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Sample records for medular tiroideo hereditario

  1. Como Lo Hago Yo: Lipomas Medulares

    PubMed Central

    Portillo, Santiago

    2014-01-01

    Basados en la experiencia de 82 casos; en 5% se observaron anomalías pélvicas asociadas. En los menores de 3 años el motivo de consulta (85%) fue la tumoración. En los mayores de 3 años (42%) tenía problemas neurológicos. Solo el 24% preocupados por la tumoración. El objetivo de la cirugía es desanclar la médula y no remover la totalidad del lipoma. El lipoma de filum es el que es mas simple para operar. Aún cuando la escuela francesa propone operar solamente cuando hay síntomas favorezco cirugía preventiva. Favorezco una segunda cirugía si hay signos de anclaje postoperatorio, aún cuando observamos empeoramiento postoperatorio motor en 2.5% de los operados y urológico a largo plazo en 6% de los operados. PMID:24791218

  2. [Clinical characteristics of the thyroid follicular carcinoma].

    PubMed

    Gutiérrez-Hermosillo, Hugo; Tamez-Peréz, Héctor Eloy; Díaz de León-Gonzaléz, Enrique; Gutiérrez-Hermosillo, Violeta; Avila-Sanchéz, Jair

    2013-01-01

    Introducción: se ha identificado carcinoma folicular en 39 % de los pacientes con nódulos tiroideos cuya citología prequirúrgica ha indicado resultados indeterminados. El propósito de esta investigación fue conocer la prevalencia de esta entidad en un hospital de concentración. Métodos: se buscaron los reportes quirúrgicos con diagnóstico de carcinoma folicular. Se registró tamaño del tumor, sexo y edad del paciente, diagnósticos pre y posquirúrgico y patologías asociadas. Resultados: se diagnosticó carcinoma folicular en 35 pacientes: 30 mujeres (85 %) y cinco hombres (15 %). La edad en los hombres fue de 57 ± 6.6 y de 44 ± 16.9 en las mujeres. Los diagnósticos preoperatorios fueron carcinoma folicular en 14 (40 %), cáncer tiroideo en seis (17.1 %), adenoma folicular en cuatro (11.4 %), bocio en tres (8.5 %), nódulo tiroideo en tres (8.5 %); carcinoma papilar, tumor de tiroides, carcinoma poco diferenciado de tiroides, adenocarcinoma folicular bien diferenciado, cáncer medular en un paciente (2.8 %) cada uno. Las patologías asociadas fueron tiroiditis de Hashimoto y carcinoma papilar contralateral, con dos pacientes cada uno (5.6 %). Conclusiones: la edad de los pacientes y la presentación clínica del carcinoma folicular difirieron de las informadas en otras investigaciones.

  3. [High medular compression caused by neurenteric cyst. Report of a case].

    PubMed

    Pianetti Filho, G; Fonseca, L F

    1993-06-01

    The authors report the case of a child with a neuroenteric cyst compressing the high cervical spinal cord at the level of C1 to C3. The tumor was completely excised through a laminotomy with good results. The literature is revised, and the embryology, symptomatology, treatment and results are discussed.

  4. [Double medular scintigraphy using 99mTc-colloids and 111In-transferrin in myeloid splenomegaly (author's transl)].

    PubMed

    Colonna, P; Rain, J D; Pecking, A; Brière, J; Najean, Y

    1978-11-25

    Simultaneously with bone marrow biopsy and 59Fe kinetic study, bone marrow scintigraphy using 99mTc-colloids and 111In-transferrin was performed in 15 patients with a documented diagnosis of agnogenic myeloid metaplasia. This rapid, simple and non-traumatic method permits visualization of changes in the reticular and the erythropoietic marrow which are not always the same. The technique can demonstrate diminution of active marrow in the axial skeleton, peripheral extension of bone marrow and its heterogeneity from site to site. These abnormalities, which vary from case to case, correlated well with the results of 59Fe external countings. The degree of splenic myeloid metaplasia, as judged by 111In uptake, is also well correlated with 59Fe uptake into the spleen. There was poor correlation between scintigraphic and iron kinetic data on the hand, and bone marrow cellularity assessed by marrow biopsy on the other. While scintigraphic studies are chiefly qualitative, they appear to provide useful information for diagnosis, and possibly for prognostic and therapeutic decision.

  5. [Bone marrow transplantation in Mexico. Report of the 1st successful case in acute myeloblastic leukemia. Grupo de Trasplante Medular Oseo del INNSZ].

    PubMed

    León, E; Sosa, R

    1992-01-01

    The first case of allogeneic bone marrow transplantation in acute myelogenous leukemia (AML) done in Mexico is reported. The patient was a 26 year old Mexican woman who in October 1987 was diagnosed of having AML of the M2 subtype. After three cycles of the TADOP regimen (6-thioguanine, cytosine-arabinoside, doxorubicin, vincristine & prednisone), the patient entered complete remission. Unfortunately, after a seven month period of remission she suffered a relapse which was refractory to a new chemotherapy cycle. On 9/14/88 an allogeneic BMT from her HLA identical brother was performed. The conditioning regimen consisted of busulfan and cyclophosphamide. Prophylaxis for GVHD consisted of cyclosporine and methylprednisolone. The posttransplantation course was satisfactory, reaching > 500 neutrophils x 10(9)/L on day 14 and > 50,000 platelets x 10(9)/L without support on day 23 posttransplant. The patient developed fever of unknown etiology, which was satisfactorily resolved with ceftazidime, vancomycin and metronidazole. She also presented a grade II oral and esophageal mucositis. As a late complication, on day 90 posttransplant, she developed a bilateral pneumonia which was resolved with sulfamethoxazole-trimethoprim administration. Up to the time of this report (40 months posttransplant) the patient is completely asymptomatic, is under no immunosuppression, and shows no evidence of graft versus host disease or recurrent leukemia.

  6. [Postoperative spinal cord ischemia in thoracoabdominal aneurysms].

    PubMed

    Latorre, J; Rosendo, A; Vidal, J; Sarrias, M

    1991-01-01

    At the present article, 12 cases of paraplegia secondary to the surgical treatment of thoracoabdominal aneurysms are presented. Study includes patients admitted between 1973-1987 for treatment and rehabilitation of its medular injury. Factors of risk, surgical technics practiced, peroperative complications and type of medular injury are analyzed. The most common medular injury was an anterior medular syndrome (rather than 60%). In the same way, preventive methods are analyzed and somatosensory evoked potentials (SEP) and motor evoked potentials (MEP), both in developing phase at the present moment, are recommended as the most viable method for detecting changes during the surgical procedure.

  7. [Pathogenesis of spinal cord injuries and mechanisms of repair induced by olfactory ensheathing cells].

    PubMed

    Botero, Lucía; Gomez, Rosa Margarita; Chaparro, Orlando

    2013-05-16

    Introduccion. La lesion medular es un evento catastrofico, cuyas consecuencias persisten durante toda la vida del paciente. La investigacion en tratamiento se ha basado principalmente en el desarrollo de terapias que reduzcan la discapacidad, pero desde los anos noventa hay un avance significativo y se han probado varios trasplantes celulares en modelos animales de lesion medular, celulas de Schwann, astrocitos y celulas de la glia envolvente olfatoria (CGEO). Objetivo. Hacer un recuento detallado de la patogenia de la lesion medular primaria y secundaria y de los mecanismos por los cuales las CGEO inducirian sus posibles efectos regenerativos descritos en la bibliografia. Desarrollo. Despues del traumatismo, la lesion se desarrolla en dos fases, la primaria se caracteriza por las lesiones de compresion y la secundaria se produce por una serie de factores que se dan en paralelo y que incluyen factores vasculares, celulares, moleculares y formacion de cicatriz glial. La mayoria de los modelos de lesion medular y trasplante con CGEO han comunicado recuperacion funcional, remielinizacion y regeneracion axonal. Estas celulas ejercen su accion de manera indirecta a traves de la produccion de factores de crecimiento y de manera directa induciendo regeneracion neuronal, axonal y remielinizacion. Conclusiones. Las CGEO son una opcion terapeutica en pacientes con lesion medular debido a que inducen de modo directo o indirecto regeneracion neuronal, axonal, remielinizacion de axones, disminucion de cicatriz glial y otros efectos que conducen a la recuperacion funcional.

  8. [MCT8-specific thyroid hormone cell transporter deficiency: a case report and review of the literature].

    PubMed

    López-Marín, Laura; Martín-Belinchón, Mónica; Gutiérrez-Solana, Luis G; Morte-Molina, Beatriz; Duat-Rodríguez, Anna; Bernal, Juan

    2013-06-16

    Introduccion. El MCT8 es un transportador especifico para las hormonas tiroideas T4 y T3, que permite su entrada en el cerebro y otros organos. La deficiencia de MCT8, o sindrome de Allan-Herndon-Dudley, es un trastorno ligado a X que, generalmente, se presenta como un cuadro neurologico grave de inicio precoz, con un perfil tiroideo caracteristico (aumento de T3 y disminucion de T4 y rT3). Objetivo. Se presenta el primer caso diagnosticado en España con este sindrome y se revisa la bibliografia publicada, las distintas formas de presentacion clinica, los avances geneticos, el diagnostico diferencial y las perspectivas terapeuticas, y se propone un algoritmo diagnostico. Caso clinico. Varon de 5 años con un cuadro clinico compatible con una enfermedad de Pelizaeus-Merzbacher. La secuenciacion del gen PLP1 no mostro alteraciones. Todos los estudios metabolicos y geneticos realizados fueron normales. Finalmente, un estudio completo del perfil tiroideo revelo alteraciones compatibles con una deficiencia del transportador MCT8. La secuenciacion del gen SLC16A2 (MCT8) mostro una mutacion en el exon 3 y el estudio celular confirmo que esta mutacion cambia las propiedades de la proteina. Conclusiones. En los ultimos años se han multiplicado las publicaciones sobre este sindrome, con la identificacion de mas de 50 familias en el mundo. Es importante conocer este sindrome y sospecharlo, porque el diagnostico es facil, economico y accesible (perfil tiroideo), y, aunque no tiene tratamiento especifico, el diagnostico precoz evita pruebas innecesarias y permite ofrecer consejo genetico a las familias afectadas.

  9. [The glomus caroticum tumor--an unusal case].

    PubMed

    Danĕk, T; Janousek, R; Havlícek, K

    2006-01-01

    There is discussed case of malignant paraganglioma with cervical lymph node metastasis that was complicated by mistake during peroperative histology. Peroperative histological examination revealed metastasis of medular carcinoma of thyroid gland. Total thyroidectomy was performed. Postoperative histological assessment revealed metastasis of carotic paraganglioma. Tumour was resected together with carotic arteries. Their reconstruction was performed during second procedure.

  10. [Treatment of thyroid cancer in our field: attitude regarding lymph node surgery].

    PubMed

    Campos Dana, J J; Faubel Serra, M; Artazkoz del Toro, J J; Vendrell Marqués, J B; Dalmau Galofre, J; Piñón Selles, F

    1990-01-01

    We comment our attitude in dealing with lymph nodes and thyroid gland surgery for thyroid cancer. This was based on our 10 years experience with such surgery, in which we have performed 350 chirurgic interventions. Of them, in 55 cases a thyroid carcinoma was detected (36 papilar, 13 follicular, 4 medular, 1 anaplasic and 1 metastasic clear-cell carcinoma).

  11. [What kind of health information search the spinal cord injured patients from Spain on the internet?].

    PubMed

    Bea-Muñoz, Manuel; Medina-Sánchez, María; Flórez-García, Mariano

    2015-04-16

    Introduccion. Internet es una alternativa para la educacion sanitaria en la poblacion. Los lesionados medulares consultan la red sobre cuestiones de su salud. Objetivo. Conocer cuales son las fuentes de informacion, los temas sobre salud mas consultados y la confianza en el material obtenido de la red por un grupo de lesionados medulares espanoles usuarios de Internet. Pacientes y metodos. Realizamos una encuesta a lesionados medulares espanoles mediante un cuestionario en Google Drive. Se accedia a el mediante un enlace en la pagina de ASPAYM-Asturias. El cuestionario incluia datos epidemiologicos y cuestiones sobre Internet, fuentes de informacion y confianza en ellas. Resultados. Contestaron 121 lesionados medulares (el 64%, hombres), con una edad media de 45 anos. La etiologia predominante era la traumatica (70%), y en el 72%, las lesiones eran paraplejias. El 83% prefiere consultar al personal sanitario. Busca en Internet mas del 70% de la muestra, y lo hace en paginas web en espanol. El tema de mayor interes es el material ortopedico. El 27% confia mucho o bastante en la informacion de la red, mientras que el 32% lo hace poco o nada. Conclusiones. Los resultados nos aproximan al uso de Internet que hacen los lesionados medulares espanoles. Asumiendo el sesgo inherente en un estudio de este tipo, mas del 70% de la muestra consulta sobre su salud en la red, sobre todo en paginas web espanolas. El tema mas buscado es 'material ortopedico y sillas de ruedas'. Solo uno de cada cuatro confia en los contenidos de la red, y la mayoria prefiere consultar sus problemas de salud directamente con los profesionales sanitarios.

  12. [Hereditary angioedema: strange cause of abdominal pain].

    PubMed

    Salas-Lozano, Nereo Guillermo; Meza-Cardona, Javier; González-Fernández, Coty; Pineda-Figueroa, Laura; de Ariño-Suárez, Mauricio

    2014-01-01

    Antecedentes: el angioedema hereditario es un trastorno inflamatorio episódico, que se hereda de manera autosómica dominante y se caracteriza por episodios de edema periférico. Los pacientes pueden tener edema de la pared de cualquier víscera hueca, incluido el intestino. Caso clínico: se comunica el caso de un paciente masculino de 33 años de edad, sin antecedentes de importancia, con dolor abdominal, localizado en el epigastrio, irradiado al cuadrante inferior derecho, acompañado de 5 vómitos. La tomografía abdominal mostró engrosamiento de la pared de la segunda y tercera porción del duodeno, con infiltración de grasa y líquido libre. Los exámenes de laboratorio mostraron: concentraciones bajas del complemento C4 (5.5 mg/dL) y actividad del inhibidor de C1 del complemento de 30%. Conclusiones: el angioedema hereditario es consecuencia de la deficiencia (tipo I) o disfunción (tipo II) del inhibidor C1 del complemento. El dolor abdominal asociado con angioedema es de inicio súbito, como dolor cólico, recurrente y de intensidad moderada. En la actualidad existen dos medicamentos aprobados por la Food and Drug Administration para el tratamiento de pacientes con esta afección.

  13. Ultrasound examination using contrast agent and elastosonography in the evaluation of single thyroid nodules: Preliminary results.

    PubMed

    Ferrari, F S; Megliola, A; Scorzelli, A; Guarino, E; Pacini, F

    2008-06-01

    Sommario SCOPO: Valutare l'utilità dell'ecografia con ecoamplificatore e dell'elastosonografia nella caratterizzazione del nodulo tiroideo. MATERIALI E METODI: Periodo novembre 2006–luglio 2007, studiati 23 pazienti con nodulo solitario tiroideo, sottoposti a ecografia B-mode e power Doppler, ecografia con mezzo di contrasto, elastosonografia e FNAC (Fine Needle Aspiration Citology). Sedici pazienti sono stati sottoposti a tiroidectomia. RISULTATI: I 23 noduli studiati comprendevano 14 lesioni benigne e 9 maligne. Alla valutazione delle curve intensità/tempo le lesioni maligne presentavano un tempo di wash-in (8,8 ± 1,3 vs 12,1 ± 2,6 secondi; p = 0,002, t-test) e un tempo di picco (15,3 ± 4,6 vs 22,2 ± 3,9 secondi; p = 0,001, t-test) significativamente più precoci rispetto alle lesioni benigne. La fase di wash-out presentava andamento monofasico nel 70% dei noduli benigni e in nessuno dei maligni; polifasico nel 30% dei noduli benigni e nel 100% dei maligni. L'andamento polifasico è associato in maniera statisticamente significativa (p = 0,0007, χ) alla malignità. L'andamento polifasico ha mostrato sensibilità del 100%, specificità del 71%, VPP (valore predittivo positivo) del 69%, VPN (valore predittivo negativo) del 100% e accuratezza diagnostica dell'83%. Nel 78% (11/14) dei noduli benigni sono stati rilevati i pattern elastosonografici 1–2 (maggiore elasticità), nel 88% (8/9) dei noduli maligni i pattern 3–4 (minore elasticità). L'elastosonografia ha mostrato sensibilità dell'88%, specificità del 78%, VPP dell'72%, VPN del 91% e accuratezza diagnostica del 82%. Il pattern elastosonografico 3–4 è associato (p = 0,001, χ) alla malignità. CONCLUSIONI: L'ecografia con ecoamplificatore e l'elastosonografia possono rappresentare ausili diagnostici nella valutazione del nodulo tiroideo solitario, soprattutto quando la FNAC è non diagnostica, quando indica lesione follicolare e nei noduli <1 cm.

  14. [Robotic systems for gait re-education in cases of spinal cord injury: a systematic review].

    PubMed

    Gandara-Sambade, T; Fernandez-Pereira, M; Rodriguez-Sotillo, A

    2017-03-01

    Introduccion. La evidencia que sustenta la reeducacion de la marcha mediante sistemas robotizados de entrenamiento locomotor en pacientes con lesion medular presenta aspectos pobremente caracterizados. Objetivo. Realizar una revision sistematica cualitativa de la eficacia de esta terapia. Pacientes y metodos. Se realizo una busqueda en PubMed, CINAHL, Cochrane Library y PEDro desde enero de 2005 a abril de 2016. Tambien se reviso la bibliografia de estos articulos por si hubiese algun estudio adicional no identificado con la estrategia inicial. El nivel metodologico de los articulos se evaluo mediante la escala PEDro y la de Downs y Black. Se localizaron 129 articulos potencialmente interesantes, de los que 10 estudios cumplieron los criterios de inclusion. Estos estudios evaluaron 286 pacientes, que eran predominantemente jovenes y varones. La mayoria tenia una lesion medular incompleta y una clasificacion de C o D en la escala ASIA. Resultados. Los dispositivos robotizados empleados en estos estudios fueron Lokomat, Gait Trainer y LOPES. La mejoria en los parametros de la marcha evaluados fue mas evidente en los pacientes jovenes, con lesion medular subaguda, asi como en los que tenian puntuaciones altas de ASIA o LEMS. En cambio, factores como la etologia, los niveles de lesion o el sexo fueron menos predictivos de mejoria. El nivel metodologico de estos estudios fue aceptable de acuerdo con la escala PEDro y la de Downs y Black. Conclusiones. La evidencia del entrenamiento locomotor con dispositivos roboticos en pacientes con lesion medular es positiva, aunque limitada y de nivel metodologico aceptable respecto al sistema convencional cuando el tiempo desde la lesion es de varios meses (4-6 meses). A pesar de ello, este efecto se invierte durante el primer mes tras la lesion, y el sistema convencional muestra mejores resultados que el robotizado.

  15. [Spinal cord compression disclosing rib hydatidosis].

    PubMed

    Ousehal, A; Adil, A; El Azhari, A; Kadiri, R

    1995-12-01

    The authors report an exceptional case of spinal compression following an isolate rib hydatidosis. The CT scan has suspected the diagnosis. The authors recall the anatomoclinic features and specify the radiologic aspects of the osseous hydatidosis, especially the rib's localization which is very rare. MR imaging in addition of its diagnosis role showing a very evocative cyst images, is the exam of choice in order to appreciate the disease's extent and the degree of medular sufferance.

  16. [Morbus Albers Schonberg osteopetrosis].

    PubMed

    Saracević, Ediba; Hasanbegović, Edo

    2005-01-01

    The patient presented has bone disease, so called "mramor disease". The disease is characterized by insuffiticnty of ostcoclasts which results n persisting of primary spongiosis without normal eroding and bone rebuilding. The discase is diagnosed by X rays where the bone density is increased. The medular space is completly closed by dense bone knitting which, with soft cortical space, seems like bone in bone. This is autosomal recessive disease with serious clinical picture in infants.

  17. [Hirayama disease in paediatrics: a clinical case report and review of the literature].

    PubMed

    Martínez-Cayuelas, Elena; Martínez-Salcedo, Eduardo; Alarcón-Martínez, Helena; Puche-Mira, Alberto; Domingo-Jiménez, Rosario; de Mingo-Casado, Pedro; Serrano-García, Cristina

    2015-04-01

    Introduccion. La enfermedad de Hirayama es una rara atrofia muscular juvenil que afecta a varones jovenes de origen asiatico, con atrofia muscular habitualmente de una de las extremidades superiores de progresion lenta con estabilizacion posterior. Se diagnostica por estudios electromiograficos/electroneurograficos con velocidad de conduccion (EMG/ENG-VC), y por resonancia magnetica (RM) medular en posicion neutra y en flexion cervical. El tratamiento se basa en el collarin cervical y cirugia (casos graves). Son muy pocos los estudios realizados en edad pediatrica. Caso clinico. Niña de 7 años, con atrofia de la musculatura de la mano y el antebrazo izquierdos, de dos años de evolucion. En EMG/ENG-VC presenta signos de denervacion cronica muy grave en los miotomos correspondientes a C7, C8 y D1 izquierdos, con conservacion de amplitudes de potenciales sensitivos evocados, congruentes con mielopatia cervical. La RM medular cervical en posicion neutra muestra un resultado normal en ese nivel. Posteriormente, por la sospecha dirigida de enfermedad de Hirayama, se realiza una nueva RM medular cervical en posicion neutra y en flexion, que muestra asimetria en el tamaño y morfologia de los cordones anteriores medulares en C6/C7, hiperseñal en el asta anterior homolateral e ingurgitacion del plexo venoso epidural posterior. Con el diagnostico de enfermedad de Hirayama se inicia tratamiento con collarin cervical para evitar la progresion del daño. Conclusiones. Se presenta un caso de enfermedad de Hirayama peculiar por las caracteristicas epidemiologicas, con la finalidad de difundir esta entidad en nuestro medio, cuyo diagnostico precoz permite un tratamiento eficaz, y se revisan los estudios realizados en edad pediatrica.

  18. [Spinal cord injury in patients over 65 years of age].

    PubMed

    Varela-Lage, Cristina; Alcobendas-Maestro, Mónica; Luque-Ríos, Inmaculada; Esclarín-De Ruz, Ana; Talavera-Díaz, Francisco; Ceruelo-Abajo, Silvia

    2015-06-01

    Introduccion. La poblacion de mayores de 65 años activos fisicamente continua en aumento, lo que condiciona un mayor riesgo de caidas y de lesion medular en un rango de edad con importante presencia de patologia cronica. Objetivo. Revisar la incidencia, el tipo de lesion, las complicaciones asociadas y los resultados funcionales de las lesiones medulares ocurridas en pacientes mayores de 65 años. Pacientes y metodos. Estudio descriptivo retrospectivo en lesionados medulares agudos mayores de 65 años ingresados en el Hospital Nacional de Paraplejicos desde enero de 2010 hasta diciembre de 2011. Las variables del estudio fueron datos demograficos y de lesion, antecedentes personales, complicaciones ocurridas durante el ingreso y capacidad funcional al alta medida con las escalas Spinal Cord Independence Measure (SCIM III) y Walking Index Spinal Cord Injury (WISCI). Resultados. Se incluyeron 111 individuos con una media de edad de 72,5 años. La incidencia anual fue de 17,3 pacientes/100 ingresos. El 33,3% eran lesiones cervicales y fueron incompletas el 66,7%. La etiologia medica fue mas frecuente que la traumatica. El 5% no presentaba otras enfermedades intercurrentes. El 97% sufrio algun tipo de complicacion. La media alcanzada para la SCIM III fue de 42 puntos y el 35% consiguio capacidad de marcha. Conclusiones. En los ultimos años se ha producido un aumento de lesion medular en mayores de 65 años, en los que la etiologia traumatica no es superior a la medica; mas frecuentemente son lesiones incompletas que asocian mayor comorbilidad que la poblacion general, y se consiguen resultados funcionales mas pobres a pesar de las mejoras neurologicas.

  19. [Cervical ischaemic neuronopathy and cardioembolism: another cause of man-in-the-barrel syndrome].

    PubMed

    Gonzalez-Usigli, H; Gandarilla, A; Garcia, J J; Serrato, J; Estrada, N

    2016-12-16

    Introduccion. Los infartos de la medula espinal ocurren aproximadamente en el 1% de todos los infartos del sistema nervioso. El cardioembolismo es una causa rara. Las areas comunmente afectadas en infartos medulares son zonas de circulacion limitrofe en la region dorsal o lumbar; sin embargo, se han descrito previamente infartos medulares en la zona cervical asociados a la diseccion de arterias vertebrales. Caso clinico. Se presenta un nuevo caso de sindrome del hombre en el barril asociado con fibrilacion auricular durante un infarto agudo de miocardio, que causo una neuronopatia cervical isquemica (infarto de astas anteriores). Conclusiones. Los hallazgos clasicos de isquemia medular cervical son tetraplejia aguda, disfuncion vesical, intestinal y cardiovascular, asi como perdida de la sensibilidad disociada. La colateralizacion incompleta y las caracteristicas anatomicas de la arteria espinal anterior en la medula cervical hacen de la porcion C3-C5 la region mas vulnerable de daño isquemico, ya que la irrigacion de las arterias radiculares se inicia debajo de C5 y la fisiopatologia de la lisis rapida de un coagulo fresco produce unicamente daño bilateral de las celulas de las astas neuronales.

  20. [Proposal for a survey for assisting the family and caregivers of patients with spinal cord injuries].

    PubMed

    Mancussi e Faro, A C

    1999-12-01

    This study proposes a basis survey for assistance to the family and caregivers because we believe there is necessity of family participation on the treatment, trying to understand and share the disease or deficiency situation. We objectified to sketch the relationship degree and the people's gender that accompanied the spinal cord injured hurt medular patient in nursing consultations and to discuss the necessity of basis survey to the assistance family and to the caregiver. 101 nursing consultations were accomplished, in clinic health, to the spinal cord injured patient and his/her relative and 36 patients were totalized, from this number 26 (72.22%) were male and 10 (27.78%), were female. It was verified that the men with medular lesion, in the greater number (27-80.7 O/o), were accompanied with his relatives specially mother and wife, while the women with medular lesion, in the greater number too (7-70%) were accompanied with her relatives of diversified proximity. In reference to the basis survey that comprehend the care at house and the caregiver necessity, we can affirm its relevance, trying to context the family support identified attending the caregivers.

  1. [Algorithm for diagnosis and treatment of hereditary angioedema as a tool for management].

    PubMed

    Baeza, María Luisa; Caballero Molina, Teresa; Crespo Diz, Carlos; González-Quevedo; Guilarte Clavero, Mar; Hernández Fernández de Rojas, Dolores; Lobera Labairu, Teófilo; Marcos Bravo, Carmen; Navarro Ruiz, Andrés; Navarro Ruiz, A; Poveda Andrés, José Luis; Poveda Andrés, J L; Cebollero, María Antonia; Cebollero de Torre, A

    2013-01-01

    Introducción: El angioedema hereditario es una enfermedad rara de baja prevalencia y gran heterogeneidad en la gravedad del cuadro clínico, lo que dificulta su diagnóstico, y establece la necesidad de iniciar un tratamiento precoz y específico con el fin de evitar complicaciones. Objetivo: Proponer un algoritmo de decisión en el angioedema hereditario (AEH), basado en la evidencia disponible, sobre el diagnóstico, valoración clínica y tratamiento. Se trata de presentar opciones terapéuticas disponibles, así como un algoritmo de decisión para seleccionar el tratamiento más eficiente en cada momento. Material y Métodos: Revisión bibliográfica mediante una búsqueda a través de PubMed y otras fuentes de interés. Resultados: Se han desarrollado cuatro algoritmos de decisión para el AEH; diagnóstico de angioedema mediado por bradicinina, tratamiento del ataque agudo y profilaxis a corto y largo plazo del AEH por déficit del inhibidor C1. Conclusiones: La aplicación de un algoritmo de decisión, en función de unas variables clínicas, ayuda a la selección de la opción terapéutica más eficiente en cada momento y puede ser un instrumento de utilidad en el abordaje terapéutico.

  2. [Usefulness of studies looking for autoimmunity in patients with spontaneous chronic urticaria].

    PubMed

    Rojo-Gutiérrez, María Isabel; Flores-Ruvalcaba, Christian Nataly; Mellado-Ábrego, Jaime; Castillo-Narváez, Gloria; Ramírez-Rojo, Danika Pammela

    2015-01-01

    Antecedentes: la urticaria crónica espontánea es una enfermedad común en los adultos, sobre todo entre las mujeres; esta entidad con frecuencia está relacionada con padecimientos autoinmunitarios. Objetivo: evaluar, mediante estudios de laboratorio, si los pacientes con urticaria crónica espontánea tuvieron signos de autoinmunidad. Material y método: estudio transversal de 35 pacientes del área de Alergia e Inmunología del Hospital Juárez de México, diagnosticados con urticaria crónica espontánea. Se les realizó biometría hemática completa, anticuerpos antitiroideos (antiperoxidasa y tiroglobulina), anticuerpos antinucleares, factor reumatoide, anticoagulante lúpico, células LE, prueba cutánea de suero autólogo (Autologus Serum Skin Test, ASST), complemento (C3 y C4); como estudios adicionales se les realizó prueba de Helicobacter pylori, perfil tiroideo (T3,T4, TSH) y dímero D. Resultados: evaluamos 35 pacientes adultos, 27 eran mujeres. La prueba ASST fue positiva en cuatro pacientes, los anticuerpos antinucleares fueron negativos en todos los casos, pero los anticuerpos antitiroideos resultaron positivos en cuatro pacientes. Las células LE, anticoagulante lúpico, complemento, dímero D, perfil tiroideo y Helicobacter pylori fueron normales o negativos y el factor reumatoide fue positivo en un paciente. Todos los pacientes antitiroideos positivos eran mujeres y de ellas, 26 tuvieron ASST negativa. La correlación entre ASST y AAT no fue significativa. Conclusiones: en nuestro estudio, la mayoría de los pacientes con urticaria crónica espontánea eran mujeres y sólo cuatro tuvieron la prueba ASST positiva, pero esto no se correlaciona con existencia de anticuerpos antitiroideos. La mayor parte de los estudios realizados resultaron normales, por lo que sugerimos no hacer estudios de laboratorio innecesarios en esta afección.

  3. PREVALENCE OF AUTOIMMUNE THYROIDITIS AND THYROID DYSFUNCTION IN HEALTHY ADULT MEXICANS WITH A SLIGHTLY EXCESSIVE IODINE INTAKE.

    PubMed

    Flores-Rebollar, Armando; Moreno-Castañeda, Lidia; Vega-Servín, Norman S; López-Carrasco, Guadalupe; Ruiz-Juvera, Aída

    2015-08-01

    Objetivo: el objetivo del presente estudio fue evaluar la prevalencia de tiroiditis autoinmune y disfunción tiroidea en individuos sanos sin enfermedad tiroidea conocida, de un área urbana de la ciudad de México. Material y métodos: el estudio se realizó en voluntarios sin enfermedad tiroidea conocida. Se reclutaron 427 individuos entre personal médico y administrativo del hospital. A todos se les realizó ultrasonido (US) tiroideo, TSH, T4 libre (FT4), T3 total (TT3), anticuerpos anti-peroxidasa tiroidea (TPOAb) y anti tiroglobulina (TgAb). Dentro de la evaluación por US se incluyó la hipoecogenicidad y el volumen tiroideo. También se midió la excreción urinaria de yodo (UI). Resultados: la frecuencia de tiroiditis autoinmune fue de 8,4% (36/427), las mujeres fueron más afectadas que los hombres (11,6 vs. 4,3%, respectivamente, P = 0,008), cuando se sumó la tiroides atrófica, esta frecuencia se elevó al 15,7% (67/427) de los estudiados. El hipotiroidismo clínico fue detectado en el 1,2% (5/427) y el subclínico en el 5,6%. El hipertiroidismo clínico solo se observó en el 0,5% (2/427) y el subclínico en el 1,9%. El bocio se identificó en el 5,9% (25/427) de los voluntarios. La mediana de la UI fue de 267 μg/L, RIQ (161,3 – 482,5). Conclusiones: a pesar de las limitaciones de nuestro estudio, es clara la frecuencia incrementada de tiroiditis autoinmune en la población estudiada. Son necesarios más estudios que definan tanto la prevalencia de enfermedad tiroidea autoinmune como el estatus nutricional de yodo actual en nuestro país.

  4. [Traumatic spinal cord injury in children and adolescents in Asturias].

    PubMed

    Álvarez-Pérez, M José; López-Llano, M Luisa

    2015-05-01

    Introduccion. La lesion medular traumatica es rara en la infancia, pero con graves complicaciones. Objetivo. Conocer la incidencia, etiologia y caracteristicas sociodemograficas de los pacientes pediatricos y adolescentes con lesion medular traumatica en Asturias. Pacientes y metodos. Censo de pacientes entre 0-17 años codificados como 'lesion medular traumatica con o sin fractura vertebral' en Asturias entre 1934 y 2013. Se recogen variables sociodemograficas, hospitalarias y clinicas. Resultados. Se registran 72 pacientes, la mayoria varones (79,2%), con una edad media de 16 años (rango: 5-17 años). La incidencia en 2011 fue de 7,3 por millon. Predominaron las lesiones completas (68,1%) y la localizacion dorsal (44,4%). Hubo lesion osea en el 95,8%, y en la mitad de ellos, afectacion de dos o mas vertebras. La etiologia predominante fueron los accidentes de trafico (52,1%), sobre todo de vehiculos de cuatro ruedas (63,4%), con una mayoria de varones con una edad media de 17 años y una localizacion dorsal (46,3%). En segundo y tercer lugar se situaron la etiologia laboral y la deportiva, con el mismo numero de casos. En la laboral predominaron los varones y el nivel toracico (77,8%), y el mecanismo fundamental fue el golpe directo. En la deportiva, la mayoria fueron varones, y la zambullida fue la causa mas importante, de predominio cervical. Conclusiones. Son necesarios estudios centrados en este grupo poblacional que permitan determinar sus caracteristicas diferenciadoras para establecer programas de cuidados adaptados a sus necesidades, asi como las medidas preventivas mas oportunas para reducir las posibilidades de una lesion con tan graves repercusiones.

  5. [Shouldn't the Achilles' heel be on the foot - regarding a clinical case].

    PubMed

    Cavaco, Raquel; Machado, Célia; Gorjão Clara, J

    2008-01-01

    Clinical suspicion is the bedrock of a thorough clinical work-up, and a review of the clinical files with no definitive diagnosis is a must. Such a review can uncover rare diagnoses, such as Waldenstrom's macroglobulinaemia, a proliferative B-cell disease characterised by medular infiltration and monoclonocal IgM production. 1% of these are biclonal. We present a case of a 74 year old patient diagnosed in October 2004 with acute cholecystitis. Surgical evaluation revealed bilateral pleural effusion with an inconclusive aetiology. Patient underwent a right pleurodesis in May 2005 and the aetiology remained inconclusive. The third evaluation, in July 2005, led to a final diagnosis of Waldenstrom's macroglobulinaemia.

  6. [Osteoma and exostosis of the external auditory meatus: a clinical diagnosis].

    PubMed

    Granell, J; Puig, A; Benito, E

    2003-03-01

    Proliferative osseous lesions usually found in the external ear are exostoses and osteomata. In other sites they are clearly different entities, but in this location histopathologic differential features are not so reliable in the study of the specimens. An occlusive osteomata is shown, with the typical clinical presentation demonstrated in a multiplanar CT. Microscopically, the lesion consisted of mature bone trabeculae, separated by medular spaces with fibrovascular tissue, characteristic features of osteomata. However, in the most superficial areas, lines of bone apposition, like those in exostoses, were found. A literature review confirms the lack of specificity of the histopathologic study, so diagnosis is based on clinical data.

  7. [Osteomyelitic pseudarthrosis of the tibia with loss of substance treated with a graft of the opposite fibula].

    PubMed

    Bumbic, S

    1986-01-01

    Dragan Dj./Re. No. 2755/76, 5,5-year-old boy, referred to this hospital with signs of bipolar osteomyelitis, destruction and fistulisation of the left tibia and talocrural arthritis. Staphylococcus albus and streptococcus haemoliticus were isolated from the fistula. Osteomyelitis was treated with an adequate therapy including long usage of Lincocin. In Feb. and Oct. of 1977 a sequestrotomy of the mid portion of the tibia and transmedular fixation using Ratschmann's nail were performed. The process resulted in pseudarthrosis of the mid portion of the tibia with loss of bone substance in the length of 2.5 cm and talocrural arthrosis and deformed foot. The boy walking support. In July 1980, in the stage of "ripe" pseudarthrosis a complete resection of pseudoarthrosis with sclerotic portions of tibia to healthy bone was performed. The mid part of the right tibia was resected subperiostally and was grafted centromedularlly into the upper and lower medular channel of the left tibia. Two Kirschner's needles were implanted centromedularlly so as to strengthen the bone osteosynthesis. Complete union of the grafted fibula with treppassage of the medular channel occurred with its tibilisation and growth in length and width. In July 1982, the concave foot was corrected using Bertrand's method. The present difference in the length between the two legs is 4.5 cm which is corrected by the use of padded shoes. Lengthening of the leg is planned to be performed before he reaches the age of 14.

  8. [Myelopathy secondary to an aneurysmal bone cyst of thoracic spine].

    PubMed

    Navas-García, Marta; Penanes, Juan Ramón; Fraga, Javier; Sola, Rafael G

    2016-02-01

    Introduccion. Los quistes oseos aneurismaticos espinales son lesiones osteoliticas benignas muy infrecuentes constituidas por cavidades hematicas limitadas por septos osteoconectivos y celulas gigantes tipo osteoclastos. Clinicamente se manifiestan con dolor local, sintomas neurologicos secundarios a compresion medular, asi como fracturas, deformidades e inestabilidad vertebral. Presentamos un caso de quiste oseo aneurismatico espinal dorsal con sintomatologia neurologica, tratado mediante una reseccion microquirurgica completa, sin secuelas neurologicas asociadas. Caso clinico. Mujer de 47 años, sin antecedentes traumaticos previos, valorada por presentar un cuadro de parestesias de los miembros inferiores de semanas de evolucion. El estudio radiologico de resonancia magnetica dorsal demostro la existencia de una lesion litica de bordes bien delimitados y esclerosis marginal en D4, con afectacion de los elementos posteriores vertebrales y compresion del cordon medular subyacente. La lesion fue extirpada en su totalidad, con desaparicion de la clinica sensitiva tras la intervencion. El diagnostico anatomopatologico definitivo fue quiste oseo aneurismatico espinal. Conclusion. A pesar de su baja incidencia, los quistes oseos aneurismaticos espinales deben considerarse, en el diagnostico diferencial de los tumores oseos espinales, como una posible causa de mielopatia compresiva subaguda o cronica. La reseccion tumoral completa se considera el tratamiento de eleccion, el cual con frecuencia es curativo y asocia un buen pronostico del paciente a largo plazo.

  9. [Chorea due to TITF1/NKX2-1 mutation: phenotypical description and therapeutic response in a family].

    PubMed

    Salvado, Maria; Boronat-Guerrero, Susanna; Hernández-Vara, Jorge; Álvarez-Sabin, José

    2013-05-16

    Introduccion. El corea por mutacion en el gen TITF1, tambien denominado corea hereditario benigno, es un trastorno autosomico dominante que suele iniciarse antes de los 5 anos. En la mayoria de casos, el corea tiende a mejorar con la edad. Puede asociar hipotiroidismo y problemas respiratorios, como el sindrome de distres respiratorio alveolar neonatal o la enfermedad pulmonar intersticial, ya que TITF1 es un factor de transcripcion esencial para el desarrollo del cerebro, tiroides y pulmon. Casos clinicos. Presentamos el fenotipo clinico de una familia con corea, en la cual dos hermanas presentan hipotiroidismo congenito, y una de ellas, sindrome de distres respiratorio alveolar. En ambas se identifico una mutacion en TITF1 (c.825delC) y se observo mejoria clinica en respuesta al tratamiento con levodopa-carbidopa en dosis bajas. Conclusiones. El corea por mutacion de TITF1 es una causa infradiagnosticada de corea en ninos. Debido a la posibilidad de realizar diagnostico genetico, creemos indicado realizarlo siempre en casos familiares dominantes, teniendo en cuenta la penetrancia variable, asi como en pacientes que presenten afectacion concomitante de pulmon o hipotiroidismo. En casos esporadicos, puede ser recomendable en coreas de causa no filiada, lo que nos permitira evitar otras pruebas, dar un pronostico no degenerativo, permitir un consejo genetico, y hacer ensayos terapeuticos mas dirigidos y eficaces. Por el momento, la levodopa parece el tratamiento sintomatico de eleccion.

  10. [Medullary carcinoma experience in breast oncology unit of Hospital Juarez Mexico].

    PubMed

    Jiménez-Villanueva, Xicoténcatl; Hernández-Rubio, Angela; García-Rodríguez, Francisco Mario; García, Rebeca Gil; Moreno-Eutimio, Mario; Herrera-Torre, Analy

    2014-01-01

    Antecedentes: el carcinoma de mama, variante medular, es poco frecuente y de buen pronóstico. Objetivo: conocer las características epidemiológicas y clínicas de la población atendida en el Hosital Juárez de México, saber si se asemejan a las descritas a nivel mundial y si los tratamientos propuestos internacionalmente son aplicables para este centro hospitalario. Material y métodos: estudio retrospectivo y descriptivo de 41 expedientes de pacientes con cáncer de mama tipo medular atendidas entre febrero de 1993 y febrero 2011. Resultados: se encontró que la incidencia de cáncer de mama de tipo medular fue de 3.04% en pacientes originarias de 11 estados mexicanos, con edad promedio de 50 años, nivel socioeconómico medio bajo para 39.02%, sin antecedentes familiares pero sí personales patológicos para: diabetes mellitus tipo 2, hipertensión arterial sistémica y cáncer de mama previo. Eran postmenopáusicas 63.41%. El promedio del tamaño clínico del tumor fue 58 mm, localizado en 63% de los casos en la mama izquierda. Los estadios clínicos fueron: 53.1% en I y II, 46.3% en III y 9.6% no etapificable. El 47% de las pacientes tenía ganglios linfáticos axilares positivos al momento del diagnóstico. La inmunohistoquímica sólo se reportó en 14 de las 41 pacientes; de acuerdo con la clasificación molecular para cáncer de mama: 8 fueron triple negativo, 2 luminal A, 1 luminal B y 3 Her2Neu. Conclusión: la población mexicana tiene características epidemiológicas y clínicas similares a las de las pacientes descritas en estudios internacionales.

  11. The effects of lauromacrogol on thyroid tissue in rabbits. Is this a safe option for the treatment of nodular thyroid disease?

    PubMed

    Idiz, Ufuk Oguz; Aysan, Erhan; Can, Ismail; Buyukpinarbasili, Nur; Yardimci, Erkan Yardimci; Bektasoglu, Huseyin

    2016-01-01

    Lo studio è finalizzato al rilevamento degli effetti del lauromacroglo, un agente sclerosante, sul tessuto tiroideo del coniglio, utilizzando 12 conigli divisi in due gruppi di sei ciascuno. Nel gruppo di studio è stato iniettato nel tessuto tiorideo 0,1 ml di lauromacrogolo, ed in quello di controllo lo stesso volume di soluzione fisiologica. Al controllo postoperatorio sono stati valutati il tasso di FT3, FT4, TSH, la presenza di aderenze e le differenze istopatologiche dei tessuti tiroidei. Non sono risultate differenza significative nel livelli di FT3, FT4, TSH (p>0,05) ma i livelli di , la presenza di aderenze e le differenze istopatologiche dei tessuti tiroidei. Ai controlli i valori di FT3, FT4 ed TSH non sono risultati significativamente differenti (p>0,05), mentre i livelli di FT3 sono stati significativamente differenti all’interno dei due gruppi (p=0,20). Non sono state riscontrate differenze macroscopicamente significative delle aderenze postoperatorie (p>0,05), ma flogosi e fibrosi sono risultate istologicamente più elevate nel gruppo di studio (p=0,003). Due sono i risultati importanti dello studio: la differenza non signifcativa dei test di funzione tiroidea tra i due gruppi, suggerendo che il lauromacrogol può essere usato con sicurezza senza rischi di ipo- o ipertiroidismo; la valutazione istopatologica su modello Erlich-Hunt ha dimostrato che flogosi e fibrosi sono significativamente accresciute nel gruppo di studio, indicando che il lauromacrogol più essere usato efficacemente e con sicurezza per il trattamento dei noduli tiroidei per provocare fibrosi, senza significative aderenze peritiroidee e differenze della funzione.

  12. Sentinel node radioguided biopsy in surgical management of the medullary thyroid carcinoma A case report.

    PubMed

    Boni, Giuseppe; Mazzarri, Sara; Grosso, Mariano; Manca, Giampiero; Biricotti, Marco; Ambrosini, Carlo Enrico; Fregoli, Lorenzo; Puccini, Marco; Caldarelli, Claudio; Spisni, Roberto

    2014-01-21

    Il carcinoma midollare della tiroide è raro. Il suo trattamento è chirurgico e consiste in una tiroidectomia totale associata a dissezione dei linfonodi centrali. L’opportunità della linfoadenectomia dei linfonodi cervicali laterali è argomento controverso. Per ridurre l’estensione della dissezione dei linfonodi laterocervicali ai casi in cui tale procedura sia effettivamente necessaria abbiamo eseguito la tecnica della biopsia del linfonodo sentinella, già praticata in altra patologia tumorale, in un caso di carcinoma midollare, sporadico, diagnosticato con ecografia, determinazione dei livelli di calcitonina serica e citologia dell’agoaspirato. All’ecografia non si evidenziavano linfonodi cervicali centrali o laterali. Abbiamo eseguito mappaggio preoperatorio dei linfonodi sentinella iniettando Tecnezio 99-m nel nodulo tiroideo. La paziente è stata poi sottoposta a tiroidectomia totale e biopsia radioguidata dei linfonodi sentinella. L’esame istologico ha confermato la presenza di un carcinoma midollare della tiroide e di micrometastasi in due linfonodi sentinella situati nel compartimento laterale destro. Dopo la tiroidectomia l’intervento è stato completato con dissezione dei compartimenti centrale e laterala destro. Al followup non sono stati rilevati livelli di calcitonina serica nè basali nè dopo stimolazione con pentagastrina. Si tratta del primo caso, riportato in letteratura, che dimostra l’utilità della biopsia radioguidata del linfonodo sentinella nella stadiazione linfonodale e del trattamento chirurgico del microcarcinoma midollare della tiroide. Tale biopsia può essere utile ad eseguire la dissezione linfonodale laterale solo nei pazienti con provato coinvolgimento dei linfonodi laterali del collo e quindi a ridurre l’entità della dissezione e delle relative complicanze.

  13. Traumatic optic neuropathy: to treat or not to treat? Report of two cases.

    PubMed

    Soldevila, L; Cano-Parra, J; Ruiz, A; Vázquez, J M; Poposka, D; Barnola, M E

    2013-03-01

    We present two cases of blunt ocular trauma with clinical findings and complementary tests compatible with traumatic optic neuropathy (TON), and progression to sectorial optic atrophy. TON have an essentially clinical diagnosis, and in the last few years has been treated with high doses of intravenous steroids, based on weak evidence of the benefit of the steroids in cases of medular trauma. Nevertheless, subsequent studies have concluded that there is a relatively high proportion of cases in all series with spontaneous visual recovery, and there was no convincing evidence of a benefit of steroids compared to observation only. Copyright © 2011 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.

  14. Origin, structure and function of subcuticular cells of Fasciola hepatica.

    PubMed

    Poljakova-Krusteva, O; Donchev, N; Gorchilova, L; Krustev, L

    1976-10-12

    In the present paper the ultrastructure of the subcuticulare zone of the tegument of Fasciola hepatica and the distribution of thimidine-H3 for establishing the localization of DNA-synthesis in the tegument was studied. There were two types of subcuticular cells: 1) non-differentiated cells with presence of incorporated labelled thimidine in nuclei presented by DNA non-stable macromolecules, and 2) differentiated or definitive subcuticular cells without aggregates of silver grains. The results showed a high level of DNA replication leading to mitotic activity of the non-differentiated cells and absence of mitotic activity in the definitive cells. There was a morphological similarity between non-differentiated cells and the cells from the medular zone, supposing a relationship in their origin.

  15. Combined procedure of vascularized bone marrow transplantation and mesenchymal stem cells graft - an effective solution for rapid hematopoietic reconstitution and prevention of graft-versus-host disease.

    PubMed

    Coliţă, Andrei; Coliţă, Anca; Zamfirescu, Dragos; Lupu, Anca Roxana

    2012-09-01

    Hematopoietic stem cell transplantation (HSCT) is a a standard therapeutic option for several diseases. The success of the procedure depends on quality and quantity of transplanted cells and on stromal capacity to create an optimal microenvironment, that supports survival and development of the hematopoietic elements. Conditions associated with stromal dysfunction lead to slower/insufficient engraftment and/or immune reconstitution. A possible solution to this problem is to realize a combined graft of hematopoietic stem cells along with the medular stroma in the form of vascularized bone marrow transplant (VBMT). Another major drawback of HSCT is the risk of graft versus host disease (GVHD). Recently, mesenchymal stromal cells (MSC) have demonstrated the capacity to down-regulate alloreactive T-cell and to enhance the engraftment. Cotransplantation of MSC could be a therapeutic option for a better engraftment and GVHD prevention. Copyright © 2012 Elsevier Ltd. All rights reserved.

  16. [Treatment of pain at a community pharmacy].

    PubMed

    Malonne, H; Leemans, L; Fontaine, J

    1996-01-01

    The first part of this article deals with the physiology of pain. We focus on the different pathways of pain. Two main mechanisms of pain control are described, namely peripheral control, by the supraspinal gate and central or supra-medular control. Three different mechanisms can induce pain. We focus on pain perception by excess of stimuli and desafferent ways of pain. The following part deals with the different kinds of pain presented to the community pharmacist. At the end we discuss the treatment of pain, describing the pharmacological aspects of the three most important "Over The Counter" molecules, namely paracetamol, aspirin and ibuprofen. Also some combinations of analgesic agents and adjuvants are discussed.

  17. [Complications of TPN in gastrointestinal surgery patients].

    PubMed

    Prieto Reyes, M A; Márquez Báez, M A; Reyes Cerezo, M; Redel del Pueyo, J; Solórzano Peck, G; Vázquez Márquez, L; Gordón del Río, A; Arévalo Jiménez, E

    1991-01-01

    Retrospective study of a group of 77 patients subjected to gastrointestinal surgery, who received total parenteral nutrition (TPN) during the postoperative period, During the evolution of the nutrition, 76 cases with technical complications arose, one case of sepsis, 10 cases of metabolic complications and one patient with haematological complications (acute medular failure). Although a higher percentage of metabolic and haematological alterations not requiring medical or surgical treatment for correction was observed, these were indicative of the tendencies of the metabolic and haematological states of the patients. An analysis was also made of the variance, observing a direct relationship between the components of TPN and the variations of the metabolic and haematological values studied, However, these values did not correlate with the number of days during which the patients was on nutrition, and thus the technique and guidelines for administration are the most important factors which determine the presence or absence of complications during TPN.

  18. [Hepatic myelolipoma: A rare entity, case report and review of the literature].

    PubMed

    Gallo, Mathieu; Mineur, Laurent; Emptas, Hélène; Costes, Valérie; Ramos, Jeanne

    2017-09-18

    Hepatic myelolipoma is a rare entity with only 17 cases described in the literature. A 73mm right liver mass was fortuitously discovered in a 55-year-old man. The biopsy showed normal hepatic tissue adjacent to a normal medular like hematopoïetic tissue, showing trilieage hematopoieses, including myeloid cells, erythroid cells and megakaryocytic cells. The diagnosis of hepatic myelolipoma was proposed. This benign tumor was initially described in adrenal gland, which is the most common topography. No malignancy or bleeding complication has been described in its hepatical location. The diagnosis is histological due to non-specific radiological presentation; it allows to avoid a surgical treatment in relation to its excellent prognosis. The etiology is not well established; but some hypotheses are discussed: adrenal or medullar heterotopia, bone marrow embolism, myeloïd metaplasia. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  19. [The effect of verticalization of the resulting force (R) of weight bearing in the hip joint on morphologic characteristics of the medullary canal in the femoral shaft in patients with coxarthrosis].

    PubMed

    Jovanović, S

    1992-01-01

    An influence of verticalization of the resulting force of weight-bearing on the hip joint "R" on the morphological characteristics of the medullar canal on the proximal edge of the shaft of femur was researched. Progressive degenerative changes of the hip joint with a consequent sideways limping or changes of the collodiaphysial angle (ccd angle) were the cause of the verticalization of the resulting force "R". The analysis of patients treated and operated on The Orthopaedic Department of the General Hospital Osijek and The Orthopaedic Clinic of The Medical Faculty of The University of Zagreb. The research, undoubtedly, proved that the patients with coxarthrosis and side-ways in the hip or with changed collodiaphysial angle experienced verticalization of the resulting force of weigh-bearing of the hip joint and the proximal edge of femur which caused morphological changes of the medular canal of the shaft of femur.

  20. [Participation of the adrenals in the pathogenesis of metabolic acid-base disorders].

    PubMed

    Iluchev, D; Shtereva, S

    1976-01-01

    The authors examined in dynamics the changes in the functional state of the adrenals on 240 rabbits, which served as models for acute metabolic deviations in the acid-base balance. The obtained results showed that the acute metabolic acidosis increased moderately the values of ACTH and 17-hydroxycorticosteroids in blood without changing their concentration on the adrenal tissue. It lowered strongly the content of catecholamines (adrenaline and noradranaline) in the adrenal medular part. The metabolic alkalosis raised the concentration of ACTH in blood plasma and increased the amount of corticosteroids in blood and adrenals. There was no well formed parallelism in normalizing acid-base and hormonal indices. As a consequence of this a stage of postaciodotic catecholamine adrenal deficit was formed as well as metabasic hypercorticism in the experimental animals.

  1. [Factors associated with empowerment in people with a spinal cord injury due to traffic accidents].

    PubMed

    Suriá Martínez, Raquel

    2015-09-01

    Analizar la capacidad de empoderamiento de un grupo de personas con lesión medular en función de la edad, el sexo, la condición funcional y la edaden la cual adquirieron la lesión. Ninety-four participants with a spinal cord injury (42 tetraplegics and 52 paraplegics) completed the Spanish version of the Rogers, Chamberlin, Ellison and Crean Scale (1997), designed to measure empowerment. The analyses indicated higher levels of empowerment among women. Persons with tetraplegia whose injury was more longstanding also showed greater empowerment. This study suggests that the capacity to become empowered can vary and evolve and should therefore be promoted in intervention programs. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

  2. [Factors associated with empowerment in people with a spinal cord injury due to traffic accidents].

    PubMed

    Suriá Martínez, Raquel

    2015-01-01

    Analizar la capacidad de empoderamiento de un grupo de personas con lesión medular en función de la edad, el sexo, la condición funcional y la edaden la cual adquirieron la lesión. Ninety-four participants with a spinal cord injury (42 tetraplegics and 52 paraplegics) completed the Spanish version of the Rogers, Chamberlin, Ellison and Crean Scale (1997), designed to measure empowerment. The analyses indicated higher levels of empowerment among women. Persons with tetraplegia whose injury was more longstanding also showed greater empowerment. This study suggests that the capacity to become empowered can vary and evolve and should therefore be promoted in intervention programs. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

  3. [Cushing syndrome due to ectopic ACTH secretion].

    PubMed

    Mendonça, B B; Madureira, G; Bloise, W; Albergaria, A; Halpern, A; Liberman, B; Villares, S M; Batista, M C; Avancini, V F; Nitterdorfi, C T

    1989-01-01

    The authors studied 8 patients (4 males and 4 females) with Cushing's syndrome due to ectopic ACTH secretion. Chronological age ranged from 15 to 45 years and duration of the disease ranged from 3 to 48 months. All patients presented typical signs of Cushing's syndrome, blood hypertension, and four of them had hyperpigmentation of the skin. Five patients had fasting hyperglycemia and all patients but one had serum hypokalemia (serum K = 2.2 to 3.9mEq/l). The circadian rhythm of cortisol was absent in all patients and basal cortisol levels were elevated in all patients but one. Basal ACTH levels evaluated in 7 patients were elevated in 6 (29 to 1050 pg/ml-MRC). One patient presented normal depression of urinary 17-OH after two days of dexamethasone and normal increase of urinary 17-OH and serum 11-dexycortisol after methyrapone. Four patients had carcinoid tumor (3 thymic and 1 bronchial), two had pancreatic islets cell tumors, one had bilateral pheochromocytoma and medular carcinoma of the thyroid, and one had oat cell carcinoma of the lung and medular carcinoma of the thyroid. Thoracic X-rays identified the ectopic ACTH secretion tumor in four cases, all confirmed by CT scan. Abdominal CT showed a difuse enlargement of the adrenals in seven cases and bilateral nodules in one case (pheochromocytomas). Six patients died within 3 years of the diagnosis. The authors concluded that clinical and hormonal findings could mislead the findings of ACTH ectopic secretion and Cushing's disease, and suggest that thoracic X-rays and CT scans of the skull, thorax, and abdome should be done in all cases of Cushing's syndrome.

  4. [Evaluation of patients with humeral midshaft fractures treated with DCP plate vs. intramedullary nail UHN].

    PubMed

    Guzmán-Guevara, Jonathan; López-Cázares, Gerardo; Barragán-Hervella, Rodolfo Gregorio; Villegas-Rosas, José Saúl Alejandro; Alvarado-Ortega, Iván; Montiel-Jarquín, Álvaro José

    2016-01-01

    Introducción: las fracturas diafisiarias de húmero deben de ser manejadas quirúrgicamente, por lo que se requiere el conocimiento de la funcionalidad, consolidación ósea y dolor de estos tratamientos para poder obtener los resultados esperados. El objetivo de este trabajo es comparar la evolución de los pacientes con fractura diafisiaria de húmero operados con clavo centro medular UHN frente a aquellos operados con placa DCP. Métodos: estudio comparativo, realizado durante el periodo de junio 2014 a junio 2015, en pacientes con fractura diafisiaria de húmero, incidentes, operados con clavo UHN y placa DCP. La evaluación funcional, del dolor y la radiográfica se llevaron a cabo por las escalas UCLA, Andersen y por personal del departamento de radiodiagnóstico, respectivamente. Resultados: se seleccionaron 40 pacientes, 57.5% con placa DCP, 67.5% hombres, promedio de edad 42.38 años, tiempo quirúrgico promedio 73.3 minutos, lado afectado 50% derecho, 87% tuvieron consolidación completa con placa DCP contra 70.6% de los manejados con clavo centro medular UHN. La consolidación radiográfica fue buena para ambos tratamientos, la funcionalidad de los pacientes y el dolor presentado no tuvo diferencias estadísticamente significativas para ambos grupos (p > 0.05). Las complicaciones están en el rango descrito a nivel mundial para ambos tratamientos. Conclusiones: ambos tratamientos son eficaces para las lesiones diafisiarias del húmero, sin embargo se debe de tener precaución y tratar de evitar las complicaciones que pueden llegar a ser graves.

  5. [Tropical spastic paraparesis in a non tropical region].

    PubMed

    Pias-Peleteiro, L; Pias-Peleteiro, J M; Arias, M

    2015-10-16

    Introduccion. El virus linfotropo humano de celulas T tipo 1 (HTLV-1) es el agente causal de la paraparesia espastica tropical. Su prevalencia, elevada en determinadas areas tropicales, es baja en Europa y Norteamerica. Casos clinicos. Se describen dos casos de paraparesia espastica tropical en varones naturales y residentes en Galicia. Se realizaron estudios analiticos en la sangre y el liquido cefalorraquideo (LCR), examenes neurofisiologicos y resonancia magnetica craneal y medular. En ambos pacientes, la presentacion clinica fue la de una mielopatia cronica, con cuadro torpido y progresivo que evoluciono a paraparesia espastica. Un paciente desarrollo uveitis antes de la clinica neurologica. En los dos casos, el estudio del LCR demostro leve pleocitosis linfoide, ligera hiperproteinorraquia, bandas oligoclonales negativas y anticuerpos anti-HTLV-1 positivos. La reaccion en cadena de la polimerasa para HTLV-1 resulto positiva en ambos casos. La resonancia magnetica raquidea resulto normal en un paciente y mostro en el otro hiperseñal medular dorsal, que desaparecio tras el tratamiento. No se demostraron datos de polineuropatia periferica. Recibieron corticoides e interferon alfa, con leve mejoria y estabilizacion del cuadro clinico. La anamnesis dirigida revelo antecedentes de contactos sexuales de riesgo en regiones endemicas de HTLV-1. Conclusiones. La uveitis asociada a HTLV-1 podria ser predictora de paraparesia espastica tropical. Esta es probablemente una entidad infradiagnosticada (alto porcentaje de portadores asintomaticos, clinica insidiosa y bajo indice de sospecha en areas no endemicas). Debe considerarse su diagnostico en zonas no tropicales que reciben inmigrantes de areas endemicas y tambien en regiones con una tradicional emigracion a regiones tropicales.

  6. [Magnetic resonance imaging with gadolinium in the acute phase of relapses in multiple sclerosis].

    PubMed

    Ortiz, P; Bareno, J; Cabrera, L; Rueda, K; Rovira, A

    2017-03-16

    Objetivo. Describir los factores que estan relacionados con el realce de gadolinio en la resonancia magnetica (RM) en pacientes con esclerosis multiple (EM) con sintomas de recaida. Pacientes y metodos. Estudio observacional de corte transversal, retrospectivo, de pacientes mayores de 18 años con diagnostico de EM remitente recurrente o progresiva, que presentaron actividad clinica y a quienes se les realizo resonancia cerebral y medular con contraste durante la fase aguda de los sintomas. Resultados. De los 93 pacientes incluidos, el 70% fueron mujeres, con una edad media de 37 ± 9,6 años. El 90% presentaba un diagnostico de EM remitente recurrente y el 50% tenia una duracion de la enfermedad de al menos cinco años. El 56% presento actividad clinica de origen medular, y las alteraciones sensitivas fueron las mas frecuentes (44%). La mediana de duracion de los sintomas fue de seis dias (rango: 1-89 dias). El 93% requirio tratamiento con metilprednisolona intravenosa durante 3-5 dias, que se administro despues de realizar los estudios de RM. La presencia de lesiones que realzaran con contraste durante la fase de recaida en los estudios de RM no mostro relacion significativa con ninguna de las variables clinicas analizadas y solo se observo una tendencia con los sintomas asociados (p = 0,07). Conclusiones. La definicion de recaida en la EM es clinica. Una RM en la fase de recaida podria ser util para confirmar la actividad de la enfermedad, pero el realce de gadolinio durante la recaida no se encontro que fuera determinado por la presentacion clinica, la localizacion anatomica o la duracion del sintoma.

  7. [Determination of von Willebrand factor multimers in Mexican population].

    PubMed

    Hernández-Zamora, Edgar; Zavala-Hernández, Cesar; Viveros-Sandoval, Martha Eva; Ochoa-Rico, Angeles; Martínez-Murillo, Carlos; Reyes-Maldonado, Elba

    2014-01-01

    Antecedentes: la enfermedad de von Willebrand es un padecimiento hereditario en el que la estructura, función y concentración del factor de von Willebrand están alteradas y, en consecuencia, también la interacción plaqueta-factor de von Willebrand-endotelio. En México no hay registros epidemiológicos de la enfermedad, sólo se han efectuado algunos estudios aislados desde el punto de vista clínico y hematológico. Material y métodos: estudio retrospectivo efectuado en 155 mexicanos mestizos, 75 de ellos con diagnóstico presuntivo de enfermedad de von Willebrand, 15 con sospecha de hemofilia A y 65 donadores sanos (testigos). Se realizaron pruebas: básicas de coagulación, especiales y de clasificación: análisis de la composición multimérica. Resultados: 15 pacientes se diagnosticaron con hemofilia A; de los 75 sujetos con sospecha de enfermedad de von Willebrand se diagnosticaron 50 de la manera siguiente: tipo 1 (62%), tipo 2 (22%) [subtipos: 2A (14%), 2B (2%) y 2N (6%)] y tipo 3 (16%). Conclusión: el análisis de los multímeros del factor de von Willebrand es un método que cumple con las características adecuadas para el diagnóstico de la enfermedad de von Willebrand, por lo que es necesario implementar esta metodología para su estudio y mejorar su diagnóstico específico.

  8. [Description of a series of hospital patients with a spinal fistula].

    PubMed

    Garcia-Cabo, C; Morales-Deza, E S; Martinez-Rodriguez, L; Murias-Quintana, E; Perez-Alvarez, A; Martinez-Ramos, J; Vega-Valdes, P; Suarez-Santos, P; Garcia-Rua, A; Moris, G

    2016-10-01

    Introduccion. Aunque las fistulas espinales suponen el 70% de las malformaciones arteriovenosas espinales, son una entidad infradiagnosticada. El shunt arteriovenoso produce una congestion vascular que da lugar a una mielopatia progresiva, en ocasiones irreversible si no se trata de forma precoz. Objetivo. Describir las caracteristicas clinicorradiologicas de una serie de pacientes con fistula espinal. Pacientes y metodos. Se realizo una busqueda retrospectiva de pacientes con diagnostico de fistula espinal ingresados en el area de neurociencias de un hospital de tercer nivel asistencial. Resultados. Se identificaron 19 pacientes (7 mujeres y 12 varones) con una edad media de 56 años. La fistula espinal fue de tipo I en un 79% de los pacientes y la localizacion dorsal fue la mas frecuente. La mayoria de los casos presento un curso progresivo (90%). Un 74% de los pacientes se diagnostico mediante resonancia magnetica. En cuatro casos fue necesaria la realizacion de una angiografia para llegar al diagnostico, y en uno de ellos se preciso una biopsia intraoperatoria. Se realizaron tres punciones lumbares, en dos de las cuales se objetivo pleocitosis linfocitaria e hiperproteinorraquia. El retraso diagnostico medio fue de nueve meses. Se trato a un 79% de los pacientes, y de ellos solo mejoro el 10%. Conclusiones. Ante una clinica sugestiva de fistula espinal, debe realizarse una angiografia espinal diagnostica aunque el paciente estudiado pueda presentar caracteristicas licuorales atipicas y normalidad en la resonancia magnetica medular.

  9. Peritubular capillary changes in alport syndrome, diabetic glomerulopathy, Balkan endemic nephropathy and hemorrhagic fever with renal syndrome.

    PubMed

    Hvala, Anastazija; Ferluga, Dusan; Rott, Tomaz; Kobenter, Tatjana; Koselj-Kajtna, Mira; Trnacević, Seneid

    2005-01-01

    The morphology of peritubular capillary has been mostly studied in relation to chronic transplant rejection, where an association has been found between transplant glomerulopathy and reduplication of peritubular capillary basement membranes (PCBM). This electron microscopy study of peritubular capillaries was done on kidney biopsies performed on patients with conditions involving primarily glomeruli (diabetic glomerulopathy (23), Alport syndrome (37)) or causing more or less isolated changes of nephron structures outside the glomeruli (Balkan endemic nephropathy (15) and hemorrhagic fever with renal syndrome (19)). The aim was to explore the ultrastructural features of the PCBM. In patients with diabetic glomerulopathy, the PCBM was homogeneous, with a width ranging from normal to evidently increased (55-355 nm). In patients with Alport syndrome, the PCBM was homogeneous, with no substantial splitting or prominent thickening. Mean thickness varied between 80 (85-100) nm in children and 120 (46-250) nm in adults. Mean PCBM thickness in patients with Balkan endemic nephropathy was 209 (90-1270) nm. The thickened PCBM was also often split. In patients with hemorrhagic fever with renal syndrome, peritubular capillaries and medular vasa recta were generally extremely congested and focally ruptured, and their basal lamina showed prevailing thinning and focal discontinuities.

  10. [Secondary biliary cirrhosis in a patient with histiocytosis X].

    PubMed

    Romão, Zita; Pontes, J; Andrade, P; Leitão, M C; Donato, A; Freitas, Diniz

    2002-01-01

    Histiocitose X or Histiocytosis of the Langerhans cells represents a complex spectrum of clinical alterations, resulting from infiltration by anomalous histiocytes of various organs, including the skin, bones, lungs, lymphatic ganglia and liver. Liver disease is rare and the mechanism by which lesions appear is unknown. Cholestasis results from phenomena of sclerosant colangitis, which affects the intrahepatic ducts, or from proliferation of histiocytic cells in the periportal areas. Some patients develop biliar cyrrhosis. The authors present the clinical case of a 62-year-old female patient, hospitalized for chronic cholestasis, diabetes and gallstone in the main bile duct. She had metastatic lesions of the hypophysis and bones, the biopsies of which revealed infiltration by histiocytic cells. Endoscopic Retrograde Colangiopancreatography (E.R.C.P.) revealed dilatation of intrahepatic bile ducts and stenosis of left hepatic duct. A histological study of the hepatic biopsy showed chronic cholestasis and areas of fibrosis, without infiltration by histiocytic granulomas, which were observed in the medular biopsy and in the thyroid nodule cytology.

  11. The effects of zoledronic acid and dexamethasone on osseointegration of endosseous implants: histological and histomorphometrical evaluation in rats.

    PubMed

    de Oliveira, Marcio A; Asahi, Denise A; Silveira, Celey A E; Lima, Luiz Antonio P A; Glick, Michael; Gallottini, Marina

    2015-04-01

    Bisphosphonates are a widely used class of drugs that prevent bone loss. Several side effects related to bisphosphonate therapy have been reported, including osteonecrosis of the jaws associated with invasive dental procedures and implants placement. To evaluate the influence of intravenous nitrogen-containing BPs in combination with or without dexamethasone on osseointegration of titanium implants placed in an animal model. Twenty-seven male Wistar rats were divided into three groups: group 1 was treated solely with zoledronic acid, group 2 was treated with zoledronic acid and dexamethasone, and group 3 did only receive saline solution injections. Two endosseous implants were placed in each tibia, and three animals from each group were sacrificed at postoperative times of seven, 14, and 28 days. Non-decalcified sections were observed with light microscopy for histological and histomorphometrical analyses. Histomorphometrical analysis using the animals and the implants as unit of measurement revealed no statistically significant difference regarding bone-implant contact and bone density among the three groups. Histological observation revealed that zoledronic acid-treated animals in combination with or without dexamethasone showed expressive less bone remodeling activity at 14 and 28 days after implants placement, compared with control specimens. The studied bisphosphonate regimens did not interfere with the osseointegration of the implants, cortical, or medular bone deposition, but a possible lack of bone remodeling of the original cortical bone may affect long-term osseointegration. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  12. [Histopathology of Q rickettsiosis in sheep].

    PubMed

    Belchev, L; Pavlov, N

    1977-01-01

    Examined was material taken from five sheep (ewes) and two weaned lambs having naturally contracted Qu rickettsiosis. Described are the clinical symptoms of the disease and the morphologic changes. The diseased animals showed rise in temperature (39.5--40.5 degrees C), loss of appetite, and depression. Some of the weaned lambs manifested slight cough and digestive troubles. Part of the animals showed nervous symptoms--tic movements of the head and limbs. Morphologically, the liver was edematired, of lower compactness, and the spleen was enlarged, the meninges being hyperemic and peppered with pinpointed hemorrhages. Histologically, a strong diffuse activation and proliferation of the liver capillary endothelium was established along with necrobiosis of the liver epithelial cells and a diffuse leukocyte infiltration. Established was also hyperplasia of the reticular cells and the lymph follicles of the spleen and the bronchial lymph nodes. The epithelial cells of the kidney tubules were involved in vacuolar dystrophy, and in the medular section there were fibroblastic proliferations with hyperemia. Inflammatory changes in the brain were also found.

  13. Morpho-functional patterns of kidney injury in the experimental leptospirosis of the guinea-pig (L. icterohaemorrhagiae).

    PubMed

    Dávila de Arriaga, A J; Rocha, A S; Yasuda, P H; De Brito, T

    1982-10-01

    Thirty-seven guinea-pigs experimentally infected with a virulent strain of L. icterohaemorrhagiae, were submitted to a renal function study as evaluated through the maximal urinary concentration (MUC) test, blood urea nitrogen (BUN) and afterwards had their kidneys examined by light and electron microscopy. Vascular changes were also studied after the administration of colloidal carbon as a marker. Through the MUC test and BUN determination, two groups of tubulo-interstitial lesions can be visualised, one in animals without renal sufficiency, manifested chiefly by cell edema with RE dilation and another, in animals with renal insufficiency, characterised not only by marked cell edema and mitochondrial changes, but also by proximal tubule regenerative aspects without overt tubular necrosis. Interstitial edema and focal nephritis was prominent in both groups, a finding which minimises their role in the pathogenesis of renal failure in experimental leptospirosis. Vascular injury, affecting the vessels of the renal microcirculation chiefly at the cortico-medular junction, was observed in both groups. Its severity and extension ran parallel to the intensity of the tubular injury. This suggests a simultaneous action of a noxious agent liberated by the leptospires over both structures, tubular damage being accentuated by the local circulatory changes.

  14. [Buerger's disease or thromboangiitis obliterans].

    PubMed

    Léger, P; Pathak, A; Hajji, L; Faivre-Carrere, C; Boccalon, H

    2001-03-01

    The Buerger's disease or thromboangiitis obliterants (TAO) is a non atheromatous inflammatory disease which alters medium and small-sized arteries and veins. It can be found world-wide, but it is more frequent in Eastern Europe, Middle East, Asia and Southeast Asia. Young men and smokers are the most affected. The incidence of this disease is increasing among women. The cause of this disease is unknown yet. The most striking fact is the relationship between TAO and tobacco. The diagnostic is most often late in front of a digital leg ischemia. Complementary exams help to its diagnostic and management but none of them are specific out of the pathology. The affection is evolving towards distal gangrene with amputation in 5 to 10% of cases. Prostacyclin demonstrated its efficiency. Revascularization surgery is difficult but sometimes possible. Sympathectomy, medular stimulation must be suggested. The patient survival is not at stake and the prognosis is above all functional. The most important element in the treatment is stop smoking definitively.

  15. The effects of caffeine administration on the early stage of bone healing and bone density A histometric study in rats.

    PubMed

    Duarte, Poliana Mendes; Marques, Marcelo Rocha; Bezerra, Joyce Pinho; Bastos, Marta Ferreira

    2009-08-01

    The aim of this study was to evaluate the effect of the daily administration of high doses of caffeine on the early stages of bone healing and on bone density in rats. Twenty-four Wistar rats were assigned to one of the following groups: Non-caffeine group (n=12): animals without caffeine ingestion; Caffeine group (n=12): 10mg/100g body weight/day of caffeine via drinking water for 56 days. Forty-eight days after the beginning of caffeine intake, a critical-size surgical defect was created in the right tibia of both groups, while the contralateral tibia was left without defect. Eight days later, the animals were sacrificed and the specimens processed in order to obtain decalcified sections. The area of new bone formation in the right tibia and the bone density in the left tibia were histometrically evaluated in the medular bone. At 8 days post-operative, the caffeine group presented a significantly lower area of new bone formation, when compared to the non-caffeine group (p<0.001). In addition, the administration of caffeine during 56 days did not alter the bone density. In conclusion, the present study demonstrated that a high daily caffeine intake may disturb the early stages of bone healing, but does not alter bone density after a period of 56 days of administration.

  16. Stress fracture development classified by bone scintigraphy

    SciTech Connect

    Zwas, S.T.; Elkanovich, R.; Frank, G.; Aharonson, Z.

    1985-05-01

    There is no consensus on classifying stress fractures (SF) appearing on bone scans. The authors present a system of classification based on grading the severity and development of bone lesions by visual inspection, according to three main scintigraphic criteria: focality and size, intensity of uptake compare to adjacent bone, and local medular extension. Four grades of development (I-IV) were ranked, ranging from ill defined slightly increased cortical uptake to well defined regions with markedly increased uptake extending transversely bicortically. 310 male subjects aged 19-2, suffering several weeks from leg pains occurring during intensive physical training underwent bone scans of the pelvis and lower extremities using Tc-99-m-MDP. 76% of the scans were positive with 354 lesions, of which 88% were in th4e mild (I-II) grades and 12% in the moderate (III) and severe (IV) grades. Post-treatment scans were obtained in 65 cases having 78 lesions during 1- to 6-month intervals. Complete resolution was found after 1-2 months in 36% of the mild lesions but in only 12% of the moderate and severe ones, and after 3-6 months in 55% of the mild lesions and 15% of the severe ones. 75% of the moderate and severe lesions showed residual uptake in various stages throughout the follow-up period. Early recognition and treatment of mild SF lesions in this study prevented protracted disability and progression of the lesions and facilitated complete healing.

  17. [Traumatic rupture of the thoracic aorta].

    PubMed

    Glock, Y; Roux, D; Soula, P; Cerene, A; Fournial, G

    1996-01-01

    This is a retrospective analysis of 50 postraumatic aortic rupture (1968-1996, 39 males, mean age: 34.5). Group A is composed of 35 patients with an acute aortic rupture and a prompt diagnosis. Group B includes 13 patients with a chronic rupture. All patients from group A had a severe politraumatism with abdominal, cranial, extremities or hip fractures. Mediastinal thickening with or without hemothorax indicated an angiography or a transesophageal echocardiography lately. In group A, 36 patients have been operated on urgently (12-24 hours); cardiopulmonary bypass was performed on 20 patients; an aorto-aortical bypass was done in 27 cases and a direct suture in the remaining 9. In group B, cardiopulmonary bypass was performed on 9 patients; a aorto-aortical bypass was done in 11 cases and a direct suture in 2. Overall hospital mortality was 16%; 19% in group A and 7.6% in group B. Ischemic paraplejia appeared in 5 patients (10%), all from group A. No false aneurysm developed after 4.5 years of follow-up (3-135 months) in the 38 survivors. The usefulness of transesophageal echocardiography, the importance of medular protection and the utility of several interventionist radiologic techniques are discussed.

  18. [A urinary outbreak of Acinetobacter baumanii in a spinal cord injury unit].

    PubMed

    Pedraza, F; Andreu, A; Saune, M; Moreno, A; Ramírez, L; García, L

    1993-02-01

    From January 1990 to April 1992, 114 urinary strains of Acinetobacter baumanii were isolated in 57 patients with traumatic spinal cord [correction of medular] injury. The strains were characterized by having all of them the same biochemical identification, except for citrate, maltose and tryptophan-desaminase. Until December 1990, (5 strains) were resistant to all antibiotics, except to tobramicine, amikacine, cotrimoxazol and imipenem (6.3%, 33.9%, 26.7% and 0% of resistances, respectively); since January 1991, (99 strains) became resistant to all of them, except to imipenem. 39.5% of AB were isolated in pure cultures, 46% of them with pyuria. Between February 1991 and January 1992, we observed the highest number of affected patients, although without seasonal predominance. We observed as well a higher incidence among males (46 males, 11 females). 80% of them carried a permanent probe. Only 6 patients presented clinical signs directly related to AB. The environmental study could not demonstrate any source of contagion or transmission mechanism.

  19. The histopathological study of osteoporosis.

    PubMed

    Marcu, Fl; Bogdan, Fl; Muţiu, Gabriela; Lazăr, L

    2011-01-01

    The osteoporosis is characterized by the imbalance between the activity of the osteoblasts, the bone forming cells, and the osteoclasts, the cells that resorb the bone tissue, imbalance that favors the osteoclasts. As a conclusion, in the case of osteoporosis, for the same volume, the bone is less compact and more fragile. The objective of our study is to make a histological evaluation of the different elements of the bone tissue in many 47 bone samples: 27 bone fragments were collected from the head and the femoral head of patients who required hip arthroplasty and 20 bone fragments were collected from the vertebral body of dead patients. The results of our study emphasized the thinned trabeculae of the bone that lost continuity, the preferential resorption of the horizontal trabeculae, the consecutive trabecular anisotropy and the reduction of the trabecular connectivity with enlarged areolae and the adipose degeneration of the marrow. One notices in the osteoporosis a reduction of the trabecular network connectivity directly proportional with the stage of the illness; thus, we determined a strong reduction of the trabecular connectivity in advanced osteoporosis stages. The growth aspects of the medular adiposity, associated with the intratrabecular connectivity concurs to highlight the functional connection between bone and marrow. The diminution of the medullar cellularity together with its enrichment in fat cells has negative outcomes on the bone.

  20. [Maculopathy in Curschmann-Steinert myotonic dystrophy].

    PubMed

    Austermann, P; Kuba, G B; Kroll, P

    2000-11-01

    Maculopathy occurring in young patients is a challenge in differential diagnosis. Besides hereditary macular dystrophies and acquired macular degenerations, rare systemic disorders should be considered. A 36 year old female patient complained about a gradually decrease of visual acuity in both eyes and an increasing exotropia of her right eye. Visual acuity was 0.7, the orthoptical status revealed an intermittent exophoria with exclusion of the right eye. Slit lamp examination showed punctate and cristalline lens opacities. In fundus examination and fluorescein angiography clumpy pigment epithelium hypertrophies and atrophies with a reticular character could be observed. Color vision and perimetry were normal; dark visual acuity was reduced. Because of remarkable deformations of jaw and teeth, a high hairline and an uncertain step we arranged a neurological consultation. Clinical observation together with myotonic activities in electromyography and diffuse lesions in the cerebral medular corpus shown in MRT led to the diagnosis of myotonic dystrophy (Curschmann Steinert syndrome). Besides hereditary macular dystrophies and acquired macular degenerations the differential diagnosis of maculopathies in young patients also includes systemic disorders. Myotonic dystrophy (Curschmann Steinert syndrome) should be taken into account as a rare cause of a juvenile maculopathy.

  1. [Immune complex glomerulonephritis associated with pulmonary tuberculosis].

    PubMed

    Villar, I; Hernández, E; Cozzi, J; Paletta, C; Mathurín, S

    1994-01-01

    A 32 year old man was admitted for dyspnea, hemoptysis, macroscopic hematuria, hypertension (140/100), peripheral edema and hemodynamic decompensation. Lung Xrays revealed pulmonary edema and a cavity in the left apex. Laboratory determinations revealed an altered renal function with increased creatinine and urea levels and nephrotic syndrome. There was leucocyturia, hematuria and cylindruria. The sputum showed a large number of acid-fast bacilli. The patient began anti-tuberculosis treatment with three drugs (isoniacid, rifampicin, pirazinamide). On ultrasonography, both kidneys revealed ecogenic lesions with size, shape and cortico-medular relationship preserved. The patient persisted with altered renal function, steady levels of urea nitrogen, creatinine and potassium, preserved diuresis and hypertension. Bidimensional echocardiogram: LVDD 55 mm, hypoquinetic septum, pericardic effusion, thickened pericardium, pleural effusion, shortening fraction decreased. He received treatment for this congestive cardiac failure and hypertension with enalapril, nifedipine and fursemide. A percutaneous renal biopsy was performed with anatomopathologic diagnosis of diffuse encocapillar proliferative glomerulonephritis with crescents (15%) and total glomerular sclerosis (33%). Immunofluorescence: positive, immune-complexes with IgM and C3. The patient gradually recovered his normal renal function, improved his pleural effusions and normalized his cardiac function. He was discharged in good clinical condition on the 69th day of anti-tuberculosis treatment. An association between pulmonary tuberculosis and glomerulonephritis is discussed. It is proposed that renal lesions might be the consequence of the tuberculosis due to the sedimentation of circulating immune-complexes.

  2. [Amyotrophic lateral sclerosis in literature, cinema and television].

    PubMed

    Collado-Vázquez, Susana; Carrillo, Jesús María

    2014-07-01

    Introduccion. La esclerosis lateral amiotrofica (ELA) es una enfermedad neurodegenerativa de curso progresivo que afecta a las motoneuronas corticoespinales y medulares, y que se manifiesta principalmente con debilidad muscular, amiotrofia e hiperreflexia. Su incidencia es de 0,4-2,4 casos/100.000 habitantes/año, y su prevalencia, de 4-6 casos/100.000 habitantes. Es mas frecuente en varones adultos mayores de 50 años. Se han mostrado diversas enfermedades neurologicas en la literatura, el cine y la television, entre ellas la ELA, que se ha presentado de forma correcta y realista. Objetivo. Analizar el abordaje que la literatura, el cine y la television han hecho de la ELA. Desarrollo. Existen diversas obras literarias que abordan la ELA, como El desencuentro, Lou Gehrig: the luckiest man o Martes con mi viejo profesor; el cine tambien ha reflejado esta enfermedad en titulos como El orgullo de los Yankees, My love beside me (closer to Heaven) o Derecho a morir; y en la television se ha mostrado esta enfermedad en series, documentales y telefilmes, como Martes con mi viejo profesor, Jenifer o Mi vida con Lou Gehrig. La mayor parte de las obras es de tipo biografico y de testimonio, y muestra la enfermedad con realismo, con la intencion de dar a conocer la ELA y de concienciar a la poblacion. Conclusion. La literatura, el cine y la television han mostrado la ELA de forma realista y creible, a diferencia de otras enfermedades de origen neurologico.

  3. [IgG4- and MPO-ANCA-associated hypertrophic pachymeningitis].

    PubMed

    Aragonès, Josep M; Arias-Rivero, Montserrat; García-Barrionuevo, Joan M; Lucchetti, Gianni

    2015-11-16

    Introduccion. La paquimeningitis hipertrofica idiopatica es una enfermedad fibroinflamatoria de la duramadre. Su diagnostico requiere la exclusion de enfermedades infecciosas, tumorales y otras enfermedades inflamatorias. En los ultimos años se han descrito nuevas entidades que pueden presentarse con paquimeningitis hipertrofica: la enfermedad relacionada con IgG4 y la paquimeningitis MPO-ANCA+ como forma de vasculitis limitada al sistema nervioso central. Caso clinico. Varon de 64 años con cefalea y cervicalgia de predominio nocturno y clinica de compresion medular. Tras el diagnostico de paquimeningitis hipertrofica craneocervical facilitado por el estudio de resonancia magnetica, se realizo un estudio etiologico. Se descartaron enfermedades infecciosas y tumorales. La clinica no mostraba afectacion sistemica y en la analitica presentaba IgG4 elevada y MPO-ANCA+. Tras tratamiento con corticoides presento una rapida mejoria de la clinica. Conclusiones. La enfermedad relacionada con IgG4 y la vasculitis asociada a MPO-ANCA limitada al sistema nervioso central pueden representar un alto porcentaje de las paquimeningitis hipertroficas que se consideraban idiopaticas, y su diagnostico requiere biopsia y estudio histologico.

  4. Public transport accessibility for wheelchair users: a perspective from macro-ergonomic design.

    PubMed

    Almada, Juan Felipe; Renner, Jacinta Sidegum

    2015-01-01

    Considering the current experience of Persons with Disabilities (PWD) seeking to join the labor market as well as improve their quality of life, full accessibility is an important tool to enable their integration into society. The primary objective of this study was to identify ergonomics and accessibility issues faced by wheelchair users and persons with mobility alterations when using public transport, from a user perspective. This was an observational, descriptive study, with a quantitative approach to data analysis and discussion. The study sample comprised 30 wheelchair-bound public transport users, and was drawn from the membership of LEME - Associação dos Lesados Medulares de Novo Hamburgo (Novo Hamburgo Spinal Injury Victims' Association). Data were collected by means of an open-ended interview, which guided questionnaire development, and direct field observations conducted during bus rides. Results indicate that the primary issues are the quality of services offered, particularly the schedule and number of accessible vehicles, and the lack of trained employees to aid wheelchair users. The paper also identifies issues related to accessibility and safety, both when accessing vehicles and during transportation.

  5. Quality of websites with patient information about spinal cord injury in Spanish.

    PubMed

    Bea-Muñoz, M; Medina-Sánchez, M; Flórez-García, M T

    2016-07-01

    Descriptive, cross-sectional analysis of websites with information on spinal cord injury (SCI) in Spanish. To assess the quality, readability and presence of quality labels on web pages with information about SCI in Spanish. The Internet. An Internet search was conducted on Google with the keywords 'lesión medular' (spinal cord injury), 'paraplejia' (paraplegia) and 'tetraplejia' (tetraplegia). The first 50 results of each search were included. The quality of websites was assessed with the LIDA tool while the readability was assessed with the Flesch-Szigriszt index and the INFLESZ scale. We also checked the presence of any quality label. After excluding duplicated and irrelevant results, 33 websites were analysed. Only four of them had a quality label. The mean score of the LIDA tool was 61.12% (medium quality), and the worst results were those referring to the reliability of the information. The readability of the web pages was somewhat difficult, with a mean of 48.22 in the Flesch-Szigriszt index. Only eight of the websites showed normal readability. We observed no differences in either the quality or the readability of the websites according to their origin or the presence of quality labels. The websites analysed present a medium quality. Mainly, they should improve the reliability of their contents and their readability, including more quality labels. For SCI information in Spanish to be understandable and to provide valuable content, websites analysed in our study need to improve the quality parameters.

  6. [Therapeutic potential of bone marrow stem cells in cerebral infarction].

    PubMed

    Sánchez-Cruz, Gilberto; Milián-Rodríguez, Lismary

    2015-05-16

    Introduccion. Las celulas madre constituyen una alternativa terapeutica que se encuentra en fase de experimentacion para el infarto cerebral. Objetivo. Mostrar la evidencia cientifica existente sobre el potencial terapeutico de las celulas madre de la medula osea en esta enfermedad. Desarrollo. El infarto cerebral representa el 80% de las enfermedades cerebrovasculares. La trombolisis constituye la unica terapia aprobada, pero, por su estrecha ventana terapeutica, solo se aplica a un bajo porcentaje de los pacientes. De manera alternativa, los tratamientos neurorrestauradores, como el de celulas madre, pueden aplicarse en periodos mas prolongados. Por esta razon se efectuo una busqueda bibliografica en PubMed con el empleo de las palabras clave 'stem cells', 'bone marrow derived mononuclear cells' y 'stroke'. Se encontraron evidencias de seguridad y eficacia de dichas celulas en diferentes momentos evolutivos del infarto cerebral. Se identificaron estudios que en clinica y preclinica las recolectaron por puncion medular y en sangre periferica, y las trasplantaron directamente en el area infartada o por via intravascular. El efecto terapeutico se relaciona con sus propiedades de plasticidad celular y liberacion de factores troficos. Conclusiones. El concentrado de celulas mononucleares autologas, obtenido en sangre periferica o por puncion de la medula osea, y trasplantado por via intravenosa, es una factible opcion metodologica que permitira rapidamente incrementar el numero de ensayos clinicos en diferentes etapas evolutivas del infarto cerebral. Esta terapia muestra seguridad y eficacia; sin embargo, deben ampliarse las evidencias que avalen su generalizacion en humanos.

  7. Behavioral coping strategies in response to social stress are associated with distinct neuroendocrine, monoaminergic and immune response profiles in mice.

    PubMed

    De Miguel, Zurine; Vegas, Oscar; Garmendia, Larraitz; Arregi, Amaia; Beitia, Garikoitz; Azpiroz, Arantza

    2011-12-01

    Individual variation in behavioral coping strategies to stress implies that animals may have a distinct physiological adaptation to stress; these differences may underlie differences in vulnerability to stress-related diseases. This study was designed to test the hypothesis that different behavioral coping strategies (active vs. passive) are stable over time and that they would be associated with differences in hypothalamic-pituitary-adrenal (HPA) and sympathetic-adreno-medular (SAM) axes, and monoaminergic and immune activity. Male mice were subjected to social stress. Twelve days after the first social interaction, mice were subjected to a second identical social stress interaction. Behavior was videotaped and assessed during both sessions. One hour after the final social interaction, serum was collected for corticosterone and adrenaline concentrations and brains were collected for hypothalamic corticotrophin-releasing hormone (CRH) mRNA expression. Monoaminergic system activity was determined by mRNA expression of serotonin, dopamine and noradrenaline synthetic enzymes in the brain stem. Immune system activity was determined by mRNA expression of hypothalamic interleukin-1β (IL-1β) and splenic IL-1β and interleukin-2 (IL-2). Mice engaging in a passive strategy had higher serum corticosterone and lower serum adrenaline concentrations than the active group. The passive group showed lower hypothalamic mRNA expression of IL-1β and CRH and lower splenic mRNA expression of IL-2 and IL-1β relative to mice in the active group. An active strategy was associated with higher expression of the dopaminergic synthetic enzyme, while a passive strategy was associated with decreased expression of the serotonergic synthetic enzyme. These findings indicate that individual coping strategies are stable over time and are related to differences in the physiological stress response and immune activity. Copyright © 2011 Elsevier B.V. All rights reserved.

  8. [Clinical effects of the transfusion of leukocytes isolated by filtration from continuous flux].

    PubMed

    Malinvaud, G; Gailiard, S; Gualde, N

    1977-09-01

    The present work studies clinical effects of leukocyte transfusions to patients with medular aplasis. Leukocytes were collected by filtration on a continuous flow, according to the technique earlier described in this review [9]. Two major points are stressed on tolerance by the patients of the injected products and clinical efficiency. Seventy eight suspensions were prepared and transfused to 30 patients in the course of 36 incidents of myeloid insufficiency. All patients but two evidenced by the time of transfusion a number of polynuclears inferior to 500 per cubic millimeter. The infection was quite serious with increased gravity despite the antibiotherapy. Intolerance was noticeable in about one third of the cases, half of which consisted only in chillis by the end or after transfusion. Only one accident consisting in acute respiration troubles and shock was observed. This however does not occur by chance. It involves sensitization which may be related to HLA system but may also be of different nature, although not clearly identified. Nevertheless is efficiency of the injected products demonstrated by recirculation of the transfused leukocytes. This was noticed within an hour following transfusion for more than 50 percent of the cases. Furthermore it lasted for 16 hours in more than one fourth of the patients. In addition following results are in favour of real clinical efficiency. Certainly in the course of 16 aplasic incidents, no improvement was observed. For most patients however transfusions were late and not renewed or the patients were highly immunized. Conversely the infection state did improve in 8 patients, the disease responsible for aplasia running its course on its own. Lastly in the course of 12 aplasic incidents, infection and acute aplasia did cure. All these observations should lead one to study with great care the immunological state of the recipient. Instructions being known, the number of transfused leukocytes should be sufficient and

  9. Hemorrhagic cytitis after bone marrow transplantation.

    PubMed

    Padilla-Fernandez, Barbara; Bastida-Bermejo, J M; Virseda-Rodriguez, A J; Labrador-Gomez, J; Caballero-Barrigon, D; Silva-Abuin, J M; San Miguel-Izquierdo, J F; Lorenzo-Gomez, M F

    2014-03-01

    Hemorrhagic cystitis (HC) presenting with gross hematuria, bladder pain and urinary frequency develops in 13-38% of patients following bone marrow transplantation (BMT). The objective of the study was to study the characteristics of patients suffering hemorrhagic cystitis after hematopoietic stem cell transplantation in our center. We conducted a retrospective chart review of all patients who underwent BMT at our institution between January 1996 and August 2012. We recorded the age, sex, diagnosis, conditioning regimen, interval between BMT and development of symptoms of cystitis and treatment instituted. Five hundred patients underwent BMT in the period of time studied. 52 of them developed hemorrhagic cystitis. The mean age of the affected patients was 39 years; there were 34 males and 18 females. The diagnoses include AML (n=11), ALL (n=8), CML (n=6), MDS (n=11), CLL (n=5), NHL (n=1), HD (n=5), MM (n=2), Medular aplasia((n=3). HC appeared 59.48 days after BMT. There were no differences between sexes. Mortality among the 52 patients was 51.14% but HC was not the cause of death in any patient. Polyomaviruses were detected in the urine of 78.94 % of survivors. Polyomavirus infection with BK and JC types is usually acquired in infancy and the virus remains latent in renal tissue. Immunosuppression facilitates reactivation of the renal infection and replication of the virus responsible for the clinical manifestations of HC. The differential diagnoses include other urinary infections, lithiasis, thrombocytopenia and adverse effects of pharmacological agents. The urologist plays a limited role in the management of this disease.

  10. Immunoexpression of Cbfa-1/Runx2 and VEGF in sinus lift procedures using bone substitutes in rabbits.

    PubMed

    De Souza Nunes, Leandro Soeiro; De Oliveira, Renato Victor; Holgado, Leandro Andrade; Nary Filho, Hugo; Ribeiro, Daniel Araki; Matsumoto, Mariza Akemi

    2010-06-01

    To analyze and compare the expression of core binding factor-1 (Cbfa-1)/Runx2 and vascular endothelium growth factor (VEGF) in sinus lift procedures using bovine hydroxyapatite (HA) and beta-tricalcium phosphate (beta-TCP). Twenty-four male rabbits that had undergone bilateral sinus lift procedures were divided into three groups, according to the sinus filling material: Group 1: autogenous bone graft; Group 2: bovine HA; and Group 3: beta-TCP. All groups were sacrificed after 7, 14, 30 and 60 days, for microscopic, histomorphometry and immunohistochemistry analysis. Microscopic analysis showed a similar bone repair pattern between the tested groups. New bone formation, soft and medular tissue, remaining material or particulate bone graft area were obtained by histomorphometric analysis. After 14 days, statistically significant differences in new bone formation were found between Group 1 (27.76+/-7.8) and Groups 2 (14.22+/-3.2) and 3 (11.1+/-7.7). After 30 days, statistically significant differences (P<0.05) were detected in bone formation between Groups 1 (31.39+/-36.5) and 2 (14.13+/-3.2). The last period showed improved bone formation in Group 2. Also, Group 2 showed higher Cbfa-1/Runx2 immunoexpression when compared with Group 3. No remarkable differences were observed in VEGF immunoexpression among groups. Taken together, both biomaterials allowed bone tissue growth in a conductive pattern and did not interfere with bone remodeling in the late period, with a slight improvement in bone tissue formation when using HA, confirmed by marked expression of Cbfa-1 at initial periods.

  11. Calcium balance in the quail (Coturnix coturnix japonica). 1, Influence of sex and diethylstilbestrol.

    PubMed

    Navarro, M P; Murillo, A

    1976-11-01

    Young adult male and laying female quail, fed with a diet containing 2.64% Ca and 0.70% P, were used to study nutritive utilization, corporal calcium retention and endogenous excretion, calcemia, laying and properties of the egg (including the shell structure), mineralization of the femur bone, as well as the influence of diethylstilbestrol upon these parameters. The coefficient of nutritive utilization (C.N.U.) in the female was high and logically superior to that of the male, while the corporal retention was quite similar for both sexes. Most of the Ca absorbed (81.8%) and not excreted in urine, went to the egg and only 18.2% remained in the body. The diethylstilbestrol caused a big reduction of the C.N.U. in the female, but not in the male, parallel to an inhibition of laying, and an increase of corporal retention of used calcium. In both sexes the calcemia surprisingly increased, and the calcium level of the femur bone was higher, and even though the cortical osseous zone was slightly wider, the effect of treatment was noticeable, particularly in the medular tissue, which incremented in the female and appeared in the male. When quail were fed a calcium-restricted diet, the endogenous excretion of this mineral was small in the case of the female and significantly smaller in the male. This situation suppressed egg laying and resulted in a clearly decreased bone mineralization. The ingestion of diethylstilbestrol before feeding a diet poor in calcium provoked an increase of the endogenous excretion of calcium in both female and male quail.

  12. Indoleamine 2, 3-dioxygenase (IDO) increases during renal fibrogenesis and its inhibition potentiates TGF-β 1-induced epithelial to mesenchymal transition.

    PubMed

    Matheus, Luiz Henrique Gomes; Simão, Gislene Mendes; Amaral, Taíssa Altieri; Brito, Rodrigo Barbosa Oliveira; Malta, Camila Soares; Matos, Yves Silva Teles; Santana, Alexandre Chagas; Rodrigues, Gabriela Gomes Cardoso; Albejante, Maria Clara; Bach, Erna Elisabeth; Dalboni, Maria Aparecida; Camacho, Cleber Pinto; Dellê, Humberto

    2017-09-06

    Indoleamine 2, 3-dioxygenase (IDO) is an immunomodulatory molecule that has been implicated in several biological processes. Although IDO has been linked with some renal diseases, its role in renal fibrosis is still unclear. Because IDO may be modulated by TGF-β1, a potent fibrogenic molecule, we hypothesized that IDO could be involved in renal fibrosis, especially acting in the TGF-β1-induced tubular epithelial-mesenchymal transition (EMT). We analyzed the IDO expression and activity in a model of renal fibrogenesis, and the effect of the IDO inhibitor 1-methyl-tryptophan (MT) on TGF-β1-induced EMT using tubular cell culture. Male Wistar rats where submited to 7 days of UUO. Non-obstructed kidneys (CL) and kidneys from SHAM rats were used as controls. Masson's Tricrome and macrophages counting were used to chatacterize the tissue fibrosis. The EMT was analysed though immunohistochemistry and qRT-PCR. Immunohistochemestry in tissue has used to show IDO expression. MDCK cells were incubated with TGF- β1 to analyse IDO expression. Additionally, effects of TGF- β1 and the inhibition of IDO over the EMT process was acessed by immunoessays and scrath wound essay. IDO was markedly expressed in cortical and medular tubules of the UUO kidneys. Similarly to the immunolocalizaton of TGF- β1, accompanied by loss of e-cadherin expression and an increase of mesenchymal markers. Results in vitro with MDCK cells, showed that IDO was increased after stimulus with TGF-β1, and treatment with MT potentiated its expression. MDCK stimulated with TGF-β1 had higher migratory activity (scratch-wound assay), which was exacerbated by MT treatment. IDO is constitutively expressed in tubular cells and increases during renal fibrogenesis. Although IDO is induced by TGF-β1 in tubular cells, its chemical inhibitor acts as a profibrotic agent.

  13. Spondylotic myelopathy mimicking myelitis: diagnostic clues by magnetic resonance imaging.

    PubMed

    Rua, Adriana; Blanco, Yolanda; Sepúlveda, María; Sola-Valls, Núria; Martínez-Hernández, Eugenia; Llufriu, Sara; Berenguer, Joan; Graus, Francesc; Saiz, Albert

    2015-12-01

    Introduccion. La mielopatia espondilotica es la causa mas frecuente de mielopatia no traumatica. Sus caracteristicas radiologicas en ocasiones son indistinguibles de las de una mielopatia inflamatoria, y pueden ocasionar retrasos diagnosticos o llevar a un diagnostico y tratamiento incorrectos. La descripcion reciente de un patron caracteristico de realce de gadolinio puede ayudar a diferenciar la mielopatia espondilotica de la causa inflamatoria. Casos clinicos. Caso 1: varon de 38 años que consulto por historia de dos años de evolucion de parestesias en las extremidades superiores, a las que se añadieron un año mas tarde calambres en las extremidades derechas y acorchamiento en los dermatomas C5 y C6 en relacion con los movimientos del cuello. Caso 2: varon de 44 años que consulto por historia de un año de evolucion de alteracion progresiva de la marcha con trastorno sensitivo en las manos y disfuncion vesical reciente. En ambos casos, la resonancia magnetica medular mostro en las secciones sagitales una hiperseñal cervical fusiforme en T2, asociada a una banda transversa de realce de gadolinio en forma de barra (pancakelike) justo por debajo de la zona de maxima estenosis, y un realce circunferencial o hemimedular en los cortes axiales. Conclusiones. Las caracteristicas radiologicas de la mielopatia espondilotica pueden parecerse a las de origen inflamatorio. El reconocimiento de un realce transverso en barra inmediatamente por debajo del lugar de maxima compresion como signo radiologico tipico de la mielopatia espondilotica es importante para reducir el riesgo de errores diagnosticos, y de utilidad para el manejo de estos pacientes.

  14. Epidemiology of traumatic spinal cord injury in Galicia, Spain: trends over a 20-year period.

    PubMed

    Montoto-Marqués, A; Ferreiro-Velasco, M E; Salvador-de la Barrera, S; Balboa-Barreiro, V; Rodriguez-Sotillo, A; Meijide-Failde, R

    2017-06-01

    Observational study with prospective and retrospective monitoring. To describe the epidemiological and demographic characteristics of traumatic spinal cord injury (TSCI), and to analyze its epidemiological changes. Unidad de Lesionados Medulares, Complejo Hospitalario Universitario A Coruña, in Galicia (Spain). The study included patients with TSCI who had been hospitalized between January 1995 and December 2014. Relevant data were extracted from the admissions registry and electronic health record. A total of 1195 patients with TSCI were admitted over the specified period of time; 76.4% male and 23.6% female. Mean patient age at injury was 50.20 years. Causes of injury were falls (54.2%), traffic accidents (37%), sports/leisure-related accidents (3.5%) and other traumatic causes (5.3%). Mean patient age increased significantly over time (from 46.40 to 56.54 years), and the number of cases of TSCI related to traffic accidents decreased (from 44.5% to 23.7%), whereas those linked to falls increased (from 46.9% to 65.6%). The most commonly affected neurological level was the cervical level (54.9%), increasing in the case of levels C1-C4 over time, and the most frequent ASIA (American Spinal Injury Association) grade was A (44.3%). The crude annual incidence rate was 2.17/100 000 inhabitants, decreasing significantly over time at an annual percentage rate change of -1.4%. The incidence rate of TSCI tends to decline progressively. Mean patient age has increased over time and cervical levels C1-C4 are currently the most commonly affected ones. These epidemiological changes will eventually result in adjustments in the standard model of care for TSCI.

  15. [Myxoid liposarcoma of the lumbosacral spine. Clinical case report].

    PubMed

    Granados-López, Sandy Lucero; Tavares-García, Juana Sonia; Pérez-Contreras, Alberto

    2013-01-01

    Introducción: el liposarcoma es un tumor maligno de tejidos blandos que constituye el grupo más numeroso de sarcomas en el adulto. La variante mixoide representa 30 a 35 % de todos los liposarcomas. Comúnmente se observa en los muslos. En la literatura se han informado solo dos pacientes con liposarcoma en la columna vertebral. Caso clínico: mujer de 28 años de edad con síntomas de compresión medular (marcha claudicante, fuerza en la extremidad derecha 4/5, disminución de la sensibilidad). La imagen por resonancia magnética confirmó una masa paravertebral derecha que se extendía desde L4 hasta S2, multinodular, sólido quística, que seguía el trayecto de los forámenes de conjunción de S1 y S2 hacia el espacio presacro, con señales hipointensas en T1 e hiperintensas en T2. Con los estudios radiológicos se concluyó que presentaba un neurofibroma. Se realizó resección extra e intrarraquídea, de la que se extrajo un tumor. El estudio histopatológico definitivo indicó que se trataba de un liposarcoma mixoide. Conclusiones: la columna vertebral es una localización poco frecuente para esta neoplasia, así como para sus metástasis. Es difícil lograr una resección completa en este sitio, por lo que la tasa de recurrencia es alta.

  16. [Clinico-radiological profile of acute disseminated encephalomyelitis in the childhood population. A retrospective analysis of a series of 20 patients in a tertiary hospital].

    PubMed

    Tomás-Vila, Miguel; Menor, Francisco; Otero-Reigada, M Carmen; Pérez-Tamarit, Amparo; Téllez de Meneses, Montserrat; Pitarch-Castellanos, Inmaculada

    2014-01-01

    Introduccion. La encefalomielitis aguda diseminada (EAD) es un trastorno inflamatorio del sistema nervioso central mediado inmunologicamente y de patogenia desconocida. Puede presentarse en cualquier edad, pero es mucho mas frecuente en niños. La EAD no tiene marcador biologico especifico y el diagnostico se basa en hallazgos clinicos y neurorradiologicos. Objetivo. Mejorar el conocimiento del perfil clinicorradiologico de esta enfermedad. Pacientes y metodos. Estudio retrospectivo con inclusion de pacientes menores de 14 años ingresados en un hospital terciario en los ultimos 15 años con el diagnostico de EAD. Se revisaron antecedentes, signos clinicos de presentacion, datos analiticos en sangre/liquido cefalorraquideo y la semiologia radiologica. En 16 casos se realizo un seguimiento medio de 25 meses. Resultados. Se revisaron 20 pacientes, un 70% niños, con una edad media de 4,4 años. El 40% tuvo un episodio febril previo. El 85% presento fiebre o vomitos, y el 70%, afectacion del estado de consciencia. Predominaron los deficits motores (45%), las convulsiones (35%) y la afectacion de pares craneales (30%). Tres niños presentaron una evolucion recidivante, y otros tres, secuelas motoras. Los estudios de resonancia magnetica mostraron lesiones hiperintensas en secuencias T2, con patron de realce escaso o nulo, que predominaron en los talamos (70%), la medula (67%) y la sustancia blanca subcortical (50%). En dos pacientes se diagnostico EAD hemorragica. Conclusiones. La EAD representa una entidad con importante afectacion general y repercusion neurologica, que muestra un potencial secuelar considerable. Los datos clinicoanaliticos y la resonancia magnetica cerebral y medular son relevantes para el diagnostico inicial y seguimiento de pacientes con EAD.

  17. [Arnold-Chiari malformation in Noonan syndrome and other syndromes of the RAS/MAPK pathway].

