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1.
Bioprocess Biosyst Eng ; 44(7): 1525-1538, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33860372

RESUMO

A biofertilizer of Azospirillum brasilense was produced in solid-state culture (SSC) from laboratory to pilot scale. Similar operation conditions (continuous aeration and mild intermittent mixing) and two dimensionless numbers with similar L/D ratio and a similar working volume were applied to reach a scale-up factor of 75. An innovative bioreactor with rotating helical ribbons (15 kg wet matter) was used at pilot scale. A mathematical model was proposed and validated to evaluate the respirometry trends at laboratory and pilot scale exhibiting similar behavior. The cell viability was (1.3 ± 0.4) × 109 and (1.3 ± 0.3) × 109 colony-forming units per gram of initial dry mass at laboratory and pilot scale, at 36 and 43 h, respectively. A. brasilense maintains its viability twelve months of storage at 4 and 30 °C. This is the first report of A. brasilense being cultivated in SSC under controlled conditions. SSC processes involving unicellular microorganisms with tolerance to agitation are a promising technology to produce biofertilizers.


Assuntos
Azospirillum brasilense/metabolismo , Reatores Biológicos , Biotecnologia/métodos , Glicerol/química , Microbiologia Industrial/métodos , Fermentação , Fertilizantes , Concentração de Íons de Hidrogênio , Cinética , Laboratórios , Microscopia Eletrônica de Varredura , Modelos Teóricos , Consumo de Oxigênio , Células-Tronco
2.
Radiologia ; 58(3): 214-20, 2016.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-26774850

RESUMO

OBJECTIVES: To evaluate the possibility of determining the genetic profile of primary malignant tumors of the breast from specimens obtained by ultrasound-guided percutaneous biopsies during the diagnostic imaging workup. MATERIAL AND METHODS: This is a retrospective study in 13 consecutive patients diagnosed with invasive breast cancer by B-mode ultrasound-guided 12 G core needle biopsy. After clinical indication, the pathologist decided whether the paraffin block specimens seemed suitable (on the basis of tumor size, validity of the sample, and percentage of tumor cells) before sending them for genetic analysis with the MammaPrint® platform. RESULTS: The size of the tumors on ultrasound ranged from 0.6cm to 5cm. In 11 patients the preserved specimen was considered valid and suitable for use in determining the genetic profile. In 1 patient (with a 1cm tumor) the pathologist decided that it was necessary to repeat the core biopsy to obtain additional samples. In 1 patient (with a 5cm tumor) the specimen was not considered valid by the genetic laboratory. The percentage of tumor cells in the samples ranged from 60% to 70%. In 11/13 cases (84.62%) it was possible to do the genetic analysis on the previously diagnosed samples. CONCLUSION: In most cases, regardless of tumor size, it is possible to obtain the genetic profile from tissue specimens obtained with ultrasound-guided 12 G core biopsy preserved in paraffin blocks.


Assuntos
Neoplasias da Mama/genética , Neoplasias da Mama/patologia , Ultrassonografia , Adulto , Neoplasias da Mama/diagnóstico por imagem , Feminino , Humanos , Biópsia Guiada por Imagem/métodos , Pessoa de Meia-Idade , Estudos Retrospectivos
3.
J Fish Dis ; 36(5): 467-81, 2013 May.
Artigo em Inglês | MEDLINE | ID: mdl-23167612

