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1.
Medicine (Baltimore) ; 99(36): e22023, 2020 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-32899056

RESUMO

BACKGROUND: Traditional Chinese medicine (TCM) or combined with western medicine in the treatment of pediatric adenoidal hypertrophy has been widely used in clinical practice, but the overall efficacy and safety is still unclear. This paper aims to evaluate the efficacy and safety analysis of TCM or combined with western medicine for pediatric adenoidal hypertrophy. METHODS: PubMed, EMbase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), WanFang, the Chongqing VIP Chinese Science and Technology Periodical Database, and China biomedical literature database (CBM) were searched for randomized controlled trials of TCM or combined with western medicine for pediatric adenoidal hypertrophy from the date of establishment to July 2020, and Baidu Scholar, Google Scholar, International Clinical Trials Registry Platform (ICTRP), and Chinese Clinical Trials Registry (ChiCTR) were searched for unpublished grey literature. Two researchers independently applied RevMan 5.3 software for data extraction and risk assessment of bias. RESULTS: The effectiveness and safety of TCM or combined with western medicine for pediatric adenoidal hypertrophy is evaluated by means of the Adenoid (A) /(Nasopharyngeal (N) ratio, clinical efficacy, integral score of TCM syndromes, clinical single symptom score, disease specific quality of life for children with obstructive sleep apnea 18 items survey (OSA-18), Interleukin 4 (IL-4) and adverse reaction incidence. CONCLUSION: This study will provide theoretical support for the clinical application of TCM or combined with western medicine for pediatric adenoidal hypertrophy. OSF REGISTRATION NUMBER: DOI 10.17605/OSF.IO/J76AG.


Assuntos
Tonsila Faríngea/patologia , Medicamentos de Ervas Chinesas/uso terapêutico , Hipertrofia/terapia , Medicina Tradicional Chinesa/métodos , Criança , China/epidemiologia , Terapia Combinada , Prescrições de Medicamentos/normas , Prescrições de Medicamentos/estatística & dados numéricos , Feminino , Humanos , Interleucina-4/sangue , Masculino , Qualidade de Vida , Segurança , Apneia Obstrutiva do Sono/epidemiologia , Apneia Obstrutiva do Sono/psicologia , Resultado do Tratamento
2.
Zhonghua Nei Ke Za Zhi ; 59(9): 711-715, 2020 Sep 01.
Artigo em Chinês | MEDLINE | ID: mdl-32838503

RESUMO

Objective: Mesenteric fat hypertrophy is present in about a quarter of Crohn's disease (CD) patients and it can be easily detected by bowel ultrasound (US). The purpose of this research was to assess the correlation between mesenteric fat hypertrophy and behavior and activity of CD. Methods: A total of 89 CD patients who admitted to the First Affiliated Hospital of Nanjing Medical University from August 2018 to November 2019 were recruited in this study. The total CD patients were divided into two groups depending on with or without mesenteric fat hypertrophy by US tests. Crohn's disease activity index (CDAI), simplified endoscopic score for Crohn's disease (SES-CD), serum inflammatory indicators and fecal calprotectin were assessed. Results: Mesenteric fat hypertrophy was significantly associated with stricturing behavior (B2, P<0.01). CDAI (P=0.002) , blood platelet (P=0.001) , C-reactive protein (P=0.024) , fecal calprotectin (P=0.004) and bowel wall thickness (P<0.01) in patients with mesenteric fat hypertrophy were significantly higher than those without, but not the erythrocyte sedimentation rate (P=0.110) and SES-CD (P=0.115) . Serum albumin (P=0.001) in patients with mesenteric fat hypertrophy was lower than that in patients without mesenteric fat hypertrophy. Conclusion: Mesenteric fat hypertrophy is correlated with intestinal stenosis and disease activity in patients with Crohn's disease.


Assuntos
Doença de Crohn , Fezes , Humanos , Hipertrofia , Complexo Antígeno L1 Leucocitário , Mesentério , Índice de Gravidade de Doença
3.
Plast Reconstr Surg ; 146(2): 127e-136e, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32740569

