Assuntos
Imageamento Tridimensional , Cálculos das Glândulas Salivares/cirurgia , Glândula Submandibular/cirurgia , Cirurgia Assistida por Computador , Cirurgia Vídeoassistida , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Boca , Cirurgia Assistida por Computador/métodos , Adulto JovemRESUMO
OBJECTIVES: To verify the role of interventional sialendoscopy and steroidal ductal irrigation in patients with recurrent sialadenitis. DESIGN: A prospective, cross-sectional pilot study. SETTING: University of Milan. PARTICIPANTS: Fifty-four patients with sine causa recurrent sialadenitis who underwent interventional sialendoscopy (group A, 36 patients) or interventional sialendoscopy followed by a intraductal steroidal irrigations (group B, 18 patients). MAIN OUTCOMES MEASURES: The number of episodes of sialadenitis three and 6 months before and after sialendoscopy, and their severity assessed by means of a 0-10 pain visual analogue scale. RESULTS: In the population as a whole, a significant post-treatment reduction in the number of episodes of 30.7 ± 5.5 after 3 months and 34.6 ± 10.2 after 6 months (P < 0.001) and a significant reduction in pain visual analogue scale values of 4.7 ± 0.4 after 6 months (P < 0.001) occurred. There was a statistically significant reduction in both parameters at the same time points in both treatment groups (P ≥ 0.001), with no significant between-group difference in pain visual analogue scale values, an albeit non-significant trend in favour of group B in terms of the number of episodes 3 months after therapy that became significant after 6 months (11.0 ± 9.9 versus 20.5 ± 9.5; P = 0.05). CONCLUSIONS: Interventional sialendoscopy is effective for the treatment of recurrent sialadenitis; the addition of intraductal steroidal irrigations seems to increase its value in the medium term. Further studies of larger case series with longer follow-up are needed to establish the possibly primary role of steroid therapy in blocking inflammation.
Assuntos
Betametasona/administração & dosagem , Endoscopia , Glucocorticoides/administração & dosagem , Sialadenite/terapia , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Estudos Prospectivos , Recidiva , Irrigação Terapêutica , Resultado do TratamentoRESUMO
Migraine can induce ischaemic stroke, and is considered an independent risk factor for stroke in the young. To date, the nature of the link between migraine and stroke is essentially unknown. Forty-five children were studied. Homocysteine levels (fasting and post methionine load), vitamin B12 and plasma folate levels, factor V Leiden, factor II G20210A, methylenetetrahydrofolate reductase (MTHFR) C677T and A1298C mutations were examined. Compared with controls, patients with migraine had higher levels of post-methionine load homocysteine values (19.5 +/- 4.9 vs. 16.9 +/- 1.9; P = 0.025) and significantly lower folate levels (5.8 +/- 2.6 vs. 7.5 +/- 2.1; P = 0.002). We found a trend toward an increased risk of migraine in subjects carrying a homozygous mutant genotype for MTHFR C677T and MTHFR A1298C polymorphisms. Genetic prothrombotic conditions do not seem to be related to migraine in the young, whereas the biochemical differences between migrainous patients and controls are an appealing topic for further investigation.
Assuntos
Ácido Fólico/sangue , Predisposição Genética para Doença/epidemiologia , Homocisteína/sangue , Metilenotetra-Hidrofolato Redutase (NADPH2)/genética , Transtornos de Enxaqueca/genética , Transtornos de Enxaqueca/metabolismo , Medição de Risco/métodos , Adolescente , Criança , Pré-Escolar , Comorbidade , Feminino , Predisposição Genética para Doença/genética , Humanos , Itália/epidemiologia , Masculino , Doenças Metabólicas/epidemiologia , Doenças Metabólicas/genética , Doenças Metabólicas/metabolismo , Transtornos de Enxaqueca/epidemiologia , Mutação , Prevalência , Fatores de Risco , Trombose/epidemiologia , Trombose/genética , Trombose/metabolismoRESUMO
INTRODUCTION: Serotonergic agents have greater effectiveness than noradrenergic ones in the treatment of Panic Disorder (PD). However preliminary studies suggested that reboxetine might be effective in the treatment of PD. We compared the effectiveness and tolerability of reboxetine and paroxetine in the treatment of PD. METHODS: Sixty-eight patients with PD were assigned to treatment groups in a single-blind, randomized design. Each patient was assessed at day 0 and 90 by the Panic Associated Symptoms Scale (PASS), the Sheehan Disability Scale (SDS) and the Fear Questionnaire (FQ). Side effects were also recorded. RESULTS: Reduction of PASS scores was significantly greater in the paroxetine group than in the reboxetine one. Vice versa we did not find any significant differences for other outcome measures. Sexual dysfunction and weight gain were significantly less frequent in the reboxetine group. CONCLUSIONS: The results showed a greater effect of paroxetine on panic attacks than reboxetine, while no differences for anticipatory anxiety and avoidance were found, suggesting a different role of noradrenaline and serotonin in the treatment of PD.
