Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 29
Filtrar
Mais filtros










Intervalo de ano de publicação
1.
Reprod Biol Endocrinol ; 18(1): 6, 2020 Jan 21.
Artigo em Inglês | MEDLINE | ID: mdl-31964400

RESUMO

LINE1 retrotransposons are mobile DNA elements that copy and paste themselves into new sites in the genome. To ensure their evolutionary success, heritable new LINE-1 insertions accumulate in cells that can transmit genetic information to the next generation (i.e., germ cells and embryonic stem cells). It is our hypothesis that LINE1 retrotransposons, insertional mutagens that affect expression of genes, may be causal agents of early miscarriage in humans. The cell has evolved various defenses restricting retrotransposition-caused mutation, but these are occasionally relaxed in certain somatic cell types, including those of the early embryo. We predict that reduced suppression of L1s in germ cells or early-stage embryos may lead to excessive genome mutation by retrotransposon insertion, or to the induction of an inflammatory response or apoptosis due to increased expression of L1-derived nucleic acids and proteins, and so disrupt gene function important for embryogenesis. If correct, a novel threat to normal human development is revealed, and reverse transcriptase therapy could be one future strategy for controlling this cause of embryonic damage in patients with recurrent miscarriages.

3.
J Am Med Inform Assoc ; 26(11): 1218-1226, 2019 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-31300825

RESUMO

OBJECTIVE: Identifying patients who meet selection criteria for clinical trials is typically challenging and time-consuming. In this article, we describe our clinical natural language processing (NLP) system to automatically assess patients' eligibility based on their longitudinal medical records. This work was part of the 2018 National NLP Clinical Challenges (n2c2) Shared-Task and Workshop on Cohort Selection for Clinical Trials. MATERIALS AND METHODS: The authors developed an integrated rule-based clinical NLP system which employs a generic rule-based framework plugged in with lexical-, syntactic- and meta-level, task-specific knowledge inputs. In addition, the authors also implemented and evaluated a general clinical NLP (cNLP) system which is built with the Unified Medical Language System and Unstructured Information Management Architecture. RESULTS AND DISCUSSION: The systems were evaluated as part of the 2018 n2c2-1 challenge, and authors' rule-based system obtained an F-measure of 0.9028, ranking fourth at the challenge and had less than 1% difference from the best system. While the general cNLP system didn't achieve performance as good as the rule-based system, it did establish its own advantages and potential in extracting clinical concepts. CONCLUSION: Our results indicate that a well-designed rule-based clinical NLP system is capable of achieving good performance on cohort selection even with a small training data set. In addition, the investigation of a Unified Medical Language System-based general cNLP system suggests that a hybrid system combining these 2 approaches is promising to surpass the state-of-the-art performance.

4.
Rev Assoc Med Bras (1992) ; 65(5): 678-681, 2019 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-31166445

RESUMO

OBJECTIVE: We describe the case of a diabetic patient who developed vertebral osteomyelitis and bilateral psoas abscess with gas formation due to klebsiella pneumoniae. METHODS: A 64-year-old woman with a 4-year history of type-2 diabetes mellitus was admitted to the Emergency Department. The subject had a 2-day history of high-grade fever associated with chills and a 5-hour history of consciousness. She received empirical treatment with febrifuge, after which her fever decreased. RESULTS: Her fever recurred after an interval of three hours. A computed tomography scan of the abdomen revealed vertebral osteomyelitis and bilateral psoas muscle abscess with gas formation. Blood culture and purulent fluid described the growth of the Klebsiella pneumoniae. The patient received antibiotic therapy and bilateral drainage therapy after the drainage catheter was placed into the abscess cavity by CT-guidance. Due to the serious damage to the vertebral column and permanent pain, the patient underwent minimally invasive internal spinal fixation and recovered successfully. CONCLUSION: A case of vertebral osteomyelitis and bilateral psoas abscess with gas formation caused by Klebsiella pneumoniae in a diabetic patient. Antibiotic therapy, drainage, and minimally invasive internal spinal fixation were performed, which enabled a good outcome.


Assuntos
Complicações do Diabetes/cirurgia , Infecções por Klebsiella/cirurgia , Klebsiella pneumoniae/patogenicidade , Osteomielite/cirurgia , Abscesso do Psoas/cirurgia , Doenças da Coluna Vertebral/cirurgia , Complicações do Diabetes/microbiologia , Drenagem/métodos , Feminino , Gases/metabolismo , Humanos , Infecções por Klebsiella/microbiologia , Pessoa de Meia-Idade , Osteomielite/microbiologia , Abscesso do Psoas/microbiologia , Reprodutibilidade dos Testes , Doenças da Coluna Vertebral/microbiologia , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento
5.
Rev. Assoc. Med. Bras. (1992) ; 65(5): 678-681, May 2019. graf
Artigo em Inglês | LILACS-Express | ID: biblio-1012972

RESUMO

SUMMARY OBJECTIVE: We describe the case of a diabetic patient who developed vertebral osteomyelitis and bilateral psoas abscess with gas formation due to klebsiella pneumoniae. METHODS: A 64-year-old woman with a 4-year history of type-2 diabetes mellitus was admitted to the Emergency Department. The subject had a 2-day history of high-grade fever associated with chills and a 5-hour history of consciousness. She received empirical treatment with febrifuge, after which her fever decreased. RESULTS: Her fever recurred after an interval of three hours. A computed tomography scan of the abdomen revealed vertebral osteomyelitis and bilateral psoas muscle abscess with gas formation. Blood culture and purulent fluid described the growth of the Klebsiella pneumoniae. The patient received antibiotic therapy and bilateral drainage therapy after the drainage catheter was placed into the abscess cavity by CT-guidance. Due to the serious damage to the vertebral column and permanent pain, the patient underwent minimally invasive internal spinal fixation and recovered successfully. CONCLUSION: A case of vertebral osteomyelitis and bilateral psoas abscess with gas formation caused by Klebsiella pneumoniae in a diabetic patient. Antibiotic therapy, drainage, and minimally invasive internal spinal fixation were performed, which enabled a good outcome.


RESUMO OBJETIVO: Descrever o caso de uma paciente diabética que desenvolveu osteomielite vertebral e abcesso bilateral do psoas com formação de gás causada por klebsiella pneumoniae. MÉTODOS: Uma mulher de 64 anos de idade, com 4 anos de histórico de diabetes mellitus tipo 2, foi admitida no Serviço de Emergência. A paciente apresentava um quadro de dias de febre alta acompanhada de calafrios e um histórico de 5 horas de consciência. Ela recebeu tratamento empírico com antitérmico, após o qual a febre diminuiu. RESULTADOS: A febre retornou após um intervalo de três horas. Uma tomografia computadorizada do abdome revelou osteomielite vertebral e abcesso bilateral do músculo psoas com formação de gás. A cultura do sangue e o fluido purulento revelaram o crescimento de Klebsiella pneumoniae. A paciente recebeu antibióticos e terapia de drenagem bilateral após o cateter de drenagem ser posicionado na cavidade do abscesso com auxílio de TC. Devido a sérios danos à coluna vertebral e a dor permanente, a paciente foi submetida à fixação vertebral interna minimamente invasiva e recuperou-se com sucesso. CONCLUSÃO: Um caso de osteomielite vertebral e abscesso do psoas bilateral com a formação de gás causada por Klebsiella pneumoniae em uma paciente diabética. Antibioticoterapia, drenagem e fixação vertebral interna minimamente invasiva foram realizadas, o que permitiu um bom resultado.

6.
FASEB J ; 33(6): 7667-7683, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30893559

RESUMO

Current pharmacological intervention for the treatment of osteolytic bone diseases such as osteoporosis focuses on the prevention of excessive osteoclastic bone resorption but does not enhance osteoblast-mediated bone formation. In our study, we have shown that 4-iodo-6-phenylpyrimidine (4-IPP), an irreversible inhibitor of macrophage migration inhibitory factor (MIF), can inhibit receptor activator of NF-κB ligand (RANKL)-induced osteoclastogenesis and potentiate osteoblast-mediated mineralization and bone nodule formation in vitro. Mechanistically, 4-IPP inhibited RANKL-induced p65 phosphorylation and nuclear translocation by preventing the interaction of MIF with thioredoxin-interacting protein-p65 complexes. This led to the suppression of late osteoclast marker genes such as nuclear factor of activated T cells cytoplasmic 1, resulting in impaired osteoclast formation. In contrast, 4-IPP potentiated osteoblast differentiation and mineralization also through the inhibition of the p65/NF-κB signaling cascade. In the murine model of pathologic osteolysis induced by titanium particles, 4-IPP protected against calvarial bone destruction. Similarly, in the murine model of ovariectomy-induced osteoporosis, 4-IPP treatment ameliorated the bone loss associated with estrogen deficiency by reducing osteoclastic activities and enhancing osteoblastic bone formation. Collectively, these findings provide evidence for the pharmacological targeting of MIF for the treatment of osteolytic bone disorders.-Zheng, L., Gao, J., Jin, K., Chen, Z., Yu, W., Zhu, K., Huang, W., Liu, F., Mei, L., Lou, C., He, D. Macrophage migration inhibitory factor (MIF) inhibitor 4-IPP suppresses osteoclast formation and promotes osteoblast differentiation through the inhibition of the NF-κB signaling pathway.

7.
Medicine (Baltimore) ; 97(36): e12183, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30200123

RESUMO

RATIONALE: In 1891, Dr. Hermann Kümmell, a German surgeon, described a clinical entity characterized by the development of progressive painful kyphosis following an asymptomatic period of months or years after a minor spinal trauma, leading to a gradual collapse of the vertebra and dynamic instability, ultimately progressing to kyphosis with prolonged back pain and/or paraparesis. To date, the main pathologic eliciting event remains unclear, and no standard treatment or single effective treatment are available for Kümmell disease. PATIENT CONCERNS: A 74-year-old woman presented with severe back pain and numbness of both legs for approximately 2 months. DIAGNOSES: According to the clinical symptoms and imaging examinations, the patient was diagnosed with stage III Kümmell disease. INTERVENTIONS: The patient underwent titanium mesh bone grafting combined with pedicle screw internal fixation. OUTCOMES: Postoperative kyphosis was corrected, and the vertebra was reconstructed. LESSONS: Kümmell disease is not a rare complication of osteoporotic vertebral compression fractures, and treatment of each patient must be individualized. The application of titanium mesh bone grafting combined with pedicle screw internal fixation is an effective treatment option for stage III Kümmell disease.


Assuntos
Dor nas Costas/cirurgia , Transplante Ósseo , Fixação Interna de Fraturas/métodos , Cifose/cirurgia , Compressão da Medula Espinal/cirurgia , Idoso , Dor nas Costas/diagnóstico por imagem , Dor nas Costas/etiologia , Feminino , Humanos , Hipestesia/diagnóstico por imagem , Hipestesia/etiologia , Hipestesia/cirurgia , Cifose/complicações , Cifose/diagnóstico por imagem , Parafusos Pediculares , Compressão da Medula Espinal/complicações , Compressão da Medula Espinal/diagnóstico por imagem , Telas Cirúrgicas , Titânio
8.
J Cell Physiol ; 233(12): 9724-9738, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30059597

RESUMO

Osteoporosis (OP) is a serious metabolic disease that, due to the increased number or function of osteoclasts, results in increased bone brittleness and, therefore, fragile fracture. Some recent studies report the importance of the transforming growth factor ß (TGFß) pathway in bone homeostasis. RepSox is a small molecule inhibitor of TGFßRI that has a wide range of potential application in clinical medicine, except OP. The aim of our study is to evaluate the effects of RepSox on the differentiation and bone resorption of osteoclasts in vitro and in vivo in an ovariectomy (OVX)-induced OP model. An initial analysis showed TGFßRI messenger RNA expression in both bone samples and bone cells. In the in vitro study, RepSox inhibited the receptor activator of nuclear factor κB ligand (RANKL)-induced osteoclast differentiation and bone resorption activity. Real-time polymerase chain reaction (PCR) analysis showed that RepSox suppressed osteoclastic marker gene expression in both dose-dependent and time-dependent manners. In addition, RepSox did not affect osteoblast differentiation, migration or osteoblastic-specific gene expression in vitro. Furthermore, western blot analysis indicated the underlying mechanisms of the RepSox suppression of osteoclastogenesis via the Smad3 and c-Jun N-terminal kinase/activator protein-1 (JNK/AP-1) signaling pathways. Finally, our animal experiments revealed that RepSox prevented OVX-induced bone loss in vivo. Together, our data suggest that RepSox regulates osteoclast differentiation, bone resorption, and OVX-induced OP via the suppression of the Smad3 and JNK/AP-1 pathways.


Assuntos
Reabsorção Óssea/tratamento farmacológico , Osteoporose/tratamento farmacológico , Pirazóis/administração & dosagem , Piridinas/administração & dosagem , Proteína Smad3/genética , Animais , Reabsorção Óssea/etiologia , Reabsorção Óssea/genética , Reabsorção Óssea/patologia , Diferenciação Celular/efeitos dos fármacos , Humanos , Proteínas Quinases JNK Ativadas por Mitógeno/genética , Camundongos , Osteoclastos/efeitos dos fármacos , Osteoporose/etiologia , Osteoporose/genética , Osteoporose/patologia , Ovariectomia/efeitos adversos , Ligante RANK/genética , Bibliotecas de Moléculas Pequenas/administração & dosagem , Fator de Transcrição AP-1/genética , Fator de Crescimento Transformador beta/genética
9.
Pain Physician ; 21(3): 209-218, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29871365

