RESUMO
The use of SNOMED CT as a standard reference terminology enables interoperability between clinical systems. This reference tool provides a method for creating post-coordinated terms by users according to local needs. While the creation of these terms is free, there are a number of rules, as defined in the user manual of SNOMED CT that must be followed.The Hospital Italiano of Buenos Aires has a Terminology Server that encodes medical terms, using SNOMED CT as the reference vocabulary. An interoperability analysis performed with the Nebraska Medical Center in 2006 found a high error rate (26%) in post-coordinated terms. Therefore, we implemented an automatic system of rules within the Terminology Server as defined in the user manual. Following rules implementation, the error rate decreased from 26% to 2%.
Assuntos
Systematized Nomenclature of Medicine , Sistemas Computadorizados de Registros Médicos , Nebraska , Garantia da Qualidade dos Cuidados de Saúde , Terminologia como Assunto , Interface Usuário-Computador , Vocabulário ControladoRESUMO
With the aim to study the magnitude of infection by the metacestode of Taenia solium in a population of epileptic patients in the arid region of Bahia, Northeastern Brazil, we examined 200 consecutive cases who attended an ambulatory clinic in the disctrict of Mulungu do Morro. Sixty-six of the patients had a diagnosis of epilepsy. From them 10 (15.2%) presented antibodies against a specific fraction of antigens in Western blot, and 4 (6.0%) had circulating parasite products, as tested by capture ELISA. Only 1 case was positive for antibodies and antigens. We found that the frequency of seropositivity was related to the time without epileptic seizure. We conclude that cysticercosis is endemic in the region of Mulungu do Morro and that it is related to a benign form of epilepsy.
Assuntos
Cisticercose/epidemiologia , Doenças Endêmicas , Epilepsia/parasitologia , Adolescente , Adulto , Anticorpos Anti-Helmínticos , Western Blotting , Brasil/epidemiologia , Criança , Cisticercose/complicações , Cisticercose/diagnóstico , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neurocisticercose/complicações , Neurocisticercose/epidemiologia , Áreas de Pobreza , PrevalênciaRESUMO
We report a case of non-Hodgkin's lymphoma in a 16-year-old male, whose peripheral white blood cells have a t(8;13)(q24;q14). There are no previous reports that describe this association. Although the tumor cells were not studied, we discuss the possible link between this finding and the development of the malignant lymphoma.
Assuntos
Cromossomos Humanos Par 13 , Cromossomos Humanos Par 8 , Linfoma não Hodgkin/genética , Translocação Genética , Adolescente , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Bleomicina/administração & dosagem , Medula Óssea/patologia , Bandeamento Cromossômico , Ciclofosfamida/administração & dosagem , Doxorrubicina/administração & dosagem , Etoposídeo/administração & dosagem , Humanos , Cariotipagem , Linfoma não Hodgkin/tratamento farmacológico , Linfoma não Hodgkin/patologia , Masculino , Prednisona/administração & dosagem , Vincristina/administração & dosagemRESUMO
Congenital diverticulum of the heart is an unusual malformation. It is frequently associated with thoracic or abdominal midline alterations and also with various types of congenital heart disease. Complications of this anomaly are rupture, peripheral embolism and heart failure. Surgical management consists of resection of the diverticulum either as an isolated operation or at the time of correction of accompanying malformations. We present six cases of congenital diverticulum of the heart, four on the right ventricle and two on the left. In one patient with Fallot's tetralogy a diverticulum was found at necropsy; in two cases the underlying malformation was double outlet ventricle; one case had pulmonary artery stenosis and two did not have associated malformations.
Assuntos
Divertículo/congênito , Cardiopatias Congênitas/patologia , Criança , Pré-Escolar , Divertículo/diagnóstico por imagem , Divertículo/patologia , Divertículo/cirurgia , Feminino , Cardiopatias Congênitas/diagnóstico por imagem , Cardiopatias Congênitas/cirurgia , Humanos , Lactente , Masculino , RadiografiaRESUMO
We studied atrial appendages and valvular apparatus from patients undergoing cardiac surgery for rheumatic heart disease, looking for active histologic lesions. After reviewing 673 specimens (1980-1985) we studied two groups: 31 cases with Aschoff nodules or ill-differentiated histopathological lesions, and 31 cases, without tissular inflammatory abnormalities. In the former we found 8 cases with suspected clinical activity in a 3 months period before surgery, in the latter only 2 cases had similar findings. The Jones criteria are not useful for recognizing rheumatic activity among patients with chronic rheumatic heart disease, there is no clinical-histopathological correlations and it is possible that chronic inflammation occurs at the heart as an organ-limited condition.
Assuntos
Cardiopatia Reumática/patologia , Nódulo Reumático/patologia , Adolescente , Adulto , Biópsia , Feminino , Átrios do Coração/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Valva Mitral/patologiaRESUMO
We studied 10 patients between the ages of 30 and 69 years, all of whom had suffered myocardial infarction (MI) at least 6 months before they died. Two-dimensional echocardiography (2-D E) and catheterism were done no more than 15 days before death. The location and extension of MI were compared to the segmentary mobility (SM), end diastolic wall thickness (EDWT) and percentage of systolic wall thickening (PSWT) determined by 2-D E, in the 15 segments of the left ventricular wall. We also compared 2-D E and coronariographic findings. There was a good correlation between the location (P less than 0.01) and extension (P less than 0.05) of the necrotic area dyssynergy, specially when the MI was transmural. The postmortem measurement of the wall thickness in each one of the segments had also good correlation with the EDWT as measured with 2-D E (r = 0.926). The EDWT was less in the necrotic segments (8.8 +/- 1.8 mm) than in non affected segments (14.1 +/- 1.9 mm) and this difference was significant (P less than 0.05). The wall was thinnest in segment affected by transmural necrosis. The PSWT was significantly less (P less than 0.01) in necrotic segments (12.1 +/- 3%) than in segments without necrosis (24.1 +/- 4.3%). The alteration of SM correlated with coronary obstructions greater than 75%, specially when it was associated with necrosis. The EDWT was less in necrotic segments with important coronary artery obstruction than in those without necrosis even though vascular narrowing was marked (P less than 0.01). The PSWT was also less in the areas with necrosis when coronary obstruction was severe as well as moderate (11.3 +/- 2.3%) than in segments with coronary obstruction but without necrosis (22.3 +/- 4.2%) and even less than that obtained in cases with neither coronary artery obstruction nor necrotic area (30.1 +/- 2.2%) and the difference is statistically significant (P less than 0.01). The segmentary measurement by 2-D E of the EDWT and the PSWT are useful for recognizing areas with necrosis and differentiating it from ischemic areas of left ventricle in coronary artery disease.
Assuntos
Ecocardiografia , Infarto do Miocárdio/patologia , Adulto , Idoso , Cateterismo Cardíaco , Doença das Coronárias/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/fisiopatologia , NecroseRESUMO
Right atrial (RA) damage was produced by subepicardial infiltration with 96 percent alcohol in 18 dogs' hearts. Anterolateral, right appendage and right side of interauricular band were injected. 19 surface readings, including right thoracic, abdominal (MD, ME, MI), and five direct atrial unipolar records were obtained using VR6 photographic paper and a direct-writing machine (Sanborn 150) with 4 channels at 50 and 100 mm/sec speed. Records were made in control conditions and immediately after infiltration as well as 120 minutes later. Premature atrial contractions and A-V block were provoked in order to measure, precisely, the QTa duration and its termination in the ventricular ST. Rate slowing, slight broadening of P and P-R as well and in 4 cases low right atrial rhythm were observed. Significant changes in the right thoracic leads and even in the V4-V5 leads, as well as in RA unipolars, were also demonstrated, that is: P-R segment elevation (injury vector pointing toward the RA), Qr or Wp waves (necrosis vector away from RA). Nevertheless, leads II, III and a VF showed q o w p waves with less significant Ta changes. Ischemic vector went away RA pointing toward the left one, magnifying the protuberance or irregularities on ventricular ST. The QTac was prolonged beyond VM + 0.04, with the greater one in RA leads. This behaviour was evidenced on premature blocked atrial contractions as well as in A-V block. Similar alterations of P wave can be observed in RA infarction as well in myocarditis.