Influência dos polimorfismos Taql e Bsml do gene do receptor de vitamina D no surgimento de infecção, tempo de internação e mortalidade em pacientes queimados

Pós-graduação em Fisiopatologia em Clínica Médica - FMB

Orientação sobre posse responsável em uma área endêmica para leishmaniose visceral canina

The purpose of this work was to provide guidance to householders in the responsible care of their pets, in a region where canine visceral leishmaniasis is endemic. Questionnaires on responsible ownership and the control of this disease were completed by owners of dogs and cats in the city of Araçatuba, São Paulo State, Brazil, in order to evaluate their level of knowledge. Based on the identified deficiencies, the project team provided the owners of the pets with individual guidance at home, focusing on the most critical issues. Concerning nutrition, 70.45% (62/88) of owners provided pet food only, 27.28% (24/88) administered a mixed diet, and 2.27% (2/88) provided homemade food. Additionally, 78.41% (69/88) did not permit the consumption of raw meat, rare meat, or bones. 9.09% (8/88) of owners allowed their pets to wander the neighborhood alone. Among dogs, 14.77% (13/88) had never been clinically tested by a qualified professional, and 6.82% (6/88) and 15.91% (14/88) had never received any kind of vaccine or vermifuge, respectively. In relation to population control, only 20.45% (18/88) of the dogs had been sterilized. It was also observed that 25% (22/88) of owners had already had canine visceral leishmaniasis seropositive dogs in their homes. 54.55% (12/22) of these owners had referred their pets to veterinary clinics for euthanasia, 22.73% (5/22) had used the services of the city’s animal disease control center, and 18.18% (4/22) had paid for private treatment. Nevertheless, 35.23% (31/88) of the dogs had never been submitted to tests for infection diagnosis. From the results obtained, it could be inferred that the individuals who participated in this study were poorly informed concerning basic pet care, demonstrating a need to implement community awareness campaigns for the responsible ownership of pets.

Substitutions due to antiretroviral toxicity or contraindication in the first 3 years of antiretroviral therapy in a large South African cohort

INTRODUCTION: The patterns and reasons for antiretroviral therapy (ART) drug substitutions are poorly described in resource-limited settings. METHODS: Time to and reason for drug substitution were recorded in treatment-naive adults receiving ART in two primary care treatment programmes in Cape Town. The cumulative proportion of patients having therapy changed because of toxicity was described for each drug, and associations with these changes were explored in multivariate models. RESULTS: Analysis included 2,679 individuals followed for a median of 11 months. Median CD4+ T-cell count at baseline was 85 cells/microl. Mean weight was 59 kg, mean age was 32 years and 71% were women. All started non-nucleoside reverse transcriptase inhibitor-based ART (60% on efavrienz) and 75% started on stavudine (d4T). After 3 years, 75% remained in care on-site, of whom 72% remained on their initial regimen. Substitutions due to toxicity of nevirapine (8% by 3 years), efavirenz (2%) and zidovudine (8%) occurred early. Substitutions on d4T occurred in 21% of patients by 3 years, due to symptomatic hyperlactataemia (5%), lipodystrophy (9%) or peripheral neuropathy (6%), and continued to accumulate over time. Those at greatest risk of hyperlactataemia or lipodystrophy were women on ART > or =6 months, weighing > or =75 kg at baseline. DISCUSSION: A high proportion of adult patients are able to tolerate their initial ART regimen for up to 3 years. In most instances treatment-limiting toxicities occur early, but continue to accumulate over time in patients on d4T. Whilst awaiting other treatment options, the risks of known toxicities could be minimized through early identification of patients at the highest risk.

Comparison between Radiographic (2-dimensional and 3-dimensional) and Histologic Findings of Periapical Lesions Treated with Apical Surgery.

INTRODUCTION The aim of this study was to evaluate the concordance of 2- and 3-dimensional radiography and histopathology in the diagnosis of periapical lesions. METHODS Patients were consecutively enrolled in this study provided that preoperative periapical radiography (PR) and cone-beam computed tomographic imaging of the tooth to be treated with apical surgery were performed. The periapical lesional tissue was histologically analyzed by 2 blinded examiners. The final histologic diagnosis was compared with the radiographic assessments of 4 blinded observers. The initial study material included 62 teeth in the same number of patients. RESULTS Four lesions had to be excluded during processing, resulting in a final number of 58 evaluated cases (31 women and 27 men, mean age = 55 years). The final histologic diagnosis of the periapical lesions included 55 granulomas (94.8%) and 3 cysts (5.2%). Histologic analysis of the tissue samples from the apical lesions exhibited an almost perfect agreement between the 2 experienced investigators with an overall agreement of 94.83% (kappa = 0.8011). Radiographic assessment overestimated cysts by 28.4% (cone-beam computed tomographic imaging) and 20.7% (periapical radiography), respectively. Comparing the correlation of the radiographic diagnosis of 4 observers with the final histologic diagnosis, 2-dimensional (kappa = 0.104) and 3-dimensional imaging (kappa = 0.111) provided only minimum agreement. CONCLUSIONS To establish a final diagnosis of an apical radiolucency, the tissue specimen should be evaluated histologically and specified as a granuloma (with/without epithelium) or a cyst. Analysis of 2-dimensional and 3-dimensional radiographic images alike results only in a tentative diagnosis that should be confirmed with biopsy.

Mus Hs 2144 - Tristan und Isolde (zweiter Aufzug) von Richard Wagner : Liebesscene

für zwei Klaviere zu acht Händen bearb. ... von Engelbert Humperdinck

FDG-PET Intra-tratamiento como valor pronóstico en el tratamiento del linfoma Hodgkin

Introducción: La utilización de regímenes de tratamiento más individualizados requiere de mejores sistemas de estratificación temprana en Linfoma Hodgkin (LH). El estudio Tomografía por Emisión de Positrones utilizando 2-[18F] fluoro-2-deoxi-Dglucosa (FDG-PET) intra-tratamiento podría jugar un rol muy importante en esta evaluación. Objetivo: Determinar el valor pronóstico del FDG-PET intra-tratamiento en pacientes con LH para predecir sobrevida libre de progresión y sobrevida global. Material y método: El estudio fue llevado a cabo en el Servicio de Hematología del Hospital Central de Mendoza incluyendo pacientes con diagnóstico de LH confirmados por histología. De acuerdo al estadio y sitio de presentación, los pacientes recibieron quimioterapia sola o la combinación de radioterapia y quimioterapia, con el uso del esquema ABVD (adriamicina, bleomicina, vinblastina y dacarbazina) como protocolo estándar. Los estudios FDG-PET fueron practicados como parte de la evaluación intra-tratamiento y a la finalización. Resultados: En total fueron evaluados 8 pacientes, Sexo: F/M: 4/4, Edad: 18-58 años (Mediana: 29 años), Estadios: IIB:1, IIIA:2, IIIB:1, IVA:1, IVB:3, regiones nodales: 2-10 (Mediana:4), compromiso extranodal: 4/8, síntomas B: 5/8, enfermedad bulky 2/8 . Subtipos: Escleronodular: 6/8, Celularidad mixta: 1/8, Depleción linfocítica: 1/8. IPS: 1: 3/8 2: 3/8 3: 1/8 4: 0/8 ≥ 5: 1/8. Tratamientos: ABVD x 6: 6/8, ABVD x 6 + Radioterapia: 2/8. PET intermedio: 8/8 negativos (6/8 PET 3, 2/8 PET 2). PET final: 7/8 PET negativo, 1/8 PET positivo. Recaída: 1/8 (10° mes). Seguimiento: 11-37 meses (mediana de 24 meses). Discusión y Conclusiones: Al momento actual el FDG-PET intra-tratamiento demostró tener un importante valor predictivo negativo dado que todos los pacientes, menos uno, se encuentran en remisión completa sin progresión de enfermedad. Resta aún determinar el rol que esta herramienta pueda tener en el futuro en la terapia adaptada al riesgo de pacientes con LH.

Presentación a la reedición del artículo : "¿Qué es enseñar?" de Roger Cousinet. Publicado en la Revista Archivos de Ciencias de la Educación, 3° época, n°3, enero-junio de 1962

Fil: Antelo, Estanislao. Universidad Nacional de La Plata. Facultad de Humanidades y Ciencias de la Educación; Argentina.

Presentación a la reedición del artículo : "¿Qué es enseñar?" de Roger Cousinet. Publicado en la Revista Archivos de Ciencias de la Educación, 3° época, n°3, enero-junio de 1962

Fil: Antelo, Estanislao. Universidad Nacional de La Plata. Facultad de Humanidades y Ciencias de la Educación; Argentina.

Presentación a la reedición del artículo : "¿Qué es enseñar?" de Roger Cousinet. Publicado en la Revista Archivos de Ciencias de la Educación, 3° época, n°3, enero-junio de 1962

Fil: Antelo, Estanislao. Universidad Nacional de La Plata. Facultad de Humanidades y Ciencias de la Educación; Argentina.