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1.
Int. j. morphol ; 38(2): 448-457, abr. 2020. tab, graf
Artigo em Inglês | LILACS (Américas) | ID: biblio-1056461

RESUMO

Inconsistent data are available on the relation between breast cancer, adiposity, body size and somatotype. The aim of our study was to compare anthropometric characteristics, body composition and somatotype between breast cancer patients and healthy controls. Study group consisted of 106 breast cancer patients while control group consisted of 100 healthy women who underwent 29 anthropometric measurements. Women with breast cancer expressed more male anthropometric features like higher stature (160.75±6.91 vs. 158.17±4.89 cm, p=0.020), shorter trunk (sitting height in premenopausal: 84.94±5.07 vs. 88.50±3.84 cm, p=0.001 and postmenopausal women: 81.96±6.08 vs. 85.19±3.36 cm, p=0.001), narrower hips (29.20±3.78 vs. 32.24±1.78 cm, p=0.000), higher biepicondylar diameter of humerus (premenopausal: 6.64±0.71 vs. 6.31±0.42 cm, p=0.012; postmenopausal: 6.95±0.63 vs. 6.54±0.49 cm, p=0.000), larger upper- and forearm as well as upper thigh circumferences followed by lower biceps and higher thigh skinfold thicknesses. They also had significantly lower endomorphy (premenopausal: 5.84±1.78 vs. 6.55±0.96, p=0.027; postmenopausal: 6.89±1.52 vs. 7.37±0.86, p=0.035) and significantly higher ectomorphy (premenopausal: 2.05±1.30 vs. 1.41±0.99, p=0.018; postmenopausal: 1.06±0.90 vs. 0.68±0.56, p=0.007), as well as higher mesomorphy only in postmenopausal women (6.10±2.04 vs. 5.37±1.34, p=0.022). Most represented somatotype among breast cancer patients was endomorph-mesomorph while the most healthy controls were mesomorphic endomorph. Android body type increases the risk of development of breast cancer. Indicators of skeletal dimensions, muscle volume and peripheral adiposity had better predictive value over markers of central and overall adiposity.


La información en la literatura es variable sobre la relación entre el cáncer de mama, la adiposidad, el tamaño corporal y somatotipo de las mujeres. El objetivo de este estudio fue comparar las características antropométricas, la composición corporal y el somatotipo entre pacientes con cáncer de mama y controles sanos. El grupo de estudio consistió en 106 pacientes con cáncer de mama y el grupo de control de 100 mujeres sanas que se sometieron a 29 mediciones antropométricas. Las mujeres con cáncer de mama tenían mayor cantidad características antropométricas masculinas, tal como una estatura más alta (160.75±6.91 vs. 158.17±4.89 cm, p = 0.020), tronco más corto (altura sentada en premenopáusica: 84.94±5.07 vs. 88.50±3.84 cm, p = 0.001 y mujeres posmenopáusicas: 81.96±6.08 vs. 85.19±3.36 cm, p = 0.001), caderas más estrechas (29.20±3.78 vs. 32.24±1.78 cm, p = 0.000), mayor diámetro biepicondilar del húmero (premenopáusico: 6.64±0.71 vs. 6.31 ±0.42 cm, p = 0.012; posmenopáusica: 6.95±0.63 vs. 6.54±0.49 cm, p = 0.000), mayor circunferencia del antebrazo y la parte superior del muslo, bíceps inferiores y mayor grosor del pliegue de la piel del muslo. Además se observó una endomorfia significativamente menor (premenopáusica: 5.84±1.78 vs. 6.55±0.96, p = 0.027; posmenopáusica: 6.89±1.52 vs. 7.37±0.86, p = 0.035) y una ectomorfia significativamente más alta (premenopáusica: 2.05±1.30 vs. 1.41 .990.99, p = 0.018; posmenopáusica: 1.06±0.90 vs. 0.68±0.56, p = 0.007), así como una mayor mesomorfia solo en mujeres posmenopáusicas (6.10±2.04 vs. 5.37±1.34, p = 0.022). El somatotipo más representado entre las pacientes con cáncer de mama fue el endomorfomesomorfo, mientras que los controles más sanos fueron el mesomórfico endomorfo. Las características del cuerpo tipo androide aumenta el riesgo de desarrollar cáncer de mama. Los indicadores de dimensiones esqueléticas, volumen muscular y adiposidad periférica tuvieron un mejor valor predictivo sobre los marcadores de adiposidad central y general.


Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Adulto Jovem , Somatotipos , Neoplasias da Mama/patologia , Antropometria , Composição Corporal , Estudos de Casos e Controles
2.
Rev. ADM ; 77(2): 62-69, mar.-abr. 2020. tab
Artigo em Espanhol | LILACS (Américas) | ID: biblio-1100144

RESUMO

Introducción: La obesidad sigue siendo considerada un serio problema de salud pública en el mundo. Aunque es bien sabido que esta condición puede aumentar el riesgo para desarrollar o agravar otras condiciones sistémicas; hoy en día, sigue siendo escasa la información que determine los niveles de asociación entre esta enfermedad sistémica con enfermedades orales como la periodontitis. Objetivo: El objetivo de este estudio fue medir la asociación de pacientes obesos con el desarrollo de periodontitis, así como hábitos de higiene oral. Material y métodos: Se realizó un estudio de casos y controles en 24 pacientes obesos y 24 pacientes sin obesidad. Las variables evaluadas fueron hábitos de higiene bucal, profundidad al sondeo, nivel de inserción clínica y nivel de inflamación gingival. Resultados: Los pacientes obesos tuvieron mayor riesgo para desarrollar bajas frecuencias de cepillado bucal diario (70.8%) y un incremento en la presencia de enfermedad periodontal (70.8%) comparado con los sujetos no obesos (25.0 y 58.3%, respectivamente), lo cual determinó asociaciones estadísticamente significativas (baja frecuencia de cepillado RM = 7.2, IC 95% = 2.0-26.1) y presencia de enfermedad periodontal (RM = 1.7, IC 95% = 0.5-5.7). Conclusiones: Es posible que la obesidad actúe como un factor que facilite la aparición de periodontitis por deficiencias en el cepillado dental diario (AU)


Introduction: Obesity is still considered a serious public health problem in the world. Although it is well known that this condition may increase the risk of developing or aggravating other systemic conditions; nowadays, the information that determines the levels of association between this systemic disease with oral diseases such as periodontitis still scarce. Objective: The objective of this study was to measure the association of obese patients with the development of periodontitis as well as oral hygiene habits. Material and methods: A case-control study was conducted in 24 obese patients and 24 patients without obesity. The variables evaluated were oral hygiene habits, depth of probing, clinical attachment level and gingival inflammation. Results: Obese patients had a higher risk of developing low frequencies of daily oral brushing (70.8%) and an increase in the presence of periodontal disease (70.8%) compared to non-obese subjects (25.0 and 58.3%, respectively) determining statistically significant associations (low frequency of brushing RM = 7.2, 95% CI = 2.0-26.1) and presence of periodontal disease (RM = 1.7, 95% CI = 0.5-5.7). Conclusions: It is possible that obesity acts as a factor that facilitates the presence of periodontitis due to deficiencies in daily toothbrushing (AU)


Assuntos
Humanos , Masculino , Adulto , Higiene Bucal , Periodontite , Obesidade , Escovação Dentária , Estudos de Casos e Controles , Análise Estatística , Fatores de Risco , México
3.
Int. arch. otorhinolaryngol. (Impr.) ; 24(1): 73-79, Jan.-Mar. 2020. tab
Artigo em Inglês | LILACS (Américas) | ID: biblio-1090558

RESUMO

Abstract Introduction Papillary and follicular thyroid carcinoma are common head and neck cancers. This cancer expresses a thyroid stimulating hormone (TSH) receptor that plays a role as a cancer stimulant substance. This hormone has a diagnostic value in the management of thyroid carcinoma. Objective The present study aimed to determine the difference in TSH levels between differentiated thyroid carcinoma and benign thyroid enlargement. Methods The present research design was a case-control study. The subjects were patients with thyroid enlargement who underwent thyroidectomies at the Dr. Sardjito General Hospital, Yogyakarta, Indonesia. Thyroid stimulating hormone levels were mea- sured before the thyroidectomies. The inclusion criteria for the case group were: 1) differentiated thyroid carcinoma, and 2) complete data; while the inclusion criteria for the control group were: 1) benign thyroid enlargement, and 2) complete data. The exclusion criteria for both groups were: 1) patients suffering from thyroid hormone disorders requiring therapy before thyroidectomy surgery, 2) patients receiving thyroid suppression therapy before the thyroidectomy was performed, and 3) patients suffering from severe chronic diseases such as renal insufficiency, and severe liver disease. Results There were 40 post-thyroidectomy case group patients and 40 post-thyroidect- omy control group patients. There were statistically significant differences in TSH levels between the groups with differentiated thyroid carcinoma and benign thyroid enlargement (p = 0.001; odds ratio [OR] = 8.42; 95% confidence interval [CI]: 3.19-36.50). Conclusion Based on these results, it can be concluded that there were significant differences in TSH levels between the groups with differentiated thyroid carcinoma and benign thyroid enlargement.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Neoplasias da Glândula Tireoide/diagnóstico , Tireotropina/sangue , Adenocarcinoma Folicular/diagnóstico , Câncer Papilífero da Tireoide/diagnóstico , Tireoidectomia , Neoplasias da Glândula Tireoide/cirurgia , Neoplasias da Glândula Tireoide/patologia , Biomarcadores Tumorais/sangue , Estudos de Casos e Controles , Adenocarcinoma Folicular/patologia , Diagnóstico Diferencial , Câncer Papilífero da Tireoide/patologia
4.
Int. arch. otorhinolaryngol. (Impr.) ; 24(1): 5-10, Jan.-Mar. 2020. tab
Artigo em Inglês | LILACS (Américas) | ID: biblio-1090555

RESUMO

Abstract Introduction The cochlea and the vestibular receptors are closely related in terms of anatomy and phylogeny. Patients with moderate to profound sensorineural hearing loss (MPSHL) should have their vestibular organ functions tested. Objective To evaluate the incidence of vestibular abnormalities in patients with MPSHL and to study the correlation between the etiology of hearing loss (HL) and a possible damage to the labyrinth. Methods A case-control retrospective study was performed. In the case group, 20 adults with MPSHL of known etiology were included. The control group was composed of 15 adults with normal hearing. The case group was divided into 4 subgroups based on the etiology (bacterial meningitis, virus, vascular disease, congenital). Cervical vestibular-evoked myogenic potentials (cVEMPs) were used to rate the saccular function and lower vestibular nerve. Results The study was performed in 70 ears, and it highlighted the presence of early biphasic P1-N1 complex in 29 (71.5%) out of 40 ears in the study group, and in all of the 30 ears in the control group (p = 0.001). Regarding the presence or absence of cVEMPs among the four subgroups of patients with MPSHL, the data were statistically significant (p < 0.001). The comparison between the latencies and amplitude of P1-N1 in case and control groups from other studies and in the four subgroups of cases in the present study did not detect statistically significant differences. Conclusion The present study demonstrates that patients with MPSHL have a high incidence of damage to the labyrinthine organs, and it increases the current knowledge about the etiopathogenesis of sensorineural HL, which is often of unknown nature.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Potenciais Evocados Miogênicos Vestibulares , Perda Auditiva Neurossensorial/diagnóstico , Perda Auditiva Neurossensorial/etiologia , Perda Auditiva Neurossensorial/fisiopatologia , Audiometria de Tons Puros , Doenças Vasculares/complicações , Viroses/complicações , Estudos de Casos e Controles , Doenças Vestibulares/diagnóstico , Doenças Vestibulares/epidemiologia , Incidência , Estudos Retrospectivos , Meningites Bacterianas/complicações , Perda Auditiva Neurossensorial/congênito , Doenças do Labirinto/diagnóstico , Doenças do Labirinto/fisiopatologia , Doenças do Labirinto/epidemiologia
5.
Rev. inf. cient ; 99(1): 12-19, ene.-feb. 2020. tab
Artigo em Espanhol | LILACS (Américas) | ID: biblio-1093925

RESUMO

RESUMEN Introducción: La sepsis y el choque séptico representan una de las complicaciones más graves durante el puerperio. Objetivos: Identificar los factores asociados a la presentación de sepsis puerperal en las pacientes que ingresaron en el Servicio de Cuidados Intensivos del Hospital General Docente "Dr. Agostinho Neto" durante el período 2017-2018. Método: Se realizó un estudio explicativo-observacional, longitudinal, retrospectivo y tipo caso control. Resultados: La endomiometritis fue la principal causa de ingreso con el 79,5 %. Las variables que se comportaron como predictoras de sepsis puerperal fueron la paridad-multípara, la edad gestacional menor de 37 semanas, el parto por cesárea, el antecedente de preclampsia, de sepsis vaginal y sepsis urinaria, la rotura prematura de membranas y el trabajo de parto mayor a 12 horas. Las variables que constituyeron factores de riesgo independiente para la morbilidad por sepsis grave fueron el exceso de base <- 4 (OR=11,9; IC 95 %; 3,9-35,3; p<0,05) la proteína C reactiva >8 mg/L (OR=9,67; IC 95 %; 5,9-14,24), la SatO2< 75 (OR=6,35; IC 95 %; 1,72-23,4), el anión gap >16 mmol/L (OR=5,88; IC 95 %; 3,86-8,97), el APACHE II y la escala SOFA (Sequential Organ Failure Assessment) al ingreso con el (OR=2,57; IC 95 %; 0,97-6,80) y el (OR=2,67; IC 95 %; 1,95-3,66), respectivamente. Conclusiones: La sepsis puerperal significa una problemática en el Hospital General Docente "Dr. Agostinho Neto" de Guantánamo, por lo que su reconocimiento y tratamiento adecuados son las claves para disminuir la morbilidad por esta causa.


ABSTRACT Introduction: Sepsis and septic shock represent one of the most serious complications during the puerperium. Objective: To identify the factors associated with the presentation of puerperal sepsis in patients admitted to the Intensive Care Service of the General Teaching Hospital "Dr. Agostinho Neto" during the 2017-2018 period. Method: An explanatory, observational, longitudinal, retrospective and case-control study was conducted. Results: Endomyometritis was the main cause of admission with 79.5%. The variables that behaved as predictors of puerperal sepsis were multiparous parity, gestational age under 37 weeks, delivery by caesarean section, history of preclampsia, vaginal sepsis and urinary sepsis, premature rupture of membranes and work of delivery greater than 12 hours. The variables that constituted independent risk factors for severe sepsis morbidity were base excess <- 4 (OR=11.9; 95% CI; 3.9-35.3; p <0.05) protein C reactive> 8 mg/L (OR=9.67; 95% CI; 5.9-14.24), SatO2 <75 (OR=6.35; 95% CI; 1.72-23.4), the gap anion> 16 mmol/L (OR=5.88; 95% CI; 3.86-8.97), APACHE II and the SOFA (Sequential Organ Failure Assessment) scale upon admission with (OR=2, 57; 95% CI; 0.97-6.80) and (OR=2.67; 95% CI; 1.95-3.66), respectively. Conclusions: Puerperal sepsis means a problem at the "Dr. Agostinho Neto" General Teaching Hospital in Guantanamo, so that its recognition and adequate treatment are the keys to reducing morbidity from this cause.


RESUMO Introdução: Sepse e choque séptico representam uma das complicações mais graves durante o puerpério. Objetivo: Identificar os fatores associados à apresentação de sepse puerperal em pacientes internados no Serviço de Terapia Intensiva do Hospital Geral de Ensino "Dr. Agostinho Neto" no período 2017-2018. Método: Estudo explicativo, observacional, longitudinal, retrospectivo e caso-controle. Resultados: A endomiometrite foi a principal causa de admissão com 79,5%. As variáveis que se comportaram como preditores de sepse puerperal foram: paridade multípara, idade gestacional abaixo de 37 semanas, parto por cesariana, história de pré-eclâmpsia, sepse vaginal e sepse urinária, ruptura prematura de membranas e trabalho de parto. entrega superior a 12 horas. As variáveis que constituíram fatores de risco independentes para morbidade grave por sepse foram excesso de base <- 4 (OR=11,9; IC 95%; 3,9-35,3; p<0,05) proteína C reativo> 8 mg/L (OR=9,67; IC 95%; 5,9-14,24), SatO2 <75 (OR=6,35; IC 95%; 1,72-23,4), o ânion de gap> 16 mmol/L (OR=5,88; IC 95%; 3,86-8,97), APACHE II e SOFA (Sequential Organ Failure Assessment) na admissão com (OR=2, 57; IC95%; 0,97-6,80) e (OR=2,67; IC95%; 1,95-3,66), respectivamente. Conclusões: Sepse puerperal representa um problema no Hospital Geral Dr. Agostinho Neto, em Guantánamo, para que seu reconhecimento e tratamento adequado sejam as chaves para reduzir a morbidade por essa causa.


Assuntos
Humanos , Feminino , Infecção Puerperal/etiologia , Fatores de Risco , Estudos de Casos e Controles , Estudos Retrospectivos , Estudos Longitudinais , Estudo Observacional
6.
Arch. argent. pediatr ; 118(1): 4-10, 2020-02-00. tab
Artigo em Inglês, Espanhol | LILACS (Américas), BINACIS | ID: biblio-1095269

RESUMO

Introducción. El maltrato infantil es causa frecuente de hospitalización en países en desarrollo. Los niños que sufren algún tipo de abuso físico o psicológico pueden desarrollar problemas de adaptación social. Este estudio analiza los factores de riesgo asociados con el síndrome de maltrato infantil en niños hospitalizados en el Servicio de Urgencias. Población y métodos. Estudio de casos y controles de niños con y sin maltrato infantil en una proporción 1:1, desde enero de 2015 a diciembre de 2016. Se analizaron los factores de riesgo más relevantes; se consideró estadísticamente significativo si la P ≤ 0,05. Resultados. Se incluyeron 148 niños con maltrato y 148 sin maltrato. El maltrato fetal fue el más frecuente, seguido del abandono. El agresor, en la mayoría de los casos, fue un familiar o algún conocido del niño. Ser madre adolescente (oddsratio ajustado [ORa] 3,19; intervalo de confianza [IC] 95 %: 1,49-6,80), baja educación (ORa 4,70; IC 95 %: 2,33-9,45), ingresos económicos bajos (ORa 2,02; IC 95 %: 1,16-3,5), uso de drogas ilegales (ORa 15,32; IC 95 %: 6,22-37,7), niño con discapacidad (ORa 8,58; IC 95 %: 2,76-26,6) y menores de 2 años (ORa 2,08; IC 95 %: 1,20- 3,63) fueron los factores de mayor riesgo para maltrato infantil. Conclusión. Madres adolescentes con bajo nivel socioeconómico tienen mayor riesgo por parte del cuidador. La discapacidad es un factor de riesgo que se incrementa al doble en el análisis multivariado cuando se asocia madre adolescente y consumo de drogas ilegales


Introduction. Child maltreatment is a common cause of hospitalization in developing countries. Children who suffer some type of physical or psychological abuse may develop social adaptation problems. This study analyzed the risk factors associated with child maltreatment syndrome in children admitted to the Emergency Department. Population and methods. This was a case-control study of children who suffered maltreatment and controls at a 1:1 ratio conducted between January 2015 and December 2016. The most relevant risk factors were analyzed; a p value ≤ 0.05 was considered statistically significant. Results. In total, 148 children who suffered maltreatment and 148 controls were included. Fetal abuse was the most common problem, followed by neglect. In most cases, the abuser was a relative or acquaintance of the child. Being a teenage mother (adjusted odds ratio [aOR]: 3.19; 95 % confidence interval [CI]: 1.49-6.80), a low level of education (aOR: 4.70; 95 % CI: 2.33-9.45), a low income (aOR: 2.02; 95 % CI: 1.16-3.5), illegal drug use (aOR: 15.32; 95 % CI: 6.22-37.7), a child with disability (aOR: 8.58; 95 % CI: 2.76-26.6), and age younger than 2 years (aOR: 2.08; 95% CI: 1.20-3.63) were the highest risk factors for child maltreatment. Conclusion. Teenage mothers with a low socioeconomic level have the higher risk for abuse from a caregiver. Disability is a risk factor that doubles in the multivariate analysis when associated with teenage mothers.


Assuntos
Humanos , Masculino , Feminino , Gravidez , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Maus-Tratos Infantis/etnologia , Maus-Tratos Infantis/estatística & dados numéricos , Fatores de Risco , Classe Social , Estudos de Casos e Controles , Estudos Prospectivos , Transtornos Relacionados ao Uso de Substâncias , Serviços Médicos de Emergência , México
7.
Arch. argent. pediatr ; 118(1): 38-43, 2020-02-00. tab
Artigo em Inglês, Espanhol | LILACS (Américas), BINACIS | ID: biblio-1095346

RESUMO

Introducción. El asma es una enfermedad inflamatoria crónica con alta prevalencia en pacientes pediátricos. Existen resultados contradictorios respecto al efecto de esta enfermedad en los índices de caries dental. El objetivo del estudio fue determinar la prevalencia de caries dental en pacientes pediátricos asmáticos con medicación inhalatoria. Población y métodos. Estudio de casos y controles cuya muestra estuvo conformada por pacientes pediátricos que acudieron al Centro Médico Naval "Cirujano Mayor Santiago Távara" de diciembre de 2014 a marzo de 2015. Se dividieron en dos grupos: el primero (casos), integrado por pacientes asmáticos que utilizaban inhaladores en su tratamiento; el segundo (controles), por pacientes sanos del mismo nosocomio. Se realizó una evaluación médica para determinar tipo, tiempo y frecuencia del tratamiento y un examen oral para determinar la prevalencia de caries dental y el índice de dientes cariados, perdidos y obturados (CPOD). Resultados. Se encontró que la prevalencia de caries dental en el grupo control fue del 34,2 %, mientras, en el grupo casos, fue del 28,3 % (p = 0,094). Con respecto al índice de caries dental, el grupo control presentó CPOD de 4,73 ± 0,32, y el grupo casos, de 3,98 ± 0,31 (p = 0,08). Sin embargo, se evidenció que, a mayor tiempo de tratamiento con los inhaladores, el índice CPOD aumentaba significativamente (p = 0,04).Conclusiones. La medicación inhalatoria no incrementa la prevalencia de caries dental en pacientes pediátricos asmáticos. Sin embargo, existe una relación directa entre la duración del tratamiento y la prevalencia de caries dental


Introduction. Asthma is a chronic inflammatory disease that is highly prevalent among pediatric patients. The results about the effect of asthma on the rate of dental caries are contradictory. The objective of this study was to determine the prevalence of dental caries in asthma pediatric patients using inhaled drugs. Population and methods. Case-control study in a sample made up of pediatric patients who attended Centro Médico Naval "Cirujano Mayor Santiago Távara" between December 2014 and March 2015. Patients were divided into two groups: group A (cases) included asthma patients using inhalers as part of their treatment; group B (controls), healthy subjects who attended the same facility. A medical examination was done to determine the type, time, and frequency of treatment and an oral exam, to establish the prevalence of dental caries and the decayed, missing, and filled teeth (DMFT) index. Results. The prevalence of dental caries was 34.2 % in the control group and 28.3 % in the case group (p = 0.094). In relation to the rate of dental caries, the DMFT index in the control group was 4.73 ± 0.32, and 3.98 ± 0.31 in the case group (p = 0.08). However, it was evidenced that a longer duration of inhaler use led to a significantly higher DMFT index (p = 0.04).Conclusions. Inhaled drugs do not increase the prevalence of dental caries in asthma pediatric patients. However, there is a direct relationship between treatment duration and the prevalence of dental caries.


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adolescente , Asma/tratamento farmacológico , Suscetibilidade à Cárie Dentária , Inaladores Dosimetrados , Inaladores de Pó Seco , Broncodilatadores/administração & dosagem , Estudos de Casos e Controles , Epidemiologia Descritiva , Prevalência , Perda de Dente , Corticosteroides/administração & dosagem , Assistência Odontológica para Crianças
8.
Arch. Clin. Psychiatry (Impr.) ; 47(1): 19-24, Jan.-Feb. 2020. tab, graf
Artigo em Inglês | LILACS (Américas) | ID: biblio-1088743

RESUMO

Abstract Background Sleep disorders are common in psychiatric diseases. Panic disorder (PD) and generalized anxiety disorder (GAD) are two major anxiety disorders that are associated with sleep disorders. Objective We hypothesized that poor sleep quality continues in PD and GAD during remission. Therefore, in this study we aimed to compare the sleep quality of patients with PD and GAD to that of healthy controls. Methods The study included patients with PD (n = 42) and GAD (n = 40) who had been in remission for at least 3 months and healthy control volunteers (n = 45). The patients were administered the Pittsburgh Sleep Quality Index (PSQI), Beck Anxiety Inventory (BAI), and Beck Depression Inventory (BDI). Results The total PSQI scores of the GAD group were significantly increased in comparison to those of the PD (p = 0.009) and control (p < 0.001) groups. The rate of poor sleep quality in GAD during remission (77.5%) was greater than that of the PD (47.6%) and control (51.1%) groups (p = 0.011). Discussion GAD is a chronic and recurrent disease. In this study, it was found that the deterioration in sleep quality of patients with GAD may continue during remission. In the follow-up and treatment of patients, it is appropriate to question about sleep symptoms and to plan interventions according to these symptoms.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Transtornos de Ansiedade/complicações , Transtornos do Sono-Vigília/etiologia , Qualidade do Solo , Transtorno de Pânico/complicações , Transtornos de Ansiedade/tratamento farmacológico , Tabagismo/psicologia , Estudos de Casos e Controles , Estudos Transversais , Transtorno de Pânico/tratamento farmacológico , Inibidores de Captação de Serotonina/uso terapêutico , Intervalo Livre de Doença , Inibidores da Recaptação de Serotonina e Norepinefrina/uso terapêutico , Questionário de Saúde do Paciente
9.
Braz. J. Psychiatry (São Paulo, 1999, Impr.) ; 42(1): 27-32, Jan.-Feb. 2020. tab, graf
Artigo em Inglês | LILACS (Américas) | ID: biblio-1055350

RESUMO

Objective: Patients with schizophrenia have visual processing impairments. The main findings from the literature indicate that these deficits may be related to differences in paradigms, medications, and illness duration. This study is part of a large-scale study investigating visual sensitivity in schizophrenia. Here we aimed to investigate the combined effects of illness duration and antipsychotic use on contrast sensitivity function. Methods: Data were collected from 50 healthy controls and 50 outpatients with schizophrenia (classified according to illness duration and medication type) aged 20-45 years old. The contrast sensitivity function was measured for spatial frequencies ranging from 0.2 to 20 cycles per degree using linear sine-wave gratings. Results: Patients with an illness duration > 5 years had more pronounced deficits. Differences in the combined effects of illness duration and antipsychotic use were marked in patients on typical antipsychotics who had been ill > 10 years. No significant differences were found between typical and atypical antipsychotics in patients with an illness duration < 5 years. Conclusion: Visual impairment was related to both long illness duration and medication type. These results should be tested in further studies to investigate pharmacological mechanisms.


Assuntos
Humanos , Masculino , Feminino , Adulto , Adulto Jovem , Esquizofrenia/tratamento farmacológico , Antipsicóticos/efeitos adversos , Transtornos da Visão/induzido quimicamente , Escalas de Graduação Psiquiátrica , Esquizofrenia/complicações , Fatores de Tempo , Visão Ocular/efeitos dos fármacos , Sensibilidades de Contraste/efeitos dos fármacos , Estudos de Casos e Controles , Clorpromazina/efeitos adversos , Resultado do Tratamento , Pessoa de Meia-Idade
10.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-816628

RESUMO

Since parathyroid hormone (PTH) was first isolated and its gene (PTH) was sequenced, only eight PTH mutations have been discovered. The C18R mutation in PTH, discovered in 1990, was the first to be reported. This autosomal dominant mutation induces endoplasmic reticulum stress and subsequent apoptosis in parathyroid cells. The next mutation, which was reported in 1992, is associated with exon skipping. The substitution of G with C in the first nucleotide of the second intron results in the exclusion of the second exon; since this exon includes the initiation codon, translation initiation is prevented. An S23P mutation and an S23X mutation at the same residue were reported in 1999 and 2012, respectively. Both mutations resulted in hypoparathyroidism. In 2008, a somatic R83X mutation was detected in a parathyroid adenoma tissue sample collected from a patient with hyperparathyroidism. In 2013, a heterozygous p.Met1_Asp6del mutation was incidentally discovered in a case-control study. Two years later, the R56C mutation was reported; this is the only reported hypoparathyroidism-causing mutation in the mature bioactive part of PTH. In 2017, another heterozygous mutation, M14K, was detected. The discovery of these eight mutations in the PTH gene has provided insights into its function and broadened our understanding of the molecular mechanisms underlying mutation progression. Further attempts to detect other such mutations will help elucidate the functions of PTH in a more sophisticated manner.


Assuntos
Apoptose , Estudos de Casos e Controles , Códon de Iniciação , Estresse do Retículo Endoplasmático , Éxons , Humanos , Hiperparatireoidismo , Hipoparatireoidismo , Íntrons , Doenças das Paratireoides , Glândulas Paratireoides , Hormônio Paratireóideo , Neoplasias das Paratireoides
11.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-782205

RESUMO

OBJECTIVE: Recently, the association between periodontal diseases and polycystic ovary syndrome (PCOS) has been established, and it has been revealed that visfatin levels increase in chronic periodontitis (CP) and PCOS. However, there was no study comparing the mean visfatin levels between advanced CP and PCOS. Therefore, the probable role of visfatin linking these diseases remains unknown, and this study was conducted to address this gap.METHODS: In this age- and weight-matched case-control study (cases with PCOS disease and controls without it), 110 female participants were divided into 4 groups based on clinical findings. The 1st group participants had both PCOS and advanced CP (n=30), 2nd group participants had only PCOS (n=25), 3rd group participants had only advanced CP (n=23), and 4th group comprised of healthy participants (n=32). Enzyme-linked immunosorbent assay was used to investigate visfatin levels in the gingival crevicular fluid (GCF). Data were collected and analyzed using Stata software (version 11).RESULTS: The results revealed the significant effect of both PCOS and advanced CP on visfatin levels in the GCF (P < 0.05).CONCLUSION: According to the results of this study, the visfatin level in the GCF could be the probable link of association between PCOS and advanced CP.


Assuntos
Estudos de Casos e Controles , Periodontite Crônica , Ensaio de Imunoadsorção Enzimática , Feminino , Líquido do Sulco Gengival , Voluntários Saudáveis , Humanos , Nicotinamida Fosforribosiltransferase , Doenças Periodontais , Síndrome do Ovário Policístico
12.
Annals of Dermatology ; : 21-30, 2020.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-782144

RESUMO

BACKGROUND: Associations between acne and gastrointestinal comorbidities suggest that microbial dysbiosis and intestinal permeability may promote inflammatory acne, a condition often managed with oral antibiotics.OBJECTIVE: We performed a case-control study to investigate the skin and gut microbiota in 8 acne patients before and after receiving oral minocycline compared to controls matched by age ±5 years, sex, and race.METHODS: DNA was extracted from stool samples and facial skin swabs. Sequencing of the V3V4 region of the bacterial 16S rRNA gene was performed using Illumina MiSeq and analyzed using QIIME/MetaStats 2.0 software.RESULTS: Acne patients included 7 female and 1 male, ages 20~32. Shannon diversity was not significantly different between the skin (p=0.153) or gut (p < 0.999) microbiota of acne patients before and after antibiotics. The gut microbiota in pre-antibiotic acne patients compared to acne-free controls was depleted in probiotics Lactobacillus iners (p=0.001), Lactobacillus zeae (p=0.001), and Bifidobacterium animalis (p=0.026). After antibiotics, the gut microbiota of acne patients was depleted in Lactobacillus salivarius (p=0.001), Bifidobacterium adolescentis (p=0.002), Bifidobacterium pseudolongum (p=0.010), and Bifidobacterium breve (p=0.042), while the skin microbiota was enriched in probiotics Bifidobacterium longum (p=0.028) and Leuconostoc mesenteroides (p=0.029) and depleted in Staphylococcus epidermidis (p=0.009) and Prevotella nigrescens (p=0.028). At the phylum level, significant enrichment of Bacteroidetes in stool of acne patients following antibiotic treatment (p=0.033) led to a decreased Firmicutes to Bacteroidetes ratio.CONCLUSION: Minocycline produces significant derangements in the microbiota of the skin and gut, including many probiotic species, highlighting the potential for more targeted antimicrobial treatments for acne.


Assuntos
Acne Vulgar , Antibacterianos , Bacteroidetes , Bifidobacterium , Estudos de Casos e Controles , Comorbidade , Grupos de Populações Continentais , DNA , Disbiose , Feminino , Firmicutes , Microbioma Gastrointestinal , Trato Gastrointestinal , Genes de RNAr , Humanos , Lactobacillus , Leuconostoc , Masculino , Microbiota , Minociclina , Permeabilidade , Prevotella nigrescens , Probióticos , Propionibacterium , Pele , Staphylococcus epidermidis , Sulfaleno
13.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-782096

RESUMO

OBJECTIVE: Bevacizumab maintenance following platinum-based chemotherapy is an effective treatment for epithelial ovarian cancer (EOC), both in primary and recurrent disease. Our aim was to identify criteria to select elderly patients who can safely benefit from bevacizumab addition.METHODS: This is a case-control study on patients with primary or recurrent EOC who received platinum-based chemotherapy plus bevacizumab, between January 2015 and December 2016. Patient characteristics, treatment details and adverse events were reviewed and analyzed in 2 settings: younger (1.1 g/dL, estimated glomerular filtration rate (eGFR) ≤60 mL/min, ≥3 comorbidities were independently associated with a higher severe toxicity.CONCLUSIONS: Elderly patients with EOC can safely be treated with bevacizumab; factors other than age, as higher creatinine serum levels, eGFR and number of comorbidities should be considered to better estimate bevacizumab-related toxicity risk.


Assuntos
Idoso , Bevacizumab , Estudos de Casos e Controles , Comorbidade , Creatinina , Diagnóstico , Tratamento Farmacológico , Feminino , Taxa de Filtração Glomerular , Humanos , Modelos Logísticos , Neoplasias Ovarianas
14.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wprim-781698

RESUMO

OBJECTIVE@#To study the association of related maternal factors with the susceptibility to congenital hypothyroidism (CH) in neonates.@*METHODS@#A case-control study was designed. The neonates who were diagnosed with CH in Neonatal Screening Center of Henan Province from January 1, 2016 to December 31, 2017 were enrolled as cases. Healthy neonates, matched for sex and age were enrolled as controls. A conditional logistic regression analysis and additive and multiplicative interaction analyses were used to identify the risk factors for susceptibility to CH.@*RESULTS@#A total of 2 771 661 neonates were screened during this period, among whom 1 494 neonates were diagnosed with CH, with a crude incidence rate of 53.9/100 000. A total of 843 pairs of the cases and the controls completed the telephone survey and provided qualified data. The conditional logistic regression analysis showed that an older maternal age at delivery, a low educational level in mothers, living in the rural area, a family history of thyroid diseases, histories of exposure to formaldehyde during pregnancy, exposure to radiation during pregnancy, and medication during pregnancy, were risk factors for CH (P<0.05), while low maternal age at delivery and progesterone intake during pregnancy were protective factors against CH (P<0.05).@*CONCLUSIONS@#An older maternal age at delivery, a low educational level in mothers, living in the rural area, a family history of thyroid diseases, and histories of exposure to formaldehyde during pregnancy, exposure to radiation during pregnancy and medication during pregnancy may increase the susceptibility to CH in neonates.


Assuntos
Estudos de Casos e Controles , Hipotireoidismo Congênito , Feminino , Humanos , Recém-Nascido , Idade Materna , Triagem Neonatal , Gravidez , Fatores de Risco
15.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wprim-781289

RESUMO

OBJECTIVE@#To assess the association of JAG2 gene single nucleotide polymorphisms with the occurrence of nonsyndromic cleft lip with or without cleft palate (NSCLP) among northwest Chinese population.@*METHODS@#A case-control study was carried out on 301 NSCLP patients and 304 healthy controls. An iMLDR(TM) genotyping technique was used to detect three single nucleotide polymorphisms (SNPs) [rs741859 (T/C), rs11621316 (A/G) and rs1057744(C/T)] of the JAG2 gene. Allelic and genotypic frequencies and haplotypic distribution among the two groups were compared.@*RESULTS@#A significant difference was found in the frequency of C and T alleles for rs741859 between the two groups. The CT genotype of rs741859 could significantly reduce the risk for NSCLP to 65% (P 0.8), whose distribution difference between the two groups was not statistically significant (P> 0.05).@*CONCLUSION@#The CT genotype of the JAG2 gene rs741859 may confer a protective effect for NSCLP among northwest Chinese population.


Assuntos
Estudos de Casos e Controles , China , Fenda Labial , Genética , Fissura Palatina , Genética , Frequência do Gene , Genótipo , Humanos , Proteína Jagged-2 , Genética , Polimorfismo de Nucleotídeo Único
17.
Artigo em Português | LILACS (Américas) | ID: biblio-1088518

RESUMO

Resumo Objetivo Identificar prevalência e fatores associados à lesão renal aguda em pacientes clínicos intensivos, e compará-los com um grupo controle; analisar se a coexistência de fatores constitui preditor de risco para o desenvolvimento de lesão renal aguda. Métodos Estudo caso-controle, com abordagem quantitativa, realizado em unidade de terapia intensiva geral adulto do interior de São Paulo, Brasil, com 205 pacientes que desenvolveram lesão renal aguda e o mesmo número de controles, durante os anos de 2014 e 2015. Coleta de dados realizada mediante levantamento dos registros de prontuário. Relações foram estatisticamente significativas se p<0,05. Resultados A prevalência de lesão renal aguda foi de 7,5% e os principais fatores associados foram: hipertensão arterial (p=0,004; OR=1,9615; IC=1,0491-3,6645); hipovolemia (p=0,006; OR=5,6071; IC=1,6382-19,1854); insuficiência cardíaca (p=0,003; OR=5,3123; IC=1,7521-16,1051); noradrenalina (p<0,0001; OR=9,4913; IC=4,4824-20,0981); dopamina (p=0,0009; OR=3,5212; IC=1,6701-7,4242); dobutamina (p=0,0131; OR=5,2612; IC=1,4172-19,5323); e antibióticos simultâneos (p<0,0001; OR=3,7881; IC=2,0253-7,0884). A coexistência de mais de três fatores de risco foi estatisticamente significante para lesão renal aguda (p<0,0001; OR=5,0074; IC=2,5601-9,7936). Conclusão A lesão renal aguda é um evento multifatorial que se associou à doença de base, às complicações decorrentes da gravidade dos participantes e à utilização de medicamentos nefrotóxicos. Ter três ou mais fatores de risco aumentou as chances para o desenvolvimento da doença.


Resumen Objetivo Identificar prevalencia y factores asociados a la lesión renal aguda en pacientes clínicos intensivos y compararlos con un grupo de control; analizar si la coexistencia de factores constituye predictor de riesgo para el desarrollo de lesión renal aguda. Métodos Estudio caso-control, con enfoque cuantitativo, realizado en unidad de cuidados intensivos general adulto del interior del estado de São Paulo, Brasil, con 205 pacientes que desarrollaron lesión renal aguda y el mismo número de controles, durante los años 2014 y 2015. Recolección de datos realizada mediante recopilación de registros de historia clínica. Relaciones fueron estadísticamente significativas si p<0,05. Resultados La prevalencia de lesión renal aguda fue de 7,5% y los principales factores asociados fueron: hipertensión arterial (p=0,004; OR=1,9615; IC=1,0491-3,6645); hipovolemia (p=0,006; OR=5,6071; IC=1,6382-19,1854); insuficiencia cardíaca (p=0,003; OR=5,3123; IC=1,7521-16,1051); noradrenalina (p<0,0001; OR=9,4913; IC=4,4824-20,0981); dopamina (p=0,0009; OR=3,5212; IC=1,6701-7,4242); dobutamina (p=0,0131; OR=5,2612; IC=1,4172-19,5323); y antibióticos simultáneos (p<0,0001; OR=3,7881; IC=2,0253-7,0884). La coexistencia de más de tres factores de riesgo fue estadísticamente significante para la lesión renal aguda (p<0,0001; OR=5,0074; IC=2,5601-9,7936). Conclusión La lesión renal aguda es un evento multifactorial que se asoció a la enfermedad de base, a las complicaciones resultantes de la gravedad de los participantes y a la utilización de medicamentos nefrotóxicos. Tener tres o más factores de riesgo aumentó las chances de desarrollo de la enfermedad.


Abstract Objective Identify the prevalence and associated factors of acute renal injury in intensive clinical patients and compare them with a control group; analyze if the coexistence of factors serves as a predictor for the risk of developing acute renal injury. Method Case-control study with a quantitative approach, developed at a general adult intensive care unity in the interior of São Paulo, Brazil, involving 205 patients who developed acute renal injury and the same number of controls, during 2014 and 2015. Data were collected through a survey of patient file records. Relationships were statistically significant if p<0.05. Results The prevalence of acute renal injury was 7.5% and the main associated factors were: arterial hypertension (p=0.004; OR=1.9615; CI=1.0491-3.6645); hypovolemia (p=0.006; OR=5.6071; CI=1.6382-19.1854); heart failure (p=0.003; OR=5.3123; CI=1.7521-16.1051); noradrenaline (p<0.0001; OR=9.4913; CI=4.4824-20.0981); dopamine (p=0.0009; OR=3.5212; CI=1.6701-7.4242); dobutamine (p=0.0131; OR=5.2612; CI=1.4172-19.5323); and simultaneous antibiotics (p<0.0001; OR=3.7881; CI=2.0253-7.0884). The coexistence of more than three risk factors was statistically significant for acute renal injury (p<0.0001; OR=5.0074; CI=2.5601-9.7936). Conclusion Acute renal injury is a multifactorial event associated with the baseline disease, the complications deriving from the severity of the patients' condition and the use of nephrotoxic drugs. Having three or more risk factors increased the chances for the development of the disease.


Assuntos
Humanos , Masculino , Feminino , Idoso , Cuidados Críticos , Lesão Renal Aguda/epidemiologia , Pacientes Internados , Unidades de Terapia Intensiva , Estudos de Casos e Controles , Estudos de Avaliação como Assunto , Registros Médicos , Estudos Retrospectivos , Fatores de Risco
18.
Prensa méd. argent ; 105(11): 775-782, dic2019. graf
Artigo em Inglês | LILACS (Américas), BINACIS | ID: biblio-1049768

RESUMO

Antecedentes: En la cirugía video-laparoscópica, aparecieron nuevas complicaciones, donde se incluyen las relacionadas con las eventraciones de los orificios de los trocares (EOT). Objetivos: Observar la aparición de hernias a través de los orificios de los trocares en la cirugía video laparoscópica. Diseño: Prospectivo, protocolizado y cooperativo Lugar de aplicación: Servicio de Guardia del HNC. Clínica Privada Caraffa. Servicio de Cirugía General "Pablo Luis Mirizzi". HNC Material y Método: Entre diciembre de 2005 y diciembre del 2018 hemos intervenido quirúrgicamente 81 pacientes con EOT. 49 eran del sexo femenino y los 32 restantes del masculino con un promedio de 49, 05 de edad (rango: 25-85 años). En un primer grupo (no complicados), 62 de 73 pacientes presentaban tumor y dolor en la región umbilical y peri umbilical y los otros 11 con dolor y tumor en región epigástrica. Los 8 pacientes restantes que conforman el grupo II (complicados), ingresaron por un cuadro abdominal oclusivo. Resultados: En los pacientes no complicados, se decidió la reparación de la eventración mediante la utilización de una malla de polipropileno. Asimismo, en dos complicados se utilizó este procedimiento. Por otro lado, en el grupo complicado, una paciente presentaba una peritonitis fecal, donde se realizó una diversión de los cabos. En otro paciente, se realizó una resección intestinal. En los otros cuatro restantes, solamente se comprobó una necrosis de epiplón, el cual fue resecado. Conclusiones: A través de los años, con el incremento de los procedimientos laparoscópicos, ha comenzado a observarse un llamativo número de EOT.


Background: in surgery video-laparoscopic, appeared new complications, including those related to the port site incisional hernia (PIH). Objectives: Observe the emergence of hernias through the holes of trocars in the video laparoscopic surgery. Design: Prospective, cooperative and protocoled. Place of application: Emergency Room of the HNC. Private Clinic Caraffa. General Surgery Service. "Pablo Luis Mirizzi". HNC. Methods: Between December 2005 and December of 2018 we have intervened surgically 81 patients with PIH. 49 were female and the 32 remaining of the male with an average of 49.05 of age (range: 25-85 years). In the first group (No complicated), 62 of 73 patients showed tumour and pain in the umbilical region and perumbilical and the other 11 with pain and tumour in epigastric region. The 8 remaining patients comprising Group II (Complicated), were by an occlusive abdominal picture. Results: In uncomplicated patients (Group I), it was decided to repair of PIH using a polypropylene mesh. In addition, this procedure was used in two complicated. On the other hand, the complicated group (Group II), a patient presented a faecal peritonitis, which was a fun of los capes. In another patient, was a bowel Resection. The other four remaining, only found a necrosis of omentum, which was resected. Conclusions: Through the years, with the increase in laparoscopic procedures, it has begun to observe a striking number of PIH.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Instrumentos Cirúrgicos , Telas Cirúrgicas , Estudos de Casos e Controles , Laparoscopia , Cirurgia Vídeoassistida , Hérnia Abdominal/complicações
19.
Prensa méd. argent ; 105(11): 827-835, dic2019. tab
Artigo em Inglês | LILACS (Américas), BINACIS | ID: biblio-1049981

RESUMO

The metabolic syndrome (MetS) or insulin resistance syndrome is widespread and multi-factorial disorder. This article aims to assess and observe samples with the MetS to start efforts to take the proper treatments to minimize the risk of cardiovascular diseases. Additionally, we evaluate the association of Helicobacter pylori (H. Pylori) Ab tests with MetS. To meet this goal, 350 reviewers of K1 Hospital are participated in this work for six months from October 2016 to March 2017. The patients (N=350) are divided into two groups, a group subjects with MetS (N=109), whereas the latter is without MetS (N=241). A venous blood sample is taken after 8 hours of fasting to measure fasting blood glucose, H. Pylori Ab test and other required biochemical assays. Additionally, blood pressure (BP), Body Mass Index (BMI) (i.e. weight and height), and waist circumference are measured. The assays revealed that the frequency of MetS is 31.1% as per the modified National Cholesterol Education Program Adult Treatment Panel III (NCEP: ATPIII) criteria. Furthermore, a statistically significant age (p=0.02) corresponded higher rate of MetS cases is larger than 40 years old (i.e. 69%). Moreover, BMI recorded as (27.6 ± 4.4 vs 31.4 ± 4.5, p <0.001), height (169 ± 8.4 vs 168.1 ± 8.5, p ≤ 0.11), weight (78.8 ± 12.3 vs 88.6 ± 13.2, p<0.01) and waist circumference (83.3 ± 16.1 vs 96.3 ± 11.6, p<0.001). Besides, BP showed positively correlation with systolic (120.3 ± 10.6 vs 130.6 ± 10.8, p<0.04) and diastolic (70.9 ± 0.9 vs 80.8 ± 10, p<0.01). The biochemical assays for employees with and without MetS are mean values of fasting Serum glucose (5.3 ± 1.4 vs 7.5 ± 3.2, p ≤ 0.001). The highest average total cholesterol recorded as (4.3 ± 1.3 vs 4.9 ± 1.3, p ≤ 0.001), serum triglyceride (2 ± 1.5 vs 2.8 ± 1.2, p ≤ 0.001) and lower HDL levels (1.2 ± 0.5 vs 0.8 ± 0.1, p ≤ 0.001). Accordingly, the results showed that H. Pylori infection is associated significantly with metabolic syndrome. In consequence, the outcome demonstrated high rates of obesity and overweight in MetS cases


Assuntos
Humanos , Doenças Cardiovasculares/terapia , Estudos de Casos e Controles , Helicobacter pylori , Infecções por Helicobacter/terapia , Técnicas de Laboratório Clínico , Síndrome Metabólica/terapia , Diabetes Mellitus Tipo 2/terapia
20.
J. bras. nefrol ; 41(4): 509-517, Out.-Dec. 2019. tab, graf
Artigo em Inglês | LILACS (Américas) | ID: biblio-1056618

RESUMO

Abstract Introduction: Although microalbuminuria remains the gold standard for early detection of diabetic nephropathy (DN), it is not a sufficiently accurate predictor of DN risk. Thus, new biomarkers that would help to predict DN risk earlier and possibly prevent the occurrence of end-stage kidney disease are being investigated. Objective: To investigate the role of zinc-alpha-2-glycoprotein (ZAG) as an early marker of DN in type 2 diabetic (T2DM) patients. Methods: 88 persons were included and classified into 4 groups: Control group (group I), composed of normal healthy volunteers, and three patient groups with type 2 diabetes mellitus divided into: normo-albuminuria group (group II), subdivided into normal eGFR subgroup and increased eGFR subgroup > 120 mL/min/1.73m2), microalbuminuria group (group III), and macroalbuminuria group (group IV). All subjects were submitted to urine analysis, blood glucose levels, HbA1c, liver function tests, serum creatinine, uric acid, lipid profile and calculation of eGFR, urinary albumin creatinine ratio (UACR), and measurement of urinary and serum ZAG. Results: The levels of serum and urine ZAG were higher in patients with T2DM compared to control subjects and a statistically significant difference among studied groups regarding serum and urinary ZAG was found. Urine ZAG levels were positively correlated with UACR. Both ZAG levels were negatively correlated with eGFR. Urine ZAG levels in the eGFR ˃ 120 mL/min/1.73m2 subgroup were higher than that in the normal eGFR subgroup. Conclusion: These findings suggest that urine and serum ZAG might be useful as early biomarkers for detection of DN in T2DM patients, detectable earlier than microalbuminuria.


Resumo Introdução: Embora a microalbuminúria continue sendo o padrão ouro para a detecção precoce da nefropatia diabética (ND), ela não é um preditor suficientemente preciso do risco de ND. Assim, novos biomarcadores para prever mais precocemente o risco de ND e possivelmente evitar a ocorrência de doença renal terminal estão sendo investigados. Objetivo: Investigar a zinco-alfa2-glicoproteína (ZAG) como marcador precoce de ND em pacientes com debates mellitus tipo 2 (DM2). Métodos: Os 88 indivíduos incluídos foram divididos em quatro grupos: grupo controle (Grupo I), composto por voluntários saudáveis normais; e três grupos de pacientes com DM2 assim divididos: grupo normoalbuminúria (Grupo II), subdivididos em TFG normal e TFG > 120 mL/min/1,73 m2), grupo microalbuminúria (Grupo III) e grupo macroalbuminúria (Grupo IV). Todos foram submetidos a urinálise e exames para determinar glicemia, HbA1c, função hepática, creatinina sérica, ácido úrico, perfil lipídico, cálculo da TFG, relação albumina/creatinina (RAC) e dosagem urinária e sérica de ZAG. Resultados: Os níveis séricos e urinários de ZAG foram mais elevados nos pacientes com DM2 em comparação aos controles. Foi identificada diferença estatisticamente significativa entre os grupos estudados em relação aos níveis séricos e urinários de ZAG. Os níveis urinários de ZAG foram positivamente correlacionados com a RAC. Ambos os níveis de ZAG foram negativamente correlacionados com TFG. Os níveis urinários de ZAG no subgrupo com TFG ˃ 120 mL/min/1,73m2 foram maiores do que no subgrupo com TFG normal. Conclusão: Constatamos que a ZAG sérica e urinária pode ser um útil biomarcador precoce para detecção de ND em pacientes com DM2, sendo detectável mais precocemente que microalbuminúria.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Biomarcadores/análise , Proteínas de Plasma Seminal/análise , Diabetes Mellitus Tipo 2/complicações , Nefropatias Diabéticas/fisiopatologia , Estudos de Casos e Controles , Valor Preditivo dos Testes , Sensibilidade e Especificidade , Medição de Risco , Creatinina/sangue , Diagnóstico Precoce , Diabetes Mellitus Tipo 2/urina , Nefropatias Diabéticas/urina , Nefropatias Diabéticas/sangue , Albuminúria/urina , Taxa de Filtração Glomerular/fisiologia , Falência Renal Crônica/prevenção & controle
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