Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 15 de 15
Filtrar
1.
Ginecol. obstet. Méx ; Ginecol. obstet. Méx;92(7): 303-314, ene. 2024. tab, graf
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1574927

RESUMO

Resumen OBJETIVO: Determinar si existe asociación entre los polimorfismos G-308A (rs1800629) y G-238A (rs361525) del promotor del factor de necrosis tumoral alfa y la pérdida gestacional recurrente. MATERIALES Y MÉTODOS: Estudio observacional, transversal, descriptivo de casos y controles llevado a cabo entre enero de 2020 y diciembre de 2021 en el Hospital de la Mujer de Aguascalientes y en el Laboratorio de Virología e Ingeniería Genética de la Universidad Autónoma de Aguascalientes. Se estudiaron pacientes con pérdidas gestacionales recurrentes y sin éstas, con embarazo normal (controles). RESULTADOS: Se estudiaron 300 pacientes: 150 con pérdida gestacional recurrente y 150 con embarazo normal (controles). Se encontraron 19 pacientes (12.6%) con pérdida gestacional recurrente primaria y 131 (87.4%) con pérdida gestacional recurrente secundaria. Las pacientes con pérdida gestacional recurrente tuvieron, significativamente, mayor edad (28 ± 6.43 en comparación con 26 ± 6.07 años; p = 0.006), más abortos (mediana de 2 en comparación con 0; p = 0.049) y menos semanas de gestación (13.18 ± 12.51 en compoaración con 34.55 ± 10.99; p = 0.0001) que las pacientes del grupo control. De los diferentes modelos genéticos, ninguno demostró un incremento significativo de riesgo para G-308A (rs1800629); sin embargo, para G-238A (rs361525) los modelos heterocigoto (RM 4.36, IC95%: 1.2-15.78; p = 0.012) y dominante (RM 4.36, IC95%: 1.42-13.36; p = 0.005) sí mostraron un aumento de probabilidad. En el análisis multivariado ninguna variable clínica demostró significación estadística. CONCLUSIÓN: En el grupo estudiado, el polimorfismo G-238 A (rs361525) del gen TNF-α mostró asociación con la pérdida gestacional recurrente, no así el polimorfismo G-308A (rs1800629).


Abstract OBJECTIVE: To determine if there is an association between polymorphisms G-308A (rs1800629) and G-238A (rs361525) of the tumor necrosis factor alpha (TNF-α) with the presence of recurrent pregnancy loss in patients treated at the Women's Hospital of the City of Aguascalientes. MATERIALS AND METHODS: An observational, case-control study was conducted in 150 patients with recurrent pregnancy loss and 150 patients with normal pregnancies. Different clinical variables were studied and the polymorphisms of the TNF-α tumor gene, G-308A (rs1800629) and G-238A (rs361525). Were genotyped by restriction fragment length polymorphism (RFLP) reaction and the prevalences of the genotypes between both groups was compared, as well as the Odds ratios (OR) of the genotypes and mutated alleles using various genetic models. Multivariate analysis was performed to determine the effect of clinical variables and the presence of these polymorphisms. RESULTS: Patients with recurrent pregnancy loss were significantly older, had more miscarriages and a lower gestational age than those in the control group. For the G-308A (rs1800629) polymorphism, no significant difference was observed in the prevalences between both groups. For G-238A (rs361525) the prevalence was 6.7% for patients and 1.7% for women with normal pregnancies, with a statistically significant difference (p = 0.004). None of the different genetic models showed a significant increase for G-308A (rs1800629), however, for G-238A (rs361525) the heterozygous (OR 4.36, 95%IC: 1.2-15.78; p=0.012) and dominant (OR 4.36, 95%IC: 1.42-13.36, p=0.005) models did show an increase in said probability. In the multivariate analysis, no clinical variable showed statistical significance. CONCLUSION: The G-238A (rs361525) polymorphism of the tumor necrosis factor alpha gene shows an association, and a higher risk of recurrent pregnancy loss in our population.

2.
Ginecol. obstet. Méx ; Ginecol. obstet. Méx;90(6): 504-512, ene. 2022. tab, graf
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1404934

RESUMO

Resumen OBJETIVO: Comparar el índice neutrófilo-linfocito, la relación plaquetas-linfocito y la distribución de la anchura del eritrocito de mujeres con preeclampsia con o sin criterios de severidad y los de mujeres sin ésta. MATERIALES Y MÉTODOS: Estudio retrospectivo, de casos y controles, efectuado en mujeres con y sin preeclampsia atendidas entre enero y diciembre de 2019. RESULTADOS: Se estudiaron 70 mujeres con preeclampsia y 70 con embarazo sin esta complicación. El índice neutrófilo-linfocito fue significativamente mayor en las mujeres con preeclampsia (4.11 ± 2.76; IC95%: 3.47-4.75) que en las mujeres sin esta complicación (2.99 ± 1.6; IC95%: 2.62-3.36; p = 0.004), similar a la relación plaquetas-linfocitos (117.61 ± 47.53; IC95%:106.48-128.24 vs 97.64 ± 43.67; IC95%: 87.41-107.87; p = 0.006) y para la distribución de la anchura del eritrocito (14.46 ± 1.9; IC95%: 14.02-14.9 vs 13.56 ± 1.38; IC95%: 13-13.72; p = 0.0002). Ninguno de estos parámetros logró discriminar entre las pacientes con preeclampsia con o sin criterios de severidad. CONCLUSIÓN: Un índice neutrófilo-linfocito ≥ 5.1 y una relación plaquetas-linfocito ≥ 113.1 son capaces de discriminar de manera adecuada entre preeclampsia con o sin criterios de severidad.


