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1.
Int J Neurosci ; 133(8): 901-907, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34906029

RESUMO

PURPOSE: We report two cases of optic nerve pathology after the administration of the Pfizer-BioNTech and AstraZeneca-Oxford COVID-19 vaccines, respectively, and describe the implications for management of post-vaccination central nervous system (CNS) inflammation. CASE REPORTS: A 69-year-old woman presented with bilateral optic nerve head oedema, 16 days after the second dose of the Pfizer-BioNTech vaccine. She was diagnosed with post-vaccination CNS inflammatory syndrome and was treated for five days with intravenous methylprednisolone at a dose of 1 gram per day. Her optic disc swelling improved, and her vision stabilised. A 32-year-old woman presented six days after her first dose of the AstraZeneca-Oxford vaccine with two days of sudden onset of progressive blurring of vision in her left eye. Posterior segment examination revealed left optic disc swelling, and an MRI of the brain, orbit, and cervical spine was significant for left optic nerve enhancement. The patient was diagnosed with a unilateral post-vaccination optic neuritis. She was treated with a three-day course of intravenous methylprednisolone followed by oral prednisone. Her optic disc swelling and visual field improved, and she recovered 6/6 vision. CONCLUSIONS: Clinicians and patients should be aware of the potential for post-vaccination CNS inflammatory syndromes associated with COVID-19 vaccine administration. Neuroimaging and cerebrospinal fluid analysis may aid in the diagnosis of the cause of vision loss. Further studies are needed to evaluate the spectrum and frequency of optic nerve involvement associated with COVID-19 vaccination.


Assuntos
Vacinas contra COVID-19 , COVID-19 , Doenças do Nervo Óptico , Papiledema , Adulto , Idoso , Feminino , Humanos , COVID-19/prevenção & controle , Vacinas contra COVID-19/efeitos adversos , Metilprednisolona/uso terapêutico , Nervo Óptico/diagnóstico por imagem , Doenças do Nervo Óptico/induzido quimicamente , Doenças do Nervo Óptico/tratamento farmacológico , Vacinação/efeitos adversos
2.
Orbit ; 42(4): 397-403, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-36069075

RESUMO

PURPOSE: To evaluate the effect of optic nerve sheath fenestration (ONSF) on the rate of visual function improvement in patients with pseudotumor cerebri syndrome (PTCS). METHODS: Retrospective chart review of patients with PTCS who underwent ONSF between 1998 and 2017. Visual function was evaluated by evaluating visual field (VF), mean deviation (MD), retinal nerve fiber layer (RNFL) thickness, papilledema grade, and visual acuity (VA) prior to and after ONSF. RESULTS: Seventeen female patients aged 17 to 36 years underwent unilateral ONSF. Follow-up averaged 40.1 months. VF MD improved steadily in both eyes up to 12 months. Average RNFL thickness improved in the operated eye from 347 ± 166 mm to 92 ± 27 mm (p < .001) and the non-operated eyes from 306 ± 165 mm to 109 ± 46 mm (p < .001). The grade of papilledema improved in the operated eye from 3.3 ± 1.3 to 0.3 ± 0.7 and the non-operated eye from 3.0 ± 1.6 to 0.18 ± 0.4. There was an exponential rate of improvement in papilledema and RNFL thickness, with the greatest improvement occurring within the first 30 days. Average visual acuity remained intact in both eyes before and after surgery. CONCLUSIONS: ONSF in appropriately selected patients leads to rapid improvement in papilledema and a steady recovery in VF.


Assuntos
Papiledema , Pseudotumor Cerebral , Humanos , Feminino , Pseudotumor Cerebral/cirurgia , Papiledema/etiologia , Papiledema/cirurgia , Nervo Óptico/cirurgia , Estudos Retrospectivos , Campos Visuais
3.
Phys Chem Chem Phys ; 24(47): 28923-28933, 2022 Dec 07.
Artigo em Inglês | MEDLINE | ID: mdl-36416292

RESUMO

Green synthesis of copper oxide nanoparticles and its effects on photocatalytic dye degradation and antibacterial activities are reported. The synthesis of nanoparticles by green routes provides many advantages over chemical routes, including simplicity, cost-effectiveness, and fast processing route without using any costly or harmful chemicals. Tridax procumbense (coat buttons) plant root extract was used to synthesize copper oxide nanoparticles. The synthesized Tridax procumbense-copper oxide nanoparticles (TP-CuO NPs) were characterized by UV-visible spectroscopy, Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), transmission electron microscopy (TEM), dynamic light scattering spectroscopy (DLS), and X-ray diffraction (XRD) techniques. The synthesized TP-CuO NPs were applied for photocatalytic dye degradation and antibacterial activity studies. The TP-CuO NPs exhibited a maximum antibacterial activity at 500 µg mL-1 concentration against Staphylococcus aureus and E. coli showing inhibition zones of 7.5 mm and 7.2 mm, respectively. The photocatalytic ability of the TP-CuO was also tested against the textile dye Trypan blue (TB), and showed about 55% degradation after 48 h for 500 µg mL-1 CuO NP concentration, showing a concentration-dependent degradation efficiency. This is the first work on TP-derived CuO nanoparticles and their photocatalytic and antimicrobial applications. Overall, this study supports the superiority of green-synthesized TP-CuO NPs as photocatalytic and antimicrobial agents.


Assuntos
Cobre , Escherichia coli , Óxidos
4.
Environ Res ; 201: 111520, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34153332

RESUMO

The pentadentate ligand and the precursors were combined to form complexes by green approach. The ligand formation was confirmed by UV-Vis, FT-IR, 1H-NMR, and LC-MS. The optimised stable structure was obtained by molecular simulation studies and the complexes were interpreted by conductivity measurements, UV-Vis, FT-IR, magnetic susceptibility, VSM, and ESR spectral studies. The redox nature of the complexes was investigated by cyclic voltammetry. The cyclic voltammogram shows complexes exhibited single electron transfer from Cu+2/Cu+1. Complexes and penta-dentate ligand were screened for in vitro cytotoxicity by MTT assay method on A431 skin cancer cell line. The ligand structural stability and biological activity were confirmed by theoretical computational studies. The magnetic behaviour showed antiferromagnetic properties at low temperature. The complexes were used as high bar magnets. Similarly, the redox behaviour showed that the complexes could be used in electroplating techniques and sensors. Clinical application revealed that the complexes had effective cytotoxicity. From the data obtained, the complexes were in the form [MLR], where L was the penta-dentate ligand and R = [C6H5COO] & R = [C6H4COO (OH)].


Assuntos
Complexos de Coordenação , Linhagem Celular , Cobre , Células Epidérmicas , Humanos , Espectroscopia de Infravermelho com Transformada de Fourier
5.
Phytother Res ; 35(4): 1847-1871, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33140507

RESUMO

Hydrocotyle sibthorpioides Lam. (Araliaceae) is a short and edible medicinal herb, which is used in the traditional system of medicines. The review aims to report the current information of H. sibthorpioides on the basis of its botanical and taxonomical description, traditional use, active phytoconstituents, pharmacological use and toxicity. The information on H. sibthorpioides with respect to its journey from traditional uses to scientific validation was gathered based on the online survey. The results from the review signify that the plant is used by the different tribes of the world for the treatment of patients suffering from fever, edema, dysentery, rheumatalgia, whooping cough, jaundice, throat pain, psoriasis, herpes zoster infection, hepatitis-B infection, soothing pain, dysmenorrhoea and carbunculosis. It is also used as a brain tonic, detoxifying agent and hepatoprotective agent. Scientific investigation reported that the plant has a significant pharmacological activity, viz. cognitive agent, anti-cancer, antiviral, antibacterial, anti-fungal and hepatoprotective. Moreover, based on the phytochemical aspects, a total of 50 phytoconstituents was identified and isolated from the plant. In conclusion, the outcome of this review will be useful for (a) developing a comprehensive plant profile; (b) assist investigators for exploring further research; and (c) to fulfil the gaps lacking in terms of clinical studies.


Assuntos
Centella/química , Extratos Vegetais/química , Extratos Vegetais/uso terapêutico , Humanos
6.
J Food Sci Technol ; 57(7): 2732-2738, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32549623

RESUMO

Diet plays an important role in management of diabetes and foods having low glycemic index are gaining more importance as they delay the release of glucose in the blood. It is essential to develop low glycemic food mix from regionally available ingredients for use in daily dietaries. Hence, the present study was undertaken to assess the glycemic index of the traditional recipes prepared from developed millet based food mix and their effect on pre diabetic subjects. The developed millet based food mix had appreciable amount of protein (19.41 g/100 g) and dietary fibre (21.11 g/100 g). The traditional recipes viz., roti, dosa and dumpling (mudde) prepared from developed mix exhibited higher acceptance with good sensory parameters and are comparable to regional preparations. The glycemic index was found to be 37, 48 and 53 for dosa, mudde and roti respectively with a glycemic load of 11.05, 18.43 and 18.09. However, all the three developed products showed the relatively lower glycemic index (< 55) and moderate glycemic load of < 20. Further, dietary intervention on pre diabetic subjects revealed that there was a significant reduction in FBS (120.50 ± 18.73 to 97.81 ± 20.00) and HbA1c (6.14 ± 0.30 to 5.67 ± 0.40) indicating their preferable option in the management of diabetes mellitus.

7.
J Med Syst ; 43(7): 199, 2019 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-31119389

RESUMO

The article India: Intruder Node Detection and Isolation Action in Mobile Ad Hoc Networks Using Feature Optimization and Classification Approach, written by T. Kavitha, K. Geetha and R. Muthaiah, was originally published electronically on the publisher's internet portal (currently SpringerLink) on May 11, 2019 with open access.

8.
J Med Syst ; 43(6): 179, 2019 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-31076950

RESUMO

Due to lack of a central bureaucrat in mobile ad hoc networks, the security of the network becomes serious issue. During malicious attacks, according to the motivation of intruder the severity of the threat varies. It may lead to loss of data, energy or throughput. This paper proposes a lightweight Intruder Node Detection and Isolation Action mechanism (INDIA) using feature extraction, feature optimization and classification techniques. The indirect and direct trust features are extracted from each node and the total trust feature is computed by combining them. The trust features are extracted from each node of MANET and these features are optimized using Particle Swarm Optimization (PSO) algorithm as feature optimization technique. These optimized feature sets are then classified using Neural Networks (NN) classifier which identifies the intruder node. The performance of the proposed methodology is studied in terms of various parameters such as success rate in packet delivery, delay in communication and the amount of energy consumption for identifying and isolating the intruder.


Assuntos
Segurança Computacional , Redes Neurais de Computação , Algoritmos , Índia , Informática Médica
10.
Mol Biol Rep ; 44(1): 19-24, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-28110431

RESUMO

CYMBOPOGON: is an important member of grass family Poaceae, cultivated for essential oils which have greater medicinal and industrial value. Taxonomic identification of Cymbopogon species is determined mainly by morphological markers, odour of essential oils and concentration of bioactive compounds present in the oil matrices which are highly influenced by environment. Authenticated molecular marker based taxonomical identification is also lacking in the genus; hence effort was made to evaluate potential DNA barcode loci in six commercially important Cymbopogon species for their individual discrimination and authentication at the species level. Four widely used DNA barcoding regions viz., ITS 1 & ITS 2 spacers, matK, psbA-trnH and rbcL were taken for the study. Gene sequences of the same or related genera of the concerned loci were mined from NCBI domain and primers were designed and validated for barcode loci amplification. Out of the four loci studied, sequences from matK and ITS spacer loci revealed 0.46% and 5.64% nucleotide sequence diversity, respectively whereas the other two loci i.e., psbA-trnH and rbcL showed 100% sequence homology. The newly developed primers can be used for barcode loci amplification in the genus Cymbopogon. The identified Single Nucleotide Polymorphisms from the studied sequences may be used as barcodes for the six Cymbopogon species. The information generated can also be utilized for barcode development of the genus by including more number of Cymbopgon species in future.


Assuntos
Cymbopogon/classificação , Código de Barras de DNA Taxonômico/métodos , Polimorfismo de Nucleotídeo Único , Sequência de Bases , Cymbopogon/genética , DNA de Plantas/genética , DNA Espaçador Ribossômico/genética , Filogenia , Análise de Sequência de DNA/métodos , Especificidade da Espécie
11.
J Neuroophthalmol ; 37(1): 7-12, 2017 03.
Artigo em Inglês | MEDLINE | ID: mdl-28192385

RESUMO

BACKGROUND: Patterns of ganglion cell complex (GCC) loss detected by optical coherence tomography provide an objective measure of optic nerve injury. These patterns aid in early diagnosis and localization of chiasmal lesions. METHODS: Twenty-three patients with chiasmal compression seen between 2010 and 2015 were imaged with the Cirrus high-definition optical coherence tomography macular cube 512 × 128, retinal nerve fiber layer (RNFL) scan protocols and automated (30-2 Humphrey) visual fields (VFs). Age-matched controls were included for comparison. Generalized estimating equations were performed comparing RNFL and GCC thicknesses between patients and their controls. Effect size (d) was calculated to assess the magnitude of difference between patients and controls. The average GCC and RNFL thicknesses also were correlated with VF mean deviation (MD). Pre operative average GCC thickness was correlated to post operative VF MD. RESULTS: Patterns of GCC thinning corresponded to VF defects. The average GCC thickness was 67 ± 9 µm in patients and 86 ± 5 µm in controls (P < 0.001). The effect size was the greatest for GCC thickness (d = 2.72). The mean deviation was better correlated with GCC thickness (r =0.25) than RNFL thicknesses (r =0.15). Postoperatively, VF MD improved in 7 of 8 patients with persistent nasal GCC thinning. Six patients had no VF defect and showed statistically significant loss of GCC compared with controls (P = 0.001). CONCLUSIONS: Distinct patterns of GCC loss were identified in patients with chiasmal compression. Binasal GCC loss was typical and could be seen with minimal or no detectable VF loss. Thinning of the GCC may be detected before loss of the RNFL in some patients. After decompression, the majority of patients showed improvement in VF despite persistent GCC loss. Patients with less GCC loss before decompression had better postoperative VFs. Therefore, GCC analysis may be an objective method to diagnose and follow patients with chiasmal lesions.


Assuntos
Síndromes de Compressão Nervosa/diagnóstico , Fibras Nervosas/patologia , Quiasma Óptico/patologia , Células Ganglionares da Retina/patologia , Tomografia de Coerência Óptica/métodos , Campos Visuais , Neoplasias Encefálicas/complicações , Neoplasias Encefálicas/diagnóstico , Neoplasias Encefálicas/cirurgia , Estudos de Casos e Controles , Descompressão Cirúrgica , Feminino , Seguimentos , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Síndromes de Compressão Nervosa/etiologia , Síndromes de Compressão Nervosa/cirurgia , Estudos Retrospectivos , Testes de Campo Visual
12.
Cell Biol Int ; 40(9): 991-8, 2016 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-27338984

RESUMO

Nuclear pore complexes in the nuclear membrane act as the sole gateway of transport of molecules from the cytoplasm to the nucleus and vice versa. Studies on biomolecular transport through nuclear membranes provide vital data on the nuclear pore complexes. In this work, we use fluorescein isothiocyanate-labeled dextran molecules as a model system and study the passive nuclear import of biomolecules through nuclear pore complexes in digitonin-permeabilized HeLa cells. Experiments are carried out under transient conditions in the time lapse imaging scheme using an in-house constructed confocal laser scanning microscope. Transport rates of dextran molecules having molecular weights of 4-70 kDa corresponding to Stokes radius of 1.4-6 nm are determined. Analyzing the permeability of the nuclear membrane for different sizes the effective pore radius of HeLa cell nuclear membrane is determined to be 5.3 nm, much larger than the value reported earlier using proteins as probe molecules. The range of values reported for the nuclear pore radius suggest that they may not be rigid structures and it is quite probable that the effective pore size of nuclear pore complexes is critically dependent on the probe molecules and on the environmental factors.


Assuntos
Poro Nuclear/metabolismo , Transporte Ativo do Núcleo Celular , Permeabilidade da Membrana Celular , Núcleo Celular/metabolismo , Citoplasma/metabolismo , Células HeLa , Humanos , Microscopia Confocal , Membrana Nuclear/metabolismo , Permeabilidade , Imagem com Lapso de Tempo
13.
Phytother Res ; 30(11): 1775-1784, 2016 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-27406028

RESUMO

Despite the widespread use of hormone replacement therapy, various reports on its side effects have generated an increasing interest in the development of safe natural agents for the management of postmenopausal discomforts. The present randomized, double-blinded, placebo-controlled study investigated the effect of 90-day supplementation of a standardized extract of fenugreek (Trigonella foenum-graecum) (FenuSMART™), at a dose of 1000 mg/day, on plasma estrogens and postmenopausal discomforts. Eighty-eight women having moderate to severe postmenopausal discomforts and poor quality of life (as evidenced from the scores of Greene Climacteric Scale, short form SF-36® and structured medical interview) were randomized either to extract-treated (n = 44) or placebo (n = 44) groups. There was a significant (p < 0.01) increase in plasma estradiol (120%) and improvements on various postmenopausal discomforts and quality of life of the participants in the extract-treated group, as compared with the baseline and placebo. While 32% of the subjects in the extract group reported no hot flashes after supplementation, the others had a reduction to one to two times per day from the baseline stages of three to five times a day. Further analysis of haematological and biochemical parameters revealed the safety of the extract and its plausible role in the management of lipid profile among menopausal women. Copyright © 2016 John Wiley & Sons, Ltd.


Assuntos
Menopausa/metabolismo , Extratos Vegetais/química , Pós-Menopausa/efeitos dos fármacos , Trigonella/química , Método Duplo-Cego , Feminino , Humanos , Pessoa de Meia-Idade , Extratos Vegetais/farmacologia , Extratos Vegetais/uso terapêutico , Qualidade de Vida
14.
Mol Genet Genomics ; 290(3): 1155-68, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25573779

RESUMO

Antioxidant enzymes can contribute to disease susceptibility or determine response to therapy in individuals with malaria. Genetic variations due to polymorphisms in host genes encoding antioxidant enzymes such as glutathione S-transferases-theta, mu, pi (GSTT, GSTM, GSTP), superoxide dismutases (SOD) and catalase (CAT), may therefore, influence inter-individual response to malaria pathology and propensity of infection caused by Plasmodium vivax (Pv) and Plasmodium falciparum (Pf). Therefore, using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and DNA sequencing, we investigated the association of deletions of GSTT1 and GSTM1, single nucleotide polymorphisms (SNPs) of GSTP1 (rs1695), SOD1 (rs2234694), SOD2 (rs4880, rs1141718), SOD3 (rs2536512) and CAT (rs1001179) in individuals infected with Pf (n = 100) and Pv (n = 100) against healthy controls (n = 150). Our data suggest a significant role for GSTM1 deletions in complicated Pv (p = 0.0007) malaria with ODDs ratio 3.8 [with 95 % confidence interval (CI) 1.9-7.4]. The results also indicated that polymorphisms present in GSTP1, SOD1 and CAT genes may be associated with malaria susceptibility (p < 0.05), whereas SOD3 polymorphism may play a role in malarial resistance (p < 0.05). In addition, we observed significant SNP-SNP interactions with synergistic genetic effects in SOD2, SOD3 and CAT genes for Pv and in SOD2 and SOD3 genes for Pf. In conclusion, our results provide convincing evidence for a relationship between polymorphisms in host antioxidant enzymes and susceptibility to malaria infection.


Assuntos
Povo Asiático/genética , Catalase/genética , Variação Genética , Glutationa Transferase/genética , Malária/genética , Superóxido Dismutase/genética , Adulto , Antioxidantes/metabolismo , Estudos de Casos e Controles , Feminino , Predisposição Genética para Doença , Genótipo , Glutationa S-Transferase pi/genética , Humanos , Índia , Malária/enzimologia , Masculino , Pessoa de Meia-Idade , Polimorfismo de Fragmento de Restrição , Polimorfismo de Nucleotídeo Único/genética , Fatores de Risco , Adulto Jovem
15.
J Microsc ; 256(2): 111-6, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25179372

RESUMO

We report on the design and construction of a laser scanning photothermal microscope and present images of gold nanoparticles of size as small as 5 nm. Laser scanning method allows fast image acquisition at 80 µs pixel dwell time so that a 500 × 500 pixel image is acquired in 20 s. Photothermal imaging at fast time scales can have potential applications in variety of fields including tracking of biomolecular transport processes.

16.
Sci Rep ; 14(1): 19044, 2024 08 16.
Artigo em Inglês | MEDLINE | ID: mdl-39152185

RESUMO

The nuclear pore complexes on the nuclear membrane serve as the exclusive gateway for communication between the nucleus and the cytoplasm, regulating the transport of various molecules, including nucleic acids and proteins. The present work investigates the kinetics of the transport of negatively charged graphene quantum dots through nuclear membranes, focusing on quantifying their transport characteristics. Experiments are carried out in permeabilized HeLa cells using time-lapse confocal fluorescence microscopy. Our findings indicate that negatively charged graphene quantum dots exhibit rapid transport to the nuclei, involving two distinct transport pathways in the translocation process. Complementary experiments on the nuclear import and export of graphene quantum dots validate the bi-directionality of transport, as evidenced by comparable transport rates. The study also shows that the negatively charged graphene quantum dots possess favorable retention properties, underscoring their potential as drug carriers.


Assuntos
Transporte Ativo do Núcleo Celular , Núcleo Celular , Grafite , Pontos Quânticos , Pontos Quânticos/química , Pontos Quânticos/metabolismo , Humanos , Grafite/química , Células HeLa , Núcleo Celular/metabolismo , Membrana Nuclear/metabolismo , Poro Nuclear/metabolismo , Microscopia Confocal
17.
Histopathology ; 63(6): 788-801, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-24117687

RESUMO

AIMS: To reassess the prognostic validity of immunohistochemical markers and algorithms identified in the CHOP era in immunochemotherapy-treated diffuse large B cell lymphoma patients. METHODS AND RESULTS: The prognostic significance of immunohistochemical markers (CD10, Bcl-6, Bcl-2, MUM1, Ki-67, CD5, GCET1, FoxP1, LMO2) and algorithms (Hans, Hans*, Muris, Choi, Choi*, Nyman, Visco-Young, Tally) was assessed using clinical diagnostic blocks taken from an unselected, population-based cohort of 190 patients treated with R-CHOP. Dichotomizing expression, low CD10 (<10%), low LMO2 (<70%) or high Bcl-2 (≥80%) predicted shorter overall survival (OS; P = 0.033, P = 0.010 and P = 0.008, respectively). High Bcl-2 (≥80%), low Bcl-6 (<60%), low GCET1 (<20%) or low LMO2 (<70%) predicted shorter progression-free survival (PFS; P = 0.001, P = 0.048, P = 0.045 and P = 0.002, respectively). The Hans, Hans* and Muris classifiers predicted OS (P = 0.022, P = 0.037 and P = 0.011) and PFS (P = 0.021, P = 0.020 and P = 0.004). The Choi, Choi* and Tally were associated with PFS (P = 0.049, P = 0.009 and P = 0.023). In multivariate analysis, the International Prognostic Index (IPI) was the only independent predictor of outcome (OS; HR: 2.60, P < 0.001 and PFS; HR: 2.91, P < 0.001). CONCLUSIONS: Results highlight the controversy surrounding immunohistochemistry-based algorithms in the R-CHOP era. The need for more robust markers, applicable to the clinic, for incorporation into improved prognostic systems is emphasized.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Imunoterapia , Linfoma Difuso de Grandes Células B/terapia , Proteínas Adaptadoras de Transdução de Sinal/metabolismo , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Algoritmos , Anticorpos Monoclonais Murinos/administração & dosagem , Biomarcadores Tumorais/metabolismo , Estudos de Coortes , Terapia Combinada , Ciclofosfamida/administração & dosagem , Proteínas de Ligação a DNA/metabolismo , Intervalo Livre de Doença , Doxorrubicina/administração & dosagem , Feminino , Humanos , Imuno-Histoquímica , Estimativa de Kaplan-Meier , Proteínas com Domínio LIM/metabolismo , Linfoma Difuso de Grandes Células B/tratamento farmacológico , Linfoma Difuso de Grandes Células B/metabolismo , Masculino , Pessoa de Meia-Idade , Proteínas de Neoplasias/metabolismo , Neprilisina/metabolismo , Prednisona/administração & dosagem , Prognóstico , Proteínas Proto-Oncogênicas/metabolismo , Proteínas Proto-Oncogênicas c-bcl-2/metabolismo , Proteínas Proto-Oncogênicas c-bcl-6 , Rituximab , Serpinas/metabolismo , Vincristina/administração & dosagem , Adulto Jovem
20.
Ther Adv Rare Dis ; 4: 26330040231152957, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37181072

RESUMO

This case features a young healthy male who was diagnosed with immunoglobulin A (IgA) nephropathy after presenting with blurry vision that was caused by hypertensive retinopathy and papilledema. In this report, we examine the relationship between hypertension and increased intracranial pressure (ICP), along with the ocular signs of IgA nephropathy that may present in the setting of kidney disease.


Immunoglobulin A (IgA) nephropathy is an immune-mediated inflammatory condition that affects the kidneys and is characterized by deposits of IgA antibodies across the body. Nephropathy in general is defined as the deterioration of kidney function. Hypertension is a common complication because of the resultant kidney damage. IgA can also deposit widely across the body, including within the eyes, and may lead to various inflammatory manifestations affecting the front and back of the eyes. We present a case of a 38-year-old male with 2 weeks of worsening vision and headaches. His blood pressure was extremely high (206/116 mmHg) and he was found to have acute kidney injury. Examination of his eye revealed hypertensive retinopathy but also significant swelling of both of his optic discs, concerning for increased intracranial pressure (ICP), which is unusual in a young, otherwise healthy male. The investigation for the cause of increased ICP led to the diagnosis of IgA nephropathy. Treatment of his increased ICP and blood pressure resulted in improvement of his vision. It is important to consider increased ICP as a cause of optic disc swelling in patients with very high blood pressures. Prompt evaluation and management of elevated ICP is important to preserve vision, prevent brain complications and diagnose the underlying disease process. Especially important is the communication and coordination across medical specialties to ensure safe treatment given the multisystem organ involvement. In this article, we also review the eye findings associated with IgA nephropathy, as well as other immune-mediated complications of this rare disease.

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