RESUMO

Salmonid fish viruses, such as infectious haematopoietic necrosis virus (IHNV), are responsible for serious losses in the rainbow trout and salmon-farming industries, and they have been the subject of intense research in the field of aquaculture. Thus, the aim of this work is to study the antiviral effect of milk-derived proteins as bovine caseins or casein-derived peptides at different stages during the course of IHNV infection. The results indicate that the 3-h fraction of casein and α(S2) -casein hydrolysates reduced the yield of infectious IHNV in a dose-dependent manner and impaired the production of IHNV-specific antigens. Hydrolysates of total casein and α(S2) -casein target the initial and later stages of viral infection, as demonstrated by the reduction in the infective titre observed throughout multiple stages and cycles. In vivo, more than 50% protection was observed in the casein-treated fish, and the kidney sections exhibited none of the histopathological characteristics of IHNV infection. The active fractions from casein were identified, as well as one of the individual IHNV-inhibiting peptides. Further studies will be required to determine which other peptides possess this activity. These findings provide a basis for future investigations on the efficacy of these compounds in treating other viral diseases in farmed fish and to elucidate the underlying molecular mechanisms of action. However, the present results provide convincing evidence in support of a role for several milk casein fractions as suitable candidates to prevent and treat some fish viral infections.


Assuntos
Antivirais/farmacologia , Caseínas/farmacologia , Doenças dos Peixes/prevenção & controle , Vírus da Necrose Hematopoética Infecciosa/efeitos dos fármacos , Infecções por Rhabdoviridae/veterinária , Truta , Animais , Bovinos , Linhagem Celular , Cromatografia Líquida de Alta Pressão , Doenças dos Peixes/imunologia , Doenças dos Peixes/virologia , Vírus da Necrose Hematopoética Infecciosa/imunologia , Perciformes , Infecções por Rhabdoviridae/imunologia , Infecções por Rhabdoviridae/prevenção & controle , Infecções por Rhabdoviridae/virologia , Espectrometria de Massas por Ionização por Electrospray , Espectrometria de Massas em Tandem
4.
Cir Pediatr ; 36(1): 22-27, 2023 Jan 01.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-36629345

RESUMO

AIM OF THE STUDY: To describe perianal Crohn's disease behavior and the role of biological therapy in a sample of pediatric patients. METHODS: A retrospective study of pediatric patients with Crohn's disease (CD) treated in our institution from 2017 to 2021, with a minimum follow up period of 6 months, was conducted. Patients were divided whether they had perianal disease (PD) or not. Baseline characteristics, extension of disease, growth failure rate, aggressive pattern rate, use of biological therapy and need for surgery, among other variables, were compared between both groups. Clinical and/or radiological improvement in the last 6 months of follow up was considered good control of PD. RESULTS: Seventy eight pediatric patients with CD were included. Median age at diagnosis was 10.5 years, and median follow up time was 3.8 years. 64.1% patients were male. Of all, 15 (19.2%) had perianal disease, of which 10 had fistulizing findings and 5 had non fistulizing findings. PD was presented at diagnosis in 8 patients, and the rest developed it in a median time of 1 year from diagnosis. PD was associated with growth failure (p = 0.003), use of biological therapies (p = 0.005), and need for second line of biologics (p = 0.005). Most patients (12/15, 80%) had good control of PD with the treatment received. CONCLUSIONS: CD patients with PD seem to need a more aggressive treatment, with biological therapies playing a key role for its handling nowadays. These patients require close nutritional evaluation that ensures proper development and growth.


OBJETIVO DEL ESTUDIO: Describir el comportamiento de la enfermedad de Crohn perianal y el papel de la terapia biológica en una muestra de pacientes pediátricos. METODOS: Estudio retrospectivo de pacientes pediátricos con enfermedad de Crohn (EC) tratados en nuestro centro entre 2017 y 2021, con un seguimiento mínimo de seis meses. Los pacientes se dividieron en función de si tenían enfermedad perianal (EP) o no. Se compararon entre ambos grupos las características iniciales, la extensión de la enfermedad, el índice de retraso en el crecimiento, el índice de patrón agresivo, el empleo de terapia biológica y la necesidad de cirugía, entre otras variables. Se consideró un buen control de la EP una mejoría clínica o radiológica en los 6 últimos meses de seguimiento. RESULTADOS: Se incluyeron 78 pacientes pediátricos con EC. La edad mediana en el momento del diagnóstico fue de 10,5 años, y el tiempo mediano de seguimiento fue de 3,8 años. El 64,1% de los pacientes eran varones. Del total, 15 (19,2%) tenían enfermedad perianal, de los cuales 10 presentaban hallazgos fistulizantes y 5 no fistulizantes. La EP estaba presente en el momento del diagnóstico en 8 pacientes, y el resto la desarrolló en una mediana de 1 año desde el diagnóstico. La EP se asoció con retraso en el crecimiento (p = 0,003), empleo de terapias biológicas (p = 0,005) y necesidad de una segunda línea de terapia biológica (p = 0,005). La mayoría de los pacientes (12/15, 80%) tuvieron un buen control de la EP con el tratamiento recibido. CONCLUSIONES: Los pacientes de EC con EP parecen necesitar un tratamiento más agresivo, en el que las terapias biológicas desempeñan hoy en día un papel fundamental. Estos pacientes precisan de una estrecha evaluación nutricional que garantice su correcto crecimiento y desarrollo.


Assuntos
Doença de Crohn , Fístula Retal , Humanos , Masculino , Criança , Feminino , Doença de Crohn/tratamento farmacológico , Doença de Crohn/complicações , Estudos Retrospectivos , Resultado do Tratamento , Terapia Biológica , Fístula Retal/terapia , Fístula Retal/complicações
5.
Rev Sci Instrum ; 93(3): 033304, 2022 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-35364990

RESUMO

The response of the BAS-TR image plate (IP) was absolutely calibrated using a CR-39 track detector for high linear energy transfer Au ions up to ∼1.6 GeV (8.2 MeV/nucleon), accelerated by high-power lasers. The calibration was carried out by employing a high-resolution Thomson parabola spectrometer, which allowed resolving Au ions with closely spaced ionization states up to 58+. A response function was obtained by fitting the photo-stimulated luminescence per Au ion for different ion energies, which is broadly in agreement with that expected from ion stopping in the active layer of the IP. This calibration would allow quantifying the ion energy spectra for high energy Au ions, which is important for further investigation of the laser-based acceleration of heavy ion beams.

6.
Rev Sci Instrum ; 93(5): 053303, 2022 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-35649771

RESUMO

Image plates (IPs) are a popular detector in the field of laser driven ion acceleration, owing to their high dynamic range and reusability. An absolute calibration of these detectors to laser-driven protons in the routinely produced tens of MeV energy range is, therefore, essential. In this paper, the response of Fujifilm BAS-TR IPs to 1-40 MeV protons is calibrated by employing the detectors in high resolution Thomson parabola spectrometers in conjunction with a CR-39 nuclear track detector to determine absolute proton numbers. While CR-39 was placed in front of the image plate for lower energy protons, it was placed behind the image plate for energies above 10 MeV using suitable metal filters sandwiched between the image plate and CR-39 to select specific energies. The measured response agrees well with previously reported calibrations as well as standard models of IP response, providing, for the first time, an absolute calibration over a large range of proton energies of relevance to current experiments.

7.
Int J Surg ; 97: 106168, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34785344

RESUMO

BACKGROUND AND AIMS: Emergency General Surgery (EGS) conditions account for millions of deaths worldwide, yet it is practiced without benchmarking-based quality improvement programs. The aim of this observational, prospective, multicenter, nationwide study was to determine the best benchmark cutoff points in EGS, as a reference to guide improvement measures. METHODS: Over a 6-month period, 38 centers (5% of all public hospitals) attending EGS patients on a 24-h, 7-days a week basis, enrolled consecutive patients requiring an emergent/urgent surgical procedure. Patients were stratified into cohorts of low (i.e., expected morbidity risk <33%), middle and high risk using the novel m-LUCENTUM calculator. RESULTS: A total of 7258 patients were included; age (mean ± SD) was 51.1 ± 21.5 years, 43.2% were female. Benchmark cutoffs in the low-risk cohort (5639 patients, 77.7% of total) were: use of laparoscopy ≥40.9%, length of hospital stays ≤3 days, any complication within 30 days ≤ 17.7%, and 30-day mortality ≤1.1%. The variables with the greatest impact were septicemia on length of hospital stay (21 days; adjusted beta coefficient 16.8; 95% CI: 15.3 to 18.3; P < .001), and respiratory failure on mortality (risk-adjusted population attributable fraction 44.6%, 95% CI 29.6 to 59.6, P < .001). Use of laparoscopy (odds ratio 0.764, 95% CI 0.678 to 0.861; P < .001), and intraoperative blood loss (101-500 mL: odds ratio 2.699, 95% CI 2.152 to 3.380; P < .001; and 500-1000 mL: odds ratio 2.875, 95% CI 1.403 to 5.858; P = .013) were associated with increased morbidity. CONCLUSIONS: This study offers, for the first time, clinically-based benchmark values in EGS and identifies measures for improvement.


Assuntos
Cirurgia Geral , Procedimentos Cirúrgicos Operatórios , Adulto , Idoso , Benchmarking , Estudos de Coortes , Emergências , Feminino , Mortalidade Hospitalar , Humanos , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Estudos Prospectivos , Melhoria de Qualidade , Estudos Retrospectivos
8.
Sci Rep ; 11(1): 23078, 2021 Nov 29.
Artigo em Inglês | MEDLINE | ID: mdl-34845293

RESUMO

Dehydration of the oceanic subducting slab promotes the formation of magmatic arcs, intra-slab intermediate-depth seismicity, and hydration of the overlying mantle wedge. However, the complex permeability structure of the overriding plate controls the magma and fluid migration and their accumulation at shallower depths. In this regard, mapping the inner structure of the overriding crust and mantle is crucial to understand the magmatic and hydrological processes in subduction zones. We integrate 3-D P-wave, [Formula: see text], and electrical resistivity tomographic models of the northern Chilean subduction zone to map the magmatic and fluids derived from the subducting oceanic Nazca plate. Results show a continental crust relatively thick (50-65 km) characterized by a lower zone of high [Formula: see text] values (7.2-7.6 km/s), which is interpreted as the presence of plutonic rocks. The mantle lithospheric wedge is weakly hydrated ([Formula: see text] = 1.75-1.8) while the forearc continental crust is traversed by regions of reduced electrical resistivity values ([Formula: see text] [Formula: see text]) interpreted as zones of relatively high permeability/fracturing and fluid content. These regions spatially correlate with upper plate trans-lithospheric deformation zones. Ascending melts accumulate preferentially in the back-arc, whereas hydrothermal systems form trenchward of the volcanic arc. The results highlight the complex permeability structure of the upper South American plate.

10.
Tob Control ; 17(2): 105-10, 2008 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-18285383

RESUMO

BACKGROUND: The price of cigarettes to consumers in Mexico, and Latin America in general, remains low in comparison with other regions of the world. In Mexico, taxes represented 59% of the total price of cigarettes in 2006, compared to 75% or more in many high-income countries. The feasibility of raising taxes on cigarettes in Mexico--to both discourage consumption and increase revenues--is an important policy question. METHODS: Using household survey data, we undertake a pooled cross-sectional analysis of the demand for cigarettes in Mexico. We use a two-part model to estimate the price elasticity of cigarettes. This model controls for the selection effect that arises from the fact that the impact of price on the decision to smoke or not is estimated using all households in the dataset. RESULTS: The results indicate that price is a significant factor in household decisions concerning smoking and the number of cigarettes smoked. Holding other factors constant, our simulations show that a 10% increase in the cigarette tax in Mexico--calculated as a percentage of the price--yields a 12.4% increase in the price to the consumer, a 6.4% decrease in consumption of cigarettes and a 15.7% increase in the revenue yielded by the tax. CONCLUSION: In Mexico, there are strong arguments for increasing cigarette taxes. Revenue raised could be used to further prevent tobacco consumption and to finance current funding shortages for the treatment of diseases related to smoking.


Assuntos
Fumar/epidemiologia , Impostos , Adolescente , Adulto , Idoso , Criança , Estudos Transversais , Feminino , Humanos , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Prevalência , Fumar/economia , Fumar/legislação & jurisprudência , Fatores Socioeconômicos
11.
Acta Radiol ; 49(10): 1112-8, 2008 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-18932053

RESUMO

BACKGROUND: Carbon marking of the biopsy site and needle track following stereotactic breast biopsy in nonpalpable mammography-detected lesions provides for safe and accurate localization for subsequent surgical excision. No significant complications of carbon marking have been reported to date. PURPOSE: To report follow-up imaging findings and histological changes (foreign-body giant-cell reaction) attributable to the use of carbon marking after vacuum breast biopsies. MATERIAL AND METHODS: This was a retrospective study of 130 patients in a mammographic screening program with nonpalpable suspicious breast lesions that were referred for stereotactic directional vacuum-assisted breast biopsy with carbon marking. Histological diagnosis was benign in all cases, but 1-year follow-up mammograms demonstrated suspect findings in four of them. RESULTS: For all four patients, the results of the initial stereotactic vacuum-assisted biopsy were benign, but mammographic follow-up and ultrasound findings revealed suspicious changes that, in all cases, were histologically shown to be foreign-body giant-cell reactions attributable to the use of carbon. CONCLUSION: In four of 130 lesions (3%) that were carbon marked following stereotactic vacuum-assisted breast biopsy, and in which surgical excision was not required, the mammographic and ultrasound follow-up appearance of the breast simulated malignancy. The abnormality was attributable to the use of carbon, which represents a potential source of misdiagnosis.


Assuntos
Neoplasias da Mama/diagnóstico , Carvão Vegetal/efeitos adversos , Reação a Corpo Estranho/etiologia , Células Gigantes de Corpo Estranho/diagnóstico por imagem , Mamografia/métodos , Técnicas Estereotáxicas/efeitos adversos , Ultrassonografia Mamária/métodos , Biópsia , Biópsia por Agulha , Mama/patologia , Neoplasias da Mama/diagnóstico por imagem , Diagnóstico Diferencial , Feminino , Fibroadenoma/diagnóstico , Doença da Mama Fibrocística/diagnóstico , Seguimentos , Reação a Corpo Estranho/diagnóstico , Humanos , Estudos Retrospectivos , Vácuo
12.
Ann R Coll Surg Engl ; 100(3): e57-e58, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29364009

RESUMO

Chylous ascites is a rare condition little reported in literature, with even more exceptional traumatic origin. Its production mechanism is not known exactly but has been attributed to hyperflexion or hyperextension of the spine leading to a rupture of lymph ducts. We present a case of post-traumatic chyloperitoneum in a young patient after abdominal blunt trauma. Conservative treatment should be the first therapeutic option, especially if the origin is traumatic, reserving more aggressive possibilities for cases that do not respond after 15 days, if debt is greater than 1.5 litres/day in adult patients or in those with metabolic complications. A laparoscopic approach is indicated to confirm the diagnosis and to rule out other associated injuries that may require other surgical procedures.


Assuntos
Traumatismos Abdominais/complicações , Ascite Quilosa/diagnóstico por imagem , Laparoscopia , Ferimentos não Penetrantes/complicações , Adulto , Ascite Quilosa/etiologia , Ascite Quilosa/terapia , Feminino , Humanos
13.
Cir. pediátr ; 36(1): 22-27, Ene. 2023. tab
Artigo em Espanhol | IBECS (Espanha) | ID: ibc-214576

RESUMO

Objetivo del estudio: Describir el comportamiento de la enfermedad de Crohn perianal y el papel de la terapia biológica en una muestra de pacientes pediátricos. Métodos: Estudio retrospectivo de pacientes pediátricos con enfermedad de Crohn (EC) tratados en nuestro centro entre 2017 y 2021, con un seguimiento mínimo de seis meses. Los pacientes se dividieron en función de si tenían enfermedad perianal (EP) o no. Se compararon entre ambos grupos las características iniciales, la extensión de la enfermedad, el índice de retraso en el crecimiento, el índice de patrón agresivo, el empleo de terapia biológica y la necesidad de cirugía, entre otras variables. Se consideró un buen control de la EP una mejoría clínica o radiológica en los 6 últimos meses de seguimiento. Resultados: Se incluyeron 78 pacientes pediátricos con EC. La edad mediana en el momento del diagnóstico fue de 10,5 años, y el tiempo mediano de seguimiento fue de 3,8 años. El 64,1% de los pacientes eran varones. Del total, 15 (19,2%) tenían enfermedad perianal, de los cuales 10 presentaban hallazgos fistulizantes y 5 no fistulizantes. La EP estaba presente en el momento del diagnóstico en 8 pacientes, y el resto la desarrolló en una mediana de 1 año desde el diagnóstico. La EP se asoció con retraso en el crecimiento (p = 0,003), empleo de terapias biológicas (p = 0,005) y necesidad de una segunda línea de terapia biológica (p = 0,005). La mayoría de los pacientes (12/15, 80%) tuvieron un buen control de la EP con el tratamiento recibido. Conclusiones: Los pacientes de EC con EP parecen necesitar un tratamiento más agresivo, en el que las terapias biológicas desempeñan hoy en día un papel fundamental. Estos pacientes precisan de una estrecha evaluación nutricional que garantice su correcto crecimiento y desarrollo.(AU)


Aim of the study: To describe perianal Crohn’s disease behavior and the role of biological therapy in a sample of pediatric patients. Methods: A retrospective study of pediatric patients with Crohn’s disease (CD) treated in our institution from 2017 to 2021, with a minimum follow up period of 6 months, was conducted. Patients were divided whether they had perianal disease (PD) or not. Baseline characteristics, extension of disease, growth failure rate, aggressive pattern rate, use of biological therapy and need for surgery, among other variables, were compared between both groups. Clinical and/or radiological improvement in the last 6 months of follow up was considered good control of PD. Results: Seventy eight pediatric patients with CD were included. Median age at diagnosis was 10.5 years, and median follow up time was 3.8 years. 64.1% patients were male. Of all, 15 (19.2%) had perianal disease, of which 10 had fistulizing findings and 5 had non fistulizing findings. PD was presented at diagnosis in 8 patients, and the rest developed it in a median time of 1 year from diagnosis. PD was associated with growth failure (p = 0.003), use of biological therapies (p = 0.005), and need for second line of biologics (p = 0.005). Most patients (12/15, 80%) had good control of PD with the treatment received. Conclusions: CD patients with PD seem to need a more aggressive treatment, with biological therapies playing a key role for its handling nowadays. These patients require close nutritional evaluation that ensures proper development and growth.(AU)


Assuntos
Humanos , Masculino , Feminino , Criança , Pacientes , Terapia Biológica , Doença de Crohn , Pediatria , Estudos Retrospectivos , Cirurgia Geral
14.
J Dairy Sci ; 90(11): 4966-73, 2007 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-17954735

RESUMO

A total of 107 different peptides, all derived from alphaS1-, alphaS2-, and beta-casein, were identified in different fractions of artisan or industrial Manchego cheese at 4 and 8 mo of ripening, and their sequences were examined. Most of these peptides are described for the first time in Manchego cheese. Taste characteristics (umami and bitter) were assigned based on their AA sequence and the position of these AA within the sequence. The umami taste was predominant in all fractions analyzed by the panelists, and the peptides EQEEL, QEEL, and EINEL, containing a high number of glutamic residues, were found within the fractions. However, in several fractions described as having umami characteristics, no peptides responsible for this taste were detected. Therefore, compounds other than peptides seem to be involved in the umami properties of water-soluble extracts lower than 1,000 Da of Manchego cheese.


Assuntos
Queijo/análise , Espectrometria de Massas/métodos , Peptídeos/análise , Animais , Queijo/normas , Cromatografia Líquida de Alta Pressão/métodos , Feminino , Humanos , Masculino , Peptídeos/química , Paladar , Fatores de Tempo
15.
J Dairy Sci ; 90(11): 5001-3, 2007 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-17954738

RESUMO

Water-soluble fractions from Protected Denomination of Origin Manchego cheese, with molecular weight <1,000 Da, were fractionated using gel permeation chromatography and studied using both instrumental and sensorial analysis. In 2 of the fractions, panelists detected a floral, rose-like flavor. Analysis of these fractions by gas chromatography-mass spectrometry after simultaneous distillation extraction with dichloromethane identified 2-phenylethanol and phenylacetaldehyde as the compounds responsible for this flavor.


Assuntos
Queijo/análise , Paladar , Acetaldeído/análogos & derivados , Acetaldeído/análise , Cromatografia Gasosa-Espectrometria de Massas/métodos , Humanos , Álcool Feniletílico/análise , Água/química
17.
Gastroenterol Hepatol ; 29(8): 451-4, 2006 Oct.
Artigo em Espanhol | MEDLINE | ID: mdl-17020678

RESUMO

We describe the case of a patient with chronic hepatitis C (CHC) who showed a progressive increase in aminotransferase level, reaching values of aspartate aminotransferase 1723 UI/L, alanine aminotransferase 1519 UI/L and gamma-glutamyl-transpeptidase 296 with a bilirubin level of 6 mg/dL and direct bilirubin level of 4.6 mg/dL. One year previously, the patient had been diagnosed with CHC, genotype 1, and had an initial hepatitis C virus RNA load of 249,000 UI/mL. All the specific blood tests performed were negative except for antisoluble liver antigen (anti-SLA) antibodies, which were positive in two different determinations. A diagnosis of overlap syndrome CHC and autoimmune hepatitis was made. Steroid and azathioprine treatment was started with good response. The relationship between CHC and anti-SLA is not well characterized but has been described in these patients. We found no prior reports in the literature of CHC associated with positive anti-SLA in a patient with persistent acute hepatitis.


Assuntos
Hepatite C Crônica/complicações , Hepatite Autoimune/complicações , Idoso , Autoanticorpos/sangue , Autoantígenos/imunologia , Biópsia por Agulha , Anticorpos Anti-Hepatite C/sangue , Hepatite C Crônica/imunologia , Hepatite C Crônica/terapia , Hepatite Autoimune/tratamento farmacológico , Hepatite Autoimune/imunologia , Humanos , Imunossupressores/uso terapêutico , Fígado/imunologia , Fígado/patologia , Fígado/virologia , Testes de Função Hepática , Masculino , Resultado do Tratamento
18.
Surg Endosc ; 19(7): 990-5, 2005 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-15971098

RESUMO

BACKGROUND: The placement of intraabdominal polypropylene mesh entails risks of adhesions and fistulas that can be avoided by preperitoneal placement. METHODS: This comparative, open, experimental, prospective, randomized, and transversal study randomized pigs into two groups of 11 each for intraperitoneal (IPOM) or preperitoneal (TAPP) polypropylene mesh placement by laparoscopy. Diagnostic laparoscopy and tissue en-bloc resection was performed 28 days postoperatively for histopathologic analysis. RESULTS: The following data were observed for the two study groups: surgical time (IPOM: 35.73 +/- 4.22 min; TAPP: 58.09 +/- 6.28 min; p = or < 0.0001); adhesions (IPOM: 81.81%; TAPP: 27.27%; p = 0.032), grade III for IPOM and grade II for TAPP (p = 0.001); and interloop adhesions (IPOM: 81.81%; TAPP: 9.09%; p = 0.003). No fistulas were found in either group. The TAPP procedure showed better integration of mesh, without lesion to abdominal organs. Two complications, occurred with IPOM, and one with TAPP (p = 1.0, not significant). CONCLUSIONS: The perperitoneal technique requires more time, but has fewer adhesions and less intraabdominal inflammatory response. It is a feasible technique that may diminish risks in the laparoscopic treatment of incisional hernias with polypropylene mesh.


Assuntos
Procedimentos Cirúrgicos do Sistema Digestório/métodos , Hérnia Abdominal/cirurgia , Próteses e Implantes , Telas Cirúrgicas , Parede Abdominal , Animais , Feminino , Fibrose , Íleo/patologia , Laparoscopia , Modelos Animais , Polipropilenos , Estudos Prospectivos
19.
Rev Esp Enferm Dig ; 97(7): 521-6, 2005 Jul.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-16262531

RESUMO

Whipple' disease is mainly characterized by affecting the digestive system, although it can be a multisystemic process with different clinical symptoms. The bacillus causing the disease has been isolated and cultivated in 2000 and the genome sequence has been recently analyzed in 2003, which means new perspectives for its diagnosis and treatment. Giardiasis is an infestation caused by a protozoo and may cause a malabsorption syndrome or run in a subclinic way. The case of a middle-aged male is described, who after a three-year period of migratory arthralgias, showed weight loss, diarrheas and abdominal pain, being diagnosed of Giardiasis, and after the persistent symptoms and a number of studies, was diagnosed with Whipple disease. Nineteen cases of Giardia-Whipple coinfection have been described in the literature, but the reason of this association has not been found yet. The discussion on whether there is an alteration in the immunitary system which facilitates infections or, the development of an infection lead to the other one, goes on.


Assuntos
Giardíase/complicações , Doença de Whipple/complicações , Anti-Infecciosos/administração & dosagem , Anti-Infecciosos/uso terapêutico , Antiprotozoários/administração & dosagem , Antiprotozoários/uso terapêutico , Giardíase/diagnóstico , Giardíase/tratamento farmacológico , Humanos , Masculino , Metronidazol/administração & dosagem , Metronidazol/uso terapêutico , Pessoa de Meia-Idade , Fatores de Tempo , Resultado do Tratamento , Combinação Trimetoprima e Sulfametoxazol/administração & dosagem , Combinação Trimetoprima e Sulfametoxazol/uso terapêutico , Doença de Whipple/diagnóstico , Doença de Whipple/tratamento farmacológico
20.
J Neurol Sci ; 356(1-2): 77-82, 2015 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-26139339

RESUMO

BACKGROUND: Dalfampridine extended release 10mg tablets (D-ER) have demonstrated improvement in walking for ambulatory persons with multiple sclerosis (pwMS), termed "responders." OBJECTIVE: This study examined the extent additional aspects of gait and dexterity change for patients prescribed D-ER. METHODS: Over 14-weeks, walking endurance, dynamic gait, self-report walking ability and fine and gross dexterity were examined in pwMS prescribed D-ER as a part of routine clinical care. RESULTS: The final results (n=39) validate that a subset of pwMS improve walking speed (Time 25-Foot Walk Test, p<0.0001). Significant improvements in gait and dexterity were observed even among participants who did not improve walking speed. Improvements were evident in gait and dexterity domains including Six Minute Walk Test, p=0.007, Six-Spot Step Test, p<0.0001, Multiple Sclerosis Walking Scale-12, p<0.0001, Nine Hole Peg Test, p<0.0001 dominant and non-dominant sides, and Box and Blocks Test, p=0.005 and 0.002, dominant and non-dominant sides, respectively. CONCLUSIONS: These findings suggest that D-ER may be a potential treatment for gait impairments, beyond walking speed and dexterity in pwMS. Further investigation regarding D-ER response is warranted.


Assuntos
4-Aminopiridina/uso terapêutico , Transtornos Neurológicos da Marcha/etiologia , Esclerose Múltipla/complicações , Esclerose Múltipla/tratamento farmacológico , Bloqueadores dos Canais de Potássio/uso terapêutico , Adulto , Idoso , Sistemas de Liberação de Medicamentos , Teste de Esforço , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Tempo de Reação , Autorrelato , Índice de Gravidade de Doença , Fatores de Tempo , Resultado do Tratamento , Caminhada/fisiologia
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