Assuntos
COVID-19 , Melanoma , Estudos de Coortes , Humanos , Melanoma/diagnóstico , Melanoma/epidemiologia , Pandemias , SARS-CoV-2RESUMO
This study focused on dating of a sediment core from the Alvarado Lagoon System, Veracruz, Mexico, calculating the sedimentation rate by using 210Pb to determine the tendency towards pollution by polycyclic aromatic hydrocarbons, organochlorides, the metals Cd, Cr, Cu, Hg, Ni, Pb, and V, and organic matter content. The activity of total Pb and supported Pb in the samples was 83.1 and 29.5 Bq kg-1, respectively, whereas the average estimated sedimentation rate was 0.48 ± 0.09 cm per year-1. The organic matter values exhibited linear behavior throughout the historical profile, with values under 2.5%. Metal concentrations followed the order V > Cr > Ni > Cu > Pb > Hg > Cd. Variations found in Cr, Ni, Pb, and V concentrations are basically due to three meteorological phenomena that hit the region: hurricanes Gladys, Hilda, and Janet in September of 1955. V, Ni, and Hg input comes from anthropogenic and lithogenic sources. The presence of individual polycyclic aromatic hydrocarbons showed no ascending accumulation pattern over time, nor did it show any significant statistical correlation to OM. As for the organochlorine pesticides, 63.61% of the total sum of these compounds were from the ciclodienics family. Concentration of p,p'-DDT was observed only in the earliest profile, from 1929.
Assuntos
Sedimentos Geológicos/análise , Metais Pesados/análise , Praguicidas/análise , Poluentes Químicos da Água/análise , DDT/análise , Monitoramento Ambiental , Hidrocarbonetos Clorados/análise , Radioisótopos de Chumbo/análise , Mercúrio/análise , México , Hidrocarbonetos Policíclicos Aromáticos/análiseRESUMO
El síndrome de Münchausen por poder es una forma de maltrato infantil, con graves consecuencias para el niño afectado. El diagnóstico de esta afección constituye un desafío para los médicos por su heterogeneidad en los síntomas y signos de presentación. Variadas manifestaciones otorrinolaringológicas están descritas en esta patología. En este artículo se presenta un caso clínico de otitis media crónica con otorragia en un paciente de 2 años, donde se logró establecer el diagnóstico de síndrome de Münchausen por poder a través de la identificación de elementos incongruentes en la historia clínica y finalmente por la detección in fraganti de la agresión por parte de la madre. En esta revisión se concluye que es necesario un alto índice de sospecha para identificar esta patología, la que debe ser una preocupación habitual del equipo de salud para evitar asi consecuencias graves en estos pacientes, tales como secuelas psiquiátricas o incluso la muerte.
Münchausen's syndrome by proxy is a form of child abuse with severe consequences for the affected child. The diagnosis of this condition is a challenge for physicians due to the heterogeneity of the presentation symptoms. A lot of otorhinolaryngological manifestations have been described in this syndrome. We present a case of a 2 year old patient with chronic otitis media and otorrhagia, where we could establish the diagnosis of Münchausen's syndrome by proxy through the identifications of incongruent elements on the clinical history and finally the direct visualization of mother's aggression. In this should be a common concern for health workers to avoid severe consequences in these patients like psychiatric diseases or even death.
Assuntos
Humanos , Masculino , Pré-Escolar , Otite Média/diagnóstico , Síndrome de Munchausen Causada por Terceiro/diagnóstico , Hemorragia/diagnóstico , Doença CrônicaRESUMO
Eosinophilic cholecystitis is a rare disease with clinical presentation similar to acute cholecystitis. The diagnosis is based on typical symptoms of acute cholecystitis with presence of more than 90% eosinophilic infiltration within the gallbladder wall. The case of a 27-year-old woman with periodic epigastric pain during ten years is presented. Routine and Boyden s technique biliary ultrasounds were normal. Hepatobiliary scintigraphy showed delayed gallbladder empty and patient underwent endoscopic sphinterotomy. Laparoscopic cholecystectomy was performed with uneventful postoperative course. Histopathologic examination of the gallblader demonstrated infiltration with eosinophils, consistent with acute eosinophilic cholecystitis.
