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1.
Clin Nucl Med ; 46(1): e40-e43, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32804768

RESUMO

Sarcoidosis is a systemic disorder of unknown etiology characterized by development of noncaseating granulomas in more than 1 organ system. Development of sarcoidosis during or immediately after chemotherapy and immunotherapy is not uncommon. We present a 61-year-old woman in whom restaging F-FDG PET/CT detected asymptomatic sarcoidosis after neoadjuvant chemoradiotherapy for carcinoma rectum, which resolved spontaneously by the end of adjuvant chemotherapy with no specific treatment. Recognition of anatomic-metabolic pattern of sarcoidosis could prevent erroneous upstaging of the primary malignancy during restaging PET/CT following chemotherapy, and such lesions may show self-resolution.


Assuntos
Fluordesoxiglucose F18 , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Neoplasias Retais/diagnóstico por imagem , Neoplasias Retais/patologia , Sarcoidose/etiologia , Quimioterapia Adjuvante/efeitos adversos , Feminino , Humanos , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Neoplasias Retais/terapia , Remissão Espontânea , Sarcoidose/patologia
2.
Clin Nucl Med ; 46(1): e51-e53, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33181749

RESUMO

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


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Calcinose/induzido quimicamente , Linfoma não Hodgkin/tratamento farmacológico , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Calcinose/diagnóstico por imagem , Feminino , Humanos , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Remissão Espontânea
3.
PLoS Med ; 17(10): e1003396, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33112845

RESUMO

BACKGROUND: Remission has been identified as a top priority by people with type 2 diabetes. Remission is commonly used as an outcome in research studies; however, a widely accepted definition of remission of type 2 diabetes is lacking. A report on defining remission was published (but not formally endorsed) in Diabetes Care, an American Diabetes Association (ADA) journal. This Diabetes Care report remains widely used. It was the first to suggest 3 components necessary to define the presence of remission: (1) absence of glucose-lowering therapy (GLT); (2) normoglycaemia; and (3) for duration ≥1 year. Our aim is to systematically review how remission of type 2 diabetes has been defined by observational and interventional studies since publication of the 2009 report. METHODS AND FINDINGS: Four databases (MEDLINE, EMBASE, Cochrane Library, and CINAHL) were searched for studies published from 1 September 2009 to 18 July 2020 involving at least 100 participants with type 2 diabetes in their remission analysis, which examined an outcome of type 2 diabetes remission in adults ≥18 years and which had been published in English since 2009. Remission definitions were extracted and categorised by glucose-lowering therapy, glycaemic thresholds, and duration. A total of 8,966 titles/abstracts were screened, and 178 studies (165 observational and 13 interventional) from 33 countries were included. These contributed 266 definitions, of which 96 were unique. The 2009 report was referenced in 121 (45%) definitions. In total, 247 (93%) definitions required the absence of GLT, and 232 (87%) definitions specified numeric glycaemic thresholds. The most frequently used threshold was HbA1c<42 mmol/mol (6.0%) in 47 (20%) definitions. Time was frequently omitted. In this study, a total of 104 (39%) definitions defined time as a duration. The main limitations of this systematic review lie in the restriction to published studies written in English with sample sizes of over 100. Grey literature was not included in the search. CONCLUSIONS: We found that there is substantial heterogeneity in the definition of type 2 diabetes remission in research studies published since 2009, at least partly reflecting ambiguity in the 2009 report. This complicates interpretation of previous research on remission of type 2 diabetes and the implications for people with type 2 diabetes. Any new consensus definition of remission should include unambiguous glycaemic thresholds and emphasise duration. Until an international consensus is reached, studies describing remission should clearly define all 3 components of remission. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42019144619.


Assuntos
Diabetes Mellitus Tipo 2/metabolismo , Indução de Remissão/métodos , Adulto , Glicemia/análise , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/epidemiologia , Feminino , Glucose/metabolismo , Humanos , Masculino , Remissão Espontânea
4.
Vaccine ; 38(48): 7629-7637, 2020 11 10.
Artigo em Inglês | MEDLINE | ID: mdl-33071000

RESUMO

This work demonstrates the presence of immune regulatory cells in the cervical lymph nodes draining Bacillus Calmette-Guérin (BCG) vaccinated site on the dorsum of the ear in guinea pigs. It is shown that whole cervical lymph node cells did not proliferate in vitro in the presence of soluble mycobacterial antigens (PPD or leprosin) despite being responsive to whole mycobacteria. Besides, T cells from these lymph nodes separated as a non-adherent fraction on a nylon wool column, proliferated to PPD in the presence of autologous antigen presenting cells. Interestingly, addition of as low as 20% nylon wool adherent cells to these, sharply decreased the proliferation by 83%. Looking into what cells in the adherent fraction suppressed the proliferation, it was found that neither the T cell nor the macrophage enriched cell fractions of this population individually showed suppressive effect, indicating that their co-presence was necessary for the suppression. Since BCG induced granulomas resolve much faster than granulomas induced by other mycobacteria such as Mycobacterium leprae the present experimental findings add to the existing evidence that intradermal BCG vaccination influences subsequent immune responses in the host and may further stress upon its beneficial role seen in Covid-19 patients.


Assuntos
Antígenos de Bactérias/farmacologia , Vacina BCG/farmacologia , Granuloma/imunologia , Linfonodos/imunologia , Linfócitos T/imunologia , Tuberculina/farmacologia , Animais , Células Apresentadoras de Antígenos/efeitos dos fármacos , Células Apresentadoras de Antígenos/imunologia , Células Apresentadoras de Antígenos/microbiologia , Adesão Celular , Proliferação de Células , Infecções por Coronavirus/prevenção & controle , Orelha , Feminino , Granuloma/microbiologia , Cobaias , Humanos , Injeções Intradérmicas , Linfonodos/microbiologia , Macrófagos/efeitos dos fármacos , Macrófagos/imunologia , Macrófagos/microbiologia , Masculino , Mycobacterium bovis/imunologia , Mycobacterium leprae/imunologia , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Remissão Espontânea , Linfócitos T/classificação , Linfócitos T/efeitos dos fármacos , Linfócitos T/microbiologia
8.
Artigo em Inglês | MEDLINE | ID: mdl-32903208

RESUMO

Objectives The number of coronavirus disease (COVID-19) cases is increasing in Bangladesh. Many people have suffered from symptoms like COVID-19 during this pandemic, and some people have cured without taking any treatment or taking minor pharmacological and non-pharmacological treatments. However, they might be spreading their infections among their family members and perhaps in the community. It is unsure that individuals with COVID-19-like symptoms are positive with COVID-19, but our concern is, during this pandemic, any types of symptoms such as flu-like symptoms should have been taken seriously. This study was observed in the cases from three families with COVID-19 like symptoms. Case presentation This observational study was done between May 20 and Jun 2, 2020, in Bangladesh. The members of the inspected families shared COVID-19 like symptoms that were lasted for 3-10 days. Conclusions COVID-19 might be spread and cured silently in Bangladesh, which recommends that awareness is needed throughout the country to prevent the spreading of the disease.


Assuntos
Infecções por Coronavirus/transmissão , Pneumonia Viral/transmissão , Adulto , Bangladesh , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Remissão Espontânea , Adulto Jovem
9.
Pediatrics ; 146(4)2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32883808

RESUMO

BACKGROUND: Children with isolated neutropenia (absolute neutrophil count [ANC] <1500/µL) are frequently referred to pediatric hematology and oncology clinics for further diagnostic evaluation. Scant literature exists on interventions and outcomes for isolated neutropenia. We hypothesized that children will have resolution of their neutropenia without the need for intervention(s) by a pediatric hematologist and oncologist. METHODS: We performed a 5.5-year institutional review board-approved retrospective chart review of children referred to our pediatric hematology and oncology clinics for isolated neutropenia. Neutropenia was categorized as mild (ANC of 1001-1500/µL), moderate (ANC of 500-1000 µL), severe (ANC of 201-500/µL), or very severe (ANC of ≤200/µL). RESULTS: Among 155 children referred with isolated neutropenia, 45 (29%) had mild neutropenia, 65 (42%) had moderate neutropenia, 30 (19%) had severe neutropenia, and 15 (10%) had very severe neutropenia. Only 29 (19%) children changed to an ANC category lower than their initial referral category. At a median follow-up of 12 months, 101 children had resolution of neutropenia, 40 children had mild neutropenia, 10 children had moderate neutropenia, 3 children had severe neutropenia, and 1 patient had very severe neutropenia. A specific diagnosis was not identified in most (54%) children. The most common etiologies were viral suppression (16%), autoimmune neutropenia (14%), and drug-induced neutropenia (8%). Black children had a 3.5 higher odds of having persistent mild neutropenia. Six (4%) children received granulocyte colony-stimulating factor therapy. CONCLUSIONS: Most children referred for isolated neutropenia do not progress in severity and do not require subspecialty interventions or hospitalizations.


Assuntos
Neutropenia/epidemiologia , Encaminhamento e Consulta/estatística & dados numéricos , Adolescente , Afro-Americanos/estatística & dados numéricos , Anticorpos Antinucleares/análise , Americanos Asiáticos/estatística & dados numéricos , Doenças Autoimunes/complicações , Neutropenia Febril Induzida por Quimioterapia/epidemiologia , Criança , Pré-Escolar , Progressão da Doença , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Feminino , Seguimentos , Fator Estimulador de Colônias de Granulócitos/uso terapêutico , Hematologia , Hospitalização/estatística & dados numéricos , Humanos , Lactente , Recém-Nascido , Masculino , Oncologia , Neutropenia/diagnóstico , Neutropenia/tratamento farmacológico , Neutropenia/etiologia , Remissão Espontânea , Estudos Retrospectivos , Viroses/complicações
10.
Medicine (Baltimore) ; 99(36): e21835, 2020 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-32899012

RESUMO

RATIONALE: Macular hole (MH) formation after vitrectomy is rare and it may be due to several mechanisms associated with change of foveolar anatomy by vitrectomy. If a MH develops after vitrectomy, surgical treatments including internal limiting membrane peeling and intravitreal gas injection are usually needed for repair of hole. Spontaneous closure of MH is much rarer. PATIENT CONCERNS: A 66-year-old patient had a vitrectomy for rhegmatogenous retinal detachment not involving the macula of the right eye. Eight months after the vitrectomy, the visual acuity decreased and full-thickness defect of macula, epiretinal membrane progression, intraretinal cysts, and flame shape hemorrhage along with superior temporal vascular arcade were observed on fundus examination and optical coherence tomography. DIAGNOSES: MH and branch retinal vein occlusion (BRVO) accompanying cystoid macular edema (CME) were both present on her right eye. Thus, we planned a surgery for MH repair. INTERVENTIONS: The status of MH was observed while waiting the surgery schedule. At 2 weeks after detection of the MH, optical coherence tomography showed that intraretinal cysts had decreased in extent and the inner wall of the MH had contracted; 4 weeks later, the MH was closed with a subtle subretinal space. OUTCOMES: The fovea was well-maintained with a complete closure for 9 months. LESSONS: MH formation and spontaneous closure occurred in association with BRVO accompanying CME in a patient who had a vitrectomy. In vitrectomized eyes, physicians should consider the possibility of MH development in association with BRVO, and possible spontaneous closure of the MH in accordance with CME resolution.


Assuntos
Perfurações Retinianas/etiologia , Vitrectomia/efeitos adversos , Idoso , Feminino , Humanos , Complicações Pós-Operatórias/etiologia , Remissão Espontânea
11.
Echocardiography ; 37(9): 1465-1469, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32856328

RESUMO

A previously healthy 49-year-old male patient presented with COVID-19 infection and required mechanical ventilation and extracorporeal membrane oxygenation due to severe hypoxemia. Echocardiography showed cardiac dysfunction with an apical sparing strain pattern, which rapidly normalized within a week. Apical sparing myocardial strain in patients with COVID-19 infection may suggest reverse-type stress cardiomyopathy.


Assuntos
/complicações , Ecocardiografia/métodos , Remissão Espontânea , Disfunção Ventricular Esquerda/diagnóstico por imagem , Disfunção Ventricular Esquerda/etiologia , /fisiopatologia , Ventrículos do Coração/diagnóstico por imagem , Ventrículos do Coração/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Disfunção Ventricular Esquerda/fisiopatologia
12.
Am Fam Physician ; 102(4): 229-233, 2020 08 15.
Artigo em Inglês | MEDLINE | ID: mdl-32803924

RESUMO

Henoch-Schönlein purpura, now called immunoglobulin A (IgA) vasculitis, is a systemic, immune complex-mediated, small-vessel leukocytoclastic vasculitis characterized by nonthrombocytopenic palpable purpura, arthritis, and abdominal pain. It is the most common vasculitis in children but can also occur in adults. Diagnostic testing is required only to exclude other etiologies of purpura, to identify renal involvement, and, if indicated, to determine its extent with biopsy. Imaging or endoscopy may be needed to assess organ complications. IgA vasculitis spontaneously resolves in 94% of children and 89% of adults, making supportive treatment the primary management strategy. However, a subset of patients experience renal involvement that can persist and relapse years later. Additional complications can include gastrointestinal bleeding, orchitis, and central nervous system involvement. Systematic reviews have shown that steroids do not prevent complications and should not be used prophylactically. However, randomized trials have demonstrated success with high-dose steroids, cyclosporine, and mycophenolate in treating glomerulonephritis and other complications. Long-term prognosis depends on the extent of renal involvement. Six months of follow-up is prudent to assess for disease relapse or remission.


Assuntos
Analgésicos não Entorpecentes/uso terapêutico , Artralgia/tratamento farmacológico , Glomerulonefrite/tratamento farmacológico , Imunossupressores/uso terapêutico , Púrpura de Schoenlein-Henoch/diagnóstico , Púrpura de Schoenlein-Henoch/terapia , Acetaminofen/uso terapêutico , Corticosteroides/uso terapêutico , Adulto , Anti-Inflamatórios não Esteroides/uso terapêutico , Artralgia/etiologia , Criança , Ciclosporina/uso terapêutico , Progressão da Doença , Glomerulonefrite/diagnóstico , Glomerulonefrite/etiologia , Glomerulonefrite/patologia , Humanos , Ácido Micofenólico/uso terapêutico , Nefrologia , Púrpura de Schoenlein-Henoch/complicações , Recidiva , Encaminhamento e Consulta , Remissão Espontânea , Urinálise
13.
BMC Public Health ; 20(1): 1271, 2020 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-32819348

RESUMO

BACKGROUND: People living in temporary housing for long periods after a disaster are at risk of poor mental health. This study investigated the post-disaster incidence and remission of common mental disorders among adults living in temporary housing for the 3 years following the 2011 Great East Japan Earthquake. METHODS: Three years after the disaster, face-to-face interviews were conducted with 1089 adult residents living in temporary housing in the disaster area, i.e., the shelter group, and a random sample of 852 community residents from non-disaster areas of East Japan. The World Health Organization Composite International Diagnostic Interview was used to diagnose DSM-IV mood, anxiety, and alcohol use disorders. Information on demographic variables and disaster experiences was also collected. RESULTS: Response rates were 49 and 46% for the shelter group and the community residents, respectively. The incidence of mood/anxiety disorder in the shelter group was elevated only in the first year post-disaster compared to that of the general population. The rate of remission for mood and anxiety disorders was significantly lower in the shelter group than in the community residents. The proportion seeking medical treatment was higher in the shelter group. CONCLUSIONS: The onset of common mental disorders increased in the first year, but then levelled off in the following years among residents in temporary housing after the disaster. Remission from incident post-disaster mental disorders was slower in the shelter group than in the general population. Post-disaster mental health service could consider the greater incidence in the first year and prolonged remission of mental disorders among survivors with a long-term stay in temporary housing after a disaster.


Assuntos
Ansiedade/etiologia , Desastres , Terremotos , Habitação , Transtornos Mentais/etiologia , Saúde Mental , Sobreviventes/psicologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Ansiedade/epidemiologia , Abrigo de Emergência , Feminino , Acidente Nuclear de Fukushima , Pessoas em Situação de Rua/psicologia , Humanos , Incidência , Japão/epidemiologia , Masculino , Transtornos Mentais/epidemiologia , Pessoa de Meia-Idade , Transtornos do Humor/epidemiologia , Transtornos do Humor/etiologia , Remissão Espontânea , Tsunamis , Adulto Jovem
14.
Int J Hematol ; 112(6): 894-899, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32772263

RESUMO

Diamond-Blackfan Anemia (DBA) is a congenital pure red cell aplasia caused by heterozygous variants in ribosomal protein genes. The hematological features associated with DBA are highly variable and non-hematological abnormalities are common. We report herein on an affected mother and her daughter presenting with transfusion-dependent anemia. The mother showed mild physical abnormalities and entered spontaneous remission at age 13 years. Her daughter was born with occipital meningocele. Exome sequencing of DNA from the mother revealed a heterozygous novel splice site variant (NM_001011.4:c.508-3T > G) in the Ribosomal Protein S7 gene (RPS7) inherited by the daughter. Functional analysis of the RPS7 variant expressed from a mini-gene construct revealed that the exon 7 acceptor splice site was replaced by a cryptic splice resulting in a transcript missing 64 bp of exon 7 (p.Val170Serfs*8). Our study confirms a pathogenic effect of a novel RPS7 variant in DBA associated with spontaneous remission in the mother and meningocele in her daughter, thus adding to the genotype-phenotype correlations in DBA.


Assuntos
Anemia de Diamond-Blackfan/genética , Aberrações Cromossômicas , Estudos de Associação Genética , Variação Genética/genética , Meningocele/genética , Processamento de RNA/genética , Proteínas Ribossômicas/genética , Adolescente , Adulto , Anemia de Diamond-Blackfan/etiologia , Criança , Éxons/genética , Feminino , Humanos , Meningocele/etiologia , Relações Mãe-Filho , Remissão Espontânea , Análise de Sequência de DNA
15.
Psychiatry Res ; 292: 113292, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32707217

RESUMO

Aims Patients with bipolar disorder present milder cognitive impairment in comparison to patients with schizophrenia. Psychotic symptoms are associated with poorer cognitive functioning in both disorders. We aim to compare cognitive dysfunction between bipolar disorder and schizophrenia across symptomatic and remitted states. Methods An extensive cognitive battery was used to assess bipolar disorder patients (32 in manic episodes with psychotic features, 44 in euthymia), patients with schizophrenia (41 symptomatic, 39 remitted), and 55 healthy controls. A global cognitive factor and six neurocognitive domain factors were identified using principal component analyses. Results Global cognition components differed according to both illness and remission status; working memory differed according to remission status regardless of diagnosis; verbal fluency differed according to diagnosis regardless of remission status. An omnibus F test revealed that the remission state had a significant impact on processing speed in schizophrenia. Conclusion Our data suggest that both disorders are associated with state dependent (i.e., global cognition and working memory) and diagnosis dependent (i.e., global cognition and verbal fluency) neurocognitive dysfunctions. Processing speed was exclusively influenced by symptomatic states of schizophrenia.


Assuntos
Transtorno Bipolar/psicologia , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/psicologia , Testes de Estado Mental e Demência , Esquizofrenia/diagnóstico , Psicologia do Esquizofrênico , Adulto , Transtorno Bipolar/diagnóstico , Cognição/fisiologia , Estudos Transversais , Feminino , Humanos , Masculino , Memória de Curto Prazo/fisiologia , Pessoa de Meia-Idade , Remissão Espontânea
16.
Dermatol Online J ; 26(4)2020 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-32621680

RESUMO

Porokeratosis is a heterogeneous group of dermatoses with alterations of keratinization. Histologically, they are characterized by the presence of cornoid lamellae. Eruptive pruritic papular porokeratosis (EPPP) or the inflammatory form of disseminated superficial porokeratosis (or eruptive disseminated porokeratosis) is an infrequent variant, characterized by pruritic erythematous papules or annular lesions. We present a 72-year-old woman with EPPP, exhibited by pruritic lesions on the extremities and back, and review the literature concerning this condition. We found 32 cases of EPPP or inflammatory disseminated superficial porokeratosis (including the current case) reported in the literature, with a median age of 66 years (range, 13-84); 59.3% were men. Eruptive pruritic papular porokeratosis was associated with various neoplasms in 31.2% of cases. Six patients had an associated viral infection. Response to treatment was poor in most cases. Eruptive pruritic papular porokeratosis resolved spontaneously in 75% of cases. Median time to resolution was 6 months (range, 1-24). Eruptive pruritic papular porokeratosis (or inflammatory disseminated superficial porokeratosis/eruptive disseminated porokeratosis) is an infrequent variant of porokeratosis characterized by intense pruritus and spontaneous resolution in most individuals. Eruptive pruritic papular porokeratosis can be associated with neoplasms and screening for malignancies is recommended if clinically indicated.


Assuntos
Poroceratose , Prurido/etiologia , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Poroceratose/complicações , Poroceratose/patologia , Remissão Espontânea , Pele/patologia
17.
Am J Cardiol ; 131: 122-124, 2020 09 15.
Artigo em Inglês | MEDLINE | ID: mdl-32718546

RESUMO

There have been no recent descriptions of the spontaneous conversion of long-standing atrial fibrillation (AF) or flutter (AFl) to sinus rhythm which, in the past, has been associated with rheumatic mitral valve disease and treatment with digoxin. We present 3 contemporary cases, all of whom progressed from AF to slow AFl and then spontaneously converted to slow sinus or junctional rhythm. None of these patients had rheumatic heart disease or were treated with digoxin. In conclusion, we believe that they provide support for the broader view that this uncommon phenomenon is associated with a severe atrial myopathy due to scar and inflammation.


Assuntos
Fibrilação Atrial/fisiopatologia , Flutter Atrial/fisiopatologia , Idoso , Idoso de 80 Anos ou mais , Progressão da Doença , Eletrocardiografia , Mapeamento Epicárdico , Humanos , Masculino , Remissão Espontânea
18.
Am J Cardiol ; 131: 125-126, 2020 09 15.
Artigo em Inglês | MEDLINE | ID: mdl-32718558

RESUMO

A 64-year-old man with known coronary disease presented to the hospital with sinus bradycardia, chest pain, and normal cardiac enzymes. During an exercise stress test he developed ventricular fibrillation that spontaneously resolved.


Assuntos
Stents , Fibrilação Ventricular/fisiopatologia , Fibrilação Ventricular/terapia , Eletrocardiografia , Teste de Esforço , Massagem Cardíaca , Humanos , Masculino , Pessoa de Meia-Idade , Remissão Espontânea
19.
Int Heart J ; 61(4): 851-855, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32728004

RESUMO

Protein-losing enteropathy (PLE) is one of the major complications after a Fontan operation. Some PLE patients suffer from concurrent gastrointestinal bleeding. An effective treatment regimen for such patients has not been established yet. Further, it remains unknown whether PLE and gastrointestinal bleeding coexist independently, or protein losing is associated with gastrointestinal bleeding. We report a 7-year-old steroid-refractory post-Fontan PLE case suggesting the latter pathogenesis together with a literature review.


Assuntos
Técnica de Fontan/efeitos adversos , Hemorragia Gastrointestinal/complicações , Síndrome do Coração Esquerdo Hipoplásico/cirurgia , Enteropatias Perdedoras de Proteínas/etiologia , Administração Oral , Anemia Refratária/etiologia , Cateterismo Cardíaco/métodos , Criança , Glucocorticoides/administração & dosagem , Glucocorticoides/uso terapêutico , Humanos , Hipoalbuminemia/etiologia , Masculino , Prednisolona/administração & dosagem , Prednisolona/uso terapêutico , Enteropatias Perdedoras de Proteínas/tratamento farmacológico , Remissão Espontânea , Resultado do Tratamento
20.
Medicine (Baltimore) ; 99(27): e21069, 2020 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-32629737

RESUMO

Lumbar disc herniation (LDH) is a common, disabling musculoskeletal disorder. Magnetic resonance imaging has clarified the natural history of lumbar disc lesions and has documented that disc lesions can become smaller and can even be completely resorbed. Previous studies have confirmed that some traditional Chinese medicine (TCM) therapies can promote resorption of the protrusion. However, high-quality research evidence is needed to support the effectiveness of the protocol. OBJECTIVE: This clinical trial aims to establish whether TCM can promote the resorption of LDH and to assess the efficacy of such therapy for LDH, thereby evaluating its clinical effect. METHODS: The present study design is for a single-center, 2-arm, open-label randomized controlled trial. A total of 150 eligible LDH patients will be randomly assigned to either a TCM treatment group or a control group in a 1:1 ratio. Patients in the TCM group will be administered a TCM decoction for 4 weeks. Patients in the conventional drug control group will be instructed to take a specific daily dose of celecoxib. The primary outcome measure is the change from baseline in the volume of the protrusion, as assessed using MR images. Secondary outcome measures include visual analog scale pain scores and Japanese Orthopaedic Association scores assessed at 3 and 6 months. DISCUSSION: The design and methodological rigor of this trial will allow evaluation of the basic clinical efficacy and safety data for TCM in the treatment of patients with LDH. The trial will also assess whether TCM can promote the resorption of LDH. This research will therefore help provide a solid foundation for the clinical treatment of LDH and for future research in TCM therapy. TRIAL REGISTRATION: ChiCTR1900022377.


Assuntos
Deslocamento do Disco Intervertebral/terapia , Vértebras Lombares/diagnóstico por imagem , Medicina Tradicional Chinesa/métodos , Adulto , Anti-Inflamatórios não Esteroides/uso terapêutico , Estudos de Casos e Controles , Celecoxib/uso terapêutico , Humanos , Deslocamento do Disco Intervertebral/diagnóstico por imagem , Vértebras Lombares/patologia , Imagem por Ressonância Magnética/métodos , Pessoa de Meia-Idade , Medição da Dor/métodos , Remissão Espontânea , Projetos de Pesquisa , Segurança , Resultado do Tratamento , Escala Visual Analógica
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