1,832 research outputs found

    Histological Examination in Obtaining a Diagnosis in Patients with Lymphadenopathy in Lima, Peru.

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    The differential diagnosis for lymphadenopathy is wide and clinical presentations overlap, making obtaining an accurate diagnosis challenging. We sought to characterize the clinical and radiological characteristics, histological findings, and diagnoses for a cohort of patients with lymphadenopathy of unknown etiology. 121 Peruvian adults with lymphadenopathy underwent lymph node biopsy for microbiological and histopathological evaluation. Mean patient age was 41 years (Interquartile Range 26-52), 56% were males, and 39% were HIV positive. Patients reported fever (31%), weight loss (23%), and headache (22%); HIV infection was associated with fever (P < 0.05) and gastrointestinal symptoms (P < 0.05). Abnormalities were reported in 40% of chest X-rays (N = 101). Physicians suspected TB in 92 patients (76%), lymphoma in 19 patients (16%), and other malignancy in seven patients (5.8%). Histological diagnoses (N = 117) included tuberculosis (34%), hyperplasia (27%), lymphoma (13%), and nonlymphoma malignancy (14%). Hyperplasia was more common (P < 0.001) and lymphoma less common (P = 0.005) among HIV-positive than HIV-negative patients. There was a trend toward reduced frequency of caseous necrosis in samples from HIV-positive than HIV-negative TB patients (67 versus 93%, P = 0.055). The spectrum of diagnoses was broad, and clinical and radiological features correlated poorly with diagnosis. On the basis of clinical features, physicians over-diagnosed TB, and under-diagnosed malignancy. Although this may not be inappropriate in resource-limited settings where TB is the most frequent easily treatable cause of lymphadenopathy, diagnostic delays can be detrimental to patients with malignancy. It is important that patients with lymphadenopathy undergo a full diagnostic work-up including sampling for histological evaluation to obtain an accurate diagnosis

    Ankle-brachial index as a predictor of coronary disease events in elderly patients submitted to coronary angiography

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    OBJECTIVES: To correlate the importance of the ankle-brachial index in terms of cardiovascular morbimortalityand the extent of coronary arterial disease amongst elderly patients without clinical manifestations of lowerlimb peripheral arterial disease.METHODS: We analyzed prospective data from 100 patients over 65 years of age with coronary arterial disease,as confirmed by coronary angiography, and with over 70% stenosis of at least one sub-epicardial coronaryartery. We measured the ankle-brachial index immediately after coronary angiography, and a value of ,0.9was used to diagnose peripheral arterial disease.RESULTS: The patients’ average age was 77.4 years. The most prevalent risk factor was hypertension (96%), andthe median late follow-up appointment was 28.9 months. The ankle-brachial index was ,0.9 in 47% of thepatients, and a low index was more prevalent in patients with multiarterial coronary disease compared topatients with uniarterial disease in the same group. Using a bivariate analysis, only an ankle-brachial index of,0.9 was a strong predictive factor for cardiovascular events, thereby increasing all-cause deaths and fatal andnon-fatal acute myocardial infarctions two- to three-fold.CONCLUSION: In elderly patients with documented coronary disease, a low ankle-brachial index (,0.9) wasassociated with the severity and extent of coronary arterial disease, and in late follow-up appointments, a lowindex was correlated with an increase in the occurrence of major cardiovascular events

    Thermoresponsive Hydrogel Containing Viscum album Extract for Topic and Transdermal Use: Development, Stability and Cytotoxicity Activity

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    Viscum album L. (Santalaceae), also known as European mistletoe, is a semi-parasitic plant that grows on different host trees. Our group recently demonstrated the antitumoral activity of ethanolic V. album extracts in vitro, depending on the dose and the host tree, V. album ssp abietis from Abies alba being the most active extract. The goal of this work focused on the development of a new topical formulation containing V. album extracts, evaluation of in vitro toxicity and ex vivo skin permeation assays. The Poloxamer 407 hydrogel containing 5% of dry (VA_DEH) or aqueous (VA_AEH) extract presented dermal compatible pH and microbiological stability for 180 days. The hydrogels flow curve presented a non-linear relation, characteristic of non-Newtonian fluids, and the mean viscosity for the VA_DEH and VA_AEH was 372.5 ± 7.78 and 331.0 ± 2.83 Pa.s, respectively, being statistically different (Welch’s t test; p < 0.01). Additionally, WST-1 in vitro assays revealed a dose-dependent toxicity for both formulations and VA_DEH presented a higher activity than the VA_AEH. The promising cytotoxic potential of VA_DEH lead to the ex vivo skin permeation assay with 2.73 ± 0.19 µg/cm(2) of chlorogenic acid, which permeated at 8 h, showing a transdermal potential. These in vitro results support the idea that VA_DEH is a novel promising candidate for mistletoe therapy. Therefore, further in vivo and pre-clinical experiments should be performed to evaluate the safety and efficacy of this new dermic delivery system

    Ankle-brachial index as a predictor of coronary disease events in elderly patients submitted to coronary angiography

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    OBJECTIVES: To correlate the importance of the ankle-brachial index in terms of cardiovascular morbimortality and the extent of coronary arterial disease amongst elderly patients without clinical manifestations of lower limb peripheral arterial disease.METHODS: We analyzed prospective data from 100 patients over 65 years of age with coronary arterial disease, as confirmed by coronary angiography, and with over 70% stenosis of at least one sub-epicardial coronary artery. We measured the ankle-brachial index immediately after coronary angiography, and a value of <0.9 was used to diagnose peripheral arterial disease.RESULTS: the patients' average age was 77.4 years. the most prevalent risk factor was hypertension (96%), and the median late follow-up appointment was 28.9 months. the ankle-brachial index was <0.9 in 47% of the patients, and a low index was more prevalent in patients with multiarterial coronary disease compared to patients with uniarterial disease in the same group. Using a bivariate analysis, only an ankle-brachial index of,0.9 was a strong predictive factor for cardiovascular events, thereby increasing all-cause deaths and fatal and non-fatal acute myocardial infarctions two-to three-fold.CONCLUSION: in elderly patients with documented coronary disease, a low ankle-brachial index (<0.9) was associated with the severity and extent of coronary arterial disease, and in late follow-up appointments, a low index was correlated with an increase in the occurrence of major cardiovascular events.Univ Fed Estado São Paulo, Dept Cardiol, São Paulo, BrazilHosp Israelita Albert Einstein, Dept Cardiol, São Paulo, BrazilDuke Univ, Sch Med, Dept Med, Durham, NC 27706 USAUniv Fed Estado São Paulo, Dept Cardiol, São Paulo, BrazilWeb of Scienc

    A SURVEY of CHRONIC GVHD and OTHER OUTCOMES - A SNAPSHOT of BRAZILIAN ALLOGENEIC HEMATOPOIETIC CELL TRANSPLANTATION (HCT) CENTERS

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    Univ Fed Parana, BR-80060000 Curitiba, Parana, BrazilNatl Canc Inst, Rio de Janeiro, BrazilState Univ São Paulo, São Paulo, BrazilUniv Estadual Campinas, Campina, BrazilUniv Fed Rio de Janeiro, Rio de Janeiro, BrazilAmaral Carvalho Hosp, Jau, BrazilAmaral Carvalho Hosp, São Paulo, BrazilUniversidade Federal de São Paulo, São Paulo, BrazilAlbert Einstein Hosp, São Paulo, BrazilCanc Hosp Barretos, São Paulo, BrazilUniv Fed Rio Grande do Sul, Porto Alegre, RS, BrazilPernambuco Blood Bank, Recife, PE, BrazilUniv Fed Minas Gerais, Belo Horizonte, MG, BrazilUniv State Univ São Paulo, Ribeirao Preto, BrazilFred Hutchinson Canc Res Ctr, Seattle, WA 98104 USAUniversidade Federal de São Paulo, São Paulo, BrazilWeb of Scienc

    Genetic diversity and structure of Iberian Peninsula cowpeas compared to world-wide cowpea accessions using high density SNP markers

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    Cowpea (Vigna unguiculata L. Walp) is an important legume crop due to its high protein content, adaptation to heat and drought and capacity to fix nitrogen. Europe has a deficit of cowpea production. Knowledge of genetic diversity among cowpea landraces is important for the preservation of local varieties and is the basis to obtain improved varieties. The aims of this study were to explore diversity and the genetic structure of a set of Iberian Peninsula cowpea accessions in comparison to a worldwide collection and to infer possible dispersion routes of cultivated cowpea.This study was supported by EUROLEGUME project. This project has received funding from the European Union’s Seventh Framework Programme for research, technological development and demonstration under grant agreement no 613781. European Investment Funds by FEDER/COMPETE/ POCI – Operational Competitiveness and Internationalization Programme, under Project POCI-01-0145-FEDER-006958 and National Funds by FCT – Portuguese Foundation for Science and Technology, under the project UID/AGR/04033/2013. MMA was partially supported by the Feed the Future Innovation Lab for Climate Resilient Cowpea (USAID Cooperative Agreement AID-OAA-A-13-00070), which is directed by TJC. The funding entities had no role in the design of the study, collection, analysis and interpretation of data, or in writing the manuscript.info:eu-repo/semantics/publishedVersio

    Characterization of Dengue Virus Type 2: New Insights on the 2010 Brazilian Epidemic

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    Dengue viruses (DENV) serotypes 1, 2, and 3 have been causing yearly outbreaks in Brazil. In this study, we report the re-introduction of DENV2 in the coast of São Paulo State. Partial envelope viral genes were sequenced from eighteen patients with dengue fever during the 2010 epidemic. Phylogenetic analysis showed this strain belongs to the American/Asian genotype and was closely related to the virus that circulated in Rio de Janeiro in 2007 and 2008. The phylogeny also showed no clustering by clinical presentation, suggesting that the disease severity could not be explained by distinct variants or genotypes. The time of the most recent common ancestor of American/Asian genotype and the São Paulo and Rio de Janeiro (SP/RJ) monophyletic cluster was estimated to be around 40 and 10 years, respectively. Since this virus was first identified in Brazil in 2007, we suggest that it was already circulating in the country before causing the first documented outbreak. This is the first description of the 2010 outbreak in the State of São Paulo, Brazil, and should contribute to efforts to control and monitor the spread of DENVs in endemic areas

    PELLETS DE KAOLIN POROSOS UTILIZADOS COMO SISTEMA DE LIBERACIÓN LENTA DE FEROMONA BENZALDEHYDE PARA CAPTURAR TRIATOMINOS

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    El objetivo de este trabajo es estudiar las propiedades de los gránulos de caolín porosos que se aplicarán como un sistema de liberación lenta de feromonas, para la captura de vectores de la enfermedad de Chagas.CONACYT – Consejo Nacional de Ciencia y TecnologíaPROCIENCI
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