Comparação da eficácia de tenoxicam administrado por via oral e intra‐articular a pacientes com osteoartrite de joelhos

ResumoJustificativa e objetivosTenoxicam é amplamente usado no tratamento da osteoartrite (OA) e o nosso objetivo foi comparar a eficácia de tenoxicam administrado por via oral (VO) e intra‐articular (IA) no tratamento da OA.MétodosEste estudo foi conduzido entre 2011 e 2012 por meio de análise retrospectiva e comparação dos resultados de 60 pacientes que foram clínica e radiologicamente diagnosticados com OA degenerativa de joelhos na Policlínica de Tratamento da Dor do Hospital Estadual de Bünyan. Os 60 pacientes incluídos no estudo foram alocados em dois grupos. O primeiro grupo (tenoxicam IA, n=30) incluiu resultados de pacientes submetidos à injeção nos joelhos por via IA de 20mg de tenoxicam uma vez por semana durante três semanas e o segundo grupo (tenoxicam VO, n=30) incluiu pacientes que receberam 20mg de tenoxicam por VO uma vez por dia durante três semanas. Todos os pacientes foram avaliados clinicamente na fase basal pré‐tratamento e em uma semana, um mês e três meses pós‐tratamento, de acordo com os critérios especificados.Resultados e conclusõesDos 60 pacientes, 22 eram do sexo masculino e 38 do sexo feminino. Em ambos os grupos, melhorias significativas foram detectadas em todos os parâmetros da escala visual analógica, do índice Western Ontario and MacMaster (Womac – dor, atividade física e rigidez dos joelhos) e do índice de Lequesne nas avaliações feitas em uma semana, um mês e três meses e comparadas aos valores basais. Além disso, uma melhor adesão ao tratamento e tolerabilidade ao sistema gastrointestinal no grupo tenoxicam IA também foram observadas. A administração de tenoxicam IA pode ser considerada como um método opcional de tratamento em pacientes com OA de joelhos que não podem usar tenoxicam por VO, especialmente por causa dos efeitos colaterais sobre o sistema gastrintestinal, e naqueles com dificuldades de adaptação ao tratamento.AbstractBackground and objectivesTenoxicam is widely used in osteoarthritis treatment and we aimed to compare the effectivity of oral and intra‐articular administration of tenoxicam in osteoarthritis treatment.MethodsThis study was performed between 2011 and 2012 by retrospectively analyzing and comparing the findings of 60 patients who were clinically and radiologically diagnosed with knee degenerative osteoarthritis in Bünyan state hospital pain policlinic. 60 patients included in the study were divided into two groups. The first group (tenoxicam IA, n=30) included patient findings of those subjected to intra‐articular injection of 20mg tenoxicam to the knee once a week for three weeks and the second group (oral tenoxicam, n=30) included patients who were administered 20mg oral tenoxicam once a day for three weeks. All patients were clinically evaluated pre‐treatment and in the 1st week, 1st month and 3rd month post‐treatment according to specified criteria.Results and conclusions22 of 60 patients included in the study were male and 38 were female. In both groups significant improvements were detected in all of the observed parameters: visual analog scale, Western Ontario McMaster Osteoarthritis Index (pain, physical activity, knee stiffness) and Lequesne index scores and in the evaluations performed in 1st week, 1st month and 3rd month with respect to pre‐treatment values. Besides, a better compliance to treatment and gastrointestinal system tolerability in tenoxicam IA group was also observed. Intra‐articular tenoxicam administration could be thought as an alternative treatment method in patients with knee osteoarthritis who cannot use oral tenoxicam especially due to systemic gastrointestinal system side effects and those who have difficulties in adapting to treatment

Przepływ w gałęzi przedniej zstępującej lewej tętnicy wieńcowej u pacjentów z marskością wątroby

Introduction. Although cardiac function appears normal in patients with cirrhosis at rest, cardiac function deteriorates in these patients under stress conditions. Decreased cardiac function against stress may be due to coronary microvascular dysfunction in these patients. In this study, we aimed to evaluate coronary microvascular dysfunction in patients with cirrhosis by measuring coronary flow reserve (CFR) by transthoracic echocardiography. Materials and methods. Thirty-eight patients with cirrhosis and 32 healthy subjects (as control group) were examined. In addition to standard two-dimesional (2D) and Doppler echocardiography, coronary flow velocity was measured by pulsed-wave Doppler from the middle to the distal part of the left anterior descending artery at the beginning and after dipyridamole infusion in the hyperemic state. CFR was measured as the ratio of hyperemic peak diastolic flow rate to basal peak diastolic flow rate. Results. CFR was significantly lower in the cirrhosis group than in the control group (2.01 ± 0.31 and 2.84 ± 0.62; p < 0.0001). Increasing age, increasing myocardial mass, high aspartate aminotransferase and alanine aminotransferase, low hemoglobin, high C-reactive protein, decreased cholesterol and platelet levels were found to be associated with the reduction in CFR. Among all these factors only, the hemoglobin level and age were independent determinants of impaired CFR. Conclusions. Impaired CFR in patients with cirrhosis promotes coronary microvascular dysfunction. The coronary microvascular dysfunction can potentially contribute to the development of cirrhotic cardiomyopathy.Wstęp. Chociaż czynność serca u pacjentów z marskością wątroby oceniana w spoczynku wydaje się prawidłowa, to w warunkach wysiłku fizycznego lub obciążenia farmakologicznego ulega ona pogorszeniu. Zaburzenie czynności serca podczas obciążenia może być spowodowane dysfunkcją mikrokrążenia wieńcowego u tych chorych. Celem badania była ocena dysfunkcji mikrokrążenia wieńcowego u pacjentów z marskością wątroby przez pomiar rezerwy przepływu wieńcowego (CRF) za pomocą echokardiografii przezklatkowej. Materiał i metody. Do badania włączono 38 chorych z marskością wątroby i 32 osoby zdrowe (grupa kontrolna). Oprócz standardowej echokardiografii dwuwymiarowej (2D) i echokardiografii doplerowskiej prędkość przepływu wieńcowego w odcinkach środkowym i dystalnym gałęzi przedniej lewej tętnicy zstępującej zmierzono za pomocą badania dopplerowskiego metodą fali pulsacyjnej bezpośrednio przed wlewem dipirydamolu i po nim. Rezerwę przepływu wieńcowego mierzono jako stosunek maksymalnego przepływu rozkurczowego w obciążeniu do maksymalnego przepływu rozkurczowego w spoczynku. Wyniki. Rezerwa przepływu wieńcowego była istotnie niższa w grupie z marskością wątroby niż w grupie kontrolnej (2,01 ± 0,31 i 2,84 ± 0,62; p &lt; 0,0001). Stwierdzono, że ze zmniejszeniem CFR wiązały się: wiek, zwiększenie masy mięśnia sercowego, wysoka aktywność aminotransferaz asparaginianowej i alaninowej, niskie stężenie hemoglobiny, wysokie stężenie białka C-reaktywnego, obniżone stężenie cholesterolu i zmniejszona liczba płytek krwi. Jednak tylko stężenie hemoglobiny i wiek były niezależnymi determinantami zmniejszonej CFR. Wnioski. Zmniejszenie CFR u chorych z marskością wątroby sprzyja dysfunkcji mikrokrążenia wieńcowego, która może prowadzić do rozwoju kardiomiopatii wątrobowej (marskiej)

XRCC1 suppresses somatic hypermutation and promotes alternative nonhomologous end joining in Igh genes

As revealed using mice heterozygous for the base excision repair (BER) protein XRCC1, BER and mutagenic repair pathways can simultaneously compete for access to single-strand breaks induced by activation-induced deaminase

Volume CXIV, Number 4, November 7, 1996

Objective: Turner syndrome (TS) is a chromosomal disorder caused by complete or partial X chromosome monosomy that manifests various clinical features depending on the karyotype and on the genetic background of affected girls. This study aimed to systematically investigate the key clinical features of TS in relationship to karyotype in a large pediatric Turkish patient population.Methods: Our retrospective study included 842 karyotype-proven TS patients aged 0-18 years who were evaluated in 35 different centers in Turkey in the years 2013-2014.Results: The most common karyotype was 45,X (50.7%), followed by 45,X/46,XX (10.8%), 46,X,i(Xq) (10.1%) and 45,X/46,X,i(Xq) (9.5%). Mean age at diagnosis was 10.2±4.4 years. The most common presenting complaints were short stature and delayed puberty. Among patients diagnosed before age one year, the ratio of karyotype 45,X was significantly higher than that of other karyotype groups. Cardiac defects (bicuspid aortic valve, coarctation of the aorta and aortic stenosis) were the most common congenital anomalies, occurring in 25% of the TS cases. This was followed by urinary system anomalies (horseshoe kidney, double collector duct system and renal rotation) detected in 16.3%. Hashimoto's thyroiditis was found in 11.1% of patients, gastrointestinal abnormalities in 8.9%, ear nose and throat problems in 22.6%, dermatologic problems in 21.8% and osteoporosis in 15.3%. Learning difficulties and/or psychosocial problems were encountered in 39.1%. Insulin resistance and impaired fasting glucose were detected in 3.4% and 2.2%, respectively. Dyslipidemia prevalence was 11.4%.Conclusion: This comprehensive study systematically evaluated the largest group of karyotype-proven TS girls to date. The karyotype distribution, congenital anomaly and comorbidity profile closely parallel that from other countries and support the need for close medical surveillance of these complex patients throughout their lifespa

Clinical and Laboratory Characteristics of Hyperprolactinemia in Children and Adolescents: National Survey

Conclusion: We present the largest cohort of children and adolescents with hyperprolactinemia in the literature to date. Hyperprolactinemia is more common in females and cabergoline is highly effective and practical to use in adolescents, due to its biweekly dosing. Indications for surgery in pediatric cases need to be revised

Calibration of the CMS hadron calorimeters using proton-proton collision data at root s=13 TeV

Methods are presented for calibrating the hadron calorimeter system of theCMSetector at the LHC. The hadron calorimeters of the CMS experiment are sampling calorimeters of brass and scintillator, and are in the form of one central detector and two endcaps. These calorimeters cover pseudorapidities vertical bar eta vertical bar ee data. The energy scale of the outer calorimeters has been determined with test beam data and is confirmed through data with high transverse momentum jets. In this paper, we present the details of the calibration methods and accuracy.Peer reviewe

Measurement of the W gamma Production Cross Section in Proton-Proton Collisions at root s=13 TeV and Constraints on Effective Field Theory Coefficients

A fiducial cross section for W gamma production in proton-proton collisions is measured at a center-of-mass energy of 13 TeV in 137 fb(-1) of data collected using the CMS detector at the LHC. The W -> e nu and mu nu decay modes are used in a maximum-likelihood fit to the lepton-photon invariant mass distribution to extract the combined cross section. The measured cross section is compared with theoretical expectations at next-to-leading order in quantum chromodynamics. In addition, 95% confidence level intervals are reported for anomalous triple-gauge couplings within the framework of effective field theory.Peer reviewe

Search for long-lived particles decaying to jets with displaced vertices in proton-proton collisions at root s=13 Te V

A search is presented for long-lived particles produced in pairs in proton-proton collisions at the LHC operating at a center-of-mass energy of 13 TeV. The data were collected with the CMS detector during the period from 2015 through 2018, and correspond to a total integrated luminosity of 140 fb(-1). This search targets pairs of long-lived particles with mean proper decay lengths between 0.1 and 100 mm, each of which decays into at least two quarks that hadronize to jets, resulting in a final state with two displaced vertices. No significant excess of events with two displaced vertices is observed. In the context of R-parity violating supersymmetry models, the pair production of long-lived neutralinos, gluinos, and top squarks is excluded at 95% confidence level for cross sections larger than 0.08 fb, masses between 800 and 3000 GeV, and mean proper decay lengths between 1 and 25 mm.Peer reviewe

Search for top squark production in fully hadronic final states in proton-proton collisions at root s=13 TeV

A search for production of the supersymmetric partners of the top quark, top squarks, is presented. The search is based on proton-proton collision events containing multiple jets, no leptons, and large transverse momentum imbalance. The data were collected with the CMS detector at the CERN LHC at a center-of-mass energy of 13 TeV, and correspond to an integrated luminosity of 137 fb(-1). The targeted signal production scenarios are direct and gluino-mediated top squark production, including scenarios in which the top squark and neutralino masses are nearly degenerate. The search utilizes novel algorithms based on deep neural networks that identify hadronically decaying top quarks and W bosons, which are expected in many of the targeted signal models. No statistically significant excess of events is observed relative to the expectation from the standard model, and limits on the top squark production cross section are obtained in the context of simplified supersymmetric models for various production and decay modes. Exclusion limits as high as 1310 GeVare established at the 95% confidence level on the mass of the top squark for direct top squark production models, and as high as 2260 GeV on the mass of the gluino for gluino-mediated top squark production models. These results represent a significant improvement over the results of previous searches for supersymmetry by CMS in the same final state.Peer reviewe