RESUMO
The mechanisms of action (MA) of electroconvulsive therapy (ECT) in affective disorders are poorly understood. We synthesized and discussed the evidence provided by primary studies and systematic reviews in humans. There are differences in the methylation of candidate genes involved in the response to ECT. Functioning of the hippocampal serotonin receptor 5-HT1B is associated with the response in patients with major depressive disorder (PMDD), while the striatal dopamine transporter would participate in the response of PMDD and in patients with bipolar disorders (BD). The only neurotrophic factor associated with ECT response was vascular endothelial growth factor. In BD, some oxidative stress metabolites had a clinical correlation, while tryptophan metabolism showed a clinical association in BD and PMDD. Furthermore, in PMDD, some neurodegeneration markers were implicated in the MA of ECT. There were no other biological dimensions associated with BD. In PMDD, multiple inflammatory mediators were associated with the clinical response (natural killer cells, tumor necrosis and growth factors, and interleukins 1, 4, 6, 10,1ß). Likewise, some structures and circuits consistently involved at the morphological and functional level are the default mode network, cognitive control networks, frontal, temporal, cingulate, occipital and temporal cortices, frontal, temporal, precentral, fusiform and left angular gyri, hippocampus, thalamus and amygdala. Investigations are mostly focused on PMDD, are observational, and their samples limited, but they show relatively consistent results with clinical significance.
Assuntos
Transtorno Bipolar , Transtorno Depressivo Maior , Eletroconvulsoterapia , Humanos , Transtorno Depressivo Maior/terapia , Fator A de Crescimento do Endotélio Vascular , Eletroconvulsoterapia/métodos , Transtorno Bipolar/terapia , Imageamento por Ressonância MagnéticaRESUMO
Electroconvulsive therapy (ECT) has multiple uses in psychiatry, but its mechanisms of action (MA) in patients with schizophrenia (PS) are poorly understood. We synthesize and discuss the available evidence in this regard. We conducted a search for primary human studies and systematic reviews searching MA of ECT in PS published in PubMed/Medline, SciELO, PsycInfo, and the Cochrane Library, including 24 articles. Genetic findings are scarce and inconsistent. At the molecular level, the dopaminergic and GABAergic role stands out. The increase in brain derived neurotrophic factor (BDNF) after ECT, is a predictor of positive clinical outcomes, while the change in N-acetyl aspartate levels would demonstrate a neuroprotective role for ECT. This intervention would improve inflammatory and oxidative parameters, thereby resulting in a symptomatic improvement. ECT is associated with an increase in functional connectivity in the thalamus, right putamen, prefrontal cortex and left precuneus, structures that play a role in the neural default mode network. A decrease in connectivity between the thalamus and the sensory cortex and an enhanced functional connectivity of the right thalamus to right putamen along with a clinical improvement have been reported after ECT. Moreover a volumetric increase in hippocampus and insula has been reported after ECT. These changes could be associated with the biochemical pathophysiology of schizophrenia. Most of the included studies are observational or quasi-experimental, with small sample sizes. However, they show simultaneous changes at different neurobiological levels, with a pathophysiological and clinical correlation. We propose that the research on ECT should be carried out from neurobiological dimensions, but with a clinical perspective.
Assuntos
Eletroconvulsoterapia , Esquizofrenia , Humanos , Eletroconvulsoterapia/métodos , Esquizofrenia/tratamento farmacológico , Imageamento por Ressonância Magnética , Córtex Pré-FrontalRESUMO
Tuberous sclerosis complex (TSC) disease results from inactivation of the TSC1 or TSC2 gene, and is characterized by benign tumors in several organs. Because TSC tumorigenesis correlates with hyperactivation of mTORC1, current therapies focus on mTORC1 inhibition with rapamycin or its analogs. Rapamycin-induced tumor shrinkage has been reported, but tumor recurrence occurs on withdrawal from rapamycin. Autophagy has been associated with development of TSC tumors and with tumor cell survival during rapamycin treatment. mTORC1 and AMPK directly inhibit and activate autophagy, respectively. AMPK is hyperactivated in TSC cells and tumors, and drives cytoplasmic sequestration of the cell-cycle inhibitor p27KIP (p27). Whether AMPK and p27 are involved in rapamycin-induced autophagy and survival of TSC cells remain unexplored. Here, we show that inhibition of AMPK by compound C or by shRNA-mediated depletion of LKB1 reduces activation of autophagy by rapamycin in Tsc2-null cells. Similarly, shRNA-mediated depletion of p27 inhibited rapamycin-induced autophagy. In support of p27 lying downstream of AMPK on the activation of autophagy in Tsc2-null cells, a p27 mutant that preferentially localizes in the cytosol recovered the effect of rapamycin on autophagy in both p27- and LKB1-depleted cells, but a nuclear p27 mutant was inactive. Finally, we show that p27-dependent activation of autophagy is involved in Tsc2-null cell survival under rapamycin treatment. These results indicate that an AMPK/p27 axis is promoting a survival mechanism that could explain in part the relapse of TSC tumors treated with rapamycin, exposing new avenues for designing more efficient treatments for TSC patients.
Assuntos
Proteínas Quinases Ativadas por AMP/metabolismo , Autofagia/efeitos dos fármacos , Inibidor de Quinase Dependente de Ciclina p27/metabolismo , Fibroblastos/efeitos dos fármacos , Sirolimo/farmacologia , Proteínas Supressoras de Tumor/deficiência , Animais , Antibióticos Antineoplásicos/farmacologia , Autofagia/genética , Sobrevivência Celular/efeitos dos fármacos , Sobrevivência Celular/genética , Células Cultivadas , Inibidor de Quinase Dependente de Ciclina p27/genética , Embrião de Mamíferos/citologia , Fibroblastos/citologia , Fibroblastos/metabolismo , Immunoblotting , Camundongos Knockout , Microscopia Confocal , Microscopia de Fluorescência , Interferência de RNA , Proteína 2 do Complexo Esclerose Tuberosa , Proteínas Supressoras de Tumor/genéticaRESUMO
Global changes have increased the risk of emerging infectious diseases, which can be prevented or mitigated by studying host-parasite interactions, among other measures. Bats and their ectoparasitic flies of the families Streblidae and Nycteribiidae are an excellent study model but, so far, our knowledge has been restricted to fragmented records at a local scale. To help boost research, we assembled a data set of bat-fly interactions from 174 studies published between 1904 and 2022 plus three original data sets. Altogether, these studies were carried out at 650 sites in the Neotropics, mainly distributed in Mexico, Brazil, Argentina, southern USA, and Colombia, among other countries. In total, our data set contains 3984 interaction records between 237 bat species and 255 fly species. The bat species with the largest number of recorded interactions were Carollia perspicillata (357), Artibeus jamaicensis (263), and Artibeus lituratus (228). The fly species with the largest number of recorded interactions were Trichobius joblingi (256), Megistopoda aranea (235), and Megistopoda proxima (215). The interaction data were extracted, filtered, taxonomically harmonized, and made available in a tidy format together with linked data on bat population, fly population, study reference, sampling methods and geographic information from the study sites. This interconnected structure enables the expansion of information for each interaction record, encompassing where and how each interaction occurred, as well as the number of bats and flies involved. We expect BatFly to open new avenues for research focused on different levels of ecological organization and spatial scales. It will help consolidate knowledge about ecological specialization, resource distribution, pathogen transmission, and the drivers of parasite prevalence over a broad spatial range. It may also help to answer key questions such as: Are there differences in fly prevalence or mean infestation across Neotropical ecoregions? What ecological drivers explain those differences? How do specialization patterns vary among fly species in the Neotropics? Furthermore, we expect BatFly to inspire research aimed at understanding how climate and land-use changes may impact host-parasite interactions and disease outbreaks. This kind of research may help us reach Sustainable Development Goal 3, Good Health and Wellbeing, outlined by the United Nations. The data are released under a Creative Commons Attribution 4.0 International License.
Assuntos
Quirópteros , Dípteros , Parasitos , Animais , Brasil/epidemiologia , Interações Hospedeiro-ParasitaRESUMO
Rheb is a small GTPase member of the Ras superfamily and an activator of mTORC1, a protein complex master regulator of cell metabolism, growth, and proliferation. Rheb/mTORC1 pathway is hyperactivated in proliferative diseases, such as Tuberous Sclerosis Complex syndrome and cancer. Therefore, targeting Rheb-dependent signaling is a rational strategy for developing new drug therapies. Rheb activates mTORC1 in the cytosolic surface of lysosomal membranes. Rheb's farnesylation allows its anchorage on membranes, while its proper localization depends on the prenyl-binding chaperone PDEδ. Recently, the use of PDEδ inhibitors has been proposed as anticancer agents because they interrupted KRas signaling leading to antiproliferative effects in KRas-dependent pancreatic cancer cells. However, the effect of PDEδ inhibition on the Rheb/mTORC1 pathway has been poorly investigated. Here, we evaluated the impact of a new PDEδ inhibitor, called Deltasonamide 1, in Tsc2-null MEFs, a Rheb-dependent overactivated mTORC1 cell line. By using a yeast two-hybrid assay, we first validated that Deltasonamide 1 disrupts Rheb-PDEδ interaction. Accordingly, we found that Deltasonamide 1 reduces mTORC1 targets activation. In addition, our results showed that Deltasonamide 1 has antiproliferative and cytotoxic effects on Tsc2-null MEFs but has less effect on Tsc2-wild type MEFs viability. This work proposes the pharmacological PDEδ inhibition as a new approach to target the abnormal Rheb/mTORC1 activation in Tuberous Sclerosis Complex cells.
RESUMO
Health systems provides care only to those people who spontaneous demand for attention; excluding those who dont perceive illness or are not aware enough to consult. Alternative healthcare models based on the nominal-personalized care like "University Center for Integrated Care of Referred Health Care" (CUIDARAS) may have better results. In order to demonstrate benefits of this model, it was performed an experience based in colorectal cancer (CRC) detection and care that focused the entire population of the town. METHODS: It is an intervention study for early detection of CRC. A survey and a physical examination were performed in each adult from "CH" town. Two visits were made. Blood in stool test (BIST) was self-collected, analyzed and results delivered with appointment for a programmed video-colonoscopy (VCC) when test was positive. RESULTS: people enrolled (n546) had 59.9+/-6.4 yrs. Adherence was 93.8% of the target population; 99.2% performed BIST; while 95.3% a positive BIST had access to VCC and treatment. Overall cost of the experience (stool test, VCC, biopsy, local treatment) was 7685 USD, while costs associated to an advanced CRC classic treatment was USD 9577/patient (USD 26098 if treatment included bevacizumab). CONCLUSION: The present study based on preventive actions like blood in stool test, applied as a screening to all inhabitants in town, had 93.8% of adherence and high level of CRC early detection. A health model based on personalized care (CUIDARAS), achieved more effective results in terms health care and disease prevention, with a favorable benefit/cost ratio compared with classical health care provide by current system. Key words: Model of care; colorectal cancer; CUIDARAS; personalized care.
Assuntos
Neoplasias Colorretais , Detecção Precoce de Câncer , Adulto , Colonoscopia , Neoplasias Colorretais/diagnóstico , Atenção à Saúde , Humanos , Sangue OcultoRESUMO
Through qualitative data collected with women affected by drug use and drug-related violence in Bogotá, this article explores the convergence of harm reduction rationales and violence prevention programming in the urban margins to advocate for women's health empowerment and health rights as victims of intergenerational trauma and violence. We propose a methodological shift of public health praxis from street-based outreach models to intimate spaces of intervention for health outcomes embodiment 1 as we continue to develop our community health model to work with marginalised communities in the urban global South. Through this work committed to social justice in marginalised urban communities, we seek to support women's health needs through harm reduction in historically marginalised communities in urban settings. Our results expose how multi-level gender-based violence affects women's health in their living spaces in the urban margins. Drawing from women's voices and narratives of urban violence, we call for a feminist alternative to traditionally masculinist and public-space oriented harm reduction practice for health empowerment in the urban margins.
Assuntos
Redução do Dano , População Urbana , Violência , Feminino , Humanos , Violência/prevenção & controleRESUMO
The mechanisms of action (MA) of electroconvulsive therapy (ECT) in affective disorders are poorly understood. We synthesized and discussed the evidence provided by primary studies and systematic reviews in humans. There are differences in the methylation of candidate genes involved in the response to ECT. Functioning of the hippocampal serotonin receptor 5-HT1B is associated with the response in patients with major depressive disorder (PMDD), while the striatal dopamine transporter would participate in the response of PMDD and in patients with bipolar disorders (BD). The only neurotrophic factor associated with ECT response was vascular endothelial growth factor. In BD, some oxidative stress metabolites had a clinical correlation, while tryptophan metabolism showed a clinical association in BD and PMDD. Furthermore, in PMDD, some neurodegeneration markers were implicated in the MA of ECT. There were no other biological dimensions associated with BD. In PMDD, multiple inflammatory mediators were associated with the clinical response (natural killer cells, tumor necrosis and growth factors, and interleukins 1, 4, 6, 10,1β). Likewise, some structures and circuits consistently involved at the morphological and functional level are the default mode network, cognitive control networks, frontal, temporal, cingulate, occipital and temporal cortices, frontal, temporal, precentral, fusiform and left angular gyri, hippocampus, thalamus and amygdala. Investigations are mostly focused on PMDD, are observational, and their samples limited, but they show relatively consistent results with clinical significance.
RESUMO
BACKGROUND: Childhood obesity is an important health problem worldwide. In this context, there is a need for the development and evaluation of innovative educational interventions targeting prevention and formation of health habits. OBJECTIVES: To ascertain the impact of ludic workshops on children's knowledge, self-care, and body weight. METHODS: This was a randomized, clinical study with 79 students aged 7-11 years, conducted from March to November 2012. Anthropometric measurements were collected and two questionnaires (Typical Day of Physical Activities and Food Intake, in Portuguese, and the CARDIOKIDS, a questionnaire of knowledge about cardiovascular risk factors) were applied at baseline, at the end of intervention, and three months thereafter. The intervention consisted of eight playful workshops, which involved the presentation of a play. RESULTS: Seventy-nine students were randomized to the intervention (n = 40) or the control group (n = 39). Mean age was 10.0 ± 1.1 years. After eight weeks, the intervention group showed significant improvement in the knowledge score (p < 0.001). There was an increase in physical activity scores in both groups, but with no difference between the groups at the end of intervention (p = 0.209). A reduction in the BMI percentile was observed in the intervention group, but there was no significant statistical difference between the two groups after the intervention. CONCLUSIONS: Playful interventions may improve knowledge and physical activity levels in children and, when combined with other strategies, may be beneficial to prevent child obesity and improve self-care.
Assuntos
Doenças Cardiovasculares/prevenção & controle , Comportamento Alimentar , Comportamentos Relacionados com a Saúde , Educação em Saúde/métodos , Promoção da Saúde/métodos , Obesidade/prevenção & controle , Índice de Massa Corporal , Estudos de Casos e Controles , Criança , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Fatores de Risco , Fatores SocioeconômicosRESUMO
Electroconvulsive therapy (ECT) has multiple uses in psychiatry, but its mechanisms of action (MA) in patients with schizophrenia (PS) are poorly understood. We synthesize and discuss the available evidence in this regard. We conducted a search for primary human studies and systematic reviews searching MA of ECT in PS published in PubMed/Medline, SciELO, PsycInfo, and the Cochrane Library, including 24 articles. Genetic findings are scarce and inconsistent. At the molecular level, the dopaminergic and GABAergic role stands out. The increase in brain derived neurotrophic factor (BDNF) after ECT, is a predictor of positive clinical outcomes, while the change in N-acetyl aspartate levels would demonstrate a neuroprotective role for ECT. This intervention would improve inflammatory and oxidative parameters, thereby resulting in a symptomatic improvement. ECT is associated with an increase in functional connectivity in the thalamus, right putamen, prefrontal cortex and left precuneus, structures that play a role in the neural default mode network. A decrease in connectivity between the thalamus and the sensory cortex and an enhanced functional connectivity of the right thalamus to right putamen along with a clinical improvement have been reported after ECT. Moreover a volumetric increase in hippocampus and insula has been reported after ECT. These changes could be associated with the biochemical pathophysiology of schizophrenia. Most of the included studies are observational or quasi-experimental, with small sample sizes. However, they show simultaneous changes at different neurobiological levels, with a pathophysiological and clinical correlation. We propose that the research on ECT should be carried out from neurobiological dimensions, but with a clinical perspective.
Assuntos
Humanos , Esquizofrenia/tratamento farmacológico , Eletroconvulsoterapia/métodos , Imageamento por Ressonância Magnética , Córtex Pré-FrontalRESUMO
Resumen Paciente masculino de 40 años, consulta por dolor en región glútea izquierda, asociado a masa de crecimiento progresivo; inicialmente valorado por ortopedia, donde le realizan radiografía y gammagrafía sin diagnóstico definitivo; revalorado por ortopedia y traumatología, luego de resonancia magnética y biopsia del glúteo comprometido se diagnostica fibromatosis glútea, la cual fue tratada con una resección del tejido invasivo y posteriormente radioterapia complementaria con acelerador lineal. Conclusión: Los tumores desmoides son infrecuentes y representan 0,03 % de todas las neoplasias y < 3 % de todos los tumores de tejidos; la cirugía ha sido tradicionalmente el pilar terapéutico debido a la variabilidad en el curso clínico y la importancia del sitio involucrado se asocia al tratamiento y aplicación de radioterapia.
Abstract 40 year old male patient complains about pain in left gluteal region, associated with progressive growing mass; initially valued by orthopedics, which performed x-ray scan and gammagraphy without a definitive diagnosis. He was reassessed by orthopedics and traumatology, through magnetic resonance imaging and biopsy of the committed gluteal, and was diagnosed with gluteal fibromatosis, which was treated with invasive tissue resection and subsequently additional accelerator radiotherapy. Conclusions: Desmoid tumors are rare and account for 0.03 % of all malignancies and <3 % of all tumors of tissues. Surgery has traditionally been the therapeutic mainstay due to variability in the clinical course and importance of the site of involvement is associated with the treatment and application of radiation therapy.
RESUMO
Abstract Background: Childhood obesity is an important health problem worldwide. In this context, there is a need for the development and evaluation of innovative educational interventions targeting prevention and formation of health habits. Objectives: To ascertain the impact of ludic workshops on children's knowledge, self-care, and body weight. Methods: This was a randomized, clinical study with 79 students aged 7-11 years, conducted from March to November 2012. Anthropometric measurements were collected and two questionnaires (Typical Day of Physical Activities and Food Intake, in Portuguese, and the CARDIOKIDS, a questionnaire of knowledge about cardiovascular risk factors) were applied at baseline, at the end of intervention, and three months thereafter. The intervention consisted of eight playful workshops, which involved the presentation of a play. Results: Seventy-nine students were randomized to the intervention (n = 40) or the control group (n = 39). Mean age was 10.0 ± 1.1 years. After eight weeks, the intervention group showed significant improvement in the knowledge score (p < 0.001). There was an increase in physical activity scores in both groups, but with no difference between the groups at the end of intervention (p = 0.209). A reduction in the BMI percentile was observed in the intervention group, but there was no significant statistical difference between the two groups after the intervention. Conclusions: Playful interventions may improve knowledge and physical activity levels in children and, when combined with other strategies, may be beneficial to prevent child obesity and improve self-care.
Resumo Fundamento: A obesidade infantil é um importante problema de saúde no mundo. Nesse contexto, há uma necessidade para o desenvolvimento e a avaliação de intervenções educativas inovadoras que objetivem a prevenção e a formação de hábitos saudáveis. Objetivo: Avaliar o impacto de workshops lúdicos sobre o conhecimento, autocuidado, e peso corporal de crianças. Métodos: Esse foi um estudo clínico randomizado, com 79 estudantes com idade entre 7 e 11 anos. Medidas antropométricas foram coletadas, e dois questionários (DAFA, Dia Típico de Atividades Físicas e de Alimentação e o CARDIOKIDS, um questionário de conhecimento sobre fatores de risco cardiovasculares) foram aplicados no basal, ao final da intervenção, e três meses depois. A intervenção consistiu em oito workshops lúdicos, que incluiu a apresentação de uma peça de teatro. Resultados: Setenta e nove estudantes foram randomizados para o grupo intervenção (n = 40) ou para o grupo controle (n = 39). A idade média foi 10 ± 1,1 anos. Após oito semanas, o grupo intervenção mostrou uma melhora significativa no escore de conhecimento (p < 0,01). Houve um aumento nos escores de atividade física em ambos os grupos, mas sem diferença entre os grupos no final da intervenção (p=0,209). Observou-se uma redução no percentil do IMC no grupo intervenção, mas não houve diferença estatística entre os grupos após a intervenção. Conclusões: Intervenções lúdicas podem melhorar o conhecimento e níveis de atividade física em crianças e, quando combinadas com outras estratégias, podem ser benéficas na prevenção da obesidade e melhoria do autocuidado.
Assuntos
Humanos , Masculino , Feminino , Criança , Doenças Cardiovasculares/prevenção & controle , Comportamentos Relacionados com a Saúde , Educação em Saúde/métodos , Comportamento Alimentar , Promoção da Saúde/métodos , Obesidade/prevenção & controle , Fatores Socioeconômicos , Índice de Massa Corporal , Estudos de Casos e Controles , Conhecimentos, Atitudes e Prática em Saúde , Fatores de RiscoRESUMO
A insatisfação com a imagem corporal pode ser um agravante no desenvolvimento de distúrbios psíquicos e físicos. O objetivo deste estudo é avaliar a frequência de insatisfação corporal e distorção da imagem corporal em crianças de baixa renda e descrever diferenças quanto ao gênero e estado nutricional. Métodos: Foram estudados todos os 79 indivíduos de 7 a 11 anos de uma instituição filantrópica que atende crianças de famílias de baixa renda cujos pais concordaram na inclusão dos filhos no estudo. A insatisfação corporal foi avaliada comparando a imagem desejada com a imagem percebida, de acordo com escala de silhuetas de Tiggemann e Wilson-Barret, enquanto a distorção foi avaliada pela diferença entre a imagem percebida e o estado nutricional avaliado de acordo com os critérios da Organização Mundial da Saúde. Resultados: Verificou-se que 37,5% das crianças estavam acima do peso. A insatisfação corporal atingiu 75,6% dos meninos e 76,2% das meninas, sendo que 45,9% dos meninos e 52,4% das meninas desejavam ser mais magros. Nas crianças eutróficas, o percentual de insatisfação foi de 66%, nas crianças com sobrepeso foi de 69% e nos obesos de 100% (p <0, 001). A distorção da imagem corporal foi de 12,2% nos eutróficos, 30,8% nos com sobrepeso e 42,1% nos obesos (p <0,001). Conclusão: A insatisfação com a imagem corporal e distorção da percepção em relação ao estado nutricional atual foram elevadas em nossa amostra de crianças de 7 a 11 anos, o que corrobora achados de pesquisas com adolescentes e é relevante à luz das potenciais consequências para o desenvolvimento psíquico...
Dissatisfaction with ones body image may be related to the development of physical and psychological disturbances. The objective of the study is to evaluate the frequency of body dissatisfaction and distortion in children from low-income families, describing differences in terms of gender and nutritional status. Methods: The subjects were 79 individuals aged 7-11 years, from a philanthropic institution in Porto Alegre, Brazil, which receives children from low-income families whose parents agreed with the inclusion of their children in the study. Body dissatisfaction was evaluated comparing the desired image with the perceived image, according to Tiggemann & Wilson-Barrets childrens figure rating scale. The nutritional status was categorized according to the criteria of the World Health Organization. Results: Of 37.5% of children were overweight. Body dissatisfaction affected 75.6% of boys and 76.2% of girls, with 45.9% of the boys and 52.4% of the girls wanting to be thinner. The percentage of subjects dissatisfied with their body image was 66% in normal weight children, 69% in overweight children, and 100% in obese children (p<0.001). Image distortion was observed in 12.2% of normal weight children, 30.8% of overweight children, and 42.1% in obese children (p<0.001). Conclusion: Body image dissatisfaction and distortion were elevated in children from 8 to 11 years old, which is in agreement with studies on adolescents, and may be relevant given the potential consequences on psychological development...
Assuntos
Criança , Imagem Corporal , Índice de Massa CorporalRESUMO
Se presenta trabajo retrospectivo, en 64 pacientes portadores de quiste pilonidal en los que se realizó la técnica de marsupialización. La mayoría eran mujeres (56,2 por ciento), con el promedio de edad de 22,8 años. El tiempo de evolución previo a la consulta fue de 24 meses en promedio y la sintomatología más frecuente fue el aumento de volumen (92,1 por ciento) y dolor (65,6 por ciento). No hubo morbilidad post-operatoria. El seguimiento se logró en el 87 por ciento de los pacientes. La cicatrización completa se observó como promedio a los 25 días y la recidiva ffue de 3,1 por ciento a los 12 y 20 meses. En nuestra experiencia la marsupialización en quistes pilonidales, simples o complejos, resulta ser una técnica sencilla y con buenos resultados
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Seio Pilonidal/cirurgia , Procedimentos Cirúrgicos Operatórios/métodos , Estudos Retrospectivos , Sinais e Sintomas , CicatrizaçãoRESUMO
Se presenta grupo de 45 pacientes seropositivos al virus de la inmunodeficiencia humana, portadores anorrectal, que fueron separados en dos grupos: los HIV + (42,2 por ciento) y los con SIDA clínico (57,8 por ciento). Todos fueron de sexo masculino, jóvenes (edad promedio 32,2 años), siendo los factores de riesgo más frecuentes la homosexualidad (66,6 por ciento) y bisexualidad (22,2 por ciento). En los HIV+ la lesión más frecuente fue la considerada dentro de la de tipo común (47,3 por ciento), mientras que en los pacientes con SIDA clínico fue la ocasionada por inmunosupresión (50 por ciento). La patología común más frecuente en ambos grupos fue la enfermedad hemorroidaria. La enfermedad de transmisión sexual, también en ambos grupos, más frecuente fueron los condilomas. La respuesta al tratamiento en el grupo HIV+ fue óptima y/o buena en todos los casos. En los pacientes con SIDA clínico se observó evolución regular y mala, cuestión que resultó más frecuente en los sometidos a manejo quirúrgico (60 por ciento) que en los manejo médico (10 por ciento)