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2.
Adv Gerontol ; 32(4): 545-549, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31800182

RESUMO

A comprehensive study of lipidograms of 36 patients with initial signs of calcification of aortic semilunium was performed. It was determined that the content of apolipoprotein A-1 was significantly lower in comparison with the control groups, which requires further studies of the evaluation of the effect on the process of early development of calcification of drugs capable to increasing its content. If the concentration of apolipoprotein A-1 is less than 1,1 mg/dl and/or the apoB/apoA ratio is increased by more than 1, it is advisable to recommend dispensary follow-up with regular (no less than 1 time in 5 years) echocardiographic study with a detailed study of the functional state of the aortic valve.


Assuntos
Estenose da Valva Aórtica , Biomarcadores , Calcinose , Lipídeos , Estenose da Valva Aórtica/sangue , Estenose da Valva Aórtica/diagnóstico , Biomarcadores/sangue , Calcinose/sangue , Calcinose/diagnóstico , Humanos , Lipídeos/análise , Lipídeos/sangue
4.
Eur J Radiol ; 120: 108653, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31550638

RESUMO

OBJECTIVE: Calcium hydroxyapatite depositional disease (HADD) is usually asymptomatic and self-limiting; however, when there is an associated inflammatory process or HADD occurs in an unusual location, it may mimic trauma, infection, or neoplasm. The purpose of this article is to review the imaging features of HADD and how to distinguish it from more worrisome entities that can have similar appearances. CONCLUSION: An understanding of the presentations of HADD is important to allow early and confident diagnosis. In particular, familiarity with presentations that resemble more ominous pathologies is essential to avoid costly and time-consuming workup or intervention.


Assuntos
Doenças Ósseas/diagnóstico , Durapatita , Adulto , Doenças Ósseas Infecciosas/diagnóstico , Neoplasias Ósseas/diagnóstico , Calcinose/diagnóstico , Diagnóstico Diferencial , Diagnóstico Precoce , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X
5.
Bratisl Lek Listy ; 120(9): 676-679, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31475553

RESUMO

OBJECTIVES: Medial arterial calcification (MAC) is a nonobstructive condition leading to reduced arterial compliance. The disease most commonly occurs in diabetes mellitus. Decreased ankle-brachial pressure index (ABI) is a well-known marker of increased cardiovascular mortality. However, also the values of ABI above 1.3, typical in MAC, are associated with increased mortality. METHODS: By means of Holter ECG monitoring, we investigated 41 patients (25 men, 16 women) with mean age of 59±8 years, suffering of type 2 diabetes mellitus and identified as having MAC, and Holter ECG monitoring with an average duration of recording 22.36 hours, was carried out by GE-Marquette MARS ECG Holter system. RESULTS: We found frequent incidence of cardiac arrhythmias and myocardial ischemia in 22 patients (53.7 %). Only 19 patients (46.3 %) had normal Holter ECG recordings. ABI values were significantly higher in patients with abnormal ECG Holter recordings. CONCLUSION: Our results confirm the importance of ABI estimation in clinical practice. As the central goal of therapy for patients with myocardial ischemia and/or complex forms of cardiac arrhythmias is the reduction or elimination of these episodes. Ambulatory Holter ECG monitoring plays an important role in the management of these patients (Tab. 7, Ref. 16).


Assuntos
Arritmias Cardíacas/diagnóstico , Calcinose/diagnóstico , Diabetes Mellitus Tipo 2/complicações , Eletrocardiografia Ambulatorial , Isquemia Miocárdica/diagnóstico , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
6.
Malays J Pathol ; 41(2): 177-183, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31427553

RESUMO

INTRODUCTION: Coronary artery disease (CAD) is a known cause of major cardiovascular events and calcium score (CS) has been developed as a marker of coronary atherosclerosis. Yet, the relationship between post mortem computed tomography (PMCT) CS with histologically observed calcification and the severity of coronary artery stenosis has not been widely explored and is still unclear. This study aims to determine the association between coronary artery PMCT CS with histologically observed calcification and degree of stenosis of coronary arteries in post-mortem cases. MATERIALS & METHODS: This was a cross-sectional study involving 101 subjects recruited from the National Institute of Forensic Medicine (IPFN) Hospital Kuala Lumpur (HKL) over a period of 15 months, from December 2012 until April 2014. PMCT CS of the coronary arteries was calculated using Agatston-Janowitz score. Histological presence of calcification was observed and the degree of stenosis was calculated using an image analysis technique. RESULTS: PMCT CS increased with increasing severity of stenosis (p<0.001). PMCT CS showed a positive correlation with the presence of calcification (r=-0.82, p<0.001). CONCLUSION: Calcium score is strongly associated with coronary artery calcification and the degree of luminal stenosis in post mortem subjects. Thus, PMCT may be useful as a non-invasive tool in diagnosing CAD in the event that an autopsy is not possible.


Assuntos
Calcinose/diagnóstico , Estenose Coronária/diagnóstico , Vasos Coronários/patologia , Adulto , Autopsia , Calcinose/patologia , Cálcio , Estenose Coronária/patologia , Vasos Coronários/diagnóstico por imagem , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X
7.
BMC Musculoskelet Disord ; 20(1): 362, 2019 Aug 07.
Artigo em Inglês | MEDLINE | ID: mdl-31391033

RESUMO

BACKGROUND: Fahr's syndrome presenting multiple and symmetric calcification of basal ganglia and cerebral cortex is rare, and idiopathic hypoparatyroidism is known as one of the causes. The relationship between ossification of posterior longitudinal ligament (OPLL) and idiopathic hypoparatyroidism is also reported in a few cases. Here, we report a patient presenting concomitant Fahr's syndrome and thoracic OPLL developed by idiopathic hypoparatyroidism. CASE PRESENTATION: 53-year-old female patient presented myelopathic sign including gait disturbance and both leg weakness (Grade 3) for 4 months after slip down, and has the history of anti-epileptic medication for several years. Magnetic resonance imaging revealed cord compression by the mixed-type OPLL from T5 to T9, and decompressive surgery was planned. Sudden onset generalized tonic-clonic seizure attack developed before the surgery. Hypocalcemia (3.7 mg/dL) with QT prolongation on electrocardiogram, hypomagnesemia (1.4 mg/dL), hyperphosphatemia (7.7 mg/dL), hypoparathyroidism, and normal range of vitamin D was noted. Brain study showed Fahr's syndrome with multiple and symmetric calcification of basal ganglia, cerebral cortex, and cerebellum. Decompressive laminectomy was performed after transient correction of hypocalcemia. The myelopathic symptoms improved to normal walking by the 14-month follow-up. The cause of hypoparathyroidism was concluded to be idiopathic. CONCLUSION: Concomitant expression of Fahr's syndrome and OPLL related with idiopathic hypoparatyroidism is very rare. However, we recommend considering the possibility of hypoparathyroidism and Fahr's syndrome when we evaluate the patients with OPLL to avoid the risks of sudden onset seizure and cardiac arrhythmia due to cerebral lesions and hypocalcemia.


Assuntos
Doenças dos Gânglios da Base/etiologia , Calcinose/etiologia , Hipoparatireoidismo/complicações , Doenças Neurodegenerativas/etiologia , Ossificação do Ligamento Longitudinal Posterior/etiologia , Doenças dos Gânglios da Base/diagnóstico , Encéfalo/diagnóstico por imagem , Calcinose/diagnóstico , Descompressão Cirúrgica , Feminino , Humanos , Hipoparatireoidismo/diagnóstico , Ligamentos Longitudinais/diagnóstico por imagem , Imagem por Ressonância Magnética , Pessoa de Meia-Idade , Doenças Neurodegenerativas/diagnóstico , Ossificação do Ligamento Longitudinal Posterior/diagnóstico , Ossificação do Ligamento Longitudinal Posterior/cirurgia , Vértebras Torácicas , Tomografia Computadorizada por Raios X
8.
Mymensingh Med J ; 28(3): 694-698, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31391447

RESUMO

"Porcelain gallbladder" term has been used to highlight the blue staining and fragile consistency of the gallbladder wall at surgery. Some authorities avoid these terms and alternately call all calcified gallbladders "porcelain gallbladders". It is a morphological deviation of chronic cholecystitis. Inflammatory scarring of the wall combined with dystrophic calcification inside the wall transforms the gallbladder into a porcelain-like container. In porcelain gallbladder patients are usually asymptomatic and the condition is usually noted incidentally on plain abdominal radiographs, sonograms, or computed tomography (CT) images. Porcelain gallbladder is a rare condition; recognizing the clinical and imaging characteristics of the disease is important because of the high frequency (22%) of adenocarcinoma in porcelain gallbladder. Operation should not be delayed even if the patient is asymptomatic, because the incidence of carcinoma in porcelain gallbladder is extremely high. Here we present a case of 45 years old lady with porcelain gallbladder who was initially diagnosed as a case of carcinoma gallbladder at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh on 5th August 2017. But she was found to have a benign gallbladder after cholecystectomy.


Assuntos
Calcinose , Doenças da Vesícula Biliar , Vesícula Biliar , Bangladesh , Calcinose/diagnóstico , Feminino , Vesícula Biliar/patologia , Doenças da Vesícula Biliar/cirurgia , Humanos , Pessoa de Meia-Idade
9.
World Neurosurg ; 130: 298-303, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31306838

RESUMO

BACKGROUND: A 61-year-old man was admitted complaining of myelopathy and back pain for 3 months. CASE DESCRIPTION: A 15-mm hemangioma with calcification was noted on magnetic resonance imaging and computed tomography. Intraoperatively, the mass was hard with ill-defined demarcation. The cranial portion of the mass was brown and dark gray on the dorsal cord. During surgery, motor evoked potentials transiently decreased, but they fully recovered at the end of surgery. After surgery, the patient's symptoms recovered without severe neurologic deficit. CONCLUSIONS: Hemangioma calcificans, a variant of cavernous hemangioma with full calcification and ossification, is an extremely rare disease in the spine and brain. Here we report a rare case of intramedullary cavernous hemangioma with calcification of the spinal cord.


Assuntos
Calcinose/patologia , Hemangioma Cavernoso/cirurgia , Neoplasias da Medula Espinal/cirurgia , Medula Espinal/cirurgia , Calcinose/diagnóstico , Potencial Evocado Motor/fisiologia , Hemangioma Cavernoso/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Medula Espinal/patologia , Neoplasias da Medula Espinal/diagnóstico , Coluna Vertebral/patologia , Tomografia Computadorizada por Raios X/métodos
10.
Arch Ital Urol Androl ; 91(2)2019 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-31266275

RESUMO

INTRODUCTION/AIM: Although prostatic calculi/calcifications are encountered frequently in the urological practice, little is known about the incidence of such lesions, their mechanism of formation, their relationship to other prostate conditions and their clinical significance. The purpose of this study is to describe the characteristics and to investigate the clinical significance of prostatic calcifications (PCs) in patients with chronic bacterial prostatitis (CBP). MATERIALS AND METHODS: This study was conducted between 01/02/2013 and 20/02/2018. The patient population for this study included subjects with or without PCs and a confirmed diagnosis of NIH category II Chronic Bacterial Prostatitis (CBP). Demographics and clinical history of each assessed patient were reviewed. Eligible patients underwent prostatic ultrasound with post-void residual measurement, and the Meares-Stamey "4-glass" test. Symptom severity was measured using the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) and the International Prostatic Symptoms Score (IPSS). Antimicrobials were administered to confirmed cases of CBP according to the results of susceptibility tests. After four weeks off-therapy, the NIH-CPSI and IPSS tests were repeated. Variables were compared between patients with and without prostatic calcifications. RESULTS: Ninety-five CBP patients were included in the study. According to the presence of PCs detected by ultrasound examination, patients were divided into two groups: 41 had PCs (group 1) and 54 didn't (group 2). No significant between-group baseline differences were found regarding age, marital status, prostate volume, the proportion of common CBP pathogens. Concerning highrisk sexual behavior, a significantly higher number of men with PCs practiced anal penetration. Moreover, a significantly higher number of men with PCs had a history of chronic prostatitis relapsing episodes. Microbiological eradication and the complete resolution of clinical symptoms occurred in similar proportions between the two groups. However, intergroup analysis resulted in significantly higher scores of the NIH-CPSI test in group 1, both at the pre-therapy and at the post-therapy time points. Conversely, no IPSS score differences between groups 1 and 2 were found at both pre- and post-therapy time points. CONCLUSIONS: Prostatic calcifications do not seem to influence the microbiological outcome of antibacterial treatment. However, the CBP symptoms appear to be more severe in carriers of prostatic calcifications, either before or after antibacterial therapy.


Assuntos
Infecções Bacterianas/patologia , Calcinose/diagnóstico , Doenças Prostáticas/diagnóstico , Prostatite/patologia , Antibacterianos/administração & dosagem , Infecções Bacterianas/tratamento farmacológico , Calcinose/patologia , Doença Crônica , Humanos , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Estudos Prospectivos , Doenças Prostáticas/patologia , Prostatite/tratamento farmacológico , Índice de Gravidade de Doença , Fatores de Tempo , Resultado do Tratamento
11.
Biomed Res Int ; 2019: 5026860, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31355265

RESUMO

Aims: Calcifying fibrous tumor (CFT) is a very rare begin fibroblastic tumor featuring a widely anatomical distribution and may mimic various spindle cell tumors. Misdiagnosis and hence mistreatment are likely caused due to unfamiliarity to clinicians or junior pathologists. We collected a relatively large series of CFTs in our institution aiming at further summarizing their clinicopathologic features in Chinese patients and discussing the diagnosis and differential diagnosis in clinical practice. Methods: Clinicopathologic data of 22 CFTs were retrospectively reviewed. Histologic features were reevaluated and summarized. Immunostaining markers include CD34, SMA, Desmin, keratin, S100, ALK1, CD117, IgG, IgG4, and Ki-67. Follow-up of all cases was performed. Results: 22 CFTs include gastric (n=8), pulmonary (n=2), hepatic (n=2), cervical (n=1), appendiceal (n=1), esophageal (n=1), retroperitoneal (n=1), intra-abdominal (n=1), diaphragmatic (n=1), spermatic cord and scrotum (n=1), anconeal (n=1), mesenteric (n=1), and omental (n=1) lesions. Coexisting hepatocellular carcinoma, pancreatic carcinoma, pheochromocytoma, Castleman disease, and leiomyoma of the uterus and other metabolic or functional disorders were also appreciated. CFT histologically features spindle cells embedded dense hyalinized stroma with scattered psammomatous calcifications and lymphoplasmacytic infiltration and immunohistochemically for CD34. None of any individuals die of CFT per se. Conclusion: Our study discloses that CFT is a bona fide benign fibroblastic lesion, regardless of its developing location. Involvement of digestive tract seems much more common in the Chinese population. Awareness of the clinicopathologic characteristics of this rare entity and its mimickers contribute to avoiding misdiagnosis and mistreatment in clinical practice.


Assuntos
Calcinose , Proteínas de Neoplasias/metabolismo , Neoplasias de Tecido Fibroso , Adolescente , Adulto , Idoso , Calcinose/diagnóstico , Calcinose/metabolismo , Calcinose/patologia , Criança , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias de Tecido Fibroso/diagnóstico , Neoplasias de Tecido Fibroso/metabolismo , Neoplasias de Tecido Fibroso/patologia
12.
Acta Med Port ; 32(5): 402-406, 2019 May 31.
Artigo em Português | MEDLINE | ID: mdl-31166902

RESUMO

Pathological basal ganglia calcification, or Fahr's Syndrome, can be secondary to a variety of diseases, namely parathyroid disturbances. Movement disorders are common clinical features, in which chorea is seen in less than 20% of cases and dystonia just in 8%. We report the clinical case of a 49-year-old male with a history of thyroidectomy, who was admitted in Emergency Service with acute generalized chorea and focal painful feet dystonia. Laboratory analysis showed hypocalcemia and rhabdomyolysis, and computed tomography scan revealed parenchymal calcification with basal ganglia involvement. After complementary studies we established a Fahr's Syndrome diagnosis secondary to an iatrogenic hypoparathyroidism. Clinical management has been successful with stabilized calcium levels, with no more neurologic symptoms. Hypocalcemia should be readily investigated and treated after a thyroidectomy, given the irreversibility of intracerebral calcifications and potential neurological or systemic consequences.


Assuntos
Doenças dos Gânglios da Base/etiologia , Calcinose/etiologia , Coreia/etiologia , Distonia/etiologia , Hipoparatireoidismo/complicações , Doenças Neurodegenerativas/etiologia , Doenças dos Gânglios da Base/diagnóstico , Calcinose/diagnóstico , Humanos , Hipocalcemia/diagnóstico , Hipocalcemia/etiologia , Doença Iatrogênica , Masculino , Pessoa de Meia-Idade , Doenças Neurodegenerativas/diagnóstico , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/etiologia , Tireoidectomia/efeitos adversos , Tomografia Computadorizada por Raios X
13.
Pediatr. aten. prim ; 21(82): 187-190, abr.-jun. 2019. ilus
Artigo em Espanhol | IBECS | ID: ibc-184598

RESUMO

La presencia de calcificaciones hepáticas fetales puede ser advertida durante el seguimiento ecográfico gestacional. Pueden ser únicas o múltiples, y estar asociadas o no a problemas tales como infecciones connatales o cromosomopatías. Aquellas lesiones aisladas, sin otras alteraciones asociadas, tienen buen pronóstico y cursan en la mayoría de las ocasiones de forma asintomática. Comunicamos dos casos clínicos de pacientes con calcificaciones hepáticas congénitas múltiples. Se revisa el manejo y el pronóstico de esta patología


Fetal hepatic calcifications may be noticed during gestational ultrasound follow-up. They may be unique or multiple, and may be associated with or without problems such as chromosomopaties or prenatal infections. Isolated lesions have a good prognosis and are most often asymptomatic. We communicate two clinical cases of patients with multiple congenital hepatic calcifications. The management and prognosis of this pathology is reviewed


Assuntos
Humanos , Masculino , Lactente , Calcinose/diagnóstico , Hepatopatias/congênito , Diagnóstico Diferencial , Diagnóstico Pré-Natal/métodos
14.
EuroIntervention ; 15(8): 714-721, 2019 Oct 20.
Artigo em Inglês | MEDLINE | ID: mdl-31062700

RESUMO

Heavily calcified lesions may be difficult to dilate adequately with conventional balloons and stents, which causes frequent periprocedural complications and higher rates of target lesion revascularisation (TLR). High-pressure non-compliant balloon angioplasty may be of insufficient force to modify calcium and, even when successful, may be limited in its ability to modify the entire calcified lesion. Scoring and cutting balloons hold theoretical value but data to support their efficacy are lacking and, because of their high lesion crossing profile, they often fail to reach the target lesion. Rotational and orbital atherectomy target superficial calcium; however, deep calcium, which may still impact on vessel expansion and luminal gain, is not affected. Intravascular lithotripsy (IVL), based on lithotripsy for renal calculi, is a new technology which uses sonic pressure waves to disrupt calcium with minimal impact to soft tissue. Energy is delivered via a balloon catheter, analogous to contemporary balloon catheters, with transmission through diluted ionic contrast in a semi-compliant balloon inflated at low pressure with sufficient diameter to achieve contact with the vessel wall. With coronary and peripheral balloons approved in Europe, peripheral balloons approved in the USA and multiple new trials beginning, we review the indications for these recently introduced devices, summarise the clinical outcomes of the available trials and describe the design of ongoing studies.


Assuntos
Artérias/diagnóstico por imagem , Aterectomia Coronária/métodos , Calcinose/cirurgia , Litotripsia , Calcificação Vascular/terapia , Aterectomia Coronária/efeitos adversos , Calcinose/diagnóstico , Constrição Patológica , Europa (Continente) , Humanos , Tomografia de Coerência Óptica , Ultrassonografia de Intervenção , Calcificação Vascular/diagnóstico por imagem
15.
PLoS One ; 14(5): e0216947, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31086410

RESUMO

CONTEXT: MicroRNA (miRNA) regulate post-transcriptionally the expression of osteogenesis and angiogenesis associated genes and emerge as potential non-invasive biomarkers in vascular and bone diseases. Severe abdominal aortic calcification (AAC) is associated with higher risk of cardiovascular event and of fragility fracture. OBJECTIVE: To identify miRNA linked to the aggravation of AAC and to incident osteoporotic fracture. DESIGN: Postmenopausal women (>50 years) with available serum at inclusion and data for each outcome (Kauppila score and incident fracture) were selected from the OFELY prospective cohort. We conducted a case-control study in 434 age-matched women, 50% with incident osteoporotic fracture over 20 years of follow-up and a second study in 183 women to explore AAC over 17 years. METHODS: Serum expression of three miRNA involved in vascular calcification and bone turnover regulation (miRs-26a-5p,-34a-5p, and -223-5p) was quantified at baseline by TaqMan Advanced miRNA technology and expressed by relative quantification. Outcomes were the association of miRNA levels with (1) incident osteoporotic fractures during 20 years, (2) AAC aggravation during 17 years. RESULTS: MiRNA level was not associated with incident fractures (miR-26a-5p: 1.06 vs 0.99, p = 0.07; miR-34a-5p: 1.15 vs 1.26, p = 0.35; miR-223a-5p: 1.01 vs 1.05, p = 0.32). 93 women had an increase in Kauppila score over 17 years while 90 did not. None of the miRNAs was associated with an aggravation in AAC (miR-26a-5p: 1.09 vs 1.10, p = 0.95; miR-34a-5p: 0.78 vs 0.73, p = 0.90; miR-223-5p: 0.97 vs 0.78, p = 0.11). CONCLUSIONS: Circulating miR-26a-5p, -34a-5p and -223-5p are not significantly associated with incident fracture and AAC aggravation.


Assuntos
Calcinose/genética , MicroRNAs/genética , Osteoporose Pós-Menopausa/genética , Fraturas por Osteoporose/genética , Idoso , Aorta Abdominal/metabolismo , Aorta Abdominal/patologia , Biomarcadores/sangue , Calcinose/sangue , Calcinose/diagnóstico , Calcinose/patologia , Estudos de Casos e Controles , Feminino , Humanos , MicroRNAs/sangue , Pessoa de Meia-Idade , Razão de Chances , Osteoporose Pós-Menopausa/sangue , Osteoporose Pós-Menopausa/diagnóstico , Osteoporose Pós-Menopausa/patologia , Fraturas por Osteoporose/sangue , Fraturas por Osteoporose/diagnóstico , Fraturas por Osteoporose/patologia , Reação em Cadeia da Polimerase , Pós-Menopausa/sangue , Pós-Menopausa/genética , Prognóstico , Estudos Prospectivos , Risco
17.
Pediatr Dermatol ; 36(4): e102-e103, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31134636

RESUMO

A case of a 15-year-old male patient with a 3-year history of linear, segmental amyopathic dermatomyositis with calcinosis cutis is presented. The calcinosis was recalcitrant to treatment with topical steroids and hydroxychloroquine. Topical 10% sodium thiosulfate use for 8 weeks resulted in improvement. The use of topical sodium thiosulfate for patients in whom surgical extraction is not an option is detailed.


Assuntos
Calcinose/diagnóstico , Dermatomiosite/tratamento farmacológico , Dermatomiosite/patologia , Tiossulfatos/uso terapêutico , Administração Tópica , Adolescente , Biópsia por Agulha , Calcinose/complicações , Doença Crônica , Dermatomiosite/complicações , Dermatomiosite/diagnóstico , Humanos , Imuno-Histoquímica , Dermatoses da Perna/diagnóstico , Dermatoses da Perna/etiologia , Masculino , Dermatopatias/tratamento farmacológico , Dermatopatias/patologia , Resultado do Tratamento
18.
Endocrinol. diabetes nutr. (Ed. impr.) ; 66(5): 297-304, mayo 2019. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-182804

RESUMO

Introducción: Los pacientes con enfermedad renal crónica (ERC) y diabetes mellitus (DM) tienen un elevado riesgo cardiovascular. Ambas enfermedades se relacionan con el desarrollo de ateroesclerosis sistémica y calcificación vascular. La prevalencia y la severidad de la calcificación arterial coronaria (CaC) es mayor en personas con DM, independientemente de su función renal. Los datos acerca del papel pronóstico a largo plazo de la CaC en pacientes con DM y ERC son escasos. Material y métodos: Se diseñó un estudio prospectivo que incluía a 137 pacientes (85 en hemodiálisis y 52 con ERC avanzada). Se realizó una tomografía computerizada (TC) helicoidal multicorte coronario basal. La CaC se cuantificó mediante el método de Agatston y los pacientes fueron clasificados en CaC leve-moderada (CaC<400UH) y severa (CaC≥400UH). Resultados: El tiempo medio de seguimiento fue de 87,5 meses. El 28% eran pacientes con DM; tenían una CaC más severa, menor nivel de albúmina y una proteína C reactiva más elevada. La albúmina se correlacionó con la CaC severa (r=-0,45; p=0,009). La mortalidad fue del 58%. Los casos con DM mostraban una tendencia lineal de mayor mortalidad en comparación con los sujetos sin DM (Chi cuadrado 3,51, p=0,061). Los pacientes con DM y CaC severa tuvieron, además, una mayor mortalidad en comparación con aquellos con CaC severa sin DM (93% vs.73%; p=0,04). Conclusiones: Los pacientes con ERC avanzada y DM presentan una CaC más severa, datos bioquímicos compatibles con una mayor inflamación-malnutrición y una mayor mortalidad en comparación con aquellos sin DM


Introduction: Patients with chronic kidney disease (CKD) and diabetes mellitus (DM) have high cardiovascular risk. Both conditions are related to systemic atherosclerosis and vascular calcification. The prevalence and severity of coronary artery calcification (CaC) is higher in patients with DM, regardless of their renal function. Data about the long-term prognostic role of CaC in diabetic patients with CKD are scarce. Material and methods: We carried out a prospective longitudinal study enrolling 137 patients with advanced CKD. A non-enhanced multislice coronary computed tomography (CT) was performed at baseline. CaC was assessed using Agatston method. Patients were stratified according to their CaC score: severe calcification group (CaCs≥400HU) and mild-moderate calcification group (CaCs<400HU). Results: The median follow-up time was 87.5 months. DM was found in 28% of subjects. The patients with DM showed more severe CaC, lower albumin and higher C-reactive protein serum levels. Serum albumin was correlated with severe CaC (r=-0.45, P=.009). Overall mortality rate reached 58%. Patients with DM also tended to have higher mortality compared to non-diabetic subjects (X2 3.51, P=.061) especially those with severe CaC showed higher mortality than those with severe CaC without DM (93% vs.73%, P=.04). Conclusions: Patients with advanced CKD and DM have more severe CaC, increased inflammation-malnutrition data and higher mortality compared to those without DM


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Doença da Artéria Coronariana/complicações , Doença da Artéria Coronariana/diagnóstico , Insuficiência Renal Crônica/complicações , Calcificação Vascular/diagnóstico , Diabetes Mellitus/fisiopatologia , Calcinose/diagnóstico , Estudos de Coortes , Vasos Coronários/patologia , Fatores de Risco , Estudos Prospectivos , Diálise Renal/métodos , Calcinose/epidemiologia , Diabetes Mellitus Tipo 2/complicações , Índice de Gravidade de Doença
20.
Mayo Clin Proc ; 94(4): 652-659, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30947832

RESUMO

The aim of this study was to characterize endothelial progenitor cells with osteoblastic phenotype (EPC-OCNs) and their role in individuals with varying degrees of aortic stenosis (AS). Peripheral blood mononuclear cells retrieved from blood samples of individuals with mild (n=40), moderate (n=35), or severe (n=103) AS from September 16, 2008, through March 30, 2015, were analyzed by flow cytometry for the EPC surface markers CD34, CD133, and kinase insert domain receptor (KDR) and the osteoblastic cell surface marker OCN. Levels of EPC-OCNs were correlated with AS severity and calcifications. Patients with severe AS had significantly elevated numbers of total circulating EPC-OCNs, including the EPC-OCN subtypes CD133+/OCN+, CD34+/CD133+/OCN+, and CD133+/KDR+/OCN+, compared with those with mild AS. Individuals with moderate AS also had significantly increased numbers of the circulating progenitor cell CD133+/OCN+ compared with patients with mild AS. There was a significant association between total circulating EPC-OCN levels and aortic valve (AV) calcification, AV mean gradient, and AV area measured by echocardiography. In summary, this study found the presence of circulating EPC-OCNs in patients with progressive AV stenosis. These findings might support the potential role for EPC-OCNs in the progression of AV stenosis and calcification.


Assuntos
Estenose da Valva Aórtica/sangue , Estenose da Valva Aórtica/diagnóstico , Osteoblastos/fisiologia , Células-Tronco/fisiologia , Adulto , Idoso , Biomarcadores/sangue , Circulação Sanguínea/fisiologia , Calcinose/sangue , Calcinose/diagnóstico , Feminino , Humanos , Leucócitos Mononucleares/fisiologia , Masculino , Pessoa de Meia-Idade , Osteogênese/fisiologia
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