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1.
ACS Omega ; 7(26): 22394-22405, 2022 Jul 05.
Article in English | MEDLINE | ID: mdl-35811898

ABSTRACT

A simple and efficient method for the stereoselective synthesis of nojirimycin α-C-glycoside derivatives has been developed using a bicyclic carbamate-type sp2-iminosugar, whose preparation on a gram scale has been optimized, as the starting material. sp2-iminosugar O-glycosides or anomeric esters serve as excellent precursors of acyliminium cations, which can add nucleophiles, including C-nucleophiles. The stereochemical outcome of the reaction is governed by stereoelectronic effects, affording the target α-anomer with total stereoselectivity. Thus, the judicious combination of C-allylation, carbamate hydrolysis, cross-metathesis, and hydrogenation reactions provides a very convenient entry to iminosugar α-C-glycosides, which have been transformed into N,C-biantennary derivatives by reductive amination or thiourea-forming reactions. The thiourea adducts undergo intramolecular cyclization to bicyclic iminooxazolidine iminosugar α-C-glycosides upon acid treatment, broadening the opportunities for molecular diversity. A preliminary evaluation against a panel of commercial glycosidases validates the approach for finely tuning the inhibitory profile of glycomimetics.

2.
J Neuroeng Rehabil ; 19(1): 75, 2022 Jul 19.
Article in English | MEDLINE | ID: mdl-35854321

ABSTRACT

BACKGROUND: Children with spinal muscular atrophy (SMA) present muscle weakness and atrophy that results in a number of complications affecting their mobility, hindering their independence and the development of activities of daily living. Walking has well-recognized physiological and functional benefits. The ATLAS 2030 exoskeleton is a paediatric device that allows gait rehabilitation in children with either neurological or neuromuscular pathologies with gait disorders. The purpose is to assess the effects in range of motion (ROM) and maximal isometric strength in hips, knees and ankles of children with SMA type II after the use of ATLAS 2030 exoskeleton. METHODS: Three children (mean age 5.7 ± 0.6) received nine sessions bi-weekly of 60 min with ATLAS 2030. ROM was assessed by goniometry and strength by hand-held dynamometer. All modes of use of the exoskeleton were tested: stand up and sit down, forward and backward walking, and gait in automatic and active-assisted modes. In addition, different activities were performed during the gait session. A descriptive analysis of all variables was carried out. RESULTS: The average time of use was 53.5 ± 12.0 min in all sessions, and all participants were able to carry out all the proposed activities as well as to complete the study. Regarding isometric strength, all the measurements increased compared to the initial state, obtaining the greatest improvements for the hip flexors (60.2%) and extensors muscles (48.0%). The ROM increased 12.6% in hip and 34.1% in the ankle after the study, while knee ROM remained stable after the study. CONCLUSION: Improvements were showed in ROM and maximal isometric strength in hips, knees and ankles after using ATLAS 2030 paediatric gait exoskeleton in all three children. This research could serve as a preliminary support for future clinical integration of ATLAS 2030 as a part of a long-term rehabilitation of children with SMA. TRIAL REGISTRATION:  The approval was obtained (reference 47/370329.9/19) by Comunidad de Madrid Regional Research Ethics Committee with Medical Products and the clinical trial has been registered on Clinical Trials.gov: NCT04837157.


Subject(s)
Exoskeleton Device , Muscular Atrophy, Spinal , Activities of Daily Living , Child , Child, Preschool , Gait/physiology , Humans , Range of Motion, Articular , Walking/physiology
3.
Clin Case Rep ; 10(7): e6116, 2022 Jul.
Article in English | MEDLINE | ID: mdl-35898750

ABSTRACT

We report our experience with venetoclax/hypomethylating agents (Ven/HMA) in 8 AML patients not candidates for intensive CT or refractory/relapsed with limited treatment options. The response rate was 50%. Venetoclax was well-tolerated in 62.5% of the patients. Ven/HMA provides a benefit particularly when used in patients without prior HMA exposure.

4.
Inorg Chem ; 61(28): 10898-10914, 2022 Jul 18.
Article in English | MEDLINE | ID: mdl-35775932

ABSTRACT

Here, we describe the neutral cyclometalated tert-butylisocyanide PtII complexes, [Pt(C∧N)Cl(CNBut)] 1, the double salts [Pt(C∧N)(CNBut)2][Pt(C∧N)Cl2] 2, and the cationic complexes [Pt(C∧N)(CNBut)2]ClO4 3 [C∧N = difluorophenylpyridine (dfppy, a), 4-(2-pyridyl)benzaldehyde (ppy-CHO, b)]. A comparative study of the pseudopolymorphs 1a, 1a·CHCl3, 1b, 1b·0.5Toluene, 1b·0.5PhF, and 3a·0.25CH2Cl2 reveals strong aggregation through Pt···Pt and/or π···π stacking interactions to give a variety of distinctive one-dimensional (1D) infinite chains, which modulate the photoluminescent properties. This intermolecular long-range aggregate formation is the main origin of the photoluminescent behavior of 1a and 1b complexes, which exhibit highly sensitive and reversible responses to multiple external stimuli including different volatile organic compounds (VOCs), solvents, temperatures, and pressures, with distinct color and phosphorescent color switching from green to red. Furthermore, complex 1b undergoes supramolecular self-assembly via Pt···Pt and/or π···π interactions into a polymer thin polystyrene (PS) film 10 wt % in response to toluene vapors, and 3a exhibits vapochromic and vapoluminescent behavior. Theoretical simulations on the dimer, trimer, and tetramer models of 1a and 1b have been carried out to get insight into the photophysical properties in the aggregated solid state.

5.
Enferm Clin (Engl Ed) ; 32(4): 225-233, 2022.
Article in English | MEDLINE | ID: mdl-35649470

ABSTRACT

AIM: To evaluate the effect of the Otago Exercise Programme on the frailty of non-institutionalized people between 65 and 80 years of age and study factors associated with frailty. METHOD: Pre-post test study (baseline and after 12 months) without control group in people aged 65-80 years (living in the community and with independent ambulation) after being trained in the Otago Exercise Programme in 5 sessions: weeks 1, 2, 4 and 8, and a reinforcement session at 6 months. Patients were recruited from 3 health areas (n = 200). Frailty was assessed with the FRAIL scale. RESULTS: There were 198 people who started the study and 161 completed the 12-month follow-up. The average age of the sample was 72.28 years; predominance of female sex 64.65%; low educational level 76.50%; people living alone 24.50%; overweight in 42%, and grade I obesity in 32.32%. Significant differences were observed with a P = .023 in the level of frailty between baseline and 12 months. The exploratory analysis identified significant differences before and after the intervention by sex (being a woman) (P = .018) and condition of living alone (P = .0468). CONCLUSIONS: The Otago Exercise Programme prevents positive results in frailty in people 65 to 80 years of age and can help maintain function and prevent deterioration.


Subject(s)
Frailty , Activities of Daily Living , Aged , Aged, 80 and over , Exercise , Exercise Therapy/methods , Female , Frailty/prevention & control , Humans , Male
6.
Radiologia (Engl Ed) ; 64(3): 256-265, 2022.
Article in English | MEDLINE | ID: mdl-35676057

ABSTRACT

Breast cancer is the second most common cancer in Peruvian women. Due to limitations in national breast cancer screening programs, especially in rural areas, more than 50% of cases of breast cancer in Peru are diagnosed in advanced stages. In collaboration with a local clinic registered as a nongovernmental organization (CerviCusco), RAD-AID International aims to create a sustainable diagnostic structure to improve breast cancer screening in Cuzco. With the support of local, national, and international partners that have collaborated in analyzing radiological resources, raising awareness in the population, acquiring equipment, training clinical staff, and building referral networks, our teams of radiologists, included in the RAD-AID team, have participated in training CerviCusco staff in breast ultrasound, thus enabling additional training for radiology residents through a regulated international collaboration.


Subject(s)
Breast Neoplasms , Radiology , Breast Neoplasms/diagnostic imaging , Early Detection of Cancer , Female , Humans , Peru , Volunteers
9.
Semergen ; 2022 Mar 14.
Article in Spanish | MEDLINE | ID: mdl-35753944

ABSTRACT

INTRODUCCION: The COVID-19 pandemic that began in Wuhan, China, at the end of 2019, and which today threatens all the inhabitants of the planet, is currently the priority research topic. In this context, this article focuses on how this health problem directly affects the psychological and educational status of 344 university and high school students in Córdoba, Spain. MATERIAL AND METHODS: For the analysis, the structural equation model (SEM) has been used, through the quantification of a set of relationships between one or more independent variables, trying to condense the pandemic scenario and its health, psychological and educational implications. RESULTS: The first latent variable "Health" is causal of the latent variable "Psychology", and, of the endogenous variables, "social relations effects", "sadness effects" and "sexuality effects", which confirms that the COVID-19 seriously affected the psychological behavior of university and high school students in Córdoba.

10.
Rev. esp. med. nucl. imagen mol. (Ed. impr.) ; 41(3): 164-170, mayo - jun. 2022. ilus, tab, graf
Article in Spanish | IBECS | ID: ibc-ADZ-760

ABSTRACT

Objetivo: Determinar la utilidad de los parámetros cuantitativos de la PET/TC con 18F-FDG como factores pronósticos para la respuesta al tratamiento neoadyuvante, la supervivencia libre de progresión (SLP) y la supervivencia cáncer específica (SCE) en pacientes con carcinoma de células escamosas de esófago (CCE). Material y métodos: Se valoraron retrospectivamente 30 pacientes (29 hombres) diagnosticados de CCE durante un intervalo de 6años. Se determinaron los parámetros metabólicos SUV máximo (SUVmax), SUV medio (SUVmed), volumen metabólico tumoral (MTV) y glucólisis tumoral total (TLG) del estudio PET/TC al diagnóstico. Tras tratamiento con quimioterapia y/o radioterapia, se valoró la respuesta al tratamiento y la supervivencia de los pacientes. La comparación de parámetros entre grupos de respondedores y no respondedores se realizó mediante la prueba U de Mann-Whitney. Las curvas ROC y el método de Kaplan-Meier se utilizaron para el análisis de factores pronósticos y curvas de supervivencia. Resultados: El seguimiento medio fue de 22,4meses, produciéndose 22 recurrencias-progresiones y 25 fallecimientos. Se demostraron diferencias significativas entre respondedores y no respondedores con respecto al tamaño tumoral, el MTV y la TLG. El análisis de supervivencia halló diferencias significativas para SCE y SLP dependiendo de estos tres parámetros. Conclusión: Los parámetros metabólicos MTV y TLG, así como el tamaño tumoral, fueron factores pronósticos para la respuesta al tratamiento neoadyuvante, la SLP y la SCE en pacientes diagnosticados de CCE. Ni el SUVmax ni el SUVmed fueron predictores para ninguno de los criterios de evaluación. Los resultados permitirían personalizar el tratamiento de los pacientes (AU)


Aim: To determine the utility of 18F-FDG PET/CT quantitative parameters as prognostic factors for the response to neoadjuvant treatment, progression-free survival (PFS) and cancer-specific survival (CSS) in patients with esophageal squamous cell carcinoma (SCC). Material and methods: Thirty patients (29 men) diagnosed with SCC were retrospectively evaluated over a 6-year interval. Metabolic parameters were determined: maximum SUV (SUVmax), mean SUV (SUVmed), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) from baseline PET/CT study. After treatment with chemotherapy and/or radiotherapy, response to treatment and patient survival were assessed. The comparison of parameters between groups of responders and non-responders was carried out using a Mann-Whitney U test. ROC curves and the Kaplan-Meier method were used for analysis of prognostic factors and survival curves. Results: The average follow-up was 22.4months, with 22 recurrence-progressions and 25 deads. Significant differences were demonstrated between responders and non-responders with respect to tumor size, MTV and TLG. Survival analysis found significant differences for SCE and CSS depending on these three parameters. Conclusion: Metabolic parameters MTV and TLG, and tumor size were prognostic factors for neoadjuvant treatment response, PFS, and CSS in patients diagnosed with SCC. Neither SUVmax nor SUVmed were predictive for any of the evaluation criteria. Results could help to personalize patient treatment (AU)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Esophageal Squamous Cell Carcinoma/diagnostic imaging , Esophageal Neoplasms/diagnostic imaging , Positron Emission Tomography Computed Tomography , Fluorodeoxyglucose F18 , Retrospective Studies , Follow-Up Studies , Disease-Free Survival , Radiopharmaceuticals , Prognosis
11.
J Enzyme Inhib Med Chem ; 37(1): 1364-1374, 2022 Dec.
Article in English | MEDLINE | ID: mdl-35575117

ABSTRACT

The late-onset form of Tay-Sachs disease displays when the activity levels of human ß-hexosaminidase A (HexA) fall below 10% of normal, due to mutations that destabilise the native folded form of the enzyme and impair its trafficking to the lysosome. Competitive inhibitors of HexA can rescue disease-causative mutant HexA, bearing potential as pharmacological chaperones, but often also inhibit the enzyme O-glucosaminidase (GlcNAcase; OGA), a serious drawback for translation into the clinic. We have designed sp2-iminosugar glycomimetics related to GalNAc that feature a neutral piperidine-derived thiourea or a basic piperidine-thiazolidine bicyclic core and behave as selective nanomolar competitive inhibitors of human Hex A at pH 7 with a ten-fold lower inhibitory potency at pH 5, a good indication for pharmacological chaperoning. They increased the levels of lysosomal HexA activity in Tay-Sachs patient fibroblasts having the G269S mutation, the highest prevalent in late-onset Tay-Sachs disease.


Subject(s)
Tay-Sachs Disease , Hexosaminidase A/genetics , Humans , Lysosomes , Piperidines , Tay-Sachs Disease/drug therapy , Tay-Sachs Disease/genetics , beta-N-Acetylhexosaminidases
12.
Curr Drug Saf ; 2022 Apr 29.
Article in English | MEDLINE | ID: mdl-35507800

ABSTRACT

BACKGROUND: Crohn Disease (CD) is an intestinal inflammatory condition char-acterized by a complex pathogenesis, with elevated levels of inflammatory cytokines. Ada-limumab and certolizumab are two biologic drugs inhibiting TNF-α. OBJECTIVE: We report the first case of a probable relationship, according to Naranjo causality assessment score, between two consecutive treatments with TNF-α inhibitors and induced erectile dysfunction (ED), that disappeared after switching to another biologic drug (ustekinumab). CASE PRESENTATION: This case report describes a possible and important association of two TNF-α inhibitors (certolizumab and adalimumab) and ED in a male patient with CD, with resolution after switching to Ustekinumab (anti-interleukin 12 and 23 biologic drug). A 65 years old man experienced erectile dysfunction during treatment with an anti-TNF. The adverse effect disappeared after discontinuation of the drug. All necessary urologic exams were carried out. Adalimumab was replaced by certolizumab and sexual disfunction symptoms appeared again, improving typically at the end of treatment periods and getting worse with each new dose. RESULTS: Switching to ustekinumab lead to a resolution of the erectile dysfunction. CONCLUSION: We describe for the first time a sexual dysfunction possibly due to two similar anti TNF drugs and its resolution after the switch to another similar but different drug, highlighting the potential difference between biologic drugs.

14.
Radiología (Madr., Ed. impr.) ; 64(3): 256-265, May-Jun 2022. tab, graf, ilus
Article in Spanish | IBECS | ID: ibc-204583

ABSTRACT

El cáncer de mama es el segundo cáncer más frecuente en las mujeres peruanas. Las limitaciones de los programas nacionales de detección precoz, sobre todo en las regiones rurales, propician que más del 50% de los nuevos casos de cáncer de mama en Perú se diagnostiquen en estadios avanzados. RAD-AID Internacional, en colaboración con una clínica local registrada como organización no gubernamental (CerviCusco), pretende crear una estructura diagnóstica sostenible que mejore el cribado del cáncer de mama en Cuzco. Para ello se ha contado con socios locales, nacionales e internacionales que han colaborado en el análisis de recursos radiológicos, la concienciación de la población, la adquisición de equipamiento, el entrenamiento clínico y las redes de referencia. Nuestros equipos de radiólogos, incluidos en el equipo RAD-AID, han participado en la capacitación ecográfica del personal de CerviCusco, permitiendo una formación adicional a los residentes de radiología gracias a una colaboración internacional reglada.(AU)


Breast cancer is the second most common cancer in Peruvian women. Due to limitations in national breast cancer screening programs, especially in rural areas, more than 50% of cases of breast cancer in Peru are diagnosed in advanced stages. In collaboration with a local clinic registered as a nongovernmental organization (CerviCusco), RAD-AID International aims to create a sustainable diagnostic structure to improve breast cancer screening in Cuzco. With the support of local, national, and international partners that have collaborated in analyzing radiological resources, raising awareness in the population, acquiring equipment, training clinical staff, and building referral networks, our teams of radiologists, included in the RAD-AID team, have participated in training CerviCusco staff in breast ultrasound, thus enabling additional training for radiology residents through a regulated international collaboration.(AU)


Subject(s)
Humans , Female , Volunteers , Peru , Breast Neoplasms/diagnostic imaging , Ultrasonography , Early Detection of Cancer
15.
Hipertens. riesgo vasc ; 39(2): 56-61, abr.-jun. 2022. tab, graf
Article in Spanish | IBECS | ID: ibc-203954

ABSTRACT

Introducción: Un incremento matutino de presión arterial (IMPA) elevado se asocia con la aparición de eventos cardiovasculares. Evaluamos la presencia de un IMPA elevado en pacientes con ictus isquémico reciente. Material y métodos: Se realizó un estudio casos-control. Se incluyeron 100 pacientes con un ictus isquémico en los 6 meses previos y 50 pacientes hipertensos sin enfermedad cardiovascular como controles. Resultados: Se estudiaron 61 ictus lacunares (LAC) y 39 no lacunares (NLAC). La edad media fue de 65±11 años, y 60 (40%) pacientes eran mujeres. El IMPA elevado estaba presente en el 9% de los ictus (en 5 LAC y 4 NLAC) y en el 8% de los controles (p no significativa [NS]), con un valor medio similar de IMPA en ambos grupos: 23,9±14mmHg y 24,9±15mmHg respectivamente (p=NS), aunque los pacientes controles presentaron una PA más alta en consulta (sistólica [p=0,008] y diastólica [p=0,0001]), PA sistólica de 24h (p=0,028) y PA sistólica diurna (p=0,022). Entre los pacientes con ictus, un IMPA elevado se asoció con enfermedad coronaria previa (p=0,005), con el patrón circadiano de PA (p=0,029), pero no con el tratamiento antihipertensivo prescrito. En el análisis multivariante, el IMPA elevado solo se asoció con enfermedad coronaria previa (p=0,001). Conclusiones: Aproximadamente uno de cada 10 pacientes con ictus isquémico reciente presenta un IMPA elevado. Se deberían implementar estrategias para la detección y tratamiento del IMPA tras un ictus.


Introduction: High morning BP surge (MBPS) has been associated with an increased risk of cardiovascular events. We evaluated the presence of a high MBPS in patients with recent ischaemic stroke. Material and methods: A case-control study was carried out. One hundred patients with an ischaemic stroke in the previous 6 months and fifty hypertensive patients without cardiovascular disease were included as controls. Results: 61 lacunar (LAC) and 39 non-lacunar (NLAC) strokes were studied. The mean age was 65±11 years, and 60 (40%) patients were women. High MBPS was present in 9% of strokes (in 5 LAC and 4 NLAC) and in 8% of controls (p not significant [NS]), with a similar mean value of MBPS in both groups: 23.9±14mmHg and 24.9±15mmHg respectively (p=NS), although the control patients had a higher office BP (systolic [p=.008] and diastolic [p=.0001]), 24h systolic BP (p=.028) and daytime systolic BP (p=.022). Among the stroke patients, high MBPS was associated with previous coronary heart disease (p=.005), circadian BP pattern (p=.029), but not with the type of antihypertensive treatment prescribed. In multivariate analysis, elevated MBPS was only associated with previous coronary artery disease (p=.001). Conclusions: Approximately one in ten patients with recent ischaemic stroke has a high MBPS. Strategies to detect and treat high MBPS after a stroke are needed.


Subject(s)
Humans , Male , Female , Aged , Brain Ischemia/epidemiology , Stroke/epidemiology , Stroke/etiology , Hypertension/prevention & control , Arterial Pressure , Case-Control Studies , Blood Pressure Monitoring, Ambulatory , Risk Factors
16.
Arch Pediatr ; 29(4): 277-280, 2022 May.
Article in English | MEDLINE | ID: mdl-35387750

ABSTRACT

Sleep problems are highly prevalent in patients with attention-deficit/hyperactivity disorder (ADHD). Although chronotype has been linked to behavioral problems, its specific contribution to ADHD symptoms remains unclear. We assessed the association between chronotype and sleep and behavioral problems in adolescents with ADHD between 12 and 18 years of age using questionnaires (Morningness-Eveningness Scale for Children [MESC], Strengths and Difficulties Questionnaire [SDQ], and Pediatric Sleep Questionnaire [PSQ]). Overall, 84 families (parents and adolescents) were enrolled. The intermediate chronotype was the most common in the study sample. No sex differences were detected in the proportion of morning, intermediate, and evening types. No correlation was found between MESC score and body mass index nor total PSQ score. Regarding SDQ, a significant negative correlation was found between the MESC score and hyperactivity/inattention score. We conclude that adolescents with ADHD tend to have an intermediate chronotype and eveningness is related to hyperactivity/inattention problems.


Subject(s)
Attention Deficit Disorder with Hyperactivity , Sleep Wake Disorders , Adolescent , Attention Deficit Disorder with Hyperactivity/diagnosis , Child , Circadian Rhythm , Humans , Parents , Sleep , Sleep Wake Disorders/epidemiology , Sleep Wake Disorders/etiology , Surveys and Questionnaires
17.
Neurologia (Engl Ed) ; 37(3): 216-228, 2022 Apr.
Article in English | MEDLINE | ID: mdl-35241415

ABSTRACT

INTRODUCTION: Spinal muscular atrophy (SMA) is a neurodegenerative disease caused by a biallelic mutation of the SMN1 gene, located on the long arm of chromosome 5, and predominantly affects the motor neurons of the anterior horn of the spinal cord, causing progressive muscle weakness and atrophy. The development of disease-modifying treatments is significantly changing the natural history of SMA, but uncertainty remains about which patients can benefit from these treatments and how that benefit should be measured. METHODOLOGY: A group of experts specialised in neurology, neuropediatrics, and rehabilitation and representatives of the Spanish association of patients with SMA followed the Delphi method to reach a consensus on 5 issues related to the use of these new treatments: general aspects, treatment objectives, outcome assessment tools, requirements of the treating centres, and regulation of their use. Consensus was considered to be achieved when a response received at least 80% of votes. RESULTS: Treatment protocols are useful for regulating the use of high-impact medications and should guide treatment, but should be updated regularly to take into account the most recent evidence available, and their implementation should be assessed on an individual basis. Age, baseline functional status, and, in the case of children, the type of SMA and the number of copies of SMN2 are characteristics that should be considered when establishing therapeutic objectives, assessment tools, and the use of such treatments. The cost-effectiveness of these treatments in paediatric patients is mainly influenced by early treatment onset; therefore, the implementation of neonatal screening is recommended. CONCLUSIONS: The RET-AME consensus recommendations provide a frame of reference for the appropriate use of disease-modifying treatments in patients with SMA.


Subject(s)
Muscular Atrophy, Spinal , Neurodegenerative Diseases , Child , Consensus , Delphi Technique , Humans , Infant, Newborn , Muscular Atrophy, Spinal/genetics , Muscular Atrophy, Spinal/therapy , Spain
18.
J Arthroplasty ; 37(5): 864-868, 2022 05.
Article in English | MEDLINE | ID: mdl-35114322

ABSTRACT

BACKGROUND: The purpose of this study is to analyze the potential influence of subclinical hypothyroidism (SCH) on improvement in patient-reported outcome measures following primary total knee arthroplasty. METHODS: A prospective, comparative cohort study between 92 SCH and 90 euthyroid patients was performed. Patients were followed up to 5 postoperative years. Patient-reported outcome measure was assessed by the Western Ontario and McMaster Universities Osteoarthritis Index questionnaire. The Knee Society Scores were used for functional evaluation, and 5-point Likert scale for patient satisfaction. The Hospital Anxiety and Depression scale was also used. RESULTS: All outcome scores significantly improved from preoperative to final follow-up in both groups (P = .001). There were no significant differences between groups in Knee Society Scores (P = .057) at the final follow-up, but Western Ontario and McMaster Universities Osteoarthritis Index scores were significantly lower in the SCH group (P = .015). Likewise, the patient satisfaction rate was significant lower in the SCH group (0.010). CONCLUSION: SCH patients have a slower functional recovery than euthyroid patients, and trended toward lower improvements in patient-reported scores. Depression was the most important negative factor. The findings of this study can provide the surgeon with an important information for better counseling the SCH patients.


Subject(s)
Arthroplasty, Replacement, Knee , Hypothyroidism , Osteoarthritis, Knee , Osteoarthritis , Arthroplasty, Replacement, Knee/psychology , Cohort Studies , Humans , Hypothyroidism/complications , Knee Joint/surgery , Osteoarthritis/surgery , Osteoarthritis, Knee/complications , Osteoarthritis, Knee/surgery , Patient Reported Outcome Measures , Patient Satisfaction , Prospective Studies , Treatment Outcome
19.
Int J Pediatr Otorhinolaryngol ; 155: 111073, 2022 Apr.
Article in English | MEDLINE | ID: mdl-35220158

ABSTRACT

INTRODUCTION: Langerhans cell histiocytosis (LCH) is a rare disease of unknown etiology with a heterogeneous and unspecific clinical presentation. Any organ or system may be involved but the most frequent is the skeleton. The diagnostic gold standard is done through histopathology combined with immunohistochemistry in the correct clinical setting. Treatment is still controversial. The objective of this study is to present a series of pediatric patients in order to contribute to the diagnosis and treatment of LCH. MATERIAL AND METHODS: A longitudinal, descriptive and retrospective study was done in 20 pediatric patients histologically diagnosed of LCH int the last 10 years, in a tertiary center. A review of the medical history was done and data collection included: epidemiological data, clinical manifestations and classification, lesion characteristics, treatment employed, follow-up and evolution. RESULTS: The mean age presentation was 6.5 years (2-12). The most frequent disease presentation was a palpable skull tumor followed by headache. Other otorhinolaryngologic presenting symptoms were bloody otorrhea and post auricular swelling. Single-systems LCH with skull tumors was the most frequent classification. Treatment options (surgery, chemotherapy and corticosteroid infiltration) were indicated according to disease classification. CONCLUSION: LCH should be suspected in pediatric patients with a palpable cranial vault tumor, as well as in patients with chronic otorrhea with granulation tissue at the external ear canal. Management of LCH fundamentally includes chemotherapy and surgery, or the combination of both. High-risk organs lesions, including temporal bone lesions, and multi-system LCH are predictors of recurrence and should have a long-term follow-up.


Subject(s)
Histiocytosis, Langerhans-Cell , Child , Child, Preschool , Head , Histiocytosis, Langerhans-Cell/diagnosis , Histiocytosis, Langerhans-Cell/epidemiology , Histiocytosis, Langerhans-Cell/therapy , Humans , Neck/pathology , Retrospective Studies , Temporal Bone/pathology
20.
Hipertens Riesgo Vasc ; 39(2): 56-61, 2022.
Article in Spanish | MEDLINE | ID: mdl-35168914

ABSTRACT

INTRODUCTION: High morning BP surge (MBPS) has been associated with an increased risk of cardiovascular events. We evaluated the presence of a high MBPS in patients with recent ischaemic stroke. MATERIAL AND METHODS: A case-control study was carried out. One hundred patients with an ischaemic stroke in the previous 6 months and fifty hypertensive patients without cardiovascular disease were included as controls. RESULTS: 61 lacunar (LAC) and 39 non-lacunar (NLAC) strokes were studied. The mean age was 65±11 years, and 60 (40%) patients were women. High MBPS was present in 9% of strokes (in 5 LAC and 4 NLAC) and in 8% of controls (p not significant [NS]), with a similar mean value of MBPS in both groups: 23.9±14mmHg and 24.9±15mmHg respectively (p=NS), although the control patients had a higher office BP (systolic [p=.008] and diastolic [p=.0001]), 24h systolic BP (p=.028) and daytime systolic BP (p=.022). Among the stroke patients, high MBPS was associated with previous coronary heart disease (p=.005), circadian BP pattern (p=.029), but not with the type of antihypertensive treatment prescribed. In multivariate analysis, elevated MBPS was only associated with previous coronary artery disease (p=.001). CONCLUSIONS: Approximately one in ten patients with recent ischaemic stroke has a high MBPS. Strategies to detect and treat high MBPS after a stroke are needed.


Subject(s)
Brain Ischemia , Ischemic Stroke , Stroke , Aged , Blood Pressure , Brain Ischemia/epidemiology , Case-Control Studies , Female , Humans , Male , Middle Aged , Stroke/epidemiology , Stroke/etiology
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