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1.
Sensors (Basel) ; 21(4)2021 Feb 14.
Article in English | MEDLINE | ID: mdl-33672874

ABSTRACT

The stability of power systems is very sensitive to voltage or current variations caused by the discontinuous supply of renewable power feeders. Moreover, the impact of these anomalies varies depending on the sensitivity/resilience of customer and transmission system equipment to those deviations. From any of these points of view, an instantaneous characterization of power quality (PQ) aspects becomes an important task. For this purpose, a wavelet-based power quality indices (PQIs) are introduced in this paper. An instantaneous disturbance index (ITD(t)) and a Global Disturbance Ratio index (GDR) are defined to integrally reflect the PQ level in Power Distribution Networks (PDN) under steady-state and/or transient conditions. With only these two indices it is possible to quantify the effects of non-stationary disturbances with high resolution and precision. These PQIs offer an advantage over other similar because of the suitable choice of mother wavelet function that permits to minimize leakage errors between wavelet levels. The wavelet-based algorithms which give rise to these PQIs can be implemented in smart sensors and used for monitoring purposes in PDN. The applicability of the proposed indices is validated by using a real-time experimental platform. In this emulated power system, signals are generated and real-time data are analyzed by a specifically designed software. The effectiveness of this method of detection and identification of disturbances has been proven by comparing the proposed PQIs with classical indices. The results confirm that the proposed method efficiently extracts the characteristics of each component from the multi-event test signals and thus clearly indicates the combined effect of these events through an accurate estimation of the PQIs.

2.
Gastroenterol Hepatol ; 42(6): 351-361, 2019.
Article in English, Spanish | MEDLINE | ID: mdl-30954319

ABSTRACT

AIM: To assess the effectiveness of a telephonic interview performed by primary care professionals among non-participants in the first round of the colorectal cancer early detection programme in the basic urban health area Guineueta in Barcelona, Spain. PATIENTS AND METHODS: The Primary Healthcare Team of La Guineueta contacted people who did not respond to the invitation to the first round of the colorectal cancer early detection programme using a standardised telephone call protocol. We analysed the impact of the intervention based on participation and diagnosed disease. RESULTS: We made 3,327 phone calls to 2,343 people. After the intervention the participation rate was 54.9%, which meant an increase of 5.7% with respect to the participation in the usual protocol for the programme (49.2%). The intervention allowed 5cancers, 2high-risk neoplasms and 8low- and intermediate-risk lesions to be diagnosed. An average of 9phone calls was necessary to achieve the participation of one additional person. DISCUSSION: The telephonic intervention performed by primary care professionals has significantly increased the population participation rate and the detection of neoplasms with respect to the usual colorectal cancer early detection programme protocol.


Subject(s)
Colorectal Neoplasms/diagnosis , Early Detection of Cancer/statistics & numerical data , Primary Health Care/statistics & numerical data , Surveys and Questionnaires/statistics & numerical data , Telephone/statistics & numerical data , Aged , Algorithms , Community Participation/statistics & numerical data , Female , Humans , Male , Middle Aged , Spain
3.
Foods ; 13(3)2024 Jan 27.
Article in English | MEDLINE | ID: mdl-38338548

ABSTRACT

Microplastics (MPs) and nanoplastics (NPs) are widely spread in the environment, generating significant concern due to their potential impact on environmental health. Marine species usually ingest plastic fragments, mistaking them for food. Many toxic compounds, such as plastic additives that are not chemically bound to the plastic matrix, can be released from MPs and NPs and reach humans via the food chain. This paper highlights the development and validation of a straightforward solid-liquid extraction clean-up procedure in combination with a matrix solid-phase dispersion method using high-performance liquid chromatography coupled with mass spectrometry (HPLC-MS) detection, enabling facile, precise, and reliable identification and quantitation of a total of six bisphenols and phthalates in gilthead sea breams. Under the optimized conditions, the developed method showed good linearity (R2 > 0.993) for all target compounds. The recoveries obtained were between 70 and 92%. The relative standard deviations (RSDs) for reproducibility (inter-day) and repeatability (intra-day) were less than 9% and 10%, respectively. The limit of detection (LOD) and limit of quantification (LOQ) for the target compounds ranged from 0.11 to 0.68 µg/kg and from 0.37 to 2.28 µg/kg, respectively. A new, efficient extraction methodology for the determination of BPA, BPS, BPF, DBP, DEP, and DHEP in gilthead seabream has been optimized and validated.

