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1.
J Craniofac Surg ; 2024 Jan 22.
Artículo en Inglés | MEDLINE | ID: mdl-38252534

RESUMEN

Basal cell carcinoma (BCC) is one among the most prevalent malignant neoplasms that has exhibited a notable surge in global incidence over recent decades. This slow-growing malignancy is typified by its localized invasiveness while demonstrating an exceedingly rare metastatic proclivity. It predominantly afflicts the sun-exposed skin of aging individuals, with a heightened predilection for the maxillofacial region. Scraping cytology offers numerous benefits, including the potential for an earlier diagnosis and the absence of scarring, as opposed to a biopsy. The cytodiagnosis of BCC proves to be straightforward with various techniques, making it highly advantageous in an outpatient environment as a swift diagnostic method when planning a surgical excision. Our study sought to scrutinize the clinicopathological facets of BCC within the maxillofacial region. We compared advanced cytological techniques for diagnosis, including scraping, scratching, and imprinting using Papanicolau and Diff-Quick stains. In addition, we evaluated the therapeutic effectiveness of diode lasers operating at wavelengths of 940nm and 980n. A retrospective analysis was undertaken, encompassing facial BCC lesions smaller than 2.5 cm in diameter that underwent treatment through diode laser ablation between September 2021 and August 2023 at Ramadi Teaching Hospital and a private clinic in Ramadi City, Iraq. Among the cohort of 48 patients with BCC, a majority (58%) were 50 years of age or older, with a predominance of males (62%). The mean duration of lesion existence exceeded 4 months. The anatomical region most commonly involved was the middle 1/3 of the face, accounting for 34% of cases. Intriguingly, the therapeutic approach of diode laser ablation yielded exceptional esthetic and functional outcomes, which were consistently observed throughout the follow-up period post-healing. The occurrence of complications following diode laser ablation was relatively infrequent. This investigation revealed that cytological examination is easily conducted, eliminating the need for local anesthesia, saving time, being more cost-effective than a conventional biopsy, and delivering swift diagnoses. The process of smear-taking for cytology is well-tolerated, inflicting minimal trauma or discomfort on the patient. BCC predominantly afflicts elderly males and most frequently affects the middle third of the face. Notably, nodular BCC emerged as the prevailing histological subtype. The use of diode laser ablation exhibited a commendable track record, producing exemplary functional and esthetic outcomes over a 6-month follow-up period.

2.
BMC Oral Health ; 24(1): 1144, 2024 Sep 27.
Artículo en Inglés | MEDLINE | ID: mdl-39334335

RESUMEN

BACKGROUND: The urokinase-type plasminogen activator receptor (uPAR) plays an essential function in leukocytes and endothelial homeostasis and, therefore, in the development of chronic periodontitis. METHODS: The study enrolled 150 participants, 50 chronic periodontitis with head and neck cancer post radiotherapy (CP + HNC post-RT) patients, 50 chronic periodontitis (CP) without HNC patients, and 50 healthy controls. Clinical Attachment Loss (CAL), Probing Pocket Depth (PPD), Plaque Index (PI), and Gingival Bleeding Index (GBI) were recorded. An enzyme-linked immunosorbent assay (ELISA) was constructed to quantify serum (suPAR) levels. RESULTS: Stage and grade of periodontitis were stage III-IV, grade C in patients (CP + HNC post-RT), stage I-III, grade A/B in patients (CP without HNC), and absent in (healthy). Chronic periodontitis with HNC post-RT patients presented a significantly higher proportion of suPAR levels (506.7 pg/ml) compared to chronic periodontitis without HNC and healthy controls (423.08 pg/ml and 255.9 pg/ml), respectively. A significant positive correlation was found between serum suPAR levels and CAL, PPD, PI, and GBI in the periodontal disease groups. ROC results of suPAR (AUC = 0.976 for CP + HNC post-RT, AUC = 0.872 for CP without HNC). Hyposalivation appeared in patients (CP + HNC post-RT; 0.15 [0.11-0.23] ml/min, P = 0.001) and (CP without HNC; 0.30 [0.25-0.41] ml/min, P = 0.001), compared to healthy controls; 0.35 [0.28-0.54] ml/min, P = 0.001). CONCLUSION: The study showed a significant elevation in serum suPAR levels in CP + HNC post-RT patients compared to the CP without HNC and control groups. CLINICAL TRIAL REGISTRATION: The study was registered retrospectively; clinicaltrials.gov identifier: NCT06529588. Date of registration: July 31, 2024 https://clinicaltrials.gov/study/NCT06529588 .


Asunto(s)
Biomarcadores , Periodontitis Crónica , Neoplasias de Cabeza y Cuello , Receptores del Activador de Plasminógeno Tipo Uroquinasa , Humanos , Receptores del Activador de Plasminógeno Tipo Uroquinasa/sangre , Femenino , Masculino , Persona de Mediana Edad , Neoplasias de Cabeza y Cuello/radioterapia , Neoplasias de Cabeza y Cuello/sangre , Neoplasias de Cabeza y Cuello/patología , Biomarcadores/sangre , Periodontitis Crónica/sangre , Estudios de Casos y Controles , Adulto , Índice Periodontal , Anciano , Ensayo de Inmunoadsorción Enzimática
3.
BMC Oral Health ; 24(1): 831, 2024 Jul 23.
Artículo en Inglés | MEDLINE | ID: mdl-39044217

RESUMEN

BACKGROUND: Dentigerous cysts, deemed of developmental origin, are benign odontogenic cysts characterized by a gradual growth rate. Their occurrence is twice as prevalent in men compared to women. These cysts are recognized as the most frequent developmental cysts affecting the jaws, with a typical manifestation in individuals aged 20 to 40, while infrequently identified in young children. Notably, dentigerous cysts have the potential to attain significant dimensions, resulting in painless enlargement of the jaw and subsequent deformation. OBJECTIVES: To assess the clinicopathological features and management of ten years of experience with dentigerous cysts. METHODS: A challenging cases were reported from reviewed records of the patients who were treated by the surgical intervention of various dentigerous cysts throughout the period of ten years, 2012-2022 and only histologically confirmed cases were selected, at Ramadi Teaching Hospital in addition to Rashid, Razi, Zuhur Private Hospitals and private clinics in Iraq. RESULTS: 76 patients were included in this clinicopathological research. The highest age group affected was ≤ 18 years (68.4%), 54% were male, the mandible was more affected (63.1%) than the maxilla (36.9%). Marsupialization was applied to 30.3% of the cases, while enucleation was carried out in 69.7%. CONCLUSIONS: The significance of meticulous examination of radiographs and the consequences associated with undetected and untreated ailments is affirmed by this case study. A comprehensive understanding of oral pathology serves as a valuable resource for dentists, facilitating accurate diagnosis, appropriate referrals, and the provision of anticipatory guidance to patients striving to achieve optimal oral health across various age groups.


Asunto(s)
Quiste Dentígero , Humanos , Quiste Dentígero/cirugía , Quiste Dentígero/patología , Quiste Dentígero/diagnóstico por imagen , Masculino , Femenino , Adolescente , Adulto , Niño , Adulto Joven , Persona de Mediana Edad , Irak , Estudios Retrospectivos
4.
J Craniofac Surg ; 34(8): 2433-2436, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37646342

RESUMEN

Zygoma is considered the main support of the midface. Zygoma is frequently fractured owing to its prominent site on the face. Treatment of zygomaticomaxillary complex fractures can be performed through either conservative or surgical measures (closed or open reduction). The study was a cross-sectional retrospective observational investigation done at 4 hospitals in Ramadi and Baghdad cities, Iraq. This investigation covered a duration of 6 years (2016-2021). We reviewed the medical records of patients with ZCFs. The participants were divided into 2 groups according to the approach used for their management (direct versus indirect approach). Data regarding the demographic and clinical characteristics were recorded for each subject. Of 265 patients with ZCFs, 209 (78.9%) were males. The highest age group affected was 18 to 40 years (51.7%). The majority of the ZCFs were caused by road traffic accidents (31.7%). Most of the cases belong to single fractures (72.1%). Cheek flattening (73.6%) was the commonest sign of the ZCFs. The majority of the fractures were treated by direct approach, 65.4% of the isolated fractures and 62.2% for multiple fractures. Excellent patient satisfaction was seen in the majority of the cases. There were no statistically significant differences between the 2 approaches regarding the abovementioned variables ( P -value > 0.05). The majority of the cases were with excellent patient satisfaction (n = 149) while only 7 patients with poor satisfaction. The age groups below 18 years and 18 to 40 years were associated with excellent patient satisfaction than good and poor satisfaction. All (n = 7) of the cases with poor satisfaction belong to the age group above 40 years. The majority of male (n = 113) and female (n = 36) patients were with excellent satisfaction, while all patients with poor results were males (n = 7). There were statistically significant differences between the results of the patient satisfaction and age group and complications ( P -value < 0.05). The ophthalmic complications were the most complications seen after ZCF surgical treatment (2.56%). Direct and indirect approaches can be used safely in the treatment of ZCFs owing to excellent patient satisfaction in the majority of the cases and a low complication rate. This study aims to evaluate the demographic and clinical characteristics and to compare different surgical procedures to treat patients with zygomaticomaxillary complex fractures in a country overwhelmed by violence.


Asunto(s)
Fracturas Craneales , Fracturas Cigomáticas , Adolescente , Adulto , Femenino , Humanos , Masculino , Adulto Joven , Estudios Transversales , Fijación Interna de Fracturas/métodos , Estudios Retrospectivos , Fracturas Craneales/complicaciones , Fracturas Cigomáticas/cirugía
5.
Med J Malaysia ; 78(6): 787-792, 2023 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-38031222

RESUMEN

INTRODUCTION: In Malaysia, studies on self-reported bone fractures are scarce. Due to the fact that bone fractures may serve as an indicator of osteoporosis in the community, this study aimed to identify the factors associated with their occurrence among adults in Malaysia. MATERIALS AND METHODS: Epidemiological data for selfreported bone fractures were obtained through direct interviews using a validated questionnaire from the Prospective Urban and Rural Epidemiology (PURE) study. RESULTS: Of 15,378 respondents, 6.63% (n=1019) reported bone fractures, with a higher proportion of men (65.8%, n=671) than women (34.2%, n=348). Higher odds of selfreporting bone fractures were seen in males (aOR, 2.12; 95%CI: 1.69, 2.65), those with a history of injury (aOR 5.01; 95%CI: 3.10, 6.32) and those who were obese (aOR: 1.46; 95% CI: 1.13, 1.89), highly active (aOR 1.25; 95%CI: 1.02, 1.53), smokers (aOR 1.35; 95%CI: 1.11, 1.65) and alcohol consumers (aOR 1.67; 95%CI: 1.20,2.32). CONCLUSION: Adopting a healthier lifestyle that includes a balanced diet and moderate physical activity is critical for weight loss, increased muscle and bone mass and better stability, which reduces the likelihood of fractures following a fall.


Asunto(s)
Fracturas Óseas , Masculino , Humanos , Adulto , Femenino , Autoinforme , Malasia/epidemiología , Estudios Prospectivos , Estudios de Cohortes , Fracturas Óseas/epidemiología , Fracturas Óseas/etiología , Factores de Riesgo
6.
Malays J Pathol ; 45(1): 123-127, 2023 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-37119252

RESUMEN

INTRODUCTION: M-protein secreted by myeloma cells do not only contribute to myeloma-related complications but is also a well-recognised source of interference in laboratory assays. We describe a case of a 62-year-old woman whose blood sample showed improper serum separation even after resampling. CASE REPORT: Centrifugation of a biochemistry specimen in a serum-separator tube received by the laboratory failed to separate any serum, nor did repeating the process at a longer duration. Repeat sampling only yielded a small volume of serum from which highly elevated total protein was noted upon analysis. Additional history from the treating clinician unveiled a diagnosis of multiple myeloma in this patient. DISCUSSION: This case represents one of the rare, but significant pre-analytical interferences caused by M-proteins.


Asunto(s)
Mieloma Múltiple , Femenino , Humanos , Persona de Mediana Edad , Manejo de Especímenes , Recolección de Muestras de Sangre
7.
Neurosurg Focus ; 51(1): E8, 2021 07.
Artículo en Inglés | MEDLINE | ID: mdl-34198244

RESUMEN

OBJECTIVE: Acute basilar artery occlusion (BAO) is a rare large-vessel occlusion associated with high morbidity and mortality. Modern thrombectomy with stent retrievers and large-bore aspiration catheters is highly effective in achieving recanalization, but a direct comparison of different techniques for acute BAO has not been performed. Therefore, the authors sought to compare the technical effectiveness and clinical outcomes of stent retriever-assisted aspiration (SRA), aspiration alone (AA), and a stent retriever with or without manual aspiration (SR) for treatment of patients presenting with acute BAO and to evaluate predictors of clinical outcome in their cohort. METHODS: A retrospective analysis of databases of large-vessel occlusion treated with endovascular intervention at two US endovascular neurosurgery centers was conducted. Patients ≥ 18 years of age with acute BAO treated between January 2013 and December 2020 with stent retrievers or large-bore aspiration catheters were included in the study. Demographic information, procedural details, angiographic results, and clinical outcomes were extracted for analysis. RESULTS: Eighty-three patients (median age 67 years [IQR 58-76 years]) were included in the study; 33 patients (39.8%) were female. The median admission National Institutes of Health Stroke Scale (NIHSS) score was 16 (IQR 10-21). Intravenous alteplase was administered to 26 patients (31.3%). The median time from symptom onset to groin or wrist puncture was 256 minutes (IQR 157.5-363.0 minutes). Overall, successful recanalization was achieved in 74 patients (89.2%). The SRA technique had a significantly higher rate of modified first-pass effect (mFPE; 55% vs 31.8%, p = 0.032) but not true first-pass effect (FPE; 45% vs 34.9%, p = 0.346) than non-SRA techniques. Good outcome (modified Rankin Scale [mRS] score 0-2) was not significantly different among the three techniques. Poor outcome (mRS score 3-6) was associated with a higher median admission NIHSS score (12.5 vs 19, p = 0.007), a higher rate of adjunctive therapy usage (9% vs 0%, p < 0.001), and a higher rate of intraprocedural complications (10.7% vs 14.5%, p = 0.006). The admission NIHSS score significantly predicted good outcome (OR 0.98, 95% CI 0.97-0.099; p = 0.032). Incomplete recanalization after thrombectomy significantly predicted mortality (OR 1.68, 95% CI 1.18-2.39; p = 0.005). CONCLUSIONS: The evaluated techniques resulted in high recanalization rates. The SRA technique was associated with a higher rate of mFPE than AA and SR, but the clinical outcomes were similar. A lower admission NIHSS score predicted a better prognosis for patients, whereas incomplete recanalization after thrombectomy predicted mortality.


Asunto(s)
Procedimientos Endovasculares , Accidente Cerebrovascular , Anciano , Arteria Basilar/diagnóstico por imagen , Arteria Basilar/cirugía , Femenino , Humanos , Estudios Retrospectivos , Stents , Accidente Cerebrovascular/diagnóstico por imagen , Accidente Cerebrovascular/cirugía , Trombectomía , Resultado del Tratamiento
8.
Med J Malaysia ; 76(3): 417-418, 2021 05.
Artículo en Inglés | MEDLINE | ID: mdl-34031343

RESUMEN

Fertility preservation is significant for oncology patients to maintain their ability to start a family when they are ready. Onco-fertility, as a discipline, exists at the intersection of oncology and reproductive medicine that safeguards and expands the fertility options for cancer survivors, by facilitating early intervention and suitable treatment with favourable outcomes. Successful fertility preservation requires a comprehensive networking among the gynaecologists, oncologists, pathologists, imaging and other specialists, involved in diagnosing and treating cancer in the reproductive age group. There are several ways in which fertility can be preserved, like role of gonadotrophin releasing hormone analogues, in vitro maturation, and cryopreservation.


Asunto(s)
Preservación de la Fertilidad , Neoplasias , Criopreservación , Fertilidad , Humanos , Malasia , Neoplasias/terapia
9.
Neurosurg Focus ; 49(5): E15, 2020 11.
Artículo en Inglés | MEDLINE | ID: mdl-33130627

RESUMEN

The proportion of neurosurgeons facing a malpractice suit each year is highest among all medical and surgical specialties. It is critical for neurosurgeons to understand local malpractice laws because they vary among states. Sovereign immunity, as described in the 11th constitutional amendment, provides absolute immunity to states from being sued by their residents and by other states. A state may waive its sovereign immunity, however, and substitute itself as the defendant in place of a state-employed physician in the court of law. This means that a physician working for a state-funded hospital may not be liable to a malpractice suit. Further provisions of the law allow the state not to pay indemnity beyond a certain limit, which discourages plaintiff attorneys from pursuing indemnity charges against physicians working for state-funded institutions. In this review, the authors describe the concept of sovereign immunity and its implications for the practice of neurosurgery.


Asunto(s)
Mala Praxis , Neurocirugia , Médicos , Humanos , Neurocirujanos , Estados Unidos
10.
Acta Neurochir (Wien) ; 162(6): 1353-1362, 2020 06.
Artículo en Inglés | MEDLINE | ID: mdl-32215742

RESUMEN

BACKGROUND: There is wide variation in the reported size of ruptured intracranial aneurysms and methods of size estimation. There is widespread belief that small aneurysms < 7 mm do not rupture. Therefore, we performed a systematic review and meta-analysis of the literature to determine the size of ruptured aneurysms according to aneurysm locations and methods of size estimation. METHODS: We searched PubMed, Cochrane, CINAHL, and EMBASE databases using a combination of Medical Subject Headings (MeSH) terms. We included articles that reported mean aneurysm size in consecutive series of ruptured intracranial. We excluded studies limited to a specific aneurysm location or type. The random-effects model was used to calculate overall mean size and location-specific mean size. We performed meta-regression to explain observed heterogeneity and variation in reported size. RESULTS: The systematic review included 36 studies and 12,609 ruptured intracranial aneurysms. Overall mean aneurysm size was 7.0 mm (95% confidence interval [CI 6.2-7.4]). Pooled mean size varied with location. Overall mean size of 2145 ruptured anterior circulation aneurysms was 6.0 mm (95% CI 5.6-6.4, residual I2 = 86%). Overall mean size of 743 ruptured posterior circulation aneurysms was 6.2 mm (95% CI 5.3-7.0, residual I2 = 93%). Meta-regression identified aneurysm location and definition of size (i.e., maximum dimension vs. aneurysm height) as significant determinants of aneurysm size reported in the studies. CONCLUSIONS: The mean size of ruptured aneurysms in most studies was approximately 7 mm. The general wisdom that aneurysms of this size do not rupture is incorrect. Location and size definition were significant determinants of aneurysm size.


Asunto(s)
Aneurisma Roto/patología , Aneurisma Intracraneal/patología , Anciano , Aneurisma Roto/epidemiología , Femenino , Humanos , Aneurisma Intracraneal/complicaciones , Masculino , Persona de Mediana Edad
11.
J Stroke Cerebrovasc Dis ; 29(2): 104504, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31761735

RESUMEN

BACKGROUND: Accurate assessment of the frequency of large vessel occlusion (LVO) is important to determine needs for neurointerventionists and thrombectomy-capable stroke facilities. Current estimates vary from 13% to 52%, depending on acute ischemic stroke (AIS) definition and methods for AIS and LVO determination. We sought to estimate LVO prevalence among confirmed and suspected AIS patients at 2 comprehensive US stroke centers using a broad occlusion site definition: internal carotid artery (ICA), first and second segments of the middle cerebral artery (MCA M1,M2), the anterior cerebral artery, vertebral artery, basilar artery, or the proximal posterior cerebral artery. METHODS: We analyzed prospectively maintained stroke databases of patients presenting to the centers between January and December 2017. ICD-10 coding was used to determine the number of patients discharged with an AIS diagnosis. Computed tomography angiography (CTA) or magnetic resonance angiography (MRA) was reviewed to determine LVO presence and site. Percentages of patients with LVO among the confirmed AIS population were reported. RESULTS: Among 2245 patients with an AIS discharge diagnosis, 418 (18.6%:95% confidence interval [CI] 17.3%-20.0%) had LVO documented on CTA or MRA. Most common occlusion site was M1 (n=139 [33.3%]), followed by M2 (n=114 [27.3%]), ICA (n=69[16.5%]), and tandem ICA-MCA lesions (n=44 [10.5%]). Presentation National Institutes of Health Stroke Scale scores were significantly different for different occlusion sites (P=.02). CONCLUSIONS: The LVO prevalence in our large series of consecutive AIS patients was 18.6% (95% CI 17.3%-20.0%). Despite the use of a broad definition, this estimate is less than that reported in most previous studies.


Asunto(s)
Arteria Carótida Interna/diagnóstico por imagen , Estenosis Carotídea/epidemiología , Infarto de la Arteria Cerebral Anterior/epidemiología , Infarto de la Arteria Cerebral Media/epidemiología , Insuficiencia Vertebrobasilar/epidemiología , Anciano , Anciano de 80 o más Años , Arteria Cerebral Anterior/diagnóstico por imagen , Arteria Cerebral Anterior/fisiopatología , Arteria Basilar/diagnóstico por imagen , Arteria Basilar/fisiopatología , Arteria Carótida Interna/fisiopatología , Estenosis Carotídea/diagnóstico por imagen , Estenosis Carotídea/fisiopatología , Angiografía Cerebral/métodos , Circulación Cerebrovascular , Angiografía por Tomografía Computarizada , Bases de Datos Factuales , Femenino , Humanos , Infarto de la Arteria Cerebral Anterior/diagnóstico por imagen , Infarto de la Arteria Cerebral Anterior/fisiopatología , Infarto de la Arteria Cerebral Media/diagnóstico por imagen , Infarto de la Arteria Cerebral Media/fisiopatología , Angiografía por Resonancia Magnética , Masculino , Persona de Mediana Edad , Arteria Cerebral Media/diagnóstico por imagen , Arteria Cerebral Media/fisiopatología , Valor Predictivo de las Pruebas , Prevalencia , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Estados Unidos/epidemiología , Arteria Vertebral/diagnóstico por imagen , Arteria Vertebral/fisiopatología , Insuficiencia Vertebrobasilar/diagnóstico por imagen , Insuficiencia Vertebrobasilar/fisiopatología
12.
J Stroke Cerebrovasc Dis ; 29(7): 104836, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-32414581

RESUMEN

INTRODUCTION: Effectiveness of mechanical thrombectomy for mild-deficit stroke due to large-vessel occlusion is controversial. We present a single-center consecutive case series on thrombectomy for large-vessel occlusion mild stroke. We evaluated various thrombectomy parameters to better understand disagreement in the literature. METHODS: Data from a retrospective cohort of large-vessel occlusion mild stroke patients (National Institutes of Health Stroke Scale <6) treated with mechanical thrombectomy over 6 years and 2 months were analyzed. Patients were divided into 2 groups: successful reperfusion (modified Thrombolysis in Cerebral Infarction 2b or 3) and failed reperfusion (modified Thrombolysis in Cerebral Infarction 0,1, or 2a). Ninety-day modified Rankin Scale in-hospital mortality, and symptomatic hemorrhage rates were compared between groups. Multivariate logistic regression was performed to evaluate reperfusion status as a predictor of 90-day favorable (modified Rankin Scale 0-2) and excellent (modified Rankin Scale 0-1) outcomes. RESULTS: We identified 61 patients with large-vessel occlusion mild stroke who underwent thrombectomy. Reperfusion was successful in 49 patients and a failure in 12. The successful group exhibited significantly higher rates of favorable outcome (83.7% vs. 25.0%; p < 0.001) and excellent outcome (69.4% vs.16.7%; p = 0.002) at 90 days. In-hospital mortality was significantly higher in the failure group (41.7% vs.10.2%; p = 0.019). Multivariate logistic regression identified successful reperfusion as a significant predictor (p = 0.001) of 90-day favorable outcome. CONCLUSION: Reperfusion success was significantly associated with improved functional outcomes in large-vessel occlusion mild stroke mechanical thrombectomy. Future studies should consider reperfusion rates when evaluating the effectiveness of thrombectomy against that of medical management in these patients.


Asunto(s)
Isquemia Encefálica/terapia , Circulación Cerebrovascular , Procedimientos Endovasculares , Accidente Cerebrovascular/terapia , Trombectomía , Anciano , Anciano de 80 o más Años , Isquemia Encefálica/diagnóstico , Isquemia Encefálica/mortalidad , Isquemia Encefálica/fisiopatología , Evaluación de la Discapacidad , Procedimientos Endovasculares/efectos adversos , Procedimientos Endovasculares/mortalidad , Femenino , Mortalidad Hospitalaria , Humanos , Masculino , Persona de Mediana Edad , Recuperación de la Función , Estudios Retrospectivos , Medición de Riesgo , Factores de Riesgo , Accidente Cerebrovascular/diagnóstico , Accidente Cerebrovascular/mortalidad , Accidente Cerebrovascular/fisiopatología , Trombectomía/efectos adversos , Trombectomía/mortalidad , Factores de Tiempo , Resultado del Tratamiento
13.
Prostate ; 75(3): 255-65, 2015 Feb 15.
Artículo en Inglés | MEDLINE | ID: mdl-25327758

RESUMEN

BACKGROUND: Accumulating evidence suggests that chronic prostatic inflammation may lead to prostate cancer development. Growth differentiation factor-15 (GDF-15) is highly expressed in the prostate and has been associated with inflammation and tumorigenesis. METHODS: To examine the relationship between GDF-15 and prostatic inflammation, GDF-15 expression was measured by immunohistochemical (IHC) staining in human prostatectomy specimens containing inflammation. The relationship between GDF-15 and specific inflammatory cells was determined using non-biased computer image analysis. To provide insight into a potential suppressive role for GDF-15 in inflammation, activation of inflammatory mediator nuclear factor of kappa B (NFκB) was measured in PC3 cells. RESULTS: GDF-15 expression in luminal epithelial cells was decreased with increasing inflammation severity, suggesting an inverse association between GDF-15 and inflammation. Quantification of IHC staining by image analysis for GDF-15 and inflammatory cell markers revealed an inverse correlation between GDF-15 and CD3+, CD4+, CD8+, CD68+, and inos+ leukocytes. GDF-15 suppressed NFκB activity in luciferase reporter assays. Expression of the NFκB target, interleukin 8 (IL-8), was downregulated by GDF-15. CONCLUSIONS: The inverse relationship between GDF-15 and inflammation demonstrates a novel expression pattern for GDF-15 in the human prostate and suppression of NFκB activity may shed light on a potential mechanism for this inverse correlation.


Asunto(s)
Factor 15 de Diferenciación de Crecimiento/metabolismo , FN-kappa B/metabolismo , Próstata/metabolismo , Prostatitis/metabolismo , Antígenos CD/metabolismo , Atrofia/metabolismo , Atrofia/patología , Humanos , Masculino , Próstata/patología , Prostatitis/patología
15.
J Endocrinol Invest ; 38(10): 1111-5, 2015 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-25952300

RESUMEN

PURPOSE: Metabolically obese but normal weight (MONW) is associated with higher risk of type 2 diabetes, dyslipidemia, and hypertension. The aim of this study was to evaluate the association of metabolic syndrome components with MONW in each sex in Iranian population. METHODS: This cross-sectional study was performed on 417 normal weight subjects in Qazvin, Iran between September 2010 and April 2011. MONW was defined by insulin resistance (IR) using the homeostatic model assessment (HOMA). Cut off point for IR was defined as the lower limit of top quintile of HOMA-IR values in normal weight population without any metabolic risk factors. Data were analyzed using T test, Mann-Whitney U test, and multi-variant logistic regression analysis. RESULTS: Of 417 subjects, 44.3 % were female. The prevalence of MONW was 33.8 % in men and 39.8 % in women. Triglycerides levels were significantly higher in both men and women with MONW. Waist circumference was significantly higher in men with MONW, while high-density lipoprotein cholesterol levels were significantly lower in women with MONW. In logistic regression analysis, hypertriglyceridemia in women (OR 3.398; 95 % CI 1.306-8.846) and waist circumference (per 5 cm increment) in men (OR 1.653; 95 % CI 1.279-2.136) had independent association with MONW. CONCLUSION: Association of metabolic syndrome components with MONW is different in men and women. Waist circumference had an independent association with IR in men but not in women. IR and its complications should be considered in lean women with hypertriglyceridemia.


Asunto(s)
Peso Corporal/fisiología , Diabetes Mellitus Tipo 2/fisiopatología , Resistencia a la Insulina/fisiología , Síndrome Metabólico/fisiopatología , Obesidad/fisiopatología , Circunferencia de la Cintura/fisiología , Adulto , Anciano , Índice de Masa Corporal , Estudios Transversales , Femenino , Humanos , Hipertrigliceridemia/fisiopatología , Masculino , Persona de Mediana Edad , Factores de Riesgo , Adulto Joven
16.
Clin Exp Obstet Gynecol ; 42(1): 101-3, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-25864292

RESUMEN

Placenta percreta detected in the first trimester is a very rare condition. It is a known obstetric condition leading to serious maternal morbidity and mortality. High index of clinical suspicion and anticipation of placenta percreta is highly essential in early pregnancy as it is difficult to diagnose. The authors report on a patient who presented with heavy pervaginal bleeding in week 9 of pregnancy. Pelvic examination showed a 12-week sized uterus. Ultrasonography revealed a non-viable fetus. The subsequent emergency curettage performed was complicated by massive haemorrhage which required an abdominal hysterectomy performed as a life-saving procedure.


Asunto(s)
Pérdida de Sangre Quirúrgica , Dilatación y Legrado Uterino/efectos adversos , Histerectomía/métodos , Placenta Accreta , Hemorragia Uterina/cirugía , Adulto , Volumen Sanguíneo , Dilatación y Legrado Uterino/métodos , Femenino , Humanos , Placenta Accreta/diagnóstico , Placenta Accreta/fisiopatología , Placenta Accreta/cirugía , Embarazo , Primer Trimestre del Embarazo , Resultado del Tratamiento , Ultrasonografía , Hemorragia Uterina/etiología , Útero/diagnóstico por imagen , Útero/cirugía
17.
Br J Surg ; 106(7): 949-950, 2019 06.
Artículo en Inglés | MEDLINE | ID: mdl-31162667
19.
Sci Rep ; 14(1): 2804, 2024 02 02.
Artículo en Inglés | MEDLINE | ID: mdl-38307930

RESUMEN

This work aimed at tailoring of different properties of antibacterial drug delivery Ca-phosphate cements by incorporation of bioactive glass (BG). The cements were prepared from beta-tricalcium phosphate cement (ß-TCP) and BG based on 50 SiO2-20 CaO-15 Na2O-7 B2O3-4 P2O5-4 Al2O3 wt% with different percentages of BG [5, 10, 15, and 20% (w/w)]. The composite cements were characterized by XRD, FTIR, and TEM. Moreover, in vitro bioactivity and biodegradation were evaluated in the simulated body fluid (SBF) at 37 °C. In addition, physical properties and mechanical strength were determined. Also, the effect of glass addition on the drug release profile was examined using gentamicin. Finally, the antimicrobial activity was studied against Staphylococcus aureus, Pseudomonas aeruginosa, and Klebsiella pneumonia bacteria, one unicellular fungal strain (Candida albicans), and one multicellular fungal strain (Mucor racemosus). The results showed that after soaking in SBF, the compression strength values ranged from 14 to 36 MPa, the bulk densities and porosities were within 1.35 to 1.49 g/cm3 and 51.3 to 44.71%, respectively. Furthermore, gentamicin was released in a sustained manner, and BG decreased the released drug amount from ~ 80% (in pure ß-TCP) to 47-53% in the composite cements. A drug release profile that is sustained by all samples was achieved. The antimicrobial test showed good activity of gentamicin-conjugated cements against bacteria and fungi used in this study. Additionally, cytotoxicity results proved that all samples were safe on MG-63 cells up to 50 µg/mL with no more than 7-12% dead cells. From the view of the physico-mechanical properties, bioactivity, biodegradation, and drug release rate, 20BG/ß-TCP sample was nominated for practical bone grafting material, where it showed appropriate setting time and a relatively high mechanical strength suitable for cancellous bone.


Asunto(s)
Antibacterianos , Cementos para Huesos , Cementos para Huesos/farmacología , Antibacterianos/farmacología , Dióxido de Silicio , Fosfatos de Calcio , Vidrio , Gentamicinas/farmacología , Ensayo de Materiales
20.
Sci Rep ; 14(1): 18417, 2024 Aug 08.
Artículo en Inglés | MEDLINE | ID: mdl-39117707

RESUMEN

The study describes the successful development of a TiO2 ceramic substrate with a protective nano-Al2O3 coating using two different coating techniques: microwave combustion and polymeric methods. The coated ceramics demonstrate enhanced corrosion resistance compared to the uncoated substrate. The optimal TiO2 substrate was prepared by firing it at 1000 °C. This was done to give the desired physical properties of the TiO2 substrate for the coating procedures. Nano-Al2O3 powder was coated onto the surface of the TiO2 substrates. The TiO2 substrates with the Al2O3 coating were then calcined (heat-treated) at 800 and 1000 °C. The structures, morphology, phase composition, apparent porosity, bulk density, and compressive strength of the substrate and coated substrate were characterized. Upon firing at 1000 °C, it was discovered that the two phases of TiO2-rutile and anatase-combine in the substrate. Once the substrate has been coated with nano Al2O3 at 1000 °C, the anatase is transferred into rutile. When compared to the substrate, the coated substrate resulted in a decrease in porosity and an increase in strength. The efficiency of the ceramic metal nanoparticles Al2O3 as a good coating material to protect the TiO2 substrates against the effect of the corrosive medium 0.5 M solution of H2SO4 was measured by two methods: potentio-dynamic polarization (PDP) and the electrochemical impedance spectroscopy (EIS). The results indicated that the corrosion rate was decreased after the substrate coated with alumina from (67.71 to 16.30 C.R. mm/year) and the percentage of the inhibition efficiency recorded a high value reaching (78.56%). The surface morphology and composition after electrochemical measurements are investigated using SEM and EDX analysis. After conducting the corrosion tests and all the characterization, the results indicated that the coated TiO2 substrate prepared by the polymeric method at 800 °C displayed the best physical, mechanical, and corrosion-resistant behavior.

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