1194 research outputs found
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Synchronous liver metastases, oncosurgical strategy: How to resect the unresectable?
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Statin-related myotoxicity
Get PDFStatin therapy has a very important role in decreasing cardiovascular risk, and treatment non-compliance may therefore be a concern in high cardiovascular risk patients. Myotoxicity is a frequent side effect of statin therapy and one of the main causes of statin discontinuation, which limits effective treatment of patients at risk of or with cardiovascular disease. Because of the high proportion of patients on statin treatment and the frequency of statin-related myotoxicity, this is a subject of concern in clinical practice. However, statin-related myotoxicity is probably underestimated because there is not a gold standard definition, and its diagnosis is challenging. Moreover, information about pathophysiology and optimal therapeutic options is scarce. Therefore, this paper reviews the knowledge about the definition, pathophysiology and predisposing conditions, diagnosis and management of statin-related myotoxicity, and provides a practical scheme for its management in clinical practice
Treatment of Metastasized Prostate Carcinoma: Emergence of New Therapeutic Horizons
Get PDFA evolução no tratamento do carcinoma da próstata metastizado proporciona atualmente ao Urologista uma vasta gama de possibilidades terapêuticas que comprovadamente melhoram a sobrevida e a qualidade de vida dos doentes. É apresentado um caso clínico neste artigo onde é patente não só a eficácia destas terapêuticas mas também a sua rápida evolução
Significance of glycolytic metabolism-related protein expression in colorectal cancer, lymph node and hepatic metastasis
Get PDFBACKGROUND:
Colorectal cancer (CRC) is one of the most common malignancies and a leading cause of cancer death worldwide. Most cancer cells display high rates of glycolysis with production of lactic acid, which is then exported to the microenvironment by monocarboxylate transporters (MCTs). The main aim of this study was to evaluate the significance of MCT expression in a comprehensive series of primary CRC cases, lymph node and hepatic metastasis.
METHODS:
Expressions of MCT1, MCT4, CD147 and GLUT1 were studied in human samples of CRC, lymph node and hepatic metastasis, by immunohistochemistry.
RESULTS:
All proteins were overexpressed in primary CRC, lymph node and hepatic metastasis, when compared with non-neoplastic tissue, with exception of MCT1 in lymph node and hepatic metastasis. MCT1 and MCT4 expressions were associated with CD147 and GLUT1 in primary CRC. These markers were associated with clinical pathological features, reflecting the putative role of these metabolism-related proteins in the CRC setting.
CONCLUSION:
These findings provide additional evidence for the pivotal role of MCTs in CRC maintenance and progression, and support the use of MCTs as biomarkers and potential therapeutic targets in primary and metastatic CRC
Orolingual angioedema after thrombolysis is not associated with insular cortex ischemia on pre-thrombolysis CT
Get PDFOrolingual angioedema (OA) is a well known early complication of treatment with alteplase in ischemic stroke patients. Our aim was to study risk factors for OA in these patients, namely insular cortex ischemia
Usefulness of ACTH stimulation test in the differential diagnosis of precocious pubarche
Get PDFIntrodução
Nos doentes com pubarca precoce, o gold‐standard para o diagnóstico diferencial entre pubarca precoce idiopática (PPI) e a forma não clássica da hiperplasia congénita da suprarrenal (HCSR‐NC) é a prova de Synacthen. Esta permite também estimar a reserva adrenal de cortisol nos doentes com HCSR‐NC.
Objetivos
Comparar as características clínicas e perfil hormonal basal dos doentes com pubarca precoce; avaliar a importância da prova de Synacthen no diagnóstico diferencial entre PPI e HCSR‐NC e na determinação da reserva adrenal de cortisol.
Material e métodos
Estudo transversal de doentes com pubarca precoce que realizaram prova de Synacthen.
ResultadosForam incluídos 43 doentes, com idade mediana de 7,5 anos (3,5‐9,4), sendo 37 (86,0%) do sexo feminino. Na prova de Synacthen, 37 (86,0%) foram classificados como PPI e 6 (14,0%) como HCSR‐NC. Não houve diferenças significativas entre os 2 grupos quanto às características clínicas e doseamentos basais de ACTH, cortisol e androgénios da suprarrenal. A 17‐OHP basal e estimulada foi mais elevada nos doentes com HCSR‐NC (p = 0,001 e p < 0,001, respetivamente) (basal: 4,62 ± 3,70 ng/ml [0,80‐10,50]; estimulada: 35,41 ± 24,87 ng/ml [12,0‐80,2]) do que nos doentes com PPI (basal: 1,04 ± 0,77 ng/ml [0,22‐3,80]; estimulada: 4,18 ± 1,71 ng/ml [1,0‐8,96]). O cut‐off basal habitualmente proposto (< 2,0 ng/ml) para a distinção entre estes grupos não o permitiu em 2 doentes, que apenas foram diagnosticados após realização da prova de Synacthen. Dois doentes com HCSR‐NC (33,3%) tiveram cortisol após estimulação < 18 μg/dl, revelando necessidade de tratamento com glucocorticoide em stress. Os doentes com HCSR‐NC com valores mais elevados de 17‐OHP basal tiveram valores de cortisol mais baixos após estimulação (p = 0,004; r = ‐0,43).
Conclusão
A realização desta prova foi útil para distinguir os doentes com HCSR‐NC e PPI, pois nenhum valor de 17‐OHP basal permitia fazer o diagnóstico diferencial definitivo. Em alguns doentes com HCSR‐NC a prova revelou secreção inapropriada de cortisol em stress, contribuindo para a decisão terapêutica
Scheimpflug lens densitometry and ocular wavefront aberrations in patients with mild nuclear cataract
Get PDFPURPOSE:
To test correlations between Scheimpflug optical densitometry and ocular higher-order aberrations (HOAs) in patients with mild nuclear cataract.
SETTING:
Cornea and Refractive Surgery Department, Hospital de Braga, Braga, Portugal.
DESIGN:
Retrospective single-center study.
METHODS:
In eyes with mild nuclear cataract, lens densitometry was evaluated by Scheimpflug imaging (Pentacam HR), which provided an objective quantification (mean density and maximum density) and grading (nuclear staging score) of the crystalline lens. A visual function analyzer that combines ray-tracing aberrometry and Placido disk-based topography (iTrace) was used to evaluate the total ocular and internal HOAs.
RESULTS:
The study comprised 40 eyes of 30 patients. The mean density of the lens nucleus was 8.99% ± 0.76% (SD) (range 7.5% to 10.8%), and the mean maximum density was 27.96% ± 6.97% (range 16.9% to 56.1%). Regarding the score of nuclear staging of the Scheimpflug device, 28 eyes had level 0 and 12 eyes had level 1. Significant positive correlations were found between the mean density and maximum density parameters and the internal HOAs (ρ = 0.661, P < .001 and ρ = 0.570, P < .001, respectively).
CONCLUSIONS:
There were significant correlations between the quantification parameters derived from Scheimpflug lens densitometry and ocular HOAs. The integration of these technologies can help in clinical decision making and in understanding the subjective symptoms of patients with mild nuclear cataracts.
FINANCIAL DISCLOSURE:
Dr. Ambrósio is a consultant to Oculus Optikgeräte GmbH, Alcon Surgical, Inc., and Carl Zeiss Meditec AG. None of the other authors has a financial or proprietary interest in any material or method mentioned
Evaluation of the Psychometric Properties of the Mental Vulnerability Questionnaire in Undergraduate Students
Get PDFPURPOSE:
Translate, adapt the language, and assess the psychometric properties of the Mental Vulnerability Questionnaire (MVQ) in a Portuguese population sample of young adults.
DESIGN AND METHODS:
A psychometric validation study was performed. The sample comprised 166 undergraduate students. Factor analysis was applied to extract three indicators.
FINDINGS:
The MVQ showed divergent validity with the Positive Mental Health Questionnaire (p < .001) and convergent validity with the Mental Health Inventory including five items (p < .001). Reliability was verified through the assessment of internal consistency, evidencing positive outcomes (Cronbach's α = 0.81).
PRACTICE IMPLICATIONS:
The MVQ shows psychometric properties enabling its adaptation to clinical practice and research, essential to an effective screening of mental vulnerability
