RESUMO
Myiasis occurs mainly on exposed skin-typically on the face, scalp, arms or legs. What may be the first recorded case of umbilical myiasis in a healthy adult is herein presented. The underlying entomology is briefly discussed to explain the clinical presentation.
Assuntos
Miíase , Umbigo , Adulto , Animais , Humanos , MasculinoAssuntos
Fraturas por Compressão/diagnóstico por imagem , Fraturas do Quadril/diagnóstico por imagem , Vértebras Lombares/lesões , Região Sacrococcígea/lesões , Fraturas da Coluna Vertebral/diagnóstico por imagem , Bexiga Urinaria Neurogênica/etiologia , Ferimentos não Penetrantes/diagnóstico por imagem , Acidentes de Trânsito , Adulto , Cateteres de Demora , Feminino , Seguimentos , Fraturas por Compressão/complicações , Hemoperitônio/diagnóstico , Hemoperitônio/etiologia , Fraturas do Quadril/complicações , Humanos , Vértebras Lombares/diagnóstico por imagem , Traumatismo Múltiplo , Radiografia Abdominal , Fraturas da Coluna Vertebral/complicações , Tomografia Computadorizada por Raios X , Bexiga Urinaria Neurogênica/fisiopatologia , Bexiga Urinaria Neurogênica/terapia , Urodinâmica , Ferimentos não Penetrantes/complicaçõesRESUMO
BACKGROUND: Mouse islets transplanted under the renal subcapsular space of cynomolgus monkeys are subject to a form of hyperacute rejection, the mechanism of which is unclear. As islets are in contact with whole blood at the time of transplantation, the effect of platelets and the coagulation cascade on islet destruction was assessed. METHODS: Coagulation was assessed using thromboelastography on citrated/recalcified human blood samples with freshly isolated C57/Bl6 mouse islets. A dynamic islet perifusion system was used to assess the effect of islets on blood cells and coagulation factors. Cytotoxicity was evaluated using (51)Cr labelled islets incubated with human blood and islet destruction was also evaluated using a histological grading system. Continuous PO(2) measurements were made in a static incubation system to assess the role of hypoxia in islet destruction. RESULTS: Mouse islets incubated in human blood induced accelerated coagulation and rapid consumption of platelets within 15 min. Within 1 h of incubation, 52% of mouse islets exposed to xenogeneic human blood showed features of severe damage with necrosis when compared with islets incubated in syngeneic blood. Specific lysis of the xenogeneic islets was demonstrable (Mean percentage lysis: 48%, P < 0.05 vs. control) after 4 h incubation in human blood. Oxygen levels remained constant at a level adequate to maintain islet viability in separate experiments. CONCLUSION: Mouse islets induce rapid activation of the clotting cascade and platelet consumption in vitro when exposed to human blood, which correlated with histological evidence of significant destruction demonstrable within 1 h of exposure to human or non-human primate blood. This in vitro model has features which appear to correlate with the islet destruction seen in vivo and could be a useful model for the study of the mechanisms underlying the rapid destruction of xenogeneic islets in primate recipients.