4.
Rev Med Chil ; 141(8): 1072-5, 2013 Aug.
Article in Spanish | MEDLINE | ID: mdl-24448866

ABSTRACT

Kidney biopsies were performed in two women during their 21st and 24th week of pregnancy. The first patient developed an abrupt nephrotic syndrome without hypertension or kidney failure. The pathological study disclosed diffuse podocyte alterations such as those observed in focal and segmental glomerulosclerosis, which had a good response to steroidal treatment. The second patient had a progressive renal failure associated with non-nephrotic proteinuria. The biopsy disclosed a fibrillary glomerulopathy.


Subject(s)
Kidney/pathology , Nephrotic Syndrome/pathology , Pregnancy Trimester, Second , Renal Insufficiency/pathology , Adult , Biopsy, Needle , Female , Glomerulonephritis/pathology , Glomerulosclerosis, Focal Segmental/pathology , Humans , Nephrotic Syndrome/diagnosis , Pregnancy , Proteinuria/blood , Renal Insufficiency/diagnosis , Young Adult
5.
Polymers (Basel) ; 15(21)2023 Nov 03.
Article in English | MEDLINE | ID: mdl-37959993

ABSTRACT

This paper describes a new methodology for carrying out quantitative extraction of cloxacillin from drinking and river water samples using a molecularly imprinted polymer (MIP) as a selective sorbent for solid-phase extraction (MISPE). Several polymers were synthesized via thermal polymerization using cloxacillin as a template, methacrylic acid (MAA) as a functional monomer, ethyleneglycoldimethacrylate (EGDMA) as a cross-linker and different solvents as porogens. Binding characteristics of the adequate molecularly imprinted and non-imprinted (NIP) polymers were evaluated via batch adsorption assays following the Langmuir and Freundlich isotherms and Scatchard assays. The parameters related to the extraction approach were studied to select the most appropriate polymer for cloxacillin determination. Using the optimized MIP as the SPE sorbent, a simple sample treatment methodology was combined with high-performance liquid chromatography (HPLC) to analyze cloxacillin residues in drinking and river water. Under the optimum experimental conditions, the MISPE methodology was validated using spiked samples. The linearity for cloxacillin was assessed within the limits of 0.05-1.5 µg L-1 and the recovery percentage was higher than 98% (RSD < 4%). The limits of detection and limits of quantification were 0.29 and 0.37 µg L-1 and 0.8 and 0.98 µg L-1 for drinking and river water, respectively. The selectivity of MIP against other ß-lactam antibiotics with similar structures (oxacillin, cefazoline, amoxicillin and penicillin V) was studied, obtaining a good recovery higher than 85% for all except cefazoline. The proposed MISPE-HPLC methodology was successfully applied for the detection of cloxacillin in drinking water from Canal de Isabel II (Madrid) and river water from the Manzanares River (Madrid).

6.
Heliyon ; 9(6): e16646, 2023 Jun.
Article in English | MEDLINE | ID: mdl-37274723

ABSTRACT

Nowadays augmented reality, 3D Image, mixed reality and see-through applications are very attractive technologies due to their great potential. Holographic optical elements can provide interesting solutions for injection and extraction of the image in the waveguides that are part of the see-through devices. We have developed a coupled waveguide system based on slanted transmission gratings recorded in manufactured photopolymers. In this work we optimize our schedule to a commercial photopolymer for this high demanded application. We demonstrate that high diffraction efficiencies can be obtained if we optimize the recording geometry, recording intensity and recording time for this material. In addition, we study the effects of shrinkage in our holographic system. In general shrinkage is an important drawback for holographic applications, nevertheless we demonstrate how shrinkage can help these systems open new possibilities. Lastly, we show how to significantly improve the quality of the guided image.

