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1.
Wiad Lek ; 74(9 cz 1): 2197-2201, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34725300

RESUMO

OBJECTIVE: The aim: The aim of the research was to study the features of the ultrastructure of the skin of white rats 60 and 90 days after modeling of portal hypertension. PATIENTS AND METHODS: Materials and methods: The investigations were performed on male white nonlinear rats. The animals of the first (control) group underwent a sham operation. In rats of the second group, portal hypertension was simulated by applying a ligature to the portal vein. 60 and 90 days after the start of the experiment, a biopsy was taken from the anterior abdominal wall for electron microscopy research. RESULTS: Results: It was shown that skin in intact animals (control group) was of typical structure before beginning of experiment and 60 and 90 days after a sham operation. 60 days after the start of the experiment, we found severe edema of the basal and spinous layer of the epidermis, breakdown of intercellular contacts, edema of endotheliocytes, their perivascular edema, leukocytes infiltration, edema of mitochondria and lysosomes. 90 days after the start of the experiment, ultrastructural changes in the skin were more pronounced. Ultrastructural changes of microvessels were characterized by narrowed lumen. Endothelial cells had significant edema. CONCLUSION: Conclusions: Тhe data obtained should be taken into account when performing surgical interventions to prevent complications in the formation of the scar.


Assuntos
Células Endoteliais , Hipertensão Portal , Animais , Edema , Hipertensão Portal/etiologia , Masculino , Pele
2.
Artigo em Russo | MEDLINE | ID: mdl-34719908

RESUMO

Injuries of the ligamentous apparatus of the ankle joint are one of the most common injuries of the ODA. A large number of complications and a long period of disability require the development of modern methods of physiotherapy treatment that can reduce the number of relapses and reduce the duration of rehabilitation. OBJECTIVE: Evaluation of the effectiveness of the use of electromyostimulation in motion in the treatment of post-traumatic edema of the ankle joint. MATERIAL AND METHODS: 51 athletes with post-traumatic edema of the ankle joint were examined. The main complaints were the presence of pronounced edema in the area of injury, pain, restriction of movement in the joint. The patients were randomly divided into 2 groups: the 1st group (25 patients) received treatment with electromyostimulation in motion (while performing therapeutic gymnastics); the 2nd (control) group (26 patients) performed therapeutic gymnastics recommended for the treatment of patients with lymphovenous insufficiency. The method of laser Doppler flowmetry was used to study microcirculatory disorders in the area of injury. Peripheral hemodynamics was evaluated by the RVG method. The severity of edema was assessed by measuring the circumference of the lower leg in the lower third of the injured and healthy limb. The thickness of subcutaneous fat was assessed by ultrasound. The subjective feelings of athletes were evaluated using CIVIQ-2 questionnaires and pain syndrome assessment according to VAS. RESULTS AND CONCLUSION: The use of electromyostimulation in motion in patients with post-traumatic edema of the ankle joint helped to reduce pain, relieve soft tissue edema, increase the volume of movements in the affected joint, increase motor activity and improve the quality of life.


Assuntos
Articulação do Tornozelo , Terapia por Estimulação Elétrica , Edema/etiologia , Edema/terapia , Humanos , Microcirculação , Qualidade de Vida
3.
BMJ Case Rep ; 14(11)2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-34725062

RESUMO

Substernal goitre is characterised by compressive symptoms of the airway and oesophagus. Chronic, progressive symptoms usually result in surgical removal. We report a rare presentation of substernal goitre in a male in his early 70s who suffered from severe bilateral lower extremity (LE) lymphoedema, resulting in immobility and nursing home placement, and left upper extremity lymphoedema. Our initial assessment led to a filariasis work-up, which was negative, due to the patient's prior 2-year residence in India and service overseas. Chest CT scan revealed an incidental substernal goitre extending posterior to the left innominate vein and aortic arch to the level of the left mainstem bronchus. The patient underwent a left hemithyroidectomy via cervical excision and sternotomy and had an uneventful recovery with resolution of lymphoedema and mobility. Despite extensive literature regarding clinical presentations of substernal goitre, severe lymphoedema of the LE is not a well-established association.


Assuntos
Bócio Subesternal , Edema/etiologia , Bócio Subesternal/complicações , Bócio Subesternal/diagnóstico por imagem , Bócio Subesternal/cirurgia , Humanos , Extremidade Inferior/diagnóstico por imagem , Extremidade Inferior/cirurgia , Masculino , Estudos Retrospectivos , Tireoidectomia
4.
BMC Neurol ; 21(1): 445, 2021 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-34758765

RESUMO

BACKGROUND: Posterior reversible encephalopathy syndrome (PRES) represents a transient change in mental status with associated vasogenic edema of cortical and subcortical brain structures. It is often attributed to multifactorial etiology including hypertension and altered hemodynamics and disruption of vessel integrity. Patients with autoimmune disease and certain immune modulator therapies are at greater risk. CASE PRESENTATION: A 54-year-old female with past medical history of well-controlled multiple sclerosis on interferon-beta since 2013, presented with witnessed tonic colonic seizure. She also was noted to demonstrate left gaze deviation and left-sided hemiparesis. MRI fluid-attenuated inversion recovery sequence showed hyperintensity of the subcortical U fibers, concentrated in the occipital, parietal lobes and frontal lobes. Systolic blood pressure was 160 mmHg on arrival. The patient was started on seizure prophylxis and Interferon beta was discontinued. The patient's mentation, seizures and hemiapresis significantly improved in next 72 h with tight blood pressure control, and had notble improvement on MRI imaging and inflammatory markers. Lumbar puncture CSF results were devoid of infectious and autoimmune pathology. CONCLUSIONS: A middle-aged female with multiple sclerosis who was on chronic IFN-beta presented to the emergency room with a witnessed tonic-clonic seizure, with MRI T2 FLAIR imaging consistent with PRES. She had notable clinical improvement with decreased edema on imaging and improved inflammatory markers 72 h after cessation of IFN-beta therapy.


Assuntos
Síndrome da Leucoencefalopatia Posterior , Edema , Feminino , Humanos , Inflamação , Interferon beta/uso terapêutico , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Síndrome da Leucoencefalopatia Posterior/diagnóstico por imagem , Síndrome da Leucoencefalopatia Posterior/tratamento farmacológico
5.
Ann Palliat Med ; 10(10): 10930-10937, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34763455

RESUMO

BACKGROUND: To analyze the correlation between thrombospondin-2 (TSP2), matrix metalloproteinase (MMP)-9, and perihematomal edema, as well as the short-term prognosis of patients with hypertensive intracerebral hemorrhage. METHODS: The clinical data of 114 patients with hypertensive intracerebral hemorrhage admitted to our hospital from January 2018 to February 2020 were collected and divided into groups according to the levels of TSP2 and MMP-9. We compared edema indexes in patients with different levels of TSP2 and MMP-9, and analyzed the correlation between TSP2, MMP-9 and relative edema volume index (REI), edema change index (AEI). We also assessed the TSP2 and MMP-9 levels in patients with different prognoses, and analyzed the predictive value of TSP2 and MMP-9 for poor prognosis of patients. RESULTS: (I) There was no difference in the REI and AEI values between the low and high TSP2 groups at admission and 24 h after admission (P>0.05), while the REI and AEI values of the high TSP2 group at 5 and 15 d after admission were significantly lower than those of the low TSP2 group (P<0.05); (II) the REI and AEI values of patients with different MMP-9 levels were not different between admission and 24 h after admission (P>0.05), while the REI and AEI values of the high MMP-9 group were significantly higher than those of the low MMP-9 group at 5 and 15 d after admission (P<0.05); (III) Pearson correlation analysis showed that MMP-9 was positively correlated with REI and AEI, while TSP2 was negatively correlated (P<0.05); (IV) among 114 patients, 39 had poor prognosis, 75 had good prognosis The MMP-9 levels of patients with a poor prognosis were significantly higher than those of patients with a good prognosis, and the TSP2 level was the opposite (P<0.05); (V) receiver operating characteristic (ROC) curve showed that the sensitivity, specificity and the area under the curve (AUC) of the TSP2 + MMP-9 combination in the diagnosis of hypertensive cerebral hemorrhage were significantly higher than when TSP2 and MMP-9 were tested separately (P<0.05). CONCLUSIONS: In patients with hypertensive intracerebral hemorrhage, TSP2 is negatively correlated with edema around the hematoma, while MMP-9 is positively correlated.


Assuntos
Edema Encefálico , Hemorragia Intracraniana Hipertensiva , Edema Encefálico/etiologia , Hemorragia Cerebral , Edema , Humanos , Metaloproteinase 9 da Matriz , Prognóstico , Trombospondinas
6.
BMC Musculoskelet Disord ; 22(1): 919, 2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-34724925

RESUMO

BACKGROUND: Bone marrow edema of the sacroiliac joint is the early imaging manifestation, an indicator of inflammatory activity of ankylosing spondylitis (AS) (Yang R, et. al. Medicine (Baltimore) 98:e14620, 2019). OBJECTIVE: The aim of the study was to investigate the value of magnetic resonance imaging (MRI) Dixon sequence in the diagnosis of marrow edema of the sacroiliac joint in patients with AS. METHODS: Forty-five patients with AS admitted in our hospital between November 2016 and February 2019 were selected retrospectively as the case group. Forty-five healthy subjects recruited between November 2016 and February 2019 served as the control group. Bath ankylosing spondylitis disease activity index (BASDAI), Bath ankylosing spondylitis functional index (BASFI), C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were recorded after admission to the hospital. The Dixon sequence water-fat ratio of the iliac and sacral surfaces of the bilateral sacroiliac joints in the study group were compared with indicators above in order to find the correlation. RESULTS: The water-fat ratio under the bilateral sacroiliac joints on Dixon sequence images in the case group was significantly higher than that in the healthy control group (P<0.05). The Dixon sequence water-fat ratio of the iliac and sacral surfaces of the bilateral sacroiliac joints in the study group were positively correlated with spinal arthritis research (SPARCC), BASFI and BASDAI score (all P < 0.05), but did not correlate with ESR and CRP. CONCLUSION: The water-fat ratio of magnetic resonance Dixon sequence can be used as a reference index to evaluate the degree of bone marrow edema in active stage of sacroiliac arthritis.


Assuntos
Espondilartrite , Espondilite Anquilosante , Medula Óssea/diagnóstico por imagem , Edema/diagnóstico por imagem , Edema/etiologia , Humanos , Imageamento por Ressonância Magnética , Estudos Retrospectivos , Articulação Sacroilíaca/diagnóstico por imagem , Índice de Gravidade de Doença , Espondilite Anquilosante/complicações , Espondilite Anquilosante/diagnóstico por imagem
7.
J Craniofac Surg ; 32(8): 2611-2614, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34727465

RESUMO

ABSTRACT: The authors' aim was to evaluate the effect of perioperative systemic dexamethasone (DXM) administration on postoperative pain, edema, and trismus in mandibular fracture patients. The authors conducted a prospective randomized study of 45 patients with one or 2 noncomminuted fractures of the dentate part of the mandible. All patients underwent surgery for intraoral miniplate fixation. Patients in the study group were given a total of 30 mg DXM, while patients in the control group received neither DXM nor placebo. Only paracetamol and opioids were served as analgesics. Pain severity was assessed using the visual analog scale. The effect in facial swelling was measured in centimeters and analyzed as percentage change. Trismus was evaluated as the difference in maximal mouth opening by measuring interincisal distance in millimeters. The Mann-Whitney U test was applied to determine the statistical significance of differences between the groups. Thirty-four patients were included in the statistical analysis. The visual analog scale score was significantly lower in the study group than in the control group at 18 hours postoperatively (P = 0.033). Significant differences in edema or trismus were not found postoperatively between the DXM and control groups. In conclusion, perioperative DXM decreases postoperative pain in mandibular fracture patients when nonsteroidal anti-inflammatory drugs are not used, but it does not seem to be effective in reducing edema or trismus.


Assuntos
Fraturas Mandibulares , Dente Impactado , Anti-Inflamatórios/uso terapêutico , Dexametasona/uso terapêutico , Edema/etiologia , Edema/prevenção & controle , Humanos , Fraturas Mandibulares/cirurgia , Dente Serotino , Dor Pós-Operatória/tratamento farmacológico , Dor Pós-Operatória/prevenção & controle , Estudos Prospectivos , Extração Dentária , Trismo/etiologia , Trismo/prevenção & controle
8.
BMC Nephrol ; 22(1): 376, 2021 11 11.
Artigo em Inglês | MEDLINE | ID: mdl-34763669

RESUMO

BACKGROUND: There have been cases of minimal change disease (MCD) reported following previous vaccines. During the COVID-19 era, only 3 cases of new-onset MCD and a case of MCD relapse were reported following the Pfizer-BioNTech COVID-19 vaccine. We herein report the first case of MCD after receiving the Moderna COVID-19 vaccine. CASE PRESENTATION: A 43-year-old man presented to hospital 3 weeks after receiving the first dose of the Moderna vaccine, with both bilateral lower extremities and scrotal edema. He initially developed a sudden-onset bilateral lower extremities swelling on day 7 post-vaccine. He, then, developed dyspnea and scrotal swelling over a time span of 2 weeks. On physical examination, his blood pressure was 150/92 mmHg. There was a decreased air entry at lung bases, bilateral lower extremities and scrotal edema. Labs revealed hypoalbuminemia, hyperlipidemia and 15 g of proteinuria. His immunologic and serologic work up was negative. Renal biopsy showed concomitant MCD and IgA nephropathy. Patient was treated with oral steroids and had a good response; his edema resolved, serum albumin improved, and proteinuria decreased to 1 g within 2 weeks of treatment. CONCLUSIONS: To the best of our knowledge, MCD has not been previously reported after receiving the Moderna COVID-19 vaccine. It remains unclear whether the COVID-19 mRNA vaccines are associated with the development of MCD, or it coincided with the mass vaccination. Further studies are needed to determine the incidence of MCD post COVID-19 vaccines and the underlying pathophysiology of glomerular injury post vaccination.


Assuntos
Vacinas contra COVID-19/efeitos adversos , COVID-19/prevenção & controle , Edema/etiologia , Extremidade Inferior , Nefrose Lipoide/induzido quimicamente , Escroto , Adulto , Dispneia/etiologia , Glomerulonefrite por IGA/induzido quimicamente , Glomerulonefrite por IGA/complicações , Glomerulonefrite por IGA/patologia , Humanos , Hipoalbuminemia/etiologia , Masculino , Nefrose Lipoide/complicações , Nefrose Lipoide/patologia , SARS-CoV-2
9.
J Appl Oral Sci ; 29: e20210383, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34787280

RESUMO

OBJECTIVE: The effects of the number of photobiomodulation (PBM) sessions on the postoperative inflammatory process remain controversial. The current literature comparing single and repeated PBM sessions is limited. This study aimed to compare the effects of single and repeated PBM sessions, applied at two different therapeutic wavelengths within the infrared spectrum, on postoperative inflammatory response after impacted third molar tooth extraction. METHODOLOGY: This randomized, double-blind clinical study included 40 patients with bilateral impacted mandibular third molars (80 teeth). The patients were divided into two groups each including 20 subjects (40 teeth) to receive either single-session laser at 810 nm (20 teeth) and 940 nm (20 teeth) immediately after the surgery or repeated laser sessions at 810 nm (20 teeth) and 940 nm (20 teeth) (immediately after the surgery and on postoperative Day 1). Lasers at 940 nm (power density 0.5 Watt/cm2, energy density 4 J/cm2 for a time until the cumulative energy on the device screen reaches 50 J from 0 J, in continuous mode, spot size 2.8 cm2) and at 810 nm (power density 0.14 Watt/cm2, energy density 4 J/cm2, for 30 seconds, in continuous mode, spot size 2.1 cm2) were applied intra- and extra-orally. Pain, swelling, and trismus were evaluated postoperatively. RESULTS: No significant differences were determined between the groups on the evaluated parameters (p>0.05). CONCLUSION: Within the study limitations, in PBM, the effects of 810 nm and 940 nm and those of single and repeated applications were similar regarding pain, swelling and trismus. Immediate postoperative PBM could be preferred to repeated applications performed by point application within a 24-hour period.


Assuntos
Terapia com Luz de Baixa Intensidade , Dente Impactado , Método Duplo-Cego , Edema/etiologia , Edema/prevenção & controle , Humanos , Dente Serotino/cirurgia , Dor Pós-Operatória/prevenção & controle , Extração Dentária/efeitos adversos , Dente Impactado/cirurgia , Trismo/etiologia , Trismo/prevenção & controle
10.
Schweiz Arch Tierheilkd ; 164(11): 767-777, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34758952

RESUMO

INTRODUCTION: The aim of this study was to record the course of peripartal udder oedema with ultrasonography in dairy cows and to investigate the therapeutic effects of diuretic furosemide. For this purpose, a device with a force sensor for the ultrasound probe was developed, which ensured the generation of data under similar pressure conditions and thereby repeatable and comparable results. In a pretrial with ten cows, ultrasonographic measurements were performed daily at four locations per udder quarter beginning 14 days ante partum until 14 d post partum. The main study included 50 dairy cows. The experimental group (n=25) received 500 mg furosemide intramuscularly on the day of calving, as well as on the first and second day post partum. The control group (n=25) was treated with 10 mL 0,9 % sodium chloride solution (NaCl) at the same timepoints. The experimental period was extended from 21 days ante partum until 21 days post partum and included 15 ultrasonographic measurements at three-day intervals. The measurements were performed at the teat base, which turned out to be the most suitable location in the pretrial. Quarter milk samples were collected on the day of calving, 7 and 14 days post partum. The average thickness of the udder oedema between the group treated with furosemide and the control group did not differ. In conclusion, a method for the ultrasonographic measurement of udder oedema under comparable applied forces was established. The teat base turned out to be a suitable location to monitor the characteristic temporal course of udder oedema. In the present study, treatment with furosemide did not have a measurable, positive effect on the severity of the udder oedema post partum in the study animals. Finally, further studies with a higher sample size are necessary to confirm this relationship.


Assuntos
Furosemida , Glândulas Mamárias Animais , Animais , Bovinos , Diuréticos , Edema/diagnóstico por imagem , Edema/tratamento farmacológico , Edema/veterinária , Feminino , Lactação , Glândulas Mamárias Animais/diagnóstico por imagem , Leite , Ultrassonografia/veterinária
11.
Food Res Int ; 149: 110703, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34600695

RESUMO

Chia (Salvia hispanica L.) is an herbaceous plant used as omega-3 polyunsaturated fatty acid (ω-3 PUFA) source that presents a range of beneficial effects on human health. Herein, it was used a chia oil containing over than 62% of α-linolenic acid (ALA), a compound widely related to anti-inflammatory actions. Chia oil effect was tested using paw edema and mechanical hyperalgesia induced by carrageenan, and ear edema induced by croton oil, histamine, and capsaicin. Croton oil was used in both preventive and therapeutic treatment schedules of chia oil while histamine and capsaicin were used only in preventive treatment schedule. Chia oil mechanism of action was investigated using nociception and paw edema response induced by intraplantar injection of acidified saline (ASIC activator), PGE2 (prostaglandin pathway), cinnamaldehyde (TRPA1 activator), bradykinin (BK pathway), menthol (TRPM8 activator), and capsaicin (TRPV1 activator). Further, RT-PCR for inflammatory mediators (TRPA1, NF-κB, PPAR-γ, COX-2, IL-6, TNF, FPR2, FAAH, MAGL, and IL-12A) induced by carrageenan, NLRP3 inflammasome activation, and the cell viability were then accessed. Later, chia oil actions were evaluated in the experimental autoimmune encephalomyelitis (EAE), a multiple sclerosis (MS) model. Chia oil showed anti-edematogenic and anti-hyperalgesic effects when administered 1 h before pro-inflammatory stimulus - particularly carrageenan and croton oil. Moreover, chia oil upregulated the mRNA levels of COX-2 and formyl peptide receptor 2 (FPR2) while reduced IL-6 expression in the spinal cord of mice submitted to i.pl. injection of carrageenan. Interestingly, chia oil mediates antinociceptive effects in mice decreasing the nociceptive response induced by acidified saline, PGE2, and cinnamaldehyde, but not by bradykinin, menthol, and capsaicin. On the EAE model, chia oil preventively administered attenuated EAE-induced motor deficits and mechanical hyperalgesia in mice, suggesting a valuable effect of chia oil supplementation in regulating inflammatory responses and some immune functions during immune-mediated inflammatory disorders (IMID). Nonetheless, additional reports will need to assess the effect of chia oil in well-controlled clinical trials performed in MS patients.


Assuntos
Anti-Inflamatórios , Extratos Vegetais , Animais , Anti-Inflamatórios/farmacologia , Anti-Inflamatórios/uso terapêutico , Carragenina , Edema/induzido quimicamente , Edema/tratamento farmacológico , Edema/prevenção & controle , Humanos , Mediadores da Inflamação , Camundongos , Extratos Vegetais/uso terapêutico
12.
Arthritis Res Ther ; 23(1): 261, 2021 10 15.
Artigo em Inglês | MEDLINE | ID: mdl-34654466

RESUMO

OBJECTIVES: Remitting seronegative symmetrical synovitis with pitting edema (RS3PE) is a rare inflammatory arthritis, with a higher incidence of malignancy. The aim of this study is to identify biomarkers for predicting malignancy in RS3PE. METHODS: A total of 51 patients with RS3PE from September 2007 to May 2019 were retrospectively reviewed and followed for up to 5 years, with 15 patients with osteoarthritis (OA) and 14 patients with elderly-onset rheumatoid arthritis (EORA) as disease controls. Serum levels of angiogenesis cytokines were measured by electrochemiluminescent immunoassay and Luminex Human Magnetic Assay. Clinical data and laboratory parameters were analyzed to identify risk factors for malignancy. RESULTS: A total of forty-eight RS3PE patients (94.1%) were available with follow-up data; 8 patients (16.7%) were diagnosed with malignancy, of which 6 patients were hematological tumor; and 2 patients were solid tumors. Serum levels of basic fibroblast growth factor (bFGF) were exclusively higher in RS3PE patients with malignancy [14.21 (7.52, 23.18) ng/mL] than RS3PE patients without malignancy [4.32 (2.88, 7.42) ng/mL], OA [3.20 (2.20, 5.30) ng/mL], and EORA [3.20 (2.20, 5.30) ng/mL]. The optimal cut-off value of bFGF for malignancy was 10ng/mL in RS3PE. Logistic regression analysis indicated that elevation of bFGF was a risk factor for malignancy in RS3PE. CONCLUSIONS: This study indicated that bFGF was elevated in RS3PE patients with malignancy and could serve as a biomarker for predicting paraneoplastic RS3PE.


Assuntos
Artrite Reumatoide , Neoplasias , Sinovite , Idoso , Artrite Reumatoide/diagnóstico , Biomarcadores , Estudos de Coortes , Edema , Fator 2 de Crescimento de Fibroblastos , Humanos , Estudos Retrospectivos , Sinovite/diagnóstico
13.
Artif Intell Med ; 120: 102162, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34629154

RESUMO

Reinke's edema is one of the most prevalent laryngeal pathologies. Its detection can be addressed by using computer-aided diagnosis systems based on features extracted from speech recordings. When extracting acoustic features from different voice recordings of a particular subject at a concrete moment, imperfections in technology and the very biological variability result in values that are close, but they are not identical. This suggests that the within-subject variability must be properly addressed in the statistical methodology. Regularization-based regression approaches can be used to reduce the classification errors by favoring the best predictors and penalizing the worst ones. Three replication-based regularization approaches for variable selection and classification have been specifically designed and implemented to take into account the underlying within-subject variability. In order to illustrate the applicability of these approaches, an experiment has been specifically conducted to discriminate Reinke's edema patients (30 subjects) from healthy people (30 subjects) in a hospital environment. The features have been extracted from four phonations of the sustained vowel /a/ recorded for each subject, leading to a database that has fed the proposed machine learning approaches. The proposed replication-based approaches have been proved to be reliable in terms of selected features and predictive ability, leading to a stable accuracy rate of 0.89 under a cross-validation framework. Also, a comparison with traditional independence-based regularization methods reports a great variability of the latter in terms of selected features and accuracy metrics. Therefore, the proposed approaches contribute to fill a gap in the scientific literature on statistical approaches considering within-subject variability and can be used to build a robust expert system.


Assuntos
Edema Laríngeo , Laringe , Edema , Humanos , Fonação , Prega Vocal
14.
BMJ Case Rep ; 14(10)2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34598963

RESUMO

This case describes the first documented clinical presentation of Sweet's syndrome with unilateral swelling of the neck, severe pain and fever. The clinical and radiological manifestation resembled necrotising fasciitis and the patient underwent acute neck dissection. The patient was ultimately diagnosed with a new subtype of Sweet's syndrome called necrotising Sweet's syndrome, and quickly recovered after treatment with intravenous administration of prednisolone.


Assuntos
Síndrome de Sweet , Dor no Peito , Edema/etiologia , Feminino , Febre/etiologia , Humanos , Pessoa de Meia-Idade , Pescoço/diagnóstico por imagem , Síndrome de Sweet/diagnóstico , Síndrome de Sweet/tratamento farmacológico
16.
J Biomed Opt ; 26(10)2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34689443

RESUMO

SIGNIFICANCE: Peripheral pitting edema is a clinician-administered measure for grading edema. Peripheral edema is graded 0, 1 + , 2 + , 3 + , or 4 + , but subjectivity is a major limitation of this technique. A pilot clinical study for short-wave infrared (SWIR) molecular chemical imaging (MCI) effectiveness as an objective, non-contact quantitative peripheral edema measure is underway. AIM: We explore if SWIR MCI can differentiate populations with and without peripheral edema. Further, we evaluate the technology for correctly stratifying subjects with peripheral edema. APPROACH: SWIR MCI of shins from healthy subjects and heart failure (HF) patients was performed. Partial least squares discriminant analysis (PLS-DA) was used to discriminate the two populations. PLS regression (PLSR) was applied to assess the ability of MCI to grade edema. RESULTS: Average spectra from edema exhibited higher water absorption than non-edema spectra. SWIR MCI differentiated healthy volunteers from a population representing all pitting edema grades with 97.1% accuracy (N = 103 shins). Additionally, SWIR MCI correctly classified shin pitting edema levels in patients with 81.6% accuracy. CONCLUSIONS: Our study successfully achieved the two primary endpoints. Application of SWIR MCI to monitor patients while actively receiving HF treatment is necessary to validate SWIR MCI as an HF monitoring technology.


Assuntos
Insuficiência Cardíaca , Imagem Molecular , Análise Discriminante , Edema/diagnóstico por imagem , Insuficiência Cardíaca/diagnóstico por imagem , Humanos , Análise dos Mínimos Quadrados
17.
Trials ; 22(1): 758, 2021 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-34717741

RESUMO

BACKGROUND: Lipedema is a chronic disorder of the adipose tissue that affects mainly women, characterised by symmetrical, excessive fatty tissue on the legs and pain. Standard conservative treatment is long-term comprehensive decongestive therapy (CDT) to alleviate lipedema-related pain and to improve psychosocial well-being, mobility and physical activity. Patients may benefit from surgical removal of abnormally propagated adipose tissue by liposuction. The LIPLEG trial evaluates the efficacy and safety of liposuction compared to standard CDT. METHODS/DESIGN: LIPLEG is a randomised controlled multicentre investigator-blinded trial. Women with lipedema (n=405) without previous liposuction will be allocated 2:1 to liposuction or CDT. The primary outcome of the trial is leg pain reduction by ≥2 points on a visual analogue scale ranging 0-10 at 12 months on CDT or post-completion of liposuction. Secondary outcomes include changes in leg pain severity, health-related quality of life, depression tendency, haematoma tendency, prevalence of oedema, modification physical therapy scope, body fat percentage, leg circumference and movement restriction. The primary analysis bases on intention-to-treat. Success proportions are compared using the Mantel-Haenszel test stratified by lipedema stage at a 5% two-sided significance level. If this test is statistically significant, the equality of the response proportions in the separate strata is evaluated by Fisher's exact test in a hierarchical test strategy. DISCUSSION: LIPLEG assesses whether surgical treatment of lipedema is safe and effective to reduce pain and other lipedema-related health issues. The findings of this trial have the potential to change the standard of care in lipedema. TRIAL REGISTRATION: ClinicalTrials.gov NCT04272827. Registered on February 14, 2020. TRIAL STATUS: Protocol version is 02_0, December 17, 2019.


Assuntos
Lipectomia , Lipedema , Edema , Exercício Físico , Feminino , Humanos , Lipectomia/efeitos adversos , Lipedema/diagnóstico , Lipedema/terapia , Qualidade de Vida , Resultado do Tratamento
18.
Int J Mol Sci ; 22(19)2021 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-34638973

RESUMO

The search for promising biomolecules such as chitooligosaccharides (COS) has increased due to the need for healing products that act efficiently, avoiding complications resulting from exacerbated inflammation. Therefore, this study aimed to produce COS in two stages of hydrolysis using chitosanases derived from Bacillus toyonensis. Additionally, this study aimed to structurally characterize the COS via mass spectrometry, to analyze their biocompatibility in acute toxicity models in vivo, to evaluate their healing action in a cell migration model in vitro, to analyze the anti-inflammatory activity in in vivo models of xylol-induced ear edema and zymosan-induced air pouch, and to assess the wound repair action in vivo. The structural characterization process pointed out the presence of hexamers. The in vitro and in vivo biocompatibility of COS was reaffirmed. The COS stimulated the fibroblast migration. In the in vivo inflammatory assays, COS showed an antiedematogenic response and significant reductions in leukocyte migration, cytokine release, and protein exudate. The COS healing effect in vivo was confirmed by the significant wound reduction after seven days of the experiment. These results indicated that the presence of hexamers influences the COS biological properties, which have potential uses in the pharmaceutical field due to their healing and anti-inflammatory action.


Assuntos
Anti-Inflamatórios/administração & dosagem , Materiais Biocompatíveis/administração & dosagem , Quitosana/administração & dosagem , Otopatias/tratamento farmacológico , Edema/tratamento farmacológico , Oligossacarídeos/administração & dosagem , Cicatrização/efeitos dos fármacos , Células 3T3 , Animais , Anti-Inflamatórios/química , Bacillus/enzimologia , Materiais Biocompatíveis/química , Movimento Celular/efeitos dos fármacos , Sobrevivência Celular/efeitos dos fármacos , Quitosana/química , Citocinas/metabolismo , Modelos Animais de Doenças , Otopatias/induzido quimicamente , Edema/induzido quimicamente , Feminino , Fibroblastos/efeitos dos fármacos , Fibroblastos/metabolismo , Glicosídeo Hidrolases/química , Hidrólise , Inflamação/tratamento farmacológico , Inflamação/metabolismo , Leucócitos/efeitos dos fármacos , Leucócitos/metabolismo , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Oligossacarídeos/química
19.
Med Klin Intensivmed Notfmed ; 116(8): 665-671, 2021 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-34605939

RESUMO

In the second phase of shock therapy, we regularly find fluid overload with edema in our patients, which not only involves the skin and interstitial tissue but can also impair kidney, liver and pulmonary function. Revision of the Starling principle and new insights into physiology of the endothelial glycocalyx have important implications for fluid therapy in intensive care medicine. Determination of fluid overload and an appropriate therapy with either diuretics or ultrafiltration are the focus of "late goal-directed fluid removal" management.


Assuntos
Cuidados Críticos , Hidratação , Diuréticos , Edema , Glicocálix , Humanos
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