RESUMO
BACKGROUND: Obesity is associated with metabolic abnormalities that predispose patients to increased cancer risk. Contemporary data on the long-term risk of specific cancers are sparse among patients with hospital-diagnosed overweight and obesity. OBJECTIVES: To examine the overall cancer incidence and specific site-related cancer incidences among patients with overweight and obesity, compared to the general Danish population. METHODS: For this 40-year (1977-2016), nationwide, Danish cohort study, we reviewed medical databases to identify individuals with hospital-based overweight and obesity diagnoses. We computed age- and gender-standardized incidence ratios (SIRs) for subsequent cancer compared to the general population. RESULTS: We observed 20 706 cancers among 313 321 patients diagnosed with overweight and obesity (median age 43 years; median follow-up 6.7 years, range 1-40 years) compared to the 18 480 cancers expected; thus, the SIR was 1.12 [95% confidence interval (95% CI): 1.11-1.14]. The SIR associated with overweight and obesity was increased with concomitant comorbidities, like type 2 diabetes (SIR: 1.18; 95% CI: 1.13-1.23) and alcoholism-related diseases (SIR: 1.62; 95% CI: 1.45-1.82). The SIR was 1.31 (95% CI: 1.28-1.34) for cancers previously identified as obesity-related, including pancreatic (SIR: 1.38; 95% CI; 1.27-1.49) and postmenopausal breast cancer (SIR: 1.14; 95% CI: 1.09-1.19). Obesity/overweight status also elevated the SIRs for haematological (SIR: 1.24; 95% CI: 1.18-1.29) and neurological cancers (SIR: 1.19; 95% CI: 1.11-1.27]. In contrast, SIRs were 1.01 (95% CI: 0.97-1.05) for immune-related cancers, 0.88 (95% CI: 0.82-0.95) for malignant melanoma, and 0.88 (95% CI: 0.85-0.92) for hormone-related cancers, other than postmenopausal breast cancer. CONCLUSION: In this large cohort study, overweight and obesity was associated with increased risk of several common cancers.
Assuntos
Neoplasias/etiologia , Obesidade/complicações , Sobrepeso/complicações , Adolescente , Adulto , Idoso , Consumo de Bebidas Alcoólicas/efeitos adversos , Estudos de Casos e Controles , Criança , Pré-Escolar , Comorbidade , Dinamarca/epidemiologia , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Neoplasias/epidemiologia , Obesidade/diagnóstico , Obesidade/epidemiologia , Sobrepeso/diagnóstico , Sobrepeso/epidemiologia , Sistema de Registros , Estudos Retrospectivos , Fatores de Risco , Fumar/efeitos adversos , Adulto JovemRESUMO
Psychological stress may be associated with increased risk of fractures. It is unknown whether post-traumatic stress disorder (PTSD), a marker of chronic severe psychological stress occurring in response to a traumatic event, influences fracture risk. In this nationwide cohort study, persons with PTSD had an increased risk of fractures compared to the general population. INTRODUCTION: We conducted a population-based national cohort study in Denmark to examine the association between PTSD and incident fractures. METHODS: We examined the incidence rate of overall and specific fractures among patients with clinician-diagnosed PTSD (n = 4114), compared with the incidence rate in the general population from 1995 to 2013, using Danish medical registry data. We further examined differences in associations by gender, age, psychiatric and somatic comorbidity, and follow-up time. We calculated absolute risks, standardized incidence ratios (SIRs), and 95% confidence intervals (95% CIs). RESULTS: Risk of any fracture among persons with PTSD was 24% (95% CI 20%, 28%) over the study period. The SIR for any fracture was 1.7 (95% CI 1.6, 1.9). We found little evidence of effect measure modification of the association between PTSD and fractures in our stratified analyses. CONCLUSIONS: Our findings suggest that PTSD is associated with increased fracture risk.