7.
Front Oncol ; 13: 1069369, 2023.
Article in English | MEDLINE | ID: mdl-36959805

ABSTRACT

Background: Gastric adenocarcinoma (GA) has changed in recent decades. Cancer estimates are often calculated from population-based cancer registries, which lack valuable information to guide decision-making (clinical outcomes). We describe the trends in clinical practice for GA using a hospital-based cancer registry over a timespan of 15 years. Methods: A retrospective cohort study was conducted. Data were gathered from adults diagnosed and treated for GA at Fundación Valle del Lili (FVL), between 2000 and 2014, from the hospital's own cancer registry and crossed with Cali's Cancer Registry. Additional data were obtained directly from clinical records, pathology reports and the clinical laboratory. Patients younger than 18 years and those for whom limited information was available in the medical history were excluded. A survival analysis was conducted using Kaplan-Meier method. Results: A total of 500 patients met eligibility criteria. Median age was 64 years (IQR: 54-74 years), 39.8% were female, 22.2% were at an early stage, 32.2% had a locally advanced disease, and 29% a metastatic disease, 69% had intestinal subtype, 48.6% had a positive H. pylori test, 85.2% had a distal lesion, 62% underwent gastrectomy, 60.6% lymphadenectomy, and 40.6% received chemotherapy. Survival at 5 years for all cases was 39.9% (CI 95% 35.3-44.5). Survival decreased over time in all groups and was lower in age-groups <39 and 60-79 with either locally advanced or metastatic disease. Prognostic factors that were significant in the Cox proportional-hazards model were late stages of the tumor (locally advanced: HR=2.52; metastatic: HR=4.17), diffuse subtype (HR=1.40), gastrectomy (subtotal: HR=0.42; total: 0.44) and palliative chemotherapy (HR=0.61). Conclusions: The treatment of GA has changed in recent decades. GA survival was associated with clinical staging, diffuse subtype, gastrectomy and palliative chemotherapy. These findings must be interpreted in the context of a hospital-based study.

8.
J Sep Sci ; 34(23): 3353-8, 2011 Dec.
Article in English | MEDLINE | ID: mdl-22052789

ABSTRACT

In this study, a sequential extraction method using water and methanol to recover ethylene glycol dinitrate or nitroglycol (EGDN) contained in Goma-2 ECO dynamite was developed. After, an HPLC method was used for the determination of EGDN in the two extracted phases. The analytical method was validated by evaluating its selectivity, sensitivity, linearity, and linear working concentration range, limit of detection and quantitation, precision (as repeatability and intermediate precision), accuracy, and robustness, providing appropriate values (i.e. RSD values for precision about 6% and accuracy about 100%). Finally, the EGDN content of a sample of the Goma-2-ECO dynamite was determined obtaining a concentration of 30.29%, which is in accordance with the manufacturer's specifications for this dynamite (25.7-31.4%).

9.
Rev Med Chil ; 139(10): 1313-21, 2011 Oct.
Article in Spanish | MEDLINE | ID: mdl-22286731

ABSTRACT

BACKGROUND: There is an association of interleukin (IL)1B polymorphism with gastric cancer risk. However systematic reviews of the existing evidence have shown that such association varies across populations with different genetic ancestry. AIM: To evaluate the association of IL-1B-511 and IL-1RN polymorphism and Helicobacter pylori IgG antibodies CagA, with gastric cancer in two Colombian cities located in a high risk area for gastric cancer. MATERIAL AND METHODS: A case-control study including 46 gastric cancer cases and 99 controls with non-atrophic gastritis from a high risk zone for gastric cancer. Polymorphism genotyping was carried out by polymerase chain reaction (PCR) and IgG CagA status by ELISA. RESULTS: IgG CagA seropositive individuals had an increased gastric cancer risk (odds ratio (OR) = 11.56; 95% confidence intervals (CI) 2.62-50.91 in Tunja and OR = 19.66, 95%CI 0.98-395 in Bogotá). IL-1B-511TT carriers in Tunja had increased risk of gastric cancer (OR = 11.31; 95%CI 1.20-106.54)), while IL-1RN*2 alelle carriers in Bogotá showed an inverse association with gastric cancer risk (OR = 0.03; 95%CI 0.01-0.65). CONCLUSIONS: This study adds evidence to the positive association of Helicobacter pylori CagA positive strains with non-cardial gastric cancer etiology. There is a possible heterogeneity in the association of IL-1B gene polymorphism with cancer, in populations of similar ethnic background and settled in the same risk area.


Subject(s)
Antigens, Bacterial/genetics , Bacterial Proteins/genetics , Helicobacter Infections/genetics , Helicobacter pylori/immunology , Interleukin 1 Receptor Antagonist Protein/genetics , Interleukin-1beta/genetics , Polymorphism, Genetic/genetics , Stomach Neoplasms , Adult , Aged , Case-Control Studies , Colombia/ethnology , Female , Helicobacter Infections/immunology , Helicobacter pylori/genetics , Humans , Immunoglobulin G/blood , Male , Middle Aged , Risk Factors , Stomach Neoplasms/genetics , Stomach Neoplasms/immunology , Stomach Neoplasms/microbiology
10.
Salud Publica Mex ; 52(5): 386-90, 2010.
Article in Spanish | MEDLINE | ID: mdl-21031244

ABSTRACT

OBJECTIVE: The aim was to evaluate the concordance in the diagnosis of precursor lesions of intestinal-type gastric carcinoma among observers with different levels of experience. MATERIAL AND METHODS: Gastric biopsies from 1 056 cases were studied: 341 from Colombia, 382 from Mexico, and 333 from Paraguay. Pathologists without experience (A) and with experience (B) in gastrointestinal pathology, as well as experts working in an international reference center (C) participated in the diagnosis of each case. RESULTS: The concordance (k) between pathologists with experience and those without was poor for the diagnosis of atrophic gastritis (k=0.04 to 0.12) and dysplasia (k=0.11 to 0.05), and good for the diagnosis of intestinal metaplasia (k=0.52 to 0.58). Supervision of pathologists without experience by those with experience remarkably improved the concordance in the diagnosis of atrophic gastritis (k=0.65) and intestinal metaplasia (k=0.91), and to a lesser degree, of dysplasia (k=0.28). The concordance among experts before and after the consensus meeting showed no variation in the diagnosis of atrophic gastritis (k=0.57); the concordance varied from good to excellent in the diagnosis of intestinal metaplasia (k=0.67 to 0.81) and from poor to good in that of dysplasia (k=0.18 to 0.66). CONCLUSION: The greatest differences arose in the diagnosis of chronic atrophic gastritis and dysplasia. The interobserver concordance depended on the experience of the observer and the consensus reading.


Subject(s)
Carcinoma/prevention & control , Gastritis, Atrophic/diagnosis , Precancerous Conditions/diagnosis , Stomach Neoplasms/prevention & control , Stomach/pathology , Adult , Biopsy , Carcinoma/epidemiology , Clinical Competence , Colombia/epidemiology , Consensus , Gastritis, Atrophic/pathology , Gastroscopy , Humans , Hyperplasia , Intestines/pathology , Metaplasia , Mexico/epidemiology , Observer Variation , Paraguay/epidemiology , Pathology, Clinical , Precancerous Conditions/pathology , Reproducibility of Results , Stomach Neoplasms/epidemiology
11.
Int J Surg Case Rep ; 68: 88-91, 2020.
Article in English | MEDLINE | ID: mdl-32126353

ABSTRACT

INTRODUCTION: Acute appendicitis (AA) is the most common cause of acute surgical abdomen. Complications from surgical appendectomy include intraabdominal abscess, bleeding, surgical site infections, ileus, and stump appendicitis (SA). This last one is one of the least common ones with a reported incidence of 1:50.000. METHODS: We present a case and review 132 cases of SA reported in the literature. Demographic and clinical characteristics were evaluated, as well as details of the surgical treatment. Categorical variables are presented as quantities and proportions, and continuous variables with median and interquartile range. Additionally, we calculate an incidence from 3 papers reported in the literature and our own. RESULTS: We analyzed 132 cases, 60.3 % were male with a median age at SA of 33 years. There was a wide range time interval between the episode of AA and SA from 1 day to 60 years. Initial open appendectomy was reported in 62 cases. From all the patients with SA 51 % reported complications. The median length of the appendiceal stump was 3 cm. The incidence of SA fluctuated between 0.22-1.37 in 1.000 cases of appendectomies. DISCUSSION: SA is usually underrated, and which are the risk factors for this condition are not clear. The data available suggest that a primary laparoscopic appendectomy is not related to SA, but the length of the stump left in the first surgery might be associated. The incidence of SA seems to be higher than the one reported of 1 in 50.000.

12.
IDCases ; 22: e00999, 2020.
Article in English | MEDLINE | ID: mdl-33194551

ABSTRACT

Non-tuberculous mycobacterias (NTM) are important pathogens responsible for a broad spectrum of diseases in humans. Although exposure is widespread since they are distributed in the environment, the development of the disease is rare. It will depend on the specific species, their virulence (only 50 have been found to cause disease), and the host's immune response. M Mycobacterium Malmoense is a NTM first reported in 1977 at Malmö, Sweden, based on four cases of lung infections. After these, other infections have been reported mainly involving the respiratory tract. Extrapulmonary infections are limited to cervical adenitis, and rarely to tenosynovitis and disseminated disease. We are hence reporting, to our knowledge, the first case of M. malmoense as the cause of bacterial endocarditis in the world.

13.
Helicobacter ; 14(2): 100-8, 2009 Apr.
Article in English | MEDLINE | ID: mdl-19298337

ABSTRACT

BACKGROUND: Most treatments deemed effective for Helicobacter pylori eradication in developed countries are less effective in developing countries. Regimens containing clarithromycin, metronidazole, and amoxicillin seem efficacious despite antibiotic resistance, and may be a viable option in developing countries. MATERIALS AND METHODS: We evaluated the efficacy of a 14-day regimen with 500 mg clarithromycin b.i.d., 500 mg metronidazole t.i.d., and 500 mg amoxicillin t.i.d. (with and without a proton pump inhibitor), and a 10-day regimen containing 500 mg clarithromycin b.i.d., 1 g amoxicillin b.i.d., and 20 mg omeprazole b.i.d. in Pasto, Colombia, using a randomized, single-blind design stratified by presence of atrophic gastritis. RESULTS: H. pylori was eradicated in 86.8% and 85.3% of the participants randomized to a clarithromycin-metronidazole-amoxicillin and clarithromycin-amoxicillin-omeprazole regimens, respectively (p = .79). Per-protocol analyses indicated greater efficacy for the clarithromycin-metronidazole-amoxicillin regimen (97%) versus the clarithromycin-amoxicillin-omeprazole regimen (86%) (p = .04), particularly for participants with atrophic gastritis (clarithromycin-metronidazole-amoxicillin = 100%, clarithromycin-amoxicillin-omeprazole = 81%; p = .02). Adverse events were mild, but adverse event-related non-compliance was reported more often for regimens containing clarithromycin, metronidazole, and amoxicillin. CONCLUSIONS: Our results suggest that an eradication rate of > 85% can be achieved with 14-day clarithromycin, metronidazole, and amoxicillin and 10-day clarithromycin, amoxicillin, and omeprazole regimens in Pasto, Colombia. The regimens containing clarithromycin, metronidazole, and amoxicillin appear to be superior to the clarithromycin, amoxicillin, and omeprazole regimen for compliant participants and those with atrophic gastritis. Our findings provide treatment options for a population in a developing country with a high prevalence of H. pylori infections and antibiotic resistance.


Subject(s)
Amoxicillin/administration & dosage , Clarithromycin/administration & dosage , Helicobacter Infections/drug therapy , Metronidazole/administration & dosage , Adult , Aged , Amoxicillin/adverse effects , Anti-Bacterial Agents/administration & dosage , Clarithromycin/adverse effects , Cohort Studies , Colombia , Developing Countries , Drug Therapy, Combination , Female , Gastritis, Atrophic/drug therapy , Gastritis, Atrophic/pathology , Helicobacter Infections/pathology , Helicobacter pylori/drug effects , Humans , Male , Metronidazole/adverse effects , Middle Aged , Single-Blind Method , Treatment Outcome
14.
Clin Rheumatol ; 27(3): 391-3, 2008 Mar.
Article in English | MEDLINE | ID: mdl-17932615

ABSTRACT

We describe a patient with linear IgA bullous dermatosis, who developed characteristics of systemic lupus erythematosus (SLE). This association is rare and might be considered in the spectrum of the nonspecific bullous lesions associated to SLE.


Subject(s)
Blister/immunology , Immunoglobulin A/metabolism , Lupus Erythematosus, Systemic/diagnosis , Anti-Inflammatory Agents/therapeutic use , Blister/drug therapy , Blister/etiology , Child , Female , Humans , Lupus Erythematosus, Systemic/complications , Lupus Erythematosus, Systemic/drug therapy , Methylprednisolone/therapeutic use
15.
Biomedica ; 38(3): 298-302, 2018 09 01.
Article in English | MEDLINE | ID: mdl-30335234

ABSTRACT

The small lymphocytic lymphoma is a mature B cell neoplasm with a broad spectrum of clinical presentations. Opportunistic infections that are not related to the treatment, even in advanced stages, have a low incidence rate. There are few case reports in the medical literature of patients who have not received immunosuppressive therapy and present with small lymphocytic lymphoma associated with disseminated histoplasmosis at diagnosis. A female 82-year-old patient was admitted due to an intermittent dry cough, asthenia, and adynamia that had persisted for one month. Multiple studies to detect infections and immuno-rheumatic conditions were performed and an extensive cervical, thoracic and peritoneal adenopathic syndrome was diagnosed. A flow cytometry and a cervical lymph node biopsy were performed reporting CD19+, CD20dim, CD5+, CD45+, CD23+, CD43neg, and CD10neg phenotypes with restriction in the light kappa chain compatible with a small lymphocytic lymphoma. Epithelioid granulomas without necrosis were observed in the lymph node histopathology and special colorations showed no microorganisms. The culture from the lymph node was positive for Histoplasma capsulatum. We initiated treatment with amphotericin B and itraconazole with an adequate response. In the absence of compliance with oncology treatment criteria, the patient was managed on a "watch and wait" basis. Opportunistic infections could be the initial clinical manifestation in patients with low-grade lymphoproliferative syndromes. This case report shows that they can develop even in the absence of chemotherapy.


Subject(s)
Histoplasmosis/complications , Leukemia, Lymphocytic, Chronic, B-Cell/diagnosis , Opportunistic Infections/complications , Aged, 80 and over , Alzheimer Disease/complications , Amphotericin B/therapeutic use , Antifungal Agents/therapeutic use , Diabetes Mellitus, Type 2/complications , Female , Histoplasma/isolation & purification , Histoplasmosis/diagnosis , Histoplasmosis/drug therapy , Humans , Hypertension/complications , Itraconazole/therapeutic use , Leukemia, Lymphocytic, Chronic, B-Cell/complications , Lymph Nodes/diagnostic imaging , Lymph Nodes/microbiology , Lymph Nodes/pathology , Opportunistic Infections/diagnosis , Opportunistic Infections/drug therapy , Watchful Waiting
16.
Talanta ; 166: 375-382, 2017 May 01.
Article in English | MEDLINE | ID: mdl-28213249

ABSTRACT

New analytical strategies tend to automation of sample pre-treatment and flow analysis techniques provided a number of enhanced analytical methods allowing high throughput. Flow techniques are usually faster, more robust and more flexible than their batch equivalents. In addition, flow methods use less sample and reagent amounts and reduce analytical costs and waste. A flow injection solid-phase extraction pre-concentration system using a molecularly imprinted polymer (MIP) packed micro-column was developed for the determination of 1-hydroxypyrene in human urine with fluorescence detection. The pre-concentration of 1-hydroxypyrene on the MIP was carried out based on the specific retention of analyte by on-line introducing the sample into the micro-column system. Methanol and dichloromethane mixture was used to elute the retained analyte for fluorometric analysis. Important influencing factors were studied in detail, in batch and in flow (MISPE procedure optimisation, sample and eluent volumes, flow rate, dimensions of MIP micro-column and amounts of packing material, etc). To the best of our knowledge, this is the first on-line flow injection molecularly imprinted solid phase extraction for the pre-concentration and determination of hydroxylate PAH metabolite in urine samples. The optimised method was successfully applied to the determination of 1-Hydroxypyrene in spiked urine samples, with recoveries in the range of 74-85% and RSD<4.6%. Under optimum experimental conditions, the linearity concentration range used was 10-400µgL-1, R2>0.996. We obtained limit of detection and quantification of 3.1µgL-1 and 10.5µgL-1, respectively.


Subject(s)
Flow Injection Analysis , Molecular Imprinting/methods , Pyrenes/isolation & purification , Pyrenes/urine , Solid Phase Extraction/methods , Humans , Infant, Newborn , Polymers/chemical synthesis , Solvents/chemistry
17.
Clin Rheumatol ; 36(9): 2159-2162, 2017 Sep.
Article in English | MEDLINE | ID: mdl-28762062

ABSTRACT

Eosinophilic granulomatosis with polyangiitis (EGPA), formerly known as Churg-Strauss syndrome (CSS), is a small vessel vasculitis associated with eosinophilia and asthma. Clinical manifestations commonly seen in patients presenting with EGPA range from upper airway and lung involvement to neurological, cardiac, cutaneous, and renal manifestations. Treatment for severe presentations includes steroids, cyclophosphamide, plasmapheresis, and recently, rituximab. Rituximab is associated with a good response in the treatment of vasculitis, but a variable response for the control of allergic symptoms. Here, we report a 16-year-old female patient with severe EGPA (gastrointestinal and cutaneous vasculitis, rhinitis and asthma) refractory to conventional treatment. She was treated with rituximab, which enabled rapid control of the vasculitis component of the disease, but there was no response to rhinitis and asthma. Additionally, she developed severe bronchospasm during rituximab infusion. Sequential rituximab and omalizumab were initiated, leading to remission of all manifestations of vasculitis, rhinitis, and asthma, in addition to bronchospasm related to rituximab infusion.


Subject(s)
Churg-Strauss Syndrome/drug therapy , Gastric Mucosa/pathology , Omalizumab/administration & dosage , Rituximab/administration & dosage , Adolescent , Asthma/drug therapy , Bronchial Spasm/drug therapy , Churg-Strauss Syndrome/complications , Female , Humans , Rhinitis/drug therapy , Treatment Outcome
18.
Int J Surg Case Rep ; 33: 135-138, 2017.
Article in English | MEDLINE | ID: mdl-28315818

ABSTRACT

INTRODUCTION: Sclerosing Encapsulating Peritonitis (SEP) is a rare condition with an incidence of up to 3% and a mortality of up to 51% among peritoneal dialysis (PD) patients (Brown et al., Korte et al. and Kawanishi et al.). In the last ten years, the incidence of SEP in kidney transplant recipients has increased (Nakamoto, de Sousa et al. and Korte et al.). PRESENTATION OF CASE: A 31-year old male with a 15 years history of PD and later kidney retransplantation was admitted to the emergency service after experiencing several weeks of diffuse abdominal pain which had escalated to include vomiting and diarrhea during the 24h previous to admission. The patient underwent an exploratory laparotomy where severe peritoneal thickening was found, in addition to signs of chronic inflammation and blocked intestinal loops. Histopathologic findings were suggestive of sclerosing peritonitis. After two months of treatment in hospital, the patient presented an obstructed intestine, with a rigid and thickened peritoneum compromising all the intestinal loops. DISCUSSION: Despite being rare, SEP, represents a significant complication due to its high mortality and recurrence. It is insidious in its early stages and culminates in an intestinal obstruction (Fieren). Risk factors for its development in kidney transplant recipients include a history of prolonged treatment with PD and the use of calcineurin inhibitors as an immunosuppressive treatment (Korte et al.). CONCLUSION: Given the increase in the incidence of SEP in kidney transplant recipients, the clinician should be alert to the presence of this complication. A greater number of multi-centre studies are required to identify the risk factors for SEP that are inherent in renal transplant recipients.

19.
Rev. colomb. reumatol ; 27(4): 298-302, oct.-dic. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1289334

ABSTRACT

RESUMEN La combinación de sarcoidosis y linfoma (síndrome sarcoidosis-linfoma) es una asociación poco frecuente pero reconocida en el ámbito clínico. Algunas manifestaciones pueden ser comunes entre estas entidades, por lo que es un reto para el clínico diferenciar cada enfermedad por separado o si coexisten en un mismo individuo. En este último escenario, ni las manifestaciones clínicas ni los parámetros de laboratorio son específicos, por lo que es necesario un análisis minucioso de cada caso, apoyado de laboratorios, imágenes e histopatología para llegar a un diagnóstico certero. Se presentan 2 casos de síndrome sarcoidosis-linfoma y se analizan los aspectos clave en el diagnóstico de esta forma clínica.


ABSTRACT The combination of sarcoidosis and lymphoma (sarcoidosis-lymphoma syndrome) is a rare but recognised clinical condition. Some manifestations may be common among these conditions, making it a challenge for the clinician to differentiate each disease separately, or if they coexist in the same individual. In this latter scenario, neither the clinical manifestations nor the laboratory parameters are specific, so a meticulous analysis of each case is necessary, supported by laboratory and imaging tests, and histopathology in order to obtain an accurate diagnosis. Two cases of sarcoidosis-lymphoma syndrome are presented, and an analysis is presented on the key aspects in the diagnosis of this clinical condition.


Subject(s)
Humans , Male , Female , Adult , Sarcoidosis , Lymphoma , Signs and Symptoms , Syndrome , Disease , Diagnosis
20.
Rev. cuba. pediatr ; 90(4): e360, set.-dic. 2018. tab, graf
Article in Spanish | LILACS | ID: biblio-978462

ABSTRACT

Introducción: La anemia y su erradicación es una prioridad de organizaciones de salud. La implementación de programas de suplementación nutricional para su disminución es realizada por diversas instituciones. Objetivo: Caracterizar la anemia en niños beneficiarios del proyecto EquiDar, Azuay-Ecuador. Métodos: Investigación con diseño no experimental, prospectivo, observacional, de corte descriptivo-asociativo y transversal, realizada en el período 2015-2016 en el Cantón Cuenca, Azuay- -Ecuador. La muestra probabilística correspondió a 1 091 niños beneficiarios del proyecto EquiDar. Se realizó biometría mediante equipo automatizado. Los índices hematológicos obtenidos se normalizaron según la altura. Los datos se procesaron con SPSS 23.0 mediante estadística descriptiva e inferencial para la comparación de medias y proporciones (H Kruskall Wallis, U de Mann Whitney y Ji-cuadrada). Resultados: La prevalencia de anemia fue de 23,96 por ciento con predomino en la edad preescolar y en zona rural de residencia. El incremento de la edad corrigió el padecimiento mediante asociación inversa. El principal tipo de anemia en la muestra fue de tipo normocítica hipocrómica, seguida de anemia macrocítica. El nivel de macrocitosis en la población fue alto (56 por ciento) en individuos anémicos y no anémicos sugiriendo la concurrencia de otras enfermedades como agente causante. Conclusiones: La prevalencia de anemia en la muestra es un problema moderado de salud pública influido por variables sociodemográficas. La reversión del fenómeno sobrepasa la dimensión nutricional, por lo que es necesario políticas con enfoque multifactorial que integren el área nutricional, educativa y de salud pública(AU)


Introduction: Anemia and its eradication is a priority of health organizations. The implementation of nutritional supplemental programs for its reduction is carried out by several institutions. Objective: To characterize anemia in the children who were beneficiaries of EquiDar project, in Azuay, Ecuador from 2015 to 2016. Methods: Prospective approach with non-experimental, observational, descriptive-associative and cross-sectional design carried out in the period 2015-2016 in Canton Cuenca, Azuay, Ecuador. The probabilistic sample corresponded to 1091 children who are benefit from EquiDar project. Biometry was performed using automated equipment. The hematologic indices obtained were normalized according to the height. Data were processed with SPSS 23.0 and using descriptive and inferential statistics with methods for the comparison of means and proportions (H Kruskall Wallis, Mann Whitney U and square-Ji). Results: The prevalence of anemia was 23.96 percent, predominantly in the preschool ages and in the rural areas. Increasing age corrects the condition by inverse association. The main type of anemia in the sample is hypocromic normocytic, followed by macrocytic anemia. The level of macrocytosis in the population was high (56 percent) in both anemic and non-anemic individuals, suggesting the concurrence of other pathologies as causative agent. Conclusions: The incidence of anemia in the sample is a moderate public health problem influenced by sociodemographic variables. The reversion of the phenomenon surpasses the nutritional dimension being necessary policies with multifactorial approach that integrate the nutritional, educative and public health areas(AU)


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , World Health Organization , Food, Fortified/standards , Anemia/prevention & control , Anemia/epidemiology , Epidemiologic Studies , Cross-Sectional Studies , Prospective Studies , National Health Strategies , Ecuador , Observational Study
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