RESUMO
We propose a taxonomic revision of the dixenous trypanosomatids currently classified as Endotrypanum and Leishmania, including parasites that do not fall within the subgenera L. (Leishmania) and L. (Viannia) related to human leishmaniasis or L. (Sauroleishmania) formed by leishmanias of lizards: L. colombiensis, L. equatorensis, L. herreri, L. hertigi, L. deanei, L. enriettii and L. martiniquensis. The comparison of these species with newly characterized isolates from sloths, porcupines and phlebotomines from central and South America unveiled new genera and subgenera supported by past (RNA PolII gene) and present (V7V8 SSU rRNA, Hsp70 and gGAPDH) phylogenetic analyses of the organisms. The genus Endotrypanum is restricted to Central and South America, comprising isolates from sloths and transmitted by phlebotomines that sporadically infect humans. This genus is the closest to the new genus Porcisia proposed to accommodate the Neotropical porcupine parasites originally described as L. hertigi and L. deanei. A new subgenus Leishmania (Mundinia) is created for the L. enriettii complex that includes L. martiniquensis. The new genus Zelonia harbours trypanosomatids from Neotropical hemipterans placed at the edge of the Leishmania-Endotrypanum-Porcisia clade. Finally, attention is drawn to the status of L. siamensis and L. australiensis as nomem nudums.
Assuntos
Leishmania/genética , Filogenia , Trypanosomatina/classificação , Animais , América Central/epidemiologia , Genes de Protozoários , Humanos , Leishmaniose/epidemiologia , Leishmaniose/parasitologia , Leishmaniose/transmissão , Lagartos/parasitologia , Tipagem Molecular , Porcos-Espinhos/parasitologia , Psychodidae/parasitologia , RNA Ribossômico/genética , Bichos-Preguiça/parasitologia , América do Sul/epidemiologia , Trypanosomatina/genéticaRESUMO
El hombro doloroso no es diagnóstico específico, pues abarca disímiles diagnósticos cuyos límites son poco exactos y pueden solaparse. Es una patología de bastante frecuencia en la población en general. El tratamiento con radiofrecuencia pulsada se ha vuelto cada vez más popular en la terapia del hombro doloroso crónico, debido a su duradero efecto y a la ausencia de daños. Específicamente, la radiofrecuencia del nervio supraescapular se emplea en el tratamiento del hombro doloroso crónico para varias patologías. Este trabajo de fin de máster pretende abordar la importancia del uso de la radiofrecuencia pulsada del nervio supraescapular para tratamiento del hombro doloroso. Para ello se realizó una revisión sistemática, a partir de una selección crítica de la literatura científica sobre esta temática, disponible desde 2000 hasta la fecha, utilizando como fuentes bibliográficas las plataformas Google Scholar, Web of Science, PubMed y Scopus. Fueron examinados de manera crítica 47 trabajos, seleccionados después de filtrar los registros iniciales siguiendo los criterios de inclusión y exclusión. Los estudios consultados demuestran la eficacia de la técnica en el tratamiento del dolor crónico de hombro, especialmente con la guía de la ecografía. Por lo general los estudios incluyen tres tipos de valoraciones: la valoración clínica del dolor, la valoración funcional, y la valoración de la respuesta al tratamiento. Se observan mejoras en cuanto al dolor, la flexión, abducción y rotación del hombro, las cuales se mantienen hasta los seis meses. Varios estudios combinan la técnica con otros tratamientos, lo que puede resultar prometedor para el futuro.(AU)
Shoulder pain is not a specific diagnosis, since it encompasses dissimilar diagnoses, whose limits are imprecise and may overlap. It is a fairly common pathology in the general population. Pulsed radiofrequency treatment has become increasingly popular in chronic painful shoulder therapy due to its long-lasting effect and absence of damage. Specifically, the radiofrequency of the suprascapular nerve is used in the treatment of chronic painful shoulder, for various pathologies. This Masters Project aims to address the importance of the use of pulsed radiofrequency of the suprascapular nerve for the treatment of painful shoulder. For them, a systematic review was carried out, based on a critical selection of the scientific literature on this subject, available from 2000 to date, using the Google Scholar, Web of Science, PubMed and Scopus platforms as bibliographic sources. Forty-seven works were critically examined, selected after filtering the initial records following the inclusion and exclusion criteria. The studies consulted demonstrate the efficacy of the technique in the treatment of chronic shoulder pain, especially with ultrasound guidance. Studies generally include three types of assessments: clinical pain assessment, functional assessment, and treatment response assessment. Improvements in pain, flexion, abduction and rotation of the shoulder are observed, which are maintained up to six months. Several studies combine the technique with other treatments, which may be promising for the future. Among the main limitations to the use of the technique are that there are currently limited data on the use of pulsed radiofrequency for chronic pediatric pain, the feasibility of patient follow-up, and questions about the ideal parameters (time, voltage, frequency, pulse duration), to achieve the improvement of radiofrequency treatments.(AU)