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1.
Pediatr Pulmonol ; 2021 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-33524244

RESUMO

Obstructive airway disorders, common in infancy and early childhood, include some entities that are recognized to have neuro immune mediators as their underlying pathogenetic mechanisms. The best characterized example amongst post-viral wheezing phenotypes is the disorder that follows respiratory syncytial virus (RSV) infection and leads to intermittent, long-term wheezing. The underlying mechanisms of the airway reactivity related to RSV infection have been extensively studies and are associated with dysregulation of the nonadrenergic-noncholinergic (NANC) system, via upregulation of neurotransmitters, typically Substance P. Neuroendocrine hyperplasia of infancy (NEHI), while a less common entity, is a disorder characterized by more severe and long-term obstructive airway disease. NEHI is pathophysiologically characterized by abundance of neuroendocrine cells in the airways containing the neuroimmune mediator bombesin, the release of which is presumed to be the driver of the persistent small airway obstruction and functional air-trapping. Here we review the NANC and neuroendocrine cells, the neurotransmitter systems and their studied roles in pulmonary diseases with a focus on their role in lung development, and subsequent various pediatric lung diseases. We focus on the juxtaposition of the separate neuroimmune mechanisms underlying the pathogenesis of post-RSV recurrent wheezing and NEHI's persistent small airway obstruction. We finally propose a unifying concept of neuropeptides in obstructive disorders that may encompass these two entities and possibly others.

2.
Arch Cardiol Mex ; 90(4)2020 Aug 05.
Artigo em Esperanto | MEDLINE | ID: mdl-33008150

RESUMO

Se trata de hombre de 28 años de edad conocido previamente sano. Inició su cuadro con presencia de náuseas, vómitos y ataque al estado general. Durante la valoración se documentó nitrógeno ureico en sangre (BUN) 142 mg/dl y creatinina 12.8 mg/dl. Por recursos económicos limitados no fue posible inicio inmediato de terapia dialítica y solo se inició manejo médico. Tras progresión de la sintomatología, se inició terapia dialítica 10 meses después, recibiendo solamente dos sesiones por semana.

3.
PLoS One ; 15(5): e0229297, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32427995

RESUMO

OBJECTIVES: The objectives of the study were to estimate the prevalence of different clinical signs of trachoma and identify possible factors associated with TF. METHODOLOGY: Following the approval of the study protocol by the ethics committee, a cross-sectional study was conducted in Vaupés, a department of the Colombian Amazon, between the years 2012 and 2013 in two districts. Based on the records obtained from a standardized format for the clinical evaluation of the participants and the factors associated with follicular trachoma, an excel database was built and debugged, which was analyzed using IBM SPSS, Statistics Version 23 and Stata STATA (Version 14, 2015, StataCorp LLC, Texas, USA). RESULTS: The records of 13,091 individuals was collected from 216 rural indigenous communities, of which 12,080 were examined (92.3%); 7,274 in the Western and 4,806 in the Eastern districts. A prevalence of trachomatous inflammation-follicular (TF) of 21.7% (n = 599; 95% CI 20.2-23.3) in the Western and 24.9% (n = 483; 95% CI 23.1-26.9) in the Eastern district was found in children aged 1 to 9 years. Regarding trachomatous trichiasis (TT), 77 cases were found, of which 14 belonged to the Western district (prevalence 0.3%, CI 95% 0.2-0.5) and 63 to the Eastern district (1.8%, CI 95% 1.4-2.4). Children aged between 1 to 9 years were significantly more likely to have TF when there was the presence of secretions on the face (OR: 3.2; 95% CI: 2.6-3.9). CONCLUSIONS: Trachoma is a public health problem in Vaupés that requires the implementation of the SAFE strategy (S = Surgery, A = Antibiotics, F = Face Washing, E = Environment) in the Eastern and Western districts, for at least 3 consecutive years, in accordance with WHO recommendations.


Assuntos
Inquéritos Epidemiológicos , Grupos Populacionais , Saúde Pública , Tracoma/epidemiologia , Censos , Criança , Pré-Escolar , Chlamydia trachomatis/patogenicidade , Colômbia/epidemiologia , Feminino , Humanos , Lactente , Masculino , Fatores de Risco , População Rural , Tracoma/microbiologia , Tracoma/patologia
4.
PeerJ ; 8: e8790, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32292646

RESUMO

Mexico has more than 750,000 ha of mangroves and more than 400,000 ha of seagrasses. However, approximately 200,000 ha of mangroves and an unknown area of seagrass have been lost due to coastal development associated with urban, industrial and tourist purposes. In 2018, the approved reforms to the General Law on Climate Change (LGCC) aligned the Mexican law with the international objectives established in the 2nd Article of the Paris Agreement. This action proves Mexico's commitment to contributing to the global target of stabilizing the greenhouse gas emissions concentration in the planet. Thus, restoring and conserving mangrove and seagrass habitats could contribute to fulfilling this commitment. Therefore, as a first step in establishing a mitigation and adaptation plan against climate change with respect to conservation and restoration actions of these ecosystems, we evaluated Mexican blue carbon ecosystems through a systematic review of the carbon stock using the standardized method of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We used the data from 126 eligible studies for both ecosystems (n = 1220). The results indicated that information is missing at the regional level. However, the average above and below ground organic carbon stocks from mangroves in Mexico is 113.6 ± 5.5 (95% CI [99.3-118.4]) Mg Corg ha-1 and 385.1 ± 22 (95% CI [344.5-431.9]) Mg Corg ha-1, respectively. The variability in the Corg stocks for both blue carbon ecosystems in Mexico is related to variations in climate, hydrology and geomorphology observed along the country's coasts in addition to the size and number of plots evaluated with respect to the spatial cover. The highest values for mangroves were related to humid climate conditions, although in the case of seagrasses, they were related to low levels of hydrodynamic stress. Based on the official extent of mangrove and seagrass area in Mexico, we estimate a total carbon stock of 237.7 Tg Corg from mangroves and 48.1 Tg Corg from seagrasses. However, mangroves and seagrasses are still being lost due to land use change despite Mexican laws meant to incorporate environmental compensation. Such losses are largely due to loopholes in the legal framework that dilute the laws' effectiveness and thus ability to protect the ecosystem. The estimated emissions from land use change under a conservative approach in mangroves of Mexico were approximately 24 Tg CO2e in the last 20 years. Therefore, the incorporation of blue carbon into the carbon market as a viable source of supplemental finance for mangrove and seagrass protection is an attractive win-win opportunity.

7.
Ann Hematol ; 96(12): 2015-2024, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29027574

RESUMO

There is no information about XCL1 in patients with acute lymphoblastic leukemia (ALL). The objective of this study was to correlate the serum levels of XCL1 and survival in ALL patients. Only ALL patients older than 12 months were considered to participate. Serum XCL1 was measured at diagnosis, end of remission induction, and end of consolidation. Thirty-three ALL patients with median age of 21 years (1-78) were included. Higher XCL1 level (above 50 pg/mL) at ALL diagnosis correlated with higher survival (p = 0.038), whereas XCL1 level at end of induction and consolidation had no significant correlation. Concerning the behavior of serum XCL1 during treatment, higher survival at 5 years was observed in the group with progressively decreased levels of XCL1 (70%) than those with progressively increasing (29%) or no detectable XCL1 (14%). In conclusion, higher serum XCL1 levels at diagnosis and their progressive decline throughout chemotherapy could be correlated with higher survival.


Assuntos
Quimiocinas C/sangue , Proteínas de Neoplasias/sangue , Leucemia-Linfoma Linfoblástico de Células Precursoras/sangue , Leucemia-Linfoma Linfoblástico de Células Precursoras/mortalidade , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Intervalo Livre de Doença , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamento farmacológico , Estudos Prospectivos , Taxa de Sobrevida
8.
Arch Med Res ; 47(3): 172-9, 2016 04.
Artigo em Inglês | MEDLINE | ID: mdl-27373815

RESUMO

BACKGROUND AND AIMS: FLT3-ITD mutations in acute myeloid leukemia (AML) are associated with a poor prognosis. In Latin America, little epidemiological data exist about these mutations and their influence on clinical evolution and prognosis. Standardization and well-established clinical correlation make FLT3 mutational analysis by molecular methods an invaluable tool to decide among treatment options and to determine AML prognosis. METHODS: We assessed the prevalence of FLT3-ITD mutations in 138 patients with AML at four hematology referral centers from Mexico and Colombia. Molecular methods based on polymerase chain reaction (PCR) were employed for determining FLT3-ITD status. RESULTS: Mutations were present in 28 patients indicating a prevalence of 20.28%. Median age was 47 years (5-96). The FLT3 mutation positive group was older, had higher WBC and hemoglobin values and lower platelet counts but without statistical significance. A not previously described mutation in the FLT3 gene was found in one patient involving a nucleotide exchange of timine for cytosine at the 66608 position. A high mortality was found in the FLT3-mutated group, 67.8 vs. 42.72% in the non-mutated group and median survival was 4.9 months vs. 20.4 months, p = 0.009. A mutated FLT3 did not confer poor prognosis to those with M3 AML. The mutated FLT3 population had poor overall survival (OS) despite hematoprogenitor stem cell transplantation (HSCT). CONCLUSION: Prevalence of FLT3-ITD mutation in AML was present in a proportion comparable to other populations and, when present, was associated with a very poor prognosis.


Assuntos
Leucemia Mieloide Aguda/enzimologia , Tirosina Quinase 3 Semelhante a fms/metabolismo , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Análise Mutacional de DNA , Feminino , Humanos , Leucemia Mieloide Aguda/diagnóstico , Masculino , México , Pessoa de Meia-Idade , Mutação , Prognóstico , Adulto Jovem , Tirosina Quinase 3 Semelhante a fms/genética
9.
Rev. centroam. obstet. ginecol ; 21(2): 31-37, abr.-jun. 2016.
Artigo em Espanhol | LILACS | ID: biblio-869633

RESUMO

Objetivos: analizar el nivel de conocimientos, actitudes y prácticas que tiene una muestra voluntaria de proveedores de salud en obstetricia asistentes al XXI Congreso Nacional de Ginecología y Obstetricia del Ecuador sobre muerte materna, leyes nacionales y tratamientos relacionados al aborto incompleto. Material y Métodos: Se realizó una intervención investigativa transversal...


Objectives: To examine the level of knowledge, attitudes and practices which has voluntary sample of health care providers at obstetrician tending the 21st National Congress of Gynecology and Obstetrics of Ecuador on maternal death, national laws and treatment related to incomplete abortion. Material and Methods: a descriptive and analytical cross - sectional investigative intervention through suvery...


Assuntos
Humanos , Feminino , Aborto Incompleto , Conhecimentos, Atitudes e Prática em Saúde , Obstetrícia/educação , Médicos
10.
J Eval Clin Pract ; 22(5): 751-4, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27133797

RESUMO

PURPOSE: It has been estimated that medication errors (ME) are responsible for 7000 deaths each year. Some studies show that electronic prescribing systems have achieved health benefits and patient safety, resulting in a saving of resources. Other studies suggest that they may increase adverse events. OBJECTIVE: The objective of this study was to compare medication errors between electronic and paper-based prescription detected during pharmacovigilance. METHODS: This was an observational, cross-sectional comparative study of 600 randomized medical records that were systematically reviewed by a pharmacovigilance team, with a deliberate search for ME. Each error was classified according to its severity, National Coordinating Council for Medication Error and Prevention taxonomy and high-risk medications. The number of errors was calculated per 100 prescribed medications, number of errors per record and number of records with an error as a quality indicator. RESULTS: A total of 229 ME were found with a mean per record of 0.38 (SD = 0.7), of which 155 corresponded to the paper-based method (1.04, SD = 1.67) and 74 to the electronic-based method (0.29, SD = 0.57) P = <0.001. The use of the electronic method was associated with an OR of 0.59 (95% CI 0.41-0.85) for the recording of at least one ME (P = 0.005), but to a greater severity of ME (<0.001). CONCLUSION: The use of the electronic system was associated with a reduction in ME, compared with the paper-based method. Despite this, it was associated with more severe ME.


Assuntos
Prescrições de Medicamentos , Prescrição Eletrônica , Hospitais Universitários , Erros de Medicação/prevenção & controle , Atenção Terciária à Saúde , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Segurança do Paciente , Farmacovigilância
11.
Rev. peru. ginecol. obstet. (En línea) ; 62(2): 169-174, abr.-jun. 2016. tab
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1043229

RESUMO

Objetivos: Determinar el nivel de conocimientos, actitudes y prácticas en una muestra intencionada de médicos gineco-obstetras líderes provinciales de la Federación de Sociedades de Ginecología y Obstetricia del Ecuador (FESGO) sobre el aborto inducido. Diseño: Estudio transversal, correlacional, de corte prospectivo y analítico. Institución: Federación de Sociedades de Ginecología y Obstetricia del Ecuador (FESGO). Participantes: Médicos gineco-obstetras líderes provinciales de FESGO. Metodología: En una muestra intencionada de 33 médicos gineco-obstetras se aplicó una encuesta estructurada validada y basada en experiencias de la región, acerca de datos generales y sociodemográficos del encuestado, conocimientos teóricos sobre la epidemiología del aborto y la muerte materna, actitudes con relación del manejo del aborto inseguro, y la práctica de prescripción de misoprostol y tratamiento quirúrgico por aspiración. Principales medidas de resultados: Nivel de conocimientos, actitudes y prácticas. Resultados: La población encuestada tenía promedio de edad de 49 años, 16 años de práctica, con relación estable, hijos y religión declarada. Consideraron de alta prioridad la muerte materna por aborto, pues atendían pacientes públicas y privadas con intención de aborto inducido frecuente y uso de misoprostol previo. Consideraron la ampliación de motivos para aborto con la proyección de reducción de mortalidad, aunque los casos aumentaran. En su mayoría consideraron suficientes sus conocimientos de derechos reproductivos, se sentían solventes respecto a la consejería en misoprostol, aunque la satisfacción alta respecto a consejería de aborto inducido fue apenas en 51%. Conclusiones: Los líderes provinciales de esta muestra intencionada conocían la temática del aborto y su atención integral. Los conocimientos fueron altos, aunque las actitudes y prácticas resultaron diversas, con respuestas que sugieren mayor sensibilización y capacitación. Nuevos estudios necesitan ser realizados en una población más amplia de gineco-obstetras federados, así como intervenciones educativas y de sensibilización para mejorar la calidad de atención del aborto.


Objectives: To determine knowledge, attitudes and practices regarding abortion in an intentioned sample of obstetrician/gynecologists who are provincial leaders of the Federación de Sociedades de Ginecología y Obstetricia del Ecuador (FESGO). Design: Prospective, correlational, cross-sectional, and analytical survey. Setting: Federación de Sociedades de Ginecología y Obstetricia del Ecuador (FESGO). Participants: FESGO obstetrician/gynecologists provincial leaders. Methods: A structured and validated survey was applied to an intentional sample of 33 obstetrician/gynecologists. The survey was based on experiences in the region, general and demographic information of the respondent, theoretical knowledge about the epidemiology of abortion and maternal death, attitudes about the management of unsafe abortion, and practice on misoprostol prescription and surgical aspiration. Main outcome measures: Knowledge, attitude and practices. Results: The survey respondents were 49 years old average, had 16 years of medical practice, and stable family relations, with declared children and religion. They considered maternal death due to abortion of high priority be-cause they attended public and private patients with frequent history of induced abortion and use of misoprostol. They also considered the expansion of reasons for abortion in the light of a potential reduction in mortality, even if the number of cases increased. Most considered sufficient their knowledge on reproductive rights and felt proficient with respect to counseling on misoprostol, although high satisfaction on induced abortion counseling was just 51%. Conclusions: Provincial leaders of this sample knew about abortion and its comprehensive care. Knowledge was high, but attitude and practices were diverse and require more awareness and training. Further studies are needed in a b broader federated population of obstetrician/ gynecologists. Educational and sensitizing interventions are needed to improve the quality of abortion care.

12.
Psychol Health Med ; 21(1): 10-9, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26125120

RESUMO

The role of outpatient hematopoietic stem cell transplantation (HSCT) as a therapeutic tool has been strengthened significantly because of the increasing number of patients undergoing this treatment. Due the very nature of this procedure, one of the aspects that should not be overlooked is the quality of life (QOL) of patients undergoing HSCT. Thus, one must consider not only health status after treatment, but also, the psychosocial implications for the patient. This is an observational, longitudinal, and prospective study to assess QOL in patients undergoing outpatient HSCT vs. similar patients receiving medical treatment (MxTx). By applying the COOP/WONKA charts on five occasions (pre-HSCT/initial, post-HSCT/first month, and at 3, 6, and 9 months), thirty-eight patients were analysed, 19 with HSCT and 19 with MxTx with no differences in age, gender or diagnosis. The initial survey found significant differences only in pain perception, which was higher in the HSCT group (p = .08); at the first month, there was a greater tendency for feelings of depression or anxiety in the HSCT group (p = .016), with more limitations in social (p = .003) and daily (p = .044) activities. From 3 months post-HSCT, the results were very similar. The differences persisted only in the area of social activities. Four patients developed graft-versus-host disease with no significant difference in the scores obtained compared to other transplant patients at 3, 6, and 9 months (p = .26) of follow-up.


Assuntos
Assistência Ambulatorial , Doenças Hematológicas/terapia , Transplante de Células-Tronco Hematopoéticas/métodos , Qualidade de Vida , Adolescente , Adulto , Idoso , Ansiedade/epidemiologia , Depressão/epidemiologia , Feminino , Seguimentos , Doença Enxerto-Hospedeiro/etiologia , Neoplasias Hematológicas/terapia , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Transplante de Células-Tronco Hematopoéticas/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Percepção da Dor , Estudos Prospectivos , Participação Social/psicologia , Resultado do Tratamento , Adulto Jovem
13.
CBE Life Sci Educ ; 14(3): 14:ar35, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26338318

RESUMO

A number of studies have identified correlations between children's stereotypes of scientists, their science identities, and interest or persistence in science, technology, engineering, and mathematics. Yet relatively few studies have examined scientist stereotypes among college students, and the literature regarding these issues in predominantly nonwhite and 2-yr college settings is especially sparse. We piloted an easy-to-analyze qualitative survey of scientist stereotypes in a biology class at a diverse, 2-yr, Asian American and Native American Pacific Islander-Serving Institution. We examined the reliability and validity of the survey, and characterized students' comments with reference to previous research on stereotypes. Positive scientist stereotypes were relatively common in our sample, and negative stereotypes were rare. Negative stereotypes appeared to be concentrated within certain demographic groups. We found that students identifying nonstereotypical images of scientists at the start of class had higher rates of success in the course than their counterparts. Finally, evidence suggested many students lacked knowledge of actual scientists, such that they had few real-world reference points to inform their stereotypes of scientists. This study augments the scant literature regarding scientist stereotypes in diverse college settings and provides insights for future efforts to address stereotype threat and science identity.


Assuntos
Grupos de Populações Continentais , Engenharia/educação , Matemática/educação , Pesquisa , Ciência/educação , Estereotipagem , Tecnologia/educação , Feminino , Humanos , Idioma , Masculino , Reprodutibilidade dos Testes , Projetos de Pesquisa , Estudantes , Inquéritos e Questionários , Estados Unidos , Universidades , Recursos Humanos
14.
Hematology ; 20(2): 72-6, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25034734

RESUMO

INTRODUCTION: The advent of imatinib as a therapeutic option of chronic myeloid leukemia (CML) has transformed this previously highly resistant disease into one that is susceptible to management with oral drugs that now offer high long-term survival rates. However, achieving an adequate adherence to treatment regimes is of critical importance. The characteristics of treatment compliance in Mexican patients have not been determined. METHODS: We evaluated 38 CML patients, members of the Glivec(®) International Patient Assistance Program (GIPAP). A bimonthly simplified medication adherence questionnaire was applied and the adherence rate was calculated by direct tablet counting. RESULTS: Two groups, one of local patients and another of out-of-town patients, were studied using an 85% adherence rate as a cut-off. The overall adherence rate was 85.9%. Fifteen patients were considered non-adherent (39.5%). The group of out-of-town patients presented a higher adherence rate of 92.8% in contrast with 76.3% in the local population (P = 0.021). The probability of achieving a complete cytogenetic response at some point of evolution after 8 years of follow-up was 93% in the adherent group vs. 58% in the group with an adherence rate <85% (P = 0.008). In patients with imatinib failure, the adherence rate was 75.8% compared to 95.5% (P = 0.008) in the optimal response group. CONCLUSIONS: In Mexican patients with CML, non-adherence to treatment is a cause of the failure to achieve remission or the subsequent loss of a complete cytogenetic and major molecular response.


Assuntos
Antineoplásicos/uso terapêutico , Benzamidas/uso terapêutico , Leucemia Mielogênica Crônica BCR-ABL Positiva/tratamento farmacológico , Leucemia Mielogênica Crônica BCR-ABL Positiva/psicologia , Cooperação do Paciente/etnologia , Piperazinas/uso terapêutico , Pirimidinas/uso terapêutico , Adulto , Idoso , Feminino , Acesso aos Serviços de Saúde , Humanos , Mesilato de Imatinib , Leucemia Mielogênica Crônica BCR-ABL Positiva/patologia , Masculino , México , Pessoa de Meia-Idade , Cooperação do Paciente/psicologia , Indução de Remissão , Inquéritos e Questionários
16.
Rev. Assoc. Paul. Cir. Dent ; 68(4): 308-311, out.-dez. 2014. ilus
Artigo em Português | LILACS, BBO - Odontologia | ID: lil-745429

RESUMO

A perda precoce de dentes decíduos pode acarretar dano à oclusão e outras sequelas estético-funcionais indesejáveis. Nesses casos, tão importante quanto a reabilitação do paciente, é a escolha adequada do tipo de aparelho mantenedor de espaço. Este trabalho é um relato de caso clínico no qual uma criança de três anos de idade apresentou perda precoce dos incisivos superiores decíduos onde foi instalado um aparelho mantenedor estético-funcional fixo. Em um período inicial de quatro meses de acompanhamento a mãe relatou boa aceitação quanto à adaptação e higienização do aparelho. Consultas de proservação do caso serão feitas mensalmente até o início da erupção dos incisivos permanentes.


The premature loss of primary teeth can cause damage to occlusion and other undesirable aesthetic-functional sequelaes. ln such cases, as important as the rehabilitation of the patient, is the accurate choice of space maintenance appliance. This work is a case report in which a child of three years old showed premature loss of deciduous incisors and a aesthetic-functional fixed appliance was installed. ln an initial follow-up of 4 months, the mother reported good acceptance on the adjustment and cleaning of the device. The clinical visits of proservation of the case will be scheduled monthly until the eruption of the permanent incisors.


Assuntos
Humanos , Pré-Escolar , Cárie Dentária/diagnóstico , Dente Decíduo/anatomia & histologia , Dente Decíduo/fisiologia , Mantenedor de Espaço em Ortodontia
17.
J Clin Endocrinol Metab ; 99(4): 1112-6, 2014 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-24476076

RESUMO

CONTEXT: Posterior reversible encephalopathy syndrome (PRES) is a neurological entity characterized by seizures, headache, and reversible subcortical vasogenic edema. It is associated with many etiologies, most often hypertension, chronic renal failure, and chemotherapy. Hypercalcemia is rarely associated with PRES. OBJECTIVE: The aim of this study is to describe and discuss a case of PRES that developed in a patient with malignant hypercalcemia, with emphasis on the possible pathophysiological mechanisms involved. PATIENTS AND METHODS: A 38-year-old woman presented with altered mental status. She had a 2-month history of lumbar pain of moderate intensity, weight loss, and gastrointestinal complaints, in addition to a mass in her left breast. Her corrected serum calcium was 14.5 mg/dL. She was normotensive, had no focalizing signs, and her cerebrospinal fluid was normal. Despite treatment, her neurological state did not resolve, and she developed severe headaches at day 4 of her admission. Brain magnetic resonance imaging showed a bilateral and symmetric hyperintensity in the occipital and parietal lobes on T2-weighted and fluid-attenuated inversion recovery imaging, a characteristic highly suggestive of PRES. After correction of hypercalcemia, her symptoms and imaging abnormalities resolved. CONCLUSIONS: The development of PRES in the setting of severe hypercalcemia is extremely rare. Hypercalcemia could lead to PRES in the absence of hypertension by various mechanisms, including vasospasm, endothelial dysfunction, and an inflammatory state. A high index of suspicion is needed in this setting because hypercalcemia can lead to neurological symptomatology, and prompt diagnosis is essential for adequate treatment.


Assuntos
Neoplasias da Mama/complicações , Carcinoma Ductal de Mama/complicações , Hipercalcemia/complicações , Síndromes Paraneoplásicas/complicações , Síndrome da Leucoencefalopatia Posterior/etiologia , Adulto , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/patologia , Carcinoma Ductal de Mama/diagnóstico , Carcinoma Ductal de Mama/patologia , Feminino , Humanos , Hipercalcemia/diagnóstico , Síndromes Paraneoplásicas/diagnóstico , Síndrome da Leucoencefalopatia Posterior/diagnóstico
18.
Colomb. med ; 44(2): 115-117, Apr.-Jun. 2013. tab
Artigo em Inglês | LILACS-Express | LILACS | ID: lil-677383

RESUMO

The eccrine poroma or Hidracanthoma Simplex is a rare benign adnexal tumor of ephitelial cells, with an incidence of 0.001 to 0.008%¹. In two-thirds of the patients it appears on the soles and lateral borders of the feet. We report the case of a patient with pigmented eccrine poroma in abdominal skin, of a rare entity presentation with a single report in the literature in that location.


El poroma ecrino o hidroacantoma simple, es una tumoración anexial benigna de células epiteliales, de rara presentación, con una incidencia de 0.001 a 0.008%1. En dos tercios partes de los pacientes se presenta en la planta y bordes laterales de los pies. Reportamos el caso de una paciente con Poroma ecrino pigmentado en piel abdominal, entidad de rara presentación con un sólo reporte en la literatura en esa ubicación.

19.
Eur J Haematol ; 90(6): 494-500, 2013 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-23470153

RESUMO

UNLABELLED: Corticosteroids as initial therapy for primary immune thrombocytopenia achieve a low rate of sustained remission. METHODS: We prospectively evaluated the efficacy, safety, and response duration of low-dose rituximab plus high-dose dexamethasone as frontline therapy in newly diagnosed primary immune thrombocytopenia patients. One cycle of dexamethasone, 40 mg/d/intravenously for four consecutive days, plus weekly intravenous rituximab, 100 mg for four doses, was delivered. RESULTS: Twenty-one consecutive adults were enrolled. The overall response at day +28 was 90.5%. Complete sustained response at 6 months and relapse rate were 76.2% and 15.8%, respectively, compared with 30% and 62.5% for a historical group who had received standard treatment with prednisone (P = 0.005 and P = 0.004). There was a 9.5% incidence of adverse effects. CONCLUSIONS: The combination of low-dose rituximab and high-dose dexamethasone as frontline therapy for adults with primary immune thrombocytopenia was effective and had a high overall response rate and a low incidence of relapse.


Assuntos
Anti-Inflamatórios/administração & dosagem , Anticorpos Monoclonais Murinos/administração & dosagem , Dexametasona/administração & dosagem , Fatores Imunológicos/administração & dosagem , Púrpura Trombocitopênica Idiopática/tratamento farmacológico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Anti-Inflamatórios/efeitos adversos , Anticorpos Monoclonais Murinos/efeitos adversos , Dexametasona/efeitos adversos , Quimioterapia Combinada , Feminino , Humanos , Fatores Imunológicos/efeitos adversos , Masculino , Pessoa de Meia-Idade , Recidiva , Rituximab
20.
Colomb Med (Cali) ; 44(2): 115-7, 2013 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-24892457

RESUMO

The eccrine poroma or Hidracanthoma Simplex is a rare benign adnexal tumor of ephitelial cells, with an incidence of 0.001 to 0.008%1. In two-thirds of the patients it appears on the soles and lateral borders of the feet. We report the case of a patient with pigmented eccrine poroma in abdominal skin, of a rare entity presentation with a single report in the literature in that location.

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