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Diodes are key elements for electronics, optics, and detection. Their evolution towards low dissipation electronics has seen the hybridization with superconductors and the realization of supercurrent diodes with zero resistance in only one direction. Here, we present the quasi-particle counterpart, a superconducting tunnel diode with zero conductance in only one direction. The direction-selective propagation of the charge has been obtained through the broken electron-hole symmetry induced by the spin selection of the ferromagnetic tunnel barrier: a EuS thin film separating a superconducting Al and a normal metal Cu layer. The Cu/EuS/Al tunnel junction achieves a large rectification (up to â¼40%) already for a small voltage bias (â¼200 µV) thanks to the small energy scale of the system: the Al superconducting gap. With the help of an analytical theoretical model we can link the maximum rectification to the spin polarization (P) of the barrier and describe the quasi-ideal Shockley-diode behavior of the junction. This cryogenic spintronic rectifier is promising for the application in highly-sensitive radiation detection for which two different configurations are evaluated. In addition, the superconducting diode may pave the way for future low-dissipation and fast superconducting electronics.
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We calculate the nonreciprocal critical current and quantify the supercurrent diode effect in two-dimensional Rashba superconductors with arbitrary disorder, using the quasiclassical Eilenberger equation. The nonreciprocity is caused by the helical superconducting state, which appears when both inversion and time-reversal symmetries are broken. In the absence of disorder, we find a very strong diode effect, with the nonreciprocity exceeding 40% at optimal temperatures, magnetic fields, and spin-orbit coupling. We establish that the effect persists even in the presence of strong disorder. We show that the sign of the diode effect changes as magnetic field and disorder are increased, reflecting the changes in the nature of the helical state.
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Background: Adipose tissue is a dynamic endocrine organ, a highly active metabolic tissue, and an important source of cytokines. Inflammatory factors play an important role in visceral obesity associated with insulin resistance (IR), metabolic syndrome (MS), hypertension, non-alcoholic fatty liver disease (NAFLD), diabetes mellitus type 2 (DM2), endothelial dysfunction (ED) and atherosclerosis. Objectives: To examine corelation of siMS score, as a quantification method for metabolic syndrome (MS), with insulin resistance, glucoregulation parameters, as with other co-founding factors of MS, inflammation and thrombosis factors, microalbuminuria, uric acid, fatty liver index (FLI) and homocysteine. Methods: The study included 451 obese individuals with pre-metabolic syndrome (pre-MS) and MS (age 16-75, body mass index (BMI) > 25kg/m2) classified into two groups: I-age 10-30 (167 patients); II-age 31-75 (284 patients). International Diabetes Federation (IDF) classification was applied for diagnosing metabolic syndrome. Patients with less than three criteria indicated below were considered pre-metabolic syndrome. siMS risk score was used. Results: siMS score increased with age: I-3.03 ± 0.87, II-3.27 ± 0.90. siMS score correlated with associated factors of MS: hyperinsulinemia and IR, ALT, gama-GT, FLI, uric acid in both groups and CRP (p < 0.01) in group I. Correlations in II group: siMS score with PAI-1 (p = 0.01), microalbuminuria (p = 0.006), homocysteine ââ(p = 0.076). Conclusion: Correlation of siMS score with HOMA-IR confirmed that hyperinsulinism and insulin resistance are in the basis of MS. Correlation of siMS score with parameters of NAFLD, CRP, PAI-1, uric acid, microalbuminuria and homocysteine indicates that they are significant co-founding factors of MS. Correlation of siMS score with PAI-1, microalbuminuria, homocysteine, indicates higher risk for progression of endothelial dysfunction and atherosclerosis with age.
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BACKGROUND: The serum adiponectin level (AD), adiponectin resistance (AD-R) may reflect the degree of metabolic syndrome (MetS). The role parameter AD-R, The Homeostasis Model Assessment-Adiponectin (HOMA-AD) index on the coronary artery disease (CAD) severity is not still understood. OBJECTIVE: To determine adiponectin concentration and HOMA-AD index in patients with CAD with/without MetS and to evaluate their prognostic importance on severity of CAD. METHODS: This cross-sectional study involved selected 130 examinees which were divided into three groups: CAD+MetS, CAD-MetS, control group (no CAD/MetS). In all examinees values of biochemical and anthropometric parameters were determined. We analyzed the severity of coronary artery lesions from coronary angiography. Total serum adiponectin concentration was measured by ELISA. We calculated atherogenic Gensini scoring system, Duke prognostic index, and HOMA-AD-index. RESULTS: Serum adiponectin level was significantly lower in the group with CAD+MetS (p < 0.001) and in CAD-MetS group (p < 0.01), compared to the control group. The HOMA-AD index showed statistically significant positive correlation with the key parameters of MetS, as well as with the parameters of CAD, number of CAD and modified Gensini score. After applying logistic regression analysis the best predictors for CAD were: adiponectin, blood pressure, HOMA-IR index, and HOMA-AD index. The cut-off values of adiponectin ≤1506.38 pg/mL, HOMA-IR index ≥3.91 and HOMA-AD index ≥0.67 were associated with a higher risk of CAD. CONCLUSION: Patients with CAD with or without MetS had low adiponectin levels and this hypoadiponectinemia indicates that AD and HOMA-AD index may be a useful marker for identifying patients at risk for CAD.
Assuntos
Doença da Artéria Coronariana , Resistência à Insulina , Síndrome Metabólica , Adiponectina , Doença da Artéria Coronariana/epidemiologia , Estudos Transversais , Humanos , Síndrome Metabólica/complicações , Síndrome Metabólica/epidemiologiaRESUMO
INTRODUCTION: The different degrees of adiponectin/insulin sensitivity and dysfunctional adipose tissue lead to the development of hypertension (HT). This study aimed to determine adiponectin (AD) concentration in patients with metabolic syndrome (MetS) and high-normal blood pressure or hypertension and to investigate the importance of Homeostatic Model Assessment-AD (HOMA-AD) index in assessing adiponectin/insulin resistance in hypertension. METHODS: This cross-sectional study involved 150 subjects divided into two groups: with MetS (and high-normal blood pressure, n =50; and HT, n =50), and controls without MetS (n =50). In all subjects, serum adiponectin concentration was measured by enzyme-linked immunosorbent assay method. Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) and HOMA-AD index were calculated. RESULTS: The results showed that, compared to the control group, serum AD concentrations were significantly lower in patients with MetS and high-normal blood pressure (p =0.008), and the lowest in group MetS and HT (p =0.001). High AD levels and low HOMA-AD were significantly associated with decreased blood pressure values. In patients with MetS, the value of HOMA-AD≥1.13 was associated with a higher risk of developing high-normal blood pressure. Furthermore, the value of HOMA-AD≥2.63 was associated with a higher risk of developing hypertension. CONCLUSIONS: Hypoadiponectinemia is associated with hypertension, especially in the early stages of the disease. The serum AD levels and HOMA-AD index may be useful markers for identifying patients at risk for high-normal blood pressure and hypertension. HIPPOKRATIA 2020, 24(1): 3-7.
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We studied the effect of α-tocopherol on gentamicin-induced morphological and functional changes in the kidneys of Wistar rats. Special attention was paid to the ability of α-tocopherol administered in combination with gentamicin to correct ultrastructural changes in the glomerular basal membrane and tubules. Combined treatment with α-tocopherol (100 mg/kg) and gentamicin (100 mg/kg) led to correction of histopathological and biochemical changes and oxidative injury to the kidneys induced by this antibiotic.
