Meningite Crônica, Hidrocefalia E Paraplegia Medular Em Histoplasmose Não-sistêmica

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Brazilian Guidelines for Hereditary Angioedema Management - 2017 Update Part 1: Definition, Classification and Diagnosis

Hereditary angioedema is an autosomal dominant disease characterized by recurrent angioedema attacks with the involvement of multiple organs. The disease is unknown to many health professionals and is therefore underdiagnosed. Patients who are not adequately diagnosed and treated have an estimated mortality rate ranging from 25% to 40% due to asphyxiation by laryngeal angioedema. Intestinal angioedema is another important and incapacitating presentation that may be the main or only manifestation during an attack. In this article, a group of experts from the “Associação Brasileira de Alergia e Imunologia (ASBAI)” and the “Grupo de Estudos Brasileiro em Angioedema Hereditário (GEBRAEH)” has updated the Brazilian guidelines for the diagnosis and treatment of hereditary angioedema

Poor Regenerative Outcome after Skeletal Muscle Necrosis Induced by Bothrops asper Venom: Alterations in Microvasculature and Nerves

artículo (arbitrado) -- Universidad de Costa Rica, Instituto de Investigaciones Clodomiro Picado. 2011Background: Viperid snakebite envenoming is characterized by prominent local tissue damage, including muscle necrosis. A frequent outcome of such local pathology is deficient skeletal muscle regeneration, which causes muscle dysfunction, muscle loss and fibrosis, thus provoking permanent sequelae that greatly affect the quality of life of patients. The causes of such poor regenerative outcome of skeletal muscle after viperid snakebites are not fully understood. Methodology/Principal Findings: A murine model of muscle necrosis and regeneration was adapted to study the effects of the venom and isolated toxins of Bothrops asper, the medically most important snake in Central America. Gastrocnemius muscle was injected with either B. asper venom, a myotoxic phospholipase A2 (Mtx), a hemorrhagic metalloproteinase (SVMP), or saline solution. At various time intervals, during one month, tissue samples were collected and analyzed by histology, and by immunocytochemical and immunohistochemical techniques aimed at detecting muscle fibers, collagen, endothelial cells, myoblasts, myotubes, macrophages, TUNEL-positive nuclei, and axons. A successful regenerative response was observed in muscle injected with Mtx, which induces myonecrosis but does not affect the microvasculature. In contrast, poor regeneration, with fibrosis and atrophic fibers, occurred when muscle was injected with venom or SVMP, both of which provoke necrosis, microvascular damage leading to hemorrhage, and poor axonal regeneration. Conclusions/Significance: The deficient skeletal muscle regeneration after injection of B. asper venom is likely to depend on the widespread damage to the microvasculature, which affects the removal of necrotic debris by phagocytes, and the provision of nutrients and oxygen required for regeneration. In addition, deficient axonal regeneration is likely to contribute to the poor regenerative outcome in this model.This study was supported by NeTropica (grant 2-N-2008), by Vicerrectoría de Investigación, Universidad de Costa Rica (project 741-A7-604). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.UCR::Vicerrectoría de Investigación::Unidades de Investigación::Ciencias de la Salud::Instituto Clodomiro Picado (ICP

Fatores de risco e complicações em hipertensos/diabéticos de uma regional sanitária do nordeste brasileiro

Objetivou-se com este estudo identificar os fatores de risco e a complicações associadas em usuários com hipertensão/diabetes, cadastrados no HIPERDIA da Secretaria Executiva Regional VI em Fortaleza, CE. O estudo documental analítico abordou 2.691 pessoas. Do total, 73,6% eram mulheres; 44,6% tinham 60-79 anos, com média de 60,8 anos; 87,4% eram brancos, amarelos ou pardos; 63,7% tinham até oito anos de estudo; 79,7% não eram fumantes; 56,6% sedentários; 59,6% apresentavam sobrepeso/obesidade; 48,4% possuíam antecedente familiar de doença cardiovascular. Verificou-se associação entre sedentarismo e sobrepeso/obesidade com diabéticos e diabéticos hipertensos; antecedente familiar de doença cardiovascular com os hipertensos e diabéticos hipertensos; acidente vascular encefálico, doença arterial coronariana e insuficiência renal crônica com hipertensos e diabéticos hipertensos; infarto e acidente vascular encefálico com diabéticos. O antecedente familiar cardiovascular associou-se com doença arterial coronariana e infarto. Evidenciou-se a presença relevante de fatores de risco e complicações, destacando a necessidade da educação em saúde com os usuários