Assuntos
Colecistite , Eosinofilia , Adulto , Colecistite/diagnóstico , Colecistite/cirurgia , Eosinofilia/diagnóstico , Eosinofilia/cirurgia , Feminino , HumanosRESUMO
Between June 2003 and November 2004, we collected mobilized peripheral blood units from 29 patients with non-Hodgkin's lymphoma and multiple myeloma for autologous peripheral blood stem cell transplantation. They received granulocyte colony-stimulating factor (G-CSF) (16 micro g/kg/day) for a total of 5 days. Immediately before and 3 h after the fourth and fifth dose of G-CSF, we performed flow cytometry analysis to quantify: T cells (CD3+CD4+, CD3+CD8+), B cells (CD19+), NK cells (CD3-CD16+CD56+), NKT cells (CD3+CD16+CD56+), type 1 dendritic cells (DC1) (lin-HLA-DR+CD11c+), type 2 dendritic cells (DC2) (lin-HLA-DR+CD123+), regulatory T cells (Tregs) (CD4+CD25+), and activated T cells (CD3+HLA-DR+). All cell subsets were mobilized after G-CSF treatment with the exception of B, NK, and NKT lymphocytes. The median number of Treg cells before and after G-CSF was statistically different (29+/-14.9x10(6)/l vs 70.1+/-46.1x10(6)/l, P<0.02). DCs were mobilized significantly with a 5.9-fold increase in DC2 (15.1+/-30.3x10(6)/l vs 89.8+/-81.0x10(6)/l, P<0.02) and a 2.6-fold increase for DC1 (41+/-42.5x10(6)/l vs 109.5+/-58.0x10(6)/l, P<0.04). Patients received a mean of 3.1+/-1.2x10(7)/kg NK cells, 1.3+/-0.9x10(7)/kg NKT cells, 0.41+/-0.29x10(7)/kg DC1, 0.2+/-0.22x10(7)/kg DC2, and 1.8+/-1.9x10(7)/kg Tregs. In conclusion, intermediate doses of G-CSF induce mobilization of different lymphocyte subsets, with the exception of B, NK, and NKT cells. The mobilization of certain suppressive populations (DC2 and Treg) could be in theory deleterious, at least in patients with cancer.
Assuntos
Células Dendríticas , Fator Estimulador de Colônias de Granulócitos/administração & dosagem , Mobilização de Células-Tronco Hematopoéticas , Linfócitos , Linfoma não Hodgkin , Mieloma Múltiplo , Adulto , Idoso , Antígenos de Diferenciação/metabolismo , Fracionamento Celular/métodos , Células Dendríticas/patologia , Feminino , Filgrastim , Humanos , Linfócitos/patologia , Linfoma não Hodgkin/metabolismo , Linfoma não Hodgkin/patologia , Linfoma não Hodgkin/terapia , Masculino , Pessoa de Meia-Idade , Mieloma Múltiplo/metabolismo , Mieloma Múltiplo/patologia , Mieloma Múltiplo/terapia , Transplante de Células-Tronco de Sangue Periférico/métodos , Proteínas Recombinantes , Transplante AutólogoRESUMO
We prospectively conducted a quantitative and phenotypic analysis of T, B, natural killer (NK), NKT, type 1 and 2 dendritic cells (DC), and regulatory T cells, before and after mobilization with intermediate doses of granulocyte colony-stimulating factor (G-CSF) (16 microg/kg per day). Between November, 2003, and December, 2004, we collected stem cells from 25 HLA identical sibling donors for allogeneic hematopoietic stem cell transplantation. Before mobilization and 3 h after the fourth and fifth doses of G-CSF, blood samples were taken for blood counts and flow cytometry. The median number of regulatory T cells before and after G-CSF was statistically different (69 +/- 41 x 10(6)/L versus 161 +/- 159 x 10(6)/L, p < 0.01). We observed a 1.7-fold increase in NK and NKT cells (p < 0.009 and p < 0.02, respectively). DC were mobilized with a 11.5-fold increase in type 2 (p < 0.004) and a 8.5-fold increase in type 1 DC (p < 0.003). The patients received a mean of: 2.2 x 10(7)/kg +/- 1.4 x 10(7)/kg of NK cells, 0.95 x 10(7)/kg +/- 0.81 x 107/kg of NKT cells, 0.43 x 107/kg +/- 0.53 x 10(7)/kg of type 1 DC, 0.3 v 10(7)/kg +/- 0.45 x 10(7)/kg of type 2 DC and 1.4 x 10(7)/kg +/- 1.2 x 10(7)/kg of regulatory T cells. Using intermediate doses of G-CSF, we have demonstrated the mobilization of different lymphocyte subsets, in particular regulatory T cells and DC, which can be expanded later and used in the treatment of cancer and autoimmune diseases.
Assuntos
Linfócitos T CD4-Positivos/imunologia , Transplante de Células/métodos , Células Dendríticas/imunologia , Fator Estimulador de Colônias de Granulócitos/farmacologia , Ativação Linfocitária , Linfócitos/imunologia , Receptores de Interleucina-2/análise , Células-Tronco/citologia , Adulto , Antígenos CD/análise , Remoção de Componentes Sanguíneos/métodos , Feminino , Mobilização de Células-Tronco Hematopoéticas/métodos , Humanos , Doadores Vivos , Masculino , Pessoa de Meia-Idade , Proteínas Recombinantes , IrmãosRESUMO
Primary plasma cell leukemia (PPCL) is a rare form of disease accounting for 1-2 percent of myelomas. Between September 1990 and November 2000, among 540 patients with myeloma studied, 24 fulfilled the criteria of PPCL (4.4 percent). We found high frequencies of female patients (62 percent), Bence Jones proteinuria (79 percent), anemia (88 percent), bleeding (54 percent), confusional syndrome (42 percent), weight loss (71 percent), hepatomegaly (25 percent), splenomegaly (21 percent), leukocytosis (62 percent), and thrombocytopenia (71 percent). High serum levels of creatinine, calcium, lactate dehydrogenase (LDH), and beta(2)-microglobulin were detected in 50 percent, 37 percent, 58 percent, and 71 percent, respectively. Four patients were treated with vincristine, melphalan, cyclophosphamide, prednisone, and adriamycin (VMCPA), 12 with vincristine, adriamycin, and dexamethasone (VAD), and 8 with M-80 (oral melphalan 80 mg/m(2) plus dexamethasone 40 mg/m(2)). There was a trend toward lower values of Karnofsky score (P=0.07) and higher values of LDH (P=0.2) in the VAD group. Other clinical characteristics were comparable among the three groups. Complete plus partial responses were achieved in one and six patients treated with VMCPA and M-80, respectively. All patients treated with VAD failed to respond to treatment. Patients receiving the M-80 regimen experienced higher platelet toxicity (P=0.05), vomiting (P<0.0003), and mucositis. Also, the need for red blood cell transfusions was higher in the M-80 group. Median overall survival was 60 days. Overall survival was better in patients achieving complete or partial response. In conclusion, our study illustrates that intermediate doses of melphalan plus dexamethasone are an effective chemotherapy regimen for this aggressive disease. Response to treatment is the only prognostic factor for survival in these patients.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Leucemia Plasmocitária/tratamento farmacológico , Melfalan/administração & dosagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Antineoplásicos/administração & dosagem , Antineoplásicos Alquilantes/administração & dosagem , Antineoplásicos Hormonais/administração & dosagem , Antineoplásicos Fitogênicos/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Dexametasona/administração & dosagem , Relação Dose-Resposta a Droga , Doxorrubicina/administração & dosagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fotoquimioterapia , Análise de Sobrevida , Resultado do Tratamento , Vincristina/administração & dosagemRESUMO
This study compares the use of a mark-recapture analysis and a time-series analysis to estimate the gonotrophic cycle length and survivorship of Simulium metallicum s.l. in southern Mexico. Daily collections were performed with human- and horse-baited traps at 3 sites in a coffee plantation. The mark-recapture and time series experiments on these collections conclusively yielded a gonotrophic cycle length estimate of 3 days. Horizontal estimates of daily survivorship ranged from 0.75 to 0.69 and these values were similar to that estimated vertically of 0.77. The survival to infective stage (9 days) ranged from 0.012 to 0.043, taking into account at least 12 days for development of 3rd-stage larvae of Onchocerca volvulus. Mark-recapture and time-series methods were found to be suitable for estimating the gonotrophic cycle length and daily survivorship of S. metallicum s.l. under field conditions in southern Mexico.
Assuntos
Simuliidae/fisiologia , Animais , Feminino , México , Oogênese/fisiologia , Reprodução/fisiologiaRESUMO
La eclampsia constituye una patología rara que es causa importante de morbilidad y mortalidad tanto materna como perinatal en el mundo. Su causa continúa siendo desconocida, y ha generado una serie de hipótesis etiológica. Este fue un estudio retrospectivo descriptivo sobre la base de las historias clínicas de las pacientes con diagnóstico de eclampsia entre el 1 de enero de 1993 y el 31 de diciembre de 1999. Se compararon con respecto a los hallazgos clínicos, morbilidad materna y perinatal, que presentaron eclampsia antes o después de las 32 semanas y antes del parto y en el postparto. Los datos fueron analizados por chi cuadrado de los promedios con calculo del riesgo relativo con un 95 por ciento de confianza. La incidencia fue 1 en 1152 nacimientos. Las mujeres con eclampsia antes de las 32 semanas tuvieron mayor presión diastólica > igual 110 mmHg (83,3 por ciento vs 45,8 por ciento, p > igual 0,16), pero tenía menos porcentaje de proteinuria severa (50 por ciento vs 79,16 por ciento, p > igual 0,61). Tienen mayor incidencia de abruptio placentae (RR:10), Síndrome de HELLP (RR: 1,27) y déficit neurológico (RR:4). El grupo anteparto tiene un mayor porcentaje de proteinuria severa (86,36 por ciento vs 37,5 por ciento; p < 0,015). Mayor incidencia de abruptio placentae (RR: 1,1) y déficit neurológico (RR: 1,50). El estudio demuestra que la eclampsia continúa siendo una complicación del embarazo que trae consigo altas tasas de morbilidad, siendo particularmente peligrosa en la eclampsia que se desarrolla antes del parto, y sobre todo antes de las 32 semanas