Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 87.987
Filtrar
1.
Anticancer Res ; 39(9): 4603-4612, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31519557

RESUMO

BACKGROUND/AIM: Sarcopenia describes the loss of skeletal muscle mass. While this condition is associated with a high mortality in cancer patients, its influence on survival is still underestimated. PATIENTS AND METHODS: A systematic review for articles was performed using the PubMed database, Cochrane Library, Biomed Central, Science Direct and by manual search. We used data of overall survival in sarcopenic patients for assessing the death risk. We extracted hazard ratio estimates from univariate and multivariate Cox proportional hazards models for meta-analysis. RESULTS: A total of 15 studies were eligible for meta-analysis including a total of 2,521 lung cancer patients. Univariate meta-analysis revealed a two-fold increased death risk in sarcopenic patients; multivariate meta-analysis yielded a significant, three-fold elevated risk of death. This higher mortality is independent of tumour stage. CONCLUSION: Muscle loss is an independent risk factor for increased death risk in lung cancer patients independent of cancer stage. This argues for implementing screening for sarcopenia into cancer care.


Assuntos
Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/mortalidade , Sarcopenia/etiologia , Humanos , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/epidemiologia , Músculo Esquelético/patologia , Estadiamento de Neoplasias , Tamanho do Órgão , Prognóstico , Modelos de Riscos Proporcionais , Sarcopenia/diagnóstico , Sarcopenia/epidemiologia
2.
Anticancer Res ; 39(9): 5157-5163, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31519628

RESUMO

BACKGROUND/AIM: Neoadjuvant therapy is often administered to patients with locally advanced rectal cancer (LARC). The aim of this study was to investigate the correlation between the change in the psoas muscle index (PMI) during neoadjuvant therapy and the prognosis of LARC patients. PATIENTS AND METHODS: Forty-seven patients who underwent potentially curative surgery for LARC with neoadjuvant therapy were enrolled in this study. We evaluated the relationship between the prognosis and clinicopathological factors, including the prognostic value of a change in the PMI. RESULTS: A >10% decrease in the PMI value was observed in 15 of the 47 patients. A >10% decrease in the PMI value was associated with shorter OS and RFS compared to patients who did not show a >10% decrease in their PMI. The decrease in PMI after neoadjuvant therapy was an independent negative prognostic factor for patients undergoing neoadjuvant therapy for LARC. CONCLUSION: A decrease in PMI after neoadjuvant therapy might predict a poor prognosis in LARC patients undergoing neoadjuvant therapy.


Assuntos
Músculos Psoas/patologia , Neoplasias Retais/mortalidade , Neoplasias Retais/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Terapia Combinada , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Terapia Neoadjuvante , Recidiva Local de Neoplasia , Estadiamento de Neoplasias , Tamanho do Órgão , Prognóstico , Curva ROC , Neoplasias Retais/terapia , Resultado do Tratamento , Adulto Jovem
3.
An Acad Bras Cienc ; 91(3): e20181330, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31508665

RESUMO

Type 1 diabetes (T1D) is the result of the selective destruction of the pancreatic ß-cells by T cells of the immune system. Although spleen is a secondary lymphoid organ, it is also involved in the T1D pathogenesis. However, the alterations in a variety of cellular processes of this disease need to be further understood. We aimed to analyze the benefits of resveratrol, and its complexed form on diabetic complications in the spleen of rats. To this end, we investigated important enzymes of phosphoryl transfer network, and Na+, K+-ATPase activity. Wistar rats were divided into non-diabetic groups: Control, Ethanol, Resveratrol, Hydroxypropyl-ß-cyclodextrin, Resveratrol-hydroxypropyl-ß-cyclodextrin, and diabetic groups with the same treatments. Diabetes was induced by a single dose of 60 mg/kg of streptozocin intraperitoneally, and treatments by intragastric gavage once daily for 60 days. Hyperglycemia reduced creatine kinase activity, which was reversed by the administration of resveratrol. Na+, K+-ATPase activity was greatly affected, but it was reversed by resveratrol and resveratrol-hydroxypropyl-ß-cyclodextrin. This suggest an energetic imbalance in the spleen of diabetic rats, and in case this also occurs in the diabetic patients, it is possible that resveratrol supplementation could be beneficial to the better functioning of the spleen in diabetic patients.


Assuntos
2-Hidroxipropil-beta-Ciclodextrina/farmacologia , Antioxidantes/farmacologia , Diabetes Mellitus Experimental/metabolismo , Resveratrol/farmacologia , ATPase Trocadora de Sódio-Potássio/metabolismo , Baço/metabolismo , Animais , Antioxidantes/metabolismo , Glicemia/análise , Peso Corporal , Creatina Quinase/metabolismo , Diabetes Mellitus Experimental/induzido quimicamente , Metabolismo Energético/efeitos dos fármacos , Hiperglicemia/metabolismo , Masculino , Tamanho do Órgão , Ratos , Ratos Wistar , Estreptozocina
4.
Medicine (Baltimore) ; 98(37): e16936, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31517814

RESUMO

The study aimed to investigate the effect of ratios of marrow cavity diameter to intramedullary nail diameter from different layers on hidden blood loss (HBL), overt blood loss (OBL) and total blood loss (TBL) during using proximal femoral nail antirotation-Asian version (PFNA)-II for femoral intertrochanteric fractures.We retrospectively studied 70 patients treated in our hospital recently. We recorded postoperative hematocrit (Hct) and OBL during operation. TBL and HBL were calculated using CROSS equation. The ratios of marrow cavity diameter to intramedullary nail diameter from different layers, including start of funnel, end of funnel and femoral isthmus, were measured. The mean of the ratio from frontal and lateral X-ray were designated as R. We classified all included participants into a high and a low matching group according to z-score of R within each layer. TBL, HBL, and OBL were compared between the 2 groups. We applied multiple linear regression analysis between the HBL as a dependent variable and gender, age, body mass index, fracture type, and R as independent variables.The present study indicated a significant reduction in the HBL and TBL in the high matching group compared to low matching group on three layers, whereas it showed no significant difference in OBL between the 2 groups on three layers. It showed that R values from start of funnel and end of funnel were significantly associated with HBL.Matching rate of PFNA II at the funnel might be an important factor for HBL and TBL postoperatively.


Assuntos
Perda Sanguínea Cirúrgica , Medula Óssea/diagnóstico por imagem , Fraturas do Fêmur/diagnóstico por imagem , Fraturas do Fêmur/cirurgia , Idoso , Idoso de 80 Anos ou mais , Perda Sanguínea Cirúrgica/prevenção & controle , Medula Óssea/patologia , Feminino , Fraturas do Fêmur/patologia , Humanos , Interpretação de Imagem Assistida por Computador , Masculino , Pessoa de Meia-Idade , Tamanho do Órgão , Hemorragia Pós-Operatória/patologia , Hemorragia Pós-Operatória/terapia , Estudos Retrospectivos
5.
Medicine (Baltimore) ; 98(37): e17142, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31517856

RESUMO

Morphological data of talus are important for the design of talar prostheses. The talar morphology of Chinese population has been rarely reported. This study adopted a three-dimensional (3D) measurement approach to provide accurate data for the anatomical morphology of talus in Northeast Chinese population and compared it with that of foreigners.One hundred forty-six healthy subjects form Northeast China underwent computed tomography (CT) arthrography. 3D digital talar model was reconstructed and thirteen morphological parameters were measured through Mimics and Magics software. Length and breadth indexes of total talus, trochlea, medial and lateral malleolus articular surface were mainly selected. Statistical analysis was conducted by independent-samples and paired-samples t test through SPSS software.All the indexes were normally distributed. No significant difference between left and right talus was identified in either males or females (P > .05). Most of the indexes showed significant sexual differences except the radian of lateral malleolus articular surface and the posterior breadth of trochlea (P < .05). The talar anatomy of Chinese subjects is different from the published data in other populations.The promising approach adopted in this study addresses some inconvenience with previous conventional methods on cadaver specimens. The geometric parameters of talus in Chinese population differ from those in other populations. The talar measurements and morphology analysis in this study suggest that population characteristics should be taken into account. This study will provide references for the design of talar prostheses in Chinese population.


Assuntos
Imagem Tridimensional , Ossos do Tarso/anatomia & histologia , Ossos do Tarso/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Adulto , China , Feminino , Humanos , Imagem Tridimensional/métodos , Masculino , Pessoa de Meia-Idade , Variações Dependentes do Observador , Tamanho do Órgão , Reprodutibilidade dos Testes , Caracteres Sexuais , Software , Tomografia Computadorizada por Raios X/métodos , Adulto Jovem
6.
Cancer Radiother ; 23(5): 416-422, 2019 Sep.
Artigo em Francês | MEDLINE | ID: mdl-31421998

RESUMO

This article provides a proposal for the selection and delineation of clinical target volumes for the treatment with radiation of submandibular glands tumours. This article does not deal with external radiotherapy indications but specifies the volumes to be treated if radiotherapy is chosen. High-risk and low-risk peritumoral clinical target volumes are described based on the probability of local tumoral spread. High-risk and low-risk clinical target volumes are illustrated on CT-scan slices. A proposal for the selection of nodal clinical target volumeis also proposed.


Assuntos
Planejamento da Radioterapia Assistida por Computador/métodos , Neoplasias da Glândula Submandibular/radioterapia , Humanos , Irradiação Linfática/métodos , Imagem por Ressonância Magnética , Invasividade Neoplásica , Tamanho do Órgão , Dosagem Radioterapêutica , Risco , Neoplasias da Glândula Submandibular/diagnóstico por imagem , Neoplasias da Glândula Submandibular/patologia , Tomografia Computadorizada por Raios X , Carga Tumoral
7.
An Bras Dermatol ; 94(3): 327-330, 2019 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-31365662

RESUMO

BACKGROUND: Seborrheic dermatitis is a common disease characterized by the erythematous plaques with oily-yellow desquamation. Increased sebaceous gland activity by androgenic hormones has played a role in the etiology of the disease. The second-to-fourth digit (2D:4D) ratio is thought to be a marker of prenatal androgen exposure. OBJECTIVES: To investigate the association between 2D:4D ratios and seborrheic dermatitis in a male population. METHODS: Healthy male controls and patients with seborrheic dermatitis were included in this study. One hundred seborrheic dermatitis patients and 120 healthy controls, aged 17-59, were enrolled. A digital Vernier caliper was used to measure the finger lengths. Seborrheic dermatitis severity was assessed using the Seborrheic Dermatitis Area and Severity Index (SDASI). RESULTS: The 2D:4D ratios of the patients (x = 0.977) were significantly lower than those of the controls (x = 1.050) for right hands (t = 6.948; p = 0.000; > 0.05). No similar relationship was found between the 2D:4D ratio for left hands (t = 0.901; p = 0.368; > 0.05). Seborrheic dermatitis severity was negatively correlated with 2D:4D ratios of right hands (r = -0.391; p = 0.000-0.05). STUDY LIMITATIONS: One of the main limitations of this study was the small sample, which got a head of us from acquiring certain findings about the 2D:4D ratio and seborrheic dermatitis. The other limitation is that the patient selection did not reflect the general population, as a single clinic was studied. CONCLUSION: To the authors' knowledge, this is the first study examining the relationship between 2D:4D ratios and seborrheic dermatitis. The result of this study may indicate a line of investigation and can support the theory of prenatal androgen exposure.


Assuntos
Dermatite Seborreica/diagnóstico , Dedos/anatomia & histologia , Adolescente , Adulto , Androgênios/metabolismo , Antropometria , Biomarcadores , Estudos de Casos e Controles , Feminino , Mãos/anatomia & histologia , Humanos , Masculino , Pessoa de Meia-Idade , Tamanho do Órgão , Gravidez , Efeitos Tardios da Exposição Pré-Natal , Índice de Gravidade de Doença , Adulto Jovem
8.
J Appl Oral Sci ; 27: e20180722, 2019 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-31411266

RESUMO

OBJECTIVES: Age estimation is one of the most important factors in forensic medicine. Measuring secondary dentin deposition using cone-beam computed tomography images is an easy and noninvasive method. The aim of this study was to evaluate cone-beam computed tomography images as a reliable method to estimate chronological age by pulp/teeth ratio in anterior teeth in Iranian population. METHODOLOGY: A total of 649 CBCT images from 377 Iranian patients aged between 20 and 69 years were evaluated. Pulp/teeth ratio (PTR) in maxillary and mandibular canine and central incisor teeth was measured in the axial and sagittal sections using OnDemand 3D Dental software. The Pearson correlation coefficient was determined to evaluate the correlation between the variables. Linear regression analysis, as well as age estimation formula, was used for each tooth separately. RESULTS: The regression analyses indicated that maxillary central incisors were more reliable for age estimation (R2=0.586 and standard error of estimate=7.045) compared with the other anterior teeth studied. Maxillary canine teeth had the lowest predictive power (R2=0.392 and standard error of estimate=8.387). Also, comparison of the axial and sagittal sections showed that the axial sections had a higher predictive power. (R2=0.48 for axial plans and R2=0.328 for sagittal plans). CONCLUSION: The use of cone-beam computed tomography in age estimation by pulp/teeth ratio of anterior teeth is useful and a reliable method for age estimation in Iranian population.


Assuntos
Determinação da Idade pelos Dentes/métodos , Tomografia Computadorizada de Feixe Cônico/métodos , Polpa Dentária/anatomia & histologia , Polpa Dentária/diagnóstico por imagem , Dente/anatomia & histologia , Dente/diagnóstico por imagem , Adulto , Fatores Etários , Idoso , Dente Canino/anatomia & histologia , Dente Canino/diagnóstico por imagem , Feminino , Humanos , Imagem Tridimensional , Incisivo/anatomia & histologia , Incisivo/diagnóstico por imagem , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Tamanho do Órgão , Valores de Referência , Reprodutibilidade dos Testes , Fatores Sexuais , Adulto Jovem
9.
Bratisl Lek Listy ; 120(8): 593-600, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31379183

RESUMO

OBJECTIVES: The incidence of obesity and obesity-assosiated pathologies continues to increase with profound adverse effects on health status in the developed countries. BACKGROUND: We aimed to investigate the effect of high fat diet on the adrenal gland morphology. METHODS: We fed the mice with either high-fat diet (60 % kcal from fat) or low-fat diet (10 % kcal from fat) for nine weeks. Unbiased stereological methods were used to evaluate the adrenal gland morphology. The sections were evaluated using Cavalieri's method and volume fraction approach. We calculated mean volume of adrenal gland, mean volume of adrenal medulla, VVadrenal medulla/adrenal gland, mean diameter of cromaffin cells, number of chromaffin cells in per unit volume (NVcc mm‒3), total number of cromaffin cells, VVzona glomerulosa/adrenal cortex, VVzona fasciculata/adrenal cortex , VVzona reticulosa/adrenal cortex. RESULTS: The weight of adrenal gland, body weight intraperitoneal adipose tissue and adrenal gland weight in the obese mice significantly increased when compared with the control group. No changes were observed in the mean volume of adrenal gland, mean volume of adrenal medulla, VVzona glomerulosa/adrenal cortex, VVzona fasciculata/adrenal cortex, total number of cromaffin cells and diameter of cromaffin cells. However, NVcc mm-3 and VVzona reticulosa/adrenal cortex in the obese mice considerably increased compared with the control group. CONCLUSION: The present results suggest that high fat diet adversely affects the adrenal gland morphology (Tab. 2, Fig. 6, Ref. 28).


Assuntos
Glândulas Suprarrenais/patologia , Dieta Hiperlipídica/efeitos adversos , Córtex Suprarrenal/patologia , Medula Suprarrenal/patologia , Animais , Peso Corporal , Camundongos , Tamanho do Órgão
10.
Cancer Radiother ; 23(6-7): 500-502, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31444076

RESUMO

Fractionation was established more than fifty years ago as the best way to obtain a differential effect between tumors and normal tissues. However, new technologies allowed today to spare critical organs from the radiation fields. And so protracted courses of irradiation are no longer required. Hypofractionation have clear practical advantages over classical fractionation: it saves the patient time; it saves money for public health system; it reduces pressure on radiotherapy units. In several localization, it has proved to be as efficient as classical fractionation without increasing late effects. In prostate cancer, some radiobiological considerations argue in favor of a better efficiency, but clinical trials did not demonstrated differences in biological control. In conclusion, for all diseases where hypofractionation was demonstrated efficient, it must be fully implemented. Invoice procedures must be adapted to maintain a sufficient level of reimbursement of radiotherapy centers.


Assuntos
Neoplasias da Mama/radioterapia , Neoplasias da Próstata/radioterapia , Hipofracionamento da Dose de Radiação/normas , Institutos de Câncer/economia , Feminino , Humanos , Masculino , Tamanho do Órgão/efeitos da radiação , Órgãos em Risco/efeitos da radiação , Lesões por Radiação/etiologia , Lesões por Radiação/prevenção & controle , Tolerância a Radiação , Mecanismo de Reembolso , Reprodutibilidade dos Testes
11.
Naturwissenschaften ; 106(9-10): 50, 2019 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-31456022

RESUMO

The cavities of bamboos (Poaceae) are used by various animals. Most of the animals access these cavities either by existing cracks or by excavating bamboos with soft walls or small, thin-walled bamboos. Only a few animals excavate into the cavities of large and thick- and hard-walled internodes of mature bamboos. We studied two lizard beetle species (Coleoptera: Erotylidae: Languriinae), Doubledaya ruficollis and Oxylanguria acutipennis, that excavate into large internode cavities of recently dead mature bamboos and have morphological modifications. We observed that females of D. ruficollis used their mandibles to bore oviposition holes on Schizostachyum sp. (mean wall thickness = 3.00 mm) and O. acutipennis did so on Dendrocalamus sp. (3.37 mm) bamboos. Previous studies suggested that the markedly asymmetrical mandibles and needle-like ovipositors of females in the genus Doubledaya are adaptive traits for excavating hard-walled bamboos for oviposition. Therefore, we measured their mandibular lengths and ovipositor lengths. D. ruficollis females had greater asymmetry in the mandibles and shorter and less-sclerotized ovipositors than females of congeners using small bamboos. In contrast, O. acutipennis females had slightly asymmetrical mandibles and elongated, well-sclerotized ovipositors. Oviposition holes of D. ruficollis were cone-shaped (evenly tapering), whereas those of O. acutipennis were funnel-shaped (tube-like at the internal apex). This suggests that D. ruficollis females excavate oviposition holes using the mandibles only, and O. acutipennis females use both the mandibles and ovipositors. These differences suggest different oviposition-associated morphological specialization for using large bamboos: the extremely asymmetrical mandibles in D. ruficollis and elongated, needle-like ovipositors in O. acutipennis.


Assuntos
Besouros/anatomia & histologia , Besouros/fisiologia , Estruturas Animais/anatomia & histologia , Animais , Comportamento Animal/fisiologia , Feminino , Tamanho do Órgão/fisiologia , Poaceae/anatomia & histologia , Poaceae/parasitologia
12.
JAMA ; 322(6): 524-534, 2019 08 13.
Artigo em Inglês | MEDLINE | ID: mdl-31408137

RESUMO

Importance: The effect of intensive blood pressure lowering on brain health remains uncertain. Objective: To evaluate the association of intensive blood pressure treatment with cerebral white matter lesion and brain volumes. Design, Setting, and Participants: A substudy of a multicenter randomized clinical trial of hypertensive adults 50 years or older without a history of diabetes or stroke at 27 sites in the United States. Randomization began on November 8, 2010. The overall trial was stopped early because of benefit for its primary outcome (a composite of cardiovascular events) and all-cause mortality on August 20, 2015. Brain magnetic resonance imaging (MRI) was performed on a subset of participants at baseline (n = 670) and at 4 years of follow-up (n = 449); final follow-up date was July 1, 2016. Interventions: Participants were randomized to a systolic blood pressure (SBP) goal of either less than 120 mm Hg (intensive treatment, n = 355) or less than 140 mm Hg (standard treatment, n = 315). Main Outcomes and Measures: The primary outcome was change in total white matter lesion volume from baseline. Change in total brain volume was a secondary outcome. Results: Among 670 recruited patients who had baseline MRI (mean age, 67.3 [SD, 8.2] years; 40.4% women), 449 (67.0%) completed the follow-up MRI at a median of 3.97 years after randomization, after a median intervention period of 3.40 years. In the intensive treatment group, based on a robust linear mixed model, mean white matter lesion volume increased from 4.57 to 5.49 cm3 (difference, 0.92 cm3 [95% CI, 0.69 to 1.14]) vs an increase from 4.40 to 5.85 cm3 (difference, 1.45 cm3 [95% CI, 1.21 to 1.70]) in the standard treatment group (between-group difference in change, -0.54 cm3 [95% CI, -0.87 to -0.20]). Mean total brain volume decreased from 1134.5 to 1104.0 cm3 (difference, -30.6 cm3 [95% CI, -32.3 to -28.8]) in the intensive treatment group vs a decrease from 1134.0 to 1107.1 cm3 (difference, -26.9 cm3 [95% CI, 24.8 to 28.8]) in the standard treatment group (between-group difference in change, -3.7 cm3 [95% CI, -6.3 to -1.1]). Conclusions and Relevance: Among hypertensive adults, targeting an SBP of less than 120 mm Hg, compared with less than 140 mm Hg, was significantly associated with a smaller increase in cerebral white matter lesion volume and a greater decrease in total brain volume, although the differences were small. Trial Registration: ClinicalTrials.gov Identifier: NCT01206062.


Assuntos
Anti-Hipertensivos/uso terapêutico , Encéfalo/fisiologia , Hipertensão/tratamento farmacológico , Substância Branca/patologia , Idoso , Pressão Sanguínea , Encéfalo/diagnóstico por imagem , Encéfalo/patologia , Feminino , Humanos , Hipertensão/complicações , Hipertensão/patologia , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Tamanho do Órgão , Fatores de Risco
13.
Sheng Li Xue Bao ; 71(4): 671-679, 2019 Aug 25.
Artigo em Chinês | MEDLINE | ID: mdl-31440764

RESUMO

The skeletal muscle mass accounts for more than 40% of the body weight of healthy adults. The skeletal muscle not only plays an important role in physical activities but also affects the function of other organs as a secretory organ secreting multiple muscle factors. Therefore, it is important to maintain the normal quantity and function of skeletal muscle. Skeletal muscle mass is the basis of skeletal muscle function and is often affected by many factors such as exercise and disease. Resistance exercise training induces increased protein synthesis in skeletal muscle cells, while limb disuse, chronic obstructive pulmonary disease, heart failure, chronic kidney disease, cachexia, Duchenne muscular dystrophy and many other pathological conditions lead to decreased protein synthesis or enhanced protein degradation of skeletal muscle cells. The process of skeletal muscle hypertrophy involves changes in multiple signaling pathways, such as IGF-1/PI3K/Akt, myostatin and G protein. On the other hand, activations of the ubiquitin-proteasome system, IGF-1/Akt/FoxO, autophagy-lysosomal pathway, NF-κB, and the glucocorticoid-mediated signaling pathways play important roles in regulating muscle atrophy. These signaling pathways regulate skeletal muscle mass and are modulated by some different conditions. This review briefly summarizes the signaling pathways of skeletal muscle mass control.


Assuntos
Músculo Esquelético/fisiologia , Transdução de Sinais , Humanos , Atrofia Muscular , Tamanho do Órgão
14.
Medicine (Baltimore) ; 98(26): e16073, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31261518

RESUMO

The present study aims to measure the retinal thickness of the macular region of AIDS patients with normal ocular fundus, HIV-related microvascular retinopathy patients and cytomegalovirus retinitis (CMVR) patients by optical coherence tomography, and generalize the characteristics of retinal thickness of these 3 groups of patients.In this retrospective case series, the study object comprised of 111 AIDS patients who received diagnosis and treatment in the Ophthalmology Department of Beijing Youan Hospital. There are 33 patients in the AIDS normal ocular fundus group, 47 patients in the HIV-related microvascular retinopathy group, and 31 patients in the CMVR group. The retinal thickness of the macular region of these above patients was measured. The main indicators were retinal thickness of 9 macular partitions, best corrected visual acuity, CD4+ T lymphocyte count, and the start of highly active antiretroviral therapy.In the CMVR group, except for the nasal-outer and temporal-outer sectors, the thickness of the affected eye of the rest of the regions was greater than that of healthy eye (P < .05). Furthermore, there was a difference in thickness of the superior-outer and inferior-outer sectors between the AIDS normal ocular fundus group and HIV-related microvascular retinopathy group. The difference in thickness of the superior-inner sector between patients in the AIDS normal ocular fundus group and CMVR group was not statistically significant, while the difference in thickness of the rest of the regions was statistically significant. The difference in thickness of various regions between patients in the HIV-related microvascular retinopathy group and CMVR group was statistically significant.The retinal thickness of patients in the CMVR group generally increased, the retinal thickness of superior-outer and inferior-outer sections of patients in the HIV-related microvascular retinopathy group increased, when compared to the AIDS normal ocular fundus group. These optical coherence tomography (OCT) examination results present its own characteristics in different eye diseases in AIDS patients, and different stages of eye disease.


Assuntos
Infecções Oportunistas Relacionadas com a AIDS/diagnóstico por imagem , Síndrome de Imunodeficiência Adquirida/diagnóstico por imagem , Macula Lutea/diagnóstico por imagem , Doenças Retinianas/diagnóstico por imagem , Doenças Vasculares/diagnóstico por imagem , Infecções Oportunistas Relacionadas com a AIDS/complicações , Infecções Oportunistas Relacionadas com a AIDS/patologia , Síndrome de Imunodeficiência Adquirida/complicações , Síndrome de Imunodeficiência Adquirida/patologia , Adulto , Idoso , Contagem de Linfócito CD4 , Feminino , Fundo de Olho , Humanos , Macula Lutea/patologia , Masculino , Microvasos , Pessoa de Meia-Idade , Tamanho do Órgão , Doenças Retinianas/complicações , Doenças Retinianas/patologia , Vasos Retinianos , Estudos Retrospectivos , Tomografia de Coerência Óptica , Doenças Vasculares/complicações , Doenças Vasculares/patologia , Acuidade Visual , Adulto Jovem
15.
Medicine (Baltimore) ; 98(26): e16118, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31261528

RESUMO

To explore the growth trend of fetal lateral ventricular volume, for understanding the relationship between atrial diameter (AD) and volume in normal fetus and fetus with ventriculomegaly.Overall, 97 sequential fetal head magnetic resonance imaging scans were performed; these pertained to 50 fetuses with normal lateral ventricles [normal group; gestational age (GA): 24-38 weeks] and 47 fetuses with ventriculomegaly (VM) (VM group; GA: 24-37 weeks). The left, right, and total lateral ventricular volume were measured using 3-dimensional magnetic resonance hydrography (MRH). Correlation coefficient (r) was calculated to assess the relationships of measurements. Lineal regression analysis was used to assess correlation of AD and GA with volume. Between-group differences in terms of AD and volume were assessed using t test.Significant linear growth was observed in the total lateral ventricular volume compared with GA in the normal group with a relative growth rate of 2.87% per week (P <.001). Significant linear relationship between AD and volume was observed, and a significant equation was acquired in the normal group and VM groups, respectively, using the simple linear regression model: left volume = 0.438 * normal left diameter (NLD) + 1.359; right volume = 0.493 * normal right diameter (NRD) + 1.012; left volume = 0.959 * left diameter in VM (VLD) - 2.074; right volume = 0.799 * right diameter in VM (VRD) - 0.443. A significant equation was obtained in the normal group and the VM group, using the multiple linear regression model: Total volume (mL) = 0.396 * NLD + 0.410 * NRD + 3.101; and total volume = 0.989 * VLD + 0.834 * VRD - 3.141, respectively. In terms of AD and volume, the left lateral ventricle was significantly larger than the right side in both groups. The volume of lateral ventricle in AD ≥10 mm group was larger than that in the AD <10 mm group. The total volume in the VM group was significantly larger than that in the normal group.The total lateral ventricular volume increased with GA. AD can be used to evaluate the fetal ventricular volume.


Assuntos
Hidrocefalia/diagnóstico por imagem , Hidrocefalia/embriologia , Ventrículos Laterais/diagnóstico por imagem , Ventrículos Laterais/embriologia , Feminino , Humanos , Hidrocefalia/patologia , Ventrículos Laterais/patologia , Imagem por Ressonância Magnética , Tamanho do Órgão , Gravidez , Segundo Trimestre da Gravidez , Terceiro Trimestre da Gravidez , Diagnóstico Pré-Natal , Estudos Prospectivos
16.
Medicine (Baltimore) ; 98(26): e16289, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31261602

RESUMO

To improve the detection of prostate cancer (PCa) by combining the Prostate Imaging Reporting and Data System version 2 (PI-RADS v2) and prostate-specific antigen-age volume (PSA-AV), especially among those in gray zone with PI-RADS v2 score 3 or serum total prostate-specific antigen (tPSA) 4 to 10 ng/mL.The 357 patients were enrolled in this study. The PI-RADS v2 scoring system was used to represent characteristics on multiparametric magnetic resonance imaging (mpMRI). PI-RADS v2 score 3 or tPSA 4 to 10 ng/mL were defined as the gray zone in detecting PCa. The formula equates to the patient age multiplied by the prostate volume, which is divided by the tPSA level. Univariate and multivariate analyses were done to ascertain significant predictors of prostate cancer.In all, 174 (48.7%) were benign prostatic hyperplasia, 183 (51.3%) had PCa. The results showed that PI-RADS v2, tPSA, and PSA-AV were significant independent predictors of prostate cancer. PI-RADS v2 score ≥4 could detect PCa with rate of 82.1%. Serum tPSA ≥10 ng/mL could detect PCa with rate of 66.2%, PSA density (PSAD) ≥0.15 ng/mL/cc with rate of 62.8%, and PSA-AV ≤250 with rate of 83.5%. Combining with PSA-AV ≤250, patients those with tPSA 4 to 10 ng/mL could improve the detection from 36.0% up to 81%, those with PI-RADS v2 score 3 from 28.6% up to 60.0%.PI-RADS v2 and PSA-AV are faithful variables for detecting PCa. And for patients, those in gray zones of PI-RADS v2 and tPSA, PSA-AV can improve detection rate of PCa.


Assuntos
Imagem por Ressonância Magnética , Antígeno Prostático Específico/sangue , Neoplasias da Próstata/sangue , Neoplasias da Próstata/diagnóstico por imagem , Fatores Etários , Idoso , Humanos , Imagem por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Tamanho do Órgão , Próstata/patologia , Neoplasias da Próstata/diagnóstico , Estudos Retrospectivos
17.
Zhejiang Da Xue Xue Bao Yi Xue Ban ; 48(2): 136-141, 2019 Apr 25.
Artigo em Chinês | MEDLINE | ID: mdl-31309750

RESUMO

OBJECTIVE: To determine the efficacy of second generation endometrial ablation (NovaSure) combined with levonorgestrel-releasing intrauterine system (Mirena) in the treatment of adenomyosis. METHODS: Clinical data of patients with adenomyosis admitted in Women's Hospital, Zhejiang University School of Medicine from January 2015 to December 2018 were retrospectively analyzed. Among 66 patients, 44 received Mirena placement only (control group) and 22 received Mirena placement and NovaSure treatment (study group). The menstruation blood loss, dysmenorrhea score, uterine size, expulsion rate of Mirena and the patients' satisfaction rate were assessed in two groups. RESULTS: There was a significant reduction in menstruation blood loss (P<0.05) and significant improvement in dysmenorrhea (P<0.05) after the treatment in both groups. The patients in study group had more marked improvement in menstruation blood loss than those in control group (P<0.05). The patients' satisfaction was higher and the expulsion rate of Mirena was lower in study group than that in control group (all P<0.05). The score of dysmenorrhea and the size of uterine had no significant difference between two groups (all P>0.05). CONCLUSIONS: NovaSure can improve the efficacy of Mirena in treatment of adenomyosis.


Assuntos
Adenomiose , Técnicas de Ablação Endometrial , Levanogestrel , Adenomiose/terapia , Dismenorreia , Feminino , Humanos , Levanogestrel/administração & dosagem , Tamanho do Órgão , Estudos Retrospectivos , Útero/anatomia & histologia
18.
J Forensic Leg Med ; 66: 144-146, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31302445

RESUMO

An autopsy case of sudden death due to pulmonary arterial hypertension (PAH) in a 5-year-old boy whose cause of death was not determined during autopsy, but was later determined by postmortem examination, is presented. The boy developed convulsions that subsequently stopped, but remained unconscious. He was transported to hospital by ambulance, but died soon after. The boy had been found to have right ventricular overload on ECG 2 weeks earlier. A plan had been made to consult a doctor for a specialist visit 2 months later. During autopsy, significant abnormalities or injuries were not observed on the body's external surface. Internal examination showed congested organs, and the blood remaining in the body was dark red with fluidity. The heart was significantly enlarged (146 g), with nearly equivalent thickness of the left and right ventricles, showing right ventricular hypertrophy. Obvious macroscopic abnormalities were not observed at the origin and main trunk of the pulmonary artery. The lungs were slightly swollen (right lung 100 g, left lung 95 g), severely congested, and edematous. A postmortem CT scan displayed some patchy shadows in both lungs; however, no significant abnormalities were detected. Histopathological examination suggested a diagnosis of PAH. Three genes (BMPR2, ALK1, and ENG) were tested, revealing a heterozygous insertion of five nucleotides, TTTCC, between nucleotides 2677 and 2678 within exon 12 of the BMPR2 gene. Therefore, the subject was considered to have had heritable PAH due to a BMPR2 gene mutation.


Assuntos
Receptores de Proteínas Morfogenéticas Ósseas Tipo II/genética , Morte Súbita/etiologia , Hipertensão Pulmonar/diagnóstico , Hipertensão Pulmonar/genética , Mutação , Pré-Escolar , Humanos , Hipertrofia Ventricular Direita/patologia , Pulmão/patologia , Masculino , Miocárdio/patologia , Tamanho do Órgão , Edema Pulmonar/patologia
19.
JAMA ; 322(4): 336-347, 2019 Jul 23.
Artigo em Inglês | MEDLINE | ID: mdl-31334794

RESUMO

Importance: United States government personnel experienced potential exposures to uncharacterized directional phenomena while serving in Havana, Cuba, from late 2016 through May 2018. The underlying neuroanatomical findings have not been described. Objective: To examine potential differences in brain tissue volume, microstructure, and functional connectivity in government personnel compared with individuals not exposed to directional phenomena. Design, Setting, and Participants: Forty government personnel (patients) who were potentially exposed and experienced neurological symptoms underwent evaluation at a US academic medical center from August 21, 2017, to June 8, 2018, including advanced structural and functional magnetic resonance imaging analytics. Findings were compared with imaging findings of 48 demographically similar healthy controls. Exposures: Potential exposure to uncharacterized directional phenomena of unknown etiology, manifesting as pressure, vibration, or sound. Main Outcomes and Measures: Potential imaging-based differences between patients and controls with regard to (1) white matter and gray matter total and regional brain volumes, (2) cerebellar tissue microstructure metrics (eg, mean diffusivity), and (3) functional connectivity in the visuospatial, auditory, and executive control subnetworks. Results: Imaging studies were completed for 40 patients (mean age, 40.4 years; 23 [57.5%] men; imaging performed a median of 188 [range, 4-403] days after initial exposure) and 48 controls (mean age, 37.6 years; 33 [68.8%] men). Mean whole brain white matter volume was significantly smaller in patients compared with controls (patients: 542.22 cm3; controls: 569.61 cm3; difference, -27.39 [95% CI, -37.93 to -16.84] cm3; P < .001), with no significant difference in the whole brain gray matter volume (patients: 698.55 cm3; controls: 691.83 cm3; difference, 6.72 [95% CI, -4.83 to 18.27] cm3; P = .25). Among patients compared with controls, there were significantly greater ventral diencephalon and cerebellar gray matter volumes and significantly smaller frontal, occipital, and parietal lobe white matter volumes; significantly lower mean diffusivity in the inferior vermis of the cerebellum (patients: 7.71 × 10-4 mm2/s; controls: 8.98 × 10-4 mm2/s; difference, -1.27 × 10-4 [95% CI, -1.93 × 10-4 to -6.17 × 10-5] mm2/s; P < .001); and significantly lower mean functional connectivity in the auditory subnetwork (patients: 0.45; controls: 0.61; difference, -0.16 [95% CI, -0.26 to -0.05]; P = .003) and visuospatial subnetwork (patients: 0.30; controls: 0.40; difference, -0.10 [95% CI, -0.16 to -0.04]; P = .002) but not in the executive control subnetwork (patients: 0.24; controls: 0.25; difference: -0.016 [95% CI, -0.04 to 0.01]; P = .23). Conclusions and Relevance: Among US government personnel in Havana, Cuba, with potential exposure to directional phenomena, compared with healthy controls, advanced brain magnetic resonance imaging revealed significant differences in whole brain white matter volume, regional gray and white matter volumes, cerebellar tissue microstructural integrity, and functional connectivity in the auditory and visuospatial subnetworks but not in the executive control subnetwork. The clinical importance of these differences is uncertain and may require further study.


Assuntos
Encéfalo/patologia , Empregados do Governo , Doenças do Sistema Nervoso/diagnóstico por imagem , Adulto , Encéfalo/anatomia & histologia , Encéfalo/diagnóstico por imagem , Estudos de Casos e Controles , Cuba , Imagem de Difusão por Ressonância Magnética , Feminino , Substância Cinzenta/anatomia & histologia , Substância Cinzenta/diagnóstico por imagem , Humanos , Imagem por Ressonância Magnética , Masculino , Doenças do Sistema Nervoso/etiologia , Ruído/efeitos adversos , Tamanho do Órgão , Valores de Referência , Estados Unidos , Substância Branca/anatomia & histologia , Substância Branca/diagnóstico por imagem
20.
Cancer Radiother ; 23(5): 370-377, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31331843

RESUMO

PUPOSE: Medulloblastoma is the most common primary malignant central nervous system tumor in childhood, accounting for 16-25% of cases (1). New treatment approaches have led to improved survival rates; however toxicities are still a major concern. PATIENTS AND METHODS: Participants were selected from the records of patients who were treated with craniospinal irradiation for medulloblastoma. Between January 2008 and December 2012, 62 patients were diagnosed with medulloblastoma at the national institute of oncology Rabat, 27 patients were still alive at the time of the study, of which n=16 patients were included in the study. The mean age of patients at the time of the study was 9.6 years. All children were treated with radiation therapy and chemotherapy, according to standard protocols. Median follow-up between treatment and evaluation was 4 years. All the children were assessed with the Wechsler Intelligence Scale for Children - fourth Edition (WISC-IV) three to five years after completion of radiotherapy. The test was administered by two well-trained psychologists in a distraction-free environment. The scoring was then reviewed by a psychologist from Brooklyn College. RESULTS: The mean standard score Full-Scale Intelligence Quotient (FSIQ) (M=63, SD=12.6) was found to be in the extremely low range and in the 1st percentile rank (PR), compared to the general population. All the measured primary index scales were below typical performance: verbal comprehension (M=67.7, SD=13.1), perceptual reasoning (M=63.5, SD=13.8) and processing speed (M=62.7, SD=15.5) were all found to be in the extremely low range, while xorking memory (M=75.5, SD=10.8) was found to be in the borderline range compared to the general population. To identify factors influencing the results, we performed both univariate and multivariate analyses. Age at the time of radiotherapy, initial clinical stage, total cranial radiotherapy dose, socioeconomic status, and the time of evaluation were identified as significantly impacting cognitive scores in the univariate analysis. In the multivariate analysis, only age at the time of radiotherapy and initial clinical stage remained factors significantly impacting cognitive outcomes with P=0.001 and P<0.001 respectively. CONCLUSION: Our study is evidence that tremendous efforts are still to be made in low-income countries to correctly measure neurocognitive dysfunction in medulloblastoma survivors and to prepare those patients to a typical life after the completion of treatment.


Assuntos
Neoplasias Cerebelares/radioterapia , Irradiação Craniana/efeitos adversos , Meduloblastoma/radioterapia , Transtornos Neurocognitivos/etiologia , Fatores Etários , Antineoplásicos/uso terapêutico , Neoplasias Cerebelares/tratamento farmacológico , Criança , Pré-Escolar , Terapia Combinada , Seguimentos , Substância Cinzenta/lesões , Substância Cinzenta/patologia , Hipocampo/lesões , Hipocampo/patologia , Humanos , Meduloblastoma/tratamento farmacológico , Transtornos da Memória/etiologia , Transtornos da Memória/patologia , Transtornos Neurocognitivos/patologia , Tamanho do Órgão , Modelos de Riscos Proporcionais , Escalas de Wechsler , Substância Branca/lesões , Substância Branca/patologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA