RESUMO
OBJECTIVE: To determine whether mediastinal lymph node enlargement (MLNE) predicts progressive pulmonary fibrosis (PPF).METHODS: A total of 800 patients hospitalised for interstitial lung diseases (ILDs) were included in our study. The clinical presentations, radiographic features and laboratory findings of the patients were reviewed.RESULTS: MLNE was present in 313 (39.1%) ILD patients and were associated with higher total fibrosis score and risk of death than ILD patients without MLNE. The risk factors for PPF were age (OR 1.044, 95% CI 1.020-1.069; P < 0.001), the total extent of fibrosis (OR 1.396, 95% CI 1.116-1.746; P = 0.003) and MLNE (OR 2.130, 95% CI 1.362-3.332; P = 0.001) compared to non-PPF. Multivariable analysis showed that age, the lactate dehydrogenase level, MLNE, the total fibrosis score and pulmonary arterial systolic pressure were risk/prognostic factors for ILD patients. The model was robust in patients with idiopathic pulmonary fibrosis. However, the only risk/prognostic factor common to other ILD subgroups was the total fibrosis score.CONCLUSIONS: MLNE is associated with higher total fibrosis score and worse prognosis in ILD patients and could predict the occurrence of PPF. The only risk/prognostic factor applicable to all subgroups of ILDs is the total pulmonary fibrosis score.
Assuntos
Fibrose Pulmonar Idiopática , Doenças Pulmonares Intersticiais , Linfadenopatia , Humanos , Fibrose Pulmonar Idiopática/complicações , Fibrose , Prognóstico , Linfonodos/diagnóstico por imagem , Progressão da Doença , Estudos RetrospectivosRESUMO
Several neuroimaging studies have suggested brain reorganisation in patients with cervical spondylotic myelopathy (CSM); however, the changes in spontaneous neuronal activity that are associated with connectedness remain largely unknown. In this study, functional connectivity strength (FCS), a data-driven degree centrality method based on a theoretical approach, was applied for the first time to investigate changes in the sensory-motor network (SMN) at the voxel level. Comparatively, CSM not only showed significantly decreased FCS in the operculum-integrated regions, which exhibited reduced resting-state functional connectivity (rsFC) around the Rolandic sulcus, but it also showed increased FCS in the premotor, primary somatosensory, and parietal-integrated areas, which primarily showed an enhanced rsFC pattern. Correlation analysis showed that altered FCS (in the left premotor-ventral/precentral-operculum, right operculum-parietale 4, and right S1) was associated with worsening Japanese Orthopaedic Association scores and that the rsFC pattern was influenced by cervical cord micro-structural damage at the C2 level. Together, these findings suggest that during myelopathy, the intrinsic functional plasticity of the SMN responds to the insufficient sensory and motor experience in CSM patients. This knowledge may improve our understanding of the comprehensive functional defects found in CSM patients and may inspire the development of new therapeutic strategies in the future.
Assuntos
Córtex Sensório-Motor/fisiopatologia , Doenças da Medula Espinal/fisiopatologia , Adulto , Mapeamento Encefálico , Vértebras Cervicais/patologia , Fenômenos Eletrofisiológicos , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Plasticidade Neuronal , Doenças da Medula Espinal/metabolismoRESUMO
In vitro, the photodynamic compound benzo[a]pyrene (BAP) generates singlet oxygen efficiently when irradiated in organic solvents. It also photogenerates superoxide anion radical in water and can act as a photoreducing agent in the absence of oxygen. In vivo, the hemolysis of human erythrocytes, the inactivation of Escherichia coli cells representing a series of strains differing in excision repair and catalase proficiency, and the inactivation of Haemophilus influenzae transforming DNA activity were used to characterize the phototoxicity of BAP in the presence of near-UV light (290-400 nm). The results are consistent with BAP behaving as a photosensitizer that generates both superoxide and singlet oxygen, and that damages chiefly membranes. DNA does not seem to be a major target in the phototoxic reactions investigated.