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1.
Diagnostics (Basel) ; 14(9)2024 Apr 26.
Artículo en Inglés | MEDLINE | ID: mdl-38732319

RESUMEN

A 15-year-old young girl was found dead at home. There were no indications of any intervention or the application of force. On the previous day, she was admitted to hospital because of palpitations, fatigue, a headache, and a swollen neck. During a physical examination, a swollen thyroid gland and tachycardia were found. In the family history, her mother had thyroid disease. According to the laboratory values, she had elevated thyroid hormone levels. After administration of beta-blockers, the patient was discharged and died at home during the night. The parents denounced the hospital for medical malpractice; therefore, a Forensic Autopsy was performed. Based on the available clinical data, the autopsy, histological and toxicological results, the cause of death was stated as multiorgan failure due to disseminated intravascular coagulation (DIC) caused by the autoimmune Graves disease. The forensic assessment of the case does not reveal medical malpractice. Post-mortem diagnoses of thyroid disorders in cases of sudden death can be challenging. However, as the reported case illustrates, the diagnosis could be established after a detailed evaluation of antemortem clinical data, autopsy results, histology, and a toxicological examination.

2.
Sci Rep ; 14(1): 11941, 2024 05 24.
Artículo en Inglés | MEDLINE | ID: mdl-38789490

RESUMEN

The emergence of newer SARS-CoV-2 variants of concern (VOCs) profoundly changed the ICU demography; this shift in the virus's genotype and its correlation to lethality in the ICUs is still not fully investigated. We aimed to survey ICU patients' clinical and laboratory parameters in correlation with SARS-CoV-2 variant genotypes to lethality. 503 COVID-19 ICU patients were included in our study beginning in January 2021 through November 2022 in Hungary. Furthermore, we implemented random forest (RF) as a potential predictor regarding SARS-CoV-2 lethality among 649 ICU patients in two ICU centers. Survival analysis and comparison of hypertension (HT), diabetes mellitus (DM), and vaccination effects were conducted. Logistic regression identified DM as a significant mortality risk factor (OR: 1.55, 95% CI 1.06-2.29, p = 0.025), while HT showed marginal significance. Additionally, vaccination demonstrated protection against mortality (p = 0.028). RF detected lethality with 81.42% accuracy (95% CI 73.01-88.11%, [AUC]: 91.6%), key predictors being PaO2/FiO2 ratio, lymphocyte count, and chest Computed Tomography Severity Score (CTSS). Although a smaller number of patients require ICU treatment among Omicron cases, the likelihood of survival has not proportionately increased for those who are admitted to the ICU. In conclusion, our RF model supports more effective clinical decision-making among ICU COVID-19 patients.


Asunto(s)
COVID-19 , Unidades de Cuidados Intensivos , SARS-CoV-2 , Humanos , COVID-19/mortalidad , COVID-19/epidemiología , COVID-19/virología , Unidades de Cuidados Intensivos/estadística & datos numéricos , Hungría/epidemiología , Masculino , Femenino , Persona de Mediana Edad , SARS-CoV-2/aislamiento & purificación , SARS-CoV-2/genética , Anciano , Algoritmos , Factores de Riesgo , Adulto , Hipertensión/epidemiología , Bosques Aleatorios
3.
Leg Med (Tokyo) ; 66: 102365, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38041907

RESUMEN

BACKGROUND: Various instruments, including glass fragments, can inflict sharp-force damage, resulting in injuries ranging from superficial wounds to life-threatening trauma. This case report explores the lethal consequences of a 78-year-old man accidentally sustaining a stabbed-incised wound after falling against an ordinary glass door, leading to fatal bleeding from the subclavian artery. CASE REPORT: The man's fall caused a sharp-edged glass fragment to penetrate his neck, resulting in a fatal outcome despite resuscitation attempts. AUTOPSY FINDINGS: The autopsy revealed a transected subclavian artery, additional injuries to the thorax. Notably, the type of glass used in construction played a crucial role in the severity of injuries, emphasizing the need for safety standards and awareness in architectural design. DISCUSSION: The discussion delves into the historical use of annealed glass in construction and the evolution of safety standards for architectural glazing materials. A comparison between annealed and tempered glass underscores the importance of the latter in preventing severe injuries. The prevalence of annealed glass in older constructions raises concerns, given its propensity to cause larger and more dangerous shards upon breakage. The report highlights cases of glass-related fatalities, emphasizing the unexpected dangers associated with glass-topped furniture. CONCLUSIONS: Recommendations include the adoption of safety glass in new constructions, particularly in residences with elderly occupants, and the installation of night lights to mitigate the risk of injuries from glass and other furniture. The report contributes to enhancing understanding in forensic pathology, emphasizing the evolving role of glass in fatal incidents.


Asunto(s)
Vidrio , Hemorragia , Humanos , Anciano , Hemorragia/etiología , Autopsia , Patologia Forense
4.
Biomed Res Int ; 2019: 8670398, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30882001

RESUMEN

Tyrosine kinases play crucial roles in cellular development and tumorigenesis. Tyrosine kinase inhibitors (TKIs) are effective and widely used drug molecules in targeted cancer therapies. Altered expressions of protooncogenes and tumor suppressor genes after DMBA (7,12-dimethylbenz[a]anthracene) treatment have been described as early markers of tumor induction; however their tissue-specific effects remain still unclear. Our study was aimed at examining the short-term possible antineoplastic and chemopreventive effects of a TKI compound (imatinib mesylate) on a DMBA-induced mouse tumor model. In addition, we also investigated the tissue-specific expressions of Hras, Kras, Myc, and Trp53 genes in the brain, bone marrow, spleen, liver, abdominal lymph nodes, thymus, lungs, and kidneys, respectively. 24 hours after the imatinib mesylate injection, we observed significant Kras downregulation in the bone marrow and lung of the DMBA-treated mice. Moreover, the mRNA expression of Myc was also found to be decreased significantly in the spleen. Interestingly, while Trp53 expression was significantly increased in the lung, it was decreased in the other tissues. However, there was also a tendency in the decreased Myc level in the bone marrow, brain, kidneys, lungs, and lymph nodes and in the decreased Hras level in the bone marrow, kidneys, and lungs, although no significant differences were observed. Our findings indicate rapid tissue-specific impact of imatinib mesylate on DMBA-induced gene expression in vivo, supporting the chemopreventive potential of imatinib mesylate in cancer.


Asunto(s)
Anticarcinógenos/administración & dosificación , Mesilato de Imatinib/administración & dosificación , Neoplasias/tratamiento farmacológico , Inhibidores de Proteínas Quinasas/administración & dosificación , Animales , Antracenos/toxicidad , Regulación Neoplásica de la Expresión Génica/efectos de los fármacos , Humanos , Ratones , Neoplasias/inducido químicamente , Neoplasias/patología , Especificidad de Órganos/efectos de los fármacos , Piperidinas/toxicidad , Proteínas Proto-Oncogénicas c-myc/genética , Proteínas Proto-Oncogénicas p21(ras)/genética , Proteína p53 Supresora de Tumor/genética
5.
Open Med (Wars) ; 13: 264-269, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29992190

RESUMEN

Melanin-concentrating hormone (MCH) is a cyclic 19 amino acid orexigenic hypothalamic peptide. MCH is located in the lateral and dorsal hypothalamus, as well as in the zona incerta. In mammals MCH increases food intake, contributes to regulation of energy balance, temperature, reproductive function, endocrine homeostasis and biological rhythms. Several studies have proved the significance of MCH in obesity, diabetes and depression. Although the peptide is well-characterized in mouse models, much less is known about its functions in avians. In birds the MCH system especially in the lateral and basal hypothalamus has important connections to the limbic system and it coordinates the vegetative and endocrine functions, as well as the emotional behaviour. Pharmacological modulation of MCH system could contribute to the therapy of eating disorders and improve agricultural efficiency regarding avians. Reviewing the current knowledge on MCH system in human, rodents and avians may stimulate a new wave of studies in the field.

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