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1.
Vasc Endovascular Surg ; 54(1): 85-88, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31547785

RESUMO

The common femoral artery (CFA) is the most widely used inflow in all types of surgical revascularization in patients with peripheral artery disease. However, the CFA cannot always be used because of calcification, obstruction, or previous dissection. Here, we report a rare case of selecting the deep circumflex iliac artery (DCIA) as a source of inflow to perform a surgical revascularization in a patient with chronic limb-threatening ischemia. A 62-year-old man was admitted to our hospital due to necrotized third and fifth toes with pain at rest. Computed tomography showed severe stenosis of the CFA, superficial femoral artery, and deep femoral artery, and an entirely stented external iliac artery. The DCIA was identified as the only patent artery. Considering the condition of the other arteries, we selected the DCIA as a source of inflow. Deep circumflex iliac-popliteal bypass was performed with a saphenous vein. The bypass graft was patent 9 months after surgery and limb salvage had been achieved.


Assuntos
Artéria Ilíaca/cirurgia , Isquemia/cirurgia , Extremidade Inferior/irrigação sanguínea , Doença Arterial Periférica/cirurgia , Enxerto Vascular/métodos , Doença Crônica , Humanos , Artéria Ilíaca/diagnóstico por imagem , Artéria Ilíaca/fisiopatologia , Isquemia/diagnóstico por imagem , Isquemia/fisiopatologia , Masculino , Pessoa de Meia-Idade , Doença Arterial Periférica/diagnóstico por imagem , Doença Arterial Periférica/fisiopatologia , Resultado do Tratamento , Grau de Desobstrução Vascular
3.
Rev. Pesqui. (Univ. Fed. Estado Rio J., Online) ; 12: 257-262, jan.-dez. 2020. tab
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1047911

RESUMO

Objetivo: identificar o perfil epidemiológico dos usuários atendidos em ação de saúde na Baixada Litorânea do Rio de Janeiro. Método: trata-se de um estudo descritivo, retrospectivo, exploratório de natureza quantitativa que utilizou como delineamento a pesquisa documental por meio da análise de dados secundários. Resultados: foram avaliados 746 registros, com prevalência do sexo feminino (69,7%), idade entre 20 e 29 anos (41,6%), ensino superior incompleto (63,9%) e estado civil solteiro (69,4%). O sexo masculino apresentou uma média mais elevada de níveis pressóricos quando comparado com as mulheres. Evidenciou-se que com o avançar da idade e baixa escolaridade, maiores são os níveis de pressão arterial e glicêmicos. Conclusão: estudos que ampliam o conhecimento sobre o perfil epidemiológico de uma população representam uma ferramenta importante para subsidiar o cuidado em saúde


Objective: to reveal the epidemiological profile of the users met in health action in the Coastal Lowlands of Rio de Janeiro. Method: this is a descriptive study, retrospective, exploratory quantitative in nature used as documentary research design through the analysis of secondary data. Results: 746 records were evaluated, with female prevalence (69.7%), age between 20 and 29 years (41.6%), incomplete higher education (63.9%) and marital status single (69.4%). Males showed an average blood pressure higher when compared with the female. It was evidenced that with advancing age and lower educational level, the greater the blood pressure and blood glucose levels. Conclusion: it is considered that studies about the knowledge of the epidemiological profile of a population becomes an important tool to support health actions


Objetivo: identificar el perfil epidemiológico de los usuarios se reunieron en la acción sanitaria en las tierras bajas costeras de Río de Janeiro. Método: se trata de un estudio descriptivo, retrospectivo, utilizado cuantitativo en naturaleza exploratoria como diseño de investigación documental a través del análisis de datos secundarios. Resultados: se evaluaron registros de 746, con predominio femenino (69.7%), edad entre 20 y 29 años (41.6%), educación superior incompleta (63.9%) y el estado civil solo (69,4%). Los varones mostraron mayor los niveles de presión arterial media en comparación con las mujeres. Se evidenció que con el avance de edad y menor nivel educativo, mayor será los niveles de glucosa en sangre y presión arterial. Conclusión: estudios que amplían el conocimiento sobre el perfil epidemiológico de una población representan una herramienta importante para apoyar la atención de la salud


Assuntos
Humanos , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Doença Crônica/epidemiologia , Estudos Retrospectivos , Doenças não Transmissíveis/epidemiologia , Fatores Socioeconômicos , Perfil de Saúde , Brasil/epidemiologia , Diabetes Mellitus , Hipertensão
5.
Rev. salud pública Parag ; 9(2): [P9-P15], Dic 2019.
Artigo em Espanhol | LILACS, BDNPAR | ID: biblio-1047044

RESUMO

Introducción: La Diabetes Mellitus tipo 2 es una enfermedad metabólica muy frecuente, siendo una de las principales causas de mortalidad en nuestro país. El enfoque integral, individual, familiar y comunitario de la Atención Primaria de Salud a través de las Unidades de Salud de la Familia permite identificar síntomas de depresión que pueden aparecer durante el curso de la enfermedad. Objetivo: Determinar los niveles de depresión según la cronicidad de la Diabetes Mellitus tipo 2 y sus comorbilidades en pacientes de las Unidades de Salud del distrito de Encarnación en el año 2018. Metodología: Estudio con diseño observacional, analítico de corte transversal sobre 228 pacientes con Diabetes Mellitus tipo 2 entrevistados durante el año 2018. Se aplicó un formulario validado con el test de Kuder- Richardson y la Escala de Hamilton para la depresión. Los datos fueron procesados en EpiInfo v. 7. Resultados: Se detectó depresión en el 66,7 % (152) de las personas incluidas en el estudio, siendo más frecuente la depresión ligera presente en el 32, 9 % (75) de los casos, seguido de depresión moderada y grave. Se encontró asociación estadísticamente significativa entre depresión y años de evolución de Diabetes Mellitus tipo 2 (p = 0.029), hipertensión (p = 0.0024); neuropatía (p = 0.0003). Conclusión: El nivel de depresión más frecuente fue la ligera y la presencia de síntomas de depresión en pacientes con Diabetes Mellitus tipo 2 fue alta, asociada significativamente con años de evolución de la diabetes, hipertensión y neuropatía. Palabras clave: Diabetes mellitus, Depresión, Atención Primaria de Salud.


Introduction: Type 2 Diabetes Mellitus is a very frequent metabolic disease, being one of the main causes of mortality in our country. The integral, individual, family and community approach of Primary Health Care through the Family Health Units allows to identify symptoms of depression that may appear during the course of the disease. Objective: To determine the levels of depression according to the chronicity of Type 2 Diabetes Mellitus and its comorbidities in patients of the Health Units of the district of Encarnación in the year 2018. Methodology: Study with observational, analytical cross-sectional design on 228 patients with Type 2 Diabetes Mellitus interviewed during 2018. A validated form was applied with the Kuder-Richardson test and the Hamilton Scale for depression. The data was processed in EpiInfo v. 7. Results: Depression was detected in 66.7% (152) of the people included in the study, with mild depression being more frequent in 32.9% (75) of the cases, followed by moderate and severe depression. A statistically significant association was found between depression and years of evolution of Type 2 Diabetes Mellitus (p = 0.029), hypertension (p = 0.0024); neuropathy (p = 0.0003). Conclusion: The most frequent level of depression was mild and the presence of depression symptoms in patients with Type 2 Diabetes Mellitus was high, significantly associated with years of evolution of diabetes, hypertension and neuropathy. Keywords: Diabetes mellitus, Depression, Primary Health Care.


Assuntos
Humanos , Masculino , Feminino , Atenção Primária à Saúde , Depressão , Diabetes Mellitus/psicologia , Doença Crônica/psicologia
6.
Arkh Patol ; 81(6): 41-48, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31851191

RESUMO

OBJECTIVE: To characterize endometrial structural and functional state and receptivity in women with hysteromyoma (HM) and chronic endometritis (CE) in infertile couples. MATERIAL AND METHODS: A total of 130 patients who had HM and/or CE in an infertile couple were examined. Group 1 included 64 women with HM and CE; Group 2 consisted of 24 patients with HM; group 3 comprised 42 patients with EC. A control group included endometrial biopsy specimens from 20 healthy women planning a pregnancy. RESULTS: Patients with HM and CE were found to develop endometrial dysfunction. Its structural signs were damage to the endometrial surface epithelium; intense stromal fibrosis with the high expression of type III and IV collagens; dysregulated processes of high angiogenesis; impaired maturation of pinopodia by the implantation window; high estrogen receptor (ER) expression in the nuclei of endometrial glandular and stromal cells; low progesterone receptor (PR) expression; and impaired secretory endometrial transformation. CONCLUSION: HM concurrent with CE is responsible for endometrial dysfunction. Its structural manifestations are mainly associated with CE.


Assuntos
Endometrite , Infertilidade Feminina , Leiomioma , Neoplasias Uterinas , Doença Crônica , Implantação do Embrião , Endométrio , Feminino , Humanos , Gravidez , Receptores Estrogênicos
7.
Medicine (Baltimore) ; 98(50): e18331, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31852127

RESUMO

This study assessed sex differences in cardiac and motor functions, quality of life (QoL), and mental status in Chinese chronic heart failure (CHF) patients after metoprolol treatment.This single-center prospective study, conducted from February 2013 to April 2016, included CHF patients (men and women) with resting heart rate (HR) >80 beats/min using metoprolol continuous release tablets. Metoprolol-induced changes in cardiac and motor functions, QoL, and mental status at 1, 3, 6, 9, and 12 months from baseline, within and between the sexes, were analyzed. Descriptive data were represented as counts, percentages, and mean ± standard deviation. Differences at various follow-up periods were compared using repeated measures one-way analysis of variance, followed by post hoc Dunnett's multiple comparison test. Statistical significance was considered at P < .05.Compared with men, women reported significantly higher systolic blood pressure (SBP) (122.28 ±â€Š6.76 vs 125.47 ±â€Š6.67 mm Hg, P < .05) and Veterans Specific Activity Questionnaire score (8.16 ±â€Š0.98 vs 8.47 ±â€Š0.89, P = .05) at 12 months. Men reported higher Hospital Anxiety and Depression Scale scores for depression than women at 1 month (10.27 vs 8.83, P < .05) and for anxiety at 12 months (8.4 vs 7.72, P < .05). Metoprolol significantly decreased HR and Minnesota Living with Heart Failure Questionnaire score in men (64.5 ±â€Š3.13 and 53.7 ±â€Š8.00) and women (65.38 ±â€Š3.32 and 53.85 ±â€Š8.42, respectively). Ejection fraction (%, men: 50.00 ±â€Š4.45, women: 50.72 ±â€Š4.09), cardiac index (L/min/m, men: 2.70 ±â€Š0.25, women: 2.78 ±â€Š0.23), 6-minute walk test distance (m, men: 414.41 ±â€Š20.84, women: 420.34 ±â€Š20.35), and short form-8 questionnaire scores (men: 52.05 ±â€Š1.94, women: 52.19 ±â€Š2.58) increased significantly in both the sexes (P < .001 for all) at 12 months. Copenhagen Burnout Inventory score significantly increased in men (mean score 62.43, P < .05).Metoprolol treatment improves cardiac and motor functions, QoL, and anxiety scores but causes greater depression and burnout in men and women. Sex was seen to affect mental status of CHF patients the most.


Assuntos
Insuficiência Cardíaca/tratamento farmacológico , Insuficiência Cardíaca/psicologia , Metoprolol/uso terapêutico , Qualidade de Vida , Fatores Sexuais , Adulto , Idoso , Ansiedade/tratamento farmacológico , Ansiedade/etiologia , Grupo com Ancestrais do Continente Asiático/psicologia , China , Doença Crônica , Depressão/tratamento farmacológico , Depressão/etiologia , Feminino , Frequência Cardíaca/efeitos dos fármacos , Humanos , Masculino , Pessoa de Meia-Idade , Atividade Motora/efeitos dos fármacos , Estudos Prospectivos , Inquéritos e Questionários , Resultado do Tratamento
8.
Zhonghua Xue Ye Xue Za Zhi ; 40(11): 948-952, 2019 Nov 14.
Artigo em Chinês | MEDLINE | ID: mdl-31856446

RESUMO

Objective: Chronic graft-versus-host disease (cGVHD) is a major long-term complication after allogeneic hematopoietic stem cell transplantation (allo-HSCT) . It is important to study the changes of serum biomarkers expression in patients for early diagnosis and treatment. Methods: The expression levels of five serum protein markers (IL-1b, IL-16, CXCL9, CCL19, CCL17) in patients with or without cGVHD after allo-HSCT were detected by liquid suspension microarray. Results: Compared with the control group without cGVHD, the expression levels of CXCL9 and CCL17 in serum of patients with cGVHD were significantly increased (P<0.05) . CCL17 was correlated with the severity of cGVHD (P<0.001) . CXCL9 was significantly increased in the serum of patients with skin lesion (P<0.01) , and CCL17 was significantly expressed in cGVHD patients with liver as the target organ (P<0.01) . Conclusion: The combination of CXCL9 and CCL17 can be used as serum biomarkers of cGVHD, which has certain reference value in assisting the diagnosis and evaluation of cGVHD severity.


Assuntos
Doença Enxerto-Hospedeiro , Biomarcadores , Doença Crônica , Transplante de Células-Tronco Hematopoéticas , Humanos , Transplante Homólogo
9.
Kardiologiia ; 59(12): 54-63, 2019 Dec 11.
Artigo em Russo | MEDLINE | ID: mdl-31849312

RESUMO

Increase in life expectancy during the second part of the 20th century is accompanied by increase in proportion of elderly and senile age population. However, despite the increase in life expectancy, the prevalence of most chronic diseases and functional impairments rises with age. Elderly and senile age is associated with the risk of cardiovascular diseases (CVD), therefore the problem of managing elderly patients with CVD becomes especially urgent.


Assuntos
Cardiologia , Doenças Cardiovasculares , Geriatria , Idoso , Doença Crônica , Humanos , Expectativa de Vida
10.
Kardiologiia ; 59(12): 84-91, 2019 Dec 11.
Artigo em Russo | MEDLINE | ID: mdl-31849315

RESUMO

Chronic heart failure (CHF) remains one of the most important problems of modern cardiology. One of the effective treatment methods is resynchronization therapy (RT). The article presents an analysis of literature data on the effectiveness of RT in improving the quality of life, reducing the number of hospitalizations and mortality in patients with heart failure with severe left ventricular systolic dysfunction and expanding QRS complex, and also discusses key methods for optimizing RT.


Assuntos
Insuficiência Cardíaca , Terapia de Ressincronização Cardíaca , Doença Crônica , Humanos , Qualidade de Vida , Disfunção Ventricular Esquerda , Remodelação Ventricular
11.
Medicine (Baltimore) ; 98(51): e18365, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31860996

RESUMO

INTRODUCTION: Cyclic vomiting syndrome (CVS) is a potentially exhausting disorder and has an adverse impact on quality of life, but it is poorly recognized and is always misdiagnosed leading to a diagnostic delay of several years, especially in adults. PATIENT CONCERNS: We report a case of a 32-year-old woman with recurrent severe nausea, vomiting, and abdominal pain, and repeated visits to the emergency department or the outpatient department for 4 years. Each time she was diagnosed with gastroenteritis or gastritis, and recovered after supportive treatment including antiemetics, maintenance of water and electrolyte balance, and a proton pump inhibitor. DIAGNOSIS: Laboratory examinations, gastroenteroscopy, chest and abdominal computed tomography, and brain magnetic resonance imaging all failed to reveal abnormalities that would explain her symptoms. Based on typical symptoms and the exclusion of other diseases associated with repeated vomiting, the diagnosis was made as CVS. INTERVENTIONS: She was given orally amitriptyline, 50 mg per night, and olanzapine, 1.25 mg per night. OUTCOMES: The treatment was effective in inducing remission, and symptoms did not recur after treatment. The treatment lasted for 2 months and stopped. Her symptoms did not recur over the 10-month follow up. CONCLUSION: CVS is not rare in adults, but its diagnosis is usually delayed due to poor recognition of the condition. Clinician awareness of CVS should be enhanced to improve early diagnosis.Core tip: Cyclic vomiting syndrome has a tremendous impact on the quality of life, but it is poorly recognized and is always misdiagnosed leading to a diagnostic delay of several years, especially in adults. The article presented a case report of cyclic vomiting syndrome of adult; we hope the article will attribute to increased awareness of physician and reduce delayed diagnosis.


Assuntos
Gastrite/diagnóstico , Gastrite/terapia , Vômito/diagnóstico , Vômito/terapia , Dor Abdominal/etiologia , Adulto , Antieméticos/uso terapêutico , Doença Crônica , Diagnóstico Precoce , Feminino , Humanos , Náusea/etiologia , Inibidores da Bomba de Prótons/uso terapêutico , Recidiva , Síndrome , Equilíbrio Hidroeletrolítico
12.
Medicine (Baltimore) ; 98(51): e18075, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31860957

RESUMO

RATIONALE: Dyke-Davidoff-Masson syndrome (DDMS) is a rare syndrome commonly occurring in children and characterized by cerebral hemiatrophy, hypertrophy of the skull, epilepsy, and mental retardation. However, few have been reported in China, especially in teenagers. This case investigated its possible cause and explored a relative effective solution. PATIENT CONCERNS: A 24-year-old female came to department having experienced recurrent seizures for 12 years. DIAGNOSIS: DDMS was diagnosed from its manifestations, biochemistry indexes, and imaging (computed tomography angiography, magnetic resonance venography, and so on). INTERVENTIONS: Several drugs are used to treat the disease, including valproate, carbamazepine, topiramate, and ginkgo biloba extract. OUTCOMES: Under the medicine treatment of magnesium valproate with carbamazepine, the patient experienced partial seizures approximately once per month that lasted 30 to 60 seconds each without any complications observed during a follow-up period of 24 months. CONCLUSION: The imaging and clinical features of DDMS in this teenager were similar to those in classic infantile-onset cases. A potential cause of the disease could be brain trauma, which impaired the middle cerebral artery and reduced cerebral blood supply, leading to epilepsy and hemiatrophy. LESSONS: It was concluded early diagnosis and pharmacotherapy are the keys to preventing intellectual decline in DDMS patients. Moreover, the combination of magnesium valproate and carbamazepine could significantly reduce the frequency and duration of seizures, despite not eliminating them completely.


Assuntos
Encefalopatias/diagnóstico por imagem , Deficiência Intelectual/diagnóstico , Imagem por Ressonância Magnética/métodos , Convulsões/diagnóstico , Convulsões/tratamento farmacológico , Encefalopatias/tratamento farmacológico , Carbamazepina/uso terapêutico , China , Doença Crônica , Feminino , Humanos , Deficiência Intelectual/tratamento farmacológico , Prognóstico , Recidiva , Medição de Risco , Índice de Gravidade de Doença , Síndrome , Tomografia Computadorizada por Raios X/métodos , Ácido Valproico , Adulto Jovem
13.
Int. arch. otorhinolaryngol. (Impr.) ; 23(4): 440-444, Out.-Dez. 2019. ilus
Artigo em Inglês | LILACS | ID: biblio-1024425

RESUMO

Introduction: Middle ear surgeries, including myringoplasty, have increasingly utilized endoscopes as an adjunct to or as a replacement for the operative microscope. Objectives: The objective of the present study was to evaluate the graft uptake rate and to evaluate the hearing results. Methods: This is a prospective study. We have analyzed 139 patients who underwent surgery for chronic otitis media (COM) of the mucosal type. All of the surgeries were performed exclusively under total endoscopic transcanal approach using tragal cartilage as graft, underlay technique. We have evaluated the postoperative graft uptake and performed a hearing evaluation at 6 weeks, at 12 weeks, and at 6 months. Results: During the study period, 139 patients were included, out of which 13 were lost to follow-up; therefore, only 126 patients were assessed. All of the cases were performed under total endoscopic approach. As for the surgical outcome at the postoperative otoscopy, 3 cases had initial uptake at 3 months and failed later; therefore, complete closure of the perforation was observed in 97.6% ( n = 123) of the patients 6 months after the intervention. Four patients presented with preoperative anacusis; therefore, only 122 patients were included for hearing evaluation. The preoperative air conduction threshold (ACT) and airbone gap (ABG) were 43.34 ± 11.53 and 24.73 ± 7.89, respectively. Postoperatively, the ACT and ABG closure were 28.73 ± 15.75 and 11.91 ± 8.41, respectively. This difference was statistically significant ( p < 0.001). Conclusion: The endoscopic approach for myringoplasty offers excellent visualization; avoids postaural approach, enables a faster recovery, requires less hospital stay, with excellent graft closure rate and improved functional outcomes (AU)


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Cartilagem da Orelha/transplante , Cirurgia Endoscópica por Orifício Natural/métodos , Miringoplastia/métodos , Otite Média , Doença Crônica , Estudos Prospectivos , Resultado do Tratamento , Testes Auditivos
14.
Kardiologiia ; 59(10S): 13-21, 2019 Sep 11.
Artigo em Russo | MEDLINE | ID: mdl-31876458

RESUMO

Actuality. The risk of death of patients with chronic heart failure (CHF) after acute decompensation of heart failure (ADHF) is directly related to the quality of the treatment of CHF after discharge from the hospital. In order to achieve the maximum effect of therapy in patients with CHF, experts in Europe and the USA recommend the creation of centers of specialized medical care for patients with CHF. Objective: to determine the risks of general, cardiovascular mortality and death from ADHF in patients with CHF during two years of observation, depending on their adherence to observation in a specialized center for the treatment of chronic heart failure (center CHF). Materials and methods. The study consistently included 942 patients with CHF after ADHF. The adherence of patients to follow up in center CHF was analyzed and 4 groups were distinguished: group 1 (n = 313) included patients who were observed continuously for two years; group 2 (n = 382) included patients who, after discharge, had never been observed in the center CHF; group 3 (n = 197) consisted of patients who were monitored at center CHF during the first year and then discontinued, and group 4 (n = 49) united patients who, when included in the study, abandoned observation, but after a year began to be constantly observed during the second year center CHF. Results. Statistically significant differences in age were registered only between groups 1 and 2 (69.6+9.9 and 71.8+11 years, respectively, р1/2=0.006). The overall mortality over the 2 years of follow-up was significantly higher in group 2 (32.4%) versus group 1 (1.2%, OR=3.8, 95% CI 2.5-5.7; p1/2<0.001 ); compared with group 3 (9.1%, OR=4.8, 95% CI 2.8-8.1; p2/3<0.001) and group 4 (8,2%, OR = 5.4, 95% CI 1.9-15.3; p2/4=0.0005). Cardiovascular mortality (CVM) for 2 years of follow-up was significantly higher in group 2 versus group 1 (8.1% and 1.3% of cases, OR=6.8, 95% CI 2.4-19.5; p1/2<0.001), as well as in comparison with group 3 (CVM 3% for 2 years, OR=2.8, 95% CI 1.1-6.8; p2/3=0.02). CVM in group 4 (6.1%) was 5 times higher in comparison with group 1 (OR=5.0, 95% CI 1.1-23.2; p1/4=0.02). The risks of death from ADHF over the 2 years of follow-up were significantly higher in group 2 (16.4%) compared with all groups: with group 1 (6.4%) OR=2.9, 95% CI 1.7-4, 9, p1/2<0.001; with group 3 (5.1%) OR=3.7, 95% CI 1.8-7.3, p2/3<0.001; and with group 4 (2%) OR=9.5, 95% CI 1.3-69.7, p2/4= 0.008. The combined endpoint (CVM and death from ADHF in 2 years of follow-up) was also significantly higher in group 2 (24.5%) compared with all compared groups: group 1 (7.7%), OR=3.9, 95% CI 2.4-6.3, p1/2<0.001; group 3 (8.1%), OR=3.7, 95% CI 2.1-6.5, p2/3<0.001; and group 4 (8.2%), OR=3.7, 95% CI 1.3-10.4; p2/4=0.01. Conclusion. Surveillance of patients with CHF after an episode of ADHF in a specialized center CHF, both for a long time (two years) and partially during the first year of observation, reduces the risk of all-cause death, CVM and death from ADHF.


Assuntos
Insuficiência Cardíaca , Doença Crônica , Europa (Continente) , Humanos , Prognóstico
15.
Zhonghua Shao Shang Za Zhi ; 35(12): 842-847, 2019 Dec 20.
Artigo em Chinês | MEDLINE | ID: mdl-31877605

RESUMO

Bacteria usually colonize, reproduce, and grow aggressively on chronic wounds in the form of biofilm. Different from free bacteria, bacteria in biofilm exhibit unique mechanism in epigenetics and biological behavior, especially in resistance to antibiotics and host immunity. In this article, we introduce the composition and structural function of bacterial biofilm, expound the drug-resistance mechanism of bacterial biofilm, discuss the clinical characteristics of bacterial biofilm infection wound and the diagnosis method of biofilm, and analyze the treatment strategy for bacterial biofilm. It is suggested that clinicians should pay more attention to bacterial biofilm infection and advocate in-depth study of bacterial biofilm in order to improve the quality of managing chronic wounds.


Assuntos
Infecções Bacterianas , Infecção dos Ferimentos , Antibacterianos , Bactérias , Biofilmes , Doença Crônica , Humanos
16.
Orv Hetil ; 160(52): 2067-2072, 2019 Dec.
Artigo em Húngaro | MEDLINE | ID: mdl-31868006

RESUMO

The authors present a case report of a patient who was treated conservatively for a non-specific headache for more than a decade, while an arachnoidal cyst in the middle cranial fossa, over the temporal bone tegmen was diagnosed, but ruled out as the cause of the headache. The patient was referred to our ENT department with left, purulent ear discharge. Besides a chronic purulent otitis media, a cholesterol granuloma occupying the antrum, eroding the tegmen of the pyramid bone and penetrating into the middle cranial fossa was diagnosed. Case presentation of a patient with cholesterol granuloma, surgical options, differential diagnostic problems, and a literature review are presented. Tympanoplasty with cortical mastoidectomy was carried out to treat the chronic purulent otitis media, and the cholesterol granuloma was removed during transmastoid craniotomy. The iatrogenic temporal meningo-encephalic tissue herniation was repaired and the bone defect of the tegmen was reconstructed with septal cartilage. The patient's headache diminished immediately after the surgery. The chronic ear discharge stopped, the cholesterol granuloma was excised completely and the cerebral herniation was repaired successfully. Neither CSF leak, nor further herniation or meningitis were noticed. Two years after the operation the patient is asymptomatic. A large cholesterol granuloma, eroding into the middle cranial fossa can cause serious complications, and needs a high level of attention besides individualized surgical treatment based on the surgeon's abilities and skills. Orv Hetil. 2019; 160(52): 2067-2072.


Assuntos
Colesterol/metabolismo , Fossa Craniana Média/patologia , Granuloma/cirurgia , Cefaleia/etiologia , Otite Média/complicações , Otite Média/cirurgia , Osso Temporal , Doença Crônica , Granuloma/etiologia , Granuloma/patologia , Humanos , Otite Média/diagnóstico , Resultado do Tratamento
17.
Medicine (Baltimore) ; 98(44): e17724, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31689812

RESUMO

To investigate the effect of combined periodontal-orthodontic treatment on the gingival crevicular fluid (GCF) levels of high mobility group box-1 (HMGB1) and NOD-like receptor protein 3 (NLRP3) in chronic periodontitis.A total of 60 patients with periodontitis who received combined periodontal-orthodontic treatment and 32 healthy individuals as normal controls were recruited in this study. Periodontal parameters were recorded. Enzyme-linked immunosorbent assay (ELISA) was used to examine GCF levels of HMGB1 and NLRP3.The periodontal parameters and GCF levels of HMGB1 and NLRP3 in periodontitis patients were significantly higher before treatment, and observably decreased after 6 months of treatment as compared with the healthy group. However, significant positive correlations were observed between HMGB1, NLRP3, and periodontal parameters in chronic periodontitis patients.Patients with chronic periodontitis showed higher levels of HMGB1 and NLRP3 in GCF.


Assuntos
Periodontite Crônica/genética , Periodontite Crônica/terapia , Proteína HMGB1/metabolismo , Proteína 3 que Contém Domínio de Pirina da Família NLR/metabolismo , Ortodontia/métodos , Periodontia/métodos , Adulto , Estudos de Casos e Controles , Doença Crônica , Terapia Combinada , Feminino , Líquido do Sulco Gengival/química , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento
18.
BMJ ; 367: l5922, 2019 11 05.
Artigo em Inglês | MEDLINE | ID: mdl-31690561

RESUMO

OBJECTIVE: To investigate the clinical effectiveness and safety of stand alone and blended internet based vestibular rehabilitation (VR) in the management of chronic vestibular syndromes in general practice. DESIGN: Pragmatic, three armed, parallel group, individually randomised controlled trial. SETTING: 59 general practices in the Netherlands. PARTICIPANTS: 322 adults aged 50 and older with a chronic vestibular syndrome. INTERVENTIONS: Stand alone VR comprising a six week, internet based intervention with weekly online sessions and daily exercises (10-20 minutes a day). In the blended VR group, the same internet based intervention was supplemented by face-to-face physiotherapy support (home visits in weeks 1 and 3). Participants in the usual care group received standard care from a general practitioner, without any restrictions. MAIN OUTCOME MEASURES: The primary outcome was vestibular symptoms after six months as measured by the vertigo symptom scale-short form (VSS-SF range 0-60, clinically relevant difference ≥3 points). Secondary outcomes were dizziness related impairment, anxiety, depressive symptoms, subjective improvement of vestibular symptoms after three and six months, and adverse events. RESULTS: In the intention-to-treat analysis, participants in the stand alone and blended VR groups had lower VSS-SF scores at six months than participants in the usual care group (adjusted mean difference -4.1 points, 95% confidence interval -5.8 to -2.5; and -3.5 points, -5.1 to -1.9, respectively). Similar differences in VSS-SF scores were seen at three months follow-up. Participants in the stand alone and blended VR groups also experienced less dizziness related impairment, less anxiety, and more subjective improvement of vestibular symptoms at three and six months. No serious adverse events related to online VR occurred during the trial. CONCLUSION: Stand alone and blended internet based VR are clinically effective and safe interventions to treat adults aged 50 and older with a chronic vestibular syndrome. Online VR is an easily accessible form of treatment, with the potential to improve care for an undertreated group of patients in general practice. TRIAL REGISTRATION: Netherlands Trial Register NTR5712.


Assuntos
Medicina Geral/métodos , Modalidades de Fisioterapia , Qualidade de Vida , Telemedicina/métodos , Doenças Vestibulares/reabilitação , Idoso , Doença Crônica/psicologia , Doença Crônica/reabilitação , Feminino , Humanos , Internet , Masculino , Pessoa de Meia-Idade , Países Baixos , Síndrome , Resultado do Tratamento , Doenças Vestibulares/diagnóstico , Doenças Vestibulares/psicologia
19.
Unfallchirurg ; 122(11): 834-839, 2019 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-31690985

RESUMO

A small proportion of patients with exertional leg pain (ELP) have deep posterior chronic exertional compartment syndrome (dp-CECS). These individuals report pain, tightness and cramps deep in the calf muscles that are elicited by exercise, but may also be present during rest to a lesser extent. Physical examination often reveals painful palpation of the flexor muscles in the area immediately dorsomedial to the tibial bone. Diagnosis is confirmed by intracompartmental pressure testing. Various entities may mimic or coincide with dp-CECS, including medial tibial stress syndrome (MTSS) and popliteal artery entrapment syndrome (PAES). Fasciotomy of multiple flexor muscles is the only treatment that achieves a beneficial outcome. The aim of this overview is to discuss the diagnosis and management of dp-CECS.


Assuntos
Síndromes Compartimentais/diagnóstico , Síndromes Compartimentais/terapia , Músculo Esquelético/cirurgia , Dor Musculoesquelética/etiologia , Doença Crônica , Síndromes Compartimentais/etiologia , Exercício , Fasciotomia , Humanos , Perna (Membro) , Dor Musculoesquelética/terapia
20.
Pan Afr Med J ; 33: 250, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31692793

RESUMO

Sarcoidosis is a non-caseating inflammatory chronic systemic disease of unknown etiology, which may affect one or more organs. Paranasal sinuses involvement occurs sporadic in sarcoidosis. We report a patient with a medical history of sarcoidosis involving her lungs, liver, and lymphatic system for four years who now presented with nasal and sinuses symptoms. The primary treatment with local cortisone showed no improvement. Computed tomography (CT) scan of the paranasal sinuses (PNS) revealed signs of chronic pansinusitis. She was successfully treated with endoscopic sinonasal surgery. Subsequent histological analysis confirmed the involvement of the PNS with sarcoidosis. Her follow-up during the last 6 months was without recurrence.


Assuntos
Doenças dos Seios Paranasais/diagnóstico por imagem , Sarcoidose/diagnóstico por imagem , Sinusite/diagnóstico por imagem , Adulto , Doença Crônica , Endoscopia/métodos , Feminino , Seguimentos , Humanos , Doenças dos Seios Paranasais/cirurgia , Sarcoidose/cirurgia , Tomografia Computadorizada por Raios X
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