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Clinical manifestations of ocular toxoplasmosis are reviewed. Findings of congenital and acute acquired ocular toxoplasmosis include retinal scars, white-appearing lesions in the active phase often associated with vitritis. Complications can include fibrous bands, secondary serous or rhegmatogenous retinal detachments, optic neuritis and neuropathy, cataracts, increased intraocular pressure during active infection, and choroidal neovascular membranes. Recurrences in untreated congenital toxoplasmosis occur in teenage years. Manifestations at birth are less severe, and recurrences are fewer in those who were treated promptly early in the course of their disease in utero and in the first year of life. Severe retinal involvement is common at diagnosis of symptomatic congenital toxoplasmosis in the United States and Brazil. Acute acquired infections also may be complicated by toxoplasmic retinochoroiditis, with recurrences most common close to the time of acquisition. Suppressive treatment can reduce recurrent disease.

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Congenital Toxoplasma gondii infection can result in intracranial calcification, hydrocephalus and retinochoroiditis. Acquired infection is commonly associated with ocular disease. Pathology is characterized by strong proinflammatory responses. Ligation of ATP by purinergic receptor P2X(7), encoded by P2RX7, stimulates proinflammatory cytokines and can lead directly to killing of intracellular pathogens. To determine whether P2X(7) has a role in susceptibility to congenital toxoplasmosis, we examined polymorphisms at P2RX7 in 149 child/parent trios from North America. We found association (FBAT Z-scores +/-2.429; P=0.015) between the derived C(+)G(-) allele (f=0.68; OR=2.06; 95% CI: 1.14-3.75) at single-nucleotide polymorphism (SNP) rs1718119 (1068T>C; Thr-348-Ala), and a second synonymous variant rs1621388 in linkage disequilibrium with it, and clinical signs of disease per se. Analysis of clinical subgroups showed no association with hydrocephalus, with effect sizes for associations with retinal disease and brain calcifications enhanced (OR=3.0-4.25; 0.004

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Aims: To determine whether mothers of children with congenital toxoplasmosis have chorioretinal lesions consistent with toxoplasmosis. Methods: Prospective cohort study. Ophthalmologists in our study have examined 173 children with congenital toxoplasmosis in a hospital outpatient setting. These children were referred to us by their primary care physicians. One hundred and thirty mothers of these children had retina examinations of both eyes at least once. Main outcome measure was lesion(s) consistent with ocular toxoplasmosis. Results: Of 130 mothers examined between 1991-2005, 10 (7.7%, 95% Confidence Interval 3.8%, 13.7%) had chorioretinal lesions which likely represent resolved toxoplasmic chorioretinitis. Most of these were small peripheral chorioretinal lesions. None reactivated between 1991-2005. Conclusions: Chorioretinal lesions consistent with quiescent ocular toxoplasmosis occur in mothers of children with congenital toxoplasmosis in the United States.

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AIMS: To determine whether mothers of children with congenital toxoplasmosis have chorioretinal lesions consistent with toxoplasmosis. METHODS: Prospective cohort study. Ophthalmologists in our study have examined 173 children with congenital toxoplasmosis in a hospital outpatient setting. These children were referred to us by their primary care physicians. One hundred and thirty mothers of these children had retina examinations of both eyes at least once. Main outcome measure was lesion(s) consistent with ocular toxoplasmosis. RESULTS: Of 130 mothers examined between 1991-2005, 10 (7.7%, 95% Confidence Interval 3.8%, 13.7%) had chorioretinal lesions which likely represent resolved toxoplasmic chorioretinitis. Most of these were small peripheral chorioretinal lesions. None reactivated between 1991-2005. CONCLUSIONS: Chorioretinal lesions consistent with quiescent ocular toxoplasmosis occur in mothers of children with congenital toxoplasmosis in the United States.

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BACKGROUND: Gastric lymphoma has been traditionally considered a rare neoplasm that constitutes 1-5% of malignant gastric tumors. Two studies performed in Mexico in 1960 and 1966 found that only 1.9% and 1% of gastric neoplasms were lymphomas. Nevertheless, some studies made in the U.S. and in some European countries in recept decades have revealed an increase in the frequency of this neoplasm. A recent study made at two National Health Institutes in Mexico City (Instituto Nacional de Cancerología and Instituto Nacional de la Nutrición) revealed a remarkable increase in the frequency of gastric lymphoma (9.3% and 10.3%, respectively) in recent years. AIM: To define whether there is an actual increase of lymphoma in our population and whether it includes other hospitals in Mexico City that provides attention to populations different from those who attend referral centers. MATERIALS AND METHODS: Six hospitals in Mexico City were selected, including two National Health Institutes (Instituto Nacional de la Nutrición and Instituto Nacional de Cancerología), two private general hospitals used by patient with a high socioeconomic level (Hospital Español and Hospital Inglés), and two public general hospitals frequented by low-income patients (hospital Juárez and Hospital General de México). In each case, the gastric lymphomas diagnosed in each participant hospitals in the last 5 years were registered. For comparative purpose, diagnosed cases of gastric adenocarcinoma during the same period were also registered. Other types of gastric neoplasms were excluded from the study because they formed a very heterogeneous group and represented a minimal proportion of malignant gastric tumors. Age and sex of each patient were included for all lymphomas. RESULTS: A total of 879 malignant gastric neoplasms were included in our study. The relative percentage for gastric lymphoma by institution in descendent order was Hospital Español 25.4%; Instituto Nacional de la Nutrición 13.7%, Hospital Inglés 11.5%, Hospital General de México 8.5%, Instituto Nacional de Cancerología 6%, and Hospital Juárez 6%. Mean general frequency taking into account the six hospitals was 9.1%. CONCLUSIONS: Frequency of gastric lymphomas in all analyzed institutions was higher than that reported in most series in the medical literature (1-5%) and that reported for the Mexican population in 1960 and 1966. The increase was most remarkable in hospitals attended by patients with high incomes (Hospital Español, Hospital Inglés), although the total number of neoplasms reported by these institutions was smaller than that reported by hospitals were by patients with lower incomes (Hospital Juárez, Instituto Nacional de Cancerología). The reason for this increase is unknown, but one might speculate that some strains of Helicobacter pylori, nutritional factors, and ethnic differences could be involved. Both gastroenterologists and pathologists must recognize the increase of this neoplasm because unlike gastric adenocarcinoma, gastric lymphoma is a curable disease in a high percentage of cases.

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BACKGROUND: Intestinal pseudo-obstruction is a syndrome characterized by recurrent signs and symptoms of intestinal pseudo-obstruction or dilation without any evidence of mechanical pseudo-obstruction. Its cause is unknown, and it is associated with severe alterations of gastrointestinal motility. AIMS: To report the transendoscopic treatment in a case of intestinal pseudo-obstruction as an alternative to a poor response to medical treatment. METHODS: The diagnosis of intestinal pseudo-obstruction was made in a 34-year old male patient who had not responded to conservative treatment; therefore, a colonoscopy was performed and an ileal drainage was introduced with its distal end 50 cm beyond the ileocecal valve. RESULTS: Twenty-four hours after the procedure was performed clinical and radiological improvement was evident. Such improvement was completed at 72 hours when the patient tolerated oral ingestion. CONCLUSIONS: Transrectal ileal drainage could be an alternative to consider in those patients that do not respond to conservative treatment.

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This study presents a statistical review of corrective surgery for cleft palate, based on cases treated at the maxillo-facial surgery units of the Pediatrics Hospital of the Centro Médico Nacional and at Centro Médico La Raza of the National Institute of Social Security of Mexico, over a five-year period. Interdisciplinary management as performed at the Cleft-Palate Clinic, in an integrated approach involving specialists in maxillo-facial surgery, maxillar orthopedics, genetics, social work and mental hygiene, pursuing to reestablish the stomatological and psychological functions of children afflicted by cleft palate, is amply described. The frequency and classification of the various techniques practiced in that service are described, as well as surgical statistics for 188 patients, which include a total of 256 palate surgeries performed from March 1984 to March 1989, applying three different techniques and proposing a combination of them in a single surgical time, in order to avoid complementary surgery.

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Ofrece una breve descripcion de la forma en que esta organizado un departamento y de los metodos que se pueden aplicar para hacer el trabajocorrespondiente. Un perfil no tiene el proposito de servir de definitiva descripcion, academica o teorica en forma individual, sino de describir la forma en que el departamento opera dentro del hospital

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