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1.
Acta Gastroenterol Belg ; 87(1): 40-43, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38431790

RESUMO

The authors report the case of a 74-years-old woman treated by immunotherapy for a metastatic renal cell carcinoma and having developed an important cholestasis with thrombocytosis, increased CRP, leucocytosis and hypoalbuminemia. Liver remained free of metastases at medical imaging. The diagnosis of a Stauffer syndrome was confirmed by the hepatic biopsy. A complete response of liver disorders was obtained after nephrectomy. From literature survey, Stauffer syndrome should be kept in mind in cancer patients, especially those suffering from a renal cell carcinoma, presenting with cholestasis with no underlying cause.


Assuntos
Carcinoma de Células Renais , Colestase , Neoplasias Renais , Hepatopatias , Feminino , Humanos , Idoso , Carcinoma de Células Renais/complicações , Carcinoma de Células Renais/diagnóstico , Neoplasias Renais/complicações , Neoplasias Renais/diagnóstico , Neoplasias Renais/patologia , Síndrome , Hepatopatias/diagnóstico , Colestase/complicações
2.
Artigo em Chinês | MEDLINE | ID: mdl-38433688

RESUMO

Objective:This study was to investigate the wideband acoustic immittance(WAI) characteristics of children with large vestibular aqueduct syndrome(LVAS) and to construct a diagnostic model for LVAS based on WAI and machine learning(ML) techniques. Methods:We performed a retrospective analysis of the data from 38 children(76 ears) with LVAS and 44 children(88 ears) with normal hearing. The data included conventional audiological examination, temporal bone CT scan and WAI test. We performed statistical analysis and developed multivariate diagnostic models based on different ML techniques. Results:The two groups were balanced in terms of ear, gender, and age(P>0.05). The wideband absorbance(WBA) of the LVAS group was significantly lower than that of the control group at 1 000-2 519 Hz, while the WBA of the LVAS group was significantly higher than that of the control group at 4 000-6 349 Hz(P<0.05). WBA at 5 039 Hz under ambient pressure had a certain diagnostic value(AUC=0.767). The multivariate diagnostic model had a high diagnostic value(AUC>0.8), among which the KNN model performed the best(AUC=0.961). Conclusion:The WAI characteristics of children with LVAS are significantly different from those of normal children. The diagnostic model based on WAI and ML techniques has high accuracy and reliability, and provides new ideas and methods for intelligent diagnosis of LVAS.


Assuntos
Aqueduto Vestibular , Doenças Vestibulares , Criança , Humanos , Reprodutibilidade dos Testes , Estudos Retrospectivos , Aprendizado de Máquina , Síndrome , Acústica
3.
Front Endocrinol (Lausanne) ; 15: 1338781, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38464967

RESUMO

Background: Pituitary stalk interruption syndrome (PSIS) is a complex clinical syndrome characterized by varied pituitary hormone deficiencies, leading to severe manifestations across multiple systems. These include lifelong infertility, short stature, mental retardation, and potentially life-threatening pituitary crises if not promptly diagnosed and treated. Despite extensive research, the precise pathogenesis of PSIS remains unclear. Currently, there are two proposed theories regarding the pathogenic mechanisms: the genetic defect theory and the perinatal injury theory. Methods: We systematically searched English databases (PubMed, Web of Science, Embase) and Chinese databases (CNKI, WanFang Med Online, Sinomed) up to February 24, 2023, to summarize studies on gene sequencing in PSIS patients. Enrichment analyses of reported mutated genes were subsequently performed using the Metascape platform. Results: Our study included 37 articles. KEGG enrichment analysis revealed mutated genes were enriched in the Notch signaling pathway, Wnt signaling pathway, and Hedgehog signaling pathway. GO enrichment analysis demonstrated mutated genes were enriched in biological processes such as embryonic development, brain development, axon development and guidance, and development of other organs. Conclusion: Based on our summary and analyses, we propose a new hypothesis: disruptions in normal embryonic development, partially stemming from the genetic background and/or specific gene mutations in individuals, may increase the likelihood of abnormal fetal deliveries, where different degrees of traction during delivery may lead to different levels of pituitary stalk interruption and posterior lobe ectopia. The clinical diversity observed in PSIS patients may result from a combination of genetic background, specific mutations, and variable degrees of traction during delivery.


Assuntos
Hipopituitarismo , Doenças da Hipófise , Humanos , Proteínas Hedgehog , Doenças da Hipófise/patologia , Hipófise/patologia , Hipopituitarismo/genética , Hipopituitarismo/patologia , Mutação , Síndrome
4.
Zhongguo Zhen Jiu ; 44(3): 351-356, 2024 Mar 12.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-38467513

RESUMO

The relevant passages on moxibustion at Gaohuang (BL 43) in the Chinese Medical Code (fifth edition), and relevant literature on moxibustion at Gaohuang (BL 43) published up to January 17th, 2023 in the CNKI, Wanfang, VIP, SinoMed, PubMed, Web of Science, EMbase and Scopus were searched. The localization and selection methods of Gaohuang (BL 43), types of moxibustion at Gaohuang (BL 43), moxibustion quantity, and the main clinical indications were analyzed. As a result, a total of 227 ancient passages were included, with 51 related to moxibustion quantity and 171 related to clinical indications, encompassing 33 different diseases. A total of 50 modern articles were reviewed, covering 26 different diseases. The key of selection methods of Gaohuang (BL 43) is exploring sensitivity around the scapula, with direct moxibustion as a preferred technique; the optimal moxibustion dose is detenuined by arrival and withdrawal of deqi, and primary indications were related to syndrome of heart and lung deficiencies.


Assuntos
Terapia por Acupuntura , Moxibustão , Humanos , Pontos de Acupuntura , Síndrome , Publicações
5.
Adv Exp Med Biol ; 1444: 83-95, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38467974

RESUMO

The number of human inborn errors of immunity has now gone beyond 430. The responsible gene variants themselves are apparently the cause for the disorders, but the underlying molecular or cellular mechanisms for the pathogenesis are often unclear. In order to clarify the pathogenesis, the mutant mice carrying the gene variants are apparently useful and important. Extensive analysis of those mice should contribute to the clarification of novel immunoregulatory mechanisms or development of novel therapeutic maneuvers critical not only for the rare monogenic diseases themselves but also for related common polygenic diseases. We have recently generated novel model mice in which complicated manifestations of human inborn errors of immunity affecting degradation or transport of intracellular proteins were recapitulated. Here, we review outline of these disorders, mainly based on the phenotype of the mutant mice we have generated.


Assuntos
Doenças Hereditárias Autoinflamatórias , Humanos , Animais , Camundongos , Doenças Hereditárias Autoinflamatórias/genética , Doenças Hereditárias Autoinflamatórias/terapia , Citocinas/genética , Fenótipo , Síndrome
6.
Exp Dermatol ; 33(3): e15050, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38469984

RESUMO

VEXAS (vacuoles, E1 enzyme, X-linked, autoinflammatory and somatic mutation) syndrome is a novel autoinflammatory, late-onset, disorder first identified in 2020. It is caused by mutations in the UBA1 gene. The most prominent clinical features reported by VEXAS patients are cutaneous and haematological, having characteristic skin features reported as the initial presenting findings of the disease. VEXAS is a severe and treatment-resistant condition with high morbidity and mortality rates. Here, we examine all case reports and case series of VEXAS syndrome through March 2023 focusing on those presenting cutaneous manifestations. We discuss these manifestations and their reported treatment strategies. In many cases, it might be first suspected and diagnosed by dermatologists, highlighting their vital role in initiating timely multidisciplinary care.


Assuntos
Doenças Hereditárias Autoinflamatórias , Síndromes Mielodisplásicas , Dermatopatias Genéticas , Humanos , Mutação , Pele , Síndrome , Doenças Hereditárias Autoinflamatórias/genética , Doenças Hereditárias Autoinflamatórias/terapia
7.
Arq Bras Cardiol ; 121(1): e20230242, 2024.
Artigo em Português, Inglês | MEDLINE | ID: mdl-38477763

RESUMO

BACKGROUND: The European Society of Cardiology guidelines recommend an LDL-cholesterol (LDL-C) < 55 mg/dL for patients with established cardiovascular disease. While the Friedewald equation to estimate LDL-C is still widely used, the newer Martin-Hopkins equation has shown greater accuracy. OBJECTIVES: We aimed to assess: A) the proportion of patients reaching LDL-C goal and the therapies used in a tertiary center; B) the impact of using the Martin-Hopkins method instead of Friedewald's on the proportion of controlled patients. METHODS: A single-center cross-sectional study including consecutive post-myocardial infarction patients followed by 20 cardiologists in a tertiary hospital. Data was collected retrospectively from clinical appointments that took place after April 2022. For each patient, the LDL-C levels and attainment of goals were estimated from an ambulatory lipid profile using both Friedewald and Martin-Hopkins equations. A two-tailed p-value of < 0.05 was considered statistically significant for all tests. RESULTS: Overall, 400 patients were included (aged 67 ± 13 years, 77% male). Using Friedewald's equation, the median LDL-C under therapy was 64 (50-81) mg/dL, and 31% had LDL-C within goals. High-intensity statins were used in 64% of patients, 37% were on ezetimibe, and 0.5% were under PCSK9 inhibitors. Combination therapy of high-intensity statin + ezetimibe was used in 102 patients (26%). Applying the Martin-Hopkins method would reclassify a total of 31 patients (7.8%). Among those deemed controlled by Friedewald's equation, 27 (21.6%) would have a Martin-Hopkins' LDL-C above goals. CONCLUSIONS: Less than one-third of post-myocardial infarction patients had LDL-C within the goal. Applying the Martin-Hopkins equation would reclassify one-fifth of presumably controlled patients into the non-controlled group.


FUNDAMENTO: As diretrizes da Sociedade Europeia de Cardiologia recomendam um nível de colesterol LDL (LDL-C) < 55 mg/dL para pacientes com doença cardiovascular estabelecida. Embora a fórmula de Friedewald ainda seja amplamente utilizada para estimar o LDL-C, a fórmula mais recente de Martin-Hopkins mostrou maior precisão. OBJETIVOS: Nosso objetivo foi avaliar: A) a proporção de pacientes que atingiram a meta de LDL-C e as terapias utilizadas em um centro terciário; B) o impacto da utilização do método de Martin-Hopkins em vez do método de Friedewald na proporção de pacientes controlados. MÉTODOS: Estudo transversal monocêntrico, incluindo pacientes consecutivos pós-infarto do miocárdio, acompanhados por 20 cardiologistas, em um hospital terciário. Os dados foram coletados retrospectivamente de consultas clínicas realizadas após abril de 2022. Para cada paciente, os níveis de LDL-C e o atingimento das metas foram estimados a partir de um perfil lipídico ambulatorial, utilizando as fórmulas de Friedewald e Martin-Hopkins. Um valor-p bicaudal < 0,05 foi considerado estatisticamente significativo para todos os testes. RESULTADOS: Foram incluídos 400 pacientes (com 67 ± 13 anos, 77% do sexo masculino). Utilizando a fórmula de Friedewald, a mediana de LDL-C sob terapia foi de 64 (50-81) mg/dL, e 31% tinham LDL-C dentro da meta. Estatinas de alta intensidade foram usadas em 64% dos pacientes, 37% estavam em uso de ezetimiba e 0,5% estavam em uso de inibidores de PCSK9. A terapia combinada de estatina de alta intensidade + ezetimiba foi utilizada em 102 pacientes (26%). A aplicação do método de Martin-Hopkins reclassificaria um total de 31 pacientes (7,8%). Entre aqueles considerados controlados pela fórmula de Friedewald, 27 (21,6%) teriam LDL-C estimado por Martin-Hopkins acima da meta. CONCLUSÕES: Menos de um terço dos pacientes pós-infarto do miocárdio apresentaram LDL-C dentro da meta. A aplicação da fórmula de Martin-Hopkins reclassificaria um quinto dos pacientes presumivelmente controlados no grupo de pacientes não controlados.


Assuntos
Inibidores de Hidroximetilglutaril-CoA Redutases , Infarto do Miocárdio , Humanos , Masculino , Feminino , Estudos Transversais , Pró-Proteína Convertase 9 , LDL-Colesterol , Objetivos , Estudos Retrospectivos , Ezetimiba , Síndrome
8.
Int J Mol Sci ; 25(5)2024 Feb 24.
Artigo em Inglês | MEDLINE | ID: mdl-38473903

RESUMO

Autoimmune polyglandular syndromes (APS) are classified into four main categories, APS1-APS4. APS1 is caused by AIRE gene loss of function mutations, while the genetic background of the other APS remains to be clarified. Here, we investigated the potential association between AIRE gene promoter Single Nucleotide Polymorphisms (SNPs) and susceptibility to APS. We sequenced the AIRE gene promoter of 74 APS patients, also analyzing their clinical and autoantibody profile, and we further conducted molecular modeling studies on the identified SNPs. Overall, we found 6 SNPs (-230Y, -655R, -261M, -380S, -191M, -402S) of the AIRE promoter in patients' DNA. Interestingly, folding free energy calculations highlighted that all identified SNPs, except for -261M, modify the stability of the nucleic acid structure. A rather similar percentage of APS3 and APS4 patients had polymorphisms in the AIRE promoter. Conversely, there was no association between APS2 and AIRE promoter polymorphisms. Further AIRE promoter SNPs were found in 4 out of 5 patients with APS1 clinical diagnosis that did not harbor AIRE loss of function mutations. We hypothesize that AIRE promoter polymorphisms could contribute to APS predisposition, although this should be validated through genetic screening in larger patient cohorts and in vitro and in vivo functional studies.


Assuntos
Poliendocrinopatias Autoimunes , Humanos , Síndrome , Mutação , Polimorfismo de Nucleotídeo Único , Regiões Promotoras Genéticas
9.
Int J Mol Sci ; 25(5)2024 Feb 29.
Artigo em Inglês | MEDLINE | ID: mdl-38474067

RESUMO

Severe obesity in young children prompts for a differential diagnosis that includes syndromic conditions. Rapid-Onset Obesity with Hypothalamic Dysfunction, Hypoventilation, and Autonomic Dysregulation (ROHHAD) syndrome is a potentially fatal disorder characterized by rapid-onset obesity associated with hypoventilation, neural crest tumors, and endocrine and behavioral abnormalities. The etiology of ROHHAD syndrome remains to be established, but recent research has been focusing on autoimmunity. We report on a 2-year-old girl with rapid-onset obesity during the first year of life who progressed to hypoventilation and encephalitis in less than four months since the start of accelerated weight gain. The patient had a high titer of anti-ZSCAN1 antibodies (348; reference range < 40), and the increased values did not decline after acute phase treatment. Other encephalitis-related antibodies, such as the anti-NDMA antibody, were not detected. The rapid progression from obesity onset to central hypoventilation with encephalitis warns about the severe consequences of early-onset ROHHAD syndrome. These data indicate that serial measurements of anti-ZSCAN1 antibodies might be useful for the diagnosis and estimation of disease severity. Further research is needed to determine whether it can predict the clinical course of ROHHAD syndrome and whether there is any difference in antibody production between patients with and without tumors.


Assuntos
Neoplasias das Glândulas Suprarrenais , Doenças do Sistema Nervoso Autônomo , Encefalite , Doenças Hipotalâmicas , Obesidade Pediátrica , Feminino , Humanos , Pré-Escolar , Hipoventilação/complicações , Hipoventilação/diagnóstico , Obesidade Pediátrica/complicações , Neoplasias das Glândulas Suprarrenais/complicações , Síndrome , Encefalite/complicações
10.
Int J Rheum Dis ; 27(3): e15114, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38465508

RESUMO

PASS syndrome is a rare autoinflammatory disease characterized by acne vulgaris, hidradenitis suppurativa, pyoderma gangrenosum, and ankylosing spondylitis. Unlike other autoinflammatory disorders such as PAPA and PASH syndrome, there is no documented gene mutation link. Although there are no established treatment guidelines due to the rarity of these diseases, systemic corticosteroids, biologics, and immunosuppressive drugs are used currently. In our report, we presented a case of PASS syndrome who was unresponsive to adalimumab and in whom we observed improvement in both skin and joint manifestations with intravenous immunoglobulin (IVIG) and anti-IL-1 treatment.


Assuntos
Acne Vulgar , Hidradenite Supurativa , Pioderma Gangrenoso , Humanos , Imunoglobulinas Intravenosas/uso terapêutico , Hidradenite Supurativa/tratamento farmacológico , Acne Vulgar/complicações , Acne Vulgar/tratamento farmacológico , Acne Vulgar/genética , Síndrome , Pele , Pioderma Gangrenoso/tratamento farmacológico
11.
Artigo em Russo | MEDLINE | ID: mdl-38465805

RESUMO

Functional transcranial dopplerography (FTCD) is a non-invasive ultrasound examination that allows recording the dynamics of cerebral blood flow parameters under conditions of factors stimulated the activity of the structures of the central nervous system. Judgments about the sensitivity and specificity of FTCD are based on the close connection between changes in the activity of the nervous (somatic) system and the response of regional cerebral blood flow (CBF). The technique is a portable and accessible diagnostic method used in assessing the possibility of expanding functional activity during the recovery period after a stroke. An increase in mental activity in response to the presentation of a cognitive task, accompanied by an increase in glucose and oxygen consumption and naturally requiring an increase in cerebral perfusion parameters, can also be assessed by changes in regional blood flow parameters while maintaining the reactive mechanisms of autoregulation. A search of literature sources was carried out in the electronic databases PubMed and Scopus. For the subject search, Medical Subject Headings were used. A total of 36 sources that mentioned the terms «cognitive function¼ and «functional transcranial Doppler¼ were selected for preliminary analysis. At the present stage, methodological problems are obvious, requiring the development and implementation of a standard package of targeted functional tests to assess cognitive status. Available equipment and software require technological solutions to ensure objective recording of changes in cerebral blood flow during testing and training.


Assuntos
Disfunção Cognitiva , Acidente Vascular Cerebral , Humanos , Cognição , Circulação Cerebrovascular , Disfunção Cognitiva/diagnóstico por imagem , Síndrome , Ultrassonografia Doppler Transcraniana/métodos
12.
Zhongguo Dang Dai Er Ke Za Zhi ; 26(2): 194-200, 2024 Feb 15.
Artigo em Chinês | MEDLINE | ID: mdl-38436319

RESUMO

Pediatric acute liver failure (PALF) is a rare and rapidly progressive clinical syndrome with a poor prognosis and significant mortality. The etiology of PALF is complex, and it presents with diverse and atypical clinical manifestations. Accurate diagnosis based on age-related factors, early recognition or prevention of hepatic encephalopathy, and precise supportive treatment targeting the underlying cause are crucial for improving outcomes and prognosis. This article provides a comprehensive review of recent research on the diagnosis and treatment of PALF, aiming to offer guidance for clinical practice.


Assuntos
Falência Hepática Aguda , Humanos , Criança , Fatores Etários , Falência Hepática Aguda/diagnóstico , Falência Hepática Aguda/etiologia , Falência Hepática Aguda/terapia , Síndrome
14.
Zentralbl Chir ; 149(1): 75-82, 2024 Feb.
Artigo em Alemão | MEDLINE | ID: mdl-38442886

RESUMO

About one third of all colorectal carcinomas (CRC) are localised in the rectum. As part of a multimodal therapy concept, neoadjuvant therapy achieves downstaging of the tumour in 50-60% of cases and a so-called complete clinical response (cCR), defined as clinically (and radiologically) undetectable residual tumour after completion of neoadjuvant therapy, in 10-30% of cases.In view of the perioperative morbidity and mortality associated with radical rectal resection, including the occurrence of a symptom complex known as low anterior resection syndrome (LARS) and the need for deviation, at least temporarily, the question of the risk-benefit balance of organ resection in the presence of cCR has been raised. In this context, the therapeutic concept of a "watch-and-wait" approach with omission of immediate organ resection and inclusion in a structured surveillance regime, has emerged.For a safe, oncological implementation of this option, it is necessary to develop standards in the definition of a suitable patient clientele and the implementation of the concept. In addition to the initial correct selection of the patient group that is suitable for a primarily non-surgical procedure, the inherent goal is the early and sufficient detection of tumour recurrence (so-called local regrowth) during the "watch-and-wait" phase (surveillance).In this context, in this paper we address the questions of: 1. the optimal timing of initial re-staging, 2. the criteria for assessing the clinical response and selecting the appropriate patient clientele, 3. the rhythm and design of the surveillance protocol.


Assuntos
Neoplasias Colorretais , Neoplasias Retais , Humanos , Neoplasias Retais/diagnóstico , Neoplasias Retais/cirurgia , Complicações Pós-Operatórias , Síndrome , Reto
15.
Neurol India ; 72(1): 124-128, 2024 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-38443013

RESUMO

Chromosomal deletion and duplication syndromes can lead to intellectual disability, autism, microcephaly, and poor growth. Usually manifestations of duplication syndromes are milder than that of the deletion syndromes. With the availability of tests for analysis of copy number variants, it is possible to identify the deletion and duplication syndromes with greater ease. We report 32 cases of chromosomal duplication syndromes, identified in children presenting with developmental delay, intellectual disability, or microcephaly and/or additional features, at a tertiary care center on karyotyping or microarray analysis. Seven were isolated duplications, and one child had an additional smaller pathogenic deletion. Thus, duplication syndromes can have milder presentations with spectrum of dysmorphism, behavioral problems, and intellectual disability, but it is possible to diagnose easily with latest emerging high-throughput technologies.


Assuntos
Deficiência Intelectual , Microcefalia , Criança , Humanos , Duplicação Cromossômica/genética , Microcefalia/genética , Deficiência Intelectual/genética , Pesquisa , Deleção Cromossômica , Síndrome
16.
Kyobu Geka ; 77(2): 94-99, 2024 Feb.
Artigo em Japonês | MEDLINE | ID: mdl-38459857

RESUMO

We have operated on two cases of slipped ribs syndrome( SRS). Both patients were men in their 40s with a history of right thoracic trauma who were referred to us because of unexplained lower thoracic pain. The left rib was positive for hooking maneuver (lift test), and dynamic ultrasonography showed narrowing of the intercostal space, which led to the diagnosis of SRS. in the first case, the tip of the ninth rib cartilage was excised, and the ninth and tenth rib cartilages were sutured and fixed with No.2 fiber wire in two places with Z sutures. In the second case, the tip of the ninth rib cartilage was excised, the eighth and ninth ribs and the ninth and tenth ribs were fixed with No.2 fiber wire with Z sutures as in the first case, and a 0.7 mm thick poly-L-lactide (PLLA) plate was added between the eighth and tenth rib cartilages. In both cases, the postoperative course was good and the pain disappeared. SRS should be recognized as a disease and surgical treatment should be used as therapy.


Assuntos
Cartilagem Costal , Traumatismos Torácicos , Masculino , Humanos , Feminino , Síndrome , Costelas/diagnóstico por imagem , Costelas/cirurgia , Costelas/lesões , Dor no Peito/etiologia , Traumatismos Torácicos/complicações
17.
Allergol Immunopathol (Madr) ; 52(2): 23-31, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38459887

RESUMO

Morbihan syndrome (MS) is characterized by solid facial edema, usually related to rosacea or acne vulgaris. The facial edema deforms the patient's features, can impair peripheral vision, and affects quality of life. Its pathophysiology remains unclear. The disease usually has a slow and chronic course. MS most commonly affects middle-aged Caucasian men with rosacea and is rare in people below 20 years of age. MS is a diagnosis of exclusion. There is no standard treatment for MS, though systemic isotretinoin and antihistamines are mainly used. We present the case of an adolescent girl with MS nonresponding to 19 months of isotretinoin treatment with add-on antihistamines. Therapy with monthly administration of omalizumab (anti-IgE) for 6 months was an effective therapeutic option, improving the quality of life. Our case is the second description of omalizumab use in Morbihan syndrome, the first in an adolescent.


Assuntos
Angioedema , Rosácea , Masculino , Pessoa de Meia-Idade , Feminino , Humanos , Adolescente , Isotretinoína/uso terapêutico , Omalizumab/uso terapêutico , Qualidade de Vida , Rosácea/diagnóstico , Rosácea/tratamento farmacológico , Síndrome , Edema/diagnóstico , Edema/tratamento farmacológico , Antagonistas dos Receptores Histamínicos/uso terapêutico
19.
Methodist Debakey Cardiovasc J ; 20(2): 120-123, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38495653

RESUMO

Hypertensive disorders in pregnancy (HDP) are a group of conditions-including chronic hypertension, gestational hypertension, preeclampsia with and without end-organ damage, and acute complications, which include HELLP (hemolysis, elevated liver enzymes, and low platelets) syndrome and eclampsia-that could lead to severely adverse outcomes for both mother and fetus. The incidence of HDP has increased, affecting one out of seven delivery hospitalizations. Physicians should be aware of HDP for early identification and proper treatment to improve patient outcomes.


Assuntos
Hipertensão Induzida pela Gravidez , Médicos , Feminino , Gravidez , Humanos , Hipertensão Induzida pela Gravidez/diagnóstico , Hipertensão Induzida pela Gravidez/epidemiologia , Hipertensão Induzida pela Gravidez/terapia , Pacientes , Síndrome , Assistência ao Paciente
20.
Endokrynol Pol ; 75(1): 42-50, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38497389

RESUMO

INTRODUCTION: Thyroid diseases such as low triiodothyronine syndrome (LT3S) are more common in the elderly population. Comprehensive geriatric assessment (CGA) has been proposed as a supplementary tool for evaluating medical, functional, psychological, and frailty status and various geriatric syndromes. This study aimed to evaluate the impact of thyroid diseases on overall health status using a novel CGA strategy. MATERIAL AND METHODS: 477 patients were enrolled between January 2019 and December 2022. A structured CGA was conducted by a multidisciplinary team to identify older high-risk patients. Multivariate regression was performed to assess independent factors associated with thyroid status and CGA. RESULTS: The prevalence of abnormal thyroid hormone levels in the elderly was 34.2%. LT3S and anti-thyroglobulin antibody (anti-TgAb)-positivity or anti-thyroid peroxidase antibody (anti-TPOAb)-positivity were the main manifestations of thyroid diseases in elderly patients. The patients with LT3S had a higher prevalence of diabetes (p = 0.023), were older (p = 0.000), more often female (p = 0.014), with higher C-reactive protein (p = 0.001), and with lower body mass index (BMI) (p = 0.002), albumin (Alb) (p = 0.000), and haemoglobin (Hb) (p = 0.000) than patients with normal thyroid function. The CGA results showed higher rates of malnutrition and depression in patients with LT3S. Further multivariate logistic regression analysis showed that Hb [odds ratio (OR): 0.975; 95% confidence interval (CI): 0.959-0.990; p = 0.002] and LT3S (OR: 2.213; 95% CI: 1.048-4.672; p = 0.037) were independently associated with depression. Female (OR: 0.393; 95% CI: 0.160-0.968; p = 0.042), Alb (OR: 0.892; 95% CI: 0.811-0.981; p = 0.018), Hb (OR, 0.964; 95% CI: 0.939-0.989; p = 0.006), and LT3S (OR: 3.749; 95% CI: 1.474-9.536; p = 0.006) were independently associated with malnutrition. CONCLUSIONS: LT3S was closely related to depression and malnutrition. Physicians should be more concerned about elderly patients with LT3S for their physical and mental status. Regular thyroid function checks might help to detect depression earlier.


Assuntos
Desnutrição , Doenças da Glândula Tireoide , Humanos , Feminino , Idoso , Tri-Iodotironina , Estudos Transversais , Avaliação Geriátrica/métodos , Depressão/epidemiologia , Síndrome , Doenças da Glândula Tireoide/epidemiologia
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