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Sample records for sindrome cutaneo radioinducido

  1. Prevalensi Sindrom Metabolik pada Pekerja Perusahaan

    Zahtamal Zahtamal

    2014-12-01

    Full Text Available Sindrom metabolik adalah masalah kesehatan yang prevalensinya cenderung meningkat pada pekerja. Penelitian ini bertujuan memaparkan prevalensi kasus sindrom metabolik yang terjadi pada pekerja perusahaan. Penelitian ini dilakukan pada tahun 2014 pada dua perusahaan di Provinsi Riau dengan rancangan potong lintang. Sumber data adalah rekam medis pekerja yang melakukan medical check up periode Oktober 2013 hingga Februari 2014. Populasi adalah pekerja yang menderita sindrom metabolik sebanyak 131 orang. Sampel penelitian dipilih dengan cara total sampling yakni 131 orang. Instrumen adalah kuesioner, international physical activity questionnaire, tabel 24 hours food recall, dan tabel bantu pencatatan komponen sindrom metabolik. Pengelolaan data dilakukan secara kuantitatif menggunakan analisis univariat dan bivariat, dengan uji korelasi Spearman’s Rho dan kai kuadrat. Hasil penelitian mendapatkan prevalensi sindrom metabolik sebanyak 21,58%, dengan jenis kelamin terbanyak adalah laki-laki, kelompok usia terbanyak adalah > 50 tahun. Sebagian besar kasus sindrom metabolik memiliki tiga komponen, dengan komponen terbanyak adalah lingkar perut dan tekanan darah. Sebanyak 23,50% kasus memiliki riwayat keluarga obesitas dan diabetes melitus. Sebagian besar kategori aktivitas adalah sedang. Jenis asupan makanan dengan kategori tidak sesuai dengan diet adalah serat pangan dan lemak jenuh. Variabel lingkar perut berhubungan bermakna secara statistik dengan tekanan darah sistolik dan diastolik serta kadar kolesterol high density lipoprotein (p 50 years. Most cases of metabolic syndrome has three components, with the largest component is the abdominal circumference and blood pressure. A total of 23.50% of cases have a family history of obesity and diabetes mellitus. Most categories of activity is moderate. Most types of food intake in the category “out of dietary guidelines” are dietary fiber and saturated fat. Abdominal circumference variable has a

  2. Perbedaan Sindrom Metabolik Pada Wanita Vegetarian Tipe Vegan Dan Non Vegan

    Setiyani, Diah Ari; Wirawanni, Yekti

    2012-01-01

    Latar Belakang: Sindrom metabolik adalah kumpulan kelainan metabolik yang dikaitkan dengan peningkatan risiko penyakit kardiovaskular. Diet vegetarian terutama vegan dapat berperan dalam penurunan risiko sindrom metabolik, tetapi masih didapatkan penelitian yang menyatakan bahwa vegan berisiko sindrom metabolik bahkan lebih tinggi daripada non vegan. Penelitian ini bertujuan untuk mengetahui perbedaan sindrom metabolik pada wanita vegetarian vegan dan non vegan. Metode: Penelitian ini dilakuk...

  3. ERITEMA NODOSO Y SINDROME FEBRIL PROLONGADO ASOCIADOS A HIPERPARATIROIDISMO SECUNDARIO

    Enz P

    2005-06-01

    Full Text Available El hiperparatiroidismo secundario es uno de los principales disturbios causados por la insuficiencia renal crónica, y la paratohormona es considerada una de las toxinas del sindrome urémico. El sindrome febril prolongado secundario a hiperparatiroidismo primario ya ha sido descripto en la literatura, aunque no lo ha sido aun el inducido por hiperparatiroidismo secundario. En el presente reporte se presenta un caso de eritema nodoso y sindrome febril prolongado asociado a hiperparatiroidismo secundario y que resolvió luego de efectuada una paratiroidectomía subtotal.

  4. Tata Laksana Non Imunosupresan Sindrom Nefrotik pada Anak

    Sudung Oloan Pardede

    2017-08-01

    Full Text Available Sindrom nefrotik adalah keadaan klinis yang terdiri atas proteinuria masif, hipo­albuminemia (< 2,5 g/dL, edema, dan hiperkolesterolemia. Terapi utama sindrom nefrotik adalah imunosupresan terutama kortikosteroid. Pada sindrom nefrotik relaps sering atau dependen steroid, dan sindrom nefrotik resisten steroid, selain steroid diberikan juga imunosupresan lain seperti siklofosfamid, siklosporin, mikofenolat mofetil, takrolimus, atau pun levamisol. Selain pemberian imunosupresan diperlukan terapi suportif, yang meliputi terapi diitetik,  tata laksana edema, hipertensi, hipovolemia, trombosis, hiperlipidemia, dan infeksi. Tata laksana diitetik terdiri atas kalori yang adekuat, protein sesuai recommended daily allowance, lemak low saturated, dan rendah garam. Komposisi zat gizi yang dianjurkan terdiri atas 10-14% protein; 40-50% lemak poly- dan monounsaturated, 40-50% karbohidrat. Tata laksana  edema terdiri atas restriksi cairan, pemberian diuretik, dan infus albumin jika perlu. Infeksi yang sering terjadi pada sindrom nefrotik adalah selulitis peritonitis, dan pneumonia yang diterapi dengan antibiotik sefotaksim, seftriakson, ko-amoksiklav. Antihipertensi yang digunakan pada anak umumnya diuretik, angiotensin converting enzyme inhibitors, angiotensin receptor blockers, calcium channel blockers, (amblodipin, nifedipin, isradipin, alpha-symphatetic agents, beta blockers dan vasodilator. Aktivitas fisik tidak perlu dibatasi, dan pada edema ringan atau tidak berat tidak perlu dilarang pergi ke sekolah

  5. Si?ndrome de Burnout y estre?s laboral en profesores

    Barreto E., Marilu? E.

    2013-01-01

    En la u?ltima de?cada la presencia del si?ndrome de Burnout ha ido en aumento muy considerablemente, como una consecuencia de trabajar intensamente hasta el li?mite de no tomar en cuenta las necesidades personales. Esta situacio?n se acompan?a de sentimientos de falta de ayuda, de impotencia, de actitudes negativas y de una posible pe?rdida de autoestima que sufre el trabajador, descrita como si?ndrome de Burnout (Caballero y Milla?n,1999). La prevalencia del si?ndrome de Burnout a nivel i...

  6. EFECTO DE LA ACUPUNTURA EN EL TRATAMIENTO DEL INSOMNIO EN EL SINDROME CLIMATERICO POSTMENOPAUSICO

    GUTIERREZ LOPEZ, ALMA MARGARITA

    2010-01-01

    PALABRAS CLAVE: INSOMNIO, SINDROME CLIMATERICO, ACUPUNTURA. EL INSOMNIO, SEGUN EL MANUAL DIAGNOSTICO Y ESTADISTICO DE TRASTORNOS MENTALES, ES LA DIFICULTAD PARA INICIAR O MANTENER EL SUENO, O NO TENER UN SUENO REPARADOR DURANTE AL MENOS 1 MES. ES UN SINTOMA QUE SE PRESENTA ENTRE EL 20 Y 40 POR CIENTO DE LA POBLACION, AFECTANDO CON MAYOR FRECUENCIA A MUJERES Y ANCIANOS. ESTE PORCENTAJE ES MAYOR ENTRE LA POBLACION DE MUJERES CON SINDROME CLIMATERICO. EL SERVICIO DE CLIMATERIO DEL INSTITUT...

  7. Tata Laksana Kasus Perempuan dengan Pure Gonadal Dysgenesis 46, XY (Sindrom Swyer)

    Kanadi Sumapradja; Mila Maidarti; Achmad K. Harzif; Budi Wiweko; Gita Pratama; Muharam Natadisastra; Andon Hestiantoro

    2016-01-01

    Disorders of sex development (DSD) adalah kelainan medis yang dikaitkan dengan ketidakcocokan antara kromosom, gonad dan fenotip. Sindrom Swyer adalah kelainan berupa disgenesis gonad 46,XY dan diikuti dengan tidak terjadinya pelepasan anti-mullerian hormone (AMH) dari gonad yang mengalami disgenesis sehingga mengakibatkan berkembangnya duktus muller menjadi uterus. Keadaan tersebut mengakibatkan pasien mengeluh amenorea primer dan organ seks sekunder tidak berkembang. Orientasi gender umumn...

  8. Factores de riesgo para sindrome metabólico en pacientes con higado graso.

    Uzcátegui, Lilia; Ángel, José Gregorio; Martínez, Dasyl; Gómez Pérez, Roald; Arata de Bellabarba, Gabriela

    2008-01-01

    Editorial. Periodismo, mal periodismo, mal de Chagas y ciencias de la salud. Editorial. Journalism, poor journalim, Chagas disease and health sciences. Salinas, Pedro José Cistoadenoma seroso de ovario y embarazo. Reporte de caso. Ovarian serous cystoadenoma and pregnancy. Case report Terán, Penélope; Uribarri, Carolina; Castillo, Sonia y Salinas, Roberto. Factores de riesgo para sindrome metabólico en pacientes con higado graso. Risk factors of the metabolic syndrome i...

  9. Hubungan Resistensi Insulin dengan Gambaran Klinis Sindrom Ovarium Polikistik

    Meliza Wahyuni

    2015-09-01

    Full Text Available Abstrak Sindrom Ovarium Polikistik (SOPK merupakan kelainan endokrin dan metabolik pada wanita usia reproduksi. SOPK merupakan kumpulan gejala dari amenore, oligomenore, infertilitas, obesitas, hirsutisme, acne, alopesia, dan akantosis nigrikan. Resistensi insulin diyakini sebagai salah satu penyebab tersering dari SOPK melalui berbagai mekanisme. Tujuan penelitian ini adalah untuk mengetahui hubungan resistensi insulindengan gambaran klinis SOPK. Penelitian ini dilakukan pada pasien SOPK dengan menggunakan studi cross sectional dengan pendekatan retrospektif, yaitu mengumpulkan kejadian masa lalu dari tahun 2009 - 2011, jumlah sampel 105 orang. Analisis statistik yang digunakan adalah uji chi-square. Hasil penelitian didapatkan 33,3% penderita SOPK mengalami resistensi insulin. Berdasarkan gambaran klinis 35,23% amenore, 64,77% oligomenore, 72,04% infertilitas, 50,5% obesitas, 0,95% hirsutisme, acne 20%, alopesia dan akantosis nigrikan0%. Dari 33,3% SOPK dengan resistensi insulin 40% amenore, 60% oligomenore, 71,9% infertilitas, 77,14% obesitas, dan 0% hirsutisme. Berdasarkan hasil uji statistik ditemukan hubungan bermakna antara resistensi insulin dengan obesitas (p<0,05 dan tidak ditemukan hubungan bermakna antara resistensi insulin dengan infertilitas, hirsutisme, dan acne (p>0,05.Kata Kunci: SOPK, resistensi insulin, gambaran klinisAbstract Polycystic Ovary Syndrome (PCOS is an endocrine and metabolic disorders that is common in reproductive-aged women. PCOS is a group of symptoms, such as amenorrhea, oligomenorrhea, infertility, obesity, hirsutism, acne, alopecia, and achanthosis nigricans. Insulin resistance is believed to be one of the most common causes of PCOS through a various mechanisms. The objective of this study was to find out the relationship between insulin resistance and clinical manifestation of PCOS. This research was done in patients with PCOS using cross sectional study with retrospective approach. Data was collected from

  10. Radiographic and tomographic aspects of meningeal hemangiosarcoma in a German Shepherd dog with clinical signs of cauda equina sindrome

    Pinto, A.C.B. de C.F.; Ferrigno, C.R.A.; Matera, J.M.; Torres, L.N.; Sinhorini, I.L.; Cortopassi, S.R.G.; Hage, M.C.F.N.S.

    2007-01-01

    Hemangiosarcoma is a highly malignant neoplasia derived from the endothelial cell line and, therefore, can arise in any tissue with blood vessels. A case of a rare meningeal site of hemangiosarcoma in an eight-year old German Shepherd dog with clinical signs of cauda equina sindrome is described. The diagnosis was made based on clinical, radiographic, tomographic and histopathological findings [pt

  11. La sindrome da vibrazioni mano-braccio : studi epidemiologici e clinici della funzione vascolare e neurosensitiva in coorti di lavoratori esposti a vibrazioni segmentali

    Ronchese, Federico

    2013-01-01

    Premesse: un’elevata esposizione a vibrazioni trasmesse al sistema mano-braccio (hand-transmitted vibration, HTV) è correlata con l’insorgenza di disturbi neurologici, vascolari periferici e osteoarticolari a carico degli arti superiori. Il termine “sindrome da vibrazione mano-braccio” (hand-arm vibration syndrome, HAVS) viene comunemente utilizzato per designare unitariamente il complesso di tali lesioni. La componente vascolare di tale sindrome è rappresentata da una forma secondaria di fen...

  12. HUBUNGAN ANTARA SINDROM MENOPAUSE DENGAN KUALITAS HIDUP PEREMPUAN MENOPAUSE DI PUSKESMAS SUKAHAJI KABUPATEN MAJALENGKA

    Ruri Yuni Astari

    2015-01-01

    because it is normal for a woman are especially needed.Keywords : Menopausal Syndrome, Quality of Life, MajalengkaAbstrakMenopause merupakan fase alamiah yang dialami oleh setiap perempuan, merupakan proses reproduksi yang ditandai berakhirnya masa subur seorang perempuan karena ovarium sudah tidak menghasilkan hormon estrogen dan progesteron, sehingga menimbulkan berbagai keluhan menopause yang disebut sebagai sindrom menopause. Masalah atau perubahan yang dialami perempuan menopause akan menimbulkan suatu krisis yang akan mempengaruhi kualitas hidup. Tujuan penelitian untuk menganalisis hubungan antara sindrom menopause dengan kualitas hidup. Metode penelitian dilakukan secara observasional analitik dengan rancangan potong lintang. Populasi adalah perempuan yang telah menopause selama 1–2 tahun di wilayah Puskesmas Sukahaji Kabupaten Majalengka dan memenuhi kriteria penelitian, yaitu masih mempunyai suami, sudah tidak mengalami haid selama 1-2 tahun dan mampu membaca.Teknik pengambilan sampel dilakukan secara total sampling, dilaksanakan bulan Februari sampai dengan Maret 2013. Sindrom menopause diukur menggunakan kuesioner MSQ (Menopause Symptom Questionaire dan kualitas hidup diukur menggunakan kuesioner (WHOQOLBREFThe World Health Organization Quality Of Life. Data di analisis secara statistik univariat, bivariat dan multivariat. Hasil penelitian menunjukkan adanya hubungan negatif kuat antara sindrom menopause aspek fisiologis dan psikologis dengan kualitas hidup (r= -0,786 p=0,000 dan r= -0,706 p=0,000, hubungan negatif kuat secara simultan sindrom menopause  aspek  fisiologis  dan  psikologis  dengan  kualitas  hidup  perempuan  (r=  -0,772,  p =0,000, hubungan bermakna antara penghasilan dan pendidikan dengan kualitas hidup (r= -0,313 p=0,011 dan r= -0,359 p=0,003. Paritas tidak berhubungan bermakna dengan kualitas hidup perempuan menopause. Simpulan: sindrom menopause berdampak pada penurunan kualitas hidup perempuan menopause. Perlunya memberikan

  13. Tata Laksana Kasus Perempuan dengan Pure Gonadal Dysgenesis 46, XY (Sindrom Swyer

    Kanadi Sumapradja

    2016-06-01

    Full Text Available Disorders of sex development (DSD adalah kelainan medis yang dikaitkan dengan ketidakcocokan antara kromosom, gonad dan fenotip. Sindrom Swyer adalah kelainan berupa disgenesis gonad 46,XY dan diikuti dengan tidak terjadinya pelepasan anti-mullerian hormone (AMH dari gonad yang mengalami disgenesis sehingga mengakibatkan berkembangnya duktus muller menjadi uterus. Keadaan tersebut mengakibatkan pasien mengeluh amenorea primer dan organ seks sekunder tidak berkembang. Orientasi gender umumnya adalah sebagai perempuan, karena kurangnya paparan hormon androgen terhadap otak. Tatalaksana kasus Disorders of sex development (DSD sangat mementingkan pasien (patient-centered sehingga tatalaksana medikamentosa maupun pembedahan harus berdasarkan pemahaman pasien terhadap orientasi gendernya. Pada makalah ini dilaporkan kasus sindrom swyer pada seorang perempuan usia 29 tahun dengan keluhan amenorea primer. Hasil analisis kromosom 46,XY (20 metafase dengan hormon follicle stimulating hormone (FSH 31.5miu/ml, luteinizing hormone (LH 10.8miu/ml, estradiol (E2 <5pg/ml, testosteron total (T <0.0025ng/ml. Tatalaksana medikamentosa adalah memberikan terapi hormon estrogen untuk membantu proses feminisasi. Karena risiko tinggi terjadinya tumor pada kasus disgenesis gonad intra-abdomen dengan kromosom Y, maka direncanakan tindakan gonadektomi. Kata kunci: Tatalaksana, Sindrom Swyer, pure gonadal dysgenesis Case Management of Pure Gonadal Dysgenesis 46, XY (Sindrom Swyer Abstract Disorders of sex development (DSD are medical conditions in which the development of chromosomal, gonadal or anatomic sex varies from normal and may be incongruent with each other. Swyer syndrome is a condition caused by pure gonadal dysgenesis 46,XY, which followed by inadequate anti-mullerian (AMH production results in maintenance and further development of mullerian duct into uterus. Therefore, many patients who suffer from this condition initially come with chief complaint of primary

  14. Sindrome de apnea obstructiva del sueño y alteración en la tolerancia a la glucosa

    Verner, Codoceo R.

    2013-01-01

    La disminución del riesgo cardiovascular sigue siendo uno de los objetivos principales de la Salud Pública. Contribuyen a él patologías como la Diabetes Mellitus, Obesidad e Hipertensión Arterial, todas las cuales no han logrado ser detenidas en su creciente prevalencia. Existen factores hasta ahora no considerados en forma integral al tratamiento de esta triada, como el Sindrome de Apnea Obstructiva del Sueño, que se sabe está asociado a éstas, plantea la idea de un tratamiento sinérgico com...

  15. Sindrome de apnea obstructiva del sueño y alteración en la tolerancia a la glucosa

    Codoceo R. Verner, Dr.

    2013-05-01

    Full Text Available La disminución del riesgo cardiovascular sigue siendo uno de los objetivos principales de la Salud Pública. Contribuyen a él patologías como la Diabetes Mellitus, Obesidad e Hipertensión Arterial, todas las cuales no han logrado ser detenidas en su creciente prevalencia. Existen factores hasta ahora no considerados en forma integral al tratamiento de esta triada, como el Sindrome de Apnea Obstructiva del Sueño, que se sabe está asociado a éstas, plantea la idea de un tratamiento sinérgico como alternativa para lograr las metas terapéuticas. Sin embargo las expectativas creadas no concuerdan con los resultados comunicados, demostrándose que faltan aún estudios que realizar. Se mencionan diversos estudios epidemiológicos y se resumen los fundamentos biológicos que explican la asociación SAOS - DM.

  16. Sindrom Koroner Akut dengan Komplikasi Udem Paru Akut dan Henti Jantung

    Eka Fithra Elfi

    2015-05-01

    Full Text Available Abstrak Salah satu manifestasi sindrom koroner akut yang banyak terjadi adalah non ST elevation segment ofmyocardial infarction (NSTEMI. NSTEMI dapat menimbulkan berbagai komplikasi seperti udem paru akut, hentijantung, bahkan kematian. Dilaporkan seorang pasien wanita 53 tahun dengan diagnosis NSTEMI. Pasien mengalamihenti jantung dan udem paru akut yang merupakan gagal jantung akut. Henti jantung pada pasien ini diawali  oleharitmia maligna yang disebabkan oleh kurangnya asupan oksigen pada otot jantung. Pasien memerlukanpenatalaksanaan multidisiplin dan intensif. Pada pasien diberikan dukungan ventilasi mekanik dengan tekanan positifyaitu CPAP untuk mengurangi mortalitas edema paru. Selain itu diperlukan pemantauan ketat hemodinamik danasupan nutrisi pada pasien. Selain masalah jantung dan paru, pada pasien juga terjadi penurunan kesadaran setalahhenti jantung. Gangguan pada sistem saraf pusat merupakan penyebab kematian yang cukup tinggi pada pasien yangselamat dari henti jantung dan resusitasi. Berdasarkan hal itu, perlu dilakukan resusitasi kardioserebral pada pasiendengan henti jantung. Perbedaan utama dengan resusitasi jantung paru adalah pentingnya manajemen j alan nafasyang lebih lengkap dengan ventilasi mekanik.Kata kunci: NSTEMI, henti jantung, udem paru akut Abstract One manifestation of acute coronary syndrome is the case is non-ST segment elevation of myocardial infarction(NSTEMI. NSTEMI may cause various complications: an acute pulmonary edema, cardiac arres, and even death.Reported a 53 years old female patient with a diagnosis of NSTEMI. The patient had a cardiac arrest and acutepulmonary edema is acute heart failure. Cardiac arrest in this patient initiated by malignant arrhythmias caused by lackof oxygen to the heart muscle. Patients require multidisciplinary and intensive management. In patients receivedmechanical ventilatory support with positive pressure that CPAP to reduce the mortality of pulmonary edema. Alsorequired

  17. Pancreatite esclero-gomosa simulando sindrome cancerosa da cabeça do pâncreas

    A. Penna de Azevedo

    1944-06-01

    Full Text Available Em um homem de 49 anos de idade, observou-se um sindrome de tumor da cabeça do pâncreas. Realizada a intervenççao cirúrgica foi verificada a presença de uma formaão dura de aspecto fibroso, medindo 9 x 7,5 x 6,5 cm. O exame microscópico mostrou tratar-se de uma pancreatite indurativa associada à presença de gomas miliares, infiltração de eosinófilos e lesões produtivas dos vasos sanguíneos, correspondendo ao aspecto dos processo esclerogomosos sifilíticos do pâncreas.A tumor of the head of the pancreas is reported ina a male, 49 years old, which corresponded to a nodule of fibrous tissue measuring 9 x 7,5 x 6,5 cm. Microscopically, a chronic interstitial pancreatitis associated to miliary gummata, eosinophilic infiltration and proliferation of blood vessels was found and the diagnosis of siphilitic pancreatitis was done.

  18. Sindrome de Lennox-Gastaut com inicio tardio: I - frequencia de casos com inicio anterior e ulterior aos 6 anos de idade, fatores etiologicos e nivel intelectual

    Amilton Antunes Barreira

    1980-12-01

    Full Text Available De um grupo de 66 pacientes com sindrome de Lennox Gastaut, 15 apresentaram as primeiras manifestações clinicas após os 6 anos de idade. Desses, 12 foram acompanhados durante o período médio de 2 anos e 6 meses, com avaliações neurológicas a intervalos de cerca de 2 meses. A revisão das publicações pertinentes permitiu estabelecer que em 20% das casuisticas apreciadas a sindrome de Lennox-Gastaut se inicia após o 6° ano de vida. As avaliações clinicas permitiram verificar que nosos pacientes apresentaram incidência de lesões neurológicas graves precedendo a instalação da síndrome por vários anos. As avaliações psicométricas evidenciaram intenso comprometimento do nível intelectual em contraste com os dados da literatura sobre a síndrome de Lennox-Gastaut de início tardio.

  19. Os trigonum tarsi syndrome. Magnetic Resonance features; Sindrome dell'os trigonum tarsi. Ruolo della Risonanza Magnetica

    Iovane, A.; Finazzo, M.; Carcione, A.; De Maria, M; Lagalla, R. [Palermo Policlinico Univ. P. Giaccone, Palermo (Italy). Ist. di Radiologia; Midiri, M. [Bari Policlinico Univ., Bari (Italy). Ist. di Radiologia

    2000-02-01

    aspect of the tibia, or hypo mobility to pseudoarthrosis. Forced plantar flexion acquisitions are particularly useful in this condition because can demonstrate the mechanism of injury. [Italian] L'os trigonum tarsi e' un osso accessorio del piede localizzato in sede posterolaterale rispetto al tubercolo esterno dell'astragalo e di solito non da' alcuna sintomatologia. In particolari condizioni, che comportano sollecitazioni o microtraumi ripetuti nel tempo a livello del retropiede puo' essere responsabile di talalgia posteriore realizzando la cosidetta sindrome dell'os trigonum tarsi. Il dolore e' localizzato nella sede preachillea. La diagnosi tuttavia risulta particolarmente complessa i quanto numerose altre forme patologiche si manifestano con la medesima sintomatologia clinica. Con la radiologia tradizionale e' possibile dimostrare la presenza dell'os trigonum e le sue eventuali alterazioni morfo-strutturali. La RM (Risonanza Magnetica) di contro consente non solo di identificare le alterazioni strutturali dell'osso ma anche di riconoscere le lesioni associate dei tessuti molli. Sono stati studiati con RM nove pazienti affetti da sindrome dell'os trigonum tarsi. I pazienti sono stati esaminati nella posizione supina con il piede in posizione indifferente e successivamente bloccato nella flessione plantare. Lo studio e' stato condotto con magnete superconduttivo da 0,5 T impiegando una bobina dedicata per le estremita'. Sono state utilizzate sequenze spin-echo T1, gradient-echo T2* e fast inversion recovery secondo piani di scansione assiali e saggitali. In tutti i pazienti esaminati sono state valutate: sede e morfologia dell'os trigonum; caratteristiche dell'intensita' del segnale delle strutture ossee, cartilaginee e dei tessuti adiacenti; presenza di eventuali lesioni tendinee associate. Non sono state osservate anomalie di sede ne' di forma dell'os trigonum. L

  20. Hubungan Kadar Glukosa Darah Saat Masuk Rumah Sakit Dengan Lama Hari Rawat Pasien Sindrom Koroner Akut (SKA Di RSUP Dr. M. Djamil Padang

    Rosi Oktarina

    2013-05-01

    Full Text Available AbstrakHiperglikemia masih menjadi topik penelitian yang sering dihubungkan dengan kejadian sindrom koroner akut (SKA di dunia, terutama hiperglikemia saat masuk rumah sakit. Hal ini didasari oleh beberapa pengaruh kadar glukosa darah yang tinggi terhadap sistem kardiovaskuler seperti gangguan fungsi ventrikel kiri, stroke volume yang menurun, regurgitasi katup mitral berulang, gangguan pada waktu pengisian diastolik hingga risiko tinggi untuk arritmia, serta hubungannya dengan peningkatan risiko trombosis. Sehingga semakin memperjelas pengaruh hiperglikemia yang tidak hanya dapat meningkatkan risiko terjadinya SKA, melainkan juga dapat memperburuk kondisi pasien SKA sendiri. Penelitian ini bertujuan mengidentifikasi hubungan kadar glukosa darah sewaktu dengan lama hari rawat pasien Sindrom Koroner Akut (SKA. Jenis penelitian yang digunakan adalah penelitian analitik dengan menggunakan desain penelitian Cross Sectional Study. Penelitian ini menggunakan data sekunder yang diambil di Instalasi Rekam Medik (Medical Record, yakni data rekam medik pasien yang didiagnosis sebagai Sindrom Koroner Akut (SKA yang dirawat inap di Rumah Sakit Umum Pusat DR. M. Djamil Padang Periode Januari–Desember 2011. Ditemukan sebagian besar pasien SKA masuk rumah sakit dengan kadar Glukosa Darah Sewaktu (GDS sebesar ≥ 200 mg/dl (40% dan lama hari rawat sebesar ≥ 7 hari (52%. Dari hasil analisa bivariat dengan menggunakan uji korelasi Spearman ditemukan adanya hubungan searah antara kadar glukosa darah saat masuk rumah sakit dengan lama hari rawat pasien SKA dengan kekuatan hubungan yang sedang, r = +0,492, p = 0, 000 (p<0,05. Pemantauan terhadap kadar GDS yang diperiksa saat pasien masuk rumah sakit perlu dilakukan dan untuk penelitian yang akan datang diharapkan dapat diteliti lebih lanjut faktor-faktor lain yang mempengaruhi lama hari rawat pasien SKA.Kata kunci: Kadar glukosa darah saat masuk RS, lama hari rawatAbstractHyperglicemia is still become a research

  1. L' influenza nella regione Lazio dal 1999 al 2003: casi di sindrome influenzale, ricoveri ospedalieri per malattie respiratorie e coperture vaccinali

    A. Pasquarella

    2003-05-01

    Full Text Available

    Obiettivi: 1 Descrivere l’andamento dei ricoveri ospedalieri per patologie respiratorie acute e croniche concomitanti alle epidemie stagionali da virus influenzale dal 1999 al 2003, in relazione con la segnalazione dei casi di sindrome influenzale (ILI da parte dei medici sentinella. 2 Misurare l’eccesso dell’ospedalizzazione influenza-correlata nelle diverse fasce di età rispetto ai periodi non epidemici. 3 Analizzare le modificazioni del ricorso al ricovero ospedaliero in relazione al tasso di copertura della vaccinazione antinfluenzale nella popolazione anziana, su scala regionale e nelle diverse ASL.

    Metodi: sono stati estratti dal Sistema Informativo
    Ospedaliero i ricoveri per patologie respiratorie
    influenza-correlate (codici ICD9-CM: 480-487; 460-
    466; 490-496 relativi agli anni 1999-2003.
    L’incidenza di ILI è stata stimata sulla base delle
    segnalazioni dei medici sentinella afferenti alla
    rete FLU-ISS dell’Istituto Superiore di Sanità.

    Per il calcolo dei tassi di copertura è stato utilizzato l’archivio
    nominativo dei soggetti vaccinati contro l’influenza,
    attivo nella regione Lazio dal 1999. Nel periodo considerato sono stati messi in relazione i tassi di ospedalizzazione età-specifici, le incidenze di ILI e le coperture vaccinali. L’eccesso di ospedalizzazione è stato misurato confrontando i tassi relativi ai periodi epidemici e non epidemici.

    Risultati: i tassi di ospedalizzazione per malattie respiratorie sono risultati costantemente superiori nei periodi di maggiore circolazione virale, in particolare negli ultrasessantaquattrenni. Con il progressivo aumento del tasso di copertura vaccinale regionale (da circa il 25% della stagione 1999-2000 a oltre il 60% della stagione 2002-2003 non si è registrata una corrispondente diminuzione dei ricoveri ospedalieri per patologie influenza-correlate.
    L

  2. SINDROME KID: ABORDAJE INTERDISCIPLINARIO

    Carla De Negri

    Full Text Available Se presenta el caso clínico, de una niña de 2 años de edad, nacida en el Centro Hospitalario Pereira Rossell, portadora del Síndrome KID. Se trata de una displasia congénita ectodérmica caracterizada por la asociación de queratitis, ictiosis y sordera. Es producida por un desorden autosómico dominante, esporádico. Algunos autores lo refieren asociado a la presencia de alteraciones estructurales de órganos dentarios, del tipo hipoplasia e hipomineralización del esmalte y también a gingivitis y candidiasis a nivel de la mucosa bucal. La intervención oportuna del odontopediatra, integrando el equipo de salud, brinda un aporte importante, en la búsqueda de estrategias terapéuticas adecuadas al paciente y al contexto asistencial. El abordaje de tratamiento en pacientes portadores del Síndrome KID debe ser multidisciplinario, requiriendo en niños, la integración de un equipo de salud con pediatra, dermatólogo, oftalmólogo, otorrinolaringólogo y odontopediatra

  3. Sindrom diabeticheskoy stopy

    Mikhail Borisovich Antsiferov

    2001-06-01

    Full Text Available Поражения нижних конечностей у больных сахарным диабетом (СД касаются врачей различных специальностей. Это связано с тем, что нарушение углеводного обмена приводит к изменениям периферического кровотока, иннервации, развитию трофических язв, а в ряде случаев к необходимости ампутации конечности. Хроническая гипергликемия утяжеляет течение и усложняет лечение язвенных дефектов другого генеза (посттромбофлебитический синдром, липоидный некробиоз, экзема и др.. Все это определяет необходимость точной диагностики, дифференциации и выбора адекватного лечения в каждом случае развития трофического нарушения кожи нижних конечностей. Синдром диабетической стопы объединяет патологические изменения периферической нервной системы, артериального и микроциркуляторного русла, костно-суставного аппарата, которые представляют непосредственную угрозу развития язвеннонекротических процессов и гангрены стопы. Несмотря на достаточный объем информации по патогенезу, диагностике, методам лечения и профилактики осложнений СД, данные по частоте и исходу поражений нижних конечностей по-прежнему остаются неутешительными. Настоящий обзор освещает современное представление о патогенезе, способах лечения и профилактике развития синдрома диабетической стопы.

  4. [Cutaneo-viscero-hemolytic loxoscelism with acute renal failure].

    Alfaro, Flavia V; Dotto, Beatriz; Sesin, Ana M; Prettini, Viviana; Sesin, Jorge; Aliciardi, Enrique; Vergottini, Juan C; Gonzalez, Mauricio

    2008-01-01

    The Loxoscelism is caused by the bite of spider Loxosceles laeta gender, of worldwide distribution. The poisoning can cause lesions dermonecrotic and less frequently a systemic illness that can be fatal. The mechanism of venom action is multifactorial. The characteristic dermonecrotic lesion results from the direct effects of the venom on the celular and basal membrane components, as well as the extracelular matrix. The initial interaction between the poison and tissues, causes complement activation, migration of polymorphic neutrophils, liberation of proteolytic enzymes, cytoquines, aggregation platelet, and blood flow alterations that result in edema and ischemia, with development of necrosis. There is no a definitive treatment for loxoscelism. However, the value of specific antivenom, to decrease lesion size and limit systemic illness even when such administration is delayed. We present a case of cutaneous-visceral loxoscelismo with unfavorable evolution.

  5. A Sindrome de Burnout(SB em docentes do ensino superior de instituições privadas de Santarém, PA

    Loreni Bruch Dutra

    2016-11-01

    Full Text Available A Sindrome de Burnout implica em diversas consequências sociais e afeta negativamente a qualidade de vida do docente e do trabalho desenvolvido. Compreende as seguintes dimensões: Ilusão pelo trabalho, Desgaste psíquico, Indolência e Culpa. O objetivo deste artigo foi estudar a Síndrome de Burnout (SB em docentes das instituições privadas de ensino superior de Santarém-PA e sua relação com características demográficas, laborais e estilo de vida. Foi realizado estudo transversal com 311 docentes das áreas da saúde, exatas e humanas. Utilizou-se o instrumento autoaplicável, Cuestionario para la Evaluación del Síndrome de Quemarse por el Trabajo-CESQT, e regressão linear múltipla para o estudo de cada uma das quatro dimensões da SB. Os resultados mostraram que tempo de docência e tempo de docência na instituição; qualidade da relação com chefias, colegas e alunos; presença de recursos necessários para o trabalho; desejo de mudar de profissão e percepção de saúde foram algumas das características que estiveram relacionados com as dimensões da SB. Portanto, necessita-se de investimentos em políticas institucionais que visem a melhoria da qualidade de vida do docente nas suas funções laborais e investimentos nas condições de trabalho.

  6. MR imaging in the diagnosis of the os trigonum syndrome; Il ruolo della Risonanza Magnetica nella diagnosi della sindrome dell'os trigonum

    Tamburrini, O.; Porpiglia, H.; Barresi, D.; Bertucci, B.; Console, D. [Catanzaro Univ. Magna Grecia, Catanzaro (Italy). Radiologia, Dipt. di Medicina Sperimentale e Clinica

    1999-12-01

    RM nell'ambito delle malattie dolorose del retropiede e piu' in particolare nella sindrome dell'os trigonum, in considerazione della notevole difficolta' clinica per la corretta diagnosi. Lo studio e' stato condotto su sette pazienti che lamentavano dolore al retropiede da piu' di quattro mesi (maschi/femmine=1/6), con eta' compresa tra 16 e 22 anni (eta' media 18,6 anni); 3/7 praticavano attivita' agonistica sportiva, 4/7 danza classica. In 2/7 pazienti l'os trigonum presentava margini irregolari con sclerosi subcondrale e ampliamento della sincondrosi. In 3/7 pazienti e' stata documentata tenosinovite del tendine flessore lungo dell'alluce causata verosimilmente dalla sua compressione e spostamento all'interno della propria guaina, senza ne' alterazione dell'intensita' di segnale dell'os trigonum, ne' ampliamento della sincondrosi. In 1/7 pazienti sono stati rilevati ipertrofia dell'os trigonum, modico ampliamento della sincondrosi e segni importanti di edema midollare nell'os trigonum e nel processo posteriore dell'astragalo. In 1/7 pazienti, pur in presenza di os trigonum rilevato all'esame radiologico tradizionale, l'esame RM non ha documentato alcuno dei segni da riferire a sindrome dell'os trigonum: la diagnosi definitiva e' stata tendinite achillea. La RM e' l'unica metodica che fornisce importanti informazioni sul coinvolgimento dei tessuti molli, della superficie condro-ossea e sulle reazioni sinoviali riuscendo percio' a dimostrare chiaramente l'eventuale coesistente tenosinovite del tendine flessore lungo dell'alluce ed inoltre provvedendo a fornire informazioni dettagliate per il corretto approccio terapeutico. In conclusione, nell'ambito delle malattie dolorose del retropiede da cause ossee, laddove si sospetti clinicamente la sindrome dell'os trigonum, la non invasivita' della RM

  7. Ogilvie's syndrome (acute colonic pseudo-obstruction): review of the literature and report of 6 additional cases; Sindrome di Ogilvie (pseudo-ostruzione della letteratura acuta del colon): revisione della letteratura e descrizione di 6 nuovi casi

    Grassi, Roberto; Cappabianca, Salvatore; Porto, Annamaria; Montemarano, Emilio; De Rosa, Roberto [Napoli Univ., Napoli (Italy). Dipartimento medico-chirurgico di internistica clinica e sperimentale, Sezione scientifica di radiodiagnostica, radioterapia e medicina nucleare; Sacco, Maurizio; Quantarelli, Mario [Ospedale San Gennaro, Napoli (Italy). Servisio di radiodiagnostica; Di Mizio, Roberto [Ospedale S. Massimo, Penne (Italy). Servizio di radiologia

    2005-04-01

    Purpose: Ogilvie's syndrome is defined as an acute pseudo-obstruction of the colon, characterized by the signs, symptoms and radiological pattern of a large-bowel obstruction, but without a detectable organic cause. The aetiology of Ogilvie's syndrome appears to be multifactorial, with a series of possibly interacting pathogenic noxae all resulting in colon inactivity. Our study reports on six cases of Ogilvie's syndrome diagnosed and treated between 1997 and 2002. Materials and methods: From October 1997 to September 2002 we studied six patients affected by pseudo-obstruction of the colon. The pseudo-obstruction was recurrent in two cases. Acute dilatation of the colon without radiologically-detectable organic obstruction was the inclusion criterion for the study. Results: Plain abdominal radiography revealed colon dilatation that extended to the splenic flexure in three patients, to the hepatic flexure in two patients, and confined to the transverse colon in one patient. None of the patients showed air-fluid levels of the small intestine. Conclusion: The most relevant clinical finding in Ogilvie's syndrome is abdominal distension, which arises suddenly, has a progressive course and reaches massive levels. The first-line diagnostic investigation is plain abdominal radiography which shows extreme colon dilatation without air-fluid levels of the small intestine. In three of our patients, conservative therapy alone was able to restore normal conditions within five days; two patients required decompressive colonoscopy, and one patient died from cardio-circulatory arrest after 48 hours. [Italian] Scopo: La sindrome di Ogilvie � definita come una pseudo-ostruzione acuta del colon, con i segni, i sintomi e l'aspetto radiologico di un'occlusione del grosso intestino senza una causa organica riconoscibile. L'eziologia della sindrome di Ogilvie appare multifattoriale, come se l'inerzia del colon fosse la via finale comune verso la

  8. Auto immunity in the Ovarian Resistance Syndrome: research and methodology development; Autoinmunidad en el Sindrome de Resistencia Ovarica: investigacion y desarrollo de metodologia

    Oliver, P; Balter, H; Robles, A

    1998-07-01

    The project evaluates, it selects it develops, it optimizes and been worth, analytic methods for the detection and quantification of antibodies antireceptor of FSH, decisive of precocious ovarian flaw for insensibility gonadal: Syndrome of Ovarian Resistance (SRO). The study method involves the competitive inhibition of the union marked FSH with Iodine-125 of membrane receiver. The investigations include the following components of the analysis system: to) membrane Receivers, b) Radiotracers, c) negative and positive control Serums, d) Buffers. The constants of likeness and numbers of receivers are evaluated in the material biological employee by means of graphics of Scatchard. Ace for the control of quality, the study of the maximum capacity of union was selected of the ligature to the receiver, like one of the parameters that bigger information toasts on the performance of the same one. The clinical validation was made by means of the use of isolated immuno-globulines starting from the serum of healthy donors considered as negative power stations and of women with SRO confirmed by studies made in the exterior considered as central positive. All this, provides the development of a sensitive and specific reliable qualitative method for the determination of antibodies antireceptor of FSH of immediate application in the area of the human health in our means. [Spanish] El proyecto evalua, selecciona, desarrolla, optimiza y valida, metodos analiticos para la deteccion y cuantificacion de anticuerpos antireceptor de FSH, determinantes de falla ovarica precoz por insensibilidad gonadal: Sindrome de Resistencia Ovarica (SRO). El metodo de estudio involucra la inhibicion competitiva de la union hFSH marcada con Iodo-125 de receptor de membrana. Las investigaciones incluyen los siguientes componentes del sistema de analisis: a) Receptores de membrana, b) Radiotrazadores, c) Sueros de control negativos y positivos, d) Buffers. Se evaluan las constantes de afinidad y numeros

  9. Down Syndrome = Sindrome de Down.

    Pueschel, S. M.; Glasgow, R. E.

    Presented both in English and Spanish, the brochure is primarily concerned with biological and developmental characteristics of the person with Down's syndrome. An emphasis is on the valuable humanizing influence these individuals have on society. Brief sections in the document discuss the delayed developmental aspects of Down's syndrome; the…

  10. Sarcoma cutáneo mixto radioinducido Radiation-induced mixed cutaneous sarcoma

    Isidoro Rubio-Correa

    2012-06-01

    Full Text Available Introducción: Los sarcomas son tumores malignos poco frecuentes, siendo raros en cabeza y cuello. En su etiología se involucran factores como agentes químicos, radiación, inmunosupresión y síndromes y anomalías genéticas. Caso clínico: Varón de 64 años, que presenta lesión en piel de mejilla derecha de un año de evolución, localización en la que presentó hace veinte años un carcinoma basocelular tratado con radioterapia. Tras descartar existencia de metástasis, se realizó exéresis de la lesión con márgenes de seguridad y reconstrucción con colgajo de Mustardé. Se complementó el tratamiento con radioterapia. Discusión: El diagnóstico es anatomopatológico, siendo fundamental descartar afectación metastásica. Para mejorar la supervivencia y disminuir su elevada tasa de recidiva, deberían tratarse de forma multidisciplinar (cirugía, radioterapia y/o quimioterapia. Conclusión: A pesar de su baja frecuencia, los sarcomas deben estar presentes en el diagnóstico diferencial de toda lesión que aparezca en zonas radiadas previamente, especialmente en la piel facial.Introduction: Sarcomas are malignant tumors that are infrequent, being rare in the head and neck. Factors such as chemical agents, radiation, immunosuppression, and genetic syndromes and abnormalities are involved in their etiology. Case report: A 64-year-old man developed a skin lesion on the right cheek one year earlier at the site where he had presented a basal cell carcinoma 20 years earlier that was treated with radiation therapy. After ruling out the existence of metastasis, the lesion was treated by surgical resection with safety margins and reconstruction with the Mustardé flap. Treatment was supplemented with radiation therapy. Discussion: The diagnosis of sarcomas is histopathologic and it is essential to rule out metastasis. To improve survival and reduce the high rate of recurrence, a multidisciplinary approach to treatment should be used (surgery, radiation therapy and chemotherapy. Conclusion: Despite the low frequency of sarcomas, these tumors must be considered in the differential diagnosis of any lesion that appears on previously irradiated areas, especially on facial skin.

  11. Affections cutaneo-muqueuses au cours de l'Infection a VIH /SIDA ...

    Les affections dermatologiques sont fréquentes au cours de l'infection par le virus de l'Immunodéficience Humaine (VIH). Nous avons réalisé une étude prospective de janvier à décembre 2003 au service de l'hôpital du jour de Hôpital Central de Yaoundé, afin de répertorier les affections cutanes et muqueuses associées ...

  12. Consequências da síndrome da tensão pré-menstrual na vida da mulher Consequencias de la sindrome de la tension pre-menstrual en la vida de la mujer The consequences of the syndrome of the pre-menstrual tension in the woman's life

    Clarice H. Muramatsu

    2001-09-01

    Full Text Available Este estudo tem como objetivo identificar as possíveis conseqüências da Síndrome da Tensão Pré-Menstrual na vida da mulher. Através do questionário, identificamos distúrbios relacionados a alterações físicas, emocionais e, como consequências às alterações nos relacionamentos envolvendo filho, marido/ namorado e familiar, assim como no ambiente de trabalho.Este estudio tuvo como objetivo identificar las posibles consequencias de la sindrome de la tensión pre-menstrual en la vida de la mujer. Atraves de un questionário, identificamos disturbios relacionados con alteraciones físicas y emocionales que por vez danãn los relacionamentos envolviendo hijo, marido, enamorado y familiares, asi como en el ambiente de trabajo.This study has as objective to identify the possible consequences of the Syndrome of the Pré-menstrual Tension in the woman's life. Through the questionnaire, we identified disturb related to physical and emotional discomfort and as consequences the alterations in the relationships involving son, husband / boyfriend and family, as well as in the work atmosphere.

  13. Sindrome de regresión caudal

    Maldonado, A.; Pastor, A.; Sorni, A.; Pastor Durán, Xavier; Palomeque,A.

    1995-01-01

    El síndrome de regresión caudal o de agenesia sacra se caracteriza por un déficit funcional de los esfínteres y de la muscultatura de los miembros inferiores. Se suele asociar con otras malformaciones, como son las esqueléticas, genitourinarias y del tracto intestinal. La diabetes mellitus materna es uno de los factores predisponentes más destacados. Aquí se presenta un caso de síndrome de regresión caudal con insufiencia renal secundaria a la uropatía malformativa asociada. Se comentan los d...

  14. Graves Disease And Down Sindrome : Clinical Case

    Scrinic Olesea

    2015-08-01

    Full Text Available Introduction: Pacients with Down’s syndrome present an increase revalence of autoimune endocrine disorders. We communicate the case of 14 years and 6 months old pacient known with Down syndrome admitted in Endocrinology department with suspicion of hyperthyroidism, the diagnosis being confirmed by hormonal dosage. The particularity of the case consists in: symptomatology onset during puberty, clinical evolution with mild symptoms, without ocular involvement, morphological and functional remission obtained relatively soon after the initiation of antithyroid therapy, lack of posttherapy side effects, favorabile evolution under the “block and replace” therapy

  15. Sindrome disfágica Dysphagic syndrome

    Ronaldo Mafia Cuenca

    2007-06-01

    Full Text Available INTRODUÇÃO: A disfagia é o principal sintoma das doenças do esôfago e é representada pela dificuldade em deglutir o alimento ingerido no trajeto da orofaringe até o estômago. Ela é queixa comum na prática clínica diária envolvendo várias especialidades na sua investigação. MÉTODOS: Foi realizada revisão atualizada da literatura internacional através do Pubmed (www.pubmed.com e nacional (www.lilacs.br utilizando-se as seguintes palavras-chave: disfagia e transtornos da deglutição. A extensão do tema foi limitado aos seguintes enfoques: etiologia, diagnóstico e exames complementares mais aplicáveis à exploração propedêutica. CONCLUSÃO: Embora a literatura apresente bom entendimento do processo disfágico, no diagnóstico preciso de sua causa há freqüentemente necessidade de múltiplos exames complementares que associados fazem melhor entender o que acomete o paciente e orientará mais adequadamente a conduta a ser tomadaBACKGROUND: Dysphagia is the main symptom of diseases of the esophagus, being manifested by deglutition difficulties, which reaches the oropharynx and stomach pathway. Is a common daily complaint in the clinical practice, involving numerous specialties regarding its investigation. METHODS: An international literature review was made using Pubmed (www.pubmed.com and a national utilizing (www.lilacs.br the following keywords: dysphagia and deglutition disorders. The extension of the subject was limited to the following areas: etiology, diagnosis and complementary exams which were aplicable to exploratory propedeutics. CONCLUSION: Eventhough the literature presents a good understanding of the dysphagic process, the need for multiple complementary exams is frequent during diagnosis, developing a better understanding of what the patient has, adequately orienting which conduct should be taken.

  16. EL SINDROME VESTIBULAR EN EL ADULTO MAYOR

    Dr. Hamlet Suárez

    2016-11-01

    Full Text Available El vértigo, la inestabilidad y las caídas tienen una incidencia relevante en el adulto mayor, disminuye su calidad de vida y puede ser causa de muerte en esta población. Este artículo describe las presentaciones clínicas y el abordaje de la evaluación de la patología vestibular en este grupo de edad, utilizando diferentes instrumentos para el diagnóstico así como también las reglas generales del tratamiento.

  17. SINDROME DE COLAPSO DE MORDIDA POSTERIOR

    Paula Alejandra Baldión

    2012-07-01

    El objetivo del artículo es describir la manera como evoluciona la enfermedad, la evaluación multidisciplinaria para obtener un diagnóstico preciso y la secuencia de tratamiento integral, revisando los conceptos para un mejor entendimiento del tratamiento periodontal y restaurativo que requieren los pacientes con síndrome de colapso de mordida posterior; caracterizado por procesos patológicos como enfermedad periodontal, caries dental con subsecuente alteración de la integridad del arco dentario que genera perdida de soporte posterior conllevando a un trauma oclusal secundario y disminución de la dimensión vertical oclusal. El control del proceso inflamatorio y la estabilización periodontal son puntos de partida indispensables en el tratamiento integral del paciente. La migración patológica de los dientes y las alteraciones del plano oclusal pueden exigir la corrección ortodóntica de los arcos y en algunos casos el concurso de cirugía oral para la nivelación del plano oclusal. La secuencia organizada del tratamiento por fases permite la restauración predecible de los pacientes con este síndrome, tomando en cuenta las diferentes alternativas protésicas tanto removibles como fijas con o sin implantes de oseointegración, para el éxito integral a largo plazo.

  18. Churg Strauss syndrome; Sindrome de Churg Strauss

    Lopez Rengifo, Diana Milena; Contreras Zuniga, Eduardo; Osio, Luis Fernando

    2007-07-01

    The Churg-Strauss syndrome, also called allergic granulomatosis and angiitis, is a multisystem disorder characterized by allergic rhinitis, asthma, and prominent peripheral blood eosinophilia. The most common organ involved is the lung, followed by the skin. The Churg-Strauss syndrome, however, can affect any organ system, including the cardiovascular, gastrointestinal, renal, and central nervous systems.

  19. SINDROME DE COLAPSO DE MORDIDA POSTERIOR

    Paula Alejandra Baldión

    2012-12-01

    Full Text Available El Síndrome de Colapso de Mordida posterior es una patología oclusal que se presenta como consecuencia de problemas dentales, periodontales y oclusales, que exige la correcta evaluación de los signos y síntomas que lo caracterizan.  El objetivo del artículo es describir la manera como evoluciona la enfermedad, la evaluación multidisciplinaria para obtener un diagnóstico preciso y la secuencia de tratamiento integral, revisando los conceptos para un mejor entendimiento del tratamiento periodontal y restaurativo que requieren los pacientes con síndrome de colapso de mordida posterior; caracterizado por procesos patológicos como enfermedad periodontal, caries dental con subsecuente alteración de la integridad del arco dentario que genera perdida de soporte posterior conllevando a un trauma oclusal secundario y disminución de la dimensión vertical oclusal. El control del proceso inflamatorio y la estabilización periodontal son puntos de partida indispensables en el tratamiento integral del paciente. La migración patológica de los dientes y las alteraciones del plano oclusal pueden exigir la corrección ortodóntica de los arcos y en algunos casos el concurso de cirugía oral para la nivelación del plano oclusal. La secuencia organizada del tratamiento por fases permite la restauración predecible de los pacientes con este síndrome, tomando en cuenta las diferentes alternativas protésicas tanto removibles como fijas con o sin implantes de oseointegración, para el éxito integral a largo plazo.

  20. Abordagem neurologica na sindrome do X fragil

    Marilisa Mantovani Guerreiro

    1993-01-01

    Resumo: Com o propósito de realizar a abordagem neurológica na Síndrome do X Frágil (SXF), estudaram-se 11 pacientes com este diagnóstico citogenético. A idade variou de 8 a 19 anos. Nove pacientes eram do sexo masculino e dois do feminino. Todos os indivíduos apresentaram pavilhões auriculares grandes e faces alongadas. Observou-se fronte proeminente em 63% dos casos e macrorquidia em 33% dentre aqueles do sexo masculino. Atraso na aquisição da fala, fala repetitiva, perseverativa, impulsiva...

  1. Sindromes Dolorosos Regionales, Columna, Hombro y Rodilla

    Wolff C. Verónica, Dra.

    2012-07-01

    En la rodilla, los trastornos periarticulares incluyen bursitis y tendinitis de distintas estructuras, y hay que considerar la osteonecrosis dentro del diagnóstico diferencial del dolor de rodilla del adulto mayor.

  2. Radiation induced effects in the developing central nervous system; Effectos radioinducidos sobre el sistema nervioso central en desarrollo

    Gisone, P; Dubner, D; Michelin, S C; Perez, M.R. Del [Autoridad Regulatoria Nuclear, Gerencia de Apoyo Cientifico, Buenos Aires (Argentina)

    1997-11-01

    The embryo and the human foetus are particularly sensitive to ionizing radiation and this sensitivity presents various qualitative and quantitative functional changes during intra-uterine development. Apart from radiation induced carcinogenesis, the most serious consequence of prenatal exposure in human beings is severe mental retardation. The principal data on radiation effects on human beings in the development of the central nervous system come form epidemiological studies carried out in individuals exposed in utero during the atomic explosion at Hiroshima and Nagasaki. These observations demonstrate the existence of a time of maximum radiosensitivity between the weeks 8 and 15 of the gestational period, a period in which the proliferation and neuronal migration takes place. Determination of the characteristics of dose-response relationship and the possible existence of a threshold dose of radiation effects on the development of the central nervous system is relevant to radiation protection against low dose radiation and the establishment of dose limits for occupational exposure and the public. Studies were conducted on the generation of nitrous-oxide and its relation with the production of active species of oxygen in brains of exposed rats in utero exposed to doses of up to 1 Gy during their maximum radiosensitivity. The possible role of the mechanism of radiation induced damage in the development of the central nervous system is discussed. 8 refs.

  3. Sindromes endocrinos autoinmunes: cuándo sospechar y estudiar un sindrome poliglandular (SPG)

    B. María Carolina Letelier, Dra.

    2013-01-01

    Los síndromes poliglandulares autoinmunes comprenden un amplio espectro de trastornos endocrinos. Estos síndromes incluyen trastornos monogénicos como el síndrome poliglandular tipo 1 (tipo juvenil) y trastornos genéticos complejos como el síndrome poliglandular tipo 2 (tipo adulto). Estos trastornos se basan en la presencia de infiltración linfocitaria de la glándula afectada, anticuerpos órgano-específico en sangre, defectos en la inmunidad celular y asociación con los genes de los antígeno...

  4. Freqüência da mutação gene da síndrome do estresse suíno e sua associação com características reprodutivas em marrãs híbridas Frequency of the porcine stress sindrome gene mutation and its association with reproductive traits in crossbred gilts

    Simone Eliza Facioni Guimarães

    1999-01-01

    Full Text Available O objetivo deste trabalho foi determinar a freqüência do gene causador da síndrome do estresse em suíno (PSS e sua associação com características reprodutivas em marrãs híbridas. Setenta e duas marrãs híbridas Landrace x Large White, provenientes de granjas comerciais localizadas na região de Ponte Nova - Minas Gerais, foram analisadas para a presença da mutação PSS. No diagnóstico da mutação feito por reação em cadeia da polimerase - polimorfismo de comprimento de fragmentos de restrição (PCR-RFLP, o fragmento de 659pb do gene ryr-1 foi amplificado e, nos mutantes a substituição de citosina por timina, que acarreta mudança de aminoácidos da proteína madura de arginina para cisteína nos animais afetados, foi identificado. Dados relativos ao número de leitões nascidos vivos, leitões nascidos com baixa viabilidade e leitões natimortos por leitegada, peso médio dos leitões ao nascer e repetições de cio foram analisados. Do total de marrãs analisadas, foram encontradas 13,88% de marrãs heterozigotas e nenhuma homozigota recessiva. Não houve efeito dos genótipos sobre as características analisadas.The objective of this work was to determine the frequency of the porcine stress sindrome (PSS gene mutation and its association with reproductive traits in crossbred gilts. Seventy two crossbred Landrace x Large White females from commercial farms of Ponte Nova region location - Minas Gerais State, were analyzed for the PSS mutation. The mutation diagnose was made by polimerase chain reaction - restriction fragment length polimorphism, where the 659pb fragment from the ryr-1 gene was amplifyied, and in the mutants the substitution of cytosine by thimine, that leads to the change in the mature protein amino acids from arginine to cysteine in the affected animals, was identified. Data relative to the number of piglets born alive, born alive with low viability and dead piglets per litter, average piglets born weight and

  5. Role of Nitric Oxide in Radioinduced Effects in Developing Brain Cortex; Rol del Oxido Nitrico en los Efectos Radioinducidos en Corteza Cerebral en Desarrollo

    Robello, E [Instituto Balseiro, Universidad Nacional de Cuyo, Centro Atomico Bariloche, Universidad de Buenos Aires (Argentina)

    2001-07-01

    Nowadays, prenatal exposure is a very important topic in radiopathology.Unfortunately, pregnant women have been sometimes exposed or have to expose to ionising radiation, for example, during a medical treatment.There are lots of studies made by the International Commission of Radiation Protection (ICRP) about the effects of ionising radiation and the consequences that are suffered by the exposed foetus.Hence, it has been argued that developing mammalian brain is substantially more susceptible to teratogenic insult than most other embryonic and foetal structures.Presumably, this reflects its architectural complexity, its long developmental period, the vulnerability of the undifferentiated neural cell and the inability of the brain to replace lost neurones.Furthermore, there is abundant information on the biological effects caused by prenatal exposure of mammals to ionising radiation.Only two conspicuous effects on brain growth and development have emerged thus far in the study of atomic bomb survivors exposed prenatally in Hiroshima and Nagasaki.These are some cases of severe mental retardation and some of small head size without apparent metal retardation. Additionally, groups within the survivors have shown significantly reduced IQ scores.This increase would be dose-related and, if the shift of IQ had no clear dose threshold, might, in turn, show no threshold.Besides, it has been studied that ionising radiation implies molecular ionisation and excitation in the biological systems.When radiation has a high linear transfer energy (LET) damage may be produce trough energy absorbed directly by the target molecule (direct mechanism).However, when radiation has a low LET (like {gamma} and X radiation), and without forgetting that biological systems are basically aqueous, damage may be produce trough generation of species highly reactive (like free radicals and reactive oxygen species - ROS) by molecules of water which has adsorbed energy radiation (indirect mechanism).In this context, nitric oxide (NO) is a diffusible multifunctional extracellular messenger that has been implicated in numerous physiological functions in mammals ranging contraction of muscles, dilation of blood vessels, neurotransmission, potentiation of synaptic transmission, immune defence and, also, it can be involved in reactions that produce cell damage.As a consequence of this, an intracellular increase in the number of frees radicals and in the ROS determines a very important cellular injury trough oxidative stress.In this study, pregnant Wistar rats were exposed after 17 days of gestation (d.g.) to 1 gray (Gy) gamma irradiation from a cobalt (Co{sup 6}0) source.Even though it is establish that {gamma} radiation-dependent damage is mainly due to free radical generation, neither the ascorbyl radical/ascorbic acid ratio nor lipid radicals content in developing rat brain was affected by prenatal irradiation.In addition, a distinctive electronic paramagnetic resonance (EPR) signal for the adduct NO-Fe-MGD (g=2.03 and a{sup N} = 12.5 G) was detected in foetal brain homogenates.NO dependent EPR signal increased up to 2 h post-irradiation.NO concentration in unirradiated brains was 37{+-} 4 pmol/g and 45{+-} 2, 77 {+-} 5 and 216{+-} 6 after 30, 60 and 120 min post-irradiation, respectively.Also, total nitric oxide synthase (NOS) activity was increased by 100% and 51% after 30 and 60 min post-irradiation, respectively, and returned to control values after 120 min.Therefore, it was studied whether the quantity of NOS mRNA varies at 1, 2, 6 and 24 Hs post irradiation.As a consequence, a reverse transcription (RT) and polymerase chain reaction (PCR) amplification was performed.From the analysis of electrophoretic gel from the obtained cDNA, the values of relative areas for bands due to nNOS cDNA, were 3.23, 3.73 after 1 and 2 hours post-irradiation, respectively, and were not significantly different from control values.Similarly, relative areas for bands due to iNOS cDNA, were not significantly different from controls neither.Although these results suggest it might be possible that NOS mRNAs do not vary after irradiation, more experiments ought to be made in order to find conclusive data. All in all, in spite of NO may increase the number of frees radicals and ROS determining a very important cellular injury trough oxidative stress in several systems, NO may play a completely different role in developing neurones.It could be mainly by mediating neuroprotective effects trough avoiding lipid peroxidation in vivo, due to that it cannot be detected any alteration neither in ascorbyl radical/ascorbic acid ratio nor in lipid radicals content in developing rat brain.Moreover, it has been shown that apoptosis rate goes down in cultures which have been exposed to ionising radiation in the presence of NO donors. (abstract truncated)

  6. Sindrome de Vogt-Koyanagi-Harada: relato de um caso

    José Geraldo Camargo Lima

    1978-03-01

    Full Text Available É relatado um caso de síndrome de Vogt-Koyanagi-Harada que se iniciou por um quadro oftálmico inicialmente unilateral e, depois, bilateral. Um mês após o início da doença manifestou-se um quadro psiquiátrico tipo mania com fugas de idéias, euforia e diminuição do senso crítico. As alterações encontradas nos eletrencefalogramas e exames de líquido cefalorraqueano são analisadas. O caso foi seguido durante três anos e meio e apesar de ter sido submetido a corticoterapia teve má evolução do ponto de vista oftalmológico. Do ponto de vista psiquiátrico evoluiu bem. não restando sequela alguma.

  7. Sindrome de Vogt-Koyanagi-Harada: relato de dois casos

    Paulo E. Marchiori

    1981-12-01

    Full Text Available Os autores relatam a síndrome de Vogt-Koyanagi-Harada em duas mulheres adultas e de cor parda. São discutidos os aspectos clínicos, epidemiológicos, heredofamiliares e imunológicos.

  8. Zollinger-Ellison syndrome; Sindrome de Zollinger-Ellison

    Muraro, Cirilo Luiz de Pardo Meo; Cunha, Hercio Azevedo de Vasconcelos; Freitas Junior, Carlos Eduardo de [Pontificia Univ. Catolica de Campinas, SP (Brazil). Faculdade de Ciencias Medicas. Hospital e Maternidade Celso Pierro

    2000-12-01

    The authors report a 49 years old, female patient who have been operated on several times (antrectomy with Billroth II reconstruction, partial gastrectomy with troncular vagotomy and total gastrectomy) in the last 5 years for recurrent ulcer disease. Three months ago, an abdomen ultra sound was done showing multiples images that suggested liver metastasis, which was confirmed by CT and MR. Two months ago, one new abdomen CT specifically to pancreas was done showing an expansive process in pancreas. Serial gastrine was 1532 pg/ml at the time (reference - until 115) and among clinical history and images exams Zollinger-Ellison Syndrome was suggested, a rare disease case. (author)

  9. Noonan syndrome and chylothorax; Sindrome de Noonan y quilotorax

    Martinez-Leon, M. I.; Ceres-Ruiz, L.; Solbes-Vila, R.; Valls-Moreno, E. [Hospital Infantil del C.H.U. Carlos Haya. Malaga (Spain)

    2001-07-01

    Chylothorax during childhood usually develops as a result of posto-perative complications following cardiothoracic surgery. It is rarely due to the malformations of the lymphatic system associated with dysmorphic syndrome. We report two cases of Noonan syndrome involving neonatal development of chylothorax. In children with the Noonan phenotype who develop pleural effusion during the neonatal period in the absence of obstetric trauma, it is advisable to rule out the presence of congenital lymphatic malformation and study the pleural effusion, initially introducing conservative treatment with dietary therapy. Chest radiography, ultrasound and computed tomography reveal the presence of the pleural effusion and parenchymal pattern compatible with chloroethoxy and lymphangiectasis. (Author) 15 refs.

  10. EPR - spektroskopiya pri ozhirenii i metabolicheskom sindrome u zhenshchin

    A G Maksina

    2001-03-01

    Full Text Available Цель. Исследовать изменения в структуре мембран эритроцитов крови при ожирении в сочетании с другими нарушениями, характерными для метаболического синдрома. Материалы и методы. Обследованы 42 пациентки в возрасте от 23 до 50 лет с избыточной массой тела и ожирением и контрольная группа (12 женщин с применением метода спинового зонда. Результаты. У пациенток и избытком массы тела и ожирением показатель мембранной упорядоченности фосфолипидов был выше, чем в контроле. . Изменение параметра S в цельной крови и сыворотке более выражено по сравнению с таковым в эритроцитах. При ожирении с сопутствующей артериальной гипертензией параметр упорядоченности достоверно выше (р

  11. LA SINDROME OSSESSIVA SPAZIO-TEMPORALE DEGLI ITALIANI

    User

    “Spazio e tempo sono maledizioni che gravano sulla terra”. La citazione è tratta dall'opera Trunkene Flut del 1949, tradotta in italiano con il titolo Flutto ebbro (a cura di A.M. Carpi, Guanda, Parma, 1989). Il pessimismo è una delle caratteristiche principali di Gottfried Benn (1886-1956), medico di professione, autore anche ...

  12. SINDROME DE BURNOUT E SUAS CONSEQUENCIAS NOS PROFISSIONAIS DE ENFERMAGEM

    Clecilene Gomes CARVALHO

    2011-01-01

    Full Text Available Burnout is an English word that refers to something that crashed from exhaustion. It is a problem that affects service professionals, particularly those facing care activities with others, in which the provision of care or service often occurs in situations of emotional changes. The syndrome takes a multidimensional concept, whosemanifestation is characterized by emotional exhaustion, reduced personal accomplishment and depersonalization of the other. Taking into consideration that nurses, technicians and nursing assistants, are a great group with a predisposition to develop the syndrome because they are health professionals who spend more time in contact with the patient and their family members within the work environment emotional situations of constant change, we performed abibliographic review in order to gather information on key risk factors that favor the onset of the Burnout syndrome and its consequences for the individual, organization and society. This work will serve as a subsidy for reflection and discussion, both the professionals involved, as future managers and professionals.

  13. Aplicacion de la ozonoterapia en el sindrome cocleovestibular

    Alejandro del Cerro; Silvia Menéndez; Tania Alvarez

    2010-01-01

    Se les llama síndromes cócleo-vestibulares a un grupo de afecciones caracterizadas por alteraciones de la audición y del equilibrio. Son motivos frecuentes de consulta médica y de elevado ausentismo laboral. El vértigo es el síntoma principal, aunque la hipoacusia, los acúfenos, el dolor y la sensación de humedad pueden estar presentes. Esta afección tiene una importante prevalencia y representa un alto costo económico, debido a la gama de medicamentos utilizados y prolongados tratamientos qu...

  14. [Polycystic ovary sindrome: impact on reproductive and material fetal health].

    Fux Otta, Carolina; Iraci, Gabriel Santino; Szafryk de Mereshian, Paula; Fiol de Cuneo, Marta

    2016-01-01

    Polycystic ovary syndrome (PCOS) is characterized by hyperandrogenism (H), oligo-anovulation (O) and / or polycystic ovaries (P). There is currently little information on perinatal complications. to investigate obstetric and neonatal characteristics of women with PCOS in our population. we studied 87 pregnant women with PCOS (categorized in four phenotypes according Rotterdam Consensus: A (H + O + P) n = 53; B (H + O) n = 9; C (H + P) n = 16 and D (O + P) n = 9) and 96 without PCOS (control). We analyzed clinical and biochemical features (age, anthropometry hirsutism, acanthosis nigricans, OGTT, insulin, lipid profile, androgen and gonadotropins) during preconception, (weight gain, blood pressure, OGTT) through gestation and occurrence of perinatal complications. we found no differences in age (29.4 ± 4 and 28.7 ± 5 years) and body mass index (28.2 ± 6 and 27.8 ± 6 kg / m2) in both groups; while patients with PCOS had higher waist circumference, blood pressure and acanthosis nigricans versus control. Despite similar weight gain, patients with PCOS had higher percentage of perinatal complications. In the A phenotype RR for perinatal adverse outcomes was 2.37 (95%CI: 1.67-3.36, p <0.001). The HOMA-IR index preconception and fasting glucose during pregnancy were the predictors for these complications (p=0.01). patients with PCOS have a higher risk for complications during pregnancy and newborns more frequently have low weight or macrosomy. A careful history can recognize patients with higher perinatal risk to develop complications.

  15. SINDROME DE SILVER-RUSSELL, REPORTE DE UN CASO

    Ángela Liliana Grandas Ramírez

    2012-07-01

    Full Text Available El síndrome Silver-Russell es un desorden genético (hipometilación en la región centro 1 (ICR1 del  IGF2 /H19  locus 11p15 y clínicamente heterogéneo, caracterizado por retardo del crecimiento intrauterino, baja talla y peso, y perímetro cefálico normal. Su tratamiento se basa en la  hormona del crecimiento. Se presenta el caso de una niña de 5 años que ingresa al servicio de Estomatología Pediátrica de la Fundación HOMI Hospital de la Misericordia de Bogotá, con antecedente de retardo del crecimiento intrauterino, manejada con dieta rica en carbohidratos y uso de biberón hasta los 2 y medio años, Al examen talla 88 cm y peso 9 Kg,  cara forma triangular, frente prominente, micrognatismo mandibular, apiñamiento dental y caries de la infancia temprana. Se diagnostica con retardo de la edad ósea, dental y morfológica. El tratamiento programa individual riesgo de caries y proveer una alta calidad de salud oral.

  16. Sindrom metaboličke inzulinske rezistencije i metabolizam ugljikohidrata

    Metelko, Željko; Crkvenčić, Neva

    2004-01-01

    Stanje metaboličke inzulinske rezistencije jest nemogućnost ostvarenja biološkog učinka inzulina u koncentracijama koje su učinkovite u zdravih osoba. Utjecaj se primjećuje na metabolizmu glukoze, metabolizmu lipida, funkciji krvnih žila i trombocita te regulaciji autonomnoga živčanog sustava. Fizička neaktivnost, nepravilna prehrana i sedentarni način života značajno pridonose razvoju pretilosti, metaboličke inzulinske rezistencije i tipa 2 šećerne bolesti. Metaboličk...

  17. Ejercicio, Obesidad y Sindrome Metabólico

    A. Carlos Jorquera, Nut. Msc

    2012-05-01

    Full Text Available Los bajos niveles de actividad física y/o ejercicio, junto a los malos hábitos alimentarios presentes a nivel nacional e internacional, han traído consigo una serie de complicaciones y/o morbilidades que han provocado un importante aumento de las tasas de mortalidad por enfermedades adquiridas, muchas de ellas ligadas a esta malnutrición por exceso y sedentarismo, descritos en encuestas nacionales e internacionales. La falta de movimiento es extrema en la población chilena y mundial, cada día la industria desarrolla elementos que buscan disminuir la ejecución de ejercicio físico, lo que se refleja de cierta manera en las encuestas ejecutadas, donde las tasas de inactividad física son elevadísimas, tanto en adultos como en niños, ya sean estos hombres o mujeres. Esto, sumado a los elevados niveles de obesidad, hace que enfoquemos nuestra atención al desarrollo de un tratamiento que combata estos dos factores de riesgo de manera paralela, pues en la ecuación de Balance Energético un 50% de ella corresponde a la ingesta y un 50% al gasto de energía. Los elevados niveles de sobrepeso y obesidad de nuestra realidad chilena (60% de la población, son la evidencia de un balance energético positivo provocado por una mayor ingesta de alimentos y un menor gasto en actividad física lo que ha llevado a que aumente progresivamente el Síndrome Metabólico y las ECNT en nuestra población.

  18. Churg-Strauss syndrome; Sindrome de Churg Strauss

    Ayala, Jose Javier; Velasquez, Juan Carlos

    2005-07-01

    Churg-Strauss Syndrome was described in 1951 and it is characterized by asthma, fever, hypereosinophilia and vasculitis. In 1990, following the discussion of several proposals for its classification, the American College of Rheumatology established its diagnostic criteria. A 55 year-old female patient was seen recently at the Military Hospital in Bogota, Colombia, with leucocytoclastic vasculitis, wheezing, pulmonary infiltrates and hypereosinophilia, who met all the criteria to be classified as a Churg-Strauss patient.

  19. Syndrome of Churg Strauss; Sindrome de Churg Strauss

    Sanchez Morales, Edgar Alberto; Saavedra Rodriguez, Alfredo; Henao Riveros, Sandra

    2002-09-01

    The Churg-Strauss syndrome denominated allergic granulomatosis and angeitis is characterized by a systemic vasculitis of small glasses, extravascular granulomas and hypereosinophilia. Initially described by Jacob Churg and Lotte Strauss, two pathologists who in 1951 they published the description of 13 patient postmortem with tisular infiltration for eosinophils, necrotizant vasculitis and extravascular granulomas. The paper includes nomenclature, classification approaches, pathogenesis, pathology, and clinical aspects and diagnostic.

  20. SINDROMES HEREDITARIOS QUE PREDISPONEN AL DESARROLLO DEL CANCER COLORRECTAL

    Dr. Benedito Mauro Rossi

    2017-07-01

    En ambos síndromes, el estudio genético de los pacientes permite en altos porcentajes identificar las mutaciones causantes. En base a estos resultados, se pueden identificar los familiares portadores de mutaciones, y ofrecerles los esquemas de vigilancia y eventuales tratamientos profilácticos correspondientes a su enfermedad. Para el manejo integral de estas familias es esencial contar con un equipo multidisciplinario, para poder ofrecer consejería genética, estudio genético, educación a las familias y tratamiento respectivo en forma adecuada.

  1. SINDROME DE SILVER-RUSSELL, REPORTE DE UN CASO

    Ángela Liliana Grandas Ramírez

    2012-12-01

    Full Text Available El síndrome Silver-Russell es un desorden genético (hipometilación en la región centro 1 (ICR1 del  IGF2 /H19  locus 11p15 y clínicamente heterogéneo, caracterizado por retardo del crecimiento intrauterino, baja talla y peso, y perímetro cefálico normal. Su tratamiento se basa en la  hormona del crecimiento. Se presenta el caso de una niña de 5 años que ingresa al servicio de Estomatología Pediátrica de la Fundación HOMI Hospital de la Misericordia de Bogotá, con antecedente de retardo del crecimiento intrauterino, manejada con dieta rica en carbohidratos y uso de biberón hasta los 2 y medio años, Al examen talla 88 cm y peso 9 Kg,  cara forma triangular, frente prominente, micrognatismo mandibular, apiñamiento dental y caries de la infancia temprana. Se diagnostica con retardo de la edad ósea, dental y morfológica. El tratamiento programa individual riesgo de caries y proveer una alta calidad de salud oral.

  2. Radiation therapy for the treatment of feline advanced cutaneous squamous cell carcinoma; A utilizacao da radioterapia no tratamento do carcinoma de celulas escamosas cutaneo felino avancado

    Cunha, S.C.S.; Corgozinho, K.B.; Ferreira, A.M.R, E-mail: simonecsc@gmail.com [Universidade Federal Fluminense (UFF), Niteroi, RJ (Brazil); Carvalho, L.A.V. [Coordenacao dos Programas de Pos-Graduacao em Engenharia (COPPE/UFRJ), RJ (Brazil); Holguin, P.G.

    2014-02-15

    The efficacy of radiation therapy for feline advanced cutaneous squamous cell carcinoma was evaluated. A full course radiation therapy protocol was applied to six cats showing single or multiple facial squamous cell carcinomas, in a total of seven histologically confirmed neoplastic lesions. Of the lesions, one was staged as T{sub 1}, and six as T{sub 4} according to WHO staging system of epidermal tumors. The animals were submitted to twelve radiation fractions of 4 Gy each, on a Monday-Wednesday-Friday schedule, and the equipment used was an orthovoltage unit. Energy used was 120 kV, 15 mA and 2 mm aluminum filter. The cats were evaluated during the treatment and 30 and 60 days after the end of the radiation therapy. In this study, 87% of the lesions had complete remission and 13% partial remission to the treatment. Side effects were considered mild according to Veterinary Radiation Therapy Oncology Group Toxicity criteria, and included erythema, epilation and rhinitis. Radiation Therapy was considered safe for feline cutaneous squamous cell carcinoma, leading to mild side effects and can represent a good therapeutic option. (author)

  3. Stimulation of murine stem cell proliferation by circulating activities produced during the recovery of a radiation-induced hematopoietic injury. Estimulacion proliferativa de celulas madre hematopoyeticas de raton por actividades circulantes producidas durante la recuperacion de un dano hematopoyetico radioinducido

    Grande Azanedo, M.T.

    1989-02-01

    The proliferative activity of CFU-S, low in normal steady state, increases after treatment with different aggressors, i.e., radiation. This stimulation has been attributed in part to a local regulation system of stem cell proliferation, and at least in part to a humoral regulatory system. In the present work it has been investigated the role that circulating activities have in the CFU-S stimulation, by means of in vitro and in vivo incubation assays with diffusion chambers. The results show that bone marrow of mice irradiated with 5 Gy produces in vitro diffusible activities capable of stimulating the CFU-S proliferation. As well with this same dose circulating activities are also produced in vivo. In addition we have observed that these activities are only released during the periods of active hematopoietic regeneration that follow irradiation with moderate doses (1.5 and 5 Gy). In another set of experiments we saw that the stimulating activities are also detected in serum of mice irradiated with 5 Gy. These serum activities modify the proliferative state of very primitive precursors (12 d CFU-S). When the serum activities are added to long term bone marrow cultures the CFU-S are also stimulated to proliferate. Finally, we observed that the radiation-induced serum activities stimulate the proliferation of bone marrow CFU-S when injected into normal mice, suggesting that such activities are involved in the regulation of CFU-S proliferation.

  4. Sindrome de russel tumor diencefálico em uma criança

    Luiz A. C. Roxo da Motta

    1990-03-01

    Full Text Available Apresenta-se o caso de criança do sexo masculino com síndrome de Russel devida a astrocitoma pilocítico localizado na região diencefálica. O diagnóstico foi realizado aos 16 meses de idade, mas sua sintomatologia se iniciou aos 4 meses, com emagrecimento progressivo. À internação apresentava-se com peso de 6150g e 74cm de estatura, emaciada, sem panículo adiposo, irritadica e com sinais de hipertensão intracraniana. Existia estrabismo convergente, nistagmo vertical do olho esquerdo e papiledema bilateral. Os reflexos tendinosos eram exaltados e tinha tetraparesia espástica. A avaliação endócrina demonstrou aumento basal do GH (23 ng/ml, do TSH (6,2 mUI/l e da prolactina (26 ng/ml. Os dois primeiros hormônios não responderam ao teste agudo com o TRH, enquanto a prolactina teve resposta pobre. Foi submetida a radioterapia com acelerador linear (dose total de 4000 rads e a cirurgia, na qual não se conseguiu extirpar todo o tumor, devido a seu tamanho. Nove meses após, a criança encontra-se bem, com apreciável ganho ponderai (2500g.

  5. Afferent loop syndrome - a case report; Sindrome da alca aferente - relato de um caso

    Borges, Ana Karina Nascimento; Pinheiro, Marco Antonio Lopes; Galvao, Cristine Norwig [Fundacao Pio XII - Hospital do Cancer de Barretos, SP (Brazil)

    2000-02-01

    The afferent loop syndrome occurs in patients with previous gastric surgery for tumor, when there is anastomotic edema, use of inappropriate reconstruction technique for gastro jejunostomy or recurrent gastric cancer. Complaints such jaundice, intermittent abdominal distension associated with pain, and vomiting should be investigated in order to rule out this syndrome. (author)

  6. Cistatina C, PCR, Log TG/HDLc e Sindrome Metabolica estao Relacionados a Microalbuminuria na Hipertensao

    Rafaela do Socorro Souza e Silva Moura

    2014-01-01

    Full Text Available Fundamento: Em pacientes com hipertensão arterial sistêmica, a microalbuminúria é um marcador de lesão endotelial e está associada a um risco aumentado de doença cardiovascular. Objetivo: O objetivo do presente estudo foi determinar os fatores que influenciam a ocorrência de microalbumiúria em pacientes hipertensos com creatinina sérica menor que 1,5 mg/dL. Métodos: Foram incluídos no estudo 133 pacientes brasileiros atendidos em um ambulatório multidisciplinar para hipertensos. Pacientes com creatinina sérica maior do que 1,5 mg/dL e aqueles com diabete mellitus foram excluídos do estudo. A pressão arterial sistólica e diastólica foi aferida. O índice de massa corporal (IMC e a taxa de filtração glomerular estimada pela fórmula CKD-EPI foram calculados. Em um estudo transversal, creatinina, cistatina C, colesterol total, HDL colesterol, LDL colesterol, triglicerídeos, proteína C-reativa (PCR e glicose foram mensurados em amostra de sangue. A microalbuminúria foi determinada na urina colhida em 24 horas. Os hipertensos foram classificados pela presença de um ou mais critérios para síndrome metabólica. Resultados: Em análise de regressão múltipla, os níveis séricos de cistatina C, PCR, o índice aterogênico log TG/HDLc e a presença de três ou mais critérios para síndrome metabólica foram positivamente correlacionados com a microalbuminuria (r2: 0,277; p < 0,05. Conclusão: Cistatina C, PCR, log TG/HDLc e presença de três ou mais critérios para síndrome metabólica, independentemente da creatinina sérica, foram associados com a microalbuminúria, um marcador precoce de lesão renal e de risco cardiovascular em pacientes com hipertensão arterial essencial.

  7. Sentido de Coherencia y Sindrome de Burnout en el personal sanitario de Urgencias

    Vega Martínez, Maria del Carmen

    2013-01-01

    El Sentido de coherencia es un término que hace referencia a la capacidad del individuo par aver su entorno individual y el mundo que les rodea. El Síndrome de Burnout es un problema que afecta a los profesionales sanitarios cada vez, proporcionándoles síntomas como: fatiga, insomnio, cefaleas, deterioro de comunicación con pacientes / otros profesionales y hasta se puede llegar a poner en riesgo la salud del paciente atendido. Después del pase de cuestionarios de forma adecuada a 69 pro...

  8. Imaging in Cushing's syndrome; Imagem em sindrome de Cushing

    Sahdev, Anju; Evanson, Jane [St. Bartholomew' s Hospital, London (United Kingdom). Dept. of Diagnostic Imaging; Reznek, Rodney H. [St. Bartholomew' s Hospital, London (United Kingdom). Institute of Cancer. Cancer Imaging; Grossman, Ashley B. [St. Bartholomew' s Hospital, London (United Kingdom). Dept. of Endocrinology]. E-mail: anju.sahdev@bartsandthelondon.nhs.uk

    2007-11-15

    Once the diagnosis of Cushing's syndrome (CS) has been established, the main step is to differentiate between ACTH dependent and independent disease. In adults, 80% of CS is due to ACTH-dependent causes and 20% due to adrenal causes. ACTH-secreting neoplasms cause ACTH-dependent CS. These are usually anterior pituitary microadenomas, which result in the classic Cushing's disease. Non-pituitary ectopic sources of ACTH, such as a small-cell lung carcinoma or carcinoid tumours, are the source of the remainder of ACTH-dependent disease. In the majority of patients presenting with clinical and biochemical evidence of CS, modern non-invasive imaging can accurately and efficiently provide the cause and the nature of the underlying pathology. Imaging is essential for determining the source of ACTH in ectopic ACTH production, locating the pituitary tumours and distinguishing adrenal adenomas, carcinomas and hyperplasias. In our chapter we review the adrenal appearances in ACTH-dependent and ACTH-independent CS. We also include a discussion on the use of MRI and CT for the detection and management of pituitary ACTH secreting adenomas. CT of the chest, abdomen and pelvis with intravenous injection of contrast medium is the most sensitive imaging modality for the identification of the ectopic ACTH source and detecting adrenal pathology. MRI is used for characterising adrenal adenomas, problem solving in difficult cases and for detecting ACTH-secreting pituitary adenomas. (author)

  9. Strategie di coping e sindrome da burnout nei Vigili del Fuoco

    Alessandra Curtacci

    2017-03-01

    Full Text Available In the last decades, we have seen a rapid growth in the culture of prevention, safety and care for people involved in dramatic events. These calamites, both natural and human made, can have a profound effect on the mental stability of individuals and communities. These effects can have consequences on people, which may go on for days, months and even years during the recovery, rebuilding and re-establishment of an ordinary situation. Each event due to these circumstances is an emergency from a technical-practical and also human point of view. And that is because people are forced to fight in order to survive physically and emotionally in a state of dangerousness and dramatic force. During an emergency it is necessary to help people recognize normality in their own reactions, which are consequences of a situation out of ordinary. A greater focus on the emotional and cognitive component of the person involved is needed. Actually, this component proves to be very important both for the successful management of the situation - being involved in the prevention and preparation phases - and for its contribution to a mitigation of the effects of a specific event. It is widely known that during an emergency, interventions by psychologists trained to face various contexts (e.g., incidents, natural disasters and so on and able to cooperate with other professionals are needed. The aim is to promote in the people involved, both rescuers and victims, the capacity to cope with the situation, in the short term and in the long term.

  10. SINDROME DE INMUNODEFICIENCIA ADQUIRIDA. COMPROMISO DEL CORAZÓN Y DE LOS VASOS

    Dr. Jorge Yovanovich S.

    2015-03-01

    Full Text Available Las complicaciones cardiovasculares del SIDA, son a menudo asintomáticas, aunque en ocasiones pueden constituir la causa directa de muerte. Puede comprometerse el pericardio, miocardio, endocardio y los vasos, ya sea como manifestación de la enfermedad de base o como resultado de la terapia antirretroviral y su efecto sobre los factores de riesgo, en el contexto de una patología que es actualmente de evolución crónica y con mejores expectativas de sobrevida gracias a las nuevas drogas empleadas para su control y tratamiento. El objetivo de este artículo es presentar una revisión de los aspectos más relevantes del SIDA que comprometen al corazón y los vasos.

  11. Giperkortitsizm i metabolicheskiy sindrom: slozhnosti differentsial'noy diagnostiki i lecheniya

    L K Dzeranova

    2012-06-01

    Full Text Available Hypercortisolism is a severe endocrine disorder that leads to all types of metabolic disturbances. The most frequent symptom of hypercortisolism is a specific weight gain and body fat distribution - "cushingoid" obesity which clinically reflects the pathological changes in protein, carbohydrate and lipids metabolism. We provide a clinical case of a patient with Cushing's disease. This clinical case represents challenges in the differential diagnosis of this rare endocrine disorder and metabolic syndrome, and specific approach in further evaluation and treatment of Cushing's disease that requires all the latest technology in this field to be employed.

  12. Heterotaxy syndrome: a case report; Sindrome de heterotaxia: relato de caso

    Carneiro, Daniel de Souza; Arantes, Jamil Hussein de; Souza, Gustavo Veloso de; Barreto, Aline Santos; Cardoso, Mychaell Luciano; Gontijo, Flavia, E-mail: danielmed124@gmail.com [Hospital Madre Tereza, Belo Horizonte, MG (Brazil)

    2013-05-15

    The present report describes the findings at chest computed tomography angiography of a 28-year-old female patient with heterotaxy syndrome. This syndrome consists of a variety of anomalies of position and morphology of thoracoabdominal organs which do not follow the situs solitus or situs inversus arrangement. Imaging studies play a fundamental role in the individualization of the approach to the patient. (author)

  13. [Pure gonad dysgenesia or Swyer sindrome. A case report having tumoral development: melanoma].

    Russo, D; Blanco, M; Falke, G; Rocca Rivarola, M; Séller, R; Puigdevall, J C; Bergada, C

    2006-10-01

    A 14 year old girl having 10-days lumbar pain, polaquiuria and moderate pain to palpation is reported. Blood and urine analysis were normal. Abdominal ultrasound scan showed cavity free and solid, rounded, heterogeneous, intrapelvic mass compressing bladder and uterus. Magnetic resonance image was performed showing right gonad compromise with extensive liver and sacro-lumbar spine invasion. Tumoral markers were ruled out. During surgery, primary tumor mass localizad in the right gonad was completely excised. Melanotic peritoneal and hepatic disemination were observed. The patient had left streak gonad and infantile uterus (2 x 3 cm). As gonad dysgenesia was suspected, high resolution cromosomic study was performed and resulted in cariotype 46 XY. Microscopy of the resected gonad showed primary gonad melanoma. Chemotherapy was instituted with no tumor response and the patient died two month later.

  14. [Dissociation of antihypertensive and metabolic response to losartan and spironolactone in experimental rats with metabolic sindrome].

    Machado, Hussen; Pinheiro, Helady Sanders; Terra, Marcella Martins; Guerra, Martha de Oliveira; de Paula, Rogerio Baumgratz; Peters, Vera Maria

    2012-01-01

    The treatment of arterial hypertension (AH) in patients with metabolic syndrome (MS) is a challenge, since non drug therapies are difficult to implement and optimal pharmacological treatment is not fully established. To assess the blockade of the rennin angiotensin aldosterone system (RAAS) in blood pressure (BP) in renal function and morphology in an experimental model of MS induced by high fat diet. Wistar rats were fed on high fat diet from the fourth week of life, for 20 weeks. The groups received Losartan or Spironolactone from the eighth week of life. We weekly evaluated the body weight and BP by tail plethysmography. At the end of the experiment oral glucose tolerance, lipid profile, creatinine clearance tests, and the direct measurement of BP were performed. A morphometric kidney analysis was performed. The administration of high-fat diet was associated with the development of MS, characterized by central fat accumulation, hypertension, hyperglycemia and hypertriglyceridemia. In this model there were no changes in renal histomorphometry. The blockade of angiotensin II (Ang II) receptor AT1 prevented the development of hypertension. The mineralocorticoid blockage did not have antihypertensive efficacy but was associated with reduction of abdominal fat. The dissociation of the antihypertensive response to the blockades of Ang II receptors and mineralocorticoid indicates the involvement of Ang II in the pathogenesis of hypertension associated with obesity. Reduction of central obesity with Spironolactone suggests the presence of mineralocorticoid adipogenic effect.

  15. Acute gastrointestinal bleeding following aortic valve replacement in a patient with Heyde's sindrome. Case report.

    De Palma, G D; Salvatori, F; Masone, S; Simeoli, I; Rega, M; Celiento, M; Persico, G

    2007-09-01

    A 58-year old man was admitted to the hospital because of melena. He had a 1-year history of mechanical aortic valve replacement and coronary stent placement because of myocardial infarction and he was taking warfarin and clopidogrel. Esophagogastroduodenoscopy and colonoscopy were negative for bleeding. Capsule endoscopy showed bleeding diffuse angiodysplasia of the small bowel. The patient was treated with octreotide 20 mg, at monthly interval. After 25 months there had been no recurrence of gastrointestinal bleeding. The case suggests that mechanical valve replacement may not prevent gastrointestinal bleeding in Heyde syndrome and that octreotide treatment should be considered in these cases.

  16. Relaciones de la grasa visceral y de tronco con el sindrome metabólico

    Fernández Vázquez, Rosalía Asunción

    2016-01-01

    La obesidad central es uno de los componentes que conforman el conjunto de factores del síndrome metabólico. La obesidad central se asocia a una gran incidencia de diabetes tipo 2, resistencia a la insulina, hipertensión arterial y particularmente a las enfermedades cardiovasculares. Las acciones metabólicas del tejido adiposo visceral son por sí solas un factor de riesgo independiente para una serie de alteraciones metabólicas. Objetivos: Los objetivos de la presente tesis han sido estudiar ...

  17. Pengaruh pemberian yogurt sinbiotik tepung pisang tanduk terhadap profil lipid tikus sindrom metabolik

    Zana Fitriana Octavia

    2017-04-01

    Full Text Available Background: The metabolic syndrome, which is characterized by hyperglycemia, obesity, dyslipidemia, hypertension, prothrombic and proinflamatory state, is a risk factor for cardiovascular disease and diabetes mellitus. The synbiotic yogurt of tanduk banana (Musa paradisiaca fa. corniculata flour contains lactic acid bacteria, fructooligosaccarides, flavonoids, and vitamin C which all of them play role in improving the lipid profile. Objective: The aim of this study was to prove the effect of synbiotic yogurt of tanduk banana flour on lipid profile of metabolic syndrome rats. Method: This study was an true experimental with pre-post test  control group design. The subject of this study were 18 metabolic syndrome male Wistar rats divided into 3 groups,i.e control group (standart diet, intervention group I (standart diet and synbiotic yogurt of banana flour 0,009 ml/g weight/day, and intervention group II (standart diet and synbiotic yogurt of banana flour 0,018 ml/g weight/day. The intervention period was 2 weeks. Different test before and after intervention used paired t-test. The difference test between groups used One-Way ANOVA and Kruskal wallis. Results: The result showed that both of intervention group improved lipid profile significantly (p<0,05. The intervention group II showed more effective improvement of lipid profile significantly (p<0,05 than intervention group I. The intervention group II decreased triglycerides level 41,56%; total cholesterol level 41,39%; LDL-cholesterol level 57,5%; and increased HDL-cholesterol level 139,62%. Conclucion: The intervention of synbiotic yogurt of  tanduk banana flour can decrease triglyceride level, total cholesterol level, LDL-cholesterol level, and increase HDL-cholesterol level.

  18. Sindrome de la cintilla iliotibial: presentación de un caso clínico

    Gómez Verde, Virginia

    2013-01-01

    Introducción: el síndrome de la cintilla iliotibial es un cuadro clínico relativamente frecuente en el ámbito deportivo, sobre todo en personas que participan en actividades físicas de resistencia, principalmente en corredores de fondo y ciclistas. Se caracteriza por dolor agudo en la cara externa de rodilla y se ha asociado con una flexoextensión repetitiva de rodilla en combinación con una banda iliotibial tensa Objetivo: aplicar un plan de intervención fisioterapéutico en...

  19. Osseous involvement in AIDS patients; Comprometimento osseo no paciente com sindrome da imunodeficiencia adquirida

    Marchiori, Edson [Universidade Federal Fluminense, Niteroi, RJ (Brazil). Dept. de Radiologia]|[Universidade Federal, Rio de Janeiro, RJ (Brazil); Pereira, Abercio Arantes [Universidade Federal, Rio de Janeiro, RJ (Brazil). Faculdade de Medicina

    1995-07-01

    The radiological findings of eight patients with the acquired immunodeficiency syndrome (AIDS) who developed bone lesions were analyzed in conjunction with twelve similar published cases. Our series included three patients with lymphoma, two with bacillary angiomatosis, two with tuberculosis and one with staphylococcal osteomyelitis. All the lesions were lithic regardless of the etiology. Both in our cases and in those previously published bone repair was only seen in cases of bacillary angiomatosis treated with erythromycin. No pathognomonic findings were observed. However, the association of skin and bone lesions in immuno deficient patients should always bring the consideration of bacillary angiomatosis in the differential diagnosis. This is particularly relevant since this a condition amenable to treatment once correctly identified. The radiological findings in the lymphoma and tuberculosis patients have not been described previously. (author). 9 refs., 7 figs., 3 tabs.

  20. SINDROME DE APNEAS/HIPOPNEAS DURANTE EL SUEÑO EN EDAD PEDIÁTRICA

    Navazo Eguía A

    2006-08-01

    Full Text Available SUMMARY:Sleep disordered breathing (SDB is a common condition in children. Sleep Apnea/Hypopnea syndrome (SAHS in children is a frequent sleep disorder, with a prevalence estimated to be 1 - 3% of all children. The most frequent cause of SAHS in children is the adenotonsillar hypertrophy. SAHS in children can result in severe complications if left untreated such as impaired physical growth, delayed development, poor school performance and in severe cases, hypertension and cor pulmonale, nevertheless, yet it is an under recognized condition. The gold standard diagnostic technique is the nocturnal polysomnography (PSG, guidelines for performing laboratory-based polysomnography in children have been established, the sleep laboratory should be a nonthreatening environment and personnel with pediatric training should record, score and interpret the study. The diagnostic criteria for SAHS in adults is not useful for diagnosis of SAHS in children. Adenotonsillectomy is the most common treatment for children with SAHS.RESUMEN:Los trastornos respiratorios del sueño en los niños, en particular el Síndrome de Apneas/Hipopneas durante el sueño (SAHS, es una patología frecuente, que afecta entre el 1 - 3% de la población infantil, siendo su causa más frecuente la hipertrofia adenoamigdalar. Es una enfermedad infradiagnosticada y que conlleva importantes complicaciones como son alteraciones del crecimiento, alteraciones cognitivas e incluso en casos severos Cor Pulmonale. La polisomnografía nocturna (PSG, es la técnica diagnóstica de elección para el diagnóstico del SAHS en los niños, pero en la población infantil es necesario tener en cuenta una serie de consideraciones, como son la edad de la población que se estudia, entorno adecuado y la necesidad de técnicos entrenados en el cuidado de los niños. Los criterios diagnósticos del SAHS para adultos no son útiles en los niños. El tratamiento de elección en los niños con SAHS es la adenoamigdalectomia.

  1. Sindrome de Sturge – Weber - Os síndromes raros também existem

    Cátia Canelas

    2015-12-01

    Recorreu ao serviço de urgência por crises convulsivas tónico-clónicas generalizadas quase diárias desde há 1 mês. Ao exame físico o doente apresentava-se pouco colaborante mas hemodinamicamente estável. Ao nível da cabeça eram evidentes diversas alterações: macrocefalia, hipertrofia dos tecidos moles da face com manchas em vinho do porto exuberantes bilaterais com distribuição oftálmica, maxilar e mandibular do nervo trigémio, e hemangiomas conjuntivais bilaterais (Fig. 1. Ao exame neurológico apresentava hemiparesia esquerda grau 3/5 em ambos os membros. Realizou tomografia computorizada crânio-encefálica que mostrou atrofia do hemisfério encefálico direito com calcificação cortical de configuração giriforme de predomínio frontal e occipital e maior volume do plexo coroide do ventrículo lateral direito (Fig.2, aspetos descritos na literatura como característicos de SSW4. Analiticamente sem alterações nomeadamente da função tiroideia. O doente foi observado por oftalmologia tendo sido diagnosticado glaucoma bilateral com perda visual acentuada. Trata-se então de um caso de síndrome de Sturge-Weber tipo I (angiomas da face e das leptomeninges e glaucoma segundo a The Roach Scale, que por falta de seguimento médico apresentava as diversas complicações da síndrome não controladas, convulsões frequentes, perda visual acentuada, história de episódios semelhantes a AVC com hemiparésia sequelar, cefaleias, défice cognitivo e isolamento social. Apesar da forma de apresentação grave com sintomas desde a infância o diagnóstico foi estabelecido numa idade muito pouco comum. A síndrome de Sturge-Weber é uma entidade a ter presente no diagnóstico diferencial das manchas vinho do porto e das crises convulsivas. O diagnóstico precoce e o seguimento/vigilância médica apertada são as únicas formas de melhorar o prognóstico sombrio das manifestações e complicações desta síndrome que são verdadeiramente limitadoras de autonomia no quotidiano.

  2. Nueve casos del sindrome HELLP (hemolisis, enzimas hepaticas Elevadas y plaquetopenia

    M. F. Capellino

    2003-10-01

    Full Text Available El síndrome HELLP (hemólisis, enzimas hepáticas elevadas y plaquetopenia descripto por Weinstein en 1982, se asocia a alta morbi-mortalidad materna y perinatal. Se evaluaron retrospectivamente las pacientes que presentaron síndrome HELLP entre marzo 1998 y marzo 2001 en el Hospital Privado de Córdoba. Se identificaron nueve pacientes con Síndrome HELLP (incidencia 2.3‰. La edad media de las pacientes fue 24.5 años (15-36 con una edad gestacional media de 34.5 semanas (29-40. Cinco pacientes fueron nulíparas. El síntoma principal fue epigastralgia (77.7%. El parto fue por cesárea en siete pacientes y tres tuvieron síndrome HELLP post-parto. Tres pacientes presentaron hipertensión de difícil manejo, una eclampsia y otra coagulación intravascular diseminada, insuficiencia renal aguda y muerte. Tres requirieron transfusión de derivados sanguíneos y el promedio de internación fue 4.4 días. Seis (75% neonatos fueron pretérmino. El peso medio de nacimiento fue 2030 gramos (736-3200. Cuatro recién nacidos tuvieron un score de Apgar menor de 7 al minuto y todos mayor de 7 a los cinco minutos. Tres neonatos presentaron trastornos alimentarios, uno hipoglucemia y otro enfermedad de membrana hialina, ductus arterioso permeable, sepsis y plaquetopenia. Debido a la morbi-mortalidad materna y perinatal el síndrome HELLP requiere atención en un centro de alta complejidad mediante un equipo multidisciplinario.HELLP syndrome (Hemolysis, Elevated Liver Enzymes and Low Platelets was described by Weinstein in 1982. It has a high maternal and perinatal morbi-mortality rate. We undertook this study to evaluate perinatal outcome in patients with HELLP syndrome. Patients with HELLP syndrome were identified in a retrospective study between March 1998 and March 2001 at the Hospital Privado de Córdoba. Maternal and neonatal variables were analized. Nine patients with HELLP syndrome were identified (incidence 2.3‰. Mean maternal age was 24.5 (15-36 years. Five patients were nuliparous. The mean gestacional age was 34.5 weeks (29-40. The main symptom was epigastric pain (77.7%. In seven women delivery was made by cesarean section. Three patients had postpartum HELLP syndrome. Three patients had difficult control hypertension; one had eclampsia and another one had disseminated intravascular coagulopathy with acute renal failure and died. Three women needed blood products transfusions. The average admission time was 4.4 days. There were six preterm infants (75%. Mean birth weight was 2030 g (736-3200. Four neonates had Apgar score 7 at 5 minutes. Three neonates had alimentary disorders, one had hypoglucemia and another hyaline membrane disease, patent ductus arteriosus, sepsis and thrombocytopenia. The high maternal and perinatal morbi-mortality of HELLP syndrome requires management in a centre where intensive maternal and neonatal care are available.

  3. Giperkortitsizm i metabolicheskiy sindrom: slozhnosti differentsial'noy diagnostiki i lecheniya

    2012-06-01

    Full Text Available Hypercortisolism is a severe endocrine disorder that leads to all types of metabolic disturbances. The most frequent symptom of hypercortisolism is a specific weight gain and body fat distribution - "cushingoid" obesity which clinically reflects the pathological changes in protein, carbohydrate and lipids metabolism. We provide a clinical case of a patient with Cushing's disease. This clinical case represents challenges in the differential diagnosis of this rare endocrine disorder and metabolic syndrome, and specific approach in further evaluation and treatment of Cushing's disease that requires all the latest technology in this field to be employed.

  4. Estados de mal epiléptico na sindrome Delennox-Gastaut: aspectos terapeuticos

    José Geraldo Speciali

    1977-09-01

    Full Text Available Foram descritas as condutas terapêuticas utilizadas nos estados de mal epiléptico, convulsivos e não convulsivos, observados em 14 pacientes com síndrome de Lennox-Gastaut. Verificou-se relação temporal entre aparecimento de estado de mal epiléptico e início de tratamento com clonazepam e difenilhidantoina; a retirada dessas medicações foi seguida pelo desaparecimento dos estados de mal. Indicou-se a possibilidade de tratamento dos estados de mal epiléptico modificando-se o esquema terapêutico administrado por via oral, reservando-se o tratamento parenteral para os estados com comprometimento progressivo da consciência e/ou dos distúrbios neurovegetativos.

  5. A sindrome da tensão pre-menstrual : uma abordagem psicanalitica

    Vera Aparecida de Carvalho Zoldan

    2001-01-01

    Resumo: O interesse por esta pesquisa orienta-se sobre as questões surgidas na clinica psicanalítica a partir do atendimento de pacientes vítimas da Síndrome da Tensão Pré-Menstrual (STPM) e suas manifestações sintomáticas, não somente físicas, mas predominantemente psíquicas. Embora seja considerada pela Medicina como uma doença resultante das próprias alterações orgânicas e hormonais associadas ao ciclo reprodutor feminino, a análise psicanalítica revela a existência de relações particularm...

  6. Sindrome confusional agudo por abstinencia aguda de nicotina Delirium due to acute nicotine withdrawal

    Manuel Klein

    2002-08-01

    Full Text Available El síndrome confusional agudo (SCA o delirium en pacientes hospitalizados es un problema frecuente y grave. Se caracteriza por síntomas de comienzo agudo y curso fluctuante con inatención, pensamiento desorganizado, y con distintos niveles de alteración de la conciencia.En la bibliografía consultada, el SCA como manifestación de un síndrome de abstinencia aguda nicotínica fue descripto en solo ocho casos. Presentamos el caso de un tabaquista grave que, internado por una reagudización de su enfermedad pulmonar obstructiva crónica (EPOC, presentó un cuadro de SCA al tercer día de abstinencia tabacal, cediendo los síntomas tras la administración de un parche de nicotina. Lo descripto sugiere que en pacientes internados que presentan SCA y agitación, con fuertes antecedentes de tabaquismo, un simple ensayo con un parche de nicotina puede ofrecer en pocas horas una notable respuesta terapéutica y a su vez un test confirmatorio. El reconocimiento del SCA como forma de presentación de la abstinencia nicotínica permitirá identificar casos habitualmente complejos en los que se podrá implementar una sencilla y eficaz alternativa terapéutica.Delirium or acute confusional state among hospitalized patients is a frequent and serious problem. It is characterized by acute onset symptoms, fluctuating course, impaired attention, unorganized thinking, and altered level of conciousness. Delirium, as a manifestation of acute nicotine withdrawal syndrome has been reported in the reviewed literature only in eight cases. We report the case of a heavy smoker admitted because of a reagudization of his chronic obstructive pulmonary disease. At the third day of nicotine abstinence, he developed delirium with a rapid improvement of his symptoms after treatment with a transdermal nicotine patch. This description suggests that in hospitalized heavy smokers who develop delirium with agitation, a simple trial with a nicotine patch can offer a dramatic therapeutic response in a few hours, constituing additionally a confirmatory test. The recognition of delirium as a manifestation of nicotine withdrawal could allow to determine the origin of symptoms and to apply the appropriate therapy, in certain complex cases that now remain undiagnosed.

  7. Asupan zink dan magnesium makanan dengan disfungsi ereksi pada penderita sindrom metabolik

    Saraheni Saraheni

    2014-01-01

    Full Text Available Background: Metabolic syndrome (MetS is a disease of disorder of lipid and nonlipid metabolism. The West of Scotland Coronary Prevention Study found that men with MetS had probability 3.7 dysfunctions of erection (ED by using International Index of Erectile Function (IIEF. Patient with heart disease had the risk 2 times to get ED, hypertension was 1.5-2 times, DM was 3-4 times, depression was 2-3.5 times, testosterone deficiency syndrome (TDS was 1.5-2 times, and high cholesterol was 4 times. The nutrient deficiency of zinc (Zn and magnesium (Mg was suspected being the main component which had a role in resisting a sexuality growth and maturation process. Objective: Knowing the correlation of Zn and Mg feeding with erection dysfunction in MetS person. Method: This study was observational analytic study, with case-control design in the patient aged 30-60 years old. The respondent in this study was people with MetS according to WHO criterion. There was 82 patient divided into two groups, consist of 41 cases of MetS and ED, 41 cases with the normal patient. The data collected by interview, laboratory assessment and anthropometric measurement. The data analysis using univariate, bivariate and multivariate analysis using multiple logistic regression. Results: There was significant correlation between Zn feeding and ED (OR=7.15; 95% Cl=1.47-34.71; p=0.007 and there was significant correlation between Mg feeding with ED (OR=3.34; 95% Cl=1.07-10.4; p=0.033. The end result of the multivariate analysis showed the risk variable to the ED event, that was Zn feeding with OR=15.41. If the intake of Zn accompanied with risk factors associated as a cause of ED, multivariate analysis showed HbA1c’s degree with OR=12.57; triglyceride (OR=10.47; blood pressure (OR=5.82; and abdominal obesity (OR=6.94. The result shows that these risk factors can aggravate or anticipate the onset of dysfunction erection beside low Zn intake. Conclusion: There was statistically significant correlation between Zn and Mg feeding with erection dysfunction in MetS patient.

  8. SINDROME PARANEOPLASICO EN CANCER DE CABEZA Y CUELLO: REPORTE DE UN CASO

    Danilo Terán Muñoz

    2018-05-01

    Full Text Available Introducción y objetivo:Presentamos el caso de una paciente que presentó un síndrome paraneoplásico como primera manifestación de un carcinoma epidermoide Materiales y Métodos:Varón de 57 años de edad, que  es ingresado en el servicio de neumología por presentar disnea de larga evolución junto a derrame pleural bilateral y artritis en rodillas, carpos y metacarpos de reciente aparición.  Durante su hospitalización presenta eritema y descamación en manos, pabellones auriculares, rodillas y muslos; se objetivó también un mínimo derrame pericárdico.  La analítica de autoinmunidad revelo anticuerpos antinucleares positivos y  Anti Ro positivo, siendo el resto de pruebas normales.  Las lesiones cutáneas son diagnosticadas como queratosis paraneoplásica de Basex.  La exploración física del paciente reveló la presencia de una masa cervical derecha dura y adherida, no objetivándose lesiones faringolaríngeas ni en otras localizaciones.  Se realiza una punción con aguja gruesa de la masa cervical, siendo el resultado del análisis anatomopatológico carcinoma epidermoide.  La lesión es catalogada como metástasis cervical de orígen desconocido. Discusión:Las manifestaciones clínicas sistémicas por los metabolitos de los tumores son denominadas síndromes paraneoplásicos.  Las diferentes metabolitos producidos pueden provocar un amplio abanico de síntomas, generalmente mediados por la acción toxica de las sustancias liberadas por el tumor.  Suelen afectar varios órganos y sistemas: endocrinos, dermatológicos, oculares y osteoarticulares.  Los síndromes paraneoplásicos ocurren en el 1 a 7,4% de todos los pacientes con cáncer, siendo la presentación en las neoplasias de cabeza y cuello infrecuente.  El carcinoma epidermoide es la variante asociada con más frecuencia a este tipo de síndromes, también presentándose con frecuencia en tumores neuroendocrinos,  siendo menor la incidencia en otro tipo de tumores como el adenocarcinoma, carcinoma adenoide quístico, linfomas y sarcomas.  La acroqueratosis paraneoplásica de Basex, fue descrita por primera vez en 1965, siendo asociada a carcinoma del seno piriforme.  Clínicamente se caracteriza por placas cutáneas descamativas eritematosas con predilección en extremidades y es el síndrome paraneoplásico que se presenta más frecuentemente en los tumores de laringe e hipofaringe. Conclusión:Los facultativos que tratan pacientes oncológicos deben ser capaces de diferenciar los síndromes paraneoplásicos de otros desórdenes benignos; estos síndromes pueden dominar el cuadro clínico del paciente llevando a una demora diagnóstica puesto que esta sintomatología eclipsa la patología oncológica de base.  El conocimiento de los síndromes paraneoplásicos es importante porque permite orientar el caso correctamente, para de esta manera realizar un diagnóstico precoz y un tratamiento orientado a la patología  del paciente.

  9. VALIDASI PEMERIKSAAN INFEKSI MENULAR SEKSUAL SECARA PENDEKATAN SINDROM PADA KELOMPOK WANITA BERPERILAKU RISIKO TINGGI

    Endang R. Sedyaningsih Mamahit

    2012-09-01

    Full Text Available Accurate and adequate treatment of STIs is a critical component of STI-control activities to reduce transmission and sequelaes. On the other hand, chronic shortage in skilled staff and laboratory equipment in many countries necessitate the use of clinical skills more in order to diagnose and differentiate STIs. For these places, the WHO has recommended and produced a protocol of it syndromic approach management of STIs in place of treatment by -etiology. Since 1997 the Indonesia Ministry of Health has been conducting national training on this method. However, the syndromic approach for vaginal discharge is known to be problematic since differentiation among cervicitis, vaginitis, and even normal condition is difficult. The main objective of this study is to determine the sensitivity, specificity and positive predictive value of the syndromic approach management of women with signs and/or symptoms of abnormal vaginal discharge. The sample population were women with high risk sexual behaviors in East Java and North Sulawesi provinces. The laboratory tests using DNA hybridization probe technique (the PACE 2 test, Gen-Probe, San Diego, Calif. for Neisseria gonorrhoeae and Chlamydia trachomatis were used as gold standard. In addition, we also compared the clinical approach widely used by clinicians (mainly at hospitals with laboratory results. A total of 439 participants was recruited purposively (230 from E. Java and 209 from N.Sulawesi. In E.Java, the sensitivity, specificity, and predictive value of the syndromic management for vaginal discharge are 31%, 83%, and 59%, respectively, and in N.Sulawesi 49%, 56%, and 40%,respectively. The clinical approach did not show better results. In E.Java the sensitivity, specificity, and positive predictive value are 13%, 89%, and 50%, res­pectively, while in N.Sulawesi they are 42%, 61%, and 39%, respectively. As a conclusion, the current form of syndromic management has little use for STI screening among high risk women. Further studies by adding more criteria to the syndromes are needed to improve this method.

  10. Radiological pulmonary manifestations of acquired immunodeficiency syndrome; Manifestacoes radiologicas pulmonares da sindrome da imunodeficiencia adquirida

    Marchiori, Edson; Melo, Alessandro Severo Alves de; Ossa, Alfonso Jaramillo [Universidade Federal Fluminense, Niteroi, RJ (Brazil). Dept. de Radiologia

    1999-06-01

    In this article are reviewed the principal radiologic manifestations of inflammatory and tumoral diseases the compromise the lungs of patients with acquired immunodeficiency syndrome. In the group of inflammatory diseases the radiologic aspects of pneumocystosis, cytomegalovirus disease, cryptococcosis, tuberculosis and bacterial pneumonias are emphasized. In the neoplasic diseases' group the aspects of lymphoma and Kaposi's sarcoma are specially presented. (author)

  11. CHILD ABUSE IN A MEDICAL SETTING: CASE ILLUSTRATIONS OF TWO VARIANTS OF MUNCHAUSEN SINDROME BY PROXY.

    Antonietta Lanzarone

    2017-04-01

    Full Text Available Munchausen syndrome is a complex type of abuse, which is often underdiagnosed or misdiagnosed in clinical practice, and has harmful consequences for children. Its relationship with child abuse, of which it is a variety, must be recognized in clinical and forensic practice. The authors report herein two observed cases of different types of Münchausen syndrome by proxy (MSbP. The first, is the most severe form of MSbP, with induced, true illness and related pathological symptoms into victim. The second case is a moderate form, much more complex to detect, in which a perpetrator parent simulates and aggravates the child‘s illness. Adequate training of health professionals and investigators is essential in revealing cases of MSbP. Diagnosis must be based on the study of the different forms of "abuse" and the knowledge of clinical protocols used to validate any suspected behaviour which could be potentially harmful to the child. Moreover, a lack of training may lead to misleading interpretations of medical history interpretation and fallacious conclusions. Our study aims to review the features that are to be considered in a suspected case of MSbP, in accordance with a recently updated consensus statement by the Committee on Child Abuse and Neglect from the American Academy of Pediatrics.

  12. Penatalaksanaan Oligodontia pada Anak 14 Tahun dengan Sindrom Ectodermal Dysplasia: Laporan Kasus

    Anie Apriani

    2015-12-01

    Full Text Available Ectodermal dysplasia is a hereditary disorder that is rarely seen with approximately 7000 cases in the world. In this disorder, Ectodermal dysplasia occurs as a developmental disorder of organ structures derived from the ectodermal layer such as hair, teeth, nails, and sweat glands. This is a case report of ectodermal dysplasia in a 14-year-old girl with clinical manifestations of oligodontia (tooth loss, more than 6 teeth on the upper and lower jaw, thin and curly hair, abnormal toenail shape, and impaired excretion of sweat. The purpose of the treatment was to make the patient regains her esthetic and masticatory functions, which were disrupted by the absence of permanent tooth buds, as well as to maintain the normal growth of the developing jaws. Treatment for the patient’s with oligodontia included the use of removable denture in lower jaw and application of acrylic crowns on all upper and lower anterior teeth resulting in improved esthetics and masticatory function. It is concluded that the treatment has been able to improve the esthetics and to return the masticatory function of the patient while maintaining the normal growth of the jaws.

  13. Sindrome de Landau Kleffner aspectos clinicos, eletrencefalograficos e psicossociais : estudo de seguimento a longo prazo

    Marcos Henrique Coelho Duran

    2008-01-01

    Resumo: Objetivos: A Síndrome de Landau-Kleffner (SLK) é uma entidade rara, caracterizada por epilepsia e afasia. Ocorre em crianças com aquisição normal da linguagem, geralmente, entre 3 e 7 anos de idade. A evolução a longo prazo é controversa e pouco estudada. O presente estudo tem como objetivo verificar a evolução em uma série de sujeitos com diagnóstico de SLK, enfocando os aspectos clínicos, eletrencefalográficos, psicossociais e da qualidade de vida. Métodos: Trata-se de um estudo tra...

  14. HUBUNGAN MASA KERJA DAN SIKAP KERJA DENGAN KEJADIAN SINDROM KARPAL PADA PEMBATIK CV. PUSAKA BERUANG LASEM

    Cris Purwandari Mulyawati Agustin

    2014-10-01

    Full Text Available Pembatik merupakan pekerja sektor informal, dimana pada saat membatik melakukan gerakan berulang, gerakan tangan dengan kekuatan, posisi fleksi dan ekstensi, sehingga menyebabkan stress pada jaringan disekitar terowongan karpal. Tujuan penelitian ini untuk mengetahui hubungan masa kerja dan sikap kerja dengan kejadian STK pada pembatik CV. Pusaka Beruang.Penelitian ini menggunakan pendekatan cross sectional. Populasi dalam penelitian berjumlah 68 orang. Sampel penelitian berjumlah 22 responden. Instrument penelitian berupa kuesioner dan pengukuran tes phalen. Data dianalisis dengan uji Chi-square.Hasil penelitian menunjukkan bahwa ada hubungan masa kerja p=0,029 dan sikap kerja p=0,031 dengan kejadian STK. Masa kerja > 4 tahun dan level sikap kerja yang tinggi mempunyai risiko STK karena terjadi stress disekitar jaringan terowongan karpal.Simpulan pada penelitian ini ada hubungan antara masa kerja dan sikap kerja dengan kejadian STK. Saran untuk pekerja diharapkan dapat melakukan istirahat secara teratur setiap 15-20 menit untuk mengurangi risiko STK. Batik is an informal sector workers describe or designed batik with the traditional way of working. Which time both do repetitive motion, hand movements with strength, position, position the extension and flexion, hand static, thus causing stress on the network around the carpal tunnel. The purpose of this research is to know the relation tenure and working attitude with STK batik meker in CV. Pusaka Beruang. This research uses the approach of cross sectional. The population in this research is totalling 68 peoples. Sample research amounted to 22 respondents. Research Instrument in the form of questionnaires and measurement test phalen. Data were analyzed by Chi square test. The results showed that there was a relationship tenure p = 0.029 and working attitude p = 0.031 with STK events. Tenure > 4 years and a high level of work attitudes have STK risk due to stress around the carpal tunnel syndrome network.The conclusions in this study no relationship tenure and work attitude with STK. Advice for workers expected to perform regular breaks every 15-20 minutes to reduce the risk of STK.

  15. Upaya Peningkatan Tingkat Pengetahuan Siswi MAN 2 Palembang Mengenai Sindrom Pra Menstruasi

    Muhammad Aditya Alfarizki

    2017-03-01

    Full Text Available Premenstrual syndrome characterized by affective, physical, and behavior symptoms with moderate to severe grade, that usually recurrent every luteal phase of menstrual cycle and disappear within menstruation. The frequency of premenstrual syndrome is still high, in Indonesia and all over the world. To overcome this situation, there should be a health promotion. The aim of this community service was to increase the girl’s knowledge of premenstrual syndrome. This community service was held in one day on November 2016 in public islamic high school MAN 2 Palembang. The schedule was start with pre test consist of 15 questions, counseling sesssion using power point media, discussion session, and post test consist of the same questions to measure the knowledge after counseling. Pre test score showed that 13.9% students had good knowledge and post test score showed an increase of good knowledge (66.7%. Conclusion, heatlh education through counseling method bring a change of knowledge.

  16. Aktivitas Olahraga dengan Kejadian Sindrom Premenstruasi pada Anggota Perempuan UKM INKAI UNS

    Arantika Meidya Pratiwi

    2016-03-01

    Full Text Available The purpose of this study is to determine the relationship between sport activies with premenstrual syndrome. Observational research methods using analytic techniques with cross sectional approach. This research was conducted at UKM (Unit of Student Activity INKAI (Institute Karate Indonesia UNS, on June 2012. The 36 sample of population from 40 of woman member was taken by simple random sampling. Analysis test with alpha= 0,05 obtained of Spearman rank correlation value at -0,821 that indicated strengthen correlation in negative direction. The signifi cance value are 0,000 smaller than 0,05 that indicated Ho was rejected and Ha was accepted. The conclusion are any negative relationship between sports activities with the premenstrual syndrome, if the value of sports activity was higher the value of premenstrual syndrome was lower.

  17. EFECTOS DE LA METFORMINA EN EL SINDROME DE OVARIO POLIQUISTICO ASOCIADO A INSULINO RESISTENCIA

    Caro,Claudio; Fuhrer,Juan; Sáez,Rodrigo; Rubio,Víctor; Moreno,Luis; Cumsille,Miguel

    2002-01-01

    Se presenta la experiencia clínica del uso de metformina (1,7 g día), por 4 meses, en 11 pacientes con (SOP) asociado a resistencia insulínica. Se determinaron los efectos clínicos, bioquímicos y hormonales luego de 4 meses de terapia. Cinco de las pacientes que deseaban embarazo, continuaron recibiendo la droga, hasta por un año. Se evaluó durante el tratamiento los síntomas clínicos, historia menstrual, hirsutismo; y los niveles séricos de gonadotrofinas, andrógenos, globulina ligante sexua...

  18. Il cinema di Pasolini e la morte: tra complesso della mummia e sindrome di Frankenstein

    Tomaso Subini

    2010-10-01

    Full Text Available Cinema's ability to defeat death by stopping the run of time is written inside its own statute. Confiding on this capacity, Pasolini devotes his filmic work to the theme of death (interrogated through Christ's myth and elaborates a linguistic theory (strictly linked to the performative aspects of his artistic work to give an explanation of death through a filmic metaphor.

  19. Evaluation of the in vitro biocompatibility of polymeric materials for the regeneration of cutaneous tissue; Evaluacion de la biocompatibilidad in vitro de materiales polimericos para la regeneracion de tejido cutaneo

    Escudero Castellanos, A.

    2016-07-01

    The problems associated with medical cases of functional tissue loss or organ failure are destructive and expensive, even more frequent than could be perceived, sometime if not properly treated, even deathly. Tissue engineering is an interdisciplinary field that emerged to address these clinical problems, it is based on researching and development of biomaterials that have evolved along with areas such as cell biology, molecular and materials science and engineering. Today, the technique is based on seeding cells onto prefabricated scaffold biomaterials, like the hydrogels, that are three-dimensional networks with hydrophilic properties. These materials are characterized as being porous and sticky, favoring the support for the proliferation of certain cells in order to lead the regeneration of injured tissue. As a prerequisite for the use of materials in tissue engineering is testing biocompatibility which is the ability of the bio material to allow contact with any tissue, existing a favorable host response, accepting it as their own and restoring previously lost function. The first step for evaluating biocompatibility is to perform the in vitro assays. These assays have been demonstrated more reproducibility and predictability than in vivo assays, therefore the in vitro assays are used to produce high quality scaffolds and testing on animals as less as possible. This test is essential to establish the benefits and limitations of biomaterials tested in order to improve the scaffolds. This work will focus on assessing the biocompatibility of three polymeric materials with potential use in tissue engineering by means of cytological compatibility tests and hemo compatibility tests. Furthermore, disinfection techniques and gamma sterilization were evaluated to produce sterile materials that can be used in tissue engineering. (Author)

  20. Importance of gallium-67 scintigraphy in primary cutaneous B-cell lymphoma: report of two cases;Importancia da cintilografia com galio-67 no linfoma cutaneo primario de celulas B: relato de dois casos

    Attab, Cyomara Sanches, E-mail: rubinha.attab@terra.com.b [Centro Brasileiro de Medicina Nuclear (CEBRAMEN), Goiania, GO (Brazil); Moriguchi, Sonia Marta [Fundacao Pio XII, Barretos, SP (Brazil). Hospital de Cancer; Paton, Eduardo Jose Alencar [Fundacao Pio XII, Barretos, SP (Brazil). Cancer Hospital. Div. of Hemotherapy and Bone-Marrow Transplant; Alencar, Mario Henrique Leite de [Clinica de Prevencao em Cancer, Goiania, GO, (Brazil); Rocha, Euclides Timoteo da [Fundacao Pio XII, Barretos, SP (Brazil). Cancer Hospital. Dept. of Nuclear Medicine

    2010-05-15

    The authors describe two cases of cutaneous B-cell lymphoma where correct staging, treatment and follow-up could be achieved through a combination of conventional imaging studies and gallium-67 scintigraphy. (author)

  1. Miofacialni bolečinski sindrom in sindrom fibromialgije: Myofascial pain syndrome and fibromyalgia syndrome: Nonpharmacological treatment of chronic low back pain: practice and possibilities for treatment: razlikovanje v klinični praksi in možnosti obravnave:

    Jamnik, Helena

    2010-01-01

    Fibromyalgia is a chronic syndrome that is characterized by widespread body pain. The prevalence of fibromyalgia syndrome in the general population is estimated to be 2-7%. Chronic pain is often associated with comorbidities suchas depression, chronic fatigue, anxiety. With the new evidence regarding the pathophysiology of the fibromyalgia syndrome, it has been suggested that it may be one of the neuropathic pain syndromes. Although the pathogenesis is not completely understood, it has been s...

  2. Untitled

    Elamin

    and magnesium salts in the skin, neither serum phosphate nor other tests of bone and ... Therefore, local therapy with capsaicin creams, gabapentin and the novel .... both dry skin and loss of cutaneos barrier (protective) function, reflected by.

  3. Hallervorden Spatz syndrome: magnetic resonance findings. Case report; Sindrome de Hallervorden Spatz: achados na ressonancia magnetica. Relato de caso

    Farage, Luciano; Castro, Mario Augusto Padula; Macedo, Tulio Augusto Alves [Universidade Federal de Uberlandia, MG (Brazil). Hospital de Clinicas. Setor de Radiologia; Assis, Marcelo Cardoso de [Universidade Federal de Uberlandia, MG (Brazil). Faculdade de Medicina. Dept. de Cirurgia; Souza, Lincoln Pereira de; Freitas, Luiz Oliveira de [Universidade Federal de Uberlandia, MG (Brazil). Dept. de Clinica Medica

    2004-09-01

    Hallervorden-Spatz syndrome is a neuro degenerative disease, autosomic recessive with two clinical features: early and late onset. Psychiatric, pyramidal and extrapyramidal signs are present in the late subtype. We report the case of a 41-old woman with extrapyramidal signs. Magnetic resonance imaging (MRI) showed the eye-of-the-tiger sign in the medial globus pallidus. This is due to a gliosis (increased signal) and accumulation of surrounding iron (decreased signal intensity) in long T R sequences. There is a strong relationship between MRI findings and the gene mutation responsible for this disease. It makes the MRI sensible for diagnosing this syndrome. (author)

  4. Sindrome de encefalopatia posterior reversível: relato de caso Reversible posterior encephalopathy syndrome: case report

    Francine Judith Freitas Fernandes

    2002-09-01

    Full Text Available A encefalopatia posterior reversível é uma síndrome aguda / subaguda geralmente causada pela encefalopatia hipertensiva, eclâmpsia, neurotoxicidade a ciclosporina-A, encefalopatia urêmica e púrpura trombocitopênica trombótica.. A maioria dos pacientes apresenta elevação acentuada dos níveis tensionais outros, níveis moderados ou normais. Os sintomas são progressivos e compreendem cefaléia, diminuição do nível de consciência, crises epilépticas e distúrbios visuais. A sintomatologia regride completamente se corrigidas em tempo as causas determinantes, caso contrário, podem instalar-se danos irreversíveis como a cegueira cortical e morte. A tomografia computadorizada (TC e, sobretudo, a ressonância magnética (RM contribuem para o diagnóstico. Tais métodos evidenciam edema da substância branca e cinzenta, principalmente das regiões parieto-occipitais. Os achados podem apresentar dificuldade no diagnóstico, hoje superado em parte, com a técnica de difusão pela RM, capaz de diferenciar edema citotóxico de vasogênico. Apresentamos um caso de encefalopatia posterior reversível decorrente de encefalopatia hipertensiva estudada com TC e RM.The posterior reversible leukoencephalopathy syndrome (PRES is a recently proposed cliniconeuroradiologic entity.The most common causes of PRES are hypertensive encephalopathy, eclampsia, cyclosporin A neurotoxicity and the uremic encephalopathies.Most patients are markedly hypertensive at presentation, although some have only middly elevated or even normal blood pressure. Symptoms may include headache, nausea , vomiting, altered mental status, seizures,stupor, and visual disturbances. On CT and MR studies, edema has been reported in a relatively symmetrical pattern, typically in the subcortical white matter and occasionally in the cortex of the occipital and parietal lobes. These often striking imaging findings usually are resolved on follow-up studies obtained after appropiate therarapy. Diffusion-weighted images would not show hyperintense signal because of the presence of interstitial rather than cytotoxic edema. We report a case of PRES due to hipertensive encephalopathy studied by CT and MRI.

  5. Aicardi syndrome: a case report and radiologic findings; Sindrome de Aicardi: relato de caso e achados radiologicos

    Granzotto, Enrico; Prado, Cecilia Hissae Miyake Almeida; Barros, Andre Della Barba; Botter, Carlos Eduardo [Clinica Radiologica Documenta Ltda., Ribeirao Preto, SP (Brazil)]. E-mail: gram79@gmail.com; Mendes, Rozana de Miranda [Santa Casa de Ribeirao Preto, SP (Brazil); Granzotto, Ticiana [Curso de Especializacao em Oftalmologia Professor Ivo Correa Meyer de Porto Alegre, RS (Brazil)

    2008-07-01

    The authors report the findings of Aicardi syndrome, a disease of unknown etiology composed of multiple spasms, chorioretinal lacunae and agenesis of the corpus callosum. They present a case of Aicardi syndrome with characteristic clinical presentation and magnetic resonance imaging findings. The disease, despite being considered rare, has characteristic imaging findings. Over the past years magnetic resonance imaging has improved its ability in demonstrating other findings besides agenesis of the corpus callosum, making the radiologist's role very important in the diagnostic suspicion of this disease. (author)

  6. Sobre la concepcion del sindrome piramidal y del componente yuxtapiramidal despues de 21 años

    Luis Barraquer-Bordas

    1973-12-01

    Full Text Available Tal como hemos venido manteniendo desde 1952, nos parece justo distinguir dentro del todo del sndrome piramidal un aspecto, diferenciado con suficiente claridad, al que propusimos llamar "yuxtapiramidal". Una nomenclatura científica es, ante todo, un sistema de convenciones — lo más fundamentadas que sea posible — sobre las que es necesario mantener un acuerdo para extraer de ella una utilidad operativa. El término "piramidal" no es mucho más inexacto que muchos otros empleados en Medicina. Ciertamente, si queremos tomar por referencia la palabra ecológicamente originaria, que en este caso es la pirámide bulbar, las dificultades aparecen como serias y considerables. Pero si tenemos en cuenta que a la proyección piramidal pura u ortopiramidal o córtico-espinal directa, va estrechamente aparejado el sistema anátomo-funcional que parece ser crucial en la inhibición del reflejo miotático o de tracción, esto es, la proyección córtico-bulbo(retículo-espinal, que nosotros venimos calificando (desde 1952 de "proyección yuxtapiramidal", facilmente nos daremos cuenta que ambos forman un todo, dispuesto longitudinalmente a lo largo del neuroeje, que mantiene una indudable unidad funcional, sobre todo una "unidad de afectación ante los procesos morbosos que los atañen". La dificultad de la nomenclatura proviene, en gran parte, del hecho de haber querido denominar un "sistema longitudinal" por el nombre de un "accidente casi-transversal" interpuesto en un punto determinado y concreto de su curso: la pirámide bulbar, la cual parece abarcar solamente el "componente mayor" de aquel sistema, con exclusión del otro, del yuxtapiramidal". Las aportaciones experimentales recientes de Asbhy y col. y del grupo de Lance, al confirmar lo esencial de las viejas experiencias de Magoun e col., otorgan, a nuestro juicio, una validez renovada a nuestra concepción de un "sistema yuxtapiramidal", inhibidor del reflejo de tracción. De la afectación de las funciones de este sistema derivarian la espasticidad y la exaltación de los reflejos musculares clinicos. El modo como ello tiene lugar parece ser muy complejo y aún variable de unos a otros casos. Habiendo dedicado a esta cuestión otros estudios recientes de revisión (1972, 1973, no hemos querido entrar aqui en esta materia. Pero si que queremos concluir reafirmando que sigue pareciendonos útil emplear todavia el término de "síndrome piramidal" siempre y quando se tenga en cuenta lo que dentro de él traduce la interferencia del "componente yuxtapiramidal", cuya afectación aislada no encontramos nunca o casi nunca en clínica humana. Una actitud como la que proponemos es, evidentemente, una suerte de "compromisso", pero el progreso de la ciencia clínica está montado, en gran parte, sobre compromisos de esta índole. Y nadie pretende que sean "definitivos".

  7. AIDS related thoracic lymphoma: evaluation by computed tomography; Linfoma toracico na sindrome da imunodeficiencia adquirida: avaliacao por tomografia computadorizada

    Siciliano, Antonio Alexandre de Oliveira [Hospital Universitario Clementino Fraga Filho, Rio de Janeiro, RJ (Brazil). Servico de Radiodiagnostico; Marchiori, Edson [Universidade Federal, Rio de Janeiro, RJ (Brazil). Curso de Pos-graduacao em Radiologia

    2000-02-01

    The authors reviewed five cases of patients with acquired immunodeficiency syndrome (AIDS) related lymphoma to describe the thoracic findings on computed tomography. The patients were followed at Hospital Universitario Clementino Fraga Filho, Hospital Universitario Antonio Pedro and Hospital da Lagoa, from November, 1989 to March 1998. Epidemiological, clinical and pathological data from these patients were quiet variable and pulmonary nodules and masses, hilar and mediastinal lymphadenopathy, and thoracic wall masses were observed. AIDS related lymphomas involving the chest are pleomorphic and most commonly extranodal. (author)

  8. Isolated Richter's syndrome in central nervous system: case report Sindrome de Richter isolada em sistema nervoso central: relato de caso

    Lucilene S.R. Resende

    2005-06-01

    Full Text Available Diffuse large cell non Hodgkin's lymphoma associated with chronic lymphoid leukemia (CLL, or Richter's syndrome, is a rare and serious complication. Isolated Richter's syndrome in the central nervous system is very rare; only 12 cases have been reported. We describe a 74-year-old patient with diffuse large cell non Hodgkin's lymphoma in the right frontal region with the appearance of multiform glioblastoma.Linfoma não Hodgkin difuso de grandes células em paciente portador de leucemia linfóide crônica (LLC, ou síndrome de Richter, é complicação rara e grave nesta leucemia. Síndrome de Richter isolada no sistema nervoso central é muito rara, tendo sido encontrados apenas 12 casos descritos. Descrevemos paciente de 74 anos, que apresentou linfoma não Hodgkin difuso de grandes células em região frontal direita, simulando glioblastoma multiforme.

  9. Sindrome "cabeça de pássaro" de Seckel: estudo pneumencefalografico e hormonal de um caso

    Israel Salmen Schulz

    1975-09-01

    Full Text Available Relato de um caso de síndrome de Seckel apresentando resultados pneumencefalográficos e hormonais dignos de registro. As dosagens hormonais indicaram a existência de um distúrbio na atividade do hormônio de crescimento, havendo estímulo acima do normal do H.G.H. e inatividade sobre a curva dos ácidos graxos não saturados. O registro pneumencefalográfico de atrofia das circunvoluções cerebrais é o primeiro a ser publicado em paciente com síndrome de Seckel, podendo ser considerado como uma confirmação dos achados anátomo-patológicos relatados por McKusick (mierocefalia pongidea.

  10. Sindrome do encarceramento (locked-in syndrome): registro de um caso e revisão de literatura

    Miguel Farage Filho; Mauro de Paiva Gomes

    1982-01-01

    É relatado um caso de síndrome do encarceramento (locked-in-syndrome) em paciente que apresentou quadro súbito de tetraplegia, anartria, movimentos oculares verticais e piscar além de preservação do nível de consciência. Explicação para tal quadro clínico é uma lesão na ponte junto ou sobre o núcleo do nervo abducente seccionando os tratos córtico-espinhal e córtico-bulbar, sem atingir a substância reticular do mesencéfalo. Três EEG revelaram distúrbio projetado por provável lesão do tronco c...

  11. Sindrome do encarceramento (locked-in syndrome: registro de um caso e revisão de literatura

    Miguel Farage Filho

    1982-09-01

    Full Text Available É relatado um caso de síndrome do encarceramento (locked-in-syndrome em paciente que apresentou quadro súbito de tetraplegia, anartria, movimentos oculares verticais e piscar além de preservação do nível de consciência. Explicação para tal quadro clínico é uma lesão na ponte junto ou sobre o núcleo do nervo abducente seccionando os tratos córtico-espinhal e córtico-bulbar, sem atingir a substância reticular do mesencéfalo. Três EEG revelaram distúrbio projetado por provável lesão do tronco cerebral, e que foi confirmada pelo CAT SCAN. Arteriografia vertebral mostrou grau avançado de aterosclerose. Com tratamento clínico conservador o paciente teve ótima evolução.

  12. A Classificacao Internacional de Doencas, a Familia de Classificacoes Internacionais, a CID-11 e a Sindrome Pos-Poliomielite

    Ruy Laurenti

    2013-09-01

    Full Text Available The first International Classification of Diseases (ICD was approved in 1893 and since then it has been periodically reviewed. The last, 10th revision (ICD-10, was approved in 1989. Since 1989, it was possible to update from ICD revisions, which did not happen before. The next revision (ICD-11 would probably be published in 2015. In 1989, mechanisms were established to update ICD-10, through the creation of the Morbidity Reference Group (MbRG in 1997 and the Update and Revision Committee (URC in 2000. The Morbidity Reference Group (MbRG was created in 2007 to discuss in more detail the issues to update morbidity. A specific code in ICD was not included in the revision of ICD-10 in 1989 for the post-polio syndrome (PPS. However, the ICD new code G14 for PPS was included in ICD-10 since 2010.

  13. Down Syndrome: General Information. Fact Sheet Number 4 = El Sindrome de Down: Informacion General. Fact Sheet Number 15.

    Interstate Research Associates, McLean, VA.

    This fact sheet on Down Syndrome is offered in both English and Spanish. First it provides a definition and description of this syndrome, noting its etiology in a chromosomal abnormality. Incidence figures are then given. Typical characteristics of people with Down Syndrome are listed. Commonly associated health-related problems are noted,…

  14. Analise do movimento de arremessar em diferentes tarefas realizadas por crianças portadoras de Sindrome de Down

    Marli Nabeiro

    1993-01-01

    Resumo: Este estudo teve por objetivo investigar o comportamento motor, através do arremesso por cima, de crianças portadoras de Síndrome de Down, com deficiência mental em nível moderado. Tal situação visa verificar o nível de desenvolvimento e a influência do ambiente sobre o comportamento motor. Participaram do estudo 27 crianças portadoras de Síndrome de Down, com idade entre 8 e 12 anos, alunos do Setor Educacional do Centro de Habilitação da APAE, que foram filmadas na execução do movim...

  15. Profilaxia da anemia ancilostomótica: sindrome de carencia Prophylaxis of Hookworm Anemia-carencial syndrome

    W. O. Cruz

    1945-04-01

    Full Text Available É apresentada uma revisão das recentes aquisições na anemia ancilostomótica, assinalando a importância de alimentação qualitativamente deficiente junto á infestação helmíntica na gênese desta doença. Acentuou-se que a anemia ancilostomótica é uma doença de carência. Profilaxia clássica da Ancilostomose resume-se em evitar a infestação do homem pelos ancilostomídeos. Critica-se a aplicabilidade destas medidas e eficiência das mesmas no que diz respeito á incidência da anemia. O presente trabalho mostra aquisições preliminares sôbre fundamentos de uma profilaxia de carência (tipo profilaxia do bócio endêmico da anemia ancilostomótica, baseada na administração de alimentos contaminados por um sal de ferro. As misturas sulfato ferroso-farinha de mandióca e citrato férrico amoniacal-caldo de feijão, mostraram-se eficientes em prevenir a queda das cifras hemáticas durante largos períodos de tempo em indivíduos maciçamente infestados (6-8 meses. Não foi verificada a dose diária mínima eficiente dêstes sais, obtendo-se resultados satisfatorios mesmo com 0.1 g diária de sulfato ferroso (correspondendo a 0.037 g de ferro metálico. Numerosos alimentos e sais de ferro foram experimentados com resultados infrutíferos por diferentes razões. A influência dos helmintos, pela hemorragias intestinais que acarretam poude ser mais uma vez estudada, nos casos de sais de ferro administrados em doses ineficientes ou em períodos de prova sem medicação marcial. É proposta nova classificação de intensidade de infestação, levando em consideração o conhecido fato de ser a atividade dos helmintos, exclusivamente expoliadora. Em conclusão, nos parece exequível a profilaxia da anemia ancilostomótica mediante ingestão de alimentos contaminados por quantidades eficientes de sais de ferro. Êste método profilático extremamente econômico será na prática, provàvelmente, muito superior aos métodos de profilaxia anti-helmíntica, que além de onerosos são pouco práticos, pois interferem em hábitos enraizados nas populações rurais.A review of the recent advances in the mechanism of hookworm anemia is presented, pointing out the importance of a qualitatively defective nutrition in the genesis of this disease. The carencial aspect of hookworm anemia is emphasized. The accepted prophylaxia of hookworm disease limits itself to avoiding human infestation by the ancylostomidae. This method is criticized as a pratical means of eradicating the anemia in rural population. This paper deals with preliminary studies to build up a carencial type of prophylaxis in hookworm anemia (as in prophylaxis of endemic goitre based on the administration of iron salts, in the food usually consumed in Brazil. The mixtures ferrous sulphate and mandioca flour or amoniacal ferric citrate and baked beans, have been able to prevent anemia in patients heavely infested. during long periods of time (6-8 months. the minimus efficient daily doses of iron needed to maintain normal blood levels have not been precisely ascertained, but even 0.1 g of ferrous sulphate (37 mg of metalic iron daily in mandioca flour was satisfatory for that purpose. Different foods and iron salts have been tried with no results, for different reasons. When iron salts were administered in insufficient doses, the progressive evolution of the anemia was observed in detail. In conclusion the use of iron salts in suficient quantities mixed to usual food is advised as a prophylatic method is hookworm anemia. A campaign of this type can be accomplished at extremely low cost, and probably has definite advantages over the classical prophylaxis, whose methods interferes with rooted habits of people of rural areas and therefore give very poor practical results.

  16. Sindrome peri-silviana bilateral não relacionada a malformações: relato de dois casos

    Grasel, Ralf Paulo; Carvalho Neto, Arnolfo; Bruck, Isac; Antoniuk, Sérgio A.

    1996-01-01

    In this case report we present the neuroimaging findings and clinical features of two patients with a bilateral perisylvian syndrome not related to malformations, but probably to ischemic etiology. Evaluations including history, general and neurologic examinations, electroencephalograms, and imaging data were reviewed as recent literature about the subject.Neste relato de caso, apresentamos os achados de neuroimagem e os aspectos clínicos de dois pacientes com síndrome peri-silviana bilateral...

  17. EVALUACIÓN Y PREVENCIÓN DEL SINDROME DE BOURNOUT EN LA POBLACION DOCENTE DEL NGC.

    Pinzón-Espitia, Ana Ruth

    2012-01-01

    A partir de los estudios de estrés llevados a cabo desde los años sesenta, se llega al concepto Burnout, trabajo que desarrolla Freudenberger (1974). Pero realmente las investigaciones en el tema y los desarrollos asociados al concepto de Burnout establecido por Freudenberger se multiplican de manera significativa después de la década de los 801. Burnout, término Inglés que se traduce como quemarse, gastarse, agotarse, fatigarse, consumido, apagado, fundido. El “INSHT NTP 704(1)” (Instituto n...

  18. Efek Konsumsi Suplemen Kalsium dan Magnesium terhadap Dismenore Primer dan Sindrom Premenstruasi pada Perempuan Usia 19–23 Tahun

    Fen Tih Fen Tih

    2017-12-01

    Dysmenorrhea is a menstrual disorder with the greatest prevalence followed by premenstrual syndrome that includes physical and psychological symptoms. Micronutrients intake of calcium and magnesium can help overcome these complaints. This research was conducted to find out the effect of calcium and magnesium supplements consumption on dysmenorrhea and premenstrual syndrome symptoms in 19–23 years old women. This was quasi experimental research with pre- and post-test design. The research was conducted in Maranatha Christian University Bandung from July to December 2016. The subjects of research were 60 women aged 19–23 years old, divided into two groups randomly. One group given calcium (1,000 mg/day or magnesium (250 mg/day, which was given at the second day of menstruation until the next menstrual cycle. Serum levels of calcium or magnesium were measured with spectrophotometry method. Dysmenorrhea was measured with visual analog scale (VAS, whereas score of premenstrual syndrome was measured with shortened premenstrual assessment form, before and after treatment. The consumption of calcium lowers the VAS score average on dysmenorrhea from 6.97 to 3.80 (p=0.000** and the mean score of premenstrual syndrome from 15.07 to 10.80 (p=0.000**. Consumption of magnesium reduces the VAS score average on dysmenorrhea from 7 to 4 (p=0.000** and the mean score of premenstrual syndrome from 12.27 to 9.87 (p=0.001**. In conclusion, consumption of calcium or magnesium supplements reduce dysmenorrhea and premenstrual syndrome in women aged 19–23 years old.

  19. Avaliação da tolerância e nefrotoxicidade do antimonial pentavalente administrado na dose de 40mg Sb v/kg/dia, de 12/12h, por 30 dias na forma cutaneo-mucosa de leishmaniose

    Raimunda N.R. Sampaio

    1997-12-01

    Full Text Available Foi avaliada a função renal de 11 pacientes com leishmaniose cutâneo-mucosa tratados com antimonial pentavalente na dose de 40mg SbV/kg/dia aplicada de 12/12 horas, em esquema contínuo, durante trinta dias. No estudo, um paciente apresentou insuficiência renal reversível e dois desenvolveram alterações enzimáticas hepáticas e eletrocardiográficas sendo o esquema terapêutico interrompido. Nos demais pacientes observou-se efeitos nefrotóxicos tais como diminuição da taxa de filtração glomerular, diminuição da capacidade de concentração urinária, avaliada por um jejum hídrico de 16 horas e aumento na fração de excreção de sódio. No exame do sedimento urinário observou-se um aumento no número de leucócitos e cilindros. Os resultados encontrados neste estudo sugerem que o tratamento com antimonial pentavalente na dose de 40mg SbV/kg/dia foi menos tolerado em virtude de seus efeitos tóxicos, não parecendo apresentar índice de cura superior ao esquema atualmente preconizado de 20mg SbV/kg/dia.The renal function of eleven patients with mucocutaneous leishmaniasis was analyzed in a prospective study realized at the School Hospital of University of Brasília. The patients were treated with doses of 40mg/kg/day of pentavalent antimony (SbV, in a continuous scheme during thirty days. In this study three patients were excluded, one patient with reversible renal failure and two patients with hepatic and cardiac malfunctions. In the other eight patients, severe nephrotoxics effects were observed, like reduction of glomerular filtration rate, reduction of the urinary concentration capacity, evaluated by a sixteen hours hydric fasting and an increase of sodium fractional excretion. An increase in the number of leucocytes and cylinders were observed at the urinary sediment exam. Finally, the results shows that the treatment with pentavalent antimony in doses of 40mg Sb/kg/day was less tolerated on account of its renal toxics effects. This scheme seems not be superior than the currently preconized scheme of 20mg of SbV/kg/day during 30 days.

  20. Tracheobronchomegaly (Mounier-Kuhn syndrome) - case report and review of the literature; Traqueobroncomegalia (sindrome de Mounier-Kuhn) - relato de caso e revisao da literatura

    Nobrega, Bruno Barcelos da; Figueiredo, Sizenildo da Silva; Ribeiro, Ronei Edmar; Teixeira, Kim-Ir-Sem Santos [Goias Univ., Goiania, GO (Brazil). Hospital das Clinicas. Dept. de Diagnostico por Imagem e Anatomia Patologica]. E-mail: brunoradiol@hotmail.com; Cavalcante, Luciana Porto [Goias Univ., Goiania, GO (Brazil). Faculdade de Medicina

    2002-06-01

    Tracheobronchomegaly is a rare condition of uncertain etiology characterized by marked dilatation of the trachea and main bronchi, bronchiectasis and recurrent respiratory tract infections. Clinical presentation is nonspecific and the diagnosis is usually made by imaging methods. We report a case of a patient with tracheobronchomegaly. Diagnosis was confirmed by plain X-ray films and computed tomography of the chest. (author)

  1. PACIENTES POLICONSULTANTES EN LOS SERVICIOS DE PEDIATRÍA: TRASTORNOS DE SOMATIZACIÓN Y TRASTORNO FACTICIO POR OTROS (SINDROME DE MÜNCHAUSEN BY PROXY

    Dr. Ricardo García

    2017-11-01

    Se destaca la necesidad de evaluación integral multidisciplinaria, integrando a un psiquiatra de niños y adolescentes de enlace, que permita intervenciones clínicas preventivas que incluya la familia, pesquisa temprana de los trastornos mencionados y estrategias de intervención que permitan la protección, bienestar del niño, el adolescente y su familia, evitando la transmisión intergeneracional de estos trastornos.

  2. Doença oclusiva progressiva das artérias cerebrais associada a sindrome de Down: registro de um caso

    Israel Salmen Schulz

    1980-06-01

    Full Text Available Registro de um caso que pode ser o segundo na literatura mundial de associação de "moyamoya" com síndrome de Down, caracterizando-se pela permeabilidade das artérias carótidas internas, cerebrais médias e anteriores. O comprometimento da circulação distai poderia levantar a possibilidade de uma alteração da microcirculação capilar e, inclusive, da ação de alguma substância não determinada, fatores que poderiam explicar a localização e bilateralidade das lesões.

  3. Magnetic resonance imaging findings in patients with Hallervorden-Spatz syndrome; Achados de ressonancia magnetica na sindrome de Hallervorden-Spatz

    Nomura, Cesar Higa; Lima, Eduardo Carneiro; Cerri, Giovanni Guido; Leite, Claudia da Costa [Sao Paulo Univ., SP (Brazil). Faculdade de Medicina. Dept. de Radiologia; Rosemberg, Sergio [Sao Paulo Univ., SP (Brazil). Faculdade de Medicina. Dept. de Patologia

    2003-12-01

    The objective of this study was to review the magnetic resonance imaging findings in patients with Hallervorden-Spatz syndrome. We evaluated eight patients with Hallervorden-Spatz syndrome using magnetic resonance imaging. The protocol included at least sagittal and axial T1-weighted images and axial and coronal T2-weighted images. Intravenous gadolinium was administered in a dose of 0.1 mmol/kg. Post-enhanced images were obtained at least in the axial and coronal planes. The results were: all patients presented a bilateral and symmetrical 'tiger-eye signal' on T2-weighted images, corresponding to central hyperintensity and peripheral hypointensity in the globi pallidus. FLAIR and diffusion images showed similar abnormalities. There was no gadolinium enhancement in any of the cases. We concluded that magnetic resonance imaging findings in patients with Hallervorden-Spatz syndrome are very typical and allow the diagnosis of the disease. (author)

  4. Poland's syndrome - a case report and review of the literature; Sindrome de Poland - relato de um caso e revisao da literatura

    Carvalho, Antonio Carlos Pires [Universidade Federal, Rio de Janeiro, RJ (Brazil). Faculdade de Medicina. Dept. de Radiologia; Nogueira, Adilson Gomes [Colegio Brasileiro de Radiologia, Sao Paulo, SP (Brazil); Nogueira, Juliana Elen; Beze, Rodrigo Santos. E-mail: acpcrj@hucff.ufrj.br

    2000-12-01

    The authors report the case of a patient with congenital anomalies of the left hand associated with total absence of the pectoralis minor muscle and partial absence of the pectoralis major muscle. The radiological findings were assessed and the literature was reviewed. (author)

  5. Hepatopulmonary syndrome in a patient with AIDS and virus C cirrhosis (viral cirrhosis type C); Sindrome hepatopulmonar em paciente com cirrose por virus C e SIDA

    Ferreira, Maria Angelica; Gazzana, Marcelo Basso [Hospital de Clinicas de Porto Alegre, RS (Brazil). Servico de Pneumologia; Barreto, Sergio Saldanha Menna; Knorst, Marli Maria [Rio Grande do Sul Univ., Porto Alegre, RS (Brazil). Faculdade de Medicina. Dept. de Medicina Interna

    2001-02-01

    Hepatopulmonary syndrome is characterized by a triad consisting of liver disorder, pulmonary vascular dilatation, and hypoxaemia. No case of hepatopulmonary syndrome associated with AIDS has been reported so far. In this study, the authors report the case of a 43-year woman with AIDS and virus C cirrhosis taking prophylactic cotrimoxazole for pneumocystosis and retroviral therapy. Upon admission, the patient presented dyspnoea, cyanosis, digital clubbing, vascular spiders, and normal chest examination. Chest X-ray revealed bilateral interstitial infiltration and evidenced increased alveolar-arterial gradient and liver function impairment. Intrapulmonary shunt was evidenced by contrast-enhanced echocardiography and radionuclide perfusion scanning, thus confirming hepatopulmonary syndrome. (author)

  6. Sindrome de Guillain-Barré como manifestação do lupus eritematoso sistêmico: registro de um caso

    Pedro F. Moreira Filho

    1980-06-01

    Full Text Available É relatado caso de paciente jovem do sexo feminino que apresentou, de modo agudo, quadro de polirradiculoneurite com acometimento de vários nervos cranianos e dissociação albumino-citológica no líquido cefalorraqueano. Os exames complementares mostraram tratar-se de lupus eritematoso sistêmico. A biópsia de nervo periférico revelou diminuição de fibras mielínicas, fibrose do endo e perineuro e hipertrofia da camada média dos vasa-nervorum. Os autores chamam a atenção para a raridade do acometimento do sistema nervoso periférico na vigência da doença lúpica. Acreditam que a síndrome de Guillain-Barré provocada pelo lupus eritematoso sistêmico seria devido a um mecanismo imuno-alérgico.

  7. Diagnostic imaging in Bouveret's syndrome. A report of two cases; Diagnostico por imagen del sindrome de Bouveret. A proposito de dos casos

    Aguirre, I.; Echevarria, J. J.; Vidales, L.; Abaitua, J. M. [Hospital del Galdacano. Vizacaya (Spain)

    2001-07-01

    Bouveret's syndrome is an uncommon disorder that consists of localized obstruction of the pyloroduodenal region caused by the passage of a gallstone through a cholecystoenteric fistula. It is most common in elderly women with a previous history of cholelithiasis. As the clinical signs are nonspecific, radiological studies are of great importance in the attempt to reach an early diagnosis, thus improving the prognosis. We present two patients with a history of cholelithiasis in whom Bouveret's syndrome was diagnosed preoperatively by different imaging techniques. (Author) 8 refs.

  8. Radiological features of Lemierre's syndrome: A case report; Manifestaciones radiologicas del sindrome de Lemierre: a proposito de un caso

    Tapia-Vine, M. M.; Gonzalez-Garcia, B.; Bustos, A.; Cabello, J. [Hospital Clinico San Carlos. Madrid (Spain)

    2001-07-01

    Lemierre's syndrome is a type of sepsis caused by anaerobes that is secondary to a pharyngotonsillar infection complicated by suppurative thrombophlebitis of ipsilateral jugular vein and septic emboli. Imaging studies are valuable tools for confirming the diagnosis. Chest x-ray reveals poorly defined cavitated, peripheral, nodular lesions. computed tomography (CT) is useful in confirming the pulmonary lesions, which are suggestive of septic emboli. Doppler ultrasound of the neck plays and indispensable role in demonstrating the internal jugular vein thrombosis. We report the case of patient who presented the characteristic clinical and radiological features of Lemierre's syndrome. (Author) 17 refs.

  9. Bronchogenic carcinoma in acquired immunodeficiency syndrome - report of two cases; Carcinoma broncogenico na sindrome da imunodeficiencia adquirida - relato de dois casos

    Siciliano, Antonio Alexandre de Oliveira [Hospital Universitario Clementino Fraga Filho, Rio de Janeiro, RJ (Brazil). Servico de Radiodiagnostico; Melo, Alessandro Severo Alves de; Marchiori, Edson [Universidade Federal Fluminense, Niteroi, RJ (Brazil). Dept. de Radiologia

    1999-12-01

    The authors report two cases of bronchogenic carcinoma in patients with acquired immunodeficiency syndrome. The first patient, a ee-year-old male, developed a left hilar adenocarcinoma, with spleen and bilateral adrenal metastases. The disease progressed unfavourably, resulting in the patient's death in less than a month. The second patient, a 47-year-old male, developed a large mass in the left upper lobe, with invasion of the thoracic wall and destruction of adjacent ribs. The histopathologic study revealed a non-oat-cell carcinoma. Both patients received palliative treatment since diagnosis was established late in the course of the disease. Recent studies suggest an association between bronchogenic carcinoma and human immunodeficiency virus infection. However, an actual increase in the prevalence of bronchogenic carcinoma in HIV-positive patients remains controversial. (author)

  10. Syndrome of low T{sub 3} in patients with thyroid illness; Sindrome de T{sub 3} baja en pacientes con enfermedad de tiroides

    Badillo A, V.; Castaneda L, R.; Carrera D, A.A. [Laboratorio de Radioinmunoanalisis, UAZ, 98000 Zacatecas (Mexico)]: vbadillocren@hotmail.com

    2008-07-01

    The euthyroid sick syndrome or non-thyroid systemic illness, described by first time in 1974, is a syndrome characterized by alterations of laboratory of the thyroid tests, being values, normal serics of TSH, together with low thyroxine concentrations (T{sub 4}) and triiodothyronine (T{sub 3}) totals. The more common alteration it is the fall of the concentrations of peripheral T{sub 3} caused by the decrease of the activity 5'-deiodinase and to the deficit of the capacity of fixation of the transporter proteins. In the professional practice it should differ if the changes evidenced in the thyroid hormonal levels are induced by overthrow of the thyroid function or by non-thyroid systemic illnesses. The quantification in the laboratory it makes by means of analytical techniques appropriate and sensitive as the radioimmunoanalysis (RIA) or the immunoradiometric analysis (IRMA). These nuclear analytical techniques are based on the biochemical reaction of the antigen with the antibody where in the radioimmunoanalysis (RIA), an antigen without marking well-known as 'cold' it competes with a labelled antigen with a radioisotope I-125, well-known as 'hot', by the places of union of the antibody, and in the technique of immunoradiometric analysis (IRMA), an antibody without marked is saturated with the 'cold' antigen and the biochemical reaction is completed uniting a 'hot' antibody marked with a radioisotope I-125 this reaction is also known as 'Sandwich', in both techniques the count of the radioactivity will be in function of the concentration of the antigen without marking or 'cold'. This work was carried out in the Laboratory of Radioimmunoanalysis of the Academic Unit of Nuclear studies of the Autonomous University of Zacatecas. They were studied at 813 ambulatory patients that go to be carried out exams like part of a health control, the results that were obtained are the following 103 patients with hypothyroidism (12.66%), 40 patients with hyperthyroidism (4.92%), 500 patients euthyroid (61.5%), and with concentrations of low T{sub 3}, 170 patients (20.91%). In this study it is demonstrated that a high frequency of low T{sub 3} exists due to a thyroid dysfunction, in the population that converges to a health control, and the hypothyroidism in its subclinical forms it can be the more frequent alteration, these results will allow us to identify groups of more risk of developing a thyroid pathology after a certain time, then the diagnose it will be very opportune since we have found patient that have taken up to ten years in enjoying with an appropriate diagnose and therefore a preventive treatment. (Author)

  11. Cataract in a patient with the Alport syndrome and diffuse Leiomyomatosis Catarata em paciente com sindrome de alport e leiomiomatose difusa

    Luis Santiago - Cabán

    2008-12-01

    Full Text Available We describe a case of painless progressive loss of vision in a 15 years old male patient with Alport syndrome and diffuse Leiomyomatosis. After a comprehensive history and ocular examination, a diagnosis of bilateral posterior subcapsular cataracts was given. Patient underwent cataract extraction. His best corrected post-operative visual acuity was 20/25 in both eyes. We conclude that posterior subcapsular cataracts may lead to painless and progressive loss of vision in patients with Alport syndrome and Diffuse Leiomyomatosis.Nós descrevemos o caso de perda visual progressiva indolor em um paciente de 15 anos, sexo masculino, com Síndrome de Alport e Leiomiomatose difusa. Após história completa e exame oftalmológico, foi feito o diagnóstico de catarata subcapsular posterior bilateral. O paciente foi submetido à cirurgia de catarata. Nós concluímos que cataratas subcapsulares posteriores podem levar a perda visual progressiva e indolor em pacientes com Síndrome de Alport e Leiomiomatose Difusa.

  12. Histiocytosis versus (Hand-Schuller-Christian disease) - a case report; Histiocitose versus (sindrome de Hand-Schuller-Christian) - relato de caso

    Carneiro Filho, Jose Olimar; Leite, Marta Santos [Hospital Geral de Fortaleza, CE (Brazil). Clinica Radiologica Beroaldo Jurema, Fortaleza, CE (Brazil)]. E-mail: olimar_carneiro@hotmail.com; Andrade Neto, Jose Moacyr [Hospital Universitario Lauro Wanderley, Joao Pessoa, PB (Brazil). Clinica Medica

    2002-04-01

    The authors report a case of a 4-year-old girl with headache, irritability, othorrea and unilateral exophtalmus. Computed tomography and plain films showed large lytic areas in the vault and base of the skull. No other bones were involved. The diagnosis of histiocytosis X (Hand-Schuller-Christian disease) was confirmed by bone marrow biopsy. This paper presents the cytological and radiological findings of this patient as well as a review of the literature. (author)

  13. Síndrome do ceco móvel e as doenças gastrintestinais funcionais Mobile cecum sindrome and the functional gastrointestinal illnesses

    Júlio César Monteiro dos Santos Jr.

    2006-12-01

    Full Text Available O ceco móvel é uma variação anatômica embriológica do ceco e cólon ascendente resultante da descida incompleta desses segmentos do intestino grosso e da não fixação no peritônio da goteira parieto-cólica direita. A falta dessa fusão permite movimentação do ceco e/ou do cólon ascendente, facilitando a torção sobre seu eixo longitudinal ou a dobra medial do ceco sobre si, ficando encostado com sua borda medial à borda medial do cólon ascendente. Esse fato causa sintomas intermitentes de obstrução parcial do intestino ou, no caso de torção completa (volvo, de obstrução aguda com possível necrose do segmento envolvido. A anormalidade embriológica tem alta incidência (10 a 30% na população, contudo só tem sido mencionada por ocasião da torção completa, inadequadamente denominada de volvo do ceco-ascendente, em geral com necrose cecal. Dessa forma, a ocorrência não é das mais comuns e está citada entre as causas de obstrução intestinal aguda, perfazendo, nos adultos e nas crianças, menos do que 2% de todos os casos de obstruções intestinais, mas com a importância de destaque por causa do alto índice de morbi-mortalidade entre os pacientes afetados. O objetivo foi apresentar o ceco móvel como causa de dor abdominal intermitente, distensão, empachamento e cólica de origens obscuras em pessoas de aparência saudável, mas com uma longa história de distúrbios gastrintestinais funcionais, associados à constipação e/ou diarréia, portanto, com um quadro sintomatológico sobreponível ao da síndrome do cólon irritável. Além disso, propomos um marcador anatômico para a síndrome do cólon irritável, seja o subtipo com constipação predominante, seja o da diarréia predominante ou a forma em que há alternância entre constipação e diarréia e a possibilidade de alívio daqueles sintomas com a cecopexia.Functional gastrointestinal (FGI disorders are chronic or periodic conditions characterized by several symptoms whose structural and biochemical causes have not been determined. Indeed, although (FGI disorders affect millions of people of all ages, their pathophysiological mechanisms are still unclear, so that no pathological conditions have been proven to be related to this kind of illness, nor biological markers have been found to identify their sufferers. Irritable bowel syndrome (IBS has been shown to be one of the most common FGI illnesses. IBS is characterized by abdominal discomfort or pain and it has at least two of the following three features: pain relieved by bowel movements, more frequent stools with the onset of pain, and looser stools at the onset of pain - with no resultant inflammatory, metabolic or structural abnormalities. Since IBS diagnosis is fundamentally based on the description of symptoms reported by patients, it has been considered to be an exclusion diagnosis, despite the attempt to establish a connection between the origin of the illness and disorders caused by physical or sexual abuse or even by psychological disturbances. Although biochemical and hormone dosages have been performed in routine blood test for IBS, a precise biochemical marker has not been identified. Nevertheless, when the patients of this study were assessed by means of contrast intestinal radiography so as to observe topographic alterations in the cecum, it was possible to detect a mobile cecum in all of them. Would this be a coincident factor or could the mobile cecum - a widespread but misdiagnosed illness- explain the irritable bowel syndrome? The results of our study provide evidence that the majority of patients diagnosed as having IBS do not actually suffer from such illness, but rather from the mobile cecum syndrome.

  14. Laparoscopic repair of Morgagni hernia and cholecystectomy in a 40-year-old male with Down's sindrome. Report of a case.

    De Paolis, P; Mazza, L; Maglione, V; Fronda, G R

    2007-06-01

    Morgagni-Larrey hernia (MH) is an unusual diaphragmatic hernia of the retrosternal region. Few cases of MH, treated laparoscopically, associated with Down's syndrome (DS) have been reported in literature. On October 2004, a DS 40-year-old male was admitted to our Department with mild abdominal pain and nausea. Hematochemical tests were within the normal range. Ultrasonography showed biliary sludge and multiple gallstones. Chest X-ray revealed a right-sided paracardiac mass that appeared as MH after a thoraco-abdominal computed tomography (CT). Four trocars were placed as a routinary cholecystectomy. Abdominal exploration confirmed the presence of a voluminous hernia through a wide diaphragmatic defect (12 cm) on the left side of the falciform ligament, containing the last 20 cm ileal loops and right colon with the third lateral of transverse. After retrograde cholecystectomy and reduction of the herniated ileo-colonic tract from multiple adherences, the defect was repaired with an interrupted 2/0 silk suture and then a running 2/0 polypropylene suture. Postoperative course was complicated by pulmonary edema but subsequently the patient was discharged without further complications and has no recurrence after 2 years. In conclusion, surgery is necessary for symptomatic MH and to prevent possible severe complications. We preferred laparoscopy for the reduced morbidity compared to laparotomy, even if in our case the postoperative course was not uneventful. There are still few comparative data about the modality of closure of the defect between primary repair with nonabsorbable suture material, in case of small defects, or continuous monofilament suture or prosthesis in case of large defects.

  15. Sindrome de desgaste profesional (burnout en médicos especialistas de un hospital universitario, de la ciudad de Santa Marta, Colombia

    Robert Ferrel

    2013-10-01

    Full Text Available ResumenDiversas investigaciones han señalado una estrecha relación entre el síndrome de quemarse por el trabajo o de desgaste profesional (burnout y los problemas de salud, relacionando al burnout como una de las causas del deterioro de las condiciones de trabajo y fuente de la accidentalidad y absentismo laboral, especialmente en profesionales de la salud y la educación. La presente investigación tuvo como objetivo establecer y describir la existencia del síndrome de burnout en médicos especialistas que laboran en un Hospital Universitario de tercer nivel de la Ciudad de Santa Marta, Colombia. La población estuvo conformada por 56 médicos especialistas vinculados a dicha Institución, a los cuales se les aplicó el Maslach Burnout Inventory (MBI, teniendo en cuenta la edad, especialización y tiempo de vinculación. Los datos fueron procesados por el Software SPSS, 15.0v, haciendo uso de la estadística descriptiva para establecer el nivel de burnout en esta población. Se encontró un alto nivel de agotamiento emocional (94,6% en comparación con las otras dos variables, estando la despersonalización (53,6% y la falta de realización personal (53,6 en un nivel medio, estableciéndose la presencia del síndrome de burnout en un nivel medio en los médicos especialistas del Hospital Universitario. Estos resultados concuerdan con otros estudios similares. Los autores recomiendan continuar con otros estudios incluyendo nuevas variables, así como acciones organizacionales y personales para prevenir el estrés laboral fuente del burnout y mejorar la calidad de los servicios de salud en el Distrito de Santa Marta. (DUAZARY 2010, 29 - 40Abstract Various studies have indicated a close relationship between the syndrome of burnout or burnout (burnout and health problems, relating to the syndrome as a cause of deteriorating working conditions and the source of accidents and absenteeism workforce, especially in healthcare and education. This study aimed to establish and describe the existence of burnout in medical specialists working in a tertiary University Hospital of the City of Santa Marta, Colombia. The population consisted of 56 medical specialists associated with that institution, to which we applied the Maslach Burnout Inventory (MBI, taking into account age, expertise and bonding time. The data were processed by SPSS software, 15.0V, using descriptive statistics to establish the level of burnout in this population. We found high levels of emotional exhaustion (94.6% compared with the other two variables, while depersonalization (53.6% and lack of personal accomplishment (53.6 at an average level, establishing the presence burnout syndrome in a mid-level medical specialists at University Hospital. These results are consistent with other similar studies. The authors recommend continuing with other studies including new variables and organizational and personal actions to prevent burnout source of job stress and improve the quality of health services in the District of Santa Marta.Keywords: emotional exhaustion; depersonalization; lack of personal accomplishment; burnout; Burnout.

  16. Feasibility and safety of low-flow extracorporeal carbon dioxide removal to facilitate ultra-protective ventilation in patients with moderate acute respiratory distress sindrome.

    Fanelli, Vito; Ranieri, Marco V; Mancebo, Jordi; Moerer, Onnen; Quintel, Michael; Morley, Scott; Moran, Indalecio; Parrilla, Francisco; Costamagna, Andrea; Gaudiosi, Marco; Combes, Alain

    2016-02-10

    Mechanical ventilation with a tidal volume (VT) of 6 mL/kg/predicted body weight (PBW), to maintain plateau pressure (Pplat) lower than 30 cmH2O, does not completely avoid the risk of ventilator induced lung injury (VILI). The aim of this study was to evaluate safety and feasibility of a ventilation strategy consisting of very low VT combined with extracorporeal carbon dioxide removal (ECCO2R). In fifteen patients with moderate ARDS, VT was reduced from baseline to 4 mL/kg PBW while PEEP was increased to target a plateau pressure--(Pplat) between 23 and 25 cmH2O. Low-flow ECCO2R was initiated when respiratory acidosis developed (pH 60 mmHg). Ventilation parameters (VT, respiratory rate, PEEP), respiratory compliance (CRS), driving pressure (DeltaP = VT/CRS), arterial blood gases, and ECCO2R system operational characteristics were collected during the period of ultra-protective ventilation. Patients were weaned from ECCO2R when PaO2/FiO2 was higher than 200 and could tolerate conventional ventilation settings. Complications, mortality at day 28, need for prone positioning and extracorporeal membrane oxygenation, and data on weaning from both MV and ECCO2R were also collected. During the 2 h run in phase, VT reduction from baseline (6.2 mL/kg PBW) to approximately 4 mL/kg PBW caused respiratory acidosis (pH protective mechanical ventilation strategy in patients with moderate ARDS.

  17. Presentation of an uncommon form of aortic dissection and rupture in Marifoan syndrome; Presentacion de una forma infecuente de diseccion y rotura aortica en el sindrome de Marfan

    Delgado, I; Ruiz, R; Villanueva, J M; Fernandez Cueto, J L [Servicio de Radiodiagnostico, Complejo Hospitalario, Ciudad Real (Spain)

    1995-11-01

    In Marfan syndrome, aneurysmatic enlargement of ascending aorta and dissection starting at the root are the most common cardiovascular complications. We present an infrequent case of a 15-year-old patient with a typical case of Marfan syndrome. CT disclosed an aorta and aortic arch of normal size with dissection originating distally with respect to the point where left subclavian artery arises. The disecction extended to descending aorta and to iliac and femoral arteries. Aortic rupture occurred in the arch, with massive hemothorax. The CT findings were confirmed at necropsy. 9 refs.

  18. Estrategias de gestión de la inteligencia emocional para la prevención del Sindrome de Burnout en docentes de aula

    Pablo Torres

    2016-01-01

    Full Text Available Este trabajo tiene como finalidad proponer estrategias para la prevención del Síndrome de Burnout en docentes de aula, mediante la estimulación de la inteligencia emocional. El tipo de investigación es de naturaleza proyectiva, cuyo diseño es documental - contemporáneo. Como resultado se obtuvo una propuesta conformada por tres fases de ejecución secuencial, las cuáles contienen una serie de competencias, y de estrategias para su estimulación. En conclusión, un educador que tenga la capacidad de autoconciencia, que sepa gestionar positivamente sus emociones, y que pueda automotivarse, tendrá mayor calidad de vida y bienestar, y, por ende, su desempeño será más exitoso.

  19. Spontaneous intracranial hypotension syndrome: magnetic resonance findings in two patients; Sindrome de hipotension intracraneal espontanea: hallazgos en resonancia magnetica en dos pacientes

    Ortega, R.; Pastor, J.; Escamilla, F.; Romero, M. I. [Hospital de Traumatologia y Reabilitacion. Granada (Spain)

    1999-07-01

    The postural headache syndrome associated with a decrease in the cerebrospinal fluid (CSF) pressure is generally secondary to the CSF leakage that usually occurs after diagnostic lumbar puncture. Spontaneous intracranial hypotension can not be attributed to any known cause or previous diagnostic or therapeutic intervention. The syndrome is characterized by severe headache that is relieved by lying supine. During lumbar puncture, the CSF pressure is normally low. We present two patients in whom gadolinium-enhanced magnetic resonance imaging showed widespread thickening and enhancement of the dura mater and subdural fluid collections. (Author) 13 refs.

  20. Doble Aneuploidia (Trisomia 21 Y XXY): Reporte de caso de Sindrome Down-Klinefelter con delecion (XP)(P11.3-Pter) heredada

    De La Torre-Hernandez, Carlos A; Ochoa-Sifontes, Julio C

    2015-01-01

    En los síndromes Down (SD) y Klinefelter (SK) independientes entre si, ambas aneuploidías cromosómicas son causadas por exceso. La ocurrencia de estas dos alteraciones en un individuo es un fenómeno relativamente raro. En casos de doble aneuploidiìa donde están involucrados autosomas y cromosomas sexuales, predominan las manifestaciones clínicas relacionadas con los autosomas y se solapan las de cromosomas sexuales. Caso clínico: se trata de un paciente de dos anÞos de edad, con signos sugere...

  1. Thoracic manifestations of Kaposi`s sarcoma in AIDS: radiological findings; Manifestacoes toracicas do sarcoma de Kaposi na sindrome da imunodeficiencia adquirida: aspectos radiologicos

    Marchiori, Edson [Universidade Federal Fluminense, Niteroi, RJ (Brazil). Dept. de Radiologia; [Universidade Federal, Rio de Janeiro, RJ (Brazil); Baptista, Maria Ines Garcia; Cardenas, Gloria Pamela; Costa Praxedes, Marcia da [Universidade Federal Fluminense, Niteroi, RJ (Brazil). Dept. de Radiologia; Boechat, Lucia de Fatima; Quaresma, Patricia Souto Maior [Universidade Federal, Rio de Janeiro, RJ (Brazil). Hospital Universitario Clementino Fraga Filho. Servico de Radiodiagnostico

    1995-09-01

    The radiological findings of 189 cases of Kaposi`s sarcoma occurring in patients with AIDS were studied. There was also made pathological correlations in these patients. Interstitial reticular infiltrations were frequently detected on thoracic examination showing paracardiac confluent areas. There was also lymphadenopathy, gross nodules and pleural fluid accumulation. Although there was no detection of any pathognomonic aspect, the interstitial reticular infiltration finding together with the paracardiac confluent areas and associated with gross nodules, is highly indicative to thoracic involvement by the disease. (author). 32 refs., 5 figs., 2 tabs.

  2. Estatus Eléctrico durante el sueño lento y factores de Riesgo Neurológico: Diferentes manifestaciones de un mismo sindrome

    Angélica María Uscátegui Daccarett; Johann Sebastian Ortiz de la Rosa

    2014-01-01

    Este estudio se realizó para conocer las características de un grupo de pacientes con estatus eléctrico en sueño lento evaluados en la Fundación Liga Central Contra la Epilepsia, entre los años 2003 a 2013. Se buscaron factores asociados al desarrollo del síndrome, así como la respuesta al tratamiento. De los pacientes detectados que cumplieron con los criterios según ILAE 2010, se tomaron datos sobre antecedentes, síntomas y respuesta terapéutica. En ese periodo de tiempo fueron diagnostica...

  3. Estatus Eléctrico durante el sueño lento y factores de Riesgo Neurológico: Diferentes manifestaciones de un mismo sindrome

    Angélica María Uscátegui Daccarett

    2014-04-01

    Full Text Available Este estudio se realizó para conocer las características de un grupo de pacientes con estatus eléctrico en sueño lento evaluados en la Fundación Liga Central Contra la Epilepsia, entre los años 2003 a 2013. Se buscaron factores asociados al desarrollo del síndrome, así como la respuesta al tratamiento. De los pacientes detectados que cumplieron con los criterios según ILAE 2010, se tomaron datos sobre antecedentes, síntomas y respuesta terapéutica. En ese periodo de tiempo fueron diagnosticados 15 pacientes, 60% varones; 11 iniciaron con epilepsia y 4 por alteraciones del neurodesarrollo o del aprendizaje. Todos presentaron alteraciones comportamentales y 12 epilepsia, manifestada por diferentes tipos de crisis, que en un 66% fue de difícil control pese a recibir diferentes esquemas antiepilépticos. La mayoría de ellos presentaron antecedentes de riesgo pre, peri o posnatales, considerando que estos explican la dificultad en el diagnóstico inicial y las dificultades posteriores en el tratamiento.

  4. Tratamiento quirúrgico de disección de aorta torácica ascendente en sindrome de marfán.

    Efraín Montesinos Mosqueira

    2007-04-01

    Full Text Available Se presentan 5 casos consecutivos de pacientes con Síndrome de Marfan y disección de aorta torácica ascendente, quienes fueron tratados quirúrgicamente con reemplazo de raíz aórtica (operación modificada de Bentall. Todos los pacientes tuvieron plena recuperación y al seguimiento post alta realizan actividades de la vida diaria sin problemas. (Rev Med Hered 2007;18:110-115.

  5. Diagnóstico y tratamiento de pacientes con linfomas primarios del sistema nervioso central (LPSN y sindrome de inmunodeficiencia adquirida (SIDA

    Luis E Raez

    1999-07-01

    Full Text Available La incidencia del linfoma primario del sistema nervioso central (LPSNC ha crecido rápidamente. El LPSNC as una complicación letal en pacientes con SIDA. Objetivo: Nuestro objetivo fue estudiar la historia natural, métodos diagnósticos, al tratamiento y los factores pronósticos para la sobrevida de 75 pacientes con LPSNC y SIDA seguidos en el Jackson Memorial Hospital/Universidad de Miami. Resultados: La edad media fue de 37 años. El 84% de los pacientes eran hombres y el 55% hispanos. Factores de riesgo más comunes para SIDA fueron homosexualidad y múltiples compañeros sexuales. La cuenta promedio de CD4 fue de 15/ul y al promedio de LDH fue 1.5 veces al normal. La tomografía computarizada del cerebro mostraba lesiones múltiples en el 44% de los pacientes. Gammagrafia computarizada de emisión de fotones con talio-201 (SPECT del cerebro se realizó en 2/3 de los pacientes. Las histologías más comunes en las biopsias fueron: linfoma inmunoblástico y linfoma de células grandes. La radiación craneana fue ineficiente en el 50% de los pacientes tratados. La sobrevida promedio del grupo fue de 2.2 meses. Análisis univariado y multivariado mostraron que la mayor sobrevida se asociaba con una buena capacidad funcional (ECOG=1-2 vs 3-4. La presencia previa de infecciones oportunistas, la presencia de factores de riesgo de SIDA, las cuentas de CD4, niveles de LDH y raza no mostraron influencia en la sobrevida. Conclusiones: LPSNC es una neoplasia con pronóstico muy pobre y corta sobrevida aun con radioterapia del SNC. La capacidad funcional parece ser al factor de sobrevida más importante. No se encontraron diferencias en la presentación clínica ni el resultado entre pacientes hispanos y no hispanos. ( Rev Med Hered 1999; 10:96-104 .

  6. Sindrom pomagača” kod djelatnika koji rade s osobama s oštećenjima vida

    Fulgosi-Masnjak, Rea; Vidmar, Margareta; Masnjak, Mia

    2008-01-01

    Ovo istraživanje provedeno na djelatnicima koji su zaposleni u neposrednom radu s osobama s oštecenjima vida razlicitog uzrasta prvo je u nas. Cilj istraživanja bio je odrediti stupanj izraženosti sindroma pomagaca ("Helper sindroma") u odnosu na neke kriterijske varijable. "Pomagači" su obicno oni strucnjaci koji pružaju pomoc osobama u potrebi, cesto u emocionalno stresnim okolnostima koje utjecu na njihovo mentalno zdravlje. Oni najcešce ispoljavaju altruisticnu, nematerijalisticku i hu...

  7. Quantificazione mediante PCR dell’EBV-DNA da biopsie cutanee di pazienti con linfomi cutanei primitivi (micosi fungoide e sindrome di Sèzary

    Chiara Merlino

    2007-06-01

    Full Text Available Mycosis fungoides (MF, the most indolent form of CTCL, originates from a clonal expansion of epidermotropic helper/memory T cells. Sezary syndrome (SS is a rare primay epidermotropic cutaneous T-cell lymphoma in leukemic. The aetiopathogenesis of MF and SS remains obscure despite several investigations. Infectious, environmental and genetic factors have been implicated as potential aetiological agents. The studies investigating the role of EBV in CTCL present conflicting results. The different sensitivities of the technical methods used in the evaluation of the presence of viral DNA or virus-related antigens make comparison of the results difficult. The aim of this study was to retrospectively evaluate the EBV-DNA load in skin biopsies from MF and SS patients by a highly sensitive (1-10 EBV-DNA copies/reaction quantitative-competitive PCR (QC-PCR developed in our lab to better asses the relationship between EBV and CTCL. Skin biopsies were obtained from 21 MF and 10 SS patients; skin biopsies from a 8 patients with inflammatory skin disease were used as controls. EBV-DNA was detected in 70% of biopsies from SS patients vs. 0% of MF patients. No control patients resulted EBV-DNA positive, as expected. In addition, in SS patients, the survival from diagnosis is lesser in EBV-positive patients vs.EBV-negative patients even if not statistically significant.We are going to investigate the presence of EBV-DNA in peripheral blood of a larger number of patients and to evaluate the pattern of viral genes expression, to better assess the aetiopathogenetical role of EB virus in this kind of neoplasies.

  8. Churg-Strauss syndrome: a case with unusual manifestations; Sindrome de Churg-Strauss: a proposito de un caso con manifestaciones poco usuales

    Restrepo, Mauricio; Gonzalez, Luis Alonso; Vasquez, Gloria

    2008-07-01

    Churg-Strauss syndrome, a necrotizing systemic vasculitis which involves the small and (more rarely) the medium-sized vessels, is a primary vasculitis strongly associated with anti neutrophil cytoplasm antibodies (ANCA). It is characterized by the presence of asthma, eosinophilia and extravascular eosinophilic granulomas. Herein, we report a 36-year-old woman with a history of late onset asthma and allergic rhinitis who developed central nervous system involvement, peripheral neuropathy, leucocytoclastic vasculitis and eosinophilia. Interestingly, unusual clinical manifestations of Churg-Strauss syndrome such as mesenteric micro aneurysms and jaw claudication were present in this particular patient. A brief review of the literature of Churg-Strauss syndrome is presented.

  9. ACTUACIÓN DOMICILIARIA EN EL SINDROME DE APNEAS/HIPOPNEAS DURANTE EL SUEÑO (SAHS: DIAGNÓSTICO Y TRATAMIENTO

    Coma del Corral MJ

    2006-02-01

    Full Text Available RESUMEN:Estudios recientes, relacionan el SAHS con mayor morbimortalidad cardiovascular y por otro lado, sabemos que aún hoy en día, el SAHS sigue estando infradiagnosticado. Este infradiagnóstico supone, por un lado, un déficit o perdida de salud y por otro lado, un aumento de costes, ya que está demostrado que los pacientes con SAHS no diagnosticados ni tratados, son mayores consumidores de los servicios de salud y presentan mayor absentismo laboral, mientras que estos costes se reducen en los pacientes con SAHS tratados con CPAP. Por tanto, nos encontramos ante la necesidad de diagnosticar y tratar adecuadamente al mayor número posible de pacientes que padezcan un SAHS.El método diagnóstico de elección, sigue siendo la PSG nocturna vigilada en el laboratorio de sueño, sin embargo, el futuro del diagnóstico del SAHS pasa indefectiblemente por el empleo de sistemas simplificados con alta sensibilidad y especificidad. En este sentido, la Poligrafía Respiratoria, representa una alternativa útil para el diagnóstico del SAHS, pudiendo ser realizada en el domicilio del paciente, al igual que los sistemas Auto-CPAP. De esta forma, el abordaje actual del SAHS ha cambiado y así, un paciente con alta probabilidad de padecer un SAHS, se le puede realizar una PR domiciliaria que diagnostique el SAHS y posteriormente para ajustar el nivel de presión óptima de CPAP, se le podría hacer un registro domiciliario de Auto-CPAP.Con este nuevo abordaje del SAHS, se podrán disminuir las listas de espera y por tanto disminuir el infradiagnóstico. Todo ello conlleva implícitamente un ahorro de recursos. El lugar del diagnóstico, será fundamentalmente el domicilio, y en este sentido, el desarrollo de aplicaciones telemáticas contribuirá de forma importante a la modificación de las estrategias diagnósticas.El éxito de esta forma de abordaje del SAHS, vendrá marcado por una adecuada selección de los pacientes subsidiarios de diagnóstico y ajuste de tratamiento domiciliario, por lo cual, cada unidad de sueño debe establecer su propia estrategia diagnóstico-terapeútica que resulte más costo-efectivaSUMMARYThe recent studies relate the Sleep Apnea/Hipopnea Syndrome (SAHS with cardiovascular morbidity and mortality, and today, we know it is an underdiagnosed disease. This underdiagnostic implies unhealthy and it increases of health care utilization because the patients with SAHS neither diagnostic nor treatment, they are increase health care utilization and they are more absentees work, whereas the Continuous Positive Airway Pressure (CPAP treatment significantly reduces health care utilization. So, we must diagnose and we must treat the patients with SAHS.The nocturnal polysomnography (PSG is still the diagnosis technique considered as "Gold Standard", although in the future, the diagnosis of SAHS will be to do it with simplifies systems with highly sensitivity and with highly specificity. The Respiratory Polygraphy (RP is a useful option for diagnosis of SAHS and the Respiratory Polygraphy and the auto-CPAP system could be makes at home. In this moment, when we find a patient with highly probability to have SAHS, we could make a Respiratory Polygraphy at home for diagnosis of SAHS and then, we could make auto-CPAP for titration the optimum level of CPAP pressure.With this approach, we will reduce the underdiagnostic and the waiting list, and then saving resources. The place of diagnosis will be at home and then the telematic development will aid to modify the diagnostic approach.This approach's success for diagnose of SAHS will be determinate for the patients´s suitable selection, so every sleep unit must set up its diagnostic-treatment approach that results more cost-effective

  10. Magnetic resonance imaging of the liver in postpartum stable women with HELLP syndrome; Ressonancia magnetica hepatica em puerperas estaveis com sindrome HELLP

    Carvalho, Ana Rita Marinho Ribeiro; Amorim, Melania Maria Ramos de; Katz, Leila; Souza, Alex Sandro Rolland de; Santos, Aleksana Regina Viana Dutra; Lima, Ana Luiza Medeiros Vasconcelos de [Instituto Materno Infantil Prof. Fernando Figueira, Recife, PE (Brazil). Centro de Atencao a Mulher. Unidade de Terapia Intensiva Obstetrica

    2008-09-15

    Objectives: To describe magnetic resonance (MR) findings in the liver of stable patients with HELLP syndrome in the puerperium. Methods: A descriptive study was carried out from August 2005 to July 2006, involving a series of 40 postpartum patients admitted to an obstetric intensive therapy unit in IMIP (Instituto Materno Infantil Prof. Fernando Figueira) with diagnosis of HELLP syndrome (complete and partial). Complete HELLP syndrome was defined when all laboratory parameters were present and incomplete when one or more but not all laboratory findings were present. All patients had stable clinical conditions and were evaluated with magnetic resonance of the liver and the main findings were recorded. Results. Average maternal age was 26.8 {+-} 6.4 years and gestational age at delivery was 34 {+-} 26.8 weeks. The MR imaging was performed between eight and 96 hours after diagnosis of HELLP syndrome (56 {+-} 31h). The most frequent findings were ascitis in 20% (n = 8), pleural effusion in 17.5% and hepatic steatosis in 7.5%. The periportal intensity signal was normal in all cases. Cases of liver infarction and sub-capsular or parenchymatous hematoma were not observed. Conclusion: Findings of magnetic resonance imaging of the liver in stable HELLP syndrome postpartum patients were few and unspecific. Severe liver injuries such as parenchymatous or sub-capsular hematoma, entailing life risk were not found. Results do not corroborate the use of magnetic resonance as routine examination for stable patients with HELLP syndrome. (author)

  11. Frequency and clinical, hormonal and ultrasonographic characteristics suggestive of polycystic ovarian syndrome in a group of females with metabolic syndrome; Frecuencia y caracteristicas clinicas, hormonales y ultrasonograficas sugestivas de sindrome de ovarios poliquisticos en un grupo de mujeres con sindrome metabolico

    Ovies Carballo, Gisel; Dominguez Alonso, Emma; Verdeja Varela, Olga L; Zamora Recinos, Hugo [Instituto Nacional de Endocrinologia, La Habana (Cuba)

    2008-07-01

    The polycystic ovarian syndrome is the most frequent endocrine affection in females at reproductive age. Nowadays, it is known that insulin resistance and consequent hyperinsulinism seem to be the basis of the disorders characterizing it. That's why, it is not erroneous to think that in females with metabolic syndrome, whose physiopathological bases are insulin resistance and hyperinsulinism, there may appear clinical, humoral and ultrasonographic elements of the polycystic ovarian syndrome.

  12. Libros

    Facultad de Medicina Revista

    1952-09-01

    Full Text Available Precis de Parasitologie Humaine / Sindromes Pathologiques du Nourrisson et. de L'enfant / Practique Neurnlogique / Precis D'Anatomie / Traite de Medecine / Traite de Therapeutique Chirurgicale

  13. Congenital Primary Pachydermoperiostosis and Striate Palmoplantar Keratoderma - a Case Report

    Stojanović Slobodan; Vučković Nada; Jovanović Marina; Petrović Kosta

    2014-01-01

    Uvod. Pahidermoperiostoza (PDP) predstavlja heterogeni sindrom za koji su karakteristične hipertrofi čne promene prvenstveno kože i kostiju ekstremiteta: pahidermija, klabing (clubbing) prstiju šaka i stopala i hipertrofi čna osteoartropatija. Primarna pahidermoperiostoza − sinonim Turen−Solent−Goleov sindrom (Touraine-Solente-Golé) (PPDP), ili primarna hipertrofi čna osteoartropatija (PHO), redak je nasledni poremećaj i predstavlja jedan od dva tipa hipertrofi čne osteoartropatije....

  14. Radioimmunoassay method for measurement of plasma androstenedione. Its validation in ovulatory women and in patients with polycystic ovarian syndrome; Metodo de radioimunoensaio para medida da androstenediona plasmatica. Validacao em mulheres ovulatorias e com sindrome dos ovarios policisticos

    Vilanova Socorro Veras, Maria do; Silva e Rosa, Alzira Amelia; Moura, Marcos Dias de; Ferriano, Rui Alberto; Sa, Marcos Felipe Silva de [Sao Paulo Univ., Ribeirao Preto, SP (Brazil). Faculdade de Medicina

    1995-01-01

    The present paper has as objective the standardization of a radioimmunoassay method for measurement of androstenedione. Ethyl ether was used for plasma extraction. The sensitivity of the method was 6,8 pg/tube; the reproducibility (inter assay error) was 15,6%; the precision (intrassay error) was 5,2%. As biological control, 20 ovulatory women showed median plasma values of 1250 pg/ml and 24 women with polycystic ovary syndrome presented median plasma values of 2.037 pg/ml. (author). 6 refs., 2 figs., 1 tab.

  15. Pneumocystis carinii pneumonia in acquired immunodeficiency syndrome - correlation of high-resolution computed tomography and anatomopathology; Pneumocistose na sindrome da imunodeficiencia adquirida: correlacao da tomografia computadorizada de alta resolucao com a anatomopatologia

    Marchiori, Edson; Moreira, Luiza Beatriz [Universidade Federal Fluminense, Niteroi, RJ (Brazil). Dept. de Radiologia]. E-mail: edmarchiori@zipmail.com.br; Capone, Domenico [Universidade do Estado, Rio de Janeiro, RJ (Brazil). Faculdade de Medicina; Moraes, Heleno Pinto de [Universidade Federal Fluminense, Niteroi, RJ (Brazil). Dept. de Patologia; Pereira, Cyntia Inez Guedes Soares

    2001-12-01

    We present the main findings observed on the high-resolution computed tomography examinations of 15 patients with acquired immunodeficiency syndrome and Pneumocystis carinii pneumonia. The high-resolution computed tomography and autopsy findings of 5 patients were also compared. The most frequently observed high-resolution computed tomography patterns were ground-glass attenuation, consolidation areas, crazy-paving pattern and cysts. Nodules and intralobular reticulation were less frequently observed. Ground-glass attenuation and consolidation areas corresponded to alveolar filling with inflammatory exudate. Thickening of the interlobular septa was due to cell infiltration and edema. One patient presented interlobular reticulation, and the pathology study revealed alveolar septa thickening due to cell infiltration and fibrosis. Nodules observed in one of the patients corresponded to a patchy intra alveolar accumulation of microorganisms and inflammatory cells forming a 'granulomatous' pattern. (author)

  16. Magnetic resonance findings associated with intracranial hypotension. A report of three cases occurring after lumbar puncture; Hallazgos por RM en el sindrome de hipotension intracraneal. A proposito de tres casos tras puncion lumbar

    Galan, J. [Hospital General Yague (Spain); Vuelta, R. V. [Hospital de Txagorritxu. Vitoria (Spain); Oleaga, L.; Grande, D. [Hospital de Basurto. Bilbao (Spain)

    1999-07-01

    The magnetic resonance (MR) findings are presented for three patients who developed intracranial hypotension syndrome following lumbar puncture, one of the most common causes of this complication. All three patients presented the MR findings characteristically associated with this event, consisting of diffuse dural enhancement after administration of a paramagnetic contrast medium, as well as extraaxial collection that played either an accompanying or a causative role. (Author) 7 refs.

  17. Immune Recovery Syndrome in the HIV-positive patient: Radiological Findings of Paradoxical Reactions; Sindrome de recuperacion inmune en el enfermo positivo al VIH: hallazgos radiologicos de reacciones paradojicas

    Martinez, E.; Sanchez, M. A.; Torres, M.; Benito, J.; Avila, A. [Hospital Universitario 12 de Octubre. Madrid (Spain)

    2004-07-01

    To describe immune recovery syndrome (IRS) and related radiological findings in HIV-positive patients. To alert radiologists to the ever-increasingly frequent appearance of paradoxical reactions (PR) in granulomatous diseases under antiretroviral treatment. We present a retrospective study of 9 adult HIV-positive patients who showed IRS, 6 cases of tuberculosis (TBC), 2 cases of atypical mycobacterium and a case of sarcoidosis. At the time of IRS/PR diagnosis, any suspicion of infectious activity was excluded through the use of appropriate microbiological tests. clinical and radiological characteristics of the above mentioned cases are analyze here. All patients experienced a clinical and/or radiological worsening of condition following variable periods of antiretroviral and/or anti-tuberculosis treatment, and coinciding with viral load decrease and CD4-T-lymphocyte recovery. Diagnosis of IRS/PR was clinical in five cases and radiological in four. In all but one case, antiretroviral treatment had at some time been previously administered. IRS/PR is a diagnosis of exclusion which must be included in the differential diagnosis of newly appearing lesions or worsening of already existing ones in HIV-positive patients that have recently begun antiretroviral and/or anti-tuberculosis treatment. Such should be done after excluding drug resistance, treatment non-adherence and intercurrent disease. (Author) 8 refs.

  18. Bilateral perisylvian syndrome not related to malformations: report of two cases Sindrome peri-silviana bilateral não relacionada a malformações: relato de dois casos

    Ralf Paulo Grasel

    1996-06-01

    Full Text Available In this case report we present the neuroimaging findings and clinical features of two patients with a bilateral perisylvian syndrome not related to malformations, but probably to ischemic etiology. Evaluations including history, general and neurologic examinations, electroencephalograms, and imaging data were reviewed as recent literature about the subject.Neste relato de caso, apresentamos os achados de neuroimagem e os aspectos clínicos de dois pacientes com síndrome peri-silviana bilateral não relacionada a malformações, mas provavelmente a uma etiologia isquêmica. Avaliações, incluindo história, exames físico e neurológico, eletrencefalograma e aspectos de imagem foram revistos, assim como a literatura recente sobre o assunto.

  19. Intussusception due to Peutz-Jeghers syndrome - a case report and review of the literature; Sindrome de Peutz-Jeghers e intussuscepcao - relato de um caso e revisao da literatura

    Grasso Filho, Luiz Eduardo; Albertotti, Flavio; Carvalho, Claudio Sobral de; Nersessian, Ana Carolina; Docema, Marcos F. Lima; Ogasawara, Aparecida M.; Peng Yong Sheng [Hospital Sirio Libanes, Sao Paulo, SP (Brazil). Centro de Diagnostico por Imagem; Costacurta, Marco Antonio [Hospital Sirio Libanes, Sao Paulo, SP (Brazil). Servico de Radiologia Geral; Albertotti, Cesar Jose [Hospital Sirio Libanes, Sao Paulo, SP (Brazil). Servico de Tomografia Computadorizada; Cerri, Giovanni Guido [Hospital Sirio Libanes, Sao Paulo, SP (Brazil). Servico de Ultra-Som

    2000-02-01

    The authors report a case of a 28-year-old woman with ileocecocolic intussusception due to Peutz-Jeghers syndrome, an autosomal dominant disorder characterized by hamartomatous polyposis of the gastrointestinal tract and mucocutaneous pigmentation. This condition frequently presents complications such as intestinal obstruction due to invagination or hemorrhage. In this patient, the diagnosis of intussusception was made preoperatively. The excised material revealed three large polyps which were considered to be the cause of the intussusception. (author)

  20. Sindrome de Van der Knaap megalencefalia com leucodistrofia: a respeito de dois casos na mesma família Van Der Knaap syndrome (megalencephaly with leukodystrophy: report of two cases in the same family

    CARLOS EDUARDO CAVALCANTI

    2000-03-01

    Full Text Available Relatamos os casos de dois irmãos, com quatro e seis anos de idade, com achados característicos da síndrome de Van Der Knaap. Discutimos os seus aspectos clínicos e radiológicos, assim como suas peculiaridades. Comparamos aos dados da literatura e analisamos os possíveis mecanismos etiopatogênicos envolvidos.We report on two brothers, aged four and six years-old, evidencing the Van Der Knaap syndrome. Clinical and radiological aspects are discussed as well their peculiarities. Data are compared with related literature, as etiopathogenic mechanisms possibly involved.

  1. Inclusão de crianças com Síndrome de Down Inclusión de niños con Sindrome de Down Inclusion of children with Down Syndrome

    Flávia Mendonça Rosa Luiz

    2012-12-01

    Full Text Available O objetivo deste trabalho foi explorar as experiências de famílias no processo de inclusão escolar de crianças com síndrome de Down, com vistas à promoção de saúde dessas famílias. Trata-se de um estudo de casos múltiplos, de abordagem qualitativa, em que participaram onze famílias de crianças com síndrome de Down. Os dados foram coletados por meio de entrevista semiestruturada e submetidos à análise de conteúdo. Os resultados demonstraram que, na perspectiva dos participantes, os professores não estão preparados para a inclusão, porém, ainda assim, esse processo vem se demonstrando benéfico na educação infantil. Ficou evidente a necessidade de articulação entre os setores da educação e saúde e de uma mudança de paradigma no modelo educacional. A pesquisa aponta aspectos que merecem atenção por parte dos profissionais envolvidos, de modo a tornar a inclusão um processo a ser vivido da melhor forma possível.La finalidad fue explorar las experiencias de familias en el proceso de inclusión escolar de niños con síndrome de Down, para promover la salud de esas familias. Se trata de un estudio de casos múltiples, con aproximación cualitativa, en que participaron 11 familias de niños con síndrome de Down. Los datos fueron recolectados mediante entrevista semiestructurada y analizados con análisis de contenido. Los resultados demostraron que, en la perspectiva de los participantes, los profesores no están preparados para la inclusión. Sin embargo, ese proceso viene mostrándose benéfico en la educación infantil. Se quedó evidente la necesidad de articulación entre los sectores de educación y salud y un cambio de paradigma en el modelo educacional. La investigación apunta aspectos que merecen atención de la parte de los profesionales involucrados, de manera a hacer de la inclusión un proceso a ser vivida de la mejor forma posible.This study aimed to explore families' experiences in the educational inclusion process of children with Down's syndrome, with a view to promoting the health of these families. A multiple case study was developed with a qualitative approach, involving 11 families of children with Down's syndrome. Data were collected through semistructured interviews and analyzed through content analysis. The results demonstrated that, from the participants' perspective, teachers are not prepared for this inclusion but, nevertheless, this process reveals to benefit child education. The need for articulation between education and health sectors and a change in the educational model paradigm were evidenced. The research appoints aspects which the professionals involved should pay attention to, in order to make the inclusion a process to be lived as best as possible.

  2. HTLV-I Associated uveitis, myelopathy, rheumatoid arthritis and Sjögren's syndrome Uveite, mielopatia, artrite reumatóide e sindrome de Sjogren associadas ao HTLV-I

    Sônia Regina A. A. Pinheiro

    1995-12-01

    Full Text Available A 62 year-old white female presented with a 10-year-history of slowly progressive spastic paraparesis, pain and dysesthesia in the lower limbs and sphincter disturbance. A few years after the onset of the neurologic symptoms she developped migratory arthritis with swelling of the knees and pain on palpation of knees and fingers, dry eyes, mouth and skin. Two months before admission she presented bilateral nongranulomatous anterior uveitis. Examination revealed spastic paraparesis with bilateral Babinski sign, a decreased sensation level below L3, decreased vibration sense in the lower extremities, and a postural tremor of the upper limbs. Laboratory work-up disclosed HTLV-I positive tests in the blood and cerebrospinal fluid (CSF, and a mild pleocytosis in the CSF with a normal protein content. Nerve conduction velocity studies were normal. The present case shows the association of uveitis, arthritis and Sjögren's syndrome in a patient with tropical spastic paraparesis / human T-cell lymphotropic virus type I (HTLV-I associated myelopathy (TSP/HAM, and illustrates the wide spectrum of clinical manifestations which may accompany this infection with this virus.Uma mulher branca de 62 anos foi internada apresentando história de paraparesia lentamente progressiva durante 10 anos. Dois meses antes da internação ela apresentou uveíte anterior não granulomatosa bilateral. Poucos anos após o início dos sintomas neurológicos, ela desenvolveu artrite migratória com edema dos joelhos e dor a palpação dos joelhos e dedos dos pés, boca, pele e olhos secos. Ao exame físico foi observado paraparesia espástica com sinal de Babinski positivo, sensibilidade diminuída abaixo de L3, diminuição da sensação de vibração nas extremidades inferiores, e tremor postural dos membros superiores. Apresentou testes positivos para o HTLV-I no sangue. O estudo do líquido cefalorraquidiano mostrou discreta pleocitose, proteínas normais e ELISA e Western blot positivos para o HTLV-I. O estudo da velocidade de condução dos nervos foi normal. Este caso mostra a associação de uveíte, artrite e síndrome de Sjogren em uma paciente com paraparesia espástica tropical (HTLV-I associada a mielopatia (TSP/HAM, e ilustra o largo espectro das manifestações clínicas que podem acompanhar a infecção por este vírus.

  3. Análisis bayesiano de variables relacionadas con el desarrollo del sindrome de Burnout en profesionales sanitarios (Bayesian analysis of variables related to the developmentof Burnout syndrome in health professionals

    Guillermo A. Cañadas

    2010-12-01

    Full Text Available Burnout syndrome has a high incidence among professional healthcare and social workers. This leads to deterioration in the quality of their working life and affects their health, the organization where they work and, via their clients, society itself. Given these serious effects, many studies have investigated this construct and identified groups at increased risk of the syndrome. The present work has 2 main aims: to compare burnout levels in potential risk groups among professional healthcare workers; and to compare them using standard and Bayesian statistical analysis. The sample consisted of 108 psycho-social care workers based at 2 centers run by the Granada Council in Spain. All participants, anonymously and individually, filled in a booklet that included questions on personal information and the Spanish adaptation of the Maslach Burnout Inventory (MBI. Standard and Bayesian analysis of variance were used to identify the risk factors associated with different levels of burnout. It was found that the information provided by the Bayesian procedure complemented that provided by the standard procedure.

  4. Imaging study of lymphoreticular tumor development in ataxia-telangiectasia and Nijmegen breakage syndrome; Estudio por imagen del desarrollo de tumores linforreticulares en la ataxia telangiectasia y el sindrome de Nijmegen

    Martinez-Leon, M. I.; Ceres-Ruiz, L.; Cuesta, M. A.; Garcia-Martin, F. J. [Hospital Materno-Infantil C.H.U. Carlos Haya. Malaga (Spain)

    2003-07-01

    Ataxia-telangiectasia (AT), or Louis-Bar syndrome, is an autosomal recessive illness characterized by progressive cerebellar ataxia, oculo-cutaneous telangiectasia, immunodeficiency combined with susceptibility to sinopulmonary infections and high incidence of neoplastic development. Nijmegen breakage syndrome (NBS) is a variant of AT, is also an autosomal recessive illness that presents cerebellar ataxia, as well as combined immunodeficiency and a tendency toward tumor development. Contrary to Louis-Bar syndrome, it doesn't present telangiectasia and exhibits a characteristics phenotype (short stature, bird-like face and microcephaly). Both entities are classified as syndrome of chromosomal instability or chromosomal fragility, a group which also includes Bloom syndrome and Fanconi anemia. All of these show an increase in the frequency of neoplastic pathologies, mainly lymphoid tumors. We present three patients,two with AT and one with NBS, who developed different lymphoma types in the course of the illness. We highlight the most outstanding aspects from a clinical-radiological point of view. (Author) 17 refs.

  5. Ingestion Reiterada de Cuerpos Extranos. Forma Inusual de Presentacion del Sindrome de Munchausen por Poderes (Reiterated Ingestion of Foreign Bodies. Unusual Form of Presentation of Munchausen Syndrome by Proxy).

    Terreros, I. Gomez de; And Others

    1996-01-01

    An unusual case of Munchausen syndrome by proxy is reported. A mother with a psychiatric record of behavior disorders and family dysfunction perpetrated the ingestion of foreign bodies (for example, earrings, a screw, sewing needles) on a 10-month-old infant with a history of prematurity, repeated visits to emergency rooms, and nonjustified…

  6. Effects of intensive glucose control on platelet reactivity in patients with acute coronary syndromes. Results of the CHIPS Study ("Control de Hiperglucemia y Actividad Plaquetaria en Pacientes con Sindrome Coronario Agudo").

    Vivas, David; García-Rubira, Juan C; Bernardo, Esther; Angiolillo, Dominick J; Martín, Patricia; Calle-Pascual, Alfonso; Núñez-Gil, Iván; Macaya, Carlos; Fernández-Ortiz, Antonio

    2011-05-01

    Hyperglycaemia has been associated with increased platelet reactivity and impaired prognosis in patients with acute coronary syndrome (ACS). Whether platelet reactivity can be reduced by lowering glucose in this setting is unknown. The aim of this study was to assess the functional impact of intensive glucose control with insulin on platelet reactivity in patients admitted with ACS and hyperglycaemia. This is a prospective, randomised trial evaluating the effects of either intensive glucose control (target glucose 80-120 mg/dl) or conventional control (target glucose 180 mg/dl or less) with insulin on platelet reactivity in patients with ACS and hyperglycaemia. The primary endpoint was platelet aggregation following stimuli with 20 μM ADP at 24 h and at hospital discharge. Aggregation following collagen, epinephrine and thrombin receptor-activated peptide, as well as P2Y₁₂ reactivity index and surface expression of glycoprotein IIb/IIIa and P-selectin were also measured. Of the 115 patients who underwent random assignment, 59 were assigned to intensive and 56 to conventional glucose control. Baseline platelet functions and inhospital management were similar in both groups. Maximal aggregation after ADP stimulation at hospital discharge was lower in the intensive group (47.9 ± 13.2% vs 59.1 ± 17.3%; p=0.002), whereas no differences were found at 24 h. Similarly all other parameters of platelet reactivity measured at hospital discharge were significantly reduced in the intensive glucose control group. In this randomised trial, early intensive glucose control with insulin in patients with ACS presenting with hyperglycaemia was found to decrease platelet reactivity. Clinical Trial Registration Number http://www.controlledtrials.com/ISRCTN35708451/ISRCTN35708451.

  7. Head Start Service Guide for Children and Families with HIV or AIDS = Guia de Servicios para Ninos con V.I.H. Positivo y con Sindrome de Inmunodeficiencia Adquirida (S.I.D.A.) y sus Familias.

    Puerto Rico Commonwealth Office of Children's Services and Community Development, Old San Juan.

    This document provides guidelines and procedures, in Spanish and English, for Head Start teachers in taking care of children with AIDS, or children who are HIV positive, and their families. The goal of the guide is to maximize participation of infected children in the Head Start program. The guide presents activities in three main stages:…

  8. O ato de comer e as pessoas com Síndrome de Down El acto de comer y las personas con Sindrome de Down Eating act and people with Down Syndrome

    Andréa Giaretta

    2009-06-01

    Full Text Available Trata-se do relato de experiência vivida durante a disciplina de Projetos Assistenciais de Enfermagem e de Saúde do Curso de Mestrado em Enfermagem da Universidade Federal de Santa Catarina de cunho interdisciplinar, realizado com pessoas com Síndrome de Down com foco tanto na sua racionalidade quanto no seu imaginário. Buscou-se construir junto com estas pessoas e seus familiares uma sistematização nutricional individualizada que contribuísse para sua independência pessoal na prática cotidiana do ato de comer. Os postulados do Interacionismo Simbólico guiaram esta prática e se interligaram com os instrumentos metodológicos da escuta e da observação sensível, além das atividades lúdicas. Evidenciou-se que o primeiro significado do ato de comer é construído pela sua família e reforçado pelo seu convívio social.Eso es un relato de una experiencia vivida en la disciplina de Proyectos Asistenciales de Enfermaría y de Salud del Curso de Maestría en Enfermaría de la Universidad Federal de Santa Catarina con característica interdisciplinario, hecho con personas con el Síndrome de Down, con la atención tanto para la racionalidad cuanto para el imaginario. Se ha buscado construir juntamente a las personas con el Síndrome de Down y sus familiares una sistematización de nutrición individualizada que contribuyese para su independencia personal en la práctica cotidiana del acto de comer. Los postulados del Interaccionismo Simbólico condujeron la práctica y interconectáronse con los instrumentos metodológicos de la escucha y de la observación sensible, además de las actividades lúdicas. Fue evidenciado que el primer significado del acto de comer es transmitido por sus familias y reforzado por el convivir social.This is en experience report lived in the Health and Nursing Assistance Projects of the Post-Graduate Nursing Master Degree of the Federal University of Santa Catarina as an interdisciplinary subject, and it was done with Down's Syndrome people, concentrating in their rationality and imaginary. We tried to build with these people and their families an individualized nutritional systematization that contributes to their personal independence in the daily practice of the act of eating. The postulates of symbolic interactionism guided this practice and established a connection with the methodological instruments of sensible listening and observation, besides playful activities. It was evident that the first meaning of the act of eating is built in the family and reinforced in the social life.

  9. Nonthyroidal illness syndrome in patients with subarachnoid hemorrhage due to intracranial aneurysm Sindrome da doença não tiroideana em pacientes com hemorragia subaracnoidea devida a aneurisma cerebral

    Luiz Augusto Casulari

    2004-03-01

    Full Text Available We have previously reported that subarachnoid hemorrhage due to ruptured intracranial aneurysm (SH is associated with changes in the hormonal profile in the first 24 hours after the event. We proposed that the hormonal changes observed are due to the intense stress to which the patients are exposed. However, the thyroidal hormonal profile is indicative of the presence of a nonthyroidal illness syndrome (NTIS. In this paper, we examined whether the change in the thyroid hormone profile is compatible with a NTIS. Two groups of patients were included in the study: A 30 patients with SH (21 females and 9 males; 41.7±11.4 years and B a control group including 25 patients with benign diseases of the spine (BDS (lumbar disc hernia or stable spinal trauma (8 females and 17 males; 41.3±14.2 years. In a subgroup of eight patients of each group serum triiodothyronine (T3 and reverse T3 levels were measured. The blood samples were obtained between 8:00 and 9:00 AM. The following results were obtained: The SH group had smaller serum T3 and free T4 levels than the BDS group (pNós apresentamos previamente que a hemorragia subaracnoidea devido à ruptura de aneurisma intracraniano (SH está associada com alterações no perfil hormonal nas primeiras 24 horas após o evento. Nós propusemos que as alterações hormonais observadas são devidas ao intenso estresse ao qual os pacientes estão expostos. Contudo, o perfil hormonal tireoidiano é indicativo da presença da síndrome da doença não tireoidiana (NTIS. Neste trabalho, examinamos se as alterações no perfil dos hormônios tireoidianos são compatíveis com a NTIS. Dois grupos de pacientes foram incluídos no estudo: A 30 pacientes com SH (21 mulheres e 9 homens; 41,7±11,4 anos e B um grupo controle incluindo 25 pacientes com doenças benignas da coluna (BDS (hérnia de disco lombar ou estável trauma da coluna (8 mulheres e 17 homens; 41,3±14,2 anos. Em um subgrupo de oito pacientes de cada grupo os níveis séricos de triiodotironina (T3 e T3 reverso foram medidos. As amostras de sangue foram obtidas entre 8:00 e 9:00. Os seguintes resultados foram obtidos: o grupo SH teve menores níveis de T3 e T4 livre do que o grupo BDS (p<0,05: T3 (ng/ml: SH = 58,7±1,1 e BDS = 74,5±13,9; T4 livre (ng/dl: SH = 0,9±0,2 e BDS = 1,1±0,3. Não ocorreram diferenças significativas nos níveis de tiroxina total (T4 e de hormônio estimulante da tireóide (TSH entre os dois grupos: T4 (µg/dl: SH = 6,9±1,1 e BDS = 7,4±2,1; TSH (µUI/ml: SH = 1,5±0,8 e BDS = 1,8±1,0. Na amostra de oito pacientes de cada grupo tivemos os seguintes resultados: T3 (ng/ml: SH = 66,8±3,8 e BDS = 77,2±1,1 (p <0,05; T3 reverso (ng/dl: SH = 32,8±8 e BDS = 24,7±2,2 (NS; relação T3/ T3 reverso: SH = 2,6±0,3 e BDS = 3,3±0,4 (NS. Anticorpos antitireoglobulina e antimicrossomal não foram detectáveis, exceto em um paciente no grupo SH. Em conclusão: os pacientes com SH apresentam níveis séricos de T3 e T4 livre significativamente menores do que aqueles com BDS; o perfil hormonal tireoidiano sugere que os pacientes com SH desenvolvem a síndrome da doença não tireoidiana.

  10. Perdegimo sindromą sąlygojančių veiksnių vertinimas medicininę pagalbą teikiančių gydytojų tarpe

    Mačiulytė, Aušra

    2016-01-01

    The aim of research – to identify and analyse the main factors that determine the occurance of burnout syndrome among doctors providing medical care. Tasks of research: 1. Based on the analysis of scientific literature to analyze the concept of burnout syndrome, symptoms, burnout syndrome determinants and measures of burnout syndrome prevention; 2. To analyze characteristics of the surveyed doctors; 3. Perform a correlation ratio analysis and to investigate the factors that most ...

  11. SUPLEMENTASI DAUN TORBANGUN (COLEUS AMBOINICUS LOUR UNTUK MENURUNKAN KELUHAN SINDROM PRAMENSTRUASI PADA REMAJA PUTRI (SUPPLEMENTATION OF TORBANGUN LEAVES [COLEUS AMBOINICUS LOUR] IN REDUCING THE COMPLAINST OF PRE-MENSTRUAL SYNDROME [PMS] AMONG TEENAGE G

    Mazarina Devi

    2013-07-01

    Full Text Available ABSTRACT Background: Torbangun leaves (Coleus ambonicus Lour is one of type of species from Labiatae family which contains a lot of micronutrient and active element which have been examined as beneficial for human health and quality of life. The plants containing iridoid and flavonoid as well as phytochemical which deal with reproduction hormone is applicable to traditional medication toward PMS cases. Methods: The present study was aimed to assess the efficacy of CAL leaves in the management of PMS. An experimental clinical trial was conducted in 35 teenagers with PMS. Three intervention groups were defined: CAL leaves; commercial preparation; and placebo. Participants were followed-up individually for 1 month. Result: The results showed average menarche occurred around age 13 years, with menstruation lasting 5 days. During each successive treatment cycle, participants experienced a lower pain intensity score. Chi Square test, after adjusting each cycle for baseline pain, treatment compliance and other variables, showed that the group receiving CAL extract had significantly reduced pain intensity (p<0.05 compared with commercial preparation and placebo. Conclusion: The torbangun leaves supplement can be used as treatment to relief symptoms of the premenstrual syndrome. [Penel Gizi Makan 2010, 33(2:180-194]   Keywords: Torbangun leaves (Coleus amboinicus Lour, pre-menstrual syndrome (PMS, teenage girls

  12. Suplementasi Daun Torbangun (Coleus Amboinicus Lour) Untuk Menurunkan Keluhan Sindrom Pramenstruasi Pada Remaja Putri (Supplementation of Torbangun Leaves [Coleus Amboinicus Lour] in Reducing the Complainst of Pre-menstrual Syndrome [Pms] Among Teenage G

    Devi, Mazarina; Syarief, Hidayat; Damanik, Rizal; Sulaeman, Ahmad; Setiawan, Budi; Dewi, Rousmala

    2010-01-01

    ABSTRACT Background: Torbangun leaves (Coleus ambonicus Lour) is one of type of species from Labiatae family which contains a lot of micronutrient and active element which have been examined as beneficial for human health and quality of life. The plants containing iridoid and flavonoid as well as phytochemical which deal with reproduction hormone is applicable to traditional medication toward PMS cases. Methods: The present study was aimed to assess the efficacy of CAL leaves in the managemen...

  13. Neuroendocrine axis of stress, metabolic syndrome and psychiatric disorders in cushing's sindrome Ejes neuroendocrinos del estrés, síndrome metabólico y alteraciones psiquiátricas del síndrome de Cushing

    Leidy Alexandra Lezcano Tobón

    2005-04-01

    Full Text Available The role of abnormalities of the hypophysishypothalamus- adrenal gland axis (HHA in the ongoing stress and depression is analyzed. Besides, it is evidenced that some problems, until recently considered merely endocrine-metabolic such as Cushing's syndrome (either clinical or subclinical and obesity (mainly when it is part of the metabolic syndrome may have a common etiological basis, be it a primary event, a comorbidity or a trigger in individuals with genetic susceptibility to states of maladaptative chronic stress. Some harmful effects of severe and/or ongoing hypercortisolism on some brain areas and the possibility of permanent alterations in some neuronal circuits are described. Finally, and according to some clinical evidences, the potential therapeutic role of antiglucocorticoids in the management of refractory depression is explored, as well as the role that early psychiatric intervention and antidepressant pharmacological treatment may play in some patients with the metabolic syndrome or increased cardiovascular risk. Se analiza el papel de las anormalidades del eje hipotálamo-hipófisis-adrenales (HHA en el estrés sostenido y la depresión. Además se pone en evidencia que algunos problemas hasta hace poco considerados puramente endocrino-metabólicos como el síndrome de Cushing (SC (clínico o subclínico y la obesidad, principalmente cuando hace parte del síndrome metabólico (SM, pueden tener una base etiológica común, como evento primario, comorbilidad o disparador en individuos con susceptibilidad genética a los estados de estrés crónico maladaptativo. Se describen algunas acciones lesivas del hipercortisolismo severo y/o sostenido en algunas áreas cerebrales y la posibilidad de producir alteraciones permanentes en algunos circuitos neuronales. Por último se explora, de acuerdo con algunas evidencias clínicas, el papel terapéutico potencial de fármacos antiglucocorticoides en el manejo de la depresión refractaria y el papel que pueden jugar la intervención psiquiátrica temprana y el tratamiento farmacológico antidepresivo, en algunos pacientes con síndrome metabólico y/ o aumento del riesgo cardiovascular.

  14. Case histories in scientific and pseudo-scientific mass-media communication in energy/heat production from underground (geogas storage, geothermics, hydrocarbons), in the frame of Nimby Sindrome enhancement in Europe: the proposal of a new European Direct

    Quattrocchi, Fedora; Boschi, Enzo

    2014-05-01

    In the frame of energy/heat production from underground, the paper considers some European case histories and the needs of a complex and motley stakeholders community, made by scientific-industry-institutions, involved in the difficult task to study and accept (or refuse) projects strongly impacting the lived territory & underground, in densely populate countries, as Italy, in terms of appropriate public communication and sound deontological behaviour. Successively, the paper recalls years of "scientific" communication within the mass-media, highlighting the positive and negative messages, in comparison to the true and objective experimental data gathered by the real scientific work, as perceived by citizens of medium scholastic culture, which not delve the geologic disciplines, but receive simply the journalistic front-end, very often as sensationalist scoop. The authors retrace case histories of heuristic-participatory communication with the citizenship about the scientific results on challenges raised by certain technologies. The objective and rational communication is often impeded by local interests and by local journalism, which prefers to create sensationalist news more than scientific truths. This path progressively tangles as a consequence of the complex and with conflicting use of underground to produce energy (heat as gas storage, geothermical, unconventional gas exploitation, mining, etc…). Even the chain of renewables meets by now serious issues, exacerbated also by the need to start mining and drilling for the smart grids materials too (metals, rare Earths, etc..). A new text for a smart and innovative European Directivity is discussed, starting from the Italian regulatory issue. The review efforts for a "paper" on both a newspaper or a blog could be more difficult than the review a scientific paper, as a consequence of the peculiar situations behind the scenes and the conflicts of interests staying in the nest in a newspaper article or in a blog comment (locally political interests, commercial interests, attention-seeking, colleagues envies, etc..). The scientific journalists are normally of low scientific and ethical level and they are often coopted by negative mechanisms (mainly political for some newspapers or TV). The paper travel over again the AAPG rule of ethics (American Association of Petroleum Geology), taking the advantage of certain concepts developed by Nomisma Energia too and of concepts coming from our work, building energy-related questionnaires, also with municipalities affected by disastrous geological adverseness (i.e., earthquakes, contamination, slides, floods), even managing infrastructures of energetic production from underground (rims, storage, geothermics, etc…). In conclusions we suggest a "scientific journalist licence" (from Italy this kind of skill is escaping) and grave procedures of "Hyppocrates adjuratory" for scientific journalists as well as for scientific community and operators involved in the sector. The case histories reported emblematic of how the road is long, meandrous but necessary.

