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1.
Artigo em Inglês | MEDLINE | ID: mdl-33528453

RESUMO

In everyday practice, surgeons have to deal with bone atrophy. These rehabilitations are even more complex in the posterior mandible, and it is still unclear in the literature which fixed rehabilitation option is best. The purpose of this article was to help oral surgeons to choose the proper and updated treatment for their atrophic patients. Posterior mandible bone atrophies were divided into four main groups depending on the bone height measured above the inferior alveolar nerve: (1) ≤ 4 mm; (2) > 4 mm ≤ 5 mm; (3) > 5 mm ≤ 6 mm; (4) > 6 mm < 7 mm. Different approaches were proposed for each group, considering patient expectations. If ≤ 4 mm of bone height was available, guided bone regeneration was used as the adequate approach. For bone heights > 4 mm and ≤ 6 mm, the "sandwich" technique and/or short implants were used, depending on esthetics. In cases with > 6 mm and < 7 mm above the mandibular canal, short implants might be the proper option. The authors' clinical experience and the literature were considered in order to suggest a possible correct treatment decision based on the residual bone height in the posterior mandible.


Assuntos
Aumento do Rebordo Alveolar , Implantes Dentários , Atrofia/patologia , Implantação Dentária Endo-Óssea , Prótese Dentária Fixada por Implante , Humanos , Mandíbula/diagnóstico por imagem , Mandíbula/patologia , Mandíbula/cirurgia , Resultado do Tratamento
2.
Int J Oral Maxillofac Implants ; 36(1): 30-37, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33600520

RESUMO

PURPOSE: This study aimed to assess the survival rate, marginal bone levels, and prosthetic success of short implants when placed in posterior areas of severely reabsorbed mandibles. MATERIALS AND METHODS: A systematic review was performed of all randomized controlled trials with at least 10 patients with a control group where bone augmentations were performed that were published between January 2015 and February 2020. From 77 pertinent studies, 14 full-text publications were studied, and 6 studies fulfilled the inclusion criteria. RESULTS: The implant survival rates of short dental implants ranged from 92% to 96.9% with a follow-up from 1 to 5 years, and the prosthetic success rate ranged from 90% to 100% during the same follow-up. The mean marginal bone level values of involved short implants ranged from -0.51 to -2.30 mm. CONCLUSION: The obtained data showed that short dental implants are a valid therapeutic choice to rehabilitate severe mandibular atrophy in the medium to long term.


Assuntos
Aumento do Rebordo Alveolar , Implantes Dentários , Atrofia/patologia , Implantação Dentária Endo-Óssea , Planejamento de Prótese Dentária , Prótese Dentária Fixada por Implante , Falha de Restauração Dentária , Humanos , Mandíbula/patologia , Mandíbula/cirurgia , Resultado do Tratamento
3.
Arq Bras Oftalmol ; 84(1): 78-82, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33470346

RESUMO

This report is of three cases of sicca syndrome, initially suspected to be Sjögren's syndrome, which was ruled out by clinical and laboratory investigations. The patients were a 24-year-old woman, a 32-year-old man, and a 77-year-old woman with chronic symptoms of sicca syndrome, including dry eye syndrome. The first case was associated with the use of isotretinoin, a retinoic acid. The second was associated with the use of anabolic androgenic steroids, and the third was related to a prolactin- secreting pituitary adenoma. All cases manifested sicca, including dry eye syndrome, after those events, and the manifestations persisted. Magnetic resonance imaging revealed bilateral atrophy of the lacrimal gland. The medical history, ocular examinations, laboratory exams, and magnetic resonance images confirmed dry eye syndrome; however, the exams were all negative for Sjögren's syndrome. The lacrimal gland was absent on magnetic resonance imaging in all three cases. The clinical history revealed that the signs and symptoms appeared after chronic exposure to retinoic acid, anabolic androgenic steroids, and a prolactin-secreting pituitary adenoma, respectively. Chronic isotretinoin, anabolic androgenic steroids, and prolactin-secreting pituitary adenoma or, in this last case, its inhibitory treatment, can cause lacrimal gland atrophy, sicca syndrome, and dry eye syndrome, and a differential diagnosis of Sjögren's syndrome. Further studies on doses, time, and other susceptibilities to the long-lasting adverse effects of retinoic acid, anabolic androgenic steroids, and the repercussions of prolactin-secreting pituitary adenoma are necessary to confirm and expand upon these associations.


Assuntos
Síndromes do Olho Seco , Aparelho Lacrimal , Síndrome de Sjogren , Adulto , Idoso , Androgênios , Atrofia , Diagnóstico Diferencial , Síndromes do Olho Seco/induzido quimicamente , Síndromes do Olho Seco/diagnóstico , Síndromes do Olho Seco/patologia , Feminino , Humanos , Isotretinoína/efeitos adversos , Aparelho Lacrimal/diagnóstico por imagem , Aparelho Lacrimal/patologia , Masculino , Prolactina , Síndrome de Sjogren/induzido quimicamente , Síndrome de Sjogren/diagnóstico , Síndrome de Sjogren/patologia , Adulto Jovem
4.
Lakartidningen ; 1182021 01 21.
Artigo em Sueco | MEDLINE | ID: mdl-33491762

RESUMO

Posterior cortical atrophy (PCA) is a neurodegenerative disease which was described originally in 1988 by dr Frank Benson. PCA is characterized by progressive deficits in higher visual functions while episodic memory and speech are relatively preserved. Studies have shown that the neuropathologic findings in most cases are consistent with Alzheimer's disease (AD). However, patients with PCA show greater occipitoparietal atrophy on neuroimaging compared with the more prominent mesiotemporal atrophy in patients with amnestic AD. Until recently, diagnostics were based mainly on clinical experience due to the lack of validated diagnostic criteria. In 2017, new consensus criteria for the diagnosis and classification of PCA were published. In this article we make a brief review of the disease and describe a 58 year old man with complex visual deficits and apraxia who was ultimately diagnosed with PCA.


Assuntos
Doença de Alzheimer , Doenças Neurodegenerativas , Doença de Alzheimer/diagnóstico , Doença de Alzheimer/diagnóstico por imagem , Atrofia/patologia , Córtex Cerebral/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Neurodegenerativas/diagnóstico , Doenças Neurodegenerativas/diagnóstico por imagem
5.
Clin Imaging ; 69: 238-242, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32977196

RESUMO

PURPOSE: The present study was carried out to investigate any possible linkage between cerebral grey matter volumetric, iron changes, white matter's lesions load and serum iron levels in a group of relapsing-remitting multiple sclerosis (RRMS) patients. MATERIALS AND METHODS: Sixty-five RRMS patients along with thirty-four age-matched healthy controls (HCs) were recruited. Serum samples were isolated from blood samples which were collected in vacutainer plain tubes individually from both groups. Both groups were scanned at 1.5 T magnetic resonance imaging (MRI) using the following 3D sequences; T1-weighted gradient echo (MPRAGE), T2*-weighted gradient echo and T2-weighted fluid-attenuated inversion recovery (FLAIR). RESULTS: Significant differences were observed between the RRMS patients and HCs for cortical and deep grey matter (dGM) volumes where cortical and dGM volumes in RRMS patient were significantly smaller than those in HCs. While iron deposition in the cortex, putamen (PT) and globus pallidus (GP) of RRMS patients were significantly higher than those of HCs, iron levels in thalamus (TH) and serum were significantly lower in RRMS compared to those in HCs. Except for T2 lesion load, none of volumetric measures showed any association with patients' disability status. Cerebral grey matter's iron changes did not show any association with those of serum. CONCLUSION: Smaller cortical and subcortical grey matter volumes in RRMS patients compared to HCs were detected. None of the volumetric measures showed any association with patients' disability status. RRMS patients showed increased iron levels in the PT, GP and cortex and decreased levels in the TH and serum.


Assuntos
Esclerose Múltipla Recidivante-Remitente , Esclerose Múltipla , Atrofia/patologia , Substância Cinzenta/diagnóstico por imagem , Substância Cinzenta/patologia , Humanos , Ferro , Imagem por Ressonância Magnética , Esclerose Múltipla/patologia , Esclerose Múltipla Recidivante-Remitente/diagnóstico por imagem
6.
Maturitas ; 143: 89-95, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33308642

RESUMO

OBJECTIVE: The objective of this study was to present an updated picture of the knowledge and attitudes of Italian gynecologists with regard to the genitourinary syndrome of menopause (GSM). STUDY DESIGN: An anonymous survey was sent via electronic mail to 3892 gynecologists. The survey consisted of 32 multiple-choice questions divided into four different areas: 1. general demographics of the respondents; 2. knowledge of GSM; 3. most frequently prescribed therapies; and 4. perception of patient compliance and satisfaction with current therapeutic options. MAIN OUTCOME MEASURES: Knowledge of vulvo-vaginal atrophy (VVA) and attitudes of the gynecologists to its management. RESULTS: Three hundred and seventy-four out of 3892 invited Italian gynecologists replied to the survey (response rate 9.7 %). Most (84 %) had a good knowledge of GSM and 74 % reported that they investigated it during clinic visits, but most of them underestimated its prevalence. The most frequently prescribed treatment was topical hormonal therapy (60 %), followed by vaginal moisturizers and lubricants (16 %), ospemifene (12 %) and systemic hormone therapy (12 %). According to the clinical experience of respondents, the most effective therapy is local hormonal therapy (36 %), followed by ospemifene (30 %). According to respondents, less than 50 % of patients continue therapy after 12 months, due to the discomfort in vaginal application, the cost of oral therapies and the fear of possible side-effects. CONCLUSIONS: With the limitation of the low response rate, this study suggests that although Italian gynecologists who answered the survey had some knowledge of GSM, they underestimated its prevalence, did not know its most bothersome symptoms and had inadequate knowledge of the efficacy of treatments, patient compliance and satisfaction.


Assuntos
Competência Clínica , Doenças Urogenitais Femininas , Ginecologia , Menopausa , Médicos , Atrofia , Atitude do Pessoal de Saúde , Feminino , Humanos , Itália , Masculino , Inquéritos e Questionários , Síndrome , Vagina/patologia , Vulva/patologia
7.
Support Care Cancer ; 29(1): 311-322, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32358778

RESUMO

PURPOSE: To assess the feasibility and efficacy of a non-hormonal hyaluronic acid (HLA) vaginal gel in improving vulvovaginal estrogen-deprivation symptoms in postmenopausal women with a history of hormone receptor-positive (HR+) cancer. METHODS: For this single-arm, prospective longitudinal trial, we identified disease-free patients with a history of HR+ breast cancer treated with aromatase inhibitors or HR+ endometrial cancer treated with surgery and postoperative radiation. Participants used HLA daily for the first 2 weeks, and then 3×/week until weeks 12-14; dosage was then increased to 5×/week for non-responders. Vulvovaginal symptoms and pH were assessed at 4 time points (baseline [T1], 4-6 weeks [T2], 12-14 weeks [T3], 22-24 weeks [T4]) with clinical evaluation, the Vaginal Assessment Scale (VAS), Vulvar Assessment Scale (VuAS), Female Sexual Function Index (FSFI), and Menopausal Symptom Checklist (MSCL). RESULTS: Of 101 patients, mean age was 55 years (range, 31-78), 68% (n = 69) were partnered, and 60% (n = 61) were sexually active. In linear mixed models, VAS/VuAS scores significantly improved at all assessment points (all p < 0.001). MSCL scores similarly improved (all p < 0.001). FSFI scores significantly improved from T1 to T2 (p < 0.03), T3 (p < 0.001), and T4 (p < 0.001). Severe vaginal pH (> 6.5) decreased from 26% at T1 to 19% at T4 (p = 0.18). CONCLUSIONS: HLA moisturization improved vulvovaginal health/sexual function of cancer survivors. While HLA administration 1-2×/week is recommended for women in natural menopause, a 3-5×/week schedule appears to be more effective for symptom relief in cancer survivors.


Assuntos
Inibidores da Aromatase/uso terapêutico , Sobreviventes de Câncer , Ácido Hialurônico/uso terapêutico , Vagina/patologia , Doenças Vaginais/tratamento farmacológico , Vulva/patologia , Adulto , Idoso , Atrofia , Neoplasias da Mama/patologia , Neoplasias da Mama/terapia , Neoplasias do Endométrio/patologia , Neoplasias do Endométrio/terapia , Feminino , Humanos , Estudos Longitudinais , Pessoa de Meia-Idade , Pós-Menopausa/fisiologia , Estudos Prospectivos , Cremes, Espumas e Géis Vaginais/uso terapêutico
9.
PLoS Pathog ; 16(12): e1008686, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33370399

RESUMO

Helicobacter pylori chronically infects the stomach of approximately half of the world's population. Manifestation of clinical diseases associated with H. pylori infection, including cancer, is driven by strain properties and host responses; and as chronic infection persists, both are subject to change. Previous studies have documented frequent and extensive within-host bacterial genetic variation. To define how within-host diversity contributes to phenotypes related to H. pylori pathogenesis, this project leverages a collection of 39 clinical isolates acquired prospectively from a single subject at two time points and from multiple gastric sites. During the six years separating collection of these isolates, this individual, initially harboring a duodenal ulcer, progressed to gastric atrophy and concomitant loss of acid secretion. Whole genome sequence analysis identified 1,767 unique single nucleotide polymorphisms (SNPs) across isolates and a nucleotide substitution rate of 1.3x10-4 substitutions/site/year. Gene ontology analysis identified cell envelope genes among the genes with excess accumulation of nonsynonymous SNPs (nSNPs). A maximum likelihood tree based on genetic similarity clusters isolates from each time point separately. Within time points, there is segregation of subgroups with phenotypic differences in bacterial morphology, ability to induce inflammatory cytokines, and mouse colonization. Higher inflammatory cytokine induction in recent isolates maps to shared polymorphisms in the Cag PAI protein, CagY, while rod morphology in a subgroup of recent isolates mapped to eight mutations in three distinct helical cell shape determining (csd) genes. The presence of subgroups with unique genetic and phenotypic properties suggest complex selective forces and multiple niches within the stomach during chronic infection.


Assuntos
Úlcera Duodenal/microbiologia , Infecções por Helicobacter/complicações , Infecções por Helicobacter/genética , Helicobacter pylori/genética , Gastropatias/microbiologia , Animais , Atrofia/microbiologia , Doença Crônica , Ácido Gástrico , Humanos , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Pessoa de Meia-Idade , Fenótipo , Polimorfismo de Nucleotídeo Único , Gastropatias/patologia
10.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 55(11): 871-877, 2020 Nov 09.
Artigo em Chinês | MEDLINE | ID: mdl-33171561

RESUMO

Objective: To investigate the feasibility of two-stage crestal approach sinus elevation in severe atrophic maxilla. Methods: A total of 25 patients (male: 13 cases,female: 12 cases) who attended Department of Implant Center, Stomatological Hospital, Southern Medical University from May 2016 to May 2018 were included in this study. The age of the patients was 32-49 years old. The inclusion criteria were: single or multiple tooth loss in posterior maxilla with residual bone height ranged from 1.5 to 3.0 mm and vertical bone width≥6 mm, no pathological changes or septum were detected in the sinus. The elevated sides were divided into three groups according to different buccal-palatal sinus width (SW): wide (16 case, SW>15 mm), normal (12 case, 12 mm≤SW≤15 mm), narrow (5 case, SW<12 mm). Finally, 23 patients with 33 implants were placed by the two-stage crestal approach for sinus elevation. Six months after implant placement, final restorations were delivered. Implant survival rate, implant stability quotient (ISQ), immediate vertical bone height (VBH) after surgeries, changes of sinus elevation height (cSEH), marginal bone loss (MBL) at 1 year follow-up were examined. Results: Twenty-three patients were finally included in the study, including 12 males and 11 females, aged (41.2±7.6) years old. All implants healed uneventfully. ISQ (wide: 50.81±2.69; normal: 60.58±2.54; narrow: 63.12±3.58), immediate VBH after 1st surgery [wide: (7.99±1.13) mm; normal: (8.95±0.81) mm; narrow: (9.18±0.90) mm] and 2nd surgery [wide: (11.46±0.88) mm; normal: (12.77±0.49) mm; narrow: (12.57±0.55) mm], cSEH six months after 1st [wide: (3.87±0.43) mm; normal: (2.01±0.65) mm; narrow: (1.49±0.33) mm] and 2nd [wide: (1.16±0.29) mm; normal: (1.04±0.33) mm ; narrow: (0.97±0.41) mm] surgery, MBL [wide: (0.91±0.05) mm; normal: (0.79±0.10) mm; narrow: (0.74±0.07) mm] were significantly different among three groups (P<0.05). In all the three groups, cSEH was barely detected at 1-year follow-up (P>0.05). Conclusions: Two-stage crestal approach for sinus elevation might be an alternative protocol in severe atrophic posterior maxilla, especially in cases with narrow and normal buccal-palatal width. There is an urgent need for long time follow-up and more clinical cases.


Assuntos
Implantes Dentários , Levantamento do Assoalho do Seio Maxilar , Adulto , Atrofia , Implantação Dentária Endo-Óssea , Feminino , Humanos , Masculino , Maxila/cirurgia , Seio Maxilar/cirurgia , Pessoa de Meia-Idade , Resultado do Tratamento
11.
Zhonghua Yi Xue Za Zhi ; 100(43): 3397-3401, 2020 Nov 24.
Artigo em Chinês | MEDLINE | ID: mdl-33238668

RESUMO

Objective: To investigate the association of age-related white matter hyperintensity (WMH) with brain atrophy and cognitive impairment in patients with Parkinson's disease (PD). Methods: Consecutive samples of a prospective PD cohort with complete 3-dimensional magnetic resonance imaging in the Department of Movement Disorders in Beijing Tiantan Hospital, Capital Medical University, from October 2018 to August 2019 was retrospectively analyzed. Cognition was evaluated by Mini-Mental State Scale (MMSE) and Montreal Cognitive Assessment (MoCA). The severity of WMH was semi-quantitatively measured by Fazekas scale (0-6 points), and the mean cortical thickness and thalamus volume were calculated by FreeSurfer software. The demographic and disease characteristics, the severity of WMH, the mean cortical thickness and thalamus volume were respectively compared between PD patients with and without dementia. Moreover, univariate and multivariate generalized linear models were used to analyze the correlation of the severity of WMH with brain atrophy and MoCA. Results: A total of 225 patients with PD were included in the study, with a median age of 66 years old. Comparisons between groups suggested that patients with dementia were with severer WMH, older, and had lower levels of serum cholesterol and low-density lipoprotein and more reduced mean cortical thickness than those without dementia (all P<0.05), but no significant difference in the thalamus volume was found between the two groups. The generalized linear model showed that the cognitive impairment of PD patients was significantly correlated with WMH (ß=-0.021, 95%CI:-0.040--0.002, P=0.032), but independent of age, cortical thickness, and levels of serum cholesterol and low-density lipoprotein. Conclusion: WMH may worsen PD cognitive impairment independent of brain atrophy. Clinical prevention and treatment of cerebral small vessel disease may have protective effects on cognitive function in patients with PD.


Assuntos
Disfunção Cognitiva , Doença de Parkinson , Substância Branca , Idoso , Atrofia/patologia , Encéfalo/diagnóstico por imagem , Encéfalo/patologia , Disfunção Cognitiva/etiologia , Disfunção Cognitiva/patologia , Humanos , Imagem por Ressonância Magnética , Testes Neuropsicológicos , Doença de Parkinson/complicações , Doença de Parkinson/patologia , Estudos Prospectivos , Estudos Retrospectivos , Substância Branca/patologia
14.
Neurol Neurochir Pol ; 54(5): 410-415, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33085075

RESUMO

Magnetic resonance imaging (MRI) is a widely used method for the diagnosis of multiple sclerosis that is essential for the detection and follow-up of the disease. OBJECTIVE: The Polish Medical Society of Radiology (PLTR) and the Polish Society of Neurology (PTN) present the second version of their recommendations for investigations routinely conducted in magnetic resonance imaging departments in patients with multiple sclerosis. This version includes new data and practical comments for electroradiology technologists and radiologists. The recommended protocol aims to improve the MRI procedure and, most importantly, to standardise the method of conducting scans in all MRI departments. This is crucial for the initial diagnostics necessary for establishing a diagnosis, as well as for MS patient monitoring, which directly translates into significant clinical decisions. INTRODUCTION: Multiple sclerosis (MS) is a chronic immune mediated inflammatory demyelinating disease of the central nervous system (CNS), the aetiology of which is still unknown. The nature of the disease lies in a CNS destruction process disseminated in time (DIT) and space (DIS). MRI detects focal lesions in the white and grey matter with high sensitivity (although with significantly lower specificity in the latter). It is also the best tool to assess brain atrophy in patients with MS in terms of grey matter volume (GMV) and white matter volume (WMV) as well as local atrophy (by measuring the volume of thalamus, corpus callosum, subcortical nuclei, and hippocampus) as parameters that correlate with disability progression and cognitive dysfunctions. Progress in MR techniques, as well as advances in postprocessing the obtained data, has driven the dynamic development of computer programs that allow for a more repeatable assessment of brain atrophy in both cross-sectional and longitudinal studies. MR imaging is unquestionably the best diagnostic tool available to follow up the course of the disease and support clinicians in choosing the most appropriate treatment strategy for their MS patient. However, to diagnose and follow up MS patients on the basis of MRI in accordance with the latest standards, the MRI study must adhere to certain quality criteria. Such criteria are the subject of this paper.


Assuntos
Esclerose Múltipla , Neurologia , Atrofia/patologia , Encéfalo/patologia , Estudos Transversais , Humanos , Imagem por Ressonância Magnética , Esclerose Múltipla/diagnóstico por imagem , Esclerose Múltipla/patologia , Polônia , Sociedades Médicas
15.
PLoS One ; 15(9): e0237515, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32898138

RESUMO

BACKGROUND: Regional variations in gastric cancer incidence are not explained by prevalence of Helicobacter pylori, the main cause of the disease, with several areas presenting high H. pylori prevalence but low gastric cancer incidence. The IARC worldwide H. pylori prevalence surveys (ENIGMA) aim at systematically describing age and sex-specific prevalence of H. pylori infection around the world and generating hypotheses to explain regional variations in gastric cancer risk. METHODS: We selected age- and sex-stratified population samples in two areas with different gastric cancer incidence and mortality in Chile: Antofagasta (lower rate) and Valdivia (higher rate). Participants were 1-69 years old and provided interviews and blood for anti-H. pylori antibodies (IgG, VacA, CagA, others) and atrophy biomarkers (pepsinogens). RESULTS: H. pylori seroprevalence (Age-standardized to world population) and antibodies against CagA and VacA were similar in both sites. H. pylori seroprevalence was 20% among children <10 years old, 40% among 10-19 year olds, 60% in the 20-29 year olds and close to or above 80% in those 30+ years. The comparison of the prevalence of known and potential H. pylori cofactors in gastric carcinogenesis between the high and the low risk area showed that consumption of chili products was significantly higher in Valdivia and daily non-green vegetable consumption was more common in Antofagasta. Pepsinogen levels suggestive of gastric atrophy were significantly more common and occurred at earlier ages in Valdivia, the higher risk area. In a multivariate model combining both study sites, age, chili consumption and CagA were the main risk factors for gastric atrophy. CONCLUSIONS: The prevalence of H. pylori infection and its virulence factors was similar in the high and the low risk area, but atrophy was more common and occurred at younger ages in the higher risk area. Dietary factors could partly explain higher rates of atrophy and gastric cancer in Valdivia. IMPACT: The ENIGMA study in Chile contributes to better understanding regional variations in gastric cancer incidence and provides essential information for public health interventions.


Assuntos
Infecções por Helicobacter/complicações , Helicobacter pylori/isolamento & purificação , Neoplasias Gástricas/etiologia , Estômago/patologia , Adolescente , Adulto , Idoso , Atrofia/etiologia , Atrofia/microbiologia , Atrofia/patologia , Criança , Pré-Escolar , Chile/epidemiologia , Feminino , Infecções por Helicobacter/epidemiologia , Infecções por Helicobacter/microbiologia , Infecções por Helicobacter/patologia , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Estômago/microbiologia , Neoplasias Gástricas/microbiologia , Neoplasias Gástricas/patologia , Adulto Jovem
17.
PLoS One ; 15(9): e0239548, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32956388

RESUMO

OBJECTIVE: Investigate whether socioeconomic status (SES) was related to brain volume in aging related regions, and if so, determine whether this relationship was mediated by lifestyle factors that are known to associate with risk of dementia in a population-based sample of community dwelling middle-aged adults. METHODS: We studied 645 (41% black) participants (mean age 55.3±3.5) from the Coronary Artery Risk Development in Young Adults (CARDIA) study who underwent brain magnetic resonance imaging. SES was operationalized as a composite measure of annual income and years of education. Gray matter volume was estimated within the insular cortex, thalamus, cingulate, frontal, inferior parietal, and lateral temporal cortex. These regions are vulnerable to age-related atrophy captured by the Spatial Pattern of Atrophy for Recognition of Brain Aging (SPARE-BA) index. Lifestyle factors of interest included physical activity, cognitive activity (e.g. book/newspaper reading), smoking status, alcohol consumption, and diet. Multivariable linear regressions tested the association between SES and brain volume. Sobel mediation analyses determined if this association was mediated by lifestyle factors. All models were age, sex, and race adjusted. RESULTS: Higher SES was positively associated with brain volume (ß = .109 SE = .039; p < .01) and smoking status significantly mediated this relationship (z = 2.57). With respect to brain volume, smoking accounted for 27% of the variance (ß = -.179 SE = .065; p < .01) that was previously attributed to SES. CONCLUSION: Targeting smoking cessation could be an efficacious means to reduce the health disparity of low SES on brain volume and may decrease vulnerability for dementia.


Assuntos
Encéfalo/anatomia & histologia , Fumar , Classe Social , Grupo com Ancestrais do Continente Africano/estatística & dados numéricos , Consumo de Bebidas Alcoólicas/epidemiologia , Atrofia , Pressão Sanguínea , Índice de Massa Corporal , Encéfalo/patologia , Cognição , Estudos Transversais , Dieta , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Feminino , Humanos , Atividades de Lazer , Estilo de Vida , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Tamanho do Órgão , Inquéritos e Questionários
18.
Brain Nerve ; 72(9): 923-930, 2020 Sep.
Artigo em Japonês | MEDLINE | ID: mdl-32934181

RESUMO

Marie et al. (1922) first proposed a disease entity "late cortical cerebellar atrophy (LCCA)", which is characterized neuropathologically by pure cerebello-olivary degeneration. LCCA was originally described as sporadic, late-onset, pure cerebellar ataxia of unknown etiology; however, it has occasionally been used to denote familial or secondary ataxias, particularly alcoholic cerebellar degeneration. Sporadic ataxia is classified mainly into LCCA or CCA and olivo-ponto-cerebellar atrophy (OPCA) in Japan. OPCA, now multiple system atrophy with predominant cerebellar ataxia, has characteristic brain imaging features and is clearly diagnosed based on the consensus criteria. On the other hand, there is no specific biomarker for LCCA/CCA, and neuropathological examination is required for a definitive diagnosis. Therefore, the clinical diagnosis of LCCA/CCA depends on the exclusion of other diseases manifesting as cerebellar ataxia. However the differential diagnosis for LCCA/CCA is not necessarily made carefully. As a result, the LCCA/CCA category in Japan is a "waste basket," including OPCA, hereditary ataxias, and secondary ataxias, which are unidentified yet. To refine the LCCA/CCA category, we proposed the clinically-defined term "idiopathic cerebellar ataxia (IDCA)" and established its diagnostic criteria. By nationwide screening, we have identified 51 patients with probable IDCA according to the criteria so far. Here we review the clinical characteristics of IDCA patients.


Assuntos
Ataxia Cerebelar , Degenerações Espinocerebelares , Atrofia/patologia , Ataxia Cerebelar/diagnóstico , Cerebelo , Humanos , Japão , Degenerações Espinocerebelares/diagnóstico , Degenerações Espinocerebelares/patologia
19.
Brain Nerve ; 72(9): 931-937, 2020 Sep.
Artigo em Japonês | MEDLINE | ID: mdl-32934182

RESUMO

Cerebellar ataxia-predominant multiple system atrophy (MSA-C) and cortical cerebellar atrophy are representative diseases of adult-onset sporadic degenerative ataxia. Both diseases are distinctly different because of α-synuclein pathology. However, it takes approximately 2 years for cerebellar ataxia to progress to concomitant severe autonomic dysfunction in patients with MSA-C. The period of only cerebellar ataxia (mono system atrophy) may extend to more than 10 years. Understanding mono system atrophy is vital for the early diagnosis and drug development for MSA. In this review, we discuss mono system atrophy focusing on the concept and natural history and the possibility of the of early diagnosis and disease-modifying therapy for MSA.


Assuntos
Ataxia Cerebelar , Atrofia de Múltiplos Sistemas , Adulto , Ataxia , Atrofia/patologia , Ataxia Cerebelar/diagnóstico , Ataxia Cerebelar/tratamento farmacológico , Cerebelo , Humanos , Atrofia de Múltiplos Sistemas/diagnóstico , Atrofia de Múltiplos Sistemas/tratamento farmacológico , Atrofia de Múltiplos Sistemas/patologia
20.
Brain Nerve ; 72(9): 939-946, 2020 Sep.
Artigo em Japonês | MEDLINE | ID: mdl-32934183

RESUMO

Cerebellar cortical atrophy (CCA) is a neurodegenerative disease characterized by the loss of Purkinje cells, frequently associated with atrophy of the inferior olivary nucleus. The diagnosis of CCA requires a pathologic assessment; however, this term has also been used in clinical practice as a diagnosis of exclusion for sporadic, adult-onset, and progressive ataxia. For the clinical diagnosis of CCA, diagnostic criteria for idiopathic cerebellar ataxia (IDCA) have been proposed. We herein describe two patients with a pathologic diagnosis of CCA. The first patient was clinically suspected to have Creutzfeldt-Jakob disease due to rapid progressive dementia and ataxia. The second patient was clinically diagnosed with progressive supranuclear palsy based on imbalance, frequent falls, and vertical gaze palsy. The se cases suggest that the clinical presentation of CCA is heterogeneous, and CCA does not always meet the criteria for IDCA. Therefore, the term CCA should be used solely for a pathologic diagnosis.


Assuntos
Doenças Cerebelares , Doenças Neurodegenerativas , Paralisia Supranuclear Progressiva , Adulto , Atrofia , Humanos , Doenças Neurodegenerativas/diagnóstico por imagem , Neuropatologia
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