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1.
J Cell Sci ; 135(20)2022 10 15.
Artigo em Inglês | MEDLINE | ID: mdl-36148682

RESUMO

The ligand-activated transcription factor aryl hydrocarbon receptor (AHR) regulates cellular detoxification, proliferation and immune evasion in a range of cell types and tissues, including cancer cells. In this study, we used RNA-sequencing to identify the signature of the AHR target genes regulated by the pollutant 2,3,7,8-tetrachlorodibenzodioxin (TCDD) and the endogenous ligand kynurenine (Kyn), a tryptophan-derived metabolite. This approach identified a signature of six genes (CYP1A1, ALDH1A3, ABCG2, ADGRF1 and SCIN) as commonly activated by endogenous or exogenous ligands of AHR in multiple colon cancer cell lines. Among these, the actin-severing protein scinderin (SCIN) was necessary for cell proliferation; SCIN downregulation limited cell proliferation and its expression increased it. SCIN expression was elevated in a subset of colon cancer patient samples, which also contained elevated ß-catenin levels. Remarkably, SCIN expression promoted nuclear translocation of ß-catenin and activates the WNT pathway. Our study identifies a new mechanism for adhesion-mediated signaling in which SCIN, likely via its ability to alter the actin cytoskeleton, facilitates the nuclear translocation of ß-catenin. This article has an associated First Person interview with the first authors of the paper.


Assuntos
Neoplasias do Colo , Poluentes Ambientais , Dibenzodioxinas Policloradas , Humanos , Receptores de Hidrocarboneto Arílico/genética , Receptores de Hidrocarboneto Arílico/metabolismo , beta Catenina/genética , beta Catenina/metabolismo , Via de Sinalização Wnt/genética , Citocromo P-450 CYP1A1/genética , Citocromo P-450 CYP1A1/metabolismo , Ligantes , Cinurenina , Triptofano , Actinas/metabolismo , Neoplasias do Colo/genética , RNA
2.
Chaos ; 31(9): 093108, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34598456

RESUMO

In this work, we study the development of vortical structures generated in a rotating cylinder non-homogeneously cooled on the top. In the axisymmetric regime, for moderate vertical temperature differences and any rotation rate, cyclonic and anticyclonic rotations coexist in the flow: a counterclockwise motion at upper levels, giving place to a vertical top-down vortex, and a clockwise rotation at lower levels that generates a spin up motion. For lower rotation rates and high enough vertical temperature differences, only cyclonic top-down vortices survive and get stronger. We perform a force balance analysis to explain the phenomena. In the non-axisymmetric regime, no anticyclonic rotation at the bottom is reported and the cyclonic top-down vortex either disappears or splits up in two top-down vortices, depending on the ambient rotation rate. The intensity of the cooling on the top and how localized this cool region is affect the flow developed. When the horizontal temperature difference on the top is larger than the vertical temperature difference between top and bottom, stable axisymmetric top-down vortices with an inner updraft of warmer air are reported. The more localized the cooling above, the more difficult the development of the inner updraft becomes. Results may contribute to the understanding of the relevance of thermal processes in tornadogenesis.

3.
Phys Rev E ; 99(3-1): 033109, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30999500

RESUMO

In this paper we use simulations of the magnetohydrodynamic equations coupled with heat to show the generation of magnetic field by the dynamical interaction of a pair of vortices in a fluid electrically conducting within a cylindrical domain nonhomogeneously heated from below, setting in a rotation frame. For large enough rotation rates we show that the formation of a pair of vortices inside the primary whirl gives rise to a magnetic field. The magnetic field has a strong horizontal component, and the magnetic lines go from one vortex to the other.

4.
Colloids Surf B Biointerfaces ; 172: 699-707, 2018 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-30245295

RESUMO

Lipases (EC 3.1.1.3) are very used industrial enzymes but presents drawbacks such as lack of stability, and poor recyclability. Most of these obstacles can be solved by lipase immobilization. The objective of this work was evaluated to magnetic magnesium spinel nanoparticles as support for lipase immobilization by covalent bound. The techniques used for nanoparticles synthesis presented advantages in the size selection of the nanoparticles obtained (60-100 nm). The immobilization of Candida rugosa lipase (CRL) was optimized. The optimal conditions were determined to be pH 3.7, enzyme concentration of 1.1 mg/mL at 4 °C and an ionic strength of 100 mM. The CRL@MgFe2O4 activity obtained was 3.2 times over the starting conditions (4.03 U/mL). The immobilization of the lipase on Fe3O4 was evaluated and compared. The activity of the CRL@MgFe2O4 was 61% higher than CRL@Fe3O4 and 22% higher than free enzyme. CRL@MgFe2O4 improved the lipase stability at alkaline pH, hydrophilic solvent and high temperatures. The thermogravimetric analysis showed that this new biocatalyst was more stable compared to the free enzyme. Additionally, the immobilized lipase was recycled by magnetic force and used in ten catalysis cycles. The performance of the recycle was improved using butanol or Triton X 100 during washing. Finally, CRL@FeMg2O4 showed hydrolysis and synthesis activity. Thus, CRL@FeMg2O4 as a novel biocatalyst generation presents interesting properties for industrial applications.


Assuntos
Biocatálise , Candida/enzimologia , Enzimas Imobilizadas/metabolismo , Lipase/metabolismo , Magnésio/química , Nanopartículas de Magnetita/química , Estabilidade Enzimática , Concentração de Íons de Hidrogênio , Hidrólise , Nanopartículas de Magnetita/ultraestrutura , Solventes , Espectrometria por Raios X , Espectroscopia de Infravermelho com Transformada de Fourier , Temperatura , Termogravimetria
5.
Phys Rev E ; 93(1): 013117, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26871164

RESUMO

The appearance, evolution, and disappearance of periodic and quasiperiodic dynamics of fluid flows in a cylindrical annulus locally heated from below are analyzed using nonlinear simulations. The results reveal a route of the transition from a steady axisymmetric vertical vortex to a chaotic flow. The chaotic flow regime is reached after a sequence of successive supercritical Hopf bifurcations to periodic, quasiperiodic, and chaotic flow regimes. A scenario similar to the Ruelle-Takens-Newhouse scenario is verified in this convective flow. In the transition to chaos we find the appearance of subvortices embedded in the primary axisymmetric vortex, flows where the subvortical structure strengthens and weakens, that almost disappears before reforming again, leading to a more disorganized flow to a final chaotic regime. Results are remarkable as they connect to observations describing formation, weakening, and virtual disappearance before revival of subvortices in some atmospheric swirls such as dust devils.

6.
An Pediatr (Barc) ; 84(1): 24-9, 2016 Jan.
Artigo em Espanhol | MEDLINE | ID: mdl-25858009

RESUMO

OBJECTIVES: To identify clinical characteristics that may lead to the early recognition of patients admitted to the hospital for moderate-to-severe bronchiolitis with urine results associated with the syndrome of inappropriate antidiuretic hormone secretion (SIADH). PATIENTS AND METHODS: A prospective observational study was conducted, spanning the bronchiolitis epidemic season (October 2012-March 2013), including all children who were admitted to the hospital with a diagnosis of moderate-to-severe bronchiolitis. The following criteria were used to establish a diagnosis of SIADH: urine sodium level of 40 mmol/L or greater, urine osmolarity above 500 mosm/Kg, and urine density of 1020 g/L or greater. Demographic characteristics, ventilation mode and clinical outcome were also analyzed. A comparison was made between those patients that met urine SIADH criteria and those who did not. RESULTS: A total of 126 children were included, and 23 (18.6%) of them had urine SIADH criteria. Patients in this group had a higher incidence of pneumonia and/or atelectasis on chest X-Ray (21.7% vs. 1.9%, P=.002), worse response to bronchodilator treatment with nebulized adrenaline (69,5% vs. 28,1%, P=.016), more need for respiratory assistance (high flow oxygen therapy (17.4% vs. 7.7%, p=.016), or non-invasive mechanical ventilation (13% vs. 5.8%, P=.034), and more admissions to the PICU (26.1% vs. 6.8%, P=.007). CONCLUSIONS: Patients older than one month with acute moderate bronchiolitis and urine SIADH criteria have worse clinical courses and more need for non-invasive mechanical ventilation, PICU admission, and have a higher incidence of pneumonia on chest X-ray. For that reason, it is recommended to collect a urine sample from these patients to allow an early diagnosis of SIADH, and thus early treatment of fluid and electrolyte abnormalities.


Assuntos
Bronquiolite/complicações , Bronquiolite/diagnóstico , Síndrome de Secreção Inadequada de HAD/complicações , Síndrome de Secreção Inadequada de HAD/diagnóstico , Criança , Serviço Hospitalar de Emergência , Humanos , Estudos Prospectivos
7.
Asian Pac J Trop Med ; 8(8): 612-7, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-26321513

RESUMO

OBJECTIVE: To evaluate the activity of different natural products against L3 larvae of Anisakis type I. METHODS: Information on investigations into the activity of natural products against the L3 larvae of Anisakis simplex was collected from scientific journals, books, theses and reports via a library and electronic search (using Pubmed, Scopus, Medline, Web of Science and ScienceDirect). The search terms included: natural products, medicinal plants, essential oils, terpenic derivatives, Anisakis, antinematodal activity. RESULTS: In the literature reviewed numerous papers were found concerning the in vitro and in vivo activity against Anisakis type I of various natural products (plant extracts, essential oils and their major components). Analysis of the results showed that in vitro tests the Melaleuca alternifolia essential oil and the ar-turmerone isolated from Curcuma longa displayed the greatest activity. In vivo, the most active compound was perillaldehyde, the main component of Perilla frutescens essential oil. CONCLUSIONS: This study shows that some natural products exhibited promising antianisakis properties.

8.
Climacteric ; 18(3): 350-7, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25236805

RESUMO

In this review, we analyze the efficacy and safety of DT56a in the treatment of postmenopausal symptoms. Similar to all selective estrogen receptor modulators (SERMs), DT56a demonstrates dual agonistic and antagonistic effects due to the synergy between its components. DT56a is referred to as a plant-origin SERM (phyto-SERM) and, for this reason, its therapeutic capacity in postmenopausal women differs from other phytoestrogens used independently. Although interesting data on relief of vasomotor symptoms have been reported for DT56a, further clinical studies with a greater number of cases and a longer period of study are required to correctly identify its indications for use as an alternative to hormone therapy, especially in preventing osteoporosis.


Assuntos
Fitoestrógenos/farmacologia , Fitoterapia , Extratos Vegetais/farmacologia , Pós-Menopausa/efeitos dos fármacos , Moduladores Seletivos de Receptor Estrogênico/farmacologia , Densidade Óssea/efeitos dos fármacos , Sistema Cardiovascular/efeitos dos fármacos , Feminino , Humanos , Fitoestrógenos/efeitos adversos , Extratos Vegetais/efeitos adversos , Moduladores Seletivos de Receptor Estrogênico/efeitos adversos , Sistema Vasomotor/efeitos dos fármacos
9.
Chaos ; 24(4): 043116, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25554036

RESUMO

This paper shows the influence of the inner radius on the stability and intensity of vertical vortices, qualitatively similar to dust devils and cyclones, generated in a cylindrical annulus non-homogeneously heated from below. Little relation is found between the intensity of the vortex and the magnitude of the inner radius. Strong stable vortices can be found for both small and large values of the inner radius. The Rankine combined vortex structure, that characterizes the tangential velocity in dust devils, is clearly observed when small values of the inner radius and large values of the ratio between the horizontal and vertical temperature differences are considered. A contraction on the radius of maximum azimuthal velocity is observed when the vortex is intensified by thermal mechanisms. This radius becomes then nearly stationary when frictional force balances the radial inflow generated by the pressure drop in the center, despite the vortex keeps intensifying. These results connect with the behavior of the radius of the maximum tangential wind associated with a hurricane.

10.
Artigo em Inglês | MEDLINE | ID: mdl-23944599

RESUMO

In this paper we study the generation of top-down vortices by thermoconvective mechanisms in a cylindrical annulus nonhomogeneously cooled on the top. Assuming axisymmetry we study the structure of the vortices, characterized by a spiral downward motion, similar to that observed in tornadoes generated in supercell storms.

11.
Phys Rev E Stat Nonlin Soft Matter Phys ; 84(3 Pt 2): 037301, 2011 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-22060538

RESUMO

In this paper we study the influence of localized or widespread nonhomogeneous temperature profiles on the stability and intensity of vertical vortices generated in a cylindrical annulus by a convective instability. Localized profiles lead to more stable vortices while widespread inhomogeneities intensify the spin motion around the inner cylinder.

12.
Chaos ; 21(4): 043132, 2011 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-22225369

RESUMO

This paper shows the influence of horizontal and vertical temperature gradients on the intensity of vertical vortices, qualitatively similar to dust devils, generated by a convective instability in a cylindrical annulus non-homogeneously heated. The behavior of the vortices formed is studied, showing that the increase of the temperature gradients intensifies the strength of the vortical structures developed and vice versa, small horizontal and vertical temperature gradients lead to weaker vortices or even make them disappear. Consequently, the intensity of the vortices can be controlled thermally by cooling or heating adequately the bottom boundary.


Assuntos
Algoritmos , Atmosfera , Dinâmica não Linear , Temperatura , Simulação por Computador
13.
Phys Rev E Stat Nonlin Soft Matter Phys ; 81(3 Pt 2): 036323, 2010 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-20365870

RESUMO

A reduced model to decrease the number of degrees of freedom of the discretized Navier-Stokes equations to a small set that nevertheless captures the essential dynamics of the flow is proposed. The Rayleigh-Bénard convection problem in a cylinder of aspect ratio one where the lower and upper disks, maintained at hot and cold temperatures, respectively, rotate at equal and opposite angular velocities has been chosen to test the technique. The nonlinear dynamics is rich and complex when the temperature difference between disks and their angular velocity is varied. Representatives states--stationary, periodic near sinusoidal, and near heteroclinic--are presented. In each case, the reduced model is compared with temporal integration, and we show that 41 degrees of freedom are sufficient to reproduce the signal. We discuss the strengths and weaknesses of the algorithm by which we build our reduced model.

14.
An Sist Sanit Navar ; 32(2): 249-63, 2009.
Artigo em Espanhol | MEDLINE | ID: mdl-19738649

RESUMO

Inflammatory Optic Neuritis (ON) is the most frequent cause of acute visual loss in young adults. Although the visual prognosis is excellent in the majority of cases, many patients develop pathology, such as multiple sclerosis, in its subsequent evolution. The natural history of ON has been studied in numerous works in recent years; one of the most important of which is Optic Neuritis Treatment Trial. Magnetic Resonance plays a fundamental role in the etiological diagnosis of ON and in predicting the risk of conversion into multiple sclerosis. New exploratory techniques have recently been incorporated, such as optical coherence tomography, useful for diagnosis and prognosis; serum biomarkers have been identified in the diagnosis of other pathologies with an autoimmune nature that produce ON. A better understanding of the clinical and exploratory data of typical ON will make a more rapid and accurate diagnostic study possible. Treatment of ON with steroids must be individualised bearing in mind that they do not alter the long-term prognosis and an immunomodulating therapy must be proposed for patients with a high risk of conversion into multiple sclerosis. This article reviews the existing data in the literature on its clinical manifestations, its etiological and differential diagnosis, and the treatment of inflammatory ON.


Assuntos
Neurite Óptica , Diagnóstico Diferencial , Humanos , Esclerose Múltipla/etiologia , Neuromielite Óptica/complicações , Neurite Óptica/complicações , Neurite Óptica/diagnóstico , Neurite Óptica/terapia , Prognóstico , Fatores de Risco
15.
Rev Neurol ; 48 Suppl 1: S1-6, 2009 Jan 23.
Artigo em Espanhol | MEDLINE | ID: mdl-19222008

RESUMO

INTRODUCTION: Myoclonus refers to the brief, sudden, involuntary movements like jerks or twitches which produce a sudden muscular contraction. AIMS: To review the clinical and neurophysiological features of myoclonus, or myoclonic spasms, and to carry out an updated examination of their causation and treatment. DEVELOPMENT: Myoclonic spasms can be classified on the basis of different criteria. According to the underlying physiological mechanism, myoclonic spasms can be classified as cortical, subcortical, spinal or peripheral. Myoclonic spasms appear in a wide range of neurological diseases. So-called symptomatic myoclonus is the type that occurs secondary to an identifiable disorder; it is usually accompanied by other neurological signs and is the most frequent kind. Epileptic myoclonus is that which forms part of an epileptic syndrome with a genetic or idiopathic cause, or that is due to static encephalopathy. Essential myoclonus is the least frequent type and includes palatal myoclonus and dystonia-myoclonus syndrome. The main therapeutic objective consists in treating the underlying cause of the myoclonus if possible and in using symptomatic treatment when this is not the case. Antiepileptic drugs that enhance the effect of gamma-aminobutyric acid are still the most effective medication. Among the non-antiepileptic drugs, piracetam and 5-hydroxytryptophan stand out above the rest. Botulinum toxin has proved to be effective in palatal myoclonus. In dystonia-myoclonus syndrome, research has been conducted on the effectiveness of deep brain stimulation on the internal globus pallidus. In the most severe forms of myoclonus, monotherapy is not usually effective. CONCLUSIONS: Progress has been made in furthering our knowledge of the neurophysiology of myoclonus, although no very effective forms of treatment have been reported for this motor disorder, which can be extremely disabling.


Assuntos
Mioclonia , 5-Hidroxitriptofano/uso terapêutico , Anticonvulsivantes/uso terapêutico , Antidepressivos de Segunda Geração/uso terapêutico , Diagnóstico Diferencial , Humanos , Mioclonia/tratamento farmacológico , Mioclonia/etiologia , Mioclonia/fisiopatologia , Doenças do Sistema Nervoso/complicações , Doenças do Sistema Nervoso/fisiopatologia , Fármacos Neuroprotetores/uso terapêutico , Piracetam/uso terapêutico , Ácido gama-Aminobutírico/metabolismo
17.
Osteoporos Int ; 20(3): 393-8, 2009 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-18773136

RESUMO

UNLABELLED: This study assesses the possible association between poverty and osteoporosis and/or fragility fractures in a population of postmenopausal women. We found that postmenopausal women with low socioeconomic status had lower values of BMD at the lumbar spine, a higher prevalence of densitometric osteoporosis, and a higher prevalence of total and vertebral fractures. INTRODUCTION: Some lifestyles are related to the presence of osteoporosis and/or fragility fractures, whereas poverty is related to some lifestyles. Because of this, we studied the possible association of poverty with osteoporosis and fractures. METHODS: This was an observational, cross-sectional study performed in the Canary Islands, Spain. Participants consisted of a total of 1,139 ambulatory postmenopausal women aged 50 years or older with no previous osteoporosis diagnosis and who were enrolled in some epidemiological studies. The prevalence of fractures (vertebral and non-vertebral) and the prevalence of osteoporosis (T-score <-2.5 either at the lumbar spine or the femoral neck). A previously validated questionnaire elicited the most important risk factors for osteoporosis: socioeconomic status, defined by the annual income was also assessed by a personal interview. A dorso-lateral X-ray of the spine was performed, and bone mineral density (BMD) was measured by DXA in the lumbar spine (L2-L4) and proximal femur. RESULTS: Compared to women with a medium and high socioeconomic status (n = 665), those who were classified into poverty (annual family income lower than 6,346.80 Euros, in a one-member family, n = 474), were older and heavier and had lower height, lower prevalence of tobacco and alcohol consumption, lower use of HRT and higher use of thiazides. After correcting for age and body mass index (BMI), women in poverty had lower spine BMD values than women with a medium and high socioeconomic status (0.840 g/cm(2) vs. 0.867 g/cm(2), p = 0.005), but there were no statistical differences in femoral neck BMD between groups. The prevalence of osteoporosis was also higher in women in poverty [40.6% vs. 35.6%, (OR 1.35, CI 95%: 1.03; 1.76)] after adjusting by age and BMI. Moreover, 37.8% of women in poverty had a history of at least one fragility fracture compared to 27.7% of women not in poverty (OR: 1.45, CI 95%: 1.11; 1.90). The prevalence of vertebral fractures was also higher in women in poverty 24.7% vs. 13.4%, (OR 2.01, CI 95%: 1.44; 2.81). CONCLUSIONS: Postmenopausal women with low socioeconomic status had lower values of BMD at the lumbar spine, and a higher prevalence of densitometric osteoporosis, and a higher prevalence of total and vertebral fractures. Because of this, apart from the well known risk factors for osteoporosis, poverty should be taken into account as a possible risk factor for both osteoporosis and fragility fractures, in order to establish sanitary strategies to protect unfavoured postmenopausal women.


Assuntos
Fraturas Ósseas/epidemiologia , Osteoporose Pós-Menopausa/epidemiologia , Pobreza , Absorciometria de Fóton , Idoso , Índice de Massa Corporal , Densidade Óssea/fisiologia , Estudos Transversais , Feminino , Colo do Fêmur/diagnóstico por imagem , Humanos , Estilo de Vida , Vértebras Lombares/diagnóstico por imagem , Pessoa de Meia-Idade , Pós-Menopausa , Prevalência , Fatores de Risco , Espanha/epidemiologia , Fraturas da Coluna Vertebral/epidemiologia
18.
Exp Parasitol ; 120(4): 295-9, 2008 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-18713626

RESUMO

This paper describes the activity against Anisakis simplex s.l. L(3) larvae of six monoterpenic derivatives obtained from different essential oils, (alpha-pinene, beta-pinene, ocimene, myrcene, geranyl acetate, and cineole). In in vitro assays, alpha-pinene, ocimene and cineole showed high activity at a concentration of 125 microg/mL (48h) but only alpha-pinene and ocimene were active at 62.5 microg/mL. In in vivo assays, L(3) larvae and study compounds were simultaneously administered per os to Wistar rats. The most active compound was alpha-pinene, finding lesions in only 20% of treated rats versus 98% of controls. Further in vivo studies are required to investigate whether addition of these compounds to food could have a prophylactic effect, reducing the pathogenicity of A. simplex s.l. L(3) in humans, and to explore any possible synergy among compounds.


Assuntos
Anisaquíase/tratamento farmacológico , Anisakis/efeitos dos fármacos , Anti-Helmínticos/farmacologia , Monoterpenos/farmacologia , Animais , Anisaquíase/parasitologia , Anisaquíase/prevenção & controle , Anti-Helmínticos/química , Anti-Helmínticos/uso terapêutico , Feminino , Doenças dos Peixes/tratamento farmacológico , Doenças dos Peixes/parasitologia , Doenças dos Peixes/prevenção & controle , Gadiformes/parasitologia , Intestinos/efeitos dos fármacos , Intestinos/parasitologia , Larva/efeitos dos fármacos , Monoterpenos/química , Monoterpenos/uso terapêutico , Óleos Voláteis/química , Óleos Voláteis/farmacologia , Óleos Voláteis/uso terapêutico , Testes de Sensibilidade Parasitária , Cavidade Peritoneal/parasitologia , Ratos , Ratos Wistar , Estômago/efeitos dos fármacos , Estômago/parasitologia , Estômago/patologia
19.
An Sist Sanit Navar ; 31 Suppl 1: 127-40, 2008.
Artigo em Espanhol | MEDLINE | ID: mdl-18528449

RESUMO

Acute or sub-acute movement disorders represent a small percentage of neurological emergencies but it is necessary to be aware of their existence because a failure in their diagnosis or treatment can result in significant morbidity and mortality. Clinical presentation of acute movement disorders can be diverse. In some cases acinesia or rigidity predominates, while others are characterized by dystonia, chorea o balism. The type of movement disorder suggest a specific aetiology. Drugs represent the most frequent etiologic factor and are the cause of neuroleptic malignant syndrome and serotoninergic syndrome. Emergencies secondary to Parkinson's disease are reviewed, including parkinsonism-hyperpirexia syndrome, acute psychosis and the emergencies derived from deep brain stimulators. Different aetiologies of acute dystonia and chorea are also covered and, finally, acute movement disorders due to stroke are reviewed.


Assuntos
Tratamento de Emergência , Transtornos dos Movimentos , Doença Aguda , Algoritmos , Distonia/diagnóstico , Distonia/terapia , Humanos , Transtornos dos Movimentos/diagnóstico , Transtornos dos Movimentos/terapia , Doença de Parkinson/diagnóstico , Doença de Parkinson/terapia , Síndrome da Serotonina/diagnóstico , Síndrome da Serotonina/terapia
20.
Eur J Intern Med ; 19(1): 51-6, 2008 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-18206602

RESUMO

BACKGROUND: Daily doses higher than 7.5 mg/daily of prednisone or equivalents confer a great risk of vertebral and hip fractures with a clear dose dependence of fracture risk. Information regarding the utility in assessing trabecular bone mineral density by quantitative computer tomography (QCT) in these patients, either in the Canaries or in Spain, is lacking. Moreover, in this setting, the importance of secondary hyperparathyroidism is still controversial. DESIGN, PATIENTS AND METHODS: Cross-sectional observational study performed on 1177 consecutive Canary postmenopausal women who attended our Bone Metabolic Unit. The Patient Group was composed of 88 postmenopausal women who were taking oral corticosteroids in dose higher than 7.5 mg/day of prednisone or equivalent for more than 6 months (OG group). The Control Group included 838 postmenopausal women who did not take steroids. A complete validated questionnaire for osteoporosis risk assessment and a complete physical examination were performed. A lateral X-ray of the spine was performed on every woman. Bone mineral density (BMD) was measured at the lumbar spine (LS) by dual X-ray Absorptiometry (DXA) and QCT and at the femoral neck by DXA. Fasting serum and 24 hour urine was collected and biochemical markers of bone remodelling were studied. RESULTS: Both groups were comparable in general characteristics and calcium intake. The OG group showed lower values of BMD estimated both by DXA and QCT (p<0.05). LS BMD was closely correlated by using both methods (r=0.636, p<0.001). The OG group showed lower values of osteocalcin (p=0.023) and TRAP (p=0.026) without significant differences in PTH. Patients in OG group had a higher prevalence of vertebral fractures than controls (13.3% vs 8.6%; crude values: p=0.049, OR: 1.63 (0.99-2.67); age adjusted: p=0.003, OR 2.29 (1.33-9.93)). CONCLUSIONS: In postmenopausal Canarian women, chronic glucocorticoid therapy is associated with low bone mineral density, measured either by DXA or QCT, with evidence of low turnover and high prevalence of fractures without significant changes in PTH. DXA and QCT provide similar information in the assessment of this high risk population.


Assuntos
Glucocorticoides/efeitos adversos , Osteoporose Pós-Menopausa/induzido quimicamente , Osteoporose Pós-Menopausa/epidemiologia , Prednisona/efeitos adversos , Fraturas da Coluna Vertebral/induzido quimicamente , Fraturas da Coluna Vertebral/epidemiologia , Absorciometria de Fóton , Idoso , Densidade Óssea , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Osteoporose Pós-Menopausa/sangue , Osteoporose Pós-Menopausa/diagnóstico por imagem , Hormônio Paratireóideo/sangue , Espanha/epidemiologia , Fraturas da Coluna Vertebral/sangue , Tomografia Computadorizada por Raios X
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