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1.
Chem Commun (Camb) ; 2019 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-31482882

RESUMO

A nitrogen-thermal approach via the reaction between transition metal species and N dopants affords us the ability to optimize the tradeoff between the number of exposed transition metal/carbon (exemplified by cobalt in this work) boundaries and the most pronounced interfacial rectifying contact to achieve the highly efficient and selective hydrogenation and dehydrogenation of N-heterocycle compounds in a reversible manner.

2.
Int J Biol Macromol ; 141: 460-475, 2019 Aug 29.
Artigo em Inglês | MEDLINE | ID: mdl-31473318

RESUMO

Based on the concept of endophytic fungus, if endophytic fungus can produce the same or similar product as the host plant, which will get rid of the restrictions of farmland, seasonal and pest, the active product could be sustainably obtained. In this study, an endophytic fungus polysaccharide FP showing the similar structure with the host Dendrobium officinale polysaccharide (DOP) was sustainably and cost-effectively obtained under preferred reaction conditions with different C/N ratio. The FP with high yield up to 2.77 ±â€¯0.51 g/L showed same monosaccharide composition with DOP as well as some host-plant-associated polysaccharides in published literatures. The main chain of FP was composed by →3,6)-ß-L-Man-(1→, α-D-Glc-(1→, →4)-α-D-Glc-(1→, →3,6)-ß-D-Gal-(1→, and →6)-ß-D-Gal-(1→, while the side chain was α-D-Glc-(1→. Meanwhile, FP was confirmed as a safe polysaccharide with good antioxidant, antiglycation and immunomodulatory activities. Furthermore, TLR2 and TLR4 were confirmed as the membrane receptors of FP on RAW264.7 cells.

3.
Artigo em Inglês | MEDLINE | ID: mdl-31476275

RESUMO

Operando insight into the catalytic kinetics under working conditions is important for further rationalizing the design of advanced catalysts toward efficient renewable energy applications. Here, we enable a ubiquitous carbon material as an efficient acidic oxygen evolution reaction (OER) electrocatalyst, synthesized via a facile and controllable "amino-assisted polymerization and carbonization" strategy. This as-developed metal-free amino-rich hierarchical-network carbon (amino-HNC) framework directly supported on carbon paper can catalyze OER at a quite low overpotential of 281 mV and a small Tafel slope of 96 mV dec-1 in an acid solution, and maintain ∼98% of its initial catalytic activity after 100 h oxygen evolution operation. By using the operando synchrotron infrared spectroscopy, a crucial structurally evolved H2N-(*O-C)-C, formed by adsorbing the *O intermediate on the active H2N-C═C moiety, is observed on amino-HNC electrocatalysts during the OER process in the acid medium. Furthermore, theoretical calculations reveal that the optimization of the sp2 electronic structure of C═C by amino radicals could effectively lower the kinetic formation barrier of the *O intermediate on the H2N-C═C moiety, contributing to a prominent acidic oxygen-involved catalysis.

4.
Sci Rep ; 9(1): 13059, 2019 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-31506462

RESUMO

With the trend of amplified warming in the Arctic, we examine the observed and modeled top-of-atmosphere (TOA) radiative responses to surface air-temperature changes over the Arctic by using TOA energy fluxes from NASA's CERES observations and those from twelve climate models in CMIP5. Considerable inter-model spreads in the radiative responses suggest that future Arctic warming may be determined by the compensation between the radiative imbalance and poleward energy transport (mainly via transient eddy activities). The poleward energy transport tends to prevent excessive Arctic warming: the transient eddy activities are weakened because of the reduced meridional temperature gradient under polar amplification. However, the models that predict rapid Arctic warming do not realistically simulate the compensation effect. This role of energy compensation in future Arctic warming is found only when the inter-model differences in cloud radiative effects are considered. Thus, the dynamical response can act as a buffer to prevent excessive Arctic warming against the radiative response of 0.11 W m-2 K-1 as measured from satellites, which helps the Arctic climate system retain an Arctic climate sensitivity of 4.61 K. Therefore, if quantitative analyses of the observations identify contribution of atmospheric dynamics and cloud effects to radiative imbalance, the satellite-measured radiative response will be a crucial indicator of future Arctic warming.

5.
BMC Surg ; 19(1): 117, 2019 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-31438918

RESUMO

BACKGROUND: In theory, proximal gastrectomy with double-tract reconstruction (PG-DT) was superior to total gastrectomy (TG) in hematologic and nutritional outcomes. However, its clinical effects in proximal early gastric cancer (EGC) have been controversial. METHODS: The purpose of this study was to investigate the outcomes of laparoscopic proximal gastrectomy with double-tract reconstruction (LPG-DT) for proximal EGC. For this systematic review and meta-analysis, we searched for articles published before December of 2018 in the following databases: PubMed, Web of Science, EBSCO, Medline, and Cochrane Library. RESULTS: The results showed no significant difference in the anastomotic stenosis (OR = 0.91, 95%CI = 0.33-2.50, p = 0.85) and reflux esophagitis (OR = 1.87, 95%CI = 0.62-5.65, p = 0.27) between LPG-DT and laparoscopic total gastrectomy (LTG). The vitamin B12 supplementation rate in the LPG-DT group was lower than the LTG group (OR = 0.06, 95%Cl = 0.01-0.59, p = 0.02). CONCLUSIONS: Due to comparable clinical effect, PG-DT is comparable to TG for patients with proximal EGC. In addition, LPG-DT not only appears superior to TG in terms of preventing vitamin B12 deficiency, but also does not increase the risk of anastomotic stricture and reflux esophagitis.

7.
Molecules ; 24(16)2019 Aug 09.
Artigo em Inglês | MEDLINE | ID: mdl-31395821

RESUMO

Protein tyrosine phosphatase 1B (PTP1B) plays a specific role as a negative regulator of insulin signaling pathways and is a validated therapeutic target for Type 2 diabetes. Previously, arylbenzofurans were reported to have inhibitory activity against PTP1B. However, detailed investigation regarding their structure activity relationship (SAR) has not been elucidated. The main aim of this work was to investigate the PTP1B inhibitory activity of 2-arylbenzofuran analogs (sanggenofuran A (SA), mulberrofuran D2 (MD2), mulberrofuran D (MD), morusalfuran B (MB), mulberrofuran H (MH)) isolated from the root bark of Morus alba. All compounds demonstrated potent inhibitory activity with IC50 values ranging from 3.11 to 53.47 µM. Among the tested compounds, MD2 showed the strongest activity (IC50, 3.11 µM), followed by MD and MB, while SA and MH demonstrated the lowest activity. Lineweaver-Burk and Dixon plots were used for the determination of inhibition type whereas ligand and receptor interactions were investigated in modeled complexes via molecular docking. Our study clearly supports 2-arylbenzofuran analogs as a promising class of PTP1B inhibitors and illustrates the key positions responsible for the inhibitory activity, their correlation, the effect of prenyl/geranyl groups, and the influence of resorcinol scaffold, which can be further explored in-depth to develop therapeutic agents against T2DM.

8.
Comput Biol Chem ; 83: 107101, 2019 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-31442708

RESUMO

Lupane-type triterpenoids have shown a potential effect against neurodegenerative disorders. Alzheimer's disease, one of the common neurodegenerative disease, is evident by the accumulation of amyloid-beta (Aß) plaque in the extracellular regions of the brain. ß-site amyloid precursor protein cleaving enzyme 1 (BACE1) is a key enzyme for the Aß formation viathe cleavage of amyloid precursor protein (APP). Therefore, to find the potent BACE1 inhibitors and furthermore to explore the role of the functional group responsible for the strong BACE1 inhibitory activity, we synthesized a series of triterpenoids with lupane skeleton starting from the natural compounds calenduladiol and lupeol. Compound 1 revealed a potent competitive BACE1 inhibitory activity (IC50 = 16.77 ±â€¯1.16 µM; Ki = 19.38). Furthermore, the molecular docking simulation revealed the importance of Tyr198 residue along with the other hydrophobic interactions for the strong affinity of 1‒BACE1 complex. To sum up, our results demonstrated the importance of carbonyl moiety at 3 and 16 position of lupane-type triterpenoid over the hydroxyl group at the same position.

9.
Artigo em Inglês | MEDLINE | ID: mdl-31370266

RESUMO

Anxiety, although as common and arguably as debilitating as depression, has garnered less attention, and is often undetected and undertreated in the general population. Similarly, anxiety among medical students warrants greater attention due to its significant implications. We aimed to study the global prevalence of anxiety among medical students and the associated factors predisposing medical students to anxiety. In February 2019, we carried out a systematic search for cross-sectional studies that examined the prevalence of anxiety among medical students. We computed the aggregate prevalence and pooled odds ratio (OR) using the random-effects model and used meta-regression analyses to explore the sources of heterogeneity. We pooled and analyzed data from sixty-nine studies comprising 40,348 medical students. The global prevalence rate of anxiety among medical students was 33.8% (95% Confidence Interval: 29.2-38.7%). Anxiety was most prevalent among medical students from the Middle East and Asia. Subgroup analyses by gender and year of study found no statistically significant differences in the prevalence of anxiety. About one in three medical students globally have anxiety-a prevalence rate which is substantially higher than the general population. Administrators and leaders of medical schools should take the lead in destigmatizing mental illnesses and promoting help-seeking behaviors when students are stressed and anxious. Further research is needed to identify risk factors of anxiety unique to medical students.

10.
Chem Biol Interact ; 310: 108757, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31323226

RESUMO

Fucoxanthin and fucosterol are archetypal lipid components of edible brown algae that provide several health benefits. Lately, their protective role in Aß1-42-induced cognitive dysfunction in animal models has been reported (Alghazwi et al., 2019; Oh et al., 2018). However, their role in the aminergic system and as a prime treatment approach for multifactorial neurodegenerative diseases still requires exploration. The main aims of the present study are to characterize the role of fucoxanthin and fucosterol in the aminergic pathway via in vitro human monoamine oxidase (hMAO) inhibition and cell-based functional G-protein coupled receptor (GPCR) assays and to underline their possible mechanisms of action via in silico molecular docking studies. Fucoxanthin displayed weak inhibition with IC50 values of 197.41 ±â€¯2.20 and 211.12 ±â€¯1.17 µM over two isoenzymes hMAO-A and hMAO-B, respectively. Fucosterol remained inactive up to 500 µM. In functional assay results, fucoxanthin showed a concentration-dependent agonist effect on dopamine D3 and D4 receptors. The half maximal effective concentration (EC50) of fucoxanthin for dopamine D3 and D4 receptors was 16.87 ±â€¯3.41 and 81.87 ±â€¯6.11 µM, respectively. For dopamine as a reference agonist, the EC50 values for these two receptors were 3.7 and 24 nM, respectively. Fucosterol showed no agonist activity on any of the tested receptors. Similarly, fucoxanthin showed a mild antagonist effect on dopamine D1 and tachykinin (NK1) receptor with inhibition of control agonist response by approximately 40% at 100 µM. Fucosterol displayed mild antagonist effects only on dopamine D1 and D4 receptors. In silico studies revealed potential mechanisms by which fucoxanthin binds to dopamine receptors to exert its agonist effects, including low binding energy and H-bond interactions with Ser196 and Thr115 at the D3 receptor and with Ser196 and Asp115 at the D4 receptor. Our results collectively suggest that fucoxanthin is a potential D3/D4 agonist for the management of neurodegenerative diseases, such as Parkinson's disease.


Assuntos
Doença de Parkinson/tratamento farmacológico , Receptores de Dopamina D3/agonistas , Receptores de Dopamina D4/agonistas , Xantofilas/farmacologia , Sítios de Ligação , Aminas Biogênicas , Humanos , Simulação de Acoplamento Molecular , Doenças Neurodegenerativas/tratamento farmacológico , Neurotransmissores , Feófitas/química , Ligação Proteica , Xantofilas/uso terapêutico
11.
J Am Geriatr Soc ; 2019 Jul 23.
Artigo em Inglês | MEDLINE | ID: mdl-31335969

RESUMO

OBJECTIVES: Whether early medication reconciliation and integration can reduce polypharmacy and potentially inappropriate medication (PIM) in the emergency department (ED) remains unclear. Polypharmacy and PIM have been recognized as significant causes of adverse drug events in older adults. Therefore, this pilot study was conducted to delineate this issue. DESIGN: An interventional study. SETTING: A medical center in Taiwan. PARTICIPANTS: Older ED patients (aged ≥65 years) awaiting hospitalization between December 1, 2017, and October 31, 2018 were recruited in this study. A multidisciplinary team and a computer-based and pharmacist-assisted medication reconciliation and integration system were implemented. MEASUREMENTS: The reduced proportions of major polypharmacy (≥10 medications) and PIM at hospital discharge were compared with those on admission to the ED between pre- and post-intervention periods. RESULTS: A total of 911 patients (pre-intervention = 243 vs post-intervention = 668) were recruited. The proportions of major polypharmacy and PIM were lower in the post-intervention than in the pre-intervention period (-79.4% vs -65.3%; P < .001, and - 67.5% vs -49.1%; P < .001, respectively). The number of medications was reduced from 12.5 ± 2.7 to 6.9 ± 3.0 in the post-intervention period in patients with major polypharmacy (P < .001). CONCLUSION: Early initiation of computer-based and pharmacist-assisted intervention in the ED for reducing major polypharmacy and PIM is a promising method for improving geriatric care and reducing medical expenditures.

12.
Eur J Cancer Care (Engl) ; : e13118, 2019 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-31184794

RESUMO

OBJECTIVE: This meta-analysis was performed to assess the efficacy of cryotherapy and nail solution (NS) use in preventing nail toxicity (NT) induced by taxane-based chemotherapy. METHODS: PubMed, EMBASE, Cochrane Library and ClinicalTrials.gov registry databases were searched for relevant studies published up to December 2018. The primary outcome was taxane-induced NT. Secondary outcomes were skin toxicity (ST), time to toxicity and patient comfort. RESULTS: We reviewed three randomised control trials and six prospective studies with 708 patients. For meta-analysis, taxane-induced NT grading was compared. NT and ST were significantly lower in the cryotherapy patients than in the controls (grade 1 NT: risk ratio [RR] = 0.51, 95% confidence interval [CI] = 0.30-0.89; grade 2-3 NT: RR = 0.36, 95% CI = 0.11-1.12; total NT: RR = 0.49; 95% CI = 0.30-0.79; ST: RR = 0.46, 95% CI = 0.33-0.64). The NS-treated patients exhibited significantly lower NT than the controls. CONCLUSIONS: Nail solution-treated or cryotherapy patients exhibited lower NT incidence and severity associated with taxane-based chemotherapy than the controls. For patients who can afford and comply with NS use or cryotherapy, these measures represent effective prophylactic management for taxane-induced NT and improve their quality of life and functional statuses. Further studies are needed to establish the routine usage protocols, long-term efficacy and safety for these interventions.

13.
BMC Cancer ; 19(1): 559, 2019 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-31182049

RESUMO

BACKGROUND: The future of combined immunotherapy (a PD-1/PD-L1 plus a CTLA-4 antagonist) is very bright. However, besides improving efficacy, combined therapy increases treatment-related adverse events (TRAEs). Also, the clinical application is limited in some solid tumors. METHODS: This paper purports to investigate the TRAEs for the combined immunotherapy aiming for a more appropriate utilization of immune checkpoint inhibitors (ICIs) in clinical practice through a meta-analysis. RESULTS: A total of 17 eligible studies covering 2626 patients were selected for a meta-analysis based on specified inclusion and exclusion criteria. The incidence rates of any grade and grade 3 or higher TRAEs were 88% (95%CI, 84-92%) and 41% (95%CI, 35-47%), respectively. The overall incidence of any grade TRAEs leading to discontinuation of treatment was 20% (95%CI, 16-24%). The incidence rate of treatment related deaths was 4.3‰ (95%CI, 1.4‰-8.4‰). Analysis showed that NIVO1 + IPI3 cohort had higher incidences of grade 3 or higher TRAEs (RR = 1.77, 95%CI, 1.34-2.34, p < 0.0001) and any grade TRAEs leading to discontinuation of treatment (RR = 1.81, 95%CI, 1.08-3.04, P = 0.02), compared with NIVO3 + IPI1 regimen. CONCLUSIONS: The combined therapy had high TRAEs. The TRAEs, especially grade 3 or higher, led to discontinuation of the treatment. Furthermore, the incidence of treatment-related deaths was rare. Moreover, the NIVO3 + IPI1 regimen, regardless of efficacy, is more recommended because of better tolerance and lower adverse events.

14.
J Cell Biochem ; 2019 Jun 12.
Artigo em Inglês | MEDLINE | ID: mdl-31190447

RESUMO

It has been reported that miR-623 is deregulated in lung adenocarcinoma and inhibits tumor growth and invasion. However, it is unclear whether miR-623 has a role in the progression of hepatocellular carcinoma (HCC). Herein, we found that miR-623 was significantly downregulated in HCC, and that its expression was related to poor clinical outcomes of patients with HCC. Upregulation of miR-623 decreased cell proliferation, viability, migration, and invasion and further promoted apoptosis in 7721, Huh7, and Bel-7402 cells. Moreover, we also observed that miR-623 regulated the phosphoinositide 3-kinase/protein kinase B (PI3K/Akt), Wnt/ß-catenin, and extracellular regulated protein kinases/c-Jun N-terminal kinase (ERK/JNK) signaling pathways as well as the expression level of related proteins. Further, X-ray repair cross complementing 5 (XRCC5) was a direct target for miR-623, and the suppression of PI3K/Akt, Wnt/ß-catenin, and ERK/JNK signaling pathways and cell proliferation and invasion abilities caused by miR-623 in HCC cells was significantly reversed by the upregulation of XRCC5. Collectively, our data suggested that miR-623 suppressed the progression of HCC by regulating the PI3K/Akt, Wnt/ß-catenin, and ERK/JNK pathways by targeting XRCC5 in HCC in vitro, indicating that miR-623 may be a target for the therapy of HCC.

15.
Mar Drugs ; 17(6)2019 Jun 18.
Artigo em Inglês | MEDLINE | ID: mdl-31216636

RESUMO

The marine biosphere is a treasure trove of natural bioactive secondary metabolites and the richest source of structurally diverse and unique compounds, such as phlorotannins and halo-compounds, with high therapeutic potential. Eckol is a precursor compound representing the dibenzo-1,4-dioxin class of phlorotannins abundant in the Ecklonia species, which are marine brown algae having a ubiquitous distribution. In search of compounds having biological activity from macro algae during the past three decades, this particular compound has attracted massive attention for its multiple therapeutic properties and health benefits. Although several varieties of marine algae, seaweed, and phlorotannins have already been well scrutinized, eckol deserves a place of its own because of the therapeutic properties it possesses. The relevant information about this particular compound has not yet been collected in one place; therefore, this review focuses on its biological applications, including its potential health benefits and possible applications to restrain diseases leading to good health. The facts compiled in this review could contribute to novel insights into the functions of eckol and potentially enable its use in different uninvestigated fields.

16.
Mar Drugs ; 17(6)2019 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-31238535

RESUMO

Modulation of multiple protein targets with a single compound is essential for the effective treatment of central nervous system disorders. In our previous G protein-coupled receptor (GPCR) cell-based study, a selective human monoamine oxidase (hMAO)-A inhibitor, eckol, stimulated activity of dopamine D3 and D4 receptors. This result led to our interest in marine phlorotannin-mediated modulation of hMAO enzymes and related GPCRs in neuronal disorders. Here, we evaluate the multi-target effects of phloroglucinol, phlorofucofuroeckol-A (PFF-A), and dieckol by screening their modulatory activity against hMAO-A and -B and various neuronal GPCRs. Among the tested phlorotannins, PFF-A showed the strongest inhibitory activity against both hMAO isoforms, with higher selectivity toward hMAO-B than hMAO-A. Enzyme kinetics and docking data revealed that PFF-A noncompetitively acts on hMAOs into the alternative binding pocket of enzymes with allosteric functions. In a functional assay for GPCR screening, dieckol and PFF-A exhibited a multi-target combination of D3R/D4R agonism and D1/5HT1A/NK1 antagonism. In particular, they effectively stimulated D3R and D4R, compared to other GPCRs. Docking analysis confirmed that dieckol and PFF-A successfully docked into the conserved active sites of D3R and D4R and interacted with aspartyl and serine residues in the orthosteric binding pockets of the respective receptors. Based on our experimental and computational data, we established the structure-activity relationship between tested phlorotannins and target proteins, including hMAOs and GPCRs. Our current findings suggest that hMAO inhibitors dieckol and PFF-A, major phlorotannins of edible brown algae with multi-action on GPCRs, are potential agents for treatment of psychological disorders and Parkinson's disease.

17.
Brain ; 142(8): 2238-2252, 2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31203368

RESUMO

Hereditary spastic paraplegias refer to a heterogeneous group of neurodegenerative disorders resulting from degeneration of the corticospinal tract. Clinical characterization of patients with hereditary spastic paraplegias represents progressive spasticity, exaggerated reflexes and muscular weakness. Here, to expand on the increasingly broad pools of previously unknown hereditary spastic paraplegia causative genes and subtypes, we performed whole exome sequencing for six affected and two unaffected individuals from two unrelated Chinese families with an autosomal dominant hereditary spastic paraplegia and lacking mutations in known hereditary spastic paraplegia implicated genes. The exome sequencing revealed two stop-gain mutations, c.247_248insGTGAATTC (p.I83Sfs*11) and c.526G>T (p.E176*), in the ubiquitin-associated protein 1 (UBAP1) gene, which co-segregated with the spastic paraplegia. We also identified two UBAP1 frameshift mutations, c.324_325delCA (p.H108Qfs*10) and c.425_426delAG (p.K143Sfs*15), in two unrelated families from an additional 38 Chinese pedigrees with autosomal dominant hereditary spastic paraplegias and lacking mutations in known causative genes. The primary disease presentation was a pure lower limb predominant spastic paraplegia. In vivo downregulation of Ubap1 in zebrafish causes abnormal organismal morphology, inhibited motor neuron outgrowth, decreased mobility, and shorter lifespan. UBAP1 is incorporated into endosomal sorting complexes required for transport complex I and binds ubiquitin to function in endosome sorting. Patient-derived truncated form(s) of UBAP1 cause aberrant endosome clustering, pronounced endosome enlargement, and cytoplasmic accumulation of ubiquitinated proteins in HeLa cells and wild-type mouse cortical neuron cultures. Biochemical and immunocytochemical experiments in cultured cortical neurons derived from transgenic Ubap1flox mice confirmed that disruption of UBAP1 leads to dysregulation of both early endosome processing and ubiquitinated protein sorting. Strikingly, deletion of Ubap1 promotes neurodegeneration, potentially mediated by apoptosis. Our study provides genetic and biochemical evidence that mutations in UBAP1 can cause pure autosomal dominant spastic paraplegia.

18.
Huan Jing Ke Xue ; 40(5): 2265-2270, 2019 May 08.
Artigo em Chinês | MEDLINE | ID: mdl-31087865

RESUMO

The allelopathic effects of Myriophyllum elatinoides on algal growth were investigated and potential allelochemicals secreted by Myriophyllum elatinoides were analyzed. Myriophyllum elatinoides were co-cultivated with different initial concentrations (105, 106, 107, 108, and 109 ind.·L-1) of Microcystis aeruginosa and Selenastrum capricornutum. The optical density of each group was measured daily. The results showed that 2.5 g·(200 mL)-1 of Myriophyllum elatinoides has significant inhibition effect on Microcystis aeruginosa growth with initial concentrations of 107 ind.·L-1 and 108 ind.·L-1. However, there was no significant inhibition on the growth of Selenastrum capricornutum. Through solvent extraction and GC-MS analysis, hexadecanoic acid was extracted and determined as an allelochemical in Myriophyllum elatinoides. Additionally, three potentially novel allelochemical compounds secreted by Myriophyllum elatinoides were determined as follows:3-ethyl-3-methylheptane, triethyl phosphate and dibutyl phthalate.


Assuntos
Alelopatia , Clorofíceas/crescimento & desenvolvimento , Magnoliopsida/química , Microcystis/crescimento & desenvolvimento , Feromônios/química , Ácido Palmítico , Ácidos Ftálicos
19.
Cephalalgia ; 39(10): 1277-1283, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31067080

RESUMO

BACKGROUND: The diagnostic criteria for headache attributable to cranial venous sinus stenting were first formalized in the recently published third edition of the International Classification of Headache Disorders (ICHD-3). However, the diagnostic criteria for headache caused by cranial venous sinus stenting are based on very few data and the condition is poorly characterized. OBJECTIVES: To validate the diagnostic criteria for cranial venous sinus stenting headache by retrospectively studying the characteristics of headache in patients with isolated pulsatile tinnitus who underwent curative cranial venous sinus stenting and who had not previously complained of headache. PATIENTS AND METHODS: We retrospectively studied clinical, radiological, and manometric data from patients with isolated venous pulsatile tinnitus who had not previously reported headache. All patients underwent lateral sinus stenting in our institution between October 2010 and February 2018. RESULTS: Forty eight patients, 47 females and one male, were enrolled. The mean age at symptom onset was 36.2 ± 8.7 years and the mean body mass index was 24.0 ± 3.2 kg/m2. Lateral sinus stenosis was evident in 47 patients and a sigmoid diverticulum in one. Fourteen patients experienced headaches after recovering from general anesthesia. All were female, with a mean age of 35.5 ± 9.6 years. Headache persisted for less than 3 days in six patients (42.8%); for 3 days to 3 months in four (28.6%); and for longer than 3 months in four (28.6%). The headaches were located on the same sides as the cranial venous sinus stents in 13 patients (92.9%) and were principally occipital, being oppressive in nine patients (64.3%) and of moderate intensity in seven (50%). Age at onset of pulsatile tinnitus and body mass index were significantly associated with headache (p < 0.05; t-test). CONCLUSION: To the best of our knowledge, this is the first study to describe cranial venous sinus stenting headache in detail. We found that de novo headache developed after cranial venous sinus stenting, and was usually mild to moderate, unilateral, but oppressive; almost one-third of such headaches persisted for more than 3 months. Researchers and clinicians must become familiar with this headache spectrum; further prospective studies are required.

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