Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 52
Filtrar
1.
Artigo em Inglês | MEDLINE | ID: mdl-37048013

RESUMO

In the 1990s, the Institute of Electrical and Electronics Engineers (IEEE) restricted its risk assessment for human exposure to radiofrequency radiation (RFR) in seven ways: (1) Inappropriate focus on heat, ignoring sub-thermal effects. (2) Reliance on exposure experiments performed over very short times. (3) Overlooking time/amplitude characteristics of RFR signals. (4) Ignoring carcinogenicity, hypersensitivity, and other health conditions connected with RFR. (5) Measuring cellphone Specific Absorption Rates (SAR) at arbitrary distances from the head. (6) Averaging SAR doses at volumetric/mass scales irrelevant to health. (7) Using unrealistic simulations for cell phone SAR estimations. Low-cost software and hardware modifications are proposed here for cellular phone RFR exposure mitigation: (1) inhibiting RFR emissions in contact with the body, (2) use of antenna patterns reducing the Percent of Power absorbed in the Head (PPHead) and body and increasing the Percent of Power Radiated for communications (PPR), and (3) automated protocol-based reductions of the number of RFR emissions, their duration, or integrated dose. These inexpensive measures do not fundamentally alter cell phone functions or communications quality. A health threat is scientifically documented at many levels and acknowledged by industries. Yet mitigation of RFR exposures to users does not appear as a priority with most cell phone manufacturers.


Assuntos
Telefone Celular , Exposição à Radiação , Humanos , Ondas de Rádio/efeitos adversos , Comunicação
2.
Animal Model Exp Med ; 5(4): 369-376, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-35971614

RESUMO

BACKGROUND: BioCen-128 is a new active pharmaceutical ingredient composed of a specific bovine thymic fraction of a polypeptide nature. Positive results of similar thymus extracts have been shown to be effective in delaying the processes associated with aging, immunosenescence and Alzheimer's disease (AD), where the inflammation plays an important role. Because of the anti-inflammatory potential of BioCen-128, the aim of this study was to evaluate the granuloma model induced by a cotton wool implantation and the model induced by intracerebroventricular (ICV) administration of streptozotocin (STZ). METHOD: The experiment was carried out using male OF-1cenp mice weighing 20 ± 2 g. RESULTS: Mice administered BioCen-128 in via the IP route at 5, 10 and 20 mg/kg of corporal weigh showed a decrease in the wet and dry weights of the granuloma, providing evidence of a systemic anti-inflammatory effect. In the ICV model of STZ, the administration of BioCen-128 improved cognitive function. CONCLUSION: These responses suggested an anti-neuroinflammatory effect explainable by the action of thymosin ß4 and thymosin alfa proteins. The results suggested that BioCen-128 could be used in the prevention and treatment of some diseases, for example AD, where neuroinflammation is one of the biological events that take place.


Assuntos
Doença de Alzheimer , Doença de Alzheimer/tratamento farmacológico , Animais , Bovinos , Cognição , Modelos Animais de Doenças , Granuloma/tratamento farmacológico , Masculino , Camundongos , Estreptozocina
3.
MEDICC Rev ; 23(1): 84-87, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33780427

RESUMO

This paper describes psychocardiology studies conducted from 2002 through 2018 in the Cardiology Department of the Dr Gustavo Aldereguía Lima University General Hospital in Cienfuegos Province, Cuba. Given the strong association between cardiovascular diseases and lifestyle, negative emotions and personality traits, psychology and medicine are equally necessary components of prevention and patient care, indispensable to primary and secondary prevention and to rehabilitation. When its therapeutic principles are appropriately applied, psychology can have a positive impact on the course of the disease and on patients' adaptation to new habits and lifestyles. The psychocardiologist's job is fundamental in achieving conscious participation by patients in their rehabilitation. Theoretical and practical contributions include a gender-based approach, addressing patients' sexual needs, neuropsychological assessment of damage associated with cardiovascular diseases, the particularities of pediatric patient care, family involvement in rehabilitation, and services for families at risk for cardiovascular events due to genetic factors. Results of these studies are included in published methodology for intensive psychological treatment for patients and health care workers.


Assuntos
Doenças Cardiovasculares/psicologia , Assistência Integral à Saúde , Saúde da Família , Cuba , Humanos
4.
J Sch Health ; 90(7): 572-581, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32378189

RESUMO

BACKGROUND: Our objective was to evaluate the effect of garden-based learning on outlook and behaviors toward vegetables among primarily Latinx students. An educational strategy, garden-based learning is a teaching tool that complements other disciplines. METHODS: Third- and fourth-grade students at 4 elementary schools with different garden programs completed a bingo survey and participated in class discussions to measure outlook and behaviors toward vegetables. RESULTS: Students in schools with more garden exposure were more likely to answer "Yes" to survey questions reflecting a positive attitude and behaviors toward vegetables. In class discussions, students most often mentioned vegetables grown in the school garden as their favorite vegetables. CONCLUSION: For third- and fourth-grade students, the length of exposure to a school garden appears to have a positive impact on both perceptions of and desire to consume vegetables. Other studies have shown that positive outlook and behaviors toward vegetables can change vegetable consumption habits in children. Integrating garden-based learning into the school curriculum may positively influence eating behaviors over the long-term future.


Assuntos
Atitude , Jardins , Verduras , Arizona , Criança , Hispânico ou Latino , Humanos , Instituições Acadêmicas
5.
Lab Anim Res ; 36: 7, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32206613

RESUMO

Dementia is defined as cognitive impairment in more than one cognitive area and leads to an abnormal degree of impairment in the ability to remember past events. Among mice models of dementia the most used strains are SAMP8 and C57BL/6. There is no reference to characterizing a model of dementia in naturally aged mice of the BALB/c strain, or to the minimum age at which these animals can be used. The aim of this study was the characterization of aged male BALB/ccenp mice as a model of dementia from the evaluation of behavioural, pathological and biochemical markers. One hundred and twenty mice were used and 10 of these were analysed from 8 to 9 months of age, and every 4 months, in a comparative way to young control animals from 4 to 5 months. At the age of 12-13 months there was cognitive impairment in the animals from the Y-maze and object recognition tests and this impairment was maintained at 16-17 months of age. An increase in oxidative damage to proteins in the brains of aged animals was also found in relation to young animals; as well as a decrease in the concentration of triglycerides. At the age of 16-17 months, a significant decrease in the size of the thymus and brain was obtained. We consider that it's a very useful option to use animals 12-13 months of age where there are symptoms of cognitive deficiency, histopathological and biochemical elements characteristic of dementia.

6.
Mult Scler ; 26(1): 48-56, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-30785358

RESUMO

BACKGROUND: Alemtuzumab is a highly effective therapy for relapsing-remitting multiple sclerosis (RRMS), and immune thrombocytopenia (ITP) has been identified as a risk. OBJECTIVE: To examine ITP incidence, treatment, and outcomes during the clinical development of alemtuzumab for RRMS and discuss postmarketing experience outside clinical trials. METHODS: CAMMS223 and Comparison of Alemtuzumab and Rebif® Efficacy in Multiple Sclerosis (CARE-MS) I and II investigated two annual courses of alemtuzumab 12 mg (or 24 mg in CAMMS223/CARE-MS II) versus subcutaneous interferon beta-1a three times per week. Patients completing core studies could enroll in an extension. Monthly monitoring for ITP continued until 48 months after the last alemtuzumab infusion. RESULTS: Of 1485 alemtuzumab-treated MS patients in the clinical development program, 33 (2.2%) developed ITP (alemtuzumab 12 mg, 24 [2.0%]; alemtuzumab 24 mg, 9 [3.3%]) over median 6.1 years of follow-up after the first infusion; most had a sustained response to first-line ITP therapy with corticosteroids, platelets, and/or intravenous immunoglobulin. All cases occurred within 48 months of the last alemtuzumab infusion. Postmarketing surveillance data suggest that the ITP incidence is not higher in clinical practice than in clinical trials. CONCLUSION: Alemtuzumab-associated ITP occurs in approximately 2% of patients and is responsive to therapy. Careful monitoring is key for detection and favorable outcomes.


Assuntos
Alemtuzumab/efeitos adversos , Fatores Imunológicos/efeitos adversos , Interferon beta-1a/efeitos adversos , Esclerose Múltipla Recidivante-Remitente/tratamento farmacológico , Púrpura Trombocitopênica Idiopática , Adulto , Alemtuzumab/administração & dosagem , Feminino , Seguimentos , Humanos , Fatores Imunológicos/administração & dosagem , Incidência , Interferon beta-1a/administração & dosagem , Masculino , Pessoa de Meia-Idade , Púrpura Trombocitopênica Idiopática/tratamento farmacológico , Púrpura Trombocitopênica Idiopática/epidemiologia , Púrpura Trombocitopênica Idiopática/etiologia
7.
Mult Scler ; 26(14): 1866-1876, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-31762387

RESUMO

BACKGROUND: Alemtuzumab is given as two annual courses. Patients with continued disease activity may receive as-needed additional courses. OBJECTIVE: To evaluate efficacy and safety of additional alemtuzumab courses in the CARE-MS (Comparison of Alemtuzumab and Rebif® Efficacy in Multiple Sclerosis) studies and their extensions. METHODS: Subgroups were based on the number of additional alemtuzumab courses received. Exclusion criteria: other disease-modifying therapy (DMT); <12-month follow-up after last alemtuzumab course. RESULTS: In the additional-courses groups, Courses 3 and 4 reduced annualized relapse rate (12 months before: 0.73 and 0.74, respectively; 12 months after: 0.07 and 0.08). For 36 months after Courses 3 and 4, 89% and 92% of patients were free of 6-month confirmed disability worsening, respectively, with 20% and 26% achieving 6-month confirmed disability improvement. Freedom from magnetic resonance imaging (MRI) disease activity increased after Courses 3 and 4 (12 months before: 43% and 53%, respectively; 12 months after: 73% and 74%). Safety was similar across groups; serious events occurred irrespective of the number of courses. CONCLUSION: Additional alemtuzumab courses significantly improved outcomes, without increased safety risks, in CARE-MS patients with continued disease activity after Course 2. How this compares to outcomes if treatment is switched to another DMT instead remains unknown.


Assuntos
Esclerose Múltipla Recidivante-Remitente , Esclerose Múltipla , Alemtuzumab , Humanos , Interferon beta-1a , Esclerose Múltipla Recidivante-Remitente/tratamento farmacológico , Recidiva
8.
Neuroradiology ; 61(9): 1067-1072, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31203413

RESUMO

PURPOSE: Since appearance of the balloon-remodeling technique and stent-assisted coiling, complex aneurysms have been treated successfully by endovascular means worldwide. Although these two techniques have been widely proven, the combination of both traditionally made the procedures more complicated technically. The aim of our study was to determine the technical success, safety, and efficacy of the low-profile stents delivered through double lumen balloons. METHODS: Clinical, procedural, and angiographic data were analyzed. RESULTS: Eighty-four patients (55 women; age range 20-81 years) harboring 86 aneurysms were included in this study. Aneurysm maximal diameter ranged from 2 to 26 mm, with mean 7.5 mm. There were 62 unruptured, 15 recanalized, and 9 acutely ruptured aneurysms. Aneurysm locations were ACoA (31), MCA (36), supraclinoid ICA (4), carotid bifurcation (2), basilar (7), PCA (3), PICA (2), and VA (1). Ninety-three devices were implanted (63 LVIS jr, 15 LEO Baby, 14 ACCLINO Flex and 1 Neuroform Atlas) through the double lumen balloons (Scepter C or XC and Eclipse 2 L). We found 2 minor clinical events (2.4%) and 1 major event (1.2%). Total intra-procedural technical complication rate was 11.6%. Follow-up was available for 71 patients with an average follow-up of 7 months. Complete and near complete occlusion was 90.1%. Residual aneurysms were seen in 9.9%. CONCLUSION: The "combined remodeling technique" with low-profile stents delivered through double-lumen balloons is technically feasible, safe, and effective for the treatment of intracranial aneurysms. This technique allows the operator to avoid extra maneuvers.


Assuntos
Embolização Terapêutica/métodos , Procedimentos Endovasculares/métodos , Aneurisma Intracraniano/terapia , Stents , Adulto , Idoso , Idoso de 80 Anos ou mais , Angiografia Cerebral , Embolização Terapêutica/instrumentação , Procedimentos Endovasculares/instrumentação , Feminino , Humanos , Aneurisma Intracraniano/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
9.
Mult Scler ; 25(9): 1273-1288, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-30986126

RESUMO

BACKGROUND: Autoimmune disorders including nephropathies have been reported more frequently in alemtuzumab-treated multiple sclerosis (MS) patients than in the general population. OBJECTIVE: Describe instances of autoimmune nephropathy in alemtuzumab-treated MS patients. METHODS: Cases were identified from safety monitoring within the alemtuzumab relapsing-remitting multiple sclerosis (RRMS) clinical development program (CDP) or post-marketing, or following off-label use. RESULTS: As of 16 June 2017, 16 autoimmune nephropathies have occurred following alemtuzumab treatment for MS. The incidence of autoimmune nephropathies was 0.34% within the CDP (5/1485 patients). The five CDP cases (one of anti-glomerular basement membrane (anti-GBM) disease, two of membranous glomerulonephropathy, and two of serum anti-GBM antibody without typical anti-GBM disease) were identified early, responded to conventional therapy (where needed), and had favorable outcomes. Three of 11 cases outside the CDP occurred following off-label alemtuzumab use prior to approval for RRMS and were all anti-GBM disease. Diagnosis was delayed in one of these three cases and another did not receive appropriate treatment; all three cases resulted in end-stage renal failure. All anti-GBM disease cases with documented urinalysis demonstrated prior microscopic hematuria. CONCLUSION: Close monitoring of alemtuzumab-treated MS patients facilitates diagnosis and treatment early in the nephropathy course when preservation of renal function is more likely.


Assuntos
Alemtuzumab/efeitos adversos , Glomerulonefrite Membranosa/induzido quimicamente , Glomerulonefrite/induzido quimicamente , Hemorragia/induzido quimicamente , Fatores Imunológicos/efeitos adversos , Pneumopatias/induzido quimicamente , Esclerose Múltipla Recidivante-Remitente/tratamento farmacológico , Adulto , Feminino , Seguimentos , Glomerulonefrite/diagnóstico , Glomerulonefrite/epidemiologia , Glomerulonefrite/imunologia , Glomerulonefrite Membranosa/diagnóstico , Glomerulonefrite Membranosa/epidemiologia , Glomerulonefrite Membranosa/imunologia , Hemorragia/diagnóstico , Hemorragia/epidemiologia , Hemorragia/imunologia , Humanos , Incidência , Pneumopatias/diagnóstico , Pneumopatias/epidemiologia , Pneumopatias/imunologia , Masculino , Esclerose Múltipla Recidivante-Remitente/epidemiologia
10.
Braz J Infect Dis ; 23(2): 102-110, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31028724

RESUMO

Enterobacteria-producing extended-spectrum ß-lactamases (ESBL) play an important role in healthcare infections, increasing hospitalization time, morbidity and mortality rates. Among several ESBLs that emerge from these pathogens, CTX-M-type enzymes had the most successful global spread in different epidemiological settings. Latin America presents high prevalence of CTX-M-2 in ESBL-producing enterobacterial infections with local emergence of the CTX-M-1 group. However, this high prevalence of the CTX-M-1 group has not yet been reported in Chile. The aim of this study was to identify ESBLs among enterobacteria isolated from clinical samples of critically ill patients from southern Chile. One-hundred thirty seven ESBL-producing bacteria were isolated from outpatients from all critical patient units from Hernán Henríquez Aravena Hospital. Phenotype characterization was performed by antibiogram, screening of ESBL, and determination of minimum inhibitory concentration (MIC). PCR was used for genetic confirmation of resistance. Molecular typing was performed by ERIC-PCR. ESBL-producing isolates were identified as Klebsiella pneumoniae (n=115), Escherichia coli (n=18), Proteus mirabilis (n=3), and Enterobacter cloacae (n=1), presenting multidrug resistance profiles. PCR amplification showed that the strains were positive for blaSHV (n=111/81%), blaCTX-M-1 (n=116/84.7%), blaTEM (n=100/73%), blaCTX-M-2 (n=28/20.4%), blaCTX-M-9 (0.7%), blaPER-1 (0.7%), and blaGES-10 (0.7%). The multiple production of ESBL was observed in 93% of isolates, suggesting high genetic mobility independent of the clonal relationship. The high frequency of the CTX-M-1 group and a high rate of ESBL co-production are changing the epidemiology of the ESBL profile in Chilean intensive care units. This epidemiology is a constant and increasing challenge, not only in Chile, but worldwide.


Assuntos
Infecções por Enterobacteriaceae/enzimologia , Infecções por Enterobacteriaceae/epidemiologia , Enterobacteriaceae/enzimologia , Unidades de Terapia Intensiva/estatística & dados numéricos , beta-Lactamases/genética , Antibacterianos/farmacologia , Chile/epidemiologia , DNA Bacteriano , Enterobacteriaceae/efeitos dos fármacos , Enterobacteriaceae/isolamento & purificação , Infecções por Enterobacteriaceae/microbiologia , Técnicas de Genotipagem , Humanos , Testes de Sensibilidade Microbiana , Reação em Cadeia da Polimerase , Prevalência , Valores de Referência , Fatores de Risco , beta-Lactamases/isolamento & purificação
11.
Braz. j. infect. dis ; 23(2): 102-110, Mar.-Apr. 2019. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1011579

RESUMO

ABSTRACT Enterobacteria-producing extended-spectrum β-lactamases (ESBL) play an important role in healthcare infections, increasing hospitalization time, morbidity and mortality rates. Among several ESBLs that emerge from these pathogens, CTX-M-type enzymes had the most successful global spread in different epidemiological settings. Latin America presents high prevalence of CTX-M-2 in ESBL-producing enterobacterial infections with local emergence of the CTX-M-1 group. However, this high prevalence of the CTX-M-1 group has not yet been reported in Chile. The aim of this study was to identify ESBLs among enterobacteria isolated from clinical samples of critically ill patients from southern Chile. One-hundred thirty seven ESBL-producing bacteria were isolated from outpatients from all critical patient units from Hernán Henríquez Aravena Hospital. Phenotype characterization was performed by antibiogram, screening of ESBL, and determination of minimum inhibitory concentration (MIC). PCR was used for genetic confirmation of resistance. Molecular typing was performed by ERIC-PCR. ESBL-producing isolates were identified as Klebsiella pneumoniae (n = 115), Escherichia coli (n = 18), Proteus mirabilis (n = 3), and Enterobacter cloacae (n = 1), presenting multidrug resistance profiles. PCR amplification showed that the strains were positive for blaSHV (n = 111/81%), blaCTX-M-1 (n = 116/84.7%), blaTEM (n = 100/73%), blaCTX-M-2 (n = 28/20.4%), blaCTX-M-9 (0.7%), blaPER-1 (0.7%), and blaGES-10 (0.7%). The multiple production of ESBL was observed in 93% of isolates, suggesting high genetic mobility independent of the clonal relationship. The high frequency of the CTX-M-1 group and a high rate of ESBL co-production are changing the epidemiology of the ESBL profile in Chilean intensive care units. This epidemiology is a constant and increasing challenge, not only in Chile, but worldwide.


Assuntos
Humanos , beta-Lactamases/genética , Enterobacteriaceae/enzimologia , Infecções por Enterobacteriaceae/enzimologia , Infecções por Enterobacteriaceae/epidemiologia , Unidades de Terapia Intensiva/estatística & dados numéricos , Valores de Referência , beta-Lactamases/isolamento & purificação , DNA Bacteriano , Testes de Sensibilidade Microbiana , Chile/epidemiologia , Reação em Cadeia da Polimerase , Prevalência , Fatores de Risco , Enterobacteriaceae/isolamento & purificação , Enterobacteriaceae/efeitos dos fármacos , Infecções por Enterobacteriaceae/microbiologia , Técnicas de Genotipagem , Antibacterianos/farmacologia
12.
Interv Neuroradiol ; 25(2): 150-156, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30396311

RESUMO

BACKGROUND: The new generation of flow diverters includes a surface modification with a synthetic biocompatible polymer, which makes the device more biocompatible and less thrombogenic. Optical coherence tomography (OCT) can be used to visualize perforators, stent wall apposition, and intra-stent thrombus. Unfortunately real world application of this technology has been limited because of the limited navigability of these devices in the intracranial vessels. In this report, we share our experience of using 3D-printed neurovascular anatomy models to simulate and test the navigability of a commercially available OCT system and to show the application of this device in a patient treated with the new generation of surface modified flow diverters. MATERIAL AND METHODS: Navigability of OCT catheters was tested in vitro using four different 3D-printed silicone replicas of the intracranial anterior circulation, after the implantation of surface modified devices. Intermediate catheters were used in different tortuous anatomies and positions. After this assessment, we describe the OCT image analysis of a Pipeline Shield for treating an unruptured posterior communicating artery (PCOM) aneurysm. RESULTS: Use of intermediate catheters in the 3D-printed replicas was associated with better navigation of the OCT catheters in favorable anatomies but did not help as much in unfavorable anatomies. OCT image analysis of a PCOM aneurysm treated with Pipeline Embolization Device Shield demonstrated areas of unsatisfactory apposition with no thrombus formation. CONCLUSIONS: OCT improves the understanding of the flow diversion technology. The development of less thrombogenic devices, like the Pipeline Flex with Shield Technology, reinforces the need for intraluminal imaging for neurovascular application.


Assuntos
Circulação Cerebrovascular , Aneurisma Intracraniano/diagnóstico por imagem , Aneurisma Intracraniano/cirurgia , Modelos Anatômicos , Impressão Tridimensional , Stents , Tomografia de Coerência Óptica , Angiografia Digital , Materiais Biocompatíveis , Humanos , Angiografia por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Inibidores da Agregação Plaquetária/administração & dosagem , Desenho de Prótese
13.
Neurointervention ; 13(2): 129-132, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30196685

RESUMO

A 64-year-old female presented with an incidentally-discovered right posterior inferior cerebral artery (PICA) aneurysm, initially treated in 2015 by simple coiling. Follow-up demonstrated significant coil compaction that required retreatment. Retreatment was done uneventfully using a Pipeline embolization device (PED) shield deployed starting from the basilar artery and ending at the V4 segment of the vertebral artery. Eight-weeks post-deployment, a follow-up digital subtraction imaging (DSA) and intravascular imaging with optical coherence tomography were obtained. The intravascular imaging demonstrated that the flow diverter had good wall apposition and concentric neointimal growth over the braid with exception to the areas that the PED was not in contact with the endothelial wall, such as at the right PICA ostium and at the vertebrobasilar junction. The entire procedure was safe, and the patient had no complications. In this article, we describe for the first time the assessment of the status of endothelial "healing" of the PED shield at 8-weeks.

14.
Neurointervention ; 13(2): 133-137, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30196686

RESUMO

Endoluminal reconstruction with a flow diverter device has emerged as a viable and often preferable alternative to traditional techniques for the treatment of intracranial aneurysms. Precise measurement and device selection are mandatory steps when considering flow diverters usage in order to avoid potential complications. In this sense, incomplete wall-apposition has been described as a predictive factor for immediate in-stent and delayed thrombosis after stent use. One significant usage limitation of flow diverter devices is the parent artery diameter, since the maximum opening of the sizes available are recommended for vessel diameters between 5.2-5.75 mm. Here we present the first clinical use of the largest flow diverter available, the 6×50 mm DERIVO embolization device (Acandis GmbH & Co. KG, Pforzheim, Germany), into the arterial circulation for a cervical internal carotid artery endovascular reconstruction. This is a new device for large or fusiform aneurysms requiring flow diversion, especially located in the vertebrobasilar system or extracranial segments.

15.
Neurology ; 89(11): 1107-1116, 2017 Sep 12.
Artigo em Inglês | MEDLINE | ID: mdl-28835401

RESUMO

OBJECTIVE: To evaluate 5-year efficacy and safety of alemtuzumab in treatment-naive patients with active relapsing-remitting MS (RRMS) (CARE-MS I; NCT00530348). METHODS: Alemtuzumab-treated patients received treatment courses at baseline and 12 months later; after the core study, they could enter an extension (NCT00930553) with as-needed alemtuzumab retreatment for relapse or MRI activity. Assessments included annualized relapse rate (ARR), 6-month confirmed disability worsening (CDW; ≥1-point Expanded Disability Status Scale [EDSS] score increase [≥1.5 if baseline EDSS = 0]), 6-month confirmed disability improvement (CDI; ≥1-point EDSS decrease [baseline score ≥2.0]), no evidence of disease activity (NEDA), brain volume loss (BVL), and adverse events (AEs). RESULTS: Most alemtuzumab-treated patients (95.1%) completing CARE-MS I enrolled in the extension; 68.5% received no additional alemtuzumab treatment. ARR remained low in years 3, 4, and 5 (0.19, 0.14, and 0.15). Over years 0-5, 79.7% were free of 6-month CDW; 33.4% achieved 6-month CDI. Most patients (61.7%, 60.2%, and 62.4%) had NEDA in years 3, 4, and 5. Median yearly BVL improved over years 2-4, remaining low in year 5 (years 1-5: -0.59%, -0.25%, -0.19%, -0.15%, and -0.20%). Exposure-adjusted incidence rates of most AEs declined in the extension relative to the core study. Thyroid disorder incidences peaked at year 3 and subsequently declined. CONCLUSIONS: Based on these data, alemtuzumab provides durable efficacy through 5 years in the absence of continuous treatment, with most patients not receiving additional courses. CLINICALTRIALSGOV IDENTIFIER: NCT00530348; NCT00930553. CLASSIFICATION OF EVIDENCE: This study provides Class III evidence that alemtuzumab durably improves efficacy outcomes and slows BVL in patients with RRMS.


Assuntos
Anticorpos Monoclonais Humanizados/uso terapêutico , Fatores Imunológicos/uso terapêutico , Esclerose Múltipla Recidivante-Remitente/tratamento farmacológico , Alemtuzumab , Anticorpos Monoclonais Humanizados/efeitos adversos , Encéfalo/diagnóstico por imagem , Encéfalo/efeitos dos fármacos , Avaliação da Deficiência , Seguimentos , Humanos , Fatores Imunológicos/efeitos adversos , Esclerose Múltipla Recidivante-Remitente/diagnóstico por imagem , Tamanho do Órgão , Fatores de Tempo , Resultado do Tratamento
16.
Muscles Ligaments Tendons J ; 6(3): 361-366, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-28066741

RESUMO

BACKGROUND: Chondral injuries are commonly related to poor clinical outcome, but recent data showed some improvements in function and pain after hip arthroscopy. Cell-based therapies represent an appealing alternative strategy for cartilage regeneration, and interesting results have been recently reported after intra-articular injections of mesenchymal stem cells (MSCs). The results of hip arthroscopy for femoroacetabular impingement (FAI) and intra-articular injections of autologous expanded bone marrow - MSCs (BM-MSCs) are reported in this retrospective study. MATERIALS AND METHODS: Twenty patients (29 hips) received hip arthroscopy for FAI and focal cartilage injuries or mild to moderate osteoarthrosis (OA). Three intra-articular injections of 20×106 BM-MSCs were injected from 4 to 6 weeks postoperative. The modified Harris Hip score (mHHS), the WOMAC score, the VAIL score and VAS score were administered to all patients. RESULTS: The mean age of the patients was 51.8 years, and the mean follow-up was 24 months. The median preoperative mHHS, WOMAC and VAIL scores were 64.3, 73 and 56.5 respectively, and they increased to 91, 97 and 83 at final follow up (p<0.05). The VAS score also improved from a median of 6 to 2. Four patients received a THA (13% of the hips) at the median of 9 months post intervention (range 6-36 months). Six patients referred pain after the injection of MSCs, which improved with oral pain killers. No major complications were reported. CONCLUSION: BM-MSCc injections in combination with hip arthroscopy may improve the quality of life and functional score in patient with FAI and cartilage injuries which are still not candidate to a THA. LEVEL OF EVIDENCE: IV case series.

17.
Muscles Ligaments Tendons J ; 6(3): 378-383, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-28066744

RESUMO

BACKGROUND: The iliopsoas tendon is a recognized cause of extra-articular hip pain, and tenotomy has been described as an effective treatment in patients who do not respond to conservative treatments. Endoscopic release showed higher success rate, lower recurrence, fewer complications compared to open surgery. The aim of the study is to report the results at a mean of 4 years follow-up of a series of patients affected by femoroacetabular impingement (FAI) and an associated iliopsoas tendinopathy, treated with hip arthroscopy and transcapsular tendon release. METHODS: Fifteen patients were retrospectively reviewed. Assessment of radiographic signs of FAI was performed, the alpha angle, the femoral head-neck offset and the lateral center edge angle (LCEA) were collected. Osteoarthritis was assessed from the AP pelvic and graded according to the Tönnis classification. Modified Harris Hip Score (mHHS), VAIL score and VAS score were administered to all patients before surgery, at follow-up at 1 year (T1) and final follow-up (T2). RESULTS: We found a statistical significant improvement in functional scores (mHHS and VAIL score) from the baseline to T2. According to VAS score, a statistical significant improvement was also found from T0 to T2, from a median of 5.5 (range 3-7) to 0 (range 0-5) (P<0.001). Two patients referred a recurrence of pain one year after surgery who were treated conservatively. No other complications have been reported. CONCLUSION: Iliopsoas tendinopathy can be associated to FAI in some patients, and failure in diagnosing and treating may be the reason of poor results and a revision surgery. Arthroscopic iliopsoas tendon release seems to produce good clinical outcome, reducing pain and the rate of a revision surgeries. Level of evidence: IV case series.

18.
Biointerphases ; 9(2): 029018, 2014 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-24985222

RESUMO

Nano- or microhydroxyapatites with microbiological properties are being used to detect pathogens in clinical samples and industrial environments. In this study, the calcium phosphates coral-hydroxyapatite and biphasic calcium phosphate were characterized physicochemically using x-ray diffraction, thermogravimetric, and differential thermal analysis. The morphology, texture, and chemical composition of the ceramics were also investigated using scanning electron microscopy with energy dispersive spectroscopy. The biocompatibility of the ceramics was evaluated using Escherichia coli and Enterococcus faecalis. Microorganisms were detected by incorporating the enzyme markers 4-metilumbelliferil-ß-d-glucoside and 4-metilumbelliferil-ß-d-glucuronide in the ceramic powders and evaluating fluorescence. The characterization of the ceramics revealed typical characteristics, such as crystallinity, thermal stability, and chemical composition, consistent with other calcium phosphates. The calcium phosphates coral-hydroxyapatite and biphasic calcium phosphate ceramics differed from one another in morphology, structural topography, particle size distribution, and the capacity to absorb water. These properties can influence the rates of microbiological responses and bacterial detection. Although both materials are suitable for use as structural supports in microbial diagnostic systems, BCP was more efficient and detected E. coli and E. faecalis more rapidly than CHA.


Assuntos
Antozoários/metabolismo , Materiais Biocompatíveis/metabolismo , Fosfatos de Cálcio/química , Durapatita/química , Enterococcus faecalis/isolamento & purificação , Escherichia coli/isolamento & purificação , Animais , Materiais Biocompatíveis/química , Cerâmica/química , Enterococcus faecalis/metabolismo , Escherichia coli/metabolismo , Corantes Fluorescentes/química , Corantes Fluorescentes/metabolismo , Glucuronídeos/química , Glucuronídeos/metabolismo , Tamanho da Partícula , Espectrometria de Fluorescência , Raios Ultravioleta
19.
In. Rodríguez Rodríguez, Teresa; Navarro López, Juan José; González Rodríguez, Claudio. Psicocardiología en el proceso salud-enfermedad. De la teoría a la práctica. La Habana, Ecimed, 2013. .
Monografia em Espanhol | CUMED | ID: cum-53967
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...