RESUMO
INTRODUCTION: Preeclampsia is a common hypertensive disorder of pregnancy. Several studies have demonstrated that protein aggregates, detected through urine congophilia, is associated with preeclampsia; however, it has yet to be investigated whether urine congophilia remains postpartum in these women. In this study, we aimed to augment prior studies and determine whether urine congophilia is present postpartum. METHODS: Women were recruited from Lyell McEwin Hospital, South Australia. Urine samples were collected during pregnancy and 6-months postpartum from women with non-preeclampsia pregnancies (n = 48) and women with pregnancies complicated by preeclampsia (n = 42). A Congo Red Dot blot test, total protein and creatinine levels from urine, as well as serum Soluble fms-like tyrosine kinase 1 to placental growth factor ratio (sFlt-1:PlGF), were assessed and correlated. RESULTS: Preeclamptic women exhibited increased urine congophilia (P < 0.01), sFlt-1:PlGF ratio (P < 0.0001) and total protein (P < 0.01) during pregnancy; with a positive correlation between urine congophilia and total protein across the entire cohort (P < 0.0001). Although urine congophilia was no longer detected 6-months postpartum in preeclamptic women, total protein remained elevated (P < 0.05). sFlt-1:PlGF ratio during pregnancy was positively correlated with congophilia across the cohort (P = 0.0007). Serum creatinine was also higher in preeclamptic women during pregnancy (P < 0.001). DISCUSSION: These results support that urine congophilia is significantly elevated in pregnancies complicated with preeclampsia and show that it does not continue postpartum, although larger cohort studies are needed to determine its feasibility as a diagnostic marker.
Assuntos
Hipertensão , Pré-Eclâmpsia , Gravidez , Feminino , Humanos , Pré-Eclâmpsia/metabolismo , Fator de Crescimento Placentário , Período Pós-Parto , Estudos de Coortes , Receptor 1 de Fatores de Crescimento do Endotélio Vascular/metabolismo , BiomarcadoresRESUMO
BACKGROUND: Human induced pluripotent stem cells (iPSCs) possess remarkable self-renewal capacity and the potential to differentiate into novel cell types, such as mesenchymal stem cells (MSCs). iPSC-MSCs have been shown to enhance tissue regeneration and attenuate tissue ischaemia; however, their contribution to the immune regulation of Th2-skewed allergic rhinitis (AR) and asthma remains unclear. OBJECTIVE: This study compared the immunomodulatory effects of iPSC-MSCs and bone marrow-derived MSCs (BM-MSCs) on lymphocyte proliferation, T-cell phenotypes and cytokine production in peripheral blood mononuclear cells (PBMCs) in patients with AR, and investigated the possible molecular mechanisms underlying the immunomodulatory properties of iPSC-MSCs. METHODS: In co-cultures of PBMCs with iPSC-MSCs or BM-MSCs, lymphocyte proliferation was evaluated using 3H-thymidine (3H-TdR) uptake, carboxyfluorescein diacetate, succinimidyl ester (CFDA-SE) assays; the regulatory T-cell (Treg) phenotype was determined by flow cytometry, and cytokine levels were measured using an enzyme-linked immunosorbent assay. The immunomodulatory properties of both MSCs were further evaluated using NS398 and transwell experiments. RESULTS: Similar to BM-MSCs, we determined that iPSC-MSCs significantly inhibit lymphocyte proliferation and promote Treg response in PBMCs (P < 0.05). Accordingly, the cytokine milieu (IFN-γ, IL-4, IL-5, IL-10 and IL-13) in the supernatants of PBMCs changed significantly (P < 0.05). The immunomodulatory properties of iPSC-MSCs and BM-MSCs were associated with prostaglandin E2 (PGE2) production and cell-cell contact. CONCLUSIONS: These data demonstrate that iPSC-MSCs are capable of modulating T-cell phenotypes towards Th2 suppression through inducing Treg expansion, suggesting that iPSC-MSCs can be used as an alternative candidate to adult MSCs to treat allergic airway diseases.
Assuntos
Células-Tronco Pluripotentes Induzidas/fisiologia , Ativação Linfocitária/imunologia , Células-Tronco Mesenquimais/imunologia , Rinite Alérgica Perene/imunologia , Linfócitos T/imunologia , Células Cultivadas , Humanos , Imunomodulação , Rinite Alérgica , Rinite Alérgica Perene/etiologia , Linfócitos T/fisiologiaRESUMO
OBJECTIVES. To clarify the use of ultrasonography by determining the frequency of developmental dysplasia of the hip among breech-presented Chinese neonates in Hong Kong. DESIGN. Prospective case series. SETTING. Regional hospital, Hong Kong. PATIENTS. All breech-presented Chinese neonates born during January 2008 to June 2009 were included (except premature neonates). They were examined clinically from birth till the age of 1 year. Ultrasound of the hips was performed at the age of 2 weeks, and X-ray of the pelvis at the age of 1 year. RESULTS. A total of 209 breech-presented neonates were born during the study period; 110 neonates completed all necessary investigations and follow-up. Among the latter, there were three neonates with developmental dysplasia of the hip warranting treatment, which amounted to a frequency of 2.7%. CONCLUSION. Developmental dysplasia of the hip among breech-presented Chinese babies is only slightly less common than in corresponding populations in other regions in the world. Since early diagnosis is important, ultrasonography screening in high-risk cases such as those with breech presentation may be useful.
Assuntos
Apresentação Pélvica , Luxação Congênita de Quadril/epidemiologia , Triagem Neonatal/métodos , Feminino , Seguimentos , Luxação Congênita de Quadril/diagnóstico por imagem , Hong Kong/epidemiologia , Humanos , Lactente , Recém-Nascido , Masculino , Gravidez , Estudos Prospectivos , UltrassonografiaRESUMO
STUDY DESIGN: This is a case report of a patient with thalassemia who had acute spinal cord compression at the T3 to T8 level and presented for treatment. METHODS: Magnetic resonance imaging and surgical decompression and transfusion therapy was chosen as the preferred treatment modality. RESULTS: Neurologic recovery was satisfactory from the immediate postoperative period, and full recovery was observed 2 months after surgery. CONCLUSION: Clinical awareness is important for early diagnosis. Documentation with an imaging technique, such as magnetic resonance imaging, is mandatory. Optimal treatment is tailor-made and depends on the clinical situation and the expertise available.
Assuntos
Hematopoese Extramedular , Compressão da Medula Espinal/etiologia , Compressão da Medula Espinal/cirurgia , Talassemia/complicações , Adulto , Feminino , Humanos , Imageamento por Ressonância Magnética , Mielografia , Vértebras Torácicas/diagnóstico por imagem , Vértebras Torácicas/patologia , Tomografia Computadorizada por Raios XRESUMO
A new method of treating large bony defects of the proximal femur is described. The defect is filled with a large vascular-pedicled bone graft from the iliac crest. The graft, being nourished by the deep circumflex iliac vessels, remains viable and therefore induces rapid healing of the bone. This method of bony replacement encourages adequate excision of potentially malignant bone lesions and provides sufficient mechanical support to allow early walking. Six clinical cases are presented to illustrate its application.
Assuntos
Transplante Ósseo , Fêmur/cirurgia , Adolescente , Adulto , Neoplasias Ósseas/cirurgia , Doenças das Cartilagens/cirurgia , Feminino , Fêmur/patologia , Tumores de Células Gigantes/cirurgia , Humanos , Ílio/irrigação sanguínea , Ílio/transplante , Masculino , Métodos , Microcirurgia , Pessoa de Meia-Idade , Fatores de TempoRESUMO
Routine databases containing large amounts of clinical data represent a tremendous opportunity for the evaluation of health care practices and outcomes. However, data collected for administrative purposes has limitations in content, accuracy and completeness. Routine entry of clinical information directly into clinical information systems by care providers is one strategy to address this problem. We developed a structured data entry method, the Clinical Data Framework (CDF), which has been used to support the capture of clinical information by clinicians in the normal process of care delivery. A study of the CDF over a two month period showed that it improved the accuracy of completeness of data collection over a coding method which was based on selection of ICD-9-CM codes.
Assuntos
Coleta de Dados/métodos , Armazenamento e Recuperação da Informação/métodos , Sistemas Computadorizados de Registros Médicos/organização & administração , Interface Usuário-Computador , Doença/classificação , Documentação/métodos , Fraturas Ósseas/classificação , Humanos , Sistemas de Informação/organização & administração , Sistemas Computadorizados de Registros Médicos/normas , Neoplasias/classificaçãoRESUMO
Arthroscopic surgery has become the gold standard for the diagnosis and treatment of major joint disorders. With advancement in arthroscopic technique, arthroscopy has become feasible in most human joints, even those as small as the finger joints. The metacarpophalangeal joint (MCPJ) can become spacious with simple traction, the intra-articular anatomy is simple, and its major structures can be easily visualized and identified. However, MCPJ arthroscopy has never been popular. This article describes our experience with MCPJ arthroscopy and seeks to establish its role in clinical practice.
Assuntos
Artroscopia/métodos , Articulação Metacarpofalângica/cirurgia , Adulto , Artralgia/cirurgia , Artrite/cirurgia , Cartilagem Articular/lesões , Cartilagem Articular/cirurgia , Ligamentos Colaterais/anatomia & histologia , Ligamentos Colaterais/lesões , Meios de Contraste , Diatermia , Feminino , Fibrose/cirurgia , Traumatismos dos Dedos/cirurgia , Fraturas Ósseas/cirurgia , Força da Mão , Humanos , Luxações Articulares/cirurgia , Instabilidade Articular/cirurgia , Corpos Livres Articulares/cirurgia , Masculino , Articulação Metacarpofalângica/anatomia & histologia , Articulação Metacarpofalângica/diagnóstico por imagem , Articulação Metacarpofalângica/lesões , Traumatismos dos Nervos Periféricos/etiologia , Complicações Pós-Operatórias , Radiografia , Traumatismos dos Tendões/etiologiaAssuntos
Linfonodos/patologia , Doenças Linfáticas/ultraestrutura , Neoplasias da Coluna Vertebral/ultraestrutura , Vértebras Cervicais/cirurgia , Criança , Diagnóstico Diferencial , Feminino , Histiócitos/ultraestrutura , Histiocitose de Células de Langerhans/diagnóstico , Histiocitose de Células de Langerhans/patologia , Humanos , Laminectomia , Doenças Linfáticas/diagnóstico , Doenças Linfáticas/cirurgia , Linfografia , Pescoço , Neurilemoma/diagnóstico , Neurilemoma/ultraestrutura , Neurofibroma/diagnóstico , Neurofibroma/ultraestrutura , Plasmócitos/ultraestrutura , Neoplasias da Coluna Vertebral/diagnóstico , Tomografia Computadorizada por Raios XRESUMO
One hundred and thirty-five cases of burned hands were reviewed retrospectively. These consisted of 80 acutely burned hands, and 55 burned contractures. Treatment for the acutely burned hands included initial plastic-bag coverage and early tangential excisions and skin graftings. No skin grafting was required for all the first-degree and some second-degree superficial burns while some second-degree, all third-degree and deep superficial burns required early tangential excisions and skin resurfacing. The results were invariable satisfactory. The burned contractures were classified into four categories: the mild type; the claw type; the severely distorted type and the mutilated type. Treatment for the mild types consisted of release and different forms of skin grafting, Z-plasties and local flap repairs. Distant flaps were required for the claw and severely distorted types whilst the mutilated type was treated by amputation. The operative techniques to achieve satisfactory functional restorations were discussed.
Assuntos
Queimaduras/terapia , Cicatriz/patologia , Traumatismos da Mão/terapia , Adolescente , Adulto , Idoso , Povo Asiático , Queimaduras/cirurgia , Criança , Pré-Escolar , China , Contratura/etiologia , Contratura/cirurgia , Humanos , Hipertrofia , Lactente , Pessoa de Meia-Idade , Estudos Retrospectivos , Pele/patologia , CicatrizaçãoRESUMO
A retrospective study of 32 adult patients with fractures of the femoral shaft treated with the AO dynamic compression plate in one centre was carried out. Pathological fractures, transverse and short oblique fractures in the middle third of the femur were excluded from this study. The average follow-up was 3.5 years. The complications were failure of the implant in 6.3 per cent of cases, loosened screws in 3 per cent, refracture in 3 per cent and non-union in 3 per cent. No instance of deep infection was encountered. The average time taken for union was 5.5 months. The overall objective assessment showed excellent or good results in 90.6 per cent of cases. There is a definite place for the AO dynamic compression plate in well-selected cases of fracture of the femoral shaft, provided that close attention to technical details is observed. Timing of the operation and the postoperative care also affect the results.
Assuntos
Placas Ósseas , Fraturas do Fêmur/cirurgia , Adolescente , Adulto , Idoso , Feminino , Fraturas do Fêmur/diagnóstico por imagem , Fraturas do Fêmur/fisiopatologia , Fixação Interna de Fraturas , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Radiografia , Fatores de TempoRESUMO
A retrospective review was made of 97 cases of fractured shaft of the femur treated with closed medullary nailing. A comparison was made between the Küntscher and the AO techniques with respect to union of the fracture, rehabilitation, complication and functional results. Patients treated with AO nails enjoyed more rapid recovery: 88 per cent of the fractures united in 12 weeks, 62 per cent walked with full weight bearing in 8 weeks and 78 per cent returned to work within 6 months. However, the functional results in both groups were comparable. The special technical considerations and complications in each group are discussed.