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1.
Enferm. infecc. microbiol. clín. (Ed. impr.) ; 41(2): 103-106, Feb. 2023. tab
Artigo em Espanhol | IBECS | ID: ibc-215779

RESUMO

Introducción: Mycoplasma genitalium (M. genitalium) es un patógeno de transmisión sexual emergente de importancia creciente. El objetivo de este estudio fue comparar dos test para la detección de M. genitalium; el test de Aptima® MG (Hologic® Inc., San Diego, CA, EE. UU.) y el test Cobas® TV/MG (Roche® Diagnostics, Mannheim, Alemania). Métodos: Se trata de un estudio descriptivo prospectivo donde se analizaron en paralelo y en orden aleatorio por ambos sistemas un total de 489 muestras genitales y extragenitales de pacientes procedentes del Centro de Infecciones de Transmisión Sexual en Sevilla y de las Consultas de Enfermedades Infecciosas del Hospital Virgen de Valme. Resultados: La concordancia global entre ambos ensayos fue muy buena (k >0,91). La sensibilidad y la especificidad del test Aptima® MG fueron del 100 y el 98,7% respectivamente, y del 100 y del 99,8%, respectivamente, para el test Cobas® TV/MG. Conclusión: Ambos sistemas mostraron un rendimiento excelente para la detección de M. genitalium.(AU)


Background: Mycoplasma genitalium (M. genitalium) is an emerging sexually transmitted pathogen of increasing importance. The objective of this study was to compare twotests for the detection of M. genitalium; the Aptima® MG test (Hologic® Inc., San Diego, CA) and the Cobas® TV/MG test (Roche® Diagnostics, Mannheim, Germany). Methods: This is a prospective descriptive study where a total of 489 genital and extragenital samples were analyzed in parallel and in random order by both systems. The samples were collected from patients attending the Sexually Transmitted Infections Center in Seville and the Infectious Diseases consultation of the Virgen de Valme Hospital. Results: The overall agreement between both trials was very good (k>0.91). The sensitivity and specificity of the Aptima® MG test were 100% and 98.7% respectively for the Cobas® TV/MG test. Conclusion: Both systems showed excellent performance for the detection of M. genitalium.(AU)


Assuntos
Humanos , Genitália , Mycoplasma genitalium , Reação em Cadeia da Polimerase , Infecções Sexualmente Transmissíveis , Manejo de Espécimes , Epidemiologia Descritiva , Estudos Prospectivos , Espanha
2.
Cir. plást. ibero-latinoam ; 48(3): 347-354, jul.-sep. 2022. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-211348

RESUMO

Introducción y objetivo: Las quemaduras son un importante problema global de salud pública y sus aspectos epidemiológicos varían de una comunidad a otra. El objetivo del presente estudio fue determinar los factores asociados al desarrollo de infecciones intrahospitalarias en el adulto gran quemado en un hospital de referencia en el Perú mediante un estudio retrospectivo de 5 años. Material y métodos: Estudio observacional, analítico de tipo cohorte histórico, cuali-cuantitativo. Para la muestra tomamos el total de pacientes grandes quemados del Hospital Nacional Daniel Alcides Carrión del Ca-llao, en Lima, Perú, durante el periodo 2014-2019, que fueron 45. Hicimos una revisión de las historias clínicas de aquellos que cumplieron los criterios de inclusión. Empleamos análisis bivariado de variables independientes entre los expuestos y no expuestos a las variables de causas estudiadas: edad, hipoalbuminemia, comorbilidades, porcentaje de superficie corporal total quemada y localización de la lesión, y utilizamos la prueba de correlación de Pearson y las pruebas U de Mann Whitney o la prueba de Kruskal Wallis. Resultados: La incidencia acumulada de infectados fue del 28.89%. En el análisis bivariado, los factores asociados al desarrollo de infecciones intrahospitalarias fueron: quemaduras localizadas en genitales (RR 11.6; IC95% 3.90-34.84; p<0.001), hipoalbuminemia (RR 0.07; IC95% 0.03-0.16; p=<0.001), porcentaje de superficie corporal total quemada (RR 92.9; IC95% 2.78-310; p=0.011) y edad de los pacientes (RR 1.02; IC95% 0,98-1,05; p=0.017). Conclusiones: Los principales factores asociados al desarrollo de infecciones intrahospitalarias en el paciente gran quemado en nuestro medio fueron las quemaduras en genitales, la hipoalbuminemia, el porcentaje de superficie corporal total quemado y la edad de los pacientes. (AU)


Background and objective: Burns are an important global public health problem, and its epidemiological aspects vary from one community to another. The aim of the present study was to determine the associated factors with the development of intrahospital infections in adults with severe burns in a reference hospital in Peru through a 5-year retrospective study. Methods: Observational, analytical historical cohort type, quali-quantitative study. For the sample, the total number of patients with severe burn injuries was taken on count at the Daniel Alcides Carrión del Callao National Hospital, Lima, Peru, between 2014 and 2019, which was 45. A review was made of the clinical records of patients who complied with the inclusion criteria. Use bivariate analysis of independent variables between those exposed and not exposed to the variables of causes studied: age, hypoalbuminemia, comorbidities, percentage of total body surface burned and location of the lesion, and the Pearson correlation test and the U of Mann Whitney or the test of Kruskal Wallis. Results: A cumulative incidence of infected of 28.89% was obtained. In the bivariate analysis, factors associated with the development of hospital infections were: genital burns (RR 11.6; 95% CI 3.90-34.84; p <0.001), hypoalbuminemia (RR 0.07; 95% CI 0.03-0.16; p = <0.001), percentage of total body surface burned (RR 92.9; 95 CI % 2.78-310; p = 0.011) and the age of the patients (RR 1.02; IC95% 0,98-1,05; p=0.017). Conclusions: In our environment, the main factors associated with the development of in-hospital infections in great burns patients were genital burns, hypoalbuminemia, the percentage of total body surface burned and the age of the patients. (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Queimaduras , Infecção Hospitalar , Estudos Retrospectivos , Hipoalbuminemia , Genitália
4.
Allergol. immunopatol ; 50(1): 60-67, ene 2, 2022. ilus, graf, tab
Artigo em Inglês | IBECS | ID: ibc-203086

RESUMO

Objective To investigate the effect of radiofrequency therapy (RFT) on HPV16-E7 lentivirus infection in the reproductive tract of mice and reveal its effect on immune function of splenic lymphocytes.Materials and Methods The mouse reproductive tract model was established by infection with HPV16-E7 lentivirus. Fluorescence microscope was used to evaluate successful injection. The expression of HPV16-E7 protein was detected by Western blotting test. The levels of CD4+ and CD8+ were determined by flow cytometry, and the ratio was calculated. The proliferation of splenic lymphocytes was detected by MTT assay. Expression of Interleukin (IL)-2 and interferon-γ (IFN-γ) messenger RNA (mRNA) in lymphocyte was determined by reverse transcription-quantitative polymerase chain reaction (RT-qPCR).Results Fluorescence microscope determined the successful injection of HPV16-E7 lentivirus. Compared with model group, RFT treatment decreased HPV16-E7 protein, and increased CD4+/CD8+ ratio and the proliferation activity of splenic lymphocytes. Besides, RFT treatment increased the mRNA expression levels of IL-2 and IFN-γ compared to the model group. In particular, the proliferation activity of spleen lymphocytes and the expression levels of IL-2 mRNA and IFN-γ mRNA in RFT were higher at 12 days than at 6 days after treatment.Conclusion RFT could eliminate HPV16-E7 lentivirus infection in the reproductive tract of mice, and the mechanism was related to the immune system (AU)


Assuntos
Animais , Feminino , Camundongos , Terapia por Radiofrequência , Infecções por Papillomavirus/radioterapia , Papillomavirus Humano 16/efeitos da radiação , Infecções por Lentivirus/radioterapia , Linfócitos/imunologia , Genitália/efeitos da radiação , Baço/citologia , Baço/imunologia , Camundongos Endogâmicos BALB C
6.
Prog. obstet. ginecol. (Ed. impr.) ; 60(5): 474-479, sept.-oct. 2017. ilus
Artigo em Espanhol | IBECS | ID: ibc-167335

RESUMO

La identificación del sexo fetal forma parte de la ecografía de segundo trimestre. En ocasiones se presentan anomalías genitales que no permiten definirlo adecuadamente, lo que se conoce como genitales ambiguos. La importancia de los mismos se debe a su asociación con desórdenes del desarrollo sexual, patologías más complejas y graves. En la mayoría de casos el diagnóstico y el manejo es postnatal, estando bien establecido. El diagnóstico prenatal, en cambio, es poco frecuente, limitado y menos conocido. Presentamos el caso de una gestante de 20 años con el hallazgo de genitales ambiguos en semana 29 y posteriormente se diagnosticó de disgenesia gonadal mixta (AU)


Fetal sex identification is a well-established part of the second trimester ultrasound. Sometimes there are genital abnormalities that prevent proper identification, called ambiguous genitalia. Its importance is based on its association with development sex disorders, a far more severe and complex diseases. In most of the cases, diagnosis and management are postnatal and well systematized. Prenatal diagnosis, however, is less frequent and more limited. We present the case of a 20 year old pregnant with a finding of ambiguous genitalia at 29 week and a diagnosis of mixed gonadal dysgenesis (AU)


Assuntos
Humanos , Feminino , Gravidez , Adulto , Ultrassonografia Pré-Natal/métodos , Disgenesia Gonadal Mista/genética , Disgenesia Gonadal Mista , Transtornos do Desenvolvimento Sexual , Androstenodiona/deficiência , Diagnóstico Pré-Natal/métodos , Genitália/anormalidades , Genitália , Testosterona/administração & dosagem , Testosterona/deficiência , Diferenciação Sexual/efeitos da radiação , Processos de Determinação Sexual/efeitos da radiação
8.
Rev. iberoam. micol ; 32(4): 229-234, oct.-dic. 2015. tab
Artigo em Inglês | IBECS | ID: ibc-143441

RESUMO

Background. The knowledge of the diversity of yeasts that make up the skin microbiota of human beings is essential for the efficient monitoring of infections to which a person may be predisposed. Aims. This study identified yeasts comprising the genital skin microbiota of patients attending the Dermatology Service at the Hospital São Paulo-UNIFESP, Brazil. Methods. Samples were collected from the genital region of each patient and cultured on Sabouraud dextrose agar. Individual colonies were carefully transferred to tubes daily. Yeasts were identified based on classical methodologies and confirmed using a commercial kit. Results. Eighty-three patients were included in the study. Approximately 80% were women and 20% were men. The average age was 55 years. Hypertension, diabetes, kidney transplant and AIDS were the main underlying diseases reported by the patients. The most prevalent yeasts were Candida parapsilosis (36.1%), Rhodotorula mucilaginosa (9.2%), Rhodotorula glutinis (8.3%), Candida tropicalis (5.5%) and Trichosporon inkin (1.8%). Approximately 78% of the isolates were obtained in pure cultures. Trichosporon inkin was isolated only from women, in contrast to literature describing a high prevalence in males. Conclusions. Our results suggest that Candida albicans is not the main yeast found on genital skin as previously thought, and opportunistic pathogens such as C. parapsilosis, C. tropicalis, Rhodotorula spp. and T. inkin make up the genital skin microbiota, representing a risk for infection in immunocompromised subjects. These results also indicate that women are carriers of T. inkin, the etiological agent of white piedra and trichosporonosis (AU)


Antecedentes. El conocimiento de la diversidad de las levaduras que conforman la microbiota de la piel de los seres humanos es fundamental para un eficaz seguimiento de las infecciones. Objetivos. En este estudio se identificaron las levaduras que componían la microbiota de la piel de los genitales de pacientes que acudieron al Servicio de Dermatología del Hospital São Paulo - Unifesp, Brasil. Métodos. Se recogieron muestras de la región genital de cada paciente y se cultivaron en agar dextrosa Sabouraud. Las colonias individuales se transfirieron cuidadosamente a tubos. La identificación de las levaduras se basó en metodologías clásicas y se confirmó utilizando un kit comercial. Resultados. Ochenta y tres pacientes fueron incluidos en el estudio. Aproximadamente el 80% eran mujeres y el 20% eran hombres. La edad promedio fue de 55 años. La hipertensión, la diabetes, el trasplante renal y el sida fueron las principales enfermedades subyacentes de los pacientes. Las levaduras más frecuentes fueron Candida parapsilosis (36,1%), Rhodotorula mucilaginosa (9,2%), Rhodotorula glutinis (8,3%), Candida tropicalis (5,5%) y Trichosporon inkin (1,8%). Aproximadamente el 78% de los aislamientos crecieron en cultivo puro. Trichosporon inkin fue aislado únicamente en mujeres, en contra de la literatura que describe una alta prevalencia en los hombres. Conclusiones. Nuestros resultados sugieren que Candida albicans no es la principal levadura que se encuentra en la piel de los genitales, como se pensaba, y los agentes patógenos oportunistas C. parapsilosis, C. tropicalis, Rhodotorula spp. y T. inkin conforman la microflora de la piel genital, lo que representa un riesgo inminente de infección para los pacientes inmunocomprometidos. Estos resultados también indican que las mujeres son portadoras del agente etiológico de la piedra blanca y de la tricosporonosis, T. inkin (AU)


Assuntos
Feminino , Humanos , Masculino , Leveduras/isolamento & purificação , Micoses/epidemiologia , Genitália/microbiologia , Microbiota , Trichosporon/isolamento & purificação , Candida/isolamento & purificação , Malassezia/isolamento & purificação
9.
Eur. j. anat ; 19(2): 171-178, abr. 2015. ilus, tab
Artigo em Inglês | IBECS | ID: ibc-141207

