RESUMEN
Hanseniellachilensis is the only myriapod of the class Symphyla known from Chile. This garden centipede, or pseudocentipede, was described more than 120 years ago based on morphologically incomplete specimens collected in central Chile, a well-known biodiversity hotspot. In this study, we redescribe this species based on morphologically complete specimens collected near the type locality using scanning electron microscope images. Our study provides the description of diagnostic characters hitherto unknown in this species such as macrochaetae of the tergites and spinnerets of the cerci. We also include a new record from central Chile and discuss the presumed presence of this species in Argentina and Madagascar.
RESUMEN
Background: Despite the extensive distribution of COVID-19 vaccines across Latin America, research on their real-world performance remains limited. We aimed to evaluate the effectiveness of five vaccines (BNT162b2, AZD1222, CoronaVac, Gam-COVID-Vac, and Ad5-nCoV) in a cohort of 2,559,792 pensioners covered by the Mexican Institute of Social Security. Methods: We conducted a nested test-negative design study on 28,271 individuals tested for SARS-CoV-2 infection between April and November 2021, accounting for 29,226 separate episodes. We used mixed-effects logistic regression models to estimate the vaccine effectiveness (VE) in fully vaccinated individuals for symptomatic infection, hospitalization, severe disease, and death. Findings: The median age of the study population was 70 years (interquartile range 65-76) and 76.4% (21,598/28,271) were male. VE rates were 56.3%, 75.3%, 79.7%, and 79.8% against symptomatic infection (95% confidence interval [CI]: 53.5-59.0), hospitalization (95% CI: 73.4-77.0), severe disease (95% CI: 78.0-81.3), and death (95% CI: 78.1-81.4), respectively. When evaluating vaccines individually, all showed moderate to high VE, with the best being BNT162b2 (symptomatic infection, 69.8%, 95% CI: 67.3-72.0; hospitalization, 84.1%, 95% CI: 82.5-85.6; severe disease, 88.2%, 95% CI: 86.7-89.5; and death, 88.3%, 95% CI: 86.9-89.6) and Gam-COVID-Vac (symptomatic infection, 70.0%, 95% CI: 64.8-74.4; hospitalization, 86.8%, 95% CI: 83.7-89.3; severe disease, 91.9%, 95% CI: 89.4-93.9; and death, 92.0%, 95% CI: 89.5-93.9). Interpretation: All five SARS-CoV-2 vaccines available for this population showed moderate to high levels of protection against COVID-19 and its progression to severe outcomes. Funding: Fundación IMSS, México.
RESUMEN
Background: The functionality and performance of a health information system should be evaluated from the perspective of those who develop its processes. Considering the above, this study evaluated the performance of the HIV/AIDS Epidemiological Surveillance System (SIVE VIH/SIDA, according to its initials in Spanish) in Chiapas, Mexico. Methods: Qualitative study on the performance, structure and dynamics of SIVE VIH/SIDA, based on interviews with the personnel participating in this surveillance system, using the Updated Guidelines for the Evaluation of Public Health Surveillance Systems. The analysis was performed through the cyclic interactive method of content analysis, from which the evaluation indices were constructed. Results: A total of 32 interviews were conducted. The structure was described as well defined, at the expense of organizational dimensions, procedures and material resources. The dynamics of information, from the perspective of the collection, processing and use of information, was rated as regular. The performance of the SIVE HIV/AIDS in Chiapas was regular at the expense of these attributes of the information system: simplicity, flexibility, quality of data, acceptability, sensitivity, representativeness, timeliness and stability. Conclusions: In order to improve the performance of SIVE VIH/SIDA, it is necessary to strengthen the human resources and use of information dimensions, so that it can be an instrument for action.
Introducción: la funcionalidad y el desempeño de un sistema de información en salud deben evaluarse desde la perspectiva de quienes desarrollan sus procesos. Considerando lo anterior, este estudio evaluó el desempeño del Sistema de Vigilancia Epidemiológica del Virus de Inmunodeficiencia Humana/Síndrome de Inmunodeficiencia Adquirida (SIVE VIH/SIDA) en Chiapas, México. Métodos: estudio cualitativo sobre el desempeño, la estructura y la dinámica del SIVE VIH/SIDA, el cual se llevó a cabo con base en entrevistas al personal que participa en él, de acuerdo con las Guías Actualizadas para la Evaluación de Sistemas de Vigilancia en Salud Pública de los Centros para el Control y la Prevención de Enfermedades. El análisis se hizo con el método interactivo cíclico del análisis de contenido, a partir de lo cual se construyeron los índices de evaluación. Resultados: se hicieron un total de 32 entrevistas. La estructura fue calificada como bien definida, a expensas de las dimensiones organización, procedimientos y recursos materiales. La dinámica de información, desde la perspectiva de la recolección, el procesamiento y el uso de la información, fue calificada como regular. El desempeño del SIVE VIH/SIDA en Chiapas fue regular a expensas de los atributos simplicidad, flexibilidad, calidad de los datos, aceptabilidad, sensibilidad, representatividad, oportunidad y estabilidad. Conclusiones: para mejorar el desempeño del SIVE VIH/SIDA se requiere fortalecer las dimensiones de recursos humanos y el uso de la información, para que así se constituya en un instrumento para la acción.
Asunto(s)
Infecciones por VIH/epidemiología , Sistemas de Información en Salud/normas , Vigilancia en Salud Pública/métodos , Femenino , Infecciones por VIH/diagnóstico , Infecciones por VIH/prevención & control , Humanos , Entrevistas como Asunto , Masculino , México/epidemiología , Evaluación de Programas y Proyectos de Salud , Investigación Cualitativa , Mejoramiento de la CalidadRESUMEN
Background & aims. G-allele of PNPLA3 (rs738409) favours triglycerides accumulation and steatosis. In this study, we examined the effect of quercetin and natural extracts from mushroom and artichoke on reducing lipid accumulation in hepatic cells. MATERIAL AND METHODS: Huh7.5 cells were exposed to oleic acid (OA) and treated with quercetin and extracts to observe the lipid accumulation, the intracellular-TG concentration and the LD size. Sterol regulatory element binding proteins-1 (SREBP-1), peroxisome proliferator-activated receptor (PPARα-γ) and cholesterol acyltransferase (ACAT) gene expression levels were analysed. RESULTS: Quercetin decreased the intracellular lipids, LD size and the levels of intracellular-TG through the down-regulation of SREBP-1c, PPARγ and ACAT1 increasing PPARα. The natural-extracts suppressed OA-induced lipid accumulation and the intracellular-TG. They down-regulate the hepatic lipogenesis through SREBP-1c, besides the activation of lipolysis through the increasing of PPARα expression. CONCLUSIONS: Quercetin and the aqueous extracts decrease intracellular lipid accumulation by down-regulation of lipogenesis and up-regulation of lipolysis.
Asunto(s)
Hepatocitos/efectos de los fármacos , Lipasa/genética , Lipogénesis/efectos de los fármacos , Lipólisis/efectos de los fármacos , Proteínas de la Membrana/genética , Enfermedad del Hígado Graso no Alcohólico/prevención & control , Extractos Vegetales/farmacología , Quercetina/farmacología , Acetil-CoA C-Acetiltransferasa/genética , Acetil-CoA C-Acetiltransferasa/metabolismo , Agaricales , Línea Celular Tumoral , Cynara scolymus , Flores , Genotipo , Hepatocitos/metabolismo , Humanos , Lipasa/metabolismo , Lipogénesis/genética , Lipólisis/genética , Proteínas de la Membrana/metabolismo , Enfermedad del Hígado Graso no Alcohólico/inducido químicamente , Enfermedad del Hígado Graso no Alcohólico/metabolismo , Ácido Oléico/toxicidad , PPAR alfa/genética , PPAR alfa/metabolismo , PPAR gamma/genética , PPAR gamma/metabolismo , Fenotipo , Proteína 1 de Unión a los Elementos Reguladores de Esteroles/genética , Proteína 1 de Unión a los Elementos Reguladores de Esteroles/metabolismoRESUMEN
The aim of this paper is to describe educational programs that reportedly teach how to break bad news in the emergency department. We also suggest some recommendations on how to communicate bad news based on the research of evidence available in the field. The examined evidence points toward six major components with which physicians should familiarize when communicating bad news: 1) doctor-patient empathic communication, 2) establishing a proper space to give the news, 3) identifying characteristics of the person who receives the news, 4) essential aspects for communicating the news; 5) emotional support, and 6) medical and administrative aspects of the encounter. Finally, we point out several limitations in the studies in the field and future challenges identified in the communication of bad news in emergency room facilities.
El objetivo del presente trabajo es reseñar una descripción de los programas educativos que incluyen el entrenamiento de la comunicación de malas noticias a médicos pertenecientes al departamento de urgencias. Además se hacen recomendaciones sobre cómo dar malas noticias con base en la evidencia de investigación hasta ahora disponible en las áreas de urgencias. De acuerdo con la información obtenida, es factible identificar seis grandes áreas con las que el médico requiere familiarizase cuando comunica malas noti cias: 1) comunicación empática médico-paciente, 2) preparación del ambiente para dar la noticia, 3) identificación de las características de quien recibe la noticia, 4) aspectos indispensables al comunicar la noticia, 5) manejo de reacciones emocionales y 6) aspectos médicos, administrativos y del cierre del encuentro. Finalmente, se describen las limitaciones que parecen caracterizar a los estudios en el área y se señalan los retos futuros en la comunicación de malas noticias en urgencias médicas.
Asunto(s)
Servicio de Urgencia en Hospital , Relaciones Médico-Paciente , Relaciones Profesional-Familia , Revelación de la Verdad , Competencia Clínica , Empatía , Humanos , Apoyo SocialRESUMEN
Fundamento: la Medicina Natural y Tradicional constituye un método eficaz e inocuo que enriquece el arsenal terapéutico de la medicina occidental. Objetivo: diseñar acciones metodológicas para la incorporación de los contenidos de la Medicina Natural y Tradicional en la asignatura Medicina Interna. Métodos: se realizó una investigación de desarrollo con enfoque cualitativo en el Hospital Universitario "Arnaldo Milián Castro", en los meses de abril a junio de 2013, con estudiantes de tercer año de la carrera de Medicina; se utilizaron métodos del nivel teórico: análisis-síntesis e inducción-deducción y empíricos: el análisis documental, la observación, y la encuesta en forma de entrevista. Resultados: a través de la revisión del Plan de Estudio de la asignatura Medicina Interna de 3er año, la observación a actividades y la entrevista a los docentes, se constató que el nivel de integración de sus contenidos con la Medicina Natural y Tradicional aún no es el deseado, es insuficiente el tratamiento metodológico realizado para la implementación de esta estrategia curricular. Sobre la base de los resultados anteriores se diseñaron acciones metodológicas para integrar sus contenidos en el tratamiento de algunas de las enfermedades que contempla la asignatura Medicina Interna. Conclusiones: las acciones diseñadas permiten la integración de los contenidos y fueron valoradas como efectivas por su metodología, pertinencia, factibilidad y relevancia.
Background: the Herbal and Folk Medicine constitutes an effective and innocuous method that enriches the therapeutic arsenal of the western medicine. Objective: to design methodological actions for the incorporation of the contents of Herbal and Folk Medicine to the subject Internal Medicine. Methods: it was carried out a development investigation within the qualitative approach in the University Hospital "Arnaldo Milián Castro", from April to June 2013, with students of third year of the Medicine career; methods of the theoretical level were used: analysis-synthesis and induction-deduction and empiric ones: the documental analysis, the observation, and the survey in interview form. Results: through the revision of the Study Plan of the Internal Medicine subject in the 3rd year of the career, the observation to activities and the interview to the professors, it was verified that the level of integration of its contents with the Herbal and Folk Medicine is not still the one desired, it is insufficient the methodological treatment carried out for the implementation of this curricular strategy. On the base of the previous results, methodological actions were designed to integrate their contents in the treatment of some of the diseases that contemplates the Internal Medicine discipline. Conclusions: the designed actions allow the integration of the contents and they were valued as effective by their methodology, relevancy, feasibility and relevance.
Asunto(s)
Integración Escolar , Curriculum , Educación Médica , Medicina Interna , Medicina TradicionalRESUMEN
Fundamento: la Medicina Natural y Tradicional constituye un método eficaz e inocuo que enriquece el arsenal terapéutico de la medicina occidental.Objetivo: diseñar acciones metodológicas para la incorporación de los contenidos de la Medicina Natural y Tradicional en la asignatura Medicina Interna. Métodos: se realizó una investigación de desarrollo con enfoque cualitativo en el Hospital Universitario Arnaldo Milián Castro, en los meses de abril a junio de 2013, con estudiantesde tercer año de la carrera de Medicina; se utilizaron métodos del nivel teórico: análisis-síntesis e inducción-deducción y empíricos: el análisis documental, la observación, y laencuesta en forma de entrevista.Resultados: a través de la revisión del Plan de Estudio de la asignatura Medicina Interna de 3er año, la observación a actividades y la entrevista a los docentes, se constató que el nivel de integración de sus contenidos con la Medicina Natural y Tradicional aún no es el deseado,es insuficiente el tratamiento metodológico realizado para la implementación de esta estrategia curricular. Sobre la base de los resultados anteriores se diseñaron acciones metodológicas para integrar sus contenidos en el tratamiento de algunas de las enfermedades que contempla la asignatura Medicina Interna. Conclusiones: las acciones diseñadas permiten la integración de los contenidos y fueron valoradas como efectivas por su metodología, pertinencia, factibilidad y relevancia(AU)
Asunto(s)
Comunicación Interdisciplinaria , Medicina Interna , Medicina Tradicional , Educación MédicaRESUMEN
HDV infection may occur within a primary HBV infection (co-infection) or by sub sequent acquisition ofthe virus in patients with chronic hepatitis B (superinfection). Acute HDV infection is rarely diagnosed. Since cero conversion usually takes place about six weeks after viral infection, early diagnosis requires the use of direct diagnostic techniques, such as antigen HD V (HDAg) detection, or genomic amplification by means of molecular biology methods (RT-PCR). Here were port the case of a patient with chronic HBV infection that develops a severe acute hepatitis due to VHD superinfec- tion only detected by molecular biology.
Asunto(s)
Coinfección/diagnóstico , Hepatitis D/diagnóstico , Virus de la Hepatitis Delta/inmunología , Sobreinfección/diagnóstico , Enfermedad Aguda , Adulto , Biomarcadores/sangre , Coinfección/sangre , Anticuerpos Antihepatitis/sangre , Hepatitis B/sangre , Hepatitis B/diagnóstico , Hepatitis D/sangre , Humanos , Masculino , Sobreinfección/sangreRESUMEN
BACKGROUND: Atherosclerosis severity-independent alterations in DNA methylation, a reversible and highly regulated DNA modification, have been detected in aortic atheromas, thus supporting the hypothesis that epigenetic mechanisms participate in the pathogenesis of atherosclerosis. One yet unaddressed issue is whether the progression of atherosclerosis is associated with an increase in DNA methylation drift in the vascular tissue. The purpose of the study was to identify CpG methylation profiles that vary with the progression of atherosclerosis in the human aorta. METHODS: We interrogated a set of donor-matched atherosclerotic and normal aortic samples ranging from histological grade III to VII, with a high-density (>450,000 CpG sites) DNA methylation microarray. RESULTS: We detected a correlation between histological grade and intra-pair differential methylation for 1,985 autosomal CpGs, the vast majority of which drifted towards hypermethylation with lesion progression. The identified CpG loci map to genes that are regulated by known critical transcription factors involved in atherosclerosis and participate in inflammatory and immune responses. Functional relevance was corroborated by crossing the DNA methylation profiles with expression data obtained in the same human aorta sample set, by a transcriptome-wide analysis of murine atherosclerotic aortas and from available public databases. CONCLUSIONS: Our work identifies for the first time atherosclerosis progression-specific DNA methylation profiles in the vascular tissue. These findings provide potential novel markers of lesion severity and targets to counteract the progression of the atheroma.
Asunto(s)
Aorta/patología , Aterosclerosis/genética , Aterosclerosis/patología , Metilación de ADN , Animales , Análisis por Conglomerados , Islas de CpG , Bases de Datos Genéticas , Progresión de la Enfermedad , Epigénesis Genética , Humanos , Sistema Inmunológico , Inflamación/patología , Ratones , Ratones Endogámicos C57BL , Ratones Noqueados , Análisis de Secuencia por Matrices de Oligonucleótidos , Placa Aterosclerótica/patología , Factores de Transcripción/metabolismoAsunto(s)
Antimetabolitos Antineoplásicos/administración & dosificación , Carcinoma de Células Escamosas/tratamiento farmacológico , Metotrexato/administración & dosificación , Neoplasias Cutáneas/tratamiento farmacológico , Anciano de 80 o más Años , Carcinoma de Células Escamosas/cirugía , Quimioterapia Adyuvante , Humanos , Inyecciones Intralesiones , Masculino , Terapia Neoadyuvante , Neoplasias Cutáneas/cirugíaRESUMEN
A woman in her 30s was brought to the hospital with abnormal movements. Three months prior, the patient had exacerbation of the movements after an episode of recurrent pharyngitis. Neurological examination revealed, violent involuntary movement that affected both upper and lower limbs, hypotonia and ataxia. Other findings including emotional instability and involuntary movements were considered ballistic. Throat culture showed ß haemolytic streptococci, tonsillectomy and specific antibiotic improved bilateral ballism and psychiatic disorder. This is the first report of bilateral ballism poststreptococcal infection.
Asunto(s)
Discinesias/etiología , Faringitis/terapia , Infecciones Estreptocócicas/complicaciones , Adulto , Antibacterianos/uso terapéutico , Depresión/complicaciones , Discinesias/diagnóstico , Femenino , Humanos , Penicilinas/uso terapéutico , Faringitis/microbiología , Púrpura/complicaciones , TonsilectomíaRESUMEN
OBJECTIVE: The aim of the project was to assess the effectiveness and safety of weekly epoetin-beta (EB) in patients with gastrointestinal cancer (GIC) subjected to concomitant chemoradiotherapy (CCTRT). METHODS: In this clinical prospective and multicentre cohort study EB was administered at a dose of 30,000 IU/ week, during CCTRT and in the four weeks thereafter, and suspended if haemoglobin (Hb) increased >2 g/dl or Hb >12-13 g/dl. Effectiveness was defi ned as Hb increase ≥1 g/dl vs. baseline. Time to response, treatment toxicity and transfusion requirements were also assessed. RESULTS: EB was effective in 75.8% of the evaluable population within a median of four weeks from EB initiation, without blood transfusions. Over 80% of all patients remained below the threshold (Hb ≤13 g/dl) and no study drug-related adverse reactions were recorded. CONCLUSION: Weekly EB proved to be effective and well tolerated by patients with GIC subjected to CCTRT.
Asunto(s)
Anemia/etiología , Antineoplásicos/administración & dosificación , Eritropoyetina/administración & dosificación , Neoplasias Gastrointestinales/terapia , Adulto , Anciano , Anciano de 80 o más Años , Anemia/metabolismo , Antineoplásicos/uso terapéutico , Quimioradioterapia , Estudios de Cohortes , Esquema de Medicación , Eritropoyetina/uso terapéutico , Femenino , Neoplasias Gastrointestinales/complicaciones , Hemoglobinas , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Proteínas Recombinantes/administración & dosificación , Proteínas Recombinantes/uso terapéutico , Resultado del TratamientoRESUMEN
INTRODUCTION: Endometrial cancer (EC) is the second most common gynecologic malignancy worldwide in the peri and postmenopausal period. Most often for the endometrioid variety. In early clinical stages long-term survival is greater than 80%, while in advanced stages it is less than 50%. In our country there is not a standard management between institutions. GICOM collaborative group under the auspice of different institutions have made the following consensus in order to make recommendations for the management of patients with this type of neoplasm. MATERIAL AND METHODS: The following recommendations were made by independent professionals in the field of Gynecologic Oncology, questions and statements were based on a comprehensive and systematic review of literature. It took place in the context of a meeting of four days in which a debate was held. These statements are the conclusions reached by agreement of the participant members. RESULTS: Screening should be performed women at high risk (diabetics, family history of inherited colon cancer, Lynch S. type II). Endometrial thickness in postmenopausal patients is best evaluated by transvaginal US, a thickness greater than or equal to 5 mm must be evaluated. Women taking tamoxifen should be monitored using this method. Abnormal bleeding in the usual main symptom, all post menopausal women with vaginal bleeding should be evaluated. Diagnosis is made by histerescopy-guided biopsy. Magnetic resonance is the best image method as preoperative evaluation. Frozen section evaluates histologic grade, myometrial invasion, cervical and adnexal involvement. Total abdominal hysterectomy, bilateral salpingo oophorectomy, pelvic and para-aortic lymphadenectomy should be performed except in endometrial histology grades 1 and 2, less than 50% invasion of the myometrium without evidence of disease out of the uterus. Omentectomy should be done in histologies other than endometriod. Surgery should be always performed by a Gynecologic Oncologist or Surgical Oncologist, laparoscopy is an alternative, especially in patients with hypertension and diabetes for being less morbid. Adjuvant treatment after surgery includes radiation therapy to the pelvis, brachytherapy, and chemotherapy. Patients with Stages III and IV should have surgery with intention to achieve optimal cytoreduction because of the impact on survival (51 m vs. 14 m), the treatment of recurrence can be with surgery depending on the pattern of relapse, systemic chemotherapy or hormonal therapy. Follow-up of patients is basically clinical in a regular basis. CONCLUSIONS: Screening programme is only for high risk patients. Multidisciplinary treatment impacts on survival and local control of the disease, including surgery, radiation therapy and chemotherapy, hormonal treatment is reserved to selected cases of recurrence. This is the first attempt of a Mexican Collaborative Group in Gynecology to give recommendations is a special type of neoplasm.
Asunto(s)
Carcinoma , Neoplasias Endometriales , Antineoplásicos/uso terapéutico , Carcinoma/diagnóstico , Carcinoma/epidemiología , Carcinoma/patología , Carcinoma/terapia , Quimioterapia Adyuvante , Terapia Combinada , Diagnóstico por Imagen , Neoplasias Endometriales/diagnóstico , Neoplasias Endometriales/epidemiología , Neoplasias Endometriales/patología , Neoplasias Endometriales/terapia , Antagonistas de Estrógenos/efectos adversos , Terapia de Reemplazo de Estrógeno/efectos adversos , Estrógenos/efectos adversos , Medicina Basada en la Evidencia , Femenino , Humanos , Histerectomía/métodos , Laparoscopía , Escisión del Ganglio Linfático , Tamizaje Masivo , México , Estadificación de Neoplasias/métodos , Radioterapia Adyuvante , Factores de Riesgo , Terapia Recuperativa , Tamoxifeno/efectos adversosRESUMEN
BACKGROUND: From the perspective of participative education, the critical reading of investigative reports can be developed from the first formation year. The objective was to evaluate the effect of an educational strategy to promote the participation in the development of attitudes for critical reading in the first semester of a technical career. METHODS: An instrument to determine the aptitude development was developed, validated and applied. It included comprehension, interpretation, judgment and proposal indicators. The educational strategy was implemented through discussion seminars, and promoted student participation. RESULTS: The median and the interpretation indicator increased from 38 to 56 and from 12 to 19 points, respectively (p < 0.05). The developmental aptitude of critical reading was increased 25% in all students. CONCLUSIONS: Promotion of an educational participation strategy favors the aptitude for critical reading of investigation reports in a group of students in the first semester of their nutrition career.
Asunto(s)
Juicio , Ciencias de la Nutrición/educación , Lectura , Estudiantes , Humanos , Estudios Longitudinales , Edición , Encuestas y CuestionariosRESUMEN
El Angiostrongylus Cantonensis también conocido como el parásito pulmonar de la rata, en donde el hombre puede ser un hospedero accidental cuando consume moluscos con larvas viables, produce una meningoencefalitis que se caracteriza por un elevado número de eosinófilos en el líquido cefaloraquídeo. La angioestrongiloidiasis poco frecuente en nuestro medio, tiene dos especies de Angiostrongylus que producen dos enfermedades características en el hombre: la meningitis eosinofílica, por el A. Cantonensis y la angioestrongiloidiasis abdominal; producida por el A. Costarricensis, reportada en Ecuador por primera vez en 1974. La meningitis eosinofílica por A. cantonensis es una enfermedad endémica del sudeste asiático desde 1.935; en el continente americano, Cuba reportó los primeros casos en 1981; en Ecuador nunca antes se había informado esta parasitosis, considerándola hasta entonces como una enfermedad exótica. El reporte de este caso tiene por objetivo informar a la comunidad médica de la existencia de esta parasitosis en nuestro medio ambiente, así como revisar los hallazgos anatomopatológicos de esta enfermedad.
Angiostrongylus cantonense also known as pulmonary parasite of rats, of which men can be accidental hosts when ingesting molluscs with viable larvae, meningoencephalitis appears. It is characterized by a high amount of eosinophil in the cephalospinal fluid. Angiostrongiliasis, which is not very common in our environment, has two species of angiostrongylus which produce two characteristic diseases in men: eosinophilic meningitis produced by A. Cantonensis and abdominal Angioestrongiloidiasis; produced by A. Costa Rican, reported in Ecuador for the first time in 1974. Eosinophilic meningitis by A. Cantonese is a South-east Asian endemic disease since 1935; in the American continent, Cuba reported the first cases in 1981; Ecuador had never reported this parasitosis before, considered then, an exotic disease. The report of this case is meant to inform the community of the existence of this parasitosis in our environment, as well as to check the anatomic-patholigical findings of this disease.
Asunto(s)
Masculino , Adulto Joven , Angiostrongylus cantonensis , Meningitis , Infecciones por Strongylida , Autopsia , EosinofiliaRESUMEN
Paciente femenina de 26 años de edad, quien es referida en posoperatorio de ooforectomía derecha, cuya biopsia reporta teratoma quístico maligno, patrón epitelial tipo adenoescamoso. Es reintervenida con laparotomía estadificadora donde se evidencia hallazgos de plastrones tumorales en peritoneo pélvico, mesocolon y epiplón, además múltiples adenopatías pre aórticas, ausencia de ovario derecho, y ovario izquierdo con tumor quístico de 6 cm de diámetro, adherido a la trompa ipsilateral y el piso pélvico. La biopsia definitiva reporta adenocarcinoma moderadamente diferenciado con diferenciación escamosa infiltrando ovario izquierdo, pared de la trompa uterina izquierda, parametrios derecho, izquierdo, piso pélvico, peritoneo y epiplón inframesocólico. Recibe quimioterapia adyuvante con esquema de paclitaxel y carboplatino por 4 ciclos. Al mes de terminar el tratamiento adyuvante presenta sangrado genital, evidenciándose lesión en cúpula vaginal cuya biopsia reporta carcinoma epidermoide moderadamente diferenciado. Se planifica tratamiento con doxorrubicina, ifosfamida y mesna combinado con radioterapia externa pélvica y braquiterapia complementaria.
We report the case of 26 year old female patient who is referred after undergoing right oophorectomy. The pathology of the surgical specimen was reported as malignant cystic teratoma with adenosquamous epithelial pattern. Staging laparotomy is performed. The surgical findings were: tumor implants in pelvic peritoneum, mesocolon, omentum. paraortic lymphadenopaties. Left ovary with 6 cm cystic tumor on its surface firmly adhered to the ipsilateral fallopian tube and pelvic wall. Absence of right ovary. Pathology reports moderately differentiated adenocarcinoma with squamous differentiation infiltrates left ovary, left fallopian tube, right and left parametria, pelvic wall and inframesocolic omentum. Adjuvant chemotherapy based on paclitaxel carboplatin for 4 cycles. One month after ending adjuvant treatment refers vaginal bleeding. After detailed gynecologic evaluation, an exophytic lesion on the vaginal vault is found. The biopsy reports moderately differentiated squamous carcinoma. Combined therapy based on chemotherapeutic agents (doxorubicin, iphosphamide and mesna) and external radiotherapy was scheduled.
Asunto(s)
Humanos , Adulto , Femenino , Carcinoma Adenoescamoso/diagnóstico , Doxorrubicina/uso terapéutico , Ifosfamida/uso terapéutico , Neoplasias Ováricas/cirugía , Neoplasias Ováricas/patología , Neoplasias Ováricas , Oncología Médica , Teratoma/patologíaRESUMEN
Se investigó el efecto de los biosurfactantes en la eficiencia de los procesos de recuperación de aguas contaminadas con crudo liviano. El biosurfactante utilizado fue producido a partir de cepas bacterianas (MI9 y MI10) pertenecientes al grupo de cepas del Laboratorio de Microbiología Industrial del Centro de Investigación del Agua, Universidad del Zulia, Venezuela. Para el estudio de tratabilidad, durante tres meses, además del biosurfactante utilizado, se preparó un cultivo mixto con las cepas bacterianas MI5, MI7, MI9, MI10, y MI11. Los tratamientos aplicados fueron: agua del Lago de Maracaibo, hidrocarburo, cultivo mixto y biosurfactante (ANHCB); agua del lago esterilizada, hidrocarburo y cultivo mixto (AEHC); agua del lago, hidrocarburo y cultivo mixto (ANHC); agua del lago, hidrocarburo y biosurfactante (ANHB); y agua del lago e hidrocarburo (ANH). Los análisis físico-químicos y microbiológicos permitieron determinar la eficiencia del biosurfactante y el cultivo mixto en la biorremediación. Los resultados mostraron que el mejor ensayo de tratabilidad fue el ANHCB, con una remoción del 81% de los hidrocarburos totales y la mayor remoción del N y P presentes. La adición del biosurfactante y utilización del cultivo mixto influenciaron positivamente la biodegradación del crudo liviano, lo cual permite inferir que el uso de biosurfactante es una opción que incrementa la eficiencia en los procesos de biorremediación de aguas contaminadas con hidrocarburo.