  15. Rendu-Osler-Weber syndrome: what radiologists should know. Literature review and three cases report; Sindrome de Rendu-Osler-Weber: o que o radiologista precisa saber: revisao da literatura e apresentacao de tres casos

    Agnollitto, Paulo Moraes; Barreto, Andre Rodrigues Facanha; Barbieri, Raul Fernando Pinsetta; Junior, Jorge Elias; Muglia, Valdair Francisco, E-mail: agno53@gmail.com [Universidade de Sao Paulo (HC/FMRP/USP), Ribeirao Preto, SP (Brazil). Fac. de Medicina. Hospital das Clinicas

    2013-05-15

    Rendu-Osler-Weber syndrome or hereditary hemorrhagic telangiectasia is an autosomal dominant vascular disease involving multiple systems whose main pathological change is the presence of abnormal arteriovenous communications. Most common symptoms include skin and mucosal telangiectasias, epistaxis, gastrointestinal, pulmonary and intracerebral bleeding. The key imaging finding is the presence of visceral arteriovenous malformations. The diagnosis is based on clinical criteria and can be confirmed by molecular biology techniques. Treatment includes measures for management of epistaxis, as well as surgical excision, radiotherapy and embolization of arteriovenous malformations, with emphasis on endovascular treatment. The present pictorial essay includes a report of three typical cases of this entity and a literature review. (author)

  16. Additivation of polyamide fibers by means of micro- and nano-particles containing jojoba oil

    Persico, Paola

    2006-01-01

    [Italiano] Obiettivo del Progetto di Dottorato, finanziato dalla Nylstar-Italia (azienda produttrice di poliammide), era realizzare fibre ad azione cosmetica per produrre calze, guanti e maglieria intima a nuovo valore aggiunto da introdurre nel mercato dei tessili skin care. Il primo passo dell’attività di ricerca è consistito nell’individuazione dell’agente cosmetico in base alla sua affinità con lo strato cutaneo e alla sua resistenza alla degradazione termica, tenendo conto che la poli...

  17. Congenital Primary Pachydermoperiostosis and Striate Palmoplantar Keratoderma - a Case Report

    Stojanović Slobodan

    2014-06-01

    Full Text Available Uvod. Pahidermoperiostoza (PDP predstavlja heterogeni sindrom za koji su karakteristične hipertrofi čne promene prvenstveno kože i kostiju ekstremiteta: pahidermija, klabing (clubbing prstiju šaka i stopala i hipertrofi čna osteoartropatija. Primarna pahidermoperiostoza − sinonim Turen−Solent−Goleov sindrom (Touraine-Solente-Golé (PPDP, ili primarna hipertrofi čna osteoartropatija (PHO, redak je nasledni poremećaj i predstavlja jedan od dva tipa hipertrofi čne osteoartropatije.

  18. The Army vs. the People: The Opposition of the Soviet Military to Baltic Independence

    1991-04-01

    untouched. General Fyodor Kuz’min, the commander of the Baltic Military District became Gorbachev’s de facto "Military Governer", the only powerful and... Sindrome ’, Neustavshchinye i Natsional’noi Aspekte Voinskoi Sluzhby" [Youth Try on Overcoats: on the ’Occupation Syndrome’, Non-Regulation Behavior, and...that despite the 4 V. Sein, "Komu na Ruku ’Antiarmeiskyi Sindrom ’?" [Who is Responsible for the ’Anti-Army Syndrome’?], Sovetskaya Latvia, July 5, 1989

  19. Siektes van peroksisome - 'n oorsig

    (x 14 SOO). Peroksisoomsiektes2. ,3,5.6. Ongeveer 12 genetiese siektes wat as gevolg van foute in die ontwikkeling of in die samestelling van peroksisome antstaan, is reeds beskryf. Volgens die omvang van die biogenetiese fout en die graad van verlies aan peroksisoomfunksies word hierdie sindrome in 3 groepe.

  20. Military Influence in Russian Politics

    1992-09-01

    militarization Union. I have concluded that the disappeared. 5 Indeed, a de -militarization military’s opportunity and motivation to of Soviet society and... sindrom 41-go." Novoe vremya, No. 8 (February volunteers over conscripts, and the Navy 1991); Maj. Gen. V.G. Strekozov, "Zakony ob oborone i statuse

  1. Mode of Action of Shigella Toxin: Effects on Ribosome Structure and Function

    1988-05-01

    1974. Sindrome hemolitico uremico: reporte de 60 casos asociados a una epidemia de enterocolitis hemorragica. Revista Colombiana de Ped. Puericult. 28...1518-1521. 34. Fong, J.S.C., J-P de Chadarevian and B.S. Kaplan. 1982. Hemolytic-uremic syndrome: current concepts and management. Ped. Clin. North Am

  2. Medical Problems Related to Altitude in: Human Performance Physiology and Environmental Medicine at Terrestrial Extremes. Chapter 14,

    1987-10-01

    function primarily to increase oxygen availability at the tissue level. The most significant changes occur in the cardiovascular and pulmonary systems...52. 40. Monge, M.C. La Enfermedad de Los Andes. Sindromes Eritremicos. Ann. Fac. Med. (Peru) 11:1, 1928. 41. Moore, L..G., G.L. Harrison, R.E

  3. Later in Life

    ... tics Planes de Educación Individualizados Efectos sobre el Aprendizaje Prevención del Acoso Escolar/Bullying: Estrategias Positivas ¡LEVANTEMONOS PARA SINDROME DE TOURETTE! Para los conductores de autobús Artículos Médicos ¿ ...

  4. Pneumonia Nosokomial

    Keliat, E.N; Abidin, Alwinsyah; Lubis, Nursyamsiah

    2017-01-01

    Pada masa yang lalu pneumonia diklasifikasikan sebagai pneumonia tipikal yang disebabkan oleh Str. Pneumonia daan atipikal yang disebabkan kuman atipik seperti halnya M. pneumonia. Kemudian ternyata manifestasi dari patogen lain seperti H. influenza, S. aureus dan bakteri Gram negatif memberikan sindrom klinik yang identik dengan pneumonia oleh Str E.N Keliat

  5. Enfrentamiento de las vasculitis primarias

    Dr. D. Santiago Rivero

    2012-07-01

    El diagnóstico diferencial incluye patologías muy diversas; trombosis ateroesclerótica; embolias ateroescleróticas, embolias sépticas, el uso de drogas ilícitas, y la trombosis secundaria al Sindrome Antifosfolípido.

  6. Standardization of androstenedione and estrone radioimmunoassay and profile of sex steroids, gonadotropins and prolactin - in patients with chronic anovulation due to inappropriate feedback (polycystic ovarian syndrome); Padronizacao do radioimunoensaio da androstenediona e da estrona e o perfil dos esteroides sexuais, gonadotrofinas e prolactina em pacientes com anovulacao cronica por retrocontrole improprio (sindrome dos ovarios policisticos)

    Vilanova, Maria do Socorro Veras

    1992-12-01

    Full text. In order to evaluate the profile of the sex steroids gonadotropin and prolactin in polycystic ovarian syndrome (POS), 24 patients with POS were studied and compared with 20 normal women during the early follicular phase of the menstrual cycle. Radioimmunoassay techniques for androstenedione (A) and estrone (E{sub 1}) were standardized for the purpose of the study. Androstenedione and estrone were extracted from plasma with ethyl ether. The assays were maintained in equilibrium and the labelled hormone-antibody complex was then separated from the free hormone using dextran charcoal. The sensitivity of the method was 6.8 pg/tube for A and 3.7 pg/tube for E{sub 1}. Nonspecific binding ws 3.4 for A and 3.3 for E{sub 1}. The interessay error at the D50 level was 15.6 for A and 8.6 for E{sub 1}. Patients with POS had significantly higher basal levels of LH, A, T E{sub 1} and PRL and similar FSH and DHEA-S levels when compared with normal women. The LH/FSH ratio was significantly elevated and the A/T ratio was significantly decreased. The A/E{sub 1} and T/E{sub 2} ratios were elevated and the E{sub 1}/E{sub 2} was decreased, although the differences were not statistically significant. A positive correlation between A and E{sub 1} was observed in patients with POS. In view of the above data, it was concluded that: the quality control parameters of the radioimmunoassay for A and E{sub 1} standardized in the present study are considered satisfactory, and the assay could be used for diagnosis and research; the patients with POS have a different sex steroid and gonadotropin profile when compared normal women during the early follicular phase of the menstrual cycle

  7. Nonhomogeneous immunostaining of hyaline membranes in different manifestations of diffuse alveolar damage Imunomarcação não homogênea das membranas hialinas na sindrome da angustia respiratório do adulto pulmonar, extrapulmonar e idiopática

    André Peres e Serra

    2006-01-01

    Full Text Available PURPOSE: To determine the nature of hyaline membranes in different manifestations of diffuse alveolar damage, [pulmonary and extrapulmonary acute respiratory distress syndrome], and idiopathic [acute interstitial pneumonia]. MATERIALS AND METHODS: Pulmonary specimens were obtained from 17 patients with acute respiratory distress syndrome and 9 patients with acute interstitial pneumonia. They were separated into 3 different groups: (a pulmonary diffuse alveolar damage (pDAD (n = 8, consisting only of pneumonia cases; (b extrapulmonary diffuse alveolar damage (expDAI (n = 9, consisting of sepsis and septic shock cases; and (c idiopathic diffuse alveolar damage (iDAD (n = 9, consisting of idiopathic cases (acute interstitial pneumonia. Hyaline membranes, the hallmark of the diffuse alveolar damage histological pattern, were examined using various kinds of antibodies. The antibodies used were against surfactant apoprotein-A (SP-A, cytokeratin 7 (CK7, cytokeratin 8 (CK8, alpha smooth muscle actin (a-SMA, cytokeratin AE1/AE3 (AE1/AE3, and factor VIII-related antigen (factor VIII. RESULTS: Pulmonary diffuse alveolar damage showed the largest quantity of hyaline membranes (12.65% ± 3.24%, while extrapulmonary diffuse alveolar damage (9.52% ± 3.64% and idiopathic diffuse alveolar damage (7.34% ± 2.11% showed intermediate and lower amounts, respectively, with the difference being statistically significant between pulmonary and idiopathic diffuse alveolar damage (P OBJETIVO: Determinar a natureza da membrana hialina nas diferentes manifestações do dano alveolar difuso [pulmonar e extrapulmonar síndrome do desconforto respiratório] e idiopático [pneumonia intersticial aguda]. MATERIAIS E MÉTODOS: Espécimes pulmonares foram obtidos de 17 pacientes com SDRA e 9 pacientes com pneumonia intersticial aguda e separados em três diferentes grupos: (a dano alveolar difuso pulmonar (DADp (n=8 constituído por casos de pneumonia, (b dano alveolar difuso extrapulmonar (DADexp (n=9 constituído por casos de sepse e choque séptico e (c dano alveolar difuso idiopático (DADi (n=9 constituído por casos idopáticos (ou pneumonia intersticial aguda. As características das membranas hialinas do padrão histológico de dano alveolar difuso foram examinadas usando vários tipos de anticorpos. Os anticorpos usados foram surfactante apoproteina A (SP-A, anti-citokeratina 7 (CK7, citokeratina 8 (CK8, alfa actina de músculo liso (a-SMA, citokeratina AE1/AE3 (AE1/AE3 e antígeno relacionado ao fator VIII (Fator VIII. RESULTADOS: Observaram-se aumentos maiores da quantidade de membrana hialina no dano alveolar difuso pulmonar (12.65 ± 3.24%, intermediários no dano alveolar difuso extrapulmonar (9.52 ± 3.64% e baixos no dano alveolar difuso idiopático (7.34 ± 2.11% respectivamente, esta diferencia foi estatística significante entre o dano alveolar difuso pulmonar e o dano alveolar difuso idiopático (p<0.05. Não se encontrou significância estatística para a quantidade de imunomarcação de Sp-A nos grupos de dano alveolar difuso pulmonar (15.36 ± 3.12%, extrapulmonar (16.12 ± 4.58% e idiopático (13.74 ± 4.20%. Com relação ao Fator VIII, nós encontramos maiores aumentos da imunomarcação da membrana hialina no grupo dano alveolar difuso idiopático (14.12 ± 6.25% do que no dano alveolar difuso extrapulmonar (3.93 ± 2.86%, com significância estatística (p<0.001. Da mesma forma houve um aumento progressivo da imunomarcação da membrana hialina com citokeratina AE1/AE3 nos grupos de dano alveolar difuso extrapulmonar (5.42 ± 2.80% e dano alveolar difuso idiopático (0.47 ± 0.81% (p<0.001. Nenhuns dos grupos marcou para as citokeratina CK-7, CK-8 ou para a vimentina ou actina de músculo liso. CONCLUSÕES: Este estudo só mostra os componentes epitelio/endotelio (SP-A, Fator VIII e AE1/AE da barreira alvéolo/capilar que estão presentes na formação da membrana hialina nos três diferentes grupos, sugerindo que as diferenças na sua patogênese dependem da via do ferimento (direto, indireto, ou idiopático; que dependem da causa do dano alveolar difuso. As diferenças na expressão do antígeno relacionado ao Fator VIII e nas citoqueratinas AE1/AE3 no grupo DADexp versus DADi, bem como as diferenças entre HM presente no grupo DADp versus DADi sugerem a ocorrência de lesões específicas com vias diferentes (direta, indireta ou idiopática dependentes do tipo de DAD.

  8. Diagnósticos de enfermagem em portadores da Síndrome da Imunodeficiência Adquirida Diagnósticos de enfermería em portadores del Sindrome de Inmunodeficiencia Adquirida Nursing diagnoses for patients with Acquired Immunodeficiency Syndrome

    Myria Ribeiro da Silva

    2009-02-01

    Full Text Available Os objetivos deste estudo foram identificar os diagnósticos de enfermagem mais freqüentes segundo a taxonomia II da NANDA em pacientes adultos portadores de HIV/aids e verificar com que freqüência as características definidoras, os fatores relacionados e de risco deram suporte para a elaboração destes. O levantamento dos dados foi realizado pelos pesquisadores nos 60 pacientes internados com HIV/aids e depois feita a verificação se os requisitos propostos pela NANDA para realização dos DE eram adequados. Foram selecionados 13 dos 38 diagnósticos com freqüência igual ou superior a 80%. Os resultados indicaram concordância e adequações para identificação. Porém, novos estudos serão necessários tanto para confirmação dos achados, assim como trazer novos conhecimentos ao assunto e estimular a pesquisa nesta população de pacientes.Los objetivos del estudio fuerón identificar los diagnósticos de enfermería según la taxonomia de Nanda en pacientes adultos portadores de HIV/Sida y observar con que frecuencia las caracteristicas que son definidas por los factores relacionados pelos investigadores en los 60 pacientes internados con VIH/SIDA y despúes hecha la verificación de los requisitos propuestos en Nanda para realización de los diagnósticos de la enfermeria que eran adequados. Fuerón relacionados 13 de los 38 diagnósticos con frecuencia igual al superior de 80%. Los resultados indican concordancia y sentido para identificar. Pues nuevos estudios fuerón necesarios tanto para a confirmación de los hallazgos asin como traer nuevos conhecimentos sobre el asunto y estimular a investigación neste grupo de pacientes.This study aims at identifying the most frequent nursing diagnoses, according to the NANDA's taxonomy II in adult patients of HIV/AIDS and to check how often the defining characteristics, the related factors and the risk factors provided support for their development. Data survey was conducted by researchers in the 60 patients admitted with HIV/aids, followed by the finding out whether the NANDA's proposed requirements to develop the Nursing Diagnoses were appropriate. From the 38 diagnoses, 13 diagnoses were chosen with a frequency equal or higher than 80%. Results pointed to agreement and appropriateness for identification. But new studies will be necessary either to acknowledge the findings and bring new knowledge to the topic as well, besides encouraging research with this patients' population.

  9. Existe importância na utilização de exames de fisiologia ano retal no diagnóstico da sindrome do intestino irritável? Is there importance in the use of anorectal physiologic tests in the diagnosis of the irritable bowel syndrome?

    Maria Auxiliadora Prolungatti Cesar

    2009-09-01

    Full Text Available INTRODUÇÃO: Em alguns pacientes a síndrome do intestino irritável e a constipação funcional se confundem, principalmente quando o sintoma predominante na síndrome do cólon irritável é a constipação. Dentre os vários exames alguns testes fisiológicos ano retais avaliam a função esfincteriana e sensibilidade retal OBJETIVO: Verificar se existem diferenças entre as manometrias anais dos pacientes com constipação funcional e síndrome do intestino irritável. MÉTODO: Trata-se de estudo de 55 manometrias e testes de sensibilidade anais realizadas em pacientes atendidos no ambulatório de Fisiologia Anal do Serviço de Clínica Cirúrgica do Hospital Universitário de Taubaté com diagnóstico de constipação intestinal ou síndrome do intestino irritável no período de janeiro de 2006 a maio de 2007. Todos os pacientes possuíam colonoscopia a normal e foram incluídos nos critérios diagnósticos de Roma II para Constipação Funcional e Síndrome do Intestino Irritável. As manometrias foram realizadas com aparelho ALACER, de perfusão com 8 canais. RESULTADOS: Não foram encontradas diferenças entre as manometrias quanto às pressões de repouso, contração e evacuação, assim como nos valores de sensibilidade retal. Encontramos diferenças quanto à dor abdominal desencadeada nos pacientes com síndrome do intestino irritável no momento do volume máximo tolerável em que 69,2% destes pacientes apresentaram dor abdominal. CONCLUSÃO: Os pacientes com a síndrome do intestino irritável apresentam dor à distensão da ampola retal, que não ocorre nos pacientes constipados, na aferição do volume máximo tolerável, não houve diferença em relação aos outros dados da manometria.INTRODUCTION: In some patients the irritable bowel syndrome and the functional constipation is confuse, mainly when the predominant symptom in the irritable bowel syndrome is the constipation. Amongst some examinations the anal manometry evaluates the esfincter function and retal sensitivity. METHOD: A study of 55 anal manometry was performed at the clinic of anal physiology of the Service of Surgical Clinic of the University of Toubate Hospital in patients with diagnosis of intestinal constipation or irritable bowel syndrome from january 2006 to may 2007. All the patients presented normal colonoscopy and were included in the diagnostic criteria of Rome II for Functional Constipation and Irritable Bowel Syndrome. Manometry was performed with Alacer a perfusion device with 8 channels. RESULTS: There had not been found differences between the manometry about the pressures of rest, contraction and evacuation, as well as in the values of rectal sensitivity. We find differences in abdominal pain in patients with irritable bowel syndrome at the moment of the tolerable maximum volum where 69.2% of these patients had presented abdominal pain. CONCLUSION: Patients with the irritable bowel syndrome present pain with rectal tolerable maximum volume, that does not occur in constipated patients, in the gauging of the tolerable maximum volume, which did not have difference in relation to the other data of the manometry.

  10. PREVALENCIA DEL SÍNDROME DEL BURNOUT Y SU CORRELACIÓN CON FACTORES PSICOSOCIALES EN DOCENTES DE UNA INSTITUCIÓN UNIVERSITARIA PRIVADA DE LA CIUDAD DE BARRANQUILLA -- PREVALENCE OF BURNOUT SINDROME AND ITS CORRELATION WITH PSYCHOSOCIAL FACTORS IN TEACHERS AT A PRIVATE ACADEMIC INSTITUTION IN THE CITY OF BARRANQUILLA

    CARMEN CABALLERO DOMÍNGUEZ

    2009-06-01

    Full Text Available The University teachers are forced to quite high levels of stress, largely related to psychosocial factors of work context of the educational institution, this may influence the development of Burnout syndrome. According to this the question arises, wich is the prevalence of Burnout syndrome and its correlation with psychosocial factors in academics?. To give answer to this question we made a correlational type of research, with a sample of 101 teachers with a form of full-time contract, wich were selected through stratified random sampling method. Were applied component of psychosocial risk factors questionnaire revised teacher Burnout (CBP-R and Burnout syndrome questionnaire (CESQT

  11. Evolução de uma criança com sindrome de Down à luz do modelo lúdico: estudo de caso / Evolution of a child with Down’s syndrome according to the ludic model: case study

    Tatyane Soriano Gonçalves Diniz da Silva

    2018-01-01

    Full Text Available Introdução: O brincar é fundamental para o desenvolvimento da criança. Brincando ela desenvolve os sentidos, adquire habilidades, amplia suas experiências e descobertas, e potencializa a criatividade, a inteligência e a sociabilidade. Na clínica de Terapia Ocupacional, o brincar é visto como um recurso terapêutico e uma ocupação fundamental na vida da criança, podendo ser avaliado a partir do referencial teórico do Modelo Lúdico. Objetivo: Analisar a evolução do comportamento lúdico e a percepção da família sobre o desenvolvimento de uma criança de 2 anos e 5 meses, com síndrome de Down, que foi acompanhada pela Terapia Ocupacional, em uma brinquedoteca terapêutica por 18 meses. Método: Estudo com abordagem qualitativa e quantitativa, realizado com o auxílio da Avaliação do Comportamento Lúdico, Entrevista Inicial com os Pais, Ficha de Avaliação do Serviço de Terapia Ocupacional e evoluções dos atendimentos. Resultados: Os dados mostraram evolução do interesse geral e lúdico, capacidade lúdica e atitude lúdica, mas com menor evolução na habilidade de expressão. Conclusão: Com base no referencial teórico do Modelo Lúdico, foi possível compreender o comportamento lúdico da criança estudada, planejar os atendimentos terapêuticos ocupacionais e avaliar seu desenvolvimento e as contribuições do trabalho realizado na brinquedoteca.

  12. Análise dos efeitos de um programa de exercícios associado à massagem como medida preventiva para a Sindrome do Piriforme em corredores de longa distância - doi: 10.5102/ucs.v12i2.2701

    Andreza Luiza de Almeida

    2014-12-01

    Full Text Available A Síndrome do piriforme é caracterizada pela compressão do nervo ciático, por se tratar de uma patologia muito frequente em atletas. O objetivo do estudo foi analisar o efeito do programa de exercícios associado à massagem em corredores fundistas. Este estudo caracterizou-se experimental. A amostra foi composta de 9 corredores que foram divididos aleatoriamente em 2 grupos A e B, com técnicas de massagens e alongamentos diferentes, realizado uma vez por semana. Foi realizada uma mensuração pré e pós-intervenção da rotação externa e interna do quadril e flexibilidade da coluna, para averiguar se ocorreu ganho na amplitude de movimento (ADM. Os resultados demonstraram que o "grupo A" obteve valores significativos (p<0,05 para o ganho de ADM em relação à média entre o "grupo B". Pode-se concluir o que os exercícios associados à massagem restabelecem a ADM e reduzem o risco de um possível acometimento a síndrome do piriforme em corredores.

  13. Lipodystrophy syndrome associated with antiretroviral therapy in HIV patients: considerations for psychosocial aspects Síndrome de la lipodistrofia asociado con la terapia antiretroviral en pacientes con VIH: consideraciones para los aspectos psicosociales Sindrome da lipodistrofia associada com a terapia anti-retroviral em portadores do HIV: considerações para os aspectos psicossociais

    Ana Paula Morais Fernandes

    2007-10-01

    Full Text Available Several side effects have been strongly associated with antiretroviral therapy in HIV patients. Among them, the lipodystrophy syndrome which presents alterations in body shape with central adipose hypertrophy and peripheral lipoatrophy, reported by patients as a visible marker identifying them as HIV patients. This manuscript presents an analysis of current literature regarding the psychosocial aspects of HIV patients with lipodystrophy associated with antiretroviral therapy. The results show that the alterations in body shape can be disturbing in terms of psychosocial well being, affecting quality of life and increasing the stigma associated with the disease, with consequent disturbances in social relations. This analysis provides a preliminary review of the psychosocial aspects of lipodystrophy and further studies are needed for a better understanding of this complex syndrome, which could provide new information to be used in nursing care for HIV patients affected by this problem.Varios efectos secundarios han sido fuertemente asociados con la terapia antiretroviral en pacientes con HIV. Entre ellos, el síndrome de la lipodistrofia se presenta con alteraciones en la forma del cuerpo con hipertrofia adiposa central y lipoatrofia periférica, las cuales son reportadas por pacientes como marcas visibles que los identifica como pacientes con VIH. En este manuscrito, presentamos un análisis de literatura actual con respecto a los aspectos psicosociales de pacientes con VIH presentándose con lipodistrofia asociado con la terapia antiretroviral. Los resultados demuestran que las alteraciones de la forma del cuerpo pueden ser inquietantes en lo que se refiere al bienestar psicosocial, afectando la calidad de vida y aumentando el estigma asociado con la enfermedad, con las consiguientes dificultades en las relaciones sociales. Este análisis provee un repaso preliminar de los aspectos psicosociales de la lipodistrofia; sin embargo, otros estudios son necesarios para entender mejor este complejo síndrome, proveyendo nueva información para ser utilizada en el cuidado de enfermería para pacientes con VIH que están afectados por este problema.Diversos efeitos colaterais têm sido associados à terapia anti-retroviral em portadores da infecção pelo HIV, dentre esses, a síndrome da lipodistrofia apresentando hiperlipidemia e alterações na forma do corpo, com hipertrofia adiposa central e lipoatrofia periférica, relatada pelos pacientes como um visível marcador para a identificação de portadores da infecção pelo HIV. Este estudo consiste em análise da produção científica sobre aspectos psicossociais em portadores da infecção pelo HIV que apresentam lipodistrofia associada à utilização da terapia anti-retroviral. Os resultados mostram que alterações corporais podem ser suficientemente perturbadoras para o bem-estar psicossocial, afetando a qualidade de vida e aumentando o estigma da doença, ocasionando perturbações nas relações sociais. Esta revisão possibilita uma análise preliminar dos aspectos psicossocias da lipodistrofia; entretanto, outros estudos são necessários para o melhor entendimento desta complexa síndrome, trazendo novas informações a serem utilizadas no cuidado de enfermagem a portadores da infecção pelo HIV afetados por este problema.

  14. Deteccion De Los Diferentes Grados De Motricidad A Traves Del Metodo De Mabc Para Encontrar Las Estrategias Metodologicas De Enseñanza A Los Niños Con Sindrome De Down, En La Escuela Especial “Un Nuevo Amanecer”, De La Ciudad De Babahoyo

    Galarza Acosta, Fresia

    2015-01-01

    Detectar dificultades en la aplicación de estrategias metodológicas de enseñanza mediante la evaluación del desarrollo de habilidades motrices y destrezas cognitivas que predominan en los niños con síndrome de Down que acuden a la escuela especial Un Nuevo Amanecer mediante la comparación con los parámetros del test de Mabc para conocer cuáles son las estrategias más adecuadas de enseñanza. Se hacen esfuerzos por incluir en la sociedad a las personas con síndrome de Down, especial atenció...

  15. Fissuras lábio palatinas não sindrômicas: relação entre o sexo e a extensão clínica Non sindromic cleft lip and palate: relationship between sex and clinical extension

    Daniella Reis Barbosa Martelli

    2012-10-01

    Full Text Available A fenda labial e/ou palatina representa a anomalia congênita mais comum na face. OBJETIVO: Descrever a correlação existente entre a fenda labial e/ou palatina não sindrômica e gênero e sua gravidade na população brasileira. MÉTODO: Estudo transversal, conduzido entre 2009 e 2011, em uma amostra de 366 pacientes. Os dados foram analisados com estatística descritiva e regressão logística multinomial com intervalo de 95% para estimar a probabilidade dos tipos de fenda labial e/ou palatina afetar os gêneros. RESULTADOS: Entre os 366 casos de fenda labial e/ou palatina não sindrômica, as fendas mais frequentes foram a fenda lábio-palatina, seguida, respectivamente, pela fenda labial e fenda palatina. As fendas palatinas foram mais frequentes entre as mulheres e a fenda lábio-palatina e fenda labial apenas predominaram nos homens. O risco de fenda labial em relação à fenda palatina foi de 2,19 vezes maior em homens quando comparados às mulheres; enquanto o risco de fenda labial e palatina em relação à fenda palatina apenas foi 2,78 vezes em homens, quando comparados às mulheres. CONCLUSÃO: Este estudo mostrou que há diferenças na distribuição de fendas labiais e/ou palatinas não sindrômicas entre homens e mulheres.Cleft lip and/or palate represent the most common congenital anomaly of the face. AIM: To describe the correlation between non-syndromic cleft lip and/or palate and gender, and its severity in the Brazilian population. METHODS: Cross-sectional study, between 2009 and 2011, in a sample of 366 patients. The data was analyzed with descriptive statistics and multinomial logistic regression with a 95% interval to estimate the likelihood of the types of cleft lip and/or palate affecting the genders. RESULTS: Among the 366 cases of non-syndromic cleft lip and/or palate, the more frequent clefts were cleft lip and palate, followed respectively by cleft lip and cleft palate. The cleft palates were more frequent in females, while the cleft lip and palate and cleft lips only predominated in males. The risk of cleft li in relation the cleft palate was 2.19 times in males when compared to females; while the risk of cleft lip and palate in relation to cleft palate alone was 2.78 times in males compared to females. CONCLUSION: This study showed that there were differences in the distribution of the non-syndromic cleft lip and/or palate between males and females.

  16. Molecular diagnostic of Philadelphia chromosome in patients affected by mieloid leukemia

    Campos Rudin, M.E.

    1996-01-01

    The main objective of this study, was to contribute with new elements, to the clinical diagnostic and the monitoring of hematologic diseases, through molecular techniques. Such technique is known as S outhern Blot . Non radioactive and radioactive methods were used, to sift the presence or absence of Ph chromosome. The sound denominated Transprobe-1 and the Endonuclease Bgl II were used. 41 samples proceeding from pacients diagnosed with LLMC and 9 patients grouped with myloproliferatives sindromes or myeloplast sindromes, which were getting treatment at Hospital San Juan de Dios or at Hospital Mexico, were analyzed. The studies detected the presence of rearrangements between Mocr/ABL and (Ph +), and in the remaining; the results were negative Ph . The author found that the application of one single endonuclease is usefull to make a first general sift of the patients; but the application of another endonuclease is required, to confirm the cases that resulted Ph negative. (S. Grainger)

  17. Geriatric Medicine, Sarkopenia, Frailty, dan Kualitas Hidup Pasien Usia Lanjut: Tantangan Masa Depan Pendidikan, Penelitian dan Pelayanan Kedokteran di Indonesia

    Siti Setiati

    2014-04-01

    Full Text Available Geriatri adalah cabang ilmu kedokteran dengan fokus pada penuaan dini dan tatalaksana penyakit terkaitusia lanjut. Proses menua mengakibatkan penurunan fungsi sistem organ seperti sistem sensorik, sarafpusat, pencernaan, kardiovaskular, dan sistem respirasi. Selain itu terjadi pula perubahan komposisitubuh, yaitu penurunan massa otot, peningkatan massa dan sentralisasi lemak, serta peningkatanlemak intramuscular. Masalah yang sering dijumpai pada pasien geriatri adalah sindrom geriatri yangmeliputi: imobilisasi, instabilitas, inkontinensia, insomnia, depresi, infeksi, defisiensi imun, gangguanpendengaran dan penglihatan, gangguan intelektual, kolon irritable, impecunity, dan impotensi. Dimasa yang akan datang diperlukan tempat rawat jalan terpadu dan perawatan kasus akut geriatri dirumah sakit di seluruh Indonesia. Program lainnya adalah nutrisi usia lanjut, tempat istirahat sementara,layanan psiko-geriatri dan dementia care, dukungan care giver, pencegahan penyakit kronis dankonseling, serta menyiapkan moda transportasi yang sesuai.Kata kunci: geriatri, kedokteran, penurunan fungsi, sindrom geriatri.

  18. Papiledema unilateral na síndrome do pseudotumor cerebral

    Mário L. R. Monteiro

    1985-06-01

    Full Text Available São apresentadas as fotografias de fundo de olho de 6 mulheres com papiledema unilateral e a síndrome do pseudotumor cerebral. Achados associados foram: obesidade em 5 e a sindrome da sela vazia parcial em 2. São discutidas as possíveis explicações para o desenvolvimento de papiledema unilateral nesses pacientes e que favorecem um mecanismo presente na porção distal dos nervos ópticos.

  19. SYM1, l’ortologo di lievito del gene umano MPV17, codifica per una proteina indotta da stress che modula lo stato bioenergetico e morfogenetico del mitocondrio

    Dallabona, Cristina

    2010-01-01

    Mutazioni nel gene MPV17 causano l’insorgenza di una forma epatocerebrale della sindrome da deplezione del DNA mitocondriale. MPV17 codifica per una piccola proteina idrofobica localizzata nella membrana mitocondriale interna con funzione sconosciuta. Per cercare di chiarire le basi molecolari che causano la patologia, abbiamo utilizzato il lievito S. cerevisiae come organismo modello grazie alla presenza di un ortologo di MPV17: SYM1. Abbiamo dimostrato che la proteina Sym1 è essenziale per ...

  20. EKOLOGIJA LESENE GRADNJE

    Kuhelnik, Lidija

    2011-01-01

    Diplomska naloga obravnava sisteme lesene montažne gradnje. Opisani so vsi trije sistemi, torej skeletni, okvirni in masivni. Obravnavani so lesni kompoziti za konstrukcije. V nadaljevanju je obravnavana gradbena biologija in zelena trajnostna gradnja. Podrobno je opisana zdrava hiša in njeni materiali. Predstavljen je tudi sindrom nezdrave zgradbe. Opisana je konstrukcijska zaščita lesa in modifikacija lesa.

  1. Los nuevos tratamientos de la esquizofrenia: estudios comparativos de métodos y resultados

    Julio Manrique

    1939-08-01

    Full Text Available Después de que el método de SAKEL se empleó con éxito en el tratamiento del sindrome esquizofrénico, el advenimiento de la tono-clono terapia de V. MEDUNA originó la comparación de los resultados obtenidos, para decidir cual de los procedimientos habia obtenido mayores éxitos.

  2. EVANS SYNDROME IN A 10 YEAR OLD GIRL

    A. Ariputra

    2015-10-01

    Full Text Available Evans syndrome is a coexistence of simultaneous or sequential positive direct Coombs test in conjunctionwith  immune-mediated  thrombocytopenia with no known underlying etiology. The  clinical  course  ischronic and relapsing, and the therapy is generally progressive. Recurrences of thrombocytopenia, anemiaand neutropenia are common, as well as episodes of hemorrhage and serious infections. Noncrossreactingautoantibodies are directed against red cells, platelets, and neutrophils antigens. Evans syndrome isa rare condition, no predilection is known and its exact prevalent is unknown. We report a case of Evanssyndrome in 10 years old girl with severe anemia and thrombocytopenia. Patient came with clinicalsymptoms of severe anemia. The laboratory evaluation showed severe anemia, increased reticulocytecount, anisopoikilocytosis erythrocyte, increased unconjugated bilirubin, positive direct Coombs testand thrombocytopenia. Patient was then managed with high doses of corticosteroids and showed goodresponse from both clinical and laboratory evaluations. [MEDICINA 2015;46:61-66].Sindrom Evans adalah suatu penyakit yang ditandai dengan adanya hasil positif pada direct Coombstest dan trombositopenia yang diperantarai  imun secara simultan atau sekuensial tanpa penyebabyang  jelas. Perjalanan klinis umumnya bersifat kronis, sering mengalami relaps dan memerlukanterapi yang progresif. Kejadian trombositopenia, anemia, neutropenia, perdarahan dan episode infeksiberat berulang umum terjadi. Pada sindrom ini, terjadi reaksi autoantibodi spesifik terhadap antigensel darah merah, trombosit dan juga neutrofil. Sindrom Evans merupakan kasus yang jarang ditemukandan dengan predileksi serta prevalensi yang belum banyak diketahui. Kami melaporkan satu kasusSindrom Evans pada anak perempuan usia 10 tahun.  Pasien dengan gejala klinis anemia berat dan padapemeriksaan laboratorium menunjukkan suatu anemia berat, peningkatan hitung retikulosit, gambaraneritrosit

  3. ERYTHEMA NODOSUM AND PROLONGED FEVER ASSOCIATED TO SECONDARY HYPERPARATHYROIDISM

    Galimberti R

    2005-08-01

    Full Text Available SUMMARYSecondary hyperparathyroidism is one of the main deragements caused by chronic renal failure, and parathyroid hormone is considered one of the toxins of the uremic syndrome. Prolonged fever due to primary hyperparathyroidism have already been described in the literature but not yet as induced by secondary hyperparathyroidism. In this case report a patient suffering from an erythema nodosum and prolonged fever associated to secondary hyperparathyroidism that disappeared through subtotal parathyroidectomy is presented.RESUMENEl hiperparatiroidismo secundario es uno de los principales disturbios causados por la insuficiencia renal crónica, y la paratohormona es considerada una de las toxinas del sindrome urémico. El sindrome febril prolongado secundario a hiperparatiroidismo primario ya ha sido descripto en la literatura, aunque no lo ha sido aun el inducido por hiperparatiroidismo secundario. En el presente reporte se presenta un caso de eritema nodoso y sindrome febril prolongado asociado a hiperparatiroidismo secundario y que resolvió luego de efectuada una paratiroidectomía subtotal.

  4. Churg-Strauss Syndrome and pregnancy Successful treatment with intravenous immunoglobulin - Reply

    M. Galeazzi

    2011-09-01

    Full Text Available La sindrome di Churg-Strauss è una malattia estremamente rara e ancora più raro è riscontrarla in una paziente in stato di gravidanza. Il trattamento iniziale della malattia consiste nella somministrazione di alte dosi di corticosteroidi. I pazienti più gravi o che rispondono poco o insoddisfacientemente ai corticosteroidi vengono solitamente trattati con farmaci citotossici. Le immunoglobuline somministrate per via endovenosa (IgEV stanno dimostrando di essere efficaci nel trattamento di questa patologia, tuttavia non esiste un consenso universale sulla loro effettiva utilità nelle vasculiti sistemiche. Noi presentiamo il caso di una donna con sindrome di Churg-Strauss resistente al trattamento con corticosteroidi e ciclofosfamide. Allorché si riscontrò che la paziente era al 3° mese di gravidanza fu iniziata una terapia con alte dosi di IgEV con ottimi risultati. Questo caso conferma l’utilità del trattamento con IgEV della sindrome di Churg-Strauss e ne dimostra l’efficacia anche in stato di gravidanza.

  5. Comparative transforming potential of different human papillomaviruses associated with non-melanoma skin cancer

    Massimi, Paola; Thomas, Miranda; Bouvard, Veronique; Ruberto, Irene; Campo, M. Saveria; Tommasino, Massimo; Banks, Lawrence

    2008-01-01

    It is well established that high-risk human papillomaviruses (HPVs) that infect mucosal epithelia are the causative agents of cervical cancer. In contrast, the association of cutaneo-tropic HPV types with the development of non-melanoma skin cancer (NMSC) is less well defined. In this study, we have analysed the in vitro transforming potential of various cutaneous HPV types. Using oncogene cooperation assays with activated ras, we have shown that diverse cutaneous types, including 12, 14, 15, 24, 36 and 49, have significant transforming potential. Interestingly, most of this activity appears to be encoded by the E6 gene product. In contrast, the common HPV-10 exhibits no significant transforming potential in these assays. This difference may be a reflection of different patterns of cellular localization, with transforming E6s being nuclear and non-transforming being cytoplasmic. These results provide molecular support for a role of these viruses in the development of certain human malignancies

  6. Hyperlucent lung; Pulmon hiperlucente

    Jimenez-Gutierrez, Florana; Soto-Quiros, Manuel E [Hospital Nacional de Ninos, Servicio de Neumologia, apartado 1654-1000, San Jose (Costa Rica)

    2007-10-15

    Unilateral hyperlucent lung is also known as Swyer-James Syndrome, Macleod Syndrome or lobular or unilateral emphysema. It is an uncommon disease characterized by lung or unilateral lobe hiperlucency associated to an air trapping upon expiration. As regards to etiology, this syndrome is considered to be an acquired disease that appears secondary to respiratory infections during the early years of life, probably bronchiolitis and/ or viral pneumonia. The clinical presentation varies among patients. Some of them are asymptomatic, others present a history of recurrent episodes of pulmonary infections from early years of life or present effort dyspnea. The diagnosis is usually made accidentally by a chest radiograph in a child with history of respiratory infections or in an adult during a routine chest x- ray in an asymptomatic person. It is important to differentiate this syndrome from other causes of unilateral pulmonary hiperlucency on conventional chest x-rays. Few cases of Swyer-James Syndrome in children have been reported, it is presented the clinical case of a patient who had a parainfluenza 3 bronchopneumonia when he was a month and eighteen days of age. The differential diagnosis of this syndrome should be done with other thoracic entities that diminish the radiological pulmonary unilateral density. A case of a child who is the bearer of hyperlucent lung is described. (author) [Spanish] El pulmon hiperlucente unilateral tambien se ha denominado Sindrome de Swyer-James, Sindrome de Macleod o enfisema lobular o unilateral. Es una enfermedad poco frecuente que se caracteriza por una hiperclaridad pulmonar o lobar unilateral asociada a un atrapamiento aereo en la espiracion. En cuanto a la etiologia, existe evidencia que se atribuye a una enfermedad adquirida que aparece tras una infeccion pulmonar durante la infancia, probablemente una bronquiolitis o una neumonia viral. El cuadro clinico es variable: algunos pacientes se encuentran asintomaticos, otros con

  7. Repercusiones endocrinólogicas en el apnea obstructiva del sueño

    Enrique Cipriani

    2010-01-01

    Full Text Available Las alteraciones en la oxigenación que ocurren en el Sindrome Obstructivo del Apnea de sueño comprometen el funcionamiento tisular de todos los órganos del ser humano; con relación a la disfunción endocrinológica, los aspectos concernientes a esta no son bien conocidos. La intención de este trabajo fue revisar la información existente al respecto, a través de una búsqueda en las referencias MEDLINE entre los años 1995 y 2009.(Rev Med Hered 2010;21:39-45.

  8. INFEKSI SALURAN KEMIH PADA GERIATRI

    Kokeela Torayraju

    2015-04-01

    Full Text Available Jumlah penderita infeksi saluran kemih (ISK pada geriatri di Indonesia akan semakin meningkat dan menjadi penyebab kedua tersering setelah pneumonia. Pendekatan diagnosis dan terapi ISK pada geriatri memiliki kekhususan. Ada tidaknya gejala dan tanda spesifik serta bagaimana cara pengambilan spesimen turut berperan dalam diagnosis ISK pada geriatri. Faktor predisposisi penderita ISK pada geriatri meliputi diabetes melitus, gizi kurang, gangguan faal kognitif, depresi, gangguan status fungsional, prostatitis, riwayat operasi, dan prolaps vagina. Gejala dan tanda yang sering muncul adalah sindrom delirium, inkontinensia urin dan syncope yang diawali oleh penurunan nafsu makan. Strategi penatalaksanaan meliputi modalitas non‐ farmakologik dan farmakologik. Kata Kunci : infeksi saluran kemih (ISK, geriatri.

  9. [Giant intradiploic infratentorial epidermoid cyst].

    Alberione, F; Caire, F; Fischer-Lokou, D; Gueye, M; Moreau, J J

    2007-10-01

    Epidermoid cysts are benign, uncommon lesions (1% of all intracranial tumors). Their localization is intradiploic in 25% of cases, and exceptionally subtentorial. We report here a rare case of giant intradiploic infratentorial epidermoid cyst. A 74-year old patient presented with recent diplopia and sindrome cerebellar. CT scan and MR imaging revealed a giant osteolytic extradural lesion of the posterior fossa (5.2 cm x 3.8 cm) with a small area of peripheral enhancement after contrast injection. Retrosigmoid suboccipital craniectomy allowed a satisfactory removal of the tumor, followed by an acrylic cranioplasty. The outcome was good. Neuropathological examination confirmed an epidermoid cyst. We review the literature and discuss our case.

  10. Recent Advances in HNC’s Context Vector Information Retrieval Technology

    1996-05-01

    infectados 14 20 0.360 portadoras 5 5 0.358 deficiencia 8 10 0.351 vih 10 18 0.343 adquirida 26 28 0.340 infection 12 22 0.337 aids "patients 12...0.607 portadores 16 31 0.528 immunodeficiency 6 6 0.514 infectadas 18 21 0.504 hiv 18 49 0.496 vih 10 18 0.489 aids 86 578 0.481 infectados 14...34 Table 2 shows the stem tree for the tie-word "AIDS". In Spanish, AIDS has the acronym " SIDA " which stands for sindrome inmuno deficiencia

  11. Etnopsihologijski okvir hrvatske i srpske nacije

    Rendić-Miočević, Ivo

    2000-01-01

    Na području jugoistočne Europe (Ilirik) homogenost se ostvarivala na temelju tradicionalnih modela. Istraživanje nacionalizama i nacija u jugoistočnoj Europi moguće je i etnopsihološkim pristupom. U patrijarhalnom društvu, na temelju ideologije (narodne pjesme, mitovi i dr.), autor otkriva sindrom Kraljevića Marka (simptomi: projekcije, paranoja i narcizam). Srednjovjekovna Srbija u kojoj su bile povezane država i crkva imala je drukčiji društveni razvoj od europskog društva (dugo trajanje or...

  12. Relacion entre problemas habituales del sueño con deficit atencional y trastornos conductuales en niños

    Lucila Andrade, A.

    2013-01-01

    Los trastornos del sueño en niños son frecuentes y afectan el desarrollo neurológico. Los sindromes de apnea obstructiva del sueño y piernas inquietas se destacan por sus efectos cognitivo-conductuales. Los Trastornos del neurodesarrollo, como Autismo, Síndrome Déficit Atención/hiperactividad (TDAH) y las co-morbilidades asociadas, presentan alta prevalencia de trastornos del sueño, con dificultades para conciliar el sueño e incremento de los despertares nocturnos, los que frecuentemente pasa...

  13. Patología Linfática

    Ponzinibbio, Carlos; Lima, María Silvia

    2017-01-01

    Se presenta en modo esquemático la patología del Sistema Linfoide con exclusión de las leucemias. Se repasan las bases de la ontogenia linfoide. Se presenta en forma esquemática la patología no neoplásica, aguda y crónica. Como protipo de sindrome linfoproliferativo benigno se presenta la mononucleosis infecciosa. Se presentan los fundamentos de la génesis de las neoplasias sólidas del tejido linfático: los linfomas. Se mencionan las traslocaciones como alteraciones genéticas más frecuentes p...

  14. Possibilidades e desafios na formação de professores de língua inglesa a indivíduos com a Síndrome de Asperger

    Eduardo Pimentel da Rocha

    2016-01-01

    Este trabalho tem o intuito de (re)pensar a formação de professores de inglês (LI), no que tange às suas possibilidades e os seus desafios, por meio da trans-multidisciplinaridade, mais especificamente por meio do referencial teórico da Neuroeducação, e o ensino de LI para aprendizes com a Sindrome de Asperger (SA), tendo como contexto a Universidade Estadual de Londrina (UEL) e as leis de inclusão. Para tanto, dois objetivos foram propostos, a saber: 1) Identificar se e como o curso de licen...

  15. Revista de tesis

    Revista, Facultad de Medicina

    2011-01-01

    Sindromes abdominales agudos y bloqueo anestésico esplácnico semi-lunar. Tesis de grado "Meritoria". 1945. - Presentada por Guillermo Moreno Díaz / Estudio de algunas funciones hepáticas de la anemia tropical. Tesis de grado. 1945. - Presentada por Primitivo Rey Rey / Endoscopia, laringe, traquea, bronquios y esófago. Tesis de grado declarada "Meritoria". 1945. - Presentada por Carlos Alberto /  Cleves. el neumoperitoneo en el tratamiento de la tuberculosis intestinal y peritoneal y como medi...

  16. Ataxia cerebelosa persistente despues de la administracion toxica de difenilhidantoina

    Andrés M. Villa

    1994-12-01

    Full Text Available La intoxicacion cronica con difenilhidantoina (DFH es bien conocida como causa de ataxia irreversible en pacientes epilépticos debida a atrofia cerebelosa con perdida de células de Purkinje. No es asi con la intoxicación aguda, puesto que sus signos y síntomas son reversibles. Presentamos un paciente con convulsiones parciales complejas, secundarias a un quiste temporal, que habia sido tratado irregularmente con DFH durante dos años con dosis variables que oscilaban en los 100 mg/dia. Dada la refractariedad de su cuadro convulsivo en una entrevista previa a su ingreso se le indico un aumento brusco de la dosis del fármaco que alcanzo a los 400 mg/dia. Ello ocasiono un sindrome pancerebeloso severo que motivo su internación. Posteriormente a la suspension de la DFH y la exeresis del quiste temporal mejoro su cuadro convulsivo, aunque quedo con ataxia de miembros inferiores y asinergia de tronco, cuadro con el que fue dado de alta. Un año despues, el paciente se encontraba libre de convulsiones, pero su sindrome cerebeloso no se habia modificado. El estudio por imágenes no evidencio atrofia cerebelosa.

  17. Consideraciones sobre el hidrocefalo de baja presion

    E. Herskovits

    1976-12-01

    Full Text Available Se analizan las condiciones fisiopatológicas del sindrome de hidrocéfalo de presión normal. De un grupo de 21 pacientes con sintomatologia clínica correspondiente a esta entidad, se seleccionan 10 que presentan un diagnóstico clínico, radiológico y cisternográfico indudable de la entidad en estudio. Se observó que, a pesar de esta selección solamente un 50% de ellos se vió beneficiado con la colocación de una válvula de baja presión. Surge entonces la hipotésis de que este cuadro es un sindrome multicausal; que por un proceso fisiopatogenico común produce un cuadro clínico, radiológico y cisternográfico similar y que serían beneficiados únicamente aquellos enfermos en los que se soluciona el problema mecánico.

  18. Farmacologia da unidade motora: aspectos de interesse em neurologia Pharmacology of motor end-plate: aspects related to neurology

    Paulina Sannomiya

    1975-09-01

    Full Text Available Os AA fazem revisão sobre a unidade motora em seu aspecto morfológico, fisiológico e farmacológico como base para o estudo e tratamento da miastenia grave e da síndrome miastênica. Estudos eletromiográficos, farmacológicos e eletrofisiológicos, realizados por diversos autores, determinam características especiais que definem a miastenia grave e a síndrome miastênica. Certos sinais e sintomas, comumente observados em casos de envenenamento por elapídeos, são semelhantes aos causados por drogas bloqueadoras neuromusculares.In order to understand the treatment of miasthenia gravis and miasthenic sindrome, the morphology, physiology and pharmacology of the motor unit were reviewed. Electromiographic, pharmacologic and electrophysiologic studies accomplished by several authors have special caractheristics which define miasthenia gravis and miasthenic sindrome. Certain venoms such as those from Elapidae can produce signals and symptoms resembling those produced by neuromuscular blocking drugs.

  19. Communicating by using PECS for Children with Rubinstein-Taybi Syndrome

    Derwena Mohd Bazain

    2017-07-01

    Full Text Available This study discusses communication aid using the Picture Exchange Communication System (PECS to children with Rubinstein Taybi Syndrome (RTS. RTS's children suffer mental retardation, have the - the autistic, can not speak and can not manage themselves well. The aim of this study was to determine the effectiveness of using PECS and RTS students can improve their language to communicate better to all. Based on the theory of constructivism introduced by Gagne that emphasizes learning system must start from the simple to the complex. The study design is a case study of a child suffering from Rubinstein-Taybi syndrome. In conclusion, the PECT implemented is expected can help children’s RTS and improve their academic performance. Kajian ini membincangkan mengenai bantuan komunikasi menggunakan Picture Exchange Communication System (PECS kepada kanak-kanak Sindrom Rubinstein Taybi (RTS. Kanak-kanak RTS ini mengalami kerencatan akal, memiliki ciri – ciri autisme, tidak boleh bertutur dan tidak boleh urus diri dengan baik. Tujuan kajian ini adalah untuk melihat keberkesanan menggunakan PECS dan murid RTS dapat meningkatkan penguasaan bahasa untuk berkomunikasi dengan lebih baik kepada semua. Berdasarkan teori konstruktivisme yang diperkenalkan oleh Gagne yang menekankan sistem pembelajaran harus bermula daripada yang mudah kepada yang rumit. Rekabecntuk kajian ini berbentuk kajian kes terhadap seorang kanak-kanak yang mengalami sindrom Rubinstein-Taybi. Kesimpulannya, diharapkan dengan adanya PECS yang dilaksanakan dapat membantu kanak-kanak RTS ini serta meningkatkan prestasi akademik mereka.

  20. Hantaran Sinyal Leptin dan Obesitas: Hubungannya dengan Penyakit Kardiovaskuler

    David Limanan

    2013-11-01

    Full Text Available Diperkirakan saat ini jumlah orang dengan obesitas melebihi 250 juta orang, yaitu 7% dari populasi orang dewasa di dunia. Mortalitas obesitas erat hubungannya dengan sindrom metabolik yang merupakan kelainan metabolik meliputi obesitas, resistensi insulin, gangguan toleransi glukosa, abnormalitas trigliserida dan hemostasis, disfungsi endotel dan hipertensi. Leptin dihasilkan adiposit dan merupakan anggota dari adipositokin; berperan dalam hantaran sinyal hormon jaringan adiposa. Kelainan leptin maupun reseptornyadapat menyebabkan seseorang mengalami obesitas, metabolik sindrom, diabetes dan penyakit kardiovaskuler. Kompleks leptin-reseptor mengaktifkan sistem transduksi sinyal, yang paling dominan adalah jalur janus kinase-signal transducer and activator of transcription-3 (JAK-STAT3, kemudian phospatidyl inositol 3- kinase (PI3K, mitogen-activated protein kinase (MAPK, 5’adenosine monophosphate-activated protein kinase (AMPK, dan mammalian target of rapamycin (mTOR. Jalur leptin-associated PI3K dengan ERK cascade berperan penting dalam proliferasi kardiomiosit dan melindungi jantung dari ischemia reperfusion injury. ERK1/2 mengaktifkan target gen seperti c-fos dan egr-1 yang berperan dalam proliferasi dan diferensiasi. Nuclear factor κB diduga sebagai target jalur p38 dan JNK MAPK. Faktor transkripsi inu berperan pentingdalam mengatur transkripsi sitokin proinflamasi seperti tumor necrosis factor (TNF-α dan interleukin (IL-1β. Leptin dapat meningkatkan pembentukan reactive oxygen species (ROS sel endotel pembuluh darah dan menstimulasi sekresi TNF-α dan IL-6 yang merupakan promotor hipertensi dan aterosklerosis.Kata Kunci: obesitas, leptin, sistem kardiovaskuler 

  1. Utilização da fração semipurificada da proteinase do Trypanosoma cruzi no imunodiagnóstico da doença de Chagas The use of a semipurified fraction of Trypanosoma cruzi proteinase in immunodiagnosis of Chagas' disease

    Ajax Mercês Atta

    1984-12-01

    Full Text Available Foram sensibilizadas hemácias humanas 0 Rh negativo com a fração semipurificada (Fp da proteinase do Trypanosoma cruzi, e testadas quanto a antigenicidade com soros de pacientes portadores de tripanossomíase americana crônica e de outras doenças parasitárias não relacionadas. Reações de hemaglutinação positivas foram observadas com os soros de pacientes chagásicos e com alguns soros de indivíduos portadores de leishmaniose cutaneo-mucosa. Não foram observadas reações cruzadas com os soros de pacientes portadores de leishmaniose visceral, malária, toxoplasmose, sífilis, esquistossomose e mononucleose. Os resultados obtidos são favoráveis ao emprego desta fração antigênica em testes de imunodiagnóstico da tripanossomíase americana.Group 0 Rh negative human erytrocytes were coated with the semipurified fraction of T. cruzi proteinase and tested with sera both from patients with chagas' disease and from others with unrelated parasitic diseases. Positive haemagglutination reactions were only observed with the sera from the former and with that from two patients with mucocutaneous leishmaniasis. No crossed reactions were observed with visceral leishmaniasis, malaria, toxoplasmosis syphilis, schistosomiasis or mononucleosis sera. Results suggest that this purified fraction can be used in immunodiagnosis of American Trypanosomiasis.

  2. Barrera del desempeño laboral

    María Del Rosario Alvarez-Ramirez

    2007-12-01

    Full Text Available El estres es un hecho complejo en la vida de toda persona con efectos distintos en cada quien, que no puede ser evitada ya que en todos lo momentos de la vida se esta en riesgo de presentarlo ante cualquier situacion, o una actividad laboral o familiar, que puede llegar a generar cualquier cambio que represente estres. Los sucesos negativos, dario, enfermedad o muerte de un ser querido, son hechos estresantes, asi como los sucesos positivos; ascender en el trabajo trae consigo el estres del nuevo status, de nuevas responsabilidades. Dentro de los trastornos clinicos vinculados al estres hay alteraciones como: trastornos del sumo, ulceras, dolores de cabeza, aceleracion del ritmo cardiaco y otros trastornos como los cardiovasculares: palpitaciones, hipertension arterial, trastornos digestivos, dolores, ardores, vomitos, nauseas, diarrea o estreriimiento y trastornos cutaneos: donde se presenta transpiracion de manos y pies y problemas alergicos. En el estres se pueden llegar a presentar dos tipos de estres: el positivo y el negativo. Los cuales presentan unas caracteristicas muy particulares, como en el estres negativo: una persona se encuentra ante un nitmero creciente de demandas que le plantean dificultad o constituyen una amenaza, se debe mirar el modo de afrontarlas. En el Estres positivo se presenta cuando la percepcion de capacidad de demanda es mucho mas amplia que las verdaderas demandas. Un aspecto fundamental ante la presencia de estres es la practica necesaria de un deporte o la realizacion de actividades recreativas.

  3. Estrutura e síndromes de dispersão de espécies arbóreas em um trecho de mata ciliar, Sirinhaém, Pernambuco, Brasil Structure and dispersal syndromes of tree species in a stretch of riparian vegetation, Sirinhaém, Pernambuco State, Brazil

    Roseane Karla Soares da Silva

    2012-03-01

    Full Text Available

    Este trabalho teve por objetivo conhecer a fitossociologia do componente arboreo em uma mata ciliar de um corrego que desagua no Rio Sirinhaem, localizado no Engenho Buranhem, Sirinhaem, PE e identificar as sindromes de dispersao das especies. O corrego esta situado em um fragmento de Floresta Ombrofila Densa de Terras Baixas, com 272 ha. Utilizou-se como area amostral um hectare (40 unidades amostrais, 10 m x 25 m onde foram registrados 1.307 individuos arboreos com circunferencia a altura do peito (CAP ≥ 15 cm. Foram identificadas 118 especies, pertencentes a 40 familias botanicas. Protium heptaphyllum e Pouteria sp.1 foram as especies mais abundantes. Em termos de valor de importancia (VI, as especies Protium heptaphyllum, Pouteria sp.1 e Virola gardneri estao entre as mais importantes ecologicamente. As sindromes de dispersao predominantes foram: zoocoria (72,8%, autocoria (13,6% e anemocoria (4,8%. Nao foi possivel determinar a sindrome de dispersao de 8,8% das especies estudadas.

     

    doi: 10.4336/2012.pfb.32.69.01

    This study aimed to know the phytosociology of the tree component of riparian vegetation in a stream that flows into the Sirinhaem River in Engenho Buranhem, Sirinhaem, Pernambuco State, and identify the species dispersal syndromes. The stream is located in a fragment of dense rain forest of the lowlands, with 272 ha. It was sempled used one hectare (40 sampling units of 10 m x 25 m each. It was registered 1,307 trees with circumference at breast height (CAP . 15 cm. We identified 118 species belonging to 40 botanical families. Protium heptaphyllum and Pouteria sp.1 were the most abundant species. In terms of importance value (IV, Protium heptaphyllum, Pouteria sp.1 and Virola gardneri are among the most important ecologically species. The predominant dispersal syndromes were zoocory (72.8%, autocory (13.6% and anemochory (4.8%. It was not possible to determine the type of dispersal of 8.8% of the

  4. Trastornos hematopoyéticos en trabajadores expuestos a radiaciones ionizantes

    Agustín Méndez Arias

    2014-03-01

    Full Text Available Los estándares de protección radiológica, se derivan de estimaciones principalmente de estudios epidemiológicos de los supervivientes japoneses de los bombardeos atómicos de Hiroshima y Nagasaki. El reciente accidente nuclear en Fukushima nos muestra que no estamos seguros y despierta el interés de conocer los efectos biológicos de las radiaciones ionizantes a dosis bajas por exposición laboral, mostrando la evidencia epidemiológica, relacionando las dosis y el tiempo de exposición, edad riesgo y tiempo de aparición de trastornos hematopoyéticos. La búsqueda bibliográfica se realizó mediante la selección de los términos MeSH y DeCS para buscar en las diferentes bases de datos. 82 estudios recuperados, más 14 estudios vía búsqueda manual, tras aplicarles los criterios de inclusión y exclusión se seleccionaron para revisión a texto completo 11 estudios: 4 cohorte y 7 casos y controles. En nuestra revisión hemos encontrado asociación para el desarrollo de Leucemia, P=0.03 con dosis <10 mSv de por vida, Mieloma Múltiple (MM P=0.037, Leucemia Linfoide Crónica ERR: 4.09 Gy 95% CI:<0-14.41. Encontramos que existe asociación significativa entre exposición laboral a radiaciones ionizantes a bajas dosis y el desarrollo de Leucemia y Mieloma Múltiple. Se encontró evidencia de riesgo aumentado de padecer leucemia (excluyendo LLC con tiempo de exposición mayor de 10 años y con dosis promedio de exposición <10 mSv. Existe evidencia en relación a la aparición de trastornos hematopoyéticos radioinducidos en el rango de 55-65 años coincidiendo con los últimos diez años de vida laboral. El hallazgo de una sugerente relación entre LLC y la exposición laboral a bajas dosis de radiaciones ionizantes deja la puerta abierta para futuras investigaciones.

  5. Prenatal irradiation: radioinduced apoptosis in developing central nervous system; Irradiacion prenatal: apoptosis radioinducida en el sistema nervioso central en desarrollo

    Gisone, P; Dubner, D; Michelin, S; Perez, M R [Autoridad Regulatoria Nuclear, Buenos Aires (Argentina); Barboza, M [Hospital de Clinicas Jose de San Martin, Buenos Aires (Argentina)

    1998-07-01

    produccion de apoptosis en un modelo experimental de irradiacion prenatal. Se irradiaron cultivos primarios de cerebro (rata Wistar, dia 15 de e.g.), en un rango de dosis hasta 2 Gy (Cobalto 60). Se evaluo la respuesta a la incubacion con distintos neuroprotectores. Se estudiaron los siguientes parametros: alteraciones de la morfologia celular, fragmentacion de cromatina y fraccion de celulas apoptoticas. Las celulas irradiadas mostraron condensacion nuclear con presencia de cuerpos apoptoticos. Las corridas electroforeticas evidenciaron un patron de fragmentacion caracteristico ('laddering') con aumento dosis-dependiente en la fraccion de celulas apoptoticas analizadas por citometria de flujo. La incubacion con neuroprotectores no indujo cambios significativos en las concentraciones y los tiempos ensayados. Se analizan los resultados obtenidos. Se discute acerca del rol de la apoptosis, su relacion con la injuria oxidativa y los fenomenos de excitotoxicidad como mecanismo de danio radioinducido en el sistema nervioso central en desarrollo. (autor)

  6. Meningo-encefalite equina da Halicephalobus gingivalis: contributo casistico nell’ambito delle attività di sorveglianza della Febbre del Nilo occidentale (West Nile disease

    Gabriella Di Francesco

    2012-12-01

    Full Text Available Un cavallo di 7 anni è stato abbattuto dopo aver manifestato una grave sindrome neurologica a rapida evoluzione. Campioni tessutali sono stati inviati al Centro Studi Malattie Esotiche dell’Istituto Zooprofilattico Sperimentale dell’Abruzzo e del Molise “G. Caporale” (Istituto G. Caporale per gli accertamenti diagnostici del caso. Gli esami per le più comuni virosi neurologiche equine non hanno evidenziato la presenza di infezioni in atto. Istologicamente, si è osservata a livello encefalico la presenza di manicotti perivascolari e numerosi corpi parassitari, morfologicamente riferibili a Halicephalobus gingivalis. Il rinvenimento ha consentito di formulare la diagnosi di meningo-encefalite da H. gingivalis. Il caso riportato conferma che le encefaliti parassitarie devono essere annoverate nella diagnosi differenziale delle encefalopatie equine e sottolinea l’utilità dell’approccio diagnostico multidisciplinare.

  7. Hepato-renal Syndrome: Etiopathogenesis, Diagnosis and Treatment

    Nešić Jelena

    2014-06-01

    Full Text Available Hepatorenalni sindrom (HRS predstavlja reverzibilnu bubrežnu insufi cijenciju kod bolesnika sa uznapredovalom cirozom ili akutnom insufi cijencijom jetre . Cilj rada je da utvrdi patogenetske mehanizme razvoja hepatorenalnog sindroma i da ukaže na klinički značaj ranog otkrivanja i pravovremenog lečenja bolesnika sa hepatorenalnim sindromom. Jednogodisnja stopa hepatorenalnog sindroma kod bolesnika sa cirozom jetre iznosi 18-20%. U faktore rizika za nastanak hepatorenalnog sindroma spadaju: spontani bakterijski peritonitis, gastrointestinalno krvarenje, nefrotoksični lekovi, diuretici, nesteroidni antiinflamatorni lekovi, hiponatriemija. Primarni plan lečenja je transplantacija jetre, dok sekundarni plan lečenja je primena vazokonstriktora u kombinaciji sa albuminima. Rano dijagnostikovanje i pravovremena primena odgovarajućeg lečenja znatno smanjuju stopu smrtnosti bolesnika obolelih od hepatorenalnog sindroma.

  8. ESTUDIOS DE CASOS Y CONTROLES: A PROPÓSITO DE DOS ESTUDIOS EN CIMEL

    Francisco Javier Bonilla-Escobar

    2013-08-01

    Full Text Available Los estudios de casos y controles han existido desde el siglo XIX con el analisis de Jhon Snow en Inglaterra sobre la fuente del Colera, y han tomado inusitada importancia despues de su puesta en marcha en diversos campos de la ciencia moderna (1, siendo objeto de amplias discusiones metodologicas hace mas de 50 anos. En los dos numeros anteriores de la revista CIMEL, se encuentran dos de estas publicaciones, tituladas: Factores asociados al Sindrome de Aspiracion Meconial en el hospital Jose Cayetano Heredia Piura-Peru, de Purizaca y col. (2, y Factores asociados al desarrollo de preeclampsia en un hospital de Piura, Peru, de Benites-Condor y col. (3. Reconociendo la importancia de este tipo de publicaciones y el trabajo requerido para su elaboracion, queremos mencionar aciertos y falencias metodologicas que hemos encontrado en estas publicaciones y las cuales afectan las afirmaciones de los autores

  9. Big Bologna. Le anomalie degli spazi pubblici in grande scala

    Richard Ingersoll

    2013-06-01

    Full Text Available Nella periferia di Bologna sono nati recentemente nuovi spazi pubblici, molto diversi rispetto a quelli della città storica, che esprimono chiaramente  la mania della grandezza, la sindrome di Big Bologna. Ovunque si getta lo sguardo si notano nuove manifestazioni di una scala fuori proporzione che contribuisce alla segregazione sociale. Da quando sono arrivate le torri bianche della megastruttura di Kenzo Tange alla Fiera, la grande scala ha dato origine a spazi pubblici poco ameni per la vita urbana. Forse questi megaprogetti sono inevitabili segni dell’epoca della globalizzazione, ma ci si chiede se i committenti e i loro architetti sono stati consapevoli di quanto la progettazione di tali forme causa un deterrente alla socializzazione.

  10. TYPES OF DICHOGAMY, BREEDING SYSTEMS AND POLLEN LIMITATION ON Aeschynanthus pulcher (Blume G.Don. (GESNERIACEAE

    Wiguna Rahman

    2009-07-01

    Full Text Available Observasi tentang tipe dikogami, sistem penyerbukan, dan keterbatasan serbuk sari telah dilakukan pada populasi Aeschynanthus pulcher di Kebun Raya Cibodas. Pengamatan fenologi bunga dilakukan untuk menentukan tipe dikogami. Dalam rangka menentukan sistem perkawinan dan keterbatasan serbuk sari, lima perlakuan penyerbukan telah dilakukan yaitu penyerbukan bebas sebagai kontrol, penyerbukan silang, penyerbukan sendiri, autogami, dan agamospermi. Hasil pengamatan menunjukkan bahwa dikogami pada A. pulcher adalah protandri, tidak sempurna dan durasi tampilan serbuk sari dan stigma reseptif masing-masing yaitu 3-9 hari dan 6-12 hari. A. pulcher merupakan tumbuhan yang dapat membuahi sendiri, sedangkan proses autogami dan agamospermi tidak terjadi. Sindrom keterbatasan serbuk sari pada populasi A. pulcher yang diamati diindikasikan terjadi. Derajat keterbatasan serbuk sari pada A. pulcher mencapai 0.79-0.80. Tiga faktor yang dapat menyebabkan keterbatasan serbuk sari adalah (1 kompetisi antar jenis tumbuhan yang berbunga bersamaan, (2 perilaku berbunga dalam satu periode yang sama, dan (3 kompetisi antara polinator dan pencuri nektar.

  11. Complicações pulmonares de endocardite tricúspide num doente toxicómano

    Carlos Lousada

    1997-01-01

    Full Text Available RESUMO: Os autore apresentam o caso clínico de um doente toxicodependente com embolias pulmonares sépticas, pneumotórax e derrame pleural secundários a endocardite tricúspide e sindrome nefrótico.Discutese o diagnóstico, mecanismos etiopatogénicos, terapêutica médica, indicações cirúrgicas e prognóstico destas situações. SUMMARY: The authors present a case of an intravenous drug addict with septic pulmonary embolism, pneumothorax and pleural effusion secondary to tricuspid infectious endocarditis and nephrotic syndrome.The diagnosis, etiopathogenic mechanisms, treatment implications, the role of surgery and the prognosis are discussed. Palavras-chave: embolia pulmonar séptica, pneumotórax, endocardite tricúspide, Key-Word: septic pulmonary emboli, pneumothorax, tricuspid endocarditis

  12. Study of repeated transcranial magnetic stimulation on the treatment of cocaine addiction

    Philip Leite Ribeiro

    2012-01-01

    INTRODUÇÃO: dependência de cocaína é um problema grave de saúde no Brasil e no mundo. Até hoje não existe um tratamento específico eficaz para este sindrome. A Estimulação Magnética Transcraniana de repetição(EMTr) é um método capaz de neuromodular o cérebro. MÉTODOS: Em um estudo randomizado duplo cego 25 pacientes dependentes de cocaína com diagnóstico feito pelo DSM IV-TR foram tratados em condição de EMTr de alta freqüência ativa (1250 pulsos/dia) ou EMTr placebo.O tratamento consiste em ...

  13. Idiopathic hypereosinophilic syndrome associated with rheumatoid arthritis A case report

    P. Quattrocchi

    2011-09-01

    Full Text Available The idiopathic hypereosinophilic sindrome (HES is a disease characterized by persistent blood eosinophilia (> 1500 eosinophils/mm3 > 6 months-in absence of other ethiologies for eosinophilia (parasitic, allergic, immunological or malignant diseases-associated with multiple organ involvement (heart, lung, central nervous system, skin, bone marrow, gastrointestinal tract. Reports on rheumatologic manifestations in patients with HES are very rare. In the case we report a typical rheumatoid arthritis developed in a 58-year-old woman with HES treated with glucocorticoids. Because of the marked glucocorticoids side effects shown by the patient(cushingoid habitus, hyperglycemia, we stopped this treatment and replaced it at first by methotrexate and later by cyclosporin, both of them associated with sulfasalazine. These drugs revealed very efficacious both on articular pathology and on the clinical and laboratory manifestations of HES. These data suggest that common pathogenetic mechanisms are likely acting in rheumatoid arthritis and idiopathic hypereosinophilic syndrome.

  14. Diagnosis and treatment for sick building; Diagnostico y tratamiento para edificios saludables

    Perez, Maria M; Salomon, Jorge A; Lazcano, Alejandro S [Facultad de Ingenieria UADY, Merida Yucatan (Mexico)

    2000-07-01

    In recent years, the indoor air quality (IAQ) in work spaces have acquired special importance. Health symptoms refer to a productivity and economic loss. IAQ health symptoms associated with acute discomfort that improve while away from work. More common, however, are apparent outbreaks of illness within work spaces in which neither environmental causes non recognized diseases can be identified. Usually reported within the last years, these events are often called sick building syndrome. To determine a sick building diagnosis and treatment, it is necessary to plan methodology based on environment comfort, habitability, energy efficiency use and nature preservation. Hereby it is presented a methodology to determine a sick building diagnosis and treatment which was applied in Superior Court of Justice building (Tribunales Primero y Segundo del Decimocuarto Circuito del Poder Judicial de la Federacion), where employees have expressed diseases as sleepiness, cold and difficulty breathing. [Spanish] En los ultimos anos, la calidad del aire en el ambiente de trabajo ha adquirido especial interes debido a la importancia que representa para el bienestar, eficiencia y productividad de los empleados. Los edificios carentes de esa calidad del aire ocasionan trastornos de salud relacionados con la falta de confort que prevalece en el ambiente de trabajo, es comun encontrar en los empleados que alli laboran, brotes de sintomas como dolores de cabeza, letargo y resfriados, entre otros. Usualmente encontrados en los ultimos anos en ambientes de oficinas a estos sintomas se les llama sindrome del edificio enfermo. Para lograr el diagnostico y tratamiento de un edificio enfermo es necesario plantear una metodologia basada en criterios de confort ambiental, habitabilidad, uso eficiente de la energia y preservacion del medio ambiente. En este trabajo presentamos una metodologia para el diagnostico y tratamiento de edificios con ese sindrome y presentamos un estudio de casos de los

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

    Jayme Neves

    1980-12-01

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

  16. Mielopatia neuro-óptica: Artério e arteriolosclerose. Considerações a propósito de um caso anátomo-clínico

    J. Lamartine de Assis

    1951-06-01

    Full Text Available Os autores fazem uma síntese sobre o problema atual das doenças desmielinizantes do sistema nervoso, salientando o papel da alergia, de acordo com os trabalhos mais modernos, em particular os de Ferraro e col. Assinalam a dificuldade para o estabelecimento de uma classificação, em virtude da falta de conhecimento dos agentes etiológicos desencadeantes na maioria dos casos. Apresentam uma observação anátomo-clínica de mielo-patia neuro-óptica com artério e arteriolosclerose, em que a doença se iniciou pelo acometimento do nervo óptico direito, e, somente dois meses depois, surgiram os primeiros sinais de acometimento da medula espinal. No quarto mês de doença estabeleceu-se, de modo completo, o quadro medular, com uma sindrome motora tetraplégica pirâmido-extrapiramidal, outra motora primária nas extremidades distais dos membros superiores, por acometimento das pontas anteriores e, finalmente, uma sindrome sensitiva de tipo cordonai, abrangendo todas as formas de sensibilidade, a partir de C3. A enfermidade evoluiu em 12 meses, ocorrendo a morte em conseqüência de insuficiência respiratória de origem bulbar provável. O exame anátomo-patológico mostrou atrofia e esclerose total dos nervos ópticos, discretos infiltrados parvicelulares em torno de alguns vasos intracerebrais e piais e, na medula, um quadro histopatológico comparável ao que de regra se encontra na oftalmoneuromielite; apenas, no segmento cervical, onde as lesões eram muito extensas, havia foco de amolecimento mais pronunciado do que aqueles que se observam mais freqüentemente. 0 fato talvez decorra de esclerose arterial concomitante existente neste caso. Havia, também, lesões bulbares discretas.

  17. Oximetria: papel no estudo do doente respiratório

    J.C. Winck

    1998-05-01

    Full Text Available RESUMO: A oximetria de pulso é uma técnica espectrofotométrica, que mede a variação pulsátil da traosmissão da luz. A relação dn absorção pulsátil em doís comprimentos de onda corresponde à Saturação de 02 (Sa02. As grandes vantagens dn oximetria são o seu carácter não invasivo, a medição continua e resposta rápida, que permite o reconhecimento instantâneo da hipoxemia. A sua fiabilidade diminui nomeadamente em presença de hemoglubinas anormais, hipotermia e anemia. As suas aplicações clínicas no âmbito do diagnóstic da sindrome da apeneia do sono até à monitorização da ventiloterapia domicíliária.REV PORT PNEUMOL 1998; IV (3: 307-313 ABSTRACT: Pulse oximetry is a spectrophotomtnic technique that measures the pulsatile change in light transmission. The ratio of pulsatile absorption at two wave lengths corresponds to 02, saturation (Sa02. Oximetry has the advantge of being noninvansive, allowing for continuous of rapid measurements leading to the immediate recognition of hypoxemia. It is less reliable in the presence of dyshemoglobins, hypotermia and anemia. The clinical uses of oxymetry in respiratory medicine are very wide: from the diagnosis of sleep apnoea syndrome to monitoring nasal ventilation.REV PORT PNEUMOL 1998; IV (3: 387-313 Key-words: Pulse oximtuy, Sleep apnoea syndrome, COPD, Home mechanical ventilation, Palavras chave: Oximetria de pulso, Sindrome da apneia do sono, DPOC, Ventiloterapia domiciliária

  18. ПРОФИЛЬ СВОБОДНЫХ АМИНОКИСЛОТ СЫВОРОТКИ КРОВИ И МОЧИ У ДЕТЕЙ С СИНДРОМОМ ДАУНА

    Vlada FURDUI

    2015-12-01

    Full Text Available PROFILUL AMINOACIZILOR LIBERI ÎN SERUL SANGUIN ŞI ÎN URINA COPIILOR CU SINDROM DOWNA fost investigat profilul aminoacizilor liberi în serul sanguin şi în urina copiilor cu sindrom Down, ce poate servi drept model al dizontogenezei. Aceasta din urmă este condiţionată de modificările genetice şi se caracterizează prin leziuni ale componentei cognitive a sănătăţii psihice. Rezultatele prezentului studiu sugerează implicarea directă a amino-acizilor liberi în dezvoltarea disfuncţiilor structurilor cerebrale şi diverselor sisteme ale organismului, ca urmare a unui dezechilibru al aminoacizilor cu conţinut de sulf, mediatori, esenţiali şi cetogeni. Acest dezechilibru duce în mod inevi-tabil la subdezvoltarea componentelor neurofiziologic, verbal, cognitiv, social-comportamental ale sănătăţii psihice.PROFILE FREE AMINO ACIDS OF SERUM AND URINE IN CHILDREN WITH DOWN SYNDROMEThere was investigated the amino acids profile of serum and urine in children with Down's syndrome, which can serve as a model dizontogenezis due to changes in gene and is characterized by lesions of the cognitive component of mental health. The results of this study suggest direct involvement of free amino acids in the development of dysfunction of brain structures and the various systems of the body as a result of an imbalance of sulfur, mediator, essential and ketogenic amino acids. This inevitably leads to underdevelopment of neurophysiologic, speech, cognitive, social and behavioral components of mental health.

  19. Consideraciones sobre el hidrocefalo de baja presion Considerations on low pressure hydrocephalus

    E. Herskovits

    1976-12-01

    Full Text Available Se analizan las condiciones fisiopatológicas del sindrome de hidrocéfalo de presión normal. De un grupo de 21 pacientes con sintomatologia clínica correspondiente a esta entidad, se seleccionan 10 que presentan un diagnóstico clínico, radiológico y cisternográfico indudable de la entidad en estudio. Se observó que, a pesar de esta selección solamente un 50% de ellos se vió beneficiado con la colocación de una válvula de baja presión. Surge entonces la hipotésis de que este cuadro es un sindrome multicausal; que por un proceso fisiopatogenico común produce un cuadro clínico, radiológico y cisternográfico similar y que serían beneficiados únicamente aquellos enfermos en los que se soluciona el problema mecánico.The physiopathological conditions of the normal pressure hydrocephalus syndrome are analysed. Within a group of 21 patients with clinical sinto- mathology pertaining this entity, only were 10 selected with a clinical, radiological and cisternografic indubitable diagnosis. It has been noticed that in spite of the stricked selection only a 50% of them have been beneficed by the application of a low pressure valve. Then, the hypothesis that the disease is a multicausal syndrome appears, which by an identical physiopathologic process produces or exhibits a similar clinical, radiological and cisternographic picture. Only those patients on whom the mechanical problem is solved would be beneficed by neurosurgery.

  20. Paralisis de la mirada conjugada lateral de origen pontino: discusión neuroanatómica del fasciculo longitudinal medio

    E. J. Faccio

    1981-03-01

    Full Text Available Se presenta el caso de un paciente con una parálisis de la mirada conjugada hacia la izquierda que además presentó un sindrome cerebeloso de igual lado y una paresia para la mirada conjugada hacia arriba. Durante la evolu-ción el paciente se recupera de la parálisis de la mirada hacia arriba, de su sindrome cerebeloso, para quedar con la parálisis de la mirada conjugada lateral. Posteriormente realiza un cuadro caracterizado por una dificultad en la comprensión con lenguaje mal articulado. La necropsia reveló un reblande-cimiento quístico en la cintilla longitudinal izquierda, con igual tipo de lesión en pié de la protuberancia dei lado izquierdo que comprometia al lemnisco motor. También se observo un reblandecimiento más reciente en el girus transverso izquierdo que comprometia la sustância blanca subortical. El estúdio de la cintilla mediante Ias degeneraciones secundarias reveló que se trataba de una cintilla de recorrido recto, que no se decusaba por encima del sexto par, tal cual está descripto. También se observó un balonamiento de Ias células dei núcleo intersticial de Cajal, de igual lado. Estos hallazgos justifican la sintomatologia clínica y la falta de oftalmoplejía internuclear anterior hacia la derecha.

  1. MR study of the intrinsic acromial angle in 74 symptomatic patients; Studio RM dell'angolo intrinseco dell'acromion in 74 pazienti sintomatici

    Di Mario, Mario; Fraracci, Lucio [Ospedale Fondazione Santa Lucia IRCCS, Roma (Italy). Servizio di radiologia

    2005-09-15

    effectiveness of the two quantitative parameters (intrinsic acromial angle and acromio-humeral distance) which are important causative factors in impingement syndrome. These parameters were found to be consistent and comparable with tue Bigliani classification of acromial morphology which, although providing useful qualitative data, does not fully respond to our quantitative needs. Our study suggests that impingement syndrome is negatively correlated to acromio-humeral distance and positively correlated to intrinsic acromial angle. These parameters, which are readily detected with MRI, may be used by the radiologist and orthopaedic surgeon to screen patients with nonspecific impingement syndrome. [Italian] Scopo. Lo scopo e stato quello di individuare un piano di scansione con alcune misurazioni associate che fornissero delle indicazioni quantitative sullo spazio subacromiale nei pazienti affetti di sindrome da impingement aspecifica. Materiale e metodi. Settantaquattro pazienti (47 maschi, 27 femmine, eta compresa tra 35 e 62 anni) che presentavano una sintomatologia da sospetta sindrome da impingement sono stati sottoposti al nostro studio. Le immagini sono state eseguite utilizzando sequenze SE TI pesate (TR 500 ms ,TE 12 ms ) e FSE T2 pesate (TR 3500, TE 25 ms) con bobina dedicata e scansioni acquisite lungo i piani sagittale obliquo e coronale. E stata adottata la classificazione di Bigliani per la morfologia dell'acromion confrontata con il nostro metodo di misura basato sulla rilevazione del valore espresso in gradi dell'angolo intrinseco dell'acromion e sulla misura della distanza acromion-omerale. Risultati. I dati ricavati del valore dell'angolo risultano correlati alla classificazione di Bigliani. L'angolo acromiale intrinseco espresso tra l'asse longitudinale dell'acromion e la tangente alla superficie inferiore dell'acromion stesso e risultato nei casi in nostra osservazione compreso tra 0 e 17{sup o}. Nelle rotture parziali

  2. Profiling sirolimus-induced inflammatory syndrome: a prospective tricentric observational study.

    Fanny Buron

    Full Text Available BACKGROUND: The use of the immunosuppressant sirolimus in kidney transplantation has been made problematic by the frequent occurrence of various side effects, including paradoxical inflammatory manifestations, the pathophysiology of which has remained elusive. METHODS: 30 kidney transplant recipients that required a switch from calcineurin inhibitor to sirolimus-based immunosuppression, were prospectively followed for 3 months. Inflammatory symptoms were quantified by the patients using visual analogue scales and serum samples were collected before, 15, 30, and 90 days after the switch. RESULTS: 66% of patients reported at least 1 inflammatory symptom, cutaneo-mucosal manifestations being the most frequent. Inflammatory symptoms were characterized by their lability and stochastic nature, each patient exhibiting a unique clinical presentation. The biochemical profile was more uniform with a drop of hemoglobin and a concomitant rise of inflammatory acute phase proteins, which peaked in the serum 1 month after the switch. Analyzing the impact of sirolimus introduction on cytokine microenvironment, we observed an increase of IL6 and TNFα without compensation of the negative feedback loops dependent on IL10 and soluble TNF receptors. IL6 and TNFα changes correlated with the intensity of biochemical and clinical inflammatory manifestations in a linear regression model. CONCLUSIONS: Sirolimus triggers a destabilization of the inflammatory cytokine balance in transplanted patients that promotes a paradoxical inflammatory response with mild stochastic clinical symptoms in the weeks following drug introduction. This pathophysiologic mechanism unifies the various individual inflammatory side effects recurrently reported with sirolimus suggesting that they should be considered as a single syndromic entity.

  3. [The sural medial perforator flap: Anatomical bases, surgical technique and indications in head and neck reconstruction].

    Struk, S; Schaff, J-B; Qassemyar, Q

    2018-04-01

    The medial sural artery perforator (MSAP) flap is defined as a thin cutaneo-adipose perforator flap harvested on the medial aspect of the leg. The aims of this study were to describe the anatomical basis as well as the surgical technique and discuss the indications in head and neck reconstructive surgery. We harvested 10 MSAP flap on 5 fresh cadavers. For each case, the number and the location of the perforators were recorded. For each flap, the length of pedicle, the diameter of source vessels and the thickness of the flap were studied. Finally, we performed a clinical application of a MSAP flap. A total of 23 perforators with a diameter superior than 1mm were dissected on 10 legs. The medial sural artery provided between 1 and 4 musculocutaneous perforators. Perforators were located in average at 10.3cm±2cm from the popliteal fossa and at 3.6cm±1cm from the median line of the calf. The mean pedicle length was 12.1cm±2.5cm. At its origin, the source artery diameter was 1.8mm±0.25mm and source veins diameters were 2.45mm±0.9mm in average. There was no complication in our clinical application. This study confirms the reliability of previous anatomical descriptions of the medial sural artery perforator flap. This flap was reported as thin and particularly adapted for oral cavity reconstruction and for facial or limb resurfacing. Sequelae might be reduced as compared to those of the radial forearm flap with comparable results. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  4. Alterações transitórias do exame neurológico durante o despertar da anestesia com enflurano, isoflurano ou sevoflurano Alteraciones transitorias del examen neurológico durante el despertar de la anestesia con enflurano, isoflurano o sevoflurano Transient neurological changes during emergence from enflurane, isoflurane or sevoflurane anesthesia

    Luiz Fernando Soares

    2001-12-01

    comportamiento durante la recuperación de la anestesia con enflurano (Grupo E, isoflurano (Grupo I y sevoflurano (Grupo S. MÉTODO: Fueron estudiados 44 pacientes que recibieron anestesia con enflurano, isoflurano o sevoflurano en N2O a 50%. Fueron anotados antes de la inducción, inmediatamente después de la cesación de la administración del anestésico y 5, 10, 15, 20, 30 e 40 minutos después: temperatura timpánica, nivel de consciencia, tono muscular, reflejos pupilar, ciliar, bicipital, patelar y cutaneo-plantar, bien como la ocurrencia de calofríos. RESULTADOS: Las respuestas de los reflejos pupilar, ciliar, patelar y cutaneo-plantar se correlacionaron con el nivel de consciencia. Los grupos no difirieron cuanto a la prevalencia de hipertonia muscular, hiperreflexia bicipital, clonus plantar y respuesta extensora cutaneo-plantar. Hiperreflexia patelar fue mas frecuente en el grupo del enflurano de que en el grupo del isoflurano. Calofríos fueron mas frecuentes en los grupos E e I de que en el grupo del sevoflurano. La temperatura timpánica no difirió entre los pacientes que presentaron o no calofríos. CONCLUSIONES: Alteraciones reversibles del examen neurológico pueden estar presentes por hasta 40 minutos durante la recuperación de la anestesia con enflurano, isoflurano o sevoflurano.BACKGROUND AND OBJECTIVES: Transient neurological findings are seen during emergence from halothane, enflurane, and isoflurane anesthesia. Little is known about neurological changes during recovery from sevoflurane anesthesia. This study was aimed at comparing the incidence of such findings during recovery from enflurane (Group E, isoflurane (Group I and sevoflurane (Group S anesthesia. METHODS: Forty four patients were assigned to receive enflurane, isoflurane or sevoflurane anesthesia in 50% N2O. Evaluated parameters were: tympanic temperature, consciousness level, muscle tone, pupillary, eyelash, bicipital, patellar and plantar reflexes and shivering, which were recorded before

  5. Hubungan Kadar Gula Darah saat Masuk Rumah Sakit dengan Jenis Sindroma Koroner Akut di RS Dr. M. Djamil Padang

    Willy Valerian

    2015-05-01

    Full Text Available AbstrakSindrom Koroner Akut (SKA merupakan spektrum dari penyakit arteri koroner yang tidak stabil, mulai dari angina pektoris tidak stabil sampai infark miokardium. SKA terbagi atas Unstable Angina Pectoris (UAP, ST elevation myocardial infarction (STEMI, Non-ST elevation myocardial infarction (NSTEMI. Tujuan penelitian ini adalah untuk menentukan hubungan antara kadar gula darah saat masuk rumah sakit dan jenis SKA. Metode penelitian yang digunakan adalah cross sectional. Penelitian dilakukan di Instalasi Rekam Medik RS Dr. M. Djamil Padang dengan mengambil data pasien SKA dari Januari 2012 sampai Desember 2012. Hasil penelitian ini didapatkan jenis SKA dengan gula darah yang tidak normal dari 60 sampel, yaitu: UAP 25%, NSTEMI 35%, STEMI 40%. Hasil pengolahan data dapat dilihat bahwa nilai p = 0,592 yang artinya tidak terdapat hubungan yang bermakna antara kadar gula darah saat masuk rumah sakit dengan jenis SKA. Hal ini terjadi mungkin karena terlalu sedikitnya sampel dan banyak sampel kriteria ekslusi dalam pencarian data. Sebaiknya dalam penelitian yang akan datang dapat memperbanyak sampel.Kata kunci: sindrom koroner akut, kadar gula darah, hubungan kadar gula darah dengan SKA AbstractAcute Coronary Syndrome (ACS is a spectrum of coronary artery disease that is not stable, ranging from unstable angina to myocardial infarction. Acute Coronary Syndrome is divided into Unstable Angina Pectoris (UAP, ST elevation myocardial infarction (STEMI, non-ST elevation myocardial infarction (NSTEMI. The objective of this study was to determine the relationship between blood sugar levels when admitted to hospital and Acute Coronary Syndrome type by using cross sectional study. The study was conducted at the Medical Records RS Dr. M. Djamil Padang. The ACS data collected from January 2012 until December 2012. The results of this study was found the SKA with abnormal blood sugar of 60 samples, i.e. UAP25%, NSTEMI35%, 40% STEMI. On the results of data

  6. INSUFICIENCIA RENAL AGUDA CON UREMIA NORMAL EN PACIENTE MONO-RENO SECUNDARIA A PIELONEFRITIS AGUDA

    Musso CG

    2006-03-01

    Full Text Available RESUMEN:La insuficiencia renal aguda es un sindrome que característicamente cursa con niveles plasmáticos elevados de urea y creatinina. Sin embargo, hay situaciones clínicas en las cuales este sindrome puede cursar con un incremento de la creatininemia sin presentar elevación de la uremia.En este reporte presentamos un caso clínico de una insuficiencia renal aguda con uremia normal secundaria a una pielonefritis aguda en un paciente con riñón único. El paciente presentaba una elevada excreción fraccional de urea lo cual podía explicar su uremia normal pese a estar cursando una caída del filtrado gomerular. Dicha excreción de urea elevada fue interpretada como secundaria a una diabetes insipida nefrogénica y una alteración en el recirculado intra-renal de la urea ambos producto de la pielonefritis aguda. Concluimos que la pielonefritis aguda en un paciente mono-reno puede presentarse con un patrón de insuficiencia renal aguda con uremia normal. SUMMARYAcute renal failure is a syndrome that usually runs with an increase in creatinine and urea plasma levels. However, there are clinical situations in which this syndrome may run with an increase in plasma creatinine keeping normal the urea one.In this report we present a case of acute renal failure with normal plasma urea level secondary to an acute pyelonephritis in a single kidney patient. The patient had an increased fractional excretion of urea which could explain the normal plasma urea levels found despite of his reduced glomerular filtration. This increased urea excretion state was interpreted as a consequence of the nephrogenic diabetes insipidus and alteration of the intra-renal urea reciclying process that the acute pyelonephritis induced. In conclusion: Acute pyelonephritis in a single kidney patient can appear as a pattern of acute renal failure with normal plasma urea levels.

  7. INSUFICIENCIA RENAL AGUDA CON UREMIA NORMAL EN PACIENTE MONO-RENO SECUNDARIA A PIELONEFRITIS AGUDA

    Musso CG

    2007-04-01

    Full Text Available RESUMENLa insuficiencia renal aguda es un sindrome que característicamente cursa con niveles plasmáticos elevados de urea y creatinina. Sin embargo, hay situaciones clínicas en las cuales este sindrome puede cursar con un incremento de la creatininemia sin presentar elevación de la uremia. En este reporte presentamos un caso clínico de una insuficiencia renal aguda con uremia normal secundaria a una pielonefritis aguda en un paciente con riñón único. El paciente presentaba una elevada excreción fraccional de urea lo cual podía explicar su uremia normal pese a estar cursando una caída del filtrado gomerular. Dicha excreción de urea elevada fue interpretada como secundaria a una diabetes insipida nefrogénica y una alteración en el recirculado intra-renal de la urea ambos producto de la pielonefritis aguda. Concluimos que la pielonefritis aguda en un paciente mono-reno puede presentarse con un patrón de insuficiencia renal aguda con uremia normal.SUMMARYAcute renal failure is a syndrome that usually runs with an increase in creatinine and urea plasma levels. However, there are clinical situations in which this syndrome may run with an increase in plasma creatinine keeping normal the urea one. In this report we present a case of acute renal failure with normal plasma urea level secondary to an acute pyelonephritis in a single kidney patient. The patient had an increased fractional excretion of urea which could explain the normal plasma urea levels found despite of his reduced glomerular filtration. This increased urea excretion state was interpreted as a consequence of the nephrogenic diabetes insipidus and alteration of the intra-renal urea reciclying process that the acute pyelonephritis induced. In conclusion: Acute pyelonephritis in a single kidney patient can appear as a pattern of acute renal failure with normal plasma urea levels.

  8. ACUTE RENAL FAILURE WITH NORMAL PLASMA UREA LEVEL SECONDARY TO ACUTE PYELONEPHITIS IN A SINGLE KIDNEY PATIENT

    Imperiali N

    2006-03-01

    Full Text Available SUMMARYAcute renal failure is a syndrome that usually runs with an increase in creatinine and urea plasma levels. However, there are clinical situations in which this syndrome may run with an increase in plasma creatinine keeping normal the urea one.In this report we present a case of acute renal failure with normal plasma urea level secondary to an acute pyelonephritis in a single kidney patient. The patient had an increased fractional excretion of urea which could explain the normal plasma urea levels found despite of his reduced glomerular filtration. This increased urea excretion state was interpreted as a consequence of the nephrogenic diabetes insipidus and alteration of the intra-renal urea reciclying process that the acute pyelonephritis induced. In conclusion: Acute pyelonephritis in a single kidney patient can appear as a pattern of acute renal failure with normal plasma urea levels. RESUMEN:La insuficiencia renal aguda es un sindrome que característicamente cursa con niveles plasmáticos elevados de urea y creatinina. Sin embargo, hay situaciones clínicas en las cuales este sindrome puede cursar con un incremento de la creatininemia sin presentar elevación de la uremia.En este reporte presentamos un caso clínico de una insuficiencia renal aguda con uremia normal secundaria a una pielonefritis aguda en un paciente con riñón único. El paciente presentaba una elevada excreción fraccional de urea lo cual podía explicar su uremia normal pese a estar cursando una caída del filtrado gomerular. Dicha excreción de urea elevada fue interpretada como secundaria a una diabetes insipida nefrogénica y una alteración en el recirculado intra-renal de la urea ambos producto de la pielonefritis aguda. Concluimos que la pielonefritis aguda en un paciente mono-reno puede presentarse con un patrón de insuficiencia renal aguda con uremia normal.

  9. ACUTE RENAL FAILURE WITH NORMAL PLASMA UREA LEVEL SECONDARY TO ACUTE PYELONEPHITIS IN A SINGLE KIDNEY PATIENT

    Algranati L

    2007-04-01

    Full Text Available SUMMARY: Acute renal failure is a syndrome that usually runs with an increase in creatinine and urea plasma levels. However, there are clinical situations in which this syndrome may run with an increase in plasma creatinine keeping normal the urea one. In this report we present a case of acute renal failure with normal plasma urea level secondary to an acute pyelonephritis in a single kidney patient. The patient had an increased fractional excretion of urea which could explain the normal plasma urea levels found despite of his reduced glomerular filtration. This increased urea excretion state was interpreted as a consequence of the nephrogenic diabetes insipidus and alteration of the intra-renal urea reciclying process that the acute pyelonephritis induced. In conclusion: Acute pyelonephritis in a single kidney patient can appear as a pattern of acute renal failure with normal plasma urea levels.RESUMEN: La insuficiencia renal aguda es un sindrome que característicamente cursa con niveles plasmáticos elevados de urea y creatinina. Sin embargo, hay situaciones clínicas en las cuales este sindrome puede cursar con un incremento de la creatininemia sin presentar elevación de la uremia. En este reporte presentamos un caso clínico de una insuficiencia renal aguda con uremia normal secundaria a una pielonefritis aguda en un paciente con riñón único. El paciente presentaba una elevada excreción fraccional de urea lo cual podía explicar su uremia normal pese a estar cursando una caída del filtrado gomerular. Dicha excreción de urea elevada fue interpretada como secundaria a una diabetes insipida nefrogénica y una alteración en el recirculado intra-renal de la urea ambos producto de la pielonefritis aguda. Concluimos que la pielonefritis aguda en un paciente mono-reno puede presentarse con un patrón de insuficiencia renal aguda con uremia normal.

  10. Comparison of symptoms, physical examination and electromyography findings, with the results of surgery of carpal tunnel release, in patients treated between January 2007 and December 2008, at the Hospital Calderon Guardia; Comparacion de la sintomatologia, exploracion fisica y hallazgos electromiograficos, con los resultados de la cirugia de liberacion de tunel carpal, en pacientes tratados entre enero 2007 y diciembre 2008, en el Hospital Calderon Guardia

    Chavarria Alvarado, Manuel

    2010-07-01

    A comparison of the preoperative findings was performed in patients with the diagnosis of carpal tunnel syndrome, with functional outcomes and postoperative residual pain, using the scale Patient Rate Wrist Evaluation (PRWE). All patients have had clinical history, physical examination and electromyography studies. They were operated by minimally invasive open surgery. The information was collected in an Excel table and patients have located via telephone. 100% of the evaluated patients have engaged in activities that involve trauma or repetitive wrist movements. The physical sign with predicative positive value for suspect of carpal tunnel syndrome has been the Phalen, present in over 70% of cases. The amount of physical signs present preoperatively and postoperative results were found without correlation. The mixed lesion, both sensory and motor has been the most found in electrodiagnostic studies. Patients whose studies have been negative, postoperative results have showed less favorable. Only 69% of patients operated in the orthopedic service of the Hospital Rafael Angel Calderon Guardia (HCG), have had favorable postoperative results. (author) [Spanish] Una comparacion de los hallazgos preoperatorios fue realizada en los pacientes con diagnostico del sindrome del tunel carpal, con los resultados funcionales y dolor residual en el posoperatorio, utilizando la escala Patient Rate Wrist Evaluation (PRWE). Todos los pacientes han tenido historia clinica, examen fisico y estudios electromiograficos. Ellos fueron intervenidos mediante cirugia abierta minimamente invasiva. La informacion fue recolectada en una tabla de excel y los pacientes fueron localizados via telefonica. El 100% de los pacientes evaluados se han dedicado a realizar actividades que implican trauma o movimientos repetitivos de las munecas. El signo fisico con valor predictivo positivo para la sospecha de sindrome de tunel carpal ha sido el Phalen, presente en mas del 70% de los casos. La cantidad

  11. Síndrome de lennox-gastaut com início na vida adulta? a respeito de um caso

    P. C. Trevisol-Bittencourt

    1990-12-01

    Full Text Available Apesar de ter sido relatada anteriormente, a sindrome de Lennox-Gastaut (SLG só foi definitivamente aceita como entidade distinta em 1966. Desde então, o epônimo tem sido utilizado para designar encefalopatia severa da infância, caracterizada fundamentalmente por crises epilépticas refratárias de diversos tipos associadas com alterações eletrográficas típicas. Entretanto, vários autores consideram que o rótulo de SLG está abrigando quadros nosológicos distintos, que deveriam ser separados e individualizados. Ilustrando esta situação, o caso de um paciente que iniciou quadro de «SLG-like» aos 20 anos de idade é relatado. Adicionando mais confusão, alguns casos semelhantes têm sido descritos nos últimos anos sob variada nomenclatura. Desde que um dos principais critérios para o diagnóstico da SLG é a idade dependência, como deverão então ser chamados tais quadros? Revisão dos critérios empregados para o diagnóstico da SLG se faz necessária.

  12. Encefalopatia hipertensiva seudotumoral

    Ignacio de Gispert Cruz

    1952-03-01

    Full Text Available Se describe con el nombre de encefalopatia hipertensiva seudotumoral aquellos casos en que la hipertensión arterial maligna origina un cuadro de hipertensión endocraneal que puede ir asociado a signos focales cerebrales simulando un proceso expansivo intracraneal. Se considera a la encefalopatia hipertensiva seudotumoral como una complicación relativamente frecuente de la hipertensión maligna arterial primitiva aunque también puede ser provocada a consecuencia de otros procesos causantes de hipertensión arterial (endocrinos, renales, vasculares, etc. Se describen algunas observaciones de encefalopatia hipertensiva en que se planteó el diagnostico diferencial con un tumor cerebral. Los signos clinicos focales (sindrome de Foster-Kennedy, sintomas cerebelosos, etc. aumentaron en algunos casos las dificultades diagnósticas. Se señala la importancia de los exámenes complementarios especialmente de la arteriografia cerebral y neumoencefalografia que han permitido casi siempre evitar errores diagnósticos.

  13. Necesidad de reconocimiento y síndrome de selfie: un análisis relacional basado en minería de datos

    Víctor Daniel Gil

    2017-02-01

    Full Text Available El uso excesivo de redes sociales en el mundo está despertando la necesidad de reconocimiento en hombres y mujeres. Estar conectado la mayor parte del día a redes sociales motiva la obsesión por los autorretratos o más conocidos como “Selfies”, dando origen al moderno “Síndrome de Selfie”. Este trabajo presenta un modelo de minería de datos elaborado con el programa RapidMiner para el análisis de sentimientos que permitió clasificar el efecto emocional (positivo / negativo de los comentarios publicados en 250 “Selfies” de hombres y 250 “Selfies” de mujeres en la red social Facebook. Con el modelo se concluye que existe una fuerte correlación entre la necesidad de reconocimiento y “Sindrome de Selfie”, la cual varía en función del género. Según el modelo desarrollado es mayor en el femenino, rxy = 0.75, que en el masculino, rxy = 0.61, lo que permite afirmar que el grado de relación o de asociación entre las dos variables es buena para el género femenino a diferencia del masculino, lo que indica que las mujeres constantemente están bajo una presión social estética mucho mayor que los hombres.

  14. Falso aneurisma da artéria meníngea média importância do diagnóstico angiográfico: relato de caso

    Carlos A. M. Melro

    1993-09-01

    Full Text Available É objetivo deste artigo relatar o caso de um paciente com falso aneurisma da artéria meníngea média e fazer breve revisão da literatura sobre o assunto. O paciente, etilista e vítima de quedas frequentes, foi internado para investigação de sindrome convulsiva. Dentre os exames realizados observou-se, ao raio-X do crânio, fratura do osso temporal e, na carótido-angiografia comum, presença de dilatação aneurismática na artéria meníngea média em íntima relação com a fratura. O relato do caso se justifica visto a baixa frequência desta patologia e sua analogia com hematomas intracranianos de evolução atípica, bem como para salientar o papel da carótido-angiografia na avaliação de alguns casos de traumatismo crânio-encefálico.

  15. Burnout in a sample of primary school teachers in the city of Copiapó

    Ricardo Jorquera Gutiérrez

    2014-11-01

    Full Text Available The present investigation sought to establish a relationship between burnout and a number of demographic and organizational variables. The sample consisted of 191 primary school teachers of municipal, subsidized and private educational institutions of Copiapó. The Maslach Burnout Inventory (MBI and the Cuestionario de Evaluación del Sindrome de Quemarse en el Trabajo (CESQT were used as tools to gather information from burnout levels presented by teachers. Two of them demonstrated an adequate reliability and concurrent validity. The results show a statistically significant relationship between absenteeism variable and all dimensions of burnout as measured by both instruments. No statistically significant differences between variables MBI and CESQT compared by sex, type of contract and income level were observed. When comparing the different dimensions of burnout by type of holder, statistically significant differences were detected in all of them. The results favor the private schools, showing the worst results in municipal schools. Alongside this, a negative correlation between levels of emotional exhaustion and psychological wear developed by teams of teachers and the results of the tests SIMCE [Sistema de Medición de la Calidad de la Educación] for second and fourth grade is observed.

  16. Uso de fármacos na síndrome de hiperatividade com déficit de atenção Use of drugs in attention deficit hyperactivity disorder

    Ana Guardiola

    1997-09-01

    Full Text Available A sindrome de hiperatividade com déficit de atenção (SHDA constitui distúrbio comum na infância, podendo advir de fatores exógenos ou endógenos, os quais são responsáveis por comprometimento cerebral, manifestando-se por alterações funcionais dos sistemas motores, perceptivos, cognitivos e do comportamento, comprometendo a aprendizagem de crianças com potencial intelectual adequado. Os autores estudam a ação de fármacos estimulantes e antidepressivos na SHDA, usando como parâmetro de eficácia as provas de persistência motora.Attention deficit hyperactivity disorder (ADHD is a neurological disorder which is common in the childhood and can be caused by exogenous and endogenous factors, that are responsible for cerebral disorder. This disorder presents a functional alteration of the motor, perceptive, cognition systems and conduct disorders compromising the learning of children with an adequate intellectual potential. The authors study the action of stimulants and antidepressive drugs in the ADHD, using as measure of efficacy the motor persistence tests.

  17. Angina monocitica con sovrainfezione da Prevotella denticola: caso clinico

    Maria Teresa Allù

    2005-06-01

    Full Text Available Monocytic angina with superinfection of Prevotella denticola: clinical case Monocytic angina is a clinical sindrome caused by Epstein-Barr virus characterized by fever, pharyngitis, exudative tonsillitis, swollen lymphoglands, splenomegaly and hepatomegaly.The inflamed pharynx and necrotic tonsils of infectious mononucleosis are subject to bacterial superinfection initially or during the course of the illness; the reduced PO2 tension and low oxidation-reduction potential that prevail in a vascular and necrotic tissues favour the growth of anaerobes. In this article we reported the clinical case of a ten years old children, who presented fever and tonsillopharyngitis; he was treated with cefotaxime and piperacillin, he did not improve in health. He was admitted to hospital (Department of Otorhinolaryngology. The patient was treated with aminoglycoside (tobramycin, piperacillin and cortisone; the clinical situation deteriorated. Pus sample was collected from the tonsils and cultured. Isolated strain from culture anaerobic was identified biochemically (Rapid-ID32ANA.The microorganism isolated was: Prevotella denticola (oral anaerobic gram-negative rods; β-lactamase production was tested by using the chromogenic cephalosporin disk test.The susceptibility to antibiotics was performed according to NCCLS recommendations. Prevotella denticola (β-lactamase production was resistant to penicillin, cefoxitin, cefotetan, piperacillin, clindamycin and metronidazole it was susceptible to piperacillin-tazobactam, amoxicillin-clavulanate, ticarcillin-clavulanate, imipenem and chloramphenicol. Children was treated with piperacillin-tazobactam, with rapid symptomatic relief.

  18. Relacion entre problemas habituales del sueño con deficit atencional y trastornos conductuales en niños

    A. Lucila Andrade, Dra.

    2013-05-01

    Full Text Available Los trastornos del sueño en niños son frecuentes y afectan el desarrollo neurológico. Los sindromes de apnea obstructiva del sueño y piernas inquietas se destacan por sus efectos cognitivo-conductuales. Los Trastornos del neurodesarrollo, como Autismo, Síndrome Déficit Atención/hiperactividad (TDAH y las co-morbilidades asociadas, presentan alta prevalencia de trastornos del sueño, con dificultades para conciliar el sueño e incremento de los despertares nocturnos, los que frecuentemente pasan desapercibidos para el médico. La consecuencia es una reducción de la alerta para las actividades diarias con incremento de trastornos conductuales, problemas emocionales y dificultades académicas asociadas a disfunción ejecutivas y de memoria, síntomas que pueden empeorar con tratamientos solo para trastorno primario. La evaluación del sueño debe formar parte sistemática en la valoración clínica de los niños con problemas cognitivo-conductuales, con el fin de realizar un diagnóstico y un tratamiento adecuados a cada caso, permitiendo mejorar la calidad de vida del niño y de su familia.

  19. Agregação de fatores de risco metabólicos, atividade física e comportamentos de risco à saúde em adolescentes: revisão da literatura

    Michael Pereira da Silva

    2014-12-01

    Full Text Available Objetivo: apresentar dados sobre a associação da atividade física, sedentarismo, alimentação inadequada, consumo de cigarro e bebidas alcoólicas com a agregação de fatores de risco metabólicos em adolescentes. Método: estudo de revisão utilizando critérios de diagnóstico de Sindrome Metabólica em crianças e adolescentes. Resultados e considerações finais: comportamentos como a atividade física, comportamento sedentário e hábitos alimentares possuem sua associação melhor elucidada na literatura, quando comparados aos hábitos de fumo e consumo de álcool, os quais necessitam de maiores investigações nesta população. Contudo, evidências demonstram que todos os hábitos abordados neste trabalho possuem alguma relação com a agregação de fatores de risco metabólicos na idade adulta, e sua prevenção na adolescência parece favorecer o não aparecimento dos mesmos no futuro.

  20. Revista de tesis de la Facultad de Medicina de Bogotá

    Facultad de Medicina Revista

    1943-01-01

    Full Text Available "Alergia e histamina" Tesis de grado. 1942. - Por Ariel Díaz Echeverry /  "Algunos conceptos personales sobre anemia de los tropicos y fisiopatologia del edema en este sindrome" Tesis de grado. 1942. - Por Hemando Rubiallo Groot /  "Tratamlento de las septicemias puerperales por la inmunotransfusión" Tesis de grado, declarada Meritoria. 1942. - Por Rafael F. Ramírez M. /  "Constantes hematológicas en Bogotá" Tesis de grado, declarada Meritoria. 1942. Por Jesús Maria Barragán C. / "Estudio de una cuestión médico-social sus defectos y posibles correcciones" Tesis de grado. 1942. - Por Jaime Varela /  "Importancia de la provocación en el diagnóstico de la sifills" Tesis de grado. 1942. - Por Carlos Chaparro Saavedra /  "Implantación ureteral en el recto" Tesis de grado. 1942. Declarada Meritoria. - Por Carlos J. Sabogal / "La cirugia y la anestesia intravenosa con el pentothal sódico" Tesis de grado declarada Meritoria. 1942.- Por Tirso Mayor Rojas

  1. Parasitosis y Micosis del Sistema Central como Causa de Epilepsia en Adultos

    Alejandro Jiménez Arango

    1987-12-01

    Full Text Available

    Nos corresponde hoy tratar el tema de las micosis y parasitosis del sistema nervioso central en relación con uno de los múltiples síntomas o complejos sindromáticos que pueden ocasionar: la epilepsia, se trata de uno de los síntomas más frecuentes en estas enfermedades y, en general, en las enfermedades encefálicas, y es el resultado de múltiples procesos fisiopatológicos que se producen en el cerebro. Puede la epilepsia ser síntoma de una enfermedad aguda o subaguda, o puede ser una de las secuelas, y a veces la única, de una enfermedad cuyo proceso activo ya ha terminado.