Abstract OBJECTIVE: To compare the neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and erythrocyte width distribution, of women with preeclampsia with or without severity criteria and those of women without. MATERIALS AND METHODS: Retrospective case-control study in 70 women with preeclampsia and 70 with normal pregnancy between January and December 2019. RESULTS: Seventy women with preeclampsia and 70 with pregnancy without this complication were studied. The neutrophil-lymphocyte ratio was significantly higher in women with preeclampsia (4.11 ± 2.76; 95%CI: 3.47-4.75), than in women with normal pregnancies (2.99 ± 1.6; 95%CI: 2.62-3.36; p = 0.004); which is similar for the platelet-lymphocyte ratio (117.61 ± 47.53, 95%CI: 106.48-128.24 vs 97.64 ± 43.67; 95%CI: 87.41-107.87; p = 0.006) and for the distribution of the width of the erythrocyte; (14.46 ± 1.9, CI95%: 14.02-14.9 vs 13.56 ± 1.38; CI95%: 13-13.72; p = 0.0002). None of these parameters was able to discriminate between patients with preeclampsia with or without severity criteria. A neutrophil-lymphocyte ratio ≥ 5.1 discriminates between women with a normal pregnancy and those with preeclampsia with or without severity criteria [area under the curve of 0.746, (95%CI: 0.664-0.827)], sensitivity 42%, specificity 91%, positive predictive value 82%, negative predictive value 60% and Odds Ratio 7.1 (95%CI: 2.7-18.6, p = 0.001). The platelet-lymphocyte ratio ≥ 113.4 can discriminate between women with a normal pregnancy and preeclampsia with or without severity criteria, with an area under the curve of 0.617 (95% CI 0.525-0.709). CONCLUSION: A neutrophil-lymphocyte ratio ≥ 5.1, and a platelet-lymphocyte ratio ≥ 113.1 are able to adequately discriminate between patients with normal pregnancy and those with preeclampsia with or without severity criteria.

3.
Rev Med Inst Mex Seguro Soc ; 58(1): 21-27, 2020 01 01.
Artigo em Espanhol | MEDLINE | ID: mdl-32413253

RESUMO

Background: Chlamydia trachomatis infection in women has been strongly associated with early membrane rupture and pre-term labor; however, the evidence linking Chlamydia trachomatis infection and early miscarriage is inconsistent. Objective: To determine if there is an association between Chlamydia trachomatis infection and early abortion in a group of women from Aguascalientes, Mexico. Material and methods: 108 early abortion product samples were analyzed using polymerase chain reaction technique, along with 42 samples that belonged to 42 patients with a normal pregnancy, in order to determine the presence of Chlamydia trachomatis. The strength of association between early abortion and Chlamydia trachomatis infection was measured with odds ratio (OR) and 95% confidence intervals (95% CI). A value of p < 0.05 was considered statistically significant. Results: Chlamydia trachomatis infection was positive in 39 of 150 patients (26%), in 37 of 108 women with early abortion (34%) and in two of 42 of women with uneventful control pregnancies (4.7%) (p = 0.002). We observed a positive association between the risk of early miscarriage and Chlamydia trachomatis infection (OR = 10.42, 95% CI, 2.39 45.54, p = 0.002). Conclusions: We found a higher frequency of Chlamydia trachomatis infection than the one previously reported in our country, and a higher risk of early abortion for Chlamydia trachomatis infection (10.42) in pregnant women, which suggests the necessity of including the molecular study of this pathogen in women in prenatal control.


Introducción: la infección por Chlamydia trachomatis es un factor de riesgo bien establecido en pacientes con ruptura prematura de membranas y parto prematuro; sin embargo, su papel en el riesgo de aborto temprano es incierto. Objetivo: determinar si existe asociación entre la presencia de infección por Chlamydia trachomatis y aborto temprano en un grupo de mujeres de Aguascalientes, México. Material y métodos: se estudiaron muestras de 108 productos de aborto temprano y 42 pacientes con embarazo normal mediante reacción en cadena de la polimerasa de punto final para determinar la presencia de Chlamydia trachomatis. Se evaluó la magnitud de la asociación entre aborto temprano e infección por este microrganismo con razón de momios (RM) e intervalos de confianza al 95% (IC 95%). Un valor de p < 0.05 se consideró significativo. Resultados: se encontró Chlamydia trachomatis en 39 de las 150 pacientes (26%), en 37 de 108 mujeres con aborto temprano (34.2%) y en dos de 42 mujeres con embarazo normal (4.7%) (p = 0.002). Se observó asociación positiva del riesgo de aborto temprano e infección por Chlamydia trachomatis con RM de 10.42, IC 95%: 2.39 45.54, p = 0.002. Conclusiones: encontramos una frecuencia de infección por Chlamydia trachomatis más elevada que la reportada previamente en nuestro país y un riesgo significativamente mayor de aborto temprano en mujeres embarazadas con esta infección (10.42), lo que sugiere la necesidad de incluir el estudio molecular de este patógeno en mujeres en control prenatal.


Assuntos
Aborto Espontâneo , Infecções por Chlamydia , Complicações Infecciosas na Gravidez , Aborto Espontâneo/microbiologia , Infecções por Chlamydia/complicações , Chlamydia trachomatis , Feminino , Humanos , México , Razão de Chances , Gravidez
4.
World Neurosurg X ; 3: 100027, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31225520

RESUMO

OBJECTIVE: To determine the local control rate and complication rate in the treatment of grade I intracranial meningiomas. METHODS: A retrospective study was performed of patients with grade I meningioma who received radiosurgery with a dedicated linear accelerator from January 2002 to August 2012 with a minimum follow-up of 2 years. We performed descriptive statistics, logistic regression, and progression-free survival analysis through a Kaplan-Meier curve. RESULTS: Seventy-five patients with 78 grade I meningiomas received radiosurgery, 39 underwent surgery plus adjuvant radiosurgery, and 36 only radiosurgery. The follow-up median time was 68 months (range, 35-120 months). The tumor control rate was 93%, the 5-year progression-free survival was 92% (95% confidence interval, 77%-98%). Acute toxicity was 2.6%, and grade 1-2 late toxicity was 26.6%. Postradiosurgery edema was the main late morbidity. Age >55 years was the only significant factor for attaining a response >75%. The background of surgery before radiosurgery was the only significant prognostic factor for showing edema (odds ratio 5.78 [95% confidence interval, 2.14-15.64]). CONCLUSIONS: The local control rate attained in our series is similar to that reported in other series worldwide; the acute toxicity rate was low and late toxicity was moderate.

5.
PLoS One ; 14(4): e0215222, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30998701

RESUMO

Human papillomavirus has been identified as a main etiological agent in the development of cervical cancer. HPV 16 and 18 have been reported the most widely prevalent genotypes worldwide. We conducted a study analyzing the prevalence of high and low risk human papillomavirus viral types in the Mexican state of Aguascalientes and neighboring cities in the states of Jalisco and Zacatecas in central Mexico. Specific viral genotype was determined by a PCR and hybridization-based detection test. The presence of 37 high- and low-risk HPV genotypes was evaluated in 883 female participants. Of these, 350 presented low-grade squamous intraepithelial lesions (LGSIL), 176 presented high-grade squamous intraepithelial lesions (HGSIL), 107 suffered from cervical cancer and 250 women with negative cytological report for intraepithelial lesion or malignancy (NILM). HPV 51 was the most prevalent genotype, followed by HPV 16: overall prevalence of HPV 51, including single infections and co-infections was 31.2% in women with LGSIL, whereas prevalence of HPV 16 was 25.1%. Among women with HGSIL, HPV 51 prevalence was 47.2% and HPV 16 was 30.1%. Prevalence of HPV 51 in women with cervical cancer was 49.5% and type 16 was 33.6%. Between single and co-infections, most co-infections were not associated with later stages of the disease, except 51/16 and some others. HPV 51 showed a significant correlation with the progression of the disease (OR = 10.81 for LGSIL, 19.38 for HGSIL and 22.95 for ICC), and when analyzing all other genotypes, five different groups depending on their correlation with all lesion grades were determined. According to our findings, HPV genotype 51 has a higher prevalence than HPV 16 and 18 in the Mexican state of Aguascalientes and neighboring cities in the states of Jalisco and Zacatecas in Central Mexico.


Assuntos
Genótipo , Papillomaviridae/genética , Infecções por Papillomavirus , Neoplasias do Colo do Útero , Adolescente , Adulto , Idoso , Feminino , Humanos , México/epidemiologia , Pessoa de Meia-Idade , Infecções por Papillomavirus/epidemiologia , Infecções por Papillomavirus/genética , Prevalência , Estudos Retrospectivos , Neoplasias do Colo do Útero/epidemiologia , Neoplasias do Colo do Útero/genética , Neoplasias do Colo do Útero/virologia
6.
Rev Med Inst Mex Seguro Soc ; 55(2): 176-181, 2017.
Artigo em Espanhol | MEDLINE | ID: mdl-28296368

RESUMO

BACKGROUND: It has been established a strong association between the red cell distribution width (RDW) and mean platelet volume (MPV) with hypertension in non-pregnant patients. However, few studies have been performed in patients with preeclampsia, yielding inconsistent results. Our aim is to evaluate the relationship between RDW and MPV with the severity of preeclampsia. METHODS: Analytic cross-sectional study. We include 64 patients with preeclampsia (26 mild, 38 severe) and 70 patients with normotensive pregnancy. Clinical data, sociodemographic characteristics and laboratory measures, including RDW and MPV, were recorded for each patient. RESULTS: Hemoglobin and platelet count measures were similar between groups. Preeclamptic patients had levels of RDW (14.7 ± 1.4 vs. 13.4 ± 0.7, p = 0.0001) and MPV (11.8 ± 2.4 vs. 11.0 ± 1.4, p = 0.03) more elevated than control group. Moreover, severe preeclamptic subgroup had more elevated levels of RDW (15.0 ± 1.6 vs. 14.0 ± 0.6, p = 0.001) and MPV (12.7 ± 2.8 vs. 10.8 ± 1.8, p = 0.01) in comparison with mild preeclamptic patients. CONCLUSIONS: We demonstrate that RDW and MPV are accessible and inexpensive measures associated with the severity of preeclampsia.


Introducción: se ha establecido fuertemente la asociación entre el ancho de distribución eritrocitario (ADE) y el volumen plaquetario medio (VPM) con la hipertensión arterial sistémica. Sin embargo, se han realizado pocos estudios en pacientes con preeclampsia, obteniéndose resultados inconsistentes. Nuestro objetivo es evaluar la relación entre el ADE y el VPM con la severidad de la preeclampsia. Métodos: incluimos 64 pacientes con preeclampsia (26 leve, 38 severa) y 70 pacientes con embarazo normotenso. Los datos clínicos, características sociodemográficas y valores de laboratorio, incluyendo ADE y VPM, fueron registrados en cada paciente. Resultados: las medidas de hemoglobina y conteo plaquetario fueron similares entre ambos grupos. Las pacientes con preeclampsia tuvieron niveles de ADE (14.7 ± 1.4 frente a 13.4 ± 0.7, p = 0.0001) y VPM (11.8 ± 2.4 frente a 11.0 ± 1.4, p = 0.03) más elevados que el grupo control. El subgrupo de preeclampsia severa tuvo niveles más elevados de ADE (15.0 ± 1.6 frente a 14.0 ± 0.6, p = 0.001) y VPM (12.7 ± 2.8 frente a 10.8 ± 1.8, p = 0.01) que las pacientes con preeclampsia leve. Conclusiones: se demuestra que el ADE y el VPM son medidas accesibles asociadas a la severidad de la preeclampsia.


Assuntos
Índices de Eritrócitos , Volume Plaquetário Médio , Pré-Eclâmpsia/sangue , Pré-Eclâmpsia/diagnóstico , Índice de Gravidade de Doença , Adulto , Estudos de Casos e Controles , Estudos Transversais , Feminino , Humanos , Gravidez
7.
Gac Med Mex ; 152(1): 70-7, 2016.
Artigo em Espanhol | MEDLINE | ID: mdl-26927646

RESUMO

OBJECTIVE: To demonstrate the association between red cell distribution width and short-term mortality risk in patients with acute coronary syndrome. METHODS: We prospectively recruited 78 patients with acute coronary syndrome. The study population was classified according to quartiles of the red cell distribution width at hospital admission. A high red cell distribution width was defined as a value in the upper fourth quartile (>15) and a low red cell distribution width was defined as any value set in the lower three quartiles (≤15). After discharge, all patients were followed for three months. RESULTS: The short-term cardiovascular mortality was 47.2% in the high red cell distribution width group vs. 10.2% in the low red cell distribution width group (p<0.001). In the receiver operating characteristic curve analysis, a red cell distribution width value of more than 15% yielded a sensitivity of 66.7%, a specificity of 83%, and a positive predictive value of 79.7% for cardiac mortality. After multivariate analysis, high levels of red cell distribution width were independent predictors for three-month mortality (p=0.001). CONCLUSION: We demonstrated that red cell distribution width is an accessible parameter associated with short-term cardiovascular mortality in patients with acute coronary syndrome.


Assuntos
Síndrome Coronariana Aguda/sangue , Síndrome Coronariana Aguda/mortalidade , Índices de Eritrócitos , Idoso , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Risco , Fatores de Tempo
8.
Artigo em Espanhol | LILACS | ID: lil-724859

RESUMO

La diabetes gestacional (DG) es una de las complicaciones médicas que más frecuentemente afectan a las mujeres embarazadas; algunos autores reportan una prevalencia entre el 9,7 y el 13,9%. La DG puede ser causa de efectos adversos como: nacimiento pretérmino, macrosomia, nacimiento por cesárea, hiperbilirrubinemia, hipertensión gestacional, así como la predisposición de desarrollar posteriormente diabetes mellitus tipo 2 y síndrome metabólico. La literatura señala la asociación entre los microorganismos presentes en el biofilm subgingival, etiológicos de la inflamación de los tejidos de soporte dentarios y diabetes mellitus. Uno de estos microorganismos, Porphyromonas gingivalis, expresa, entre otros factores de virulencia, una proteína llamada fimbrilina, la cual presenta variaciones genotípicas relacionadas con su capacidad de inducción en la expresión de mediadores inflamatorios; los genotipos fimA II y fimA IV se consideran con mayor capacidad de virulencia y su presencia se ha asociado con la resistencia a la insulina. En este estudio analizamos la prevalencia de los genotipos fimA II y fimA IV en un grupo de mujeres mexicanas de la región central de México con DG, en mujeres con embarazo sin diabetes y mujeres sin embarazo y sin diabetes. Los resultados encontrados muestran una elevada presencia del genotipo fimA II en mujeres con DG (p < 0,05)


Gestational diabetes (GD) is one of the most common complications in pregnant women, with some authors reporting prevalence between 9.7% and 13.9%. GD can lead to the following adverse effects: preterm birth, macrosomia, cesarean birth, hyperbilirubinemia, gestational hypertension, and predisposition to later develop diabetes mellitus type 2 and metabolic syndrome. The literature shows an association between microorganisms in the subgingival biofilm, which produces inflammation of the dental support tissue, and diabetes mellitus. Porphyromonasgingivalis is one of these microorganisms, and among other virulence factors, it expresses a protein called fimbrilin which has genotypic variations related to its ability to induce expression of inflammatory mediators. Genotypes fimA II and fimA IV are considered to have a greater virulence and their presence has been associated with insulin resistance. An analysis is made on the prevalence of genotypes fimA II and fimA IV in a group of women in central region of Mexico with GD, pregnant women without diabetes, and non-pregnant women without diabetes. The results show an elevated presence of genotype fimA II in women with GD (P <.05)


Assuntos
Humanos , Feminino , Gravidez , Adulto , Diabetes Gestacional , Infecções por Bacteroidaceae/epidemiologia , Porphyromonas gingivalis , Porphyromonas gingivalis/genética , Proteínas de Fímbrias/genética , Gestantes , Genótipo , Epidemiologia Descritiva , Prevalência , Estudos Transversais , Estudo Observacional , México
9.
Rev. chil. reumatol ; 30(2): 72-79, 2014. ilus, tab
Artigo em Espanhol | LILACS | ID: lil-776843

RESUMO

To describe the sonographic findings of the hip joint in patients with rheumatoid arthritis and to assess their correlation with signs and symptoms of disease activity (pain, range of motion, overall disease activity). Methods: We performed an observational, cross-sectional and analytical study. Patients aged 18 60 years of age diagnosed with rheumatoid arthritis were included. We did not include patients with hip prostheses or hip infiltration in the previous 3 months. We performed an ultrasound examination (7-12 MHz linear transducer) of both hips and recorded demographic, clinical, ultrasonographic and goniometric findings (flexion, extension, abduction, adduction, internal and external rotation). Results: We evaluated 102 hips of 51 patients (37 women) aged 43.5 +/- 9.4 years, body mass index (BMI): 26.4 +/- 5.18, disease duration: 117 +/- 107 months, DAS28: 4.08 +/- 1.58, hip pain history: 20 (39.2 percent), concurrent hip pain 3 (5.8 percent), use of DMARDs: 47 (92.1 percent), biological therapy 8 (15.68 percent), comorbidity: 25 (50.1 percent), positive rheumatoid factor: 43 (84.3 percent) and evocation of pain: 28 (54.9 percent). Ultrasound findings: Osteophytes: 52 (50.9 percent), cartilage injury: 47 (46.0 percent), trochanteric enthesopathy: 33 (32.3 percent), effusion: 14 (13.7 percent), erosions: 6 (5.8 percent), synovial hypertrophy: 5 (4.9 percent) and iliopsoas bursitis 2 (1.9 percent). There was no correlation of ultrasound with DAS28 or laboratory parameters. Evoking pain correlated with the presence of effusion (p = 0.038). Conclusions: The major ultrasound abnormalities were osteophytes, articular cartilage injury and trochanteric enthesopathy. According to our findings is advisable to include hip in the clinical assessment and initial and subsequent ultrasound evaluation of patients with rheumatoid arthritis...


Describir los hallazgos ecográficos de la articulación coxofemoral en pacientes con artritis reumatoide y evaluar su correlación con los signos y síntomas de actividad de la enfermedad (dolor, rango de movimiento, actividad global de la enfermedad). Material y métodos: Es un estudio observacional, transversal y analítico. Se incluyeron pacientes de 18 a 60 años de edad con diagnóstico de artritis reumatoide. No se incluyeron pacientes con prótesis de cadera o infiltración de la cadera en los tres meses previos. Se realizó ecografía (transductor lineal 7-12 MHz) de ambas caderas y se registraron datos demográficos, clínicos, ecográficos y goniométricos (flexión, extensión, abducción, aducción, rotación interna y externa). Resultados: Se evaluaron 102 caderas de 51 pacientes (37 mujeres) con edad de 43,5 +/- 9,4 años, índice de masa corporal (IMC): 26,4 +/- 5,18, evolución de la enfermedad: 117 +/- 107 meses, DAS28: 4,08 +/- 1,58, historia de dolor: 20 (39,2 por ciento), dolor concurrente: 3 (5,8 por ciento), uso de FARME: 47 (92,1 por ciento), terapia biológica: 8 (15,68 por ciento), comorbilidad: 25 (50,1 por ciento), factor reumatoide positivo: 43 (84,3 por ciento) y evocación de dolor: 28 (54,9 por ciento). Hallazgos ecográficos: Osteofitos: 52 (50,9 por ciento), lesión de cartílago: 47 (46,0 por ciento), entesopatía trocantérica: 33(32,3 por ciento), derrame: 14 (13,7 por ciento), erosiones: 6 (5,8 por ciento), hipertrofia sinovial: 5 (4,9 por ciento) y bursitis iliopsoas: 2 (1,9 por ciento). No se encontró correlación de la ecografía con el DAS28 ni con los parámetros de laboratorio. La evocación de dolor se correlacionó con la presencia de derrame (p = 0,038).Conclusiones: Las principales alteraciones ecográficas fueron osteofitos, lesión del cartílago articular y entesopatía trocantérica. De acuerdo a nuestros hallazgos, es recomendable incluir a la cadera en la valoración clínica y ecográfica inicial y subsecuente de los...


Assuntos
Humanos , Masculino , Adolescente , Adulto , Feminino , Adulto Jovem , Pessoa de Meia-Idade , Articulação do Quadril/fisiopatologia , Articulação do Quadril , Artrite Reumatoide/fisiopatologia , Artrite Reumatoide , Estudos Transversais , Músculo Esquelético
10.
Rheumatol Int ; 33(1): 173-7, 2013 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-22274131

RESUMO

To assess the inter- and intra-observer reproducibility of musculoskeletal ultrasonography among rheumatologist in detecting inflammatory and morphostructural changes in small joints of the hands in patients with rheumatoid arthritis (RA). Five members of the "Escuela de Ecografía del Colegio Mexicano de Reumatología" tested their inter- and intra-observer reliabilities in the assessment of basic sonographic findings of joint inflammation and bone erosion. Their results were compared to those obtained by a group of international experts from European League Against Rheumatism. A clinical rheumatologist evaluated eight RA patients. Five Siemens Acuson Antares ultrasound machines (7-13 MHz linear probes) were used. The OMERACT preliminary definitions of joint effusion, synovial hypertrophy, bone erosions and tenosynovitis were adopted. Inter-observer and intra-observer agreement was calculated by overall agreement and kappa statistics. Mean kappa value for joint effusion was good, 0.654 (85%); synovial hypertrophy, 0.550 (77.2%); power Doppler signal, 0.550 (82.5%); bone erosions, 0.549 (81%); and tenosynovitis, 0.500 (91.5%). Mean and overall intra-observer agreement for semiquantitative score was good for joint effusion, 0.630 (77.2%) and bone erosions, 0.605 (56.25%); and moderate to synovial hypertrophy, 0.476 (65%) and power Doppler signal, 0.471 (80%). Mean kappa value for joint effusion was 0.381 (95%), synovial hypertrophy, 0.447 (72%); power Doppler signal, 0.496 (81%); bone erosions, 0.294 (81%); and tenosynovitis, 0.030 (66%). Mean and overall inter-observer agreement for semiquantitative score was poor for joint effusion, 0.325 (57%) and bone erosions, 0.360 (43%); and moderate to synovial hypertrophy, 0.431 (55%) and power Doppler signal, 0.496 (81%). Intra-observer variability reached the highest levels of agreement. Factors related to the experience of the rheumatologist, the time spent in each examination and knowledge of the software ultrasound equipment could influence the lower level of inter-observer agreement in this study.


Assuntos
Artrite Reumatoide/diagnóstico por imagem , Articulação da Mão/diagnóstico por imagem , Articulação da Mão/patologia , Sinovite/diagnóstico por imagem , Ultrassonografia Doppler/métodos , Adulto , Idoso , Artrite Reumatoide/complicações , Artrite Reumatoide/fisiopatologia , Feminino , Articulação da Mão/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Variações Dependentes do Observador , Reprodutibilidade dos Testes , Sinovite/etiologia , Sinovite/fisiopatologia
11.
Mod Rheumatol ; 19(2): 147-50, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19023644

RESUMO

There is little evidence about the comparative efficacy of corticosteroids in the treatment of painful shoulder. The main aim was to compare the efficacy of methylprednisolone (MTP) versus triamcinolone (TMC) in the treatment of painful shoulder using an ultrasound-guided injection. Patients with painful shoulder due to subacromial bursitis and partial or full-thickness rotator cuff tears demonstrated by musculoskeletal ultrasound received a guided-injection of MTP acetate 40 mg (12 patients) or TMC acetonide 40 mg (12 patients). Range of motion and pain visual analogue scale were registered at 10 and 30 min, 1 and 2 weeks postinjection. Two weeks postinjection, both groups reported a mean improvement in range of motion (33%) and relief of pain (61%). Relief of pain of 50% or more was observed in 92% of patients in MTP group and 50% of TMC group (p = 0.02). Two months postinjection, 50% of the patients in MTP group and 25% in TMC group reported total relief of pain (p = 0.3). Patients with painful shoulder receiving an ultrasound-guided injection of MTP or TMC have a rapid and sustained overall response. Relief of pain tends to be more rapid with MTP than TMC.


Assuntos
Anti-Inflamatórios/administração & dosagem , Metilprednisolona/administração & dosagem , Dor de Ombro/tratamento farmacológico , Triancinolona/administração & dosagem , Adulto , Idoso , Anti-Inflamatórios/uso terapêutico , Método Duplo-Cego , Feminino , Humanos , Injeções , Masculino , Metilprednisolona/uso terapêutico , Pessoa de Meia-Idade , Amplitude de Movimento Articular/efeitos dos fármacos , Ombro/diagnóstico por imagem , Dor de Ombro/diagnóstico por imagem , Resultado do Tratamento , Triancinolona/uso terapêutico , Ultrassonografia
12.
Leuk Res ; 28(6): 639-47, 2004 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-15120942

RESUMO

Chronic myeloid leukemia (CML) arises from the malignant transformation of a hematopoietic stem cell (HSC) that gives rise to functionally defective progeny, including primitive and relatively mature progenitor cells (HPC). Both HSC and HPC are comprised within the population of CD34(+) cells, normally present in bone marrow (BM). In the present study, we have separated two different subpopulations of CD34(+) cells from CML marrow: Population I, enriched for CD34(+) Lin(-) cells; and Population II, enriched for CD34(+) CD36(-) CD38(-) CD45RA(-) Lin(-) cells, and assessed their progenitor cell content as well as their capacity to proliferate and expand in response to a combination of hematopoietic cytokines in serum- and stroma-free long-term liquid cultures. The absolute cell numbers recovered in Population I from normal and CML samples were similar; in contrast, we found that Population II from CML was amplified four-fold, as compared to normal. In spite of this latter observation, no significant differences were observed in terms of the absolute number of CFC when comparing Populations I and II from CML patients and normal subjects. Interestingly, the proliferation and expansion potentials of CML cells were clearly deficient as compared to their normal counterparts. Indeed, in cultures of Population I cells the maximum fold increase in total and progenitor cell numbers corresponded to 30 and 8%, respectively, of those observed in cultures of normal marrow-derived Population I cells. Such functional deficiencies were even more evident in Population II cells in which the maximum fold increase in total and progenitor cell numbers corresponded to 3 and 0.5%, respectively, of the levels found in cultures of Population II cells from normal marrow. The present study demonstrates that bone marrow-derived CD34(+) cells from CML patients possess functional abnormalities, clearly evident in the in vitro system used by us. Among the two CML subpopulations studied here, the more immature one (Population II; enriched for CD34(+) CD36(-) CD38(-) CD45RA(-) Lin(-) cells) was the one that showed the most severe abnormalities, as compared to its relatively more mature counterpart (Population I; enriched for CD34(+) Lin(-) cells).


Assuntos
Antígenos CD34/metabolismo , Medula Óssea/patologia , Células-Tronco Hematopoéticas/citologia , Leucemia Mielogênica Crônica BCR-ABL Positiva/metabolismo , Leucemia Mielogênica Crônica BCR-ABL Positiva/patologia , Adolescente , Adulto , Idoso , Estudos de Casos e Controles , Divisão Celular , Ensaio de Unidades Formadoras de Colônias , Citocinas/metabolismo , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Células Estromais/metabolismo
13.
Rev Invest Clin ; 55(4): 423-8, 2003.
Artigo em Inglês | MEDLINE | ID: mdl-14635607

RESUMO

INTRODUCTION: Chronic myeloid leukemia (CML) is characterized by a chromosomal translocation t(9; 22) resulting in the chimeric ber-abl oncogene that encode for the p210 protein which has an increased tyrosine kinase activity. The fusion part of this protein contains a novel aminoacid sequence. If peptides derived from this leukemia-specific part of p210 are expressed in the context of HLA molecules on malignant cells this may elicit immunologically specific responses. Recent studies using synthetic peptides identical to the bcr-abl fusion region revealed that breakpoint specific peptides are capable of binding to the class I molecules HLA-A3, -A11 and -B8. It has been shown that individuals expressing HLA-A3 or HLA-B8 have a diminished risk for development of CML in Caucasoid populations. Other authors have reported a statistically significant increase in the frequency of Cw3 and Cw4 antigens in Causcasoids and European CML patients. These data suggested that Cw3 and Cw4 may be markers for CML susceptibility on these populations. OBJECTIVE: To asses a possible susceptibility effect of these HLA molecules we studied 63 CML Mexican Mestizo patients and 746 healthy subjects for the distribution of HLA class I and class II molecules. RESULTS: The gene products that showed statistically significant differences between CML patients and controls were DR14, DR3, Cw3 and Cw4. DR14 and DR3 were significantly increased in the patients group with respect to the controls group (DR14 antigen frequency: 3.17% vs. 0.29%; p = 0.03; DR3 20.63% vs. 8.33%; p = 0.0001). Cw3 and Cw4 were significantly decreased in the patient group (Cw3 26.9% vs. 49.11%; p = 0.03; Cw4 antigen frequency 23.8% vs. 86.28%; p = 0.0000001). The relative risk for DR14 was 10.48 (95% CI 1.52-79.29) and for DR3 was 3.96 (95% CI 2.05-7.71). The relative risk for Cw3 was 0.38 (95% CI 0.08-1.79) and for Cw4 was 0.11 (95% CI 0.048-0.81). CONCLUSION: These results suggest that the development of CML is apparently associated with HLA phenotypes specific to each population, and indicate that Cw3 and Cw4 expression may result in a protective effect on the CML acquisition on Mexican Mestizo population probably by bcr-abl breakpoint peptides presentation through these HLA molecules.


Assuntos
Antígenos HLA-C/genética , Leucemia Mielogênica Crônica BCR-ABL Positiva/genética , Adolescente , Adulto , Feminino , Humanos , Leucemia Mielogênica Crônica BCR-ABL Positiva/epidemiologia , Masculino , México , Pessoa de Meia-Idade
14.
Gac Med Mex ; 139(6): 553-9, 2003.
Artigo em Espanhol | MEDLINE | ID: mdl-14723051

RESUMO

PROBLEM: It has been suggested that type of chimeric mRNA is associated with differences in the clinical and hematologic characteristics of chronic myeloid leukemia (CML). However, prognostic value of type of chimeric mRNA bcr-xabl (b3a2 or b2a2) is still controversial. METHODS: We analyzed 97 cases of Philadelphia-positive CML to determine mRNA type by reverse-polymerase chain reaction (RT-PCR) and its relationship with clinical features. RESULTS: We detected b3a2 bcr-abl transcripts in 27 (28%) cases, b2a2 in 57 (59%) cases, and 13 (13%) with both mRNA transcripts b3a2/b2a2. These frequencies were the total reverse of other reports. Age, sex, hemoglobin, and white-cell counts showed no significant difference for those with either b3a2 or b2a2 bcr-abl transcripts. However, platelet counts of b3a2 patients were significantly higher than those of b2a2 patients (743.3 vs 477.3 x 109/L; p = 0.01). In addition, in the subgroup of patients whose white-cell count at diagnosis was < 100 x 10(9)/L, those with b3a2 transcript had a significantly higher platelet count (679.1 vs. 352.2 x 10(9)/L; p = 0.001). CONCLUSIONS: We observed reversed frequency of bcr-abl transcripts in this population, but agreement with other Latin-American reports. In addition, our data suggested that there is different CML biological behavior in our population and that there is a subpopulation of CML patients in whom b3a2 is associated witH higher thrombopoietic activity.


Assuntos
Antígenos CD , Proteínas de Fusão bcr-abl/genética , Leucemia Mielogênica Crônica BCR-ABL Positiva/genética , Glicoproteínas de Membrana , Contagem de Plaquetas , Fatores de Transcrição/genética , Adolescente , Adulto , Idoso , Antígenos de Diferenciação/análise , Antígenos de Diferenciação/genética , Proteína BRCA2/análise , Proteína BRCA2/genética , Antígeno CD24 , Feminino , Proteínas de Fusão bcr-abl/análise , Humanos , Leucemia Mielogênica Crônica BCR-ABL Positiva/sangue , Leucemia Mielogênica Crônica BCR-ABL Positiva/patologia , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Fatores de Transcrição/química
15.
Ginecol Obstet Mex ; 70: 437-42, 2002 Sep.
Artigo em Espanhol | MEDLINE | ID: mdl-12448052

RESUMO

BACKGROUND: Gastrin has a wide variety of functions on the digestive system including the regulation of gastric acid secretion, being a growth factor for the non antral gastric mucosa and the stimulation of mucosal proliferation in the large and small intestines. Animals studies showed that various diseases of the digestive system have better clinical evolution in the presence of estrogens as is the case of peptic ulcers, now little is known in humans about this phenomenon. OBJECTIVE: To evaluate the response of gastrin after an oral calcium load in normal and postmenopausal women without hormone replacement therapy. PATIENTS AND METHODS: We studied 10 healthy women with mean age 25.3 +/- 1.79 yr (range: 23-28 yr) and 7 postmenopausal women without previous treatment and a mean age 56.5 +/- 6.4 yr (range: 50-70 yr). A permeable vein with physiologic solution was obtained in order to maintain a permeable vein in the antecubital fossa to obtain blood samples for the determination of gastrin. Before an oral administration of 1 g of calcium baseline samples were taken at time 0 and thereafter on 30, 60, 90, 120, 150, and 180 minutes. Gastrin levels were determined by RIA using CIS Bio-International commercial kits. RESULTS: Basal gastrin levels were x: 72.54 +/- 15.9 pg/mLK in normal women and x: 61.1 +/- 39.62 in postmenopausal women. Basal gonadotrophins were x: 62.1 +/- 26 and x: 32.9 +/- 7.3 for FSH and LH respectively and estradiol level of x: 13.9 +/- 4.2 pg/mL. Normal volunteers had a peak secretion of x: 173.4 +/- 15 pg/mL at 90 minutes and in postmenopausal women a peak of x: 66.2 +/- 50 at 60 minutes. Comparing the magnitude of the response between the healthy volunteers and the postmenopausal women at 90 and 120 minutes the statistical significance was a (p < 0.005) and (p < 0.001), respectively. CONCLUSIONS: These results demonstrate the lack of response of gastrin levels to the calcium stimulus in postmenopausal women probably due to the lack of hormone replacement therapy. Further studies are needed to best understand the role of sexual hormones on the synthesis and secretion of gastrin in the digestive system especially the role of the estrogens.


Assuntos
Cálcio/administração & dosagem , Terapia de Reposição de Estrogênios , Gastrinas/sangue , Pós-Menopausa , Administração Oral , Adulto , Idoso , Cálcio/farmacologia , Interpretação Estatística de Dados , Feminino , Gastrinas/metabolismo , Humanos , Pessoa de Meia-Idade , Radioimunoensaio , Fatores de Tempo
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA