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1.
Chemosphere ; 238: 124596, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31524629

RESUMO

Deteriorated environmental conditions during the bioremediation of trichloroethene (TCE)-polluted groundwater cause decreased treatment efficiencies. This study assessed the effect of applying immobilized Clostridium butyricum (a hydrogen-producing bacterium) in silica gel on enhancing the reductive dechlorination efficiency of TCE with the slow polycolloid-releasing substrate (SPRS) supplement in groundwater. The responses of microbial communities with the immobilized system (immobilized Clostridium butyricum and SPRS amendments) were also characterized by the metagenomics assay. A complete TCE removal in microcosms was obtained within 30 days with the application of this immobilized system via reductive dechlorination processes. An increase in the population of Dehalococcoides spp. was observed using the quantitative polymerase chain reaction (qPCR) analysis. Results of metagenomics assay reveal that the microbial communities in the immobilized system were distinct from those in systems with SPRS only. Bacterial communities associated with TCE biodegradation also increased in microcosms treated with the immobilized system. The immobilized system shows a great potential to promote the TCE dechlorination efficiency, and the metagenomics-based approach provides detailed insights into dechlorinating microbial community dynamics. The results would be helpful in designing an in situ immobilized system to enhance the bioremediation efficiency of TCE-contaminated groundwater.

2.
J Prosthet Dent ; 2019 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-31672422

RESUMO

STATEMENT OF PROBLEM: Intraoral scans and virtual interocclusal records (VIRs) are widely used for contemporary prosthodontic treatment of patients with partial edentulism. The accuracy of VIRs in various clinical conditions is unclear. PURPOSE: The purpose of this in vitro study was to investigate whether the span and location of edentulous areas affect the accuracy of VIRs. MATERIAL AND METHODS: Five sets of master stone casts were duplicated from a typodont model (Prosthetic Restoration Jaw Model; Nissin Dental) and then customized into 5 study groups. Six pairs of interarch markers were placed on the master stone casts as reference points for measurements. The 5 study groups were group 1-Post: 1 posterior tooth missing; group 3-Post: 3 posterior teeth missing; group 6-Ant: 6 anterior teeth missing; group Bil-Post: bilateral posterior teeth missing; and group Dent: completely dentate arch. Master stone casts along with VIRs were scanned 10 times in each group by using an intraoral scanner (IOS) (Dental Wings Intraoral Scanner; Dental Wings Inc). Digital measurement of distances between the interarch markers was obtained on all digitally articulated casts and compared with the manual measurements (with electronic calipers with an accuracy of 0.02 mm). In addition, the differences (absolute values) between the digital and manual measurements were calculated at the edentulous locations for the groups 1-Post, 3-Post, 6-Ant, and Bil-Post and were compared with the corresponding interarch marker positions in the group Dent. Two-sample t tests were used for the statistical analysis (α=.05). RESULTS: The overall differences (mean ±standard deviation) between digital and manual measurements were group 1-Post: 0.10 ±0.19 mm, group 3-Post: 0.28 ±0.63 mm; group 6-Ant: 0.19 ±0.20 mm; group Bil-Post: 0.28 ±0.25 mm; and group Dent: 0.05 ±0.18 mm. Group Dent was the only group with no significant differences between digital and manual measurements at all 6 interarch marker positions and was used as the reference to analyze the measurements in the edentulous areas. No statistical difference was found (P=.237) at the group 1-Post's edentulous area when compared with the group Dent. In the group 3-Post, the edentulous areas showed statistically significant difference when compared with those of the group Dent (P=.002 and P=.003). In the group 6-Ant, the edentulous areas showed statistical differences when compared with those of the group Dent (P=.019 and P=.008). In the group Bil-Post, only 1 side of the edentulous areas showed statistical differences when compared with group Dent (P=.006 and P=.034). CONCLUSIONS: The span and location of edentulous areas impact the accuracy of VIRs. For a single missing posterior tooth, VIRs could achieve a high level of accuracy comparable with that of the dentate condition. Unilateral and bilateral extended edentulous spans with 3 or more missing posterior teeth and the extended edentulous span in the anterior region all affected the accuracy of VIRs.

3.
Xi Bao Yu Fen Zi Mian Yi Xue Za Zhi ; 35(9): 817-822, 2019 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-31750824

RESUMO

Objective To investigate the role of RAD51 in cell proliferation, migration and chemosensitivity to temozolomide (TMZ) using U251 glioma cell line, and to clarify the underlying molecular mechanism. Methods TCGA database was utilized to analyze the expression changes of RAD51 in gliomas. RAD51 was over-expressed or knocked down in U251 glioma cells via lentivirus infection, or its activity was inhibited by small molecule inhibitors. Cell proliferation and migration ability were examined by CCK-8 assay, colony formation assay, and scratch wound-healing assay; CCK-8 assay and flow cytometry were performed to assess the effect of RAD51 on the sensitivity of glioma cells upon the treatment of temozolomide. Western blotting was used to determine the alteration of P53. Results The expression of RAD51 significantly increased in glioma tissues. RAD51 enhanced the proliferation and migration ability of U251 glioma cells; knockdown of RAD51 enhanced the sensitivity of U251 glioma cells to temozolomide. Over-expression of RAD51 increased the expression of P53, whereas knockdown of RAD51 decreased the expression of P53. Conclusion RAD51 plays an oncogene function in glioma cells. RAD51 over-expression enhances the proliferation and migration of glioma cells. RAD51 knockdown increases the sensitivity of glioma cells to temozolomide.


Assuntos
Neoplasias Encefálicas/patologia , Movimento Celular , Proliferação de Células , Glioblastoma/patologia , Rad51 Recombinase/metabolismo , Temozolomida/farmacologia , Apoptose , Neoplasias Encefálicas/genética , Linhagem Celular Tumoral , Técnicas de Silenciamento de Genes , Humanos
5.
Phys Rev E ; 100(4-1): 043203, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31770881

RESUMO

The propagation of compressional shocks in two-dimensional (2D) dusty plasmas is investigated using MD simulations under various conditions. The shock Hugoniot curves of the relationship between the shock front speed D and the mean particle speed v[over ¯] after shocks are obtained and analytically fit to parabolic expressions. As the screening parameter increases, the weaker Yukawa interparticle interaction cause the shock Hugoniot curves to be more linear. Combining the obtained shock Hugoniot curves with the Rankine-Hugoniot jump relations, analytic expressions of pressure and energy after the shocks in 2D Yukawa systems are obtained, which are functions of the observable quantities, like the shock front speed D or the mean particle speed v[over ¯] or the specific volume.

6.
Clin Neurophysiol ; 131(1): 34-39, 2019 Nov 05.
Artigo em Inglês | MEDLINE | ID: mdl-31751837

RESUMO

OBJECTIVE: Studies showed a relatively prolonged blink R1 latency in patients with diabetic distal symmetrical polyneuropathy (DSPN) compared to that without DSPN. We tested the hypothesis that blink R1 latency would provide a diagnostic alternative to nerve conduction studies (NCS) in DSPN and act as a marker of the severity of NCS abnormalities in DSPN. METHOD: A total of 109 patients with type 2 diabetes underwent blink reflex studies and NCS. We used the composite amplitude scores of nerve conductions (CAS), which consisted of motor (tibial, peroneal and ulnar) and sensory (sural and ulnar) amplitudes for estimating the severity of NCS. RESULTS: Patients with DSPN had longer blink R1, R2, and contralateral R2 latencies (P < 0.0001, P = 0.001, and P = 0.031, respectively) and higher CAS (P < 0.0001). Area under curve on receiver operating characteristic curve analysis in diagnosing occurrence of DSPN in blink R1 latency was 0.772 (P < 0.0001). Multiple linear regression analysis showed that blink R1 latency was independently associated with CAS. CONCLUSION: Blink R1 latency may be valuable in auxiliary diagnosis and in determining the severity of NCS abnormalities in DSPN. SIGNIFICANCE: Blink R1 latency can be added as a supplemental marker of severity of NCS in DSPN, especially if the patient's sural amplitudes has a floor effect.

7.
Medicine (Baltimore) ; 98(48): e18244, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31770287

RESUMO

BACKGROUND: We investigated the effects of propofol vs desflurane on ischemia and reperfusion injury (IRI)-induced inflammatory responses, especially in matrix metalloproteinase-9 (MMP-9) downregulation and heme oxygenase-1 (HO-1) upregulation, which may result in different clinical outcomes in liver transplant recipients. METHODS: Fifty liver transplant recipients were randomized to receive propofol-based total intravenous anesthesia (TIVA group, n = 25) or desflurane anesthesia (DES group, n = 25). We then measured the following: perioperative serum cytokine concentrations (interleukin 1 receptor antagonist [IL-1RA], IL-6, IL-8, and IL-10); MMP-9 and HO-1 mRNA expression levels at predefined intervals. Further, postoperative outcomes were compared between the 2 groups. RESULTS: The TIVA group showed a significant HO-1 level increase following the anhepatic phase and a significant MMP-9 reduction after reperfusion, in addition to a significant increase in IL-10 levels after the anhepatic phase and IL-1RA levels after reperfusion. Compared to DES patients, TIVA patients showed a faster return of the international normalized ratio to normal values, lower plasma alanine aminotransferase concentrations 24 hours after transplantation, and fewer patients developing acute lung injury. Moreover, compared with DES patients, TIVA patients showed a significant reduction in serum blood lactate levels. However, there were no differences in postoperative outcomes between the two groups. CONCLUSION: Propofol-based TIVA attenuated inflammatory response (elevated IL-1RA and IL-10 levels), downregulated MMP-9 response, and increased HO-1 expression with improved recovery of graft function and better microcirculation compared with desflurane anesthesia in liver transplant recipients.

8.
Artigo em Inglês | MEDLINE | ID: mdl-31749128

RESUMO

The dairy products remain as the largest reservoir for isolation of probiotic microorganisms. While probiotics have been immensely reported to exert various health benefits, it is also a common notion that these health potentials are strain and host dependent, leading to the need of more human evidence based on specific strains, health targets, and populations. This randomized, single-blind, and placebo-controlled human study aimed to evaluate the potential benefits of putative probiotic strains isolated from kefir on gastrointestinal parameters in fifty-six healthy adults. The consumption of AB-kefir (Bifidobacterium longum, Lactobacillus acidophilus, L. fermentum, L. helveticus, L. paracasei, L. rhamnosus, and Streptococcus thermophiles; total 10 log CFU/sachet) daily for 3 week reduced symptoms of abdominal pain, bloating (P = 0.014), and appetite (P = 0.041) in male subjects as compared to the control. Gut microbiota distribution profiles were shifted upon consumption of AB-kefir compared to baseline, where the abundance of bifidobacteria was increased in male subjects and maintained upon cessation of AB-kefir consumption. The consumption of AB-kefir also increased gastrointestinal abundance of total anaerobes (P = 0.038) and total bacterial (P = 0.049) in female subjects compared to the control after 3 weeks. Our results indicated that AB-kefir could potentially be developed as a natural strategy to improve gastrointestinal functions in adults.

9.
Cells ; 8(11)2019 Nov 19.
Artigo em Inglês | MEDLINE | ID: mdl-31752390

RESUMO

Cancer cells rely on aberrant transcription for growth and survival. Cyclin-dependent kinases (CDKs) play critical roles in regulating gene transcription by modulating the activity of RNA polymerase II (RNAPII). THZ1, a selective covalent inhibitor of CDK7, has antitumor effects in several human cancers. In this study, we investigated the role and therapeutic potential of CDK7 in regulating the angiogenic activity of endothelial cells and human renal cell carcinoma (RCC). Our results revealed that vascular endothelial growth factor (VEGF), a critical activator of angiogenesis, upregulated the expression of CDK7 and RNAPII, and the phosphorylation of RNAPII at serine 5 and 7 in human umbilical vein endothelial cells (HUVECs), indicating the transcriptional activity of CDK7 may be involved in VEGF-activated angiogenic activity of endothelium. Furthermore, through suppressing CDK7 activity, THZ1 suppressed VEGF-activated proliferation and migration, as well as enhanced apoptosis of HUVECs. Moreover, THZ1 inhibited VEGF-activated capillary tube formation and CDK7 knockdown consistently diminished tube formation in HUVECs. Additionally, THZ1 reduced VEGF expression in human RCC cells (786-O and Caki-2), and THZ1 treatment inhibited tumor growth, vascularity, and angiogenic marker (CD31) expression in RCC xenografts. Our results demonstrated that CDK7-mediated transcription was involved in the angiogenic activity of endothelium and human RCC. THZ1 suppressed VEGF-mediated VEGFR2 downstream activation of angiogenesis, providing a new perspective for antitumor therapy in RCC patients.

10.
BMC Cancer ; 19(1): 1128, 2019 Nov 21.
Artigo em Inglês | MEDLINE | ID: mdl-31752753

RESUMO

BACKGROUND: Hepatocellular carcinoma (HCC) is the sixth-most common malignancy worldwide. Multiple previous studies have assessed the relationship between TM6SF2 gene polymorphism and the risk of developing HCC, with discrepant conclusions reached. To assess the association of TM6SF2 rs58542926 T/C gene polymorphism with liver cancer, we performed the current meta-analysis. METHODS: This study queried the MEDLINE, PubMed, EMBASE, and CENTRAL databases from inception to April 2019. Case-control studies assessing the relationship between TM6SF2 rs5854292 locus polymorphism and liver cancer were selected according to inclusion and exclusion criteria. The Stata 12.0 software was employed for data analysis. RESULTS: A total of 5 articles, encompassing 6873 patients, met inclusion criteria and were included in the meta-analysis. Statistical analysis showed that the TM6SF2 gene polymorphism was significantly associated with liver cancer in the allele contrast, dominant, recessive and over dominant models (T vs C, OR = 1.621, 95%CI 1.379-1.905; CT + TT vs CC. OR = 1.541, 95%CI 1.351-1.758; TT vs CT + CC, OR = 2.897, 95%CI 1.690-4.966; CC + TT vs TC, OR = 0.693, 95%CI 0.576-0.834). The Egger's test revealed no significant publication bias. CONCLUSION: The present findings suggest a significant association of TM6SF2 gene polymorphism with HCC risk in the entire population studied.

11.
J Prosthet Dent ; 2019 Nov 18.
Artigo em Inglês | MEDLINE | ID: mdl-31753457

RESUMO

STATEMENT OF PROBLEM: Currently available assessment tools for evaluating the esthetic outcome of implant restorations consist of objective indices created for dentists. The investigation of esthetic parameters according to the patient's perspective is lacking. PURPOSE: The purpose of this observational study was to evaluate and compare the importance of different soft-tissue and restoration-related esthetic parameters for patients and clinicians. MATERIAL AND METHODS: A photoediting software program (Photoshop CC; Adobe Corp) was used to produce 10 photographs with modified smiles from the original photograph by altering 1 parameter of the pink esthetic score and white esthetic score (PES/WES) at a time. A total of 120 participants were recruited in the study, including 40 laypeople, 40 prosthodontists, and 40 periodontists. A total of 440 visual analog scale (VAS) values were obtained for each group to record participants' subjective esthetic assessments of all photographs (10 modified and 1 original photograph). Repeated-measures ANOVA and post hoc mean comparison (t grouping) were used to identify whether the individual alteration on the PES and WES indices was significant for each group. RESULTS: For the laypeople, color (hue and value) appeared to be the most important parameter. After color, the order of importance was as follows: root convexity along with soft-tissue color and texture, level of facial mucosa, distal papilla, mesial papilla, translucency or characterization, surface texture, and tooth form. For the periodontists, color (hue and value) was also the most important parameter, but it was not separable from a cluster of other parameters: level of facial mucosa, root convexity along with soft-tissue color and texture, mesial papilla, and distal papilla. For the prosthodontists, color (hue and value) and level of facial mucosa were the most important parameters affecting esthetic assessment, followed by root convexity along with soft-tissue color and texture, mesial papilla, and distal papilla. CONCLUSIONS: All groups graded color (hue and value) as the most important parameter affecting the esthetic outcome and the original unaltered photograph as the most esthetically pleasing image. All participants (laypeople and dental specialists) appeared to be able to perceive the same 5 parameters including color (hue and value), level of facial mucosa, mesial papilla, distal papilla, and root convexity along with soft-tissue color and texture that are negatively affecting esthetic outcomes. Except for color (hue and value), restoration-related esthetic parameters had a lesser effect on the overall esthetic assessments for all groups.

12.
Schizophr Res ; 2019 Nov 18.
Artigo em Inglês | MEDLINE | ID: mdl-31753594

RESUMO

BACKGROUND: Cognitive deficit is a fundamental trait of schizophrenia, but its mecwhanisms remain unknown. The neuregulin 3 (NRG3) gene, involving in neuronal function, has been considered to be associated with schizophrenia and cognition. However, no study has investigated the effects of NRG3 polymorphism on cognitive deficits in a large sample of the patients with schizophrenia. METHODS: A total of 1112 schizophrenia patients and 423 controls were recruited and genotyped with NRG3 rs10748842. Among them, 864 patients and 403 controls were assessed for cognition through the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). SHEsis was applied and followed by logistic regression analysis. The models of analyses of covariance (ANCOVA) were constructed to examine the effects of NRG3 rs10748842 on cognitive deficits. RESULTS: No differences in NRG3 rs10748842 allele and genotype were found between patients and controls (both p > 0.05). With the exception of Visuospatial/construction, the other RBANS scores were significantly lower in patients compared to controls after adjusting for gender and education (all p < 0.001). Interestingly, we found that NRG3 rs10748842 was associated with cognitive deficit in schizophrenia, showing that patients carrying C allele had lower attention and total scores than those with TT genotype (both p < 0.05). CONCLUSION: NRG3 rs10748842 may not confer susceptibility to schizophrenia, but may be more closely associated with cognitive deficit, especially attention performance in chronic schizophrenia.

14.
BMC Pediatr ; 19(1): 406, 2019 Nov 04.
Artigo em Inglês | MEDLINE | ID: mdl-31684911

RESUMO

BACKGROUND: Kawasaki disease (KD) is a common vasculitis of childhood in East Asia. The complications of KD ascribed to long-term cardiovascular sequelae are considerably diverse. Although studies have investigated neurodevelopmental problems following KD in the past few decades, they have reported inconsistent conclusions. This study investigated potential epilepsy and associated neurodevelopmental disorders (NDDs) following KD in Taiwanese children. METHODS: We retrospectively analyzed the data of children aged < 18 years with clinically diagnosed KD from January 1, 2005, to December 31, 2015. These patients were followed up to estimate the prevalence of epilepsy and associated NDDs in comparison with the prevalence in general pediatric population in Taiwan and worldwide. RESULTS: A total of 612 patients with an average age of 1.6 years were included. The prevalence of associated NDDs was 16.8% (n = 103/612) in the study group, which consisted of epilepsy, intellectual disability (ID), autism spectrum disorders, Tourette syndrome (TS), attention deficit hyperactivity disorder, (ADHD), and others. Moreover, children with KD had a higher prevalence of epilepsy and TS in both Taiwan and worldwide (epilepsy: 2.61% in the KD group vs 0.33% in Taiwan and 0.05-0.8% in worldwide, p < 0.05; TS: 2.77% in the KD group vs 0.56% in Taiwan and 0.3-1% in worldwide, p < 0.05). The prevalence of ID, ADHD, and developmental language disorders was not significantly different between our study patients and those in Taiwan or worldwide. CONCLUSIONS: Results revealed a higher prevalence rate of NDDs, especially epilepsy and TS, in Taiwanese children with KD than in the general pediatric population in Taiwan. However, these NDDs could be heterogeneous. Children diagnosed with KD were followed up because they had a higher risk of heterogeneous NDDs.

15.
Clin Exp Rheumatol ; 2019 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-31694740

RESUMO

OBJECTIVES: Lupus nephritis (LN) is an immune-complex mediated nephritis with complicated pathogenesis. The aims of the present study were to investigate whether inflammasomes are activated in the renal pathology of LN patients and analyse the association of inflammasome activation in different classes of LN renal tissues with the disease activity. METHODS: A total of 86 patients with renal biopsy-proven chronic kidney disease admitted in Xiangya Hospital from January 2015 to August 2018 were enrolled in the present study. Immunofluorescence analysis was applied to examine NLRP1, NLRP3 and AIM3 expression in renal tissues. RESULTS: AIM2 was mainly expressed in glomerular cells of LN class II. No obvious positive staining of AIM2 in renal tissues was found in other LN classes. NLRP1 and NLRP3 were mainly localised in tubular cells. NLRP1 was mainly expressed in tubular cells of LN class II and class IV while NLRP3 was expressed in tubular cells of LN class IV. Moreover, NLRP3 expression level was positive correlated with the activity index (AI) score in patients with LN. CONCLUSIONS: NLRP3, NLRP1 and AIM2 activation are involved in the progress of LN. NLRP3 activation has a positive correlation with the AI score of LN.

16.
J Prosthet Dent ; 2019 Nov 05.
Artigo em Inglês | MEDLINE | ID: mdl-31703920

RESUMO

The socket-shield technique can be challenging and time-consuming. This article presents a digital approach to fabricating a computer-aided design and computer-aided manufacturing (CAD-CAM) titanium preparation template for the socket-shield technique. Preoperative cone beam computed tomography (CBCT) was used to map the remaining root, and the desired shape of buccal fragment of the root was determined as the socket shield. A CAD-CAM titanium preparation template was fabricated to facilitate root sectioning and the preparation procedure for forming an adequate socket shield.

17.
J Prosthet Dent ; 2019 Nov 05.
Artigo em Inglês | MEDLINE | ID: mdl-31703923

RESUMO

STATEMENT OF PROBLEM: Candida albicans has been implicated in denture stomatitis, and this effect is exacerbated by nicotine exposure. However, studies have also suggested that caffeine exposure inhibits the growth of C. albicans. The interaction effects of nicotine and caffeine are not yet clear on the growth of C. albicans. PURPOSE: The purpose of this in vitro study was to determine the effect of caffeine on metabolic activity and biofilm formation of C. albicans growing on acrylic denture resin while simultaneously exposed to nicotine and, if an effect were to be identified, whether this effect would vary depending on the caffeine concentration. MATERIAL AND METHODS: A total of 240 acrylic resin specimens were divided into 2 equal groups (120 each). Specimens in one group were processed to measure C. albicans metabolic activity, and those in the other group were processed to measure C. albicans biofilm attachment. Ten subgroups (n=12) were established within each group with different concentration combinations of nicotine and caffeine to test the interaction effect. The first subgroup was designed as a negative control, containing 0 mg/mL of nicotine and caffeine. The following subgroups all contained 8.00 mg/mL of nicotine, and the caffeine concentrations were prepared at the following 9 levels: 0, 0.25, 0.50, 1.00, 2.00, 4.00, 8.00, 16.00, and 32.00 mg/mL. Metabolic activity was measured by using a 2,3-bis (2-methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-carboxanilide (XTT) assay. Biofilm attachment was measured by using spiral plating and calculated in terms of the number of colony-forming units (CFUs)/mL. Descriptive statistics and a 2-way ANOVA were conducted to determine whether the concentrations of nicotine and caffeine used affected the biofilm attachment and metabolic activity of C. albicans (α=.05). RESULTS: The presence of 8 mg/mL of nicotine increased the metabolic activity and biofilm formation of C. albicans. When compared with the 0 mg/mL of caffeine and 8.00 mg/mL of nicotine group, caffeine from 1.00 to 4.00 mg/mL significantly increased C. albicans biofilm metabolic activity. Caffeine at 16.00 and 32.00 mg/mL significantly decreased C. albicans biofilm metabolic activity in the presence of 8 mg/mL of nicotine. Caffeine from 1.00 to 32.00 mg/mL significantly decreased the biofilm formation of C. albicans in the presence of 8 mg/mL of nicotine. CONCLUSIONS: The presence of 8 mg/mL of nicotine alone increased the metabolic activity and biofilm formation of C. albicans. In the presence of 8 mg/mL of nicotine with different caffeine concentrations, the results suggest that, overall, caffeine at higher concentrations (16 and 32 mg/mL) inhibited the metabolic activity and biofilm formation of C. albicans on acrylic denture resin most.

18.
Minerva Pediatr ; 2019 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-31729207

RESUMO

BACKGROUND: This study investigated the clinical characteristics, cranial magnetic resonance imaging (MRI) features, MRI follow-up, and prognosis of children with acute lymphoblastic leukemia (ALL) who developed posterior reversible encephalopathy syndrome (PRES) during remission induction chemotherapy. METHODS: We analyzed the age, gender, PRES symptoms and signs, cranial MRI findings, therapeutic effect, and prognosis of children with ALL who developed PRES during chemotherapy from January 2010 to December 2013 at the Hematology Oncology Center of Beijing Children's Hospital. Changes in cranial MRI findings were analyzed, and intelligence (IQ) and cognitive function were evaluated using the Wechsler Scale and the Wisconsin Card Score Test after the children completed chemotherapy. RESULTS: There were 850 children with newly diagnosed ALL in this period; 13 (1.5%), 6 boys and 7 girls, developed PRES. All were diagnosed as B-cell ALL. The median age at PRES onset was 7 years (2-11 years). The median day of PRES onset was day 28 (day 17-34) of remission induction chemotherapy. Of the 13 children with PRES onset and seizures, 4 had visual disturbances and 2 had consciousness disturbances. Cranial MRI showed hyperintensity in the subcortical white matter on T2-weighted axial and fluid-attenuated inversion recovery (FLAIR) images. The lesion locations were as follows: occipital lobe, 12 (92.3%) patients; frontal lobe, 7 (53.8%) patients; temporal lobe, 5 (38.4%) patients; parietal lobe, 3 (23.1%) patients; and cerebellum, 1 (7.7%) patient. There were 8 (61.5%) patients with vasogenic edema and 5 (38.5%) with cytotoxic edema. After treatment, all children recovered within one month,when their PRES symtoms were relieved, they continued to receive chemotherapy. However, 1 child (1.07%) died of severecentral nervous system infection one year after PRES treatment, and 3 (25%) had recurrent seizures and were diagnosed with epilepsy after three months of PRES treatment. Their cranial MRIs showed cytotoxic edema, which was acute stage on day 15, with aggravated lesions on cranial MRI. The cranial MRI lesions returned to normal at one month in 3 (23.1%) patients, at three months in 6 (46.1%) patients, at one year in 8 (61.5%) patients, and at two years in 12 (92.3%) patients. The 12 surviving children all returned to school, and their full-scale, verbal, and performance IQs were normal, with no significant differences in intelligence or cognitive function compared with children with ALL without PRES during the same period. CONCLUSIONS: PRES can occur during remission induction chemotherapy treatment of children with ALL, but the incidence is low. Cranial MRI can be used for diagnosis and to characterize lesions. The children recover about a month after treatment, and cranial MRI lesions return to normal within two years. The time for complete resolution of MRI lesions differs, and children with cytotoxic edema have worse prognosis with sequelae, such as epilepsy, which requires close monitoring. PRES does not affect intelligence or cognitive development.

19.
20.
Artigo em Inglês | MEDLINE | ID: mdl-31761661

RESUMO

OBJECTIVE: Affective disorders are associated with increased risk of dementia, yet most studies focus on the association of major depressive disorder or depressive episodes of bipolar disorder with increased dementia risk. The association of manic/mixed episodes of bipolar disorder with increased dementia risk is unclear. PARTICIPANTS: Between January 1, 2001 and December 31, 2009, 20,535 individuals aged 45-80 years with bipolar disorder and 82,140 age- and sex-matched comparisons were enrolled and followed up to December 2011 in Taiwan. Those who developed dementia (ICD-9-CM codes: 290.0-290.4, 294.1-294.2, and 331.0-331.2) during the follow-up period were identified. DESIGN AND METHODS: Cox proportional hazards models were used to examine the relationship between manic/mixed/depressive episodes of bipolar disorder and incident dementia. We also assessed the association between the frequency of psychiatric admissions (total, manic/mixed, and depressive episodes per year) for bipolar disorder and dementia risk. RESULTS: Bipolar disorder was associated with increased risk of incident dementia (hazard ratio [HR]: 7.52, 95% confidence interval [CI]: 6.86-8.25). Greater frequency of manic/mixed (>2/year: HR: 4.50, 3.50-5.79; 1-2/year: HR: 3.17, 2.31-4.36) and depressive episodes (>2/year: HR: 7.84, 5.93-10.36; 1-2/year: HR: 2.93, 2.05-4.19) were associated with increased risk of incident dementia. CONCLUSIONS: Not only depressive episode of bipolar disorder, but manic/mixed episodes of bipolar play a role as a risk factor of incident dementia, especially for those patients with more than two manic/mixed episodes per year. These findings remind the clinicians the importance of preventing the relapse of bipolar disorder for the potential subsequent cognitive decline and disease.

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