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1.
Int J Nanomedicine ; 19: 1951-1966, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38435752

RESUMEN

Background: Curcuma longa L., commonly known as turmeric, is renowned for its therapeutic benefits attributed to bioactive compounds, namely curcumin (Cur) and aromatic turmerone (Tur), present in its rhizome. These compounds exhibit diverse therapeutic properties, including anti-inflammatory, antioxidant, and anti-tumor effects. However, the topical application of these compounds has a significant potential for inducing skin irritation. This study focuses on formulating solid lipid nanoparticle (SLN) carriers encapsulating both Cur and Tur for reduced irritation and enhanced stability. Methods: SLN formulations were prepared by a method using homogenization followed by ultrasonication procedures and optimized by applying response surface methodology (RSM). Results: The optimized SLN formulation demonstrated entrapment efficiencies, with 77.21 ± 4.28% for Cur and 75.12 ± 2.51% for Tur. A size distribution of 292.11 ± 9.43 nm was obtained, which was confirmed to be a spherical and uniform shape via environmental scanning electron microscopy (ESEM) images. The in vitro release study indicated cumulative releases of 71.32 ± 3.73% for Cur and 67.23 ± 1.64% for Tur after 24 hours under sink conditions. Physical stability tests confirmed the stability of formulation, allowing storage at 4°C for a minimum of 60 days. Notably, in vitro skin irritation studies, utilizing the reconstructed human epidermal model (EPI-200-SIT), revealed a significant reduction in irritation with the SLN containing Cur and Tur compared to nonencapsulated Cur and Tur. Conclusion: These findings collectively endorse the optimized SLN formulation as a favorable delivery system for Cur and Tur in diverse topical uses, offering enhanced stability, controlled release and reduced irritation.


Asunto(s)
Curcumina , Nanopartículas , Humanos , Antioxidantes , Epidermis , Liposomas
2.
Heliyon ; 10(5): e26833, 2024 Mar 15.
Artículo en Inglés | MEDLINE | ID: mdl-38455524

RESUMEN

Background: Information on Emergency Department (ED) follow-up of patients presenting with epileptic seizures is limited. Objectives: It was planned to investigate the factors affecting the recurrence of epileptic seizures in the follow-up of patients presenting to the ED with the complaint of epileptic seizures. Materials and methods: This prospective, observational, single-center study was carried out in an adult population presenting to the ED. The study included patients older than 18 years of age presenting to the ED with the complaint of epileptic seizures. Results: Of the 205 patients included in the study, 68 (33.2%) had seizure recurrence during the 6 h. In the univariable analysis, advanced age, prolonged post-ictal duration, increased seizure duration, generalized tonic clonic seizure, alcohol consumption within past 24 h, hypertension, coronary artery disease, Alzheimer's disease, prior ischemic cerebrovascular disease, low Glascow Coma Scale (GCS), high glucose, high C-Reactive Protein, high phosphorus, low potassium, high blood urea nitrogen, high lactate, increased anion gap, high osmolarity were statistically significant in predicting recurrent seizure recurrence within 6 h. According to the logistic regression, postictal duration, GCS score, and age were independent predictors in our model. The cut-off value of postictal duration in predicting seizure recurrence at the highest sensitivity (66.2%) and specificity (89.8%) was 22.5 min. Conclusion: A prolonged postictal state, low GCS score, advanced age may be an indication of seizure recurrence. Therefore, patients with a long postictal duration, low GCS score, advanced age should be followed up more carefully in terms of recurrent seizures in the ED.

3.
Angiology ; 75(5): 425-433, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-37345456

RESUMEN

Transradial Access (TRA) is the suggested method when performing coronary procedures. TRA has several advantages over the transfemoral approach, but also some restrictions. The present study compared the efficacy and safety of the traditional proximal transradial approach (pTRA) with a newer technique known as the distal transradial approach (dTRA) for performing a coronary angiography (CAG) and percutaneous coronary intervention (PCI). Patients (n = 700) were placed into one of two categories (dTRA or pTRA) based on a random technique. The primary endpoint was RAO at follow-up. The secondary endpoints included the time required for sheath insertion, the rate of successful sheath insertion, rate of successful completion of CAG and PCI, total procedure time, total fluoroscopy time, total radiation dose, total contrast volume used, pain perception (visual analog scale 0-10), and hemostasis duration. dTRA patients had more skin punctures, failed punctures, failed wiring, overlap of access sites, sheath insertion time, and pain evaluation scale, while the pTRA group had more hemostasis time and first-time cannulation. RAO and pseudoaneurysm (PseA) were lower in the dTRA group. In this randomized study, dTRA had lower RAO and PseA than pTRA. However, multicenter, larger-patient trials are needed to provide definitive evidence.


Asunto(s)
Intervención Coronaria Percutánea , Humanos , Cateterismo , Angiografía Coronaria/efectos adversos , Angiografía Coronaria/métodos , Corazón , Dolor , Intervención Coronaria Percutánea/efectos adversos , Intervención Coronaria Percutánea/métodos , Arteria Radial , Resultado del Tratamiento
4.
J Biomol Struct Dyn ; : 1-11, 2023 Oct 04.
Artículo en Inglés | MEDLINE | ID: mdl-37794772

RESUMEN

Cancer has been recognized as one of the deadliest diseases in the world in recent years. By chemically tailoring specific properties, anticancer agents can be prepared very effectively for the treatment of various cancer types. In this manner, as anticancer agents, a series of soluble metal-free and metallophthalocyanines carrying cinnamyloxy-groups at peripheral ß-positions have been prepared. All synthesized phthalocyanines were characterized by various spectroscopic approaches such as ultraviolet - visible (UV - Vis), Fourier transform infrared (FT-IR), and matrix-assisted laser deionization/ionization time-of-flight mass spectroscopy (MALDI-TOF MS) techniques. These compounds are highly soluble in dimethyl sulfoxide (DMSO) and soluble in common organic solvents. The spectroscopic properties, cytotoxicity, and theoretical calculations of these complexes have been investigated. In cytotoxicity tests, compounds 1, 4, and 7 are the most active against HT-29 cell lines with IC50 values of 36.9 µM, 32.5 µM, and 51.1 µM, respectively. Also, the most and the least cytotoxic compounds against healthy CCD cell line is compounds 5 and 6 with the IC50 value of 13.4 µM and >250 µM, respectively. The PDB ID:4BQG target protein representing the HT-29 cancer cell line and the anti-cancer activities of phthalonitrile and its phthalocyanines were supported by molecular docking studies. Density Functional Theory (DFT) study supported the experimental results, including the spectral data, and implied that the compounds 5-7 are comparable by their characteristics, such as electronic properties, optical properties, electrostatic potentials, reactivity parameters, with the earlier studied compounds 2-4, which were successfully proved to be good candidates for cancer treatment.Communicated by Ramaswamy H. Sarma.

5.
Gerontology ; 69(9): 1104-1112, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37607528

RESUMEN

INTRODUCTION: Alzheimer's disease (AD) is one of the pathologies that the scientific world is still desperate for. The aim of this study was the investigation of diazepam binding inhibitor (DBI) as a prognostic factor for AD prognosis. METHODS: A total of 120 participants were divided into 3 groups. Forty new diagnosed Alzheimer patients (NDG) who have been diagnosed but have not started AD treatment, 40 patients who diagnosed 5 years ago (D5YG), and 40 healthy control groups (CG) were included in the study. Levels of DBI, oxidative stress, inflammatory, and neurodegenerative biomarkers were compared between 3 groups. RESULTS: Plasma levels of DBI, oligomeric Aß, total tau, glial fibrillary acidic protein, α-synuclein, interleukin (IL) 1ß, IL6, tumor necrosis factor α, oxidative stress index, high-sensitive C-reactive protein, and DNA damage were found higher in D5YG and NDG as compared to CG (p < 0.001). On the contrary, plasma levels of total thiol, native thiol, vitamin D and vitamin B12 were lower in D5YG and NDG as compared to CG (p < 0.001). DISCUSSION: DBI may be a potential plasma biomarker and promising drug target for AD. It could help physicians make a comprehensive evaluation with cognitive and neurodegenerative tests.


Asunto(s)
Enfermedad de Alzheimer , Relevancia Clínica , Humanos , Enfermedad de Alzheimer/diagnóstico , Enfermedad de Alzheimer/tratamiento farmacológico , Inhibidor de la Unión a Diazepam , Biomarcadores , Estrés Oxidativo
6.
Turk Neurosurg ; 33(1): 156-161, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36300581

RESUMEN

AIM: To investigate the effect of vertebral artery stenosis (VAS) on the basilar artery tortuosity. MATERIAL AND METHODS: A total of 158 patients (101 males; 57 females) were divided into two main groups depending on existence of the in the vertebral artery (VA). Then, these groups were divided into two sub-groups according to the stenosis severity. All these groups were compared via the following variables: the gender, age, stroke risk factors, and basilar artery deflection angle. RESULTS: The dominant VA was found more common on the left side; and most of the cases had an adverse directional correlation between the side of the dominant VA and basilar artery bending (p= 0.002). It was noticed that the mean value of the basilar artery deflection angle was higher in the patients with a VA stenosis rate below 70%. In the left VA, hypertension was found higher in the patients with VAS (92.3%, p= 0.012). Furthermore, C-shaped (n=63, 43%) was the most observing morphological change in the basilar artery (BA). CONCLUSION: Consequently, this study suggests that the VA stenosis below 70% may contribute to the BA tortuosity by affecting asymmetric VA flow.


Asunto(s)
Accidente Cerebrovascular , Insuficiencia Vertebrobasilar , Masculino , Femenino , Humanos , Arteria Basilar/diagnóstico por imagen , Constricción Patológica , Insuficiencia Vertebrobasilar/diagnóstico por imagen , Arteria Vertebral/diagnóstico por imagen
7.
Angiology ; 73(9): 835-842, 2022 10.
Artículo en Inglés | MEDLINE | ID: mdl-35249358

RESUMEN

We evaluated the predictive factors of symptomatic intracranial hemorrhage (SICH) in endovascular treatment of stroke. We included 975 ischemic stroke patients with anterior circulation occlusion. Patients that had hemorrhage and an increase of ≥4 points in their National Institutes of Health Stroke Scale (NIHSS) after the treatment were considered as SICH. The mean age of patients was 65.2±13.1 years and 469 (48.1%) were women. The median NIHSS was 16 (13-18) and Alberta Stroke Program Early CT 9 (8-10). In 420 patients (43.1%), modified Rankin Scale was favorable (0-2) and mortality was observed in 234 (24%) patients at the end of the third month. Patients with high diastolic blood pressure (P<.05) had significantly higher SICH. SICH was significantly higher in those with high NIHSS scores (P<.001), high blood glucose (P<.001), and leukocyte count at admission (P<.05). Diabetes mellitus (DM) (OR 1.90; P<.001), NIHSS (OR 1.07; P<.05), adjuvant intra-arterial thrombolytic therapy (IA-rtPA) (OR, 1.60; P<.05), and puncture-recanalization time (OR 1.01; P<.05) were independent factors of SICH. Higher baseline NIHSS score, longer procedure time, multiple thrombectomy maneuvers, administration of IA-rtPA, and the history of DM are independent predictors of SICH in anterior circulation occlusion.


Asunto(s)
Isquemia Encefálica , Procedimientos Endovasculares , Accidente Cerebrovascular , Anciano , Procedimientos Endovasculares/efectos adversos , Procedimientos Endovasculares/métodos , Femenino , Humanos , Hemorragias Intracraneales , Masculino , Persona de Mediana Edad , Sistema de Registros , Estudios Retrospectivos , Accidente Cerebrovascular/terapia , Trombectomía/efectos adversos , Trombectomía/métodos , Activador de Tejido Plasminógeno/efectos adversos , Resultado del Tratamiento
8.
Agri ; 33(1): 7-14, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-34254656

RESUMEN

OBJECTIVES: Headache is the most common complaint in cerebral venous sinus thrombosis (CVST) and it may sometimes be the only symptom in these patients. This retrospective and prospective study was an investigation of any differences in terms of clinical risk factors, radiological findings, or prognosis in patients with CVST who presented with isolated headache (IH) and cases with other concomitant findings (non-isolated headache [NIH]). METHODS: A total of 1144 patients from a multicenter study of cerebral venous sinus thrombosis (VENOST study) were enrolled in this research. The demographic, biochemical, clinical, and radiological aspects of 287 IH cases and 857 NIH cases were compared. RESULTS: There were twice as many women as men in the study group. In the IH group, when gender distribution was evaluated by age group, no statistically significant difference was found. The onset of headache was frequently subacute and chronic in the IH group, but an acute onset was more common in the NIH group. Other neurological findings were observed in 29% of the IH group during follow-up. A previous history of deep, cerebral, or other venous thromboembolism was less common in the IH group than in the NIH group. Transverse sinus involvement was greater in the IH group, whereas sagittal sinus involvement was greater in the NIH group. The presence of a plasminogen activator inhibitor (PAI) mutation was significantly greater in the IH group. CONCLUSION: IH and CVST should be kept in mind if a patient has subacute or chronic headache. PAI, which has an important role in thrombolytic events, may be a risk factor in CVST. Detailed hematological investigations should be considered. Additional studies are needed.


Asunto(s)
Trombosis de los Senos Intracraneales , Trombosis , Femenino , Cefalea/etiología , Humanos , Masculino , Estudios Prospectivos , Estudios Retrospectivos , Trombosis de los Senos Intracraneales/complicaciones , Trombosis de los Senos Intracraneales/diagnóstico por imagen
9.
Toxicon ; 198: 73-79, 2021 Jul 30.
Artículo en Inglés | MEDLINE | ID: mdl-33971212

RESUMEN

Melanoma is a highly malignant tumor caused by melanocytes. Even though melanoma represents just 3% of all skin malignancies, it represents 75% of deaths. Extracts of A. hierchuntica were reported to have anti-inflammatory, hepatoprotective, and anti-melanogenic activities. This study aims to investigate the dose-related relationship and selectivity of the toxic effects of A. hierchuntica extracts (AHE) on melanoma cells and provide a new option that can be used in the future treatment of melanoma. B16F10 Mus musculus malign melanoma cells and L929 Mus musculus healthy fibroblast cells were treated with root and leaf AHEs in a dose-dependent manner. Intracellular glutathione levels, mitochondrial membrane potential activity, apoptosis, genotoxicity, and cytotoxicity of AHE were evaluated. This study is probably the first study to show a significant apoptotic and genotoxic activity of AHE in selected B16F10 cancer cell lines. Mitochondrial membrane potential and glutathione activity of B16F10 and L929 melanoma cells decreased with increasing concentrations of both leaf and root AHEs. However, viability and reactive oxygen species levels showed selectivity especially the AHEs concentrations between 400 µg/mL and 500 µg/mL. This selectivity based on doses was also validated in apoptosis and genotoxicity between healthy and cancer cells (p < 0.001). The results showed that when looking at melanoma-specific, AHE could be a source of inspiration as an active ingredient in future treatment protocols. AHE can be recommended as potential nutraceuticals in the prevention of human melanoma cancer.


Asunto(s)
Melanoma Experimental , Animales , Apoptosis , Línea Celular Tumoral , Daño del ADN , Humanos , Ratones , Oxidantes , Extractos Vegetales
10.
J Clin Ultrasound ; 49(6): 580-585, 2021 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-33660282

RESUMEN

PURPOSE: Acute pulmonary embolism is a life-threatening cardiothoracic emergency leading to right ventricle systolic and diastolic dysfunction. In the present study, we investigated the right ventricle diastolic function and its predictive value in patients with acute pulmonary embolism. MATERIAL AND METHODS: Were prospectively recruited in this study 621 patients diagnosed with acute pulmonary embolism between December 2015 and June 2019. Among them, 173 were excluded, leaving 448 patients for follow-up. Transthoracic echocardiography was performed for the evaluation of the right ventricle systolic and diastolic indices. At 30-day follow-up, the patients were allocated either into the benign or in the complicated clinical course group. RESULTS: The group with complicated clinical course had higher value of pulmonary artery systolic pressure (PASP), right/left ventricle diameter ratio, E-wave velocity, E/A ratio, A' wave velocity, E/E' ratio, and time interval between E and E' waves (P < .05), but lower values of tricuspid annular plane systolic excursion, A-wave velocity, isovolumetric relaxation time, deceleration time, E', and E'/A' (P < .05). Complicated clinical course was associated with shorter isovolumetric relaxation time (r = .564, P < .001), E/E' (r = .495, P < .001), and TE-E' (r = .596, P < .001). Receiver operator characteristic curve analysis showed that TE-E' had the largest area under curve (TE-E' 0.82, IVRT 0.77, E/E' 0.72). A cut-off value of TE-E' = 70 milliseconds had an 81.1% sensitivity and 71.4% specificity for the prediction of the complicated clinical course. CONCLUSION: The assessment of the right ventricle diastolic function could predict the complicated clinical course in patients with acute pulmonary embolism.


Asunto(s)
Ecocardiografía Tridimensional , Embolia Pulmonar/diagnóstico por imagen , Embolia Pulmonar/fisiopatología , Enfermedad Aguda , Diástole/fisiología , Ventrículos Cardíacos/diagnóstico por imagen , Ventrículos Cardíacos/fisiopatología , Humanos , Masculino , Persona de Mediana Edad , Sístole/fisiología
11.
Turk J Pharm Sci ; 18(6): 781-789, 2021 Dec 31.
Artículo en Inglés | MEDLINE | ID: mdl-34979739

RESUMEN

OBJECTIVES: Hepatocellular carcinoma (HCC) is the seventh most common cancer and the third leading cause of tumor-related deaths worldwide. Mechanisms underlying tumor onset, progression, and metastasis in the case of HCC have not been adequately studied. In this study, we aimed to investigate the genotoxic, cytotoxic, apoptotic and oxidant effects of olive leaf extract (OLE) on HCC cells. MATERIALS AND METHODS: H4IIE Rattus norvegicus hepatoma cells and Rattus norvegicus healthy liver clone-9 cells were treated with the increasing concentrations of OLEs (250-2000 ppm) in ethanol, acetone, dichloromethane, and methanol. ATP cell viability, intracellular reactive oxygen species generation levels, double staining test with acridine orange/ethidium bromide, comet assay, levels of interleukin 1-beta (IL-1ß), IL-6, and tumor necrosis factor alpha were measured. Significance was determined using ANOVA test. RESULTS: Apoptotic, genotoxic, cytotoxic, and oxidative effects of OLEs increased with the increasing concentrations as compared to controls in H4IIE cells (p<0.001). CONCLUSION: This is the first study to show a significant and selective cytotoxic activity of OLEs in the selected H4IIE cancer cell lines. OLEs could selectively increase the apoptotic damage and show anti-proliferative and pro-apoptotic properties against the H4IIE cells. They could be recommended as potential nutraceuticals in the prevention of cancer.

12.
Clin Exp Hypertens ; 43(3): 211-216, 2021 Apr 03.
Artículo en Inglés | MEDLINE | ID: mdl-33172302

RESUMEN

Objective: Hypertension is a multi-factorial process prevalent in developed as well as in developing countries. Urotensin-II, different antioxidants, free radicals, and inflammatory biomarkers play an essential role in the cardiovascular system. The aim of this study is to investigate Urotensin-II, oxidative stress, and inflammation markers in normotensive, hypertensive, and resistant hypertensive patients. Methods: Fifty resistance hypertensive (rHT) patients, 50 hypertensive patients, and 50 age gender matched normotensive controls (NT-control) were enrolled. Urotensin-II (UII), total oxidant status (TOS), total antioxidant status (TAS), native thiol (NT), total thiol (TT), disulfide (DIS), interleukin 1 beta (IL1ß), interleukin 6 (IL6), tumor necrosis factor-alpha (TNFα), high sensitive c reactive protein (hsCRP), high-density lipoprotein (HDL) low-density lipoprotein (LDL), and total cholesterol (TC) were evaluated. Results: Serum levels of UII, IL1ß, IL6, TNFα, DIS, TOS, and OSI were found higher in rHT and HT as compared to NT-control (p < .001). On the contrary, serum levels of TT, TAS, and NT were lower in rHT and HT as compared to NT-control (p < .001). While TC, hsCRP, TOS, OSI, UII, IL1ß, IL6, and TNFα levels increase from HT to rHT group (p < .001); TAS and NT levels decrease from HT to rHT group (p < .001). Conclusions: UII levels, oxidative stress, and inflammation are higher in rHT and HT, while antioxidants and thiol levels are lower than the NT-control. Our study clearly showed that rHT and HT are more susceptible to impaired states of antioxidants, oxidative stress, and free radicals.


Asunto(s)
Hipertensión/patología , Inflamación/patología , Estrés Oxidativo , Urotensinas/sangre , Adulto , Antioxidantes/metabolismo , Biomarcadores/sangre , Disulfuros/sangre , Femenino , Humanos , Hipertensión/sangre , Masculino , Persona de Mediana Edad , Compuestos de Sulfhidrilo/sangre
13.
Eur Neurol ; 83(6): 615-621, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33130674

RESUMEN

INTRODUCTION: Cerebral venous and sinus thrombosis (CVST) may lead to cerebral edema and increased intracranial pressure; besides, ischemic or hemorrhagic lesions may develop. Intracerebral hemorrhages occur in approximately one-third of CVST patients. We assessed and compared the findings of the cerebral hemorrhage (CH) group and the CVST group. MATERIALS AND METHODS: In the VENOST study, medical records of 1,193 patients with CVST, aged over 18 years, were obtained from 35 national stroke centers. Demographic characteristics, clinical symptoms, signs at the admission, radiological findings, etiologic factors, acute and maintenance treatment, and outcome results were reported. The number of involved sinuses or veins, localizations of thrombus, and lesions on CT and MRI scans were recorded. RESULTS: CH was detected in the brain imaging of 241 (21.1%) patients, as hemorrhagic infarction in 198 patients and intracerebral hemorrhage in 43 patients. Gynecologic causes comprised the largest percentage (41.7%) of etiology and risk factors in the CVST group. In the CH group, headache associated with other neurological symptoms was more frequent. These neurological symptoms were epileptic seizures (46.9%), nausea and/or vomiting (36.5%), altered consciousness (36.5%), and focal neurological deficits (33.6%). mRS was ≥3 in 23.1% of the patients in the CH group. DISCUSSION AND CONCLUSION: CVST, an important cause of stroke in the young, should be monitored closely if the patients have additional symptoms of headache, multiple sinus involvement, and CH. Older age and parenchymal lesion, either hemorrhagic infarction or intracerebral hemorrhage, imply poor outcome.


Asunto(s)
Hemorragia Cerebral/epidemiología , Hemorragia Cerebral/etiología , Trombosis de los Senos Intracraneales/complicaciones , Trombosis de los Senos Intracraneales/diagnóstico , Adolescente , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Factores de Riesgo , Adulto Joven
14.
Stroke Res Treat ; 2020: 8610903, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32953038

RESUMEN

BACKGROUND: Early diagnosis of cerebral venous sinus thrombosis (CVST) associated with reproductive health-related risk factors (RHRF) including pregnancy, puerperium, and oral contraceptive (OC) use can prevent severe neurological sequelae; thus, the symptoms must be documented in detail for each group. METHODS: Out of 1144 patients with CVST, a total of 777 women were enrolled from a multicenter for the study of cerebral venous sinus thrombosis (VENOST). Demographic, biochemical, clinical, and radiological aspects were compared for 324 cases with RHRF and 453 cases without RHRF. RESULTS: The mean age of the RHRF (-) group (43.2 ± 13 years) was significantly higher than of the RHRF (+) group (34 ± 9 years). A previous history of deep venous thrombosis (3%), isolated cavernous sinus involvement (1%), cranial neuropathy (13%), comorbid malignancy (7%), and its disability scores after 12 months (9%) were significantly higher in the RHRF (-) group. The RHRF (+) group consisted of 44% cases of puerperium, 33% cases of OC users and 23% of pregnant women. The mean age was found to be higher in OC users (38 ± 9 years). A previous history of deep venous thrombosis was slightly higher in the pregnancy subgroup (4%). Epileptic seizures were more common in the puerperium group (44%). CONCLUSION: The results of our study indicate that the risk of CSVT increases parallel to age, OC use, and puerperium period. In addition, when considering the frequency of findings and symptoms, epileptic seizures in the puerperium subgroup of the RHRF (+) group and malignancies in the RHRF (-) group may accompany the CSVT. In daily practice, predicting these risks for the CSVT and early recognition of the symptoms will provide significant benefits to patients.

15.
Seizure ; 78: 113-117, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-32353818

RESUMEN

PURPOSE: The aim of this study is to evaluate the presence and prognostic impact of early seizures in cerebral venous sinus thrombosis patients (CVST). METHOD: VENOST is a retrospective and prospective national multicenter observational study. CVST patients with or without epileptic seizures (ES) were analyzed and compared in terms of demographic and imaging data, causative factors, clinical variables, and prognosis in a total of 1126 patients. RESULTS: The mean age of the patients in the ES group was 39.73 ± 12.64 and 40.17 ± 14.02 years in the non-ES group (p > 0.05). Epileptic seizures were more common (76.6 %) in females (p < 0.001). Early ES occurred in 269 of 1126 patients (23.9 %). Epileptic seizures mainly presented in the acute phase (71.4 %) of the disease (p < 0.001). Majority of these (60.5 %) were in the first 24 h of the CVST. The most common neurological signs were focal neurologic deficits (29.9 %) and altered consciousness (31.4 %) in the ES group. Superior sagittal sinus (SSS) and cortical veins (CV) involvement were the most common sites of thrombosis and the mostly related etiology were found puerperium in seizure group (30.3 % vs 13.9 %). Patients with seizures had worse outcome in the first month of the disease (p < 0.001) but these did not have any influence thereafter. CONCLUSIONS: In this largest CVST cohort (VENOST) reported female sex, presence of focal neurological deficits and altered consciousness, thrombosis of the SSS and CVs, hemorrhagic infarction were risk factors for ES occurrence in patients with CVST.


Asunto(s)
Hemorragia Cerebral/fisiopatología , Infarto Cerebral/fisiopatología , Trastornos de la Conciencia/fisiopatología , Epilepsia/fisiopatología , Convulsiones/fisiopatología , Trombosis de los Senos Intracraneales/fisiopatología , Adulto , Hemorragia Cerebral/etiología , Infarto Cerebral/etiología , Trastornos de la Conciencia/etiología , Epilepsia/etiología , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Pronóstico , Estudios Prospectivos , Estudios Retrospectivos , Convulsiones/etiología , Trombosis de los Senos Intracraneales/complicaciones
16.
J Clin Ultrasound ; 48(5): 254-262, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32237150

RESUMEN

PURPOSE: Acute pulmonary embolism (APE) is a life-threating cardiothoracic thromboembolic emergency in which right ventricle dysfunction (RVD) is a major concern. In the present study, we examined the hepatic veins (HVs) blood flow with pulsed-wave spectral Doppler ultrasonography to determine its relationship with the simplified pulmonary embolism severity index (sPESI) and the patient's RVD status. METHODS: We divided the 243 patients who met the inclusion criteria into two groups based on both their sPESI scores and their RVD status. Transthoracic echocardiography was performed to evaluate the RVD and the HVs within 1 hour after patient admission. The liver was evaluated using subcostal and intercostal echocardiographic windows in grayscale B-mode, and HVs were assessed using color and spectral Doppler assessment though the same echocardiographic windows. RESULT: A cut-off value of the systolic reverse flow velocity-time integral (SrVTI) = 2.2 cm carried a sensitivity and specificity of 84.29% and 74.89%, respectively, for the prediction of sPESI ≥ 1. A SrVTI cut-off value of 2.1 cm yielded a sensitivity and specificity of 83.03% and 73.91%, respectively, for the prediction of RVD. CONCLUSION: HV Doppler assessment could be a useful method for anticipating the sPESI and the presence of RVD in patients with APE. In addition, it may provide information regarding the hemodynamic impact of APE.


Asunto(s)
Venas Hepáticas/diagnóstico por imagen , Embolia Pulmonar/complicaciones , Ultrasonografía Doppler/métodos , Disfunción Ventricular Derecha/complicaciones , Disfunción Ventricular Derecha/diagnóstico , Femenino , Ventrículos Cardíacos/fisiopatología , Venas Hepáticas/fisiopatología , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Embolia Pulmonar/fisiopatología , Sensibilidad y Especificidad , Índice de Severidad de la Enfermedad , Disfunción Ventricular Derecha/fisiopatología
17.
J Back Musculoskelet Rehabil ; 33(3): 451-454, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31561322

RESUMEN

OBJECTIVE: The aim of this study was to assess the cerebral blood flow velocity as a marker by using transcranial Doppler (TCD) ultrasonography in patients with ankylosing spondylitis (AS). METHODS: A total of 30 AS patients aged 20 to 50 were enrolled in the AS group (male/female: 4/26, mean age: 34.7 ± 5.9) consecutively. The control group (non-AS group; male/female: 4/26, mean age: 32.3 ± 4.7) consisted of 30 age- and sex-matched, randomly selected patients without AS who had other diagnoses such as fibromyalgia and did not have risk factors for atherosclerosis. Bilateral middle cerebral artery (MCA) peak-systolic, end-diastolic, and mean blood flow velocities, Gosling's pulsatility index values, and Pourcelot's resistance index values were recorded with TCD by a neurosonologist blinded to the AS and control groups. RESULTS: The erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) levels and cerebral blood flow velocities of bilateral MCA were significantly higher in the AS group than in the control group. CONCLUSIONS: This study highlights that the increased cerebral blood flow is indirectly associated with atherosclerosis regarding persistent inflammation in patients with AS.


Asunto(s)
Velocidad del Flujo Sanguíneo/fisiología , Circulación Cerebrovascular/fisiología , Arteria Cerebral Media/fisiopatología , Espondilitis Anquilosante/fisiopatología , Adulto , Femenino , Hemodinámica/fisiología , Humanos , Masculino , Persona de Mediana Edad , Arteria Cerebral Media/diagnóstico por imagen , Espondilitis Anquilosante/diagnóstico por imagen , Ultrasonografía Doppler Transcraneal , Adulto Joven
18.
J Stroke Cerebrovasc Dis ; 28(12): 104372, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31562041

RESUMEN

AIM: Systemic lupus erythematosus (SLE) is an unusual risk factor for cerebral venous sinus thrombosis (CVST). As few CVST patients with SLE have been reported, little is known regarding its frequency as an underlying etiology, clinical characteristics, or long-term outcome. We evaluated a large cohort of CVST patients with SLE in a multicenter study of cerebral venous thrombosis, the VENOST study, and their clinical characteristics. MATERIAL AND METHOD: Among the 1144 CVST patients in the VENOST cohort, patients diagnosed with SLE were studied. Their demographic and clinical characteristics, etiological risk factors, venous involvement status, and outcomes were recorded. RESULTS: In total, 15 (1.31%) of 1144 CVST patients had SLE. The mean age of these patients was 39.9 ± 12.1 years and 13 (86.7%) were female. Presenting symptoms included headache (73.3%), visual field defects (40.0%), and altered consciousness (26.7%). The main sinuses involved were the transverse (60.0%), sagittal (40.0%), and sigmoid (20.0%) sinuses. Parenchymal involvement was not seen in 73.3% of the patients. On the modified Rankin scale, 92.9% of the patients scored 0-1 at the 1-month follow-up and 90.9% scored 0-1 at the 1-year follow-up. CONCLUSIONS: SLE was found in 1.31% of the CVST patients, most frequently in young women. Headache was the most common symptom and the CVST onset was chronic in the majority of cases. The patient outcomes were favorable. CVST should be suspected in SLE patients, even in those with isolated chronic headache symptoms with or without other neurological findings.


Asunto(s)
Lupus Eritematoso Sistémico/epidemiología , Trombosis de los Senos Intracraneales/epidemiología , Adulto , Distribución por Edad , Trastornos de la Conciencia/diagnóstico , Trastornos de la Conciencia/epidemiología , Femenino , Trastornos de Cefalalgia/diagnóstico , Trastornos de Cefalalgia/epidemiología , Humanos , Lupus Eritematoso Sistémico/diagnóstico , Masculino , Persona de Mediana Edad , Pronóstico , Estudios Prospectivos , Estudios Retrospectivos , Factores de Riesgo , Distribución por Sexo , Trombosis de los Senos Intracraneales/diagnóstico , Factores de Tiempo , Turquía/epidemiología , Trastornos de la Visión/diagnóstico , Trastornos de la Visión/epidemiología
19.
Am J Alzheimers Dis Other Demen ; 34(7-8): 464-468, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31311283

RESUMEN

BACKGROUND: The most common type of dementia is an Alzheimer's disease which is a major concern in growing chronic diseases in the geriatric society, and its connection with biochemistry has not been sufficiently understood. OBJECTIVE: This study aims to evaluate the effects of blood biochemistry on Alzheimer's disease. METHOD: Eight participants aged 55+ with Alzheimer's disease were analyzed. A cross-sectional work has conducted. Eighty patients have been divided into 2 groups as group A and group B according to laboratory findings including glycosylated hemoglobin, high-density lipoprotein (HDL), low-density lipoprotein (LDL), total cholesterol (TC), triglycerides (TGA), vitamin D, folic acid, and vitamin B12. Mean Mini-Mental State Examination scores between these different 2 groups have been compared. RESULTS: High levels of HDL, vitamin D, and folic acid correlate with cognitive scores, whereas high levels of total cholesterol, HbA1c, LDL show a negative effect on cognition scores. CONCLUSION: High-density lipoprotein, vitamin D, folic acid, cholesterol, HgA1c, and LDL have an effect on dementia.


Asunto(s)
Enfermedad de Alzheimer/sangre , Enfermedad de Alzheimer/fisiopatología , HDL-Colesterol/sangre , LDL-Colesterol/sangre , Ácido Fólico/sangre , Hemoglobina Glucada/metabolismo , Vitamina D/sangre , Anciano , Anciano de 80 o más Años , Estudios Transversales , Femenino , Humanos , Masculino , Pruebas de Estado Mental y Demencia , Persona de Mediana Edad
20.
Rheumatology (Oxford) ; 58(4): 600-608, 2019 04 01.
Artículo en Inglés | MEDLINE | ID: mdl-29992235

RESUMEN

OBJECTIVE: This study was performed to determine the rate of cerebral venous sinus thrombosis (CVST) among cases of Behçet's disease (BD) included in a multicentre study of cerebral venous sinus thrombosis (VENOST). METHODS: VENOST was a retrospective and prospective national multicentre observational study that included 1144 patients with CVST. The patients were classified according to aetiologic factors, time of CVST symptom onset, sinus involvement, treatment approach and prognosis. RESULTS: BD was shown to be a causative factor of CVST in 108 (9.4%) of 1144 patients. The mean age of patients in the BD group was 35.27 years and 68.5% were men, whereas in the non-BD CVST group, the mean age was 40.57 years and 28.3% were men (P < 0.001). Among the aetiologic factors for patients aged 18-36 years, BD was predominant for men, and puerperium was predominant for women. The onset of symptoms in the BD group was consistent with the subacute form. The transverse sinuses were the most common sites of thrombosis, followed by the superior sagittal sinuses. The most common symptom was headache (96.2%), followed by visual field defects (38%). CONCLUSIONS: BD was found in 9.4% of patients in our VENOST series. Patients with BD were younger and showed a male predominance. The functional outcome of CVST in patients with BD was good; only 12% of patients presenting with cranial nerve involvement and altered consciousness at the beginning had a poor outcome (modified Rankin Score ⩾2).


Asunto(s)
Síndrome de Behçet/complicaciones , Trombosis de los Senos Intracraneales/etiología , Adulto , Factores de Edad , Síndrome de Behçet/patología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pronóstico , Estudios Prospectivos , Estudios Retrospectivos , Factores de Riesgo , Factores Sexuales , Trombosis de los Senos Intracraneales/patología
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