RESUMO
BACKGROUND: Congenital diseases are still an important medical, social, and economic problem all over the world. In North Cyprus, in addition to other reasons, early prenatal diagnostic measures are undertaken to prevent births with thalassemia major, a locally widespread genetic disease. AIM: This study aims to evaluate the results of prenatal invasive diagnostic tests performed in a private obstetrics clinic in Northern Cyprus and show the diagnosis process of thalassemia and chromosomal anomalies. MATERIALS AND METHODS: This study is a retrospective, descriptive study. Chorionic villus sampling (CVS) results and the amniocentesis tests performed between 1990 and 2022 are evaluated. Thalassemia and chromosome analysis of samples obtained by CVS and amniocentesis tests were performed. To diagnose alpha or beta thalassemia and sickle cell, 239 CVS was performed. And to diagnose chromosomal anomalies, 396 CVS and amniocentesis were performed. RESULTS: The mean age of the 480 pregnant women included in the study was 31.12 years (18-46) and 30% of them were older than 34 years. The most common indications for invasive prenatal diagnostic test (IPDT) were; mother/father thalassemia minor/major, advanced maternal age, high risk of ultrasonography erase findings, and the noninvasive screening test. The result of IPDT detected 7.3% chromosomal anomaly and 69.5% thalassemia and sickle cell anemia. Of the 239 CVS performed to diagnose alpha or beta thalasemia and sickle cell, 23.4% beta major, 42.3% beta minor, and 2.1% alpha minor were diagnosed. Of the 396 CVS and amniocentesis performed to diagnose chromosomal anormalies; 2.8% of Down syndrome and 4.54% of other chromosomal anomalies were diagnosed. CONCLUSION: IPDT is important in correctly diagnosing fetal anomalies at the prenatal stage to help families decide at the right time.
Assuntos
Anemia Falciforme , Transtornos Cromossômicos , Talassemia , Gravidez , Feminino , Humanos , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Estudos Retrospectivos , Chipre , Diagnóstico Pré-Natal/métodos , Amostra da Vilosidade Coriônica , Aberrações Cromossômicas , Testes Diagnósticos de RotinaRESUMO
BACKGROUND: Pulmonary rehabilitation (PR) is a core component of the management of patients with chronic obstructive pulmonary disease (COPD). Although several types of PR programs are implemented for patients with COPD on the basis of patient preferences or clinical protocols, the clinical efficiencies of these programs may vary, with each program having its own unique purpose, procedures, benefits, challenges, and effectiveness. AIM: The aim of this study was to compare the effects of self-management and hospital-based PR programs in COPD patients. MATERIALS AND METHODS: This study was prospective intervention research. Fifty-eight patients with stable COPD were randomly allocated to a hospital-based outpatient group and a self-management group before commencement of a 12-week PR program. Before and after the PR program, all patients were evaluated using the 6-min walk test, Modified Borg Scale, St. George's Respiratory Questionnaire, State-Trait Anxiety Inventory, and Standardized Mini-Mental Test. RESULTS: Pulmonary functions, dyspnea, quality of life, and 6MWT distance were significantly improvement the hospital-based PR than self-management PR (P < 0.05). Moreover, cognitive function significantly improved after the PR program in both groups with no significant intergroup difference (P > 0.05). CONCLUSIONS: Our findings suggest that PR is useful for to improvement functional capacity, quality of life, cognitive function and anxiety, in patients with COPD. A hospital-based PR is more effective than a self-management PR program.
Assuntos
Doença Pulmonar Obstrutiva Crônica , Autogestão , Hospitais , Humanos , Estudos Prospectivos , Qualidade de Vida , Inquéritos e Questionários , Resultado do TratamentoRESUMO
BACKGROUND: Elastase-1 is a proteolytic enzyme secreted by pancreatic acinar cells, and measurements of the concentration this enzyme are used to evaluate pancreatic exocrine function. We aimed to determine whether pancreatic exocrine function declines due to chronic hypercalcemia by measuring fecal elastase levels. METHODS: 75 patients with primary hyperparathyroidism (18 men and 47 women) and 30 healthy subjects (11 men and 19 women) participated in this study. Renal function tests, lipid parameters, bone mineral density, and serum calcium, phosphorus, vitamin D, parathormone, glucose, and thyroid stimulating hormone levels as well as fecal elastase concentrations, were determined in these patients and controls. RESULTS: The mean fecal elastase level was 335.3 ± 181.4 µg/g in the PHPT group and 317.4 ± 157.3 µg/g in the control group. There was no significant difference in fecal elastase levels between the two groups (p = 0.5). CONCLUSIONS: Chronic hypercalcemia in primary hyperparathyroidism did not decrease the fecal elastase level, which is an indirect indicator of chronic pancreatitis; therefore, chronic hypercalcemia in PHPT may not cause chronic pancreatitis.
Assuntos
Insuficiência Pancreática Exócrina/etiologia , Fezes/enzimologia , Hipercalcemia/complicações , Hiperparatireoidismo Primário/fisiopatologia , Elastase Pancreática/metabolismo , Pancreatite Crônica/etiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/análise , Estudos de Casos e Controles , Insuficiência Pancreática Exócrina/enzimologia , Feminino , Seguimentos , Humanos , Hipercalcemia/metabolismo , Masculino , Pessoa de Meia-Idade , Pancreatite Crônica/enzimologia , PrognósticoRESUMO
PURPOSE: Subcutaneous edema detected sonographically in the forms of nuchal edema, cystic hygroma (CH), or non-immune hydrops (NIH) may be a sign of chromosomal abnormalities. The aim of this study was to investigate the chromosome abnormality incidence in fetuses with nuchal edema, CH, or NIH. MATERIALS AND METHODS: The authors performed cytogenetic analysis of 218 singleton fetuses with ultrasound diagnosis of subcutaneous edema in the forms of nuchal edema in the first and second trimesters. RESULTS: Chromosomal abnormality rates were 30.4, 10.4, 36.8, 34.1, and 60% in the nuchal translucency (NT), nuchal fold thickness (NF), CH, NIH, and CH with NIH groups, respectively. In 71 cases with detected chromosomal abnormalities, 37%, 44%, 15%, and 4% of the pathologic karyotypes were identified as monosomy X, trisomy 21, trisomy 18, and trisomy 13, respectively. CONCLUSIONS: This study confirms that subcutaneous edema detected sonographically, in the forms of nuchal edema, CH, or NIH, is a significant indicator of abnormal karyotype and deserves further investigation.
Assuntos
Aberrações Cromossômicas , Hidropisia Fetal/diagnóstico por imagem , Linfangioma Cístico/diagnóstico por imagem , Medição da Translucência Nucal , Adolescente , Adulto , Feminino , Idade Gestacional , Humanos , Cariotipagem , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Gravidez , Segundo Trimestre da Gravidez , Ultrassonografia Pré-Natal , Adulto JovemRESUMO
The authors' aim was to detect the associated anomalies and their effect on the management of the fetuses with omphalocele and gastroschisis. Between the period of 2007-2013, the data of fetuses with abdominal wall defects were analyzed. Chromosomal abnormalities and associated morphologic anomalies diagnosed by ultrasonography and autopsy were evaluated. Of the. 61 fetuses, ten (20.4%) omphalocele cases and nine (75%) gastroschisis cases were isolated. Chromosomal abnormalities were found in seven fetuses with omphalocele cases. All fetuses with abnormal karyotypes had multiple additional anomalies. Termination rate was 65.3% for omphalocele group versus none in the gastroschisis group. To give better counseling about the prognosis and outcome of the fetuses with abdominal wall defects, detection of additional anomalies as well as type of the defect are essential tools even if the karyotype is normal.
Assuntos
Anormalidades Múltiplas/diagnóstico por imagem , Aberrações Cromossômicas/estatística & dados numéricos , Transtornos Cromossômicos/genética , Gastrosquise/diagnóstico por imagem , Hérnia Umbilical/diagnóstico por imagem , Adulto , Transtornos Cromossômicos/epidemiologia , Feminino , Feto , Gastrosquise/epidemiologia , Gastrosquise/genética , Hérnia Umbilical/epidemiologia , Hérnia Umbilical/genética , Humanos , Cariótipo , Cariotipagem , Masculino , Gravidez , Prognóstico , Estudos Retrospectivos , Centros de Atenção Terciária , Ultrassonografia Pré-Natal , Adulto JovemRESUMO
The aim of our study was to evaluate the incidences and chromosomal abnormality detection rates of various indications for genetic amniocentesis. We retrospectively analysed 6,142 amniocentesis cases performed in a single centre between January 2007 and April 2013. We assessed the indications for prenatal diagnosis, fetal karyotypes, maternal ages, fetal ultrasound findings and maternal serum screening results. The most common indication for genetic amniocentesis was an abnormal maternal serum-screening test (36.6%), followed by advanced maternal age (28%), advanced maternal age and an abnormal maternal serum screening test (14.9%) and abnormal ultrasound findings (11.2%). The highest positive predictive values obtained from the indications included abnormal ultrasound findings and abnormal maternal serum screening test (12.9%) and advanced maternal age (12.2%). Although advanced maternal age and abnormal maternal serum screening tests were the most common indicators, their association with abnormal ultrasound findings should be identified to increase the efficacy of genetic amniocentesis.
Assuntos
Amniocentese/estatística & dados numéricos , Aberrações Cromossômicas/estatística & dados numéricos , Feminino , Humanos , Gravidez , Estudos Retrospectivos , TurquiaRESUMO
BACKGROUND: Preliminary experience has suggested that preperitoneal mesh positioning causes less chronic pain than Lichtenstein's technique for inguinal hernia repair. Therefore, a randomized clinical trial was conducted with the aim of evaluating the incidence of postoperative chronic pain after transinguinal preperitoneal (TIPP) mesh repair versus Lichtenstein's technique. METHODS: Patients with a primary unilateral inguinal hernia were randomized to either TIPP or Lichtenstein's repair in two training hospitals. The primary outcome was the number of patients with chronic pain after surgery. Secondary outcomes were adverse events. Follow-up was scheduled after 14 days, 3 months and 1 year. Patients and outcome assessors were blinded. RESULTS: A total of 302 patients were randomized to TIPP (143) or Lichtenstein (159) repair. Baseline characteristics were comparable in the two groups. Some 98.0 per cent of the patients were included in the analysis (141 in the TIPP group and 155 in the Lichtenstein group). Significantly fewer patients in the TIPP group had continuous chronic pain 1 year after surgery: five patients (3.5 per cent) versus 20 patients (12.9 per cent) in the Lichtenstein group (P = 0.004). An additional 12 patients (8.5 per cent) in the TIPP group and 60 (38.7 per cent) in the Lichtenstein group experienced pain during activity (P = 0.001). There were two patients with recurrence in the TIPP group and four in the Lichtenstein group, but no significant differences were found in other severe adverse events between the groups. CONCLUSION: Fewer patients had continuous chronic pain at 1 year after the TIPP mesh inguinal hernia repair compared with Lichtenstein's repair.
Assuntos
Hérnia Inguinal/cirurgia , Herniorrafia/efeitos adversos , Dor Pós-Operatória/etiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Dor Crônica , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Equipe de Assistência ao Paciente , Resultado do Tratamento , Adulto JovemRESUMO
Smad-interacting protein 1 (SIP1, also known as ZEB2) represses the transcription of E-cadherin and mediates epithelial-mesenchymal transition in development and tumor metastasis. Due to the lack of human SIP1-specific antibodies, its expression in human tumor tissues has not been studied in detail by immunohistochemistry. Hence, we generated two anti-SIP1 monoclonal antibodies, clones 1C6 and 6E5, with IgG1 and IgG2a isotypes, respectively. The specificity of these antibodies was shown by Western blotting studies using siRNA mediated downregulation of SIP1 and ZEB1 in a human osteosarcoma cell line. In the same context, we also compared them with 5 commercially available SIP1 antibodies. Antibody specificity was further verified in an inducible cell line system by immunofluorescence. By using both antibodies, we evaluated the tissue expression of SIP1 in paraffin-embedded tissue microarrays consisting of 22 normal and 101 tumoral tissues of kidney, colon, stomach, lung, esophagus, uterus, rectum, breast and liver. Interestingly, SIP1 predominantly displayed a cytoplasmic expression, while the nuclear localization of SIP1 was observed in only 6 cases. Strong expression of SIP1 was found in distal tubules of kidney, glandular epithelial cells of stomach and hepatocytes, implicating a co-expression of SIP1 and E-cadherin. Squamous epithelium of the esophagus and surface epithelium of colon and rectum were stained with moderate to weak intensity. Normal uterus, breast and lung tissues remained completely negative. By comparison with their normal tissues, we observed SIP1 overexpression in cancers of the kidney, breast, lung and uterus. However, SIP1 expression was found to be downregulated in tumors from colon, rectum, esophagus, liver and stomach tissues. Finally we did nuclear/cytoplasmic fractionation in 3 carcinoma cell lines and detected SIP1 in both fractions, nucleus being the dominant one. To our best knowledge, this is the first comprehensive immunohistochemical study of the expression of SIP1 in a series of human cancers. Our finding that SIP1 is not exclusively localized to nucleus suggests that the subcellular localization of SIP1 is regulated in normal and tumor tissues. These novel monoclonal antibodies may help elucidate the role of SIP1 in tumor development.
Assuntos
Anticorpos Monoclonais , Citoplasma/metabolismo , Proteínas de Homeodomínio/análise , Imuno-Histoquímica , Neoplasias/metabolismo , Proteínas Repressoras/análise , Animais , Especificidade de Anticorpos/imunologia , Caderinas/genética , Caderinas/imunologia , Caderinas/metabolismo , Linhagem Celular , Citoplasma/imunologia , Epitélio/imunologia , Epitélio/metabolismo , Feminino , Imunofluorescência , Proteínas de Homeodomínio/imunologia , Humanos , Camundongos , Camundongos Endogâmicos BALB C , Neoplasias/imunologia , Proteínas Repressoras/imunologia , Homeobox 2 de Ligação a E-box com Dedos de ZincoRESUMO
Here, we describe a stillborn fetus who had lower mesodermal defects sequence associated with craniorachischisis, anencephaly, bilateral pulmonary hypoplasia.
Assuntos
Anormalidades Múltiplas , Mesoderma/anormalidades , Defeitos do Tubo Neural , Natimorto , Anencefalia , Feminino , Humanos , Pulmão/anormalidadesAssuntos
Doenças Fetais/diagnóstico por imagem , Hemangioma Cavernoso/diagnóstico por imagem , Neoplasias do Mediastino/diagnóstico por imagem , Ecocardiografia , Feminino , Doenças Fetais/patologia , Hemangioma Cavernoso/patologia , Humanos , Neoplasias do Mediastino/patologia , Mediastino/patologia , Gravidez , Ultrassonografia Pré-Natal , Adulto JovemRESUMO
Rapidly accumulating literature has proven feasibility of the zebrafish xenograft models in cancer research. Nevertheless, online databases for searching the current zebrafish xenograft literature are in great demand. Herein, we have developed a manually curated database, called ZenoFishDb v1.1 (https://konulab.shinyapps.io/zenofishdb), based on R Shiny platform aiming to provide searchable information on ever increasing collection of zebrafish studies for cancer cell line transplantation and patient-derived xenografts (PDXs). ZenoFishDb v1.1 user interface contains four modules: DataTable, Visualization, PDX Details, and PDX Charts. The DataTable and Visualization pages represent xenograft study details, including injected cell lines, PDX injections, molecular modifications of cell lines, zebrafish strains, as well as technical aspects of the xenotransplantation procedures in table, bar, and/or pie chart formats. The PDX Details module provides comprehensive information on the patient details in table format and can be searched and visualized. Overall, ZenoFishDb v1.1 enables researchers to effectively search, list, and visualize different technical and biological attributes of zebrafish xenotransplantation studies particularly focusing on the new trends that make use of reporters, RNA interference, overexpression, or mutant gene constructs of transplanted cancer cells, stem cells, and PDXs, as well as distinguished host modifications.
Assuntos
Bases de Dados Factuais , Transplante Heterólogo , Peixe-Zebra/cirurgia , Animais , Bases de Dados Factuais/estatística & dados numéricosRESUMO
Convolutional neural networks with strong representation ability of deep structures have ever increasing popularity in many research areas. The main difference of Convolutional Neural Networks with respect to existing similar artificial neural networks is the inclusion of the convolutional part. This inclusion directly increases the performance of artificial neural networks. This fact has led to the development of many different convolutional models and techniques. In this work, a novel convolution technique named as Differential Convolution and updated error back-propagation algorithm is proposed. The proposed technique aims to transfer feature maps containing directional activation differences to the next layer. This implementation takes the idea of how convolved features change on the feature map into consideration. In a sense, this process adapts the mathematical differentiation operation into the convolutional process. Proposed improved back propagation algorithm also considers neighborhood activation errors. This property increases the classification performance without changing the number of filters. Four different experiment sets were performed to observe the performance and the adaptability of the differential convolution technique. In the first experiment set utilization of the differential convolution on a traditional convolutional neural network structure made a performance boost up to 55.29% for the test accuracy. In the second experiment set differential convolution adaptation raised the top1 and top5 test accuracies of AlexNet by 5.3% and 4.75% on ImageNet dataset. In the third experiment set differential convolution utilized model outperformed all compared convolutional structures. In the fourth experiment set, the Differential VGGNet model obtained by adapting proposed differential convolution technique performed 93.58% and 75.06% accuracy values for CIFAR10 and CIFAR100 datasets, respectively. The accuracy values of the Differential NIN model containing differential convolution operation were 92.44% and 72.65% for the same datasets. In these experiment sets, it was observed that the differential convolution technique outperformed both traditional convolution and other compared convolution techniques. In addition, easy adaptation of the proposed technique to different convolutional structures and its efficiency demonstrate that popular deep learning models may be improved with differential convolution.
Assuntos
Aprendizado Profundo , Redes Neurais de Computação , Reconhecimento Automatizado de Padrão/métodos , Aprendizado Profundo/tendências , Humanos , Reconhecimento Automatizado de Padrão/tendênciasRESUMO
OBJECTIVE: The aim of this study was to evaluate the usefulness of integrated 2-[18F] fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (PET/CT) for the detection of para-aortic nodal status and to test whether PET/CT change management strategy in locally advanced cervical cancer (LACC) patients with negative conventional CT findings. MATERIALS AND METHODS: Sixteen locally advanced (FIGO stage IIB-IVA) cervical squamous cancer patients with negative conventional CT findings were eligible to enter this prospective study. All patients underwent firstly PET/CT scans then extraperitoneal surgical exploration for para-aortic lymphadenectomy. Based on histopathologic confirmation, the accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the PET/CT for para-aortic lymph node metastasis were estimated. RESULTS: The median age was 48.7 (range 42-67). The accuracy, sensitivity, specificity, PPV and NPV of the PET/CT were 75%, 50%, 83.3%, 50% and 83.3%, respectively. The treatment was modified in four of sixteen (25%) patients; four patients received EFRT in combination with cisplatin chemotherapy instead of standard pelvic field radiotherapy in combination with cisplatin chemotherapy. CONCLUSION: Our results, despite our study group is small, suggest that PET/CT is an effective imaging technique in the evaluation of LACC with negative CT findings. It may help planning the management especially selecting radiation field. However, larger controlled studies are needed to recommend PET/CT as an alternative to pre-treatment surgical staging.
Assuntos
Fluordesoxiglucose F18 , Linfonodos/diagnóstico por imagem , Recidiva Local de Neoplasia/diagnóstico por imagem , Compostos Radiofarmacêuticos , Neoplasias do Colo do Útero/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Antígeno Ca-125/sangue , Feminino , Humanos , Metástase Linfática , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/sangue , Recidiva Local de Neoplasia/patologia , Estadiamento de Neoplasias , Tomografia por Emissão de Pósitrons , Estudos Prospectivos , Tomografia Computadorizada por Raios X , Neoplasias do Colo do Útero/sangue , Neoplasias do Colo do Útero/patologiaRESUMO
The objective of this study is to evaluate the cardiac safety of pegylated liposomal doxorubicin (PLD) reaching or exceeding a cumulative dose of 550 mg/m(2) in patients with recurrent ovarian and peritoneal cancer. A total of 14 patients (11 ovarian cancer, 3 primary peritoneal cancer) who received PLD in our center between February 2004 and October 2006 met inclusion criteria of the study. PLD was administered at doses of 30 mg/m(2) together with carboplatin or 50 mg/m(2) as a single agent every 3-6 weeks. Left ventricular ejection fraction (LVEF) estimations performed by M Mode ultrasound (General Electric Vivid-3, Milwaukee, Wisconsin) and clinical cardiac status were used to detect PLD-related cardiotoxicity. The median cumulative dose of PLD was 685.5 mg/m(2) (range 552-1015 mg/m(2)) and the median number of PLD courses was 9.5 (range 7-17). One patient had also been previously treated with conventional doxorubicin. LVEF scans were obtained on 10 of the 14 patients at the beginning of the therapy and on all patients at the end of therapy. No clinical evidence (symptoms or physical findings) of cardiac dysfunction had been observed in these patients either during active treatment or follow-up period. Despite small number of patients and lack of control group, our study suggests that the cumulative doses in excess of 550 mg/m(2) of PLD seem to not carry a significant risk of cardiomyopathy as judged by LVEF and clinical follow-up.
Assuntos
Antineoplásicos/uso terapêutico , Doxorrubicina/análogos & derivados , Cardiopatias/induzido quimicamente , Neoplasias Ovarianas/tratamento farmacológico , Neoplasias Peritoneais/tratamento farmacológico , Polietilenoglicóis/uso terapêutico , Adulto , Idoso , Antineoplásicos/efeitos adversos , Relação Dose-Resposta a Droga , Doxorrubicina/efeitos adversos , Doxorrubicina/uso terapêutico , Ecocardiografia , Feminino , Cardiopatias/diagnóstico por imagem , Humanos , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Polietilenoglicóis/efeitos adversosRESUMO
Acetylcholinesterase (AChE), an enzyme responsible for degradation of acetylcholine, has been identified as a prognostic marker in liver cancer. Although in vivo Ache tumorigenicity assays in mouse are present, no established liver cancer xenograft model in zebrafish using an ache mutant background exists. Herein, we developed an embryonic zebrafish xenograft model using epithelial (Hep3B) and mesenchymal (SKHep1) liver cancer cell lines in wild-type and ache sb55 sibling mutant larvae after characterization of cholinesterase expression and activity in cell lines and zebrafish larvae. The comparison of fluorescent signal reflecting tumor size at 3-days post-injection (dpi) revealed an enhanced tumorigenic potential and a reduced migration capacity in cancer cells injected into homozygous ache sb55 mutants when compared with the wild-type. Increased tumor load was confirmed using an ALU based tumor DNA quantification method modified for use in genotyped xenotransplanted zebrafish embryos. Confocal microscopy using the Huh7 cells stably expressing GFP helped identify the distribution of tumor cells in larvae. Our results imply that acetylcholine accumulation in the microenvironment directly or indirectly supports tumor growth in liver cancer. Use of this model system for drug screening studies holds potential in discovering new cholinergic targets for treatment of liver cancers.
Assuntos
Acetilcolinesterase/deficiência , Linhagem Celular Tumoral , Modelos Animais de Doenças , Xenoenxertos , Neoplasias Hepáticas/patologia , Peixe-Zebra , Animais , Transplante de NeoplasiasRESUMO
OBJECTIVE: We aimed to determine the efficacy of troponin I, D-dimer, and lactate levels and right ventricular diameter (RVD)/left ventricular diameter (LVD) ratio on pulmonary computed tomography angiography (PCTA) in the risk classification of patients who were diagnosed with acute pulmonary embolism (APE) in Emergency Department (ED). PATIENTS AND METHODS: Patients who were diagnosed as having APE by PCTA in ED were included in this retrospective study. Patients were grouped as high-risk (undergoing cardiopulmonary resuscitation or given thrombolytic therapy), moderate-risk (with non-high-risk and positive ECO findings) and low risk (others). Troponin I, D-dimer, and lactate levels of patients were determined. RVD, RVD/LVD ratio, and interventricular septum deviation were calculated from PCTA images. RESULTS: A total of 121 patients were included (35 high, 36 moderate, 50 low risk). Lactate was different in the high-risk group from the other groups, whereas there was no difference between the moderate and low-risk groups. Troponin I levels were not different between the high-risk and moderate-risk groups. There were statistically significant differences between the high, moderate, and low-risk groups in terms of mean RVD/LVD ratios. ROC analyses performed in order to define high-risk group revealed a cut-off value of > 2.3 (AUC = 0.848, sensitivity = 70%, specificity = 90%, + Likelihood ratio (LR) = 7, -LR = 0.33, 95% CI = 0.752-0.943) for lactate and > 1.40 (AUC = 0.695 sensitivity = 71%, specificity = 80%, + LR = 3.6, -LR = 0.36, 95% CI = 0.668-0.822) for RVD/LVD ratio. CONCLUSIONS: Lactate levels and RVD/LVD ratio were shown to be useful in distinguishing high-risk patients from other patient groups. Troponin I is important in terms of showing cardiac involvement, but it is inadequate in distinguishing between high and moderate-risk patients. Lactate, troponin I, and RVD/LVD ratio may be used together for a more accurate separation of patients with high, intermediate and low-risk.
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Serviço Hospitalar de Emergência , Embolia Pulmonar/diagnóstico , Troponina I/metabolismo , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/metabolismo , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Curva ROC , Estudos Retrospectivos , Fatores de Risco , Sensibilidade e Especificidade , Disfunção Ventricular Direita/fisiopatologiaRESUMO
When a natural tooth connected to an implant abutment by a framework is displaced within physiologic limits under functional loads, the superstructure acts as a cantilever moment arm and the implant is loaded additionally during that moment effect. The effects of a deflecting support connected to an IMZ implant, with either the IMC resilient or the titanium rigid element, were evaluated through an experimental model. The strain values measured when the moment arm was not allowed to deflect were only 30% lower than the strains measured when it was deflected within the limits of physiologic tooth mobility. The IMC was effective and achieved a reduction in the cervical strains up to 60% when compared with the rigid connector.
Assuntos
Força de Mordida , Dente Suporte , Implantes Dentários , Planejamento de Prótese Dentária , Análise do Estresse Dentário , Retenção em Prótese Dentária , Prótese Dentária Fixada por Implante , Humanos , Modelos Estruturais , Estresse Mecânico , Mobilidade DentáriaRESUMO
Cardiac troponin levels are regarded as the most specific of currently available biochemical markers of myocardial damage. Elevated levels of troponin have been previously reported in patients with left heart failure, reflecting small areas of undetected myocardial cell death. The aim of this study was to compare the levels of the cardiac troponin I (cTnI) in patients with left- and right-sided heart failure. Cardiac troponin I levels were studied with immunochemical methods in patients with right heart failure (n = 17) resulting from chronic obstructive pulmonary disease, ischemic left heart failure (n = 23), and nonischemic left heart failure (n = 18) who were admitted to departments of cardiology and chest diseases. Also, cTnI levels were measured in 32 healthy subjects as control group. Protein markers of myocardial injury (cTnI and myoglobin) in patients with left and right heart failure were collected approximately 12 to 36 hours after onset of obvious symptoms. Serum creatine kinase MB band was determined on admission and thereafter twice a day during the first 3 days. Elevated levels of serum cTnI were found in patients with nonischemic (0.83 +/- 0.6 ng/mL, p<0.01) and ischemic left heart failure (0.9 +/- 0.5 ng/mL, p<0.01) when compared to healthy subjects, whereas serum cTnI levels in patients with right heart failure due to chronic obstructive pulmonary disease were not significantly different from those of control subjects (0.22 +/- 0.1 vs 0.16 +/- 0.1 ng/mL, p>0.05). In addition, creatine kinase MB band and myoglobin levels were not significantly different between patient and healthy groups. The mean of cTnI levels in ischemic and even nonischemic left heart failure were increased compared to the mean of values in healthy individuals but without significant creatine kinase MB band and myoglobin elevations. But cTnI levels were not increased in patients with right heart failure due to chronic obstructive pulmonary disease. These data indicate that the cTnI levels are abnormal in left heart failure but not in cor pulmonale.
Assuntos
Doença Cardiopulmonar/sangue , Troponina I/sangue , Disfunção Ventricular Esquerda/sangue , Disfunção Ventricular Direita/sangue , Adulto , Idoso , Biomarcadores/sangue , Feminino , Humanos , Imuno-Histoquímica , Pneumopatias Obstrutivas/sangue , Masculino , Pessoa de Meia-IdadeRESUMO
This experiment was carried out to investigate the role of antioxidants such as vitamin C and E, selenium and Nigella sativa (NS) on the prevention of carbon tetrachloride (CCl4)-induced liver fibrosis in rabbits. It was found that superoxide dismutase (SOD) values in all of the treated groups were significantly lower than those of the control at 12th week of experiment (p < 0.05), while at 6th week and 12th week of experiment glutathione peroxidase (GSH-Px) values in the vitamin C treated group were significantly different from the control (p < 0.05). Histopathologically, hepatocellular necrosis, degeneration and advanced fibrosis were found in the control group. Lesions were minor and only confined to midzonal regions without centrilobular necrosis and fibrosis in the NS treated animals (group B). The lesions observed in the vitamin C treated animals (group C) were similar to that of the control group. Parenchymal changes with fibrosis were less in selenium and vitamin E treated animals (group D) than in those of the control group, but more obvious than in NS group. Histopathological findings demonstrate that NS might, at least partly, be successful in the prevention of liver fibrosis in rabbits. Vitamin E plus selenium had little therapeutic effect and vitamin C seemed to be ineffective, as far as the results of this study are concerned.
Assuntos
Antioxidantes/uso terapêutico , Cirrose Hepática Experimental/veterinária , Coelhos , Animais , Ácido Ascórbico/fisiologia , Ácido Ascórbico/uso terapêutico , Cirrose Hepática Experimental/induzido quimicamente , Cirrose Hepática Experimental/prevenção & controle , Fitoterapia , Plantas Medicinais/fisiologia , Plantas Medicinais/uso terapêutico , Sementes/fisiologia , Sementes/uso terapêutico , Selênio/fisiologia , Selênio/uso terapêutico , Vitamina E/fisiologia , Vitamina E/uso terapêuticoRESUMO
This study reviewed the clinical, laboratory, therapeutic and prognostic data on genitourinary involvement of brucellosis in this largest case series reported. This multicentre study pooled adult patients with genitourinary brucellar involvement from 34 centres treated between 2000 and 2013. Diagnosis of the disease was established by conventional methods. Overall 390 patients with genitourinary brucellosis (352 male, 90.2%) were pooled. In male patients, the most frequent involved site was the scrotal area (n=327, 83.8%), as epididymo-orchitis (n=204, 58%), orchitis (n=112, 31.8%) and epididymitis (n=11, 3.1%). In female patients, pyelonephritis (n=33/38, 86.8%) was significantly higher than in male patients (n=11/352, 3.1%; p<0.0001). The mean blood leukocyte count was 7530±3115/mm3. Routine laboratory analysis revealed mild to moderate increases for erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). The mean treatment duration and length of hospital stay were significantly higher when there were additional brucellar foci (p<0.05). Surgical operations including orchiectomy and abscess drainage were performed in nine (2.3%) patients. Therapeutic failure was detected in six (1.5%), relapse occurred in four (1%), and persistent infertility related to brucellosis occurred in one patient. A localized scrotal infection in men or pyelonephritis in women in the absence of leucocytosis and with mild to moderate increases in inflammatory markers should signal the possibility of brucellar genitourinary disease.