RESUMO

BACKGROUND: Reduction mammaplasty is the standard of care for symptomatic macromastia. The process of requesting insurance coverage for reduction mammaplasty is cumbersome and potentially controversial, and insurance policies vary significantly. The goal of our analysis is to identify trends in insurance coverage rates, assess for the presence of disparities, and propose ways to increase chances of successful preauthorization. METHODS: The authors performed a retrospective review of preauthorizations for reduction mammaplasty at a single institution from 2012 to 2017. Insurance company names were deidentified. Preauthorization denial rates were assessed by year, insurance carrier, and reason for denial. Multiple regression analysis was performed to identify predictors for predetermination denial by insurance companies. RESULTS: Among 295 preauthorizations, 212 were approved (72 percent) and 83 were denied (28 percent), among which 18 were appealed, 13 successfully. Rates of insurance denials have been increasing steadily, from 18 percent to 41 percent. Medicaid had the lowest denial rates (9.3 percent), whereas private carriers denials ranged from 21.4 to 62.1 percent. In terms of reason for denial, 30 percent were because of contract exclusion, 39 percent were because of inadequate documentation or not meeting medical criteria, and 12 percent were because of inadequate predicted resection weight. Certain private insurance carriers were the only independent predictors of predetermination denial. CONCLUSIONS: Rate of preauthorization denials is high and has been increasing steadily. Insurance criteria remain arbitrary. A proper documentation and appeal process by the plastic surgeon may improve rates of insurance approval. Although resection weight does not correlate with symptom relief, predicted breast tissue resection weight continues to be critical for insurance approval.


Assuntos
Mama/anormalidades , Hipertrofia/cirurgia , Reembolso de Seguro de Saúde/economia , Mamoplastia/economia , Garantia da Qualidade dos Cuidados de Saúde/normas , Adulto , Mama/cirurgia , Feminino , Seguimentos , Humanos , Cobertura do Seguro/economia , Mamoplastia/métodos , Estudos Retrospectivos , Estados Unidos
4.
Medicine (Baltimore) ; 99(34): e21843, 2020 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-32846832

RESUMO

RATIONALE: Hypertrophic cardiomyopathy (HCM) is an inherited myocardial disease and a common cause of sudden cardiac death, heart failure, atrial fibrillation and stroke. In families affected by HCM, genotyping is useful for identifying susceptible relatives. In the present study, we investigated the disease-causing mutations in a three-generation Chinese family with HCM using whole exome sequencing (WES). PATIENT CONCERNS: The proband, a 50-year-old man, was diagnosed with HCM at the age of 41 years. He presented with an asymmetric hypertrophic interventricular septum and a maximum interventricular septum thickness of 18.04 mm. His third elder sister, niece and daughter were also clinically affected by HCM. DIAGNOSIS: Autosomal dominant HCM. INTERVENTIONS: Seven family members, including 4 affected members, accepted WES. The genetic variants were subsequently called using Genome Analysis Toolkit and annotated using the InterVar program. Following frequency filtration by the Genome Aggregation Database, the variants were evaluated using an in-house bioinformatics analysis pipeline. OUTCOMES: HCM was transmitted as an autosomal dominant trait in the family. An extremely rare stop gained mutation, rs796925245 (g.1:201359630G>A, c.835C>T, p.Gln279Ter) in the troponin T2 (TNNT2) gene was identified as the disease-causing mutation. The stop gained mutation was predicted to result in a truncated troponin T protein in cardiac sarcomere. An adolescent family member who had normal echocardiographic measurements was found to carry the same disease-causing mutation. LESSONS: A novel nonsense TNNT2 mutation was identified as the HCM-causing mutation in this Chinese pedigree. Since HCM shows a low penetrance by clinical criteria in adolescents, the adolescent mutation carrier, who is still clinically unaffected, should be offered routine follow-ups and sport activity recommendations to prevent adverse events including sudden cardiac death in the future.


Assuntos
Cardiomiopatia Hipertrófica Familiar/genética , Troponina T/genética , Adolescente , Adulto , Idoso , Grupo com Ancestrais do Continente Asiático/genética , Cardiomiopatia Hipertrófica Familiar/complicações , Cardiomiopatia Hipertrófica Familiar/diagnóstico , Códon sem Sentido , Morte Súbita Cardíaca/etiologia , Ecocardiografia/métodos , Feminino , Humanos , Hipertrofia/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Linhagem , Fenótipo , Septo Interventricular/patologia , Sequenciamento Completo do Exoma/métodos
5.
Artigo em Chinês | MEDLINE | ID: mdl-32791583

RESUMO

Objective:The study aimed to observe the difference in postoperative complications and recurrence rates of adenoidectomy plus myringotomy or adenoidectomy plus tympanostomy with tube insertion for children with adenoid hypertrophy combined with otitis media with effusion. Method:Children 4 to 12 years old with otitis media with effusion combined with adenoid hypertrophy were assigned to receive either adenoidectomy plus myringotomy(group A) or adenoidectomy plus tympanostomy tube insertion(group B). Pre-and post-operative data was recorded. Result:There is no ear complication in group A. In group B, some children suffered otorrhea, perforation, blocked tympanic membrane vent and calcification. The recurrence rate of the group A was significantly higher than that of the group B at 3 month after operation. There was no significant difference in recurrence rate between the two groups at 6th month and 12th month after operation. Conclusion:For children aged 4-12 years with adenoid hypertrophy combined with otitis media with effusion, adenoidectomy plus myringotomy can avoid complications after tympanic tube insertion without increasing the risk of long-term recurrence, we recommend this procedure as the first choice.


Assuntos
Tonsila Faríngea , Otite Média com Derrame/cirurgia , Otite Média/cirurgia , Adenoidectomia , Criança , Pré-Escolar , Humanos , Hipertrofia , Ventilação da Orelha Média , Recidiva
6.
Artigo em Chinês | MEDLINE | ID: mdl-32842178

RESUMO

Objective:To observe the efficacy of OM85-BV in the treatment of recurrent upper respiratory tract infection with adenoid hypertrophy and to explore its possible mechanism. Method:Four hundred and forty-eight children with recurrent upper respiratory tract infection and adenoid hypertrophy were collected. Three hundred and twenty-six patients in the control group were treated with conventional drugs, and one hundred and twenty-two patients in the observation group were treated with OM85-BV+conventional drugs, and the treatment lasted 12 weeks. The sleep obstructive symptoms of adenoid hypertrophy were scored according to OSA-18 before and after the treatment respectively(0, 6, 12 weeks). The symptoms scores and effective rate of treatment between the study and the control group were compared. The patients in the control group and the observation group who were unresponsive to drug treatment received surgery after 12 weeks of drug treatment. The levels of serum IL-2, IL-4, IL-6, IL-10, TNF, IFN-γ and IgE, the ratio of serum CD3, CD4, CD8 in lymphocytes and the ratio of CD4/CD8 were compared between the study and the control group before operation. The levels of HBD-2, IFN-γ, IL-4, IL-6 cytokines in the adenoid were compared between the control group and the observation group. The expression and distribution of adenoid HBD-2, IFN-γ, IL-4, IL-6 were compared between the control group and the observation group. Result:After 12 weeks of treatment, the total effective rate of the observation group was significantly higher than that of the control group, and the improvement of sleep respiratory obstruction symptoms of children with recurrent upper respiratory tract infection and adenoid hypertrophy was also much better than that of the control group. The serum IFN-γ of the observation group was significantly higher than that of the control group, and there was no significant difference in serum IL-2, IL-4, IL-6, IL-10, TNF, IgE between the observation group and the control group. There was no significant difference in serum CD3, CD4, CD8 and CD4/CD8 between the observation group and the control group. In the observation group, the adenoid HBD-2 was significantly higher but IL-4, IFN-γ were significantly lower than that in the control group, and IL-6 had no significant difference compared with the control group. Conclusion:OM85-BV can significantly improve the sleep apnea symptoms but can not rise the level of immune lymphocytes in children with adenoid hypertrophy and recurrent upper respiratory tract infection.OM85-BV can improve the Th1 immune response, enhancing the ability of human body to fight against pathogens and induce the release of HBD-2, increasing the resistance to microorganisms, reducing the bacteria aggregation, weakening the local inflammatory response in adenoids.


Assuntos
Tonsila Faríngea , Obstrução das Vias Respiratórias , Infecções Respiratórias , Criança , Citocinas , Humanos , Hipertrofia
7.
Nat Commun ; 11(1): 4337, 2020 08 28.
Artigo em Inglês | MEDLINE | ID: mdl-32859897

RESUMO

Intracellular Na elevation in the heart is a hallmark of pathologies where both acute and chronic metabolic remodelling occurs. Here, we assess whether acute (75 µM ouabain 100 nM blebbistatin) or chronic myocardial Nai load (PLM3SA mouse) are causally linked to metabolic remodelling and whether the failing heart shares a common Na-mediated metabolic 'fingerprint'. Control (PLMWT), transgenic (PLM3SA), ouabain-treated and hypertrophied Langendorff-perfused mouse hearts are studied by 23Na, 31P, 13C NMR followed by 1H-NMR metabolomic profiling. Elevated Nai leads to common adaptive metabolic alterations preceding energetic impairment: a switch from fatty acid to carbohydrate metabolism and changes in steady-state metabolite concentrations (glycolytic, anaplerotic, Krebs cycle intermediates). Inhibition of mitochondrial Na/Ca exchanger by CGP37157 ameliorates the metabolic changes. In silico modelling indicates altered metabolic fluxes (Krebs cycle, fatty acid, carbohydrate, amino acid metabolism). Prevention of Nai overload or inhibition of Na/Camito may be a new approach to ameliorate metabolic dysregulation in heart failure.


Assuntos
Reprogramação Celular/fisiologia , Citoplasma/metabolismo , Insuficiência Cardíaca/metabolismo , Miocárdio/metabolismo , Sódio/metabolismo , Animais , Modelos Animais de Doenças , Metabolismo Energético , Técnicas de Introdução de Genes , Coração , Hipertrofia , Preparação de Coração Isolado , Masculino , Doenças Metabólicas/metabolismo , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Mitocôndrias/efeitos dos fármacos , Mitocôndrias/metabolismo , Ratos , Ratos Wistar , Sódio/sangue , Trocador de Sódio e Cálcio/efeitos dos fármacos , Tiazepinas/farmacologia
8.
J Toxicol Sci ; 45(8): 475-492, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32741898

RESUMO

By analysis of the data from the Toxicogenomics Database (TG-GATEs), histidine decarboxylase gene (Hdc) was identified as largely and commonly upregulated by three fibrates, clofibrate, fenofibrate, and WY-14,643, which are known to induce hepatocellular hypertrophy and proliferation via stimulation of peroxisome proliferator-activated receptor α (PPARα) in rodents. As histamine has been reported to be involved in the proliferation of liver cells, the present study was conducted to focus on Hdc. Among other genes related to histidine and histamine, the expression of the gene of histamine ammonia lyase (Hal) was exclusively mobilized by the three fibrates. The expression of Hdc, which was usually very low in the liver, was increased with the repeated administration of fibrates, and concomitantly, the constitutive expression of Hal was suppressed. An interpretation is that the formation of urocanic acid from histidine under the normal condition switches to the formation of histamine. The mobilization of gene expression of Hdc and Hal by PPARα agonists could not be reproduced in primary cultured hepatocytes. The Hdc mRNA appeared to be translated to a protein which is processed differently from brain but similarly to gastric mucosa. Surprisingly, the fibrates caused hepatic hypertrophy but no induction of Hdc mRNA at all in mice. These results revealed that the changes in the histidine catabolism by PPARα agonists might be partially, but not directly, involved in the hepatocyte proliferation in rats, and there is a large genetic distance even between rat and mouse.


Assuntos
Clofibrato/efeitos adversos , Bases de Dados Genéticas , Fenofibrato/efeitos adversos , Expressão Gênica/efeitos dos fármacos , Histidina Descarboxilase/metabolismo , Fígado/metabolismo , Fígado/patologia , PPAR alfa/agonistas , Pirimidinas/efeitos adversos , Animais , Proliferação de Células/efeitos dos fármacos , Células Cultivadas , Hepatócitos/patologia , Histidina Descarboxilase/genética , Hipertrofia/induzido quimicamente , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Ratos , Ratos Sprague-Dawley , Especificidade da Espécie
9.
Vestn Otorinolaringol ; 85(3): 57-63, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32628385

RESUMO

OBJECTIVE: To evaluate the effectiveness of different approaches to the treatment of patients with hypertrophy of the palatine tonsils (HPT). MATERIAL AND METHODS: 90 children with HPT of II-III degree and 20 healthy children (group 1) aged from 3 to 7 years were included in the study. Children with HPT were divided into three groups: group 2 - children who underwent tonsillotomy (n=30), group 3 - children who underwent conservative treatment, including only topical use of Polyoxidonium (n=30), group 4 - children who underwent complex treatment (tonsillotomy with subsequent local use of Polyoxidonium), (n=30). The severity of nasal breathing disturbances on a visual analogue scale, the average number of acute respiratory viral infections 6 months before and after treatment, the level of gene expression of antimicrobial peptides before and after treatment, the degree of hypertrophy of the palatine tonsils and spleen with an assessment of the echostructure and determination of the spleen mass coefficient using Ultrasound were evaluated in the study. RESULTS: In children receiving only Polyoxidonium, there was a decrease in the severity of nasal breathing disorders, a decrease in the frequency of acute respiratory viral infections, an increase in the expression of antimicrobial peptide genes compared to the initial level of these indicators. Comprehensive treatment of children with HPT (group 4) showed a significant decrease in the severity of nasal breathing disorders, a decrease in the average number of acute respiratory infections within 6 months, an increase in the expression of antimicrobial peptide genes compared to children who underwent only tonsillotomy (group 2) or only conservative therapy (group 3). CONCLUSION: It is proved that the use of Polyoxidonium in the complex treatment of HPT is clinically effective and safe.


Assuntos
Tonsilectomia , Viroses , Criança , Pré-Escolar , Humanos , Hipertrofia/cirurgia , Tonsila Palatina , Respiração
10.
Eur J Radiol ; 129: 109147, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32623113

RESUMO

PURPOSE: To report the spectrum of chest computed tomographic (CT) imaging findings in coronavirus disease-19 (COVID-19) infected Indian patients. METHODS: This was a prospective descriptive study comprising 147 consecutive reverse transcriptase polymerase chain reaction (RT-PCR) positive patients who underwent CT chest. Prevalence, distribution, extent and type of abnormal lung findings were recorded. RESULTS: Among the total study cohort of 147 patients, 104 (70.7 %) were males and 43 (29.3 %) were females with mean age of 40.9 ±â€¯17.2 years (range 24-71 years). We observed lung parenchymal abnormalities in 51 (34.7 %) cases whereas 96 (65.3 %) RT-PCR positive cases had a normal chest CT. Only 12.2 % of the patients were dyspneic, 6.1 % had desaturation, 7.4 % had increased respiratory rate and 10.9 % had comorbidities. Among the patients with abnormal CT findings bilateral 39/51 (76.5 %), multilobar (88.2 %) lung involvement with a predominant peripheral and posterior distribution was commonly observed. With regards to the type of opacity, ground glass opacity (GGO) was the dominant abnormality found in all 51 (100 %) cases. Pure GGO was observed in 15 (29.4 %), GGO with crazy paving pattern was seen in 15 (29.4 %) and GGO mixed with consolidation was noted in 21(41.2 %). Peri-lesional or intralesional segmental or subsegmental pulmonary vessel enlargement was observed in 36 (70.6 %) cases. CONCLUSION: In this study population predominantly with mild symptoms and few comorbidities, two-thirds of RT-PCR positive patients had a normal chest CT; whereas the remaining patients showed typical findings of predominant GGOs with a bilateral distribution and peripheral predominance.


Assuntos
Betacoronavirus , Técnicas de Laboratório Clínico/métodos , Infecções por Coronavirus/diagnóstico por imagem , Pneumonia Viral/diagnóstico por imagem , Adulto , Idoso , Infecções por Coronavirus/diagnóstico , Dispneia/diagnóstico por imagem , Dispneia/virologia , Feminino , Humanos , Hipertrofia/diagnóstico por imagem , Hipertrofia/virologia , Índia , Pulmão/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Pandemias , Estudos Prospectivos , Taquipneia/diagnóstico por imagem , Taquipneia/virologia , Tórax/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Adulto Jovem
11.
J Biol Regul Homeost Agents ; 34(3): 785-794, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32723437

RESUMO

Previous reports indicated that specific cyclooxygenase-2 (COX-2) inhibitor suppresses osteoarthritis (OA). This study aimed to further explore the possible mechanism of Rofecoxib as a COX-2 inhibitor on the inhibition of chondrocyte (CH) hypertrophic development and tested the optimal treatment of Rofecoxib on CH. Basically, IL-1ß was used as a stimulus to establish a degenerated CH model. Immunofluorescence, Western blot, and RT-PCR were performed to determine the gene expression of Axin2, ß-catenin, GSK3ß, collagen X, collagen II, COX-2, PGE-2, SOX-9, Runx-2, and MMP- 13 expression. Cell Counting Kit (CCK-8) assay was used to analyze the viability of CHs. The data indicated that Rofecoxib significantly inhibited COX-2 expression and had less harmful effects on CH viability. Rofecoxib reversed the IL-1ß-induced upregulation of collagen X, COX-2, PGE-2, Runx-2, and MMP-13 expression, and promoted the viability of collagen II, SOX-9 expression of CHs. Furthermore, Rofecoxib suppressed Axin2, ß-catenin, and GSK3ß expression of the Wnt pathway, which was activated by IL-1ß or human recombinant Wnt-1 protein treatment. Therefore, Rofecoxib is an effective COX-2 inhibitor that protects CHs from hypertrophy by suppression of the Wnt/ß-catenin pathway.


Assuntos
Condrócitos/efeitos dos fármacos , Inibidores de Ciclo-Oxigenase 2/farmacologia , Lactonas/farmacologia , Sulfonas/farmacologia , Via de Sinalização Wnt , Células Cultivadas , Condrócitos/citologia , Humanos , Hipertrofia , beta Catenina
14.
Rev. otorrinolaringol. cir. cabeza cuello ; 80(2): 218-225, jun. 2020. tab
Artigo em Espanhol | LILACS | ID: biblio-1115838

RESUMO

La obstrucción nasal es un motivo de consulta habitual en otorrinolaringología, siendo una de las causas más frecuentes la hipertrofia de cornete inferior, la que se puede manejar con cirugía cuando falla el tratamiento médico. En las últimas décadas se han desarrollado múltiples técnicas quirúrgicas y tecnología asociada, sin embargo, no hay un consenso establecido sobre cuál es la mejor opción para el manejo de esta patología. Se realizó revisión bibliográfica, se enuncian los métodos quirúrgicos disponibles, teniendo en cuenta beneficios, complicaciones probables y resultados de cada uno. La cirugía de cornete inferior tiene resultados favorables en pacientes con cornetes hipertróficos que no responden a manejo médico. Hasta la fecha la turbinoplastía con microdebridador ha mostrado superioridad en cuanto a resultados a largo plazo y menor tasa de complicaciones. La evidencia disponible hasta la fecha carece de homogeneidad en cuanto a métodos de selección de pacientes, medición de resultados y tiempo de seguimiento, por lo que se necesitan a futuro estudios prospectivos controlados para reevaluar los métodos descritos.


Nasal obstruction is a common complaint, one of the most frequent causes being inferior turbinate hypertrophy, which can be managed with surgery when medical treatment fails. In the last decades, multiple surgical techniques and associated technology have been developed, however, there is no established consensus on what is the best option for the management of this pathology. Literature review, the available surgical methods are stated, taking into account benefits, probable complications and results of each technique. The surgery of inferior turbinate has favorable results in patients with hypertrophic turbinates that do not respond to medical management. To date, microdebrider turbinoplasty has shown superiority in terms of long-term results and lower complication rates. The evidence available to date lacks homogeneity in terms of patient selection methods, measurement of results and follow-up time, so prospective controlled studies are needed in the future to reassess the described methods.


Assuntos
Humanos , Procedimentos Cirúrgicos Otorrinolaringológicos/métodos , Conchas Nasais/cirurgia , Conchas Nasais/patologia , Hipertrofia/cirurgia
16.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 34(6): 775-780, 2020 Jun 15.
Artigo em Chinês | MEDLINE | ID: mdl-32538571

RESUMO

Objective: To explore the effectiveness of liposuction technique assisted superomedial pedicle with a vertical incision in reduction mammaplasty. Methods: Between March 2014 and March 2019, 65 patients (127 sides) with breast hypertrophy had undergone breast reduction by using liposuction technique assisted superomedial pedicle with a vertical incision. The patients were 21 to 58 years old, with an average of 42.2 years. Body mass index ranged from 18.8 to 26.5 kg/m 2, with an average of 21.3 kg/m 2. Among them, 62 cases were bilateral operations and 3 cases were unilateral operation. The degree of mastoptosis was rated as degreeⅡ in 73 sides and degree Ⅲ in 54 sides according to the Regnault criteria. Results: The unilateral breast removed 432 g on average (range, 228-932 g); the distance of nipple upward was 4.5-9.5 cm (mean, 6.5 cm); the volume of unilateral liposuction was 50-380 mL (mean, 148 mL). There were 2 sides (1.58%) of unilateral intramammary hematomas after operation, 4 sides (3.15%) of bilateral breast vertical incisions slightly split, and 1 side (0.79%) of the nipple-areola epidermis necrosis. All patients were followed up 6 months to 5 years, with an average of 18 months. During the follow-up, there was no evident re-dropping of the breast and no enlargement of the areola. No patient underwent scar excision. At last follow-up, the effectiveness was evaluated by the surgeons. There were 52 cases with very satisfactory, 10 cases with satisfactory, and 3 cases with unsatisfactory for the breast shape and symmetry. There were 51 cases with very satisfactory, 11 cases with satisfactory, and 3 cases with unsatisfactory for the nipple position and areola diameter. The incision scar was obvious in 25 cases and was not obvious in 40 cases. The results of self-assessment showed very satisfactory for the breast shape in 48 cases, satisfactory in 12 cases, and unsatisfactory in 5 cases; very satisfactory for the incision scar in 40 cases, satisfactory in 17 cases, and unsatisfactory in 8 cases. Overall evaluation of the patient was very satisfactory in 52 cases, satisfactory in 7 cases, and unsatisfactory in 6 cases. Conclusion: The liposuction technique assisted superomedial pedicle with a vertical incision in reduction mammaplasty is a safe and reliable surgical method with a satisfactory result.


Assuntos
Lipectomia , Mamoplastia , Adulto , Cicatriz , Feminino , Humanos , Hipertrofia , Lipectomia/métodos , Lipectomia/normas , Mamoplastia/métodos , Mamoplastia/normas , Pessoa de Meia-Idade , Estudos Retrospectivos , Terapêutica , Adulto Jovem
17.
Br J Radiol ; 93(1113): 20200323, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32584599

RESUMO

OBJECTIVE: Pulmonary hypertension (PH) is an underdiagnosed condition associated with poor survival and increased post-operative mortality in lung cancer. CT-based parameters of pulmonary artery enlargement are strong predictors of PH. We used these parameters to investigate pulmonary artery enlargement in lung and oesophageal cancer. METHODS: Consecutive patients with lung cancer (n = 100) or oesophageal cancer (n = 100) undergoing staging 18F-fluodeoxyglucose PET/CT were retrospectively identified. The transverse diameter of the main pulmonary artery (mPA) and ascending aorta, and the pulmonary artery-to-ascending aorta (PA:A) ratio were obtained. Abnormal values were defined following the Framingham Heart Study cohort. RESULTS: Lung cancer patients had a significantly increased mPA diameter compared to the oesophageal cancer patients (males: 27.29 ± 0.39 vs. 25.88 ± 0.24 mm, females: 26.10 ± 0.28 vs. 24.45 ± 0.18 mm). Similarly, a significantly increased proportion of these patients had an abnormal mPA diameter (males: 35.1% vs 12.5%, females: 32.6% vs 10.7%). Lung cancer patients also had a significantly higher PA:A ratio (males: 0.83 ± 0.01 vs. 0.79 ± 0.008, females: 0.85 ± 0.01 vs. 0.79 ± 0.009), with a larger proportion having an abnormal PA:A ratio (males: 24.6% vs 11.1%, females: 27.9% vs 14.3%). CONCLUSION: Simple measurements of mPA diameter and PA:A ratio reveal that lung cancer patients exhibit increased rates of pulmonary artery enlargement compared to oesophageal cancer patients. ADVANCES IN KNOWLEDGE: This study demonstrates there is an increased prevalence of pulmonary enlargement in lung cancer, easily detected on routine staging scans, holding implications for further work-up and risk stratification.


Assuntos
Neoplasias Esofágicas/complicações , Hipertensão Pulmonar/diagnóstico por imagem , Neoplasias Pulmonares/complicações , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Artéria Pulmonar/diagnóstico por imagem , Idoso , Aorta/diagnóstico por imagem , Neoplasias Esofágicas/diagnóstico por imagem , Feminino , Fluordesoxiglucose F18 , Humanos , Hipertensão Pulmonar/etiologia , Hipertrofia/diagnóstico por imagem , Hipertrofia/etiologia , Neoplasias Pulmonares/diagnóstico por imagem , Masculino , Compostos Radiofarmacêuticos , Estudos Retrospectivos , Fatores Sexuais
18.
Acta otorrinolaringol. esp ; 71(3): 147-153, mayo-jun. 2020. ilus, tab
Artigo em Inglês | IBECS | ID: ibc-192629

RESUMO

INTRODUCTION: The use of mometasone furoate (MF) intranasal spray in treating adenoid hypertrophy (AH) has a variable outcome due the different methods of adenoid size evaluation. The aim of our study was to evaluate the effect of MF intranasal spray in children and adolescents with AH using a reliable and consistent endoscopic evaluation. MATERIAL AND METHOD: A prospective interventional study was conducted. Evaluation took place during the first visit (week 0) and second visit (week 12). Symptoms of nasal obstruction, rhinorrhoea, cough and snoring were assessed, and an overall total symptoms score was obtained. A rigid nasoendoscopic examination using a four-grading system of adenoid size from 1 to 4 was performed. Patients were treated with MF intranasal spray for 12 weeks. Patients' aged 7-11-years old used 1 spray in each nostril once daily, while patients aged 12-17 used two sprays in each nostril once daily. Reassessment was carried out during the second visit (week 12). RESULTS: A total of 74 patients was recruited. There were significant improvements from week 0 to week 12 in the symptoms' score for nose obstruction, rhinorrhoea, cough, snoring including the total nasal symptoms' score (p < 0.001). AH significantly reduced in size from week 0 (2.89±.87) to week 12 (1.88±.83) (p < 0.001). CONCLUSION: MF intranasal spray is effective in improving the symptoms attributed to AH as well as reducing the adenoid size. MF intranasal spray is advocated as a treatment option before adenoidectomy is considered


INTRODUCCIÓN: El papel del aerosol nasal de mometasona furoato (MF) para tratar la hipertrofia adenoidea (HA) tiene un resultado variable, debido a los diferentes métodos de evaluación del tamaño de las adenoides. El objetivo de nuestro estudio fue evaluar el efecto del aerosol nasal de MF en niños y adolescentes con HA, utilizando una evaluación endoscópica fiable y consistente. MATERIAL Y MÉTODO: Se llevó a cabo un estudio prospectivo intervencionista. La evaluación se realizó durante la primera visita (semana 0) y la segunda visita (semana 12). Se valoraron los síntomas de obstrucción nasal, rinorrea, tos y ronquidos, obteniéndose una puntuación de síntomas totales globales. Se realizó un examen nasoendoscópico rígido utilizando un sistema de clasificación del tamaño adenoideo, con valores de 1 a 4. Los pacientes fueron tratados con aerosol intranasal de MF durante 12 semanas. Los pacientes con edades comprendidas entre 7 y 11 años utilizaron 1 pulverización en cada fosa nasal una vez al día, mientras que los pacientes de 12 a 17 años utilizaron 2 pulverizaciones en cada fosa nasal una vez al día. La re-evaluación se realizó durante la segunda visita (semana12). RESULTADOS: Reunimos a un total de 74 pacientes. Se produjeron mejoras significativas de la semana 0 a la 12 en cuanto a puntuación de los síntomas de obstrucción nasal, rinorrea, tos y ronquidos, incluyendo la puntuación total de síntomas nasales (p < 0,001). Se redujo significativamente el tamaño de HA de la semana 0 (2,89 ±0,87) a la semana 12 (1,88 ±0,83) (p < 0,001). CONCLUSIÓN: El aerosol intranasal de MF es efectivo para mejorar los síntomas atribuidos a HA, así como reducir el tamaño de las adenoides. Se propone el uso de dicho aerosol intranasal como opción de tratamiento, antes de considerarse la adenoidectomía


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Furoato de Mometasona/administração & dosagem , Sprays Nasais , Hipertrofia/tratamento farmacológico , Tonsila Faríngea/efeitos dos fármacos , Obstrução Nasal/tratamento farmacológico , Hipertrofia/complicações , Tonsila Faríngea/patologia , Obstrução Nasal/etiologia
19.
Rev. esp. cir. oral maxilofac ; 42(2): 91-93, abr.-jun. 2020. ilus
Artigo em Espanhol | IBECS | ID: ibc-189947

RESUMO

Paciente de 20 años que presentó aumento de volumen facial izquierdo. Estudiado con ecografía, TAC y biopsia quirúrgica. Se establece el diagnóstico de hipertrofia maseterina unilateral idiopática. La hipertrofia maseterina es un desorden benigno que puede manifestarse de forma unilateral o bilateral, que provoca una asimetría facial, frecuentemente asintomática. Se han propuesto varios tratamientos, siendo la infiltración con toxina botulínica tipo A un tratamiento mínimamente invasivo y eficaz


A 20-year-old patient who present an increase in left facial side. Studied with ultrasound, CT scan and surgical biopsy. The diagnosis of idiopathic unilateral masseter hypertrophy was established. Masseter hypertrophy is a benign disorder that can manifest unilaterally or bilaterally, causing facial asymmetry, often asymptomatic. Several treatments have been introduced, such as infiltration with Botulinum toxin type A, a minimally invasive and effective treatment


Assuntos
Humanos , Feminino , Adulto Jovem , Músculo Masseter/patologia , Toxinas Botulínicas Tipo A/uso terapêutico , Hipertrofia/tratamento farmacológico
20.
Plast Reconstr Surg ; 146(4): 725-733, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32590526

RESUMO

BACKGROUND: The central mound technique offers a relatively less common approach for breast reduction. This study evaluated the expected safety and efficacy outcomes using this technique in a large patient series. METHODS: A retrospective review of all patients undergoing central mound breast reduction at the authors' institution between June of 1999 and November of 2018 was performed. Both bilateral macromastia and unilateral symmetrizing reduction patients were included but evaluated separately for some outcomes. Patient demographics and comorbidities, operative details, postoperative adverse events, and BREAST-Q scores were recorded. Associations between preoperative variables and outcomes were assessed with chi-square tests, Wilcoxon tests, and Kendall tau-b correlations. RESULTS: A total of 325 patients were identified for inclusion (227 bilateral and 98 unilateral; 552 breasts). The average patient age was 46 years, and the average body mass index was 27.4 kg/m. Among the bilateral macromastia patients, the average operative time was 3 hours 34 minutes, and average breast tissue removed was 533 g (right breast) and 560 g (left breast). Among all patients, average follow-up was 169 days. On a per-breast basis for all patients, the following complication rates were observed: seroma, 0.2 percent; hematoma, 1.1 percent; dehiscence, 2.9 percent; infection, 1.5 percent; hypertrophic scar, 4.6 percent; nipple necrosis, 0.4 percent; fat necrosis, 0.9 percent; and skin flap necrosis, 1.7 percent. Using the BREAST-Q Reduction/Mastopexy questions on a Likert scale ranging from 1 to 5, restricted to the bilateral macromastia patient population, all scores improved with statistical significance. CONCLUSION: The central mound pedicle is a safe and effective approach for reduction mammaplasty for both bilateral macromastia patients and unilateral symmetrizing operations. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.


Assuntos
Mama/anormalidades , Hipertrofia/cirurgia , Mamoplastia/métodos , Adulto , Mama/cirurgia , Feminino , Humanos , Mamoplastia/efeitos adversos , Pessoa de Meia-Idade , Complicações Pós-Operatórias/epidemiologia , Estudos Retrospectivos , Resultado do Tratamento
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