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1.
BMJ Case Rep ; 14(2)2021 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-33526526

RESUMO

Pilomatrixoma is a benign subcutaneous tumour arising from the sebaceous glands. Mutation in the CTNNB1 gene is seen, suggesting beta-catenin misregulation may be the cause of pilomatrixoma. The preoperative diagnosis may be improved by the awareness of the fact that pilomatrixoma is a common and benign skin tumour of the head and neck region. It presents as a well-defined mass, which may be firm to hard in consistency, usually attached to the skin, but not to the underlying tissue. The colour of overlying skin appears a reddish-brown tinge, indicating that it could be a case of pilomatrixoma. Here, we report a case of pilomatrixoma of the cheek in a woman along with the CT findings and histopathological appearances. Dental surgeons should consider it as one of the differential diagnosis in superficial head and neck swelling with calcification.


Assuntos
Calcinose/diagnóstico por imagem , Doenças do Cabelo/diagnóstico por imagem , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Pilomatrixoma/diagnóstico por imagem , Neoplasias Cutâneas/diagnóstico por imagem , Adulto , Calcinose/patologia , Feminino , Doenças do Cabelo/patologia , Doenças do Cabelo/cirurgia , Neoplasias de Cabeça e Pescoço/patologia , Neoplasias de Cabeça e Pescoço/cirurgia , Humanos , Pilomatrixoma/patologia , Pilomatrixoma/cirurgia , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/cirurgia , Tomografia Computadorizada por Raios X
2.
Medicine (Baltimore) ; 100(7): e24801, 2021 Feb 19.
Artigo em Inglês | MEDLINE | ID: mdl-33607842

RESUMO

RATIONALE: Orbital schwannoma is a relatively rare orbital tumor, and calcification of the lesion is rarely found in the orbit. We report a case of orbital schwannoma which was characterized by calcification in the orbital muscle cone, and was cured by intracapsular excision. PATIENT CONCERNS: A 54-year-old female with a complaint of a mass in the left orbit during a magnetic resonance imaging examination and symptom of dizziness 6 months before, presented with painless exophthalmos and vision decline in the left eye. DIAGNOSES: According to clinical manifestations, imaging examinations and postoperative immunohistochemical examinations, the diagnosis was orbital schwannoma, with calcification in the muscle cone. INTERVENTIONS: The patient was treated by intracapsular excision of the left orbit. We removed the intracapsular mass and most part of the cyst wall in order to prevent orbital apex syndrome. OUTCOMES: The diagnosis of schwannoma with calcification was confirmed finally through histological and immunohistochemical exam. The patient was followed up for 28 months and the orbital CT scan showed that there were no significant lesions found in the orbital muscle cone. LESSONS: Understanding clinical, imaging diagnostic, and histopathological features of rare orbital schwannoma with calcification will facilitate timely diagnosis and treatment of this condition. The intracapsular excision can help in avoiding complications.


Assuntos
Calcinose/cirurgia , Neurilemoma/cirurgia , Neoplasias Orbitárias/cirurgia , Calcinose/complicações , Calcinose/diagnóstico por imagem , Calcinose/patologia , Feminino , Humanos , Imagem por Ressonância Magnética , Pessoa de Meia-Idade , Neurilemoma/complicações , Neurilemoma/diagnóstico por imagem , Neurilemoma/patologia , Músculos Oculomotores/diagnóstico por imagem , Músculos Oculomotores/patologia , Neoplasias Orbitárias/complicações , Neoplasias Orbitárias/diagnóstico por imagem , Neoplasias Orbitárias/patologia
3.
Medicine (Baltimore) ; 100(6): e24704, 2021 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-33578608

RESUMO

RATIONALE: Foramen magnum meningiomas are very rare lesions. They frequently originate from the arachnoid cells at the dura matter of the craniocervical junction. Foramen magnum meningiomas are challenging for neurosurgeons because of the complex anatomy of foramen magnum. We present a rare case of FMM with excessive calcification and without the dura tail sign which made the lesion mimic a teratoma. PATIENTS CONCERNS: A 63 years old woman presented with progressive numbness and hyperesthesia of the shoulders and upper limbs for 2 and half years. She also experienced occasional headaches and dizziness with no nausea, vomiting or fever. DIAGNOSES: Computed tomography scan, and magnetic resonance imaging revealed a calcified mass at occipital cistern. The lesion did not show the usual "dura tail sign" which made it mimic a teratoma on magnetic resonance imaging. Histopathology established meningioma. INTERVENTION: The tumor was completely resected via suboccipital approach. OUTCOMES: Two years follow-up revealed no recurrence of the lesion and no neurological deficits. LESSONS: We advocate the use of electromyographic and auditory brainstem responses to monitor the inferior cranial nerves because the tumor often adheres to these nerves.


Assuntos
Forame Magno/patologia , Neoplasias Meníngeas/patologia , Meningioma/patologia , Calcinose/diagnóstico por imagem , Calcinose/patologia , Angiografia por Tomografia Computadorizada , Feminino , Forame Magno/diagnóstico por imagem , Humanos , Imagem por Ressonância Magnética , Neoplasias Meníngeas/diagnóstico por imagem , Meningioma/diagnóstico por imagem , Pessoa de Meia-Idade
4.
BMJ Case Rep ; 14(1)2021 Jan 27.
Artigo em Inglês | MEDLINE | ID: mdl-33504515

RESUMO

A 39-year-old multiparous Afro-Caribbean woman attended the emergency department with sudden-onset severe right iliac fossa pain. Her inflammatory markers were mildly elevated. Computerised tomography of the abdomen demonstrated features of fat stranding in the right iliac fossa suspicious of acute appendicitis. The scan also noted uterine leiomyomas. The patient was taken to theatre for an emergency diagnostic laparoscopy where her appendix was found to be macroscopically normal. A necrotic heavily calcified parasitic leiomyoma was seen in the right adnexa, free of the uterus and adherent to the greater omentum on a long torted pedicle. The parasitic leiomyoma was successfully removed piecemeal laparoscopically. Complications of leiomyomas, namely, torsion and necrosis, are important differentials in women presenting with sudden-onset lower abdominal pain. A history of sudden-onset severe lower abdominal pain with a background of known leiomyoma should prompt the clerking surgeon to consider a complication of leiomyoma as part of the differential diagnoses.


Assuntos
Calcinose/diagnóstico por imagem , Leiomioma/diagnóstico por imagem , Anormalidade Torcional/diagnóstico por imagem , Neoplasias Uterinas/diagnóstico por imagem , Dor Abdominal/etiologia , Adulto , Apendicite/diagnóstico , Cesárea , Diagnóstico Diferencial , Feminino , Humanos , Laparoscopia , Leiomioma/cirurgia , Inoculação de Neoplasia , Omento , Tomografia Computadorizada por Raios X , Anormalidade Torcional/complicações , Anormalidade Torcional/cirurgia , Neoplasias Uterinas/cirurgia
5.
Nat Commun ; 12(1): 549, 2021 01 22.
Artigo em Inglês | MEDLINE | ID: mdl-33483479

RESUMO

Intrauterine growth restriction (IUGR) is associated with reduced kidney size at birth, accelerated renal function decline, and increased risk for chronic kidney and cardiovascular diseases in adults. Precise mechanisms underlying fetal programming of adult diseases remain largely elusive and warrant extensive investigation. Setting up a mouse model of hypoxia-induced IUGR, fetal adaptations at mRNA, protein and cellular levels, and their long-term functional consequences are characterized, using the kidney as a readout. Here, we identify fetuin-A as an evolutionary conserved HIF target gene, and further investigate its role using fetuin-A KO animals and an adult model of ischemia-reperfusion injury. Beyond its role as systemic calcification inhibitor, fetuin-A emerges as a multifaceted protective factor that locally counteracts calcification, modulates macrophage polarization, and attenuates inflammation and fibrosis, thus preserving kidney function. Our study paves the way to therapeutic approaches mitigating mineral stress-induced inflammation and damage, principally applicable to all soft tissues.


Assuntos
Fatores de Transcrição Hélice-Alça-Hélice Básicos/metabolismo , Retardo do Crescimento Fetal/metabolismo , Rim/metabolismo , Traumatismo por Reperfusão/fisiopatologia , alfa-2-Glicoproteína-HS/metabolismo , Animais , Fatores de Transcrição Hélice-Alça-Hélice Básicos/genética , Calcinose/genética , Calcinose/metabolismo , Modelos Animais de Doenças , Feminino , Retardo do Crescimento Fetal/genética , Fibrose , Hipóxia , Inflamação/genética , Inflamação/metabolismo , Rim/patologia , Ativação de Macrófagos/genética , Masculino , Camundongos Endogâmicos C57BL , Camundongos Knockout , alfa-2-Glicoproteína-HS/genética
6.
Mymensingh Med J ; 30(1): 228-232, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33397880

RESUMO

Myositis ossificans (MO) is a condition where calcification occurs in the soft tissue as well as around the bone following fracture, vigorous exercise or trauma. Although it is a radiological diagnosis, it often leads physician to an incorrect or missed diagnosis as recurrent fracture. Frequently, it follows haemorrhage into the muscle in the tissue space. We report a 45 years old house-wife presented with the complaints of weakness of right side of body and pain with restricted range of motion (ROM) in right lower limb. She was a diagnosed case of recurrent stroke with rheumatic valvular heart disease. After discharge, vigorous physical exercise was done at home by local physiotherapist without appropriate guidance from physiatrist. Gradually pain was so severe that she didn't allow moving her right lower limb. Over the course of time, she became incapacite and bed bound. She denied any positive family history. With the hip and lower limb problems she consulted with orthopedic surgeon and was referred to Physical Medicine and Rehabilitation department of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh for further management & rehabilitation. This case is presented to focus on hazard of being unguided, over-exercised and non-surgical management approach of this rare condition.


Assuntos
Calcinose , Miosite Ossificante , Bangladesh , Feminino , Humanos , Pessoa de Meia-Idade , Miosite Ossificante/diagnóstico por imagem , Miosite Ossificante/etiologia , Gestão da Segurança
7.
Cardiovasc Pathol ; 50: 107298, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33080398

RESUMO

Idiopathic myocardial calcification is a rare disease. Herein, we report a case of massive idiopathic calcification; a 78-year-old woman presented with acute heart failure with preserved ejection fraction (HFpEF). Computed tomography and magnetic resonance imaging showed diffused calcified nodules in the myocardium. The patient was treated for HFpEF; however, the calcified nodules and diastolic dysfunction gradually progressed. She was hospitalized for heart failure with preserved ejection fraction 6 times before her death at the age of 84 years. The pathological report showed calcified nodules with surrounding collagen fibers in the myocardium and tiny calcifications within the myocytes. Thus, idiopathic myocardial calcification can result in HFpEF, while calcification and diastolic dysfunction can gradually worsen.


Assuntos
Calcinose/patologia , Cardiomiopatias/patologia , Miocárdio/patologia , Idoso , Calcinose/complicações , Calcinose/diagnóstico por imagem , Cardiomiopatias/complicações , Cardiomiopatias/diagnóstico por imagem , Progressão da Doença , Feminino , Fibrose , Insuficiência Cardíaca/etiologia , Humanos
8.
Curr Opin Ophthalmol ; 32(1): 31-44, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33165018

RESUMO

PURPOSE OF REVIEW: Phacoemulsification cataract surgery is one of the most commonly performed surgical procedure worldwide. In the majority of cases, intraocular lenses (IOLs) are implanted. Due to the increasing life expectancy and the fact that cataract surgery is performed in earlier stages, the anticipated IOL duration in the eye has increased over the last decades. The aim of this study was to review the types and describe the characteristics of late intraocular lens opacifications. RECENT FINDINGS: Calcification was the most commonly reported type of opacification in hydrophilic IOLs; it usually negatively impacted the visual function and required IOL explantation. Glistening manifested in hydrophobic acrylic lenses and was frequent in some IOL models. In most cases glistening and subsurface nanoglistenigs do not lead to a decline in visual acuity or require IOL exchange. Current studies indicate that fluid-related phenomena may induce straylight, leading to a decrease of comfort and quality of vision. SUMMARY: Several reports on late IOL opacifications have been published in recent years. In some cases, particularly in glistening, the development of the opacifications might be related to IOL aging. The influence of the fluid-related microvacuoles on the quality of vision requires further research.


Assuntos
Calcinose/patologia , Implante de Lente Intraocular , Lentes Intraoculares , Óptica e Fotônica , Facoemulsificação , Falha de Prótese , Humanos
9.
Clin Nucl Med ; 46(1): e51-e53, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33181749

RESUMO

We report the case of a 30-year-old woman with stage IV, non-Hodgkin lymphoma. Baseline F-FDG PET/CT scan revealed lymphadenopathy with breasts and skeletal involvement. She received 3 cycles of R-CHOP (rituximab, cyclophosphamide, hydroxydaunorubicin, vincristine, and prednisone) chemotherapy without significant adverse effects. Biochemical examinations before and after chemotherapies were unremarkable. InterimF-FDG PET/CT showed a partial treatment response. However, there was an appearance of FDG-avid coarse calcification in breasts. Cutaneous and subcutaneous regions of elbows, pelvis, and thighs showed similar calcifications. Posttherapy PET/CT showed a significant resolution of calcinosis cutis. This case presents a postchemotherapy idiopathic calcinosis cutis with rapid spontaneous resolution.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Calcinose/induzido quimicamente , Linfoma não Hodgkin/tratamento farmacológico , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Calcinose/diagnóstico por imagem , Feminino , Humanos , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Remissão Espontânea
10.
J Urol ; 205(1): 68-77, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32856981

RESUMO

PURPOSE: Encrustation is a common phenomenon that can occur following placement of a ureteral stent into the urinary tract, and it can lead to serious complications. The following review addresses the mechanism of encrustation, the management of these stents and the newest technology developed to mitigate this issue. MATERIALS AND METHODS: We performed a comprehensive literature search on stent encrustation including peer-reviewed publications, public product listings, and material on current and future stent technology. RESULTS: The mechanism of encrustation is complex and multifaceted, including dwell time, patient specific risk factors, conditioning film formation, biofilm formation and mineral deposition. Several technological developments in stent materials and coatings may have a role in reducing the risk of stent encrustation. It is important to identify the extent of stent encrustation and plan treatment strategies accordingly. We propose a novel treatment algorithm for the management encrusted ureteral stents. CONCLUSIONS: The ubiquity of ureteral stents in urology practice mandates updated knowledge about the prevention of stent encrustation, identification of high risk patients and preparedness for removal using multimodal techniques.


Assuntos
Calcinose/cirurgia , Remoção de Dispositivo/métodos , Complicações Pós-Operatórias/cirurgia , Stents/efeitos adversos , Ureter/cirurgia , Calcinose/epidemiologia , Calcinose/etiologia , Calcinose/prevenção & controle , Cistoscopia , Dilatação/efeitos adversos , Dilatação/instrumentação , Humanos , Litotripsia , Masculino , Nefrostomia Percutânea , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/prevenção & controle , Desenho de Prótese , Fatores de Risco , Tecnologia , Tomografia Computadorizada por Raios X , Ultrassonografia , Ureter/diagnóstico por imagem , Ureter/microbiologia , Ureter/patologia , Obstrução Ureteral/cirurgia , Ureterolitíase/etiologia , Ureterolitíase/prevenção & controle
11.
Br J Radiol ; 94(1117): 20200894, 2021 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-33053316

RESUMO

Incidental coronary and cardiac calcification are frequent findings on non-gated thoracic CT. We recommend that the heart is reviewed on all CT scans where it is visualised. Coronary artery calcification is a marker of coronary artery disease and it is associated with an adverse prognosis on dedicated cardiac imaging and on non-gated thoracic CT performed for non-cardiac indications, both with and without contrast. We recommend that coronary artery calcification is reported on all non-gated thoracic CT using a simple patient-based score (none, mild, moderate, severe). Furthermore, we recommend that reports include recommendations for subsequent management, namely the assessment of modifiable cardiovascular risk factors and, if the patient has chest pain, assessment as per standard guidelines. In most cases, this will not necessitate additional investigations. Incidental aortic valve calcification may also be identified on non-gated thoracic CT and should be reported, along with ancillary findings such as aortic root dilation. Calcification may occur in other parts of the heart including mitral valve/annulus, pericardium and myocardium, but in many cases these are an incidental finding without clinical significance.


Assuntos
Estenose da Valva Aórtica/diagnóstico por imagem , Valva Aórtica/patologia , Calcinose/diagnóstico por imagem , Doença da Artéria Coronariana/diagnóstico por imagem , Achados Incidentais , Tomografia Computadorizada por Raios X/métodos , Calcificação Vascular/diagnóstico por imagem , Valva Aórtica/diagnóstico por imagem , Consenso , Coração , Humanos , Sociedades Médicas , Reino Unido
12.
BMJ Case Rep ; 13(12)2020 Dec 13.
Artigo em Inglês | MEDLINE | ID: mdl-33318275

RESUMO

Although calcific tendinopathy of the shoulder is a relatively common clinical diagnosis, calcific tendinopathy of the rectus femoris tendon near its origin at the anterior inferior iliac spine is rare. We present a case of a 53-year-old female avid runner with left hip pain. Clinical evaluation and X-ray imaging led to a diagnosis of calcific tendinopathy of the rectus femoris tendon. The patient was treated conservatively with non-steroidal anti-inflammatory drugs, physical therapy and rest. Calcific tendinopathy of the rectus femoris tendon can occur rarely in active patients and may be a cause of hip pain, responsive to conservative management, but with other treatment options possible if recalcitrant.


Assuntos
Calcinose/diagnóstico por imagem , Músculo Quadríceps/lesões , Corrida/lesões , Tendinopatia/diagnóstico por imagem , Artralgia/etiologia , Calcinose/terapia , Diagnóstico Diferencial , Terapia por Exercício , Feminino , Articulação do Quadril/diagnóstico por imagem , Humanos , Ibuprofeno/uso terapêutico , Pessoa de Meia-Idade , Força Muscular , Músculo Quadríceps/diagnóstico por imagem , Radiografia , Descanso , Tendinopatia/terapia
13.
Ter Arkh ; 92(6): 37-45, 2020 Jul 09.
Artigo em Russo | MEDLINE | ID: mdl-33346491

RESUMO

Cardiovascular calcification (CVC) makes a significant contribution to the manifestation of cardiovascular complications in patients with chronic kidney disease. Early CVC markers are currently being actively studied to optimize cardio-renoprotective strategies. We performed a prospective comparative analysis of the following factors: FGF-23, a-Klotho, sclecrostin, phosphate, parathyroid hormone, the estimated glomerular filtration rate (eGFR), central systolic pressure as an independent determinant of CVC. MATERIALS AND METHODS: The study included 131 patients with chronic kidney disease 25D st. Serum levels of FGF-23, Klotho, and sclerostin were evaluated using the ELISA method. Vascular augmentation (stiffness) indices, central arterial pressure (using the SphygmoCor device), calcification of heart valves and the degree of aortic calcification (aortic radiography) were also investigated. The observation period was 2 years. RESULTS: According to the Spearman correlation analysis, the percent of calcification increase and the change in Klotho level are most related. According to ROC analysis, a decrease in serum levels of Klotho by 50 units or more is a significant predictor of an increase in aortic calcification of 50% or more with a sensitivity of 86% and a specificity of 77%. Using logistic regression analysis, it was found that a serum Klotho level 632 pg/L predicts an eGFR below a median level of 48 ml/min/1.73 m2 with a sensitivity of 85.5% and a specificity of 78.5%. Wherein OR 17.477 (CI 95% 8.04637.962; p0.001). CONCLUSION: The factor most associated with CVC is Klotho. Decreased serum level of Klotho is a predictor of aortic calcification. In addition, the initial serum level of Klotho is a predictor of eGFR after 2 years.


Assuntos
Calcinose , Insuficiência Renal Crônica , Biomarcadores , Calcinose/diagnóstico , Fatores de Crescimento de Fibroblastos , Taxa de Filtração Glomerular , Glucuronidase , Humanos , Estudos Prospectivos , Insuficiência Renal Crônica/diagnóstico
14.
Angiol Sosud Khir ; 26(4): 17-22, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33332302

RESUMO

The number of patients with diabetes mellitus has steadily been increasing. This disease is associated with the risk for the development of micro- and macroangiopathies. One of the variants of macroangiopathy is Mönkeberg's sclerosis characterized by the presence of calcification of the media of the arterial wall. This article is a literature review reflecting the role of calcification in arterial lesions in patients with diabetes mellitus, also covering the historical aspect of studying Mönkeberg's sclerosis. Special attention is paid to its morphological forms, aetiopathogenetic mechanisms of development, taking into account contemporary studies, demonstrating mechanisms of the effect of medial arterial calcification on haemodynamics and the risk for the development of cardiovascular complications. Also presented herein are the main non-invasive and invasive methods of its diagnosis.


Assuntos
Arteriosclerose , Calcinose , Diabetes Mellitus , Calcificação Vascular , Artérias/patologia , Calcinose/diagnóstico , Calcinose/etiologia , Humanos , Fatores de Risco , Esclerose/patologia , Calcificação Vascular/diagnóstico , Calcificação Vascular/etiologia , Calcificação Vascular/patologia
15.
BMC Cardiovasc Disord ; 20(1): 521, 2020 12 11.
Artigo em Inglês | MEDLINE | ID: mdl-33308143

RESUMO

BACKGROUND: Calcific aortic valve disease (CAVD) pathophysiology is a complex, multistage process, usually diagnosed at advanced stages after significant anatomical and hemodynamic changes in the valve. Early detection of disease progression is thus pivotal in the development of prevention and mitigation strategies. In this study, we developed a diet-based, non-genetically modified mouse model for early CAVD progression, and explored the utility of two-photon excited fluorescence (TPEF) microscopy for early detection of CAVD progression. TPEF imaging provides label-free, non-invasive, quantitative metrics with the potential to correlate with multiple stages of CAVD pathophysiology including calcium deposition, collagen remodeling and osteogenic differentiation. METHODS: Twenty-week old C57BL/6J mice were fed either a control or pro-calcific diet for 16 weeks and monitored via echocardiography, histology, immunohistochemistry, and quantitative polarized light imaging. Additionally, TPEF imaging was used to quantify tissue autofluorescence (A) at 755 nm, 810 nm and 860 nm excitation, to calculate TPEF 755-860 ratio (A860/525/(A755/460 + A860/525)) and TPEF Collagen-Calcium ratio (A810/525/(A810/460 + A810/525)) in the murine valves. In a separate experiment, animals were fed the above diets till 28 weeks to assess for later-stage calcification. RESULTS: Pro-calcific mice showed evidence of lipid deposition at 4 weeks and calcification at 16 weeks at the valve commissures. The valves of pro-calcific mice also showed positive expression for markers of osteogenic differentiation, myofibroblast activation, proliferation, inflammatory cytokines and collagen remodeling. Pro-calcific mice exhibited lower TPEF autofluorescence ratios, at locations coincident with calcification, that correlated with increased collagen disorganization and positive expression of osteogenic markers. Additionally, locations with lower TPEF autofluorescence ratios at 4 and 16 weeks exhibited increased calcification at later 28-week timepoints. CONCLUSIONS: This study suggests the potential of TPEF autofluorescence metrics to serve as a label-free tool for early detection and monitoring of CAVD pathophysiology.


Assuntos
Estenose da Valva Aórtica/patologia , Valva Aórtica/patologia , Calcinose/patologia , Microscopia de Fluorescência por Excitação Multifotônica , Animais , Valva Aórtica/metabolismo , Estenose da Valva Aórtica/metabolismo , Biomarcadores/metabolismo , Calcinose/metabolismo , Modelos Animais de Doenças , Progressão da Doença , Diagnóstico Precoce , Masculino , Camundongos Endogâmicos C57BL , Valor Preditivo dos Testes , Fatores de Tempo
16.
BMJ Case Rep ; 13(12)2020 Dec 28.
Artigo em Inglês | MEDLINE | ID: mdl-33372025

RESUMO

Cardiac disease after mediastinal radiotherapy can result in progressive valvular thickening and dystrophic calcification with ensuing leaflet restriction and dysfunction. This can ultimately manifest as valvular stenosis and/or regurgitation. We report a case of a 61-year-old woman with symptomatic severe aortic stenosis and severe mitral stenosis due to severe dystrophic calcification postmediastinal radiotherapy for lymphoma. She was deemed surgically inoperable due to dense, continuous calcification throughout the leaflets and annuli of both valves, aortomitral continuity, proximal coronary arteries and proximal porcelain aorta. She underwent simultaneous transcatheter aortic valve replacement and transcatheter mitral valve replacement with an excellent technical and clinical result at 7-month follow-up. We also describe the central role of multimodality three-dimensional transoesophageal echocardiography and multidetector cardiac CT imaging in assessing the severity of valve disease, characterising the nature of cardiac calcification and guiding decisions on surgical operability and transcatheter intervention.


Assuntos
Estenose da Valva Aórtica/diagnóstico por imagem , Estenose da Valva Aórtica/cirurgia , Calcinose/complicações , Doenças das Valvas Cardíacas/complicações , Estenose da Valva Mitral/diagnóstico por imagem , Estenose da Valva Mitral/cirurgia , Radioterapia/efeitos adversos , Estenose da Valva Aórtica/etiologia , Calcinose/etiologia , Ecocardiografia Transesofagiana , Feminino , Doenças das Valvas Cardíacas/etiologia , Implante de Prótese de Valva Cardíaca , Doença de Hodgkin/radioterapia , Humanos , Neoplasias do Mediastino/radioterapia , Pessoa de Meia-Idade , Valva Mitral/cirurgia , Estenose da Valva Mitral/etiologia , Tomografia Computadorizada Multidetectores , Imagem Multimodal , Substituição da Valva Aórtica Transcateter
17.
PLoS One ; 15(12): e0243232, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33326424

RESUMO

AIM: This study explores the association between Coronary Artery Calcium (CAC) scores and dental pathology such as missing teeth, the (peri-apical) health status and restoration grade of the teeth, and the grade of alveolar bone loss seen on a dental panoramic radiograph (Orthopantomograph-OPG). MATERIALS AND METHODS: In this retrospective cross-sectional study, data was collected from three hospitals spread in the Netherlands. Patients were included when a CAC score and an OPG were available, both recorded within a maximum period of 365 days from 2009-2017. The CAC score was measured on a CT scan, using the Agatston method. To assess dental pathology, the number of missing teeth, the number of dental implants, alveolar bone loss, caries, endodontic treatments, peri-apical radiolucencies, bone loss at implants, impacted teeth and dental cysts, were determined on the OPG. All observers were calibrated. The electronic health records provided information about: gender, age, smoking, Diabetes Mellitus, hypercholesterolemia, hypertension and Body Mass Index (BMI). RESULTS: 212 patients were included. We found a statistically significant association between the number of missing teeth and the CAC score. When modeling age, sex, and other well-known risk factors for cardiovascular disease, the significant correlation was no longer present after multivariate correction. Furthermore, the results showed a trend for more teeth with peri-apical lesions and a higher percentage of mean alveolar bone loss in the group with the highest CAC scores. CONCLUSION: This study showed that being edentulous or missing teeth is correlated to higher CAC scores however failed to be an independent predictor of atherosclerotic cardiovascular diseases. The number of (missing) teeth is an easily accessible marker and could be used as a marker for atherosclerotic cardiovascular disease (ACVD) risk by almost any healthcare worker. The current study needs to be considered as an explorative pilot study and could contribute to the design of further (prospective) studies on the relationship between dental pathology and coronary artery calcification by adding clinical information and extra cardiovascular biomarkers.


Assuntos
Calcinose/etiologia , Cálcio/análise , Vasos Coronários/patologia , Perda de Dente/complicações , Adulto , Idoso , Aterosclerose/etiologia , Aterosclerose/patologia , Calcinose/patologia , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/patologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Estudos Retrospectivos , Fatores de Risco , Perda de Dente/patologia
18.
Medicine (Baltimore) ; 99(46): e23299, 2020 Nov 13.
Artigo em Inglês | MEDLINE | ID: mdl-33181720

RESUMO

Calcific tendinitis (CT) of the shoulder is a painful disorder usually identified in individuals aged 40 and 60 years. The estimated global prevalence of CT is 2.7% to 36%. We examined the association of hyperlipidemia and sex with CT of the shoulder using Taiwan Biobank (TWB) and the National Health Insurance Research Database (NHIRD).Data were available for 9903 TWB participants who were recruited between 2008 and 2015. We used multiple logistic regression analysis to estimate the odds ratios (OR) and 95% confidence intervals (CI) for CT of the shoulder.Overall, 1564 women, and 1491 men were identified with hyperlipidemia. Women, compared to men, had higher odds of CT of the shoulder (OR, 1.53; 95% CI, 1.08-2.16). Hyperlipidemia, compared to no hyperlipidemia, was associated with an increased risk of CT (OR, 1.40; 95% CI, 1.02-1.93). The test for interaction was significant for sex and hyperlipidemia (P = .006). After stratification, the odds ratio for CT was 1.95 (95% CI, 1.30-2.92) in women and 0.82 (95% CI, 0.48-1.39) in men, respectively. Compared to men with no hyperlipidemia, the odds ratio was 0.86 (95% CI, 0.53-1.38) for men with hyperlipidemia and 2.00 (95% CI, 1.29-3.10) for women with hyperlipidemia.Importantly, our findings indicated that the risk for CT of the shoulder was higher among Taiwanese women with hyperlipidemia. However, CT risk among their male counterparts with hyperlipidemia was not significant.


Assuntos
Calcinose/etiologia , Hiperlipidemias/complicações , Artropatias/etiologia , Fatores Sexuais , Ombro/anormalidades , Tendinopatia/etiologia , Doenças Vasculares/etiologia , Adulto , Idoso , Calcinose/epidemiologia , Calcinose/fisiopatologia , Feminino , Humanos , Hiperlipidemias/epidemiologia , Hiperlipidemias/fisiopatologia , Artropatias/epidemiologia , Artropatias/fisiopatologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Prevalência , Ombro/fisiopatologia , Taiwan/epidemiologia , Tendinopatia/epidemiologia , Tendinopatia/fisiopatologia , Doenças Vasculares/epidemiologia , Doenças Vasculares/fisiopatologia
19.
BMC Neurol ; 20(1): 386, 2020 Oct 23.
Artigo em Inglês | MEDLINE | ID: mdl-33097034

RESUMO

BACKGROUND: In this study, we report a case of a young female who was hospitalized for seizures and diagnosed with anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis. CASE PRESENTATION: The main feature of this patient was bilateral temporal calcifications detected by routine head computed tomography (CT). The co-existence of anti-NMDAR encephalitis and cerebral calcifications has not been reported. We supposed that the patient had an incomplete form of celiac disease (CD), epilepsy and cerebral calcifications syndrome (CEC). The patient's symptoms were alleviated by a series of treatments, and she remained stable during the follow-ups. CONCLUSIONS: Our findings confirm the rarity co-existing anti-NMDAR encephalitis and cerebral calcifications. In future clinical work, we need to elucidate the relationship between anti-NMDAR encephalitis and cerebral calcifications, and the association between anti-NMDAR encephalitis and other co-existing autoimmune disorders.


Assuntos
Encefalite Antirreceptor de N-Metil-D-Aspartato/complicações , Encefalopatias/complicações , Encefalopatias/patologia , Encefalite Antirreceptor de N-Metil-D-Aspartato/diagnóstico , Calcinose/complicações , Calcinose/patologia , Feminino , Humanos , Convulsões/etiologia , Tomografia Computadorizada por Raios X , Adulto Jovem
20.
Medicine (Baltimore) ; 99(43): e22443, 2020 Oct 23.
Artigo em Inglês | MEDLINE | ID: mdl-33120739

RESUMO

The objectives of this study were to describe the prevalence and characteristics of radiographic lesions of the hands, and calcifications of the spine on computer tomography scans (CT-scans), and to investigate the relationships between radiographic and CT-scan abnormalities and clinical features in a population of patients with systemic sclerosis (SSc).Subjects underwent X-ray examination of the hands, and thoracic or thoraco-abdominal and pelvic CT scan or lumbar CT scan in the year. Structural lesions on hand X ray was scored and spinal calcifications were evaluated in the anterior, intracanal and posterior segments. Intra and inter-reliability was tested for radiography and CT- scan. Prognostic factors considered were interstitial pulmonary lesions on the CT scan, pulmonary arterial hypertension (PAH) and death.This study involved 77 SSc patients, 58 (75%) with limited cutaneous SSc (lcSSc) and 19 (25%) with diffuse SSc (dSSc). The prevalences of radiographic lesions of the hand were 28.6% for periarticular calcifications and 26% for calcinosis. On CT scan, 64 (83%) patients exhibited at least 1 calcification. Spine calcifications were depicted in 80.5%, 27.3%, and 35.1% at the anterior, intracanal and posterior segments respectively. Calcifications were mainly localized on thoracic spine. Inter reader reliabilities were good for hands and moderate for spine respectively. Spine calcifications and periarticular calcifications in the hands were associated (P = .012). Calcinosis in the hands was related to PAH (P = .02). Posterior calcification segment and foraminal calcifications were associated with interstitial lung disease (ILD) (P = .029) and death (P = .001).More than 80% of systemic sclerosis patients presented spine calcifications. A significant association between hands and spinal calcifications were confirmed and some localization in the posterior segment considered as a bad prognostic factor.


Assuntos
Calcinose/diagnóstico por imagem , Ossos da Mão/diagnóstico por imagem , Escleroderma Sistêmico/complicações , Doenças da Coluna Vertebral/diagnóstico por imagem , Coluna Vertebral/diagnóstico por imagem , Fatores Etários , Feminino , Humanos , Hipertensão Pulmonar/complicações , Doenças Pulmonares Intersticiais/complicações , Masculino , Pessoa de Meia-Idade , Prognóstico , Radiografia , Reprodutibilidade dos Testes , Estudos Retrospectivos , Escleroderma Sistêmico/mortalidade , Tomografia Computadorizada por Raios X
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