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1.
Braz. j. biol ; 82: e234471, 2022. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1153460

RESUMO

Abstract High doses of antibiotics used in hospitals can affect the microbial composition of sewers, selecting resistant bacteria. In this sense, we evaluated the antibiotic resistance profile and the multiresistant phenotype of bacteria isolated in sewage from a tertiary hospital in the interior São Paulo state, Brazil. For bacteria isolation, 10 µL of sewage samples were sown in selective culture media and the isolates were identified using VITEK-2 automatized system. The antibiotic sensitivity test was performed by disk diffusion. High percentages of resistance were found for amoxicillin, ampicillin, ceftazidime, clindamycin, vancomycin and the multidrug-resistant phenotype (MDR) was attributed to 60.7% of the isolates. Our results show bacteria classified as critical/high priority by WHO List of Priority Pathogens (Enterococcus and Staphylococcus aureus resistant to vancomycin and Enterobacteriaceae resistant to carbapenems) in hospital sewage. Therefore, the implementation of disinfection technologies for hospital sewage would reduce the bacterial load in the sewage that will reach urban wastewater treatment plants, minimizing superficial water contamination and bacterial resistance spread in the environment.


Resumo Altas doses de antibióticos utilizados em hospitais podem afetar a composição microbiana dos esgotos, selecionando bactérias resistentes. Nesse sentido, avaliamos o perfil de resistência a antibióticos e o fenótipo multirresistente de bactérias isoladas em esgoto de um hospital terciário no interior do estado de São Paulo, Brasil. Para o isolamento de bactérias, foram semeados 10 µL das amostras de esgoto em meios de cultura seletivos e os isolados foram identificados usando o sistema automatizado VITEK-2. O teste de sensibilidade aos antibióticos foi realizado por disco-difusão em ágar. Elevadas porcentagens de resistência foram encontradas para amoxicilina, ampicilina, ceftazidima, clindamicina, vancomicina e o fenótipo multirresistente (MDR) foi atribuído a 60,7% dos isolados. Nossos resultados mostram bactérias classificadas como prioridade crítica/alta pela Lista de Patógenos Prioritários da OMS (Enterococcus e Staphylococcus aureus resistentes à vancomicina e Enterobacteriaceae resistentes aos carbapenêmicos) no esgoto hospitalar. Sendo assim, implementação de tecnologias de desinfecção do esgoto hospitalar reduziriam a carga bacteriana no esgoto que chegará às estações de tratamento de esgoto urbanas, minimizando a contaminação dos ecossistemas hídricos receptores e a disseminação da resistência bacteriana no ambiente.

2.
J Dairy Sci ; 2021 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-33934874

RESUMO

The objective was to investigate the economic effect of treating dairy cows with metritis using ceftiofur-free acid or leaving them untreated at the time of diagnosis. Cows with a fetid, watery, red-brownish vaginal discharge were diagnosed with metritis (d 0). Data from 875 dairy cows (506 primiparous and 369 multiparous) from 1 herd in northern Florida that had been part of a larger study evaluating different treatments for metritis were used for the economic analysis. Holstein cows with metritis had been randomly assigned to: Ceftiofur (CEF, n = 239) = subcutaneous injection of 6.6 mg/kg of ceftiofur crystalline-free acid in the base of the ear at d 0 and d 3; Untreated (UNT, n = 233) = no treatment applied at metritis diagnosis. Both groups could receive escape therapy if condition worsened. A group of nonmetritic healthy cows (NMET; n = 403) from the same cohort was randomly selected for comparison. Continuous outcomes such as 300-d milk production (kg/cow), milk sales ($/cow), cow sales ($/cow), treatment cost by 60 days in milk ($/cow), reproduction cost ($/cow), replacement cost ($/cow), feeding cost ($/cow), and gross profit per cow ($/cow) were analyzed using the ANOVA (MIXED procedure of SAS version 9.4). Dichotomous outcomes such as pregnancy and culling by 300 d were analyzed using logistic regression (GLIMMIX procedure of SAS). Models included the fixed effects of treatment, parity, and the interaction between treatment and parity. A stochastic analysis was performed with 10,000 iterations using the observed results from each group. The CEF treatment resulted in greater treatment cost by 60 DIM than UNT ($112 vs. $37), but resulted in a greater proportion of pregnant cows (71 vs. 61%) and decreased culling by 300 DIM (29 vs. 39%) compared with UNT. Gross profit was lesser for UNT than NMET ($2,969 vs. $3,426), and CEF was intermediate ($3,219). The stochastic analysis showed that the mean difference in gross profit between UNT and NMET was -$457; saleable milk (49%) and replacement cost (24%) accounted for most of the variation. The mean difference in gross profit between CEF and NMET group was -$207; saleable milk (82%) and initial metritis treatment cost (9%) accounted for most of the variation. The mean difference in gross profit between the UNT and the CEF group was -$250; replacement cost (41%) and cow sales (31%) accounted for most of the variation. In summary, metritis caused large economic losses when left untreated, and CEF reduced those losses by improving fertility, reducing culling and replacement cost, and reducing milk yield losses.

