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2.
Ann Hematol ; 102(5): 1087-1097, 2023 May.
Article in English | MEDLINE | ID: mdl-36892593

ABSTRACT

Intensified pediatric chemotherapy regimens to treat adolescents and young adults (AYA) patients with Philadelphia negative acute lymphoblastic leukemia (ALL) have been associated with better outcomes. The local BFM 2009-based scheme complements the risk stratification assessing the measurable residual disease (MRD) along the induction phase with increasing levels of sensitivity. The present retrospective multicenter analysis included 171 AYA (15-40 years) patients treated accordingly between 2013 and 2019. Ninety-one percent obtained morphological complete remission, 67% a negative (<0.1%) MRD at day 33 (TP1), and 78% a negative (<0.01%) MRD at day 78 (TP2). The overall survival (OS) and the event-free survival (EFS) at 2 years were 62%±4.1 and 55%±4.1, respectively. The OS and EFS were significant better for prednisone responders, who achieved <10% BM blast at day 15, a negative MRD at TP1 or at TP2, and for low-risk patients. Age ≤30 years and WBC <30×109/L, particularly among B-phenotype, were also associated with longer OS. In the multivariable analyses, TP1 MRD positive (OS HR 2.8, 95% CI 1.4-5.7, p=0.004; EFS HR 3.0, 95% CI 1.6-5.7, p=0.001) and at TP2 (OS HR 2.6, 95% CI 1.3-5.3, p=0.012; EFS HR 2.6, 95% CI 1.3-5.1, p=0.006) were independently associated with earlier events. Age >30 years was also associated with a shorter survival (HR 3.1, 95% CI 1.3-7.5, p=0.014). Therefore, those 68 patients ≤30 years with TP1/TP2 negative MRD depicted a longer OS (2 years 85%±4.8). Based on our real-world data, the pediatric-based scheme is feasible in Argentina associated with better outcomes for younger AYA patients who achieved negative MRD at day 33 and 78.


Subject(s)
Precursor Cell Lymphoblastic Leukemia-Lymphoma , Humans , Prednisone/therapeutic use , Precursor Cell Lymphoblastic Leukemia-Lymphoma/therapy , Remission Induction , Risk , Retrospective Studies , Neoplasm, Residual/drug therapy , Neoplasm, Residual/genetics , Prognosis , Disease-Free Survival , Multicenter Studies as Topic
3.
Med Clin (Engl Ed) ; 160(2): 78-81, 2023 Jan 20.
Article in English | MEDLINE | ID: mdl-36597473

ABSTRACT

Introduction and objectives: To evaluate the diagnostic performance of different artificial intelligence (AI) algorithms for the identification of pulmonary involvement by SARS-CoV-2 based on portable chest radiography (RX). Material and methods: Prospective observational study that included patients admitted for suspected COVID-19 infection in a university hospital between July and November 2020. The reference standard of pulmonary involvement by SARS-CoV-2 comprised a positive PCR test and low-tract respiratory symptoms. Results: 493 patients were included, 140 (28%) with positive PCR and 32 (7%) with SARS-CoV-2 pneumonia. The AI-B algorithm had the best diagnostic performance (areas under the ROC curve AI-B 0.73, vs. AI-A 0.51, vs. AI-C 0.57). Using a detection threshold greater than 55%, AI-B had greater diagnostic performance than the specialist [(area under the curve of 0.68 (95% CI 0.64-0.72), vs. 0.54 (95% CI 0.49-0.59)]. Conclusion: AI algorithms based on portable RX enabled a diagnostic performance comparable to human assessment for the detection of SARS-CoV-2 lung involvement.


Introducción y objetivo: Evaluar el rendimiento diagnóstico de diferentes algoritmos de inteligencia artificial (IA) para la identificación de compromiso pulmonar por SARS-CoV-2 basados en radiografía (Rx) de tórax portátil. Material y método: Estudio observacional prospectivo que incluyó pacientes ingresados por sospecha de infección por COVID-19 en un hospital universitario entre julio y noviembre de 2020. El patrón de referencia de compromiso pulmonar por SARS-CoV-2 comprendió una PCR positiva y síntomas respiratorios bajos. Resultados: Se incluyeron 493 pacientes, 140 (28%) con PCR positiva y 32 (7%) con neumonía por SARS-CoV-2. El algoritmo AI-B tuvo el mejor rendimiento diagnóstico (áreas bajo la curva ROC AI-B 0,73 vs. AI-A 0,51 vs. AI-C 0,57). Utilizando un umbral de detección superior al 55%. AI-B presentó mayor precisión que el especialista (área bajo la curva de 0,68 [IC 95%: 0,64­0,72] vs. 0,54 [IC 95%: 0,49­0,59]). Conclusión: Los algoritmos de IA basados en Rx portátiles permiten una precisión diagnóstica comparable a la humana para la detección de compromiso pulmonar por SARS-CoV-2.

4.
Med. clín (Ed. impr.) ; 160(2): 78-81, enero 2023. ilus
Article in Spanish | IBECS | ID: ibc-214923

ABSTRACT

Introducción y objetivo: Evaluar el rendimiento diagnóstico de diferentes algoritmos de inteligencia artificial (IA) para la identificación de compromiso pulmonar por SARS-CoV-2 basados en radiografía (Rx) de tórax portátil.Material y métodoEstudio observacional prospectivo que incluyó pacientes ingresados por sospecha de infección por COVID-19 en un hospital universitario entre julio y noviembre de 2020. El patrón de referencia de compromiso pulmonar por SARS-CoV-2 comprendió una PCR positiva y síntomas respiratorios bajos.ResultadosSe incluyeron 493 pacientes, 140 (28%) con PCR positiva y 32 (7%) con neumonía por SARS-CoV-2. El algoritmo AI-B tuvo el mejor rendimiento diagnóstico (áreas bajo la curva ROC AI-B 0,73 vs. AI-A 0,51 vs. AI-C 0,57). Utilizando un umbral de detección superior al 55%. AI-B presentó mayor precisión que el especialista (área bajo la curva de 0,68 [IC 95%: 0,64-0,72] vs. 0,54 [IC 95%: 0,49-0,59]).ConclusiónLos algoritmos de IA basados en Rx portátiles permiten una precisión diagnóstica comparable a la humana para la detección de compromiso pulmonar por SARS-CoV-2. (AU)


Introduction and objectives: To evaluate the diagnostic performance of different artificial intelligence (AI) algorithms for the identification of pulmonary involvement by SARS-CoV-2 based on portable chest radiography (RX).Material and methodsProspective observational study that included patients admitted for suspected COVID-19 infection in a university hospital between July and November 2020. The reference standard of pulmonary involvement by SARS-CoV-2 comprised a positive PCR test and low-tract respiratory symptoms.Results493 patients were included, 140 (28%) with positive PCR and 32 (7%) with SARS-CoV-2 pneumonia. The AI-B algorithm had the best diagnostic performance (areas under the ROC curve AI-B 0.73, vs. AI-A 0.51, vs. AI-C 0.57). Using a detection threshold greater than 55%, AI-B had greater diagnostic performance than the specialist [(area under the curve of 0.68 (95% CI 0.64-0.72), vs. 0.54 (95% CI 0.49-0.59)].ConclusionAI algorithms based on portable RX enabled a diagnostic performance comparable to human assessment for the detection of SARS-CoV-2 lung involvement. (AU)


Subject(s)
Humans , Algorithms , Artificial Intelligence , Severe acute respiratory syndrome-related coronavirus , Pneumonia , Radiography , Lung
5.
Med Clin (Barc) ; 160(2): 78-81, 2023 01 20.
Article in English, Spanish | MEDLINE | ID: mdl-35918213

ABSTRACT

INTRODUCTION AND OBJECTIVES: To evaluate the diagnostic performance of different artificial intelligence (AI) algorithms for the identification of pulmonary involvement by SARS-CoV-2 based on portable chest radiography (RX). MATERIAL AND METHODS: Prospective observational study that included patients admitted for suspected COVID-19 infection in a university hospital between July and November 2020. The reference standard of pulmonary involvement by SARS-CoV-2 comprised a positive PCR test and low-tract respiratory symptoms. RESULTS: 493 patients were included, 140 (28%) with positive PCR and 32 (7%) with SARS-CoV-2 pneumonia. The AI-B algorithm had the best diagnostic performance (areas under the ROC curve AI-B 0.73, vs. AI-A 0.51, vs. AI-C 0.57). Using a detection threshold greater than 55%, AI-B had greater diagnostic performance than the specialist [(area under the curve of 0.68 (95% CI 0.64-0.72), vs. 0.54 (95% CI 0.49-0.59)]. CONCLUSION: AI algorithms based on portable RX enabled a diagnostic performance comparable to human assessment for the detection of SARS-CoV-2 lung involvement.


Subject(s)
COVID-19 , Pneumonia , Humans , COVID-19/diagnostic imaging , Artificial Intelligence , SARS-CoV-2 , Radiography , Algorithms , COVID-19 Testing
6.
Rev. argent. radiol ; 86(2): 83-92, jun. 2022. tab, graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1387606

ABSTRACT

Resumen Objetivo: Dar a conocer la experiencia en nuestro departamento de imágenes y presentar los hallazgos de radiografía (Rx) y tomografía computada (TC) que hemos observado en nuestra serie de casos con diagnóstico confirmado de COVID-19. Método: Estudio retrospectivo analítico de los hallazgos de Rx y TC en una serie de pacientes que asistieron al servicio de urgencias por sospecha de COVID-19 en los hospitales universitarios dependientes de nuestra institución en el periodo comprendido entre el 1 de marzo y el 31 de mayo de 2020. Resultados: En el período de estudio se detectaron 127 casos de COVID-19 positivos en nuestra institución. A 57 (45%) de ellos se les realizó Rx. En 46 (80%) de ellas no mostraron hallazgos patológicos. En 8 (14%) pacientes se observaron opacidades parcheadas en vidrio esmerilado y en 3 (5%) en asociación con consolidaciones. La distribución fue predominantemente bilateral y en los lóbulos inferiores. A 11 pacientes se les realizó TC de tórax y 9 (81%) manifestaron infiltrados en vidrio esmerilado, mostrando preferencia por las áreas periféricas y los lóbulos superiores, asociándose a consolidaciones en 4 (36%) casos. Un paciente (9%) presentó patrón en empedrado y otros 2 mostraron opacidades (18%) redondeadas en vidrio esmerilado. Dos pacientes (18%) no tuvieron hallazgos patológicos. Como hallazgos atípicos, se evidenció derrame pleural en 2 pacientes (18%) y neumotórax en uno (9%) en uno de ellos. Conclusiones: Nuestra experiencia demostró como características frecuentes la presencia de opacidades parcheadas en vidrio esmerilado y consolidaciones parcheados de distribución predominantemente en los lóbulos inferiores.


Abstract Objective: To show the experience in our radiology department at X-ray and computed tomography (CT) imaging findings in patients with confirmed COVID-19. Method: Retrospective analytical study of the radiological findings on X-ray and CT on a series of patients who attended the emergency department on suspicion of COVID-19 at university hospitals dependent of our institution in the period between March 1 and May 31, 2020. Results: During the study period, 127 cases of COVID-19 were detected in our institution. X-rays were performed in 57 (45%) of them, 46 (80%) of which did not show pathological findings. In total, 8 (14%)manifested as patchy ground glass opacities, and 3 (5%), in association with consolidations. The distribution was predominantly bilateral and in the lower lobes. Eleven patients underwent chest CT, 9 (81%) of these showed ground glass opacities, showing a preference for peripheral areas and upper lobes, associated with consolidations in 4 (36%) of them. One patient (9%) presented crazy paving and 2 rounded (18%) ground glass opacities. Two patients (18%) showed no pathological findings. As atypical findings, pleural effusion was evident in two (18%) patients, and pneumothorax, in one (9%). Conclusions: Our experience demonstrated the presence of patchy ground glass opacities and patchy consolidative opacities predominantly in the lower lobes as frequent features.

7.
Rev. argent. radiol ; 84(3): 93-106, ago. 2020. tab, graf, il.
Article in Spanish | LILACS | ID: biblio-1143921

ABSTRACT

Resumen El objetivo de este artículo es realizar una revisión de las localizaciones, causas y hallazgos radiológicos específicos de los procesos avasculares óseos. Se define como isquemia ósea a las alteraciones ocasionadas por déficit de irrigación, llevando a la destrucción del hueso. Existen diferencias entre necrosis isquémica e infarto óseo, en base al sitio óseo de afectación. La etiología traumática es la más frecuente y suele ser unilateral. Los sitios de presentación más frecuentes son: cabeza femoral y humeral, rodilla y semilunar. La resonancia magnética (RM) es considerada la modalidad de imagen más sensible y específica, tanto para el diagnóstico temprano como estadificación y control. El conocimiento de las causas, características radiológicas y sus diferentes fases evitan el diagnóstico erróneo de otras etiologías, como las primarias o infecciosas, facilitando un correcto algoritmo terapéutico.


Abstract The aim of this article is to review the locations, causes and specific radiological findings of avascular bone processes. Bone ischemia is defined as the alterations caused by irrigation deficit, leading into the bone destruction. However, there are differences between ischemic necrosis and bone infarction, based on the bone site of involvement. The most frequent etiology is traumatic and is usually unilateral. The most frequent sites of presentation are: femoral and humeral head, knee, and lunate. Magnetic resonance imaging (MRI) is considered the most sensitive and specific imaging modality for early diagnosis, staging and control. The knowledge of the causes, radiological findings and their different phases avoid the erroneous diagnosis of other lesions, such as primary or infectious, facilitating a correct therapeutic algorithm.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Bone and Bones/diagnostic imaging , Bone Diseases/etiology , Magnetic Resonance Spectroscopy/methods , Osteonecrosis/diagnostic imaging , Bone Diseases/classification , Bone Diseases/diagnostic imaging , Ischemia/diagnostic imaging
8.
Eur J Haematol ; 96(4): 435-42, 2016 Apr.
Article in English | MEDLINE | ID: mdl-26119186

ABSTRACT

BACKGROUND: Anagrelide represents a treatment option for essential thrombocythemia, although its place in therapy remains controversial. AIM: To assess the impact of mutational status in response rates and development of adverse events during long-term use of anagrelide. METHODS: We retrospectively evaluated 67 patients with essential thrombocythemia treated with anagrelide during 68 (4-176) months. RESULTS: Mutational frequencies were 46.3%, 28.3%, and 1.5% for JAK2V617F, CALR and MPL mutations. Anagrelide yielded a high rate of hematologic responses, which were complete in 49.25% and partial in 46.25%, without differences among molecular subsets. The rate of thrombosis during treatment was one per 100 patient-years, without excess bleeding. Anemia was the major adverse event, 30.3% at 5-yr follow-up, being more frequent in CALR(+) (P < 0.05). Myelofibrotic transformation developed in 14.9% (12.9%, 21%, and 12.5% in JAK2V617F(+), CALR(+), and triple-negative patients, respectively, P = NS) and those treated >60 months were at higher risk, OR (95% CI) 9.32 (1.1-78.5), P < 0.01, indicating the need for bone marrow monitoring during prolonged treatment. CONCLUSION: Although CALR(+) patients were at higher risk of developing anemia, anagrelide proved effective among all molecular subsets, indicating that mutational status does not seem to represent a major determinant of choice of cytoreductive treatment among essential thrombocythemia therapies.


Subject(s)
Calreticulin/genetics , Janus Kinase 2/genetics , Platelet Aggregation Inhibitors/administration & dosage , Quinazolines/administration & dosage , Receptors, Thrombopoietin/genetics , Thrombocythemia, Essential/drug therapy , Adolescent , Adult , Aged , Aged, 80 and over , Anemia/etiology , Anemia/pathology , Calreticulin/immunology , Child , Female , Follow-Up Studies , Gene Expression , Humans , Janus Kinase 2/immunology , Male , Middle Aged , Mutation , Platelet Aggregation Inhibitors/adverse effects , Primary Myelofibrosis/etiology , Primary Myelofibrosis/pathology , Quinazolines/adverse effects , Receptors, Thrombopoietin/immunology , Retrospective Studies , Thrombocythemia, Essential/genetics , Thrombocythemia, Essential/immunology , Thrombocythemia, Essential/pathology
9.
Br J Haematol ; 165(6): 854-64, 2014 Jun.
Article in English | MEDLINE | ID: mdl-24673454

ABSTRACT

The pathophysiological mechanisms contributing to the decreased platelet count in immune thrombocytopenia (ITP) are not entirely understood. Here, we investigated the key step of proplatelet formation (PPF) by studying the effect of ITP plasma in thrombopoiesis. Normal cord blood-derived mature megakaryocytes were cultured in the presence of recalcified plasma from ITP patients, and PPF was evaluated by microscopic analysis. Patient samples induced a dose-dependent inhibition in PPF, as well as decreased complexity of proplatelet architecture. Although slightly increased, plasma-induced megakaryocyte apoptosis was not related to PPF impairment. Purified IgG reproduced the inhibitory effect, while platelet-adsorbed plasma induced its reversion, suggesting the involvement of auto-antibodies in the inhibition of thrombopoiesis. Impaired PPF, induced by ITP plasmas bearing anti-GPIIb-IIIa antibodies, was related to their ability to interfere with the normal function of this integrin, as assessed by megakaryocyte PAC-1 binding and ß3 integrin phosphorylation while the presence of anti-glycoprotein Ia-IIa auto-antibodies was associated with loss of normal inhibition of PPF induced by type I collagen. In conclusion, abnormal thrombopoiesis comprising decreased PPF and morphological changes in proplatelet structure are induced by patient samples, unveiling new mechanisms contributing to decreased platelet count in ITP.


Subject(s)
Platelet Count , Purpura, Thrombocytopenic, Idiopathic/blood , Purpura, Thrombocytopenic, Idiopathic/immunology , Thrombopoiesis , Adult , Aged , Aged, 80 and over , Antibody Specificity/immunology , Apoptosis/immunology , Autoantibodies/immunology , Blood Platelets/cytology , Humans , Integrins/immunology , Megakaryocytes/cytology , Megakaryocytes/immunology , Middle Aged , Platelet Glycoprotein GPIIb-IIIa Complex/immunology , Platelet Membrane Glycoproteins/immunology , Thrombopoiesis/immunology , Young Adult
10.
Endocrine ; 39(1): 21-7, 2011 Feb.
Article in English | MEDLINE | ID: mdl-21069582

ABSTRACT

We have previously reported that Fas activation induces apoptosis of anterior pituitary cells from rats at proestrus but not at diestrus and in an estrogen-dependent manner. In this study, we evaluated the effect of Fas activation on apoptosis of lactotropes and somatotropes during the estrous cycle and explored the action of gonadal steroids on Fas-induced apoptosis. Also, we studied whether changes in Fas expression are involved in the apoptotic response of anterior pituitary cells. Fas activation increased the percentage of TUNEL-positive lactotropes and somatotropes at proestrus but not at diestrus. FasL triggered apoptosis of somatotropes only when cells from ovariectomized rats were cultured in the presence of 17 ß-estradiol (E2). Progesterone (P4) blocked the apoptotic action of the Fas/FasL system in lactotropes and somatotropes incubated with E2. Both E2 and P4 increased the percentage of cells expressing Fas at the cell membrane. Our results show that Fas activation induces apoptosis of lactotropes and somatotropes at proestrus but not at diestrus. Gonadal steroids may be involved in the apoptotic response of lactotropes and somatotropes, suggesting that Fas activation is implicated in the renewal of these pituitary subpopulations during the estrous cycle. The effect of gonadal steroids on Fas expression may be only partially involved in regulation of the Fas/FasL apoptotic pathway in the anterior pituitary gland.


Subject(s)
Apoptosis/drug effects , Gonadal Steroid Hormones/pharmacology , Lactotrophs/cytology , Somatotrophs/cytology , fas Receptor/physiology , Animals , Apoptosis/physiology , Cells, Cultured , Estradiol/pharmacology , Estrous Cycle , Fas Ligand Protein/physiology , Female , Gene Expression/drug effects , In Situ Nick-End Labeling , Lactotrophs/drug effects , Ovariectomy , Pituitary Gland, Anterior/cytology , Progesterone/pharmacology , Rats , Rats, Wistar , Somatotrophs/drug effects , fas Receptor/genetics
11.
Medicina (B.Aires) ; 69(6): 640-642, nov.-dic. 2009. ilus
Article in Spanish | LILACS | ID: lil-633696

ABSTRACT

La enfermedad de Wegener es una vasculitis de pequeños y medianos vasos asociada a anticuerpos anticitoplasma del neutrófilo (ANCA). Dentro de los órganos blancos, el pulmón se encuentra comprometido en el 85% de los casos. Numerosas entidades deben ser consideradas en el diagnóstico diferencial, entre ellas, la tuberculosis pulmonar. Presentamos el caso de un hombre de 54 años de edad, con diagnóstico en el año 1996 de enfermedad de Wegener, que comienza en agosto de 2007 con expectoración hemoptoica, disnea de esfuerzo progresiva y esputo con baciloscopia BAAR (+), por lo que inicia tratamiento antituberculoso. La baciloscopia no se constata en dos lavados broncoalveolares contemporáneos. Evoluciona con deterioro de la función renal, púrpura palpable y anticuerpos anticitoplasma del neutrófilo patrón citoplasmático (ANCA-c) positivo. Se interpreta reactivación de su enfermedad de base. Inicia tratamiento inmunosupresor y hemodiálisis y suspende tratamiento antituberculoso. Un mes después del alta se reinterna con cuadro similar al previo, con esputo seriado positivo para BAAR.


Wegener's disease is a vasculitis of small and medium-sized vessels associated with anti-neutrophil cytoplasm antibodies (ANCA). Within their target organs the lungs are involved in 85% of cases. Many entities are part of the differential diagnosis, including pulmonary tuberculosis. We present the case of a 54 years old man, diagnosed as Wegener's disease in 1996 which begins in August 2007 with cough, hemoptysis, progressive dyspnea on effort and serial sputum positive for AFB and then starts TB treatment. Subsequent bronchoalveolar fluids resulted negative for AFB. The patient evolved with impaired renal function, palpable purpura and positive anti-neutrophil cytoplasm antibodies cytoplasmic pattern (c-ANCA), interpreted as Wegener's disease relapse. He started hemodialysis and immunosuppressive therapy and tuberculosis treatment was stopped. One month after discharge was readmitted with a similar picture with serial sputum positive for AFB.


Subject(s)
Humans , Male , Middle Aged , Lung/pathology , Tuberculosis, Pulmonary/pathology , Granulomatosis with Polyangiitis/pathology , Antibodies, Antineutrophil Cytoplasmic/analysis , Biopsy , Bronchoalveolar Lavage , Diagnosis, Differential , Tuberculosis, Pulmonary/therapy , Granulomatosis with Polyangiitis/therapy
12.
Medicina (B Aires) ; 69(6): 640-2, 2009.
Article in Spanish | MEDLINE | ID: mdl-20053604

ABSTRACT

Wegener's disease is a vasculitis of small and medium-sized vessels associated with anti-neutrophil cytoplasm antibodies (ANCA). Within their target organs the lungs are involved in 85% of cases. Many entities are part of the differential diagnosis, including pulmonary tuberculosis. We present the case of a 54 years old man, diagnosed as Wegener's disease in 1996 which begins in August 2007 with cough, hemoptysis, progressive dyspnea on effort and serial sputum positive for AFB and then starts TB treatment. Subsequent bronchoalveolar fluids resulted negative for AFB. The patient evolved with impaired renal function, palpable purpura and positive anti-neutrophil cytoplasm antibodies cytoplasmic pattern (c-ANCA), interpreted as Wegener's disease relapse. He started hemodialysis and immunosuppressive therapy and tuberculosis treatment was stopped. One month after discharge was readmitted with a similar picture with serial sputum positive for AFB.


Subject(s)
Granulomatosis with Polyangiitis/pathology , Lung/pathology , Tuberculosis, Pulmonary/pathology , Antibodies, Antineutrophil Cytoplasmic/analysis , Biopsy , Bronchoalveolar Lavage , Diagnosis, Differential , Granulomatosis with Polyangiitis/therapy , Humans , Male , Middle Aged , Tuberculosis, Pulmonary/therapy
13.
Genet. mol. biol ; 27(4): 644-650, Dec. 2004. ilus, tab, graf
Article in English | LILACS | ID: lil-391242

ABSTRACT

Pattern recognition is an important process for gene localization in genomes. The ribosome binding sites are signals that can help in the identification of a gene. It is difficult to find these signals in the genome through conventional methods because they are highly degenerated. Artificial Neural Networks is the approach used in this work to address this problem.


Subject(s)
Computational Biology , Ribosomes , Binding Sites , Neural Networks, Computer
14.
Clin Rehabil ; 17(4): 368-72, 2003 Jul.
Article in English | MEDLINE | ID: mdl-12785244

ABSTRACT

OBJECTIVE: To assess the effect of an ankle-foot orthosis on the gait and energy parameters of walking in chronic hemiparetic subjects. DESIGN: With/without group comparison. SETTING: Consecutive patients recruited from the gait analysis laboratory of our rehabilitation department. SUBJECTS: A group of nine chronic hemiparetic patients, with the same gait pattern alteration, were evaluated during walking at free speed with and without the use of an orthosis. OUTCOME MEASURES: Gait analysis and study of energy cost. RESULTS AND CONCLUSION: The orthosis significantly improved self-selected speed (15.47 versus 21.39 m/min), stride cycle (2.33 versus 2.08 s), stance (1.83 versus 1.48 s) and double support (1.55 versus 1.16 s) and reduced energy cost (0.76 versus 0.49 ml O2/kg/m) of walking without affecting cardiorespiratory response. Moreover, a significant correlation was found between the improvement of double support and the reduction of energy cost.


Subject(s)
Ankle/physiology , Energy Metabolism , Foot/physiology , Orthotic Devices , Paresis/rehabilitation , Walking , Aged , Aged, 80 and over , Female , Gait , Humans , Male , Middle Aged , Treatment Outcome
15.
Rev. Inst. Adolfo Lutz ; 49(1): 101-6, jun. 1989. tab
Article in Portuguese | LILACS, Sec. Est. Saúde SP | ID: lil-81157

ABSTRACT

Foram processadas 1.050 amostras de soro e/ou líquido cefalorraquidiano (LCR) de 450 pacientes do Estado de Säo Paulo com pesquisa positiva para anticorpos anti-HIV. Foi estudada a prevalência de anticorpos anti-Toxoplasma gondii através da reaçäo de imunofluorescência indireta nesses pacientes. Foram dosados anticorpos anti-T. gondii das classes Igtotal e IgM específico. Os resultados revelaram positividade par Igtotal nas amostras de soro e LCR em 69,1% e 47,3%, respectivamente. Em relaçäo às imunoglobulinas IgM, a sorologia mostrou-se positiva em 2,8% das amostras. Observou-se ainda elevada reatividade para Igtotal em amostras de LCR (61,2%) em pacientes com quadro clínico compatível com toxoplasmose. A concomitância de positividade em amostras de soro e LCR mostrou-se crescente, quanto mais avançada a fase clínica em que os pacientes com SIDA (AIDS) se encontravam. Em pacientes do grupo IV (ARC) da SIDA, quando os títulos de Igtotal no soro sanguíneo foram>/1.024, a concomitância de positividade no LCR foi de 80%..


Subject(s)
Toxoplasmosis , Fluorescent Antibody Technique , Acquired Immunodeficiency Syndrome
16.
Rev. Inst. Adolfo Lutz ; 49(1): 101-106, jun. 1989. tab
Article in Pt | ACV-CRTAIDS, ACV-CRTAIDS, SESSP-DSTPROD, Sec. Est. Saúde SP | ID: crt-3293

ABSTRACT

Foram processadas 1.050 amostras de soro e/ou líquido cefalorraquidiano (LCR) de 450 pacientes do Estado de São Paulo com pesquisa positiva para anticorpos anti-HIV. Foi estudada a prevalência de anticorpos anti-Toxoplasma gondii através da reacão de imunofluorescência indireta nesses pacientes. Foram dosados anticorpos anti-T. gondii das classes Igtotal e IgM específico. Os resultados revelaram positividade par Igtotal nas amostras de soro e LCR em 69,1 por cento e 47,3por cento, respectivamente. Em relacão às imunoglobulinas IgM, a sorologia mostrou-se positiva em 2,8por cento das amostras. Observou-se ainda elevada reatividade para Igtotal em amostras de LCR (61,2por cento) em pacientes com quadro clínico compatível com toxoplasmose. A concomitância de positividade em amostras de soro e LCR mostrou-se crescente, quanto mais avancada a fase clínica em que os pacientes com SIDA (AIDS) se encontravam. Em pacientes do grupo IV (ARC) da SIDA, quando os títulos de Igtotal no soro sanguíneo foram>/1.024, a concomitância de positividade no LCR foi de 80 por cento..(AU)


Subject(s)
Fluorescent Antibody Technique , Toxoplasmosis , Acquired Immunodeficiency Syndrome
17.
Rev. Inst. Adolfo Lutz ; 48(1/2): e36910, 1988. tab
Article in Portuguese | LILACS, Coleciona SUS, Sec. Est. Saúde SP, CONASS, SESSP-IALPROD, Sec. Est. Saúde SP, SESSP-IALACERVO | ID: lil-66609

ABSTRACT

No período compreendido entre fevereiro de 1984 e abril de 1987, examinaram-se, na Seção de Enteroparasitoses do Instituto Adolfo Lutz, 771 amostras de fezes de pacientes atendidos pelo Programa de Controle e Prevenção da AIDS, da Secretaria de Estado da Saúde de São Paulo. Do total, 483 pacientes estavam acometidos por AIDS e os demais 288 pertenciam a grupos de risco para infecção por HIV. Examinaram-se, também, no mesmo período, as fezes de 432 indivíduos atendidos por Unidades Sanitárias mantidas pela rede estadual de atenção primária à saúde, que, por sorteio, constituíram grupo controle. Os resultados indicaram maior frequência de parasitismo por Entamoeba histolytica e Isospora belli entre os pacientes aidéticos e os pertencentes a grupos de risco para infecção por HIV, além de índices mais elevados de infecção por Strogyloides stercoralis entre os aidéticos, quando comparados aos demais grupos. Revelou-se, ainda, infecção por Crytosporidium sp. em 12,1% dos aidéticos e 2,5% dos componentes de grupos de risco (AU).


Subject(s)
Humans , Acquired Immunodeficiency Syndrome , Enterovirus Infections
18.
Rev Inst Adolfo Lutz ; 48(1/2): 63-67, dez. 1988. tab
Article in Pt | ACV-CRTAIDS, ACV-CRTAIDS, SESSP-DSTPROD, Sec. Est. Saúde SP | ID: crt-3343

ABSTRACT

No período compreendido entre fevereiro de 1984 e abril de 1987, examinaram-se, na Secäo de Enteroparasitoses do Instituto Adolfo Lutz, 771 amostras de fezes de pacientes atendidos pelo Programa de Controle e Prevencäo da AIDS, da Secretaria de Estado da Saúde de Säo Paulo. Do total, 483 pacientes estavam acometidos por AIDS e os demais 288 pertenciam a grupos de risco para infeccäo por HIV. Examinaram-se, também, no mesmo período, as fezes de 432 indivíduos atendidos por Unidades Sanitárias mantidas pela rede estadual de atencäo primária à saúde, que, por sorteio, constituíram grupo controle. Os resultados indicaram maior frequência de parasitismo por Entamoeba histolytica e Isospora belli entre os pacientes aidéticos e os pertencentes a grupos de risco para infeccäo por HIV, além de índices mais elevados de infeccäo por Strogyloides stercoralis entre os aidéticos, quando comparados aos demais grupos. Revelou-se, ainda, infeccäo por Crytosporidium sp. em 12,1 por cento dos aidéticos e 2,5 por cento dos componentes de grupos de risco


Subject(s)
Humans , Acquired Immunodeficiency Syndrome , Enterovirus Infections
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