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1.
Ultrasound Obstet Gynecol ; 57(1): 164-172, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-32484286

RESUMEN

OBJECTIVE: To describe the ultrasound features of different endometrial and other intracavitary pathologies inpre- and postmenopausal women presenting with abnormal uterine bleeding, using the International Endometrial Tumor Analysis (IETA) terminology. METHODS: This was a prospective observational multicenter study of consecutive women presenting with abnormal uterine bleeding. Unenhanced sonography with color Doppler and fluid-instillation sonography were performed. Endometrial sampling was performed according to each center's local protocol. The histological endpoints were cancer, atypical endometrial hyperplasia/endometrioid intraepithelial neoplasia (EIN), endometrial atrophy, proliferative or secretory endometrium, endometrial hyperplasia without atypia, endometrial polyp, intracavitary leiomyoma and other. For fluid-instillation sonography, the histological endpoints were endometrial polyp, intracavitary leiomyoma and cancer. For each histological endpoint, we report typical ultrasound features using the IETA terminology. RESULTS: The database consisted of 2856 consecutive women presenting with abnormal uterine bleeding. Unenhanced sonography with color Doppler was performed in all cases and fluid-instillation sonography in 1857. In 2216 women, endometrial histology was available, and these comprised the study population. Median age was 49 years (range, 19-92 years), median parity was 2 (range, 0-10) and median body mass index was 24.9 kg/m2 (range, 16.0-72.1 kg/m2 ). Of the study population, 843 (38.0%) women were postmenopausal. Endometrial polyps were diagnosed in 751 (33.9%) women, intracavitary leiomyomas in 223 (10.1%) and endometrial cancer in 137 (6.2%). None (0% (95% CI, 0.0-5.5%)) of the 66 women with endometrial thickness < 3 mm had endometrial cancer or atypical hyperplasia/EIN. Endometrial cancer or atypical hyperplasia/EIN was found in three of 283 (1.1% (95% CI, 0.4-3.1%)) endometria with a three-layer pattern, in three of 459 (0.7% (95% CI, 0.2-1.9%)) endometria with a linear endometrial midline and in five of 337 (1.5% (95% CI, 0.6-3.4%)) cases with a single vessel without branching on unenhanced ultrasound. CONCLUSIONS: The typical ultrasound features of endometrial cancer, polyps, hyperplasia and atrophy and intracavitary leiomyomas, are described using the IETA terminology. The detection of some easy-to-assess IETA features (i.e. endometrial thickness < 3 mm, three-layer pattern, linear midline and single vessel without branching) makes endometrial cancer unlikely. Copyright © 2020 ISUOG. Published by John Wiley & Sons Ltd.


Asunto(s)
Endometrio/patología , Enfermedades Uterinas/diagnóstico , Adulto , Endometrio/diagnóstico por imagen , Femenino , Humanos , Persona de Mediana Edad , Estudios Prospectivos , Ultrasonografía , Hemorragia Uterina/epidemiología , Hemorragia Uterina/etiología
2.
Climacteric ; 23(4): 330-335, 2020 08.
Artículo en Inglés | MEDLINE | ID: mdl-32648827

RESUMEN

Endometrial cancer is the most common gynecological malignancy with a relatively good overall prognosis. It traditionally has two subtypes: type 1 (endometrioid carcinoma) and type 2 (non-endometrioid carcinoma). The prognosis is excellent for stage I endometrioid cancer, with a 5-year survival rate of 96%. However, the prognosis is much worse for women with high-risk endometrial cancer. Effective preoperative staging is important in order to tailor treatment and achieve optimal long-term survival. The majority of asymptomatic polyps detected by ultrasound are treated surgically. Conventionally, dilatation and curettage was performed to obtain a histological diagnosis, but nowadays hysteroscopy with biopsy is starting to be considered as the gold standard. Hysteroscopic resection seems to reduce the risk of underdiagnosed (atypical endometrial hyperplasia) endometrial cancer. To avoid the spread of malignant cells, hysteroscopy should be performed with concern to keep intrauterine pressure low. In comparison with cervical injection, the hysteroscopic method has a better detection rate in the para-aortic area during sentinel lymph node mapping. In the assessment of cervical involvement, the accuracy of magnetic resonance imaging is significantly higher than the accuracy of hysteroscopy. In fertility-sparing cases, hysteroscopic endometrium resection with progesterone therapy is an acceptable option.


Asunto(s)
Neoplasias Endometriales/cirugía , Endometrio/cirugía , Histeroscopía/métodos , Cuello del Útero/cirugía , Femenino , Humanos
3.
Climacteric ; 23(4): 325-329, 2020 08.
Artículo en Inglés | MEDLINE | ID: mdl-32648828

RESUMEN

Introduction: Most endometrial polyps represent focal hyperplasia of the endometrium. Endometrial polyps can be diagnosed by ultrasound, hysterocontrast sonography, hysterosalpingography, endometrial biopsy, and uterine curettage, but diagnostic hysteroscopy is considered the gold-standard method, with the greatest sensitivity and specificity and also with the opportunity for treatment at the same time.Study design: A retrospective study was conducted on 424 patients between 2006 and 2018. The polyps were verified during diagnostic hysteroscopy and were removed by resectoscopy or curettage. All samples underwent histological examination. The effectivity of the type of resection and the recurrence rate were evaluated.Results: The average age of the patients was 60.2 ± 9.3 years. Polyps were excised in 62.97% by resectoscopic polypectomy and in 37.03% by curettage. Malignancy was confirmed in 4.24% of cases. Histological verification of polyps was 79.4% in the resectoscopy group and 69.04% in the curettage group; the difference was significant (p < 0.01). The recurrence rate was 20.47% after resectoscopy and 27.12% following curettage.Conclusion: Hysteroscopy remains the best option and the gold-standard method among diagnostic procedures of endometrial pathology. In this study, there was a significant difference in matching hysteroscopic and histological findings in the two methods of polypectomy. The recurrence rate is also lower following resectoscopy.


Asunto(s)
Legrado/métodos , Neoplasias Endometriales/cirugía , Histeroscopía/métodos , Recurrencia Local de Neoplasia/epidemiología , Pólipos/cirugía , Adulto , Anciano , Anciano de 80 o más Años , Neoplasias Endometriales/patología , Endometrio/patología , Endometrio/cirugía , Femenino , Humanos , Persona de Mediana Edad , Recurrencia Local de Neoplasia/etiología , Pólipos/patología , Posmenopausia , Periodo Posoperatorio , Estudios Retrospectivos , Estadísticas no Paramétricas , Resultado del Tratamiento
5.
Andrologia ; 47(5): 519-24, 2015 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-24890860

RESUMEN

The aim of the study was to statistically prove that the HBA(®) test is an efficient practical method for andrologists to determine the fertility potential as well as to measure the efficiency of oral supplement therapy in case of male infertility. In the study, 175 patients were involved and it also included the follow-up studies of 39 patients after supplement therapy. Completing the 'classic' spermatological parameters with the results of HBA(®) test, the authors have also determined a new fertility index to be used for practical rating of the measure of fertility potential. After the supplement therapy, both sperm density and hyaluronan binding capacity increased significantly. The authors are convinced that the HBA(®) analysis is an objective, standardisable test, which provides a better approach to fertility potential. This analysis enables us to detect spermatozoa that were previously misjudged as normal by morphological assay and also makes the efficiency of the therapy more measurable.


Asunto(s)
Suplementos Dietéticos , Receptores de Hialuranos/metabolismo , Infertilidad Masculina/metabolismo , Oligoelementos/uso terapéutico , Adulto , Humanos , Infertilidad Masculina/diagnóstico , Infertilidad Masculina/tratamiento farmacológico , Masculino , Unión Proteica , Recuento de Espermatozoides , Motilidad Espermática , Vitaminas
6.
Hum Reprod ; 29(9): 1866-74, 2014 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-25047166

RESUMEN

STUDY QUESTION: Are the quantitative and qualitative characteristics of semen samples of patients with testicular cancer (TC), prior to anticancer therapy, different from infertile oligozoospermic (IO) and normozoospermic (NZ) age-matched men? SUMMARY ANSWER: Sperm concentration in TC patients was significantly decreased with no difference in estimated numerical chromosome aberrations and nuclear decondensation compared with NZ men, while the infertile, oligozoospermic men had significantly poorer sperm qualitative characteristics versus the TC group overall and oligozoospermic patients with TC. WHAT IS KNOWN ALREADY: Spermatogenesis is altered in TC patients at the time of diagnosis. However, the mechanism responsible for the decreased semen quantity in patients with TC is not well understood. Anticancer treatment may have gonadotoxic side effects and post-treatment fertility cannot be predicted. Before commencing anticancer treatment, cryopreservation may be suggested to preserve fertility but there are no data regarding the risk of genetic aberrations in these sperms. STUDY DESIGN, SIZE, DURATION: This is a cross-sectional study examining semen from 28 patients with TC, 20 IO and 20 NZ age-matched men attending the Andrology Center and the Sperm Cryopreservation Laboratory of the Medical and Health Science Center, University of Debrecen. Semen samples from patients with TC were collected after orchidectomy, but prior to anticancer treatment. Semen samples from TC patients recruited over a period of 4 years were studied. Based on their sperm concentration, TC patients were subgrouped into an oligozoospermic TC (TCO) and a normozoospermic TC group. For statistical analysis, the normal group (NZ + IO) comprised non-tumorous NZ and IO men. PARTICIPANTS/MATERIALS/SETTING, METHOD: The ejaculates were assessed as per World Health Organization guidelines. Hyaluronic acid (HA)-binding capacity was the functional test. To determine the numerical chromosome aberrations, we used multi-color fluorescence in situ hybridization. Aniline blue (AB) staining was performed as a nuclear decondensation marker test. MAIN RESULTS AND THE ROLE OF CHANCE: The results did not reveal any significant difference in disomy of sex chromosomes and chromosome 17, diploidy and estimated numerical chromosome aberrations and AB staining results upon comparing the NZ and TC groups, although the sperm concentration (P < 0.001) and HA-binding capacity (P < 0.001) were lower in the TC group. Estimated numerical chromosome aberrations (P < 0.001), AB staining (P < 0.001) and HA-binding capacity (P = 0.019) were lower in the infertile, oligozoospermic group when compared with the patients with TC. The TCO group had significantly better results in every examined parameter than the infertile, oligozoospermic group. In the non-tumorous control group (NZ + IO), a significant (P < 0.001) correlation (Spearman's rho = r) was found between sperm concentration and aneuploidy rate (r = -0.642), AB staining (r = -0.876) and HA binding (r = 0.842); the HA-binding capacity was related to the aneuploidy rate (r = -0.678) and the AB staining (r = -0.811); and there was significant correlation between aneuploidy and AB staining (r = 0.559). In the TC group, apart from the negative correlation between sperm concentration and estimated chromosomal aberrations (r = -0.642), no other correlations were observed. LIMITATIONS, REASONS FOR CAUTION: Data on confounders influencing sperm characteristics, such as smoking, occupational or environmental hazards, alcoholism, co-morbidities and other andrological conditions, were not collected. WIDER IMPLICATIONS OF THE FINDINGS: This is the first study to demonstrate that sperm qualitative characteristics in anticancer therapy naïve oligozoospermic TC patients differ significantly from those in IO men and do not differ from those in NZ men. Our results need to be validated in similar groups of men and in other patient groups with cancer where cryopreservation is advisable. STUDY FUNDING/COMPETING INTERESTS: This research was supported by the European Union and the State of Hungary, co-financed by the European Social Fund in the framework of TÁMOP-4.2.4.A/2-11/1-2012-0001 'National Excellence Program'. The authors have no conflict of interest to declare.


Asunto(s)
Aneuploidia , Histonas/metabolismo , Ácido Hialurónico/metabolismo , Recuento de Espermatozoides , Espermatozoides/metabolismo , Neoplasias Testiculares/fisiopatología , Adolescente , Adulto , Estudios Transversales , Humanos , Hibridación Fluorescente in Situ , Masculino , Persona de Mediana Edad , Análisis de Semen
7.
Pharmazie ; 69(6): 437-41, 2014 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-24974577

RESUMEN

Testicular cancer affects men mostly in their reproductive age with a cure rate over 90%. Preserved fertility is one of the main concerns of the survivors. To further elucidate the question of fertility after anticancer treatment for testicular cancer, we performed a survey among patients who underwent sperm cryopreservation procedure in our department. A structured questionnaire was designed to collect data on demography, anticancer treatment, histological type of cancer, family planning intentions and fertility prior to and after treatment. During a period of 11 years 86 men underwent semen cryopreservation before starting chemo-or radiotherapy. Fifty-nine of them consented to participate in the study. The average length of follow up was 4.6 +/- 3.8 years. In case of 11.9% of the patients their banked sperm was used, which led to live birth in 57% of the couples. The partners of 6 patients became pregnant after in vitro fertilization (IVF) resulting in 4 live births and 2 miscarriages. The spontaneous pregnancy rate was 22%. Spontaneous pregnancy occurred in 13 partners resulting in 18 pregnancies followed by 12 live births, 2 artificial abortions and 4 miscarriages. We could not prove any association between preserved fertility and anticancer treatment or the histological type of the cancer. In conclusion, although spontaneous pregnancy rate is remarkably high after anticancer treatment for testicular cancer, the risk of infertility after receiving gonadotoxic treatment cannot be predicted. Cryopreservation is a safe and effective method to preserve fertility in these cases. As a result we strongly recommend discussing the advantages of semen cryopreservation with all patients awaiting treatment for testicular cancer.


Asunto(s)
Fertilidad/fisiología , Neoplasias Testiculares/complicaciones , Neoplasias Testiculares/terapia , Adolescente , Adulto , Antineoplásicos/efectos adversos , Antineoplásicos/uso terapéutico , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Terapia Combinada , Criopreservación , Progresión de la Enfermedad , Femenino , Fertilización In Vitro , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Orquiectomía , Embarazo , Índice de Embarazo , Estudios Retrospectivos , Seminoma/complicaciones , Seminoma/patología , Seminoma/terapia , Bancos de Esperma , Espermatozoides/química , Espermatozoides/efectos de los fármacos , Encuestas y Cuestionarios , Neoplasias Testiculares/patología , Adulto Joven
8.
Basic Res Cardiol ; 107(5): 292, 2012 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-22899170

RESUMEN

Although epicardial blood flow can be restored by an early intervention in most cases, a lack of adequate reperfusion at the microvascular level is often a limiting prognostic factor of acute myocardial infarction (AMI). Our group has recently found that paracrine factors secreted from apoptotic peripheral blood mononuclear cells (APOSEC) attenuate the extent of myocardial injury. The aim of this study was to determine the influence of APOSEC on microvascular obstruction (MVO) in a porcine AMI model. A single dose of APOSEC was intravenously injected in a closed chest reperfused infarction model. MVO was determined by magnetic resonance imaging and cardiac catheterization. Role of platelet function and vasodilation were monitored by means of ELISA, flow cytometry, aggregometry, western blot and myographic experiments in vitro and in vivo. Treatment of AMI with APOSEC resulted in a significant reduction of MVO. Platelet activation markers were reduced in plasma samples obtained during AMI, suggesting an anti-aggregatory capacity of APOSEC. This finding was confirmed by in vitro tests showing that activation and aggregation of both porcine and human platelets were significantly impaired by co-incubation with APOSEC, paralleled by vasodilator-stimulated phosphoprotein (VASP)-mediated inhibition of platelets. In addition, APOSEC evidenced a significant vasodilatory capacity on coronary arteries via p-eNOS and iNOS activation. Our data give first evidence that APOSEC reduces the extent of MVO during AMI, and suggest that modulation of platelet activation and vasodilation in the initial phase after myocardial infarction contributes to the improved long-term outcome in APOSEC treated animals.


Asunto(s)
Leucocitos Mononucleares/fisiología , Infarto del Miocardio/terapia , Agregación Plaquetaria , Vasodilatación , Animales , Moléculas de Adhesión Celular/fisiología , Células Cultivadas , Modelos Animales de Enfermedad , Humanos , Técnicas In Vitro , Leucocitos Mononucleares/metabolismo , Proteínas de Microfilamentos/fisiología , Fosfoproteínas/fisiología , Activación Plaquetaria , Porcinos
9.
Pharmazie ; 65(6): 436-9, 2010 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-20614692

RESUMEN

A normal function of the thyroid gland during pregnancy is essential. Any change can affect both the pregnant woman and the fetus. Thyroid hormones play a crucial role in the brain development of the fetus, thus proper maternal free thyroid hormone levels are important especially during the first trimester. We compared the free thyroid hormone levels FT3 and FT4 in forty pregnant women with no thyroidal disease by five different assays available on the market. The blood samples were collected between the 8th and 22nd weeks of pregnancy. The correlation coefficient "r" between different assays was 0.908-0.975 for TSH, 0.676-0.892 for FT4 and 0.480-0.789 for FT3. These data show that the inter-assay results varied widely in the studied population. One reasonable explanation may be that during pregnancy the serum levels of the thyroid hormone binding proteins are altered and "free" hormone measurements by immunoassays are influenced by these alterations. Thus, the results may show higher or lower thyroid hormone values depending upon the assay used. Therefore, it is strongly suggested that every laboratory should establish its own pregnant reference ranges for the tests used for the evaluation of thyroid function, based on values of the population served.


Asunto(s)
Pruebas de Función de la Tiroides/métodos , Hormonas Tiroideas/sangre , Adulto , Automatización , Femenino , Humanos , Inmunoensayo , Embarazo , Valores de Referencia , Tirotropina/sangre , Tiroxina/sangre , Triyodotironina/sangre
10.
Neuroimage Clin ; 22: 101806, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30991614

RESUMEN

Periventricular white matter injury is common in very preterm infants and it is associated with long term neurodevelopmental impairments. While evidence supports the protective effects of erythropoetin (EPO) in preventing injury, we currently lack the complete understanding of how EPO affects the emergence and maturation of anatomical brain connectivity and function. In this case-control study, connectomic analysis based on diffusion MRI tractography was applied to evaluate the effect of early high-dose EPO in preterm infants. A whole brain, network-level analysis revealed a sub-network of anatomical brain connections in which connectivity strengths were significantly stronger in the EPO group. This distributed network comprised connections predominantly in the frontal and temporal lobe bilaterally, and the effect of EPO was focused on peripheral and feeder connections of the core structural connectivity network. EPO resulted in a globally increased clustering coefficient, higher global and average local efficiency, while higher strength and increased clustering was found for regions in the frontal lobe and cingulate gyrus. The connectivity network most affected by the EPO treatment showed a steeper increase graph theoretical measures with age compared to the placebo group. Our results demonstrate a weak but widespread effect of EPO on the structural connectivity network and a possible trophic effect of EPO reflected by increasing network segregation, predominantly in local connections.


Asunto(s)
Encéfalo/efectos de los fármacos , Encéfalo/diagnóstico por imagen , Imagen de Difusión Tensora/métodos , Eritropoyetina/farmacología , Recien Nacido Extremadamente Prematuro , Red Nerviosa/efectos de los fármacos , Red Nerviosa/diagnóstico por imagen , Fármacos Neuroprotectores/farmacología , Estudios de Casos y Controles , Eritropoyetina/administración & dosificación , Humanos , Recién Nacido , Fármacos Neuroprotectores/administración & dosificación
11.
Neuroscience ; 310: 589-99, 2015 Dec 03.
Artículo en Inglés | MEDLINE | ID: mdl-26415766

RESUMEN

The effects of sensory loss on central processing in various sensory systems have already been described. The olfactory system holds the special ability to be activated by a sensorimotor act, without the presentation of an odor. In this study, we investigated brain changes related to chronic peripheral smell loss. We included 11 anosmic patients (eight female, three male; mean age, 43.5 years) with smell loss after an infection of the upper respiratory tract (mean disease duration, 4.64 years) and 14 healthy controls (seven female, seven male; mean age, 30.1 years) in a functional magnetic resonance imaging experiment with a sniffing paradigm. Data were analyzed using group-independent component analysis and functional connectivity analysis. Our results revealed a spatially intact olfactory network in patients, whereas major aberrations due to peripheral loss were observed in functional connectivity through a variety of distributed brain areas. This is the first study to show the re-organization caused by the lack of peripheral input. The results of this study indicate that anosmic patients hold the ability to activate an olfaction-related functional network through the sensorimotor component of odor-perception (sniffing). The areas involved were not different from those that emerged in healthy controls. However, functional connectivity appears to be different between the two groups, with a decrease in functional connectivity in the brain in patients with chronic peripheral sensory loss. We can further conclude that the loss of the sense of smell may induce far-reaching effects in the whole brain, which lead to compensatory mechanisms from other sensory systems due to the close interconnectivity of the olfactory system with other functional networks.


Asunto(s)
Trastornos del Olfato/fisiopatología , Vías Olfatorias/fisiopatología , Percepción Olfatoria/fisiología , Adulto , Mapeo Encefálico , Enfermedad Crónica , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Odorantes , Trastornos del Olfato/etiología , Infecciones del Sistema Respiratorio/complicaciones
12.
Bone Marrow Transplant ; 50(11): 1453-8, 2015 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-26301968

RESUMEN

The nestin(+) perivascular bone marrow (BM) stem cell niche (N(+)SCN) may be involved in GvHD. To investigate whether acute GvHD (aGvHD) reduces the number of N(+)SCN, we examined patients with AML who had undergone allogeneic hematopoietic stem cell transplantation. In the test cohort (n=8), the number of N(+)SCN per mm(2) in BM biopsies was significantly reduced in aGvHD patients at the time of aGvHD compared with patients who did not have aGvHD (1.2±0.78 versus 2.6±0.93, P=0.04). In the validation cohort (n=40), the number of N(+)SCN was reduced (1.9±0.99 versus 2.6±0.90 N(+)SCN/mm(2), P=0.05) in aGvHD patients. Receiver operating curves suggested that the cutoff score that best discriminated between patients with and without aGvHD was 2.29 N(+)SCN/mm(2). Applying this cutoff score, 9/11 patients with clinically relevant aGvHD (⩾grade 2) and 13/20 with any type of GvHD had decreased N(+)SCN numbers compared with only 10/29 patients without clinically relevant aGvHD (P=0.007) and 6/20 patients without any type of GvHD (P=0.028). In patients tracked over time, N(+)SCN density returned to normal after aGvHD resolved or remained stable in patients who did not have aGvHD. Our results show a decrease in the number of N(+)SCN in aGvHD.


Asunto(s)
Médula Ósea/patología , Enfermedad Injerto contra Huésped/patología , Trasplante de Células Madre Hematopoyéticas/efectos adversos , Nestina/análisis , Nicho de Células Madre , Enfermedad Aguda , Adulto , Anciano , Aloinjertos , Antígenos CD34/análisis , Área Bajo la Curva , Biomarcadores , Médula Ósea/irrigación sanguínea , Médula Ósea/fisiología , Diferenciación Celular , Estudios de Cohortes , Femenino , Factores de Transcripción Forkhead/análisis , Enfermedad Injerto contra Huésped/etiología , Neoplasias Hematológicas/terapia , Humanos , Masculino , Microvasos/patología , Persona de Mediana Edad , Neovascularización Patológica/etiología , Neovascularización Patológica/patología , Procolágeno/análisis , Curva ROC , Regeneración , Acondicionamiento Pretrasplante/efectos adversos
13.
J Sports Med Phys Fitness ; 55(11): 1285-92, 2015 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-25303166

RESUMEN

AIM: The aim of this study was to investigate the short-term and long-term effects of a moderate intensity nordic walking program, and the feasibility of this exercise form among Hungarian community-living older adults. METHODS: Forty one community-living older adults aged over 60 years (mean 67.5, SD 4.8 years) participated in a nordic walking program consisting of a 10-week supervised period and a 25-week unsupervised period. The age and gender matched control group did not receive any types of exercise programs. The balance, functional mobility, lower limb strength, and aerobic endurance were measured at baseline, after 10 weeks and after 25 weeks. RESULTS: The balance, the functional mobility and the aerobic endurance significantly improved in the nordic walking group (P=0.001; P=0.04; P<0.0001, respectively), whereas there were significant deteriorations in the control group. In terms of lower limb muscle strenght (including iliopsoas, quadriceps, gluteus muscles, and hamstring muscles) we could not demonstrate improvement (P=0.274). CONCLUSION: This study showed that nordic walking is a simple, well-tolerated and effective physical activity for older people in Hungary. Based on the findings of our studies, the nordic walking will play an important role in geriatric physiotherapy in order to improve or maintain the functional abilities of this growing population.


Asunto(s)
Fuerza Muscular/fisiología , Resistencia Física/fisiología , Equilibrio Postural/fisiología , Caminata/fisiología , Anciano , Estudios de Casos y Controles , Estudios de Factibilidad , Femenino , Estudios de Seguimiento , Humanos , Vida Independiente , Pierna/fisiología , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Músculo Esquelético/fisiología , Aptitud Física/fisiología , Estudios Prospectivos
14.
J Immunol Methods ; 46(3): 259-76, 1981.
Artículo en Inglés | MEDLINE | ID: mdl-6975788

RESUMEN

In a collaborative study involving 7 laboratories, sera from 53 patients with lung cancer, 37 primary and 16 secondary tumours, and sera of 40 healthy blood donors were tested by 19 different assays or assay modifications used for detecting immune complexes. In 12 out of 19 assays, significantly higher immune complex levels were found in the cancer patients than in the healthy subjects. Assays based on interactions between immune complexes and Fc receptors of different cells (lymphocytes, macrophages of platelets) discriminated between cancer patients and health subjects and a high percentage (47-87%) of positivity was observed in such assays in patients with lung cancer. In contrast, none of the tests based on immune complex-complement interactions discriminated between cancer patients and health subjects. Immunochemical analyses of the PEG precipitates obtained from the sera tested revealed that the concentrations of IgG, IgA and C3 were significantly higher in the precipitates obtained from patients sera than from control sera, but no significant differences were seen in IgM and C1q concentrations. A 100% correct classification of individuals tested was obtained on discriminant analysis of results with 3 assays: EA rosette inhibition, ADCC inhibition and C3 concentration in PEG precipitates. Correlation between results obtained with individual sera by the different assays was very poor: significant correlation coefficients were found in only 13% of all possible paired comparisons. Our results suggest that Fc receptor-dependent assays are more suitable for detection and measurement of circulating immune complexes in lung cancer than tests based on interactions with complement.


Asunto(s)
Complejo Antígeno-Anticuerpo , Neoplasias Pulmonares/inmunología , Adenocarcinoma/inmunología , Adulto , Anciano , Citotoxicidad Celular Dependiente de Anticuerpos , Carcinoma de Células Escamosas/inmunología , Fenómenos Químicos , Química Física , Enzimas Activadoras de Complemento , Complemento C1q , Proteínas del Sistema Complemento/metabolismo , Femenino , Humanos , Neoplasias Pulmonares/secundario , Masculino , Persona de Mediana Edad , Polietilenglicoles/farmacología , Receptores Fc , Formación de Roseta , Estadística como Asunto
15.
Eur J Endocrinol ; 143(4): 479-83, 2000 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-11022193

RESUMEN

OBJECTIVE: To assess the iodine nutritional status and the prevalence of goitre during pregnancy in a region of Hungary that appeared to be iodine sufficient in previous studies. DESIGN: A cross-sectional voluntary screening study was organized in which 313 pregnant women participated. METHODS: Urine iodine concentration and the volume of the thyroid gland were measured in every woman. In the presence of low urinary iodine concentrations, goitre, or both, thyroid function tests were performed. RESULTS: Iodine deficiency was found in 57.1% of the pregnant women, and was severe in 15.6%. The volume of the thyroid gland was enlarged in 19.2% of individuals. Nodular goitre was found in 17 women (5.4%). The frequency of goitre and the mean thyroid volume were increased in the group of iodine-deficient women. In the 89 cases of iodine deficiency or goitre, thyrotrophin concentrations were in the normal range; however, the free triiodothyronine:free throxine ratio was increased in 97% of them, indicating that the thyroid gland was in a stimulated state in these individuals. CONCLUSIONS: Iodine deficiency with high prevalence of goitre was recognized among pregnant women in an area that previously appeared to be iodine sufficient. An unexpected mild iodine deficiency was also noted in the non-pregnant control group. Reassessment and continuous monitoring of iodine nutritional status is warranted even in populations that are apparently considered to be 'at no risk' of iodine deficiency, especially in pregnant women. Regular administration of iodine, starting at preconception or in early pregnancy and continuing during the period of nursing, is recommended in these regions.


Asunto(s)
Enfermedades Carenciales/epidemiología , Bocio/epidemiología , Yodo/deficiencia , Complicaciones del Embarazo/epidemiología , Adulto , Estudios Transversales , Enfermedades Carenciales/diagnóstico por imagen , Femenino , Humanos , Hungría/epidemiología , Yodo/orina , Estado Nutricional , Embarazo , Pruebas de Función de la Tiroides , Glándula Tiroides/diagnóstico por imagen , Ultrasonografía
16.
Eur J Obstet Gynecol Reprod Biol ; 71(2): 155-62, 1997 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-9138959

RESUMEN

Recent improvement of the transvaginal grey-scale and colour Doppler ultrasound scanning permits to investigate the morphology and the perfusion parameters of the female pelvic organs in the menopause. Data from detailed scanning of the ovaries and the uterus reflect the hormonal status, but the menopausal age from the last menstrual bleeding (LMB) and the sequence of the HRT given must be taken into consideration. Screening for endometrial pathology is advisable in the days after the withdrawal bleeding in women taking HRT. The positive vascular changes and increased peripheral perfusion in women with HRT detected by Doppler ultrasound are due to the oestrogen's vasodilator effect, which leads to cardiovascular and cerebrovascular protection. Changes of the uterine perfusion during the combined sequential HRT cycle doesn't seem to reflect the reverse effect of the progestin to oestrogen on the general vasculature, but correlates to the vascular changes of the normal menstrual cycle. The disappearing uterine notch in the menopause suggests decreasing vessel compliance. In women taking HRT the uterine notch persists or even may reappear years after the LMB, as a sign of the vessel compliance reserve probably activated by oestrogen and may act also as an indicator of the effect of HRT on arterial status.


Asunto(s)
Terapia de Reemplazo de Estrógeno , Menopausia/efectos de los fármacos , Ultrasonografía Doppler , Endometrio/diagnóstico por imagen , Femenino , Humanos , Quistes Ováricos/diagnóstico por imagen , Ovario/diagnóstico por imagen , Resultado del Tratamiento , Útero/diagnóstico por imagen
17.
Folia Microbiol (Praha) ; 46(4): 339-44, 2001.
Artículo en Inglés | MEDLINE | ID: mdl-11830947

RESUMEN

Occurrence and transferability of beta-lactam resistance in 30 multi-resistant Escherichia coli, Klebsiella spp., Enterobacter spp., Pantoea agglomerans, Citrobacter freundii and Serratia marcescens strains isolated from children between 0 and 3 years of age is presented. The strains were resistant to ampicillin (30), cefoxitin (22), cefotaxime (30), ceftriaxone (30), ceftazidime (30) and aztreonam (28), but susceptible to cefepime (30) and imipenem (26). Twenty-eight of 30 isolates possessed a transferable resistance confirmed by conjugation and isolation of 79-89-kb plasmids. The beta-lactam resistance was due to production of beta-lactamases and ceftazidime proved to be stronger beta-lactamase inductor than ceftriaxone. Twenty-five clinical isolates expressed transferable extended spectrum beta-lactamases, and chromosomally encoded AmpC beta-lactamase.


Asunto(s)
Antibacterianos/farmacología , Infecciones por Enterobacteriaceae/epidemiología , Enterobacteriaceae/efectos de los fármacos , Hospitales Universitarios , Resistencia betalactámica/genética , beta-Lactamas/farmacología , Ceftazidima/farmacología , Preescolar , Conjugación Genética , Enterobacteriaceae/enzimología , Enterobacteriaceae/genética , Infecciones por Enterobacteriaceae/microbiología , Humanos , Lactante , Recién Nacido , Pruebas de Sensibilidad Microbiana , Plásmidos/genética , Eslovaquia/epidemiología , beta-Lactamasas/genética
18.
Orv Hetil ; 134(8): 395-9, 1993 Feb 20.
Artículo en Húngaro | MEDLINE | ID: mdl-8441528

RESUMEN

The occurrence of multi-metabolic syndrome was studied by authors on 31 patients with obesity of android type and hypertension. Plasma glucose and plasma insulin levels were investigated during oral glucose tolerance test, plasma lipid levels were determined, furthermore body mass index and waist/hip ratio were calculated. It was considered that in 65 percent of the cases the presence of multi-metabolic syndrome could have been proved. Dyslipidemia in 22 cases, hyperinsulinemia in 20 cases, deterioration of the carbohydrate metabolism in 14 cases could be demonstrated. The negative correlation between glucose- and insulin-responses to glucose challenge may suggest the presence of insulin resistance. No significant difference was found in metabolic parameters between men and women. The multi-metabolic syndrome is regarded by authors as a process which may lead to both type 2 diabetes mellitus and atherosclerosis. According to their appearance about two third of these patients could be screened. Authors emphasize the great significance of this problem and the importance of early diagnosis and prevention.


Asunto(s)
Errores Innatos del Metabolismo de los Carbohidratos/complicaciones , Diabetes Mellitus Tipo 1/metabolismo , Diabetes Mellitus Tipo 2/metabolismo , Hipertensión/metabolismo , Obesidad/metabolismo , Adulto , Diabetes Mellitus/metabolismo , Femenino , Humanos , Hipertensión/etiología , Masculino , Persona de Mediana Edad , Obesidad Mórbida/metabolismo , Síndrome
19.
Orv Hetil ; 134(30): 1631-4, 1993 Jul 25.
Artículo en Húngaro | MEDLINE | ID: mdl-8341540

RESUMEN

The authors investigated the difficulties of differential diagnosis in diabetes, beginning in young age. They analysed the case records of fifteen young diabetics. The authors pointed out, that clinical diagnosis, carried out early, has utmost importance both of theoretical and practical significance, for correct classification according to the type of diabetes determines the therapy. In building the diagnosis, the clinician needs correct anamnestical, clinical data, immunogenetic markers (ICA, HLA), and the capacity of endogenous insulin secretion as well. In three patients they have observed a long period without insulin treatment that could be classified as remission phase. In eleven cases the treatment has started with oral antidiabetic drugs, one patient has got at he very beginning insulin treatment. At present, there is only one patient, still taking oral drugs. This diabetics has an ICA positivity in high titer, but he is refusing the recommended exogenous insulin treatment. In all of their cases the amount of injected daily insulin is low (0.3-0.6 IU/body weight/24 hours). Authors state by their careful analysis, that in all of their 15 diabetics there is existing a slowly developing type I IDDM, I/b, or very recently 1 1/2 diabetes form. The so called autoimmune form--described originally by Bottazzo--could have been disclosed in all of their cases.


Asunto(s)
Diabetes Mellitus Tipo 1/diagnóstico , Diabetes Mellitus Tipo 2/diagnóstico , Adolescente , Adulto , Factores de Edad , Diabetes Mellitus Tipo 1/inmunología , Diabetes Mellitus Tipo 2/inmunología , Diagnóstico Diferencial , Femenino , Humanos , Masculino , Persona de Mediana Edad
20.
Orv Hetil ; 139(3): 121-4, 1998 Jan 18.
Artículo en Húngaro | MEDLINE | ID: mdl-9467294

RESUMEN

Tamoxifen is a non-steroidal estrogen antagonist used mainly in the adjuvant therapy of breast cancer. Tamoxifen acts primarily as an antiestrogen, but also carries estrogenic effect, mainly to the endometrium. Although diverse pathological uterine findings has been described in connection with the long term use of this drug, there is no widely accepted protocol for the monitoring of the endometrium in these patients. All patients referred for gynecologic examination at the Department of Obstetrics and Gynecology University Medical School Debrecen, Hungary with previous treatment for breast cancer were involved in a screening programme. The gradual screening programme consists of: transvaginal sonography, color doppler imaging, hysteroscopy, and endometrial curettage or sampling. If any of the first steps proved to be negative, further evaluation could be avoided. Altogether 31 patients were referred for examination and transvaginal sonography alone excluded endometrial abnormality in 9 cases, while the rest of the patients went through further evaluation. The ratio of false positive results using transvaginal sonography alone was high and could be lowered with additional color doppler imaging. Endometrial pathology could be excluded in about 50% of cases without tissue sampling. Positive histology was found in 25% of patients receiving Tamoxifen. The most frequent pathological finding was endometrial polyp. In conclusion endometrial changes found by transvaginal sonography, should be further evaluated. The gradual screening procedures enable us to the proper use of more invasive procedures.


Asunto(s)
Neoplasias de la Mama/tratamiento farmacológico , Endometrio/efectos de los fármacos , Tamoxifeno/uso terapéutico , Adulto , Anciano , Endometrio/diagnóstico por imagen , Femenino , Estudios de Seguimiento , Humanos , Histeroscopía , Tamizaje Masivo , Persona de Mediana Edad , Estudios Prospectivos , Tamoxifeno/efectos adversos , Ultrasonografía Doppler en Color
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