-old woman with no medical history presented with a 1-year history of horizontal diplopia, bilateral exophthalmos and progressive asymmetrical ophthalmoparesis, with no pupillary dysfunction or ptosis. Within 3 months of her initial presentation, she noticed paresis of right eye abduction, followed after 1 month with paresis of left eye abduction. Initial investigations revealed positive antiperoxidase antibodies for Graves' disease and positive AChR for myasthenia gravis. MRI of the brain showed increased intensity in bilateral inferior rectus muscles and CT of the chest showed thymic hyperplasia. Treatment with carbimazole and pyridostigmine was started, with complete resolution after 1 month.

  1. Peritonitis secondary to ruptured splenic abscess: a grave complication of typhoid fever.

    Science.gov (United States)

    George, Peter; Ahmed, Ashfaq; Maroli, Roshan; Tauro, Leo Francis

    2012-12-01

    Splenic abscesses are increasingly being identified, possibly due to widespread use of imaging modalities in clinical practice. The commonest clinical features are high grade fever and exclusively localised left upper quadrant abdominal pain. These symptoms are similar to most infectious diseases prevalent in the tropics, making imaging by ultrasonography or computer tomography a necessity in the diagnosis. There are reports from different geographic areas on splenic abscesses associated with typhoid fever. We reported ruptured splenic abscess presenting with peritonitis as a rare and grave complication of typhoid fever.

  2. Avaliação e tratamento da hiperglicemia em pacientes graves

    OpenAIRE

    Marina Verçoza Viana; Rafael Barberena Moraes; Amanda Rodrigues Fabbrin; Manoella Freitas Santos; Fernando Gerchman

    2014-01-01

    A hiperglicemia é um problema frequentemente encontrado em pacientes graves em ambiente de terapia intensiva. Sua presença se associa ao aumento da morbidade e da mortalidade, independentemente da causa da admissão (infarto agudo do miocárdio, condição após cirurgia cardiovascular, acidente vascular cerebral e sepse). Entretanto, permanecem muitas dúvidas com relação à fisiopatologia e, particularmente, em relação ao tratamento ...

  3. Pathogenesis of Graves disease%Graves病的发病机制

    Institute of Scientific and Technical Information of China (English)

    王曙; 郭华

    2010-01-01

    @@ Graves病(Graves disease,GD)是一种器官特异性自身免疫病,与桥本甲状腺炎(Hashimoto thyroiditis,HT)同属自身免疫性甲状腺疾病(autoimmune thyroid disease,AITD).其患病率约为1%-2%[1].患者主要临床表现为高代谢综合征,部分患者可以出现甲状腺相关眼病(thyroid associated ophthalmopathy,TAO)、胫前黏液性水肿和(或)肝脏损害.

  4. Association of the thyroid stimulating hormone receptor gene (TSHR) with Graves' disease

    DEFF Research Database (Denmark)

    Brand, Oliver J; Barrett, Jeffrey C; Simmonds, Matthew J;

    2009-01-01

    Graves' disease (GD) is a common autoimmune disease (AID) that shares many of its susceptibility loci with other AIDs. The thyroid stimulating hormone receptor (TSHR) represents the primary autoantigen in GD, in which autoantibodies bind to the receptor and mimic its ligand, thyroid stimulating...... hormone, causing the characteristic clinical phenotype. Although early studies investigating the TSHR and GD proved inconclusive, more recently we provided convincing evidence for association of the TSHR region with disease. In the current study, we investigated a combined panel of 98 SNPs, including 70...

  5. Manejo quirúrgico de la orbitopatía de graves

    OpenAIRE

    Rodrigo Poblete, S.

    2010-01-01

    La Enfermedad de Graves corresponde a un síndrome que comprende: bocio hipertiroídeo habitualmente, oftalmopatía asociada a la tiroides y dermatopatía. No se cuenta con estadísticas nacionales, sin embargo la mayoría de los estudios internacionales muestran una frecuencia mayor en la mujer. Desde el punto de vista del manejo quirúrgico de esta enfermedad, éste se basa en tres etapas fundamentales: descompresión orbitaria, cirugía de los músculos extraoculares y finalmente la cirugía de reposi...

  6. Induction of animal model of Graves disease in BALB/c mice

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    Objective To construct an animal model of Graves' disease(GD)by immunizing BALB/c mice with hM12 cells co-expressing major histocompatibility complex(MHC)class II molecules and human thyrotropin receptor(TSHR)molecules.Methods BALB/c mice in experimental group(H-2d)were immunized with hM12 cells intraperitoneally every 2 weeks for six times,while mice in control group were immunized with M12 cells.Five weeks later,the thyroids were histologically examined,and serum samples were tested for thyroid-stimulatin...

  7. Traumatismo materno grave y cirugía múltiple con resultado perinatal exitoso

    OpenAIRE

    Hasbun H,Jorge; Benitez S,Susana; Cornejo R,Rodrigo; Asencio C,Ramón; Navarro A,José Luis; DANILLA E,STEFAN

    2011-01-01

    El traumatismo mayor de la embarazada es frecuente, tiene riesgo de muerte y agrega a sus complicaciones propias, las generadas por el embarazo como prematurez, desprendimiento placentario y daño perinatal. Presentamos el caso de una embarazada de 27 semanas, con traumatismo grave por atropello, fracturas óseas y desforramiento extenso de extremidad inferior derecha, que fue sometida a tratamiento quirúrgico con reducción y corrección de luxofracturas, aseo e injertos cutáneos. Se complica co...

  8. Estudo dos linfócitos circulantes por anticorpos monoclonais na miastenia grave

    Directory of Open Access Journals (Sweden)

    Paulo E. Marchiori

    1988-09-01

    Full Text Available Os autores avaliam os linfócitos T (CD3, CD4, CD8, CD4/8 por anticorpos monoclonais e rosácea em 20 pacientes e linfócitos B por Fab' por imunofluorescência em 9 pacientes com miastenia grave. Observam elevação significante na população de linfócito B e redução nos linfócitos T totais CD3+ por rosáceas. Não foram observadas modificações nas subpopulações celulares com timectomia e corticosteróides.

  9. Factores pronósticos en el traumatismo craneoencefálico grave

    OpenAIRE

    José Purón-Barrera; Elizabeth Reyes-Ramírez; Andrés Andrés-Matos; Alberto Piriz-Assa

    2011-01-01

    Se señalaron los factores relacionados con la mortalidad del trauma craneoencefálico grave y que pueden influir sobre su pronóstico. La presencia de puntuación en la Escala de Glasgow ¿ 8, hiperglicemia, shock, necesidad de ventilación mecánica, alteraciones pupilares y múltiples lesiones en la tomografía axial computarizada (TAC) entre las cuales siempre estuvo asociado el hematoma subdural concuerda con lo referido por otros estudios. El hallazgo de hipernatremia tuvo alta significación est...

  10. Systemic adverse events following rituximab therapy in patients with Graves' disease

    DEFF Research Database (Denmark)

    El Fassi, D; Nielsen, Claus Henrik; Junker, Michael Peter;

    2011-01-01

    Background and aim: Rituximab (RTX) therapy has shown promising results in Graves´ disease (GD), with or without ophthalmopathy. We examined the occurrence of adverse events in GD patients treated with RTX. Subjects and methods: Ten patients received RTX and methimazole, while ten patients received...... had the third highest increase in immunoglobulin deposition on monocytes by day 14. The arthralgias persisted in two of the patients, despite glucocorticoid rescue therapy. Conclusions: We report articular adverse events in three and gastrointestinal symptoms in two out of ten GD patients who received...

  11. Victims’ language: (noisy silences and (grave parodies to talk (unknowingly about individuals’ forced disappearance

    Directory of Open Access Journals (Sweden)

    Gabriel Gatti

    2011-07-01

    Full Text Available Based on the results of research carried out between 2005 and 2008 about social universes constructed in Argentina and Uruguay around the figure of the disappeared detainee, this piece aims to systematize several answer to one the more complex problems this repression figure bears: that of representation of facts and their consequences. This work focuses no on all possible answers, but on several of the more innovative and creative: those betting on talking about the impossibility to talk (the noisy silences, and those betting on forcing language up to its limit (grave parodies.

  12. Nutrición y anemias en pacientes graves Nutrition and anaemias in critical illness

    OpenAIRE

    2010-01-01

    Introducción: Realizamos un estudio clínico original sobre nutrición en pacientes graves, que incluye a un grupo heterogéneo típico de pacientes críticos, con/sin anemias, que nos han ingresado en la Unidad de Cuidados Intensivos, UCI. Es difícil individualizar y generalizar la relativa importancia de todos los factores que pueden contribuir a estas anemias en la admisión en la Unidad, incluyendo las deficiencias nutricionales, las alteraciones inflamatorias, la respuesta a las agresiones, la...

  13. Craniectomía descomprensiva precoz en el trauma craneoencefálico grave

    OpenAIRE

    Lacerda Gallardo, Angel Jesús

    2009-01-01

    Se realizó un estudio cuasiexperimental en pacientes con trauma craneoencefálico grave con 12 horas de evolución, cuyo objetivo fue evaluar el efecto de la craniectomía descompresiva precoz para controlar la hipertensión intracraneal asociada. Los pacientes fueron divididos en dos grupos de acuerdo al tratamiento recibido, en el Grupo I se incluyeron a los que se les realizó craniectomía descompresiva y en el Grupo II, los que recibieron el tratamiento convencional. Se estudiaron 68 casos, 45...

  14. Unidad hospitalaria de patología dual grave: un año de experiencia

    OpenAIRE

    Esfors Hernández, Jorge; Villar García, Mariano; Rubio Perlado, Begoña; Juan i Porcar, María; Romero Marmaneu, Francisca

    2014-01-01

    Se trata de un estudio observacional, descriptivo, transversal en el que se incluyeron los pacientes ingresados en la Unidad de Hospitalización del Programa de Patología Dual Grave (UHPPDG) durante un año. Los datos sociodemográficos, clínicos y farmacológicos se obtuvieron mediante hojas de recogida de datos diseñadas al efecto. El total de pacientes ingresados fue de 82 en cuyo perfil prevalecen los varones con una edad media de 36,7 años, derivados del subprograma ambulatori...

  15. Morbidade Materna Grave e Near Misses em Hospital de Referência Regional

    Directory of Open Access Journals (Sweden)

    Márcia Lait Morse

    2011-06-01

    Full Text Available OBJETIVO: Analisar perfil epidemiológico da morbidade materna grave/near miss em uma maternidade pública de referência regional, utilizando diferentes critérios identificadores. MÉTODOS: Trata-se de um estudo descritivo de corte transversal dos casos de morbidade materna grave/near miss realizado em Hospital de referência regional entre junho e outubro de 2009, identificados a partir dos livros de registro de internação da maternidade e análise dos prontuários clínicos. Foram estudadas mulheres que, durante a gestação, parto ou puerpério, apresentaram qualquer quadro clínico compatível com os critérios definidores de morbidade materna grave/near miss de Waterstone et al., Mantel et al. e Organização Mundial de Saúde. RESULTADOS: Entre as 1.544 internações foram identificadas 89 mulheres com morbidade materna grave, considerando os critérios adotados. As razões de morbidade materna grave/near miss variaram entre 81,4 a 9,4 por 1.000 NV, dependendo do critério utilizado. O índice de Mortalidade foi de 3,2%, chegando a 23% no critério da OMS. Das 89 mulheres, apenas 40% fizeram mais de seis consultas de pré-natal e 10% não realizaram qualquer consulta. Os marcadores mais encontrados foram a pré-eclâmpsia grave seguida de hemorragia grave, internação em UTI, Síndrome HELLP e eclâmpsia. Ocorreram três mortes maternas por causas obstétricas com RMM de 280/100.000 NV e uma morte tardia. O critério da OMS se mostrou mais específico, identificando os casos mais graves, enquanto o de Waterstone foi mais sensível. CONCLUSÃO: O estudo da morbidade materna grave/near miss em um hospital de referência regional pode contribuir para o conhecimento da magnitude deste evento, como também identificar suas características e condições clínicas mais frequentes, sendo extremamente importante para o enfrentamento da morbi-mortalidade materna.OBJECTIVE: To investigate severe maternal morbidity/near misses in a tertiary

  16. Enfermedad de Graves y cáncer de tiroides. Reporte de caso.

    OpenAIRE

    Manrique-Hurtado, Helard; Servicio de Endocrinología, Hospital Nacional Arzobispo Loayza. Lima.; Pinto-Valdivia, Miguel; Servicio de Endocrinología, Hospital Nacional Cayetano Heredia. Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia. Lima.; Acosta-Chacaltana, Max; Servicio de Endocrinología, Hospital Nacional Arzobispo Loayza. Lima.

    2011-01-01

    Se reporta el caso de una mujer de 62 años con antecedente de cáncer de recto curado, con Enfermedad de Graves de reciente diagnóstico. El examen físico mostró un bocio difuso y presencia de un nódulo en el polo inferior del lóbulo derecho. El perfil tiroideo mostró un TSH suprimido y hormonas tiroideas aumentadas. Los anticuerpos antitiroideos fueron negativos. La ecografía de tiroides confirmó la presencia de un nó...

  17. Valoración del Hiper e Hipotiroidismo Post operatorio en la enfermedad de graves Basedow

    OpenAIRE

    De La Fuente, Edgardo León

    2010-01-01

    Tesis Doctor en Medicina y Cirugía -- Universidad Nacional de Córdoba. Facultad de Ciencias Médicas. La enfermedad de Graves es una enfermedad autoinmune que tiene múltiples factores que la mantienen y que aún no pueden ser determinados. En este trabajo se investigo, sin haber precedentes, el factor de proliferación celular en relación a la función tiroidea post operatoria como principal objetivo de esta tesis, además de otros factores como las tiroiditis autoinmune que potencialmente podr...

  18. Comportamiento del fallo renal agudo en niños con sepsis grave Behavior of acute renal failure in children presenting with severe sepsis

    Directory of Open Access Journals (Sweden)

    María del Carmen Saura Hernández

    2010-03-01

    Full Text Available INTRODUCCIÓN. El objetivo de esta investigación fue determinar los factores de riesgo asociados al fallo renal agudo (FRA en un grupo de niños con sepsis grave atendidos entre enero del 2004 y diciembre del 2008. MÉTODOS. Se realizó un estudio observacional y analítico con una muestra de 171 pacientes. Se constituyeron dos grupos: el de estudio, integrado por 38 pacientes con estado de choque séptico o disfunción múltiple de órganos (DMO y FRA, y un grupo control, conformado por 133 niños en igual estadio de sepsis pero con función renal normal. Se revisaron las historias clínicas y se tuvieron en cuenta variables epidemiológicas, factores de riesgo de FRA y evolución de los casos. RESULTADOS. La incidencia de FRA fue del 22,2 %, y aunque disminuyó considerablemente en los 3 últimos años del estudio, la mortalidad fue del 42,1 %, mayoritariamente en el DMO (89,5 %. Se encontró dependencia entre la insuficiencia renal y la respuesta diurética no adecuada a la fluidoterapia (51,2 %, la inestabilidad hemodinámica por más de 24 h (46,5 %, la disfunción miocárdica (43,3 % y el uso de medicamentos nefrotóxicos (42,8 %. CONCLUSIONES. La respuesta diurética no adecuada a la fluidoterapia, la inestabilidad hemodinámica por más de 24 h, la disfunción miocárdica y el uso de medicamentos nefrotóxicos incrementan el riesgo de FRA en la sepsis grave, la cual duplica la mortalidad en relación con los pacientes que conservan la función renal. No obstante, la prevención de las formas graves de sepsis y un tratamiento adecuado de ésta disminuyen la incidencia de FRA.INTRODUCTION: The aim of present research was to determine the risk factor associated with the acute renal failure (ARF in a group of children with severe sepsis seen between January, 2004 and December, 2008. METHODS: An analytical and observational study was conducted in a sample including 171 patients. There were two groups: the study-group with 138 patients with

  19. A polymorphism within the vitamin D-binding protein gene is associated with Graves' disease but not with Hashimoto's thyroiditis.

    Science.gov (United States)

    Pani, Michael A; Regulla, Karoline; Segni, Maria; Hofmann, Stefan; Hüfner, Michael; Pasquino, Anna Maria; Usadel, Klaus-H; Badenhoop, Klaus

    2002-06-01

    Graves' disease and Hashimoto's thyroiditis are common autoimmune thyroid disorders. Experimentally, 1,25(OH)(2) D(3) prevents Hashimoto's thyroiditis. Vitamin D serum levels in Graves' disease were found to be significantly lower than in nonautoimmune hyperthyroidism. The polymorphic vitamin D-binding protein (DBP) greatly facilitates vitamin D actions, and DBP alleles differ regarding their affinity for 1,25(OH)(2) D(3). Therefore, we investigated polymorphisms of the DBP gene for an association with thyroid autoimmunity. Families with an offspring affected by Graves' disease (95 pedigrees) or by Hashimoto's thyroiditis (92 pedigrees) encompassing 561 individuals of Caucasian origin were genotyped for three DBP polymorphisms [(TAAA)(N) in intron 8; StyI; and HaeIII in exon 11]. Indirect haplotyping and (extended) transmission disequilibrium testing were performed. There was a significant transmission disequilibrium of the intron 8 polymorphism in patients with Graves' disease (P < 0.03) but not of the exon 11 polymorphism. In contrast, neither the intron 8 nor the exon 11 polymorphism was associated with Hashimoto's thyroiditis. Maternal and paternal transmission as well as allele frequencies in DQ2(+) and DQ2(-) patients did not differ in either disease. Therefore, allelic variants of the DBP gene confer susceptibility to Graves' disease but not to Hashimoto's thyroiditis in our population. These findings support a role of the vitamin D endocrine system in thyroid autoimmunity.

  20. Formação inicial de docentes – componente base da formação docente

    Directory of Open Access Journals (Sweden)

    Alcina Maria da Silva Mota Figueiroa

    2015-12-01

    Full Text Available Face às características da sociedade atual, a formação de cidadãos implica dotá-los de conhecimentos e capacidades que os prepararem para intervenções úteis e racionais, independentemente da profissão que venham a exercer. Neste domínio, insere-se a formação inicial de professores que, como componente base da qualificação profissional, deve preparar estes futuros profissionais para implementar práticas adequadas e inovadoras, nas aulas que virão a lecionar. A criação de uma comunidade de aprendizagem, no contexto de Prática de Ensino Supervisionada, pode contribuir para proporcionar condições favoráveis ao desempenho dos futuros docentes, assim como atualização didática e científica aos docentes já profissionalizados (orientadores cooperantes.