    PubMed

    Ejarque, Ismael; Millán-Salvador, José M; Oltra, Silvestre; Pesudo-Martínez, José V; Beneyto, Magdalena; Pérez-Aytés, Antonio

    2015-05-01

    Introduccion. El sindrome de Noonan (SN) y otros sindromes con fenotipo similar, como LEOPARD, cardiofaciocutaneo, Costello y Legius, estan asociados a mutaciones en genes incluidos en la via RAS/MAPK (rasopatias), una importante via de señalizacion relacionada con la proliferacion celular. El descenso de las amigdalas cerebelares dentro del canal medular cervical, conocido como malformacion de Arnold-Chiari (MAC), se ha descrito en pacientes afectos de SN, lo que ha llevado a sugerir que la MAC podria formar parte del espectro fenotipico del SN. Presentamos dos casos con SN y MAC. Casos clinicos. Caso 1: mujer de 29 años con fenotipo de Noonan. Fue intervenida a los 9 años de estenosis valvular pulmonar. A los 27 años, presento MAC sintomatica que preciso descompresion quirurgica. Presentaba mutacion c.922A>G (N308D) en el gen PTPN perteneciente a la via RAS/MAPK. Caso 2: niña de 10 años con fenotipo de Noonan y MAC asintomatica detectada en resonancia magnetica cerebral. Era portadora de la mutacion c.923A>G (N308S) en el gen PTPN11. Conclusiones. Hemos encontrado en la bibliografia seis pacientes con esta asociacion, cuatro con fenotipo Noonan y dos con LEOPARD. Nuestros dos pacientes aportan evidencia suplementaria a la hipotesis de que la MAC formaria parte del espectro fenotipico del SN. El escaso numero de pacientes publicados con esta asociacion no permite extraer recomendaciones sobre el momento y la frecuencia de estudio de neuroimagen; no obstante, una exploracion neurologica cuidadosa deberia incluirse en la guia anticipatoria de salud en los sindromes de la via RAS/MAPK.

  18. [Quality of life from the viewpoint of patients with spinal cord lesions].

    PubMed

    Loureiro, S C; Mancussi e Faro, A C; Chaves, E C

    1997-12-01

    Before the existence is negotiating of individuals that present lesion medular, we came across the problem involved in the daily of those people after a situation of sudden and unexpected trauma. With the intention of rendering effective cares to these people worried, in this study, in identifying the situation for the which they are passing, there were been changes and which were them, so much in psychic level as physicist and social. For so much, he/she/it opted for the accomplishment of a semi-structured individual interview, being used the resource of the recording, the instrument of collection of data consists of identification data and data regarding the interviewee's life. The speech free with recording and posterior transcription characterizes a study of case of nature, above all, exploratory. The obtained data received a thematic analysis using conceptions about life quality according to FORATTINI (1991). In this study they were identified a physical deficiency and a series of inabilities. The deambulação is the first loss noticed by the patient after the lesion and its first subject to the professional closer of him, it is that settles down a communication channel that allows this expression. But we should remember the possible process of rehabilitation that doesn't approach only the search for the locomoção, permeating the re-learning in this new life situation. We verified modifications in all the spheres (physics, social, psychological), and the most affected. according to the picked data, went the psychological and to social due to the physical alterations. The main loss sensation refers to the social paper, and this is characterized, mainly, for the impossibility of coming back to the work. The changes in the solemnity-image conceptions and self-esteem were also identified, in smaller degree, for the sensation of inability. The more important and comprehensibly told physical loss refers the sensibility loss and motive capacity of the members.

  19. [Mixed knee arthrodesis a rescue alternative in knee periprosthetic joint infection].

    PubMed

    López-Cervantes, Roberto Enrique; Rivera-Villa, Adrián Huematzin; Miguel-Pérez, Adrián; Morales-de Los Santos, René; Torres-González, Rubén; Pérez-Atanasio, José Manuel

    2016-01-01

    Introducción: la artrodesis es una cirugía de salvamento para la infección periprotésica de rodilla; este procedimiento reporta moderada efectividad, alto índice de complicaciones y es la última alternativa antes de la amputación. El objetivo de este estudio fue identificar si la artrodesis de rodilla con clavo expandible y fijador externo es un tratamiento seguro y efectivo. Métodos: estudio observacional, retrospectivo, en 17 pacientes con infección periprotésica y pérdida ósea importante, tratados mediante artrodesis con clavo centro-medular expandible autobloqueante y fijador externo monoplanar con evolución mínima de 1 año; la información se obtuvo del expediente clínico e imágenes de rayos X, siendo estas evaluadas por 2 ortopedistas especializados en rescate osteoarticular. Resultados: de 17 pacientes, con una pérdida ósea grado III en un 88.2% de los casos, se obtuvo una fusión en el 82.5%. Logrando la deambulación independiente en el 88.2%. Con un promedio de 2.4 intervenciones quirúrgicas por paciente. Sin complicaciones transquirúrgicas reportadas. Con un índice de complicaciones global del 47.1% incluyendo una amputación por sepsis. La evaluación inter-observador tuvo un valor de Kappa del 0.90 y la muestra alcanzó un poder estadístico del 60%. Conclusiones: se obtuvo una consolidación similar a otros métodos, en un tiempo promedio de 6.3 meses, con un menor índice de complicaciones al reportado con otras técnicas. Siendo esta una alternativa de salvamento para la realización de artrodesis de rodilla, antes de considerar la amputación de la extremidad.

  20. Quality of life of patients using intermittent urinary catheterization.

    PubMed

    Fumincelli, Laís; Mazzo, Alessandra; Martins, José Carlos Amado; Henriques, Fernando Manuel Dias; Orlandin, Leonardo

    2017-07-10

    ária neurogênica, e usuários do cateterismo urinário intermitente. na amostra de pacientes brasileiros (n = 170) e portugueses (n = 52), respectivamente, a maioria era solteira (87-51,2%; 25-48,1%), com ensino fundamental (47-45,3%; 31-59,6%), aposentada (70-41,2%; 21-40,4%). A lesão medular foi a principal causa do uso do cateter urinário nos dois países. Os pacientes brasileiros apresentaram média de escores mais elevados de qualidade de vida no domínio psicológico (68,9) e menos elevados no domínio físico (58,9). Os pacientes portugueses apresentaram escores mais elevados no domínio psicológico (68,4) e menos no domínio ambiente (59,4). A realização do autocateterismo urinário intermitente foi significativa para os dois países. nos dois países, a qualidade de vida desses pacientes pode ser determinada pela melhora dos sintomas urinários, da independência, autoconfiança, relações sociais e acesso a atividades laborais. mensurar y comparar la calidad de vida de pacientes con vejiga neurogénica en uso de cateterismo vesical intermitente durante el proceso de rehabilitación en Brasil y en Portugal. estudio multicéntrico, Brasil y Portugal, cuantitativo, trasversal, observacional-analítico y correlacional. Fueron utilizados dos instrumentos de recolecta, un cuestionario de datos sociodemográficos y clínicos y el World Health Organization Quality Life-bref. Fueron inclusos pacientes mayores de 18 años, con vejiga urinaria neurogénica, y usuarios de cateterismo vesical intermitente. en la muestra de pacientes brasileños (n = 170) y portugueses (n = 52), respectivamente, la mayoría era soltera (87-51,2%; 25-48,1%), con educación fundamental (47-45,3%; 31-59,6%), jubilada (70-41,2%; 21-40,4%). La lesión medular fue la principal causa del uso del catéter urinario en los dos países. En promedio, los pacientes brasileños presentaron scores de calidad de vida superiores en el dominio psicológico (68,9) e inferiores en el dominio físico (58

  1. Pediatric Multiple Sclerosis in Portugal: A Multicentre Study.

    PubMed

    Correia, Ana Sofia; Augusto, Luís; Meireles, Joana; Pinto, Joana; Sousa, Ana Paula

    2016-08-01

    Introdução: A esclerose múltipla é habitualmente diagnosticada em adultos jovens mas, mais raramente, pode manifestar-se durante a infância ou adolescência. Os dados sobre a esclerose múltipla pediátrica em Portugal são escassos. O objectivo principal deste estudo é a avaliação das características demográficas, clínicas, laboratoriais e neurorradiológicas da esclerose múltipla de início em idade pediátrica em Portugal. Os objetivos secundários consistem na comparação entre a esclerose múltipla de início na infância e a esclerose múltipla de início na adolescência e na caracterização dos tratamentos prescritos. Material e Métodos: Realizou-se um estudo retrospectivo, observacional e multicêntrico, que consistiu na análise dos dados de todos os doentes com apresentação da EM antes dos 18 anos. Resultados: Incluíram-se 46 doentes (72% do sexo feminino), com uma idade média de diagnóstico de 16,1 anos. Seis casos tiveram início na infância, 40 na adolescência. A esclerose múltipla apresentou-se em 98% dos casos com a forma surto-remissão. O estudo do líquor revelou bandas oligoclonais em 74% dos doentes. A ressonância magnética encefálica mostrou predominantemente lesões supratentoriais (98% dos casos), enquanto que a ressonância medular revelou que o segmento cervical foi o mais frequentemente afectado. Todos os doentes iniciaram terapêutica imunomoduladora (75% com interferão β). Relativamente às diferenças entre os dois grupos etários, encontrámos uma maior proporção de doentes do sexo masculino e com pleocitose no grupo com apresentação na infância. Discussão: Este trabalho fornece novos dados sobre as características da esclerose múltipla pediátrica em Portugal e os resultados são semelhantes aos reportados em outras partes do mundo. Conclusão: Este é o primeiro estudo multicêntrico português sobre a esclerose múltipla com apresentação na infância e adolescência. Mais estudos são necess

  2. [Serum Erythropoietin as Prognostic Marker in Myelodysplastic Syndromes].

    PubMed

    Cortesão, Emília; Tenreiro, Rita; Ramos, Sofia; Pereira, Marta; César, Paula; Carda, José P; Gomes, Marília; Rito, Luís; Magalhães, Emília; Gonçalves, Ana C; Silva, Nuno C E; Geraldes, Catarina; Pereira, Amélia; Ribeiro, Letícia; Nascimento Costa, José M; Ribeiro, Ana B Sarmento

    2015-01-01

    Introdução: A síndrome mielodisplásica é uma doença heterogénea caracterizada por displasia, medula hipercelular, citopenias e risco de evolução para leucemia aguda. Outros factores de prognóstico, nomeadamente, fibrose medular, elevação da enzima desidrogenase do lactato e 2-microglobulina têm sido descritos, contudo, a decisão terapêutica baseia-se no score do International Prognostic Scoring System. Material e Métodos: Este trabalho teve como objectivo analisar a relevãncia da eritropoietina sérica ao diagnóstico, em doentes com síndrome mielodisplásica de novo, avaliando o seu impacto na sobrevivência global e a sua implementação como factor de prognóstico. Recolhemos dados clínicos e laboratoriais de 102 doentes com síndrome mielodisplásica de novo diagnosticada entre outubro/2009 e março/2014. A análise de sobrevivência foi efectuada recorrendo à metodologia de Kaplan-Meier, de acordo com os valores de eritropoietina. Resultados: A amostra, de 102 doentes, apresenta uma mediana de idades de 74 anos e relação masculino/feminino igual a 0,8. Os doentes com o subtipo citopenia refratária com displasia unilinha apresentam, em média, valores de eritropoietina significativamente mais baixos, em oposição aos doentes com o subtipo 5q- que apresentam a média de eritropoietina sérica mais elevada (p < 0,05). Onze doentes evoluíram para leucemia aguda; estes têm, em média, eritropoietina sérica superior (p < 0,05). Adicionalmente, a eritropoietina sérica acima do limite superior da normalidade associa-se a menor sobrevivência (p = 0,0336). Após ajuste do modelo de regressão de Cox, o valor preditivo da eritropoietina para a sobrevivência global manteve-se (p < 0,001). Em análise multivariada, a eritropoietina sérica demonstrou ser um factor de prognóstico independente (p < 0,001). Discussão: A eritropoietina sérica é um factor preditivo de resposta à terapêutica com eritropoietina subcut'nea, sendo que os doentes

  3. Extracellular adenosine 5'-triphosphate concentrations changes in rat spinal cord associated with the activation of urinary bladder afferents. A microdialysis study.

    PubMed

    Rocha, Jeová Nina

    2016-01-01

    ções extracelulares do 5'-trifosfato de adenosina no interstício dos segmentos medulares L6-S1, em condições basais ou durante a ativação mecânica e química das fibras aferentes vesicais. Um cateter de microdiálise foi implantado no sentido transversal na parte dorsal da medula espinal, entre os segmentos L6-S1 de ratas. O microdialisado foi coletado em intervalos de 15 minutos, durante 135 minutos, com os animais anestesiados. A concentração de 5'-trifosfato de adenosina nas amostras foi determinada mediante ensaio de bioluminescência. Em um grupo de animais (n=7), as amostras de microdialisado foram obtidas com a bexiga vazia, com distensão da bexiga para volume de 20 ou 40cmH2O, com solução salina, solução salina com ácido acético, ou solução salina com capsaicina. Em outro grupo (n=6), foi realizada com a bexiga distendida, e a solução para microdiálise continha o inibidor de ectonucleotidase ARL 67156. Os níveis extracelulares de trifosfato de adenosina no início do estudo foram 110,9±35,36fmol/15 minutos (média±EPM, n=13), e a distensão da bexiga causou um aumento nos níveis de 5'-trifosfato de adenosina, o que não foi observado após a distensão da bexiga com solução salina contendo capsaicina (10µM). A microdiálise com solução contendo ARL 67156 (1mM) foi associada com significante aumento dos níveis de trifosfato de adenosina extracelular, e nenhum aumento do trifosfato de adenosina foi observado durante a distensão da bexiga. O 5'-trifosfato de adenosina está presente no interstício do segmento L6-S1 da medula espinal, é degradado por ectonucleotidases, e sua concentração aumentou com a ativação das fibras aferentes mecanossensíveis da bexiga, mas não das quimiossensíveis. O 5'-trifosfato de adenosina pode ter sido liberado das terminações centrais dos neurônios aferentes primários mecanossensíveis ou, mais provavelmente, de neurônios espinais intrínsecos, ou ainda de células gliais. Sua liberação parece ser

  4. Age-related changes in bone architecture.

    PubMed

    Giordano, Vincenzo; Franco, José Sérgio; Koch, Hilton Augusto; Labronici, Pedro José; Pires, Robinson Esteves S; Amaral, Ney Pecegueiro DO

    2016-01-01

    morfométricas de biópsias ósseas da região anterior da crista ilíaca de pacientes de diferentes faixas etárias. foram estudadas 30 amostras de osso da crista ilíaca, utilizando-se microscopia óptica de campo claro. As amostras foram divididas pela faixa etária dos doadores em três grupos: Grupo 1 (n = 10), indivíduos com idade entre 25 e 39 anos; Grupo 2 (n = 10), indivíduos com idade entre 40 e 64 anos; Grupo 3 (n = 10), indivíduos com idade igual ou superior a 65 anos. As amostras foram separadas aleatoriamente em dois conjuntos com 15 peças. No primeiro segmento do estudo (n = 15), foi avaliada histologicamente a propriedade osteogênica do enxerto, através da análise da reserva celular no periósteo, do número de osteócitos nas lacunas e da quantidade de canais de Havers e de Volkmann. No segundo segmento do estudo (n = 15), investigou-se morfologicamente a propriedade osteocondutora do enxerto, através da quantificação da rede trabecular (Vv) e da área trabecular (Sv). histologicamente, observou-se que ocorre degeneração do tecido ósseo com a idade, caracterizada pelo adelgaçamento do periósteo, com substituição gradual da camada osteogênica por tecido fibroso, pequena quantidade de canais de Havers e de Volkmann, osteoplastos vazios e trabéculas finas de osso esponjoso, permitindo amplo espaço medular, em geral ocupado por células lipídicas e adipócitos. Morfologicamente, com relação à quantificação da rede trabecular (Vv), foi observada diferença estatisticamente significante entre os Grupos 1 e 3 e entre os Grupos 2 e 3, com redução da rede trabecular de cerca de 45% no idoso acima de 65 anos de idade; não foi observada diferença estatisticamente significante entre os Grupos 1 e 2. Não foi observada diferença estatística entre os grupos quanto à Sv. os achados do presente experimento sugerem que nos indivíduos idosos (acima de 65 anos de idade), a propriedade osteogênica do enxerto ósseo autólogo diminui e a