RESUMO
OBJECTIVE: Asymmetrical skull deformity is frequently seen in children with cerebral palsy, and may contribute to postural abnormalities and deformities. The aim of this cross-sectional- survey was to determine the frequency of asymmetrical skull deformity and its correlation with clinical parameters. METHODS: A 10-item checklist for asymmetrical skull deformity, postural abnormalities, and deformities was developed, and its inter-rater reliability was tested. A total of 110 participants aged 1-18 years (mean age 9.3 years (standard deviation 4.7)) was assessed using the checklist. The frequency of asymmetrical skull deformity was analysed and related to the Gross Motor Function Classification System (GMFCS), postural abnormalities, and deformities. RESULTS: The reliability of the checklist was satisfactory (κ > 0.8). Asymmetrical skull deformity was observed in 44 children, 24 showing right and 20 showing left flat occipital deformity. Its frequency was significantly related to GMFCS and with the patterns of asymmetrical posture and deformities (p < 0.05). Children with right flat occipital asymmetrical skull deformity showed predominantly rightward facial direction and right-side-dominant asymmetrical tonic neck reflex, left convex scoliosis, right-side-elevated pelvic obliquity, and left-sided hip dislocation. Those with left flat occipital asymmetrical skull deformity demonstrated the reverse tendency. CONCLUSION: Asymmetrical skull deformity is frequent in cerebral palsy and closely related to asymmetrical posture and deformities. This information will be useful to manage these problems.
Assuntos
Doenças Ósseas/etiologia , Paralisia Cerebral/complicações , Anormalidades Craniofaciais/etiologia , Anormalidades Musculoesqueléticas/etiologia , Osso Occipital/anormalidades , Postura , Adolescente , Doenças Ósseas/fisiopatologia , Paralisia Cerebral/fisiopatologia , Lista de Checagem/normas , Criança , Pré-Escolar , Anormalidades Craniofaciais/epidemiologia , Anormalidades Craniofaciais/fisiopatologia , Estudos Transversais , Face , Feminino , Quadril , Luxação do Quadril/etiologia , Humanos , Lactente , Masculino , Anormalidades Musculoesqueléticas/epidemiologia , Anormalidades Musculoesqueléticas/fisiopatologia , Pescoço , Pelve , Reflexo , Reprodutibilidade dos Testes , Escoliose/etiologia , Escoliose/fisiopatologia , Coluna Vertebral/anormalidades , Coluna Vertebral/fisiopatologiaRESUMO
Myocardial infarction is a common disease and among the leading causes of death in the world. We previously reported association of variants in LGALS2, encoding galectin-2, with myocardial infarction susceptibility in a case-control association study in a Japanese population. Here we identify BRAP (BRCA1-associated protein) as a galectin-2-binding protein. We report an association of SNPs in BRAP with myocardial infarction risk in a large Japanese cohort (P = 3.0 x 10(-18), OR = 1.48, 2,475 cases and 2,778 controls), with replication in additional Japanese and Taiwanese cohorts (P = 4.4 x 10(-6), 862 cases and 1,113 controls and P = 4.7 x 10(-3), 349 cases and 994 controls, respectively). BRAP expression was observed in smooth muscle cells (SMCs) and macrophages in human atherosclerotic lesions. BRAP knockdown by siRNA using cultured coronary endothelial cells suppressed activation of NF-kappaB, a central mediator of inflammation.
Assuntos
Infarto do Miocárdio/genética , Polimorfismo de Nucleotídeo Único/fisiologia , Ubiquitina-Proteína Ligases/genética , Animais , Ásia , Aterosclerose/genética , Aterosclerose/metabolismo , Aterosclerose/patologia , Células COS , Estudos de Casos e Controles , Células Cultivadas , Chlorocebus aethiops , Predisposição Genética para Doença , Genética Populacional , Humanos , Músculo Liso Vascular/efeitos dos fármacos , Músculo Liso Vascular/metabolismo , Miócitos de Músculo Liso/efeitos dos fármacos , Miócitos de Músculo Liso/metabolismo , Miócitos de Músculo Liso/patologia , NF-kappa B/metabolismo , Ligação Proteica , RNA Interferente Pequeno/farmacologia , Fatores de Risco , Ubiquitina-Proteína Ligases/metabolismoRESUMO
BACKGROUND: The efficacy of prophylactic coronary revascularization with percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) surgery in patients with abdominal aortic aneurysm (AAA) scheduled for open repair surgery remains controversial. HYPOTHESIS: Concomitant coronary artery disease (CAD) with no inducible ischemia can be medically treated in AAA patients undergoing open repair as long as the existence of CAD is recognized. METHOD: A retrospective analysis of acute and long-term outcomes was performed for 122 patients with AAA who underwent coronary arteriography (CAG) for preoperative evaluation followed by elective open repair. RESULTS: Preoperative CAG revealed no CAD in 54 patients (non-CAD group) and the existence of CAD in 68 patients. Prophylactic PCI or CABG surgery was performed in 16 patients (CAD-PCI/CABG group) with symptomatic angina, ischemia proven by pharmacological stress scintigraphy, or coexistence of reduced cardiac contraction and coronary stenosis in multiple vessels. Medical treatment was administered to 52 patients who had no signs of ischemia (CAD-medical group). During the perioperative period, no cardiac event occurred irrespective of the existence of CAD. The long-term outcomes in the CAD-medical group were equivalent to those in the non-CAD group. In the CAD-PCI/CABG group, the cardiac event-free rate was comparable with that of other groups, although mortality was higher. CONCLUSION: In patients undergoing AAA open repair, medical treatment for concomitant CAD with no obvious inducible ischemia does not confer unfavorable outcomes. Although prophylactic coronary revascularization possibly prevents future cardiac events, it appears to be necessary in a very limited number of cases.