Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 15 de 15
Filtrar
1.
Indian J Otolaryngol Head Neck Surg ; 75(2): 1129-1132, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37275109

RESUMO

Ossifying fibroma is benign, slowly expansile, painless, well defined fibro-osseous tumour composed of calcified products such as bone, cementum, or both [1]. We opted for a novel approach for the management of ossifying fibroma of maxillary region through scarless midfacial degloving approach with iliac bone graft reconstruction. A 20 years old young female presented with left sided facial swelling involving anterior wall of maxilla and lifting the ala of nose. CT and FNAC suggested a benign lesion. Surgery was performed to remove the tumour completely and managed with scarless midfacial degloving approach with iliac bone graft reconstruction. The iliac crest free flap is an optimal method for maxillary defect reconstruction. The main advantages of the flap are the large amount of bone provided, its height, and the possibility of including the internal oblique muscle [2].

2.
Cureus ; 15(3): e36109, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37065312

RESUMO

Background Chronic suppurative otitis media (CSOM) is described as middle ear cleft inflammation that results in long-term alterations to the tympanic membrane and/or the middle ear structures. In cases of CSOM, type 1 tympanoplasty, also known as myringoplasty, is a successful procedure for repairing the tympanic membrane and can even help restore hearing loss. This study aims to compare functional and clinical outcomes of type 1 tympanoplasty performed using transcanal endoscopic ear surgery (TEES) versus those performed via microscopic ear surgery (MES) for perforation in the tympanic membrane in the safe type of CSOM. Methodology Between January 2018 and January 2022, a retrospective analysis of 100 patients (47 men and 53 women) operated for the safe type of CSOM with a perforated tympanic membrane was conducted in our department. Based on the surgical methods, cases were randomly divided into two groups. There were 50 people in group 1 who underwent endoscopic tympanoplasty and 50 in group 2 who underwent microscopic tympanoplasty. The following factors were assessed: patient demographics; tympanic membrane perforation size at the time of surgery; operating room time; hearing outcomes, that is, closure of air-bone gap (ABG); graft uptake success rate; postoperative hospital stay; and medical resource usage. Patients were followed up for 12 weeks. Results Both groups shared similar epidemiological profiles, preoperative hearing status, and perforation sizes. In both groups, the rate of graft uptake was comparable. The average ABG closure was also quite comparable. In the case of endoscopic surgeries, the mean operative time was shorter; which was statistically significant, and complications were significantly lower in group 1. Conclusions Compared to its microscopic counterpart, endoscopic tympanoplasty has a similar graft uptake success rate and a comparable hearing outcome; however, it requires less operative time and hospital stay, has early recovery, and makes lesser use of medical resources, and it is cosmetically better.

3.
F S Rep ; 3(3): 198-203, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36212573

RESUMO

Objective: To investigate the impact of chemotherapy on the uterus. Design: Cross-sectional pilot study. Setting: Single university fertility clinic. Patients: Twelve patients with a history of alkylating agent chemotherapy exposure after Hodgkin lymphoma (cancer) vs. 12 normally menstruating women (controls). Interventions: The inclusion criteria were age of 18-45 years and consent for endometrial biopsy. The exclusion criteria were the absence of the uterus, completed pelvic radiation, uterine or cervical cancer, and metastatic cancer. Each participant underwent endometrial biopsy and pelvic ultrasound. All study visits were conducted in the late proliferative phase of the menstrual cycle. Main Outcome Measures: Uterine volume, blood flow, endometrial thickness, histology, deoxyribonucleic acid methylation pattern, and relative ribonucleic acid (RNA) expression level during the same phase of the menstrual cycle. Results: In the study group, visits were conducted at a median of 31.5 (13.5-42.5) months after chemotherapy. The median uterine volume among cancer survivors was 36 (11.3-67) cm3, and that of the general population controls was 39 (13-54) cm3. On histologic examination, there were no cytologic or architectural atypia. The RNA-sequencing analysis revealed poor clustering of both control and treatment samples. However, we identified 3 differentially expressed genes on RNA-sequencing, but there was no concordance found among the differentially expressed genes and deoxyribonucleic acid methylation changes suggesting most likely false-positive results. Conclusions: Approximately 2.5 years after chemotherapy, a time at which several survivors of Hodgkin lymphoma may resume family-building, endometrial thickness and endometrial histology were not significantly affected by a history of alkylating agent chemotherapy exposure.

4.
F S Rep ; 2(4): 462-467, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34934988

RESUMO

OBJECTIVE: To define the live birth rates in a large, population-based study of the most common reproductive-age cancers in women. DESIGN: Retrospective cohort study. SETTING: Population-based study. PATIENTS: Female cancer patients diagnosed with cancer at age 18 years old or older between 1952-2014 (n = 17,952) were compared to fertility of non-cancer controls (n = 89,436). INTERVENTIONS: Live births in cancer survivors were compared with those in healthy, age-matched controls. Cases and controls were matched in the ratio of 5:1 for birth year, birthplace (Utah, yes/no), and follow-up time in Utah. MAIN OUTCOME MEASURE: Rate of at least one live birth, reported as an incidence rate ratio (IRR). RESULTS: Of all cancer survivors, 3,127 (17.4%) had at least 1 live birth after treatment in comparison to 19,405 healthy, age-matched controls (21.7%) with the same amount of time exposure for attempting pregnancy. Breast cancer was the most common cancer type (23.1% of patients in cohort). Compared with age-matched, healthy controls, IRR of live birth was 0.69 (95% confidence interval [CI], 0.67-0.70) for all cancer types, 0.25 (95% CI, 0.20-0.33) for leukemia, 0.40 (95% CI, 0.28-0.59) for gastrointestinal cancers, 0.44 (95% CI, 0.41-0.48) for breast cancer, 0.53 (95% CI, 0.47-0.59) for central nervous system cancers, and 0.57 (95% CI, 0.44-0.73) for soft tissue cancers. With all cancer types stratified by age at diagnosis, IRR for live births in cancer survivors aged >41 years at diagnosis was 0.48 (95% CI, 0.44-0.52); IRR was 0.64 (95% CI, 0.61-0.67) in the group aged 31-40 years and 0.71 (95% CI, 0.69-0.74) in the group aged 18-30 years after their cancer treatment. CONCLUSIONS: Cancer and its treatment were associated with lower live birth rates when comparing women with cancer vs. age-matched, healthy controls.

5.
Handb Clin Neurol ; 171: 3-23, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32736757

RESUMO

The neuroendocrinology of reproduction focuses on the neuromodulation of gonadotropin-releasing hormone (GnRH), the ontogeny of the hypothalamic-pituitary-gonadal axis, and common reproductive events and conditions, namely, puberty, the menstrual cycle, and disorders of reproductive function. The core concept underpinning the neuroendocrinology of reproduction is neuroregulation of hypothalamic GnRH drive. In both men and women, reproductive function requires that GnRH input elicit appropriate secretion of follicle-stimulating hormone and luteinizing hormone from the anterior pituitary and that the gonads respond to such input appropriately. Moreover, insufficient GnRH drive causes hypothalamic hypogonadism and secondary insufficiency of gonadal sex steroid hormone synthesis and release in both sexes. Alterations in GnRH drive also reflect gonadal conditions such as dysgenesis, hyperandrogenism, gonadotropin mutations, and aging and loss or absence of oocytes or Sertoli cells. The most common cause of insufficient GnRH drive is functional, that is, due to the endocrine effects of psychologic or behavioral variables. Rarely does reduced GnRH drive reflect organic or congenital causes such as developmental defects, brain tumors, or celiac disease. Despite a common neuropathogenesis the heterogeneity of behavioral variables associated with reduced GnRH drive has resulted in a variety of names, including functional hypothalamic amenorrhea, stress-induced anovulation, and psychogenic amenorrhea.


Assuntos
Hormônio Liberador de Gonadotropina , Hormônio Luteinizante , Amenorreia , Feminino , Hormônio Foliculoestimulante , Humanos , Masculino , Reprodução
6.
Indian J Otolaryngol Head Neck Surg ; 71(Suppl 3): 2182-2185, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31763317

RESUMO

This is a prospective observational cross sectional study comprising of 57 patients who were having symptoms of chronic rhinosinusitis which were evaluated with the help of computed tomography scan (coronal and axial sections) to measure the thickness of all walls of maxillary sinus and it's volume. Computed tomographic imaging of sinonasal region has become the gold standard in the evaluation of patients with chronic sinusitis. The maxillary sinus is pyramidal in shape with lateral wall of nose forming its base and its apex is directed towards zygomatic process. All three dimensions of the maxillary sinus were measured and the volume of each maxillary sinus was also calculated. Hyperostosis of maxillary sinus tended to increase maxillary sinus walls thickness which ultimately results into decrease in maxillary sinus volume in chronic rhinosinusitis patients.

7.
Indian J Otolaryngol Head Neck Surg ; 71(Suppl 3): 2199-2202, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31763320

RESUMO

This is a prospective observational cross sectional study comprising of 57 patients who were having symptoms of chronic rhinosinusitis which were evaluated with the help of computed tomography scan (Coronal and axial sections) to identify various anatomical variants of osteomeatal complex and to find their percentage and to find the pattern of sinus involvement in chronic rhinosinusitis patients. The most common anatomical variation was agger nasi which was present in 52 (91.23%) patients followed by abnormal uncinate process in 43 (75.44%) patients and maxillary sinus was the most commonally involved sinus in CRS.

8.
J Assist Reprod Genet ; 34(11): 1507-1513, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-28825156

RESUMO

PURPOSE: The pro-inflammatory advanced glycation end products (AGEs) and their anti-inflammatory soluble receptors, sRAGE, play a role in the pathogenesis of PCOS. There is a correlation between vitamin D (vit D) and sRAGE in the serum, whereby vit D replacement increases serum sRAGE levels in women with PCOS, thus incurring a protective anti-inflammatory role. OBJECTIVE: This study aims to compare levels of sRAGE, N-carboxymethyl-lysine (CML; one of the AGEs), and 25-hydroxy-vit D in the follicular fluid (FF) of women with or without PCOS, and to evaluate the correlation between sRAGE and 25-hydroxy-vit D in the FF. MATERIAL AND METHODS: Women with (n = 12) or without (n = 13) PCOS who underwent IVF were prospectively enrolled. RESULTS: Women with PCOS had significantly higher anti-Mullerian hormone levels, higher number of total retrieved and mature oocytes, and higher number of day 3 and day 5 embryos formed. Compared to women without PCOS, women with PCOS had significantly lower FF sRAGE levels. In women with PCOS, in women without PCOS, and in all participants together, there was a significant positive correlation between sRAGE and 25-hydroxy-vit D. sRAGE positively correlated with CML in women without PCOS but not in women with PCOS. CONCLUSIONS: In women with PCOS, the low ovarian levels of the anti-inflammatory sRAGE suggest that sRAGE could represent a biomarker and a potential therapeutic target for ovarian dysfunction in PCOS. Whether there is a direct causal relationship between sRAGE and vit D in the ovaries remains to be determined.


Assuntos
Antígenos de Neoplasias/metabolismo , Fertilização in vitro , Proteínas Quinases Ativadas por Mitógeno/metabolismo , Síndrome do Ovário Policístico/genética , Vitamina D/metabolismo , Adulto , Biomarcadores/metabolismo , Feminino , Líquido Folicular/metabolismo , Produtos Finais de Glicação Avançada/metabolismo , Humanos , Oócitos/crescimento & desenvolvimento , Oócitos/metabolismo , Ovário/crescimento & desenvolvimento , Ovário/metabolismo , Síndrome do Ovário Policístico/fisiopatologia
9.
Trends Endocrinol Metab ; 28(9): 656-668, 2017 09.
Artigo em Inglês | MEDLINE | ID: mdl-28651856

RESUMO

Progesterone is essential for pregnancy maintenance and menstrual cycle regulation. Hormone action has been primarily ascribed to the well-characterized classical signaling pathway involving ligand binding, activation of nuclear progesterone receptors (PRs), and subsequent activation of genes containing progesterone response elements (PREs). Recent studies have revealed progesterone actions via non-classical signaling pathways, often mediated by non-genomic signaling. Progesterone signaling, in conjunction with growth factor signaling, impacts on the function of growth factors and regulates important physiological actions such as cell growth and remodeling, as well as apoptosis. This review focuses on non-classical progesterone signaling pathways, both including and excluding PR, and highlights how research in this area will provide a better understanding of progesterone actions and may inform novel therapeutic strategies.


Assuntos
Progesterona/metabolismo , Progesterona/farmacologia , Animais , Humanos , Redes e Vias Metabólicas/efeitos dos fármacos , Redes e Vias Metabólicas/fisiologia , Receptores de Progesterona/metabolismo , Receptores de Progesterona/fisiologia , Transdução de Sinais/efeitos dos fármacos
10.
Reprod Biol Endocrinol ; 14(1): 71, 2016 Oct 21.
Artigo em Inglês | MEDLINE | ID: mdl-27769286

RESUMO

BACKGROUND: Women with PCOS have elevated levels of the harmful Advanced Glycation End Products (AGEs), which are highly reactive molecules formed after glycation of lipids and proteins. Additionally, AGEs accumulate in the ovaries of women with PCOS potentially contributing to the well-documented abnormal steroidogenesis and folliculogenesis. MAIN BODY: A systematic review of articles and abstracts available in PubMed was conducted and presented in a systemic manner. This article reports changes in steroidogenic enzyme activity in granulosa and theca cells in PCOS and PCOS-models. It also described the changes in AGEs and their receptors in the ovaries of women with PCOS and presents the underlying mechanism(s) whereby AGEs could be responsible for the PCOS-related changes in granulosa and theca cell function thus adversely impacting steroidogenesis and follicular development. AGEs are associated with hyperandrogenism in PCOS possibly by altering the activity of various enzymes such as cholesterol side-chain cleavage enzyme cytochrome P450, steroidogenic acute regulatory protein, 17α-hydroxylase, and 3ß-hydroxysteroid dehydrogenase. AGEs also affect luteinizing hormone receptor and anti-Mullerian hormone receptor expression as well as their signaling pathways in granulosa cells. CONCLUSIONS: A better understanding of how AGEs alter granulosa and theca cell function is likely to contribute meaningfully to a conceptual framework whereby new interventions to prevent and/or treat ovarian dysfunction in PCOS can ultimately be developed.


Assuntos
Produtos Finais de Glicação Avançada/metabolismo , Hormônios Esteroides Gonadais/biossíntese , Células da Granulosa/metabolismo , Ovário/metabolismo , Síndrome do Ovário Policístico/metabolismo , Células Tecais/metabolismo , 3-Hidroxiesteroide Desidrogenases/metabolismo , Animais , Enzima de Clivagem da Cadeia Lateral do Colesterol/metabolismo , Feminino , Humanos , Fosfoproteínas/metabolismo , Receptores do LH/metabolismo , Receptores de Peptídeos/metabolismo , Receptores de Fatores de Crescimento Transformadores beta/metabolismo , Esteroide 17-alfa-Hidroxilase/metabolismo
11.
Reprod Biomed Online ; 33(1): 15-28, 2016 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-27174394

RESUMO

Polycystic ovarian syndrome (PCOS) affects 5 - 10% of reproductive age women, but its pathogenesis is still poorly understood. The aim of this review is to collate evidence and summarize our current knowledge of the role of anti-Müllerian hormone (AMH) in PCOS pathogenesis. AMH is increased and correlated with the various reproductive and metabolic/endocrine alterations in PCOS. AMH plays an inhibitory role in follicular development and recruitment, contributing to follicular arrest. AMH inhibitory action on FSH-induced aromatase production likely contributes to hyperandrogenism in PCOS, which further enhances insulin resistance in these women. Elevated serum AMH concentrations are predictive of poor response to various treatments of PCOS including weight loss, ovulation induction and laparoscopic ovarian drilling, while improvement in various clinical parameters following treatment is associated with serum AMH decline, further supporting an important role for AMH in the pathophysiology of this syndrome. This review emphasizes the need for understanding the exact mechanism of action of AMH in the pathophysiology of PCOS. This may lead to the development of new treatment modalities targeting AMH to treat PCOS, as well as help clinicians in prognostication and better tailoring existing treatments for this disease.


Assuntos
Hormônio Antimülleriano/sangue , Síndrome do Ovário Policístico/sangue , Adolescente , Adulto , Animais , Feminino , Hormônio Foliculoestimulante/sangue , Humanos , Resistência à Insulina , Laparoscopia , Limite de Detecção , Hormônio Luteinizante/sangue , Pessoa de Meia-Idade , Folículo Ovariano/fisiologia , Ovulação , Indução da Ovulação , Estresse Oxidativo , Síndrome do Ovário Policístico/fisiopatologia , Adulto Jovem
12.
Int J Gynaecol Obstet ; 132(3): 329-31, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26674317

RESUMO

OBJECTIVE: To assess whether elevated carcinoembryonic antigen (CEA) concentration in amniotic fluid can indicate meconium-stained amniotic fluid (MSAF). METHODS: In a prospective cohort study, women with a term singleton pregnancy who were in labor but had intact membranes were recruited at a center in Israel over a 5-month period in 2013. Only women who subsequently underwent artificial rupture of membranes following a clear medical indication were included. Samples of amniotic fluid, urine, and serum were collected. Amniotic fluid was examined by sight and classified as clear, MSAF, or undetermined. CEA concentration in the samples was measured. RESULTS: Among 81 participants, 45 had clear amniotic fluid, 28 had MSAF, and eight had undetermined amniotic fluid. Mean CEA concentration was more than 10 times higher in MSAF (2658 µg/L, standard error 250) than in clear amniotic fluid (238 µg/L, standard error 29; P<0.001). Receiver operating characteristic curve analysis demonstrated a sensitivity of 96% and a specificity of 100% for distinguishing MSAF from clear amniotic fluid at a CEA cutoff of 799.2 µg/L. CEA concentrations in urine and serum were all within the normal range (≤5 µg/L), irrespective of amniotic fluid status. CONCLUSION: High CEA concentrations in amniotic fluid can assist in the diagnosis of MSAF. These findings could provide the basis for a bedside test to detect MSAF following rupture of membranes.


Assuntos
Líquido Amniótico/química , Antígeno Carcinoembrionário/análise , Ruptura Prematura de Membranas Fetais/diagnóstico , Mecônio , Complicações na Gravidez/diagnóstico , Nascimento a Termo , Adulto , Índice de Apgar , Biomarcadores/análise , Feminino , Humanos , Recém-Nascido , Israel , Masculino , Gravidez , Estudos Prospectivos , Curva ROC , Adulto Jovem
13.
Nutrients ; 7(12): 10129-44, 2015 Dec 04.
Artigo em Inglês | MEDLINE | ID: mdl-26690206

RESUMO

PCOS is the most common cause of anovulation in reproductive-aged women with 70% experiencing ovulatory problems. Advanced glycation end products are highly reactive molecules that are formed by non-enzymatic reactions of sugars with proteins, nucleic acids and lipids. AGEs are also present in a variety of diet where substantial increase in AGEs can result due to thermal processing and modifications of food. Elevation in bodily AGEs, produced endogenously or absorbed exogenously from high-AGE diets, is further exaggerated in women with PCOS and is associated with ovulatory dysfunction. Additionally, increased expression of AGEs as pro-inflammatory receptors in the ovarian tissue has been observed in women with PCOS. In this review, we summarize the role of dietary AGEs as mediators of metabolic and reproductive alterations in PCOS. Once a mechanistic understanding of the relationship between AGEs and anovulation is established, there is a promise that such knowledge will contribute to the subsequent development of targeted pharmacological therapies that will treat anovulation and improve ovarian health in women with PCOS.


Assuntos
Dieta , Produtos Finais de Glicação Avançada/efeitos adversos , Síndrome do Ovário Policístico/sangue , Feminino , Produtos Finais de Glicação Avançada/sangue , Humanos , Resistência à Insulina , Obesidade/sangue , Obesidade/etiologia , Síndrome do Ovário Policístico/etiologia , Receptor para Produtos Finais de Glicação Avançada/sangue , Reprodução
14.
BMJ Case Rep ; 20152015 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-25837325

RESUMO

Osseous metaplasia of the endometrium is a rare disorder associated with the presence of bone in the uterine endometrium. Most patients with this condition presenting with infertility do so owing to the presence of a foreign body in the endometrium. We report a case of a 38-year-old woman who presented with secondary infertility due to osseous metaplasia in the endometrial cavity. She conceived spontaneously after hysteroscopic removal of the bony fragments from the uterus. Uterine osseous metaplasia is a rare cause of infertility that can be easily managed by hysteroscopic removal of the bony fragments, which results in return of fertility.


Assuntos
Calcinose/cirurgia , Endométrio/patologia , Infertilidade Feminina/etiologia , Metaplasia/complicações , Doenças Uterinas/complicações , Doenças Uterinas/diagnóstico , Adulto , Calcinose/complicações , Feminino , Fertilidade , Humanos , Histeroscopia/métodos , Infertilidade Feminina/terapia , Metaplasia/cirurgia , Gravidez , Doenças Raras/diagnóstico , Resultado do Tratamento , Doenças Uterinas/patologia , Doenças Uterinas/cirurgia
15.
BMJ Case Rep ; 20152015 Mar 25.
Artigo em Inglês | MEDLINE | ID: mdl-25809433

RESUMO

A 58-year-old man presented to the emergency department with acute left-sided weakness and left visual field defect. His examination was significant for confusion, acetone odour, tachycardia and tachypnoea. Further blood tests revealed an anion gap of 31 mEq/L, serum osmolal gap of 34 mOsm/kg, and creatinine 3.6 mg/dL. Brain MRI revealed acute infarctions scattered throughout the brain along with generalised oedema. The patient deteriorated rapidly and soon thereafter it was reported that a bottle of antifreeze was found near him at home. Haemodialysis was initiated and the patient received fomepizole and bicarbonate. Three days later the patient did not show any neurological improvement and expired later that day. Ethylene glycol toxicity can rarely present with stroke which can be life-threatening when not diagnosed and managed in a timely fashion.


Assuntos
Antídotos/administração & dosagem , Etilenoglicol/intoxicação , Pirazóis/administração & dosagem , Acidente Vascular Cerebral/induzido quimicamente , Tentativa de Suicídio , Etilenoglicol/sangue , Evolução Fatal , Fomepizol , Humanos , Masculino , Pessoa de Meia-Idade
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA