RESUMO
No disponible
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Sarcoidose/induzido quimicamente , Sarcoidose/complicações , Hepatite C/complicações , Interferon-alfa/administração & dosagem , Ribavirina/administração & dosagem , Hepatite C/tratamento farmacológico , Interferon alfa-2/administração & dosagem , Dermoscopia , Joelho/patologiaAssuntos
Antivirais/efeitos adversos , Toxidermias/etiologia , Hepatite C Crônica/tratamento farmacológico , Interferon-alfa/efeitos adversos , Ribavirina/efeitos adversos , Sarcoidose/induzido quimicamente , Dermatopatias/induzido quimicamente , Antivirais/uso terapêutico , Toxidermias/patologia , Feminino , Humanos , Interferon-alfa/uso terapêutico , Joelho , Pessoa de Meia-Idade , Ribavirina/uso terapêutico , Sarcoidose/patologia , Dermatopatias/patologiaRESUMO
No disponible
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Técnicas de Imagem por Elasticidade/métodos , Técnicas de Imagem por Elasticidade , Melanoma/diagnóstico por imagem , Metástase Neoplásica/diagnóstico por imagem , Tegumento Comum/patologia , Imuno-Histoquímica/métodos , Neoplasias Cutâneas/diagnóstico por imagem , Ultrassonografia Doppler em Cores/métodosRESUMO
BACKGROUND: Fibroblast growth factor 21 (FGF21) has been suggested to be an endocrine signal of nutritional status and an active regulator of metabolism. However, there is no agreement on the effect of weight-loss therapies on circulating levels of FGF21 in humans. OBJECTIVE: To assess FGF21 circulating levels in adiposity excess and after different weight-loss strategies prescribed in five different groups from four independent centers. SUBJECTS AND METHODS: Body composition, ketosis, insulin sensitivity and FGF21 were evaluated in 181 excess body weight and 14 normal-weight subjects. From the excess body weight patients, two independent groups (discovery cohort; n=20 and validation cohort; n=28) undertook a very low-calorie ketogenic (VLCK) diet, a third group followed a low-calorie (LC) diet (n=84) and other two groups underwent bariatric surgery (discovery cohort; n=24 and validation cohort; n=25). The follow-up was 4 to 6 or 12 months, respectively. RESULTS: FGF21 levels were higher in excess body weight patients than in normal-weight subjects. The energy-restriction therapy to lose weight induced a significant decrease, with respect to baseline, in circulating levels of FGF21 (VLCK: -62.5 pg ml-1 or -14.8 pg ml-1 and LC diet: -67.9 pg ml-1). There were no differences in FGF21 levels between both energy-restriction treatments. On the contrary, after bariatric surgery morbidly obese patients showed a significant increase in FGF21, especially 1 month after surgery (148.8 pg ml-1 higher than baseline). The FGF21 differential changes occur concomitantly with a non-induced ketosis situation (0.66±0.56 mm) in bariatric surgery, and an improvement in adiposity and insulin sensitivity induced by the three therapies. CONCLUSIONS: FGF21 levels were reduced after energy-restricted treatments and severely increased after bariatric surgery, independently of the weight reduction magnitude, insulin sensitivity or ketosis. Therefore, FGF21 appears to be a marker of severe nutritional stress.
Assuntos
Cirurgia Bariátrica , Restrição Calórica , Fatores de Crescimento de Fibroblastos/sangue , Obesidade Mórbida/sangue , Obesidade Mórbida/terapia , Estresse Fisiológico , Adulto , Biomarcadores/sangue , Composição Corporal , Feminino , Seguimentos , Humanos , Resistência à Insulina , Cetose , Masculino , Estado Nutricional/fisiologia , Obesidade Mórbida/complicações , Obesidade Mórbida/cirurgia , Espanha , Redução de PesoRESUMO
BACKGROUND/OBJECTIVES: Caregiving can be a stressful task with severe consequences on caregivers' health. Our aim was to evaluate the profile and the burden of caregivers of patients with home artificial nutrition (HAN) in our area. SUBJECTS/METHODS: We conducted a prospective observational study of patients who had started HAN over a period of a year (n=573) and their home caregivers (n=103). Epidemiological characteristics of the patients and the type of HAN were registered. Caregivers' profile data (gender, age and degree of kinship) and Zarit Burden Assessments were recorded. RESULTS: Care recipients had a median age of 79.0 (IQR 87) years, neurological and oncological diseases in 50% and a high rate of mobility limitations (80%). Oral supplements with high-calorie formulas were predominant (60%). The usual caregiver profile was a patient's daughter with a mean age of 53.1 (s.d. 13.4) years acting as the primary caregiver. Burden was absent in 49.5%, light in 18.4% and intense in 32% of caregivers. Intense burden was more frequent in oral over enteral nutrition (42% versus 22.6%; P=0.036). Supplementary nutrition was also associated with higher caregiver burden scores compared with complete diets. In patients with functional limitations, a tendency toward a slightly higher burden was observed. No differences in caregiver burden were detected according to other patient or caregiver characteristics. CONCLUSIONS: HAN type appears to be a factor influencing caregiver burden and therefore, evaluation of caregiver burden should be part of HAN programs.
Assuntos
Cuidadores/psicologia , Efeitos Psicossociais da Doença , Nutrição Parenteral no Domicílio/psicologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Inquéritos e QuestionáriosRESUMO
Purpose: Teaching ultrasound procedures to undergraduates has recently been proposed to improve the quality of medical education. We address the impact of applying standardized dermatologic ultrasound teaching to our undergraduates. Materials and Methods: Medical students were offered an additional theoretical and practical seminar involving hands-on ultrasound dermatologic ultrasound during their mandatory dermatology practical training. The students' theoretical knowledge and dermatologic ultrasoud skills were tested with a multiple choice questionnaire extracted from Level 1 Spanish Society of Ultrasound Dermatologic Ultrasound accreditation exam before and after the course. After the course, the students were asked to answer a course evaluation questionnaire Results: The multiple-choice question scores after the course showed statistically significant improvement (5.82 vs. 8.71%; P<0.001). The questionnaire revealed that students were satisfied with the course, felt that it increased both their dermatologic and ultrasound knowledge, and indicated that they wanted more sonographic hands-on training in both dermatologic ultrasound and other medical fields. Conclusion: Using both objective and subjective methods, we showed that the introduction of standardized ultrasound training programs in undergraduate medical education can improve both students' understanding of the technique and the quality of medical education in dermatology.
RESUMO
No disponible
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Líquen Plano/diagnóstico , Líquen Plano/patologia , Líquen Plano/terapia , Alopecia/diagnóstico , Alopecia/patologia , Alopecia/terapia , Diagnóstico Diferencial , Couro Cabeludo/lesões , Couro Cabeludo/patologia , Couro Cabeludo/fisiopatologia , Doenças do Cabelo/complicações , Doenças do Cabelo/diagnóstico , Doenças do Cabelo/terapiaRESUMO
No disponible
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Eritema Multiforme/complicações , Eritema Multiforme/diagnóstico , Eritema Multiforme/terapia , Neoplasias Pulmonares/fisiopatologia , Neoplasias Pulmonares/terapia , Fenitoína/efeitos adversos , Fenitoína/farmacologia , Síndrome de Stevens-Johnson/terapia , Dermatopatias/complicações , Dermatopatias/terapiaRESUMO
BACKGROUND/OBJECTIVES: Obese adipose tissue, especially the visceral depot, exhibits altered production of several molecules that could have a role on the initiation/promotion of breast cancer development. The aim of this work was to evaluate the effect of excess adipose tissue and its secreted factors on the expression of genes involved in the early steps of tumor promotion on the mammary gland. SUBJECTS AND METHODS: Carcinogenesis-related gene expression was evaluated in mammary gland tissue from female diet-induced obese (DIO) Sprague-Dawley rats and circulating leukocytes isolated from a group of breast cancer diagnosed and non-diagnosed obese women and compared with their normal weight counterparts. In addition, the human non-tumoral mammary epithelial cell line MCF10A was treated in vitro with the visceral (retroperitoneal adipose tissue (RPAT)) or subcutaneous adipose tissue (SAT) secretome and with rising concentrations of the lipid peroxidation by-product 4-hydroxynonenal (4-HNE). RESULTS: DIO rats were classified as susceptible to DIO (DIO-S) or partially resistant to DIO (DIO-R) according to the maximum fat mass gain of the lean group as a cut-off. As compared with lean and DIO-R, the DIO-S group showed a higher fat mass and lower lean mass. The anatomical characteristic of DIO-S was correlated with differential expression of cellular proliferation (ALDH3A1 and MYC) and antioxidant and DNA protection (GSTM2, SIRT1), and tumor suppression (TP53, PTEN, TGFB1) genes. Remarkably, this carcinogenesis-related gene expression pattern was reproduced in MCF10A treated with the RPAT secretome from DIO-S rats and with the lipid peroxidation by-product 4-HNE. Moreover, this pattern was also detected in leukocytes from obese women compared with normal weight women without evidence of breast cancer. CONCLUSIONS: Lipid peroxides secreted by the obese visceral adipose tissue could be among the relevant factors that promote changes involved in the early steps of tumor development in mammary gland. These changes can be detected even before histological alterations and in circulating leukocytes.
Assuntos
Neoplasias da Mama/patologia , Transformação Celular Neoplásica/patologia , Proteínas de Neoplasias/metabolismo , Obesidade/patologia , Gordura Subcutânea/patologia , Animais , Apoptose , Western Blotting , Proliferação de Células , Feminino , Regulação Neoplásica da Expressão Gênica , Predisposição Genética para Doença , Estresse Oxidativo , Ratos , Ratos Sprague-DawleyRESUMO
No disponible
Assuntos
Humanos , Masculino , Idoso , Acantose Nigricans/patologia , Adenocarcinoma/complicações , Dermatoses Faciais/etiologia , Dermatoses da Mão/etiologia , Síndromes Paraneoplásicas/etiologia , Dermatopatias Papuloescamosas/etiologia , Neoplasias Gástricas/complicações , Evolução Fatal , Neoplasias Cutâneas , Neoplasias da Coluna Vertebral , Vértebras Torácicas/diagnóstico por imagem , Tomografia Computadorizada por Raios XAssuntos
Acantose Nigricans/etiologia , Adenocarcinoma/complicações , Dermatoses Faciais/etiologia , Dermatoses da Mão/etiologia , Síndromes Paraneoplásicas/etiologia , Dermatopatias Papuloescamosas/etiologia , Neoplasias Gástricas/complicações , Adenocarcinoma/diagnóstico , Adenocarcinoma/diagnóstico por imagem , Adenocarcinoma/secundário , Idoso , Evolução Fatal , Humanos , Masculino , Neoplasias Cutâneas , Neoplasias da Coluna Vertebral/diagnóstico por imagem , Neoplasias da Coluna Vertebral/secundário , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/diagnóstico por imagem , Vértebras Torácicas/diagnóstico por imagem , Tomografia Computadorizada por Raios XRESUMO
No disponible