RESUMO
Apparent resistant hypertension (aTRH) is a significant public health issue. Once low adherence to antihypertensive treatment has been ruled out and true resistant hypertension is diagnosed, aldosterone-direct-renin-ratio (ADRR) aids in the screening of an aldosterone-producing adenoma (APA) and primary aldosteronism (PA). Once PA and other secondary causes have been ruled out, the values of aldosterone and renin allow patients to be classified into phenotypes such as low renin hypertension (LRH), Liddle's-like (LLph), and primary hyperaldosteronism (PAph). These classifications could aid in the treatment decision-making process. However, optimal cut-off points for these classifications remain uncertain. This study aims to assess the prevalence of these phenotypes and the behavior of different cut-offs of the ADRR in an Afro-Colombian population with apparent resistant hypertension, as well to describe their sodium consumption. Afro-descendant individuals 18 years of age or older, diagnosed with resistant hypertension and attending to a primary care center in Colombia were recruited as volunteers. As part of the study, their plasma renin concentration (PRC) and plasma aldosterone concentration (PAC) were measured. The phenotypes were categorized into three groups based on multiple cut-off points from different authors: low renin and low aldosterone phenotype (LLph), low renin and high aldosterone phenotype (PAph), and high renin and high aldosterone phenotype, referred to as the renal phenotype (Rph). The prevalence of ADRR values exceeding the cut-off and phenotypes were calculated. A linear regression model was derived to assess the effect of sodium consumption with PAC, PRC and ADRR. A total of 88 patients with aTRH were included. Adherence to at least 3 antihypertensive medications was 62.5%. The median age was 56 years (IQR 48-60), 44% were female, and 20% had diabetes. The study found that the prevalence of ADRR values exceeding the cut-off ranged from 4.5 to 23%, while low-renin hypertension (LRH) varied from 15 to 74%, Rph was found in approximately 30 to 34% of patients, PAph in 30 to 51%, and the LLph in 15 to 41%, respectively, depending on the specific cut-off value by different authors. Notably, sodium consumption was associated with lower aldosterone (ß - 0.15, 95% CI [- 0.27, - 0.03]) and renin concentrations (ß - 0.75, 95% CI [- 1.5, - 0.02]), but ADRR showed no significant association with sodium consumption. There were no significant differences in prevalences between the groups taking < 3 vs ≥ 3 antihypertensive medications. Altered aldosterone-direct-renin-ratio, low renin hypertension, Liddle's-like, and primary hyperaldosteronism are prevalent phenotypes in patients within Afro-Colombian patients with apparent treatment-Resistant hypertension.
Assuntos
Aldosterona , Anti-Hipertensivos , Hipertensão , Fenótipo , Renina , Humanos , Renina/sangue , Aldosterona/sangue , Hipertensão/tratamento farmacológico , Hipertensão/epidemiologia , Hipertensão/sangue , Feminino , Pessoa de Meia-Idade , Masculino , Adulto , Anti-Hipertensivos/uso terapêutico , Hiperaldosteronismo/sangue , Hiperaldosteronismo/diagnóstico , Hiperaldosteronismo/tratamento farmacológico , Hiperaldosteronismo/epidemiologia , População Negra , Idoso , Resistência a MedicamentosRESUMO
La enfermedad de Darier White es una enfermedad autosómica dominante, de penetrancia completa con expresividad variable que afecta al cromosoma 12q23-24.1. Se caracteriza por manifestaciones dermatológicas como: placas o pápulas no foliculares en zonas seborreicas, que tienen un olor característico. La presente investigación busca presentar reportes de casos de dos pacientes, en un Hospital Universitario en Bogotá-Colombia y la relación que existe con enfermedades psiquiátricas, tales como: trastorno afectivo bipolar y retraso mental. Se realizó una historia clínica y examen físico completo. Posteriormente, se firmó un consentimiento informado para toma de fotos y uso de las mismas, con fines educativos. Con estos elementos, se buscó información en las bases de datos más requeridas hoy en día, como: Pubmed, Science Direct, Embase y Scielo utilizando búsquedas con palabras claves, relacionando enfermedad de Darier White y enfermedades psiquiátricas en general. Consecutivamente, se buscó información de trastorno afectivo bipolar y retraso mental. En definitiva se enfocó cada uno de los casos descritos, como enfermedad de Darier con la asociación clínica de enfermedades psiquiátricas, en relación con el trastorno afectivo bipolar y retraso mental, con los que esta enfermedad muestra una relación estrecha.
Darier White or dyskeratosis follicularis disease is a genetic disorder of autosomal dominant trait, affecting chromosome 12q23-24.1. It starts at first or second decade of life, it is characterized by cutaneous manifestations due to several hyperkeratotic papules that affect seborrheic areas such as head, neck and thorax. This article seeks to present reports of cases of two patients in a Hospital in Bogotá-Colombia and their relationship with psychiatric illnesses such as bipolar affective disorder and mental retardation. A complete clinical history was made, the patients were examined, and informed consent was signed for taking pictures and using them for educational purposes. With this information, we proceeded to look for bibliography in the most recognized databases such as: Pubmed, Science Direct, Embase using advanced searches with key words, related words like Darier White disease and its relationship with psychiatric illnesses in general. Finally, each of the cases described as Darier's disease was approached with the clinical association of psychiatric illnesses such as bipolar affective disorder and mental retardation, with which this disease shows a close relationship in relation to the percentages of presentation.
RESUMO
This paper presents original results on the Sb and heavy metals contents in sediments and waste tailings, plants and water from the giant Wadley antimony mine district (San Luis Potosí State, Mexico). The dominant antimony phases in mining wastes are stibiconite, montroydite and minor hermimorphite. The waste tailings contain high concentrations of metals and metalloids (antimony, iron, zinc, arsenic, copper, and mercury). Manganese, copper, zinc, and antimony contents exceed the quality guidelines values for groundwater, plants and for waste tailings. Results indicate that peak accumulation is seasonal due to the concentration by high metabolism plants as Solanaceae Nicotiana. The metal phytoavailability in waste tailings is highly dependant on the metal speciation, its capability to be transported in water and, more particularly, the plant metabolism efficiency.
Assuntos
Antimônio/metabolismo , Poluentes Ambientais/metabolismo , Metaloides/metabolismo , Metais Pesados/metabolismo , Plantas/metabolismo , Antimônio/análise , Poluentes Ambientais/análise , Sedimentos Geológicos/análise , Água Subterrânea/análise , Resíduos Industriais/análise , Metaloides/análise , Metais Pesados/análise , México , Mineração , Especificidade da EspécieRESUMO
Serious soft tissue lesions in patients with high energy trauma are usually underdiagnosed. They are considered as true surgical emergencies that, without an early diagnosis and treatment, lead to high morbidity and mortality rates. We report herein the case of a patient who sustained a high energy lesion and developed compartmental syndrome of the thigh associated with a Morel-Lavallée lesion, including the therapeutic approach used and the results obtained.
Assuntos
Síndromes Compartimentais/etiologia , Lesões dos Tecidos Moles/complicações , Coxa da Perna/lesões , Adulto , Síndromes Compartimentais/cirurgia , Humanos , Masculino , Lesões dos Tecidos Moles/cirurgia , Coxa da Perna/cirurgiaRESUMO
This study demonstrated that the aqueous extracts of plants employed in Mexican traditional medicine for the treatment of cardiovascular diseases are able to modify the tone of arterial smooth muscle. Agastache mexicana (Kunth) Lint & Epling (Labiatae), Chenopodium murale L. (Chenopodiaceae), Chirantodendron pentadactylon Larreat (Sterculiaceae), Dracocephalum moldavica L. (Labiatae), Psittacanthus calyculatus G. Don (Loranthaceae), Prunus serotina ssp. capuli (Cav. ex Spreng) McVaugh (Rosaceae), and Sechium edule Sw. (Cucurbitaceae) contain secondary metabolites that promote vascular relaxation and display antioxidant activities. As expected, their antioxidant effects showed a significant correlation with the polyphenolics content. However, a lower correlation was found between the antioxidant activity and the maximum vasodilatory effect, suggesting that the vasodilatation elicited by the plant extracts could be only partly attributed to their antioxidant properties. The extract of P. calyculatus, which displayed a maximum vasorelaxant effect that was higher than that of acetylcholine, induced endothelium-dependent vasodilatation. Futhermore, the vasorelaxant response to the P. calyculatus extract was reduced after adding an inhibitor of soluble guanylate cyclase activity, providing evidence that the NO/cGMP pathway is involved. On the other hand, the extracts of Bocconia frutescens L. (Papaveraceae), Magnolia grandiflora L. (Magnoliaceae), and Solanum rostratum Dunal (Solanaceae) induced concentration-dependent contraction of rat aortic rings, suggesting that these plants have potential health benefits for the treatment of ailments such as venous insufficiency. The pharmacological activities of the extracts studied provide scientific support for their ethnomedical use.
Assuntos
Antioxidantes/farmacologia , Doenças Cardiovasculares/tratamento farmacológico , Fitoterapia , Extratos Vegetais/farmacologia , Vasoconstritores/farmacologia , Vasodilatadores/farmacologia , Animais , Aorta/metabolismo , Compostos de Bifenilo/metabolismo , Avaliação Pré-Clínica de Medicamentos , Flavonoides/análise , Técnicas In Vitro , Masculino , Medicina Tradicional , México , Fenóis/análise , Picratos/metabolismo , Extratos Vegetais/química , Plantas Medicinais , Ratos , Ratos WistarRESUMO
OBJECTIVE: To determine the frequency of prostatic symptomatology, premature ejaculation (PE), erectile function, symptoms in the older adult/andropause assessment and to determine the risk factors involved. MATERIALS AND METHODS: The study was conducted by the Mexican Society of Urology and was carried out from June to October 2006. Epidemiological information was obtained through the completion of four validated questionnaires by patients receiving non-institutional urology treatment. The large database was statistically analyzed using a logistic regression model. RESULTS: A total of 1,779 men with an average age of 56.6 years were included in the study. The average prostate-specific antigen value in the sample was 1.73 (n = 1,316). Prostatic symptomatology in accordance with the international prostate symptom score was 7.96 points. A total of 41.9% of participants reported experiencing PE. The average time to reach ejaculation was 10.97 min. Of the participating individuals, 39.5% were diagnosed with andropause. Prostatic symptomatology was associated with risk factors of age and prostatitis, P < 0.01. Premature ejaculation and erectile dysfunction were associated with age, P < 0.01. Vasomotor problems in the older adult were identified with an association tendency towards alcoholism and excess weight, P < 0.063, but without statistical significance. Sexual problems in the older adult were associated with diabetes mellitus, P < 0.01. Andropause was associated with traumatic problems in general.
Assuntos
Andropausa , Ejaculação/fisiologia , Disfunção Erétil/epidemiologia , Doenças Prostáticas/epidemiologia , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Estudos Transversais , Humanos , Masculino , México , Pessoa de Meia-Idade , Antígeno Prostático Específico/sangue , Fatores de RiscoRESUMO
El presente trabajo tiene como finalidad el estudio de los patrones normales de los Potenciales Evocados Auditivos del Tallo Cerebral (PEATC) en recién nacidos hospitalizados en el Servicio de Neonatología, Unidad de Recién Nacidos del Hospital Central de San Cristóbal, en número de 30, en el período comprendido entre los meses de mayo a octubre del año 2007. El objetivo general es el de valorar la conducción nerviosa en la vía auditiva del tallo cerebral en recién nacidos sanos. Además del estudio de la respuesta auditiva tronco encefálica en los recién nacidos a término sanos, para tener como marco de referencia estos valores en el Hospital Central de San Cristóbal, el establecer los valores de normalidad para la latencia de las Ondas I, III, V de los PEATC en recién nacidos sanos y estimar la utilidad de los PEATC como técnica de investigación auditiva en el período neonatal, para diseñar a futuro un protocolo que determine precozmente la hipoacusia. Es una investigación prospectiva, transversal, analítica, no experimental, observacional. Los parámetros de estimulación son: tipo: Click; Duración: 100 ms; Ratio: 19/seg; Polaridad: alternante; Intensidad: 90 dB nHL; Auriculares: Beyerdynamic DT48. Los parámetros de registro son: Electrodos: Cz Fz M1 M2, Filtro de paso alto: 160 Hz; Filtro de paso bajo: 3.2 kHz; Sensibilidad: 50 mV; n° de promediaciones: 2000. Los resultados se presentan en valores de medias en milisegundos y desviaciones típicas para latencias de la onda I, III y V del total de sujetos estudiados n=30 para oído izquierdo a 80 dB y n=80 para oído derecho. Se incluyen los valores de ± 2,5 desviaciones típicas a 80 dB. También se presentaron las diferencias interaurales entre ambos oídos registradas en este estudio y una comparación de los valores PEATC de este estudio con los valores normales en pediatría. En conclusión se consiguieron una serie de patrones locales de los PEATC que sirven como guía para los futuros estudios.
Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Perda Auditiva/diagnóstico , Perda Auditiva/prevenção & controle , Potenciais Evocados Auditivos/fisiologia , Tronco Encefálico/fisiopatologia , Orelha/lesões , Pediatria , Valores de ReferênciaRESUMO
In the xenodiagnosis (XD) of American trypanosomiasis (Chagas disease), Trypanosoma cruzi in the triatomine bugs fed on the patient can now be detected using PCR (XD-PCR) as well as by microscopy (XD-M). In a study to compare XD-PCR with XD-M, triatomine bugs were fed on 50 cases of chronic American trypanosomiasis, of whom only 25 were ever found positive by XD-M. Overall, the bugs fed on 34 of the patients (all 25 cases found positive by XD-M and nine of the other patients) were found PCR-positive, giving a 330-bp fragment corresponding to part of the hyper variable region of the kinetoplast DNA of T. cruzi. Of the 25 patients who were ever found positive by XD-M, 20 gave bugs that were smear-positive on day 90 and a similar number (24; P=0.125) gave bugs that were PCR-positive at this time. On day 30, however, the bugs fed on only 11 of these 25 patients were found positive by microscopy, whereas 23 of these patients were found positive by XD-PCR (P=0.0016). Thus, not only was XD-PCR more sensitive than XD-M but it was also quicker, revealing more cases within 30 days than detected using XD-M over a period of 90 days.
Assuntos
Doença de Chagas/diagnóstico , Reação em Cadeia da Polimerase/métodos , Triatoma/parasitologia , Trypanosoma cruzi/isolamento & purificação , Xenodiagnóstico/métodos , Adolescente , Adulto , Animais , Doença de Chagas/sangue , Doença de Chagas/parasitologia , Chile , Doença Crônica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Trypanosoma cruzi/genéticaRESUMO
Polymerase chain reaction-restriction fragment length polymorphism assays for two single nucleotide polymorphisms in the human beta-defensin 1 gene have been validated with real-time PCR in 101 healthy individuals from western Mexico. Allele frequencies were 52.5% (692-A) and 98.5% (1836-A). These assays can be confidently used as a cheaper alternative genotyping method for these sites.