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1.
Medicine (Baltimore) ; 102(34): e34836, 2023 Aug 25.
Artigo em Inglês | MEDLINE | ID: mdl-37653796

RESUMO

Acute ischemic stroke is a major cause of morbidity and mortality worldwide, and genetic factors play a role in the risk of stroke. Single nucleotide polymorphisms (SNPs) in the VKORC1, CYP4F2, and GGCX genes have been linked to clinical outcomes, such as bleeding and cardiovascular diseases. This study aimed to investigate the association between specific polymorphisms in these genes and the risk of developing the first episode of acute ischemic stroke in patients without a known embolic source. This retrospective, cross-sectional, observational, analytical, case-control study included adult patients diagnosed with acute ischemic stroke. The SNPs in VKORC1 rs9923231, CYP4F2 rs2108622, GGCX rs11676382 genes were genotyped and analyzed together with the demographic and clinical factors of the 2 groups of patients. The presence of SNPs in VKORC1 or CYP4F2 genes significantly increased the risk of ischemic stroke in the context of smoking, arterial hypertension, and carotid plaque burden. The multivariate logistic model revealed that smoking (odds ratio [OR] = 3.920; P < .001), the presence of carotid plaques (OR = 2.661; P < .001) and low-density lipoprotein cholesterol values >77 mg/dL (OR = 2.574; P < .001) were independently associated with stroke. Polymorphisms in the VKORC1 and CYP4F2 genes may increase the risk of ischemic stroke in patients without a determined embolic source. Smoking, the presence of carotid plaques, and high low-density lipoprotein cholesterol levels were reconfirmed as important factors associated with ischemic stroke.


Assuntos
AVC Isquêmico , Acidente Vascular Cerebral , Adulto , Humanos , Estudos de Casos e Controles , Estudos Transversais , Estudos Retrospectivos , Polimorfismo de Nucleotídeo Único , Acidente Vascular Cerebral/genética , LDL-Colesterol , Família 4 do Citocromo P450/genética , Vitamina K Epóxido Redutases/genética
2.
Medicina (Kaunas) ; 59(7)2023 Jul 13.
Artigo em Inglês | MEDLINE | ID: mdl-37512103

RESUMO

Background and Objectives: Platelet-rich fibrin (PRF) membrane plays an important role in cell proliferation and aids in healing. This study aimed to assess the safety and efficacy of the addition of PRF to the graft in tympanoplasty. Materials and Methods: A retrospective study was conducted involving 47 patients with chronic dry eardrum perforation, who were candidates for different types of tympanoplasty (type I-IV). The study took place in the ENT department, County Emergency Clinical Hospital of Cluj-Napoca. In group 1 (27 patients) tympanoplasty was performed with a cartilage graft, while in group 2 (20 patients) a cartilage graft was used with the addition of a PRF membrane. The PRF clot was extracted and transformed into a thin membrane. Postoperative evaluation included otoendoscopy and otomicroscopy at 1, 3, 6, and 12 months after surgery, as well as pure-tone audiometry at 12 months. Results: Postoperative follow-up at 1, 3, 6, and 12 months showed a higher rate of graft survival in the PRF group than in the non-PRF group. At the 12-month mark, a successful outcome was observed in 95.0% of patients in the PRF group, while the success rate in group 1 was 70.4% (p < 0.05). The postoperative hearing threshold value was statistically significantly lower in the group with PRF, compared to the non-PRF group, being 18.4 ± 10.4 dB and 27.6 ± 16.2 dB (p < 0.001), respectively. Although the postoperative air-bone gap value did not differ significantly between groups, there was a greater improvement in the PRF group (p < 0.7). The PRF was well tolerated, and the incisions healed perfectly. Conclusions: The PRF membrane increases the rate of autograft survival and is therefore an effective material for patients with chronic perforations of the tympanic membrane.


Assuntos
Fibrina , Membrana Timpânica , Humanos , Membrana Timpânica/cirurgia , Fibrina/uso terapêutico , Estudos Retrospectivos , Resultado do Tratamento , Timpanoplastia
3.
Ann Ital Chir ; 91: 321-326, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32879058

RESUMO

AIM: To evaluate renal function after laparoscopic nephron-sparing surgery (NSS) and to establish the factors that might influence its dynamic one year after surgery. METHODS: The prospective study included 83 patients previously diagnosed with renal cell carcinoma who underwent laparoscopic NSS. Demographic, clinical, laboratory and surgery related data were recorded. Patients were followed up for one year after surgery. RESULTS: The majority of cases (63 (76.8%)) were included in stage T1a. Almost two thirds of patients underwent partial nephrectomy (PN) (54 (65.1%)). A slight decrease in GFR was observed 1 year after surgery (80.1±21.5 ml/min; 75.3±22.4 ml/min respectively) in all patients. Univariate analysis showed a significant decrease in GFR values one year after surgery for patients who underwent standard PN as compared with those from the enucleation group (p=0.003). Male patients showed a significant decrease in GFR one year after surgery, as compared with female patients (p<0.001), and elderly patients were more likely to show lower GFR. When considering the simultaneous influence of age, gender and type of surgery on the evolution of GFR, the threshold for statistical significance was slightly crossed (p=0.2). CONCLUSION: Partial nephrectomy as compared to enucleation, advanced age and male gender are associated with impaired renal function at one year after laparoscopic NSS. KEY WORDS: Enucleation, Laparoscopic partial nephrectomy, Renal cell carcinoma.


Assuntos
Carcinoma de Células Renais , Neoplasias Renais , Laparoscopia , Nefrectomia , Idoso , Carcinoma de Células Renais/cirurgia , Feminino , Seguimentos , Taxa de Filtração Glomerular , Humanos , Neoplasias Renais/cirurgia , Masculino , Estudos Prospectivos , Estudos Retrospectivos
4.
Genes (Basel) ; 11(7)2020 07 20.
Artigo em Inglês | MEDLINE | ID: mdl-32698322

RESUMO

INTRODUCTION: Atherosclerosis represents the process by which fibrous plaques are formed in the arterial wall, increasing its rigidity with a subsequent decrease in blood flow which can lead to several cardiovascular events. Seeing as vitamin K antagonists are involved in the pathogenesis of atherosclerosis, we decided to investigate whether polymorphisms in genes that influence vitamin K metabolism might have an impact in modulating the risk of plaque formation. PATIENTS AND METHODS: In the current study we included adult patients admitted in the Clinical Municipal Hospital of Cluj-Napoca without any carotid or femoral plaques clinically visible at the initial investigation, and a five year follow-up was subsequently performed. We recorded the following patient characteristics: age at inclusion, gender, area of living, smoking, presence of carotid and/or femoral plaques at five years, ischemic heart disease, arterial hypertension, atrial fibrillation, heart failure, diabetes mellitus, obesity, dyslipidemia, drug (oral anticoagulants, antihypertensives, hypolipidemic, anti-diabetic) use and status for the following gene polymorphisms: VKORC1 1639 G>A, CYP4F2 1347 G>T and GGCX 12970 C>G. RESULTS: We observed that the major predictor of both carotid and femoral plaque formation is represented by ischemic cardiac disease. VKORC1 and CYP4F2 polymorphisms did not predict plaque formation, except for VKORC1 homozygous mutants. Nonetheless, both VKORC1 and CYP4F2 interacted with ischemic cardiac disease, increasing the risk of developing a carotid plaque, while only CYP4F2, but not VKORC1, interacted with ischemic cardiac disease to increase the risk of femoral plaque formation. CONCLUSIONS: We documented that CYP4F2 and VKORC1 polymorphisms boost the proinflammatory plaque environment (observed indirectly through the presence of ischemic heart disease), increasing the risk of plaque development.


Assuntos
Doenças das Artérias Carótidas/genética , Família 4 do Citocromo P450/genética , Placa Aterosclerótica/genética , Polimorfismo de Nucleotídeo Único , Vitamina K Epóxido Redutases/genética , Idoso , Doenças das Artérias Carótidas/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Placa Aterosclerótica/patologia
5.
Exp Ther Med ; 18(6): 4981-4986, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31798719

RESUMO

Psoriasis is a chronic, systemic, inflammatory disorder which accelerates the life process of skin cells, based on a genetically induced deviant immune response. High-frequency ultrasonography (HF-USG) is a painless, non-invasive imaging technique that can be performed and repeated whenever the need arises. We evaluated lesional and non-lesional skin of psoriatic patients with the use of HF-USG, focusing on the immune-induced inflammation and skin thickness. Previous studies suggested that HF-USG, being a non-invasive technique, is useful as an aid to clinical evaluation of the severity of psoriatic plaques. Our goal was to determine whether the skin of psoriatic patients is influenced by the background or habits of the patients. The study included a total of 27 patients affected by psoriasis vulgaris. The thickness of the epidermis and dermis and the skin echogenicity were documented for the active plaques, as well as for the non-affected skin of all the patients included in the study, using a high-frequency ultrasonographic system. The patient's local background, sex, family history of psoriasis, smoking habits and sun exposure were analyzed. HF-USG of the psoriatic plaques exposes a three-band structure that is easily distinguished from the surrounding unaffected skin, due to a hypoechoic band in the upper dermis. Although not specific for psoriasis, it is a strong marker of inflammation. The obtained results confirm that, indeed, skin thickness is greater in lesional skin compared to non-lesional skin, by a mean of 1,180 µm (±340 µm). We consider that skin HF-USG should be used as a quantitative method in the clinical evaluation of the patients with psoriasis and may help as an objective means of assessing inflammation in lesional skin.

6.
Medicina (Kaunas) ; 55(10)2019 Oct 16.
Artigo em Inglês | MEDLINE | ID: mdl-31623212

RESUMO

Background and Objectives: Deep vein thrombosis (DVT) is a common cause of intra-hospital morbidity and mortality, and its most severe complication is pulmonary thromboembolism. The risk factors that influence the apparition of DVT are generally derived from Virchow's triad. Since the most severe complications of DVT occur in proximal rather than distal deep vein thrombosis, the aim of this study was to identify the factors influencing the apparition of proximal DVT. Materials and Methods: This was a transversal, cohort study. The study included 167 consecutive patients with lower limb DVT over a two-year period. The following data were recorded or determined: general data, conditions that are known to influence DVT, medical history and coagulation or thrombophilia-related genetic variations. Results: In the univariate analysis, male gender, neoplasia, previous DVT and mutated factor V Leiden were all associated with proximal DVT, while bed rest was associated with distal DVT. In the multivariate analysis, male gender, previous DVT and factor V Leiden mutation were independently correlated with proximal DVT, while bed rest was independently associated with distal deep vein thrombosis. Conclusion: Our observations point out that the factors indicating a systemic involvement of coagulation were correlated with proximal DVT, while local factors were associated with distal DVT.


Assuntos
Trombose Venosa/classificação , Trombose Venosa/etiologia , Idoso , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Risco , Romênia
7.
PLoS One ; 14(1): e0210666, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30650128

RESUMO

AIM: The aim of our study was to evaluate the potential role of resistin in estimating the 30 days prognosis in patients with hypoxic-ischemic organ injury who survived after a cardiac arrest (CA). MATERIALS AND METHODS: The study included 40 patients resuscitated after a non-traumatic out-of-hospital CA admitted in Emergency Department (ED). All patients were followed for 30 days after CA or until death. Clinical data on admission were recorded. Blood samples were collected on admission in ED (0-time interval), and at 6, 12, 24, 48- and 72-hours following resuscitation. Serum concentrations of resistin, S100B and neuron specific enolase (NSE) were measured. Several predictive scores for the mortality at 30 days were created with logistic regressions. RESULTS: At each time interval, median serum levels of resistin and S100 B were significantly higher in non-survivors compared to survivors. For NSE, plasma levels were significantly lower in survivors as compared to non-survivors at 48 and 72 hours, respectively. Accurate predictive scores for 30-days mortality were the ones which included the values of resistin and S100B measured at 12 hours after admittance [AUC 0.938 (0.813-0.989), sensitivity 85.71% (67.3%- 96%), specificity 91.67% (61.5%'99.8%), p<0.001], which included the values of all three markers measured at 12 hours after admittance [AUC 0.955 (0.839-0.995), sensitivity 82.14% (63.1%'93.9%), specificity 100.00% (73.5%'100.0%), p<0.001] and the that included the values of resistin and S-100B at 6 hours together with serum lactate on admission [AUC = 0.994 (0.901-1.0), sensitivity 96.4% (81.7%'99.9%), specificity 100.00% (73.5%'100.0%), p<0.001]. CONCLUSION: In our study, serum levels of resistin or a combination of resistin with S-100B or resistin with S-100B and lactate, were highly predictive for 30 days mortality in resuscitated patients after CA. Further studies on large number of patients are needed to confirm our data.


Assuntos
Biomarcadores/sangue , Parada Cardíaca/sangue , Resistina/sangue , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Parada Cardíaca/mortalidade , Parada Cardíaca/patologia , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Prognóstico , Estudos Prospectivos , Adulto Jovem
8.
J Res Med Sci ; 23: 68, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30181750

RESUMO

BACKGROUND: The objective of the present study was to determine the association between chemotherapy and infectious complications in patients diagnosed with Hematologic malignancies (HMs). MATERIALS AND METHODS: The study included 463 patients diagnosed with HMs multiple myeloma (MM), Hodgkin's lymphoma (HL), non-HL (NHL), acute myeloid leukemia (AML), acute lymphocytic leukemia, chronic lymphocytic leukemia, and chronic myeloid leukemia, between January 2014 and June 2015. The patients were followed for 1 year after inclusion, to record the infectious complications. The collected data included age, sex, type of chemotherapy regimen, and several blood tests at admission. All patients received prophylactic treatment with antibiotics and antifungal agents. For each infection, we recorded the microbiological diagnosis and the day of occurrence since HMs diagnosis. RESULTS: In patients with MM, we found that the treatment with growth factors (hazard ratio [HR] 2.2; confidence interval [CI] 95%: 1-4.6; P = 0.03) was associated with a higher chance of infectious complications. In patients with non-Hodgkin lymhoma (LNH), the following drugs were associated with a higher infectious incidence: cytarabine (HR: 2.3; CI 95%: 1-5; P = 0.03), methotrexate (HR: 2.1; CI 95%: 1.8-4; P = 0.01), dexamethasone (HR: 1.7; CI 95%: 0.9-3; P = 0.06), growth factors (HR: 1.7; CI 95%: 0.9-3.2; P = 0.001), and etoposide (HR: 2.5; CI 95%: 1.5-4.2; P = 0.002). Cytarabine (induction) (HR: 2; CI 95%: 1.1-3.7; P = 0.01), cytarabine (consolidation) (HR: 2.1; CI 95%: 1.3-3.5; P = 0.01), and growth factors (HR: 2.1; CI 95%: 1.3-3.5; P = 0.002) were often on the therapeutic plan of patients with AML, which developed infections. CONCLUSION: Regarding the chemotherapy regimen, the highest incidences of infectious complications were observed for growth factors and cytarabine.

9.
Med Sci Monit ; 24: 1359-1365, 2018 Mar 06.
Artigo em Inglês | MEDLINE | ID: mdl-29507279

RESUMO

BACKGROUND The purpose of this study was to assess the role of regression and other clinical and histological features for the prognosis and the progression of cutaneous melanoma. MATERIAL AND METHODS Between 2005 and 2016, 403 patients with melanoma were treated and followed at our Department of Dermatology. Of the 403 patients, 173 patients had cutaneous melanoma and underwent sentinel lymph node (SLN) biopsy and thus were included in this study. RESULTS Histological regression was found in 37 cases of melanoma (21.3%). It was significantly associated with marked and moderate tumor-infiltrating lymphocyte (TIL) and with negative SLN. Progression of the disease occurred in 42 patients (24.2%). On multivariate analysis, we found that a positive lymph node and a Breslow index higher than 2 mm were independent variables associated with disease free survival (DFS). These variables together with a mild TIL were significantly correlated with overall survival (OS). The presence of regression was not associated with DFS or OS. CONCLUSIONS We could not demonstrate an association between regression and the outcome of patients with cutaneous melanoma. Tumor thickness greater than 2 mm and a positive SLN were associated with recurrence. Survival was influenced by a Breslow thickness >2 mm, the presence of a mild TIL and a positive SLN status.


Assuntos
Melanoma/patologia , Linfonodo Sentinela/patologia , Neoplasias Cutâneas/patologia , Adulto , Progressão da Doença , Intervalo Livre de Doença , Feminino , Humanos , Metástase Linfática , Linfócitos do Interstício Tumoral/patologia , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/patologia , Estadiamento de Neoplasias , Prognóstico , Biópsia de Linfonodo Sentinela/métodos , Resultado do Tratamento , Melanoma Maligno Cutâneo
10.
J BUON ; 23(7): 104-110, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30722118

RESUMO

PURPOSE: to evaluate the 30-day death rate and the factors associated with short-term complications after radical cystectomy for muscle-invasive urothelial bladder cancer. METHODS: The study included 123 patients (age 64.1±7.9 years; 111 (90.2%) males and 12 (9.8%) females) previously diagnosed with urothelial bladder cancer, admitted for radical cystectomy in a tertiary center. The following data were noted: age, gender, perioperative chemotherapy and radiotherapy, pre- and postoperative hemoglobin and creatinine levels, tumor stage, type of surgery, type of diversion and Clavien classification. Patients were followed for 30 days and several complications were noted: cardiovascular, gastrointestinal, local, or infectious complications, anemia. Death rate was also recorded. RESULTS: Open cystectomy was performed in 81 (65.9%) patients, and laparoscopic approach was used in 43 (34.1%) patients. An ileal neobladder was created for 11 (8.9%) patients and noncontinent diversion for 112 (91.1%). There were 2 (1.6%) deaths following surgery. The following complication rates were noted: 27 local (22%), 16 infectious (13%), 54 cases of postoperative anemia (43.9%). Postoperative anemia was independently associated with open cystectomy (OR, 5.7; p=0.001), ileal neobladder (Odds ratio/OR, 14.6, p=0.002) and male gender (OR, 0.15, p=0.01). The Clavien classification did not differ between open and laparoscopic cystectomy (p=0.3), even though the complication grade was higher in the former. CONCLUSIONS: The 30-day death rate after radical cystectomy for muscle-invasive urothelial bladder cancer was low. Open cystectomy was associated with more severe short-term complications as compared with the laparoscopic approach. Postoperative anemia was associated with the type of surgery, diversion type and male gender.


Assuntos
Cistectomia/mortalidade , Laparoscopia/mortalidade , Procedimentos Cirúrgicos Minimamente Invasivos/mortalidade , Neoplasias Musculares/mortalidade , Complicações Pós-Operatórias , Neoplasias da Bexiga Urinária/mortalidade , Idoso , Feminino , Seguimentos , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Neoplasias Musculares/patologia , Neoplasias Musculares/cirurgia , Invasividade Neoplásica , Prognóstico , Estudos Prospectivos , Taxa de Sobrevida , Neoplasias da Bexiga Urinária/patologia , Neoplasias da Bexiga Urinária/cirurgia
11.
Ann Ital Chir ; 89: 507-512, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30665223

RESUMO

AIM: The aim of this study was to determine the impact of patient, tumor and surgery-related parameters on 1-year postoperative mortality in a cohort of patients operated in a single tertiary center. MATERIALS AND METHODS: The study included 605 patients diagnosed with colon cancer between January 2013 and December 2015 that underwent radical surgery in a tertiary center. Patient demographics, comorbidities, preoperative biological parameters alongside with tumor and surgery-related factors were prospectively recorded and then analyzed in relation 1-year postoperative mortality. RESULTS: One-year mortality rate in the study group was 10.9%. Independent risk factors in relation to 1-year mortality were advanced TNM stage (OR 3.10, 1.10 - 8.75 95% CI ), emergency surgery (OR 1.91, 1.11 - 3.74 95% CI ), location of the tumor in the ascending colon (OR 2.17, 1.32 - 3.57 95% CI ), multiorgan resections (OR 2.07, 1.15 - 3.74 95% CI), age over 63 years (OR 2.05, 1.16 - 3.62 95% CI) and the history of alcohol consumption (OR 2.058, 1.17 - 3.61 95% CI ). DISCUSSION: Postoperative complications are still being reported in colon cancer surgery, despite technological progress and constant research in the field. So far, factors that influence postoperative mortality have been mostly studied up to 30 days postoperatively. According to some recent papers, reporting 30-day mortality data can underestimate accurate communication of postoperative adverse events. Thus, 1-year mortality in colon cancer surgery could be a better indicator of the impact on surgery on postoperative period of this patients and factors that influence it should be well known. KEY WORDS: Surveillance, Colon cancer, 1-year mortality.


Assuntos
Neoplasias do Colo/mortalidade , Neoplasias do Colo/cirurgia , Complicações Pós-Operatórias/mortalidade , Procedimentos Cirúrgicos do Sistema Digestório/métodos , Humanos , Prognóstico , Fatores de Tempo
12.
Oxid Med Cell Longev ; 2017: 4297206, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28852433

RESUMO

NASH consists in lipid accumulation in hepatocytes that trigger oxidative stress, secretion of proinflammatory cytokines leading to steatohepatitis (NASH). The study aimed to investigate the levels of proinflammatory (TNF-α and IL-6) along with anti-inflammatory cytokine IL-10 in patients with NASH and to correlate the cytokines' level with their polymorphism. Sixty-six patients with NASH and 30 healthy volunteers were included in the study. The plasmatic level of IL-6, IL-10, and TNF-α were determined by ELISA. IL-10 -1082 G/A, IL-6 -174 G/C, and TNF-α -308 G/A polymorphisms were determined using the PCR-RFLP technique. IL-6, TNF-α, and CRP levels were significantly higher in patients with NASH. There was a positive correlation between proinflammatory cytokines and a negative correlation between IL-10 and proinflammatory markers. The G allele and GG genotype of IL-6 -174 G/C polymorphism were more frequently noticed in NASH patients. Regarding IL-10 -1082 G/A polymorphism, the AA genotype was correlated with NASH and with a low plasmatic level of IL-10. The A allele in position 308 of the TNF-α gene was associated with high level of cytokine. In conclusion, there was an imbalance between pro- and anti-inflammatory cytokines in NASH patients. IL-10 -1082 G/A and TNF-α -308 G/A genotypes were correlated with the plasmatic levels of cytokines.


Assuntos
Citocinas/genética , Estudos de Associação Genética , Hepatopatia Gordurosa não Alcoólica/genética , Alelos , Antropometria , Biomarcadores/sangue , Estudos de Casos e Controles , Feminino , Genótipo , Humanos , Inflamação/patologia , Interleucina-10/genética , Interleucina-6/genética , Masculino , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/sangue , Polimorfismo de Nucleotídeo Único/genética , Fator de Necrose Tumoral alfa/genética
13.
Ann Ital Chir ; 88: 505-513, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29339590

RESUMO

AIM: This study analyzes risk factors implicated in postoperative complications and mortality after anterior resection in rectal cancer. MATERIAL AND METHODS: A total number of 378 patients with anterior rectal resection, diagnosed with rectal cancer and admitted at the IIIrd Surgery Clinic, "Octavian Fodor" Regional Institute of Gastroenterology and Hepatology, Romania, between 2009 and 2016. The inclusion criteria were anterior rectal resections with curative visa for rectal cancer. The complications we assessed are the following: anastomotic fistula, intra-abdominal infections, postoperative bowel obstruction and wound infection. RESULTS: There was statistical significance regarding male gender, emergency hospitalization, hypoproteinemia and the resumption of intestinal transit. Anterior rectal resection of tumors located on the middle rectum was associated with high rate of anastomotic fistula. Patients with manual suture of anastomosis developed intraabdominal abscess more frequently. In the multivariate analysis, hypoproteinemia and a number of lymph nodes >1 remained independently associated with the occurrence of wound infection. The 30-day mortality rate was 4.8% with 18 deaths and morbidity rate 20.6% with 78 cases. CONCLUSIONS: Major complications after radical resection for rectal cancer are dependent on multiple variables such as male patients, those admitted in emergency and patients with hypoproteinemia. Location of tumor on middle rectum, manual suture of anastomosis, number of lymph nodes > 1 were associated with high rate of morbidity. Patients with coronary heart disease and diabetes mellitus didn't had statistical significance, but the rate of morbidity and mortality remains high in this groups. KEY WORDS: Complications, Radical anterior resection, Rectal cancer, Risk factors.


Assuntos
Adenocarcinoma/mortalidade , Neoplasias Retais/mortalidade , Idoso , Fístula Anastomótica/etiologia , Comorbidade , Doença das Coronárias/epidemiologia , Diabetes Mellitus/epidemiologia , Feminino , Humanos , Hipoproteinemia/etiologia , Fístula Intestinal/etiologia , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Resultado do Tratamento
14.
J Gastrointestin Liver Dis ; 25(3): 289-93, 2016 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-27689191

RESUMO

BACKGROUND: Diagnosis of portal hypertensive gastropathy (PHG) is based on endoscopic criteria. I-scan technology, a new technique of virtual chromoendoscopy, increases the diagnostic accuracy for lesions in the gastrointestinal tract. AIM: To establish the role of i-scan endoscopy in the diagnosis of PHG. METHOD: In this prospective study, endoscopic examination was conducted first by using white light and after that i-scan 1 and i-scan 2 technology in a group of 50 consecutive cirrhotic patients. The endoscopic diagnostic criteria for PHG followed the Baveno criteria. The interobserver agreement between white light endoscopy and i-scan endoscopy was determined using Cohen's kappa statistics. RESULTS: Forty-five of the 50 patients met the diagnostic criteria for PHG when examined by i-scan endoscopy and 39 patients were diagnosed with PHG by white light endoscopy. The strength of agreement between the two methods for the diagnosis of PHG was moderate (k=0.565; 95%CI 0.271-0.859; p<0.001). I-scan 1 classified the mosaic pattern better than classic endoscopy; i-scan 2 described better the red spots. CONCLUSION: I-scan examination increased the diagnostic sensitivity of PHG. The diagnostic criteria (mosaic pattern and red spots) were easier to observe endoscopically using i-scan than in white light.


Assuntos
Endoscopia Gastrointestinal/métodos , Ectasia Vascular Gástrica Antral/diagnóstico , Mucosa Gástrica/patologia , Hipertensão Portal/etiologia , Cirrose Hepática/complicações , Idoso , Feminino , Ectasia Vascular Gástrica Antral/etiologia , Ectasia Vascular Gástrica Antral/patologia , Humanos , Hipertensão Portal/diagnóstico , Cirrose Hepática/diagnóstico , Masculino , Pessoa de Meia-Idade , Variações Dependentes do Observador , Valor Preditivo dos Testes , Prognóstico , Estudos Prospectivos , Reprodutibilidade dos Testes
15.
Immunol Lett ; 156(1-2): 127-31, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24140476

RESUMO

BACKGROUND: Psoriasis is a chronic inflammatory skin disorder. Recent studies associated a number of genetic variants to this immune-mediated pathology. OBJECTIVE: This study aims to assess whether the association between the non-susceptibility allelic variants of IL12B single-nucleotide polymorphism (SNPs) rs3212227 and rs6887695, IL23R SNPs rs11209026 and rs7530511, IL6 SNP rs1800795 and HLA-Cw6 could be correlated with decreased risk for psoriasis. MATERIAL AND METHODS: We genotyped 67 psoriasis patients and 69 healthy subjects for polymorphisms of IL12B rs3212227 and rs6887695, IL23R rs11209026 and rs7530511, IL6 rs1800795 and for the presence of HLA-Cw6. The patients and controls were recruited from Dermatology Department, part of "Tor Vergata" Clinic, Rome. Demographic data of the control group matched those of psoriasis patients, with a female:male ratio of 2.55 and mean age of 45.5±12.2 years for patients and 44.8±11.7 years for controls. RESULTS: The following genotypes were less frequent in patients: IL12B SNP rs6887695 CC (OR, 0.179; CI95% 0.046-0.699; p=0.01), IL6 SNP rs1800795 CG (OR, 0.367; CI95% 0.179-0.753; p=0.006) and IL6 SNP rs1800795 CC (OR, 0.069; CI95% 0.008-0.586; p=0.01). Also the HLA-Cw6 allele was rarely found in controls (OR, 0.459; CI95% 0.230-0.916; p=0.02). The multivariate analysis showed that the existence of at least one C allele in both IL12B SNP rs6887695 and IL6 SNP rs1800795 or the absence of HLA-Cw6 allele and at least one C allele in IL12B SNP rs6887695 or IL6 SNP rs1800795 is associated with a lower risk of psoriasis (OR, 0.185; CI95% 0.037-0.929; p=0.04). The presence of at least one C allele in both IL12B SNP rs6887695 and IL6 SNP rs1800795 and the absence of HLA-Cw6 allele decreased even further the risk of psoriasis (OR, 0.038; CI95% 0.006-0.244; p=0.001). CONCLUSION: We report carriers of variations in the IL6, IL12B and absence of HLA-Cw6 as having decreased risk for psoriasis.


Assuntos
Subunidade p40 da Interleucina-12/genética , Interleucina-6/genética , Polimorfismo de Nucleotídeo Único , Psoríase/genética , Adulto , Feminino , Frequência do Gene , Genótipo , Antígenos HLA-C/genética , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Receptores de Interleucina/genética , Fatores de Risco
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