RESUMO
María llegó a la consulta con un cabestrillo hecho de trapos y palos. Era una mujer indígena mixteca de la montaña, proveniente de la Sierra Azul de Oaxaca, en México. La traían cargada sus dos hijos. Cuando la encontré, ella tenía unos 60 años. Era una mujer de campo y muy avejentada, pequeña y encogida, con el pelo corto y blanco. No podía valerse por sí misma porque tenía todas las articulaciones muy hinchadas, tanto, que eran del doble de su tamaño normal. Además, cuando las mostraba brillaban y tenían una tonalidad entre rosada y nacarada por la enorme cantidad de líquido que había dentro y por la intensa inflamación crónica; era una especie de artritis serosa y un cuadro de reumatismo articular crónico con intensa agudización de carácter deformante. Ya tenía todos los dedos de las manos y los pies desviados en modo evidente. No obstante la situación, la mujer era dulce y amable, incluso para quejarse, y tenía la actitud de extrema humildad de la gente sencilla indígena, característica del pueblo mexicano. La mujer lloraba fácilmente y estaba abatida y desesperada dentro de su silencio. Sus hijos decían que había cambiado y estaba muy irritable, muy diferente a como era antes.
Assuntos
Terapêutica HomeopáticaRESUMO
Después de las reflexiones expuestas en los artículos anteriores podemos hacer una síntesis que nos permita responder a preguntas concretas que todos queremos conocer para comprender el sufrimiento personal. Recordemos que todo ser viviente, como elemento de una especie que naturalmente está sometida a todos los procesos de selección para dar lo mejor o extinguirse en el tiempo, nace constitucionalmente sano, aunque incompleto y limitado. (AU)
Assuntos
Filosofia Homeopática , Doença , Doença Aguda , Doença CrônicaRESUMO
En este artículo pondremos un ejemplo de la vida real para demostrar con claridad todo lo escrito. Se trata del caso de una mujer de 35 años que llega a la consulta con un solo síntoma importante para ella. No le viene la menstruación desde hace años. Y si le viene, es solo esporádicamente. Refiere que la última vez que le ha venido regularmente fue cuando se separó de su novio; después se sintió libre y contenta, segura de sí misma. Años después, se ha vuelto a enamorar y han vuelto a desaparecer las menstruaciones. Cuando se configura la historia familiar nos encontramos (sin dar demasiados detalles) una historia con ciertas características que han constituido el lenguaje primordial, inconsciente y consciente, de la vida de la paciente. Resulta ser que, durante tres generaciones, mujeres dominantes y severas con los demás han tenido hijos naturales a escondidas, antes de casarse con sus maridos respectivos, que también han tenido otros hijos naturales fuera del matrimonio con anterioridad. Al final, acabaron casándose de manera oficial con sus respectivas mujeres (abuelas y madre de la paciente), ya que éstas habían quedado embarazadas. Ellos, hombres sin responsabilidad amorosa, vivieron ajenos a las obligaciones como padres; el condicionamiento social los forzó a mantener la casa y los hijos, pero sin que ello implicara la capacidad para proteger y educar a los hijos que, por tanto, siempre dependieron solo de ellas.
Assuntos
Humanos , Feminino , Adulto , Evolução Clínica , Distúrbios Menstruais/psicologiaRESUMO
The study of surfactant and bio membranes interaction is particularly complex due to the diversity in lipid composition and the presence of proteins in natural membranes. Even more difficult is the study of this interaction in vivo since cellular damage may complicate the interpretation of the results, therefore for most of the studies in this field either artificial or model systems are used. One of the model system most used to study biomembranes are erythrocytes due to their relatively simple structure (they lack nuclei and organelles having only the plasma membrane), their convenient experimental manipulation and availability. In this context, we used rabbit erythrocytes as a model membrane and Laurdan (6-lauroyl-2-dimethylaminonaphthalene) as the fluorescent probe to study changes promoted in the membrane by the interaction with the sucrose monoester of myristic acid, ß-d-fructofuranosyl-6-O-myristoyl-α-d-glucopyranoside (MMS). Surfactant and erythrocytes interaction was studied by measuring hemoglobin release and the changes in water content in the membrane sensed by Laurdan. Using two-photon excitation, three types of measurements were performed: Generalized Polarization (analyzed as average GP values), Fluorescence Lifetime Imaging, FLIM (analyzed using phasor plots) and Spectral imaging (analyzed using spectral phasor). Our data indicate that at sublytical concentration of surfactant (20µM MMS), there is a decrease of about 35% in erythrocytes size, without changes in Laurdan lifetime or emission spectra. We also demonstrate that as hemolysis progress, Laurdan lifetime increased due to the decrease in hemoglobin (strong quencher of Laurdan emission) content inside the erythrocytes. Under these conditions, Laurdan spectral phasor analyses can extract the information on the water content in the membrane in the presence of hemoglobin. Our results indicate an increase in membrane fluidity in presence of MMS.
Assuntos
2-Naftilamina/análogos & derivados , Membrana Eritrocítica/metabolismo , Eritrócitos/metabolismo , Lauratos/metabolismo , Ácido Mirístico/metabolismo , Sacarose/metabolismo , 2-Naftilamina/química , 2-Naftilamina/metabolismo , Animais , Membrana Eritrocítica/química , Membrana Eritrocítica/efeitos dos fármacos , Eritrócitos/efeitos dos fármacos , Corantes Fluorescentes/química , Corantes Fluorescentes/metabolismo , Hemoglobinas/metabolismo , Hemólise , Lauratos/química , Fluidez de Membrana/efeitos dos fármacos , Surfactantes Pulmonares/farmacologia , Coelhos , Solubilidade , Água/metabolismoRESUMO
INTRODUCTION: SIOPEN INES protocol yielded excellent 5-year survival rates for MYCN-non-amplified metastatic neuroblastoma. Patients deemed ineligible due to lack or delay of MYCN status or late registration were treated, but not included in the study. Our goal was to analyse survival at 10 years among the whole population. MATERIALS AND METHODS: Italian and Spanish metastatic INES patients' data are reported. SPSS 20.0 was used for statistical analysis. RESULTS: Among 98 infants, 27 had events and 19 died, while 79 were disease free. Five- and 10-year event-free survival (EFS) were 73 and 70 %, and overall survival (OS) was 81 and 74 %, respectively. MYCN status was significant for EFS, but not for OS in multivariate analysis. CONCLUSIONS: The survival rates of patients who complied with all the inclusion criteria for INES trials are higher compared to those that included also not registered patients. Five-year EFS and OS for INES 99.2 were 87.8 and 95.7 %, while our stage 4s population obtained 78 and 87 %. Concerning 99.3, 5-year EFS and OS were 86.7 and 95.6 %, while for stage 4 we registered 61 and 68 %. MYCN amplification had a strong impact on prognosis and therefore we consider it unacceptable that many patients were not studied for MYCN and probably inadequately treated. Ten-year survival rates were shown to decrease: EFS from 73 to 70 % and OS from 81 to 74 %, indicating a risk of late events, particularly in stage 4s. Population-based registries like European ENCCA WP 11-task 11 will possibly clarify these data.
Assuntos
Biomarcadores Tumorais/genética , Ensaios Clínicos como Assunto , Amplificação de Genes , Proteína Proto-Oncogênica N-Myc/genética , Neuroblastoma/mortalidade , Criança , Pré-Escolar , Terapia Combinada , Feminino , Seguimentos , Humanos , Lactente , Recém-Nascido , Masculino , Estadiamento de Neoplasias , Neuroblastoma/genética , Neuroblastoma/secundário , Neuroblastoma/terapia , Prognóstico , Taxa de SobrevidaRESUMO
A lack of models and sensors for describing and monitoring large-scale solid substrate cultivation (SSC) bioreactors has hampered industrial development and application of this type of process. This study presents an indirect dynamic measurement model for a 200-kg-capacity fixed-bed SSC bioreactor under periodic agitation. Growth of the filamentous fungus Gibberella fujikuroi on wheat bran was used as a case study. Real data were preprocessed using previously reported methodology. The model uses CO2 production rate and inlet air conditions to estimate average bed water content and average bed temperature. The model adequately reproduces the evolution of the average bed water content and can therefore be used as an on-line estimator in pilot-scale SSC bioreactors. To obtain a reasonable fit of the bed temperature, however, inlet air humidity measurements will have to be adjusted with a data reconciliation algorithm. Good estimation of temperature is important for the future design of improved water content estimation using state observers. The model also provides insight into understanding the complex behavior of the dynamic system, which could prove useful when establishing advanced model-based operational and control strategies.
Assuntos
Reatores Biológicos , Biotecnologia/instrumentação , Gibberella/crescimento & desenvolvimento , Água/análise , Biotecnologia/métodos , Calibragem , Dióxido de Carbono/metabolismo , Desenho de Equipamento , Gibberella/metabolismo , Cinética , Modelos Biológicos , Projetos Piloto , Fatores de Tempo , TriticumRESUMO
BACKGROUND: The impact of hepatitis C virus infection in Chile has not been well established. AIM: To assess hepatitis C virus infection in normal Chileans and in patients with liver disease. SUBJECTS AND METHODS: Antibodies against hepatitis C virus were investigated in 21,000 blood donors, 133 patients with non alcoholic chronic liver disease and in 50 patients with hepatocarcinoma. Viral RNA was studied by polymerase chain reaction in all positive blood donors, in 51 patients with chronic liver disease and in all patients with hepatocarcinoma. Hepatitis C virus genotype was established using restriction fragment length polymorphism in 118 RNA positive samples. RESULTS: In blood donors, a 0.3% prevalence of positive antibodies was found. The figure for chronic liver disease was 53% and for hepatocarcinoma, 48%. Viral RNA was detected in 100% of patients with chronic liver disease and hepatocarcinoma and in 68% of blood donors with positive antibodies. Genotype 1b was identified in all infected patients with hepatocarcinoma, in 86% of patients with chronic liver disease and in 46% of blood donors. CONCLUSIONS: Hepatitis C virus infection is an important etiologic agent for chronic liver disease in Chile. The predominance of genotype 1b among patients with the most severe form of liver disease is in agreement with observations made abroad.