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Injúria Renal Aguda/prevenção & controle , Antioxidantes/farmacologia , alfa-Tocoferol/farmacologia , Injúria Renal Aguda/induzido quimicamente , Injúria Renal Aguda/metabolismo , Injúria Renal Aguda/patologia , Animais , Catalase/sangue , Gentamicinas/toxicidade , Glomérulos Renais/efeitos dos fármacos , Glomérulos Renais/metabolismo , Glomérulos Renais/patologia , Túbulos Renais/efeitos dos fármacos , Túbulos Renais/metabolismo , Túbulos Renais/patologia , Malondialdeído/sangue , Estresse Oxidativo/efeitos dos fármacos , Ratos , Ratos WistarRESUMO
Stable gastric pentadecapeptide BPC 157 (GEPPPGKPADDAGLV, M.W. 1419) may be the new drug stable in human gastric juice, effective both in the upper and lower GI tract, and free of side effects. BPC 157, in addition to an antiulcer effect efficient in therapy of inflammatory bowel disease (IBD) (PL 14736) so far only tested in clinical phase II, has a very safe profile, and exhibited a particular wound healing effect. It also has shown to interact with the NO-system, providing endothelium protection and angiogenic effect, even in severely impaired conditions (i.e., it stimulated expression of early growth response 1 gene responsible for cytokine and growth factor generation and early extracellular matrix (collagen) formation (but also its repressor nerve growth factor 1-A binding protein-2)), important to counteract severe complications of advanced and poorly controlled IBD. Hopefully, the lessons from animal studies, particularly advanced intestinal anastomosis healing, reversed short bowel syndrome and fistula healing indicate BPC 157's high significance in further IBD therapy. Also, this supportive evidence (i.e., no toxic effect, limit test negative, LD1 not achieved, no side effect in trials) may counteract the problems commonly exercised in the use of peptidergic agents, particularly those used on a long-term basis.
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Antiulcerosos/uso terapêutico , Enteropatias/tratamento farmacológico , Fragmentos de Peptídeos/uso terapêutico , Proteínas/uso terapêutico , Animais , HumanosRESUMO
Salmonella enterica is one of the most common causes of food-borne infection in human beings. Cases of Salmonella infection have been decreasing in Europe in the last ten years, yet, Salmonella infections are still the main cause of acute diarrhea syndrome. Globalization has caused the international food industry to increase the production of collective nutrition produce and products. This has intensified the need for authorized and accredited laboratories to monitor microbiological food safety. All parameters indicate the necessity of a multi-sector approach to this problem. Food safety supervision involves the analysis and identification of risk management, as well as the monitoring, evaluating, and regulating of crop irrigation. We can be more certain with a multi-sector approach that the number of Salmonella infections caused by plant-originated food stuffs will not increase in the future.
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Produtos Agrícolas/microbiologia , Microbiologia de Alimentos , Intoxicação Alimentar por Salmonella/epidemiologia , Intoxicação Alimentar por Salmonella/microbiologia , Salmonella enterica/patogenicidade , Surtos de Doenças , Inocuidade dos Alimentos , Humanos , Microbiologia do SoloRESUMO
We focused on stable gastric pentadecapeptide BPC 157 (GEPPPGKPADDAGLV, MW 1419, an anti-ulcer peptide efficient in inflammatory bowel disease trials (PL 14736), no toxicity reported) because of its hepatoprotective effects. We investigate a particular aspect of the sudden onset of encephalopathy with extreme paracetamol overdose (5 g/kg intraperitoneally) so far not reported: rapidly induced progressive hepatic encephalopathy with generalized convulsions in rats. BPC 157 therapy (10 microg, 10 ng, 10 pg/kg, intraperitoneally or intragastrically) was effective (microg-ng range) against paracetamol toxicity, given in early (BPC 157 immediately after paracetamol, prophylactically) or advanced stage (BPC 157 at 3 hours after paracetamol, therapeutically). At 25 min post-paracetamol increased ALT, AST and ammonium serum values precede liver lesion while in several brain areas, significant damage became apparent, accompanied by generalized convulsions. Through the next 5 hour seizure period and thereafter, the brain damage, liver damage enzyme values and hyperammonemia increased, particularly throughout the 3-24 h post-paracetamol period. BPC 157 demonstrated clinical (no convulsions (prophylactic application) or convulsions rapidly disappeared (therapeutic effect within 25 min)), microscopical (markedly less liver and brain lesions) and biochemical (enzyme and ammonium serum levels decreased) counteraction. Both, the prophylactic and therapeutic benefits (intraperitoneally and intragastrically) clearly imply BPC 157 (microg-ng range) as a highly effective paracetamol antidote even against highly advanced damaging processes induced by an extreme paracetamol over-dose.
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Acetaminofen/intoxicação , Antídotos/farmacologia , Fragmentos de Peptídeos/farmacologia , Proteínas/farmacologia , Convulsões/prevenção & controle , Acetaminofen/administração & dosagem , Analgésicos não Narcóticos/administração & dosagem , Analgésicos não Narcóticos/intoxicação , Animais , Antiulcerosos/administração & dosagem , Antiulcerosos/farmacologia , Antídotos/administração & dosagem , Encéfalo/efeitos dos fármacos , Encéfalo/patologia , Relação Dose-Resposta a Droga , Overdose de Drogas , Encefalopatia Hepática/induzido quimicamente , Encefalopatia Hepática/prevenção & controle , Testes de Função Hepática , Masculino , Fragmentos de Peptídeos/administração & dosagem , Proteínas/administração & dosagem , Ratos , Ratos Wistar , Convulsões/induzido quimicamente , Fatores de TempoRESUMO
The aim of this study was to evaluate KCNQ1 K+ channel expression in the frog kidney of Rana esculenta. KCNQ1 K+ channel, also known as KvLQT1, is the pore forming a-subunit of the IKs K+ channel, a delayed rectifier voltage-gated K+ channel, which has an important role in water and salt transport in the kidney and gastrointestinal tract. The expression of KCNQ1 K+ channel along tubular epithelium differs from species to species. In the present study the expression of KCNQ1 K+ channel in the frog kidney has been demonstrated by immunohistochemistry. The presence of KCNQ1 K+ channel was demonstrated in the epithelial cells of distal convoluted tubule and collecting duct. However, the pattern of expression of KCNQ1 K+ channel differs between distal convoluted tubules and collecting duct. All epithelial cells of distal convoluted tubules revealed basolateral expression of KCNQ1 K+ channel. On the contrary, only the single cells of collecting duct, probably intercalated cells, showed diffuse cell surface staining with antibodies against KCNQ1 K+ channel. These findings suggest that KCNQ1 K+ channel has cell-specific roles in renal potassium ion transport.
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Células Epiteliais/metabolismo , Canal de Potássio KCNQ1/metabolismo , Túbulos Renais Coletores/metabolismo , Animais , Células Cultivadas , Feminino , Humanos , Immunoblotting , Masculino , Rana esculentaRESUMO
We focused on over-dose insulin (250 IU/kg i.p.) induced gastric ulcers and then on other disturbances that were concomitantly induced in rats, seizures (eventually fatal), severely damaged neurons in cerebral cortex and hippocampus, hepatomegaly, fatty liver, increased AST, ALT and amylase serum values, breakdown of liver glycogen with profound hypoglycemia and calcification development. Calcium deposits were present in the blood vessel walls, hepatocytes surrounding blood vessels and sometimes even in parenchyma of the liver mainly as linear and only occasionally as granular accumulation. As an antidote after insulin, we applied the stable gastric pentadecapeptide BPC 157 (10 microg/kg) given (i) intraperitoneally or (ii) intragastrically immediately after insulin. Controls received simultaneously an equivolume of saline (5 ml/kg). Those rats that survived till the 180 minutes after over-dose application were further assessed. Interestingly, pentadecapeptide BPC 157, as an antiulcer peptide, may besides stomach ulcer consistently counteract all insulin disturbances and fatal outcome. BPC 157 rats showed no fatal outcome, they were mostly without hypoglycemic seizures with apparently higher blood glucose levels (glycogen was still present in hepatocytes), less liver pathology (i.e., normal liver weight, less fatty liver), decreased ALT, AST and amylase serum values, markedly less damaged neurons in brain and they only occasionally had small gastric lesions. BPC 157 rats exhibited mostly only dot-like calcium presentation. In conclusion, the success of BPC 157 therapy may indicate a likely role of BPC 157 in insulin controlling and BPC 157 may influence one or more causative process(es) after excessive insulin application.
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Antiulcerosos/uso terapêutico , Antídotos/uso terapêutico , Hipoglicemia/prevenção & controle , Hipoglicemiantes/toxicidade , Insulina/toxicidade , Fragmentos de Peptídeos/uso terapêutico , Proteínas/uso terapêutico , Úlcera Gástrica/prevenção & controle , Animais , Antiulcerosos/administração & dosagem , Antídotos/administração & dosagem , Encéfalo/efeitos dos fármacos , Encéfalo/patologia , Calcinose/induzido quimicamente , Calcinose/prevenção & controle , Overdose de Drogas/tratamento farmacológico , Endotélio Vascular/efeitos dos fármacos , Endotélio Vascular/patologia , Glicogênio/metabolismo , Hepatomegalia/induzido quimicamente , Hepatomegalia/patologia , Hepatomegalia/prevenção & controle , Hipoglicemia/induzido quimicamente , Hipoglicemia/complicações , Hipoglicemia/mortalidade , Fígado/irrigação sanguínea , Fígado/efeitos dos fármacos , Fígado/metabolismo , Fígado/patologia , Masculino , Neurônios/efeitos dos fármacos , Neurônios/patologia , Neurônios/fisiologia , Fragmentos de Peptídeos/administração & dosagem , Proteínas/administração & dosagem , Ratos , Ratos Wistar , Convulsões/etiologia , Convulsões/prevenção & controle , Úlcera Gástrica/induzido quimicamente , Úlcera Gástrica/patologiaRESUMO
PURPOSE: To determine the frequency of neuron specific enolase (NSE) tissue expression and its possible influence on survival of patients treated for advanced non small cell lung cancer (NSCLC). PATIENTS AND METHODS: We studied 158 patients with histological diagnosis of NSCLC (stage III/IV). Combined chemoradiotherapy was used in stage III disease (without pleural effusion), whereas chemotherapy only was used in stage III (with pleural effusion) as well as in stage IV disease. Immunohistochemical analysis of NSE expression was determined using antibodies to NSE (DAKO, Den). One- and 2-year overall survival were assessed. RESULTS: 45 (28.5%) patients had positive NSE expression. The most frequent NSE expression was seen in 6/9 (66.7%) patients with large cell carcinoma and in 23/50 (46%) with adenocarcinoma. One- and 2-year survival rates were 70% and 30% in the group of patients with positive NSE expression compared to 26% and 3% in the group with negative NSE expression (p=0.000). The median survival time was 16.4 vs. 11.4 months in the groups of patients with and without NSE expression, respectively (p < 0.001). One-and 2-year survival rate was higher in NSCLC patients with more than 50% of NSE positive cancer cells (p=0.0004 and 0.000, respectively). CONCLUSION: A total of 28.5% of advanced NSCLC patients had positive NSE expression. Median 1- and 2-year survival time was significantly longer in patients with positive NSE expression.
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Carcinoma Pulmonar de Células não Pequenas/enzimologia , Neoplasias Pulmonares/enzimologia , Fosfopiruvato Hidratase/análise , Adulto , Idoso , Carcinoma Pulmonar de Células não Pequenas/mortalidade , Feminino , Humanos , Neoplasias Pulmonares/mortalidade , Masculino , Pessoa de Meia-Idade , Prognóstico , Taxa de SobrevidaRESUMO
Twenty different streptomycete isolates were obtained from soils of southeast Serbia. Five isolates identified as Streptomyces hygroscopicus (SH100, SH101, SH102, SH103, and SH104) showed strong activity against Botrytis cinerea, a parasite found in domestic vines. These isolates were extensively studied for their in vitro antimicrobial activity against Gram-positive bacteria, Gram-negative bacteria, yeasts and fungi, and also antiviral activity against Herpes simplex. The results indicated that the obtained isolates were highly active against Botrytis cinerea, Candida albicans, and Herpes simplex, with an inhibition zone of approximately 31 mm. The structure of the bioactive components was determined using elemental analysis, as well as UV/VIS, FTIR, and TLC.
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Streptomyces/fisiologia , Antibacterianos/isolamento & purificação , Antibacterianos/farmacologia , Antifúngicos/isolamento & purificação , Antifúngicos/farmacologia , Antiparasitários/isolamento & purificação , Antiparasitários/farmacologia , Antivirais/isolamento & purificação , Antivirais/farmacologia , Botrytis/efeitos dos fármacos , Botrytis/crescimento & desenvolvimento , Candida albicans/efeitos dos fármacos , Candida albicans/crescimento & desenvolvimento , Bactérias Gram-Negativas/efeitos dos fármacos , Bactérias Gram-Negativas/crescimento & desenvolvimento , Bactérias Gram-Positivas/efeitos dos fármacos , Bactérias Gram-Positivas/crescimento & desenvolvimento , Simplexvirus/efeitos dos fármacos , Simplexvirus/crescimento & desenvolvimento , Microbiologia do Solo , Streptomyces/classificação , Streptomyces/isolamento & purificaçãoRESUMO
BACKGROUND: The efficiency of denatured muscle grafting in nerve repair has been confirmed in experimental models and animals. The first clinical trials to repair digital nerves and mixed sensory-motor nerves were encouraging regarding sensory recovery but motor recovery was poor, probably because of delayed repair. We present the functional outcome of repair of motor nerves using denatured muscle graft and compare the results with those using standard nerve graft techniques. METHODS: This prospective study included 9 radial nerve defects repaired with denatured muscle grafts and 23 radial nerve defects repaired using nerve grafts. Missile induced nerve injury, mid-arm level of lesion, a nerve gap smaller than 6 cm, and a preoperative interval of less than 5 months were characteristics shared by all patients. None of the patients had concomitant vascular injury, severe scarring, or significant soft tissue damage in the region of nerve repair. Motor recovery was estimated with 0-5 points, at least 4.7 years after surgery, according to the BMRC scale. RESULTS: A successful outcome (>or=M3) was achieved in 7 out of the 9 patients treated using a muscle graft and in 21 out of the 23 patients treated using nerve grafts (P > 0.05). Excellent recovery and the clinically significant re-establishment of thumb extension (M5 grade) were never achieved in the patients treated using muscle grafts. The average motor score was significantly better in patients treated with nerve grafts than in those who received muscle grafts (3.8 +/- 0.9 and 3.2 +/- 0.8; P = 0.035). With the patients who received muscle grafts, an inverse correlation existed between motor recovery and the length of the nerve gap (P = 0.017). CONCLUSIONS: Denatured muscle grafts can be useful for bridging short radial nerve defects, but the quality of recovery is significantly worse than after nerve graft repair. Even if relatively short nerve defects are bridged with denatured muscle grafts, the outcomes correlate inversely with the length of the gap.
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Traumatismos do Braço/cirurgia , Microcirurgia/métodos , Neurônios Motores/fisiologia , Músculo Esquelético/transplante , Regeneração Nervosa/fisiologia , Nervos Periféricos/transplante , Complicações Pós-Operatórias/fisiopatologia , Nervo Radial/cirurgia , Ferimentos por Arma de Fogo/cirurgia , Adolescente , Adulto , Seguimentos , Congelamento , Mãos/inervação , Mãos/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Contração Muscular/fisiologia , Nervo Radial/lesõesRESUMO
OBJECTIVE: The aim of the present study was to investigate whether Ga-As laser irradiation can enhance adenosine triphosphate (ATP) production in normal human neural progenitor (NHNP) cells in culture. METHODS: NHNP were grown in tissue culture and were treated by Ga-As laser (808 nm, 50 mW/cm(2), 0.05 J/cm(2)), and ATP was determined at 10 min after laser application. RESULTS: The quantity of ATP in laser-treated cells was 7513 +/- 970 units, which was significantly higher (p < 0.05) than the non-treated cells, which comprised 3808 +/- 539 ATP units. CONCLUSION: Laser application to NHNP cells significantly increases ATP production in these cells. These findings may explain the beneficial effects of low-level laser therapy (LLLT) in stroked rats. Tissue culture of NHNP cells might offer a good model to study the mechanisms associated with promotion of ATP production in the nervous system by LLLT.
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Trifosfato de Adenosina/biossíntese , Terapia com Luz de Baixa Intensidade , Neurônios/citologia , Células-Tronco/efeitos da radiação , Trifosfato de Adenosina/efeitos da radiação , Células Cultivadas , Humanos , Neurônios/química , Neurônios/efeitos da radiação , Células-Tronco/químicaRESUMO
UNLABELLED: Studies on the outcome of hemodialysis (HD) patients over time have mainly focused on morbidity and mortality, but currently, the importance of measuring the patient's health-related quality of life (HRQoL) is being increasingly recognized. On the other hand, comorbidity is the single most important determinant of outcome in patients on HD. The aims of this study were to evaluate HRQoL in patients at the initiation of HD therapy (incident cohort), and in patients on long-term HD treatment (prevalent cohort), and to establish the relationship between the presence of comorbidity and patient's HRQoL. The study enrolled 229 patients on HD, divided into two groups: prevalent cohort comprised 192 patients on chronic HD more than 3 months, and incident cohort with 37 patients who started their dialysis during the study. Comorbidity was assessed using the Index of Coexistent Diseases (ICED), including two sub-indexes: Index of Disease Severity (IDS), a medical record review of 16 medical conditions, and Index of Physical Impairment (IPI), an observer-based assessment of 11 physical functions. ICED scores range from 0 to 3, with higher levels reflecting more severe comorbidity. Patient's self-assessment of HRQoL was measured by the 36-item Short Form Health Survey Questionnaire (SF-36), encompassing 8 summary scales and 2 summary dimensions. Based on the ICED index level, in both groups of patients (prevalent and incident group), a high presence of associated diseases was observed, i.e. 56.8 % and 67.6 % respectively. Indicators of comorbidities have negative and statistically significant correlation, so that any increase of IDS and IPI indexes produces significant decrease of HRQoL parameters. HRQoL summary scales in both groups of patients were similar, but generally with lower values in incident subjects and with statistical significance only in social functioning (SF) scale (40.5 +/- 24.9 vs 51.0 +/- 27.2). In the incident group of patients, one year of HD treatment was associated with a slight improvement in all HRQoL parameters, but statistical significance (p < 0.05) was observed only in the role-physical limitation (RP) scale and SF scale. CONCLUSIONS: In the patients on HD treatment, comorbid conditions have negative and statistically significant correlation with parameters of HRQoL, and could explain poor HRQoL to a remarkable extent. One year after starting HD, patients reported better scores in some domains, especially in the RP and SF scale. From a clinical perspective, parameters of HRQoL and comorbidities should be considered in the follow up of patients treated with HD.
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Falência Renal Crônica/epidemiologia , Qualidade de Vida , Diálise Renal , Adulto , Fatores Etários , Idoso , Doenças Cardiovasculares/epidemiologia , Comorbidade , Feminino , Gastroenteropatias/epidemiologia , Indicadores Básicos de Saúde , Humanos , Falência Renal Crônica/terapia , Masculino , Pessoa de Meia-Idade , Fatores de TempoRESUMO
Endothelin receptor antagonism is an important therapeutic tool of pulmonary arterial hypertension (PAH). Bosentan was the first orally active, dual antagonist of endothelin receptors in human adults, and has been recently considered for children as well. However, little is known about bosentan treatment in children weighing less than 10 kg. We describe the use of bosentan concomitantly to epoprostenol in an infant weighing 3.5 kg and affected with severe bronchopulmonary dysplasia (BPD) and PAH. At 5 months old, when she presented subsystemic PAH secondary to severe BPD, she was treated with oxygen, digoxin and diuretics. At 8 months old, due to severe PAH not responsive to 100% oxygen, high frequency oscillatory ventilation (HFOV) and nitric oxide (NO), we started epoprostenol and bosentan. Bosentan dose was doubled at 9 months old, when HFOV and NO were slowly discontinued due to improved oxygenation index. Regular echocardiographic measurements of systolic right ventricular pressure were recorded by the method of tricuspidal atrio-ventricular gradient. A four-month combined epoprostenol and bosentan treatment decreased systolic right ventricular pressure from 68% to 40% of the systemic level, till its normalization at 11 months old. Later, when bosentan and epoprostenol were discontinued and sildenafil was started, severe PAH was reported again. Our patient died due to septic shock and refractory hypoxia at 14 months old.
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Anti-Hipertensivos/uso terapêutico , Displasia Broncopulmonar/complicações , Epoprostenol/administração & dosagem , Hipertensão Pulmonar/tratamento farmacológico , Hipertensão Pulmonar/etiologia , Sulfonamidas/uso terapêutico , Bosentana , Quimioterapia Combinada , Feminino , Humanos , Recém-Nascido , Índice de Gravidade de DoençaRESUMO
Two cases of female patients with solitary fibrous tumor of the pleura are described. Chest radiography and computed tomography showed the presence of a giant mass with inhomogeneous density in the hemithorax in both cases. Transthoracic needle biopsy of the masses showed benign fibrous tissue. Both patients underwent thoracotomy. The tumors arose from the visceral pleura, were peduncular, appeared well-circumscribed with exterior surface smooth, firm and multinodular. The size of tumors were 16x11x6 cm and 15x11x4.5 cm, weighed 650 g and 573 g and both were successfully resected. The pathological diagnosis was benign solitary fibrous tumor of the pleura. Seven years after the operations the clinical condition and chest radiography are normal in both women.
Assuntos
Fibroma/patologia , Neoplasias Pleurais/patologia , Adulto , Feminino , Humanos , Pessoa de Meia-IdadeRESUMO
Mechanical properties of the spinal cord tissue--biological basis for the development of the modality of the DREZ surgery lesioning technique Succesful treatment of the chronic neurogenic pain of spinal cord and cauda equina injury origin remains a significant management problem. The mechanism of this pain phenomenon has been shown to be related to neurochemical changes that lead to the state of hypereactivity of the second order dorsal horn neurons. The DREZ surgery (Dorsal Root Entry Zone lesion), designed to destroy anatomy structures involved in pain generating thus interrupting the neurogenic pain mechanism, as a causative procedure in treating this chronic pain, has been performed by using different technical modalities: Radiofrequency (RF) coagulation technic, Laser, Ultrasound and Microsurgical DREZotomy technic. The purpose of the study was to assess the possibility for the establishment of the lesioning technic based on the natural difference in the mechanical properties between the white and gray cord substance. We experimentally deteminated mechanical properties of the human cadaveric cord white versus gray tissue for the purpose of testing possibility of selective suction of the dorsal horn gray substance as a DREZ lesioning procedure. Based on the fact of the difference in tissue elasticity between white and gray cord substance we established a new and simple DREZ surgical lesioning technique that was tested on cadaver cord. For the purpose of testing and comparing the size and shape of the DREZ lesion axchieved the DREZ surgery has been performed on cadaver cord by employing selective dorsal horn suction as a lesioning method. After the procedure cadaver cord underwent histological fixation and analysis of the DREZ lesions achieved. Our result revealed that the white cord substance with longitudinal fiber structure had four time higher dynamical viscosity than gray substance of local neuronal network structure (150 PaS versus 37.5 PaS) that provided possibility for the safe and selective suction of the gray substance of the dorsal horn. Technic includes incision of the dorsolateral sulcus according to Sindous Microsurgical DREZotomy technic than suction under visual control of the dorsal horn gray matter using succer adopted from the lumbar puncture nidle. Operative experimental testing and hystological analysis confirmed expected size and shape of the DREZ lesion performed by dorsal horn suction as DREZ lesioning technique. The utility, selectivity and safety of this technic has been provided by the natural mechanical properties of the cord tissue itself. Application of the Dorsal horn suction as a DREZ lesioning in humans confirmed this technic as a safe and reliable DREZ lesioning method.