RESUMO
El metotrexato es un fármaco análogo del ácido fólico ampliamente utilizado en el tratamiento de enfermedades autoinmunes, leucemias y linfomas. Su uso puede ocasionar la aparición de múltiples efectos adversos entre los que se encuentran aquellos relacionados con la presencia de toxicidad neurológica, que puede presentarse de forma aguda, subaguda o crónica. La neurotoxicidad subaguda es aquella que ocurre típicamente entre los 2 y los 14 días posteriores a la administración y puede manifestarse con una amplia gama de síntomas neurológicos. En la mayoría de los casos, no recurre con futuras exposiciones al medicamento. Presentamos tres casos de neurotoxicidad subaguda por metotrexato con manifestaciones clínicas diferentes en pacientes oncohematológicos que se internaron entre los años 2018 y 2020. Dos de ellos presentaron recurrencia frente a la nueva administración del fármaco y todos evidenciaron lesiones en resonancia magnética nuclear.
Methotrexate is a folic acid analogue widely used in the treatment of autoimmune diseases, leukemias, and lymphomas. Methotrexate use may cause multiple adverse effects, including those related to the presence of neurological toxicity, which may be acute, subacute, or chronic. Subacute neurotoxicity typically occurs between 2 and 14 days after administration and may present as a wide range of neurological symptoms. In most cases, it does not recur with future exposures to the drug. Here we describe 3 cases of subacute methotrexate neurotoxicity with different clinical manifestations in patients with oncohematological disease who were hospitalized between 2018 and 2020. Two of them showed recurrence with a new drug administration. Lesions were observed in the magnetic resonance imaging tests of all of them.
Assuntos
Humanos , Masculino , Criança , Adolescente , Síndromes Neurotóxicas/etiologia , Síndromes Neurotóxicas/patologia , Síndromes Neurotóxicas/tratamento farmacológico , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamento farmacológico , Linfoma , Imageamento por Ressonância Magnética , Metotrexato/efeitos adversos , Antimetabólitos Antineoplásicos/efeitos adversosRESUMO
Methotrexate is a folic acid analogue widely used in the treatment of autoimmune diseases, leukemias, and lymphomas. Methotrexate use may cause multiple adverse effects, including those related to the presence of neurological toxicity, which may be acute, subacute, or chronic. Subacute neurotoxicity typically occursbetween 2 and 14 days after administration and may present as a wide range of neurological symptoms.In most cases, it does not recur with future exposures to the drug. Here we describe 3 cases of subacute methotrexate neurotoxicity with different clinical manifestations in patients with oncohematological disease who were hospitalized between 2018 and 2020. Two of them showed recurrence with a new drug administration. Lesions were observed in the magnetic resonance imaging tests of all of them.
El metotrexato es un fármaco análogo del ácido fólico ampliamente utilizado en el tratamiento de enfermedades autoinmunes, leucemias y linfomas. Su uso puede ocasionar la aparición de múltiples efectos adversos entre los que se encuentran aquellos relacionados con la presencia de toxicidad neurológica, que puede presentarse de forma aguda, subaguda o crónica. La neurotoxicidad subaguda es aquella que ocurre típicamente entre los 2 y los 14 días posteriores a la administración y puede manifestarse con una amplia gama de síntomas neurológicos. En la mayoría de los casos, no recurre con futuras exposiciones al medicamento. Presentamos tres casos de neurotoxicidad subaguda por metotrexato con manifestaciones clínicas diferentes en pacientes oncohematológicos que se internaron entre los años 2018 y 2020. Dos de ellos presentaron recurrencia frente a la nueva administración del fármaco y todos evidenciaron lesiones en resonancia magnética nuclear.
Assuntos
Linfoma , Síndromes Neurotóxicas , Leucemia-Linfoma Linfoblástico de Células Precursoras , Humanos , Metotrexato/efeitos adversos , Antimetabólitos Antineoplásicos/efeitos adversos , Imageamento por Ressonância Magnética , Síndromes Neurotóxicas/etiologia , Síndromes Neurotóxicas/tratamento farmacológico , Síndromes Neurotóxicas/patologia , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamento farmacológicoRESUMO
The author wishes to make the following correction to this paper [...].
RESUMO
Increasingly stringent environmental regulations in different sectors of industry, especially the aeronautical sector, suggest the need for more investigations regarding the effect of environmentally friendly corrosion protective processes. Passivation is a finishing process that makes stainless steels more rust resistant, removing free iron from the steel surface resulting from machining operations. This results in the formation of a protective oxide layer that is less likely to react with the environment and cause corrosion. The most commonly used passivating agent is nitric acid. However, it is know that high levels of toxicity can be generated by using this agent. In this work, a study has been carried out into the electrochemical behavior of 15-5PH (precipitation hardening) and 17-4PH stainless steels passivated with (a) citric and (b) nitric acid solutions for 60 and 90 min at 49 °C, and subsequently exposed to an environment with chlorides. Two electrochemical techniques were used: electrochemical noise (EN) and potentiodynamic polarization curves (PPC) according to ASTM G199-09 and ASTM G5-13, respectively. The results obtained indicated that, for both types of steel, the passive layer formed in citric acid as passivating solution had very similar characteristics to that formed with nitric acid. Furthermore, after exposure to the chloride-containing solution and according with the localization index (LI) values obtained, the stainless steels passivated in citric acid showed a mixed type of corrosion, whereas the steels passivated in nitric acid showed localized corrosion. Overall, the results of the R n values derived show very low and similar corrosion rates for the stainless steels passivated with both citric and nitric acid solutions.
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The study of individuals with autosomal dominant Alzheimer's disease affords one of the best opportunities to characterize the biological and cognitive changes of Alzheimer's disease that occur over the course of the preclinical and symptomatic stages. Unifying the knowledge gained from the past three decades of research in the world's largest single-mutation autosomal dominant Alzheimer's disease kindred - a family in Antioquia, Colombia with the E280A mutation in the Presenilin1 gene - will provide new directions for Alzheimer's research and a framework for generalizing the findings from this cohort to the more common sporadic form of Alzheimer's disease. As this specific mutation is virtually 100% penetrant for the development of the disease by midlife, we use a previously defined median age of onset for mild cognitive impairment for this cohort to examine the trajectory of the biological and cognitive markers of the disease as a function of the carriers' estimated years to clinical onset. Studies from this cohort suggest that structural and functional brain abnormalities - such as cortical thinning and hyperactivation in memory networks - as well as differences in biofluid and in vivo measurements of Alzheimer's-related pathological proteins distinguish Presenilin1 E280A mutation carriers from non-carriers as early as childhood, or approximately three decades before the median age of onset of clinical symptoms. We conclude our review with discussion on future directions for Alzheimer's disease research, with specific emphasis on ways to design studies that compare the generalizability of research in autosomal dominant Alzheimer's disease to the larger sporadic Alzheimer's disease population.
Assuntos
Doença de Alzheimer/fisiopatologia , Peptídeos beta-Amiloides/metabolismo , Encéfalo/diagnóstico por imagem , Fragmentos de Peptídeos/metabolismo , Presenilina-1/genética , Adolescente , Adulto , Doença de Alzheimer/diagnóstico por imagem , Doença de Alzheimer/genética , Doença de Alzheimer/metabolismo , Peptídeos beta-Amiloides/sangue , Peptídeos beta-Amiloides/líquido cefalorraquidiano , Compostos de Anilina , Doenças Assintomáticas , Biomarcadores/sangue , Biomarcadores/líquido cefalorraquidiano , Biomarcadores/metabolismo , Encéfalo/metabolismo , Encéfalo/fisiopatologia , Criança , Colômbia , Imagem de Tensor de Difusão , Progressão da Doença , Eletroencefalografia , Etilenoglicóis , Feminino , Neuroimagem Funcional , Humanos , Imageamento por Ressonância Magnética , Masculino , Testes de Estado Mental e Demência , Pessoa de Meia-Idade , Fragmentos de Peptídeos/sangue , Fragmentos de Peptídeos/líquido cefalorraquidiano , Tomografia por Emissão de Pósitrons , Compostos Radiofarmacêuticos , Tomografia Computadorizada de Emissão de Fóton Único , Adulto JovemRESUMO
The aim of this study was to evaluate transcriptome changes in the muscle tissue of Bos taurus indicus cull cows subjected to recovery weight gain under grazing conditions. In all, 38 Nellore cull cows were divided randomly into two different management groups: (1) Maintenance (MA) and (2) Recovery gain (RG) from weight loss by moderate growth under high forage availability. After slaughter, RNA analysis was performed on the Longissimus thoracis muscle. Semaphorin 4A, solute carrier family 11 member 1, and Ficolin-2 were expressed in the RG, which may indicate an inflammatory response during tissue regrowth. Signaling factors, such as Myostatin, related to fibroblast activation, negative control of satellite cell proliferation in adults and muscle protein synthesis were less abundant in the RG group. The only gene related to anabolic processes that were more abundant in the MA group was related to fat deposition. The genes that were differentially expressed in the experiment showed muscle repair-related changes during RG based on the greater expression of genes involved in inflammatory responses and the lower expression of negative regulators of muscle cell proliferation and hypertrophy.
Assuntos
Bovinos/genética , Matriz Extracelular/genética , Expressão Gênica , Músculo Esquelético/metabolismo , Transcriptoma/fisiologia , Aumento de Peso , Animais , Bovinos/fisiologia , Dieta , Feminino , Distribuição AleatóriaRESUMO
INTRODUCTION: The curing of a testicular tumour is currently feasible in more than 95% of patients, and in 80% of those with metastases. Until now, there has been no study or series of cases that describe the ocular changes of the posterior segment associated with testicular cancer. OBJECTIVE: To evaluate patients with a diagnosis of testicular cancer in order to determine the presence of changes in the posterior segment and the relationship to the stage. MATERIAL AND METHOD: An observational, cross-sectional, and descriptive study was conducted on 21 male patients (42 eyes) with a diagnosis of testicular cancer. Age, histological type, time of evolution, stage, treatment, and comorbidities were recorded, as well as visual acuity measurement (LogMAR), biomicroscopy of the anterior segment, and photographic records of the posterior pole and peripheral retina. RESULTS: The mean age was 29 years (18-43 years). All (100%) of the patients were treated surgically. The most frequent histological type was classic seminoma (42.8%), followed by the mixed germinal tumour (38.0%). At the time of evaluation, 42.8% of patients had a stage II, and 23.8% had distant metastasis. The changes in the posterior segment were: vascular tortuosity (14.2%), retinopathy associated with cancer (9.5%), choroidal metastasis (9.5%), pigmentary changes of the retinal pigment epithelium (9.5%), and retinal metastasis (4.7%). CONCLUSIONS: It is possible to find changes at the level of retinal pigment epithelium, as well as vascular tortuosity, retinopathy associated with cancer, and choroidal and/or retina metastases.
Assuntos
Neoplasias da Coroide/secundário , Neoplasias Embrionárias de Células Germinativas/secundário , Segmento Posterior do Olho/patologia , Neoplasias da Retina/secundário , Neoplasias Testiculares/complicações , Adolescente , Adulto , Neoplasias da Coroide/diagnóstico , Estudos Transversais , Detecção Precoce de Câncer , Etnicidade , Hospitais Gerais , Humanos , Masculino , México , Neoplasias Embrionárias de Células Germinativas/diagnóstico , Neoplasias Embrionárias de Células Germinativas/terapia , Neoplasias da Retina/diagnóstico , Epitélio Pigmentado da Retina/patologia , Vasos Retinianos/patologia , Seminoma/diagnóstico , Seminoma/secundário , Seminoma/terapia , Neoplasias Testiculares/terapia , Acuidade Visual , Adulto JovemRESUMO
Resumen ANTECEDENTES: los cuidados centrados en el desarrollo tienen por objeto favorecer el desarrollo neurosensorial y emocional del recién nacido, disminuir el estrés asociado con la atención neonatal, el dolor relacionado con pruebas diagnósticas y los tratamientos invasores. OBJETIVO: describir el grado de implementación de los cuidados centrados en el desarrollo en las unidades de cuidados intensivos neonatales de México. MATERIALES Y MÉTODOS: estudio transversal, observacional y descriptivo. Por medios electrónicos se envió a personal que labora en unidades de cuidados intensivos neonatales, que atienden a más de 50 menores de 1500 g cada año, un cuestionario enfocado a los cuidados centrados en el desarrollo. RESULTADOS: de las 39 unidades de cuidados intensivos neonatales incluidas: 31% usó cobertores para proteger a las incubadoras de la luz, 10% recurrió a algún método de medición del ruido y 36% aplicó escalas del dolor. El tiempo de acceso de los padres a la unidad fue de 2-3 horas al día (56%). El 13% disponía de sala para padres dentro de la unidad, 36% permitían el método canguro. CONCLUSIONES: se observó falta de estrategias para elevar la cobertura de cuidados centrados en el desarrollo en las UCIN, mejorar la educación de los padres respecto a las medidas utilizadas en este programa y lograr que los cuidados centrados en el desarrollo sean aplicados en todas las regiones debido a su bajo costo y gran beneficio.
Abstract BACKGROUND: The objective of Developmental Centered Care (DCC) is to favor the neurosensorial and emotional development of the newborn and to decrease the stress associated to neonatal care and the pain related to diagnostic tests and invasive treatments. OBJECTIVE: To describe the implementation extent of the DCC in the Neonatal Intensive Care Units (NICU) in Mexico. MATERIALS AND METHODS: Cross sectional, observational and descriptive study. A questionnaire focused on DCC was sent via online to personnel working in NICUs that attend more than 50 children weighting less than 1.500 gr every year. RESULTS: A total of 39 NICUs were studied: 31% use covers as a mean of protection from light, 10% use methods of noise measurement, 36% employ pain assessment scales. The access of the parents to the units is 2-3 hours per day (56%); 13% of the units have a room exclusively for parents available inside the unit, and 36% allow the Kangaroo Care Method to be performed. CONCLUSION: A lack of strategies is noted to raise the coverage of these care methods in the NICUs, to improve the education of the parents respecting the measures used in this program, and to achieve that the DCC is applied in every region due to its low cost and great benefit.
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INTRODUCCIÓN: La cirugía laparoscópica urológica no esta exenta de complicaciones. Estas van a depender de la selección del paciente, así como de la experiencia del cirujano. MATERIAL Y MÉTODOS: Se presentan cuatro casos en los que ocurrieron complicaciones durante una cirugía laparoscópica renal. Se discute la complicación y se analizan los factores que la precipitaron, el manejo de esta y sugerencias para evitarla. RESULTADOS: Se presentan dos casos de lesión de pedículo renal durante nefrectomía parcial laparoscópica, 1 lesión de vena renal y una lesión de arteria renal. En ambos fue posible la resolución mediante sutura intracorpórea. Se presenta dos casos de lesión de pedículo durante nefrectomía radical laparoscópica. 1 lesión de arteria renal y una lesión de venal renal. En ambos casos fue necesaria la conversión a cirugía abierta para controlar la complicación. Se presenta un caso de lesión esplénica durante una nefrectomía parcial laparoscópica. La laceración fue controlada mediante compresión y electro coagulación. CONCLUSIONES: Las presencia de complicaciones durante la cirugía laparoscópica urológica es inherente al procedimiento. El uso de equipo e instrumental adecuados son fundamentales para minimizar el riesgo, así como también la selección del paciente es un factor importante. El dominio de la sutura intracorpórea es de suma importancia para solucionar la complicación una vez que esta ya está establecida. linfadenectomía aorto-ilíaca. Se realizó un abordaje transperitoneal con el sistema da Vinci S-HD® y técnica de 6 trócares. Nuestra plantilla de disección ganglionar tiene como límites el pubis hacia distal, la arteria mesentérica inferior hacia proximal, el nervio genito-femoral hacia lateral y la vejiga hacia medial. (AU)
Introduction: Laparoscopic urological surgery is not without complications. These will depend on the patient's selection as well as the surgeon's experience. Material and Methods: Four cases in which complications occurred during laparoscopic renal surgery are presented . The complication is discussed and the causes that produced it are analyzed. Results: Two cases of renal pedicle injury are presented during laparoscopic partial nephrectomy, 1 renal vein and 1 renal artery injuries. In both cases resolution was possible by intracorporeal suture. Two cases of pedicle injury are presented during laparoscopic radical nephrectomy. 1 renal artery injury and renal venal injury. In both cases, conversion to open surgery was necessary to control the complication. A case of splenic injury is presented during a laparoscopic partial nephrectomy. The laceration was controlled by compression and electrocoagulation. Conclusions: The presence of complications during laparoscopic urological surgery is inherent in the procedure. The use of appropriate equipment and instruments are essential to minimize risk, as well as patient selection is an important factor. The domain of intracorporeal suture is of paramount importance to solve the complication once it is already established. (AU)
Assuntos
Masculino , Prostatectomia , Filme e Vídeo Educativo , Procedimentos Cirúrgicos RobóticosRESUMO
INTRODUCTION: The stroke is a chronic non-transmissible disease of high impact that is caused by different factors, among which are those related to lifestyles, that dietary factors are part. AIM: To review the evidence in relation to dietary factors associated with stroke. DEVELOPMENT: We conducted a literature review of the dietary factors and stroke. Research shows a decrease risk stroke, according to the recommended intake: 39% for Mediterranean diet, 19% for DASH diet, 10% for nuts, 26% for fruits and vegetables, 31% for fish, 26% for total protein, 9% for low-fat dairy, and 18% for calcium. On the other hand an increase in the risk of up to 58% to Western diet, 13% for processed meat and 23% for salt; in relation to the intake of legumes, eggs and whole milk, the results are heterogeneous. CONCLUSIONS: The intake nuts, fruits and vegetables, fish, total protein, low-fat dairy, calcium and high adherence to Mediterranean and DASH diet could to have protective effects on stroke. While the Western diet and high consumption of red meat and processed meat, salt could to be a risk factor. Further investigation in relation to consumption of legumes, eggs, whole milk, rice, potatoes and soft drink is also necessary.
TITLE: Factores dieteticos asociados al ictus: revision de la bibliografia.Introduccion. El ictus es una condicion cronica no transmisible de alto impacto, producida por diferentes factores, entre los que estan los relacionados con el estilo de vida, de los cuales forman parte los factores dieteticos. Objetivo. Revisar la evidencia existente con relacion a los factores dieteticos asociados al ictus. Desarrollo. Se realizo una revision de la bibliografia de los factores dieteticos y el ictus. Los estudios revisados describen una disminucion del riesgo de ictus, segun el consumo recomendado, hasta del 39% para la dieta mediterranea, el 19% para la dieta DASH, el 10% para las nueces, el 26% para las frutas y verduras, el 31% para el pescado, el 26% para la proteina total, el 9% para los lacteos bajos en grasa y el 18% para el calcio. Por el contrario, describen un aumento del riesgo hasta del 58% para la dieta occidental, el 13% para la carne procesada y el 23% para la sal. En relacion con el consumo de legumbres, huevos y leche entera, los resultados son heterogeneos. Conclusiones. El consumo de nueces, frutas y verduras, pescado, proteina total, lacteos bajos en grasa, calcio y la alta adhesion a las dietas DASH y mediterranea podrian tener efectos protectores para el ictus. Mientras que el alto consumo de carnes rojas y procesadas, sal y la dieta occidental podrian constituir un factor de riesgo. Asimismo, es necesaria una mayor investigacion en relacion con el consumo de legumbres, huevos, leche entera, arroz, patatas y bebidas azucaradas.