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1.
Alcohol ; 2024 Mar 04.
Artículo en Inglés | MEDLINE | ID: mdl-38447788

RESUMEN

INTRODUCTION: Chronic alcohol-related myopathy presents with proximal muscle weakness. We studied the effect of vitamin D supplementation on muscle weakness in adults with alcohol use disorder. METHOD: Randomized controlled trial. Participants were community-dwelling adults with alcohol use disorder. Participants allocated to VIDIO, vitamin D intensive outreach, received bimonthly oral doses of 50,000‒100,000 IU cholecalciferol for 12 months. Participants allocated to CAU, care as usual, received prescriptions of once-a-day tablets containing 800 IU cholecalciferol and 500 mg calcium carbonate. Data included demographic variables, laboratory tests, alcohol use, and rating scales of help-seeking and support. Main outcomes were the participants' quadriceps maximum voluntary contractions (qMVC) and serum-25(OH)vitamin D concentrations, 25(OH)D. RESULTS: In 66 participants, sex ratio 50/16, mean age 51 year, alcohol use was median 52 [IQR 24‒95] drinks per week. Baseline qMVC values were 77% (SD 29%) of reference values. Laboratory tests were available in 44/66 participants: baseline 25(OH)D concentrations were 39.4 (SD 23.7) nmol/L. Thirty-one participants with 25(OH)D concentrations <50 nmol/L received either VIDIO or CAU and improved in qMVC, respectively with mean 51 (P<0.05) and 62 Newton (no P-value because of loss of follow-up) after one year of treatment. Vitamin D status increased with mean +56.1 and +37.4 nmol/L, respectively in VIDIO and CAU. CONCLUSION: The qMVC values improved during vitamin supplementation in adults with vitamin D deficiency and alcohol use disorder. Despite higher 25(OH)D concentrations in VIDIO, in terms of muscle health no advise could be given in favor of one vitamin strategy over the other. TRIAL REGISTRATION: Netherlands Trial Register (NTR) identifier: NTR4114.

2.
Curr Radiol Rep ; 5(5): 19, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28435761

RESUMEN

PURPOSE OF REVIEW: To explain the technique of Dual-energy CT (DECT) and highlight its applications and advantages in head and neck radiology. RECENT FINDINGS: Using DECT, additional datasets can be created next to conventional images. In head and neck radiology, three material decomposition algorithms can be used for improved lesion detection and delineation of the tumor. Iodine concentration measurements can aid in differentiating malignant from nonmalignant lymph nodes and benign posttreatment changes from tumor recurrence. Virtual non-calcium images can be used for detection of bone marrow edema. Virtual mono-energetic imaging can be useful for improved iodine conspicuity at lower keV and for reduction of metallic artifacts and increase in signal-to-noise ratio at higher keV. SUMMARY: DECT and its additional reconstructions can play an important role in head and neck cancer patients, from initial diagnosis and staging, to therapy planning, evaluation of treatment response and follow-up. Moreover, it can be helpful in imaging of infections and inflammation and parathyroid imaging as supplementary reconstructions can be obtained at lower or equal radiation dose compared with conventional single energy scanning.

3.
J Psychopharmacol ; 23(1): 56-64, 2009 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-18515454

RESUMEN

Acute tryptophan depletion (ATD) can be used to decrease serotonin levels in the brain. Traditionally, ATD has been established by administering amino acid (AA) mixtures and studies using this method showed that serotonin is involved in learning and memory processes. This study used a recently developed gelatin-based protein drink to examine whether it 1) is superior to the traditional AA method in controlling the tryptophan levels in the placebo condition, 2) impairs long-term memory and 3) differentially affects episodic and spatial memory. Sixteen healthy subjects participated in a double-blind, placebo-controlled study. Memory was assessed using a visual verbal learning test and an object relocation task (spatial memory). Tryptophan ratio significantly decreased after ATD and did not significantly increase in the placebo condition. Delayed recall in the verbal learning test and delayed relocation of objects to positions in the spatial task were impaired after ATD. Spatial short-term memory, however, improved. The current results indicate that the tryptophan levels were essentially neutral in the placebo condition compared with those in the traditional AA mixture. Our study provides further evidence that impairment in long-term episodic and elementary spatial memory after ATD is related to lowered tryptophan levels in plasma.


Asunto(s)
Aminoácidos Esenciales/deficiencia , Proteínas en la Dieta/efectos adversos , Gelatina/efectos adversos , Trastornos de la Memoria/diagnóstico , Triptófano/administración & dosificación , Triptófano/deficiencia , Adulto , Afecto/fisiología , Aminoácidos Esenciales/administración & dosificación , Aminoácidos Esenciales/sangre , Aminoácidos Esenciales/química , Estudios Cruzados , Proteínas en la Dieta/análisis , Suplementos Dietéticos , Método Doble Ciego , Ingestión de Líquidos , Femenino , Gelatina/química , Humanos , Masculino , Trastornos de la Memoria/etiología , Memoria a Corto Plazo/efectos de los fármacos , Recuerdo Mental/efectos de los fármacos , Placebos/administración & dosificación , Placebos/análisis , Placebos/química , Encuestas y Cuestionarios , Análisis y Desempeño de Tareas , Triptófano/sangre , Triptófano/química , Aprendizaje Verbal/fisiología
4.
Arch Mal Coeur Vaiss ; 98(5): 506-12, 2005 May.
Artículo en Francés | MEDLINE | ID: mdl-15966600

RESUMEN

Catecholinergic ventricular tachycardia is an adrenergic induced polymorphic ventricular arrhythmia. It occurs in infancy and is responsible for syncope and sudden death in the absence of any morphological cardiac abnormality. Without treatment the mortality in catecholinergic ventricular tachycardia is very high. We report genetic and clinical data from 25 cases of catecholinergic ventricular tachycardia referred with syncope (n=19) or resuscitated sudden death during exercise (n=6). A family history from the 25 families identified 41 apparent subjects considered as being clinically affected, with an average age of 30 +/- 10 years (11 to 62 years). Analysis of the RyR2 gene showed mutations in 13 of the 25 cases and in 39 of apparent subjects. With betablocker treatment (nadolol: 1.6 +/- 0.15 mg/kg), 96% of patients remained asymptomatic over an average follow-up of between 7.5 +/- 1.5 years, although some of them continued to display polymorphic ventricular extrasystoles on exercise. Nevertheless, 12% of the cases suffered sudden death or further syncope during follow-up. An automatic defibrillator was implanted in 2 patients who had a RyR2 mutation. High dose betablockers are effective in preventing serious rhythm disturbance in children. In adolescence, implanting an automatic defibrillator should be discussed in cases with a history of syncope or resuscitated sudden death. We confirm the importance of genetic studies in these families at high risk of sudden death.


Asunto(s)
Antagonistas Adrenérgicos beta/uso terapéutico , Muerte Súbita Cardíaca , Taquicardia Ventricular/genética , Taquicardia Ventricular/patología , Adolescente , Adulto , Catecolaminas/farmacología , Niño , Análisis Mutacional de ADN , Desfibriladores Implantables , Electrocardiografía , Ejercicio Físico , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Factores de Riesgo , Canal Liberador de Calcio Receptor de Rianodina/genética , Síncope , Taquicardia Ventricular/tratamiento farmacológico
5.
Cancer ; 79(5): 935-43, 1997 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-9041156

RESUMEN

BACKGROUND: The biologic rationale for combining cisplatin with locoregional hyperthermia (HT) relates to the potentiating effect of HT on cisplatin cytotoxicity. METHODS: Patients with recurrent cervical carcinoma, who had a pelvic recurrence after radiotherapy, were treated with weekly cycles of locoregional HT (using the 70-megahertz, 4 antenna-phased array system for 1 hour and cisplatin, 50 mg/m2 intravenously [i.v.], for a maximum of 12 cycles.) RESULTS: Twenty-three patients were entered in this study. A total of 169 cycles were given. Responses were observed in 12 of 23 patients, a response rate of 52% (95% confidence interval, 31-73%). Salvage surgery became possible in 3 of 12 responding patients, whose tumors were previously considered unresectable. The median duration of response was 9.5+ months, the median overall survival was 8+ months, and the 1-year survival was 42%. No correlation was found between treatment outcome and clinical parameters such as age, weight, performance status, and histology. Thermal parameters such as T20, T50, and T90 were higher in responding patients, but were not significantly different from nonresponding patients. Overall toxicity was moderate. Subcutaneous fatty necrosis due to HT occurred in 10% of the cycles, whereas 2 patients developed skin burns. Squamous cell carcinoma antigen proved to be a valuable tool for the evaluation of response and detection of progression. CONCLUSIONS: Weekly locoregional HT and cisplatin, 50 mg/ m2 i.v., for a maximum of 12 cycles was effective treatment in patients with a previously irradiated recurrent carcinoma of the uterine cervix.


Asunto(s)
Carcinoma de Células Escamosas/terapia , Cisplatino/uso terapéutico , Hipertermia Inducida , Serpinas , Neoplasias del Cuello Uterino/terapia , Antígenos de Neoplasias/análisis , Carcinoma de Células Escamosas/tratamiento farmacológico , Carcinoma de Células Escamosas/inmunología , Cisplatino/efectos adversos , Esquema de Medicación , Femenino , Humanos , Hipertermia Inducida/efectos adversos , Recurrencia Local de Neoplasia , Análisis de Supervivencia , Neoplasias del Cuello Uterino/tratamiento farmacológico , Neoplasias del Cuello Uterino/inmunología
6.
Int J Radiat Oncol Biol Phys ; 34(4): 887-93, 1996 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-8598366

RESUMEN

PURPOSE: The biological rationale for combining locoregional hyperthermia (HT) with cisplatin (CDDP) is the potentiating effect of HT on CDDP uptake and cytotoxicity. Feasibility, toxicity, and preliminary results of a clinical trial of weekly loco-regional HT in combination with cisplatin are described in this article. METHODS AND MATERIALS: Patients with previously irradiated unresectable local recurrent cervical carcinoma or locally advanced bladder carcinoma were treated with weekly cycles of locoregional HT (70 MHz four antenna phased array system) for 1 h and CDDP 50 mg/m(2) IV for a maximum of 12 courses. RESULTS: Fourteen patients, 10 patients with recurrent cervical carcinoma and 4 with locally advanced bladder carcinoma, were entered in this study. A total of 100 cycles were given. Overall toxicity was acceptable; Grade 3 (WHO) toxicity (gastrointestinal, hematological, and neurotoxicity) was observed in 5 out of 14 patients. No Grade 4 toxicity was seen. Subcutaneously fatty necrosis due to HT occurred in 11% of the cycles, while two patients developed skin burns. Two out of 10 patients with recurrent cervical carcinoma were not evaluable for response. Four out of eight evaluable cervical carcinoma patients responded (two pathologic complete responses, one pathologic confirmed partial response, one partial response): response rate 50% (95% confidence interval 15.7-84.3%). Salvage surgery became possible in three out of four responding patients, whose tumors were previously considered unresectable. Two out of the four evaluable patients with locally advanced bladder carcinoma responded (two partial responses). CONCLUSIONS: Weekly loco-regional HT and CDDP 50 mg/m(2)/week for a maximum of 12 courses is feasible with an acceptable toxicity, which seems not to be enhanced by the addition of loco-regional HT. The encouraging preliminary results of this treatment schedule warrant further study, especially in patients with previously irradiated recurrent cervical carcinomas.


Asunto(s)
Antineoplásicos/administración & dosificación , Carcinoma de Células Transicionales/terapia , Cisplatino/administración & dosificación , Hipertermia Inducida , Recurrencia Local de Neoplasia/terapia , Neoplasias de la Vejiga Urinaria/terapia , Neoplasias del Cuello Uterino/terapia , Adulto , Anciano , Antineoplásicos/efectos adversos , Carcinoma de Células Transicionales/patología , Carcinoma de Células Transicionales/radioterapia , Cisplatino/efectos adversos , Terapia Combinada , Esquema de Medicación , Estudios de Factibilidad , Femenino , Audición/efectos de los fármacos , Humanos , Hipertermia Inducida/efectos adversos , Riñón/efectos de los fármacos , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia/patología , Inducción de Remisión , Factores de Tiempo , Neoplasias de la Vejiga Urinaria/patología , Neoplasias de la Vejiga Urinaria/radioterapia , Neoplasias del Cuello Uterino/patología , Neoplasias del Cuello Uterino/radioterapia
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