    Con el objeto de buscar cierta coherencia en la presentación del tema, mencionaremos en primer lugar los procesos patológicos, síndromes y lesiones, varios de ellos comunes a muchas micosis y parasitosis, que pueden dar lugar al cuadro epiléptico. En seguida nos referiremos con mayor detalle a cuatro enfermedades o grupos de enfermedades que tienen particular importancia entre nosotros desde el punto de vista clínico y epidemiológico: las micosis, la toxoplasmosis del adulto, el paludismo cerebral y la cisticercosis.

    Como ha sido ampliamente expuesto, las micosis y parasitosis del sistema nervioso central comprenden un gran número de entidades...

  2. Cirugía ortognática y rinoplastia en el síndrome de Binder Orthognathic surgery and rhinoplasty in Binder syndrome

    M. Tito

    2007-04-01

    Full Text Available El síndrome de Binder es una patología caracterizada por hipoplasia nariz-maxilar, ángulo naso-frontal plano, senos frontales hipoplasicos, ausencia de la espina nasal anterior, columela corta y ángulo nasolabial agudo. El tratamiento del los pacientes con síndrome de Binder puede ser ortodóntico o quirúrgico según la gravedad de la malformación. En este trabajo hemos realizado una revision bibliográfica sobre la etiología, el diagnóstico diferential y el tratamiento de la sindrome de Binder y presentamos un caso clínico de un paciente binderiano sometido a intervención de cirugía ortognática y rinoplastia con injerto de cartílago costal para recostruir el dorso y la punta nasal.Binder syndrome is a disorder characterized by nasomaxillary hypoplasia that results in a short nose, a frontonasal angle of almost 180 degrees, hypoplasia of the frontal sinuses, an absent anterior nasal spine, a short columella and an acute nasolabial angle. The patient can be treated orthodontically or surgically depending on the seriousness of the malformation. We review the literature on the etiology, differential diagnosis and treatment of Binder syndrome. We present the case of a boy with this syndrome surgically treated with orthognatic surgery and rhinoplasty with an L-shaped rib cartilage graft.

  3. Weaknesses in the reporting of cross-sectional studies according to the STROBE statement: the case of metabolic syndrome in adults from Peru.

    Tapia, Jose Carlos; Ruiz, Eloy F; Ponce, Oscar J; Malaga, German; Miranda, Jaime

    2015-12-30

    The inadequate reporting of cross-sectional studies, as in the case of the prevalence of metabolic syndrome, could cause problems in the synthesis of new evidence and lead to errors in the formulation of public policies. To evaluate the reporting quality of the articles regarding metabolic syndrome prevalence in Peruvian adults using the STROBE recommendations. We conducted a thorough literature search with the terms "Metabolic Syndrome", "Sindrome Metabolico" and "Peru" in MEDLINE/PubMed, LILACS, SciELO, LIPECS and BVS-Peru until December 2014. We selected those who were population-based observational studies with randomized sampling that reported prevalence of metabolic syndrome in adults aged 18 or more of both sexes. Information was analysed through the STROBE score per item and recommendation. Seventeen articles were included in this study. All articles met the recommendations related to the report of the study's rationale, design, and provision of summary measures. The recommendations with the lowest scores were those related to the sensitivity analysis (8%, n= 1/17), participant flowchart (18%, n= 3/17), missing data analysis (24%, n= 4/17), and number of participants in each study phase (24%, n= 4/17). Cross-sectional studies regarding the prevalence of metabolic syndrome in peruvian adults have an inadequate reporting on the methods and results sections. We identified a clear need to improve the quality of such studies.

  4. La actividad física, el entrenamiento continuo e intervalo: una solución para la salud

    Ricardo Ortiz-Pulido

    2017-01-01

    Full Text Available El propósito de este documento fue reportar los beneficios de la actividad física, entrenamientointervalo y entrenamiento continuo moderado en adultos sedentarios y físicamente activos.La actividad física involucra cualquier movimiento corporal que produce un aumento en elgasto energético en el metabolismo, mientras que el entrenamiento intervalo y entrenamientocontinuo moderado puede ser utilizado para controlar el programa de cargas de entrenamiento(intensidad, volumen y pausa. Los beneficios que se han reportado cuando se realiza actividadfísica son: el incremento o mantenimiento de la condición física muscular, funciones cognitivas,cardiorespiratoria, equilibrio, peso corporal, control de la obesidad; todos ellos disminuyen losriesgos de enfermedades cardiovasculares, enfernedades crónicorrespiratorias, diabetes, presiónalterial alta, sindrome metabolico, cáncer de colon, depresión y todas las causas de mortalidad.En contraste, la falta de actividad fisica ha ha sido identificada como factor de riesgo y estáasociada a diversas enfemedades no transmisibles a nivel mundial. En este documento puntua-lizamos dos tipos de entrenamiento que han tenido aplicaciones para la salud en adultos. Estetrabajo podría ayudar a promover la salud calidad de vida de la población adulta y eliminar elsedentarismo mediante la prescripción de la actividad física para la salud.

  5. Weaknesses in the reporting of cross-sectional studies according to the STROBE statement

    Malaga, German; Miranda, Jaime

    2015-01-01

    Introduction: The inadequate reporting of cross-sectional studies, as in the case of the prevalence of metabolic syndrome, could cause problems in the synthesis of new evidence and lead to errors in the formulation of public policies. Objective: To evaluate the reporting quality of the articles regarding metabolic syndrome prevalence in Peruvian adults using the STROBE recommendations. Methods: We conducted a thorough literature search with the terms "Metabolic Syndrome", "Sindrome Metabolico" and "Peru" in MEDLINE/PubMed, LILACS, SciELO, LIPECS and BVS-Peru until December 2014. We selected those who were population-based observational studies with randomized sampling that reported prevalence of metabolic syndrome in adults aged 18 or more of both sexes. Information was analysed through the STROBE score per item and recommendation. Results: Seventeen articles were included in this study. All articles met the recommendations related to the report of the study's rationale, design, and provision of summary measures. The recommendations with the lowest scores were those related to the sensitivity analysis (8%, n= 1/17), participant flowchart (18%, n= 3/17), missing data analysis (24%, n= 4/17), and number of participants in each study phase (24%, n= 4/17). Conclusion: Cross-sectional studies regarding the prevalence of metabolic syndrome in peruvian adults have an inadequate reporting on the methods and results sections. We identified a clear need to improve the quality of such studies. PMID:26848197

  6. FISURAS LABIO PALATINAS. TRATAMIENTO MULTIDISCIPLINARIO

    Dr. Luis Monasterio A.

    2016-01-01

    Full Text Available La fisura labio palatina es la segunda malformación congénita más frecuente. En su génesis hay factores genéticos (25% y ambientales siendo en general multifactorial. La incidencia en Chile es de aproximadamente 1 en 550 recién nacidos vivos. Las fisuras pueden afectar el labio a uno o ambos lados, el paladar o ambos. La evaluación genética es fundamental para descartar casos sindrómicos, siendo estos frecuentes en las fisuras asiladas de paladar (sindrome velocardiofacial, stickler. El tratamiento de esta enfermedad debe ser multidisciplinario e iniciarse en el periodo de recién nacido para garantizar los mejores resultados. El equipo debiera estar integrado por enfermera especialista, otorrinolaringólogo, odontólogos de diferentes especialidades, genetista, fonoaudióloga y cirujano plástico. Las cirugías primarias incluyen la plastia del labio(3-6 meses, plastia de velo del paladar (6 meses y el cierre de paladar óseo junto a plastia de velo (12 meses.

  7. Síndrome de hiperlaxitud articular benigno en el niño

    D. Mariana Haro, Dra.

    2014-03-01

    Full Text Available El síndrome de hipermovilidad articular se caracteriza por la presencia de articulaciones con rango de movilidad aumentada, asociada a dolor y deterioro funcional del sistema musculoequelético. Su etiología correspondería a una alteración del colágeno tipo I genéticamente determinada con un patrón de herencia autosómico dominante. Su incidencia es mayor en mujeres y en niños. Se ha descrito asociación con algunos síntomas extraarticulares, por lo cual los síntomas podrían no estar solo limitados al sistema musculoesquelético. El sistema de Beighton es una herramienta útil en definir la condición de hiperlaxitud. Su validación para uso en niños fue publicada por Engelsman y cols el año 2011. No obstante para el diagnóstico de Sindrome de Hiperlaxitud articular sería insuficiente, sugiriéndose el uso del sistema de clasificación de Brighton. Su tratamiento se basa en la educación, estabilización articular global, reeducación postural y de la marcha, mejorar capacidad aeróbica, uso de plantillas y órtesis de pie.

  8. Revista de tesis

    Facultad de Medicina Revista

    1945-09-01

    Full Text Available Sindromes abdominales agudos y bloqueo anestésico esplácnico semi-lunar. Tesis de grado "Meritoria". 1945. - Presentada por Guillermo Moreno Díaz / Estudio de algunas funciones hepáticas de la anemia tropical. Tesis de grado. 1945. - Presentada por Primitivo Rey Rey / Endoscopia, laringe, traquea, bronquios y esófago. Tesis de grado declarada "Meritoria". 1945. - Presentada por Carlos Alberto /  Cleves. el neumoperitoneo en el tratamiento de la tuberculosis intestinal y peritoneal y como medio colapsoterapico de la tuberculosis pulmonar. Tesis de grado. 1945. - Presentada por Marco Hernández / La procaina oral en el tratamiento de la úlcera péptica. Tesis de grado. 1945. - Presentada por L. Enrique Plata Esguerra / Estudio estadístico y tratamiento de la enfermedad Legg-Perthes-Calve y la coxalgia en nuestromedio. Tesis de grado declarada "Meritoria". 1945. - Presentada por Rafael Barberí Zamorano / La bilirrubina-eter-extraible en el diagnóstico las ictericias. Tesis de grado. 1945. - Presentada por Rafael Uribe García.

  9. Gangguan Ginjal terkait Obesitas pada Anak

    Sudung Oloan Pardede

    2017-06-01

    Full Text Available Prevalensi obesitas pada anak serta komplikasinya cenderung mengalami peningkatan. Salah satu komplikasi obesitas adalah kelainan ginjal yang disebut obesity-related renal injury atau gangguan ginjal terkait obesitas. Banyak faktor yang berperan dalam terjadinya obesity-related renal injury. Overweight atau obesitas berhubungan erat dengan berbagai faktor risiko penyakit ginjal kronik yaitu hiperinsulinemia, gangguan metabolisme glukosa, hipertensi, hiperlipidemia, dan sindrom metabolik. Di antara semua faktor tersebut, faktor yang paling berperan antara obesitas dan kerusakan ginjal adalah berkurangnya sensitivitas insulin. Manifestasi klinis  obesity related renal injury biasanya berupa proteinuria bermakna tanpa edema, albumin plasma sedikit menurun, dan kolesterol normal atau sedikit meningkat. Salah satu tata laksana obesity-related renal injury adalah penurunan berat badan. Pengurangan asupan diet dan penurunan berat badan dapat menyebabkan berkurangnya lesi glomerulosklerosis fokal segmental. Terapi lainnya adalah pemberian obat yang memiliki efek negatif terhadap sistem renin-angiotensin seperti inhibitor angiotensin-converting-enzyme dan angitensin receptor blocker. Dapat juga diberikan obat yang meningkatkan sensitivitas insulin. Golongan statin mempunyai peranan dalam melindungi ginjal. Usaha mencegah atau menangani obesitas sejak dini memberikan dampak besar terhadap insidens, progresivitas, biaya, dan komorbiditas penyakit ginjal

  10. Choroid plexus papilloma and Aicardi syndrome: case report Papiloma do plexo coróideo e síndrome de Aicardi: relato de caso

    Geraldo Pianetti Filho

    2002-12-01

    Full Text Available A case of Aicardi syndrome associated with a choroid plexus papilloma of the third and both lateral ventricles in a 15 months old baby girl is repported. The tumor was completely removed via three craniotomies. Reports of the literature with the association of choroid plexus papilloma and Aicardi syndrome are rare. We suggest that children diagnosed with Aicardi syndrome should routinely undergo imaging studies of the brain, such as computed tomography or magnetic resonance.Relatamos o caso de uma criança com 15 meses de idade, portadora da síndrome de Aicardi associada a tumores nos ventrículos laterais e terceiro ventrículo (papilomas que foram retirados cirurgicamente através de três craniotomias. A ocorrência de papiloma do plexo coróideo associada à sindrome de Aicardi é raramente descrita na literatura. Sugerimos que as crianças portadoras da síndrome de Aicardi sejam rotineiramente submetidas a estudo radiológico do encéfalo através da tomografia computadorizada ou ressonância nuclear.

  11. Doença pulmonar induzida pelas radiações ou pelos fármacos citostáticos

    Ulrich Costabel

    2000-03-01

    Full Text Available RESUMO: O artigo discute dois temas afins: 1 doença pulmonar induzida pela radioterapia nas suas diferentes apresentações: pneumonite de radiação clássica e fibrose pulmonar e outras duas mais recentemente descritas, BOOP e alveolite linfocitária bilateral São discutidos os mecanismos patoeenicos, clinic:a e tratamento; 2 a patologia intersticial induzida por fármacos citostáticos nas suas várias formas de apresentação.REV PORT PNEUMOL 2000; VI (2: 141-144 ABSTRACT: In this paper two topics art adressed: 1 the radiation induced lung injury in its possible forms: classical radiation pneumonitis and radiation fibrosis or two other newly recoenised sindromes BOOP and bilateral lymphodtic alveolitis. The mecanism and treatment are discussed; 2 the cytotocic drug-induced lung diseases and their pulmonary reaction patterns.REV PORT PNEUMOL 2000; VI (2: 141-144 Palavras-chave: Radioterapia, Citostaticos, BOOP, Alveolite Linfocitica, Key-words: Radiation, Cytotocic Drugs, Lymphocitic Alveolitis

  12. Selección de donantes y receptores en trasplante pulmonar: procedimientos generales

    C. María Teresa Parada, Dra.

    2010-03-01

    Full Text Available El trasplante pulmonar es una alternativa terapéutica que se ha validado en lo últimos 30 años para aquellos pacientes portadores de una enfermedad pulmonar terminal. Las características propias del trasplante pulmonar dadas por su conexión al ambiente a través de la vía aérea y la isquemia presente en las suturas durante el primer mes han constituído por mucho tiempo la principal causa de morbilidad y mortalidad de los pacientes trasplantados pulmonares. Los nuevos medicamentos inmunosupresores, la mejoría de las soluciones de preservación y de las técnicas quirúrgicas han disminuido las complicaciones y mortalidad precoz, siendo el gran desafío aún, el rechazo crónico conocido como el Sindrome de Bronquiolitis Obliterante (SBO. La selección del receptor de acuerdo a la patología de base se ha modificado, promoviendo la derivación precoz en patologías como la fibrosis pulmonar y la fibrosis quística disminuyendo así la mortalidad en la lista de espera.

  13. Enfermedad de Graves: Presentación tardía de síndrome de reconstitución inmune en VIH/SIDA.: Reporte de casos y revisión de la literatura.

    Miguel Eduardo Pinto Valdivia

    2007-10-01

    Full Text Available Se reportan dos casos de enfermedad de Graves relacionados con sindrome de Reconstitución Inmune en dos pacientes infectados con VIH luego de iniciar la terapia antiretroviral de gran actividad (TARGA. Se revisaron las historias clínicas de los pacientes y se hizo una revisión bibliográfica. Dos pacientes con historia de infección por VIH desarrollaron pérdida de peso, taquicardia, tremor en la manos y diarrea, luego de 30 y 48 meses después de iniciado tratamiento TARGA con zidovudina, lamivudina y atazanavir. Al momento de desarrollar este problema su conteo de células CD4 estaba en rangos de normalidad y su carga viral estaba en niveles indetectables. En el examen Físico se detectó un aumento de volumen de la glándula tiroides. Los niveles de tirotropina estaban suprimidos y los niveles de tiroxina libre elevados; se detectó niveles positivos de anticuerpos anti-TPO. Ambos pacientes mejoraron con el tratamiento metimazol y atenolol. La enfermedad de Graves ha sido reportada como complicación inusual en pacientes VIH como reconstitución Inmune luego del inicio de TARGA. Estos dos pacientes muestran un cuadro compatible.

  14. Rol de las trombofilias en infertilidad: ¿juegan un rol?

    B. Juan Luis Leiva, Dr.

    2010-05-01

    Full Text Available Las trombofilias son un grupo de enfermedades que favorecen la formación de trombosis, tanto arteriales como venosas, y han sido asociadas con diferentes complicaciones durante el embarazo, entre las cuales podemos mencionar: aborto recurrente, preclampsia, restricción de crecimiento intrauterino y muerte fetal in útero, entre otras. Recientemente, se ha sugerido una asociación entre trombofilias e infertilidad. Las mutaciones de la enzima Metilentetrahidrofolato Reductasa (MTHFR y de Leiden se encuentran con mayor frecuencia en pacientes con infertilidad de causa desconocida, al compararlas con grupos controles. Durante la etapa de estimulación ovárica diversas trombofilias han sido vinculadas con la aparición de sindrome de hiperestimulación ovárica severo. Por último, las pacientes con historia de falla recurrente de implantación, luego de múltiples ciclos de fertilización in Vitro, demuestran una mayor prevalencia de trombofilias que las pacientes con éxito en dichas terapias. Este artículo presenta una revisión de las publicaciones relevantes que abordaran los distintos aspectos de la relación entre trombofilias e infertilidad hasta agosto de 2009. El objetivo es describir los estudios utilizados y sus implicancias en el manejo de la pareja infértil.

  15. Magnitude and consequences of undertreatment of high-risk patients with non-ST segment elevation acute coronary syndromes: insights from the DESCARTES Registry.

    Heras, M; Bueno, H; Bardají, A; Fernández-Ortiz, A; Martí, H; Marrugat, J

    2006-11-01

    To analyse intensity of treatment of high-risk patients with non-ST elevation acute coronary syndromes (NSTEACS) included in the DESCARTES (Descripción del Estado de los Sindromes Coronarios Agudos en un Registro Temporal Español) registry. Patients with NSTEACS (n = 1877) admitted to 45 randomly selected Spanish hospitals in April and May 2002 were studied. Patients with ST segment depression and troponin rise were considered high risk (n = 478) and were compared with non-high risk patients (n = 1399). 46.9% of high-risk patients versus 39.5% of non-high-risk patients underwent angiography (p = 0.005), 23.2% versus 18.8% (p = 0.038) underwent percutaneous revascularisation, and 24.9% versus 7.4% (p or = 4, 2-3 and or = 4 (OR 2.87, 95% CI 1.27 to 6.52, p = 0.012). Class I recommended treatments were underused in high-risk patients in the DESCARTES registry. This undertreatment was an independent predictor of death of patients with an acute coronary syndrome.

  16. Schistosomal glomerular disease (a review

    Zilton A. Andrade

    1984-12-01

    Full Text Available In this review paper schistosomal glomerulopathy is defined as an immune-complex disease. The disease appears in 12-15 per cent of the individuals with hepatosplenic schistosomiasis. Portal hypertension with collateral circulation helps the by pass of the hepatic clearance process and the parasite antigens can bind to antibodies in the circulation and be trapped in the renal glomerulus. Chronic membranousproliferative glomerulonephritis is the most commom lesion present and the nephrotic syndrome is the usual form of clinical presentation. The disease can be experimentally produced, and schistosomal antigens and antibodies, as well as complement, can be demonstrated in the glomerular lesions. Specific treatment of schistosomiasis does not seem to alter the clinical course of schistosomal nephropathy.A glomerulopatia esquistossomotica e um exemplo de doenca causada por complexos imunes. Ela se manifesta em 12 a 15% dos portadores de forma hepato-eplenica da esquistossomose. A hipertensao porta, com circulacao colateral, facilita a ultrapassagem do filtro hepatico e os antigenos esquistossomoticos podem se acoplar aos anticorpos na circulacao e vir a se depositar nos glomerulos. O tipo histologico mais frequente e a glomerulonefrite cronica membrano-proliferativa, geralmente com sindrome nefrotica. A doenca e passivel de reproducao experimental e os antigenos esquistossomoticos, os anticorpos e fracoes do complemento podem ser demonstrados nas lesoes glomerulares. O tratamento especifico da esquistossomose nao mostrou ate o momento a capacidade de alterar o curso da nefropatia.

  17. Anti-Ro and anti-La autoantibodies induce TNF-α production by human salivary gland cells: an in vitro study

    V. Mitolo

    2011-09-01

    Full Text Available Obiettivo: Lo scopo di questo studio è stato valutare la produzione di TNF-α, induttore della via estrinseca del processo apoptotico, in seguito al trattamento con gli autoanticorpi anti-Ro ed anti-La isolati da pazienti con sindrome di Sjögren primaria in un modello sperimentale rappresentato dalla linea cellulare di ghiandole salivari umane, A- 253. È stata, inoltre, valutata la presenza sulla superficie di tali cellule di recettori specifici per tale induttore, TNFR1 e TNFR2. Materiali e metodi: Gli autoanticorpi anti-La ed anti-Ro sono stati purificati su una colonna cromatografia ad alta affinità. Le metodiche utilizzate per la valutazione della produzione di TNF-α e lo studio dei recettori di superficie sono state immunofluorescenza, RT-PCR e saggi immunoenzimatici. Risultati: I nostri risultati hanno dimostrato che le cellule A-253 esprimono in superficie i recettori TNFR1 e TNFR2 e che gli autoanticorpi anti-Ro e anti-La sono in grado di indurre la produzione di TNF-α nelle stesse cellule. Conclusioni: Il trattamento con gli autoanticorpi anti-Ro ed anti-La induce la produzione di TNF-α in cellule di ghiandole salivari umane e questo potrebbe spiegare la attivazione della via estrinseca della apoptosi.

  18. hyperlexia and autism report of a case Hiperlexia y autismo

    Clara Mónika Uribe Pérez

    1998-02-01

    Full Text Available Hyperlexia is an extraordinary skill for spontaneous early reading in the background of an autistic child with serious linguistic disorders. Generally it is a mechanical skill in the transcodification of graphemes to phonemes but there is lack of comprehension. We present the clinical characterization of a case of hyperlexia in an autistic boyas a transcortical developmental aphasia that originated perhaps in a neurodevelopment disconnection syndrome. La hiperlexia es una habilidad excepcional para el aprendizaje precoz y espontáneo de la lectura, en el contexto de un severo retraso en el desarrollo del lenguaje y un sindrome autista. En general es una habilidad mecánica en la transcodificación grafemo-fonemática pero carente, en gran parte, de capacidad comprensiva. Se presenta la caracterización clínica de un cuadro de hiperlexia como disfasia transcortical del desarrollo en un niño autista, originado posiblemente en un síndrome de desconexión durante el neurodesarrollo.

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

    Jayme Neves

    1980-12-01

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

  20. Clinical Impact and Relevance of Antiganglioside Antibodies Test Results / Antigangliozīdu Antivielu Testa Rezultātu Klīniskā Ietekme un Nozīme Pacientam

    Ķēniņa Viktorija

    2015-09-01

    Full Text Available Visbiežāk atrastās autoantivielas asociācijā ar perifērām neiropātijām ir pret gangliozīdiem GM1, GQ1b, asialo-GM1, GM2, GD1a un GD1b. Atzīta diagnostiska vērtība ir divām no tām - anti-GM1 un anti-GQ1b. Tika veikts retrospektīvs pētījums ar mērķi izvērtēt antigangliozīdu antivielu noteikšanas nozīmi pacientiem ar iespējamu autoimūnu neiropātiju. Pētījumā tika iekļauti 85 pacienti, kuri bija stacionēti Paula Stradiņa Klīniskajā universitātes slimnīcā laika posmā no 2013. gada janvāra līdz 2014. gada decembrim un kuru perifērajās asinīs tika noteiktas antigangliozīdu antivielas. Tika reģistrēti un analizēti arī pacientu demogrāfiskie dati, iepriekšējas un esošas saslimšanas, paraklīnisko izmeklējumu dati, t.sk. cerebrospinālā šķidruma atradne un elektrofizioloģiskās izmeklēšanas rezultāti. Mūsu pētījumā 27 pacienti (32% bija seropozitīvi attiecībā vismaz uz vienu no antigangliozīdu grupas antivielām. Visbiežāk atrastās antivielas bija pret asialo-GM1 (n = 13 un GM1 (n = 10 gangliozīdiem. Astoņu pacientu diagnozes sakrita ar slimībām, kur antigangliozīdu antivielām ir atzīta diagnostiska marķiera vērtība: pieciem pacientiem - Gijēna-Barē sindroms (GBS, vienam pacientam - Millera-Fišera sindroms (MFS, diviem pacientiem - multifokāla motora neiropātija (MMN. Trīs no pieciem pacientiem, kuriem bija diagnosticēts GBS, un viens no diviem pacientiem, kuriem bija diagnosticēta MMN, bija seronegatīvi. Akūta slimības gaita, pozitīvas antigangliozīdu antivielas un citoalbumināra disasociācija cerebrospinālajā šķidrumā bija faktori, kas noteica pacientam nepieciešamu specifisku imūnterapiju. Mūsu pētījuma rezultāti atbilst iepriekš aprakstītām novērotām asociācijam starp antigangliozīdu grupas antivielām un GBS, MFS un MMN.

  1. Deterioro cognitivo leve: Encuesta sobre actitudes de médicos especialistas y generalistas Mild cognitive impairment: Survey of attitudes of specialists and general physicians

    Cecilia M. Serrano

    2007-02-01

    Full Text Available El deterioro cognitivo leve es una entidad caracterizada por el compromiso predominante de la memoria en ausencia de trastorno funcional. Ha sido asociado a un período predemencial de la enfermedad de Alzheimer. Sin embargo, se considera que otras áreas cognitivas pueden verse afectadas, pudiendo implicar también otras etiologías. Así, algunos profesionales lo consideran un término etiológico, dirigido hacia la enfermedad de Alzheimer y otros un complejo sindromático, incluyendo varias enfermedades. Otro factor agregado que generó confusión ha sido el porcentaje de conversión a demencia. El objetivo de nuestro trabajo fue evaluar la opinión médica sobre el deterioro cognitivo leve y los problemas que genera en la práctica diaria. Se adaptó el cuestionario sobre deterioro cognitivo leve de Dubois y col, 2003; 24 médicos expertos en demencia de Argentina y Brasil (16 neurólogos y 8 psiquiatras y 30 médicos generalistas aceptaron responder al mismo. Los resultados muestran que el 92% de los médicos expertos piensa que es una entidad heterogénea, no la limitan a un estadio predemencia de la enfermedad de Alzheimer; y el 63% refieren que puede empeorar. El 83% de los expertos inician tratamiento específico utilizando preferentemente anticolinesterásicos, memantine y vitamina E. La vasta mayoría de médicos considera al deterioro cognitivo leve como una entidad sindromática, que no está limitada a la enfermedad de Alzheimer; pero sin embargo, inicia tratamiento con drogas dirigidas hacia ella. La ambigüedad existente hace necesario estandarizar definiciones y reconceptualizar la enfermedad de Alzheimer en su estadio pre-demencia.Mild cognitive impairment (MCI refers to persons who are slightly cognitively impaired for age but do not meet the criteria for dementia. MCI has been related to a pre-dementia stage of Alzheimer&'s disease (AD. However, other possible diagnoses such as cerebro-vascular disease, frontotemporal

  2. Characteristics of the Biological Effects and the RBE of High Energy Protons; Caracteristiques des Effets Biologiques et EBR des Protons de Haute Energie; Osobennosti biologicheskogo dejstviya i obeh protonov vysokikh ehnergii; Caracteristicas de los Efectos Biologicos y de la EBR de los Protones de Elevada Energia

    Grigor' ev, Ju. G.; Darenskaja, N. G.; Domshlak, M. M.; Lebedinskij, A. V.; Nefedov, Ju. G.; Ryzhov, N. I.

    1964-03-15

    sindrome hemorragico provocado en el perro por la irradiacion protonica es mas pronunciado. La hemorragia se presenta al cabo de un tiempo mas breve y es mas abundante. Verificaron asimismo que la EBR de los protones es diferente segun se trate de animales pequeflos (ratas o ratones) o de animales grandes (perros). La diferencia es apreciable, ya que los valores respectivos son 0,7 para los primeros y 1,0 o 1,15 para los segundos. En la memoria se examinan las posibles causas de estas diferencias. (author) [Russian] Harakteristiki biologicheskogo dejstvija protonov vysokih jenergij (120, 210 i 510Mjev) izuchalis' v jeksperimentah na myshah, krysah i sobakah. Bylo pokazano, chto narjadu s nekotorym shodstvom ili identichnost'ju radiacionnogo porazhenija pri dejstvii rentgenovskih luchej i protonov imelsja rjad razlichij. Pri protonnom obluchenii sobak byl bolee otchetlivo vyrazhen gemorrogicheskij sindrom. Krovoizlijanija pojavljalis' u zhivotnyh ran'she i byli b olee obil'nymi. Obnaruzhena raznica v urovnjah OBJe protonov dlja melkih (krysy, myshi) i krupnyh zhivotnyh (sobaki). Jeta raznica javljaetsja dovol'no znachitel'noj i ravnjaetsja so otvetstvenno 0,7 i 1,0 - 1,15. V doklade privodjatsja nekotorye soobrazhenija otnositel'no prichiny jetih razlichij. (author)

  3. Mutações no gene da metilenotetrahidrofolato redutase e síndrome de Down

    Laura Brunelli das Neves Grillo

    2002-12-01

    Full Text Available Sindrome de Down (SD é uma alteração genética e metabólica complexa atribuída à presença de três cópias do cromossomo 21. O cromossomo extra em 93% dos casos é de origem materna e é resultante de uma segregação anormal durante a meiose (não-disjunção. Com exceção da idade materna avançada, fatores de risco para a não-disjunção meiótica não estão bem estabelecidos. Um estudo preliminar sugeriu que o metabolismo anormal do folato e a mutação 677 (C->T no gene da metilenotetrahidrofolato redutase (MTHFR podem ser fatores de risco maternos para a SD. A freqüência das mutações MTHFR 677 (C->T e 1.298 (A->C foram avaliadas em 36 mães de crianças com SD e em 200 indivíduos-controle. Os resultados demonstraram que as mutações 677 (C->T e 1.298 (A->C são mais prevalentes entre mães de crianças com SD do que nos controles. A heterozigose das duas mutações foi a combinação mais freqüente. O resultado desse estudo inicial sugere que mutações no gene da MTHFR seriam um fator de risco para a SD.

  4. Tetralogía de Fallot asociada a duplicación distal del brazo largo del cromosoma 11

    Elodia Torres

    2015-04-01

    Full Text Available La tetralogía de Fallot es una cardiopatía frecuente y puede representar hasta el 11 al 13% de todas las cardiopatías congénitas clínicas, se presenta en 1 de cada 8.500 nacidos vivos. En la mayoría de los casos, se asocia a una microdeleción del cromosoma 22 y con menor frecuencia al síndrome de Down. El síndrome de la dup 11q es una anomalía cromosómica causada por la duplicación de la porción distal del extremo del brazo largo del cromosoma 11, ocasionando una trisomía parcial del mismo, producto de un desbalance cromosómico, con disfunción de los genes involucrados en este material genético adicional que ocasiona anormalidades tanto físicas como mentales en un recién nacido. Se presenta el caso de un niño de 3 meses de vida que es derivado a la consulta genética por fenotipo sindromático, Tetralogía de Fallot y retraso del crecimiento. El estudio citogenético se realizó en sangre periférica, los cromosomas fueron procesados con técnicas de tinción convencional, bandas de alta resolución y centroméricas, observándose una duplicación 11q. Cariotipo: 46, XY, dup11 (q23àqter. Se enfatiza la importancia del estudio cromosómico en recién nacidos con malformaciones congénitas mayores para el diagnóstico de certeza y posterior asesoramiento genético a los progenitores.

  5. Síndromes Neurocutáneos identificables por el Médico General Integral mediante examen físico

    Odalys Salas San Juan

    Full Text Available Introducción: el Síndrome Neurocutáneo es el término general que se utiliza para referirse a determinados trastornos neurológicos. Constituye un grupo heterogéneo de desórdenes congénitos que afectan principalmente a las estructuras derivadas del neuroectodermo embrionario. Objetivo: caracterizar los hallazgos clínicos de los Síndromes Neurocutáneos identificables al examen físico por el Médico General Integral. Métodos: se realizó un trabajo de revisión donde se utilizaron métodos teóricos en el proceso de revisión de la bibliografía actualizada seleccionada, específicamente en el campo de la neurología, la dermatología y la genética. Resultados: las características clínicas de la Esclerosis Tuberosa, Neurofibromatosis Tipo 1, Tipo 2, Schwannomatosis y Enfermedad de Sturge-Weber (Sindromes Neurocutáneos se pueden identificar durante el examen físico. Conclusiones: el adecuado conocimiento por el Médico General Integral, de las características clínicas del síndrome neurocutáneo, considerando su heterogeneidad y expresividad clínica, permite realizar al examen físico el diagnóstico oportuno de la enfermedad, lo que favorece el manejo del paciente.

  6. Evaluación de la Vía Aérea superior en Ortodoncia. Revisión Narrativa

    Erwin Rojas

    Full Text Available Resumen:Introducción: La valoración de la vía aérea es parte del diario trabajo del ortodoncista, odontopediatra, otorrino, fonoaudiólogo, etc. debido su interrelación con el desarrollo de las estructuras craneofaciales, así como también con patologías como el Sindrome Apnea Obtructiva del Sueño. Objetivo: Recordar los limites, funciones y anomalías de la vía aérea superior, informar acerca de los métodos para su evaluación, así como evaluar el nivel de información y precisión diagnóstica de los exámenes complemetarios, (cefalometría lateral y cone beam. Materiales y Metodo: La búsqueda se realizó por Pubmed con palabras clave y solo se seleccionaron los que tenían menos de 5 años, de éstos se excluyeron a partir del título los que se consideraron irrelevantes para la revisión. Fueron leidos 46 resumenes y seleccionados 38 articulos. Conclusiones: Es fundamental conocer métodos de evaluación de vía aérea que incluyen; un examen clínico, evaluación radiográfica y de Conebeam, éstos alertan de alteraciones que interfieren en el tratamiento.

  7. Deteccion de antigeno del polisacarido capsular de Cryptococcus neoformans en pacientes con SIDA y neurocriptococosis en São Paulo, Brasil

    B. Calvo

    1991-12-01

    Full Text Available Antígeno del polisacárido capsular (Ag PC de Cryptococcus neoformans fue detectado por la técnica de aglutinación de latex (AL en LCR y suero de pacientes con Sindrome de Inmunodeficiencia Adquirida (SIDA y primer episodio de neurocriptococosis, usando como patrón el examen micológico (examen directo y cultivo de LCR. Se obtuvo una sensibilidad del 100% de AL para detectar AgPC de C. neoformans, el cual por su rápidez permite tratamiento específico precoz. Títulos iniciales de AgPC de la levadura en esos pacientes pueden ser > 1.000.000, pareciendo que cuando esos títulos están presentes en suero, se relacionan con mortalidad durante el tratamiento. En los pacientes que sobrevivieron se observó que el examen micológico directo y AgPC de C. neoformans, en LCR y suero, permanecen positivos aún después de tratamiento y mejoría clínica del paciente.Capsular polysaccharide antigen (AgPC of Cryptococcus neoformans was detected by latex agglutination technique (LA in cerebrospinal fluid and serum of patients with AIDS during their first central nervous system manifestation of the disease. Direct mycological examination and culture were used as controls. Sensitivity was 100% by LA allowing an early specific treatment of cryptococcosis. Initial titres of AgPC in such patients can be > 1000000 and it appears that when such titres are present in the serum they are related to mortality during treatment. Surviving patients showed positivity of the direct mycological examination and AgPC of C. neoformans in cerebrospinal fluid and sera even after treatment and clinical recovery.

  8. Teorijske refleksije o mogućim uzrocima inertnosti egalitarnog sindroma

    Ivan Burić

    2018-02-01

    Full Text Available Jedna od osnovnih postavki teorije egalitarnog sindroma Josipa Županova, postavka o egalitarnom sindromu kao klasteru naslijeđenih neformalnih normi, kompatibilna je s nekoliko teorijskih koncepata kulturne inercije. Iz perspektive teorija ovisnosti o prijeđenom putu perzistencija egalitarnog sindroma može se objasniti djelovanjem faktora odgovornih za reprodukciju društvenih normi. Riječ je o faktorima koji ne utječu na genezu određenoga društvenog fenomena (primjerice, normi, nego ga kroz vrijeme reproduciraju. Shodno rezultatima recentnih empirijskih istraživanja, jedan od reprodukcijskih faktora egalitarnog sindroma može se pronaći u tranzicijskim troškovima. Na osnovi toga, kao i propozicije o razlikovanju generativnih od reprodukcijskih faktora društvenih fenomena, legitimiramo tezu da tranzicijski troškovi nisu stvorili egalitarni sindrom, nego su pridonijeli njegovoj perzistenciji i u postsocijalističkom društvenom kontekstu. Moguće izvore hipoteza o dodatnim čimbenicima reprodukcije egalitarnog sindroma u tranzicijskim okolnostima pruža koncept kulturne inercije svojstven teorijskoj perspektivi institucionalizma, teorija kulturne evolucije Roberta Boyda i Petera J. Richersona, kao i koncept zapinjača Michaela Tomasella. Također, sukladno ideji o »efektu tunela« Alberta Hirschmana, možemo pretpostaviti da je očekivana stagnacija u društvenoj pokretljivosti jedan od mogućih specifičnih faktora reprodukcije egalitarnog sindroma.

  9. TEORÍA DE THEODORE MILLON

    Claribel Morales de Barbenza

    2003-01-01

    Full Text Available En el presente artículo se describe la evolución de las propuestas teóricas de Theodore Millon desde 1967 a la fecha. Su obra es considerada como uno de los primeros intentos relevantes de integración en el área de las teorías de la personalidad. Se pone énfasis en los aspectos de mayor potencialidad integradora de sus desarrollos teóricos, tales como la evolución biosocial de la persona (expuesta en su primera teoría, en la que ya incluía dos polaridades: actividad versus pasividad; sí mismo versus otros, las posteriores consideraciones destinadas a enriquecer el modelo de persona, mediante la incorporación de una nueva polaridad, placer-dolor, la resignificación de las etapas vitales que figuraban en su teoría originaria y la interrelación entre áreas estructurales y áreas funcionales de la personalidad. Se puntualizan los aportes incorporados por Millon a la práctica de la evaluación psicológica y psicopatológica, desde una perspectiva sistémica, en la que el concepto de sinergia cobra una especial relevancia. Juntamente con el desarrollo de su teoría personológica, Millon produjo una serie de instrumentos destinados a evaluar la personalidad. Se destaca la importancia que el autor atribuye al proceso de evaluación psicológica, tan complejo como la persona misma, y la vinculación que establece entre los trastornos de personalidad (faceta disfuncional de los estilos de personalidad y los sindromes severos y clínicos con los ejes del DSM-III-R y el DSM-IV.

  10. Diagnóstico e tratamento do lenticone anterior

    Ana Luiza Biancardi

    2011-08-01

    Full Text Available Relato de caso de um paciente de 18 anos com sindrome de Alport apresentando perda visual progressiva. A biomicroscopia revelou lenticone anterior bilateral. O paciente realizou tomografia de córnea e segmento anterior com o sistema Scheimpflug (Pentacam e aberrometria e topografia corneana (i-Trace. O paciente foi submetido à facoemulsificação com implante de lente intraocular peça única hidrofóbica (Acrysof® SN60AT. As imagens de Scheimpflug documentaram o lenticone anterior. A aberrometria total mostrou acentuado astigmatismo miópico com acentuada aberração esférica negativa, havendo grande impacto das aberrações de alta ordem (HOA na conversão da letra E de Snellen. O mapa de integração da aberrometria do olho todo com a topografia corneana mostrou maior semelhança das aberrrações totais com as aberrações intraoculares do que com as aberrações da superfície anterior da córnea. Após a cirurgia, o paciente apresentou acuidade visual corrigida igual a 20/20 em ambos os olhos, as imagens de Scheimpflug revelaram lentes intraoculares tópicas e os mapas diferenciais revelaram resolução da miopia e redução das aberrações da alta ordem (total e interna. Os exames de imagem foram úteis para demonstrar o impacto do lenticone anterior na qualidade visual e a resolução das aberrações ópticas após a cirurgia.

  11. Contribuciones tecnicas para la medida de la contaminacion electromagnetica de microondas. Estudio en diversas poblaciones

    Segura Garcia, Jaume

    La contaminacion ambiental por campos electromagneticos ha resultado ser en estos ultimos anos uno de los problemas mas acuciantes del panorama tecnologico y de salud publica. En el primero de los casos porque las inversiones realizadas son enormes y en el segundo porque cada vez es mayor el numero de articulos, "technical reports" e informes medicos que afirman la existencia de una cierta causalidad, aunque sea debil, entre los campos electromagneticos y ciertos cuadros sintomatologicos. En nuestro caso, hemos dedicado bastantes esfuerzos a investigar el llamado "sindrome de radiofrecuencia / microondas", denominado asi en la literatura cientifica por presentarse en operarios de estaciones de radar y en trabajadores de potentes emisoras de radio y television. En esta memoria presentamos un resumen del trabajo realizado durante los ultimos anos en la medida de la contaminacion electromagnetica ambiental asociado a las comunicaciones inalambricas. En ella se recogen los fundamentos fisicos y propiedades de las ondas electromagneticas, la tecnologia empleada en los sistemas de telefonia celular y los antecedentes relativos a la investigacion de la interaccion de las ondas electromagneticas con organismos vivos. Se desarrolla un procedimiento de medida que ha conducido a la elaboracion de los primeros "mapas de radiofrecuencia" similares, en el aspecto descriptivo, a los mapas de ruido desarrollados en el area de la contaminacion acustica. Por ultimo, se analiza la respuesta subjetiva de los residentes, personas que viven en el entorno de cobertura de las estaciones base de telefonia movil y que se ven sometidos a determinados niveles de radiacion electromagnetica, con el fin de situar este fenomeno al nivel que le corresponde en el ambito de la respuesta subjetiva ciudadana.

  12. Cognitive functioning and insight in schizophrenia and in schizoaffective disorder.

    Birindelli, Nadia; Montemagni, Cristiana; Crivelli, Barbara; Bava, Irene; Mancini, Irene; Rocca, Paola

    2014-01-01

    The aim of this study was to investigate cognitive functioning and insight of illness in two groups of patients during their stable phases, one with schizophrenia and one with schizoaffective disorder. We recruited 104 consecutive outpatients, 64 with schizophrenia, 40 with schizoaffective disorder, in the period between July 2010 and July 2011. They all fulfilled formal Diagnostic and Statistical Manual of Mental disorders (DSM-IV-TR) diagnostic criteria for schizophrenia and schizoaffective disorder. Psychiatric assessment included the Clinical Global Impression Scale-Severity (CGI-S), the Positive and Negative Sindrome Scale (PANSS), the Calgary Depression Scale for Schizophrenia (CDSS) and the Global Assessment of Functioning (GAF). Insight of illness was evaluated using SUMD. Neuropsychological assessment included Winsconsin Card Sorting Test (WCST), California Verbal Learning Test (CVLT), Stroop Test and Trail Making Test (TMT). Differences between the groups were tested using Chi-square test for categorical variables and one-way analysis of variance (ANOVA) for continuous variables. All variables significantly different between the two groups of subjects were subsequently analysed using a logistic regression with a backward stepwise procedure using diagnosis (schizophrenia/schizoaffective disorder) as dependent variable. After backward selection of variables, four variables predicted a schizoaffective disorder diagnosis: marital status, a higher number of admission, better attentive functions and awareness of specific signs or symptoms of disease. The prediction model accounted for 55% of the variance of schizoaffective disorder diagnosis. With replication, our findings would allow higher diagnostic accuracy and have an impact on clinical decision making, in light of an amelioration of vocational functioning.

  13. Difference in Injury Mode, Dose-Rate Dependence and RBE of 730-Mev Protons, 100-KVp X-Rays and 250-KVp X-Rays; Differences dans le Type de Lesion, l'Importance du Debit de Dose et l'EBR entre les Protons de 730 Mev, les Rayons X de 100 Kv-Crete et les Rayons X de 250 Kv-Crete; Razlichiya kharaktera porazheniya, zavisimosti ot moshchnosti dozy i obeh protonov s ehnergiej 730 mehv i rentgenovskikh luchej s pikovym napryazheniem 100 i 250 kv; Diferencias en la Modalidad de La Lesion, la Relacion con la Intensidad de Dosis y la EBR de los Protones de 730 Mev, y los Rayos X de 100 Kvp Y de 250 Kvp

    Sondhaus, C. A.; Wallace, R. W.; Lyman, J. T.; Kase, K. W.; Steward, P. G. [University of California Lawrence Radiation Laboratory Berkeley (United States)

    1964-03-15

    meme effet du debit de doee que dans l'exposition a bas TLE. Les auteurs examinent les consequences pratiques de la distribution de la dose et du debit de dose. (author) [Spanish] Los autores estudiaron la mortalidad a los 6, 12 y 30 d en ratones blancos machos de la variedad Swiss Webster expuestos a protones de 730 MeV, a rayos X de 250 kVp y a rayos X de 100 kVp, con diferentes intensidades de dosis. En los ratones irradiados con protones, predomino la muerte por sindrome gastrointestinal, a los 6 a 8 d, con dosis de 100 y 1000 rad/min, y el efecto letal fue mas intenso con la intensidad de dosis mayor. En la exposicion a los rayos X, predomino la muerte por sindrome hematopoyetico, a los 12 a 14 d, con efectos de la intensidad de dosis semejantes a los del caso anterior. Comprobaron los autores que la EBR de los protones para la DL{sub 50} a los 30 d, comparada con la de los rayos X de 250 kVp, asciende a 0,8; en cuanto a la EBR para la DL{sub 50} a los 6 d, es 1,2, con igual intensidad de dosis (100 rad/min). Atribuyen la diferencia de modalidad de la lesion a las distintas distribuciones de la dosis en los tejidos. En la EBR de los protones para la muerte por sindrome intestinal a los 6 d , que asume un valor elevado pero variable, se manifiesta al parecer el efecto de intensidad de doeis caracteristico de las exposiciones de baja TLE. Los autores examinan las consecuencias practicas de los factores de distribucion de dosis y de la intensidad de dosis senalados. (author) [Russian] Izuchalas' smertnost' samcov belyh myshej linii Sviss Vebster, podvergnutyh oblucheniju protonami s jenergiej 730 Mjev, rentgenovskimi luchami s pikovym naprjazheniem 250 i 100 kv pri razlichnyh moshhnostjah dozy. Myshi, obluchennye protonami, pogibali na shestoj- vos'moj den', glavnym obrazom v rezul'tate zheludochno-kishechnyh porazhenij posle obluchenija 100 i 1000 rad/min, prichem smertnost' povyshalas' s povysheniem moshhnosti dozy. Posle rentgenovskogo obluchenija zhivotnye

  14. Occult inflammatory breast cancer: review of clinical, mammographic, US and pathologic signs; Carcinoma infiammatorio occulto della mammella: revisione di reperti mammografici, ecografici, clinici ed anatomo-patologici

    Cumo, Francesca; Gaioni, Maria Berenice; Bonetti, Franco; Manfrin, Erminia; Remo, Andrea; Pattaro, Christian [Policlinico G.B. Rossi, Verona (Italy). Dipartimento di scienze morfologico biomediche; Policlinico G.B. Rossi, Verona (Italy). Sezione di radiologia, Sezione di anatomia patologica. Dipartimento di medicina e sanita' pubblica, Sezione di epidemiologia e statistica medica, igiene

    2005-04-01

    uno studio retrospettivo di 19 donne affette da IBCO giunte all'osservazione nel nostro Istituto dal 1993 al 2002. Sono stati analizzati i dati clinico-anamnestici, mammografici, ecografici ed anatomo-patologici e, successivamente, sono stati valutati i fattori prognostici, la sopravvivenza totale (OS) e le associazioni radio-patologiche. Risultati: I reperti mammografici pi� comuni sono stati: aumento diffuso di densit� (52.63%), ispessimento trabecolare (42,1%), massa 36,84%). I reperti ecografici pi� frequenti sono stati: linfoadenopatia ascellare (68.75%), ispessimento cutaneo (43.75%) e massa (56.25%). Almeno uno dei reperti riscontrati nelle forme pi� comuni di carcinoma infiammatorio primitivo (IBC comune e clinico), in corso di mammografia (ispessimento del sottocute, ispessimento trabecolare, diffuso aumento della densit�) od ecografia (ispessimento del sottocute, aumento diffuso dell'ecogenicit�, parenchimale da edema, dilatazione dei canali linfatici) � stato riscontrato in 14 donne (74%). Nel 63,2% era presente positivit� recettoriale per gli estrogeni (ER), nel 36.8% per il progesterone. Fattori prognostici significativi sono risultati ER e Ki67. Conclusioni: Nell'IBCO il pattern radiologico dell'IBC comune e clinico viene ritrovato con frequenza inferiore; tuttavia, il radiologo deve prestare attenzione a questi segni perch� spesso solo uno di essi � presente in caso di IBCO e ci� rende possible l'orientamento verso la diagnosi corretta. Inoltre, l'assenza di segni clinici e radiologici di infiammazione non esclude la possibilit� di IBC poich� l'IBCO pu� anche manifestarsi all'imaging come massa o calcificazioni isolate. La positivit� recettoriale per estrogeni e progesterone risultando abbastanza elevata, conferma la prognosi migliore delle forme occulte rispetto a quelle clinicamente manifeste e rende opportuno un approfondimento conoscitivo delle sue caratteristiche cliniche

  15. Nuevas modalidades de acoso: el acoso virtual en el ámbito educativo New modalities of harassment: the virtual harassment in the educational area

    Osvaldo H. Varela

    2010-12-01

    Full Text Available El acoso psicológico en tanto modalidad de hostigamiento, no se limita exclusivamente al ámbito laboral u hogareño en tanto hecho de violencia psíquica ejercida deliberadamente hacia un sujeto en su presencia y con la intención manifiesta o no de socavar su integridad psíquica en pos de la obtención de algún beneficio en lo material o inmaterial para quien lo ejerce. Puede también comprender ámbitos como el educativo y viabilizarse por intermedio de lo virtual, facilitado por la ampliación en la utilización de las nuevas tecnologías en el aula. Surge la pregunta, desde la psicología, acerca de los límites conceptuales de la figura del hostigamiento u acoso cuando quien lo ejerce no es un sujeto plenamente conciente del alcance de sus actos ni de aquello que genera en la víctima, debido a que algunas de sus facultades mentales se encuentran socavadas como consecuencia de un cuadro psicótico presente.The psychological harassment while modality of harassment, it does not limit itself exclusively to the labour or domestic area while fact of psychic violence exercised deliberately towards a subject in his presence and with the manifest intention or not of undermining his psychic integrity in pursuit of the obtaining of any benefit in the material or immaterial thing for the one who exercises it. It can include also áreas as the educational one and viabilizarse through the virtual thing, facilitated by the extension of the utilization of the new technologies in the classroom. On the other hand the question arises, from the psychology, brings over from the limits to the figure of the harassment or I harass when the one who exercises it it´s a subject fullly conciente neither of the scope of his acts nor of that one that it generates in the victim, due to the fact that some of his mental powers are undermined to consequences of a psychotic present sindrome.

  16. Detecção de imunoglobulinas IgG, IgM e IgA anti-Toxoplasma gondii no soro, líquor e saliva de pacientes com síndrome da imunodeficiência adquirida e neurotoxoplasmose Detection of anti-Toxoplasma gondii IgG, IgM and IgA immunoglobulins in the serum, cerebrospinal fluid and saliva of patients with acquired immunodeficiency syndrome and neurotoxoplasmosis

    Aercio Sebastião Borges

    2004-12-01

    Full Text Available Estudamos 55 pacientes com sindrome da imunodeficiência adquirida (SIDA e neurotoxoplasmose (grupo 1; 37 pacientes com SIDA e comprometimento neurológico por outra etiologia (grupo 2 e 18 indivíduos anti-HIV negativos com manifestações neurológicas (grupo 3, pesquisando IgG, IgA e IgM anti-Toxoplasma gondii, no soro, líquor e saliva, utilizando teste ELISA, para fins diagnósticos. O valor preditivo negativo do teste para o encontro de IgG no soro foi 100% e no líquor, 92,4%. Não houve diferença entre os três grupos quanto aos anticorpos IgA neste material. Para IgA, no líquor, o teste alcançou 72,7% de especificidade (pWe studied 55 patients with acquired immunodeficiency syndrome (AIDS and neurotoxoplasmosis (group 1, 37 patients with AIDS and neurological involvement due to another etiology (group 2 and 18 anti-HIV-negative individuals with neurological manifestations, by searching for anti-T. gondii IgG, IgA and IgM immunoglobulins in serum, cerebrospinal fluid (CSFand saliva, using ELISA. The negative predictive value of the test for IgG in serum was 100% and in CSF, 92.4%. There was no difference among the three groups studied regarding IgA in serum. For IgA, in CSF the test reached 72.7% specificity (p<0.05. In saliva, only the detection of IgG was found to be correlated with a diagnosis of neurotoxoplasmosis. We emphasize that the absence of anti-T. gondii IgG antibodies in serum and CSF strongly indicates the absence of a diagnosis of neurotoxoplasmosis and that specific IgA immunoglobulins in CSF and IgG in saliva may represent two auxiliary markers for the differential diagnosis of toxoplasmic encephalitis in AIDS.

  17. Neurocisticercosis en niños: Hospital Universitario San Vicente de Paúl, Medellín 1989-1996 Neurocysticercosis in children: experience in Medellín, Colombia 1989-1996

    José William Cornejo Ochoa

    1997-03-01

    Full Text Available Se hace un estudio retrospectivo de las historias cínicas de los menores de 18 años con diagnóstico de egreso de neurocisticercosis, del Hospital Universitario San Vicente de Paúl, de Medellín (HUSVP durante el período 1989 a 1996. Se encontraron 16 pacientes: Trece mujeres y 3 hombres, con un promedio de edad de 11 años. Los motivos de consulta mas frecuentes fueron convulsiones (68.8%, cefalea (62.5% y alteraciones visuales (37.5%. La evolución de los síntomas fue menor de tres meses en el 81% de los casos. Los diagnósticos sindromáticos mas frecuentes fueron los síndromes convulsivo (68.8% y de hipertensión endocraneana (43.8%. La tomografía computarizada mostró lesiones parenquimatosas múltiples en 8 casos y únicas en 4. El tratamiento con albendazol (10 mg/kg/dla mejor6 la sintomatología en todos los casos; se emplearon corticoides en todos los pacientes que recibieron tratamiento antiparasitario. Las convulsiones se controlaron fácilmente con difenilhidantolna o carbamazepina. Neurocysticercosis in children. Experience in Medellín, Colombia, 1989-1996 This is a retrospective clinical study of neurocisticercosis in patients aged 18 years or less, at Hospital Universitario San Vicente de Paul, in Medellln, Colombia, during the period 1989-1996. There were 16 patients, 13 girls and 3 boys; average age was 11 years. The main complaints were: Seizures (68.8%, headache (62.5% and visual disturbances (37.5%. Evolution of symptoms was less than three months in 81% of the patients. The most frequent syndromatic diagnoses were: Convulsive (68.8% and intracraneal hypertension syndromes (43.8%. Computed tomography revealed intraparenchimal multiple lesions in 8 cases and solitary lesions in 4 cases. Treatment with albendazole (10 mg/kg/day improved symptoms in every patient; children treated with antiparasitic drugs also received corticosteroids for 7 to 14 days. Seizures were easily controlled with anticonvulsivants such as

  18. Molecular diagnostic of the philadelphia chromosome; Diagnostico molecular del cromosoma filadelfia

    Campos Rudin, M [Instituto de Investigaciones en Salud (INISA), Costa Rica (Costa Rica) and Escuela de Biologia; Cuenca Berger, P [Instituto de Investigaciones en Salud (INISA), Costa Rica (Costa Rica) and Escuela de Biologia; Gutierrez Espeleta, G [Instituto de Investigaciones en Salud (INISA), Costa Rica (Costa Rica) and Escuela de Biologia; Jimenez Cruz, G [Hospital Mexico, Costa Rica (Costa Rica). Seccion Hematologia; Montero Umana, C [Hospital Mexico, Costa Rica (Costa Rica). Seccion Hematologia; Vazquez Castillo, L [Hospital San Juan de Dios, Costa Rica (Costa Rica). Seccion de Hematologia; Ramon Ortiz, M [Hospital San Juan de Dios, Costa Rica (Costa Rica). Seccion de Hematologia

    1998-07-01

    The importance that has to confirm the presence or absence of the chromosome Philadelphia in the diagnostic and follow up of the patient affected with chronic myeloid leukemia and other leukemia. It is considered necessary to implement the molecular diagnostic in Costa Rica. They studied 32 patient affected by Chronic Myeloid Leukemia, 7 by other Myeloproliferative Chronic Disorders and 2 by Myelodysplastic Syndrome. It utilized the sound Trans probe-1 (Oncogene Science, Inc), which was marked with radioactivity ({sup 32}P) or chemiluminescence (digoxigenin). Of the 32 cases affected by L mc, in 28 it was possible to carry out the molecular analysis detecting the characteristic translocation of the chromosome Philadelphia among the Mbcr/c-ABL genes in 21 (75%) of the patients, in 7 (25%) the rearrangement was not found. In seven of the nine affected by other sufferings it was possible to obtain results, 3 that turned out to be positive for the rearrangement among Mbcr/c-ABL and 4 normal. In all the cases, they obtained results marking the sound with radioactivity. However, they tested the marks with digoxigenin in seven of the patients, as an methodological alternative for the laboratories that lacks the requirements to work with radiation. The results obtained were identical. (S. Grainger) [Spanish] La relevancia que tiene confirmar la presencia o ausencia del cromosoma Filadelfia en el diagnostico y seguimiento de los pacientes afectados con leucemia mieloide cronica y otras leucemias, se considero necesario implementar el diagnostico molecular en Costa Rica. Se estudiaron 32 pacientes afectados por Leucemia Mieloide Cronica, 7 por otros Desordenes Mieloproleferativos Cronicos y 2 por Sindromes Mielodisplasicos. Se utilizo la sonda Transprobe-1 (Oncogene Science, Inc), la cual fue marcada con radioactividad ({sup 32}P) o quimioluminiscencia (digoxigenina). De los 32 casos afectados por LMC, en 28 se logro realizar el analisis molecular detectandose la

  19. Germinomas cerebrais (teratomas atípicos da pineal Cerebral germinomas (atipical teratomas of the pineal region

    Alexandre Alencar

    1981-12-01

    Full Text Available São estudados três casos de germinomas cerebrais, sendo um tópico, da região pineal, e dois ectópicos, chamados germinomas supra-selares ou quiasmáticos. Estes últimos parecem ser mais agressivos que os seus congeneres tópicos, pois alem de se disseminarem pelas cisternas basais, costumam infiltrar as paredes do III ventrículo, fórnix, hipotálamo, nervos e quiasma ópticos. Caracteristicamente produzem um enorme aumento das proteínas liquóricas, desacompanhado de uma pleocitose proporcional. As proteínas liquóricas aumentadas sao globulinas cujas reações mostram-se fortemente positivas, possivelmente produzidas pelas celulas de aspecto linfocitario que constituem parte desta neoplasia. O aumento das proteinas liquoricas e tao acentuado que em presenca de uma crianca ou adolescente com sindrome de hipertensão intracraniana, hiperproteinoraquia sem pleocitose e sinais clínicos ou radiológicos sugestivos de localização na base do crânio a possibilidade de um germinoma quiasmático deve ser seriamente considerada, pois o quadro e muito sugestivo.Three cases of Cerebral Germinomas, one of them situated in the pineal region (topical and two ectopical of the so called suprasellar or chiasmal Germinomas are studied. These last ones may be more aggressive than the congeneral topical ones, since besides it's dissemination throughout the basal cisternas they usually infilstrate into de walls of the III Ventricle, Fornix, Hypothalamus, Chiasma and Optic nervs. A high level of proteins in the spinal fluid without proportional increase of the cells is characteristic. Globulins are the predominant fraction of the increased spinal fluid proteins, as indicated by the highly positive laboratory test. These globulins are possibly produced by the lymphocytes which are part of this neoplasm. The high level of protein in the spinal fluid without proportional increase of the cells, in the presence of intracranial syndrome in a child or

  20. Graft Polymerization of Styrene to Polyethylene; Polymerisation par greffage du styrene sur des pellicules de polyethylene; Privitaya polimerizatsiya stirola k poliehtilen; Polimerizacion por injerto de estireno en polietileno

    Silverman, J.; Srinivasan, S. I.; Phalangas, C. J. [Department of Chemical Engineering, University of Maryland, College Park, MD (United States)

    1963-11-15

    obtenues 4 la suite d'experiences de greffage a 18 et a 40{sup o}C sur des pellicules et des peluches de polyethylene, avec des doses de rayons gamma de {sup 60}Co allant jusqu'a 8,0 x 10{sup 5} r/h. Les auteurs ont egalement mesure la vitesse de conversion du styrene en homopolymere dans les peluches en suspension. Ils ont fait des examens microscopiques des pellicules greffees afin de connaitre la quantite d'homopolymere absorbe. Les resultats obtenus montrent que l'augmentation de poids dans les echantillons de pellicules est due en grande partie a l'homopolymere absorbe. Pour les experiences faites sur les peluches, dans lesquelles l'augmentation de poids est imputable en grande partie au copolymere greffe, cette augmentation est a peu pres proportionnelle a la dose et la vitesse de reaction est presque proportionnelle a la racine carree du debit de dose des rayons gamma. Du fait d'une energie d'activation faible pour la vitesse de reaction, on ne peut pas agir sur la vitesse de diffusion dans les peluches et dans des pellicules minces si les debits de dose sont inferieurs a 10{sup 5} r/h. La vitesse de formation de l'homopolymere dans les experiences sur peluches faites a 18{sup o}C et a 7,2 x 10{sup 4} r/h est la meme que dans l a polymerisation du styrene pur. L'energie d'activation, 3,5 kcal/mole, represente a peu pres la moitie de la valeur enregistree pour le monomere pur. (author) [Spanish] Del estudio de los datos publicados acerca del injerto radioinducido de estireno en peliculas de polietileno de baja densidad, se deduce que la intensidad de la dosis gamma y el espesor de la pelicula ejercen una influencia poco acusada sobre el fndice de incremento de peso. Los autores demuestran que los modelos utilizados por otros investigadores en la interpretacion de los datos sobre el incremento de peso con miras a determinar las constantes de velocidad carecen de validez en este caso. Presentan datos obtenidos en experimentos de injerto a 18{sup o}C y 40{sup o}C con

  1. Role of Spiral and Multislice Computed Tomography in the evaluation of traumatic and spontaneous oesophageal perforation. Our experience; Ruolo della Tomografia Computerizzata Spirale e Multistrato nello studio delle lesioni traumatiche e spontanee dell'esofago: nostra esperienza

    De Lutio di Castelguidone, Elisabetta; Pinto, Antonio; Merola, Stefanella; Stavolo, Ciro; Romano, Luigia [Azienda Ospedaliera di Rilievo Nazionale A. Cardarelli, Napoli (Italy). Dipartimento di Diagnostica per Immagini

    2005-03-01

    periesofageo (4 casi), ispessimento parietale dell'esofago (3 casi), lacerazione della parete esofagea (2 casi), con anomalo decorso del sondino naso gastrico in uno, e stravaso extraluminale del mdc per os (2 casi). In 2 pazienti con complicanze post-intubazione, l'esame TC mostrava una modesta raccolta fluida periesofagea con piccole bolle gassose nel contesto in un caso e nell'altro una grossolana raccolta mista di tipo ascessulae in sede periesofagea. Nei 2 pazienti con riferita ingestione di corpo estraneo, l'esame diretto cervico-toracico integrato da quello TC, evidenziava in un caso la presenza, in sede cervicale, di sottile corpo estraneo metallico (frammento di protesi dentaria) e minimo stravaso extraluminale di gastrografin, mentre nel secondo paziente, l'esame TC mostrava la pesenza di corpo estraneo (piccolo osso di pollo) a sede ipofaringea con ispessimento parietale dell'esofago ed edema dei tessuti circostanti. Nei rimanenti 3 casi con sospetta lesione spontanea dell'esofago, la TC evidenziav ain un caso la presenza di un ematoma intramurale, in un altro caso sovradistensione fluida dell'esofago con nucleo gassoso e piccola soffusione fluida periesofagea (indicativi di sindrome di Mallory-Weiss) e nel terzo caso la rottura dell'esofago (sindrome di Boerhaave). Conclusioni: Dalla nostra esperienza emerge che nella valutazione dei pazienti con sospetta lesione traumatica o spontanea dell'esofago, l'esame radiologico standard della regione cervicale e del torace puo' suggerire il sospetto di perforazione esofagea in una bassa percentuale di casi, mentre lo studio contrastografico dell'esofago per os presenta una sensibilita' piu' elevata. La TC, infine, eseguita con tecnica accurata, consente, attraverso una attenta analisi di tutti i segni suggestivi e specifici di lesione esofagea, di formulare una diagnosi corretta nella maggioranza dei casi influenzando la prognosi in modo determinante

  2. Estudos sobre a Esquistosomose em Pernambuco, Brasil

    Aggeu Magalhães

    1940-01-01

    da desinfestação dos outros parasitas intestinais, do tratamento corretivo das sindromes anemicas e da terapeutica anti-esquistosomotica. Somente a esplenectomia conseguiu apagar aquela disfunção hemo-reguladora. Os AA. acreditam que alguns dos casos apresentados sejam de esplenopatias cronicas de origem esquistosomotica. Como tal procuram realçar uma das variedades do acometimento esquistosomoso esplenico moldado na sindrome de hiperesplenia cronica hipomielica. Os requisitos exigidos para esta catalogação estiveram presentes, tal como em verdadeiras esplenopatias cronicas palustres, leishmanioticas ou de outra etiologia semelhante em atuação.

  3. Direct Measurement of Tritium in Biological Materials with the Liquid Scintillation Counter; Determination quantitative directe du tritium dans les substances biologiques, au moyen de compteurs a scintillations a liquides; Neposredstvennoe izmerenie kolichestva tritiya v biologicheskikh materialakh pri pomoshchi zhidkogo stsintillyatsionnogo schetchika; Determinacion cuantitativa directa del tritio en sustancias biologicas mediante contadores de centelleador liquido

    Halvorsen, K [Institutt for Atomenergi, Kjeller, Lillestroem (Norway)

    1962-01-15

    'hyamine et le rendement de la detection peut etre de 10 a 15%. L'auteur examine les techniques de correction de coupage et certains phenomenes de phosphorescence dans la mesure ou ils ont une influence sur le dispositif de comptage a un seul phototube. Cette methode, bien que moins precise que le dispositif de coincidence, l'est suffisamment pour de nombreuses applications. L'experience qui fait l'objet du memoire a porte sur des echantillons de tissus de souris auxquelles on avait injecte au prealable de la thymidine marquee au tritium. Lorsqu'une dose d'environ 1 {mu}c de thymidine tritiee par gramme de poids du corps est injectee aux souris, on peut suivre pendant un mois les transformations metaboliques de la thymidine incorporee a l'acide deoxyribonucleique (ADN) des divers tissus. (author) [Spanish] Ya se han presentado informes acerca de los procedimientos aplicados para la determinacion cuantitativa del tritio en tejidos animales y fracciones aisladas de los mismos. Sin embargo, en los trabajos respectivos se han utilizado siempre, para el recuento de la muestra, espectrometros de coincidencia de centelleador liquido. En cambio, en el presente trabajo las mediciones se han efectuado con un contador de centelleador liquido equipado con un fototubo unico. Se investigo principalmente la disolucion directa de tejido animal en la hiamina 10-KH y el recuento del tejido liofilizado en suspension en geles de centelleo. Es posible disolver directamente en hiamina tejidos diferentes tales como el hepatico, el intestinal, el sanguineo y el cutaneo, y medirlos con un rendimiento de 10 a 15%. El autor examina la tecnica aplicada para la correccion por extincion, asi como ciertos fenomenos de fosforescencia que afectan la determinacion en el sistema de recuento de fototubo unico. Parece que el metodo ofrece una sensibilidad suficiente para muchas aplicaciones, aunque un poco menor que la del dispositivo de recuento por coincidencias. La labor de que se informa se llevo a cabo con

  4. Avaliação eletromiográfica dos músculos estabilizadores da patela durante exercício isométrico de agachamento em indivíduos com síndrome da dor femoropatelar Evaluacion eletromiográfica de los músculos estabilizadores patelares durante el ejercício isométrico de agachamiento en indivíduos con síndrome de dolor femoropatelar Electromyographic activity evaluation of the patella muscles during squat isometric exercise in individuals with patellofemoral pain syndrome

    Débora Bevilaqua-Grossi

    2005-06-01

    Full Text Available O objetivo deste trabalho foi comparar a atividade elétrica dos músculos vasto medial oblíquo (VMO, vasto lateral longo (VLL e vasto lateral oblíquo (VLO durante os exercícios isométricos de agachamento wall slide a 45º (WS 45º e 60º (WS 60º de flexão do joelho. Foram avaliadas 15 mulheres clinicamente saudáveis e 15 mulheres com síndrome da dor femoropatelar (SDFP. Os registros eletromiográficos foram obtidos por eletrodos ativos simples conectados a um eletromiógrafo durante a contração isométrica voluntária máxima (CIVM do WS 45º e WS 60º. Os dados foram analisados pela média dos valores do root mean square (RMS do sinal eletromiográfico, normalizado pela média do RMS obtido no agachamento a 75º de flexão do joelho. A análise estatística empregada foi o teste ANOVA two way (p El objetivo de este trabajo fué el de comparar la actvividad eléctrica de los músculos vasto medial oblíqüo (VMO, vasto lateral longo (VLL y vasto lateral oblicuo (VLO durante los ejercicios isometricos de agachamiento wall slide a 45º (WS 45º e 60º (WS 60º de flexión de rodilla. Fueron evaluadas 15 mujeres clinicamente saludables con sindrome de dolor femoropatelar (SDFP. Los registros fueron obtenidos por electrodos activos simples conectados a un electromiografo durante la contraccion isometrica voluntaria máxima (CIVM de WS 45º y de WS 60º. Los datos fueron analizados por la media de los valores de Root Mean Square - RMS de señal eletromiográfica, normalizada por la media del RMS obtenido en el agachamiento a 75º de flexión de la rodilla. El análisis estatístico empleado fue el test ANOVA two way (p The objective of this study was to compare the electromyographic (EMG activity of vastus medialis obliquus (VMO, vastus lateralis longus (VLL and vastus lateralis oblíquus (VLO during wall slide squat isometric exercises at 45º (WS 45º and at 60º (WS 60º of knee flexion. Fifteen healthy control women and fifteen women

  5. Circulação extracorpórea por membrana (ECMO em recém-nascido com insuficiência respiratória por síndrome de aspiração meconial: efeitos da administração de surfactante exógeno Extracorporeal membrane oxygenation (ECMO in a neonate with respiratory distress due to meconium aspiration syndrome: Effect of the administration of exogenous surfactant

    João Gilberto Maksoud-Filho

    2001-06-01

    Full Text Available OBJETIVO: apresentar a evolução clínica de recém-nascido portador de insuficiência respiratória grave neonatal secundária à Sindrome de Aspiração Meconial tratado por Circulação Extracorpórea por Membrana, ou, conforme o termo consagrado em língua inglesa, ECMO (Extracorporeal Membrane Oxygenation, o efeito do uso de surfactante exógeno neste caso e os custos do procedimento. MÉTODOS: Descrição de um caso de Síndrome de Aspiração Meconial, tratado na UCINE (Unidade de Cuidados Intensivos Neonatais do Instituto da Criança Prof. Pedro de Alcantara, Hospital das Clínicas da Universidade de São Paulo. RESULTADOS: O suporte extracorpóreo teve a duração de 5 dias, sem complicações clínicas ou mecânicas. Surfactante exógeno de origem porcina foi administrado no 4o dia, após o quê observamos uma melhora significativa na complacência pulmonar. O recém-nascido pôde então ser rapidamente decanulado. Os custos do tratamento foram compatíveis com a realidade nacional em relação a um recém-nascido criticamente enfermo. CONCLUSÕES: a ECMO é indicada em casos de insuficiência respiratória neonatal que não respondam a outros tratamentos existentes. Deve ser disponível em Unidades de Tratamento Intensivo (UTIs neonatais de hospitais terciários e ser empregada conforme critérios bem estabelecidos. A utilização de surfactante exógeno aparentemente antecipou a retirada da ECMO e, portanto, deve ser considerada em casos semelhantes. Os custos do tratamento justificam a organização de Equipes de ECMO nessas UTIs.OBJECTIVES: to present the clinical outcome of a newborn with severe respiratory distress secondary to meconium aspiration syndrome and treated by extracorporeal membrane oxygenation (ECMO; and to present the effect of the use of exogenous surfactant in this case and the cost of the procedure. METHODS: Case report of a newborn with meconium aspiration syndrome and treated at the neonatal ICU of the

  6. Contribuição ao estudo da hipsarritmia

    Ana Maria Fisch

    1966-03-01

    Full Text Available Resumindo as principais contribuições que resultaram na conceituação atual da hipsarritmia, destacam os autores a noção de que não constitui ela uma entidade clínica determinada, mas uma sindrome eletroclínica especial, própria da primeira infância, e cujo diagnóstico só pode ser firmado à luz do traçado eletrencefalográfico característico. Analisam a variedade de fatôres etiológicos à maneira do que ocorre com as encefalopatias infantis em geral, chamando a atenção para a importância do fator etário, das condições traumáticas e do problema da anóxia cerebral neonatorum. Necessária ênfase é conferida ao fenômeno da maturação encefálica que explica, segundo o consenso dos autores modernos, as características peculiares da síndrome. A hipsarritmia pode instalar-se em indivíduo previamente são ou em encefalopata, tendo evolução variável, pois tanto pode evolver favoràvelmente, o que é mais raro, como modificar-se, seja no sentido da epilepsia focal ou outra forma de epilepsia, o que é mais comum, ou, então, permanecer inalterada. Essa evolução - a história natural da hipsarritmia - é apreciada especialmente sob o aspecto eletrencefalográfico, o qual pode, ou não, ser acompanhado de correspondente evolução clínica. A sintomatologia é variável, sendo de notar a grande dominância das crises de espasmos em flexão. Sendo pobre o subsídio anátomo-patológico da condição, os autores, a êsse propósito, apenas acrescentam os dados referentes à necropsia de um dos seus casos, com achados inespecíficos. O prognóstico, na maioria das vêzes mau, pode variar, especialmente após o uso do ACTH. O tratamento é difícil, freqüentemente desapontador. As melhores respostas são obtidas com o ACTH e, algumas vêzes, com os antibióticos e medicação sintomática, porém, quase sempre reaparece a sintomatologia, se suprimida a medicação que, por outro lado, nem sempre pode ser continuada.

  7. Estudo da morbidade e da mortalidade perinatal em maternidades: III - Anomalias congênitas em nascidos vivos A study of perinatal morbidity and mortality in maternity hospitals: III - Congenital anomalies in live briths

    José Maria Pacheco de Souza

    1987-02-01

    Full Text Available Realizou-se estudo das anomalias congênitas encontradas em recém-nascidos vivos, em nove maternidades, durante o ano de 1981-1982. O material é parte de uma pesquisa desenvolvida em sete maternidade do Estado de São Paulo, uma do Rio de Janeiro e uma de Florianópolis, Santa Catarina (Brasil, no período de agosto de 1981 a julho de 1982, quando foram coletados dados sobre todos os nascimentos ocorridos nesses nove serviços. As anomalias congênitas foram definidas como as descritas no XIV.° capítulo da Classificação Internacional de Doenças - 1975, 9ª Revisão, tendo sido utilizada essa classificação para codificá-las. Na análise estatística foram utilizados o X² (com um grau de liberdade, o teste de inclinação para proporções ("Trend test" e a técnica de Berkson para a verificação da hipótese de aderência à distribuição de Poisson. Em 12.782 recém-nascidos vivos, 286 (2,24% apresentavam algum tipo de anomalia congênita, tendo havido 26 (0,20% crianças com duas anomalias, 9 (0,07% com três e duas (0,02 apresentando quatro tipos de malformações congênitas. As deformidades osteomusculares congênitas (código 754 da CID foram as mais freqüentes (19%;segue-se as outras anomalias congênitas do coração (746 com uma freqüência de 14,1%. Ao se analisar a prevalência dessas malformações pela idade da mãe nota-se que há um aumento da prevalência à medida que a idade avança, apenas para Sindrome de Down (758.Congenital anomalies in live births in nine maternities in the period 1981-1982 were studied. This was one aspect of a research project carried out in seven maternities in the State of S.Paulo, one in Rio de Janeiro and another in Florianópolis (Brazil, from which data on all births occurring between August 1981 and July 1982 were obtained. Congenital anomalies were classified according to the XIVth chapter of the CID-1975 - 9thRevision. Chi square for associations and for trend and Berkson

  8. Adherencia a la Guía de manejo de la paciente con síndrome hipertensivo asociado a la gestación, en el Hospital Universitario San Vicente de Paúl, Medellín, Colombia

    John Jairo Zuleta Tobón

    2008-11-01

    Full Text Available INTRODUCCIÓN: la implementación de guías de manejo como apoyo al equipo médico optimiza los recursos y disminuye las complicaciones en el tratamiento de pacientes con una enfermedad determinada. Aunque las guías se conocen y se elaboran en todo el mundo, su uso es discutible, la adherencia es variable y el impacto depende de la adherencia. Su uso se ha extendido mundialmente, por lo que existen guías para diferentes enfermedades, las cuales han sido analizadas desde diversos puntos de su desarrollo, incluyendo el soporte de la evidencia existente, la adherencia dentro de los servicios de salud y, por último, el impacto de su uso sobre la morbilidad y la mortalidad en un grupo específico de la población. El Hospital Universitario San Vicente de Paúl diseñó su primera Guía de Manejo del Síndrome Hipertensivo asociado al embarazo hace 20 años y su última actualización fue en agosto de 2005. Este síndrome continúa siendo una de las principales causas de morbilidad y mortalidad maternas tanto local como nacionalmente, con indicadores superiores a los de otros países, y comparándolo con países con igual desarrollo económico, razón por la cual es pertinente contar con esta guía en las instituciones de nuestro país, como una herramienta para el cumplimiento de las metas planteadas por el Ministerio de Protección Social para la disminución de la morbilidad y mortalidad maternas. Sin embargo, esta guía no ha sido objeto de análisis. Para medir su impacto sobre los indicadores, es imprescindible conocer primero la adherencia a las recomendaciones de la guía. En un segundo paso podrá corroborarse el efecto que tienen las recomendaciones sobre la evolución de la enfermedad. OBJETIVO: evaluar la adherencia a las recomendaciones de la Guía de Manejo del Sindrome Hipertensivo Asociado a la Gestación del Hospital Universitario San Vicente de Paúl. MATERIALES Y MÉTODOS: estudio descriptivo, retrospectivo. CONTEXTO: Hospital

  9. Brote de legionelosis asociado a un balneario Legionella outbreak at a spa

    E. Serrano Ibarbia

    2001-06-01

    , developed pneumonia or a clinical sindrome compatible with that of Pontiac fever (EIC-9.The environmental study included spa and surrounds, and samples of the sanitary water systems and all water therapy elements.12.5% of the 278 people surveyed in the Basque Autonomous Community matched the case definition. 9 had pneumonia and 27 Pontiac fever. The epidemic curve began on May 7th, peaked on May 14th and 15th, and finalized on the 20th. The risk of illness adjusted according to age, sex and tobacco consumption was associated with the length of stay at the spa (RR=118.5, 95% C.I.: 18.7-750.2 and with swimming-pool use. Serogroup 1 L. pneumophila was detected in counts above 103 ufc/l at different points in the water therapy system and in the shower in the room of one patient. The pulsed field gel eletrophoresis analysis of one of the biological samples and environmental samples allowed genotypic confirmation. The establishment was reopened to the public after emergency treatment was carried out and confirm that after 15 days no L. pneumophila had been detected in the environmental samples.

  10. Síndrome de dificultad respiratoria secundario a miasis sinusal y traqueopulmonar Acute respiratory distress syndrome secondary to sinus and tracheopulmonary myiasis

    Héctor Julio Meléndez

    2012-06-01

    Full Text Available La miasis es una enfermedad causada por la infestación de larvas en tejidos vivos o muertos; se clasifica entomológicamente o según el tropismo por los tejidos. Se reporta un caso de síndrome de dificultad respiratoria aguda secundario a miasis sinusal y traqueopulmonar en un hombre de 65 años, quien ingresó al servicio con epistaxis y sensación de obstrucción nasal. Se le hizo diagnóstico de crisis hipertensiva, se dio tratamiento sintomático y se hizo taponamiento nasal. El paciente reingresó a las 24 horas por edema hemifacial derecho, bradilalia y dificultad respiratoria; se retiró el tapón nasal y se evidenció salida de larvas. Se remitió a una institución de tercer nivel de atención, en donde fue valorado por otorrinolaringología y decidieron revisar las vías respiratorias bajo anestesia general, y desobstruirlas por infestación masiva de larvas. El paciente fue trasladado a la unidad de cuidados intensivos donde se diagnosticó síndrome de dificultad respiratoria aguda, y fue tratado con ivermectina y antibióticos. Posteriormente, se obtuvo una evolución satisfactoria a pesar de la gravedad del cuadro clínico. Se presenta un caso de síndrome de dificultad respiratoria aguda secundario a miasis sinusal y traqueopulmonar, y parece ser el primer caso reportado en Latinoamérica. Se destaca la adecuada evolución posterior al manejo médico sintomático y específico, a pesar de la alta mortalidad de este sindrome.Myiasis is a disease caused by the infestation of larvae in dead or living tissue. It is classified entomologically or according to tropism of the tissues. We report a case of acute respiratory distress syndrome (ARDS secondary to sinus and tracheopulmonary myiasis in a 65-year-old man who entered the service with epistaxis and nasal obstruction sensation. He was diagnosis with a hypertensive crisis, and symptomatic management and nasal plugging were performed. The patient was readmitted 24 hours later with

  11. Síndrome platipnea-ortodeoxia Platypnea-orthodeoxia syndrome

    Osvaldo D. López Gastón

    2005-06-01

    shunts, as in hepatopulmonary syndrome and a-v pulmonary fistulas, the mechanism of hypoxemia is related to the preferential circulation to basal areas of both lungs in the upright position. On the other hand, lung diseases affecting basal areas and increasing the alveolar pressure are related to the development of parenchimal pulmonary shunts with hypoxemia during postural changes, since the dead space, the functional shunt and the hypoxic vascular pulmonary constriction are affected. The autonomic neuropathy may attenuate normal sympathetic vasoconstrictor responses during postural changes, resulting in ventilation-perfusion mismatching and hypoxemia. Clinical and therapeutic aspects of this sindrome are provided.

  12. Manifestações renais na síndrome de Joubert Renal symptoms in the Joubert syndrome

    Ana Paula Weiss

    2009-06-01

    Full Text Available OBJETIVO:Descrever o caso clínico de paciente com Síndrome de Joubert associada a alterações renais. DESCRIÇÃO DO CASO: Paciente de dois meses de idade admitida com quadro hipotonia e hiperpneia. Ao exame físico, observaram-se, além da respiração irregular, movimentos oculares anormais e hipertensão arterial; não se evidenciaram alterações na ausculta cardíaca e pulmonar. Durante investigação clínico-laboratorial inicial, as causas cardíacas e pulmonares foram descartadas. Aventaram-se hipóteses diagnósticas de patologias neurológicas com doença renal. Os exames laboratoriais mostraram presença de alcalose respiratória, acidose metabólica e hipercalemia, com função renal normal. A ressonância magnética evidenciou alterações neurológicas compatíveis com "sinal do dente molar", quadro frequentemente associada à Sindrome de Joubert. Levando-se em consideração a associação dessa síndrome com alterações renais, a investigação nefrológica demonstrou imagens císticas em parênquima renal. COMENTÁRIOS: Patologias cardíacas e pulmonares estão frequentemente associadas a manifestações clínicas como taquipneia e distúrbios metabólicos. Entretanto, pode ser necessária uma investigação neurológica porque diversas doenças que acometem o sistema nervoso central apresentam tais alterações. A associação entre alterações renais e malformações de sistema nervoso central é frequente em diversos processos sindrômicos, justificando-se a sua investigação. A Síndrome de Joubert e as desordens a ela relacionadas caracterizam-se por aplasia do vermix cerebelar, ataxia, movimentos oculares anormais, respiração irregular e retardo do desenvolvimento neuropsicomotor. As alterações renais mais comuns são os cistos renais e a nefronoftise, que pode progredir para doença renal terminal.OBJECTIVE:To describe the case of a patient with Joubert syndrome associated with renal impairments. CASE

  13. Nuclear magnetic resonance in the evaluation of the disk luxation in the temporomandibular articulation conditioned for degenerative osseous changes; Resonancia magnetica nuclear en la valoracion de la luxacion discal en la articulacion temporomandibular condicionada por cambios degenerativos oseos

    Marchegiani, Silvio; Guzman Urquhart, Romel; Marangoni, Alberto; Alvarez, Federico; Surur, Alberto [Sanatorio Allende, Cordoba (Argentina). Servicio de Diagnostico por Imagenes

    2006-07-01

    incidencia de la patologia de acuerdo al sexo, relacionar las luxaciones del disco interarticular con los cambios degenerativos oseos, relacionar la falta de reduccion del disco luxado en la apertura bucal, con los cambios degenerativos oseos, y evaluar la utilidad de la RM en el estudio de la articulacion temporo-mandibular. Material y metodo: Se evaluaron 215 pacientes, estudiados desde enero de 1999 a agosto de 2004. Se excluyeron a pacientes portadores de material ferromagnetico o que presentaron sindrome de claustrofobia. Se utilizo un equipo Elscint de 2 tesla de campo magnetico, con bobina especifica y secuencias T1 y T2 con supresion grasa. Se evaluaron: luxaciones (reductibles y no reductibles), cambios degenerativos oseos, osteocondritis, cambios degenerativos discales, perforaciones discales, y lesiones retrodiscales. Resultados: De los 215 pacientes, se analizaron 175 pacientes que presentaron anormalidades en el estudio por IRM. Los 40 pacientes restantes fueron excluidos por presentar un estudio de (IRM) normal. De estos 175 pacientes, 146 fueron mujeres y 29 hombres. La luxacion mas comun fue la anterior y la demostracion de las lesiones articulares y la artrosis por IRM fue satisfactoria en todos los casos. Discusion: en nuestro trabajo la disfuncion de la ATM mas comun fue la luxacion anterior, concordando con otros autores. Se encontro una relacion exacta entre las luxaciones no reductibles, con cambios degenerativos oseos. Conclusion: Se demuestra que la IRM es el examen de eleccion para evaluar la ATM. El sexo femenino es el mas afectado por este tipo de patologia. La luxacion del disco es la alteracion mas frecuente encontrada en la disfuncion de la ATM, demostrando que en pacientes con osteofitosis marginales del condilo no fue posible la reduccion del disco. (autor)

  14. Abscessos dentários periapicais em leitões com síndrome multissistêmica do definhamento Dental periapical abscesses in piglets affected by postweaning multisystemic wasting syndrome PMWS

    Felipe L. Koller

    2008-06-01

    Full Text Available Duzentos e oitenta leitões, entre 40 e 70 dias de idade, afetados pela sindrome multissistêmica do definhamento (SMD foram examinados após eutanásia para pesquisa de lesões dentárias. Pelo menos um abscesso periapical foi observado em 58 leitões (20,7%, dos quais 12 apresentaram abscessos múltiplos. Terceiros incisivos superiores, 3os incisivos inferiores, caninos superiores, caninos inferiores e outros dentes apresentaram respectivamente 22 (31,4%, 16 (22,9%, 4 (5,7%, 23 (32,9% e 5 (7,1% abscessos periapicais. A maior prevalência de abscessos observada nos dentes 3os incisivos e caninos inferiores está provavelmente associada com a maior área de corte ou desgaste que sofrem esses dentes. Entre as bactérias isoladas de amostras de 65 abscessos, Streptococcus sp. foi a mais prevalente e esteve presente em 21,48% e 27,7% dos isolados em aerobiose e anaerobiose, respectivamente. Na segunda posição em prevalência estiveram as bactérias corineformes, as quais foram mais freqüentemente isoladas em atmosfera anaeróbica do que aeróbica. Houve preponderância de isolamentos de bactérias Gram-positivas. Não foi possível determinar se as co-infecções bacterianas predispuseram às lesões características de SMD ou foram conseqüentes à imunossupressão causada pela infecção com PCV2.Swine producers have historically resected needle teeth of newborn pigs to prevent potential injuries to the sow mammary gland and faces of littermates. However, the possible impact of this practice on pig performance has been questioned. As part of a study, 280 PMWS affected piglets, with 40-70 days of age, were examined for the presence of dental lesions immediately after euthanasia. Most pigs were confirmed as PMWS by the detection of typical microscopic lesions and immunohistochemical pattern. At least one periapical abscess was observed in 58 piglets (20.7%, of which 12 had multiple abscesses. There were 22 (31.4%, 16 (22.9%, 4 (5.7%, 23 (32

  15. Avaliação da importância da coloração de Perls na rotina de mielogramas de pacientes com anemia associada a uma ou mais citopenias em sangue periférico Evaluation of the importance of Perls stain in the routine testing of myelograms of patients with anemia associated with one or more peripheral blood cytopenias

    Nydia S. Bacal

    2005-06-01

    Full Text Available As síndromes mielodisplásicas (SMD são um grupo heterogêneo de doenças malignas das células-tronco hematopoéticas, classificadas segundo a Organização Mundial da Saúde (OMS em: anemia refratária, anemia refratária com sideroblastos em anel, citopenia refratária com displasia de multilinhagens, anemia refratária com excesso de blastos, síndrome mielodisplásica inclassificável e sindrome mielodisplásica associada com anormalidade isolada do cromossomo 5q(del. Na anemia refratária com sideroblastos em anel observam-se hiperplasia e displasia eritróide com presença de 15% ou mais de sideroblastos em anel. Utilizamos neste estudo a coloração de Perls em esfregaços de medula óssea de pacientes com idade superior a 40 anos e que apresentavam uma ou mais citopenias no sangue periférico associada a anemia. Por tratar-se de técnica de manejo fácil e ágil sugerimos seu emprego em esfregaços de aspirado de medula óssea de pacientes que apresentem os achados laboratoriais acima, pois, dentre os casos analisados 18,7% apresentavam mais que 10 grânulos sideróticos circundando a terça parte ou mais do núcleo do precursor eritróide (sideroblasto em anel, sugerindo ao hematologista um possível diagnóstico de Síndrome Mielodisplásica com Sideroblastos em Anel (SMD-ARSA. Importante relatar que a grande maioria destes casos com aumento de sideroblastos em anel não foi encaminhada ao nosso serviço, com suspeita de SMD, e em somente um caso foi solicitada a realização da coloração de Perls.Myelodisplastic syndromes are a heterogeneous group of malignant haematopoietic stem cells. They are classified by the World Health Organization as refractory anemia, refractory anemia with ringed sideroblasts, refractory cytopenia with multilineage displasia, refractory anemia with excess of blast cells, unclassified myelodisplastic syndrome and myelodisplastic syndrome associated with a 5q chromosomal delection. Refractory anemia with

  16. Study of a Case Involving Accidental Irradiation of a Human Being; Estudio de un Caso de Irradiacion Humana Accidental

    Beninson, D.; Placer, A.; Vander Elst, E. [Comision Nacional de Energia Atomica, Buenos Aires (Argentina)

    1969-10-15

    cual un obrero llevo en los bolsillos de su pantalon una fuente de {sup 137}Cs, perteneciente a un equipo de gammagrafia industrial, durante un lapso fraccionado de unas 18 h, los dfas 3 y 4 de mayo de 1968. La baja irradiacion de los organos hematopoyeticos y gastrointestinal impidio la aparicion de sindrome agudo. Las caras anteriores de los muslos, la region inguinoescrotal y en menor grado las manos, fueron las zonas mas lesionadas. Se han estimado las dosis de radiacion recibidas en las zonas afectadas a partir de parametros de radiodosimetrfa biologica.( extension y secuencia temporal de algunas lesiones) y datos experimentales sobre la variacion de las dosis con la distancia y la profundidad de los tejidos, obtenidos mediante la reconstruccion del accidente con un 'fantomas' y un conjunto de dosimetros termo- luminescentes. Se describe la aparicion a los pocos dfas de zonas de radiodermitis humeda que se extendieron paulatinamente hasta aproximadamente el limite representado por la linea de isodosis de 1000 rad. La progresion de la radiodermitis se completo hacia fines del mes de mayo. A principios de junio se observo la aparicion de una descamacion epidermica seca hasta aproximadamente la linea de 500 rad. Con el transcurso del tiempo se observo la atrofia muscular de ambas piernas y un edema importante de la zona inguinoescrotal. La aparicion de hemorragias femorales importantes en noviembre de 1968 y enero de 1969 motivo la amputacion primero del miembro inferior izquierdo, luego del derecho. El indice de frecuencia de aberraciones cromosomicas en sangre periferica confirma las bajas dosis recibidas por el compartimiento sanguineo (alrededor de 50 rad). Se presenta un resumen de los resultados de los analisis realizados y se comenta el pronostico de la evolucion del paciente en base a la distribucion de la dosis de radiacion recibida. (author)

  17. Action of Mercaptan and Disulfide in Hydrogen Atom Exchange Reactions; Action des Thioalcools et des Disulfures dans les Reactions d'Echange d'Atomes d'Hydrogene; Vozdejstvie merkaptanov i disul'fidov v reaktsiyakh obmena atoma vodoroda; Accion de los Mercaptanos y Disulfuros en las Reacciones de Intercambio del Hidrogeno Atomico

    Cohen, S. G. [Brandeis University Waltham, MA (United States)

    1965-10-15

    que no es en cadena y que pasa por los radicales (C{sub 6}H{sub 5}){sub 2}C-OH and (CH{sub 3}){sub 2}COH. La reaccion se retarda y se inhibe mediante mercaptanos y disulfuros, que reconvierten los radicales en los productos iniciales por medio de reacciones rapidas de transferencia de hidrogeno y que recobran sus estados de valencia primitivos; en ese proceso, cada molecula de compuesto sulfurado anula los efectos qufmicos de numerosos cuantos: (C{sub 6}H{sub 5}){sub 2}C-OH + AS' -> (C{sub 6}H{sub 5}){sub 2}C = O + ASH; (CH{sub 3}){sub 2}C-OH + ASH -> (CH{sub 3}){sub 2}C = 0 + AS'. La prueba de este mecanismo se halla en los siguientes procesos que se observan durante la inhibicion: equili- bratniento del mecaptano o disulfuro inicialmente presentes, racemizacion del alcohol opticamente activo e intercambio de deuterio. Se observa una inhibicion analoga cuando solo se forma un radical intermedio, como en los sistemas benzofenona-benzhidrol y acetofenona-alcohol-{alpha}-metilbencflico. La accion inhibidora de los compuestos sulfurados que obedece al mismo mecanismo, se observa en la transformacion de la benzofenona en benzopinacol, inducida por los rayos gamma del {sup 60}Co; si bien el naftaleno interrumpe la reaccion fotoquimica, no ejerce efecto protector alguno sobre la benzofenona en ese sistema. Asi, pues, la proteccion de los solutos contra las dafios radioinducidos mediante compuestos de azufre se debe a reacciones de transferencia de atomos de hidrogeno. Los compuestos sulfurados tambien inhiben en virtud de reacciones de transferencia de atomos de hidrogeno, la fotorreduccion de la benzofenona en eteres. Se observa en este sistema (a diferencia de los sistemas cetona- alcohol) un mecanismo por el cual los compuestos sulfurados pueden consumirse de manera irreversible. Esto conduce a un periodo de induccion en lugar de un retardo permanente; cada molecula de compuesto de azufre anula los efectos de unos 15 cuantos. (author) [Russian] Reakcii so svobodnymi

  18. Yttrium-90 Needles in Interstitial Beta-Ray Therapy; Les Aiguilles d'Yttrium-90 en Endo-Electron-Therapie (Betatherapie Interstitielle); ИГЛЫ ИЗ ИТТРИЯ-90 ДЛЯ ЭНДОЭЛЕКТРОННОЙ ТЕРАПИИ ВНУТРИТКАНЕВОЙ БЕТА-ТЕРАГИ; Agujas de Itrio-90 en la Endo-Electronterapia (Betaterapia Intersticial)

    Pierquin, B.; Mortreuil, M.; Beyer, H.; Dutreix, J.; Chassagne, D.; Galle, P.; Jammes, R. [Centre d' Etudes Nucleaires, Saclay (France)

    1963-03-15

    - 90 con una actividad normalizada de 1 a 1,5 mc/cm (longitud radiactiva). La actividad se controla simultaneamente por recuento 4 {pi} por densimetria mediante pelicula. La dosis de referencia se calcula siempre de la misma manera, a 2 mm de la pared del tubo, suponiendo que la intensidad de dosis es del orden de 10 rad/min para una actividad de 1 mc/cm. Aplicaciones terapeuticas: La actividad radiobiologica de las agujas de itrio- 90 no esta bien estudiada aun. La dosis disminuye rapidamente a partir de 3 mm de la pared de la aguja, lo que dificulta la irradiacion homogenea de los tejidos tratados. En principio, las agujas se podrian colocar a 5 o 6 mm una de otra, pero esto requiere un dispositivo de implantacion muy dificil de manejar; un error de 1 o 2 mm podria producir excesivos puntos calientes o frios. Por tal motivo, en una primera etapa, los autores utilizaron las agujas en tumores angiomatosos benignos sin tratar de irradiar homogeneamente el tejido, sino solamente de crear zonas de esclerosis, concentricas a las agujas, separadas por zonas de tejido poco o nada irradiadas. De esta manera, esperan lograr en algunos angiomas tuberosos un efecto esclerogeno suficiente con la ventaja de que los enfermos reciben una dosis integral muy reducida. La ausencia de difusion en los tejidos sanos tiene particular interes para los angiomas situados cerca de tejidos radiosensibles (globo ocular, glandula mamaria) o proximos a las gonadas. Al parecer, los resultados obtenidos en los primeros casos tratados son satisfactorios. En una segunda etapa, los autores esperan poder utilizar estas agujas en tumores cutaneos malignos situados tambien en la vecindad de tejidos sanos radiosensibles (por ejemplo, cancer de los parpados) [Russian] V naotojashheee vremja v sotrudnichestve s jaderkym centrom Sakle tehnicheskij otdel vnutritkanevoj radioterapii instituta Gustava Russi izuchaet nekotorye vidy terapevticheskogo primenenija vnutritkanevoj betaterapii s pomoshh'ju ittrija-90

  19. Diagnóstico y manejo de litiasis renales en adultos y niños

    Ricardo Susaeta, Dr.

    2018-03-01

    Full Text Available Resumen: La litiasis urinaria representa una patología importante en la práctica urológica y requiere de un abordaje multidisciplinario. Su incidencia es del 10%, afecta a un grupo etario extenso, con factores que pueden influir en su aumento en determinados lugares.Su diagnóstico aparece como hallazgo en controles rutinarios de salud o a través del sindrome de cólico renal, cuadro característico y de consulta frecuente en los servicios de urgencia. Su etiología no está del todo definida, siendo las hipótesis más aceptadas, las alteraciones excretoras del riñón sumada a factores ambientales y hábitos. El estudio incluye exámenes de laboratorio para descartar complicaciones como infecciones e insuficiencia renal. Las imágenes determinan el volumen de la litiasis, su ubicación y densidad, para decidir de qué manera resolver el caso, ya sea de manera espontánea o activa mediante distintos tipos de intervenciones quirúrgicas.La tomografía computarizada sin contraste se considera como el estándar de oro para el diagnóstico por imágenes de la litiasis urinaria.Los tratamientos se plantean según las distintas situaciones clínicas: manejo médico del cólico renal y terapia expulsiva para resolución espontánea del cuadro; manejo quirúrgico, cuyas técnicas más frecuentes son la nefrolitectomía o ureterolitectomía endoscópica rígida o flexible, litotripcia extracorpórea (LEC, nefrolitectomía percutánea (NLP, y finalmente el estudio etiológico de la litiasis urinaria y medidas de prevención.En niños, la incidencia de litiasis urinaria es menor que en adultos, sin embargo, las consecuencias de esta enfermedad pueden ser desastrosas. La etiología es fuertemente asociada a factores genéticos. Actualmente los tratamientos quirúrgicos son similares a los practicados en pacientes adultos. Summary: Urinary stones represent an important pathology in urological practice and requires a multidisciplinary approach. Its

  20. Effect of UV radiation on the genetic inactivation of sperm of the bullseye puffer Sphoeroides annulatus (Jenyns, 1842); Efecto de la radiacion UV en la inactivacion genetica del esperma de botete diana Sphoeroides annulatus (Jenyns, 1842)

    Arias-Rodriguez, Lenin; Rodriguez-Ibarra, Luz Estela; Del Valle-Pignataro, Gabriela [Laboratorio de Genetica, Centro de Investigacion en Alimentacion y Desarrollo, A. C., Sinaloa (Mexico)

    2004-09-15

    extendedora Cortland modificada en dilucion 1:50, y se utilizaron para probar el efecto de nueve dosis de radiacion ultravioleta (0.2-1.0 J cm{sup -}2 ) sobre la duracion de la motilidad en segundos, el indice de motilidad del esperma, y los porcentajes de superviviencia de embriones obtenidos de la fertilizacion de huevos provenientes de cinco hembras de la misma especie. Los tiempos de motilidad del esperma en las muestras irradiadas con 0.2-0.9 J cm{sup -}2 resultaron estadisticamente no diferentes de los controles, mientras que las muestras irradiadas con 1.0 J cm{sup -}2 fueron significativamente menores. El indice de motilidad (IM), por otra parte, permitio la diferenciacion estadistica de cuatro grupos en cuanto a su respuesta a diferentes dosis de radiacion. El primer grupo se caracterizo por valores altos del IM, e incluyo a los controles y a las muestras irradiadas con 0.2-0.3 J cm{sup -}2; el segundo agrupo a las irradiaciones de 0.4 a 0.7 J cm{sup -}2, en las cuales se observo un descenso del IM; en el tercer grupo (0.8-0.9 J cm{sup -}2 ) el IM aumento nuevamente; y en el ultimo (1.0 J cm{sup -}2) se observo el menor IM. En cuanto a los porcentajes de supervivencia, se observo una curva descendente con valores altos de supervivencia en los controles y en las muestras irradiadas con 0.2 J cm{sup -}2, con un descenso en los tratamientos de 0.3 a 0.4 J cm{sup -}2, y una recuperacion significativa a partir del tratamiento de 0.5 y hasta 0.8 J cm{sup -}2, observandose nuevamente un decremento en la supervivencia de los tratamientos de 0.9 a 1.0 J cm{sup -}2 . Ambos resultados, IM y supervivencia, indican que la dosis optima para la produccion de organismos haploides se encuentra cercana a 0.7 J cm{sup -}2. En el tratamiento de 0.7 J cm{sup -}2 se observaron larvas con las caracteristicas tipicas del sindrome haploide, indicando nuevamente que esta puede ser la dosis mas adecuada para producir organismos ginogeneticos.

  1. Avaliação da maturidade pulmonar fetal em gestações de alto risco Prenatal diagnosis of fetal lung maturity in high-risk pregnancies

    Wladimir Taborda

    1998-07-01

    Full Text Available Trata-se de um estudo prospectivo para a avaliação da maturidade fetal em 121 gestações de alto risco realizado no Hospital São Paulo - Universidade Federal de São Paulo, entre janeiro de 1990 e janeiro de 1995. Em todos os casos, o parto foi realizado em até 3 dias após a obtenção de líquido amniótico por amniocentese. O objetivo principal foi o de analisar a acurácia do teste de Clements (TC, da relação lecitina/esfingomielina (L/E, da presença de fosfatidilglicerol (PG e do perfil pulmonar (relação L/E >1,7 e PG presente para antecipar a ocorrência ou não de sindrome de desconforto respiratório neonatal (SDR. Foram calculados a sensibilidade, a especificidade e os valores preditivos positivo (VPP e negativo (VPN de todos os testes. O grupo de estudo foi composto por 48 gestações complicadas por diabetes mellitus, 41 por síndromes hipertensivas, 14 por isoimunização Rh e 18 por diversas patologias. O perfil pulmonar apresentou sensibilidade de 100% em todos os casos. O teste de Clements também não apresentou resultados falso-positivos em gestantes hipertensas, apurando-se, contudo, de 20% a 50% de falso-negativos em todos os outros testes. Os quatro testes apresentaram baixos VPP (23% no TC, 51% na relação L/E, 63% na presença de PG, 61% no perfil pulmonar e elevados VPN (92% no TC, 88% na relação L/E, 89% na presença de PG, 100% no perfil pulmonar. Este estudo demonstrou que a presença de PG e relação L/E >1,7 simultâneos no líquido amniótico comprovam a maturidade pulmonar com muito baixo risco de DR ao nascimento. Concluiu-se também que o teste de Clements deve constituir o rastreamento inicial para predizer a ausência de SDR, particularmente em gestações complicadas por síndromes hipertensivas.The objective was to evaluate the accuracy of the foam stability test, lecithin/sphingomyelin (LS ratio, presence of phosphatidylglycerol (PG and lung profile (L/S ratio > 1.7 and PG present simultaneously

  2. Patología Quirúrgica Neonatal de Alto Riesgo. Del Académico Hernando Forero Caballero

    Gilberto Rueda Pérez

    2003-10-01

    la medicina ha sido el control casi total de la mortalidad materna e infantil durante el embarazo y el parto, pero esto no ha hecho que las malformaciones fetales y neonatales hayan disminuido, aunque se tiene hoy en día la esperanza fundada en la genética que pueda conducir a la prevención de tan doloroso cuadro.

    La humanidad, en su extrema dureza, se ha ensañado siempre con la niñez, ejemplo de ello son las actitudes brutales y condenables de pueblos enteros que arrojan a la muerte a los recién nacidos del sexo femenino, o a los que presentan sindrome de Down, o malformaciones congénitas, u obligan a los que sobreviven a los trabajos mas rudos o, mas tarde a la prostitución, al analfabetismo y a la delincuencia, como pasa para nuestra vergüenza en la actualidad en nuestra tierra.

    Pero en medio de este angustioso estado de cosas y como contrapeso a tanto dolor, surgen personas como el doctor Hernando Forero Caballero que, como el mismo lo dice “en su soledad de Profesor emérito retirado”, crean obras como las que hoy oficialmente ha presentado ante esta benemérita Academia.

    El libro del Académico Forero tiende, en el campo científico, a compendiar en un volumen de naturaleza netamente didáctica, el enfoque con el que el cirujano pediatra neonatólogo debe atender el producto intrauterino, o al recién nacido que presente esas terribles deficiencias, que tanto dolor y angustia producen en sus progenitores y familiares, o para recuperar para la sociedad a los miles de niños condenados antes a la muerte, o al sufrimiento y a la burla durante su triste existencia...

  3. Analysis of epidemiological and clinical characteristics of patients admitted diagnosed with acute ischemic cerebrovascular event in internal medicine services and neurology of the Hospital Mexico in March 2013 to March 2014; Analisis de las caracteristicas epidemiologicas y clinicas de los pacientes ingresados con diagnostico de evento cerebrovascular isquemico agudo en los servicios de medicina interna y neurologia del Hospital Mexico de marzo 2013 a marzo 2014

    Araya Gonzalez, Manuel Alberto

    2014-07-01

    mas frecuentemente encontradas han sido: hemiparesia faciobraquiocrural 60%, sindrome confusional 22%, disartria 22%, cefalea 20%, nauseas y/o vomito 17% y afasia en 15%. Un total de 13% de los pacientes han presentado alteracion de la consciencia y 5% ha necesitado soporte ventilatorio en las primeras 24 horas evolucion. El 27% de los pacientes han llegado en las primeras 3 horas de iniciado los sintomas, un 11% entre las 3 a 4.5 horas y el restante 62% mas alla de las 4.5 horas de evolucion. El 70% de los pacientes han tenido 1 o mas comorbilidades previas al evento, las 5 principales han sido: cardiopatia isquemica 31%, fibrilacion atrial 29%, enfermedad cerebrovascular 19%, enfermedad renal cronica 16% e insuficiencia cardiaca congestiva un 12%. En cuanto a la clasificacion topografica de los ictus, un 16% eran TACI, un 46% PACI, un 27% LACI y solo un 11% PoCI. El promedio de la escala de NIHSS ha sido de 9 puntos al ingreso, 10 a las 48 horas y 6 puntos al momento de egreso. Con respecto a la tomografia de cerebro al ingreso a 98% de los pacientes les fue realizada mientras que entre las 48 a 72 horas solo al 74%. Los hallazgos tomograficos mas frecuentes en el TAC inicial han sido: 49% hipodensidad de mas de 1/3 de territorio de arteria cerebral media, 46% sin alteraciones, 8% datos de edema cerebral y desviacion en la linea media. La transformacion hemorragica fue documentada en 6% de los casos. Al 70% de los pacientes les fue realizado ultrasonido Doppler de vasos del cuello. El 82% sin lesiones, un 9% con obstruccion entre 50-70% y 9% con mas de 70% obstruccion del lumen. La ecocardiografia fue realizada en 54% de los casos y fue obtenida 76% hipertrofia ventricular izquierda, 37% delitacion atrio izquierdo y 2% trombo intramural. Con respecto a la funcionalidad el 81% de los pacientes tenian ninguna o minima dependencia al momento de ingreso, para el momento de egreso 74% habian tenido discapacidad de moderada a severa, 12% leve y apenas un 14% se mostraba

  4. Sacral-neuromodulation CT-guided; Nuova tecnica di centraggio TC-assistista nella neuromodulazione sacrale

    Amoroso, Lamberto; Ricci, Stefano [INRCA, Ancona (Italy). Dipartimento di radiologia e medicina nucleare; Pelliccioni, Giuseppe; Scarpino, Osvaldo [INRCA, Ancona (Italy). Unita' operativa di radiologia; Ghiselli, Roberto; Saba, Vittorio [INRCA, Ancona (Italy). Dipartimento di chirurgia

    2005-04-01

    total of 38 centering. Eight patients underwent the PNE procedure on both the S3 foramina. The sacral foramen was centred at the first attempt in 36 out of 38 cases. Two cases required several attempts to centre correctly the foramen. In 4 patients out of 30 a second electrode was implanted. In one patient who had a non consolidated sacral fracture, CT guidance enabled insertion of the electrode inside the only practicable foramen, a manoeuvre that would have been impossible with fluoroscopic guidance. Only once was repositioned after a CT control. During the whole trial period we had a positive response to the PNE test in 18 out of 30 patients (60%), a partial response in 4 out of 30 patients and a negative response in the remaining 8 patients. None of the patients who underwent the PNE test had infectious complications and the procedure was well tolerated by all. The procedure lasted about 45 minutes. Conclusions: The PNE test under Ct guidance proved to be more efficient compared with the traditional technique as the direct view of the electrode position helped to define with greater reliability the patients who were non-responsive to sacral stimulation. Moreover, this method was particularly efficient in patients with sacral anomalies where the traditional guide might fail. The operators' reduced exposure to radiation is an advantage to be taken into consideration. Finally, the usage of mobile CT apparatus in an operating theatre can improve the technique for permanent implantations. [Italian] Scopo: La neuromodulazione sacrale ? una nuova procedura diagnostico-terapeutica pe ri disturbi funzionali del basso tratto urinario come l'incontinenza urinaria da urgenza, la ritenzione urinaria non ostruttiva, la sindrome urgenza/frequenza, il dolore pelvico cronico intrattabile e, di recente, anche per il trattamento della stipsi e dell'incontinemza fecale. Il trattamento prevede una prima fase definita PNE test (Percutaneous Nerve Evaluation) che consiste