3.
Braz J Biol ; 82: e234471, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33681897

RESUMO

High doses of antibiotics used in hospitals can affect the microbial composition of sewers, selecting resistant bacteria. In this sense, we evaluated the antibiotic resistance profile and the multiresistant phenotype of bacteria isolated in sewage from a tertiary hospital in the interior São Paulo state, Brazil. For bacteria isolation, 10 µL of sewage samples were sown in selective culture media and the isolates were identified using VITEK-2 automatized system. The antibiotic sensitivity test was performed by disk diffusion. High percentages of resistance were found for amoxicillin, ampicillin, ceftazidime, clindamycin, vancomycin and the multidrug-resistant phenotype (MDR) was attributed to 60.7% of the isolates. Our results show bacteria classified as critical/high priority by WHO List of Priority Pathogens (Enterococcus and Staphylococcus aureus resistant to vancomycin and Enterobacteriaceae resistant to carbapenems) in hospital sewage. Therefore, the implementation of disinfection technologies for hospital sewage would reduce the bacterial load in the sewage that will reach urban wastewater treatment plants, minimizing superficial water contamination and bacterial resistance spread in the environment.


Assuntos
Bactérias , Esgotos , Bactérias/genética , Brasil , Testes de Sensibilidade Microbiana , Fenótipo , Centros de Atenção Terciária
4.
PLoS One ; 16(2): e0245746, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33592005

RESUMO

BACKGROUND: The uterine cervical length is an important risk factor for preterm birth. The aim of this study was to assess cervical length distribution in women with singleton pregnancies, measured by transvaginal ultrasound between 16 and 24 weeks, and its association with population characteristics. MATERIALS AND METHODS: We searched electronic databases and other sources for studies published from April 1, 1990 to July 21, 2020. Of the 2019 retrieved publications, full-text versions of 137 articles were considered. We included 77 original articles that reported cervical length measurements of 363,431 women. The main aim of this study was to identify the pattern of cervical length in different populations. We collected demographic and clinical data concerning the population, in addition to information regarding the ultrasound examination and cervical length measurement. Regarding study bias, 56 were at low risk of bias and 21 were at medium risk of bias. RESULTS: The meta-analysis included 57 articles with data from 158,346 women. The mean cervical length was 37.96. mm (95% CI [36.68, 39.24]). Cervical length was shorter in women from Africa and Asia, in those from low-income countries, with a lower body weight, and in those who delivered before 37 gestational weeks. We found that the cervical length from pooled studies is longer than that usually discussed in the literature. Regarding limitations, we had difficulty assessing our main variable because there was no consistent pattern in the way authors reported cervical length measurement. Another limitation was the great heterogeneity between studies. CONCLUSIONS: The use of a single cutoff value to define a short cervix diagnosis, an important risk factor for preterm birth, may not be correct and cervical length must be considered according to maternal population characteristics. Future studies should identify different specific curves and cutoff values for cervical length in different populations. This meta-analysis was registered in the PROSPERO database under CRD42017070246 at https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=70246.

5.
J Dairy Sci ; 104(3): 3158-3168, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33455790

RESUMO

The objective of this study was to estimate the cost of metritis in dairy herds. Data from 11,733 dairy cows from 16 different farms located in 4 different regions of the United States were compiled for up to 305 d in milk, and 11,581 cows (2,907 with and 8,674 without metritis) were used for this study. Metritis was defined as fetid, watery, red-brownish vaginal discharge that occurs ≤21 d in milk. Continuous outcomes such as 305-d milk production, milk sales ($/cow), cow sales ($/cow), metritis treatment costs ($/cow), replacement costs ($/cow), reproduction costs ($/cow), feeding costs ($/cow), and gross profit per cow ($/cow) were analyzed using mixed effect models using the MIXED procedure of SAS (SAS Institute Inc., Cary, NC). Gross profit was also compared using the Kruskal-Wallis test. Dichotomous outcomes such as pregnant and culling by 305 d in milk were analyzed using the GLIMMIX procedure of SAS. Time to pregnancy and culling were analyzed using the PHREG procedure of SAS. Models included the fixed effects of metritis, parity, and the interaction between metritis and parity, and farm as the random effect. Variables were considered significant when P ≤ 0.05. Metritis cost was calculated by subtracting the gross profit of cows with metritis from the gross profit of cows without metritis. A stochastic analysis was performed with 10,000 iterations using the observed results from each group. Milk yield and proportion of cows pregnant were lesser for cows with metritis than for cows without metritis, whereas the proportion of cows leaving the herd was greater for cows with metritis than for cows without metritis. Milk sales, feeding costs, residual cow value, and gross profit were lesser for cows with metritis than for cows without metritis. Cow sales and replacement costs were greater for cows with metritis than for cows without metritis. The mean cost of metritis from the study herds was $511 and the median was $398. The stochastic analysis showed that the mean cost of a case of metritis was $513, with 95% of the scenarios ranging from $240 to $884, and that milk price, treatment cost, replacement cost, and feed cost explained 59%, 19%, 12%, and 7%, respectively, of the total variation in cash flow differences. In conclusion, metritis caused large economic losses to dairy herds by decreasing milk production, reproduction, and survival in the herd.


Assuntos
Doenças dos Bovinos , Indústria de Laticínios , Animais , Bovinos , Feminino , Lactação , Leite , Paridade , Gravidez , Reprodução
6.
J Dairy Sci ; 98(11): 7810-22, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26298767

RESUMO

The objectives were to evaluate the effects of synchronizing estrus and ovulation to implement a timed artificial insemination (AI) at first insemination on reproductive performance and cost per pregnancy in dairy heifers. Six hundred eleven Holsteins heifers at approximately 400 d of age from 3 farms were enrolled in the study. Six days before moving to the breeding pens, heifers were allocated randomly to AI after detected estrus from study d 0 to 84 (CON, n=306), or to timed AI for first AI followed by detected estrus for the remainder of the 84-d study (TAI, n=305). Heifers receiving TAI were enrolled in the 5-d timed AI protocol on study d -6 (d -6, GnRH and a progesterone insert; d -1, PGF2α and insert removal; d 0, PGF2α; d 2, GnRH + AI), and they were allowed to be bred the day before scheduled timed AI if detected in estrus. Starting on study d 0, estrus was detected daily. Heifers in estrus were inseminated on the same morning as detected estrus. Control heifers not inseminated by study d 7 received PGF2α and this treatment was repeated every 2 wk until AI. The study lasted 84 d to allow a period of breeding equivalent to four 21-d estrous cycles. A herd budget accounting for inputs for both treatments was created to determine the cost per pregnancy. Sensitivity analysis compared economic differences between the 2 treatments under different input scenarios when detection of estrus after the first AI varied from 50 to 80%. Interval to first AI was 8 d shorter for TAI than for CON. Pregnancy at first AI did not differ between treatments (CON=58.3 vs. TAI=62.8%). In contrast, TAI increased pregnancy per AI (P/AI) compared with CON in heifers inseminated with sex-sorted semen (CON=31.6 vs. TAI=54.8%). The 21-d cycle insemination rate was greater for TAI (91.4%) than for CON (82.4%), even when evaluated after the first 21 d in the study (CON=68.2 vs. TAI=77.1%). The increased insemination rate improved the 21-d cycle pregnancy rate from 47.9% in CON to 57.2% in TAI heifers. In fact, the hazard of pregnancy was 60% greater for TAI than CON. The increased pregnancy rate in TAI reduced the median days to pregnancy by 12 d (CON=2.0 vs. TAI=14.0) and increased the proportion of pregnant heifers by 6.3 percentage points by study d 84 (CON=85.2 vs. TAI=91.5%). The cost per pregnancy was $17.00 less for TAI than CON. The sensitivity analysis indicated that TAI was economically more advantageous to produce a pregnancy compared with CON. Only when insemination rate after the first 21 d of breeding was very high and P/AI was relatively low did the cost per pregnancy become similar for the 2 treatments. Collectively, inseminating all heifers within 2 d of breeding with the 5-d timed AI protocol maintains P/AI, improves pregnancy rate, and reduces cost per pregnancy compared with insemination after detected estrus.


Assuntos
Bovinos/fisiologia , Inseminação Artificial/veterinária , Ovulação/fisiologia , Reprodução/fisiologia , Animais , Cruzamento/economia , Cruzamento/métodos , Custos e Análise de Custo , Indústria de Laticínios/economia , Indústria de Laticínios/métodos , Dinoprosta/administração & dosagem , Ciclo Estral/efeitos dos fármacos , Estro/efeitos dos fármacos , Detecção do Estro/métodos , Feminino , Hormônio Liberador de Gonadotropina/administração & dosagem , Inseminação Artificial/economia , Inseminação Artificial/métodos , Ovulação/efeitos dos fármacos , Gravidez , Taxa de Gravidez , Progesterona/administração & dosagem , Reprodução/efeitos dos fármacos , Fatores de Tempo
7.
Genet Mol Res ; 14(1): 53-62, 2015 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-25729935

RESUMO

Adult stem cells are known for their plasticity and their potential to differentiate into several different cell types; these characteristics have implications for cell therapy and reproductive biotechnologies. In this study, we report on the isolation and characterization of mesenchymal stem cells (MSC) derived from bovine and buffalo adipose tissue. Cells isolated using enzymatic digestion of bovine and buffalo adipose-tissue biopsy samples were grown in vitro for at least 15 passages, verifying their capacity to proliferate. These cells were also subjected to immunophenotypic characterization for the presence of CD90, CD105, and CD79, and the absence of CD45, CD34, and CD73, which are positive and negative markers of MSC, respectively. To prove their multipotency, the cells were induced to differentiate into three different cell types, chondrocytes, osteoblasts, and adipocytes, which were stained with tissue-specific dyes (Chondrogenic-Alcian Blue, Osteogenic-Alizarin Red, and Adipogenic-Oil-Red O, respectively) to confirm differentiation. Gene expression analysis of pluripotency-related genes was also conducted. Our results suggest that adipose tissue from bovines and buffalos can be used as a source of MSC, making adipose tissue-derived cells an interesting option for cell therapy and regenerative medicine. Additionally, these findings have implications for reproductive biotechnology because the use of MSC as nuclear donors has been linked to an increase in the efficiency of nuclear transfer.


Assuntos
Tecido Adiposo/citologia , Separação Celular/métodos , Células-Tronco Multipotentes/citologia , Adipogenia , Animais , Búfalos , Bovinos , Proliferação de Células , Condrogênese , Imunofenotipagem , Osteogênese
8.
Theriogenology ; 80(4): 295-301, 2013 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-23683691

RESUMO

Developmental competence of in vitro-matured bovine oocytes is a limiting factor in production of embryos in vitro. Several studies have suggested a potential positive effect of thyroid hormones on cultured oocytes and/or their supporting cells. Therefore, the aim of the present study was to ascertain whether medium supplementation with triiodothyronine (T3) improved subsequent developmental competence of in vitro-matured bovine oocytes. For this purpose, we first documented (using reverse transcription PCR) that whereas bovine cumulus cells expressed both thyroid hormone receptor (TR)-α and TRß, immature bovine oocytes expressed TRα only. Thereafter, to test the effects of TH on developmental competence, abattoir-derived oocytes were matured in vitro in a medium containing 0, 25, 50, or 100 nM T3 and subjected to in vitro fertilization. Embryo quality was evaluated by assessing cleavage and blastocyst rates, morphological quality, development kinetics, and total cell number on Day 8 of culture. Notably, addition of 50 or 100 nM T3 to the in vitro maturation medium increased (P < 0.05) the rate of hatched blastocysts on the eighth day of culture, as compared with other groups (62.4 ± 11.7, 53.1 ± 16.3, and 32.4 ± 5.3, respectively). Next, the relative expression levels of genes related to embryo quality POU-domain transcription factor (POU5F1) and glucose transporter-1 (GLUT 1) were compared between in vivo- and in vitro-produced blastocysts. On the basis of the previous experiments, IVP embryos originating from oocytes that were matured in vitro in the presence or absence of 50 nM T3 were evaluated. The treatment had no effect (P > 0.05) on gene expression. We concluded that supplementation of bovine oocyte in vitro maturation medium with T3 may have a beneficial effect on the kinetics of embryo development.


Assuntos
Técnicas de Maturação in Vitro de Oócitos/métodos , Oócitos/efeitos dos fármacos , Oogênese/efeitos dos fármacos , Tri-Iodotironina/farmacologia , Animais , Bovinos , Células Cultivadas , Células do Cúmulo/efeitos dos fármacos , Células do Cúmulo/fisiologia , Desenvolvimento Embrionário/efeitos dos fármacos , Desenvolvimento Embrionário/genética , Feminino , Regulação da Expressão Gênica no Desenvolvimento/efeitos dos fármacos , Técnicas de Maturação in Vitro de Oócitos/veterinária , Masculino , Oócitos/fisiologia , Oogênese/genética , Receptores dos Hormônios Tireóideos/genética , Receptores dos Hormônios Tireóideos/metabolismo
9.
Theriogenology ; 79(2): 344-50, 2013 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-23140803

RESUMO

The aim of this research was to perform in situ quantification, morphometry evaluation, and apoptosis analysis of ovarian follicular wall cells in mechanically isolated follicles obtained from ovaries of bovine fetuses (Bos taurus indicus) between 3 and 9 months of age. Apoptosis was evaluated using the terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling assay. The number of isolated follicles increased from 3 months onward (102.5 ± 141.1, mean ± SEM), peaked at 6 months (12855.0 ± 9030.1), and then decreased by 7 months (3208.7 ± 3249.5), consistent with atresia occurring at these stages. Follicular density was greatest at 4 months, consistent with a sudden boost in follicular activity independent of a corresponding increase in ovarian size. Antral follicles were first observed at 5 months. As fetal age increased, there was a tendency for the percentage of primordial and primary follicles to decrease, and the percentage of secondary follicles to increase. However, the high variability (P < 0.05) for all follicle populations up to 5 months of age precluded further interpretation of these results. Oocyte diameter increased from the primordial (23.6 ± 4.4 µm) to the secondary follicular stages (38.0 ± 14.9 µm). Apoptosis was observed in ovaries from all fetal ages analyzed. We concluded that preantral follicles could be isolated from bovine fetuses by 3 months of age, with apoptosis affecting ovarian follicular dynamics throughout fetal life.


Assuntos
Apoptose , Bovinos/embriologia , Folículo Ovariano/embriologia , Ovário/embriologia , Animais , Feminino , Idade Gestacional , Marcação In Situ das Extremidades Cortadas/veterinária , Oócitos/citologia , Tamanho do Órgão , Folículo Ovariano/citologia
10.
Reprod Domest Anim ; 46(1): e17-22, 2011 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-20403125

RESUMO

The objective of this study was to determine the number, morphology and ultrastructure of preantral ovarian follicles of buffalo (Bubalus bubalis) foetuses at different ages. Quantification revealed number of primordial, primary and secondary follicles of 48,857 ± 17,506, 26,000 ± 20,452, 18,428 ± 10,875 and 18,375 ± 19,690, 225 ± 349, 326 ± 288 at 12-34 cm and 35-60 cm crown rump length (CRL), respectively. Follicular diameter values were 28.9 (± 3.4), 34.7 (± 5.9) and 59.4 (± 12.6) µm; oocyte diameters were 21.7 (± 2.8), 24.3 (± 3.4) and 33.0 (± 7.7) µm, and the numbers of follicular cells in the follicle equatorial section were 7.1 (± 1.4), 12.0 (± 2.4) and 13.8 (± 2.4) for primordial, primary and secondary follicles, respectively. The primordial follicle consisted of an oocyte surrounded by a layer of flattened follicular cells with a normally eccentric oocyte nucleus. Dispersed Golgi complex, smooth endoplasmic reticulum, rounded mitochondria and several lipid vesicles were observed in the cytoplasm and cell junctions between the follicle cell membranes and the oocyte. This work describes the number, morphometry and ultrastructure of preantral follicles of buffalo foetuses, concluding that folliculogenesis is established between 8 and 34 cm CRL and that follicle number varies individually and according to age and that further studies are needed in this species.


Assuntos
Búfalos/embriologia , Folículo Ovariano/embriologia , Animais , Núcleo Celular/ultraestrutura , Citoplasma/ultraestrutura , Feminino , Idade Gestacional , Microscopia Eletrônica de Varredura/veterinária , Microscopia Eletrônica de Transmissão/veterinária , Oócitos/ultraestrutura , Folículo Ovariano/ultraestrutura
11.
Rev Neurol ; 38(4): 327-31, 2004.
Artigo em Espanhol | MEDLINE | ID: mdl-14997456

RESUMO

INTRODUCTION: Pantothenate kinase deficiency (Hallervorden-Spatz syndrome, HSS) triggers cerebral neurodegeneration with iron deposition in the basal ganglia. The classical form has an early onset in infancy, a progressive course, the presence of extrapyramidal symptoms (dystonia, chorea, rigidity) and pigmentary retinitis. There are atypical late onset forms with predominance of symptoms of Parkinsonism and dementia, which progress slowly and course somewhat less progressively. CASE REPORT: We describe three patients with HSS and an atypical presentation, with onset during the second decade of life. In all cases magnetic resonance imaging showed areas of hyposignal in T2 sequences in medial globus pallidus, with central hypersignal, which gave rise to a tiger's eye image. Other aetiologies, such as Wilson's disease, gangliosidosis GM1, hypoprebetalipoproteinemia, hexosaminidase A deficiency, aminoacidurias and infantile Huntingdon's chorea, were precluded. In the 20-year-old male the initial manifestations at the age of 17 were superposed over Gilles de la Tourette syndrome, with complex motor and vocal tics, palilalia, behavioural disorders and postural instability. The 13-year-old patient presented symptoms of chorea, hemiballic movements and dystonia in the lower limbs, which limited walking at the age of 12. The 28-year-old female patient presented a progressive rigid akinetic syndrome, with dementia and partial response to levodopa. CONCLUSIONS: The clinical spectrum of HSS is broad and its differential diagnosis must include hemiballism, Tourette syndrome and juvenile Parkinsonism.


Assuntos
Discinesias/etiologia , Neurodegeneração Associada a Pantotenato-Quinase/complicações , Neurodegeneração Associada a Pantotenato-Quinase/enzimologia , Transtornos Parkinsonianos/etiologia , Fosfotransferases (Aceptor do Grupo Álcool)/deficiência , Síndrome de Tourette/etiologia , Adolescente , Adulto , Criança , Diagnóstico Diferencial , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Neurodegeneração Associada a Pantotenato-Quinase/patologia
12.
Rev Neurol ; 36(11): 1040-4, 2003.
Artigo em Espanhol | MEDLINE | ID: mdl-12808500

RESUMO

INTRODUCTION: Decompression sickness (DS) is caused when bubbles of an inert gas usually nitrogen, since oxygen is metabolised in the tissues are released into the bloodstream and tissues during fast ascents once the atmospheric pressure is lowered near the surface. Neurological complications are its most serious form of expression and include vertigo, headache, stroke and acute myelopathy, among others. DS that affects the spinal cord is infrequent. CASE REPORT: A male, 42 years old, who presented progressive tetraparesis 15 minutes after returning to the surface following several immersions up to 40 metres deep in the same day. Neurological exploration revealed tetraparesis that was predominantly distal and in the lower limbs, a posterior cord syndrome, urinary incontinence and neurogenic pain. Total column magnetic resonance imaging showed areas of diffused hypersignal in the T2 sequence in the thoracic and cervical (C2 to C6) regions, predominating in the posterior cords. The echocardiogram, transcranial Doppler and spirometric studies ruled out an arterial gas embolism following pulmonary barotrauma. CONCLUSIONS: Spinal DS can give rise to a serious myelopathy, which affects the pyramidal pathway, posterior cords and sphincteral control, and which generally appears after sudden ascents from the deep dives.


Assuntos
Doença da Descompressão/complicações , Doença da Descompressão/patologia , Mergulho/efeitos adversos , Doenças da Medula Espinal/etiologia , Doenças da Medula Espinal/patologia , Adulto , Barotrauma/patologia , Humanos , Imagem por Ressonância Magnética , Masculino , Medula Espinal/patologia
13.
Rev. neurol. (Ed. impr.) ; 36(11): 1040-1044, 1 jun., 2003.
Artigo em Es | IBECS | ID: ibc-27632

RESUMO

Introducción. El síndrome de descompresión (SD) se produce por la liberación de burbujas de gas inerte- habitualmente nitrógeno, ya que el oxígeno se metaboliza en los tejidos- en la corriente sanguínea y en los tejidos, durante los ascensos rápidos, una vez que la presión ambiental se ha reducido, cerca de la superficie. Las complicaciones neurológicas constituyen su forma más grave de expresión e incluyen vértigo, cefalea, ictus y mielopatía aguda, entre otros. ElSD que afecta a la médula espinal es poco frecuente. Caso clínico. Varón de 42 años, que presentó una tetraparesia progresiva 15 minutos después de regresar a la superficie, después de varias inmersiones de hasta 40 metros de profundidad en el mismo día. En la exploración neurológica se observaba una tetraparesia de predominio distal y en las extremidades inferiores, un síndrome cordonal posterior, incontinencia esfinteriana y dolor neurogénico. La resonancia magnética de columna total mostró áreas de hiperseñal en secuencia T2 de modo difuso en la región torácica y cervical de C2 a C6, de predominio en cordones posteriores. El estudio ecocardiográfico, el doppler transcraneal y el espirométrico descartaron un embolismo arterial gaseoso tras barotrauma pulmonar. Conclusiones. El SD espinal puede provocar una mielopatía grave, que afecta a la vía piramidal, los cordones posteriores y el control esfinteriano, que generalmente aparece tras ascensos bruscos desde la profundidad (AU)


No disponible


Assuntos
Adulto , Masculino , Feminino , Humanos , Veias Cerebrais , Medula Espinal , Doenças da Medula Espinal , Hiper-Homocisteinemia , Trombose Venosa , Barotrauma , Mergulho , Doença da Descompressão , Imagem por Ressonância Magnética
14.
Rev Neurol ; 35(2): 131-4, 2002.
Artigo em Espanhol | MEDLINE | ID: mdl-12221624

RESUMO

INTRODUCTION: Schwartz Jampel syndrome is a usually recessive disorder that presents myotonia, skeletal (bone dysplasia) and facial (blepharophimosis) anomalies and low height, which is diagnosed in childhood. We report on the clinical, electromyographical and radiological findings of two siblings affected by the disease and who were diagnosed late, in adulthood. CASE REPORTS: Two siblings, a male aged 39 and a female of 49, the only members of a family of five siblings born to consanguineous parents to be affected, were studied because of deformities in the joints that appeared at the age of nine months and alterations in their gait. Both had a syndromic facies with hypertelorism, micrognathia, blepharospasm, thin mouth, saddle nose and low height. The sister presented lumbar hyperlordosis, dislocation of the kneecaps, clubfeet, fists with radial deviation, bilateral dislocation of the head of the radius and limited pronosupination and flexure tension of the elbow. Deep reflexes were diminished. The male had deformities in both knees and in the right elbow, and was unable to perform pronosupination of the arm or bend the knee. A coxofemoral X ray revealed an epiphysial dysplasia. The magnetoencephalogram showed continuous muscular activity with complex repetitive discharges in the sister s orbicularis oculi and biceps. The brother had a bilateral entrapment of the ulnar nerve in the ulnar canal with a secondary axonal compromise. Magnetic resonance imaging of the encephalon of the patient showed cortical atrophy, hyperintense focal areas in the periventricular white matter and platybasia. CONCLUSIONS: In the adult, myotonic chondrodystrophia evolves with decreased blepharospasm, the presence of structured deformities and entrapments of peripheral nerves.


Assuntos
Osteocondrodisplasias/diagnóstico , Adulto , Eletromiografia , Feminino , Humanos , Região Lombossacral/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/fisiopatologia , Osteocondrodisplasias/fisiopatologia , Radiografia
16.
Rev Neurol ; 35(4): 337-41, 2002.
Artigo em Espanhol | MEDLINE | ID: mdl-12235564

RESUMO

INTRODUCTION: As a chronic chagasic myocardiopathy, Chagas disease (CD) may give rise to cardiac insufficiency, arrhythmias, thromboembolism and stroke. Occlusive vascular disease of the rostral portion of the basilar artery or of its emergent branches may cause ischemia and necrosis in different areas of the midbrain, thalamic nuclei, cerebellum and occipital lobe. CASE REPORTS: We describe four patients (three males and a female, the average age being 54 years) with positive chagasic serology (indirect immunofluorescence and hemagglutination) and suffering from CD and top of the basilar syndrome. All of them underwent tests to determine proteins C and S, antithrombin III, factor V Leiden, and lupic anticoagulant, as well as being submitted to explorations using electrocardiogram (ECG), echocardiogram, carotid and transcranial echo Doppler, computerised tomography (CAT) and magnetic resonance imaging (MRI). RESULTS: The coagulopathy studies were normal or negative in the four patients. We also describe the findings from the electrocardiograms (blockage in right branch, two cases; auricular fibrillation, one case; repolarization disorder, one case) and the echocardiograms (left ventricular dysfunction, two patients; apical aneurysm, one patient; mural thrombus, one patient). Neuroimaging revealed one case of each of the following infarctions: bilateral thalamic, bilateral cerebellar and occipital, cerebellar, thalamic mesencephalic and occipital, and thalamic mesencephalic and occipitotemporal. CONCLUSIONS: In a patient with positive chagasic serology, with or without findings in the ECG and in the electrocardiogram that can be put down to a cardioembolic source, a vascular syndrome produced by occlusion of the distal basilar artery suggest a cardioembolism. We recommend secondary anticoagulation because of the high risk of recurrence.


Assuntos
Infarto Encefálico/etiologia , Cardiomiopatia Chagásica/complicações , Insuficiência Vertebrobasilar/etiologia , Adulto , Idoso , Infarto Encefálico/diagnóstico , Cardiomiopatia Chagásica/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Insuficiência Vertebrobasilar/diagnóstico
17.
Rev. neurol. (Ed. impr.) ; 35(2): 131-134, 16 jul., 2002.
Artigo em Es | IBECS | ID: ibc-22142

RESUMO

Introducción. El síndrome de Schwartz-Jampel es un trastorno habitualmente recesivo que cursa con miotonía, anomalías esqueléticas (displasia ósea) y faciales (blefarofimosis) y talla baja, de diagnóstico en la infancia. Aportamos los hallazgos clínicos, electromiográficos y radiológicos de dos hermanos afectados, con un diagnóstico tardío en la edad adulta. Casos clínicos. Dos hermanos, un varón de 39 años y una mujer de 49 años, únicos afectados de una familia de cinco hermanos fruto de padres consanguíneos, se estudiaron por presentar deformidades articulares desde los nueve meses de edad y una alteración de la marcha. Ambos tenían una facies sindrómica con hipertelorismo, micrognatia, blefaroespasmo, boca afilada, nariz en silla y talla baja. La hermana presentaba hiperlordosis lumbar, luxación de rótulas, pies equinos, puños con desvío radial, luxación de cabeza de radio bilateral y limitación para la pronosupinación y flexoextensión del codo. Los reflejos profundos estaban disminuidos. El varón tenía deformidades en ambas rodillas y en el codo derecho, y era incapaz de pronosupinar el brazo y de flexionar la rodilla. Una radiografía coxofemoral mostró una displasia epifisaria. El magnetoencefalograma evidenció una actividad muscular continua con descargas repetitivas complejas en orbicularis oculi y bíceps en la hermana. El hermano tenía un atrapamiento del nervio cubital bilateral en el canal cubital con un compromiso axonal secundario. La resonancia magnética del encéfalo de la paciente mostró atrofia cortical, áreas hiperintensas focales en la sustancia blanca periventricular y platibasia. Conclusiones. La condrodistrofia miotónica evoluciona en el adulto con una disminución del blefaroespasmo, con presencia de deformidades estructuradas y atrapamientos de nervios periféricos (AU)


Assuntos
Pessoa de Meia-Idade , Criança , Adulto , Masculino , Feminino , Humanos , Músculo Esquelético , Osteocondrodisplasias , Paraplegia , Quadriplegia , Diagnóstico Diferencial , Doença Aguda , Região Lombossacral , Eletromiografia , Hemiplegia
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