RESUMO

The Black Bengal buck has a notable goat genetic resource. Seminal fluids from male accessory reproductive glands contain nutrients and other substances necessary for the optimum motility and fertility of spermatozoa, and act as a buffer against excess acidity of the female genital tract. This study was conducted to understand the anatomy and histomorphometry of accessory reproductive glands of the Black Bengal buck of Bangladesh. Anatomical study was performed immediately after euthanasia, and histomorphometrical study was performed by Hematoxylin and Eosin staining. There was a difference in biometric values between right and left accessory reproductive glands within the same buck. The average length, width and weight were 1.653 ± 0.025 cm, 1.146 ± 0.015 cm and 1.486 ± 0.010 gm, respectively for the vesicular glands, and 1.045 ± 0.037 cm, 0.918 ± 0.042 cm and 0.537 ± 0.029 gm respectively for the bulbourethral glands. The secretory units of the vesicular glands were lined by pseudostratified columnar epithelium consisting of tall columnar type cells and short basal type cells. The vesicular secretion was stored in the lumen of secretory units. We also found the myoepithelial cells around the secretory cells of glandular end pieces of vesicular gland in all bucks that helped in the excretion of vesicular secretion. All the bucks in the present study had only pars disseminata of prostate gland, and located in the propria-submucosa of the dorsal wall of the pelvic urethra. The secretory units and intraglandular ducts of the prostate gland were lined with simple cuboidal to columnar epithelium with basal cells. The bulbourethral glands were surrounded by the bulboglandular muscle, and the secretory units were lined with tall simple columnar epithelium and occasional basal cells. Most of the columnar cells were of the mucous type, with the nuclei basally placed and the cytoplasm contained the secretion granules in Black Bengal bucks


No disponible


Assuntos
Animais , Glândulas Exócrinas/anatomia & histologia , Genitália/anatomia & histologia , Ruminantes/anatomia & histologia , Reprodução/fisiologia , Glândulas Vestibulares Maiores/anatomia & histologia , Glândulas Bulbouretrais/anatomia & histologia
10.
Eur. j. anat ; 19(2): 201-203, abr. 2015. ilus
Artigo em Inglês | IBECS | ID: ibc-141211

RESUMO

Ischiopagus is a very rare variety of conjoined twins with very few cases reported in the literature. A case of ischiopagus-tetrapus conjoined twins is reported here. Twins were fused at the lower halves of the bodies. There were four well-formed separate lower limbs. The twins had two anal openings for passage of both urine and stool. In general, female predominance is found in conjoined twins. But this particular case, where external genitalia were absent making gender determination difficult, is even more unusual among the rare type. Follow-up of the twins was not possible, as they passed away during pre-operative procedure


No disponible


Assuntos
Humanos , Recém-Nascido , Gêmeos Unidos , Anormalidades Múltiplas , Genitália/anormalidades , Ultrassonografia
11.
An. pediatr. (2003, Ed. impr.) ; 82(1): e64-e67, ene. 2015. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-131672

RESUMO

La enzima P450c17 cataliza 2 reacciones diferentes: 17alfa-hidroxilación de la progesterona y pregnenolona y segmentación de la unión del carbono 17-20 a partir de la 17,20 liasa para producir andrógenos suprarrenales. Esta enzima está codificada por el gen CYP17A1. Se presenta una paciente de 14 años con retraso en el desarrollo puberal y presión arterial elevada para su talla y edad. Cariotipo 46,XX. En el estudio hormonal destaca hipogonadismo hipergonadotropo, así como una insuficiencia suprarrenal y exceso mineralocorticoideo. El estudio genético mostró una mutación en homozigosis en el gen CYP17A1 (c.753+1G>A), no descrita previamente, la cual es responsable de la fisiopatología de la deficiencia de 17alfa-hidroxilasa. Esta entidad es una forma rara de hiperplasia suprarrenal congénita. Normalmente la enfermedad suele pasar desapercibida hasta la adolescencia o el inicio de la vida adulta y se debería sospechar ante individuos 46,XY con genitales ambiguos o 46,XX con retraso puberal que asocia hipertensión y/o hipopotasemia


P450c17 enzyme catalyses two different reactions: the 17Alpha-hydroxylation of progesterone and pregnenolone, and segmenting the carbon 17-20 binding from the 17,20 lyase producing adrenal androgens. This enzyme is coded by the CYP17A1 gene. The case is presented of a 14 year old patient with delayed pubertal development and a high blood pressure for height and age. 46,XX karyotype. Hormonal studies highlighted hypergonadotropic hypogonadism, adrenal insufficiency and mineralocorticoid excess. Subsequent genetic studies showed a homozygous mutation in the CYP17A1 gene (c.753+G>A), not previously described, which is responsible for the pathophysiology of 17Alpha-hydroxylase deficiency. This entity is a rare form of congenital adrenal hyperplasia. The disease often goes unnoticed until adolescence or early adult life, and should be suspected in 46,XY individuals with ambiguous genitalia or 46,XX with delayed puberty associated with hypertension and/or hypokalaemia


Assuntos
Humanos , Feminino , Criança , Hiperplasia Suprarrenal Congênita/diagnóstico , Hiperplasia Suprarrenal Congênita/genética , Hipogonadismo/complicações , Hipogonadismo/diagnóstico , Hipopotassemia/congênito , Genitália/anormalidades , Hiperplasia Suprarrenal Congênita/complicações , Hiperplasia Suprarrenal Congênita/metabolismo , Hipogonadismo/congênito , Hipogonadismo/patologia , Hipopotassemia/complicações , Genitália/crescimento & desenvolvimento
12.
Med. cután. ibero-lat.-am ; 41(1): 3-6, ene.-feb. 2013. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-113560

RESUMO

Realizamos un estudio prospectivo de 1.000 recién nacidos vistos en las primeras 72 horas de vida en el Área Sanitaria de Ferrol (noroeste de España)con el objetivo de conocer la prevalencia de la hiperpigmentación del área genital y ver como influyen, en su aparición, los factores neonatales y maternos, el momento de exploración y la modalidad de parto. La frecuencia de la hiperpigmentación genital fue del 15,3%. Encontramos una prevalencia superior en los neonatos no caucásicos (p = 0,000) de sexo masculino (p = 0,000), con mancha mongólica (p = 0,000), nacidos por vía vaginal (p =0,030) y con madre menor de 30 años (p = 0,006) y con al menos 2 gestaciones previas (p = 0,015) (AU)


We performed a prospective study of 1,000 neonates investigated in the first 72 hours of life in the Health Area of Ferrol (northwest of Spain), in order to assess the prevalence of hyperpigmentation of the genital area, the influence of different maternal and neonatal parameters, day of neonatalexploration and type of delivery. Overall frequency of hyperpigmentation was 15.3%. We found a higher prevalence of this dermatosis in non-Caucasian infants (p = 0.000) of male sex (p = 0.000), with Mongolian spot (p = 0.000), vaginal delivery (p = 0.030), maternal age below 30 years (p =0.006) and at least two previous pregnancies (p = 0.015) (AU)


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Hiperpigmentação/epidemiologia , Genitália/anormalidades , Estudos Prospectivos , Fatores de Risco , Hiperplasia Suprarrenal Congênita/epidemiologia
15.
Rev. esp. pediatr. (Ed. impr.) ; 68(3): 216-219, mayo-jun. 2012. ilus
Artigo em Espanhol | IBECS | ID: ibc-113544

RESUMO

La presencia de genitales ambiguos en un recién nacido constituye una urgencia no solo médico-quirúrgica, sino también social, que requiere la colaboración de un equipo multidisciplinario. Se trata de una patología con una amplia diversidad de formas clínicas a considerar en el diagnóstico diferencial de formas clínicas a considerar en el diagnóstico deferencial de estas afecciones, entre ellas el hermafroditismo verdadero. El hermafroditismo verdadero es un trastorno poco frecuente caracterizado por la presencia de tejido ovárico y testicular en un mismo individuo. Presentamos el caso de un recién nacido con unos genitales ambiguos aunque con cierta orientación femenina, órganos internos femeninos, cariotipo 46 XX/46 XY, presencia de ovoteste y de ovario confirmados por estudio histológico de las gónadas. Se realiza una revisión de los principales aspectos clínicos de estas afecciones (AU)


The presence of ambiguous genitalia in a newborn is not only a surgical and medical emergency, but also social. It requires the collaboration of a multidisciplinary team. This disease has a wide variety of clinical forms that have to be considered in the differential diagnosis, one of them is the true hermaphroditism. True hermaphroditism is a rare disorder characterized by the presence of ovarian and testicular tissue in the same individual. We report the case od a newborn with ambiguous genitalia with a slight female predominance, female internal organs, karyotype 46XX/46 XY and presence of ovotestis and ovary tissue confirmed by histopathological examination of the gonads. We review the major clinical aspects of these conditions (AU)


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Transtornos do Desenvolvimento Sexual/diagnóstico , Transtornos Ovotesticulares do Desenvolvimento Sexual/diagnóstico , Anormalidades Urogenitais/diagnóstico , Genitália/anormalidades , Cariótipo Anormal , Diagnóstico Diferencial
16.
Cuad. med. forense ; 16(1/2): 99-108, ene.-jun. 2010. ilus
Artigo em Espanhol | IBECS | ID: ibc-94653

RESUMO

El diagnóstico de abuso sexual de niñas y niños casi siempre es un difícil desafío para el médico forense. En la mayoría de los casos el agresor es un familiar o una persona muy allegada y, en las edades más tempranas, casi nunca existe penetración anal o vaginal. Estas características determinan que los hallazgos periciales difieran complemente de los que se encuentran en las víctimas adultas de agresiones sexuales. Es necesario conocer la sensibilidad y especificidad de los hallazgos capaces de asociarse con abuso sexual, y la manera de evitar pasar por alto los casos reales o formular diagnósticos erróneos, ya que ambas situaciones generan un considerable daño a las niñas, niños y sus familias. Especialmente se debe relativizar la importancia de un examen genital y anal negativo, a la vez que se debe ser prudente al atribuir al abuso sexual los hallazgos anormales genitales o anales. Se jerarquiza el valor de la entrevista a la presunta víctima y la necesidad de que se lleve a cabo bajo estándares mínimos. En esta puesta al día se discute el valor diagnóstico de los signos y síntomas atribuibles a abuso sexual y se concluye con la formulación de diez reglas de aplicación general para el trabajo médico-legal en la materia (AU)


Diagnosing child sexual abuse is usually a hard challenge for Forensic Doctors. In most cases, the sex offender is a relative or somebody who is really close to the victim, and at early ages there is seldom any anal or vaginal intercourse. As a result, findings in these cases are completely different from the once found in adult victims who suffered from sexual attacks. We need to learn about the sensitivity and specificity of findings that may be associated with child sexual abuse, in order to avoid ignoring real cases or perform mistaken diagnosis, since both situations cause significant harm to the boy, the girl and their families. We specially need to understand the low importance of a negative anal/genital exam and, at the same time, consider we face a case of abuse whenever abnormal anal or genital findings are present. We emphasize on the value of interviewing the alleged victim, and the need for it to be carried out according to minimum standards. The present article comprises the diagnostic value of child sexual abuse signs and symptoms and as a conclusion suggests ten rules to be generally applied in medico-legal work in the field (AU)


Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Criança , Ciências Forenses/métodos , Abuso Sexual na Infância/diagnóstico , Entrevista Psicológica , Diagnóstico Diferencial , Exame Físico/métodos , Genitália/lesões , Sensibilidade e Especificidade , Infecções Sexualmente Transmissíveis/diagnóstico
17.
Pediatr. aten. prim ; 12(46): 273-285, abr.-jun.2010.
Artigo em Espanhol | IBECS | ID: ibc-80898

RESUMO

La experiencia de abuso sexual conlleva importantes repercusiones en el bienestar físico y psicológico de la víctima. Se hace necesario conocer qué efectos puede tener esta experiencia sobre la salud, tanto para su posible detección temprana como para un tratamiento efectivo. Determinadas lesiones genitales y anales, la presencia de esperma, infecciones y enfermedades de transmisión sexual (gonococia, condilomas acuminados, sífilis) antes de la pubertad, así como el embarazo, pueden ser importantes indicadores de abuso sexual, si bien en la mayor parte de casos los hallazgos físicos son nulos en estas víctimas, dificultando la detección de estos casos. En la edad adulta, los dolores físicos, el trastorno de conversión, las crisis no epilépticas, el trastorno de somatización, trastornos ginecológicos, así como un inicio significativamente temprano de la menopausia, son algunos de los problemas físicos más frecuentemente presentes. Conclusiones: conocer los indicadores y consecuencias del abuso sexual para identificarlos y detectarlos tan pronto como sea posible se plantea como una necesidad de la que los profesionales del ámbito sanitario debemos ser conscientes para poder intervenir tempranamente y de forma efectiva en estos casos (AU)


Introduction: Child sexual abuse experience is usually followed by serious physical and psychological consequences. It is necessary to know the possible effects of this problem on the victim’s health to detect early these situations and to conduct effective treatments. Exposition: important physical indicators of child sexual abuse would include: genital and anal injuries, sperm, infections and sexually transmitted diseases (gonococci, condiloms, or genital warts, and syphilis) before puberty, and pregnancy. However, a great number of the cases do not present physical evidence, making difficult to detect. In adult victims, physical pain, conversion disorder, non-epileptic seizures, somatization, gynecological disorders, and early menopause, are some of the most frequent physical problems. Conclusions: health professionals must know the indicators and consequences of child sexual abuse to identify these cases as soon as possible and to early and effectively intervene onits serious consequences (AU)


Assuntos
Humanos , Masculino , Feminino , Criança , Abuso Sexual na Infância/diagnóstico , Abuso Sexual na Infância/prevenção & controle , Abuso Sexual na Infância/psicologia , Gastroenteropatias/complicações , Sífilis Cutânea/complicações , Sífilis/complicações , Condiloma Acuminado/complicações , Abuso Sexual na Infância/legislação & jurisprudência , Abuso Sexual na Infância/estatística & dados numéricos , Impactos da Poluição na Saúde/prevenção & controle , Genitália/lesões , Genitália/patologia , Coito/psicologia
18.
Emergencias (St. Vicenç dels Horts) ; 21(2): 114-116, abr. 2009. tab
Artigo em Espanhol | IBECS | ID: ibc-59929

RESUMO

Objetivos: Establecer la frecuencia con la que aparece prurito genital tras administrar hidrocortisona iv y los factores que determinan su aparición. Método: Estudio observacional, prospectivo de pacientes que recibieron hidrocortisona fosfato sódico i.v en el servicio de urgencias del Hospital La Paz entre diciembre de 2007 y mayo de 2008. Se rellenó un protocolo donde se incluyeron las variables: edad, sexo, dosis, forma de administración, aparición de prurito e intensidad del mismo y fármacos concomitantes. Resultados: Se incluyeron 54 pacientes de los cuales 39 eran varones (72,2%). La edad media fue de 56,9 años. Las dosis administradas fueron 200 mg en 30 pacientes (55,6%)y 100 mg en el resto. Presentaron prurito en el área anogenital 26 enfermos (48,1%),que osciló entre 5 y 45 segundos y que cedió espontáneamente. Se encontraron diferencias significativas en relación con la edad (los pacientes con prurito tenían menor edad media) y con la forma de perfusión; de tal forma que cuanto más concentrado y más rápido(en bolo) se administre, mayor es la probabilidad de presentar prurito. Conclusiones: La aparición de prurito tras la administración de hidrocortisona fosfato sódico intravenosa es un hecho frecuente y pasajero que aparece especialmente en personas jóvenes y cuando se administra en bolo. La administración de este fármaco diluido en 50 ml de suero, cuando sea posible, puede evitar la aparición de este efecto secundario (AU)


Objectives: To determine the frequency of genital pruritus after intravenous administration of hydrocortisone and the associated risk factors. Methods: Observational, prospective study of patients who received intravenous hydrocortisone sodium phosphate in the emergency department of La Paz Hospital between December 2007 and May 2008. The variables studied included age, sex, dose, form of administration, onset of pruritus, the severity of itching, and concomitant medication. Results: We included 54 patients, of whom 39 were males (72.5%). The mean age was 56.9 years. The dose administered was 200 mg in 30 patients (55.6%) and 100 mg in the remainder. In total, 26 patients developed anogenital pruritus(48.1%). Itching lasted between 5 and 45 seconds and resolved spontaneously. Significant differences were observed with respect to age (the mean age of the patients with pruritus was lower) and the infusion method used (the higher the concentration used and the faster the drug was administered, the greater the probability of pruritus).Conclusions: Transient pruritus following administration of intravenous hydrocortisone sodium phosphate is a commonside effect that affects younger people and is associated with bolus administration. Dilution of the drug in 50 mL of saline solution, whenever possible, can prevent the appearance of this side effect (AU)


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Prurido/induzido quimicamente , Hidrocortisona/efeitos adversos , Genitália , Estudos Prospectivos
19.
Cuad. med. forense ; 15(55): 17-35, ene. 2009. tab
Artigo em Espanhol | IBECS | ID: ibc-61634

RESUMO

Los delitos contra la libertad e indemnidad sexualessiguen siendo un campo de extraordinaria importancia enla práctica diaria médico forense. En esta revisión se presentacuál es el estado actual del problema, se apuntauna posible estrategia para mejorar su estudio y se exponela literatura científica más reciente respecto a las distintasvariedades con que se presentan(AU)


Sexual crimes remain an area of paramountimportance in daily forensic practice. This review carriesout what is the current state of the problem, it suggests apossible strategy for improving their study and presents thelatest scientific literature regarding the different types fromwhich they are presented(AU)


Assuntos
Humanos , Delitos Sexuais/tendências , Ciências Forenses/tendências , Abuso Sexual na Infância , Assédio Sexual , Delitos Sexuais , Estupro , Liberdade , Fatores Etários , Genitália/lesões , Exame Físico/métodos
20.
Arch. esp. urol. (Ed. impr.) ; 60(8): 873-886, oct. 2007. ilus
Artigo em Es | IBECS | ID: ibc-056373

RESUMO

OBJETIVO: Dar a conocer, de un modo exhaustivo, un episodio casi inédito en la vida del Doctor Francisco Díaz (1527-1590), cirujano del rey Felipe II, y autor del Primer Tratado de Urología en la historia de la Medicina. Que sepamos hasta la fecha existían pocas noticias de la actuación que, como experto, tuvo que realizar Díaz en el proceso inquisitorial contra Elena/o de Céspedes, un presunto hermafrodita acusado por el Santo Oficio que siendo mujer y haciéndose pasar por hombre, se había casado con otra. El juicio tuvo lugar en Toledo en 1587 y alcanzó gran resonancia en su época, ya que la encausada, vestida con indumentaria masculina y usurpando las prerrogativas del varón, había conseguido fraudulentamente títulos y prebendas vedadas a la mujer, entre ellos la titulación de cirujana. Salvo las referencias de Folch Jou y Burshatin, ambas escuetas e incompletas, ningún autor ni biógrafo del celebre cirujano, había hecho cita de este pasaje de su vida que a nuestro juicio debió suponer para el urólogo un gran quebranto de su reputación. MÉTODOS: Se han revisado los trabajos de los dos autores antes citados, todas las obras y biografías del Dr. Francisco Díaz a nuestro alcance y microfilmado y transcrito en su totalidad el legajo 234, expediente 24, de la Sección Inquisición del Archivo Histórico Nacional de Madrid, correspondiente a Elena de Céspedes (alias Eleno de) (> de 500 folios) para extraer el mayor número de datos acerca de la acusada y sobre la actuación en el proceso del Dr. Francisco Díaz. RESULTADO Y CONCLUSIONES: La exploración como especialista en órganos génito-urinarios había sido solicitada a Francisco Díaz por el Vicario de Madrid para conceder o no una licencia de matrimonio a dicha mujer que afirmaba ser varón. En su informe de 1586 el urólogo declaró, sorprendentemente, que el peticionario era hombre. Como se demostraría durante el juicio la encausada, que en su defensa alegaba ser hermafrodita, había logrado engañar al experto con sus «malas artes» alterando su morfología genital. Gracias a sus conocimientos en cirugía se había automutilado obturando quirúrgicamente su vagina y colocado un «artificio» para simular que era varón. Al final, tras la opinión de los contraexpertos del Santo Oficio, Francisco Díaz tendría que retractarse, confirmar que era mujer y acusar a la reo de hechicería para salvar su responsabilidad. En el trabajo, sin embargo, concluimos que la acusada era un transexual masculino lo que, en parte, disculparía el error del urólogo 400 años después (AU)


OBJECTIVES: To make known, comprehensively, an almost unknown episode in the life of Dr. Francisco Diaz (1527-1590), surgeon of the king Philip II, and author of the first urology treaty in the history of medicine. To our knowledge, to date there were few references about the participation that, as an expert, Francisco Diaz had to have in the inquisitorial process against Elena de Cespedes, a presumed hermaphrodite accused by the Inquisition because being a woman married another one pretending to be a man. The trial was carried out in Toledo in 1587 and had great impact in that time, because the accused, dressing with male clothes and usurping the prerogatives of a man, had gotten by fraud titles and favours which were forbidden for women, the title of surgeon among them. Except for the reference by Folch Jou and Burshatin, both short and incomplete, no other author or biographer of the famous surgeon had cited this episode of his life, which to our judgment could mean a great damage to his reputation. METHODS: We reviewed the works by the two a fore mentioned authors, all the works and biographies about Dr. Francisco Diaz that we could found, and microfilmed and transcript the whole bundle 234, expedient 24, from the section Inquisition at the National Historical Archive in Madrid, corresponding to Elena de Cespedes (alias Eleno) (> 500 pages) to obtain the greatest amount of data about the accused and the performance of Dr. Francisco Diaz. RESULTS AND CONCLUSIONS: Francisco Diaz was requested, as an expert, by the Vicar of Madrid to perform the examination of the genitourinary organs to give or not marriage license to that woman saying she was a man. In his report in the year 1586, surprisingly the urologist declared that the petitioner was a man. As it would be demonstrated during the trial, the accused, who alleged being hermaphrodite in her defense, had been able to deceive the expert with her tricks alteringher genital morphology. Thanks to her surgical knowledge she had mutilated herself surgically closing her vagina and placed a device to simulate she was a male. At the end, after the opinion of the counter experts of the Inquisition Francisco Diaz had to retract, confirmed that the accused was a female, and accused her of witchcraft to save his responsibility. Nevertheless, in the work we conclude that the accused was a male transsexual, which, in part, would excuse the urologist's error 400 years later (AU)


Assuntos
História do Século XVI , Médicos/história , Transexualidade/história , Urologia/história , Doenças Urológicas/história , Julgamento/ética , Doenças dos Genitais Femininos/história , Análise para Determinação do Sexo/história , Médicos/legislação & jurisprudência , Sistema Urogenital/anatomia & histologia , Sistema Urogenital/fisiopatologia , Esfíncter Urinário Artificial/história , Genitália/anormalidades
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