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Sample records for quemados muy graves

  1. Síndrome hemofagocítico secundario a infecciones graves en un quemado

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    Carolina V. Mahuad

    2013-06-01

    Full Text Available El síndrome hemofagocítico constituye una entidad infrecuente, heterogénea, subdiagnosticada, y muchas veces fatal. En los casos secundarios, los desencadenantes pueden ser numerosos, tales como infecciones, fármacos, enfermedades autoinmunes y neoplasias. El mecanismo fisiopatogénico se explica por la presencia de una función disminuida o defectuosa de células NK y linfocitos T citotóxicos, que resulta en una activación inmune inefectiva y descontrolada, conduciendo al daño celular, falla multiorgánica y proliferación macrofágica con hemofagocitosis. Existen diferentes opciones terapéuticas, mayormente combinaciones de citostáticos y esteroides, cuyo objetivo es la supresión de la respuesta inmune descontrolada. Ocasionalmente, la condición clínica de algunos pacientes con síndrome hemofagocítico impide la utilización de esquemas terapéuticos intensivos. Comunicamos el caso de un paciente quemado grave, que reúne los criterios diagnósticos de síndrome hemofagocítico, quien presentó una evolución favorable con el tratamiento combinado de esteroides e inmunoglobulinas endovenosas.

  2. Uso de homoinjertos en el quemado grave. Presentación de un caso.

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    Tatiana Hernández González

    2015-12-01

    Full Text Available El homoinjerto es en la actualidad una de las mejores cobertura de tratamiento en la especialidad de Cirugía Reconstructiva y Quemado, ya que constituye una barrera, disminuyendo la pérdida de agua, electrolitos y proteínas, reduciendo la frecuencia de las infecciones y aliviando el dolor. Con el objetivo de dar a conocer la técnica de homoinjerto a través de un caso clínico. Metodológicamente se abordó la alternativa de hacer uso de piel de las piezas de excéresis de las dermolipectomías y mastoplastias reductoras. Los resultados obtenidos fueron satisfactorios por lo que se concluye que esta estrategia resulta de gran utilidad para abastecer la amplia cobertura cutánea en grandes quemados con un costo mínimo.

  3. Una historia muy simple

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    Miha Mazzini

    2009-12-01

    Full Text Available Voy a contarles una historia muy simple. Probablemente no les parecerá nada espe- cial y no quiero robarles tiempo, así que voy a tratar de hacerlo lo más rápido posible. Me inscribí en psicología porque eso hizo mi mejor amiga. Éramos compañeras desde jardín de infantes y siempre la seguí en todo. En tercer año de facultad conoció a su novio y continuó sus estudios en otro país; por primera vez no podía seguirla. Cuando rendí todos los exámenes, el profesor me preguntó si estaba interesada en hacer mi tesis sobre el perfil psicológico de los participantes de reality shows. Accedí para no tener que pensar en otro tema, aunque no veía mucho la televisión porque me pasaba las noches entre los libros de estudio. Enseguida me di cuenta de que, evidentemente, el profesor había firmado un contrato con la emisora: a él lo empleaban y y yo era la que iba a tener que trabajar, pero no me importaba. La tesis de licenciatura no es más que eso y hay que hacerla. Yo evaluaba los candidatos y elegía a los participantes que vivirían juntos duran- te algunos meses. Como hacían el programa con una licencia extranjera y ya sabían qué le interesaba a la audiencia, yo tenía preparados los rasgos de los perfiles psicológicos que en ese aislamiento colectivo no resultan bien. Tuve que elegir gente variada, pero dentro de la media; nunca nada verdaderamente especial. Cuando me gradué, tuve las noches libres: de pronto tenía mucho más tiempo y podía haber visto el programa, pero ya había terminado. Pero oí que había sido todo un éxito y que sobre todo a los chicos les había encantado el reality y los participantes elegidos.

  4. Tendencias en el tratamiento del paciente quemado

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    Gómez Daza Bertha

    2010-01-01

    Es significativo el progreso logrado en los últimos años en la atención de los pacientes quemados, un mejor conocimiento de la fisiopatología, la utilización adecuada de los medicamentos específicos, la cirugía e injertación precoz, así como el establecimiento de técnicas y  procedimientos  apropiados, son aspectos que han logrado una notable disminución en la morbimortalidad de los pacientes quemados.

  5. Tendencias en el tratamiento del paciente quemado

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    Gómez Daza Bertha

    1995-12-01

    Full Text Available

    Es significativo el progreso logrado en los últimos años en la atención de los pacientes quemados, un mejor conocimiento de la fisiopatología, la utilización adecuada de los medicamentos específicos, la cirugía e injertación precoz, así como el establecimiento de técnicas y  procedimientos  apropiados, son aspectos que han logrado una notable disminución en la morbimortalidad de los pacientes quemados.

  6. Injuria inhalatoria en pacientes quemados: Revisión Inhalation injury in burned patient: A review

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    CESAR PEDREROS P; CRISTOBAL LONGTON B; SANDRA WHITTLE V; JORGE VILLEGAS C

    2007-01-01

    Cada año casi tres mil personas sufren quemaduras en Chile. En la población adulta se estima que este número se incrementará en los próximos años. En este grupo, cerca del 40% de las quemaduras graves se asocian a injuria inhalatoria. la injuria inhalatoria aumenta significativamente la mortalidad en los pacientes quemados. la prevalencia, fisiopatologia, cuadro clínico, manejo y pronóstico de esta patología no han sido incorporados en los estudios de pregrado de las escuelas de medicina y so...

  7. Colecistitis acalculosa en el paciente quemado

    OpenAIRE

    Granados Quesada, Ronny

    2012-01-01

    La colecistitis aguda acalculosa es una complicación rara en el paciente quemado. Es secundaria a atonía e isquemia de la vesícula biliar que evoluciona a un proceso necro- inflamatorio que habitualmente se complica con infección biliar y sepsis sistémica. Además, dicha atonía altera la composición de la bilis, lo que hace la mucosa de la vesícula más susceptible al daño. Clínicamente se manifiesta con dolor y plastrón en cuadrante superior derecho del abdomen, fiebre, leucocitosis e incremen...

  8. Análisis estadístico de la actividad integral desarrollada por la Unidad de Grandes Quemados del Hospital La Fe de Valencia.

    OpenAIRE

    2015-01-01

    Este trabajo centra su área de interés en la evaluación de los resultados y costes de la Unidad de Quemados del Hospital Universitario La Fe de Valencia entre 1969 y 2010, por medio de indicadores. Los indicadores epidemiológicos son herramientas muy útiles porque permiten medir el alcance y la evolución temporal de las quemaduras. Una dificultad para lograr indicadores epidemiológicos comparables son los diferentes enfoques metodológicos existentes, la variación producida en los medi...

  9. [Graves' ophthalmopathy].

    Science.gov (United States)

    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.

  10. Risk factors for multiple organic dysfunctions syndrome in burnt children. Factores de riesgo de síndrome de disfunción orgánica múltiple en niños quemados

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    Jorge González Mendoza

    2009-05-01

    niños quemados. Métodos: Estudio analítico, retrospectivo, de serie de casos. Se incluyeron los pacientes de 0 a 15 años, que ingresaron en la unidad de quemados del Hospital Pediátrico Universitario “Paquito González Cueto” de Cienfuegos, del 1 de enero del 2000 al 31 de diciembre del 2005 clasificados como graves, muy graves, críticos y críticos extremos. Los sistemas considerados para diagnóstico de disfunción fueron: respiratorio, cardiovascular, gastrointestinal, hepático, renal, metabólico, sistema nervioso central, hematológico, inmunológico y curación de heridas. Los datos se procesaron mediante análisis bivariado de las variables independientes en función de la dependiente, para modelar una variable respuesta del tipo aparición del síndrome o no. Se aplicó el análisis multivariado de regresión logística. Resultados: Desarrollaron el síndrome 34 niños (44,2 %, las variables con significación estadística asociadas al desarrollo de este fueron: profundidad de las lesiones, potasio sérico, creatinina en sangre, recuento leucocitario y frecuencia cardíaca. Conclusiones: Las variables de riesgo para síndrome de disfunción multiorgánico a los 5 días después de producido el trauma térmico fueron: quemaduras AB y B, potasio sérico, creatinina sérica, recuento leucocitario y frecuencia cardíaca.

  11. [Graves' ophthalmopathy].

    Science.gov (United States)

    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.

  12. Síndrome hemofagocítico secundario a infecciones graves en un quemado

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    Carolina V. Mahuad; Gonzalo M. Garate; María de los Ángeles Vicente Reparaz; Claudia Casali; Mercedes Del Olmo; Alberto Bolgiani

    2013-01-01

    El síndrome hemofagocítico constituye una entidad infrecuente, heterogénea, subdiagnosticada, y muchas veces fatal. En los casos secundarios, los desencadenantes pueden ser numerosos, tales como infecciones, fármacos, enfermedades autoinmunes y neoplasias. El mecanismo fisiopatogénico se explica por la presencia de una función disminuida o defectuosa de células NK y linfocitos T citotóxicos, que resulta en una activación inmune inefectiva y descontrolada, conduciendo al daño celular, falla mu...

  13. Conejos. Muy meritorios, pero poco reconocidos.

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    Camps Rabadà, Jaume

    2011-01-01

    Los conejos son la única especie animal doméstica de origen europeo, y además, fue formada en nuestra península, único lugar relacionado con su evolución, con la etimología del nombre de España, y con su historia, dentro del pasado. Y, ya en la actualidad, la cría de conejos es importante por su relación con la economía, tanto en la balanza import-export, como en la producción ganadera, y, sobre todo, y muy destacable, con nuestra salud nutricional. A pesar de estos “méritos”, suelen ser, en ...

  14. Injuria inhalatoria en pacientes quemados: Revisión Inhalation injury in burned patient: A review

    Directory of Open Access Journals (Sweden)

    CESAR PEDREROS P

    2007-06-01

    Full Text Available Cada año casi tres mil personas sufren quemaduras en Chile. En la población adulta se estima que este número se incrementará en los próximos años. En este grupo, cerca del 40% de las quemaduras graves se asocian a injuria inhalatoria. la injuria inhalatoria aumenta significativamente la mortalidad en los pacientes quemados. la prevalencia, fisiopatologia, cuadro clínico, manejo y pronóstico de esta patología no han sido incorporados en los estudios de pregrado de las escuelas de medicina y son temas desconocidos para la mayoría de los médicos. En el contexto de la próxima incorporación de este tipo de dolencias en el plan de garantías explícitas en la salud chilena hemos realizado una actualización del temaEvery year almost three thousand people get burned in Chile. In this group, about 40% of the critical burned patients also suffer inhalation injury. This number is expected to grow bigger among the adult population in the next few years. Inhalation injury significantly increases mortality in burned patients. The prevalence, pathophysiology, clinical characteristics, treatment, and prognosis of this pathology have not been incorporated in the undergraduate curses of Chilean medical schools. Therefore, this subject is pooly known by most of our physicians. Because this disease will be included in the explicit warranties health plan of the public health care system in Chile, we decide to write this review about this pathological condition

  15. Características del paciente quemado usuario de opioide y factores que contribuyen a depresión respiratoria

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    Mendonça Henrique, Danielle; Dopico Silva, Lolita; Maciqueira Pareira, Sandra Regina

    2016-01-01

    RESUMEN Objetivo: Describir las características de los pacientes quemados usuarios de opioides e identificar los factores que predisponen a depresión respiratoria. Método: Transversal retrospectivo, en el que se analizaron 272 historiales de pacientes quemados internados de 2011 a 2013 en un Centro de Tratamiento de Quemados (CTQ). Se seleccionaron historiales completos de pacientes, con registro relleno de alta u óbito, periodo de internamiento mínimo de 48 horas, mayores d...

  16. Ansiedad percibida por los pacientes hospitalizados por quemaduras, en una Unidad de Quemados

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    M. Alcázar-Gabás

    2014-06-01

    Full Text Available El presente trabajo, pretende describir el estado de ansiedad que experimentan los pacientes ingresados en una Unidad de Quemados. Uno de los factores clave en los cuidados del paciente quemado es una buena atención psicológica. La realidad demuestra que es el profesional de enfermería quien observa los síntomas emocionales durante los primeros días de ingreso y trata de responder a esa demanda de cuidado. Pretendemos, a través de la medición del nivel de ansiedad que perciben los pacientes ingresados en la Unidad de Quemados elegida para nuestro estudio durante el primer semestre del año 2009, identificar a aquellos que estén en riesgo de padecer mayores niveles de ansiedad durante su hospitalización, para así poder establecer un plan de cuidados adaptado a las necesidades emocionales de cada uno. Los resultados obtenidos nos permiten concluir que los pacientes quemados ingresados en la Unidad de Quemados presentaron niveles elevados de ansiedad que son superiores entre la población femenina, así como en aquellos pacientes con lesiones de mayor extensión. Determinamos también que los pacientes ingresados por quemaduras en la Unidad de Quemados a estudio fueron mayoritariamente varones, de nacionalidad española, residentes en medio urbano con una media de edad de 50 años, siendo las quemaduras producidas por llama en accidentes domésticos la causa más frecuente.

  17. Tratamiento quirúrgico de las complicaciones del shock meningocóccico grave Surgical treatment of the severe meningococcal septic shock complications

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    P. Casteleiro Roca

    2010-06-01

    Full Text Available El shock meningocóccico es una entidad relativamente frecuente y de pronóstico muy grave, que provoca fallo multiorgánico con una alta mortalidad y que precisa ingreso en Unidad de Cuidados Intensivos. En los casos grandes puede provocar necrosis de tejidos mediante una fisiopatología poco clara. En los últimos años la supervivencia de estos pacientes ha aumentado debido al diagnóstico precoz y a medidas de reanimación más agresivas. Como consecuencia encontramos un aumento del número de pacientes con necrosis extensas de tejidos que precisan tratamiento. Lo fundamental ante el diagnóstico de un shock meningocóccico es establecer el tratamiento médico precoz con medidas de reanimación agresivas y antibioterapia. Sugerimos que la necrosis extensa de tejidos que sufren estos pacientes debe tratarse como si se tratase de un paciente quemado, realizando curas diarias con sulfadiacina argéntica y cirugías seriadas (desbridamiento - amputación - cobertura tan pronto como la situación clínica del paciente lo permita. Es necesario un seguimiento muy cercano de estos pacientes, dada la necesidad de cirugías secundarias que van a precisar a lo largo de su vida, así como la realización de pruebas de imagen para descartar la presencia de osteomielitis secundarias.Meningococcal shock is a relatively frequent disease with a serious prognosis, that causes a multiorganic failure with high mortality and Intensive Care Unit admission. Serious meningococcal shock causes tissue necrosis by uncertain physiopathology. In the last years, there is an increase of the survival, as a result of early diagnosis and aggressive resuscitation. So, there is an increase of patient's tissue necrosis that needs surgery. The most important aspect in front of meningococcal shock is to establish early medical treatment with aggressive resuscitation and antibiotics. Tissue necrosis should be treated like burn patient: argentic sulfadiazine daily cure and serial

  18. 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.

  19. Tratamento da dor em queimados Tratamiento del dolor en quemados Pain management in burn patients

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    Rodrigo José Alencar de Castro

    2013-02-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Apesar dos avanços, ainda é observado manejo analgésico inadequado dos pacientes com queimaduras. O objetivo desta revisão foi coletar dados sobre tratamento da dor em queimados. CONTEÚDO: Foi feita revisão sobre os mecanismos de dor, avaliação do paciente com queimadura e o tratamento farmacológico e não farmacológico. CONCLUSÕES: O manejo da dor em pacientes vítimas de queimaduras ainda é um desafio por parte da equipe multiprofissional. A avaliação frequente e contínua da resposta apresentada pelo paciente é muito importante, tendo em vista os vários momentos por que passa o paciente internado em decorrência de uma queimadura, além de uma terapêutica combinada com medicações analgésicas e medidas não farmacológicas. Entender a complexidade de alterações fisiopatológicas, psicológicas e bioquímicas apresentadas por um paciente em tratamento de queimadura é o primeiro passo para alcançar o sucesso no seu manejo analgésico.JUSTIFICATIVA Y OBJETIVOS: Pese a los progresos alcanzados, todavía se observa un manejo analgésico inadecuado de los pacientes con quemaduras. El objetivo de esta revisión, fue la recolección de datos sobre el tratamiento del dolor en pacientes quemados. CONTENIDO: Se efectuó una revisión sobre los mecanismos de dolor, evaluación del paciente con quemadura, y el tratamiento farmacológico y no farmacológico. CONCLUSIONES: El manejo del dolor en los pacientes víctimas de quemaduras todavía es un reto por parte del equipo multiprofesional. La evaluación frecuente y continua de la respuesta presentada por el paciente es muy importante, teniendo en cuenta los diversos momentos por los que pasa el paciente ingresado en razón de una quemadura, además de una terapéutica combinada con medicaciones analgésicas y con medidas no farmacológicas. Entender la complejidad de las alteraciones fisiopatológicas, psicológicas y bioquímicas presentadas por un

  20. Estar quemado (burnout y su relación con el afrontamiento

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    G. Lastenia Hernández Zamora

    2004-01-01

    Full Text Available El presente estudio correlacional forma parte de una investigación sobre el constructo de “estar quemado” tal y como lo entendieron inicialmente Maslach y Jackson. En este trabajo nos centramos en la relación que el constructo tiene con el afrontamiento. Se aplicó el Cuestionario de Burnout para enfermería (CBE de Hernández, Olmedo y Fernández y el Ways of Coping Questionnaire (WOCQ de Folkman y Lazarus a una muestra de personal sanitario de 222 participantes, de los cuales 187 son mujeres y 35 son varones. Los resultados de los análisis correlacionales, de regresión múltiples y los efectuados para grupos criterio (“altos” frente a “bajos” en los factores de “estar quemado” indican pocas relaciones y de escasa magnitud entre los dos constructos, si bien estos van en la línea de trabajos previos planteándose la necesidad de recurrir a otras variables de tipo personal para explicar el fenómeno del “estar quemado”.

  1. Aspectos básicos de la nutrición enteral en el paciente quemado

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    Carlos Manuel Collado Hernández

    Full Text Available El tratamiento nutricional es un elemento importante en la terapia combinada de las lesiones por quemaduras severas, permitiendo un control del catabolismo en el paciente. En los pacientes quemados el hipermetabolismo estimula el aumento de las necesidades proteico calóricas, la influencia del inicio precoz de la nutrición apoya la estabilidad hemodinámica. El objetivo de esta revisión es describir los aspectos esenciales y actuales de la nutrición enteral en el paciente gran quemado como su concepto, vías de administración, importancia de su aplicación, fórmulas principales para el cálculo proteico energético, tratamiento con macronutrientes y micronutrientes para garantizar una nutrición adecuada y acorde a las necesidades. La nutrición enteral continua siendo la vía más importante y segura en el paciente gran quemado para la administración de macronutrientes y micronutrientes necesarios en los procesos metabólicos que garantizan la cicatrización y curación de los mismos.

  2. Graves' ophthalmopathy: interdisciplinary approach

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    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.

  3. 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.

  4. Hormigón de muy alta densidad

    OpenAIRE

    Herrera Toledo, Yasmila

    2008-01-01

    Esta investigación tuvo por objetivo medular, la creación de un hormigón de muy alta densidad que cumpliera con las características requeridas en el proyecto. Se contempló antecedentes de este tipo de hormigones y algunos proyectos realizados. A partir de lo investigado, señalamos que el hormigón de alta densidad se ocupa principalmente como protección biológica nuclear y de rayos x o gama. Un ejemplo de esto fue la aplicación del hormigón de alta densidad en diferentes salas r...

  5. Mass Graves, Landscapes of Terror

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    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

  6. VOCES DE LAS ENFERMERAS AL PERCIBIR EL DOLOR DEL PACIENTE INFANTIL QUEMADO

    OpenAIRE

    Danelia Gómez-Torres; Victoria Maldonado-González; Berenice Reyes-Robles; Ana Laura Muciño-Carrera

    2014-01-01

    El objetivo del estudio fue revelar la percepción de la enfermera frente al dolor nociceptivo del paciente infantil que sufre quemaduras. Desarrollado en un hospital pediátrico del Distrito Federal, México. Investigación cualitativa, de tipo descriptivo. Para la recolección se aplicó una guía de entrevista semiestructurada a diez enfermeras del área de quemados, siendo los datos analizados mediante análisis de contenido. Como resultados se obtuvieron tres categorías. Se utilizó como referenci...

  7. 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.

  8. 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....

  9. Digging One's Own Grave

    Directory of Open Access Journals (Sweden)

    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.

  10. 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.

  11. 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.

  12. 20º Aniversario Piel para Renacer Fundación del Quemado

    Directory of Open Access Journals (Sweden)

    L. Guerrero-Serrano

    2015-03-01

    Full Text Available Los pacientes con quemaduras agudas en Colombia son necesariamente atendidos, bien o mal, por el Servicio de Salud. Sin embargo una vez salen del hospital, con o sin cobertura sanitaria, no reciben la atención necesaria para su rehabilitación. Las empresas promotoras de salud, que reciben una cuota por usuario afiliado, tratan de restringir al máximo las atenciones para incrementar sus excedentes en una visión perversa de lo que es la obligatoriedad del Servicio de Salud; y cuando lo hacen, no es oportuna, no es de calidad, ni continua. La mayoría de las veces logran esta atención presentando el recurso jurídico de las tutelas que las obliga a prestar el servicio que niegan. Por ello, hace 20 años, 7 profesionales de la Unidad de Quemados del Hospital Simón Bolívar de Bogotá, decidieron constituir una fundación para apoyar el tratamiento de los pacientes quemados una vez hubieran salido de su período de hospitalización. En poco tiempo pasó de suministrar prendas de presión, silicona y cremas protectoras del sol a los pacientes a estructurar su rehabilitación integral, con un equipo compuesto por profesionales de: Cirugía Plástica, Fisioterapia, Psicología y Trabajo Social. Creó el primer Banco de Piel de Colombia y en la actualidad cuenta con sede propia y tiene múltiples convenios con organizaciones nacionales e internacionales que le permiten atender con calidad, oportunidad y eficiencia a un número cada vez mayor de pacientes con secuelas de quemadura. El objetivo de este trabajo es poner en evidencia cómo el cirujano plástico, ciudadano privilegiado al haber podido recibir una educación especializada y contar con todas las oportunidades de trabajo, tiene un espacio de responsabilidad social en la cual puede y debe apoyar a la población vulnerable que no cuenta con recursos económicos ni cobertura en salud, aportando lo mejor de su saber hacer como profesional de su especialidad: reconstruir las secuelas de los

  13. Nutrición artificial en el paciente quemado Nutritional support in burnt patients

    Directory of Open Access Journals (Sweden)

    T. Grau Carmona

    2005-06-01

    Full Text Available La agresión térmica da lugar a una respuesta hipermetabólica cuya magnitud se encuentra entre las más elevadas que pueden presentar los pacientes críticos. El gasto energético debería ser medido por calorimetría indirecta en los pacientes quemados. En ausencia de ésta, las fórmulas publicadas para la estimación del gasto energético en estos pacientes son de utilidad. El tratamiento nutricional del paciente quemado debe iniciarse de forma precoz y por la vía enteral siempre que sea posible. El aporte calórico total es mayor que el recomendado para otros pacientes críticos, pero no debe superar el 200% del gasto energético basal. También se recomienda un aporte más hiperproteico que el sugerido en otras situaciones. Respecto al empleo de substratos nutrientes, existen datos para recomendar el empleo de farmaconutrientes, como arginina y glutamina, en los pacientes quemados. Con el fin de estimular la cicatrización, se recomienda también la administración de suplementos de vitamina A, vitamina C y zinc.Thermal injury leads to a hypermetabolic response which magnitude is among the highest that critically ill patients may present. The energetic waste should be measured by indirect calorimetry in burnt patients. When this test is lacking, published calculations to estimate the energetic waste are useful in these patients. Nutritional therapy in burnt patients should be started early and through the enteral route whenever possible. Total caloric intake is higher than that recommended for other critically ill patients, but should not be higher than 200% of basal energetic waste. Also recommended is a higher hyperproteic intake than that suggested for other situations. With regards to the use of nutrient substrates, there are data to recommend the use of pharmaco-nutrients, such as arginine and glutamine, in burnt patients. In order to stimulate wound healing, it is also recommended to administer vitamin A, vitamin C and zinc

  14. [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

  15. Fisiopatologia da asma grave

    OpenAIRE

    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...

  16. 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.

  17. 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.

  18. 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.

  19. 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...

  20. Uso tradicional de plantas medicinales con accion diuretica en el Municipio de Quemado de Guines, Cuba

    National Research Council Canada - National Science Library

    Perez Machin, Maykel; Sueiro, Mario L; de la Cruz, Ania; Boffill, Maria A; Moron, Francisco; Mendez, Orestes R; Cardenas, Jaqueline

    2011-01-01

    La flora de Cuba es muy rica en plantas medicinales, de las cuales se reportan aproximadamente 179 especies que la poblacion utiliza para fines diureticos, sin embargo, un gran numero de ellas carece...

  1. Análisis retrospectivo de 23 años de necrólisis epidérmica tóxica en la Unidad de Quemados de Alicante, España

    Directory of Open Access Journals (Sweden)

    F.I. Castillo-Muñoz

    2014-09-01

    Full Text Available El Síndrome de Lyell o Necrólisis Epidérmica Tóxica (NET se encuadra dentro del espectro de reacciones cutáneas adversas graves y se caracteriza por presentar una baja incidencia pero una elevada mortalidad. La mayoría de los casos de NET se relacionan con una reacción medicamentosa idiosincrática. El objetivo de este trabajo es reflejar la experiencia clínica con esta entidad en la Unidad de Quemados del Hospital General Universitario de Alicante, España, durante los últimos 23 años. Realizamos un estudio retrospectivo recogiendo los datos epidemiológicos, agentes causales probables, pruebas complementarias, patologías concomitantes, tratamiento y evolución clínica. En total recogimos 16 pacientes con una media de edad de 53,19 años, 68,75% mujeres y 31,25% varones. Los antibióticos fueron los fármacos más comúnmente implicados (31,25%, seguidos de los AINES (25%. Durante el ingreso hospitalario, el 43,75% de los pacientes recibió corticoides sistémicos, el 37,5% exclusivamente tratamiento de soporte y el 25% inmunoglobulinas intravenosas. El 56,25% sufrió algún tipo de secuela, siendo la afectación ocular la más frecuente (18,75%. Calculamos el SCORTEN (Severity of illness score for toxic epidermal necrolisys para todos los pacientes en las primeras 24 horas de ingreso, siendo la suma de las probabilidades predichas de morir por NET de un 32%, cifra superior a los datos reales (mortalidad del 25%. La utilización de corticoides sistémicos sigue siendo controvertida, apareciendo en nuestro estudio un mayor número de infecciones y una mayor mortalidad asociada a dicho tratamiento. La retirada inmediata del fármaco sospechoso, el ingreso precoz en una Unidad de Quemados o de Cuidados Intensivos, el tratamiento de soporte y la reposición hidroelectrolítica, siguen siendo medidas cruciales y de primera línea en el tratamiento de estos pacientes. A pesar de que están descritos diferentes tipos de tratamiento

  2. Uso tradicional de plantas medicinales con acción diurética en el Municipio de Quemado de Güines, Cuba

    Directory of Open Access Journals (Sweden)

    Maykel Pérez Machín

    2011-12-01

    Full Text Available La flora de Cuba es muy rica en plantas medicinales, de las cuales se reportan aproximadamente 179 especies que la población utiliza para fines diuréticos, sin embargo, un gran número de ellas carece de validación experimental de su efecto farmacológico. El presente estudio se realizó con el propósito de documentar la importancia relativa de las especies medicinales más empleadas con fines diuréticos en el municipio de Quemado de Güines de la provincia de Villa Clara, Cuba. Se realizó un estudio etnobotánico en dos comunidades pertenecientes a ese municipio, para lo cual se realizó un muestreo a un total de 85 habitantes, y se aplicó aleatoriamente 80 encuestas a conocedores de plantas y 5 entrevistas entre yerberos y médicos practicantes de medicina tradicional, los cuales nos indicaron las plantas más utilizadas con estos fines en las comunidades estudiadas. La información etnofarmacológica fue registrada mediante la metodología TRAMIL y las especies de interés fueron identificadas y depositadas en el Herbario de la Universidad Central "Marta Abreu" de Las Villas. Los datos se analizaron mediante los índices cuantitativos de valor de uso para cada especie (IVU y el nivel de uso significativo (UST. Este indicador expresa que aquellos usos medicinales que son citados con una frecuencia superior o igual al 20%, por las personas encuestadas pueden considerarse significativos desde el punto de vista de su aceptación cultural y, por lo tanto, merecen su validación científica en Cuba. Se identificaron 26 especies medicinales agrupadas en 19 familias botánicas y se encontraron 10 plantas con un mayor nivel de uso significativo y un mayor IVU. El 53.8% de las plantas reportadas como diuréticas no se han validado experimentalmente en Cuba, el resto de las especies identificadas han sido estudiadas a nivel preclínico, pero aún no está autorizado su empleo como fitomedicamento.Tradicional use of medicinal plants with diuretic

  3. VOCES DE LAS ENFERMERAS AL PERCIBIR EL DOLOR DEL PACIENTE INFANTIL QUEMADO

    Directory of Open Access Journals (Sweden)

    Danelia Gómez-Torres

    2014-01-01

    Full Text Available El objetivo del estudio fue revelar la percepción de la enfermera frente al dolor nociceptivo del paciente infantil que sufre quemaduras. Desarrollado en un hospital pediátrico del Distrito Federal, México. Investigación cualitativa, de tipo descriptivo. Para la recolección se aplicó una guía de entrevista semiestructurada a diez enfermeras del área de quemados, siendo los datos analizados mediante análisis de contenido. Como resultados se obtuvieron tres categorías. Se utilizó como referencial teórico la fenomenología. Los resultados muestran las vivencias de las enfermeras, la expresión, del mecanismos de conducta auto-defensiva, en la percepción de sus intervenciones, se destaca la carga humanística que tienen las emociones, pues el hecho de manifestarlas implica un gasto extra de fuerza y energía, resultando que a mayor intensidad de la emoción a la que se enfrentan, más es el trabajo emocional que realizan. En conclusión el sujeto aprende las vivencias del yo por medio de la experiencia.

  4. Uso tradicional de plantas medicinales con acción diurética en el Municipio de Quemado de Güines, Cuba

    Directory of Open Access Journals (Sweden)

    Maykel Pérez Machín

    2011-12-01

    Full Text Available La flora de Cuba es muy rica en plantas medicinales, de las cuales se reportan aproximadamente 179 especies que la población utiliza para fines diuréticos, sin embargo, un gran número de ellas carece de validación experimental de su efecto farmacológico. El presente estudio se realizó con el propósito de documentar la importancia relativa de las especies medicinales más empleadas con fines diuréticos en el municipio de Quemado de Güines de la provincia de Villa Clara, Cuba. Se realizó un estudio etnobotánico en dos comunidades pertenecientes a ese municipio, para lo cual se realizó un muestreo a un total de 85 habitantes, y se aplicó aleatoriamente 80 encuestas a conocedores de plantas y 5 entrevistas entre yerberos y médicos practicantes de medicina tradicional, los cuales nos indicaron las plantas más utilizadas con estos fines en las comunidades estudiadas. La información etnofarmacológica fue registrada mediante la metodología TRAMIL y las especies de interés fueron identificadas y depositadas en el Herbario de la Universidad Central "Marta Abreu" de Las Villas. Los datos se analizaron mediante los índices cuantitativos de valor de uso para cada especie (IVU y el nivel de uso significativo (UST. Este indicador expresa que aquellos usos medicinales que son citados con una frecuencia superior o igual al 20%, por las personas encuestadas pueden considerarse significativos desde el punto de vista de su aceptación cultural y, por lo tanto, merecen su validación científica en Cuba. Se identificaron 26 especies medicinales agrupadas en 19 familias botánicas y se encontraron 10 plantas con un mayor nivel de uso significativo y un mayor IVU. El 53.8% de las plantas reportadas como diuréticas no se han validado experimentalmente en Cuba, el resto de las especies identificadas han sido estudiadas a nivel preclínico, pero aún no está autorizado su empleo como fitomedicamento.

  5. Ensambles de aves en un sitio quemado y en un sitio no alterado en un área forestal del noroeste de la Patagonia argentina

    OpenAIRE

    Grigera, Dora; Pavic, Carolina

    2007-01-01

    Se muestrearon las aves de un sitio no alterado y de un sitio afectado por un incendio en un área de la cuenca del arroyo Challhuaco, en el Parque Nacional Nahuel Huapi, Argentina, registrándose la densidad y los sustratos de alimentación de cada especie. Se registraron 24 especies de aves, 19 en el sitio no alterado y 15 en el quemado. Algunas especies presentes en el sitio no alterado no se encontraron o se registraron en menor densidad en el quemado. Estas especies se alimentan sobre el fo...

  6. Humanización de los cuidados en la Unidad de Quemados del Hospital General Universitario de Alicante

    OpenAIRE

    Andreu Gómez, Daniel

    2016-01-01

    Introducción: Existen numerosos estudios que demuestran que la incidencia de muerte por quemaduras ha disminuido, por lo que la cuestión que debe preocuparnos en estos momentos es la calidad de vida de los supervivientes. La continuidad de los cuidados por parte de los profesionales de enfermería en las unidades de quemados es una pieza clave en la recuperación y rehabilitación del paciente en todos sus ámbitos. Objetivo: Identificar la humanización de los cuidados de enfermería en la Unidad ...

  7. Perfil psicológico del paciente gran quemado: prevalencia psicopatológica y variables asociadas

    Directory of Open Access Journals (Sweden)

    E. Gallach-Solano

    2015-12-01

    Full Text Available La Unidad de Grandes Quemados del Hospital La Fe de Valencia (España atiende al año aproximadamente 1.600 urgencias por quemaduras. El paciente gran quemado constituye un gran reto para los profesionales sanitarios por las implicaciones biopsicosociales que requiere su abordaje: atención médica para su supervivencia, atención psicológica por el importante riesgo de sufrir alteraciones, asistencia rehabilitadora y fisioterapéutica destinada a su activación funcional y atención social. Realizamos un estudio observacional caso-control transversal de carácter descriptivo, con pacientes hospitalizados en nuestra Unidad de Grandes Quemados con trastornos mentales previos. El objetivo general fue determinar y describir las características sociodemográficas, tipología del trauma sufrido, características y topografía de las quemaduras y la comorbilidad con trastornos mentales previos del paciente gran quemado. El 19,8% de estos pacientes presentó trastornos relacionados con el espectro ansioso, psicótico, del ánimo, tóxicos y alcohol, de la personalidad y alteraciones cognitivas previos a la lesión. Los que menor prevalencia parecen tener son los del espectro psicótico y los trastornos asociados al consumo de alcohol y tóxicos. No aparecieron diferencias significativas entre ninguna de las variables sociodemográficas y clínicas, salvo sexo, edad y grupo de convivencia. Los resultados de nuestro estudio reflejan que en este tipo de pacientes podrían estar directamente implicados diferentes trastornos psiquiátricos. Es importante considerar que la propia quemadura también puede generar trastornos psicológicos. Por ello las intervenciones psicológicas precoces y la determinación en este tipo de pacientes son imprescindibles elementos que permitan conseguir un buen ajuste adaptativo.

  8. Serotipificación y susceptibilidad antibacteriana de cepas de Pseudomonas aeruginosa aisladas de pacientes quemados infectados

    Directory of Open Access Journals (Sweden)

    Aniel Moya

    2003-06-01

    Full Text Available Se aislaron 11 cepas de Pseudomonas aeruginosa en 10 pacientes quemados que se encontraban hospitalizados y se les realizó tipificación serológica y antibiotipia para determinar los serotipos más frecuentes en este tipo de pacientes. Los serotipos de mayor frecuencia de aislamiento fueron el O4 y el O5. Observamos una marcada resistencia frente a los antibióticos: carbenicilina (81,8% y la azlocilina (72,7%.

  9. 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

  10. 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.

  11. 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.

  12. ¿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.

  13. Materiales, tecnologías y prototipos de viviendas de muy bajo coste

    OpenAIRE

    Salas Serrano, Julián; Díaz-Romeral Bringas, Pablo

    1982-01-01

    Not available.El fin último de la investigación es el de conseguir unas tipologías de viviendas realizadas mediante materiales, procedimientos o sistemas constructivos que permitan proporcionar un producto final, cuyas características fundamentales sean: adecuación a las necesidades físicas y socioculturales de la zona y, prioritariamente, la consecución de un muy bajo coste da ejecución de las mismas. Cuando se habla a continuación de «viviendas de muy bajo coste» se debe entender que n...

  14. Proceso fisiológico de envejecimiento renal en el muy anciano

    OpenAIRE

    2011-01-01

    [ES] El estudio de la fisiología de las personas sanas muy ancianas, es decir de edad mayor o igual a 75 años, constituye una excelente oportunidad para poder comprender mejor los límites que separan la vejez normal de las patologías seniles. Sin embargo, la fisiología de este subgrupo de personas muy ancianas ha sido poco estudiada. Es de esta forma que ya se ha aprendido que el proceso de envejecimiento trasciende el concepto de simultáneo y global, y que en realidad se trata de un fenó...

  15. Las penas en las contravenciones muy graves de tránsito en relación con el principio constitucional de proporcionalidad de la pena

    OpenAIRE

    Barragán Bósquez, Verónica Angelita

    2015-01-01

    Es incuestionable que el índice de accidentes de tránsito ha disminuido por la nueva norma aplicada a los infractores,con la entrada en vigencia en el Código Orgánico Integral Penal, sin embargoha aumentado las vulneraciones a los principios constitucionales manteniéndose la problemáticade la anteriorLey Orgánica de Tránsito Transporte Terrestre y Seguridad Vial. Es necesario no olvidar que las penas deben cumplir con una característica esencial que es la relación proporcional entre el hec...

  16. El reto de las transferencias de colgajos libres en pacientes quemados: ¿cuál es el momento para la cirugía?

    Directory of Open Access Journals (Sweden)

    M.E. Villaverde-Doménech

    Full Text Available La transferencia de colgajos libres es una herramienta fundamental dentro del arsenal reconstructivo para el tratamiento quirúrgico del gran quemado. Durante años ha existido controversia sobre la influencia del momento de la cirugía sobre la tasa de complicaciones, así como el alto riesgo de complicaciones al realizar reconstrucciones con colgajos libres en pacientes quemados. Diseñamos un estudio retrospectivo de las reconstrucciones quirúrgicas mediante colgajos libres realizadas en nuestra Unidad de Quemados del Hospital Universitari y Politecnic La Fe, de Valencia (España en el periodo comprendido entre 2001 y 2013, recogiendo todos los datos relativos al paciente, a la lesión, al procedimiento reconstructivo, a los resultados y relacionando todo ello con el momento en el cual se realizó la cirugía. Para el análisis de los datos y asociaciones entre distintas variables usamos tablas de contingencia y aplicamos el test de independencia de Chi-cuadrado. Exponemos además 2 casos clínicos representativos de la cirugía reconstructiva practicada en pacientes quemados. Recogimos en total datos de 21 procedimientos de reconstrucción mediante colgajo libre en pacientes quemados. En ninguno se realizó reconstrucción primaria inmediata (en los primeros 5 días, mientras que la reconstrucción primaria temprana (entre el día 5 y el 21 se realizó en el 28,57 % de los casos, la primaria intermedia (entre el día 21 y las 6 semanas en el 28,57 %, la secundaria (más de 6 semanas en el 9,5 %, y la cirugía de secuelas en el 33,33 % de los casos. Las tasas de complicaciones mayores y menores fueron respectivamente 19,05 % y 9,5 % . El 50 % de complicaciones mayores ocurrieron en el periodo de reconstrucción primaria temprana, mientras que no registramos ninguna en el periodo primario intermedio. El resto de complicaciones se repartió a partes iguales entre el periodo secundario y la cirugía de secuelas (ambas con el 25 %. No

  17. Estrategias de vida y rutas de desarrollo de jóvenes rurales en Nicaragua: los casos en Muy Muy y en Matiguás

    Directory of Open Access Journals (Sweden)

    Griet Steel

    2011-08-01

    Full Text Available Existe una preocupación creciente en la industria del desarrollo sobre la situación de hombres y mujeres jóvenes creciendo en contextos de pobreza. Sin embargo, aún hay una escasez de investigación que dé cuenta de lo que ocurre en la vida diaria de losjóvenes y la forma en que éstos experimentan y tratan de manejar las situaciones de pobreza. Los estudios de juventud generalmente consideran a las personas jóvenes como pasivos receptáculos de las decisiones y políticas definidas por los adultos, y tienden a ignorar la capacidad que tienen las personas jóvenes de generar riqueza. Enel presente artículo enfatizamos la necesidad de hacer investigación más profunda sobre las estrategias de vida de los jóvenes y su transición hacia la adultez. Sobre la base de estudios de caso de jóvenes rurales nicaragüenses, analizamos cómo los jóvenes de Muy Muy y Matiguás negocian sus estrategias de vida con sus padres, conla perspectiva de acumular recursos necesarios para lograr independizarse. En eldesenvolvimiento de sus estrategias de vida reconocemos a los jóvenes como agentes activos del desarrollo de sus hogares y localidades. En esta medida, promovemos que las instituciones de desarrollo razonen sobre las iniciativas de los jóvenes en sus intervenciones de desarrollo. En este sentido, el presente estudio tiene la perspectiva no sólo de enriquecer el debate académico alrededor de las estrategias de vida de los jóvenes sino también de proveer insumos a las organizaciones que implementanestrategias de desarrollo con jóvenes en Nicaragua y la región.

  18. 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.

  19. 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...

  20. 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.

  1. Reestenosis “muy tardía”, sintomática, de un stent coronario

    Directory of Open Access Journals (Sweden)

    Luis A. Kortsarz

    2007-01-01

    Full Text Available Un paciente de sexo masculino, de 50 años, luego de ocho años y medio del implante de un stent coronario metálico presenta reestenosis sintomática.Los stents coronarios se reestenosan debido a un proceso de proliferación neointimal seguido de retracción tardía. Los eventos clínicos relacionados con reestenosis ocurren, en general, durante el primer año. La reestenosis sintomática “muy tardía” es poco frecuente. Hay sólo unos pocos casos comunicados en la literatura. La reestenosis angiográfica “muy tardía” es más común. Este proceso se debe, probablemente, al desarrollo de enfermedad aterosclerótica dentro del stent

  2. Ensilaje de cogollo de caña quemado y ensilaje de maíz en la ceba de novillos

    OpenAIRE

    Sánchez G. Hugo; Zapata O.; Morales V. F.; López B. J. A.

    2012-01-01

    Se ensiló cogollo de caña quemado, usando como aditivos melazas al 3% y úrea al 1% en base fresca. Los tratamientos consistieron en una combinación de ensilaje de cogollo quemado y ensilaje de maíz como dieta básica a voluntad y dos suplementos que contenían 1.5 kg de gallinaza, 1.0 kg de melaza y/o 0.1 kg de úrea para el tratamiento uno y 0.4 kg de torta de soya para el tratamiento dos, con nueve novillos cebú mestizos por tratamiento. Las ganancias de peso diario fueron de 0.52 y 0.54 kg; y...

  3. Estado de salud bucodental de escolares residentes en localidades abastecidas con agua de consumo humano de muy alto y muy bajo contenido de fluoruros

    Directory of Open Access Journals (Sweden)

    Ana Isabel Azcurra

    1995-10-01

    Full Text Available Se describen y analizan los resultados de una investigación epidemiológica de corte transversal destinada a evaluar el estado de salud bucodental en escolares de 6-7 y 12-13 años residentes en Sampacho y Porteña, dos localidades de la Provincia de Córdoba (Argentina, abastecidas con agua de bebida que poseen cantidades deF- muy diferentes. En Sampacho, el nivel de F- es de 9,05 mg/l, en tanto que en Porteña la concentración es de 0,19 mg/l. La proporción de escolares (6-7 y 12-13 años que no tuvo experiencia de caries fue significativamente mayor en Sampacho que en Porteña, mientras que los índices ceo-d, ceo-s, CPO-D y CPO-S resultaron considerablemente más altos en esta última localidad. La severidad de la enfermedad de caries en los niños de 12-13 años de Sampacho estuvo comprendida entre baja y moderada (CPO-D= 2,53, en tanto que en sus similares de Porteña alcanzó el grado de moderada a alta (CPO-D= 4,41. No se registró ningún caso de fluorosis dental en Porteña, mientras que en Sampacho hubo una alta proporción de niños que presentó fluorosis leve (6-7 años y leve o intensa (12-13 años. Los niveles salivales de calcio, fosfatos, tiocianato, proteínas totales e Ig A secretoria fueron muy similares en los escolares de ambas localidades, y también entre niños con diferente experiencia de caries y distintos grados de fluorosis dental. Se concluye que son necesarias urgentes medidas sanitarias (preventivas y/o curativas para reducir o controlar la enfermedad de caries en Porteña y la fluorosis dental en Sampacho.

  4. Estado de salud bucodental de escolares residentes en localidades abastecidas con agua de consumo humano de muy alto y muy bajo contenido de fluoruros

    Directory of Open Access Journals (Sweden)

    Azcurra Ana Isabel

    1995-01-01

    Full Text Available Se describen y analizan los resultados de una investigación epidemiológica de corte transversal destinada a evaluar el estado de salud bucodental en escolares de 6-7 y 12-13 años residentes en Sampacho y Porteña, dos localidades de la Provincia de Córdoba (Argentina, abastecidas con agua de bebida que poseen cantidades deF- muy diferentes. En Sampacho, el nivel de F- es de 9,05 mg/l, en tanto que en Porteña la concentración es de 0,19 mg/l. La proporción de escolares (6-7 y 12-13 años que no tuvo experiencia de caries fue significativamente mayor en Sampacho que en Porteña, mientras que los índices ceo-d, ceo-s, CPO-D y CPO-S resultaron considerablemente más altos en esta última localidad. La severidad de la enfermedad de caries en los niños de 12-13 años de Sampacho estuvo comprendida entre baja y moderada (CPO-D= 2,53, en tanto que en sus similares de Porteña alcanzó el grado de moderada a alta (CPO-D= 4,41. No se registró ningún caso de fluorosis dental en Porteña, mientras que en Sampacho hubo una alta proporción de niños que presentó fluorosis leve (6-7 años y leve o intensa (12-13 años. Los niveles salivales de calcio, fosfatos, tiocianato, proteínas totales e Ig A secretoria fueron muy similares en los escolares de ambas localidades, y también entre niños con diferente experiencia de caries y distintos grados de fluorosis dental. Se concluye que son necesarias urgentes medidas sanitarias (preventivas y/o curativas para reducir o controlar la enfermedad de caries en Porteña y la fluorosis dental en Sampacho.

  5. [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.

  6. Mioma primario de la trompa de Falopio: una localización muy infrecuente

    OpenAIRE

    2013-01-01

    Presentamos un caso muy poco frecuente de mioma extrauterino, localizado en la trompa de Falopio derecha, en su porción media. A la inspección y anatomía patológica, no se encontraron evidencias de dependencia alguna con el útero. Constituyó un hallazgo en una mujer sometida a cirugía abdomino-pélvica debido a infertilidad primaria y dolor abdominal derecho. Los estudios previos con ultrasonido identificaron una imagen compatible con un mioma subseroso grande y pediculado.

  7. 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.

  8. 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...

  9. Materiales, tecnologías y prototipos de viviendas de muy bajo coste

    Directory of Open Access Journals (Sweden)

    Salas Serrano, Julián

    1982-11-01

    Full Text Available Not available.El fin último de la investigación es el de conseguir unas tipologías de viviendas realizadas mediante materiales, procedimientos o sistemas constructivos que permitan proporcionar un producto final, cuyas características fundamentales sean: adecuación a las necesidades físicas y socioculturales de la zona y, prioritariamente, la consecución de un muy bajo coste da ejecución de las mismas. Cuando se habla a continuación de «viviendas de muy bajo coste» se debe entender que nos referimos a las que cumplen básicamente las dos condiciones limitativas aceptadas por las Naciones Unidas (UNCHSHABITAT: a Superficie construida comprendida entre 30 y 50 m2. b Coste de construcción inferior a los 100 $ USA (1982 por metro cuadrado construido. (Para nuestras condiciones, fijaríamos un coste aproximado de 10.000 pts/m2.

  10. La Neurociencia Computacional hoy: II. El Proyecto Blue Brain, un ejemplo muy representativo en el campo

    Directory of Open Access Journals (Sweden)

    Jesús Cortés

    2009-01-01

    Full Text Available La Neurociencia Computacional es un campo reciente, pero bien establecido dentro de las Neurociencias. En un primer artículo (Cortés, 2009, http://www.cienciacognitiva.org/?p=55, “Qué es y por qué es difícil su estudio”, explico su principal paradigma: todo proceso mental que tiene lugar en nuestro cerebro tiene un circuito o cableado físico que lo sustenta. En este artículo comento un ejemplo muy representativo en el campo: el macro-proyecto de simulación a gran escala y en tiempo real de procesos en la corteza cerebral, el famoso Blue Brain Project.

  11. Reanimación del paciente quemado Resuscitation of burned patients

    Directory of Open Access Journals (Sweden)

    Marco Antonio Hoyos Franco

    2008-06-01

    ón que permita optimizar la atención del paciente quemado, con miras a obtener una disminución de la mortalidad y de las secuelas y complicaciones derivadas de una inadecuada reanimación. Se hizo una búsqueda en Internet, utilizando la base de datos Pubmed. Se usaron las palabras clave “Resuscitation” y “Burn”, y se limitó la búsqueda a los artículos publicados después del año 2000. Se incluyeron además algunos artículos considerados de importancia para la comprensión del tema, publicados con anterioridad a ese año.

     

  1. La importancia de los materiales en las viviendas de muy bajo coste

    Directory of Open Access Journals (Sweden)

    Salas, Julián

    1992-09-01

    Full Text Available This text fits into the context of the attempt to emphasize the considerable importance of the factor of the construction materials in the subsection of low cost housing in Developing Countries in general and in Latín America in particular. The author tries to quantify, in a global manner, the repercussion of the materials through different assumptions and to show how it increases as the sections of installations and finishes diminish —in fact, practically disappear—. In accordance with this and as a consequence, the author discusses the necessity to use autochthonous materials and to support the research and technological development which lay stress on the use of alternative materials and the re-use of agro-industrial waste. As a pan of the Chapter V reproduced here, a special Section entitled "The Industry of Construction Materials" is contemplated, a section which we omitted and which can be found in n.º 198 of this Quarterly where it was originally published.

    El texto que sigue se encuadra en el contexto de intentar enmarcar la importancia considerable del capítulo de los materiales de construcción en el subsector de las viviendas de muy bajo coste en los Países en Vías de Desarrollo en general, y en Latinoamérica en particular. El autor trata de cuantificar, en forma global, la repercusión de los materiales en varios supuestos y como ésta aumenta al disminuir —prácticamente desaparecer— las partidas de instalaciones y acabados. De conformidad y como consecuencia de lo anterior, el autor se ocupa de la necesidad de emplear materiales autóctonos y de apoyar la investigación y el desarrollo tecnológico que ponen énfasis en la utilización de materiales alternativos y la reutilización de desechos agro-industriales. Formando parte del Capítulo V que se reproduce, se contempla un apartado específico con el título "La Industria de Materiales de la Construcción" que hemos omitido, remitiendo al lector

  2. 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

  3. 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.

  4. Estado de la provisión de cuidados nutricionales al paciente quemado: Auditoría de procesos en un Servicio de Quemados de un hospital terciario Current status of nutritional care provision to burnt patients: Processes audit of a burnt patients department from a tertiary hospital

    OpenAIRE

    L. M. Miquet Romero; R. Rodríguez Garcell; J. Barreto Penié; S. Santana Porbén

    2008-01-01

    Justificación: La respuesta al tratamiento médico-quirúrgico del paciente quemado pudiera depender tanto de los estragos provocados por la agresión térmica, a saber las demandas metabólicas incrementadas, la aparición del Síndrome de Respuesta Inflamatoria Sistémica, y las infecciones microbianas; como de las prácticas culturales incluidas dentro de los procesos institucionales de cuidados nutricionales. Objetivo: Evaluar cómo la conducción de los procesos nutricionales de evaluación e interv...

  5. 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.

  6. Ensilaje de cogollo de caña quemado y ensilaje de maíz en la ceba de novillos

    Directory of Open Access Journals (Sweden)

    Sánchez G. Hugo

    1990-12-01

    Full Text Available Se ensiló cogollo de caña quemado, usando como aditivos melazas al 3% y úrea al 1% en base fresca. Los tratamientos consistieron en una combinación de ensilaje de cogollo quemado y ensilaje de maíz como dieta básica a voluntad y dos suplementos que contenían 1.5 kg de gallinaza, 1.0 kg de melaza y/o 0.1 kg de úrea para el tratamiento uno y 0.4 kg de torta de soya para el tratamiento dos, con nueve novillos cebú mestizos por tratamiento. Las ganancias de peso diario fueron de 0.52 y 0.54 kg; y los consumos de materia seca por animal de 11.37 y 11.01 kg/día para los tratamientos uno y dos respectivamente. La factibilidad del uso del cogollo de caña depende de la eficiencia de los procesos de ensilado y de la suplementación adecuada y de bajo costo.Were used burned sugar cane tops silage with 3 % of molasses and 1% of urea on fresch base and com silage as basic diet. The treatments were as follow: Treatment 1 (t1 - Burned sugar cane tops silage + Com Silage + 1.5 kg of poultry litter + 1.0 kg of molasse + 0.1 kg of urea and 0.4 kg of soybean meal by urea for treatment 2 (T2, with nine crossbreed steers for treatment. The average daily gains were 0.52 and 0.54 and 0.54 kg/day and the total consumption per animal were 11.37 and 11.01 kg/day for TI and T2 respectively. The use of sugar cane tops depends on silage process efficiency and the adition of adecuate supplements with low prices.

  7. Análisis comparativo de morbilidad en grandes quemados tratados con sesiones de autoinjertos frente a cultivo de queratinocitos

    Directory of Open Access Journals (Sweden)

    M. Rubio-Yanchuck

    2015-09-01

    Full Text Available La cobertura rápida y eficaz de las lesiones es un factor limitante en el tratamiento de grandes quemados. Los autoinjertos siguen siendo el tratamiento de elección pero no están exentos de riesgos. El uso de sustitutos de piel cultivada (SPC puede llegar a reducir la morbilidad implícita en el uso de autoinjertos. El objetivo de este estudio es realizar un análisis comparativo de la morbilidad asociada al uso de queratinocitos y autoinjertos en pacientes tratados inicialmente con aloinjertos como cobertura temporal. Realizamos un análisis retrospectivo de morbilidad en 21 pacientes con una superficie corporal quemada (SCQ mayor o igual al 40% en el Hospital Universitario La Paz, Madrid (España entre 2011y 2015. Fueron divididos en 2 grupos según la cobertura definitiva utilizada: un primer grupo con sesiones de autoinjerto, y un segundo grupo con cultivos de queratinocitos y áreas menores de autoinjertos. Fueron 5 mujeres y 16 varones con media de edad de 40,38 años, SCQ del 60,43% y SCQ dérmico profunda-subdérmica del 59,05%. La media de cirugías necesarias en pacientes tratados con autoinjertos y SPC fue 5,36 y 6,7 respectivamente. La incidencia de sepsis fue 80 frente a 50%; el fracaso renal agudo del 63,6 frente al 50%; y de neumonía del 27.3 frente al 40%. Entre los pacientes que sobrevivieron la estancia media en Unidad de Cuidados Intensivos fue de 66,16 frente a 50,6 días, la estancia media hospitalaria fue de 75,6 frente a 63,3 días y la media del número de trasfusiones fue de 75,6 frente a 63.3. La complicación del lecho quirúrgico en el grupo de autoinjertos fue del 63% frente al 0% en los tratados con queratinocitos, y las necesidades medias de noradrenalina fueron de 0,1 frente a 0,03 µg/kg/min. Los pacientes con lecho quirúrgico complicado tuvieron unos requerimientos medios de noradrenalina de 0,117 frente a 0,044 en pacientes con lecho quirúrgico no complicado. Como conclusión, los pacientes tratados con

  8. 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.

  9. 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.

  10. 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...

  11. Tratamiento quirúrgico de las complicaciones del shock meningocóccico grave Surgical treatment of the severe meningococcal septic shock complications

    OpenAIRE

    P. Casteleiro Roca; J. Midón Miguez; J. García Barreiro; F. Martelo Villar

    2010-01-01

    El shock meningocóccico es una entidad relativamente frecuente y de pronóstico muy grave, que provoca fallo multiorgánico con una alta mortalidad y que precisa ingreso en Unidad de Cuidados Intensivos. En los casos grandes puede provocar necrosis de tejidos mediante una fisiopatología poco clara. En los últimos años la supervivencia de estos pacientes ha aumentado debido al diagnóstico precoz y a medidas de reanimación más agresivas. Como consecuencia encontramos un aumento del número de paci...

  12. 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...

  13. 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....

  14. 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....

  15. 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...

  16. 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.

  17. Factores de riesgo en la mortalidad de los recién nacidos de muy bajo peso con membrana hialina

    OpenAIRE

    García Arias, M.B.; Zuluaga Arias, Pilar; Arrabal Terán, M. C.; Arizcun Pineda, J.

    2005-01-01

    Introducción: La expectativa de vivir de los recién nacidos de muy bajo peso (RNMBP) ha mejorado en los últimos años. Cuando estos pacientes presentan, además, enfermedad de membrana hialina (EMH), es difícil conocer con seguridad cuáles son los factores que más influyen en su mortalidad. Este trabajo tiene el objetivo de averiguar, dentro de un conjunto de variables, las más influyentes en la mortalidad desde una perspectiva multifactorial. Pacientes y métodos: Se tomó una muestra de 209 RNM...

  18. Plan integral de servicio social en municipios de muy alta marginación en el estado de Oaxaca

    OpenAIRE

    2013-01-01

    El plan de servicio social implantado por la UABJO, pretende la creación de cuatro Brigadas de Servicio Social integradas por estudiantes de diversas carreras, con el fin de atender a veinte municipios de las Sierras norte y sur en condiciones de muy alta marginación. El objetivo es incidir en la mejora de niveles de salud, vivienda, economía familiar, desarrollo urbano y sustentable. Desarrollando acciones múltiples de diagnósticos de necesidades esenciales, asesorías contables, administrat...

  19. Diagnostico De La Deficiencia De Acil-Coa Deshidrogenasa De Cadena Muy Larga Mediante El Uso De Sustratos Tritiados

    OpenAIRE

    Osorio, José Henry; Laboratorio de Patología Molecular, Departamento de Ciencias Básicas de la Salud. Universidad de Caldas. e.mail:; Ribes, Antonia; Instituto de Bioquímica Clínica. Corporació Sanitaria Clínic. Barcelona. España Correspondencia: Universidad de Caldas, Departamento de Ciencias Básicas de la Salud. Calle 65 N0. 26-10. Manizales; Lluc, Montse; Instituto de Bioquímica Clínica. Corporació Sanitaria Clínic. Barcelona. España Correspondencia: Universidad de Caldas, Departamento de Ciencias Básicas de la Salud. Calle 65 N0. 26-10. Manizales

    2008-01-01

    Introducción: la acil-CoA deshidrogenasa de cadena muy larga (VLCAD) cataliza la primera reacción de la degradación de ácidos grasos de 14 a 24 átomos de carbono. Su deficiencia debe ser siempre confirmada por estudios de laboratorio. Materiales y métodos: en el presente trabajo, fueron incubados fibroblastos de pacientes que presentaban la deficiencia de VLCAD, en presencia de sustratos tritiados. Resultados y discusión: Fue encontrada diferencia significativa (P<0.05) al comparar la degr...

  20. El análisis por elementos finitos: una metodología muy reciente en economía

    OpenAIRE

    Escribano Ródenas, Miguel

    2006-01-01

    La técnica de análisis por elementos finitos (AEF) consiste en dividir la geometría en la que se quiere resolver una ecuación diferencial de un campo escalar o vectorial en un dominio, en pequeños elementos, teniendo en cuenta unas ecuaciones de campo en cada elemento, los elementos del entorno de vecindad y las fuentes generadoras de campo en cada elemento. Habitualmente, esta técnica es muy utilizada en el ámbito de la ingeniería debido a que muchos problemas físicos de interés se form...

  1. Cobertura de grandes quemados con cultivo de queratinocitos: casuística de nuestra Unidad y protocolo de tratamiento Massive burn coverage with keratinocytes cultured: our casuistry and treatment protocol

    Directory of Open Access Journals (Sweden)

    I. González Alaña

    2012-09-01

    Full Text Available El paciente gran quemado sigue siendo hoy en día un difícil reto al que se enfrentan múltiples profesionales sanitarios. La elevada mortalidad de estos pacientes se justifica por la severa alteración del estado general que sufren, las múltiples complicaciones que se asocian y por la ausencia de piel válida para cubrir las quemaduras, como sucede en el caso de los quemados de gran extensión. Este último inconveniente se solventa de diferentes maneras, siendo una de las más importantes el cultivo de queratinocitos. En la Unidad de Quemados del Hospital Universitario de Cruces en Baracaldo (Vizcaya, España, iniciamos la aplicación de esta técnica en 2001, con una experiencia acumulada en esta década de 14 pacientes. El objetivo de este artículo es mostrar nuestro protocolo de aplicación del procedimiento para la cobertura de quemados extensos, los criterios de inclusión y la terapéutica pre y postaplicación de las láminas de queratinocitos que empleamos en nuestra Unidad. Así mismo, presentamos las características de los pacientes tratados y nuestra propia experiencia en la aplicación de esta técnica que, a pesar de lograr resultados cada vez más satisfactorios y ser en ocasiones la única alternativa para un paciente extensamente quemado, tiene todavía hoy en día tantos detractores.The severe burn patient continues being nowadays a difficult challenge which multiple sanitary professionals face. The high mortality of these patients justifies itself by the severe alteration of the general condition, the multiple complications that they suffer and the absence of skin for their coverage, as is the case of extensive burns. This last disadvantage is settled in different ways, being one of the most important the treatment with keratinocytes culture. In the Cruces Universitary Hospital Burn Unit in Baracaldo (Vizcaya, Spain, we began the clinical application of this technique in 2001, with a 14 patients accumulated experience in

  2. 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

  3. 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).

  4. 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.

  5. 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)

  6. 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.

  7. 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.

  8. 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.

  9. Ameloblastoma mandibular muy agresivo

    OpenAIRE

    2008-01-01

    Se presenta una paciente de sexo femenino con diagnóstico de ameloblastoma folicular que se comportó de manera extraordinariamente agresiva, considerando este tipo histológico, con recidiva extensa que requirió cirugía radical y reconstrucción con doble colgajo libre, y que a pesar de obtener márgenes negativos, presenta una nueva y más extensa recidiva, quedando fuera del alcance quirúrgico y falleciendo 11 meses luego de la última cirugía

  10. Un viaje muy especial

    OpenAIRE

    Carlos Palero Gómez

    2005-01-01

    El presente artículo es una reflexión personal, expresada en forma de metáfora, sobre el viaje que profesor y alumnos emprenden juntos al inicio de cada curso académico, y que juntos deben terminar. El autor se apoya para ello en su experiencia personal, a lo largo de más de una década, como alumno en los diferentes niveles del sistema educativo.

  11. 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.

  12. Efecto del Clima Psicosocial del Grupo y de la Personalidad en el Síndrome de Quemado en el Trabajo de los docentes

    Directory of Open Access Journals (Sweden)

    Ivette Margarita Espinoza-Díaz

    2015-05-01

    Full Text Available El presente estudio evalúa las relaciones de la percepción del clima psicosocial y de la personalidad con el síndrome de quemado en el trabajo (SQT o burnout en docentes de educación infantil, primaria y secundaria con este fin se administraron cuestionarios para evaluar el clima psicosocial, la personalidad y el burnout a una muestra de 386 docentes. Se analizaron las relaciones entre dichas variables y se analizó hasta qué punto las variables de clima y personalidad permiten establecer un modelo predictivo del SQT mediante el análisis de regresión múltiple. Los resultados mostraron que tanto el clima psicosocial (especialmente el grado de desorganización como la personalidad (especialmente la amabilidad influyen en el burnout y, aunque los factores de clima parecen ser mejores predictores del SQT, la utilización de medidas de personalidad incrementan la capacidad predictiva de dicho síndrome. De este modo la utilización conjunta de estos dos tipos de predictores mejoran la capacidad de establecer modelos que permitan la prevención del SQT en entornos docentes.

  13. Análisis de la casuística de 5 años en la Unidad de Quemados del Hospital Luis Vernaza, Guayaquil, Ecuador

    Directory of Open Access Journals (Sweden)

    R. Guerrero-Torbay

    2014-03-01

    Full Text Available En el periodo comprendido entre 2006 y 2010 registramos 646 ingresos a la Unidad de Quemados del Hospital Luis Vernaza, en Guayaquil, Ecuador. El género masculino fue más afectado que el femenino (70,7% frente a 29,3%. El domicilio fue el lugar donde más ocurrieron los accidentes. La llama fué la etiología más común (n=233. El 85% de los pacientes ingresados requirió algún tipo de tratamiento quirúrgico. La estancia media hospitalaria no tuvo diferencias al comparar género o edad, pero fue mayor para aquellos pacientes con lesiones de más del 30% de la superficie corporal total (46,9 frente a 25,1 días; p < 0,05 y en pacientes con quemaduras de tercer grado (34,6 frente a 20,8 días; p < 0,05. Según los criterios de la American Burn Association, los pacientes con quemaduras de grado moderado a mayor tuvieron una estancia superior a la de los pacientes en la primera categoría (p < 0,05. No observamos diferencias entre los pacientes con quemaduras de grado moderado y mayor.

  14. Evaluación del potencial uranífero del volcanismo jurásico (complejos Bahía Laura y El Quemado, provincia de Santa Cruz, mendiante espectrometría gamma terrestre y geoquímica de rocas

    Directory of Open Access Journals (Sweden)

    Laura E Kleiman

    2013-09-01

    Full Text Available Los relevamientos radimétricos constituyen una herramienta rápida para medir concentraciones de uranio (U, torio (Th, y potasio (K en las rocas y resultan muy útiles para la exploración de minerales radioactivos. En este trabajo, se evalúa la distribución del uranio en volcanitas jurásicas de la provincia de Santa Cruz, utilizando datos de espectrometría gamma terrestre y de geoquímica de rocas, con el objetivo de determinar su potencial para formar yacimientos. Se seleccionaron cinco zonas con antecedentes de valores radimétricos elevados e información geológica detallada. Las mediciones se realizaron con un espectrómetro de rayos gamma portátil (Exploranium-GR 320® en andesitas, ignimbritas, riolitas, áreas silicificadas, tobas de caída y sedimentos lacustres de los complejos Bahía Laura y El Quemado. Los resultados obtenidos son similares en todas las zonas relevadas: los valores radimétricos muestran buenas correlaciones con los datos químicos de roca para el K y el Th y menores para el U. Los procesos de diferenciación magmática, cristalización en fase vapor, alteración hidrotermal y alteración supergénica se reflejan en la distribución de estos elementos. Los contenidos de U se incrementan en las rocas más vítreas, en zonas de silicificación hidrotermal y en zonas de fractura, características a considerar en futuros relevamientos. La naturaleza calcoalcalina con impronta de arco del magmatismo jurásico no es de las más favorables para el enriquecimiento de uranio y para contener importantes mineralizaciones. Sin embargo, el ambiente extensional, la presencia de calderas con facies levemente enriquecidas en uranio y torio así como la de actividad hidrotermal, son factores positivos para la exploración por uranio.

  15. Enfermedad cardíaca grave en la esclerosis sistémica Severe cardiac disease in scleroderma

    Directory of Open Access Journals (Sweden)

    Alejandro R. Grinberg

    2004-10-01

    Full Text Available Una mujer de 36 años de edad con diagnóstico de esclerosis sistémica (ES desarrolló un cuadro agudo de miositis esquelética e insuficiencia cardíaca grave. Evolucionó con shock cardiogénico y a pesar del tratamiento con drogas inotrópicas y altas dosis de corticoides falleció a los cinco días de haber ingresado. La autopsia reveló áreas de necrosis coagulativa miocárdicas con miocitolisis y necrosis en banda de contracción. Son muy pocos los casos comunicados de insuficiencia cardíaca grave asociada a la ES.A 36 year-old female with a diagnosis of systemic sclerosis suffered from an acute episode of skeletal myositis and refractory heart failure with cardiogenic shock. Despite immunosuppressive treatment with high doses of corticosteroids and hemodynamic support she died five days after admission. The autopsy showed cardiac myocytolysis, myocyte necrosis and contraction band necrosis. There are very few reported cases of severe heart failure associated to systemic sclerosis.

  16. 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.

  17. 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...

  18. 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.

  19. 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.

  20. 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.

  1. 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.

  2. 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.

  3. Factores de riesgo para el desarrollo de infecciones intrahospitalarias en pacientes quemados. Hospital S. Juan de Dios, Costa Rica: Enero 2003-Diciembre 2005. Parte I Risk factors for development of intrahospitalary infections in burned patients. Hospital S. Juan de Dios, Costa Rica: January 2003-December 2005. Part I

    OpenAIRE

    S. Vargas Naranjo; Romero Zúñiga, J.J.; Y. Prada Castellanos; G. Fonseca Portilla; W. Lao Gallardo

    2009-01-01

    La infección intrahospitalaria es una de las principales causas de morbilidad y mortalidad en los pacientes quemados. El presente estudio caracteriza a los ingresados por quemadura(s) y la presencia de esta clase de infección en la Unidad Nacional de Quemados del Hospital San Juan de Dios, en Costa Rica, entre los años 2003 y 2005. Realizamos un análisis descriptivo de la infección intrahospitalaria en el sitio de la quemadura según las características de los pacientes y de la quemadura así c...

  4. 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.

  5. 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.

  6. 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.

  7. 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.

  8. 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.

  9. Alcohol Advertising description and analysis in the Muy Interesante magazine/ Descripción y análisis de la publicidad de alcohol en la revista Muy Interesante

    Directory of Open Access Journals (Sweden)

    Lic. Álvaro García del Castillo-López; alvaro.garciac@umh.es

    2009-01-01

    Full Text Available The topics concerning advertising arise great interest because of the persuasive effects of publicity but also for its influence on the behaviour of the individuals to whom it is directed. From the beginning we found several controversies, which motivate research on advertising and its perception and interpretation on the part of the public. In this work we aim at analyzing the advertising of alcohol, in Muy Interesante magazine, taking as a sample students from State Universities in the Province of Alicante. The sample consists of 380 insertions of 51 brands of different alcoholic drinks. Our intention is double; 1. To describe the contents of the spotted advertising messages; 2. To identify the underlying values in the advertising of alcohol. The analysis was performed by two groups of key reporters: one consisted off seven university students from different qualifications and sex, and another one integrated by seven experts of different areas related to the main goals of this study.. The gathering of information was done through a structured questionnaire. Los temas que giran en torno a la publicidad han generado gran interés, tanto por los efectos persuasivos de la misma, como por la influencia sobre el comportamiento de los individuos a la que va dirigida. Desde sus orígenes nos encontramos diversas controversias, que motivan investigaciones sobre la publicidad y su percepción e interpretación por parte del público. En este trabajo se pretende analizar la publicidad del alcohol, en la revista Muy Interesante, por una muestra de estudiantes de las Universidades Públicas de la Provincia de Alicante. La muestra se compone de 380 inserciones de 51 marcas de bebidas alcohólicas diferentes. Nuestro propósito es doble; 1. Describir los contenidos de los mensajes publicitarios localizados; 2. Identificar los valores subyacentes en la publicidad de alcohol. El análisis fue realizado por dos grupos de informantes claves: uno compuesto por

  10. 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.

  11. 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.

  12. Prebióticos, probióticos y simbióticos en la dietoterapia de los pacientes quemados Prebiotics, probiotics and synbiotics in the diet therapy of burned patients

    OpenAIRE

    Gabriela Paula Toyama

    2010-01-01

    La composición de la microflora del tracto gastrointestinal es esencial en el mantenimiento de la función de barrera. Ésta se altera en los pacientes quemados inmediatamente después de sufrir la injuria y el consecuente aumento de la permeabilidad intestinal conlleva una mayor posibilidad de infecciones incontroladas que pueden conducir a la muerte en estos pacientes inmunocomprometidos. Los alimentos funcionales con pre-, pro- y simbióticos surgen como una estrategia terapéutica de contar co...

  13. Manejo de morbimortalidad del paciente pediátrico quemado en el hospital "Baca Ortiz" de Quito, Ecuador Handling of morbi-mortality of pediatric burned patient at "Baca Ortiz" hospital, Quito, Ecuador

    OpenAIRE

    P. Dávalos Dávalos; J. Lorena Dávila; S. Alexandra Meléndez

    2007-01-01

    En la unidad de quemados del Hospital de Niños "Baca Ortiz" de la ciudad de Quito (Ecuador) se ha realizado un estudio de la morbimortalidad de pacientes pediátricos ingresados durante el año 2005. La principal causa de quemaduras en nuestro medio son los líquidos hirvientes, con una mayor mortalidad en varones que en mujeres: 2,55% frente a 1,7%. La mortalidad global fue de 4,25% durante el año 2005, notablemente inferior al 17 % que teníamos como media hace 5 años. Existen muchos factores q...

  14. Estado de la provisión de cuidados nutricionales al paciente quemado: Auditoría de procesos en un Servicio de Quemados de un hospital terciario Current status of nutritional care provision to burnt patients: Processes audit of a burnt patients department from a tertiary hospital

    Directory of Open Access Journals (Sweden)

    L. M. Miquet Romero

    2008-08-01

    Full Text Available Justificación: La respuesta al tratamiento médico-quirúrgico del paciente quemado pudiera depender tanto de los estragos provocados por la agresión térmica, a saber las demandas metabólicas incrementadas, la aparición del Síndrome de Respuesta Inflamatoria Sistémica, y las infecciones microbianas; como de las prácticas culturales incluidas dentro de los procesos institucionales de cuidados nutricionales. Objetivo: Evaluar cómo la conducción de los procesos nutricionales de evaluación e intervención influye sobre los indicadores de la efectividad terapéutica de los Servicios de Quemados. Serie de estudio: Cuarenta y dos pacientes atendidos con una superficie corporal quemada (SCQ > 10%, entre enero del 2001-diciembre del 2003, en el Servicio de Quemados del Hospital Clínico Quirúrgico "Hermanos Ameijeiras" (Ciudad La Habana, Cuba. Métodos: Los procesos nutricionales de evaluación e intervención conducidos en el paciente quemado se auditaron mediante revisión de las historias clínicas. Los procesos auditados se declararon como Completados (o no. El grado de completamiento del proceso se relacionó con las tasas de complicaciones y mortalidad, y el índice de hospitalización predicho de la SCQ. Resultados: Los procesos nutricionales de evaluación e intervención se completaron en el 49,4% y 22,6% de las historias auditadas, respectivamente. El registro evolutivo del peso corporal se asoció con una menor mortalidad. La evaluación nutricional temprana y un aporte energético suficiente en lesionados con SCQ > 20% se asociaron con menores tasas de complicaciones y un mejor cumplimiento del índice de hospitalización. Conclusiones: Este trabajo constituye la primera aproximación al comportamiento del Servicio de Quemados de la institución, como antesala del diseño e implementación de un programa de mejoría continua de la calidad en la atención médica. Se pudo comprobar que, a pesar del estado actual de completamiento

  15. 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

  16. Mecanismos de movilidad de dislocaciones a temperaturas medias en plomo de muy alta pureza (99.9999 %

    Directory of Open Access Journals (Sweden)

    Gallego, I.

    1998-05-01

    Full Text Available The internal friction spectrum of high purity lead (99.9999 % at medium temperatures has been studied. A new peak (P1 has been found at 240 K, which has not been studied up to now. The activation energy of the process associated with F, has been determined and its experimental behaviour has also been systematically studied. The comparison between the results and the theoretical predictions of the models of dislocation mobility allows us to attribute the P1 peak to the sliding of dislocations, controlled by the climbing of jogs induced by the diffusion of vacancies along the dislocation line. This conclusion is analogue to that obtained in previous works for the P1v peak in very high purity aluminium (99.9999 %.

    Se ha realizado un estudio sistemático del espectro de fricción interna del plomo de muy alta pureza (99,9999 % a temperaturas medias, encontrándose un pico a 240 K (P1 que no ha sido estudiado en la bibliografía hasta el momento. Los análisis mediante fricción interna nos han permitido evaluar la energía de activación del proceso ligado a P1 y determinar el comportamiento de este pico en función de diversos parámetros. La comparación de los resultados experimentales con las predicciones teóricas de varios modelos microscópicos de movilidad de dislocaciones nos ha permitido concluir que el pico P1 está asociado con el deslizamiento de dislocaciones controlado por la escalada de escalones mediante la difusión de vacantes a lo largo de, la línea de dislocación. Esta interpretación es análoga a la realizada en trabajos previos para el pico P1 del aluminio de muy alta pureza (99,9999 %.

  17. MUCHO Y MUY BUEN VINO. PRODUCCIÓN VITIVINÍCOLA EN LA ZONA NORTE DE SANTIAGO (SIGLOS XVI -XVIII

    Directory of Open Access Journals (Sweden)

    Carlos Ruiz Rodríguez

    2011-10-01

    Full Text Available En la zona norte de Santiago (sectores de la Chimba, Renca, Conchalí, El Salto, Quilicura, se comenzó a producir desde poco después de la conquista española, “mucho y muy buen vino”. Se reseña el origen y particularidades de esta producción vinícola durante el período colonial. Se reconstruye un cuadro descriptivo de la viñatería colonial en la zona, junto con analizar los aspectos económicos: la evolución de la infraestructura productiva, el tipo de predios dedicados a la producción de vino, el precio de los suelos y de las plantas de viña, el uso de mano de obra (asalariada, servil y esclava y el impacto del establecimiento del régimen colonial y del consumo de alcohol en la población indígena.

  18. 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.

  19. VALORACIÓN GERIÁTRICA DE ANCIANOS DE MUY BAJOS RECURSOS SOCIO-ECONÓMICOS EN LA ARGENTINA

    Directory of Open Access Journals (Sweden)

    José Ricardo Jáuregui

    2011-01-01

    Full Text Available Objetivos: Describir el estado funcional, socio-económico y la situación ambiental de una población muy pobre de ancianos (mayores de 65 años de Argentina, y su relación con su autonomía. Métodos: Se trata de un estudio descriptivo y prospectivo. El instrumento empleado fue la escala de la Cruz Roja en español. La evaluación arriba mencionada fue completada aplicando un segundo instrumento para evaluación social descripto por Marin y colaboradores en Chile en 1994. Además, se recolectó información general de la población estudiada, como: condiciones ambientales, familiares y sociales. La comparación estadística se realizó mediante prueba de Chi-cuadrado, mientras que el test de Student o un test no paramétrico fue empleado según la distribución de los datos. Resultado: De una muetra de 219 personas, con una edad media 69 ± 6 años, se obtuvo la evaluación funcional de cada uno de ellos aplicando la escala de la Cruz Roja, clasificando los datos según la edad (mayor o menor de 75 años, educación, ingreso económico y género. No se hallo diferencia estadísticamente significativa entre los grupos etareos comparados, en ninguna de las escalas aplicadas (p=NS, ANOVA-Bonferroni. Conclusion: No se hallo diferencia estadísticamente significativa entre las personas estudiadas ni en los estados funcionales, habilidad para realizar tareas de la vida diaria, ni estado cognitivo en función de su edad, género, nivel educativo y económico.

  20. El análisis por elementos finitos: una metodología muy reciente en economía

    Directory of Open Access Journals (Sweden)

    Escribano Ródenas, Miguel

    2006-01-01

    Full Text Available La técnica de análisis por elementos finitos (AEF consiste en dividir la geometría en la que se quiere resolver una ecuación diferencial de un campo escalar o vectorial en un dominio, en pequeños elementos, teniendo en cuenta unas ecuaciones de campo en cada elemento, los elementos del entorno de vecindad y las fuentes generadoras de campo en cada elemento. Habitualmente, esta técnica es muy utilizada en el ámbito de la ingeniería debido a que muchos problemas físicos de interés se formulan mediante la resolución de una ecuación diferencial en derivadas parciales, a partir de cuya solución es posible modelar dicho problema (transmisión del calor, electromagnetismo, cálculo de estructuras, etc. Esta técnica se encuentra automatizada en las herramientas software comerciales, llamadas herramientas de análisis por elementos finitos para problemas físicos tanto de propósito general, como aplicadas a problemas físicos particulares. Sin embargo, su aplicación es aún poco conocida en economía y a veces es incluso confundida con la discretización de las ecuaciones diferenciales, técnica que es mucho más utilizada en estudios económicos. No es habitual encontrar herramientas comerciales en que se automatice esta labor para problemas económicos. Esta comunicación presenta la técnica matemática del AEF y algunas ideas para su aplicación en la resolución de problemas de tipo económico.

  1. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  3. 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)

  4. 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.

  5. 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.

  6. 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...

  7. 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.

  8. 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.

  9. 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

  10. 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...

  11. 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...

  12. 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.

  13. 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.

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

    Directory of Open Access Journals (Sweden)

    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

  15. Fricción interna en plomo de muy alta pureza (99,9999% a temperaturas medias

    Directory of Open Access Journals (Sweden)

    Gallego, I.

    2001-04-01

    Full Text Available Internal friction spectra of high purity lead (99.9999% at medium temperatures exhibit a main relaxation peak at 230 K (P1 which depends strongly on the dislocation arrangement. The mechanism associated to P1 relaxation has an activation area between 500b2 and 2000b2 and its activation energy is 0.65±0.05 eV (63±5 KJ/mol, which is only 0,6 times the autodiffusion energy of lead. The behaviour of P1 peak and its dependence on thermomechanical treatments has allowed us to conclude that it is associated to the sliding of dislocations controlled by the climbing of jogs by diffusion of vacancies along the dislocation lines. At a slightly higher temperature, another relaxation (P1 turns up in the spectra, which can be associated to different mechanisms.

    El espectro de fricción interna, a medias temperaturas, del plomo de muy alta pureza (99,9999% presenta una relajación principal a 230 K (P1, cuya intensidad depende fuertemente del estado de organización de las dislocaciones. La medida de los parámetros de activación de P1 indica que el mecanismo asociado a esta relajación tiene un área de activación comprendida entre 500b2 y 2.000b2 y un valor de la energía de activación de 0,65 ±0,05 eV (63±5 KJ/mol, que es sólo 0,6 veces la energía de autodifusión del plomo. El comportamiento de esta relajación y su dependencia con los tratamientos termomecánicos, nos ha permitido concluir que P1 está originado por el deslizamiento de dislocaciones controlado por la escalada de escalones a lo largo de la línea de dislocación. A temperaturas ligeramente superiores, aparece otra relajación (P1, cuyo origen puede estar ligado a diferentes mecanismos.

  16. 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...

  17. 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...

  18. Difusión de ondas acústicas por una esfera hueca con pared de muy poco espesor, inmersa en agua y llena de aire

    OpenAIRE

    Carbó, Rafael

    2006-01-01

    [ES] En este trabajo se investiga la difusión de ondas acústicas por una esfera hueca, de tamaño grande (ka>>1), sumergida en agua y con aire en su interior, en el caso en que el espesor de la pared de la esfera sea muy delgado (espesor de la pared

  19. 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...

  20. 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.

  1. [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

  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

  3. 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

  4. 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...

  5. 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

  6. 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

  7. 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

  8. 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.

  9. 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.

  10. 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.

  11. 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...

  12. 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...

  13. 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...

  14. 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...

  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. 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.

  17. El soporte nutrimental y su relación con algunos indicadores pronósticos del niño quemado Nutritional support and its relation to some prognostic indicators of burnt child

    Directory of Open Access Journals (Sweden)

    Alejandro Torres Amaro

    2011-12-01

    Full Text Available Introducción: las quemaduras constituyen una de las principales causas de accidentes en el niño. El tamaño de estas y el estado hipercatabólico son determinantes de la dinámica del tratamiento y la supervivencia del niño con grandes quemaduras. Objetivo: buscar la posible relación entre el soporte nutrimental establecido en las primeras horas después de la reanimación, y algunos indicadores pronósticos en niños quemados. Métodos: se realizó un estudio retrospectivo, de carácter analítico, que incluyó a 252 niños que tuvieron un ingreso en el servicio de quemados del Hospital Pediátrico Docente "Juan Manuel Márquez"de Marianao, en La Habana, con estadía superior a los 7 días, durante el decenio 2000-2009. A partir de la auditoría de las historias clínicas se obtuvieron los indicadores siguientes del pronóstico del niño quemado: superficie corporal quemada, tiempo de estadía, por ciento de pérdida de peso y mortalidad. De la misma forma se obtuvo la información acerca del tipo de soporte nutrimental metabólico empleado durante el tratamiento. Resultados: el tipo de soporte nutrimental metabólico más empleado fue el mixto, en el que se combinan las modalidades enteral y parenteral periférica, que abarcó al 52 % de los pacientes tratados. Los niños con menor por ciento de pérdida de peso (inferior al 10 % recibieron la forma enteral exclusiva (53,1 % de los casos tratados; en el 37,4 % el soporte fue mixto, pero usando la modalidad periférica de uso parenteral. Conclusiones: la estrategia nutrimental empleada en el niño quemado puede modificar algunos indicadores del pronóstico y debe ser una prioridad terapéutica para prevenir el deterioro clínico de estos pacientes.Introduction: burns are one of the major causes of accidents in child. Its size and the hypercatabolic status are determinant factors of treatment dynamics and the survival of child with large burns. Objective: to look for the possible relation

  18. Craniectomía descompresiva en el trauma encefalocraneano grave: factores pronósticos y complicaciones

    Directory of Open Access Journals (Sweden)

    Pedro Grille

    2015-06-01

    Full Text Available RESUMEN Objetivo: Análisis de las características clínicas, las complicaciones y los factores asociados al pronóstico de los pacientes con trauma encefalocraneano grave en los que se realizó craniectomía descompresiva. Métodos: Estudio retrospectivo de los pacientes asistidos en una Unidad de Cuidados Intensivos, con trauma encefalocraneano grave en los que se realizó craniectomía descompresiva, entre los años 2003 y 2012. Se siguieron los pacientes hasta el egreso de la unidad de cuidados intensivos, analizándose sus características clínico-tomográficas, las complicaciones y los factores asociados al pronóstico (análisis uni y multivariado. Resultados: Se estudiaron 64 pacientes. Se realizó craniectomía descompresiva primaria y lateral en la mayoría de los pacientes. Se halló una alta incidencia de complicaciones (78% neurológicas y 52% no neurológicas. 42 pacientes (66% presentaron mala evolución y 22 (34% tuvieron una buena evolución neurológica. De los pacientes que sobrevivieron, el 61% tuvo una buena evolución neurológica. En el análisis univariado, los factores asociados significativamente con mala evolución neurológica fueron: la hipertensión intracraneana post-craniectomía descompresiva, la mayor gravedad y el peor estado neurológico al ingreso. En el análisis multivariado, solo la hipertensión intracraneana post-craniectomía descompresiva se asoció significativamente con mala evolución. Conclusión: Se trata de un grupo de pacientes muy grave, de difícil manejo, con elevada morbimortalidad, donde la hipertensión intracraneana es un factor principal de mala evolución.

  19. 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.

  20. 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

  1. Espiritualidad, esperanza y dependencia como predictores de la satisfacción vital y la percepción de salud: efecto moderador de ser muy mayor

    Directory of Open Access Journals (Sweden)

    Amparo Oliver

    2015-01-01

    Full Text Available Objetivo: analizar algunos predictores de la calidad de vida en personas mayores, diferenciando entre mayores jóvenes o muy ma- yores. Esto es, se estudia un potencial efecto moderador debido a ser muy mayor, dado que este sector de la población está en rápido crecimiento en todo el mundo. Materiales y métodos: estudio transversal analítico de encuesta a 224 personas mayores, en dos grupos diferenciales, menores de 75 años y 75 años o más, que viven en la ciudad de Valencia (España. Resultados: se ajustó un modelo es- tructural multimuestra donde las dimensiones de espiritualidad y la esperanza predicen dos indicadores de calidad de vida en personas mayores: satisfacción vital y percepción de salud. Se han encontrado relaciones estadísticamente significativas ( p < 0,05 entre la espi- ritualidad y la esperanza, y los dos indicadores; especialmente potente es la predicción de la satisfacción vital. Asimismo, los resultados multimuestra indican que la fe juega un papel diferencial relevante en los muy mayores. Discusión: se ponen en relación los hallazgos con la literatura. Conclusiones: existe un importante impacto, en algunos casos diferencial para los muy mayores, de la espiritualidad sobre indicadores de envejecimiento con éxito tales como la satisfacción vital y la salud, y la capacidad para realizar actividades, ya sea instrumentales de la vida diaria, o en general todo tipo de actividades productivas.

  2. 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.

  3. 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.

  4. 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.

  5. 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.

  6. Dolines in Sierra de Quemado and their relationship with the development of the Gran Caverna de Santo Tomàs, Vinales, Cuba

    Science.gov (United States)

    Farfan Gonzalez, Hermes; Diaz Guanche, Carlos; Aldana Vilas, Carlos

    2010-05-01

    Dolines are the most representative landforms of karst territories, and have a very significant development in the tropical karst. In the Sierra de los Órganos (West Cuba), the doline development in size and depth has been taken in consideration in several papers, especially after the classic works of Herbert Lehman in the 50's. Recent studies have revealed that horizontal and vertical development of doline is conditioned by tectonics, their spatial location, and is strongly controlled by the local base level. In the Sierra de Quemado, about 30 dolines were recognized with a remarkable variability in shape, size and depth. They are mainly collapsed dolines with different deepening phases, clearly marking the various evolutionary stages of the system, and working as individual entities to control the surface erosion, notably influencing the configuration of the main karst system such as the Gran Caverna de Santo Tomás. Collapse dolines originate as a consequence of the loss of mass, due to speleogenetic processes and the likely fall of the roofs of caves that developed below the dolines. The successive evolution of dolines often took place for the proximity of a cave (active or not), evolving parallelly. When doline deepening reached this level, the retraction of the walls began, which also had an influence on the hypodermic cavities observed in the dolines, and on some foot-caves ("marginal caves" or "füsshölen") that acted as important recharge points. Instability of part of the slope will cause its final collapse. Vertical jointing and faulting, together with the high values in the angles of internal friction, thoroughly contribute to the process of slope recession. Because of their different phases and evolutionary stages, the ranges in the morphometric values of dolines are high: some dolines have dimensions similar to "Tiankeng", with more than 100 metres in diameter and depth. As a rule, the different deepening phases that mark the evolutionary stages of

  7. 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.

  8. 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.

  9. 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).

  10. Proteoliposomas de muy pequeña talla:un nuevo adyuvante diseñado para la inmunoterapia del cáncer

    OpenAIRE

    Mesa Pardillo, Cirse

    2005-01-01

    En el Centro de Inmunología Molecular se diseñó y describió un nuevo adyuvante dirigido al uso en vacunas para tratamientos de pacientes inmunocomprometidos. Estos proteoliposomas de muy pequeño tamaño, llamados VSSP, combinan en su estructura el gangliósido GM3, para el que se han descrito propiedades inmunosupresoras del sistema inmune, y vesículas de membrana externa de Neisseria meningitidis con demostradas características inmunoestimuladoras. En este trabajo se demuestra que los VSSP, in...

  11. Requisitos de usuario para los satélites post-MSG aplicados al nowcasting y predicción a muy corto plazo

    OpenAIRE

    Tamayo, Jorge

    2001-01-01

    Ponencia presentada en: V Simposio Nacional de Predicción, celebrado en 2001 en Madrid. El consejo de EUMETSAT ha iniciado las actividades preparatorias para planificar las misiones de los satélites geoestacionarios que sustituirán a la serie MSG, próxima a entrar en operación. Con este objetivo, se ha formado, entre otros, un grupo de trabajo dedicado al Nowcasting y predicción a muy corto plazo. Entre otras tareas, este grupo debe presentar cuáles son los escenarios previstos a medio ...

  12. 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...

  13. 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...

  14. 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.

  15. Prebióticos, probióticos y simbióticos en la dietoterapia de los pacientes quemados Prebiotics, probiotics and synbiotics in the diet therapy of burned patients

    Directory of Open Access Journals (Sweden)

    Gabriela Paula Toyama

    2010-09-01

    Full Text Available La composición de la microflora del tracto gastrointestinal es esencial en el mantenimiento de la función de barrera. Ésta se altera en los pacientes quemados inmediatamente después de sufrir la injuria y el consecuente aumento de la permeabilidad intestinal conlleva una mayor posibilidad de infecciones incontroladas que pueden conducir a la muerte en estos pacientes inmunocomprometidos. Los alimentos funcionales con pre-, pro- y simbióticos surgen como una estrategia terapéutica de contar con inmunomoduladores biológicos que limiten el desarrollo y la translocación de bacterias patógenas y endotoxinas, la infección nosocomial y la respuesta inflamatoria sistémica de origen intestinal. Los objetivos de este trabajo fueron describir el fenómeno de translocación bacteriana y la alteración de la permeabilidad de la mucosa intestinal en el paciente quemado, y reconocer los productos alimenticios y nutroterápicos funcionales con efecto pre-, pro-y simbiótico más adecuados que puedan ser ofrecidos oportunamente. Los mecanismos que favorecen la translocación son: la pérdida de la función de barrera, la modificación en el contenido de las bacterias de la luz intestinal y las alteraciones inmunológicas del huésped. Los prebióticos pueden ocasionar síntomas gastrointestinales secundarios al efecto osmótico y a la fermentación en la luz intestinal. El uso de la bacterioterapia con probióticos y simbióticos requiere una consideración juiciosa de los potenciales efectos adversos de determinadas cepas bacterianas, como son las infecciones por transmigración y la acidosis Dláctica. La experiencia en el abordaje del paciente quemado con alimentos y nutroterápicos con función pre-, pro-o simbiótica es aún insuficiente para poder formular recomendaciones en cuanto a su consumo y más aún de aquellos disponibles en el mercado.The composition of the gastrointestinal tract microflora is essential to maintain the barrier function

  16. Prevalencia del síndrome del quemado y estudio de los factores asociados en los trabajadores de un hospital comarcal Burnout syndrome: prevalence and associated factors among workers in a district hospital

    Directory of Open Access Journals (Sweden)

    G. Pera

    2002-12-01

    Full Text Available Objetivo: El síndrome del quemado o de burnout es un tipo de estrés laboral que puede tener repercusiones psicosomáticas, conductuales, emocionales, familiares y sociales, y que puede ser motivo de absentismo laboral y de bajo rendimiento en el trabajo. El objetivo de este trabajo es conocer la prevalencia del síndrome del quemado entre los trabajadores de un hospital comarcal, así como conocer las características personales y laborales que se asocian a dicho síndrome. Métodos: Se diseñó un estudio observacional transversal en el que se seleccionó una muestra aleatoria, estratificada por categoría profesional, de 300 trabajadores a los que se les administró el Maslach Burnout Inventory para medir el grado de burnout. Este cuestionario consta de tres subescalas: el cansancio emocional, la despersonalización y la realización personal. Resultados: El 13,9% de los entrevistados presentó un grado elevado de burnout para el cansancio emocional, el 11,1% para la despersonalización y el 6,6% para la realización personal. Ninguno de los entrevistados obtuvo puntuaciones elevadas en las tres escalas a la vez, mientras que un 27% presentó un grado alto de burnout en al menos una de las tres escalas. En el análisis multivariante la categoría profesional y el sexo se asociaron de forma estadísticamente significativa con un alto grado de burnout. Conclusiones: La prevalencia de síndrome del quemado en el hospital de Mataró es relativamente baja y se asocia al género y la categoría profesional.Aim: Burnout syndrome refers to a kind of occupational stress that can have psychosomatic, behavioral, emotional, familial, and social repercussions; it can also cause absenteeism and loss of efficacy at work. The aim of this study was to determine the prevalence of burnout among staff in a district hospital, as well as the personal and working characteristics associated with the syndrome. Methods: A cross-sectional study was designed in which a

  17. 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.

  18. 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.

  19. 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.

  20. 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.

  1. 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.

  2. Processo de cuidar da criança queimada: vivência de familiares Procedimiento para el cuidado de los niños quemados: experiencia en familia Burnt children care procedure: experience in family

    Directory of Open Access Journals (Sweden)

    Milla Chianca Gomes Varela

    2009-10-01

    Full Text Available Este estudo teve o objetivo de descrever a vivência de familiares no cuidado da criança que sofreu queimadura. Foi realizado um estudo exploratório, em um hospital de emergência na cidade de João Pessoa - PB, com dez acompanhantes de crianças hospitalizadas, vítimas de queimadura. Os resultados mostraram que os agentes térmicos foram os maiores causadores das queimaduras nas crianças. O discurso dos participantes revela que a maioria dos acidentes ocorreu na presença do cuidador, menciona algumas condutas erradas após a ocorrência do acidente e alguns consideram a experiência de cuidar da criança queimada como negativa, o que evidencia a necessidade de orientação da população em geral e a participação no cuidar da criança queimada.Este estudio tuvo como objetivo describir la experiencia de la familia en el cuidado de los niños que han sufrido quemaduras. Un estudio exploratorio fue realizado en un hospital de emergencia en la ciudad de João Pessoa - PB, con diez compañeros de los niños hospitalizados por quemaduras. Los resultados enseñaron que los agentes térmicos fueron la principal causa de quemaduras en los niños. El discurso de los participantes indica que la mayoría de los accidentes se produjo en presencia del cuidador, menciona algunos procedimientos equivocados después del accidente, mientras que algunos consideran que la experiencia de cuidar de los niños quemados es negativa, destacando la necesidad de orientación para la población general y participación en el cuidado de los niños quemados.This study aimed to describe the family experience in the care of the child who got burnt. An exploratory study was conducted in a hospital emergency room in the city of João Pessoa - PB, with ten companions of hospitalized burnt children. The results showed that the thermal agents were the biggest cause of children's burns. The speech of the participants shows that most accidents occurred in the presence of the

  3. 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.

  4. 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...

  5. Conduta anestésica em balneoterapia de pacientes queimados: avaliação prospectiva de 2852 procedimentos Conducta anestésica en balneoterapia de pacientes quemados: evaluación prospectiva de 2852 procedimientos Anesthetic procedure for balneotherapy of burned patients: prospective evaluation of 2852 cases

    Directory of Open Access Journals (Sweden)

    Fernando Antônio de Freitas Cantinho

    2004-04-01

    (+-cetamina, midazolam e fentanil pela mesma via (p = 0,039. Houve um caso de parada cardíaca em paciente moribundo, que foi recuperado, prosseguindo-se o banho até o final. CONCLUSÕES: A S(+-cetamina, o midazolam e o fentanil foram os agentes mais empregados, sendo a S(+-cetamina o principal agente. As técnicas anestésicas empregadas mostraram-se seguras e eficazes.JUSTIFICATIVA Y OBJETIVOS: La analgesia profunda en el paciente quemado, que necesita de cuidados diarios de las lesiones, constituye un campo de actuación del anestesiologista en que las referencias de conducta aun son muy escasas. El objetivo de este estudio fue evaluar la conducta anestésica en balneoterapia de pacientes quemados en 2852 procedimientos. MÉTODO: Fue realizada evaluación prospectiva de las alternativas de analgesia y sedación utilizadas por anestesiologistas, en el período de 1 año. Edad, peso, sexo, superficie corporal quemada (SCQ, drogas y dosis utilizadas, duración, monitorización, número de procedimientos por paciente y complicaciones, fueron registradas. Para la análisis de los resultados, la muestra fue dividida en grupos: grupo A, con edad hasta 10 años; grupo B, 11 a 17 años; grupo C, 18 a 65 años; grupo D, mayores de 65 años, los datos fueron comparados. RESULTADOS: Fueron 2852 procedimientos realizados en 134 pacientes. En el grupo A, fueron 743 procedimientos en 42 pacientes; en el grupo B, 354 procedimientos en 16 pacientes; en el grupo C, 1573 procedimientos en 68 pacientes; en el grupo D, 182 procedimientos en 8 pacientes. En toda la muestra, la S(+-cetamina por vía venosa, como agente único, fue usada en 116 casos. La S(+-cetamina, asociada al midazolam, por vía venosa, fue usada en 631 casos. La S(+-cetamina, asociada al midazolam y al fentanil, por vía venosa, fue usada en 1562 casos. La S(+-cetamina por vía muscular, como agente único, fue utilizada en 188 casos, siendo 173 en el grupo A. El propofol fue asociado en otros 149 casos. La cetamina racémica fue

  6. Ventilación mecánica convencional en recién nacidos muy bajo peso ingresados en el hospital provincial Dr. Ernesto Guevara de la Serna

    OpenAIRE

    Lenny Carbonell García; Alicia Fernández Chacón; Yadira Rodríguez Ramírez; Maribel Machado

    2015-01-01

    Se realizó un estudio descriptivo de corte transversal, para determinar el comportamiento de los recién nacidos muy bajo peso, ventilados en modalidades convencionales en el Hospital General Docente “Dr. Ernesto Guevara de la Serna”, en el período de enero de 2010 a julio de 2012. El universo estuvo constituido por 104 recién nacidos vivos muy bajo peso, tomándose como muestra a los 66 recién nacidos muy bajo peso que necesitaron apoyo ventilatorio. Las principales variables a estudiar fueron...

  7. 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.

  8. 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...

  9. 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...

  10. 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...

  11. 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...

  12. 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...

  13. 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...

  14. 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.

  15. 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.

  16. 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...

  17. 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.

  18. ¿Trombosis muy tardía de stent coronario? Más allá de la angiografía

    Directory of Open Access Journals (Sweden)

    Teresa Alvarado

    2016-03-01

    Full Text Available Varón de 60 años con antecedentes de hipertensión arterial, dislipemia y cardiopatía isquémica, esta última con debut 8 años antes por angina inestable; en ese momento se realizó coronariografía que mostró enfermedad de la coronaria derecha (CD: un vaso ectásico, con importante remodelado positivo y lesiones graves en su segmento distal, y en el proximal de la rama posterolateral. Se trató mediante implante de dos stents no farmacoactivos. Desde entonces el paciente permaneció asintomático, con buen control de los factores de riesgo cardiovascular.

  19. Viviendas de muy bajo coste

    Directory of Open Access Journals (Sweden)

    Lemus, V.

    1982-11-01

    Full Text Available Not available.En el Instituto de Investigaciones en Materiales de la Universidad Nacional Autónoma de México, se está desarrollando un área de investigación sobre tecnología de materiales y tecnología de sistemas constructivos, la cual está integrada por diversos proyectos encaminados a solucionar problemas relativos a la vivienda. El presente trabajo consiste en el desarrollo de materiales compuestos a base de desechos agrícolas e industriales, con características tales como baja densidad, resistencia adecuada, excelentes propiedades térmicas y acústicas y, fundamentalmente, bajo costo y gran disponibilidad. Los resultados obtenidos son bastante alentadores debido a la durabilidad y resistencia mecánica obtenidos a base del tratamiento proporcionado a la materia orgánica. Se comentan las aplicaciones actuales y futuras de estos nuevos materiales.

  20. Viviendas de muy bajo coste

    OpenAIRE

    Lemus, V.; López, H.; Olvera, H.

    1982-01-01

    Not available.En el Instituto de Investigaciones en Materiales de la Universidad Nacional Autónoma de México, se está desarrollando un área de investigación sobre tecnología de materiales y tecnología de sistemas constructivos, la cual está integrada por diversos proyectos encaminados a solucionar problemas relativos a la vivienda. El presente trabajo consiste en el desarrollo de materiales compuestos a base de desechos agrícolas e industriales, con características tales como baja densidad, r...

  1. 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.

  2. Las dietas de muy bajo valor calórico (DMBVC en el manejo clínico de la obesidad mórbida

    Directory of Open Access Journals (Sweden)

    Francisco Javier Vilchez López

    2013-04-01

    Full Text Available La obesidad mórbida y sus complicaciones suponen un problema cada vez más prevalente. Para su abordaje terapéutico existen diferentes modalidades dietéticas, siendo las dietas de muy bajo valor calórico (DMBVC, que aportan entre 450 y 800 kcal diarias, una opción cada vez más utilizada. Tras una adecuada selección del paciente, pueden conseguir una importante pérdida ponderal en 8-16 semanas, contribuyendo a la mejora del control de las complicaciones crónicas como la diabetes, la hipertensión arterial, la dislipemia (salvo por elevación inicial de HDL colesterol y el síndrome de apnea-hipopnea del sueño. Las dietas muy bajas en calorías son cada vez más utilizadas en el preoperatorio de la cirugía bariátrica, habiéndose demostrado una disminución en la esteatosis hepática y la grasa visceral abdominal. Aunque los resultados de los diferentes estudios son controvertidos, la utilización preoperatoria de estas dietas podrían disminuir la tasa de complicaciones perioperatorias, el tiempo quirúrgico de la intervención y la estancia hospitalaria. Tras la cirugía bariátrica se produce una disminución drástica en la ingesta, con riesgo de déficit proteico en la dieta, que deben ser corregidos con frecuencia con la suplementación mediante módulos de proteínas. Se debe monitorizar a los pacientes sometidos a este tipo de dietas, ante el riesgo de desarrollar efectos secundarios como colelitiasis, hiperuricemia y pérdida de masa ósea entre otros.

  3. Estructuras de fábrica: enfoques «antiguos» y «modernos» para fenómenos muy locales

    Directory of Open Access Journals (Sweden)

    Magdalena-Layos, F.

    2016-06-01

    Full Text Available The characterization of the material as a discontinuous media is proposed to study strongly local phenomena in the behaviour of historical masonry structures. Three methods are implemented: an experimental method, photoelastic, and two numerical methods, heterogeneous finite elements and rigid blocks in unilateral contact. Qualitative comparison of the results shows that the random irregularities in the contact between bodies play an important role in explaining local behaviour of masonry. Quantitative comparison with the results of load tests previously performed on dry masonry walls support this hypothesis. The results are very encouraging and suggest that it is necessary to develop approaches of this kind –approaches that, although relatively common in the field of granular media, have been very scarce in the field of historic masonry structures.Para estudiar ciertos fenómenos de comportamiento local en las estructuras históricas de fábrica se propone la caracterización del material como un medio discontinuo. Se implementan tres métodos: uno experimental, fotoelástico, y dos numéricos, elementos finitos heterogéneos y bloques rígidos en contacto unilateral. De la comparación cualitativa de los resultados se deduce que las irregularidades aleatorias en el contacto entre piezas desempeñan un importante papel en la explicación del comportamiento local de la fábrica. La comparación cuantitativa con los resultados de ensayos de carga realizados previamente sobre muros aparejados en seco apoyan esta hipótesis. Los resultados obtenidos son muy esperanzadores y hacen pensar que es necesario profundizar en el desarrollo de enfoques de este tipo que, aún siendo relativamente comunes en el campo de los medios granulares, han sido muy escasos en el campo de las estructuras históricas de fábrica.

  4. [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.

  5. 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...

  6. 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.

  7. 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.

  8. 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...

  9. 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.

  10. 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.

  11. 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.

  12. 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.

  13. 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.

  14. Recuperación nutricional de recién nacidos de muy bajo peso durante el primer año de vida

    Directory of Open Access Journals (Sweden)

    Virginia Díaz-Argüelles Ramírez-Corría

    2003-06-01

    Full Text Available Los recién nacidos de muy bajo peso al nacer tienen un doble reto en su crecimiento durante el primer año de vida, porque tienen escasas reservas energéticas, disminución de la capacidad para tolerar grandes ingestas, y elevadas necesidades de energía y macronutrientes para asegurar un crecimiento acelerado. El objetivo de este trabajo fue caracterizar el crecimiento durante el primer año de vida de recién nacidos de muy bajo peso y un grupo control de término. Para ello se realizó un estudio de cohorte en 25 recién nacidos con peso al nacer menor de 1 800 g y 34 semanas de edad gestacional, nacidos en el Hospital Ginecoobstétrico "Ramón González Coro", en Ciudad de La Habana, desde enero de 2000 hasta enero de 2001 y en 25 recién nacidos de buen peso a término como grupo control. Se evaluaron aspectos del desarrollo nutricional perinatal y antropométrico, mediante la utilización de la evolución del peso, talla, circunferencia cefálica y circunferencia del brazo, durante el primer año de vida. Se encontró que el crecimiento longitudinal fue bueno en recién nacidos de muy bajo peso, aunque no lograron los canales de crecimiento de lactantes de término al cumplir el año de edad. El peso para la edad fue el indicador que demoró más la recuperación.The very low birthweight newborns face a double challenge in their growth during the first year of life because they have little energy reserves, reduced capacity to tolerate large intakes and high energy and micronutrient requirements to assure an accelerated growth. The objective of this paper was to characterize the growth during the first year of life of very low birthweight newborns and a term control group. To this end, a cohort study was conducted on 25 newborns whose birthweight was under 1800g, with 34 weeks of gestational age, born at "Ramón Gónzalez Coro" Gynecological and Obstetric hospital in City of Havana from January, 2000 to January 2001 and on 25 term

  15. 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...

  16. 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.

  17. Algunos aspectos del manejo del paciente quemado en un servicio de cirugía infantil: A propósito de 47 pacientes pediátricos Some aspects burned patient management in a department of surgery child: About 47 pediatric patients

    OpenAIRE

    Schwartz, R. J.; C N Chirino; S V Sáenz; T V Rodríguez

    2008-01-01

    Si bien el manejo inicial de los niños quemados es fundamental para el resultado exitoso del tratamiento de esta cohorte de pacientes, el aspecto quirúrgico en el siguiente nivel tiene una importancia similar. En este estudio se presenta un análisis epidemiológico de 47 pacientes, tratados en nuestro Servicio en un período de dos años. Se esboza un análisis de los datos estadísticos obtenidos, se sacan conclusiones y se elaboran normas de profilaxis.While the initial management of burned chil...

  18. 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

  19. 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.

  20. El basamento metamórfico de muy bajo a bajo grado de las estancias La Modesta y La Josefina, macizo del Deseado, provincia de Santa Cruz

    Directory of Open Access Journals (Sweden)

    P. Moreira

    2005-03-01

    Full Text Available En este trabajo se exponen los resultados de un relevamiento detallado de las metamorfitas de la Formación La Modesta en su localidad tipo. Estudios petrográficos, geoquímicos y estructurales de estas rocas permitieron identificar nuevas litologías que integran esta unidad (rocas calcosilicáticas, metavolcanitas básicas, turmalinitas y bancos de óxidos de Fe y Mn, posibilitaron además establecer que el grado metamórfico alcanzado ha sido de muy bajo a bajo en prehnita-pumpellita transicional a facies de esquistos verdes. Se reconoció una esquistosidad S1 subparalela a las superficies de sedimentación S0. Se ha reinterpretado su ubicación temporal sobre la base de una datación (errorcrona Rb-Sr: 413 ± 17 Ma. Además se correlaciona esta formación con otras unidades sedimentarias de bajo grado metamórfico de regiones aledañas del macizo del Deseado y separarla de las rocas del Complejo Río Deseado. Por último, se propone una posible evolución geológica pre-mesozoica para la zona a partir de un margen protopacífico.

  1. 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).

  2. 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

  3. 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

  4. 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...

  5. 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...

  6. 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...

  7. 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.

  8. 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.

  9. [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.

  10. 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.

  11. Manejo de morbimortalidad del paciente pediátrico quemado en el hospital "Baca Ortiz" de Quito, Ecuador Handling of morbi-mortality of pediatric burned patient at "Baca Ortiz" hospital, Quito, Ecuador

    Directory of Open Access Journals (Sweden)

    P. Dávalos Dávalos

    2007-09-01

    Full Text Available En la unidad de quemados del Hospital de Niños "Baca Ortiz" de la ciudad de Quito (Ecuador se ha realizado un estudio de la morbimortalidad de pacientes pediátricos ingresados durante el año 2005. La principal causa de quemaduras en nuestro medio son los líquidos hirvientes, con una mayor mortalidad en varones que en mujeres: 2,55% frente a 1,7%. La mortalidad global fue de 4,25% durante el año 2005, notablemente inferior al 17 % que teníamos como media hace 5 años. Existen muchos factores que agravan el pronóstico evolutivo de estos pacientes como son: la edad, superficie corporal quemada, estado nutricional y antecedentes personales. El proceso infeccioso se detecta mediante la clínica; realizamos cultivos de biopsias de piel con un alto porcentaje de positividad de 67,64%. Detectamos resistencia bacteriana y empezamos a utilizar Quinolonas (Ciprofloxacina.We present a study of morbi-mortality of burned children who entered in Burned Unit at "Baca Ortiz" Children Hospital in Quito (Ecuador during 2005. Burns main cause are boiling liquids and mortality is higher in men than in women: 2,55% vs 1,7%. Global mortality during 2005 was of 4,25% with a noted decrease than the one obtained five years ago, which was 17%. There are many factors aggravating patients' evolutional prognosis, such as: age, burned body surface, nutritional status and personal backgrounds. Infectious process is detected by the clinic and tissue biopsies cultivations are made, with a highly positive percentage (67,64%. Antibacterial resistance was detected and we began to use Quinolones (Ciprofloxacin.

  12. 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.

  13. 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.

  14. 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.

  15. Crecimiento en recién nacidos prematuros de muy bajo peso natal Growth of very low birthweight pre-term neonates

    Directory of Open Access Journals (Sweden)

    Tania Mayvel Espinosa Reyes

    2013-04-01

    Full Text Available Introducción: la expectativa de crecimiento óptimo de recién nacidos pretérminos, cuyos pesos al nacer fueron muy bajos, no está totalmente dilucidada, lo cierto es que esta población no crece de forma homogénea. Objetivos: caracterizar el crecimiento posnatal durante el primer año de vida, y determinar los factores asociados al crecimiento recuperador de esos recién nacidos. Métodos: se realizó un estudio descriptivo longitudinal prospectivo, que incluyó a los prematuros con peso natal inferior a 1 500 g nacidos en 4 hospitales ginecobstétricos de Ciudad de La Habana, entre el 1ro. de enero de 2005 y el 31 de diciembre de 2007. Resultados: la muestra estuvo conformada por 73 pacientes, 37 del sexo femenino (50,7 %. El 60,2 % nació entre las 32-36 semanas de gestación, el 50,6 % con un peso entre 1 200-1 399 g, y el 36 % con una talla entre 38-40,9 cm. A los 3 meses el 70 % se encontró por debajo del 3 percentil de talla/edad y peso/edad, y al año más del 50 % alcanzó percentiles normales. La menor edad gestacional, el embarazo único, la lactancia materna exclusiva (68,5 %, su mayor duración, así como la ausencia de infecciones, se relacionaron con mayor ganancia de peso, con significación estadística. Conclusiones: los recién nacidos pretérmino y de muy bajo peso al nacer tienen un ritmo de crecimiento acelerado durante el primer año de vida. Este crecimiento recuperador está relacionado con factores perinatales, posnatales y nutricionales.Introduction: the expectations of optimal growth of preterm newborns, whose birthweights were very low, are not totally clear; the real thing is that this population does not show homogeneous growth. Objectives: to characterize the postnatal growth for the first year of life and to determine those factors associated with their catch-up growth. Methods: a prospective longitudinal and descriptive study was conducted, which included preterm infants with birthweight under 1 500 g, born

  16. 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)

  17. 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.

  18. 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.

  19. 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.

  20. [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.

  1. RELACIÓN ENTRE LA DIVERSIDAD DE ANUROS Y LOS ESTADOS SUCESIONALES DE UN BOSQUE MUY HÚMEDO MONTANO BAJO DEL VALLE DEL CAUCA, SUROCCIDENTE COLOMBIANO

    Directory of Open Access Journals (Sweden)

    GARCÍA-R. JUAN CARLOS

    2007-12-01

    Full Text Available Se examinó la relación de parámetros vegetales y variables climáticas con ladistribución y la abundancia de anuros en un bosque muy húmedo montano bajo deloccidente del Valle del Cauca, Colombia. Se muestrearon durante siete meses seistransectos en tres tipos de hábitat (bosque secundario, bosque secundario tempranoy matorral. Se obtuvieron datos de las características del bosque (cobertura, alturaspromedias y densidades de diferentes estratos, profundidad de la hojarasca, temperaturadel aire, temperatura del suelo y humedad relativa en cada sitio. Se registraron cincoespecies del género Pristimantis y una del género “Eleutherodactylus”, siendo la másabundante P. brevifrons con un total de 19 individuos, seguida de P. palmeri con 15 y P.erythropleura con 14. La distribución de las especies presentó diferencias significativasentre los hábitats y las variables climáticas. La abundancia de las especies en el bosquesecundario estuvo correlacionada con la temperatura del suelo, y en bosque secundariotemprano y matorral con la humedad relativa. De acuerdo con los aspectos estructuralesde la vegetación, se sugiere la existencia de tres comportamientos diferentes dentrodel grupo de anuros respecto a los siguientes parámetros: cobertura vegetal (%, alturapromedio (m del estrato subarbóreo (Ar, densidad de este estrato (ind/m2, densidad(ind/m2 del estrato arbustivo (ar y la profundidad de la capa de hojarasca (cm. Porlo tanto, se observan tres grupos de especies aparentemente diferentes, definidossegún los siguientes criterios: el grupo I, constituido por especies que toleran más losambientes medianamente intervenidos (P. brevifrons, P. erythropleura, “E”. mantipus;el grupo II, cuyas especies se encuentran presentes en ambientes más conservados(P. calcaratus, P. thectopternus; y el grupo III conformado por P. palmeri, presenteen ambientes mediana y altamente intervenidos

  2. Hábitos alimentarios del mapachín (Procyon lotor (Carnivora: Procyonidae en un bosque muy húmedo tropical costero de Costa Rica

    Directory of Open Access Journals (Sweden)

    Eduardo Carrillo

    2001-12-01

    Full Text Available Se determinaron los hábitos alimentarios del mapachín (Procyon lotor en el Parque Nacional Manuel Antonio, un bosque tropical muy húmedo ubicado en la costa del Pacífico de Costa Rica, durante la estación lluviosa del año 1987 (mayo a diciembre, la estación lluviosa de 1989 (setiembre a diciembre y durante la estación seca del año 1990 (enero a abril. Mediante el análisis de 134 muestras de heces se determinó que la categoría más importante en la dieta del mapachín estuvo compuesta por los cangrejos de tierra (Gecarcinus quadratus y Cardisoma crassum, con una frecuencia relativa de 0.94 en la estación lluviosa del año 1987, 0.76 en la estación lluviosa del año 1989 y 0.65 en la estación seca de 1990. La segunda categoría en importancia estuvo compuesta por frutos, con una frecuencia relativa de 0.09 en la estación lluviosa del año 1987, 0.32 en la estación lluviosa del año 1989 y 0.44 en la estación seca del año 1990. De acuerdo con los cambios estacionales en la dieta, los mapachines forrajearon de manera eficiente para maximizar la ganancia en la tasa neta de energíaRaccoon (Procyon lotor food habits were studied at Manuel Antonio National Park, a tropical rain forest in the Pacific coast of Costa Rica from May to December 1987, from September to December 1989 and from January to April 1990. A 134 feces sample size was used to assess the most important items in raccoon diet: two crab species (Gecarcinus quadratus and Cardisoma crassum with a relative frequency of 0.94 in the rainy season of 1987, 0.76 in the rainy season of 1989 and 0.65 in the dry season of 1990. Fruits were the second category in importance, with relative frequencies of 0.09 for 1987, 0.32 for 1989 and 0.44 for 1990

  3. 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

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

    Directory of Open Access Journals (Sweden)

    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.

  5. 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.

  6. 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.

  7. La Función Atencional en niños que concurren a una escuela de contexto socio económico muy desfavorable

    Directory of Open Access Journals (Sweden)

    Adriana Cristóforo

    2013-11-01

    Full Text Available La función atencional es una compleja función en tanto requiere para su desarrollo de la estimulación de la estructura anatómica y funcional del cerebro en los primeros tiempos del desarrollo del bebé; de la disponibilidad de los padres para el cuidado y para la consideración de las necesidades afectivas del niño; y de prácticas de crianza que la favorezcan. Se presentan en el artículo resultados parciales de la investigación “La función atencional en la generación Milenium Interrogando el diagnóstico de ADD/ADHD” (2010-2012. Se trata de los resultados obtenidos por niños y niñas de entre 6 y 9 años que viven en situación de pobreza, y que cursan primer año en una escuela de contexto socio económico muy desfavorable de Montevideo. Se exponen las características que presentó la función atencional de los 14 niños estudiados. Se examinó la atención a través del Test de cancelación de Hale – Denckla (HDCT y del Índice de Ausencia de Distractibilidad (IAD de la escala Weschler para niños (WISC III. Para estudiar las fantasías y sentimientos vinculados a la atención, se utilizó un dispositivo gráfico: Situación Persona Prestando Atención. Los niños y niñas del estudio, obtuvieron en su mayoría rendimientos que se ubicaron por debajo de la media esperada para su edad, en el HDCT y en el IAD. Sus producciones gráficas mostraron fallas en la constitución subjetiva (en la diferenciación yo-no yo, ausencia de escena y de otro personaje, dando cuenta de la dificultad para significar al mundo y a los otros, necesarios en el proceso de atender. The attention function is a complex one since its development requires stimulation of the anatomic and functional structures of the brain in the first moments of the child's development. In addition, it needs that the parents be available for child care and the consideration of their emotional needs, as well as parenting practices that favor it. In this article I present

  8. Avaliação da cetamina racêmica e do isômero S(+, associados ou não a baixas doses de fentanil, na balneoterapia do grande queimado Evaluación de la cetamina racémica y del isómero S(+, asociados o no a bajas dosis de fentanil, en la balneoterapia del gran quemado Assessment of the use of racemic ketamine and its S(+ isomer, associated or not with low doses of fentanyl, in balneotherapy for major burn patients

    Directory of Open Access Journals (Sweden)

    Fernando Antônio de Freitas Cantinho

    2009-08-01

    desencadena un estímulo doloroso muy intenso. Este estudio tuvo el objetivo de evaluar la seguridad y la eficacia de diferentes combinaciones de fármacos en la anestesia para balneoterapia. MÉTODO: Con la aprobación del Comité de Ética, fueron estudiados 200 procedimientos de balneoterapia en 87 grandes quemados adultos. En todos los casos se usó el midazolam. Se utilizaron frascos numerados de la cetamina, y cuando se usaron no se sabía si era racémica o S (+. Todas las mañanas, se hacía el sorteo para saber si los procedimientos de ese día serían comandados por el fentanil o no. Quedaron establecidos cuatro grupos: ISO/sf (isómero S(+ sin el fentanil, ISO/cf (isómero S(+ con el fentanil, RAC/sf (cetamina racémica sin el fentanil y RAC/cf (cetamina racémica con el fentanil. Las dosis iniciales propuestas fueron: midazolam 0,06 mg.kg-1, cetamina 1,0 a 1,1 mg.kg-1, fentanil 0,8 ¼g.kg-1; las dosis adicionales se administraban conforme a lo necesario. RESULTADOS: En solo un caso hubo recuerdo de dolor durante la balneoterapia. En el grupo que recibió la cetamina S(+, la añadidura del fentanil no mostró ventajas. Asociado a la forma racémica, el fentanil redujo la dosis total y el número de bolo de la cetamina. La extensión de la superficie corporal quemada fue el principal determinante de la intensidad de dolor posprocedimiento. La menor intensidad de dolor posprocedimiento, fue el principal factor considerado por el paciente para su satisfacción por la anestesia recibida. CONCLUSIONES: Las cuatro diferentes combinaciones de fármacos fueron seguras y permitieron la ausencia de dolor durante la balneoterapia. Las características no vinculadas directamente a los anestésicos, tuvieron una mayor importancia en la definición del dolor posprocedimiento, que fue la principal característica considerada por el gran quemado para definir su satisfacción con la anestesia recibida.BACKGROUND AND OBJECTIVES: The care of the wounds of major burn patients triggers

  9. 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.

  10. 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...

  11. 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...

  12. 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...

  13. 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.

  14. 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.

  15. 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.

  16. [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.

  17. 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...

  18. 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...

  19. 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...

  20. 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.

  1. 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.

  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. 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....

  6. Algunos aspectos del manejo del paciente quemado en un servicio de cirugía infantil: A propósito de 47 pacientes pediátricos Some aspects burned patient management in a department of surgery child: About 47 pediatric patients

    Directory of Open Access Journals (Sweden)

    R J Schwartz

    2008-06-01

    Full Text Available Si bien el manejo inicial de los niños quemados es fundamental para el resultado exitoso del tratamiento de esta cohorte de pacientes, el aspecto quirúrgico en el siguiente nivel tiene una importancia similar. En este estudio se presenta un análisis epidemiológico de 47 pacientes, tratados en nuestro Servicio en un período de dos años. Se esboza un análisis de los datos estadísticos obtenidos, se sacan conclusiones y se elaboran normas de profilaxis.While the initial management of burned children is fundamental to the successful outcome of treatment of this cohort of patients, surgical appearance at the next level has an equal importance. This study provides an epidemiological analysis of 47 patients treated in our department in a period of two years, outlined an analysis of statistical data obtained, conclusions drawn and develop standards for prophylaxis.

  7. Factores de riesgo para el desarrollo de infecciones intrahospitalarias en pacientes quemados. Hospital S. Juan de Dios, Costa Rica: Enero 2003-Diciembre 2005. Parte I Risk factors for development of intrahospitalary infections in burned patients. Hospital S. Juan de Dios, Costa Rica: January 2003-December 2005. Part I

    Directory of Open Access Journals (Sweden)

    S. Vargas Naranjo

    2009-09-01

    Full Text Available La infección intrahospitalaria es una de las principales causas de morbilidad y mortalidad en los pacientes quemados. El presente estudio caracteriza a los ingresados por quemadura(s y la presencia de esta clase de infección en la Unidad Nacional de Quemados del Hospital San Juan de Dios, en Costa Rica, entre los años 2003 y 2005. Realizamos un análisis descriptivo de la infección intrahospitalaria en el sitio de la quemadura según las características de los pacientes y de la quemadura así como el total de días de estancia hospitalaria, utilizando para ello un diseño de estudio tipo cohorte retrospectiva. La incidencia acumulada de la infección intrahospitalaria en el sitio de la quemadura fue de 19.0%. Los meses posteriores al ingreso a clases presentaron un mayor número de hospitalizaciones por quemaduras. La edad, la superficie corporal total quemada, el número de segmentos corporales quemados, la profundidad de la quemadura y los días de estancia hospitalaria presentaron diferencias significativas entre los individuos infectados y no infectados. El tipo de accidente que produjo la quemadura y el sexo no presentaron diferencias significativas entre ambos grupos de pacientes. La electricidad fue el agente causal más frecuente en los pacientes con infección, mientras que el agua caliente lo fue en los pacientes sin infección. Concluimos que las características fisiopatológicas de las quemaduras favorecen infección en los pacientes quemados; asimismo, existen factores que pueden y deben ser tomados en cuenta para controlar y prevenir la infección y sus efectos.Intrahospitalary infection in burned patients is one of the most important causes of morbidity and mortality. This study characterizes the admitted burn victims and the presence of inner-hospital infection at the National Burn Victims Unit , San Juan de Dios Hospital, Costa Rica, between 2003 and 2005. We made a descriptive analyze of intrahospital infection in the

  8. 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....

  9. 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

  10. 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

  11. 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...

  12. 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.

  13. 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...

  14. 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.

  15. 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.

  16. 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

  17. 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...

  18. 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...

  19. 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...

  20. 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...

  1. 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.

  2. 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…

  3. 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.

  4. /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.

  5. 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.

  6. 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...

  7. 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…

  8. Ventilación mecánica convencional en recién nacidos muy bajo peso ingresados en el hospital provincial Dr. Ernesto Guevara de la Serna

    Directory of Open Access Journals (Sweden)

    Lenny Carbonell García

    2015-02-01

    Full Text Available Se realizó un estudio descriptivo de corte transversal, para determinar el comportamiento de los recién nacidos muy bajo peso, ventilados en modalidades convencionales en el Hospital General Docente “Dr. Ernesto Guevara de la Serna”, en el período de enero de 2010 a julio de 2012. El universo estuvo constituido por 104 recién nacidos vivos muy bajo peso, tomándose como muestra a los 66 recién nacidos muy bajo peso que necesitaron apoyo ventilatorio. Las principales variables a estudiar fueron las causas de la ventilación, peso al nacer, edad gestacional, sexo, modalidades empleadas, supervivencia y complicaciones presentadas en estos recién nacidos. Se concluyó que la causa más frecuente de intubación y ventilación fue la depresión respiratoria neonatal (33,3 %, el peso que predominó fue entre 1251 y 1500 gramos, prevaleció el recién nacido ventilado de 32 y más semanas (40,9 %, del sexo masculino, la modalidad más utilizada fue la asistida/controlada y se alcanzó mayor sobrevida en las modalidades con soporte de presión y presión positiva continua, con un 100 %. Las complicaciones presentadas con mayor frecuencia fueron la atelectasia y la neumonía nosocomial

  9. Efecto de la severidad de quemado sobre la concentración de carbono orgánico en montículos e intermontículos en el monte austral Effect of burn severity on the soil organic carbon concentration mounds and intermounds in the monte austral

    Directory of Open Access Journals (Sweden)

    Juan José Gaitán

    2007-12-01

    Full Text Available El efecto de la severidad de quemado sobre la concentración de carbono orgánico (COS en los montículos vegetados y en los intermontículos de suelo desnudo fue evaluado 4 años luego de la ocurrencia de un incendio natural en un área del Monte Austral (provincia de Río Negro. Los montículos actúan como "islas de fertilidad" dado que la concentración de COS fue mayor que en los intermontículos. La concentración de COS en los intermontículos no fue afectada por el incendio. En cambio en los montículos se halló una disminución en la concentración de COS al incrementarse la severidad de quemado. La pérdida de COS podría inducir una degradación de los pastizales, por lo tanto las prácticas de manejo del fuego deberían tender a la realización de quemas de baja severidad.The effect of burn severity on soil organic carbon concentration (COS in vegetated mounds and in bare soil intermounds was evaluated 4 years after the occurrence of a natural fire in an area of the Monte Austral (Río Negro province. The mounds act as "fertility islands" since COS concentration was higher than in the intermounds. The COS concentration in the intermounds was not affected by fire. On the other hand, in the mounds a decrease in the COS concentration was found when the burn severity increased. The COS loss could induce rangelands degradation, therefore fire management practices should tend to the realization of low severity burns.

  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. 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.

  12. 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.

  13. 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

  14. 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...

  15. Quemado 1:100000 Quad Hydrography DLGs

    Data.gov (United States)

    Earth Data Analysis Center, University of New Mexico — Digital line graph (DLG) data are digital representations of cartographic information. DLG's of map features are converted to digital form from maps and related...

  16. Manejo del Niño Quemado

    OpenAIRE

    José Edmundo Sánchez-López

    2011-01-01

    Las quemaduras en la población infantil constituyen un serio problema debido al alto riesgo de mortalidad, presencia delesiones invalidantes, funcionales y estéticas; siendo una causa importante de muerte accidental en los niños. Los pediatrasdesempeñan un papel importante, instruyendo a los padres para la prevención de las quemaduras más comunes en losniños.Las quemaduras pueden producirse por agentes químicos, biológicos y físicos; los últimos constituyen la causa más frecuentede quemaduras...

  17. 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.

  18. 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.

  19. 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.

  20. 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.

  1. 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.

  2. 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.

  3. 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.

  4. 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.

  5. 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...

  6. 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

  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

    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...

  8. 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.

  9. 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.

  10. 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...

  11. 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

  12. 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.

  13. 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.

  14. 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.

  15. 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....

  16. 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.

  17. 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.

  18. 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.

  19. 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...

  20. 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).

  1. Estado de salud bucodental de escolares residentes en localidades abastecidas con agua de consumo humano de muy alto y muy bajo contenido de fluoruros State of oral health among schoolchildren living in towns supplied with drinking water containing very high and very low levels of fluoride

    Directory of Open Access Journals (Sweden)

    Ana Isabel Azcurra

    1995-10-01

    Full Text Available Se describen y analizan los resultados de una investigación epidemiológica de corte transversal destinada a evaluar el estado de salud bucodental en escolares de 6-7 y 12-13 años residentes en Sampacho y Porteña, dos localidades de la Provincia de Córdoba (Argentina, abastecidas con agua de bebida que poseen cantidades deF- muy diferentes. En Sampacho, el nivel de F- es de 9,05 mg/l, en tanto que en Porteña la concentración es de 0,19 mg/l. La proporción de escolares (6-7 y 12-13 años que no tuvo experiencia de caries fue significativamente mayor en Sampacho que en Porteña, mientras que los índices ceo-d, ceo-s, CPO-D y CPO-S resultaron considerablemente más altos en esta última localidad. La severidad de la enfermedad de caries en los niños de 12-13 años de Sampacho estuvo comprendida entre baja y moderada (CPO-D= 2,53, en tanto que en sus similares de Porteña alcanzó el grado de moderada a alta (CPO-D= 4,41. No se registró ningún caso de fluorosis dental en Porteña, mientras que en Sampacho hubo una alta proporción de niños que presentó fluorosis leve (6-7 años y leve o intensa (12-13 años. Los niveles salivales de calcio, fosfatos, tiocianato, proteínas totales e Ig A secretoria fueron muy similares en los escolares de ambas localidades, y también entre niños con diferente experiencia de caries y distintos grados de fluorosis dental. Se concluye que son necesarias urgentes medidas sanitarias (preventivas y/o curativas para reducir o controlar la enfermedad de caries en Porteña y la fluorosis dental en Sampacho.Descrevem-se e analizam-se os resultados de uma pesquisa epidemiológica de corte transversal destinada a avaliar o estado de saúde buco-dental de escolares de 6-7 e 12-13 anos, residentes em Sampacho e Porteña, duas localidades da Província de Córdoba (Argentina, abastecidas com água potável contendo quantidade de F- muito diferentes. Em Sampacho o nível de F- é de 9,05 mg/l enquanto que em Porte

  2. 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.

  3. 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.

  4. 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.

  5. 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.

  6. 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.

  7. 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.

  8. 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.

  9. 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)

  10. Transcaruncular Medial Wall Orbital Decompression: An Effective Approach for Patients with Unilateral Graves Ophthalmopathy

    Directory of Open Access Journals (Sweden)

    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.

  11. 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.

  12. Chronology of the Third – Fifth Centuries Male Graves from the Tarasovo Burial Ground

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    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.

  13. Factores de riesgo para el desarrollo de infecciones intrahospitalarias en pacientes quemados. Hospital S. Juan de Dios, Costa Rica: Enero 2003-Diciembre 2005. Parte II Risk factors for development of intrahospitalary infections in burned patients. Hospital S. Juan de Dios, Costa Rica: January 2003-December 2005. Part II

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    S. Vargas Naranjo

    2009-12-01

    Full Text Available En los pacientes quemados, existen diferentes factores como la edad, sexo y días de estancia hospitalaria entre otros, que influyen en el desarrollo de infección intrahospitalaria (IIH. Debido a la mayor frecuencia de este tipo de infecciones en los pacientes quemados, pretendemos identificar qué factores influyen en la presentación y predicción de la infección intrahospitalaria en el sitio de la quemadura (IISQ. El presente estudio es una cohorte retrospectiva, sobre 298 registros de expedientes clínicos de pacientes ingresados en la Unidad Nacional de Quemados del Hospital San Juan de Dios (UNQ-HSJD en Costa Rica, continuando otra investigación del mismo grupo de autores publicada anteriormente en Cirugía Plástica Iberolatinoamericana. A cada factor de riesgo estudiado se le calcularon los odds ratio crudos en un análisis univariado definiendo como variables de exposición principal la superficie corporal total quemada (SCTQ y la profundidad de la quemadura (PQ. Observamos con este cálculo que el tipo de accidente no presentaba asociación con la IISQ. Después, realizamos un modelo multivariado logístico, no condicional, en el que se introdujeron los siguientes factores de riesgo: SCTQ, PQ, edad, número de segmentos corporales quemados (NSCQ, días de estancia hospitalaria previos a la infección intrahospitalaria en el sitio de la quemadura (DEHP-IISQ y el agente causal de la quemadura. Consideramos variables confusora y modificadora de efecto al NSCQ y DEHP-IISQ. Determinamos que las principales variables predictoras para la IISQ fueron SCTQ (OR=3.02; 1.20-7.84, PQ (OR=11.44; 4.90-26.71, NCSQ (OR=2.80; 1.13-6.95, y DEHP-IISQ (9 a 14 días: OR=2.43; 0.52- 11.29, >19 días: OR=31.89; 2.17-467.68. Pese a que no mostró significancia estadística, también se introdujo la edad en el modelo, debido a la tendencia a aumentar el riesgo conforme ésta aumentaba ( >64 años: OR= 3.15; 0.61-16.29. Concluimos que los pacientes quemados

  14. El crimen organizado en Europa: Una grave amenaza para la seguridad y el orden público/The crime organized in Europe: A serious threat to the security and public order

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    Francisco José Rodrigo Luelmo (España

    2009-01-01

    Full Text Available El crimen organizado es una de las amenazas más graves para la seguridad internacional y de los Estados por la multitud de actividades delictivas que practica, pero también por su mundialización. Su existencia ha preocupado a organizaciones como Naciones Unidas y la Unión Europea, que lo han intentado definir para mejorar la eficacia jurídico-policial en la lucha contra este riesgo. Europa es un espacio muy afectado por el crimen organizado, en forma de mafias (por ejemplo, en Italia y Rusia y narcotraficantes de droga. Se trata, pues, de un fenómeno criminal que pone en riesgo la integridad de los ciudadanos y el respeto al Estado de Derecho en Europa y en el resto del mundo. The organized crime is one of the most important threats for the international and states’ security, because of the enormous variety of punishable activities which practices, but also because of its global spreading. Its existence has worried some organizations such as United Nations and European Union, which have tried to define it in order to improve the judicial and police efficiency in the fight against this threat. Europe is a space very affected by the organized crime, with mafias (e.g., in Italy and Russia and drugs-traffickers. So, this criminal phenomenon risks the citizen’s integrity and the respect for the rule of law in Europe and in the rest of the world.

  15. [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.

  16. Morbidade materna extremamente grave: uso do Sistema de Informação Hospitalar

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    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

  17. Intoxicaciones agudas graves en un servicio de medicina intensiva durante doce años

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    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%

  18. Percepções da equipe de enfermagem sobre seu trabalho em uma unidade de queimados La percepción del personal de enfermería de su trabajo en una unidad de quemados How the nursing staff perceives work in a burn unit

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    Maria de Lourdes Custódio Duarte

    2012-03-01

    Full Text Available O objetivo do estudo foi analisar a percepção dos profissionais de enfermagem sobre o seu trabalho em uma Unidade de Tratamento ao Queimado de um hospital público no Rio Grande do Sul. Trata-se de um estudo com abordagem qualitativa, desenvolvido a partir de entrevistas semi-estruturadas com 20 profissionais da equipe de enfermagem. A análise dos dados possibilitou a emergência de três categorias: O significado de trabalhar em uma Unidade de Tratamento ao Queimado; Dificuldades enfrentadas no cotidiano do trabalho; Estratégias utilizadas pela enfermagem no exercício do trabalho. Conclui-se que é dever das instituições, onde as Unidades de Tratamento ao Queimado estão locadas, proporcionar espaços de apoio psicológico no atendimento às demandas dos profissionais que prestam assistência às vítimas de trauma térmico. Às instituições de ensino, enfatiza-se a necessidade de dar maior ênfase a essa área durante a formação dos futuros profissionais.El objetivo de este estudio fue analizar la percepción de las enfermeras acerca de su trabajo en una planta de aguas residuales de un hospital de quemados público de Rio Grande do Sul. Estudio con enfoque cualitativo, desarrollado a partir de entrevistas semi-estructuradas con 20 profesionales del personal de enfermería. El análisis de los datos permitió la aparición de tres categorías: El sentido del trabajo en una Unidad de Tratamiento de Quemados; Dificultades en el trabajo diario, Las estrategias utilizadas por las enfermeras en el desempeño laboral. Llegamos a la conclusión de que es deber de las instituciones, en las Unidades de Tratamiento de Quemados que se alquilan, ofrecer espacios de apoyo psicológico para atender las demandas de los profesionales que asisten a las víctimas de trauma térmico. Instituciones educativas, haciendo hincapié en la necesidad de un mayor énfasis a esta área durante la formación de futuros profesionales.The aim of this study is to

  19. 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/

  20. 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.

  1. Occurrence of Type 1 Diabetes in Graves' Disease Patients Who Are Positive for Antiglutamic Acid Decarboxylase Antibodies: An 8-Year Followup Study

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    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.

  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. VALOR DEL ESTRONCIO EN LA PREVENCIÓN DE FRACTURAS ÓSEAS SECUNDARIAS A CAÍDAS EN PERSONAS MUY ANCIANAS PORTADORAS DE OSTEOPOROSIS PRIMARIA: UNA REVISIÓN SISTEMÁTICA

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    Carlos G. Musso

    2011-01-01

    Full Text Available Introducción: dado que entre el 25-30% de las fracturas óseas, y 60% de las fracturas de cadera de la población general, acontecen en el subgrupo correspondiente a las mujeres muy ancianas. Esto se debe a la alta prevalencia de osteoporosis primaria e incidencia de caídas característica de este grupo, hemos decidido investigar el valor del estroncio en la prevención de fracturas óseas secundarias a caídas en personas muy ancianas portadoras de osteoporosis primaria por medio de una revisión sistemática de la bibliografía. Material y Métodos: se realizó una revisión sistemática de la literatura siguiendo las recomendaciones de la metodología Cochrane. De los 8 los documentos inicialmente recuperados, sólo 2 terminaron siendo incluidos (2 revisores independientes, seleccionaron evaluaron y extractaron los datos de los estudios incluidos por ser los únicos que cumplían con el criterio de elegibilidad de ser estudios realizados sobre una población de pacientes muy ancianos: mayor de 74 años de edad, totalizando 2616 personas en estudio. Resultados: a pesar la abundancia de datos a favor del tratamiento con estroncio, hay un riesgo relativo para fractura no vertebral al año de tratamiento que pasa por la unidad: 0.58 [0.32, 1.06]. En cuanto al riesgo de fractura a nivel de la cadera, existe ciertas diferencias respecto de los datos antes mencionados. Por un lado, la reducción del riesgo de fractura (32% luego de 3 años de tratamiento con ranelato de estroncio documentada por el estudio Seeman 2006 no alcanzó significación estadística (p=0.112, y su riesgo relativo pasa por la unidad: 0.68 [0.45, 1.05] Sin embargo, el estudio Reginster 2008 demostró luego de 5 años de tratamiento con ranelato de estroncio una reducción mayor (43% y estadísticamente significativa (p=0.036. Estos datos podrían significar que tal vez el hueso de la cadera requiera un tiempo de exposición más prolongado al estroncio para verse beneficiado

  4. Metamorfismo de muy bajo grado asociado a un sistema geotermal en rocas volcánicas básicas del Jurásico Medio, Formación Lonco Trapial, Paso Berwin, Chubut extra-andino

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    P. Montecinos

    2004-12-01

    Full Text Available Las rocas volcánicas básicas de la Formación Lonco Trapial, poseen una mineralogía primaria compuesta principalmente por olivino, plagioclasa cálcica y piroxeno, presentando además gran cantidad de amígdalas. La mineralogía metamórfica de muy bajo grado en estas rocas está caracterizada por ceolitas, minerales arcillosos y micáceos. La asociación mineral más característica está compuesta por celadonita, montmorillonita, heulandita, analcima, gonnardita y, además, por levyna y minerales de la serie analcima-wairakita en forma subordinada. Esta asociación pertenece a la facies ceolita y tuvo un origen asociado a un sistema geotermal. La analogía establecida con las zonas de ceolitas conocidas para sistemas geotermales equivalentes y el uso de la grilla petrogénetica para paragénesis ceolíticas, en el sistema An-Ab-SiO2-H2O, permiten establecer un rango de temperatura entre 80°-180°C. En este contexto habría ocurrido un único evento metamórfico hidrotermal en presencia de una fase fluida, muy pobre en CO2, cuya composición química habría cambiado desde un carácter neutro con baja a(SiO2 y a(K2O moderada (permitiendo la precipitación de esmectitas y celadonita a un carácter neutro-alcalino con a(SiO2 que posibilita la estabilidad de la heulandita.

  5. TEMPORAL RELATIONSHIP BETWEEN THE ONSET OF THYROID DERMOPATHY AND GRAVES' OPHTHALMOPATHY

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    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. 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...

  11. 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.

  12. 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

  13. 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.

  14. 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...

  15. 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.

  16. 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 ...

  17. 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...

  18. 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.

  19. 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.

  20. 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.

  1. 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 ...

  2. 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.

  3. 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...

  4. 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...

  5. 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...

  6. 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...

  7. 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.

  8. 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...

  9. 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...

  10. 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.

  11. 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...

  12. 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...

  13. 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...

  14. 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

  15. 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...

  16. 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...

  17. 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.

  18. Graves' Disease

    Science.gov (United States)

    ... This condition results from a buildup of certain carbohydrates in the skin — the cause of which also ... lead to heart rhythm disorders, changes in the structure and function of the heart muscles, and the ...

  19. Graves' Disease

    Science.gov (United States)

    ... Updated March 2017. Accessed August 17, 2017. [4] Ross DS, Burch HB, Cooper DS, et al. 2016 ... Sciences; Leonard Wartofsky, M.D., M.A.C.P., Washington Hospital Center and Georgetown University Hospital Contact ...

  20. Massive vulval edema with severe preeclampsia. Case report Edema vulvar masivo con preeclampsia grave. Presentación de un caso.

    Directory of Open Access Journals (Sweden)

    José Luis Gómez Miranda.

    2009-11-01

    Full Text Available Massive vulval edema with severe preeclampsia is presented as one of the consequences that may appear on patients with hypertension disorders during pregnancy, therefore the attention in the Obstetrics and Gynecology Service must be systematical and permanent. On women with hypertensive disorders during pregnancy, although edemas may not be constant, they may either appear at minor, barely perceptible extents, or even in the most severe ways, such as anasarca. A very peculiar manifestation of edema on preeclampsia is massive vulval edema, which appears as a highly rare complication, in whose basis there is a complex, systemic pathological process involved. We present a case of a pregnant woman who was admitted with high blood pressure values and excessive weight gain, plus very noticeable general edemas, and during her stay developed massive vulval edema. No data on this complication were found in the bibliography reviewed. Very few experienced professionals recall having dealt with similar cases in the last fifteen years, hence the decision to publish it.El edema vulvar masivo con preeclampsia grave se presenta como una de las consecuencias que pueden aparecer en pacientes con trastornos de hipertensión en el embarazo, por lo que la atención en el Servicio de Obstetricia debe ser sistemática y permanente. En las mujeres con trastornos hipertensivos del embarazo, los edemas, aunque no son constantes, se manifiestan desde las formas más leves, apenas perceptibles, hasta las más severas, como la anasarca. Una manifestación particular del edema en la preeclampsia, es el edema vulvar masivo, que se presenta como una complicación sumamente rara, en cuya base hay un proceso patológico sistémico y complejo. Se presenta el caso de una embarazada que ingresó con cifras elevadas de presión arterial y aumento de peso exagerado, con edemas generalizados muy acentuados, que durante su estancia desarrolló un edema vulvar masivo. En la bibliograf

  1. Análisis de parámetros bioquímicos en grandes quemados: nuevos factores pronósticos. De la investigación básica a la clínica Analysis of biochemical parameters in major burn patients: new prognostic factors. From the basic to the clinical research

    Directory of Open Access Journals (Sweden)

    A.A. Maldonado

    2012-12-01

    Full Text Available Nuestro objetivo es el cálculo de la carga eléctrica en plasma de grandes quemados mediante un programa informático enfocado a predecir la mortalidad del paciente. Partimos del software informático PICAL (de confección propia con el fin de calcular la carga plasmática y la influencia de iones y proteínas, aplicado a 143 pacientes en la Unidad de Grandes Quemados del Hospital Unfallkrankenhaus de Berlín (Alemania. Realizados los cálculos anteriores, efectuamos un estudio estadístico para definir la mortalidad del paciente, considerando: 1 sus parámetros bioquímicos en las primeras 48 horas, 2 sus factores clínicos: edad, superficie quemada total, profundidad de la quemadura, presencia de síndrome inhalatorio, etc. Con estos datos, hacemos un análisis de regresión logística donde se calcula la función predictiva de mortalidad, validándose en un grupo de 35 nuevos pacientes. Calculamos la importancia de cada ión plasmático y proteínas dentro del equilibrio eléctrico del gran quemado. Para el estudio de la mortalidad en estos pacientes a través del análisis estadístico, se introdujeron las variables de edad, superficie quemada, pH y [Mg2+] Del estudio se confirmó que los aniones [HCO3¯] y [Cl] junto al catión [Na+] son los iones más influyentes en el equilibrio plasmático del gran quemado. La concentración de proteínas tiene menor incidencia en dicho equilibrio: una pérdida del 50 % de la concentración de albúmina durante las primeras 48 horas, equivale a una pérdida de 1 mmol/l de la concentración [HCO3¯]. También se puede afirmar que el uso de los parámetros pH y [Mg2+] puede mejorar la predicción de mortalidad en estos pacientes.Our objective is the calculation of the plasma electrical charge in major burn patients, by means of a computer programme focussed on predicting patient mortality. The PICAL computer software (own development starts off with the objective of calculating the plasmatic charge and

  2. La nutrición enteral precoz en el enfermo grave Early enteral nutrition in the critically-ill patient

    OpenAIRE

    B. García Vila; Grau, T

    2005-01-01

    La nutrición enteral se ha demostrado como un método eficaz y seguro de nutrir a los enfermos graves ingresados en una Unidad de Cuidados Intensivos. Aunque se desconoce cuánto tiempo puede estar un enfermo grave sin nutrición, el catabolismo acelerado y el ayuno pueden ser deletéreos en el enfermo grave y la recomendación más frecuente es la de empezar la nutrición artificial cuando se prevea un período de ayuno superior a los siete días. Las ventajas de la nutrición enteral sobre la nutrici...

  3. A 33-Year-Old Man with Gynaecomastia and Galactorrhea as the First Symptoms of Graves Hyperthyroidism.

    Science.gov (United States)

    Khoohaphatthanakul, Somdul; Sriwijitkamol, Apiradee

    2016-01-01

    Graves' hyperthyroidism has a various number of well-recognized manifestations. Galactorrhea is a rare manifestation in this disease. We describe a 33-year-old man who presented with the symptoms of hyperthyroidism, gynaecomastia, and galactorrhea for 2 months. Physical examination revealed goitre, gynaecomastia, and galactorrhea, bilaterally. Laboratory investigations demonstrated high free thyroxine with suppressed thyroid-stimulating hormone level together with elevated anti-TSH receptor; therefore, the diagnosis of Graves' disease was confirmed. Other investigations to elucidate the etiology of galactorrhea were normal, so the galactorrhea was hypothesized to be caused by Graves' disease. The gynaecomastia and galactorrhea resolved with the successful treatment of hyperthyroidism. Although the galactorrhea is extremely rare in thyrotoxicosis male patients, to the best of our knowledge, this is the third case which reported gynaecomastia and galactorrhea in male patient who presented with thyrotoxicosis.

  4. Antiphospholipid Antibody Syndrome Associated with Graves' Disease Presenting As Inferior Vena Cava Thrombosis with Bilateral Lower Limb DVT.

    Science.gov (United States)

    Jain, Ankur

    2014-01-01

    We report a case of a 60-year-old lady who presented with bilateral lower limb swelling and a thyroid swelling with clinical features consistent with thyrotoxicosis. Investigations revealed the presence of a thrombus in bilateral external, internal iliac veins, and inferior vena cava extending up to its infrahepatic part. Hormone profile and radioiodine uptake scan confirmed the diagnosis of Graves' disease. Further workup revealed the presence of antiphospholipid antibodies (confirmed after a repeat test at 12 weeks). The patient was treated with antithyroid drugs and anticoagulants. The patient improved with normalization of thyroid function and partial recanalization of the infrahepatic part of inferior vena cava. Hyperthyroidism has been implicated as a potential hypercoagulable state; however, the association of Graves' disease with antiphospholipid antibody syndrome is limited to isolated case reports. This case highlights a new mechanism underlying hypercoagulability associated with Graves' disease.

  5. Prediction of remission in Graves' disease after thionamide therapy by technetium-99m early uptake

    Energy Technology Data Exchange (ETDEWEB)

    Misaki, Takashi; Dokoh, Shigeharu; Koh, Toshikiyo; Shimbo, Shin-ichiro (Kyoto City Hospital, Kyoto (Japan)); Hidaka, Akinari; Iida, Yasuhiro; Kasagi, Kanji; Konishi, Junji

    1991-02-01

    In the clinical management of Graves' thyrotoxicosis, one of the most important subject is when to stop antithyroid drugs after achieving an euthyroid state. T{sub 3} suppression test and other methods have been used to forecast the outcome after drug cessation, but the results were not always satisfactory. We have attempted to predict remission of Graves' disease by single measurement of early technetium uptake without administration of triiodothyronine. Drugs were discontinued in the seventy-five patients with Graves' disease on maintenance doses of either methimazole or propylthiouracil who showed normalized uptake (4.0% or less). Of 64 patients evaluable after twelve months, 55 (86%) remained euthyroid, 8 relapsed, and 1 became hypothyoid. With its accuracy in prediction of short-term remission comparable or superior to T{sub 3} suppression test, this rapid and simple method seemed suitable for routine use in clinical practice. (author).

  6. Transient Hypothyroidism after Radioiodine for Graves' Disease: Challenges in Interpreting Thyroid Function Tests.

    Science.gov (United States)

    Sheehan, Michael T; Doi, Suhail A R

    2016-03-01

    Graves' disease is the most common cause of hyperthyroidism and is often managed with radioactive iodine (RAI) therapy. With current dosing schemes, the vast majority of patients develop permanent post-RAI hypothyroidism and are placed on life-long levothyroxine therapy. This hypothyroidism typically occurs within the first 3 to 6 months after RAI therapy is administered. Indeed, patients are typically told to expect life-long thyroid hormone replacement therapy to be required within this timeframe and many providers expect this post-RAI hypothyroidism to be complete and permanent. There is, however, a small subset of patients in whom a transient post-RAI hypothyroidism develops which, initially, presents exactly as the typical permanent hypothyroidism. In some cases the transient hypothyroidism leads to a period of euthyroidism of variable duration eventually progressing to permanent hypothyroidism. In others, persistent hyperthyroidism requires a second dose of RAI. Failure to appreciate and recognize the possibility of transient post-RAI hypothyroidism can delay optimal and appropriate treatment of the patient. We herein describe five cases of transient post-RAI hypothyroidism which highlight this unusual sequence of events. Increased awareness of this possible outcome after RAI for Graves' disease will help in the timely management of patients.

  7. Protracted Hypofractionated Radiotherapy for Graves' Ophthalmopathy: A Pilot Study of Clinical and Radiologic Response

    Energy Technology Data Exchange (ETDEWEB)

    Casimiro de Deus Cardoso, Cejana; Giordani, Adelmo Jose [Department of Clinical and Experimental Oncology, Division of Radiotherapy, Federal University of Sao Paulo, Sao Paulo, SP (Brazil); Borri Wolosker, Angela Maria [Department of Radiology, Federal University of Sao Paulo, Sao Paulo, SP (Brazil); Souhami, Luis [Department of Radiotherapy, McGill University Heath Centre, Montreal, Quebec (Canada); Gois Manso, Paulo [Department of Ophthalmology, Federal University of Sao Paulo, Sao Paulo, SP (Brazil); Souza Dias, Rodrigo; Comodo Segreto, Helena Regina [Department of Clinical and Experimental Oncology, Division of Radiotherapy, Federal University of Sao Paulo, Sao Paulo, SP (Brazil); Araujo Segreto, Roberto, E-mail: segreto.dmed@epm.br [Department of Clinical and Experimental Oncology, Division of Radiotherapy, Federal University of Sao Paulo, Sao Paulo, SP (Brazil)

    2012-03-01

    Purpose: To evaluate the clinical and radiologic response of patients with Graves' ophthalmopathy given low-dose orbital radiotherapy (RT) with a protracted fractionation. Methods and Materials: Eighteen patients (36 orbits) received orbital RT with a total dose of 10 Gy, fractionated in 1 Gy once a week over 10 weeks. Of these, 9 patients received steroid therapy as well. Patients were evaluated clinically and radiologically at 6 months after treatment. Clinical response assessment was carried out using three criteria: by physical examination, by a modified clinical activity score, and by a verbal questionnaire considering the 10 most common signs and symptoms of the disease. Radiologic response was assessed by magnetic resonance imaging. Results: Improvement in ocular pain, palpebral edema, visual acuity, and ocular motility was observed in all patients. Significant decrease in symptoms such as tearing (p < 0.001) diplopia (p = 0.008), conjunctival hyperemia (p = 0.002), and ocular grittiness (p = 0.031) also occurred. Magnetic resonance imaging showed decrease in ocular muscle thickness and in the intensity of the T2 sequence signal in the majority of patients. Treatments were well tolerated, and to date no complications from treatment have been observed. There was no statistical difference in clinical and radiologic response between patients receiving RT alone and those receiving RT plus steroid therapy. Conclusion: RT delivered in at a low dose and in a protracted scheme should be considered as a useful therapeutic option for patients with Graves' ophthalmopathy.

  8. 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.

  9. Automatic health record review to help prioritize gravely ill Social Security disability applicants.

    Science.gov (United States)

    Abbott, Kenneth; Ho, Yen-Yi; Erickson, Jennifer

    2017-07-01

    Every year, thousands of patients die waiting for disability benefits from the Social Security Administration. Some qualify for expedited service under the Compassionate Allowance (CAL) initiative, but CAL software focuses exclusively on information from a single form field. This paper describes the development of a supplemental process for identifying some overlooked but gravely ill applicants, through automatic annotation of health records accompanying new claims. We explore improved prioritization instead of fully autonomous claims approval. We developed a sample of claims containing medical records at the moment of arrival in a single office. A series of tools annotated both patient records and public Web page descriptions of CAL medical conditions. We trained random forests to identify CAL patients and validated each model with 10-fold cross validation. Our main model, a general CAL classifier, had an area under the receiver operating characteristic curve of 0.915. Combining this classifier with existing software improved sensitivity from 0.960 to 0.994, detecting every deceased patient, but reducing positive predictive value to 0.216. True positive CAL identification is a priority, given CAL patient mortality. Mere prioritization of the false positives would not create a meaningful burden in terms of manual review. Death certificate data suggest the presence of truly ill patients among putative false positives. To a limited extent, it is possible to identify gravely ill Social Security disability applicants by analyzing annotations of unstructured electronic health records, and the level of identification is sufficient to be useful in prioritizing case reviews.

  10. A lesão muscular na miastenia grave: estudo de 17 casos com histoquimica muscular

    Directory of Open Access Journals (Sweden)

    Lineu Cesar Werneck

    1982-03-01

    Full Text Available Estudo de 17 biópsias musculares de pacientes com miastenia grave, utilizando técnicas de coloração a fresco e histoquímica muscular. Foram encontradas 15 biópsias musculares anormais, sendo que as principais alterações foram fibras musculares angulares escuras atróficas, excesso de gotículas de gordura na membrana externa das fibras, variação no diâmetro das fibras e atrofia de fibras do tipo II. Os achados foram interpretados como denervação em 11 biópsias, atrofia de fibras do tipo II em 7, infiltrado linfocitário em 4, necrose de fibras musculares com fagocitose em 1 e em 2 biópsias não foi encontrada qualquer anormalidade. Quanto maior o tempo de doença, mais severa foi a anormalidade encontrada. Dois pacientes apresentavam timoma, um miastenia grave congênita, um artrite reumatoide, um neurite hipertrófica intersticial, um tireoidite de Hashimoto e um com síndrome miastênica concomitante. São discutidos os achados anatomopatológicos e sua possível explicação.

  11. Can bone loss be reversed by antithyroid drug therapy in premenopausal women with Graves' disease?

    Directory of Open Access Journals (Sweden)

    Belsing Tina Z

    2010-09-01

    Full Text Available Abstract Context Hyperthyroidism can lead to reduced bone mineral density (BMD and increased fracture risk particularly in postmenopausal women, but the mechanism behind is still unclear. Objective Prospective examination of the influence of thyroid hormones and/or thyroid autoantibodies on BMD in premenopause. Design We have examined 32 premenopausal women with untreated active Graves' disease from time of diagnosis, during 18 months of antithyroid drug therapy (ATD and additionally 18 months after discontinuing ATD. Variables of thyroid metabolism, calcium homeostasis and body composition were measured every 3 months. BMD of lumbar spine and femoral neck were measured at baseline, 18 ± 3 and 36 ± 3 months. Data were compared to base line, a sex- and age matched control group and a group of patients with Hashimoto's thyroiditis treated with non-suppressive doses of levothyroxine. Results The study showed significantly (p Conclusion The results indicated a clinically relevant impact of thyroid function on bone modulation also in premenopausal women with Graves' disease, and further indicated the possibility for a direct action of TRAb on bones.

  12. Intraoperative parathyroid hormone assay in patients with Graves' disease for prediction of postoperative tetany.

    Science.gov (United States)

    Moriyama, Taiki; Yamashita, Hiroyuki; Noguchi, Shiro; Takamatsu, Yuji; Ogawa, Takahiro; Watanabe, Shin; Uchino, Shinya; Ohshima, Akira; Kuroki, Syoji; Tanaka, Masao

    2005-10-01

    We measured intraoperative parathyroid hormone (IOPTH) levels before and after thyroidectomy in a large group of patients to test whether changes in IOPTH can predict postoperative tetany. Subjects were 111 consecutive patients (94 females and 17 males) with Graves' disease undergoing subtotal thyroidectomy. Blood samples for IOPTH assay were obtained after anesthesia (basal) and following skin closure (postoperative). Data were compared between patients who developed tetany (n = 9) and those who did not (n = 102). There was no significant difference in sex, age, period of antithyroid drug administration, or the weight of the thyroid between the two groups. The preoperative serum calcium level was significantly lower (p tetany group than in the non-tetany group. The IOPTH level was significantly lower (p tetany group than in the non-tetany group. A decrease in IOPTH of more than 70% was shown to be 78% sensitive, 94% specific, and 93% accurate, and it has 78% positive predictive value and 94% negative predictive value for the development of tetany. Our study shows that a postoperative decrease of IOPTH level is the most predictive of postoperative tetany of the clinical risk factors investigated. We recommend IOPTH measurement as an adjunct to postoperative management of patients with Graves' disease to assist in preventing hypocalcemia and determining the earliest time for safe discharge.

  13. Predictive risk factors for postoperative tetany in female patients with Graves' disease.

    Science.gov (United States)

    Yamashita, H; Noguchi, S; Murakami, T; Uchino, S; Watanabe, S; Ohshima, A; Toda, M; Yamashita, H; Kawamoto, H

    2001-04-01

    Postoperative tetany occurs in patients with secondary hyperparathyroidism caused by a deficiency in calcium and vitamin D concomitant with transient hypoparathyroidism induced by surgery. In the present study, we further clarified the risk factors by referring to serum 25-hydroxyvitamin D [25(OH)D] and alkaline phosphatase. The serum levels of intact parathyroid hormone, calcium and other electrolytes, and 25-hydroxyvitamin D [25(OH)D] were measured preoperatively in 178 female patients with Graves' disease who underwent subtotal thyroidectomy. Of the 178 female patients, 15 (8.4%) developed tetany. Univariate analysis of 16 possible risk factors showed that 2 were statistically significant: serum 25(OH)D and alkaline phosphatase levels. The incidence of tetany according to the serum levels of 25(OH)D and alkaline phosphatase was 19.1% (9/47) in patients with 25(OH)D 155, 11.8% (4/34) in those with 25(OH)D 25 nmol/L and alkaline phosphatase > 155, and 0% (0/50) in those with 25(OH)D > 25 nmol/L and alkaline phosphatase tetany. Serum 25(OH)D and alkaline phosphatase should be monitored in patients with Graves' disease.

  14. Factores genéticos en casos graves de gripe (H1N1 2009

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    Francesc Calafell i Majó

    2011-01-01

    Full Text Available La pandemia de gripe (H1N1 2009 generó una serie de cuestiones, entre las cuales estuvo que entre un 25 y un 30% de los casos graves de gripe no presentaron ningún factor de riesgo obvio. Hipotetizamos que un elemento que puede contribuir a la respuesta son factores de riesgo gené ticos del huésped involucrados en la mala progresió n de la enfermedad. Varios indicios nos llevaron a esta hipótesis: estudios de agregación familiar en islandeses y mormones de Utah muestran una cierta heredabilidad de la mortalidad por gripe; se conocen casi 300 genes humanos necesarios para la replicació n del virus de la gripe; y los pacientes más graves de gripe (H1N12009 mostraron una desregulació n del sistema inmune adaptativo. Estamos abordando este problema mediante un diseñ o caso-control (casos hospitalizados de gripe (H1N12009 confirmados contra casos ambulatorios, tambié n confirmados para (H1N12009, en el que se genotiparán más de un milló n de polimorfismos de cambios de nucleó tido (SNPs y de variació n de número de copia (CNVs en casos y controles.

  15. Vasculite cerebral e doença de Basedow-Graves: relato de dois casos

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    Rocha Maria Sheila Guimarães

    2001-01-01

    Full Text Available OBJETIVO: Relatar dois casos de pacientes com vasculite cerebral associada à doença de Basedow-Graves. RELATO DOS CASOS: O primeiro é uma paciente de 22 anos de idade com quadro súbito de disartria e déficit motor em dimídio esquerdo. Ao exame clínico, apresentava taquicardia, exoftalmia bilateral e bócio difuso. Referia tratamento para hipertiroidismo há um mês. O segundo é uma paciente de 15 anos de idade, que apresentou quadro súbito de perda da consciência seguindo-se distúrbio de linguagem e déficit motor em hemicorpo direito. RESULTADOS: Os exames de imagem revelaram áreas de lesão cerebral sugestivas de isquemia. Os estudos angiográficos cerebrais evidenciaram estenoses vasculares múltiplas compatíveis com arterite. Foram descartadas outras causas possíveis de vasculite cerebral. Os exames laboratoriais revelaram hipertiroidismo e presença dos anticorpos antimicrossomais e antitireoglobulina. As duas pacientes receberam tratamento para o hipertiroidismo. CONCLUSÃO: A associação entre arterite cerebral e doença de Basedow-Graves sugere que possa existir um elo na patogenia das duas doenças através de mecanismo auto-imune comum a ambas.

  16. Adverse Events Associated with Methimazole Therapy of Graves' Disease in Children

    Directory of Open Access Journals (Sweden)

    Kerry Stephenson

    2010-01-01

    Full Text Available Objective. Graves' disease is the most common cause of hyperthyroidism in the pediatric population. Antithyroid medications used in children and adults include propylthiouracil (PTU and methimazole (MMI. At our center we have routinely used MMI for Graves' disease therapy. Our goals are to provide insights into adverse events that can be associated with MMI use. Methods. We reviewed the adverse events associated with MMI use in our last one hundred consecutive pediatric patients treated with this medication. Results. The range in the patient age was 3.5 to 18 years. The patients were treated with an average daily dose of MMI of 0.3±0.2 mg/kg/day. Adverse events attributed to the use of the medication were seen in 19 patients at 17±7 weeks of therapy. The most common side effects included pruritus and hives, which were seen in 8 patients. Three patients developed diffuse arthralgia and joint pain. Two patients developed neutropenia. Three patients developed Stevens-Johnson syndrome, requiring hospitalization in 1 child. Cholestatic jaundice was observed in 1 patient. No specific risk-factors for the development of adverse events were identified. Conclusions. MMI use in children is associated with a low but real risk of minor and major side effects.

  17. Autoimmune thyroid diseases and Helicobacter pylori: The correlation is present only in Graves's disease

    Institute of Scientific and Technical Information of China (English)

    Vincenzo Bassi; Gennaro Marino; Alba Iengo; Olimpia Fattoruso; Crescenzo Santinelli

    2012-01-01

    AIM:To investigate the correlation between autoimmune thyroid diseases (ATDs) and the prevalence of Cag-A positive strains of Helicobacter pylori (H.pylon)in stool samples.METHODS:Authors investigated 112 consecutive Caucasian patients (48 females and 4 males with Graves' disease and 54 females and 6 males with Hashimoto's thyroiditis HT),at their first diagnosis of ATDs.Authors tested for H.pylori in stool samples using an amplified enzyme immunoassay and Cag-A in serum samples using an enzyme-linked immunoassay method (ELISA).The results were analyzed using the two-sided Fisher's exact test and the respective odds ratio (OR) was calculated.RESULTS:A marked correlation was found between the presence of H.pylori (P ≤ 0.0001,OR 6.3) and,in particular,Cag-A positive strains (P ≤ 0.005,OR 5.3)in Graves' disease,but not in Hashimoto's thyroiditis,where authors found only a correlation with Cag-A strains (P ≤ 0.005,OR 8.73) but not when H.pylori was present.CONCLUSION:The marked correlation between H.pylori and Cag-A,found in ATDs,could be dependent on the different expression of adhesion molecules in the gastric mucosa.

  18. The relationship between serum adipocytokines and Graves' ophthalmopathy: A hospital-based study.

    Science.gov (United States)

    Kim, Bo-Yeon; Mok, Ji-Oh; Kang, Sung-Koo; Jang, Sun-Young; Jung, Chan-Hee; Kim, Chul-Hee

    2016-05-31

    Adipocytokines are thought to be associated with inflammatory disorders and autoimmune diseases. However, limited information is available on the relationship between serum adipocytokine levels, Graves' disease (GD), and Graves' ophthalmopathy (GO). The present study examined the relationship between serum adipocytokine levels and GD and GO. A total of 80 patients with GD participated in this study. The medical records of patients were reviewed retrospectively. GO activity was assessed using the clinical activity score (CAS). GO severity was assessed by the modified NOSPECS classification and included soft tissue involvement, proptosis, and extraocular muscle involvement. Serum adiponectin, leptin, resistin, and retinol-binding protein 4 (RBP-4) levels were measured using commercially available enzyme-linked immunosorbent assays. The prevalence of GO was 36.3%. Serum adiponectin, leptin, and resistin levels were significantly higher in patients with GO than in those without GO. The CAS was positively correlated with serum adiponectin and leptin levels. The total eye score was positively correlated with serum adiponectin, leptin, resistin, and RBP-4 levels. A multivariate analysis revealed that serum leptin and resistin levels were associated with the presence of GO after adjusting for clinical factors. Free thyroxine was negatively correlated with serum leptin level. These results suggest that adipocytokines, such as leptin and resistin, may play a role in inflammatory and autoimmune processes of GD and GO. Future studies with larger numbers of patients are required to establish relationships between serum adipocytokines levels and GO and ascertain the role of adipocytokines in GD and GO.

  19. Necessidades proteicas, morbidade e mortalidade no paciente grave: fundamentos e atualidades

    Directory of Open Access Journals (Sweden)

    Haroldo Falcão Ramos da Cunha

    2013-03-01

    Full Text Available Evidências recentes sugerem que o balanço proteico negativo secundário à doença grave se associa ao aumento de morbidade. A perda da proteína corporal total é inevitável nesse cenário, mesmo com uma abordagem nutricional agressiva, e resulta, principalmente, do catabolismo da fibra muscular esquelética. O principal mecanismo bioquímico e metabólico envolvido nesse processo é o sistema ubiquitina-proteassoma, que, paradoxalmente, consome a adenosina trifosfatocomo fonte energética e motriz. É possível que a neutralidade do balanço proteico nessas instâncias clínicas, seja tão importante na melhora dos desfechos quanto atingir a meta calórica estimada ou medida pela calorimetria indireta. Estudos recentes apontam a utilização de concentrações mais elevadas de proteínas na terapia nutricional do paciente grave como importante para um impacto positivo na mortalidade. A proposta deste trabalho foi revisar alguns princípios da terapia nutricional relativos ao metabolismo proteico, sinalizar para as principais assertivas das diretrizes das sociedades especializadas e comentar estudos recentes, que abordam a questão em tela, sob a visão crítica da experiência clínica dos autores.

  20. Grave number 121 of the argaric site of Castellón Alto (Galera, Granada

    Directory of Open Access Journals (Sweden)

    Molina, Fernando

    2003-06-01

    Full Text Available A new grave with partly mummified bodies was discovered during fieldwork to prepare the argaric site of Castellón Alto for public visits. Timber slabs and a dry stone wall seal the artificial cave preserving the interior. The human bones belong to one adult and one infant, both with preserved hair and skin fragments. The grave goods comprise several pottery vessels, one dagger, one ax with wooden handle, metal ornaments and fragments of flax and possibly wool.

    Recientes excavaciones en el yacimiento argárico de Castellón Alto con motivo de los trabajos de acondicionamiento para su visita publica han permitido descubrir una sepultura con restos humanos momificados en su interior. La sepultura de tipo covacha se encontraba sellada por tablones de madera y un muro de mampostería. En el interior aparecieron un individuo adulto y un infantil que conservan restos de pelo y piel. El ajuar se compone de varias vasijas cerámicas, un puñal, una azuela con mango de madera y adornos en metal, así como restos de lino y posiblemente lana.

  1. Therapeutic use of mini-scleral lenses in a patient with Graves' ophthalmopathy.

    Science.gov (United States)

    Harthan, Jennifer S

    2014-01-01

    Patients with Graves' ophthalmopathy can be very challenging to manage secondary to the complex nature of their disease presentation. Patients may present with a variety of ocular findings including: lid retraction, periorbital and lid swelling, chemosis, conjunctival hyperemia, proptosis, optic neuropathy, restrictive myopathy, exposure keratopathy and/or keratoconjunctivitis sicca. Mini-scleral and scleral lens designs have been important in the management of irregular and regular corneas, and in the therapy of ocular surface diseases. We present here the case of a 48-year-old Caucasian male who had been diagnosed with Graves' ophthalmopathy 13 years earlier. With significant ocular surface staining and over ten diopters of astigmatism, the patient had never been able to wear contact lenses comfortably. After being fit with the Mini-Scleral Design™ lenses, his vision improved to 20/25 OU, his ocular surface improved, and overall quality of vision increased. Copyright © 2012 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.

  2. Familial myasthenia gravis: report of four cases Miastenia grave familial: registro de quatro casos

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    José Lamartine de Assis

    1976-09-01

    Full Text Available Two pairs of siblings with myasthenia gravis, belonging to two different families, are reported. This is the only record of familial myasthenia during the past twenty years, in a total of 145 patients seen at the Neurological Clinic of the São Paulo Medical School. In spite of the fact that myasthenia gravis does not show hereditary characteristics, the peculiar features of the four cases justify the present report. The two pairs of siblings were born from non myasthenic nor consanguineous parents. The disease started at birth showing bilateral partial eyelid ptosis in all patients. The course of the illness has been favorable. There was no thymoma.Os autores registram dois pares de gêmeos com miastenia grave, pertencentes a duas famílias diferentes. Este é o único registro de miastenia familial durante os últimos 20 anos, num total de 145 pacientes examinados na Clínica Neurológica da FMUSP. Apesar do fato de a miastenia grave não ter características hereditárias, os aspectos peculiares dos quatro pacientes justificam o presente registro. Os dois pares de gêmeos nasceram de pais não miastênicos e sem consanguinidade. A doença iniciou-se no nascimento, evoluindo com ptose bilateral parcial da pálpebra superior precocemente em todos os pacientes. O curso da moléstia tem sido favorável. Não havia timoma.

  3. Thyroid peroxidase antibody positivity and triiodothyronine levels are associated with pediatric Graves' ophthalmopathy

    Institute of Scientific and Technical Information of China (English)

    Jung Hyun Lee; So Hyun Park; Dae Gyun Koh; Byung Kyu Suh

    2014-01-01

    Background: Graves' ophthalmopathy (GO) occurs commonly in children with Graves' disease (GD). However, there are limited studies on the clinical manifestations and thyroid autoantibodies in pediatric GO. The aim of this study was to investigate the prevalence and risk factors of GO in childhood GD. Methods: Clinical and biochemical data from children and adolescents with GD were retrospectively reviewed. Eighty patients under 19 years of age were included in the present study. We compared the clinical and biochemical differences between patients with and without GO. Results: Thirty-nine percent of the patients had GO, and 81% of the GO patients were females. Of these, two patients showed unilateral GO. Triiodothyronine (T3) levels were higher in GO patients than in those without GO. Anti-thyroglobulin antibody and thyroid stimulating hormone receptor antibody titers were not significantly different between the two groups. Anti-thyroid peroxidase antibody (TPO Ab) positivity was 68% in the patients with GO and only 47% in the patients without GO. In multivariate regression analysis, high T3 levels and TPO Ab positivity were related to the presence of GO. Conclusion: In children and adolescents with GD, TPO Ab positivity and high T3 levels could act as predictive factors for the presence of GO.

  4. The gravimeter "B-grave" for the in-situ surface gravity measurements of an asteroid

    Science.gov (United States)

    van Ruymbeke, Michel; karatekin, ozgur; rasson, jean; wielant, françois; dumont, Phillipe; Ritter, Birgit; zhu, Ping

    2016-04-01

    In the context of the preliminary study phase for the CubeSats supporting ESA's Asteroid Impact Mission (AIM) to the Didymos, we investigate a miniaturized gravimeter as part of the geophysical instrument package for the Asteroid Geophysical Explorer (AGEX). AGEX intends to land a CubeSat on the secondary object in the Didymos system, Didymoon in order to characterize the asteroid surface and internal structure A 3D compact gravimeter is developed at the Royal Observatory of Belgium. Its design allows to meter a weak 50 μm/sec² gravity field corresponding to 5 ppm of Earth gravity in a harsh environment. A system with three components mounted in an orthogonal geometry allows obtaining the gravity field in amplitude and in angular position without any requirement of levelling. B-GRAVES will use a in-situ calibration and multi-parameter approach for validation of the measurements. A laboratory simulation is induced with centrifugal forces applied to the pendulum set-up in a vertical position to reject the Earth gravity field. Signal treatment and uncertainties are discussed keeping in mind questions of thermal and vibration influence. The B-GRAVES can serve as a novel and robust instrument for future lander and rover missions .

  5. Timectomia na miastenia grave: avaliação dos resultados em 73 pacientes

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    J. Lamartine de Assis

    1978-03-01

    Full Text Available Foi feita avaliação dos resultados da timectomia transtorácica em 73 pacientes com miastenia grave generalizada, sendo 64 não timomatosos e 9 com timomas. Os resultados foram analisados à curto, médio e, em muitos casos, a longo prazo. Foi feito, também um estudo comparativo dos resultados em relação à idade, sexo, tempo de doença e à presença ou não do timoma. A experiência adquirida neste grupo de pacientes sugere que a timectomia transtorácica é método terapêutico útil na miastenia grave generalizada não timomatosa; seu efeito benéfico aparece no pós-operatório mediato e se mantém a longo prazo na maioria dos pacientes. Os resultados da timectomia em pacientes com timoma foram menos favoráveis. A análise estatística não mostrou diferenças significantes na evolução pós-operatória entre os pacientes não timomatos selecionados e não selecionados.

  6. Miastenia grave tratamento clínico x cirúrgico

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    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.

  7. Associação rara: polimiosite, miastenia grave e timoma

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    V. Van Boekel

    1990-12-01

    Full Text Available Fundamentados no fato de que, tanto na literatura nacional quanto na estrangeira, inexiste referência da associação de polimiosite, miastenia grave e timoma em adulto jovem do sexo masculino, os autores se propõem a descrever um caso da citada síndrome. O paciente aqui apresentado teve sua doença iniciada aos 22 anos de idade, atingindo sua expressão clínica máxima 4 anos miais tarde. No estudo em apreço, são enfatizadas as dificuldades no diagnóstico diferencial entre polimiosite e miastenia grave, doenças que, a principio, têm suas manifestações clinicas características, de modo geral bem individualizadas. Na presente observação chamamos a atenção para a possível existência de aspectos clínicos sugestivos de miastenia em enfermos com polimiosite e, por outro lado, alterações histopatológicas típicas de polimiosite em músculos de miastênicos, inviabilizando muitas vezes o diagnóstico clínico de certeza.

  8. Safety of different types of methylprednisolone puls-therapy in the treatment of Graves' orbitopathy

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    O I Vinogradskaya

    2012-09-01

    Full Text Available According to the EUGOGO’s (European Group On Graves' Orbitopathy last consensus, the treatment of choice for Graves’ Orbitopathy (GO is pulses of glucocorticoid (GC. There is a lack of evidence for superiority of any intravenous (iv GC schedules. As a rule this therapy is pretty safe. However, acute cardiovascular diseases and acute severe liver damage has been reported in sporadic cases during ivGC, resulting in fatal acute liver failure in a few patients. Design: we performed a prospective study in 36 Graves' patients with GO who were treated with 1000 mg of ivGC daily for 5 days (group I, n = 20 or weekly for 5 weeks (group II, n = 16. Results: ALAT and ASAT increases were much more prominent in group I than in group II especially during the treatment and in the first 4 weeks after the treatment. Increase of blood pressure, glycemia and negative ECG alterations in group I resulted to their management. And we revealed much more patients complains in group I. Conclusion: Both schedules seem to be pretty safe, but therapy once a week (for 5 weeks is safer and allows to treat patients in outpatient clinics, reduce expenditures on inpatient care, accelerate of initial treatment and include more patients into treatment.

  9. Association between age at diagnosis of Graves' disease and variants in genes involved in immune response.

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    Beata Jurecka-Lubieniecka

    Full Text Available BACKGROUND: Graves' disease (GD is a complex disease in which genetic predisposition is modified by environmental factors. The aim of the study was to examine the association between genetic variants in genes encoding proteins involved in immune response and the age at diagnosis of GD. METHODS: 735 GD patients and 1216 healthy controls from Poland were included into the study. Eight genetic variants in the HLA-DRB1, TNF, CTLA4, CD40, NFKb, PTPN22, IL4 and IL10 genes were genotyped. Patients were stratified by the age at diagnosis of GD and the association with genotype was analysed. RESULTS: Polymorphism in the HLA-DRB1, TNF and CTLA4 genes were associated with GD. The carriers of the HLA DRB1*03 allele were more frequent in patients with age at GD diagnosis ≤30 years than in patients with older age at GD diagnosis. CONCLUSIONS: HLADRB1*03 allele is associated with young age at diagnosis of Graves' disease in Polish population.

  10. Imaging studies for diagnosing Graves' orbitopathy and dysthyroid optic neuropathy

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    Allan C. Pieroni Gonçalves

    2012-11-01

    Full Text Available Although the diagnosis of Graves' orbitopathy is primarily made clinically based on laboratory tests indicative of thyroid dysfunction and autoimmunity, imaging studies, such as computed tomography, magnetic resonance imaging, ultrasound and color Doppler imaging, play an important role both in the diagnosis and follow-up after clinical or surgical treatment of the disease. Imaging studies can be used to evaluate morphological abnormalities of the orbital structures during the diagnostic workup when a differential diagnosis versus other orbital diseases is needed. Imaging may also be useful to distinguish the inflammatory early stage from the inactive stage of the disease. Finally, imaging studies can be of great help in identifying patients prone to develop dysthyroid optic neuropathy and therefore enabling the timely diagnosis and treatment of the condition, avoiding permanent visual loss. In this paper, we review the imaging modalities that aid in the diagnosis and management of Graves' orbitopathy, with special emphasis on the diagnosis of optic nerve dysfunction in this condition.

  11. Hidropesía fetal en una gestante con enfermedad hipertensiva grave. Presentación de un caso

    OpenAIRE

    Maribel Rodríguez Matos; Laritza Isabel Mengana Fontes; Mayda Urrutia Carmenaty

    2013-01-01

    La hidropesía fetal es un grave proceso de elevada mortalidad perinatal, de etiología multifactorial, caracterizado por un síndrome edematoso generalizado, con o sin acumulación de líquido en las cavidades serosas del organismo fetal. Se presenta un caso de hidropesía fetal no inmunológica en una paciente de sexo femenino, de color de piel blanca y de 20 años de edad con enfermedad hipertensiva grave, diagnosticada mediante ultrasonido, como estudio de bienestar fetal a las 35,1 semanas de ge...

  12. Elastic modulus of orbicularis oculi muscle in normal humans, humans with Graves' eye disease, and cynomolgus monkeys.

    Science.gov (United States)

    Oestreicher, J H; Frueh, B R

    1995-06-01

    We built an experimental apparatus to investigate the passive elastic characteristics of orbicularis oculi muscle and examined specimens from normal humans, humans with stable Graves' eye disease, and cynomolgus monkeys. Stress-strain curves were determined and found to be exponential. The elastic modulus (Young's modulus), analogous to the stiffness of the material, was calculated as a function of strain. Elastic modulus as a function of instantaneous stress was linear. Monkey elastic modulus values were determined, but did not allow meaningful interspecies comparison because of the small sample size. No significant difference was found between normal humans and humans with Graves' eye disease with respect to elastic modulus values.

  13. Study on T lymphocyte subsets and NK cells in patients with Graves disease combined with type 2 diabetes

    Institute of Scientific and Technical Information of China (English)

    魏枫; 杜婧; 苏秀兰; 乌兰; 王津京; 霍晓静

    2008-01-01

    Objective To investigate changes in T lymphocyte subsets and NK cells in patients with simple Graves' disease(GD)and Graves' disease combined with type 2 diabetes mellitus(GD/T2DM).Methods Fifteen cases of GD/T2DM were selected from our hospital from November 2001 to November 2004.Before and after therapy thyroid function,thyroglobulin antibody(TGA),thyroid microsomal antibody(TMA)and blood glucose level were measured,and T lymphocyte subsets(CD3,CD4,CD8,CD4/CD8)and NK cells(CD56)were measured by immunofluo...

  14. Role of insulin-like growth factor-1 (IGF-1) pathway in the pathogenesis of Graves' orbitopathy

    DEFF Research Database (Denmark)

    Smith, Terry J; Hegedüs, Laszlo; Douglas, Raymond S

    2012-01-01

    with GD. These abnormal patterns of IGF-1R display are also found in rheumatoid arthritis and carry functional consequences. In addition, activating IgGs capable of displacing IGF-1 from IGF-1R have also been detected in patients with these diseases. IGF-1R forms a complex with TSHR which is necessary......The etiology of Graves' orbitopathy (GO) remains enigmatic and thus controversy surrounds its pathogenesis. The role of the thyroid stimulating hormone receptor (TSHR) and activating antibodies directed against it in the hyperthyroidism of Graves' disease (GD) is firmly established. Less well...

  15. O terapeuta na clínica do sofrimento psíquico grave : particularidades e vivências

    OpenAIRE

    Brito,Luciana Stoimenoff

    2012-01-01

    Este trabalho teve como objetivo principal investigar e descrever as vivências experimentadas pelo terapeuta que trabalha na clínica do sofrimento psíquico grave, bem como apontar de que maneira a vivência desses profissionais dialoga com a teoria clínica das psicoses, especialmente a teoria winnicottiana. Foram realizadas entrevistas individuais semi-estruturadas com oito terapeutas que atuam na clínica do sofrimento psíquico grave. Para a análise das narrativas utilizamos a a...

  16. Atitudes de profissionais de enfermagem em relação ao paciente queimado: elaboração e teste de fidedignidade de um instrumento Actitudes de profesionales de enfermería en relación al paciente quemado: elaboración y teste de fidedignidad de un instrumento de medida Attitudes of nursing professionals towards burn patients: elaboration and reliability tests of a measurement instrument

    Directory of Open Access Journals (Sweden)

    Fatima Aparecida Emm Faleiros Souza

    1994-01-01

    Full Text Available Desenvolveu-se um instrumento de Medida de Atitudes dos Profissionais de enfermagem em relação ao Paciente Queimado. Cento e noventa e quatro (194 itens agrupados em subescalas, declarativos de atitudes favoráveis e desfavoráveis frente ao paciente queimado foram analisados quanto à validade aparente e de conteúdo. Após essa análise psicométrica, cento e setenta (170 itens compuseram a escala definitiva. O coeficiente de fidedignidade calculado pelo método da divisão por metades, variou de 0,61 a 0,82 para as diferentes subescalas. A fidedignidade da escala total foi de 0,92.En este trabajo fue desarrollado un instrumento de medida de Actitudes de los Profesionales de Enfermería con Ocupación frente al Paciente Quemado. Ciento y noventa y cuatro (194 itens, agrupados en subescalas, declarativos de actitudes favorables y desfavorables hacia al paciente quemado fueron analisados cuanto a la validad aparente y de contenido. Después de esse análisis psicométrica, ciento y setenta (170 itens formaron la escala definitiva. El enfoque de fidedignidad calculado por el metodo de división por mitades ha variado de 0,61 a 0,82 para las diferentes subescalas. La fidedignidade de la escala total fué de 0,92.In this study it was developed an instrument for Measuring the Attitudes of Nursing Professionals toward patients with Burns. 194 items into subscales, expressing favorable and unfavorable attitudes toward patients with burns, were analyzed their apparent and context validity. Following this psychometric analysis 170 items were selected to compose the definitive scale. The coefficient estimated by the split - half method for the different subscales ranged from 0,61 to 0,81. The confiability coefficient of the total scale was equal to 0,92.

  17. Association between TSH-Receptor Autoimmunity, Hyperthyroidism, Goitre, and Orbitopathy in 208 Patients Included in the Remission Induction and Sustenance in Graves' Disease Study

    DEFF Research Database (Denmark)

    Laurberg, Peter; Nygaard, Birte; Andersen, Stig

    2014-01-01

    Background. Graves' disease may have a number of clinical manifestations with varying degrees of activity that may not always run in parallel. Objectives. To study associations between serum levels of TSH-receptor autoantibodies and the three main manifestations of Graves' disease (hyperthyroidis...

  18. 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 K;

    2007-01-01

    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...

  19. Grave 22 of the Belgrade necropolis in Karaburma: Retrospective and perspective

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    Blečić-Kavur Martina

    2010-01-01

    Full Text Available Almost four decades after its discovery was initially announced, the Celtic necropolis in Karaburma, a suburb of Belgrade, is still one of the most important archaeological sites for the interpretation of the historical, economic, and cultural processes taking place in the central Balkans from the 4th to the end of the 1st centuries B.C. Most of all, it represents a wide-ranging source for explaining the chronology of the oldest Celtic presence in this area, also illustrating cultural exchanges in the network in which they were included. In this necropolis, belonging to the regional military elite, there are several graves in which, in addition to standard offerings relating to the regional material culture, items originating from a wider cultural area were found. Amongst these, grave number 22, the subject of our research, is especially important. In this grave were found objects mainly made of bronze and iron, with a smaller fragment of pottery. The iron items represent the attire of the deceased and his offensive weapons, while bronze items are characteristically imported vessels and a smaller bronze ring (figs. 1, 2. The imported vessels are represented by the well-known situla and cup. According to the basic typological scheme, we can classify the situla within the large group of ovoid situlae with the leaf-shaped or the so-called heart-shaped ornament under the attachment (figs. 1, 9; 2; 3, 7. According to the typological scheme here suggested, the situla found in Karaburma belongs to the first group, namely to its variant b (Ib, which is characterized by situlae with a leaf-shaped ornament on the attachment, separately cast and then pinned down or soldered to the body of the vessel (fig. 3, 7. Also belonging to this group are situlae from Skillountia, Goce Delčev (fig. 3, 8, Vărbica (fig. 3, 9 and from Chirnogi (fig. 3, 10. Situlae from Budva (fig. 3, 11 and Belgrade (fig. 3, 12 should also be included here, probably the one from Bitola

  20. The clandestine multiple graves in Malaysia: The first mass identification operation of human skeletal remains.

    Science.gov (United States)

    Mohd Noor, Mohd Suhani; Khoo, Lay See; Zamaliana Alias, Wan Zafirah; Hasmi, Ahmad Hafizam; Ibrahim, Mohamad Azaini; Mahmood, Mohd Shah

    2017-09-01

    The first ever mass identification operation of skeletal remains conducted for the clandestine graves in Malaysia consisted of 165 individuals unearthed from 28 human trafficking transit camps located in Wang Kelian, along the Thai-Malaysia border. A DVI response was triggered in which expert teams comprising of pathologists, anthropologists, odontologists, radiologists and DNA experts were gathered at the identified operation centre. The Department of Forensic Medicine, Hospital Sultanah Bahiyah, Alor Star, Kedah, located approximately 75km away from Wang Kelian, was temporarily converted into a victim identification centre (VIC) as it is the nearest available forensic facility to the mass grave site. The mortuary operation was conducted over a period of 3 months from June to September 2015, and was divided into two phases; phase 1 involving the postmortem examination of the remains of 116 suspected individuals and for phase 2 the remains of 49 suspected individuals. The fact that the graves were of unknown individuals afforded the mass identification operation a sufficient duration of 2 weeks as preparatory phase enabling procedurals and daily victim identification workflow to be established, and the setting up of a temporary body storage for the designated mortuary. The temporary body storage has proven to be a significant factor in enabling the successful conclusion of the VIC operation to the final phase of temporary controlled burials. Recognition from two international observers, Mr. Andréas Patiño Umaña, from the International Committee of Red Cross (ICRC) and Prof. Noel Woodford from Victoria Institute of Forensic Medicine (VIFM) had proven the mortuary operation was in compliance to the international quality and standards. The overall victim identification and mortuary operation identified a number of significant challenges, in particular the management of commingled human remains as well as the compilation of postmortem data in the absence of

  1. Efeito da hipertermia na pancreatite aguda grave experimental Effects of hyperthermia on experimental severe acute pancreatitis

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    Maurício Gustavo Ieri Yamanari

    2007-02-01

    Full Text Available OBJETIVO: O objetivo deste estudo é avaliar os efeitos da hipertermia na pancreatite aguda (PA grave experimental induzida por ácido taurocólico. MÉTODO: A PA grave foi induzida pela injeção retrógrada de ácido taurocólico a 2,5% ou 5% no ducto pancreático principal. Após a indução, os animais foram colocados numa gaiola contendo duas lâmpadas de 100 W. A temperatura corporal foi aumentada para 39,5ºC e mantida neste nível por 45 minutos. Foram estudados taxa de mortalidade em 72 horas, permeabilidade vascular no pâncreas, porcentagem de água no tecido pancreático, amilase sérica, histologia (edema, necrose acinar e infiltrado inflamatório e níveis séricos de IL-6 e IL-10. RESULTADOS: Não houve alteração em nenhum dos parâmetros avaliados. CONCLUSÃO: Não há benefício da hipertermia na PA grave experimental induzida por ácido taurocólico.OBJECTIVE: The aim of this study is to evaluate the effects of hyperthermia post-treatment on taurocholate-induced severe acute pancreatitis (AP in rats. METHOD: Severe AP was induced by retrograde injection of 2,5% or 5% taurocholate solution into the main pancreatic duct. After the AP induction, animals were heated in a cage with two 100 W lamps. Body temperature was increased to 39ºC and maintained at that level for 45 minutes. 72-hours mortality rate, amylase serum levels, histology (edema, acinar necrosis and inflammatory infiltrate, vascular permeability, pancreatic water content and serum levels of IL-6 and IL-1 were determinated. RESULTS: Hyperthermia post-treatment on severe AP showed no evidence of alteration in all evaluated parameters. CONCLUSION: The findings suggest no beneficial effect of the thermal stress on inflammatoy edema and mortality rate in taurocholate AP model.

  2. Postoperative tetany in Graves disease: important role of vitamin D metabolites.

    Science.gov (United States)

    Yamashita, H; Murakami, T; Noguchi, S; Shiiba, M; Watanabe, S; Uchino, S; Kawamoto, H; Toda, M; Murakami, N

    1999-02-01

    To test the authors' hypothesis of the causal mechanism(s) of postoperative tetany in patients with Graves disease. Previous studies by the authors suggested that postoperative tetany in patients with Graves disease occurs during the period of bone restoration and resulted from continuation of a calcium flux into bone concomitant with transient hypoparathyroidism induced by surgery. A prospective study was carried out to investigate sequential changes in serum levels of intact parathyroid hormone (iPTH), calcium and other electrolytes, 25-hydroxyvitamin D (25OHD), 1,25-dihydroxyvitamin D (1,25(OH)2D), and bone metabolic markers in 109 consecutive patients with Graves disease who underwent subtotal thyroidectomy. Preoperative serum iPTH levels negatively correlated with ionized calcium levels and positively correlated with 1,25(OH)2D or 1,25(OH)2D/25OHD. After the operation, there was a significant decline in levels of ionized calcium, magnesium, and iPTH. Serum iPTH was not detected in 15 patients after surgery. Four of these 15 patients, and 1 patient whose iPTH level was below normal, developed tetany. Preoperative serum ionized calcium levels were significantly lower, and iPTH levels were higher, in the 5 patients with tetany than in the 11 patients who did not develop tetany despite undetectable iPTH levels. The tetany group had significantly lower serum 25OHD levels and higher 1,25(OH)2D levels, and had increased 1,25(OH)2D/25OHD as an index of the renal 25OHD-1-hydroxylase activity than those in the nontetany group. These results suggest that patients with a high serum level of iPTH as a result of low serum calcium levels (secondary hyperparathyroidism) are susceptible to tetany under conditions of hypoparathyroid function after surgery. Postoperative tetany occurs in patients with secondary hyperparathyroidism caused by a relative deficiency in calcium and vitamin D because of their increased demand for bone restoration after preoperative medical therapy

  3. Deformação miocárdica pelo speckle tracking na cardiomiopatia dilatada grave

    Directory of Open Access Journals (Sweden)

    Maria Cristina Donadio Abduch

    2012-09-01

    Full Text Available FUNDAMENTO: A alta e crescente prevalência de Cardiomiopatia Dilatada (CMD representa sério problema de saúde pública. Novas tecnologias vêm sendo utilizadas objetivando diagnósticos mais sofisticados, que melhorem a abordagem terapêutica. Nesse cenário, o Speckle Tracking (STE utiliza marcadores miocárdicos naturais para analisar a deformação sistólica do Ventrículo Esquerdo (VE. OBJETIVO: Mensurar o strain transmural longitudinal global (SG do VE através do STE em pacientes com CMD grave, comparando os resultados com indivíduos normais e com parâmetros ecocardiográficos consagrados para análise da função sistólica do VE, validando o método nessa população. MÉTODOS: Foram estudados 71 pacientes com CMD grave, (53 ± 12a, 72% homens e 20 controles (30 ± 8a, 45% homens. Foram obtidos os volumes e a FEVE pela ecocardiografia bi e tridimensional, parâmetros do Doppler, Doppler tecidual e o SG pelo STE. RESULTADOS: Comparados ao grupo controle, os volumes do VE foram maiores no grupo CMD; entretanto, a FEVE e velocidade de pico da onda E foram menores neste último. O índice de performance miocárdica foi maior entre os pacientes. As velocidades do miocárdio pelo Doppler tecidual (S', e', a' foram consideravelmente menores e a relação E/e' foi maior no grupo CMD. O SG apresentou-se diminuído no grupo CMD (-5,5% ± 2,3%, em relação aos controles (-14,0% ± 1,8%. CONCLUSÃO: No presente estudo, o SG foi significativamente menor nos pacientes com CMD grave, abrindo novas perspectivas para abordagens terapêuticas nessa população específica.

  4. Les cellulites cervico-faciales graves, facteurs et critères de gravité

    Science.gov (United States)

    Lakouichmi, Mohammed; Tourabi, Khalid; Abir, Bader-eddine; Zouhair, Said; Lahmiti, Saad; Hattab, Nadia Mansouri

    2014-01-01

    La cellulite cervico-faciale grave est une infection polymicrobienne extensive et redoutable du tissu cellulo-adipeux de la face et du cou. L'objectif de cette étude est d'analyser certains facteurs favorisants et d’évaluer les critères de gravité en fonction des formes anatomo-cliniques. Il s'agit d'une étude rétrospective réalisée, entre janvier 2007 et décembre 2012, au service de chirurgie maxillo faciale de l'hôpital militaire Avicenne de Marrakech. Sur 147 cas de cellulites cervico-faciales pris en charge au niveau du service, 13 dossiers de cellulites graves ont été retenus. Neuf hommes (69%) et quatre femmes (31%) ont fait l'objet de cette étude, avec un âge moyen de 35 ans. Tous les patients ont été adressés pour prise en charge secondaire après avoir pris des anti-inflammatoires (AI). Sept cas (54%) étaient immunocompétents. La cause dentaire était soulevée chez neufs cas (69%). Cinq cas (38%) ont présenté une forme pseudo phlegmoneuse avec des signes compressifs des voies aéro-digestives. L'extension médiastinale a été observée chez quatre patients (31%). La forme nécrosante extensive a été retrouvée dans trois cas (23%). L’étude bactériologique, réalisée chez tous les patients, avait mis en évidence une flore microbienne mixte et polymorphe. Les cellulites cervico-faciales graves posent un réel problème de prise en charge thérapeutique. L'analyse des facteurs favorisants et l’évaluation des critères de gravité dans cette série ont permis de limiter une évolution défavorable. PMID:26113891

  5. Graves' ophthalmopathy and {sup 1}31{sup I} therapy

    Energy Technology Data Exchange (ETDEWEB)

    Marcocci, C.; Bartalena, L.; Tanda, M.L.; Manetti, L.; Dell' Unto, E.; Mazzi, B.; Rocchi, R.; Barbesino, G.; Pinchera, A. [Pisa Univ. of Pisa, Pisa (Italy). Dept. of Endocrinology and Metabolism

    1999-12-01

    Graves' ophthalmopathy is an autoimmune process initiated and maintained by antigen(s) shared by the thyroid and the orbit. A matter of argument concerns the choice of the method of treatment for Graves' hyperthyroidism when clinically evident ophthalmopathy is present. Restoration of euthyroidism appears to be beneficial for ophthalmopathy. On the other hand the continuing disease activity associated with the recurrence of hyperthyroidism appears to adversely affect the course of ophthalmopathy. For these reasons it is our opinion that in patients with Graves' hyperthyroidism and ophthalmopathy the permanent control of thyroid hyper function by ablation of thyroid tissue should be obtained by radioiodine therapy or thyroidectomy. The rationale for an ablative strategy is the following: (i) permanent control of hyperthyroidism avoids exacerbations of eye disease associated with recurrence of hyperthyroidism; (ii) hypothyroidism, which follows thyroid tissue ablation, should be regarded as a therapeutic end point rather than as an undesirable result; (iii) ablation of thyroid tissue may result in the removal of both the thyroid-orbit cross-reacting antigen(s) and the major source of thyroid-auto reactive lymphocytes. The relationship between radioiodine therapy and the course of GO is a matter of controversy, and some authors have suggested that radioiodine administration ma be associated with a worsening of preexisting ophthalmopathy. This was not observed when radioiodine treatment was associated with a 3-month oral course of prednisone. The development or progression of GO after radioiodine therapy might be due to the release of thyroid antigens following radiation injury and to subsequent exacerbations of autoimmune reactions directed towards antigens shared by the thyroid and the orbit. The view that radioiodine therapy may be associated with a progression of ophthalmopathy is not shared by some authors who claim that the apparent link between

  6. A bioassay for thyroid stimulating immunoglobulins of patients with Graves' disease using porcine thyroid monolayer cells.

    Science.gov (United States)

    Fukue, Y; Uchimura, H; Kuzuya, N; Okano, S; Kanaji, Y; Takaku, F

    1986-06-01

    A bioassay for thyroid stimulating immunoglobulins (TSI) of patients with Graves' disease was developed by porcine thyroid monolayer cells. Thyroid cells were prepared by dispersion using collagenase and trypsin. Aliquots of the cell suspension (2 X 10(6) cells/1.5 ml/dish) in Ham's F-12 medium (pH 7.2) containing 10% calf serum and 1.5 mM Hepes were seeded and cultured in air at 36 C. On day 6 of culture, cells were incubated with test samples (IgG or bTSH) in 1 ml of serum-free, 0.5 mM IMX-included fresh medium for an additional time, and cAMP in the cells was measured by radioimmunoassay. Intracellular cAMP was increased within 5 minutes after the addition of bTSH and the maximal increase was observed after 30 min. Responses of cAMP were in a dose-related manner up to 10 mU/ml of bTSH. With the addition of IgG from untreated Graves' patients, dose-related increases in cAMP were also observed up to 10 mg/ml IgG and the maximal response was seen at 2 hours incubation. Thyroid stimulating activity in IgG's from normal subjects and patients with Graves' disease was tested with a dose of 10 mg/ml and 2 hours incubation and the activity was expressed as a percent of the control (incubated in the same experiment without IgG). One hundred forty one of 145 untreated patients showed higher activity (228 +/- 51.8%, mean +/- SD; 127-393%, range) than normal subjects (103 +/- 13.3%, mean +/- SD, n = 24; 80-129%, range). Sequential changes in TSI activity in 27 patients after initiating thionamide drugs were studied for 24 months. Initially all 27 patients showed positive TSI and 6 months later 15 remained positive. At 6 months after that, 10 of 23, 4 of 16, and 2 of 6 followed patients showed positive TSI. These results indicate that this bioassay is clinically useful for detecting TSI.

  7. La nutrición enteral precoz en el enfermo grave

    Directory of Open Access Journals (Sweden)

    B. García Vila

    Full Text Available La nutrición enteral se ha demostrado como un método eficaz y seguro de nutrir a los enfermos graves ingresados en una Unidad de Cuidados Intensivos. Aunque se desconoce cuánto tiempo puede estar un enfermo grave sin nutrición, el catabolismo acelerado y el ayuno pueden ser deletéreos en el enfermo grave y la recomendación más frecuente es la de empezar la nutrición artificial cuando se prevea un período de ayuno superior a los siete días. Las ventajas de la nutrición enteral sobre la nutrición parenteral son evidentes a nivel experimental inmune tanto local como sistémica y mantiene las funciones de barrera del intestino. Estudios clínicos han demostrado que la nutrición enteral precoz, administrada en las primeras 48 horas de ingreso, disminuye la incidencia de infecciones nosocomiales en estos enfermos aunque no la mortalidad, salvo en grupos concretos de pacientes, especialmente en enfermos quirúrgicos. El mayor inconveniente de la nutrición enteral es su intolerancia digestiva y el abordaje trans-pilórico, necesario cuando se produce gastroparesia. También existen dudas de su eficacia cuando el enfermo está en situación de isquemia tisular. Para que la nutrición enteral precoz sea eficaz hace falta instaurar una estrategia terapéutica que incluye tanto medidas sencillas como la elevación del cabecero de la cama, a medidas más sofisticadas como el abordaje trans-pilórico o el uso de nutrientes con capacidad inmunomoduladora. El uso de nutrición enteral precoz es, hoy por hoy, el mejor método de soporte nutricional en estos enfermos si se individualiza su uso en función de la situación clínica de cada paciente y se realiza mediante una estrategia terapéutica adecuada.

  8. Thyroid stimulating immunoglobulins in Graves' disease with goitre growth, low thyroxine and increasing triiodothyronine during PTU treatment

    DEFF Research Database (Denmark)

    Hegedüs, Laszlo; Hansen, J M; Bech, K

    1984-01-01

    In 50 consecutive patients with Graves' disease treated with PTU, 7 (group 1) developed increasing goitre in spite of unmeasurable TSH. Thyroid variables were compared with those from 10 controls with an ordinary response to PTU (group 2). Serum T4 decreased in group 1 from 246 +/- 47 nmol/l (mean...

  9. Loss of integrity of thyroid morphology and function in children born to mothers with inadequately treated Graves' disease.

    NARCIS (Netherlands)

    Kempers, M.J.E.; Trotsenburg, A.S. van; Rijn, R.R. van; Smets, A.M.; Smit, B.J.; Vijlder, J.J. de; Vulsma, T.

    2007-01-01

    CONTEXT: Central congenital hypothyroidism (CH-C) in neonates born to mothers with inadequately treated Graves' disease usually needs T(4) supplementation. The thyroid and its regulatory system have not yet been extensively studied after T(4) withdrawal, until we observed disintegrated thyroid

  10. In Graves' disease, increased muscle tension and reduced elasticity of affected muscles is primarily caused by active muscle contraction

    NARCIS (Netherlands)

    H.J. Simonsz (Huib); G. Kommerell (Guntram)

    1989-01-01

    textabstractIn three patients with Graves' disease of recent onset, length-tension diagrams were made during surgery for squint under eyedrop anesthesia, while the other eye looked ahead, into the field of action, or out of the field of action of the muscle that was measured. The affected muscles

  11. Migratory polyarthritis as an adverse effect of thiamazole use in a 13-year-old girl with Graves' disease

    NARCIS (Netherlands)

    Janson, J.A.; Laat, P. de; Draaisma, J.M.T.

    2015-01-01

    Graves' disease is the most prevalent cause of hyperthyroidism in children. The treatment commonly involves antithyroid therapy using a thionamide. We present a case of a 13-year-old girl with the antithyroid arthritis syndrome, presenting as a migratory polyarthritis, after the initiation of

  12. Hulth$\\grave{e}$n potential models for $\\alpha−\\alpha$ and $\\alpha−He^3$ elastic scattering

    Indian Academy of Sciences (India)

    J BHOI; U LAHA

    2017-03-01

    Simple Hulth$\\grave{e}$n-type potential models are proposed to treat the $\\alpha−\\alpha$ and $\\alpha−He^3$ elastic scattering. The merit of our approach is examined by computing elastic scattering phases through the judicious use of the phase function method. Reasonable agreements in scattering phase shifts are obtained with the standard data.

  13. Interferon-alpha-induced destructive thyroiditis followed by Graves' disease in a patient with chronic hepatitis C: a case report.

    Science.gov (United States)

    Kim, Bu Kyung; Choi, Young Sik; Park, Yo Han; Lee, Sang Uk

    2011-12-01

    Interferon-induced thyroiditis (IIT) is a major clinical problem for patients receiving interferon-alpha (IFN-α) therapy. But, destructive thyroiditis followed by Graves' disease associated with IFN-α therapy is very rarely reported. Herein, we report a rare case of pegylated IFN-α (pegIFN-α) induced destructive thyroiditis followed by Graves' disease in a patient with HCV infection. A 31-yr-old woman suffered from chronic active hepatitis C and was treated with pegIFN-α and ribavirin for 12 months. Results of a thyroid function test and autoantibody levels were normal before IFN-α therapy was initiated. Destructive thyrotoxicosis appeared seven months after the initiation of IFN-α therapy, followed by Graves' thyrotoxicosis two months after the cessation of therapy. The diagnoses of destructive thyroiditis and Graves' disease were confirmed by the presence of TSH receptor antibodies in addition to Tc-99m scintigraphy findings. The patient's antithyroglobulin antibody titer increased gradually during IFN-α therapy and remained weakly positive after IFN-α therapy was discontinued.

  14. Migratory polyarthritis as an adverse effect of thiamazole use in a 13-year-old girl with Graves' disease

    NARCIS (Netherlands)

    Janson, J.A.; Laat, P. de; Draaisma, J.M.T.

    2015-01-01

    Graves' disease is the most prevalent cause of hyperthyroidism in children. The treatment commonly involves antithyroid therapy using a thionamide. We present a case of a 13-year-old girl with the antithyroid arthritis syndrome, presenting as a migratory polyarthritis, after the initiation of thiona

  15. In Graves' disease, increased muscle tension and reduced elasticity of affected muscles is primarily caused by active muscle contraction

    NARCIS (Netherlands)

    H.J. Simonsz (Huib); G. Kommerell (Guntram)

    1989-01-01

    textabstractIn three patients with Graves' disease of recent onset, length-tension diagrams were made during surgery for squint under eyedrop anesthesia, while the other eye looked ahead, into the field of action, or out of the field of action of the muscle that was measured. The affected muscles we

  16. A Refined Study of FCRL Genes from a Genome-Wide Association Study for Graves Disease: e57758

    National Research Council Canada - National Science Library

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

    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...

  17. Leucopenia grave em paciente com artrite reumatoide tratada com combinação de metotrexato e leflunomida

    Directory of Open Access Journals (Sweden)

    Paola Toth

    2014-04-01

    Full Text Available Apresentamos o caso de uma paciente com artrite reumatoide tratada por dois anos com associação de metotrexato e leflunomida. A paciente foi internada com leucopenia grave quatro semanas após acrescentar ao esquema medicamentoso as drogas clopidogrel, isosorbida, sinvastatina, AAS e omeprazol.

  18. Síntomas de miastenia grave en un paciente con antecedente de timectomía por timoma invasor

    Directory of Open Access Journals (Sweden)

    Lilliana María Giraldo

    2015-12-01

    Conclusiones. Los pacientes con miastenia grave y aquellos con timoma asociado, deben someterse a la timectomía como parte del tratamiento. Sin embargo, la exacerbación de los síntomas o su reaparición después del procedimiento no necesariamente implica una nueva alteración en el timo.

  19. Tratamento não operatório do trauma de baço grave

    Directory of Open Access Journals (Sweden)

    Bernardino C. Branco

    Full Text Available A reunião de revista "Telemedicina baseada em evidências - Cirurgia do Trauma e Emergência" (TBE-CiTE realizou uma revisão crítica da literatura e selecionou três artigos atuais sobre o tratamento do trauma de baço. O foco foi em lesão de baço grave, definida pela American Association for the Surgery of Trauma (AAST como graus III a V. O primeiro artigo foi uma atualização do protocolo de 2003 da Eastern Association for the Surgery of Trauma (EAST para o tratamento não operatório de trauma do baço. O segundo artigo foi apresentado na plenária de 2012 da AAST avaliando o papel do extravasamento de contraste na tomografia computadorizada em pacientes com lesão grave de baço (AAST IV-V. O último artigo é europeu e investigou o efeito da angioembolização da artéria esplênica na função do baço após lesão esplênica grave (AAST III-V. A reunião de revista TBE-CiTE elaborou conclusões e recomendações para o tratamento de lesão grave do baço.

  20. Loss of integrity of thyroid morphology and function in children born to mothers with inadequately treated Graves' disease.

    NARCIS (Netherlands)

    Kempers, M.J.E.; Trotsenburg, A.S. van; Rijn, R.R. van; Smets, A.M.; Smit, B.J.; Vijlder, J.J. de; Vulsma, T.

    2007-01-01

    CONTEXT: Central congenital hypothyroidism (CH-C) in neonates born to mothers with inadequately treated Graves' disease usually needs T(4) supplementation. The thyroid and its regulatory system have not yet been extensively studied after T(4) withdrawal, until we observed disintegrated thyroid gland

  1. Leucopenia grave em paciente com artrite reumatoide tratada com combinação de metotrexato e leflunomida

    OpenAIRE

    Paola Toth; Roberto Bernd

    2014-01-01

    Apresentamos o caso de uma paciente com artrite reumatoide tratada por dois anos com associação de metotrexato e leflunomida. A paciente foi internada com leucopenia grave quatro semanas após acrescentar ao esquema medicamentoso as drogas clopidogrel, isosorbida, sinvastatina, AAS e omeprazol.

  2. Onset of Graves' disease during pregnancy in a woman with established hypothyroidism.

    Science.gov (United States)

    Alberiche, María; Sánchez-Hernández, Rosa María; López Mérida, Xabier; Wägner, Ana María

    2017-01-01

    Pregnancy strongly influences the thyroid gland and its function. Thyroid guidelines recommend a 30 to 50% increase of the preconceptional levothyroxine dose in women with hypothyroidism, when pregnancy is diagnosed. A 33 year-old, 8-week pregnant woman with hypothyroidism, presents with a 2-week history of palpitations, sweating, nervousness and fatigue. Physical examination shows tachycardia (108 bpm), distal tremors and diffuse goiter. After biochemical confirmation of hyperthyroidism, her levothyroxine dose is reduced and finally interrupted. Propylthiouracil is started and maintained until after the delivery of a healthy baby at week 40. Two weeks postpartum, hyperthyroidism worsens and propylthiouracil is replaced by methimazole. Eighteen months after delivery 7.5 mCi 131Iodine was given. Two months later, hypothyroidism developed and levothyroxine was initiated. Although conversion of Hashimoto's hypothyroidism into Graves' disease is exceptional in pregnancy, pregnant women with autoimmune hypothyroidism should ideally have their TSH concentrations measured before empirically increasing their levothyroxine dose.

  3. Recurrent Thyrotoxicosis due to Both Graves' Disease and Hashimoto's Thyroiditis in the Same Three Patients.

    Science.gov (United States)

    Schaffer, Ashley; Puthenpura, Vidya; Marshall, Ian

    2016-01-01

    Hashimoto's thyroiditis (HT) and Graves' disease (GD) are the 2 most common autoimmune disease processes affecting the thyroid gland. The relationship between the two is complex and not clearly understood. It has been theorized that HT and GD are 2 separate disease processes due to unique genetic differences demonstrated by genome studies. On the other hand, based on occurrence of both HT and GD in monozygotic twins and within the same family, they have been regarded to represent 2 ends of the same spectrum. This case report describes 3 patients who presented with thyrotoxicosis due to both GD and HT. The initial presentation was thyrotoxicosis due to GD treated with antithyroid medication followed by temporary resolution. They all subsequently experienced recurrence of thyrotoxicosis in the form of Hashitoxicosis due to HT, and then eventually all developed thyrotoxicosis due to GD, requiring radioablation therapy.

  4. Digital Memory: The Visual Recording of Mass Grave Exhumations in Contemporary Spain

    Directory of Open Access Journals (Sweden)

    Francisco Ferrándiz

    2008-09-01

    Full Text Available Exhumations of the victims of Franco's repressive policies are cultural practices of tremendous heuristic value and allow for the analysis of the public emergence, circulation and consumption of traumatic memory in local contexts. The use of visual media to capture social action in the surroundings of the exhumations serves as both a recording and as a triggering device for this emerging social memory. In the first part of this article we shall reflect on the different forms of visual and audiovisual interventions by different social actors that shape around mass grave exhumations. In the second part we will focus on the visual methods used by social scientists, particularly the recording of video-testimony of survivors and witnesses. URN: urn:nbn:de:0114-fqs0803351

  5. PTU-associated vasculitis in a girl with Turner Syndrome and Graves' disease.

    Science.gov (United States)

    Hardy, Olga T; Smolinski, Kara N; Yan, Albert C; Grimberg, Adda

    2006-01-01

    Palpable purpura is a concerning clinical finding in pediatric patients and can have many causes, including infectious and autoimmune processes. A rare cause, drug-induced vasculitis, may result from the production of antineutrophil cytoplasmic antibodies (ANCAs) in response to a medication. We report a girl with Turner syndrome and Graves' disease who presented with palpable purpuric lesions. The diagnosis of propylthiouracil (PTU)-associated vasculitis was made by observation of consistent clinical features, the detection of elevated ANA and ANCA in the blood, and the observed clinical resolution of symptoms following withdrawal of PTU. Subsequent treatment of persistent hyperthyroidism with radioablation did not result in an exacerbation of the vasculitis, a complication described in prior case reports.

  6. Prótesis total y unicompartimental en el manejo de artrosis grave de rodilla

    Directory of Open Access Journals (Sweden)

    DR. U. Jaime duboy

    2014-09-01

    Full Text Available La artrosis grave de rodilla es una patología prevalente y puede ser en algunos casos invalidante. Se revisan los fundamentos e historia sobre cómo la prótesis de rodilla ha llegado a ser el tratamiento de elección para eliminar el dolor y recuperar función, mejorando la calidad de vida de los pacientes. Se muestran las alternativas actuales que incluyen las prótesis Unicompartamentales, de creciente uso en los últimos años y se señalan también las mejoras en los cuidados perioperatorios y rehabilitación que han permitido una mejora significativa de los resultados.

  7. Grave's病患者外周血T细胞亚群变化意义

    Institute of Scientific and Technical Information of China (English)

    施毕; 成兴波; 金皆怡

    2001-01-01

    目的了解T细胞亚群在Grave's病(GD)患者治疗前后外周血中的分布情况.方法采用碱性磷酸酶-抗碱性磷酸酶桥联酶联免疫法.结果 GD治疗前、治疗6月后的CD3+T细胞、CD4+T细胞、CD4+T细胞与CD8+T细胞的比值均较正常对照组低,而C8+T细胞比正常组明显增高,差异均有显著性.结论细胞免疫在GD的发生、发展中起着重要的作用.

  8. Feasibility of tomotherapy for Graves' ophthalmopathy. Dosimetry comparison with conventional radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Nguyen, Nam P.; Krafft, Shane P. [Arizona Univ., Tucson, AZ (United States). Dept. of Radiation Oncology; Vos, Paul [East Carolina Univ., Greenville, NC (US). Dept. of Biostatistics] (and others)

    2011-09-15

    To compare the dosimetry of tomotherapy and the conventional half-beam technique (HBT) or non-split beam technique (NSBT) for target coverage and radiation dose to the lacrimal glands and lens. A retrospective review of 7 patients with Graves' ophthalmopathy who had radiotherapy because of disease progression on high steroid dose is reported: 3 patients were treated with tomotherapy and 4 patients with HBT. Compared to HBT, tomotherapy may provide better target coverage and significant reduction of radiation dose to the lacrimal glands and a higher dose to the lens. The NSBT improved target coverage but resulted in significantly higher doses to the lens and lacrimal glands. Tomotherapy may provide better coverage of the target volume and may be more effective in reducing severe exophthalmos compared to the conventional radiotherapy technique. (orig.)

  9. Current opinions on the radioiodine treatment of Graves' hyperthyroidism

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sang Woo; Lee, Jae Tae [School of Medicine, Kyungpook National Univ., Daegu (Korea, Republic of)

    2003-12-01

    Radioactive iodine therapy using I-131 for hyperthyroidism has been used for more than 50 years, and generally considered safe and devoid of major side effects. Appropriate patient selection criteria and clinical judgement concerning patient preparation should be employed for its optimal use. It has not been possible to resolve the trade-off between efficient definite cure of hyperthyroidism and the high incidence of post-therapy hypothyroidism. The dose of the I-131 needed to maintain euthyroid state remains an area of uncertainty and debate. Early side effects are uncommon and readily manageable. Other than the need for long-term monitoring and, in most cases, lifelong thyroid hormone treatment for late adverse consequences of this treatment remains only conjectural. We have reviewed general principles and recent advances in radioiodine treatment for Graves' hyperthyroidism, specially regarding to several controversies.

  10. Respuesta al tratamiento de la Enfermedad de Graves-Basedow en pacientes pediátricos

    Directory of Open Access Journals (Sweden)

    Martha Calagua Quispe

    2014-04-01

    Full Text Available Objetivos: Describir la respuesta clínica y bioquímica al tratamiento del hipertiroidismo por enfermedad de Graves en pacientes pediátricos. Diseño: Estudio retrospectivo. Institución: Instituto Nacional de Salud del Niño, Lima, Perú. Participantes: Niños con enfermedad de Graves. Métodos: Se incluyó 32 pacientes con diagnóstico de hipertiroidismo por Enfermedad de Graves, entre 1996 a 2007. Se consideró remisión, cuando se encontraban asintomáticos y bioquímicamente eutiroideos, luego de 6 meses de suspendido el tratamiento; y recaída, si luego de este periodo de tiempo, se encontró valores hormonales alterados. Principales medidas de resultados: Remisión o recaída luego del tratamiento. Resultados: Al diagnóstico, la edad promedio fue 10,5 años (3,2 a 17,9 años; 26 pacientes (81,2% fueron de sexo femenino, 13 (40,6% púberes y 19 (59,3% pre-púberes. Los síntomas y signos más frecuentes fueron bocio, sudoración, nerviosismo, pérdida de peso, taquicardia y exoftalmos. Se usó metimazol como primera opción terapéutica a una dosis inicial promedio de 0,78 mg/kg/ día (0,4 a 2 mg/kg/día. La TSH (57,1% y el T4L (50% alcanzaron valores normales entre los 6 y 8 meses. Se observó remisión en 11 pacientes (34,3%, 3 (9,3% sufrieron recaída, 12 (37,5% pasaron a tratamiento con radioyodo (I131 y 6 (18,7% continuaron recibiendo metimazol. La remisión de la enfermedad se alcanzó a los 2,81± 0,91 años de tratamiento (rango de 1.5 a 4,8; 4,1% remitió luego del primer año, y 35,3%, 37,5% y 25% luego del segundo, tercer y cuarto año de tratamiento, respectivamente. La edad promedio de los que recibieron I131 fue 14,6 años (7,1 a 19,6 años, a una dosis alrededor de 7mCi. El 75% de ellos remitió a los 0,64± 0,60 años (rango de 0,16 a 1,5 años. Conclusiones: El hipertiroidismo por enfermedad de Graves es de relativa frecuencia en pediatría. Se obtuvo remisión en 34,3% de pacientes tratados con metimazol en un tiempo

  11. 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...

  12. Hazardous materials management using a Cradle-to-Grave Tracking and Information System (CGTIS)

    Energy Technology Data Exchange (ETDEWEB)

    Kjeldgaard, E.; Fish, J.; Campbell, D.; Freshour, N.; Hammond, B.; Bray, O. [Sandia National Labs., Albuquerque, NM (United States); Hollingsworth, M. [Ogden Environmental & Energy Services Co., Inc., Albuquerque, NM (United States)

    1995-03-01

    Hazardous materials management includes interactions among materials, personnel, facilities, hazards, and processes of various groups within a DOE site`s environmental, safety & health (ES&H) and line organizations. Although each group is charged with addressing a particular aspect of these properties and interactions, the information it requires must be gathered into a coherent set of common data for accurate and consistent hazardous material management and regulatory reporting. It is these common data requirements which the Cradle-to-Grave Tracking and Information System (CGTIS) is designed to satisfy. CGTIS collects information at the point at which a process begins or a material enters a facility, and maintains that information, for hazards management and regulatory reporting, throughout the entire life-cycle by providing direct on-line links to a site`s multitude of data bases to bring information together into one common data model.

  13. Clinical evaluation of Graves ophthalmopathy in north-east Islamic Republic of Iran.

    Science.gov (United States)

    Razavi, M E; Abotoraby, R B; Kakhki, R D; Ghanavati, S Z; Layegh, P; Taghavi, M; Rajabian, M T

    2008-01-01

    This study evaluated the prevalence and severity of ophthalmic manifestations in all Graves disease patients (n = 68) presenting to endocrine clinics at Mashad University of Medical Sciences between December 2002 and September 2005. The mean age of patients was 38.0 (SD 14.0) years, range 15 to 71 years. The most common complaints were foreign body sensation (54.0%) and puffy eyelids (48.4%). The most common apparent abnormality was lid retraction in 64.2% of patients (bilateral in 95.3% of cases). The patients had a mean modified Werner's NO SPECS classification score of 3.00 (SD 1.46). The score was significantly higher in males than females [3.58 (SD 1.44) versus 2.63 (SD 1.35)] and was positively correlated with age.

  14. Miastenia grave: aspectos históricos Myasthenia gravis: historical aspects

    Directory of Open Access Journals (Sweden)

    FRANCISCO MARCOS B. CUNHA

    1999-06-01

    Full Text Available Foram pesquisados aspectos históricos da miastenia grave desde as primeiras descrições da doença em 1672, pelo clínico inglês Thomas Willis. São descritas as dificuldades encontradas no manuseio dos primeiros pacientes diagnosticados. Pesquisaram-se fatos históricos ligados à investigação da doença, o tratamento, bem como curiosidades pouco citadas na literatura.We studied historical aspects of myasthenia gravis starting from its first description by the English physician, Sir Thomas Willis, in 1672. We also describe the difficulties in managing triating the first diagnosed patient. Historical facts related to the investigation and the initial treatment of this disorder as well as curiosities seldom mentioned in the literature are part of this paper.

  15. Preliminary Study on Chinese Drug-Induced Apoptosis ofThyrocytes in Graves' Disease

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    After 2-10 weeks treatment, effect of anti-thyroid drugs combined with Chinese drugs on the thyrocytes of Graves' disease: apoptosis ratio is 18.66±20.01% (n=13), P<0.01; Compared with that of single anti-thyroid drug group: 2.11±1.78%, n=13TUNEL  The increase of TUNEL-positive nuclei (blue color) was observed: 3-5 cells/vision field in combining Chinese drugs treatment group; 0-1 cell/vision field in treating with anti-thyroid drugs before combining with Chinese drugs group, and the control cell showed red color, see Figure 4.

  16. 3D GPR in forensics: Finding a clandestine grave in a mountainous environment.

    Science.gov (United States)

    Novo, Alexandre; Lorenzo, Henrique; Rial, Fernando I; Solla, Mercedes

    2011-01-30

    In the present work we show a forensic case study carried out in a mountainous environment. Main objective was to locate a clandestine grave which is around 10-20 years old and contains human remains of one individual and a metallic tool, probably a pick. Survey design started with an experimental burial of a pick at the expected depth (1m) as well as the calculation of synthetic radargrams in order to know if the 250MHz antenna was suitable for its detection and to have a record of the reflection of the pick. Conclusions extracted from the experiments together with rough terrain conditions suggested the use of the 250MHz antenna which allowed a good compromise between target detection and dense grid acquisition of an extensive survey area.

  17. Expression and clinical significance of connective tissue growth factor (CTGF) in Graves' ophthalmopathy.

    Science.gov (United States)

    Huang, Yi-Ming; Chang, Pei-Chen; Wu, Shi-Bei; Kau, Hui-Chuan; Tsai, Chieh-Chih; Liu, Catherine Jui-Ling; Wei, Yau-Huei

    2017-05-01

    To examine the expression of connective tissue growth factor (CTGF) in human cultured orbital fibroblasts from patients with Graves' ophthalmopathy (GO) and investigate whether a correlation exists between the presence of CTGF protein and clinical parameters of the disease. The protein expression levels of CTGF were analysed by western blots in cultured orbital fibroblasts from 10 patients with GO and 7 age-matched normal controls. Associations between the protein expression of CTGF and the clinical factors of GO, including clinical demographics, thyroid function, clinical activity score (CAS) and ophthalmopathy index (OI), was evaluated. The mean protein expression levels of CTGF in the GO orbital fibroblasts were significantly higher than those of normal controls (ppathophysiology of GO. 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/.

  18. Cytokine Status, Thyroid Autoantibodies and Their Dynamic Changes During the Treatment of Graves' Disease

    Directory of Open Access Journals (Sweden)

    V V Lazanovich

    2008-09-01

    Full Text Available It has been found during the research that the changes of Th1 and Th2 marker cytokine content in Graves Disease are dynamic and are directly correlated not only with the severity of autoimmune thyrotoxicosis, but also with the method of treatment used and duration of Thiamazole therapy. The beginning of autoimmune thyrotoxicosis shows the largest amounts of both pro-inflammatory (IL-1a, IL-8, IFN-γ and anti-inflammatory (IL-10 cytokines which are significantly reduced during Thiamazole therapy, with the exception of the cases of severe disease course. Thyroid resection does not result in immunologic remission either, which is confirmed by persisting high serum levels of IL-1a, IL-8, IFN-γ, IL-10 and TSH antibodies in the severe GBD group. Among the unfavorable prognostic factors for recurrent disease are high serum levels of TSH antibodies, IL-1a and IFN-γ during pre-surgery period.

  19. Myopathy Associated with Acute Hypothyroidism following Radioiodine Therapy for Graves Disease in an Adolescent

    Directory of Open Access Journals (Sweden)

    Rivkees ScottA

    2010-08-01

    Full Text Available We describe acute myopathy following I-131 treatment for hyperthyroidism due to Graves Disease (GD in an adolescent. A 15 year-old diagnosed with GD required treatment with radioactive iodine (I-131 therapy. Six weeks post I-131, he developed generalized muscle cramps. The CK was 19.800 U/L, the total thyroxine was 2.3 mcg/dL (29.6 nmol/L SI and the estimated free thyroxine (EFT was 0.5 ng/dL (6.4 pmol/L SI. The ALT was 112 U/L and AST was 364 U/L (normal

  20. Injuria renal aguda en la sepsis grave Acute kidney injury in severe sepsis

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    Hernán Trimarchi

    2009-06-01

    Full Text Available La sepsis afecta al 40% de los pacientes críticos, siendo su mortalidad de aproximadamente un 30% en el caso de la sepsis grave, y de 75% con injuria renal aguda, la cual sucede en el 20-51% de los casos. Se realizó un estudio prospectivo, observacional, longitudinal, en 80 pacientes sépticos graves en el lapso de 1 año para determinar el desarrollo de injuria renal aguda y su relación con la mortalidad; correlacionar antecedentes clínicos y variaciones del laboratorio con la mortalidad; determinar la tasa de mortalidad de la sepsis grave; relacionar óbito y foco séptico primario; evaluar la predictibilidad de mortalidad según niveles de creatinina de ingreso y sus variaciones finales. Se definieron dos grupos: Obito (n = 25 y No-óbito (n = 55. Analizados según la creatinina de ingreso, 39 tenían valores normales de creatinina (10 óbitos y 41 la presentaban elevada (15 óbitos; según la creatinina de egreso, 48 presentaron creatinina normal y fallecieron 7, mientras que 32 tenían daño renal agudo, de los cuales 18 fallecieron. De los 25 pacientes fallecidos, el 72% presentaron daño renal. De éstos, 7 pacientes vivos y 2 fallecidos requirieron hemodiálisis. El foco primario más frecuente fue el respiratorio (26.4%. El desarrollo de daño renal es un alto predictor de mortalidad en la sepsis, independientemente de los valores iniciales de creatinina. Edad más avanzada, hipertensión arterial, score APACHE más elevado, anemia más grave, hipoalbuminemia, hiperfosfatemia e hiperkalemia se asociaron a mayor mortalidad. La mortalidad global fue 31.3%. La imposibilidad de identificar el foco séptico primario se asoció a mayor mortalidad. El foco respiratorio se relacionó a mayor riesgo de requerir hemodiálisis.Sepsis affects 40% of critically ill patients, with a reported mortality of approximately 30% in severe sepsis, raising to 75% when acute kidney injury ensues, which occurs in about 20-51% of cases. The present study

  1. [Distribution of IgG subclasses of TgAb and TPOAb in sera from patients with Graves' disease, Graves' disease plus Hashimoto's thyroiditis and Hashimoto's thyrotoxicosis].

    Science.gov (United States)

    Yuan, Shanshan; Yu, Nan; Gao, Ying; Huang, Wei; He, Yifan; Dong, Bin; Lu, Guizhi; Li, Maorong; Cai, Xiaopin; Peng, Dingqiong; Wang, Yunhong; Li, Ting; Huang, Youyuan; Gao, Yanming; Guo, Xiaohui; Shi, Bingyin

    2014-01-14

    To evaluate the distribution of IgG subclasses of TgAb and TPOAb in sera from patients with Graves' disease (GD), Graves' disease plus Hashimoto's thyroiditis (GH) and Hashimoto's thyrotoxicosis. Patients with GD (n = 33), GH (n = 31) or Hashimoto's thyrotoxicosis (n = 18) diagnosed by fine needle aspiration cytology at Department of Endocrinology of Peking University First Hospital, Beijing Haidian Hospital, China-Japan Friendship Hospital and Civil Aviation General Hospital during the period from January 2010 to May 2013 were enrolled. All of them had TgAb and TPOAb. The total serum IgG and IgG subclasses of TgAb and TPOAb were detected by antigen-specific enzyme-linked immunosorbent assay (ELISA). The prevalence and relative amount of IgG subclasses were calculated and compared among three groups. The levels of TRAb in GD group (21.80(7.53, 40) U/L) were significantly higher than those in GH (7.30(3.10, 25.40) U/L) (P = 0.000) and Hashimoto's thyrotoxicosis groups (4.90(1.69, 16.43) U/L) (P = 0.003). And no significant differences were found in the levels of TgAb and TPOAb. The prevalence of TgAb IgG3 subclass in Hashimoto's thyrotoxicosis group (66.7%) was higher than GD group (35.5%) and GH group (36.4%) and the difference was close to significance (P = 0.066). There were significant differences of relative amount of TgAb IgG2 and TgAb IgG4 among three groups (P = 0.039 and 0.013), and GD patients had higher relative amounts of TgAb IgG2 (0.59(0.34, 0.94)) and TgAb IgG4 (0.57(0.28, 0.97)) than GH patients (TgAb IgG2, 0.31(0.23, 0.34); TgAb IgG4, 0.26(0.09, 0.48)) or patients with Hashimoto's thyrotoxicosis (TgAb IgG2, 0.32(0.24, 0.83); TgAb IgG4, 0.33(0.10, 0.65)) (for TgAb IgG2, P = 0.009 and 0.167; for TgAb IgG4, P = 0.005 and 0.041 respectively). No significant difference was found in the prevalence of each TPOAb IgG subclass. The difference of relative amount of TPOAb IgG2 among three groups was close to significance (P = 0.069). And the relative amount

  2. Hipertiroidismo por doença de Graves durante a gestação Hyperthyroidism due to Graves' disease during pregnancy

    Directory of Open Access Journals (Sweden)

    Carla Amaral de Almeida

    2005-05-01

    Full Text Available OBJETIVO: avaliar a influência do hipertiroidismo na evolução da gravidez e a necessidade de ajustes na dose de antitiroidianos neste período e no pós-parto. MÉTODOS: avaliação prospectiva de dados clínicos e laboratoriais de treze gestações em onze mulheres com hipertiroidismo devido à doença de Graves, com dosagem de TSH e T4 livre a cada trimestre ou quatro semanas após ajuste do antitiroidiano. O objetivo foi manter o T4 livre no terço superior da normalidade usando a menor dose possível de antitiroidiano. RESULTADOS: a média de idade no início da gravidez foi de 31,1 anos (23 a 41. Houve redução da dose de antitiroidiano em oito gestações (69,5% e, em duas, a droga foi suspensa. Antes da gravidez, a dose média de propiltiouracil era de 400 mg/dia (200 a 900 e a de metimazol, 45 mg/dia (20 a 60. Após o parto, a dose dos antitiroidianos foi reduzida para 200 e 30 mg/dia, respectivamente. Uma paciente apresentou parto prematuro (36ª semana de gestação e outra, recém-nato pequeno para a idade gestacional (2.000 g com 38 semanas de gestação. Houve um caso de natimortalidade. Não houve abortamentos ou anomalias congênitas. Após o parto, a dose de antitiroidiano foi aumentada em sete pacientes e mantida nas demais. CONCLUSÕES: recomendamos acompanhamento rigoroso de gestantes hipertiroidianas e titulação decrescente da dose dos antitiroidianos no decorrer da gestação, com o intuito de evitar o hipotiroidismo materno e suas conseqüências no desenvolvimento fetal. O acompanhamento após o parto dever ser cuidadoso, já que há a possibilidade de nova exacerbação do hipertiroidismo. O uso dos antitiroidianos foi seguro para as pacientes e sua prole.PURPOSE: to evaluate the influence of hyperthyroidism during pregnancy and the necessity of changing antithyroid drug dose in this period and after delivery. METHODS: prospective evaluation of clinical and laboratorial findings of thirteen pregnancies in eleven

  3. Supervoltage orbital radiotherapy for progressive Graves' ophthalmopathy; Results of a twenty-year experience

    Energy Technology Data Exchange (ETDEWEB)

    Kriss, J.P.; McDougall, I.R. (Division of Nuclear Medicine, Department of Diagnostic Radiology and Nuclear Medicine, Stanford University School of Medicine, Stanford Medical Center, Palo Alto, California (USA)); Petersen, I.A.; Donaldson, S.S. (Department of Radiation Oncology, Stanford University School of Medicine, Stanford Medical Center, Palo Alto, California (USA))

    1989-01-01

    Since 1968 we have employed supervoltage orbital radiation as treatment for severe progressive Graves' ophthalmopathy. A numerical ophthalmic index was used to asess pre- and post-treatment serverity. In the past 20 years we have treated 311 patients of whom 275 have been followed for {le} 1 year or until any eye surgery was performed. An orbital radiation dosage of 2000 rads in 2 weeks was used for the majority of patients (Series I and III). Series II patients received an orbital dose of 3000 rads in 3 weeks. Demographic differences were observed between these series, thus mandating presentation of the results of each separately. Analyses excluded any result achieved by any post-radiation surgical procedure on the eyes. Post-theraphy worsening of ophtalmopathy occurred in only 29 of 1025 observations. Improvement or complete resolution was observed within each category of eye involvement, but lack of favorable response was also recorded in significant numbers. Improvement in proptosis occurred with the lowest frequency and magnitude. About 30% of the patients required eye muscle surgery to correct residual diplopia. Analysis of the data by step-wise linear regression analysis enabled us a. to derive formulae predicting the problable response to radiation therapy according to sign and severity, and b. identify parameters which diminished the likelihood or the extent of a favorable response. The latter included male sex, never thyrotoxic, age greater than 60 years, and requirement for concomitant treatment for hyperthyroidism. No long-term adverse reactions attributable to the radiotherapy have been observed. We conclude that supervoltage orbital radiotherapy, combined with later eye muscle surgery if necessary, is an effective treatment strategy for progressive Graves' ophthalmopathy. (author).

  4. 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.

  5. 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.

  6. 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.

  7. Effect of double-fold surgery on spontaneous resolution of Graves' upper eyelid retraction.

    Science.gov (United States)

    Kim, Dong Kyu; Choi, Moonjung; Yoon, Jin Sook

    2015-02-01

    To investigate the effect of previous incisional double-fold surgery on spontaneous resolution of eyelid retraction caused by Graves orbitopathy (GO) in Asian individuals. Retrospective review of medical records. Patients (N = 30; 39 eyes) with eyelid retraction associated with GO with symptom duration of less than 6 months. Patients who visited the Ophthalmology Department of Severance Hospital, Yonsei University, between January 2010 and December 2011, followed up for more than 6 months and in a euthyroid state with antithyroid drug treatment were included. Patients treated with steroids or who underwent surgery during follow-up were excluded. Upper scleral show was measured as the distance between the central upper lid margin and limbus at initial presentation and after 6 months. Comparative analysis was performed between the 2 groups delineated by history (n = 12; 16 eyes), or lack thereof (n = 18; 23 eyes), of incisional double-fold surgery before onset of GO symptoms and signs. Patient demographics and initial upper scleral show were not significantly different between groups. In both groups, upper scleral show significantly decreased at 6 months of follow-up (p < 0.001 in both groups); however, improvement of upper scleral show was significantly reduced in patients who had undergone previous double-fold surgery (0.8 ± 0.5 mm) than in nonsurgical patients (1.8 ± 0.5 mm; p < 0.001). Graves eyelid retraction resolves spontaneously over time, albeit not completely. Previous double-fold surgery hinders the degree of spontaneous resolution, probably because of the fibrosis and cicatrization between the skin, the subcutaneous layer, and the levator complex. Copyright © 2015 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

  8. Factores que influyen en la mortalidad en los pacientes graves con cirugía abdominal

    Directory of Open Access Journals (Sweden)

    Anabel Hernández Ruíz

    Full Text Available Introducción: los pacientes quirúrgicos se encuentran entre los más susceptibles de recibir asistencia médica intensiva. Objetivo: determinar los factores que influyen en la morbilidad y mortalidad de los pacientes quirúrgicos graves. Métodos: se realizó un estudio prospectivo descriptivo con 193 pacientes quirúrgicos que ingresaron en la Unidad de Cuidados Intensivos del Hospital "Joaquín Albarrán" durante el año 2012. Resultados: de 193 pacientes falleció el 17,6 %, entre los que predominaron los pacientes con operaciones de urgencia (14. Influyeron sobre el aumento de la mortalidad la edad mayor de 60 años, la presencia de insuficiencia renal aguda (p = 0,0011 y la necesidad de apoyo con aminas vasoactivas (p < 0,0001, con una asociación altamente significativa entre albúmina y estado al egreso (p < 0,0001. El requerimiento de líquidos por más de 5 L se asoció a una mejor supervivencia (p = 0,0002. Conclusiones: los principales factores de riesgo para la mortalidad de los pacientes quirúrgicos graves son el shock hipovolémico, la necesidad de apoyo con aminas, la hipoalbuminemia y la presencia de insuficiencia renal aguda, por lo que su prevención o detección temprana permitirá intensificar o particularizar las acciones terapéuticas en cada paciente, lo que puede contribuir a la reducción de la mortalidad en estos enfermos.

  9. Radiation therapy for Graves' ophthalmopathy: a systematic review and meta-analysis of randomized controlled trials

    Directory of Open Access Journals (Sweden)

    Gustavo Arruda Viani

    2012-10-01

    Full Text Available PURPOSE: To evaluate the efficacy of radiotherapy (RT with total dose of 20 Gy (RT 20 Gy in the treatment of Graves' ophthalmopathy. METHODS: A systematic review and meta-analysis of randomized controlled trials was performed comparing RT 20 Gy with or without glucocorticoid to clinical treatments for Graves' ophthalmopathy. The MEDLINE, EMBASE, Cochrane Library databases and recent relevant journals were searched. Relevant reports were reviewed by two reviewers. Response to radiotherapy was defined as clinical success according to each trial. We also evaluated the quality of life and whether RT to produce fewer side effects than other treatments. RESULTS: A total of 8 randomized controlled trials (439 patients were identified. In the subgroup analysis, the overall response to treatment rates was better for: RT 20 Gy plus glucocorticoid vs glucocorticoids alone, OR=17.5 (CI95% 1.85-250, p=0.04, RT 20 Gy vs sham RT, OR= 3.15 (CI95%1.59-6.23, p=0.003 and RT 20Gy plus intravenous glucocorticoid vs RT 20Gy plus oral glucocorticoid, OR=4.15(CI95% 1.34-12.87, p=0.01. There were no differences between RT 20 Gy versus other fractionations and RT 20 Gy versus glucocorticoid alone. RT 20 Gy with or without glucocorticoids showed an improvement in diplopia grade, visual acuity, optic neuropathy, lid width, proptosis and ocular motility. No difference was seen for costs, intraocular pressure and quality of life. CONCLUSION: Our data have shown that RT 20 Gy should be offered as a valid therapeutic option to patients with moderate to severe ophthalmopathy. The effectiveness of orbital radiotherapy can be increased by the synergistic interaction with glucocorticoids. Moreover, RT 20 Gy is useful to improve a lot of ocular symptoms, excluding intraocular pressure, without any difference in quality of life and costs.

  10. THE EFFECT OF FCγ RECEPTOR ON THE PATHOGENESIS OF GRAVES' DISEASE

    Institute of Scientific and Technical Information of China (English)

    Pu dan(蒲丹); Guo Hui(郭辉); Luo Wentian(雒文田); Liu Qiuyue(刘秋月); Aosai Fumie

    2004-01-01

    Objective To explore the roles of Fcγ receptor in the pathogenesis of Graves' disease. Methods Fcγ receptor gene knockout mice(Fcγ R KO mice) which were rooted in C57BL/6 mice and wild type C57BL/6 mice were immunized by hTSH receptor expressing cells (DAP3.WT).1-2×107 DAP3.WT cells were peritoneally injected into mice every two weeks for a total of six times.Two weeks after final immunization, mice were killed for measurement of total thyroxine,TRAb and pathological examination.Results The thyroxine level of the immunized Fcγ receptor gene knockout mice was significantly lower than that of the immunized wild type control mice (2.2±0.31 vs.3.32±0.59g·dL-1,P<0.05), but there was no significant difference between immunized Fcγ R KO mice and non-immunized wild type control group.The TRAb levels of the immunized Fγ R KO mice significantly increased compared to those of the immunized wild type mice (21.75±8.21 vs.14.11±6.21, P<0.05). The lymphocyte cells infiltration and destruction of thyroid follicles were found in the thyroid gland of the immunized Fcγ R KO mice. Conclusion These results suggest that Fcγ receptor may be involved in the pathogenesis of Graves'disease.

  11. 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

  12. Usefulness of Measuring Thyroid Stimulating Antibody at the Time of Antithyroid Drug Withdrawal for Predicting Relapse of Graves Disease

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    Hyemi Kwon

    2016-06-01

    Full Text Available BackgroundHyperthyroidism relapse in Graves disease after antithyroid drug (ATD withdrawal is common; however, measuring the thyrotropin receptor antibody (TRAb at ATD withdrawal in order to predict outcomes is controversial. This study compared measurement of thyroid stimulatory antibody (TSAb and thyrotropin-binding inhibitory immunoglobulin (TBII at ATD withdrawal to predict relapse.MethodsThis retrospective study enrolled patients with Graves disease who were treated with ATDs and whose serum thyroid-stimulating hormone levels were normal after receiving low-dose ATDs. ATD therapy was stopped irrespective of TRAb positivity after an additional 6 months of receiving the minimum dose of ATD therapy. Patients were followed using thyroid function tests and TSAb (TSAb group; n=35 or TBII (TBII group; n=39 every 3 to 6 months for 2 years after ATD withdrawal.ResultsTwenty-eight patients (38% relapsed for a median follow-up of 21 months, and there were no differences in baseline clinical characteristics between groups. In the TSAb group, relapse was more common in patients with positive TSAb at ATD withdrawal (67% than patients with negative TSAb (17%; P=0.007. Relapse-free survival was shorter in TSAb-positive patients. In the TBII group, there were no differences in the relapse rate and relapse-free survivals according to TBII positivity. For predicting Graves disease relapse, the sensitivity and specificity of TSAb were 63% and 83%, respectively, whereas those of TBII were 28% and 65%.ConclusionTSAb at ATD withdrawal can predict the relapse of Graves hyperthyroidism, but TBII cannot. Measuring TSAb at ATD withdrawal can assist with clinical decisions making for patients with Graves disease.

  13. 核素显像在活动性Graves'眼病中的临床研究进展

    Institute of Scientific and Technical Information of China (English)

    李剑明; 史蓉芳

    2011-01-01

    @@ Graves'眼病(Graves ophthalmopathy, GO)也称为甲状腺相关性眼病(thyroid associated ophthalmopathy,TAO)、甲状腺眼病(thyroid eye-disease)、内分泌突眼,近年来倾向于称之为Graves'眶病.GO最常见于Graves'病(Graves' disease, GD),一般可见于50%左右的GD患者,其发生时间与GD可不同步,且该病因及发病机制尚未彻底阐明,它以眶部炎症、水肿、继发性纤维化为特征,其早期组织病理学变化为大量淋巴细胞浸润(主要为T淋巴细胞)、氨基葡聚糖(glycosaminoglycans, GAGs)沉积和组织水肿,晚期则表现为眼球后组织纤维化[1].GO的自然进程通常经历初始阶段、进展恶化阶段(活动期)、部分缓解阶段和稳定阶段.判断GO 是否处于炎性活动期对指导治疗方案、疗效评估都十分重要,本文就核素显像在活动性GO诊断及治疗评价方面的临床研究进展做一综述.

  14. Autoimmunity in Graves' ophthalmopathy: the result of an unfortunate marriage between TSH receptors and IGF-1 receptors?

    Science.gov (United States)

    Wiersinga, Wilmar M

    2011-08-01

    The immunopathogenesis of Graves' ophthalmopathy (GO) is still incompletely understood. Attention has shifted from the TSH receptor (TSHR) to the IGF-I receptor (IGF-1R) as a major autoantigen. This review on the pathophysiology of GO focused on orbital fibroblasts and the question whether autoimmunity against TSHR or IGF-1R is primarily involved. Relevant papers on GO were identified by a search on PubMed and scrutiny of their reference lists. In addition, abstracts presented on GO at the 14th International Thyroid Congress in 2010 in Paris, France, were read. Orbital fibroblasts (OF) are recognized as the prime target cells of the autoimmune attack in GO. In early stages OF are undifferentiated with low TSHR expression and are stimulated to produce hyaluronan by cytokines (released by activated infiltrating T cells) and not by Graves' IgG. OF lacking the surface glycoprotein Thy-1 (not present in the muscle compartment) may differentiate into adipocytes, associated with increased TSHR expression. Graves IgG stimulate hyaluronan in differentiated OF mostly via non-cAMP signaling pathways for growth, which can also be activated via TSHR. The existence of IGF-1R stimulating antibodies in serum remains dubious. Autoimmunity against IGF-1R is also observed in rheumatoid arthritis and is not specific for Graves' disease. Expression of IGF-1R on T and B lymphocytes may contribute to autoimmunity against fibroblasts. Autoimmunity against TSHR is most likely initiating the immune response in GO. Autoimmunity against IGF-1R is not specific for Graves' DISEASE but may contribute to ongoing immune reactions.

  15. Estudio comparativo de efectividad de un apósito de plata nanocristalina frente a sulfadiazina argéntica en el tratamiento de pacientes quemados Comparative study on the effectiveness of a dressing of nanocrystalline silver opposite to the use of silver sulfadiazine in burned patients treatment

    Directory of Open Access Journals (Sweden)

    J.F. Salvador Sanz

    2011-09-01

    Full Text Available La plata es un producto utilizado como agente antimicrobiano desde la antigüedad y ya a finales del siglo XIX se empezaron a utilizar compuestos de plata con finalidades médicas. La utilización tópica de la crema de sulfadiazina argéntica al 1 % se considera mayoritariamente como tratamiento de elección para las quemaduras a fin de tratar o prevenir la infección local. El objetivo de este artículo es comparar el tratamiento con Acticoat® (plata nanocristalina 15 nanómetros frente al tratamiento con sulfadiazina argéntica, ambos regímenes en igualdad de condiciones y un mismo centro de quemados. También se realiza una revisión de la literatura reciente sobre los factores de riesgo para la infección en quemaduras, las medidas que se utilizan para prevenirla y su importancia en la disminución de la morbi-mortalidad.Silver is a product that has been used as antimicrobial agent from ancient times; at the end of the XIXth century silver compounds were used with medical purposes. The use of silver sulfadiazine to 1 % cream is considered as gold standard for local treatment of burns in order to prevent or to treat local infection We compare treatment with Acticoat® (nanocrystalline silver 15 nanometers and silver sulfadiazine, both sistems on equal terms and in the same medical burned center. We review recent literature of risk factors for burn infection, methods to prevent it and to dininish morbimortality in burned patients.

  16. NUEVAS EVIDENCIAS SOBRE LA EDAD DE ABANDONO DEL SITIO ARQUEOLÓGICO PLAZUELAS (GUANAJUATO, MÉXICO MEDIANTE LA DATACIÓN ARQUEOMAGNÉTICA DE UN PISO QUEMADO (New Evidence of the Date of Abandonment of the Plazuelas Archaeological Site in Guanajuato, Mexico through Archaeomagnetic Dating of a Burned Floor

    Directory of Open Access Journals (Sweden)

    Juan Morales

    2015-10-01

    Full Text Available Se presentan los resultados de la datación arqueomagnética de un piso quemado del sitio arqueológico Plazuelas, Guanajuato. La carencia de una datación para la edad de abandono del sitio, detallada en relatos etnohistóricos, así como de carbón asociado a esta etapa, motivó la aplicación de un método alternativo de datación, independiente de los métodos tradicionales. La edad obtenida en este estudio, como la más probable para la última exposición al fuego del piso analizado, es bastante congruente con las evidencias arqueológicas disponibles para el sitio Plazuelas. Difícilmente una exposición posterior al fuego (ya sea de origen natural o provocada por el hombre daría como resultado una combinación de valores para los tres parámetros magnéticos determinados que convergieran en el intervalo de edad estimado para el abandono del sitio en cuestión. ENGLISH: The results of the archaeomagnetic dating of a burned floor from the archaeological site Plazuelas, Guanajuato, Mexico, are presented. The lack of an absolute date for the age of abandonment of the site, which is detailed in ethnohistorical accounts, as well as the lack of carbon remains conclusively associated with this stage, led to the implementation of an alternative method. The age obtained in this study, most likely representing the floor’s last exposure to fire, is quite consistent with the available archaeological evidence for the site’s date of abandonment. A subsequent exposure to fire (either natural or anthropogenic would not likely yield a combination of three magnetic parameters that would converge around the estimated period of abandonment of the site under study.

  17. Radioiodine treatment of Grave's disease; Radiojodtherapie des Morbus Basedow

    Energy Technology Data Exchange (ETDEWEB)

    Heidenreich, P.; Vogt, H.; Dorn, R.; Graf, G.; Kopp, J. [Klinik fuer Nuklearmedizin, Zentralklinikum Augsburg (Germany)

    2001-09-01

    In Germany radioiodine therapy of Grave's disease is performed in patients older than 20 years, after at least one year of unsuccessful antithyroid therapy, intolerance against antithyroid medication, recurrences after surgical interventions and small goiters. Hyperthyroidism is eliminated with an ablative dose concept (300 Gy) in more than 90% associated with rate of hypothyroidism in the outcome of also more than 90%. Adverse prognostic factors are an insufficient dose to the thyroid and/or concomitant antithyreoid medication. Radioiodine therapy in Germany must be an inpatient single time approach due to quality assurance and radiation protection reasons. The mean hospitalization is only 3-4 days with the patient being discharged at an annual dose of less than 1 mSv at 2 m distance (dose rate at discharge < 3,5 {mu}Sv/h at 2 m). An adjuvant treatment with cortisone is recommended in a simultaneous endocrine ophthalmopathy to prevent from deterioration. Radioiodine therapy of Grave's disease is cost effective with a low probability of side-effects and is not associated with an increased genetic or somatic risk. Therapy control and life span follow up has to be carried out by the expert physician legally responsible for the radioiodine therapy. (orig.) [German] Die Radiojodtherapie des Morbus Basedow wird in Deutschland, bei Patienten aelter als 20 Jahre, erst nach mindestens einjaehriger, erfolgloser thyreostatischer Therapie, bei Thyreostatikaunvertraeglichkeit, Rezidiven nach Operation und kleinen Strumen durchgefuehrt. Die Beseitigung der Hyperthyreose wird mit einem ablativen Dosiskonzept (300 Gy) in > 90%, verbunden mit einer Hypothyreoserate von ebenfalls > 90% erreicht. Prognostisch unguenstige Einflussfaktoren sind eine zu niedrig gewaehlte Herddosis und/oder eine begleitende Thyreostase. Aus Gruenden der Qualitaetssicherung und des Strahlenschutzes muss in Deutschland die Radiojodtherapie stationaer als Einzeittherapie durchgefuehrt werden. Die

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

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    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.

  19. The role of imaging in Graves' disease: A cost-effectiveness analysis

    Energy Technology Data Exchange (ETDEWEB)

    Cappelli, C. [Department of Medical and Surgical Sciences, Internal Medicine and Endocrinology Unit, University of Brescia (Italy)], E-mail: cappelli@med.unibs.it; Pirola, I.; De Martino, E.; Agosti, B.; Delbarba, A.; Castellano, M.; Rosei, E. Agabiti [Department of Medical and Surgical Sciences, Internal Medicine and Endocrinology Unit, University of Brescia (Italy)

    2008-01-15

    According to many guidelines, scintigraphy remains the first suggested diagnostic procedure in hyperthyroid patients in spite of the widespread availability of ultrasounds. The aim of this study was to evaluate the cost-effectiveness of sonography versus scintigraphy in the management of Graves's disease, and to assess ultrasound features suggesting cancer in detecting thyroid nodules. Among 1470 hyperthyroid patients evaluated in our department from 2002 to 2005, 426 (29%) had Graves' disease: echographic and scintigraphic features were not suggestive of GD in 20/426 (4.8%) and 11/426 (2.6%) patients, respectively (p = 0.763), even if one of the two procedures was almost always diagnostic. Ultrasound identified 68/426 (16%) patients with a concomitant solid lesion, while scintigraphy detected only 9/426 (2.1%) 'cold' nodules (p < 0.001). Thyroid cancer was diagnosed in 30/68 (47.7%) patients. Malignancy presented at ultrasound investigation blurred margins (26.7% versus 15.8%), microcalcifications (33.3% versus 28.9%) and an anteroposterior and transverse diameter ratio {>=}1 (73.3% versus 71.1%); more frequently than benign nodules, but this was not statistically significant. The total cost to obtain a diagnosis by ultrasound was Euro 14645.34 ( Euro 13312.5 for echography + Euro 1332.84 for scintigraphy in the 29 patients 'negative' at echographic evaluation for GD) versus Euro 19922.71 by scintigraphy ( Euro 19578.96 for scan + Euro 343.75 for ultrasounds in the 11 patients 'negative' at scintigraphy). Our data show no difference in terms of diagnosis between sonography and scintigraphy. Indeed, scintigraphy was less sensitive in detecting nodules (often of malignant nature) than ultrasound, and, moreover, with a consequent increase of the direct cost of nodule management when scintigraphy is the first line procedure. In conclusion, according to our results, we suggest that ultrasounds with color-Doppler evaluation should

  20. Efecto sobre el consumo de recursos hospitalarios de un programa de atención geriátrica domiciliaria en personas ancianas con patología cardiorrespiratoria muy evolucionada

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    Pérez Martín Alejandro

    2001-01-01

    Full Text Available Fundamento: Los equipos de atención geriátrica domiciliaria tienen entre sus objetivos el seguimiento de pacientes ancianos con alto riesgo de reingreso hospitalario. Aunque llevan años funcionando en nuestro país, no se tienen datos sobre la repercusión que dicho seguimiento representa en el consumo de recursos hospitalarios. El objetivo del presente estudio es analizar el efecto que supone, sobre dichos recursos, el control por una unidad de atención geriátrica domiciliaria de pacientes con patología cardiorrespiratoria crónica muy evolucionada. Métodos: En el estudio se incluyó a los pacientes con patología cardiorrespiratoria crónica atendidos por la unidad entre enero de 1995 y enero de 1999, habiéndose excluido a los que permanecieron menos de 3 meses en seguimiento. Se comparan el número de visitas al servicio de urgencias hospitalario, ingresos en planta y días de estancia en el año anterior a la atención por la unidad y durante el tiempo de seguimiento por la misma.Resultados: 81 pacientes con una edad media de 80,57 años (DE 7,39 y una mediana de atención por la unidad de 9 meses (5-13,5, fueron incluidos en el estudio. Los consumos por paciente y mes de seguimiento disminuyeron en 0,07 visitas a Urgencias (0,02-0,11 (p=0,04, 0,10 ingresos hospitalarios (0,07-0,14 (p < 0,001, y 2,01 días de ingreso (1,87-2,15 (p < 0,001. Conclusiones: Una unidad especializada de atención geriátrica domiciliaria disminuye el consumo de recursos hospitalarios de población anciana con enfermedad cardiorrespiratoria crónica.