Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 379
Filtrar
1.
Respirar (Ciudad Autón. B. Aires) ; 16(4): 421-423, Dic.2024.
Artigo em Espanhol | LILACS, UNISALUD, BINACIS | ID: biblio-1580726

RESUMO

Los empiemas fúngicos representan una entidad potencialmente fatal, con tasas de mortalidad elevadas en la mayoría de las series. Se presenta el caso de un empiema por Candida albicans tratado exitosamente en un paciente diabético. Se demuestra la importancia del inicio precoz y agresivo del tratamiento.


Fungal empyemas represent a potentially fatal entity, with high mortality rates in most series. A case of empyema due to Candida albicans successfully treated in a diabetic patient is presented, demonstrating the importance of early and aggressive initiation of treatment.


Assuntos
Humanos , Masculino , Adulto , Derrame Pleural , Candida albicans/isolamento & purificação , Doença Celíaca , Diabetes Mellitus , Empiema/tratamento farmacológico , Toracoscopia , Ferimentos e Lesões , Incidência , Mortalidade , Febre , Laparotomia , Leucocitose , Antifúngicos/uso terapêutico
2.
Rev. méd. hondur ; 92(2): 139-139, jul.-dic. 2024. ilus
Artigo em Espanhol | LILACS, BIMENA | ID: biblio-1581345

RESUMO

Introducción: El síndrome de Ramsay Hunt, también conocido como herpes zóster ótico, es una complicación tardía de la infección por el virus de la varicela zóster que resulta en la inflamación del ganglio geniculado del nervio craneal VII; el diagnóstico es clínico y se describe como una tríada de parálisis facial ipsilateral, otalgia y vesículas cerca del oído y el conducto auditivo. El tratamiento está dirigido a disminuir la duración de la enfermedad, así como proporcionar analgesia y prevenir las complicaciones. Descripción del caso: Femenina, 11 años, con historia reciente de infección por Varicela y COVID-19, que presenta dolor en cara y oído derecho, al examen físico se encuentra presencia de lesiones vesiculares herpéticas en pabellón y concha de oído derecho y disminución de la mímica facial por parálisis facial periférica grado IV; el manejo fue con terapia antiviral, esteroides y antiinflamatorios, además de prevención de daño de la córnea y terapia de rehabilitación, egresa sin complicaciones. Conclusión: El Síndrome de Ramsay Hunt, poco frecuente en pediatría, es una consecuencia de la reactivación de la infección por el virus de la Varicela Zóster, el pronóstico depende del diagnóstico y manejo oportuno, se debe sospechar en paciente pediátrico que se presenta con parálisis facial y/o dolor auricular...(AU)


Assuntos
Humanos , Masculino , Recém-Nascido , Leucemia Eritroblástica Aguda , Leucocitose , Leucemia Mieloide , Eritroblastos
3.
Arch Endocrinol Metab ; 68: e230183, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39420911

RESUMO

Objective: Leukocytosis is often observed among children presenting with diabetic ketoacidosis (DKA). This study compares detailed parameters of leukocytosis in children presenting with DKA versus infection. Subjects and methods: In this comparative cohort study, we collected data from two groups of children, one hospitalized with DKA and another with community-acquired pneumonia (CAP). The primary objective was to compare the neutrophil-to-lymphocyte ratio (NLR) between the groups. Total leukocyte count (TLC), absolute neutrophil count (ANC), platelet-to-lymphocyte ratio (PLR), and platelet-to-monocyte ratio (PMR) were also compared. The correlation of these hematological parameters with the clinical outcomes in the DKA group was also explored. Results: Data from 35 children with DKA (mean age 7.4 years, 12 boys) and 40 children with CAP (mean age 7.9 years, 15 boys) were available for comparison. No significant NLR difference was observed between the DKA and CAP groups. Similarly, no significant difference was observed in TLC and ANC between the groups. However, significant differences between the DKA and CAP groups were observed regarding mean (standard deviation) PLR (108.26 [67.51] versus 166.60 [163.83], respectively, p = 0.01) and mean PMR (1,795.40 [4,307.00] versus 886.33 [1,726.41], p = 0.01). Among children with DKA, ANC and PMR correlated positively and hemoglobin level correlated negatively with unfavorable outcomes. Conclusions: Specific parameters of leukocytosis (PLR and PMR) differed significantly in children with DKA versus CAP. Some widely available and inexpensive hematological parameters of inflammation (hemoglobin, ANC, and PMR) may predict outcomes in patients with DKA.


Assuntos
Cetoacidose Diabética , Leucocitose , Humanos , Masculino , Cetoacidose Diabética/sangue , Criança , Feminino , Leucocitose/sangue , Contagem de Leucócitos , Estudos de Coortes , Pré-Escolar , Neutrófilos , Infecções Comunitárias Adquiridas/sangue , Pneumonia/sangue , Estudos Retrospectivos , Relevância Clínica
4.
Front Immunol ; 15: 1368460, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39072336

RESUMO

Background: Leprosy reactions represent immunologically mediated episodes of acute inflammation that, if not diagnosed and treated promptly, can cause irreversible impairment of nerve function and permanent disabilities. A frequent type of reaction experienced by patients with lepromatous leprosy (LL) and borderline lepromatous leprosy (BL) is erythema nodosum leprosum (ENL), an inflammatory complication that may become chronic or recur in multiple episodes. Although ENL is commonly described as a neutrophil-mediated immune disease, the role of neutrophils is not fully understood. In this study, we assess neutrophilic leukocytosis in a retrospective cohort of patients affected by BL or LL leprosy. Materials and methods: A retrospective observational study was performed using data from 146 patients with BL and LL leprosy diagnosed and treated at the Souza Araújo Outpatient Clinic, Fiocruz, Rio de Janeiro, Brazil. Clinical, demographic, and hematological data were extracted from medical records. Skin biopsy samples obtained from patients for ENL diagnosis were used for histopathological evaluations. Results: Most patients were male (75%) and had a reactional episode (85%), of which 65% were ENL. Multiple episodes were common, 55% of the 80 patients with ENL presented more than 2 episodes (average of 2.6 episodes). In treatment-naive BL/LL patients, the median blood neutrophil counts of patients who developed ENL at some points of their disease course were higher than those who did not experience any reaction (median= 4,567 cells/mm3 vs 3,731 cells/mm3 respectively, p=0.0286). A correlation between the increase in median neutrophil counts and ENL severity was confirmed (6,066 cells/mm3 for mild ENL vs 10,243 cells/mm3 for moderate/severe ENL, p=0.0009). A longitudinal assessment was also performed in 34 patients, confirming the neutrophilic leukocytosis (BL/LL: 4896 cells/mm3 vs ENL: 8408 cells/mm3, p<0.0001). Moreover, increased NLR was associated with a greater neutrophilic infiltration in ENL lesions. Conclusion: We demonstrate that ENL episodes in patients affected by leprosy are associated with elevated blood leukocyte and neutrophil counts and an increased NLR. These findings highlight the significant involvement of neutrophils in the ENL immunological/inflammatory process.


Assuntos
Eritema Nodoso , Hanseníase Virchowiana , Leucocitose , Neutrófilos , Humanos , Eritema Nodoso/imunologia , Eritema Nodoso/diagnóstico , Eritema Nodoso/etiologia , Masculino , Estudos Retrospectivos , Feminino , Adulto , Neutrófilos/imunologia , Hanseníase Virchowiana/imunologia , Hanseníase Virchowiana/diagnóstico , Pessoa de Meia-Idade , Adulto Jovem , Idoso , Adolescente
5.
Toxicon ; 246: 107797, 2024 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-38852745

RESUMO

The Brazilian Amazon is home to a rich fauna of scorpion species of medical importance, some of them still poorly characterized regarding their biological actions and range of clinical symptoms after envenoming. The Amazonian scorpion species Tityus strandi and Tityus dinizi constitute some of the scorpions in this group, with few studies in the literature regarding their systemic repercussions. In the present study, we characterized the clinical, inflammatory, and histopathological manifestations of T. strandi and T. dinizi envenoming in a murine model using Balb/c mice. The results show a robust clinical response based on clinical score, hyperglycemia, leukocytosis, increased cytokines, and histopathological changes in the kidneys and lungs. Tityus strandi envenomed mice presented more prominent clinical manifestations when compared to Tityus dinizi, pointing to the relevance of this species in the medical scenario, with both species inducing hyperglycemia, leukocytosis, increased cytokine production in the peritoneal lavage, increased inflammatory infiltrate in the lungs, and acute tubular necrosis after T. strandi envenoming. The results presented in this research can help to understand the systemic manifestations of scorpion accidents in humans caused by the target species of the study and point out therapeutic strategies in cases of scorpionism in remote regions of the Amazon.


Assuntos
Camundongos Endogâmicos BALB C , Picadas de Escorpião , Venenos de Escorpião , Escorpiões , Animais , Venenos de Escorpião/toxicidade , Camundongos , Modelos Animais de Doenças , Citocinas/metabolismo , Brasil , Leucocitose/induzido quimicamente , Pulmão/patologia , Pulmão/efeitos dos fármacos , Masculino , Rim/patologia , Rim/efeitos dos fármacos , Feminino
6.
Cambios rev. méd ; 23(1): 936, 14/05/2024. ilus., tabs.
Artigo em Espanhol | LILACS | ID: biblio-1554083

RESUMO

Introducción. La hidatidosis biliar es la complicación más frecuente de la hidatidosis hepática. La colangiopancreatografía retrógrada endoscópica desempeña un papel clave en el tratamiento. Caso clínico. Femenina de 57 años acude por dolor abdominal, vómito, diarrea, leucocitosis, hiperbilirrubinemia, en colangioresonancia magnética presenta vía biliar dilatada, defecto de señal en tercio proximal y distal. La colangiopancreatografía retrógrada endoscópica evidencia presencia de cuerpo extraño de aspecto de membranas, vía biliar dilatada, se extrae quistes de aspecto parasitario. Conclusión. El tratamiento de elección es quirúrgico y farmacológico, la colangiopancreatografía retrógrada endoscópica antes de la cirugía, asegura la extracción del material hidatídico y trata la obstrucción biliar, identifica el trayecto fistuloso y facilita su cierre mediante colocación de prótesis y esfinterotomía, por lo que constituye un tratamiento no quirúrgico efectivo y con margen amplio de seguridad.


Introduction: Biliary hydatid disease is the most common complication of hepatic hydatid disease. Endoscopic retrograde cholangiopancreatography plays a key role in treatment. Clinical case: A 57-year-old female presented with abdominal pain, vomiting, diarrhea, leukocytosis, mixed hyperbilirubinemia, and magnetic resonance cholangiography showed a dilated bile duct and a signal defect in the proximal and distal third. Endoscopic retrograde cholangiopancreatography shows the presence of a foreign body with a membrane appearance, a dilated bile duct, and cysts with a parasitic appearance. Conclusion: The treatment of choice is surgical and pharmacological, endoscopic retrograde cholangiopancreatography before surgery ensures the extraction of hydatid material and treats biliary obstruction, identifies the fistulous tract and facilitates its closure by placing a prosthesis and sphincterotomy, which is why it constitutes a Effective non-surgical treatment with a wide margin of safety.


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Ductos Biliares/parasitologia , Colangite , Colangiopancreatografia Retrógrada Endoscópica , Trato Gastrointestinal/diagnóstico por imagem , Equinococose , Endoscopia , Cirurgia Geral , Ductos Biliares , Equinococose Hepática , Equador , Esfincterotomia , Hiperbilirrubinemia , Leucocitose
7.
PLoS One ; 19(2): e0297490, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38421951

RESUMO

COVID-19 disease has been a challenge for health systems worldwide due to its high transmissibility, morbidity, and mortality. Severe COVID-19 is associated with an imbalance in the immune response, resulting in a cytokine storm and a hyperinflammation state. While hematological parameters correlate with prognosis in COVID patients, their predictive value has not been evaluated specifically among those severely ill. Therefore, we aim to evaluate the role of hematological and immune response biomarkers as a prognostic factor in critically ill patients with COVID-19 admitted to the intensive care unit. From May 2020 to July 2021, a retrospective cohort study was conducted in a reference hospital in Manaus, which belongs to the Brazilian public health system. This study was carried out as single-center research. Clinical and laboratory parameters were analyzed to evaluate the association with mortality. We also evaluated the role of neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR), and C-reactive protein-to-lymphocyte ratio (CLR). We gathered information from medical records, as well as from prescriptions and forms authorizing the use of antimicrobial medications. During the study period, 177 patients were included, with a mean age of 62.58 ± 14.39 years. The overall mortality rate was 61.6%. Age, mechanical ventilation (MV) requirement, leukocytosis, neutrophilia, high c-reactive protein level, NLR, and CLR showed a statistically significant association with mortality in the univariate analysis. In the multivariate logistic regression analysis, only MV (OR 35.687, 95% CI: 11.084-114.898, p< 0.001) and NLR (OR 1.026, 95% CI: 1.003-1.050, p = 0.028) remained statistically associated with the outcome of death (AUC = 0.8096). While the need for mechanical ventilation is a parameter observed throughout the hospital stay, the initial NLR can be a primary risk stratification tool to establish priorities and timely clinical intervention in patients with severe COVID-19 admitted to the ICU.


Assuntos
Proteína C-Reativa , COVID-19 , Humanos , Pessoa de Meia-Idade , Idoso , Prognóstico , Estudos Retrospectivos , Biomarcadores , Leucocitose
8.
Cambios rev. méd ; 22 (2), 2023;22(2): 842, 16 octubre 2023. ilus, tabs
Artigo em Espanhol | LILACS | ID: biblio-1526546

RESUMO

INTRODUCCIÓN. La Encefalitis Autoinmune es una afección inflamatoria severa del sistema nervioso central mediada por anticuerpos. Su diagnóstico en pediatría es complejo, por lo que ahondar en su cuadro clínico, métodos diagnósticos y tratamiento es relevante. OBJETIVO. Establecer el cuadro clínico, el diagnóstico y el tratamiento de la Encefalitis Autoinmune en pacientes menores de 18 años. MATERIALES Y MÉTODOS. Revisión sistemática. A través de las bases PubMed, Google Scholar, The Lancet se realizó la búsqueda de artículos publicados en idioma inglés y español (2016-2021), con las siguientes palabras clave: encefalitis autoinmune AND pediatría OR niños AND diagnóstico AND anticuerpos OR tratamiento OR inmunoterapia. La calidad de los estudios se evaluó con la escala NIH Quality Assessment Tools. La heterogeneidad de los datos únicamente permitió el calculó de las frecuencias de sintomatología, y se hizo una descripción narrativa de los hallazgos. RESULTADOS. De un total de 100 artículos, 15 fueron seleccionados. La encefalitis por anticuerpos contra el receptor de N-metil-D-aspartato es la frecuente. Las convulsiones (52.6%), los trastornos del movimiento (45%) y los cambios de la personalidad o conducta (44.4%) forman la sintomatología de presentación clínica de esta afección más frecuente en los niños. El estudio de líquido cefalorraquídeo presentó pleocitosis linfocitaria y aumento de proteínas. El tratamiento con inmunoterapia empírica luego de descartar causas infecciosas o metabólicas es seguro, en comparación a ningún tratamiento. CONCLUSIÓN. La encefalitis autoinmune contra receptor de N-metil-D-aspartato es más frecuente en niños, tiene diversidad de presentación clínica, y mejora con inmunoterapia empírica; es necesario mantener una alta sospecha de esta entidad.


INTRODUCTION. Autoimmune encephalitis is a severe inflammatory disorder of the central nervous system caused by antibodies. Its diagnosis in pediatrics is complex, so it is relevant to deeply analyze its clinical symptoms, diagnostic methods, and treatment. OBJECTIVE. To establish the clinical symptoms, diagnosis, and treatment of Autoimmune Encephalitis in patients under 18 years of age. MATERIALS AND METHODS. Systematic review. A search for articles published in English and Spanish (2016-2021) was performed through PubMed, Google Scholar, The Lancet databases, with the following keywords: autoimmune encephalitis AND pediatrics OR children OR diagnosis AND antibodies OR treatment OR immunotherapy. The study quality was assessed using the NIH Quality Assessment Tools scale. The heterogeneity of the data only allowed the calculation of the symptom frequencies, and a narrative description of the findings was made. RESULTS. Out of 100 articles, 15 were selected. Encephalitis due to antibodies against the N-methyl-D-aspartate receptor is the most frequent. Seizures (52.6%), movement disorders (45%), and personality or behavior changes (44.4%) form the most frequent clinical symptomatology of this condition in children. The cerebrospinal fluid study showed lymphocytic pleocytosis and increased protein. Treatment with empirical immunotherapy after excluding infectious or metabolic causes is safe, compared to any other treatment. CONCLUSION. Autoimmune encephalitis against the N-methyl-D-aspartate receptor is more common in children. It has a diverse clinical presentation and improves with empirical immunotherapy; it is necessary to maintain a strong presumption of this condition.


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Pediatria , Autoimunidade , Encefalite/diagnóstico , Encefalite/tratamento farmacológico , Imunoterapia , Anticorpos , Patologia , Líquido Cefalorraquidiano , Criança , Equador , Proteínas ELAV , Leucocitose
9.
Rev. colomb. cir ; 38(3): 512-520, Mayo 8, 2023. tab, fig
Artigo em Inglês | LILACS | ID: biblio-1438581

RESUMO

Introducción. El bazo es un órgano linfoide implicado en el reconocimiento antigénico, la depuración de patógenos y la remoción de eritrocitos envejecidos o con inclusiones citoplasmáticas. La esplenectomía es una técnica utilizada tanto para el diagnóstico (linfomas), el tratamiento (trombocitopenia inmune, anemia hemolítica adquirida) y la curación (microesferocitosis hereditaria) de diversas enfermedades. Métodos. Describir los principales cambios hematológicos y complicaciones asociadas al procedimiento de esplenectomía. Discusión. Los cambios posteriores a la esplenectomía pueden ser inmediatos, como la aparición de cuerpos de Howell-Jolly, la trombocitosis y la presencia de leucocitosis durante las primeras dos semanas. Otras complicaciones tempranas incluyen la presencia de trombosis, en especial en pacientes con factores de riesgo secundarios (edad, sedentarismo, manejo hospitalario, obesidad) o un estado hipercoagulable (diabetes, cáncer, trombofilia primaria), siendo tanto el flujo de la vena porta como el volumen esplénico los principales factores de riesgo para su aparición. Las complicaciones tardías incluyen la alteración en la respuesta inmune, aumentando el riesgo de infecciones por bacterias encapsuladas, en conjunto con una reducción en los niveles de IgM secundario a la ausencia de linfocitos B a nivel de bazo. Debido al riesgo de infecciones, principalmente por Streptococcus pneumoniae, la esplenectomía parcial se ha considerado una opción. Conclusión. Una adecuada valoración de la indicación de esplenectomía y la identificación precoz de complicaciones posoperatorias son fundamentales para reducir la mortalidad asociada a la esplenectomía


Introduction. The spleen is a lymphoid organ involved in antigen recognition, pathogen clearance, and removal of aged erythrocytes or those with cytoplasmic inclusions. Splenectomy is a technique used for diagnosis (lymphomas), treatment (immune thrombocytopenia, acquired hemolytic anemia), and cure (hereditary microspherocytosis) of various diseases. Methods. To describe the main hematological changes and complications associated with the splenectomy procedure. Discussion. Changes after splenectomy can be considered immediate: the appearance of Howell-Jolly bodies, thrombocytosis, and leukocytosis during the first two weeks. Other complications include the presence of thrombosis, especially in patients with risk factors (age, sedentary lifestyle, long hospital stay, obesity) or a hypercoagulable state (diabetes, cancer, primary thrombophilia), with both portal vein flow and splenic volume being the main risk factors for its appearance. Late complications include altered immune response, increased risk of infections by encapsulated bacteria, and a reduction in IgM levels secondary to the absence of B lymphocytes in the spleen; due to the risk of diseases mainly by Streptococcus pneumoniae, partial splenectomy has been considered an option. Conclusion. An adequate assessment of the indication for splenectomy and the early identification of complications are essential to reduce the mortality associated with splenectomy


Assuntos
Humanos , Esplenectomia , Esplenopatias , Complicações Pós-Operatórias , Trombose , Inclusões Eritrocíticas , Leucocitose
10.
Rev Colomb Psiquiatr (Engl Ed) ; 52(1): 78-81, 2023.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-37031016

RESUMO

INTRODUCTION: Neuroleptic malignant syndrome (NMS) is uncommon, with an incidence of 0.01%-3.23%, and is associated with the use of drugs that intervene with dopamine, causing hyperthermia, muscular rigidity, confusion, autonomic instability and death. CASE REPORT: A 35-year-old man with a history of catatonia, refractory epilepsy and functional impairment, required frequent changes in his anticonvulsant and antipsychotic treatment, due to adverse effects. During 2019, in the month of July, clozapine was changed to amisulpride, in September he developed fever, muscle stiffness, stupor, diaphoresis and tachypnea over a two-week period; paraclinical tests showed elevated creatine phosphokinase (CPK) and leukocytosis, so NMS was considered. The antipsychotic was withdrawn and he was treated with bromocriptine and biperiden, with a good response. Ten days after discharge, he began treatment with olanzapine, which generated a similar episode to the one described in December, with subsequent management and resolution. DISCUSSION: The diagnosis is based on the use of drugs that alter dopamine levels, plus altered state of consciousness, fever, autonomic instability and paraclinical tests showing leukocytosis and elevated CPK. Differential diagnoses must be ruled out. Early diagnosis generally leads to total remission, although some patients will suffer complications, long-term sequelae or recurrences. The recurrence in this case derived from the early reintroduction of the neuroleptic after the first episode. Treatment should be individualised according to severity to avoid mortality. CONCLUSIONS: Atypical antipsychotics are rarely suspected of generating NMS. Moreover, the time to reintroduction after an episode must also be taken into account.


Assuntos
Antipsicóticos , Síndrome Maligna Neuroléptica , Masculino , Humanos , Adulto , Antipsicóticos/efeitos adversos , Síndrome Maligna Neuroléptica/diagnóstico , Síndrome Maligna Neuroléptica/etiologia , Dopamina/uso terapêutico , Leucocitose/induzido quimicamente , Leucocitose/complicações , Leucocitose/tratamento farmacológico , Amissulprida/efeitos adversos
12.
Rev. venez. cir ; 76(2): 138-141, 2023. ilus
Artigo em Espanhol | LILACS, LIVECS | ID: biblio-1553932

RESUMO

Introducción: la presencia de un conducto colédoco doble es una variante anatómica infrecuente con menos de 200 casos publicados en la literatura hasta la fecha, siendo fundamental los estudios preoperatorios que se le deben realizar a los pacientes, a fin de tener la sospecha o el diagnóstico confirmado, no sólo de la variante anatómica, sino de la patología asociada, siendo estas la coledocolitiasis y las patologías malignas del árbol biliar las más frecuentes, aunque gran parte de los casos son hallazgos incidentales e intraoperatorios.Caso clínico : se presenta el caso de masculino de 81 años de edad, con antecedente de colecistectomía 20 años previos, con diagnóstico de síndrome ictérico obstructivo, y estudios de colangiorresonancia y CPRE que reportan coledocolitiasis. Se decide llevar a acto quirúrgico y se diagnóstica la presencia de conducto colédoco doble como hallazgo. Se realiza derivación biliodigestiva de tipo hepaticoyeyunoanastomosis más ligadura de conducto colédoco accesorio con evolución satisfactoria, con alta médica a los 5 días posteriores, y resultado de biopsia negativo para malignidad.Conclusión : el doble colédoco debe ser adecuadamente diagnosticado y estudiado, así no se confirme el diagnóstico preoperatorio los pacientes deben acudir con estos estudios realizados al acto quirúrgico, ya que, dicho tratamiento dependerá fundamentalmente de la patología asociada(AU)


Introduction: the presence of a double common bile duct is an infrequent anatomical variant with less than 200 cases published in the literature to the date, and preoperative studies that must be performed on patients are essential in order to have the suspicion or diagnosis confirmed, not only of the anatomical variant, but also of the associated pathology, these being choledocholithiasis and malignant pathologies of the biliary tract the most frequent, although most of the cases are incidental and intraoperative findings.Clinical case : the case of an 81-year-old male is presented, with a history of cholecystectomy 20 years prior, with a diagnosis of obstructive icteric syndrome, and magnetic resonance cholangiography and ERCP studies that reported choledocholithiasis. It was decided to carry out surgery and the presence of double common bile duct was diagnosed as a finding. Biliodigestive derivation hepaticojejunoanastomosis type and accessory common bile duct ligation was performed with satisfactory evolution, with medical discharge 5 days later, and biopsy result negative for malignancy.Conclusion : the double common bile duct should be properly diagnosed and studied, even if the preoperative diagnosis is not confirmed, patients should attend the surgical procedure with these studies, since said treatment will depend fundamentally on the associated pathology(AU)


Assuntos
Humanos , Masculino , Idoso de 80 Anos ou mais , Ductos Biliares , Ducto Colédoco , Coledocolitíase/fisiopatologia , Colecistectomia , Leucocitose
13.
Can Vet J ; 63(12): 1242-1246, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-36467385

RESUMO

Objectives: This study aimed to characterize the findings in cerebral spinal fluid (CSF) analysis of horses, cattle, and sheep diagnosed with rabies. Animals: The study included 62 animals (horses, cattle, and sheep) diagnosed with rabies at a referral hospital. Methods: This was a retrospective study using medical records from large animals with neurological signs and confirmed positive direct immunofluorescence test for rabies from 2003 to 2020. The results of CSF analysis are presented descriptively. Results: Cerebral spinal fluid samples (N = 67) from 62 animals (31 horses, 24 cattle, and 7 sheep) were retrospectively evaluated. Of these 3 species, 28% (19/67) showed increased protein concentration, whereas 58% (39/67) presented mononuclear pleocytosis. In total, 37% of the samples (25/67) had protein concentration and total nucleated cell count within the reference range. Conclusions and clinical relevance: Cerebral spinal fluid from animals diagnosed with rabies was either normal or characterized by mild mononuclear pleocytosis and hyperproteinorrachia.


Analyse du liquide céphalo-rachidien chez des chevaux, bovins et moutons diagnostiqués avec la rage: une étude rétrospective de 62 cas. Objectifs: Cette étude visait à caractériser les résultats de l'analyse du liquide céphalo-rachidien (LCR) de chevaux, bovins et moutons diagnostiqués avec la rage. Animaux: L'étude a inclus 62 animaux (chevaux, bovins et moutons) diagnostiqués avec la rage dans un hôpital de référence. Méthodes: Il s'agissait d'une étude rétrospective utilisant les dossiers médicaux de grands animaux présentant des signes neurologiques et un test d'immunofluorescence directe confirmé positif pour la rage de 2003 à 2020. Les résultats de l'analyse du LCR sont présentés de manière descriptive. Résultats: Des échantillons de liquide céphalo-rachidien (N = 67) de 62 animaux (31 chevaux, 24 bovins et 7 moutons) ont été évalués rétrospectivement. Parmi ces 3 espèces, 28 % (19/67) présentaient une concentration accrue de protéines, tandis que 58 % (39/67) présentaient une pléocytose mononucléaire. Au total, 37 % des échantillons (25/67) avaient une concentration en protéines et un nombre total de cellules nucléées dans la plage de référence. Conclusions et pertinence clinique: Le liquide céphalo-rachidien des animaux diagnostiqués avec la rage était soit normal soit caractérisé par une légère pléocytose mononucléaire et une hyperprotéinorrachie.(Traduit par Dr Serge Messier).


Assuntos
Doenças dos Bovinos , Doenças dos Cavalos , Raiva , Doenças dos Ovinos , Ovinos , Bovinos , Cavalos , Animais , Estudos Retrospectivos , Raiva/diagnóstico , Raiva/veterinária , Leucocitose/veterinária , Prontuários Médicos , Valores de Referência , Doenças dos Bovinos/diagnóstico , Doenças dos Cavalos/diagnóstico , Doenças dos Ovinos/diagnóstico
14.
BMJ Case Rep ; 15(10)2022 Oct 03.
Artigo em Inglês | MEDLINE | ID: mdl-36192033

RESUMO

We present a woman in her 40s who arrived at the emergency room with hypertension and optic ataxia. Her medical history is only relevant for obesity. Her lumbar puncture revealed high intracranial pressure and lymphocytic pleocytosis, and her neuroimaging tests, including angiography and venography, were normal. The patient improved after a cerebrospinal fluid drainage with a lumbar puncture, and her clinical manifestations resolved in parallel to the lymphocytic pleocytosis.The patient was diagnosed with a syndrome of transient headache and neurological deficits with cerebrospinal fluid lymphocytosis and fully recovered 21 days after her discharge.


Assuntos
Linfocitose , Doenças do Sistema Nervoso , Ataxia/etiologia , Feminino , Humanos , Leucocitose , Linfocitose/diagnóstico , Síndrome
15.
Rev Med Chil ; 150(3): 397-401, 2022 Mar.
Artigo em Espanhol | MEDLINE | ID: mdl-36156725

RESUMO

BCR-ABL1 negative atypical chronic myeloid leukemia (aCML) is a rare type of myeloproliferative / myelodysplastic syndrome characterized by leukocytosis and proliferation of dysplastic neutrophilic precursors in the absence of positivity for the BCR-ABL1 fusion gene. We report a 66-year-old woman and a 57-year-old man with aCML, who initially presented with general malaise and weight loss, associated with anemia, thrombocytopenia, and leukocytosis with left shift and dysplasia in the neutrophil series. Both evolved unfavorably after admission and died a few days later due to multiple organ failure.


Assuntos
Leucemia Mielogênica Crônica BCR-ABL Positiva , Leucemia Mieloide Crônica Atípica BCR-ABL Negativa , Trombocitopenia , Idoso , Feminino , Humanos , Leucemia Mielogênica Crônica BCR-ABL Positiva/diagnóstico , Leucemia Mielogênica Crônica BCR-ABL Positiva/genética , Leucemia Mieloide Crônica Atípica BCR-ABL Negativa/genética , Leucocitose , Masculino , Pessoa de Meia-Idade
16.
Ciênc. Anim. (Impr.) ; 32(3): 9-17, jul.-set. 2022. ilus, tab
Artigo em Português | VETINDEX | ID: biblio-1402278

RESUMO

O objetivo deste trabalho foi realizar um levantamento casuístico de diagnósticos de Hepatozoon durante 2018 e 2019, enfatizando os aspectos hematológicos de maior incidência relacionados aos animais e a sazonalidade. A pesquisa foi realizada no Laboratório de Patologia Clínica do Hospital Veterinário do Instituto Federal da Paraíba e em um laboratório veterinário particular, localizado no município de Sousa/PB. Os dados foram obtidos através de uma avaliação retrospectiva de hemogramas realizados em 718 amostras de cães, provenientes da zona urbana e diagnosticados para Hepatozoon spp. Verificou-se que 35 (4,8%) cães foram positivos, a partir da visualização de gamontes parasitando neutrófilos. Dentre esses animais infectados, 16 (45%) eram fêmeas e 19 (55%) eram machos. Em relação à idade, houve predominância em animais jovens com até três anos, totalizando 25 (72%) animais. A infecção natural por Hepatozoon spp. foi superior na estação mais seca, entre os meses de janeiro e maio. Os aspectos hematológicos foram variáveis nos animais infectados, onde os mais observados foram: anemia em 23 (65%); trombocitopenia em 14 (40%); leucocitose por neutrofilia em 11 (31%) e hiperproteinemia em 11 (31%) dos animais. Conclui-se que a prevalência da infecção por Hepatozoon spp. foi de 4,8% em cães na região urbana do Sertão Paraíbano, destacando-se o período dos meses mais quentes, com ocorrência maior em cães sem raça definida (SRD), sem predileção por sexo e idade. Os achados hematológicos entre os animais infectados foram variáveis, com maior frequência de anemia, trombocitopenia, leucocitose e hiperproteinemia.


This study aimed to conduct a case-by-case survey of diagnosed cases of Hepatozoon during in the period from 2018 - 2019, emphasizing the hematological aspects of higher incidence related to the animals and the seasonality. The research was carried out at the Clinical Pathology Laboratory of the Veterinary Hospital of the Federal Institute of Paraíba, and at a private Veterinary Laboratory located in the city of Sousa/PB. Data were obtained through a retrospective evaluation of blood counts performed in 718 samples of dogs from urban areas and diagnosed for Hepatozoon spp. It was found that 35 (4.8%) dogs were positive, from the visualization of gamontes parasitizing neutrophils. Among these infected animals, 16 (45%) were female and 19 (55%) were males. Regarding the age, there was a predominance in young animals up to 3 years old, totalizing 25 (72%) animals. The natural infection by Hepatozoon spp. was higher in the driest season, from January to May. The hematological aspects were variable in the infected animals, where the most observed were: anemia 23 (65%), thrombocytopenia 14 (40%), leukocytosis by neutrophilia 11 (31%), and hyperproteinemia 11 (31%). It is concluded that the prevalence of infection by Hepatozoon spp. was 4.8% in dogs in the urban region of Sertão Paraíbano, highlighting the period of warmer months, with a greater occurrence in mixed breed dogs (SRD), with no predilection for sex and age. The hematological findings among the infected animals were variable, with a higher frequency of anemia, thrombocytopenia, leukocytosis, and hyperproteinemia.


Assuntos
Animais , Cães , Trombocitopenia/veterinária , Transtornos das Proteínas Sanguíneas/veterinária , Eucoccidiida , Coccidiose/patologia , Anemia/veterinária , Leucocitose/veterinária , Contagem de Células Sanguíneas/veterinária
17.
Sao Paulo Med J ; 140(5): 691-696, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35976368

RESUMO

BACKGROUND: Clinical judgment of initial baseline laboratory tests plays an important role in triage and preliminary diagnosis among coronavirus disease 2019 (COVID-19) patients. OBJECTIVES: To determine the differences in laboratory parameters between COVID-19 and COVID-like patients, and between COVID-19 and healthy children. Additionally, to ascertain whether healthy children or patients with COVID-like symptoms would form a better control group. DESIGN AND SETTING: Cross-sectional study at the Institute for Child and Youth Health Care of Vojvodina, Novi Sad, Serbia. METHODS: A retrospective study was conducted on 42 pediatric patients of both sexes with COVID-19. Hematological parameters (white blood cell count, absolute lymphocyte count and platelet count) and biochemical parameters (natremia, kalemia, chloremia, aspartate aminotransferase [AST], alanine aminotransferase [ALT], lactate dehydrogenase [LDH] and C-reactive protein [CRP]) were collected. The first control group was formed by 80 healthy children and the second control group was formed by 55 pediatric patients with COVID-like symptoms. RESULTS: Leukocytosis, lymphopenia, thrombocytosis, elevated systemic inflammatory index and neutrophil-lymphocyte ratio, hyponatremia, hypochloremia and elevated levels of AST, ALT, LDH and CRP were present in COVID patients, in comparison with healthy controls, while in comparison with COVID-like controls only lymphopenia was determined. CONCLUSIONS: The presence of leukocytosis, lymphopenia, thrombocytosis, elevated systemic inflammatory index and neutrophil-lymphocyte ratio, hyponatremia, hypochloremia and elevated levels of AST, ALT, LDH and CRP may help healthcare providers in early identification of COVID-19 patients. Healthy controls were superior to COVID-like controls since they provided better insight into the laboratory characteristics of children with novel betacoronavirus (SARS-CoV-2) infection.


Assuntos
COVID-19 , Hiponatremia , Linfopenia , Trombocitose , Adolescente , Alanina Transaminase , Aspartato Aminotransferases/metabolismo , Proteína C-Reativa/análise , COVID-19/diagnóstico , Teste para COVID-19 , Criança , Estudos Transversais , Feminino , Humanos , L-Lactato Desidrogenase/metabolismo , Leucocitose , Masculino , Estudos Retrospectivos , SARS-CoV-2
18.
Rev. méd. Chile ; 150(3): 397-401, mar. 2022. ilus, tab
Artigo em Espanhol | LILACS | ID: biblio-1409816

RESUMO

BCR-ABL1 negative atypical chronic myeloid leukemia (aCML) is a rare type of myeloproliferative / myelodysplastic syndrome characterized by leukocytosis and proliferation of dysplastic neutrophilic precursors in the absence of positivity for the BCR-ABL1 fusion gene. We report a 66-year-old woman and a 57-year-old man with aCML, who initially presented with general malaise and weight loss, associated with anemia, thrombocytopenia, and leukocytosis with left shift and dysplasia in the neutrophil series. Both evolved unfavorably after admission and died a few days later due to multiple organ failure.


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Trombocitopenia , Leucemia Mielogênica Crônica BCR-ABL Positiva/diagnóstico , Leucemia Mielogênica Crônica BCR-ABL Positiva/genética , Leucemia Mieloide Crônica Atípica BCR-ABL Negativa/genética , Leucocitose
19.
Crit Care ; 26(1): 14, 2022 01 06.
Artigo em Inglês | MEDLINE | ID: mdl-34991675

RESUMO

A biomarker describes a measurable indicator of a patient's clinical condition that can be measured accurately and reproducibly. Biomarkers offer utility for diagnosis, prognosis, early disease recognition, risk stratification, appropriate treatment (theranostics), and trial enrichment for patients with sepsis or suspected sepsis. In this narrative review, we aim to answer the question, "Do biomarkers in patients with sepsis or septic shock predict mortality, multiple organ dysfunction syndrome (MODS), or organ dysfunction?" We also discuss the role of pro- and anti-inflammatory biomarkers and biomarkers associated with intestinal permeability, endothelial injury, organ dysfunction, blood-brain barrier (BBB) breakdown, brain injury, and short and long-term mortality. For sepsis, a range of biomarkers is identified, including fluid phase pattern recognition molecules (PRMs), complement system, cytokines, chemokines, damage-associated molecular patterns (DAMPs), non-coding RNAs, miRNAs, cell membrane receptors, cell proteins, metabolites, and soluble receptors. We also provide an overview of immune response biomarkers that can help identify or differentiate between systemic inflammatory response syndrome (SIRS), sepsis, septic shock, and sepsis-associated encephalopathy. However, significant work is needed to identify the optimal combinations of biomarkers that can augment diagnosis, treatment, and good patient outcomes.


Assuntos
Sepse , Choque Séptico , Biomarcadores , Humanos , Leucocitose , Sepse/diagnóstico , Síndrome de Resposta Inflamatória Sistêmica
20.
Rev. Soc. Bras. Clín. Méd ; 20(2): 108-112, 2022.
Artigo em Português | LILACS | ID: biblio-1428751

RESUMO

A Síndrome de DRESS (do inglês, Drug Rash with Eosinophilia and Systemic Symptoms) é uma patologia rara que consiste em uma severa reação medicamentosa mediada por células T. O presente relato de caso retrata uma paciente do sexo feminino, 59 anos, que apresentou icterícia, febre não termometrada, acolia, colúria, mialgia, placas hipercrômicas e lesões pruriginosas. Referiu uso recente de alopurinol, paracetamol e nimesulida, apresentando melhora importante e espontânea após a suspensão das medicações. A extensão do tempo de exposição ao medicamento agressor ocasiona um maior período de internação e risco de mortalidade. Além disso, os dados restritos sobre a Síndrome de DRESS impõe desafios ao seu diagnóstico. Sendo assim, este estudo busca destacar a importância do diagnóstico clínico precoce, a suspensão do medicamento agressor e a instituição da terapêutica adequada para um prognóstico favorável


The Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) Syndrome is a rare pathology that consists of a severe drug reaction mediated by T cells. The present case report depicts a female patient, 59 years old, who presented jaundice, non thermometered fever, acholia, choluria, myalgia, hyperchromic plaques and pruritic lesions. She mentioned recent use of allopurinol, paracetamol and nimesulide, showing significant and spontaneous improvement after discontinuation of medications. The extension of time of exposure to the offending drug causes a longer period of hospitalization and risk of mortality. In addition, the restricted data on DRESS Syndrome poses challenges to its diagnosis. Therefore, this study seeks to highlight the importance of early clinical diagnosis, suspension of the offending drug and the institution of appropriate therapy for a favorable prognosis


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Dermatopatias/induzido quimicamente , Alopurinol/efeitos adversos , Supressores da Gota/efeitos adversos , Síndrome de Hipersensibilidade a Medicamentos/diagnóstico , Falência Hepática Aguda/induzido quimicamente , Eosinofilia/sangue , Exantema/induzido quimicamente , Síndrome de Hipersensibilidade a Medicamentos/sangue , Leucocitose/sangue
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA