Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 167
Filtrar
1.
ANZ J Surg ; 2019 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-31566295

RESUMO

BACKGROUND: Hepatocellular carcinoma is the most frequent primary tumour of the liver. Although often associated with chronic liver disease, it can also occur in non-cirrhotic livers. The aim of this study was to describe post-operative morbidity (POM), and survival of patients with hepatocellular carcinoma in non-cirrhotic liver treated surgically, and to identify variables associated with prognosis. METHODS: Case series of patients who underwent surgery for hepatocellular carcinoma in non-cirrhotic liver at Clínica RedSalud Mayor de Temuco, Chile (2001-2017), were studied. The minimum follow-up time considered was 12 months. Principal outcomes were development of POM and survival. Other variables of interest were age, sex, tumour diameter, surgical time, hospital stay, follow-up time, need for surgical re-intervention, mortality, vascular and lymph node invasion and staging. Descriptive and analytic statistics were calculated. RESULTS: A total of 32 patients were studied. They were characterized by a mean age of 67.3 ± 7.2 years, 62.5% of whom were men. Averages of tumour diameter, surgical time and hospitalization were 12.0 ± 2.6 cm, 114.4 ± 32.3 min and 7.2 ± 2.9 days, respectively. POM was 31.3%. There was no mortality and there were no re-interventions. The overall actuarial survival at 1, 2 and 3 years was 96.8%, 73.4% and 17.3%, respectively. Lower survival was verified in patients with vascular invasion, lymph node infiltration and stages III and IVa. CONCLUSION: Despite the tumour diameter and extent of the resections, POM in patients with hepatocellular carcinoma in non-cirrhotic liver is moderate. However, its prognosis is poor. Vascular invasion, lymph node invasion and advances stages were associated with worse survival.

2.
Int. j. morphol ; 37(3): 917-927, Sept. 2019. graf
Artigo em Espanhol | LILACS-Express | ID: biblio-1012376

RESUMO

RESUMEN: El carcinoma gástrico (CG) de tipo intestinal se origina en un epitelio displásico, que a su vez se desarrolla en medio de una atrofia gástrica (AG) y metaplasia intestinal (MI). La infección por Helicobacter pylori (HP) es la causa más frecuente de AG, causando una pangastritis atrófica multifocal. Entre otras condiciones que producen inflamación crónica de la mucosa gástrica se encuentran también la gastritis autoinmune y la anemia perniciosa. El marco conceptual sobre el cual descansa gran parte de la investigación actual y nuestra comprensión de los cambios que ocurren en la mucosa gástrica se debe a la denominada "cascada de Correa"; quien planteó que la mucosa gástrica crónicamente inflamada, da paso a la AG, que va adquiriendo focos de MI y en dicho epitelio se desarrollará finalmente una displasia (DIS). Se ha acuñado el término lesiones preneoplásicas gástricas (LPG), para referirse a: AG, MI y DIS.Después de la erradicación de HP, se ha demostrado una reducción general de la incidencia de CG; efecto que no es tan claro, cuando la pangastritis por HP ha evolucionado a AG extensa. De tal modo que el efecto de la erradicación de HP medido a través de EC, ha sido poco consistente. La AG grave diagnosticada por histología representa la condición de mayor riesgo. Por otra parte, la MI puede ser de tipo intestinal (delgado-entérica ó incompleta) y la colónica (colónica ó completa) considerándose a esta última, como la variedad de peor pronóstico. El diagnóstico histológico de este tipo de lesiones determina que quien las padece, debe someterse a vigilancia endoscópica. El objetivo de este manuscrito fue resumir la evidencia existente respecto de las LPG, en términos de su caracterización morfológica y sus repercusiones diagnóstico-terapéuticas (significado patológico, graduación del riesgo, vigilancia recomendada; y factores de riesgo).


SUMMARY: Gastric carcinoma (GC) of intestinal type, originates from a dysplastic epithelium, which in turn develops in the midst of gastric atrophy (GA) and intestinal metaplasia (IM). Helicobacter pylori (HP) infection is the most frequent cause of GA, causing a multifocal atrophic pangastritis. Among other conditions that produce chronic inflammation of gastric mucosa are also autoimmune gastritis and pernicious anemia. The conceptual framework on which much of current research rests and our understanding of the changes that occur in the gastric mucosa is due to the so-called "Correa waterfall"; who stated that gastric mucosa chronically inflamed, gives way to the GA, which is acquiring foci of IM and in said epithelium a dysplasia (DIS) will eventually develop. The term precancerous conditions (PCC) of the gastric mucosa have been coined to refer to: GA, IM and DIS. After HP eradication, a general reduction in the incidence of GC has been demonstrated; effect that is not so clear, when pangastritis by HP has evolved to extensive GA. Thus, the effect of HP eradication measured through clinical trials has been inconsistent. Severe GA diagnosed represents the highest risk condition. On the other hand, IM can be enteric (grade I), enterocolic (grade II) or colonic (grade III); considering IM III as the variety with the worst prognosis. Histological diagnosis of gastric PCC, determines that the one who suffers them, must undergo endoscopic surveillance. The aim of this manuscript was to update morphological aspects and diagnostic-therapeutic scope of gastric PCC.

