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The Impact of Prenatal Exposure to Dexamethasone on Gastrointestinal Function in Rats
Get PDFAntenatal treatment with synthetic glucocorticoids is commonly used in pregnant women at risk of preterm delivery to accelerate tissue maturation. Exposure to glucocorticoids during development has been hypothesized to underlie different functional gastrointestinal (GI) and motility disorders. Herein, we investigated the impact of in utero exposure to synthetic glucocorticoids (iuGC) on GI function of adult rats. Wistar male rats, born from pregnant dams treated with dexamethasone (DEX), were studied at different ages. Length, histologic analysis, proliferation and apoptosis assays, GI transit, permeability and serotonin (5-HT) content of GI tract were measured. iuGC treatment decreased small intestine size and decreased gut transit. However, iuGC had no impact on intestinal permeability. iuGC differentially impacts the structure and function of the GI tract, which leads to long-lasting alterations in the small intestine that may predispose subjects prone to disorders of the GI tract
Procriação Assistida em Mulheres Transplantadas: Experiência de uma Unidade de Medicina da Reprodução e Revisão da Literatura
Get PDFDiseases in end stage typically occur with hypothalamic-pituitary-ovarian axis disorders, with consequent anovulation and infertility. The solid organ transplantation increased survival of patients with end-stage organs disease and the vast majority of women improve their reproductive capacity after transplantation. Although adoption can always be a possibility, the transplanted infertile woman has the right to self-reproductive determination using assisted reproductive techniques. While it is known that pregnancies in transplantedwomen are at high risk, there is no evidence of differences in pregnancy outcome in pregnant transplanted subject to technical, compared with spontaneous pregnancies. The use of assisted reproductive techniques in transplanted women is a medical, ethical and psychosocial challenge, whose approach must be multidisciplinary, to ensure reproductive success without compromising the function of the transplanted organ or maternal health, allowing the birth of a healthy child. The literature remains scarce. Three clinical cases are presented
Acute Alithiasic Cholecystitis and Human Herpes Virus Type-6 Infection: First Case
Get PDFA three-year-old male child presented with erythematous maculopapular nonpruritic generalized rash, poor feeding, vomiting, and cramping generalized abdominal pain. He was previously healthy and there was no family history of immunologic or other diseases. On examination he was afebrile, hemodynamically stable, with painful palpation of the right upper quadrant and positive Murphy's sign. Laboratory tests revealed elevated inflammatory markers, elevated aminotransferase activity, and features of cholestasis. Abdominal ultrasound showed gallbladder wall thickening of 8 mm with a positive sonographic Murphy's sign, without gallstones or pericholecystic fluid. Acute Alithiasic Cholecystitis (AAC) was diagnosed. Tests for underlying infectious causes were negative except positive blood specimen for Human Herpes Virus Type-6 (HHV-6) by polymerase chain reaction. With supportive therapy the child became progressively less symptomatic with gradual improvement. The child was discharged on the sixth day, asymptomatic and with improved analytic values. Two months later he had IgM negative and IgG positive antibodies (1/160) for HHV-6, which confirmed the diagnosis of previous infection. In a six-month follow-up period he remains asymptomatic. To the best of our knowledge, this represents the first case of AAC associated with HHV-6 infection
Wake-up Stroke and Stroke within the Therapeutic Window for Thrombolysis Have Similar Clinical Severity, Imaging Characteristics, and Outcome
Get PDFBACKGROUND:
Wake-up stroke (WUS) represents 25% of all ischemic strokes. There is conflicting evidence concerning clinical severity, imaging characteristics, and outcome when WUS is compared with stroke of known time of onset. Our aim was to compare WUS patients with patients with ischemic stroke within the therapeutic window (STW) for thrombolysis.
METHODS:
This is a retrospective hospital-based study of all consecutive patients hospitalized for acute ischemic stroke during 2013. Patients with STW, WUS, and WUS with computed tomography (CT) at 3 hours or less after awakening (WUS≤3h) were selected for the study. The methods used include a review of clinical records, an independent quantification of early signs of ischemia on admission CT scan, and determination of functional outcome on follow-up.
RESULTS:
Of 554 patients evaluated, 190 had STW, 113 had WUS (20.4%), and 25 had WUS≤3h. Among all WUS patients, 33.6% did not have any other formal contraindication for thrombolysis besides undetermined time of onset. WUS patients had demographic characteristics, vascular risk factors, and clinical severity similar to STW patients. Mild or absent early signs of ischemia on admission CT in WUS≤3h patients were similar to those in STW patients when adjusted for clinical severity (odds ratio [OR] = .50, 95% confidence interval [CI]=.17-1.47). Favorable prognosis in WUS≤3h was similar to STW when adjusted for age, clinical severity, and thrombolysis (OR = .53, 95% CI=.09-3.14).
CONCLUSIONS:
This study strengthens the evidence that clinical and early imaging characteristics of WUS patients are similar to those of patients with stroke who are eligible for thrombolysis based on the time window criteria, and patients with WUS do not have a worse short outcome
Hotspot TERT promoter mutations are rare events in testicular germ cell tumors
Get PDFThe abnormal activation of telomerase, codified by the telomerase reverse transcriptase (TERT) gene, is related to one of cancer hallmarks. Hotspot somatic mutations in the promoter region of TERT, specifically the c.-124:C>T and c.-146:C>T, were recently identified in a range of human cancers and have been associated with a more aggressive behavior. Testicular germ cell tumors frequently exhibit a good prognosis; however, the development of refractory disease is still a clinical challenge. In this study, we aim to evaluate for the first time the presence of the hotspot telomerase reverse transcriptase gene promoter mutations in testicular germ cell tumors. A series of 150 testicular germ cell tumor cases and four germ cell tumor cell lines were evaluated by PCR followed by direct Sanger sequencing and correlated with patient's clinical pathological features. Additionally, we genotyped the telomerase reverse transcriptase gene promoter single nucleotide polymorphism rs2853669 (T>C) located at -245 position. We observed the presence of the TERT promoter mutation in four patients, one exhibited the c.-124:C>T and three the c.-146:C>T. No association between TERT mutation status and clinicopathological features could be identified. The analysis of the rs2853669 showed that variant C was present in 22.8 % of the cases. In conclusion, we showed for the first time that TERT promoter mutations occur in a small subset (~3 %) of testicular germ cell tumors
Lipid profile and persistent lipid abnormalities in diabetic patients – a retrospective study
No full textIntroduction
The purposes of this study are the characterization the lipid profile and the suitability of the statins treatment according to the cardiovascular profile. Also, in statin-treated patients, we aim to determine the prevalence of persistent lipid abnormalities.
Material and methods
Observational and retrospective study of outpatient diabetic patients of a hospital consultation, between Jun/2014 and Jun/2015.
Results
Of the 199 diabetic patients included, 58.6% were treated with statins and only 13.9% were treated with statin dose adequate for its cardiovascular profile. The patients without overt cardiovascular disease had higher total cholesterol (178.0 vs 157.5mg/dl; p=0.003), HDL-C (51.0 vs 43.0mg/dl; p=0.005), LDL-C (97.0 vs 79.0mg/dl; p=0.004) and non-HDL-C (127.0 vs 112.5mg/dl; p=0.04) and higher prevalence of patients who achieved HDL-C goals (64.3 vs 33.3%; p<0.0001). Almost half of statin-treated patients (46.8%) failed to achieve the LDL-C goals, 35.8% and 51.6% failed the triglycerides and HDL-C goals, respectively. Only 11.7% achieved all three goals. In statin-treated patients, we found a statistically significant difference between patients with and without cardiovascular disease on the prevalence of patients reaching the target HDL-C (68.1 vs 35.4%; p=0.001). There were no differences in the prevalence of patients who achieved LDL-C and triglyceride goals.
Discussion/conclusion
There is a suboptimal utilization of statins and a substantial percentage of diabetic patients that do not achieve the therapeutic goals. We emphasize the need for an effort to optimize the lipid profile of diabetics in order to contribute to reducing the prevalence of cardiovascular diseases in this population.info:eu-repo/semantics/publishedVersio