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1.
Reprod Fertil Dev ; 34(3): 350-361, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35101163

RESUMO

Ionising radiation exposure of 5-10gray (Gy) to the pelvic area induces premature ovarian failure (POF). Twenty-four young adult Wistar albino female rats were were treated with subcutaneous capsaicin 0.5mg/kg per day or placebo for 10days then exposed to whole body irradiation. Rats were randomly divided into four groups: (1) control; (2) capsaicin; (3) radiation only (IR): rats were injected with placebo before exposure to a single dose of 8.3-Gy whole body irradiation; (4) radiation-capsaicin (IR+CAP): rats were injected with capsaicin prior to whole body irradiation. Radiation triggered oxidative stress, increased ovarian inflammation, increased follicular apoptosis and diminished ovarian follicle pool. Capsaicin significantly ameliorated oxidative stress by decreasing serum total oxidant status, oxidative stress index, disulphide, and malondialdehyde levels (P ≤0.001); ovarian inflammatory status by decreasing expressions of TNF-α, IL-1ß, PARP-1 (P =0.002); apoptosis by decreasing expressions of active caspase-3 and p53 (P =0.015, P =0.002); and follicle counts by increasing primordial follicles and decreasing apoptotic follicles (P ≤0.001) in rats when administered before radiation exposure. The beneficial effects of capsaicin are demonstrated for the first time on ionising radiation exposed rat ovaries. Capsaicin pre-treatment before radiotherapy restores the primordial follicle pool, inhibits atresia of ovarian follicles and may be an acceptable therapeutic modality to prevent radiation-induced POF.


Assuntos
Insuficiência Ovariana Primária , Animais , Apoptose , Capsaicina , Feminino , Folículo Ovariano/metabolismo , Estresse Oxidativo , Insuficiência Ovariana Primária/etiologia , Insuficiência Ovariana Primária/prevenção & controle , Ratos , Ratos Wistar
2.
Clin Oral Investig ; 25(3): 901-905, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32472255

RESUMO

OBJECTIVES: This ex vivo study was performed to investigate the effect of radiotherapy (RT) delivery time on fracture resistance of mandibular premolars filled with Biodentine or gutta-percha/sealer (GPS). MATERIALS AND METHODS: Seventy-two mandibular premolars were used in this study. Randomly selected 24 teeth were kept intact for the control groups (with and without irradiation). Then, the remaining 48 teeth were randomly assigned into 4 groups (n = 12) according to RT delivery time (irradiated before or after root canal treatment) and obturation materials as follows: Group RT + GPS, Group: GPS + RT, Group RT + Biodentine and Group Biodentine + RT. The samples were either initially endodontically treated and then irradiated or initially irradiated and then endodontically treated with one of the abovementioned materials. The samples were irradiated at 2 Gy per fraction, 5 times a week for a total dose of 60 Gy in 30 fractions over 6 weeks. The roots were embedded in self-polymerizing acrylic resin. The fracture resistance was evaluated in a universal testing machine. Data was analyzed by one-way ANOVA and Games-Howell post hoc test at p < 0.05. RESULTS: Radiation therapy significantly reduced fracture resistance of intact teeth (p < 0.05). The highest fracture resistance was observed in intact/non-irradiated teeth and the lowest fracture resistance in Biodentine + RT group (p < 0.05). The effect of RT delivery time was insignificant when GPS was preferred as the root canal filling material (p > 0.05); it was significant when preferring Biodentine (p < 0.05). When RT was applied to the teeth after Biodentine obturation, the fracture resistance decreased significantly compared to the teeth that were obturated with GPS after or before RT application (p < 0.05). CONCLUSION: Both RT time and obturation materials (Biodentine or gutta-percha/sealer) affect the fracture resistance of the endodontically treated teeth. CLINICAL RELEVANCE: Endodontic treatment could be completed with both materials after RT; however, when the endodontic treatment was initially completed and the teeth were subsequently exposed to RT, it was shown that the reinforcement effect of Biodentine decreased.


Assuntos
Materiais Restauradores do Canal Radicular , Fraturas dos Dentes , Dente Pré-Molar , Resinas Epóxi , Guta-Percha , Humanos , Teste de Materiais , Obturação do Canal Radicular , Fraturas dos Dentes/prevenção & controle
3.
J Pak Med Assoc ; 71(7): 1736-1739, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34410237

RESUMO

OBJECTIVE: To investigate the utility of quantitative lung perfusion scintigraphy and pulmonary function tests in the assessment of radiation-induced lung injury. METHODS: The prospective study was conducted at Zonguldak Bulent Ecevit University Hospital, Turkey, from May 2012 to October 2016, and comprised female breast cancer patients having undergone lung perfusion scintigraphy with Tc-99m macroaggregated albumin before and after radiotherapy. Pulmonary function tests and carbon monoxide diffusing capacity tests were also carried out on all the patients, and the relationship between treatment-related changes and its association with radiotherapy doses was analysed. Data was analysed using SPSS 19. RESULTS: There were 43 patients with a median age of 49 (interquartile range: 32-71 years). Carbon monoxide diffusing capacity values at baseline showed a significant decrease at 6 and 12 months post- radiotherapy (p<0.05), while none of the parameters of the pulmonary function tests showed a significant difference (p>0.05). Also, the median percentage of perfusion studies in the irradiated lung decreased significantly (p<0.001) at 12 months post-treatment. There was significant reduction in perfusion studies of irradiated lungs (p<0.05). CONCLUSIONS: Carbon monoxide diffusing capacity and quantitative lung perfusion scintigraphy were found to be useful tools for the early diagnosis and monitoring of radiation-induced lung injury.


Assuntos
Neoplasias da Mama , Neoplasias Pulmonares , Adulto , Idoso , Neoplasias da Mama/radioterapia , Feminino , Humanos , Pulmão/diagnóstico por imagem , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/radioterapia , Pessoa de Meia-Idade , Perfusão , Imagem de Perfusão , Estudos Prospectivos , Testes de Função Respiratória
4.
Regul Toxicol Pharmacol ; 104: 128-132, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30878575

RESUMO

Radiation induced colitis is one the most common clinical issue for patients receiving radiotherapy. For this reason, we aimed to investigate the effect of antioxidant-effective flavonoids hesperidin and quercetin on the intestinal damage induced by radiation in this study. TNF-alpha, interleukin-10 (IL-10), heat shock protein 70 (HSP 70) and caspase 3, 8, 9 markers of apoptotic pathways were measured in the colon tissues of irradiated acute intestinal damage by enzyme-linked immunosorbent assay (ELISA). Irradiation of rats caused a significance increase of TNF-alpha, caspase 3/8/9 and decrease of IL-10 concentrations. Hesperidin and quercetin treatment resulted in decreased levels of TNF-alpha and increased levels of IL-10. Quercetin significantly decreased caspase 3/8/9 levels. Hesperidin produced a decreased of caspase 3/8/9 levels compared with irradiation group but this was statistically not significant. Only significant alteration of HSP 70 were seen in hesperidin treated rats. Further studies are needed to elucidate the mechanism by which flavonoids induced signaling provides protection against apoptosis and inflammation.


Assuntos
Antioxidantes/farmacologia , Colite/etiologia , Colite/prevenção & controle , Colo/efeitos dos fármacos , Hesperidina/farmacologia , Substâncias Protetoras/farmacologia , Quercetina/farmacologia , Raios X/efeitos adversos , Animais , Antioxidantes/administração & dosagem , Caspase 3/análise , Caspase 3/metabolismo , Caspase 9/análise , Caspase 9/metabolismo , Colite/metabolismo , Colo/metabolismo , Ensaio de Imunoadsorção Enzimática , Hesperidina/administração & dosagem , Inflamação/metabolismo , Inflamação/prevenção & controle , Interleucina-10/análise , Interleucina-10/metabolismo , Masculino , Substâncias Protetoras/administração & dosagem , Quercetina/administração & dosagem , Radioterapia/efeitos adversos , Ratos , Fator de Necrose Tumoral alfa/análise , Fator de Necrose Tumoral alfa/metabolismo
5.
Am J Perinatol ; 31(2): 167-74, 2014 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-23592318

RESUMO

BACKGROUND: Our aims are to determine whether the urinary neutrophil gelatinase-associated lipocalin (uNGAL) can predict acute kidney injury (AKI) development in nonseptic and nonasphyxiated but critically ill preterm infants. METHODS: Fifty preterm infants, gestational age (GA) between 28 and 34 weeks, were included in this case control study. Blood and urine samples were taken for blood urea nitrogen, serum creatinine, and uNGAL on postnatal (PN) days 1 and 7. uNGAL levels were measured by enzyme-linked immunoassay. Clinical and laboratory characteristics of the AKI group were compared with the non-AKI group. RESULTS: AKI was diagnosed in six infants during the first week. The median uNGAL levels were significantly higher in the preterm infants with AKI than those of the controls on PN days 1 and 7 (p = 0.006 and p = 0.023, respectively). Backward stepwise logistic regression analysis identified that 5-minute Apgar score and uNGAL levels were significantly associated with the development of AKI, even after controlling for GA, birth weight, gender, and 1-minute Apgar score in nonseptic and nonasphyxiated but critically ill preterm infants. CONCLUSIONS: uNGAL can be useful as a predictive marker of AKI in nonseptic and nonasphyxiated but critically ill preterm infants.


Assuntos
Injúria Renal Aguda/urina , Proteínas de Fase Aguda/urina , Doenças do Prematuro/urina , Lipocalinas/urina , Proteínas Proto-Oncogênicas/urina , Biomarcadores/urina , Estado Terminal , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Lipocalina-2
6.
Heliyon ; 10(4): e25932, 2024 Feb 29.
Artigo em Inglês | MEDLINE | ID: mdl-38370260

RESUMO

In this study, it was aimed to evaluate the effect of ethanol extract of Annona Muricata (AM) leaves in the prevention of brain damage caused by ionizing radiation (IR). This study was conducted in the Experimental Animal Research Unit of a university with 28 adults female Wistar Albino rats. The experimental groups were as follows: Control group (n = 8), AM group (n = 6), IR group (n = 8), AM + IR group (n = 6). In the IR group, astrocyte hypertrophy, microglial reaction and inflammatory reaction levels were significantly higher than the control and AM groups (P < 0.001). Edema was significantly higher in the IR group compared to the control group (P=0.001). The MDA of the IR group was significantly higher compared to the control group and AM group (P=0.031, P=0.006, respectively). The MDA of the AM + IR group was significantly higher than the AM group (P=0.039). Our findings show that histomorphology and oxidant damage caused by IR can be ameliorated using AM, as demonstrated by the comparison of the controls to AM + IR recipients, which showed similar histomorphology and oxidant damage levels.

7.
Pediatr Nephrol ; 28(3): 477-84, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23070277

RESUMO

BACKGROUND: We aimed to compare serum cystatin C levels (sCysC) in preterm neonates with respiratory distress syndrome (RDS) with a control group and to investigate whether it could be used as a predictor for acute kidney injury (AKI). METHODS: sCysC was measured in 62 neonates with RDS (n = 28) and control neonates without RDS (n = 34), whose gestational ages (GA) were between 27 and 29 weeks (subgroup 1) and 30-32 weeks (subgroup 2). AKI was defined as oliguria and/or increase of serum creatinine. Blood samples were obtained on postnatal days (PND) 3 and 30. sCysC levels were determined by particle-enhanced nephelometric immunoassay. RESULTS: There were six neonates with AKI (RDS-AKI subgroup) and 22 neonates without AKI (RDS-no AKI subgroup) during the first 7 days. Although sCysC levels were lower in neonates with RDS than controls on PND3 in both GA subgroups, the differences were not significant. However, in neonates with RDS and AKI, sCysC levels were significantly higher than neonates with RDS but no AKI and neonates in the control group on PND3. sCysC level was found to have a statistically significant association with AKI development in preterm neonates with RDS. CONCLUSIONS: sCysC is an independent predictor of AKI in preterm neonates with RDS.


Assuntos
Injúria Renal Aguda/etiologia , Cistatina C/sangue , Recém-Nascido Prematuro , Síndrome do Desconforto Respiratório do Recém-Nascido/complicações , Injúria Renal Aguda/sangue , Injúria Renal Aguda/diagnóstico , Biomarcadores/sangue , Estudos de Casos e Controles , Distribuição de Qui-Quadrado , Creatinina/sangue , Feminino , Idade Gestacional , Humanos , Imunoensaio , Recém-Nascido , Modelos Logísticos , Masculino , Análise Multivariada , Nefelometria e Turbidimetria , Valor Preditivo dos Testes , Estudos Prospectivos , Curva ROC , Síndrome do Desconforto Respiratório do Recém-Nascido/sangue , Síndrome do Desconforto Respiratório do Recém-Nascido/diagnóstico , Medição de Risco , Fatores de Risco , Fatores de Tempo
8.
Ulus Travma Acil Cerrahi Derg ; 28(3): 233-241, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35485570

RESUMO

BACKGROUND: Annona muricata (AM) (graviola) is a plant that grows in tropical regions and is thought to be good for many diseases by local people. Unfortunately, there is no acceptable medical treatment for spinal cord injury (SCI) yet. In our study, we investigated the neuropeotective effects of AM leaf extract on SCI in an experimental rat model. METHODS: A total of 40 Wistar albino rats were randomly divided into five equal groups (n=8). Group 1 was the control group in which only laminectomy was performed. Trauma was induced in four groups after laminectomy. Group 2 (untreated trauma group) was given no medication. In Group 3, a single intraperitoneal dose of methylprednisolone (30 mg/kg) was administered after trauma. The rats in Groups 4 received a low dose (100 mg/kg) of AM leaf extracts by oral gavage one week before trauma while the rats in Group 5 received a high-dose (300 mg/kg) of these extracts by oral gavage one week before trauma. All rats, including the control group, were sacrificed 24 h after the trauma was created. RESULTS: Tissue samples taken to evaluate the neuroprotective effect were examined biochemically and histopathologically. Inflam-matory findings in the trauma group were significantly better in both groups treated with AM. There was no difference between the groups in terms of clinical motor examination and inclined plane test results. CONCLUSION: Our histopathological and biochemical results showed that AM is an agent with neuroprotective effects in trau-matic SCI.


Assuntos
Annona , Fármacos Neuroprotetores , Traumatismos da Medula Espinal , Animais , Humanos , Metilprednisolona/uso terapêutico , Extratos Vegetais/farmacologia , Extratos Vegetais/uso terapêutico , Ratos , Ratos Wistar , Traumatismos da Medula Espinal/tratamento farmacológico , Traumatismos da Medula Espinal/patologia
9.
Medicine (Baltimore) ; 100(1): e24266, 2021 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-33429836

RESUMO

BACKGROUND: Intensity-modulated radiotherapy (IMRT) is a widely used irradiation technique in rectal cancer patients. We aimed to compare 4 different IMRT plans with 3-dimensional conformal radiotherapy (3D-CRT) considering organs at risk (OARs) in patients with rectal carcinoma. METHODS: This retrospective study included 27 rectal cancer patients who were irradiated preoperatively between January 2016 and December 2018. Five different plans (4-field 3D-CRT in 2 phases, 7-field IMRT in 2 phases, 9-field IMRT in 2 phases, 7-field simultaneous integrated boost [SIB] IMRT, and 9-field SIB IMRT) were generated for each patient. Comparison of 5 different plans according to bladder and bilateral femoral head mean doses, bladder V40, bilateral femoral head V40, and small bowel V35 values were evaluated. RESULTS: Most of the OAR parameters significantly favored IMRT plans compared to the 3D-CRT plan. The largest difference was observed in bladder V40 values (reduction of V40 value up to 51.2% reduction) in favor of IMRT. In addition, SIB plans showed significantly better reduction in OARs than phase plans except for small bowel V35 values. CONCLUSIONS: IMRT plans reduced almost all the OARs doses compared with the 3D-CRT plan in rectal cancer patients. Furthermore, SIB plans demonstrated lower OAR doses than the phase plans. IMRT techniques, especially SIB plans, reduce OAR doses and provide safer doses for the treatment of rectal carcinoma.


Assuntos
Adenocarcinoma/radioterapia , Neoplasias Retais/radioterapia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Órgãos em Risco/efeitos da radiação , Período Pré-Operatório , Dosagem Radioterapêutica , Planejamento da Radioterapia Assistida por Computador , Radioterapia de Intensidade Modulada , Estudos Retrospectivos
10.
Mol Imaging Radionucl Ther ; 30(2): 117-118, 2021 06 03.
Artigo em Inglês | MEDLINE | ID: mdl-34082515

RESUMO

A 37-year-old female with a history of invasive breast carcinoma was referred to our department for an 18flor-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography whole-body scan. An intense 18F-FDG uptake in striped muscles anterior to the left thigh region was noted. Excisional biopsy outcome from the left vastus medialis muscle was found to be consistent with striped muscle metastasis from breast carcinoma.

11.
J Radiat Res ; 59(4): 404-410, 2018 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-29688418

RESUMO

Extensive research has been focused on radiation-induced brain injury. Animal and human studies have shown that flavonoids have remarkable toxicological profiles. This study aims to investigate the neuroprotective effects of quercetin in an experimental radiation-induced brain injury. A total of 32 adult male Wistar-Albino rats were randomly divided into four groups (control, quercetin, radiation, and radiation+quercetin groups, with eight rats in each group). Doses (50 mg/kg) of quercetin were administered to the animals in the quercetin and radiation+quercetin groups; radiation and radiation+quercetin groups were exposed to a dose of 20 Gy to the cranium region. Tissue samples, and biochemical levels of tissue injury markers in the four groups were compared. In all measured parameters of oxidative stress, administration of quercetin significantly demonstrated favorable effects. Both plasma and tissue levels of malondialdehyde and total antioxidant status significantly changed in favor of antioxidant activity. Histopathological evaluation of the tissues also demonstrated a significant decrease in cellular degeneration and infiltration parameters after quercetin administration. Quercetin demonstrated significant neuroprotection after radiation-induced brain injury. Further studies of neurological outcomes under different experimental settings are required in order to achieve conclusive results.


Assuntos
Lesões Encefálicas/tratamento farmacológico , Fármacos Neuroprotetores/uso terapêutico , Quercetina/uso terapêutico , Lesões Experimentais por Radiação/tratamento farmacológico , Animais , Lesões Encefálicas/sangue , Lesões Encefálicas/patologia , Córtex Cerebral/patologia , Masculino , Malondialdeído/sangue , Fármacos Neuroprotetores/farmacologia , Quercetina/farmacologia , Lesões Experimentais por Radiação/sangue , Lesões Experimentais por Radiação/patologia , Ratos Wistar
12.
Arch Argent Pediatr ; 114(3): e163-6, 2016 Jun 01.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-27164349

RESUMO

Wolfram syndrome (DIDMOAD: diabetes insipidus, diabetes mellitus, optic atrophy and deafness) is a rare neurodegenerative disorder. Mutations of the WFS1 (wolframin) on chromosome 4 are responsible for the clinical manifestations in majority of patients with Wolfram syndrome. Wolfram syndrome is also accompanied by neurologic and psychiatric disorders, urodynamic abnormalities, restricted joint motility, cardiovascular and gastrointestinal autonomic neuropathy, hypergonadotrophic hypogonadism in males and diabetic microvascular disorders. There are very limited data in the literature regarding cardiac malformations associated in children with Wolfram syndrome. A 5-year-old girl with Wolfram syndrome and tetralogy of Fallot is presented herein.


El síndrome de Wolfram (DIDMAOS: diabetes insípida, diabetes mellitus, atrofia óptica y sordera) esuntrastorno neurodegenerativo raro. Las mutaciones del gen WFS1 (wolframina) en el cromosoma 4 son responsables de las manifestaciones clínicas en la mayoría de los pacientes con síndrome de Wolfram. El síndrome de Wolfram también está acompanado por trastornos psiquiátricos, anomalías urodinámicas, movilidad articular limitada, neuropatía autónoma cardiovascular y gastrointestinal, hipogonadismo hipogonadotrópico en los varones y complicaciones microvasculares de la diabetes. Los datos acerca de las malformaciones cardíacas asociadas en los niños con síndrome de Wolfram disponibles en las publicaciones científicas son muy limitados. En este artículo presentamos el caso de una niña de 5 años con síndrome de Wolfram y tetralogía de Fallot.


Assuntos
Tetralogia de Fallot/complicações , Síndrome de Wolfram/complicações , Pré-Escolar , Feminino , Humanos
13.
J Pediatr Endocrinol Metab ; 28(7-8): 961-5, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-25879310

RESUMO

We report two newborns with female external genitalia and bilateral inguinal swelling who were diagnosed with 17ß-hydroxysteroid dehydrogenase type 3 deficiency, a rare cause of 46,XY disorder of sexual development. The first case had normal clitoral size and vaginal and urethral openings, palpable gonads in the inguinal region, low testosterone, and low levels of basal and GNRH-stimulated gonadotropin. The second case had similar external genitalia, low testosterone but borderline basal and normal stimulated gonadotropin levels. Low testosterone/androstenedione ratios (0.22 and 0.24, respectively; normal, >0.8) after human chorionic gonadotropin stimulation indicated 17ß-hydroxysteroid dehydrogenase type 3 deficiency. HSD17B3 sequencing revealed a homozygous novel mutation (c.464A>C, p.H155P) in exon 6 in the first case and homozygous c.239G>A (p.R80Q) in exon 3 in the second.


Assuntos
17-Hidroxiesteroide Desidrogenases/deficiência , 17-Hidroxiesteroide Desidrogenases/genética , Transtornos do Desenvolvimento Sexual/diagnóstico , Transtornos do Desenvolvimento Sexual/enzimologia , Mutação/genética , Puberdade/genética , Transtornos do Desenvolvimento Sexual/genética , Feminino , Homozigoto , Humanos , Recém-Nascido , Fenótipo , Prognóstico , Maturidade Sexual/genética
14.
J Cancer Res Ther ; 10(3): 558-62, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25313739

RESUMO

AIMS: The aim of this study was to evaluate and compare the effect of radiotherapy on testicles with different treatment positions and plans for rectal cancer patients. SETTINGS AND DESIGN: Mono-institutional prospective study. PATIENTS AND METHODS: Three different plans; supine 4-fields (s4f), prone 4-fields (p4f), and prone 3-fields (p3f) of 15 male patients with rectal carcinoma receiving 45 Gy pelvic radiotherapy were evaluated. Testicular doses in each plan were calculated. Since the localizations of the primary tumor may affect testicular dose, boost doses were not taken into account. STATISTICAL ANALYSIS USED: Kruskal Wallis test, Pearson and Spearman correlation analysis. RESULTS: Median cumulative testicular doses of s4f, p4f, and p3f plans were 19.8, 69.3, and 100.8 cGy, respectively (P = 0.013). Median V0.5 (Volume receiving more than 0.5 Gy) and V1 (Volume receiving more than 1 Gy) for testicles were also significantly lower in s4f plans (3%, 60.7%, and 78.1% for V0.5 and 0.3%, 35.8%, and 52.3% for V1 in s4f, p4f, and p3f, respectively) (P = 0.001). The median distances between lower edge of fields and testicles in s4f, p4f, and p3f plans were 65 mm, 29 mm, and 29 mm, respectively (P < 0.01). Median bladder doses were significantly lower in p3f plans (P = 0.002). CONCLUSIONS: S4f external beam radiotherapy for rectal carcinoma allows better testicular dose than p3f and p4f. The probably reason was the increase of distance between lower edge of the field and testicles.


Assuntos
Posicionamento do Paciente , Planejamento da Radioterapia Assistida por Computador , Neoplasias Retais/radioterapia , Testículo/efeitos da radiação , Adulto , Idoso , Humanos , Masculino , Pessoa de Meia-Idade , Doses de Radiação , Dosagem Radioterapêutica
15.
J Clin Res Pediatr Endocrinol ; 6(4): 258-61, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25541899

RESUMO

We report two cases emphasizing the importance of insulin assays for evaluation of hypoglycemia in diabetic patients. Case 1 was a 96/12-year-old female patient with type 1 diabetes mellitus and case 2 was a 1010/12-year-old male patient with DIDMOAD. Both patients were on a basal-bolus insulin regimen. Both were admitted because of persistent hypoglycemia. Analyses of serum samples obtained at the time of hypoglycemia initially showed low insulin and C-peptide levels. Recurrent episodes of unexplained hypoglycemia necessitated measurement of insulin levels by using different insulin assays, which revealed hyperinsulinemic hypoglycemia with low C-peptide levels, findings which confirmed a diagnosis of factitious hypoglycemia. Surreptitious administration of insulin should not be excluded in diabetic patients with hypoglycemia without taking into account the rate of cross-reactivity of insulin analogues with the insulin assay used.


Assuntos
Diabetes Mellitus Tipo 1/tratamento farmacológico , Transtornos Autoinduzidos/diagnóstico , Hipoglicemia/diagnóstico , Insulina/administração & dosagem , Insulina/sangue , Síndrome de Wolfram/tratamento farmacológico , Criança , Feminino , Humanos , Imunoensaio/normas , Masculino
16.
J Matern Fetal Neonatal Med ; 26(15): 1474-8, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-23528044

RESUMO

OBJECTIVE: The aim of this study is to determine the reference values of serum Cystatin C (CysC) and CysC-based estimated glomerular filtration rate (GFR) on the 3rd and 30th day of life in comparison with serum creatinine (Cr) and Cr-based estimated GFR. METHODS: This prospective study was performed on 52 preterm neonates whose gestational ages were between 28 and 34 weeks. Preterm neonates were divided into three groups according to the gestational age as follows: gestational week of 28-29 (group 1), gestational week of 30-32 (group 2) and gestational week of 33-34 (group 3). Blood samples were obtained on the 3rd and the 30th days of life. CysC was determined by particle-enhanced nephelometric immunoassay. RESULTS: The group 1 preterm neonates have higher CysC values (1.34 ± 0.1 mg/L) on the 3rd day of life than the group 2 (1.28 ± 0.2 mg/L) and the group 3 (1.24 ± 0.2 mg/L) but the differences were not significant (p > 0.05, for each). CysC values were independent of gestational age, birth weight and gender (p > 0.05, for each). No correlation was found between CysC and Cr on the 3rd day of life (p > 0.05). CONCLUSIONS: CysC is regarded as an alternative for assessing the renal function in preterm neonates.


Assuntos
Cistatina C/sangue , Taxa de Filtração Glomerular , Recém-Nascido Prematuro/fisiologia , Peso ao Nascer , Creatinina/sangue , Feminino , Idade Gestacional , Humanos , Recém-Nascido , Terapia Intensiva Neonatal , Testes de Função Renal , Masculino , Estudos Prospectivos , Valores de Referência
17.
Int Urol Nephrol ; 45(4): 1047-55, 2013 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-22826143

RESUMO

PURPOSE: In this study, we aimed to evaluate short- and long-term effects of levamisole therapy in steroid-sensitive nephrotic syndrome (SSNS) in children. METHODS: The study consisted of 29 SSNS patients who had been treated with levamisole for 12 months. Laboratory values and clinical data were analyzed for three separate periods for each patient: 1 year prior to the initiation of levamisole therapy (Pre-Lev), during 1 year of levamisole therapy (During-Lev), and the year following cessation of levamisole therapy (End-Lev). RESULTS: The level of proteinuria fell from median 135.0 (24.0-633.0) mg/h/m(2) Pre-Lev to median 4.4 (2.4-654.0) mg/h/m(2) During-Lev and median 4.8 (2.2-105.0) mg/h/m(2) End-Lev (p = 0.0001, for each). Median relapse frequency fell from 4.0 (3.0-8.0) relapses/patient per year Pre-Lev to 0.0 (0.0-2.0) During-Lev (p = 0.0001) with 23/29 patients having no relapse and 0.0 (0.0-1.0) End-Lev (p = 0.0001) with 18/29 patients without relapse. During-Lev, all children had marked diminution in annual steroid burden from a median of 5582.0 (2137.0-17340.0) mg/m(2) per year Pre-Lev to 2166.0 (840.0-9325.0) mg/m(2) per year (p = 0.0001). End-Lev, the annual steroid burden also continued to fall, to 0.0 (0.0-5386.0) mg/m(2) per year (p = 0.0001). The age and duration of NS were significantly higher in the children with relapses than in the children with sustained remission (p = 0.009 and p = 0.014, respectively). The side effects that are expected during levamisole therapy did not occur in our patients. CONCLUSION: Thus, our study showed that levamisole is a safe and effective steroid-sparing agent, with long-lasting effect even 12 months after withdrawal.


Assuntos
Adjuvantes Imunológicos/administração & dosagem , Levamisol/administração & dosagem , Síndrome Nefrótica/diagnóstico , Síndrome Nefrótica/tratamento farmacológico , Esteroides/uso terapêutico , Adjuvantes Imunológicos/efeitos adversos , Administração Oral , Adolescente , Criança , Pré-Escolar , Estudos de Coortes , Relação Dose-Resposta a Droga , Esquema de Medicação , Feminino , Seguimentos , Humanos , Testes de Função Renal , Levamisol/efeitos adversos , Masculino , Segurança do Paciente , Proteinúria/prevenção & controle , Análise de Regressão , Estudos Retrospectivos , Prevenção Secundária , Índice de Gravidade de Doença , Estatísticas não Paramétricas , Esteroides/efeitos adversos , Fatores de Tempo , Resultado do Tratamento
18.
J Clin Res Pediatr Endocrinol ; 3(4): 222-4, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-22155468

RESUMO

Diabetic ketoacidosis (DKA) is a life-threatening acute complication of type 1 diabetes mellitus. Infections are the leading cause of DKA, but trauma, myocardial infarction, or surgery may also precipitate this condition. In patients with DKA, although cerebral edema is the most common cause of neurological symptoms, other possibilities such as meningitis or encephalitis should also be considered. Herein, we present the case of an 8-year-old girl with DKA and tuberculous meningitis.


Assuntos
Cetoacidose Diabética/complicações , Tuberculose Meníngea/complicações , Antituberculosos/uso terapêutico , Edema Encefálico/tratamento farmacológico , Criança , Dexametasona/uso terapêutico , Cetoacidose Diabética/tratamento farmacológico , Feminino , Humanos , Manitol/uso terapêutico , Tuberculose Meníngea/tratamento farmacológico
19.
Arch. argent. pediatr ; 114(3): e163-e166, jun. 2016. ilus
Artigo em Inglês, Espanhol | LILACS, BINACIS | ID: biblio-838218

RESUMO

El síndrome de Wolfram (DIDMAOS: diabetes insípida, diabetes mellitus, atrofia óptica y sordera) esuntrastorno neurodegenerativo raro. Las mutaciones del gen WFS1 (wolframina) en el cromosoma 4 son responsables de las manifestaciones clínicas en la mayoría de los pacientes con síndrome de Wolfram. El síndrome de Wolfram también está acompanado por trastornos psiquiátricos, anomalías urodinámicas, movilidad articular limitada, neuropatía autónoma cardiovascular y gastrointestinal, hipogonadismo hipogonadotrópico en los varones y complicaciones microvasculares de la diabetes. Los datos acerca de las malformaciones cardíacas asociadas en los niños con síndrome de Wolfram disponibles en las publicaciones científicas son muy limitados. En este artículo presentamos el caso de una niña de 5 años con síndrome de Wolfram y tetralogía de Fallot.


Wolfram syndrome (DIDMOAD: diabetes insipidus, diabetes mellitus, optic atrophy and deafness) is a rare neurodegenerative disorder. Mutations of the WFS1 (wolframin) on chromosome 4 are responsible for the clinical manifestations in majority of patients with Wolfram syndrome. Wolfram syndrome is also accompanied by neurologic and psychiatric disorders, urodynamic abnormalities, restricted joint motility, cardiovascular and gastrointestinal autonomic neuropathy, hypergonadotrophic hypogonadism in males and diabetic microvascular disorders. There are very limited data in the literature regarding cardiac malformations associated in children with Wolfram syndrome. A 5-year-old girl with Wolfram syndrome and tetralogy of Fallot is presented herein.


Assuntos
Humanos , Feminino , Pré-Escolar , Tetralogia de Fallot/complicações , Síndrome de Wolfram/complicações
20.
Clin Rheumatol ; 28(9): 1059-65, 2009 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-19544043

RESUMO

This study aimed to compare the short-term efficacy of splinting (S) and splinting plus low-level laser therapy (SLLLT) in mild or moderate idiopathic carpal tunnel syndrome (CTS) with a prospective, randomized controlled study. The patients with unilateral, mild, or moderate idiopathic CTS who experienced symptoms over 3 months were included in the study. The SLLLT group received ten sessions of laser therapy and splinting while S group was given only splints. The patients were evaluated at the baseline and after 3 months of the treatment. Follow-up parameters were nerve conduction study (NCS), Boston Questionnaire (BQ), grip strength, and clinical response criteria. Forty-five patients with CTS completed the study. Twenty-four patients were in S and 21 patients were in SLLLT group. In the third-month control, SLLLT group had significant improvements on both clinical and NCS parameters (median motor nerve distal latency, median sensory nerve conduction velocities, BQ symptom severity scale, and BQ functional capacity scale) while S group had only symptomatic healing (BQ symptom severity scale). The grip strength of splinting group was decreased significantly. According to clinical response criteria, in SLLLT group, five (23.8%) patients had full and 12 (57.1%) had partial recovery; four (19%) patients had no change or worsened. In S group, one patient (4.2%) had full and 17 (70.8%) partial recovery; six (25%) patients had no change or worsened. Additionally, applied laser therapy provided better outcomes on NCS but not in clinical parameters in patients with CTS.


Assuntos
Síndrome do Túnel Carpal/terapia , Terapia com Luz de Baixa Intensidade , Contenções , Adulto , Idoso , Terapia Combinada , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Condução Nervosa , Estudos Prospectivos , Índice de Gravidade de Doença , Resultado do Tratamento
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