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1.
Musculoskelet Surg ; 2024 Jun 19.
Artigo em Inglês | MEDLINE | ID: mdl-38898343

RESUMO

BACKGROUND: Periprosthetic joint infection (PJI) is an extremely damaging complication that can occur after total knee arthroplasty (TKA). There is no study in the literature investigating the relationship between systemic inflammatory response index (SIRI) and systemic inflammation immune index (SII) values and prognosis and infection in patients who have undergone TKA. The aim of the study was to determine the relationship between the inflammatory index values and the rate of PJI in patients who had previously had TKA. METHODS: A total of 187 patients who underwent TKA between 2015 and 2023 years were retrospectively analyzed. RESULTS: The median value of the postoperative SII index was 1862.3 (1146.6-2630.4) in the infected group, while it was 1058.2 (605.0-1762.8) in the non-infected group (p < 0.001). In the infected group, the median value of preoperative SIRI was observed as 2.3 (1.7-3.5), while in the non-infected group it was 0.9 (0.7-1.5) (p < 0.001). The cutoff value for postoperative SIRI was observed to be 2.19, with a sensitivity value of 95%, a specificity value of 46%, the AUC value observed was 65%. The cutoff value for the postoperative SII index was observed to be 1058.96, with a sensitivity value of 100%, a specificity value of 50%. CONCLUSIONS: Our study has associated the inflammatory markers SIRI, SII, neutrophil lymphocyte ratio, and platelet lymphocyte ratio with PJI, which are easy and inexpensive to obtain. There is no widely recognized serum biomarker that can be used alone with good sensitivity and specificity. This study contributes to finding the gold standard inflammatory marker for diagnosing PJI.

2.
Eur Rev Med Pharmacol Sci ; 28(4): 1407-1416, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38436174

RESUMO

OBJECTIVE: This study aims to evaluate the effects of total intravenous anesthesia (propofol), volatile anesthesia (desflurane), and spinal anesthesia on intraocular pressure (IOP) during lumbar disc herniation surgery in the prone position. PATIENTS AND METHODS: This randomized controlled trial was conducted between January 2022 and January 2023. The study included 75 patients with lumbar disc herniation between the ages of 18-75, with the American Society of Anesthesiologists (ASA) 1-2. The patients were randomly divided into 3 groups: propofol, desflurane, and spinal. IOP was measured at 5-time points throughout surgery, including baseline (T1), 10 minutes after anesthesia (T2), 10 minutes after prone positioning (T3: early prone), 30 minutes after prone positioning (T4: late prone), and 10 minutes after returning to the supine position (T5). Hemodynamic parameters were measured at these time points. Hemoglobin and hematocrit values were measured preoperatively and on the first postoperative day. RESULTS: There were 25 patients in each group. The groups were similar in terms of all characteristics except for weight and body mass index, which were lower in the spinal group. Propofol recipients had significantly higher T3 (prone) IOP compared to desflurane recipients (p = 0.001). We found no significant differences between groups in terms of T1, T2, T4, and T5 IOP. Multivariable linear regression revealed that diabetes mellitus (p = 0.016) and high T1 IOP (p = 0.001) were independently associated with higher T3 IOP. In addition, we found that the desflurane (p < 0.001) and spinal (p = 0.002) groups had significantly lower T3 IOP compared to propofol recipients after adjusting for diabetes mellitus and T1 IOP. CONCLUSIONS: Our findings suggest that volatile anesthesia (desflurane) and spinal anesthesia are linked to lower IOP in the prone position among patients undergoing spinal surgery, in comparison to those receiving total intravenous anesthesia. There is a need to test the results with more comprehensive, population-based studies in different patient groups. ClinicalTrials gov ID: NCT06070480.


Assuntos
Raquianestesia , Diabetes Mellitus , Oftalmopatias , Deslocamento do Disco Intervertebral , Propofol , Humanos , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Pressão Intraocular , Desflurano , Deslocamento do Disco Intervertebral/cirurgia
3.
Acta Endocrinol (Buchar) ; 19(3): 326-332, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38356975

RESUMO

Context: Sleeve gastrectomy is an effective method for management of obesity. The Bariatric Analysis and Reporting Outcome System (BAROS) is a comprehensive and standard system for the assessment of outcomes of weight loss surgery. It is consisted of weight loss, changes in obesity-related comorbidities and quality of life measurements. We investigated results of the sleeve gastrectomy based on the BAROS. Material and Methods: Outcomes of laparoscopic sleeve gastrectomy surgery was studied in 45 patients with obesity (11 male, 34 female), after 45 months in Turkey. Results: Total weight loss was 26.4±0.1% of body weight at 45 months. Weight regain was seen in 97.8% of the patients with an average 14.5 kg and 13.7% body mass index points. The surgery caused 76% decrease in incidence of obstructive sleep apnea, 73% decrease in type 2 diabetes, 63% decrease in hyperlipidemia and 62% decrease in hypertension. Significant improvement is observed in all quality-of-life parameters. The final score of the BAROS was 4.23±1.02. Conclusion: Based on BAROS, sleeve gastrectomy provides significant improvements in weight loss, incidence of medical comorbidities and quality of life after surgery. Future studies should address prevention of weight regain after the surgery.

4.
Eur Rev Med Pharmacol Sci ; 26(21): 8098-8104, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-36394759

RESUMO

OBJECTIVE: Detection of endometrial cancer (EC) is crucial in pre-operative EC management. The study aimed at determining the most reliable sequence in magnetic resonance imaging (MRI) evaluation at the EC. Different sequences were compared using histopathological results as the gold standard. PATIENTS AND METHODS: In this retrospective study, 62 women diagnosed with EC were examined using 3 Tesla MR and post-hysterectomy histopathological examination. The MRI protocol included diffusion-weighted imaging (DWI), T2 weighted images, Dynamic Contrast T1 weighted images, and ZOOMit DWI. Apparent diffusion coefficient (ADC) maps were also obtained. ADC maps were calculated for both DWI and ZOOMit DWI. All serial images were analyzed by endometrial distance to account for myometrial invasion and tumor size. All sequences and histopathological results were compared using the paired sample t-test. RESULTS: In all 32 women, post-hysterectomy histopathological confirmation was obtained. Mean myometrial invasion values were not significantly different after comparing DWI, ZOOM it DWI, and Dynamic contrast enhancement (DCE)-T1WI (p=0.054, p=0.039). The first strong correlation was found between DWI and ZOOMit DWI (0.943). The second was between ZOOMit DWI and DCE-T1 WI (0.949). Comparing each set of sequences, no statistically significant differences in tumor size (p > 0.05) were found. Also, no statistically significant differences between images and histopathological size were found. The ADC values of ZOOMit DWI indicated that this method detected significant differences between EC histological subtypes. CONCLUSIONS: Each sequence is essential and valuable, whereas priorities may vary depending on the desired information. The most valuable sequences for the myometrial invasion were ZOOMit and conventional DWI. T2WI and DCE T1 WI were more valuable sequences the size of EC.


Assuntos
Imagem de Difusão por Ressonância Magnética , Neoplasias do Endométrio , Humanos , Feminino , Estudos Retrospectivos , Imagem de Difusão por Ressonância Magnética/métodos , Neoplasias do Endométrio/diagnóstico por imagem , Neoplasias do Endométrio/cirurgia , Neoplasias do Endométrio/patologia , Imageamento por Ressonância Magnética , Histerectomia
5.
Eur Rev Med Pharmacol Sci ; 26(16): 5793-5801, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-36066154

RESUMO

OBJECTIVE: We aimed to evaluate the association of incomplete revascularization score and the treated coronary artery disease burden with the development of contrast-induced nephropathy (CIN) in patients with ST-segment elevation myocardial infarction (STEMI) who underwent primary percutaneous intervention. Incomplete revascularization score was expressed by the residual SYNTAX (SYNergy between percutaneous coronary intervention with TAXus and cardiac surgery) (rSS) and the treated coronary artery disease burden was expressed by the SYNTAX revascularization index (SRI). PATIENTS AND METHODS: In our study, 604 sequential patients who underwent percutaneous coronary intervention diagnosed with STEMI between January 2018 and December 2021 were included. Patients were categorized into two groups; 'CIN (+)' who developed CIN and 'CIN (-)' who did not develop CIN. Baseline demographic, laboratory, echocardiographic, and angiographic data of the groups were compared. SYNTAX score I and II, rSS, and SRI were calculated. The diagnostic power of these angiographic parameters in the prediction of CIN was evaluated. Predictors for the development of CIN in STEMI patients were investigated. RESULTS: The mean age of the patients included in our study was 58.7 ± 12.4 years, and 79.9% of them were men. CIN was observed in 17.8% of study patients. The SYNTAX score [17.8 (11.4-24.2) vs. 15.1 (10.1-21.2); p = 0.008] and rSS [8.14 (3.9-116) vs. 4.2 (2.6-8.2); p < 0.001] were higher and SRI [56.2 ± 10.2 vs. 71.1 ± 13.6; p < 0.001] was lower in the CIN (+) group compared to the CIN (-) group. In predicting CIN, rSS was found to have significant diagnostic power at a cut-off value of 5.2, sensitivity of 81% and specificity of 69% [AUC (95% CI) = 0.752 (0.602-0.814); p < 0.001]. In logistic regression analysis, rSS [OR (95% CI) = 1.492 (1.124-1.884); p < 0.001] and SRI [OR (95% CI) = 1.055 (1.027-1.092); p < 0.001] were defined as independent predictors for the development of CIN. CONCLUSIONS: rSS and SRI are associated with CIN in STEMI patients. Although rSS is superior in predicting CIN, both angiographic scorings have significant diagnostic power. rSS and SRI are independent predictors for the development of CIN.


Assuntos
Doença da Artéria Coronariana , Nefropatias , Intervenção Coronária Percutânea , Infarto do Miocárdio com Supradesnível do Segmento ST , Idoso , Angiografia Coronária/efeitos adversos , Doença da Artéria Coronariana/cirurgia , Feminino , Humanos , Nefropatias/induzido quimicamente , Masculino , Pessoa de Meia-Idade , Intervenção Coronária Percutânea/efeitos adversos , Fatores de Risco , Infarto do Miocárdio com Supradesnível do Segmento ST/diagnóstico por imagem , Infarto do Miocárdio com Supradesnível do Segmento ST/cirurgia , Fatores de Tempo , Resultado do Tratamento
6.
Eur J Orthop Surg Traumatol ; 31(7): 1427-1433, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33590317

RESUMO

PURPOSE: Instability of the posterior pelvic ring may be stabilized by lumbopelvic fixation. The optimal osseous corridor for iliac screw placement from the posterior superior iliac spine to the anterior inferior iliac spine requires multiple ap- and lateral-views with additional obturator-outlet and -inlet views. The purpose of this study was to determine if navigated iliac screw placement for lumbopelvic fixation influences surgical time, fluoroscopy time, radiation exposure, and complication rates. METHODS: Bilateral lumbopelvic fixation was performed in 63 patients. Implants were inserted as previously described by Schildhauer. A passive optoelectronic navigation system with surface matching on L4 was utilized for navigated iliac screw placement. To compare groups, demographics were assessed. Operative time, fluoroscopic time, and radiation were delineated. RESULTS: Conventional fluoroscopic imaging for lumbopelvic fixation was performed in 32 patients and 31 patients underwent the procedure with navigated iliac screw placement. No differences were found between the groups regarding demographics, comorbidities, or additional surgical procedures. Utilization of navigation led to fluoroscopy time reduction of more than 50% (3.2 vs. 8.6 min.; p < 0.001) resulting in reduced radiation (2004.5 vs. 5130.8 Gy*cm2; p < 0.001). Operative time was reduced in the navigation group (176.7 vs. 227.4 min; p = 0.002) despite the necessity of additional surface referencing. CONCLUSION: For iliac screws, identifying the correct entry point and angle of implantation requires detailed anatomic knowledge and multiple radiographic views. In our study, additional navigation reduced operative time and fluoroscopy time resulting in a significant reduction of radiation exposure for patients and OR personnel.


Assuntos
Fraturas da Coluna Vertebral , Cirurgia Assistida por Computador , Parafusos Ósseos , Fluoroscopia , Fixação Interna de Fraturas/efeitos adversos , Humanos , Ílio/cirurgia , Sacro/diagnóstico por imagem , Sacro/lesões , Sacro/cirurgia
7.
West Indian med. j ; 69(3): 148-153, 2021. graf
Artigo em Inglês | LILACS | ID: biblio-1341890

RESUMO

ABSTRACT The concomitant epidermal growth factor receptor (EGFR) mutation and anaplastic lymphoma kinase (ALK) translocations in lung adenocancers are very rare scenarios. Until now, 42 cases described in the literature have all been treated by different drugs. There is no overall consensus regarding the treatment for this adenocarcinoma subgroup. We report here a case of lung adenocarcinoma with concomitant EGFR mutation in exon 21 (L858R) and ALK rearrangement in primary tumour, EGFR mutation in exon 21 (L858R) and no ALK rearrangement in its synchronous metastasis. We treated this patient with crizotinib as the second-line therapy (after the first line docetaxel-cisplatin chemotherapy), but no response was obtained. The therapeutic choice for the lung adenocancer patients with concomitant EGFR mutation and ALK rearrangement is unclear. Examination of c-ros oncogene 1 mutation can be used as an indicator in the prediction of the crizotinib treatment success. The ALK mutation may not responsible for the resistance to EGFR-tyrosine kinase inhibitors (TKI), and EGFR-TKI can be initiated to EGFR and ALK dual mutant patients as the first treatment.


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Adenocarcinoma/genética , Genes erbB-1/genética , Neoplasias Pulmonares/genética , Mutação/genética , Adenocarcinoma/tratamento farmacológico , Éxons/genética , Cisplatino/uso terapêutico , Inibidores de Proteínas Quinases/uso terapêutico , Docetaxel/uso terapêutico , Crizotinibe/uso terapêutico , Neoplasias Pulmonares/tratamento farmacológico , Antineoplásicos/uso terapêutico
8.
Curr HIV Res ; 18(4): 258-266, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32342820

RESUMO

OBJECTIVE: The aim of this study was to analyze the temporal trends of HIV epidemiology in Turkey from 2011 to 2016. METHODS: Thirty-four teams from 28 centers at 17 different cities participated in this retrospective study. Participating centers were asked to complete a structured form containing questions about epidemiologic, demographic and clinical characteristics of patients presented with new HIV diagnosis between 2011 and 2016. Demographic data from all centers (complete or partial) were included in the analyses. For the cascade of care analysis, 15 centers that provided full data from 2011 to 2016 were included. Overall and annual distributions of the data were calculated as percentages and the Chi square test was used to determine temporal changes. RESULTS: A total of 2,953 patients between 2011 and 2016 were included. Overall male to female ratio was 5:1 with a significant increase in the number of male cases from 2011 to 2016 (p<0.001). The highest prevalence was among those aged 25-34 years followed by the 35-44 age bracket. The most common reason for HIV testing was illness (35%). While the frequency of sex among men who have sex with men increased from 16% to 30.6% (p<0.001) over the study period, heterosexual intercourse (53%) was found to be the most common transmission route. Overall, 29% of the cases presented with a CD4 count of >500 cells/mm3 while 46.7% presented with a CD4 T cell count of <350 cells/mm3. Among newly diagnosed cases, 79% were retained in care, and all such cases initiated ART with 73% achieving viral suppression after six months of antiretroviral therapy. CONCLUSION: The epidemiologic profile of HIV infected individuals is changing rapidly in Turkey with an increasing trend in the number of newly diagnosed people disclosing themselves as MSM. New diagnoses were mostly at a young age. The late diagnosis was found to be a challenging issue. Despite the unavailability of data for the first 90, Turkey is close to the last two steps of 90-90-90 targets.


Assuntos
Infecções por HIV/epidemiologia , HIV/patogenicidade , Hepacivirus/patogenicidade , Vírus da Hepatite B/patogenicidade , Hepatite B/epidemiologia , Hepatite C/epidemiologia , Adolescente , Adulto , Fármacos Anti-HIV/uso terapêutico , Terapia Antirretroviral de Alta Atividade , Contagem de Linfócito CD4 , Linfócitos T CD4-Positivos/efeitos dos fármacos , Linfócitos T CD4-Positivos/virologia , Criança , Pré-Escolar , Coinfecção , Diagnóstico Tardio , Feminino , HIV/efeitos dos fármacos , HIV/fisiologia , Infecções por HIV/tratamento farmacológico , Infecções por HIV/mortalidade , Infecções por HIV/virologia , Hepacivirus/efeitos dos fármacos , Hepacivirus/fisiologia , Hepatite B/tratamento farmacológico , Hepatite B/mortalidade , Hepatite B/virologia , Vírus da Hepatite B/efeitos dos fármacos , Vírus da Hepatite B/fisiologia , Hepatite C/tratamento farmacológico , Hepatite C/mortalidade , Hepatite C/virologia , Heterossexualidade/estatística & dados numéricos , Homossexualidade Masculina/estatística & dados numéricos , Humanos , Incidência , Lactente , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Análise de Sobrevida , Turquia/epidemiologia , Carga Viral/efeitos dos fármacos
9.
Int J Oral Maxillofac Surg ; 48(12): 1558-1563, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31109746

RESUMO

The actual role of splint therapy in preventing excessive loading of the temporomandibular joint (TMJ) is still debated. Lower intra-articular pressure levels have been measured in patients wearing occlusal splints, which may also reduce oxidative stress in the articular spaces. The aim of this study was to determine whether splint therapy reduces oxidative stress and inflammation in TMJ internal derangement patients by measuring interleukin 6 (IL-6), malondialdehyde (MDA), and 8-hydroxydeoxyguanosine (8-OHdG) levels in the synovial fluid (SF). Twenty-four patients with a temporomandibular disorder (TMD) were included in the study. TMJ SF samples were obtained prior to arthrocentesis. Twelve patients used a 2-mm hard acrylic, maxillary stabilization-type splint for 3 months after arthrocentesis. Twelve patients had no treatment after the SF aspiration. Second SF samples were obtained from all patients at 3 months post arthrocentesis. IL-6, MDA, and 8-OHdG levels in the samples were evaluated. All patients showed a significant symptomatic improvement after treatment (P < 0.005). No statistical correlation was found between the two groups concerning pre-treatment and 3-month SF levels of MDA, 8-OHdG, and IL-6. Although splint therapy was found to be successful in eliminating clinical symptoms of TMD, the results showed no beneficial effect on inflammation and oxidative stress markers in the synovial fluid.


Assuntos
Placas Oclusais , Transtornos da Articulação Temporomandibular , 8-Hidroxi-2'-Desoxiguanosina , Desoxiguanosina/análogos & derivados , Humanos , Interleucina-6 , Malondialdeído , Líquido Sinovial , Resultado do Tratamento
10.
Clin Transl Oncol ; 21(11): 1510-1517, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30924091

RESUMO

PURPOSE: We aimed to assess whether anti-EGFR combined chemotherapy regimens are related with loss of skeletal muscle mass and to compare cetuximab and panitumumab therapies in the aspect of skeletal muscle area change as well as to assess whether skeletal muscle mass loss has prognostic significance in the RAS wild mCRC patients. MATERIALS AND METHODS: A total of 56 patients (30 patients in cetuximab arm and 26 patients in panitumumab) who had computed tomography images were retrospectively evaluated at the diagnosis and follow up during the treatment period before progression. RESULTS: During treatment period 24 patients (42.8%) had muscle loss. Of these, 7 (29.2%) patients were treated at first-line and 17 (70.8%) patients were treated at second-line setting. There was no significant difference in the aspect of skeletal muscle loss among cetuximab and panitumumab combined treatment regimens. Median PFS was 9.1 (8.6-9.6) months in muscle loss group and 13.9 (7.2-20.6) months in muscle stable group (p = 0.001). Median OS was 23.4 (95% CI 15.8-31.0) months in muscle stable group and 19.1 (95% CI 17.0-21.3) months in muscle loss group (p = 0.57) at first-line setting. For second-line, median OS was 21.2 (14.7-27.7) months in muscle stable group and 14.4 (6.0-22.4) months in muscle loss group (p = 0.003). CONCLUSIONS: Decrease in skeletal muscle mass before progression on CT imaging is an independent indicator for shorter PFS value in RAS WT mCRC patients who received anti-EGFR combined chemotherapy regimens at both the first and second-line settings. Beside that shorter overall survival values also were significantly seen in patients who had muscle loss during anti-EGFR therapy in the second-line setting.


Assuntos
Antineoplásicos Imunológicos/efeitos adversos , Cetuximab/efeitos adversos , Neoplasias Colorretais/tratamento farmacológico , Atrofia Muscular/induzido quimicamente , Panitumumabe/efeitos adversos , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Camptotecina/administração & dosagem , Camptotecina/análogos & derivados , Neoplasias Colorretais/patologia , Receptores ErbB/antagonistas & inibidores , Feminino , Fluoruracila/administração & dosagem , Genes ras , Humanos , Leucovorina/administração & dosagem , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/diagnóstico por imagem , Músculo Esquelético/efeitos dos fármacos , Atrofia Muscular/diagnóstico por imagem , Compostos Organoplatínicos/administração & dosagem , Prognóstico , Estudos Retrospectivos , Tomografia Computadorizada por Raios X
11.
J Food Sci Technol ; 56(2): 634-642, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30906021

RESUMO

This study aims to report the composition of bioactives and volatile aromatic compounds, and determine the descriptive sensory properties of cold-pressed orange seed oil. The effects of oven pre-roasting and microwave pre-roasting of the seeds before cold pressing were compared. Thirteen sensory parameters were used to define the oil samples. The major bioactive components of the orange seed oils were naringin, hesperidin, and trans-ferulic acid. Flavonoids constituted the main phenolic class with 78.5% and 74.4%, followed by phenolic acids with 21.4% and 25.5% in the oven and microwave pre-roasted oil samples. The mean concentration of hesperidin and naringin varied from 903.4 to 909.6 mg/kg and from 234.3 to 299.8 mg/kg, respectively. The results showed for the first time in the literature that orange seed oil contains some volatile aromatic compounds and glycosylated flavanones that could have functional properties. Hence, cold-pressed orange seed oil could be suggested as the new potential health-promoting oil.

12.
Niger J Clin Pract ; 22(1): 92-100, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30666026

RESUMO

OBJECTIVES: A prospective case-control study was carried out to assess the value of elastosonography in identifying endometrial pathology in women using Tamoxifen (TAM) for breast cancer. MATERIALS AND METHODS: In total, 66 women using TAM for breast cancer were enrolled for the study with 61 premenopausal and 61 postmenopausal healthy controls. Ultrasonographic findings (strain ratio, endometrial thickness) were evaluated in regard to the duration of TAM usage, histopathological findings, and menopausal status. RESULTS: Patients with endometrial cancer (EC) and cystic endometrial hyperplasia (CEH) were found to have longer duration of TAM usage, increased endometrial thickness, and higher strain ratios compared with controls. A significant positive correlation was found between duration of TAM usage, endometrial thickness, and the strain ratios. Endometrial thickness and the strain ratios were significant predictors for groups under risk. Cutoff values for endometrial thickness, strain ratios, and duration of TAM usage were 12.55 mm, 2.46, and 18 months in premenopausal group and 7.75 mm, 7.70, and 32 months in postmenopausal group to predict risky population, respectively. CONCLUSION: Endometrial tissue strain ratio was found to be significantly increased in cases with endometrial pathologies. Addition of elastosonography modality to B-mode may improve the diagnostic accuracy during the follow-up of women using TAM for breast cancer.


Assuntos
Antineoplásicos Hormonais/efeitos adversos , Neoplasias da Mama/tratamento farmacológico , Técnicas de Imagem por Elasticidade/métodos , Hiperplasia Endometrial/diagnóstico por imagem , Neoplasias do Endométrio/diagnóstico por imagem , Endométrio/diagnóstico por imagem , Tamoxifeno/efeitos adversos , Ultrassonografia/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Antineoplásicos Hormonais/uso terapêutico , Neoplasias da Mama/patologia , Estudos de Casos e Controles , Hiperplasia Endometrial/induzido quimicamente , Neoplasias do Endométrio/induzido quimicamente , Endométrio/efeitos dos fármacos , Feminino , Humanos , Pessoa de Meia-Idade , Pós-Menopausa , Pré-Menopausa , Estudos Prospectivos , Tamoxifeno/uso terapêutico
14.
Comput Methods Programs Biomed ; 146: 91-100, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-28688493

RESUMO

BACKGROUND AND OBJECTIVES: In this article, we propose a decision support system for effective classification of dental periapical cyst and keratocystic odontogenic tumor (KCOT) lesions obtained via cone beam computed tomography (CBCT). CBCT has been effectively used in recent years for diagnosing dental pathologies and determining their boundaries and content. Unlike other imaging techniques, CBCT provides detailed and distinctive information about the pathologies by enabling a three-dimensional (3D) image of the region to be displayed. METHODS: We employed 50 CBCT 3D image dataset files as the full dataset of our study. These datasets were identified by experts as periapical cyst and KCOT lesions according to the clinical, radiographic and histopathologic features. Segmentation operations were performed on the CBCT images using viewer software that we developed. Using the tools of this software, we marked the lesional volume of interest and calculated and applied the order statistics and 3D gray-level co-occurrence matrix for each CBCT dataset. A feature vector of the lesional region, including 636 different feature items, was created from those statistics. Six classifiers were used for the classification experiments. RESULTS: The Support Vector Machine (SVM) classifier achieved the best classification performance with 100% accuracy, and 100% F-score (F1) scores as a result of the experiments in which a ten-fold cross validation method was used with a forward feature selection algorithm. SVM achieved the best classification performance with 96.00% accuracy, and 96.00% F1 scores in the experiments in which a split sample validation method was used with a forward feature selection algorithm. SVM additionally achieved the best performance of 94.00% accuracy, and 93.88% F1 in which a leave-one-out (LOOCV) method was used with a forward feature selection algorithm. CONCLUSIONS: Based on the results, we determined that periapical cyst and KCOT lesions can be classified with a high accuracy with the models that we built using the new dataset selected for this study. The studies mentioned in this article, along with the selected 3D dataset, 3D statistics calculated from the dataset, and performance results of the different classifiers, comprise an important contribution to the field of computer-aided diagnosis of dental apical lesions.


Assuntos
Tomografia Computadorizada de Feixe Cônico , Diagnóstico por Computador , Imageamento Tridimensional , Tumores Odontogênicos/diagnóstico por imagem , Cisto Radicular/diagnóstico por imagem , Humanos , Software , Máquina de Vetores de Suporte
15.
J Pediatr Urol ; 13(4): 393.e1-393.e6, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28713006

RESUMO

INTRODUCTION: Although grayscale ultrasound and color Doppler ultrasound characteristics of the torsed testis are well established in the literature, less is known about its anatomic partner: the epididymis. OBJECTIVE: The purpose of this study was to describe the ultrasound characteristics of the epididymis in pediatric patients with testicular torsion, and to describe their potential role as prognostic criteria for testicular salvage outcomes. STUDY DESIGN: During a retrospective review of 217 pediatric patients with acute testicular torsion during 2009-2016, morphological features of the epididymis from scrotal ultrasounds (size, parenchymal characteristics, and vascular flow of both epididymis heads), as well as patient demographics, time duration, surgical outcomes, histopathology results, and follow-up periods were analyzed. RESULTS: Mean epididymis size and twisting degree were significantly higher in the torsed testes than in the contralateral epididymis (P < 0.001) (Summary table). Cystic structures in the epididymis were identified: a higher number of cysts was associated with testicular non-viability (P = 0.025) and higher twisting degree (P = 0.017). Histopathologic examination showed that these spaces were infiltrated connective tissue most likely formed by venous congestion and vessel rupture. DISCUSSION: Scrotal ultrasound can provide information on testicular morphology and viability, as well as morphological changes in the epididymis over time in pediatric patients with testicular torsion. These findings may provide potential prognostic information regarding testicular viability, as a higher number of cystic spaces in the epididymis was associated with a higher rate of testicular non-viability and a higher twisting degree. In addition, the epididymis size (volume) can change during the time course of the ischemic state. CONCLUSIONS: This was the first study to describe and analyze epididymis ultrasound findings in pediatric patients with testicular torsion and to correlate them with testicular salvage outcomes. Further prospective studies are needed to determine the role of epididymis ultrasound findings as a potential pre-operative prognostic tool.


Assuntos
Epididimo/diagnóstico por imagem , Torção do Cordão Espermático/diagnóstico por imagem , Adolescente , Criança , Pré-Escolar , Epididimo/patologia , Humanos , Lactente , Masculino , Estudos Retrospectivos , Torção do Cordão Espermático/patologia , Torção do Cordão Espermático/cirurgia , Fatores de Tempo , Resultado do Tratamento , Ultrassonografia Doppler em Cores
16.
Eur J Gynaecol Oncol ; 38(3): 346-349, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29693870

RESUMO

OBJECTIVE: Evaluation of mean platelet volume (MPV), neutrophil to lymphocyte ratio (NLR), and platelet count in the detection of malignant and benign ovarian tumors. MATERIAL AND METHODS: Sixty-six patients admitted to the present clinic over three years were in- cluded in the study. Patients diagnosed with ovarian cancer were grouped into the areas of epithelial and granulosa cell tumor diagno- sis. The values were compared to patients with benign cystic structure. Patients' preoperative hematologic parameters and their values four weeks postoperatively were analyzed. Statistical analyses were performed with SPSS software. RESULTS: MPV, NLR, and platelet count were observed at a higher rate as statistically significant in patients diagnosed with malignant ovarian cancer, compared to those with benign adnexal mass. CONCLUSION: The hemnatological parameters such as MPV, NLR, and platelet count in the detection of malignant ovarian tumors have been evaluated as useful new markers.


Assuntos
Linfócitos , Volume Plaquetário Médio , Neutrófilos , Neoplasias Ovarianas/diagnóstico , Contagem de Plaquetas , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores , Feminino , Humanos , Pessoa de Meia-Idade , Neoplasias Ovarianas/sangue , Adulto Jovem
17.
Unfallchirurg ; 120(1): 69-75, 2017 Jan.
Artigo em Alemão | MEDLINE | ID: mdl-27596973

RESUMO

Acetabular nonunions are rare, especially after operative treatment of an acetabular fracture. There are only single reports of the reconstruction and therapy of acetabular nonunion. Furthermore, there are fewer reports for treatment of acetabular nonunion with a long follow-up. We report a successful revision of an acetabular nonunion after transversal fracture and previous operative intervention, as well as the long-term follow-up after revision surgery.


Assuntos
Acetabuloplastia/métodos , Acetábulo/lesões , Acetábulo/cirurgia , Fixação Interna de Fraturas/métodos , Fraturas Ósseas/cirurgia , Fraturas Mal-Unidas/cirurgia , Terapia Combinada/métodos , Fraturas Ósseas/diagnóstico por imagem , Fraturas Mal-Unidas/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Reoperação/métodos , Resultado do Tratamento
18.
Hippokratia ; 20(1): 55-59, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27895444

RESUMO

AIM: Recent studies associate thyroid cancer with oxidative stress. We aim to clarify the relation between papillary thyroid cancer, oxidative stress, hemoxygenase-1, prolidase enzymes and investigate the availability of these enzymes as markers for diagnosis, success of treatment, and follow-up. METHODS: Thirty-one patients with papillary thyroid carcinoma and 25 healthy control subjects were included in this study. Hemoxygenase-1, prolidase (oxidant stress indicator), malondialdehyde, protein carbonyl, and superoxide dismutase (an indicator of antioxidant defense system) were measured pre-operatively and 30 days after thyroidectomy. RESULTS: There was a significant decrease in serum levels of malondialdehyde and superoxide dismutase (p <0.001 for both) after thyroidectomy in papillary thyroid carcinoma group. In addition, there was a significant difference in the postoperative serum levels of prolidase, malondialdehyde, protein carbonyl, and superoxide dismutase between papillary thyroid carcinoma and control groups (p =0.024, p <0.001, p =0.002, and p =0.016, respectively) beside significant difference of malondialdehyde, protein carbonyl, hemoxygenase-1, and superoxide dismutase pre-operative serum levels (p <0.001, p =0.003, p =0.006, and p =0.025, respectively). CONCLUSION: When the unquestionable role of oxidative stress in the pathogenesis of cancer is considered, in the future it is expected to associate parametric changes in the serum of patients caused by oxidative stress to papillary thyroid cancer. Hippokratia 2016, 20(1): 55-59.

19.
Neuroscience ; 300: 210-8, 2015 Aug 06.
Artigo em Inglês | MEDLINE | ID: mdl-25982563

RESUMO

The purpose of the present study was to test the prediction that the unique manifestation of chemotherapeutic-induced peripheral neuropathy (CIPN) would be reflected in a specific pattern of changes in the regulation of the intracellular Ca(2+) concentration ([Ca(2+)]i) in subpopulations of cutaneous neurons. To test this prediction, we characterized the pattern of changes in mechanical nociceptive threshold associated with paclitaxel administration (2mg/kg, iv, every other day for four days), as well as the impact of target of innervation and paclitaxel treatment on the regulation of [Ca(2+)]i in subpopulations of putative nociceptive and non-nociceptive neurons. Neurons innervating the glabrous and hairy skin of the hindpaw as well as the thigh were identified with retrograde tracers, and fura-2 was used to assess changes in [Ca(2+)]i. Paclitaxel was associated with a persistent decrease in mechanical nociceptive threshold in response to stimuli applied to the glabrous skin of the hindpaw, but not the hairy skin of the hindpaw or the thigh. However, in both putative nociceptive and non-nociceptive neurons, resting [Ca(2+)]i was significantly lower in neurons innervating the thigh after treatment. The magnitude of the depolarization-evoked Ca(2+) transient was also lower in putative non-nociceptive thigh neurons. More interestingly, while paclitaxel had no detectable influence on either resting or depolarization-evoked Ca(2+) transients in putative non-nociceptive neurons, in putative nociceptive neurons there was a subpopulation-specific decrease in the duration of the evoked Ca(2+) transient that was largely restricted to neurons innervating the glabrous skin. These results suggest that peripheral nerve length alone, does not account for the selective distribution of CIPN symptoms. Rather, they suggest the symptoms of CIPN reflect an interaction between the toxic actions of the therapeutic and unique properties of the neurons deleteriously impacted.


Assuntos
Antineoplásicos Fitogênicos/toxicidade , Cálcio/metabolismo , Nociceptores/efeitos dos fármacos , Paclitaxel/toxicidade , Doenças do Sistema Nervoso Periférico/induzido quimicamente , Animais , Modelos Animais de Doenças , Gânglios Espinais/efeitos dos fármacos , Gânglios Espinais/fisiopatologia , Espaço Intracelular/efeitos dos fármacos , Espaço Intracelular/metabolismo , Masculino , Potenciais da Membrana/efeitos dos fármacos , Potenciais da Membrana/fisiologia , Dor Nociceptiva/induzido quimicamente , Dor Nociceptiva/fisiopatologia , Nociceptores/fisiologia , Medição da Dor , Doenças do Sistema Nervoso Periférico/fisiopatologia , Ratos Sprague-Dawley , Pele/inervação , Tato
20.
J Cancer Epidemiol ; 2015: 254823, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25648523

RESUMO

Purpose. To examine the relationship between esophageal and gastric cancers commonly seen in Van Lake region and the traditional eating habits of the geography. Materials and Methods. Esophageal and gastric cancer cases, who underwent surgery between January 1, 2012, and December 31, 2013, were examined. Pathology reports of the patients and presence of Helicobacter pylori (HP) were recorded. Surveys were filled by face to face meeting or telephone call. Control group was created with randomly selected individuals without any cancer diagnosis having age, gender, and socioeconomic characteristics similar to patient group. All data were analyzed using SAS.9.3 statistical programme. Results. Compared with the control group, herby cheese consumption (a component of eating habits) and smoking were significantly higher in the patient group (P < 0.001). Tandoor exposure is compared in terms of female gender, and significant difference was found between the groups (P = 0.0013). As a result of the analysis with logistic regression more than 150 gr of herby cheese consumption per day was found to increase the cancer risk (odds ratio 1.017; 95% CI: 1.012-1.022). Conclusion. A high consumption of herby cheese, cooking bread on tandoor, and heavy smoking were seen to be important risk factors for esophageal and gastric cancers.

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