ABSTRACT
The treatment of supraglottic carcinoma remains a controversial issue. Five accepted surgical and non-surgical oncological treatments have been currently established: standard horizontal supraglottic laryngectomy (HSL), supraglottic CO2 laser microsurgery (TLM), transoral robotic surgery, radiotherapy alone and radiotherapy in combination with chemotherapy. Some studies have shown that complications of head and neck surgeries increase significantly in patients over 65 years compared to younger patients. We designed a retrospective analysis to assess the rate of complications and functional outcomes of patients treated by TLM and HSL in cases of T1-T3 supraglottic squamous cell carcinomas (SCC) in a tertiary University Hospital. Results were compared between patients younger and older than 65 years. We found significant differences in the rate of aspiration pneumonia (p = 0.026), mean time to decannulation (p = 0.001) and mean hospital stay (p = 0.007) in patients treated by TLM, which was higher and longer in the group of patients over 65 years of age. Regarding HPL, we only found significant differences in the mean time to decannulation (p = 0.001), which was longer in the group of patients younger than 65 years. According to our results, TLM or HPL can both be a safe surgical option for patients older than 65 years, but previous evaluation of lung function before surgery is mandatory because of an increased risk of aspiration pneumonia in patients with lung problems, especially when treated by TLM. Concerning functional outcomes in patients older than 65 years, TLM reduces the postoperative rate of tracheostomy, mean time required for decannulation and mean hospital stay compared with HPL. However, no significant difference in the occurrence of aspiration pneumonia, dysphagia or in the mean length of NGT feeding was found.
Subject(s)
Carcinoma, Squamous Cell/surgery , Glottis , Laryngeal Neoplasms/surgery , Laryngectomy/methods , Laser Therapy , Microsurgery , Aged , Aged, 80 and over , Humans , Laser Therapy/methods , Microsurgery/methods , Middle Aged , Mouth , Recovery of Function , Retrospective Studies , Treatment OutcomeABSTRACT
It is known that the common physiological denominator of the ageing process is an attenuation of functional performance with respect to the situation of young people and adults. However, since the first cohort-based longitudinal studies, it has not been possible to establish a "linear" relationship between age and glomerular filtration in all cases. This does not mean that there is no physiological ageing process at all; in addition to those already elucidated, its mechanisms include cell senescence, podocyte dysfunction, a vitamin D deficiency, and homozygotic forms of the MYH9 gene. The aim of the present work was to analyse the prevalence of chronic kidney disease (CKD) and, where possible, the correlation between CKD, defined by an eGFR < 60 ml/min/1.73 m(2), plasma 25(OH)D3 levels and the MYH9 gene in a population of elderly and very elderly persons. These parameters have not been evaluated previously in populations of elderly and very elderly patients. It is concluded that a moderate decrease in the eGFR occurs with age. This does not imply the presence of CKD in elderly people, since in most individuals the reduced eGFR is not accompanied by anaemia, and no individuals show hypocalcaemia, hyperphosphataemia or a high Alb/Cr ratio. Here we observed a lower Hb level and an elevated Alb/Cr ratio in subjects heterozygotic for the MYH9 gene. This could be interpreted in the sense that the gene could exert some protective effect on renal function, whereas the heterozygotic form (allele A) of the MYH9 gene could be considered a very early marker, a new risk factor for the appearance of CKD, or a sign of renal frailty in elderly people.
Subject(s)
Aging , Calcifediol/blood , DNA/genetics , Glomerular Filtration Rate/physiology , Molecular Motor Proteins/genetics , Myosin Heavy Chains/genetics , Polymorphism, Genetic , Renal Insufficiency, Chronic/genetics , Adolescent , Adult , Age Factors , Aged , Aged, 80 and over , Biomarkers/blood , Female , Humans , Male , Middle Aged , Molecular Motor Proteins/metabolism , Myosin Heavy Chains/metabolism , Renal Insufficiency, Chronic/blood , Renal Insufficiency, Chronic/physiopathology , Risk Factors , Young AdultABSTRACT
Formalin-fixed tissues are an important source of biological samples for biomedical research. However, proteomics analysis of formalin-fixed tissues has been set aside by formalin-induced protein modifications, which reduce protein extraction efficiency. In this study, a two level full factorial experimental design (2(4)) was used to determine the effects of the extracting conditions in the efficiency of protein recovery from formalin-fixed kidney samples. The following variables were assessed: temperature of extraction, pH of extraction, composition of the extracting buffer and the use ultrasonic energy applied with probe. It is clearly demonstrated that when hating and ultrasonic energy are used in conjunction, a 7-fold increase (p < 0.05) in protein extraction is obtained if compared to extracting conditions for which neither heating nor ultrasonic energy are used. The optimization study was done following the amount of protein extracted by UV (Nanodrop(®) technology, protein ABS at 280 nm) and by 1D SDS-PAGE. Extracts obtained with the optimized conditions were subjected to LC-MALDI MS/MS. A total of 112 proteins were identified.
Subject(s)
Formaldehyde , Kidney/chemistry , Proteins/isolation & purification , Chromatography, Liquid , Electrophoresis, Polyacrylamide Gel , Humans , Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization , Tandem Mass SpectrometrySubject(s)
Calciphylaxis/therapy , Combined Modality Therapy , Debridement , Thiosulfates/therapeutic use , Anti-Bacterial Agents/therapeutic use , Antiphospholipid Syndrome/complications , Carcinoma, Renal Cell/complications , Carcinoma, Renal Cell/surgery , Cardiovascular Diseases/complications , Cardiovascular Diseases/drug therapy , Cinacalcet , Clostridium Infections/complications , Clostridium Infections/drug therapy , Clostridium Infections/surgery , Clostridium perfringens , Foot Ulcer/drug therapy , Foot Ulcer/etiology , Foot Ulcer/microbiology , Foot Ulcer/surgery , Humans , Hyperparathyroidism, Secondary/drug therapy , Hyperparathyroidism, Secondary/etiology , Hyperparathyroidism, Secondary/surgery , Kidney Failure, Chronic/complications , Kidney Failure, Chronic/surgery , Kidney Failure, Chronic/therapy , Kidney Neoplasms/complications , Kidney Neoplasms/surgery , Kidney Transplantation , Male , Middle Aged , Naphthalenes/therapeutic use , Postoperative Complications/etiology , Postoperative Complications/therapy , Renal Replacement Therapy , Staphylococcal Infections/complications , Staphylococcal Infections/drug therapy , Staphylococcal Infections/surgeryABSTRACT
No disponible
Subject(s)
Humans , Gentamicins/pharmacokinetics , Drug Resistance, Microbial , Catheter-Related Infections/prevention & control , Peritoneal Dialysis/adverse effects , Peritonitis/prevention & controlABSTRACT
No disponible
Subject(s)
Humans , Male , Middle Aged , Calciphylaxis/drug therapy , Renal Insufficiency, Chronic/complications , Renal Replacement Therapy/adverse effects , Vascular Calcification/physiopathologySubject(s)
Antibiotic Prophylaxis , Catheter-Related Infections/prevention & control , Peritoneal Dialysis/adverse effects , Peritonitis/prevention & control , Administration, Topical , Candidiasis/etiology , Candidiasis/prevention & control , Catheter-Related Infections/epidemiology , Catheter-Related Infections/etiology , Catheter-Related Infections/microbiology , Catheters, Indwelling , Device Removal , Gentamicins/administration & dosage , Gentamicins/adverse effects , Gentamicins/therapeutic use , Gram-Negative Bacterial Infections/epidemiology , Gram-Negative Bacterial Infections/etiology , Gram-Negative Bacterial Infections/prevention & control , Humans , Peritoneal Dialysis/instrumentation , Peritonitis/epidemiology , Peritonitis/etiology , Peritonitis/microbiology , Staphylococcal Infections/epidemiology , Staphylococcal Infections/etiology , Staphylococcal Infections/prevention & controlSubject(s)
Hemolytic-Uremic Syndrome/therapy , Hypertension/drug therapy , Pre-Eclampsia/therapy , Puerperal Disorders/therapy , Adult , Angiotensin II Type 1 Receptor Blockers/therapeutic use , Anti-Inflammatory Agents/therapeutic use , Antihypertensive Agents/therapeutic use , Cesarean Section , Combined Modality Therapy , Emergencies , Female , Hemolytic-Uremic Syndrome/drug therapy , Humans , Labetalol/therapeutic use , Methyldopa/therapeutic use , Plasmapheresis , Pre-Eclampsia/drug therapy , Prednisone/therapeutic use , Pregnancy , Puerperal Disorders/drug therapy , Remission InductionABSTRACT
No disponible
Subject(s)
Humans , Catheter-Related Infections/prevention & control , Peritoneal Dialysis/methods , Peritonitis/prevention & control , Risk FactorsABSTRACT
No disponible
Subject(s)
Humans , Female , Pregnancy , Adult , Pre-Eclampsia , Hypertension/complications , Hemolytic-Uremic Syndrome/complications , Pulmonary Edema/complications , Acute Kidney Injury/physiopathology , Pregnancy ComplicationsSubject(s)
Edema/etiology , Genital Diseases, Male/etiology , Peritoneal Dialysis/adverse effects , Aged , Humans , MaleABSTRACT
No disponible
Subject(s)
Humans , Male , Aged, 80 and over , Edema/etiology , Genital Diseases, Male/etiology , Peritoneal Dialysis/adverse effects , Tomography, X-Ray ComputedABSTRACT
No disponible
Subject(s)
Humans , Male , Aged , Peritonitis/etiology , Peritoneal Dialysis/adverse effects , Renal Insufficiency, Chronic/complicationsABSTRACT
No disponible