Assuntos
Fraturas por Osteoporose/etiologia , Transtornos de Estresse Pós-Traumáticos/complicações , Adolescente , Adulto , Idoso , Comorbidade , Dinamarca/epidemiologia , Feminino , Seguimentos , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Fraturas por Osteoporose/epidemiologia , Sistema de Registros , Medição de Risco/métodos , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Adulto JovemRESUMO
BACKGROUND: Adherence to topical corticosteroids (TCS) is essential for the effective treatment of atopic dermatitis but can be limited by concerns about their use. This study examined the feasibility of applying the validated TOPICOP score for assessing TCS phobia across different countries. METHODS: This was a prospective multicentre feasibility study conducted in 21 hospitals in 17 countries. Patients >3 months of age with atopic dermatitis or their parents or legal representatives completed a validated translation of the TOPICOP questionnaire in the country's native language. Respondents also completed questionnaires collecting opinions about the feasibility and acceptability of the TOPICOP questionnaire. RESULTS: A total of 1564 participants in 15 countries were included in the analysis. 81% of respondents considered the questions clear or very clear, and 79% reported that it took less than 5 minutes to complete. Each of the individual items in the TOPICOP questionnaire was considered to be not at all difficult to answer by 49% to 74% of participants. The mean global TOPICOP score was 44.7%±20.5. Mean TOPICOP subscores were 37.0±22.8% for knowledge and beliefs, 54.7±27.8% for fears and 50.1±29.1% for behaviours. Global scores and subscores differed between countries, although the subscores did not always vary in parallel, suggesting different levels of TCS phobia and different drivers for each country. CONCLUSIONS: The TOPICOP score can be feasibly applied across countries and may therefore be useful for obtaining qualitative and quantitative data from international studies and for adapting patient education and treatment.
Assuntos
Corticosteroides/uso terapêutico , Dermatite Atópica/tratamento farmacológico , Transtornos Fóbicos , Administração Tópica , Criança , Pré-Escolar , Dermatite Atópica/psicologia , Estudos de Viabilidade , Humanos , Lactente , Estudos Prospectivos , Inquéritos e QuestionáriosRESUMO
Adulteration of botanical food supplements with undeclared synthetic drugs is a common problem. One of the most affected product groups are the slimming agents. There are no analytical protocols for the detection of synthetic adulterants from these products. The present study aimed at the development of a multistep analytical method for the quick and reliable determination of sibutramine, one of the most common adulterants among botanical food supplements. The extract of a sibutramine-containing slimming formula was analysed by colour tests, TLC, HPLC-DAD, MS and NMR. The multistep method proposed by the authors allows the quick identification of sibutramine in counterfeit samples in laboratories with different instrumentation.
Assuntos
Depressores do Apetite/análise , Ciclobutanos/análise , Suplementos Nutricionais/análise , Cromatografia Líquida de Alta Pressão , Cromatografia em Camada Fina , Cor , Contaminação de Medicamentos , Espectroscopia de Ressonância Magnética , Espectrometria de Massas por Ionização por Electrospray , Espectrofotometria UltravioletaRESUMO
OBJECTIVE: Standard treatment for chronic obstructive pulmonary disease (COPD) includes inhalation therapy along with mucoactive drugs. The aim of this study was to assess the efficacy and safety of orally administered mucolytic N-acetylcysteine and propolis (NACp) in COPD patients. PATIENTS AND METHODS: A randomized, double-blind, prospective, interventional, 6 months study was conducted at the Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, Serbia. Effects of daily NACp administration (600 mg, 1200 mg or placebo) on exacerbation, life quality (St. George's Respiratory Questionnaire-SGRQ), symptoms (COPD assessment test-CAT; Visual analogue cough scale-VAS; Leicester Cough Questionnaire-LCQ; Medical Research Council Dyspnoea scale-mMRC) and spirometric parameters in 120 COPD patients were assessed. Tests were conducted at three-time points: baseline, after three months and after 6 months of NACp treatment. RESULTS: Repeated measures ANOVA showed that pulmonary function parameters, 6-minute walk test and mMRC score did not significantly change during the study. Cough VAS and CAT scores were significantly different between groups as within experimental groups. LCQ and SGRQ scores did not differ between placebo, and both examined groups, but within each examined group statistically significant difference was confirmed in observed parameters during therapy. Factorial analysis and subsequent binary logistic regression revealed "Symptoms related factor" as the strongest predictor of exacerbation for supplemented groups (p<0.01). CONCLUSIONS: Treatment with high NACp for 6 months is safe and beneficial for cough and expectoration symptoms and improves the life quality. NACp significantly reduces acute exacerbation frequency in COPD patients by controlling COPD related symptoms.
Assuntos
Própole , Doença Pulmonar Obstrutiva Crônica , Acetilcisteína/uso terapêutico , Tosse/tratamento farmacológico , Humanos , Própole/uso terapêutico , Estudos Prospectivos , Qualidade de VidaRESUMO
OBJECTIVES: Circulating IgG antibodies to oxidized low-density lipoprotein (anti-oxLDL) have been implicated in the development of atherosclerotic plaques. In this study, we investigated the prognostic value of IgG anti-oxLDL antibodies in patients with acute coronary syndrome (ACS). METHODS: In total 54 patients with ACS and 41 matched healthy controls were involved in this prospective study. Serum IgG anti-oxLDL levels were assessed by ELISA. RESULTS: Higher IgG anti-oxLDL levels were found in patients with ACS versus controls (22.8 ± 23.3 vs. 7.5 ± 5.27 EU/ml, p < 0.0001). IgG anti-oxLDL concentrations were significantly higher in ACS patients with unstable clinical complications (circulatory insufficiency, malignant arrhythmias, recurring ischaemic pain, positive stress-test, need for urgent coronary intervention or sudden cardiac death) versus those without such complications (30.0 vs. 11.7 EU/ml, p < 0.001). Twelve patients (22%) were taking statins. Patients on statins had a significant reduction in clinical complications (33%) versus patients not receiving statin therapy (61%). IgG anti-oxLDL levels were also different in these two groups (11.4 vs. 25.8 EU/ml, respectively; p = 0.03). Serum IgG anti-oxLDL levels correlated with the subsequent development of unstable coronary events. Levels of anti-oxLDL significantly decreased in response to statin therapy, independently of its lipid-lowering effect. CONCLUSIONS: Anti-oxLDL antibodies are involved in ACS. The association of anti-oxLDL with unstable clinical complications may indicate the role of this antibody in plaque destabilization.
Assuntos
Síndrome Coronariana Aguda/imunologia , Autoanticorpos/imunologia , Imunoglobulina G/sangue , Lipoproteínas LDL/imunologia , Síndrome Coronariana Aguda/sangue , Síndrome Coronariana Aguda/tratamento farmacológico , Adulto , Idoso , Estudos de Casos e Controles , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/farmacologia , Masculino , Pessoa de Meia-Idade , Placa Aterosclerótica/imunologia , Prognóstico , Estudos ProspectivosRESUMO
The most commonly occurring atherosclerotic manifestations are peripheral artery diseases (PAD). Immune-mediated processes contribute to the development of atherosclerosis, and affect the diseases outcome. The aim of the present study was to assess various immune-competent cells, cytokines and chemokines in patients with PAD and to evaluate whether the base immunological values reflect the subsequent development of cardio/cerebrovascular symptoms. One hundred sixty patients with PAD were followed-up for 42 months. At the time of enrolment, we determined blood lymphocyte subpopulations, both T-helper (Th)1/Th2-type intracytoplasmic cytokines and soluble cytokines, chemokines. Intracellular cytokines were measured on phorbol-myristate-acetate- and ionomycine- stimulated cells. Lymphocyte subgroups were quantified by flow cytometry, soluble cytokines by ELISA and intracellular cytokine levels were measured by flow cytometry. The ankle-brachial index (ABI), indicator of atherosclerosis, was also evaluated. The clinical results were correlated with the immune-parameters to assess the input of immune-inflammatory events in the propagation of vascular manifestation. CD4(+) T-cell proportions in patients with PAD with cerebro- cardio-vascular manifestations were decreased, which further reduced in patients with fatal outcome. Of circulating chemokines, IL-8 (CXCL-8) was increased in patients with subsequent cerebro- cardio-vascular manifestations, compared to those without the symptoms, and further raised in patients with fatal outcome. The percentage of interferon (IFN)-gamma positive cells showed clear negative correlation with ABI. We conclude that altered peripheral lymphocyte subsets and cytokine/chemokine imbalance play important roles in the proinflammatory cascade and reflect disease severity in patients with PAD.
Assuntos
Doenças Cardiovasculares/imunologia , Transtornos Cerebrovasculares/imunologia , Interleucina-8/imunologia , Doenças Vasculares Periféricas/imunologia , Doenças Cardiovasculares/complicações , Transtornos Cerebrovasculares/complicações , Citocinas/imunologia , Feminino , Humanos , Ativação Linfocitária/imunologia , Masculino , Pessoa de Meia-Idade , Doenças Vasculares Periféricas/complicações , Fatores de Risco , Linfócitos T/imunologiaRESUMO
Antiphospholipid syndrome (APS) is a distinct clinical entity characterized by arterial and venous thromboembolic events, recurrent fetal loss and the presence of antiphospholipid antibodies in the patients' sera. In primary APS, there is no detectable underlying disease, while overlap APS is associated with clinical syndromes including systemic autoimmune diseases, infections, or malignancies. We carried out a retrospective analysis of serological and clinical manifestations as well as assessed outcome-measures in 165 patients with primary APS. Thrombotic manifestations and possible signs of autoimmune diseases were determined at the time of the diagnosis, followed by the analysis of recurrent thrombotic events and effects of therapy during the follow-up period. Among the 165 patients with primary APS at onset, 105 patients (63%) remained primary APS after a mean 5.2 years of follow-up. In 14% of the patients, subsequently APS became associated with various characteristics of undifferentiated connective tissue disease. Finally 23% of patients evolved into a definitive systemic autoimmune disease during a mean 9.75 years of follow-up. Recurrent thrombotic events were registered in 24% of patients. Our results suggest that primary APS may be considered as a potential early phase of a dynamic transition towards a well-defined systemic autoimmune disease.
Assuntos
Síndrome Antifosfolipídica/fisiopatologia , Doenças do Tecido Conjuntivo/epidemiologia , Trombose/epidemiologia , Adolescente , Adulto , Idoso , Síndrome Antifosfolipídica/imunologia , Doenças Autoimunes/epidemiologia , Doenças Autoimunes/etiologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva , Estudos Retrospectivos , Trombose/etiologia , Adulto JovemRESUMO
BACKGROUND: Introduction of disease modifying treatment may have increased the cancer incidence in multiple sclerosis patients. Our aim was to estimate the incidence of any cancer, malignant melanoma, nonmelanoma skin cancer, and female breast cancer, and cancer specific mortality in multiple sclerosis patients diagnosed in 1995-2015 i.e. after introduction of disease modifying treatment. METHODS: Linking various Danish medical registers, we compared observed cancer incidence and cancer-specific mortality in multiple sclerosis patients versus expected based on general population rates. RESULTS: Among 10,752 multiple sclerosis patients, we identified 5.76 incident cancers per 1,000 person-years. The standardized incidence ratio was 0.98 (95% confidence interval [CI], 0.90-1.06) for any cancer, 0.99 (95% CI, 0.84-1.15) for non-melanoma skin cancer, and 0.98 (95% CI, 0.81-1.18) for female breast cancer. For malignant melanoma, the standardized incidence ratio was 1.51 (95% CI, 1.13-1.98) for the entire period (1995-2015) but 1.16 (95% CI, 0.62-1.99) for 2005-2015. The overall mortality rate was 1.31 (95% CI, 1.09-1.53) per 1000 person-years with a standardized mortality ratio of 0.99 (95% CI, 0.83-1.17). CONCLUSION: In this nationwide study, multiple sclerosis patients did not have increased cancer incidence or increased cancer-specific mortality. We observed an increased risk of malignant melanoma mainly attributed to increased risk in the first part of our study period.
Assuntos
Esclerose Múltipla/epidemiologia , Neoplasias/epidemiologia , Adulto , Idoso , Estudos de Coortes , Comorbidade , Dinamarca/epidemiologia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Sistema de RegistrosRESUMO
OBJECTIVES: Urinary tract infections have been linked with urinary tract cancer, but the association remains controversial. We examined whether pyelonephritis is a clinical marker of urogenital cancer. METHODS: We used Danish medical databases to create a population-based cohort of patients with an incident hospital-based pyelonephritis diagnosis during 1994-2013. Follow-up for cancer began at pyelonephritis diagnosis and ended on 30 November 2013. We restricted the cohort to patients older than 50 years, as urogenital cancer risk in the younger population is low. We calculated the absolute risk of urogenital cancer and the standardized incidence ratio (SIR) comparing risk observed in pyelonephritis patients to risk expected in the general population of Denmark. RESULTS: Among 15 070 patients with pyelonephritis, we observed 197 urinary tract cancers and 374 genital organ cancers over a 20-year follow-up period. The absolute risk of urogenital cancer was 1.5% 6 months after a pyelonephritis diagnosis, and the cumulative risk was 3.0% at 5 years. During the first 6 months following a pyelonephritis diagnosis, the SIR of urogenital cancer was 8.56 (95% CI 7.49-9.75). Between 6 and 12 months following this diagnosis, the SIR was 1.75 (95% CI 1.26-2.35), and beyond 1 year the SIR was approximately unity for most cancers. Notably, the SIR for bladder cancer among women remained elevated beyond 1 year of follow-up. CONCLUSIONS: Patients presenting with a hospital-based diagnosis of pyelonephritis had a higher 6-month risk of urogenital cancer than expected. However, causation cannot be inferred because of the study design.
Assuntos
Pielonefrite/complicações , Sistema de Registros , Neoplasias Urogenitais/diagnóstico , Idoso , Idoso de 80 Anos ou mais , Biomarcadores , Estudos de Coortes , Feminino , Hospitais , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Razão de Chances , Pielonefrite/epidemiologia , Fatores de Risco , Infecções Urinárias/complicações , Infecções Urinárias/epidemiologia , Neoplasias Urogenitais/epidemiologiaRESUMO
OBJECTIVES: To describe how certain peripheral immune parameters reflect the inflammatory alterations in patients with primary APS. METHODS: Twenty-eight patients with newly diagnosed primary APS were studied. The control group included 26 patients with stable coronary disease and 38 healthy individuals. Peripheral blood lymphocyte subgroups were quantified, intracellular cytokines were measured by flow cytometry, soluble cytokines and auto-antibodies were assessed using ELISA. Endothelial dysfunction was evaluated by measuring endothelium-dependent (flow-mediated; FMD) vasodilation. Carotid duplex ultrasound was performed to quantify the carotid artery intima-media thickness (IMT). Stiffness parameters, augmentation index (AIx) and pulse wave velocity (PWV) were assessed by TensioClinic technology. RESULTS: Serum IL-4 and IL-6 levels were significantly higher in APS. CD4+IL10+ and CD8+IL10+ cell percentages in APS were significantly increased compared with controls. Th 0 and T cytotoxic 0 cell percentages were significantly decreased in patients compared with controls. FMD in APS was significantly lower, while IMT was higher than that of controls. FMD showed strong association with stiffness parameters, AIx and PWV. A significant negative linear correlation was detected between PWV and CD8+IL10+ cell percentages and significant positive linear correlation was found between PWV and CD8+IL10- cell percentage. CONCLUSION: In APS, the orchestrated pro-inflammatory cascade can eventually result in endothelial dysfunction, leading to the characteristic vascular abnormalities of the disease.
Assuntos
Síndrome Antifosfolipídica/imunologia , Endotélio Vascular/imunologia , Doenças Vasculares/imunologia , Síndrome Antifosfolipídica/diagnóstico por imagem , Síndrome Antifosfolipídica/fisiopatologia , Biomarcadores/sangue , Velocidade do Fluxo Sanguíneo , Linfócitos T CD4-Positivos/imunologia , Linfócitos T CD8-Positivos/imunologia , Artérias Carótidas/diagnóstico por imagem , Artérias Carótidas/fisiopatologia , Estudos de Casos e Controles , Doença da Artéria Coronariana/diagnóstico por imagem , Elasticidade , Endotélio Vascular/diagnóstico por imagem , Endotélio Vascular/fisiopatologia , Feminino , Citometria de Fluxo , Humanos , Interferon gama/sangue , Interleucina-10/sangue , Interleucina-4/sangue , Interleucina-6/sangue , Ativação Linfocitária , Contagem de Linfócitos , Masculino , Estatísticas não Paramétricas , Túnica Íntima/diagnóstico por imagem , Ultrassonografia Doppler Dupla , Doenças Vasculares/diagnóstico por imagem , Doenças Vasculares/fisiopatologia , VasodilataçãoRESUMO
Defects in the formation of the septum and gradually autolysis of cells occur when the dap-dependent mutant of Escherichia coli is grown in a medium with 4-hydroxy-diaminopimelic acid. When the culture grown in the presence of the labelled analogue is supplemented with the non-radioactive diaminopimelic acid a portion of the TCA-soluble radioactivity is released from the cells during 20 min after the addition of diaminopimelic acid. During this time interval the elongated forms formed in the presence of the analogue divide, however, only on the condition that the above forms are not irreversibly damaged. The increased concentration of the analogue in the medium substantially suppresses the irregularities in the development of the septum as well as the degradation of analogue containing cell wall. However, the growth rate in the presence of the analogue is always slightly lower than that in the presence of diaminopimelic acid. The cell wall pulse-labelled with diaminopimelic acid or its analogue for a time interval shorter than 1/4 of the generation time exhibits the same or only slightly higher rate of diaminopimelic acid is probably utilized less effectively for the synthesis of murein than diaminopimelic acid. However, its incorporation into the wall does not result in pronounced damage of the cell.
Assuntos
Ácido Diaminopimélico/metabolismo , Escherichia coli/metabolismo , Peptidoglicano/biossíntese , Ácidos Pimélicos/metabolismo , Divisão Celular , Parede Celular/metabolismo , Ácido Diaminopimélico/análogos & derivados , Escherichia coli/crescimento & desenvolvimento , Hidroxiácidos/metabolismo , Mutação , Peptidoglicano/metabolismoRESUMO
Tritium-labelled 4-deoxy-D-glucose (4-dglc) and 6-deoxy-D-glucose (6-dgcl) were prepared by catalytic hydrogenolysis of the corresponding deoxyiodo derivatives with gaseous tritium. The two sugars are transported into Saccharomyces cerevisiae by both the constitutive glucose and the inducible galactose carrier. Uranyl ions are powerful inhibitors. The pH optimum in uninduced cells lies at 5.5 for both sugars, the apparent activation energies (between 15 and 35 degrees C) are 25.1 kJ/mol and 16.5 kJ/mol, respectively. The steady-state intracellular concentration of both sugars is less than the extracellular one (no uphill transport). Neither of them is a substrate of yeast hexokinase. 4-Deoxy-D-glucose undergoes a dinitrophenol-sensitive conversion to an unknown metabolite which is not phosphorylated and may represent one of its oxidation products.
Assuntos
Desoxiaçúcares/metabolismo , Desoxiglucose/metabolismo , Saccharomyces cerevisiae/metabolismo , Desoxiglucose/síntese química , Dinitrofenóis/farmacologia , Transporte de Elétrons , Frutose/metabolismo , Glucose/metabolismo , Hexoquinase/metabolismo , Concentração de Íons de Hidrogênio , Iodoacetamida/farmacologia , Saccharomyces cerevisiae/enzimologia , Temperatura , Urânio/farmacologiaRESUMO
A new radioimmunological method was developed for the determination of the mycotoxin ochratoxin A. The specific antibodies used in this method had been prepared by the immunization of rabbits by means of administration of ochratoxin A conjugate with bovine serum albumin. Their effective affinity constant was Ka = 5.1 X 10(-9) l. Mol-1. The substance used as radioligand was 125I-ochratoxin with a high specific radioactivity (Czechoslovak patent PV 6136, 1986). The average sensitivity of determination (ED 85%) was 10 to 15 picograms per 0.1 ml of sample. The range of the calibration curve was mostly from 5 to 360 picograms.
Assuntos
Ocratoxinas/análise , Radioimunoensaio/métodos , Animais , Especificidade de Anticorpos , Ocratoxinas/imunologia , CoelhosRESUMO
Sweet's syndrome is an acute febrile neutrophilic dermatosis. Classical form occurs after infection of the gastrointestinal or respiratory tract. This syndrome is often associated with myeloproliferative disorders and solid tumors. Some cases are reported in the literature in which usage of granulocyte colony-stimulating factor induced the symptoms of Sweet's syndrome. We report the case of an 53-year-old woman with hyperthyreosis. She wasn't euthyreoid in spite of medicaments since 1994, so her doctors planned operation. In the preoperative period her peripheral blood revealed agranulcytosis and she has got fever. 2 days after administration of granulocyte colony-stimulating factor erythematous plaques appeared on her face, neck and extremities. Biopsy from these plaques showed dermal neutrophilia, so a diagnosis of neutrophilic dermatosis was made. After the administration of corticosteroids, immunglobulin and antibiotics the skin lesions were resolved. She was examined because of suspicion of autoimmune diseases but we couldn't find any of them. Retrospectively, appearance of Sweet's syndrome was associated with granulocyte colony-stimulating factor. The case of this woman is important because usage of colony-stimulating factors is widespread and the Sweet's syndrome could be occurs as side effect of these drugs.
Assuntos
Fator Estimulador de Colônias de Granulócitos/efeitos adversos , Hipertireoidismo/tratamento farmacológico , Síndrome de Sweet/induzido quimicamente , Corticosteroides/uso terapêutico , Feminino , Fator Estimulador de Colônias de Granulócitos/farmacologia , Humanos , Pessoa de Meia-Idade , Neutrófilos/patologia , Pele/patologia , Síndrome de Sweet/tratamento farmacológico , Síndrome de Sweet/patologiaRESUMO
The authors detected lupus anticoagulant and/or anticardiolipin antibodies in 1519 patients' blood samples between 1986-1999 in 3rd Department of Internal Medicine of Medical School of Debrecen. Examining only the proved thrombotic events and fetal losses as symptoms of antiphospholipid syndrome 218 patients had suffered from this syndrome. Secunder antiphospholipid syndrome was the diagnosis in case of 420 patients, the most common in Systemic Lupus Erythematosus (288 patients). In 704 antiphospholipid antibody positivity cases the diagnosis of antiphospholipid syndrome was not fulfilled. Analysing the antibodies profile of primary and secondary antiphospholipid syndrome in SLE, IgG type anticardiolipin antibody positivity was significantly higher in blood samples of SLE patients (82 patients, p < 0.01). Among thrombotic manifestations of antiphospholipid syndrome cerebrovascular thrombosis were significantly higher in patients suffering from SLE (128 patients, p < 0.04), while the occurrence of venous thrombosis, thrombosis of coronary, carotic, aorta and peripheral arteries and recurrent abortions was not significantly different in case of primary and secondary antiphospholipid syndrome. Lupus anticoagulant positivity means higher risk for venous thrombosis (94 patients, p < 0.0001), but anticardiolipin antibody positivity associated with a higher risk for thrombosis of coronary, carotic, aorta and peripheral arteries (59 patients, p < 0.00006). Comparing IgG- and IgM-type anticardiolipin antibody positivity the authors found significantly higher cerebrovascular thrombosis events in IgG-anticardiolipin group (p < 0.004). Sneddon syndrome were detected in 17 patients in the primary antiphospholipid syndrome group and in 16 cases in secundary, SLE-associated antiphospholipid syndrome group. One of the patients had died because of the Catastrophic Antiphospholipid Syndrome.
Assuntos
Anticorpos Antifosfolipídeos/sangue , Síndrome Antifosfolipídica/diagnóstico , Síndrome Antifosfolipídica/imunologia , Lúpus Eritematoso Sistêmico/imunologia , Anticorpos Anticardiolipina/sangue , Síndrome Antifosfolipídica/complicações , Ensaio de Imunoadsorção Enzimática , Humanos , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Inibidor de Coagulação do Lúpus/sangue , RiscoRESUMO
Antiphospholipid syndrome is characterized by the presence of antiphospholipid antibodies resulting in arterial and venous thromboembolism. Apart from primary cases, this syndrome is often associated with autoimmune diseases. Around 50 cases of catastrophic antiphospholipid antibody syndrome have been reported as yet. Authors describe a case of a female patients with catastrophic antiphospholipid syndrome associated with gastric cancer. This may be the first case of such association in the literature. Authors also discuss the possible pathomechanism of this disorder, as well as the available therapeutic approaches.
Assuntos
Adenocarcinoma/patologia , Anticorpos Antifosfolipídeos/imunologia , Neoplasias Gástricas/patologia , Adenocarcinoma/imunologia , Evolução Fatal , Feminino , Humanos , Pessoa de Meia-Idade , Neoplasias Gástricas/imunologia , SíndromeRESUMO
Hyssopus officinalis L. (Lamiaceae family) has been cultivated in Central Europe for a long time. This essential oil containing species serves not only as spice but in many countries including Hungary, it is used as a folk medicine against certain respiratory diseases. Despite this fact, little is known about the variation of its productivity under Central European climatic conditions. The cultivated populations of hyssop can be characterised by a significant heterogenity. In the course of its breeding the uniformity of flower colour (e.g. blue form), and increase in the oil content are the main achievable purposes. The purpose of this work was to investigate both the variability of strains of different crigin and the time-dependent variations of its production parameters. The optimum of phytomass was obtained at the beginning of July. The essential oil content as well as compounds of the non volatile fractions were also investigated. The non volatile fractions for rosmarinic, caffeic acids were analysed mainly by TLC and densitometry. Both compounds were present in all samples and they are suitable for the characterisation of the plant. The essential oils were gained with Water Steam Distillation (WSD) and Supercritical Fluid Extraction (SFE) with CO2. The oils were analysed by GC, GC-MS techniques. In the essential oil composition of the populations studied significant heterogenity could be observed. In the case of applying SFE extraction the oil composition is more uniform, similarly to the obtained by WSD adding hexane. The heterogenity can be experienced in the offsprings, too. If only the main four components (beta-pinene, limonene, pinocamphone, isopinocamphone) are regarded, among the offsprings clear and mixed lines alike can be found. Results of these experiments justify the necessity and usefulness of selection which is going on.
Assuntos
Óleos Voláteis/química , Óleos Voláteis/metabolismo , Plantas Medicinais/química , Cromatografia Gasosa , Clima , Cromatografia Gasosa-Espectrometria de Massas , Hungria , Medicina Tradicional , Óleos Voláteis/isolamento & purificação , Plantas Medicinais/classificação , Plantas Medicinais/fisiologia , Especificidade da EspécieRESUMO
Primary antiphospholipid syndrome (APS) is characterized by venous or arterial thrombotic events and/or recurrent abortions, fetal death, preeclasmpsia, eclampsia in the presence of anticardiolipin antibodies or lupus anticoagulant, in the absence of accompanying diseases. Antiphospholipid antibodies can activate endothelial cells, and were recently implicated in atherosclerosis. To assess potential endothelial impairment and early signs of atherosclerosis, flow-mediated (endothelium-dependent) and nitrate-mediated (endothelium independent) vasodilation, as well as von Willebrand factor antigen level and carotid artery intima-media thickness (IMT) were measured in patients with primary antiphospholipid syndrome and in healthy controls. Flow-mediated vasodilation in patients with primary APS was significantly lower than that of controls (3.43 +/- 2.86% versus 7.96 +/- 3.57%; P < 0.0001). We also found significantly higher von Willebrand antigen levels in patients with primary APS than in the control group (157.91 +/- 52.45% versus 125.87 +/- 32.8%; P = 0.012). Moreover, carotid artery IMT was significantly larger in the primary APS group compared to controls (0.714 +/- 0.2 mm versus 0.58 +/- 0.085 mm; P = 0.0037). Our results reflect ongoing endothelial damage and accelerated atherosclerosis in patients with primary APS, and suggest that vasoprotective therapy may be beneficial in the treatment of these patients.