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Sample records for otite externa aguda

  1. [Bacteriology and mycology of otitis externa in dogs].

    PubMed

    Bornand, V

    1992-01-01

    The bacterial and fungal flora of 1118 ears of dogs with otitis externa and 100 ears of healthy control dogs were studied in order to isolate the causative agents. The yeast Malassezia pachydermatis (56%) was by far the most common organism in otitic dogs followed by the bacteria Staphylococcus intermedius (23%), Pseudomonas aeruginosa (12%), Proteus spp. (6%) and Streptococcus canis (5%). A statistical analysis of observed results showed that the incidence of these organisms is significant in otitic dogs. Many strains of S.intermedius, P.aeruginosa and Proteus spp. are resistant to antimicrobial agents commonly used to treat otitis externa. Therefore an antimicrobial susceptibility testing was performed using "Cobas Bact" for these bacterias. Furthermore, 80 strains of M.pachydermatis were submitted to identification-kits (API 20 CAUX, API STAPH, Cobas Micro). The observed results showed that an identification with these tests was not possible.

  2. Otite externe maligne à Candida Albicans

    PubMed Central

    Elayoubi, Fahd; Lachkar, Azeddine; Aabach, Ahmed; Chouai, Mohamed; Ghailan, Mohamed Rachid

    2016-01-01

    L’otite externe maligne est une ostéomyélite de la base du crane. Le Pseudomonas aeruginosa est le germe le plus incriminé. Cependant l’origine fongique n’est pas rare. Patiente âgée de 80 ans avait présenté une otalgie gauche persistante depuis deux mois malgré un traitement bien conduit. L’examen otologique mettait en évidence des signes inflammatoires au niveau du pavillon, une sténose du conduit avec des granulomes, et otorrhée d’allure purulente. Le scanner montrait un comblement otomastoïdien, un processus inflammatoire extensif des tissus pré et rétro-auriculaire et une lyse du tympanal. Vu l’absence d’amélioration un examen mycologique a été réalisé et qui a révélé la présence de Candida Albicans. Les cas d’otite externe maligne à Candida Albicans sont rarement rapportés. L’origine fongique doit être suspecté devant la négativité des prélèvements bactériologiques et la non amélioration malgré un traitement antibiotique bien conduit, et confirmée par des prélèvements mycologiques parfois multiples. L’otite externe maligne à Candida Albicans est une infection rare potentiellement mortelle. PMID:28154677

  3. Two peculiar new species of Otites Latreille 1804 (Diptera: Ulidiidae) with reduced phallus.

    PubMed

    Morgulis, Elizabeth

    2015-04-29

    Two new closely related species of the genus Otites are described and illustrated: O. freidbergi n. sp. from Israel, and O. friedmani n. sp. from Cyprus. The two species exhibit unusual male terminalia for Otites and other Otitini. Laboratory behavioral observations on live O. freidbergi individuals showed unusually long copulation duration compared to other examined Otitini species.

  4. Aspects epidemiologiques, cliniques et therapeutiques des otites externes: à propos de 801 cas

    PubMed Central

    Bathokedeou, Amana; Essobozou, Pegbessou; Akouda, Patassi; Essohanam, Boko; Eyawelohn, Kpémissi

    2014-01-01

    L'objectif de ce travail etait de déterminer l’épidémiologie, la clinique et la thérapeutique des otites externes (OE). Il s'agissait d'une étude rétrospective d'une année menée du 1er janvier au 31 décembre 2006 dans le service ORL du CHU-Tokoin. Huit cent un cas d'otite externe (OE) soit 11,9% des consultations étaient recensés. Le sexe féminin représentait 476 cas (59,42%). Le sex ratio était de 0,68. L’âge moyen des patients était de 25,4 ans avec des extrêmes de 05 mois et 81 ans. La tranche d’âge de 0-15 ans était la plus fréquente avec 360 cas (45%). L'allergie dans 74 cas (60,66%), la lésion de grattage dans 24 cas (19,67%), les corps étrangers du conduit auditif externe dans 18 cas (14,75%) et la natation dans 6 cas (4,92%) étaient les facteurs favorisants. L'otalgie dans 638 cas (79,65%) était le symptôme le plus fréquent. Les différentes formes cliniques des otites externes se répartissaient comme suit: otite externe diffuse dans 612 cas (76,40%), furoncle du CAE 126 dans cas (15,73%), otomycose dans 58 cas (7,24%), zona du conduit auditif externe dans 3 cas (0,37%) et otite externe nécrosante dans 2 cas (0,25%). Les gouttes auriculaires étaient administrées à tous les patients. L’évolution avait noté 799 patients (99,75%) guéris sans complication, un cas de décès et un cas de guérison avec séquelle. Traitée correctement, l'otite externe guérit sans complication. Son éviction passe par une sensibilisation des populations sur l'entretien du conduit auditif externe. PMID:25379111

  5. MANAGEMENT OF OTITIC HYDROCEPHALUS—With Particular Attention to the Effect of Antibiotics

    PubMed Central

    Barnes, LeRoy J.

    1956-01-01

    Otitic hydrocephalus as a complication of otitis media is probably not so rare as is generally assumed. The onset is insidious and first symptoms are vague. Even after signs of elevated cerebrospinal fluid pressure appear, differential diagnosis remains a difficult problem. On the basis of what is known of the pathologic features and clinical course of otitic hydrocephalus a plan for the prevention and management of this complication is suggested. In children and adolescents with a history of recurrent otitis media and other conditions likely to produce hydrocephalic disturbances, new episodes of otitis media must be treated along classical lines, notwithstanding supplementary use of antibiotics. After recovery, extended follow-up observation is required, which should include repeated ophthalmoscopic examinations. A finding of changes in the eyegrounds calls for neurologic evaluation. Energetic treatment, particularly daily spinal taps, may prevent ultimate blindness. PMID:13304693

  6. [Otitis externa and cerumen obturans].

    PubMed

    Pieren, C

    1995-11-01

    Otitis externa and cerumen obturans are two of the most frequently encountered disturbances in the external auditory canal. Both conditions can lead to hearing loss due to reduced sound transmission. Other symptoms include ear pressure, pain and secretion. Acute otitis externa occurs frequently during the swimming season. The main symptoms are local pain and secretion. Treatment consists of careful and frequent cleaning and application of topical medication to the outer ear canal and prescription of medication against pain. Systemic antibiotics are only rarely necessary and are indicated if perichondritis or lymphadenitis are present. Chronic otitis externa is often caused by eczema of the outer ear canal. Allergies, systemic diseases, such as diabetes mellitus, and manipulation by the patient must be ruled out. Therapy includes the application of topical steroid solutions. The natural pH of the skin can be reestablished by use of diluted acetic acid solutions. Blockage of the outer ear canal by cerumen [cerumen obturans] can bring the patient to the office because of sudden hearing loss. After cleaning of the ear canal, a screening hearing test should be performed to assure that the problem has been resolved.

  7. Otitis externa: management of the recalcitrant case.

    PubMed

    Selesnick, S H

    1994-05-01

    Most cases of otitis externa respond to routine treatment, however, there is a subset of patients who frequently develop otitis externa that is usually severe and recalcitrant to routine therapy. These patients include the immunocompromised, those with AIDS, transplant recipients, severe diabetics, patients treated with high dose steroids or chemotherapeutic agents, and those who are malnourished or are chronically ill. Local factors that lead to worsening of otitis externa include dermatitides and prior local irradiation. Patients who find topical therapy painful may be noncompliant with medications, and they too, may develop recalcitrant otitis externa. For successful treatment, a broad understanding of external auditory canal anatomy, the microbiology and pathophysiology of otitis externa, and available treatment options, including topical and systemic medications, must be attained. These topics are reviewed.

  8. Acute otitis externa in children

    PubMed Central

    McWilliams, Colin J.; Smith, Christine H.; Goldman, Ran D.

    2012-01-01

    Abstract Question In the summer months I see many children with uncomplicated acute otitis externa (AOE). I am aware of the multiple ototopical preparations. Which is the best first-line agent to treat AOE, and is there a role for an oral antibiotic? Answer There are no specific Canadian guidelines for the management of AOE. However, current American guidelines promote initial ototopical therapy without systemic antibiotics for uncomplicated AOE; suggest there is little difference between the various ototopical preparations; and recommend the choice of treatment be based on the specific clinical situation. In practice, this often results in prescribing an antibiotic-steroid formulation for 7 to 10 days. This ototopical treatment option is supported by a recent Cochrane review that has documented the superiority of an antibiotic-steroid combination when compared with placebo or acetic acid in providing clinical resolution of AOE. PMID:23152458

  9. L'otite moyenne chronique cholestéatomateuse de l'enfant: à propos de 30 cas

    PubMed Central

    Touati, Mohamed Mliha; Darouassi, Youssef; Chihani, Mehdi; Bouaity, Brahim; Ammar, Haddou

    2015-01-01

    Le cholstéatome de l'oreille moyenne est une otite chronique qualifiée de dangereuse en raison de ses risques évolutifs et de ses complications potentiellement graves pouvant mettre en jeu le pronostic vital. L’évolution du cholestèatome est sensiblement différente entre l'adulte et l'enfant, avec une agressivité particulière des cholestèatomes pédiatriques nécessitant ainsi une prise en charge adéquate. Le but de notre travail est d'analyser à travers une revue bibliographique les particularités des otites moyennes chroniques cholestèatomateuses chez 30 enfants pris en charge dans le service d'oto-rhino-laryngologie de l'hôpital militaire Avicenne de Marrakech. Le traitement est exclusivement chirurgical, actuellement, la plupart des auteurs optent pour l'utilisation d'une technique fermée en première intention chez l'enfant PMID:26401218

  10. Disentangling the effects of mating systems and mutation rates on cytoplamic diversity in gynodioecious Silene nutans and dioecious Silene otites

    PubMed Central

    Lahiani, E; Dufaÿ, M; Castric, V; Le Cadre, S; Charlesworth, D; Van Rossum, F; Touzet, P

    2013-01-01

    Many flowering plant species exhibit a variety of distinct sexual morphs, the two most common cases being the co-occurrence of females and males (dioecy) or the co-occurrence of hermaphrodites and females (gynodioecy). In this study, we compared DNA sequence variability of the three genomes (nuclear, mitochondrial and chloroplastic) of a gynodioecious species, Silene nutans, with that of a closely related dioecious species, Silene otites. In the light of theoretical models, we expect cytoplasmic diversity to differ between the two species due to the selective dynamics that acts on cytoplasmic genomes in gynodioecious species: under an epidemic scenario, the gynodioecious species is expected to exhibit lower cytoplasmic diversity than the dioecious species, while the opposite is expected in the case of balancing selection maintaining sterility cytoplasms in the gynodioecious species. We found no difference between the species for nuclear gene diversity, but, for the cytoplasmic loci, the gynodioecious S. nutans had more haplotypes, and higher nucleotide diversity, than the dioecious relative, S. otites, even though the latter has a relatively high rate of mitochondrial synonymous substitutions, and therefore presumably a higher mutation rate. Therefore, as the mitochondrial mutation rate cannot account for the higher cytoplasmic diversity found in S. nutans, our findings support the hypothesis that gynodioecy in S. nutans has been maintained by balancing selection rather than by epidemic-like dynamics. PMID:23591518

  11. Rearing Chrysoperla externa Larvae on Artificial Diets.

    PubMed

    Bezerra, C E S; Amaral, B B; Souza, B

    2017-02-01

    We tested three artificial diets for rearing larvae of Chrysoperla externa (Hagen) (Neuroptera: Chrysopidae), aiming at reducing the production costs of this predator. Two of the diets come from studies with other species of lacewings, and the third is a modification described in this paper. All diets were based on animal protein and were supplied to 2nd and 3rd instar larvae, whereas 1st instar larvae received eggs of Anagasta kuehniella (Zeller) (Lepidoptera: Pyralidae). We evaluated the preimaginal duration and survival, adult size, longevity and fecundity, egg hatchability, and predatory capacity of larvae produced. The performance of the diets was followed for seven generations. The diet we describe showed to be the best among the artificial diets tested. Our results show that C. externa can be successfully reared on artificial diets during second and third instars, reducing in 90% the dependency on eggs of A. kuehniella.

  12. Mastoiditis mimicry: retro-auricular cellulitis related to otitis externa.

    PubMed

    Block, Stan L

    2014-09-01

    Retro-auricular cellulitis associated with otitis externa is now the great mimicker of mastoiditis. It may be the most common cause of this specific cellulitis/auricular protrusion when it is associated with otitis externa. This column presents six cases of children who presented with peri-auricular redness, four of whom had protuberant ear and retro-auricular cellulitis.

  13. Incidence of otitis externa in dogs and cats in Japan.

    PubMed

    Baba, E; Fukata, T

    1981-05-02

    The incidence of otitis externa in dogs and cats admitted to the animal hospital of the University of Osaka Prefecture was investigated and the bacteria isolated were tested for antibiotic susceptibility. Of the various breeds examined, the incidence of otitis externa was highest in miniature poodles and cocker spaniels and Himalayan and Persian cats. The organisms most commonly associated with otitis externa were coagulase-negative staphylococci, followed by coagulase-positive staphylococci, streptococci and Escherichia coli. Most staphylococci were susceptible to the antibiotics tested, but 15 per cent of staphylococci were resistant to more than three antibiotics. Pseudomonas and Alcaligenes species were resistant to almost all antibiotics except gentamicin and colistin.

  14. Otitis externa. Management in the primary care office.

    PubMed

    Mirza, N

    1996-05-01

    Otitis externa is a widespread problem that is most commonly caused by Pseudomonas aeruginosa. Pain, ear discharge, and edema of the ear canal are the main manifestations. The presence of granulation tissue is an ominous sign that usually indicates necrotizing otitis externa or even a neoplastic process. It is important for primary care physicians to be familiar with methods of ear cleaning and use of topical medications for otitis externa. It is equally vital to be aware of the importance of a timely referral to an otolaryngologist when a serious underlying cause is suspected.

  15. Otitis Externa Associated with Malassezia sympodialis in Two Cats

    PubMed Central

    Crespo, M. J.; Abarca, M. L.; Cabañes, F. J.

    2000-01-01

    The lipid-dependent species Malassezia sympodialis was isolated from two cats with otitis externa. To our knowledge, this is the first report of the isolation of lipid-dependent species of the genus Malassezia associated with skin disease in domestic animals. PMID:10699037

  16. The joint in vitro action of polymyxin B and miconazole against pathogens associated with canine otitis externa from three European countries

    PubMed Central

    Pietschmann, Silvia; Meyer, Michael; Voget, Michael; Cieslicki, Michael

    2013-01-01

    for applying both agents in combination to treat otitis externa when infected with these types of bacteria. Résumé Contexte L'otite externe canine, une inflammation du conduit auriculaire externe, peut être entretenue et aggravée par les infections bactériennes ou fongiques. Pour le traitement topique, les associations d'anti-inflammatoires et d'antimicrobiens sont principalement utilisées. Hypothèses/Objectifs Cette étude a été menée pour déterminer l'activité in vitro de la polymyxine B et du miconazole contre les souches bactériennes cliniques isolées dans trois pays européens, d'étudier les différences possibles de sensibilité et de déterminer les interactions médicamenteuses. Sujets Dix-sept souches d'Escherichia coli, 24 souches de Pseudomonas aeruginosa, 24 souches de Proteus mirabilis et 25 souches de Staphylococcus pseudintermedius ont été isolées de chiens atteints d'otite externe en Allemagne, France et Italie. Résultats L'activité des molécules a été évaluée par la concentration minimale inhibitrice (CMI) et la concentration minimale bactéricide. La potentialisation de la polymyxine B et du miconazole a été calculée par l'indice de concentration inhibitrice fractionnaire (FICI). Un FICI ≤ 0.5 définissait la synergie. En outre, les variations géographiques dans le FICI et la CMI étaient évaluées par analyses statistiques. Résultats Les sensibilités bactériennes étaient comparables dans les différents pays européens parce qu'aucune différence significative n'a été mise en évidence entre les variations de CMI et de FICI (P > 0.05). La polymyxine B en tant que seul agent avait une activité bactéricide contre la plupart des souches de E. coli et P. aeruginosa, et, à plus forte concentration, contre les souches de S. pseudintermedius. Le miconazole était bactéricide contre toutes les souches de S. pseudintermedius. Une synergie a été mise en évidence contre les souches de E. coli et P

  17. Bacterial Otitis Externa in Patients Attending an ENT Clinic in Babol, North of Iran

    PubMed Central

    Kiakojuri, Keyvan; Mahdavi Omran, Saeid; Jalili, Bahareh; Hajiahmadi, Mahmood; Bagheri, Meghdad; Ferdousi Shahandashti, Elaheh; Rajabnia, Ramazan

    2016-01-01

    Background Acute otitis externa, an inflammatory condition of the external auditory canal, is a common clinical problem in general medicine. Objectives This study aimed to determine the etiology of otitis externa in patients from the Mazandaran province, north of Iran, which has a humid climate, as humidity can affect the prevalence of pathogenic microorganisms. Patients and Methods This cross-sectional study involved 116 patients with otitis externa. Two sets of samples were collected from their ears; one set was used for slide preparations, and the other for microbial culturing. After culturing, the microorganisms were identified by conventional methods. Results Patients between 35 and 44 years of age were most frequently affected (25.00%) by otitis externa (average age, 43.87 ± 18.08 years). Moreover, women (54.31%) were more frequently affected than men (45.69%). Upon direct investigation, Gram-positive bacilli were the most commonly identified microorganisms (22.41%). Furthermore, Bacillus spp. and coagulase-negative staphylococci (22.41% and 19.83%, respectively), were the organisms most frequently identified from cultures of otitis externa samples. Conclusions Direct examination and culture showed that a mixed infection of fungi and bacteria is the most common cause of otitis externa. The present study revealed that Bacilli spp. were the most abundant bacteria isolated from patients with otitis externa. Thus, it is recommended that both organisms should be considered as etiologic agents in protocols for treatment of otitis externa. PMID:27127584

  18. Antimicrobial susceptibility of staphylococci isolated from otitis externa in dogs.

    PubMed

    Lilenbaum, W; Veras, M; Blum, E; Souza, G N

    2000-07-01

    Samples were obtained from 65 unmedicated adult dogs, processed for isolation of Staphylococcus species and tested for susceptibility to penicillin G, gentamicin, oxacillin, tetracycline, trimethoprim-sulphamethoxazole, streptomycin, ampicillin and rifampin. Forty-four isolates were obtained, which represents 67.7% of samples. Coagulase-negative species were most commonly found, and the most frequently isolated staphylococcus species were Staph. epidermidis and Staph. aureus. Other species, such as Staph. simulans, Staph. haemolyticus, Staph. saprophyticus and Staph. intermedius were also isolated. Resistance to antibiotics was frequently observed, with 90.9% of the isolates showing resistance to at least one drug. The most active antimicrobial agents against staphylococci isolated from otitis externa of dogs were rifampin and oxacillin. Multidrug resistance was a common finding, and one strain of Staph. haemolyticus species, was resistant to all tested antimicrobial agents. Resistance to three or more different drugs was a common finding, observed in 16 strains (36.4%) of both coagulase-positive and coagulase-negative staphylococci. This study highlights the emergence of cases of otitis externa determined by coagulase-negative staphylococcus strains and once more emphasizes the need for bacterial culture with species identification and susceptibility testing of swab specimens from the ear canal in order to choose appropriate antimicrobial agents.

  19. [Drug therapy of otitis externa and otitis media].

    PubMed

    Okovityĭ, S V; Ivkin, D Iu; Malygin, S V

    2012-01-01

    The objective of the present work was to analyse the available pharmaceutical products used for treatment of otitis media. The rational application of these medications makes it possible to eliminate rapidly a variety of etiological factors, reduce the severity of inflammation, and improve the quality of life of the patients. One of the approaches to the achievement of these goals for the patients with otitis externa and otitis media consists of the use of combined preparations containing antibacterial, antimycotic, anti-inflammatory and analgetic components. Candibiotic is a four-components drug composed of chloramphenicol, clotrimazol, beclomethasone and lidocaine. The advantages of Candibiotic include high therapeutic efficacy due to its ethiotropic and pathogenetic activity and safety as its components do not have ototoxicity in the case of local application).

  20. Is laterality of malignant otitis externa related to handedness?

    PubMed

    Migirov, Lela; Lipshitz, Noga; Dagan, Elad; Wolf, Michael

    2013-07-01

    Malignant otitis externa (MOE) usually affect patients with systemic diseases, especially diabetes mellitus. MOE is a mainly unilateral disease. Given that around 90% of human adults are right-handed we hypothesized that hand preference might be one of the factors involved in the development of MOE. All 38 of the patients whom we treated for MOE between August 2009 and November 2012 (28 males and 10 females, age range 43-91 years) had poorly controlled diabetes mellitus, and all of them reported itching in the involved ear. The difference in the laterality of MOE among our right- and left-handed subjects was significant: right hand dominance was associated mostly with right-sided MOE (24/34) and left hand dominance was associated with occurrence of MOE only in the left ears (4/4, p=0.006). These findings point to an unexpectedly strong relationship between the patient's handedness and laterality of his/her MOE, leading us to hypothesize that the development of MOE might be attributable to self-inflicted local trauma to the ear canal on the same side as the dominant hand.

  1. Deep brain stimulation in the globus pallidus externa promotes sleep.

    PubMed

    Qiu, M H; Chen, M C; Wu, J; Nelson, D; Lu, J

    2016-05-13

    The basal ganglia, a network of subcortical structures, play a critical role in movements, sleep and mental behavior. Basal ganglia disorders such as Parkinson's disease and Huntington's disease affect sleep. Deep brain stimulation (DBS) to treat motor symptoms in Parkinson's disease can ameliorate sleep disturbances. Our series of previous studies lead the hypothesis that dopamine, acting on D2 receptors on the striatopallidal terminals, enhances activity in the globus pallidus externa (GPe) and promotes sleep. Here, we tested if DBS in the GPe promotes sleep in rats. We found that unilateral DBS (180 Hz at 100 μA) in the GPe in rats significantly increased both non-rapid eye movement and rapid eye movement sleep compared to sham DBS stimulation. The EEG power spectrum of sleep induced by DBS was similar to that of the baseline sleep, and sleep latency was not affected by DBS. The GPe is potentially a better site for DBS to treat both insomnia and motor disorders caused by basal ganglia dysfunction.

  2. Control region sequences indicate that multiple externae represent multiple infections by Sacculina carcini (Cirripedia: Rhizocephala)

    PubMed Central

    Rees, David; Glenner, Henrik

    2014-01-01

    The rhizocephalan barnacle, Sacculina carcini, is a common parasite of the European shore crab, Carcinus maenas, in which it causes significant detrimental physical and behavioral modifications. In the vast majority of cases, the external portion of the parasite is present in the form of a single sac-like externa; in rare cases, double or even triple externae may occur on the same individual host. Here, we use a highly variable DNA marker, the mitochondrial control region (CR), to investigate whether multiple externae in S. carcini represent infection by multiple parasites or asexual cloning developed by a single parasite individual. Sequences for multiple externae from C. maenas hosts from the Danish inlet, Limfjorden, and from the mud flates at Roscoff, France, were compared. In almost all cases, double or triple externae from an individual host yielded different haplotypes. In the few cases where identical haplotypes were identified from externae on a multiple-infected host, this always represented the most commonly found haplotype in the population. This indicates that in Sacculina carcini, the presence of multiple externae on a single host reflects infection by different individual parasites. A haplotype network of CR sequences also suggests a degree of geographical partitioning, with no shared haplotypes between the Limfjorden and Roscoff. Our data represent the first complete CR sequences for a rhizocephalan, and a unique gene order was also revealed. Although the utility of CR sequences for population-level work must be investigated further, the CR has proved a simple to use and highly variable marker for studies of S. carcini and can easily be applied to a variety of studies in this important parasite. PMID:25473481

  3. Epidemiological study of dogs with otitis externa in Cape Breton, Nova Scotia.

    PubMed

    Perry, Laura R; MacLennan, Bernard; Korven, Rebecca; Rawlings, Timothy A

    2017-02-01

    From May 2008 to December 2013, 320 cases of otitis externa were diagnosed among 2012 dogs undergoing routine physical examinations at Celtic Creatures Veterinary Clinic, Sydney River, Nova Scotia for a diagnosis frequency of 15.9% [95% confidence interval (CI): 14.3% to 17.6%]. Twenty-four percent of these dogs exhibited 1 or multiple recurrences despite initial treatment with topical antimicrobial/anti-inflammatory solutions. The frequency of diagnosis was significantly higher in breeds with pendulous ears, but was not affected by ear hairiness. There were no seasonal patterns in the frequency of diagnosis. In clinical examination of 60 dogs with otitis externa, bacteria were evident in 47% of infections. Of 10 genera cultured, Staphylococcus spp. and diptheroids were most common. In this study, analysis of clinical records provided insights into the local prevalence of otitis externa and the efficacy of treatment in routine clinical situations.

  4. Susceptibility of bacterial isolates from chronic canine otitis externa to twenty antibiotics.

    PubMed

    Guedeja-Marrón, J; Blanco, J L; Ruperez, C; Garcia, M E

    1998-10-01

    In this paper we present the results of studies on the susceptibility to antibiotics of bacteria isolated from chronic canine otitis externa. We tested 46 bacterial strains (S. aureus, coagulase-negative staphylococci, Corynebacterium spp., and gram-negative bacilli) with 20 different antibiotics. We observed increased resistance to antibiotics of bacteria isolated from canine otitis externa as compared to the resistance reported earlier. This may be due to the indiscriminate use of some antibiotics in the last years and indicates the importance of sensitivity testing for the effective treatment of chronic otitis externa, especially that caused by gram-negative bacilli. The clinician may initiate empiric treatment with antibiotics before obtaining the sensitivity test results; the best results may be expected from a topical application of Bacitracin or Chloramphenicol, and from a systemic therapy with Cephalosporines. Therapeutical scheme for treating various bacterial groups are presented in the paper.

  5. In vitro antimicrobial resistance of Pseudomonas aeruginosa isolated from canine otitis externa in Rio de Janeiro, Brazil

    PubMed Central

    Penna, B.; Thomé, S.; Martins, R.; Martins, G.; Lilenbaum, W.

    2011-01-01

    Isolates of Pseudomonas aeruginosa (167) were obtained from 528 samples of canine otitis externa, identified by biochemical reactions and tested for susceptibility to 10 antimicrobials. The most effective drug was ciprofloxacin. The study reports alarming resistance among P. aeruginosa isolated from canine otitis externa samples in Rio de Janeiro, Brazil. PMID:24031774

  6. Fungal otitis externa as a cause of tympanic membrane perforation: a case series.

    PubMed

    Song, James Eingun; Haberkamp, Thomas J; Patel, Riddhi; Redleaf, Miriam I

    2014-08-01

    We describe a series of 11 patients--8 men and 3 women, aged 18 to 70 years (mean: 46.0)--who had fungal otitis externa that had been complicated by a tympanic membrane perforation. These patients had been referred to us for evaluation of chronic, mostly treatment-refractory otitis externa, which had manifested as otorrhea, otalgia, and/or pruritus. Seven of the 11 patients had no history of ear problems prior to their current condition. Five patients had been referred to us by a primary care physician and 4 by an otolaryngologist; the other 2 patients were self-referred. All patients were treated with a thorough debridement of the ear and one of two antifungal medication regimens. Eight of the 11 patients experienced a complete resolution of signs and symptoms, including closure of the tympanic membrane perforation. The other 3 patients underwent either a tympanoplasty (n = 2) or a fat-graft myringotomy (n = 1) because the perforation did not close within a reasonable amount of time. This series demonstrates that the nonspecific signs and symptoms of fungal otitis externa can make diagnosis difficult for both primary care physicians and general otolaryngologists. This study also demonstrates that most cases of tympanic membrane perforation secondary to fungal otitis externa will resolve with cleaning of the ear and proper medical treatment. Therefore, most patients with this condition will not require surgery.

  7. Selectivity of pesticides used in integrated apple production to the lacewing, Chrysoperla externa.

    PubMed

    Moura, Alexandre Pinho; Carvalho, Geraldo Andrade; Moscardini, Valéria Fonseca; Lasmar, Olinto; Rezende, Denise Tourino; Marques, Márcio Candeias

    2010-01-01

    This research aimed to assess the toxicity of the pesticides abamectin 18 CE (0.02 g a.i. L-1), carbaryl 480 SC (1.73 g a.i. L-1), sulfur 800 GrDA (4.8 g a.i. L-1), fenitrothion 500 CE (0.75 g a.i. L-1), methidathion 400 CE (0.4 g a.i. L-1), and trichlorfon 500 SC (1.5 g a.i. L-1) as applied in integrated apple production in Brazil on the survival, oviposition capacity, and egg viability of the lacewing, Chrysoperla externa (Hagen) (Neuroptera: Chrysopidae) from Bento Gonçalves and Vacaria, Rio Grande do Sul State, Brazil. An attempt was made to study morphological changes caused by some of these chemicals, by means of ultrastructural analysis, using a scanning electronic microscope. Carbaryl, fenitrothion, and methidathion caused 100% adult mortality for both populations, avoiding evaluation of pesticides' effects on predator reproductive parameters. Abamectin and sulfur also affected the survival of these individuals with mortality rates of 10% and 6.7%, respectively, for adults from Bento Gonçalves, and were harmless to those from Vacaria at the end of evaluation. Trichlorfon was also harmless to adults from both populations. No compound reduced oviposition capacity. C. externa from Vacaria presented higher reproductive potential than those from Bento Gonçalves. In relation to egg viability, sulfur was the most damaging compound to both populations of C. externa. Ultrastructural analyses showed morphological changes in the micropyle and the chorion of eggs laid by C. externa treated with either abamectin or sulfur. The treatment may have influenced the fertilization of C. externa eggs and embryonic development. Sulfur was responsible for malformations in the end region of the abdomen and genitals of treated females. When applied to adults, abamectin, sulfur, and trichlorfon were harmless, while carbaryl, fenitrothion, and methidathion were harmful, according to the IOBC classification.

  8. Selectivity of Pesticides used in Integrated Apple Production to the Lacewing, Chrysoperla externa

    PubMed Central

    Moura, Alexandre Pinho; Carvalho, Geraldo Andrade; Moscardini, Valéria Fonseca; Lasmar, Olinto; Rezende, Denise Tourino; Marques, Márcio Candeias

    2010-01-01

    This research aimed to assess the toxicity of the pesticides abamectin 18 CE (0.02 g a.i. L-1), carbaryl 480 SC (1.73 g a.i. L-1), sulfur 800 GrDA (4.8 g a.i. L-1), fenitrothion 500 CE (0.75 g a.i. L-1), methidathion 400 CE (0.4 g a.i. L-1), and trichlorfon 500 SC (1.5 g a.i. L-1) as applied in integrated apple production in Brazil on the survival, oviposition capacity, and egg viability of the lacewing, Chrysoperla externa (Hagen) (Neuroptera: Chrysopidae) from Bento Gonçalves and Vacaria, Rio Grande do Sul State, Brazil. An attempt was made to study morphological changes caused by some of these chemicals, by means of ultrastructural analysis, using a scanning electronic microscope. Carbaryl, fenitrothion, and methidathion caused 100% adult mortality for both populations, avoiding evaluation of pesticides' effects on predator reproductive parameters. Abamectin and sulfur also affected the survival of these individuals with mortality rates of 10% and 6.7%, respectively, for adults from Bento Gonçalves, and were harmless to those from Vacaria at the end of evaluation. Trichlorfon was also harmless to adults from both populations. No compound reduced oviposition capacity. C. externa from Vacaria presented higher reproductive potential than those from Bento Gonçalves. In relation to egg viability, sulfur was the most damaging compound to both populations of C. externa. Ultrastructural analyses showed morphological changes in the micropyle and the chorion of eggs laid by C. externa treated with either abamectin or sulfur. The treatment may have influenced the fertilization of C. externa eggs and embryonic development. Sulfur was responsible for malformations in the end region of the abdomen and genitals of treated females. When applied to adults, abamectin, sulfur, and trichlorfon were harmless, while carbaryl, fenitrothion, and methidathion were harmful, according to the IOBC classification. PMID:20879916

  9. Atypical Lipid-Dependent Malassezia Species Isolated from Dogs with Otitis Externa

    PubMed Central

    Crespo, M. J.; Abarca, M. L.; Cabañes, F. J.

    2000-01-01

    During a survey of the occurrence of Malassezia species in the external ear canals of dogs with chronic otitis externa, lipid-dependent Malassezia species were isolated in three dogs. These species were identified as Malassezia furfur and M. obtusa but showed atypical assimilation patterns. To our knowledge, this is the first report of the isolation of lipid-dependent species of the genus Malassezia in association with canine otitis. PMID:10835009

  10. A randomised controlled trial comparing Triadcortyl with 10% glycerine-ichthammol in the initial treatment of severe acute otitis externa.

    PubMed

    Masood, Ajmal; Moumoulidis, Ioannis; Ray, Shalina; Chawla, Om; Panesar, Jaan

    2008-08-01

    Acute otitis externa is a common clinical condition accounting for a large proportion of patients attending the otolaryngology department, although milder cases are often managed in primary care. Treatment of the most severe forms of otitis externa involves aural toilet, followed by the application of a topical preparation, commonly in the form of an ear canal dressing. A prospective single-blind randomized controlled trial was performed to compare the efficacy of 10% glycerine-ichthammol (GI) solution and Triadcortyl (TAC) ointment, both applied as ear canal dressings, in the initial management of severe acute otitis externa. A total of 64 patients were studied. Both treatment modalities were proven efficacious in the treatment of severe acute otitis externa. Although there was a statistically significant improvement of pain parameters in the TAC group, we found no significant differences in clinical findings between the two groups. Therefore, it is recommended that GI dressing can be used instead of an antibiotic dressing as an initial treatment of severe acute otitis externa on the basis of cost, avoidance of resistance and toxicity.

  11. Proliferative and necrotizing otitis externa in a kitten: successful treatment with intralesional and topical corticosteroid therapy

    PubMed Central

    MOMOTA, Yutaka; YASUDA, Junya; IKEZAWA, Mitsutaka; SASAKI, Jun; KATAYAMA, Masaaki; TANI, Kenji; MIYABE, Masahiro; ONOZAWA, Eri; AZAKAMI, Daigo; ISHIOKA, Katsumi; SAKO, Toshinori

    2016-01-01

    Proliferative and necrotising otitis externa (PNOE) is a very rare disease affecting the ear canals and concave pinnae of kittens. This report describes a 5-month-old cat with PNOE. Histopathological examination confirmed the diagnosis. Treatment was initiated with local injection of methylprednisolone acetate into the lesions. The cat was subsequently treated with clobetasol propionate cream, a potent topical glucocorticoid ointment. The cat showed marked improvement. While topical treatment with tacrolimus, an immunosuppressive agent, is reported to be an effective therapy, to the best of our knowledge, this is the first report to treat PNOE with local corticosteroid therapy. PMID:27570137

  12. Proliferative and necrotizing otitis externa in a kitten: successful treatment with intralesional and topical corticosteroid therapy.

    PubMed

    Momota, Yutaka; Yasuda, Junya; Ikezawa, Mitsutaka; Sasaki, Jun; Katayama, Masaaki; Tani, Kenji; Miyabe, Masahiro; Onozawa, Eri; Azakami, Daigo; Ishioka, Katsumi; Sako, Toshinori

    2017-01-10

    Proliferative and necrotising otitis externa (PNOE) is a very rare disease affecting the ear canals and concave pinnae of kittens. This report describes a 5-month-old cat with PNOE. Histopathological examination confirmed the diagnosis. Treatment was initiated with local injection of methylprednisolone acetate into the lesions. The cat was subsequently treated with clobetasol propionate cream, a potent topical glucocorticoid ointment. The cat showed marked improvement. While topical treatment with tacrolimus, an immunosuppressive agent, is reported to be an effective therapy, to the best of our knowledge, this is the first report to treat PNOE with local corticosteroid therapy.

  13. Temporal bone osteomyelitis: the relationship with malignant otitis externa, the diagnostic dilemma, and changing trends.

    PubMed

    Chen, Jia-Cheng; Yeh, Chien-Fu; Shiao, An-Suey; Tu, Tzong-Yang

    2014-01-01

    Fifty-five patients hospitalized for osteomyelitis of the temporal bone between 1990 and 2011 were divided into two study groups: group 1 was patients collected from 1990 to 2001 and group 2 was composed of patients between 2002 and 2011. Clinical diagnostic criteria and epidemiologic data were analyzed to illustrate the altering features of osteomyelitis of the temporal bone. Group 1 patients were characterized by high prevalence of diabetes and more commonly suffered from otalgia, otitis externa and granulation tissue in the external auditory canal and higher positive culture for Pseudomonas aeruginosa. Noticeable changing trends were found between both groups, including declining prevalence of diabetes, fewer patients complaining of pain or presenting with otitis externa, and canal granulation, and increased variety of pathogens in group 2. We should highlight the index of clinical suspicion for osteomyelitis of the temporal bone, even in nondiabetic or immunocompetent patients. Painless otorrhea patients were also at risk of osteomyelitis of the temporal bone, especially patients with previous otologic operation. Increased multiplicity of pathogens amplified the difficulty of diagnosis for osteomyelitis of the temporal bone.

  14. Entomopathogenic activity of a variety of the fungus, Colletotrichum acutatum, recovered from the elongate hemlock scale, Fiorinia externa.

    PubMed

    Marcelino, José A P; Gouli, Svetlana; Parker, Bruce L; Skinner, Margaret; Giordano, Rosanna

    2009-01-01

    A fungal epizootic in populations of Fiorinia externa Ferris (Hemiptera: Diaspididae) infesting hemlock trees, Tsuga canadensis (L.) Carrière (Pinales: Pinaceae) in forests of the Northeastern US has been recently detected. The current known distribution of the epizootic spans 36 sites in New York, Pennsylvania, New Jersey and Connecticut. Colletotrichum acutatum Simmonds var. fioriniae Marcelino and Gouli var. nov. inedit. (Phyllachorales: Phyllachoraceae) was the most prevalent fungus recovered from infected scales. Bioassays indicated that this C. acutatum variety is highly pathogenic to F. externa. Mortality rates of >90 and >55% were obtained for F. externa crawlers and settlers, respectively. Significantly lower mortality levels, externa epizootics in the US, and the previously reported C. gloeosporioides f. sp. ortheziidae causing Orthezia praelonga epizootics in Brazil, may constitute distinct biotypes of Colletotrichum that have attained the ability to infect insects in addition to the commonly reported plant hosts.

  15. Suitability of leguminous cover crop pollens as food source for the green lacewing Chrysoperla externa (Hagen) (Neuroptera: Chrysopidae).

    PubMed

    Venzon, Madelaine; Rosado, Maria C; Euzébio, Denise E; Souza, Brígida; Schoereder, José H

    2006-01-01

    Diversification of crops with species that provide suitable pollen for predators may reduce pest population on crops by enhancing predator effectiveness. In this paper we evaluated the suitability of leguminous cover crop pollens to the predatory green lacewing Chrysoperla externa (Hagen). The predator is commonly found in coffee agroecosystems and the plant species tested were pigeon pea and sunn hemp, which are used in organic coffee systems. Newly emerged females and males of C. externa were reared on diets containing pollen of pigeon pea, sunn hemp, or castor bean, used as a control. The reproductive success of C. externa was evaluated when females fed the pollen species and when honey was added to the diets, to verify the predator need for an extra carbohydrate source. Similar intrinsic growth rates were found for females fed on pigeon pea pollen and on sunn hemp pollen but these rates increased significantly when honey was added to the diets. Females fed with pigeon pea pollen plus honey and with sunn hemp pollen plus honey had higher intrinsic growth rates than those fed with castor bean pollen plus honey. Females fed on castor bean pollen only or on honey only, did not oviposit. Leguminous pollen species were equally suitable for C. externa especially when they were complemented with honey. The results suggest that to successfully enhance predator effectiveness, organic coffee plantation should be diversified with plant providing pollen in combination with plant providing nectar.

  16. Concurrent necrotising otitis externa and adenocarcinoma of the temporal bone: a diagnostic challenge

    PubMed Central

    Foden, Neil; Burgess, Christopher; Damato, Stephen; Ramsden, James

    2013-01-01

    We present a case of an 81-year-old man who was diagnosed with a necrotising (malignant) otitis externa (NOE). Initial biopsies from the external auditory canal showed scanty squamous epithelium but no evidence of malignancy. Despite an initial improvement on intravenous antibiotics and subsequent discharge from hospital, the patient returned with worsening otalgia. Following readmission to the hospital, intravenous antibiotics were restarted. Despite this, the patient developed a lower motor neurone palsy of cranial nerve VII on the ipsilateral side of the pain. He was taken to the theatre for an exploration of the left mastoid with further biopsies. Adenocarcinoma was diagnosed histologically and the patient was started on palliative radiotherapy. This case adds to the known literature on metastatic disease in the temporal bone and highlights the need to exclude malignancy in cases of NOE. PMID:24197806

  17. Use of ticarcillin in the management of canine otitis externa complicated by Pseudomonas aeruginosa.

    PubMed

    Nuttall, T J

    1998-04-01

    Twelve dogs were referred with purulent and proliferative otitis externa. Prior treatment included fluoroquinolones, glucocorticoids and polyvalent ear drops over seven days to five months. In all cases the vertical and horizontal ear canals were inflamed and thickened, with ruptured tympanic membranes in four cases. No abnormalities were seen on radiography of the osseous bullae. Numerous rod bacilli and degenerate neutrophils were seen on cytology. Pseudomonas aeruginosa resistant to fluoroquinolones and gentamicin was cultured in all cases. Treatment was initiated with 1 to 2 mg/kg prednisolone per os once daily, and a cleansing and drying ear cleaner followed by topical administration of injectable ticarcillin solution four times daily. Cases with ruptured tympanae also received 15 to 25 mg/kg ticarcillin three times daily intravenously until the membranes had healed. All cases were anaesthetised for repeated saline ear flushes until no further discharge was evident and no rods were seen on cytology. Topical ticarcillin and the ear cleaner were continued twice daily for 14 days after clinical resolution. The duration of treatment ranged from 14 to 36 days. Treatment was withdrawn in one case which developed a drug reaction. All other cases responded well with no adverse effects.

  18. Necrotizing otitis externa: diagnosis, treatment, and outcome in a case series.

    PubMed

    Glikson, Eran; Sagiv, Doron; Wolf, Michael; Shapira, Yisgav

    2017-01-01

    We reviewed 25 cases of patients diagnosed with necrotizing otitis externa in our tertiary university-affiliated medical center between 2009 and 2015. Mean overall hospitalization duration was 14.52days, 95% of the patients showed specific seasonal incidence. Mean duration of symptoms prior to hospitalization was 6weeks and the duration correlated with outcome. Only 8% of the patients presented with cranial neuropathies; however, this presentation correlated with adverse outcome. Pseudomonas aeruginosa was the main causative organism (50%), with a 30% multidrug-resistance rate. A high rate (35%) of fungal pathogens was noted. Seventeen patients (68%) were eventually operated; however, only 5 patients needed extensive surgery under general anesthesia. Computed tomography (CT) evidence of adjacent structures' involvement correlated with adverse outcome. Eighty percent of our patients improved clinically. The overall death rate was 12% and the disease-related mortality rate was 8%. Our findings state the importance of limited surgical intervention and microbiologic cultures in disease treatment. This is particularly important in patients with cranial neuropathies and CT finding of adjacent structural involvement that correlate with adverse prognosis. A rising pseudomonal antibiotic resistance and fungal infections may challenge antibiotic treatment in the future.

  19. Randomized controlled trial on the treatment of otitis externa with one per cent silver nitrate gel.

    PubMed

    van Hasselt, Piet; Gudde, Hugo

    2004-02-01

    Otitis externa (OE) and especially otomycosis can be very persistent and difficult to control. In the present study the efficacy of treatment of OE with a single instillation in the ear canal of one per cent silver nitrate in three per cent hypromellose gel compared to 0.1 per cent silver nitrate gel was tested in a single-blinded randomized controlled parallel group study. The outcome measure was complete resolution of the OE after one week. Forty-four patients with refractory, bacterial as well as fungal, OE entered the study, comprising 30 ears in each treatment arm. Eight patients defaulted from follow-up, five ears in each treatment arm. A single instillation of one per cent silver nitrate gel cured 23 (92 per cent) of 25 ears with OE, whereas with 0.1 per cent silver nitrate gel seven (28 per cent) of 25 ears treated were cured (Fisher-exact test, p-exact = 0.00010). In a non-controlled series of 120 ears 93.3 per cent needed only a single instillation of one per cent silver nitrate gel while another five per cent were cured after a second instillation a week later. There were no adverse reactions. OE can be treated effectively with instillation of one per cent silver nitrate gel and is particularly useful in recalcitrant otomycosis. The treatment method saves both cost and time.

  20. Peltogasterella sensuru n. sp. (Crustacea: Cirripedia: Rhizocephala) from off Okinawa Island (Ryukyu Archipelago, Japan) with remarks on its single brood externae.

    PubMed

    Yoshida, Ryuta; Hirose, Mamiko; Hirose, Euichi

    2015-09-01

    Peltogasterella sensuru n. sp. infests Pagurixus hermit crabs inhabiting rocky shores off Okinawa Island (Ryukyu Archipelago, Japan). This species is clearly distinguishable from Peltogasterella gracilis (Boschma, 1927): the stalk emerges from the middle part of the externa in the present species and P. sulcata (Lilljeborg, 1859), while the stalk in P. gracilis emerges from the posterior end of the externae. The new species differs from P. sulcata based on the morphology of the mantle aperture. Peltogasterella sensuru n. sp. repeatedly produces single brood externae that have not been previously observed in species belonging to the suborder Kentrogonida Delage, 1884. We also determined partial sequences of the COI gene and 16S rRNA gene of the new species for use as molecular markers for species identification.

  1. Toxicity and Metabolism of Zeta-Cypermethrin in Field-Collected and Laboratory Strains of the Neotropical Predator Chrysoperla externa Hagen (Neuroptera: Chrysopidae).

    PubMed

    Haramboure, M; Smagghe, G; Niu, J; Christiaens, O; Spanoghe, P; Alzogaray, R A

    2017-03-09

    Resistance to pesticides has been studied in several insect pests, but information on the natural enemies of pests-including the Neotropical predator Chrysoperla externa Hagen (Neuroptera: Chrysopidae), a major biological control agent in South America-is lacking. We report here a comparative study between a field-collected strain of C. externa subjected to monthly sprayings of pyrethroids and neonicotinoids and a laboratory strain without exposure to pesticides. The tolerance of both strains against zeta-cypermethrin was similar, and addition of the synergist piperonyl butoxide increased the toxicity by 30% in both strains. Gas-chromatography analyses and mixed-function-oxidase measurements indicated similar values in both strains and also confirmed the key role of oxidative metabolism in this species. Because C. externa has maintained a tolerance to zeta-cypermethrin without previous pesticide exposure, this species could potentially be mass-reared and released in fields in the presence of pesticide pressure.

  2. Evaluation of a cuprimyxin-hydrocortisone acetate suspension in the treatment of otitis externa in dogs and cats.

    PubMed

    Maestrone, G; Brandt, W

    1979-02-01

    The therapeutic efficacy of a 0.5% cuprimyxin plus 1% hydrocortisone acetate-water-base suspension was evaluated in 130 clinical cases of otitis externa in dogs and cats in various geographic areas of the United States. The otic microbial flora was studied before treatment in 125 (96%) of the dogs and cats, with multiple isolates recovered from mated from 70%, yeasts from 65%, and fungi from 5% of the animals. Evens though multiple drug reistance was frequently observed in the bacterial flora, all bacteria and yeast isolates were sensitive to cuprimyxin. Of the 130 treated animals, a statistically significant (P less than 0.01) favorable response was obtained in 84,6% and no response in 13;1%; in2.3%, the condition became worse. An adverse reaction (pain at the time of first application) was observed in 1 (0.8%) animal.

  3. Consensus of microbiology reporting of ear swab results to primary care clinicians in patients with otitis externa.

    PubMed

    Geyer, M; Howell-Jones, R; Cunningham, R; McNulty, C

    2011-01-01

    Otitis externa is a ubiquitous inflammatory disease; although it arises most commonly from an infection, there is no consensus in the UK for the reporting of ear swab culture results. This study aims to review current microbiology laboratory reporting of ear swab specimens to primary care and reach an evidence-based consensus for a reporting policy. Fifty consecutive ear swab reports were reviewed from each of 12 laboratories in the South West region to determine and discuss reporting practice. The Health Protection Agency (HPA) GP Microbiology Laboratory Use Group reviewed the underlying evidence and worked towards a consensus of expert microbiology opinion for laboratory reporting of ear swab results using a modified version of the Delphi technique. A total of 487 reports from primary care were reviewed (54% female; 46% male). Cultures most commonly yielded Pseudomonas species (36%), Staphylococcus species (21%), Streptococcus species (15%) and fungi (11%). Five reporting policies were agreed: Policy 1: Common pathogens such as group A beta-haemolytic streptococci, Streptococcus pneumoniae, Staphylococcus aureus - Always reported by name with antibiotic susceptibilities. Policy 2: Pseudomonas species - Always reported, but antibiotic susceptibilities only reported in severe disease. Policy 3: Aspergillus, Candida, coliforms and Proteus species, as well as non-group A streptococci and anaerobes - Only reported if moderate numbers of colonies and it is the predominant organism present; if appropriate report antibiotic susceptibilities. Policy 4: Coagulase-negative staphylococci, diphtheroids and enterococci - Not reported by name; generic terms used and antibiotic susceptibilities not reported. Policy 5: When antibiotic susceptibilities reported these must include susceptibility to a topical antibiotic. It is suggested that laboratories should consider adopting this evidence-based reporting consensus for ear swab culture results from primary care patients with

  4. Enfermedad diarreica aguda por Escherichia coli patógenas en Colombia

    PubMed Central

    Gómez-Duarte, Oscar G.

    2014-01-01

    Resumen Las cepas de E. coli patógenas intestinales son causas importantes de la enfermedad diarreica aguda (EDA) en niños menores de 5 años en América Latina, África y Asia y están asociadas a alta mortalidad en niños en las comunidades más pobres de África y el Sudeste Asiático. Estudios sobre el papel de las E. coli patógenas intestinales en la EDA infantil en Colombia y otros países de América Latina son limitados debido a la carencia de ensayos para detección de estos patógenos en los laboratorios clínicos de centros de salud. Estudios recientes han reportado la detección de E. coli patógenas intestinales en Colombia, siendo la E. coli enterotoxigénica la cepa más frecuentemente asociada a diarrea en niños menores de 5 años. Otros patógenos detectados en estos pacientes incluyen las E. coli enteroagregativa, enteropatógena, productora de toxina Shiga, y de adherencia difusa. Con base en estudios que reportan la presencia de E. coli productora de toxina Shiga y E. coli enteroagregativa en carnes y vegetales en supermercados, se cree que productos alimentarios contaminados contribuyen a la transmisión de estos patógenos y a la infección del huésped susceptible. Más estudios son necesarios para evaluar los mecanismos de transmisión, el impacto en la epidemiologia de la EDA, y las pautas de manejo y prevención de estos patógenos que afectan la población pediátrica en Colombia. PMID:25491457

  5. Hypoglycemia enhances turnover of corticotropin-releasing factor and of vasopressin in the zona externa of the rat median eminence.

    PubMed

    Berkenbosch, F; De Goeij, D C; Tilders, F J

    1989-07-01

    Insulin administration to overnight fasted rats causes a dose-dependent decline in plasma glucose concentrations and a dose-dependent increase in plasma ACTH concentrations. The ACTH response, but not the glucose response, was blocked by treatment with chlorpromazine-morphine-pentobarbital, indicating that the main factors triggering the ACTH response are of central, rather than peripheral, origin. To study whether insulin affected the turnover of CRF and vasopressin (AVP) in the zona externa of the median eminence (ZEME), we determined the rate of decline of both hypophysiotropic factors in rats with or without blockade of axonal transport by colchicine. In the ZEME, the concentrations of CRF and AVP were assessed by quantitative immunocytochemistry (QICC) in tissue sections or by RIA in median eminence extracts. QICC allows selective quantification of AVP and other peptides within the ZEME. The changes in the CRF content, as measured by QICC and RIA, were linearly correlated (r = 0.99), demonstrating that changes in peptide-staining intensity reflect changes in peptide content. Colchicine, when given intracisternally in a nontoxic dose of 5 micrograms, had no marked effect on resting plasma levels of ACTH and only slightly reduced the ACTH response to insulin-induced hypoglycemia. In the ZEME, CRF and AVP concentrations at rest were not affected by colchicine. In colchicine-treated rats insulin-induced hypoglycemia resulted in a prominent decline in CRF and AVP concentrations in the ZEME. The CRF concentration declined at a rate of 23%/h over a period of 3 h. The AVP concentration declined to a similar extent as CRF over the first hour, but tended to fall at the later time points. We conclude that hypoglycemia increases turnover of both CRF and AVP in the ZEME. However, the turnover rates of both hypophysiotropic peptides do not appear to be quantitatively coupled.

  6. Identification of plant families associated with the predators Chrysoperla externa (Hagen) (Neuroptera: Chrysopidae) and Hippodamia convergens Guérin-Menéville (Coleoptera: Coccinelidae) using pollen grain as a natural marker.

    PubMed

    Medeiros, M A; Ribeiro, P A; Morais, H C; Castelo Branco, M; Sujii, E R; Salgado-Laboriau, M L

    2010-05-01

    The predators Hippodamia convergens Guérin-Menéville (Coleoptera: Coccinelidae) and Chrysoperla externa (Hagen) (Neuroptera: Chrysopidae), are frequently observed on vegetable crops, especially on tomato plants, as well as on flowers of several plants around crop fields. It is well known that when predators feed on pollen and nectar they can increase their longevity and reproductive capacity. The objective of this work was to identify plants that could be a pollen source for H. convergens and C. externa in order to develop strategies to attract and keep these predators in vegetable fields like the tomato crop. Adults of C. externa (53 individuals) and H. convergens (43 individuals) were collected in fields from 2004-2005 at Embrapa Hortaliças, Brasília, Federal District. The insects were processed by the acetolysis method and pollen from them was extracted and identified. A total of 11335 grains of pollen belonging to 21 families were extracted from C. externa. A total of 46 pollen grains belonging to ten families were extracted from H. convergens. The Poaceae family was the most abundant one for C. externa while Asteraceae was the commonest pollen for H. convergens. The importance of pollen from different plant species as a food resource for each predator species gives an indication of the importance of plant community structure inside and around crop fields for the establishment of these predator populations and to enhance conservation biological control.

  7. High prevalence of Fluoroquinolone- and Methicillin-resistant Staphylococcus pseudintermedius isolates from canine pyoderma and otitis externa in veterinary teaching hospital.

    PubMed

    Yoo, Jong-Hyun; Yoon, Jang W; Lee, So-Young; Park, Hee-Myung

    2010-04-01

    Recently, a total of 74 Staphylococcus pseudintermedius isolates were collected from clinical cases of canine pyoderma and otitis externa in Korea. In this study, we examined in vitro fluoroquinolone resistance among those isolates using a standard disk diffusion technique. The results demonstrated that approximately 18.9% to 27.0% of the isolates possessed bacterial resistance to both veterinary- and human-licensed fluoroquinolones except one isolate, including moxifloxacin (18.9% resistance), levofloxacin (20.3% resistance), ofloxacin (24.3% resistance), ciprofloxacin (25.7% resistance), and enrofloxacin (27.0% resistance). Most surprisingly, 14 out of 74 (18.9%) isolates were resistant to all the five fluoroquinolones evaluated. Moreover, a PCR detection of the methicillin resistance gene (mecA) among the 74 isolates revealed that 13 out of 25 (52.0%) mecA-positive isolates, but only 7 out of 49 (14.3%) mecA-negative isolates, were resistant to one or more fluoroquinones. Taken together, our results imply that bacterial resistance to both veterinary- and human-use fluoroquinolones becomes prevalent among the S. pseudintermedius isolates from canine pyoderma and otitis externa in Korea as well as that the high prevalence of the mecA-positive S. pseudintermedius isolates carrying multiple fluoroquinolone resistance could be a potential public health problem.

  8. Malignant otitis externa

    MedlinePlus

    ... drainage from the ear that is yellow or green and smells bad. Ear pain deep inside the ear. Pain may get worse when you move your head. Hearing loss . Itching of the ear or ear canal. Fever. Trouble swallowing. Weakness in the muscles of the face.

  9. First identification of methicillin-resistant Staphylococcus pseudintermedius strains among coagulase-positive staphylococci isolated from dogs with otitis externa in Trinidad, West Indies

    PubMed Central

    Dziva, Francis; Wint, Crystal; Auguste, Tennille; Heeraman, Carolyn; Dacon, Cherrelle; Yu, Priscilla; Koma, Lee M.

    2015-01-01

    Background Otitis externa is a common inflammatory ear disease in dogs caused by a variety of pathogens, and coagulase-positive staphylococci are frequently isolated from such infections. Objective To identify antimicrobial susceptibility profiles and methicillin-resistant strains among coagulase-positive staphylococci isolated from otitis externa in dogs. Methods A cross-sectional study was performed over 2 years on 114 client-owned dogs presented to the Veterinary Teaching Hospital with a primary complaint of ear infections. Swabs were obtained from both ears and cultured for staphylococci which were subsequently confirmed as coagulase-positive using rabbit plasma. Antimicrobial susceptibility assays were assessed on all isolates followed by subsequent genetic analysis for species identification and detection of the mecA gene. Results Sixty-five coagulase-positive staphylococci were isolated from 114 client-owned dogs. The isolates exhibited resistance against neomycin (58.5%), streptomycin (49.2%), penicillin (49.2%), polymyxin B (44.6%), tetracycline (36.9%), sulphamethoxazole/trimethoprim (33.8%), kanamycin (33.8%), doxycycline (32.3%), norfloxacin (23.1%), amoxicillin/clavulanate (20%), ciprofloxacin (20%), enrofloxacin (18.5%), gentamicin (16.9%), and cephalothin (9.2%). Forty (61.5%) of the isolates were resistant to at least three or more antimicrobials and 10 were sensitive to all. Using a multiplex polymerase chain reaction assay based on species-specific regions of the thermonuclease (nuc) gene, 38/65 (58.5%) isolates were classified as Staphylococcus aureus, 23/65 (35.4%) as S. pseudintermedius, 2/65 (3.1%) as S. intermedius, and 2/65 (3.1%) as S. schleiferi. Analysis for the mecA gene revealed two positive isolates of S. pseudintermedius which were oxacillin-resistant, representing a first report of such organisms in the Caribbean. Conclusion Despite the relatively high prevalence of multidrug-resistant coagulase-positive staphylococci in Trinidad

  10. "Swimmer's Ear" (Otitis Externa) Prevention

    MedlinePlus

    ... Work: Healthy Swimming Policy & Recommendations Fast Facts Healthy Water Sites Healthy Water Drinking Water Healthy Swimming Global ... painful. How is swimmer's ear spread at recreational water venues? Swimmer’s ear can occur when water stays ...

  11. Prognostic factors in multiple myeloma: definition of risk groups in 410 previously untreated patients: a Grupo Argentino de Tratamiento de la Leucemia Aguda study.

    PubMed

    Corrado, C; Santarelli, M T; Pavlovsky, S; Pizzolato, M

    1989-12-01

    Four hundred ten previously untreated multiple myeloma patients entered onto two consecutive Grupo Argentino de Tratamiento de la Leucemia Aguda (GATLA) protocols were analyzed to identify significant prognostic factors influencing survival. The univariate analysis selected the following variables: performance status, renal function, percentage of bone marrow plasma cells at diagnosis, hemoglobin, and age. A multivariate analysis showed that performance status, renal function, percentage of bone marrow plasma cells, hemoglobin, and age were the best predictive variables for survival. A score was assigned to each patient according to these variables, which led to their classification in three groups: good, intermediate, and poor risk, with a probability of survival of 26% and 10% at 96 months, and 5% at 56 months, and median survival of 60, 37, and 14 months, respectively (P = .0000). In our patient population, this model proved to be superior to the Durie-Salmon staging system in defining prognostic risk groups, and separating patients with significantly different risks within each Durie-Salmon stage.

  12. Bacterial flora of stethoscopes' earpieces and otitis externa.

    PubMed

    Brook, I

    1997-09-01

    External otitis caused by Staphylococcus aureus was observed in a nurse after extensive use of a stethoscope. The infection recurred and a similar organism was isolated from the stethoscope's earpiece. The infection did not recur after the earpiece was cleansed after each use. In a prospective study, the bacterial flora of 35 earpieces was evaluated. Fifty-three isolates, 36 aerobic or facultative and 17 anaerobic, were recovered. The number of organisms per earpiece ranged from 14 to 204 (average 92 +/- 17). The predominant isolates were Staphylococcus epidermidis (16 isolates), Propionibacterium acnes (12), and Saureus (7). The study demonstrates the colonization of the stethoscope's earpiece with microorganisms that possess the potential for causing nosocomial infection.

  13. Ruprecht 44 y la estructura espiral externa de la Galaxia

    NASA Astrophysics Data System (ADS)

    Giorgi, E. E.; Solivella, G. R.; Vázquez, R. A.; De Laurenti, M. A.

    We present first results of a photometric study UBVI CCD; complemented with MK spectral classification and 2MASS data; focusing on the region of the open cluster Ruprecht 44. This cluster is in an area of very low interstellar absorption; through which it is possible examine in the optical range the spiral structure outside the solar circle. Precise distances determination of blue stars in the field of this cluster enable analyze; with other data recently obtained; the structure of great design in the third galactic quadrant. FULL TEXT IN SPANISH

  14. Externa otitis caused by the Graphium stage of Pseudallescheria apiosperma

    PubMed Central

    Neji, Sourour; Ines, Hadrich; Houaida, Trabelsi; Malek, Mnejja; Fatma, Cheikhrouhou; Hayet, Sellami; Fattouma, Makni; Mounôm, Ghorbel; Ali, Ayadi

    2013-01-01

    We report a case of otomycosis caused by the Graphium stage of Pseudallescheria apiosperma in an immunocompetent 32 years old man who was suffering from hypoacusia and purulent otorrhea. Isolates were identified as Graphium stage of Pseudallescheria sp. on the basis of macroscopic and microscopic characteristics. Pseudallescheria apiosperma was correctly identified by PCR sequencing of ITS regions and β-tubulin gene. In this case the contamination could be due to intensive activity of gardening with poor hygiene. PMID:24432231

  15. Evaluating synergy between marbofloxacin and gentamicin in Pseudomonas aeruginosa strains isolated from dogs with otitis externa.

    PubMed

    Jerzsele, Ákos; Pásztiné-Gere, Erzsébet

    2015-03-01

    The aim of this study was to determine antimicrobial susceptibility of Pseudomonas aeruginosa strains to marbofloxacin and gentamicin, and investigate the possible synergistic, additive, indifferent or antagonistic effects between the two agents. P. aeruginosa strains can develop resistance quickly against certain antibiotics if used alone, thus the need emerges to find synergistic combinations. A total of 68 P. aeruginosa strains isolated from dogs were examined. In order to describe interactions between marbofloxacin and gentamicin the checkerboard microdilution method was utilized. The MICs (minimum inhibitory concentrations) for marbofloxacin and gentamicin were in the range 0.25-64 mg/L and 0.25-32 mg/L, respectively. The combination of marbofloxacin and gentamicin was more effective with a MIC range of 0.031-8 mg/L and a MIC90 of 1 mg/L, compared to 16 mg/L for marbofloxacin alone and 8 mg/L for gentamicin alone. The FIC (fractional inhibitory concentration) indices ranged from 0.0945 (pronounced synergy) to 1.0625 (indifference). Synergy between marbofloxacin and gentamicin was found in 33 isolates. The mean FIC index is 0.546, which represents a partial synergistic/additive effect close to the full synergy threshold. In vitro results indicate that marbofloxacin and gentamicin as partially synergistic agents may prove clinically useful in combination therapy against P. aeruginosa infections. Although marbofloxacin is not used in the human practice, the interactions between fluoroquinolones and aminoglycosides may have importance outside the veterinary field.

  16. A Modified Prophylactic Regimen for the Prevention of Otitis Externa in Saturation Divers

    DTIC Science & Technology

    2013-10-01

    regimen of two to three times daily while in a saturation environment. However, on two occasions during a 1000 feet of sea water ( fsw ) dry saturation...dive and during a 150 fsw dive in the U.S. Navy Saturation Flyaway Diving System (SATFADS), two different divers noted bilateral ear itching and...irritation. During the 1000 fsw dive, one diver reported bilateral ear itching and irritation of the left ear that was greater than the right ear on

  17. Treatment of feline otitis externa due to Otodectes cynotis and complicated by secondary bacterial and fungal infections with Oridermyl auricular ointment

    PubMed Central

    Roy, Josée; Bédard, Christian; Moreau, Maxim

    2011-01-01

    A blinded randomized study was conducted on 24 cats to confirm the presence of bacterial and/or fungal secondary infections associated with otoacariasis and to verify the efficacy of Oridermyl, an acaricidal/antibiotic/antifungal/anti-inflammatory ointment, for treatment of the primary infestation and secondary infections. Sixteen cats were treated once daily for 10 d; 4 cats were not treated and 4 were treated with a placebo ointment. On Days 0 and 10, ears were swabbed for counts of bacteria and yeasts, for bacterial culture and sensitivity, and examined for determination of the degree of clinical otitis. Auricular secretions were removed for mite counts on Day 10, except for 8 treated cats that were done on Day 30. There was a high number of bacteria and yeasts in most cats and Oridermyl treatment significantly decreased those numbers. Staphylococci were the most frequently isolated bacteria. No live ear mites were found in cats treated with Oridermyl or the placebo ointment. PMID:21629420

  18. [The use of the dacron net in the externa tightening of the endoleak type I, after the stengraft implantation in the abdominal aorta aneurysm].

    PubMed

    Janczak, Dariusz; Pupka, Artur; Garcarek, Jerzy; Skóra, Jan; Szyber, Piotr

    2010-01-01

    Implantation of the vascular prosthesis below renal artery when the neck of the aneurysm is short, carries the risk of the appearance of the endoleak type I. At such patients one ought to make allowance for with the necessity of the single-stage or two-stage-supply of the endoleak with banding method that is to say with the tightening of the neck of the aneurysm on the stentgraft with the open method. This method consisting in to the compression of the neck of the aneurysm on stentgraft at the use of ribbons or the wide belt from the dacron net. In this paper one represented 3 patients operated with banding method. In the face the massive endoleak type I and the threat of the ruptum of the aneurysm one decided on the realization of the surgical correction with the open method with banding.

  19. [Acute posterior multifocal placoid pigment epitheliopathy. A rare cause of ischaemic stroke].

    PubMed

    del Saz-Saucedo, Pablo; Alfaya-Muñoz, Laura Blanca; Recio-Bermejo, Marta; Lara-Medina, Francisco Javier; García-Chiclano, Amalia; Ortega-León, Teresa; Rueda-Medina, Ignacio; Domínguez-Fernández, María José; Madrid-Muñiz, Carmen; Franco-Huerta, María

    2013-06-01

    Introduccion. La epiteliopatia pigmentaria placoide multifocal posterior aguda (EPPMPA) es una enfermedad inflamatoria rara, generalmente de etiologia indeterminada, de la coriocapilar, el epitelio pigmentario y la retina externa. Afecta predominantemente a pacientes jovenes y en algunos casos puede involucrar al sistema nervioso central en forma de ictus o de meningoencefalitis. Presentamos el caso clinico de una mujer joven con EPPMPA complicada con ictus e hipertension intracraneal. Caso clinico. Mujer de 16 anos que comienza con cefalea intensa sugestiva de hipertension intracraneal, asi como con un deficit agudo hemisferico izquierdo. La resonancia magnetica craneal ponia de manifiesto lesiones embolicas o vasculiticas en diferentes territorios. No se evidenciaron datos de meningoencefalitis en el estudio del liquido cefalorraquideo, pero si de hipertension intracraneal asociada. La presencia de lesiones muy especificas en el polo ocular posterior permitio el diagnostico de EPPMPA complicada con ictus isquemico, probablemente por mecanismo vasculitico. Un amplio estudio etiologico fue negativo para identificar un factor desencadenante claro del proceso. Se inicio tratamiento corticoideo con buena evolucion clinica y radiologica. Conclusiones. La EPPMPA es una entidad rara que generalmente entrana buen pronostico; sin embargo, en algunos casos puede complicarse con afectacion del sistema nervioso central, y el ictus isquemico secundario a vasculitis es la complicacion mas grave. Ante un paciente joven con ictus que presente sintomatologia visual y lesiones coriorretinianas, debe considerarse la EPPMPA en su diagnostico etiologico.

  20. Lightning as a Source of NO sub x in the Troposphere.

    DTIC Science & Technology

    1981-12-01

    Press, New York, Berger, K., "Methoden und Resultate der Blitz-Forschung auf dem Monte San Salvatore 1963-71," Bull. Schweiz . Elektrotech. Ver., 64, 120...Office of Telecommunications, OT/ITS RR 12 (COM-75-1202), April 1971. Croft, T.A., Nocturnal Images of the Earth From Space, Stanford Research Institute

  1. OPSATCOM Field Measurements. Volume II. Supplemental Information

    DTIC Science & Technology

    1976-06-01

    which is penetrated by a packing gland for passage of the multiconductor interconnection cable. The cable contains ten No. 22 AWG conductors and two...chromiates penial ly fabricatedc for th in instrument, A portion of tho flux from the lanip lit canrried directly to the ruceiver by a fiber otitic light

  2. [Cutaneous manifestations of leukemia].

    PubMed

    Pulido-Díaz, Nancy; Medina, Gabriela; Palomino, Nymrod; Peralta, Fidelio

    2015-01-01

    Introducción: el objetivo de este estudio es describir la frecuencia y tipo de manifestaciones cutáneas en pacientes con leucemia.Métodos: estudio observacional, descriptivo. Se incluyeron pacientes mayores de 16 años, con diagnóstico confirmado de leucemia, de los departamentos de Hematología y Dermatología procedentes de la consulta externa u hospitalizados. Se excluyeron los pacientes trasplantados de médula ósea. Se les efectuó historia clínica y revisión dermatológica completa de la piel y anexos, toma de biopsias y cultivos en caso de requerirlo. Las manifestaciones cutáneas se clasificaron en manifestaciones secundarias a procesos infecciosos o medicamentos, infiltración leucémica, dermatosis asociadas a la leucemia y lesiones inespecíficas. Se empleó estadística descriptiva.Resultados: Se incluyeron 142 pacientes con los siguientes diagnósticos: leucemia mieloide aguda (n = 36 pacientes), leucemia linfoblástica aguda (n = 52), leucemia mieloide crónica (n = 21), leucemia linfocítica crónica (n = 30), leucemia de células peludas (n = 3). El 42.25 % de los pacientes (n = 60) presentaron hallazgos positivos para alguna dermatosis. Se encontraron 36 dermatosis inespecíficas, 21 medicamentosas, 20 infecciosas, 3 infiltrativas y ninguna asociada.Conclusiones: las manifestaciones cutáneas directamente relacionadas a leucemia son frecuentes, siendo las inespecíficas las más comúnmente observadas. Sin embargo, el examen dermatológico completo es importante en estos pacientes como parte de su evaluación integral.

  3. 21 CFR 524.1881b - Prednisolone acetate-neomycin sulfate sterile suspension.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... conjunctivitis, acute otitis externa, and chronic otitis externa in dogs and cats. (2) For beginning treatment of acute ocular inflammations 1 or 2 drops may be placed in the conjunctival sac 3 to 6 times during a...

  4. Otitis

    MedlinePlus

    ... Based on location otitis can be: Otitis externa (swimmer's ear). Involves the outer ear and ear canal. ... chronic Malignant otitis externa Otitis media with effusion Swimmer's ear Patient Instructions Ear tube surgery - what to ...

  5. Swimmer's Ear (For Parents)

    MedlinePlus

    ... Feeding Your 1- to 2-Year-Old Swimmer's Ear (Otitis Externa) KidsHealth > For Parents > Swimmer's Ear (Otitis ... español Otitis del nadador (otitis externa) About Swimmer's Ear Otitis externa (OE) — commonly known as swimmer's ear — ...

  6. Relatorio Final Sobre o Ensino Bilingue: Resultados da Avaliacao Externa da Experiencia de Escolarizacao Bilingue em Mocambique (PEBIMO) (Final Report on Bilingual Education: Results of External Evaluation of an Experiment in Bilingual Education in Mozambique).

    ERIC Educational Resources Information Center

    Benson, Carolyn J.

    The PEBIMO project was designed to determine whether bilingual education could improve the quality of primary education in Mozambique, recognizing that Portuguese is not the native language of the majority of Mozambican students. The project began in 1992 with 8 cohorts of first grade in 2 provinces; during this investigation, students were in…

  7. Comparative short-term efficacy of Oridermyl® auricular ointment and Revolution® selamectin spot-on against feline Otodectes cynotis and its associated secondary otitis externa

    PubMed Central

    Roy, Josée; Bédard, Christian; Moreau, Maxim; Sauvé, Frédéric

    2012-01-01

    The efficacy of Oridermyl® (acaricidal/antibiotic/antifungal/anti-inflammatory ointment) and Revolution® (selamectin spot-on) was compared in a blinded randomized study on 24 adult cats with otoacariasis. Twelve cats were treated once daily for 10 d with Oridermyl® and 12 cats were treated on Day 0 with Revolution®. Otitis was assessed with cytological counts of mean number of bacteria and yeast on Days 0 and 10, and scored clinically every other day. All auricular secretions were removed for mite count on Day 10. On Day 0, cytological examination confirmed the presence of secondary bacterial (24/24) and fungal (21/24) infections. No live mites were observed otoscopically after Day 4 and in auricular secretions at Day 10 in both groups. On Day 10, secondary infections were resolved for all cats treated with Oridermyl® but were present in all cats treated with Revolution®. Improvement in clinical signs of otitis over time was superior in the Oridermyl® group (P < 0.001). PMID:23277643

  8. Intra cranial complications of tuberculous otitis media

    PubMed Central

    Prakash, M.; Johnny, J. Carlton

    2015-01-01

    Tuberculosis is one of the most common infections in the world. It is seen that tuberculous otitis media (TOM) is almost secondary to pulmonary tuberculosis. In this review we have tried to deal with all the aspects of the intra cranial complications of TOM such as tuberculoma, otitic hydrocephalus, brain abscess and tuberculous meningitis. The aspects covered in this review are the pathology, clinical features, and investigations of the intra cranial manifestations. PMID:26015748

  9. [Variability in the in-hospital management of acute myocardial infarction in Spain. IBERICA Study (Investigación, Búsqueda Específica y Registro de Isquemia Coronaria Aguda)].

    PubMed

    Fiol, M; Cabadés, A; Sala, J; Marrugat, J; Elosua, R; Vega, G; José Tormo Díaz, M; Segura, A; Aldasoro, E; Moreno-Iribas, C; Muñiz, J; Hurtado de Saracho, I; García, J

    2001-04-01

    Introduction and objective. Although some in-hospital studies have described the management of acute myocardial infarction (MI) patients in Spain, none has been able to guarantee the exhaustiveness of patient registry. This study sought to determine the clinical characteristics and in-hospital management of patients with MI in eight Spanish population registries.Methods. The IBERICA study is a population-based MI registry carried out in the 25 to 74 year-old population, in eight Spanish regions in 1997. A standardized methodology was used to register and investigate all MI arriving alive to a hospital. Clinical characteristics, cardiovascular risk factors prevalence, pharmacological treatment, invasive and non-invasive procedures performed and complications at 28 days of evolution were recorded. A descriptive analysis was performed and the variation coefficient (VC) was calculated.Results. In 1997, 4,041 MI patients were registered, 79.9% were men with a mean age of 61.1 years. Although 10.9% (95% CI: 9.9-11.9%) were not admitted to the coronary care unit, a large variability existed among different areas (VC = 53%). There was a high variability in the utilization and performance of non-invasive and invasive procedures among regions, as well as in the use of pharmacological treatment. Only the use of antiaggregants (91.5%) and thrombolytic therapy (41.8%) showed a low variability (VC < 10%). Twenty-eight day mortality was 16.2% (95% CI: 15.1-17.4%) with a high variability being observed among the different regions (VC = 20.6%).Conclusion. Patient characteristics vary among the different Spanish regions. The differences in management and prognosis suggest a lack of equality in the health care provided to MI patients in the different regions in Spain.

  10. [Carotid body paraganglioma in a teenager. Case report].

    PubMed

    López-Vázquez, María Elisa; Llamas-Macías, Francisco Javier; Nuño-Escobar, César; González-Ojeda, Alejandro; Fuentes-Orozco, Clotilde; Macías-Amezcua, Michel Dassaejv

    2014-01-01

    Antecedentes: los paragangliomas de cabeza y cuello son tumores neuroendocrinos de baja incidencia (0.6%), en su mayor parte benignos, en cuyo origen se han involucrado múltiples factores. Los seres humanos y otras especies que viven a grandes alturas (por arriba de 2000 metros sobre el nivel del mar) son propensos a sufrir hipoxia crónica relativa, hiperplasia del cuerpo carotídeo y, eventualmente, paragangliomas. Este padecimiento aparece en la quinta década de la vida y en la tercera, en caso de presentación familiar. Caso clínico: se comunica el caso de una adolescente de 16 años de edad que un año antes tuvo faringitis aguda con tumor localizado en la cara lateral izquierda del cuello, de crecimiento gradual, sin ningún síntoma. El ultrasonido Doppler dúplex de cuello mostró una lesión nodular sólida sobre el trayecto de la bifurcación carotídea izquierda. Fue intervenida quirúrgicamente mediante cervicotomía lateral izquierda, en la cual se encontró una tumoración de aproximadamente 4 × 3 × 3 cm, sumamente vascularizada, que afectaba la carótida común desde su tercio medio, la carótida interna hasta la base del cráneo y la carótida externa hasta el tercio superior, con íntima relación con la tráquea, el esófago y la columna cervical. La tumoración se resecó en su totalidad, el estudio histopatológico corroboró los paragangliomas. Conclusiones: la edad de presentación es poco común, por lo que se considera relevante y de interés clínico comunicar este caso, toda vez que debe considerarse como posibilidad diagnóstica.

  11. 21 CFR 524.1484g - Neomycin sulfate-thiabendazole-dexamethasone solution.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... and otitis externa in dogs and cats. (2) In treating dermatoses affecting areas other than the ear, the surface of the lesions should be well moistened (two to four drops per square inch) twice daily. In treating otitis externa, five to 15 drops of the drug should be instilled in the ear twice...

  12. 21 CFR 524.1484g - Neomycin sulfate-thiabendazole-dexamethasone solution.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... and otitis externa in dogs and cats. (2) In treating dermatoses affecting areas other than the ear, the surface of the lesions should be well moistened (two to four drops per square inch) twice daily. In treating otitis externa, five to 15 drops of the drug should be instilled in the ear twice...

  13. 21 CFR 524.1881b - Prednisolone acetate-neomycin sulfate sterile suspension.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... conjunctivitis, acute otitis externa, and chronic otitis externa in dogs and cats. (2) For beginning treatment of acute ocular inflammations 1 or 2 drops may be placed in the conjunctival sac 3 to 6 times during a 24 hour period. When improvement occurs, the dosage may be reduced to 1 drop 2 to 4 times daily. In...

  14. 21 CFR 524.1881b - Prednisolone acetate-neomycin sulfate sterile suspension.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... conjunctivitis, acute otitis externa, and chronic otitis externa in dogs and cats. (2) For beginning treatment of acute ocular inflammations 1 or 2 drops may be placed in the conjunctival sac 3 to 6 times during a 24 hour period. When improvement occurs, the dosage may be reduced to 1 drop 2 to 4 times daily. In...

  15. 21 CFR 524.1881b - Prednisolone acetate-neomycin sulfate sterile suspension.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... conjunctivitis, acute otitis externa, and chronic otitis externa in dogs and cats. (2) For beginning treatment of acute ocular inflammations 1 or 2 drops may be placed in the conjunctival sac 3 to 6 times during a 24 hour period. When improvement occurs, the dosage may be reduced to 1 drop 2 to 4 times daily. In...

  16. 21 CFR 524.1484g - Neomycin sulfate-thiabendazole-dexamethasone solution.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... and otitis externa in dogs and cats. (2) In treating dermatoses affecting areas other than the ear, the surface of the lesions should be well moistened (two to four drops per square inch) twice daily. In treating otitis externa, five to 15 drops of the drug should be instilled in the ear twice...

  17. 21 CFR 524.1484g - Neomycin sulfate-thiabendazole-dexamethasone solution.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... and otitis externa in dogs and cats. (2) In treating dermatoses affecting areas other than the ear, the surface of the lesions should be well moistened (two to four drops per square inch) twice daily. In treating otitis externa, five to 15 drops of the drug should be instilled in the ear twice...

  18. 21 CFR 524.1484k - Neomycin sulfate, prednisolone, tetracaine, and squalane topical-otic suspension.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ..., DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS OPHTHALMIC AND... in dogs and cats for treating acute otitis externa and as adjunctive therapy in management of chronic otitis externa. The product may also be used for treating moist dermatitis in dogs. (3)...

  19. 75 FR 16346 - Ophthalmic and Topical Dosage Form New Animal Drugs; Orbifloxacin, Mometasone Furoate Monohydrate...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-01

    ... orbifloxacin, mometasone furoate monohydrate, and posaconazole for the treatment of otitis externa in dogs... of otitis externa in dogs associated with susceptible strains of yeast (Malassezia pachydermatis) and... posaconazole. (b) Sponsor. See No. 000061 in Sec. 510.600(c) of this chapter. (c) Conditions of use in...

  20. 21 CFR 524.981b - Fluocinolone acetonide solution.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... inflammation associated with otitis externa and certain superficial acute and chronic dermatoses in the dog. It is also indicated for the relief of pruritus and inflammation associated with acute otitis externa and certain superficial acute and chronic dermatoses in the cat. (2) A small amount of solution...

  1. Operational Alternatives for Air Assault Forces in the 1990s.

    DTIC Science & Technology

    1982-06-01

    in emergency. Attack helicopters will go after hostile ADA to strip it out as soon as a flight is fired upon. Smoke and deception measures are also... Assesment , Incl. 2, p. 9. Paraphraae, not verbatim. 43. 101st Assesnent, Incl. 2, pp. 9-10. 44. Richard S. otite, BG, US Deptment of the Army, Forces...Reforg9r 76, p. Ill-I. Ihdes is a classified docment. Only unclassified portions are cited or excerpted.) (here- after cited ’ l Assesment .) 45. R==(i

  2. Gradenigo's syndrome--surgical management in a child.

    PubMed

    Humayun, Hassan Nabeel; Akhtar, Shabbir; Ahmed, Shakeel

    2011-04-01

    Otits media is a common problem. Some of its complications that were seen frequently in the preantibiotic era are rare today. We report a case of an 8 year boy who presented with earache, retro-orbital pain and diplopia secondary to a sixth nerve palsy--Gradenigo's syndrome. In this syndrome infection from the middle ear spreads medially to the petrous apex of the temporal bone. Work-up includes CT scan of the temporal bones. Timely management with intravenous antibiotics (+ surgery) is needed to prevent intra-cranial complications.

  3. Acute Myeloid Leukemia (AML) (For Parents)

    MedlinePlus

    ... Your 1- to 2-Year-Old Acute Myeloid Leukemia (AML) KidsHealth > For Parents > Acute Myeloid Leukemia (AML) ... Treatment Coping en español Leucemia mieloide aguda About Leukemia Leukemia is a type of cancer that affects ...

  4. 21 CFR 524.1484f - Neomycin sulfate, prednisolone acetate, tetracaine hydrochloride eardrops.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...-susceptible organisms and/or allergy. In otitis externa, 2 to 6 drops may be placed in the external ear canal... hypersensitivity or allergy. If such signs are noted, therapy should be stopped.1 (3) Federal law restricts...

  5. 21 CFR 524.1484f - Neomycin sulfate, prednisolone acetate, tetracaine hydrochloride eardrops.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...-susceptible organisms and/or allergy. In otitis externa, 2 to 6 drops may be placed in the external ear canal... hypersensitivity or allergy. If such signs are noted, therapy should be stopped.1 (3) Federal law restricts...

  6. 21 CFR 524.1484f - Neomycin sulfate, prednisolone acetate, tetracaine hydrochloride eardrops.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...-susceptible organisms and/or allergy. In otitis externa, 2 to 6 drops may be placed in the external ear canal... hypersensitivity or allergy. If such signs are noted, therapy should be stopped.1 (3) Federal law restricts...

  7. 21 CFR 524.1044b - Gentamicin sulfate, betamethasone valerate otic solution.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... use—(i) For the treatment of acute and chronic otitis externa caused by bacteria sensitive to.... (ii) For the treatment of infected superficial lesions caused by bacteria sensitive to gentamicin...

  8. 21 CFR 524.1204 - Kanamycin sulfate, calcium amphomycin, and hydrocortisone acetate.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... HEALTH AND HUMAN SERVICES (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS OPHTHALMIC AND TOPICAL DOSAGE FORM NEW ANIMAL DRUGS § 524.1204 Kanamycin sulfate, calcium amphomycin, and hydrocortisone acetate... antibiotics: Acute otitis externa, furunculosis, folliculitis, pruritus, anal gland infections,...

  9. 21 CFR 524.1044b - Gentamicin sulfate, betamethasone valerate otic solution.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... use—(i) For the treatment of acute and chronic otitis externa caused by bacteria sensitive to.... (ii) For the treatment of infected superficial lesions caused by bacteria sensitive to gentamicin...

  10. 21 CFR 524.1044b - Gentamicin and betamethasone otic solution.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... treatment of acute and chronic otitis externa caused by bacteria sensitive to gentamicin in dogs, instill... of infected superficial lesions caused by bacteria sensitive to gentamicin in dogs and cats, apply...

  11. 21 CFR 524.1044b - Gentamicin sulfate, betamethasone valerate otic solution.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... use—(i) For the treatment of acute and chronic otitis externa caused by bacteria sensitive to.... (ii) For the treatment of infected superficial lesions caused by bacteria sensitive to gentamicin...

  12. 21 CFR 524.1044b - Gentamicin sulfate, betamethasone valerate otic solution.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... use—(i) For the treatment of acute and chronic otitis externa caused by bacteria sensitive to.... (ii) For the treatment of infected superficial lesions caused by bacteria sensitive to gentamicin...

  13. Isolation of Malassezia furfur from a Cat

    PubMed Central

    Crespo, M. J.; Abarca, M. L.; Cabañes, F. J.

    1999-01-01

    During a survey of the occurrence of Malassezia species in the external ear canals of cats without otitis externa, Malassezia furfur was isolated. This is the first report of the isolation of M. furfur from cats. PMID:10203525

  14. Inventario mundial de la calidad del carbon mineral (WoCQI) [The world coal quality inventory (WoCQI)

    USGS Publications Warehouse

    Finkelman, R.B.; Lovern, V.S.

    2001-01-01

    Los oficiales encargados de la politica comercial de cada pais requieren informacion clara y precisa sobre el recurso del carbon mineral, particularmente sobre sus propiedades y caracteristicas, para tomar decisiones bien fundamentadas con respecto al mejor uso de los recursos naturales, necesidades de importacion y oportunidades de exportacion, objetivos de politica interna y externa, oportunidades de transferencia tecnologica, posibilidades de inversion externa, estudios ambientales y de salud, y asuntos relacionados con el uso de productos secundarios y su disposicion.

  15. Cholestéatome de l'oreille moyenne - étude rétrospective à propos de 145 cas

    PubMed Central

    Bouaity, Brahim; Chihani, Mehdi; Nadour, Karim; Moujahid, Mountassir; Touati, Mliha; Darouassi, Youssef; Ammar, Haddou

    2014-01-01

    L'otite moyenne chronique cholestéatomateuse représente une entité fréquente et dangereuse en chirurgie otologique, mettant en jeu le pronostic fonctionnel auditif et exposant à des complications redoutables justifiant pleinement le recours exclusif à un traitement chirurgical et à un suivi post-opératoire rigoureux. Dans le but de mettre le point sur les caractéristiques épidémiologiques, cliniques, thérapeutiques et évolutives de cette pathologie, nous avons mené une étude rétrospective, étalée sur 11 ans et portant sur 145 cas de cholestéatome de l'oreille moyenne opérés au sein du service d'oto-rhino-laryngologie et chirurgie cervico-faciale de l'hôpital militaire Avicenne de Marrakech. PMID:25120876

  16. Genotyping and characterisation of the secretory lipolytic enzymes of Malassezia pachydermatis isolates collected from dogs

    PubMed Central

    Teramoto, Hideshi; Kumeda, Yuko; Yokoigawa, Kumio; Hosomi, Koji; Kozaki, Shunji; Mukamoto, Masafumi; Kohda, Tomoko

    2015-01-01

    Introduction Malassezia species are commensals of normal skin microbial flora of humans and animals. These may become pathogenic under certain conditions such as those associated with atopic dermatitis or otitis externa in dogs. Material and methods Isolates of Malassezia pachydermatis were obtained from 27 dogs with healthy external ears and 32 dogs with otitis externa. Isolates were characterised on the basis of their first internal transcribed spacer (ITS) and internal spacer 1 (IGS1) sequences. Their extracellular lipase and phospholipase activity were also analysed. Three types of phospholipase inhibitor were used to identify the subclasses of phospholipase associated with otitis externa. Results The clinical isolates were classified into three ITS and three IGS1 sequence types. No significant differences in pathogenicity were detected among the ITS or IGS1 genotypes, and all of the isolates exhibited similar levels of lipase activity. The isolates derived from the dogs with otitis externa showed significantly higher phospholipase activity than those obtained from the dogs with healthy external ears. A phospholipase D inhibitor reduced the phospholipase activity of the isolates obtained from the dogs with otitis externa. Conclusions This study did not show any significant differences in pathogenicity among the ITS or IGS1 genotypes but does suggest that phospholipase D might be one of the virulence factors involved in the inflammation of the external ear caused by M. pachydermatis. PMID:26392911

  17. Otomycosis: Diagnosis and treatment.

    PubMed

    Vennewald, Irina; Klemm, Eckart

    2010-03-04

    Aspergillus and Candida spp are the most frequently isolated fungi in patients with otomycosis. The diagnosis of otitis externa relies on the patient's history, otoscopic examination under microscopic control, and imaging studies. Direct preparation of the specimens, particularly with optical brighteners, mycologic culture, and histologic examination, is very important and strongly recommended for the correct diagnosis. Patients with noninvasive fungal otitis externa should be treated with intense débridement and cleansing, and topical antifungals. Topical antifungals, such as clotrimazole, miconazole, bifonazole, ciclopiroxolamine, and tolnaftate, are potentially safe choices for the treatment of otomycosis, especially in patients with a perforated eardrum. The oral triazole drugs, itraconazole, voriconazole, and posaconazole are effective against Candida and Aspergillus, with good penetration of bone and the central nervous system. These drugs are essential in the treatment of patients with malignant fungal otitis externa complicated by mastoiditis and meningitis.

  18. [Rescue treatment in acute thrombosis of intracranial stents].

    PubMed

    Pumar, José M; Banguero, Alexandra; Arias-Rivas, Susana; Blanco, Miguel; Rodríguez-Yáñez, Manuel; Sucasas, Paula; Blanco, Miguel; Castiñeira-Mourenza, José A; Vázquez-Herrero, Fernando

    2014-02-01

    Introduccion. La trombosis aguda intrastent es una complicacion potencialmente grave en el stenting intracraneal. Es primordial determinar cual es la terapia mas adecuada en las trombosis intrastent. Caso clinico. Mujer de 58 años, el primer caso de trombosis aguda de un stent intracraneal, que fue tratada con exito mediante fibrinolisis tras la implantacion de un dispositivo diversificador de flujo (Silk) en un aneurisma basilar fusiforme. Conclusion. La administracion de abciximab como tratamiento de rescate parece segura en los casos de formaciones de trombos agudos intrastent.

  19. Violence in Brazil and Its Connection with Transnational Crime

    DTIC Science & Technology

    2007-11-02

    revistaepoca.globo.com/epoca/0,6993,EPT397991-1664,00.html>. Accessed 23 September 2002. 13 André Geraldo de M. Simões, As Mortes por Causas Violentas no Rio...ISER in 2002 and published by the own Institute, entitled: Epidemiologia de Causas Externas – Dados para a Tomada de Decisões. Indicadores de Violência...Americas Security. Washington, DC: National Defense University, 2001. Instituto de Ensino da Religião – ISER. Epidemiologia das Causas Externas – Dados

  20. Laser assisted Drug Delivery: Grundlagen und Praxis.

    PubMed

    Braun, Stephan Alexander; Schrumpf, Holger; Buhren, Bettina Alexandra; Homey, Bernhard; Gerber, Peter Arne

    2016-05-01

    Die topische Applikation von Wirkstoffen ist eine zentrale Therapieoption der Dermatologie. Allerdings mindert die effektive Barrierefunktion der Haut die Bioverfügbarkeit der meisten Externa. Fraktionierte ablative Laser stellen ein innovatives Verfahren dar, um die epidermale Barriere standardisiert, kontaktfrei zu überwinden. Die Bioverfügbarkeit im Anschluss applizierter Externa wird im Sinne einer laser assisted drug delivery (LADD) signifikant gesteigert. Das Prinzip der LADD wird bereits in einigen Bereichen der Dermatologie erfolgreich eingesetzt. Die vorliegende Übersichtsarbeit soll einen Überblick über die aktuellen aber auch perspektivischen Einsatzmöglichkeiten der LADD bieten.

  1. Surgical Management of Ear Diseases in Rabbits.

    PubMed

    Csomos, Rebecca; Bosscher, Georgia; Mans, Christoph; Hardie, Robert

    2016-01-01

    Otitis externa and media are frequently diagnosed disorders in rabbits and are particularly common in lop-eared breeds because of the specific anatomy of the ear canal. Medical management for otitis externa and media often provides only a temporary improvement in clinical signs. Surgery by means of partial or total ear canal ablation (PECA or TECA) combined with lateral bulla osteotomy (LBO) represents a feasible approach that is well tolerated and provides a good clinical outcome. Short-term complications associated with PECA/TECA-LBO include facial nerve paralysis and vestibular disease.

  2. [Cerebral artery infarction presented as an unusual complication of acute middle otitis].

    PubMed

    Moscote-Salazar, Luis Rafael; Alcalá-Cerra, Gabriel; Castellar-Leones, Sandra Milena; Gutiérrez-Paternina, Juan José

    2013-01-01

    Introducción: la otitis media aguda es una inflamación del oído medio frecuente en la edad pediátrica. Aproximadamente 2 % de todos los casos desarrolla complicaciones intracraneales, más específicamente meningitis; por lo general, los infartos cerebrales originados por esta última son venosos. Rara vez se ha descrito la ocurrencia de un infarto arterial cerebral como complicación directa de la otitis media aguda. Caso clínico: niña de 12 meses de edad quien fue llevada a un servicio de urgencias por síndrome febril secundario a otitis media aguda y alteración del estado de conciencia. A la exploración física se identificó que estaba somnolienta, con anisocoria, midriasis en el ojo derecho y hemiparesia izquierda. Con la tomografía axial computarizada de cerebro se apreció un infarto arterial cerebral extenso. Los padres no autorizaron la craniectomía descompresiva y la paciente falleció a las 48 horas de su ingreso hospitalario. Conclusiones: a pesar de los recursos tecnológicos con los que se dispone actualmente, el infarto cerebral relacionado con la otitis media aguda tiene una evolución tórpida. Los signos neurológicos focalizadores y el deterioro progresivo deben apuntar a la ineficacia del tratamiento antimicrobiano instaurado.

  3. [Acute otitis media: could it be a sentinel indicator of health care?].

    PubMed

    Cabrera-Gaytán, David Alejandro; Valle-Alvarado, Gabriel; Krug-Llamas, Ernesto; Grajales-Muñiz, Concepción

    2014-01-01

    INTRODUCCIÓN: la otitis media aguda es la enfermedad bacteriana más frecuente en los niños menores de cinco años, por lo que constituye una de las causas más comunes de consulta médica pediátrica. El objetivo de esta investigación fue conocer el panorama epidemiológico de la otitis media aguda, con la finalidad de determinar la factibilidad de considerarla un indicador centinela de la atención médica. MÉTODOS: se recolectaron y analizaron todos los casos nuevos de otitis media aguda que se presentaron entre 2008 y 2011. Se determinaron proporciones, razones y tasas de incidencia, y se calcularon los límites para proporciones por prueba exacta de P-media. Resultados: en los niños menores de cinco años de edad se observó 20 % de los casos de otitis media no supurativa y 17 % de los casos de otitis media supurativa. En ese grupo de edad, aumentó la razón de casos de infecciones respiratorias agudas en relación con los de otitis media: 87:1 en 2008 a 53:1 en 2011.

  4. Extraintestinal Vibrio infections in Mauritius.

    PubMed

    Issack, Mohammad I; Appiah, Deoraz; Rassoul, Ameen; Unuth, Mahesswaree N; Unuth-Lutchun, Nehma

    2008-10-01

    Few extraintestinal Vibrio infections have been reported in the African region. We report 3 cases from Mauritius: one case of Vibrio alginolyticus otitis externa; one case of soft tissue infection caused by non-O1 Vibrio cholerae and Vibrio parahaemolyticus; and one fatal case of non-O1 V. cholerae cellulitis and septicaemia.

  5. "Hot Tub Rash" and "Swimmer's Ear" (Pseudomonas)

    MedlinePlus

    ... previously covered by swimsuit > Pus-filled blisters around hair follicles Swimmer’s Ear (Otitis externa) > Pain when infected ear ... ear. You can find this product at your drug store. > Avoid putting objects in the ear (for ... levels drop, so testing your pool or hot tub’s disinfectant and pH ...

  6. 21 CFR 524.1484g - Neomycin, thiabendazole, and dexamethasone solution.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... cats—(1) Amount. In treating dermatoses affecting areas other than the ear, the surface of the lesions should be well moistened (2 to 4 drops per square inch) twice daily. In treating otitis externa, instill 5 to 15 drops in the ear twice daily. Treat for up to 7 days. (2) Indications for use. As an aid...

  7. 21 CFR 524.1484k - Prednisolone and neomycin suspension.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... use in dogs and cats—(1) Amount. For beginning treatment of acute ocular inflammations place 1 or 2 drops in the conjunctival sac 3 to 6 times during a 24 hour period. When improvement occurs, reduce the dosage to 1 drop 2 to 4 times daily. For otitis externa, place 2 to 6 drops in the external ear canal...

  8. An Overview of the Special Operations Interactive Medical Training Program (SOIMTP).

    DTIC Science & Technology

    2007-11-02

    carbohydrates, tendonitis, amino acids, human anatomy, sprains, strains, dislocations, and other related topics. Medical Administration by LCDR Clifton...provides information about cellulitis, urinary infections, herpes simplex, upper respiratory infections, immersion (trench) foot, otitis externa, ringworm ...Atlanta, GA : U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control, (1991). 52. Pediatric Infectious

  9. Effects of hemlock woolly adelgid and elongate hemlock scale on eastern hemlock growth and foliar chemistry.

    PubMed

    Miller-Pierce, Mailea R; Orwig, David A; Preisser, Evan

    2010-04-01

    In the eastern United States, two invasive specialist insects share a native host plant, Eastern hemlock, Tsuga canadensis. In recent years, much research has focused on the impacts of the hemlock woolly adelgid (Adelges tsugae) because of the detrimental effects it has on hemlock growth and survival. In contrast, the invasive elongate hemlock scale (Fiorinia externa) is thought to have only minor impacts on hemlock. We infested hemlock saplings with each insect and compared them with control (i.e., neither insect herbivore) saplings to assess how early infestations impact Eastern hemlock health (measured using new branch growth, foliar %N, and C:N ratio). Our study showed that, at equal densities, the two insects differed in their effect on Eastern hemlock. F. externa did not impact plant growth or foliar chemistry over the course of the 2-yr experiment. A. tsugae significantly reduced plant growth and caused a reduction of %N in the first year of the experiment. By the end of the experiment, A. tsugae trees had the same %N in their foliage as control and F. externa trees but drastically reduced growth patterns. The most likely explanation for this result is the greater growth in control and F. externa saplings during the second year resulted in the dilution of available foliar N over a larger amount of newly produced plant tissue. For early infestations of both insects, our study suggests that management plans should focus on the more detrimental A. tsugae.

  10. Incidence and burden of earaches due to recreational swimming: Results from a nationwide study ofover 50,000 respondents

    EPA Science Inventory

    Background: Earaches and ear pain due to outer ear infections (otitis externa) are common following swimming and can result in time lost from work and school and visits to the physician or hospital. Objectives: Determine the proportion of self-reported earache attributable to ma...

  11. Organic synthesis via magnetic attraction: benign and sustainable protocols using magnetic nanoferrites

    EPA Science Inventory

    Magnetic nano-catalysts have been prepared using simple modification of iron ferrites wherein their quasi-homogeneous state, because of nm size range, facilitates the catalysis process as increased surface is available for reaction; the easy separation of the catalysts by externa...

  12. 21 CFR 524.1484d - Neomycin sulfate, hydrocortisone acetate, tetracaine hydrochloride ear ointment.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ..., tetracaine hydrochloride ear ointment. 524.1484d Section 524.1484d Food and Drugs FOOD AND DRUG..., tetracaine hydrochloride ear ointment. (a) Specifications. The product contains 5 milligrams of neomycin... a lesser degree, chronic otitis externa in dogs and cats. In treatment of ear canker and...

  13. 21 CFR 524.1484d - Neomycin sulfate, hydrocortisone acetate, tetracaine hydrochloride ear ointment.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ..., tetracaine hydrochloride ear ointment. 524.1484d Section 524.1484d Food and Drugs FOOD AND DRUG..., tetracaine hydrochloride ear ointment. (a) Specifications. The product contains 5 milligrams of neomycin... a lesser degree, chronic otitis externa in dogs and cats. In treatment of ear canker and...

  14. 21 CFR 524.1484d - Neomycin sulfate, hydrocortisone acetate, tetracaine hydrochloride ear ointment.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ..., tetracaine hydrochloride ear ointment. 524.1484d Section 524.1484d Food and Drugs FOOD AND DRUG..., tetracaine hydrochloride ear ointment. (a) Specifications. The product contains 5 milligrams of neomycin... a lesser degree, chronic otitis externa in dogs and cats. In treatment of ear canker and...

  15. Outcome of 22 cases of perforated tympanic membrane caused by otomycosis.

    PubMed

    Hurst, W B

    2001-11-01

    Twenty-two cases of perforated tympanic membrane due to fungal otitis externa were observed over a five-year period. The diagnosis of fungal otitis externa was made on clinical grounds due to the obvious presence of fungal bloom in the external ear canal. Some perforations were noted at the first treatment after the fungal debris had been removed from the external ear canal using a microscope. Other perforations were observed to develop over a few days. Initially, a discrete area of the tympanic membrane appeared white and opaque. As time progressed the white area disintegrated, forming a perforation. Once the otitis externa had resolved most perforations healed spontaneously. Two that were observed to develop during treatment required a myringoplasty. Another one closed significantly but a tiny persistent perforation required cauterization with trichloracetic acid to encourage it to close over completely. The only residual hearing loss was in a case with almost total disintegration of the tympanic membrane requiring a myringoplasty. Treatment of fungal otitis externa for the patients in this series was aural toilet using suction under a microscope and insertion of a gauze wick saturated in a combination of hydrocortisone, clotrimazole, framycetin and gramicidin.

  16. False ring formation in eastern hemlock branches: impacts of hemlock woolly adelgid and elongate hemlock scale.

    PubMed

    Gonda-King, Liahna; Radville, Laura; Preisser, Evan L

    2012-06-01

    Herbivores can alter plant physiology through the induction of abnormal wood formation. Feeding by some insects induces the formation of false rings, a band of thick-walled latewood cells within the earlywood portion of the tree ring that reduces water transport. Hemlock woolly adelgid (Adelges tsugae Annand) and elongate hemlock scale (Fiorinia externa Ferris) are invasive insects that both feed on eastern hemlock [Tsuga canadensis (L.) Carrière]. Adelges tsugae has a greater effect on tree health than F. externa, but the mechanism underlying their differential effect is unknown. We explored the effects of these herbivores by assessing growth ring formation in branches of trees that had been experimentally infested for 4 yr with A. tsugae, F. externa, or neither insect. We measured false ring density, ring growth, and earlywood: latewood ratios in the two most recently deposited growth rings. Branches from A. tsugae-infested trees had 30% more false rings than branches from F. externa-infested trees and 50% more than branches from uninfested trees. In contrast, branches from F. externa-infested trees and control trees did not differ in false ring formation. Radial growth and earlywood: latewood ratios did not differ among treatments. Our results show that two invasive herbivores with piercing-sucking mouth parts have differing effects on false ring formation in eastern hemlock. These false rings may be the product of a systemic plant hypersensitive response to feeding by A. tsugae on hemlock stems. If false rings are responsible for or symptomatic of hemlock water stress, this may provide a potential explanation for the relatively large effect of A. tsugae infestations on tree health.

  17. Indications, usage, and dosage of the transfer factor.

    PubMed

    Berrón-Pérez, Renato; Chávez-Sánchez, Raúl; Estrada-García, Iris; Espinosa-Padilla, Sara; Cortez-Gómez, Rudyard; Serrano-Miranda, Ernestina; Ondarza-Aguilera, Rodolfo; Pérez-Tapia, Mayra; Pineda Olvera, Benjamín; Jiménez-Martínez, María del Carmen; Portugués, Abraham; Rodríguez, Azucena; Cano, Laura; Pacheco, Pedro Urcino; Barrientos, Javier; Chacón, Rommel; Serafín, Jeannet; Mendez, Patricia; Monges, Abelardo; Cervantes, Edgar; Estrada-Parra, Sergio

    2007-01-01

    The transfer factor (TF) was described in 1955 by S. Lawrence. In 1992 Kirkpatrick characterized the specific TF at molecular level. The TF is constituted by a group of numerous molecules, of low molecular weight, from 1.0 to 6.0 kDa. The 5 kDa fraction corresponds to the TF specific to antigens. There are a number of publications about the clinical indications of the TF for diverse diseases, in particular those where the cellular immune response is compromised or in those where there is a deficient regulation of the immune response. In this article we present our clinical and basic experiences, especially regarding the indications, usage and dosage of the TF. Our group demonstrated that the TF increases the expression of IFN-gamma and RANTES, while decreases the expression of osteopontine. Using animal models we have worked with M. tuberculosis, and with a model of glioma with good therapeutic results. In the clinical setting we have worked with herpes zoster, herpes simplex type I, herpetic keratitis, atopic dermatitis, osteosarcoma, tuberculosis, asthma, post-herpetic neuritis, anergic coccidioidomycosis, leishmaniasis, toxoplasmosis, mucocutaneous candidiasis, pediatric infections produced by diverse pathogen germs, sinusitis, pharyngitis, and otits media. All of these diseases were studied through protocols which main goals were to study the therapeutic effects of the TF, and to establish in a systematic way diverse dosage schema and time for treatment to guide the prescription of the TF.

  18. Infection respiratoire aigüe et statut nutritionnel chez les enfants de 0-5 ans: cas des cliniques universitaires de Lubumbashi, République Démocratique du Congo

    PubMed Central

    Ngombe, Léon Kabamba; Mbombo-Ditunga; Kameya, Nduwa; Malingo, Aimé Abasiko; Kayomb, Nathalie Kaj; ea Ngolomba, Jean Ngolomba; Nday, David Kakez; Numbi, Luboya

    2014-01-01

    Les auteurs rapportent les données d'une étude rétrospective de 153 dossiers d'enfants hospitalisés dans le service de pédiatrie des Cliniques Universitaires de Lubumbashi/RD Congo pour IRA. En ce qui nous concerne, les IRA chez les enfants de moins de 5 ans représentent 26,11% de l'effectif, dont 17,75% âgés de moins d'un an. Le sexe masculin est légèrement prédominant (85 contre 68) et près de 70% des enfants ont un statut nutritionnel précaire. La répartition mensuelle connaît des pics en mars et octobre. Les diagnostiques notifiés sont: rhinite(16,3%),Amygdalite(5,9%),Otite Moyenne Aigue(0,7%),Laryngite (3,3%), Rhinopharyngite (39,2%), Pharyngite (6,5%), Bronchite (7,2%), Bronchopneumonie (5,9%), Pneumonie(2,6%) et Bronchiolite (12,4%).Tous les cas ont bien évolués sous traitement. Le but de ce travail est de déterminer la fréquence des IRA et le statut nutritionnel des enfants ayant été admis dans le service des pédiatries aux C.U.L. PMID:25995789

  19. Facilitators of implementing occupation based practice among Iranian occupational therapists: A qualitative study

    PubMed Central

    Khayatzadeh Mahani, Mohammad; Hassani Mehraban, Afsoon; Kamali, Mohammad; Parvizy, Soroor

    2015-01-01

    Background: The Occupation-Based Practice (OBP) is a central core of occupational therapy (OT).It refers to using a meaningful occupation based on the client’s interests, needs, health and participation in daily life. This study aimed to explore the facilitators of implementing OBP among Iranian occupational therapists. Methods: Fourteen occupational therapists participated in this study. Data were collected through semi-structured interviews, and the sampling method was purposeful. The interviews were continued until data saturation was reached, and data were recorded and transcribed verbatim. Data were analyzed through qualitative content analysis using constant comparative analysis. Results: Our analysis explored two themes: Factors attributed to context, and factors attributed to therapists. The first theme consisted of three subthemes: Educational programs of OT department, public information about OBP and clinical setting compatible with OBP. The second theme also contained three subthemes including: Positive attitude regarding effectiveness of OBP, emphasis on client- centered and family- centered practice and convincing the clients to utilize OBP. Conclusion: The facilitators of implementing OBP are attributed to factors internal to the therapists as well as to issues in the external environment and context. Understanding these factors will help occupational therapists, OT educational staff, administrators and rehabilitation team members to facilitate the implementation of OBP. PMID:26913270

  20. Formulation of Thermosensitive in situ Otic Gel for Topical Management of Otitis Media

    PubMed Central

    Shau, P. A.; Dangre, P. V.; Potnis, V. V.

    2015-01-01

    Antibiotics and antiinflammatory agents are the primary and main therapeutic categories in the treatment of otitis media. One of the simpler and feasible approaches of minimizing the problem of repeated use and subsequent resistance is development of sustained release formulation. Therefore, the present investigation aimed to develop a sustained release in situ gel formulation containing combination of broad spectrum antibiotic and antiinflammatory agents for the management of otits media. The prolonged release is achieved by phase transition of Poloxamer 407 (in situ) from sol to gel at a physiological temperature in combination with viscosity imparting agent Natrasol 250 and Klucel HF. The formulation P3N3 (19% w/v Poloxamer 407, 1.5% w/v Natrasol 250) and P3K3 (19% w/v Poloxamer 407, 1.5% w/v Klucel HF) showed mucoadhesive strength 37.17±0.32×103 and 38.12±0.13×103 dyne/cm2, respectively, and gel strength 2.1 and 2 cm, respectively. Both these formulations indicated good drug content and viscosity besides a good gelling ability. The in vitro diffusion has demonstrated prolongation of release of both the drugs over a period of 8 h. PMID:26997706

  1. Les infections à Fusobacterium chez l’enfant

    PubMed Central

    Arane, Karen; Goldman, Ran D.

    2016-01-01

    Résumé Question Une otite moyenne aiguë chez un patient de 2 ans qui fréquente ma clinique a dégénéré en mastoïdite avec forte fièvre et les résultats de culture se sont révélés positifs pour le Fusobacterium. Que dois-je faire ensuite? Réponse Le Fusobacterium est un genre de bactéries anaérobies. Quoique les infections à Fusobacterium soient rares, elles peuvent devenir graves si elles ne sont pas traitées rapidement. Le traitement approprié est une antibiothérapie combinée associant une β-lactamine (pénicilline, céphalosporine) et un agent contre les microbes anaérobies (métronidazole, clindamycine). Il faut parfois une intervention chirurgicale pour la mastoïdite, comme le drainage d’abcès ou l’insertion d’un tube de ventilation. Le traitement tardif d’une infection causée par le Fusobacterium peut entraîner de sérieuses complications, dont le syndrome de Lemierre. Il faudrait une surveillance étroite de l’enfant en milieu hospitalier. PMID:27737993

  2. [Effect of metformin addition to an acute lymphoblastic leukemia chemotherapy treatment].

    PubMed

    Ramos-Peñafiel, Christian Omar; Martínez-Murillo, Carlos; Santoyo-Sánchez, Adrián; Jiménez-Ponce, Fiacro; Rozen-Fuller, Etta; Collazo-Jaloma, Juan; Olarte-Carrillo, Irma; Martínez-Tovar, Adolfo

    2014-01-01

    INTRODUCCIÓN: se ha informado efecto benéfico con metformina en pacientes con cáncer. El objetivo de esta investigación fue evaluar el efecto de adicionar metformina a la quimioterapia sobre las recaídas tempranas en pacientes con leucemia linfoblástica aguda. MÉTODOS: estudio prospectivo, longitudinal y experimental de pacientes portadores de leucemia linfoblástica aguda de novo, realizado en el Hospital General de Mexico. La muestra fue dividida en dos brazos de tratamiento: uno recibió metformina (850 mg cada ocho horas) + quimioterapia; otro recibió únicamente quimioterapia estándar. La distribución de los pacientes fue aleatoria, 3:1 a favor del segundo brazo.

  3. A new genus and two new species of Peltogastridae (Crustacea: Cirripedia: Rhizocephala) parasitizing hermit crabs from Okinawa Island (Ryukyu Archipelago, Japan), and their DNA-barcodes.

    PubMed

    Yoshida, Ryuta; Osawa, Masayuki; Hirose, Mamiko; Hirose, Euichi

    2011-11-01

    A new genus and two new species of Peltogastridae, Peltogaster postica sp. nov. and Ommatogaster nana gen. et sp. nov., are described from Okinawa Island, Ryukyu Islands, southwestern Japan. The two new rhizocephalans were found to be parasitic on the estuarine hermit crabs, Pagurus minutus Hess, 1865 and Diogenes leptocerus Forest, 1956, respectively. Peltogaster postica sp. nov. is allied to P. curvata Kossmann, 1874, P. paguri Rathke, 1842 , and P. reticulata Shiino, 1943 , but is distinguished by its relative length and internal and external structures of the mature externa. Ommatogaster gen. nov. is established for the present new species O. nana based on the morphologies of the visceral mass of the externa and the presence of a nauplius eye in the larvae. Partial COI sequences were obtained from the two new species and one known species, Dipterosaccus indicus Van Kampen and Boschma, 1925, to test the possible usefulness of the sequences as tags for species identification.

  4. Prediction of Success in External Cephalic Version under Tocolysis: Still a Challenge.

    PubMed

    Vaz de Macedo, Carolina; Clode, Nuno; Mendes da Graça, Luís

    2015-01-01

    Introdução: A versão cefálica externa é o procedimento de rotação fetal para uma apresentação cefálica através de manobras sobre o abdómen materno. Encontram-se descritos na literatura vários factores prognósticos para o sucesso da versão cefálica externa e foram propostos scores preditores, mas a sua verdadeira implicação para a prática clínica é controversa. Pretendemos identificar possíveis factores contributivos para o sucesso de uma tentativa de versão cefálica externa na nossa população. Material e Métodos: Examinámos retrospectivamente 207 tentativas consecutivas de versão cefálica externa sob tocólise conduzidas entre Janeiro de 1997 e Julho de 2012. Consultámos a base de dados do departamento para as seguintes variáveis: raça, idade, paridade, índice de massa corporal, idade gestacional, peso fetal estimado, categoria de apresentação, localização placentária e índice de líquido amniótico. Efectuámos avaliação estatística descritiva e analítica monovariada e regressão binária logística. Resultados: A versão cefálica externa foi bem-sucedida em 46,9% dos casos (97/207). Nenhuma das variáveis incluídas se associou com o desfecho da tentativa após ajuste para factores de confundimento.Discussão: Apresentamos uma taxa de sucesso semelhante ao descrito na literatura. No entanto, ao contrário de estudos anteriores, não associámos nenhuma das variáveis analisadas com o sucesso das tentativas de versão cefálica externa. Acreditamos que esta discrepância poderá ser parcialmente explicada pelo tipo de análise estatística efectuada. Conclusões: Apesar de terem sido identificados numerosos factores de prognóstico para o seu sucesso, o aconselhamento e selecção de grávidas para versão cefálica externa deverão ser cautelosos. Os dados obtidos sugerem que a versão cefálica externa deverá continuar a ser oferecida a todas as grávidas elegíveis independentemente de factores prognósticos de

  5. [ORL].

    PubMed

    Marchal, F

    2015-01-21

    This 2014 version of news in ENT--established by reading more than 10,000 abstracts published in 2014--will focuss this year on two main topics that are trendy: Robotic surgery in ENT, and e-cigarette. Of course, other subjects will be treated as well, in the format of guidelines, like for otitis externa, tinnitus, ear grommets, Bell's palsy, children's sinusitis, topical treatments in sinusitis, or dangers of radiation on kids. Some interesting mobile applications will be as well presented.

  6. Antibacterial activity, chemical composition, and cytotoxicity of leaf’s essential oil from brazilian pepper tree (schinus terebinthifolius, raddi)

    PubMed Central

    Silva, A.B.; Silva, T.; Franco, E.S.; Rabelo, S.A.; Lima, E.R.; Mota, R.A.; da Câmara, C.A.G.; Pontes-Filho, N.T.; Lima-Filho, J.V.

    2010-01-01

    The antibacterial potential of leaf’s essential oil (EO) from Brazilian pepper tree (Schinus terebinthifolius Raddi) against staphylococcal isolates from dogs with otitis externa was evaluated. The minimum inhibitory concentration of EO ranged from 78.1 to 1,250 μg/mL. The oil was analyzed by GC and GC/MS and cytotoxicity tests were carried out with laboratory animals. PMID:24031476

  7. Index of Submarine Medical Officer’s Qualification Theses 1944-1974

    DTIC Science & Technology

    1976-04-01

    CONNECTICUT. 12 JUN 63 SNRL 1963-0009 ERDEA. EACTERIAL . FLORA OF THE UPPER RESPIRATCRY TRACT OF SCJBA DIVERS A SURVEY OF.= SUBMARINE MEDICAL QUALIFICATIGN...THE FUNGAL FLORA OF THE SUBMARINE ENVIRONMENT DURING PROLONGED SUBMERGENCE.= SUBMARINE MEDICAL QUALIFICATICK THESES U. S. NAVAL SUBMARINE...BACTERIAL FLORA OF THE UPPER RESPIRA 1963-0005 L EAR CANAL IN STUDENT+ BACTERIOLOGIC CHANGES IN THE EXTERNA 1962-3011 INVOLVED IN DOING BALANCE

  8. [Language disorders in acute cerebellitis: beyond dysarthria].

    PubMed

    Barragan-Martinez, D; Nunez-Enamorado, N; Berenguer-Potenciano, M; Villora-Morcillo, N; Martinez de Aragon, A; Camacho-Salas, A

    2017-01-01

    Introduccion. La cerebelitis aguda es una de las principales causas de sindrome cerebeloso en la infancia. Entre un amplio elenco de manifestaciones, en el que predominan la cefalea y la ataxia, podemos encontrar otras menos habituales, aunque interesantes, como las alteraciones del lenguaje, mas alla de la bien conocida disartria cerebelosa. Las diferentes combinaciones en que pueden aparecer los sintomas, especialmente cuando no se acompañan de ataxia, hacen de este cuadro un verdadero reto para el clinico. Casos clinicos. Se presentan dos pacientes, de 2 y 4 años, con clinica, pruebas de laboratorio y neuroimagen compatibles con cerebelitis aguda parainfecciosa, que asociaron una llamativa alteracion del lenguaje, uno en forma de mutismo cerebeloso y otro en forma de hipofluencia y agramatismo, y este ultimo cursaba ademas en ausencia de ataxia. La evolucion de ambos casos fue buena, y persistieron leves alteraciones del habla en el seguimiento posterior. Conclusiones. Casos como estos amplian el espectro de manifestaciones clinicas de la cerebelitis aguda. Cada vez cobra mayor importancia la participacion del cerebelo en procesos neurocognitivos como el lenguaje y, aunque muchos aspectos son aun especulativos, alcanzar a definir su verdadero papel tendra una repercusion en el diagnostico, el tratamiento y el pronostico a largo plazo de estos pacientes.

  9. [Clinical features of acute leukemia and its relationship to the season of the year].

    PubMed

    Santoyo-Sánchez, Adrián; Ramos-Peñafiel, Christian; Palmeros-Morgado, Goujon; Mendoza-García, Emma; Olarte-Carrillo, Irma; Martínez-Tovar, Adolfo; Collazo-Jaloma, Juan

    2014-01-01

    INTRODUCCIÓN: en 2009, 17.9 % de la morbilidad hospitalaria por tumores malignos en México correspondió a neoplasias hematooncológicas, principalmente a leucemias agudas. Algunos estudios sugieren un patrón estacional al presentarse más casos durante el verano. El objetivo de esta investigación fue estimar la relación entre los diferentes subtipos de leucemia aguda, la edad de presentación y la estación del año. MÉTODOS: estudio retrospectivo, observacional, que se llevó a cabo con los registros de enero de 2006 a abril de 2012 en un servicio de hematología; se incluyeron únicamente los pacientes con diagnósticos de novo de leucemia aguda, estratificada según la clasificación de la Asociación Franco-Américo-Británica. El análisis de temporalidad se realizó con el modelo periódico de Edward.

  10. Ear Mite Removal in the Santa Catalina Island Fox (Urocyon littoralis catalinae): Controlling Risk Factors for Cancer Development

    PubMed Central

    Moriarty, Megan E.; Vickers, T. Winston; Clifford, Deana L.; Garcelon, David K.; Gaffney, Patricia M.; Lee, Kenneth W.; King, Julie L.; Duncan, Calvin L.; Boyce, Walter M.

    2015-01-01

    Ear mites (Otodectes cynotis) and ear canal tumors are highly prevalent among federally endangered Island foxes (Urocyon littoralis catalinae) living on Santa Catalina Island off the coast of Southern California. Since studies began in the 1990s, nearly all foxes examined were found to be infected with ear mites, and ceruminous gland tumors (carcinomas and adenomas) were detected in approximately half of all foxes ≥ 4 years of age. We hypothesized that reduction of ear mite infection would reduce otitis externa and ceruminous gland hyperplasia, a risk factor for tumor development. In this study, we conducted a randomized field trial to assess the impact of acaricide treatment on ear mite prevalence and intensity of infection, otitis externa, ceruminous gland hyperplasia, and mite-specific IgG and IgE antibody levels. Treatment was highly effective at eliminating mites and reducing otitis externa and ceruminous gland hyperplasia, and mite-specific IgG antibody levels were significantly lower among uninfected foxes. Ceruminous gland hyperplasia increased in the chronically infected, untreated foxes during the six month study. Our results provide compelling evidence that acaricide treatment is an effective means of reducing ear mites, and that mite removal in turn reduces ear lesions and mite-specific IgG antibody levels in Santa Catalina Island foxes. This study has advanced our understanding of the underlying pathogenesis which results in ceruminous gland tumors, and has helped inform management decisions that impact species conservation. PMID:26641820

  11. Ear Mite Removal in the Santa Catalina Island Fox (Urocyon littoralis catalinae): Controlling Risk Factors for Cancer Development.

    PubMed

    Moriarty, Megan E; Vickers, T Winston; Clifford, Deana L; Garcelon, David K; Gaffney, Patricia M; Lee, Kenneth W; King, Julie L; Duncan, Calvin L; Boyce, Walter M

    2015-01-01

    Ear mites (Otodectes cynotis) and ear canal tumors are highly prevalent among federally endangered Island foxes (Urocyon littoralis catalinae) living on Santa Catalina Island off the coast of Southern California. Since studies began in the 1990s, nearly all foxes examined were found to be infected with ear mites, and ceruminous gland tumors (carcinomas and adenomas) were detected in approximately half of all foxes ≥ 4 years of age. We hypothesized that reduction of ear mite infection would reduce otitis externa and ceruminous gland hyperplasia, a risk factor for tumor development. In this study, we conducted a randomized field trial to assess the impact of acaricide treatment on ear mite prevalence and intensity of infection, otitis externa, ceruminous gland hyperplasia, and mite-specific IgG and IgE antibody levels. Treatment was highly effective at eliminating mites and reducing otitis externa and ceruminous gland hyperplasia, and mite-specific IgG antibody levels were significantly lower among uninfected foxes. Ceruminous gland hyperplasia increased in the chronically infected, untreated foxes during the six month study. Our results provide compelling evidence that acaricide treatment is an effective means of reducing ear mites, and that mite removal in turn reduces ear lesions and mite-specific IgG antibody levels in Santa Catalina Island foxes. This study has advanced our understanding of the underlying pathogenesis which results in ceruminous gland tumors, and has helped inform management decisions that impact species conservation.

  12. Microstructure Features of Proventriculus and Ultrastructure of the Gastric Gland Cells in Chinese Taihe Black-bone Silky Fowl (Gallus gallus domesticus Brisson).

    PubMed

    Zhang, H; Ge, T; Peng, S; Zhong, S; Zhou, Z

    2016-02-01

    To investigate microstructure of proventriculus and ultrastructure of the gastric gland cells from Chinese Taihe black-bone silky fowl (BSF), the proventriculus of 4-week-old BSF was sampled. Conventional histological and transmission electron microscope (TEM) methods were used in this study. The wall of the Taihe BSF proventriculus was consisted of four layers, the mucous, submucosa, muscularis externa and the serosa as others birds. The muscularis externa of the birds' proventriculus contained three layers. Much of the melanin was present in loose connective tissue of lamina propria, submucosa, and muscularis externa unlike others. In addition, the ultrastructure of the gastric gland cells was observed by TEM. There was only one kind of gland cell, for example oxynticopeptic cell in proventriculus of Taihe BSF. The oxynticopeptic cells contained numerous mitochondria, cisternae of rough endoplasmic reticulum (CRER), intracellular canaliculi (IC) that secrete hydrochloric acid and small amounts of pepsinogen granules. The rough endoplasmic reticulum (RER) was irregular cisternae with ribosomes and surrounded tightly the mitochondria along their configuration. The electron-dense pepsinogen granules were round with various sizes. The neighbouring oxynticopeptic cells were closed up with tight junction and gap junction. The inter-space between the neighbouring oxynticopeptic cells was stenosis or was filled with electron-dense extracellular substance. In conclusion, the gastric gland cells of Chinese Taihe BSF proventriculus were only oxynticopeptic cells that secrete hydrochloric acid and pepsinogen, but no parietal cells and chief cells of mammal. The gastric gland cells of proventriculus were underdeveloped compared with those of mammals.

  13. [Acute gastroenteritis by Cambylobacter spp: a retrospective study of a paediatric emergency department].

    PubMed

    Soares, Ana Teresa; Couto, Catarina; Romão, Patrícia; Melo, Isabel Saraiva de; Braga, Manuela; Diogo, José; Calhau, Paulo

    2014-01-01

    Introdução: A infeção por Campylobacter é a principal causa de gastroenterite aguda bacteriana pediátrica na União Europeia.Objetivos: Conhecer a prevalência de isolamento deste agente nas crianças admitidas na urgência com gastroenterite aguda que realizaram coprocultura, caracterizando a microbiologia, epidemiologia, clínica, terapêutica e complicações associadas.Material e Métodos: Casuística por consulta dos processos dos doentes admitidos na Urgência Pediátrica dum hospital distrital, durante 30 meses, com o diagnóstico de gastroenterite aguda e isolamento em coprocultura de Campylobacter.Resultados: Das 216 coproculturas efetuadas, 98 (45%) foram positivas. Identificámos Campylobacter spp. em 49 (50%) doentes. Destes, 30 (61%) eram do género feminino. A mediana de idades foi 23 meses. Catorze doentes tinham idade inferior a um ano, 25 entre um e cinco anos e 10 idade superior a cinco anos. Verificámos diarreia aquosa em cinco (10%) doentes, diarreia com sangue em 44 (90%), sangue e muco em 14 (29%), febre em 23 (47%), dor abdominal em 14 (29%) e vómitos em 11 (22%). Registámos um caso de sépsis. Internámos cinco doentes. Oito doentes foram medicados com azitromicina.Discussão: Esta é a maior casuística nacional publicada de gastroenterite aguda a Campylobacter em idade pediátrica e a primeira no sul do país. Campylobacter foi a principal bactéria identificada, associada maioritariamente a doença auto-limitada. Contudo, há a considerar formas de infeção graves. O aumento da resistência às quinolonas é preocupante.Conclusão: A utilização criteriosa da coprocultura permite a identificação etiológica na gastrenterite aguda bacteriana. O crescente aumento dos casos de Campylobacter diagnosticados reforça a necessidade de maior controlo das medidas de higiene na manipulação dos alimentos.

  14. [Neurological complications in the population of children with leukaemia].

    PubMed

    Martínez-Cayuelas, Elena; Domingo-Jiménez, Rosario; Pascual-Gázquez, Juan F; Martínez-Salcedo, Eduardo; Alarcón-Martínez, Helena; Bermúdez-Cortés, Mar; Fuster-Soler, José L; Pérez-Fernández, Virginia

    2015-02-01

    Introduccion. La leucemia es el cancer mas frecuente en edad pediatrica. Su tasa de curacion es del 80% con quimioterapia intensiva, que mejora la supervivencia, pero que tambien aumenta la frecuencia de efectos adversos, incluyendo los neurologicos. Objetivos. Describir la frecuencia y caracteristicas de las complicaciones neurologicas (CN) en pacientes con leucemia aguda linfoide (LAL) y leucemia aguda mieloide (LAM), e identificar los factores asociados a su presencia, la tasa de morbilidad neurologica y la supervivencia. Pacientes y metodos. Estudio retrospectivo de las CN presentes durante el tratamiento y seguimiento de los pacientes con LAL y LAM entre 1997 y 2012 por la unidad de oncohematologia infantil. Variables analizadas: datos demograficos, diagnostico oncologico, tratamiento y CN. Resultados. Se incluyo un total de 157 pacientes, 145 sin infiltracion de sistema nervioso central al diagnostico y ocho con infiltracion (tasa de CN del 14 y 12%, respectivamente). Las CN mas frecuentes fueron: neuropatias (31%), alteracion del nivel de conciencia (27%), convulsiones (22%) y cefalea (12%). Un 40% de los pacientes con CN ha presentado secuelas, pero ninguno ha fallecido como consecuencia de la CN. Se han detectado mas CN en el grupo de edad menor de 6 años con LAL de alto grado, en niveles de gravedad mas altos y en pacientes que habian recibido trasplante de precursores hematopoyeticos, todas ellas con diferencias estadisticamente significativas. Conclusiones. Las complicaciones neurologicas son frecuentes en los pacientes con leucemia aguda, en especial en aquellos con estadio de riesgo alto (sobre todo si son menores de 6 años) y trasplante de precursores hematopoyeticos. La mortalidad asociada es baja.

  15. Hamster thecal cells express muscle characteristics

    SciTech Connect

    Self, D.A.; Schroeder, P.C.; Gown, A.M.

    1988-08-01

    Contraction of the follicular wall about the time of ovulation appears to be a coordinated event; however, the cells that mediate it remain poorly studied. We examined the theca externa cells in the wall of hamster follicles for the presence of a functional actomyosin system, both in developing follicles and in culture. We used a monoclonal antibody (HHF35) that recognizes the alpha and gamma isoelectric variants of actin normally found in muscle, but not the beta variant associated with non-muscle sources, to evaluate large preovulatory follicles for actin content and composition. Antibody staining of sectioned ovaries showed intense circumferential reactivity in the outermost wall of developing follicles. Immunoblots from two-dimensional gels of theca externa lysates demonstrated the presence of the two muscle-specific isozymes of actin. Immunofluorescence of cultured follicular cells pulse-labeled with (3H) thymidine (for autoradiographic detection of DNA replication) revealed the presence, in many dividing cells, of actin filaments aligned primarily along the longitudinal axis of the cells. In cultures exposed to the calcium ionophore A23187 (10(-4) M) for varying periods (5 min to 1 h), contraction of many individual muscle-actin-positive cells was observed. Immunofluorescence of these cells, fixed immediately after ionophore-induced contraction, revealed compaction of the actin filaments. Our findings demonstrate that the cells of the theca externa contain muscle actins from an early stage and that these cells are capable of contraction even while proliferating in subconfluent cultures. They suggest that follicular growth may include a naturally occurring developmental sequence in which a contractile cell type proliferates in the differentiated state.

  16. Acute and Chronic Changes in Aquaporin 4 Expression After Spinal Cord Injury

    PubMed Central

    Nesic, Olivera; Lee, Julieann; Ye, Zaiming; Unabia, Geda C.; Rafati, Danny; Hulsebosch, Claire E.; Perez-Polo, J. Regino

    2007-01-01

    The effect of spinal cord injury (SCI) on the expression levels and distribution of water channel aquaporin 4 (AQP4) has not been studied. We have found AQP4 in gray and white matter astrocytes in both uninjured and injured rat spinal cords. AQP4 was detected in astrocytic processes that were tightly surrounding neurons and blood vessels, but more robustly in glia limitans externa and interna, which were forming an interface between spinal cord parenchyma and cerebrospinal fluid (CSF). Such spatial distribution of AQP4 suggests a critical role that astrocytes expressing AQP4 play in the transport of water from blood/CSF to spinal cord parenchyma and vice versa. SCI induced biphasic changes in astrocytic AQP4 levels, including its early down-regulation and subsequent persistent up-regulation. However, changes in AQP4 expression did not correlate well with the onset and magnitude of astrocytic activation, when measured as changes in GFAP expression levels. It appears that reactive astrocytes began expressing increased levels of AQP4 after migrating to the wound area (thoracic region) two weeks after SCI, and AQP4 remained significantly elevated for months after SCI. We also showed that increased levels of AQP4 spread away from the lesion site to cervical and lumbar segments, but only in chronically injured spinal cords. Although overall AQP4 expression levels increased in chronically-injured spinal cords, AQP4 immunolabeling in astrocytic processes forming glia limitans externa was decreased, which may indicate impaired water transport through glia limitans externa. Finally, we also showed that SCI-induced changes in AQP4 protein levels correlate, both temporally and spatially, with persistent increases in water content in acutely and chronically injured spinal cords. Although correlative, this finding suggests a possible link between AQP4 and impaired water transport/edema/syringomyelia in contused spinal cords. PMID:17074445

  17. Developmental origins of colon smooth muscle dysfunction in IBS-like rats

    PubMed Central

    Li, Qingjie; Winston, John H.

    2013-01-01

    Epidemiological studies show that subsets of adult and pediatric patients with irritable bowel syndrome (IBS) have prior exposures to psychological or inflammatory stress. We investigated the cellular mechanisms of colonic smooth muscle dysfunction in adult rats subjected to neonatal inflammation. Ten-day-old male rat pups received 2,4,6-trinitrobenzene sulfonic acid to induce colonic inflammation. Colonic circular smooth muscle strips were obtained 6 to 8 wk later. We found that about half of the neonate pups subjected to inflammatory insult showed a significant increase in expression of the pore-forming α1C-subunit of Cav1.2b channels in adult life. These were the same rats in whom Vip mRNA increased in the colon muscularis externae. Additional experiments showed reduced interaction of histone deacetylase (HDAC) 3 with α1C1b promoter that increased the acetylation of histone H3 lysine 9 (H3K9) in the core promoter region. Vasoactive intestinal peptide (VIP) treatment of naïve muscularis externae swiftly recruited CREB-binding protein (CBP) to the α1C1b promoter and dissociated HDAC3 from this region to initiate transcription. The CBP interaction with the α1C1b promoter was transient, but the dissociation of HDAC3 persisted to sustain H3K9 hyperacetylation and increase in transcription. Intraperitoneal treatment of adult naïve rats with butyrate mimicked the effects of neonatal colon inflammation. We concluded that neonatal inflammation upregulates VIP in the colon muscularis externae, which modulates epigenetic events at the α1C1b promoter to activate α1C1b gene transcription. Inflammatory insult in early life may be one of the etiologies of smooth muscle dysfunction in adult life, which contributes to the altered motility function in patients with diarrhea-predominant IBS. PMID:23886858

  18. [Prehospital emergency care injuries from external causes in a region of Venezuela].

    PubMed

    Herrera, Rafael; Bastidas, Daniel; Arteaga, Everilda; Bastidas, Gilberto

    2017-01-01

    Introducción: a nivel mundial, anualmente mueren aproximadamente 3 500 000 personas como consecuencia de lesiones debidas a causas externas, lo que representa para Venezuela la tercera causa de morbilidad general. Sin embargo, no existen registros en el país de los aspectos que definen la atención de emergencia prehospitalaria como herramienta para afrontar este problema socio-sanitario, objeto de la presente investigación. Métodos: estudio descriptivo, transversal y de campo con base en la información registrada diariamente durante un año en emergencia prehospitalaria. Resultados: fueron en total 1493 los lesionados por causas externas, con edad promedio de 29.5 ± 12 años, 84.5% del género masculino. Las lesiones fueron, en su mayoría, de severidad menor-moderada (69.4%), debidas a accidentes de transporte terrestre (70.9%), ocurridos de día (75.9%), entre lunes y viernes (72.9%), atendidos en 20 minutos o menos, y trasladados en el 97.3% de los casos. Conclusiones: los hombres jóvenes, económicamente productivos, de las zonas con mayor densidad poblacional y urbanismos son los más afectados por lesiones por causas externas; en ambos géneros, los accidentes de transporte terrestre son las causas más frecuente de lesión, de severidad menor-moderada; asimismo, la atención de emergencia prehospitalaria puede considerarse adecuada.

  19. [Clinical impact of social marketing strategy on breast cancer detection].

    PubMed

    Quintana-Vidaurri, Adriana Guadalupe; Santana-Chávez, Luis Alejandro; González-Villalobos, Cynthia Guadalupe

    2013-01-01

    Objetivo: determinar el impacto clínico de la mercadotecnia social en la detección del cáncer mamario; el parámetro de medición fueron las solicitudes de mastografía. Métodos: estudio cuasiexperimental, antes y después, en una unidad de medicina familiar. Se incluyeron 69 médicos de la consulta externa y 14 enfermeras de PREVENIMSS. Se aplicaron estrategias de mercadotecnia social. Las solicitudes de mastografía fueron analizadas con suma de rangos de Wilcoxon (significación < 0.05). Resultados: en el turno matutino, al comenzar el estudio se registraron 1.5 solicitudes por consultorio al mes y 2.14 en PREVENIMSS; al primer y segundo mes posintervención, 2.45 (p = 0.007) en la consulta externa y 3.25 (p = 0.007) y 3.28 (p = 0.000) en PREVENIMSS. En el turno vespertino, al comenzar el estudio se registraron 0.47 solicitudes por consultorio al mes y 0.85 en PREVENIMSS; al primer y segundo mes posintervención, 2.38 (p = 0.000) y 2.35 (p = 0.000) en consulta externa y 2.79 (p = 0.000) y 3.91 (p = 0.000) en PREVENIMSS. Conclusiones: la mercadotecnia social impactó en la práctica clínica de los médicos y las enfermeras, al aumentar estadísticamente el número de solicitudes de mastografía.

  20. [The Importance of Early Referral in Pediatric Acute Liver Failure].

    PubMed

    Jerónimo, Mónica; Moinho, Rita; Pinto, Carla; Carvalho, Leonor; Gonçalves, Isabel; Furtado, Emanuel; Farela Neves, José

    2015-01-01

    Introdução: A falência hepática aguda é uma doença rara associada a elevada morbilidade e mortalidade apesar do aumento da sobrevida devido ao transplante hepático. Em 2008, decorreu em Portugal uma reunião sobre esta patologia em pediatria, resultando num consenso de atuação que salientou a importância da abordagem multidisciplinar e referenciação precoce para um centro de transplantação hepática. Objetivos: Caracterizar as admissões por falência hepática aguda no Serviço de Cuidados Intensivos Pediátricos do centro português com transplante hepático pediátrico. Comparar resultados antes (A) e depois de 2008 (B). Material e Métodos: Estudo observacional retrospetivo de 20 anos (1994-2014). Critérios de inclusão: idade < 18 anos e falência hepática aguda (INR ≥ 2 sem resposta à vitamina K e necrose hepatocelular). Excluíram-se as crianças com doença hepática crónica. Resultados: Incluíram-se 50 crianças com idade mediana de 24,5 meses. A causa mais comum de falência hepática aguda abaixo dos 2 anos foi metabólica (34,6%) e acima infeciosa (29,2%). Foram submetidos a transplante hepático 46%, tendo sobrevivido 78%. A mortalidade global foi 34%. A mediana do tempo de referenciação foi 7 dias no período A (n = 35) e 2 no B (n = 15; p = 0,006). A mediana do risco de mortalidade prevista pelo PRISM foi 14,7% no período A e 6,5% no B (p = 0,019). A mortalidade foi 37% vs 26% no período A e B respetivamente (p = 0,474).Discussão e Conclusões: A mortalidade global foi sobreponível à de outros centros europeus, sendo o transplante hepático a opção terapêutica mais eficaz. Após 2008 o tempo de referenciação e a gravidade dos casos na admissão reduziram, ainda sem tradução significativa na mortalidade.

  1. [ANTIOXIDANT DYSFUNCTIONALITY OF HIGH-DENSITY LIPOPROTEINS (HDL) IN DECOMPENSATED DIABETIC PATIENTS].

    PubMed

    Awad, Fernanda; Contreras-Duarte, Susana; Molina, Patricia; Quiñones, Verónica; Serrano, Valentina; Abbott, Eduardo; Maiz, Alberto; Busso, Dolores; Rigotti, Attilio

    2015-09-01

    Introducción: las lipoproteínas de alta densidad (HDL) tienen un importante efecto protector cardiovascular mediado por su función durante el transporte reverso del colesterol, así como por otras actividades, incluyendo una significativa acción antiinflamatoria y antioxidante. La funcionalidad antiinflamatoria y antioxidante de las HDL está alterada en los pacientes diabéticos crónicos estables, aunque no existe mayor información en caso de una crisis hiperglicémica. Objetivo: determinar si durante un estado de descompensación diabética aguda las partículas de HDL exhiben un deterioro de su función antioxidante y si esta logra recuperarse una vez resuelto el cuadro agudo. Métodos: la actividad antioxidante de las HDL se midió mediante un ensayo de fluorescencia in vitro en muestras plasmáticas de pacientes diabéticos con descompensación aguda obtenidas tanto al ingreso, alcanzada la resolución intrahospitalaria del evento agudo, así como en un control ambulatorio post-hospitalización. Como comparación, se analizaron partículas de HDL de algunos sujetos sanos como condición control. Resultados: la actividad antioxidante de las HDL en pacientes con descompensación diabética aguda fue significativamente menor a la observada en el grupo control sano, y esta se fue recuperando progresivamente hasta normalizarse en el momento del control ambulatorio. La crisis hiperglicémica también demostró una baja actividad plasmática de la enzima antioxidante paraoxonasa- 1, la cual aumentó significativamente en el control ambulatorio. Conclusión: las partículas de HDL presentes en pacientes con una descompensación diabética aguda presentan una reducción significativa y reversible de su capacidad antioxidante, probablemente como consecuencia de una alteración en la actividad de la paraoxonasa-1.

  2. Etiological agents and antimicrobial susceptibility in hospitalized children with acute pyelonephritis.

    PubMed

    Flor-de-Lima, Filipa; Martins, Tânia; Teixeira, Ana; Pinto, Helena; Botelho-Moniz, Edgar; Caldas-Afonso, Alberto

    2015-01-01

    Introdução: A resistência aos antimicrobianos, provocada pela utilização de antibióticos continua a ser um importante problema de saúde pública e uma preocupação para os profissionais de saúde. O nosso objetivo foi conhecer a prevalência local dos uropatógenos e o seu perfil de suscetibilidade aos antimicrobiannos na pielonefrite aguda. Material e Métodos: Estudo prospetivo nas crianças internadas por pielonefrite aguda no internamento de Pediatria de um hospital do norte de Portugal entre 1994-2012. Os agentes etiológicos e o seu perfil de sensibilidade aos antimicrobianos foram avaliados em quatro períodos de tempo (G1: 1994-1997, G2: 2002; G3: 2007; G4: 2012). Resultados: Avaliámos 581 doentes, 66% do sexo feminino, com idade mediana de 22 meses. A Escherichia coli foi o principal uropatógeno e a sua prevalência manteve-se estável durante os últimos 18 anos. Verificou-se um aumento da sensibilidade à amoxicilina/ácido clavulânico de 71% no G1 para 81,5% no G4 (p = 0,001) e uma diminuição da taxa de resistência de 8,7% no G1 para 2,8% G4 (p = 0,008). A sua sensibilidade às cefalosporinas de segunda e terceira geração e nitrofurantoína foi superior a 90% (p = ns). A taxa de resistência ao cotrimoxazol aumentou de 22 % para 26 % (p = 0,008). Discussão: A Escherichia coli continua a ser o uropatogénio mais frequente responsável por pielonefrite aguda, motivo pelo qual o seu perfil de sensibilidade aos antimicrobianos determina a escolha da antibioticoterapia empírica. Conclusões: A amoxicilina/ácido clavulânico mantém-se como escolha de primeira linha para o tratamento empírico da pielonefrite aguda em regime de internamento.

  3. [Isolated bacteria from nasal cultures. Are they important in patients with acute leukemia?].

    PubMed

    Barranco-Lampón, Gilberto; Mendoza-García, Carlos Alberto; Cabrera-Osuna, Silvia; Olarte-Carrillo, Irma; Ventura, Yanet; Gutiérrez-Romero, Mario; Martínez-Murillo, Carlos; Martínez-Tovar, Adolfos; Ramos-Peñafiel, Christian Omar

    2014-01-01

    INTRODUCCIÓN: la colonización nasal por Staphylcoccus epidermidis y Staphylococcus aureus es frecuente y se ha relacionado con bacteremia en huéspedes inmunocomprometidos. En la investigación que se presenta, los objetivos fueron determinar la frecuencia de cepas que colonizan la mucosa nasal en pacientes en tratamiento de leucemia aguda y su relación con los cultivos de sangre periférica. MÉTODOS: estudio retrospectivo, observacional, transversal, retrolectivo de cultivos nasales obtenidos durante cuatro semanas. La relación con los hemocultivos se estableció mediante chi cuadrada; se calculó razón de momios.

  4. Vibrant Soundbridge rehabilitation of conductive and mixed hearing loss.

    PubMed

    Lüers, Jan-Christoffer; Hüttenbrink, Karl-Bernd

    2014-12-01

    The Vibrant Soundbridge is the world's most often implanted active middle ear implant or hearing aid. During the last few years, the device indications have expanded from sensorineural hearing loss to conductive and mixed hearing loss. Titanium couplers have led to improved contact of the floating mass transducer with the middle ear structures. The resulting hearing gain is satisfying for most patients, but so far, there is no clear audiologic advantage over conventional hearing aids. Currently, the indications are mainly related to intolerance of conventional hearing aids (eg, chronic otitis externa), severe mixed hearing loss with a destructed middle ear and certain medical diagnosis (eg, congenital atresia).

  5. Policy Dilemmas in Brazil-Africa Relations,

    DTIC Science & Technology

    1982-01-22

    dirloiratic planner and spokesman is founc In Pona:Jc Sardenberz, "A politica externa do Brasil nas duas ultimas decadas," Re’.ista d Servicc 1u0ico 0 1...the cunntrv. Even though political interests may eventua!!1Y accrue with the development of comercial involvement in Africa, Brazil resists engagement...34Brazil’s Arms find Willing Buyers in the Third World," New York Times (August ?, 1?81), p. E-3; "Armas: Brasil invade o mercado mundial," Senhor (February

  6. [Clinical and therapeutic management of respiratory tract infections. Consensus document of the Andalusian Infectious Diseases Society and the Andalusian Family and Community Medicine Society].

    PubMed

    Cordero Matía, Elisa; de Dios Alcántara Bellón, Juan; Caballero Granado, Javier; de la Torre Lima, Javier; Girón González, José Antonio; Lama Herrera, Carmen; Morán Rodríguez, Ana; Zapata López, Angel

    2007-04-01

    Respiratory tract infections are frequent and they are one of the commonest causes of antibiotic prescription. However, there are few clinical guidelines that consider this group of infections. This document has been written by the Andalusian Infectious Diseases Society and the Andalusian Family and Community Medicine Society. The primary objective has been to define the recommendations for the diagnosis and antibiotic treatment of respiratory tract infections apart from pneumonia. The clinical syndromes evaluated have been: a) pharyngitis; b) sinusitis; c) acute otitis media and otitis externa; d) acute bronchitis, laryngitis, epiglottitis; e) acute exacerbation of chronic bronchitis; and f) respiratory infectious in patients with bronchiectasis. This document has focused on immunocompetent patients.

  7. Optimum management of the discharging ear.

    PubMed

    Ruddy, J; Bickerton, R C

    1992-02-01

    Discharge from the ear can be the result of many disease processes. The ear may discharge blood, pus, cerebrospinal fluid (CSF) or wax. Keratosis obturans, stenosis of the external meatus and benign tumours of the external meatus all lead to wax build-up, which may cause recurrent attacks of otitis externa. Malignant tumours, such as basal cell carcinoma, squamous cell carcinoma and tumours of ceruminous gland origin may also present with discharge. Tumours should be excluded by submitting all material removed from the external canal for histological examination. Single or multiple abscesses (known as furuncles) may occur in the hair follicles in the skin of the external acoustic meatus (EAM). Compulsive scratching, hearing aids and foreign bodies placed in the ear predispose to otitis externa, which is also often associated with infection by Pseudomonas aeruginosa, Staphylococcus aureus and faecal organisms. Management may be with aluminium acetate 14%, topical antibiotic/steroid drops, a gauze wick soaked with icthammol 10% in glycerin or polymyxin B sulphate--neomycin sulphate--hydrocortisone acetate cream placed into the EAM and replaced every 24 to 48 hours, or systemic antibiotics according to severity. Malignant (necrotising) otitis externa causes progressive destruction of the temporal bone, and cranial nerve palsies (usually facial first). Treatment is limited debridement of infected bone, accompanied by intravenous aminoglycosides, and local antibiotic treatment and aural cleanout or oral ciprofloxacin. Middle ear conditions causing discharge include acute otitis media, infected grommets, traumatic perforations and chronic suppurative otitis media, as well as tumours of the ear canal skin and middle ear, radiation-induced otitis externa and osteoradionecrosis of the temporal bone, tuberculosis, Langerhans cell histiocytosis, spontaneous or post-traumatic CSF leaks, Wegeners granulomatosis and immune deficiency states. Topical application of aminoglycoside

  8. Artificial tritrophic exposure system for environmental risk analysis on aphidophagous predators.

    PubMed

    Paula, Débora P; Souza, Lucas M DE; Andow, David A; Sousa, Alex A T Cortês DE; Pires, Carmen S S; Sujii, Edison R

    2016-09-01

    We evaluated an artificial tritrophic exposure system for use in ecotoxicological evaluations of environmental stressors on aphidophagous predators. It consists of an acrylic tube with a Parafilm M sachet containing liquid aphid diet, into which can be added environmental stressors. Immature Cycloneda sanguinea, Harmonia axyridis and Chrysoperla externa, and adult H. axyridis were reared on Myzus persicae. Larval and pupal development and survival of all species and reproductive parameters of H. axyridis were similar to published results. The system provides a suitable tritrophic exposure route, enables ex-ante evaluation of stressors, and improves the accuracy of the assessment.

  9. Use of thyroid scintigraphy and pituitary immunohistochemistry in the diagnosis of spontaneous hypothyroidism in a mature cat.

    PubMed

    Blois, Shauna L; Abrams-Ogg, Anthony C G; Mitchell, Colleen; Yu, Anthony; Stoewen, Debbie; Lillie, Brandon N; Kiupel, Matti

    2010-02-01

    A 12-year old, castrated male domestic shorthair cat presented with a 2-year history of poor hair coat, seborrhea, generalized pruritus and otitis externa. Low circulating concentrations of total serum thyroxine (TT(4)) and free thyroxine (fT(4)) and an elevated thyroid stimulating hormone concentration supported a diagnosis of primary hypothyroidism. Thyroid scintigraphy did not show uptake of radioactive technetium in the thyroid area. Treatment with levothyroxine resulted in clinical improvement. Recurrence of dermatitis 8 months after onset of treatment resulted in euthanasia of the cat. On post-mortem examination, thyroid tissue was not identified on gross or histological examination. Pituitary immunohistochemistry identified hyperplasia of chromophobe cells.

  10. [Gelastic seizures as the presenting symptom of infarction of the cingulate gyrus].

    PubMed

    Egea-Lucas, I; Martinez-Mondejar, E; Piqueres-Vidal, C F; Frutos-Alegria, M T

    2015-09-01

    Introduccion. Las crisis gelasticas son crisis epilepticas poco frecuentes en las que la risa inapropiada es la manifestacion principal. Su etiologia es diversa. No hemos encontrado en la bibliografia ningun caso de risa patologica claramente epileptica relacionada con ictus, aunque hay multiples descripciones de risa patologica no epileptica como sintoma prodromico en pacientes con ictus (fou rire prodromique). Presentamos un caso de infarto del giro cingulado que curso con crisis gelasticas al inicio y durante la evolucion del proceso clinico. Caso clinico. Mujer de 81 años, que bruscamente presento episodios de dificultad para la expresion verbal con desconexion del medio, acompañados de accesos de risa inmotivada e incontrolable de duracion inferior a cinco minutos. Tras los episodios, tenia bajo nivel de consciencia. Coincidiendo con alguno de ellos, se observaron tambien movimientos involuntarios de los miembros superiores. La resonancia desvelo la existencia de una lesion isquemica aguda del territorio del giro cingulado izquierdo y el electroencefalograma puso de manifiesto la existencia de actividad epileptogena frontal y temporal anterior izquierda. Conclusiones. El perfil clinico, los resultados de las exploraciones complementarias y la respuesta al tratamiento antiepileptico permiten afirmar que los episodios descritos en esta paciente corresponden a crisis gelasticas relacionadas con una lesion isquemica aguda del giro cingulado izquierdo.

  11. [Acute optic neuropathy: differential diagnoses].

    PubMed

    Buompadre, María Celeste

    2013-09-06

    Introduccion. La alteracion funcional del nervio optico se caracteriza por un deficit en la agudeza visual, en la vision cromatica y en el campo visual, defecto pupilar aferente y, en algunos casos, edema del nervio o atrofia y palidez. Objetivo. Describir el espectro de neuropatias opticas agudas, su clinica, diagnostico y tratamiento, con mayor interes en aquellas de presentacion en la edad pediatrica. Desarrollo. La neuritis optica puede ser monofasica, recurrente o el componente de un cuadro desmielinizante polisintomatico. El objetivo del tratamiento es reducir el numero y la gravedad de los ataques y prevenir discapacidad. La infecciosa es secundaria a diferentes microorganismos (bacterias, virus, hongos y protozoos). El tratamiento depende de la etiologia. La isquemica anterior no arteritica o idiopatica es la forma mas frecuente y es secundaria a enfermedad de pequeños vasos (ciliares posteriores). La neuropatia optica hereditaria o de Leber representa una causa importante de afectacion visual cronica y se caracteriza por la afectacion selectiva de las celulas ganglionares de la retina. Hasta el momento, la terapia solo es de apoyo. En el papiledema asociado a hipertension endocraneal, la agudeza visual generalmente se conserva pero existe aumento de la mancha ciega. El tratamiento se basa en disminuir la hipertension y el factor etiologico si existe. Conclusiones. Las neuropatias opticas agudas constituyen un amplio grupo de entidades, de etiologia diversa y con un pronostico visual variable. La presencia de signos del examen neurologico, fondo de ojo y neuroimagenes pueden orientar hacia el diagnostico y tratamiento oportuno.

  12. The clinical implications of ear canal debris in hearing aid users

    PubMed Central

    Orji, Foster Tochukwu; O. Onyero, Emmanuel; Agbo, Christian Ejiofor

    2014-01-01

    Objective : The ear irritations suffered by hearing aid (HA) users are yet to be related to the clinical state of canal. We undertook this study to examine the nature of debris and the microbial flora of ears of hearing aid users, as well as evaluate the determinant factors of ear irritation in this population. Methods : An observational clinical study was carried out involving 32 unilateral hearing aid users recruited from ENT clinic of a tertiary referral center. Each subject underwent otoscopic assessment of canal debris and microbial analysis of swab cultures taken from the hearing aid-wearing ear and contralateral normal ear without hearing aid. Results : Canal debris [wax (28%), fungal deposits (19%), bacteria exudates (13%)]. as well as microorganisms were identified in significant number of ears with hearing aids than ears without hearing aid (P = 0.003 and P = 0.006 respectively). Coagulase-negative staphylococci were the commonest identified bacteria. Others were Staphylococcus aureus, Pseudomonas aeruginosa, and Proteus species. Intolerable irritations of hearing aid wearing ears were significantly associated with bacterial and fungal otitis externa, and ear discharge (P = 0.005, 0.02, 0.03 respectively). Conclusions : This study demonstrates that using hearing aid alters the ear canal flora; increases risk of both fungal and bacterial otitis externa, as well as encourage wax debris formation, with resultant ear irritations. To ensure compliance their ears should periodically be attended to, by de-waxing or given topical antimicrobial agents where indicated. PMID:24948963

  13. [Neurological health care activity in a recently created district hospital: model of high efficiency].

    PubMed

    Jiménez-Jiménez, Félix J; Plaza-Nieto, José F; Navacerrada, Francisco; Alonso-Navarro, Hortensia; Pilo-de-la-Fuente, Belén; Arroyo-Solera, Margarita; Guillán, Marta; Calleja, Marisol; Moreno-Puertas, Dolores

    2015-03-01

    Objetivo. Analizar la actividad asistencial de un hospital comarcal de reciente creacion, con especial enfasis en los indicadores asistenciales en consultas externas y en actos medicos de pacientes ingresados. Pacientes y metodos. Describimos la actividad asistencial realizada por nuestra seccion de neurologia durante los años 2008-2013. Se comparan nuestros indicadores asistenciales de los años 2012 y 2013 (quinto y sexto año de actividad), tanto en consultas externas como en pacientes ingresados, con los de otros dos hospitales de caracteristicas similares, otros tres de nivel secundario y otros cuatro de nivel terciario. Resultados. La seccion de neurologia de nuestro hospital fue la que realizo mayor numero de primeras consultas por facultativo, tuvo el mejor indice de consultas sucesivas/primeras y el mayor porcentaje de consultas de alta resolucion, tuvo la menor estancia media en los dos grupos relacionados por el diagnostico (GRD) mas frecuentes en nuestra especialidad, y fue la segunda en ingresos por facultativo del GRD 'ictus con infarto' y la tercera en ingresos por facultativo del GRD 'otros trastornos del sistema nervioso'. Conclusiones. Los indicadores asistenciales de la seccion de neurologia de nuestro hospital muestran un modelo de muy alta eficiencia, al cual solo se aproximan los de otros dos de caracteristicas y desarrollo similares al nuestro. La implantacion gradual de modelos similares al de estos tres hospitales en los niveles secundario y terciario podria ser de utilidad en la mejora de su eficiencia asistencial.

  14. Histochemical localization and characterization of AKP, ACP, NSE, and POD from cultured Apostichopus japonicus

    NASA Astrophysics Data System (ADS)

    Li, Jiye; Sun, Xiuqin; Zheng, Fengrong; Sun, Hushan

    2009-09-01

    We investigated the distribution of four enzymes involved in the immune response of Apostichopus japonicus. We collected samples of the tentacles, papillate podium, integument, respiratory tree, and digestive tract and stained them for acid phosphatase (ACP), alkaline phosphatase (AKP), non-specific esterase (NSE) and peroxidase (POD) activity. The distribution and content of ACP, AKP, NSE, and POD differed among the tissues. The coelomic epithelium of the tentacle, papillate podium, and integument and the mucous layer of respiratory tree were positive for ACP activity. The coelomic epithelium and cuticular layer of the tentacle, papillate podium, and integument and the mucous layer and tunica externa of the respiratory tree and digestive tract stained positive or weakly positive for AKP activity. Almost all the epithelial tissues stained positive, strongly positive, or very strongly positive for NSE activity. The cuticular layer of the tentacle and integument and the mucous layer, tunica submucosa, and tunica externa of the respiratory tree and digestive tract stained positive for POD activity. We hypothesize that these enzymes play a role in the immune response in A. japonicus.

  15. External Otitis: An Unusual Presentation in Neonates

    PubMed Central

    Alizadeh Taheri, Peymaneh; Rostami, Shima

    2016-01-01

    Acute otitis externa (AOE) is an infection of the external auditory canal, the auricle, and the outer surface of the tympanic membrane. Although AOE is one of the most common otologic conditions encountered in pediatric population, it is known to primarily affect children older than 2 years. We report a case of AOE caused by Staphylococcus aureus in a 23-day-old neonate. A 23-day-old female infant presented to our neonatology clinic with irritability and discharge from the right ear. There were yellow otorrhea, mild erythema, and edema of right external ear canal. There was no sign of otitis media on otoscopy. The results of laboratory tests were insignificant. The discharge culture grew colonies of methicillin-sensitive Staphylococcus aureus. After 48 hours of treatment with intravenous cloxacillin, significant improvement was observed. The present case highlights an unusual presentation of staphylococcal infection in a neonate. This is the first case of methicillin-sensitive Staphylococcus aureus otitis externa in an immunocompetent newborn. PMID:27703821

  16. Ear problems in swimmers.

    PubMed

    Wang, Mao-Che; Liu, Chia-Yu; Shiao, An-Suey; Wang, Tyrone

    2005-08-01

    Acute diffuse otitis externa (swimmer's ear), otomycosis, exostoses, traumatic eardrum perforation, middle ear infection, and barotraumas of the inner ear are common problems in swimmers and people engaged in aqua activities. The most common ear problem in swimmers is acute diffuse otitis externa, with Pseudomonas aeruginosa being the most common pathogen. The symptoms are itching, otalgia, otorrhea, and conductive hearing loss. The treatment includes frequent cleansing of the ear canal, pain control, oral or topical medications, acidification of the ear canal, and control of predisposing factors. Swimming in polluted waters and ear-canal cleaning with cotton-tip applicators should be avoided. Exostoses are usually seen in people who swim in cold water and present with symptoms of accumulated debris, otorrhea and conductive hearing loss. The treatment for exostoses is transmeatal surgical removal of the tumors. Traumatic eardrum perforations may occur during water skiing or scuba diving and present with symptoms of hearing loss, otalgia, otorrhea, tinnitus and vertigo. Tympanoplasty might be needed if the perforations do not heal spontaneously. Patients with chronic otitis media with active drainage should avoid swimming, while patients who have undergone mastoidectomy and who have no cavity problems may swim. For children with ventilation tubes, surface swimming is safe in a clean, chlorinated swimming pool. Sudden sensorineural hearing loss and some degree of vertigo may occur after diving because of rupture of the round or oval window membrane.

  17. [A case of cavernous sinus aspergillosis].

    PubMed

    Hase, Tomomi; Kurita, Hideharu; Matsumoto, Eiji; Kuroda, Hajime; Hashimoto, Masaaki; Shinoda, Souji

    2013-10-01

    We reported a case of cavernous sinus aspergillosis. A 62-year-old man complained of trigeminal neuralgia in the right V1 region. Neurological examination on admission showed ptosis, loss of light reflex and ophthalmoplegia externa in the right side. MRI enhanced with gadolinium demonstrated sphenoid sinusitis and mass lesion in the right cavernous sinus. MRA revealed right internal carotid artery occlusion. An open biopsy using the extradural temporopolar approach was performed. Pus discharge was observed from the cavernous sinus and histological examination showed hypha of Aspergillus. With early voriconazole treatment, the patient had improvement in headache, ptosis and ophthalmoplegia externa. Cavernous sinus aspergillosis is often found after sphenoiditis. It results in invasion to an internal carotid artery and worsens the patient's prognosis by cerebral infarction, so early diagnosis and treatment are important. We should consider aspergillosis as one of the differential diagnoses of a mass in the cavernous sinus. The epidural approach to this lesion was available to obviate aspergillus dissemination into the medullary cavity.

  18. The basal ganglia in Parkinson's disease: current concepts and unexplained observations.

    PubMed

    Obeso, Jose A; Marin, Concepcio; Rodriguez-Oroz, C; Blesa, Javier; Benitez-Temiño, B; Mena-Segovia, Juan; Rodríguez, Manuel; Olanow, C Warren

    2008-12-01

    The pathophysiology of Parkinson's disease is reviewed in light of recent advances in the understanding of the functional organization of the basal ganglia (BG). Current emphasis is placed on the parallel interactions between corticostriatal and corticosubthalamic afferents on the one hand, and internal feedback circuits modulating BG output through the globus pallidus pars interna and substantia nigra pars reticulata on the other. In the normal BG network, the globus pallidus pars externa emerges as a main regulatory station of output activity. In the parkinsonian state, dopamine depletion shifts the BG toward inhibiting cortically generated movements by increasing the gain in the globus pallidus pars externa-subthalamic nucleus-globus pallidus pars interna network and reducing activity in "direct" cortico-putaminal-globus pallidus pars interna projections. Standard pharmacological treatments do not mimic the normal physiology of the dopaminergic system and, therefore, fail to restore a functional balance between corticostriatal afferents in the so-called direct and indirect pathways, leading to the development of motor complications. This review emphasizes the concept that the BG can no longer be understood as a "go-through" station in the control of movement, behavior, and emotions. The growing understanding of the complexity of the normal BG and the changes induced by DA depletion should guide the development of more efficacious therapies for Parkinson's disease.

  19. Privatisation, Decentralisation and Education in the United Kingdom: The Role of the State

    NASA Astrophysics Data System (ADS)

    Turner, David

    2004-07-01

    Since the early 1950s, the axis `centralisation-decentralisation', especially as thematised in the work of Isaac Kandel, has represented a major focus of comparative studies in education. Kandel argued that issues relating to the internal conduct of the classroom (interna) should, so far as possible, be decentralised, while issues relating to administration, school structure and organisation of the educational system (externa) might safely be centralised. After 1988, successive governments in the United Kingdom have undertaken reforms which have placed more central control on the curriculum and even methods of teaching (interna), while school finance and administration (externa) have been devolved to the school level. The present essay argues that a simplistic approach to centralisation and decentralisation is not likely to be fruitful. Instead, we should acknowledge the role of the State in creating a `permissive framework' for educational systems. Local action can then be seen as part of a policy accommodating or resisting the implications of that framework.

  20. Impacto del Seguro Popular en el gasto catastrófico y de bolsillo en el México rural y urbano, 2005–2008

    PubMed Central

    Sosa-Rubí, Sandra G; Salinas-Rodríguez, Aarón; Galárraga, Omar

    2016-01-01

    Objetivo Estimar el efecto del Seguro Popular (SP) sobre la incidencia del gasto catastrófico en salud (GCS) y sobre el gasto de bolsillo en salud (GBS) en el mediano plazo. Material y métodos Con base en la Encuesta de Evaluación del Seguro Popular (2005–2008), se analizaron los resultados del efecto del SP en la cohorte rural para dos años de seguimiento (2006 y 2008) y en la cohorte urbana para un año (2008). Resultados A nivel conglomerado no se detectaron efectos del SP. A nivel hogar se encontró que el SP tiene un efecto protector en el GCS y en el GBS en consulta externa y hospitalización en zonas rurales; y efectos significativos en la reducción de GBS en consulta externa en zonas urbanas. Conclusiones El SP se muestra como un programa efectivo para proteger a los hogares contra gastos de bolsillo por motivos de salud en el mediano plazo. PMID:22282205

  1. Otomycosis in iran: a review.

    PubMed

    Gharaghani, Maral; Seifi, Zahra; Zarei Mahmoudabadi, Ali

    2015-06-01

    Fungal infection of the external auditory canal (otitis externa and otomycosis) is a chronic, acute, or subacute superficial mycotic infection that rarely involves middle ear. Otomycosis (swimmer's ear) is usually unilateral infection and affects more females than males. The infection is usually symptomatic and main symptoms are pruritus, otalgia, aural fullness, hearing impairment, otorrhea, and tinnitus. Fungal species such as yeasts, molds, dermatophytes, and Malassezia species are agents for otitis externa. Among molds, Aspergillus niger was described as the most common agent in the literature. Candida albicans was more prevalent than other yeast species. Otomycosis has a worldwide distribution, but the prevalence of infection is related to the geographical location, areas with tropical and subtropical climate showing higher prevalence rates. Otomycosis is a secondary infection and is more prevalent among swimmers. As a result, a higher incidence is reported in summer season, when more people interested in swimming. Incidence of otomycosis in our review ranged from 5.7 to 81 %, with a mean value of 51.3 %. Our results showed that 78.59 % of otomycosis agents were Aspergillus, 16.76 % were Candida species, and the rest (4.65 %) were other saprophytic fungi. Among Iranian patients, incidence of infection was highest in summer, followed by autumn, winter, and spring. In Iran, otomycosis was most prevalent at the age of 20-40 years and the lowest prevalence was associated with being <10 years old. The sex ratio of otomycosis in our study was (M/F) 1:1.53.

  2. Clinical practice guideline: tonsillitis I. Diagnostics and nonsurgical management.

    PubMed

    Windfuhr, Jochen P; Toepfner, Nicole; Steffen, Gregor; Waldfahrer, Frank; Berner, Reinhard

    2016-04-01

    More than 120,000 patients are treated annually in Germany to resolve repeated episodes of acute tonsillitis. Therapy is aiming at symptom regression, avoidance of complications, reduction in the number of disease-related absences in school or at work, increased cost-effectiveness and improved quality of life. The purpose of this part of the guideline is to provide clinicians in any setting with a clinically focused multi-disciplinary guidance through different conservative treatment options in order to reduce inappropriate variation in clinical care, improve clinical outcome and reduce harm. Surgical management in terms of intracapsular as well as extracapsular tonsillectomy (i.e. tonsillotomy) is the subject of part II of this guideline. To estimate the probability of tonsillitis caused by β-hemolytic streptococci, a diagnostic scoring system according to Centor or McIsaac is suggested. If therapy is considered, a positive score of ≥3 should lead to pharyngeal swab or rapid test or culture in order to identify β-hemolytic streptococci. Routinely performed blood tests for acute tonsillitis are not indicated. After acute streptococcal tonsillitis, there is no need to repeat a pharyngeal swab or any other routine blood tests, urine examinations or cardiological diagnostics such as ECG. The determination of the antistreptolysin O-titer (ASLO titer) and other antistreptococcal antibody titers do not have any value in relation to acute tonsillitis with or without pharyngitis and should not be performed. First-line therapy of β-hemolytic streptococci consists of oral penicillin. Instead of phenoxymethylpenicillin-potassium (penicillin V potassium), also phenoxymethlpenicillin-benzathine with a clearly longer half-life can be used. Oral intake for 7 days of one of both the drugs is recommended. Alternative treatment with oral cephalosporins (e.g. cefadroxil, cefalexin) is indicated only in cases of penicillin failure, frequent recurrences, and whenever a more

  3. Stepwise enforcement of the notochord and its intersection with the myoseptum: an evolutionary path leading to development of the vertebra?

    PubMed Central

    Grotmol, Sindre; Kryvi, Harald; Keynes, Roger; Krossøy, Christel; Nordvik, Kari; Totland, Geir K

    2006-01-01

    The notochord constitutes the main axial support during the embryonic and larval stages, and the arrangement of collagen fibrils within the notochord sheath is assumed to play a decisive role in determining its functional properties as a fibre-wound hydrostatic skeleton. We have found that during early ontogeny in Atlantic salmon stepwise changes occur in the configuration of the collagen fibre-winding of the notochord sheath. The sheath consists of a basal lamina, a layer of type II collagen, and an elastica externa that delimits the notochord; and these constituents are secreted in a specific order. Initially, the collagen fibrils are circumferentially arranged perpendicular to the longitudinal axis, and this specific spatial fibril configuration is maintained until hatching when the collagen becomes reorganized into distinct layers or lamellae. Within each lamella, fibrils are parallel to each other, forming helices around the longitudinal axis of the notochord, with a tangent angle of 75–80° to the cranio-caudal axis. The helical geometry shifts between adjacent lamellae, forming enantiomorphous left- and right-handed coils, respectively, thus enforcing the sheath. The observed changes in the fibre-winding configuration may reflect adaptation of the notochord to functional demands related to stage in ontogeny. When the vertebral bodies initially form as chordacentra, the collagen lamellae of the sheath in the vertebral region are fixed by the deposition of minerals; in the intervertebral region, however, they represent a pre-adaptation providing torsional stability to the intervertebral joint. Hence, these modifications of the sheath transform the notochord per se into a functional vertebral column. The elastica externa, encasing the notochord, has serrated surfaces, connected inward to the type II collagen of the sheath, and outward to type I collagen of the mesenchymal connective tissue surrounding the notochord. In a similar manner, the collagen matrix of

  4. Diseases of the pinna.

    PubMed

    Angarano, D W

    1988-07-01

    has owned or worked closely with an animal suffering from chronic otitis externa should appreciate the animal's discomfort and the owner's frustration. All too frequently, the chronic otitis externa is the result of a hypersensitivity (either inhalant or food) that has been overlooked in the attempt to treat the subsequent infectious otitis. Thus, in animals with recurrent otitis externa, every attempt should be made to identify and treat the underlying etiology.

  5. Stepwise enforcement of the notochord and its intersection with the myoseptum: an evolutionary path leading to development of the vertebra?

    PubMed

    Grotmol, Sindre; Kryvi, Harald; Keynes, Roger; Krossøy, Christel; Nordvik, Kari; Totland, Geir K

    2006-09-01

    The notochord constitutes the main axial support during the embryonic and larval stages, and the arrangement of collagen fibrils within the notochord sheath is assumed to play a decisive role in determining its functional properties as a fibre-wound hydrostatic skeleton. We have found that during early ontogeny in Atlantic salmon stepwise changes occur in the configuration of the collagen fibre-winding of the notochord sheath. The sheath consists of a basal lamina, a layer of type II collagen, and an elastica externa that delimits the notochord; and these constituents are secreted in a specific order. Initially, the collagen fibrils are circumferentially arranged perpendicular to the longitudinal axis, and this specific spatial fibril configuration is maintained until hatching when the collagen becomes reorganized into distinct layers or lamellae. Within each lamella, fibrils are parallel to each other, forming helices around the longitudinal axis of the notochord, with a tangent angle of 75-80 degrees to the cranio-caudal axis. The helical geometry shifts between adjacent lamellae, forming enantiomorphous left- and right-handed coils, respectively, thus enforcing the sheath. The observed changes in the fibre-winding configuration may reflect adaptation of the notochord to functional demands related to stage in ontogeny. When the vertebral bodies initially form as chordacentra, the collagen lamellae of the sheath in the vertebral region are fixed by the deposition of minerals; in the intervertebral region, however, they represent a pre-adaptation providing torsional stability to the intervertebral joint. Hence, these modifications of the sheath transform the notochord per se into a functional vertebral column. The elastica externa, encasing the notochord, has serrated surfaces, connected inward to the type II collagen of the sheath, and outward to type I collagen of the mesenchymal connective tissue surrounding the notochord. In a similar manner, the collagen

  6. [Acute respiratory distress syndrome: case series, two years at an intensive care unit].

    PubMed

    Taborda, Lúcia; Barros, Filipa; Fonseca, Vitor; Irimia, Manuel; Carvalho, Ramiro; Diogo, Cláudia; Ramos, Armindo

    2014-01-01

    Introdução: A Síndrome de Dificuldade Respiratória Aguda apresenta incidência e mortalidade significativas em Cuidados Intensivos, justificando estudos adicionais, nomeadamente para definição de novas abordagens terapêuticas. Os autores propuseram-se caracterizaros casos duma Unidade de Cuidados Intensivos em dois anos.Material e Métodos: Procedeu-se a um estudo observacional retrospectivo dos casos admitidos numa Unidade de Cuidados Intensivos, cumprindo os critérios diagnósticos da American-European Consensus Conference on ARDS, tendo sido excluídos os não ventilados invasivamente. Pesquisados e submetidos a tratamento estatístico: dados demográficos, etiologia do Síndrome de Dificuldade Respiratória Aguda, comorbilidades, Índices de Gravidade, PaO2/FiO2, modalidades e parâmetros ventilatórios, compliance pulmonar, dias de ventilação mecânica invasiva, corticoterapia, terapêuticas de resgate, complicações, duração do internamento, óbitos.Resultados: Obtiveram-se 40 doentes, com uma mediana de 72,5 anos (amplitude interquartil 22) e um ratio feminino:masculino ≈1:1,86. Cinquenta e cinco por cento dos Síndrome de Dificuldade Respiratória Aguda tiveram etiologia pulmonar. A média do PaO2/ FiO2 mínimo foi 88mm Hg (IC 95%: 78,5-97,6). A média da PEEP máxima aplicada foi 12,4 cmH2O (Desvio Padrão 4,12) e a médiado Volume Corrente máximo utilizado foi 8,2 mL/Kg peso ideal (IC 95%: 7,7-8,6). A mediana dos dias de ventilação mecânica invasiva foi 10. Em 47,5% dos doentes foram administrados corticóides. Em 52,5% foi executado recrutamento alveolar. A complicação mais frequente foi a Pneumonia Associada a Ventilação (20%). A mediana da duração do internamento foi 10,7 dias (amplitude interquartil10,85). Faleceram 60% dos doentes. A probabilidade de outcome favorável ‘não óbito na Unidade de Cuidados Intensivos’ foi 4,4x superior nos doentes sob corticoterapia e 11x superior nos doentes com idade < 65 anos

  7. Are perioperative statins beneficial for cardiac surgery?

    PubMed

    Bravo-Soto, Gonzalo A; Llovet-Gutiérrez, Valentina; Rada, Gabriel

    2017-01-16

    La cirugía cardiaca conlleva una alta morbimortalidad debido a múltiples causas tales como fibrilación auricular, infarto al miocardio, insuficiencia renal aguda, accidente vascular encefálico, entre otros. Por otra parte, las estatinas son una familia de medicamentos que ha demostrado disminución de eventos cardiovasculares, principalmente debido a su efecto clínico en el perfil lipídico. Sin embargo, se ha propuesto un efecto pleiotrópico, incluyendo un mecanismo antiinflamatorio agudo, cuyo real impacto clínico es controvertido. En este contexto, se ha planteado que el uso de estatinas perioperatorias podría disminuir la morbimortalidad en cirugía cardiaca.

  8. III SBC Guidelines on the Analysis and Issuance of Electrocardiographic Reports - Executive Summary.

    PubMed

    Pastore, Carlos Alberto; Samesima, Nelson; Pereira-Filho, Horacio Gomes

    2016-11-01

    The third version of the guidelines covers recently described topics, such as ion channel diseases, acute ischemic changes, the electrocardiogram in athletes, and analysis of ventricular repolarization. It sought to revise the criteria for overloads, conduction disorders, and analysis of data for internet transmission. Resumo A terceira versão das diretrizes aborda tópicos recentemente descritos, como as doenças dos canais iônicos, alterações isquêmicas agudas, o eletrocardiograma dos atletas e análise da repolarização ventricular. Ela buscou rever critérios de sobrecargas, distúrbios de condução e análise de dados transmitidos via internet.

  9. [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

  10. Are probiotics effective to prevent traveler’s diarrhea?

    PubMed

    Pinos, Yazmín; Castro-Gutiérrez, Victoria; Rada, Gabriel

    2016-12-23

    La diarrea aguda es la enfermedad más común que afecta a los viajeros, principalmente aquellos que se dirigen a regiones de alto riesgo. El uso de probióticos podría prevenir su aparición, sin embargo, los datos que apoyan su uso no son consistentes y no se recomiendan en las guías clínicas actuales. Utilizando la base de datos Epistemonikos, la cual es mantenida mediante búsquedas en múltiples bases de datos, identificamos cuatro revisiones sistemáticas que en conjunto incluyen siete estudios aleatorizados pertinentes a esta pregunta. Realizamos un metanálisis y tablas de resumen de los resultados utilizando el método GRADE. Concluimos que los probióticos podrían prevenir la diarrea del viajero, pero la certeza de la evidencia es baja.

  11. A case report and literature review of "Chiclero's ulcer".

    PubMed

    Blaylock, Jason M; Wortmann, Glenn W

    2012-09-01

    An 86-year-old man with history of travel to Guatemala presented with a 4-month history of an enlarging ulcerative lesion on his right ear. After several weeks of empiric treatment for otitis externa, histopathology, culture, and PCR analysis of a biopsy specimen confirmed the diagnosis of localized cutaneous leishmaniasis secondary to Leishmania mexicana. Known as "Chiclero's ulcer" in southeast Mexico and Latin America, this unique presentation of cutaneous leishmaniasis is caused mainly by the L. mexicana complex. Infection results in a single ulcerative lesion, most commonly involving the ear pinna, without a tendency for cutaneous metastasis, lymphatic or mucosal involvement. The majority of cases of "Chiclero's ulcer" spontaneously re-epithelialize without treatment within 3-9 months. This patient's lesion completely resolved without therapy after 11 months. "Chiclero's ulcer" should be considered in the differential diagnosis of a patient presenting with a chronic ulcerative lesion and history of travel to an endemic area.

  12. [Infection complicated with diabetes mellitus].

    PubMed

    Nemoto, Ken-ichi; Maegawa, Hiroshi

    2015-12-01

    Patients with diabetes mellitus are believed to be suspected to be immunocompromized hosts. Many reports have pointed out that diabetic patients are susceptible to certain infections such as surgical site infections, malignant otitis externa, mucormycosis, and necrotizing fasciitis. But their etiology seems to be non-uniform, heterogenous and individualized. Above all, obesity-related infections are also increasing accompanied with the recent rising incidence of obesity. Further studies should be addressed about the relationships between infections and diabetes which include the factors of body mass index, life style, degree of diabetes complications, and poor glycemic control duration. They could live a normal life the same as healthy subjects if good glycemic control is achieved without hypoglycemia.

  13. Direct healthcare costs of selected diseases primarily or partially transmitted by water.

    PubMed

    Collier, S A; Stockman, L J; Hicks, L A; Garrison, L E; Zhou, F J; Beach, M J

    2012-11-01

    Despite US sanitation advancements, millions of waterborne disease cases occur annually, although the precise burden of disease is not well quantified. Estimating the direct healthcare cost of specific infections would be useful in prioritizing waterborne disease prevention activities. Hospitalization and outpatient visit costs per case and total US hospitalization costs for ten waterborne diseases were calculated using large healthcare claims and hospital discharge databases. The five primarily waterborne diseases in this analysis (giardiasis, cryptosporidiosis, Legionnaires' disease, otitis externa, and non-tuberculous mycobacterial infection) were responsible for over 40 000 hospitalizations at a cost of $970 million per year, including at least $430 million in hospitalization costs for Medicaid and Medicare patients. An additional 50 000 hospitalizations for campylobacteriosis, salmonellosis, shigellosis, haemolytic uraemic syndrome, and toxoplasmosis cost $860 million annually ($390 million in payments for Medicaid and Medicare patients), a portion of which can be assumed to be due to waterborne transmission.

  14. Pipeline embolization device and subsequent vessel sacrifice for treatment of a bleeding carotid pseudoaneurysm at the skull base: a case report.

    PubMed

    Kadkhodayan, Yasha; Shetty, Vilaas S; Blackburn, Spiros L; Reynolds, Matthew R; Cross, DeWitte T; Moran, Christopher J

    2013-09-01

    An attempt at parent vessel reconstruction with Pipeline embolization devices to treat a mycotic pseudoaneurysm of the internal carotid artery at the skull base is presented. A 50-year-old woman with malignant otitis externa and bilateral temporal bone osteomyelitis presented with brisk bleeding from her left ear. She had bony dehiscence of the left carotid canal at CT and extravasation from a pseudoaneurysm of the carotid petrous segment at angiography. Carotid tortuosity proximally precluded placing a covered stent. After the lesion stopped bleeding spontaneously and given the presence of bilateral osteomyelitis putting the contralateral carotid at risk, the decision was made to attempt preservation of the parent vessel with flow diversion. However, bleeding recurred after 12 days, necessitating carotid sacrifice. This first reported experience in treating a carotid pseudoaneurysm at the skull base with the Pipeline device shows that transient cessation of bleeding is insufficient for flow diversion to be effective.

  15. The microbial environment of the ear canal in health and disease.

    PubMed

    Kowalski, J J

    1988-07-01

    Otitis externa is an important disease of dogs and, to a lesser degree, cats. The yeast Malassezia canis is the most common organism demonstrated in ear infections. Coagulase-positive staphylococci are the most common bacteria isolated, often occurring with M. canis. Pseudomonas aeruginosa and Proteus are gram-negative bacteria that are frequently encountered. Other bacteria, such as beta-hemolytic streptococci, enterococci, Escherichia coli, and Corynebacterium are also important. Malassezia canis, coagulase-positive staphylococci, and Pseudomonas aeruginosa commonly occur as monoinfections, whereas other bacteria are typically associated with mixed infections. Smears may provide rapid diagnosis on which to base empiric treatment. Cultures should be considered in recurrent or refractory cases, especially those involving gram-negative bacteria. In practices that are not equipped to perform culture and susceptibility tests, it is advisable to seek the advice of a microbiology laboratory.

  16. [Nasal mucosa in patients with diabetes mellitus].

    PubMed

    Müller, Maciej; Betlejewski, Stanisław

    2003-01-01

    Diabetes mellitus is the most common endocrinologic disease all over the world. 150 million people suffer from this disease, in Poland about 2 million. The disease on the basis of the onset and pathophysiology may be divided into type I and type II. Pathophysiologic changes include diabetic microangiopathy, macroangiopathy and neuropathy. The most common presentations in head and neck are otitis externa, hypoacusis, vertigo, disequilibrium, xerostomia, dysphagia, fungal and recurrent infections. The changes in nasal mucosa are not very well known. Only few papers concerned the problem. The main complaints of patients regarding the nose are xeromycteria, hyposmia and various degree of decreased patency of the nose. Chronic atrophic rhinitis, septal perforation, ulceration of nasal mucosa, alar necrosis, symptoms of staphylococcal or fungal infection can be found during otolaryngologic examination. The treatment in this group of patients should consist of systemic therapy of diabetes mellitus and on the other hand focal therapy with the use of a solution to moisten the nasal mucosa.

  17. Pseudomonas aeruginosa dose response and bathing water infection.

    PubMed

    Roser, D J; van den Akker, B; Boase, S; Haas, C N; Ashbolt, N J; Rice, S A

    2014-03-01

    Pseudomonas aeruginosa is the opportunistic pathogen mostly implicated in folliculitis and acute otitis externa in pools and hot tubs. Nevertheless, infection risks remain poorly quantified. This paper reviews disease aetiologies and bacterial skin colonization science to advance dose-response theory development. Three model forms are identified for predicting disease likelihood from pathogen density. Two are based on Furumoto & Mickey's exponential 'single-hit' model and predict infection likelihood and severity (lesions/m2), respectively. 'Third-generation', mechanistic, dose-response algorithm development is additionally scoped. The proposed formulation integrates dispersion, epidermal interaction, and follicle invasion. The review also details uncertainties needing consideration which pertain to water quality, outbreaks, exposure time, infection sites, biofilms, cerumen, environmental factors (e.g. skin saturation, hydrodynamics), and whether P. aeruginosa is endogenous or exogenous. The review's findings are used to propose a conceptual infection model and identify research priorities including pool dose-response modelling, epidermis ecology and infection likelihood-based hygiene management.

  18. Crosstalk between Muscularis Macrophages and Enteric Neurons Regulates Gastrointestinal Motility

    PubMed Central

    Muller, Paul Andrew; Koscsó, Balázs; Rajani, Gaurav Manohar; Stevanovic, Korey; Berres, Marie-Luise; Hashimoto, Daigo; Mortha, Arthur; Leboeuf, Marylene; Li, Xiu-Min; Mucida, Daniel; Stanley, E. Richard; Dahan, Stephanie; Margolis, Kara Gross; Gershon, Michael David; Merad, Miriam; Bogunovic, Milena

    2014-01-01

    SUMMARY Intestinal peristalsis is a dynamic physiologic process influenced by dietary and microbial changes. It is tightly regulated by complex cellular interactions; however, our understanding of these controls is incomplete. A distinct population of macrophages is distributed in the intestinal muscularis externa. We demonstrate that in the steady state muscularis macrophages regulate peristaltic activity of the colon. They change the pattern of smooth muscle contractions by secreting bone morphogenetic protein 2 (BMP2), which activates BMP receptor (BMPR) expressed by enteric neurons. Enteric neurons, in turn, secrete colony stimulatory factor 1 (CSF1), a growth factor required for macrophage development. Finally, stimuli from microbial commensals regulate BMP2 expression by macrophages and CSF1 expression by enteric neurons. Our findings identify a plastic, microbiota-driven, crosstalk between muscularis macrophages and enteric neurons, which controls gastrointestinal motility. PMID:25036630

  19. Ciclosporin 10 years on: indications and efficacy

    PubMed Central

    Forsythe, Peter; Paterson, Sue

    2014-01-01

    Ciclosporin is a lipophilic cyclic polypeptide with powerful immunosuppressive and immunomodulatory properties that has been used in veterinary medicine for two decades. It is a calcineurin inhibitor whose principal mode of action is to inhibit T cell activation. The drug is principally absorbed from the small intestine and is metabolised in the intestine and liver by the cytochrome P450 enzyme system. Ciclosporin is known to interact with a wide range of pharmacological agents. Numerous studies have demonstrated good efficacy for the management of canine atopic dermatitis and this has been a licensed indication since 2003. In addition to the treatment of atopic dermatitis, it has been used as an aid in the management of numerous other dermatological conditions in animals including perianal fistulation, sebaceous adenitis, pododermatitis, chronic otitis externa and pemphigus foliaceus. This article reviews the mode of action, pharmacokinetics, indications for use and efficacy of ciclosporin in veterinary dermatology. PMID:24682697

  20. [Ceruminous gland adenoma of the external auditory canal: a case report].

    PubMed

    Namysłowski, Grzegorz; Scierski, Wojciech; Misiołek, Maciej; Czecior, Eugeniusz; Lange, Dariusz

    2003-01-01

    Ceruminous adenoma (ceruminoma) of the external auditory meatus is a rare neoplasm with benign clinical behavior. This tumor is mainly composed of the ceruminous gland cells (modified apocrine sweat glands). These glands are localized deep in the skin mostly in the cartilaginous part of the external auditory meatus. The most often symptom of the ceruminous adenoma of external auditory meatus is the unilateral conductive hearing loss. Occasionally symptoms of this tumor (pain, otorrhoea) can result from an otitis externa secondary to meatus obstruction. Ceruminous adenoma should be radical excised with adequate margins of the normal tissues. The prognosis of these tumors is good. The difficulties of nomenclature, histological structure of the auditory external meatus ceruminoma, as well as symptomatology, treatment and clinical behavior are discussed on the basis of the literature. A case of histologically confirmed ceruminoma (ceruminous adenoma) of the external auditory meatus in a surgically treated 53 years old men is presented.

  1. Otitis: anatomy every practitioner should know.

    PubMed

    Griffin, Craig

    2009-11-01

    Chronic otitis externa is a difficult, frustrating problem. Four etiologic components must be considered: primary and secondary causes and perpetuating and predisposing factors.1 Usually, these cases are complex and involve more than one component. Perpetuating factors are changes in the anatomy and physiology of the ear that occur in response to inflammation in the ear canal and the perpetuating factors already present. They are self-perpetuating, are not disease specific, and include failure of self-cleaning mechanisms and proliferative changes that create folds and stenosis of the lumen of the ear canal. Elimination of perpetuating factors often requires aggressive cleaning of the ear and long-term therapy. It is important to avoid damaging key structures while aggressively cleaning the ear. Therefore, to adequately diagnose and manage perpetuating factors, veterinarians must recognize normal ear anatomy and physiology.

  2. [An information system for injuries from external causes (SILEX): a successful project in El Salvador].

    PubMed

    Salinas, Oscar; de Cosío, Gerardo; Clavel-Arcas, Carme; Montoya, Jeannette; Serpas, Mario; Morán de García, Silvia; Concha-Eastman, Alberto

    2008-12-01

    This article examines the stages in developing an information system for injuries from external causes (Sistema de Información de Lesiones de Causa Externa-SILEX), as well as its limitations and achievements. SILEX is a Web-based application for collection, quality control, presentation, and analysis of data available from the hospital system for surveillance of injuries from external causes created by Ministry of Health of El Salvador with data from the hospital emergency services. This system maintains comprehensive information on the injured person-type of injury, intention, injury site, activity being performed at the time of injury, risk factors, etc.-in the form of tables, graphs, and maps, which streamlines the development of intervention plans and prevention initiatives for these types of injuries in El Salvador. This experience is an example of what can be done to close the information gap on injuries by external causes in the Region of the Americas.

  3. Granulomatosis with Polyangiitis with Bilateral Facial Palsy and Severe Mixed Hearing Loss

    PubMed Central

    Szymańska, Anna; Jeleniewicz, Radosław

    2016-01-01

    Granulomatosis with polyangiitis is autoimmune and rare disease. It affects many organs, but the most often affected organs are the nose, lungs, and kidneys. It is part of vasculitis and causes an autoimmune attack by an abnormal type of circulating antibody termed ANCAs against small blood vessels. Disease concerns both men and women with a peak age of presentation in the sixth and seven decades. Typically upper and lower respiratory tract and kidneys are involved. Otitis externa, otitis media, or mastoiditis rarely occurs in granulomatosis with polyangiitis. Deafness is the most dangerous aural complication. Histological examination of biopsy is often not specific. A case of GPA with bilateral otitis media, bilateral deafness, and bilateral facial palsy with fatal course is presented. PMID:27493820

  4. Study of the morphology of the olfactory organ of African ostrich chick.

    PubMed

    Jin, E H; Peng, K M; Wang, J A X; Du, A N; Tang, L; Wei, L; Wang, Y; Li, S H; Song, H

    2008-06-01

    The anatomy and histology of the olfactory organ of African ostrich chick were carefully observed by gross anatomy observation, paraffin sectioning and haematoxylin-eosin (HE) staining. The results showed that there were no keratotic nose lids at the entrance of the external naris, and that the nasal cavity was separated into two imperforate compartments by the nasal septum. The posterior conchae were connected with the middle conchae without cohering to nasal walls, and appeared to be part of a palinal elongation of the middle conchae. Olfactory cells were distributed in the mucosal epithelium of middle and posterior conchae. Nasal glands were shaped like irregular rectangles, and their connective tissue extended to the parenchyma, which was divided into many glandular lobules. The layers of the olfactory bulb were indistinct, the globular structure was inconspicuous and the granular cells were scattered relatively in the lamina granularis externa.

  5. Risk factors and prevalence of Demodex mites in young adults.

    PubMed

    Horváth, Andrea; Neubrandt, Dóra Maja; Ghidán, Á; Nagy, K

    2011-06-01

    Demodex mites are ectoparasites often found in follicles of facial skin. Their role in human diseases is under investigation, and a growing number of studies indicated that they contribute to chronic inflammatory conditions of the skin, such as rosacea, blepharitis, otitis externa, alopecia and folliculitis. In our study we tested 96 healthy adults for the presence of Demodex mites. Risk factors influencing presence of mites and skin types of the tested individuals were evaluated. We found Demodex folliculorum or Demodex brevis in 17.7% of the samples, more frequently in males (21.9%) and in older adults (20%). Use of make-up seems to reduce the likelihood of Demodex carriage, while pet ownership, use of shared items and living in close contact with older adults had no significant influence of presence of mites. Demodex positive individuals described their skin to be drier, more prone to erythema, but less for folliculitis compared to Demodex negative subjects.

  6. [Clinical and epidemiological characterization of patients evaluated at a pediatric ophthalmology department].

    PubMed

    Hernández, Augusto Antonio; Balparda, Kepa; Díaz, Ana María; Pamplona, Ana Paulina; Jiménez, Daniel; Londoño, Ana María

    2014-01-01

    INTRODUCCIÓN: el adecuado tratamiento de las enfermedades requiere un conocimiento extenso de la epidemiología de las entidades patológicas más comunes en el medio en el cual se desenvuelve el médico. De ahí la importancia de realizar estudios de caracterización clínica epidemiológica que permitan determinar la evolución de las enfermedades en la consulta externa. El objetivo de esta investigación fue realizar la caracterización de los pacientes atendidos en un servicio de oftalmopediatría durante un año, en Medellín, Colombia. MÉTODOS: estudio descriptivo retrospectivo, en el cual se revisaron las historias clínicas de los pacientes con edad inferior a 18 años, atendidos en un servicio de oftalmopediatría por cualquier causa.

  7. First 3D reconstruction of the rhizocephalan root system using MicroCT

    NASA Astrophysics Data System (ADS)

    Noever, Christoph; Keiler, Jonas; Glenner, Henrik

    2016-07-01

    Parasitic barnacles (Cirripedia: Rhizocephala) are highly specialized parasites of crustaceans. Instead of an alimentary tract for feeding they utilize a system of roots, which infiltrates the body of their hosts to absorb nutrients. Using X-ray micro computer tomography (MicroCT) and computer-aided 3D-reconstruction, we document the spatial organization of this root system, the interna, inside the intact host and also demonstrate its use for morphological examinations of the parasites reproductive part, the externa. This is the first 3D visualization of the unique root system of the Rhizocephala in situ, showing how it is related to the inner organs of the host. We investigated the interna from different parasitic barnacles of the family Peltogastridae, which are parasitic on anomuran crustaceans. Rhizocephalan parasites of pagurid hermit crabs and lithodid crabs were analysed in this study.

  8. Proliferative and necrotising otitis in a kitten: first demonstration of T-cell-mediated apoptosis.

    PubMed

    Vidémont, E; Pin, D

    2010-11-01

    Otitis externa in cats is relatively uncommon. This report describes a case of a rare, visually distinctive, proliferative and necrotising otitis in a three-month-old Persian kitten. The cat had proliferative, erythematous and necrotic tissue covering most of the proximal pinnae and vertical ear canals. On histopathological examination, the most striking feature was the existence of scattered apoptotic-appearing keratinocytes within severely hyperplastic epithelium. For the first time, immunohistochemistry was used to show a closed association between CD3(+) T cells and caspase-3 stained keratinocytes, consistent with a keratinocyte apoptosis by epidermal-infiltrating T cells. Treatment was initiated using topical tacrolimus twice daily and an ear cleanser once daily. A marked improvement was observed after 10 days of treatment and the lesions completely resolved over a period of three weeks. The origin of T cells directed against keratinocytes is currently unknown.

  9. Species composition of Malassezia yeasts in dogs in Slovakia.

    PubMed

    Sihelská, Zuzana; Váczi, Peter; Conková, Eva

    2016-01-01

    Malassezia (M.) pachydermatis is the lipophilic yeast, which is normally present on the skin and in the ear canal of dogs but under certain conditions it may cause dermatitis and otitis. There is less known about the occurrence of lipid-dependent Malassezia species in dogs. The aim of this study was to detect whether lipid-dependent yeasts are part of the normal microflora in dogs. Two groups of animals were selected for comparison. The group of healthy dogs contained samples of 118 individuals and the group of dogs with cutaneous lesions or otitis externa comprised 328 dogs. The isolates of Malassezia were identified by using genotypic methods that allow the precise identification. M. pachydermatis was the most frequently isolated species in this study (121 isolates). Only four isolates were identified as M. furfur and one isolate was identified as M. nana.

  10. Treatment outcome of otomycosis in Ilorin, Nigeria.

    PubMed

    Ologe, F E; Nwabuisi, C

    2002-01-01

    Among 141 patients suspected of having otomycosis, 76 (53.9%) were mycologically confirmed. The fungi isolated were Aspergillus sp (63.4%), Candida (35.5%) and Mucor (1.3%). Ninety-six per cent were symptom free within 2 weeks of topical application of 1% clotrimazole cream, after thorough failures in the cleaning of debri in the ear canal. Treatment failures were minimal, including recurrence (2.6%), acute otitis externa (1.3%), foreign body in the ear (1.3%) and blocking of ear by therapeutic agent (2.6%). This treatment regimen is simple, efficacious, cost effective and safe; hence it is recommended for adoption in the management of otomycosis.

  11. A clinical study on the effect of Arka Taila in the management of Karnasrava (Otomycosis).

    PubMed

    Palmer, Komal K; Vaghela, D B; Manjusha, R

    2011-07-01

    Karnasrava is the condition characterized by discharge from Karna and occurs mainly due to Avarana of Vata Dosha. Otomycosis denotes diffuse otitis externa due to fungal infection in ear. Otomycosis being one of the causes of Karnasrava was selected for the study. The present study is done on 28 patients of Karnasrava, who were grouped in to two with 14 patients in each group. Group-A was treated with Arka TailaKarnapurana and Group-B with Clotrimazole ear drops (standard control). The signs and symptoms were studied before and after treatment. Result of the study indicates that Arka Taila and Clotrimazole are equally effective in all the signs and symptoms of Karnasrava (Otomycosis).

  12. Otomycosis: subdermal growth in calcified mass.

    PubMed

    Hoshino, Tomoyuki; Matsumoto, Mariko

    2006-09-01

    Reports on clear identification of fungi in subdermal tissue in chronic fungal external otitis are rare in recent years. Our patient was an immunocompetent adult male with an 8 year history of chronic otitis externa who presented with pustules on the external auditory canal (EAC) and necrosis and perforation of the tympanic membrane. Type I tympanoplasty was performed, but wound healing was delayed and swelling of the EAC occurred. Incision biopsy and staining (Gomori-Grocott and PAS) revealed fungal hyphae within small, calcified, subepidermal masses. A 3 month course of oral itraconazole was effective in healing the lesion. Calcification, a rarely reported finding in otomycosis, may represent a protective reaction against topical use of antifungal drugs.

  13. Otomycosis due to Aspergillus spp. in a dog: case report and literature review.

    PubMed

    Coyner, Kimberly

    2010-12-01

    This report describes the clinical findings, clinicopathology and treatment of otomycosis caused by Aspergillus spp. in an atopic dog affected by chronic unilateral purulent otitis externa unresponsive to topical and oral antibiotics and antifungal treatments. Cytology of otic exudate revealed neutrophils and septate fungal hyphae, and otic culture grew Aspergillus spp. and no bacteria. Treatments included allergen-specific immunotherapy, topical and oral antifungal therapy and anti-inflammatory steroid therapy. Final resolution occurred after treatment of the underlying hypersensitivity disorder, administration of topical ketoconazole and debridement of infectious ear exudate. Otomycosis due to filamentous fungi may, as in humans, occur in dogs with ear canals compromised by pre-existing allergic or bacterial otitis, and possibly previous antibiotic therapy. Antifungal medications provided clinical improvement, but the key to successful treatment was the restoration of the normal physiology of the external auditory canal.

  14. A clinical study on the effect of Arka Taila in the management of Karnasrava (Otomycosis)

    PubMed Central

    Palmer, Komal K.; Vaghela, D. B.; Manjusha, R.

    2011-01-01

    Karnasrava is the condition characterized by discharge from Karna and occurs mainly due to Avarana of Vata Dosha. Otomycosis denotes diffuse otitis externa due to fungal infection in ear. Otomycosis being one of the causes of Karnasrava was selected for the study. The present study is done on 28 patients of Karnasrava, who were grouped in to two with 14 patients in each group. Group-A was treated with Arka Taila Karnapurana and Group-B with Clotrimazole ear drops (standard control). The signs and symptoms were studied before and after treatment. Result of the study indicates that Arka Taila and Clotrimazole are equally effective in all the signs and symptoms of Karnasrava (Otomycosis). PMID:22529649

  15. A new species of the genus Bothrioplana (Platyhelminthes: Bothrioplanida: Bothrioplanidae) and a new species of the genus Pentacoelum (Tricladida: Bdellouridae) from southern China.

    PubMed

    He, Yi; Zhao, Jia-Qi; Ning, Wan-Ru; Zhuang, Jie-Yi; Zhang, Yu; Wang, An-Tai

    2016-10-31

    Two new species of turbellarians, Bothrioplana sinensis n. sp., and Pentacoelum sinensis n. sp., were described based on their reproductive behavior, ontogenic development, morphology in whole-mounted and sectioned specimens, and 18S rDNA phylogenetic classification. Bothrioplana sinensis n. sp. represents a newly recorded order in China and the second identified species in the genus Bothrioplana. It is characterized by a pair of spherical-shaped well-developed testes located dorsally behind the pharynx, and the common vas deference located ventrally to the gonopore. Phylogenetic analysis showed that this new species is closely related to parasitic flatworms. Pentacoelum sinensis n. sp. is characterized by two uteri instead of lateral bursae located laterally near the tail end and a lack of connection between the posterior intestinal branches. Each uterus has a ventral receptaculum seminalis (also functioning as bursa copulatrix) which has a muscular vagina externa opening obliquely to the ventral side at the tail end.

  16. Fotometría CCD en el campo del cúmulo abierto Ruprecht 58

    NASA Astrophysics Data System (ADS)

    Giorgi, E. E.; Vázquez, R. A.; Seggewiss, W.; Ostrov, P.; Solivella, G. R.

    La región de Vela-Puppis contiene varios cúmulos cuyo estudio puede brindarnos información acerca de la cinemática y el estado evolutivo de la población estelar en las zonas externas del disco galáctico. A través de observaciones CCD en los filtros UBV en el campo del cúmulo abierto Ruprecht 58 (α2000= 8h 14m 41s, δ2000=-31o 57'), se han determinado por primera vez los parámetros fundamentales de este cúmulo tales como distancia, enrojecimiento y edad. Se analiza también la estructura de su secuencia principal y la presencia de gigantes y binarias.

  17. [Study of death with secondary diagnosis of malnutrition in a third level hospital].

    PubMed

    Fernández Valdivia, Antonia; Lobo Támer, Gabriela; Martínez Cirre, Ma Carmen; Valero Aguilera, Beatriz; Peña Taveras, Manuel del Carmen; Rodríguez Rodríguez, José María; Martínez Tapias, Jesús; Pérez de la Cruz, Antonio Jesús

    2013-01-01

    Introducción: La desnutrición constituye uno de los principales problemas de Salud Pública, según datos de la OMS, es la primera causa de mortalidad, cuando la misma afecta al colectivo de los sujetos hospitalizados, toma entidad propia denominándose “desnutrición hospitalaria”. Objetivos: El objetivo general es cuantificar los diagnósticos principales de alta más frecuentes, que causan exitus, con el diagnóstico secundario de desnutrición. Métodos: Se trata de un estudio transversal y descriptivo, en el que se han incluido todas las altas hospitalarias del año 2011 y primer semestre de 2012, que han sido exitus y que tienen como diagnóstico secundario la desnutrición, siendo el total de 33. Se ha realizado un análisis estadístico descriptivo, efectuándose el test de Mann-Whitney para pruebas no paramétricas (p < 0,05). Resultados: Los diagnósticos principales más frecuentes entre las 33 altas analizadas son la sepsis (12,1%), metástasis hepáticas (9,1%), neumonía (6,1%), insuficiencia respiratoria aguda (6,1%) e insuficiencia renal aguda (6,1%). Conclusiones: Aunque el diagnóstico principal más frecuente es la sepsis, al agrupar los diagnósticos, el GRD más frecuente es de patología respiratoria, por lo que se ha de hacer codificación exhaustiva y de calidad para ajustar el peso relativo de los mismos a la realidad. Es fundamental especificar en la fuente de información clínica utilizada para la codificación, el grado de desnutrición, para obtener mayor especificidad en los datos.

  18. CHRONIC ENTERITIS IN PATIENTS UNDERGOING PELVIC RADIOTHERAPY: PREVALENCE, RISK FACTORS AND ASSOCIATED COMPLICATIONS.

    PubMed

    Hernández-Moreno, Ana; Vidal-Casariego, Alfonso; Calleja-Fernández, Alicia; Kyriakos, Georgios; Villar-Taibo, Rocío; Urioste-Fondo, Ana; Cano-Rodríguez, Isidoro; Ballesteros-Pomar, María D

    2015-11-01

    Introducción: la radiacion de los tumores de la cavidad pelvica puede provocar mucositis a nivel intestinal. El objetivo de nuestro estudio fue determinar la prevalencia, los factores de riesgo y las complicaciones de la enteritis radica cronica en los pacientes tratados con radioterapia pelvica. Pacientes y métodos: estudio transversal sobre 150 pacientes tratados con radioterapia pelvica durante el ano 2008 debido a un cancer de prostata, cervix, endometrio o recto. Se interrogo a los pacientes sobre la presencia de sintomas sugestivos de enteritis y sobre cambios en el peso habitual y modificaciones en su dieta. Los parametros considerados como posibles factores de riesgo de enteritis cronica (sexo, edad, tratamiento antitumoral, enteritis aguda previa y tipo de tumor) se analizaron con metodos univariantes y multivariantes. Resultados: el estudio incluyo finalmente a 100 pacientes, el 84% varones, con una mediana de edad de 72,3 anos. Se encontro una prevalencia de enteritis radica cronica del 20%, en la mayoria de grado 1 (45%). Por otra parte, el 10% referian una perdida de peso ≥ 5 kg, el 3% habian requerido hospitalizacion debido a diarrea incoercible o a obstruccion intestinal, y el 11% habian modificado su patron de alimentacion habitual, reduciendo principalmente el consumo de verduras, legumbres y dulces. Se encontro asociacion entre la enteritis radica cronica y el sexo masculino, la edad, la enteritis radica aguda previa y la quimioterapia, pero solo esta resulto asociarse de forma independiente con el desarrollo de enteritis radica cronica despues del analisis multivariante (OR = 3,59 [95% CI 1,20–10,73]). Conclusión: la enteritis cronica es una entidad frecuente en los pacientes tratados con radioterapia pelvica, sobre todo cuando se asocia con quimioterapia. La tasa de complicaciones por esta patologia es baja, pero un numero importante de pacientes realiza modificaciones en su dieta habitual para aliviar o evitar la sintomatologia derivada

  19. Hypertriglyceridemia: Is there a role for prophylactic apheresis? A case report.

    PubMed

    Francisco, Ana Rita; Gonçalves, Inês; Veiga, Fátima; Pedro, Mónica Mendes; Pinto, Fausto J; Brito, Dulce

    2016-01-01

    Severe hypertriglyceridemia has been consistently associated with an increased risk of cardiovascular disease and other complications, namely acute pancreatitis. We report a case of a 64 year-old woman with hypertrophic cardiomyopathy and metabolic syndrome with triglyceride level of 3260 mg/dL. Plasma exchange was performed with simultaneous medical treatment to achieve a rapid and effective lowering of triglycerides in order to prevent clinical complications. After three plasmapheresis sessions a marked reduction in triglyceride and total cholesterol levels was observed. Several cases have shown the importance of plasmapheresis in the treatment of acute pancreatitis. We intend to demonstrate the applicability of this technique as primary prophylaxis in the presence of extremely high serum triglyceridemia levels. Resumo A hipertrigliceridemia grave tem sido associada de forma consistente ao aumento do risco cardiovascular e a outras complicações, nomeadamente, pancreatite aguda. Descrevemos um caso de uma mulher de 64 anos, com miocardiopatia hipertrófica e síndrome metabólica com valor sérico de triglicerídeos de 3260 mg/dL. Foi efectuada plasmaferese e optimizado o tratamento médico para alcançar uma redução rápida e efectiva dos níveis dos triglicerídeos, prevenindo complicações clínicas. Após três sessões de plasmaferese, verificou-se uma redução marcada dos triglicerídeos e do colesterol total. Existem alguns casos descritos na literatura demonstrado a importância da plasmaferese no tratamento da pancreatite aguda em contexto de hipertrigliceridemia grave. Os autores pretendem com este caso demonstrar a aplicabilidade desta técnica em contexto de prevenção primária em doentes com níveis de triglicerídeos extremamente aumentados.

  20. [Complex febrile crises: should we change the way we act?].

    PubMed

    Martinez-Cayuelas, E; Herraiz-Martinez, M; Villacieros-Hernandez, L; Cean-Cabrera, L; Martinez-Salcedo, E; Alarcon-Martinez, H; Domingo-Jimenez, R; Perez-Fernandez, V

    2014-11-16

    Introduccion. Las convulsiones febriles son una de las causas mas frecuentes de consulta. Hasta ahora, los pacientes con convulsiones febriles complejas (CFC) deben ingresar, dado el mayor porcentaje de epilepsia y complicaciones agudas descrito clasicamente. En la actualidad hay estudios que apoyan ser menos invasivos en el abordaje de estos pacientes. Objetivo. Describir las caracteristicas de los pacientes ingresados por CFC y proponer un nuevo protocolo de actuacion. Pacientes y metodos. Analisis retrospectivo de historias clinicas de ingresados por CFC (enero de 2010-diciembre de 2013). Se ofrecen datos epidemiologicos, clinicos, pruebas complementarias y evolucion. Resultados. Las CFC suponian un 4,2% de los ingresos de neuropediatria (n = 67). Edad media al evento: 25 meses. El 47% tenia antecedentes familiares patologicos, y el 31%, antecedentes personales de convulsion febril previa. En el 54% de los pacientes, la CFC duro menos de cinco minutos; hubo recurrencia, la mayoria con un total de dos crisis y durante el primer dia (las CFC por recurrencia son las mas frecuentes). De las pruebas complementarias realizadas, ninguna de ellas sirvio como apoyo diagnostico en el momento agudo. Durante su seguimiento, cinco pacientes presentaron complicaciones. Los pacientes con antecedentes familiares de convulsiones febriles presentan mayor riesgo de epilepsia o recurrencia (p = 0,02), sin diferencias significativas respecto a la edad, numero de crisis, intervalo de fiebre, estado epileptico o tipo de CFC. Conclusiones. Las CFC no asocian mayores complicaciones agudas; las exploraciones complementarias no permiten discriminar precozmente a los pacientes de riesgo. Su ingreso podria evitarse en ausencia de otros signos clinicos y limitarse a casos seleccionados.

  1. [Scorpionism causing severe acute flaccid paralysis. Case report].

    PubMed

    Villa-Manzano, Alberto I; Vázquez-Solís, Ma Guadalupe; Zamora-López, Xochitl Xitlalli; Arias-Corona, Fernando; Palomera-Ávila, Francisco Miguel; Pulido-Galaviz, Carlos; Pacifuentes-Orozco, Adán

    2016-01-01

    Introducción: el alacranismo es un problema de salud pública en diversas regiones del mundo, siendo México el país que tiene mayor número de casos. Las manifestaciones clínicas oscilan desde sintomatología local hasta cuadros graves con repercusiones a nivel cardiovascular, respiratorio y neurológico, e incluso la muerte. No existen reportes de parálisis flácida como una manifestación del cuadro clínico por picadura del alacrán del género Centruroides, familia Buthidae, especie altamente tóxica, endémica y causante de altos índices de morbimortalidad en nuestra región. Caso clínico: documentamos un caso de alacranismo grave, provocado por escorpión de la familia Buthidae del género Centruroides, que causó parálisis flácida aguda, posterior a resolución de otras manifestaciones severas. Solo existe un reporte de caso de alacranismo que produce parálisis flácida aguda en la literatura médica, pero relacionado con el escorpión de la familia Parabuthus, endémico de Sudáfrica, el cual no es endémico en México. Conclusiones: conocer esta complicación, nueva para nuestra región, permitirá maximizar esfuerzos para diagnosticar y manejar oportunamente esta entidad con la aplicación temprana de faboterápico específico y soporte vital avanzado.

  2. Noninflammatory upregulation of nerve growth factor underlies gastric hypersensitivity induced by neonatal colon inflammation

    PubMed Central

    Li, Qingjie; Winston, John H.

    2015-01-01

    Gastric hypersensitivity is one of the key contributors to the postprandial symptoms of epigastric pain/discomfort, satiety, and fullness in functional dyspepsia patients. Epidemiological studies found that adverse early-life experiences are risk factors for the development of gastric hypersensitivity. Preclinical studies found that neonatal colon inflammation elevates plasma norepinephrine (NE), which upregulates expression of nerve growth factor (NGF) in the muscularis externa of the gastric fundus. Our goal was to investigate the cellular mechanisms by which NE upregulates the expression of NGF in gastric hypersensitive (GHS) rats, which were subjected previously to neonatal colon inflammation. Neonatal colon inflammation upregulated NGF protein, but not mRNA, in the gastric fundus of GHS rats. Western blotting showed upregulation of p110γ of phosphatidylinositol 4,5-bisphosphate 3-kinase (PI3K), phosphoinositide-dependent kinase-1 (PDK1), pAKT(Ser473), and phosphorylated 4E-binding protein (p4E-BP1)(Thr70), suggesting AKT activation and enhanced NGF protein translation. AKT inhibitor MK-2206 blocked the upregulation of NGF in the fundus of GHS rats. Matrix metalloproteinase 9 (MMP-9), the major NGF-degrading protease, was suppressed, indicating that NGF degradation was impeded. Incubation of fundus muscularis externa with NE upregulated NGF by modulating the protein translation and degradation pathways. Yohimbine, an α2-adrenergic receptor antagonist, upregulated plasma NE and NGF expression by activating the protein translation and degradation pathways in naive rats. In contrast, a cocktail of adrenergic receptor antagonists suppressed the upregulation of NGF by blocking the activation of the protein translation and degradation pathways. Our findings provide evidence that the elevation of plasma NE induces NGF expression in the gastric fundus. PMID:26608656

  3. [Design and validation of a classification system for assessing the degree of disability of patients with amyotrophic lateral sclerosis].

    PubMed

    Diaz-Gomez, M F; Ortiz-Corredor, F

    2017-02-01

    Introduccion. Actualmente no existe un sistema de clasificacion validado y de uso comun para estadificar la gravedad de la esclerosis lateral amiotrofica. Pacientes y metodos. Basados en la escala de valoracion funcional para la esclerosis lateral amiotrofica revisada, se establecieron cuatro dominios (bulbar, destrezas manuales, funcion motora gruesa y funcion respiratoria). A cada item se le asigno una puntuacion de 0 si su calificacion era igual o mayor de 3 (independencia), o 1 si su calificacion era menor de 3 (dependencia). La escala de clasificacion funcional se definio desde el estadio 1 (sin perdida de independencia en ningun dominio) hasta el estadio 5 (perdida de independencia en los cuatro dominios). Esta clasificacion se correlaciono con la necesidad de ayudas externas, la calidad de vida aplicando la escala del cuestionario de evaluacion de la esclerosis lateral amiotrofica-40, la fuerza muscular y la sobrevida. Resultados. De un total de 244 pacientes, el 14,3% se encontraba en estadio 1; el 23,8%, en estadio 2; el 21,3%, en estadio 3; el 19,3%, en estadio 4; y el 21,3%, en estadio 5. Fuerza muscular y calidad de vida fueron inversamente proporcionales a la etapa de la enfermedad. La necesidad de ayudas externas se relaciona directamente con el aumento de los estadios de la enfermedad de 1 a 5 (p < 0,012). Se encontro una mayor sobrevida de los pacientes en los estadios 1 y 2 con respecto a los estadios 3, 4 y 5 (p = 0,004). Conclusion. El sistema de clasificacion propuesto es de facil aplicacion y se correlaciona bien con la clinica del paciente, su calidad de vida, el requerimiento de recursos y la sobrevida.

  4. Differences in brain activation between tremor- and nontremor-dominant Parkinson disease.

    PubMed

    Prodoehl, Janey; Planetta, Peggy J; Kurani, Ajay S; Comella, Cynthia L; Corcos, Daniel M; Vaillancourt, David E

    2013-01-01

    OBJECTIVE To compare differences in functional brain activity between tremor- and nontremor-dominant subtypes of Parkinson disease (PD) using functional magnetic resonance imaging. DESIGN In our study, patients with tremor-dominant PD and those with nontremor-dominant PD performed a grip task, and the results obtained were compared using voxelwise analysis. Areas of the brain that were significantly different were then examined using a region-of-interest analysis to compare these patients with healthy controls. Voxel-based morphometry was used to determine macroscopic differences in gray and white matter volume between patient groups. SETTING University-affiliated research institution. PARTICIPANTS A total of 20 drug-naive patients with PD (10 with tremor-dominant PD and 10 with nontremor-dominant PD) and a total of 20 healthy controls. MAIN OUTCOME MEASURES Blood oxygenation level-dependent activation and percent signal change. RESULTS Robust findings across both voxelwise and region-of-interest analyses showed that, compared with patients with tremor-dominant PD, patients with nontremor-dominant PD had reduced activation in the ipsilateral dorsolateral prefrontal cortex, the globus pallidus interna, and the globus pallidus externa. Region-of-interest analyses confirmed that patients with nontremor-dominant PD had reduced activity in the ipsilateral dorsolateral prefrontal cortex, the globus pallidus interna, and the globus pallidus externa compared with patients with tremor-dominant PD and healthy controls. Patients with tremor-dominant PD had increased activity in the contralateral dorsolateral prefrontal cortex compared with patients with nontremor-dominant PD and healthy controls. These results could not be explained by differences in gray or white matter volume. CONCLUSIONS Reduced brain activity occurs in the prefrontal cortex and globus pallidus of patients with nontremor-dominant PD compared with both patients with tremor-dominant PD and healthy controls

  5. Paradoxical regulation of ChAT and nNOS expression in animal models of Crohn's colitis and ulcerative colitis.

    PubMed

    Winston, John H; Li, Qingjie; Sarna, Sushil K

    2013-08-15

    Morphological and functional changes in the enteric nervous system (ENS) have been reported in inflammatory bowel disease. We examined the effects of inflammation on the expression of choline acetyltransferase (ChAT) and nNOS in the muscularis externae of two models of colonic inflammation, trinitrobenzene sulfonic acid (TNBS)-induced colitis, which models Crohn's disease-like inflammation, and DSS-induced colitis, which models ulcerative Colitis-like inflammation. In TNBS colitis, we observed significant decline in ChAT, nNOS, and protein gene product (PGP) 9.5 protein and mRNA levels. In DSS colitis, ChAT and PGP9.5 were significantly upregulated while nNOS levels did not change. The nNOS dimer-to-monomer ratio decreased significantly in DSS- but not in TNBS-induced colitis. No differences were observed in the percentage of either ChAT (31 vs. 33%)- or nNOS (37 vs. 41%)-immunopositive neurons per ganglia or the mean number of neurons per ganglia (55 ± 5 vs. 59 ± 5, P > 0.05). Incubation of the distal colon muscularis externae in vitro with different types of inflammatory mediators showed that cytokines decreased ChAT and nNOS expression, whereas H₂O₂, a component of oxidative stress, increased their expression. NF-κB inhibitor MG-132 did not prevent the IL-1β-induced decline in either ChAT or nNOS expression. These findings showed that TNBS- and DSS-induced inflammation differentially regulates the expression of two critical proteins expressed in the colonic myenteric neurons. These differences are likely due to the exposure of the myenteric plexus neurons to different combinations of Th1-type inflammatory mediators and H₂O₂ in each model.

  6. Expression of vimentin and glial fibrillary acidic protein in the developing rat spinal cord: an immunocytochemical study of the spinal cord glial system.

    PubMed Central

    Oudega, M; Marani, E

    1991-01-01

    The glial system in the developing rat spinal cord was studied using immunocytochemistry. Antibodies to vimentin and glial fibrillary acidic protein (GFAP) were used. At E11, vimentin was first found in the membrana limitans externa. In the matrix layer, short vimentin protrusions were found near the membrana limitans externa at E12. In addition, vimentin was scattered throughout the matrix layer, where it was also present as vimentin-positive tangles. Later in development, vimentin immunoreactivity was distributed in a distinct radial pattern in the matrix layer. During the first postnatal weeks, vimentin was replaced by GFAP which is therefore expressed in a similar radial pattern. This orderly structural organisation of vimentin and GFAP in the matrix layer could indicate the involvement of both proteins in morphogenetic processes such as neuron migration and cell organisation. In the mantle layer, a distinct radial vimentin immunoreactivity was replaced by GFAP immunoreactivity during the first 2 postnatal weeks. In addition, GFAP fibres appeared first, at E18, in the ventral mantle layer associated with the motor neuron columns. These glial fibres originated from a local source. In the dorsal mantle layer, GFAP-positive fibres were oriented tangentially, which is different from the overall radial arrangement. This expression pattern may be related to the ingrowth of primary afferents. In the ventral and dorsal raphe, a major vimentin expression was replaced by a minor presence of GFAP. Within the white matter, a vimentin-positive radial pattern was demonstrated which, after birth, was replaced by GFAP. This palisading pattern suggested an involvement of both proteins in the development and guidance of the ascending and descending spinal cord fibre systems. The general transition from the expression of vimentin to the expression of GFAP in the rat spinal cord takes place during the first 3 postnatal weeks. Images Fig. 2 (cont.) Fig. 2 Fig. 3 Fig. 4 (cont.) Fig

  7. Ultrastructural observations of previtellogenic ovarian follicles of the caecilians Ichthyophis tricolor and Gegeneophis ramaswamii.

    PubMed

    Beyo, Reston S; Sreejith, Parameswaran; Divya, Lekha; Oommen, Oommen V; Akbarsha, Mohammad A

    2007-04-01

    The ultrastructural organization of the previtellogenic follicles of the caecilians Ichthyophis tricolor and Gegeneophis ramaswamii, of the Western Ghats of India, were observed. Both species follow a similar seasonal reproductive pattern. The ovaries contain primordial follicles throughout the year with previtellogenic, vitellogenic, or postvitellogenic follicles, depending upon the reproductive status. The just-recruited primordial follicle includes an oocyte surrounded by a single layer of follicle and thecal cells. The differentiation of the theca into externa and interna layers, the follicle cells into dark and light variants, and the appearance of primordial yolk platelets and mitochondrial clouds in the ooplasm mark the transition of the primordial follicle into a previtellogenic follicle. During further development of the previtellogenic follicle the following changes occur: i) the theca loses distinction as externa and interna; ii) all the follicle cells become the dark variant and increase in the complexity of ultrastructural organization; iii) the nucleus of the oocyte transforms into the germinal vesicle and there is amplification of the nucleoli; iv) the primordial yolk platelets of the cortical cytoplasm of the oocyte increase in abundance; v) the mitochondrial clouds fragment and the mitochondria move away from the clouds, leaving behind the cementing matrix, which contains membrane-bound vesicles of various sizes, either empty or filled with a lipid material; vi) the perivitelline space appears first as troughs at the junctional points between the follicle cells and oocyte, which subsequently spread all around to become continuous; vii) macrovilli and microvilli develop from the follicle cells and oocyte, respectively; and viii) the precursor material of the vitelline envelop arrives at the perivitelline space. The sequential changes in the previtellogenic follicles of two species of caecilians are described.

  8. The morphogenesis of the arteries of the pelvic extremity. A comparative study of mammals with special reference to the tree shrew Tupaia belangeri (Tupaiidae, Scandentia, Mammalia).

    PubMed

    Funke, C; Kuhn, H J

    1998-01-01

    The ontogeny of the arteries of the pelvic extremity of Tupaia belangeri was investigated by light microscopy on the basis of serial sections of 30 embryos, dating from day 17 to day 42 post-copulation. In Tupaia, the gestational period takes approximately 43 days. Additionally, a 3-D reconstruction of the pelvic region and the right leg of a 22-day embryo was prepared. The arteries of an adult Tupaia were studied on the basis of a corrosion cast. The results were compared with the ontogeny of the arterial system of other mammals. In the 17-day embryo, the anlage of the pelvic extremity is penetrated by a capillary plexus. In the 18-day embryo, the a. ischiadica reaches the pelvic limb bud, representing the primary axial artery. On day 19, its r. perforans tarsi extends from the plantar to the dorsal aspect of the foot plate. The a. ischiadica is the main artery of the leg until the stage of the 22-day embryo. Afterwards, the peripheral arteries supplied by it are taken over by the a. iliaca externa and its extension, the a. femoralis. The a. iliaca externa springs from the a. iliaca communis in the 19-day embryo. From day 21 to day 22, the capillary plexus, which is nourished by the a. femoralis, closely approaches the a. ischiadica, and finally, a connecting branch joins the a. ischiadica. The a. ischiadica is then reduced to the a. glutea caudalis, and the aa. femoralis, poplitea profunda (at the cranial aspect of the m. popliteus), and interossea become the main arteries of the pelvic extremity. The a. poplitea superficialis, lying at the caudal aspect of the m. popliteus, and its continuation in the crural region, the a. peronea, develop until the 25-day embryo. The a. peronea gives rise to an r. perforans which penetrates the membrana interossea towards the dorsum of the foot. As a result of a shift of the origin of the a. iliaca externa in the proximal direction, the length of the a. iliaca communis gradually decreases until, on day 24, the a. iliaca externa

  9. [A short-term training program reduced acute phase proteins in premenopausal women with metabolic syndrome].

    PubMed

    Rosety-Rodríguez, Manuel; Fornieles, Gabriel; Camacho-Molina, Alejandra; Rosety, Ignacio; Díaz, Antonio J; Rosety, Miguel A; Rodríguez-Pareja, Antonia; Ordonez, Francisco J

    2013-01-01

    Fundamento y objetivo: Actualmente se acepta la importancia del estatus proinflamatorio en la fisiopatología del síndrome metabólico. De hecho, ha sido propuesto como diana terapéutica en el manejo clínico de estos pacientes. Por consiguiente este estudio pretende reducir los niveles plasmáticos de reactantes de fase aguda en mujeres con síndrome metabólico mediante un corto programa de entrenamiento. Material y método: Un total de 135 mujeres jóvenes adultas (38,4 ± 3,3 años) con diagnóstico de síndrome metabólico participaron voluntariamente en este estudio. El grupo de intervención se sometió a un programa de entrenamiento aeróbico de 12 semanas, con 3 sesiones/ semana en el que duración e intensidad de la parte principal se incrementaron progresivamente. Los niveles plasmáticos de proteína C-reactiva (PCR) y fibrinógeno se determinaron mediante nefelometría y HPLC respectivamente. También se evaluaron el fitness cardiovascular mediante prueba de esfuerzo máxima e índices de distribución de masa grasa. Este protocolo fue aprobado por un Comité de Ética Institucional. Resultados: Tras completar el programa, se observo una mejora significativa del fitness cardiovascular además de una reducción también significativa de los niveles de fibrinógeno y PCR. Asimismo, se encontraron correlaciones entre niveles de reactantes e índices de distribución de masa grasa, siendo la de mayor fuerza de asociación la establecida entre PCR y perímetro cintura. Conclusión: Un programa de 12 semanas consiguió reducir los niveles de reactantes de fase aguda en mujeres con síndrome metabólico. Futuros estudios longitudinales son necesarios para conocer el impacto del efecto anti-inflamatorio del ejercicio en el manejo de estos pacientes a medio/largo plazo.

  10. [Features of Guillain-Barre syndrome in adults: results of a university hospital].

    PubMed

    De la O-Peña, Daniel; Robles-Figueroa, Martín; Chávez-Peña, Quetzalcóatl; Bedolla-Barajas, Martín

    2015-01-01

    Introducción: el Síndrome de Guillain-Barré (SGB) tiene una distribución cosmopolita. Usualmente su curso es benigno y tiende a autolimitarse, pero en casos severos puede ocasionar la muerte. El objetivo de este artículo es describir las características de un grupo de adultos con SGB diagnosticados y tratados en un hospital universitario. Métodos: se analizaron todos los casos de SGB ocurridos del 1 de enero de 2005 al 31 de diciembre de 2009. Se revisaron los expedientes clínicos a través de la aplicación de una cédula estructurada que comprendió las siguientes secciones: identificación del paciente, datos clínicos, historia de infección, estación del año de ocurrencia, tipos de variantes electrofisiológicas y letalidad. Resultados: en total se incluyeron 45 pacientes; la relación hombre-mujer fue de 1.4:1 y la edad media del grupo fue 48.2 ± 16.0 años. La estación del año con mayor número de casos fue el verano. La historia de infección intestinal estuvo presente en 40 % de los pacientes, y la infección respiratoria en 24.4 %. La letalidad asociada con SGB fue de 11.1 % (IC: 95 %, 4.4-23.9), los casos fatales se presentaron en los pacientes con mayor edad que los que sobrevivieron (65.2 ± 15.0 frente a 46.0 ± 14.9, p = 0.01). La variante más frecuente fue la neuropatía axonal motora aguda (64.4 %); hubo cuatro casos de síndrome de Miller Fisher. Conclusiones: la variante electromiográfica más frecuente del SGB fue la neuropatía axonal motora aguda. Se observó mayor número de casos durante la estación de verano.

  11. Changes on metabolic parameters induced by acute cannabinoid administration (CBD, THC) in a rat experimental model of nutritional vitamin A deficiency.

    PubMed

    El Amrani, Loubna; Porres, Jesús M; Merzouki, Abderrahmane; Louktibi, Abdelaziz; Aranda, Pilar; López-Jurado, María; Urbano, Gloria

    2013-01-01

    Introducción: La deficiencia en vitamina A está asociada a la malnutrición, malabsorción de este nutriente, metabolismo alterado de vitaminas por enfermedad hepática, o enfermedades crónicas debilitantes como VIH, cáncer o infección. La administración de cannabis ha sido descrita como una terapia eficaz en el tratamiento sintomático de determinadas manifestaciones de la deficiencia nutricional en vitamina A y de diversas enfermedades crónicas debilitantes. Objetivos: El objetivo de este trabajo era estudiar el efecto de la administración de tetrahidrocannabinol (THC) y cannabidiol (CBD) sobre las concentraciones plasmáticas y hepáticas de retinol y sobre parámetros bioquímicos relacionados con el metabolismo glucídico y lipídico (colesterolemia, trigliceridemia, glucemia) en un modelo experimental de rata deficiente en vitamina A. Métodos: El modelo experimental de deficiencia en vitamina A se desarrolló durante un periodo experimental de 50 días en los que las ratas consumieron una dieta libre en vitamina A. La administración de tetrahidrocannabinol (THC) (10 mg/kg peso corporal) y cannabidiol (CBD) (5 mg/kg peso corporal) se llevo a cabo por vía intraperitoneal 2 horas antes del sacrificio de los animales al final del periodo experimental. Resultados: La deficiencia nutricional en vitamina A causó un descenso significativo en el contenido plasmático y hepático de retinol y en parámetros bioquímicos de metabolismo glucídico, lipídico y mineral. La administración intraperitoneal aguda de tetrahidrocannabinol y cannabidiol no mejoró los índices de estado nutricional de vitamina A en ratas deficientes o control. Sin embargo, tuvo un efecto significativo sobre parámetros bioquímicos específicos como la glucemia, colesterolemia y trigliceridemia. Conclusión: Bajo nuestras condiciones experimentales, el efecto de la administración de cannabinoides sobre determinadas manifestaciones de la deficiencia en vitamina A parece estar

  12. [Not Available].

    PubMed

    Corella Aznar, Elena Guadalupe; Ayerza Casas, Ariadna; Samper Villagrasa, Pilar; Rodríguez Vigil, Carmen; Jiménez Montañés, Lorenzo; Calvo Escribano, Carlota; Labarta Aizpun, José Ignacio

    2016-06-30

    Introducción: los supervivientes de leucemia aguda (LA) infantil presentan un riesgo incrementado de alteraciones metabólicas y cardiovasculares que aumentan su morbimortalidad a largo plazo.Objetivo: estimar la prevalencia de obesidad, resistencia a la insulina, dislipemia e hipertensión arterial como factores de riesgo cardiometabólico (FRCM) en un grupo de supervivientes de LA infantil, y analizar las posibles causas asociadas a su desarrollo.Material y métodos: estudio observacional retrospectivo en 47 supervivientes de LA tratados en un periodo de 4 años, que recibieron seguimiento durante 10 años.Resultados: el 40% de los participantes presentaron al menos un FRCM durante el seguimiento, siendo la dislipemia (aumento LDL) el más frecuente (38,3%), seguido de obesidad/sobrepeso (31,9%) y HTA sistólica (23,4%). El sexo femenino se estableció como factor de riesgo parael desarrollo de todos ellos (RR 1,6; RR 3,16; RR 1,69; p < 0,05). Ningún superviviente desarrolló diabetes mellitus, pero sí resistencia a la insulina el 19,4%. Los pacientes con leucemias de peor pronóstico presentaron mayor riesgo de desarrollar obesidad, resistencia a la insulina y aumento de LDL (RR 3,56; RR 4,08; RR 2,53; p < 0,05). Los pacientes tratados con trasplante de progenitores hematopoyéticos presentaron mayor riesgo de obesidad, aumento de LDL e HTA sistólica (RR 2,86; RR 2,39; RR 3,12; p<0,05). La radioterapia se asoció de igual modo con un incremento de resistencia a la insulina e hipertensión arterial sistólica (RR 2,47; RR 2,53; p < 0,05).Conclusiones: existe un aumento en la prevalencia de obesidad/sobrepeso, dislipemia, resistencia a la insulina y alteración de la tensión arterial sistólica en supervivientes de leucemia aguda infantil a lo largo del tiempo, especialmente en aquellos con enfermedades y tratamientos más agresivos.

  13. [PCR detection of relevant translocations in pediatric acute lymphoblastic leukemia].

    PubMed

    Guerra-Castillo, Francisco Xavier; Ramos-Cervantes, María Teresa; Rosel-Pech, Cecilia; Jiménez-Hernández, Elva; Bekker-Méndez, Vilma Carolina

    2016-01-01

    Introducción: en México, las leucemias representan el tipo de cáncer más frecuente en la población menor de 15 años con una tasa de incidencia alta cuando se compara con países desarrollados. La etiología de las leucemias puede ser desconocida, sin embargo se presentan distintos factores que pueden condicionar la enfermedad, tal es el caso de las translocaciones cromosómicas. El objetivo de este trabajo es detectar las alteraciones moleculares: TEL-AML1, MLL-AF4, BCR-ABL menor y E2A-PBX1 en los pacientes pediátricos con leucemia aguda linfoblástica. Métodos: se colectaron 91 muestras de médula ósea de enero de 2012 a marzo de 2013 de pacientes pediátricos con leucemia aguda linfoblástica del Servicio de Hematología. Se detectaron las translocaciones (TEL-AML1, MLL-AF4, BCR-ABL menor y E2A-PBX1) con técnicas moleculares de tiempo real con SYBR Green (Qiagen, Alameda, CA). Resultados: se procesaron 91 muestras, las frecuencias detectadas para cada una de las translocaciones fueron: TEL-AML1 (7.21%), E2A-PBX1 (5.15%). Las translocaciones MLL-AF4 y BCR-ABL menor no fueron detectadas en este estudio. Conclusiones: las frecuencias mostradas en este estudio están en concordancia con los datos mostrados en la literatura donde TEL-AML1 es la translocación más común encontrada en pacientes pediátricos. Es importante mencionar que E2A-PBX1 se encuentra en una frecuencia alta en países en vías de desarrollo al comparase con países desarrollados.

  14. [Nutrition-related risk factors in autonomous non-institutionalized adult elderly people].

    PubMed

    Montejano Lozoya, A Raimunda; Ferrer Diego, Rosa M; Clemente Marín, Gonzalo; Martínez-Alzamora, Nieves; Sanjuan Quiles, Angela; Ferrer Ferrándiz, Esperanza

    2014-10-01

    Objetivos: Determinar factores asociados al riesgo nutricional en adultos mayores autónomos no institucionalizados. Métodos: Estudio transversal realizado en 660 adultos mayores autónomos, no institucionalizados. Los participantes fueron evaluados en 12 centros sociales (provincia de Valencia) seleccionados mediante un muestreo estratificado por bloques. Criterios de inclusión: tener 65 años o más, vivir en el domicilio, poseer autonomía funcional, residir más de un año en la provincia de Valencia, acudir periódicamente a los centros sociales y colaborar voluntariamente en el estudio. Se usa el MNA para la valoración nutricional y se recogen factores asociados al estado nutricional en una encuesta adhoc. Resultados: De los 660 sujetos estudiados, el 48,33% son hombres y el 51,67% mujeres, la edad media es de 74,3±6,57 años. El 23,33% presentan riesgo de malnutrición. Los factores independientes asociados al riesgo de malnutrición, con el odds de prevalencia ajustada, son: no poseer estudios (OR=2,29), sentir soledad (OR=2,34), mantener dietas controladas (OR=0,55), un apetito escaso (OR=2,56), número de fracciones en la ingesta diaria (OR=0,66), sufrir xerostomía (OR=1,72), tener dificultades para deglutir (OR=2,30), el número de enfermedades crónicas (OR=1,38) y haber sufrido enfermedades agudas en el último año (OR=2,03). Un incremento en el IMC se asocia a un buen estado nutricional (OR=0,85). Estos factores nos han permitido clasificar correctamente a un 80% de los pacientes encuestados. Conclusiones: Tener numerosas enfermedades crónicas, haber sufrido enfermedades agudas recientes, mantener dietas sin control, sufrir xerostomía y dificultad para deglutir, comer pocas veces al día y con escaso apetito, sentirse solo y no tener estudios son factores que, permiten predecir el riesgo de malnutrición en los adultos mayores.

  15. Petrology of the alkaline rocks of the Macau Volcanic Field, NE Brazil

    NASA Astrophysics Data System (ADS)

    Ngonge, Emmanuel Donald; de Hollanda, Maria Helena Bezerra Maia; Pimentel, Márcio Martins; de Oliveira, Diógenes Custódio

    2016-12-01

    The Macau Volcanic Field (MVF) in the Borborema Province, NE Brazil, contains multiple centres of volcanic activity of Early to Late Cenozoic ages. We present element and Sr-Nd-Pb isotope geochemical data for four of the few most prominent basalt types of this volcanic field: Serrote Preto-type, Serra Aguda-type, Pico do Cabugi-type and Serra Preta-type, in order to assess their magmatic history from source to crystallization and the evolution of the mantle beneath the Borborema Province. The basalts are basically sodic nephelinitic-basanitic-alkali olivine basalts enriched in LILE and in Nb-Ta. The Serra Preta, Cabugi and Serra Aguda types demonstrate compositions close to primitive characteristics with 10% < MgO < 15 wt.% and 200 ppm < Ni < 500 ppm, and experienced limited fractional crystallization of olivine-clinopyroxene-plagioclase-oxides with negligible wall-rock assimilation. Rb/Sr and Ba/Rb constraints support the generation of SiO2-undersaturated magmas from mantle melting of amphibole-bearing peridotites with minor phlogopite. The source for the basanites and alkali basalts is estimated to be a garnet-bearing domain around the lithosphere-asthenosphere boundary (80-93 km deep), while the nephelinites are derived from the adiabatic asthenosphere at 105 km with temperatures of 1480 °C. Their incompatible trace element patterns and Sr-Nd-Pb isotopic compositions are similar to FOZO and EM-type OIB magmas. From the comparison of data with those of the Ceará-Mirim dyke swarm we propose that there is a ubiquitous FOZO reservoir in the SCLM beneath the Borborema Province. This FOZO signature characterized the upwelling asthenosphere during the lithospheric extension and thinning at the opening of the Equatorial Atlantic and is clearly represented in the Mesozoic olivine tholeiites of Ceará-Mirim. The upwelled asthenosphere cooled as a rigid SCLM since the Cretaceous and has preserved its FOZO signature evident in the Macau Cenozoic basalts. The EM signatures

  16. [Appendicovesical fistula treated with elective laparoscopic surgery].

    PubMed

    García-Muñoz-Najar, Alejandro; Carrión-Álvarez, Lucía; Medina-García, Manuel; García-González, María Dolores; Pereira-Pérez, Fernando

    2013-01-01

    Antecedentes: la fístula apendicovesical es una complicación infrecuente de la apendicitis aguda en estadio avanzado y representa un tipo poco habitual de fístula enterovesical. La laparotomía exploradora ha sido durante muchos años pieza clave para el diagnóstico y su tratamiento efinitivo, pero actualmente el abordaje laparoscópico se está imponiendo entre diferentes grupos experimentados. Caso clínico: aportamos un nuevo caso de fístula apendicovesical en una mujer de 45 años de edad remitida del servicio de Urología por disuria y leucocituria permanente; finalmente, el diagnóstico se estableció mediante técnica de imagen (tomografía computada) y se resolvió por laparoscopia. Este caso se suma a los 115 casos descritos hasta ahora en la bibliografía y a los cuatro tratados mediante laparoscopia. Discusión: los métodos de imagen convencionales no son fiables para el diagnóstico de fístula enterovesical. La mayoría de los casos de fístula apendicovesical son secundarios a una apendicitis aguda no evidenciada y evolucionada. En la mayor parte de las publicaciones consultadas la laparotomía es una herramienta de diagnóstico de la fístula apendicovesical y, en pocos artículos, se describe la laparoscopia como alternativa diagnóstica y terapéutica. En la bibliografía sólo se encontraron tres artículos que hacen referencia al abordaje laparoscópico con fines terapéuticos. Conclusión: ante la sospecha de comunicación entre el tubo digestivo y el aparato urinario, la tomografía computada es el método diagnóstico de elección, sobre todo si se sospecha una fístula apendicovesical. El abordaje laparoscópico de la fístula apendicovesical puede confirmar el diagnóstico radiológico a la vez que constituye una opción quirúrgica definitiva.

  17. [Acute generalized exanthematous pustulosis induced by piroxicam].

    PubMed

    Bissinger, Ingrid; Matute-Turizo, Gustavo; Mejía-Barreneche, María Natalia

    2016-01-01

    Antecedentes: Entre 62 y 90% de los casos de pustulosis exantemática generalizada aguda son causados por medicamentos. Su inicio es rápido con pústulas generalizadas, fiebre, conteo de neutrófilos en sangre mayor de 7000; la resolución de las pústulas es espontánea en menos de 15 días. Se describe un caso asociado a piroxicam. Caso clínico: Hombre de 36 años de edad con eritema inicial en tórax y abdomen, acompañado de ardor, sin fiebre, que posteriormente se extendió a antebrazos, brazos y muslos; con edema de cara. Una semana antes había consumido piroxicam por dolor lumbar; al momento de su hospitalización recibía antihistamínicos, esteroides tópicos y sistémicos. El hemoleucograma mostró leucocitos de 8920, eosinófilos de 600, neutrófilos de 6600, IgE sérica total de 188 mg/L, proteína C reactiva de 2.9 mg/L, sin compromiso hepático, renal ni pulmonar. Se inició tratamiento con antihistamínicos y ranitidina intravenosos, solución salina, vaselina tópica más mupirocina tópica y esteroides sistémicos. Al segundo día de hospitalización, los neutrófilos aumentaron a 9000 y la proteína C reactiva a 3.3 mg/L. La puntuación para validar pustulosis exantemática aguda en el paciente fue de 8, indicativa de diagnóstico definitivo. Conclusiones: El diagnóstico diferencial debe establecerse principalmente con psoriasis pustulosa. El pronóstico en general es bueno, como sucedió con el caso informado.

  18. Prevalence of Disorders Recorded in Dogs Attending Primary-Care Veterinary Practices in England

    PubMed Central

    O′Neill, Dan G.; Church, David B.; McGreevy, Paul D.; Thomson, Peter C.; Brodbelt, Dave C.

    2014-01-01

    Purebred dog health is thought to be compromised by an increasing occurence of inherited diseases but inadequate prevalence data on common disorders have hampered efforts to prioritise health reforms. Analysis of primary veterinary practice clinical data has been proposed for reliable estimation of disorder prevalence in dogs. Electronic patient record (EPR) data were collected on 148,741 dogs attending 93 clinics across central and south-eastern England. Analysis in detail of a random sample of EPRs relating to 3,884 dogs from 89 clinics identified the most frequently recorded disorders as otitis externa (prevalence 10.2%, 95% CI: 9.1–11.3), periodontal disease (9.3%, 95% CI: 8.3–10.3) and anal sac impaction (7.1%, 95% CI: 6.1–8.1). Using syndromic classification, the most prevalent body location affected was the head-and-neck (32.8%, 95% CI: 30.7–34.9), the most prevalent organ system affected was the integument (36.3%, 95% CI: 33.9–38.6) and the most prevalent pathophysiologic process diagnosed was inflammation (32.1%, 95% CI: 29.8–34.3). Among the twenty most-frequently recorded disorders, purebred dogs had a significantly higher prevalence compared with crossbreds for three: otitis externa (P = 0.001), obesity (P = 0.006) and skin mass lesion (P = 0.033), and popular breeds differed significantly from each other in their prevalence for five: periodontal disease (P = 0.002), overgrown nails (P = 0.004), degenerative joint disease (P = 0.005), obesity (P = 0.001) and lipoma (P = 0.003). These results fill a crucial data gap in disorder prevalence information and assist with disorder prioritisation. The results suggest that, for maximal impact, breeding reforms should target commonly-diagnosed complex disorders that are amenable to genetic improvement and should place special focus on at-risk breeds. Future studies evaluating disorder severity and duration will augment the usefulness of the disorder prevalence

  19. Prevalence of disorders recorded in dogs attending primary-care veterinary practices in England.

    PubMed

    O Neill, Dan G; Church, David B; McGreevy, Paul D; Thomson, Peter C; Brodbelt, Dave C

    2014-01-01

    Purebred dog health is thought to be compromised by an increasing occurence of inherited diseases but inadequate prevalence data on common disorders have hampered efforts to prioritise health reforms. Analysis of primary veterinary practice clinical data has been proposed for reliable estimation of disorder prevalence in dogs. Electronic patient record (EPR) data were collected on 148,741 dogs attending 93 clinics across central and south-eastern England. Analysis in detail of a random sample of EPRs relating to 3,884 dogs from 89 clinics identified the most frequently recorded disorders as otitis externa (prevalence 10.2%, 95% CI: 9.1-11.3), periodontal disease (9.3%, 95% CI: 8.3-10.3) and anal sac impaction (7.1%, 95% CI: 6.1-8.1). Using syndromic classification, the most prevalent body location affected was the head-and-neck (32.8%, 95% CI: 30.7-34.9), the most prevalent organ system affected was the integument (36.3%, 95% CI: 33.9-38.6) and the most prevalent pathophysiologic process diagnosed was inflammation (32.1%, 95% CI: 29.8-34.3). Among the twenty most-frequently recorded disorders, purebred dogs had a significantly higher prevalence compared with crossbreds for three: otitis externa (P = 0.001), obesity (P = 0.006) and skin mass lesion (P = 0.033), and popular breeds differed significantly from each other in their prevalence for five: periodontal disease (P = 0.002), overgrown nails (P = 0.004), degenerative joint disease (P = 0.005), obesity (P = 0.001) and lipoma (P = 0.003). These results fill a crucial data gap in disorder prevalence information and assist with disorder prioritisation. The results suggest that, for maximal impact, breeding reforms should target commonly-diagnosed complex disorders that are amenable to genetic improvement and should place special focus on at-risk breeds. Future studies evaluating disorder severity and duration will augment the usefulness of the disorder prevalence information reported

  20. Dynamic Autologous Reendothelialization of Small-Caliber Arterial Extracellular Matrix: A Preclinical Large Animal Study

    PubMed Central

    Dahan, Nitsan; Sarig, Udi; Bronshtein, Tomer; Baruch, Limor; Karram, Tony; Hoffman, Aaron

    2017-01-01

    Effective cellularization is a key approach to prevent small-caliber (<4 mm) tissue-engineered vascular graft (TEVG) failure and maintain patency and contractility following implantation. To achieve this goal, however, improved biomimicking designs and/or relatively long production times (typically several months) are required. We previously reported on porcine carotid artery decellularization yielding biomechanically stable and cell supportive small-caliber (3–4 mm diameter, 5 cm long) arterial extracellular matrix (scaECM) vascular grafts. In this study, we aimed to study the scaECM graft patency in vivo and possibly improve that patency by graft pre-endothelialization with the recipient porcine autologous cells using our previously reported custom-designed dynamic perfusion bioreactor system. Decellularized scaECM vascular grafts were histologically characterized, their immunoreactivity studied in vitro, and their biocompatibility profile evaluated as a xenograft subcutaneous implantation in a mouse model. To study the scaECM cell support and remodeling ability, pig autologous endothelial and smooth muscle cells (SMCs) were seeded and dynamically cultivated within the scaECM lumen and externa/media, respectively. Finally, endothelialized-only scaECMs—hypothesized as a prerequisite for maintaining graft patency and controlling intimal hyperplasia—were transplanted as an interposition carotid artery graft in a porcine model. Graft patency was evaluated through angiography online and endpoint pathological assessment for up to 6 weeks. Our results demonstrate the scaECM-TEVG biocompatibility preserving a structurally and mechanically stable vascular wall not just following decellularization and recellularization but also after implantation. Using our dynamic perfusion bioreactor, we successfully demonstrated the ability of this TEVG to support in vitro recellularization and remodeling by primary autologous endothelial and SMCs, which were seeded on the

  1. The influence of changes in hospital drug formulary on the prescription of proton pump inhibitors.

    PubMed

    Vázquez-Mourelle, Raquel; Carracedo-Martínez, Eduardo

    2017-01-01

    Objetivo: Analizar el impacto de introducir el omeprazol en el formulario del Hospital de Barbanza sobre las prescripciones intrahospitalarias y extrahospitalarias (consultas externas y atención primaria) de todos los Inhibidores de la Bomba de Protones (IBP). Material y métodos: Estudio descriptivo retrospectivo de 36 meses en un hospital de nivel I. Las unidades básicas de trabajo son las dosis-habitantes-día en el ámbito extrahospitalario y las dosis diarias definidas/estancias-día para hospitalización; como medida de eficiencia se utiliza el porcentaje de DDD de omeprazol sobre el resto de IBP. Para el análisis estadístico construimos un modelo de regresión segmentada. Resultados: En consultas externas sufren cambios estadísticamente significativos el pantoprazol y el rabeprazol; el primero, estacionado antes de la intervención, sufre una disminución inmediata; el rabeprazol, en crecimiento antes de la intervención, presenta una posterior tendencia decreciente. En atención primaria se constata un cambio estadísticamente significativo en el pantoprazol, con tendencia decreciente a largo plazo. En hospitalización se observan cambios estadísticamente significativos para el pantoprazol y el omeprazol; el primero con disminución inmediata y tendencia al decrecimiento a largo plazo; el segundo experimenta un aumento inmediato y crecimiento a largo plazo. La evolución del % de omeprazol respecto al total de IBP mostró aumentos en los tres escenarios. Conclusiones: Se observa un cambio hacia una prescripción de IBP más eficiente en todos los ámbitos asistenciales tras la introducción del omeprazol en la guía farmacoterapéutica del hospital. La inclusión de medicamentos eficientes, o la retirada de ineficientes, puede ser una herramienta potencialmente útil para mejorar los perfiles de prescripción.

  2. Randomized prospective comparative study: short-term treatment with ciclopiroxolamine (cream and solution) versus boric acid in the treatment of otomycosis.

    PubMed

    del Palacio, A; Cuétara, M S; López-Suso, M J; Amor, E; Garau, M

    2002-10-01

    Sixty-four patients with symptomatic otomycosis (80 infected ears) confirmed by direct microscopy and culture were randomly treated for I week with ciclopiroxolamine cream 11% (group A, 20 infected ears, 17 patients), ciclopiroxolamine solution 1% (group B, 20 infected ears, 17 patients) and boric acid (group C, 40 infected ears, 30 patients) and daily mechanical suction aspiration of the debris. An attempt was made to match 11 clinical parameters with both the mycological and bacteriological findings. There was no significant association between the fungal species cultured and the clinical parameters did not vary with the presence or absence of different bacteria; pus was never present in fungal otitis externa (Fisher's test, P < 0.001). Before therapy, a significant number of ears had completely sterile bacterial cultures (p < 0.01, chi2 test); saprophytic Gram-positive bacteria increased after treatment, whilst Gram-negative bacteria, Pseudomonas aeruginosa and Proteus species, decreased after treatment. Clinical total cure rates 3 days after the end of therapy ranged from 50% in group A, 25% in group B to 22.5% in group C. Mycological cure rates were 80% (group A), 95% (group B) and 72.5% (group C). Two weeks after the end of therapy the clinical cure rates were 60% (group A), 65% (group B) and 80% (group C) and the mycological cure rates was 65% for group A and 75% for both group B and C. Eleven patients relapsed with otitis externa: four (20%) in groups A and C and three (15%) in group B. In four cases the infection was due to bacteria and the remaining seven were due to fungi. Six sites relapsed with the same fungal species as that isolated at the start of the study. In this short-term assessment the relapse rate was not significantly associated with predisposing conditions. The tolerance was excellent in group A. Four patients (20%) in group B had mild (two patients) or moderate (two patients) burning and itching with each application. Twelve patients (30

  3. [Pure neural leprosy. Diagnostic aspects of a clinical case].

    PubMed

    Pardal-Fernandez, J M; Ezsol-Lendvai, S; Rodriguez-Vazquez, M; Agudo-Mena, J L; Godes-Medrano, B

    2016-09-16

    Introduccion. La lepra es una enfermedad infecciosa causada por la bacteria Mycobacterium leprae. Presenta especial avidez por la piel y los troncos nerviosos, y, de hecho, ambos se afectan en la mayor parte de los infectados. Se trasmite por exposicion con enfermos y en ocasiones por reactivacion. Una posibilidad inhabitual es la lepra neural pura, caracterizada por neuropatia, pero sin lesiones en la piel. Se describe un paciente con lepra neural pura y se revisan los aspectos diagnosticos. Caso clinico. Varon de 40 años, inmigrante, diagnosticado y tratado de lepra 20 años antes. Acudio por parestesias y disestesias dolorosas en las manos y las piernas sin lesiones en la piel. Se demostro mononeuritis multiple aguda con principal afectacion de cubitales. La enfermedad, tipificada como tuberculoide paucibacilar, se trato y en pocas semanas la mejoria fue evidente. Conclusiones. En este caso de lepra neural pura por reactivacion, el diagnostico temprano permitio un rapido tratamiento. Es recomendable la evaluacion de la neuropatia integrada con criterios clinicos, electrofisiologicos y ecograficos. De este modo se consigue una alta sensibilidad y especialmente una precocidad en el diagnostico y la instauracion del tratamiento, y por consecuencia una mejor recuperacion funcional.

  4. [Therapeutic plasma exchange: applications in neurology].

    PubMed

    Láinez-Andrés, José M; Gascón-Giménez, Francisco; Coret-Ferrer, Francisco; Casanova-Estruch, Bonaventura; Santonja, José M

    2015-02-01

    Introduccion. El recambio plasmatico es una tecnica utilizada en el tratamiento de algunas enfermedades neurologicas de base autoinmune desde los años ochenta, especialmente en situaciones agudas. En los ultimos años se han publicado nuevos datos sobre su empleo en numerosas entidades con base autoinmune, ampliando, con ello, el espectro de utilizacion. Objetivo. Actualizar las indicaciones de esta tecnica en el tratamiento de las enfermedades neurologicas. Desarrollo. Se ha realizado una revision exhaustiva de todos los articulos publicados desde los años ochenta sobre la eficacia del recambio plasmatico en el tratamiento de las diferentes enfermedades neurologicas. Tambien se ha efectuado un analisis detallado de las recomendaciones y evidencias de la utilizacion de este procedimiento por parte de las diferentes sociedades cientificas. Conclusiones. El recambio plasmatico ha demostrado ser una alternativa eficaz con evidencia cientifica de primer nivel en enfermedades como el sindrome de Guillain-Barre, la polineuropatia desmielinizante inflamatoria cronica o la miastenia grave. Ha mostrado ser eficaz en el tratamiento de episodios desmielinizantes agudos sin respuesta a otras terapias, en los brotes de neuromielitis optica y en otras enfermedades del sistema nervioso central producidas por anticuerpos. En los estudios comparativos con inmunoglobulinas intravenosas, la eficacia de ambas terapias es similar. Es preciso seguir realizando estudios comparativos para conocer mejor los mecanismos y establecer indicaciones prioritarias y comparar la relacion coste-eficacia de ambos procedimientos.

  5. [Adverse effects with ambulatory intravenous immunoglobulin administration in adult patients with common variable immunodeficiency].

    PubMed

    Rodríguez-Mireles, Karen A; Galguera-Sauceda, Angélica; Gaspar-López, Arturo; López-Rocha, Eunice G; Campos-Romero, Freya; Del Rivero-Hernández, Leonel; Amaya-Mejía, Adela; Galindo-Pacheco, Lucy; O'Farril-Romanillos, Patricia; Segura-Méndez, Nora Hilda

    2014-01-01

    Antecedentes: la inmunodeficiencia común variable es la inmunodeficiencia primaria sintomática más frecuente, afecta a 1 por cada 25,000 a 75,000 sujetos. Se distingue por la ausencia o disminución de anticuerpos. Su tratamiento consiste en el reemplazo de anticuerpos con inmunoglobulina humana y la vía de administración más frecuente es la intravenosa, a dosis de 400 a 800 mg/kg de peso/dosis cada tres a cuatro semanas. Los efectos adversos asociados con la administración de inmunoglobulina intravenosa (IgIV) ocurren incluso en 25% de todas las infusiones realizadas, las reacciones severas afectan a menos de 1% de los pacientes. Entre las reacciones adversas severas están la insuficiencia renal aguda, que sobreviene 1 a 10 días después del inicio de tratamiento con IgIV. En nuestro centro elaboramos e implementamos un esquema ambulatorio para la aplicación de IgIV que permite su administración en un promedio de 3 h, sin efectos adversos graves. Objetivos: describir los efectos adversos y evaluar la frecuencia de insuficiencia renal secundaria a la aplicación ambulatoria de IgIV en pacientes adultos con inmunodeficiencia común variable. Material y método: estudio descriptivo y prospectivo en el que participaron pacientes adultos con diagnóstico definitivo de inmunodeficiencia común variable, que recibían IgIV a dosis de sustitución cada tres semanas, a quienes se realizó exploración física, somatometría, determinación sérica de creatinina, albúmina y urea, depuración de creatinina en orina de 24 horas, cálculo de la tasa de filtración glomerular por la fórmula CKD-EPI y evaluación de la función renal inmediata, así como la asociada con la administración acumulada de IgIV a través del cálculo de la tasa de filtración glomerular. Los resultados se analizaron con estadística descriptiva para el reporte de los efectos en la función renal y la dosis acumulada de IgIV. Resultados: se determinó la frecuencia de reacciones adversas

  6. [Opportunistic bacteria and microbial flora in children with leukemia and neutropenic enterocolitis].

    PubMed

    García-Elorriaga, Guadalupe; Corona-de Los Santos, Juan C; Méndez-Tovar, Socorro; del Rey-Pineda, Guillermo; Pérez-Casillas, Ruy X

    2013-01-01

    Objetivo: determinar la microbiota y la prevalencia de microorganismos oportunistas en niños con leucemia y enterocolitis neutropénica. Métodos: se realizó un estudio prospectivo observacional en pacientes con leucemia aguda y neutropenia. Se tomaron cultivos de heces para identificar la presencia de bacterias y microbiota. Se aplicó estadística descriptiva para su análisis. Resultados: fueron incluidos 21 pacientes (12 hombres, 57.1 %). En 68 % de los coprocultivos se observó desarrollo de microorganismos gramnegativos. La presencia de microorganismos grampositivos fue de 20 %, 6 % de Candida sp., 3 % de Cryptosporidium sp. y en 3 % se observaron bacilos ácido alcohol resistentes. Staphylococcus epidermidis, Enterobacter sp., y Escherichia coli se observaron en cultivo puro. No se encontró asociación entre microorganismos grampositivos y gramnegativos con la edad, el recuento leucocitario ni el cultivo puro o mixto.Conclusiones: aunque los microorganismos gramnegativos fueron los más frecuentes, se aislaron de manera importante grampositivos y otros que no se buscan de rutina en el coprocultivo.

  7. [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.

  8. [Delayed neurological syndrome following carbon monoxide poisoning].

    PubMed

    Vázquez-Lima, Manuel J; Álvarez-Rodríguez, Cesáreo; Cruz-Landeira, Angelines; López-Rivadulla, Manuel

    2015-08-16

    Introduccion. La intoxicacion por monoxido de carbono es la mas frecuente en nuestro medio a consecuencia de la exposicion a gases toxicos. Los efectos de la intoxicacion por monoxido de carbono no se limitan a la exposicion aguda porque, tras la aparente recuperacion de la intoxicacion, pueden aparecer alteraciones neurologicas o del comportamiento. Pacientes y metodos. Se realizo un estudio de las intoxicaciones por monoxido de carbono en un area sanitaria de 80.000 habitantes durante un periodo de 10 años. Posteriormente se hizo un seguimiento de estos pacientes y se valoro la aparicion de sindrome neurologico tardio (SNT) y su relacion con diferentes variables en la exposicion inicial al monoxido de carbono, en el tratamiento administrado o en la gravedad de la intoxicacion. Resultados y conclusiones. Se observo que el 9,1% de los intoxicados por monoxido de carbono detectados en el area sanitaria de Salnes desarrollan el SNT, que es mas frecuente en los pacientes con criterios analiticos de gravedad y muy poco probable en los que no los tienen. Los pacientes con SNT no expresaron manifestaciones clinicas ni analiticas diferentes a los que no presentaron el sindrome; tampoco se observaron diferencias en relacion con la terapia con oxigeno administrada. La tasa de SNT en el area sanitaria de Salnes entre 2002 y 2012 es de 0,84 casos por 100.000 habitantes y año.

  9. [Hemorrhagic colloid cyst of the third ventricle: fulminant deterioration].

    PubMed

    Martínez-Gómez, Debora; Joanes, Vicente; Herrera, Juan Manuel; Rivera-Paz, Marlon; Vanaclocha, Vicente

    2015-03-16

    Introduccion. Los quistes coloides son tumores benignos del tercer ventriculo. La mayoria permanecen asintomaticos. Sin embargo, algunos pacientes pueden desarrollar desde cefaleas intermitentes hasta un deterioro agudo e incluso muerte subita. Existen varias teorias por las que se produciria una muerte subita en estos pacientes, entre las que se incluyen el rapido crecimiento del quiste, su rotura, la alteracion del control cardiovascular reflejo mediado por el hipotalamo y, rara vez, el sangrado del quiste, con solo 15 casos descritos en la bibliografia. Caso clinico. Varon de 45 años, con hipertension arterial como unico antecedente de interes, que sufre un deterioro brusco del nivel de consciencia a causa de una hidrocefalia aguda debida a un quiste coloide hemorragico del tercer ventriculo. Se implanto un drenaje ventricular externo en cada lado e ingreso en la unidad de cuidados intensivos, donde se certifico la muerte encefalica. Tras la extirpacion del quiste mediante abordaje transcortical frontal, se confirmo el diagnostico de quiste coloide con restos de material hemolizado subagudo. Conclusion. La hemorragia en los quistes coloides es excepcional y puede producirse en pacientes tanto sintomaticos como asintomaticos, lo que dificulta, de forma extraordinaria, el reconocimiento de esta complicacion.

  10. [Knowledge of cerebrovascular disease in the population of Zaragoza].

    PubMed

    Perez-Lazaro, C; Santos-Lasaosa, S; Velazquez-Benito, A; Bellosta-Diago, E; Tejero-Juste, C; Iniguez-Martinez, C

    2017-01-01

    Introduccion. El ictus es una de las principales causas de invalidez y mortalidad en nuestra sociedad, con importantes repercusiones socioeconomicas y sanitarias. La asistencia precoz puede mejorar el pronostico de los pacientes. Actualmente, existen tratamientos en fase aguda, que consiguen reperfundir el tejido isquemico en riesgo y revertir la sintomatologia, pero son pocos los pacientes que se benefician, por el retraso en su atencion, debido a la falta de reconocimiento de los sintomas y la escasa percepcion de gravedad. Objetivo. Analizar el conocimiento de la poblacion de nuestra area de salud sobre el ictus. Sujetos y metodos. La muestra analizada ha sido la poblacion del sector III de la provincia de Zaragoza, con seleccion aleatoria. La herramienta utilizada ha sido una encuesta telefonica estructurada (total de 583). Resultados. Un 63,5% de los encuestados desconoce los sintomas del ictus, y un 48%, los factores de riesgo vascular. Solo un 9% reconoce al menos dos sintomas y dos factores de riesgo. En cuanto a la actitud, un 56% actuaria correctamente frente a un 44% que no. El analisis multivariante mostro que los factores mas relacionados con el conocimiento fueron el nivel cultural y la edad joven. Vivir en un pueblo y sexo femenino se relacionaron con la mejor actitud. Conclusiones. El conocimiento del ictus es escaso, con una baja percepcion de urgencia. Los factores que implican un mejor conocimiento son la edad joven y el nivel cultural alto.

  11. [Posterior reversible encephalopathy in a case of late-onset eclampsia].

    PubMed

    Castrillo-Sanz, Ana; Mendoza, Amelia; Gutiérrez-Ríos, Raúl; Zamora, M Isabel; Morollón, Noemí; Rodríguez-Sanz, M Fernanda; Duarte, Jacinto

    2013-08-01

    Introduccion. El sindrome de encefalopatia posterior reversible (SEPR) es un sindrome clinico-radiologico de presentacion aguda o subaguda que se caracteriza por la presencia de cefalea, vomitos, crisis epilepticas, trastornos visuales y alteracion del nivel de conciencia asociado a lesiones localizadas fundamentalmente en la sustancia blanca de regiones posteriores cerebrales. Caso clinico. Mujer de 32 años que desarrollo un SEPR en el periodo posparto secundario a eclampsia tardia. La paciente presento 10 dias despues del parto un cuadro clinico consistente en cefalea, crisis epilepticas, ceguera y deterioro del nivel de conciencia. El estudio de imagen con resonancia magnetica confirmo la afectacion de la sustancia blanca de predominio posterior. Conclusiones. Aunque la eclampsia es una entidad tipica del embarazo y puerperio inmediato, es necesario recordar que tambien puede producirse de forma tardia tras el parto y que puede ser la causa de otros sindromes, como el SEPR. Aunque en estos casos el pronostico suele ser favorable, el tratamiento debe ser precoz, efectuando un rapido control de la tension arterial y las convulsiones con el fin de evitar un daño cerebral permanente. Es necesario considerar siempre este sindrome en mujeres con crisis epilepticas u otros sintomas neurologicos durante el posparto.

  12. [Laparoscopic cholecystectomy and open cholecystectomy in acute cholecystitis: critical analysis of 520 cases].

    PubMed

    Teixeira, João Araújo; Ribeiro, Carlos; Moreira, Luís M; de Sousa, Fabiana; Pinho, André; Graça, Luís; Maia, José Costa

    2014-01-01

    IntroduçÉo: Apesar do cepticismo com que inicialmente foi encarada, a colecistectomia laparoscópica é hoje a técnica de eleiçÉo na colecistite aguda. Torna-se, porém, importante avaliar os seus resultados, em comparaçÉo com a colecistectomia clássica, uma vez que esta última ainda é seguida por alguns cirurgiões em determinadas situações.Material e Métodos: No nosso estudo foram incluídos 520 doentes com colecistites agudas operados no Serviço de Cirurgia Geral do Hospital de S. JoÉo, entre 2007 e 2013, dos quais 412 (79,2%) por laparoscopia e 108 (20,8%) por via aberta, com uma incidência de conversÉo de 10,7%. Procedeu-se ao estudo relativo às doenças coexistentes, leucocitose, tempo decorrido entre o diagnóstico na urgência e a cirurgia, classificaçÉo ASA, complicações intra e pós-operatórias, mortalidade, reintervenções, lesÉo biliar e estadia hospitalar. Os doentes convertidos foram incluídos no grupo das colecistectomias laparoscópicas. A análise estatística baseou-se em processos descritivos e a avaliaçÉo das diferenças entre grupos foi realizada com base no teste exato de Fisher, sendo considerados valores significativos para p < 0,05.Resultados: Colecistectomia laparoscópica versus Colecistectomia aberta: Mortalidade: 0,7% vs 3,7% (p = 0,0369); Complicações per-operatórias: 3,6% vs 12,9% (p = 0,0006); Complicações pós-operatórias cirúrgicas: 7,7% vs 17,5% (p = 0,0055); Pós-operatórias médicas: 4,3% vs 5,5% (p = 0,6077); LesÉo da via biliar principal: 0,9% vs 1,8% (p = 0,6091); Reintervenções: 2,9% vs 5,5% (p = 0,2315); Internamento hospitalar inferior ou igual a quatro dias: 64,8% vs 18,5% (p < 0,0001). Na colecistectomia laparoscópica houve 10,7% de conversões: nas precoces (intervenções realizadas antes das 96 h após o diagnóstico na urgência) esta taxa foi de 8,8% e nas tardias (após aquele período de tempo mas no mesmo internamento) de 13,7% (p = 0,1425); Complicações nos doentes

  13. [Pulmonary carcinomatous lymphangitis: presentation as acute pneumopathy. Report of two cases].

    PubMed

    Ré, D P; Cazaux, A; Cambursano, V H; Zaya, A; Cortez, J R

    2013-01-01

    Introducción: La linfangitis carcinomatosa(LC) representa el 6-8% de las metástasis pulmonares. Existe evidencia de que puede ser una condición oncológicamente tratable, con impacto sobre la progresión de la disnea y lesiones radiológicas, con mejoría de la sobrevida. Se describen dos casos con el objetivo de inducir la sospecha de esta entidad ante un paciente con datos de neumopatía aguda. Métodos: Caso 1: mujer 32 años, disnea progresiva y tos de dos semanas de evolución sin respuesta a antibióticos. Taquipnea, aumento del trabajo respiratorio, crepitantes bibasales. Insuficiencia respiratoria. Radiografía: radiopacidadalvéolointersticialbibasal. Se inicia tratamiento para neumonía grave de la comunidad. Evoluciona desfavorablemente con requerimiento de ARM y desenlace fatal. Caso 2: mujer 46 años, disnea progresiva y tos de una semana de evolución. Taquipnea, subcrepitantes difusos.Insuficiencia respiratoria. Radiografía: radiopacidadintersticionodulillar difusa, con imagen radiopaca homogénea en vértice derecho.

  14. [Spanish translation and validation of the Postural Assessment Scale for Stroke Patients (PASS) to assess balance and postural control in adult post-stroke patients].

    PubMed

    Cabanas-Valdés, Rosa; Girabent-Farrés, Monserrat; Cánovas-Vergé, David; Caballero-Gómez, Fernanda M; Germán-Romero, Ana; Bagur-Calafat, Caritat

    2015-02-16

    Introduccion. En los ultimos años, la Postural Assessment Scale for Stroke Patients (PASS) se ha convertido en la escala mas utilizada para valorar el equilibrio y el control postural en pacientes adultos que han sufrido un ictus, especialmente en la fase aguda y subaguda. Objetivo. Traducir y validar la PASS para la poblacion española como instrumento de valoracion del equilibrio y el control postural en pacientes adultos postictus. Pacientes y metodos. Se tradujo al español la version original francesa de la PASS; dicha version fue consensuada por un equipo de expertos. Posteriormente se hizo una retrotraduccion al frances y se envio al autor de la escala, el cual aprobo dicha version. Seguidamente se evaluo la fiabilidad intra e interobservador; para ello se llevaron a cabo cuatro mediciones a 60 pacientes postictus, a partir de una videograbacion. Dos de estas mediciones fueron realizadas por el mismo observador, y la tercera y cuarta, por un segundo y tercer observadores. Resultados. Los valores obtenidos referidos a la puntuacion total de la escala reflejan un indice de fiabilidad del 0,999; tambien muestran una fiabilidad superior a 0,90 en cada uno de los items, tanto en las comparaciones intraobservador como interobservador, y una consistencia interna del 0,94. Conclusion. La version española de la PASS es valida y fiable para valorar el equilibrio y el control postural en pacientes adultos postictus.

  15. [Churg-Strauss abdominal manifestation].

    PubMed

    Suarez-Moreno, Roberto; Ponce-Pérez, Luis Virgilio; Margain-Paredes, Miguel Angel; Garza-de la Llave, Heriberto; Madrazo-Navarro, Mario; Espinosa-Álvarez, Arturo

    2014-01-01

    Antecedentes: la enfermedad de Churg-Strauss es poco común, idiopática, caracterizada por hipereosinofilia en sangre y tejidos, aunada a vasculitis sistémica en pacientes con antecedentes de asma o rinitis alérgica. Las manifestaciones gastrointestinales del síndrome de Churg Strauss se caracterizan por dolor abdominal, seguido de diarrea y hemorragia en 31-45% de los casos. Caso clínico: paciente masculino con antecedente de asma que acudió a consulta por abdomen agudo con probable apendicitis aguda; durante el protocolo de estudio se diagnosticó síndrome de Churg Strauss, con manifestaciones intestinales. Conclusión: el síndrome de Churg Strauss es una vasculitis poco frecuente que puede manifestarse con síntomas intestinales, como en este caso; es importante tenerlo en mente a la hora de los diagnósticos diferenciales. Existen pocos reportes con este síndrome asociado con abdomen agudo, todos ellos con mal pronóstico.

  16. Tissue effects of glutamine in rectal cancer patients treated with preoperative chemoradiotherapy.

    PubMed

    Vidal-Casariego, Alfonso; Hernando-Martín, Mercedes; Calleja-Fernández, Alicia; Cano-Rodríguez, Isidoro; Cordido, Fernando; Ballesteros-Pomar, María D

    2015-04-01

    Introducción: El objetivo fue evaluar los efectos de la administración de glutamina sobre la regresión tumoral y sobre el tejido sano en pacientes con cáncer rectal que recibieron quimiorradioterapia. Material y métodos: Se incluyó 10 pacientes con cáncer rectal operado después de quimiorradioterapia, un subgrupo de un ensayo clínico que comparó glutamina con placebo en la prevención de enteritis aguda. Un patólogo experto analizó las muestras de tumor y tejido sano, buscando datos de regresión tumoral, mucífagos y daño por radiación. Resultados: No hubo diferencias entre placebo y glutamina en el grado de regresión tumoral. Todos los pacientes con glutamina presentaron mucífagos, frente al 28,6% con placebo (p = 0,038). El daño sobre tejido sano fue similar en los pacientes con glutamina y placebo, y entre aquellos con y sin enteritis. Conclusión: La glutamina no ejerce un efecto protector frente a la quimiorradioterapia sobre el tumor o el tejido rectal sano.

  17. [Lung eosinophilic syndrome: clinical presentation and cases report].

    PubMed

    Egea, N; Merlo, A; Esponda, L; Cazaux, A; Cambursano, V H; Cortés, J R

    2014-01-01

    Introducción: El síndrome de eosinofilia pulmonar se caracteriza por un grupo de patologías que presentan afección clínico – radiológica pulmonar con eosinofilia periférica o en parénquima pulmonar en su evolución. Materiales y métodos: Se describen las características de presentaciones clínico-radiológicas y evolutivas de pacientes atendidos entre 2007 y 2010 en Hospital Rawson. Resultados: Sobre 8 casos, se observó mayor número de casos en mujeres. Los signos y síntomas principales fueron tos, disnea, fiebre y sibilancias. Los hallazgos radiológicos más prevalentes fueron patrón alveolar y alveolointersticial. En la TAC el más frecuente fue el patrón en vidrio esmerilado. La eosinofilia periférica presentó valores entre 550 y 10.000 cel/mm3. Los pacientes fueron abdordados inicialmente como neumonía adquirida en la comunidad en el 62% de los casos. Los diagnósticos principales realizados fueron neumonía eosinofílica aguda y crónica, ambas con respuesta a esteroides. Conclusiones: El síndrome de eosinofilias pulmonares comparte características clínico-radiológicas comunes con entidades de mayor prevalencia, particularmente NAC.

  18. [Influenza-like illness. Therapeutic experience in family medicine].

    PubMed

    Muñoz-Cortés, Gerardo; García-Zavala, Guadalupe Ulises; Estrada-Andrade, María Elena

    2013-01-01

    Introducción: la influenza es una enfermedad respiratoria muy contagiosa. Se debe iniciar el tratamiento antiviral en las primeras 48 horas para evitar la neumonía. El objetivo de este informe es describir la experiencia en el tratamiento de la enfermedad tipo influenza en una unidad de medicina familiar. Métodos: estudio descriptivo de pacientes que acudieron a urgencias con enfermedad tipo influenza (fiebre de 38 °C, cefalea y tos, acompañadas de otro síntoma) y que fueron contactados por vía telefónica. Los datos se expresan en media ± desviación estándar. Resultados: de 537 consultas por infecciones respiratorias agudas, 1.3 % reunió los criterios de enfermedad tipo influenza; 85.7 % era del sexo masculino. El promedio de la edad fue de 18 ± 24.21 años. La atención inicial ocurrió a las 19.14 horas después de que se iniciaron los síntomas. Todos los pacientes recibieron oseltamivir y zanamivir; 14.3 % presentó neumonía. El 100 % se restableció. No hubo enfermedades concomitantes. Conclusiones: existe un protocolo para el manejo de la enfermedad tipo influenza que hace posible el diagnóstico y el tratamiento oportunos de los pacientes.

  19. [Detection of vascular risk factors and unknown atrial fibrillation in patients hospitalised in the stroke unit].

    PubMed

    Jiménez-Caballero, Pedro E; López-Espuela, Fidel; Portilla-Cuenca, Juan C; Jiménez-Gracia, M Antonia; Casado-Naranjo, Ignacio

    2013-05-01

    Introduccion. Existe una serie de factores de riesgo cerebrovascular modificables, como son la hipertension arterial, la diabetes mellitus, dislipidemias y la fibrilacion auricular, cuyo reconocimiento y control es fundamental para disminuir la aparicion de enfermedades cerebrovasculares. En ocasiones, el ictus puede ser el sintoma de presentacion de estos factores de riesgo. Pacientes y metodos. Estudio observacional prospectivo de los pacientes que ingresan en la unidad de ictus de nuestro hospital por enfermedad cerebrovascular aguda –accidente isquemico transitorio e ictus isquemico– para conocer el porcentaje de pacientes con hipertension arterial, diabetes mellitus, dislipidemias y fibrilacion auricular no diagnosticadas previamente. Resultados. Se selecciono a 186 pacientes, de los que 24 presentaban hipertension arterial no conocida (12,9%); 11, diabetes mellitus no conocida (5,9%); 49, hipercolesterolemia no conocida (26,3%); 15, hipertrigliceridemia no conocida (8,1%), y 22 tenian fibrilacion auricular no conocida (11,8%). En total, 96 pacientes (51,6%) tenian alguno de estos factores de riesgo cerebrovascular. La existencia de un factor de riesgo no diagnosticado previamente era mayor en el medio rural, en los sujetos que no habian fallecido a los seis meses y en los ataques isquemicos transitorios respecto a los ictus isquemicos. Conclusiones. Mas de la mitad de los sujetos que sufren un evento cerebrovascular tienen un factor de riesgo que no se ha diagnosticado previamente. Se deben realizar campanas para implementar la deteccion de estos factores, asi como incidir en el control de estos para disminuir la aparicion y recidiva de patologia vascular.

  20. [Cluster headache in pediatric population: four case reports and review of the literature].

    PubMed

    Alfaro-Iznaola, C; Natera-de Benito, D; Rodriguez-Diaz, R; Taboas-Pereira, M A; Cuadrado-Martin, M; Ballesteros-Garcia, M M

    2016-07-16

    Introduccion. La cefalea en racimos es una cefalea primaria de origen trigeminoautonomico cuyo inicio en la infancia es infrecuente. Se presentan cuatro casos en los que el inicio de la sintomatologia se produjo entre los 2 y los 13 años. Casos clinicos. Se incluyen tres varones y una niña con inicio a los 2, 7, 13 y 12 años, respectivamente. Los cuatro pacientes cumplen los criterios propuestos por la tercera edicion de la Clasificacion Internacional de las Cefaleas ICHD-III (beta). Conclusiones. A pesar de ser poco frecuente durante la edad pediatrica, la cefalea en racimos debe formar parte del diagnostico diferencial de un niño que consulta por cefalea. Subrayamos la importancia de conocer sus criterios diagnosticos para evitar el retraso diagnostico que se ha descrito con frecuencia. En nuestros pacientes, el tratamiento con verapamilo resulto mas eficaz que el tratamiento con flunaricina. Los tratamientos con mejor respuesta en fase aguda fueron la oxigenoterapia y los triptanes.

  1. [Gorlin syndrome in the paediatric age].

    PubMed

    Roncalés-Samanes, P; Peña-Segura, J L; Fernando-Martínez, R; Fuertes-Rodrigo, C; García-Oguiza, A; López-Pisón, J

    2014-04-01

    Introduccion. El sindrome de Gorlin (SG) es un trastorno de herencia autosomica dominante asociado a mutaciones en el gen PTCH1, cuya principal caracteristica es la aparicion de carcinomas basocelulares, unido a anomalias esqueleticas, queratoquistes odontogenicos y tumores intracraneales. Caso clinico. Niña de 3 años y 10 meses, ingresada por ataxia aguda. Destacan como antecedentes personales retraso psicomotor y como antecedentes familiares la sospecha de SG en la madre por quiste maxilar. En la exploracion, se aprecia macrocefalia con frente prominente e hipertelorismo, asi como nevo. Se solicita estudio genetico de SG, en el que se detecta la mutacion c.930delC en el exon 6 del gen PTCH1 en heterocigosis. Conclusiones. En el SG hay un aumento de la susceptibilidad al desarrollo de carcinomas basocelulares y es preciso un estrecho control dermatologico. Es necesario un seguimiento neurologico clinico y de imagen, mediante resonancia magnetica, para el diagnostico precoz de tumores intracraneales, fundamentalmente el meduloblastoma. Tambien son caracteristicos los queratoquistes odontogenicos, otras alteraciones cutaneas, fibromas cardiacos y ovaricos, asi como anomalias esqueleticas, que precisan controles clinicos y de imagen periodicos, y tratamiento en caso de ser necesarios, pero debe evitarse la radiacion. El SG es un trastorno poco frecuente, que se debe sospechar ante la presencia de alteraciones caracteristicas. Es necesario un seguimiento multidisciplinar, asi como establecer un protocolo de actuacion, para un temprano diagnostico y tratamiento de las complicaciones potencialmente graves derivadas de esta enfermedad.

  2. [Poliomyelitis in literature, cinema and television].

    PubMed

    Collado-Vázquez, Susana; Carrillo, Jesús M; Águila-Maturana, Ana M

    2014-10-01

    Introduccion. La poliomielitis es una enfermedad infecciosa cuyos sintomas iniciales son fiebre, cansancio, cefalea, vomitos, rigidez de cuello y dolores en los miembros. En muchos casos, las secuelas son paralisis irreversibles, y puede producirse la muerte si hay afectacion bulbar o respiratoria. Se describe tambien un conjunto de sintomas, llamado sindrome pospolio, que aparece años despues de la infeccion aguda. Objetivo. Analizar el abordaje que la literatura, el cine y la television han hecho de la poliomielitis. Desarrollo. Los escritores y los directores de cine y television han mostrado interes por la poliomielitis y la han reflejado de manera correcta y realista, tanto en las obras de ficcion como en las biograficas o de tipo documental. Nemesis, Secreto de hermanas, Que el cielo la juzgue u Oscura son algunos ejemplos de obras literarias. El cine ha mostrado la poliomielitis desde su epoca silente con titulos como The woman in his house, The Silver Streak, Amor sublime o Las sesiones. Tambien la television ha reflejado esta enfermedad y sus secuelas en series como Hospital Central, Anatomia de Grey, House o Amar en tiempos revueltos, y en telefilmes como El asunto, Eleanor y Roosevelt o Warm Springs. Conclusiones. La poliomielitis se ha mostrado en la literatura, el cine y la television de forma realista, presentando la sintomatologia, las secuelas, y el impacto personal, familiar y social de esta enfermedad.

  3. Changes in the Population of Methicillin-Resistant Staphylococcus pseudintermedius and Dissemination of Antimicrobial-Resistant Phenotypes in the Netherlands

    PubMed Central

    Verstappen, Koen M.; Broens, Els M.; Laarhoven, Laura M.; van Duijkeren, Engeline; Hordijk, Joost; de Heus, Phebe; Spaninks, Mirlin; Timmerman, Arjen J.; Wagenaar, Jaap A.

    2015-01-01

    Methicillin-resistant Staphylococcus pseudintermedius (MRSP), which is often multidrug resistant (MDR), has recently emerged as a threat to canine health worldwide. Knowledge of the temporal distribution of specific MRSP lineages, their antimicrobial resistance phenotypes, and their association with clinical conditions may help us to understand the emergence and spread of MRSP in dogs. The aim of this study was to determine the yearly proportions of MRSP lineages and their antimicrobial-resistant phenotypes in the Netherlands and to examine possible associations with clinical conditions. MRSP was first isolated from a canine specimen submitted for diagnostics to the Faculty of Veterinary Medicine of Utrecht University in 2004. The annual cumulative incidence of MRSP among S. pseudintermedius increased from 0.9% in 2004 to 7% in 2013. MRSP was significantly associated with pyoderma and, to a lesser extent, with wound infections and otitis externa. Multilocus sequence typing (MLST) of 478 MRSP isolates yielded 39 sequence types (ST) belonging to 4 clonal complexes (CC) and 15 singletons. CC71 was the dominant lineage that emerged since 2004, and CC258, CC45, and several unlinked isolates became more frequent during the following years. All but two strains conferred an MDR phenotype, but strains belonging to CC258 or singletons were less resistant. In conclusion, our study showed that MDR CC71 emerged as the dominant lineage from 2004 and onward and that less-resistant lineages were partly replacing CC71. PMID:26582835

  4. Changes in the Population of Methicillin-Resistant Staphylococcus pseudintermedius and Dissemination of Antimicrobial-Resistant Phenotypes in the Netherlands.

    PubMed

    Duim, Birgitta; Verstappen, Koen M; Broens, Els M; Laarhoven, Laura M; van Duijkeren, Engeline; Hordijk, Joost; de Heus, Phebe; Spaninks, Mirlin; Timmerman, Arjen J; Wagenaar, Jaap A

    2016-02-01

    Methicillin-resistant Staphylococcus pseudintermedius (MRSP), which is often multidrug resistant (MDR), has recently emerged as a threat to canine health worldwide. Knowledge of the temporal distribution of specific MRSP lineages, their antimicrobial resistance phenotypes, and their association with clinical conditions may help us to understand the emergence and spread of MRSP in dogs. The aim of this study was to determine the yearly proportions of MRSP lineages and their antimicrobial-resistant phenotypes in the Netherlands and to examine possible associations with clinical conditions. MRSP was first isolated from a canine specimen submitted for diagnostics to the Faculty of Veterinary Medicine of Utrecht University in 2004. The annual cumulative incidence of MRSP among S. pseudintermedius increased from 0.9% in 2004 to 7% in 2013. MRSP was significantly associated with pyoderma and, to a lesser extent, with wound infections and otitis externa. Multilocus sequence typing (MLST) of 478 MRSP isolates yielded 39 sequence types (ST) belonging to 4 clonal complexes (CC) and 15 singletons. CC71 was the dominant lineage that emerged since 2004, and CC258, CC45, and several unlinked isolates became more frequent during the following years. All but two strains conferred an MDR phenotype, but strains belonging to CC258 or singletons were less resistant. In conclusion, our study showed that MDR CC71 emerged as the dominant lineage from 2004 and onward and that less-resistant lineages were partly replacing CC71.

  5. Pathology and Epidemiology of Ceruminous Gland Tumors among Endangered Santa Catalina Island Foxes (Urocyon littoralis catalinae) in the Channel Islands, USA

    PubMed Central

    Vickers, T. Winston; Clifford, Deana L.; Garcelon, David K.; King, Julie L.; Duncan, Calvin L.; Gaffney, Patricia M.; Boyce, Walter M.

    2015-01-01

    In this study, we examined the prevalence, pathology, and epidemiology of tumors in free-ranging island foxes occurring on three islands in the California Channel Islands, USA. We found a remarkably high prevalence of ceruminous gland tumors in endangered foxes (Urocyon littoralis catalinae) occurring on Santa Catalina Island (SCA)—48.9% of the dead foxes examined from 2001–2008 had tumors in their ears, and tumors were found in 52.2% of randomly-selected mature (≥ 4 years) foxes captured in 2007–2008, representing one of the highest prevalences of tumors ever documented in a wildlife population. In contrast, no tumors were detected in foxes from San Nicolas Island or San Clemente Island, although ear mites (Otodectes cynotis), a predisposing factor for ceruminous gland tumors in dogs and cats, were highly prevalent on all three islands. On SCA, otitis externa secondary to ear mite infection was highly correlated with ceruminous gland hyperplasia (CGH), and tumors were significantly associated with the severity of CGH, ceruminous gland dysplasia, and age group (older foxes). We propose a conceptual model for the formation of ceruminous gland tumors in foxes on SCA that is based on persistent, ubiquitous infection with ear mites, and an innate, over exuberant inflammatory and hyperplastic response of SCA foxes to these mites. Foxes on SCA are now opportunistically treated with acaricides in an attempt to reduce mite infections and the morbidity and mortality associated with this highly prevalent tumor. PMID:26618759

  6. Delayed diagnosis of central skull-base osteomyelitis with abscess: case report and learning points.

    PubMed

    Chawdhary, G; Hussain, S; Corbridge, R

    2017-01-01

    Central skull-base osteomyelitis (CSBO) is a rare life-threatening infection, usually resulting from medial spread of necrotising otitis externa. Here, we describe a case with no identifiable source of infection, causing a delay in diagnosis. An 80-year-old man with Crohn's disease treated with mesalazine presented with collapse and tonic-clonic seizure. Computed tomography and magnetic resonance imaging showed a nasopharyngeal mass that was initially thought to be a neoplasm. Awaiting formal biopsy, he represented with collapse and repeat imaging showed features of abscess formation. Review of previous scans revealed skull-base erosion and the diagnosis was revised to skull-base osteomyelitis. This is the first reported case of CSBO associated with mesalazine use, an aminosalicylate used in Crohn's disease. It is only the second reported case with abscess formation. We discuss the learning points in making a timely diagnosis and examine the potential association of factors such as mesalazine use and abscess formation in this case.

  7. On Equilibrium Figures for Ideal Fluids in the Form of Confocal Ellipsoids Rotating with Common Angular Velocity

    NASA Astrophysics Data System (ADS)

    Martinez, F. J.; Cisneros, J.; Montalvo, D.

    1990-06-01

    RESUMEN Se demuestra la existencia de figuras de equilibrio para un cuerpo fluido, autogravitante y libre de presi6n externa, que consiste de dos elipsoides confocales de distiiita densidad que giran con velocidad angular comun. El analisis muestra que a cada valor asignado a la densidad relativa del cuerpo, le corresponde un solo grado de achatamiento, es decir, no puede existir una sene. Otra conclusi6n es que Ia densidad relativa posee un inferior (tal que la densidad del elipsoide interior es ligeramente mayor que el doble de Ia del exterior) y al respecto se ofrece una explicaci6n semicualitativa. Se asume que el flufdo es ideal e incompresible. ABSTRACT For a self-gravitating free from external pressure fluid body, consisting of two homogeneous Co nfo cal ellipsoids of different density rotating with common angular velocity, we demonstrate the existence of equilibrium figures. No senes is possible, however, since the rotating body attains, for given values of its relative density, a unique degree of flattening. In addition, the analysis shows that there is a lower limit to the relative density (in which case the density of the interior ellipsoid is only slightly larger than twice the density of the exterior one) and a semi-qualitative explanation on the subject is offered. The fluids are assumed ideal and incompressible. Key words: HYDRODYNAMICS

  8. [Kidney function in marginalized population: a pilot study].

    PubMed

    Medina-Escobedo, Martha; Sansores-España, Delia; Villanueva-Jorge, Salha

    2014-01-01

    INTRODUCCIÓN: la enfermedad renal crónica (ERC) es un problema de salud pública. A nivel mundial, más del 6 % de la población la padece. Tener un nivel educativo y socioeconómico bajo, así como acceso limitado a los servicios médicos incrementan la probabilidad de daño renal. Los objetivos de esta investigación fueron evaluar y clasificar la función renal de la población marginada de Yucatán. MÉTODOS: estudio observacional, prospectivo, transversal, descriptivo, en una muestra no probabilística consecutiva, en adultos del área de consulta externa de un hospital general. Se incluyeron sujetos marginados (confirmado por encuesta socioeconómica), sin edema, embarazo ni diabetes mellitus. Se realizaron pruebas de función renal; se calculó filtrado glomerular y se estadificaron las enfermedades de los pacientes, según guías KDOQI. Se determinó peso, talla, índice de masa corporal (IMC), porcentaje de grasa y presión arterial. Se compararon los resultados entre grupos por sexo y por población rural y urbana.

  9. [Changes introduced into the recent International Classification of Headache Disorders: ICHD-III beta classification].

    PubMed

    Belvis, Robert; Mas, Natàlia; Roig, Carles

    2015-01-16

    Introduccion. La Sociedad Internacional de Cefaleas (IHS) ha publicado la tercera edicion de la Clasificacion Internacional de las Cefaleas (ICHD-III beta), la guia diagnostica de las cefaleas mas utilizada en el mundo. Objetivo. Revisar las recientes aportaciones de la guia, explicando las nuevas entidades que en ella aparecen y comparando las entidades que han matizado sus criterios con sus criterios de la edicion precedente. Desarrollo. Hemos registrado multitud de matices en los criterios de practicamente todas las cefaleas y neuralgias de la clasificacion, pero las entidades que han experimentado mas matizaciones trascendentales son la migraña cronica, la cefalea asociada exclusivamente a la actividad sexual, las cefaleas neuralgiformes unilaterales de breve duracion, la cefalea diaria persistente de novo, la cefalea por abuso de medicacion sintomatica, el sindrome de cefalea y deficits neurologicos transitorios con pleocitosis linfocitaria. Las entidades nuevas mas destacables que se han incorporado son las cefaleas por presion externa, las cefaleas por crioestimulo, la cefalea numular, la cefalea atribuida a vuelos de avion y la cefalea atribuida a disreflexia autonomica. Tambien cabe destacar las nuevas cefaleas, aun no consideradas como entidades, que se incorporan al apendice, entre las que destacan la epicranea fugax, la migraña vestibular y los colicos infantiles. Conclusiones. La IHS recomienda utilizar ya la nueva clasificacion (ICHD-III beta), prescindiendo de la anterior clasificacion, en la asistencia, la docencia y la investigacion, asi como hacer la maxima difusion de esta nueva guia.

  10. Conditions for the generation of beta oscillations in the subthalamic nucleus-globus pallidus network.

    PubMed

    Holgado, Alejo J Nevado; Terry, John R; Bogacz, Rafal

    2010-09-15

    The advance of Parkinson's disease is associated with the existence of abnormal oscillations within the basal ganglia with frequencies in the beta band (13-30 Hz). While the origin of these oscillations remains unknown, there is some evidence suggesting that oscillations observed in the basal ganglia arise due to interactions of two nuclei: the subthalamic nucleus (STN) and the globus pallidus pars externa (GPe). To investigate this hypothesis, we develop a computational model of the STN-GPe network based upon anatomical and electrophysiological studies. Significantly, our study shows that for certain parameter regimes, the model intrinsically oscillates in the beta range. Through an analytical study of the model, we identify a simple set of necessary conditions on model parameters that guarantees the existence of beta oscillations. These conditions for generation of oscillations are described by a set of simple inequalities and can be summarized as follows: (1) The excitatory connections from STN to GPe and the inhibitory connections from GPe to STN need to be sufficiently strong. (2) The time required by neurons to react to their inputs needs to be short relative to synaptic transmission delays. (3) The excitatory input from the cortex to STN needs to be high relative to the inhibition from striatum to GPe. We confirmed the validity of these conditions via numerical simulation. These conditions describe changes in parameters that are consistent with those expected as a result of the development of Parkinson's disease, and predict manipulations that could inhibit the pathological oscillations.

  11. Diagnosis and treatment of HIV-associated manifestations in otolaryngology

    PubMed Central

    lacovou, Emily; Vlastarakos, Petros V.; Papacharalampous, George; Kampessis, George; Nikolopoulos, Thomas P.

    2012-01-01

    Almost 30 years after its first description, HIV still remains a global pandemic. The present paper aims to review the current knowledge on the ear, nose and throat (ENT) manifestations of HIV infection, and present the available diagnostic and treatment options. A literature review was conducted in Medline and other available database sources. Information from related books was also included in the data analysis. It is well acknowledged that up to 80% of HIV-infected patients eventually develop ENT manifestations; among which, oral disease appears to be the most common. Oro-pharyngeal manifestations include candidiasis, periodontal and gingival disease, HSV and HPV infection, oral hairy leucoplakia, Kaposi's sarcoma, and non-Hodgkin's lymphoma. ENT manifestations in the neck can present as cervical lymphadenopathy or parotid gland enlargement. Respective nasal manifestations include sinusitis (often due to atypical bacteria), and allergic rhinitis. Finally, otological manifestations include otitis (externa, or media), inner ear involvement (sensorineural hearing loss, disequilibrium), and facial nerve palsy (up to 100 times more frequently compared to the general population). Although ENT symptoms are not diagnostic of the disease, they might be suggestive of HIV infection, or related to its progression and the respective treatment failure. ENT doctors should be aware of the ENT manifestations associated with HIV disease, and the respective diagnosis and treatment. A multi-disciplinary approach may be required to provide the appropriate level of care to HIV patients. PMID:24470939

  12. [The role of alexithymia as a psychosomatic factor in psoriasis].

    PubMed

    Torres-Hernández, Marcela; López-García, Sonia; Pedroza-Escobar, David; Escamilla-Tilch, Mónica

    2015-01-01

    Introducción: la alexitimia consiste en la carencia de representaciones mentales de las emociones que conduce a una capacidad limitada para comprender y regular estas, y que puede contribuir en el desarrollo o mantenimiento de una enfermedad psicosomática. El objetivo de este estudio fue demostrar que la alexitimia es una característica que se presenta más frecuentemente en pacientes con psoriasis y que la coexistencia de alexitimia-psoriasis se asocia, como rasgo, a niveles altos de ansiedad. Métodos: la escala de alexitimia de Toronto-20 (TAS- 20) y el inventario de ansiedad estado-rasgo (IDARE) se aplicaron a 16 pacientes con psoriasis de la consulta externa de Dermatología del Hospital de Especialidades del Centro Médico Nacional Siglo XXI y se compararon con 25 individuos control. Resultados: de los pacientes con psoriasis, 25 % presentaron alexitimia, mientras que en el grupo control fue un 8 % (p = 0.002). Se observó correlación entre las puntuaciones de la TSA-20 y del IDARE-rasgo (r = 0.6957, p < 0.0001). Conclusiones: la alexitimia se presenta con mayor frecuencia en individuos con psoriasis que en la población en general y los niveles de ansiedad como rasgo en individuos con psoriasis son similares, independientemente de la presencia de alexitimia.

  13. [Influence of breathing at negative pressure on redistribution of local blood volumes in anti-orthostatic load in cats].

    PubMed

    Baranov, V M; Tikhonov, M A; Kotov, A N; Donina, Zh A; Pogodin, M A; Lavrova, I N

    2000-01-01

    To improve methods of offsetting the hemodynamic shifts in microgravity, applicability of breathing at negative pressure (BNP, pressure relief by -5.0 cm of water column) during inspiration and expiration was assessed in acute experiments with unconscious cats tilted head-down (-30 degrees). Direct measurement of pressure in v. cava superior and v. jugularis externa using a catheter revealed a concurrent significant (p < 0.05) growth of the parameter which should be considered a sign of impeded venous outflow from the craniocervical vessels. BNP added to the sucking effect of the thoracic cavity (the siphoning effect) and led to more massive venous outflow from cephalic vessels as evidenced by pressure drop in the jugular vein and v. cava superior to the values determined in the basic horizontal position. However, BNP did not significantly alter arterial hemodynamics, respiration pattern or gas exchange. Data of the investigation attest effectiveness of this method of moderating blood flow to the cat's head during HDT and possibility to apply it in the zero-g environment.

  14. Alligators, contaminants and steroid hormones.

    PubMed

    Guillette, Louis J; Edwards, Thea M; Moore, Brandon C

    2007-01-01

    Steroids are essential for successful reproduction in all vertebrate species. Over the last several decades, extensive research has indicated that exposure to various environmental pollutants can disrupt steroidogenesis and steroid signaling. Although steroidogenesis is regulated by the hypothalamic-pituitary axis, it is also modified by various paracrine and autocrine factors. Furthermore, the classical two-cell model of steroidogenesis in the developing ovarian follicle, involving the granulosa and theca cells in mammals, may not be universal. Instead, birds and probably reptiles use the two thecal compartments (theca interna and theca externa) as sites of steroid production. We have documented that embryonic or juvenile exposure to a complex mixture of contaminants from agricultural and storm water runoff leads to altered steroid hormone profiles in American alligators. Our observations suggest that alterations in plasma steroid hormone concentrations are due in part to altered gene expression, modified hepatic biotransformation and altered gonadal steroidogenesis. Future studies must examine the interplay between endocrine and paracrine regulation in the development and expression of gonadal steroidogenesis in individuals exposed to endocrine disrupting contaminants at various life stages if we are to fully understand potential detrimental outcomes.

  15. [Sluggish cognitive tempo: an updated review].

    PubMed

    Tirapu-Ustárroz, Javier; Ruiz-García, Beatriz M; Luna-Lario, Pilar; Hernáez-Goñi, Pilar

    2015-10-01

    Introduccion. El estudio del tempo cognitivo lento (TCL) surgio en gran parte de las investigaciones del trastorno por deficit de atencion/hiperactividad (TDAH). Este constructo se define con una gama de sintomas conductuales, como apariencia de somnolencia, soñar despierto, hipoactividad fisica, pobre iniciativa, letargo y apatia. Desarrollo. Se revisa el constructo de TCL a traves de articulos recientemente publicados al respecto sobre caracteristicas clinicas, sintomas asociados, evaluacion, prevalencia, etiologia, comorbilidad, perfiles neuropsicologicos y tratamiento. Los trabajos mas actuales proponen entender el TCL como un cluster de sintomas distintivo del TDAH. Aunque no hay un consenso claro, los datos son cada vez mas consistentes y dotan de gran validez externa al TCL, asociandolo con sintomas internalizantes. Conclusiones. Consideramos necesario anclar los diferentes subtipos de TDAH en modelos conceptuales atencionales. Asi, la red de orientacion atencional se relacionaria con el TCL, la red de vigilancia o atencion sostenida con el TDAH subtipo inatento, y la atencion ejecutiva seria la implicada en el TDAH subtipo combinado. La evidencia hasta la fecha, incluyendo esta revision, apoya la idea de que el TCL es un trastorno de atencion diferenciado del TDAH, pero que, como cualquier trastorno dimensional, puede solaparse con el aproximadamente en la mitad de los casos.

  16. SPECT imaging in evaluating extent of malignant external otitis: case report

    SciTech Connect

    English, R.J.; Tu'Meh, S.S.; Piwnica-Worms, D.; Holman, B.L.

    1987-03-01

    Otitis externa, a benign inflammatory process of the external auditory canal, is general responsive to local therapy. Some patients however, develop a less controllable disease leading to chondritis and osteomyelitis of the base of the skull. The direct invasive characteristic of the disease has led to the descriptive term malignant external otitis (MEO), more appropriately called necrotizing or invasive external otitis. Malignant external otitis is caused by an aggressive pseudomonas or proteus infection that almost exclusively occurs in elderly diabetic patients. The primary imaging modalities previously used in the diagnosis and evaluation of MEO were standard planar scintigraphic techniques with technetium-99M (/sup 99m/Tc) bone agents and gallium-67 (/sup 67/Ga), and pluridirectional tomography. The advent of high resolution computed tomography (CT) effectively allowed demonstration of the soft tissue extension and bone destruction associated with MEO, but still suffered from the low sensitivity constraints of all radiographic techniques in determining early inflammatory bone involvement. Recent work suggests that scintigraphic detection of MEO with /sup 99m/Tc-MDP and /sup 67/Ga, combined with the cross-sectional resolution of single photon emission computed tomography (SPECT) may be of value in planning treatment of this inflammatory condition.

  17. Interstitial cells of Cajal, macrophages and mast cells in the gut musculature: morphology, distribution, spatial and possible functional interactions.

    PubMed

    Mikkelsen, Hanne B

    2010-04-01

    Interstitial cells of Cajal (ICC) are recognized as pacemaker cells for gastrointestinal movement and are suggested to be mediators of neuromuscular transmission. Intestinal motility disturbances are often associated with a reduced number of ICC and/or ultrastructural damage, sometimes associated with immune cells. Macrophages and mast cells in the intestinal muscularis externa of rodents can be found in close spatial contact with ICC. Macrophages are a constant and regularly distributed cell population in the serosa and at the level of Auerbach's plexus (AP). In human colon, ICC are in close contact with macrophages at the level of AP, suggesting functional interaction. It has therefore been proposed that ICC and macrophages interact. Macrophages and mast cells are considered to play important roles in the innate immune defence by producing pro-inflammatory mediators during classical activation, which may in itself result in damage to the tissue. They also take part in alternative activation which is associated with anti-inflammatory mediators, tissue remodelling and homeostasis, cancer, helminth infections and immunophenotype switch. ICC become damaged under various circumstances - surgical resection, possibly post-operative ileus in rodents - where innate activation takes place, and in helminth infections - where alternative activation takes place. During alternative activation the muscularis macrophage can switch phenotype resulting in up-regulation of F4/80 and the mannose receptor. In more chronic conditions such as Crohn's disease and achalasia, ICC and mast cells develop close spatial contacts and piecemeal degranulation is possibly triggered.

  18. Heat-induced formulation inhomogeneity of a three-component suspension.

    PubMed

    Toongsuwan, Siriporn; Li, Luk-Chiu; Chang, Hung-Chih; Stephens, Dennis; Robinson, Dan

    2004-08-01

    A suspension formulation containing sarafloxacin HCl, triamcinolone acetonide, and clotrimazole was developed for the treatment of otitis externa in dogs. The potency for the three active ingredients in this suspension was monitored at 25 degrees C and 40 degrees C for up to 3 months. The potencies of triamcinolone and clotrimazole were found unchanged, but the potency of sarafloxacin HCl in the samples stored at 40 degrees C for 1 month varied significantly between samples. However, assay inconsistency for sarafloxacin HCl was not seen in samples stored at 25 degrees C. Under an optical microscope, large crystals were found in the 40 degrees C stability samples but not in the 25 degrees C samples. The large crystals in 40 degrees C samples were identified as sarafloxacin by high-performance liquid chromatography (HPLC). This finding suggests that crystal growth of sarafloxacin took place at 40 degrees C during storage, leading to the formation of larger crystals and the consequent sampling nonuniformity and assay inconsistency. The solid-state properties of these crystals were further evaluated using hot-stage microscopy and Fourier transform infrared (FTIR) analysis. The results indicate that the crystal growth of sarafloxacin was most likely attributed to a change in the hydration form of sarafloxacin.

  19. Movimiento regular y caótico en cúmulos globulares

    NASA Astrophysics Data System (ADS)

    Carpintero, D. D.; Muzzio, J. C.; Wachlin, F. C.

    Los cúmulos globulares exhiben diferentes grados de elipticidad y se mueven en el campo gravitatorio de la galaxia a la que pertenecen. Las órbitas de sus estrellas no necesitan, por ello, conservar la energía ni el momento angular, y resulta probable la presencia de movimientos caóticos. Como paso preliminar de una investigación más extensa, presentamos aquí los resultados de un estudio de órbitas estelares en un cúmulo globular levemente triaxial que describe una órbita circular dentro de una galaxia. Las órbitas se investigan utilizando dos métodos: 1) La clasificación por frecuencias de D.D. Carpintero y L.A. Aguilar (1998, MNRAS, en prensa), y 2) Los exponentes de Lyapunov (subrutina LIAMAG, gentilmente suministrada por D. Pfenniger). Utilizando diversos espacios de condiciones iniciales, investigamos las familias de órbitas de las estrellas del cúmulo. Confirmamos la presencia de órbitas caóticas, particularmente en las zonas externas del cúmulo, y discutimos su importancia para la estructura del cúmulo.

  20. Description of Enterococcus canis sp. nov. from dogs and reclassification of Enterococcus porcinus Teixeira et al. 2001 as a junior synonym of Enterococcus villorum Vancanneyt et al 2001.

    PubMed

    De Graef, E M; Devriese, L A; Vancanneyt, M; Baele, M; Collins, M D; Lefebvre, K; Swings, J; Haesebrouck, F

    2003-07-01

    Strains from anal swabs and chronic otitis externa in dogs were shown to be phylogenetically related to the Enterococcus faecium species group. They shared a number of phenotypic characteristics with these species, but they could be easily differentiated by biochemical reactions. In addition, the canine strains were unusual in their nearly complete failure to grow on sodium azide-containing enterococci-selective media and in their Voges-Proskauer reactions (usually negative). By using 16S rRNA sequencing and DNA-DNA hybridization of representative strains, as well as tDNA interspacer gene PCR and SDS-PAGE of whole-cell proteins, the group of canine strains was shown to constitute a novel enterococcal species. The name Enterococcus canis sp. nov. is proposed for this species, with LMG 12316T (= CCUG 46666T) as the type strain. Concurrently, the taxonomic situation and nomenclatural position of Enterococcus porcinus were investigated. As no phenotypic or genotypic differences were found between this species and Enterococcus villorum, the name E. porcinus is considered to be a junior synonym of E. villorum.

  1. The ovarian and uterine arteries in the chinchilla (Chinchilla lanigera).

    PubMed

    Cevik-Demirkan, A; Ozdemir, V; Demirkan, I

    2010-03-01

    The purpose of this study was to describe arteries supplying the ovaries and uterus in the chinchilla. Five healthy adult female chinchillas were used. In order to reveal the arterial network by dissecting under a stereoscopic microscope, latex coloured with red ink was injected through the common carotid artery. The ovaries of the chinchilla are supplied by the arteriae ovaricae which formed end-to-end anastomoses with the cranial termination of the arteria uterina. Soon after leaving the aorta abdominalis, the arteriae ovaricae extended 2-3 mm caudolaterally, then released 1 branch and extended caudally and bifurcated into 2 further branches. One of these supplied branches to fat tissue. The other branch coursed caudally and anastomosed with the arteria circumflexa ilium profunda and dispersed into fat tissue. The arteria ovarica further subdivided into 2 rami ovaricae. The origins of the uterine arteries were exclusively from the left arteria iliaca externa. The arteria uterina gave a branch to the arteria umbilicalis and consecutive branches which supplied to the ureter, urinary bladder and cranial aspects of the vagina. It also gave rise to 2-3 branches to the cervix and further supplied 10-12 meandering branches to the uterine horns. The arteria uterina gave rise to many tortuous arteries to the uterus and provided 2 further branches to the ovary.

  2. [The use of a synthetic vascular artificial prosthesis or arterial homograft in cases of patients with the arteriosclerosis and terminal insufficiency of kidney cured by the kidney transplantation].

    PubMed

    Pupka, Artur; Blocher, Dariusz; Staniszewski, Tomasz; Płonek, Tomasz; Bogdan, Justyna

    2009-01-01

    Arterial transplantations were practiced in the vascular surgery since the beginning of her formation but without successes in the distant observation. Transplantation of a kidney is a routine conduct in the treatment of the decadent incapacity of a kidney. The dissertation concerns a use of arterial allografts kept using a method of a cold ischaemia in the protective liquid or synthetic vascular dacron artificial limbs or PTFE used as arterial foot-bridges at patients with the atherosclerotic obstruction aortal-pelvic, treated with the kidney transplantation. The arterial transplant is created from the aorta, arteria iliacas common and externa, femoral arteries common and superficial. A tissue material is kept using the method of the cold ischaemia and practical as the aortal foot-bridge-femoral or aortal-two-femoral at classified earlier patients being subjecteds to transfusion. The other way of a transplantation of a kidney at patients with the arteriosclerosis is the realization earlier or one-temporarily the vascular foot-bridge with use of the synthetic artificial limb. It seems that vascular artificial limbs about enlarged resistance on the contagion should be used in such a case. Sonographic examinations with duplex doppler and angiography are performed in all cases. The analysis of such cures can make a creation of the most profitable algorithm of the conduct possible in cases of patients suffering from ischaemia of lower limbs and requiring a transplantation of a kidney because of its incapacity.

  3. Pathology and Epidemiology of Ceruminous Gland Tumors among Endangered Santa Catalina Island Foxes (Urocyon littoralis catalinae) in the Channel Islands, USA.

    PubMed

    Vickers, T Winston; Clifford, Deana L; Garcelon, David K; King, Julie L; Duncan, Calvin L; Gaffney, Patricia M; Boyce, Walter M

    2015-01-01

    In this study, we examined the prevalence, pathology, and epidemiology of tumors in free-ranging island foxes occurring on three islands in the California Channel Islands, USA. We found a remarkably high prevalence of ceruminous gland tumors in endangered foxes (Urocyon littoralis catalinae) occurring on Santa Catalina Island (SCA)--48.9% of the dead foxes examined from 2001-2008 had tumors in their ears, and tumors were found in 52.2% of randomly-selected mature (≥ 4 years) foxes captured in 2007-2008, representing one of the highest prevalences of tumors ever documented in a wildlife population. In contrast, no tumors were detected in foxes from San Nicolas Island or San Clemente Island, although ear mites (Otodectes cynotis), a predisposing factor for ceruminous gland tumors in dogs and cats, were highly prevalent on all three islands. On SCA, otitis externa secondary to ear mite infection was highly correlated with ceruminous gland hyperplasia (CGH), and tumors were significantly associated with the severity of CGH, ceruminous gland dysplasia, and age group (older foxes). We propose a conceptual model for the formation of ceruminous gland tumors in foxes on SCA that is based on persistent, ubiquitous infection with ear mites, and an innate, over exuberant inflammatory and hyperplastic response of SCA foxes to these mites. Foxes on SCA are now opportunistically treated with acaricides in an attempt to reduce mite infections and the morbidity and mortality associated with this highly prevalent tumor.

  4. Multivariate approach to quantitative analysis of Aphis gossypii Glover (Hemiptera: Aphididae) and their natural enemy populations at different cotton spacings

    NASA Astrophysics Data System (ADS)

    Malaquias, José B.; Ramalho, Francisco S.; Dos S. Dias, Carlos T.; Brugger, Bruno P.; S. Lira, Aline Cristina; Wilcken, Carlos F.; Pachú, Jéssica K. S.; Zanuncio, José C.

    2017-02-01

    The relationship between pests and natural enemies using multivariate analysis on cotton in different spacing has not been documented yet. Using multivariate approaches is possible to optimize strategies to control Aphis gossypii at different crop spacings because the possibility of a better use of the aphid sampling strategies as well as the conservation and release of its natural enemies. The aims of the study were (i) to characterize the temporal abundance data of aphids and its natural enemies using principal components, (ii) to analyze the degree of correlation between the insects and between groups of variables (pests and natural enemies), (iii) to identify the main natural enemies responsible for regulating A. gossypii populations, and (iv) to investigate the similarities in arthropod occurrence patterns at different spacings of cotton crops over two seasons. High correlations in the occurrence of Scymnus rubicundus with aphids are shown through principal component analysis and through the important role the species plays in canonical correlation analysis. Clustering the presence of apterous aphids matches the pattern verified for Chrysoperla externa at the three different spacings between rows. Our results indicate that S. rubicundus is the main candidate to regulate the aphid populations in all spacings studied.

  5. Multivariate approach to quantitative analysis of Aphis gossypii Glover (Hemiptera: Aphididae) and their natural enemy populations at different cotton spacings.

    PubMed

    Malaquias, José B; Ramalho, Francisco S; Dos S Dias, Carlos T; Brugger, Bruno P; S Lira, Aline Cristina; Wilcken, Carlos F; Pachú, Jéssica K S; Zanuncio, José C

    2017-02-09

    The relationship between pests and natural enemies using multivariate analysis on cotton in different spacing has not been documented yet. Using multivariate approaches is possible to optimize strategies to control Aphis gossypii at different crop spacings because the possibility of a better use of the aphid sampling strategies as well as the conservation and release of its natural enemies. The aims of the study were (i) to characterize the temporal abundance data of aphids and its natural enemies using principal components, (ii) to analyze the degree of correlation between the insects and between groups of variables (pests and natural enemies), (iii) to identify the main natural enemies responsible for regulating A. gossypii populations, and (iv) to investigate the similarities in arthropod occurrence patterns at different spacings of cotton crops over two seasons. High correlations in the occurrence of Scymnus rubicundus with aphids are shown through principal component analysis and through the important role the species plays in canonical correlation analysis. Clustering the presence of apterous aphids matches the pattern verified for Chrysoperla externa at the three different spacings between rows. Our results indicate that S. rubicundus is the main candidate to regulate the aphid populations in all spacings studied.

  6. Un modelo general de eyección de materia estelar

    NASA Astrophysics Data System (ADS)

    Rotstein, N. O.

    Posiblemente, la más directa y dramática evidencia de la pérdida de masa por parte de diferentes objetos astrofísicos la constituye el fenómeno de eyección persistente de materia. En el caso particular de las estrellas, las características y los mecanismos que impulsan a sus atmósferas externas hacia el medio interestelar varían a lo largo del diagrama evolutivo. En parte por este motivo, en parte por las dificultades matemáticas involucradas, es muy difícil elaborar un modelo que pueda dar cuenta de los diferentes mecanismos que originan e impulsan el viento estelar. Cabe entonces preguntarse si es posible desarrollar un único modelo en el que estos mecanismos puedan ser considerados (y variados) como parámetros externos que responden a las características de cada región de la secuencia evolutiva. La respuesta es que, en función de la geometría del campo electromagnético involucrado, todo depende de la simetría del problema. En este trabajo se presenta el análisis detallado de una de tales simetrías, discutiendo en particular los resultados obtenidos a la luz de las observaciones disponibles.

  7. Pseudomonas aeruginosa on vinyl-canvas inflatables and foam teaching aids in swimming pools.

    PubMed

    Schets, F M; van den Berg, H H J L; Baan, R; Lynch, G; de Roda Husman, A M

    2014-12-01

    Swimming pool-related Pseudomonas aeruginosa infections mainly result in folliculitis and otitis externa. P. aeruginosa forms biofilms on surfaces in the swimming pool environment. The presence of P. aeruginosa on inflatables and foam teaching aids in 24 public swimming pools in the Netherlands was studied. Samples (n = 230) were taken from 175 objects and analysed for P. aeruginosa by culture. Isolated P. aeruginosa were tested for antibiotic resistance by disk diffusion. P. aeruginosa was detected in 63 samples (27%), from 47 objects (27%) in 19 (79%) swimming pools. More vinyl-canvas objects (44%) than foam objects (20%) were contaminated, as were wet objects (43%) compared to dry objects (13%). Concentrations were variable, and on average higher on vinyl-canvas than on foam objects. Forty of 193 (21%) P. aeruginosa isolates from 11 different objects were (intermediate) resistant to one or more of 12 clinically relevant antibiotics, mostly to imipenem and aztreonam. The immediate risk of a P. aeruginosa infection from exposure to swimming pool objects seems limited, but the presence of P. aeruginosa on pool objects is unwanted and requires attention of pool managers and responsible authorities. Strict drying and cleaning policies are needed for infrequently used vinyl-canvas objects.

  8. Exotic herbivores on a shared native host: tissue quality after individual, simultaneous, and sequential attack.

    PubMed

    Gómez, Sara; Orians, Colin M; Preisser, Evan L

    2012-08-01

    Plants in nature are often attacked by multiple enemies whose effect on the plant cannot always be predicted based on the outcome of individual attacks. We investigated how two invasive herbivores, the hemlock woolly adelgid (Adelges tsugae) (HWA) and the elongate hemlock scale (Fiorinia externa) (EHS), alter host plant quality (measured as amino acid concentration and composition) when feeding individually or jointly on eastern hemlock (Tsuga canadensis), an important long-lived forest tree that is in severe decline. The joint herbivore treatments included both simultaneous and sequential infestations by the two herbivores. We expected resource depletion over time, particularly in response to feeding by HWA. In contrast, HWA dramatically increased the concentration and altered the composition of individual free amino acids. Compared to control trees, HWA increased total amino acid concentration by 330% after 1 year of infestation. Conversely, EHS had a negligible effect when feeding individually. Interestingly, there was a marginally significant HWA × EHS interaction that suggests the potential for EHS presence to reduce the impact of HWA on foliage quality when the two species co-occur. We suggest indirect effects of water stress as a possible physiological mechanism for our results. Understanding how species interactions change the physiology of a shared host is crucial to making more accurate predictions about host mortality and subsequent changes in affected communities and ecosystems, and to help design appropriate management plans.

  9. Variation in plant defense against invasive herbivores: evidence for a hypersensitive response in eastern hemlocks (Tsuga canadensis).

    PubMed

    Radville, Laura; Chaves, Arielle; Preisser, Evan L

    2011-06-01

    Herbivores can trigger a wide array of morphological and chemical changes in their host plants. Feeding by some insects induces a defensive hypersensitive response, a defense mechanism consisting of elevated H(2)O(2) levels and tissue death at the site of herbivore feeding. The invasive hemlock woolly adelgid Adelges tsugae ('HWA') and elongate hemlock scale Fiorinia externa ('EHS') feed on eastern hemlocks; although both are sessile sap feeders, HWA causes more damage than EHS. The rapid rate of tree death following HWA infestation has led to the suggestion that feeding induces a hypersensitive response in hemlock trees. We assessed the potential for an herbivore-induced hypersensitive response in eastern hemlocks by measuring H(2)O(2) levels in foliage from HWA-infested, EHS-infested, and uninfested trees. Needles with settled HWA or EHS had higher H(2)O(2) levels than control needles, suggesting a localized hypersensitive plant response. Needles with no direct contact to settled HWA also had high H(2)O(2) levels, suggesting that HWA infestation may induce a systemic defense response in eastern hemlocks. There was no similar systemic defensive response in the EHS treatment. Our results showed that two herbivores in the same feeding guild had dramatically different outcomes on the health of their shared host.

  10. Multivariate approach to quantitative analysis of Aphis gossypii Glover (Hemiptera: Aphididae) and their natural enemy populations at different cotton spacings

    PubMed Central

    Malaquias, José B.; Ramalho, Francisco S.; dos S. Dias, Carlos T.; Brugger, Bruno P.; S. Lira, Aline Cristina; Wilcken, Carlos F.; Pachú, Jéssica K. S.; Zanuncio, José C.

    2017-01-01

    The relationship between pests and natural enemies using multivariate analysis on cotton in different spacing has not been documented yet. Using multivariate approaches is possible to optimize strategies to control Aphis gossypii at different crop spacings because the possibility of a better use of the aphid sampling strategies as well as the conservation and release of its natural enemies. The aims of the study were (i) to characterize the temporal abundance data of aphids and its natural enemies using principal components, (ii) to analyze the degree of correlation between the insects and between groups of variables (pests and natural enemies), (iii) to identify the main natural enemies responsible for regulating A. gossypii populations, and (iv) to investigate the similarities in arthropod occurrence patterns at different spacings of cotton crops over two seasons. High correlations in the occurrence of Scymnus rubicundus with aphids are shown through principal component analysis and through the important role the species plays in canonical correlation analysis. Clustering the presence of apterous aphids matches the pattern verified for Chrysoperla externa at the three different spacings between rows. Our results indicate that S. rubicundus is the main candidate to regulate the aphid populations in all spacings studied. PMID:28181503

  11. Neurological and cellular regulation of visceral hypersensitivity induced by chronic stress and colonic inflammation in rats.

    PubMed

    Chen, J; Winston, J H; Sarna, S K

    2013-09-17

    The role of inflammation in inducing visceral hypersensitivity (VHS) in ulcerative colitis patients remains unknown. We tested the hypothesis that acute ulcerative colitis-like inflammation does not induce VHS. However, it sets up molecular conditions such that chronic stress following inflammation exaggerates single-unit afferent discharges to colorectal distension. We used dextran sodium sulfate (DSS) to induce ulcerative colitis-like inflammation and a 9-day heterotypic chronic stress protocol in rats. DSS upregulated Nav1.8 mRNA in colon-responsive dorsal root ganglion (DRG) neurons, TRPV1 in colonic muscularis externae (ME) and BDNF in spinal cord without affecting the spike frequency in spinal afferents or VMR to CRD. By contrast, chronic stress did not induce inflammation but it downregulated Kv1.1 and Kv1.4 mRNA in DRG neurons, and upregulated TRPA1 and nerve growth factor in ME, which mediated the increase of spike frequency and VMR to CRD. Chronic stress following inflammation exacerbated spike frequency in spinal afferent neurons. TRPA1 antagonist suppressed the sensitization of afferent neurons. DSS-inflammation did not affect the composition or excitation thresholds of low-threshold and high-threshold fibers. Chronic stress following inflammation increased the percent composition of high-threshold fibers and lowered the excitation threshold of both types of fibers. We conclude that not all types of inflammation induce VHS, whereas chronic stress induces VHS in the absence of inflammation.

  12. Critical Roles of the Direct GABAergic Pallido-cortical Pathway in Controlling Absence Seizures

    PubMed Central

    Li, Min; Ma, Tao; Wu, Shengdun; Ma, Jingling; Cui, Yan; Xia, Yang; Xu, Peng; Yao, Dezhong

    2015-01-01

    The basal ganglia (BG), serving as an intermediate bridge between the cerebral cortex and thalamus, are believed to play crucial roles in controlling absence seizure activities generated by the pathological corticothalamic system. Inspired by recent experiments, here we systematically investigate the contribution of a novel identified GABAergic pallido-cortical pathway, projecting from the globus pallidus externa (GPe) in the BG to the cerebral cortex, to the control of absence seizures. By computational modelling, we find that both increasing the activation of GPe neurons and enhancing the coupling strength of the inhibitory pallido-cortical pathway can suppress the bilaterally synchronous 2–4 Hz spike and wave discharges (SWDs) during absence seizures. Appropriate tuning of several GPe-related pathways may also trigger the SWD suppression, through modulating the activation level of GPe neurons. Furthermore, we show that the previously discovered bidirectional control of absence seizures due to the competition between other two BG output pathways also exists in our established model. Importantly, such bidirectional control is shaped by the coupling strength of this direct GABAergic pallido-cortical pathway. Our work suggests that the novel identified pallido-cortical pathway has a functional role in controlling absence seizures and the presented results might provide testable hypotheses for future experimental studies. PMID:26496656

  13. Windows of opportunities and technological innovation in the Brazilian pharmaceutical industry.

    PubMed

    Tigre, Paulo Bastos; Nascimento, Caio Victor Machado França do; Costa, Laís Silveira

    2016-11-03

    The Brazilian pharmaceutical industry is heavily dependent on external sources of inputs, capital, and technology. However, the emergence of technological opportunities and the development of biotechnology and the decline of the patent boom and resulting advances by generic drugs have opened windows of opportunities for the local industry. The article examines the Brazilian industry's innovative behavior vis-à-vis these opportunities, showing that although the industry as a whole invests little in innovation, a few large Brazilian companies have expanded their market share and stepped up their investments in research and development, supported by public policies for innovation. Resumo: A indústria farmacêutica brasileira caracteriza-se pela grande dependência de fontes externas de insumos, capital e tecnologia. O surgimento de oportunidades tecnológicas, associadas ao desenvolvimento da biotecnologia e ao fim do boom das patentes com o consequente avanço dos medicamentos genéricos, entretanto, vem abrindo janelas de oportunidades para a indústria local. Este artigo examina o comportamento inovador da indústria brasileira à luz dessas oportunidades, revelando que, embora o conjunto da indústria mantenha baixos níveis de investimentos em inovação, um pequeno grupo de grandes empresas nacionais vem ampliando sua participação no mercado e intensificando seus investimentos em pesquisa e desenvolvimento, apoiados por políticas públicas de inovação.

  14. Modos de produccion cientifica: Culturas y metodologias de investigacion en la Universidad de Cadiz

    NASA Astrophysics Data System (ADS)

    Gonzalez Ramos, Ana M.

    2004-12-01

    Este trabajo de investigacion supone un modelo teorico de caracter aplicado, que proporciona la oportunidad de evaluar la produccion cientifica de los investigadores. Se encuadra dentro de la tradiccion de la estadistica aplicada y la sociologia del conocimiento. Atiende especialmente a dos conjuntos de temas de interes, por una parte, las caracteristicas principales que determinan el nivel y tipo de produccion academica producida por las unidades de investigacion y por los propios investigadores; por otra, la utilizacion que se hace de los metodos y tecnicas de investigacion puesto que de ello tambien depende el modo de produccion cientifica. Los puntos novedosos de esta tesis son: la medicion cuantitativa del objeto de estudio, la suma de los productos y las condiciones externas a la produccion del conocimiento mas otros elementos internos como las caracteristicas de los investigadores y la metodologia utilizada para desarrollar sus trabajos; y, finalmente, el uso de las nuevas tecnologias. El aprovechamiento de los recursos estadisticos y las fuentes de informacion secundarias se complementan con el diseno propio de una encuesta donde se implementa las caracteristicas descritas en un capitulo anterior sobre los metodos cientificos mas idoneos descritos en los principales manuales y articulos cientificos desde distintas disciplinas de conocimiento. Dicha encuesta ha sido desarrollada como un programa propio y en base a los mas innovadores usos de la tecnologia en la metodologia de encuestas.

  15. Morphology of the large intestine of the pig: haustra versus taenia.

    PubMed

    Hedemann, Mette Skou; Kristiansen, Eva; Brunsgaard, Grete

    2002-07-01

    The aim of the present study was to compare the morphological characteristics of the taenia and haustra of the large intestine in pigs. Ten pigs were fed a barley/wheat-based diet for a period of five weeks. Tissue samples were taken from the cecum and the proximal part of the colon at slaughter and processed histologically for determination of crypt volume, depth and density of the crypts, thickness of muscularis externa, and carbohydrate histochemistry. In all parameters examined regional differences in mucosal architecture of the cecum and proximal colon were demonstrated. Apparently, the regional differences in mucosal architecture between taenia and haustra were more pronounced in the cecum than in the proximal colon. The regional variation in mucin characteristics and in crypt parameters could be explained by differences in functional status and/or in the local environment. As all the parameters investigated in this study are not only dependent on sampling site, but also, e.g., on type of diet and its physical form, great care must be taken to obtain tissue from comparable sites in all animals in experimental studies to avoid incorrect conclusions.

  16. The development and distribution of the interstitial cells of Cajal in the intestine of the equine fetus and neonate.

    PubMed

    Fintl, C; Pearson, G T; Ricketts, S W; Mayhew, I G; Hudson, N P H

    2004-07-01

    This study set out to determine the pattern of development and distribution of the interstitial cells of Cajal (ICC) in the intestinal tract of the equine fetus and neonate. Intestinal tissue samples from 12 naturally aborted equine fetuses and three euthanized neonates were collected and fixed in formalin prior to applying standard immunohistochemical labelling techniques targeting the c-Kit protein of the ICC. At 6 months of gestation, a network of ICC was present in the myenteric plexus region of both the small and the large intestine. ICC were also present within the circular muscle layer. In the large intestine, a proximal to distal gradient of distribution was evident, with few ICC observed in the more distal parts of the large intestine in the younger fetuses compared with the near-term animals. A transmural gradient of distribution was also evident within the large intestine, with the most luminal part of the muscularis externa being the last area to be colonized by ICC. This region did not appear fully developed until the early neonatal period. An increased density of ICC was noted throughout the large intestine in the regions of the taenial bands in all animals. This study is the first to describe ICC development and distribution in the equine fetus and neonate.

  17. Effects of otitis on hearing in dogs characterised by brainstem auditory evoked response testing.

    PubMed

    Eger, C E; Lindsay, P

    1997-09-01

    Hearing function was measured in normal dogs and in dogs with otitis using brainstem auditory evoked response testing. Data were obtained from 86 normal ears and from 105 ears with otitis, categorised into four degrees of severity. The data were analysed to illustrate the differences between the hearing function in the normal and abnormal ears and to estimate the degree of impairment associated with differing degrees of pathology. While severe hearing loss seemed to be present in the dogs with more severe otitis, only two individuals were identified as being totally deaf in the affected ears and no dogs were identified in which the cleaning and examination processes had caused damage to hearing function. Cleaning the ear canal produced measurable improvements in hearing in several dogs, indicating the profound effect of physical obstruction of the external ear canal by debris. It is concluded that most dogs with chronic otitis externa are not totally deaf and that the hearing impairment that does occur has the characteristics of conductive hearing loss.

  18. [Factors associated with atelectasis following extubation in very low weight premature newborns].

    PubMed

    Castilla-Castilla, Cristina María Del Carmen; Vidales-Roque, Lydia Beatriz; Pérez-Durán, Juana; Tena-Reyes, Daniel; Tapia-Rombo, Carlos Antonio

    2014-01-01

    INTRODUCCIÓN: la atelectasia es la disminución del volumen pulmonar causada por obstrucción de las vías aéreas o presión en la parte externa del pulmón. Es común después de una cirugía y de la extubación. El objetivo de esta investigación fue determinar los factores relacionados con la atelectasia posterior a extubación en recién nacidos prematuros con peso menor de 1250 g que fueron referidos a una unidad de cuidados intensivos neonatales. MÉTODOS: el estudio se realizó en los neonatos que ingresaron a una unidad de cuidados intensivos neonatales y que ameritaron asistencia mecánica para la ventilación. Se incluyeron los recién nacidos pretérmino de 28 a 36 semanas de gestación y de 0 a 28 días de vida extrauterina, con asistencia mecánica para la ventilación por lo menos durante 24 horas y que al ser extubados en forma planeada tuvieron un peso menor a 1250 g. Se formaron dos grupos comparativos: grupo A, con atelectasias posterior a extubación; grupo B, sin atelectasia posterior a extubación.

  19. Treating epilepsy: a review of Polish historical sources.

    PubMed

    Owczarek, Krzysztof

    2011-10-01

    The first surviving Polish publications on epilepsy were written in the 16th and 17th centuries. Many causes of epileptic seizures are quoted and they are divided into two categories: internal and external. Internal causes (causa interna) include imbalance in the basic bodily humors, that is, yellow bile, black bile, phlegm, and blood. According to medieval writers, the principal cause of epilepsy was vapor, a damp, cold volatile substance originating in the excessive production of one of the basic organismic liquids. Vapor allegedly stuck to the openings leading to the cerebral ventricles or blocked them entirely, resulting in convulsions. External causes (causa externa) include overeating and excessive drinking, teething, spoiled milk, poisons, badly treated spots and fever, cold air, moonlight, and wearing donkey hide. Medical treatments for epilepsy included surgical interventions (bloodletting) and pharmacological interventions. The latter included laxatives, sea onion (scilla maritima, urginea maritima), and ground human skull, all of which were supposed to protect the body from vapors. Medical practitioners of that time also advised that the factors and circumstances conducive to epileptic seizures be observed and identified so that patients could be isolated from these alleged causal factors and their seizures reduced or ended.

  20. Alternative methods for ray tracing in uniaxial media. Application to negative refraction

    NASA Astrophysics Data System (ADS)

    Bellver-Cebreros, Consuelo; Rodriguez-Danta, Marcelo

    2007-03-01

    In previous papers [C. Bellver-Cebreros, M. Rodriguez-Danta, Eikonal equation, alternative expression of Fresnel's equation and Mohr's construction in optical anisotropic media, Opt. Commun. 189 (2001) 193; C. Bellver-Cebreros, M. Rodriguez-Danta, Internal conical refraction in biaxial media and graphical plane constructions deduced from Mohr's method, Opt. Commun. 212 (2002) 199; C. Bellver-Cebreros, M. Rodriguez-Danta, Refraccion conica externa en medios biaxicos a partir de la construccion de Mohr, Opt. Pura AppliE 36 (2003) 33], the authors have developed a method based on the local properties of dielectric permittivity tensor and on Mohr's plane graphical construction in order to study the behaviour of locally plane light waves in anisotropic media. In this paper, this alternative methodology is compared with the traditional one, by emphasizing the simplicity of the former when studying ray propagation through uniaxial media (comparison is possible since, in this case, traditional construction becomes also plane). An original and simple graphical method is proposed in order to determine the direction of propagation given by the wave vector from the knowledge of the extraordinary ray direction (given by Poynting vector). Some properties of light rays in these media not described in the literature are obtained. Finally, two applications are considered: a description of optical birefringence under normal incidence and the study of negative refraction in uniaxial media.

  1. [The use of therapeutic writing in an institutional context].

    PubMed

    Reyes-Iraola, Adriana

    2014-01-01

    Introducción: se expone el efecto del uso de la escritura en un espacio terapéutico-institucional, como un medio para lograr el cambio terapéutico en el paciente y una mayor eficiencia de los tiempos y espacios institucionales. Métodos: se muestran y se sustentan teóricamente en el contexto de la terapia narrativa y colaborativa diferentes formas de uso del documento escrito, además de ejemplos de ellos con la presentación de extractos de escritos de los participantes. La muestra fue conformada por pacientes que acudieron a un hospital de psiquiatría a recibir tratamiento (por medio de internamiento o consulta externa). Resultados: la escritura y el lenguaje oral intercambian significados en un continuo paralelo y demuestran que el proceso terapéutico se produce más allá del tiempo y espacio terapéutico institucional, lo cual alienta las ventajas que ofrece el uso del lenguaje escrito en los procesos psicoterapéuticos orales. Conclusión: la escritura es un recurso intelectual que facilita el pensamiento, pues al escribir la propia experiencia, los eventos que la conforman se logran organizar en el tiempo, lo cual genera una percepción del cambio, una representación de significados y promueve la autoeficacia al producir diferentes relatos de los eventos y la experiencia.

  2. Untangling Basal Ganglia Network Dynamics and Function: Role of Dopamine Depletion and Inhibition Investigated in a Spiking Network Model

    PubMed Central

    2016-01-01

    Abstract The basal ganglia are a crucial brain system for behavioral selection, and their function is disturbed in Parkinson’s disease (PD), where neurons exhibit inappropriate synchronization and oscillations. We present a spiking neural model of basal ganglia including plausible details on synaptic dynamics, connectivity patterns, neuron behavior, and dopamine effects. Recordings of neuronal activity in the subthalamic nucleus and Type A (TA; arkypallidal) and Type I (TI; prototypical) neurons in globus pallidus externa were used to validate the model. Simulation experiments predict that both local inhibition in striatum and the existence of an indirect pathway are important for basal ganglia to function properly over a large range of cortical drives. The dopamine depletion–induced increase of AMPA efficacy in corticostriatal synapses to medium spiny neurons (MSNs) with dopamine receptor D2 synapses (CTX-MSN D2) and the reduction of MSN lateral connectivity (MSN–MSN) were found to contribute significantly to the enhanced synchrony and oscillations seen in PD. Additionally, reversing the dopamine depletion–induced changes to CTX–MSN D1, CTX–MSN D2, TA–MSN, and MSN–MSN couplings could improve or restore basal ganglia action selection ability. In summary, we found multiple changes of parameters for synaptic efficacy and neural excitability that could improve action selection ability and at the same time reduce oscillations. Identification of such targets could potentially generate ideas for treatments of PD and increase our understanding of the relation between network dynamics and network function. PMID:28101525

  3. Neural control of dopamine neurotransmission: implications for reinforcement learning.

    PubMed

    Aggarwal, Mayank; Hyland, Brian I; Wickens, Jeffery R

    2012-04-01

    In the past few decades there has been remarkable convergence of machine learning with neurobiological understanding of reinforcement learning mechanisms, exemplified by temporal difference (TD) learning models. The anatomy of the basal ganglia provides a number of potential substrates for instantiation of the TD mechanism. In contrast to the traditional concept of direct and indirect pathway outputs from the striatum, we emphasize that projection neurons of the striatum are branched and individual striatofugal neurons innervate both globus pallidus externa and globus pallidus interna/substantia nigra (GPi/SNr). This suggests that the GPi/SNr has the necessary inputs to operate as the source of a TD signal. We also discuss the mechanism for the timing processes necessary for learning in the TD framework. The TD framework has been particularly successful in analysing electrophysiogical recordings from dopamine (DA) neurons during learning, in terms of reward prediction error. However, present understanding of the neural control of DA release is limited, and hence the neural mechanisms involved are incompletely understood. Inhibition is very conspicuously present among the inputs to the DA neurons, with inhibitory synapses accounting for the majority of synapses on DA neurons. Furthermore, synchronous firing of the DA neuron population requires disinhibition and excitation to occur together in a coordinated manner. We conclude that the inhibitory circuits impinging directly or indirectly on the DA neurons play a central role in the control of DA neuron activity and further investigation of these circuits may provide important insight into the biological mechanisms of reinforcement learning.

  4. The Cancer Drug Tamoxifen: A Potential Therapeutic Treatment for Spinal Cord Injury

    PubMed Central

    Guptarak, Jutatip; Wiktorowicz, John E.; Sadygov, Rovshan G.; Zivadinovic, Dragoslava; Paulucci-Holthauzen, Adriana A.; Vergara, Leoncio

    2014-01-01

    Abstract Tamoxifen (TMX) is a selective estrogen receptor modulator that can mimic the neuroprotective effects of estrogen but lacks its systemic adverse effects. We found that TMX (1 mg/day) significantly improved the motor recovery of partially paralyzed hind limbs of male adult rats with thoracic spinal cord injury (SCI), thus indicating a translational potential for this cancer medication given its clinical safety and applicability and the lack of currently available treatments for SCI. To shed light on the mechanisms underlying the beneficial effects of TMX for SCI, we used proteomic analyses, Western blots and histological assays, which showed that TMX treatment spared mature oligodendrocytes/increased myelin levels and altered reactive astrocytes, including the upregulation of the water channels aquaporin 4 (AQP4), a novel finding. AQP4 increases in TMX-treated SCI rats were associated with smaller fluid-filled cavities with borders consisting of densely packed AQP4-expressing astrocytes that closely resemble the organization of normal glia limitans externa (in contrast to large cavities in control SCI rats that lacked glia limitans-like borders and contained reactive glial cells). Based on our findings, we propose that TMX is a promising candidate for the therapeutic treatment of SCI and a possible intervention for other neuropathological conditions associated with demyelination and AQP4 dysfunction. PMID:24004276

  5. A model of the anterior esophagus in snakes, with functional and developmental implications.

    PubMed

    Cundall, David; Tuttman, Cassandra; Close, Matthew

    2014-03-01

    The gross anatomy of the mouth of snakes has always been interpreted as an evolutionary response to feeding demands. In most alethinophidian species, their anatomy allows limited functional independence of right and left sides and the roof and floor of the mouth as well as wide separation of the tips of the mandibles. However, locations of the tongue and glottis in snakes suggest extraordinary rearrangement of pharyngeal structures characteristic of all vertebrates. Serial histological sections through the heads of a number of colubroid species show muscularis mucosal smooth muscle fibers appearing in the paratracheal gutter of the lower jaw at varying levels between the eye and ear regions. Incomplete muscularis externa elements appear beneath the paratracheal gutter more caudally but typically at otic levels. Both muscle layers encompass more of the gut wall at more posterior levels, encircling the gut at the level of the atlas or axis. The pattern in snakes suggests developmental dissociation of dorsal and ventral splanchnic derivatives and extensive topological rearrangements of some ventral pharyngeal arch derivatives typical of most tetrapods. When snakes swallow large prey, the effective oral cavity becomes extremely short ventrally. The palatomaxillary arches function as ratchets packing the prey almost directly into the esophagus. Our findings raise questions about germ layer origins and regulation of differentiation of gut regions and derivatives in snakes and suggest that significant aspects of the evolution of lepidosaurs may be difficult to recover from bones or molecular sequence data alone.

  6. Malignant external otitis: early scintigraphic detection

    SciTech Connect

    Strashun, A.M.; Nejatheim, M.; Goldsmith, S.J.

    1984-02-01

    Pseudomonas otitis externa in elderly diabetics may extend aggressively to adjacent bone, cranial nerves, meninges, and vessels, leading to a clinical diagnosis of ''malignant'' external otitis. Early diagnosis is necessary for successful treatment. This study compares the findings of initial radiographs, thin-section tomography of temporal bone, CT scans of head and neck, technetium-99m methylene diphosphonate (MDP) and gallium-67 citrate scintigraphy, and single-photon emission computed tomography (SPECT) for detection of temporal bone osteomylitis in ten patients fulfilling the clinical diagnostic criteria of malignant external otitis. Skull radiographs were negative in all of the eight patients studied. Thin-section tomography was positive in one of the seven patients studied using this modality. CT scanning suggested osteomyelitis in three of nine patients. Both Tc-99m and Ga-67 citrate scintigraphy were positive in 10 of 10 patients. These results suggest that technetium and gallium scintigraphy are more sensitive than radiographs and CT scans for early detection of malignant external otitis.

  7. [Aniseikonia reduces binocular summation in the VECP].

    PubMed

    Krause, K; Gerding, H; Timmermann, M; Kauffmann, T

    1995-04-01

    The binocular summation effect of human VECP (increase in amplitude from about 4.0 microV to about 5.4 microV) was proved and optimized in 32 subjects. Stimulus parameters: TV steady-state pattern reversal (7.0 Hz); pattern size 1 degree; stimulus contrast 5% (higher stimulus contrasts reduced considerably the selectivity of the binocular summation effect); 96 sweeps averaging (Nicolet Compaq Four); position of electrodes: 10% and 30% above Protuberantia occipitalis externa of nasioninion distance. Aniseikonia of 7 to 52% was generated by means of small Galilei telescopes. Because of comparatively large interindividual variance within the series of subjects, no decrease in binocular VECP amplitude could be demonstrated at an aniseikonia less than 52%. On one woman subject, a significant reduction in amplitude (5% level) at 14%, 26% and 52% aniseikonia was apparent, but not at 7%. Thus, for this subject, it was possible to correlate the results with the clinically known limits of toleration for aniseikonia. This result was confirmed by more than 60% of the subjects in the test group.

  8. [Comparison of the Wechsler Memory Scale-III and the Spain-Complutense Verbal Learning Test in acquired brain injury: construct validity and ecological validity].

    PubMed

    Luna-Lario, P; Pena, J; Ojeda, N

    2017-04-16

    Objetivo. Profundizar en la validez de constructo y en la validez ecologica de la escala de memoria de Wechsler-III (WMS-III) y el test de aprendizaje verbal España-Complutense (TAVEC). Pacientes y metodos. La muestra consta de 106 adultos con daño cerebral adquirido atendidos en el Area de Neuropsicologia y Neuropsiquiatria del Complejo Hospitalario de Navarra, con deficit de memoria como secuela principal, medido a traves de test especificos de memoria. Para determinar la validez de constructo se examinan las tareas requeridas en cada prueba sobre los modelos teoricos de base, comparando el rendimiento segun los parametros ofrecidos por los tests, contrastando los indices de gravedad de cada prueba y analizando su convergencia. La validez externa se explora a traves de la correlacion entre las pruebas y mediante modelos de regresion. Resultados. De acuerdo con los resultados obtenidos, la WMS-III y el TAVEC tienen validez de constructo. El TAVEC es mas sensible y capta no solo los deficits en la consolidacion mnesica, sino en las estrategias ejecutivas implicadas en la memoria. El indice de memoria de trabajo de la WMS-III es util para predecir la reincorporacion laboral a los dos años del daño cerebral adquirido, pero ningun instrumento anticipa la discapacidad y la dependencia al menos seis meses despues de la lesion. Conclusion. Se reflexiona sobre la validez de constructo de las pruebas y su capacidad insuficiente para predecir la funcionalidad cuando las secuelas se cronifican.

  9. Variations in prevalence of viral, bacterial, and rhizocephalan diseases and parasites of the blue crab (Callinectes sapidus).

    PubMed

    Rogers, Holly A; Taylor, Sabrina S; Hawke, John P; Anderson Lively, Julie A

    2015-05-01

    Prevalence of blue crab diseases and parasites has not been consistently monitored in the Gulf of Mexico. To establish current prevalence levels and to more fully understand population dynamics, commercial landing trends, and effects of future natural and anthropogenic disasters on animal health, we measured the prevalence of white spot syndrome virus (WSSV), Loxothylacus texanus, shell disease, and Vibrio spp. in blue crabs collected from Louisiana in 2013 and the beginning of 2014. We used PCR to detect WSSV and L. texanus infections, visual gross diagnosis for L. texanus externae and shell disease, and standard microbiological culture techniques and biochemical testing for Vibrio spp. We found no crabs infected with WSSV or L. texanus. Absence of L. texanus parasitization was expected based on the sampled salinities and the sampling focus on large crabs. Shell disease was present at a level of 54.8% and was most prevalent in the winter and summer and least prevalent in the spring. Vibrio spp. were found in the hemolymph of 22.3% of the crabs and prevalence varied by site, season, and sex. Additionally, three of 39 crabs tested were infected with reo-like virus.

  10. Molecular identification and antifungal susceptibilities of black Aspergillus isolates from otomycosis cases in Hungary.

    PubMed

    Szigeti, Gyöngyi; Kocsubé, Sándor; Dóczi, Ilona; Bereczki, László; Vágvölgyi, Csaba; Varga, János

    2012-08-01

    Otomycosis, also known as fungal otitis externa, has been used to describe a fungal infection of the external auditory canal, but sometimes involving the middle ear. Many fungal species have been identified as infectious agents in otomycosis, with Aspergillus and Candida species being the most common. Among aspergilli, Aspergillus niger is the most commonly described species in the literature. In this study, 14 black Aspergillus strains were analyzed, which were isolated from otomycosis cases in Hungary between 2010 and 2011. These strains were identified as A. niger according to conventional morphological methods. Species identification was based on sequencing of part of the calmodulin gene. Our results indicate that instead of A. niger, A. awamori and A. tubingensis are the predominant species that cause ear infections in Southern Hungary. Antifungal susceptibility tests were carried out against four antifungal drugs: amphotericin B, itraconazole, ketoconazole and terbinafine. All isolates were found to exhibit low in vitro MIC values to amphotericin B, terbinafine and itraconazole. However, the examined isolates exhibited high in vitro MIC values to ketoconazole.

  11. [Histologic studies on otomycosis].

    PubMed

    Vennewald, Irina; Schönlebe, J; Klemm, E

    2002-01-01

    Fungal infections of the ear are mostly described as mycoses of the auditory canal. The aim of our investigations was to find out how fungi colonize the ear in immunocompetent patients. In the years from 1993 to 2000, 128 patients suspected of having otomycosis were examined. Of these 115 patients suffered from chronic otitis media with persisting tympanum perforation and otorrhea. A further 13 patients had clinical signs of otitis externa only. In 54 out of 139 samples, fungi were found in the auditory canal, in five on the tympanic membrane, and in five in the middle ear. Two-thirds were isolated as moulds and one-third as yeasts. Dominating species were Aspergillus niger and Candida parapsilosis. Samples of 15 patients suspected of having mastoiditis or cholesteatoma were examined histologically. Fungal hyphae were observed in the middle ear cavity and/or between horny lamellae of cholesteatoma in 4 patients. In the middle ear of immunocompetent patients chronic-hyperplastic (polypous) inflammation was detected with increased production of mucus, which probably promotes the colonization with pathogenic fungi as in the middle ear just like in the auditory canal.

  12. System Identification of Local Field Potentials under Deep Brain Stimulation in a Healthy Primate

    PubMed Central

    Pedoto, Gilda; Santaniello, Sabato; Montgomery, Erwin B.; Gale, John T.; Fiengo, Giovanni; Glielmo, Luigi; Sarma, Sridevi V.

    2013-01-01

    High frequency (HF) Deep Brain Stimulation (DBS) in the Sub-Thalamic Nucleus (STN) is a clinically recognized therapy for the treatment of motor disorders in Parkinson Disease (PD). The underlying mechanisms of DBS and how it impacts neighboring nuclei, however, are not yet completely understood. Electrophysiological data has been collected in PD patients and primates to better understand the impact of DBS on STN and the entire Basal Ganglia (BG) motor circuit. We use single unit recordings from Globus Pallidus, both pars interna and externa segments (GPi and GPe) in the BG, in a normal primate before and after DBS to reconstruct Local Field Potentials (LFPs) in the region. We then use system identification techniques to understand how GPe LFP activity and the DBS signal applied to STN influence GPi LFP activity. Our models suggest that when no stimulation is applied, the GPe LFPs have an inhibitory effect on GPi LFPs with a 2-3 ms delay, as is the case for single unit neuronal activity. On the other hand, when DBS is ON the models suggest that stimulation has a dominant effect on GPi LFPs which mask the inhibitory effects of GPe. PMID:21096635

  13. [Use of glutamine in total parenteral nutrition of bone marrow transplant patients].

    PubMed

    Herrera-Martínez, Aura Dulcinea; Alhambra Expósito, María R; Manzano García, Gregorio; Molina Puertas, María J; Calañas Continente, Alfonso; Bahamondez Opazo, Rodrigo; Muñoz Jiménez, Concepción; Rojas Contreras, Rafael; Gálvez Moreno, María A

    2015-04-01

    La glutamina es un amioácido esencial para la síntesis de nucleótidos y una fuente de energía para la replicación celular, existe evidencia contradictoria respecto a los beneficios de su administración como parte de la nutrición parenteral en pacientes sometidos a trasplante de médula ósea (TMO). Más del 75% de los pacientes sometidos a trasplante de precursores hematopoyéticos, presentan durante su evolución complicaciones que comprometen el tracto digestivo, principalmente mucositis, limitando la ingesta oral, de allí la necesidad del uso de nutrición parenteral total (NPT) en estos casos. Objetivo: Analizar la relación entre uso de glutamina en la NPT de TMO y la evolución de complicaciones agudas como mucositis, EICH e infecciones, así como la estancia hospitalaria y los días de nutrición parenteral total. Material y métodos: Estudio observacional retrospectivo. Se incluyeron la totalidad de TMO con NPT entre 2007 y 2013 en nuestro hospital. Se analizaron días de hospitalización, días de soporte nutricional, uso de glutamina y complicaciones agudas. Los resultados se analizaron con el programa SPSS 15.0. Resultados: Se incluyeron 73 pacientes trasplantados, se dividieron en dos grupos según el aporte de glutamina siendo ambos grupos comparables entre sí. La edad media fue de 36,96±12,89 años. El 47,9% de los pacientes estudiados recibió suplemento de glutamina en la NPT. Los pacientes que recibieron glutamina tuvieron una estancia media de 31,49±7,41 días con 14,11±5,87 días de NPT en comparación a los que no recibieron glutamina con 32,16±7,99 y 15,50±7,71 días respectivamente (p=0,71 y 0,39). La duración de la mucositis en los pacientes que recibieron glutamina fue de 12,23±5,66 días comparado con 15,50±7,71 días en los que no recibieron glutamina (p=0,042).Se observaron grados severos de EICH (II, III) en un 20,6% de los pacientes sin glutamina en comparación al 13,7% en los que la recibieron (p=0,636). . Del total

  14. Effects of Acute Sleep Deprivation Resulting from Night Shift Work on Young Doctors.

    PubMed

    Sanches, Inês; Teixeira, Fátima; dos Santos, José Moutinho; Ferreira, António Jorge

    2015-01-01

    Introdução: Avaliar a privação do sono e seus efeitos sobre os jovens médicos relativamente à capacidade de concentração e desempenho psicomotor. Material e Métodos: Dezoito médicos, com idades entre 26 - 33 anos, divididos em dois grupos: grupo sem privação de sono (sem trabalho nocturno) e grupo com privação de sono (no mínimo 12 horas de trabalho nocturno / semana). Aplicámos o Índice de Qualidade de Sono de Pittsburgh para rastrear a presença de patologia do sono e a Escala de Sonolência Epworth para avaliar subjectivamente a sonolência diurna; usamos actigrafia e o diário de sono para avaliar a higiene do sono e os ciclos de sono-vigília. Para demonstrar os efeitos da privação do sono, foi aplicado o teste de Toulouse-Piéron (teste de concentração) e uma bateria de trêstestes de tempo de reação após o período de trabalho nocturno. Resultados: O grupo com privação de sono apresentou maior sonolência diurna na Escala de Sonolência Epworth (p < 0,05) e durante a semana a privação de sono foi maior (p < 0,010). A duração média do sono durante o período de trabalho nocturno foi de 184,2 minutos para o grupo com privação de sono e 397,7 minutos para grupo sem privação de sono (p < 0,001). No teste Toulouse-Piéron o grupo com privação de sono apresentou maior número de omissões (p < 0,05) com um pior resultado no índice de concentração (p < 0,05). Os testes psicomotores que avaliaram a resposta a estímulos simples revelaram maior latência na resposta (p < 0,05) e mais erros (p < 0,05) no grupo com privação de sono; no teste de reacção a instrução o e grupo com privação de sono apresentou pior índice de perfeição (p < 0,05); no teste de movimentos finos não houve diferença estatisticamente significativa entre os grupos. Discussão: A privação de sono aguda resultante do trabalho nocturno em profissões médicas está associada a uma diminuição da atenção e concentração e no atraso de resposta

  15. [Clinical features of patients with influenza-like illness who went to a third level center in the winter of 2013-2014].

    PubMed

    Albarrán-Sánchez, Alejandra; Ramírez-Rentería, Claudia; Huerta-Montiel, Fernando; Martínez-Jerónimo, Angélica; Herrera-Landero, Alejandro; García-Álvarez, José Luis; Ortiz-Rodríguez, Elia; Palmas-Pineda, Lorena

    2016-01-01

    Introducción: el Centro para el Control y Prevención de Enfermedades (CDC, por sus siglas en inglés) registró, entre octubre de 2013 y abril de 2014, el pico más alto de casos relacionados con la influenza AH1N1. No todos los casos sospechosos de influenza resultan positivos, pero todos les generan costos a las instituciones. Nuestro objetivo fue describir las características de la población que acude con sospecha de influenza al Hospital de Especialidades del Centro Médico Nacional Siglo XXI durante una nueva epidemia. Métodos: estudio transversal de casos admitidos al servicio de Urgencias del hospital mencionado por sospecha de influenza de acuerdo con las guías de práctica clínica. Con base en estas se analizaron los factores asociados a la severidad de la infección. Resultados: se registraron 109 pacientes con promedio de 44 años edad; el 78 % de ellos tenía menos de 60 años; el 62 % fueron mujeres; 75 % tenía por lo menos un factor de riesgo como obesidad (26 %) o hipertensión (27 %). Solo 65 pacientes tuvieron prueba confirmatoria, 33.8 % fueron diagnóstico positivo y 21 % de ellos fallecieron. Conclusiones: la frecuencia de casos confirmados de influenza es baja. Los factores asociados a mortalidad en los casos confirmados son la presencia de hipertensión, de leucocitosis y la presentación clínica de insuficiencia respiratoria aguda grave (IRAG).

  16. [Acute pancreatitis and afferent loop syndrome. Case report].

    PubMed

    Barajas-Fregoso, Elpidio Manuel; Romero-Hernández, Teodoro; Macías-Amezcua, Michel Dassaejv

    2013-01-01

    Antecedentes: el síndrome de asa aferente se caracteriza por la obstrucción mecánica del asa aferente luego de la reconstrucción tipo Billroth II o en Y de Roux, en la mayoría de los casos secundaria a gastrectomía distal o subtotal. Caso clínico: paciente masculino de 76 años de edad, con antecedentes de: colecistectomía, adenocarcinoma gástrico seis años previos, gastrectomía subtotal y reconstrucción en Y de Roux. Inició con dolor abdominal, náusea y vómito; abdomen distendido, sin datos de irritación peritoneal. Amilasa 1246 U/L, lipasa 3381 U/L. La tomografía computada abdominal mostró dilatación y engrosamiento de la pared del asa aferente y el páncreas con incremento de tamaño. Se le diagnosticó pancreatitis aguda, originada por síndrome de asa aferente. Conclusiones: el síndrome de asa aferente aparece en 0.3 a 1% de los casos de pacientes con reconstrucción Billroth II, a consecuencia de la obstrucción mecánica del asa aferente, con mortalidad incluso de 57%. La obstrucción del intestino aferente por acumulación de secreción biliar, pancreática e intestinal incrementa la presión, que resulta en dilatación del asa aferente de la vía biliar y del conducto de Wirsung, lo que desencadena una respuesta inflamatoria que finaliza en un cuadro de pancreatitis. Su manifestación severa se relaciona con el grado y duración de la obstrucción.

  17. [The impact of neurological and medical complications on the mortality and functional situation of acute stroke patients].

    PubMed

    Bragado-Trigo, I; Portilla-Cuenca, J C; Falcon-Garcia, A; Fermin-Marrero, J A; Romero-Sevilla, R M; Redondo-Penas, M I; Gamez-Leyva, G; Serrano-Cabrera, A; Gomez, M; Calle-Escobar, M L; Jimenez-Caballero, P E; Casado-Naranjo, I

    2014-11-16

    Introduccion. Los pacientes con ictus presentan un elevado riesgo de presentar complicaciones. Su aparicion puede condicionar el pronostico del ictus. Estudiamos la frecuencia y el impacto de la aparicion de diversas complicaciones en el pronostico precoz y a medio plazo en estos pacientes. Pacientes y metodos. Estudio observacional de los pacientes ingresados en una unidad de ictus. Se registraron las complicaciones durante su estancia, distinguiendose entre complicaciones neurologicas y medicas. Se estudio la influencia de estas segun subtipo de ictus en la mortalidad intrahospitalaria y a los 90 dias, y en la situacion funcional a los 90 dias, analizandose los factores clinicos predictores para la aparicion de complicaciones. Resultados. Muestra de 847 pacientes. Un 29,5% de los pacientes presento complicaciones, que fueron mas frecuentes en el ictus hemorragico (50,5% frente a 26,6%; p < 0,0001). Las complicaciones mas habituales fueron las neurologicas (21%). Para ambos subtipos, la presencia de complicaciones se asocio a mayor mortalidad intrahospitalaria (2,1% frente a 12,6%; p < 0,0001) y a 90 dias (5,7% frente a 29,6%; p < 0,0001), y menor probabilidad de independencia a 90 dias (72,9% frente a 30,4%; p < 0,0001). La gravedad del ictus al ingreso se mostro como el predictor mas potente en la aparicion de cualquier tipo de complicacion. Conclusiones. La aparicion de complicaciones durante la fase aguda del ictus influye de forma adversa en la mortalidad y en el pronostico funcional. La identificacion de factores predictores podria disminuir el impacto sobre la evolucion del paciente con un ictus agudo.

  18. Profiles of paralytic shellfish toxins in bivalves of low and elevated toxicities following exposure to Gymnodinium catenatum blooms in Portuguese estuarine and coastal waters.

    PubMed

    Botelho, Maria João; Vale, Carlos; Ferreira, João Gomes

    2015-11-01

    Profiles of paralytic shellfish toxins (PSTs) were examined in 405 composite samples of Mytilus spp., Cerastoderma edule, Donax trunculus and Spisula solida collected between 2007 and 2012 from natural production areas in two estuaries (Aveiro and Mondego), two coastal lagoons (Óbidos and Formosa), and three open coastal areas (Aguda, Comporta and Culatra). Toxin concentrations were obtained from the biotoxin monitoring programme database. Episodes of PST toxicity in Portugal have been associated with Gymnodinium catenatum blooms. Toxin profiles for each species showed no trend over the surveyed years. In general, profiles differ only slightly among areas, except for Óbidos. However, toxin profiles in bivalves varied between low and elevated toxicities, corresponding to below and above the PST regulatory limit, respectively. The ratio R1=(C1+2):B1, which were the main toxins produced by G. catenatum cells, decreased considerably between elevated and low toxicity cockles, indicating the elimination of C1+2 or conversion of compounds into B1. R2=[(dcSTX)+(dcGTX2+3)]:[(C1+2)+(B1)], which represents the ratio of minor to major toxins in G. catenatum cells, increased substantially in wedge clams (D. trunculus) of low toxicity and less markedly in cockles (C. edule) and mussels (Mytilus spp.). These differences are interpreted as the predominance of a biotransformation phase after exposure to the algal bloom. The toxin profile of surf clams (S. solida) was dominated by decarbamoyl compounds, reflecting intense biotransformation during exposure to blooms. The higher ratio R2 in low toxicity samples suggests that elimination of the produced decarbamoyl toxins was slower than biotransformation.

  19. Effect of L-arginine supplementation on insulin resistance and adipocitokines levels in head and neck cancer non diabetic patients after surgery.

    PubMed

    de Luis, Daniel; Izaola, Olatz; de la Fuente, Beatriz; Aller, R

    2014-10-10

    Introducción: Alguntos trabajos han encontrado que la L-arginina induce efectos beneficiosos sobre la resistencia a la insulina, tanto en pacientes con diabetes tipo 2 como en individuos sanos. El objetivo de nuestro estudio fue investigar si la suplementación enteral de L-arginina (20 g por día) en pacientes con cáncer de cabeza y cuello puede modificar la resistencia a la insulina, los niveles de leptina y adiponectina después de la cirugía. Material y métodos: Tras la cirugía 82 pacientes fueron asignados aleatoriamente a dos grupos: grupo I recibió un enterales suplementos de dieta con una dosis alta de arginina (20 g por día) y el grupo II recibió una fórmula enteral sin arginina. En el momento basal y el día 10 tras la cirugia, se registraron los siguientes parámetros: glucosa, proteína C reactiva, insulina, HOMA (Homeostasis Model Assessment), leptina y adiponectina. Resultados: Los valores de peso, índice de masa corporal, la masa grasa y la masa libre de grasa se mantuvieron sin cambios durante la intervención nutricional aguda en ambos grupos. Los niveles de insulina UI/L (-0,21 + / -0,18) y HOMA (-0,07 + / -0,13) disminuyeron en el grupo de arginina. Los niveles de adiponectina (1,8 + / -2.3ng/ml) aumentaron en el grupo de arginina. Conclusión: La nutrición enteral con L-arginina a corto plazo en los pacientes afectados por cáncer de cabeza y cuello y tras cirugía es capaz de mejorar la resistencia a la insulina y los niveles de adiponectina.

  20. [Sigmoid diverticulitis in adolescent. Case report].

    PubMed

    Valenzuela-Salazar, Carlos; Orozco-Tapia, Luis Manuel; de la Concha Blankenagel, Erika; Gallardo-Ramírez, Mario Alberto; Blas-Franco, Miguel; Cárdenas-Lailson, Luis Eduardo

    2013-01-01

    Antecedentes: la enfermedad diverticular colónica en niños y adolescentes es poco frecuente y sólo existen reportes de casos aislados en la bibliografía. La mayoría de los casos reportados se asocian con divertículos verdaderos congénitos y enfermedades genéticas de producción de la colágena. Caso clínico: paciente femenina de 13 años de edad, que ingresó a la División de Cirugía General y Endoscópica con diagnóstico de apendicitis aguda complicada. En la laparotomía se encontró enfermedad diverticular complicada de colon sigmoides. Se le practicó sigmoidectomía y colorrecto-anastomosis. El reporte histopatológico evidenció perforación de pseudodivertículo de colon sigmoides y peritonitis. La paciente fue dada de alta del hospital 72 horas posteriores a la cirugía, sin complicaciones. Conclusión: existen sólo reportes de casos aislados de niños y adolescentes con diverticulitis colónica, y su etiología no ha sido aún debidamente establecida. Esta paciente tuvo diverticulitis de sigmoides, similar a la enfermedad en adultos, sin padecimientos genéticos concomitantes. El caso es una excepción a lo reportado en la bibliografía de las diverticulitis en niños y adolescentes.

  1. [Quality care in an intensive therapy unit at private hospital].

    PubMed

    Tejeda-Miranda, Mauricio; Anthon-Mendez, Francisco Javier; Esponda-Prado, Juan Gerardo; Rendón-Macías, Mario Enrique

    2015-01-01

    Introducción: el objetivo es evaluar la calidad de la atención en una unidad de terapia intensiva con índices internacionales de calidad. Métodos: estudio descriptivo, en una unidad de cuidados intensivos de atención privada en México. Se analizan los indicadores de 2012 con un total de 446 pacientes hospitalizados. Los indicadores de calidad fueron acordes a recomendaciones internacionales. La gravedad fue determinada por la escala SAPS III. Resultados: el indicador de neumonías asociadas a ventilación se encontró por debajo del estándar recomendado (11.7 frente a 12 por mil); la bacteremia relacionada a catéter venoso central en rangos aceptados (5.7 frente a 4 por mil). Las acciones de profilaxis de úlceras, prevención de tromboembolia pulmonar y prevención de caídas en altas proporciones de cumplimiento (> 90, > 95 % y 0 caídas). Las tasas de extubación no programada y reintubaciones estuvieron por debajo de los indicadores (< 1 por mil días intubación y < 12 %). La mortalidad fue menor a la estimada por la gravedad. Conclusión: En esta terapia la implementación de acciones recomendadas a nivel internacional ha permitido mantener una adecuada calidad de atención. El esfuerzo a impactado no solo a los pacientes con condiciones agudas de ingreso, sino también a pacientes con alto riesgo de mortalidad.

  2. [Surveillance of Haemophilus influenzae serotypes in Argentina from 2005 to 2010 during the Haemophilus influenzae type b conjugate vaccine era].

    PubMed

    Efron, Adriana M; Moscoloni, María A; Reijtman, Vanesa R; Regueira, Mabel

    2013-01-01

    The introduction of the Haemophilus influenzae type b vaccine in the immunization programs of many countries has greatly reduced this invasive disease and the carriage caused by this serotype, also increasing other capsular types and non-capsular isolations. There were 313 isolations of H. influenzae under study, which were recovered from a sterile site coming from pediatric and adult patients carrying the invasive disease. Patients were treated at 90 different hospitals belonging to the Red Nacional de Laboratorios para Meningitis e Infecciones Respiratorias Agudas Bacterianas (National Lab Network for Meningitis and Acute Bacterial Respiratory Infections) from 2005 to 2010 for the following disorders: pneumonia, 40.3% (n=126), meningitis, 30.0% (n=94) and bacteremia, 26.5% (n=83). In pediatric patients (n=279), the highest frequency of isolations corresponded to children under the age of 2 years, 74.5% (n=208). Regarding type distribution, 61.3% corresponded to non-capsular H. influenzae (n=192), 20.1% to type b (n=63), 11.2% to type a (n=35), 4.8% to type f, and 2.6% to other types. Capsular H. influenzae was predominant in meningitis whereas non-capsular H. influenzae in pneumonia and bacteremia. The biotype was determined in 306 isolations. The totality (100%) of type a (n=35) was biotype II whereas 66.7% of type b (n=63) was biotype I. Slide agglutination and PCR tests were used in 220 isolations. There was a match of 0.982 (IC: 0.92-1.00) between them. During the last year, there was a great increase in type b, showing the importance of clinical and laboratory-based surveillance of the invasive disease caused by H. influenzae.

  3. [Acute coronary syndromes in Latin America: lessons from the ACCESS registry].

    PubMed

    Martínez-Sánchez, Carlos; Jerjes-Sánchez, Carlos; Nicolau, José Carlos; Bazzino, Oscar; Antepara, Norka; Mármol, Ricardo

    2016-01-01

    Introducción: se desconocen las características, la evolución y el tratamiento de pacientes latinoamericanos con síndromes coronarios agudos (SCA). Métodos: registro internacional multicéntrico y prospectivo para evaluar riesgo, terapéutica y evolución en SCA. Punto primario: toda causa de mortalidad durante el primer año y mortalidad a 30 días. Ingresaron pacientes con síntomas de isquemia coronaria aguda en las primeras 24 horas del inicio de los síntomas y evidencia electrocardiográfica de isquemia. El diagnóstico final requirió pruebas invasivas o no invasivas. Resultados: entre el 2007 y 2008 se ingresaron en ocho países latinoamericanos 4436 pacientes, 2562 con angina inestable o infarto sin elevación del ST y 2374 con infarto con elevación del ST. Al ingreso tuvieron síntomas agudos 79 y 90 %, respectivamente. Ambos grupos tuvieron retraso entre el inicio de síntomas y el ingreso hospitalario. En infarto y elevación del ST se observó baja accesibilidad a reperfusión farmacológica (29 %) y mecánica (32 %). Al ingreso en ambos el porcentaje de tratamiento basado en evidencia fue bajo. Las complicaciones hospitalarias fueron la insuficiencia cardiaca (angina inestable e infarto sin elevación del ST 10 % y el infarto con elevación del ST 20 %) e isquemia recurrente (8 y 11 %). La mortalidad a 30 días fue 2 % y a un año 8 %. Conclusiones: el registro ACCESS ofrece información contemporánea sobre el espectro de pacientes, el manejo hospitalario y la evolución clínica subsecuente.

  4. [Metabolic myopathies].

    PubMed

    Papazian, Óscar; Rivas-Chacón, Rafael

    2013-09-06

    Objetivo. Revisar las miopatias metabolicas manifestadas solamente por crisis de mialgias, calambres y rigidez musculares con dificultad para contraer los musculos afectados y el examen neurologico normal entre las crisis en niños y adolescentes. Desarrollo. Estas miopatias metabolicas se deben a deficits enzimaticos heredados en forma autosomica recesiva del metabolismo de los carbohidratos y lipidos. El resultado final es una reduccion del trifosfato de adenosina principalmente a traves de la fosforilacion oxidativa mitocondrial con disminucion de la energia disponible para la contraccion muscular. Las secundarias a trastornos del metabolismo de los carbohidratos se producen por ejercicios de alta intensidad y breves (< 10 min) y las secundarias a trastornos de los lipidos, por ejercicios de baja intensidad y prolongados (> 10 min). Los deficits enzimaticos en el primer grupo son de miofosforilasa (glucogenosis V), fosfofructocinasa muscular (glucogenosis VII), fosfoglicerato mutasa 1 (glucogenosis X) y beta enolasa (glucogenosis XIII), y en el segundo, de carnitina palmitol transferasa tipo II y de acil-CoA deshidrogenasa de cadena muy larga. Conclusiones. Las caracteristicas diferenciales de los pacientes en cada grupo y dentro de cada grupo permitiran el diagnostico clinico presuntivo inicial en la mayoria y solicitar solamente los examenes necesarios para corroborar el diagnostico. El tratamiento de las crisis consiste en hidratacion, glucosa y alcalinizacion de la orina. Las medidas preventivas son evitar el tipo de ejercicio que induce las crisis y el ayuno. No existe cura o tratamiento especifico. El pronostico es bueno con la excepcion de casos raros de insuficiencia renal aguda debido a la elevacion sanguinea de la mioglobina producto de una rabdomiolisis grave.

  5. [Small infundibulectomy versus ventriculotomy in tetralogy of Fallot].

    PubMed

    Bojórquez-Ramos, Julio César

    2013-01-01

    Introducción: en la corrección quirúrgica de la tetralogía de Fallot existe uniformidad en la forma de cerrar el defecto septal, pero variedad en cómo ampliar el tracto de salida del ventrículo derecho, por lo que se compara la evolución clínica posoperatoria temprana de la ampliación del tracto de salida del ventrículo derecho con ventriculotomía clásica e infundibulectomía minima. Métodos: análisis de la base de datos de un servicio de cardiocirugía pediátrica de 2008 a 2011. Se eligieron pacientes con tetralogía de Fallot no compleja sometidos a corrección completa mediante ventriculotomía clásica o infundibulectomía minima. Para el análisis estadístico se obtuvo Anova, χ(2) y prueba exacta de Fisher. Resultados: 55 % fue del sexo masculino, la edad media fue de 43 meses, la ventriculotomía clásica se realizó en 61.7 %, con la que se tuvo mayor nivel máximo de lactato (9.07 adversus 6.8 mmo/L), de magnitud en el índice hemorragia/kg en las primeras 12 horas (39.1 adversus 20.3 mL/kg), de mortalidad (31.03 adversus 5.6 %), de complicaciones exclusivas como insuficiencia renal aguda, hemoneumotórax, neumonía, bloqueo auriculoventricular permanente y falla orgánica múltiple. Conclusiones: la morbimortalidad fue mayor con la ventriculotomía clásica, relacionada posiblemente con el mayor volumen de sangrado.

  6. [Differences in the management of epileptic seizures between the elderly and younger adults treated in an emergency department].

    PubMed

    Fernandez-Alonso, C; Matias-Guiu, J A; Castillo, C; Fuentes-Ferrer, M E; Gonzalez-Del Castillo, J; Martin-Sanchez, F J

    2014-09-16

    Objetivo. Estudiar las diferencias en el manejo y los resultados a corto plazo de los pacientes adultos atendidos en un servicio de urgencias por una crisis epileptica en funcion de ser anciano. Pacientes y metodos. Estudio observacional de cohorte retrospectivo que selecciono a todos los pacientes de 15 años o mas atendidos por una crisis epileptica en un servicio de urgencias de un hospital terciario y universitario desde el 1 de septiembre al 31 de diciembre de 2011. Se recogieron las variables de la atencion aguda y de seguimiento a los 30 dias del episodio indice de urgencias. Resultados. Se incluyeron 114 pacientes con una mediana de edad de 46,4 años (rango intercuartilico: 32,6-74,3 años), de los cuales 34 (29,8%) tenian 65 años o mas. El grupo de los mayores presento mas frecuentemente un primer episodio epileptico (p = 0,001), desencadenante desconocido (p = 0,02), etiologia estructural (p < 0,001), realizacion de tomografia computarizada en urgencias (p < 0,001), inicio de farmaco antiepileptico preventivo en urgencias (p = 0,001) y estancia prolongada (p = 0,002) que los adultos mas jovenes. Tras un analisis multivariable, el ser anciano fue un factor independiente asociado a un mayor requerimiento de pruebas complementarias especificas (Odds ratio = 3,7; intervalo de confianza al 95% = 1,3-10,3) e intervencion farmacologica en urgencias (odds ratio = 3,3; intervalo de confianza al 95% = 1,4-8,1). No hubo diferencias estadisticamente significativas en los resultados a 30 dias entre ambos grupos en terminos de revisita (p = 0,316) y mortalidad (p = 0,087). Conclusiones. La atencion de las crisis epilepticas del anciano en urgencias, en comparacion con adultos mas jovenes, es mas compleja, siendo necesario un mayor consumo de recursos hospitalarios.

  7. [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.

  8. MicMac GIS application: free open source

    NASA Astrophysics Data System (ADS)

    Duarte, L.; Moutinho, O.; Teodoro, A.

    2016-10-01

    The use of Remotely Piloted Aerial System (RPAS) for remote sensing applications is becoming more frequent as the technologies on on-board cameras and the platform itself are becoming a serious contender to satellite and airplane imagery. MicMac is a photogrammetric tool for image matching that can be used in different contexts. It is an open source software and it can be used as a command line or with a graphic interface (for each command). The main objective of this work was the integration of MicMac with QGIS, which is also an open source software, in order to create a new open source tool applied to photogrammetry/remote sensing. Python language was used to develop the application. This tool would be very useful in the manipulation and 3D modelling of a set of images. The main objective was to create a toolbar in QGIS with the basic functionalities with intuitive graphic interfaces. The toolbar is composed by three buttons: produce the points cloud, create the Digital Elevation Model (DEM) and produce the orthophoto of the study area. The application was tested considering 35 photos, a subset of images acquired by a RPAS in the Aguda beach area, Porto, Portugal. They were used in order to create a 3D terrain model and from this model obtain an orthophoto and the corresponding DEM. The code is open and can be modified according to the user requirements. This integration would be very useful in photogrammetry and remote sensing community combined with GIS capabilities.

  9. [High performance of an implantable Holter monitor in the detection of concealed paroxysmal atrial fibrillation in patients with cryptogenic stroke and a suspected embolic mechanism].

    PubMed

    Rojo-Martinez, Esther; Sandín-Fuentes, María; Calleja-Sanz, Ana I; Cortijo-García, Elisa; García-Bermejo, Pablo; Ruiz-Piñero, Marina; Rubio-Sanz, Jerónimo; Arenillas-Lara, Juan F

    2013-09-16

    Introduccion. El holter implantable permite detectar fibrilacion auricular paroxistica (FAP) oculta en pacientes con ictus criptogenico, pero se desconoce que algoritmo de seleccion tiene un mayor rendimiento y la duracion optima de monitorizacion. Objetivo. Conocer la frecuencia y el tiempo hasta detectar la FAP mediante un holter implantable Reveal XT ® en pacientes con ictus criptogenico seleccionados por sospecha elevada de embolismo cerebral. Pacientes y metodos. Criterios de seleccion: ausencia de etiologia del ictus tras el estudio completo incluyendo un ecocardiograma transesofagico, monitorizacion ECG y holter de 24 horas, asi como confirmacion de oclusion aguda embolica de la arteria intracraneal por duplex transcraneal o bien alta sospecha de embolismo por caracteristicas de neuroimagen. Tras implantar el holter Reveal XT se formo a los pacientes para que emprendieran transmisiones todos los meses o ante sintomas. Se reviso la informacion online mensualmente y se realizaron visitas clinicas en las unidades de Neurologia y Cardiologia. Resultados. Se incluyeron 101 pacientes con ictus criptogenico y al menos un mes de seguimiento: edad media de 67 años, 54 mujeres (53,5%). Tiempo medio de seguimiento: 281 ± 212 dias. Se detecto FAP oculta en 34 pacientes (33,7%) y falsos positivos en 23 (22,8%). Mediana desde el implante hasta la deteccion de la arritmia: 102 dias (rango: 26-240 dias). En un 70% de los pacientes se registraron multiples episodios de FAP. El 75% de los eventos se detectaron durante los primeros seis meses de monitorizacion. Conclusiones. El algoritmo de seleccion de pacientes con ictus criptogenico segun sospecha de embolismo cerebral se asocio a una elevada frecuencia (33,7%) de FAP oculta con holter implantable. Uno de cada cuatro eventos sucedio tras los primeros seis meses de monitorizacion.

  10. [Acute silicosis. An infrequent pneumoconiosis].

    PubMed

    Méndez-Vargas, María Martha; Soto-de la Fuente, Andrés Eduardo; Soto-Vera, Eduardo Andrés; Leo-Méndez, Rodolfo

    2015-01-01

    Introducción: la silicosis aguda fue descrita inicialmente en 1900 por Betts. Se le denomina también silicoproteinosis alveolar. Es una forma infrecuente de neumoconiosis producida al utilizar chorro de arena (sandblast) para pulir. Caso clínico: masculino de 27 años, trabajó 4 años en un expendio de vidrios, esmerilándolos por medio de chorro de arena. Padecimiento de 4 años con disnea de esfuerzos rápidamente progresiva hasta mínimos esfuerzos, tos seca, emetizante y disneizante, con expectoración hialina 50 ml diarios, pérdida de 20 kg de peso en 1 año y dolor torácico generalizado de tipo pungitivo intenso. Frecuencia respiratoria 36X´ frecuencia cardiaca 120X´, estertores crepitantes basales bilaterales. En la telerradiografía de tórax se observa festón de Mengeaux en hemidiafragma derecho y en el vértice derecho, opacidades redondeadas entre 3 y 10 mm de diámetro tipo 2/2 r/r de la Clasificación de la OIT, 2000. En el pulmón izquierdo las opacidades confluyen formando un silicoma tipo B e imágenes en panal de abeja. Silueta cardiaca deshilachada y cardiomegalia grado 1. Fallece a los 5 años de iniciado su padecimiento. Conclusiones: se deben prohibir estas operaciones o aplicar programa de higiene industrial con uso de respirador autónomo.

  11. Dietary intake of ain-93 standard diet induces Fatty liver with altered hepatic fatty acid profile in Wistar rats.

    PubMed

    Farias Santos, Juliana; Suruagy Amaral, Monique; Lima Oliveira, Suzana; Porto Barbosa, Júnia; Rego Cabral-Jr, Cyro; Sofia Melo, Ingrid; Bezerra Bueno, Nassib; Duarte Freitas, Johnatan; Goulart Sant'ana, Antônio; Rocha Ataíde, Terezinha

    2015-05-01

    Introducción: En la investigación científica, hay varias dietas estándar para los animales, generalmente concebidas por instituciones científicas. La dieta AIN-93 es ampliamente utilizada, pero hay algunos informes de esteatosis hepática en ratones Wistar alimentadas con esta dieta. Objetivo: Evaluar las repercusiones hepáticas de la ingesta de la dieta estándar AIN-93 en ratones Wistar. Métodos: Cuarenta recién destetados, ratones Wistar machos, con 21 días de edad fueron alimentados con la dieta AIN-93 o una dieta comercial, durante 1 mes o 4 meses. El aumento de peso, la bioquímica sérica, la histología hepática y el perfil de ácidos grasos hepáticos fueron analizados. Resultados: Se observó esteatosis hepática, especialmente en el grupo alimentado con la dieta AIN-93. Glucosa en suero, peso absoluto y relativo del hígado y los niveles hepáticos de ácidos grasos oleico, palmitoleico, esteárico y palmítico se relacionaron con la esteatosis observada, mientras el lipidograma y los marcadores sanguíneos de la función hepática, no se relacionaron. Conclusión: La dieta estándar AIN-93 causó esteatosis hepática aguda en ratones Wistar, que puede comprometer su uso como una dieta estándar para los estudios experimentales con roedores. El perfil de ácidos grasos hepáticos se asoció con la esteatosis, con posibles implicaciones para el pronóstico de la enfermedad.

  12. [Analysis of a series of cases with an initial diagnosis of acute disseminated encephalomyelitis over the period 2000-2010].

    PubMed

    Rodríguez-Fernández, Cristina; López-Marín, Laura; López-Pino, Miguel Ángel; Gutiérrez-Solana, Luis G; Soto-Insuga, Víctor; Conejo-Moreno, David

    2013-10-01

    Introduccion. La encefalomielitis aguda diseminada (EMAD) es una enfermedad desmielinizante que afecta fundamentalmente a la sustancia blanca del sistema nervioso central. El diagnostico se basa en hallazgos clinicorradiologicos y evolutivos. La resonancia magnetica cerebral es la herramienta diagnostica mas util. El curso suele ser monofasico y el tratamiento inicial de eleccion, los corticoides. Pacientes y metodos. Estudio retrospectivo de 18 pacientes con diagnostico de sospecha inicial de EMAD. Se analizo la sintomatologia, los hallazgos radiologicos, la evolucion y el tratamiento. El diagnostico definitivo se establecio en 12 pacientes, excluyendo un paciente con reaccion en cadena de la polimerasa positiva para el virus herpes simple en el liquido cefalorraquideo, uno con clinica compatible pero resonancia magnetica cerebral normal, y cuatro con inicio similar a EMAD cuyos diagnosticos definitivos fueron: sindrome de Rassmusen, sindrome hemofagocitico, tumor cerebral y MELAS (encefalomiopatia mitocondrial con acidosis lactica y accidentes cerebrovasculares). Resultados. La mediana de edad fue de 31 meses, sin predominio de sexo. La infeccion de la via respiratoria superior fue la causa mas frecuente en niños mayores y la gastrointestinal, en menores de 2 años. Todos presentaron alteracion en el nivel de conciencia y deficits neurologicos multifocales. El hallazgo radiologico mas frecuente fue la alteracion multifocal bihemisferica de la sustancia blanca. Los corticoides fueron el tratamiento de eleccion en la mayoria. La evolucion fue favorable en casi todos los pacientes excepto en dos, que tuvieron secuelas importantes. Conclusiones. La EMAD puede presentarse a cualquier edad, incluyendo lactantes. Hay multiples entidades que pueden simular una EMAD en un inicio.

  13. [Mucha-Habermann disease and orthotopic heart transplant. Case report].

    PubMed

    Zetina-Tun, Hugo; de la Cerda-Belmont, Gustavo Armando; Lezama-Urtecho, Carlos Alberto; Careaga-Reyna, Guillermo

    2013-01-01

    Introducción: la enfermedad de Mucha-Habermann es la afección cutánea de etiología desconocida más frecuente en los pacientes jóvenes. Se caracteriza por la erupción aguda de lesiones papulares que evolucionan a vesículas, pústulas y cicatrices deprimidas hiperpigmentadas de aspecto varioliforme. Su curso habitual es subagudo o crónico. El objetivo es describir la enfermedad de Mucha-Habermann en un hombre con trasplante ortotópico de corazón. Caso clínico: hombre de 62 años de edad que cuatro años después de recibir trasplante de corazón presentó lesiones papulares diseminadas en cuello y miembros torácicos, las cuales se extendieron al resto del cuerpo y evolucionaron a vesículas y pústulas. Se obtuvo biopsia de piel y se conformó el diagnóstico de enfermedad de Mucha-Habermann. El paciente recibió tratamiento con esteroide y antimicrobiano, al que respondió favorablemente. Al momento de este informe, las lesiones habían desaparecido. Conclusiones: la enfermedad de Mucha-Habermann es poco frecuente y requiere confirmación mediante biopsia de piel para tratarla adecuadamente. El caso que se describe es poco común por el tipo de paciente y la edad en que se manifestó la enfermedad.

  14. [Etanercept on steroid-refractary acute graft-versus-host disease].

    PubMed

    González Munguía, Silvia; Pérez León, Moisés; Piñero González, Marta; Díaz Pestano, Marina Magnolia; Molero Gómez, Rafael; Luzardo Henríquez, Hugo Daniel

    2015-05-01

    Objetivo: Describir el uso y la efectividad de etanercept como terapia en la enfermedad de injerto contra huésped refractaria a corticoides tras el trasplante alogénico de progenitores hematopoyéticos. Método: Se seleccionaron los pacientes en los que se utilizó etanercept fuera de indicación para el tratamiento de la enfermedad de injerto contra huésped y se revisaron retrospectivamente sus historias clínicas para evaluar la respuesta al tratamiento. Resultados: De un total fueron cinco pacientes tratados cuatro presentaban enfermedad con afectación digestiva y otro con manifestación pulmonar y hepática. En el 80% de los casos se alcanzó alguna respuesta clínica: 60% respuesta parcial y 20% respuesta completa. En cuatro pacientes se utilizo etanecept 25mg dos veces por semana con duración variable, obteniendo una respuesta nula en uno (3 semanas), parcial en dos (4 y 8 semanas) y total en otro (8 semanas). Sólo en un caso se usó etanercept 50mg dos veces en semana durante 5 semanas con respuesta parcial. Conclusiones: Los resultados obtenidos de respuesta clínica son coherentes con los publicados previamente y vienen a incrementar la escasa bibliografía sobre la utilidad de etanercept en el tratamiento en la enfermedad de injerto contra huésped aguda y refractaria a corticoides. Dadas las limitaciones del diseño y el reducido número de pacientes, estudios controlados deberán evaluar en el futuro la eficacia y la seguridad de etanercept en estos pacientes.

  15. [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.

  16. [Maternal mortality rate in the Aurelio Valdivieso General Hospital: a ten years follow up].

    PubMed

    Noguera-Sánchez, Marcelo Fidias; Arenas-Gómez, Susana; Rabadán-Martínez, Cesar Esli; Antonio-Sánchez, Pedro

    2013-01-01

    Antecedentes: en México, la mortalidad materna ha disminuido en las últimas décadas. En Oaxaca esto no se ha manifestado porque se incrementó la tasa de mortalidad materna. Este estado se ubica entre las entidades con más muertes maternas. Objetivo: analizar 10 años de mortalidad materna en el Hospital General Dr. Aurelio Valdivieso de los Servicios de Salud de Oaxaca, para conocer el comportamiento epidemiológico y caracterización de los decesos. Material y métodos: estudio retrospectivo, transversal y descriptivo efectuado mediante la revisión de expedientes clínicos de mortalidad materna en la División de Gineco-Obstetricia. Se consideraron variables sociales, obstétricas y circunstanciales y las comprobaciones se efectuaron con estadística general y descriptiva. Resultados: entre el 1 de enero de 2000 y el 31 de diciembre de 2009 se registraron 109 muertes maternas, excluidas dos que no fueron obstétricas; es decir, que hubo 107 muertes maternas: 75 directas y 32 indirectas. La tasa de mortalidad materna fue de 172.14 × 100,000 nacidos vivos. De las muertes maternas revisadas 89 pudieron evitarse (83%) y 18 no (17%), esto con base en el dictamen del Comité ad hoc del Hospital General Dr. Aurelio Valdivieso. La enfermedad hipertensiva aguda del embarazo fue la de mayor mortalidad; la escolaridad y el puerperio ueron el mayor riesgo. Conclusiones: las variables atribuibles a bajo índice de desarrollo humano, como: baja escolaridad y paridad elevada incrementaron el riesgo de mortalidad materna, que fue intrahospitalaria y durante el puerperio. La tasa de mortalidad materna fue la mayor encontrada en publicaciones nacionales con respecto a este referente.

  17. [Physical activity by pregnant women and its influence on maternal and foetal parameters; a systematic review].

    PubMed

    Aguilar Cordero, M J; Sánchez López, A M; Rodríguez Blanque, R; Noack Segovia, J P; Pozo Cano, M D; López-Contreras, G; Mur Villar, N

    2014-10-01

    Introducción: Las múltiples ventajas que aporta a la salud la práctica de una actividad física de forma continuada son conocidas. Aunque es importante en todas las etapas de la vida, cuando llega la gestación aparecen algunas dudas sobre la conveniencia de realizar ejercicio físico, así como del tipo de actividad, de su frecuencia, intensidad y duración. Objetivo: Analizar los principales estudios sobre la influencia de la actividad física sobre los parámetros materno- fetales. Método: Revisión sistemática de programas de actividad física destinados a las mujeres embarazadas y sus resultados durante el embarazo, el parto y el postparto. Se identificaron 45 artículos a través de la búsqueda automatizada en las bases de datos PUBMED, Scopus y Google Scholar; se llevó a cabo entre los meses de octubre de 2013 y marzo de 2014. Para seleccionar los artículos fue preciso considerar la utilidad y la relevancia del tema estudiado y la credibilidad o experiencia de los autores en la temática. Se tuvo en cuenta la validez interna y externa de cada uno de los artículos revisados. Conclusiones: Los resultados de la revisión ponen de manifiesto la importancia de la actividad física durante el periodo gestacional y se constata que la información disponible en la actualidad puede servir de referente inicial para continuar profundizando en los resultados que sobre la salud materno fetal tiene la práctica de actividad física en el medio acuático.

  18. The current practice trends in pediatric bone-anchored hearing aids in Canada: a national clinical and surgical practice survey

    PubMed Central

    2013-01-01

    Background Since the introduction of bone-anchored hearing aids (BAHAs) in the 1980s, the practices of surgeons who implant these hearing aids have become varied; different indications and surgical techniques are utilized depending on the surgeon and institution. The objective of the current study is to describe the clinical and surgical practices of otolaryngologists in Canada who perform pediatric BAHA operations. Methods A detailed practice questionnaire was devised and sent to all members of the Canadian Society of Otolaryngology-Head and Neck Surgery. Those who performed pediatric BAHA surgeries were asked to participate. Results Twelve responses were received (response rate of 80%). All of the respondents identified congenital aural atresia to be an indication for pediatric BAHAs. Other indications were chronic otitis externa or media with hearing loss (92%), allergic reactions to conventional hearing aids (75%), congenital fixation or anomaly of ossicular chain (67%), and unilateral deafness (25%). Minor complications, such as skin reactions, were reported in 25% of cases, while major complications were very rare. There was great variability with regards to surgical techinque and post-operative management. The extent of financial support for the BAHA hardware and device also varied between provinces, and even within the same province. Conclusion There is a lack of general consensus regarding pediatric BAHA surgeries in Canada. With such a small community of otolaryngologists performing this procedure, we are hopeful that this survey can serve as an impetus for a national collaboration to establish a set of general management principles and inspire multi-site research ventures. PMID:23815797

  19. Parvalbumin-immunoreactive neurons in the hippocampal formation of Alzheimer's diseased brain.

    PubMed

    Brady, D R; Mufson, E J

    1997-10-01

    The number and topographic distribution of immunocytochemically stained parvalbumin interneurons was determined in the hippocampal formation of control and Alzheimer's diseased brain. In control hippocampus, parvalbumin interneurons were aspiny and pleomorphic, with extensive dendritic arbors. In dentate gyrus, parvalbumin cells, as well as a dense plexus of fibers and puncta, were associated with the granule cell layer. A few cells also occupied the molecular layer. In strata oriens and pyramidale of CA1-CA3 subfields, parvalbumin neurons gave rise to dendrites that extended into adjacent strata. Densely stained puncta and beaded fibers occupied stratum pyramidale, with less dense staining in adjacent strata oriens and radiatum. Virtually no parvalbumin profiles were observed in stratum lacunosum-moleculare or the alveus. Numerous polymorphic parvalbumin neurons and a dense plexus of fibers and puncta characterized the deep layer of the subiculum and the lamina principalis externa of the presubiculum. In Alzheimer's diseased hippocampus, there was an approximate 60% decrease in the number of parvalbumin interneurons in the dentate gyrus/CA4 subfield (P<0.01) and subfields CA1-CA2 (P<0.01). In contrast, parvalbumin neurons did not statistically decline in subfields CA3, subiculum or presubiculum in Alzheimer's diseased brains relative to controls. Concurrent staining with Thioflavin-S histochemistry did not reveal degenerative changes within parvalbumin-stained profiles. These findings reveal that parvalbumin interneurons within specific hippocampal subfields are selectively vulnerable in Alzheimer's disease. This vulnerability may be related to their differential connectivity, e.g., those regions connectionally related to the cerebral cortex (dentate gyrus and CA1) are more vulnerable than those regions connectionally related to subcortical loci (subiculum and presubiculum).

  20. EXPRESSION AND FUNCTION OF THE BILE ACID RECEPTOR GPBAR1 (TGR5) IN THE MURINE ENTERIC NERVOUS SYSTEM

    PubMed Central

    Poole, Daniel P.; Godfrey, Cody; Cattaruzza, Fiore; Cottrell, Graeme S.; Kirkland, Jacob G.; Pelayo, Juan Carlos; Bunnett, Nigel W.; Corvera, Carlos U.

    2010-01-01

    Background Bile acids (BAs) regulate cells by activating nuclear and membrane-bound receptors. GpBAR1 is a membrane-bound G-protein-coupled receptor that can mediate the rapid, transcription-independent actions of BAs. Although BAs have well-known actions on motility and secretion, nothing is known about the localization and function of GpBAR1 in the gastrointestinal tract. Methods We generated an antibody to the C-terminus of human GpBAR1, and characterized the antibody by immunofluorescence and Western blotting of HEK293-GpBAR1-GFP cells. We localized GpBAR1 immunoreactivity (IR) and mRNA in the mouse intestine, and determined the mechanism by which BAs activate GpBAR1 to regulate intestinal motility. Key Results The GpBAR1 antibody specifically detected GpBAR1-GFP at the plasma membrane of HEK293 cells, and interacted with proteins corresponding in mass to the GpBAR1-GFP fusion protein. GpBAR1-IR and mRNA were detected in enteric ganglia of the mouse stomach and small and large intestine, and in the muscularis externa and mucosa of the small intestine. Within the myenteric plexus of the intestine, GpBAR1-IR was localized to ~50% of all neurons and to >80% of inhibitory motor neurons and descending interneurons expressing nitric oxide synthase. Deoxycholic acid, a GpBAR1 agonist, caused a rapid and sustained inhibition of spontaneous phasic activity of isolated segments of ileum and colon by a neurogenic, cholinergic and nitrergic mechanism, and delayed gastrointestinal transit. Conclusions and Inferences GpBAR1 is unexpectedly expressed in enteric neurons. BAs activate GpBAR1 on inhibitory motor neurons to release nitric oxide and suppress motility, revealing a novel mechanism for the actions of BAs on intestinal motility. PMID:20236244

  1. [Bibliometric analysis of Revista Médica del IMSS in the Scopus database for the period between 2005-2013].

    PubMed

    García-Gómez, Francisco; Ramírez-Méndez, Fernando

    2015-01-01

    Objetivo: analizar la visibilidad de la Revista Médica del Instituto Mexicano del Seguro Social (Rev Med Inst Mex Seguro Soc) en la base de datos Scopus y describir los principales indicadores bibliométricos cuantitativos de la producción científica publicados durante el periodo 2005-2013. Métodos: para el análisis se utilizó la base de datos Scopus y se limitó el periodo de búsqueda a los años 2005-2013. La estrategia de búsqueda se ejecutó en los campos específicos de Título de la Publicación (Source Title) con el término Revista Médica del Instituto Mexicano del Seguro Social y sus posibles variantes, asícomo el número ISSN de la revista. Para el análisis de los datos obtenidos se utilizaron las herramientas de Scopus y los programas Excel y Access. Resultados: se encontraron 864 trabajos publicados durante el periodo 2005-2013 que fueron incluidos en Scopus. Se identificaron los autores con mayor producción científica y mayor número de citas acumuladas a sus trabajos, asícomo las principales revistas que citan a la Rev Med Inst Mex Seguro Soc. Se describen las principales áreas temáticas, tipos de documentos y otros indicadores bibliométricos que caracterizan a la publicación. Conclusiones: el uso de Scopus brinda la posibilidad de analizar con una herramienta externa al IMSS la visibilidad de la producción científica publicada en la Revista Médica del IMSS, además de que contribuye a identificar el estado de la ciencia en México y de los países en vías desarrollo.

  2. Lessons Learnt from Post-Infectious IBS

    PubMed Central

    Sarna, Sushil K.

    2011-01-01

    The development of IBS symptoms – altered bowel function and abdominal cramping in a subset of adult subjects exposed to severe enteric infections opened up an unprecedented opportunity to understand the etiology of this poorly understood disorder. Perhaps, for the reasons that these symptoms follow a severe enteric infection, and mucosal biopsy tissues are readily available, the focus of most studies thus far has been to show that mild/low-grade mucosal inflammation persisting after the initial infection has subsided causes the IBS symptoms. Parallel studies in non-infectious IBS patients, who did not have prior enteritis, showed similar mild mucosal inflammation. Together, these studies examined the mucosal infiltration of specific immune cells, increase of select inflammatory mediators, mast cell and enterochromaffin cell hyperplasia, and epithelial permeability. In spite of the fact that the data on these topics were not consistent among different studies and clinical trials with prednisone, fluoxetine, and ketotifen failed to provide relief of IBS symptoms, the predominant conclusions were that mild mucosal inflammation is the cause of IBS symptoms. However, the circular smooth muscle cells, and myenteric neurons are the primary regulators of gut motility function, while primary afferent neurons and CNS play essential roles in induction of visceral hypersensitivity – no explanation was provided as to how mild mucosal inflammation causes dysfunction in cells far removed. Accumulating evidence shows that mild mucosal inflammation in IBS patients is in physiological range. It has little deleterious effects on cells within its own environment and therefore it is unlikely to affect cells in the muscularis externa. This review discusses the disconnect between the focus on mild/low-grade mucosal inflammation and the potential mechanisms and molecular dysfunctions in smooth muscle cells, myenteric neurons, and primary afferent neurons that may underlie IBS

  3. Purinergic signalling in the enteric nervous system (An overview of current perspectives).

    PubMed

    King, Brian F

    2015-09-01

    Purinergic Signalling in the Enteric Nervous System involves the regulated release of ATP (or a structurally-related nucleotide) which activates an extensive suite of membrane-inserted receptors (P2X and P2Y subtypes) on a variety of cell types in the gastrointestinal tract. P2X receptors are gated ion-channels permeable to sodium, potassium and calcium. They depolarise cells, act as a pathway for calcium influx to activate calcium-dependent processes and initiate gene transcription, interact at a molecular level as a form of self-regulation with lipids within the cell wall (e.g. PIP2) and cross-react with other membrane-inserted receptors to regulate their activity (e.g. nAChRs). P2Y receptors are metabotropic receptors that couple to G-proteins. They may release calcium ions from intracellular stores to activate calcium-dependent processes, but also may activate calcium-independent signalling pathways and influence gene transcription. Originally ATP was a candidate only for NANC neurotransmission, for inhibitory motoneurons supplying the muscularis externa of the gastrointestinal tract and bringing about the fast IJP. Purinergic signalling later included neuron-neuron signalling in the ENS, via the production of either fast or slow EPSPs. Later still, purinergic signalling included the neuro-epithelial synapse-for efferent signalling to epithelia cells participating in secretion and absorption, and afferent signalling for chemoreception and mechanoreception at the surface of the mucosa. Many aspects of purinergic signalling have since been addressed in a series of highly-focussed and authoritative reviews. In this overview however, the current focus is on key aspects of purinergic signalling where there remains uncertainty and ambiguity, with the view to stimulating further research in these areas.

  4. Adrenergic β2-receptors mediates visceral hypersensitivity induced by heterotypic intermittent stress in rats.

    PubMed

    Zhang, Chunhua; Rui, Yun-Yun; Zhou, Yuan-Yuan; Ju, Zhong; Zhang, Hong-Hong; Hu, Chuang-Ying; Xiao, Ying; Xu, Guang-Yin

    2014-01-01

    Chronic visceral pain in patients with irritable bowel syndrome (IBS) has been difficult to treat effectively partially because its pathophysiology is not fully understood. Recent studies show that norepinephrine (NE) plays an important role in the development of visceral hypersensitivity. In this study, we designed to investigate the role of adrenergic signaling in visceral hypersensitivity induced by heterotypical intermittent stress (HIS). Abdominal withdrawal reflex scores (AWRs) used as visceral sensitivity were determined by measuring the visceromoter responses to colorectal distension. Colon-specific dorsal root ganglia neurons (DRGs) were labeled by injection of DiI into the colon wall and were acutely dissociated for whole-cell patch-clamp recordings. Blood plasma level of NE was measured using radioimmunoassay kits. The expression of β2-adrenoceptors was measured by western blotting. We showed that HIS-induced visceral hypersensitivity was attenuated by systemic administration of a β-adrenoceptor antagonist propranolol, in a dose-dependent manner, but not by a α-adrenoceptor antagonist phentolamine. Using specific β-adrenoceptor antagonists, HIS-induced visceral hypersensitivity was alleviated by β2 adrenoceptor antagonist but not by β1- or β3-adrenoceptor antagonist. Administration of a selective β2-adrenoceptor antagonist also normalized hyperexcitability of colon-innervating DRG neurons of HIS rats. Furthermore, administration of β-adrenoceptor antagonist suppressed sustained potassium current density (IK) without any alteration of fast-inactivating potassium current density (IA). Conversely, administration of NE enhanced the neuronal excitability and produced visceral hypersensitivity in healthy control rats, and blocked by β2-adrenoceptor antagonists. In addition, HIS significantly enhanced the NE concentration in the blood plasma but did not change the expression of β2-adrenoceptor in DRGs and the muscularis externa of the colon. The

  5. [Hypoplasia of internal carotid artery associated with carotid paraganglioma. A case report and review of the literature].

    PubMed

    Ruiz-Mercado, Héctor; Maldonado-Hernández, Héctor; Cruz-González, Juan Antonio

    2014-01-01

    Antecedentes: la hipoplasia de la arteria carótida interna es una rara malformación congénita. Se le ha relacionado principalmente con aneurismas y otros padecimientos, pero no con paraganglioma. Su incidencia es menor de 0.01% de todas las anomalías de los vasos carotídeos. Aunque su origen exacto no se conoce, se cree que es una secuela de una lesión provocada por causas mecánicas o por estrés hemodinámico; sin embargo, también pudieran estar implicados aspectos de biología molecular del desarrollo embrionario. Caso clínico: se describe un caso raro de una mujer de 37 años de edad con paraganglioma concomitante con hipoplasia de la arteria carótida interna. En estudios angiográficos y análisis rutinarios previos no se había detectado alteración de la arteria carótida interna. En la intervención se extirpó el tumor y se ligó la arteria carótida externa dado que estaba involucrada en la lesión; se dejó intacta la arteria carótida interna hipoplásica. Conclusión: es importante realizar estudios angiográficos de la base del cráneo, así como análisis hemodinámicos para no pasar por alto estas anomalías. La evolución fue satisfactoria y sin secuelas.

  6. Comportamiento dinámico de asteroides en la región 23 < a < 26 UA

    NASA Astrophysics Data System (ADS)

    López García, F.

    Los Kuiper Belt Objects (KBOs) pueden ser una fuente de origen de los cometas de corto período. Muchos de los KBOs observados parecen provenir, al igual que el sistema Pluton-Charonte, de órbitas resonantes con Neptuno. Los Centauros son objetos que dinámicamente provienen de órbitas inestables cuyo semieje mayor se encuentra entre las órbitas de Júpiter y Neptuno. Pudiera ser que estos cuerpos fueron expulsados desde la región del cinturón de Kuiper y se encuentran en un proceso de ``scattering" debido a los efectos gravitacionales de los planetas gigantes. Su tiempo de vida dinámico es de algunos millones de años. La evolución orbital de los objetos trans-Neptunianos nos permite conocer su comportamiento anterior, por eso, es importante su relación dinámica con la evolución orbital de Neptuno. El objeto de este trabajo es estudiar el comportamiento dinámico de partículas test que se encuentran entre las resonancias 3:2 con Neptuno y 2:3 con Urano, las cuales comprenden una región de 2 UA aproximadamente. Los primeros resultados indican que la mayoría de los objetos ficticios son eyectados hacia la parte externa del Sistema Solar, mientras que sólo una parte pequeña del total de objetos estudiados, aproximadamente un 7%, son eyectados hacia la parte interna del Sistema Solar, y en algunos casos sus órbitas pueden cruzar la órbita de los planetas terrestres.

  7. Epidemiology of Otologic Diagnoses in United States Emergency Departments

    PubMed Central

    Kozin, Elliott D.; Sethi, Rosh K.V.; Remenschneider, Aaron K.; Kaplan, Alyson; del Portal, Daniel A.; Gray, Stacey T.; Shrime, Mark G.; Lee, Daniel J.

    2015-01-01

    Objective Otologic complaints may place a significant burden on emergency departments (EDs) in the United States; however, few studies have comprehensively examined this discrete patient population. We aim to identify utilization of EDs by patients with primary otologic complaints. Study Design Retrospective analysis of the Nationwide Emergency Department Sample (NEDS) from 2009 through 2011. Methods The NEDS database was queried for patient encounters with a primary otologic diagnosis based on ICD9 codes (380–389). Weighted estimates for demographic, diagnostic characteristics, SES, and trends over time were extracted. Predictors of mortality and admission were determined by multivariable logistic regression. Results A weighted total of 8,611,282 visits between 2009 and 2011 were attributed to otologic diagnoses, representing 2.21% of all ED visits. Stratified by patient age, otologic diagnoses encompassed 1.01% and 6.79% of all adult and pediatric ED visits, respectively. The majority of patients were treated and released (98.17%). The average age of patients presenting with an otologic complaint was 17.9 years (Standard Error [SE] = 0.23). Overall, 62.7% of patients that presented with an otologic complaint were 0–17 years old. The most common diagnoses among all age groups included otitis media NOS (60.6%), infected otitis externa NOS (11.8%), and otalgia NOS (6.8%). Conclusions We provide a comprehensive overview of otologic complaints that are an overlooked diagnostic category in public health research. NEDS data demonstrates significant number of visits related to otologic complaints, especially in the pediatric population, that are non-emergent. PMID:25702897

  8. Determinação da composição química em nebulosas planetárias na direção do anticentro galáctico

    NASA Astrophysics Data System (ADS)

    Costa, R. D. D.; Uchida, M. M. M.; Maciel, W. J.

    2003-08-01

    Existe um gradiente radial de abundâncias no disco galáctico, cujo comportamento é razoavelmente bem conhecido para distâncias galactocêntricas entre 3 e 10 kpc. Foi obtido a partir de resultados derivados de nebulosas planetárias, regiões HII e estrelas, como as estrelas quentes de tipo O, B e aglomerados abertos. Com o objetivo de investigar o comportamento deste gradiente radial na região externa do disco, conhecida como anticentro galáctico, reportamos aqui os resultados finais da análise de uma amostra de nebulosas planetárias na direção do anticentro, observadas no LNA e no ESO entre 1995 e 2000. O uso de nebulosas planetárias permite o cálculo das abundâncias de elementos traçadores da evolução química do disco como oxigênio, argônio e neônio com o uso de técnicas de espectroscopia nebular. Os resultados indicam uma distribuição de abundâncias distinta daquela encontrada na vizinhança solar, mostrando que o gradiente radial diminui sensivelmente para distâncias galactocêntricas maiores que 10 kpc. Este resultado está de acordo com os mais recentes modelos de evolução química do disco, que prevêem uma diminuição ou mesmo um desaparecimento do gradiente radial no bordo externo do disco galáctico. (FAPESP/CNPq)

  9. Prediction of a neuropeptidome for the eyestalk ganglia of the lobster Homarus americanus using a tissue-specific de novo assembled transcriptome.

    PubMed

    Christie, Andrew E; Roncalli, Vittoria; Cieslak, Matthew C; Pascual, Micah G; Yu, Andy; Lameyer, Tess J; Stanhope, Meredith E; Dickinson, Patsy S

    2017-03-01

    In silico transcriptome mining is a powerful tool for crustacean peptidome prediction. Using homology-based BLAST searches and a simple bioinformatics workflow, large peptidomes have recently been predicted for a variety of crustaceans, including the lobster, Homarus americanus. Interestingly, no in silico studies have been conducted on the eyestalk ganglia (lamina ganglionaris, medulla externa, medulla interna and medulla terminalis) of the lobster, although the eyestalk is the location of a major neuroendocrine complex, i.e., the X-organ-sinus gland system. Here, an H. americanus eyestalk ganglia-specific transcriptome was produced using the de novo assembler Trinity. This transcriptome was generated from 130,973,220 Illumina reads and consists of 147,542 unique contigs. Eighty-nine neuropeptide-encoding transcripts were identified from this dataset, allowing for the deduction of 62 distinct pre/preprohormones. Two hundred sixty-two neuropeptides were predicted from this set of precursors; the peptides include members of the adipokinetic hormone-corazonin-like peptide, allatostatin A, allatostatin B, allatostatin C, bursicon α, CCHamide, corazonin, crustacean cardioactive peptide, crustacean hyperglycemic hormone (CHH), CHH precursor-related peptide, diuretic hormone 31, diuretic hormone 44, eclosion hormone, elevenin, FMRFamide-like peptide, glycoprotein hormone α2, glycoprotein hormone β5, GSEFLamide, intocin, leucokinin, molt-inhibiting hormone, myosuppressin, neuroparsin, neuropeptide F, orcokinin, orcomyotropin, pigment dispersing hormone, proctolin, pyrokinin, red pigment concentrating hormone, RYamide, short neuropeptide F, SIFamide, sulfakinin, tachykinin-related peptide and trissin families. The predicted peptides expand the H. americanus eyestalk ganglia neuropeptidome approximately 7-fold, and include 78 peptides new to the lobster. The transcriptome and predicted neuropeptidome described here provide new resources for investigating peptidergic

  10. DISYUNTIVAS EN LAS CONCEPCIONES SOBRE AUTONOMÍA Y BENEFICENCIA QUE AFECTAN LA TERAPÉUTICA DEL INTENTO SUICIDA1

    PubMed Central

    Mondragón, Liliana; Monroy, Zuraya; Ito, Ma. Emily; Medina-Mora, Dra. Ma. Elena

    2010-01-01

    El objetivo del trabajo es conocer las disyuntivas entre los principios de beneficencia y autonomía, que se presentan en la relación médico-paciente, durante la terapéutica del intento de suicidio. La investigación se realizó en dos hospitales psiquiátricos de la Ciudad de México. La muestra incluyó a tres sujetos con intento de suicidio, mayores de 18 años, que eran atendidos en consulta externa a causa de una lesión autoinfligida en el último año, y a tres psiquiatras que trataban a estos pacientes. La información se obtuvo previo consentimiento informado en entrevistas individuales. Se llevó a cabo un análisis de discurso argumentado para encontrar los significados que los participantes otorgaron a los principios bioéticos y las posibles disyuntivas entre éstos. Las discordancias entre la beneficencia y la autonomía estuvieron relacionadas con el beneficio del tratamiento, el respeto por los valores y las creencias de los pacientes, entre otros. Este trabajo presenta consideraciones éticas relevantes en el escenario clínico, al ofrecer al psiquiatra un análisis bioético que le permita actuar de acuerdo con la beneficencia y respetando la autonomía del paciente frente a casos de intento de suicidio y, de esta forma procurar una mejor atención para ellos. PMID:20830214

  11. Analysis of Long-Term Diet Changes in Tropical Seabirds Using Naturally Occurring Stable Isotopes

    NASA Astrophysics Data System (ADS)

    Vilchis, I.; Ballance, L.

    2010-12-01

    A clear understanding of ecosystem response to past environmental changes will provide more accurate interpretations of current ecosystem trends. With this mindset, we investigated the effects of the 1976/77 regime shift in the Pacific Ocean on a tropical pelagic community of apex predators. Using study skins from museum collections from 1960 to 2006, we measured stable carbon (δ13C) and nitrogen (δ15N) isotopes for a suite of ecologically and phylogenetically diverse seabirds from the eastern Pacific warm pool. In this region, seabirds generally forage by depending on subsurface predators to drive prey to the surface or by associating with oceanographic features that increase productivity or aggregate prey in space and time. We found that annual δ15N means from Sooty Terns’ (Onychoprion fuscatus) feathers decreased by 2.98‰, while all other species did not show any significant trends over the study period. Annual δ13C means from feathers of Sooty Terns, Wedge-tailed Shearwaters (Puffinus pacificus), Red-footed Boobies (Sula sula) and Juan Fernandez Petrels (Petrodroma externa) decreased by an average of 1.02‰, at rates between 0.01 and 0.02 δ13C‰ per year-1. Our results do not suggest a response of the seabird community to the 1976/77 regime shift. Instead, they are consistent with a trophic shift and/or change in foraging area for Sooty Terns and a long-term decrease in feather δ13C for the eastern Pacific warm pool seabird community. This long-term decrease in feather δ13C is most likely due to the Suess effect and less likely due to a decline in primary productivity of the system. We hypothesize that a deepening trend in thermocline depth in the eastern Pacific warm pool affected Sooty Terns more than other species in the subsurface predator-dependent guild that depend less on smaller subsurface predators like skipjack tuna.

  12. Eradication of elephant ear mites (Loxoanoetus bassoni) in two African elephants (Loxodonta africana).

    PubMed

    Wyatt, Jeff; DiVincenti, Louis

    2012-03-01

    Elephant ear mites, not previously described in North America, were eradicated in two African elephants (Loxodonta africana) after six otic instillations of ivermectin at 2-wk intervals. The microscopic examination of a clear, mucoid discharge collected from the external ear canals of two wild-born African elephants housed in a New York State zoo for 25 yr revealed live mites (Loxoaneotus bassoni). The cytologic examination demonstrated no evidence of inflammation or infection. Both elephants were asymptomatic with normal hemograms and serum chemistry panels. A diagnosis of otoacariasis was made. Each elephant was treated six times with 5 ml of 1% ivermectin syrup instilled in each ear canal once every 2 wk. Microscopic examinations of clear mucus collected from each elephant's ear canals 9 days after the first instillation of ivermectin were negative for any life stages of ear mites. Microscopic examinations of mucus collected from both elephants' ear canals at 6, 11, and 16 wk, as well as annually post-treatment for 7 yr, confirmed eradication of the ear mites. The L. bassoni ear mite was first identified in the external ear canals of wild, asymptomatic, lesion-free, African elephants culled in Kruger National Park in South Africa. However, a new species in the same genus of mites (Loxoanoetus lenae) was identified at the necropsy of an 86-yr-old Asian elephant (Elephas maximus) living in a circus in Australia. The autopsy revealed a marked, ballooning distension of bone around the left external acoustic meatus, suggestive of mite-induced otitis externa, as seen in cattle infested with ear mites (Raillieta auris). Elephant health care providers should identify the prevalence of, and consider treatment of, elephants in their care infested with ear mites, given the possible risk for adverse health effects.

  13. PKC delta-isoform translocation and enhancement of tonic contractions of gastrointestinal smooth muscle.

    PubMed

    Poole, Daniel P; Furness, John B

    2007-03-01

    PKC is involved in mediating the tonic component of gastrointestinal smooth muscle contraction in response to stimulation by agonists for G protein-coupled receptors. Here, we present pharmacological and immunohistochemical evidence indicating that a member of the novel PKC isoforms, PKC-delta, is involved in maintaining muscarinic receptor-coupled tonic contractions of the guinea pig ileum. The tonic component of carbachol-evoked contractions was enhanced by an activator of conventional and novel PKCs, phorbol 12,13-dibutyrate (PDBu; 200 nM or 1 microM), and by an activator of novel PKCs, ingenol 3,20-dibenzoate (IDB; 100 or 500 nM). Enhancement was unaffected by concentrations of bisindolylmaleimide I (BIM-I; 22 nM) that block conventional PKCs or by a PKC-epsilon-specific inhibitor peptide but was attenuated by higher doses of BIM-I (2.2 microM). Relevant proteins were localized at a cellular and subcellular level using confocal analysis. Immunohistochemical staining of the ileum showed that PKC-delta was exclusively expressed in smooth muscles distributed throughout the layers of the gut wall. PKC-epsilon immunoreactivity was prominent in enteric neurons but was largely absent from smooth muscle of the muscularis externa. Treatment with PDBu, IDB, or carbachol resulted in a time- and concentration-dependent translocation of PKC-delta from the cytoplasm to filamentous structures within smooth muscle cells. These were parallel to, but distinct from, actin filaments. The translocation of PKC-delta in response to carbachol was significantly reduced by scopolamine or calphostin C. The present study indicates that the tonic carbachol-induced contraction of the guinea pig ileum is mediated through a novel PKC, probably PKC-delta.

  14. Pallidostriatal Projections Promote β Oscillations in a Dopamine-Depleted Biophysical Network Model

    PubMed Central

    Corbit, Victoria L.; Whalen, Timothy C.; Zitelli, Kevin T.; Crilly, Stephanie Y.; Rubin, Jonathan E.

    2016-01-01

    In the basal ganglia, focused rhythmicity is an important feature of network activity at certain stages of motor processing. In disease, however, the basal ganglia develop amplified rhythmicity. Here, we demonstrate how the cellular architecture and network dynamics of an inhibitory loop in the basal ganglia yield exaggerated synchrony and locking to β oscillations, specifically in the dopamine-depleted state. A key component of this loop is the pallidostriatal pathway, a well-characterized anatomical projection whose function has long remained obscure. We present a synaptic characterization of this pathway in mice and incorporate these data into a computational model that we use to investigate its influence over striatal activity under simulated healthy and dopamine-depleted conditions. Our model predicts that the pallidostriatal pathway influences striatal output preferentially during periods of synchronized activity within GPe. We show that, under dopamine-depleted conditions, this effect becomes a key component of a positive feedback loop between the GPe and striatum that promotes synchronization and rhythmicity. Our results generate novel predictions about the role of the pallidostriatal pathway in shaping basal ganglia activity in health and disease. SIGNIFICANCE STATEMENT This work demonstrates that functional connections from the globus pallidus externa (GPe) to striatum are substantially stronger onto fast-spiking interneurons (FSIs) than onto medium spiny neurons. Our circuit model suggests that when GPe spikes are synchronous, this pallidostriatal pathway causes synchronous FSI activity pauses, which allow a transient window of disinhibition for medium spiny neurons. In simulated dopamine-depletion, this GPe-FSI activity is necessary for the emergence of strong synchronization and the amplification and propagation of β oscillations, which are a hallmark of parkinsonian circuit dysfunction. These results suggest that GPe may play a central role in

  15. Hemlock woolly adelgid and elongate hemlock scale induce changes in foliar and twig volatiles of eastern hemlock.

    PubMed

    Pezet, Joshua; Elkinton, Joseph; Gomez, Sara; McKenzie, E Alexa; Lavine, Michael; Preisser, Evan

    2013-08-01

    Eastern hemlock (Tsuga canadensis) is in rapid decline because of infestation by the invasive hemlock woolly adelgid (Adelges tsugae; 'HWA') and, to a lesser extent, the invasive elongate hemlock scale (Fiorinia externa; 'EHS'). For many conifers, induced oleoresin-based defenses play a central role in their response to herbivorous insects; however, it is unknown whether eastern hemlock mobilizes these inducible defenses. We conducted a study to determine if feeding by HWA or EHS induced changes in the volatile resin compounds of eastern hemlock. Young trees were experimentally infested for 3 years with HWA, EHS, or neither insect. Twig and needle resin volatiles were identified and quantified by gas chromatography/mass spectrometry. We observed a suite of changes in eastern hemlock's volatile profile markedly different from the largely terpenoid-based defense response of similar conifers. Overall, both insects produced a similar effect: most twig volatiles decreased slightly, while most needle volatiles increased slightly. Only HWA feeding led to elevated levels of methyl salicylate, a signal for systemic acquired resistance in many plants, and benzyl alcohol, a strong antimicrobial and aphid deterrent. Green leaf volatiles, often induced in wounded plants, were increased by both insects, but more strongly by EHS. The array of phytochemical changes we observed may reflect manipulation of the tree's biochemistry by HWA, or simply the absence of functional defenses against piercing-sucking insects due to the lack of evolutionary contact with these species. Our findings verify that HWA and EHS both induce changes in eastern hemlock's resin chemistry, and represent the first important step toward understanding the effects of inducible chemical defenses on hemlock susceptibility to these exotic pests.

  16. Pulsation, Mass Loss and the Upper Mass Limit

    NASA Astrophysics Data System (ADS)

    Klapp, J.; Corona-Galindo, M. G.

    1990-11-01

    RESUMEN. La existencia de estrellas con masas en exceso de 100 M0 ha sido cuestionada por mucho tiempo. Lfmites superiores para la masa de 100 M0 han sido obtenidos de teorfas de pulsaci6n y formaci6n estelar. En este trabajo nosotros primero investigamos la estabilidad radial de estrellas masivas utilizando la aproximaci6n clasica cuasiadiabatica de Ledoux, la aproximaci6n cuasiadiabatica de Castor y un calculo completamente no-adiabatico. Hemos encontrado que los tres metodos de calculo dan resultados similares siempre y cuando una pequefia regi6n de las capas externas de la estrella sea despreciada para la aproximaci6n clasica. La masa crftica para estabilidad de estrellas masivas ha sido encontrada en acuerdo a trabajos anteriores. Explicamos Ia discrepancia entre este y trabajos anteriores por uno de los autores. Discunmos calculos no-lineales y perdida de masa con respecto a) lfmite superior de masa. The existence of stars with masses in excess of 100 M0 has been questioned for a very long time. Upper mass limits of 100 Me have been obtained from pulsation and star formation theories. In this work we first investigate the radial stability of massive stars using the classical Ledoux's quasiadiabatic approximation. the Castor quasiadiabatic approximation and a fully nonadiabatic calculation. We have found that the three methods of calculation give similar results provided that a small region in outer layers of the star be neglected for the classical approximation. The critical mass for stability of massive stars is found to be in agreement with previous work. We explain the reason for the discrepancy between this and previous work by one of the authors. We discuss non-linear calculations and mass loss with regard to the upper mass limit. Key words: STARS-MASS FUNCTION - STARS-MASS LOSS - STARS-PULSATION

  17. Side-effects of glyphosate on the life parameters of Eriopis connexa (Coleoptera: Coccinelidae) in Argentina.

    PubMed

    Mirande, L; Haramboure, M; Smagghe, G; Piñeda, S; Schneider, M I

    2010-01-01

    In Argentina, transgenic soybean crop (Roundup Ready, RR) has undergone a major expansion over the last 15 years, with the consequent increase of glyphosate applications, a broad-spectrum and post emergence herbicide. Soybean crops are inhabited by several arthropods. Eriopis connexa Germar (Coleoptera: Coccinelidae) is a predator associated to soybean soft-bodies pest and have a Neotropical distribution. Nowadays, it is being considered a potentially biological control agent in South America. The objectives of this work were to evaluate the side-effects of glyphosate on larvae (third instar) and adults of this predator. Commercial compound and the maximum registered concentrations for field use were employed: GlifoGlex 48 (48% glyphosate, 192 mg a.i./litre, Gleba Argentina S.A.). The exposure was by ingestion through the treated prey (Rophalosiphum padi) or by drinking treated water during 48 h for treatment of the adult. The herbicide solutions were prepared using distilled water as solvent. The bioassays were carried out in the laboratory under controlled conditions: 23 +/- 0.5 degrees C, 75 +/- 5% RH and 16:8 (L:D) of photoperiod. Development time, weight of pupae, adult emergence, pre-oviposition period, fecundity and fertility were evaluated as endpoints. Larvae from glyphosate treatment molted earlier than controls. In addition, the weight of pupae, longevity, fecundity and fertility were drastically reduced in treated organisms. The reductions were more drastic when the treatments were performed at the third larval stage than as adult. The reproduction capacity of the predator was the most affected parameter and could be related to a hormonal disruption by glyphosate in the treated organisms. This work can confirm the deleterious effects of this herbicide on beneficial organisms. Also, it agrees with prior studies carried out on other predators associated to soybean pest, such as Chrysoperla externa (Neuroptera: Chrysopidae) and Alpaida veniliae (Araneae

  18. Curva de rotação óptica de ESO-LV 5100550

    NASA Astrophysics Data System (ADS)

    Carvalho, D. B.; Soares, D. S. L.

    2003-08-01

    ESO-LV 5100550 é o membro mais fraco do par de galáxias austral SBG 357 (Soares et al. 1995). É classificada no catálogo RC3 como uma espiral ordinária de tipo inicial (early-type); porém, uma análise morfológica sugere que ela tenha uma grande barra. O objetivo do estudo é determinar sua cinemática de tal modo que possamos inferir mais a respeito de sua dinâmica, provavelmente perturbada, já que se espera que esteja sob forte influência da companheira ESO-LV 5100560. Apresentarei resultados parciais determinados a partir de espectros obtidos com o instrumento Double Spectrograph montado no telescópio Hale do Monte Palomar, EUA. As observações foram realizadas por D.S.L. Soares, P.M.V. Veiga e T.E. Nordgren, em 1998. Foram tomados espectros de fenda longa posicionada sobre a linha dos nodos do disco e ao longo da suposta barra. Os dados foram reduzidos com uso do pacote IRAF. Obtivemos o perfil de velocidades radiais na linha de visada ao longo das fendas e calculamos o desvio para o vermelho cosmológico do sistema, com base no espectro central. Determinamos as curvas de rotação deprojetadas, com base em cálculos para os valores teóricos esperados das componentes de velocidades puramente circulares em um disco inclinado. A inclinação do disco, dado fundamental nesta deprojeção, foi estimada através da média das elipticidades das isofotas mais externas.

  19. Compound gravity receptor polarization vectors evidenced by linear vestibular evoked potentials

    NASA Technical Reports Server (NTRS)

    Jones, S. M.; Jones, T. A.; Bell, P. L.; Taylor, M. J.

    2001-01-01

    The utricle and saccule are gravity receptor organs of the vestibular system. These receptors rely on a high-density otoconial membrane to detect linear acceleration and the position of the cranium relative to Earth's gravitational vector. The linear vestibular evoked potential (VsEP) has been shown to be an effective non-invasive functional test specifically for otoconial gravity receptors (Jones et al., 1999). Moreover, there is some evidence that the VsEP can be used to independently test utricular and saccular function (Taylor et al., 1997; Jones et al., 1998). Here we characterize compound macular polarization vectors for the utricle and saccule in hatchling chickens. Pulsed linear acceleration stimuli were presented in two axes, the dorsoventral (DV, +/- Z axis) to isolate the saccule, and the interaural (IA, +/- Y axis) to isolate the utricle. Traditional signal averaging was used to resolve responses recorded from the surface of the skull. Latency and amplitude of eighth nerve components of the linear VsEP were measured. Gravity receptor responses exhibited clear preferences for one stimulus direction in each axis. With respect to each utricular macula, lateral translation in the IA axis produced maximum ipsilateral response amplitudes with substantially greater amplitude intensity (AI) slopes than medially directed movement. Downward caudal motions in the DV axis produced substantially larger response amplitudes and AI slopes. The results show that the macula lagena does not contribute to the VsEP compound polarization vectors of the sacculus and utricle. The findings suggest further that preferred compound vectors for the utricle depend on the pars externa (i.e. lateral hair cell field) whereas for the saccule they depend on pars interna (i.e. superior hair cell fields). These data provide evidence that maculae saccule and utricle can be selectively evaluated using the linear VsEP.

  20. Developmental Programming: Does Prenatal Steroid Excess Disrupt the Ovarian VEGF System in Sheep?1

    PubMed Central

    Ortega, Hugo Héctor; Veiga-Lopez, Almudena; Sreedharan, Shilpa; del Luján Velázquez, Melisa María; Salvetti, Natalia Raquel; Padmanabhan, Vasantha

    2015-01-01

    Prenatal testosterone (T), but not dihydrotestosterone (DHT), excess disrupts ovarian cyclicity and increases follicular recruitment and persistence. We hypothesized that the disruption in the vascular endothelial growth factor (VEGF) system contributes to the enhancement of follicular recruitment and persistence in prenatal T-treated sheep. The impact of T/DHT treatments from Days 30 to 90 of gestation on VEGFA, VEGFB, and their receptor (VEGFR-1 [FLT1], VEGFR-2 [KDR], and VEGFR-3 [FLT4]) protein expression was examined by immunohistochemistry on Fetal Days 90 and 140, 22 wk, 10 mo (postpubertal), and 21 mo (adult) of age. Arterial morphometry was performed in Fetal Day 140 and postpubertal ovaries. VEGFA and VEGFB expression were found in granulosa cells at all stages of follicular development with increased expression in antral follicles. VEGFA was present in theca interna, while VEGFB was present in theca interna/externa and stromal cells. All three receptors were expressed in the granulosa, theca, and stromal cells during all stages of follicular development. VEGFR-3 increased with follicular differentiation with the highest level seen in the granulosa cells of antral follicles. None of the members of the VEGF family or their receptor expression were altered by age or prenatal T/DHT treatments. At Fetal Day 140, area, wall thickness, and wall area of arteries from the ovarian hilum were larger in prenatal T- and DHT-treated females, suggestive of early androgenic programming of arterial differentiation. This may facilitate increased delivery of endocrine factors and thus indirectly contribute to the development of the multifollicular phenotype. PMID:26178718

  1. Functional assessment of intestinal motility and gut wall inflammation in rodents: analyses in a standardized model of intestinal manipulation.

    PubMed

    Vilz, Tim O; Overhaus, Marcus; Stoffels, Burkhard; Websky, Martin von; Kalff, Joerg C; Wehner, Sven

    2012-09-11

    Inflammation of the gastrointestinal tract is a common reason for a variety of human diseases. Animal research models are critical in investigating the complex cellular and molecular of intestinal pathology. Although the tunica mucosa is often the organ of interest in many inflammatory diseases, recent works demonstrated that the muscularis externa (ME) is also a highly immunocompetent organ that harbours a dense network of resident immunocytes.(1,2) These works were performed within the standardized model of intestinal manipulation (IM) that leads to inflammation of the bowel wall, mainly limited to the ME. Clinically this inflammation leads to prolonged intestinal dysmotility, known as postoperative ileus (POI) which is a frequent and unavoidable complication after abdominal surgery.(3) The inflammation is characterized by liberation of proinflammatory mediators such as IL-6(4) or IL-1β or inhibitory neurotransmitters like nitric oxide (NO).(5) Subsequently, tremendous numbers of immunocytes extravasate into the ME, dominated by polymorphonuclear neutrophils (PMN) and monocytes and finally maintain POI.(2) Lasting for days, this intestinal paralysis leads to an increased risk of aspiration, bacterial translocation and infectious complications up to sepsis and multi organ failure and causes a high economic burden.(6) In this manuscript we demonstrate the standardized model of IM and in vivo assessment of gastrointestinal transit (GIT) and colonic transit. Furthermore we demonstrate a method for separation of the ME from the tunica mucosa followed by immunological analysis, which is crucial to distinguish between the inflammatory responses in these both highly immunoactive bowel wall compartments. All analyses are easily transferable to any other research models, affecting gastrointestinal function.

  2. Morphological and molecular description of Tenuisentis niloticus (Meyer, 1932) (Acanthocephala: Tenuisentidae) from Heterotis niloticus (Cuvier) (Actinopterygii: Arapaimidae), in Burkina Faso, with emendation of the family diagnosis and notes on new features, cryptic genetic diversity and histopathology.

    PubMed

    Amin, Omar M; Evans, R Paul; Boungou, Magloire; Heckmann, Richard

    2016-02-01

    Specimens described as Rhadinorhynchus niloticus Meyer, 1932 (Rhadinorhynchidae) from two male specimens collected from Heterotis niloticus (Cuvier) in the Egyptian Nile were later redescribed in the genus Tenuisentis Van Cleave, 1936 (Tenuisentidae) based on 12 specimens collected from the same host species in the White Nile. That redescription basically distinguished the two genera based on five traits but did not actually provide a formal description. His account left out information about cerebral ganglion, lemnisci, some reproductive structures, eggs, proboscis hook dissymmetry and roots, size of trunk and a few other structures. We provide (i) the first complete description of this species enhanced by SEM, molecular, and histo-pathological studies; (ii) expand the existing descriptions; (iii) correct questionable accounts advanced by Van Cleave on the cement gland and the hypodermal giant nuclei; and (iv) add descriptions of new features such as the para-receptacle structure which we also report from Paratenuisentis Bullock & Samuel, 1975, the only other genus in Tenuisentidae Van Cleave, 1936. The subsequent description of a few more specimens from the same host collected in Mali was more informative yet incomplete and at variance with our specimens from Burkina Faso. Genetic divergence and phylogenetic analyses of mitochondrial (cytochrome oxidase c subunit I; COI) and nuclear (18S ribosomal RNA) gene relationships uncovered a cryptic species complex containing two lineages. Based on our studies, the family diagnosis is emended. The acanthocephalan causes damage to the host intestine as depicted in histopathological sections. The invading worm can extend from the mucosal layer to the muscularis externa of the host with subsequent tissue necrosis, villi compression, haemorrhaging and blood loss.

  3. [Risk factors and rejection frequency in patients undergoing penetrating keratoplasty].

    PubMed

    Gittins-Nuñez, Luis Othón; Díaz Del Castillo-Martín, Ernesto; Huerta-Albañil, Irma; Ríos-Prado, Rita; Soto-Dávila, Marco Antonio

    2016-01-01

    Introducción: el trasplante de córnea representa uno de los procedimientos quirúrgicos que con mayor frecuencia se realizan en todo el mundo y de los que tienen un mejor pronóstico. Dentro de sus principales indicaciones se encuentran: el queratocono, la queratopatía bullosa, el rechazo corneal previo, la distrofia corneal y la infección. Los factores de riesgo conocidos para rechazo del trasplante son: edad del receptor, presencia de vasos en la córnea receptora, presión intraocular y retrasplante. El objetivo de este artículo es determinar los factores de riesgo y la frecuencia de rechazo corneal en pacientes sometidos a queratoplastia penetrante. Métodos: el diseño del estudio fue descriptivo, observacional, transversal, retrospectivo y analítico. Se estudiaron los pacientes operados de queratoplastia penetrante en la consulta externa de córnea, con seguimiento mínimo de 6 meses. Se llevó a cabo una revisión de expedientes clínicos de pacientes operados de queratoplastia penetrante en Hospital de Especialidades del Centro Médico Nacional Siglo XXI del IMSS. Resultados: del total de los pacientes trasplantados 35.3 % presentaron rechazo del trasplante corneal. La neovascularización corneal previa al trasplante de la corona receptora estuvo presente en 21.3 %. Conclusiones: en nuestro estudio encontramos resultados similares a los reportados en la literatura, siendo los factores de riesgo más importantes para presentar rechazo: el uso de trépanos mayores a 7.50 mm, paciente con antecedentes de neovascularización corneal previa, queratopatía y queratitis herpética.

  4. [Prevalence of malnutrition in Spanish institutionalized older people: a multicentric nationwide analysis].

    PubMed

    Vaca Bermejo, Raúl; Ancizu García, Iciar; Moya Galera, David; de las Heras Rodríguez, Mónica; Pascual Torramadé, Josep

    2014-10-06

    Introducción: Un estado nutricional deficitario tiene importantes consecuencias en la salud de los colectivos en situación de especial vulnerabilidad, como las personas con enfermedades crónicas o personas mayores en situación de dependencia. Objetivo: Conocer el estado nutricional al ingreso de usuarios en centros SARquavitae. Material y Método: Se estudió el estado de salud, cognitivo y funcional de las personas que ingresaron durante el año 2012 en algún centro de la compañía. El estado nutricional fue evaluado mediante la versión corta del Mini Nutritional Assessment. Asimismo, se realizó un análisis para conocer las variables con mayor influencia en el estado nutricional de la muestra objeto de estudio. Resultados: Se analizaron las historias clínicas de 4.297 ingresos. La edad media fue de 82,08 años. Un 66,1% eran mujeres con una alta pluripatología. Al ingreso, un 30,4% de la muestra se encuentra en situación de desnutrición y un 49,4% en riesgo de desnutrición. Se observa una mayor prevalencia de desnutrición en mujeres, en aquellas personas que son derivadas por un hospital de agudos o por sus consultas externas, con peor estado funcional y cognitivo y en aquellas con procesos patológicos como demencia, enfermedades cerebrovasculares o disfagia. Conclusiones: Los resultados de este estudio ponen de manifiesto la alta complejidad clínica de las personas que ingresan en los centros residenciales estudiados, evidenciando la necesidad de realizar valoraciones integrales que permitan establecer planes de cuidados específicos para los perfiles atendidos.

  5. [Chronic low back pain and associated risk factors, in patients with social security medical attention: A case-control study].

    PubMed

    Durán-Nah, Jaime Jesús; Benítez-Rodríguez, Carlos René; Miam-Viana, Emilio Jesús

    2016-01-01

    Introducción: la lumbalgia crónica (LC) es un padecimiento frecuente en el ámbito de la Ortopedia. El objetivo de este trabajo es identificar los factores de riesgo asociados a LC en pacientes atendidos durante 2012, en un Hospital General del Instituto Mexicano del Seguro Social, en Yucatán, México. Métodos: se identificaron de la consulta externa de Ortopedia 95 casos y 190 controles, comparando entre grupos diversos datos demográficos y clínicos mediante modelo de regresión logístico (ML) binario del que se obtuvieron las razones de momios (RM) y los intervalos de confianza de 95 % (IC 95 %). Resultados: fueron incluidos en el ML la escolaridad, el índice de masa corporal (IMC, como variable continua), la manipulación de objetos pesados, la presencia de comorbilidad y de dislipidemia, siendo identificados como estadísticamente significativas: el nivel secundaria de la escolaridad (RM 0.25, IC 95 %: 0.08 a 0.81), la dislipidemia (RM 0.26, IC 95 %: 0.12 a 0.56), la manipulación de objetos pesados (RM 0.22, IC 95 %: 0.12 a 0.42) y el IMC (RM 1.22, IC 95 %: 1.12 a 1.32). Conclusiones: la escolaridad secundaria, la ausencia de dislipidemia y no manipular objetos pesados redujeron el riesgo de LC, mientras que la obesidad lo incrementó.

  6. Safety and tolerability of 0.1% tacrolimus solution applied to the external ear canals of atopic beagle dogs without otitis.

    PubMed

    Kelley, Laura S; Flynn-Lurie, Alison K; House, Rossi A; Simpson, Andrew C; Marsella, Rosanna

    2010-12-01

    Tacrolimus is a nonsteroidal alternative to treat noninfectious otitis externa (OE) in people. This 21-day study investigated whether twice daily application (0.2 mL/dose) of sterile olive oil based 0.1% tacrolimus suspension in ears of atopic beagle dogs without OE was associated with adverse local reactions, development of OE, change in otic cytology, vestibular dysfunction, or hearing loss detected by brainstem auditory evoked response (BAER). The study was randomized, double-blinded, and placebo-controlled. Twenty-two dogs matched for age and sex were randomized to tacrolimus or vehicle control treatment groups. Two investigators independently evaluated dogs for signs of adverse effects including OE the first 4 days of treatment, then every 3 days. A logistic regression model was fit for each investigator's clinical scores (SAS, 9.2, 2008). Time (P = 0.0032) and group (P = 0.0167) were always significant for OE. Inter-observer reliability of clinical scores was strong, measured using Kappa coefficients and proportion of agreement. All nine exclusions (7/10 control- and 2/12 tacrolimus-treated dogs) were excluded for yeast OE. Inter-observer agreement to exclude was 100%. All dogs not excluded had normal BAER assessments before treatment, weekly during treatment, and after 21 days of treatment. None showed vestibular abnormalities at these times. Tacrolimus blood concentrations (Abbott IMx Tacrolimus II) were below detection limits (3 ng/mL) at baseline and after 21 days of treatment. Results suggest otic application of olive oil based tacrolimus suspension to canine ears with intact tympanic membranes is unlikely to result in hearing loss or vestibular dysfunction but yeast OE is a possible risk.

  7. Destruction of the germinal disc region of an immature preovulatory chicken follicle induces atresia and apoptosis.

    PubMed

    Yao, H H; Volentine, K K; Bahr, J M

    1998-09-01

    The germinal disc region (GDR), which contains the germinal disc and overlying granulosa cells, is essential for completion of maturation of the preovulatory chicken follicle. The current study was conducted to test the hypothesis that destruction of the GDR (GDRX) of an immature preovulatory chicken follicle blocks ovulation, induces apoptosis, and causes atresia. The GDR of immature preovulatory follicles (F2) were destroyed by freezing with dry ice (3 mm in diameter) 48-50 h before ovulation. As a control for the effect of freezing, a nonGDR portion (a portion of the follicular wall opposite to the GDR relative to the follicular stalk) of other F2 follicles were destroyed (nonGDRX). Treatment of F2 follicles by GDRX caused atresia and blocked ovulation of all treated follicles (6 of 6), whereas none of the nonGDRX follicles (0 of 5) underwent atresia. Treatment of follicles by GDRX induced apoptotic DNA fragmentation (laddering) in theca and granulosa layers obtained from the frozen area and in the theca layer obtained from the follicular wall distal to the frozen area. In contrast, apoptosis was only present in theca and granulosa layers in the frozen area of the nonGDRX follicle. Furthermore, the in situ DNA end-labeling technique demonstrated that in the GDRX follicle 24 h after treatment, cells in the theca interna, endothelial cells in blood vessels of the theca externa, and a few granulosa cells underwent apoptosis. These results indicate that destruction of the GDR of an immature preovulatory follicle causes atresia and apoptosis and blocks ovulation. These novel findings suggest that the GDR maintains development of the chicken preovulatory follicle by producing one or more survival factors. Without the GDR, chicken follicles cannot develop further and they eventually die.

  8. Heme oxygenase-1 deficiency promotes the development of necrotizing enterocolitis-like intestinal injury in a newborn mouse model.

    PubMed

    Schulz, Stephanie; Wong, Ronald J; Jang, Kyu Yun; Kalish, Flora; Chisholm, Karen M; Zhao, Hui; Vreman, Hendrik J; Sylvester, Karl G; Stevenson, David K

    2013-06-01

    Necrotizing enterocolitis (NEC) is typified by mucosal destruction, which subsequently can lead to intestinal necrosis. Prematurity, enteral feeding, and bacterial colonization are the main risk factors and, combined with other stressors, can cause increased intestinal permeability, injury, and an exaggerated inflammatory response. Heme oxygenase-1 (HO-1) mediates intestinal protection due to anti-inflammatory, antioxidative, and antiapoptotic effects of its products carbon monoxide, biliverdin, and bilirubin. This study investigates a possible role of HO-1 in the pathogenesis of NEC using a newborn mouse model. We induced NEC-like intestinal injury in 7-day-old HO-1 heterozygous (HO-1 Het, Hmox1(+/-)) and wild-type (Wt, Hmox1(+/+)) mice by gavage feeding and hypoxic exposures. Control (Con) pups of both genotypes were dam-fed. Intestines of HO-1 Het Con pups appeared predisposed to injury, with higher histological damage scores, more TUNEL-positive cells, and a significant reduction in muscularis externa thickness compared with Wt Con pups. The increase in HO activity after HO-1 induction by the substrate heme or by hypoxic stress was significantly impaired in HO-1 Het pups. After induction of intestinal injury, HO-1 Het pups displayed significantly higher NEC incidence (78 vs. 43%), mortality (83 vs. 54%), and median scores (2.5 vs. 1.5) than Wt NEC pups. PCR array analyses revealed increased expressions of IL-1β, P-selectin, matrix metallopeptidase 2, collagen type XVIII-α1, serpine 1, and others in NEC-induced HO-1 Het ileal and jejunal tissues. We conclude that a partial HO-1 deficiency promotes experimental NEC-like intestinal injury, possibly mediated by exaggerated inflammation and disruption in tissue repair.

  9. Quantifying the Neural Elements Activated and Inhibited by Globus Pallidus Deep Brain Stimulation

    PubMed Central

    Johnson, Matthew D.; McIntyre, Cameron C.

    2008-01-01

    Deep brain stimulation (DBS) of the globus pallidus pars interna (GPi) is an effective therapy option for controlling the motor symptoms of medication-refractory Parkinson's disease and dystonia. Despite the clinical successes of GPi DBS, the precise therapeutic mechanisms are unclear and questions remain on the optimal electrode placement and stimulation parameter selection strategies. In this study, we developed a three-dimensional computational model of GPi-DBS in nonhuman primates to investigate how membrane channel dynamics, synaptic inputs, and axonal collateralization contribute to the neural responses generated during stimulation. We focused our analysis on three general neural elements that surround GPi-DBS electrodes: GPi somatodendritic segments, GPi efferent axons, and globus pallidus pars externa (GPe) fibers of passage. During high-frequency electrical stimulation (136 Hz), somatic activity in the GPi showed interpulse excitatory phases at 1–3 and 4–5.5 ms. When including stimulation-induced GABAA and AMPA receptor dynamics into the model, the somatic firing patterns continued to be entrained to the stimulation, but the overall firing rate was reduced (78.7 to 25.0 Hz, P < 0.001). In contrast, axonal output from GPi neurons remained largely time-locked to each pulse of the stimulation train. Similar entrainment was also observed in GPe efferents, a majority of which have been shown to project through GPi en route to the subthalamic nucleus. The models suggest that pallidal DBS may have broader network effects than previously realized and the modes of therapy may depend on the relative proportion of GPi and/or GPe efferents that are directly affected by the stimulation. PMID:18768645

  10. Trajectory and terminal distribution of single centrifugal axons from olfactory cortical areas in the rat olfactory bulb.

    PubMed

    Matsutani, S

    2010-08-11

    The olfactory bulb receives a large number of centrifugal fibers whose functions remain unclear. To gain insight into the function of the bulbar centrifugal system, the morphology of individual centrifugal axons from olfactory cortical areas was examined in detail. An anterograde tracer, Phaseolus vulgaris leucoagglutinin, was injected into rat olfactory cortical areas, including the pars lateralis of the anterior olfactory nucleus (lAON) and the anterior part of the piriform cortex (aPC). Reconstruction from serial sections revealed that the extrabulbar segments of centrifugal axons from the lAON and those from the aPC had distinct trajectories: the former tended to innervate the pars externa of the AON before entering the olfactory bulb, while the latter had extrabulbar collaterals that extended to a variety of targets. In contrast to the extrabulbar segments, no clear differences were found between the intrabulbar segments of axons from the lAON and from the aPC. The intrabulbar segments of centrifugal axons were mainly found in the granule cell layer but a few axons extended into the external plexiform and glomerular layer. Approximately 40% of centrifugal axons innervated both the medial and lateral aspects of the olfactory bulb. The number of boutons found on single intrabulbar segments was typically less than 1000. Boutons tended to aggregate and form complex terminal tufts with short axonal branches. Terminal tufts, no more than 10 in single axons from ipsilateral cortical areas, were localized to the granule cell layer with varying intervals; some tufts formed patchy clusters and others were scattered over areas that extended for a few millimeters. The patchy, widespread distribution of terminals suggests that the centrifugal axons are able to couple the activity of specific subsets of bulbar neurons even when the subsets are spatially separated.

  11. Pontine Infarct Presenting with Atypical Dental Pain: A Case Report.

    PubMed

    Goel, Rajat; Kumar, Sanjeev; Panwar, Ajay; Singh, Abhishek B

    2015-01-01

    Orofacial pain' most commonly occurs due to dental causes like caries, gingivitis or periodontitis. Other common causes of 'orofacial pain' are sinusitis, temporomandibular joint(TMJ) dysfunction, otitis externa, tension headache and migraine. In some patients, the etiology of 'orofacial pain' remains undetected despite optimal evaluation. A few patients in the practice of clinical dentistry presents with dental pain without any identifiable dental etiology. Such patients are classified under the category of 'atypical odontalgia'. 'Atypical odontalgia' is reported to be prevalent in 2.1% of the individuals. 'Atypical orofacial pain' and 'atypical odontalgia' can result from the neurological diseases like multiple sclerosis, trigeminal neuralgia and herpes infection. Trigeminal neuralgia has been frequently documented as a cause of 'atypical orofacial pain' and 'atypical odontalgia'. There are a few isolated case reports of acute pontine stroke resulting in 'atypical orofacial pain' and 'atypical odontalgia'. However, pontine stroke as a cause of atypical odontalgia is limited to only a few cases, hence prevalence is not established. This case is one, where a patient presented with acute onset atypical dental pain with no identifiable dental etiology, further diagnosed as an acute pontine infarct on neuroimaging. A 40 years old male presented with acute onset, diffuse teeth pain on right side. Dental examination was normal. Magnetic resonance imaging(MRI) of the brain had an acute infarct in right pons near the trigeminal root entry zone(REZ). Pontine infarct presenting with dental pain as a manifestation of trigeminal neuropathy, has rarely been reported previously. This stresses on the importance of neuroradiology in evaluation of atypical cases of dental pain.

  12. Neuronal activity (c-Fos) delineating interactions of the cerebral cortex and basal ganglia

    PubMed Central

    Qiu, Mei-Hong; Chen, Michael C.; Huang, Zhi-Li; Lu, Jun

    2014-01-01

    The cerebral cortex and basal ganglia (BG) form a neural circuit that is disrupted in disorders such as Parkinson’s disease. We found that neuronal activity (c-Fos) in the BG followed cortical activity, i.e., high in arousal state and low in sleep state. To determine if cortical activity is necessary for BG activity, we administered atropine to rats to induce a dissociative state resulting in slow-wave electroencephalography but hyperactive motor behaviors. Atropine blocked c-Fos expression in the cortex and BG, despite high c-Fos expression in the sub-cortical arousal neuronal groups and thalamus, indicating that cortical activity is required for BG activation. To identify which glutamate receptors in the BG that mediate cortical inputs, we injected ketamine [N-methyl-d-aspartate (NMDA) receptor antagonist] and 6-cyano-nitroquinoxaline-2, 3-dione (CNQX, a non-NMDA receptor antagonist). Systemic ketamine and CNQX administration revealed that NMDA receptors mediated subthalamic nucleus (STN) input to internal globus pallidus (GPi) and substantia nigra pars reticulata (SNr), while non-NMDA receptor mediated cortical input to the STN. Both types of glutamate receptors were involved in mediating cortical input to the striatum. Dorsal striatal (caudoputamen, CPu) dopamine depletion by 6-hydroxydopamine resulted in reduced activity of the CPu, globus pallidus externa (GPe), and STN but increased activity of the GPi, SNr, and putative layer V neurons in the motor cortex. Our results reveal that the cortical activity is necessary for BG activity and clarifies the pathways and properties of the BG-cortical network and their putative role in the pathophysiology of BG disorders. PMID:24723855

  13. DISYUNTIVAS EN LAS CONCEPCIONES SOBRE AUTONOMÍA Y BENEFICENCIA QUE AFECTAN LA TERAPÉUTICA DEL INTENTO SUICIDA.

    PubMed

    Mondragón, Liliana; Monroy, Zuraya; Ito, Ma Emily; Medina-Mora, Dra Ma Elena

    2010-06-01

    El objetivo del trabajo es conocer las disyuntivas entre los principios de beneficencia y autonomía, que se presentan en la relación médico-paciente, durante la terapéutica del intento de suicidio.La investigación se realizó en dos hospitales psiquiátricos de la Ciudad de México. La muestra incluyó a tres sujetos con intento de suicidio, mayores de 18 años, que eran atendidos en consulta externa a causa de una lesión autoinfligida en el último año, y a tres psiquiatras que trataban a estos pacientes. La información se obtuvo previo consentimiento informado en entrevistas individuales. Se llevó a cabo un análisis de discurso argumentado para encontrar los significados que los participantes otorgaron a los principios bioéticos y las posibles disyuntivas entre éstos.Las discordancias entre la beneficencia y la autonomía estuvieron relacionadas con el beneficio del tratamiento, el respeto por los valores y las creencias de los pacientes, entre otros. Este trabajo presenta consideraciones éticas relevantes en el escenario clínico, al ofrecer al psiquiatra un análisis bioético que le permita actuar de acuerdo con la beneficencia y respetando la autonomía del paciente frente a casos de intento de suicidio y, de esta forma procurar una mejor atención para ellos.

  14. Studies of gonadal sex differentiation

    PubMed Central

    Makiyan, Zograb

    2016-01-01

    ABSTRACT Gonadal differentiation has a determinative influence on sex development in human embryos. Disorders of sexual development (DSD) have been associated with persistent embryonal differentiation stages. Between 1998 and 2015, 139 female patients with various (DSD) underwent operations at the Scientific Center of Obstetrics, Gynaecology and Perynatology in Moscow, Russia. Clinical investigations included karyotyping, ultrasound imaging, hormonal measurement and investigations of gonadal morphology. The male characteristics in the embryo are imposed by testicular hormones. When these are absent or inactive, the fetus may be arrested at between developmental stages, or stay on indifferent stage and become phenotypically female. A systematic analysis of gonadal morphology in DSD patients and a literature review revealed some controversies and led us to formulate a new hypothesis about sex differentiation. Proliferation of the mesonephric system (tubules and corpuscles) in the gonads stimulates the masculinization of gonads to testis. Sustentacular Sertoli cells of the testes are derived from mesonephric excretory tubules, while interstitial Leydig cells are derived from the original mesenchyme of the mesonephros. According of the new hypothesis, the original mesonephric cells (tubules and corpuscles) potentially persist in the ovarian parenchyma. In female gonads, some mesonephric excretory tubules regress and lose the tubular structure, but form ovarian theca interna and externa, becoming analogous to the sustentacular Sertoli cells in the testis. The ovarian interstitial Leydig cells are derived from intertubal mesenchyme of the mesonephros, similar to what occurs in male gonads (testis). Surprisingly, the leading determinative factor in sexual differentiation of the gonads is the mesonephros, represented by the embryonic urinary system. PMID:26950283

  15. Ceruminal diffusion activities and ceruminolytic characteristics of otic preparations – an in-vitro study

    PubMed Central

    2013-01-01

    Background An in-vitro setup was established in order to determine a) the diffusion activities of eight otic preparations (Aurizon®, Eas Otic®, Epi Otic®, Otifree®, Otomax®, Panolog®, Posatex®, Surolan®) through synthetic cerumen, and b) the ceruminolytic capacity and impregnation effects of these products. The main lipid classes of canine cerumen produced with moderate, non-purulent otitis externa were determined by thin layer chromatography and were subsequently used to produce a standardised synthetic cerumen (SCC). SCC was filled into capillary tubes, all of which were loaded with six commercially available multipurpose otic medications and two ear cleaners, each mixed with two markers in two experimental setups. These two marker compounds (Oil red O and marbofloxacin) were chosen, since they exhibit different physicochemical drug characteristics by which it is possible to determine and verify the diffusion activity of different types of liquids (i.e. the otic preparations). A synthetic cerumen described in the literature (JSL) was also used for comparison as its lipid composition was different to SCC. The diffusion activities of the otic preparations through both types of synthetic cerumen were studied over 24 hours. A second in-vitro experiment determined both the ceruminolytic activity and impregnation effect of the otic preparations by comparing the weight loss or weight gain after repeated incubation of JSL. Results Canine cerumen is mainly composed of triglycerides, sterol esters, fatty acid esters and squalene. The diffusion experiments showed a high diffusion efficacy along with a high impregnation effect for one test product. All the other products exhibited a lower diffusion activity with a mild to moderate impregnation effect. A mild ceruminolytic activity was observed for the two ear cleaners but not for any of the otic medications. Conclusions The present study demonstrates that there are significant differences in the diffusion

  16. Effects of antidromic and orthodromic activation of STN afferent axons during DBS in Parkinson's disease: a simulation study.

    PubMed

    Kang, Guiyeom; Lowery, Madeleine M

    2014-01-01

    Recent studies suggest that subthalamic nucleus (STN)-Deep Brain Stimulation (DBS) may exert at least part of its therapeutic effect through the antidromic suppression of pathological oscillations in the cortex in 6-OHDA treated rats and in parkinsonian patients. STN-DBS may also activate STN neurons by initiating action potential propagation in the orthodromic direction, similarly resulting in suppression of pathological oscillations in the STN. While experimental studies have provided strong evidence in support of antidromic stimulation of cortical neurons, it is difficult to separate relative contributions of antidromic and orthodromic effects of STN-DBS. The aim of this computational study was to examine the effects of antidromic and orthodromic activation on neural firing patterns and beta-band (13-30 Hz) oscillations in the STN and cortex during DBS of STN afferent axons projecting from the cortex. High frequency antidromic stimulation alone effectively suppressed simulated beta activity in both the cortex and STN-globus pallidus externa (GPe) network. High frequency orthodromic stimulation similarly suppressed beta activity within the STN and GPe through the direct stimulation of STN neurons driven by DBS at the same frequency as the stimulus. The combined effect of both antidromic and orthodromic stimulation modulated cortical activity antidromically while simultaneously orthodromically driving STN neurons. While high frequency DBS reduced STN beta-band power, low frequency stimulation resulted in resonant effects, increasing beta-band activity, consistent with previous experimental observations. The simulation results indicate effective suppression of simulated oscillatory activity through both antidromic stimulation of cortical neurons and direct orthodromic stimulation of STN neurons. The results of the study agree with experimental recordings of STN and cortical neurons in rats and support the therapeutic potential of stimulation of cortical neurons.

  17. Optimizing a basal bark spray of dinotefuran to manage armored scales (Hemiptera: Diaspididae) in Christmas tree plantations.

    PubMed

    Cowles, Richard S

    2010-10-01

    The armored scales Fiorinia externa Ferris and Aspidiotus cryptomeriae Kuwana (Hemiptera: Diaspididae) are increasingly damaging to Christmas tree plantings in southern New England. The systemic insecticide dinotefuran was investigated for selectively suppressing armored scale populations relative to their natural enemies in cooperating growers' fields in 2008 and 2009. Banded soil application of dinotefuran resulted in poor control. However, a dinotefuran spray applied to the basal 25 cm of trunk resulted in its absorption through the bark, translocation to the foliage, and good efficacy. The basal bark spray did not significantly impact the activity of predators Chilocorus stigma (Say) or Cybocephalus nipponicus Enrody-Younga and in 2009 showed a dosage-dependent improvement in the percentage of scales parasitized by Encarsia citrina Craw. A field dosage-response factorial experiment revealed that a 0.25% (vol:vol) addition of a surfactant with dinotefuran did not enhance insecticidal effect. Probit-transformed scale population reduction relative to the untreated check was subjected to linear regression analysis; reduction of scale populations was proportional to the log of insecticide dosage, whereas basal bark spray efficacy declined in proportion to the cube of tree height. The regression equation can be used to optimize dosage relative to tree height. Excellent efficacy resulted from basal bark spray application dates of 28 April (prebud break) to mid-June, but earlier spray timing within that treatment window had fewer crawlers discoloring new growth with their short-lived feeding. A basal bark spray of dinotefuran is well suited for integration with natural enemies to manage armored scales in Christmas tree plantations.

  18. Developmental Programming: Does Prenatal Steroid Excess Disrupt the Ovarian VEGF System in Sheep?

    PubMed

    Ortega, Hugo Héctor; Veiga-Lopez, Almudena; Sreedharan, Shilpa; del Luján Velázquez, Melisa María; Salvetti, Natalia Raquel; Padmanabhan, Vasantha

    2015-09-01

    Prenatal testosterone (T), but not dihydrotestosterone (DHT), excess disrupts ovarian cyclicity and increases follicular recruitment and persistence. We hypothesized that the disruption in the vascular endothelial growth factor (VEGF) system contributes to the enhancement of follicular recruitment and persistence in prenatal T-treated sheep. The impact of T/DHT treatments from Days 30 to 90 of gestation on VEGFA, VEGFB, and their receptor (VEGFR-1 [FLT1], VEGFR-2 [KDR], and VEGFR-3 [FLT4]) protein expression was examined by immunohistochemistry on Fetal Days 90 and 140, 22 wk, 10 mo (postpubertal), and 21 mo (adult) of age. Arterial morphometry was performed in Fetal Day 140 and postpubertal ovaries. VEGFA and VEGFB expression were found in granulosa cells at all stages of follicular development with increased expression in antral follicles. VEGFA was present in theca interna, while VEGFB was present in theca interna/externa and stromal cells. All three receptors were expressed in the granulosa, theca, and stromal cells during all stages of follicular development. VEGFR-3 increased with follicular differentiation with the highest level seen in the granulosa cells of antral follicles. None of the members of the VEGF family or their receptor expression were altered by age or prenatal T/DHT treatments. At Fetal Day 140, area, wall thickness, and wall area of arteries from the ovarian hilum were larger in prenatal T- and DHT-treated females, suggestive of early androgenic programming of arterial differentiation. This may facilitate increased delivery of endocrine factors and thus indirectly contribute to the development of the multifollicular phenotype.

  19. Prospective Trial of High-Dose Reirradiation Using Daily Image Guidance With Intensity-Modulated Radiotherapy for Recurrent and Second Primary Head-and-Neck Cancer

    SciTech Connect

    Chen, Allen M.; Farwell, D. Gregory; Luu, Quang; Cheng, Suzan; Donald, Paul J.; Purdy, James A.

    2011-07-01

    Purpose: To report a single-institutional experience using intensity-modulated radiotherapy with daily image-guided radiotherapy for the reirradiation of recurrent and second cancers of the head and neck. Methods and Materials: Twenty-one consecutive patients were prospectively treated with intensity-modulated radiotherapy from February 2006 to March 2009 to a median dose of 66 Gy (range, 60-70 Gy). None of these patients received concurrent chemotherapy. Daily helical megavoltage CT scans were obtained before each fraction as part of an image-guided radiotherapy registration protocol for patient alignment. Results: The 1- and 2-year estimates of in-field control were 72% and 65%, respectively. A total of 651 daily megavoltage CT scans were obtained. The mean systematic shift to account for interfraction motion was 1.38 {+-} 1.25 mm, 1.79 {+-} 1.45 mm, and 1.98 {+-} 1.75 mm for the medial-lateral, superior-inferior, and anterior-posterior directions, respectively. Pretreatment shifts of >3 mm occurred in 19% of setups in the medial-lateral, 27% in the superior-inferior, and 33% in the anterior-posterior directions, respectively. There were no treatment-related fatalities or hospitalizations. Complications included skin desquamation, odynophagia, otitis externa, keratitis, naso-lacrimal duct stenosis, and brachial plexopathy. Conclusions: Intensity-modulated radiotherapy with daily image guidance results in effective disease control with relatively low morbidity and should be considered for selected patients with recurrent and second primary cancers of the head and neck.

  20. Paracrine Hedgehog signaling in stomach and intestine: new roles for Hedgehog in gastrointestinal patterning

    PubMed Central

    Kolterud, Åsa; Grosse, Ann S.; Zacharias, William J.; Walton, Katherine D.; Kretovich, Katherine E.; Madison, Blair; Waghray, Meghna; Ferris, Jennifer E.; Hu, Chunbo; Merchant, Juanita L.; Dlugosz, Andrzej; Kottmann, Andreas H.; Gumucio, Deborah L.

    2009-01-01

    Background & Aims Hedgehog signaling is critical in gastrointestinal patterning. Mice deficient in Hedgehog signaling exhibit abnormalities that mirror deformities seen in the human VACTERL (vertebral, anal, cardiac, tracheal, esophageal, renal, limb) association. However, the direction of Hedgehog signal flow is controversial and the cellular targets of Hedgehog signaling change with time during development. We profiled cellular Hedgehog response patterns from embryonic day 10.5 (E10.5) to adult in murine antrum, pyloric region, small intestine and colon. Methods Hedgehog signaling was profiled using Hedgehog pathway reporter mice and in situ hybridization. Cellular targets were identified by immunostaining. Ihh-overexpressing transgenic animals were generated and analyzed. Results Hedgehog signaling is strictly paracrine from antrum to colon throughout embryonic and adult life. Novel findings include: mesothelial cells of the serosa transduce Hedgehog signals in fetal life; the hindgut epithelium expresses Ptch but not Gli1 at E10.5; the two layers of the muscularis externa respond differently to Hedgehog signals; organogenesis of the pyloric sphincter is associated with robust Hedgehog signaling; dramatically different Hedgehog responses characterize stomach and intestine at E16; after birth, the muscularis mucosa and villus smooth muscle (SM) consist primarily of Hedgehog responsive cells and Hh levels actively modulate villus core SM. Conclusions These studies reveal a previously unrecognized association of paracrine Hedgehog signaling with several gastrointestinal patterning events involving the serosa, pylorus and villus smooth muscle. The results may have implications for several human anomalies and could potentially expand the spectrum of the human VACTERL association. PMID:19445942

  1. [Brainstem dysgenesis: functional prognosis and rehabilitative treatment. A series of nine cases].

    PubMed

    Alberdi-Otazu, Ainara; Vives-Ortega, Juan C; Castelló-Verdú, Teresa; Toro-Tamargo, Esther; Meléndez-Plumed, Mar

    2014-05-01

    Introduccion. La disgenesia del tronco encefalico es una entidad clinica heterogenea, de baja incidencia y alta variabilidad clinica, que afecta a estructuras del tronco del encefalo. La combinacion de sintomatologia, neuroimagen y estudios neurofisiologicos es la base diagnostica. Objetivo. Conocer las caracteristicas clinicas comunes, pronostico funcional y necesidades de tratamiento rehabilitador en un grupo de niños con disgenesia del tronco encefalico. Pacientes y metodos. Estudio retrospectivo observacional de nueve pacientes diagnosticados de disgenesia del tronco encefalico controlados en consultas externas. Resultados. La edad media de los pacientes era de 5,5 años. Cinco presentaron alteraciones en la neuroimagen y, en los cinco con estudio neurofisiologico, este estaba alterado. Seis presentaron hipotonia muscular; ocho, amimia/hipomimia; seis, hipoacusia central, y cinco, gastrostomia. Un tercio presento un episodio de parada cardiorrespiratoria. En todos se detecto retraso psicomotor. Actualmente cinco realizan marcha autonoma por interiores y cuatro de ellos por exteriores. Un porcentaje elevado (77,7%) comprende ordenes simples y es capaz de comunicarse (66,6%). Conclusiones. Las alteraciones de los pares craneales, del tono muscular y la disfagia son las manifestaciones mas comunes en nuestra poblacion. El riesgo de broncoaspiracion y parada cardiorrespiratoria supone una amenaza vital para estos pacientes. Todos los niños presentan retraso psicomotor y la mitad de ellos alcanza marcha autonoma. Dada la diversidad de discapacidad que presentan estos pacientes, consideramos necesario un tratamiento de rehabilitacion integral e individualizado para conseguir un nivel funcional optimo. Necesitamos estudios con muestras mas amplias para obtener grupos homogeneos y establecer el pronostico funcional y las necesidades de tratamiento rehabilitador.

  2. [Complications of pediatric renal transplantation].

    PubMed

    Gonçalves, Cristina; Sandes, Ana Rita; Azevedo, Sara; Stone, Rosário; Almeida, Margarida

    2013-01-01

    Introdução: A transplantação renal é a terapêutica de eleição na criança com doença renal crónica terminal, evidenciando impacto positivo na sobrevida e qualidade de vida dos doentes. Não é, no entanto, isenta de complicações, algumas com importante morbilidade. Os autores pretendem caracterizar o perfil de complicações pós transplantação renal em doentes pediátricos (até 18 anos).Material e Métodos: Análise retrospectiva dos doentes submetidos a transplantação renal e seguidos na Unidade de Nefrologia Pediátrica entre Setembro de 1995 e Agosto de 2010. Dados obtidos dos processos clínicos: características demográficas, etiologia da doença renal crónica terminal, terapêutica de substituição renal, mortalidade e perda de enxertos, complicações cirúrgicas, infecciosas e não infecciosas (rejeição aguda e crónica, recidiva da doença de base, alterações metabólicas e factores de risco cardiovascular). Análise estatística descritiva simples.Resultados: Foram incluídas 78 crianças transplantadas (48,7% sexo masculino), com idade mediana à data da transplantaçãorenal de 12 anos (2 - 18). A maioria fez previamente diálise peritoneal: 49 (62,6%). Cinco doentes (6,4%) foram transplantados sem diálise prévia. A mediana do tempo de seguimento após transplante foi 37,5 meses (1 - 169). As principais etiologias de doença renal crónica terminal foram: uronefropatias (41%) e glomerulopatias (28,2%). As complicações infecciosas ocorreram em 74,4%; infecçõesvirais em 56,4%, sendo a mais prevalente a infecção citomegalovírus (39,7%); infecções bacterianas em 53,8% (na maioria infecções urinárias em doentes urológicos). Outras complicações: 1) factores de risco para doença cardiovascular: hipertensão arterial em 85,9%; dislipidémia em 16,7% e diabetes de novo em 7,7%; 2) episódios de rejeição aguda em 32,1% e nefropatia crónica do enxerto em 17,9%; 3) complicações relacionáveis com a cirurgia em 16

  3. Relaciones entre el sueño y la adicción

    PubMed Central

    Cañellas, Francesca; de Lecea, Luis

    2016-01-01

    Resumen La interacción entre los trastornos del sueño y el abuso de sustancias es ya conocida, pero seguramente más compleja de lo que se pensaba. Existe tanto una relación positiva entre tener un trastorno por uso de substancias y sufrir un trastorno de sueño, como viceversa. Los efectos sobre el sueño dependen de la substancia utilizada, pero se ha demostrado que tanto durante su uso como en período de abstinencia los consumidores tienen diferentes problemas de sueño y fundamentalmente un sueño más fragmentado. Sabemos que hay que tener en cuenta los problemas de sueño para evitar recaídas en la adicción. Investigaciones recientes indican que el sistema hipocretinérgico definido por el neuropéptido hipocretina/orexina (Hcrt/ox), localizado en el hipotálamo lateral e implicado entre otros en la regulación del ciclo sueño-vigilia, jugaría un papel importante en las conductas adictivas. Diferentes estudios han demostrado interacciones entre el sistema hipocretinérgico, los circuitos de respuesta aguda al estrés y los sistemas de recompensa. También sabemos que la activación optogenética selectiva del sistema hipocretinérgico incrementa la probabilidad de la transición del sueño a la vigilia, y también es suficiente para iniciar un comportamiento compulsivo de recaída adictiva. La activación del sistema hipocretinérgico podría explicar la hipervigilia asociada al estrés y a la adicción. El mayor conocimiento de esta interacción permitiría entender mejor los mecanismos de la adicción y encontrar nuevas estrategias para el tratamiento de las adicciones. PMID:23241715

  4. Alterações Induzidas Pelo Exercício no Número, Função e Morfologia de Monócitos de Ratos

    PubMed Central

    GUERESCHI, MARCIA G.; PRESTES, JONATO; DONATTO, FELIPE F.; DIAS, RODRIGO; FROLLINI, ANELENA B.; FERREIRA, CLÍLTON KO.; CAVAGLIERI, CLAUDIA R.; PALANCH, ADRIANNE C.

    2008-01-01

    O propósito desse estudo foi verificar as alterações histofisiológicas em monócitos e macrófagos induzidas por curtos períodos de exercícios. Ratos Wistar (idade = 2 meses, peso corporal = 200g) foram divididos em sete grupos (n=6 cada): controle sedentário (C), grupos exercitados (natação) na intensidade leve por 5 (5L), 10 (10L) e 15 minutos (15L), e grupos exercitados em intensidade moderada por 5 (5M), 10 (10M) e 15 minutes (15M). Na intensidade moderada os animais carregaram uma carga de 5% do peso corporal dos mesmos em seus respectivos dorsos. Os monócitos sangüíneos foram avaliados quanto à quantidade e morfologia e os macrófagos peritoneais foram analisados quanto à quantidade e atividade fagocitária. Os dados foram analisados usando ANOVA e Tukey’s post hoc test (p ≤ 0,05). Os grupos de intensidade leve e 5M apresentaram aumento nos níveis dos monócitos quando comparados com o controle. Foi observado aumento na área celular dos monócitos para os grupos 5L, 10L, 5M e 10M; a área nuclear aumentou para os grupos 10L, 5M e 10M em comparação com o controle. Houve aumento nos macrófagos peritoneais para os grupos 15L, 10M, 15M e diminuição no grupo 5M. A capacidade fagocitária dos macrófagos aumentou nos grupos de intensidade leve e para o grupo 10M. O exercício realizado por curtos períodos modulou o número e função dos macrófagos, assim como o número e morfologia dos monócitos, sendo tais alterações dependentes da intensidade. A soma das respostas agudas observadas nesse estudo pode exercer um efeito protetor contra doenças, podendo ser utilizada para a melhora da saúde e qualidade de vida.

  5. [Pertussis predictors in hospitalized infants with acute lower respiratory tract infection].

    PubMed

    Moreno, Laura; Montanaro, Patricia; Bujedo, Elizabeth; Cámara, Jorge; Abilar, C; Terzoni, M; Romano, M; Marqués, Inés; Quiroga, Daniel; Orecchini, Alejandra; Jacome, Javier; Ferrero, Fernando

    2013-01-01

    Antecedentes. La tos ferina o coqueluche, producida por Bordetella pertussis (BP) representa un problema re-emergente en nuestro medio. Aunque suele considerarse que la enfermedad es relativamente fácil de identificar, las infecciones por Virus Respiratorio Sincicial (VRS) pueden presentarse con síntomas similares en los lactantes siendo difícil su discriminación. Objetivo. Comparar síntomas clínicos y estudios complementarios al ingreso en lactantes hospitalizados con infección respiratoria aguda (IRA) por BP y por VSR a fin de establecer marcadores que posibiliten su predicción clínica temprana. Material y método. Estudio observacional, analítico, transversal de casos cruzados, comparando menores de 6 meses internados por IRA y sospecha de coqueluche (2007-2012) en los que se identificó BP (PCR y cultivo) y/o VRS (inmunofluorescencia en secreciones nasales); se excluyeron los pacientes con coinfecciones. Se realizó un análisis bivariado mediante el cálculo de OR con IC95%. Se consideró significativo un valor de p<0,05. Las variables en estudio fueron: edad, sexo, tos en accesos, cianosis, vómitos, apneas, sibilancias y hemograma completo con fórmula leucocitaria Resultados. Se incluyeron 174 lactantes; 72 (41%) BP y 102 (59%) VRS. Edad 2±1 mes (Rango:1-6). En ambos grupos se documentó tos y sibilancias (OR:1,2 (0,9-1,5) p:0,1 y OR:0,9 (0,8-1,06) p:0,2, respectivamente). Cianosis (87% vs. 6%;OR:14,8 p<0,01), apnea (38% vs. 3%;OR:13,4 p<0,01) y vómitos (26% vs. 5%;OR:3,4 p<0,01) fueron más frecuentes en lactantes con BP. El recuento absoluto de linfocitos fue significativamente mayor en niños con BP (9387±6317 vs. 5127±2766;p<0,01). Por curva ROC se identificó a 9000 cel/ml como el mejor punto para diferenciar BP de VSR (abc= 0,73; IC95%:0,64-0,81). Conclusiones. En lactantes menores de 6 meses con IRA la presencia al ingreso de apnea, cianosis y linfocitosis predicen significativamente coqueluche permitiendo diferenciarlos de aquellos con

  6. Effects of parenteral fish oil lipid emulsions on colon morphology and cytokine expression after experimental colitis.

    PubMed

    Garib, Ricardo; Garla, Priscila; Torrinhas, Raquel S; Bertevello, Pedro L; Logullo, Angela F; Waitzberg, Dan L

    2013-01-01

    Objetivo: Estudiar los efectos de los diferentes protocolos de infusión de la emulsion de lípidos de aceite de pescado (Fole) sobre la inflamación aguda en el modelo de colitis en la rata. Material y métodos: Ratas Wistar macho adultas (n = 51) fueron asignados al azar en 5 grupos para recibir infusión parenteral de solución salina (SS) o emulsión de lípidos de aceite de soja (SO), como controles, y Fole compone de: aceite de pescado solo (FO), una mezcla (9:1 v/v) de SO con FO (SO/FO), o 30% de aceite de soja, 30% triglicéridos de cadena media, 25% de aceite de oliva, y 15% de aceite de pescado (SMOF). Después de 72 h de infusión intravenosa, colitis experimental fue inducida con ácido acético. Después de 24 h, las muestras de colon se analizaron para determinar cambios histológicos y citoquinas. Resultados: En relación en el SS grupo, necrosis macroscópica fue menos frecuente en el grupo FO y necrosis histológica fue más frecuente en el grupo de SMOF. Existe una relación directa e inversa de colon interleuquina (IL) -1 e IL-4, respectivamente, con necrosis histológica. En comparación con el grupo SS, en el FO hubo aumento de IL-4 e IFN-gamma y disminución de TNF-alfa, SO/FO disminuyó TNF-alfa, y en el SMOF hubo aumento de IL-1 y la disminución de IL-4. Conclusión: En la colitis inducida por ácido acético, la infusion aislada de Fole compuesto de aceite de pescado por sí solo fue más ventajosa en la atenuacion de la inflamacióndo que la infusión de Fole contiendo otros aceites, y esta diferencia puede ser debida las influencias de su diferente contenido de ácido graso.

  7. Acute tubulointerstitial nephritis with severe renal impairment associated with multisystem IgG4-related disease.

    PubMed

    Beltrame, Rafael Coimbra Ferreira; Friderichs, Maurício; Fior, Bárbara Rayanne; Schaefer, Pedro Guilherme; Thomé, Gustavo Gomes; Silva, Dirceu Reis da; Barros, Elvino José Guardão; Seligman, Renato; Veronese, Francisco Veríssimo

    2016-01-01

    The IgG4-related disease has a wide clinical spectrum where multiple organs can be affected, and the diagnosis depends on typical histopathological findings and an elevated IgG4 expression in plasma cells in the affected tissue. We describe the clinical presentation and evolution of a patient with acute tubulointerstitial nephritis, severe kidney failure and systemic manifestations such as lymphadenomegaly and chronic pancreatitis. The diagnosis was confirmed by the clinical picture and kidney and lymph node histopathology, in which immunohistochemistry of the lymphoid tissue showed policlonality and increased expression of IgG4, with a IgG4/total IgG ratio > 80%. The patient was treated with prednisone at a dose of 60 mg/day, followed by mycophenolate mofetil, and showed clinical and renal function improvement at 6 months of follow-up. The high index of suspicion of IgG4-related disease with multisystem involvement and the early treatment of this condition are essential to improve the prognosis of affected patients. Resumo A doença relacionada à IgG4 tem um espectro clínico amplo em que múltiplos órgãos podem ser afetados, e o diagnóstico depende de achados histopatológicos típicos e elevada expressão de IgG4 em plasmócitos no tecido afetado. Descrevemos o quadro clínico e a evolução de um paciente com nefrite túbulo-intersticial aguda, insuficiência renal grave e manifestações sistêmicas como linfoadenomegalias e pancreatite crônica. O diagnóstico foi confirmado pelas características clínicas e pela histopatologia renal e de linfonodo, na qual a imunohistoquímica mostrou tecido linfoide com policlonalidade e expressão aumentada de IgG4, com uma relação IgG4/IgG total > 80%. O paciente foi tratado com prednisona na dose de 60 mg/dia, seguido de micofenolato mofetil, e apresentou melhora clínica e da função renal depois de 6 meses de tratamento. O alto índice de suspeição da doença relacionada ao IgG4 com comprometimento multissist

  8. High-oleic peanuts increase diet-induced thermogenesis in overweight and obese men.

    PubMed

    Duarte Moreira Alves, Raquel; Boroni Moreira, Ana Paula; Silva Macedo, Viviane; Brunoro Costa, Neuza Maria; Gonçalves Alfenas, Rita de Cássia; Bressan, Josefina

    2014-05-01

    Antecedentes: Las pruebas sugieren que el consumo de frutos secos puede mejorar el metabolismo energético. Propósito: Este estudio tenía por finalidad comparar los efectos de la ingesta aguda de cacahuetes con alto contenido en oleico y cacahuetes convencionales sobre el apetito, el consumo de alimentos y el metabolismo energético in hombres con sobrepeso y obesos. Métodos: Se distribuyó a 71 individuos (29,8 ± 2,4 kg/m2) a los grupos: control (CT, n = 24); cacahuetes convencionales (CVP, n = 23); cacahuetes con alto contenido en oleico (HOP, n = 24). Los individuos consumieron 56 g de cacahuetes (CVP y HOP) o control (CT) tras un ayuno nocturno. Posteriormente, se evaluó el metabolismo energético a lo largo de 200 minutes, durante los cuales se analizaron la termogénesis inducida por la dieta (TID) y la oxidación de sustratos. La sensación de apetito se registró durante 3 horas. Se realizaron los análisis estadísticos con el programa SAS considerando un nivel de significación del 5%. Resultados: El consumo de energía posprandial y la TID fueron significativamente superiores en el HOP que el CVP. La oxidación de sustratos no difirió entre los grupos. Sólo el HOP presentó una puntuación por debajo de 100, lo que indicaba una compensación incompleta. El CT y el CVP mostraron una compensación calórica completa (puntuaciones > 100). Con respecto a la sensación de apetito, el grupo CVP se mostró menos “lleno” que los grupos HOP y CT. A las 3 horas, la puntuación de saciedad del CVP volvió a la situación basal, mientras que en los grupos HOP y CT permanecía significativamente superior. Las puntuaciones de hambre volvieron a la situación basal in los grupos CVP y CT y se mantuvieron significativamente por debajo a las del grupo HOP. Conclusión: Los cacahuetes con alto contenido en oleico contribuyen a una mayor TID, mayor sensación de plenitud y una compensation incompleta del consumo de energía en comparación con los cacahuetes

  9. [Bouveret's syndrome: A rare presentation of gallstone ileus].

    PubMed

    Franco-Avilés, Luis; Arce-Guridi, Héctor Tonalli; Mercado, Ulises

    2016-01-01

    Introducción: el síndrome de Bouveret se caracteriza por una obstrucción de la salida gástrica, causado por un cálculo en el bulbo duodenal, después de pasar a través de una fístula colecistoduodenal. Caso clínico: reportamos el caso clínico de una mujer de 46 años de edad, quien se presentó con dolor epigástrico intermitente, nausea, vómito y pérdida de peso de 2 meses de duración. No tenía fiebre, deshidratación o ictericia. La paciente admitió uso de alcohol y abuso de metanfetamina. La amilasa, enzimas, electrolitos y creatinina estuvieron dentro de los límites normales. Siete meses antes había ingresado a Urgencias por colecistitis aguda. El ultrasonido fue reportado como colelitiasis sin dilatación de la vía biliar intra/extrahepática. Las radiografías simples de abdomen no mostraron hallazgos relevantes. Recibió tratamiento conservador y fue egresada. Se programó para cirugía laparoscópica. Durante el procedimiento se encontró un plastrón subhepático con adherencias firmes, por lo que se efectuó cirugía abierta. La vesícula se encontró adherida al bulbo duodenal y un cálculo impactado en el duodeno. Se removió el calculo por enterotomía. Habia leve distension gastrica. Debido a la inflamacion regional, el cirujano decidio efectuar Bilroth 1; no hubo complicaciones. Conclusiones: las manifestaciones clínicas del síndrome de Bouveret son inespecíficas. El diagnóstico preoperatorio es un desafío para el clínico por la rareza del padecimiento. El tratamiento debe individualizarse.

  10. [First report of complete genome sequence and phylogenetic analysis of Human Bocavirus 1 isolated in Argentina].

    PubMed

    Cardozo Tomas, Agustina; Ghietto, Lucia Maria; Insfran, Constanza; Wasinger, Nicolas; Marchesi, Ariana; Adamo, Maria Pilar

    2015-01-01

    Antecedentes. El Bocavirus humano (HBoV) es un parvovirus descripto por primera vez en 2005, asociado a cuadros leves y graves de infección respiratoria aguda (IRA), una de las principales causas de morbimortalidad en la población infantil en todo el mundo. Al presente se han identificado 4 genotipos, nombradas HBoV1 a 4, de los cuales el primero es el que se asocia a IRA con predominancia. Objetivo. Obtener el genoma completo de HBoV respiratorio aislado localmente. Métodos. Se diseñaron primers para fragmentos superpuestos del genoma completo de HBoV, empleando las herramientas informáticas ClustalW y NCBI Primer-Blast. Los fragmentos se amplificaron por PCR convencional y se secuenciaron mediante tecnología capilar BigDye Terminator. La edición de las secuencias y análisis filogenético se realizó con el programa MEGA v6. Resultados. Se obtuvo la secuencia genómica completa de HBoV1 cepa 307AR09, aislada de secreción respiratoria de paciente pediátrico con bronquiolitis. La misma fue depositada en la base de datos GenBank con número de acceso KJ634207. El análisis filogenético con secuencias genómicas completas de los 4 genotipos obtenidas en distintas regiones del mundo muestra similitud cercana al 100% con la secuencia original descubierta en Suecia (DQ000495), así como el agrupamiento de los 4 genotipos en 2 clusters de alta homología interna: HBoV1-HBoV3 y HBoV2-HBoV4. Conclusiones. Se aportan datos locales para futuros desarrollos tecnológicos destinados tanto a la investigación como al diseño de métodos diagnósticos para la práctica médica. Por otra parte, los resultados sustentan la propuesta de redistribución taxonómica de los 4 genotipos en 2 especies.

  11. [231 laparoscopic cholecystectomy in ambulatory: what results?].

    PubMed

    Goulart, André; Delgado, Margarida; Antunes, Maria Conceição; Braga Dos Anjos, João

    2013-01-01

    Introdução: A colecistectomia laparoscópica é actualmente o gold standard no tratamento da patologia litiásica vesicular e colecistite aguda. A sua realização em regime de cirurgia de ambulatório permanece em discussão. O presente estudo tem por objectivo analisar a qualidade e segurança das colecistectomias laparoscópicas realizadas pela Unidade de Cirurgia de Ambulatório do Hospital de Braga e comparar os resultados com outros centros europeus que realizam colecistectomia laparoscópica em regime de ambulatório.Material e Métodos: Estudo observacional prospectivo de doentes submetidos a colecistectomia laparoscópica em regime de ambulatório durante 26 meses. Foram recolhidos dados referentes à demografia do doente, complicações peri e pós-operatórias, tempo cirúrgico e tempo de permanência no recobro e internamentos não programados.Resultados: Foram submetidos a colecistectomia laparoscópica em regime de ambulatório com pernoita (alta < 24h) 231 doentes. Três doentes tiveram intercorrências intra-operatórias com necessidade de conversão para laparotomia e quatro doentes foram internados após a cirurgia. O tempo médio de cirurgia foi de 58 minutos e o tempo médio de recobro de 19h19m. A morbilidade pósoperatória foi de 7,8% tendo, ocorrido dois internamentos não programados.Discussão: Uma das discussões que existe em torno da colecistectomia laparoscópica em regime de ambulatório é a necessidade de vigilância hospitalar durante a primeira noite após a cirurgia. Na nossa unidade, iniciamos a realização da colecistectomia laparoscópica em regime de ambulatório com pernoita hospitalar. Os resultados de mais de dois anos e 231 doentes operados a colecistectomia laparoscópica mostram que é uma técnica perfeitamente segura em regime de ambulatório.Conclusões: Os dados do estudo mostram que a colecistectomia laparoscópica é uma técnica segura em regime de ambulatório, com resultados semelhantes comparativamente com

  12. Aspergilosis cervical con diseminación al sistema nervioso central. Presentación de un caso y revisión de bibliografía

    PubMed Central

    Vergara, Guillermo Enrique; Roura, Natalia; del Castillo, Marcelo; Mora, Andrea; Alcorta, Santiago Condomi; Mormandi, Rubén; Cervio, Andrés; Salvat, Jorge

    2015-01-01

    Introducción: la Aspergilosis Invasiva (AI) del Sistema Nervioso Central (SNC) es infrecuente y ocurre generalmente en pacientes inmunocomprometidos. Puede presentarse con cuadros de meningitis, aneurismas micóticos, infartos o abscesos. Es una infección con pronóstico reservado y puede afectar el SNC de forma primaria o secundaria a partir de un foco que se disemina por vía hematógena. Presentamos el caso de un paciente con AI con invasión primaria a nivel óseo y diseminación posterior al cerebro. Caso clínico: Paciente masculino de 25 años con diagnóstico de leucemia linfática aguda en tratamiento quimioterápico que presentó neumonitis por metotrexate por lo que inicia tratamiento con corticoides. Posteriormente agregó cervicalgia y con el diagnóstico de osteomielitis cervical se realiza punción bajo tomografía computada (TC) sin aislarse gérmenes. Se colocó Halo Vest e inició tratamiento antibiótico empírico. Posteriormente presentó afasia de expresión secundaria a lesión frontal izquierda. Se realizó evacuación de absceso cerebral aislando A. fumigatus. El tratamiento antibiótico específico posterior permitió una buena respuesta clínica y radiológica. Conclusión: La presencia de lesiones en el SNC de pacientes inmunocomprometidos debe incluir a las micosis como diagnóstico diferencial. La evacuación quirúrgica permite llegar rápidamente al diagnóstico mejorando la respuesta posterior al tratamiento antibiótico. Para evaluar la respuesta terapéutica y posibles recaídas se debe realizar un seguimiento periódico clínico radiológico. Palabras clave: Aspergilosis cerebral; Aspergilosis cervical; Aspergilosis invasiva; Voriconazol. PMID:26600985

  13. [HLA DRB1*, DQB1*, DPA1*, and DPB1* and their association with the pathogenesis of leukemia in the population of Venezuela].

    PubMed

    Rivera-Pirela, Sergio E; Echeverría, Miriam; Salcedo, Pedro; Márquez, Georgina; Carrillo, Zuhey; Parra, Yennis; Cipriani, Ana María; Núñez, José R; Álvarez de Mon, Melchor

    2016-01-01

    Antecedentes: La presencia de HLA es un factor que influye en la patogénesis de las leucemias. Objetivos: Se evaluó la presencia de alelos HLA clase II DRB1*, DQB1*, DPA1* y DPB1* en 47 pacientes con leucemia linfoide aguda (LLA) y 48 con leucemia mieloide crónica (LMC), para compararlos con 48 voluntarios sanos de Zulia, Venezuela, y determinar las posibles asociaciones de HLA con las leucemias. Métodos: Se utilizó la técnica de PCR-SSP de baja y alta resolución para las regiones HLA clase II DRB1*, DQB1*, DPA1* y DPB1* conforme las instrucciones del KIT Olerup SSP Genovision. Resultados: Los alelos HLA-DRB1*14, especialmente DRB1*14:21, -DPA1*1:06, -DPA1*01:03,-DPA1*02:01, y los haplotipos HLA-DPA1*01:03-DPB1*04:01, DPA1*01:03-DPB1*02:01, DPA1*01:03-DPB1*99:01, -DRB1*14-DPA1*01:03, -DRB1*15-DPA1*01:03 tuvieron asociación con LMC (RR > 3); los alelos HLA-DRB1*13, -DQB1*02, -DPA1*01:05, -DPA1*01:09 y los haplotipos HLA-DPA1*01:09-DPB1*02:01, DPA1*01:09-DPB1*04:01 resultaron protectores (RR < 1). Los alelos HLA-DQB1*04, -DQB1*05, -DPA1*1:06, -DPA1*01:07, -DPA1*1:08 tuvieron asociación positiva con LLA. Los alelos HLA-DPA1*01:09, -DPA1*02:01, -DPB1*02:01, -DPB1*03:01 y los haplotipos HLA-DPA1*01:03-DPB1*04:02, -DPA1*01:09-DPB1*02:01, -DPA1*01:09-DPB1*04:01, -DPA1*02:01-DPB1*04:02 resultaron asociados negativamente. Conclusiones: La fuerte asociación de HLA DRB1*14 con la LMC y la ausencia de asociaciones DRB1* con LLA y los otros patrones de asociación identificados sugieren marcadas diferencias en las patogénesis de las leucemias, lo que orienta hacia posibles deficiencias en la presentación antigénica para LLA o posibles efectos de mimetismo molecular en LMC.

  14. [Mexican guidelines on the diagnosis and treatment of urticaria].

    PubMed

    Larenas-Linnemann, Désirée; Medina-Ávalos, Miguel Alejandro; Ortega-Martell, José Antonio; Beirana-Palencia, Angélica María; Rojo-Gutiérrez, María Isabel; Morales-Sánchez, Martha Alejandra; Solorio-Gómez, Héctor; Alonzo-Romero Pareyón, María Lourdes; Vargas-Correa, Jorge Bernardo; Baez-Loyola, Carlos; Blancas-Espinosa, Roberto; Esquer-Flores, Joaquín; Gómez-Vera, Javier; Guzmán-Perea, María Graciela; Macías-Weinmann, Alejandra; Maldonado-García, César Alfonso; Martínez-Villarreal, José Darío; Matta-Campos, Juan José; Medina-Segura, Elías; Del Río-Navarro, Blanca; Salgado-Gama, Juan Ignacio; Stone-Aguilar, Héctor; Sienra-Monge, Juan José Luis; González-Díaz, Sandra Nora; Mendoza-López, Enrique; Amaya-Guerra, Mario; Lemini-López, Alicia; Blanco-Montero, Andrés; Chavarría-Jiménez, María Teresa; Guerrero-Michaus, Martha Graciela; Martínez-Pérez, Albina; Ramírez-Segura, Ruth Ivonne Mireya; Montes-Narváez, Gabriel; Olvera-Salinas, Jorge; Rosas-Sumano, Ana Beatriz

    2014-01-01

    Antecedentes: la urticaria es una enfermedad que padece una quinta parte de la población en algún momento de su vida. Las guías internacionales recientes han propuesto unos cambios de fondo en su diagnóstico y tratamiento, por lo que había la necesidad de crear una guía nacional y multidisciplinaria, con base amplia en los gremios de especialistas y médicos de primer contacto en México. Material y método: un grupo interdisciplinario de expertos clínicos y algunos expertos en metodología determinó los objetivos y alcances de la Guía de Práctica Clínica Basada en Evidencia con el instrumento SCOPE. Se decidió llevar a cabo la adaptación y transculturización de guías internacionales para el diagnóstico y tratamiento de urticaria. Con el instrumento AGREE-II se seleccionaron las tres guías de alta calidad, como guías base (Zuberbier 2014, Sánchez-Borges 2012, Powell 2007) para formular y contestar la preguntas clínicas clave, en el contexto cultural y económico mexicano, según el método de desarrollo de recomendaciones GRADE. Resultados: mediante un proceso formal de discusión y votación durante varias juntas de expertos, se terminó la redacción de la forma final de la guía, con especial cuidado de lograr un ajuste a las realidades, valores y preferencias de los pacientes de México. Se hace hincapié en la administración de antihistamínicos vía oral de segunda generación, como tratamiento de primera elección. Conclusión: este documento es una Guía de Práctica Clínica Basada en Evidencia para el diagnóstico y tratamiento de urticaria aguda y crónica, basada en tres guías internacionales de alta calidad. Se desarrolló por un grupo multidisciplinario. Los cuadros y algoritmos hacen a la guía amigable para su uso por médicos de primer contacto y por especialistas.

  15. [Pseudomyxoma peritonei. Two-case-report].

    PubMed

    Carranza-Martínez, Ixchel; Cornejo-López, Gilberto; Monroy-Argumedo, Montserrat; Villanueva-Sáenz, Eduardo

    2014-01-01

    Antecedentes: el pseudomixoma peritoneal se caracteriza por la diseminación celular intraperitoneal de un tumor adenomucinoso; el apéndice cecal es la etiología más frecuente. Objetivo: reportar la experiencia de un grupo de Cirugía General y revisar la bibliografía. Casos clínicos: 1: paciente femenina de 74 años de edad, que cuatro días previos inició con dolor abdominal tipo cólico en el mesogastrio y fosa iliaca derecha, evacuaciones diarreicas y fiebre. A su ingreso al hospital se la encontró con datos de irritacion peritoneal y resistencia muscular, leucocitosis de 14,500 células por mm3, neutrófilos 89%, bandas 1%. Se diagnosticó: apendicitis aguda y se programó para laparoscopia diagnóstica, con distensión importante de asas, por lo que se decidió convertir a laparotomía. Caso 2: paciente masculino de 73 años de edad; el padecimiento actual se inició con dolor intermitente en la fosa iliaca derecha e hipogastrio, de un año de evolución. Al cuadro se agregaron: disnea, estreñimiento alternado con periodos de diarrea, plenitud gástrica, y pirosis. A la exploración física se encontró un tumor palpable en el mesogastrio y ambas fosas iliacas. Por eso se le realizó la laparotomía exploradora. En ambos casos el diagnóstico se estableció en el transoperatorio con el hallazgo de múltiples implantes tumorales mucinosos multilobulados diseminados en la cavidad peritoneal, el diagnóstico se confirmó con el reporte histopatológico de pseudomixoma peritoneal. Conclusiones: el pseudomixoma peritoneal es una neoplasia poco frecuente y de difícil diagnóstico, caracterizada por producción copiosa de ascitis mucinosa y de múltiples implantes tumorales en la serosa de las vísceras intracavitarias. El tratamiento ideal es la cirugía citorreductiva y la quimioterapia intraperitoneal perioperatoria o la quimioterapia postoperatoria, o ambas.

  16. [Appendiceal carcinoid tumors. Evaluation of long-term outcomes in a tertiary level].

    PubMed

    Suárez-Grau, Juan Manuel; García-Ruiz, Salud; Rubio-Chaves, Carolina; Bustos-Jiménez, Manuel; Docobo-Durantez, Fernando; Padillo-Ruiz, Francisco Javier

    2014-01-01

    Antecedentes: los tumores apendiculares se encuentran en cerca de 1% de las apendicectomías y representan 0.5% de las neoplasias intestinales. El tipo de tumor más frecuente es el carcinoide apendicular, que casi siempre es un hallazgo durante la apendicectomía por otro motivo. Su pronóstico es excelente y la supervivencia es mayor de 95% a cinco años de la intervención. Objetivo: reportar una serie de casos y analizar la supervivencia media a cinco años posteriores a la identificación el tumor. Material y métodos: análisis retrospectivo (1990-2010) de pacientes con tumor carcinoide apendicular intervenidos en el servicio de Cirugía General y del Aparato Digestivo del Hospital Universitario Virgen del Rocío, Sevilla, España. Se analizaron: la supervivencia a cinco años, la necesidad de tratamiento complementario y las pruebas para seguimiento en la consulta. Resultados: se encontraron 42 pacientes intervenidos por tener un tumor carcinoide apendicular. En 38 pacientes la operación fue de urgencia, la mayoría por sospecha de apendicitis aguda, sin que en ninguno se hubiera establecido el diagnóstico de tumor carcinoide antes de la operación. El síntoma predominante al ingreso fue el dolor abdominal. El tratamiento quirúrgico fue: apendicectomía en 34 pacientes (12 por laparoscopia), en el intraoperatorio siete pacientes requirieron resecciones colónicas mayores debido a la afectación del colon; sólo uno requirió la reintervención para completar la hemicolectomía derecha. Al momento del diagnóstico dos pacientes tenían enfermedad diseminada (metástasis hepáticas). La supervivencia a cinco años fue superior a 95%, sin recidivas o tratamiento posterior de la enfermedad. Conclusiones: el tumor carcinoide apendicular difícilmente se diagnostica antes del procedimiento quirúrgico. La apendicectomía suele ser suficiente aunque en algunos pacientes las resecciones colónicas son necesarias por diseminación. La supervivencia a 5 años es

  17. [Clinical applications of the use of probiotics in pediatrics].

    PubMed

    Álvarez-Calatayud, Guillermo; Pérez-Moreno, Jimena; Tolín, Mar; Sánchez, César

    2013-01-01

    Introducción: El empleo de probióticos supone un novedoso avance en el campo de la Pediatría puesto que pueden ser útiles en la prevención y tratamiento de múltiples patologías gastrointestinales, constituyendo un elemento más en nuestro arsenal terapéutico. Objetivo: En este artículo se presenta una revisión actualizada de la literatura científica sobre el uso de los probióticos en Pediatría, principalmente en problemas gastrointestinales con alteración en la microbiota intestinal describiéndose las principales aplicaciones del empleo de los probióticos y prebióticos en la infancia y repasando las líneas de investigación futuras. Resultados y conclusiones: A pesar de existir suficiente evidencia científica en varias patologías, la utilización de probióticos no está del todo incorporado a la práctica clínica habitual de los pediatras. Se emplea en el contexto de las enfermedades gastrointestinales (diarrea aguda infecciosa, la diarrea asociada a antibióticos, sobredesarrollo bacteriano) y, más recientemente, en procesos inflamatorios crónicos como la enfermedad inflamatoria intestinal o en trastornos funcionales como el cólico del lactante o el estreñimiento. También se ha valorado su efecto beneficioso en alteraciones extraintestinales, tales como la alergia (dermatitis atópica) o los efectos sobre las mucosas respiratorias o urogenitales y, en los últimos años, en la prevención de patología del recién nacido pretérmino y en la infección por H. pylori. Además existen varias líneas de investigación abiertas en la suplementación alimentaria con probióticos y prebióticos. Cada cepa prebiótica debe ser estudiada individualmente y extensamente para determinar su eficacia y seguridad en todas aquellas situaciones en que su empleo puede ser aconsejable.

  18. EFFECTS OF A DIETARY SUPPLEMENT ON THE INCIDENCE OF ACUTE RESPIRATORY INFECTIONS IN SUSCEPTIBLE ADULTS: A RANDOMIZED CONTROLLED TRIAL.

    PubMed

    Bernal-Orozco, María Fernanda; Posada-Falomir, Margarita; Ortega-Orozco, Rafael; Silva-Villanueva, Elvia Elaonor; Macedo-Ojeda, Gabriela; Márquez-Sandoval, Yolanda Fabiola; Vizmanos-Lamotte, Barbara

    2015-08-01

    Introducción: aunque la suplementación de micronutrientes específicos puede mejorar determinados factores inmunológicos, han sido publicados pocos estudios sobre la combinación de micronutrientes con extractos herbales y la incidencia de infecciones respiratorias agudas (ARI) . Objetivos: evaluar el efecto de un suplemento alimenticio con micronutrientes y extractos herbales en la incidencia de ARI en adultos susceptibles, en enero-abril de 2012. Métodos: se realizó un ensayo clínico paralelo, aleatorizado, doble ciego, controlado con placebo. Se incluyeron adultos susceptibles a ARI, sanos en el momento de la evaluación, que firmaron un consentimiento informado y que no tomaban medicamentos. Completaron una historia clínica y se evaluó: peso, talla, signos vitales y de laboratorio. Se asignaron aleatoriamente para consumir durante 90 días el suplemento o un placebo. Los sujetos registraron diariamente si presentaban o no síntomas de ARI en un diario. En caso de enfermedad, se lo notificaron a los investigadores y el médico responsable confirmó la presencia de infección. Se utilizó la prueba exacta de Fisher para comparar la proporción de enfermos entre los grupos y se calculó el riesgo relativo y la diferencia de riesgos (p < 0,05 significativa). Resultados: de 59 sujetos incluidos, 45 (25 mujeres) completaron el estudio (21 del grupo suplementado y 24 del placebo). No hubo diferencias significativas al inicio entre grupos. Al finalizar la intervención, el grupo suplementado tuvo una menor incidencia de ARI en comparación con el placebo (57,1% vs 91,7%, p = 0,013, RR = 0,62, IC95% 0,42, 0,92). Discusión: en conclusión, el consumo de un suplemento a base de micronutrientes y extractos herbales puede disminuir la incidencia de ARI en adultos susceptibles.

  19. [Giant abscessed urachal cyst in adult. Case report].

    PubMed

    Ponce-Pérez, Luis Virgilio; Cárdenas-Lailson, Luis Eduardo; Domínguez-Muñoz, Guillermo; López-Díaz, Yazmín Araceli; Vera-Rodríguez, Fernando

    2013-01-01

    antecedentes: durante la gestación, el uraco representa la conexión entre la vejiga y el alantoides. Su infección se manifiesta, principalmente, en adultos jóvenes. La vía hematógena o linfática son las posibles rutas de trasmisión, aunque también puede ocurrir el origen umbilical o de vejiga. El quiste de uraco es raro en adultos y sólo puede observarse en 2%. Caso clínico: paciente masculino de 30 años, con antecedente de hepatopatía alcohólica, diabetes mellitus tipo 2, desnutrición crónica. Inició con aumento del volumen abdominal, dolor abdominal generalizado, tumor abdominal de 20 por 15 cm, móvil, de consistencia sólida, sin signos de irritación peritoneal.La tomografía computada mostró un tumor probablemente dependiente de la vejiga, de aspecto quístico. En la laparotomía exploradora se encontró un quiste de uraco infectado, que drenaba 3,000 cc de material purulento. Se realizó la resección parcial de la cara anterior y se conservó la posterior debido a la adherencia firme a las asas intestinales. La evolución postoperatoria fue satisfactoria. discusión: las alteraciones uracales son raras, con razón hombre:mujer de 2:1. Aunque un absceso uracal representa una infección confinada a un espacio cerrado, su tratamiento definitivo no debe ser la simple incisión y drenaje, debido a la posibilidad de degeneración maligna de los restos uracales. El tratamiento definitivo debe considerar la escisión completa del quiste, y del uraco, cuando la infección esté limitada. Conclusión: el quiste de uraco es una afección poco frecuente, que debe considerarse en el diagnóstico diferencial de apendicitis aguda, y tener en mente su tratamiento definitivo.

  20. [Undifferentiated high grade pleomorphic sarcoma/ malignant fibrous histiocytoma associated a gouty tophus. a case report].

    PubMed

    Szlabi, Susana; Flores, Jorge O; Diller, Ana L de; Cabrera, Marta

    2012-01-01

    Antecedentes: La gota es una enfermedad metabólica por depósito de cristales de ácido úrico, que compromete articulaciones y tejidos blandos tanto en sus etapas agudas como crónicas. Constituye un suceso poco común la aparición de un tumor en el sitio propio de la lesión. Objetivo: presentar un caso de asociación infrecuente entre tofo gotoso y sarcoma. Material y métodos: hombre de 83 años que consultó por tumoración en codo izquierdo de aproximadamente 40 años de evolución, que comenzó a doler espontáneamente. Con la presunción diagnóstica de tofo gotoso se trató quirúrgicamente. La lesión recidivó a los 60 días, se realizó reintervención y radioterapia por diagnóstico de tumor mesenquimal maligno asociado a tofo gotoso. A los 10 meses desarrolló metástasis ganglionar homolateral, falleció antes de los 2 años de la consulta inicial. Resultados: El diagnóstico de la primer biopsia fue tofo gotoso. En el material de reintervención se diagnosticó tofo gotoso asociado a neoplasia mesenquimal fusocelular de alto grado; la inmunohistoquímica reveló: vimentina +/+, MYO D1 -/-, ASMA -/-, FVIII -/-, A1ATT -/-, CD68-/-, S100-/- con resultado diagnóstico final de sarcoma pleomórfico indiferenciado de alto grado. Conclusión: Es infrecuente que los tofos gotosos se asocien a otras enfermedades y menos que lo hagan a tumores. En la bibliografía se han reportado tres casos previos concurrentes con neoplasias, las cuales fueron angiosarcoma, tumor de células gigantes y fibrohistiocitoma maligno. Estos últimos tienen una alta tendencia a recidivar y poseen capacidad de dar metástasis, especialmente a pulmones y ganglios regionales. Palabras clave: tofo gotoso, fibrohistiocitoma maligno, sarcoma pleomórfico indiferenciado.

  1. PubMed

    García de Lorenzo Y Mateos, Abelardo

    2017-02-01

    Ante cualquier agresión, el organismo pone en marcha una respuesta inflamatoria, mediada por factores humorales y celulares, que tiende a limitar el proceso y a conseguir la curación. En algunos casos, ya sea por la intensidad o duración de la noxa,ya por una inadecuada respuesta del huésped secundaria a polimorfismos genéticos, malnutrición u otras causas, se produce un estado de hiperactivación de las células inflamatorias, con liberación de células inmaduras y activación de monocitos y macrófagos, que liberan poderosos mediadores proinflamatorios e inducen un estado de inflamación sistémica generalizada. Numerosos procesos pueden dar lugar a esta respuesta inflamatoria (sepsis, traumatismos, quemaduras, pancreatitis, etc.) con activación de los sistemas leucocitarios, endoteliales, de la coagulación y de la respuesta neuroendocrina, lo que genera un complejo entramado de mediadores (citocinas, moléculas de adhesión y factores de crecimiento, entre otros). Clínicamente, la respuesta se caracteriza por inflamación, anorexia, inmovilidad, aumento en la permeabilidad vascular que condiciona la aparición de edema, vasodilatación que se acompaña de hipotensión, taquicardia e incremento del gasto cardiaco. Por otro lado, la respuesta metabólica al estrés forma parte de ese mecanismo de adaptación, que el organismo genera para sobrevivir a la enfermedad aguda aumentando el aporte de sustratos energéticos a los tejidos vitales. Como resultado de esa compleja respuesta metabólica, el control de la utilización de los sustratos energéticos está solo parcialmente regulado por su disponibilidad, debido a que al estar alterados los mecanismos de producción energética, el organismo busca sustratos alternativos.

  2. [Deep Vein Thrombosis Prophylaxis in Patients with Traumatic Brain Injury].

    PubMed

    Silva, Vinícius Trindade Gomes da; Iglesio, Ricardo; Paiva, Wellingson Silva; Siqueira, Mario Gilberto; Teixeira, Manoel Jacobsen

    2015-01-01

    Introdução: O risco de trombose venosa profunda encontra-se aumentado em doentes vítimas de traumatismo cranioencefálico, mas a profilaxia da trombose venosa profunda se confronta com o possível risco de piora de lesões hemorrágicas relacionados ao traumatismo cranioencefálico. Neste artigo apresentamos uma revisão crítica do tema e propomos um protocolo de profilaxia para estes doentes.Material e Métodos: Foi realizada uma pesquisa na base de dados Medline/PubMed, Cochrane, e Scielo de janeiro de 1998 a janeiro de 2014 com a expressão de busca âÄúdeep venous thrombosis and prophylaxis and traumatic brain injuryâÄù. Foram encontrados 44 artigos usando os termos MeSH definidos. Destes foram selecionados 23 artigos, usando como critérios: publicação em inglês ou português, fase aguda do traumatismo cranioencefálico moderado e grave, profilaxia mecânica não invasiva ou química.Resultados: O traumatismo cranioencefálico é um fator de risco para trombose venosa profunda e tromboembolismo pulmonar. A chance de trombose venosa profunda é 2,59 vezes maior em doentes com traumatismo cranioencefálico. A prevalência de trombose venosa profunda e embolia pulmonar em doentes que sofreram traumatismo cranioencefálico é de 20%, podendo atingir 30% dos doentes em alguns estudos.Discussão e Conclusão: As diversas formas de traumatismo de forma isolada constituem fator de risco para trombose venosa profunda e tromboembolismo pulmonar. Ensaios clínicos são necessários para estabelecer a eficácia da profilaxia e o melhor momento de iniciar medicação para trombose venosa profunda em doentes com traumatismo craniencefálico.

  3. Growth and molting in epizoic pedunculate barnacles genus Octolasmis (Crustacea: Thecostraca: Cirripedia: Thoracica).

    PubMed

    Blomsterberg, Mikkel; Glenner, Henrik; Høeg, Jens T

    2004-05-01

    Scanning electron microscopy, light microscopy, and histology were used to study growth in species of the pedunculate barnacle genus Octolasmis (O. angulata, O. cor, O. californiana, O. mülleri). These species are epizoic in the gill chamber of portunid crabs and have highly reduced capitular shell plates, with large areas of general cuticle in between. The external integument grows by means of a system of narrow growth zones, one encircling the peduncle and a Y-shaped system on either side of the capitulum. Growth is by a regular series of molts, but shedding of old cuticle and production of new layers is entirely restricted to the growth zones. Just prior to ecdysis, the new cuticle lies in a highly folded fashion beneath the old cuticle that is about to be shed. At ecdysis, the old cuticle breaks along the margins of the growth zones and the resulting scars remain as a system of "ecdysial lines" along either side of the zone. Once exposed after ecdysis, the new cuticle remains as a part of the permanent external integument. The growth zones divide the externa into five cuticular areas, two on the peduncle and three on the capitulum. The calcareous shell plates (carina, paired scuta, and, when present, paired terga) all lie within the capitular regions and the ecdysial lines pass across, not around, these mineralized areas. The number, relative spacing, and topology of the ecdysial lines form a record of the growth history of the specimen. These and other growth patterns demonstrate that size increase is due to the formation of new cuticle by molting in the growth zones, while expansion of the shell plates by mineralization follows only after production of the new cuticle. Thus, although specialized, growth in Octolasmis still complies with the general crustacean model, complicated only by the mineralization of parts of the capitular cuticle into shell plates. The results are compared with the very scarce information on molting in other barnacles. We argue that

  4. [β-Tricalcium Phosphate in the Surgical Treatment of Proximal Humeral Fractures].

    PubMed

    Sarmento, Marco; Martins, Samuel; Monteiro, Jacinto

    2016-01-01

    Introdução: As fraturas proximais do úmero são cada vez mais frequentes, com maior tendência para o seu tratamento cirúrgico, predominado a utilização da osteossíntese com placa e parafusos bloqueados. Pela falência mecânica e biológica, apesar da evolução deste tipo de implantes, a utilização de enxertos ósseos sintéticos passaram a ser uma opção. Material e Métodos: Num período de 96 meses, avaliámos os doentes com fraturas proximais do úmero, tratados cirurgicamente com placa e parafusos bloqueados e nos quais foi usado enxerto ósseo sintético de fosfato β-tricálcico. Avaliaram-se os resultados funcionais pelo arco de mobilidade e pelos exames radiográficos. Resultados: Nos 19 doentes avaliados, para um follow-up médio de 53 meses, obteve-se um arco de mobilidade com valores médio de abdução de 140º, flexão anterior de 142º, rotação externa de 37º e rotação interna com mão a L3, para um ângulo cefalo-diafisário de 136º. Discussão: A utilização de enxerto ósseo sintético de fosfato β-tricálcico permite a estabilização da redução após fixação das fraturas proximais do úmero estabilizadas com placa e parafusos bloqueados. Esta redução que se traduz na manutenção do ângulo cefalodiafisário, permite a obtenção de bons resultados funcionais como o demonstra o arco de mobilidade nos vários planos. Conclusão: O enxerto ósseo sintético de fosfato β-tricálcico deverá ser encarado como uma terapêutica auxiliar na osteossíntese extramedular das fraturas proximais do úmero, principalmente naquelas com maior dificuldade de manutenção da redução pela maior cominução do calcar medial.

  5. Characterization of persistent follicles induced by prolonged treatment with progesterone in dairy cows: an experimental model for the study of ovarian follicular cysts.

    PubMed

    Díaz, Pablo U; Stangaferro, Matías L; Gareis, Natalia C; Silvia, William J; Matiller, Valentina; Salvetti, Natalia R; Rey, Florencia; Barberis, Fabián; Cattaneo, Luciano; Ortega, Hugo H

    2015-10-15

    Cystic ovarian disease (COD) is a major factor contributing to poor reproductive efficiency of lactating dairy cows. The objective of the present study was to analyze the endocrine profile, growth dynamics, and histologic characteristics of persistent ovarian follicles-cysts developing in response to long-term administration of intermediate levels of progesterone. To this end, after synchronization of cows, a low dose of progesterone was administered for 5, 10, and 15 days after the expected day of ovulation in treated cows (groups P5, P10, and P15, respectively), using an intravaginal progesterone-releasing device. A significant increase in diameter was detected on Day 11 of progesterone treatment and thereafter (P < 0.05), and at Day 15 of persistence, the diameter of the persistent follicle reached a mean of 23 ± 0.6 mm. Microscopically, the persistent follicles had a complete granulosa, an intensely vascularized theca interna, and a collagenous theca externa layer. Temporal changes in the serum concentrations of estradiol, progesterone, and FSH were detected (effects of time, P < 0.01). Progesterone treatment completely inhibited the LH preovulatory surge in treated cows and affected the basal concentration of LH. The pulse frequency remained high at 5 and 10 days of persistence and declined (P < 0.05) after 15 days of persistence. The LH pulse concentration and pulse amplitude had a significant reduction (P < 0.05) during follicular persistence. Changes in the serum levels of estradiol, progesterone, 17-hydroxyprogesterone, and testosterone in serum and follicular fluid were also observed. In serum, estradiol increased gradually from proestrus to Day 10 of follicular persistence (P < 0.05), progesterone showed an increase (P < 0.05) at Day 5 of follicular persistence, 17-hydroxyprogesterone showed a significant decrease at 5 days of follicular persistence in relation to proestrus, and testosterone showed a significant increase (P < 0.05) from proestrus and

  6. [Acoustic trauma generated by exposure to gun powder].

    PubMed

    Arch-Tirado, Emilio; Garnica-Escamilla, Marco Antonio; Delgado-Hernández, Alhelí; Campos-Muñoz, Teodora; Rodríguez-Rodríguez, Lourdes; Verduzco-Mendoza, Antonio

    2014-01-01

    Antecedentes: la pérdida auditiva inducida por ruido se ha incrementado debido a factores como la industrialización. Se estima que un tercio de la población mundial padece algún grado de hipoacusia causada por exposición a ruidos de alta intensidad. La exposición al ruido puede afectar diferentes estructuras del oído y destruir las células ciliadas externas, que provocan diferentes grados de hipoacusia. Objetivo: describir los hallazgos audiológicos encontrados en un grupo de personas expuestas a una fuente de explosión en el estado de Tlaxcala, México. Metodología: estudio transversal, descriptivo, con muestreo censal efectuado en ocho pacientes ingresados al Centro Nacional de Investigación y Atención de Quemados del Instituto Nacional de Rehabilitación, expuestos a una explosión de pólvora. En cada sujeto se evaluó la vía aérea con audiometría de tonos puros, convencional, de 125 a 8000 Hz. Se utilizó un audiómetro clínico marca Madson, modelo Midimate 622, de dos canales y audífonos THD 39. Casos clínicos: en los 8 pacientes se encontró hipoacusia en todas las frecuencias, de media a severa en ambos oídos. Las audiometrías tuvieron caídas a partir de los 4000 Hz, en todos los pacientes se diagnosticó trauma acústico de tercer grado. Conclusiones: el principal síntoma referido por los pacientes fue el acúfeno, otros estudios donde los pacientes refieren acúfeno son, en el trauma acústico por uso de reproductores de audio, en músicos de orquesta sinfónica y en militares por detonación de arma de fuego. Para determinar de manera certera si existe alguna disfunción auditiva posterior a un accidente explosivo se recomienda la valoración audiométrica.

  7. Assessment of the quality of sample labelling for clinical research.

    PubMed

    Pérez-Huertas, Pablo; Tordera-Baviera, María; Martínez-Nieto, Concepción; Benito-Zazo, Natalia; García-Robles, Ana; Poveda-Andrés, José Luis

    2016-03-01

    Objetivo: Evaluar la calidad de las etiquetas de muestras para ensayos clínicos mediante la normativa vigente y analizar su posible correlación con las características específicas de cada muestra. Método: Estudio transversal multicéntrico en el que se analizaron las muestras de ensayos clínicos de dos hospitales de tercer nivel. Se estudió la presencia de los once ítems de la Directiva 2003/94/CE, el nombre del ensayo y la dosis en la portada de la etiqueta como variables de calidad del etiquetado. Se analizó la influencia de las características propias de la muestra con la calidad del etiquetado. Resultado: Se analizaron un total de 503 muestras de 220 ensayos. La calidad media del etiquetado, entendido como el porcentaje de ítems del Anexo 13, fue del 91,9%. El 6,6% no contenía el nombre de la muestra en la cara externa de la etiqueta, mientras que a un 9,7% les faltaba la dosis. Las muestras con presentación de tipo ensayo clínico presentaron mayor calidad (p < 0,049), el enmascaramiento disminuía la calidad (p = 0,017) y la identificación por número de kit o por paciente la aumentaban (p < 0,01). La variable promotor fue la que más variabilidad introdujo en el análisis. Conclusiones: La calidad media del etiquetado es adecuada en la mayoría de las muestras del ensayo clínico. Resulta preocupante la ausencia de información esencial, como el código del ensayo clínico y el período de validez, en algunas muestras que pueden ser fuente potencial de errores de dispensación o de administración.

  8. Differences in globus pallidus neuronal firing rates and patterns relate to different disease biology in children with dystonia

    PubMed Central

    McClelland, V M; Valentin, A; Rey, H G; Lumsden, D E; Elze, M C; Selway, R; Alarcon, G; Lin, J-P

    2016-01-01

    Background The pathophysiology underlying different types of dystonia is not yet understood. We report microelectrode data from the globus pallidus interna (GPi) and globus pallidus externa (GPe) in children undergoing deep brain stimulation (DBS) for dystonia and investigate whether GPi and GPe firing rates differ between dystonia types. Methods Single pass microelectrode data were obtained to guide electrode position in 44 children (3.3–18.1 years, median 10.7) with the following dystonia types: 14 primary, 22 secondary Static and 8 progressive secondary to neuronal brain iron accumulation (NBIA). Preoperative stereotactic MRI determined coordinates for the GPi target. Digitised spike trains were analysed offline, blind to clinical data. Electrode placement was confirmed by a postoperative stereotactic CT scan. Findings We identified 263 GPi and 87 GPe cells. Both GPi and GPe firing frequencies differed significantly with dystonia aetiology. The median GPi firing frequency was higher in the primary group than in the secondary static group (13.5 Hz vs 9.6 Hz; p=0.002) and higher in the NBIA group than in either the primary (25 Hz vs 13.5 Hz; p=0.006) or the secondary static group (25 Hz vs 9.6 Hz; p=0.00004). The median GPe firing frequency was higher in the NBIA group than in the secondary static group (15.9 Hz vs 7 Hz; p=0.013). The NBIA group also showed a higher proportion of regularly firing GPi cells compared with the other groups (p<0.001). A higher proportion of regular GPi cells was also seen in patients with fixed/tonic dystonia compared with a phasic/dynamic dystonia phenotype (p<0.001). The GPi firing frequency showed a positive correlation with 1-year outcome from DBS measured by improvement in the Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS-m) score (p=0.030). This association was stronger for the non-progressive patients (p=0.006). Interpretation Pallidal firing rates and patterns differ significantly with dystonia aetiology

  9. [ASSOCIATION OF OLFACTORY SENSITIVITY WITH ENERGY INTAKE: ROLE IN DEVELOPMENT OF OBESITY].

    PubMed

    Valladares Vega, Macarena; Obregón Rivas, Ana Maria

    2015-12-01

    La obesidad se produce por un desequilibrio entre la energía consumida y el gasto de energía generado. Dentro de los factores que regulan la ingesta no homeostática se encuentra el sentido del olfato, que constituye una importante señal externa que induce la ingesta de alimentos. Los humanos lo utilizan para apreciar la palatabilidad de los alimentos y, en general, para seleccionar alimentos. Materiales y método: se realizó una búsqueda electrónica de artículos en las bases de datos de Pubmed y Scielo, donde se utilizaron las palabras claves: “olfato”, “ingesta energética” y “obesidad”; adicionalmente se sumaron los siguientes límites para restringir la exploración: “animales”, “humanos”, “ensayo clínico” y “metaanálisis”. Resultados: el estado de hambre individual esta modulado por la sensibilidad olfatoria, donde se observa que la sensibilidad del olfato aumenta frente a un estado de ayunas. Existen dos hormonas que han permitido relacionar el sentido del olfato con la ingesta energética: orexina, que aumenta la sensibilidad olfativa y la ingesta, y leptina, que disminuye la sensibilidad olfativa y la ingesta. Las personas obesas con IMC > 45 presentan baja sensibilidad olfativa, situación que no varía después de la cirugía bariátrica. Conclusiones: determinar la relación entre el olfato, la ingesta energética y la obesidad es un campo escasamente estudiado y que abre nuevos caminos para el tratamiento de patologías en las que existen trastornos alimentarios como la obesidad. A futuro es necesario la realización de ensayos clínicos que permitan determinar la causalidad entre ambas variables, así como estudios moleculares para comprender mejor las señales que relacionan el olfato con la ingesta energética.

  10. Indications for cesarean deliveries during a 7-year period in a tertiary hospital.

    PubMed

    Costa, Ana; Policiano, Catarina; Clode, Nuno; Graça, Luís M

    2013-01-01

    Introdução: Analisar a evolução da taxa de cesarianas e as principais indicações para cesariana num centro terciário.Material e Métodos: Estudo retrospectivo conduzido num hospital universitário que incluiu 5751 grávidas submetidas a cesariana entre 2005 e 2011. Analisaram-se as taxas de cesarianas, incluindo a taxa de primeiras cesarianas e de cesarianas repetidas. Para avaliar a contribuição relativa de cada uma das indicações na variação da taxa de primeiras cesarianas recorreu-se à regressão linear e determinou-se o valor do r2 ajustado.Resultados: Durante o período do estudo a taxa de cesarianas diminuiu de 30,9% para 27,6%. Esta descida deveu-se à diminuição da taxa de primeiras cesarianas (21,9% para 18,2%), apesar de se ter constatado um ligeiro aumento da taxa de cesarianas repetidas (9,0 para 9,4%). Entre as indicações para primeiras cesarianas, as causas materno-fetais e de apresentação anómala foram as que diminuiram mais, com valores de r2 ajustado de 0,70 e 0,55, respectivamente.Discussão: Os dados coligidos permitiram identificar a hipótese de que a diminuição da taxa de cesarianas se deveria a uma retração detectada sobretudo a nível das primeiras cesarianas, em particular as decorrentes de causas materno-fetais e apresentação anómala.Conclusão: A diminuição da taxa de primeiras cesarianas pode ser atribuída a várias modificações na prática clínica do Departamento, como a implementação da versão cefálica externa, a indução do trabalho de parto a partir das 41 semanas de gestação, em gravidezes de baixo risco e da realização de provas de trabalho de parto em casos de patologia materno-fetal. No entanto, indicações subjectivas, como a paragem de progressão do trabalho de parto e a suspeita de sofrimento fetal são ainda causas major de primeiras cesarianas.

  11. [Primary cardiac hemangioendothelioma: early diagnosis and surgical resection].

    PubMed

    Gaytán-Cortés, Fernando Celso; Arteaga-Adame, Juan; Careaga-Reyna, Guillermo; Lezama-Urtecho, Carlos; Álvarez-Sánchez, Luis

    2016-01-01

    Introducción: el hemangioendotelioma engloba todos los tumores que derivan del endotelio de los vasos sanguíneos. Es de pronóstico incierto y siempre se considera como una lesión maligna de bajo grado. Caso clínico: paciente masculino de 23 años que ingresó a urgencias con dolor retroesternal intermitente, disnea paroxística nocturna y ataque al estado general. Negó antecedentes crónico-degenerativos y tuvo pérdida ponderal de 6 kg en dos meses. Las pruebas sugirieron derrame pericárdico. Presentó tendencia a la hipotensión por tamponade, resuelta con punción subxifoidea, y drenaje de 800 mL de líquido de características hemáticas antiguas. El paciente presentó un tumor de la aurícula derecha de 8 x 4 cm, dependiente de la pared anterior de la aurícula, sin involucro de septum interatrial. Al someter al paciente a cirugía, se identificó lesión tumoral en la pared anterior de orejuela derecha. Se hizo resección del tumor y del 70 % de la orejuela derecha, sustituida con parche de pericardio bovino. El paciente presentó buena evolución; egresó a los 10 días de la cirugía con seguimiento por seis meses en la consulta externa. Conclusión: estamos ante un tumor vascular oncológicamente impredecible y que rara vez se origina en el corazón. Una detección oportuna y la resección quirúrgica radical es el manejo más aceptado ante la poca experiencia que hay a nivel mundial para lidiar con esta entidad. Sugerimos un abordaje clínico agresivo y la extirpación quirúrgica dentro de las primeras horas de la sospecha diagnóstica para obtener la mayor posibilidad de resección total y la reducción del riesgo de recidiva.

  12. [In Process Citation].

    PubMed

    Rodríguez-Valle, Ana; Navarro-Ferrando, María Ángeles; Boj-Carceller, Diana; Escanero-Marcén, Jesús Fernando; Sanz-Paris, Alejandro

    2016-03-25

    Objetivo: poco se conoce sobre el impacto de orlistat en el sistema leptina. Estudiamos la respuesta de la leptina plasmática y la sensación de saciedad tras dos días de tratamiento con orlistat sin dieta hipocalórica ni pérdida de peso. Material y métodos: reclutamos veinte mujeres obesas en nuestras consultas externas de medicina. Habían recibido restricción dietética y modificación del estilo de vida, pero se habían mantenido obesas con peso corporal estable durante seis meses antes de su inclusión en el estudio. Resultados: las pacientes tomaron 120 mg de orlistat 3 veces al día y mantuvieron su dieta habitual. Al inicio y dos días después del tratamiento con orlistat se repitieron el examen físico, la sensación de hambre y la analítica. No hubo diferencias significativas en el consumo de energía de la dieta, el peso corporal y la relación cintura-cadera, así como en glucosa sérica, insulina y péptido C. Solamente las concentraciones de leptina y triglicéridos en suero disminuyeron (p: 0,0001 y 0,01, respectivamente). La disminución de la concentración de leptina en suero se correlacionó positivamente con cambios en la concentración de triglicéridos (p: 0.01, r2: 0,45). La sensación de hambre aumento antes de la cena y se correlacionó negativamente con la disminución de la leptina (p: 0,0001, r2: 0,74) y triglicéridos (p: 0,02, r2: 0.59). Conclusión: estos datos sugieren que la malabsorción parcial de grasas por el tratamiento con orlistat disminuye rápidamente los niveles plasmáticos de triglicéridos y leptina. Este descenso se asoció con aumento del apetito antes de la ingesta que sigue a la comida principal del día.

  13. Protective effect of Xuebijing injection against acute lung injury induced by left ventricular ischemia/reperfusion in rabbits

    PubMed Central

    JI, MINGLI; WANG, YUXIA; WANG, LEI; CHEN, LIPING; LI, JING

    2016-01-01

    Xuebijing (XBJ) is a Chinese herbal preparation. Previous studies have demonstrated that XBJ injection is able to inhibit the uncontrolled release of endogenous inflammatory mediators, attenuate inflammation, and alleviate organ damage. However, there are no relevant reports on the protective effect of XBJ against left ventricular ischemia/reperfusion (I/R)-induced acute lung injury (ALI). Therefore, the aim of the present study was to evaluate the protective effect of XBJ on ALI induced by left ventricular I/R, and provide evidence for the clinical application of XBJ. In the present study, 120 healthy rabbits of mixed gender were randomly assigned to a normal control group, ischemia group, I/R group (I/RG) and XBJ-injection treatment group (TG). In addition, each group was further divided into three subgroups (n=10/subgroup), namely, 30 min pre-ischemia, 30 min post-ischemia and 30 min post-reperfusion subgroups. Blood samples (5 ml) were collected from the jugularis externa and carotis communis of the rabbits at the three time points, and a blood gas analyzer was used to measure the arterial partial pressure of oxygen (PaO2) and carbon dioxide (PaCO2). Following sacrifice, the lungs of the rabbits were removed and a bronchoalveolar lavage (BAL) was immediately performed. An enzyme-linked immunosorbent assay was used to measure the expression levels of tumor necrosis factor-α (TNF-α) in the BAL fluid (BALF) and peripheral blood. In addition, the lower lobe of the right lung was removed in order to measure the protein expression levels of intercellular adhesion molecule-1 (ICAM-1) and TNF-α. The results demonstrated that in the rabbits of the TG PaO2 was increased, PaCO2 was decreased, the lung tissue congestion edema was attenuated, the expression levels of TNF-α in the peripheral blood and BALF were reduced and the protein expression levels of ICAM-1 and TNF-α in the lung tissue samples were decreased, as compared with those in the I/RG rabbits. These

  14. Estudio de la formación de galaxias espirales en un modelo de agregación jerárquica

    NASA Astrophysics Data System (ADS)

    Tissera, P.; Saiz, A.; Dominguez-Tenreiro, R.

    El estudio de formación de galaxias espirales ha llevado al desarrollo de numerosos modelos teóricos (e.g. White & Rees 1978). En la actualidad, el modelo más aceptado predice la formación de una galaxia espiral a partir del colapso disipativo del gas en el pozo de potencial de un halo oscuro, conservando su momento angular específco (Fall & Efstathiou 1980). En los últimos años, ha sido posible realizar simulaciones numéricas hidrodinámicas, las cuales describen la evolución conjunta de la materia oscura y los bariones. Estos experimentos han señalado la dificultad de formar estructuras discoidales con propiedades consistentes con las observaciones, en modelos de agregación jerárquica. El problema principal se origina en la pérdida catastrófica de momento angular de la componente disipativa, durante el proceso de ensamblaje de los objetos, a través de la fusión de subestructura (Navarro & Steinmetz 1997). Estos experimentos no incluían procesos de formación estelar. En este trabajo, se expondrán resultados de simulaciones hidrodinámicas cosmológicas, incluyendo formación estelar (Tissera et al 1997), donde ha sido posible reproducir objetos discoidales con contrapartida observacional. El elemento fundamental ha sido la formación de bulbos estelares, los cuales han evitado la pérdida catastrófica de momento angular de los bariones. Se encontró que los discos exponenciales puramente gaseosos son altamente inestables y suceptibles de generar barras, responsables de la pérdida de momento angular y la caída violenta del gas hacia la región central. Estas inestabilidades son fácilmente inducidas durante interacciones y fusiones con objetos vecinos (Barnes & Hernquist 1996). Un bulbo estelar (o un objeto masivo y compacto) estabiliza el disco ante perturbaciones externas, asegurándole un potencial simétrico (Sellwood & Moore 1998, Van der Bosch 1998). En este caso, el gas en el disco no pierde completamente su momento angular intr

  15. An imbalance between apoptosis and proliferation contributes to follicular persistence in polycystic ovaries in rats

    PubMed Central

    Salvetti, Natalia R; Panzani, Carolina G; Gimeno, Eduardo J; Neme, Leandro G; Alfaro, Natalia S; Ortega, Hugo H

    2009-01-01

    theca externa showed low expression of the pro and anti-apoptotic proteins. Conclusion These results show that the combination of weak proliferation indices and low apoptosis observed in follicular cysts, could explain the cause of the slow growth of cystic follicles and the maintenance of a static condition without degeneration, which leads to their persistence. These alterations may be due to structural and functional modifications that take place in these cells and could be related to hormonal changes in animals with this condition. PMID:19570211

  16. [Food intake, nutritional status and physical activity between elderly with and without chronic constipation. A comparative study].

    PubMed

    Vargas-García, Elisa Joan; Vargas-Salado, Enrique

    2013-01-01

    antecedentes: el estreñimiento es uno de los trastornos gastrointestinales más comunes en la población de edad avanzada porque con el paso de los años los factores implicados en su causa se modifican y repercuten en la ingestión de alimentos, el estado de nutrición y la actividad física. Objetivo: evaluar en el adulto mayor el efecto en el estreñimiento crónico del consumo de alimentos con alto contenido de fibra, el estado nutricio, y la actividad física. Material y métodos: estudio comparativo, prospectivo y transversal efectuado en 140 adultos mayores de la consulta externa de la Unidad de Medicina Familiar51 del Instituto Mexicano del Seguro Social en la ciudad de León, Guanajuato, durante el periodo del 4 mayo al 30 de octubre de 2009. Se valoró si padecían o no estreñimiento de acuerdo con los criterios de Roma III. Se valoró: peso,talla, circunferencia del brazo, pliegue cutáneo tricipital; se aplicó un cuestionario de actividad física validado, y se obtuvo el registro dietético de tres días (dos de entre semana y uno de sábado o domingo). Resultados: la ingestión promedio de fibra y agua no esultó estadísticamente diferente entre los grupos estudiados. Los pacientes con estreñimiento tuvieron dietas menos completas y variadas (p < 0.02; p < 0.03). El estado nutricio predominante en los adultos mayores de ambos grupos fue de sobrepeso (p= 0.49) pero el grupo sin estreñimiento tuvo niveles más altos de actividad física en comparación con los estreñidos (1664 vs 1049 METs, p= 0.004).Conclusiones: el menor nivel de actividad física, la monotonía en la dieta, y no incluir todos los grupos de alimentos son factores que se asocian con el estreñimiento en el adulto mayor. De acuerdo con los resultados de este estudio la menor ingestión de fibra no se relacionó con el estreñimiento.

  17. [Syphilis: Prevalence in a Hospital in Lisbon].

    PubMed

    Lopes, Leonor; Ferro-Rodrigues, Rita; Llobet, Samuel; Lito, Luís; Borges-Costa, João

    2016-01-01

    Introdução: A sífilis é uma doença de transmissão sexual e vertical. A sua incidência está a aumentar na Europa, particularmente em Portugal. Material e Métodos: Estudo retrospetivo baseado na análise laboratorial de testes treponémicos positivos, entre janeiro e dezembro de 2013, no Hospital de Santa Maria. Foram incluídos doentes internados, da consulta externa, do hospital dia e da urgência. Procedeu-se a caraterização epidemiológica, classificação da doença e de fatores de risco associados. Resultados: Obteve-se uma amostra de 484 doentes, após exclusão de 51 por ausência de dados clínicos nos processos e de 45 por valores falsos positivos. Verificou-se predomínio do sexo masculino (75%) e idade média de 47 anos. A maioria (59%) tinha testes serológicos compatíveis com sífilis no passado e 3,7% encontrava-se em vigilância clínica. Diagnosticou-se sífilis primária em 13doentes, secundária em 71, latente precoce em 40, latente indeterminada em 49 e latente tardia em cinco. No grupo sífilis recente, 42% (n = 124) eram seropositivos para o VIH e 8% tiveram, em simultâneo, este diagnóstico. Discussão: Salienta-se a elevada prevalência da coinfeção pelo VIH nos doentes com sífilis recente, reforçando a importância de promover a utilização de medidas preventivas. Registaram-se 11% de formas clínicas tardias, que são de notificação obrigatória desde junho de 2014. Todos os testes serológicos para o diagnóstico de sífilis apresentam limitações, o que enfatiza a importância da correlação clínico-laboratorial. Conclusão: A sífilis continua a ser um problema de saúde pública pelo que é necessário estabelecer programas de educação, rastreio e follow-up para reduzir a sua prevalência e tornar mais eficiente o rastreio dos parceiros.

  18. Management of Upper Respiratory Tract Infections by Different Medical Practices, Including Homeopathy, and Consumption of Antibiotics in Primary Care: The EPI3 Cohort Study in France 2007–2008

    PubMed Central

    Grimaldi-Bensouda, Lamiae; Bégaud, Bernard; Rossignol, Michel; Avouac, Bernard; Lert, France; Rouillon, Frederic; Bénichou, Jacques; Massol, Jacques; Duru, Gerard; Magnier, Anne-Marie; Abenhaim, Lucien; Guillemot, Didier

    2014-01-01

    Background Prescribing of antibiotics for upper respiratory tract infections (URTI) varies substantially in primary care. Objectives To describe and compare antibiotic and antipyretic/anti-inflammatory drugs use, URTI symptoms' resolution and occurrence of potentially-associated infections in patients seeking care from general practitioners (GPs) who exclusively prescribe conventional medications (GP-CM), regularly prescribe homeopathy within a mixed practice (GP-Mx), or are certified homeopathic GPs (GP-Ho). Method The EPI3 survey was a nationwide population-based study of a representative sample of 825 GPs and their patients in France (2007–2008). GP recruitment was stratified by self-declared homeopathic prescribing preferences. Adults and children with confirmed URTI were asked to participate in a standardized telephone interview at inclusion, one-, three- and twelve-month follow up. Study outcomes included medication consumption, URTI symptoms' resolution and potentially-associated infections (sinusitis or otitis media/externa) as reported by patients. Analyses included calibration to account for non-respondents and groups were compared using multivate analyses adjusting for baseline differences with a propensity score. Results 518 adults and children with URTI (79.3% rhinopharyngitis) were included (36.9% response rate comparable between groups). As opposed to GP-CM patients, patients in the GP-Ho group showed significantly lower consumption of antibiotics (Odds ratio (OR) = 0.43, 95% confidence interval (CI): 0.27–0.68) and antipyretic/anti-inflammatory drugs (OR = 0.54, 95% CI: 0.38–0.76) with similar evolution in related symptoms (OR = 1.16, 95% CI: 0.64–2.10). An excess of potentially-associated infections (OR = 1.70, 95% CI: 0.90–3.20) was observed in the GP-Ho group (not statistically significant). No difference was found between GP-CM and GP-Mx patients. Conclusion Patients who chose to consult GPs certified in homeopathy used

  19. Evolución de estrellas enanas blancas de Helio de masa baja e intermedia

    NASA Astrophysics Data System (ADS)

    Althaus, L. G.; Benvenuto, O. G.

    Numerosas observaciones realizadas particularmente en los últimos dos años parecen confirmar que las enanas blancas (EB) de helio de masa baja e intermedia son el resultado de la evolución de sistemas binarios cercanos. Con el objeto de realizar una adecuada interpretación de estos objetos son necesarios modelos de EBs de helio lo más detallado posibles. En este estudio presentamos cálculos detallados de la evolución de EBs de helio con masas entre M=0.1Msolar y M=0.5Msolar a intervalos de 0.05Msolar . Para ello, hemos tenido en cuenta los efectos de temperatura finita mediante un código de evolución estelar lo más actualizado posible. En particular, el transporte de energía es descripto en el marco del nuevo modelo para la convección turbulenta desarrollado por Canuto - Mazzitelli. Además hemos considerado la nueva ecuación de estado para plasmas de helio de Saumon et al. y nuevas opacidades radiativas OPAL. Las pérdidas por neutrinos fueron asimismo tenidas en cuenta. Excepto para las EBs más masivas, nuestros modelos iniciales están ubicados en las cercanías de la correspondiente línea de Hayashi para configuraciones de helio. Nuestros resultados muestran que existe una región prohibida en el diagrama observacional HR donde ninguna EB de helio puede encontrarse. Dicha región es para log{(L/Lsolar )}>= -0.25 and log{Teff} >= 4.45. Hemos encontrado también que los tracks evolutivos en el diagrama HR en el dominio de alta luminosidad (pre - EB) son fuertemente afectados por la eficiencia convectiva y que las pérdidas por neutrinos son importantes en los modelos más masivos. Finalmente hemos analizado la estructura de la zona convectiva externa encontrando que la teoría de Canuto - Mazzitelli conduce a un perfil convectivo muy diferente del dado por cualquier versión de la popular teoría de la mixing length. Si bién este comportamiento es decisivo en el contexto de las inestabilides pulsacionales, los radios y gravedades superficiales de

  20. Supplementation of direct-fed microbials as an alternative to antibiotic on growth performance, immune response, cecal microbial population, and ileal morphology of broiler chickens.

    PubMed

    Salim, H M; Kang, H K; Akter, N; Kim, D W; Kim, J H; Kim, M J; Na, J C; Jong, H B; Choi, H C; Suh, O S; Kim, W K

    2013-08-01

    An experiment was conducted to investigate the supplementation of direct-fed microbials (DFM) as an alternative to antibiotics on growth performance, immune response, cecal microbial population, and ileal morphology of broiler chickens. A total of 800 one-day-old male broiler chicks (Ross × Ross) were randomly allotted to 4 dietary treatments with 4 replicate pens per treatment (50 birds/replicate pen). The 4 dietary treatments fed for 35 d were a corn-soybean meal basal diet (control); control plus 0.1% virginiamycin, as an antibiotic growth promoter (AGP); control plus 0.1% direct-fed microbials that contained Lactobacillus reuteri (DFM 1); and control plus 0.1% direct-fed microbials that contained a mixture of L. reuteri, Bacillus subtilis, and Saccharomyces cerevisiae (DFM 2). Results showed that dietary AGP and DFM supplementation significantly increased (P < 0.05) the BW gain of broilers during 0 to 21 d. The feed intake was reduced, whereas the feed conversion was improved significantly when birds were fed DFM 2 at 0 to 7 d of age. The white blood cell and monocyte levels were significantly higher in the DFM 2 group compared with the control. In addition, feeding DFM significantly (P < 0.05) increased the plasma immunoglobulin levels where a higher level was observed in DFM 2 compared with those of the other treatments. Neither DFM nor AGP treatments affected the cecal Lactobacillus and Salmonella content; however, cecal Escherichia coli content significantly decreased in broiler chickens fed DFM and AGP. The ileal villus height, and width and total thickness of muscularis externa were significantly increased when birds were fed DFM compared with AGP and control. These results indicate that the dietary supplementation of DFM increases the growth performance of birds at an early age, stimulates the immune response, decreases the number of E. coli, and improves the ileal morphology of broiler chickens. Thus, DFM that contained a mixture of several beneficial

  1. [The disclosed DSM-5: what impact will it have on forensic psychiatry?].

    PubMed

    Fernandes, Susana; Leite, Edna; Vieira, Fernando; Costa Santos, Jorge

    2014-01-01

    Introdução: Em 10 de Fevereiro de 2010, a American Psychiatric Association publicou online a versão preliminar (draft) da quinta edição do Manual de Diagnóstico e Estatística das Perturbações Mentais (Diagnostic and Statistical Manual of Mental Disorders), que, à semelhança das edições anteriores, depois de ter acolhido comentários e contribuições diversas, esteve sujeita, durante os dois anos seguintes, a um escrutínio técnico e científico, e, naturalmente, a alterações e revisões suscetíveis de conduzirem a uma versão final melhorada.Material e Métodos: Este artigo visa analisar as alterações propostas por esta nova revisão, averiguar se estas têm implicações no domínio da Psiquiatria Forense e discutir as implicações identificadas.Discussão: Nesta perspetiva, constituem objeto de análise as questões relacionadas com a classificação e estruturação das entidades nosológicas, com especial enfoque nas perturbações da personalidade, perturbações de abuso de substâncias, perturbações sexuais e da identidade de género, perturbações de ansiedade, perturbações dissociativas, perturbações psicóticas e, ainda, perturbações sugeridas por fontes externas.Conclusão: As principais alterações propostas têm a ver essencialmente com os critérios de diagnóstico, que, relativamente a algumas das entidades nosológicas, poderão dificultar o resultado da avaliação pericial, enquanto em relação a outras poderá verificar-se o contrário, uma vez que a introdução de novos modelos de aproximação à realidade parece oferecer uma maior objetividade e rigor diagnósticos.

  2. Ovarian folliculogenesis in collared peccary, Pecari tajacu (Artiodactyla: Tayassuidae).

    PubMed

    Guimarães, Diva Anelie; de Garcia, Sylvia Cristina Garcia; Ferreira, Maria Auxiliadora Pantoja; da Silva, Suleima do Socorro Bastos; de Albuquerque, Natália Inagaki; Le Pendu, Yvonnick

    2012-03-01

    The sustainability and production of collared peccary (Pecari tajacu) has been studied in the last few years; however, further information on its reproduction is necessary for breeding systems success. Understanding folliculogenesis aspects will contribute to effective reproductive biotechniques, which are useful in the preservation and production of wildlife. The aim of this study was-to evaluate the ovarian folliculogenesis in collared peccary. Ovaries from six adult females of collared peccary were obtained through ovariectomy and analyzed. These were fixed in aqueous Bouin's solution and sectioned into 7 microm slices, stained with hematoxilin-eosin and analyzed by light microscopy. The number of pre-antral and antral follicles per ovary was estimated using the Fractionator Method. The follicles, oocytes and oocyte nuclei were measured using an ocular micrometer. Results showed that the length, width, thickness, weight, and the gross anatomy of the right and left ovaries were not significantly different. However, the mean number of corpora lutea was different between the phases of the estrous cycle (p<0.05), with the highest mean in the luteal phase. Primordial follicles were found in the cortex; the oocytes were enveloped by a single layer of flattened follicular cells. In the primary follicles, proliferation of the follicular cells gave rise to cuboidal cells (granulosa cells). The secondary follicle was characterized by two or more concentric layers of cuboidal cells (granulosa), beginning of antrum formation, and the presence of pellucid zone and theca cells. Antral follicles were characterized by a central cavity (antrum), the presence of cumulus oophorus and theca layers (interna and externa). In the right ovary, the values of the primordial and primary follicles were similar, but significantly different from the secondary ones (p<0.05). In the left ovary, significant differences were observed between all follicles in the follicular phase (p<0.05); the

  3. Common cutaneous disorders in athletes.

    PubMed

    Conklin, R J

    1990-02-01

    form, a mixed fungal/bacterial infection, is treated with debridement, antibiotics and drying routine similar to the therapy of otitis externa. Nail infections by a variety of organisms may appear as onycholysis with or without paronychia and should be treated with the appropriate antibiotics. Tinea versicolor occurs in heat and humidity. Since Pityrosporum orbiculare is part of the normal flora it often recurs, necessitating regular treatment. Acute trauma injuries include contusions, black heel or petichiae of the heel, black toe (bleeding under the nail), 'jogger's nipple' caused by chafing, and foot blisters. Chronic trauma may result in calluses, corns and paronychia. Plantar corns can be disabling and may be caused by overly tight shoes or abnormalities in biomechanics; treatment includes restoring normal foot function and minimal surgical procedures. Paronychia is treated best by wedge resection.(ABSTRACT TRUNCATED AT 400 WORDS)

  4. Glomerular anionic site distribution in nonproteinuric rats. A computer-assisted morphometric analysis.

    PubMed

    Pilia, P A; Swain, R P; Williams, A V; Loadholt, C B; Ainsworth, S K

    1985-12-01

    The cationic ultrastructural tracer polyethyleneimine (PEI: pI approximately equal to 11.0), binds electrophysically to uniformly spaced discrete electron-dense anionic sites present in the laminae rarae of the rat glomerular basement membrane (GBM), mesangial reflections of the GBM, Bowman's capsule, and tubular basement membranes when administered intravenously. Computer-assisted morphometric analysis of glomerular anionic sites reveals that the maximum concentration of stainable lamina rara externa (lre) sites (21/10,000 A GBM) occurs 60 minutes after PEI injection with a site-site interspacing of 460 A. Lamina rara interna (lri) sites similarly demonstrate a maximum concentration (20/10,000 A GBM) at 60 minutes with a periodicity of 497 A. The concentration and distribution of anionic sites within the lri was irregular in pattern and markedly decreased in number, while the lre possesses an electrical field that is highly regular at all time intervals analyzed (15, 30, 60, 120, 180, 240, and 300 minutes). Immersion and perfusion of renal tissue with PEI reveals additional heavy staining of the epithelial and endothelial cell sialoprotein coatings. PEI appears to bind to glomerular anionic sites reversibly: ie, between 60 and 180 minutes the concentration of stained sites decreases. At 300 minutes, the interspacing once again approaches the 60-minute concentration. This suggests a dynamic turnover or dissociation followed by a reassociation of glomerular negatively charged PEI binding sites. In contrast, morphometric analysis of anionic sites stained with lysozyme and protamine sulfate reveals interspacings of 642 A and 585 A, respectively; in addition, these tracers produce major glomerular ultrastructural alterations and induce transient proteinuria. PEI does not induce proteinuria in rats, nor does it produce glomerular morphologic alterations when ten times the tracer dosage is administered intravenously. These findings indicate that the choice of

  5. Sebaceous adenitis in Swedish dogs, a retrospective study of 104 cases

    PubMed Central

    Hernblad Tevell, Elisabeth; Bergvall, Kerstin; Egenvall, Agneta

    2008-01-01

    Background Sebaceous adenitis (SA) is an uncommon, immune mediated skin disease in dogs. The aim was to retrospectively investigate SA in dogs in Sweden with respect to breed, sex and age distribution. A second aim was to retrospectively compare clinical signs in dogs with generalized SA and to estimate the survival after diagnosis in the English springer spaniel, standard poodle and the akita. Methods In total 34 Swedish veterinarians contributed with 104 clinically and histologically verified SA cases. Breed, gender and age at diagnosis were registered for each case. The degree of clinical signs at time for diagnosis and at follow-up and information about treatments, concurrent diseases and euthanasia were recorded for the springer spaniels, standard poodles and akitas using a standardized questionnaire. Results A total of 104 cases of SA were included; most cases were recorded for the springer spaniel (n = 25), standard poodle (n = 21) and the akita (n = 10). These three breeds, together with the lhasa apso and the chow-chow, were the most common when national registry data from the Swedish Board of Agriculture and Swedish Kennel Club were considered. The mean age at diagnosis was 4.8 years. The proportion of males was 61%. When the springer spaniels, standard poodles and the akitas with generalized signs were compared (n = 51), the spaniels showed significantly more severe clinical signs than the poodles at diagnosis regarding alopecia, seborrhoea, pyoderma and the overall severity of clinical signs. At follow-up, the degree of clinical signs for otitis externa and pyoderma differed significantly between the breeds. The estimated median survival time was 42 months. In dogs where data regarding survival was available at the end of the study (n = 44), SA was reported to be the reason for euthanasia in 14 dogs, whereof 7 within 24 months after diagnosis. Conclusion The result of this study implicates that the English springer spaniel is a breed predisposed to SA

  6. [Agents of otomycosis in Manisa region, Turkey, 1995-2011].

    PubMed

    Değerli, Kenan; Ecemiş, Talat; Günhan, Kıvanç; Başkesen, Tolga; Kal, Elçin

    2012-01-01

    Otomycosis, which is otitis externa caused by fungi, is common throughout the world especially in tropical and subtropical countries. However, the epidemiologic data about the etiologic agents of otomycosis in Turkey is limited. The aim of this retrospective study was to evaluate the agents of otomycosis in patients living at Manisa region (located at western Anatolia of Turkey). A total of 2279 cases [1465 male, 813 female; age range 1-87 (mean: 41.7) years] who were clinically prediagnosed as otomycosis at Celal Bayar University Hospital, between February 1995 and July 2011, were included in the study. External ear swab samples from patients with suspicion of otomycosis have been evaluated by routine mycological methods. Identification of mold-like fungi was based on colony morphology and microscopic examination of fungal structure, whereas germ tube test, growth characteristics on cornmeal-Tween 80 agar and API 20C AUX (bio-Mérieux, France) system were used for the identification of yeast-like fungi. Of the samples, 28% (638/2279) were found positive by direct microscopy and 24% (544/2279) by culture methods. Among culture-positive cases the isolation rates of mold-like and yeast-like fungi were 66% (359/544) and 34% (185/544), respectively. The number of distribution of the molds were as follows; Aspergillus niger (180), Aspergillus fumigatus (95), Aspergillus terreus (32), Aspergillus flavus (23), Aspergillus spp. (14), Penicillium spp. (13), Trichophyton spp. (T.rubrum 1, T.mentagrophytes 1); while this distribution was as follows for the yeasts; Candida tropicalis (97), Candida albicans (39), Candida parapsilosis (21), Candida glabrata (19), Candida kefyr (4), C.guilliermondii (2), Candida krusei (1), Geotrichum candidum (1) and Trichosporon capitatum (1). It was notable that 96% (344/359) of mold-like fungi were Aspergillus spp., and 99% (183/185) of yeast-like fungi were Candida spp. The results of this study indicated that the most frequent agents of

  7. [Adalimumab versus etanercept in the treatment of active rheumatoid arthritis: cost-effectiveness analysis].

    PubMed

    González Álvarez, A; Gómez Barrera, M; Borrás Blasco, J; Giner Serrer, E J

    2013-01-01

    Objetivo: Valorar el grado de efectividad y eficiencia de las dos alternativas principalmente utilizadas en nuestro ámbito, etanercept (ETN) y adalimumab (ADA), para el tratamiento de pacientes diagnosticados de artritis reumatoide (AR) en condiciones reales de la práctica clínica diaria. Material y método: Se realizó un estudio observacional retrospectivo, cuyo horizonte temporal fue de 12 meses referidos al año 2012, en el que se analizaron las características de los pacientes, así como la efectividad y eficiencia de ETN y ADA en la población de estudio. Se estudiaron todos los pacientes de ambos sexos mayores de 18 años, diagnosticados de AR, atendidos en las consultas externas del Servicio de Reumatología del Sector Sanitario de Teruel. Se determinó el descenso medio del valor de DAS28 (DAS28r) de cada fármaco y se definió como unidad de efectividad en el estudio farmacoeconómico un valor DAS28 al inicio (DAS28a) inferior a 3,2 puntos y DAS28r mayor a 1,2 puntos. Como parámetro del estudio para determinar el coste-efectividad de ambas alternativas se utilizó el beneficio neto sanitario (BNS). Resultados: El valor medio de DAS28a fue 2,25 y 2,72 puntos para ETN y ADA respectivamente, con un valor DAS28r de 1,01 puntos superior para ETN, aunque sin ser estadísticamente significativo (p > 0,05). El cálculo del parámetro BNS obtuvo un valor igual a -0,121; IC95% (-0,951 a 0,709), sin embargo la inclusión del valor 0 en el intervalo de confianza hizo que no se observaran diferencias de coste-efectividad. Conclusiones: Ambas alternativas son efectivas en el tratamiento de la AR, aunque parece existir una tendencia a favor de ETN en el grado coste-efectividad sin ser significativa.

  8. [Association between malnutrition and depression in elderly].

    PubMed

    Pérez Cruz, Elizabeth; Lizárraga Sánchez, Diana Cecilia; Martínez Esteves, María Del Rosario

    2014-04-01

    Antecedentes: La desnutrición y la depresión son trastornos geriátricos comunes. Nuestro objetivo fue determinar la prevalencia de desnutrición y depresión en adultos mayores, así como evaluar su asociación. Métodos: Estudio transversal que se realizó en población geriátrica de la consulta externa de un Hospital Público de referencia de Alta Especialidad de la Ciudad de México. El estado nutricional se clasifico mediante la Evaluación Mínima Nutricional (MNA), el Índice de Quetelet se clasificó acorde a la Organización Mundial para la Salud. La depresión se evaluó mediante la Escala de Depresión Geriátrica (GDS). La funcionalidad se obtuvo mediante el Índice de Katz. Las diferencias entre grupos se analizaron usando la prueba de Chi cuadrada y t-student. La asociación entre el MNA y GDS, así como la determinación de factores predictores para desnutrición se analizó usando análisis multivariado y se determinó la razón de momios (RM). Resultados: 96 pacientes de ≥65 años fueron evaluados, 79,2% fueron mujeres. El 15,5% de la población se clasifico con adecuado estado nutricional, el 72,2% con riesgo de desnutrición y 11,3% con desnutrición. La prevalencia de depresión fue de 63,9%. El análisis de regresión múltiple reveló que la depresión y el sexo masculino son factores predictores independientes de desnutrición. La depresión se asoció positivamente con desnutrición en RM 2,4 (IC 95% 0,79-7,38). Para los individuos del sexo masculino la RM para desnutrición fue de 1,42 (IC 95% 1,0-2,0). Conclusión: La depresión y el sexo masculino están fuertemente asociados con el riesgo de desnutrición en los adultos mayores.

  9. [Total immunoglobulin E as marker of allergy at Northeast of Mexico].

    PubMed

    Ramírez-Enríquez, Francisca; Prado-Rendón, Jesús; Lachica-Valle, Jesús; Valle-Leal, Jaime

    2016-01-01

    Antecedentes: la relación entre IgE total en suero y alergia se ha estudiado para determinar si puede ser un complemento útil para el diagnóstico de alergia. Objetivo: conocer si la IgE sérica total es una herramienta útil en el diagnóstico de alergia en la población pediátrica que acude a la consulta externa de Alergología pediátrica del Hospital General Regional 1, Ciudad Obregón, Sonora. Material y método: estudio epidemiológico, observacional, retrospectivo, transversal y analítico de prueba diagnóstica, en el que se revisaron los expedientes de niños entre 3 y 16 años de edad, atendidos en el servicio de Alergología pediátrica. Para el análisis estadístico se utilizó el programa SPSS versión 22 y por medio de una tabla tetracórica se determinó la sensibilidad y especificidad de IgE para el diagnóstico de alergias; se tomaron pruebas cutáneas como patrón de referencia para el diagnóstico de alergias. Se determinó el valor de p entre las variables de estudio con la prueba t de Student. Resultados: se estudiaron 248 expedientes, el género masculino fue más frecuente (59%). La sensibilidad de IgE fue de 85% y la especificidad de 20%; el punto de corte encontrado fue de 148 UI/mL, concentraciones elevadas de IgE en pruebas cutáneas para aeroalergenos y existencia de síntomas respiratorios. Conclusiones: la determinación de IgE es una prueba útil de tamizaje inicial en pacientes con sospecha de alergia.

  10. [Morphometric characteristics of the asterion and the posterolateral surface of the skull: its relationship with dural venous sinuses and its neurosurgical importance].

    PubMed

    Galindo-de León, Salvador; Hernández-Rodríguez, Alejandra Nohemí; Morales-Ávalos, Rodolfo; Theriot-Girón, María Del Carmen; Elizondo-Omaña, Rodrigo Enrique; Guzmán-López, Santos

    2013-01-01

    antecedentes: el conocimiento de la ubicación y características morfométricas del seno venoso lateral (transverso y sigmoides), así como de su relación con este y otros puntos de referencia anatómicos superficiales, es imprescindible durante los abordajes posterolaterales de la fosa craneal posterior para evitar lesionar las estructuras vasculares y las complicaciones quirúrgicas. Objetivo: determinar un área anatómica de seguridad para realizar un trépano que permita ingresar en la fosa craneal posterior sin lesionar estructuras adyacentes, y estudiar las características morfométricas del asterion, el seno lateral y puntos de referencia óseos de la superficie posterolateral del cráneo. Material y métodos: estudio observacional, transversal y descriptivo efectuado en el Departamento de Anatomía Humana de las Facultad de Medicina y de Odontología de la Universidad Autónoma de Nuevo León. Se analizaron 176 hemicráneos secos, estructuralmente íntegros y sin ninguna patología o anormalidad evidente. Se utilizó una broca de 1.3 mm de diámetro con la que se perforaron ambos lados de 88 cráneos secos (176 hemicráneos). Los puntos de referencia anatómicos estudiados fueron: asterion, vértice de la apófisis mastoides, espina suprameatal, plano horizontal de Frankfurt, raíz posterior del arco cigomático, protuberancia occipital externa y su relación con el seno venoso lateral. Resultados: el asterion tipo I prevalece en 74.4% de las piezas. En 82.4% de los cráneos el seno venoso lateral se encuentra a nivel del asterion inferior a éste en 12.5% y superior en 5.1%. Conclusiones: con los datos obtenidos de esta y otras investigaciones, el trépano inicial debe situarse 15 mm por debajo del asterion inferior y 15 mm posterior a éste para disminuir los riesgos de lesión del seno venoso lateral.

  11. Axon-glial relationships in the anterior medullary velum of the adult rat.

    PubMed

    Berry, M; Ibrahim, M; Carlile, J; Ruge, F; Duncan, A; Butt, A M

    1995-12-01

    abutting on the basal lamina of the pia. Many of these processes branched and ran along the axonal bundles. A monolayer of microglia occupied a subependymal stratum in which the non-overlapping dendritic territories of each cell formed a regular mosaic throughout the velum without any obvious interaction with either axons or other glial cells. Astrocytes were also uniformly distributed; their fine processes made up a dense lattice amongst axons, often running parallel and within the fibre bundles; stouter ones had terminal end-feet which undercoated the basal lamina of both the glia limitans externa and the blood vessels in the velum.

  12. Medicinal ethnobotany in Huacareta (Chuquisaca, Bolivia)

    PubMed Central

    2012-01-01

    used as a base for subsequent work related to traditional medicine and its contribution to allopathic medicine in San Pablo de Huacareta. Resumen Introducción El objetivo del presente estudio fue documentar los tipos de enfermedades tratadas mediante el uso de plantas medicinales, sus aplicaciones principales y también tener un reporte de las enfermedades mayormente atendidas en el Hospital de San Pablo de Huacareta (Chuquisaca, Bolivia). Métodos Se realizaron encuestas semiestructuradas a 10 informantes locales anotando los usos atribuidos a sus plantas medicinales, se agruparon las plantas por categorías de enfermedades tratadas en la medicina tradicional. Se obtuvieron reportes de casos tratados en el Hospital de Huacareta para poder relacionar el tratamiento de enfermedades recurrentes en la zona entre la medicina tradicional y la medicina occidental. Resultados Se reportaron 91 especies nativas y exóticas, además de un espécimen indeterminado exótico que intervienen en un total de 258 aplicaciones medicinales, las cuales son empleadas en un total de 13 categorías de enfermedades. Los desórdenes gastrointestinales (55%) son mayormente tratados mediante plantas medicinales, seguidas de las afecciones al sistema esqueleto-muscular (25%) y enfermedades dermatológicas (24%). La información del Hospital indica que las enfermedades más frecuentes son Infecciones Respiratorias Agudas (47%) y Enfermedades Diarreicas Agudas (37%). Los remedios vegetales se emplean en forma de infusiones y cocciones principalmente. Se emplean mayormente plantas nativas, también se introdujo en la farmacopea médica el uso de plantas exóticas al lugar. Conclusiones El tratamiento de trastornos gastrointestinales constituye el objetivo primordial de la etnobotánica médica de los habitantes de Huacareta, las enfermedades del sistema respiratorio, son mayormente tratadas en el Hospital. Observando los datos del libro de consultas del Hospital, se puede inferir que los des

  13. Focused Cardiac Ultrasound Using a Pocket-Size Device in the Emergency Room.

    PubMed

    Mancuso, Frederico José Neves; Siqueira, Vicente Nicoliello; Moisés, Valdir Ambrósio; Gois, Aécio Flavio Teixeira; Paola, Angelo Amato Vincenzo de; Carvalho, Antonio Carlos Camargo; Campos, Orlando

    2014-10-28

    direcionada como complemento diagnóstico ao exame físico em um serviço terciário de emergências clínicas. Métodos: Foram incluídos cem pacientes adultos sem doenças cardíacas ou pulmonares conhecidas que procuraram atendimento de urgência com queixas cardiológicas. Foram excluídos pacientes com alterações isquêmicas no eletrocardiograma ou febre. A ecocardiografia direcionada foi realizada logo após a avaliação inicial do paciente na sala de emergência, com aparelho ultraportátil GE Vscan, avaliando subjetivamente: dimensões das cavidades, função sistólica ventricular, fluxos intracardíacos pelo mapeamento de fluxo em cores, pericárdio e aorta. Resultados: A idade média dos pacientes foi 61 ± 17 anos. O quadro clínico inicial foi dor torácica (52 pacientes), dispneia (32 pacientes), arritmia/avaliação da função ventricular (dez pacientes), hipotensão/tontura (cinco pacientes) e edema periférico (um paciente). Em 28 pacientes a ecocardiografia direcionada confirmou a hipótese diagnóstica inicial: 19 pacientes com insuficiência cardíaca, cinco com síndrome coronariana aguda, dois com tromboembolismo pulmonar e dois com tamponamento cardíaco. Em 17 pacientes, a ecocardiografia direcionada alterou o diagnóstico, afastando a hipótese clínica inicial em dez casos com suspeita de insuficiência cardíaca, dois com suspeita de tromboembolismo pulmonar, dois com hipotensão a esclarecer, e em cada um dos três restantes com suspeitas de síndrome coronariana aguda, tamponamento cardíaco e dissecção de aorta. Conclusão: A ecocardiografia direcionada ultraportátil em serviço de emergências clínicas pode definir rapidamente o diagnóstico e, com isso, é possível iniciar mais precocemente o tratamento adequado.

  14. [Pulmonary Embolism in Portugal: Epidemiology and In-Hospital Mortality].

    PubMed

    Gouveia, Miguel; Pinheiro, Luís; Costa, João; Borges, Margarida

    2016-08-01

    Introdução: Em Portugal, a epidemiologia da embolia pulmonar aguda é mal conhecida. Neste estudo, pretendeu-se caracterizar a embolia pulmonar a partir dos dados do internamento hospitalar, assim como avaliar a sua mortalidade intra-hospitalar (definida como mortalidade do internamento hospitalar) e respetivos fatores de prognóstico.Material e Métodos: Microdados dos Grupos de Diagnóstico Homogéneo dos hospitais do Sistema Nacional de Saúde (2003 a 2013) e dados sobre população do Instituto Nacional de Estatística para estabelecer a evolução dos internamentos, da mortalidade intrahospitalar e das taxas de incidência na população. Os microdados foram estudados numa regressão logit modelizando a mortalidade intra-hospitalar como função de características individuais e de variáveis de contexto.Resultados: Entre 2003 e 2013 ocorreram 35 200 episódios de internamento (doentes ≥ 18 anos) em que pelo menos um dos diagnósticos foi embolia pulmonar (diagnóstico principal em 67% dos casos). A taxa de incidência estimada em 2013 foi 35/100 000 habitantes (≥ 18 anos). Entre 2003 e 2013, o número anual de episódios foi aumentando, mas a taxa de mortalidade intra-hospitalar foi diminuindo (de 31,8% para 17% em todos os episódios e de 25% para 11,2% nos episódio com embolia pulmonar como diagnóstico principal). Entre 2010 e 2013 a probabilidade de morte reduziu-se com a existência de registo de tomografia computorizada, em doentes do género feminino e aumentou com a idade e a presença de comorbilidades.Discussão: Na última década ocorreu um aumento da incidência de embolia pulmonar provavelmente relacionado com um maior número de pessoas dependentes e acamadas. No entanto, verificou-se uma redução da mortalidade intra-hospitalar de tal dimensão que a própria taxa de mortalidade na população em geral se reduziu. Uma explicação possível é que tenha ocorrido um aumento dos episódios de embolia pulmonar com níveis de gravidade

  15. [A community-based study of stroke code users in northern Portugal].

    PubMed

    Moutinho, Mariana; Magalhães, Rui; Correia, Manuel; Silva, M Carolina

    2013-01-01

    Introdução: Em 2002 Portugal detinha uma das mais altas taxas de mortalidade por doenças cerebrovasculares entre os países europeus. Várias estratégias foram adoptadas para melhorar a prevenção da doença e o seu tratamento na fase aguda, entre as quais a criação da Via Verde do Acidente Vascular Cerebral. O objectivo deste trabalho é descrever a utilização e resultados desta estratégia no contexto de um registo prospectivo comunitário na Região Norte de Portugal. Material e Métodos: Foram registados todos os AVCs ocorridos entre 1 de Outubro de 2009 e 30 de Setembro de 2010 nos utentes inscritos no agrupamento de centros de saúde do Porto Ocidental e nos de Mirandela e Vila Pouca de Aguiar. Para a detecção de casos utilizaram-se múltiplas fontes de informação: notificação via WEB, e-mail, Alerta P1 e pesquisas sistemáticas em registos disponibilizados pelas entidades envolvidas - urgências hospitalares, listas de altas, procedimentos de diagnóstico, óbitos, Via Verde do Acidente Vascular Cerebral e serviço de atendimento de situações urgentes. Resultados: Ocorreram 600 AVCs em 241 000 habitantes (taxa de incidência de 250 / 100 000), dos quais 434 foram primeiros na vida (180 / 100 000). Foram registados 72 acessos à Via Verde do Acidente Vascular Cerebral, dos quais 66,7% foram diagnosticados como AVC. Considerando os quatro critérios de activação (idade ≤ 80 anos, independência funcional, sinais/sintomas do AVC e tempo após episódio ≤ 3 horas), só 15,9% dos doentes a poderiam utilizar e, dos utilizadores, apenas 56,3% satisfaziam esses critérios. Dos doentes com critérios de activação, foram internados 96,3% pela VV pré-hospitalar, 83,3% pela VV intra/inter-hospitalar e 64,0% dos restantes; a fibrinólise foi realizada em 77,3%, 36,4% e 17,4% dos doentes com enfarte cerebral, respectivamente. O Rankin pós- AVC é mais grave nos utilizadores da VV pré-hospitalar (70,3% vs. 35,3%), mas estes apresentam mais

  16. [Neuroimaging and Blood Biomarkers in Functional Prognosis after Stroke].

    PubMed

    Branco, João Paulo; Costa, Joana Santos; Sargento-Freitas, João; Oliveira, Sandra; Mendes, Bruno; Laíns, Jorge; Pinheiro, João

    2016-11-01

    Introdução: O acidente vascular cerebral é uma das principais causas de mortalidade e morbilidade em todo o mundo, associando-se a considerável incapacidade funcional. Atualmente sabe-se que tanto técnicas de neuroimagem como determinados biomarcadores fornecem informações úteis acerca da etiologia, decisão terapêutica, follow-up e prognóstico em doentes com acidente vascular cerebral isquémico. Assiste-se, porém, a um interesse particular na previsão do prognóstico vital em detrimento do prognóstico funcional. Antecipar o prognóstico funcional permitiria definir um programa de reabilitação adequado, objetivo e individualizado, com uma alocação de recursos mais eficiente. O presente trabalho tem como objetivo rever o conhecimento atual acerca do papel da neuroimagem e dos biomarcadores sanguíneos em fase aguda na previsão da recuperação funcional dos doentes que sobrevivem a um acidente vascular cerebral isquémico. Material e Métodos: Revisão da literatura publicada entre 2005 e 2015, em língua inglesa, utilizando os termos “ischemic stroke”, “neuroimaging” e “blood biomarkers”. Resultados: Foram selecionados nove artigos com base na leitura dos resumos. Discussão: Técnicas de neuroimagem como a tomografia computorizada, a ecografia doppler transcraniana, a angiografia cerebrale a imagem de difusão por ressonância magnética apresentam potencial preditivo do prognóstico funcional do acidente vascular cerebral, nomeadamente através da avaliação do fluxo sanguíneo e do volume e localização da lesão, sobretudo quando usados em associação com a National Institutes of Health Stroke Scale. Vários biomarcadores têm sido estudados como potenciais marcadores de diagnóstico, estratificação de risco e previsão de prognóstico no acidente vascular cerebral, em particular a S100 calcium binding protein B, a proteína C-reativa, as metaloproteinases de matriz e o peptídeo natriurético cerebral. Conclus

  17. [Hypofractionation in locally advanced breast cancer: "flash" scheme].

    PubMed

    Padilha, Marisa; Gonçalves, Sara; Fardilha, Carlos; Melo, Gilberto; Miranda, Cristina; Alves, Paula

    2013-01-01

    Introdução: O carcinoma da mama é uma das principais causas de morte no nosso país. No Serviço de Radioterapia do Instituto Português de Oncologia de Coimbra de Coimbra utilizamos, desde há mais de 30 anos, um esquema de hipofraccionamento de radioterapia, denominado “Flash”, como opção terapêutica em doentes idosos ou com baixo Performance Status, portadores de carcinoma da mama localmente avançado ou com estádios IIb ou IV, com intenção neoadjuvante ou paliativa. Objectivos: Avaliar a resposta ao tratamento, nomeadamente sobrevivência global aos três anos, resposta local e toxicidades aguda e crónica, no grupo de doentes seleccionados submetidos a esquema de hipofraccionamento, em estudo retrospectivo. Metodologia: Entre Janeiro de 2006 e Dezembro de 2008, um total de 83 doentes com diagnóstico de Carcinoma da Mama Localmente Avançado ou com estádios IIb ou IV, foi submetido a “Flash” mamário. A dose de radioterapia prescrita foi de 13Gy / 2Fr / 3 dias (em 23 doentes - 27,7%) e 26Gy / 4Fr / 2,5 semanas (em 60 doentes - 72,3%), com fotões de 4 MV, sobre a mama afectada. Foi avaliada sobrevivência global segundo o método de Kaplan-Meier. A análise estatística foi efectuada através da aplicação SPSS, versão 17.0 e os testes estatísticos foram avaliados ao nível de significância de 5%. Resultados: 80 doentes (96,4%) que efectuaram “Flash” mamário eram do género feminino, com idades compreendidas entre os 59 e os 93 anos (idade média 80,72 + 5,87 anos) e Performance Status (Karnosfsky: 0 - 100) entre 90 e 50%. Em 72 doentes (86,7%) o diagnóstico histológico foi Carcinoma Ductal Invasivo. A cirurgia após a realização do “Flash” Mamário foi realizada em 44 doentes (53%) após evidência de resposta local à radioterapia, sendo a Mastectomia Radical Modificada a técnica cirúrgica mais frequente. Efectuou-se o diagnóstico de metastização óssea em 10 doentes (12%), sendo que a taxa de sobrevivência global foi

  18. [SwapINN: analytic study about prescription swaps at pharmacies].

    PubMed

    Moutinho, Ana; Alexandra, Denise; Rodrigues, Renata

    2014-01-01

    Introdução: A prescrição obrigatória por DCI foi imposta em 2012, para redução de custos do SNS e motivou discussão entre as partes envolvidas. Estudámos, numa população real, a dinâmica prescrição-dispensa de medicamentos.Objetivos: Determinar a percentagem de prescrições substituídas; avaliar os fatores associados à substituição; identificar as respetivas justificações; quantificar os diferenciais dos custos para utente e Serviço Nacional de Saúde.Material e Métodos: Estudo analítico. Amostra de conveniência constituída pelos medicamentos prescritos de uma unidade de saúde, de 19 a 23 de Dezembro de 2011. Três dias depois, os utentes foram entrevistados telefonicamente. Software: Excel® e SPSS®. Testes: Qui-quadrado e Mann-Whitney; n.s. = 0,05.Resultados: Total de 255 prescrições. A maioria foi efetuada a mulheres (62%), idade média 52 anos, 4 anos de escolaridade (33%) e para situações agudas (53%). Foram substituídas 31% das prescrições, sem relação com idade, sexo ou escolaridade, nem com o médico prescritor ou farmácia. Os medicamentos prescritos para situações crónicas foram menos substituídos (p < 0,001), assim como as prescrições de marca (p < 0,001). Os anti-infeciosos e anti-alérgicos foram os grupos com mais substituições (p = 0,009). Os utentes não se aperceberam da substituição em 72% dos casos. Nos casos de substituição, o utente pagou, em média, mais 79% que o prescrito e o Serviço Nacional de Saúde 5%.Discussão/Conclusão: Verificou-se substituição de 31% das prescrições, com mais custos para utente e Serviço Nacional de Saúde. Consideramos possível viés de seleção, informação e registo. Sendo agora obrigatória a prescrição por DCI, sugerimos a análise regular, a nível nacional, com base nas aplicações informáticas em uso, da prescrição e respetiva dispensa.

  19. [Physical activity programmes to reduce overweight and obesity in children and adolescents; a systematic review].

    PubMed

    Aguilar Cordero, M J; Ortegón Piñero, A; Mur Vilar, N; Sánchez García, J C; García Verazaluce, J J; García García, I; Sánchez López, A M

    2014-10-01

    Introducción: El tratamiento contra la obesidad ha sido muy discutido y varios autores abogan por un tratamiento integral de la obesidad. Todos los referentes conducen a plantear ¿cuál es el programa de actividad física más efectivo para reducir el sobrepeso y la obesidad de niños y adolescentes? Objetivo: Analizar los principales estudios sobre la eficacia de la actividad física para reducir el sobrepeso y la obesidad de niños y adolescentes. Método: Revisión sistemática de los resultados de programas de actividad física para reducir el sobrepeso y la obesidad publicados en artículos científicos. Se identificaron 85 artículos a través de la búsqueda automatizada en las bases de datos PUBMED y Google Scholar; se llevó a cabo entre los meses de octubre de 2013 y marzo de 2014. Para seleccionar los artículos fue preciso considerar la utilidad y la relevancia del tema estudiado y la credibilidad o experiencia de los autores en la temática. Se tuvo en cuenta la validez interna y externa de cada uno de los artículos revisados. Conclusiones: Se identificó la efectividad de la actividad física para reducir el sobrepeso y la obesidad de niños y adolescentes. El programa de actividad física más efectivo es el que combina ejercicios aeróbicos y anaeróbicos. Existe consenso en acumular más de 180 minutos a la semana dedicados a estos fines, con 3 sesiones de 60 minutos cada una de ejercicio físico a la semana. De una intensidad moderada, podrían ser suficientes para ejecutar un programa de ejercicio físico para esas personas con sobrepeso y obesidad. Coinciden los autores en que, cuando se combina una dieta controlada por una adecuada distribución de las comidas y con la práctica de actividad física, se potencian mutuamente, con lo que se obtie nen los mejores resultados. Los programas de reducción de peso que tengan en cuenta la participación familiar son más eficaces que la propia educación alimentaria y otras intervenciones de rutina

  20. [Software for performing a global phenotypic and genotypic nutritional assessment].

    PubMed

    García de Diego, L; Cuervo, M; Martínez, J A

    2013-01-01

    Antecedentes: La evaluación nutricional del paciente requiere del manejo simultáneo de una extensa información y de numerosas bases de datos, ya que se analizan tanto aspectos relacionados con el proceso de la nutrición como la situación y evolución clínica del paciente. Con la introducción de la informática dentro del ámbito nutricional se ha producido un avance extraordinario en la administración de la información, permitiendo la realización de valoraciones exhaustivas del estado nutricional de forma rápida y sencilla. Objetivo: Desarrollar un programa informático que sirva como instrumento para la evaluación del estado nutricional del paciente, la educación del personal clínico, en estudios epidemiológicos y con fines pedagógicos. Diseño: Un programa informático que ayude al especialista de la salud a realizar una evaluación nutricional completa del paciente, mediante el registro y valoración de las características fenotípicas y genotípicas. La aplicación ofrece pronósticos nutricionales basados en parámetros antropométricos y bioquímicos, imágenes de estados de desnutrición, cuestionarios de caracterización de enfermedades, criterios de diagnóstico, identificación de alelos relacionados con el desarrollo de ciertas enfermedades metabólicas y cuestionarios de calidad de vida, para una actuación personalizada. El programa incluye como parte de la valoración nutricional del paciente el análisis de la ingesta alimentaria, la elaboración de dietas y la promoción de la actividad física, introduciendo cuestionarios de frecuencia alimentaria, recordatorios dietéticos, índices de alimentación saludable, dietas modelo, test de condición física así como recomendaciones, recordatorios y cuestionarios de actividad física. Resultado: Un programa informático diseñado mediante el lenguaje de programación Java Swing, usando la base de datos SQLite y algunas librerías externas como JFreeChart para el diseño de gr

  1. Condições físicas do disco de acréscimo da nova-anã V4140 SGR

    NASA Astrophysics Data System (ADS)

    Borges, B.; Baptista, R.

    2003-08-01

    Discos de acréscimo são aparatos cósmicos que permitem que matéria seja eficientemente acrescida sobre uma fonte compacta pela remoção de momento angular via tensões viscosas enquanto transforma a energia potencial gravitacional em calor e, posteriormente, em radiação. Sistemas binários semi-ligados, como Variáveis Cataclísmicas (VCs) não-magnéticas, são talvez os melhores ambientes encontrados para o estudo da física desses discos de acréscimo. O desenvolvimento de técnicas de imageamento indireto, como o mapeamento por eclipses (MME) e a tomografia Doppler, permitiu avanços importantes na compreensão da física dos processos de acréscimo desses sistemas. V4140 Sagitarii é uma VC eclipsante de curto período orbital (~ 90 min) que não havia sido classificada como nova-anã ou polar. Neste trabalho apresentamos a análise do mapeamento por eclipse feito com dados de fotometria CCD nas bandas B, V e R de V4140 Sgr realizada no LNA. O objeto foi observado no declínio de erupção em julho de 1992 e em erupção em julho de 2001, isso indicou a classificação do sistema como uma nova-anã. A análise, feita sobre os mapas já apresentados em trabalho anterior, apresenta (i) diagrama cor-cor, que indica uma emissão opticamente espessa nas partes internas do disco em quiescência (R < RL1); (ii) diagrama cor-magnitude, usado para inferir uma distância de 600 +/- 10 pc ao sistema; (iii) a distribuição radial de temperatura observada que concorda com a lei de disco espesso em estado estacionário TµR-3/4, com temperaturas em torno de 10000 K e 3000 K ns partes internas e externas do disco em quiescência, respectivamente; (iv) a evolução da distribuição de temperatura no declínio de erupção; (v) estimativa da transferência de massa de 109.9+/-0.1 M¤/ano em quiescência, similar àquelas observadas em novas-like. O sistema é comparado à outras novas-anãs (e.g. OY Car e Z Cha) em quiescência e erupção, mostrando-se tratar um

  2. Cambios históricos en el aporte terrígeno de la cuenca del Río de la Plata sobre la plataforma interna Uruguaya

    NASA Astrophysics Data System (ADS)

    Marrero, Analía; Tudurí, Adriana; Pérez, Laura; Cuña, Caroline; Muniz, Pablo; Lopes Figueira, Rubens; Michaelovitch de Mahiques, Michel; Alves de Lima Ferreira, Paulo; Pittauerová, Daniela; Hanebuth, Till; García Rodríguez, Felipe

    2014-12-01

    B 13813-4. También se determinó una mayor acumulación de sedimentos a través del tiempo en el cinturón de barro del Río de la Plata (plataforma continental adyacente), comparado con aquel registrado en la Barra del Indio (límite entre zona intermedia y externa del estuario). Estas diferencias podrían estar relacionadas con la influencia del Río de la Plata, el cual genera un ambiente altamente dinámico sobre la Barra del Indio y un ambiente más estable sobre el cinturón de barro en la plataforma continental.

  3. Extensional Detachment faulting in melange rocks. Plurikilometres migration by W the External Zone (Cordillera Bética, Spain)

    NASA Astrophysics Data System (ADS)

    Roldán, Francisco Javier; Azañon, Jose Miguel; Rodríguez, Jose; Mateos, Rosa Maria

    2014-05-01

    ético durante el Mioceno medio-superior: El Complejo Extensional Subbético. Boletín Geológico y Minero, 124 (3): 477-504. Roldán, F.J., Azañón, J.M. y Rodríguez-Fernández, J. (2012): Desplazamiento extensional del Subbético entre las sierras de Cabra y Alta Coloma (Valdepeñas de Jaén. Zonas Externas de la Cordillera Bética). VIII Congreso Geológico de España oviedo. GEOTEMAS, V-13: 484. Roldán, F.J., Rodríguez-Fernández, J., Villalobos, M., Lastra, J., Díaz-Pinto, G., Pérez Rodríguez, A.B. (2012). Zonas: Subbético, Cuenca del Guadalquivir y Campo de Gibraltar. In GEODE. Mapa Geológico Digital Continuo de España. Sistema de Información Geológica Continua: SIGECO. IGME. Editor Navas, J. Disponible en: http://cuarzo.igme.es/sigeco.default.htm

  4. Minimal Hepatic Encephalopathy: The Reality Beyond Our Eyes.

    PubMed

    Barbosa, Mara; Marinho, Carla; Mota, Paula; Cotter, José

    2015-01-01

    Introdução: A encefalopatia hepática mínima define-se como um défice neurocognitivo ligeiro, não detectável ao exame clínico, que pode estar presente nos doentes cirróticos. Objectivo: Determinar a prevalência da encefalopatia hepática mínima num hospital prestador de cuidados de saúde secundários no Norte de Portugal. Material e Métodos: Realizou-se um estudo transversal em que foram incluídos os doentes cirróticos seguidos na consulta externa. Critérios de exclusão: encefalopatia hepática clínica, iliteracia, consumo activo de álcool e terapêutica com fármacos psicotrópicos ou lactulose. A presença de encefalopatia hepática mínima foi definida como um valor ≥ -4 na Pontuação Psicométrica da Encefalopatia Hepática, calculado de acordo com as normas portuguesas. Analisaram-se as variáveis: etiologia e gravidade da doença hepática e concentração da amónia sanguínea venosa. Considerou-se o valor de p < 0,05 como significativo. Resultados: Dos 102 doentes avaliados, 41 foram incluídos: 31 homens, idade média de 57 ± 10 anos, escolaridade média de 5 ± 2 anos, 31 Child-Pugh classe A, score MELD médio de 6 ± 3. Foi diagnosticada encefalopatia hepática mínima em 14 (34%) doentes. A presença de encefalopatia hepática mínima não se relacionou com a gravidade da doença hepática. Apesar de mais elevado, o valor médio da concentração da amónia venosa nos doentes com encefalopatia hepática mínima não foi significativamente diferente do valor médio da concentração da amónia venosa nos doentes sem encefalopatia hepática mínima (48,5 ± 13,3 vs. 45,6 ± 15,6 μmol/L, p = 0,555). Discussão: A prevalência da encefalopatia hepática mínima descrita está de acordo com os dados internacionais. Conclusão: A encefalopatia hepática mínima é uma entidade frequente que está presente precocemente na história natural da cirrose, mesmo em doentes compensados. Consequentemente, esta condição escondida deve ser

  5. Vertebral column and associated elements in dipnoans and comparison with other fishes: development and homology.

    PubMed

    Arratia, G; Schultze, H P; Casciotta, J

    2001-11-01

    A vertebral column consisting of a persistent notochord and ossified arcocentra is the primitive condition for Gnathostomata; it still persists in primitive actinopterygians and sarcopterygians. Advanced actinopterygians and sarcopterygians develop numerous types of centra that include, among others, the presence of holocentrum, chordacentrum, and autocentrum. The chordacentrum, a mineralization or calcification of the fibrous sheath of the notochord, is only found in actinopterygians, whereas an autocentrum is a synapomorphy of teleosts above Leptolepis coryphaenoides. The chordacentrum, formed by migration of cartilaginous cells from the arches into the fibrous sheath of the notochord and usually covered by a thin calcification, is a unique feature of chondrichthyans. The actinopterygian chordacentrum and the chondrichthyan chordacentrum are not homologous. The postcaudal cartilaginous centrum is only known in postcaudal vertebrae of living dipnoans. The holocentrum is present in certain fossil dipnoans and actinopterygians, where it has been independently acquired. It is formed by proliferation of cartilage cells around the elastica externa of the notochord. These cells later ossify, forming a compact centrum. A vertebral column formed by a persistent notochord without vertebral centra is the primitive pattern for all vertebrates. The formation of centra, which is not homologous among vertebrate groups, is acquired independently in some lineages of placoderms, most advanced actinopterygians, and some dipnoans and rhipidistians. Several series of structures are associated with the vertebral column such as the supraneurals, interhaemals, radials, and ribs. In living dipnoans median neural spine, "supraneural," and dorsal radial result from growth and distal differentiation of one median cartilage into two or three median bones during ontogeny. The median neural spine articulates with the neural arch and fuses with it in the caudal vertebrae early in ontogeny. Two

  6. Revista de Saúde Pública in scientific publications on Violence and Health (1967-2015).

    PubMed

    Schraiber, Lilia Blima; Barros, Claudia; d'Oliveira, Ana Flávia Pires Lucas; Peres, Maria Fernanda Tourinho

    2016-11-10

    This article retrieved the publications from the Revista de Saúde Pública journal (from 1967 to 2015) on violence and health, on the SciELO and PubMed bases, by searching for the terms "violence", "suicide", "aggression", "bullying", and "external causes", registered in any part of the text. We found 130 articles (the first one published in 1974). We observed: increase of publications over time, with decrease in the last five years; similar production volume in lethal and non-lethal violence; later publication of the latter; few studies in qualitative research; mostly descriptive production; and visualization of the problem more by the acts than by contexts or motivations and aggressors. Social markers were little approached, appearing, from largest to smallest frequency, social class, gender, race/ethnicity, and generation. Human rights were little used and only recently used as analytical framework, connected more to gender than to social class. Although Revista de Saúde Pública has registered the theme in its publications, consolidating it as scientific production line, there is still great explanatory theoretical rarefaction and little intersectionality between violence, social inequalities, and human rights. RESUMO A produção da Revista de Saúde Pública (de 1967 até 2015) sobre violência e saúde foi recuperada nas bases SciELO e PubMed utilizando-se os termos "violência", "suicídio", "agressões", "bullying" e "causas externas", registrados em qualquer parte do texto. Foram encontrados 130 artigos (o primeiro deles publicado em 1974). Constatou-se: aumento das publicações no tempo, com decréscimo nos últimos cinco anos; volume similar de produção em violência letal e não letal; publicação mais tardia desta última; poucos estudos em pesquisa qualitativa; produção majoritariamente descritiva; e visibilização do problema, mais pelos atos que pelos contextos ou motivações e agressores. Os marcadores sociais foram pouco tematizados

  7. [Self-reported experience in patients treated with Hepatitis C direct acting antivirals].

    PubMed

    Cañamares Orbis, Irene; Saez de la Fuente, Javier; Escobar Rodriguez, Ismael; Esteban Alba, Concepción; Such Díaz, Ana; Escobar Rodríguez, Ismael

    2016-11-01

    Introducción y objetivo: Conocer y analizar la experiencia autorreferida del tratamiento de los pacientes VHC que iniciaron tratamiento con agentes antivirales directos (AAD), a tiempo real, de forma proactiva e integrada en el proceso asistencial de atención farmacéutica. Material y métodos: Estudio observacional y transversal desarrollado entre abril (inicio del Plan Estratégico Nacional) y diciembre de 2015 en la Consulta Externa del Servicio de Farmacia. Se utilizó como herramienta un cuestionario prospectivo cumplimentado por los pacientes donde se recogieron variables relacionadas con la calidad de vida vinculadas con la salud (CVRS), adherencia, efectos adversos (EA), satisfacción con el tratamiento, y valoración y utilidad del programa formativo implementado por el Servicio de Farmacia. Se realizó un análisis descriptivo de todas las variables incluidas en el estudio y se analizó la influencia de las diferentes variables en el grado de adherencia y CVRS. El análisis de las diferencias entre los dos grupos se realizó mediante el test de chi cuadrado y el cálculo de las OR con un modelo de regresión logística simple. Se utilizó el programa SPSS® versión 20, y se estableció una significación estadística para valores de p < 0,05. Resultados: Se recogieron155 encuestas de las 226 enviadas, tasa de respuesta del 68,6%.En referencia a la CVRS (valoración del estado físico y emocional), un 38,7% de los pacientes refieren que su estado físico y emocional es mucho mejor desde el inicio del tratamiento. La presencia de EA y una peor información global de su enfermedad se asoció con un peor estado físico y emocional (p < 0,05). La adherencia reportada fue del 84,5% y el tratamiento fue valorado como muy bueno o bueno por el 87% de los pacientes. Un 52,9% de los pacientes no tuvieron efectos adversos relacionados con la medicación y el proceso formativo realizado por el farmacéutico especialista en la primera consulta fue valorado por el 96

  8. [Fractional exhaled nitric oxide in monitoring and therapeutic management of asthma].

    PubMed

    Melo, Bruno; Costa, Patrício; Afonso, Ariana; Machado, Vânia; Moreira, Carla; Gonçalves, Augusta; Gonçalves, Jean-Pierre

    2014-01-01

    Introdução: A asma é uma doença respiratória crónica caracterizada pela hiper-reactividade e inflamação brônquica. A inflamação brônquica destes doentes pode ser monitorizada através da medição da fração exalada de óxido nítrico. Este estudo tem por objetivo determinar a associação do valor da fração exalada de óxido nítrico com o débito expiratório máximo instantâneo e com o controlo da asma determinado pela Classificação da Iniciativa Global para a Asma.Material e Métodos: Estudo observacional, analítico e transversal de crianças com asma, 6-12 anos, seguidas na Consulta Externa de Patologia Respiratória do Hospital de Braga. Informação sociodemográfica e clínica colhida através de um questionário. Determinado o valor da fração exalada de óxido nítrico, através do analisador portátil Niox Mino®, e do débito expiratório máximo instantâneo,através do debitómetro.Resultados: A amostra é constituída por 101 crianças asmáticas, 63 (62,4%) do sexo masculino e 38 (37,6%) do sexo feminino. A idade média dos participantes na amostra é de 9,18 (1,99) anos. A regressão logística, realizada com o valor de cutoff obtido pela curva de ROC, revelou que a fração exalada de óxido nítrico tem um efeito estatisticamente significativo (bNíveis do FENO = 0,85; χ2Wald (1) = 8,71; OR = 2,33; p = 0,003) sobre a probabilidade de mudar de nível de controlo da asma. Por cada nível de fração exalada de óxido nítrico incrementado o odds de passar a não controlada é 2,33 vezes superior.Discussão e Conclusão: A probabilidade de uma criança asmática mudar o seu nível de controlo da asma, de ‘controlada’ para ‘parcialmente controlada/não controlada’, tendo em consideração uma alteração no seu nível da fração exalada de óxido nítrico, aumenta 133%.

  9. Serum Potassium Levels Inversely Correlate with D-Dimer In Patients with Acute-Onset Atrial Fibrillation.

    PubMed

    Cervellin, Gianfranco; Bonfanti, Laura; Picanza, Alessandra; Lippi, Giuseppe

    2014-12-09

    D-dímero são frequentemente aumentada em pacientes com fibrilação atrial (FA) em comparação com indivíduos em ritmo sinusal. A hipocalemia desempenha um papel em várias doenças cardiovasculares, mas pouco se sabe sobre a associação com FA. Objetivo: As concentrações de D-dímero encontram-se frequentemente aumentadas em pacientes com FA, quando comparados com indivíduos em ritmo sinusal. A hipopotassemia desempenha um papel importante nas doenças cardiovasculares, porém, pouco é conhecido sobre sua associação com a FA. O objetivo deste estudo foi investigar a correlação entre os níveis séricos de D-dímero e potássio na FA aguda (FAA). Métodos: Para investigar a existência de uma potencial correlação entre os níveis séricos de potássio e D-dímero em pacientes com FAA, realizamos uma revisão retrospectiva de dados clínicos e laboratoriais relacionados a todas as visitas ao departamento de emergência devido à FAA, no ano de 2013. Resultados: Entre os 271 pacientes com FAA, aqueles com hipopotassemia (n = 98) mostraram aumento significativo nos níveis de D-dímero, quando comparados com pacientes com concentrações normais de potássio (139 versus 114 ng/mL, p = 0,004). A taxa de pacientes com níveis de D-dímero excedendo o valor limiar de diagnóstico foi maior no grupo de pacientes com hipopotassemia, quando comparado com o grupo de pacientes com concentrações normais de potássio (26,5% versus 16,2%; p = 0,029). Detectamos uma correlação inversa e altamente significativa entre os níveis séricos de potássio e D-dímero (r = -0,21; p < 0,001), até mesmo após ajuste para idade e sexo (coeficiente beta -94,8; p = 0,001). O risco relativo de um valor positivo de D-dímero estar relacionado à hipopotassemia foi de 1,64 (95% CI, 1,02 to 2,63; p = 0,040). A correlação permaneceu estatisticamente significativa em pacientes livres de medicamentos hipertensivos (r = -0,25; p = 0,018), porém não nos pacientes em tratamento

  10. [Analysis of the nutritional parameters and adjustment of the requirements of the initial parenteral nutrition in post surgical critically ill patients].

    PubMed

    Herrero Domínguez-Berrueta, M Carmen; Martín de Rosales Cabrera, Ana María; Pérez Encinas, Montserrat

    2014-02-01

    Objetivos: Analizar los parámetros nutricionales en pacientes críticos postquirúrgicos en situación de estrés, su evolución y evaluar el grado de ajuste de la Nutrición Parenteral (NP) de inicio a los requerimientos de las recomendaciones recientemente publicadas. Material y métodos: Estudio observacional, retrospectivo incluyendo pacientes críticos postquirúrgicos ingresados en una unidad de reanimación postquirúrgica en 2011 con prescripción de NP. Se recogieron datos demográficos, antropométricos, diagnóstico, parámetros nutricionales, mortalidad, estancia total y en Reanimación (REA), y complicaciones. Se comparó el tipo de NP pautada, con la individualización de los requerimientos por kg según las últimas recomendaciones publicadas de nutrición en el paciente crítico (ASPEN, ESPEN, SENPE): 18-30 kcal/kg, 0,8-1,5 g/kg/proteínas, 4 mg/kg/min/glucosa y 2-3 mg/kg/min/glucosa en pacientes con hiperglucemia de estrés, y 0,5-1 g/kg/día lípidos. Las variables analizadas fueron ajuste calórico, proteico y de glucosa en la NP de inicio, recuperación de la albúmina > 3 g/dl a día 10º y la posible asociación clínica con el número de complicaciones, mortalidad y estancia. Resultados: Se analizaron 60 pacientes. El 23,3% (14/60) presentaban al ingreso desnutrición con una pérdida significativa de peso previa a la intervención. La albúmina, reactante de fase aguda negativo, fue significativamente baja al inicio, media 1,9 g/dl (IC95% 1,83-2,12) indicando un alto grado de estrés metabólico de los pacientes postquirúrgicos. Las NP pautadas se ajustaron a las recomendaciones en kcal, proteínas y lípidos en un 68,3%, 71,7%, 80,4% respectivamente. El 57,1% estaban ajustados en glucosa aunque no se tuvo en cuenta el posible aporte en sueroterapia. En pacientes con IMC < 22 kg/m2 (16/60) se observó que el 81,8% de las NP pautadas presentaban exceso calórico, 60% exceso proteico y 43,8% exceso de lípidos (p < 0,05). Un 34 % de todos

  11. Tumores neonatales y malformaciones congénitas

    PubMed Central

    Tornero, O. Berbel; García, J.A. Ortega; Tortajada, J. Ferrís i; Castell, J. García; Colomer, J. Donat i; Soldin, O.P.; Soler, J.L. Fuster

    2013-01-01

    Introducción La asociación entre tumores y malformaciones congénitas está bien establecida, pero no existen datos exclusivos en el período neonatal y se desconocen los mecanismos subyacentes que generan dicha relación. Objetivos Este trabajo tiene dos objetivos: primero, analizar la frecuencia de los tumores neonatales asociados a malformaciones congénitas, y segundo, comentar las posibles hipótesis etiopatogénicas de la relación entre ambas entidades. Materiales y método Estudio retrospectivo de las historias clínicas de los tumores neonatales, en el Hospital Universitario Materno- Infantil La Fe de Valencia, desde enero de 1990 hasta diciembre de 1999. Selección y descripción de las variedades histológicas asociadas a malformaciones congénitas. Éstas se han agrupado siguiendo los criterios de la Clasificación Internacional de Enfermedades CIE-9, códigos 740.0–759.9. Revisión sistemática bibliográfica de los últimos 25 años, obtenida del Medline, Cancerlit, Index Citation Science y Embase. El perfil de búsqueda utilizado fue la combinación de “neonatal/congenital-tumors/cancer/neoplasms” y “congenital malformations/birth defects”. Resultados Se identificaron 72 tumores neonatales (2,8 % del total de tumores pediátricos diagnosticados en dichos años) y 15 de ellos (20,8 %) asociados a malformaciones congénitas, enfermedades o síndromes congénitos. Las asociaciones entre tumores neonatales y malformaciones congénitas fueron las siguientes: a) angioma en 3 pacientes: con dos cardiopatías congénitas y una atresia de coanas-laringomalacia; b) neuroblastoma en 2 pacientes: uno con riñón en herradura y anomalías vertebrales, y otro con cardiopatía congénita; c) teratoma en 2 pacientes: uno con fisura palatina y anomalías vertebrales, y otro con metatarso varo; d) tumor del sistema nervioso central en un paciente con hernia de Bochdaleck; e) tumor cardíaco en 4 pacientes con esclerosis tuberosa; f) leucemia aguda en un

  12. Application of the groundwater-balance equation to indicate interbasin and vertical flow in two semi-arid drainage basins, Mexico

    NASA Astrophysics Data System (ADS)

    Carrillo-Rivera, J. J.

    2000-09-01

    conclusion est qu'une étude par bilan de la nappe est une méthode qui n'est pas satisfaisante pour déterminer certains paramètres comme le coefficient d'emmagasinement. En particulier, l'approche par le bilan de la nappe donne des résultats qui ne sont pas fiables lorsque l'on ignore la drainance verticale ou que l'on ne peut pas la définir correctement. L'existence d'une drainance verticale est prouvée par des températures de l'eau souterraine pouvant être supérieures de 23 °C à la température ambiante. Des failles régionales peuvent permettre ces écoulements vers le haut. Lorsque l'on ignore la drainance verticale, on introduit une incertitude sur l'estimation de l'emmagasinement à partir des calculs du bilan régional de la nappe. Sur la base de l'équation du bilan de la nappe, une valeur de S=0,19 semble représenter les conditions captives de la partie développée de l'aquifère ce résultat est plus élevé, de plusieurs ordres de grandeur, que celui que l'on peut raisonnablement attendre des conditions géologiques. Ces résultats sont utiles pour évaluer si une ressource en eau souterraine est "surexploitée". Ces conclusions sont intéressantes lorsque l'on applique des modèles d'écoulement transitoire dans lesquels on ne prend pas en compte la drainance verticale d'une eau plus légère remontant. Resumen. En este trabajo, se investigan las entradas y salidas de flujo horizontal en la ecuación de balance de agua subterránea, así como el papel que desempeñan en el flujo entre cuencas. Se analizan dos ejemplos de México, uno en la Península de Baja California y otro en la parte central del país. En ambos, destaca la influencia del flujo entre cuencas, ya que se estima que una parte importante (aproximadamente el 70%) del agua termal extraída procede de una cuenca superficial externa. Se concluye que el método basado en cálculos de balance de agua subterránea no es satisfactorio para determinar algunos parámetros, como, por ejemplo, el

  13. EXPERIENCE WITH THE BRAZILIAN NETWORK FOR STUDIES IN REPRODUCTIVE AND PERINATAL HEALTH: THE POWER OF COLLABORATION IN POSTGRADUATE PROGRAMS.

    PubMed

    Cecatti, José G; Silveira, Carla; Souza, Renato T; Fernandes, Karayna G; Surita, Fernanda G

    2015-01-01

    , contribuem para a disseminação do conhecimento e estruturação da pesquisa em saúde. Diversas vantagens são atribuídas ao trabalho em rede como: a inclusão de maior número de participantes nos estudos; gerar evidências mais fortes e com maior representatividade da população (generalização secundária e validade externa); maior facilidade das publicações oriundas dos estudos serem aceitas em periódicos de impacto e abrangência; maior probabilidade de obtenção de verbas para financiamento; maior facilidade na coleta de dados sobre condições raras; inclusão de participantes de diferentes grupos étnicos e culturas, entre outras. No Brasil a Rede Brasileira de Estudos em Saúde Reprodutiva e Perinatal foi criada em 2008 com o objetivo inicial de desenvolver rede nacional de cooperação científica para vigilância da morbidade materna grave. Desde sua formação, cinco estudos foram desenvolvidos, alguns já encerrados e outros em fase de finalização, com outros dois em fase final de implantação. Os resultados das atividades desta Rede têm sido bastante produtivos e impactaram positivamente não apenas no Programa de Pós-Graduação em Tocoginecologia da Universidade Estadual de Campinas, seu centro coordenador, mas também o de outros centros participantes, uma vez que expressivo número de artigos científicos foi publicado, mestrados e doutorados foram defendidos e pós-doutorados finalizados, de alunos de diversas áreas da saúde, de diferentes regiões e de várias instituições de todo o país, com alto impacto social dada a relevância dos temas estudados para o país.

  14. Farmyard Manure and Fertilizer Effects on Seed Potato (Solanum tuberosum L.) Yield in Green House Production

    NASA Astrophysics Data System (ADS)

    László, M.

    2009-04-01

    ção Diversos fatores como potencial de produção do solo, modo de aplicação do fertilizante dentre outro fatores afetam a resposta da batateira á aplicação de fertilizantes (Refschneider 1987.). Depreende- se pois que no estabelecimento de um nivel ideal de fertilização as variáveis planta, solo e condições climaticas devem ser visualizadas como um sistema pouco provável de ser homogeneo mesmo em nivel de fazenda. Como tal, generalizações a respeito de doses ou niveis de fertlização são difíceis de serem feitas, recomendações exigem julgamento hábil por parte do fazendeiro ou do tecnico responsavel pela cultura (Márton 2001a., 2001b.). Este julgamento será mais preciso conhecendo- se pontos que serão rápidamente discutidos a seguir. A taxa de absorção de nutrientes é governada pela concentração externa ou suprimento de nutrientes pelo solo e a demanda do nutriente criada pelo desenvolvimento e funcinamento normal dos diversos órgãos das plantas. O nivel de nutrientes na solução do solo deve ser suficiamente alto para que suas taxas de absorção não sejam limitantes ao crescimento. Por outro lado, não deve ser demasiado para causar excessiva absorção de outros nutrientes. Forte associação existe entre a absorção de nutrientes e o desenvolvimento da planta. De maneira geral, a fase de rapido desenvolvimento da cultura é acompanhada por um grande aumento na absorção de nutrientes com a taxa de absorção declinado quando a taxa de crescimento diminuiu. Normalmente todos os fertilizantes potássicos e fosfatados são adicionados ao solo na época do plantio. O nitrogênio normalmente é parcelado. Cerca de 2 por 3 do nível recomendado é colocado no sulco de plantio e o restante adicionado por ocasião da amontoa. É uma prática tradicinal e com pouco suporte experimental no condiõces brasileiras. Espera -se que a aplicação parcelada do nitrogênio e mesmo do potássio possem ser benéficas quando houver chuva excessiva ou irriga