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1.
J Am Soc Mass Spectrom ; 31(3): 527-537, 2020 Mar 04.
Artigo em Inglês | MEDLINE | ID: mdl-32126778

RESUMO

Recently, the olive oil industry has been the subject of harsh criticism for false labeling and even adulterating olive oils. This situation in which both the industry and the population are affected leads to an urgent need to increase controls to avoid fraudulent activities around this precious product. The aim of this work is to propose a new analytical platform by coupling electrospray ionization (ESI), differential mobility analysis (DMA), and mass spectrometry (MS) for the analysis of olive oils based on the information obtained from the chemical fingerprint (nontargeted analyses). Regarding the sample preparation, two approaches were proposed: (i) sample dilution and (ii) liquid-liquid extraction (LLE). To demonstrate the feasibility of the method, 30 olive oil samples in 3 different categories were analyzed, using 21 of them to elaborate the classification model and the remaining 9 to test it (blind samples). To develop the prediction model, principal component analysis (PCA) and orthogonal partial least-squares discriminant analysis (OPLS-DA) were used. The overall success rate of the classification to differentiate among extra virgin olive oil (EVOO), virgin olive oil (VOO), and lampante olive oil (LOO) was 89% for the LLE samples and 67% for the diluted samples. However, combining both methods, the ability to differentiate EVOO from lower-quality oils (VOO and LOO) and the edible oils (EVOO and VOO) from nonedible oil (LOO) was 100%. The results show that ESI-DMA-MS can become an effective tool for the olive oil sector.

2.
Neurobiol Learn Mem ; 155: 474-485, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30243850

RESUMO

Most long-term memories are forgotten, becoming progressively less likely to be recalled. Still, some memory fragments may persist, as savings memory (easier relearning) can be detected long after recall has become impossible. What happens to a memory trace during forgetting that makes it inaccessible for recall and yet still effective to spark easier re-learning? We are addressing this question by tracking the transcriptional changes that accompany learning and then forgetting of a long-term sensitization memory in the tail-elicited siphon withdrawal reflex of Aplysia californica. First, we tracked savings memory. We found that even though recall of sensitization fades completely within 1 week of training, savings memory is still detectable at 2 weeks post training. Next, we tracked the time-course of regulation of 11 transcripts we previously identified as potentially being regulated after recall has become impossible. Remarkably, 3 transcripts still show strong regulation 2 weeks after training and an additional 4 are regulated for at least 1 week. These long-lasting changes in gene expression always begin early in the memory process, within 1 day of training. We present a synthesis of our results tracking gene expression changes accompanying sensitization and provide a testable model of how sensitization memory is forgotten.


Assuntos
Gânglios dos Invertebrados/metabolismo , Memória de Longo Prazo/fisiologia , Rememoração Mental/fisiologia , Animais , Aplysia , Comportamento Animal , Perfilação da Expressão Gênica
3.
Learn Mem ; 25(1): 45-48, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-29246980

RESUMO

Most long-term memories are forgotten. What happens, then, to the changes in neuronal gene expression that were initially required to encode and maintain the memory? Here we show that the decay of recall for long-term sensitization memory in Aplysia is accompanied both by a form of savings memory (easier relearning) and by persistent transcriptional regulation. A behavioral experiment (N = 14) shows that sensitization training produces a robust long-term sensitization memory, but that recall fades completely within 1 wk. This apparent forgetting, though, is belied by persistent savings memory, as we found that a weak reminder protocol reinstates a long-term sensitization memory only on the previously trained side of the body. Using microarray (N = 8 biological replicates), we found that transcriptional regulation largely decays along with recall. Of the transcripts known to be regulated 1 d after training, 98% (1172/1198) are no longer significantly regulated 7 d after training. Still, there is a small set of transcripts which remain strongly regulated even when recall is absent. Using qPCR (N = 11 additional biological replicates) we confirmed that these include the peptide transmitter FMRFamide, a transcript encoding a putative homolog of spectrin beta chain (Genbank: EB255259) , a transcript encoding a protein with a predicted EF-hand calcium-binding domain (Genbank: EB257711), and eight uncharacterized transcripts. To our knowledge, this is the first work to show that transcriptional changes evoked by learning can outlast recall. The small set of transcriptional changes that persist could mediate the rapid relearning of the memory (savings), or the decay of recall, or both, or neither.


Assuntos
Gânglios dos Invertebrados/metabolismo , Regulação da Expressão Gênica , Memória de Longo Prazo/fisiologia , Rememoração Mental/fisiologia , Transcrição Genética , Animais , Aplysia , Eletrochoque , Análise em Microsséries , Atividade Motora/fisiologia , Plasticidade Neuronal/fisiologia , Reflexo/fisiologia , Transcriptoma
4.
Epilepsy Behav ; 79: 138-145, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-29287217

RESUMO

OBJECTIVE: The purpose of this study was to evaluate the relation between cognitive performance and white matter (WM) integrity in patients with temporal lobe epilepsy (TLE) with mesial temporal sclerosis (MTS). METHODS: We included 26 patients with TLE (10 right, 16 left onset) as well as 24 healthy controls matched for age, gender, and years of education. In addition to quantitative hippocampal volume and transverse relaxation (T2) evaluation, whole-brain WM was analyzed using fractional anisotropy (FA) maps, derived from the diffusion tensor model. Average FA values were obtained from 38 regions of interest (ROI) of the main WM fascicles using an atlas-based approach. All subjects underwent extensive coFignitive assessments, Wechsler Adult Intelligence Scale (WAIS-IV) and Wechsler Memory Scale (WMS-IV). Fractional anisotropy was correlated with neuropsychological scores, and group effects were evaluated. Finally, patients were clustered based on their cognitive performance to evaluate if clinical and structural variables relate to specific cognitive profiles. RESULTS: Patients had differential alterations in the integrity of the WM dependent on seizure laterality and presence of hippocampal sclerosis. Patients with TLE showed, on average, lower scores in most of the cognitive assessments. Correlations between cognition and WM followed specific trajectories per group with TLE, particularly in Left-TLE, in which we found a marked association between cognitive abilities and WM abnormalities. Cluster analysis of cognitive performance revealed three cognitive profiles, which were associated with the degree and spread of WM abnormalities. SIGNIFICANCE: White matter diffusion characteristics differ between patients, particularly in relation to seizure laterality and hippocampal damage. Moreover, WM abnormalities are associated with cognitive performance. The extent of WM alterations leads to disrupted cerebral intercommunication and therefore negatively affects cognition.


Assuntos
Transtornos Cognitivos/patologia , Cognição/fisiologia , Epilepsia do Lobo Temporal/patologia , Hipocampo/diagnóstico por imagem , Convulsões , Lobo Temporal/diagnóstico por imagem , Substância Branca/diagnóstico por imagem , Adulto , Anisotropia , Estudos de Casos e Controles , Transtornos Cognitivos/etiologia , Imagem de Tensor de Difusão , Epilepsia do Lobo Temporal/complicações , Feminino , Lateralidade Funcional , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Esclerose/diagnóstico por imagem
5.
Learn Mem ; 24(10): 502-515, 2017 10.
Artigo em Inglês | MEDLINE | ID: mdl-28916625

RESUMO

We characterized the transcriptional response accompanying maintenance of long-term sensitization (LTS) memory in the pleural ganglia of Aplysia californica using microarray (N = 8) and qPCR (N = 11 additional samples). We found that 24 h after memory induction there is strong regulation of 1198 transcripts (748 up and 450 down) in a pattern that is almost completely distinct from what is observed during memory encoding (1 h after training). There is widespread up-regulation of transcripts related to all levels of protein production, from transcription (e.g., subunits of transcription initiation factors) to translation (e.g., subunits of eIF1, eIF2, eIF3, eIF4, eIF5, and eIF2B) to activation of components of the unfolded protein response (e.g., CREB3/Luman, BiP, AATF). In addition, there are widespread changes in transcripts related to cytoskeleton function, synaptic targeting, synaptic function, neurotransmitter regulation, and neuronal signaling. Many of the transcripts identified have previously been linked to memory and plasticity (e.g., Egr, menin, TOB1, IGF2 mRNA binding protein 1/ZBP-1), though the majority are novel and/or uncharacterized. Interestingly, there is regulation that could contribute to metaplasticity potentially opposing or even eroding LTS memory (down-regulation of adenylate cyclase and a putative serotonin receptor, up-regulation of FMRFa and a FMRFa receptor). This study reveals that maintenance of a "simple" nonassociative memory is accompanied by an astonishingly complex transcriptional response.


Assuntos
Gânglios dos Invertebrados/metabolismo , Memória/fisiologia , Plasticidade Neuronal/fisiologia , Transcriptoma , Animais , Aplysia , Eletrochoque , Lateralidade Funcional , Análise em Microsséries , RNA Mensageiro/metabolismo , Reflexo/fisiologia , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Cauda/fisiologia
6.
J Inorg Biochem ; 175: 154-166, 2017 10.
Artigo em Inglês | MEDLINE | ID: mdl-28755573

RESUMO

In Latin America Chagas disease is an endemic illness caused by the parasite Trypanosoma cruzi (T. cruzi), killing more people than any other parasitic disease. Current chemotherapies are old and inadequate, thus the development of efficient ones is urgently needed. Vanadium-based complexes have been shown to be a promising approach both against parasitic diseases and cancer and this study aims to achieve significant advances in the pursue of effective compounds. Heteroleptic vanadium complexes of Schiff bases and polypyridine compounds were prepared and their stability in solution evaluated by EPR (Electronic Paramagnetic Resonance) and NMR spectroscopy. Their in vitro activities were evaluated against T. cruzi and a set of cells lines representative of human cancer conditions, namely ovarian, breast and prostate cancer. In T. cruzi, most of the complexes depicted IC50 values in the low µM range, induced changes of mitochondrial membrane potential and apoptosis. In cancer cells, complexes showed good to moderate activity and in metastatic cells (prostate PC3), some complexes inhibited the migratory ability, this suggesting that they display antimetastatic potential. Interestingly, complex 5 seemed to have a dual effect being the most cytotoxic complex on all cancer cells and also the most active anti-T-cruzi compound of the series. Globally the complexes showed promising anticancer and anti T. cruzi activities and also displayed some characteristics indicating they are worth to be further explored as antimetastatic drugs.


Assuntos
Antineoplásicos , Doença de Chagas/tratamento farmacológico , Complexos de Coordenação , Neoplasias da Próstata/tratamento farmacológico , Piridinas , Tripanossomicidas , Trypanosoma cruzi/metabolismo , Vanadatos , Antineoplásicos/síntese química , Antineoplásicos/química , Antineoplásicos/farmacologia , Linhagem Celular Tumoral , Doença de Chagas/metabolismo , Doença de Chagas/patologia , Complexos de Coordenação/síntese química , Complexos de Coordenação/química , Complexos de Coordenação/farmacologia , Humanos , Masculino , Neoplasias da Próstata/metabolismo , Neoplasias da Próstata/patologia , Piridinas/química , Piridinas/farmacologia , Tripanossomicidas/síntese química , Tripanossomicidas/química , Tripanossomicidas/farmacologia , Vanadatos/química , Vanadatos/farmacologia
8.
Rev. chil. endocrinol. diabetes ; 10(3): 100-102, jul. 2017. ilus
Artigo em Espanhol | LILACS | ID: biblio-998985

RESUMO

Introducción: Diabetes insipidus as the first clinical manifestation of pituitary neoplasm metastasis Up to de 90 percent of the masses that are detected in the pituitary gland correspond to adenomas. On the contrary, pituitary metastasis only represent a 1 percent, which is a diagnostic challenge in the medical practice. Most of the time, these lesions are detected casually in autopsy; but it is important to consider that aproximatelly a 7 percent of these lesions can be clinically expresed as diabetes insipidus. Here we present a patient with initial symptoms of diabetes insipidus with the final diagnostic of lung adenocarcinoma


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Neoplasias Hipofisárias , Adenocarcinoma/secundário , Diabetes Insípido , Neoplasias Pulmonares/patologia , Neoplasias Hipofisárias
9.
J Gastrointest Oncol ; 8(1): 96-101, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-28280614

RESUMO

BACKGROUND: There is an increase in the incidence of rectal carcinoma (RC) in young patients. METHODS: We analyzed 175 patients with sporadic RC which were divided in two groups according their age: 24 patients ≤40 years and 151 patients >40 years and the two groups were compared in order to determine if the outcomes (especially overall 5-year survival) were different. RESULTS: Overall 5-year survival was similar between groups (67.1% for patients over 40 years and 70.4% for those under 40 years, P=0.803). The only differences found were in some clinicopathologic features: patients <40 years showed more dissected lymph nodes (LNs) (21 vs. 15, P=0.035) and more LN metastasis (54.2% vs. 39.1%, P=0.048). In multivariate analysis factors associated with worse survival were incomplete resection and no use of neoadjuvant therapy. Age did not demonstrate prognostic value (P=0.077). CONCLUSIONS: RC in people ≤40 years demonstrated greater number of LN harvested and LN metastases but oncologic outcomes, especially 5-year overall survival, were similar between groups.

10.
Melanoma Res ; 27(2): 140-144, 2017 04.
Artigo em Inglês | MEDLINE | ID: mdl-28125448

RESUMO

Several studies have reported that a high neutrophil-to-lymphocyte ratio (NLR) is associated with poor clinical outcomes in several cancers, but this ratio has not been thoroughly studied in melanoma except in stage IV. This is the first study on NLR in melanoma stages I-III. This was a retrospective study of 742 melanoma patients. The NLR was classified into NLR<2 and a NLR≥2 on the basis of a receiver operating characteristic curve. Associations of NLR with clinicopathological characteristics and survival were examined. The median patient age was 57 years (range: 15-91; Q1=46, Q3=70), and the median Breslow's thickness was 3.0 mm (range: 0.5-60; Q1=1.0, Q3=7). Clinical stage at presentation was as follows: (i) stage I in 27%; (ii) stage II in 33.2%; (iii) stage III in 36.5%; and (iv) stage IV in 3.3%. NLR≥2 was associated with lymph node metastasis (36.6 vs. 18.1%) and recurrence (28.2 vs. 22.1%). The 5-year overall survival (OS) was 63% for the NLR<2 group and 53% for the NLR≥2 group. Stage-by-stage analysis showed that the 5-year OS in the NLR≥2 group for stages I, II, III, and IV were 91, 60, 28, and 0%, respectively, whereas for the NLR<2 group the 5-year OS were 98, 68, 31, and 0%, respectively. Significant differences between NLR<2 and ≥2 occurred only in stage II (P=0.014). Univariate analysis showed that factors associated with decreased OS clinical stage were Breslow's thickness, ulceration, male sex, and NLR≥2. In the multivariate analysis, all of these factors were predictors of decreased survival. The NLR appears to be an accurate prognostic marker for decreased OS in patients with melanoma, especially in clinical stage II. NLR≥2 correlated with lymph node metastasis and recurrence.


Assuntos
Linfócitos , Melanoma/sangue , Melanoma/secundário , Neutrófilos , Neoplasias Cutâneas/sangue , Neoplasias Cutâneas/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Contagem de Linfócitos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Estudos Retrospectivos , Taxa de Sobrevida , Adulto Jovem
11.
Cir Cir ; 85(3): 245-249, 2017.
Artigo em Espanhol | MEDLINE | ID: mdl-26997294

RESUMO

BACKGROUND: Androgen insensitivity syndrome is an X-linked disorder, and is characterised by a female phenotype in a chromosomally male individual. It usually occurs in puberty with primary amenorrhoea or as an inguinal tumour in a female infant. In recent years, it is often also diagnosed in fertility clinics in adulthood. OBJECTIVE: The case is presented of a pure seminoma in a woman with the reference diagnosis of inguinal hernia. CLINICAL CASE: A 53 year old woman, who was operated on in 2014 due to a nodule in left groin. Androgen insensitivity syndrome was corroborated, and histopathology reported it as a right testicular seminoma. DISCUSSION: The importance of early diagnosis is discussed, highlighting the consequences of misdiagnosis, and question whether these patients have been adequately treated in the past. The risk of malignant transformation of an undescended testicle increases with age, thus gonadectomy should be performed after puberty, and in some cases hormone replacement therapy.


Assuntos
Síndrome de Resistência a Andrógenos/complicações , Criptorquidismo/complicações , Disgenesia Gonadal 46 XY/complicações , Neoplasias Primárias Múltiplas/diagnóstico , Seminoma/diagnóstico , Neoplasias Testiculares/diagnóstico , Síndrome de Resistência a Andrógenos/sangue , Síndrome de Resistência a Andrógenos/diagnóstico , Biomarcadores Tumorais/sangue , Gonadotropina Coriônica/sangue , Diagnóstico Tardio , Erros de Diagnóstico , Disgerminoma/diagnóstico , Detecção Precoce de Câncer , Feminino , Hérnia Inguinal/complicações , Humanos , Hormônio Luteinizante/sangue , Imagem por Ressonância Magnética , Masculino , Neoplasias Ovarianas/diagnóstico , Seminoma/sangue , Seminoma/etiologia , Neoplasias Testiculares/sangue , Neoplasias Testiculares/etiologia , Testosterona/sangue
12.
Melanoma Res ; 27(2): 116-120, 2017 04.
Artigo em Inglês | MEDLINE | ID: mdl-28030434

RESUMO

The objective of this study is to determine whether a less exhaustive pathologic work-up to detect melanoma metastasis is clinically useful and does not affect patient prognosis. The success and evolution of the sentinel lymph node (SLN) depends on histological techniques. Several exhaustive protocols of SLN analysis have been published, but are time and cost consuming, with slight increases in the rates of metastasis detection. From 281 patients with SLN biopsy, each SLN was sectioned every 2 mm and from each paraffin block, 2-3 histological sections were evaluated. The patients were divided as follows: the first group (n=185) was subjected to extensive SLN examination (eSLNe) and the second group (n=96) was not subjected to an extensive SLN examination (wSLNe). The average SLN resected was 2 (range: 1-7), evaluating one in 50.9%. The SLN metastasis detection rate was 28.5%, whereas eSLNe increased by 3.2%. During follow-up, 4/26 (17.4%) cases in the wSLNe group showed recurrence in the SLN basin. Factors associated with decreased survival in univariant analysis were recurrence, Breslow thickness, advanced clinical stage, ulceration, and SLN metastasis. eSLNe did not affect disease-specific survival. Multivariate analysis showed recurrence (hazard ratio 23.475, 95% confidence interval: 1903-4559, P<0.001) and Breslow thickness of more than 3.5 mm (hazard ratio 15.222, 95% confidence interval: 1448-3059, P<0.001) as independent risk factors for decreased survival. Our routine for SLN examination enabled an adequate rate of SLN metastasis detection and the eSLNe increased the rate of detection in 3.2%, but did not affect the survival. We did not find any benefit from performing the eSLNe in patients with Breslow thickness less than 3.5 mm.


Assuntos
Melanoma/secundário , Recidiva Local de Neoplasia/patologia , Linfonodo Sentinela/patologia , Neoplasias Cutâneas/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Técnicas Histológicas , Humanos , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Patologia/métodos , Biópsia de Linfonodo Sentinela , Úlcera Cutânea/etiologia , Taxa de Sobrevida , Carga Tumoral , Adulto Jovem
13.
Med Arch ; 70(4): 256-260, 2016 Jul 27.
Artigo em Inglês | MEDLINE | ID: mdl-27703284

RESUMO

BACKGROUND: Several studies have reported that an elevation in neutrophils/lymphocyte ratio (NLR) is correlated with poor survival in patients with colorectal cancer, but in rectal cancer (RC), it has been reported only in a few studies. It is necessary to separate colon cancer and rectal cancer to clarify the prognostic significance of NLR, especially in patients who received chemoradiotherapy. METHODS: It is a comparative, observational retrospective study of a cohort of 175 patients. We grouped the patients into two based on their NLR (0-3 vs. > 3) to correlate with disease-specific survival (DSS) and pathologic complete response (pCR). RESULTS: The average NLR was 2.65 + 1.32 (range 0.58-6.89), and 144 (82.3%) patients had an NLR of 0-3. The median follow-up was 33.53 months. There were no differences in pCR between the two groups. The 5-year DSS was 78.8%. NLR did not correlate with survival. Mesorectal quality, pT3-4 tumors, lymph node metastasis, lymphovascular invasion, perineural invasion, positive margins and recurrence were statistically significant predictors of increased mortality in univariate analysis. In multivariate analysis, only overall recurrence correlated with poor survival. The analysis of the association of NLR with outcomes with different cut points (2.0, 2.5, 4 and 5) did not show differences in DSS and pCR. CONCLUSION: In our cohort, the NLR did not serve as a prognostic marker in patients with locally advanced rectal cancer and who received chemoradiotherapy and did not correlate with pCR as well.


Assuntos
Quimiorradioterapia , Linfócitos , Terapia Neoadjuvante , Neutrófilos , Neoplasias Retais/sangue , Neoplasias Retais/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Intervalo Livre de Doença , Feminino , Humanos , Contagem de Linfócitos , Masculino , Pessoa de Meia-Idade , Neoplasias Retais/mortalidade , Estudos Retrospectivos , Sensibilidade e Especificidade , Taxa de Sobrevida , Adulto Jovem
14.
Qual Health Res ; 26(12): 1674-88, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27578852

RESUMO

The aim of this article was to describe and analyze the doctor-patient relationship between fibromyalgia patients and rheumatologists in public and private health care contexts within the Mexican health care system. This medical anthropological study drew on hospital ethnography and patients' illness narratives, as well as the experiences of rheumatologists from both types of health care services. The findings show how each type of medical care subsystem shape different relationships between patients and doctors. Patient stigmatization, overt rejection, and denial of the disease's existence were identified. In this doctor-patient-with-fibromyalgia relationship, there are difficult encounters, rather than difficult patients. These encounters are more fluid in private consultations compared with public hospitals. The doctor-centered health care model is prevalent in public institutions. In the private sector, we find the characteristics of the patient-centered model coexisting with the traditional physician-centered approach.


Assuntos
Fibromialgia/terapia , Relações Médico-Paciente , Reumatologistas , Humanos , México , Médicos
15.
Arch. pediatr. Urug ; 87(3): 245-252, set. 2016. ilus, tab
Artigo em Espanhol | LILACS | ID: lil-796330

RESUMO

El Chagas congénito se produce cuando la embarazada infectada trasmite el parásito al feto, situación que puede suceder en cualquier estadio de la enfermedad y momento del embarazo. Es el único mecanismo de trasmisión presente actualmente en Uruguay, con una incidencia cercana al 4%. La mayoría de los neonatos infectados nacen asintomáticos y un 10% al 40% presentan síntomas que son indistinguibles de otras infecciones de trasmisión vertical. La prematurez, el bajo peso, la hepatoesplenomegalia y las alteraciones hematológicas son los síntomas más frecuentes. El diagnóstico representa un desafío en aquellos lugares del país en donde, si bien la enfermedad era considerada endémica, no se realiza actualmente el screening obligatorio de la embarazada. Se describe un lactante procedente de Paysandú, de medio socioeconómico deficitario, que fue pretérmino severo y que presentó al nacer alteraciones hematológicas de las tres series y hepatoesplenomegalia, lo cual motivó múltiples estudios. Sin embargo, no se sospechó la enfermedad hasta los 5 meses de vida, cuando volvió a ingresar por otra patología. Se confirmó la infección a los 9 meses mediante tres técnicas serológicas diferentes. Se indicó tratamiento con nifurtimox por 2 meses y a los 26 y 36 meses de vida presentó serología negativa. Consideramos importante tener alto índice de sospecha de la enfermedad en neonatos con signos de infección congénita y sin serología materna que la descarte. Es importante saber que el tratamiento antes del primer año de vida tiene una excelente respuesta y evita secuelas crónicas que pueden ser invalidantes en etapa adulta.


Congenital Chagas disease occurs when an infected pregnant woman transmits the parasite to the fetus, a situation that can happen at any stage of disease and time of pregnancy. It is the only transmission mechanism currently present in Uruguay, with an incidence close to 4%. Most infected infants are born asymptomatic and 10 to 40% have symptoms that are indistinguishable from other infections’ vertical transmission. Prematurity, low birth weight, hepatosplenomegaly and hematological disorders are the most common symptoms. Diagnosis is a challenge in those areas where there is no current compulsory screening for pregnant women in spite of the disease being considered endemic. The study presents the case of an infant from Paysandú, coming from a low socio-economic environment, which was a severe preterm, and presented hematologic disorders of the three series at birth and hepatosplenomegaly, which caused many studies. However, there was no suspicion of the disease until the infant was five months old when re-entering by other pathology. Infection at nine months is confirmed by three different serological techniques. Nifurtimox therapy is indicated for two months and at twenty six and thirty six months of life the patient presents negative serology. A high level of suspicion is needed in order to diagnose the disease in infants with signs of congenital infection without maternal serology. It is important to know that treatment before the first year of life has excellent response and prevents chronic sequelae that can be disabling in adulthood.


Assuntos
Humanos , Masculino , Lactente , Doença de Chagas/diagnóstico , Transmissão Vertical de Doença Infecciosa , Anormalidades Congênitas , Tripanossomicidas/uso terapêutico , Uruguai , Doença de Chagas , Doença de Chagas/complicações , Doença de Chagas/epidemiologia , Técnicas e Procedimentos Diagnósticos , Nifurtimox/uso terapêutico
16.
Ann Surg Oncol ; 23(13): 4189-4194, 2016 12.
Artigo em Inglês | MEDLINE | ID: mdl-27401447

RESUMO

BACKGROUND: The aim of this study was to analyze the clinicopathologic features of melanoma in México as the demographics of melanoma are not well known in Mexican and Latin American people. MATERIALS AND METHODS: A total of 1219 patients with cutaneous melanoma were analyzed through a retrospective database collected from a cancer referral institute, and the results were compared with developed countries. RESULTS: Median age was 57 years, and 713 (58.5 %) were females. The most common melanoma subtype was acral lentiginous melanoma (ALM), which was observed in 538 (44.1 %) patients. Median Breslow thickness was 5.2 mm. Among 837 patients with complete data, the 5-year disease-specific survival (DSS) was 52.3 %. Factors associated with worse DSS on univariate analysis were Breslow thickness (p < 0.001), recurrence (p < 0.001), ulceration (p < 0.001), positive margin (p < 0.001), ALM (p = 0.001), and male sex (p = 0.001). Multivariate analysis demonstrated Breslow thickness [hazard ratio (HR) 1.45, 95 % confidence interval (CI) 1.27-1.65; p < 0.001], positive margin (HR 1.25, 95 % CI 1.03-1.57; p = 0.018), recurrence (HR 9.56, 95 % CI 6.89-9.87; p = 0.002), ALM (HR 8.07, 95 % CI 6.77-8.95; p = 0.004), and male sex (HR 1.33, 95 % CI 1.06-1.68; p = 0.013) as independent risk factors for DSS. CONCLUSION: Our patients had worse prognosis compared with data from the US Surveillance, Epidemiology, and End Results database. We found male sex and ALM as independent risk factors for worse survival, in addition to known risk factors.


Assuntos
Sarda Melanótica de Hutchinson/patologia , Recidiva Local de Neoplasia , Neoplasias Cutâneas/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Extremidades , Feminino , Humanos , Sarda Melanótica de Hutchinson/epidemiologia , Sarda Melanótica de Hutchinson/mortalidade , Incidência , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/mortalidade , Estadiamento de Neoplasias , Neoplasia Residual , Estudos Retrospectivos , Fatores de Risco , Fatores Sexuais , Neoplasias Cutâneas/epidemiologia , Neoplasias Cutâneas/mortalidade , Taxa de Sobrevida , Carga Tumoral , Adulto Jovem
17.
CorSalud ; 8(1)ene.-mar. 2016. ilus
Artigo em Espanhol | CUMED | ID: cum-66696

RESUMO

Los tumores primarios del corazón son extremadamente raros. El fibroelastomapapilar es el tercer tumor benigno más frecuente del corazón, con una incidencia de 0,33 por ciento en series de autopsia y el más frecuente en las válvulas cardíacas. Se presenta una paciente con fibroelastoma papilar de la válvula mitral y el acercamiento a su diagnóstico ecocardiográfico(AU)


Assuntos
Humanos , Feminino , Adulto , Neoplasias Cardíacas , Valva Mitral , Ecocardiografia
18.
New Phytol ; 209(2): 855-70, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26350789

RESUMO

Despite progress based on multilocus, phylogenetic studies of the palms (order Arecales, family Arecaceae), uncertainty remains in resolution/support among major clades and for the placement of the palms among the commelinid monocots. Palms and related commelinids represent a classic case of substitution rate heterogeneity that has not been investigated in the genomic era. To address questions of relationships, support and rate variation among palms and commelinid relatives, 39 plastomes representing the palms and related family Dasypogonaceae were generated via genome skimming and integrated within a monocot-wide matrix for phylogenetic and molecular evolutionary analyses. Support was strong for 'deep' relationships among the commelinid orders, among the five palm subfamilies, and among tribes of the subfamily Coryphoideae. Additionally, there was extreme heterogeneity in the plastid substitution rates across the commelinid orders indicated by model based analyses, with c. 22 rate shifts, and significant departure from a global clock. To date, this study represents the most comprehensively sampled matrix of plastomes assembled for monocot angiosperms, providing genome-scale support for phylogenetic relationships of monocot angiosperms, and lays the phylogenetic groundwork for comparative analyses of the drivers and correlates of such drastic differences in substitution rates across a diverse and significant clade.


Assuntos
Arecaceae/genética , Genomas de Plastídeos , Filogenia , Evolução Molecular , Magnoliopsida/genética , Proteínas de Plantas/genética
19.
J Clin Rheumatol ; 21(4): 175-80, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-26010179

RESUMO

OBJECTIVE: A consensus meeting of representatives of 16 Latin American and Caribbean countries and the REAL-PANLAR group met in the city of Bogota to provide recommendations for improving quality of care of patients with rheumatoid arthritis (RA) in Latin America, defining a minimum standards of care and the concept of center of excellence in RA. METHODS: Twenty-two rheumatologists from 16 Latin American countries with a special interest in quality of care in RA participated in the consensus meeting. Two RA Colombian patients and 2 health care excellence advisors were also invited to the meeting. A RAND-modified Delphi procedure of 5 steps was applied to define categories of centers of excellence. During a 1-day meeting, working groups were created in order to discuss and validate the minimum quality-of-care standards for the 3 proposed types of centers of excellence in RA. Positive votes from at least 60% of the attending leaders were required for the approval of each standard. RESULTS: Twenty-two opinion leaders from the PANLAR countries and the REAL-PANLAR group participated in the discussion and definition of the standards. One hundred percent of the participants agreed with setting up centers of excellence in RA throughout Latin America. Three types of centers of excellence and its criteria were defined, according to indicators of structure, processes, and outcomes: standard, optimal, and model. The standard level should have basic structure and process indicators, the intermediate or optimal level should accomplish more structure and process indicators, and model level should also fulfill outcome indicators and patient experience. CONCLUSIONS: This is the first Latin American effort to standardize and harmonize the treatment provided to RA patients and to establish centers of excellence that would offer to RA patients acceptable clinical results and high levels of safety.


Assuntos
Instituições de Assistência Ambulatorial , Artrite Reumatoide/terapia , Consenso , Humanos , América Latina
20.
Arch. pediatr. Urug ; 86(1): 14-25, mar. 2015. ilus, tab
Artigo em Espanhol | LILACS | ID: lil-754231

RESUMO

Introducción: la infección por Toxoplasma gondii durante el embarazo puede resultar en graves complicaciones para el feto y dejar importantes secuelas en el recién nacido (RN). El objetivo del estudio fue realizar un seguimiento clínico y serológico de los recién nacidos cuyas madres tenían IgM reactiva para toxoplasmosis en el embarazo y analizar las características clínicas y serológicas de los que presentaron toxoplasmosis congénita (TC). Material y método: estudio descriptivo, prospectivo y longitudinal de RN cuyas madres tuvieron serología IgM reactiva en el embarazo y que fueron derivados para su seguimiento a la Policlínica de Infectología Pediátrica del Hospital de Paysandú en el período junio de 2008 a junio de 2013. Resultados: de los 51 RN evaluados, 50 fueron de término con una media de peso al nacer de 3.120 g y 5 fueron pequeños para la edad gestacional (PEG). Dos presentaron microcefalia y dos estuvieron expuestos a otras infecciones durante el embarazo (sífilis y virus de la inmunodeficiencia humana). De los 42 (82,3%) que completaron su seguimiento, en siete se diagnosticó TC (13,7%) y se descartó la infección en 35 (68,5%). En éstos la media de desaparición de la IgG fue de 6,2 meses. Tres de los infectados fueron sintomáticos y tenían IgM reactiva al nacer. Cuatro presentaron secuelas en la evolución. De ocho RN a los que se les indicó tratamiento, tres lo completaron. En 6 (85,7%) de los infectados se confirmó la seroconversión materna durante el embarazo. Conclusiones: si bien la TC no es muy frecuente en nuestro país, la morbilidad es muy importante. La presencia de seroconversión materna obliga a estudiar y tratar al RN hasta que se descarte la infección. La serología en el RN demuestra, en nuestro medio, una escasa sensibilidad y a falta de otras técnicas obliga a realizar el seguimiento clínico y serológico con IgG durante el primer año de vida.


Introduction: Toxoplasma gondii infection during pregnancy can result in serious complications for the fetus and causes serious sequelae in the newborn. The study aimed to conduct a clinical and serological follow-up of newborns whose mothers were toxoplasma IgM positive during pregnancy and to analyze the clinical and serological evolution of those with congenital toxoplasmosis (CT) features. Method: descriptive, prospective, longitudinal study of newborns whose mothers were toxoplasma IgM positive during pregnancy and who were referred for follow-up to the Pediatrics Infectious Diseases Polyclinic. Escuela del Litoral Hospital, Paysandú, from June, 2008 through June, 2013. Results: out of 51 newborns assessed, 50 were term newborns with a mean birth weight of 3,120 g and 5 were small for gestational age (SGA). Two had microcephaly and 2 were exposed to other infections during pregnancy (syphilis and human immunodeficiency virus). Seven (13.7%) of the 42 (82.3%) newborns who completed follow-up CT were diagnosed with toxoplasmosis, and infection was ruled out in 35 (68.5%) newborns. In the latter half of the disappearance of IgG was 6.2 months. Three (43%) were infected symptomatic and had reactive IgM at birth. Four (57%) evidenced sequelae in evolution. Eight newborns were prescribed treatment, 3 of them completed it. In six (85.7%) of them infected maternal seroconversion during pregnancy was confirmed. Conclusions: although CT is not very common in our country, the disease is very important. The presence of maternal seroconversion forced to study and treat the newborns until infection is ruled out. Serology in the newborns demonstrates, in our environment, poor sensitivity and lack of other techniques necessary to undertake clinical and serological follow-up of IgM during the first year of life.


Assuntos
Humanos , Toxoplasmose Congênita , Toxoplasmose Congênita/complicações , Toxoplasmose Congênita/diagnóstico , Toxoplasmose Congênita/epidemiologia , Uruguai , Testes Sorológicos , Protocolos Clínicos , Gestantes
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