RESUMEN
OBJETIVO: Estudar a apresentação clínica e a evolução de pacientes portadores de glomerulonefrite lúpica. CASUÍSTICA E MÉTODOS: Foram estudados 37 pacientes portadores de glomerulonefrite lúpica, atendidos pela Disciplina de Nefrologia - Faculdade de Medicina de Botucatu, com seguimento médio de 52,4 + ou - 13,3 meses. Os dados foram obtidos através do levantamento retrospectivo dos prontuários. RESULTADOS: A idade média foi de 26,05 + ou - 11,12 anos, com predomínio do sexo feminino (84 por cento) sendo que a glomerulonefrite classe IV foi a mais freqüente (80 por cento). No início do seguimento a média da creatinina sérica foi de 1,74 + ou - 1,15 mg/dl, e a da proteinúria de 24h foi de 2,62 + ou - 2.89 g. Cinqüenta e um porcento dos pacientes com creatinina sérica elevada apresentaram, durante o seguimento, diminuição desses valores. Dentre diferentes variáveis estudadas, à época da biopsia renal, (idade, sexo, proteinúria, presença de hipertensão arterial e creatinina sérica) a única que se associou com pior prognóstico foi a elevação da creatinina sérica. Remissão da síndrome nefrótica ocorreu em 65 por cento das vezes. A sobrevida atuarial foi de 96 por cento, 82 por cento, 70 por cento e 70 por cento em 1, 5, 10 e 12 anos. Cinco pacientes desenvolveram insuficiência renal crônica terminal e sete morreram, sendo infecção a principal causa de óbito (57 por cento) CONCLUSÃO: Em pacientes com nefropatia lúpica, o aumento da creatinina sérica, à época da biópsia, se associou com o desenvolvimento de insuficiência renal crônica ao fim do seguimento e a principal causa de óbito foi processo infeccioso.
Asunto(s)
Humanos , Masculino , Femenino , Niño , Adolescente , Adulto , Persona de Mediana Edad , Nefritis Lúpica/fisiopatología , Pronóstico , Proteinuria/sangre , Factores de Tiempo , Nefritis Lúpica/complicaciones , Análisis de Supervivencia , Estudios Retrospectivos , Estudios de Seguimiento , Creatinina/sangre , Fallo Renal Crónico/etiología , Síndrome Nefrótico/etiologíaRESUMEN
Os autores apresentam 49 casos de criancas com insuficiencia renal aguda tratados en Unidade de Terapia Intensiva. O prognostico e especialmente grave no periodo neonatal e a evolucao em geral e dependente das condicoes iniciais da crianca. As principais causas etiologicas foram diarreia, desidratacao e septicemia: recomenda-se especial atencao para o diagnostico precoce de insuficiencia renal aguda nesses pacientes. Propoe-se a realizacao sistematica de testes diureticos e utilizacao de parametros laboratoriais diagnosticos, permitindo assim, o diagnostico precoce e prevencao de lesoes renais eventualmente irreversiveis. Uma vez instalada a insuficiencia renal aguda, urge controle hidroeletrolitico, rigoroso e monitorizacao dos niveis de ureia e potassio. A dialise peritoneal e recurso terapeutico valioso, mas nao modifica o prognostico das criancas em muito mau estado geral a admissao
Asunto(s)
Recién Nacido , Lactante , Preescolar , Niño , Humanos , Masculino , Femenino , Lesión Renal Aguda , Cuidados Críticos , Diálisis PeritonealRESUMEN
Os autores relatam o caso de um recem-nascido admitido no Instituto da Crianca com os diagnosticos de broncopneumonia e insuficiencia cardiaca congestiva. Medicado basicamente em digitalicos, diureticos, antibioticos e oxigenio. Apos um curto periodo de melhora, o paciente veio a falecer. O diagnostico anatomo-patologico foi arteriopatia calcificante idiopatica na infancia, comprometendo multiplas arterias, incluindo coronarias, do que resultaram infartos do miocardio
Asunto(s)
Arteriopatías Oclusivas , CalcinosisRESUMEN
Os autores apresentam aspectos clinico-radiologicos em uma crianca com pneumopatia grave, na qual foi diagnosticada "Doenca de Chagas aguda". A crianca evolui clinica e radiologicamente bem. O caso mostra que devemos investigar melhor a correlacao entre doenca de Chagas e pneumopatia
Asunto(s)
Lactante , Humanos , Enfermedad de Chagas , Enfermedades Pulmonares , Nitroimidazoles , RadiografíaRESUMEN
Onychomycosis epidemiology is a combination of various factors which include, among others, clinical presentation, etiologic agents of the infection and the patient's history background. Out of a total of 672 nail samples examined, 460 (68.4) were microscopy positive for fungi and 306 (66.5) of these were culture positive, including Candida (82), dermatophytes (13.4), Trichosporon spp (3.6) and nondermatophyte molds (1). Onychomycosis was more frequent in females (79.7) than in males (20.3). These were more common in fingernails (96.1) than in toenails (60) and yeasts were the most isolated etiologic agents. Among the clinical presentations, paronychia (CP) (57.2) and onycholysis (CO) (24.8) were the most common, caused frequently by C. albicans in 52.6 and 60.5 of the cases, respectively. T. rubrum (44.4) and Trichosporon spp (22.2) were the most frequent species in the case of distal lateral subungual onychomycosis (DLSO). Fusarium spp was the agent responsible for 33.3 of the cases of proximal subungual onychomycosis (PSO) and for 14.3 of white superficial onychomycosis (WSO), whereas Acremonium spp was responsible for 14.3 of the cases of WSO.
Asunto(s)
Humanos , Masculino , Femenino , Lactante , Preescolar , Niño , Adolescente , Adulto , Persona de Mediana Edad , Onicomicosis , Acremonium , Anciano de 80 o más Años , Brasil , Candida albicans , Candidiasis Cutánea/epidemiología , Candidiasis Cutánea/microbiología , Dedos , Fusarium , Uñas , Onicomicosis , Paroniquia , Prevalencia , Tiña , Dedos del Pie , Trichosporon , Población UrbanaRESUMEN
Piedra negra é uma infecção causada por um ascomiceto, Piedraia Hortae que se caracteriza pelo aparecimento no terço distal dos cabelos de nódulos fusiformes de consistência dura e coloração preta constituídos por massas compactas e organizadas de fungos. No homem, a piedra negra ocorre em regiões tropicais e subtropicais com precipitações pluviais abundantes, temperaturas elevadas e alta umidade do ar. No presente trabalho, os autores apresentam seis casos de piedra negra observados em pacientes atendidos no Laboratório de Micologia da Universidade Federal da Paraíba - Paraíba - Brasil.
Asunto(s)
Humanos , Masculino , Femenino , Preescolar , Niño , Adolescente , Adulto , Ascomicetos , Técnicas de Laboratorio Clínico , Enfermedades del Cabello , Micosis , PiedraRESUMEN
Onychomycosis epidemiology is a combination of various factors which include, among others, clinical presentation, etiologic agents of the infection and the patients history background. Out of a total of 672 nail samples examined, 460 (68.4) were microscopy positive for fungi and 306 (66.5) of these were culture positive, including Candida (82), dermatophytes (13.4), Trichosporon spp (3.6) and nondermatophyte molds (1). Onychomycosis was more frequent in females (79.7) than in males (20.3). These were more common in fingernails (96.1) than in toenails (60) and yeasts were the most isolated etiologic agents. Among the clinical presentations, paronychia (CP) (57.2) and onycholysis (CO) (24.8) were the most common, caused frequently by C. albicans in 52.6 and 60.5 of the cases, respectively. T. rubrum (44.4) and Trichosporon spp (22.2) were the most frequent species in the case of distal lateral subungual onychomycosis (DLSO). Fusarium spp was the agent responsible for 33.3 of the cases of proximal subungual onychomycosis (PSO) and for 14.3 of white superficial onychomycosis (WSO), whereas Acremonium spp was responsible for 14.3 of the cases of WSO.(AU)
Asunto(s)
Humanos , Masculino , Femenino , Lactante , Preescolar , Niño , Adolescente , Adulto , Persona de Mediana Edad , Anciano , Onicomicosis/epidemiología , Acremonium/aislamiento & purificación , Anciano de 80 o más Años , Brasil/epidemiología , Candida albicans/aislamiento & purificación , Candidiasis Cutánea/epidemiología , Candidiasis Cutánea/microbiología , Dedos , Fusarium/aislamiento & purificación , Uñas/microbiología , Onicomicosis/microbiología , Paroniquia/epidemiología , Paroniquia/microbiología , Prevalencia , Tiña/epidemiología , Tiña/microbiología , Dedos del Pie , Trichosporon/aislamiento & purificación , Población UrbanaRESUMEN
1. The interaction between experimental protein deprivation and natural intestinal infection by Giardia lamblia was studied in terms of its effects on the intraepithelial lymphocyte (IEL) population and morphology of the jejunal mucosa of rats of different ages. 2. Young, adult and old male Wistar rats received a protein-deficient diet (2 casein) or a control diet (20 casein) for 42 days. Mucosal height and the number of lymphocytes located among 500 consecutive epithelial cells (EC) along the villi or crossing the basement membrane were determined in PAS-stained jejunal fragments. 3. The number of IEL increased progressively with animal age, from 14 to 25 per 100 epithelial cells, with significant differences between age ranges. However, the number of IEL did not differ between control and protein-deficient rats in any of the age groups. The proportion of lymphocytes crossing the basement membrane was approximately two-fold greater in young (2.8/100 EC) and adult (5.8/100 EC) protein-deficient animals than in their respective controls (1.6 and 2.8/100 EC). The intensity of parasite colonization was moderate, from 3 to 5/100 EC and did not differ between groups. The pattern of morphologic changes of jejunal mucosa in protozoal infection did not differ between control and protein-deficient animals in any of the three age groups. 4. We conclude that intestinal infection with Giardia lamblia probably stimulated the local immune response, masking the reduction of the IEL population induced by protein deficiency. The increase in lymphocyte numbers with age may be related to prolonged antigenic stimulation promoted by infection.
Asunto(s)
Animales , Masculino , Ratas , Deficiencia de Proteína/inmunología , Giardia lamblia , Giardiasis/inmunología , Mucosa Intestinal , Linfocitos T , Factores de Edad , Análisis de Varianza , Peso Corporal , Deficiencia de Proteína/metabolismo , Células Epiteliales , Epitelio , Mucosa Intestinal , Proteínas en la Dieta/administración & dosificación , Proteínas en la Dieta/farmacología , Ratas WistarRESUMEN
Onychomycosis epidemiology is a combination of various factors which include, among others, clinical presentation, etiologic agents of the infection and the patients history background. Out of a total of 672 nail samples examined, 460 (68.4
) were microscopy positive for fungi and 306 (66.5
) of these were culture positive, including Candida (82
), dermatophytes (13.4
), Trichosporon spp (3.6
) and nondermatophyte molds (1
). Onychomycosis was more frequent in females (79.7
) than in males (20.3
). These were more common in fingernails (96.1
) than in toenails (60
) and yeasts were the most isolated etiologic agents. Among the clinical presentations, paronychia (CP) (57.2
) and onycholysis (CO) (24.8
) were the most common, caused frequently by C. albicans in 52.6
and 60.5
of the cases, respectively. T. rubrum (44.4
) and Trichosporon spp (22.2
) were the most frequent species in the case of distal lateral subungual onychomycosis (DLSO). Fusarium spp was the agent responsible for 33.3
of the cases of proximal subungual onychomycosis (PSO) and for 14.3
of white superficial onychomycosis (WSO), whereas Acremonium spp was responsible for 14.3
of the cases of WSO.