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1.
AJR Am J Roentgenol ; 222(1): e2330008, 2024 01.
Artículo en Inglés | MEDLINE | ID: mdl-37910038

RESUMEN

BACKGROUND. International medical graduates (IMGs) are a source of physicians who could help alleviate radiologist workforce shortages in the United States. However, IMGs may face barriers in obtaining appropriate visas (e.g., H-1B or O-1 visas) to allow faculty employment. OBJECTIVE. The purpose of this study was to assess the policies and experiences of U.S. academic radiology departments in offering visas to IMGs applying for faculty positions. METHODS. A web-based survey on policies and experiences in offering visas to IMG faculty candidates was distributed to chairs of U.S. radiology departments with a diagnostic radiology training program recognized by the National Resident Matching Program. Individual survey questions were optional. The initial survey and subsequent reminders were sent from October 7, 2022, through November 7, 2022. RESULTS. The survey response rate was 81% (143/177). A total of 24% (28/115), 38% (44/115), 17% (20/115), and 20% (23/115) of departments offered H-1B visas to IMG faculty frequently, sometimes, rarely, and never, respectively; 3% (3/113), 27% (31/113), 22% (25/113), and 48% (54/113) of departments offered O-1 visas frequently, sometimes, rarely, and never, respectively. However, 41% (46/113) and 5% (6/113) of departments had default policies of offering H-1B and O-1 visas for IMG faculty candidates, respectively. The most common reasons given for why departments did not offer visas included, for both H-1B and O-1 visas, the time-consuming process, lack of reliability of candidates' starting time, and the expense of the visa application; for O-1 visas, the reasons given also included lack of expertise. A total of 15% (16/108) of departments set their own visa policies, 75% (81/108) followed institutional policies, and 10% (11/108) followed policies set by other entities (e.g., state government). CONCLUSION. Although to at least some extent most U.S. academic radiology departments offer H-1B and O-1 visas for IMGs seeking faculty positions, use of such visas typically is not the departments' default policy. A variety of barriers contributed to visas not being offered. The departments' visa policies were primarily determined at the institutional level. CLINICAL IMPACT. The identified barriers faced by U.S. academic radiology departments in offering visas to IMG faculty candidates impact the role of IMGs in helping to address radiologist workforce shortages.


Asunto(s)
Internado y Residencia , Médicos , Radiología , Estados Unidos , Humanos , Reproducibilidad de los Resultados , Docentes , Recursos Humanos , Docentes Médicos
2.
Iran J Med Sci ; 48(2): 118-129, 2023 03.
Artículo en Inglés | MEDLINE | ID: mdl-36895460

RESUMEN

Hydatid disease is a zoonotic infection caused primarily by the tapeworm parasite, Echinococcus granulosus. It is considered an endemic disease in the Mediterranean region.  In about 90% of cases, hydatid cysts are found in the liver and lungs; however, any other organ in the body may be affected, particularly in endemic areas. When encountering cystic lesions in these areas, the physician should always keep hydatid disease as a possible diagnosis in mind. To avoid life-threatening conditions such as anaphylactic shock or pressure effect on vital organs, timely diagnosis, and proper management are critical. When a rare site is involved, hydatid disease should be diagnosed using a combination of serologic assays and imaging modalities such as ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI). These imaging modalities can also be used to determine the extent of the disease and assess possible complications. Here, we present a pictorial review of typical imaging manifestations of hydatid cysts in unusual sites. Being aware of these imaging features will assist physicians in making an accurate, timely diagnosis and subsequently, providing optimal management.


Asunto(s)
Equinococosis , Echinococcus granulosus , Animales , Equinococosis/diagnóstico , Tomografía Computarizada por Rayos X , Imagen por Resonancia Magnética , Ultrasonografía
3.
J Clin Med ; 12(3)2023 Jan 20.
Artículo en Inglés | MEDLINE | ID: mdl-36769491

RESUMEN

At present, clinicians are expected to manage a large volume of complex clinical, laboratory, and imaging data, necessitating sophisticated analytic approaches. Machine learning-based models can use this vast amount of data to create forecasting models. We aimed to predict short- and medium-term functional outcomes in acute ischemic stroke (AIS) patients with proximal middle cerebral artery (MCA) occlusions using machine learning models with clinical, laboratory, and quantitative imaging data as inputs. Included were consecutive AIS patients with MCA M1 and proximal M2 occlusions. The XGBoost, LightGBM, CatBoost, and Random Forest were used to predict the outcome. Minimum redundancy maximum relevancy was used for selecting features. The primary outcomes were the National Institutes of Health Stroke Scale (NIHSS) shift and the modified Rankin Score (mRS) at 90 days. The algorithm with the highest area under the receiver operating characteristic curve (AUROC) for predicting the favorable and unfavorable outcome groups at 90 days was LightGBM. Random Forest had the highest AUROC when predicting the favorable and unfavorable groups based on the NIHSS shift. Using clinical, laboratory, and imaging parameters in conjunction with machine learning, we accurately predicted the functional outcome of AIS patients with proximal MCA occlusions.

4.
Integr Cancer Ther ; 22: 15347354221150787, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36752115

RESUMEN

The ketogenic diet (KD) was initially used in 1920 for drug-resistant epileptic patients. From this point onward, ketogenic diets became a pivotal part of nutritional therapy research. To date, KD has shown therapeutic potential in many pathologies such as Alzheimer's disease, Parkinson's disease, autism, brain cancers, and multiple sclerosis. Although KD is now an adjuvant therapy for certain diseases, its effectiveness as an antitumor nutritional therapy is still an ongoing debate, especially in Neuroblastoma. Neuroblastoma is the most common extra-cranial solid tumor in children and is metastatic at initial presentation in more than half of the cases. Although Neuroblastoma can be managed by surgery, chemotherapy, immunotherapy, and radiotherapy, its 5-year survival rate in children remains below 40%. Earlier studies have proposed the ketogenic diet as a possible adjuvant therapy for patients undergoing treatment for Neuroblastoma. In this study, we seek to review the possible roles of KD in the treatment of Neuroblastoma.


Asunto(s)
Dieta Cetogénica , Neuroblastoma , Niño , Humanos , Dieta Cetogénica/efectos adversos , Terapia Combinada , Resultado del Tratamiento
5.
J Neuroimaging ; 33(1): 44-57, 2023 01.
Artículo en Inglés | MEDLINE | ID: mdl-36207276

RESUMEN

Stroke mimics constitute a significant proportion of patients with suspected acute ischemic stroke. These conditions may resemble acute ischemic stroke and demonstrate abnormalities on perfusion imaging sequences. The most common stroke mimics include seizure/epilepsy, migraine with aura, brain tumors, functional disorders, infectious encephalopathies, Wernicke's encephalopathy, and metabolic abnormalities. Brain perfusion imaging techniques, particularly computed tomography perfusion and magnetic resonance perfusion, are being widely used in routine clinical practice for treatment selection in patients presenting with large vessel occlusion. At the same time, the utilization of these imaging modalities enables the opportunity to better diagnose patients with stroke mimics in a time-sensitive setting, leading to appropriate management, decision-making, and resource allocation. In this review, we describe patterns of perfusion abnormalities that could discriminate patients with stroke mimics from those with acute ischemic stroke and provide specific case examples to illustrate these perfusion abnormalities. In addition, we discuss the challenges associated with interpretation of perfusion images in stroke-related pathologies. In general, perfusion imaging can provide additional information in some cases-when used in combination with conventional magnetic resonance imaging and computed tomography-and might help in detecting stroke mimics among patients who present with acute onset focal neurological symptoms.


Asunto(s)
Isquemia Encefálica , Epilepsia , Accidente Cerebrovascular Isquémico , Accidente Cerebrovascular , Humanos , Accidente Cerebrovascular Isquémico/complicaciones , Accidente Cerebrovascular/complicaciones , Encéfalo/diagnóstico por imagen , Isquemia Encefálica/complicaciones , Imagen de Perfusión/métodos
6.
Arch Physiol Biochem ; 129(2): 373-378, 2023 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33043692

RESUMEN

BACKGROUND: Glucagon-like peptide-1 (GLP-1), a gut-derived incretin hormone, plays a pivotal role in glucose-induced insulin secretion. Currently, the role of incretin hormones in the pathogenesis of cirrhosis is not clearly defined. This study aimed to investigate circulating levels of GLP-1 in liver cirrhosis and its association with the severity of liver disease. METHODS: A total of 80 participants including 39 patients with a definite diagnosis of liver cirrhosis and 41 healthy controls recruited in this cross-sectional study. Circulating levels of GLP-1 were determined using the ELISA method. The severity of liver cirrhosis was assessed according to the Child-Pugh, MELD (i), MELD-Na, MELD New, and UK end-stage liver disease score (UKELD) criteria. RESULTS: The mean age of patients and healthy subjects was 42.51 ± 12.80 and 42.07 ± 10.92 years, respectively (p value = .869). The mean MELD (i), MELD-Na, MELD New, UKELD, and Child-Pugh scores were 14.36 ± 4.26, 15.26 ± 4.81, 14.74 ± 4.66, 52.33 ± 3.82, and 7.28 ± 1.50, respectively. In this study, circulating levels of GLP-1 were statistically lower in cirrhotic patients compared with healthy controls (95.26 ± 17.15 vs 111.84 ± 38.14 pg/mL; p value = .017). CONCLUSION: Larger prospective studies are needed to explore the incretin effect in cirrhosis patients compared with healthy individuals.


Asunto(s)
Péptido 1 Similar al Glucagón , Hepatopatías , Humanos , Adulto , Persona de Mediana Edad , Incretinas , Estudios Transversales , Cirrosis Hepática/diagnóstico , Índice de Severidad de la Enfermedad , Pronóstico
7.
Iran J Child Neurol ; 16(3): 133-143, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36204430

RESUMEN

Objectives: Antiepileptic drugs are among the most common triggers of cutaneous adverse reactions. About 5-17% of epileptic patients develop idiosyncratic skin reactions at some point during their treatment course, most of which occur within the first two months of drug initiation. This study aimed to investigate the pattern of cutaneous drug reactions associated with anticonvulsant use among the pediatric population in Iran to identify high-risk individuals. Materials & Methods: In this retrospective descriptive study, medical records of children aged two months to 14 years, who were diagnosed with drug reactions due to anticonvulsant drugs between April 2007 and March 2018, were reviewed, and relevant information were extracted. This multicenter study was conducted in several provinces of Iran. Results: A total of 186 cases with a final diagnosis of the antiepileptic drug-induced eruption were evaluated. The median age of participants was 36 months (range: 2-168), and 56% were male. In approximately 70% of the children, the phenobarbital was the culprit. The median time interval between initiation of the causative drug and development of rash and fever was 10 and 7 days, respectively. The most common rash type was maculopapular rashes (69%). Overall, 33% of the patients only received antihistamines after discontinuation of the causative drug. Conclusion: Similar to previously published studies in Iran, phenobarbital was the main cause of cutaneous drug reactions to antiepileptic drugs, indicating the necessity of paying more attention when prescribing phenobarbital for Iranian pediatrics.

8.
Diagnostics (Basel) ; 12(10)2022 Oct 21.
Artículo en Inglés | MEDLINE | ID: mdl-36292246

RESUMEN

Mechanical thrombectomy (MT) is an important therapeutic option in the management of acute ischemic stroke (AIS) caused by large vessel occlusions (LVO). While achieving a modified thrombolysis in cerebral infarction (mTICI), grades of 2b, 2c, and 3 are all considered successful recanalization; recent literature suggests that mTICI grades of 2c/3 are associated with superior outcomes than 2b. The aim of this preliminary study is to determine whether any baseline or procedural parameters can predict whether successfully recanalized patients achieve an mTICI grade of 2c/3 over 2b. Consecutive patients from 9/2019 to 10/2021 who were successfully recanalized following MT for confirmed LVO were included in the study. Baseline and procedural data were collected through manual chart review and analyzed to ascertain whether any variables of interest could predict mTICI 2c/3. A total of 47 patients were included in the preliminary study cohort, with 35 (74.5%) achieving an mTICI score of 2c/3 and 12 (25.5%) achieving an mTICI score of 2b. We found that a lower groin puncture to recanalization time was a strong, independent predictor of TICI 2c/3 (p = 0.015). These findings emphasize the importance of minimizing procedure time in achieving superior reperfusion but must be corroborated in larger scale studies.

9.
Adv Exp Med Biol ; 1367: 411-431, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35286706

RESUMEN

Adverse drug reactions (ADRs) are the cause of nearly three to six percent of inpatient admissions and are associated with high morbidity and mortality rates. Cutaneous adverse drug reactions (cADRs) represent the most frequent ADRs observed among patients during hospital stay. Recent investigations have found that various HLA genotypes have a significant association with ADRs, especially immune-mediated ADRs. This chapter is devoted to the description of the immunopathogenic mechanism of these reactions and the specific HLA-drug associations. Also, we discuss the association of other non-HLA genes with the development of cADRs and provide a summary of the currently approved recommendations on pre-treatment HLA genotyping tests.


Asunto(s)
Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos , Inmunogenética , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/genética , Genotipo , Humanos
10.
J Clin Med ; 11(4)2022 Feb 17.
Artículo en Inglés | MEDLINE | ID: mdl-35207321

RESUMEN

Cerebrovascular disease is the leading cause of long-term disability in the world and the third-leading cause of death in the United States. The early diagnosis of transient ischemic attack (TIA) is of great importance for reducing the mortality and morbidity of cerebrovascular diseases. Patients with TIA have a high risk of early subsequent ischemic stroke and the development of permanent nervous system lesions. The diagnosis of TIA remains a clinical diagnosis that highly relies on the patient's medical history assessment. There is a growing list of biomarkers associated with different components of the ischemic cascade in the brain. In this review, we take a closer look at the biomarkers of TIA and their validity with a focus on the more clinically important ones using recent evidence of their reliability for practical usage.

11.
Ultrasound ; 30(1): 44-51, 2022 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-35173778

RESUMEN

INTRODUCTION: We aimed to describe shear wave elastography parameters of non-mass lesions of the breast and to assess the measures of diagnostic accuracy of shear wave elastography in the differentiation of non-mass lesions compared with conventional ultrasound, using histopathologic results as the reference standard. METHODS: This retrospective study included breast ultrasound-detected non-mass lesions with a confirmed pathologic diagnosis during a two-year study period. B-mode ultrasound and shear wave elastography were performed for all lesions before biopsy. Ultrasound features, shear wave elastography parameters (mean elasticity and maximum stiffness color), as well as Breast Imaging-Reporting and Data System categories were recorded for each lesion. Measures of diagnostic accuracy of ultrasound and ultrasound + shear wave elastography were also assessed. RESULTS: From a total of 567 breast lesions requiring core-needle biopsy, 49 (8.6%) were considered as non-mass lesions. Based on histopathologic reports, 32 patients (65.3%) had non-high-risk benign lesions, five (10.2%) had high-risk benign lesions, five (10.2%) had ductal carcinoma in situ, and seven (14.3%) had invasive carcinoma. There was no significant difference in patients' age and palpability between benign and malignant lesions (p = 0.16 and p = 0.12, respectively). Mean elasticity values and Breast Imaging-Reporting and Data System categories were significantly higher among malignant lesions compared with benign non-mass lesions (both p < 0.001). Furthermore, the addition of shear wave elastography to grayscale ultrasound increased the specificity, positive predictive value, and diagnostic accuracy. CONCLUSION: The complementary use of shear wave elastography with conventional ultrasound might help in the differentiation of non-mass breast lesions and has the potential to decrease the frequency of unnecessary biopsies performed for benign non-mass lesions.

12.
Cancer Invest ; 40(3): 268-281, 2022 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-34726558

RESUMEN

Primary sarcomas of the lung represent less than 0.5% of all primary lung tumors and comprise a heterogeneous group of malignancies including synovial sarcoma (SS). Primary pleuropulmonary SS has non-specific presentations, such as chest pain, shortness of breath and cough, and its associated imaging features resemble those of other intrathoracic malignancies. The diagnosis of these tumors needs to be confirmed by cytogenetic and molecular studies. Here, we describe two rare cases of primary pleuropulmonary SS who were admitted to our hospital. We also provide a concise review of clinical, radiological, and histopathological characteristics of pleuropulmonary SS after exploring 168 studies (415 corresponding patients) that were identified through a literature search.


Asunto(s)
Neoplasias Pulmonares/patología , Sarcoma Sinovial/patología , Adulto , Femenino , Humanos , Neoplasias Pulmonares/diagnóstico por imagen , Neoplasias Pulmonares/mortalidad , Neoplasias Pulmonares/terapia , Pronóstico , Sarcoma Sinovial/diagnóstico por imagen , Sarcoma Sinovial/mortalidad , Sarcoma Sinovial/terapia , Adulto Joven
13.
Iran J Nurs Midwifery Res ; 26(5): 406-410, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34703778

RESUMEN

BACKGROUND: Emotional disorders and depression make cancer patients reluctant about adherence to their treatment. The present study was conducted to determine the relationship between self-compassion and adherence to treatment in cancer patients. MATERIALS AND METHODS: This cross-sectional study was conducted on 214 patients with cancer in 2019. They were inpatients aged over 18 years. Two months had passed since their cancer was diagnosed, and they had undergone a course of chemotherapy. Data were collected using a personal details form, Neff's Self-Compassion Scale and the Modanloo Adherence to Treatment Questionnaire and were then analyzed using the mean, frequency, Pearson's correlation coefficient and linear regression analysis. RESULTS: The mean (SD) total score of self-compassion was 80.07 (15.68), and the mean (SD) total score of adherence to treatment was 134.44 (38.37). Pearson's correlation coefficient showed a direct relationship between the total score of self-compassion and the total score of adherence to treatment (p < 0.05). The linear regression analysis showed that the score of suffering as a common humanity (ß = 0.47, p ≤ 0.001) and the variable of education (ß = 0.27, p ≤ 0.001) were significant predictors of the total score of adherence to treatment (R2 = 0.33). CONCLUSIONS: According to the results, suffering as a common humanity and education were significant predictors of adherence to treatment. Oncology nurses are therefore recommended to get further educated about self-compassion, so that they take this concept more seriously in providing patient care. Nurses should also educate the patients with low levels of education about the consequences of not adhering to their treatment.

14.
Am J Trop Med Hyg ; 105(2): 449-453, 2021 Jul 08.
Artículo en Inglés | MEDLINE | ID: mdl-34237015

RESUMEN

COVID-19 first emerged in Wuhan, China, in December 2019. Since that time, the frequency of bacterial and fungal coinfections has been continuously increasing. Although invasive pulmonary aspergillosis is being increasingly recognized in association with COVID-19, there is limited information regarding COVID-19-associated mucormycosis. We describe a 50-year-old woman with uncontrolled diabetes who received systemic corticosteroids and remdesevir during her admission for COVID-19. A few days after discharge, the patient was readmitted because of facial swelling and numbness, and a diagnosis of COVID-19-associated rhinosinusitis mucormycosis caused by Rhizopus arrhizus (formerly called Rhizopus oryzae) was confirmed with sequencing of the internal transcribed spacer region of the ribosomal DNA. This report aimed to address the importance of short-term follow-up for COVID-19 patients who have received systemic corticosteroids, particularly those with predisposing conditions, because early detection and prompt, aggressive treatment are essential for the management of invasive fungal infections.


Asunto(s)
Corticoesteroides/uso terapéutico , Tratamiento Farmacológico de COVID-19 , COVID-19/complicaciones , Rinitis/etiología , Rhizopus oryzae/patogenicidad , SARS-CoV-2/efectos de los fármacos , Sinusitis/etiología , Corticoesteroides/administración & dosificación , Corticoesteroides/efectos adversos , ADN de Hongos/genética , ADN Espaciador Ribosómico/genética , Diabetes Mellitus , Resultado Fatal , Femenino , Humanos , Infecciones Fúngicas Invasoras/etiología , Persona de Mediana Edad , Mucormicosis , Rinitis/diagnóstico , Rinitis/microbiología , Sinusitis/diagnóstico , Sinusitis/microbiología
15.
Clin Case Rep ; 9(5): e04231, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-34026193

RESUMEN

Medullary carcinoma of the thyroid should be considered in the differential diagnosis of miliary pattern of micronodules on chest imaging, irrespective of clinical features.

16.
J Immunol Res ; 2021: 6661406, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33681388

RESUMEN

Cancer immunotherapy, which reactivates weakened immune cells of cancer patients, has yielded great success in recent years. Among immunotherapeutic agents, immune checkpoint inhibitors have been of particular interest and have gained approval by the FDA for treatment of cancers. Immune checkpoint blockade through targeting programmed cell death protein-1 (PD-1) has demonstrated promising antitumor effects in cancer immunotherapy of many different solid and hematologic malignancies. However, despite promising results, a favorable response is observed only in a fraction of patients, and there is still lack of a single therapy modality with curative ability. In this paper, we review the current and future perspectives of PD-1/L1 blockade in cancer immunotherapy, with a particular focus on predictive biomarkers of response to therapy. We also discuss the adverse events associated with PD-1/L1/2 inhibitors, ranging from severe life-threatening conditions such as autoimmune myocarditis to mild and moderate reactions such as skin rashes, and explore the potential strategies for improving the efficacy of immunotherapy with PD-1/L1 checkpoint inhibitors.


Asunto(s)
Antineoplásicos Inmunológicos/uso terapéutico , Antígeno B7-H1/antagonistas & inhibidores , Inhibidores de Puntos de Control Inmunológico/uso terapéutico , Inmunoterapia , Receptor de Muerte Celular Programada 1/antagonistas & inhibidores , Animales , Antineoplásicos Inmunológicos/farmacología , Biomarcadores de Tumor , Humanos , Inhibidores de Puntos de Control Inmunológico/farmacología , Proteínas de Punto de Control Inmunitario/genética , Proteínas de Punto de Control Inmunitario/metabolismo , Inmunoterapia/métodos , Inmunoterapia/tendencias , Terapia Molecular Dirigida/métodos , Terapia Molecular Dirigida/tendencias , Neoplasias/etiología , Neoplasias/metabolismo , Neoplasias/terapia , Transducción de Señal/efectos de los fármacos , Resultado del Tratamiento
17.
Allergol. immunopatol ; 49(2): 40-45, mar. 2021. tab
Artículo en Inglés | IBECS | ID: ibc-214236

RESUMEN

Introduction and objectives Chronic spontaneous urticaria (CSU) is thought to be an autoimmune disease in a subpopulation of patients. Protein tyrosine phosphatase-22 (PTPN22) polymorphisms are considered to be one of the strongest contributing factors to autoimmune diseases. In this study, we aimed to investigate the potential association of several PTPN22 single nucleotide polymorphisms (SNPs) with CSU in an Iranian population. Material and methods A total of 93 CSU patients and 100 healthy individuals were included in this study. Five SNPs within the PTPN22 gene were analyzed using TaqMan genotyping assays. The frequency of alleles, genotypes, and haplotypes of PTPN22 SNPs (rs12760457, rs2476601, rs1310182, rs1217414, and rs33996649) was investigated. Results A significantly higher prevalence of the rs1310182 T allele was observed among patients compared with controls [OR = 1.75 (95% CI: 1.17–2.63); P = 0.007]. In addition, the rs1310182 CC genotype and TT genotype were 0.47 and 2.06 times more common in patients, respectively (P = 0.03). Moreover, haplotype analysis demonstrated that CGCGC, CGTGC, and TGCGC (P < 0.001) were significantly associated with CSU. No significant differences were observed between the patients and controls in the other analyzed PTPN22 SNPs. Conclusions Polymorphisms of the PTPN22 gene are associated with an increased susceptibility to CSU in the studied Iranian population (AU)


Asunto(s)
Humanos , Proteína Tirosina Fosfatasa no Receptora Tipo 22/genética , Predisposición Genética a la Enfermedad , Urticaria/genética , Estudios de Casos y Controles , Urticaria/epidemiología , Enfermedad Crónica , Frecuencia de los Genes , Haplotipos , Voluntarios Sanos , Irán/epidemiología , Prevalencia , Alelos
18.
Case Rep Med ; 2021: 6649663, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33628262

RESUMEN

Accessory and cavitated uterine mass (ACUM) is a rare form of Mullerian anomaly that usually presents in young females with chronic cyclic pelvic pain and/or dysmenorrhea. This clinical entity is often underdiagnosed as it may be mistaken for other differential diagnoses, such as pedunculated myoma or adnexal lesions. Imaging modalities, including ultrasonography and magnetic resonance imaging (MRI), accompanied with relevant and suspicious clinical findings are important tools in making acorrect diagnosis. To date, surgical excision of the mass remains the mainstay of treatment,which provides significant symptom relief. In this study, we present a female adolescent with chronic pelvic pain since menarche who underwent laparotomy with the presumed diagnosis of a left-sided ovarian mass. Retrospective evaluation of pelvic MR images demonstrated that the lesion was in fact an ACUM, which was further confirmed by histopathological examination.

19.
Allergol Immunopathol (Madr) ; 49(2): 40-45, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33641292

RESUMEN

INTRODUCTION AND OBJECTIVES: Chronic spontaneous urticaria (CSU) is thought to be an autoimmune disease in a subpopulation of patients. Protein tyrosine phosphatase-22 (PTPN22) polymorphisms are considered to be one of the strongest contributing factors to autoimmune diseases. In this study, we aimed to investigate the potential association of several PTPN22 single nucleotide polymorphisms (SNPs) with CSU in an Iranian population. MATERIAL AND METHODS: A total of 93 CSU patients and 100 healthy individuals were included in this study. Five SNPs within the PTPN22 gene were analyzed using TaqMan genotyping assays. The frequency of alleles, genotypes, and haplotypes of PTPN22 SNPs (rs12760457, rs2476601, rs1310182, rs1217414, and rs33996649) was investigated. RESULTS: A significantly higher prevalence of the rs1310182 T allele was observed among patients compared with controls [OR = 1.75 (95% CI: 1.17-2.63); P = 0.007]. In addition, the rs1310182 CC genotype and TT genotype were 0.47 and 2.06 times more common in patients, respectively (P = 0.03). Moreover, haplotype analysis demonstrated that CGCGC, CGTGC, and TGCGC (P < 0.001) were significantly associated with CSU. No significant differences were observed between the patients and controls in the other analyzed PTPN22 SNPs. CONCLUSIONS: Polymorphisms of the PTPN22 gene are associated with an increased susceptibility to CSU in the studied Iranian population.


Asunto(s)
Urticaria Crónica/genética , Predisposición Genética a la Enfermedad , Proteína Tirosina Fosfatasa no Receptora Tipo 22/genética , Alelos , Estudios de Casos y Controles , Niño , Urticaria Crónica/epidemiología , Frecuencia de los Genes , Haplotipos , Voluntarios Sanos , Humanos , Irán/epidemiología , Polimorfismo de Nucleótido Simple , Prevalencia
20.
J Diabetes Res ; 2021: 6666086, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33506050

RESUMEN

BACKGROUND: The risk factors for acute kidney injury (AKI) development in patients with diabetes hospitalized for COVID-19 have not been fully studied yet. In this study, we aimed to estimate the rate of AKI among the hospitalized population with COVID-19 and to identify the risk factors associated with AKI among patients with diabetes. Material and Methods. This retrospective cohort study included 254 patients (127 with diabetes and 127 without diabetes) who were admitted for COVID-19 to a tertiary hospital in Tehran, Iran, between February and May 2020. Clinical characteristics and outcomes, radiological findings, and laboratory data, including data on AKI, hematuria, and proteinuria were recorded and analyzed. RESULTS: Of 254 patients, 142 (55.9%) were male and the mean (± SD) age was 65.7 years (±12.5). In total, 58 patients (22.8%) developed AKI during hospitalization, of whom 36 patients had diabetes (p = 0.04); most patients (74.1%) had stage 1 or 2 AKI. Also, 8 patients (13.8%) required renal replacement therapy (RRT) after developing AKI. Regardless of diabetes status, patients who developed AKI had significantly higher mortality rates compared with patients who did not develop AKI (p = 0.02). Hematuria and proteinuria were observed in 38.1% and 55% of patients, respectively. Multivariate analysis showed that invasive mechanical ventilation, proteinuria, HBA1c level, history of cardiovascular disease, and use of statins were independent risk factors for AKI development in patients with diabetes. CONCLUSION: Results of this study showed that AKI develops in a considerable percentage of patients with COVID-19, especially in those with diabetes, and is significantly associated with mortality.


Asunto(s)
Lesión Renal Aguda/epidemiología , COVID-19/complicaciones , COVID-19/epidemiología , Complicaciones de la Diabetes/epidemiología , Diabetes Mellitus/epidemiología , Anciano , Enfermedades Cardiovasculares/complicaciones , Femenino , Hemoglobina Glucada/análisis , Hematuria/epidemiología , Mortalidad Hospitalaria , Hospitalización , Humanos , Inhibidores de Hidroximetilglutaril-CoA Reductasas/farmacología , Irán/epidemiología , Masculino , Persona de Mediana Edad , Análisis Multivariante , Prevalencia , Proteinuria/epidemiología , Terapia de Reemplazo Renal/efectos adversos , Respiración Artificial , Estudios Retrospectivos , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Factores de Riesgo , Resultado del Tratamiento
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