3.
Int. j. morphol ; 37(3): 1033-1037, Sept. 2019. graf
Artigo em Espanhol | LILACS-Express | ID: biblio-1012392

RESUMO

RESUMEN: La infección por Actinomices (actinomicosis), es una entidad poco frecuente y que puede crear dificultades diagnósticas y terapéuticas; principalmente cuando por su presentación se asemeja a neoplasias malignas. El objetivo de este estudio fue reportar un caso de actinomicosis de pared abdominal con infiltración hepática y revisar la evidencia existente. Se trata de una paciente sexo femenino, de 33 años de edad, sin antecedentes quirúrgicos ni de utilización de dispositivos intra-uterinos. Consultó por dolor abdominal y masa palpable a nivel epigástrico. Se estudió con imágenes, las que permitieron verificar una masa de pared abdominal con trayecto fistuloso al hígado. Se realizó una exéresis amplia de la lesión antes descrita. Una vez extirpado el espécimen, se fue a estudio histopatológico, que reveló gránulos de azufre consistentes con actinomices. La paciente evolució de forma satisfactoria, sin inconvenientes. Presentamos un caso poco común de actinomicosis de pared abdominal con infiltración hepática. Cuando se encuentra una gran masa intraperitoneal, la actinomicosis debe incluirse en el proceso de diagnóstico diferencial.


SUMMARY: Actinomyces infection (actinomycosis) may create diagnostic conflicts and be confused with malignant neoplasms, especially in the abdomen. The objective of this study was to report a case of abdominal wall actinomycosis with hepatic infiltration, and review the existing evidence. Female patient, 33 years of age, with no surgical history or use of intra-uterine devices. She consulted for abdominal pain and palpable mass at the epigastrium. It was studied with images, which allowed verifying an abdominal wall mass with hepatic fistulae. A broad extirpation of the lesion was performed. The histological study revealed sulfur granules consistent with actinomyces. The patient has evolved satisfactorily, without problems; and is currently in treatment with amoxicillin. We present an unusual case of abdominal wall actinomycosis with hepatic infiltration that resulted in a difficult diagnosis. When a large intraperitoneal mass is found, actinomycosis needs to be included as a differential diagnoses.

4.
Int. j. odontostomatol. (Print) ; 13(3): 310-315, set. 2019. graf
Artigo em Espanhol | LILACS-Express | ID: biblio-1012428

RESUMO

RESUMEN: La odontodisplasia regional (OR) es una alteración en el desarrollo, no hereditario y que afecta tanto la dentición temporal como la dentición definitiva. Involucra a los tejidos mesodérmicos y ectodérmicos de los dientes lo que es condescendiente con hallazgos clínicos, radiográficos e histológicos. Su etiología aun es desconocida y se presenta mayoritariamente en mujeres. Clínicamente puede afectar al maxilar, a la mandíbula o ambas arcadas pero generalmente solo se ve comprometida una ellas, principalmente el más afectado es el hueso maxilar. Radiográficamente se observa una pobre diferencia entre los tejidos del esmalte y la dentina, siendo tejidos menos radiopacos que su contraparte sana generando un aspecto descrito como "diente fantasma". Histológicamente se observan zonas hipocalcificadas del esmalte con un orden de prismas irregulares mientras que la dentina se observa con un número reducido de túbulos dentinarios y de consistencia más fibrosa en su zona coronal. El tratamiento de la OR es controversial ya que su incidencia es baja y la literatura al respecto no es clara. El objetivo de este manuscrito, fue reportar un caso de OR y revisar la literatura relacionada. Presentamos un caso de OR en una paciente de 12 años que presenta ausencia de los dientes 2.4, 2.5 y 2.6; restos radiculares y agenesia de los dientes 3.5 y 4.5. Se describirán sus aspectos clínicos, radiográficos e histológicos. Se realizó una búsqueda sistemática en las siguientes bases de datos: Clínical key, Science Direct, PubMed y SciELO.


ABSTRACT: Regional odontodysplasia (RO) is a variation in the development; it is not hereditary and it affects both deciduous and permanent dentition. It involves the mesodermal and ectodermal tissues of dental pieces, and coincides with clinical, radiographic and histological findings. Its etiology is still unknown and it reportedly occurs mostly in women. Clinically it can affect the maxilla, mandible or both arches but generally only one is compromised, mainly the maxilla which is affected the most. Radiographically there is limited difference between enamel and dentin tissue, which is less radiopaque than their healthy counterpart, generating an aspect described as "phantom tooth". Histologically hypocalcified areas of the enamel are observed with an irregular order of prisms while the dentine is observed with a reduced number of dentinal tubules and more fibrous consistency in the coronal area. RO treatment is controversial since its incidence is low and the literature on these events is not clear. The aim of this manuscript was to report a case of RO and review related literature. We present a case of RO in a 12-year-old patient who presents absence of parts 2.4.2.5 and 2.6; radicular remains and agenesis of parts 3.5 and 4.5. Its clinical, radiographic and histological aspects are described. A systematic search was carried out in the following databases: Clinical key, Science Direct, PubMed and SciELO.

5.
Artigo em Espanhol | LILACS-Express | ID: biblio-1020668

RESUMO

RESUMEN: La Pansinusitis aguda odontogénica es un cuadro infeccioso infrecuente que afecta a todos los senos paranasales, en el cual se hace necesario un diagnóstico precoz para obtener una menor morbilidad. Un correcto diagnóstico requiere una evaluación dental exhaustiva, apoyándose con imágenes apropiadas. El presente caso clínico reporta paciente femenino de 17 años, sin enfermedades crónicas de base, diagnosticada con pansinusitis aguda odontogénica a través de examen de tomografía axial computarizada. Fue manejada de forma intrahospitalaria con un equipo multidisciplinario para su recuperación. Tratada con antibioterapia de amplio espectro vía parenteral y manejo del dolor, posterior al alta médica se realizó endodoncia del diente afectado y rehabilitación con prótesis fija unitaria.


ABSTRACT: Acute Odontogenic Pansinusitis is an infrequent infectious disease that affects all the paranasal sinuses. It requires an early diagnosis to obtain a lower morbidity. A correct diagnosis requires thorough dental evaluation, supported by appropriate images. The present clinical case reports a 17-year-old female patient, without chronic underlying diseases, with anacute Odontogenic Pansinusitis diagnosed through a computerized axial tomography scan. She was treated by a multidisciplinary team for recovery, through parenteral wide spectrum antibiotic therapy and pain management. After medical discharge, root canal of the affected tooth and rehabilitation with fixed unitary prosthesis were performed.

6.
Int. j. morphol ; 37(2): 773-779, June 2019. tab, graf
Artigo em Espanhol | LILACS | ID: biblio-1002292

RESUMO

La información disponible referente a las características proteómicas del E. granulosus es escasa (no supera los 50 estudios publicados); y nos parece que la identificación proteómica, podría mejorar la comprensión de algunas características bioquímicas e inmunológicas de la Equinococosis Quística (EQ). De tal modo que el proteoma de E. granulosus aún no está bien descrito. Sólo existen reportes de algunas secuencias de proteínas. El objetivo de este manuscrito fue comentar algunos aspectos de la evidencia existente respecto de los estudios del perfil proteómico del E. granulosus. Se recomienda el estudio de al menos el quiste y su pared, el líquido hidatídico y la víscera del hospedero. Para ello, existen metodologías que han sido empleadas para estudiar las características proteómicas de la EQ. Entre ellas, destacan SDS-PAGE, electroforesis bidimensional combinada con Western Blot, inmunoanálisis, y espectrometría de masas mediante técnicas MALDI-TOF. Se han identificado una serie de proteínas en muestras de EQ. Algunas de ellas, asociadas a procesos inmunológicos, de gluconeogénesis, glucogenolisis y glucogénesis. Por otra parte, se ha documentado la liberación de exosomas al líquido hidatídico por parte de los protoescólex y la capa germinativa; estructuras en las que se han identificado factores de virulencia asociados con la supervivencia del quiste. No obstante lo anteriormente señalado, se requiere de múltiples estudios exhaustivos en la materia para comprender mejor la caracterización perfil proteómico del E. granulosus.


The information available regarding the proteomic characteristics of E. granulosus is scarce; and it seems that the proteomic identification could improve the understanding of some biochemical and immunological characteristics of cystic echinococcosis (CE). So, the proteome of E. granulosus is still not well described yet. There are only reports of some protein sequences. The objective of this manuscript was to comment on some aspects of the existing evidence regarding studies of the proteomic profile of E. granulosus. The study of at least the cyst and its wall, the hydatid fluid and the viscera of the host are recommended. There are a series of methodologies that have been used to study the proteomic characteristics of EQ. These include SDS-PAGE, bidimensional electrophoresis combined with Western Blot, immunoassay, and mass spectrometry using MALDI-TOF techniques. A series of proteins have been identified in CE samples. Some of them, associated with immune response, gluconeogenesis, glycogenolysis and glycogenesis. On the other hand, release of exosomes to the hydatid fluid by protoescolex and germinative layer has been documented (associated virulence factors have been identified in these structures). Notwithstanding the foregoing, it requires multiple exhaustive studies in the field to better understand the characterization of the proteomic profile of E. granulosus.


Assuntos
Proteínas/análise , Proteômica/métodos , Echinococcus granulosus/química , Echinococcus granulosus/genética , Echinococcus granulosus/metabolismo , Eletroforese em Gel de Poliacrilamida
7.
Int. j. morphol ; 37(2): 677-681, June 2019. graf
Artigo em Espanhol | LILACS | ID: biblio-1002275

RESUMO

El angiomixoma de la pelvis es un tumor mesenquimal inusual; que dado su alto potencial de recidiva es relevante que la exéresis quirúrgica sea lo más radical posible. Por su parte, la endometriosis infiltrativa profunda, es otra entidad poco frecuente que requiere de tratamientos complejos. La co-existencia de ambas patologías representa una situación absolutamente infrecuente; de los que hay muy pocos casos reportado en la literatura occidental. Se presenta el caso de una mujer de 41 años de edad que desarrolló ambas entidades nosológicas de forma concomitante y que fue tratada quirúrgicamente con buenos resultados.


Angiomyxoma of the pelvis is an unusual mesenchymal tumor; that given its high potential for recurrence, it is relevant that the surgical resection be as radical as possible. For its part, to deep infiltrative endometriosis is another rare entity that requires complex treatments. The co-existence of both pathologies represents an absolutely infrequent situation; of which there are very few cases reported in western literature. We present the case of a 41-year-old woman who developed both clinical entities concomitantly and who was treated surgically with good results.


Assuntos
Humanos , Feminino , Adulto , Neoplasias Pélvicas/patologia , Endometriose/patologia , Mixoma/patologia , Neoplasias Pélvicas/cirurgia , Neoplasias Pélvicas/complicações , Colectomia , Endometriose/cirurgia , Endometriose/complicações , Mixoma/cirurgia , Mixoma/complicações
8.
Int. j. odontostomatol. (Print) ; 13(2): 189-194, jun. 2019. graf
Artigo em Espanhol | LILACS-Express | ID: biblio-1002304

RESUMO

RESUMEN: La displasia cleidocraneal (DCC), es un trastorno autosómico dominante poco común, que involucra principalmente a los huesos que se osifican por vía membranosa; afectando el cierre de fontanelas craneales y el desarrollo de las clavículas, además de anomalías dentales y vertebrales. El objetivo de este manuscrito fue reportar el caso de una paciente con DCC que presentó un queratoquiste odontogénico (QQO) intrasinusal. Presentamos el caso de una paciente de 81 años, diagnosticada en su niñez con DDC, que consultó por un desajuste protésico y molestias en relación a la zona del seno maxilar derecho. Clínicamente se observó desajuste de la prótesis y aumento de volumen de márgenes poco definidos en la zona maxilar derecha, color rosa coral; que se extendía por todo el margen hemimaxilar derecho hasta el fondo de vestíbulo; doloroso a la palpación, con un mes de evolución. Se solicitó CBCT, con el que se pudo verificar la presencia de un desarrollo tumoral de contenido similar a dentículos, ubicado en la totalidad del seno maxilar derecho; extendiéndose hasta el piso de la cavidad nasal y orbitaria. Se estableció la hipótesis diagnóstica de "odontoma compuesto". Se le intervino quirúrgicamente, bajo anestesia general, realizándose una excisión de la lesión; la que era de márgenes definidos, con cambios de coloración en tonos oscuros, con la inclusión de tres piezas dentarias; de aspecto maligno. Se logró enucleación completa, dejando remanente óseo limpio. La pieza fue enviada a estudio histopatológico. En informe histopatológico, describió la presencia de una lesion quistica con pared compatible con queratoquiste.


ABSTRACT: Cleidocranial dysplasia (CCD) is an uncommon autosomal dominant disorder that mainly involves bones that ossify via the membrane, affecting the closure of cranial fontanels and the development of the clavicles, as well as presenting dental and vertebral anomalies. The aim of this manuscritpt was to report a case of a patient with CCD who presented an intrasinusal odontogenic keratocyst.We present an 81-year-old female patient, diagnosed with this syndrome in childhood, who comes to our service for a prosthetic misalignment and discomfort of the right maxillary sinus area. Clinically, there was a mismatch of the prosthesis and an increase in the volume of undefined margins under it, coral pink color, which extended all over the right hemimaxillary margin to the bottom of the vestibule, painful on palpation, with a one month evolution. A CBCT was requested, which revealed the presence of a tumor development with content similar to denticles, located in the entire right maxillary sinus, extending to the floor of the nasal and orbital cavity. The diagnostic hypothesis of "compound odontoma" was established. The patient was operated on in the central ward, under general anesthesia performing the excisional biopsy of the lesion, which showed changes in coloration in dark tones, with defined edges, with the inclusion of three teeth showing malignancy aspects. Complete enucleation was achieved, leaving tumor-free clean bone remnant. In a histopathological report, the presence of a keratocyst wall was described, which is not very compatible given the appearance of the lesion, the presence of the dental pieces included in it, and the behavior of the lesion.

9.
Cir Cir ; 87(3): 313-320, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31135772

RESUMO

Objective: To describe the results of the extension of surgical treatment and adjuvant chemotherapy (ACT) in incidental gallbladder cancer (CVB), in terms of postoperative morbidity (POM) and 5-year overall survival rate. Method: Case series of patients operated on for incidental GBC in Clínica Mayor, Temuco, Chile (2001-2016). All cases were treated by partial hepatectomy (segments IVb and V), and regional lymphadenectomy. The minimum follow-up time was 12 months. Outcome variables were MPO and 5-year overall survival rate. Other variables of interest were: infiltration depth in vesicular wall, lymph nodes and resected liver; surgical time, need for reoperation, hospital stay, follow-up and mortality. Descriptive statistics were applied as well as bivariate analysis applying Fisher's exact and t-test and non-parametrical tests for continuous variables and Kaplan Meier curves. Results: The series was composed of 50 patients, whose average age was 58.6 ± 9.6 years; 68.0% of which were women. The mean surgical time and hospital stay were 224 ± 93 min (90 to 480) and 6.9 ± 2.9 days (4 to 20), respectively. POM was 28.0%. 5-year overall survival rate was 47%. There were no reoperations or mortality. Conclusions: The results verified in terms of POM and 5-year overall survival rate are similar to previously reported series.

10.
HPB (Oxford) ; 21(11): 1427-1435, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30922845

RESUMO

BACKGROUND: Equipoise exists regarding the benefit of adjuvant therapy (AT) in patients with gallbladder cancer (GBC). The aim of this study was to critically review the available evidence for the effectiveness of AT in patients with GBC following surgery with curative intent. METHODS: A systematic review was performed. Relevant studies were identified from Trip Database, BIREME-BVS, SciELO, Cochrane Central Register, WoS, MEDLINE, EMBASE and SCOPUS. Adjuvant therapies considered included chemotherapy, chemoradiotherapy, and radiotherapy. The primary outcome was overall survival (OS). Subgorup analysis of patients with positive lymph node disease (PLND), positive surgical margin (PSM), or advanced stage (AS) were performed. RESULTS: 748 related articles were identified; 27 met the selection criteria (3 systematic reviews and 24 observational studies). Evidence provided was moderate, poor and very poor for chemotherapy, chemoradiotherapy, and radiotherapy. Existing evidence is not robust, but suggests certain benefits with AT in improving OS, especially in patients with PLND, PSM and AS. CONCLUSION: Results do not provide strong evidence that AT is effective in patients who undergo resection for GBC. Subgroups of PLND and PSM may have a survival advantage. Future studies with appropriate internal validity and adequate number of patients are required to better answer this question.

11.
Rev. nefrol. diál. traspl ; 39(1): 50-54, ene. 2019. ilus, tab
Artigo em Espanhol | LILACS | ID: biblio-1007125

RESUMO

En México la enfermedad renal crónica en la población pediátrica es un grave problema de salud pública. Las alternativas terapéuticas en niños con enfermedad renal crónica (ERC) son la diálisis y el trasplante renal (TxR), siendo esta última, la mejor opción terapéutica actual en niños con estadios terminal de la función renal. El objetivo de este manuscrito, fue reportar nuestra experiencia en el tratamiento perioperatorio de pacientes pediátricos sometidos a trasplante renal en bloque. Paciente de sexo femenino, 12 años de edad, originaria de Veracruz, México. Portadora de ERC estadio IV de KDOQI, secundaria a glomerulopatía. Fue programada para TxR en bloque de donante cadavérico pediátrico; el que se realizó bajo anestesia general balanceada, con ventilación mecánica controlada, isquemia fría de 17 hs, isquemia caliente de 30 min y un tiempo quirúrgico de 5 hs y 10 min. El tiempo anestésico total, fue de 6 hs. La paciente fue trasladada a la Unidad de Terapia Intensiva Pediátrica, con adecuada aceptación del injerto renal. Durante los siguientes siete meses, el curso clínico ha sido satisfactorio, con estudios ecotomográficos renales normales. En esta paciente la glomerulonefritis, le ocasionó que debutara a muy corta edad con una enfermedad renal crónica con terapia sustitutiva de hemodiálisis. El trasplante renal en bloque realizado, fue exitoso debido al manejo multidisciplinario que participa en el programa de trasplante renal


In Mexico, chronic kidney disease is a major public health problem in pediatric patients. The therapeutic options for chronic kidney disease (CKD) in children are dialysis and kidney transplant (KT); the latter constitutes the current treatment of choice for children suffering from end-stage renal disease. The aim of this study was to describe our experience of perioperative treatment of pediatric patients undergoing en bloc kidney transplant. Female patient, 12 years old, from Veracruz, Mexico, suffering from stage 4 CKD according to KDOQI criteria, secondary to glomerulonephritis. An en bloc kidney transplantarion from a pediatric deceased donor was performed; balanced general anesthesia with mechanical ventilation was used. Cold ischemia time was 17 hours and warm ischemia time was 30 minutes. The surgery lasted 5 hours and 10 minutes and the total anesthesia time was 6 hours. The patient was taken to the pediatric intensive care unit and showed an adequate renal graft acceptance. During the following seven months the clinical course was satisfactory and kidney echotomography showed normal results. Glomerulonephritis made this patient undergo hemodialysis replacement therapy due to CKD at a very early age. The en bloc kidney transplantation performed was successful thanks to the multidisciplinary management involved in the Kidney Transplant Program


Assuntos
Humanos , Feminino , Transplante de Rim , Diálise Renal , Glomerulonefrite/complicações
12.
Int. j. morphol ; 36(4): 1485-1489, Dec. 2018. tab, graf
Artigo em Espanhol | LILACS | ID: biblio-975726

RESUMO

La neoplasia papilar intracolecística (NPIC), es un tumor compuesto por células neoplásicas preinvasivas, que forman masas de hasta 1,0 cm, clínicamente detectables. El objetivo de este estudio fue reportar un caso de NPIC y revisar la evidencia existente. Se trata de un paciente sexo masculino, de 33 años de edad, asintomático, que en el curso de un examen de salud, se realiza una ecotomografía abdominal, en la que se verifica una lesión polipoide vesicular de 32 x 19 mm de diámetro. Se programa para colecistectomía electiva, la que se realizó por vía laparoscópica, cirugía que se pudo realizar sin inconvenientes. Una vez extirpado el espécimen, se fue a estudio histopatológico en el que tras un mapeo vesicular se concluye NPIC, colecistitis crónica inespecífica, colesterolosis y pólipos colesterínicos. El paciente ha evolucionado sin inconvenientes. Presentamos un caso de NPIC en un paciente joven, cuyo diagnóstico fue confirmado por anatomía patológica tras una colecistectomía electiva, descartándose la presencia de carcinoma invasivo y displasia de alto grado, por lo que el pronóstico es favorable.


Intracholecystic papillary neoplasm (ICPN) is a tumor composed of pre-invasive neoplastic cells, with up to 1.0 cm clinically detectable masses. The objective of this study was to report a case of NPIC and review the evidence in the literature. A 33-year-old asymptomatic male patient had an abdominal ultrasonography during a health examination, in which a vesicular polyp lesion of 32 x 19 mm in diameter was verified. Thepatient was subsequently scheduled for elective cholecystectomy, which was performed laparoscopically and the surgery was uneventful. Once removed, the specimen was studied histopathologically and after performing vesicular mapping, we determined an ICPN, chronic non-specific cholecystitis, cholesteroliasis and cholesteric polyps. The patient has evolved without reported problems. We present a case of ICPN in a young patient, whose diagnosis was confirmed by pathological anatomy after an elective cholecystectomy, ruling out the presence of invasive carcinoma and high-grade dysplasia, with a favorable prognosis.


Assuntos
Humanos , Masculino , Adulto , Adenocarcinoma Papilar/patologia , Neoplasias da Vesícula Biliar/patologia , Pólipos/patologia , Adenocarcinoma Papilar/cirurgia , Colecistectomia Laparoscópica , Neoplasias da Vesícula Biliar/cirurgia
13.
Int. j. morphol ; 36(4): 1222-1224, Dec. 2018. graf
Artigo em Espanhol | LILACS | ID: biblio-975686

RESUMO

El lipoma gástrico (LG), es un tumor benigno raro que representa el 5 % de los lipomas gastrointestinales y menos del 1 % de todos los tumores gástricos. Se localizan habitualmente a nivel de la submucosa y generalmente en la región antral. La endoscopia y la tomografía computarizada son las herramientas diagnósticas más utilizadas en el proceso diagnóstico. Dada su relativa rareza, quedan a menudo fuera del diagnóstico diferencial de las masas submucosas gastrointestinales superiores. El objetivo de este manuscrito, es reportar dos casos tratados de forma consecutiva y revisar la literatura existente en esta materia. Se trata de dos pacientes de sexo masculino, de 49 y 69 años de edad, a quienes se diagnosticó una lesión submucosa gástrica por endoscopia y fueron tratados quirúrgicamente y cuyos especímenes fueron estudiados histológicamente, concluyéndose en ambos casos la existencia de un LG. Ambos pacientes evolucionaron de forma correcta y permanecen en controles clínicos y endoscópicos hasta la actualidad, sin inconvenientes. El LG es una entidad poco común, que puede simular una enfermedad maligna. Presentamos dos casos tratados quirúrgicamente con resultados satisfactorios.


Gastric lipoma (GL), is a rare benign tumor that represents 5 % of gastrointestinal lipomas and less than 1 % of all gastric tumors. They are usually located at the level of the submucosa and usually in the antral region. Endoscopy and computed tomography are the diagnostic tools most used in the diagnostic process. Given their relative rarity, they are often left out of the differential diagnosis of the upper gastrointestinal submucosal masses. The aim of this manuscript was to report two cases treated consecutively and review the existing literature on this subject. Two male patients, 49 and 69 years of age, were diagnosed with a gastric submucosal lesion by endoscopy and were treated surgically. The specimens were studied histologically; concluding the existence of a GL in both cases. The two patients evolved adequately and have remained in clinical and endoscopic controls until now, without problems. GL is a rare entity, which can simulate a malignant disease. We present two cases treated surgically with satisfactory results.


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Idoso , Neoplasias Gástricas/cirurgia , Lipoma/cirurgia , Neoplasias Gástricas/complicações , Neoplasias Gástricas/diagnóstico , Tomografia Computadorizada por Raios X , Dor Abdominal/etiologia , Endoscopia do Sistema Digestório , Lipoma/complicações , Lipoma/diagnóstico
14.
Rev. cub. inf. cienc. salud ; 29(4): 1-11, oct.-dic. 2018. ilus, tab
Artigo em Espanhol | LILACS | ID: biblio-991006

RESUMO

La gestión de información es importante para las instituciones de salud. Por eso, el objetivo de esta investigación fue identificar los productos de información obtenidos desde un sistema de información georreferenciado, utilizando como ejemplo la distribución espacial de las personas mordidas por perros en la ciudad de Temuco, para mostrar productos útiles para la toma de decisiones. Los productos de información asociados a su componente geográfico permitieron visualizar elementos ambientales que los productos clásicos como informes dificultan representar. Mediante un sistema de información georreferenciado e imágenes satelitales pudimos indicar que existen dos zonas de alta concentración de personas mordidas por perros: Pedro De Valdivia y Pueblo Nuevo, con el 36,8 y el 1,4 por ciento respectivamente. También pudimos evaluar los eventos de interés particulares en relación con las fuentes fijas de información y determinar los componentes ambientales involucrados. Por último, utilizando datos basados en un sistema de información georreferenciado, se generaron múltiples productos de información que serían dependientes de las necesidades de información requerida. Los sistemas de información georreferenciados son herramientas de gran ayuda en dar respuesta a las necesidades, cada vez más demandantes, por productos de información inmediatos, económicos y sencillos. Los productos obtenidos a través del sistema de información georreferenciado permiten a los epidemiólogos consolidar e integrar información, conocer la distribución y la densidad, así como realizar los análisis de acuerdo con las necesidades que los eventos de interés patológico requieren y que se resumen en el monitoreo, el control y su posible erradicación(AU)


Information management is important for health institutions. Therefore, as the objective, information products obtained from a georeferenced information system are examined, using as an example the spatial distribution of people bitten by dogs in the city of Temuco, to show useful products for decision making. Information products associated with its geographic component allow the visualization of environmental elements that classic products such as reports make difficult to represent. Using a geo-referenced information system and satellite images, we can indicate that there are two areas of high concentration of people bitten by dogs: Pedro De Valdivia and Pueblo Nuevo, with 36.8 percent and 1.4 percent respectively. We can also evaluate the events of particular interest associated with the fixed sources of information and determine the environmental components involved. Finally, using data based on a geo-referenced information system, multiple information products can be generated that will be dependent on the information needs required. Geo-referenced information systems are very helpful tools in responding to the increasingly demanding needs for immediate, economic and simple information products. The products obtained through georeferenced information systems allow epidemiologists to consolidate and to integrate information, to know the distribution and density, as well as to perform the analyses according to the needs required by the events of pathological interest and that are summarized by monitoring, control and possible eradication(AU)


Assuntos
Humanos , Mordeduras e Picadas/epidemiologia , Gestão da Informação/métodos , Cães , Monitoramento Ambiental/métodos
15.
Rev. cub. inf. cienc. salud ; 29(4): 1-11, oct.-dic. 2018. ilus, tab
Artigo em Espanhol | CUMED | ID: cum-74041

RESUMO

La gestión de información es importante para las instituciones de salud. Por eso, el objetivo de esta investigación fue identificar los productos de información obtenidos desde un sistema de información georreferenciado, utilizando como ejemplo la distribución espacial de las personas mordidas por perros en la ciudad de Temuco, para mostrar productos útiles para la toma de decisiones. Los productos de información asociados a su componente geográfico permitieron visualizar elementos ambientales que los productos clásicos como informes dificultan representar. Mediante un sistema de información georreferenciado e imágenes satelitales pudimos indicar que existen dos zonas de alta concentración de personas mordidas por perros: Pedro De Valdivia y Pueblo Nuevo, con el 36,8 y el 1,4 por ciento respectivamente. También pudimos evaluar los eventos de interés particulares en relación con las fuentes fijas de información y determinar los componentes ambientales involucrados. Por último, utilizando datos basados en un sistema de información georreferenciado, se generaron múltiples productos de información que serían dependientes de las necesidades de información requerida. Los sistemas de información georreferenciados son herramientas de gran ayuda en dar respuesta a las necesidades, cada vez más demandantes, por productos de información inmediatos, económicos y sencillos. Los productos obtenidos a través del sistema de información georreferenciado permiten a los epidemiólogos consolidar e integrar información, conocer la distribución y la densidad, así como realizar los análisis de acuerdo con las necesidades que los eventos de interés patológico requieren y que se resumen en el monitoreo, el control y su posible erradicación(AU)


Information management is important for health institutions. Therefore, as the objective, information products obtained from a georeferenced information system are examined, using as an example the spatial distribution of people bitten by dogs in the city of Temuco, to show useful products for decision making. Information products associated with its geographic component allow the visualization of environmental elements that classic products such as reports make difficult to represent. Using a geo-referenced information system and satellite images, we can indicate that there are two areas of high concentration of people bitten by dogs: Pedro De Valdivia and Pueblo Nuevo, with 36.8 percent and 1.4 percent respectively. We can also evaluate the events of particular interest associated with the fixed sources of information and determine the environmental components involved. Finally, using data based on a geo-referenced information system, multiple information products can be generated that will be dependent on the information needs required. Geo-referenced information systems are very helpful tools in responding to the increasingly demanding needs for immediate, economic and simple information products. The products obtained through georeferenced information systems allow epidemiologists to consolidate and to integrate information, to know the distribution and density, as well as to perform the analyses according to the needs required by the events of pathological interest and that are summarized by monitoring, control and possible eradication(AU)


Assuntos
Humanos , Mordeduras e Picadas/epidemiologia , Gestão da Informação/métodos , Cães , Monitoramento Ambiental/métodos
16.
Int. j. morphol ; 36(3): 1134-1142, Sept. 2018. graf
Artigo em Espanhol | LILACS | ID: biblio-954242

RESUMO

La progresivas preocupación de los países para optimizar el acceso, la eficiencia y la calidad de la salud, han impulsado la utilización más apropiada de las intervenciones en salud. Por ende, el interés tanto de profesionales sanitarios como de tomadores de decisiones en salud, ha sido orientado hacia la medicina basada en la evidencia, la eficacia comparativa y la Evaluación de Tecnologías Sanitarias (ETESA). Aunque los conceptos anteriormente señalados son convergentes en sus características, no son sinónimos. Sin embargo, todos estos, se basan en la orientación sistemática de pruebas y el enfoque en resultados relevantes para el paciente entre otras. Como consecuencia de todo esto, el interés no sólo implica los conceptos de eficacia, efectividad y eficiencia; sino que también en práctica clínica, costes y transparencia. En este artículo se resumen los conceptos de economía de la salud, evaluación económica, tecnología sanitaria (TS) y ETESA. Luego, se comenta el ciclo de vida de una TS, razones para implementar un programa de ETESA; para finalizar con algunos ejemplos de TS emergentes, comentarios respecto de la evidencia científica en la ETESA; y algunos ejemplos de estudios de ETESA en la práctica clínica cotidiana.


The progressive concern of countries to optimize access, efficiency and quality of health have led to the most appropriate use of health interventions. Therefore, the interest of both health professionals and health decision makers has been oriented towards evidence-based policy, comparative efficacy and Health Technologies Assessment (HTA). Although the aforementioned concepts are converging in their characteristics, they are not synonymous. However, all these are based on systematic testing orientation and focus on relevant patient outcomes among others. As a consequence of all this, interest does not only imply the concepts of effectiveness, effectiveness and efficiency, but also in clinical practice, costs and transparency.This manuscript summarizes concepts of health economics, economic evaluation, health technology and HTA. Then, the life cycle of a health technology and the reasons for implementing an HTA program are discussed. Concluding with some examples of emerging health technologies, comments on the scientific evidence in HTA, and some examples of HTA studies in daily clinical practice.


Assuntos
Avaliação da Tecnologia Biomédica , Economia da Saúde , Medicina Baseada em Evidências , Qualidade da Assistência à Saúde , Efetividade , Chile , Eficácia , Análise Custo-Benefício , Eficiência
17.
Rev Chilena Infectol ; 35(2): 186-188, 2018 04.
Artigo em Espanhol | MEDLINE | ID: mdl-29912256

RESUMO

Dogs may cause zoonoses and damages; especially when we accept as normal some dangerous behavior, losing the perception of disease risk. The purpose of this review was to demonstrate that the presence of stray dogs as well as community dogs, are public health hazard. Through sustainable epidemiological information, we believe this measure could prevent it from spreading. Dog's aggressiveness regulates its social relationships through submission or dominance; those characteristics are difficult to be recognized by human population. In Chile, 327.150 people were bitten by dogs, between years 2003 and 2012 with a cost of USD$22.7 to USD$177,9 million in addition to the USD$3,13 million for the surgical intervention of 767 human subjects of Hydatidosis during 2012. However zoonosis more dangerous is Rabies with death results. As a conclusion we state that the presence of stray and community dogs in the streets cannot be tolerated. This measure must have a sustainable technical of Health and Public safety because population have lost its ability of recognize the risk of contracting zoonotic diseases, with high costs for the health care system, besides the economical decline and psychological damage to the affected individuals.


Assuntos
Mordeduras e Picadas/epidemiologia , Doenças do Cão/epidemiologia , Cães , Animais , Mordeduras e Picadas/economia , Chile/epidemiologia , Doenças do Cão/economia , Doenças do Cão/transmissão , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Saúde Pública , Raiva , Zoonoses
18.
Int. j. morphol ; 36(2): 743-749, jun. 2018. tab, graf
Artigo em Inglês | LILACS | ID: biblio-954180

RESUMO

Research in diagnostic accuracy studies (DAS) is a rapidly developing area in medicine, but there are only three instruments used in this scenario. The aim of this study was to design and validate a scale to determine methodological quality (MQ) of DAS. Scale validation study. A systematic literature review about the MQ of diagnostic accuracy studies was accomplished, and an expert panel generated a first draft (content validity) of the scale. An alphanumeric order was given and rated by six researchers (second draft) and a pilot study to optimise its use and understanding was performed (third draft). Two independent researchers applied the final scale (9 items/3 domains) to 110 articles from 13 journals with high, medium and low impact factors. Criterion validity was determined by contrasting MQ scores with the Oxford Centre for Evidence-Based Medicine levels of evidence. The construct validity of the extreme groups and high and low IF were estimated. The intraclass correlation coefficient was used to determine inter-observer reliability, and the cut-off point was calculated using a ROC curve. The best cut-off point was 24 points, with an under curve area of 93.4 %. The content validity rating was 80-100 % for all included items. Criterion and construct validity were statistically significant with p<0.05. Interobserver reliability was estimated in 0.96. A scale to measure the MQ of DAS was designed and validated.


La investigación en estudios de precisión diagnóstica (EPD) es un área de rápido desarrollo en medicina, sin embargo, en este escenario sólo existen tres instrumentos. El objetivo de este estudio fue diseñar y validar una escala para determinar calidad metodológica (CM) de EPD. Estudio de validación de escala. Se realizó una extensa revisión de la literatura sobre el CM de EPD y un panel de expertos generó un primer borrador (validez del contenido) de la escala. Se asignó un orden alfanumérico, el que evaluado por 6 investigadores independientes (2º borrador). Posteriormente, se realizó un estudio piloto para optimizar el uso y entendimiento (3º borrador). Dos investigadores independientes aplicaron la escala final (9 ítems / 3 dominios) a 110 artículos de 13 revistas con factores de impacto alto, medio y bajo. Se determinó validez de criterio contrastando puntuaciones de CM con niveles de evidencia del Oxford Centre for Evidence-Based Medicine. Se determinó validez de constructo de grupos extremos (factores de impacto alto y bajo). La confiabilidad interobservador se estimó aplicando coeficiente de correlación intraclase. Finalmente, se evaluaron puntos de corte construyendo curvas ROC. El mejor punto de corte fue 24 puntos (área bajo la curva de 93,4 %). La validez de contenido fue de 80-100 % para todos los elementos incluidos. Validez de criterio y constructo fueron estadísticamente significativos (p<0,05). La confiabilidad interobservador fue de 0,96. Se diseñó y validó una escala para medir el CM de EPD.


Assuntos
Controle de Qualidade , Medicina Baseada em Evidências , Técnicas e Procedimentos Diagnósticos , Reprodutibilidade dos Testes , Curva ROC
19.
Int. j. morphol ; 36(2): 762-767, jun. 2018. tab, graf
Artigo em Inglês | LILACS | ID: biblio-954183

RESUMO

Research in methodological quality (MQ) of prognosis studies (PS) is relevant in view of the important number of studies developed in this scenario. However, currently there are no instruments designed to measure MQ in PS, thus the aim of this study was to validate a scale to determine the MQ in PS. Scale validation study. Two independent researchers applied the scale (10 items/4 domains) in 119 articles found in 13 Journals of high, medium and low impact factor. Criterion validity was determined by contrasting MQ scores with Oxford Centre for Evidence-Based Medicine levels of evidence. Construct validity of extreme groups and high and low impact factors were estimated. Intraclass correlation coefficient was used to determine interobserver reliability, and the cut-off point was calculated using a ROC curve. The best cut-off point was 33, with an under curve area of 82.6 %. Criterion and construct validity were statistically significant with (p<0.001). Interobserver reliability was 0.91 and a scale to measure the MQ in PS was validated.


El objetivo de este estudio fue validar una escala para determinar calidad metodológica (CM) de estudios de pronóstico (EP). Se realizó un estudio de validación de escalas. La escala, compuesta por 10 ítems y 4 dominios; se aplicó a 119 artículos de 13 revistas, de factores de impacto alto, medio y bajo; por dos investigadores independientes. La validez del criterio se determinó al contrastar las puntuaciones de CM de cada artículo con los niveles de evidencia del Centro de Medicina Basada en la Evidencia de Oxford de la revista en la cual fueron publicados. Se estimó la validez de constructo de grupos extremos (factores de impacto alto y bajo). Se utilizó el coeficiente de correlación intraclase para determinar la confiabilidad interobservador, y el punto de corte se calculó construyendo curvas ROC. El mejor punto de corte fue 33 puntos (área bajo la curva de 82,6 %). La validez de criterio y de constructo fueron estadísticamente significativas (p<0,001). La confiabilidad interobservador fue 0,91. Se validó una escala para medir CM en EP.


Assuntos
Prognóstico , Controle de Qualidade , Medicina Baseada em Evidências , Reprodutibilidade dos Testes , Curva ROC
20.
Artigo em Inglês | MEDLINE | ID: mdl-29757440

RESUMO

The objective of this article is to present initial occupational dose values using digital active personal dosimeters for medical staff during adult interventional cardiology procedures in a public hospital in Chile. Personal dose equivalent Hp(10) over the lead apron of physician, nurse and radiographer were measured during 59 procedures. Mean values of occupational dose Hp(10) per procedure were 47.6, 6.2 and 4.3 µSv for physician, nurse and radiographer, respectively. If no protective tools are used, physician dose can exceed the new eye lens dose limit.

SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA