RESUMO
The engineered Hand Test System (HTS) glove has shown high reliability in assessing the baseline functional status of rheumatoid arthritis (RA) hand. Starting from this achievement, the aim of the present observational prospective study was to assess the functionality of the single fingers of rheumatoid hand at follow-up. Eighty RA patients performed HTS glove tests at baseline and among these fifty-six patients were re-tested after 7 months. The HTS glove parameters [Touch Duration (TD), Movement Rate (MR), Inter Tapping Interval (ITI)] were correlated with disease activity and disability clinimetric indexes [Disease Activity Score 28 joint count-C-reactive protein (DAS28-CRP), Clinical Disease Activity Index (CDAI), Simplified Disease Activity Index (SDAI), Health Assessment Questionnaire-Disability Index (HAQ-DI), grip strength, visual analogue scale of pain (VAS), patient global assessment (PGA)], and with laboratory values. HTS glove parameters (TD, ITI, and MR) showed statistically significant correlations with clinimetric and clinical indexes at both time points (p < 0.05). During follow-up, a statistically significant variation of all HTS glove parameters for the fingers that have performed both the worst or best HTS test at baseline was detected (p < 0.05), while the mean HTS glove parameter values by considering all fingers did not show a statistically significant variation over time, as well as the traditional clinimetric indexes. Besides the objective role in assessing the RA hand function by integrating the traditional clinimetric indexes, the HTS glove seems a useful tool for evaluating worst or best finger function during time by measuring the movement speed.
Assuntos
Artrite Reumatoide , Humanos , Estudos Prospectivos , Reprodutibilidade dos Testes , Artrite Reumatoide/diagnóstico , Proteína C-Reativa , Dor , Índice de Gravidade de DoençaRESUMO
Mean blood flow velocity (MFV) of the middle cerebral arteries was monitored in 19 healthy, adult, right-handed subjects during the resting phase and the execution of a series of neuropsychological tests: two right/left discrimination tasks, two mental rotation paradigms (the Ratcliff's test and a cube comparison test) and a phonemic fluency task, which was utilised as an internal control. In the group as a whole, the Ratcliff's test was associated with a significant bilateral increase in MFV versus both the resting state (right: p < .000001, left: p < .000001) and right/left discrimination tasks (task 1: right: p = .003, left: p = .005; task 2: right: p = .001, left: p = .001). The cube comparison in turn produced a significant increase in MFV versus both the baseline conditions (right: p < .000001, left: p < .000001) and the Ratcliff's test (right: p = .01, left: p = .002). As expected, the fluency task was associated with a significant asymmetric increase in cerebral perfusion (left > right: p = .0001). Increasing task difficulty (right/left discrimination < Ratcliffs test < cube comparison) was paralleled by a roughly proportional rise in MFV values (right: r = .424, p < .01; left: r = .331, p = .01). In conclusion, we were able to demonstrate that (1) in addition to the amount of MFV variation due to right/left discrimination (when required), mental rotation per se causes a bihemispheric activation irrespective of the experimental paradigm; (2) the MFV variation is proportional to the difficulty of the tasks.
Assuntos
Encéfalo/irrigação sanguínea , Encéfalo/fisiologia , Cognição/fisiologia , Lateralidade Funcional/fisiologia , Percepção Espacial/fisiologia , Ultrassonografia Doppler Transcraniana/métodos , Adulto , Velocidade do Fluxo Sanguíneo/fisiologia , Ecoencefalografia/métodos , Feminino , Humanos , Masculino , Testes NeuropsicológicosRESUMO
Upper gastrointestinal bleeding is still a subject much discussed as much for the diagnostic approach and as by the therapeutic decisions read. The authors present their experience of the treatment of upper gastrointestinal bleeding not caused by portal hypertension or by neoplasm. The patients undergo emergency endoscopy by haemostatic treatment if necessary and pharmacological therapy by omeprazole. The evaluation criteria are: stopped bleeding, the need of blood transfusion, the healing of the bleeding site. Stopped bleeding has been watched at first endoscopic check in 85% of patients; only 26 blood units has been necessary; the complete healing of bleeding injury happened not later than 30 days.
Assuntos
Endoscopia Gastrointestinal , Hemorragia Gastrointestinal/terapia , Omeprazol/uso terapêutico , Adulto , Idoso , Idoso de 80 Anos ou mais , Terapia Combinada , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
The Authors report their experience in cases of severe lower intestinal bleeding. On the basis of personal data and previously reported results, endoscopy is shown to be the primary and sometimes essential method, especially in the case of colo-rectal bleeding, both in terms of its diagnostic precision and possible therapeutic uses. This technique was used to treat all emergency cases, obtaining a diagnostic resolution in 85.6% and hemostasis and/or the concomitant removal of the lesion in 52.3% of cases.
Assuntos
Hemorragia Gastrointestinal , Doença Aguda , Diagnóstico Diferencial , Diverticulite/diagnóstico , Emergências , Endoscopia , Feminino , Hemorragia Gastrointestinal/diagnóstico , Hemorragia Gastrointestinal/terapia , Humanos , Neoplasias Intestinais/diagnóstico , Pólipos Intestinais/diagnóstico , Masculino , Pessoa de Meia-Idade , Doenças Retais/diagnóstico , Recidiva , Úlcera/diagnósticoRESUMO
The authors report a case of large-cell mediastinal lymphoma, a recently defined, fairly infrequent, highly aggressive tumor which responds scarcely to conventional chemotherapy. On the basis of its histopathology, the tumor must be classified as a highly malignant non-Hodgkin lymphoma. The latest data in the literature give cause for a little more optimism thanks to the introduction of the most recent schemes of chemotherapy combined with large-dose radiation for consolidation. Our patient was treated with chemotherapy CHOP high-dose radiation which resulted in complete disappearance of the mediastinal mass and rapid remission of the severe symptoms of mediastinal compression. After about 30 months, instrumental and laboratory findings confirm the persistence of the complete remission.
Assuntos
Linfoma Difuso de Grandes Células B/terapia , Neoplasias do Mediastino/terapia , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Terapia Combinada , Ciclofosfamida/uso terapêutico , Doxorrubicina/uso terapêutico , Feminino , Seguimentos , Humanos , Linfoma Difuso de Grandes Células B/patologia , Linfoma Difuso de Grandes Células B/radioterapia , Neoplasias do Mediastino/patologia , Neoplasias do Mediastino/radioterapia , Mediastino/patologia , Aceleradores de Partículas , Prednisona/uso terapêutico , Dosagem Radioterapêutica , Fatores de Tempo , Vincristina/uso terapêuticoAssuntos
Administração Tópica , Coroas , Hidrocortisona , Técnica para Retentor Intrarradicular , Obturação do Canal Radicular/métodos , Anti-Inflamatórios/farmacologia , Dexametasona/farmacologia , Combinação de Medicamentos/farmacologia , Estudos de Avaliação como Assunto , Formaldeído/farmacologia , Guta-Percha/farmacologia , Materiais Restauradores do Canal Radicular/farmacologia , Timol/análogos & derivados , Timol/farmacologia , Cimento de Óxido de Zinco e Eugenol/farmacologiaRESUMO
The bond strength of porcelain to a magnetizable Pd-Co alloy was compared with that of a precious and nonprecious ceramic alloy by using the four-point flexure test and a direct shear test. The test procedure consisted of continuous loading until a bond failure occurred. The fractured surfaces were then examined with a scanning electron microscope. A good strength of the magnetizable Pd-Co alloy comparable to that of two specific ceramic alloys and intermediate between precious and nonprecious alloys was observed. Most of the failures of the precious alloy occurred at the oxide-porcelain interface. The preferential fracture paths were observed for the nonprecious alloy between the metal fracture and the oxide layer. The fractures of the magnetizable alloy occurred at the oxide-porcelain interface and in the bulk of the porcelain, clearly pointing out the possibility of using magnetizable Pd-Co alloy for metal ceramic abutment crowns.
Assuntos
Ligas Dentárias , Colagem Dentária , Porcelana Dentária , Análise do Estresse Dentário , Cobalto , Magnetismo , PaládioRESUMO
An electrophoretic method to demonstrate human red cell membrane acetylcholinesterase is described. The method, performed with crude Triton lysates of red cells on a flat-bed polyacrylamide gel, is sufficiently simple to be suitable for a population survey.
Assuntos
Acetilcolinesterase/genética , Eletroforese em Gel de Poliacrilamida/métodos , Polimorfismo Genético , Membrana Eritrocítica/enzimologia , Humanos , PolietilenoglicóisRESUMO
A method for electrophoretic detection of NAD(P)+ase solubilized from red cell membranes is described. The method reveals both NAD+ase and NADP+ase and can be applied to a screening procedure for the detection of electrophoretic variants. The initial chracterization of the solubilized enzyme is also described.
Assuntos
Membrana Eritrocítica/enzimologia , Eritrócitos/enzimologia , N-Glicosil Hidrolases/sangue , Eletroforese em Acetato de Celulose , Temperatura Alta , Humanos , Concentração de Íons de Hidrogênio , Cinética , Métodos , N-Glicosil Hidrolases/isolamento & purificaçãoRESUMO
The membrane bound enzyme acetylcholinesterase (AChE) of human erythrocytes shows a lower level of activity in the newborn than in the adult. To evaluate if the decreased activity is correlated with changes in other properties of the enzyme, an electrophoretic method, recently devised to detect AChE activity, was used. Our results revealed an electrophoretic difference between adult and fetal enzymes. Sialic acid removal through neuraminidase treatment reduced the electrophoretic mobility of both forms rendering them identical in migration without, however, altering the activity.
Assuntos
Acetilcolinesterase/sangue , Membrana Eritrocítica/enzimologia , Eritrócitos/enzimologia , Sangue Fetal/enzimologia , Adulto , Fatores Etários , Centrifugação , Eletroforese em Gel de Poliacrilamida , Sangue Fetal/citologia , Humanos , Recém-Nascido , Neuraminidase/farmacologiaRESUMO
INTRODUCTION: Properly oriented endoscopic biopsies allow an effective assessment of some diagnostic features in non neoplastic gastrointestinal diseases. MATERIALS AND METHODS: We used cellulose acetate millipore filters (Endofilter, Bio-Optica, Milan, Italy) in order to improve the orientation of biopsies during processing. Forty biopsies were placed on filter after endoscopic sampling whereas no orientation attempt was done for other 40 filter-free biopsies (20 from esophagus and 20 from gastric antrum in each group). Both groups were compared in terms of orientation and assessability of the following morphological features: thickness of basal layer in the esophageal squamous epithelium, length of esophageal papillae, interstitial space dilatations in the esophageal squamous epithelium and gland atrophy in the gastric antrum. Both orientation and assessability of individual morphological features were graded with a score ranging from 1 (good) to 3 (poor). The impact of this procedure on costs was analysed, both in terms of material and technical workload. RESULTS: All 20 esophageal and 20 antral biopsies on filter showed acceptable (score 1 or 2) orientation. In contrast, 14/20 filter-free esophageal and 13/20 antral biopsies showed poor (score 3) orientation (p = 0.0001 for both groups). Basal layer thickness was assessable (score 1 or 2) in 20/20 esophageal biopsies on filter vs 14/20 filter-free ones (p = 0.0001) and length of papillae in 15/20 biopsies on filter vs 4/20 filter-free ones (p = 0.0002). Interstitial space dilatation assessability was not affected by orientation procedures. Gland atrophy in the antrum was assessable (score 1 or 2) in 20/20 gastric biopsies on filter vs 8/20 filter-free ones (p = 0.0001). The use of endofilters permitted the process of numerous (up to 8 for each block) samples from different biopsy sites together and produced a significant reduction in costs (18.35 in the case of 8 biopsies from 4 different biopsy sites). CONCLUSIONS: The use of millipore filters allows orientation of biopsy samples, improves the assessment of several diagnostic features in esophageal and gastric pathology and yields a significant reduction in costs when biopsies from different sites are processed together.
Assuntos
Biópsia/métodos , Celulose/análogos & derivados , Esofagoscopia , Esôfago/patologia , Gastroscopia , Filtros Microporos , Antro Pilórico/patologia , Manejo de Espécimes/instrumentação , Atrofia , Biópsia/economia , Mucosa Gástrica/patologia , Humanos , Hiperplasia , Manejo de Espécimes/economiaRESUMO
Right-to-left shunt (RLS), usually due to patent foramen ovale, is a well-established risk factor for ischemic stroke in young patients, while the role of migraine as an independent factor is still debated. We evaluated 44 patients suffering from migraine with aura, and compared them with 73 patients younger than 50 with focal cerebral ischemia, and 50 controls, asymptomatic for cerebrovascular disease, and without a history of migraine. All the subjects underwent bilateral transcranial Doppler with injection of contrast medium in an antecubital vein. The test was performed during normal ventilation and during Valsalva maneuver, recording both the middle cerebral arteries and the basilar artery. Criteria for diagnosing RLS was the presence of at least 3 microbubbles within 15 s from injection. Eighteen out of 44 migraine patients (41%) showed RLS, as opposed to 8 of 50 controls (16%) (p < 0.005). Twenty-six out of 73 patients with cerebral ischemia had RLS (35%). We conclude that the prevalence of RLS in patients with migraine with aura is significantly higher than in normal controls, and is similar to the prevalence of RLS in young patients with stroke. These findings could be helpful in understanding the relationship between migraine and stroke.