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[PMID]:29340680
[Au] Autor:Jakobsen GS; Småstuen MC; Sandbu R; Nordstrand N; Hofsø D; Lindberg M; Hertel JK; Hjelmesæth J
[Ad] Endereço:Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway.
[Ti] Título:Association of Bariatric Surgery vs Medical Obesity Treatment With Long-term Medical Complications and Obesity-Related Comorbidities.
[So] Source:JAMA;319(3):291-301, 2018 01 16.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: The association of bariatric surgery and specialized medical obesity treatment with beneficial and detrimental outcomes remains uncertain. Objective: To compare changes in obesity-related comorbidities in patients with severe obesity (body mass index ≥40 or ≥35 and at least 1 comorbidity) undergoing bariatric surgery or specialized medical treatment. Design, Setting, and Participants: Cohort study with baseline data of exposures from November 2005 through July 2010 and follow-up data from 2006 until death or through December 2015 at a tertiary care outpatient center, Vestfold Hospital Trust, Norway. Consecutive treatment-seeking adult patients (n = 2109) with severe obesity assessed (221 patients excluded and 1888 patients included). Exposures: Bariatric surgery (n = 932, 92% gastric bypass) or specialized medical treatment (n = 956) including individual or group-based lifestyle intervention programs. Main Outcomes and Measures: Primary outcomes included remission and new onset of hypertension based on drugs dispensed according to the Norwegian Prescription Database. Prespecified secondary outcomes included changes in comorbidities. Adverse events included complications retrieved from the Norwegian Patient Registry and a local laboratory database. Results: Among 1888 patients included in the study, the mean (SD) age was 43.5 (12.3) years (1249 women [66%]; mean [SD] baseline BMI, 44.2 [6.1]; 100% completed follow-up at a median of 6.5 years [range, 0.2-10.1]). Surgically treated patients had a greater likelihood of remission and lesser likelihood for new onset of hypertension (remission: absolute risk [AR], 31.9% vs 12.4%); risk difference [RD], 19.5% [95% CI, 15.8%-23.2%], relative risk [RR], 2.1 [95% CI, 2.0-2.2]; new onset: AR, 3.5% vs 12.2%, RD, 8.7% [95% CI, 6.7%-10.7%], RR, 0.4 [95% CI, 0.3-0.5]; greater likelihood of diabetes remission: AR, 57.5% vs 14.8%; RD, 42.7% [95% CI, 35.8%-49.7%], RR, 3.9 [95% CI, 2.8-5.4]; greater risk of new-onset depression: AR, 8.9% vs 6.5%; RD, 2.4% [95% CI, 1.3%-3.5%], RR, 1.5 [95% CI, 1.4-1.7]; and treatment with opioids: AR, 19.4% vs 15.8%, RD, 3.6% [95% CI, 2.3%-4.9%], RR, 1.3 [95% CI, 1.2-1.4]). Surgical patients had a greater risk for undergoing at least 1 additional gastrointestinal surgical procedure (AR, 31.3% vs 15.5%; RD, 15.8% [95% CI, 13.1%-18.5%]; RR, 2.0 [95% CI, 1.7-2.4]). The proportion of patients with low ferritin levels was significantly greater in the surgical group (26% vs 12%, P < .001). Conclusions and Relevance: Among patients with severe obesity followed up for a median of 6.5 years, bariatric surgery compared with medical treatment was associated with a clinically important increased risk for complications, as well as lower risks of obesity-related comorbidities. The risk for complications should be considered in the decision-making process.
[Mh] Termos MeSH primário: Cirurgia Bariátrica
Obesidade Mórbida/complicações
[Mh] Termos MeSH secundário: Adulto
Cirurgia Bariátrica/efeitos adversos
Índice de Massa Corporal
Estudos de Coortes
Comorbidade
Depressão/complicações
Diabetes Mellitus Tipo 2/complicações
Feminino
Ferritinas/sangue
Seres Humanos
Hipertensão/complicações
Masculino
Meia-Idade
Obesidade Mórbida/tratamento farmacológico
Obesidade Mórbida/cirurgia
Indução de Remissão
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
9007-73-2 (Ferritins)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180311
[Lr] Data última revisão:
180311
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180118
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.21055


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[PMID]:29340676
[Au] Autor:Salminen P; Helmiö M; Ovaska J; Juuti A; Leivonen M; Peromaa-Haavisto P; Hurme S; Soinio M; Nuutila P; Victorzon M
[Ad] Endereço:Division of Digestive Surgery and Urology, Turku University Hospital, Turku, Finland.
[Ti] Título:Effect of Laparoscopic Sleeve Gastrectomy vs Laparoscopic Roux-en-Y Gastric Bypass on Weight Loss at 5 Years Among Patients With Morbid Obesity: The SLEEVEPASS Randomized Clinical Trial.
[So] Source:JAMA;319(3):241-254, 2018 01 16.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: Laparoscopic sleeve gastrectomy for treatment of morbid obesity has increased substantially despite the lack of long-term results compared with laparoscopic Roux-en-Y gastric bypass. Objective: To determine whether laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass are equivalent for weight loss at 5 years in patients with morbid obesity. Design, Setting, and Participants: The Sleeve vs Bypass (SLEEVEPASS) multicenter, multisurgeon, open-label, randomized clinical equivalence trial was conducted from March 2008 until June 2010 in Finland. The trial enrolled 240 morbidly obese patients aged 18 to 60 years, who were randomly assigned to sleeve gastrectomy or gastric bypass with a 5-year follow-up period (last follow-up, October 14, 2015). Interventions: Laparoscopic sleeve gastrectomy (n = 121) or laparoscopic Roux-en-Y gastric bypass (n = 119). Main Outcomes and Measures: The primary end point was weight loss evaluated by percentage excess weight loss. Prespecified equivalence margins for the clinical significance of weight loss differences between gastric bypass and sleeve gastrectomy were -9% to +9% excess weight loss. Secondary end points included resolution of comorbidities, improvement of quality of life (QOL), all adverse events (overall morbidity), and mortality. Results: Among 240 patients randomized (mean age, 48 [SD, 9] years; mean baseline body mass index, 45.9, [SD, 6.0]; 69.6% women), 80.4% completed the 5-year follow-up. At baseline, 42.1% had type 2 diabetes, 34.6% dyslipidemia, and 70.8% hypertension. The estimated mean percentage excess weight loss at 5 years was 49% (95% CI, 45%-52%) after sleeve gastrectomy and 57% (95% CI, 53%-61%) after gastric bypass (difference, 8.2 percentage units [95% CI, 3.2%-13.2%], higher in the gastric bypass group) and did not meet criteria for equivalence. Complete or partial remission of type 2 diabetes was seen in 37% (n = 15/41) after sleeve gastrectomy and in 45% (n = 18/40) after gastric bypass (P > .99). Medication for dyslipidemia was discontinued in 47% (n = 14/30) after sleeve gastrectomy and 60% (n = 24/40) after gastric bypass (P = .15) and for hypertension in 29% (n = 20/68) and 51% (n = 37/73) (P = .02), respectively. There was no statistically significant difference in QOL between groups (P = .85) and no treatment-related mortality. At 5 years the overall morbidity rate was 19% (n = 23) for sleeve gastrectomy and 26% (n = 31) for gastric bypass (P = .19). Conclusions and Relevance: Among patients with morbid obesity, use of laparoscopic sleeve gastrectomy compared with use of laparoscopic Roux-en-Y gastric bypass did not meet criteria for equivalence in terms of percentage excess weight loss at 5 years. Although gastric bypass compared with sleeve gastrectomy was associated with greater percentage excess weight loss at 5 years, the difference was not statistically significant, based on the prespecified equivalence margins. Trial Registration: clinicaltrials.gov Identifier: NCT00793143.
[Mh] Termos MeSH primário: Gastrectomia
Derivação Gástrica
Laparoscopia
Obesidade Mórbida/cirurgia
Perda de Peso
[Mh] Termos MeSH secundário: Adolescente
Adulto
Diabetes Mellitus Tipo 2/complicações
Feminino
Seguimentos
Gastrectomia/efeitos adversos
Gastrectomia/métodos
Derivação Gástrica/efeitos adversos
Derivação Gástrica/métodos
Seres Humanos
Hiperlipidemias/complicações
Hipertensão/complicações
Masculino
Meia-Idade
Obesidade Mórbida/complicações
Obesidade Mórbida/fisiopatologia
Complicações Pós-Operatórias
Qualidade de Vida
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:COMPARATIVE STUDY; EQUIVALENCE TRIAL; JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180311
[Lr] Data última revisão:
180311
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180118
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.20313


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[PMID]:29447174
[Au] Autor:Lee S; You CY; Kim J; Jo YH; Ro YS; Kang SH; Lee H
[Ad] Endereço:Department of Emergency Medicine, Seoul National University Bundang Hospital, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea.
[Ti] Título:Long-term cardiovascular risk of hypertensive events in emergency department: A population-based 10-year follow-up study.
[So] Source:PLoS One;13(2):e0191738, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Hypertension-related visits to the emergency department (ED) are increasing every year. Thus, ED could play a significant role in detecting hypertension and providing necessary interventions. However, it is not known whether a hypertensive event observed in the ED is an independent risk factor for future major adverse cardiovascular events (MACE). METHODS: A population-based observational study was conducted using a nationally representative cohort that contained the claim data of 1 million individuals from 2002 to 2013. We included non-critical ED visits without any history of MACE, and compared the new occurrences of MACE according to the presence of hypertensive events using extended Cox regression model. The disease-modifying effect of a follow-up visit was assessed by analyzing the interaction between hypertensive event and follow-up visit. RESULTS: Among 262,927 first non-critical ED visits during the study period (from 2004 to 2013), 6,243 (2.4%) visits were accompanied by a hypertensive event. The hypertensive event group had a higher risk of having a first MACE at 3 pre-specified intervals: 0-3 years (HR, 4.25; 95% CI, 3.83-4.71; P<0.001), 4-6 years (HR, 3.65; 95% CI, 3.14-4.24; P<0.001), and 7-10 years (HR, 3.20; 95% CI, 2.50-4.11; P<0.001). Follow-up visits showed significant disease-modifying effect at 2 intervals: 0-3 years (HR 0.65, 95% CI, 0.50-0.83) and 4-7 years (HR 0.68, 95% CI, 0.48-0.95). CONCLUSIONS: A hypertensive event in the ED is an independent risk factor for MACE, and follow-up visits after the event can significantly modify the risk.
[Mh] Termos MeSH primário: Doenças Cardiovasculares/etiologia
Serviço Hospitalar de Emergência
Hipertensão/complicações
[Mh] Termos MeSH secundário: Estudos de Coortes
Seguimentos
Seres Humanos
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180216
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191738


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[PMID]:29391274
[Au] Autor:Chen YL; Li TJ; Hao Y; Wu BG; Li H; Geng N; Sun ZQ; Zheng LQ; Sun YX
[Ad] Endereço:Department of Cardiology, The First Hospital of China Medical University, Shenyang, Liaoning, PR China.
[Ti] Título:Association of rs2271037 and rs3749585 polymorphisms in CORIN with susceptibility to hypertension in a Chinese Han population: A case-control study.
[So] Source:Gene;651:79-85, 2018 Apr 20.
[Is] ISSN:1879-0038
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:Corins are membrane-bound protease that regulates blood pressure by activating the natriuretic peptides. These pro-atrial natriuretic peptide convertases are essential for sodium homeostasis and normal blood pressure. CORIN variants have been identified in humans and other animals, but no studies of CORIN polymorphisms have been conducted in northeastern China. This study aims to investigate the association of 2 single nucleotide polymorphisms (SNPs) in CORIN (rs2271037 and rs3749585) with hypertension, as well as their potential interactions with some risk factors of hypertension in a Han population of northeastern China. A case-control study, including 402 patients with hypertension and 406 participants with normal blood pressure, was conducted in Liaoning province. SNP genotyping was carried out by high resolution melting (HRM) after polymerase chain reaction amplifications. Since rs3749585 is located in 3' untranslated region (UTR) of CORIN, in silico analysis was used to predict target micro RNAs on TargetScan, miRanda, and DIANA-microT. As a result, mutant T allele in rs2271037 (odds ratio [OR], 1.693; 95% confidence [CI], 1.528-1.877; p < 0.001) and C allele in rs3749585 (OR, 1.114; 95% CI 1.011-1.227; p = 0.029) increased the risk of hypertension, comparing with wild G allele and T allele, respectively. Patients with genotype TT (OR, 10.209; 95% CI, 6.414-16.250; p < 0.001) and GT (OR, 1.730; 95% CI, 1.226-2.443; p = 0.002) have higher risk of hypertension than those with genotype GG. SNP rs2271037 was significantly associated with susceptibility to hypertension in all genetic models (dominant model: OR, 2.879; 95% CI, 2.080-3.986; p < 0.001; recessive model: OR, 7.159; 95% CI, 4.779-10.724; p < 0.001; additive model: OR, 1.535; 95% CI, 1.163-2.027; p = 0.002). SNP rs3749585 was significantly correlated with hypertension susceptibility only in dominant model (OR, 1.533; 95% CI, 1.073-2.189; p = 0.019), but not in recessive model (OR, 1.220; 95% CI, 0.906-1.644; p = 0.191) or additive model (OR, 0.915; 95% CI, 0.694-1.205; p = 0.527). After adjusting for age, gender, body mass index (BMI), smoking, low-density lipoprotein cholesterol, and serum sodium level in logistic models, the same statistical results were obtained. Interaction study showed the association between CORIN polymorphisms and hypertension could be changed by overweight (BMI ≥ 25 kg/m ). In silico analyses implicated hsa-miR-495 as a target miRNA that potentially interacts with the 3' UTR of CORIN. In conclusion, polymorphisms of rs2271037 and rs3749585 in CORIN were significantly associated with hypertension in a Han population of northeastern China. The mutant-type T allele of rs2271037 and C allele of rs3749585 might increase the susceptibility to hypertension in this population.
[Mh] Termos MeSH primário: Grupo com Ancestrais do Continente Asiático/genética
Hipertensão/genética
Polimorfismo de Nucleotídeo Único
Serina Endopeptidases/genética
[Mh] Termos MeSH secundário: Alelos
Estudos de Casos e Controles
Feminino
Interação Gene-Ambiente
Estudos de Associação Genética
Predisposição Genética para Doença
Genótipo
Seres Humanos
Masculino
MicroRNAs/metabolismo
Meia-Idade
RNA Mensageiro/metabolismo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (MicroRNAs); 0 (RNA, Messenger); EC 3.4.21.- (CORIN protein, human); EC 3.4.21.- (Serine Endopeptidases)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE


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[PMID]:27772648
[Au] Autor:Nesper PL; Simjanoski E; Mirza RG
[Ad] Endereço:Department of Ophthalmology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois.
[Ti] Título:Retinal Macroaneurysm in Long-Standing Hypertension.
[So] Source:Ophthalmology;123(11):2327, 2016 11.
[Is] ISSN:1549-4713
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Aneurisma/etiologia
Hipertensão/complicações
Artéria Retiniana/patologia
Doenças Retinianas/etiologia
[Mh] Termos MeSH secundário: Idoso
Aneurisma/diagnóstico por imagem
Arteríolas/diagnóstico por imagem
Arteríolas/patologia
Feminino
Angiofluoresceinografia
Seres Humanos
Artéria Retiniana/diagnóstico por imagem
Doenças Retinianas/diagnóstico por imagem
Hemorragia Retiniana/diagnóstico
Líquido Sub-Retiniano
Tomografia de Coerência Óptica
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE


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[PMID]:29381739
[Au] Autor:Smith EE; Muzikansky A; McCreary CR; Batool S; Viswanathan A; Dickerson BC; Johnson K; Greenberg SM; Blacker D
[Ad] Endereço:Department of Clinical Neurosciences, University of Calgary, Calgary, Canada.
[Ti] Título:Impaired memory is more closely associated with brain beta-amyloid than leukoaraiosis in hypertensive patients with cognitive symptoms.
[So] Source:PLoS One;13(1):e0191345, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Hypertension is the strongest modifiable risk factor for subcortical ischemic changes and is also a risk factor for Alzheimer's dementia. We used neuroimaging to investigate the pathological basis of early cognitive symptoms in patients with hypertension. METHODS: In this cross-sectional cohort study 67 patients age >60 years with hypertension and Clinical Dementia Rating scale score of 0.5 without dementia, and without history of symptomatic stroke, underwent MRI for measurement of subcortical vascular changes and positron emission tomography (PET) scan with Pittsburgh Compound B (PiB-PET) to detect beta-amyloid deposition. These imaging measures were related to neuropsychological tests of memory, executive function and processing speed. RESULTS: Mean age was 75.0 (standard deviation, SD, 7.3). Mean neuropsychological Z scores were: episodic memory -0.63 (SD 1.23), executive function -0.40 (SD 1.10), processing speed -0.24 (SD 0.88); 22 of the 67 subjects met criteria for mild cognitive impairment (MCI) and the remaining 45 subjects had subjective cognitive concerns only. In multivariable models adjusting for age and years of education, each 0.1 unit increase in mean cortical PiB-PET binding was associated with 0.14 lower mean Z score for episodic memory (95% CI -0.28 to -0.01). This means that for every 0.1 unit increase in mean cortical PiB-PET, episodic memory was 0.14 standard deviations lower. White matter hyperintensity volume, silent brain infarcts and microbleeds were not associated with neuropsychological test scores. CONCLUSIONS: Episodic memory was prominently affected in hypertensive participants with MCI or subjective cognitive concerns, and was associated with PiB-PET binding. This suggests a prominent role for Alzheimer pathology in cognitive impairment even in hypertensive participants at elevated risk for vascular cognitive impairment.
[Mh] Termos MeSH primário: Peptídeos beta-Amiloides/metabolismo
Encéfalo/metabolismo
Cognição
Hipertensão/complicações
Hipertensão/fisiopatologia
Leucoaraiose/complicações
[Mh] Termos MeSH secundário: Idoso
Feminino
Seres Humanos
Hipertensão/diagnóstico
Hipertensão/metabolismo
Masculino
Tomografia por Emissão de Pósitrons
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Nm] Nome de substância:
0 (Amyloid beta-Peptides)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180131
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191345


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[PMID]:29203738
[Au] Autor:Popruha AA; Bobyreva LE; Samarchenko LA; Mykhaylychenko TE
[Ad] Endereço:Higher State Educational Establishment Of Ukraine, "Ukrainian Medical Dental Academy", Poltava, Ukraine.
[Ti] Título:Mathematical model of diabetic encephalopathy.
[So] Source:Wiad Lek;70(5):906-909, 2017.
[Is] ISSN:0043-5147
[Cp] País de publicação:Poland
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Diabetes mellitus (DM) is one of the leading risk factors for cerebrovascular disorders. The risk of stroke is 3-4 times higher in this population. In 10% of cases of vascular accidents in diabetic patients leads to fatal. The mortality rate for ischemic stroke is undergoing 50-60% and 70-95% of hemorrhagic form. It is known that diabetes increases the course of acute disorders of cerebral circulation. At the same time, there are data that about 415 million of the inhabitants of the planet suffer from diabetes, in 95% of cases they have type 2 diabetes, which is the second risk factor for the development of ischemic stroke after an arterial hypertension. This determines the relevance of studying the factors that affect the development of the ischemic process in patients with diabetes The aim of this research is to optimize the methods for diagnosis of diabetic encephalopathy based on a study of indicators of cerebrovascular hemodynamics, functional state of the brain, metabolic disorders and morphological characteristics of the brain tissue. MATERIALS AND METHODS: It was carried out a comprehensive survey of 537 patients with diabetes, including type 1 diabetes is set to 342 (63.7%) type 2 diabetes - in 195 (36.3%) patients. In 108 (20.1%) patients with diabetes, the clinical syndrome DE not identified in 429 (79.9%) - found DE I, II and stage III disease. CONCLUSIONS: Construction of mathematical model allows to objectify the diagnosis where with the help of clinical and metabolic parameters without expensive equipment. At the same time, the availability of informative indicators identified will allow the doctor to diagnose DE the early stages or to predict its development and to discover at the preclinical stage.
[Mh] Termos MeSH primário: Isquemia Encefálica/etiologia
Diabetes Mellitus Tipo 1/complicações
Diabetes Mellitus Tipo 2/complicações
Modelos Teóricos
[Mh] Termos MeSH secundário: Seres Humanos
Hipertensão/complicações
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171206
[St] Status:MEDLINE


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[PMID]:29397599
[Au] Autor:Chen Z; Yang YJ; Li J; Tian XP
[Ad] Endereço:Department of Rheumatology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing 100730, China.
[Ti] Título:[The clinical characteristics of Takayasu's arteritis with glomerulonephropathy].
[So] Source:Zhonghua Nei Ke Za Zhi;57(2):129-133, 2018 Feb 01.
[Is] ISSN:0578-1426
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:To investigate the clinical features of Takayasu's arteritis (TAK) with glomerulonephropathy and to improve physicians' understanding of this complication in patients with TAK. Clinical data were retrospectively collected including manifestations, laboratory tests, image findings and treatment of 8 patients diagnosed as Takayasu's arteritis with glomerulonephropathy from January 2002 to January 2017 in Peking Union Medical College Hospital. Glomerulonephropathy was confirmed based on percutaneous renal biopsy. There were 6 women and 2 men. The median onset age and median disease duration were 24 (18-37) years and 42 (3-360) months, respectively. Five patients had hypertension. The 24 hour urinary protein was 0.18-14.91 g. Red blood cells and casts in urine were tested among 4 and 2 patients, respectively. Three patients had renal artery stenosis. Three patients demonstrated mesangial proliferative glomerulonephritis, two with IgA nephropathy, two with minimal change disease and one with membranoproliferative glomerulonephritis. Seven patients received glucocorticoid combined with cyclophosphamide therapy (glucocorticoid 40-60 mg/d, prednisone or equivalent; cyclophosphamide 0.4 g/week iv. or cyclophosphamide 0.1 g/d po.). Uninary blood cells removed and 24 hour urinary protein decreased from 1.65 g to 0.90 g after treatment for 12 months in one patient. The other 7 patients were missing. Glomerulonephropathy is occasionally observed among TAK patients. Mesangial proliferative glomerulonephritis is the most common pathological subtype. Glucocorticoid combined with cyclophosphamide therapy could be an optional therapy for Takayasu's arteritis with glomerulonephropathy.
[Mh] Termos MeSH primário: Glomerulonefrite Membranoproliferativa/etiologia
Glomerulonefrite/etiologia
Arterite de Takayasu/patologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Ciclofosfamida/administração & dosagem
Ciclofosfamida/uso terapêutico
Eritrócitos
Feminino
Glomerulonefrite/patologia
Glomerulonefrite por IGA
Glomerulonefrite Membranoproliferativa/patologia
Glucocorticoides/administração & dosagem
Glucocorticoides/uso terapêutico
Seres Humanos
Hipertensão
Masculino
Prednisona/administração & dosagem
Prednisona/uso terapêutico
Arterite de Takayasu/complicações
Arterite de Takayasu/tratamento farmacológico
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Glucocorticoids); 8N3DW7272P (Cyclophosphamide); VB0R961HZT (Prednisone)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180206
[St] Status:MEDLINE
[do] DOI:10.3760/cma.j.issn.0578-1426.2018.02.009


  9 / 198445 MEDLINE  
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[PMID]:29325264
[Au] Autor:Xiong Y; Xia HX; Wang YS; Lin XL; Zhu TT; Zhao Y; Li XT
[Ad] Endereço:Department of Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, China.
[Ti] Título:[High risk factors analysis of stillbirth].
[So] Source:Zhonghua Fu Chan Ke Za Zhi;52(12):811-817, 2017 Dec 25.
[Is] ISSN:0529-567X
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:To explore the high risk factors of stillbirth. 176 cases of stillbirth were collected in the Obstetrics and Gynecology Hospital of Fudan University from January 1(st), 2010 to December 31(st), 2016. All cases were analyzed retrospectively, including general profile, high risk factors of stillbirth in different years and pregnancy periods. (1) The incidence of stillbirth was 0.178%(176/98 785). Stillbirth occured mostly at 28-28(+6) gestational weeks (10.8%,19/176), and the second peak was 29-29(+6) weeks(10.2%,18/176), while the third common period was 37-37(+6) weeks (9.1%,16/176). After 39 weeks, it maintained at a low level. (2) The top 5 high risk factors of stillbirth were infection (18.2%,32/176), unexplained (13.6%,24/176), hypertention disorders in pregnancy (13.1%, 23/176), umbilical cord torsion (12.5%, 22/176) and fetal malformations (10.2%, 18/176). (3) From 2010 to 2012, the top 3 high risk factors were unexplained, the umbilical cord torsion and infection, while hypertention in pregnancy, infection and fetal malformation became the top 3 high risk factors after 2013. (4) Early stillbirth (20-27(+6) weeks) accounted for 21.6%(38/176); and unexplained (47.4%, 18/38), fetal edema (13.2%, 5/38),infection (13.2%, 5/38), umbilical cord torsion (5.3%, 2/38) were the top 4 high risk factors. Late stillbirth (≥28 weeks) accounted for 78.4%(138/176), with infection (19.6%,27/138), hypertention in pregnancy (15.9%,22/138), umbilical cord torsion (14.5%,20/138) and fetal malformation(12.3%,17/138)being the top 4 high risk factors. More attention should be paid to maternal complications, especially infection and hypertension in pregnancy. Antenatal fetal monitoring, timely termination of pregnancy, standard management of stillbirth and looking for the causes may help reduce the incidence of stillbirth.
[Mh] Termos MeSH primário: Morte Fetal/etiologia
Monitorização Fetal
Hipertensão/epidemiologia
Natimorto/epidemiologia
[Mh] Termos MeSH secundário: Adulto
Feminino
Idade Gestacional
Hospitais
Seres Humanos
Incidência
Gravidez
Estudos Retrospectivos
Fatores de Risco
Natimorto/etnologia
Cordão Umbilical
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180112
[St] Status:MEDLINE
[do] DOI:10.3760/cma.j.issn.0529-567x.2017.12.004


  10 / 198445 MEDLINE  
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[PMID]:29220561
[Au] Autor:Michaud A; Lamarre-Cliche M; Milot A; Pinard J; Poirier L; Cloutier L
[Ad] Endereço:GMF Jolibourg du CISSS de Laval, Québec, Canada.
[Ti] Título:Le MAPA. Au coeur du diagnostic et du suivi de l'hypertension artérielle..
[So] Source:Perspect Infirm;14(3):41-46, 2017 May-Jun.
[Is] ISSN:1708-1890
[Cp] País de publicação:Canada
[La] Idioma:fre
[Mh] Termos MeSH primário: Hipertensão/diagnóstico
Hipertensão/terapia
[Mh] Termos MeSH secundário: Seguimentos
Seres Humanos
Guias de Prática Clínica como Assunto
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:171209
[St] Status:MEDLINE



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