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1.
Artigo em Inglês | MEDLINE | ID: mdl-37107817

RESUMO

OBJECTIVE: to verify the acute effect of running a half marathon on pelvic floor muscle (PFM) function and electromyographic (EMG) activity in female runners with and without urinary incontinence. METHODS: This is a cross-sectional pilot study. The sample was divided into two groups: runners with urinary incontinence (with UI) and runners without urinary incontinence (without UI). A semi-structured form and the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-UI-SF) were used for data collection. The EMG and PFM function were evaluated using the PERFECT method before and immediately after running a half marathon. RESULTS: A total of 14 runners were included (8 with UI; 6 without UI). Runners with and without UI did not show significant differences for EMG and PERFECT. The acute effects of the half marathon on runners without UI were reduced PFM function in terms of strength (p = 0.00), reduced endurance (p = 0.02), and reduced repetition (p = 0.03), and an increase in EMG measured by the median frequency (p = 0.02). Runners with UI showed reduced PFM function in terms of strength (p = 0.05) and repetition (p = 0.01). CONCLUSION: there was no difference in the acute effects of the half marathon on PFM function and EMG in women with and without UI.


Assuntos
Força Muscular , Incontinência Urinária , Feminino , Humanos , Força Muscular/fisiologia , Projetos Piloto , Diafragma da Pelve/fisiologia , Estudos Transversais , Corrida de Maratona , Incontinência Urinária/epidemiologia
2.
Rev. Headache Med. (Online) ; 14(2): 97-103, 2023.
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1531768

RESUMO

Objective: To evaluate the prevalence of migraine in patients with fibromyalgia and the impacts of these comorbidities on the daily life of patients. Methods: Questionnaires were applied to fibromyalgia patients. The questionnaires were applied through a Google forms application link and in person, printed. We used FIQ, PHQ-9, and ID migraine. And for patients with a positive ID migraine, we applied the Midas subsequently. Results: Seventy fibromyalgia patients were recruited, age of 47.31 ± 14.5 years. Sixty-five (92.86%) were female and 5 (7.14%) were male. We obtained a prevalence of 60% (n = 42) of migraine associated with fibromyalgia. Among the analyzed variables, severity of depression (p = 0.007), aggregate severity of depression (p = 0.004), and impact of fibromyalgia (p = 0.008) were significantly associated. Among the migraine patients, the vast majority, 34/42 (80.95%), were classified as having severe disability. Conclusion: There is a high prevalence of migraine in patients with fibromyalgia that has an associated impact on patients' lives, which makes clinical and psychosocial management of these patients necessary.


Objetivo: Avaliar a prevalência de enxaqueca em pacientes com fibromialgia e os impactos dessas comorbidades no cotidiano dos pacientes. Métodos: Questionários foram aplicados a pacientes com fibromialgia. Os questionários foram aplicados por meio de link de aplicativo Google Forms e presencialmente, impressos. Usamos FIQ, PHQ-9 e enxaqueca ID. E para pacientes com enxaqueca ID positiva, aplicamos o Midas posteriormente. Resultados: Foram recrutados 70 pacientes com fibromialgia, idade de 47,31 ± 14,5 anos. Sessenta e cinco (92,86%) eram do sexo feminino e 5 (7,14%) do sexo masculino. Obtivemos uma prevalência de 60% (n = 42) de enxaqueca associada à fibromialgia. Entre as variáveis ​​analisadas, a gravidade da depressão (p = 0,007), a gravidade agregada da depressão (p = 0,004) e o impacto da fibromialgia (p = 0,008) foram significativamente associadas. Entre os pacientes com enxaqueca, a grande maioria, 34/42 (80,95%), foi classificada como portadora de incapacidade grave. Conclusão: Existe uma elevada prevalência de enxaqueca em pacientes com fibromialgia que tem impacto associado na vida dos pacientes, o que torna necessário o manejo clínico e psicossocial destes pacientes.

3.
CuidArte, Enferm ; 15(1): 82-89, jan.-jun. 2021.
Artigo em Português | BDENF - Enfermagem | ID: biblio-1290694

RESUMO

Introdução: As alterações sociodemográficas que acarretaram o aumento do número de idosos mundialmente têm sido responsáveis pelas pesquisas cada vez mais constantes na área de gerontologia e qualidade de vida (QV), em busca de avanços e melhorias nos serviços de promoção, prevenção e assistência aos longevos. Objetivos: Avaliar a qualidade de vida dos idosos institucionalizados, caracterizar de forma sociodemográfica as pessoas idosas investigadas e apresentar quais das atividades oferecidas interferem significativamente nos escores da QV dos mesmos. Método: Amostra obtida de 13 idosos residentes em Instituição de Longa Permanência (ILPI), entre novembro de 2017 a janeiro de 2018, os quais foram entrevistados através de questionários, sendo dois destes de Avaliação de QV da Organização Mundial da Saúde, e o terceiro de caracterização sociodemográfica e de atividades. Resultados: A maior parte dos idosos são do gênero masculino, têm boa adesão e participação nas atividades oferecidas e possuem QV satisfatórias quando comparadas a outros estudos em idosos institucionalizados. Houve maiores escores nos domínios Social e Morte e Morrer, e menores nos Físico e Autonomia. Conclusão: É necessário fortalecer e incentivar atividades que promovam melhorias físicas autonômicas aos idosos institucionalizados, os quais são afetados pelas idades mais avançadas e pelo desuso ocasionado na institucionalização. Estes idosos constituem parte importante de nossa sociedade, logo, cabe aos gestores dos serviços que prestam atenção em gerontologia, às universidades e à sociedade promover campanhas, projetos, medidas educativas capazes de melhorar a QV e proporcionar maior autonomia e independência aos nossos idosos.


Introduction: The sociodemographic changes that have led to the increase in the number of elderly people worldwide have been responsible for the increasingly constant research in the area of Gerontology and quality of life (QOL), in search of advances and improvements in promotion services, prevention and assistance to longevity. Objectives: To evaluate the quality of life of institutionalized elderly people, to characterize in a sociodemographic way the elderly people investigated and to present which of the activities offered significantly interfere in their QOL scores. Method: Sample obtained from 13 elderly residents of Long Stay Institution (ILPI), between November 2017 to January 2018, who were interviewed through questionnaires, two of them from World Health Organization's QOL Assessment, and the third of socio-demographic characterization and activities. Results: Most of the elderly are male, have good adherence and participation in the activities offered and have satisfactory QOL when compared to other studies in institutionalized elderly. There were higher scores in the Social and Death and Death domains, and lower scores in the Physical and Autonomy domains. Conclusion: It is necessary to strengthen and encourage activities that promote autonomic physical improvements to institutionalized elderly, who are affected by advanced ages and disuse caused by institutionalization. These elderly people are an important part of our society, so it is up to the managers of the services that pay attention to Gerontology, universities and society to promote campaigns, projects, educational measures capable of improving the QOL and providing greater autonomy and independence to our elderly.(AU)


Introducción: Los cambios sociodemográficos que han propiciado un incremento en el número de personas mayores a nivel mundial han sido responsables de una investigación cada vez más constante en el campo de la gerontología y la calidad de vida (CV), en busca de avances y mejoras en los servicios de promoción, prevención y asistencia a los longevos. Objetivo: Evaluar la calidad de vida de ancianos institucionalizados, caracterizar sociodemográficamente a los ancianos investigados y presentar cuáles de las actividades ofrecidas interfieren significativamente en sus puntuaciones de CV. Método: Muestra obtenida de 13 ancianos residentes en el Centro de Cuidados a Largo Plazo (ILPI), entre noviembre de 2017 y enero de 2018...(AU)


Assuntos
Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Saúde do Idoso Institucionalizado , Atividades de Lazer/psicologia , Qualidade de Vida , Instituição de Longa Permanência para Idosos
4.
Psicol. teor. prát ; 22(1): 351-367, Jan.-Apr. 2020. ilus, tab
Artigo em Inglês, Português | LILACS, Index Psicologia - Periódicos | ID: biblio-1098547

RESUMO

Autism spectrum disorder (ASD) affects different areas of development. The application of behavior analysis by an interdisciplinary team of professionals has shown promising results. The aim was to describe an interdisciplinary case study, involving an intervention with a child with ASD, designed using the principles of behavior analysis. The procedure involved five phases: evaluation of the child's repertoire, interdisciplinary meeting, curriculum implementation, parent training, and weekly interdisciplinary meetings. The results section presents the evaluation data, organization of the curriculum, and analysis of the case study, drawing on the notion of interlocking behavioral contingencies. Each team member in their specific area of expertise played an important role in designing a structured, individualized, varied curriculum. This experience provides an initial reflection on the design and implementation of interventions for children with ASD, involving their parents and professionals.


O transtorno do espectro autista (TEA) acomete as diferentes áreas do desenvolvimento. A aplicação da Análise do Comportamento Aplicada (ABA) por diferentes profissionais tem demonstrado resultados promissores. O objetivo foi descrever um estudo de caso interdisciplinar delineado nos princípios analítico-comportamentais, a partir de uma intervenção aplicada com uma criança com TEA. O procedimento envolveu cinco fases: avaliação do repertório da criança com TEA, reunião interdisciplinar, aplicação do currículo, formação dos pais e novamente reunião interdisciplinar. Os resultados apresentam os dados de avaliação da criança com TEA, a organização do currículo e uma análise do estudo de caso, a partir do entrelaçamento de contingências comportamentais. Cada profissional da equipe, em sua área de atuação, colaborou para a construção, aplicação e análise do currículo de ensino estruturado, individualizado e diversificado, o que gerou reflexões, ainda que embrionárias, sobre esse tipo de organização de intervenção, envolvendo os profissionais, pais e a criança com TEA.


El trastorno del espectro del autismo (TEA) acomete las diferentes áreas del desarrollo. El Análisis Aplicada de la Conducta (ABA) por diferentes profesionales ha demostrado resultados prometedores. El objetivo fue describir un estudio de caso interdisciplinario delineado en los principios analíticos-comportamentales, a partir de una intervención aplicada con un niño con TEA. El procedimiento involucró cinco fases: evaluación del repertorio del niño, reunión interdisciplinaria, aplicación de los currículos, capacitación de los padres y nuevamente reunión interdisciplinaria. Los resultados presentan los datos de evaluación del niño, la organización del currículo y un análisis del estudio de caso, a partir del entrelazamiento de contingencias comportamentales. Cada profesional del equipo, en su área de actuación, colaboró para la construcción, aplicación y análisis del currículo de enseñanza estructurado, individualizado y diversificado, lo que generó reflexiones, aunque embrionarias sobre ese tipo de organización de intervención, involucrando a los profesionales, padres y el niño con TEA.


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Adulto , Transtorno Autístico , Análise do Comportamento Aplicada , Equipe de Assistência ao Paciente , Crescimento e Desenvolvimento
5.
Leuk Res ; 60: 109-114, 2017 09.
Artigo em Inglês | MEDLINE | ID: mdl-28777950

RESUMO

BACKGROUND: Current results regarding treatment outcomes in acute myeloid leukemia (AML) point to significant differences between low- and middle-income countries (LMIC) and high-income countries (HIC). Excluding well-known socioeconomic issues, genetic markers important for prognosis have not been properly incorporated into the clinical practice so far and their usefulness outside of well-controlled clinical trials remain unknown. METHODS: Here, we assessed the clinical significance of the European LeukemiaNet (ELN) recommendations in 196 consecutive patients with AML in a real-life setting. All patients were younger than 60 years of age (49% male) and treated with conventional chemotherapy for induction and consolidation in three Brazilian Institutions that well represent Brazilian geographic and socioeconomic diversity. FINDINGS: Multivariable analysis showed that ELN recommendations had a slight association with complete remission achievement (odds ratio: 0.74, 95% confidence interval, CI: 0.53-1.01; P=0.06), but were independently associated with poor overall survival (OS) (hazard ratio, HR: 1.3, 95% CI: 1.1-1.54; P=0.002), disease-free survival (DFS) (HR: 1.42, 95% CI: 1.03-1.95; P=0.028) and event-free survival (EFS) (HR: 1.24, 95% CI: 1.06-1.47; P=0.007), considering initial leukocyte counts and age as confounders. ELN recommendations had no impact on cumulative incidence of relapse (P=0.09). INTERPRETATION: Our results suggest that within the context of LMIC, the prognostic markers recommended by ELN may be useful to predict patient's clinical outcomes; however, the OS, DFS and EFS were shorter than the reported in Europe and US for the respective risk groups.


Assuntos
Leucemia Mieloide Aguda/diagnóstico , Guias de Prática Clínica como Assunto/normas , Fatores Socioeconômicos , Adulto , Brasil , Intervalo Livre de Doença , Feminino , Humanos , Leucemia Mieloide Aguda/mortalidade , Masculino , Pessoa de Meia-Idade , Prognóstico , Taxa de Sobrevida , Resultado do Tratamento , Adulto Jovem
7.
Exp Biol Med (Maywood) ; 237(8): 973-84, 2012 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-22903135

RESUMO

Cisplatin (CDDP) is one of the most active cytotoxic agents commonly used in the treatment of peritoneal carcinomatosis. The disadvantages of its clinical use are systemic side-effects, such as nephrotoxicity and myelotoxicity. Long-circulating and pH-sensitive liposomes containing CDDP (SpHL-CDDP) were developed by our research group aiming to promote the release of CDDP near the tumor as well as decreasing toxicity. The aim of this study was to evaluate the antitumor efficacy and toxicity of SpHL-CDDP after intraperitoneal administration in initial or disseminated tumor-bearing mice, at a dose of 12 mg/kg. The survival was monitored and blood samples were collected for biochemical and hematological analysis. Kidneys, liver and spleen were removed for histopathological examination. Tumor cells were evaluated for cellular viability and cell cycle. The survival of animals treated with SpHL-CDDP was higher than those treated with free CDDP. The cell death caused by treatment with SpHL-CDDP occurred through induction of apoptosis, with a cell cycle arrest at the G0/G1 phase. The treatment of mice presenting initial cancer with both formulations provoked a suppression of granulocytes. Mice treated with free CDDP also showed a decrease in platelet count, which suggests a high myelotoxicity. In an advanced cancer model, SpHL-CDDP treatment allowed an improvement of the immune response. Mice affected by cancer at an early stage and treated with free CDDP or SpHL-CDDP showed a lower urea/creatinine index compared with the saline control group. These findings indicate that both treatments were able to reduce the renal damage caused by peritoneal carcinomatosis. Microscopic analysis of kidneys from mice treated with SpHL-CDDP showed a discrete morphological alteration, while tubular necrosis was observed for free CDDP-treated mice. Concerning hepatotoxicity, no alteration in clinical chemistry parameters was observed. These findings reveal that SpHL-CDDP can improve the antitumor efficacy and decrease renal and bone marrow toxicity.


Assuntos
Antineoplásicos/administração & dosagem , Antineoplásicos/efeitos adversos , Carcinoma de Ehrlich/tratamento farmacológico , Cisplatino/administração & dosagem , Cisplatino/efeitos adversos , Lipossomos/efeitos adversos , Animais , Apoptose , Modelos Animais de Doenças , Portadores de Fármacos/administração & dosagem , Portadores de Fármacos/efeitos adversos , Feminino , Histocitoquímica , Concentração de Íons de Hidrogênio , Injeções Intraperitoneais , Rim/patologia , Lipossomos/administração & dosagem , Fígado/patologia , Camundongos , Baço/patologia , Análise de Sobrevida , Trombocitopenia/induzido quimicamente , Resultado do Tratamento
8.
Blood ; 119(24): 5824-31, 2012 Jun 14.
Artigo em Inglês | MEDLINE | ID: mdl-22490330

RESUMO

The prevalence, the prognostic effect, and interaction with other molecular markers of DNMT3A mutations was studied in 415 patients with acute myeloid leukemia (AML) younger than 60 years. We show mutations in DNMT3A in 96 of 415 patients with newly diagnosed AML (23.1%). Univariate Cox regression analysis showed that patients with DNMT3A(mutant) AML show significantly worse overall survival (OS; P = .022; hazard ratio [HR], 1.38; 95% confidence interval [CI], 1.04-1.81), and relapse-free survival (RFS; P = .005; HR, 1.52; 95% CI, 1.13-2.05) than DNMT3A(wild-type) AMLs. In a multivariable analysis, DNMT3A mutations express independent unfavorable prognostic value for OS (P = .003; HR, 1.82; 95% CI, 1.2-2.7) and RFS (P < .001; HR, 2.2; 95% CI, 1.4-3.3). In a composite genotypic subset of cytogenetic intermediate-risk AML without FLT3-ITD and NPM1 mutations, this association is particularly evident (OS: P = .013; HR, 2.09; 95% CI, 1.16-3.77; RFS: P = .001; HR, 2.65; 95% CI, 1.48-4.89). The effect of DNMT3A mutations in human AML remains elusive, because DNMT3A(mutant) AMLs did not express a methylation or gene expression signature that discriminates them from patients with DNMT3A(wild-type) AML. We conclude that DNMT3A mutation status is an important factor to consider for risk stratification of patients with AML.


Assuntos
DNA (Citosina-5-)-Metiltransferases/genética , Leucemia Mieloide Aguda/enzimologia , Leucemia Mieloide Aguda/genética , Proteínas Mutantes/metabolismo , Adolescente , Adulto , Biomarcadores Tumorais , Análise por Conglomerados , Metilação de DNA/genética , DNA Metiltransferase 3A , Feminino , Perfilação da Expressão Gênica , Regulação Leucêmica da Expressão Gênica , Humanos , Leucemia Mieloide Aguda/diagnóstico , Leucemia Mieloide Aguda/terapia , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Mutação/genética , Proteínas de Neoplasias/genética , Proteínas de Neoplasias/metabolismo , Nucleofosmina , Prognóstico , Recidiva , Análise de Sobrevida , Resultado do Tratamento , Adulto Jovem
9.
Rev. bras. farmacogn ; 22(2): 364-373, Mar.-Apr. 2012. graf, tab
Artigo em Inglês | LILACS | ID: lil-624666

RESUMO

The aim of this study was to investigate the effect of Arrabidaea chica (Humb. & Bonpl.) B. Verl., Bignoniaceae, extracts on Ehrlich solid tumor development in Swiss mice. Leaves of A. chica were extracted with two distinct solvents, ethanol and water. The phytochemical analysis of the extracts indicated different classes of secondary metabolites like as anthocyanidins, flavonoids, tannins and saponins. Ethanol (EE) and aqueous (AE) extracts at 30 mg/kg reduced the development of Ehrlich solid tumor after ten days of oral treatment. The EE group presented increase in neutrophil count, α1 and β globulin values, and decrease of α2 globulin values. Furthermore, EE reduced the percentage of CD4+ T cells in blood but did not alter the percentage of inflammatory mononuclear cells associated with tumor suggesting a direct action of EE on tumor cells. Reduced tumor development observed in AE group was accompanied by a lower percentage of CD4+ T lymphocytes in blood. At the tumor microenvironment, this treatment decreased the percentage of CD3+ T cells, especially due to a reduction of CD8+ T subpopulation and NK cells. The antitumor activity presented by the AE is possibly related to an anti-inflammatory activity. None of the extracts produced toxic effects in animals. In conclusion, the ethanol and aqueous extracts of A. chica have immunomodulatory and antitumor activities attributed to the presence of flavonoids, such as kaempferol. These effects appear to be related to different mechanisms of action for each extract. This study demonstrates the potential of A. chica as an antitumor agent confirming its use in traditional popular medicine.

10.
Rev. bras. hematol. hemoter ; 33(6): 478-480, Dec. 2011. ilus
Artigo em Inglês | LILACS | ID: lil-611387

RESUMO

Acute promyelocytic leukemia is potentially a highly curable type of leukemia that usually presents with pancytopenia, coagulopathies and bleeding. We describe a case of an unusual presentation of acute promyelocytic leukemia. A 53 year-old male was admitted complaining of pain and weakness in his legs. He presented at examination a spastic paraparesis with a sensitive level at the eighth thoracic medullar (T8) segment. Magnetic resonance imaging showed a posterolateral extradural mass from T6 through T8 segments with medullar compression. A complete blood count showed anemia, thrombocytopenia and the presence of promyelocytes and blasts. Marrow examination was compatible with the diagnosis of acute promyelocytic leukemia by cytogenetics and polymerase chain reaction for the PML-RARα gene. He was treated with all-trans-retinoic acid therapy plus daunorubicin and presented an all-trans-retinoic acid syndrome. Despite hematological remission, the patient presented neurologic deterioration and had to be treated with radiotherapy (total dose 3000 cGy) of the extradural lesion. The patient evolved with severe sepsis and died without any recovery from his neurologic deficit. Extramedullary infiltration is a very rare complication in acute promyelocytic leukemia. Most cases are related to relapse after initial treatment with all-trans-retinoic acid. The skin and the central nervous system are the most frequently involved sites. This is possibly the first case reported of this condition in which the patient had a symptomatic extradural mass.


Assuntos
Humanos , Masculino , Adulto , Leucemia Promielocítica Aguda , Sarcoma Mieloide , Neoplasias da Medula Espinal
11.
Clinics (Sao Paulo) ; 66(10): 1699-705, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-22012040

RESUMO

OBJECTIVE: This study aimed to examine the association between different inflammatory markers and specific clinical endpoints in patients with febrile neutropenia. METHOD: We prospectively evaluated the expression of procalcitonin (PCT), interleukin 8 (IL-8), induced protein-10, tumor necrosis factor alpha (TNF-α), two soluble TNF-α receptors (sTNF-R I and sTNF-R II), monocyte chemotactic protein-1 (MCP-1), macrophage inflammatory protein-1 alpha, and eotaxin in 37 episodes of febrile neutropenia occurring in 31 hospitalized adult onco-hematologic patients. Peripheral blood samples were collected in the morning at inclusion (day of fever onset) and on days 1, 3, and 7 after the onset of fever. Approximately 2-3 ml of plasma was obtained from each blood sample and stored at -80 °C. RESULTS: The sTNF-R II level at inclusion (day 1), the PCT level on the day of fever onset, and the change (day 3 - day 1) in the IL-8 and eotaxin levels were significantly higher in patients who died during the 28-day follow-up. A requirement for early adjustment of antimicrobial treatment was associated with higher day 3 levels of IL-8, sTNF-R II, PCT, and MCP-1. CONCLUSION: Procalcitonin, sTNF-R II, IL-8, MCP-1, and eotaxin could potentially be used to assess the risk of death and the requirement for early adjustment of antimicrobial treatment in febrile, neutropenic onco-hematologic patients. The levels of the other markers showed no association with any of the evaluated endpoints.


Assuntos
Calcitonina/sangue , Neutropenia/sangue , Precursores de Proteínas/sangue , Adulto , Biomarcadores/sangue , Proteína C-Reativa/metabolismo , Peptídeo Relacionado com Gene de Calcitonina , Causas de Morte , Quimiocina CCL11/sangue , Quimiocina CCL2/sangue , Quimiocina CCL3/sangue , Métodos Epidemiológicos , Feminino , Humanos , Inflamação/sangue , Interleucina-6/sangue , Interleucina-8/sangue , Masculino , Pessoa de Meia-Idade , Neutropenia/mortalidade , Estudos Prospectivos , Receptores Tipo I de Fatores de Necrose Tumoral/sangue , Fatores de Tempo , Fator de Necrose Tumoral alfa/sangue
12.
Rev Bras Hematol Hemoter ; 33(6): 478-80, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-23049367

RESUMO

Acute promyelocytic leukemia is potentially a highly curable type of leukemia that usually presents with pancytopenia, coagulopathies and bleeding. We describe a case of an unusual presentation of acute promyelocytic leukemia. A 53 year-old male was admitted complaining of pain and weakness in his legs. He presented at examination a spastic paraparesis with a sensitive level at the eighth thoracic medullar (T8) segment. Magnetic resonance imaging showed a posterolateral extradural mass from T6 through T8 segments with medullar compression. A complete blood count showed anemia, thrombocytopenia and the presence of promyelocytes and blasts. Marrow examination was compatible with the diagnosis of acute promyelocytic leukemia by cytogenetics and polymerase chain reaction for the PML-RARα gene. He was treated with all-trans-retinoic acid therapy plus daunorubicin and presented an all-trans-retinoic acid syndrome. Despite hematological remission, the patient presented neurologic deterioration and had to be treated with radiotherapy (total dose 3000 cGy) of the extradural lesion. The patient evolved with severe sepsis and died without any recovery from his neurologic deficit. Extramedullary infiltration is a very rare complication in acute promyelocytic leukemia. Most cases are related to relapse after initial treatment with all-trans-retinoic acid. The skin and the central nervous system are the most frequently involved sites. This is possibly the first case reported of this condition in which the patient had a symptomatic extradural mass.

13.
Clinics ; 66(10): 1699-1705, 2011. graf, tab
Artigo em Inglês | LILACS | ID: lil-601902

RESUMO

OBJECTIVE: This study aimed to examine the association between different inflammatory markers and specific clinical endpoints in patients with febrile neutropenia. METHOD: We prospectively evaluated the expression of procalcitonin (PCT), interleukin 8 (IL-8), induced protein-10, tumor necrosis factor alpha (TNF-a), two soluble TNF-a receptors (sTNF-R I and sTNF-R II), monocyte chemotactic protein-1 (MCP-1), macrophage inflammatory protein-1 alpha, and eotaxin in 37 episodes of febrile neutropenia occurring in 31 hospitalized adult onco-hematologic patients. Peripheral blood samples were collected in the morning at inclusion (day of fever onset) and on days 1, 3, and 7 after the onset of fever. Approximately 2-3 ml of plasma was obtained from each blood sample and stored at -80°C. RESULTS: The sTNF-R II level at inclusion (day 1), the PCT level on the day of fever onset, and the change (day 3 - day 1) in the IL-8 and eotaxin levels were significantly higher in patients who died during the 28-day follow-up. A requirement for early adjustment of antimicrobial treatment was associated with higher day 3 levels of IL-8, sTNF-R II, PCT, and MCP-1. CONCLUSION: Procalcitonin, sTNF-R II, IL-8, MCP-1, and eotaxin could potentially be used to assess the risk of death and the requirement for early adjustment of antimicrobial treatment in febrile, neutropenic onco-hematologic patients. The levels of the other markers showed no association with any of the evaluated endpoints.


Assuntos
Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Calcitonina/sangue , Neutropenia/sangue , Precursores de Proteínas/sangue , Biomarcadores/sangue , Proteína C-Reativa/metabolismo , Causas de Morte , /sangue , /sangue , /sangue , Métodos Epidemiológicos , Inflamação/sangue , /sangue , /sangue , Neutropenia/mortalidade , Estudos Prospectivos , Receptores Tipo I de Fatores de Necrose Tumoral/sangue , Fatores de Tempo , Fator de Necrose Tumoral alfa/sangue
14.
Arq. bras. endocrinol. metab ; 48(4): 525-534, ago. 2004. ilus, tab
Artigo em Português | LILACS | ID: lil-393701

RESUMO

O efeito do hipotireoidismo sobre o metabolismo ósseo e as paratireóides na deficiência ou suficiência dos esteróides ovarianos foi estudado em 32 ratas Wistar, com 2 meses de idade, distribuídas em 4 grupos de 8: eutireóideo não castrado (ENC), eutireóideo castrado (EC), hipotireóideo não castrado (HNC) e hipotireóideo castrado (HC). Após 120 dias de tratamento, as ratas foram sacrificadas e o plasma colhido para dosagem de T4 livre. Foi evidenciada hipertrofia das paratireóides somente no grupo HNC. As ratas do grupo HNC apresentaram osteopenia de maior extensão e intensidade, decorrente do menor crescimento, da inibição da aposição e do aumento da reabsorção ósseas. Nas ratas EC, a osteopenia foi causada por menor aposição e aumento da reabsorção ósseas. Embora a osteopenia na associação hipotireoidismo-castração tenha sido quase sempre mais intensa em relação à das ratas EC, sua intensidade, quando comparada à osteopenia dos animais HNC, foi variável e dependente do sítio ósseo estudado. Apesar de causar necrose dos ossos de maior metabolismo, a associação hipotireoidismo-castração não potencializou a osteopenia decorrente da ação isolada do hipotireoidismo até os 120 dias de tratamento.


Assuntos
Animais , Feminino , Ratos , Osso e Ossos/patologia , Hipotireoidismo/patologia , Ovariectomia , Glândulas Paratireoides/patologia , Ratos Wistar
15.
Arq Bras Endocrinol Metabol ; 48(4): 525-34, 2004 Aug.
Artigo em Português | MEDLINE | ID: mdl-15761517

RESUMO

The effect of hypothyroidism on bone metabolism and the parathyroids in states of deficiency or sufficiency of sex steroids was studied in 32 two-months-old female Wistar rats distributed in 4 groups of 8 animals each: intact euthyroid (IE), castrated euthyroid (CE), intact hypothyroid (IH) and castrated hypothyroid (CH). After 120 days of treatment, animals were sacrificed and plasma taken to assess free T4. Hyperplasia or hypertrophy of all parathyroids were evident only in IH and CE groups. Of all groups, IH rats presented the most extensive osteopenia, reaching lumbar vertebrae, dental alveolae (jaw and mandible) and long bones. In this group osteopenia resulted from the reduced bone growth, inhibition of bone apposition and return of bone resorption. Although osteopenia in the CH group was almost always more intense in relation to osteopenia presented by CE rats, its intensity was variable when compared to IH rats and dependent on the region studied. Even though it also caused necrosis of higher metabolism bones, the association hypothyroidism-castration did not potentialize the resultant osteopenia of the isolated action of hypothyroidism or castration until 120 days of treatment.


Assuntos
Osso e Ossos/patologia , Hipotireoidismo/patologia , Ovariectomia , Glândulas Paratireoides/patologia , Animais , Feminino , Ratos , Ratos Wistar
16.
Arq. bras. endocrinol. metab ; 47(3): 228-236, jun. 2003.
Artigo em Português | LILACS | ID: lil-345923

RESUMO

Apesar da dedicação incessante dos pesquisadores no estudo da osteoporose, muito ainda necessita ser elucidado. A deficiência dos esteróides sexuais, principalmente a de estrógeno, é considerada a principal causa de osteoporose, embora existam inúmeros outros fatores envolvidos. O hipertireoidismo, por exemplo, é considerado um dos fatores de risco para indução ou agravamento da osteoporose e tem despertado o interesse para o estudo dos efeitos de T3 e T4 sobre o metabolismo ósseo. Embora o hipotireoidismo e a afuncionalidade das gônadas seja uma associação freqüente na mulher, a hipofunção da tireóide não é considerada fator de risco para a osteoporose da menopausa. Assim, o estudo da inter-relação entre os distúrbios endócrinos, tão comuns na idade avançada, e a osteoporose é fundamental, pois deste conhecimento poderão advir meios de controle e tratamento adequados, bem como a definição da real natureza do distúrbio ósseo. O objetivo desta revisão é apresentar e discutir alguns aspectos da osteoporose e sua inter-relação com os distúrbios endócrinos da tireóide e das gônadas.


Assuntos
Humanos , Feminino , Hipertireoidismo , Hipogonadismo , Hipotireoidismo , Osteoporose , Hormônios Esteroides Gonadais/deficiência , Fatores de Risco
17.
Arq. bras. endocrinol. metab ; 45(3): 258-264, jun. 2001. tab
Artigo em Português | LILACS | ID: lil-285585

RESUMO

A foliculogênese e a esteroidogênese ovarianas foram estudadas em ratas adultas hipertireóideas. O hipertireoidismo foi induzido em 27 ratas Wistar com cinco meses de idade pela administração diária de 50ng de L-tiroxina. Outras 27 ratas foram mantidas em estado eutireóideo e serviram como controle. Aos 30, 60 e 90 dias após o início do tratamento, nove ratas de cada grupo foram sacrificadas, os ovários inspecionados, pesados e processados para avaliação histomorfométrica e o plasma sanguíneo colhido para dosagem de T4-livre, estradiol e progesterona. As concentrações plasmáticas de T4-livre foram significativamente maiores nas ratas hipertireóideas aos 30, 60 e 90 dias, e o peso médio dos ovários foi significativamente maior somente aos 90 dias. Já o número de folículos secundários e terciários e de corpos lúteos foi significativamente maior aos 60 ou aos 90 dias, mas a taxa percentual de atresia folicular só foi diferente aos 90 dias. O número de folículos primários e pré-ovulatórios, assim como as concentrações plasmáticas , de estradiol e progesterona, não diferiram entre grupos e entre períodos. Concluiu-se que o hipertireoidismo estimula a foliculogênese ovariana em ratas sexualmente maduras e diminui a atresia folicular.


Assuntos
Animais , Feminino , Ratos , Folículo Ovariano/fisiopatologia , Hipertireoidismo/induzido quimicamente , Ovário/fisiologia , Esteroides/fisiologia , Estradiol/sangue , Progesterona/sangue , Ratos Wistar , Receptores dos Hormônios Tireóideos/sangue , Tiroxina/efeitos adversos
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