Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 32
Filtrar
Más filtros

Tipo del documento
Intervalo de año de publicación
1.
J Surg Oncol ; 129(4): 728-733, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38164022

RESUMEN

BACKGROUND AND OBJECTIVES: Following gastric and esophageal cancer surgery, patients often experience significant, prolonged eating-related symptoms. One promising approach to help patients improve their eating-related quality of life (QOL) is through self-management coaching to aid in diet modification. We performed a randomized pilot study of a nutritionist-led telehealth intervention for the self-management of eating after gastroesophageal cancer surgery. METHODS: Patients who were within 30 days of resuming oral intake after undergoing surgery for gastric and/or esophageal cancer were consented and then randomized to the intervention or usual care. The intervention was performed by a nutritionist trained in self-management coaching and delivered in four telehealth sessions over 4 months. The following outcomes were measured at baseline and at 6 months after baseline: QOL (EORTC QLQC30), weight, body mass index, and sarcopenia. RESULTS: Fifty-three patients were enrolled. 22/27 usual care and 21/26 intervention patients completed the study for a retention rate of 81%. Differences between the intervention and control groups were not statistically significant, but the intervention group had indications of greater improvements in overall QOL as measured by EORTC QLQC30 Summary Score (8.7 vs. 2.3, p = 0.17) as well as greater improvements in 4/5 functional domains (p > 0.3). The intervention group also had slightly more weight gain (6 kg vs. 3 kg, p = 0.3) and less sarcopenia (3/16 vs. 9/18, p = 0.07). CONCLUSIONS: This pilot study demonstrated the feasibility and acceptability of a telehealth intervention for self-management of eating symptoms after gastroesophageal cancer surgery. There were trends toward improved overall QOL in the intervention group. A larger study is needed to validate the results.


Asunto(s)
Neoplasias Esofágicas , Sarcopenia , Automanejo , Neoplasias Gástricas , Telemedicina , Humanos , Calidad de Vida , Proyectos Piloto , Neoplasias Esofágicas/cirugía , Neoplasias Gástricas/cirugía
2.
Medicina (Kaunas) ; 56(11)2020 Oct 30.
Artículo en Inglés | MEDLINE | ID: mdl-33142973

RESUMEN

Background and objectives: When the drowning timeline evolves and drowning occurs, the lifeguard tries to mitigate the event by applying the last link of the drowning survival chain with the aim of treating hypoxia. Quality CPR (Cardiopulmonary Resuscitation) and the training of lifeguards are the fundamental axes of drowning survival. Mobile applications and other feedback methods have emerged as strong methods for the learning and training of basic CPR in the last years so, in this study, a randomised clinical trial has been carried out to compare the traditional method as the use of apps or manikins with a feedback system as a method of training to improve the quality of resuscitation. Materials and Methods: The traditional training (TT), mobile phone applications (AP) and feedback manikins (FT) are compared. The three cohorts were subsequently evaluated through a manikin providing feedback, and a data report on the quality of the manoeuvres was obtained. Results: Significant differences were found between the traditional manikin and the manikin with real-time feedback regarding the percentage of compressions with correct depth (30.8% (30.4) vs. 68.2% (32.6); p = 0.042). Hand positioning, percentage correct chest recoil and quality of compressions exceeded 70% of correct performance in all groups with better percentages in the FT (TT vs. FT; p < 0.05). Conclusions: As a conclusion, feedback manikins are better learning tools than traditional models and apps as regards training chest compression. Ventilation values are low in all groups, but improve with the feedback manikin.


Asunto(s)
Reanimación Cardiopulmonar , Aplicaciones Móviles , Humanos , Maniquíes , Presión , Tórax
3.
Behav Brain Res ; 471: 115114, 2024 Jun 13.
Artículo en Inglés | MEDLINE | ID: mdl-38878972

RESUMEN

Zika virus (ZIKV) is a neurotropic Orthoflavivirus that causes a myriad of neurological manifestations in newborns exposed in uterus. Despite the devastating consequences of ZIKV on the developing brain, strategies to prevent or treat the consequences of viral infection are not yet available. We previously showed that short-term treatment with the TNF-α neutralizing monoclonal antibody. Infliximab could prevent seizures at acute and chronic stages of ZIKV infection, but had no impact on long-term cognitive and motor dysfunction. Due to the central role of inflammation in ZIKV-neuropathology, we hypothesized that prolonged treatment with the anti-TNF-α monoclonal antibody Infliximab could provide complete rescue of long-term behavioral deficits associated with neonatal ZIKV infection in mice. Here, neonatal (post-natal day 3) Swiss mice were submitted to subcutaneous (s.c.) injection of 106 PFU of ZIKV or mock medium and were then treated with Infliximab (20 µg/day) or sterile saline intraperitoneally (i.p.), for 40 days starting on the day of infection, and behavioral assessment started at 60 days post-infection (dpi). Infliximab prevented ZIKV-induced cognitive and motor impairments in mice. In addition, microgliosis and cell death found in mice following ZIKV infection were partially reversed by TNF-α blockage. Altogether, these results suggest that TNF-α-mediated inflammation is central for late ZIKV-induced behavioral deficits and cell death and strategies targeting this cytokine may be promising approaches to treat subjects exposed to the virus during development.

4.
J Perinatol ; 2024 Jul 23.
Artículo en Inglés | MEDLINE | ID: mdl-39043994

RESUMEN

OBJECTIVE: To investigate fetal/neonatal and obstetric events in pregnancies with both maternal and fetal heart disease. STUDY DESIGN: From the CARPREG database, singleton pregnancies (>24 weeks) in patients with structural heart disease that underwent fetal/neonatal echocardiograms were selected and separated in two groups: maternal heart disease only (M-HD) and maternal and fetal heart disease (MF-HD). Differences in adverse fetal/neonatal (death, preterm birth, and small for gestational age) and obstetric (preeclampsia/eclampsia) outcomes between groups were analyzed. RESULTS: From 1011 pregnancies, 93 had MF-HD. Fetal/neonatal events (38.7% vs 25.3%, p = 0.006) and spontaneous preterm birth (10.8% vs 4.9%, p = 0.021) were more frequent in MF-HD compared to M-HD, with no difference in obstetric events. MF-HD remained as a significant predictor of fetal/neonatal events after adjustment (OR:1.883; 95% CI:1.182-3.000; p = 0.008). CONCLUSIONS: Pregnancies with MF-HD are at risk of adverse fetal/neonatal events and spontaneous preterm birth. Larger studies are needed to determine their association with preeclampsia.

5.
Sleep Med Clin ; 18(4): 423-433, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-38501515

RESUMEN

Postmenopause is defined retrospectively after 12 consecutive months of amenorrhea. It represents the end of the reproductive period and ovarian failure. A decrease in estrogen leads to several changes in the short and long term. Among the early changes, vasomotor symptoms (hot flashes) are particularly common, occurring in about 70% of women. In addition, there are changes in mood, anxiety, depression, and insomnia. Insomnia occurs in almost 60% of postmenopausal women. Psychosocial aspects may also affect sleep. Proper diagnosis may lead to adequate treatment of sleep disturbances during menopause. Hormonal or other complementary therapies can improve sleep quality.


Asunto(s)
Trastornos del Inicio y del Mantenimiento del Sueño , Femenino , Humanos , Trastornos del Inicio y del Mantenimiento del Sueño/diagnóstico , Trastornos del Inicio y del Mantenimiento del Sueño/terapia , Estudios Retrospectivos , Menopausia , Sueño , Posmenopausia
6.
Trop Med Infect Dis ; 8(4)2023 Apr 10.
Artículo en Inglés | MEDLINE | ID: mdl-37104346

RESUMEN

Epidemiological studies on infections by Toxoplasma gondii and Neospora caninum in cats in the North Region of Brazil are scarce. We intended to assess the seroprevalence in cats of anti-T. gondii and anti-N. caninum antibodies, as well as the associated risk factors that may lead them to contract these infections in Rolim de Moura, state of Rondônia, North Brazil. For this, blood serum samples of 100 cats from different regions of the city were evaluated. To assess possible factors associated with infections, epidemiological questionnaires were applied to tutors. The Immunofluorescence Antibody Test (IFAT) was performed for anti-T. gondii (cutoff 1:16) and anti-N. caninum (cutoff 1:50) antibodies. After identifying the positive samples, antibody titration was performed. The results showed the prevalence of 26% (26/100) of anti-T. gondii antibodies, with titration varying between 1:16 to 1:8192. There were no factors associated with the prevalence of anti-T. gondii antibodies in the multivariate analysis in this study. There was no occurrence of seropositive cats for anti-N. caninum. It was concluded that there was a high prevalence of anti-T. gondii antibodies in cats in Rolim de Moura, state of Rondônia, North Brazil. However, the evaluated animals did not present anti-N. caninum antibodies. Therefore, knowing that T. gondii has different transmission forms, we emphasize the importance of spreading more information to the population about cat's relevance in the T. gondii life cycle and how to avoid the parasite transmission and proliferation.

7.
Healthcare (Basel) ; 11(10)2023 May 15.
Artículo en Inglés | MEDLINE | ID: mdl-37239724

RESUMEN

Smoking causes significant morbidity and mortality worldwide, mainly in developed countries. In addition, it is the cause of numerous diseases in the body, despite the fact that the prevalence of tobacco use is decreasing. Nursing students, as future professionals, should be aware of action plans for cessation and information designed for smokers. To determine the level of knowledge among nursing students about smoking-related diseases and analyze the prevalence of student who smoke at the University of Leon, Spain, a descriptive cross-sectional study was carried out in which students were given an anonymous questionnaire, which was previously validated, during the 2021-2022 academic year. In a sample of 477 (79.5%) nursing students, a smoking prevalence of 17.6% was obtained. In addition, students' knowledge about the diseases directly caused by tobacco consumption and others associated with exposure to environmental smoke was assessed, and in both cases (8.03 points of 9 for consumption and 5.24 of 6 to exposure), scores were obtained that allow us to state that students do not know for sure the types of diseases that are related to tobacco use and passive smoking. In spite of this, it is necessary to continue to reduce the prevalence of smoking through different programs implemented in schools and universities, as it is also necessary to improve teaching plans when explaining smoking-related diseases, so that students, in the future, will be able to advise patients correctly.

8.
J Matern Fetal Neonatal Med ; 35(25): 5140-5148, 2022 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-33632045

RESUMEN

BACKGROUND: Cardiac diseases complicate 4% of pregnancies, with a mortality rate between 0 and 15%. Early referral has shown to reduce the risk of maternal major cardiac events (MACEs). METHODS: We retrospectively analyzed a cohort of pregnant women with heart disease from two referral centers in Mexico City. We examined MACEs: maternal death, pulmonary edema, acute heart failure, endocarditis, stroke, myocardial infarction, acute aortic syndromes, arrhythmias requiring urgent treatment, and the need for an urgent intervention; preterm birth and obstetric events such as HELLP syndrome, preeclampsia, eclampsia, placental abruption, obstetric hemorrhage. We analyzed the association between each modified World Health Organization (mWHO) group and MACEs, preterm birth and obstetric outcomes between March 2014 and March 2019. RESULTS: Using the mWHO classification, 399 deliveries were included and stratified as follows: I, 162; II, 133; II-III, 21; III, 18; and IV, 52 patients. MACEs were observed in 12.5% of the cohort and were associated with mWHO II (odds ratio [OR], 3.0; 95% confidence interval [95% CI], 1.1-8.1; p = 0.027), II-III (OR, 3.3; 95% CI, 0.9-1.0; p = 0.116), III (OR, 5.3; 95% CI, 1.2-23; p = 0.026), and IV (OR, 8.2; 95% CI, 2.7-24.5; p < 0.001) after adjusting for age, desaturation, previous functional class, and gestational age at referral. An association between mWHO and frequency of preterm birth was observed. Association between mWHO and obstetric events, even when adjusted, was not observed. CONCLUSIONS: The prevalence of MACEs and preterm birth is similar to that seen worldwide; MACEs and preterm birth are associated with the severity of heart disease stratified by mWHO, but there is no association between the severity of heart disease and obstetric events.


Asunto(s)
Cardiopatías , Nacimiento Prematuro , Femenino , Humanos , Recién Nacido , Embarazo , Nacimiento Prematuro/epidemiología , Estudios Retrospectivos , Placenta , Cardiopatías/epidemiología , Estudios de Cohortes
9.
Glob Heart ; 17(1): 49, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36051327

RESUMEN

Objectives: Describe the use and findings of cardiopulmonary imaging-chest X-ray (cX-ray), echocardiography (cEcho), chest CT (cCT), lung ultrasound (LUS), and/or cardiac magnetic resonance imaging (cMRI)-in COVID-19 hospitalizations in Latin America (LATAM). Background: There is a lack of information on the images used and their findings during the SARS-CoV-2 pandemic in LATAM. Methods: Multicenter, prospective, observational study of COVID-19 inpatients, conducted from March to December 2020, from 12 high-complexity centers, in nine LATAM countries. Adults (>18 years) with at least one imaging modality performed, followed from admission until discharge and/or in-hospital death, were included. Results: We studied 1,435 hospitalized patients (64% males) with a median age of 58 years classified into three regions: Mexico (Mx), 262; Central America and Caribbean (CAC), 428; and South America (SAm), 745. More frequent comorbidities were overweight/obesity, hypertension, and diabetes. During hospitalization, 58% were admitted to the ICU. The in-hospital mortality was 28%, and it was highest in Mx (37%).The most frequent images performed were cCT (61%), mostly in Mx and SAm, and cX-ray (46%), significant in CAC. The cEcho was carried out in 18%, similarly among regions, and LUS was carried out in 7%, with a higher frequently in Mx. Abnormal findings on the cX-ray were peripheral or basal infiltrates, and in cCT abnormal findings were the ground glass infiltrates, more commonly in Mx. In LUS, interstitial syndrome was the most abnormal finding, predominantly in Mx and CAC.Renal failure was the most prevalent complication (20%), predominant in Mx and SAm. Heart failure developed in 13%, predominant in Mx and CAC. Lung thromboembolism was higher in Mx while myocardial infarction was in CAC.Logistic regression showed associations of abnormal imaging findings and their severity, with comorbidities, complications, and evolution. Conclusions: The use and findings of cardiopulmonary imaging in LATAM varied between regions and had a great impact on diagnosis and prognosis.


Asunto(s)
COVID-19 , Adulto , COVID-19/diagnóstico por imagen , COVID-19/epidemiología , Femenino , Mortalidad Hospitalaria , Humanos , América Latina/epidemiología , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Sistema de Registros , SARS-CoV-2 , Tomografía Computarizada por Rayos X/métodos
10.
Case Rep Hematol ; 2020: 7819321, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32509363

RESUMEN

Thymus neoplasms are frequently related to paraneoplastic autoimmune manifestations. Its most common associations are myasthenia gravis and pure red cell aplasia. Aplastic anemia has been increasingly documented as an initial presentation of thymoma. Nevertheless, its development after successful surgical resection of thymoma is a rare condition. We report a case of a 53-year-old man with severe aplastic anemia preceded by amegakaryocytic thrombocytopenia three years after thymectomy with no signs of disease recurrence. He underwent immunosuppressive therapy with cyclosporine 5 mg/kg/day and prednisone 2 mg/kg/day for six weeks. Considering the availability of a compatible donor, allogeneic stem cell transplantation was carried out. However, the patient died 11 days after transplant. A literature review was conducted, and another ten cases of aplastic anemia, diagnosed three months to four years after thymectomy, were identified. These cases suggest persistence of peripheral self-reactive T lymphocytes even years after tumor definitive treatment.

11.
Trials ; 21(1): 920, 2020 Nov 11.
Artículo en Inglés | MEDLINE | ID: mdl-33176886

RESUMEN

OBJECTIVES: The primary objective is to test if heparin added to a standard regional anticoagulation protocol based on citrate is able to reduce dialysis circuit losses by clotting without increasing the risk of thrombocytopenia or bleeding, in patients with COVID-19 with acute kidney injury requiring dialysis. TRIAL DESIGN: Randomized, parallel-group, open-label trial, with two arms (ratio 1:1) comparing different continuous renal replacement therapy anticoagulation strategies. PARTICIPANTS: Eligibility conditions: All ICU patients of University of Sao Paulo General Hospital (Hospital das Clínicas), Brazil will be screened for eligibility conditions. Adults (> 18 years old) with confirmed COVID-19 and acute kidney injury requiring dialysis with agreement between ICU and nephrology teams for the introduction of renal continuous replacement therapy in daily ICU rounds. Continuous renal replacement therapy will be prescribed by consulting nephrologists based on standard clinical guidelines, including acute kidney injury with hemodynamic instability plus hyperkalemia, severe acidosis, volume overload, respiratory distress, multiorgan failure or some combination of these factors. DATA COLLECTION: Patients demographics and associated clinical data and comorbidities will be recorded at ICU entry. Demographic information will include the patient's age, sex, and admission dates. Clinical data comprise comorbidities, APACHE 2, SAPS 3, need for mechanical ventilation, and use of vasopressor drugs. Physiological data collected by the day of CRRT start will be vital signs, the arterial oxygen tension/fraction of inspired oxygen (PaO2/FiO2) index, and serum creatinine, blood urea nitrogen, bilirubin, hemoglobin, hematocrit, platelets, white blood cell count levels and Peak D-dimer levels. Patients will be analyzed for the first 72h of CRRT, and they will be evaluated regarding clinical variables, filter patency and any adverse events that could be related to the anticoagulation choice, as bleeding (mild or major) or low platelets counts (<100.000 ui/uL) during treatment period. Mild and major bleeding will be defined by hemorrhagic event without clinical impact or hemoglobin (Hb) fall lesser than 1g/dL and hemorrhagic event with clinical impact or Hb fall higher than 1g/dL, respectively. EXCLUSION CRITERIA: Hypersensitivity to any of the substances going to be used in the study (Citric acid dextrosol 2.2% and unfractionated heparin); Previous diagnosis of coagulopathy or thrombophilia; Contraindication to the use of unfractionated heparin; Risk of citrate poisoning - (Lactate> 30 mg/dL, international normalized ratio > 2.5, Total bilirubin> 15 mg/dL); Pregnancy; Patients unlikely to survive for more than 24 hours. The trial is being undertaken at the University of Sao Paulo General Hospital (Hospital das Clinicas), Brazil. INTERVENTION AND COMPARATOR: Group A (control) - Patients on continuous renal replacement therapy (blood flow 150 ml/min, dose of 30 mL/Kg/h) receiving anticoagulation with sodium citrate at 4 mmol/L Group B (experiment): Patients on continuous hemodialysis (blood flow 150 mL/min, dose of 30 mL/Kg/h) receiving anticoagulation with sodium citrate at 4 mmol/L associated with unfractionated heparin at 10 U/Kg/h. MAIN OUTCOMES: The percentage of clotted dialyzers within 72 hours in each of the studied groups (Primary outcome) Secondary outcomes: Number of dialyzers used in the first 72 hours of dialysis protocol, Mortality in the first 72 h of dialysis protocol, Bleeding events (Major or minor) in the first 72 h of dialysis protocol, Thrombocytopenia (less than 50.000 platelets) proportion in the first 72 h of dialysis protocol, Dialysis efficiency (Urea sieving) - variation in urea sieving between the first, second and third days of dialysis protocol, Continuous renal replacement therapy pressures (Arterial, Venous, dialysate and pre-filter pressure) in the first 72 h of dialysis protocol, in-hospital mortality. RANDOMIZATION: RedCap→ randomization - 2 blocks randomization by D-dimer level (5000ng/dL cut-off) and catheter site (Right Internal Jugular versus other sites) with 1:1 allocation ratio. BLINDING (MASKING): No blinding - Open label format NUMBERS TO BE RANDOMIZED (SAMPLE SIZE): Total number of patients 90 (45 per group) TRIAL STATUS: Trial version 2.0 - ongoing recruitment. First recruitment: June 29, 2020 Estimated date for last recruitment: December 31, 2020 TRIAL REGISTRATION: Responsible Party: University of Sao Paulo General Hospital (Hospital das Clinicas) ClinicalTrials.gov Identifier: NCT04487990 , registered July 27, 2020, ReBec www.ensaiosclinicos.gov.br/rg/RBR-45kf9p/ Other Study ID Numbers: U1111-1252-0194 FULL PROTOCOL: The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1) In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol.


Asunto(s)
Lesión Renal Aguda , Infecciones por Coronavirus , Monitoreo de Drogas/métodos , Heparina , Pandemias , Neumonía Viral , Diálisis Renal , Trombosis/prevención & control , Lesión Renal Aguda/etiología , Lesión Renal Aguda/terapia , Adulto , Anticoagulantes/administración & dosificación , Anticoagulantes/efectos adversos , Coagulación Sanguínea/efectos de los fármacos , COVID-19 , Infecciones por Coronavirus/sangre , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/tratamiento farmacológico , Femenino , Productos de Degradación de Fibrina-Fibrinógeno/análisis , Hemoglobinas/análisis , Hemorragia/etiología , Hemorragia/prevención & control , Heparina/administración & dosificación , Heparina/efectos adversos , Humanos , Masculino , Evaluación de Resultado en la Atención de Salud , Neumonía Viral/sangre , Neumonía Viral/complicaciones , Neumonía Viral/tratamiento farmacológico , Ensayos Clínicos Controlados Aleatorios como Asunto , Diálisis Renal/efectos adversos , Diálisis Renal/métodos , Ajuste de Riesgo/métodos , Trombocitopenia/etiología , Trombocitopenia/prevención & control , Trombosis/complicaciones
13.
Fam Cancer ; 7(2): 141-9, 2008.
Artículo en Inglés | MEDLINE | ID: mdl-17823852

RESUMEN

Linkage studies have identified susceptibility loci for familial nonmedullary thyroid cancer (FNMTC), with and without cell oxyphilia, at chromosomal regions 19p13.2 and 2q21. There are few genetic analyses of FNMTC tumours reported at the present time and the eventual gene involved was not identified yet. The aim of this study was to assess the occurrence of loss of heterozygosity (LOH) at these loci in the tumours from familial clusters of NMTC. We have analysed LOH in 14 tumours from 9 two-case familial clusters of NMTC. Using paired blood (normal) and tumour DNA samples, we have genotyped ten microsatellite and one SNP markers throughout 19p13.2 and fourteen microsatellite markers at 2q21. Overall, eight (57%) and two (14%) out of the fourteen tumours analysed exhibited LOH at 19p13.2 and 2q21, respectively. In two families (22%), LOH for the same markers was demonstrable in the tumours of the two members of the same family. In one family (11%) LOH was demonstrable at both loci analysed. In four two-case familial clusters (44%), LOH at the 19p13.2 locus was found in only one of the tumour cases analysed. Detailed haplotype analysis showed that, in two families (22%), the pattern of LOH in tumours was consistent with selective retention of the haplotype shared by affected members. In the remaining cases, it was consistent with random allelic losses. In conclusion, we report the finding of LOH at the 19p13.2 and 2q21 loci in tumours from familial clusters of NMTC, providing evidence that inactivation of putative genes in these regions, acting as tumour-suppressors, may be involved in the development of tumours in the context of FNMTC.


Asunto(s)
Cromosomas Humanos Par 19 , Pérdida de Heterocigocidad , Familia de Multigenes , Neoplasias de la Tiroides/genética , Adolescente , Adulto , Alelos , Femenino , Genes Supresores de Tumor , Genotipo , Humanos , Masculino , Repeticiones de Microsatélite , Persona de Mediana Edad , Factores de Riesgo , Neoplasias de la Tiroides/patología
17.
Eur J Endocrinol ; 157(1): 101-7, 2007 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-17609408

RESUMEN

BACKGROUND: Fine-needle aspiration cytology is frequently used for differential diagnosis of neck masses of unknown origin. Inconclusive and even false-negative results are not uncommon. AIM: To evaluate the utility of thyroglobulin (Tg) measurement in fine-needle aspirates (FNA-Tg) for detecting cervical lymph node (CLNs) metastases from differentiated thyroid carcinomas. METHODS: An ultrasound-guided fine-needle aspiration was done in 67 patients with 83 suspicious enlarged CLNs to obtain material for cytology and Tg measurement in the needle washout, using an immunometric chemiluminescent assay. Measurement of anti-Tg antibodies (FNA-TgAb) was also carried out in half of all the aspirates. Subjects were divided into two groups: one of 16 patients awaiting thyroidectomy and the other of 51 patients in follow-up after surgery. RESULTS: The first group of patients had positive FNA biopsy (FNAB-Tg) in 14 out of the 18 studied CLNs with a range of 3.2-43 352 ng/ml, while FNAB-cytology indicated metastasis in only 8 out of the 14 CLNs with positive histology. A total of 65 CLNs were studied in the follow-up group. Lymphadenectomy was performed in 23 patients and 28 aspirated CLNs were removed. Histology confirmed the diagnosis of metastasis suggested by FNAB-Tg in 20 CLNs and of reactive lymphadenitis in the remaining 8 CLNs. FNAB-cytology was positive in only 11 CLNs. Sensitivity of FNAB-Tg was not affected by the studied FNAB-TgAb. CONCLUSIONS: The FNAB-Tg achieved a sensitivity of 100% in both groups. FNAB-Tg is an easy and inexpensive technique which proved to increase the diagnostic of cytology in the early diagnosis of papillary carcinoma recurrence to CLN even in the presence of serum TgAb.


Asunto(s)
Carcinoma Papilar/diagnóstico , Carcinoma Papilar/patología , Ganglios Linfáticos/química , Tiroglobulina/análisis , Neoplasias de la Tiroides/diagnóstico , Neoplasias de la Tiroides/patología , Adulto , Anciano , Biopsia con Aguja Fina , Carcinoma Papilar/cirugía , Diagnóstico Diferencial , Femenino , Estudios de Seguimiento , Humanos , Técnicas In Vitro , Ganglios Linfáticos/patología , Metástasis Linfática , Masculino , Persona de Mediana Edad , Cuello , Sensibilidad y Especificidad , Neoplasias de la Tiroides/cirugía , Tiroidectomía
19.
PLoS One ; 12(1): e0169861, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28072885

RESUMEN

Anoxia is one of the most prevalent causes of neonatal morbidity and mortality, especially in preterm neonates, constituting an important public health problem due to permanent neurological sequelae observed in patients. Oxygen deprivation triggers a series of simultaneous cascades, culminating in cell death mainly located in more vulnerable metabolic brain regions, such as the hippocampus. In the process of cell death by oxygen deprivation, cytosolic calcium plays crucial roles. Intracellular inositol 1,4,5-trisphosphate receptors (IP3Rs) are important regulators of cytosolic calcium levels, although the role of these receptors in neonatal anoxia is completely unknown. This study focused on the functional role of inositol 1,4,5-trisphosphate receptor type 1 (IP3R1) in rat hippocampus after neonatal anoxia. Quantitative real-time PCR revealed a decrease of IP3R1 gene expression 24 hours after neonatal anoxia. We detected that IP3R1 accumulates specially in CA1, and this spatial pattern did not change after neonatal anoxia. Interestingly, we observed that anoxia triggers translocation of IP3R1 to nucleus in hippocampal cells. We were able to observe that anoxia changes distribution of IP3R1 immunofluorescence signals, as revealed by cluster size analysis. We next examined the role of IP3R1 in the neuronal cell loss triggered by neonatal anoxia. Intrahippocampal injection of non-specific IP3R1 blocker 2-APB clearly reduced the number of Fluoro-Jade C and Tunel positive cells, revealing that activation of IP3R1 increases cell death after neonatal anoxia. Finally, we aimed to disclose mechanistics of IP3R1 in cell death. We were able to determine that blockade of IP3R1 did not reduced the distribution and pixel density of activated caspase 3-positive cells, indicating that the participation of IP3R1 in neuronal cell loss is not related to classical caspase-mediated apoptosis. In summary, this study may contribute to new perspectives in the investigation of neurodegenerative mechanisms triggered by oxygen deprivation.


Asunto(s)
Región CA1 Hipocampal/metabolismo , Hipoxia/metabolismo , Receptores de Inositol 1,4,5-Trifosfato/metabolismo , Animales , Apoptosis , Señalización del Calcio , Receptores de Inositol 1,4,5-Trifosfato/genética , Masculino , Transporte de Proteínas , Ratas , Ratas Wistar
20.
Mundo saúde (Impr.) ; 45: e1532020, 2021-00-00.
Artículo en Inglés, Portugués | LILACS-Express | LILACS | ID: biblio-1526071

RESUMEN

O aumento da expectativa de vida entre indivíduos acima de 65 anos, vem modificando a pirâmide etária da população brasileira. Qualidade de vida (QV) é um parâmetro importante para avaliação do estado de saúde. O objetivo do estudo foi descrever a QV de idosos inseridos em um programa de atendimento ao idoso, evidenciar associações com as características do paciente, doença, terapêutica e suporte social contribuindo para melhor assistência a idosos que frequentam o serviço. Tratou-se de estudo, descritivo, quantitativo, transversal, correlacional com 85 indivíduos com 60 anos ou mais, alfabetizados, independentes nas atividades da vida diária, sem deficiência cognitiva/psíquica diagnosticada e que frequentavam o Centro Social Nossa Senhora do Rosário há no mínimo um mês. Para coleta das variáveis independentes utilizou-se um instrumento elaborado pelas autoras; além do teste de Morisk-Green e Índice de Complexidade Terapêutica (ICFT). A QV foi avaliada pelo WHOQOL-breve. 89,4% eram mulheres; 38,8% apresentavam 60 a 70 anos; 77,6% até 3 comorbidades, a mais frequente foi hipertensão (77,65%); 49,41% fazia uso de polifarmácia, o ICTF variou de 2,5 a 48,0 pontos para um a doze medicamentos/dia; 57,65% adquiriam a medicação pelo SUS; 64,80% apresentaram média/baixa adesão; 43,53% declararam como boa percepção de saúde. Quanto aos domínios do WHOQOL-breve, obteve-se como maior média no domínio social (75,5), seguido do psicológico (68,3), físico (67,1) e (64,8) no meio ambiente. Os resultados deste estudo destacaram que o sexo feminino, presença de doenças, a complexidade terapêutica e percepção de saúde ruim estão associados com menores índices de qualidade de vida desta população.


The increase in life expectancy among individuals over 65 years of age has changed the age pyramid of the Brazilian population. Quality of life (QoL) is an important parameter to assess health status. The aim of the study was to describe the QoL of elderly people enrolled in an elderly care program, showing associations with the characteristics of the patient, disease, therapy, and social support, contributing to improve care for the elderly who receive this service. This was a descriptive, quantitative, cross-sectional, correlational study with 85 individuals aged 60 years or more, who were literate, independent in activities of daily living, without diagnosed cognitive/psychological impairment, and who had been going to the Nossa Senhora do Rosário Social Center for at least one month. To collect the independent variables, an instrument developed by the authors was used; in addition to the Morisk-Green test and Medication Regimen Complexity Index (MRCI). QoL was assessed by WHOQOL-brief. 89.4% were women; 38.8% were 60 to 70 years old; 77.6% had up to 3 comorbidities, the most frequent was hypertension (77.65%); 49.41% used polypharmacy, the MRCI ranged from 2.5 to 48.0 points for one to twelve medications/day; 57.65% acquired their medication through the SUS; 64.80% had medium/low adherence; 43.53% declared having a good perception of health. As for the WHOQOL-brief domains, the highest mean was obtained in the social domain (75.5), followed by the psychological (68.3), physical (67.1), and environmental (64.8) domains. The results of this study highlighted that the female gender, presence of diseases, therapeutic complexity, and perception of poor health are associated with lower quality of life indices in this population.

SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA