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1.
J Tradit Chin Med ; 44(2): 388-395, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38504545

RESUMO

OBJECTIVE: To explore the effect of electroacupuncture on skeletal muscle pain in Parkinson's disease (PD). METHODS: A single-center randomized controlled trial was conducted with sixty patients with Parkinson's disease with skeletal muscle pain were randomly divided into electroacupuncture group and sham acupuncture control group with 30 patients each. The electric acupuncture group was treated with electric acupuncture, while the control group was treated with Park needle pseudoacupuncture. Both groups were treated 5 times a week for a total of 4 weeks, and both groups completed 20 treatments. King's Parkinson's Pain Scale (KPPS) and visual analog scale (VAS) were used before and after treatment to evaluate the pain degree of patients. Real-time shear wave elastography (SWE) and modified Ashworth score (MAS) were used to evaluate the changes of muscle tone. Parkinson's comprehensive Score Scale (MDS-UPDRS, including UPDRSⅡ and UPDRS Ⅲ) was used to evaluate exercise ability. Hamilton Depression Scale (HAMD) score was used to evaluate the emotional changes of patients. Spearman correlation analysis was used to explore the correlation between pain degree and muscle tone, exercise ability and emotion. RESULTS: During the study, one case fell off in the control group, and 30 cases were eventually included in the analysis and treatment group and 29 cases in the control group. After treatment, Young's modulus of biceps and quadriceps and shear wave velocity of biceps were decreased in electroacupuncture group compared with before treatment, while KPPS score, VAS score, UPDRSⅡ, UPDRS Ⅲ and modified Ashworth score were decreased, with statistical significance (P < 0.05). There was no statistical significance in control group (P > 0.05). After treatment, KPPS score, VAS score, UPDRSⅡ and UPDRS Ⅲ, MAS, HAMD score, Young's modulus of biceps and shear wave velocity in electroacupuncture group were significantly lower than those in control group (P < 0.05). Spearman correlation analysis showed that KPPS score was positively correlated with UPDRS Ⅲ (r = 0.414, P < 0.05). KPPS score was positively correlated with HAMD score (r = 0.576, P < 0.01). CONCLUSION: Electroacupuncture therapy can effectively improve skeletal muscle pain in patients with Parkinson's disease, reduce the muscle hardness of patients, improve patients' daily life ability, and improve patients' emotional disorders. The degree of skeletal muscle pain in PD patients is correlated with motor ability and emotional disorders, but there is no significant correlation between the degree of skeletal muscle pain and the muscle tone of PD patients.


Assuntos
Terapia por Acupuntura , Eletroacupuntura , Doença de Parkinson , Humanos , Doença de Parkinson/terapia , Doença de Parkinson/tratamento farmacológico , Dor/etiologia , Músculo Esquelético
2.
J Tradit Chin Med ; 43(4): 829-833, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-37454270

RESUMO

Nonketotic hyperglycemic hemichorea-hemiballismus is a rare syndrome in the clinic, and treatment is often delayed. Hypoglycemic therapy is the most widely used and effective treatment, but some patients experience a slower improvement. Other symptomatic treatment medicines have some degree of side effects. Acupuncture treatment is beneficial for hemichorea-hemiballismus. A male patient, aged 59 years, first visited our hospital outpatient department due to motor agitation with involuntary movements of the right limb. He had a history of type 2 diabetes mellitus and poor blood glucose control. His serum glucose was 26.5 mmol/L (normal: 4.4-6.1 mmol/L), and magnetic resonance imaging demonstrated an irregular area of high signal intensity in T1-weighted imaging, low signal intensity on T2-weighted imaging, and high signal intensity in the left corpus striatum in T2-FLAIR imaging. Hospitalization was recommended for the patient. After ruling out other possibilities, he was eventually diagnosed with nonketotic hyperglycemic hemichorea-hemiballismus. Intensive glycemic control was immediately started with subcutaneous injection and acupuncture treatment at "governor vessel 13 acupoints", and the involuntary movements completely disappeared on the ninth day of hospitalization. The pathophysiology of nonketotic hyperglycemic hemichorea-hemiballismus is unclear. Different patient histories lead to different brain tissue conditions, and relapses and uncontrolled blood glucose add difficulties to treatment. According to Traditional Chinese Medicine theory, insufficient kidney essence leads to brain dystrophy and causes the symptoms of hemichorea-hemiballismus. Research evidence has shown that acupuncture at "governor vessel 13 acupoints" has a beneficial treatment effect on nonketotic hyperglycemic hemichorea-hemiballismus.


Assuntos
Terapia por Acupuntura , Coreia , Diabetes Mellitus Tipo 2 , Discinesias , Humanos , Masculino , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/terapia , Diabetes Mellitus Tipo 2/patologia , Discinesias/etiologia , Discinesias/terapia , Discinesias/diagnóstico , Coreia/etiologia , Coreia/terapia , Coreia/diagnóstico , Encéfalo/patologia , Terapia por Acupuntura/efeitos adversos
3.
Zhongguo Zhong Yao Za Zhi ; 45(19): 4756-4765, 2020 Oct.
Artigo em Chinês | MEDLINE | ID: mdl-33164443

RESUMO

To systematically evaluate the efficacy and safety of Xinmailong Injection in the treatment of coronary heart disease complicated with heart failure. Seven databases,namely CNKI, VIP,WanFang,SinoMed,PubMed,EMbase,Cochrane Library, were retrieved by computer for collecting the randomized controlled trials about Xinmailong Injection in the treatment of coronary heart disease complicated with heart failure. The literatures were screened out, data was extracted, and the methodological quality evaluation was conducted by 2 researchers independently according to inclusion and exclusion criteria. RevMan 5.3 software was used for Meta-analysis and corresponding description analysis. A total of 19 studies involving 1 922 patients were included, including 967 cases in the trial group and 955 cases in the control group. All the clinical studies showed a low quality. Meta-analysis results showed that Xinmailong Injection combined with conventional treatment could better reduce the BNP level(SMD=-3.34, 95%CI[-4.06,-2.63]) in patients of coronary heart disease complicated with heart failure or NT-proBNP level, improve the cardiac function(RR=1.23,95%CI[1.18,1.29]) and LVEF(MD=6.85,95%CI[4.93,8.76]),increase 6 MWT(MD=24.34, 95%CI[16.05, 32.64]) and VEGF(MD=26.39,95%CI[24.30,28.49]),and decreased LVEDD(MD=-4.06, 95%CI[-6.33,-1.80]). And subgroup analysis suggested that the course of treatment may be related to the increase of LVEF. This study found that Xinmailong Injection for coronary heart disease complicated with heart failure can further alleviate clinical symptoms and relevant indicators, with no serious adverse reaction. However, it still needs the support of well-designed multicenter, double-blind and high-quality clinical trials.


Assuntos
Doença das Coronárias , Medicamentos de Ervas Chinesas , Insuficiência Cardíaca , Doença das Coronárias/complicações , Doença das Coronárias/tratamento farmacológico , Medicamentos de Ervas Chinesas/uso terapêutico , Insuficiência Cardíaca/complicações , Insuficiência Cardíaca/tratamento farmacológico , Humanos , Injeções
4.
Clin Exp Dermatol ; 44(4): e110-e117, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30734345

RESUMO

BACKGROUND: Primary localized cutaneous amyloidosis (PLCA) is a chronic pruritic skin disorder. The genetic basis of familial (f)PLCA involves mutations in the oncostatin M receptor (OSMR) and interleukin-31 receptor A (IL31RA) genes, but the disease pathophysiology is not fully understood. AIM: To investigate the OSMR mutation spectrum in patients with sporadic (s)PLCA/fPLCA, lichen/macular PLCA in mainland China. METHODS: This study was carried out on 64 patients with sPLCA, along with 36 with fPLCA and 10 unaffected individuals collected from 23 unrelated Chinese families. Genomic DNA was extracted from peripheral blood samples. Mutation screening of 17 OSMR exons was performed by Sanger sequencing. RESULTS: PLCA lesions are typically localized to the shins, forearm and back. Sequence analysis of OSMR exons demonstrated that the OSMR missense mutation rate in patients with fPLCA (63.89%) was significantly higher than that in patients with sPLCA (34.38%). The male/female ratio of patients carrying a homozygous OSMR mutation (0.29) was significantly lower than that of patients carrying a heterozygous OSMR mutation (1.08; P < 0.05) and of patients with wildtype OSMR (1.75; P < 0.01). Age of onset of PLCA with OSMR homozygous mutation (median age 20 years) was earlier than that of PLCA with OSMR heterozygous mutation (median age 32 years; P < 0.01) or PLCA with wildtype genotype (median age 32 years; P < 0.01). CONCLUSION: The present data indicate OSMR mutations as not only the main cause of fPLCA, but also the potential source of the pathogenesis of sPLCA, although the exact molecular mechanism remains unknown.


Assuntos
Amiloidose Familiar/genética , Povo Asiático/genética , Dermatopatias Genéticas/genética , Adolescente , Adulto , Idoso , Amiloidose Familiar/patologia , Criança , China , Éxons , Feminino , Heterozigoto , Humanos , Masculino , Pessoa de Meia-Idade , Mutação , Mutação de Sentido Incorreto , Subunidade beta de Receptor de Oncostatina M , Linhagem , Receptores de Interleucina , Análise de Sequência de DNA/métodos , Dermatopatias Genéticas/patologia , Adulto Jovem
5.
Folia Biol (Praha) ; 65(5-6): 246-255, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-32362308

RESUMO

In vitro produced ß-like cells can provide promising cell therapy for curing the epidemic of diabetes. In this context, we aimed to investigate the effects of different concentrations of γ-aminobutyric acid (GABA) on the differentiation of rat pancreatic ductal epithelial-like stem cells (PDESCs) into ß-like cells. The PDESC line cells were cultured in the basal media (DMEM/F12 + 10% FBS + 1% penicillinstreptomycin) supplemented with 0 µM, 5 µM, 50 µM, 500 µM, and 5 mM of GABA for 28 days to induce their differentiation. The differentiated cells were detected by cell morphology, dithizone (DTZ) staining, immunofluorescence staining, real-time polymerase chain reaction (qPCR), and glucose-stimulated insulin secretion (GSIS) assay to validate their identity. At the end of 28 days, compared with the control group, enrichment of induced cells was high among the 5 µM, 50 µM, 500 µM, and 5 mM GABA induction groups. The formation of islet-like cell clusters (ICCs) began at 14 days, and the cell clusters showed a growth trend with the culture time. The induced ICCs were positive for DTZ staining, while the control group showed negative results for DTZ staining and the differentiated cells were also positive for ß-cell-specific markers (Ins1 and Pdx1). GSIS assay of 50 µM induction group cells at 28 days showed significantly higher levels of C-peptide and insulin secretion than the control, 5 µM, 500 µM, and 5 mM GABA-treated groups (P < 0.01). At the same time, the 50 µM induction group cells also showed significantly higher levels of Ins1, Pdx1 and Nkx6.1 mRNA as compared to the 5 µM, 500 µM and 5 mM GABA groups (P < 0.01). Thus, the addition of GABA to the basal medium effectively induced differentiation of adult rat PDESCs into insulin-secreting ß-like cells, and 50 µM was the most effective concentration for the induction.


Assuntos
Diferenciação Celular/efeitos dos fármacos , Células Secretoras de Insulina/citologia , Ductos Pancreáticos/citologia , Células-Tronco/citologia , Ácido gama-Aminobutírico/farmacologia , Animais , Peptídeo C/metabolismo , Agregação Celular/efeitos dos fármacos , Forma Celular/efeitos dos fármacos , Regulação da Expressão Gênica/efeitos dos fármacos , Proteínas de Homeodomínio/genética , Proteínas de Homeodomínio/metabolismo , Insulina/metabolismo , Células Secretoras de Insulina/metabolismo , Ratos Sprague-Dawley , Células-Tronco/efeitos dos fármacos , Células-Tronco/metabolismo , Transativadores/genética , Transativadores/metabolismo
6.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-698182

RESUMO

Irritable bowel syndrome(IBS)is a common functional intestinal disease,and its etiology and pathogenesis are not completely clear. The pathogenesis of IBS involves disturbed gastrointestinal motility,gut hypersensitivity,intestinal inflammation,immune dysfunction and brain-gut axis abnormality. Cathepsin S(CTSS)is a proteolytic enzyme widely distributed in various cell lysosomes,and participates in a variety of pathophysiological processes. Recent studies have shown that CTSS may be involved in the pathogenesis of IBS. This article reviewed the advances in study on role of CTSS in IBS.

7.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-698171

RESUMO

Gastroesophageal reflux disease(GERD)is a chronic and recurrent disease with a wide variety of symptoms,often overlapping with functional gastrointestinal disorders,having different response to proton pump inhibitor (PPI)therapy,and facing various challenging for diagnosis and treatment. It is important for improving the diagnosis via knowing well the clinical manifestations of GERD and related diseases,rational using PPI test,upper gastrointestinal endoscopy and ambulatory esophageal pH/impedance monitoring,and understanding the relationship between the symptoms and reflux events. Different strategies of maintenance therapy should be chosen in accordance with patient's condition for decreasing recurrence. Aggressive acid suppressive therapy,inhibiting gastroesophageal reflux and modulating esophageal hypersensitivity are the main treatment methods for patients with poor response to PPI after ruling out the non-GERD causes.

8.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 29(4): 402-405, 2017 Aug 15.
Artigo em Chinês | MEDLINE | ID: mdl-29508568

RESUMO

Objective To evaluate the effect of comprehensive schistosomiasis control measures with focus on total removal of cattle and sheep in Junshan District, Yueyang City. Methods The retrospective review and field survey were implemented in the pilot villages in Junshan District. The data of Schistosoma japonicum infection status of human, cattle, sheep and Oncomelania hupensis snails, and density of snails were gathered and modeled in the period of 2006 to 2016. Results The prevalence of schistosome infection in residents in the pilot villages decreased from 3.44% in 2006 to 0.59% in 2012 (F = 14.501, P = 0.013). After removal of all the cattle and sheep in 2013, the prevalence of schistosome infection in the residents decreased to zero in 2016 (F = 14.148, P = 0.033). The density of living snails decreased from 0.883 3/0.1 m2 in 2006 to 0.308 8/0.1 m2 in 2012 (F = 76.250, P = 0.005). Conclusion The comprehensive schistosomiasis control strategy with focus on cattle and sheep removal is remarkably effective.


Assuntos
Bovinos/parasitologia , Reservatórios de Doenças/veterinária , Esquistossomose/prevenção & controle , Ovinos/parasitologia , Animais , China , Cidades , Reservatórios de Doenças/parasitologia , Humanos , Estudos Retrospectivos , Caramujos/parasitologia
9.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 29(4): 517-519, 2017 Jul 27.
Artigo em Chinês | MEDLINE | ID: mdl-29508597

RESUMO

Objective To analyze the epidemiological characteristics of imported malaria in Zhangjiagang City. Methods The epidemiological data were collected and retrospectively analyzed for the distribution, cost, and exit-entry mode and port of imported malaria cases in Zhangjiagang City from 2005 to 2015. Results There were 25 imported malaria cases in Zhangjiagang City from 2005 to 2015, and among them, there were 16 cases of falciparum malaria (64%), 6 cases of vivax malaria (24%), and 3 cases of ovale malaria (12%); there was 1 cases of critically ill (4%), there were 8 cases of serious ill (32%) and 16 cases of mild ill (64%). The time of onset was in accordance with the circular distribution. The peak of the incidence of the imported malaria was one month earlier than that of the domestic infection. The seasonal peak was gentle, and there was also the occurrence in the non-epidemic season in the city. The imported malaria patients were mainly from Africa, followed by Southeast Asia and Oceania. Conclusion The information technology should be applied to improve the key population coverage on the basis of improving the ability of malaria diagnosis and treatment of medical staff and the multi-sector's cooperation for the imported malaria prevention and control in Zhangjiagang City.


Assuntos
Malária/epidemiologia , África , China/epidemiologia , Cidades , Humanos , Malária Falciparum/epidemiologia , Malária Vivax/epidemiologia , Fatores de Tempo
10.
Med. infant ; 23(3): 224-230, Sept.2016. tab, ilus
Artigo em Espanhol | LILACS | ID: biblio-884400

RESUMO

El mielomeningocele (MMC) es la forma más grave de los disrafismos de la columna vertebral. Afecta a 1/1200 recién nacidos vivos. Su etiología es multifactorial. El 80% cursa con hidrocefalia (HC) asociada a malformación de Arnold Chiari. El coeficiente intelectual (CI) oscila en un rango entre fronterizo y normal promedio. La tasa mundial de la población general de zurdos es del 10% pero se describe un aumento de su presentación en niños con MMC. Además se evidencian déficits visoespaciales, grafomotores, atencionales, memorísticos, dificultades en aritmética y en la comprensión de textos. Materiales y métodos: Este es un trabajo analítico, descriptivo, transversal. Se evaluaron 179 pacientes derivados del Consultorio Interdisciplinario de MMC; edad: entre 5 años, 0 meses y 15 años, 11 meses. No se emplearon controles sanos. Instrumentos administrados: Stanford Binet IV, Prolec ­ Prolec-Se, Wrat3, TMT A y B, d2, Stroop y pruebas de lateralidad de Zazzo. Objetivo: Describir la lateralidad, el perfil cognitivo y el rendimiento escolar en pacientes pediátricos con patología de mielomeningocele, analizando también las funciones ejecutivas, los procesos atencionales, memorísticos y la modalidad escolar en la cual se encuentran inmersos. Resultados: El 20% (35/179 pacientes) con edades que oscilan entre los 5 años, 0 meses y 15 años, 11 meses han presentado lateralidad zurda, y de ellos presentaban antecedentes familiares de zurdera 26%. Se observó lateralidad cruzada en 6% y eran ambidiestros 11%. El perfil cognitivo de la muestra completa (N: 179) fue homogéneo en todas las áreas (verbal, abstracto/visual y memoria de corto plazo), arrojando puntuaciones fronterizas. En pruebas atencionales el 100% obtuvo niveles descendidos. Todos reportaron dificultades en el rendimiento escolar. Sólo el 14% tuvo plan de integración y el 11% accedió a algún tipo de tratamiento. Conclusiones: Los niños con MMC evidencian déficits neuropsicológicos y alta tasa de zurdera, siendo probablemente los problemas de lateralidad una de las causas que ocasionarían el bajo rendimiento escolar y afectando el rendimiento académico (AU)


Myelomeningocele (MMC) is the most severe form of spinal dysraphism, affecting 1/1200 live newborns. Its etiology is multifactorial. Overall, 80% develops hydrocephalus (HC) associated with an Arnold Chiari malformation. The intelligence quotient (IQ) ranges from borderline to average. The worldwide incidence in the general population of left-handedness is 10%; however, an increase is found among children MMC. Additionally, visuospatial, graphomotor, attention, memory deficits as well as difficulties in arithmetic and text comprehension is found. Material and methods: A cross-sectional, analytical, descriptive study was conducted. Overall, 179 patients aged between 5 years 0 months and 15 years 11 months referred from the interdisciplinary MMC clinic were evaluated. No healthy control group was used. Instruments administrated: Stanford Binet IV, Prolec ­ Prolec-Se, Wrat3, TMT A and B, d2, Stroop and Zazzo's laterality test. Aim: To describe laterality, cognitive profile, and school performance in pediatric patients with MMC, analyzing executive functions, attention and memory, and the school system the children were attending. Results: 20% (35/179 patients) aged between 5 years, 0 months and 15 years, 11 months were left-handed, 26% of whom had a family history of left-handedness. Cross dominance was observed in 6% and ambidexterity in 11%. Overall, the cognitive profile of the sample (N: 179) was homogeneous in all areas (verbal, abstract/visual, and short-term memory), with borderline scores. In attention tasks, levels were low in 100%. All children had difficulties in school performance. Only 14% had an integration program and 11% received some type of treatment. Conclusions: Children with MMC show neuropsychological deficits and a high rate of left-handedness, the latter of which may be one of the causes of poor school performance and affecting academic achievements (AU)


Assuntos
Humanos , Criança , Adolescente , Desempenho Acadêmico , Transtornos Cognitivos/diagnóstico , Transtornos Cognitivos/etiologia , Lateralidade Funcional , Meningomielocele/psicologia , Testes Neuropsicológicos , Disrafismo Espinal/psicologia , Estudos Transversais
11.
Clin Exp Obstet Gynecol ; 42(4): 505-9, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26411221

RESUMO

PURPOSE OF INVESTIGATION: To assess the preliminary results of tubal surgery and its effect on pregnancy outcome. MATERIALS AND METHODS: The study included 440 patients with unilateral or bilateral tubal disease as the only cause of the infertility. All patients undergoing a laparoscopy for infertility were studied in reproductive surgery centre. The fallopian tube was classified into class I-IV. The studied outcomes were live birth, ectopic pregnancy, and miscarriage. After 12 months, cumulative conception rate was calculated. RESULTS: In the 440 patients, 172 patients with mild salpinx abnormality (class I) had a 34% cumulative pregnancy rate, 151 patients with moderate salpinx abnormality (class II) had a 16% cumulative pregnancy rate, and 77 patients with severe salpinx abnormality (class III) had a 10% cumulative pregnancy rate. No intrauterine pregnancies were observed in the severe group of 40 patients (class IV). CONCLUSION: Surgical laparoscopy is helpful for class I and II tubal abnormality, while it is not for class III and IV abnormalities.


Assuntos
Doenças das Tubas Uterinas/cirurgia , Infertilidade Feminina/cirurgia , Aborto Espontâneo , Adulto , China , Doenças das Tubas Uterinas/patologia , Feminino , Humanos , Laparoscopia/métodos , Gravidez , Resultado da Gravidez , Gravidez Ectópica , Índice de Gravidade de Doença
12.
Med. infant ; 22(3): 201-209, Sept.2015. tab
Artigo em Espanhol | LILACS | ID: biblio-906475

RESUMO

Introducción: la diabetes tipo 1 es la segunda enfermedad crónica más frecuente de la infancia. Dentro de sus comorbilidades de la diabetes tipo 1, los efectos sobre el riñón, la retina, los nervios, los vasos sanguíneos y el sistema cardiovascular son ampliamente conocidos, sin embargo y a pesar de su importancia, en los niños, aún se conoce poco acerca del impacto de la diabetes tipo 1 sobre el sistema nervioso central en desarrollo. Objetivo: estudiar el desarrollo neurocognitivo alcanzado por nuestros pacientes con diabetes tipo 1 de comienzo temprano, analizando su relación con el control metabólico de la enfermedad y con factores socio-ambientales. Material y Métodos: se realizó un estudio descriptivo, observacional y transversal, con análisis retrospectivo. Fueron incluidos los niños atendidos en el Hospital de Pediatría Garrahan, con diabetes tipo 1, con comienzo de la enfermedad antes de los 7 años de vida. Se evaluó perfil neurocognitivo incluyendo capacidad cognitiva general, razonamiento verbal y perceptivo motor, velocidad de procesamiento y memoria operativa. Las variables metabólicas analizadas fueron mal control por hiperglucemia o por hipoglucemia y grado de descompensación al debut. Resultados: El coeficiente intelectual total se relacionó significativamente con educación secundaria materna. (R2 0.56 F= 5.21, p= 0.01). El índice de comprensión verbal se relacionó significativamente tanto con el escore de hiperglucemia como con educación secundaria materna. (R2 0.56 F= 5.16, p= 0.01). El índice de velocidad de procesamiento presentó relación significativa solo con el valor de bicarbonato al debut. (R2 0.39 F= 3.72, p= 0.03) y el índice de memoria operativa presentó relación significativa con vivienda propia y valor de bicarbonato al debut. (R2 0.50 F= 5.32, p= 0.009). Los pacientes con mayores eventos de hipoglucemias no presentaron diferencias significativas en ninguna variable neurocognitiva con respecto a los demás. Conclusión: hemos hallado alteraciones neurocognitivas leves asociadas principalmente a hiperglucemia, grado de descompensación al debut y a causas socioambientales. Resulta clara la necesidad de alcanzar objetivos de control glucémico con el fin de evitar o retrasar la posible aparición de complicaciones crónicas entre las cuales deben incluirse las que afectan al sistema nervioso central en desarrollo (AU)


Introduction: Type-1 diabetes is the second-most common chronic disease in childhood. Among the co-morbidities of type-1 diabetes, kidney, retina, nerve, blood-vessel, and cardiovascular involvement is widely known; however, in spite of its importance in children little is known about the impact of type-1 diabetes on the developing central nervous system. Aim: To study neurocognitive development in our patients with early-onset type-1 diabetes, with a focus on the association with metabolic control of the disease. Material and Methods: A descriptive, observational, and transsectional study was conducted using retrospective data analysis. Children with type-1 diabetes with a disease onset before 7 years of age seen at the pediatric Hospital Garrahan were included in the study. The neurocognitive profile was assessed, including general cognitive abilities, verbal and perceptive motor reasoning, processing speed, and working memory. Metabolic variables evaluated were poor hyperglycemia control or hypoglycemia and degree of decompensation at onset. Results: Total intellectual quotient was significantly related to maternal secondary education (R2 0.56 F= 5.21, p= 0.01). Verbal comprehension index score was significantly associated both with hyperglycemia score and maternal secondary education (R2 0.56 F= 5.16, p= 0.01). Processing speed index was significantly related only to bicarbonate levels at onset (R2 0.39 F= 3.72, p= 0.03) and working memory index was significantly related to family homeownership and bicarbonate levels at onset (R2 0.50 F= 5.32, p=0.009). Patients with a greater number of hypoglycemia events did not have significant differences in any of the neurocognitive variables compared to the other children. Conclusion: We found that mild neurocognitive impairment was mainly associated with hyperglycemia, degree of decompensation at onset, and environmental causes. There is a clear need to achieve the goal of glycemia control so as to avoid or delay possible chronic complications including those that affect the developing central nervous system (AU)


Assuntos
Humanos , Pré-Escolar , Criança , Adolescente , Cognição , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 1/psicologia , Desenvolvimento da Linguagem , Memória , Destreza Motora , Glicemia/metabolismo , Doença Crônica , Estudos Transversais , Estudo Observacional , Estudos Retrospectivos
13.
Med. infant ; 21(4): 291-300, diciembre 2014. ilus
Artigo em Espanhol | LILACS | ID: biblio-916213

RESUMO

Objetivos: caracterización de las Funciones Ejecutivas (FE) y Calidad de Vida (CV) en niños de 8 a 12 años con trasplante hepático (TxHep). Metodología: Se evaluó al primer paciente de la agenda de seguimiento de TxHep (37 niños). Excluidos 7: 6 por discapacidad intelectual: 16,6%, 1 desertó. Instrumentos: escala Graffar, WISC III, NEPSY II, d2, Test de Trazados A y B, y Peds QL. FE: 30 TxHep y 30 controles. (Statistical Package for Social Sciences, versión 11.5). Resultados: 53,3% diagnóstico de Falla Hepática Fulminante (FHF), 70% TxHep con dificultades escolares. CI total: diferencia estadísticamente significativa: p < 0.023; T test de Student (TtS), entre FHF (82 ± 8.2) y el resto TxHep (75.43 ± 6.5). 60% TxHep en el nivel fronterizo. Diferencias estadísticamente significativas FE: Flexibilidad cognitiva; Fijación de Metas; y Procesamiento de la Información. Calidad de Vida: déficit leve en el dominio Escolar (score Z, -0.88 ± 0.87) y en el Psicosocial (score Z, -0.63 ± 1.06), en el reporte de niños TxHep. Conclusiones: una muestra mas amplia podría diferenciar las FE y CV entre FHF y otros diagnósticos. La intervención oportuna del diagnóstico y terapia neurocognitivos favorecen el neurodesarrollo acompañando la sobrevida (AU)


Purpose: To describe executive functions (EF) and quality of life (QOL) in children between 8 and 12 years of age who underwent liver transplantation (LTx). Methods: Patients from the list of LTx patients in follow-up were evaluated (37 children). Excluded 7: 6 because of intellectual disability: 16.6%, 1 dropped out. Tools: Graffar index, WISC III, NEPSY II, d2, Trail Making Tests A and B, and Peds QL. EF: 30 LTx and 30 controls. (Statistical Package for Social Sciences, versión 11.5). Results: 53.3% had a diagnosis of acute liver failure (ALF), 70% of LTx had difficulties in their school performance. Total IQ: a significant statistical difference was found: p < 0.023; Student's t test (StT), between patients with ALF (82 ± 8.2) and the remaining LTx patients (75.43 ± 6.5). Sixty percent had a borderline level. Statistically significant differences in EF: Cognitive flexibility; Goal setting; and Information Processing speed. QOL: A mild deficit in the School (Z-score, -0.88 ± 0.87) and Psychosocial Domain (Z score, -0.63 ± 1.06) in the LTx children's report. Conclusions: A larger study sample will be useful to differentiate EF and QOL in LTx children with ALF and those with other diagnoses. Early intervention after diagnosis and neurocognitive therapy is important to improve patients' quality of survival (AU)


Assuntos
Humanos , Criança , Qualidade de Vida , Transplante de Fígado/psicologia , Função Executiva , Testes Neuropsicológicos , Neuropsicologia , Estudos de Casos e Controles , Cognição , Neurociência Cognitiva
14.
Genet Mol Res ; 13(3): 4867-82, 2014 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-25062420

RESUMO

Blood pressure levels were evaluated among prehypertension patients with associated cardiovascular risk factors to determine the effect of different interventions with respect to new endpoint events. A total of 1112 patients were equally and randomly divided into control, lifestyle, drug, and lifestyle + drug groups, and were followed-up for 12 months. We collected the age, height, weight, blood pressure, heart rate, blood lipid levels, blood glucose levels, and other clinical data from all subjects at the baseline and at the end of the follow-up period. The average systolic blood pressure (SBP) and diastolic blood pressure (DBP) in the intervention groups were significantly reduced after the intervention (lifestyle + drug > drug > lifestyle). SBP and DBP were higher in the control group than before intervention (P < 0.05). Age, gender, heart rate, triglyceride (TG) levels, body mass index (BMI), alcohol consumption, and family history were the major factors affecting blood pressure. Increased BMI, TG, high-sensitivity C-reactive protein, alcohol consumption, family history, SBP, and DBP were major risk factors of hypertension. At the end of the follow-up period, there were 67 cases of hypertension, 32 cases of diabetes, and 12 cases of the endpoint events. Hypertension and diabetes events were reduced in the intervention groups relative to the control group (P < 0.05). The number of cases with incident cardiovascular endpoints did not differ among the three intervention groups (P > 0.05). Therefore, hypertension and related cardiovascular events can be controlled with different interventions.


Assuntos
Anti-Hipertensivos/uso terapêutico , Diabetes Mellitus/prevenção & controle , Hipertensão/prevenção & controle , Pré-Hipertensão/tratamento farmacológico , Adulto , Consumo de Bebidas Alcoólicas/fisiopatologia , Glicemia/metabolismo , Pressão Sanguínea , Índice de Massa Corporal , Proteína C-Reativa/metabolismo , China , Diabetes Mellitus/sangue , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/fisiopatologia , Feminino , Seguimentos , Frequência Cardíaca , Humanos , Hipertensão/sangue , Hipertensão/diagnóstico , Hipertensão/fisiopatologia , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Pré-Hipertensão/sangue , Pré-Hipertensão/diagnóstico , Pré-Hipertensão/fisiopatologia , Fatores de Risco , Triglicerídeos/sangue
15.
Aquat Toxicol ; 150: 144-50, 2014 May.
Artigo em Inglês | MEDLINE | ID: mdl-24680750

RESUMO

In this study, immunological and histological responses of the crab Charybdis japonica to sulfide stress were investigated. The 24, 48, 72, and 96-h LC50 values of Na2S were 6.634, 4.703, 3.886, and 2.190 mM, respectively. Based on these results, the crabs were exposed to 0.25, 0.50, 0.75, 1.00, and 1.25 mM of Na2S over a 15-day period, and sampled at 0, 1, 3, 5, 10, and 15 day for analyzing changes in immunity-related indicators in the hemolymph (including total hemocyte (THC), hemocyanin content, the activities of the phenoloxidase (PO), lysozyme (LSZ), superoxide dismutase (SOD) and catalase (CAT), and malondialdehyde (MDA) content), and the histological structures of major organs (gill, hepatopancreas, and stomach). The results showed that the activities of most immune-related factors declined after an initial rise under Na2S-induced stress, with the exception of MDA content that showed an overall increasing trend. After exposure to Na2S for 15 days, most of the measured indices were lower in treatment groups than in the control. Significant negative correlations was found between Na2S concentration and the activities of LSZ, SOD, CAT (p<0.01), while MDA content was found to be positively correlated with Na2S concentration (p<0.05). Noticeable changes in the histological structure of the main organs of C. japonica were observed upon exposure to high concentration of Na2S: the outer chitin layer of the gills became thin and partialy ruptured; hemocytes in the gill hemocoel were severely vacuolized; the morphology of glandular epithelium was irregular; the rough endoplasmic reticulum became swollen and reduced in number; and several large vacuoles and some residual bodies were observed in the gastric epithelium. These results indicate that stress induced by high concentration of sulfide can significantly affect the activities of immune-related enzymes and the organ structure of C. japonica. Furthermore, changes in the activities of LSZ, SOD, and CAT, and the content of MDA may be used as indices for evaluating the immune state of C. japonica under sulfide stress.


Assuntos
Braquiúros/efeitos dos fármacos , Sulfetos/toxicidade , Poluentes Químicos da Água/toxicidade , Animais , Braquiúros/imunologia , Braquiúros/metabolismo , Braquiúros/ultraestrutura , Ativação Enzimática/efeitos dos fármacos , Enzimas/metabolismo , Sistema Imunitário/efeitos dos fármacos , Dose Letal Mediana , Malondialdeído/metabolismo , Microscopia Eletrônica de Transmissão
16.
Med. infant ; 21(1): 20-27, mar. 2014. tab
Artigo em Espanhol | BINACIS | ID: bin-132616

RESUMO

El presente trabajo intenta realizar una descripción del perfil cognitivo de los niños con altas capacidades y dificultades que pueden asociarse. La superdotación supone una inteligencia muy superior respecto a su grupo de edad medida a través de las pruebas de inteligencia. Estos sujetos poseen gran creatividad, imaginación, sensibilidad y curiosidad insaciable. El perfil cognitivo evidencia un elevado nivel ling³ístico, pero generalmente con mayor descompensación de las habilidades de procesamiento gráfico. Un niño con altas capacidades no sólo cuestiona sus altos potenciales, sino también su existencia, ocasionándole lo que se denomina ôSíndrome de Bajo Rendimiento (SBR)ö. Cuando se encuentran en esta situación, ocultan sus capacidades para evitar ser rechazados o discriminados por sus compañeros. En esta etapa los sujetos sobresalientes, pueden confundirse con niños con trastornos de aprendizaje, trastornos por déficit de atención, Sme. de Asperger u otras patologías, presentando distintos perfiles y generándoles dificultades en las habilidades sociales, trastornos conductuales, etc., tanto en el ámbito escolar como extraescolar


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Criança Superdotada , Criança Superdotada/psicologia , Psicometria/instrumentação , Técnicas Psicológicas , Testes Neuropsicológicos , Educação Inclusiva , Criança Superdotada/educação , Baixo Rendimento Escolar , Argentina
17.
Med. infant ; 21(1): 32-36, mar. 2014. tab
Artigo em Espanhol | BINACIS | ID: bin-132614

RESUMO

Se incluyeron 28 pacientes, el 75% de sexo masculino, con una mediana de edad de 13 años (r 8-17). Se utilizaron las siguientes pruebas: Enfocar-Ejecutar: Stroop y Trail Making A; Sostener la Atención: D2; Codificar la Información (Memoria de Trabajo): Tomal; Capacidad de cambiar la atención adaptativamente: Trail Making B y Wisconsin. Se administró también un test de inteligencia abreviado (KBit). Los pacientes fueron evaluados antes del ingreso a la unidad de trasplante y un año después si se encontraban en seguimiento ambulatorio y en remisión de la enfermedad que motivo el TCPH. También fue estudiado un grupo control de niños y adolescentes sanos, sin trastornos de aprendizaje, de dos escuelas. Se compararon los resultados de los pacientes antes del TCPH con el grupo control y los resultados pre y post TCPH de los 17 que pudieron ser evaluados al año. Se utilizó la prueba t de Student y se consideró significativa una p< 0,05. En la evaluación previa al TCPH los pacientes presentaban resultados significativamente inferiores a los controles para las siguientes prueba: Wisconsin, Trail Making A y B, Stroop, D2 y K-Bit, lo que implicaría compromiso de las siguientes funciones cognitivas: Atención sostenida, Enfocar - ejecutar y Funciones ejecutivas respectivamente, debido a que tomamos el modelo de Misky en donde el cambio adaptativo de la atención está implicando a las funciones ejecutivas. En la evaluación posterior al TCPH se observaron pocas diferencias respecto a la evaluación inicial, que involucraron el sostén de la atención, la capacidad de cambiar el foco de la misma y las funciones ejecutivas. Conclusión: los pacientes llegan al TCPH con un compromiso previo de sus funciones atencionales que podría estar relacionado con las limitaciones para la actividad escolar, producto de la enfermedad y tratamientos previos. Esta situación podría afectar su rendimiento académico posterior y ser un factor de riesgo de fracaso escolar


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Transplante Homólogo , Transplante Homólogo/efeitos adversos , Transtorno do Deficit de Atenção com Hiperatividade/etiologia , Transplante de Células-Tronco Hematopoéticas , Cognição , Argentina
18.
Med. infant ; 21(1): 32-36, mar. 2014. tab
Artigo em Espanhol | LILACS | ID: lil-774895

RESUMO

Se incluyeron 28 pacientes, el 75% de sexo masculino, con una mediana de edad de 13 años (r 8-17). Se utilizaron las siguientes pruebas: Enfocar-Ejecutar: Stroop y Trail Making A; Sostener la Atención: D2; Codificar la Información (Memoria de Trabajo): Tomal; Capacidad de cambiar la atención adaptativamente: Trail Making B y Wisconsin. Se administró también un test de inteligencia abreviado (KBit). Los pacientes fueron evaluados antes del ingreso a la unidad de trasplante y un año después si se encontraban en seguimiento ambulatorio y en remisión de la enfermedad que motivo el TCPH. También fue estudiado un grupo control de niños y adolescentes sanos, sin trastornos de aprendizaje, de dos escuelas. Se compararon los resultados de los pacientes antes del TCPH con el grupo control y los resultados pre y post TCPH de los 17 que pudieron ser evaluados al año. Se utilizó la prueba t de Student y se consideró significativa una p< 0,05. En la evaluación previa al TCPH los pacientes presentaban resultados significativamente inferiores a los controles para las siguientes prueba: Wisconsin, Trail Making A y B, Stroop, D2 y K-Bit, lo que implicaría compromiso de las siguientes funciones cognitivas: Atención sostenida, Enfocar - ejecutar y Funciones ejecutivas respectivamente, debido a que tomamos el modelo de Misky en donde el cambio adaptativo de la atención está implicando a las funciones ejecutivas. En la evaluación posterior al TCPH se observaron pocas diferencias respecto a la evaluación inicial, que involucraron el sostén de la atención, la capacidad de cambiar el foco de la misma y las funciones ejecutivas. Conclusión: los pacientes llegan al TCPH con un compromiso previo de sus funciones atencionales que podría estar relacionado con las limitaciones para la actividad escolar, producto de la enfermedad y tratamientos previos. Esta situación podría afectar su rendimiento académico posterior y ser un factor de riesgo de fracaso escolar.


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Cognição , Transplante de Células-Tronco Hematopoéticas , Transplante Homólogo , Transplante Homólogo/efeitos adversos , Transtorno do Deficit de Atenção com Hiperatividade/etiologia , Argentina
19.
Med. infant ; 21(1): 20-27, mar. 2014. tab
Artigo em Espanhol | LILACS | ID: lil-774897

RESUMO

El presente trabajo intenta realizar una descripción del perfil cognitivo de los niños con altas capacidades y dificultades que pueden asociarse. La superdotación supone una inteligencia muy superior respecto a su grupo de edad medida a través de las pruebas de inteligencia. Estos sujetos poseen gran creatividad, imaginación, sensibilidad y curiosidad insaciable. El perfil cognitivo evidencia un elevado nivel lingüístico, pero generalmente con mayor descompensación de las habilidades de procesamiento gráfico. Un niño con altas capacidades no sólo cuestiona sus altos potenciales, sino también su existencia, ocasionándole lo que se denomina “Síndrome de Bajo Rendimiento (SBR)”. Cuando se encuentran en esta situación, ocultan sus capacidades para evitar ser rechazados o discriminados por sus compañeros. En esta etapa los sujetos sobresalientes, pueden confundirse con niños con trastornos de aprendizaje, trastornos por déficit de atención, Sme. de Asperger u otras patologías, presentando distintos perfiles y generándoles dificultades en las habilidades sociales, trastornos conductuales, etc., tanto en el ámbito escolar como extraescolar.


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Criança Superdotada , Educação Inclusiva , Testes Neuropsicológicos , Criança Superdotada/educação , Criança Superdotada/psicologia , Técnicas Psicológicas , Psicometria/instrumentação , Argentina , Baixo Rendimento Escolar
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