RESUMO

BACKGROUND: An increasing number of studies have been conducted to apply unilateral balloon kyphoplasty in the treatment of ostroporotic vertebral compression fractures (OVCFs). However, the efficacy and safety of unilateral kyphoplasty and whether a unilateral or a bilateral approach is superior is controversial. OBJECTIVES: The purpose of this study was to evaluate the role of unilateral balloon kyphoplasty and use meta-analysis to compare the efficacy and safety of unilateral and bilateral kyphoplasty in patients with OVCFs. STUDY DESIGN: A systematic literature search was conducted from 1970 to April 2017 using Medline database and the Cochrane Central Register of Controlled Trials. Articles were limited to those published in English. Randomized controlled trials and nonrandomized comparative studies were also included. SETTING: The following search terms were used: "osteoporotic vertebral compression fractures," or "OVCF," and "unilateral kyphoplasty," or "unipedicular approach," or "single balloon kyphoplasty," or "one balloon kyphoplasty." A comprehensive search of reference lists of retrieved articles and previous published reviews was also performed to ensure inclusion of all possible studies. METHODS: All potential articles were independently reviewed by 2 investigators for inclusion into the final analysis. MINORS score was used for nonrandomized studies, and Detsky quality index was applied for prospective randomized controlled trials. Systematic review and meta-analysis was performed for the included studies. RESULTS: After unilateral balloon kyphoplasty the mean postoperative visual analog score (VAS) was from 1.74 to 4.77, mean postoperative kyphotic angle was from 5.9º to 11.22º, and complications involving cement leaks was from 6.8 to 21.9% or adjacent level fractures was from 0 to 5.6%). Unilateral kyphoplasty had significantly lower operative time, and less bone cement volume; however, the postoperative VAS, Oswestry Disability Index (ODI), vertebral height restoration rate, and cement leakage and adjacent vertebral fracture rate, were similar to bilateral kyphoplasty. LIMITATIONS: Only 6 randomized controlled trials and 3 retrospective comparative studies were selected for analysis. Heterogeneity was detected among the studies when we pooled the outcomes. CONCLUSIONS: Based on the available evidence, the clinical and radiological results of unilateral balloon kyphoplasty were as good as those of bilateral balloon kyphoplasty for the treatment of OVCFs. And unilateral kyphoplasty had advantages in terms of operation time, radiation exposure, and cost. KEY WORDS: Unilateral balloon kyphoplasty, bilateral balloon kyphoplasty, osteoporotic vertebral compression fractures, complications of balloon kyphoplasty, meta-analysis.


Assuntos
Fraturas por Compressão/cirurgia , Cifoplastia/métodos , Fraturas por Osteoporose/cirurgia , Fraturas da Coluna Vertebral/cirurgia , Idoso , Feminino , Humanos , Estudos Prospectivos , Estudos Retrospectivos , Resultado do Tratamento
10.
World Neurosurg ; 120: e1-e7, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29945011

RESUMO

OBJECTIVE: To reevaluate the cement distribution patterns and further investigate associations between cement distribution patterns and the occurrence rates of recompression in cemented vertebrae after percutaneous vertebroplasty (PVP) for osteoporotic vertebral compression fractures. METHODS: Two hundred twenty-four patients with a mean age of 71.9 years were enrolled and treated with single-level PVP between June 2012 and July 2015. The mean follow-up time was 16.5 months. Data from medical records and radiographs were collected and analyzed. Cement distribution patterns were divided into 4 cement distribution patterns extending from the traditional 2 patterns: interlocked solid pattern (LS) and uninterlocked solid pattern (ULS); contiguous trabecular pattern (CT) and discontiguous trabecular pattern (DCT). Differences in treatment efficacy and the occurrence rates of recompression in cemented vertebrae were compared for both groups using the Wilcoxon rank sum test and chi-squared test. RESULTS: Thirty-seven patients who underwent PVP developed recompression in cemented vertebrae. Recompression in cemented vertebrae was significantly more frequent in the ULS and DCT groups than in the LS and CT groups (P < 0.05 or 0.001), with the Visual Analogue Scale score at the time of final follow-up was also significantly higher in the ULS and DCT groups (P < 0.001). CONCLUSIONS: Significant associations were found between cement distribution patterns and recompression in cemented vertebrae, which affected the clinical outcome in patients after PVP. A higher incidence of recompression in cemented vertebrae was seen in patients with treated vertebrae exhibiting ULS pattern or DCT pattern.


Assuntos
Cimentos para Ossos/uso terapêutico , Fraturas por Compressão/cirurgia , Vértebras Lombares/diagnóstico por imagem , Fraturas por Osteoporose/cirurgia , Fraturas da Coluna Vertebral/cirurgia , Vértebras Torácicas/diagnóstico por imagem , Vertebroplastia , Idoso , Feminino , Fraturas por Compressão/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Fraturas por Osteoporose/epidemiologia , Radiografia , Recidiva , Estudos Retrospectivos , Fraturas da Coluna Vertebral/epidemiologia , Estatísticas não Paramétricas
11.
Acta Orthop Traumatol Turc ; 52(4): 283-288, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29803679

RESUMO

OBJECTIVE: This study aimed to conduct a systematic review of literature comparing the clinical effectiveness and safety between anterior reconstruction (AR) and posterior osteotomy (PO) in the treatment of Kümmell's disease with neurological deficits. METHODS: We systematically reviewed the literature in PubMed, EMBASE, Cochrane Database of Systematic Reviews, and the Web of Science for "spin*," "surg*," "Kümmell's disease," "Kummell's disease," "Kummell disease," "vertebral osteonecrosis," "vertebral pseudarthrosis," "intravertebral vacuum cleft," "delayed vertebral collapse," and "compression fracture nonunion". Quality was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation method. RESULTS: A total of 10 publications involving 268 Kümmell's disease patients with neurological deficits were included in this review, with 7 studies of low- or very low-quality. There were 37.7% and 62.3% of patients receiving AR and PO, respectively. For clinical outcomes, AR group showed no significant differences in pain, neurological dysfunction, and imaging outcome improvements compared with patients who underwent PO. However, the incidence of implant-related complications including loose screw, screw fracture, screw disconnection, and plate dislodgment, was higher in AR group compared with PO group (21.6% vs. 14.3%). As another major complication, AR group more often required a second surgery. CONCLUSION: This systematic review demonstrated that both AR and PO could improve pain, neurological dysfunction and imaging outcomes. However, serious comorbidities, multilevel corpectomies and/or severe osteoporosis highly required PO. Design discrepancies were found in the current studies, further higher-quality studies are warranted. LEVEL OF EVIDENCE: Level III, therapeutic study.


Assuntos
Fraturas por Compressão/cirurgia , Fraturas Espontâneas/cirurgia , Osteonecrose/cirurgia , Osteotomia/métodos , Fraturas da Coluna Vertebral/cirurgia , Parafusos Ósseos , Humanos , Pseudoartrose , Resultado do Tratamento
12.
J Pediatr Endocrinol Metab ; 30(12): 1305-1310, 2017 Nov 27.
Artigo em Inglês | MEDLINE | ID: mdl-29176022

RESUMO

BACKGROUND: This study aims to investigate the spectrum and frequency of phenylalanine hydroxylase (PAH) gene mutations and the power to prenatally diagnose phenylketonuria (PKU) patients in Shaanxi, China. METHODS: Polymerase chain reaction (PCR) and DNA sequencing analyses were performed to examine the PAH gene in 33 PKU patients and seven amniotic fluid samples. Thirty-four pathogenic variants were indicated in all 63 alleles, in which two probands carried three variants. RESULTS: Pedigree analysis suggested that the [c.158G>A([p.R53H)][IVS7+2T>A] mutation was located at the same chromatid. However, there was a controversial viewpoint that thought the c.158G>A(p.R53H) variant was a polymorphism in the Chinese. We also found one novel indel mutation and identified the c.59_60delAGinsCC mutation of the PAH gene for the very first time. The spectrum of the PAH mutations in Shaanxi Province were similar to that among China's population. Based on the results of PAH gene analysis, we further performed prenatal genetic diagnoses for seven PKU families. All foetuses were definitively diagnosed, and their parents were provided with genetic counselling. CONCLUSIONS: PAH gene analysis is a crucial method for PKU diagnosis and prenatal genetic prognosis, even though many uncommon mutations would affect the analysis and diagnosis of genetic abnormalities.


Assuntos
Líquido Amniótico/química , Análise Mutacional de DNA/métodos , Fenilalanina Hidroxilase/genética , Fenilcetonúrias/diagnóstico , Diagnóstico Pré-Natal/métodos , Grupo com Ancestrais do Continente Asiático/genética , Pré-Escolar , China/epidemiologia , Feminino , Aconselhamento Genético , Testes Genéticos/métodos , Humanos , Lactente , Recém-Nascido , Masculino , Triagem Neonatal , Fenilalanina Hidroxilase/análise , Fenilcetonúrias/epidemiologia , Fenilcetonúrias/genética , Polimorfismo Genético , Gravidez
13.
Menopause ; 24(10): 1136-1144, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28609385

RESUMO

OBJECTIVE: The aim of this study was to revisit and further investigate the association between menopause and disc degeneration in the lumbar spine using a magnetic resonance imaging-based eight-level grading system. METHODS: This study cohort comprised of 1,566 women and 1,382 age-matched men who were admitted for low back pain from June 2013 to October 2016. Data on age, weight, height, body mass index, age at natural menopause, and years since menopause (YSM) were obtained. Lumbar disc degeneration was assessed using a magnetic resonance imaging-based eight-level grading system. RESULTS: After adjustment for the confounding factors of age, height, and weight, young age-matched men were more susceptible to disc degeneration than premenopausal women (P < 0.05). However, after menopause, postmenopausal women had a significant tendency to develop more severe disc degeneration than their age-matched men (P < 0.05), and also compared with premenopausal and perimenopausal women (P < 0.01). Postmenopausal women were divided into nine subgroups by every 5 YSM. When YSM was less than 15 years, a positive trend was observed between YSM and severity of disc degeneration, respectively, at L1/L2 (r = 0.241), L2/L3 (r = 0.193), L3/L4 (r = 0.191), L4/L5 (r = 0.165), L5/S1 (r = 0.153), and all lumbar discs (r = 0.237) (P < 0.05 or 0.01). The analysis of covariance indicated a significant difference in each disc level (P < 0.05 or 0.01) between every two groups. When YSM was more than 15 years, the significant difference, however, disappeared in each disc level (P > 0.05). CONCLUSIONS: Menopause is associated with lumbar disc degeneration. The association occurred in the first 15 YSM, suggesting estrogen deficiency might be a risk factor of disc degeneration of the lumbar spine. Further studies need to be carried out for deciding whether age or menopause plays a more important role in the progression of disc degeneration in the lumbar spine.


Assuntos
Degeneração do Disco Intervertebral/etiologia , Vértebras Lombares , Menopausa , Adulto , Idoso , Idoso de 80 Anos ou mais , Análise de Variância , Estudos de Casos e Controles , Estudos de Coortes , Progressão da Doença , Feminino , Inquéritos Epidemiológicos , Humanos , Degeneração do Disco Intervertebral/diagnóstico por imagem , Dor Lombar/etiologia , Vértebras Lombares/diagnóstico por imagem , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Fatores Sexuais , Adulto Jovem
14.
Menopause ; 23(11): 1239-1246, 2016 11.
Artigo em Inglês | MEDLINE | ID: mdl-27326816

RESUMO

OBJECTIVE: The purpose of this study was to investigate the association between menopause and severity of knee joint cartilage degeneration using a magnetic resonance imaging-based six-level grading system, with six cartilage surfaces, the medial and lateral femoral condyle, the femoral trochlea, the medial and lateral tibia plateau, and the patella. METHODS: The study cohort comprised 860 healthy women (age 36-83 y), and 5,160 cartilage surfaces were analyzed. Age, weight, height, age at natural menopause, and years since menopause (YSM) were obtained. Cartilage degeneration was assessed using a magnetic resonance imaging-based six-level grading system. RESULTS: After removing the age, height, and weight effects, postmenopausal women had more severe cartilage degeneration than pre- and perimenopausal women (P < 0.001). A positive trend was observed between YSM and severity of cartilage degeneration (P < 0.05). Postmenopausal women were divided into seven subgroups by every five YSM. When YSM was less than 25 years, the analysis of covariance indicated a significant difference in medial tibia plateau, medial femoral condyle, trochlea, patella, and total surfaces (P < 0.05 or 0.01) between every two groups. When YSM was more than 25 years, the significant difference, however, disappeared in these four surfaces (P > 0.05). No significant difference was observed in lateral tibia plateau and lateral femoral condyle in postmenopausal women. CONCLUSIONS: Menopause is associated with cartilage degeneration of knee joint. After menopause, cartilage showed progressive severe degeneration that occurred in the first 25 YSM, suggesting estrogen deficiency might be a risk factor of cartilage degeneration of the knee joint. Further studies are needed to investigate whether age or menopause plays a more important role in the progression of cartilage degeneration in the knee joint.


Assuntos
Doenças das Cartilagens/patologia , Cartilagem Articular/patologia , Artropatias/patologia , Articulação do Joelho/patologia , Menopausa/fisiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Feminino , Humanos , Imagem por Ressonância Magnética , Pessoa de Meia-Idade , Pós-Menopausa/fisiologia
15.
Clinics (Sao Paulo) ; 71(3): 179-84, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-27074180

RESUMO

This meta-analysis was designed to elucidate whether preoperative signal intensity changes could predict the surgical outcomes of patients with cervical spondylosis myelopathy on the basis of T1-weighted and T2-weighted magnetic resonance imaging images. We searched the Medline database and the Cochrane Central Register of Controlled Trials for this purpose and 10 studies meeting our inclusion criteria were identified. In total, 650 cervical spondylosis myelopathy patients with (+) or without (-) intramedullary signal changes on their T2-weighted images were examined. Weighted mean differences and 95% confidence intervals were used to summarize the data. Patients with focal and faint border changes in the intramedullary signal on T2 magnetic resonance imaging had similar Japanese Orthopaedic Association recovery ratios as those with no signal changes on the magnetic resonance imaging images of the spinal cord did. The surgical outcomes were poorer in the patients with both T2 intramedullary signal changes, especially when the signal changes were multisegmental and had a well-defined border and T1 intramedullary signal changes compared with those without intramedullary signal changes. Preoperative magnetic resonance imaging including T1 and T2 imaging can thus be used to predict postoperative recovery in cervical spondylosis myelopathy patients.


Assuntos
Imagem por Ressonância Magnética/métodos , Doenças da Medula Espinal/patologia , Espondilose/patologia , Humanos , Período Pós-Operatório , Valor Preditivo dos Testes , Cuidados Pré-Operatórios/métodos , Prognóstico , Recuperação de Função Fisiológica , Doenças da Medula Espinal/reabilitação , Doenças da Medula Espinal/cirurgia , Espondilose/reabilitação , Espondilose/cirurgia
16.
Clinics ; 71(3): 179-184, Mar. 2016. tab, graf
Artigo em Inglês | LILACS | ID: lil-778992

RESUMO

This meta-analysis was designed to elucidate whether preoperative signal intensity changes could predict the surgical outcomes of patients with cervical spondylosis myelopathy on the basis of T1-weighted and T2-weighted magnetic resonance imaging images. We searched the Medline database and the Cochrane Central Register of Controlled Trials for this purpose and 10 studies meeting our inclusion criteria were identified. In total, 650 cervical spondylosis myelopathy patients with (+) or without (-) intramedullary signal changes on their T2-weighted images were examined. Weighted mean differences and 95g% confidence intervals were used to summarize the data. Patients with focal and faint border changes in the intramedullary signal on T2 magnetic resonance imaging had similar Japanese Orthopaedic Association recovery ratios as those with no signal changes on the magnetic resonance imaging images of the spinal cord did. The surgical outcomes were poorer in the patients with both T2 intramedullary signal changes, especially when the signal changes were multisegmental and had a well-defined border and T1 intramedullary signal changes compared with those without intramedullary signal changes. Preoperative magnetic resonance imaging including T1 and T2 imaging can thus be used to predict postoperative recovery in cervical spondylosis myelopathy patients.


Assuntos
Humanos , Imagem por Ressonância Magnética/métodos , Doenças da Medula Espinal/patologia , Espondilose/patologia , Período Pós-Operatório , Valor Preditivo dos Testes , Prognóstico , Cuidados Pré-Operatórios/métodos , Recuperação de Função Fisiológica , Doenças da Medula Espinal/reabilitação , Doenças da Medula Espinal/cirurgia , Espondilose/reabilitação , Espondilose/cirurgia
17.
Zhen Ci Yan Jiu ; 41(3): 225-9, 2016 Jun 25.
Artigo em Chinês | MEDLINE | ID: mdl-29071910

RESUMO

OBJECTIVE: To observe the effect of electroacupuncture (EA) intervention on pain thresholds (PT) and contents of ß-endorphin (EP) in the hypothalamus and spinal cord, and the expression of 5-HT in the dorsal raphe nucleus(DRN)in rats with pelmatic incisional pain, so as to investigate the underlying mechanisms of acupuncture in reducing post-operative pain. METHODS: Wistar rats were randomized into normal control, model, EA and non-acupoint groups (n=8/group). The pelmatic pain model was induced by making an incision (about 1 cm in length, to the fascia and muscle layers) from the heel towards the toes. EA (2 Hz, 1.5-2 V) was applied to "Zusanli" (ST 36) and "Kunlun" (BL 60) or non-acupoint (about 3 mm beside the ST 36 and BL 60) on the affected side for 20 min, once daily for three days. The thermal PT and mechanical PT were measured before and after operation and after EA. The contents of ß-EP in hypothalamus and L3-S4 spinal cord were detected using enzyme linked immunosorbent assay (ELISA) and the expressions of ß-EP in hypothalamus and 5-HT in DRN were measured with immunohistochemistry. RESULTS: After EA intervention, the markedly decreased mechanical and thermal pain thresholds on day 1 and 3 after paw incision were significantly increased in the EA group (P<0.05), but not in the non-acupoint group (P>0.05). The hypothalamic ß-EP content was significantly higher in the model group than in the normal group (P<0.05), and further up-regulated in the EA group (not the non-acupoint group) than in the model group (P<0.05). In addition, the hypothalamic ß-EP immunoreactive (IR)-positive cell number and 5-HT immunoactivity level in DRN were also considerably up-regulated in the EA group (P<0.05) but not in the non-acupoint group (P>0.05). No significant changes were found in the lumbar spinal ß-EP contents in the model, EA and non-acupoint groups (P>0.05). CONCLUSIONS: EA stimulation of "Zusanli"(ST 36) and "Kunlun" (BL 60) has an analgesic effect in pelmatic incision pain rats, which may be related to its effects in raising the level of hypothalamic ß-EP and the expression of 5-HT in DRN.


Assuntos
Eletroacupuntura , Hipotálamo/química , Medula Espinal/química , Ferida Cirúrgica/terapia , beta-Endorfina/análise , Pontos de Acupuntura , Animais , Núcleo Dorsal da Rafe/química , Manejo da Dor , Ratos , Ratos Sprague-Dawley , Ratos Wistar , Serotonina/análise
18.
J Neurosurg Spine ; 23(4): 505-9, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26161517

RESUMO

OBJECT: The aim of the present study was to retrospectively evaluate progressive correction of coronal and sagittal alignment and pelvic parameters in patients treated with a Chêneau brace. METHODS: Thirty-two patients with adolescent idiopathic scoliosis (AIS) were assessed before initiation of bracing treatment and at the final follow-up. Each patient underwent radiological examinations, and coronal, sagittal, and pelvic parameters were measured. RESULTS: No statistically significant modification of the Cobb angle was noted. The pelvic incidence remained unchanged in 59% of the cases and increased in 28% of the cases. The sacral slope decreased in 34% of the cases but remained unchanged in 50%. Thoracic kyphosis and lumbar lordosis were significantly decreased, whereas the sagittal vertical axis was significantly increased from a mean of -44.0 to -30.2 mm (p = 0.02). The mean pelvic tilt increased significantly from 4.5° to 8.3° (p = 0.002). CONCLUSIONS: The Chêneau brace can be useful for preventing curvature progression in patients with AIS. However, the results of this study reveal high variability in the effect of brace treatment on sagittal and pelvic alignment. Treatment with the Chêneau brace may also influence sagittal global balance.


Assuntos
Braquetes , Escoliose/terapia , Adolescente , Feminino , Humanos , Masculino , Radiografia , Estudos Retrospectivos , Escoliose/diagnóstico por imagem , Resultado do Tratamento
19.
J Neurosurg Pediatr ; 15(5): 475-9, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-25658249

RESUMO

OBJECT: The goal of this study was to evaluate the feasibility of the C-1 posterior arch crossing screw fixation technique in the pediatric age group. METHODS: One hundred twenty-three pediatric patients were divided into 6 age groups. Computed tomography morphometric analysis of the C-1 posterior arch was performed. Measurements included height, width, and length. Statistical analysis was performed using the Student t-test and linear regression analysis. RESULTS: The mean measurement of the posterior arch was height (6.35 ± 1.80 mm), width (Width 1: 4.48 ± 1.25 mm; Width 2: 4.42 ± 0.68 mm; Width 3: 4.42 ± 0.50 mm), and length (14.48 ± 1.67 mm). Seven (6.93%) of the 101 children in Groups 1-4 and 13 (59.1%) of the 22 children in Groups 5 and 6 could safely accommodate placement of C-1 posterior arch crossing screws. CONCLUSIONS: This investigation found that a C-1 posterior arch crossing screw was feasible in this group of Chinese pediatric patients, particularly in those 13 years and older. Preoperative thin-cut CT is essential for identifying children in whom this technique is applicable and for planning screw placement.


Assuntos
Parafusos Ósseos , Vértebras Cervicais/cirurgia , Fusão Vertebral/métodos , Tomografia Computadorizada por Raios X , Adolescente , Grupo com Ancestrais do Continente Asiático , Criança , Pré-Escolar , China , Estudos de Viabilidade , Feminino , Humanos , Masculino
20.
Zhonghua Zheng Xing Wai Ke Za Zhi ; 30(3): 215-9, 2014 May.
Artigo em Chinês | MEDLINE | ID: mdl-25112015

RESUMO

OBJECTIVE: To investigate the vascular supply of intrinsic muscles of foot and anatomic basis for muscular flap design. METHODS: A radiopaque injectate (lead oxide-gelatin mixtures, 26 ml/kg) was injected into 10 fresh cadavers. The dissected regions were photographed and each intrinsic muscles on the foot was removed and radiographed. The number, type, diameter of vascular branches of muscles and their distributions were observed. The area of the vascular territory supplied by each source vessel was calculated using Scion Image for Windows software. RESULTS: There were significant architectural differences among the intrinsic muscles. The muscles length varied from 22.5mm to 116.2mm [average, (66.1 +/- 23.2)mm]. The measured fiber length were relatively consistent, ranging from 14.2 mm to 27.5 mm [average, (20.2 +/- 4.5)mm]. There are 63 vascular branches into the 23 foot muscles, each muscle having average branches of 3.2 +/- 0.8. The average diameter of branches, the length and width of each vascular territorial area is (0.8 +/- 0.3) mm, (2.2 +/- 0.8) cm, and (0.9 +/- 0.4) cm, respectively. Other findings included that some muscles were not present in some cadavers. CONCLUSIONS: The blood supply of intrinsic muscles of foot is abundant with different diameter and distributions of branches. There is an anatomic basis for muscular or musculoosseous flap design. There are 7 intrinsic muscles with large and reliable vascular supply which can be chosen as muscular flaps.


Assuntos
Pé/irrigação sanguínea , Músculo Esquelético/irrigação sanguínea , Retalhos Cirúrgicos , Adulto , Humanos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA