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1.
Acta Orthop Belg ; 89(1): 103-111, 2023 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-37294992

RESUMEN

Previous literature has reported changes in the length or thickness of the patellar tendon (PT) following primary total knee arthroplasty (TKA). This study aims to determine the structural changes in both the length and thickness of the PT after primary TKA using ultrasound (US) and to investigate the association between these changes and clinical outcomes after a minimum follow-up of 48 months. This prospective study used the US on 60 knees of 32 patients (aged 54-80, mean 64.8±7 years) before and after primary TKA to evaluate changes in both the length and thickness of the patellar tendon. Clinical outcomes were assessed with HSS and Kujala scores. At the latest follow-up evaluation, there was a significant overall shortening of PT by 9.1% (p<0.001), in addition to significant global thickening by 20% (p<0.001). Besides, there was significant thickening by 30% in the proximal 1/3 (p<0.01) and 27% in the middle 1/3 (p<0.01) segments of PT. There was a significant negative correlation between the thickening identified in all three parts of the tendon and both clinical outcome measures (p<0.05). The results show the presence significant changes in PT in terms of length and thickness after primary TKA; in addition, increased thickness in PT was more strongly and significantly associated with inferior clinical outcomes, including functionality and anterior knee pain, than shortness in PT. This study also suggests that the US is a viable, non-invasive method for documenting PT changes in both length and thickness after TKA with serial scans.


Asunto(s)
Artroplastia de Reemplazo de Rodilla , Osteoartritis de la Rodilla , Ligamento Rotuliano , Humanos , Artroplastia de Reemplazo de Rodilla/métodos , Ligamento Rotuliano/diagnóstico por imagen , Ligamento Rotuliano/cirugía , Estudios Prospectivos , Estudios de Seguimiento , Articulación de la Rodilla/cirugía , Rótula/cirugía , Osteoartritis de la Rodilla/diagnóstico por imagen , Osteoartritis de la Rodilla/cirugía
2.
J Periodontal Res ; 50(1): 44-51, 2015 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-24690077

RESUMEN

OBJECTIVES: The purpose of this study was to evaluate the gingival crevicular fluid levels of interleukin-1beta (IL-1ß), matrix metalloproteinases-3 (MMP-3), tissue type plasminogen activator (t-PA) and plasminogen activator inhibitor 2 (PAI-2) in patients with chronic periodontitis, aggressive periodontitis (AgP) and healthy individuals (controls). MATERIAL AND METHODS: Systemically healthy (21 chronic periodontitis, 23 AgP and 20 controls) subjects were included in this study. Plaque index, gingival index, probing pocket depth and clinical attachment level were recorded and gingival crevicular fluid samples were collected. Assays for IL-1ß, MMP-3, t-PA and PAI-2 levels in gingival crevicular fluid were carried out by an enzyme-linked immunosorbent assay. The one-sample Kolmogorov-Smirnov test, Mann-Whitney U test and Spearman correlation coefficient were used for data analyses. RESULTS: Gingival crevicular fluid levels of t-PA and IL-1ß were significantly higher in chronic periodontitis and AgP groups than in the control group (p < 0.001). MMP-3 levels in gingival crevicular fluid were detected as significantly higher in the chronic periodontitis and AgP groups compared with the control group (p < 0.05). The t-PA/PAI-2 rate of patients with chronic periodontitis and AgP were significantly higher than the control group (p < 0.05). The positive correlations were found among the PAI-2, t-PA, IL-1ß and MMP-3 levels in gingival crevicular fluid. The volume of the gingival crevicular fluid correlated with all of the clinical parameters (p < 0.001). There were positive correlations between the gingival crevicular fluid levels of PAI-2 and the probing pocket depth and between gingival crevicular fluid levels of PAI-2 and the clinical attachment level (p < 0.01). Similarly, significant correlations were found between t-PA levels and probing pocket depth and between t-PA levels and clinical attachment level measurements (p < 0.001). CONCLUSION: The present data showed that gingival crevicular fluid levels of IL-1 ß, MMP-3 and t-PA increased in periodontal disease regardless of the periodontitis type and played a part in tissue destruction.


Asunto(s)
Periodontitis Agresiva/metabolismo , Periodontitis Crónica/metabolismo , Líquido del Surco Gingival/química , Interleucina-1beta/análisis , Metaloproteinasa 3 de la Matriz/análisis , Inhibidor 2 de Activador Plasminogénico/análisis , Activador de Tejido Plasminógeno/análisis , Adulto , Índice de Placa Dental , Femenino , Fibrinolíticos/análisis , Humanos , Masculino , Persona de Mediana Edad , Pérdida de la Inserción Periodontal/clasificación , Pérdida de la Inserción Periodontal/metabolismo , Índice Periodontal , Bolsa Periodontal/clasificación , Bolsa Periodontal/metabolismo , Inhibidores de Serina Proteinasa/análisis , Adulto Joven
3.
Chirurgia (Bucur) ; 109(1): 60-5, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-24524472

RESUMEN

BACKGROUND AND AIM: Sutureless total thyroidectomy by using vessel sealing devices has been shown to be safe in some recent clinical studies. However, some surgeons are still concerned about the use of these energy devices in the vicinity of there current laryngeal nerve and parathyroid glands. The objective of this study was to investigate the effects of the use of pure LigaSure on postoperative complications and to discuss the pertinent literature. METHODS: A total of 456 patients having undergone a total thyroidectomy operation between June 2009 and March 2011 were included in the study. Data were prospectively collected and retrospectively evaluated. Patients were separated into 2 groups. Group L comprised of 182 patients where onlyLigaSure was used, and group LT consisted of 274 patients where ligation was used in the vicinity of the recurrent laryngeal nerve and parathyroid glands, and LigaSure was used in all other parts of the surgery. Patient's blood calcium values were checked preoperatively and at postoperative 24, 48, and 72 hours. Groups were assessed in terms of demographic properties, thyroid pathology, duration of operation, and postoperative complications. RESULTS: Groups were similar in respect of demographic properties, operation duration, thyroid gland pathology. No mortality rate was recorded. Laboratory hypocalcemia rate was higher in group L (P 0.003), but no significant difference was identified between groups in terms of symptomatic hypocalcemia.No permanent hypocalcemia or recurrent laryngeal nerve injury developed in any of the patients in the two groups. CONCLUSIONS: Pure LigaSure for total thyroidectomy may increase laboratory hypocalcemia rate, but not symptomatic hypocalcemia. Hemorrhage related complications were similar and low in the two groups. Ligations in the places close to delicate anatomic structures did not cause longer operative times and may be a safer option in total thyroidectomy.


Asunto(s)
Pérdida de Sangre Quirúrgica/prevención & control , Hipocalcemia/prevención & control , Seguridad del Paciente , Tiroidectomía/métodos , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Hemostasis Quirúrgica/métodos , Humanos , Hipocalcemia/sangre , Ligadura/métodos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Estudios Retrospectivos , Enfermedades de la Tiroides/cirugía , Tiroidectomía/instrumentación , Resultado del Tratamiento
4.
Eur Rev Med Pharmacol Sci ; 28(1): 191-198, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-38235870

RESUMEN

OBJECTIVE: Radiotherapy is an important treatment for a wide variety of malignancies, although many cancer patients who receive radiotherapy suffer from serious side effects during and after their treatment. Thymoquinone (TQ), the main active ingredient of Nigella sativa, has been reported to have various pharmacological properties, such as antioxidant, hepatoprotective, neuroprotective, antidiabetic, anti-inflammatory, nephroprotective, anticarcinogenic in many pharmacological and toxicological studies. In this study, we aimed to investigate whether there is a radioprotective effect of TQ on the lung tissue of rats exposed to ionizing radiation. MATERIALS AND METHODS: This study was designed as a prospective, placebo-controlled study. A total of 40 Sprague-Dawley rats were divided into four groups to test the radiation-protective effectiveness of TQ administered by intraperitoneal injection. Biochemical parameters were studied to assess the radiation-protective effects of TQ. RESULTS: Oxidative stress parameters, such as oxidative stress index (OSI), lipid hydroperoxide (LOOH) and total oxidant status (TOS), in lung tissue of the rats treated with TQ, were found to be lower than in received irradiation alone. Anti-oxidative parameters, such as total antioxidant status (TAS) level and paraoxonase (PON) activity, were statistically higher in the TR (IR plus TQ group) group compared with other groups. CONCLUSIONS: Findings show that TQ clearly protects lung tissue from radiation-induced oxidative stress and can be used as a radioprotective agent.


Asunto(s)
Antioxidantes , Protectores contra Radiación , Humanos , Ratas , Animales , Antioxidantes/farmacología , Ratas Sprague-Dawley , Estudios Prospectivos , Estrés Oxidativo , Benzoquinonas/farmacología , Benzoquinonas/uso terapéutico , Protectores contra Radiación/farmacología , Peróxidos Lipídicos/farmacología , Pulmón
5.
Int J Immunogenet ; 40(5): 349-55, 2013 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-23331481

RESUMEN

Behçet's disease (BD) is a chronic immune-mediated systemic disease, characterized by oral and genital lesions and ocular inflammation. Several cytokine genes may play crucial roles in host susceptibility to BD, because the cytokine production capacity varies among individuals and depends on the cytokine gene polymorphisms. The association of the interleukin (IL)-2 gene polymorphisms with the susceptibility to BD was investigated in this study. DNA samples were obtained from a Turkish population of 97 patients with BD and 76 healthy control subjects. Polymorphisms of IL-2 gene at position -330 and +166 were determined using the polymerase chain reaction with sequence-specific primers. In the patients with BD, there was a significantly increased frequency of IL-2 -330 GT genotype. Interestingly, we demonstrated that the frequencies of IL-2 -330 GT and IL-2 + 166 GG genotypes were increased in BD patients with ocular involvement, whilst IL-2 -330 TT genotype was significantly decreased. Also, analysis of allele frequency demonstrated that the presence of G allele at position +166 of IL-2 seems to be a risk factor for ocular involvement. These results reveal that IL-2 -330 GT genotype may be a susceptibility factor for BD, whereas IL-2 -330 TT genotype seems to display a protective association with BD. Additionally, IL-2 gene polymorphisms might be associated with ocular involvement in BD.


Asunto(s)
Síndrome de Behçet/genética , Ojo/inmunología , Interleucina-2/genética , ADN/genética , Ojo/patología , Femenino , Frecuencia de los Genes , Predisposición Genética a la Enfermedad , Genotipo , Humanos , Inflamación/inmunología , Linfocitos/inmunología , Masculino , Neutrófilos/inmunología , Polimorfismo de Nucleótido Simple , Turquía
6.
Eur Rev Med Pharmacol Sci ; 17(14): 1967-73, 2013 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-23877864

RESUMEN

OBJECTIVES: We aimed to compare the effect of remifentanil without muscle relaxant with succinylcholine for intubation in microlaryngoscopy. PATIENTS AND METHODS: Eighty patients were randomly divided into two groups: Group R (n=40) and S (n=40) received remifentanil 4 µg/kg intravenously or 1 µg/kg respectively. Anesthesia was induced with 2 mg/kg propofol in both groups. Intubation was performed after bolus administration of 10 ml saline as a placebo or 1 mg/kg of succinylcholine in Group R and S respectively. Remifentanil infusion was initiated at 0.025 µg/kg in each groups. RESULTS: Intubation conditions were similar in both groups. The mean arterial pressure (MAP) values at post-induction period were significantly lower in the Group S than in the Group R (p = 0.001). The requirement for ephedrine in Group R was found to be significantly lower than Group S (p = 0.023). Recovery times were significantly shorter (p = 0.001) and recovery scores were significantly higher (p = 0.021) in Group R. Time to patient could respond to commands was significantly longer in the Group S (p = 0.001). The surgeon's satisfaction score was significantly higher in Group R (p = 0.001). CONCLUSIONS: It was concluded that remifentanil without muscle relaxants provides similar intubating conditions as that provided by succinylcholine, and remifentanil is superior to succinylcholine with regard to haemodynamic stability and recovery duration.


Asunto(s)
Anestésicos Intravenosos , Intubación Intratraqueal/métodos , Laringoscopía/métodos , Piperidinas , Periodo de Recuperación de la Anestesia , Presión Sanguínea/efectos de los fármacos , Método Doble Ciego , Femenino , Hemodinámica , Humanos , Masculino , Persona de Mediana Edad , Fármacos Neuromusculares Despolarizantes , Remifentanilo , Succinilcolina
7.
Aust Dent J ; 2023 Oct 24.
Artículo en Inglés | MEDLINE | ID: mdl-37875350

RESUMEN

BACKGROUND: To assess the shear bond strength (SBS) of four calcium silicate-based cements (CSCs) to composite resin using a universal adhesive in self-etch (SE) and etch-and-rinse (ER) modes and to evaluate surface microstructure and chemical composition of CSCs after acid-etching. METHODS: In total, 30 specimens of each cement, Biodentine (BD), mineral trioxide aggregate (MTA) Angelus (MTA-A), ProRoot MTA (MTA-P) and MTA Repair HP (MTA-HP), were prepared and assigned into 2 groups (n = 15) according to universal adhesive (Clearfil Universal Bond Quick) applied in SE and ER mode. After composite resin (Clearfil Majesty Esthetic) was applied, the SBS was measured. Scanning electron microscope-energy dispersive spectroscopy (SEM-EDS) analysis was used to evaluate the changes in surface structure and elemental composition. RESULTS: MTA-P demonstrated significantly higher SBS than all CSCs, except for MTA-HP in the SE mode. The ER mode exhibited significantly higher SBS compared to the SE mode for MTA-P and MTA-A. Acid-etching caused morphological differences and affected elemental distribution. CONCLUSIONS: MTA-P may be a more suitable pulp capping material due to its superior SBS compared to BD and MTA-A. The application of a universal adhesive in ER mode may be suggested to increase the SBS of MTA-P and MTA-A to composite resin.

8.
Clin Exp Rheumatol ; 30(1 Suppl 70): S11-4, 2012.
Artículo en Inglés | MEDLINE | ID: mdl-22274654

RESUMEN

OBJECTIVES: Takayasu's arteritis (TA) is a chronic arterial inflammation of unknown etiology involving mainly the aorta and its major branches. Based on the associations of programmed death-1 (PD-1) protein encoding gene (PDCD1) with connective tissue diseases and vasculitides, PDCD1 polymorphisms are studied for susceptibility to TA in this study. METHODS: The study group is made up of TA patients (n=229) fulfilling the 1990 ACR classification criteria and compared to 193 healthy controls (HC). PD-1.3, PD-1.5 and PD-1.6 single nucleotide polymorphisms of PDCD1 gene are genotyped by polymerase chain reaction and restriction analysis (PCR-RFLP). RESULTS: The distribution of PD-1.5 polymorphism in TA patients and HC revealed a similar presence of TT genotype in patients and controls (13.3% vs. 11.4%). PD-1.3 and PD-1.6 were less polymorphic and did not differ between the groups. Rare AA genotype of PD-1.3 (1.4% vs. 1.0%) and AG genotype of PD-1.6 was again similarly (22.4% vs. 19.2%) present in TA and HC. CONCLUSIONS: PD-1.3, 1.5 and 1.6 polymorphisms of PDCD1 gene, which were shown to be associated with various autoimmune disorders and vasculitides, are not associated with a susceptibility to TA in Turkish population.


Asunto(s)
Polimorfismo de Nucleótido Simple , Receptor de Muerte Celular Programada 1/genética , Arteritis de Takayasu/genética , Adulto , Estudios de Casos y Controles , Distribución de Chi-Cuadrado , Femenino , Frecuencia de los Genes , Predisposición Genética a la Enfermedad , Humanos , Masculino , Fenotipo , Reacción en Cadena de la Polimerasa , Medición de Riesgo , Factores de Riesgo , Arteritis de Takayasu/epidemiología , Turquía/epidemiología
9.
Rheumatol Int ; 32(11): 3581-6, 2012 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-22090005

RESUMEN

Articular symptoms are common in SSc and joint pain is a frequent presenting feature of this disease. Hand involvement is often the first clinical manifestation of SSc and could be resulted from fibrosis or synovitis or an overlap syndrome with rheumatoid arthritis (RA); though, the latter is a controversy in practice. To define the clues when identifying the nature of the hand arthropathy in SSc. In order to determine the hand arthropathy, serological tests, hand radiography, finger-to-palm (FTP) distance and other clinical features, disease activity and functional scoring parameters were assessed. Twenty-eight consecutive SSc patients and 43 controls (21 rheumatoid arthritis and 22 healthy controls) were included. Radiographic findings in SSc patients were: Erosions 25%, joint space narrowing 17.9%, arthritis 10.7%, radiological demineralisation 42.9%, acro-osteolysis 25%, flexion contracture 28.6% and calcinosis 17.9%. Anti-CCP antibody and RF positivity were as follows: In SSc group: 3 (11%) and 7 patients (25%); In RA group: 13 (62%) and 19 patients (90.5%); In healthy control group: 1 (4%) and 3 persons (13.6%), respectively. Two patients (7.14%) were regarded as RA overlap, whom both had positive RF and positive anti-CCP results and their radiographs revealed arthritis. Seventeen patients (61%) were regarded as SSc arthropathy; all were negative for RF and anti-CCP but revealed nonarthritic radiological findings. (Among them, only one patient had positive anti-CCP result). The remainder (9 patients) had no radiological or serological finding positive for arthropathy. Arthritis was found to have correlation with heart involvement and FTP was correlated with lung involvement. Hand involvement in SSc is a challenge in rheumatology practice; Radiographic testing when evaluated with RF and anti-CCP will be a helpful tool to discriminate SSc arthropathy from RA-SSc overlap. Hand arthropathy should increase the interest in the serious internal organ involvements of SSc.


Asunto(s)
Articulaciones de la Mano/diagnóstico por imagen , Mano/diagnóstico por imagen , Dolor/diagnóstico por imagen , Esclerodermia Sistémica/diagnóstico por imagen , Adolescente , Adulto , Artritis Reumatoide/sangre , Artritis Reumatoide/diagnóstico por imagen , Artritis Reumatoide/inmunología , Autoanticuerpos/sangre , Autoanticuerpos/inmunología , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Dolor/sangre , Dolor/inmunología , Péptidos Cíclicos/inmunología , Radiografía , Factor Reumatoide/sangre , Esclerodermia Sistémica/sangre , Esclerodermia Sistémica/inmunología
10.
Eur Rev Med Pharmacol Sci ; 16(4): 559-61, 2012 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-22696887

RESUMEN

Children with congenital anomalies such as Goldenhar syndrome affecting the airway can be a problem for the anaesthesiologist. We present the case of an 18 month-old child with Goldenhar syndrome, in whom the ProSeal Laryngeal Mask Airway was successfully used for inguinal hernia surgery.


Asunto(s)
Manejo de la Vía Aérea/instrumentación , Anestesia General/instrumentación , Síndrome de Goldenhar/complicaciones , Hernia Inguinal/cirugía , Máscaras Laríngeas , Diseño de Equipo , Hernia Inguinal/complicaciones , Humanos , Lactante , Masculino
11.
Eur Rev Med Pharmacol Sci ; 16(2): 207-12, 2012 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-22428471

RESUMEN

BACKGROUND: Neuroaxial blockade for ambulatory transurethral resection of the prostate is a well established technique. Patients in this group are often at high risk for perioperative complications from concurrent diseases. The purpose of this study was to compare the elderly patients who received intrathecal fentanyl alone or intrathecal fentanyl plus bupivacaine or epidural anesthesia for transurethral resection of prostate surgery. MATERIAL AND METHODS: Ninety-nine patients were prospectively randomized to receive fentanyl 25 microg (Group F), fentanyl 25 microg plus hyperbaric bupivacaine 2.5 mg (Group BF), or epidural anesthesia adding fentanyl 50 microg (Group E) by combined spinal epidural anesthesia technique. RESULTS: The amount of local anesthetics used until when the sensorial block reached the level of T10 was significantly lower in the Group BF than in the Group E and the Group F (p < 0.001). Maximum level of sensory block was significantly lower in the Group BF than in the Group E and the Group F (p = 0.01). The time elapsed until the sensory block reached T10, the regression of sensory block to L5 level were significantly lower in the Group BF than in the Group E and the Group F (p = 0.005, p < 0.001, respectively). Compared to the basal values, mean arterial pressures were significantly lower in the Group BF than in the Group E and the Group F (p < 0.05). The occurrence of hypotension was significantly lower in the Group BF (9.4%) than in the Group E (18.2%) and the Group F (24.2%). CONCLUSIONS: Intrathecal hyperbaric bupivacaine 2.5 mg plus fentanyl 25 microg administration provides shorter motor block onset time, less local anesthetic usage and adequate hemodynamic stability in elderly patients.


Asunto(s)
Anestesia Epidural/métodos , Anestesia Raquidea/métodos , Anestésicos Intravenosos/administración & dosificación , Fentanilo/administración & dosificación , Hemodinámica/efectos de los fármacos , Anciano , Anciano de 80 o más Años , Envejecimiento/fisiología , Anestésicos Intravenosos/efectos adversos , Anestésicos Locales , Presión Sanguínea/efectos de los fármacos , Estatura/fisiología , Peso Corporal/fisiología , Bupivacaína , Fentanilo/efectos adversos , Humanos , Masculino , Complicaciones Posoperatorias/epidemiología , Náusea y Vómito Posoperatorios/epidemiología , Resección Transuretral de la Próstata
12.
Eur Rev Med Pharmacol Sci ; 26(21): 7986-7995, 2022 11.
Artículo en Inglés | MEDLINE | ID: mdl-36394749

RESUMEN

OBJECTIVE: Unlike adults, there is no valid and reliable scoring system for upper gastrointestinal system bleeding (UGB) in children. The Sheffield scoring system, which is awaiting confirmation, is the single scoring system which can be predictive for children who require high-risk, endoscopic therapeutic intervention. The aim of this study was to evaluate the efficacy of the Sheffield scoring system, the clinical characteristics of patients, and the treatments applied. PATIENTS AND METHODS: Evaluation was made of a total of 86 children with UGB who underwent esophagogastroduodenoscopy and for whom the Sheffield score was calculated. The decision for therapeutic intervention was made according to the clinical status independently of the score. The demographic data of the patients, clinical symptoms and findings, risk factors, and treatments were examined retrospectively. RESULTS: The Sheffield score was calculated as ≤8 in 67.4% of the patients and >8 in 32.6%. Endoscopic hemostatic intervention was applied to 15.1% of the patients. The rate of therapeutic endoscopy was significantly high in the high-score group. In 11 patients with Sheffield score >8, the bleeding was brought under control with octreotide treatment administered before endoscopy and no invasive intervention was applied. The sensitivity and specificity of the Sheffield score were determined to be at a good level in the prediction of the requirement for therapeutic endoscopy and octreotide treatment. CONCLUSIONS: The Sheffield score can reliably predict the need for endoscopic treatment with high sensitivity and specificity. In children with a high score, the need for an invasive intervention can be reduced with the administration of vasoactive treatment before esophagogastroduodenoscopy. The Sheffield score can thus be of guidance in the determination of the need for vasoactive treatment.


Asunto(s)
Hemorragia Gastrointestinal , Octreótido , Niño , Adulto , Humanos , Estudios Retrospectivos , Hemorragia Gastrointestinal/diagnóstico , Hemorragia Gastrointestinal/terapia , Hemorragia Gastrointestinal/etiología , Endoscopía Gastrointestinal , Factores de Riesgo
13.
Eur Rev Med Pharmacol Sci ; 26(9): 3374-3376, 2022 05.
Artículo en Inglés | MEDLINE | ID: mdl-35587091

RESUMEN

OBJECTIVE: There are no reports of tracheomediastinal fistula development after tracheostomy. CASE REPORT: A 72-year-old female patient with post acute COVID-19 was transferred to our intensive care unit. After two unsuccessful weaning attempts, a tracheostomy was performed at hospitalization on day 32. The patient's body mass index was 35 kg/m2 and she had a narrow neck anatomy. A percutaneous tracheostomy was performed using the Griggs method without any problems. Pneumothorax, pneumomediastinum, subcutaneous emphysema, and hemorrhage were not observed. Twenty-two days after the tracheostomy, the patient developed subcutaneous emphysema and experienced a sudden decrease in oxygen saturation. Bedside anterior-posterior chest X-ray did not detect pneumothorax and a tracheoesophageal fistula was found via esophageal endoscopy. A tracheomediastinal fistula was observed just below the cannula distal end via computed tomography. CONCLUSIONS: There are multiple reasons why a tracheomediastinal fistula could develop after tracheostomy. Therefore, this condition should be considered in cases of sudden subcutaneous emphysema and oxygen deterioration following tracheostomy.


Asunto(s)
COVID-19 , Fístula , Neumotórax , Enfisema Subcutáneo , Anciano , COVID-19/complicaciones , Femenino , Fístula/complicaciones , Humanos , Neumotórax/etiología , Enfisema Subcutáneo/complicaciones , Enfisema Subcutáneo/etiología , Traqueostomía
14.
Folia Morphol (Warsz) ; 81(3): 567-573, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-34699056

RESUMEN

BACKGROUND: Pseudotumor cerebri (PTC) occurs when the pressure inside the skull increases for no obvious reason. The aim of this study was to investigate three different methods: the optic nerve sheath diameter (ONSD) method, ONSD/eyeball transverse diameter (ETD) index, and ONSD/orbital transverse diameter (OTD) index for the initial detection of elevated intracranial pressure in patients with PTC. MATERIALS AND METHODS: A retrospective study of magnetic resonance data from adult PTC patients (n = 42) and control group (n = 40) was performed. ONSD and OTD measurements were made 3 mm and 10 mm posterior to the globe, after intracranial pressure was measured with lumbar puncture. The sensitivity, specificity, and overall accuracy of the findings on magnetic resonance imaging were calculated. RESULTS: The optic nerve sheath was enlarged in the PTC group compared with the control group. It showed 97% sensitivity and 100% specificity and 79% sensitivity and 87.5% specificity for 3 mm and 10 mm, respectively. The ONSD/ETD and ONSD/OTD indices were increased in the PTC group compared with the control group. For 3 mm posterior to the globe, the ONSD/ETD index had 90.5% sensitivity and 92% specificity, and the ONSD/OTD index had 86% sensitivity and 95% specificity. For 10 mm posterior to the globe, the sensitivity and specificity of the ONSD/ETD and ONSD/OTD indices were 86% and 80% and 74% and 82.5%, respectively. CONCLUSIONS: According to our study, the ONSD method and the ONSD/ETD and ONSD/OTD indices are reliable diagnostic markers for PTC. These noninvasive techniques may be useful in monitoring the invasive intracranial catheter and have wide potential clinical applications in district hospitals, emergency departments and intensive care units.


Asunto(s)
Hipertensión Intracraneal , Seudotumor Cerebral , Adulto , Humanos , Hipertensión Intracraneal/diagnóstico por imagen , Presión Intracraneal/fisiología , Nervio Óptico/diagnóstico por imagen , Seudotumor Cerebral/diagnóstico por imagen , Estudios Retrospectivos , Ultrasonografía
15.
Arthritis Rheum ; 62(10): 3064-76, 2010 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-20533546

RESUMEN

OBJECTIVE: To assess the efficacy and tolerability of canakinumab, a fully human anti-interleukin-1ß monoclonal antibody, for the treatment of acute gouty arthritis. METHODS: In this 8-week, single-blind, double-dummy, dose-ranging study, patients with acute gouty arthritis whose disease was refractory to or who had contraindications to nonsteroidal antiinflammatory drugs and/or colchicine were randomized to receive a single subcutaneous dose of canakinumab (10, 25, 50, 90, or 150 mg; n = 143) or an intramuscular dose of triamcinolone acetonide (40 mg; n = 57). Patients assessed pain using a 100-mm visual analog scale. RESULTS: Seventy-two hours after treatment, a statistically significant dose response was observed for canakinumab. All canakinumab doses were associated with numerically less pain than triamcinolone acetonide; thus, a dose with equivalent efficacy to triamcinolone acetonide 72 hours after treatment could not be determined. The reduction from baseline in pain intensity with canakinumab 150 mg was greater than with triamcinolone acetonide 24, 48, and 72 hours after treatment (differences of -11.5 mm [P = 0.04], -18.2 mm [P = 0.002], and -19.2 mm [P < 0.001], respectively), and 4, 5, and 7 days after treatment (all P < 0.05). Canakinumab significantly reduced the risk of recurrent flares versus triamcinolone acetonide (P ≤ 0.01 for all doses) (relative risk reduction 94% for canakinumab 150 mg versus triamcinolone acetonide). The overall incidence of adverse events was similar for canakinumab (41%) and triamcinolone acetonide (42%); most were mild or moderate in severity. CONCLUSION: Our findings indicate that canakinumab 150 mg provides rapid and sustained pain relief in patients with acute gouty arthritis, and significantly reduces the risk of recurrent flares compared with triamcinolone acetonide.


Asunto(s)
Anticuerpos Monoclonales/administración & dosificación , Artritis Gotosa/tratamiento farmacológico , Supresores de la Gota/administración & dosificación , Interleucina-1beta/antagonistas & inhibidores , Adolescente , Adulto , Anciano , Anticuerpos Monoclonales Humanizados , Relación Dosis-Respuesta a Droga , Femenino , Humanos , Inyecciones Intramusculares , Inyecciones Subcutáneas , Masculino , Persona de Mediana Edad , Dolor/tratamiento farmacológico , Adulto Joven
16.
Folia Morphol (Warsz) ; 70(4): 235-9, 2011 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-22117239

RESUMEN

Brain balance changes have been recognised in migraine, but cerebellar function between or during attacks has been assessed only in a few studies. Previous studies have indicated that migraine affects cerebellar function. In the present study we aimed to evaluate the hemicerebellar volume changes of patients with migraine without aura (MWoA). Volumetric changes of cerebellar hemispheres were evaluated in terms of asymmetry using stereological methods on magnetic resonance images (MRI) retrospectively. Nineteen patients with MWoA and 18 age- and gender-matched control subjects were included in the study. MRIs were analysed by using the point-counting approach of stereological methods by Cavalier's principle. There was no statistically significant cerebellar atrophy or hemicerebellar asymmetry between the MWoA and control subjects. There was no cerebellar atrophy or asymmetry between the MWoA and age-matched control group. The stereological evaluation of cerebellar asymmetry and atrophy in humans is important for both clinicians and anatomists. The technique is simple, inexpensive, and reliable.


Asunto(s)
Cerebelo/patología , Migraña sin Aura/patología , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Tamaño de los Órganos
17.
ChemMedChem ; 16(5): 839-850, 2021 03 03.
Artículo en Inglés | MEDLINE | ID: mdl-33301228

RESUMEN

Ser/Thr protein phosphatases (PPs) regulate a substantial range of cellular processes with protein phosphatases 1 (PP1) and 2 A (PP2A) accounting for over 90 % of the activity within cells. Nevertheless, tools to study PPs are limited as PPs inhibitors, particularly those selective for PP1 inhibition, are relatively scarce. Two examples of PP1-selective inhibitors, which share structural similarities, are tautomycin (TTM) and tautomycetin (TTN). This work describes the development of PP1/PP2A inhibitors that incorporate key structural features of TTM and TTN and are designed to conserve regions known to bind the active site of PP1/PP2A but vary regions that differentially contact the hydrophobic groove of PP1/PP2A. In all 28 TTN analogues were synthetically generated that inhibit PP1/PP2A activity at <250 mM; seven possessed inhibition activity at 100 nM. The IC50 values were determined for the seven most active analogues, which ranged from 34 to 1500 nM (PP1) and 70 to 6800 nM (PP2A). Four of the seven analogues possessed PP1 selectivity, and one demonstrated eightfold selectivity in the nanomolar range (PP1 IC50 =34 nM, PP2A IC50 =270 nM). A rationale is given for the observed differences in selectivity.


Asunto(s)
Inhibidores Enzimáticos/farmacología , Furanos/farmacología , Lípidos/farmacología , Proteína Fosfatasa 2/antagonistas & inhibidores , Receptores de Neuropéptido Y/antagonistas & inhibidores , Relación Dosis-Respuesta a Droga , Inhibidores Enzimáticos/síntesis química , Inhibidores Enzimáticos/química , Furanos/síntesis química , Furanos/química , Humanos , Lípidos/síntesis química , Lípidos/química , Estructura Molecular , Proteína Fosfatasa 2/metabolismo , Receptores de Neuropéptido Y/metabolismo , Relación Estructura-Actividad
18.
Appl Radiat Isot ; 173: 109738, 2021 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-33910130

RESUMEN

In this study, we have synthesized B doped Ca5(PO4)3OH (HAP) by a sonication chemical method. The thermoluminescence (TL) properties of the family of synthesized samples (B doped Ca5(PO4)3OH (HAP) were investigated using an IRSL-TL 565 nm filter. This gave the highest TL intensity of each phosphor after 2 Gy ß-irradiation. Three TL glow peaks of B doped Ca5(PO4)3OH (HAP) are centered at around 84, 208 and 324 °C (with a heating rate of 2 °Cs-1). The trapping parameters such as activation energy (E), order of kinetics (b), frequency factor (s) were calculated by using initial rise (IR), various heating rates (VHR) and computerized glow curve deconvolution (CGCD) method. The response of TL glow curves remained constant within ±5% deviation from the initial value after 9 cycles of reuse; but only at tenth cycle the deviation goes up to 6%.

19.
Biotech Histochem ; 96(2): 111-116, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-32573272

RESUMEN

Angiogenesis is the formation of new blood vessels. Angiogenesis affects cancer growth and is a useful target for cancer therapeutics. The effects of geldanamycin on angiogenesis in cases of gastric cancer are poorly understood. We investigated the effects of different doses of 17-allylamino-17-demethoxygeldanamycin (17-AGG), a semi-synthetic derivative of geldanamycin, on the interactions between cellular matrix proteins and angiogenesis factors in a gastric cancer cell line. We examined cancer cells on laminin and collagen I coated surfaces to determine their response to the angiogenic effect of these matrix molecules. We also evaluated the expression levels of VEGF, MMP-9, ES and TSP-1 using ELISA. We found that application of 17-AAG to the gastric cancer cell line on culture dish plastic decreased VEGF, TSP-1, ES and MMP-9 expression, whereas of all of these proteins were increased by laminin and collagen coating. 17-AAG currently is in clinical trial phase 2 and may be a promising drug for treatment of gastric cancer.


Asunto(s)
Inductores de la Angiogénesis , Neoplasias Gástricas , Benzoquinonas , Línea Celular , Humanos , Lactamas Macrocíclicas , Neoplasias Gástricas/tratamiento farmacológico , Factor A de Crecimiento Endotelial Vascular
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