Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 19 de 19
Filtrar
1.
J Clin Endocrinol Metab ; 106(9): e3546-e3558, 2021 08 18.
Artigo em Inglês | MEDLINE | ID: mdl-33982107

RESUMO

PURPOSE: To determine whether periodontal disease is positively associated with incident diabetes across the continuum of body mass levels (BMI) and test the hypothesis that the periodontal risk for incident diabetes is modified by BMI. METHODS: We included 5569 diabetes-free participants from Visit 4 (1996-1998) of the Atherosclerosis Risk in Communities study and followed them until 2018. Periodontal disease status was classified by periodontal profile class (PPC)-Stages , and incident diabetes was based on participant report of physician diagnosis. We estimated the hazard ratios (HR) for diabetes using a competing risk model for each PPC-Stage. We assessed multiplicative interactions between periodontal disease and BMI (as a continuous variable) on risk of diabetes. RESULTS: During a median time of 19.4 years of follow-up, 1348 incident diabetes cases and 1529 deaths occurred. Compared to the "Health/Incidental Disease" stage, participants with PPC "Severe Periodontal Disease" or "Severe Tooth Loss" stage and lower BMI had elevated risk for diabetes adjusting for demographic, smoking, education, and biological variables when accounting for death as a competing risk with HRs of 1.76 (95% CI 1.10-2.80) and 2.11 (95% CI 1.46-3.04), respectively. The interaction between PPC-Stages and BMI was significant (P = 0.01). No significant associations of PPC-Stages with incident diabetes were present when BMI was above 31 kg/m2. CONCLUSION: Periodontal disease was associated with incident diabetes, especially in nonobese participants. Dentists should be aware that periodontal disease is associated with incident diabetes but the association may be modified for patient's at higher BMI levels.


Assuntos
Aterosclerose/epidemiologia , Índice de Massa Corporal , Complicações do Diabetes/epidemiologia , Diabetes Mellitus/epidemiologia , Periodontite/complicações , Periodontite/epidemiologia , Adulto , Idoso , Estudos de Coortes , Etnicidade , Feminino , Seguimentos , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Obesidade/epidemiologia , Modelos de Riscos Proporcionais , Risco , Fatores Socioeconômicos
2.
Lasers Surg Med ; 51(4): 363-369, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30575060

RESUMO

BACKGROUND: Femtosecond (fs) Laser Ionisation Mass Spectrometry (fs-LIMS) on colon tissues are described and investigated using ionization/fragmentation processes in details to present a new application in this study. Linear Time of Flight (L-TOF) mass analyzer was utilized to investigate paraffin-embedded human tissue in this study. The effect of fs laser intensity on the spectral characteristics was investigated and interpreted due to mass spectra obtained using 800 nm wavelength with 90 fs pulses at 1 kHz repetition rate. OBJECTIVES: Mass spectra of tissues were recorded from L-TOF system and then analyzed by performing a statistical approach called Principal Component Analysis (PCA). The fs-LIMS method applied is proposed as a new and pioneering technology to analyze tissues using L-TOF system, as a human free fast and reliable intra-operative cancer diagnosis method for guiding surgeon to clean the edges of cancerous tissues to be applied during the surgical operation, for pathological examinations. Fs-LIMS provides some unique diagnosis opportunities to investigate biochemical characteristics of cancerous tissues leading to obtain sensitive, fast, and reliable results. The analysis of tissue is based on distribution of molecular ion (m/z) peaks in low mass region (

Assuntos
Adenocarcinoma/diagnóstico , Colo/patologia , Neoplasias do Colo/diagnóstico , Lasers , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz/métodos , Adenocarcinoma/patologia , Neoplasias do Colo/patologia , Diagnóstico Diferencial , Humanos , Análise de Componente Principal , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz/instrumentação
3.
Andrology ; 5(4): 783-789, 2017 07.
Artigo em Inglês | MEDLINE | ID: mdl-28544660

RESUMO

In cryptorchid boys, failures in germ cell development have been clearly established. Some studies reported some abnormalities in Sertoli cells morphology but the results regarding their endocrine secretion remain controversial. To compare testicular hormone levels in young boys with and without cryptorchidism, we performed a cross-sectional hospital-based study. From surgery appointment records, we identified a case group of boys with unilateral or bilateral cryptorchidism and a control group undergoing dental care, minor osteoarticular or dermal surgery. Blood samples were withdrawn during the surgical procedure to perform testosterone, inhibin B and anti-müllerian hormone (AMH) immunoassays. We included 27 cryptorchid boys and 27 controls aged of 26.6 vs. 24.2 months, respectively (p = 0.172) far from the post-natal mini-puberty and the corresponding hormonal surges. Age-adjusted AMH and inhibin B levels were significantly lower in cryptorchid than in control boys (AMH: 87 ng/mL vs. 135 ng/mL; p = 0.009, inhibin B: 97 pg/mL vs. 133 pg/mL; p = 0.019, respectively). Moreover, AMH and inhibin B levels were significantly lower in the bilateral cryptorchid subgroup, being 50% lower than in the controls (p = 0.011 and 0.019, respectively) and while both hormones levels were independent in controls, they became strongly correlated in bilateral cryptorchid boys (R² = 0.75, p = 0.001). In addition, testosterone levels were still detectable in some boys, with significantly lower levels in cryptorchid group than in controls. Overall, 2-year-old cryptorchid patients presented a simultaneous and significant drop in AMH and inhibin B levels, suggesting a functional defect of Sertoli cells. This deficiency appeared more pronounced in bilateral cryptorchidism and thus, regarding the pivotal role of Sertoli cells in germ cell development, it may explain the compromised fertility found later in men born with such a malformation.


Assuntos
Hormônio Antimülleriano/sangue , Criptorquidismo/sangue , Inibinas/sangue , Células de Sertoli/metabolismo , Testosterona/sangue , Fatores Etários , Hormônio Antimülleriano/metabolismo , Biomarcadores/sangue , Estudos de Casos e Controles , Pré-Escolar , Estudos Transversais , Criptorquidismo/diagnóstico , Regulação para Baixo , Hospitais Universitários , Humanos , Lactente , Inibinas/metabolismo , Masculino , Testosterona/metabolismo
4.
Rev Pneumol Clin ; 72(6): 353-358, 2016 Dec.
Artigo em Francês | MEDLINE | ID: mdl-27789163

RESUMO

Neuroblastoma (NB) is an embryonal tumor of the sympathetic nervous system. It represents the most common malignant extracerebral solid tumor, and the first solid tumor in children aged less than one year. Neuroblastoma is rare in adults. We report the case of a 21-year-old male patient. Diagnosis of neuroblastoma was confirmed by percutanous CT scanner biopsy. Radiological assessment of the extension concluded to a stage IV NB with multifocal bone disease. The patient received chemotherapy based on cisplatin-etoposide (6 cycles) and a mediastinal radiotherapy. The evolution was marked by the progression of bone metastasis and the emergence of a tissular process sheathing the left optic nerve and the terminal portion of the internal carotid artery. Second line chemotherapy was indicated. A thoracic localization of NB is rare. Treatment is not codified and the prognosis is variable.


Assuntos
Neoplasias do Mediastino/diagnóstico , Neuroblastoma/diagnóstico , Adulto , Diagnóstico Tardio , Evolução Fatal , Humanos , Achados Incidentais , Masculino , Adulto Jovem
5.
Neurochirurgie ; 60(3): 63-140, 2014 Jun.
Artigo em Francês | MEDLINE | ID: mdl-24856008

RESUMO

PURPOSES: To review in the literature, all the epidemiological, clinical, radiological, histological and therapeutic data regarding chordomas as well as various notochordal entities: ecchordosis physaliphora, intradural and intraparenchymatous chordomas, benign notochordal cell tumors, parachordomas and extra-axial chordomas. To identify different types of chordomas, including familial forms, associations with tuberous sclerosis, Ollier's disease and Maffucci's syndrome, forms with metastasis and seeding. To assess the recent data regarding molecular biology and progress in targeted therapy. To compare the different types of radiotherapy, especially protontherapy and their therapeutic effects. To review the largest series of chordomas in their different localizations (skull base, sacrum and mobile spine) from the literature. MATERIALS: The series of 136 chordomas treated and followed up over 20 years (1972-2012) in the department of neurosurgery at Lariboisière hospital is reviewed. It includes: 58 chordomas of the skull base, 47 of the craniocervical junction, 23 of the cervical spine and 8 from the lombosacral region. Similarly, 31 chordomas in children (less than 18 years of age), observed in the departments of neurosurgery of les Enfants-Malades and Lariboisière hospitals, are presented. They were observed between 1976 and 2010 and were located intracranially (n=22 including 13 with cervical extension), 4 at the craniocervical junction level and 5 in the cervical spine. METHODS: In the entire Lariboisière series and in the different groups of localization, different parameters were analyzed: the delay of diagnosis, of follow-up, of occurrence of metastasis, recurrence and death, the number of primary patients and patients referred to us after progression or recurrence and the number of deaths, recurrences and metastases. The influence of the quality of resection (total, subtotal and partial) on the prognosis is also presented. Kaplan-Meier actuarial curves of overall survival and disease free survival were performed in the entire series, including the different groups of localization based on the following 4 parameters: age, primary and secondary patients, quality of resection and protontherapy. In the pediatric series, a similar analysis was carried-out but was limited by the small number of patients in the subgroups. RESULTS: In the Lariboisière series, the mean delay of diagnosis is 10 months and the mean follow-up is 80 months in each group. The delay before recurrence, metastasis and death is always better for the skull base chordomas and worse for those of the craniocervical junction, which have similar results to those of the cervical spine. Similar figures were observed as regards the number of deaths, metastases and recurrences. Quality of resection is the major factor of prognosis with 20.5 % of deaths and 28 % of recurrences after total resection as compared to 52.5 % and 47.5 % after subtotal resection. This is still more obvious in the group of skull base chordomas. Adding protontherapy to a total resection can still improve the results but there is no change after subtotal resection. The actuarial curve of overall survival shows a clear cut in the slope with some chordomas having a fast evolution towards recurrence and death in less than 4 years and others having a long survival of sometimes more than 20 years. Also, age has no influence on the prognosis. In primary patients, disease free survival is better than in secondary patients but not in overall survival. Protontherapy only improves the overall survival in the entire series and in the skull base group. Total resection improves both the overall and disease free survival in each group. Finally, the adjunct of protontherapy after total resection is clearly demonstrated. In the pediatric series, the median follow-up is 5.7 years. Overall survival and disease free survival are respectively 63 % and 54.3 %. Factors of prognosis are the histological type (atypical forms), localization (worse for the cervical spine and better for the clivus) and again it will depend on the quality of resection. CONCLUSIONS: Many different pathologies derived from the notochord can be observed: some are remnants, some may be precursors of chordomas and some have similar features but are probably not genuine chordomas. To-day, immuno-histological studies should permit to differentiate them from real chordomas. Improving knowledge of molecular biology raises hopes for complementary treatments but to date the quality of surgical resection is still the main factor of prognosis. Complementary protontherapy seems useful, especially in skull base chordomas, which have better overall results than those of the craniocervical junction and of the cervical spine. However, we are still lacking an intrinsic marker of evolution to differentiate the slow growing chordomas with an indolent evolution from aggressive types leading rapidly to recurrence and death on which more aggressive treatments should be applied.


Assuntos
Cordoma/mortalidade , Cordoma/cirurgia , Recidiva Local de Neoplasia/cirurgia , Neoplasias da Base do Crânio/mortalidade , Neoplasias da Base do Crânio/cirurgia , Terapia Combinada , Seguimentos , Humanos , Resultado do Tratamento
6.
J Fr Ophtalmol ; 36(2): 117-23, 2013 Feb.
Artigo em Francês | MEDLINE | ID: mdl-22989988

RESUMO

PURPOSE: The aim of this study was to analyze the indications and the effect of permanently maintaining silicone oil in the treatment of certain cases of vitreoretinal pathology. PATIENTS AND METHODS: Twenty-seven cases seen from January 2002 to December 2008 were retrospectively studied. Silicone oil was kept in the eyes for more than 2years. The surgical file was analyzed in all cases. The evaluation criteria were ocular pressure, emulsification, cataract, corneal dystrophy, and the functional response of the retina and optic nerve. Ultrasound echography (12 MHz), magnetic resonance imaging, and electrophysiological explorations (visual evoked potential and electroretinography) were performed. RESULTS: Twenty-seven eyes of 27 patients were included in this study. The main reasons for maintaining long-term silicone oil are recurrent vitreous hemorrhage, retinal detachment with severe proliferative vitreoretinopathy, and penetrating injury. The patients were distributed into two groups: group 1 included patients with both functional and anatomic failure, group 2 patients had achieved ambulatory vision. Follow-up ranged from 27 to 72months. Cataract incidence was approximately 91% in group 2. Emulsification was noted without high pressure in 50% of the cases in group 1. High pressure averaged 31.8% in group 2. Keratopathy was observed in 9% of the cases in group 2. Intraorbital migration of silicone oil was found in one case. The visual field was improved in 77% of the cases in group 2. CONCLUSION: This study provided interesting insights into certain clinical situations in which silicone oil has to be maintained permanently. The complications stem not only from the presence of silicone oil, but also from the preoperative status of the eye and the vitreoretinal surgery.


Assuntos
Oftalmopatias/terapia , Óleos de Silicone/uso terapêutico , Adolescente , Adulto , Idoso , Oftalmopatias/epidemiologia , Oftalmopatias/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/epidemiologia , Descolamento Retiniano/epidemiologia , Descolamento Retiniano/cirurgia , Estudos Retrospectivos , Óleos de Silicone/efeitos adversos , Fatores de Tempo , Vitrectomia/reabilitação , Vitreorretinopatia Proliferativa/epidemiologia , Vitreorretinopatia Proliferativa/cirurgia , Adulto Jovem
7.
Rev Pneumol Clin ; 68(4): 261-5, 2012 Aug.
Artigo em Francês | MEDLINE | ID: mdl-22522042

RESUMO

Congenital cystic adenomatoid malformation (CCAM) of the lung is a rare congenital developmental abnormality, representing about 25% of all congenital lung lesions. It is very rare that presentation is delayed until adulthood. We report a case of 63-year-old woman without notable pathological antecedents in whom a systematic chest X-ray revealed multiple bilateral pulmonary nodules. The patient was asymptomatic and her physical examination was normal. CT scan showed bilateral liquid rounded thin-walled densities of various size, with a homogeneous non calcified content. The diagnosis was based on radiological findings and surgery. The result of histopathological examination obtained by thoracic surgery confirmed CCAM without malignancy. The postoperative follow up showed an excellent recovery.


Assuntos
Malformação Adenomatoide Cística Congênita do Pulmão/complicações , Nódulos Pulmonares Múltiplos/etiologia , Malformação Adenomatoide Cística Congênita do Pulmão/diagnóstico , Feminino , Humanos , Pessoa de Meia-Idade
8.
Hematol Oncol Stem Cell Ther ; 4(4): 161-6, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-22198187

RESUMO

BACKGROUND AND OBJECTIVES: In Algeria, the incidence of hematologic malignancies has been difficult to estimate for many years. Today, many hematological centers, including 14 university hospitals, have been developed in the entire north and have useful epidemiological data pertinent to acute myeloid leukemia (AML). We studied the incidence of AML and its subtypes, age distribution, geographic distribution and trends in the rate of diagnosis over the last 5 years in Algeria. Secondary goals were to study trends of referral of AML cases from various regions to specific centers to assess the needs for health infrastructure and change of current practices. DESIGN AND SETTING: Retrospective analysis of nationwide survey of all adult cases of AML (>16 years) diagnosed between 1 January 2006 and 31 December 2010. PATIENTS AND METHODS: A survey form was distributed to all departments of hematology at the 15 participating centers. RESULTS: The 1426 cases of AML diagnosed during the study period represented an annual incidence of 0.91/100000 persons with a male to female (M/F) ratio of 1:16 and a median age of 45 years (range, 16-82 years). Nationally, 20% of cases AML were diagnosed in the whole western region of the country, 47% in the central and 33% in the east. There was a trend of continuous increase in the rate with age and in the rate of diagnosis over the last 5 years. The most common subtype was M2, followed by M4 and M5. CONCLUSION: An overall increase in the number of AML patients diagnosed nationwide over the last five years indicates a need for additional health care resources including curative and therapy-intense strategies, such as stem cell transplant facilities to optimize outcome. The relatively younger age of patients compared to the Western countries may be due to the demographic composition of our population.


Assuntos
Leucemia Mieloide Aguda/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Argélia/epidemiologia , Feminino , Humanos , Incidência , Leucemia Mieloide Aguda/diagnóstico , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
9.
Eur Rev Med Pharmacol Sci ; 15(3): 303-12, 2011 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-21528777

RESUMO

OBJECTIVES: The purpose of the present work was to investigate the effect of marine crustacean extract (MCE) from marine mantis shrimp Erugosquilla massavensis and silymarin on oxidative stress induced by carbon tetrachloride (CCl4) in rat liver and erythrocytes. MATERIALS AND METHODS: Male rats were randomly divided into 3 main groups, (1) control group which administered olive oil orally for 2 days, followed by distilled water for 7 consecutive days, (2) MCE group in which rats administered orally MCE, 250 mg/kg body weight for 9 consecutive days and (3) CCl4-treated group in which rats given CCl4 orally (2.5 ml/kg body weight) for 2 days. This group then subdivided into 5 subgroups. All subgroups treated orally for 7 consecutive days with distilled water (subgroup I), silymarin, 150 mg/kg body weight (subgroup II) and MCE at three tested doses 50, 100 and 250 mg/kg body weight (subgroups III, IV and V). RESULTS: The MCE and silymarin produced significant hepatoprotective effect by decreasing the activity of serum aminotransferases (ASAT and ALAT) and alkaline phosphatase (ALP) as well as malondialdehyde (MDA) level, and increasing the serum total protein, glutathione reduced (GSH) levels and the activities of glutathione-S-transferase (GST) and catalase (CAT). The MCE and silymarin also showed the same antioxidant effect on erythrocytes. CONCLUSIONS: The results of the present study, suggested that, the MCE could protect the liver and erythrocytes injuries perhaps, by its antioxidative effect, hence eliminating the deleterious effect of toxic metabolites from CCl4.


Assuntos
Antioxidantes/farmacologia , Tetracloreto de Carbono/toxicidade , Crustáceos , Eritrócitos/efeitos dos fármacos , Fígado/efeitos dos fármacos , Estresse Oxidativo/efeitos dos fármacos , Administração Oral , Alanina Transaminase/metabolismo , Fosfatase Alcalina/metabolismo , Animais , Antioxidantes/administração & dosagem , Antioxidantes/isolamento & purificação , Aspartato Aminotransferases/metabolismo , Tetracloreto de Carbono/administração & dosagem , Catalase/metabolismo , Crustáceos/química , Citoproteção , Eritrócitos/metabolismo , Glutationa/metabolismo , Glutationa Transferase/metabolismo , Fígado/metabolismo , Masculino , Malondialdeído/metabolismo , Ratos , Silimarina/farmacologia
10.
Minim Invasive Neurosurg ; 54(5-6): 282-5, 2011 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-22278799

RESUMO

BACKGROUND: After completing a craniotomy, it is important to replace the removed bone flap in its natural position in order to guarantee brain protection as well as improve cosmesis. A skull defect can expose the brain to accidental damage, and in cases of larger defects it may also cause the patients psychosocial problems. The ideal fixation device should provide reliable attachment of the flap to the skull and promote fast bony healing to avoid possible pseudo-arthrosis and/or osteolytic changes. MATERIALS AND METHODS: This is a pilot randomized clinical trial on a series of 16 patients undergoing different craniotomies for benign brain lesions in which the bone flaps were replaced using traditional sutures (Prolene 0.0) in 8 cases and with a new skull fixation device (Skull Grip) in the other 8 (randomly allocated). All patients underwent CT scans of the head with 3D reconstruction at day 1 and day 90 postoperatively to evaluate bone flap position and fusion. These scans were independently reviewed by a neuroradiologist. Cosmesis was also evaluated clinically by the surgeon and radiologically by the neuroradiologist in the 2 patient groups. RESULTS: The new "Skull Grip" device has shown stronger fixation qualities with optimal bone flap fusion and increased cosmetic healing features vs. traditional sutures. CONCLUSION: The "Skull Grip" has shown to be a reliable, effective and stronger bone flap fixation device when compared to traditional sutures.


Assuntos
Craniotomia/instrumentação , Craniotomia/métodos , Crânio/cirurgia , Retalhos Cirúrgicos , Técnicas de Sutura/instrumentação , Suturas , Titânio , Idoso , Neoplasias Encefálicas/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Reprodutibilidade dos Testes , Instrumentos Cirúrgicos , Resultado do Tratamento , Cicatrização
11.
Ann Cardiol Angeiol (Paris) ; 59(4): 183-9, 2010 Aug.
Artigo em Francês | MEDLINE | ID: mdl-20709314

RESUMO

UNLABELLED: Previous studies have shown that smokers with acute myocardial infarction (AMI) treated by thrombolysis have lower mortality rates than nonsmokers, a phenomenon often termed "smoker's paradox". This "smoker's paradox" has been rarely studied in case of primary angioplasty. AIM OF THE STUDY: To evaluate the impact of smoking status on the early mortality of patients admitted with AMI with regard to the strategy of reperfusion (intravenous thrombolysis versus primary angioplasty). PATIENTS AND METHODS: Study undertaken from the Monsatir registry of ST elevation MI including 688 patients having had either a hospital or a prehospital thrombolysis (n=397) or a primary angioplasty (n=291). Among those patients, 482 (70.1%) were active smokers. RESULTS: In the thrombolysis group, the prevalence of hypertension, diabetes and anterior location of MI was significantly less among smokers. In the group primary angioplasty, only diabetes and hypertension were less frequent. The immediate mortality was significantly less among smokers in case of thrombolysis comparatively to non-smokers (5.3 vs 13%; p=0.008). By multivariate analysis, cardiogenic shock (p<0.0001), anterior MI (p=0.03) and active smoking (p=0.03) were independent predictive factors of mortality in case of thrombolysis. A trend toward a lower mortality among smokers was observed in the primary angioplasty group (10 vs 17.6%; p=0.07). CONCLUSION: "The smoker's paradox" seems to be observed mainly among patients having had thrombolysis.


Assuntos
Angioplastia Coronária com Balão , Fibrinolíticos/administração & dosagem , Infarto do Miocárdio/mortalidade , Infarto do Miocárdio/terapia , Reperfusão Miocárdica/métodos , Fumar , Terapia Trombolítica , Idoso , Anticoagulantes/uso terapêutico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Infarto do Miocárdio/fisiopatologia , Reperfusão Miocárdica/mortalidade , Prognóstico , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Choque Cardiogênico/mortalidade , Fumar/efeitos adversos , Fumar/mortalidade , Resultado do Tratamento , Tunísia/epidemiologia
12.
Rev Pneumol Clin ; 66(3): 204-8, 2010 Jun.
Artigo em Francês | MEDLINE | ID: mdl-20561488

RESUMO

During the course of generalised amyloidosis, pulmonary diseases are mainly represented by tracheobronchial involvement and diffuse or nodular parenchymal localizations. The authors report the case of a 61-year-old woman presenting exudative pleural effusion. The diagnosis of generalised amyloidosis in association with multiple myeloma with cardiac and renal involvement was established. A thoracoscopy performed during the investigation of the pleural effusion and the biopsy revealed amyloid deposits in the pleura. The patient died although melphalan/prednisone treatment was initiated. Pleural involvement in amyloidosis is without doubt under-estimated and plays a central role in the creation and persistence of pleural effusion.


Assuntos
Amiloidose/complicações , Doenças Pleurais/etiologia , Feminino , Humanos , Pessoa de Meia-Idade
14.
Neurosurg Rev ; 34(2): 229-34, 2010 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-21301916

RESUMO

The aging of the population in westernized countries constitutes an important issue for the health systems struggling with limited resources and increasing costs. Morbidity and mortality rates reported for neurosurgical procedures in the elderly vary widely. The lack of data on risk benefit ratios may result in challenging clinical decisions in this expanding group of patients. The aim of this paper is to analyze the elderly patients cohort undergoing neurosurgical procedures and any trend variations over time. The medical records of elderly patients (defined as an individual of 70 years of age and over) admitted to the Neurosurgical and Neuro-ICU Departments of a major University Hospital in Paris over a 25-year period were retrospectively reviewed. The analysis included: (1) number of admissions, (2) percentage of surgically treated patients, (3) type of procedures performed, (4) length of hospital stay, and (5) mortality. The analysis showed a progressive and significant increase in the proportion of elderly presenting for neurosurgical elective and/or emergency procedures over the last 25 years. The number of procedures on patients over 70 years of age increased significantly whereas the mortality dropped. Though the length of hospital stay was reduced, it remained significantly higher than the average stay. The types of procedures also changed over time with more craniotomies and endovascular procedures being performed. Age should not be considered as a contraindication for complex procedures in neurosurgery. However, downstream structures for postoperative elderly patients must be further developed to reduce the mean hospital stay in neurosurgical departments because this trend is likely to continue to grow.


Assuntos
Idoso/fisiologia , Neurocirurgia , Procedimentos Neurocirúrgicos , Encéfalo/cirurgia , Interpretação Estatística de Dados , Procedimentos Endovasculares , Feminino , Humanos , Tempo de Internação , Masculino , Neurocirurgia/estatística & dados numéricos , Neurocirurgia/tendências , Procedimentos Neurocirúrgicos/mortalidade , Procedimentos Neurocirúrgicos/estatística & dados numéricos , Procedimentos Neurocirúrgicos/tendências , Estudos Retrospectivos , Medição de Risco , Medula Espinal/cirurgia , Procedimentos Cirúrgicos Vasculares/mortalidade , Procedimentos Cirúrgicos Vasculares/estatística & dados numéricos , Procedimentos Cirúrgicos Vasculares/tendências
15.
Blood Cells Mol Dis ; 35(2): 116-21, 2005.
Artigo em Inglês | MEDLINE | ID: mdl-16023874

RESUMO

Fluorescent lipid probes were used to track lipid trafficking between parent RBL cells and exosomes. We have checked the intracellular labeling of exosomes ("in vivo labeling") from parent cell incubated with either Bodipy-Cer, Bodipy-PC, or NBD-PC. Bodipy-PC labeled equally cells and exosomes, whereas Bodipy-Cer, a Golgi marker, was enriched in exosomes. Golgi membranes participated effectively in exosome biogenesis since cell incubation with brefeldin A leads to a modified phospholipid/protein ratio in exosomes. At the opposite, NBD-PC, a plasma membrane marker weakly labeled exosome membranes. Sorting of subpopulations indicated that the MHC-II containing exosomes were enriched in Bodipy-PC, whereas tetraspanin(CD 63 or CD81)-containing exosomes are essentially labeled with Bodipy-Cer and Bodipy-PC. These results indicated that RBL released two main subpopulations of exosomes that can be discriminated by their protein and lipid contents. When the bulk of exosomes was labeled after their purification ("in vitro labeling") with either of the above-mentioned lipid probes, the Bodipy-Cer was the only one to incorporate noticeably in all the subpopulations, indicating that the previous results obtained during "in vivo labeling" monitored real intracellular lipid trafficking between organelles and exosomes. Bodipy-Cer was further used as a tool to measure the respective amounts of each subpopulations. CD63, MHC II, and CD81-containing exosomes accounted for 47%, 32%, and 21%, respectively, of total exosomes.


Assuntos
Endossomos/química , Lipídeos/análise , Animais , Antígenos CD/análise , Transporte Biológico , Linhagem Celular Tumoral , Endossomos/classificação , Exocitose , Corantes Fluorescentes , Complexo de Golgi/química , Complexo de Golgi/ultraestrutura , Antígenos de Histocompatibilidade Classe II/análise , Membranas Intracelulares/química , Membranas Intracelulares/metabolismo , Proteínas de Membrana/análise , Neuropeptídeos/análise , Glicoproteínas da Membrana de Plaquetas , Ratos , Tetraspanina 28 , Tetraspanina 30
16.
J Chromatogr A ; 969(1-2): 143-51, 2002 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-12385387

RESUMO

The surface properties of poly(methyl methacrylate) (PMMA) impregnated fumed silicas, in a large range of impregnation ratios, were examined using inverse gas chromatography at infinite dilution. It was observed that the dispersive component gamma(s)d does not decrease monotonously with the impregnation ratio. Two critical coverage ratios were evidenced corresponding at first to the shielding of the most energetic sites and then to the achievement of total coverage of the silica surface. The influence of the coverage ratio on the glassy temperature (tg) of the adsorbed PMMA was also studied, which was evidenced down to a very low coverage ratio (1 monomer unit/nm2).


Assuntos
Cromatografia Gasosa/métodos , Polimetil Metacrilato/química , Dióxido de Silício/química , Adsorção , Propriedades de Superfície , Temperatura , Termodinâmica
17.
J Immunol Methods ; 227(1-2): 149-60, 1999 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-10485262

RESUMO

We have developed an original protocol of direct in situ RT-PCR with biotinylated labeled primers to detect cytokine mRNA inside cells. This label improved the specificity of the technique compared with the use of digoxigenin or fluorescein-labeled primers. We found a reliable correlation between the known expression of cytokine mRNA in a given cell and a positive signal with in situ RT-PCR. Nuclear counterstaining demonstrated that the positive signal obtained was distributed in the cytoplasm in accordance with mRNA localization. In addition, direct demonstration of the presence of the expected PCR product in cell extracts without non-specific parasitic DNA amplification provided strong support for the specificity of the method. Designing the primers in order to prevent DNA amplification, the use of recombinant Thermus thermophilus (rTth) DNA polymerase and a decreased duration of each cycle of PCR by combining the annealing and hybridization steps improved the reproducibility and reliability of the technique and morphological preservation of the cells. Experiments in which different proportions of cytokine mRNA positive and negative cells were mixed argue against significant diffusion of PCR product into initially cytokine mRNA negative cells, thereby leading to false-positive results. In comparison with the direct incorporation of labeled dNTP during amplification, our procedure appears to ensure greater specificity and does not need DNAse treatment which is often difficult to standardize. Detection of IL-2 and IFNgamma mRNA induction after T cell activation using this direct in situ RT-PCR method showed that the technique may be helpful for monitoring cytokine gene expression at a single cell level.


Assuntos
Citocinas/genética , RNA Mensageiro/análise , Reação em Cadeia da Polimerase Via Transcriptase Reversa/métodos , Animais , Células CHO , Cricetinae , Difusão , Humanos , Interferon gama/genética , Ativação Linfocitária , Sensibilidade e Especificidade , Linfócitos T/metabolismo , Células Tumorais Cultivadas
18.
Ann Fr Anesth Reanim ; 18(6): 677-82, 1999 Jun.
Artigo em Francês | MEDLINE | ID: mdl-10464536

RESUMO

We report a retrospective analysis of four cases of peripartum cardiomyopathy admitted, within a 10-year period, to the maternity hospital of Sousse. The age of the patients was over 30 years, two had gemellary pregnancies and two suffered toxaemia. Congestive cardiac failure, mainly of the left ventricle, with acute pulmonary oedema, was the main symptom. Chest X-ray showed a cardiothoracic index above 0.58 and echocardiography a left ventricular telediastolic diameter above 5.7 cm and a shortening ratio of 25% or less. Endomyocardial biopsy for ascertaining the diagnosis was not available. Treatment included bed rest, water and salt restriction, digitalis, a diuretic and an anticoagulant in case antepartum cardiomyopathy, a converting enzyme inhibitor and a diuretic in case of postpartum cardiomyopathy. Three patients recovered totally and in one echocardiography showed a persisting impaired left ventricular function. Five neonates had a favourable outcome and one foetus died in utero. Main problems raised by peripartum cardiomyopathy are discussed.


Assuntos
Cardiomiopatias/terapia , Complicações Cardiovasculares na Gravidez/terapia , Transtornos Puerperais/terapia , Adulto , Biópsia , Cardiomiopatias/diagnóstico , Feminino , Insuficiência Cardíaca/etiologia , Humanos , Miocárdio/patologia , Gravidez , Complicações Cardiovasculares na Gravidez/diagnóstico , Transtornos Puerperais/diagnóstico , Radiografia Torácica , Estudos Retrospectivos , Tunísia
19.
J Wildl Dis ; 28(2): 316-8, 1992 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-1602589

RESUMO

Fifty-seven wild boars (Sus scrofa) from protected regions of Iran were examined for helminths. Sixteen species of helminths were collected; there were ten nematodes, one acanthocephalan, two trematodes and three larval cestodes. New host and distribution records were established for all helminths except of Taenia solium cysticerci. Wild boar shared nine of these helminths with domestic pigs, six with ruminants and three with human beings in Iran. Metastrongylus pudendotectus and M. salmi are reported for the first time from Iran.


Assuntos
Helmintíase Animal , Doenças dos Suínos/epidemiologia , Animais , Animais Selvagens , Sistema Digestório/parasitologia , Feminino , Helmintíase/epidemiologia , Irã (Geográfico)/epidemiologia , Fígado/parasitologia , Pulmão/parasitologia , Masculino , Mesentério/parasitologia , Músculos/parasitologia , Prevalência , Suínos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA