Base de dados : MEDLINE
Pesquisa : C10.597.751.791.500 [Categoria DeCS]
Referências encontradas : 2529 [refinar]
Mostrando: 1 .. 10   no formato [Detalhado]

página 1 de 253 ir para página                         

  1 / 2529 MEDLINE  
              next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:29390464
[Au] Autor:Zhang X; Li X; Meng M; Cao J; Song X; Liu K; Fang S
[Ad] Endereço:Department of Neurology, Neuroscience Centre, the First Teaching Hospital of Jilin University, Changchun, China.
[Ti] Título:Vascular spinal cord obstruction associated with superior vena cava syndrome: A case report and literature review.
[So] Source:Medicine (Baltimore);96(51):e9196, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Superior vena cava syndrome (SVCS) is the obstruction of blood flow through the SVC, causing complete or partial blockade of the collateral circulation of returning venous blood. SVCS is frequently presented with facial, neck, trunk, and upper limbs swelling and so on. However, to the best of our knowledge, the obstruction of the venous return in the spinal veins is rarely a manifestation of SVCS. PATIENT CONCERNS: We presented a rare case of a 52-year-old male patient with 2-month history of progressive right upper limb numbness and swelling and 10-day history of extremities malfunctioning. Cervical magnetic resonance imaging (MRI) detected obstruction of the spinal venous return. Lung computed tomography (CT) revealed lesions in the esophagus, which indicated esophageal cancer with mediastinal lymph nodes metastasis and signified SVCS. DIAGNOSES: With the results of laboratory findings, cervical MRI, lung CT findings, and physical examination, the patient was diagnosed with SVCS manifesting as spinal vein obstruction. INTERVENTIONS AND OUTCOMES: The family abandoned further treatment, and the patient passed away 2 months after discharge. LESSONS: The case indicates that SVCS can induce systemic and spinal cord diseases affecting the venous return. Further studies are necessary to reveal the mechanism for SVCS inducing spinal veins obstruction and to explore whether SVCS patients with and without vascular spinal cord obstruction have different prognoses.
[Mh] Termos MeSH primário: Compressão da Medula Espinal/complicações
Compressão da Medula Espinal/diagnóstico por imagem
Síndrome da Veia Cava Superior/complicações
Síndrome da Veia Cava Superior/diagnóstico por imagem
Doenças Vasculares/complicações
[Mh] Termos MeSH secundário: Progressão da Doença
Evolução Fatal
Seres Humanos
Hipestesia/diagnóstico
Hipestesia/etiologia
Angiografia por Ressonância Magnética/métodos
Masculino
Meia-Idade
Doenças Raras
Medição de Risco
Índice de Gravidade de Doença
Compressão da Medula Espinal/fisiopatologia
Síndrome da Veia Cava Superior/fisiopatologia
Tomografia Computadorizada por Raios X/métodos
Extremidade Superior
Doenças Vasculares/diagnóstico por imagem
Doenças Vasculares/fisiopatologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180214
[Lr] Data última revisão:
180214
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009196


  2 / 2529 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28460850
[Au] Autor:Hu X; Heyn PC; Schwartz J; Roberts P
[Ti] Título:What Is Mild Stroke?
[So] Source:Arch Phys Med Rehabil;98(11):2347-2349, 2017 Nov.
[Is] ISSN:1532-821X
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Acidente Vascular Cerebral/complicações
[Mh] Termos MeSH secundário: Emoções
Fadiga/etiologia
Seres Humanos
Hipestesia/etiologia
Transtornos da Memória/etiologia
Debilidade Muscular/etiologia
Índice de Gravidade de Doença
Acidente Vascular Cerebral/diagnóstico
Acidente Vascular Cerebral/psicologia
Avaliação de Sintomas
[Pt] Tipo de publicação:JOURNAL ARTICLE; PATIENT EDUCATION HANDOUT
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180209
[Lr] Data última revisão:
180209
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE


  3 / 2529 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28468199
[Au] Autor:Cho SE; Shin HS; Tak MS; Kang SG; Lee YS; Kim HS; Kim CH
[Ad] Endereço:*Department of Plastic and Reconstructive Surgery, College of Medicine, Soonchunhyang University Seoul Hospital, Seoul †Department of Plastic and Reconstructive Surgery, College of Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea.
[Ti] Título:A Rare Complication of Infraorbital Nerve Hyperesthesia in Surgically Repaired Orbital Fracture Patients.
[So] Source:J Craniofac Surg;28(3):e233-e234, 2017 May.
[Is] ISSN:1536-3732
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Injury to the peripheral sensory branches of the trigeminal nerve can follow a wide variety of craniofacial injuries. Many patients with facial fractures complain about the symptom of numbness to the distribution of injured nerve, which is indicative of hypoesthesia. Hyperesthesia involving the infraorbital nerve is rare in comparison to hypoesthesia secondary to facial trauma. The authors report on 2 patients with infraorbital nerve hyperesthesia in surgically repaired orbital fracture patients. Surgical decompression of the infraorbital nerve led to rapid resolution of hyperesthesia. To the best of our knowledge, these were rare cases of patients who presented with persistent hyperesthesia. Clinician should perform early surgical decompression of the infraorbital nerve in patient with persistent hyperesthesia of the infraorbital nerve.
[Mh] Termos MeSH primário: Hiperestesia/etiologia
Nervo Maxilar/lesões
Fraturas Orbitárias/complicações
Fraturas Orbitárias/cirurgia
[Mh] Termos MeSH secundário: Adulto
Descompressão Cirúrgica
Seres Humanos
Hiperestesia/diagnóstico
Hiperestesia/cirurgia
Hipestesia/etiologia
Hipestesia/cirurgia
Masculino
Meia-Idade
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180205
[Lr] Data última revisão:
180205
[Sb] Subgrupo de revista:D
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE
[do] DOI:10.1097/SCS.0000000000003439


  4 / 2529 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
[PMID]:29172311
[Au] Autor:Rice N; Srinivasan B; Macpherson D
[Ti] Título:Case Report: Metastatic Infratemporal Soft Tissue Myeloma Presenting as a Numb Lower Lip.
[So] Source:Dent Update;44(1):53-4, 2017 Jan.
[Is] ISSN:0305-5000
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:This is a case of a patient presenting to his general dental practitioner (GDP) with altered sensation in his lower lip with no obvious cause. Due to a prompt referral, the patient was investigated and diagnosed with an extramedullary presentation of multiple myeloma. A numb lip can present in general dental practice, although this is not common. There are several causes, for example, dental infection or fractured mandible. Clinical relevance: It is very important for the dental practitioner to recognize when there could be a potential sinister underlying cause and prompt referral, under the two week rule referral system, is indicated
[Mh] Termos MeSH primário: Mieloma Múltiplo/secundário
Neoplasias de Tecidos Moles/secundário
[Mh] Termos MeSH secundário: Idoso
Seres Humanos
Hipestesia/etiologia
Lábio
Masculino
Mandíbula
Mieloma Múltiplo/complicações
Mieloma Múltiplo/diagnóstico
Neoplasias de Tecidos Moles/complicações
Neoplasias de Tecidos Moles/diagnóstico
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180123
[Lr] Data última revisão:
180123
[Sb] Subgrupo de revista:D
[Da] Data de entrada para processamento:171128
[St] Status:MEDLINE


  5 / 2529 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28984782
[Au] Autor:Zhou Y; Zhu L; Lin Y; Cheng H
[Ad] Endereço:Department of Neurosurgery, Jinling Hospital, Jinling School of Clinical Medicine, Nanjing Medical University, Jiangsu, China.
[Ti] Título:Chiari type I malformation with occult tethered cord syndrome in a child: A case report.
[So] Source:Medicine (Baltimore);96(40):e8239, 2017 Oct.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Chiari type I malformation (CM1) and occult tethered cord syndrome (OTCS) are considered to be malformations associated with subtle structural abnormalities of the terminal filum. Few studies have reported patients with CM1 and OTCS. Treatment strategy for patients of CM1 associated with OTCS is controversial. PATIENT CONCERNS: A 14-year-old child was admitted with intermittent pain and numbness in the right upper limb. And he had urinary frequency, neck pain, back pain, and numbness simultaneously. The imaging examinations showed CM1, syringomyelia, small fat in the filum at the level of the L2 vertebral body but the conus medullaris at the aspect of the L1 vertebral body. DIAGNOSES: The child was diagnosed with CM1 associated with OTCS. INTERVENTIONS: Patient underwent sectioning of filum terminale (SFT) under electrophysiological monitoring during the first hospital and posterior fossa decompression (PFD) during the second hospital. OUTCOMES: After first discharge pain of the right upper limb was relieved, but he still felt numbness. And his numbness was relieved after second discharge. The imaging examinations also showed corresponding improvement during the 2-year follow-up period. LESSONS: For pediatric patients with CM1 and TCS, treatment trouble is not only to choose the staging operation or simultaneous operation but also staging procedures for treatment of 2 lesions. Detailed preoperative evaluation is essential for development of individualized surgical plan. Staging operation of firstly minimally invasive SFT and later PFD may be helpful for such cases owing to its positive effect on both the symptoms and imaging findings.
[Mh] Termos MeSH primário: Malformação de Arnold-Chiari/complicações
Defeitos do Tubo Neural/complicações
[Mh] Termos MeSH secundário: Adolescente
Dor nas Costas/etiologia
Seres Humanos
Hipestesia/etiologia
Masculino
Cervicalgia/etiologia
Extremidade Superior
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171012
[Lr] Data última revisão:
171012
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171007
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008239


  6 / 2529 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28723914
[Au] Autor:Tarcha EJ; Olsen CM; Probst P; Peckham D; Muñoz-Elías EJ; Kruger JG; Iadonato SP
[Ad] Endereço:Kineta Inc., Seattle, WA, United States of America.
[Ti] Título:Safety and pharmacodynamics of dalazatide, a Kv1.3 channel inhibitor, in the treatment of plaque psoriasis: A randomized phase 1b trial.
[So] Source:PLoS One;12(7):e0180762, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Dalazatide is a specific inhibitor of the Kv1.3 potassium channel. The expression and function of Kv1.3 channels are required for the function of chronically activated memory T cells, which have been shown to be key mediators of autoimmune diseases, including psoriasis. OBJECTIVE: The primary objective was to evaluate the safety of repeat doses of dalazatide in adult patients with mild-to-moderate plaque psoriasis. Secondary objectives were to evaluate clinical proof of concept and the effects of dalazatide on mediators of inflammation in the blood and on chronically activated memory T cell populations. METHODS: Patients (n = 24) were randomized 5:5:2 to receive dalazatide at 30 mcg/dose, 60 mcg/dose, or placebo twice weekly by subcutaneous injection (9 doses total). Safety was assessed on the basis of physical and neurological examination and laboratory testing. Clinical assessments included body-surface area affected, Psoriasis Area and Severity Index (PASI), and investigator and patient questionnaires. RESULTS: The most common adverse events were temporary mild (Grade 1) hypoesthesia (n = 20; 75% placebo, 85% dalazatide) and paresthesia (n = 15; 25% placebo, 70% dalazatide) involving the hands, feet, or perioral area. Nine of 10 patients in the 60 mcg/dose group had a reduction in their PASI score between baseline and Day 32, and the mean reduction in PASI score was significant in this group (P < 0.01). Dalazatide treatment reduced the plasma levels of multiple inflammation markers and reduced the expression of T cell activation markers on peripheral blood memory T cells. LIMITATIONS: The study was small and drug treatment was for a short duration (4 weeks). CONCLUSION: This study indicates that dalazatide is generally well tolerated and can improve psoriatic skin lesions by modulating T cell surface and activation marker expression and inhibiting mediators of inflammation in the blood. Larger studies of longer duration are warranted.
[Mh] Termos MeSH primário: Canal de Potássio Kv1.3/antagonistas & inibidores
Bloqueadores dos Canais de Potássio/efeitos adversos
Proteínas/efeitos adversos
Psoríase/tratamento farmacológico
[Mh] Termos MeSH secundário: Adulto
Método Duplo-Cego
Feminino
Seres Humanos
Hipestesia/induzido quimicamente
Masculino
Meia-Idade
Parestesia/induzido quimicamente
Bloqueadores dos Canais de Potássio/farmacologia
Bloqueadores dos Canais de Potássio/uso terapêutico
Proteínas/farmacologia
Proteínas/uso terapêutico
Resultado do Tratamento
[Pt] Tipo de publicação:CLINICAL TRIAL, PHASE I; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Kv1.3 Potassium Channel); 0 (Potassium Channel Blockers); 0 (Proteins); 0 (Shk-186 peptide)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170926
[Lr] Data última revisão:
170926
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170721
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0180762


  7 / 2529 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28721891
[Au] Autor:Kotecha R; Miller JA; Modugula S; Barnett GH; Murphy ES; Reddy CA; Suh JH; Neyman G; Machado A; Nagel S; Chao ST
[Ad] Endereço:Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio.
[Ti] Título:Stereotactic Radiosurgery for Trigeminal Neuralgia Improves Patient-Reported Quality of Life and Reduces Depression.
[So] Source:Int J Radiat Oncol Biol Phys;98(5):1078-1086, 2017 Aug 01.
[Is] ISSN:1879-355X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To characterize quality-of-life (QOL) outcomes after stereotactic radiosurgery (SRS) for trigeminal neuralgia (TN). METHODS AND MATERIALS: The EuroQOL 5 Dimensions (EQ-5D) and Patient Health Questionnaire 9 (PHQ-9) were prospectively collected before and after SRS for 50 patients with TN. Pain response and treatment-related facial numbness were classified by Barrow Neurological Institute (BNI) scales. Differences in pooled QOL outcomes were tested with paired t tests and sign tests. The Kaplan-Meier method was used to estimate time-dependent improvements in the EQ-5D index, EQ-5D perceived health status (PHS), PHQ-9 score, and freedom from pain failure (BNI class IV-V) or facial numbness (BNI class III-IV). RESULTS: Following SRS, the 12-month rate of freedom from pain failure was 92% (95% confidence interval [CI], 77%-97%) while the 12-month rate of freedom from facial numbness was 89% (95% CI, 66%-97%). Significant improvements in the EQ-5D index (P<.01), PHS (P=.01), and PHQ-9 (P=.03) were observed, driven by the EQ-5D subscores for self-care and for pain and/or discomfort (P=.02 and P<.01, respectively). At 12 months after SRS, the actuarial rates of improvement in the EQ-5D, PHS, and PHQ-9 were 55% (95% CI, 40%-70%), 59% (95% CI, 40%-76%), and 59% (95% CI, 39%-76%), respectively. The median time to improvement in each of the QOL measures was 9 months (95% CI, 3-36 months) for the EQ-5D index, 5 months (95% CI, 3-36 months) for PHS, and 9 months (95% CI, 3-18 months) for the PHQ-9. On multivariate analysis, only higher prescription dose (86 Gy vs ≤82 Gy) was associated with improvement in the EQ-5D index (hazard ratio, 5.73; 95% CI, 1.85-22.33; P<.01). CONCLUSIONS: Patients with TN treated with SRS reported significant improvements in multiple QOL measures, with the therapeutic benefit strongly driven by improvements in pain and/or discomfort and in self-care, along with lower rates of depression. In this analysis, there appears to be a correlation between prescription dose and treatment response as measured by the EQ-5D.
[Mh] Termos MeSH primário: Depressão/terapia
Qualidade de Vida
Radiocirurgia/métodos
Neuralgia do Trigêmeo/psicologia
Neuralgia do Trigêmeo/cirurgia
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Face
Nível de Saúde
Seres Humanos
Hipestesia/cirurgia
Estimativa de Kaplan-Meier
Avaliação de Estado de Karnofsky
Meia-Idade
Estudos Prospectivos
Dosagem Radioterapêutica
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170814
[Lr] Data última revisão:
170814
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170720
[St] Status:MEDLINE


  8 / 2529 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28636859
[Au] Autor:David WS; Bowley MP; Mehan WA; Shin JH; Gerstner ER; DeWitt JC
[Ad] Endereço:From the Departments of Neurology (W.S.D., M.P.B., E.R.G.), Radiology (W.A.M.), Neurosurgery (J.H.S.), and Pathology (J.C.D.), Massachusetts General Hospital, and the Departments of Neurology (W.S.D., M.P.B., E.R.G.), Radiology (W.A.M.), Neurosurgery (J.H.S.), and Pathology (J.C.D.), Harvard Medical
[Ti] Título:Case 19-2017 - A 53-Year-Old Woman with Leg Numbness and Weakness.
[So] Source:N Engl J Med;376(25):2471-2481, 2017 Jun 22.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Linfoma Difuso de Grandes Células B/patologia
Raízes Nervosas Espinhais/patologia
[Mh] Termos MeSH secundário: Encéfalo/diagnóstico por imagem
Encéfalo/patologia
Líquido Cefalorraquidiano/química
Líquido Cefalorraquidiano/citologia
Diagnóstico Diferencial
Feminino
Seres Humanos
Hipestesia/etiologia
Vértebras Lombares/diagnóstico por imagem
Linfoma Difuso de Grandes Células B/complicações
Linfoma Difuso de Grandes Células B/diagnóstico por imagem
Imagem por Ressonância Magnética
Meia-Idade
Debilidade Muscular/etiologia
Sistema Nervoso Periférico/anatomia & histologia
Sistema Nervoso Periférico/fisiologia
Sarcoidose/diagnóstico
Tuberculose/diagnóstico
[Pt] Tipo de publicação:CASE REPORTS; CLINICAL CONFERENCE; JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170629
[Lr] Data última revisão:
170629
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170622
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMcpc1701762


  9 / 2529 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28606011
[Au] Autor:Alawneh K; Raffee L; Hamouri S
[Ad] Endereço:1 Department of Radiology, Faculty of Medicine, Jordan University of Science and Technology, Jordan, Irbid, Jordan.
[Ti] Título:Delayed Endovascular Stenting of Right Subclavian Artery Pseudoaneurysm Caused by Gunshot Accident in a Syrian Refugee: A Case Report.
[So] Source:Vasc Endovascular Surg;51(6):386-389, 2017 Aug.
[Is] ISSN:1938-9116
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Sharp penetrating injuries causing right subclavian artery pseudoaneurysm are considered rare. Surgical repair is reportedly associated with a high mortality rate and is considered technically challenging. In this case report, we report the successful endovascular repair of a delayed pseudoaneurysm of the right subclavian artery caused by a gunshot injury in a 22-year-old Syrian refugee that was associated with significant right brachial panplexopathy. The patient was successfully managed with angioplastic ballooning of the stenotic region of the artery and a covered self-expanding stent. The patient recovered uneventfully, and follow-up evaluation revealed significant improvement in neurological deficit.
[Mh] Termos MeSH primário: Falso Aneurisma/terapia
Angioplastia com Balão/instrumentação
Refugiados
Stents
Artéria Subclávia/lesões
Extremidade Superior/inervação
Lesões do Sistema Vascular/terapia
Ferimentos por Arma de Fogo/complicações
[Mh] Termos MeSH secundário: Falso Aneurisma/diagnóstico por imagem
Falso Aneurisma/etiologia
Angiografia por Tomografia Computadorizada
Seres Humanos
Hipestesia/etiologia
Hipestesia/fisiopatologia
Masculino
Debilidade Muscular/etiologia
Debilidade Muscular/fisiopatologia
Dor/etiologia
Dor/fisiopatologia
Artéria Subclávia/diagnóstico por imagem
Síria
Resultado do Tratamento
Lesões do Sistema Vascular/diagnóstico por imagem
Lesões do Sistema Vascular/etiologia
Ferimentos por Arma de Fogo/diagnóstico por imagem
Adulto Jovem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170918
[Lr] Data última revisão:
170918
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170614
[St] Status:MEDLINE
[do] DOI:10.1177/1538574417710412


  10 / 2529 MEDLINE  
              first record previous record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28587056
[Au] Autor:Chen AM; Yoshizaki T; Velez MA; Mikaeilian AG; Hsu S; Cao M
[Ad] Endereço:Department of Radiation Oncology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California. Electronic address: achen5@kumc.edu.
[Ti] Título:Tolerance of the Brachial Plexus to High-Dose Reirradiation.
[So] Source:Int J Radiat Oncol Biol Phys;98(1):83-90, 2017 May 01.
[Is] ISSN:1879-355X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To study the tolerance of the brachial plexus to high doses of radiation exceeding historically accepted limits by analyzing human subjects treated with reirradiation for recurrent tumors of the head and neck. METHODS AND MATERIALS: Data from 43 patients who were confirmed to have received overlapping dose to the brachial plexus after review of radiation treatment plans from the initial and reirradiation courses were used to model the tolerance of this normal tissue structure. A standardized instrument for symptoms of neuropathy believed to be related to brachial plexus injury was utilized to screen for toxicity. Cumulative dose was calculated by fusing the initial dose distributions onto the reirradiation plan, thereby creating a composite plan via deformable image registration. The median elapsed time from the initial course of radiation therapy to reirradiation was 24 months (range, 3-144 months). RESULTS: The dominant complaints among patients with symptoms were ipsilateral pain (54%), numbness/tingling (31%), and motor weakness and/or difficulty with manual dexterity (15%). The cumulative maximum dose (Dmax) received by the brachial plexus ranged from 60.5 Gy to 150.1 Gy (median, 95.0 Gy). The cumulative mean (Dmean) dose ranged from 20.2 Gy to 111.5 Gy (median, 63.8 Gy). The 1-year freedom from brachial plexus-related neuropathy was 67% and 86% for subjects with a cumulative Dmax greater than and less than 95.0 Gy, respectively (P=.05). The 1-year complication-free rate was 66% and 87%, for those reirradiated within and after 2 years from the initial course, respectively (P=.06). CONCLUSION: The development of brachial plexus-related symptoms was less than expected owing to repair kinetics and to the relatively short survival of the subject population. Time-dose factors were demonstrated to be predictive of complications.
[Mh] Termos MeSH primário: Neuropatias do Plexo Braquial/etiologia
Plexo Braquial/efeitos da radiação
Neoplasias de Cabeça e Pescoço/radioterapia
Tolerância a Radiação
Reirradiação
[Mh] Termos MeSH secundário: Adulto
Idoso
Plexo Braquial/diagnóstico por imagem
Feminino
Neoplasias de Cabeça e Pescoço/diagnóstico por imagem
Seres Humanos
Hipestesia/etiologia
Masculino
Meia-Idade
Recidiva Local de Neoplasia/radioterapia
Dor/etiologia
Radiocirurgia
Dosagem Radioterapêutica
Radioterapia de Intensidade Modulada
Reirradiação/efeitos adversos
Estudos Retrospectivos
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170721
[Lr] Data última revisão:
170721
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170608
[St] Status:MEDLINE



página 1 de 253 ir para página                         
   


Refinar a pesquisa
  Base de dados : MEDLINE Formulário avançado   

    Pesquisar no campo  
1  
2
3
 
           



Search engine: iAH v2.6 powered by WWWISIS

BIREME/OPAS/OMS - Centro Latino-Americano e do Caribe de Informação em Ciências da Saúde