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1.
Zhongguo Yi Liao Qi Xie Za Zhi ; 44(1): 20-23, 2020 Jan 08.
Artigo em Chinês | MEDLINE | ID: mdl-32343060

RESUMO

OBJECTIVE: Identifying Atrial Ventricular Hypertrophy Electrocardiogram (AVH ECG)and diagnosing the classification of theirs automatically. METHODS: The ECG data used in this experiment was collected from the First Affiliated Hospital of China Medical University. CNN are combined with conventional methods and a 10 layers of one dimensional CNN are created in this experiment to extract the features of ECG signals automatically and achieve the function of classifying. ROC, sensitivity and F1-score are used here to evaluate the effects of the model. RESULTS: In the experiment of identifying AVH ECG, the AUC of test dataset is 0.991, while in the experiment of classifying AVH ECG, the maximal F1-score can reach 0.992. CONCLUSIONS: The CNN model created in this experiment can achieve the auxiliary diagnosis of AVH ECG.


Assuntos
Eletrocardiografia , Átrios do Coração/patologia , Redes Neurais de Computação , China , Humanos , Hipertrofia
2.
Mod Pathol ; 33(6): 1007-1014, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32291399

RESUMO

Data on pathologic changes of the 2019 novel coronavirus disease (COVID-19) are scarce. To gain knowledge about the pathology that may contribute to disease progression and fatality, we performed postmortem needle core biopsies of lung, liver, and heart in four patients who died of COVID-19 pneumonia. The patients' ages ranged from 59 to 81, including three males and one female. Each patient had at least one underlying disease, including immunocompromised status (chronic lymphocytic leukemia and renal transplantation) or other conditions (cirrhosis, hypertension, and diabetes). Time from disease onset to death ranged from 15 to 52 days. All patients had elevated white blood cell counts, with significant rise toward the end, and all had lymphocytopenia except for the patient with leukemia. Histologically, the main findings are in the lungs, including injury to the alveolar epithelial cells, hyaline membrane formation, and hyperplasia of type II pneumocytes, all components of diffuse alveolar damage. Consolidation by fibroblastic proliferation with extracellular matrix and fibrin forming clusters in airspaces is evident. In one patient, the consolidation consists of abundant intra-alveolar neutrophilic infiltration, consistent with superimposed bacterial bronchopneumonia. The liver exhibits mild lobular infiltration by small lymphocytes, and centrilobular sinusoidal dilation. Patchy necrosis is also seen. The heart shows only focal mild fibrosis and mild myocardial hypertrophy, changes likely related to the underlying conditions. In conclusion, the postmortem examinations show advanced diffuse alveolar damage, as well as superimposed bacterial pneumonia in some patients. Changes in the liver and heart are likely secondary or related to the underlying diseases.


Assuntos
Infecções por Coronavirus/patologia , Fígado/patologia , Pulmão/patologia , Miocárdio/patologia , Pneumonia Viral/patologia , Idoso , Idoso de 80 Anos ou mais , Autopsia , Biópsia com Agulha de Grande Calibre , China , Infecções por Coronavirus/complicações , Feminino , Fibrose , Humanos , Hipertrofia , Imuno-Histoquímica , Leucemia Linfocítica Crônica de Células B/complicações , Leucemia Linfocítica Crônica de Células B/patologia , Contagem de Leucócitos , Pulmão/diagnóstico por imagem , Linfopenia/patologia , Linfopenia/virologia , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/complicações , Radiografia , Reação em Cadeia da Polimerase em Tempo Real , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Tomografia Computadorizada por Raios X
3.
J Laryngol Otol ; 134(4): 323-327, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32241312

RESUMO

OBJECTIVE: The nasal septal swell body is a normal anatomical structure located in the superior nasal septum anterior to the middle turbinate. However, the impact of the septal swell body in nasal breathing during normal function and disease remains unclear. This study aimed to establish that the septal swell body varies in size over time and correlates this with the natural variation of the inferior turbinates. METHOD: Consecutive patients who underwent at least two computed tomography scans were identified. The width and height of the septal swell body and the inferior turbinates was recorded. A correlation between the difference in septal swell body and turbinates between the two scans was performed using a Pearson's coefficient. RESULTS: A total of 34 patients (53 per cent female with a mean age of 58.3 ± 20.2 years) were included. The mean and mean difference in septal swell body width between scans for the same patient was 1.57 ± 1.00 mm. The mean difference in turbinate width between scans was 2.23 ± 2.52 mm. A statistically significant correlation was identified between the difference in septal swell body and total turbinate width (r = 0.35, p = 0.04). CONCLUSION: The septal swell body is a dynamic structure that varies in width over time in close correlation to the inferior turbinates. Further research is required to quantify its relevance as a surgical area of interest.


Assuntos
Obstrução Nasal/patologia , Septo Nasal/diagnóstico por imagem , Rinite/patologia , Conchas Nasais/diagnóstico por imagem , Adulto , Idoso , Austrália/epidemiologia , Feminino , Humanos , Hipertrofia , Masculino , Pessoa de Meia-Idade , Obstrução Nasal/etiologia , Obstrução Nasal/terapia , Septo Nasal/patologia , Seios Paranasais/diagnóstico por imagem , Osso Petroso/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Conchas Nasais/patologia
5.
PLoS One ; 15(3): e0228653, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32160187

RESUMO

Current efforts to improve muscle performance are focused on muscle trophism via inhibition of the myostatin pathway: however they have been unsuccessful in the clinic to date. In this study, a novel protein has been created by combining the soluble activin receptor, a strong myostatin inhibitor, to the C-terminal agrin nLG3 domain (ActR-Fc-nLG3) involved in the development and maintenance of neuromuscular junctions. Both domains are connected via the constant region of an Igg1 monoclonal antibody. Surprisingly, young male mice treated with ActR-Fc-nLG3 showed a remarkably increased endurance in the rotarod test, significantly longer than the single domain compounds ActR-Fc and Fc-nLG3 treated animals. This increase in endurance was accompanied by only a moderate increase in body weights and wet muscle weights of ActR-Fc-nLG3 treated animals and were lower than expected. The myostatin inhibitor ActR-Fc induced, as expected, a highly significant increase in body and muscle weights compared to control animals and ActR-Fc-nLG3 treated animals. Moreover, the prolonged endurance effect was not observed when ActR-Fc and Fc-nLG3 were dosed simultaneously as a mixture and the body and muscle weights of these animals were very similar to ActR-Fc treated animals, indicating that both domains need to be on one molecule. Muscle morphology induced by ActR-Fc-nLG3 did not appear to be changed however, close examination of the neuromuscular junction showed significantly increased acetylcholine receptor surface area for ActR-Fc-nLG3 treated animals compared to controls. This result is consistent with published observations that endurance training in rats increased acetylcholine receptor quantity at neuromuscular junctions and provide evidence that improving nerve-muscle interaction could be an important factor for sustaining long term muscle activity.


Assuntos
Peso Corporal/efeitos dos fármacos , Músculo Esquelético/efeitos dos fármacos , Miostatina/antagonistas & inibidores , Condicionamento Físico Animal/fisiologia , Resistência Física/efeitos dos fármacos , Proteínas Recombinantes/farmacologia , Animais , Linhagem Celular , Hipertrofia , Masculino , Camundongos , Camundongos Endogâmicos C57BL
6.
Wiad Lek ; 73(1): 156-160, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32124827

RESUMO

OBJECTIVE: The aim: To compare the content of α and γ-interferons, interleukins 1ß ,4, 10, IgA, IgG, as well as the level of the general forms of immune complexes in tissue extracts from tonsils of children with hypertrophy and chronic tonsillitis. RESULTS: Results: In tissue extracts from tonsils with CT, there is a predominance of inflammation factors, potential sensitization, and the development of immunopathological reactions. The presence of inflammation is indicated by elevated levels of interleukin-1ß, immunoglobulin G. High levels of interleukin-4 may indicate that both HPT and CT have a tendency to increase sensitization to microbial and other antigens. CONCLUSION: Conclusion: The results indicate a significant difference in the qualitative and quantitative state of inflammation factors and allergy in case of HPT and CT. In tonsils with CT, there predominate both simple and allergic inflammations, as well as immunopathological reactions.


Assuntos
Tonsila Palatina , Tonsilite , Criança , Pré-Escolar , Citocinas , Humanos , Hipertrofia , Imunoglobulinas , Extratos de Tecidos
7.
Medicine (Baltimore) ; 99(10): e19329, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32150069

RESUMO

Sleep-disordered breathing symptoms may recur in some children after successful adenoidectomy. A potential etiology that warrants consideration is torus tubarius hypertrophy (TTH) as well as residual or recurrent adenoid hypertrophy. Here, we report our experience and the treatment outcomes with microscopic coblator-assisted partial resection of TTH.Seven children who had undergone coblator-assisted partial resection of TTH under microscopy from April 2000 through January 2017 were retrospectively reviewed. The patient age at the time of initial adenotonsillectomy and the interval between the first operation and partial resection of TTH were identified. Lateral cephalometry and scores on the Korean version of the obstructive sleep apnea-18 (KOSA-18) questionnaire were reviewed.The median age at the time of the first operation was 3.0 years and the average time interval between the first operation and subsequent tubal tonsillectomy was 44.0 months. The average width between the torus tubarius was 2.1 mm preoperatively. Symptoms of sleep-disordered breathing were relieved in all patients after operation. Preoperative and postoperative KOSA-18 scores were 73.5 and 35.5, respectively (P = .024). On polysomnography, the preoperative and postoperative apnea-hypopnea index scores were 22.9 and 4.7, respectively (P = .068). The patients were followed up for an average of 1.3 years. One patient developed a recurrence of symptoms and underwent a revision operation. Complications such as bleeding and nasopharyngeal stenosis were not observed.Otorhinolaryngologists should keep TTH in mind as one of the differential diagnoses for recurrent upper airway obstruction symptoms after adenoidectomy. Microscopic coblator-assisted partial resection of TTH is likely to be safe and effective.


Assuntos
Tonsila Faríngea/cirurgia , Ronco/cirurgia , Resultado do Tratamento , Estudos de Casos e Controles , Pré-Escolar , Humanos , Hipertrofia , Lactente , Masculino , República da Coreia , Estudos Retrospectivos , Síndromes da Apneia do Sono/etiologia , Síndromes da Apneia do Sono/cirurgia , Ronco/etiologia , Inquéritos e Questionários
9.
Surgery ; 167(6): 917-923, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32014304

RESUMO

BACKGROUND: To assess the safety and efficacy of liver venous deprivation (simultaneous hepatic vein embolization with portal vein embolization) compared with portal vein embolization alone before major hepatectomy in patients with small future liver remnant. METHODS: We assessed all consecutive patients who underwent ipsilateral liver venous deprivation before major hepatectomy (>4 Couinaud's segments) at the University Hospital Lausanne from 2016 to 2018. Postembolization, volumetric analysis after liver venous deprivation and postoperative outcomes were compared with patients who underwent portal vein embolization alone (portal vein embolization group) from 2010 to 2016. RESULTS: During the study period, 21 patients underwent liver venous deprivation and 39 portal vein embolization alone. In the liver venous deprivation versus portal vein embolization groups, dropout rate owing to disease progression was 1 of 21 vs 9 of 39 (P = .053). There were no per procedural complications after liver venous deprivation and no difference in the postoperative outcomes. Future liver remnant hypertrophy was greater in the liver venous deprivation group (median 135%, interquartile range: 123%-154%) than in the portal vein embolization group (median 124%, interquartile range: 107%-140%) at a median time of 22 days after liver venous deprivation vs 26 days after portal vein embolization (P = .034). The median kinetic growth rate was also greater (2.9%/week, interquartile range: 1.9-4.3% vs 1.4%/week, interquartile range: 0.7-2.1%; P < .001). CONCLUSION: Ipsilateral liver venous deprivation before major hepatectomy is safe and seems to induce a greater and faster future liver remnant hypertrophy than after portal vein embolization alone. More data are needed to analyze the impact of liver venous deprivation on tumor growth.


Assuntos
Embolização Terapêutica , Hepatectomia , Veias Hepáticas , Hipertrofia , Fígado/patologia , Veia Porta , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Fígado/diagnóstico por imagem , Testes de Função Hepática , Neoplasias Hepáticas/cirurgia , Regeneração Hepática , Masculino , Pessoa de Meia-Idade , Cuidados Pré-Operatórios , Tomografia Computadorizada por Raios X
10.
Plast Reconstr Surg ; 145(3): 499e-506e, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32097298

RESUMO

BACKGROUND: Breast reduction mammaplasty is a common plastic surgery operation. Although many contemporary surgeons provide breast reduction mammaplasty as an outpatient procedure, roughly 15 percent of patients are still observed postoperatively. The authors hypothesize that observation confers no safety benefit but engenders significant cost. METHODS: The authors reviewed cases of breast reduction mammaplasty in a commercial database and formulated three propensity score-matched cohorts: inpatient, 23-hour observation, and outpatient. Comparisons were made between inpatients and outpatients and between 23-hour observation patients and outpatients. The primary outcome variable was 14-day re-presentation rate to the emergency department or readmission. Financial data were also collected. RESULTS: Comparison of inpatients and outpatients included 1237 patients each (n = 2474 total patients). The 23-hour observation-outpatient comparison included 8153 patients each (n = 16,306 total patients). For inpatients versus outpatients, the 14-day re-presentation rate was 1.4 percent for inpatients and 0.3 percent for outpatients (p < 0.01). The overall surgical complication rate was higher for inpatients (7.8 percent) than for outpatients (4.9 percent) (p < 0.01). Comparing outpatients to 23-hour observation patients, the 14-day re-presentation rate was similar (0.5 percent observation versus 0.3 percent outpatient; p = 0.10). The complication rate was higher for 23-hour observation patients (4.8 percent) than for outpatients (3.2 percent) (p < 0.01). When compared with outpatients (median, $9077), inpatients (median, $19,975) generated $10,898 more in costs. Similarly, 23-hour observation patients (median, $12,451) generated $4050 more in costs than outpatients (median, $8401) (p < 0.01). CONCLUSIONS: Outpatient breast reduction mammaplasty is equally safe when compared to observation or admission. Non-outpatient breast reduction mammaplasty had median costs of 148 to 220 percent that of outpatient breast reduction mammaplasty. In an era of cost consciousness, ambulatory reduction mammaplasty may offer a relatively simple method of decreasing expenditures. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.


Assuntos
Procedimentos Cirúrgicos Ambulatórios/economia , Mama/anormalidades , Hipertrofia/cirurgia , Mamoplastia/economia , Cuidados Pós-Operatórios/economia , Complicações Pós-Operatórias/epidemiologia , Demandas Administrativas em Assistência à Saúde/estatística & dados numéricos , Adulto , Procedimentos Cirúrgicos Ambulatórios/efeitos adversos , Procedimentos Cirúrgicos Ambulatórios/métodos , Mama/cirurgia , Estudos de Coortes , Análise Custo-Benefício , Bases de Dados Factuais/estatística & dados numéricos , Feminino , Custos de Cuidados de Saúde/estatística & dados numéricos , Humanos , Tempo de Internação/economia , Tempo de Internação/estatística & dados numéricos , Masculino , Mamoplastia/efeitos adversos , Mamoplastia/métodos , Pessoa de Meia-Idade , Readmissão do Paciente/economia , Readmissão do Paciente/estatística & dados numéricos , Cuidados Pós-Operatórios/métodos , Cuidados Pós-Operatórios/estatística & dados numéricos , Complicações Pós-Operatórias/economia , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/prevenção & controle , Pontuação de Propensão , Fatores de Tempo , Estados Unidos/epidemiologia
11.
J Assoc Physicians India ; 68(2): 83-84, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32009371

RESUMO

Objective: To describe an unusual case of bilateral masseter and pterygoid muscle hypertrophy. Clinical Presentation and Intervention: A 23-year-old male patient presented with a bilateral, painless swelling of 1 year duration at the parotid areas without improvement after using antibiotics/systemic corticosteroids/non steroidal anti-inflammatory agents. His medical history was not significant. The initial differential diagnosis included salivary gland/jaw bone/masseter pathology, but the MRI revealed only an increase in the size of the masseter and pterygoid muscles. The patient was informed of the benign nature of the swelling and was advised to discontinue the use of non steroidal anti-inflammatory agents. Conclusion: The bilateral hypertrophy of masseter muscles should be considered in differential diagnosis in cases of unilateral or bilateral swelling of the parotid or lateral mandible area.


Assuntos
Hipertrofia/diagnóstico , Músculo Masseter , Músculos Pterigoides , Adulto , Edema , Humanos , Imagem por Ressonância Magnética , Masculino , Adulto Jovem
12.
Biosci Trends ; 14(1): 23-34, 2020 Mar 16.
Artigo em Inglês | MEDLINE | ID: mdl-32092745

RESUMO

The roots of Angelica dahurica have long been used as a traditional medicine in Korea to treat various diseases such as toothache and cold. In this study, we investigated the effect of ethanol extract from the roots of this plant on metastatic melanoma, a highly aggressive skin cancer, in B16F10 melanoma cells and B16F10 cell inoculated-C57BL/6 mice. Our results showed that the ethanol extracts of Angelicae dahuricae Radix (EEAD) suppressed cell growth and induced apoptotic cell death in B16F10 cells. EEAD also activated the mitochondria-mediated intrinsic apoptosis pathway, with decreased mitochondrial membrane potential, and increased production of intracellular reactive oxygen species and ration of Bax/Bcl-2 expression. Furthermore, EEAD reduced the migration, invasion, and colony formation of B16F10 cells through the reduced expression and activity of matrix metalloproteinase (MMP)-2 and -9. In addition, in vivo results demonstrated that oral administration of EEAD inhibited lactate dehydrogenase activity, hepatotoxicity, and nephrotoxicity without weight loss in B16F10 cell inoculated-mice. Importantly, EEAD was able to markedly suppress lung hypertrophy, the incidence of B16F10 cells lung metastasis, and the expression of tumor necrosis factor-alpha in lung tissue. Taken together, our findings suggest that EEAD may be useful for managing metastasis and growth of malignant cancers, including melanoma.


Assuntos
Angelica/química , Melanoma Experimental/tratamento farmacológico , Extratos Vegetais/farmacologia , Animais , Apoptose , Linhagem Celular Tumoral , Hipertrofia , L-Lactato Desidrogenase/antagonistas & inibidores , Pulmão/patologia , Neoplasias Pulmonares , Masculino , Metaloproteinase 2 da Matriz/metabolismo , Metaloproteinase 9 da Matriz/metabolismo , Camundongos Endogâmicos C57BL , Metástase Neoplásica/prevenção & controle , Raízes de Plantas/química , Proteínas Proto-Oncogênicas c-bcl-2/metabolismo , Espécies Reativas de Oxigênio/metabolismo , Fator de Necrose Tumoral alfa/metabolismo , Proteína X Associada a bcl-2/metabolismo
13.
Eur Radiol ; 30(6): 3306-3309, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32055945

RESUMO

OBJECTIVES: The purpose of this study was to observe the imaging characteristics of the novel coronavirus pneumonia. METHODS: Sixty-three confirmed patients were enrolled from December 30, 2019 to January 31, 2020. High-resolution CT (HRCT) of the chest was performed. The number of affected lobes, ground glass nodules (GGO), patchy/punctate ground glass opacities, patchy consolidation, fibrous stripes and irregular solid nodules in each patient's chest CT image were recorded. Additionally, we performed imaging follow-up of these patients. RESULTS: CT images of 63 confirmed patients were collected. M/F ratio: 33/30. The mean age was 44.9 ± 15.2 years. The mean number of affected lobes was 3.3 ± 1.8. Nineteen (30.2%) patients had one affected lobe, five (7.9%) patients had two affected lobes, four (6.3%) patients had three affected lobes, seven (11.1%) patients had four affected lobes while 28 (44.4%) patients had 5 affected lobes. Fifty-four (85.7%) patients had patchy/punctate ground glass opacities, 14 (22.2%) patients had GGO, 12 (19.0%) patients had patchy consolidation, 11 (17.5%) patients had fibrous stripes and 8 (12.7%) patients had irregular solid nodules. Fifty-four (85.7%) patients progressed, including single GGO increased, enlarged and consolidated; fibrous stripe enlarged, while solid nodules increased and enlarged. CONCLUSIONS: Imaging changes in novel viral pneumonia are rapid. The manifestations of the novel coronavirus pneumonia are diverse. Imaging changes of typical viral pneumonia and some specific imaging features were observed. Therefore, we need to strengthen the recognition of image changes to help clinicians to diagnose quickly and accurately. KEY POINTS: • High-resolution CT (HRCT) of the chest is critical for early detection, evaluation of disease severity and follow-up of patients with the novel coronavirus pneumonia. • The manifestations of the novel coronavirus pneumonia are diverse and change rapidly. • Radiologists should be aware of the various features of the disease and temporal changes.


Assuntos
Betacoronavirus , Infecções por Coronavirus/diagnóstico por imagem , Pneumonia Viral/diagnóstico por imagem , Adulto , China , Feminino , Humanos , Hipertrofia , Masculino , Pessoa de Meia-Idade , Pandemias , Tórax , Tomografia Computadorizada por Raios X
16.
Sci Rep ; 10(1): 1296, 2020 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-31992827

RESUMO

Mitochondrial mutations and dysfunction have been demonstrated in several age-related disorders including osteoarthritis, yet its relative contribution to pathogenesis remains unknown. Here we evaluated whether premature aging caused by accumulation of mitochondrial DNA mutations in PolgD275A mice predisposes to the development of knee osteoarthritis. Compared with wild type animals, homozygous PolgD275A mice displayed a specific bone phenotype characterized by osteopenia of epiphyseal trabecular bone and subchondral cortical plate. Trabecular thickness was significantly associated with osteocyte apoptosis rates and osteoclasts numbers were increased in subchondral bone tissues. While chondrocyte apoptosis rates in articular and growth plate cartilage were similar between groups, homozygous mitochondrial DNA mutator mice displayed elevated numbers of hypertrophic chondrocytes in articular calcified cartilage. Low grade cartilage degeneration, predominantly loss of proteoglycans, was present in all genotypes and the development of osteoarthritis features was not found accelerated in premature aging. Somatically acquired mitochondrial DNA mutations predispose to elevated subchondral bone turnover and hypertrophy in calcified cartilage, yet additional mechanical or metabolic stimuli would seem required for induction and accelerated progression of aging-associated osteoarthritis.


Assuntos
Senilidade Prematura , Doenças Ósseas Metabólicas , Condrócitos , Polimerase do DNA Mitocondrial , Mutação de Sentido Incorreto , Osteoartrite , Senilidade Prematura/enzimologia , Senilidade Prematura/genética , Senilidade Prematura/patologia , Substituição de Aminoácidos , Animais , Doenças Ósseas Metabólicas/enzimologia , Doenças Ósseas Metabólicas/genética , Doenças Ósseas Metabólicas/patologia , Condrócitos/enzimologia , Condrócitos/patologia , Polimerase do DNA Mitocondrial/genética , Polimerase do DNA Mitocondrial/metabolismo , Hipertrofia , Camundongos , Camundongos Mutantes , Osteoartrite/enzimologia , Osteoartrite/genética , Osteoartrite/patologia
18.
BMC Neurol ; 20(1): 11, 2020 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-31918670

RESUMO

BACKGROUND: Hypertrophic pachymeningitis (HP) is a rare disorder that involves localized or diffuse thickening of the dura mater. HP is associated with various inflammatory, infectious, and malignant diseases, such as rheumatic arthritis, sarcoidosis, anti-neutrophil cytoplasmic antibody-associated vasculitis, IgG4-related disorders, syphilis, tuberculosis, bacterial and fungal infections, cancer, and idiopathic diseases, when evaluation fails to reveal a cause. Among them, chronic infection with Propionibacterium acnes is a rare etiology of HP, and its pathology remains unclear. CASE PRESENTATION: An 80-year-old man having refractory otitis media with effusion of the right ear presented with progressive right-sided headache and nausea. Post-contrast brain magnetic resonance imaging revealed right mastoiditis and remarkable thickening of the dura mater and enhancement of pia mater extending from the right middle cranial fossa to the temporal lobe. HP secondary to middle ear infection was suspected, and a biopsy of the right mastoid was performed. An anaerobic culture of the biopsied right mastoid showed the growth of P. acnes, and histopathological examination using P. acnes-specific monoclonal antibody (PAB antibody) revealed the infiltration of inflammatory cells with P. acnes. Moreover, using PAB antibody, P. acnes was detected in the biopsy specimen of the thickening dura mater. No granulomas were identified in either specimen. HP was resolved with long-term administration of antibiotics and steroids. CONCLUSION: This is the first documentation of pathologically demonstrated chronic HP associated with P. acnes infection followed by refractory otitis media. This report showed that chronic latent P. acnes infection induces chronic inflammation.


Assuntos
Infecções por Bactérias Gram-Positivas/complicações , Meningite/microbiologia , Otite Média/complicações , Otite Média/microbiologia , Propionibacterium acnes , Idoso de 80 Anos ou mais , Antibacterianos/uso terapêutico , Anti-Inflamatórios/uso terapêutico , Infecções por Bactérias Gram-Positivas/tratamento farmacológico , Humanos , Hipertrofia , Masculino , Meningite/tratamento farmacológico , Otite Média/tratamento farmacológico , Recidiva
19.
Ann R Coll Surg Engl ; 102(2): 115-119, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31538808

RESUMO

BACKGROUND: Surgical management of breast cancer with gigantomastia can be challenging when planning breast conservation, as major breast reduction is required. Complex oncoplastic procedures can carry an additional surgical risk in this situation. We suggest batwing mammoplasty as a simple and safe oncoplastic procedure for those patients. MATERIALS AND METHODS: Fourteen patients with gigantomastia diagnosed with breast cancer were included in this prospective cohort study. All underwent batwing mammoplasty and contralateral symmetrisation procedure between May 2016 and June 2018. Patient satisfaction assessed by the Breast-Q questionnaire. RESULTS: All patients had a body mass index above 30kg/m2 with a mean of 36.7kg/m2 (range 31.6-44.9kg/m2). The mean distance from midclavicular point to nipple was 42cm (range 38-50cm). The mean operative time was 83 minutes for procedures done by a single surgeon. Mean specimen weight was 1.2kg (ranging from 1.035-1.63kg). Postoperative complications occurred in 14.2% of patients. Nipple-areola complex viability was not compromised nor sensation impaired. The mean Breast-Q score for patient satisfaction with breasts was 68.6 (range 61-74). The mean score for physiological wellbeing was 77.3 (range 64-84) and the mean score for physical wellbeing was 35 (range 31-40). CONCLUSION: Batwing mammoplasty is a safe and simple oncoplastic procedure in patients who have breast cancer with gigantomastia. It has short operative time and low complications rate. In our cohort of patients, there was no delay in the delivery of adjuvant treatment. The cosmetic outcome was favourable with a high patient satisfaction.


Assuntos
Neoplasias da Mama/cirurgia , Mama/anormalidades , Hipertrofia/cirurgia , Mamoplastia/métodos , Mastectomia/métodos , Complicações Pós-Operatórias/epidemiologia , Adulto , Idoso , Mama/cirurgia , Neoplasias da Mama/complicações , Feminino , Humanos , Hipertrofia/complicações , Mamoplastia/efeitos adversos , Mastectomia/efeitos adversos , Pessoa de Meia-Idade , Duração da Cirurgia , Satisfação do Paciente , Complicações Pós-Operatórias/etiologia , Estudos Prospectivos , Resultado do Tratamento
20.
World Neurosurg ; 134: e75-e81, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31648055

RESUMO

OBJECTIVE: Ultra-early hematoma growth (uHG), the black hole sign, and the blend sign are common predictors of hematoma enlargement (HE). This study aimed to develop a new diagnostic criterion for predicting HE using uHG and to compare the accuracy of uHG, the black hole sign, and the blend sign in predicting HE in patients with spontaneous intracerebral hemorrhage (sICH). METHODS: We retrospectively analyzed data of 920 patients with sICH from August 2013 to January 2018. Receiver operating characteristic curves were plotted to determine the optimal threshold values of uHG to predict HE. The effects of the black hole sign, blend sign, and uHG on HE were assessed using univariate and multivariate logistic regression models, and their prediction accuracies were analyzed using receiver operator analyses. RESULTS: The black hole sign was identified in 131 patients, the blend sign in 163 patients, and uHG >6.46 mL/h in 441 patients. Logistic analysis showed that the black hole sign, blend sign, and uHG >6.46 mL/h were independent predictors of HE. The sensitivity values of uHG >6.46 mL/h, the black hole sign, and the blend sign were 70.43%, 24.19%, and 36.56%, respectively, and specificity values were 57.77%, 88.28%, and 87.06%, respectively. uHG had the greatest area under the curve. The black hole and blend signs were more commonly found in patients with uHG >6.46 mL/h (P < 0.001). CONCLUSIONS: uHG >6.46 mL/h was the optimal predictor used for identifying patients at high risk of developing HE. A greater uHG value was associated with an increased prevalence of the black hole and blend signs.


Assuntos
Hemorragia Cerebral/cirurgia , Hematoma/cirurgia , Adulto , Idoso , Hemorragia Cerebral/complicações , Hemorragia Cerebral/diagnóstico por imagem , Progressão da Doença , Feminino , Hematoma/complicações , Hematoma/diagnóstico por imagem , Humanos , Hipertrofia/complicações , Hipertrofia/cirurgia , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Curva ROC , Estudos Retrospectivos , Tomografia Computadorizada por Raios X/métodos
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