Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 326
Filtrar
1.
J Periodontal Res ; 59(3): 480-490, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38356138

RESUMO

BACKGROUND AND OBJECTIVE: Periodontitis is an inflammatory disease that destroys periodontal tissues. Interleukin-20 (IL-20), on the other hand, is known as a potent angiogenic, chemotactic, and pro-inflammatory cytokine associated with various chronic inflammatory disorders. IL-20 has a significant role in the regulation of osteoclastogenesis and osteoblastogenesis. This study aimed to evaluate the effect of IL-20 on periodontal destruction. METHODS: In this study, a total of 60 participants were included, 30 of whom were systemically and periodontally healthy (control group), and 30 were systemically healthy but had periodontitis (periodontitis group). Gingival crevicular fluid (GCF) and serum samples were collected from the participants for biochemical analysis. Enzyme-linked immunosorbent assay was used to determine the levels of IL-20, tumor necrosis factor (TNF)-α, IL1ß/IL-10, RANKL/osteoprotegerin (OPG), and matrix metalloproteinase-8 (MMP8). For statistical analysis, the independent t-test, Pearson correlation coefficients, and the Chi-square test were used. RESULTS: GCF IL-20, RANKL, RANKL/OPG, serum IL-20, RANKL, RANKL/OPG, MMP-8, TNF-α, IL-1B, and IL-1ß/IL-10 values were found to be statistically significantly higher in the periodontitis group than in the control group. GCF OPG and serum IL-10 values were found to be statistically significantly higher in the control group than in the periodontitis group. No statistically significant difference was observed between the groups in serum OPG values. A statistically significantly positive correlation was observed between serum IL-20 value and serum RANKL, RANKL/OPG, MMP-8, TNF-α, IL-1ß values, and periodontal clinical parameters. The ROC curves showed: AUC = 0.788 for GCF IL-20, and AUC = 1.000 for serum IL-20. CONCLUSION: According to the results of the study, IL-20 was found to be associated with periodontitis. The role of IL-20 in periodontal pathogenesis is related to osteoclastogenesis and collagen degradation. It is conceivable that IL-20 may increase bone destruction by both affecting the RANKL/OPG ratio and proinflammatory cytokines.


Assuntos
Líquido do Sulco Gengival , Interleucina-1beta , Interleucinas , Metaloproteinase 8 da Matriz , Osteoprotegerina , Periodontite , Ligante RANK , Fator de Necrose Tumoral alfa , Humanos , Interleucinas/sangue , Líquido do Sulco Gengival/química , Masculino , Feminino , Ligante RANK/análise , Ligante RANK/sangue , Adulto , Metaloproteinase 8 da Matriz/sangue , Metaloproteinase 8 da Matriz/análise , Osteoprotegerina/sangue , Osteoprotegerina/análise , Periodontite/metabolismo , Periodontite/sangue , Fator de Necrose Tumoral alfa/sangue , Fator de Necrose Tumoral alfa/análise , Interleucina-1beta/sangue , Interleucina-1beta/análise , Pessoa de Meia-Idade , Interleucina-10/sangue , Interleucina-10/análise , Estudos de Casos e Controles , Ensaio de Imunoadsorção Enzimática
2.
Brain Behav Immun ; 108: 279-291, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36549577

RESUMO

Age-related cognitive decline, a common component of the brain aging process, is associated with significant impairment in daily functioning and quality of life among geriatric adults. While the complexity of mechanisms underlying cognitive aging are still being elucidated, microbial exposure and the multifactorial inflammatory cascades associated with systemic infections are emerging as potential drivers of neurological senescence. The negative cognitive and neurobiological consequences of a single pathogen-associated inflammatory experience, such as that modeled through treatment with lipopolysaccharide (LPS), are well documented. Yet, the brain aging impacts of repeated, intermittent inflammatory challenges are less well studied. To extend the emerging literature assessing the impact of infection burden on cognitive function among normally aging mice, here, we repeatedly exposed adult mice to intermittent LPS challenges during the aging period. Male 10-month-old C57BL6 mice were systemically administered escalating doses of LPS once every two weeks for 2.5 months. We evaluated cognitive consequences using the non-spatial step-through inhibitory avoidance task, and both spatial working and reference memory versions of the Morris water maze. We also probed several potential mechanisms, including cortical and hippocampal cytokine/chemokine gene expression, as well as hippocampal neuronal function via extracellular field potential recordings. Though there was limited evidence for an ongoing inflammatory state in cortex and hippocampus, we observed impaired learning and memory and a disruption of hippocampal long-term potentiation. These data suggest that a history of intermittent exposure to LPS-induced inflammation is associated with subtle but significantly impaired cognition among normally aging mice. The broader impact of these findings may have important implications for standard of care involving infections in aging individuals or populations at-risk for dementia.


Assuntos
Lipopolissacarídeos , Potenciação de Longa Duração , Camundongos , Animais , Masculino , Lipopolissacarídeos/farmacologia , Lipopolissacarídeos/metabolismo , Qualidade de Vida , Camundongos Endogâmicos C57BL , Cognição/fisiologia , Envelhecimento/metabolismo , Inflamação/complicações , Hipocampo/metabolismo , Aprendizagem em Labirinto
3.
Molecules ; 27(19)2022 Sep 22.
Artigo em Inglês | MEDLINE | ID: mdl-36234762

RESUMO

The prevalence of cardiovascular disease, oxidative stress-related complications, and chronic age-related illnesses is gradually increasing worldwide. Several causes include the ineffectiveness of medicinal treatment therapies, their toxicity, their inability to provide radical solutions in some diseases, and the necessity of multiple drug therapy in certain chronic diseases. It is therefore necessary for alternative treatment methods to be sought. In this review, polyphenols were identified and classified according to their chemical structure, and the sources of these polyphenol molecules are indicated. The cardioprotective, ROS scavenging, anti-aging, anticancer properties of polyphenolic compounds have been demonstrated by the results of many studies, and these natural antioxidant molecules are potential alternative therapeutic agents.


Assuntos
Antioxidantes , Polifenóis , Antioxidantes/química , Suplementos Nutricionais , Estresse Oxidativo , Polifenóis/química , Espécies Reativas de Oxigênio/farmacologia
4.
Niger J Clin Pract ; 25(9): 1418-1423, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36149199

RESUMO

Background: In coronavirus disease 2019 (COVID-19) caused by SARSCoV2 viruses, coagulation abnormalities are strongly correlated between disease severity and mortality risk. Aims: The aim was to search for new indices to determine mortality risk. Fibrinogen times D-dimer to albumin times platelet ratio calculated with the formula (FDAPR index: ((Fibrinogen × D-dimer)/(Albumin × Platelet)) investigated as a mortality marker in COVID-19 patients. The hospitalization data of 1124 patients were analyzed from the electronic archive system. Hemogram, coagulation, and inflammatory markers were investigated in the study group. Materials and Methods: All statistical analyses like the student t-test, Mann-Whitney U, Kaplan-Meier, and Cox hazard ratio, were performed with the SPSS 22.0 program. Results: Prothrombin time was prolonged significantly in patients (P < 0.05) compared to healthy subjects (n = 30). D-dimer and fibrinogen were high, and albumin and platelet counts were low in COVID-19 patients (all, P < 0.001). When the data of 224 non-survivors and 900 survived patients were compared, D-dimer and fibrinogen were higher, and albumin and platelet lower (all, P < 0.001) compared to mild and severe patients. At the cut-off value of 0.49, the FDAPR index was performed with 89.1% sensitivity and 88.6% specificity. FDAPR index had the highest mortality predictive power (P < 0.01; HR = 5.366; 95% CI; 1.729-16.654). Conclusions: This study revealed that the FDAPR index could be used as a mortality marker of COVID-19 disease.


Assuntos
COVID-19 , Albuminas , Biomarcadores/sangue , COVID-19/sangue , COVID-19/mortalidade , Produtos de Degradação da Fibrina e do Fibrinogênio , Fibrinogênio , Humanos , Estudos Retrospectivos , SARS-CoV-2
5.
Immunol Invest ; 50(5): 478-491, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32611246

RESUMO

CD55 and CD59 are complement regulatory proteins suggested to be related with progression of diabetes and its complications. The stromal cell-derived factor 1 (SDF-1) and C-X-C chemokine receptor type 4 (CXCR-4) are chemokine proteins. We aimed to investigate the relation of CD55 and CD59 expression levels and polymorphisms of SDF-1 and CXCR-4 with type 2 diabetes mellitus (T2DM) and its complications. Seventy-five T2DM patients and 73 controls were enrolled. Expression levels of CD55 and CD59 were measured by FACS Calibur; qRT-PCR was used to determine SDF-1 and CXCR-4 gene polymorphisms. CD55 and CD59 expressions in patients with nephropathy, retinopathy and cardiovascular disease were significantly lower than controls. Frequency of CXCR-4 T allele carrying was high in patients and created 1.6 fold risk for the disease (p = .07). CXCR-4 a allele carriers had decreased nephropathy; although there was no statistical significance in carrying CXCR-4 T allele, presence of nephropathy was approximately 2 times higher (p = .254). The nephropathy risk increased 10-fold in CXCR-4 TT genotype carriers (p = .02). All SDF-1 CC genotype carriers had retinopathy, so, it was considered that the CC genotype was effective in retinopathy development (p = .031). For the presence of cardiovascular disease, significant difference was observed for SDF-1 genotypes. Increased cardiovascular risk of 5- and 1.9-fold in SDF-1 T (p = .007) and CXCR-4 T (p = .216) allele carriers, respectively, was observed. We suggest that CD55 and CD59 protein levels and SDF-1 and CXCR-4 have predictive importance in process, complications and tendency of T2DM.


Assuntos
Antígenos CD55/metabolismo , Antígenos CD59/metabolismo , Doenças Cardiovasculares/genética , Quimiocina CXCL12/genética , Diabetes Mellitus Tipo 2/imunologia , Genótipo , Receptores CXCR4/genética , Idoso , Antígenos CD55/genética , Antígenos CD59/genética , Feminino , Frequência do Gene , Predisposição Genética para Doença , Humanos , Masculino , Pessoa de Meia-Idade , Polimorfismo Genético
6.
J Eur Acad Dermatol Venereol ; 35(11): 2143-2148, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34289187

RESUMO

In chronic skin diseases such as atopic dermatitis (AD), therapeutic failure due to poor patient adherence to treatment is commonly reported. Therapeutic patient education (TPE) is an approach to improve self-management and adherence. Several studies demonstrated that TPE programmes have positive effects on disease management resulting in decreased disease severity and improved quality of life in AD patients. Various healthcare professionals (dermatologists, nurses, psychologists, dieticians) have been involved. TPE performed by trained dermatology nurses are highly efficient and improve various health-related outcomes. The aim of this position paper is to analyse the aims, modalities and efficacy of TPE in AD, to identify specific roles of dermatology nurses, to assess qualification requirements, and to propose practical recommendations. Potential activities of nurses in ongoing and future TPE programmes for AD patients will be discussed.


Assuntos
Dermatite Atópica , Eczema , Enfermeiras e Enfermeiros , Dermatite Atópica/terapia , Humanos , Educação de Pacientes como Assunto , Qualidade de Vida
7.
J Chem Phys ; 153(12): 124114, 2020 Sep 28.
Artigo em Inglês | MEDLINE | ID: mdl-33003704

RESUMO

Quantum Monte Carlo (QMC) belongs to the most accurate simulation techniques for quantum many-particle systems. However, for fermions, these simulations are hampered by the sign problem that prohibits simulations in the regime of strong degeneracy. The situation changed with the development of configuration path integral Monte Carlo (CPIMC) by Schoof et al. [Contrib. Plasma Phys. 51, 687 (2011)] that allowed for the first ab initio simulations for dense quantum plasmas [Schoof et al., Phys. Rev. Lett. 115, 130402 (2015)]. CPIMC also has a sign problem that occurs when the density is lowered, i.e., in a parameter range that is complementary to traditional QMC formulated in coordinate space. Thus, CPIMC simulations for the warm dense electron gas are limited to small values of the Brueckner parameter-the ratio of the interparticle distance to the Bohr radius-rs=r¯/aB≲1. In order to reach the regime of stronger coupling (lower density) with CPIMC, here we investigate additional restrictions on the Monte Carlo procedure. In particular, we introduce two different versions of "restricted CPIMC"-called RCPIMC and RCPIMC+-where certain sign changing Monte Carlo updates are being omitted. Interestingly, one of the methods (RCPIMC) has no sign problem at all, but it introduces a systematic error and is less accurate than RCPIMC+, which neglects only a smaller class of the Monte Carlo steps. Here, we report extensive simulations for the ferromagnetic uniform electron gas with which we investigate the properties and accuracy of RCPIMC and RCPIMC+. Furthermore, we establish the parameter range in the density-temperature plane where these simulations are both feasible and accurate. The conclusion is that RCPIMC and RCPIMC+ work best at temperatures in the range of Θ = kBT/EF ∼ 0.1…0.5, where EF is the Fermi energy, allowing to reach density parameters up to rs ∼ 3…5, thereby partially filling a gap left open by existing ab initio QMC methods.

8.
Med Vet Entomol ; 34(4): 402-410, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32426867

RESUMO

Toscana virus (TOSV) is a prominent arthropod-borne viral agent of human central nervous system infections occurring in the Mediterranean region. The main transmission route to susceptible individuals involves sandflies as vectors. Despite several reports revealing widespread TOSV activity in Turkey, vectors remained unidentified. A sandfly field survey was carried out in five provinces in Central, Southeast and Mediterranean Anatolia in 2017 to identify TOSV and related sandfly-borne phleboviruses and Leishmania parasites, with evidence for circulation in the region. A total of 7136 sandfly specimens, collected via standard methods, were evaluated in 163 pools. TOSV was detected in 11 pools (6.7%), comprising Phlebotomus major sensu lato, Sergentomyia dentata and Phlebotomus papatasi species. TOSV partial L and S segment sequences were characterized, that phylogenetically clustered with local and global genotype A strains. An amino acid substitution outside the conserved motifs of the viral polymerase, also present in previous TOSV sequences in endemic regions, was observed. Leishmania tropica was detected in a single pool of Ph. sergentii (0.6%). This is the first report of TOSV in sandflies from Turkey, and this study further provides evidence for additional sandfly species with the potential to transmit TOSV.


Assuntos
Phlebotomus , Vírus da Febre do Flebótomo Napolitano , Animais , Infecções por Bunyaviridae/transmissão , Humanos , Insetos Vetores/parasitologia , Insetos Vetores/virologia , Leishmania tropica/isolamento & purificação , Leishmaniose Cutânea/transmissão , Phlebotomus/classificação , Phlebotomus/parasitologia , Phlebotomus/virologia , Filogenia , Psychodidae/classificação , Psychodidae/parasitologia , Psychodidae/virologia , RNA Viral , Vírus da Febre do Flebótomo Napolitano/genética , Vírus da Febre do Flebótomo Napolitano/isolamento & purificação , Turquia/epidemiologia , Doenças Transmitidas por Vetores/parasitologia , Doenças Transmitidas por Vetores/transmissão , Doenças Transmitidas por Vetores/virologia
9.
Herz ; 45(Suppl 1): 145-151, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31388710

RESUMO

BACKGROUND: We aimed to investigate the predictive value of the fibrinogen-to-albumin ratio (FAR) regarding the development of major cardiovascular events (MACE) in patients treated with percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS). METHODS: This was a prospective, observational cohort study that included 261 consecutive patients who were treated with PCI. The patients were grouped according to the occurrence of MACE during the follow-up period. RESULTS: During follow-up, MACE occurred in 68 (26%) patients. The FAR was independently predictive of MACE (HR: 1.017, 95% CI: 1.010-1.024, p < 0.001). In addition, left ventricular ejection fraction (LVEF) and a diagnosis of ST-segment elevation myocardial infarction (STEMI) were independent predictors of MACE. The area under the curve (AUC) of the multivariable model, including LVEF and diagnosis of STEMI, was 0.707 (95% CI: 0.631-0.782, p < 0.001). When the FAR was added to the multivariable model, the AUC was 0.770 (95% CI: 0.702-0.838, z = 2.820, difference p = 0.0048). CONCLUSION: The FAR could be used for the prediction of MACE in patients with ACS who have undergone PCI.


Assuntos
Síndrome Coronariana Aguda , Intervenção Coronária Percutânea , Síndrome Coronariana Aguda/diagnóstico , Albuminas , Fibrinogênio , Humanos , Estudos Prospectivos , Volume Sistólico , Função Ventricular Esquerda
10.
Br Poult Sci ; 61(5): 523-530, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32316760

RESUMO

1. There is no current data about the genotypes of Marek's disease virus (MDV) in Turkish poultry flocks; hence, this study was performed to analyse CVI988/Rispens, turkey herpesvirus (HVT) vaccine viruses and MDV field viruses as well as to perform phylogenetic analysis of MDV in Turkish layer chickens. 2. In 2017 and 2018, a total of 602 spleen samples from 49 layer flocks were collected from the Marmara, West Black Sea and Aegean regions. DNA was extracted from the spleen samples and the samples were analysed by real-time PCR probe assay to detect CVI988/Rispens and HVT vaccine viruses and MDV field strains. Samples found positive for MDV by real-time PCR were subjected to PCR using the Meq gene primers for phylogenetic analysis. 3. Amongst 49 flocks, virulent MDV was detected in nine flocks. CVI988/Rispens and HVT vaccine strains were detected in 47 flocks and HVT in all 49 flocks. Splenomegaly, hepatomegaly and tumours in the oviduct were observed in chickens of affected flocks. Virulent MDV was detected in 120 out of 602 spleen samples. Sequencing and phylogenetic analyses showed that MDVs detected in this study were closely related to MDV strains from Italy, Poland, Saudi Arabia, Iraq, India and China but showed diversity with MDV strains from Egypt and Hungary. Multiple sequence analysis of the Meq protein revealed several point mutations in deduced amino acid sequences. Interestingly, CVI988/Rispens vaccine virus from China (AF493555) showed mutations at position 66 (G66R) and 71 (S66A) along with two other vaccine strains from China (GU354326.1) and Russia (EU032468.1), in comparison with the other vaccine strain CVI988/Rispens (DQ534538). The molecular analyses of the Meq gene suggested that Turkish field strains of MDV are in the class of virulent or very virulent pathotypes. 4. The results have shown that MDV still affects poultry health, and the phylogenetic and amino acid variation data obtained will help in vaccination and control strategies.


Assuntos
Herpesvirus Galináceo 2 , Doença de Marek , Doenças das Aves Domésticas , Animais , Galinhas , China , Herpesvirus Galináceo 2/genética , Índia , Itália , Doença de Marek/epidemiologia , Filogenia , Polônia , Doenças das Aves Domésticas/epidemiologia , Federação Russa , Arábia Saudita
11.
Pneumologie ; 74(1): 24-34, 2020 Jan.
Artigo em Alemão | MEDLINE | ID: mdl-31863422

RESUMO

Sarcoidosis is a multisystemic granulomatous disorder which affects the respiratory system in the majority of the cases. Symptomatic cardiac manifestations are found in less than 10 % of the affected cohorts and show a large heterogeneity based on the ethnic background. Cardiac sarcoidosis is not only found in patients with rhythmogenic heart disease, such as atrial and ventricular fibrillation but also in all phenotypes of cardiomyopathy. The overall morbidity and mortality caused by cardiac sarcoidosis in Germany remains unclear and large prospective international observational studies.underline the importance of this disease entity. This consensus paper on diagnostic and therapeutic algorithms for cardiac sarcoidosis is based on a current literature search and forms an expert opinion statement under the auspices of the German Respiratory Society and the German Cardiac Society. The rationale of this statement is to provide algorithms to facilitate clinical decision-making based on the individual case situation.


Assuntos
Cardiologia/normas , Guias de Prática Clínica como Assunto , Sarcoidose Pulmonar/diagnóstico , Sarcoidose Pulmonar/terapia , Cardiomiopatias , Consenso , Alemanha/epidemiologia , Humanos , Comunicação Interdisciplinar , Pneumologia/normas , Sociedades Médicas
12.
Bratisl Lek Listy ; 121(7): 512-515, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32990006

RESUMO

OBJECTIVE: To investigate the protective potential of resveratrol (RES) in blunt hepatic trauma (BHT) by exploring the anti-inflammatory and histopathologic effects as well as modulatory effects on hepatic biomarkers of acute injury, regeneration, apoptosis and survival in a rat model of BHT. METHODS: A total of 21 Wistar Albino rats (weighing 120-250 g) were separated into 3 groups (n = 7 for each group), namely control group (CON; standard feeding), BHT group (BHT; blunt hepatic trauma plus observation) and trauma plus BES group (BHT-RES; blunt hepatic trauma plus intraperitoneal injection of 10 mg/kg RES). Serum levels for aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH) and bilirubin were measured on Day 7 and rats were sacrificed for histopathological (inflammation scores) and immunohistochemical [expression of proliferation marker (Ki-67) and apoptosis-related markers (Bcl-2, and Bax)] analyses in resected liver tissue. RESULTS: The highest levels for serum AST (p = 0.002), ALT (p = 0.002) and LDH (p = 0.002) were obtained from BHT group of rats, as followed by BHT-RES and control groups, respectively. The highest scores for Ki 67 (p = 0.002 for each), Bcl 2 (p = 0.002 for each) and Bax (p = 0.002 for each) were obtained from BHT-RES group of rats, as followed by BHT and control groups, respectively. Inflammation scores were significantly higher in BHT vs BHT-RES group (2.42 ± 0.53 vs 1.42 ± 0.53; p = 0.001) and both groups had higher inflammation scores than the control group (0.0 ± 0.0; p = 0.001). CONCLUSION: In conclusion, our findings revealed for the first time that RES exerts promising hepato-ameliorative effects against blunt hepatic injury as evidenced by decreased inflammation scores, parallel with improved hepatic histology, decreased serum transaminase activity as well as enhanced modulatory effect on regenerative and apoptotic processes in RES-treated rats subjected to experimentally-induced blunt hepatic trauma (Tab. 1, Fig. 1, Ref. 37).


Assuntos
Anti-Inflamatórios , Fígado , Resveratrol , Ferimentos não Penetrantes , Animais , Anti-Inflamatórios/farmacologia , Apoptose , Biomarcadores , Fígado/lesões , Ratos , Ratos Wistar , Regeneração , Resveratrol/farmacologia , Ferimentos não Penetrantes/terapia
13.
Bratisl Lek Listy ; 121(5): 366-369, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32356435

RESUMO

OBJECTIVE: In this study we aimed to evaluate whether there is a link between circulating 25-OH-D levels and molecular response in chronic myeloid leukemia (CML). MATERIAL AND METHOD: A total of 61 patients with CML (31 women, 30 men) were recruited in this cross-sectional study. RESULTS: Binary logistic regression analysis demonstrated that increased vitamin D levels were independently associated with molecular response in subjects with CML. CONCLUSION: Our results indicated for the first time in the literature that severe deficiency of vitamin D was independently associated with molecular unresponsiveness in subjects with CML. 25-OH-D may be contributing to molecular response in the patients (Tab. 3, Ref. 24).


Assuntos
Leucemia Mielogênica Crônica BCR-ABL Positiva , Deficiência de Vitamina D , Vitamina D , Calcifediol , Estudos Transversais , Feminino , Humanos , Leucemia Mielogênica Crônica BCR-ABL Positiva/sangue , Leucemia Mielogênica Crônica BCR-ABL Positiva/terapia , Masculino , Vitamina D/sangue
14.
Diabet Med ; 36(10): 1243-1250, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31099079

RESUMO

AIMS: To describe the baseline clinical and laboratory findings and treatment modalities of 367 children and adolescents diagnosed with Type 2 diabetes in various paediatric endocrinology centres in Turkey. METHODS: A standard questionnaire regarding clinical and laboratory characteristics at onset was uploaded to an online national database system. Data for 367 children (aged 6-18 years) newly diagnosed with Type 2 diabetes at 37 different paediatric endocrinology centres were analysed. RESULTS: After exclusion of the children with a BMI Z-score < 1 SD, those with genetic syndromes associated with Type 2 diabetes, and those whose C-peptide and/or insulin levels were not available, 227 cases were included in the study. Mean age was 13.8 ± 2.2 (range 6.5-17.8) years, with female preponderance (68%). Family history of Type 2 diabetes was positive in 86% of the children. The mean BMI was 31.3 ± 6.5 kg/m2 (range 18.7-61) and BMI Z-score was 2.4 ± 0.8 (range 1-5). More than half (57%) of the children were identified by an opportunistic diabetes screening due to existing risk markers without typical symptoms of diabetes. Only 13% (n = 29) were treated solely by lifestyle modification, while 40.5% (n = 92) were treated with metformin, 13% (n = 30) were treated with insulin, and 33.5% (n = 76) were treated with a combination of insulin and metformin initially. Mean HbA1C levels of the insulin and combination of insulin and metformin groups were 98 (11.1%) and 102 mmol/mol (11.5%), respectively, and also were significantly higher than the lifestyle modification only and metformin groups mean HbA1C levels (70(8.6%) and 67 mmol/mol (8.3%), respectively). CONCLUSIONS: An opportunistic screening of children who are at high risk of Type 2 diabetes is essential, as our data showed that > 50% of the children were asymptomatic at diagnosis. The other important result of our study was the high rate of exclusion from the initial registration (38%), suggesting that accurate diagnosis of Type 2 diabetes in youth is still problematic, even for paediatric endocrinologists.


Assuntos
Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/terapia , Adolescente , Glicemia/análise , Índice de Massa Corporal , Peptídeo C/sangue , Criança , Estudos Transversais , Diabetes Mellitus Tipo 2/tratamento farmacológico , Jejum , Feminino , Hemoglobinas Glicadas/análise , Humanos , Hipoglicemiantes/uso terapêutico , Insulina/sangue , Insulina/uso terapêutico , Estilo de Vida , Masculino , Programas de Rastreamento/métodos , Metformina/uso terapêutico , Puberdade , Fatores de Risco , Turquia
15.
Ultrasound Obstet Gynecol ; 54(1): 110-118, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30381856

RESUMO

OBJECTIVE: To evaluate the application of artificial intelligence (AI), i.e. deep learning and other machine-learning techniques, to amniotic fluid (AF) metabolomics and proteomics, alone and in combination with sonographic, clinical and demographic factors, in the prediction of perinatal outcome in asymptomatic pregnant women with short cervical length (CL). METHODS: AF samples, which had been obtained in the second trimester from asymptomatic women with short CL (< 15 mm) identified on transvaginal ultrasound, were analyzed. CL, funneling and the presence of AF 'sludge' were assessed in all cases close to the time of amniocentesis. A combination of liquid chromatography coupled with mass spectrometry and proton nuclear magnetic resonance spectroscopy-based metabolomics, as well as targeted proteomics analysis, including chemokines, cytokines and growth factors, was performed on the AF samples. To determine the robustness of the markers, we used six different machine-learning techniques, including deep learning, to predict preterm delivery < 34 weeks, latency period prior to delivery < 28 days after amniocentesis and requirement for admission to a neonatal intensive care unit (NICU). Omics biomarkers were evaluated alone and in combination with standard sonographic, clinical and demographic factors to predict outcome. Predictive accuracy was assessed using the area under the receiver-operating characteristics curve (AUC) with 95% CI, sensitivity and specificity. RESULTS: Of the 32 patients included in the study, complete omics, demographic and clinical data and outcome information were available for 26. Of these, 11 (42.3%) patients delivered ≥ 34 weeks, while 15 (57.7%) delivered < 34 weeks. There was no statistically significant difference in CL between these two groups (mean ± SD, 11.2 ± 4.4 mm vs 8.9 ± 5.3 mm, P = 0.31). Using combined omics, demographic and clinical data, deep learning displayed good to excellent performance, with an AUC (95% CI) of 0.890 (0.810-0.970) for delivery < 34 weeks' gestation, 0.890 (0.790-0.990) for delivery < 28 days post-amniocentesis and 0.792 (0.689-0.894) for NICU admission. These values were higher overall than for the other five machine-learning methods, although each individual machine-learning technique yielded statistically significant prediction of the different perinatal outcomes. CONCLUSIONS: This is the first study to report use of AI with AF proteomics and metabolomics and ultrasound assessment in pregnancy. Machine learning, particularly deep learning, achieved good to excellent prediction of perinatal outcome in asymptomatic pregnant women with short CL in the second trimester. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.


Assuntos
Líquido Amniótico/metabolismo , Inteligência Artificial/normas , Colo do Útero/diagnóstico por imagem , Metabolômica/métodos , Proteômica/métodos , Adolescente , Adulto , Amniocentese/métodos , Medida do Comprimento Cervical/métodos , Colo do Útero/anormalidades , Feminino , Humanos , Unidades de Terapia Intensiva Neonatal/estatística & dados numéricos , Valor Preditivo dos Testes , Gravidez , Resultado da Gravidez/epidemiologia , Segundo Trimestre da Gravidez/metabolismo , Estudos Retrospectivos , Sensibilidade e Especificidade , Ultrassonografia/métodos , Adulto Jovem
16.
Bratisl Lek Listy ; 120(11): 860-863, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31747768

RESUMO

AIM: We intended to investigate the association of bilirubin with total mortality in patients with chronic total coronary occlusion (CTO). METHODS: We included 172 patients who underwent coronary angiography due to stable angina pectoris and had CTO. We checked the viability of patients after 9 years of follow-up. RESULTS: Direct bilirubin levels were significantly lower in the non-viable group. We revealed age (OR = 1.045, 95% C.I: 1.009‒1.083; p = 0.015) and direct bilirubin concentrations (OR = 0.029, 95% C.I: 0.002‒0.435; p = 0.029) as independent predictors of mortality. Direct bilirubin value of > 0.2 mg/dL was associated with decreased mortality with a sensitivity of 85 %, and a specificity of 46 %. CONCLUSION: Serum direct bilirubin concentrations independently predict total mortality in patients with chronic total occlusion over 9 years of follow-up (Tab. 1, Fig. 2, Ref. 23).


Assuntos
Bilirrubina/sangue , Oclusão Coronária/mortalidade , Doença Crônica , Angiografia Coronária , Humanos , Fatores de Risco
17.
Med Vet Entomol ; 32(2): 186-196, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29111588

RESUMO

The spatial and temporal distribution of Phlebotomus perniciosus (Diptera: Psychodidae) (Newstead, 1911), the sand fly vector of pathogens of public and animal health importance, was investigated in a high sand fly density rural area in Spain using light-attraction and sticky-interception traps. Traps were placed inside animal buildings and outside at increasing distance from animals. A total of 8506 sand flies were collected, 87% with light traps. Species frequency differed between trap types. The abundance of P. perniciosus decreased exponentially with increasing distance to animals and, while females were most common in the animal enclosure, males predominated in adjoining storage places. Increasing CO2 concentration had an additional positive effect on female abundance only. Both male and female density increased with rising temperature, and there was some indication that females were more active than males at higher relative humidity. The study confirms that P. perniciosus aggregates around animal premises, although male and female distributions differ and should be analysed separately to account for biological and behavioural differences. This provides further evidence that light traps offer an accurate estimation of the relative spatial and temporal abundance of P. perniciosus, conferring an added value for the study of this species and the risk of pathogen transmission.


Assuntos
Distribuição Animal , Abrigo para Animais , Phlebotomus/fisiologia , Animais , Feminino , Masculino , Estações do Ano , Espanha , Análise Espacial
18.
Andrologia ; 50(6): e13031, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29700836

RESUMO

Previous studies have reported that repeated administrations of linear gadolinium-based contrast agents lead to their accumulation in the brain and other tissues in individuals with normal renal functions. The purpose of this prospective animal study was to investigate the effect of multiple administrations of macrocyclic ionic (gadoteric acid) and linear nonionic (gadodiamide) gadolinium-based contrast agents (GBCAs) on rat testis tissue and to compare these molecules in terms of tissue damage. Thirty-two male Sprague-Dawley rats were kept without drugs for 5 weeks after administration of 0.1 mmol mg-1 kg-1 (0.2 ml/kg) gadodiamide and gadoteric acid for 4 days over 5 weeks. Biochemical, histopathological and immunohistochemical changes in testis tissue were evaluated at the end of 10 weeks. When used in repeated clinical doses, gadolinium was observed to increase apoptosis in the Leydig cells of the rat testis, and to increase serum Ca+2 levels and reduce testosterone levels (p < .05). Although the difference was not statistically significant, a greater loss of spermatozoa and immature germinal cell accumulation were observed in the seminiferous tubule lumen in the GBCA groups compared with the control and saline groups (p > .05). Both linear and macrocyclic contrast agents have toxic effects on testis tissue, irrespective of the type of drug.


Assuntos
Meios de Contraste/farmacocinética , Gadolínio DTPA/farmacocinética , Gadolínio/análise , Células Intersticiais do Testículo/efeitos dos fármacos , Testículo/efeitos dos fármacos , Animais , Apoptose/efeitos dos fármacos , Cálcio/sangue , Masculino , Estudos Prospectivos , Ratos , Ratos Sprague-Dawley , Túbulos Seminíferos/efeitos dos fármacos , Testosterona/sangue
19.
Folia Morphol (Warsz) ; 77(1): 65-71, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-28832088

RESUMO

BACKGROUND: The objective of this study was to evaluate the prevalence and characteristics of ponticulus posticus (PP) in groups with sagittal skeletal anomalies in a Turkish population using cone beam computed tomography (CBCT). MATERIALS AND METHODS: A total of 181 CBCT images were evaluated according to gender, side and characteristics of PP in the three different sagittal skeletal groups. RESULTS: The average age of the patients was 13.88 ± 2.99 years (ranging 8-18 years). The study population consisted of 104 (57.5%) females and 77 (42.5%) males. PP was detected in 66 (36.5%) patients. Unilateral and bilateral PP was identified in 29 (43.9%) and 37 (56.1%) patients, respectively. The prevalence of PP in the atlas vertebrae was found to be higher in males than in females and this was statistically significant (p ≤ 0.05). PP was most frequently detected in class III patients (25, 13.8%). Statistically significant differences between the different sagittal skeletal groups were observed (p ≤ 0.05). CONCLUSIONS: Ponticulus posticus is a common anomaly in Turkish populations and is associated with different sagittal skeletal patterns. The highest frequency of PP was found in angle class III patients. (Folia Morphol 2018; 77, 1: 65-71).


Assuntos
Atlas Cervical , Tomografia Computadorizada de Feixe Cônico , Caracteres Sexuais , Adolescente , Atlas Cervical/anormalidades , Atlas Cervical/diagnóstico por imagem , Criança , Feminino , Humanos , Masculino , Músculo Esquelético/anormalidades , Músculo Esquelético/diagnóstico por imagem , Ortodontia , Estudos Retrospectivos
20.
Bratisl Lek Listy ; 119(8): 503-508, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30160159

RESUMO

BACKGROUND: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is considered cautiously in the diagnosis of lymphoma. In this study, we present our data with literature review, to ask the readers to re-evaluate this opinion. MATERIALS AND METHODS: Several demographic, clinical and procedural variables of patients who had been diagnosed with lymphoma with EBUS-TBNA at our institution between January 2011 and December 2016 were noted and analyzed. RESULTS: We analyzed 27 patients with a proven diagnosis of lymphoma, out of whom twenty patients were with classical Hodgkin's lymphoma and seven with non-Hodgkin's lymphoma. The sensitivity, specificity, positive and negative predictive values and accuracy of EBUS-TBNA for the diagnosis of lymphoma was found to be 70.3 %, 100 %, 100 %, 99.4 % and 99.4 %, respectively. The diagnostic sensitivity of EBUS-TBNA in ten patients with the history of lymphoma was 100 %; while in patients with no history of lymphoma it was 52.9 %. The patients with non-Hodgkin's lymphoma were presented at older ages (p = 0.001), with larger lesions (p = 0.046) and higher SUVmax values (p < 0.001). No complications occurred. CONCLUSION: EBUS-TBNA may be used as an initial diagnostic modality in patients suspicious for lymphoma instead of repeated mediastinoscopy (Tab. 2, Fig. 1, Ref. 34).


Assuntos
Brônquios/patologia , Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico/métodos , Neoplasias Pulmonares/patologia , Linfoma/diagnóstico , Adulto , Idoso , Feminino , Humanos , Linfoma/patologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Sensibilidade e Especificidade , Adulto Jovem
SELEÇÃO DE REFERÊNCIAS
Detalhe da pesquisa