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Dietary supplementation of full-fat canola seeds (FFCS) can be part of the global solution to the problem of incessant raise in feed cost. Genetic improvement via plant breeding constantly introduces varieties of canola with higher content of unsaturated fatty acids and lower content of anti-nutritional factors. This experiment was conducted to evaluate the dietary inclusion effect of new mutant of FFCS on growth performance, carcass traits, blood metabolites, thyroid activity, antioxidant status, and immune response of growing Japanese quails. A total of 640 21-day-old quails were used in a completely randomize design with and equally allotted to four experimental groups and eight replicates each. The experimental groups fed diets supplemented with 0, 50, 100, and 150 g FFCS/kg diet from 21 to 49 days of age. All experimental diets were isocaloric and isonitrogenous. The inclusion level of FFCS did not affect body weight and body weight gain at all studied periods, while feed intake was reduced and feed conversion ratio was enhanced linearly under all experimental periods except the duration from 28 to 35 days of age. All carcass traits were not statistically affected with graded levels of FFCS. Hemoglobin, leucocytes, mean corpuscular hemoglobin (MCH), and MCH concentration values were linearly increased. Serum protein fractions, liver enzymes activities, renal function biomarkers, and triiodothyronine concentration were not affected. However, serum lipid profile was significantly altered, where high-density lipoprotein was linearly increased while triglycerides and low-density lipoprotein (LDL) were linearly (and quadratically for LDL) decreased. Antioxidant and immune statuses were improved; significant increment in glutathione and glutathione peroxidase values and antibody titer against Newcastle disease virus were elevated in groups treated with 10% and 15% FFCS. In conclusion, studied levels of FFCS, however, were not able to promote the growth rate of growing Japanese quails; they were more effective in boosting their antioxidant status and humoral immune response.
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Antioxidantes/metabolismo , Brassica napus , Coturnix/crescimento & desenvolvimento , Sementes , Glândula Tireoide/metabolismo , Ração Animal , Fenômenos Fisiológicos da Nutrição Animal , Animais , Peso Corporal , Coturnix/sangue , Coturnix/imunologia , Dieta/veterinária , Suplementos Nutricionais , Codorniz/crescimento & desenvolvimento , Triglicerídeos/sangue , Aumento de PesoRESUMO
Inelastic helium atom scattering (HAS) is suitable to determine low-energy (few meV) vibrations spatially localized on structures in the nanometer range. This is illustrated for the nanodomes that appear often on graphene (Gr) epitaxially grown on single crystal metal surfaces. The nature of the inelastic losses observed in Gr/Ru(0001) and Gr/Cu/Ru(0001) has been clarified by intercalation of Cu below the Gr monolayer, which decouples the Gr layer from the Ru substrate and changes substantially the out-of-plane, flexural phonon dispersion of epitaxial Gr, while maintaining the nanodomes and their localized vibrations. He diffraction proves that the Cu-intercalated Gr layer is well ordered structurally, while scanning tunneling microscopy reveals the persistence of the (slightly modified) periodic array of Gr nanodomes. A simple model explains the order of magnitude of the energy losses associated with the Gr nanodomes and their size dependence. The dispersionless, low-energy phonon branches may radically alter the transport of heat in intercalated Gr.
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INTRODUCTION: COVID-19 restrictive containment was responsible for major psychological distress and alteration of quality of life (QoL) in the general population. Their impact in a group of patients having cerebral small vessel disease (SVD) and at high risk of stroke and disability was unknown. OBJECTIVE: We aimed to determine the potential psychological impact of strict containment during the COVID-19 pandemic in a sample of CADASIL patients, a rare SVD caused by NOTCH3 gene mutations. METHODS: Interviews of 135 CADASIL patients were obtained just after the end of the strict containment in France. Depression, QoL and negative subjective experience of the containment were analysed, as well as predictors of posttraumatic and stressor-related manifestations, defined as an Impact Event Scale-Revised score ≥ 24, using multivariable logistic analysis. RESULTS: Only 9% of patients showed a depressive episode. A similar proportion had significant posttraumatic and stressor-related disorder manifestations independently associated only with socio-environment factors, rather than clinical ones: living alone outside a couple (OR 7.86 (1.87-38.32), unemployment (OR 4.73 (1.17-18.70)) and the presence of 2 or more children at home (OR 6.34 (1.35-38.34). CONCLUSION: Psychological impact of the containment was limited in CADASIL patients and did not appear related to the disease status. About 9% of patients presented with significant posttraumatic and stressor-related disorder manifestations which were predicted by living alone, unemployment, or exhaustion related to parental burden.
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CADASIL , COVID-19 , Doenças de Pequenos Vasos Cerebrais , Criança , Humanos , CADASIL/complicações , CADASIL/epidemiologia , CADASIL/genética , Qualidade de Vida , Pandemias , COVID-19/complicações , Doenças de Pequenos Vasos Cerebrais/complicações , Receptor Notch3/genética , Mutação , Receptores Notch/genéticaRESUMO
A five weeks biological experiment was planned to investigate the impacts of dietary supplementation with zinc oxide nanoparticles (ZnONPs) synthesized by the endophytic fungus Alternaria tenuissima on productive performance, carcass traits, organ relative weights, serum biochemical parameters, histological alteration in some internal organs and concentration of this element in the serum, liver, thigh and breast muscle in broiler chicks. A total of 108 3-day-old commercial broiler chicks (Cobb 500) were individually weighed and equally distributed in a completely randomized design arrangement according to the dose of ZnONPs supplementation into 3 dietary experimental groups. There were 6 replications having 6 birds per replicate (n = 36/ treatment) for each treatment. The three experiential dietary treatments received corn-soybean meal-based diets enhanced with 0 (control), 40 and 60 mg/kg diet of ZnONPs respectively with feed and water were provided ad libitum consumption through 5 weeks life span. Present results indicated that after 5 weeks of feeding trial and as compared to control, the ZnONPs supplementation groups recorded higher body weight, improved feed consumption, feed conversion ratio and performance index. Serum biochemical analyses revealed that serum cholesterol, triglyceride, low density lipoprotein and uric acid decreased significantly, while high density lipoprotein and liver enzyme concentrations were increased significantly. Meanwhile, zinc accumulation in serum, liver and breast and thigh muscle were linearly increased with increasing zinc supplementation. It could be concluded that supplementation of ZnONPs to broiler diet at 40 or 60 mg/kg improved productive performance, birds' physiological status and the lower levels Zn (40 mg/kg diet) revealed promising results and can be used as an effective feed additive in broilers.
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Nanopartículas , Óxido de Zinco , Animais , Ração Animal/análise , Fenômenos Fisiológicos da Nutrição Animal , Galinhas/metabolismo , Dieta/veterinária , Suplementos Nutricionais/análise , Zinco/farmacologia , Zinco/metabolismo , Óxido de Zinco/farmacologia , Óxido de Zinco/metabolismoRESUMO
BACKGROUND AND PURPOSE: By studying the evolution of brain volume across the life span in male and female patients, we aimed to understand how sex, brain volume, and the epidermal growth factor repeat domain of the mutation, the 3 major determinants of disability in CADASIL, interact in driving disease evolution. MATERIALS AND METHODS: We used validated methods to model the evolution of normalized brain volume with age in male and female patients using nonparametric regression in a large, monocentric cohort with prospectively collected clinical and high-resolution MR imaging data. We used k-means clustering to test for the presence of different clinical course profiles. RESULTS: We included 229 patients (mean age, 53 [SD, 12] years; 130 women). Brain volume was larger in women (mean size, 1024 [SD, 62] cm3 versus 979 [SD, 50] cm3; P < .001) and decreased regularly. In men, the relationship between brain volume and age unexpectedly suggested an increase in brain volume around midlife. Cluster analyses showed that this finding was related to the presence of a group of older male patients with milder symptoms and larger brain volumes, similar to findings of age-matched women. This group did not show specific epidermal growth factor repeat domain distribution. CONCLUSIONS: Our results demonstrate a detrimental effect of male sex on brain volume throughout life in CADASIL. We identified a subgroup of male patients whose brain volume and clinical outcomes were similar to those of age-matched women. They did not have a specific distribution of the epidermal growth factor repeat domain, suggesting that yet-unidentified predictors may interact with sex and brain volume in driving disease evolution.
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CADASIL , Fator de Crescimento Epidérmico , Adulto , Idoso , Encéfalo/diagnóstico por imagem , CADASIL/diagnóstico por imagem , CADASIL/genética , Progressão da Doença , Fator de Crescimento Epidérmico/genética , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , MutaçãoRESUMO
The tuberculin skin test (TST) has many limitations for the diagnosis of latent tuberculosis (TB infection. The aim of this study in Egypt was to estimate the usefulness of an interferon-gamma release assay (IFN-gamma) assay for the detection of latent TB infection in contacts of active TB cases. A total of 116 participants were enrolled and divided into 3 groups: community controls, casual (laboratory and clinic) contacts and close (household) contacts. Subjects diagnosed with latent TB infection by TST were 11.5% of controls, 71.1% of casual contacts and 29.6% of close contacts. Subjects diagnosed as latent TB infection by IFN-gamma assay (QuantiFERON-TB Gold In-Tube) were 5.9% of controls, 31.0% of casual contacts and 33.3% of close contacts. The overall agreement between TST and IFN-gamma was 66.7% (kappa = 0.28). The IFN-gamma method could be more helpful than TST for detection of latent TB infection in contacts.
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Testes de Liberação de Interferon-gama , Tuberculose Latente/diagnóstico , Adulto , Estudos Transversais , Egito , Feminino , Humanos , Tuberculose Latente/transmissão , Masculino , Sensibilidade e Especificidade , Teste Tuberculínico/métodos , Adulto JovemRESUMO
Closed-shell atoms scattered from a metal surface exchange energy and momentum with surface phonons mostly via the interposed surface valence electrons, i.e., via the creation of virtual electron-hole pairs. The latter can then decay into surface phonons via electron-phonon interaction, as well as into acoustic surface plasmons (ASPs). While the first channel is the basis of the current inelastic atom scattering (IAS) surface-phonon spectroscopy, no attempt to observe ASPs with IAS has been made so far. In this study we provide evidence of ASP in Ni(111) with both Ne atom scattering and He atom scattering. While the former measurements confirm and extend so far unexplained data, the latter illustrate the coupling of ASP with phonons inside the surface-projected phonon continuum, leading to a substantial reduction of the ASP velocity and possibly to avoided crossing with the optical surface phonon branches. The analysis is substantiated by a self-consistent calculation of the surface response function to atom collisions and of the first-principle surface-phonon dynamics of Ni(111). It is shown that in Ni(111) ASP originate from the majority-spin Shockley surface state and are therefore collective oscillation of surface electrons with the same spin, i.e. it represents a new kind of collective quasiparticle: a Spin Acoustic Surface Plasmon (SASP).
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BACKGROUND: European member states are increasingly vying with one another to recruit patients for clinical trials (CTs). The French national agency for medicines (ANSM) now receives an ever-growing number of CTs, extending response times. The aim of the new methodology presented herein is to reduce assessment times below the national mandatory timeframe of 60 days and to improve patient safety. MATERIALS AND METHODS: Based on an analysis of the criteria defining CTs, 4 key points were identified (safety, fragile population, loss of opportunity, design complexity) to build a criticality score which would determine evaluation type. This score also determines the resources needed (complete evaluation, multidisciplinary advice, ad hoc evaluation) and the timeframe required for appropriate analysis. All post-phase I CTs were analysed from the implementation of the new assessment method, on 01/02/2018 through to 31/12/2019. RESULTS: 447 CTs were analysed (63% industry and 37% academic sponsors). Based on a criticality scale, 27% of the CTs received a type A evaluation (complete), 37% a type B (multidisciplinary evaluation), 23% a type C evaluation (ad hoc evaluation) and 13% a type D evaluation (fast evaluation). From 2014 to 2017, 37% of the CTs were analysed within the mandatory timeframe, with a mean of 68 days, reaching a maximum of 102 days in 2017. Using this new assessment method, 92% of CTs respected the mandatory timeframe in 2019; the mean time in 2018-2019 was 34 days; Grounds for Non-Acceptance (GNA) were raised for 66% of the CTs (69% from academic sponsors and 65% from industrial firms). 3 CTs were refused. CONCLUSION: Here, we demonstrate the feasibility of risk analysis and multidisciplinarity method, which resulted in a dramatic improvement of assessment times.
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Hematologia , Projetos de Pesquisa , Humanos , Medição de RiscoRESUMO
INTRODUCTION: Lack of recent data on asthma control in Algeria led to this study whose results were compared with those of the same study conducted in the Middle East and North Africa (MENA). METHOD: This cross-sectional epidemiological study was performed in adults who had been diagnosed with asthma for at least one year and without exacerbation within the last 4 weeks. Asthma control was assessed using the 2012 Global Initiative for Asthma (GINA) criteria and the Asthma control test (ACT) questionnaire. RESULTS: We studied 984 patients mainly managed by specialist physicians; 61% female, mean age 45 years, body mass index 27kg/m2, active smokers 2%. Medication was prescribed in 92% with 78% receiving inhaled corticosteroids alone or with add-on therapies. Good adherence was observed in 27%. Asthma control was observed in 34.6% vs. 28.6% in other countries (P < 0.001). Low level of education, absence of medical insurance, lack of physical exercise, and-long duration of the disease were significantly associated with uncontrolled asthma. CONCLUSION: Poor control of asthma is still observed in Algeria despite a high level of specialist involvement. Except for adherence, known predictive factors of poor asthma control have been observed. Quality improvement training of health care professionals and patient education are probably the main issues to be addressed.
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Asma/epidemiologia , Asma/terapia , Adesão à Medicação/estatística & dados numéricos , Administração por Inalação , Adolescente , Corticosteroides/administração & dosagem , Adulto , África do Norte/epidemiologia , Idoso , Argélia/epidemiologia , Asma/patologia , Estudos Transversais , Progressão da Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Oriente Médio/epidemiologia , Fumar/efeitos adversos , Fumar/epidemiologia , Abandono do Hábito de Fumar/estatística & dados numéricos , Resultado do Tratamento , Adulto JovemRESUMO
INTRODUCTION: Febrile seizures are very commonly encountered in the setting of the pediatric emergency department; it represents 72.2% of seizures presenting to the pediatric emergency department in Saudi Arabia and affects about 3-8% of children. Febrile seizures are usually benign and treated conservatively. This is in contrast to bacterial meningitis, which carries a fatality rate of 14.4%. Meningitis presents with seizures in 23% of cases. Differentiation between febrile seizures and meningitis is therefore of utmost importance to avoid poor outcomes. On the other hand, this may cause many patients with febrile seizures to get exposed to unnecessary invasive testing. This study aims to define the incidence of meningitis in patients with febrile seizures and the proportion of these patients who undergo invasive lumbar puncture. METHODS: This retrospective cross-sectional study was conducted at the Maternity and Children's Hospital in Madinah, Saudi Arabia. All patients presenting with febrile seizures in the period between January 2015 and June 2019 were covered. Patients' data were gathered from the hospital database and files. Descriptive analysis was performed using SPSS. RESULTS: A total of 1375 patients were studied, with a male-to-female ratio of 1.44:1. The median age of the sample was 24 months (interquartile range: 13 - 42). Lumbar puncture was done for 108 (7.67%) of them. Only nine patients (8.3%) had meningitis, while the other 99 (91.7 %) had no meningitis. CONCLUSION: Febrile seizures are a common disease among children. The distinction between febrile seizures and meningitis is paramount to avoid poor outcomes. Bacterial meningitis is rare among patients with febrile seizures. The clinical judgement remains the cornerstone in deciding which patients should undergo invasive testing.
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Metals in river sediments from a semi-arid Mediterranean basin were investigated from upstream to downstream during contrasting hydrological conditions in 2014 and 2015. The level and origin of the contamination were evaluated using several geochemical and isotopic indicators. Elements were grouped by their level of contamination: high (Pbâ¯>â¯Cdâ¯>â¯Znâ¯>â¯Cu) and low (Al, Fe, Cr, Co, Ni). Multiple local sources of contamination were identified (industrial, agricultural and domestic waste), as well as very specific ones (gasoline station) and diffuse pollution from atmospheric deposition (gasoline, ores, aerosols). During storm events, the upstream dams can either be secondary sources of contamination or dilutors through particles derived from natural erosion. The contamination was slowed downstream due to the river geomorphology, but eventually washed into the Mediterranean Sea by intense storm events. Naturally derived elements (Co, Ni, Cr, As) were associated with Al, Fe and Mn oxides or clays, and anthropogenic originated metals with phosphorus (Cd and Zn), sulphur (Cu) and POC (Pb enrichment). Cadmium and Pb were the most available metals upstream and at the outlet, but their availability was not strictly related to their degree of contamination. These conclusions could be drawn thanks to an approach by multiple indicators.
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OBJECTIVE: To evaluate the effect of 25 (OH) vitamin D supplementation on blood pressure (BP) variability in hypertensive women in the pre-menopausal and post-menopausal periods. MATERIALS AND METHODS: 881 hypertensive women prospectively followed for an interventional study between January 2016 and September 2017, in specialized consultation at the department of internal medicine at the Blida University Hospital (Algeria). Four hundred and thiry nine premenopausal women (group I) and 442 menopausal women (group II). The initial serum 25 (OH) D level for each group was determined by the enzyme immunoassay. In groups I and II, we identified 2 subgroups, A: insufficiency (vit D between 29 and 20ng/ml) and B: deficiency (vit D less than 20ng/L). Antihypertensive therapy was supplemented with an additional 200000IU/month cholecalciferol for the two B subgroups. The variability in BP was calculated as the ratio of mean systolic and diastolic BP during daytime and nighttime, with performing ambulatory BP measurement at baseline, 3, 6, and 12 months of follow-up. RESULTS: At inclusion, the level of 25 (OH) D was lower (P<0.05) in subgroups IB (19.3±8.5ng/ml) and IIB (18.2±9, 5ng/ml) compared to subgroups IA (28.1±10.7ng/ml) and IIA (25.2±10.1ng/ml). After supplementation, the level of 25 (OH) D increased in subgroup IB (38.3±11.9ng/ml) and in subgroup IIB (37.3±10, 5ng/ml) and became higher (P<0.001) than in subgroups IA and IIA. Between subgroups IA and IB, at inclusion, there is no difference (P>0.05) in the SBP and DBP variability during the day and at night. After treatment, the variability of the SBP at night became lower (P<0.02) in group IB compared to group IA. In subgroup IIB, daytime variability indices were higher (P=0.04) at inclusion than in group IIA. After treatment, the variability of SBP during the day decreased but remained the highest (P<0.05) in subgroup IIB (14.8±10.8mmHg) compared to subgroup IB (12.0±8.1mmHg), as well as to subgroups IIA (10.9±9.8mmHg) and IA (10±8.1mmHg). We found a significant correlation of cholecalciferol with the variability of SBP during the day. CONCLUSIONS: Vitamin D deficiency appears to be a factor of BP variability. Although the variability of the postmenopausal group remains higher than that of the other groups, the correction of the level of 25 (OH) D by the supply of cholecalciferol 200000 IU per month leads to a reduction in the variability of BP in the studied hypertensive women could help to prevent morbimortal complications.
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Pressão Sanguínea/efeitos dos fármacos , Colecalciferol/farmacologia , Colecalciferol/uso terapêutico , Hipertensão/complicações , Deficiência de Vitamina D/complicações , Deficiência de Vitamina D/tratamento farmacológico , Argélia , Feminino , Humanos , Menopausa , Pessoa de Meia-Idade , Pré-Menopausa , Estudos Prospectivos , Deficiência de Vitamina D/fisiopatologiaRESUMO
PURPOSE: Diabetes mellitus (DM) and lipid disorders (LD) in hypertensive patients are associated with an increased risk of cardiovascular complications requiring follow-up and more aggressive therapeutic strategies. The main objective of this study was to describe the prevalence of DM and LD in adult hypertensive patients followed in specialized consultation of hypertension in the region of Blida (North Algeria) during the period from January 2013 to June 2017. MATERIALS AND METHODS: We included 3268 hypertensive patients (1453 men and 1815 women), mean age of 58.3±13.8years. Descriptive statistics were used to estimate means by sex and age for subgroups [under 30, 30-39, 40-49, 50-60, over 70]. A linear regression was used to determine annual trends. The age and sex specific results were adjusted to the general population data of the city of Blida for a period of 4years and each year studied. RESULTS: The mean prevalence of diabetes was 21.8% and glucose tolerance was 10.9% without significant trend of increase during the study period in the overall population and according to sex, while in the subgroup of hypertensive patients over 60, there has been an increase in the prevalence of diabetes and a decrease in glucose tolerance over the 4 years (R2=0.78, P=0.05 and R2=0.95, P=0.005, respectively). The mean prevalence of LD for the study period was 16.1% without significant trend at 4years. The increase in total cholesterol combined with the increase in low-density lipoprotein (LDL) levels was the most common disorder (32.2%). There was no significant difference in LD prevalence and characteristics in subgroups by sex. Age group analysis showed a greater increase in the frequency of lipid disorders in patients over 60years of age (R2=0.80, P=0.001). CONCLUSIONS: Over the 4years of study, age over 60 was associated with an increase in the prevalence of metabolic disorders in hypertensive patients. This trend may explain the poor control of BP. Above all, it must be taken into account for the requirement to achieve therapeutic objectives that effectively reduce the risk of cardiovascular complications occurring in these high-risk patients whose number is becoming increasingly important.
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Diabetes Mellitus/epidemiologia , Angiopatias Diabéticas/epidemiologia , Dislipidemias/complicações , Dislipidemias/epidemiologia , Hipertensão/complicações , Adulto , Idoso , Argélia/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , PrevalênciaRESUMO
PURPOSE: To compare differences in prevalence rates, treatment and control of hypertension (AHT) between males and females in general medicine consultation in the area of Blida (Algeria). METHODS: We included 3622 patients in the study (42% males and 58% females), with a mean age of 48.14±10.11 years, examined between January 2014 and June 2016 in general medicine consultation in the area of Blida (Algeria). Data was collected with individual questionnaires. Measurement of blood pressure was made using validated semi-automatic devices (OMRON HEM model 705CP). Individuals using antihypertensive drugs and/or blood pressure (BP) greater than or equal to 140/90mmHg were considered as hypertensives. The knowledge about the disease was identified among those who claimed to be aware of the diagnosis before the measurements. The treatment rate was calculated with those who reported using antihypertensive drugs. Controlled blood pressure was considered in individuals with values lower than 140/90mmHg. Lipid profile (total cholesterol, triglycerides, HDL and LDL cholesterol), and fasting blood sugar were measured. All calculations and statistical analyses are processed by the SPSS 20.0. RESULTS: The prevalence of hypertension was higher among men (46.2%) than women (31.6%) (P<0.001), and among aged over 55 years (P< 0.05) and those that have referred hypertensive parents (P<0.05). Among hypertensive men, 55.7% knew the diagnosis, 63.6% of them were under treatment, and 22% had controlled BP. Among the hypertensive women 69.8% knew the diagnosis, 85.1% were under treatment and 35.6% were with controlled BP (P<0.001 for the three variables). The most frequent associated risk factors were diabetes mellitus in 36.8% of the patients, obesity in 35.7% of the patients, microalbuminuria in 23.6% of the patients, hypercholesterolemia>2g/L in 11.6% of the patients, smoking in 7.7% of them. Presence of controlled AHT was not found to be associated with presence of other risk factors. The likelihood of having AHT was higher among men, diabetics, older subjects and higher BMI. CONCLUSION: Our study confirmed the high prevalence of AHT in general medicine consultation in Blida, which is a representative city in the north of Algeria. Although women are better treated, much remains to be done to reach BP goal, much in our countries which have the least financial resources to combat cardiovascular disabilities.
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Hipertensão/epidemiologia , Distribuição por Idade , Albuminúria/epidemiologia , Argélia/epidemiologia , Anti-Hipertensivos/uso terapêutico , Diabetes Mellitus/epidemiologia , Feminino , Humanos , Hipercolesterolemia/epidemiologia , Hipertensão/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Prevalência , Fatores de Risco , Distribuição por SexoRESUMO
BACKGROUND: The metastases of a primary lung cancer over the thyroid gland are extremely rare. We report on an unusual presentation of thyroid metastasis of lung cancer in order to improve the management of similar cases. CASE PRESENTATION: Three years ago, a Moroccan male 59-year-old was admitted for dyspnea, dry cough, and chest pain. He had smoked about 30 cigarette packs a year. Clinical examination revealed a right thyroid nodule. Chest and neck computed tomography (CT) scan showed a proximal left tumor in contact with the pulmonary artery and revealed a suspected nodule in the right lobe of the thyroid with homolateral neck node. Transbronchial biopsy was performed and pathological examination revealed adenocarcinoma of the lung and positive for thyroid transcription factor. Other explorations carried out, such as brain CT, bone scan and abdominal ultrasound were normal. After a repeated negative fine needle aspiration biopsy of the suspected nodule of the right lobe of the thyroid, we performed total thyroidectomy with neck dissection. An anatomopathologic exam revealed a tubulopapillary adenocarcinoma poorly differentiated. An Immunohistochemistry showed positive tumor cells with TTF1 and cytokeratin (CK) 7 but negative cells with thyroglobulin and CK20. Thus, the pulmonary tumor was classified stage IV. Chemotherapy based on the combination of cisplatin and etoposide was conducted along with supportive care. The tumor grew up with brain metastases after three cycles of chemotherapy. Unfortunately, the patient died 2 months after despite brain radiotherapy. CONCLUSION: We presented a medical case of a patient with thyroid metastasis resulting from a pulmonary adenocarcinoma which has rapidly evolved to brain metastases. The prognosis was pejorative in our clinical case (5 months after admission).
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Adenocarcinoma/secundário , Neoplasias Pulmonares/patologia , Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/secundário , Adenocarcinoma/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Glândula Tireoide/diagnóstico por imagem , Glândula Tireoide/cirurgia , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Neoplasias da Glândula Tireoide/cirurgia , Tireoidectomia , Tomografia Computadorizada por Raios XRESUMO
This study aimed to evaluate the correlation between serum levels of fetuin-A and the presence and severity of erectile dysfunction (ED) in Egyptian population. The study was performed on 60 ED patients and 20 age-matched healthy controls. A comprehensive medical history and complete physical examination were obtained and performed in all participants. ED and its severity were assessed via International Index of Erectile Function (IIEF-5). Doppler ultrasound, fasting blood glucose level, complete lipid profile, serum total testosterone (TT) and serum fetuin-A were performed. Our results revealed that there were no statistically significant differences between the ED group and the controls regarding body mass index, fetal bovine serum, cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL) and triglyceride (TG). However, IIEF-5 and serum TT levels were significantly lower in ED patients than controls. Regarding serum fetuin-A, our data demonstrated that ED patients had significantly lower serum fetuin-A levels than controls. In addition, patients with severe ED had lower fetuin-A levels than moderate and mild ED (P<0.001). Serum fetuin-A levels are positively correlated with cholesterol, LDL, TG and IIEF-5 and negatively correlated with HDL. In conclusion, serum fetuin-A level could be a potentially useful and sensitive biomarker for ED diagnosis.
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Disfunção Erétil/sangue , Lipídeos/sangue , Testosterona/sangue , alfa-2-Glicoproteína-HS/análise , Adulto , Biomarcadores/sangue , Estudos de Casos e Controles , Egito , Disfunção Erétil/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Curva ROC , Fatores de Risco , Índice de Gravidade de DoençaRESUMO
Sclerosing mesenteritis is a rare inflammatory disease of the bowel mesentery of unknown aetiology. It poses a diagnostic challenge for clinicians, as it can be mistaken for malignancy. We report a case of sclerosing mesenteritis initially presented with abdominal pain, tender abdominal mass and small bowel obstruction. Emergency laparotomy revealed fibrous thickening of the small bowel mesentery mimicking small bowel lymphoma. An ileo-ileal bypass procedure was performed. Six months later, the patient developed retroperitoneal fibrosis, manifesting as bilateral obstructive uropathy. Our case is unique, as it describes retroperitoneal fibrosis developing in a patient with small bowel retractile mesenteritis, with no evidence of colonic or other anatomical involvement. Furthermore, the patient had no risk factors for this condition. We conclude that the presence of sclerosing mesenteritis should cue clinicians to search for other coexisting inflammatory disorders that can have serious sequelae.
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Obstrução Intestinal/etiologia , Intestino Delgado , Paniculite Peritoneal/complicações , Fibrose Retroperitoneal/etiologia , Idoso , Diagnóstico Diferencial , Humanos , Neoplasias Intestinais/diagnóstico , Linfoma/diagnóstico , Masculino , Paniculite Peritoneal/diagnósticoRESUMO
OBJECTIVE: Assess the prevalence, the degree of control, and the comorbidities of hypertension in postmenopausal women. DESIGNS AND METHODS: This is a cohort descriptive and prospective study conducted in 2years in a population with hypertension treated for arterial hypertension in specialized university hospital in Blida, which included one thousand seven hundred and twenty-one postmenopausal women with amenorrhea fore more than 12 consecutive months. All anthropometric data were recorded. All cardiovascular complications were sought. All calculations and statistical analysis are processed by the SPSS 20.0. RESULTS: The mean age of onset menopause is 50.7±6.2yearsold. The prevalence of hypertension is 71%, significantly higher in postmenopausal women aged 65 and over. Among women, 82.3% had a systolic arterial pressure>150mmHg and 42.2% had a diastolic arterial pressure>90mmHg. The prevalence of diabetes was 34.8%, and 88.4% presented type 2 diabetes. Tobacco in 1.3%, hypoHDLmia in 52%, the hypertriglyceridemia in 43.5%, obesity in 31.7%. The metabolic syndrome in 57.8%. The major cardiovascular complications observed are: stroke in 26.4%, heart failure in 14.8%, myocardial infarction in 13.2%, renal failure in 10.1%. The control of high blood pressure is achieved only in 31.7%. CONCLUSIONS: The systolic blood pressure is more important than the diastolic blood pressure in postmenopausal women. The cerebral vascular accident remains the most feared complication. The control of hypertension remains not enough and the balance of arterial pressure figures is highly recommended to avoid morbidity and fatal complications.