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1.
Niger J Clin Pract ; 22(5): 598-602, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31089012

RESUMO

Objective: The aim of this study was to determine the effectiveness of hematological parameters measured at the moment of admission to the emergency room in predicting in-hospital mortality and to determine cut-off values of strongly predictive values. Subjects and Methods: The study began with approval of the ethics committee. In total, 1,929 patients over 18 years of age, whose date could be obtained, were included in the study. From the hemogram parameters, white blood cells (WBC), red cell distribution width, mean platelet volume, and ratio of neutrophils to lymphocytes (NLR) values were determined and recorded. CK-MB and high-sensitive Troponin T values were recorded as cardiac markers. For statistical analysis, "SPSS for Windows Version 21" package program was used. Findings: About 71.7% (n = 1384) of the patients were male and 28.3% (n = 545) of the patients were female. About 92.5% of the patients (n = 1785) were discharged from the hospital, whereas the remaining 144 patients (7.5%) were exitus in the hospital. When the efficacy of hematological parameters and cardiac markers in predicting mortality was examined by receiver operating charecteristics analysis, NLR was found to be the strongest predictor (area under the curve [AUC], 0.772, standard deviation [SD] = 0.022, 95% confidence interval [CI]). It was found that the WBC value came in second place after NLR as a strong predictor of mortality (AUC, 0.749, SD = 0.024, % 95 CI). Conclusion: The use of predictors for the prediction of mortality for ST elevation myocardial infarction patients is of great importance for faster implementation of treatment modalities. We found that WBC and especially NLR values obtained with a simple method can be used as powerful predictors.


Assuntos
Mortalidade Hospitalar , Linfócitos , Neutrófilos , Infarto do Miocárdio com Supradesnível do Segmento ST/sangue , Infarto do Miocárdio com Supradesnível do Segmento ST/mortalidade , Idoso , Área Sob a Curva , Creatina Quinase Forma MB/sangue , Índices de Eritrócitos , Feminino , Humanos , Contagem de Linfócitos , Masculino , Volume Plaquetário Médio , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Curva ROC , Troponina T/sangue
2.
Case Rep Otolaryngol ; 2019: 7170832, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30944747

RESUMO

We describe a case of a 31-year-old woman with a chondrosarcoma of the hyoid bone. The patient presented with a mass in the left submandibular region. Fine-needle aspiration cytology suggested chondroma, but further imaging investigation with CT revealed an exophytic tumor originating from the body of the hyoid bone. Histopathology of the surgical specimen confirmed the diagnosis of a intermediate-grade chondrosarcoma. Chondrosarcomas account for 11% of all bone cancers. Primary sites of the head and the neck include the nasal cavity, the skull base, the maxilla, the mandible. Chondrosarcomas of the hyoid bone are very rare, with only 23 cases previously reported in the literature.

4.
Clin Radiol ; 71(3): 244-9, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26732890

RESUMO

AIM: To assess the efficiency of a novel quiescent-interval single-shot (QISS) technique for non-contrast-enhanced magnetic resonance angiography (MRA) of haemodialysis fistulas. MATERIALS AND METHODS: QISS MRA and colour Doppler ultrasound (CDU) images were obtained from 22 haemodialysis patients with end-stage renal disease (ESRD). A radiologist with extensive experience in vascular imaging initially assessed the fistulas using CDU. Two observers analysed each QISS MRA data set in terms of image quality, using a five-point scale ranging from 0 (non-diagnostic) to 4 (excellent), and lumen diameters of all segments were measured. RESULTS: One hundred vascular segments were analysed for QISS MRA. Two anastomosis segments were considered non-diagnostic. None of the arterial or venous segments were evaluated as non-diagnostic. The image quality was poorer for the anastomosis level compared to the other segments (p<0.001 for arterial segments, and p<0.05 for venous segments), while no significant difference was determined for other vascular segments. CONCLUSION: QISS MRA has the potential to provide valuable complementary information to CDU regarding the imaging of haemodialysis fistulas. In addition, QISS non-enhanced MRA represents an alternative for assessment of haemodialysis fistulas, in which the administration of iodinated or gadolinium-based contrast agents is contraindicated.


Assuntos
Derivação Arteriovenosa Cirúrgica , Falência Renal Crônica/terapia , Angiografia por Ressonância Magnética/métodos , Diálise Renal , Adulto , Estudos de Viabilidade , Feminino , Humanos , Masculino , Ultrassonografia Doppler em Cores
5.
Diagn Interv Imaging ; 97(4): 461-9, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26612669

RESUMO

PURPOSE: "Flash Spiral" imaging is a new prospective ECG-triggered spiral scan mode that uses a very high-pitch for coronary computed tomography angiography (CTA). This enables complete image acquisition within one cardiac cycle with a very low radiation exposure. The aim of this study was to investigate the diagnostic accuracy, image quality, and effective radiation dose of prospectively ECG-triggered high-pitch spiral method (Flash spiral mode) of coronary CTA using dual-source technology for the evaluation of coronary artery stenoses. MATERIAL AND METHODS: The study included 186 consecutive patients (115men, 71women; mean age: 53.37 years) who underwent coronary CTA. Coronary CTA was performed with a 128×2-slice dual-source CT (Somatom Definition Flash, Siemens, Germany) using a prospectively ECG-triggered high-pitch spiral mode. Patients were divided into three groups according to heart rate (≤65bpm, 66-75bpm, ≥76bpm) and body mass index (BMI) (20-24kg/m(2), 25-29kg/m(2), 30-34kg/m(2)) values. The correlation between heart rates, image quality and BMI values are investigated. A four-point scale (1=excellent, 4=poor/non-diagnostic) was used to rank the comparative image quality. Effective radiation doses were calculated. Also the correlation between radiation dose, sex and BMI values were investigated. In addition, diagnostic accuracy of CTA for detection of significant (≥50%) coronary artery stenoses was compared with invasive coronary angiography findings of 612vessel segments in 38patients. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy rate were calculated. RESULTS: A total of 2976coronary artery segments were present. Of all coronary artery segments, 2381 (80%) had an image quality score of 1, and 1.5% segments were rated as "poor/non-diagnostic". When the correlation between heart rate and image quality is investigated, there was a significant difference between ≤65bpm and ≥76bpm groups. However, there was no significant difference between ≤65bpm and 66-75bpm groups. The mean effective dose was found as 1.3mSv (min: 0.5, max: 2.4mSv). The correlation between effective radiation dose and BMI was moderate. However, the correlation between gender and radiation dose was significant. Sensitivity, specificity, negative predictive value and accuracy of coronary CTA on a per-vessel segment were 90.1%, 97.4%, 98.6%, and 96.5%, respectively. CONCLUSIONS: Prospectively ECG-triggered high-pitch spiral mode coronary CTA provides high image quality and diagnostic accuracy, with very low radiation dose for evaluation and exclusion of coronary artery stenoses.


Assuntos
Angiografia Coronária , Estenose Coronária/diagnóstico por imagem , Doses de Radiação , Adulto , Idoso , Angiografia Coronária/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Índice de Gravidade de Doença
6.
J Obstet Gynaecol ; 36(1): 93-6, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26368575

RESUMO

The objective of this study was to investigate serum adenosine deaminase (ADA) activity as a marker of T lymphocyte activation and parameters of oxidative stress and antioxidant defence in hyperemesis gravidarum (HG). Serum ADA activity, malondialdehyde (MDA), catalase (CAT) and glutathione peroxidase (GPx) levels were investigated in 40 pregnant women with the HG and 40 with healthy pregnancies, in a descriptive study. Although serum ADA and CAT were measured to be higher in HG group, the difference was not significant. Serum MDA and GPx levels were significantly elevated in women with HG when compared with those without HG. The significance of changes in lipid peroxidation and T-cell activation in the pathogenesis of HG and whether this is a cause or a compensatory reaction to HG requires further investigations with larger multicentre trials.


Assuntos
Hiperêmese Gravídica/fisiopatologia , Peroxidação de Lipídeos , Ativação Linfocitária , Linfócitos T/fisiologia , Adenosina Desaminase/sangue , Adulto , Estudos de Casos e Controles , Catalase/sangue , Feminino , Glutationa Peroxidase/sangue , Humanos , Malondialdeído/sangue , Gravidez , Adulto Jovem
9.
Herz ; 40(2): 325-8, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-24297399

RESUMO

Chronic upper limb ischemia is an uncommon clinical condition and is most often caused by subclavian artery stenosis. Surgical and percutaneous treatment modalities have been shown to be effective for the management of subclavian artery occlusion. Because of lower mortality and morbidity rates, percutaneous interventions for subclavian arterial occlusions are more acceptable than surgery. Chronic total occlusions of the subclavian artery are challenging to treat percutaneously because of the structure and complexity of the lesion. The complexity of the lesion causes its own complications. In this paper, we report a case of a completely occluded left subclavian artery that was complicated by a malpositioned stent hanging into the aortic arch and the ascending aorta during percutaneous intervention, which was successfully managed by our heart team.


Assuntos
Braço/irrigação sanguínea , Remoção de Dispositivo/métodos , Isquemia/etiologia , Stents , Síndrome do Roubo Subclávio/complicações , Síndrome do Roubo Subclávio/cirurgia , Aorta , Terapia Combinada/métodos , Humanos , Isquemia/diagnóstico , Isquemia/prevenção & controle , Masculino , Pessoa de Meia-Idade , Síndrome do Roubo Subclávio/diagnóstico , Resultado do Tratamento
12.
Acta Clin Belg ; 69(5): 367-70, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-25092198

RESUMO

Chest pain after thoracic trauma may be a symptom of cardiac injury or myocardial infarction. A 63-year-old healthy man had chest pain after blunt chest trauma in a motor vehicle accident. Chest computed tomography scan showed a displaced sternal fracture, lung contusion in the left upper lobe, atelectasis and consolidation in both lower lobes, and bilateral haemothorax. Electrocardiography showed ST elevation (2 mm) in leads II, III, and aVF and ST depression (2 mm) in leads I and aVL, consistent with acute inferior myocardial infarction. Urgent coronary angiography showed ostial occlusion of the right coronary artery. After the right coronary occlusion was passed with a guide wire, dissection of the right coronary artery was observed and treated with a balloon and stent to reestablish normal flow. This case emphasizes the importance of a high index of suspicion for coronary artery injury and myocardial infarction after blunt chest trauma.


Assuntos
Acidentes de Trânsito , Infarto do Miocárdio , Traumatismos Torácicos , Ferimentos não Penetrantes , Dor no Peito , Angiografia Coronária , Eletrocardiografia , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/diagnóstico por imagem , Infarto do Miocárdio/etiologia , Infarto do Miocárdio/cirurgia , Traumatismos Torácicos/complicações , Traumatismos Torácicos/diagnóstico por imagem , Traumatismos Torácicos/cirurgia , Tomografia Computadorizada por Raios X , Ferimentos não Penetrantes/complicações , Ferimentos não Penetrantes/diagnóstico por imagem , Ferimentos não Penetrantes/cirurgia
13.
Bratisl Lek Listy ; 115(6): 367-71, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25023428

RESUMO

Soybean (Glycine max), mistletoe (Viscum album) and red clover (Trifolium pratence) have been argued to have anti-cancer effects. In the present study it was aimed to investigate possible effects of these plant extracts on the activities of DNA turn-over enzymes, namely adenosine deaminase (ADA) and xanthine oxidase (XO) in cancerous and non-cancerous gastric and colon tissues. For this aim, 6 cancerous and 6 non-cancerous adjacent human gastric tissues, and 7 cancerous and 7 non-cancerous adjacent colon tissues were obtained by surgical operations. Our results suggest that aqueous soybean, mistletoe and red clover extracts may exhibit anti-tumoral activity by depleting hypoxanthine concentration in the cancer cells through XO activation, which may lead to lowered salvage pathway activity necessary for the cancer cells to proliferate in the cancerous colon tissue. Some foods like soybean, mistletoe and red clover may provide nutritional support to medical cancer therapy through inhibiting and/or activating key enzymes in cancer metabolism (Tab. 4, Ref. 33).


Assuntos
Adenosina Desaminase/efeitos dos fármacos , Neoplasias Gastrointestinais/enzimologia , Erva-de-Passarinho , Soja , Trifolium , Xantina Oxidase/efeitos dos fármacos , Adenosina Desaminase/metabolismo , Neoplasias Gastrointestinais/patologia , Humanos , Extratos Vegetais/farmacologia , Técnicas de Cultura de Tecidos , Xantina Oxidase/metabolismo
14.
Clin Microbiol Infect ; 20(11): O847-53, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-24831227

RESUMO

This study reviewed the clinical, laboratory, therapeutic and prognostic data on genitourinary involvement of brucellosis in this largest case series reported. This multicentre study pooled adult patients with genitourinary brucellar involvement from 34 centres treated between 2000 and 2013. Diagnosis of the disease was established by conventional methods. Overall 390 patients with genitourinary brucellosis (352 male, 90.2%) were pooled. In male patients, the most frequent involved site was the scrotal area (n=327, 83.8%), as epididymo-orchitis (n=204, 58%), orchitis (n=112, 31.8%) and epididymitis (n=11, 3.1%). In female patients, pyelonephritis (n=33/38, 86.8%) was significantly higher than in male patients (n=11/352, 3.1%; p<0.0001). The mean blood leukocyte count was 7530±3115/mm3. Routine laboratory analysis revealed mild to moderate increases for erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). The mean treatment duration and length of hospital stay were significantly higher when there were additional brucellar foci (p<0.05). Surgical operations including orchiectomy and abscess drainage were performed in nine (2.3%) patients. Therapeutic failure was detected in six (1.5%), relapse occurred in four (1%), and persistent infertility related to brucellosis occurred in one patient. A localized scrotal infection in men or pyelonephritis in women in the absence of leucocytosis and with mild to moderate increases in inflammatory markers should signal the possibility of brucellar genitourinary disease.


Assuntos
Brucelose/tratamento farmacológico , Brucelose/patologia , Doenças Urogenitais Femininas/tratamento farmacológico , Doenças Urogenitais Femininas/patologia , Doenças Urogenitais Masculinas/tratamento farmacológico , Doenças Urogenitais Masculinas/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Brucelose/diagnóstico , Feminino , Doenças Urogenitais Femininas/diagnóstico , Humanos , Masculino , Doenças Urogenitais Masculinas/diagnóstico , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Adulto Jovem
15.
Eur Rev Med Pharmacol Sci ; 18(3): 393-7, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24563440

RESUMO

AIM: We aimed to determine the relationship between blood lactate, carboxy-hemoglobin (COHb) levels and the severity of clinical findings in patients with CO poisoning. PATIENTS AND METHODS: Patients over 18 years old and of both gender who were admitted to Emergency Department with the diagnosis of CO poisoning between 10.02.2008 and 17.03.2011 were enrolled in this study. Detailed physical examination of each patient was performed, patients and their relatives were informed about the study and written consents were noted. The levels of consciousness, physical examination findings, electrocardiographic findings, Glasgow Coma Scale (GCS) scores, laboratory results (lactate, COHb, CK-MB, Troponin-I levels) and applied treatments [normobaric oxygen therapy (NBOT), hyperbaric oxygen therapy (HBOT)] were recorded to standart data entry form for each patient. "SPSS for Windows version 18" package program was used for statistical analysis of the data. RESULTS: Total 201 patients were included in this study. Thirty five patients (17.4%) received HBOT and lactate; COHb, CKMB, Troponin-I levels of this group were higher than the other patients. Lactate and COHb levels were statistically significantly higher in patients with GCS < 15 than the ones with GCS = 15 (p < 0.01). The patients whose both Troponin-I and CK-MB levels increased have higher lactate levels (p = 0.038), but COHb levels of these patients did not change (p = 0.495). CONCLUSIONS: According to our study, blood lactate and COHb levels were both correlated with the changes of consciousness in CO poisoning. Blood lactate levels together with COHb in defining indications for HBO treatment might be suggested.


Assuntos
Intoxicação por Monóxido de Carbono/sangue , Intoxicação por Monóxido de Carbono/terapia , Carboxihemoglobina/análise , Oxigenação Hiperbárica , Ácido Láctico/sangue , Adulto , Intoxicação por Monóxido de Carbono/psicologia , Estado de Consciência , Eletrocardiografia , Feminino , Escala de Coma de Glasgow , Humanos , Masculino , Estudos Prospectivos , Índice de Gravidade de Doença , Troponina I/sangue , Adulto Jovem
17.
Perfusion ; 29(3): 265-71, 2014 May.
Artigo em Inglês | MEDLINE | ID: mdl-24280344

RESUMO

OBJECTIVE: Total atrial conduction time (TACT) is the most important parameter in predicting the development of new-onset atrial fibrillation. We investigated the effect of cilostazol therapy on TACT in patients with peripheral artery disease. METHODS: Thirty patients with peripheral artery disease were treated with cilostazol (200 mg/day) for 6 months. The baseline echocardiographic total atrial conduction time parameter was compared with the 6-month follow-up. RESULTS: The TACT duration was decreased in all patients compared with the baseline after therapy (121.8 ± 19.3 vs. 109.1 ± 15.9 milliseconds, p<0.001). However, left atrial (LA) diameter was not changed with the therapy. The reduction of TACT duration was correlated with the increase in mitral E wave velocity/mitral A wave velocity ratio (r=-0.48, p<0.003). CONCLUSION: Our results showed that 200 mg cilostazol treatment decreased TACT duration in patients with peripheral artery disease, which may also prevent the development and/or recurrence of atrial fibrillation (AF).


Assuntos
Doença Arterial Periférica/tratamento farmacológico , Doença Arterial Periférica/fisiopatologia , Tetrazóis/administração & dosagem , Vasodilatadores/administração & dosagem , Idoso , Fibrilação Atrial/etiologia , Fibrilação Atrial/fisiopatologia , Fibrilação Atrial/prevenção & controle , Cilostazol , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Doença Arterial Periférica/complicações
19.
Andrologia ; 46(10): 1089-97, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-24266675

RESUMO

The protective effect of quercetin on cisplatin-induced renal and testicular tissue damage was investigated using biochemical, histopathological and histological approaches. A total of 40 male rats were divided into 5 groups as follows: control; cisplatin alone; quercetin alone; cisplatin + quercetin; and quercetin + cisplatin. Cisplatin was administered to rats at a single dose of 7 mg kg(-1) intraperitoneal. Quercetin was administered by gavage daily for 10 days at dosage 50 mg kg(-1) . At the end of the study serum, total antioxidant capacity (TAC) levels and total oxidant status (TOS) were determined. Malondialdehyde (MDA), superoxide dismutase (SOD), catalase (CAT) and xanthine oxidase (XO) were studied separately in serum, renal tissue and testicular tissue. Renal and testicular morphological alterations were assessed, histopathologically. Epididymal sperm concentration, motility and morphology were investigated. Testicular and renal TAC and TOS values did not alter significantly. Renal CAT levels were increased by cisplatin and cisplatin plus quercetin groups that is reversed by administration of quercetin before cisplatin. MDA, CAT, SOD ve XO levels of testicular tissue did not differ significantly. Cisplatin and cisplatin plus quercetin groups had decreased sperm motility ratio and increased abnormal spermatozoa. Quercetin partially reverses some of the cisplatin-related pathological effects on kidney and testis.


Assuntos
Antineoplásicos/toxicidade , Antioxidantes/farmacologia , Cisplatino/toxicidade , Rim/efeitos dos fármacos , Estresse Oxidativo/efeitos dos fármacos , Quercetina/farmacologia , Espermatozoides/efeitos dos fármacos , Testículo/efeitos dos fármacos , Animais , Catalase/metabolismo , Glutationa Peroxidase/metabolismo , Rim/metabolismo , Rim/patologia , Peroxidação de Lipídeos/efeitos dos fármacos , Masculino , Malondialdeído/metabolismo , Ratos , Contagem de Espermatozoides , Espermatozoides/metabolismo , Espermatozoides/patologia , Testículo/metabolismo , Testículo/patologia , Xantina Oxidase/metabolismo
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