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1.
Medicine (Baltimore) ; 99(9): e19376, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-32118783

RESUMEN

To introduce the use of a new surgical approach named single-incision bilateral inguinal herniorrhaphy (SBIH) in pediatric surgical population.This was a STROBE-compliant retrospective cohort study using data from 101 patients who had undergone bilateral inguinal herniorrhaphy in our institution. Children with bilateral inguinal hernias without contraindications for surgery, ranging in age from 6 months to 12 years, were included. Fifty-six children with bilateral inguinal hernias underwent SBIH (SBIH group) and 45 patients underwent laparoscopic bilateral inguinal herniorrhaphy (LBIH) (LBIH group). Differences in operative time, postoperative pain, recurrence, and complications between the 2 groups were analyzed. Patient satisfaction with cosmetic result was also investigated using questionnaires.There were no statistically significant differences in operative time (P = .2257), postoperative pain (P = .0607), recurrence (P = .8756), and complications (P = .7467) between the 2 groups. Interestingly, the operation time of girls in SBIH group was significantly shorter than that of the boys in this group (P < .0001), but also shorter than that of girls in LBIH group (P = .0038). Postoperative pain for boys was lower in SBIH group than in the LBIH group (P = .0340). No ascending testis, testicular atrophy, and hydrocele occurred in either group. According to the questionnaire, both procedures had equally high levels of satisfaction for cosmetic results (P = .7531).Initial results show that SBIH for pediatric patients, regardless of gender, is a safe and feasible procedure compared with LBIH with an equally low recurrence rate, few complication, and satisfactory cosmetic outcomes.


Asunto(s)
Hernia Inguinal/cirugía , Herniorrafia/métodos , Herniorrafia/normas , Distribución de Chi-Cuadrado , Niño , Preescolar , Estudios de Cohortes , Femenino , Hernia Inguinal/epidemiología , Herniorrafia/estadística & datos numéricos , Humanos , Masculino , Complicaciones Posoperatorias/epidemiología , Estudios Retrospectivos , Estadísticas no Paramétricas , Resultado del Tratamiento
2.
Medicine (Baltimore) ; 99(10): e19337, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32150072

RESUMEN

OBJECTIVE: To examine the efficacy of combined inspiratory and expiratory respiratory muscle training (RMT) with respect to the swallowing function, pulmonary function, functional performance, and dysarthria in patients with stroke. DESIGN: Prospective, randomized controlled trial. SETTING: Tertiary hospital. PARTICIPANTS: The trial included 21 subjects (12 men, 9 women) aged 35 to 80 years presenting with 6 months history of unilateral stroke, respiratory muscle weakness (≥70% predicted maximal inspiratory pressure (MIP) and/or ≤70% maximal expiratory pressure (MEP)), dysphagia, or dysarthria. These subjects were randomly assigned to the control (n = 10, rehabilitation) and experimental (n = 11, rehabilitation with RMT) groups. INTERVENTION: Inspiratory RMT starting from 30% to 60% of MIP and expiratory RMT starting from 15% to 75% of MEP for 5 days/week for 6 weeks. MAIN OUTCOME MEASURES: MIP, MEP, pulmonary function, peak cough flow, perception of dyspnea, Fatigue Assessment Scale, Modified Rankin Scale, Brunnstrom stage, Barthel index, Functional Oral Intake Scale (FOIS), and parameters of voice analysis. RESULTS: Significant differences were observed between both groups in terms of MIP, forced vital capacity (FVC), and forced expiratory volume per second (FEV1) of the percentage predicted. Significant difference was found with respect to the change in fatigue, shimmer percent, amplitude perturbation quotient, and voice turbulence index (VTI) according to the acoustic analysis in the RMT group. The FEV1/FVC ratio was negatively correlated with jitter percent, relative average perturbation, pitch perturbation quotient, and VTI; the maximum mid-expiratory flow (MMEF) and MMEF% were also negatively correlated with VTI. Significant differences among participants of the same group were observed while comparing the Brunnstrom stage before and after training of the affected limbs and the Barthel scale and FOIS scores in both the groups. CONCLUSIONS: Altogether, 6-week combined inspiratory and expiratory RMT is feasible as adjuvant therapy for stroke patients to improve fatigue level, respiratory muscle strength, lung volume, respiratory flow, and dysarthria.Clinical trial registration number (Clinical Trial Identifier): NCT03491111.


Asunto(s)
Ejercicios Respiratorios/métodos , Trastornos de Deglución/terapia , Disartria/terapia , Debilidad Muscular/terapia , Accidente Cerebrovascular/complicaciones , Adulto , Anciano , Anciano de 80 o más Años , Ejercicios Respiratorios/normas , Trastornos de Deglución/etiología , Trastornos de Deglución/fisiopatología , Disartria/etiología , Disartria/fisiopatología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Debilidad Muscular/etiología , Debilidad Muscular/fisiopatología , Estudios Prospectivos , Músculos Respiratorios/fisiopatología , Estadísticas no Paramétricas , Accidente Cerebrovascular/fisiopatología , Accidente Cerebrovascular/terapia
3.
Rev Bras Epidemiol ; 23: e200001, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32130390

RESUMEN

INTRODUCTION: In high-income countries, persons of high socioeconomic status (SES) have a lower cardiovascular risk. However, in middle and low-income countries, the results are controversial. OBJECTIVE: To evaluate the association between family income and cardiovascular risk factors in young adults. METHODS: A total of 2,063 individuals of a birth cohort initiated in 1978/79 in the city of Ribeirão Preto, Brazil, were evaluated at age of 23/25 years. Cardiovascular risk factors (hypertension, sedentary lifestyle, smoking, low high-density lipoprotein (HDL)-cholesterol, high low-density lipoprotein (LDL)-cholesterol, high fibrinogen, insulin resistance, diabetes, abdominal and total obesity, and metabolic syndrome) were evaluated according to family income. Income was assessed in multiples of the minimum wage. Simple Poisson regression models were used to estimate the prevalence ratios (PR) with robust estimation of the variance. RESULTS: High-income women showed lower prevalences of low HDL-cholesterol (PR = 0.47), total obesity (PR = 0.22), abdominal obesity (PR = 0.28), high blood pressure (PR = 0.28), insulin resistance (PR = 0.57), sedentary lifestyle (PR = 0.47), metabolic syndrome (PR = 0.24), and high caloric intake (PR = 0.71) (p < 0.05). High-income men showed lower prevalences of low HDL-cholesterol (PR = 0.73) and sedentarism (PR = 0.81) (p < 0.05). These results may be explained by the fact that high-income women pay more attention to healthy habits and those with the lowest family income are least likely to access health services resources and treatments. CONCLUSION: Women were in the final phase of the epidemiologic transition, whereas men were in the middle phase.


Asunto(s)
Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/etiología , Renta/estadística & datos numéricos , Adulto , Análisis de Varianza , Brasil/epidemiología , Estudios Transversales , Femenino , Humanos , Masculino , Prevalencia , Valores de Referencia , Medición de Riesgo , Factores de Riesgo , Distribución por Sexo , Factores Socioeconómicos , Estadísticas no Paramétricas , Adulto Joven
4.
Bull Cancer ; 107(3): 295-307, 2020 Mar.
Artículo en Francés | MEDLINE | ID: mdl-32115178

RESUMEN

OBJECTIVES: To evaluate the impact of systematic radiological review by breast specialist radiologist of malignant breast lesion imaging on the therapeutic management of patients. MATERIALS AND METHODS: Data collection was performed for patients with histopathologically proved breast cancer or suspicious breast lesion on imaging realized out of our institution. Patients underwent systematic mammary and axillary ultrasound, imaging review and if necessary complementary mammographic images. We analyzed the number of additional breast biopsies and axillary lymph node fine needle aspiration (FNA) with their histopathological results. We assessed their impact by comparing the final surgical treatment to the one planned before review. RESULTS: Two hundred and seventeen patients were included, with a total of 230 BIRADS 0, 4, 5 or 6 breast lesions. Seventy-six additional breast core biopsies were realized, leading to diagnose 43 additional BIRADS 6 lesions (24 infiltrative carcinomas, 9 DCIS and 10 atypical lesions) in 30 patients (13.82%). Thirty-five additional lymph node FNA were realized with 12 metastatic nodes and 3 false negative samples. Imaging review lead to change surgical treatment in 59 patients (27.19%, P<0.01) with modification in breast surgery in 37 patients, axillary surgery in 8 patients and both sites surgery in 12 patients. CONCLUSION: This study shows an impact of systematic radiological review by breast specialist radiologist in therapeutic management of patients treated for malignant breast lesion.


Asunto(s)
Neoplasias de la Mama/diagnóstico por imagen , Neoplasias de la Mama/terapia , Ganglios Linfáticos/diagnóstico por imagen , Radiólogos , Adulto , Anciano , Axila , Biopsia con Aguja Fina/estadística & datos numéricos , Mama/diagnóstico por imagen , Mama/patología , Neoplasias de la Mama/patología , Neoplasias de la Mama/cirugía , Calcinosis/diagnóstico por imagen , Quimioterapia Adyuvante/estadística & datos numéricos , Distribución de Chi-Cuadrado , Femenino , Humanos , Escisión del Ganglio Linfático , Ganglios Linfáticos/patología , Mamografía , Mastectomía/estadística & datos numéricos , Mastectomía Simple/estadística & datos numéricos , Persona de Mediana Edad , Periodo Preoperatorio , Oncología por Radiación , Estudios Retrospectivos , Estadísticas no Paramétricas , Ultrasonografía Mamaria/estadística & datos numéricos
5.
Medicine (Baltimore) ; 99(11): e19196, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32176046

RESUMEN

BACKGROUND: To explore the role of preoperative prealbumin levels in predicting the prognosis of patients with gastric cancer. METHODS: A total of 989 gastric cancer patients in the Affiliated Tumour Hospital of Harbin Medical University who underwent gastrectomy were included in this retrospective study. The preoperative prealbumin level, clinicopathological data, and follow-up data were recorded. According to the maximum chi-square survival correlation value, the survival of patients with low preoperative prealbumin (<140 mg/L) and high preoperative prealbumin (≥140 mg/L) were compared using the log-rank test and the Cox proportional hazard regression model. RESULTS: Based on the best cut-off value of 140 mg/L, we divided the patients into the lower prealbumin group (<140 mg/L) and the higher prealbumin group (≥140 mg/L). Compared with the higher prealbumin group, the lower prealbumin group were older and had larger tumor volumes, lower hemoglobin (Hb) levels, and more upper gastric cancer tumors. The univariate analysis showed that prealbumin and other clinicopathological factors, including age, hemoglobin, tumor size, macroscopic type, cell differentiation, liver metastasis, operation type, N stage, and T stage, were significant prognostic factors. The multivariable analysis showed that age, prealbumin, macroscopic type, location, T stage, and N stage were independent prognostic factors. CONCLUSIONS: The preoperative prealbumin level was an independent prognostic factor for patients with gastric cancer. The preoperative prealbumin level can be used to predict the prognosis of patients with gastric cancer and guide clinical practice.


Asunto(s)
Biomarcadores de Tumor/sangre , Gastrectomía/mortalidad , Prealbúmina/metabolismo , Neoplasias Gástricas/mortalidad , Neoplasias Gástricas/cirugía , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Distribución de Chi-Cuadrado , China , Estudios de Cohortes , Supervivencia sin Enfermedad , Femenino , Gastrectomía/métodos , Hospitales Universitarios , Humanos , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Cuidados Preoperatorios/métodos , Modelos de Riesgos Proporcionales , Estudios Retrospectivos , Medición de Riesgo , Estadísticas no Paramétricas , Neoplasias Gástricas/patología , Análisis de Supervivencia , Resultado del Tratamiento
6.
J Appl Oral Sci ; 28: e20190148, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32049133

RESUMEN

OBJECTIVE: The site of the sinus tract depends on the rate of resistance against abscess exudate drainage, bone morphology, and distance from the root apex to the outer cortical bone. To assess apical bone thickness in buccal and palatal/lingual aspects of maxillary and mandibular teeth, using a high-resolution cone-beam computed tomography (CBCT) system. METHODOLOGY: In total, 422 CBCT examinations were included in the study, resulting in a sample of 1400 teeth. The scans were acquired by PreXion 3D, with a high-resolution protocol. The bone thickness was taken as the distance between the center of the apical foramen and the buccal and lingual/palatal cortical bone. The quantitative variables were expressed as mean values±standard deviation. The independent samples were analyzed using the t-test or the Mann-Whitney test (p<0.05). RESULTS: The lowest mean value of bone thickness was observed in the buccal cortical bone of the upper canines (1.49 mm±0.86) and in the upper central incisors (1.59 mm±0.67). In premolar teeth, the lowest values were found in the buccal cortical bone of upper first premolars (1.13 mm±0.68). In the posterior teeth, the lowest values were found in the buccal cortical bone of upper first molars (1.98 mm±1.33). In the lower second molar region, the buccal cortical bone (8.36 mm±1.84) was thicker than the lingual cortical bone (2.95 mm±1.16) (p<0.05). CONCLUSIONS: The lowest mean values of bone thickness are in the buccal cortical bone of the maxillary teeth. In the mandible, bone thickness is thinner in the buccal bone around the anterior and premolar teeth, and in the lingual aspect of mandibular molars. All these anatomic characteristics could make the occurrence of the sinus tract more susceptible in these specific regions of the maxillary and mandibular alveolar bone.


Asunto(s)
Tomografía Computarizada de Haz Cónico/métodos , Mandíbula/anatomía & histología , Maxilar/anatomía & histología , Diente/anatomía & histología , Adulto , Femenino , Humanos , Masculino , Mandíbula/diagnóstico por imagen , Maxilar/diagnóstico por imagen , Odontometría/métodos , Valores de Referencia , Estadísticas no Paramétricas , Diente/diagnóstico por imagen
7.
J Appl Oral Sci ; 28: e20190393, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32049137

RESUMEN

OBJECTIVES: This study assessed the incidence and variability features of root canals system (RCS) and their ramifications according to Pucci & Reig (PR) (1944) and the American Association of Endodontists (AAE) (2017) by micro-computed tomography (µCT). METHODOLOGY: 500 representative extracted human teeth of each tooth group (n=50) (maxillary/mandibular central and lateral incisors, canines, first and second premolars and molars) were scanned by µCT with a resolution of 26.70 µm. The reconstructed cross-sections images and the visualization of the continuous slices in the transversal axis were performed using DataViewer software. RCS were classified according to Pucci & Reig (main canal, collateral canal, lateral canal, secondary canal, accessory canal, intercanal, recurrent canal) and AAE (main canal, accessory canal, lateral canal). The apical deltas were assessed for both classifications. The prevalence of apical deltas was evaluated using the Chi-squared test (p<0.05). RESULTS: According to PR, a higher incidence of lateral canals was observed in maxillary canines (10%), central incisors (8%) and first premolars (6%). Using AAE, the highest incidence of lateral canals was observed in the mandibular first premolars (85%), first and second molars (84%), lateral incisors (67%), canines (59%), and in maxillary first premolars (52%). Regarding accessory canals, the PR showed a frequency in 2% of the maxillary lateral incisors and maxillary and mandibular first premolars and 3% of mandibular first and second molars. On the other hand, the AAE showed the highest incidence of accessory canals in 86% of the maxillary first premolars, 71% in mandibular lateral incisors, 69% in mandibular first premolars, 65% in mandibular canines, and 56% in maxillary canines. The PR showed the lowest incidence of apical deltas for all dental groups when compared with AAE (p=0.004). Interestingly, distal canals in maxillary molars showed a significant discrepancy between classifications (p=0.027). CONCLUSIONS: µCT enabled accurately describing the RC system and related ramifications, adding to the PR and AAE classifications, with some discrepancies reported for maxillary molars. Clinical Relevance This µCT study enabled a thorough description of the variability among root canals and their ramifications, including clinically relevant details on the presence and location of lateral canals and accessories in all human tooth groups, beyond the currently existing classification systems.


Asunto(s)
Cavidad Pulpar/anatomía & histología , Microtomografía por Rayos X/métodos , Cavidad Pulpar/diagnóstico por imagen , Humanos , Imagen Tridimensional , Mandíbula/anatomía & histología , Mandíbula/diagnóstico por imagen , Maxilar/anatomía & histología , Maxilar/diagnóstico por imagen , Valores de Referencia , Estadísticas no Paramétricas , Ápice del Diente/anatomía & histología , Ápice del Diente/diagnóstico por imagen
8.
Braz Oral Res ; 34: e001, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32022221

RESUMEN

This study analyzed the effect of prior application of copaiba oil (CO) emulsions as a dentin cleaning substance on microleakage and microtensile adhesive strength. Twenty-five premolars and sixty-four molars were used for microleakage and microtensile assays. For the microleakage assays, specimens with standard class V cavities were divided (n = 5), according to the tested CO emulsions: CO10%X, CO10%Y, and CO10%Z, as well as chlorhexidine 2% (CHX) and distilled water (DW), as positive and negative controls, respectively. Restorations were performed using the Adper Single Bond® and/or Clearfil SE Bond® systems. Cervical, occlusal, distal and mesial sections were assessed for tracer penetration degree at the composite/tooth interface. For the microtensile assay, healthy molars were divided into sixteen groups, in which artificial caries were induced in half of the groups. Dentin surfaces were treated with CO10%X and CO10%Y, CHX and DW. Microtensile bond strength was measured by fixing each sample to the plate of a universal testing machine operated at a speed of 0.5 mm/minute until failure. Dentin treated with CO10%X showed a lower infiltration rate than dentin treated with the other CO emulsions, CHX2% and DW. According to the microtensile assay, both healthy and affected dentin treated with CO10%X and Adper Single Bond® adhesive system presented higher adhesive strength. CO emulsion, used as a dentin biomodifier, interfered positively in microleakage and improved adhesive strength after acid etching in the Adper Single Bond® adhesive system, or before applying the Clearfil SE Bond® self-etching system.


Asunto(s)
Recubrimiento Dental Adhesivo/métodos , Recubrimientos Dentinarios/química , Dentina/efectos de los fármacos , Fabaceae/química , Aceites Vegetales/química , Análisis de Varianza , Clorhexidina/química , Resinas Compuestas/química , Cementos Dentales/química , Filtración Dental , Dentina/química , Emulsiones/química , Humanos , Ensayo de Materiales , Reproducibilidad de los Resultados , Cementos de Resina/química , Estadísticas no Paramétricas , Propiedades de Superficie , Resistencia a la Tracción
9.
Braz Oral Res ; 34: e003, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32022222

RESUMEN

This retrospective study evaluated facial profile pleasantness determined by two protocols of Class II treatment. The sample comprised facial profile silhouettes obtained retrospectively from the pretreatment (T1) and posttreatment (T2) cephalograms of 60 patients (42 males and 18 females) divided into two groups. One group of 30 patients (mean age of 12.84 years) was treated with the extraction of maxillary first premolars (mean treatment time of 2.7 years), and the other group of 30 patients (mean age of 12.81 years) was treated with a mandibular advancement appliance (Forsus) (mean treatment time of 2.49 years). The facial profile silhouettes (T1 and T2) were randomly distributed in an album containing one patient per sheet. The examiners consisted of 60 orthodontists and 60 lay individuals, who analyzed the profiles in regard to facial pleasantness, using the Likert scale. A comparison between stages T1 and T2 of the two treatment protocols and between the examiners was performed by mixed-design analysis of variance at a significance level of 5%. The results demonstrated a significant difference between T1 and T2 (greater scores for T2 compared to T1), and between lay individuals and orthodontists (orthodontists assigned higher scores), but with no significant difference between the treatment protocols. Both protocols produced positive effects on the facial profile esthetics, from the standpoint of lay individuals and orthodontists.


Asunto(s)
Estética Dental , Cara/patología , Maloclusión de Angle Clase II/patología , Maloclusión de Angle Clase II/terapia , Extracción Dental/métodos , Adolescente , Análisis de Varianza , Diente Premolar/cirugía , Cefalometría , Niño , Femenino , Humanos , Masculino , Variaciones Dependientes del Observador , Aparatos Ortodóncicos Fijos , Ortodoncia Correctiva/métodos , Ortodoncistas , Percepción , Estudios Retrospectivos , Estadísticas no Paramétricas , Resultado del Tratamiento
10.
Braz Oral Res ; 34: e005, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32022224

RESUMEN

The purpose of this study was to evaluate the effect of ionizing radiation from high energy X-ray on fluoride release, surface roughness, flexural strength, and surface chemical composition of the materials. The study groups comprised five different restorative materials: Beautifil II, GCP Glass Fill, Amalgomer CR, Zirconomer, and Fuji IX GP. Twenty disk-shaped specimens (8x2 mm) for fluoride release and 20 bar-shaped specimens (25 x 2x 2 mm) for flexural strength were prepared from each material. Each material group was divided into two subgroups: irradiated (IR) and non-irradiated (Non-IR). The specimens from IR groups were irradiated with 1.8 Gy/day for 39 days (total IR = 70.2 Gy). The amount of fluoride released into deionized water was measured using a fluoride ion-selective electrode and ion analyzer after 24 hours and on days 2, 3, 7, 15, 21, 28, 35, and 39 (n = 10). The flexural strength was evaluated using the three-point bending test (n = 10). After the period of measurement of fluoride release, seven specimens (n = 7) from each group were randomly selected to evaluate surface roughness using AFM and one specimen was randomly selected for the SEM and EDS analyses. Data were analyzed with two-way ANOVA and Tukey tests (p = 0.05). The irradiation significantly increased fluoride release and surface roughness for Amalgomer CR and Zirconomer groups (p < 0.05). No significant change in flexural strength of the materials was observed after irradiation (p > 0.05). The ionizing radiation altered the amount of fluoride release and surface roughness of only Amalgomer CR and Zirconomer. The effect could be related to the chemical compositions of materials.


Asunto(s)
Apatitas/efectos de la radiación , Bisfenol A Glicidil Metacrilato/efectos de la radiación , Resinas Compuestas/efectos de la radiación , Fluoruros/química , Cementos de Ionómero Vitreo/efectos de la radiación , Radiación Ionizante , Circonio/efectos de la radiación , Análisis de Varianza , Apatitas/química , Bisfenol A Glicidil Metacrilato/química , Resinas Compuestas/química , Resistencia Flexional , Cementos de Ionómero Vitreo/química , Ensayo de Materiales , Microscopía Electrónica de Rastreo , Valores de Referencia , Reproducibilidad de los Resultados , Espectrometría por Rayos X , Estadísticas no Paramétricas , Propiedades de Superficie/efectos de la radiación , Factores de Tiempo , Circonio/química
11.
Medicina (B Aires) ; 80(1): 17-22, 2020.
Artículo en Español | MEDLINE | ID: mdl-32044737

RESUMEN

Infective endocarditis (IE) is a serious and potentially lethal condition. The diagnostic capacity of the modified Duke criteria is high for native valves, but it declines in the case of EI of prosthetic valves or EI associated with devices. Echocardiography and microbiological findings are essential for diagnosis but may be insufficient in this group of patients. Our objective was to evaluate the usefulness of positron emission tomography and fusion with computed tomography (PET / CT) in patients with suspected IE, carriers of prosthetic valves or intracardiac devices; 32 patients were studied, who underwent PET / CT with 18F-Fluorine deoxyglucose (18F-FDG). Those with intense focal and/or heterogeneous uptake with a Standard Uptake Value SUV) cut-off point greater than or equal to 3.7 were considered suggestive of infection. The initial diagnoses according to the modified Duke criteria were compared with the final diagnosis established by the Institutional Endocarditis Unit. The addition of PET / CT to these criteria, provided a conclusive diagnosis in 22 of the 32 initial cases reclassifying 11 cases in definitive EI; another 5 cases were negative for that diagnosis. EI continues to be a serious clinical problem. In those cases where the Duke criteria are not sufficient to establish the diagnosis and clinical suspicion persists, PET / CT can be a useful complementary tool to increase the diagnostic sensitivity.


Asunto(s)
Desfibriladores Implantables/efectos adversos , Endocarditis/diagnóstico por imagen , Endocarditis/microbiología , Prótesis Valvulares Cardíacas/efectos adversos , Marcapaso Artificial/efectos adversos , Tomografía Computarizada por Tomografía de Emisión de Positrones/métodos , Infecciones Relacionadas con Prótesis/diagnóstico por imagen , Adulto , Anciano , Anciano de 80 o más Años , Desfibriladores Implantables/microbiología , Femenino , Fluorodesoxiglucosa F18 , Prótesis Valvulares Cardíacas/microbiología , Humanos , Masculino , Persona de Mediana Edad , Marcapaso Artificial/microbiología , Valores de Referencia , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Estadísticas no Paramétricas , Adulto Joven
12.
Braz Oral Res ; 34: e013, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32074213

RESUMEN

This study evaluated the effect of a cyclopentenone-type PG, 15-Deoxy-Δ12,14-PG J2 (15d-PGJ2), and lectin (ScLL) on the viability of human gingival fibroblasts (HGFs), and on IL-6 and TGFß-1 release by these fibroblasts, stimulated with lipopolysaccharide (LPS). HGFs were stimulated with LPS 10 µg/ml and treated with 15d-PGJ2 1 and 2 µg/ml, and ScLL 2 and 5 µg/ml, for 1 and 3h, and then evaluated for viability by MTT assay. Supernatant was collected to detect IL-6 and TGFß-1 release, by ELISA. Positive control was cells kept in Dulbecco's Modified Eagle's Medium, and negative control was those kept in LPS. Data were analyzed by ANOVA and Dunnett's test (α = 0.05). No significant difference was found in viability among experimental groups at 1h (p > 0.05). Percentage of ScLL 5 µg/ml viable cells was similar to that of positive control at evaluated periods (p > 0.05), whereas the other groups had lower levels than the positive control (p < 0.05). IL-6 release was statistically higher for ScLL 5 µg/ml and 15d-PGJ2 2 µg/ml at 1h, compared with the other treated groups and positive control (p < 0.05). No significant differences were found among the groups at 3h (p > 0.05), except for ScLL 2 µg/ml and 15d-PGJ2 1 µg/ml, which showed lower IL-6 release compared with that of negative control (p < 0.05). No significant difference was found among the groups for TGFß-1 release (p > 0.05). Results indicated that ScLL 5 µg/ml did not interfere in viability, and ScLL 2 µg/ml and 15d-PGJ2 1 µg/ml demonstrated reduced IL-6 release. Tested substances had no effect on TGFß-1 release.


Asunto(s)
Fibroblastos/efectos de los fármacos , Fibroblastos/metabolismo , Interleucina-6/metabolismo , Lipopolisacáridos/farmacología , Lectinas de Plantas/farmacología , Prostaglandina D2/análogos & derivados , Factor de Crecimiento Transformador beta1/metabolismo , Análisis de Varianza , Supervivencia Celular/efectos de los fármacos , Células Cultivadas , Ensayo de Inmunoadsorción Enzimática , Encía/citología , Humanos , Prostaglandina D2/farmacología , Valores de Referencia , Estadísticas no Paramétricas , Factores de Tiempo , Factor de Crecimiento Transformador beta1/efectos de los fármacos
13.
Braz Oral Res ; 34: e014, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32074214

RESUMEN

Although dental implants and bone regenerative procedures are important approaches for the reestablishment of esthetics and function in young patients with a history of generalized aggressive periodontitis (GAP), no predictable outcomes have been reported, and the host osteo-immunoinflammatory response may play a relevant role in this context. In view of the lack of molecular investigations into the bone tissue condition of young patients with periodontitis, the aim of this study was to evaluate the gene expression of bone-related factors in this population. Bone biopsies were obtained from the posterior mandible in 16 individuals previously diagnosed with GAP and on periodontal support therapy and from 17 periodontally healthy (PH) patients. The gene expression of tumor necrosis factor (TNF)-α, transforming growth factor (TGF)-ß, receptor activator of the NF-κB ligand (RANKL), osteoprotegerin (OPG), osteocalcin (OC), bone sialoprotein (BSP), and type I collagen (COL-I), important biomarkers of bone turnover, was evaluated by qRT-PCR. Lower TGF-ß and OPG mRNA levels were observed in GAP patients compared to PH individuals (p ≤ 0.05). There were no between-group differences in levels of TNF-α, BSP, RANKL, OC, or COL-I mRNA (p>0.05). In young adults, a history of periodontal disease can negatively modulate the gene expression of important bone-related factors in alveolar bone tissue. These molecular outcomes may contribute to the future development of therapeutic approaches to benefit bone healing in young patients with history of periodontitis via modulation of osteo-immuno-inflammatory biomarkers.


Asunto(s)
Periodontitis Agresiva/genética , Expresión Génica , Adulto , Periodontitis Agresiva/metabolismo , Proceso Alveolar/química , Biomarcadores , Colágeno Tipo I/análisis , Colágeno Tipo I/genética , Estudios Transversales , Femenino , Humanos , Sialoproteína de Unión a Integrina/análisis , Sialoproteína de Unión a Integrina/genética , Masculino , Osteocalcina/análisis , Osteocalcina/genética , Osteoprotegerina/análisis , Osteoprotegerina/genética , Ligando RANK/análisis , Ligando RANK/genética , Reacción en Cadena en Tiempo Real de la Polimerasa , Valores de Referencia , Método Simple Ciego , Estadísticas no Paramétricas , Factor de Crecimiento Transformador beta/análisis , Factor de Crecimiento Transformador beta/genética , Factor de Necrosis Tumoral alfa/análisis , Factor de Necrosis Tumoral alfa/genética , Adulto Joven
14.
Braz Oral Res ; 34: e009, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32049110

RESUMEN

The sense of coherence (SOC) is a measure of global orientation regarding the ability of individuals to cope with stressful situations. The aim of the present study was to evaluate the association between SOC and quality of life (QoL) and clinical and sociodemographic characteristics among survivors of oral, oropharynx, hypopharynx, or larynx cancer. A cross-sectional study was conducted with 90 cancer patients in follow up at the Santa Maria University Hospital in southern Brazil who had completed conformal 3D radiotherapy at least three months earlier. QoL was assessed using the University of Washington Quality of Life (UW-QOL) questionnaire and SOC was measured using the Brazilian version of the SOC-13 questionnaire. Data on socio-demographic characteristics and the disease were obtained from patients' charts. Oral clinical conditions were also evaluated. Associations between exploratory variables and mean UW-QOL scores were evaluated through Poisson regression and the results were presented as rate ratios (RR) and 95% confidence intervals (CI). The mean overall UW-QOL score was 67.90 (± 18.71). Moderate and high SOC scores were associated with higher mean UW-QOL scores, that is, individuals with a stronger SOC demonstrated better QoL, (p < 0.05). Regarding the clinical variables, individuals with advanced stage cancer and those with hyposalivation and trismus had poorer QoL (p < 0.05). Patients with a greater SOC reported a better quality of life. Our findings show the importance of focusing on psychosocial factors, which can alleviate the impact caused by the disease and improve the QoL of these patients.


Asunto(s)
Carcinoma de Células Escamosas/psicología , Neoplasias de Cabeza y Cuello/psicología , Calidad de Vida/psicología , Sentido de Coherencia , Anciano , Carcinoma de Células Escamosas/patología , Estudios Transversales , Femenino , Neoplasias de Cabeza y Cuello/patología , Humanos , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Valores de Referencia , Análisis de Regresión , Índice de Severidad de la Enfermedad , Factores Socioeconómicos , Estadísticas no Paramétricas , Encuestas y Cuestionarios , Trismo/psicología , Xerostomía/psicología
15.
Einstein (Sao Paulo) ; 18: eAO5023, 2020.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-31994606

RESUMEN

OBJECTIVE: To adapt an antibiotic dose adjustment software initially developed in English, to Portuguese and to the Brazilian context. METHODS: This was an observational, descriptive study in which the Delphi method was used to establish consensus among specialists from different health areas, with questions addressing the visual and operational aspects of the software. In a second stage, a pilot experimental study was performed with the random comparison of patients for evaluation and adaptation of the software in the real environment of an intensive care unit, where it was compared between patients who used the standardized dose of piperacillin/tazobactam, and those who used an individualized dose adjusted through the software Individually Designed and Optimized Dosing Strategies. RESULTS: Twelve professionals participated in the first round, whose suggestions were forwarded to the software developer for adjustments, and subsequently submitted to the second round. Eight specialists participated in the second round. Indexes of 80% and 90% of concordance were obtained between the judges, characterizing uniformity in the suggestions. Thus, there was modification in the layout of the software for linguistic and cultural adequacy, minimizing errors of understanding and contradictions. In the second stage, 21 patients were included, and there were no differences between doses of piperacillin in the standard dose and adjusted dose Groups. CONCLUSION: The adapted version of the software is safe and reliable for its use in Brazil.


Asunto(s)
Antiinfecciosos/administración & dosificación , Lingüística/normas , Piperacilina/administración & dosificación , Diseño de Programas Informáticos , Tazobactam/administración & dosificación , Anciano , Anciano de 80 o más Años , Antropometría , Brasil , Comparación Transcultural , Técnica Delfos , Femenino , Humanos , Unidades de Cuidados Intensivos , Masculino , Persona de Mediana Edad , Estándares de Referencia , Reproducibilidad de los Resultados , Estadísticas no Paramétricas , Encuestas y Cuestionarios
16.
Br J Radiol ; 93(1108): 20190558, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-31957473

RESUMEN

OBJECTIVE: To build and validate a CT radiomic model for pre-operatively predicting lymph node metastasis in early cervical carcinoma. METHODS AND MATERIALS: A data set of 150 patients with Stage IB1 to IIA2 cervical carcinoma was retrospectively collected from the Nanfang hospital and separated into a training cohort (n = 104) and test cohort (n = 46). A total of 348 radiomic features were extracted from the delay phase of CT images. Mann-Whitney U test, recursive feature elimination, and backward elimination were used to select key radiomic features. Ridge logistics regression was used to build a radiomic model for prediction of lymph node metastasis (LNM) status by combining radiomic and clinical features. The area under the receiver operating characteristic curve (AUC) and κ test were applied to verify the model. RESULTS: Two radiomic features from delay phase CT images and one clinical feature were associated with LNM status: log-sigma-2-0 mm-3D_glcm_Idn (p = 0.01937), wavelet-HL_firstorder_Median (p = 0.03592), and Stage IB (p = 0.03608). Radiomic model was built consisting of the three features, and the AUCs were 0.80 (95% confidence interval: 0.70 ~ 0.90) and 0.75 (95% confidence intervalI: 0.53 ~ 0.93) in training and test cohorts, respectively. The κ coefficient was 0.84, showing excellent consistency. CONCLUSION: A non-invasive radiomic model, combining two radiomic features and a International Federation of Gynecology and Obstetrics stage, was built for prediction of LNM status in early cervical carcinoma. This model could serve as a pre-operative tool. ADVANCES IN KNOWLEDGE: A noninvasive CT radiomic model, combining two radiomic features and the International Federation of Gynecology and Obstetrics stage, was built for prediction of LNM status in early cervical carcinoma.


Asunto(s)
Ganglios Linfáticos/diagnóstico por imagen , Metástasis Linfática/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Neoplasias del Cuello Uterino/diagnóstico por imagen , Área Bajo la Curva , Intervalos de Confianza , Femenino , Humanos , Modelos Logísticos , Ganglios Linfáticos/patología , Persona de Mediana Edad , Periodo Preoperatorio , Curva ROC , Estudios Retrospectivos , Estadísticas no Paramétricas , Neoplasias del Cuello Uterino/patología
17.
Br J Radiol ; 93(1108): 20190929, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-31971823

RESUMEN

OBJECTIVE: To introduce capped biparametric (bp) MRI slots for follow-up imaging of prostate cancer patients enrolled in active surveillance (AS) and evaluate the effect on weekly variation in the number of AS cases and total MRI workload. METHODS: Three 20 min bpMRI AS slots on two separate days were introduced at Addenbrooke's Hospital, Cambridge. The weekly numbers of total prostate MRIs and AS cases recorded 15 months before and after the change (Groups 1 and 2, respectively). An intergroup variation in the weekly scan numbers was assessed using the coefficient of variance (CV) and mean absolute deviation; the Mann-Whitney U test was used for an intergroup comparison of the latter. RESULTS: In AS patients, a shift from considerable to moderate variation in weekly scan numbers was observed between the two groups (CV, 51.7 and 26.8%, respectively); mean absolute deviation of AS scans also demonstrated a significant decrease in Group 2 (1.28 vs 2.58 in Group 1; p < 0.001). No significant changes in the variation in total prostate MRIs were observed, despite a 10% increased workload in Group 2. CONCLUSION: A significant reduction in weekly variation of AS cases was demonstrated following the introduction of capped bpMRI slots, which can be used for more accurate long-term planning of MRI workload. ADVANCES IN KNOWLEDGE: The paper illustrates the potential of introducing capped AS MRI slots using a bp protocol to reduce weekly variation in demand and allow for optimising workflow, which will be increasingly important as the demands on radiology departments increase worldwide.


Asunto(s)
Imagen por Resonancia Magnética/estadística & datos numéricos , Vigilancia de la Población , Neoplasias de la Próstata/diagnóstico por imagen , Carga de Trabajo/estadística & datos numéricos , Anciano , Anciano de 80 o más Años , Humanos , Imagen por Resonancia Magnética/métodos , Masculino , Persona de Mediana Edad , Estadísticas no Paramétricas , Factores de Tiempo
18.
An Bras Dermatol ; 95(1): 40-45, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31889591

RESUMEN

BACKGROUND: Psoriasis is a chronic immune-mediated inflammatory skin disease that is associated with cardiovascular comorbidities. OBJECTIVES: The objective of this retrospective study is to assess the C-reactive protein, monocyte-to-high-density-lipoprotein ratio, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and monocyte-to-lymphocyte ratio as inflammatory markers in patients with psoriasis and to search for a relationship between these parameters and psoriasis severity, as defined by the psoriasis area and severity index. METHODS: There were 94 patients with psoriasis and 118 healthy controls enrolled in the study. The C-reactive protein, monocyte-to-high-density-lipoprotein ratio, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and monocyte-to-lymphocyte ratio values of two groups were retrospectively evaluated. RESULTS: Statistically significant differences were observed in terms of C-reactive protein, monocyte-to-high-density-lipoprotein ratio, neutrophil-to-lymphocyte ratio and monocyte-to-lymphocyte ratio between the patient and control groups (p=0.001, p=0.003, p=0.038, and p=0.007, respectively). Positive correlations were found between the psoriasis area and severity index and the values of C-reactive protein, monocyte-to-high-density-lipoprotein ratio, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and monocyte-to-lymphocyte ratio (r: 0.381; p<0.01, r: 0.203; p<0.05, r: 0.268; p<0.01, r: 0.374; p<0.01, r: 0.294; p<0.01, respectively). STUDY LIMITATIONS: The small sample size and the retrospective design of the study are limitations. CONCLUSION: Elevated C-reactive protein, monocyte-to-high-density-lipoprotein ratio, neutrophil-to-lymphocyte ratio, and monocyte-to-lymphocyte ratio were significantly associated with psoriasis. A positive correlation between C-reactive protein and monocyte-to-high-density-lipoprotein ratio leads to the suggestion that monocyte-to-high-density-lipoprotein ratio might be a reliable parameter in psoriasis during the follow-up. The relationship between the diasease and inflammatory parameters might provide early detection of cardiovascular morbidities in psoriasis patients.


Asunto(s)
Plaquetas , Proteína C-Reactiva/análisis , Lipoproteínas HDL/sangre , Linfocitos , Monocitos , Neutrófilos , Psoriasis/sangre , Adulto , Análisis de Varianza , Biomarcadores/sangre , Enfermedades Cardiovasculares/sangre , Enfermedades Cardiovasculares/etiología , Estudios de Casos y Controles , Femenino , Humanos , Recuento de Leucocitos , Masculino , Persona de Mediana Edad , Recuento de Plaquetas , Psoriasis/complicaciones , Valores de Referencia , Estudios Retrospectivos , Factores de Riesgo , Índice de Severidad de la Enfermedad , Estadísticas no Paramétricas , Adulto Joven
19.
An Bras Dermatol ; 95(1): 20-24, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31899062

RESUMEN

BACKGROUND: Despite the economic burden of psoriasis for patients and societies, scant information exists regarding the impact and burden of the disease in Argentina. OBJECTIVE: The objective of this study was to estimate medical resource consumption and direct health care costs for patients with moderate/severe psoriasis in Buenos Aires, Argentina from the perspective of the payer. METHODS: Adults with moderate/severe psoriasis (severity was defined as receiving systemic treatment), during January 2010-January 2014, aged 18 years and older, members of the Italian Hospital Medical Care Program with at least 18 months of follow-up were included. All data on hospitalizations, drug prescription, outpatient episodes, consultations, and investigations/tests in the 12 months before inclusion in the study were considered for the estimation of medical resource consumption and direct health care costs. First-quarter 2018 costs were obtained from the IHMCP and converted into US dollars (using the January 2018 exchange rate). RESULTS: A total of 791 patients were included. The mean age at diagnosis was 34±12 years. Almost 65% of the patients had a dermatologist as their usual source of care, 43% had internists, and 14% had rheumatologists. The average yearly direct cost was US$ 5326 (95% CI: 4125-7896) per patient per year. STUDY LIMITATION: The single center design and the retrospective nature are the main limitations. CONCLUSION: This is the first Argentine study that evaluated the costs of moderate/severe psoriasis by taking into consideration the direct medical costs of the disease.


Asunto(s)
Costos de la Atención en Salud/estadística & datos numéricos , Psoriasis/economía , Adulto , Argentina , Prescripciones de Medicamentos/economía , Femenino , Hospitalización/economía , Humanos , Masculino , Persona de Mediana Edad , Derivación y Consulta/economía , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Estadísticas no Paramétricas , Factores de Tiempo , Adulto Joven
20.
An Bras Dermatol ; 95(1): 15-19, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31899067

RESUMEN

BACKGROUND: Palmoplantar pustulosis is a chronic and relapsing disease of the palms and soles, which is characterized by scattered clusters of pinhead-sized, sterile pustules. OBJECTIVE: The aim of the present study was to determine demographic features, co-morbidities, and relation of palmoplantar pustulosis with psoriasis. METHODS: A total of 48 patients (M/F: 15/33) were enrolled in the present study. A detailed history regarding age of onset, palmoplantar pustulosis duration, number of recurrences, personal and family history of psoriasis, accompanying arthritis, sternoclavicular tenderness, dental fillings, smoking status, and autoimmune disease was obtained; thorough dermatological examination was carried out. Patch testing results and laboratory investigations for thyroid autoimmunity were recorded. RESULTS: Thirty-five of 48 patients (72.9%) were current smokers. Twenty of the 48 patients (41.7%) had dental fillings. There was not any significant correlation between palmoplantar pustulosis duration and dental filling duration (p=0.170). Psoriasis was not detected in any patients either in history or in dermatological examination. Nail involvement and joint complaints were observed in seven of 48 patients (14%) and in nine of 48 patients (18%), respectively. Autoimmune thyroiditis was observed in four of 48 patients (12%). Patients with patch testing positivity (12.5% of patients, M/F: 1/5) had no considerable association for history of external contact with these materials. STUDY LIMITATIONS: Retrospective analysis. CONCLUSION: Palmoplantar pustulosis appears to be a distinct entity from psoriasis. Routine thyroid functions test could be analyzed, but patch testing is not required in patients with palmoplantar pustulosis. Also, patients with palmoplantar pustulosis must be evaluated for musculoskeletal symptoms and signs.


Asunto(s)
Psoriasis/epidemiología , Psoriasis/patología , Adulto , Anciano , Enfermedades Autoinmunes/epidemiología , Comorbilidad , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Exposición Profesional , Pruebas del Parche , Psoriasis/etiología , Estudios Retrospectivos , Fumar/epidemiología , Estadísticas no Paramétricas , Turquia/epidemiología , Adulto Joven
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