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1.
Int J Colorectal Dis ; 39(1): 10, 2023 Dec 27.
Artigo em Inglês | MEDLINE | ID: mdl-38150157

RESUMO

PURPOSE: This study aims to adapt and validate the Cleveland Clinic Colorectal Cancer Quality of Life Questionnaire (CCF-CaQL) in Turkish, addressing the significant need for reliable, language-specific QoL measures for colorectal cancer (CRC) in Turkiye. This effort fills a critical gap in CRC patient care, enhancing both patient-provider communication and disease-specific QoL assessment. METHODS: The CCF-CaQL was translated into Turkish, verified for accuracy, and reviewed for clarity and relevance. Eligible patients who underwent colorectal surgery for cancer between July 2021 and July 2022 from six hospitals completed the CCF-CaQL and SF-36 questionnaires. For analysis, confirmatory factor analysis using Smart PLS 4 and descriptive statistics were employed. The questionnaire's reliability and validity were assessed using Cronbach alpha, composite reliability, and the heterotrait-monotrait (HTMT) ratio, along with multicollinearity checks and factor loadings. Nonparametric resampling was used for precise error and confidence interval calculations, and the Spearman coefficient and split-half method were applied for reliability testing. RESULTS: In the study involving 244 colorectal cancer patients, confirmatory factor analysis of the CCF-CaQL indicated effective item performance, with one item removed due to lower factor loading. The questionnaire exhibited high internal consistency, evidenced by a Cronbach alpha value of 0.909. Convergent validity was strong, with all average variance extracted (AVE) values exceeding 0.4. Discriminant validity was confirmed with HTMT coefficients below 0.9, and no significant multicollinearity issues were observed (VIF values < 10). Parallel testing with the SF-36 scale demonstrated moderate to very strong correlations, affirming the CCF-CaQL's comparability in measuring quality of life. CONCLUSION: The Turkish version of the CCF-CaQL was validated for assessing quality of life in colorectal cancer patients. This validation confirms its reliability and cultural appropriateness for use in Turkiye. The disease-specific nature of the CCF-CaQL makes it a useful tool in clinical and research settings, enhancing patient care by accurately monitoring treatment effects and interventions in the Turkish colorectal cancer patient population.


Assuntos
Neoplasias Colorretais , Qualidade de Vida , Humanos , Reprodutibilidade dos Testes , Turquia , Idioma , Neoplasias Colorretais/cirurgia
2.
Turk J Med Sci ; 48(6): 1278-1284, 2018 Dec 12.
Artigo em Inglês | MEDLINE | ID: mdl-30542596

RESUMO

Background/aim: Pneumoperitoneum with high pressure results in decreased glomerular filtration rates (GFRs). Cystatin-C (Cys-C), neutrophil gelatinase-associated lipocalin (NGAL), and interleukin 18 (IL-18) are new parameters in the evaluation of GFR instead of creatinine. The aim of this study is to show the effects of pneumoperitoneum on renal function with the help of these new acute kidney injury markers. Materials and methods: Sixty rats were divided into 10 groups according to the length of time and degree of pneumoperitoneum pressure achieved during CO2 insufflation: 0 mmHg (control) for 1 h; 4 mmHg for 1, 2, and 4 h; 8 mmHg for 1, 2, and 4 h; and 12 mmHg for 1, 2, and 4 h. Serum samples were obtained to measure the serum creatinine, blood urea nitrogen (BUN), Cys-C, NGAL, and IL-18. Results: There were no differences between the serum creatinine levels of the groups. Serum levels of BUN, Cys-C, NGAL, and IL-18 were significantly increased in the 2nd hour of the experiment. This increase was more prominent at high pressures. Conclusion: Although serum creatinine is a practical way of estimating GFR, it has been shown that Cys-C, NGAL, and IL-18 are superior in the estimation of decreased GFR in pneumoperitoneum.

3.
Ulus Cerrahi Derg ; 30(4): 225-7, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25931935

RESUMO

Dieulafoy lesion should be considered in massive gastrointestinal bleeding that may be difficult to localize. If the endoscopic and angiographic approaches fail, surgery must be considered according to the patient's clinical condition within an appropriate time. Although mostly seen in the stomach of old male patients with co-morbidities, here we presented a Dieulafoy lesion in the jejunum of a 21-year-old female patient without any significant comorbidity. After endoscopic and angiographic attempts, surgical resection with the help of intraoperative endoscopy was performed. It was shown that perioperative endoscopy may reveal the localization of jejunal bleedings and may guide the definitive treatment.

4.
Acta Med Port ; 37(7-8): 556-559, 2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-38785172

RESUMO

Anorectal malignant melanoma, a rare and aggressive tumor, lacks specific symptoms and frequently presents diagnostic challenges due to its similarity to benign anorectal conditions. This case report describes the diagnostic and treatment process of incidentally discovered anorectal malignant melanoma post-hemorrhoidectomy, guided by the existing literature.


Assuntos
Neoplasias do Ânus , Hemorroidectomia , Melanoma , Neoplasias Retais , Humanos , Melanoma/cirurgia , Hemorroidectomia/efeitos adversos , Neoplasias do Ânus/cirurgia , Neoplasias do Ânus/patologia , Neoplasias Retais/cirurgia , Neoplasias Retais/patologia , Masculino , Pessoa de Meia-Idade , Hemorroidas/cirurgia , Achados Incidentais , Feminino
5.
Clin Exp Med ; 24(1): 173, 2024 Jul 28.
Artigo em Inglês | MEDLINE | ID: mdl-39069567

RESUMO

Idiopathic granulomatous mastitis (IGM) is a benign, chronic inflammatory lesion of the breast. Immunoglobulin G4 (IgG4) associated disease is rare in the breast. In our study, we aimed to evaluate the efficacy of steroid treatment on IgG4 levels in tissue in patients diagnosed with IGM. Between 2008 and 2017, 55 patients diagnosed with IGM in our clinic were included in the study. Demographic, clinical, microbiologic and histopathologic characteristics, treatment modality and recovery time were evaluated retrospectively. Patients were divided into 3 groups according to tissue IgG4 levels: negative (Group I), infrequently and slightly positive (Group II), and highly positive (Group III). Group I patients had a complete response rate of 77.8%. In the rest of the patients (22.2%), insufficient response was detected from the beginning of the treatment. In Group II, the response rate was 91.3% and the permanent success rate after treatment was 87.0%. Although group III patients had a complete response at the beginning (95.65%), they relapsed in a short period of time (26.1%) after discontinuation of steroid treatment. At least one steroid-related side effect was observed in 47 (85.8%) patients in all groups. There is no consensus on the dose and duration of immunosuppressive treatment in IGM. In this study, responses to steroid treatment according to IgG4 concentration in pathologic breast tissue and recurrences after the end of treatment were determined. We think that high IgG4 concentration in the tissue is associated with recurrence and other immunosuppressive drugs should be added as maintenance after steroid treatment.


Assuntos
Mastite Granulomatosa , Imunoglobulina G , Humanos , Feminino , Mastite Granulomatosa/tratamento farmacológico , Adulto , Estudos Retrospectivos , Pessoa de Meia-Idade , Resultado do Tratamento , Esteroides/uso terapêutico , Adulto Jovem , Mama/patologia , Recidiva
6.
Curr Med Imaging ; 2023 Nov 07.
Artigo em Inglês | MEDLINE | ID: mdl-37957874

RESUMO

BACKGROUND: Benign multicystic peritoneal mesothelioma is a multiloculated cystic mass which originates from the peritoneum. This rare tumor is usually seen in women of childbearing age and has a high recurrence rate after surgery. CASE PRESENTATION: We present two benign multicystic peritoneal mesothelioma cases with different imaging modalities, which were also pathologically proven. CONCLUSION: The imaging features which may be diagnostic should be well known as there are very few reports regarding this entity.

