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1.
Stem Cell Res Ther ; 13(1): 345, 2022 07 26.
Artículo en Inglés | MEDLINE | ID: mdl-35883198

RESUMEN

Peripheral arterial disease is atherosclerotic occlusive disease of the lower extremity arteries and afflicts hundreds of millions of individuals worldwide. Its most severe manifestation is chronic limb-threatening ischemia (Petersen et al. (Science 300(5622):1140-2, 2003)), which is associated with severe pain at rest in the limbs, which progresses to necrosis, limb amputation, and/or death of the patient. Consequently, the care of these patients is considered a financial burden for both patients and health systems. Multidisciplinary endeavors are required to address this refractory disease and to find definitive solutions that lead to improved living conditions. Revascularization is the cornerstone of therapy for preventing limb amputation, and both open vascular surgery and endovascular therapy play a key role in the treatment of patients with CLI. Around one-third of these patients are not candidates for conventional surgical treatment, however, leading to higher amputation rates (approaching 20-25% at one year) with high morbidity and lower quality of life. Advances in regenerative medicine have enabled the development of cell-based therapies that promote the formation of new blood vessels. Particularly, mesenchymal stem cells (MSCs) have emerged as an attractive therapeutic agent in various diseases, including CLI, due to their role in tissue regeneration and immunomodulation. This review discusses the characteristics of MSCs, as well as their regenerative properties and their action mechanisms on CLI.


Asunto(s)
Recuperación del Miembro , Células Madre Mesenquimatosas , Isquemia Crónica que Amenaza las Extremidades , Humanos , Isquemia/terapia , Extremidad Inferior/irrigación sanguínea , Extremidad Inferior/cirugía , Calidad de Vida , Factores de Riesgo , Resultado del Tratamiento
2.
Rev. colomb. psiquiatr ; 49(3): 202-207, jul.-set. 2020. tab, graf
Artículo en Español | LILACS, COLNAL | ID: biblio-1149828

RESUMEN

RESUMEN Introducción: La neurosífilis es una enfermedad infecciosa crónica ocasionada por Treponema pallidum y puede producir una gran variedad de signos y síntomas neuropsiquiátricos, lo que complica su diagnóstico. Descripción del caso: Se presenta el caso de un paciente de 40 años que consultó al servicio de urgencias por una convulsión de novo, junto con un cuadro crónico de deterioro cognitivo y psicosis. Se le realizaron los estudios pertinentes para el diagnóstico de neurosífilis y se inició el tratamiento recomendado. El paciente presentó mejoría clínica y fue dado de alta. Discusión: Con resultados de serología VDRL positivos y hallazgos imagenológicos de atrofia cortical marcada, se consideró una neurosífilis parenquimatosa de tipo tardío, junto con franco deterioro cognoscitivo y psicosis. Se le dejó tratamiento con penicilina cristalina, que disminuyó la intensidad de los síntomas del paciente; sin embargo, el poco interés de este en asistir a sus controles disminuye sus probabilidades de una recuperación adecuada. Conclusiones: La neurosífilis se debe sospechar en pacientes con síntomas neurológicos o psiquiátricos clínicamente evidentes. El análisis de la serología de VDRL y los estudios de neuroimagen son importantes como evaluación inicial del paciente, que debe complementarse con pruebas cognitivas o examen mental para determinar el estado de deterioro cognitivo.


ABSTRACT Introduction: Neurosyphilis is a chronic infectious disease caused by Treponema pallidum that can cause a great variety of neuropsychiatric signs and symptoms, which complicates its diagnosis. Case description: This case occurred in a 40-year-old man who consulted the Emergency Department because of a convulsion (de novo) which was related to a chronic condition of cognitive impairment and psychosis. The appropriate studies were performed for the diagnosis of neurosyphilis and the recommended treatment was initiated. The patient presented clinical improvement and was discharged. Discussion: Positive VDRL serology results and imaging findings of marked cortical atrophy conducted to consider a late-stage parenchymatous neurosyphilis with serious cognitive impairment and associated psychosis. Treatment with crystalline penicillin was formulated, which reduced the intensity of the patient's symptoms; however, the patient's lack of interest to attend the check-ups significantly reduces his chances of an adequate recovery. Conclusions: Neurosyphilis must be suspected in patients with clinically evident neurological or psychiatric symptoms. Analysis of VDRL serology and neuroimaging studies are important as an initial evaluation of the patient and must be complemented with cognitive tests or mental examination to determine the state of cognitive impairment.


Asunto(s)
Humanos , Masculino , Adulto , Disfunción Cognitiva , Neurosífilis , Penicilinas , Trastornos Psicóticos , Treponema pallidum , Enfermedades Transmisibles , Trastornos Neurocognitivos , Urgencias Médicas , Neuroimagen
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