7.
Neurobiol Dis ; 48(3): 488-94, 2012 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-22813864

RESUMO

Huntington's disease (HD) is characterized by neuronal loss in the striatum, ultimately leading to an 'imbalance' in the electrical activity of the basal ganglia-thalamocortical circuits. To restore this 'imbalance' in HD patients, which is held responsible for (some) of the motor symptoms, different basal ganglia nuclei have been targeted for surgical therapies, such as ablative surgery and deep brain stimulation. However, evidence to target brain nuclei for surgical therapies in HD is lacking. We reasoned that a neuronal and metabolic mapping of the basal ganglia nuclei could identify a functional substrate for therapeutic interventions. Therefore, the aim of the present study was to investigate the metabolic and neuronal activity of basal ganglia nuclei in a transgenic rat model of HD (tgHD). Subjects were 10-12 month old tgHD rats and wildtype littermates. We examined the striatum, globus pallidus, entopeduncular nucleus, the subthalamic nucleus and substantia nigra at different levels. First, we determined the overall neuronal activity at a supracellular level, by cytochrome oxidase histochemistry. Secondly, we determined the subcellular metabolic activity, by immunohistochemistry for peroxisome proliferator-activated receptor-γ transcription co-activator (PGC-1α), a key player in the mitochondrial machinery. Finally, we performed extracellular single unit recordings in the nuclei to determine the cellular activity. In tgHD rats, optical density analysis showed a significantly increased cytochrome oxidase levels in the globus pallidus and subthalamic nucleus when compared to controls. PGC-1α expression was only enhanced in the subthalamic nucleus and electrophysiological recordings revealed decreased firing frequency of the majority of the neurons in the globus pallidus and increased firing frequency of the majority of the neurons in the subthalamic nucleus. Altogether, our results suggest that the globus pallidus and subthalamic nucleus play a role in the neurobiology of HD and can be potential targets for therapeutic interventions.


Assuntos
Gânglios da Base/metabolismo , Gânglios da Base/fisiopatologia , Doença de Huntington/metabolismo , Doença de Huntington/fisiopatologia , Animais , Modelos Animais de Doenças , Imuno-Histoquímica , Masculino , Técnicas de Patch-Clamp , Ratos , Ratos Transgênicos
8.
Arch Iran Med ; 25(11): 730-736, 2022 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-37543897

RESUMO

BACKGROUND: Prophylactic central lymph node dissection (CLND) in papillary thyroid carcinoma (PTC) is still controversial. This study aimed to analyze the factors related to the patient and tumor characteristics affecting central lymph node metastasis (CLNM) in PTC patients and to evaluate the contribution of the results to shaping the surgical treatment algorithm. METHODS: Two hundred and fifty-five PTC patients who underwent total thyroidectomy and CLND were evaluated retrospectively. Histopathology reports were examined to reveal tumor characteristics. The CLNM ratio and the relationship between CLNM with clinicopathological and demographic characteristics were analyzed. RESULTS: The incidence of CLNM was 54.9% (95 CI%: 49-60.8). Male gender (P=0.027), age<45 years (P=0.016), tumor size≥9.5 mm (P<0.001), lymphovascular invasion (P<0001) and extracapsular invasion (P=0.007) were factors that increased the risk of metastasis. The follicular variant decreased the risk (P=0.010). There was no relationship between CLNM and focality (P=0.054). A low-to-moderate correlation was found between tumor diameter and the metastatic lymph node (MLN) number/total lymph node number ratio (r=0.396, P<0.001). CONCLUSION: A selective prophylactic CLND strategy can be applied in cN0 patients. As the tumor diameter increases in PTC, both the risk of CLNM and the number of MLN increase. Lymphovascular and extracapsular invasion are other factors that increase the risk. The follicular variant is associated with a lower risk of CLNM. Male patients who are under the age of 45 and have a tumor diameter of 9.5 mm or more are definite candidates for prophylactic CLND.


Assuntos
Carcinoma Papilar , Neoplasias da Glândula Tireoide , Humanos , Masculino , Pessoa de Meia-Idade , Câncer Papilífero da Tireoide/cirurgia , Câncer Papilífero da Tireoide/patologia , Neoplasias da Glândula Tireoide/cirurgia , Neoplasias da Glândula Tireoide/patologia , Metástase Linfática/patologia , Estudos Retrospectivos , Carcinoma Papilar/cirurgia , Carcinoma Papilar/patologia , Fatores de Risco , Linfonodos/cirurgia , Linfonodos/patologia
9.
Turk J Surg ; 38(4): 413-417, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36875267

RESUMO

Gardner's syndrome (GS) is a very rare autosomal dominant multisystem disease. Osteomas, skin and soft tissue tumors are present with gastrointestinal polyposis. The polyps have very high malignancy potentials. If prophylactic resection is not performed, colorectal cancer development is inevitable in all patients with GS. Polyposis is usually asymptomatic. Therefore, careful evaluation of extraintestinal findings of the disease is very important for early diagnosis. In this article, diagnosis and treatment of GS are presented in monozygotic twins, which have not been previously described in the literature. The diagnostic process, which started with dental complaints of one case, was carried out in an effective manner and then, prophylactic surgery was performed in twins. This article aimed to make clinicians and dentists attentive for early diagnosis of disease and to review treatment options.

10.
Pol Przegl Chir ; 94(6): 46-53, 2022 Feb 23.
Artigo em Inglês | MEDLINE | ID: mdl-36468509

RESUMO

<b> Introduction:</b> Inguinal hernia repair is the most common operation worldwide. The essential factors in hernia repair have been the postoperative quality of life, early return to work, low recurrence rate, and chronic pain prevention. </br></br> <b>Aim:</b> The aim of this study was to compare the short- and long-term results of the self-adhesive mesh and the conventional polypropylene mesh in Lichtenstein repair. </br></br> <b> Material and methods:</b> A total of 100 male patients were randomized and operated on, 50 with the self-adhesive mesh (S group), 50 with the conventional polypropylene mesh (P group). Prospectively, the patients were followed for an average of 36 months. The two groups were compared for the duration of surgery, duration of hospital stay, duration of daily activity/resumption of work, postoperative pain, chronic pain, recurrence, wound infection, hematoma/seroma formation, and postoperative analgesic consumption. </br></br> <b>Results:</b> The study involved 39 patients in the P group and 37 patients in the S group who underwent inguinal hernia surgery. The P group had a longer mean operation time than the S group, and the difference between the two groups was statistically significant (45.1 ± 6.6 min vs. 28.8 ± 3.0 min, P = 0.0001). In recurrence, postoperative discomfort, chronic pain, length of hospital stay, daily activity/return to work, wound infection, hematoma/seroma, and postoperative analgesic use, there was no statistically significant difference between the two groups. </br></br> <b>Conclusion:</b> It was found that the self-adhesive mesh did not produce statistically significant advantages over the conventional polypropylene mesh, except for operative time, in the Lichtenstein repair.


Assuntos
Dor Crônica , Hérnia Inguinal , Humanos , Masculino , Estudos Prospectivos , Hérnia Inguinal/cirurgia , Polipropilenos/uso terapêutico , Cimentos de Resina , Adesivos , Seroma , Qualidade de Vida , Telas Cirúrgicas , Hematoma
11.
Turk J Surg ; 37(1): 76-79, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34585099

RESUMO

Esophageal melanocytosis is a rare clinical and pathological condition characterized by non-atypical melanocytic proliferation and increased melanin in the esophageal mucosa, which is normally histologically non-melanocytic. Intensive melanin accumulation and hyperpigmentation are necessary for endoscopic recognition. Due to the fact that it is a rare gastrointestinal system pathology, experience and knowledge about its diagnosis, treatment and course are also limited. Although it is argued that chronic stimulating factors have an influence, there is no clear information about its etiology and pathogenesis. Malignant melanomas and melanocytic nevus in particular come to the fore in the differential diagnosis. Opinions and findings indicating that melanocytosis may be a precursor for malignant melanoma make the recognition and follow-up of this clinical and pathological entity more important. In this article, a patient with esophageal melanocytosis diagnosed by endoscopic evaluation is presented, with the aim of increasing the awareness of clinicians, especially endoscopists and pathologists, on this subject.

12.
Pol Przegl Chir ; 93(6): 40-46, 2021 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-36169540

RESUMO

<b>Introduction:</b>Minimizing recurrence in hernia surgery is one of the major aims. Defining surgeon-dependent risk factors for recurrence is therefore of great importance in laparoscopic ventral hernia repair (LVHR). This study aims to analyze the predictive value of the mesh area/defect area ratio (M/D ratio) in terms of recurrence as a new criterion in LVHR.</br> </br> <b>Methods:</b> A total of 124 patients were enrolled in the study. Age, gender, hernia type, body mass index, defect size, size of the mesh, mesh overlapping, area of the defect, area of the mesh, M/D ratio, postoperative complications, follow-up time, recurrences and timing of recurrence were also recorded. The potential variables that may affect recurrence were examined by univariate and multivariate analysis.</br> </br> <b>Results:</b> There were 12 (9.7%) recurrences in our series. A statistically significant difference was found if either the mesh/defect ratio was ≤6 or >6 (p = 0.012). Multivariate analysis confirmed that M/D ratio was the only independent parameter for recurrence. </br></br><b>Conclusion:</b> Understanding M/D ratio concept and using it in surgical clinical practice may help reduce recurrence rates after LVHR.</br>.


Assuntos
Hérnia Ventral , Herniorrafia , Laparoscopia , Feminino , Hérnia Ventral/etiologia , Hérnia Ventral/cirurgia , Herniorrafia/efeitos adversos , Humanos , Laparoscopia/efeitos adversos , Masculino , Recidiva , Telas Cirúrgicas/efeitos adversos
13.
Exp Clin Transplant ; 19(9): 914-918, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34085914

RESUMO

OBJECTIVES: Deceased donor renal transplant is an accepted treatment for patients with end-stage renal disease. We retrospectively analyzed urological and surgical complications and outcomes in our series. MATERIALS AND METHODS: Since 2016, we have performed 263 renal transplants at the Gazi University Transplantation Center, Ankara, and 92 of these were from deceased donors. We retrospectively analyzed outcomes of these 92 deceased donor transplants from our database records. There were 45 female and 47 male recipients, and 20 were pediatric recipients. Mean recipient and donor ages were 36 ± 14 and 38 ± 18 years old, respectively. Immunosuppression therapy consisted of steroids, mycophenolate, and calcineurin inhibitors. Induction therapy was 20 mg basiliximab (Simulect) on day 0 and day 4. Antithymocyte globulin (2 mg∕kg) was used in steroid-resistant acute rejection cases. RESULTS: There were 13 surgical complications (14.1%) after 92 consecutive deceased donor renal transplants, and 4 of these were classified as miscellaneous surgical complications. Four of 9 cases were early, and the rest were classified as late complications. Postoperative early complications were bleeding (n = 2), urine leak (n = 1), and renal artery thrombosis (n = 1). Lymphoceles (n = 4) and urine leak (n = 1) occurred as late complications. Postoperative median follow-up was 78 months, during which 11 grafts (12%) were lost and 7 patients (7.6%) died from sepsis (n = 4), myocardial infarction, aortic dissection, and fungal pneumonia. No patients died from any surgical complications. The 1-year, 5-year, and 10-year survival rates of patients were 98%, 94%, and 94% and for grafts were 97%, 94%, and 88%, respectively. CONCLUSION: Despite the limited number of deceased donor organs, improvements of surgical techniques at our center have facilitated success with deceased donor renal transplant at rates similar to other successful centers in the world.


Assuntos
Transplante de Rim , Basiliximab , Criança , Feminino , Rejeição de Enxerto/etiologia , Rejeição de Enxerto/prevenção & controle , Sobrevivência de Enxerto , Humanos , Transplante de Rim/métodos , Masculino , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos , Esteroides , Doadores de Tecidos , Resultado do Tratamento
14.
Ir J Med Sci ; 190(3): 1117-1122, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33078264

RESUMO

BACKGROUND: Idiopathic granulomatous mastitis (IGM) is a benign and rare chronic inflammatory disease of the breast with unknown etiology. While there is no consensus regarding its post-diagnosis management, there are different treatment alternatives. AIMS: In this study, it was aimed to question the effectiveness of follow-up strategy without administering any treatment. METHODS: One hundred eighteen female patients diagnosed with IGM were retrospectively evaluated. Patients with histopathologically confirmed IGM were included in the study. Medical treatment was given only to patients who did not accept the follow-up option without treatment. The protocol used in steroid therapy was 16 mg prednisolone twice daily for 2 weeks, and then the dose was gradually reduced, and the treatment was stopped after 2 months. Patients were followed up with a physical examination every 3 months. The effectiveness of the systemic corticosteroid treatment and the follow-up approach without any treatment was compared. The recurrence rates and pre-treatment and post-treatment methods of the patients were examined. RESULTS: While 30.5% of the patients recovered with corticosteroid treatment, 42.4% recovered under observation without any treatment. The mean recovery period of the patients in these two groups was calculated as 3.9 months and 5.6 months, respectively. However, no statistically significant difference was found in terms of recovery period (p = 0.064). The recurrence rate was 11.9%. CONCLUSION: For IGM, the "watch and wait" approach is an effective option. A chance should be given to the self-limiting nature of the disease with the addition of drainage when necessary.


Assuntos
Mastite Granulomatosa , Corticosteroides/uso terapêutico , Feminino , Mastite Granulomatosa/tratamento farmacológico , Humanos , Prednisolona/uso terapêutico , Estudos Retrospectivos , Resultado do Tratamento
15.
Turk J Gastroenterol ; 32(2): 218-224, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33960947

RESUMO

BACKGROUND: Selective versus routine histopathological examination after cholecystectomy is still in debate. This study aims to investigate the effect of histopathology results on treatment modality and surgery strategy. The validity of the selective histopathology approach was questioned. METHODS: The data of patients undergoing laparoscopic cholecystectomy between January 2009 and December 2019 were retrospectively analyzed. The demographics and histopathology results, whether the operation was emergent or elective, and the reasons for conversion to open surgery were recorded. Malignant and precursor histopathology diagnoses were examined, and their relationship with the surgical strategy was questioned. RESULTS: A total of 2723 patients were included in the study. Of these patients, 2600 (95.5%) were operated under elective, while 123 (4.5%) were operated under emergency conditions. While the surgery was completed laparoscopically in 2685 (98.6%) patients, it was converted to open surgery in 38 (1.4%) patients. Age, gender, the presence of primary gallbladder cancer, acute cholecystitis, and xanthogranulomatous cholecystitis in histopathological examination were found to be independent predictive factors for conversion to open surgery (P < .05). The rate of primary invasive carcinoma in the series was 0.1%. CONCLUSION: Routine histopathological examination of the gallbladder is important for demonstrating a wide spectrum of pathological changes in this organ. Invasive cancer or precursor lesions can be detected even in patients without any macroscopic abnormality. Histopathological examination also plays a role in determining follow-up, further examination, and treatment modality in addition to the diagnosis in these patients.


Assuntos
Colecistectomia Laparoscópica , Colecistite , Colecistectomia , Colecistite/cirurgia , Humanos , Estudos Retrospectivos
16.
Sisli Etfal Hastan Tip Bul ; 54(4): 457-462, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33364887

RESUMO

OBJECTIVES: Acute appendicitis during pregnancy may be associated with severe maternal and fetal complications. The clinical, laboratory and radiological parameters used in diagnosis and the effects of the surgical method and timing on the results are controversial. The present study aims to reveal the relationship between clinical approach, surgical treatment methods and complications in pregnant women with suspected acute appendicitis. METHODS: Between December 2007 and August 2019, 21 pregnant women who underwent appendectomy were included in this study. Age, gestational age, complaints at admission, leukocyte count, radiological examination results, type of surgery (conventional or laparoscopic), histopathology results, time from admission to operation, maternal and fetal complications were retrospectively evaluated. RESULTS: The number of patients who developed complications was six (28.6%). Three (14.3%) of these patients had preterm birth and three (14.3%) had an abortion. There was no statistically significant relationship between trimester and complication (p=0.747). Fourteen patients (66.7%) underwent laparoscopic surgery and seven patients (33.3%) underwent conventional surgery. Although the complication rate was higher in the laparoscopic group, there was no statistically significant difference (p=0.306). The fetal loss rate in the series was 14.3% and all were in the laparoscopic group. However, there was no statistically significant difference between the groups (p=0.158). CONCLUSION: Pregnancy-related limiting factors may complicate the diagnosis of acute appendicitis. These patients definitely need a more skeptical assessment and additional diagnostic tools beyond the standard clinical approach. Although laparoscopic appendectomy appears to be a safe option in treatment, its relationship with a higher risk of fetal loss should be kept in mind.

17.
PLoS One ; 15(10): e0241691, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33125440

RESUMO

Behçet's Syndrome (BS) is a multisystem vasculitis with various clinical manifestations. Pathogenesis is unclear, but studies have shown genetic factors, innate immunity and autoinflammation to have an important role in the disease course. Diversity in the microbial community of gut microbiota may significantly contribute to the activation of the innate immune system. The clinical features of BS present themselves in clusters and each cluster may be a consequence of different disease mechanisms. For this reason we aimed to investigate the gut microbiota of BS patients with uveitis. In addition to healthy controls, we have aimed to compare the gut microbiota of BS with that of Familial Mediterranean Fever (FMF) and Crohn's Disease (CD) as both diseases have innate and autoinflammatory features in their pathogenesis. Seven patients with BS, 12 patients with FMF, 9 patients with CD and 16 healthy controls (HC) were included in the study. Total genomic DNAs were isolated from fecal samples of the patients. Partial 16S rRNA gene was sequenced using the PGM Ion Torrent (Thermo Fisher Scientific, Waltham, MA, USA) for microbiota analysis. Statistical analysis showed that significant differences were detected on the microbial community of four groups. Succinivibrionaceae is dominant and the signature family, whereas Bacteroides was absent in BS patients.


Assuntos
Síndrome de Behçet/complicações , Fezes/microbiologia , Infecções por Bactérias Gram-Negativas/complicações , Succinivibrionaceae/isolamento & purificação , Uveíte/complicações , Adulto , Síndrome de Behçet/microbiologia , Feminino , Infecções por Bactérias Gram-Negativas/microbiologia , Humanos , Masculino , Uveíte/microbiologia
18.
Epilepsia ; 50(7): 1760-7, 2009 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-19453709

RESUMO

PURPOSE: Several results support the conclusion that the cannabinoid system has a role in generation and cessation of epileptic seizures. The aim of this study was to evaluate the effects of intracerebroventricular AM-251 [N-(piperidin-1-yl)-5-(4-iodophenyl)-1-(2,4-dichlorophenyl)-4-methyl-1H-pyrazole-3-carboxamide], a CB1-receptor antagonist, and ACEA (arachidonyl-2-chloroethylamide), a CB1-receptor agonist, on penicillin-induced epileptiform activity in rats. METHODS: In the first set of experiments, 30 min after penicillin injection, AM-251, at doses of 0.125, 0.25, 0.5, and 1 µg, was administered intracerebroventricularly (i.c.v.). In the second set of experiments, 30 min after penicillin injection, ACEA, at doses of 2.5, 5, 7.5, and 15 µg (i.c.v.), was administered. In the third set of experiments, AM-251, at doses of 0.125 and 0.25 µg (i.c.v.), was administered 10 min before ACEA (7.5 µg, i.c.v.) injection. RESULTS: ACEA, at a dose of 7.5 µg, significantly decreased the frequency of penicillin-induced epileptiform activity without changing the amplitude. ACEA, at doses of 2.5, 5, and 15 µg, had no impact on either frequency or amplitude of epileptiform activity. AM-251, at doses of 0.25 and 0.50 µg, significantly increased the frequency of epileptiform activity. AM-251, at a dose of 0.25 µg (i.c.v.), was the most effective in changing the frequency of penicillin-induced epileptiform activity, and it also caused status epilepticus-like activity. AM-251, at doses of 0.125 and 0.25 µg, 10 min before ACEA (7.5 µg), reversed the anticonvulsant action of ACEA. DISCUSSION: The results of the present study provide electrophysiologic evidence for the role of CB1 receptors in regulating the frequency of epileptiform activity in the model of penicillin-induced epilepsy. To elucidate the precise mechanism of cannabinoid action in the brain during seizure, more advanced electrophysiologic and neurochemical studies are required.


Assuntos
Ácidos Araquidônicos/farmacologia , Canabinoides/farmacologia , Epilepsia/induzido quimicamente , Epilepsia/prevenção & controle , Penicilinas , Piperidinas/farmacologia , Pirazóis/farmacologia , Receptor CB1 de Canabinoide/antagonistas & inibidores , Animais , Anticonvulsivantes/farmacologia , Ácidos Araquidônicos/administração & dosagem , Encéfalo/efeitos dos fármacos , Encéfalo/fisiopatologia , Córtex Cerebral/efeitos dos fármacos , Córtex Cerebral/fisiopatologia , Modelos Animais de Doenças , Relação Dose-Resposta a Droga , Eletroencefalografia/estatística & dados numéricos , Epilepsia/fisiopatologia , Injeções Intraventriculares , Masculino , Piperidinas/administração & dosagem , Pirazóis/administração & dosagem , Ratos , Receptor CB1 de Canabinoide/fisiologia , Convulsões/induzido quimicamente
19.
Acta Neurobiol Exp (Wars) ; 69(2): 177-88, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19593332

RESUMO

The present study was designed to investigate the influence of acute ethanol intake and its withdrawal on the anticonvulsant effect of alpha-tocopherol in penicillin-induced epileptiform activity. Ethanol-treated rats received a daily dose of 3 g/kg or 9.0 g/kg of 30% ethanol solution for 3 days. Thirty minutes after penicillin injection (500 units, i.c.) the most effective dose of alpha-tocopherol (500 mg/kg) was administered intramuscularly (i.m.). Acute administration of ethanol, in a dose of 3 g/kg, did not change either frequency or amplitude of penicillin-induced epileptiform activity, while dose of 9 g/kg ethanol significantly decreased the mean frequency of penicillin-induced epileptiform ECoG activity in the ethanol-treated group. Ethanol (9 g/kg) withdrawal also caused an increase in the amplitude of epileptiform ECoG activity in the withdrawal group. The results suggest that acute administration of high dose ethanol (9 g/kg) and alpha-tocopherol have some limited anticonvulsive effects in penicillin-induced epileptiform activity in rats.


Assuntos
Antioxidantes/farmacologia , Epilepsia/induzido quimicamente , Epilepsia/fisiopatologia , Penicilinas , alfa-Tocoferol/farmacologia , Consumo de Bebidas Alcoólicas , Convulsões por Abstinência de Álcool , Análise de Variância , Animais , Modelos Animais de Doenças , Relação Dose-Resposta a Droga , Interações Medicamentosas , Eletroencefalografia/métodos , Epilepsia/tratamento farmacológico , Etanol/efeitos adversos , Masculino , Ratos , Ratos Wistar
20.
Anat Sci Int ; 83(3): 131-9, 2008 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-18956784

RESUMO

The vestibular system helps the body to maintain equilibrium. There are four vestibular nuclei on the right and left sides, the medial vestibular nucleus being the largest. The volumes and total numbers of neurons in the left and right medial vestibular nuclei of adult male and female rats were estimated using stereological techniques. The volumes of the left and right medial vestibular nucleus were 0.67 +/- 0.03 mm3 and 0.71 +/- 0.02 mm3 in the female, and 0.55 +/- 0.02 mm3 and 0.61 +/- 0.03 mm3 in the male rats, respectively. Total neuron numbers in the left and right medial vestibular nuclei were 19.364 +/- 791 and 20.978 +/- 784 in the female, and 16.905 +/- 229 and 15.547 +/- 439 in the male rats, respectively. No asymmetry in volume was found between the left and right sides in either sex; but a significant difference in volume was observed for the right medial vestibular nucleus between male and female rats. A significant difference in total neuron number between the left and right medial vestibular nuclei was observed in female and male rats: in male rats, left > right; in female rats, right > left. There was also a significant difference between male and female rats with regard to total number of neurons in the medial vestibular nuclei, the female having more neurons than the male on both sides, that is, female > male. These results indicate that neuron number in the medial vestibular nucleus shows laterality in the same sex, and a female-based sexual dimorphism.


Assuntos
Ratos Wistar/anatomia & histologia , Caracteres Sexuais , Núcleos Vestibulares/anatomia & histologia , Animais , Contagem de Células , Feminino , Masculino , Neurônios/citologia , Ratos , Núcleos Vestibulares/citologia
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