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‣ Systemic lupus erythematosus in the elderly: antimalarials in disease remission

SHINJO, Samuel Katsuyuki
Fonte: SPRINGER Publicador: SPRINGER
Tipo: Artigo de Revista Científica
Português
Relevância na Pesquisa
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To analyze the long-term antimalarials (AM) usage on elderly systemic lupus erythematosus (SLE) patients from 2002 to 2008. Fifty-seven consecutive SLE patients, a parts per thousand yen65 years, were enrolled. The patients were divided into groups A (disease remission) and B (disease activity: with clinical and/or laboratory alterations attributed to SLE activity, and/or using steroid and immunosuppressors). Forty-three patients (75.4%) were in group A. The mean age in groups A and B was, respectively, 69.8 +/- A 4.5 versus 67.8 +/- A 4.8 years (P = 0.210), with similar disease onset (46.9 +/- A 11.2 vs. 42.3 +/- A 11.6 years; P = 0.220). There was no difference in gender, ethnicity, and clinical previous manifestations. In 21 out of 57 cases (10 from group A and 11, group B, P < 0.001), AM had been suspended after 5.2 +/- A 1.3 years, because of its side effects (maculopathy). The disease remission was strongly associated to AM usage (OR 12.91; 95% CI 2.87-58.13). In summary, SLE remission was significantly associated with the long-term AM usage.

‣ The presence of anti-citrullinated protein antibodies (ACPA) and rheumatoid factor on patients with rheumatoid arthritis (RA) does not interfere with the chance of clinical remission in a follow-up of 3 years

Henrique da Mota, Licia Maria; dos Santos Neto, Leopoldo Luiz; de Carvalho, Jozelio Freire; Pereira, Ivanio Alves; Burlingame, Rufus; Menard, Henri A.; Magalhaes Laurindo, Ieda Maria
Fonte: SPRINGER HEIDELBERG; HEIDELBERG Publicador: SPRINGER HEIDELBERG; HEIDELBERG
Tipo: Artigo de Revista Científica
Português
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Autoantibodies in early rheumatoid arthritis (RA) have important diagnostic value. The association between the presence of autoantibodies against cyclic citrullinated peptide and the response to treatment is controversial. To prospectively evaluate a cohort of patients with early rheumatoid arthritis (< 12 months of symptoms) in order to determine the association between serological markers (rheumatoid factor (RF), anti-citrullinated protein antibodies) such as anti-cyclic citrullinated peptide antibodies (anti-CCP) and citrullinated anti-vimentin (anti-Sa) with the occurrence of clinical remission, forty patients diagnosed with early RA at the time of diagnosis were evaluated and followed for 3 years, in use of standardized therapeutic treatment. Demographic and clinical data were recorded, disease activity score 28 (DAS 28), as well as serology tests (ELISA) for RF (IgM, IgG, and IgA), anti-CCP (CCP2, CCP3, and CCP3.1) and anti-Sa in the initial evaluation and at 3, 6, 12, 18, 24, and 36 months of follow-up. The outcome evaluated was the percentage of patients with clinical remission, which was defined by DAS 28 lower than 2.6. Comparisons were made through the Student t test, mixed-effects regression analysis, and analysis of variance (significance level of 5%). The mean age was 45 years...

‣ TDAH : remissão na adolescência e preditores de persistência em adultos; ADHD : remission in adolescence and predictors of persistence into adulthood

Schmitz, Marcelo; Polanczyk, Guilherme Vanoni; Rohde, Luis Augusto Paim
Fonte: Universidade Federal do Rio Grande do Sul Publicador: Universidade Federal do Rio Grande do Sul
Tipo: Artigo de Revista Científica Formato: application/pdf
Português
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Embora no passado se acreditasse que o TDAH persistia somente até a adolescência, atualmente já há um corpo sólido de conhecimento científico evidenciando que o TDAH freqüentemente persiste em adultos que foram diagnosticados como tendo TDAH na infância. São poucos os relatos na literatura sobre o padrão dessa evolução dos sintomas e, principalmente, sobre os fatores que predizem esse desfecho. O objetivo deste artigo é revisar a literatura científica sobre o TDAH, com foco específico em dados sobre remissão dos sintomas na adolescência e preditores de persistência do transtorno até a vida adulta. São apresentados dados de prevalência na adolescência e idade adulta, fatores relacionados à variabilidade de resultados entre os estudos, potenciais fatores de risco de persistência e o único estudo delineado especificamente com o objetivo de avaliar um conjunto abrangente de preditores do transtorno da infância à idade adulta.; Although in the past it was thought that ADHD did not continue beyond adolescence, nowadays there is a consistent body of scientific knowledge showing that ADHD often persists in adults who had been diagnosed as having ADHD in childhood. There are very few studies in the literature on the pattern of the evolution of the symptoms and mainly on the factors that predict this outcome in adulthood. The aim of this paper is to review the scientific literature on ADHD with specific focus on data about symptom remission during adolescence and predictors of the disorder persistence into adulthood. The authors present data on prevalence in adolescence and adulthood...

‣ Prognostic factors associated with time to hCG remission in patients with low-risk postmolar gestational trophoblastic neoplasia

Maestá, Izildinha; Growdon, Whitfield B.; Goldstein, Donald P.; Bernstein, Marilyn R.; Horowitz, Neil S.; Rudge, Marilza Vieira Cunha; Berkowitz, Ross S.
Fonte: Universidade Estadual Paulista Publicador: Universidade Estadual Paulista
Tipo: Artigo de Revista Científica Formato: 312-316
Português
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Objective The purpose of this study was to identify the clinical factors associated with time to hCG remission among women with low-risk postmolar GTN. Methods This study included a non-concurrent cohort of 328 patients diagnosed with low-risk postmolar GTN according to FIGO 2002 criteria. Associations of time to hCG remission with history of prior mole, molar histology, time to persistence, use of D&C at persistence, presence of metastatic disease, FIGO score, hCG values at persistence, type of first line therapy and use of multiagent chemotherapy were investigated with both univariate and multivariate analyses. Results Overall median time to remission was 46 days. Ten percent of the patients required multi-agent chemotherapy to achieve hCG remission. Multivariate analysis incorporating the variables significant on univariate analysis confirmed that complete molar histology (HR 1.45), metastatic disease (HR 1.66), use of multi-agent therapy (HR 2.00) and FIGO score (HR 1.82) were associated with longer time to remission. There was a linear relationship between FIGO score and time to hCG remission. Each 1-point increment in FIGO score was associated with an average 17-day increase in hCG remission time (95% CI: 12.5-21.6). Conclusions Complete mole histology prior to GTN...

‣ Probability of remission of juvenile idiopathic arthritis following treatment with steroid joint injection

Oliveira Sato, J. de; Albuquerque Pedrosa Fernandes, T. de; Bicalho do Nascimento, C.; Corrente, J. E.; Saad-Magalhaes, C.
Fonte: Clinical & Exper Rheumatology Publicador: Clinical & Exper Rheumatology
Tipo: Artigo de Revista Científica Formato: 291-296
Português
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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq); Objectives: Steroid joint injection is indicated as starting treatment for juvenile idiopathic arthritis, but its effect as single treatment has not been explored. Our aim was to estimate arthritis remission probability after single or repeated injections.MethodsConduct a retrospective analysis of inactive arthritis status, remission on medication and remission off medication, estimating cumulative probability and mean time to survival, from the first joint injection session to the last follow-up visit or disease-modifying anti-rheumatic drugs initiation. Remission and time to achieve remission status after single or repeated injections were compared.ResultsSeventy-seven patients with 4-year medium follow-up and 254 treated joints, were reviewed. Eighty-three percent of the individuals had oligoarticular subtype and 57% had persistent oligoarticular course. Overall, 26% achieved remission off medication status, 4% remission on medication and 38% initiated disease-modifying anti-rheumatic drugs. Survival analysis resulted in mean time of achieving inactive disease status, remission on medication and off medication of 8, 11 and 56 months, respectively. The cumulative probability of remission off medication was 2% at 12 months...

‣ Adalimumab in the induction of Crohn's disease remission: results of a Brazilian multicenter case series

Kotze,Paulo Gustavo; Vieira,Andrea; Sobrado Junior,Carlos Walter; Salem,Juliana Barreto; Kotze,Lorete Maria da Silva
Fonte: Sociedade Brasileira de Coloproctologia Publicador: Sociedade Brasileira de Coloproctologia
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/09/2011 Português
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Introduction: Adalimumab (ADA) is a subcutaneous fully-human anti-TNF antibody which has a significant role in the management of Crohn's disease (CD). Its efficacy has been demonstrated in several clinical trials. The main objective of this study was to evaluate the role of ADA in the induction of clinical remission in a Brazilian series of CD cases. Method: A retrospective analysis of CD patients treated with ADA was performed in three Brazilian inflammatory bowel diseases (IBD) reference centers. The following characteristics were analyzed: gender, age, indication to ADA treatment, type of response, previous exposure to infliximab (IFX), concomitant use of immunomodulators and adverse events, among others. Results: 54 patients (29 females) were included in this series, with mean age of 36.72 years (ranging from 15 to 62 years). After induction regimen, 26 patients (48.14%) were in clinical remission, 26 (48.14%) had partial response, and 2 (3.72%) were primary non-responders. After a mean follow-up of 9.83 (2 to 28) months, 17 patients (31.48%) presented adverse events. The most common event was pain on the injection site (7 patients - 12.96%). Conclusions: ADA was effective to induce CD remission in this Brazilian case series. The remission and response rates were similar to the literature...

‣ Assessing full remission

McIntyre, Roger; Kennedy, Sidney; Bagby, R. Michael; Bakish, David
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /07/2002 Português
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The 17-item Hamilton Rating Scale for Depression (HAM-D17) has been used for 4 decades as the “gold standard” instrument to assess the severity of depression and response to therapy in clinical research. The clinical utility of the HAM-D17 is hampered, in part, by the length of time required to administer the interview and by concern about a lack of inter-rater reliability. Several groups have developed shorter versions of the HAM-D17 for use in clinical practice. However, despite extensive research highlighting the importance of achieving full remission in minimizing the risk of relapse and recurrence, these shortened questionnaires have not been validated for the task of distinguishing between remission and response. A shortened form of the HAM-D17 with cut-off scores for full remission would offer a useful tool that physicians could readily employ in clinical practice. On the basis of the responses of a sample of 292 patients with major depression who received standard clinical treatment at a tertiary university affiliated hospital (Depression Clinic, Centre for Addiction and Mental Health, Toronto, Ont.) we derived a shortened versionof the HAM-D. Seven items with the greatest frequency of occurrence and sensitivity to change with treatment were identified and designated as the Toronto HAM-D7. A score of 3 or less on the Toronto HAM-D7 was found to correlate with the 17-item HAM-D definition of full remission (i.e....

‣ Excess cost of non-remission among outpatients with major depressive disorder

Woo, Jong-Min; Jeon, Hong Jin; Kim, Hyo-Jin; Lee, Kwang-Hun; Lee, Chang Uk; Noh, Jai Sung; Lee, Chang Hwa; Hong, Jin Pyo
Fonte: BioMed Central Publicador: BioMed Central
Tipo: Artigo de Revista Científica
Português
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Background: The purpose of this study was to assess the economic benefit of achieving remission among outpatients with major depressive disorder (MDD) who are currently employed in Korea. Methods: Cross-sectional observational study. A total of 337 outpatients with MDD with paid jobs were recruited from 14 psychiatric clinics in Korea and were then divided into three groups as follows: new visit group (n = 128), remitted group (n = 100) and non-remitted group (n = 109). The 17-item Hamilton Depression Rating Scale (HAM-D) was used to decide whether a patient should be assigned to the remitted or non-remitted group. Direct medical and non-medical costs were measured via interview with the subjects. The World Health Organization Health and Work Performance Questionnaire (HPQ) were applied in order to measure the lost productive time (LPT) and related productivity costs. Results: The three groups did not show a significant difference in direct medical cost. However, the difference between the remitted group and non-remitted group was statistically significant (25.49 ± 52.99 vs. 44.79 ± 126.55, χ2 = 12.99, p = 0.0015). The remitted group demonstrated a significant improvement in productivity (particularly presenteeism) when compared with the new visit group (Z = −3.29...

‣ Active foot synovitis in patients with rheumatoid arthritis: applying clinical criteria for disease activity and remission may result in underestimation of foot joint involvement

Wechalekar, M.; Lester, S.; Proudman, S.; Cleland, L.; Whittle, S.; Rischmueller, M.; Hill, C.
Fonte: Wiley-Liss Publicador: Wiley-Liss
Tipo: Artigo de Revista Científica
Publicado em //2012 Português
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OBJECTIVE: To determine whether application of criteria for remission in rheumatoid arthritis (RA) may result in underestimation of foot joint involvement among patients in a clinic setting. METHODS: RA patients (n _ 123) were assessed at baseline and 6 months after commencement of a response-driven combination disease-modifying antirheumatic drug (DMARD) protocol. Remission was assessed using disease activity measures (the 28-joint Disease Activity Score using the erythrocyte sedimentation rate [DAS28-ESR], Simplified Disease Activity Index [SDAI], and Clinical Disease Activity Index [CDAI]) as well as Boolean-based criteria for remission (the 1981 American College of Rheumatology [ACR] preliminary criteria and the 2011 ACR/European League Against Rheumatism [EULAR] provisional criteria). The prevalence of foot synovitis and the mean swollen/tender foot joint count in RA patients meeting any of these remission criteria were estimated by hurdle (mixed distribution) regression. RESULTS: In patients who received 6 months of combination DMARD treatment, application of the 1981 ACR criteria and the newly proposed 2011 ACR/EULAR criteria, each utilizing full joint counts (which includes assessment of the feet), classified the least number of patients as being in remission (8–10%)...

‣ Remission from post-traumatic stress disorder in the general population

Chapman, C.; Mills, K.; Slade, T.; McFarlane, A.; Bryant, R.; Creamer, M.; Silove, D.; Teesson, M.
Fonte: Cambridge Univ Press Publicador: Cambridge Univ Press
Tipo: Artigo de Revista Científica
Publicado em //2012 Português
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Background: Few studies have focused on post-traumatic stress disorder (PTSD) remission in the population, none have modelled remission beyond age 54 years and none have explored in detail the correlates of remission from PTSD. This study examined trauma experience, symptom severity, co-morbidity, service use and time to PTSD remission in a large population sample. Method: Data came from respondents (n=8841) of the 2007 Australian National Survey of Mental Health and Wellbeing (NSMHWB). A modified version of the World Health Organization's World Mental Health Composite International Diagnostic Interview (WMH-CIDI) was used to determine the presence and age of onset of DSM-IV PTSD and other mental and substance use disorders, type, age, and number of lifetime traumas, severity of re-experiencing, avoidance and hypervigilance symptoms and presence and timing of service use. Results: Projected lifetime remission rate was 92% and median time to remission was 14 years. Those who experienced childhood trauma, interpersonal violence, severe symptoms or a secondary anxiety or affective disorder were less likely to remit from PTSD and reported longer median times to remission compared to those with other trauma experiences, less severe symptoms or no co-morbidity. Conclusions: Although most people in the population with PTSD eventually remit...

‣ Criteria of cure and remission in Cushing's disease: an update

Czepielewski,Mauro A.; Rollin,Guilherme A.F.S.; Casagrande,Alessandra; Ferreira,Nelson P.
Fonte: Sociedade Brasileira de Endocrinologia e Metabologia Publicador: Sociedade Brasileira de Endocrinologia e Metabologia
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/11/2007 Português
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We review the clinical and biochemical criteria used for evaluation of the transsphenoidal pituitary surgery results in the treatment of Cushing's disease (CD). Firstly, we discuss the pathophysiology of the hypothalamic-pituitary-adrenal axis in normal subjects and patients with CD. Considering the series published in the last 25 years, we observed a significant variation in the remission or cure criteria, including the choice of biochemical tests, timing, threshold values to define remission, and the interference of glucocorticoid replacement or previous treatment. In this context we emphasize serum cortisol levels obtained early (from hours to 12 days) in the postoperative period without any glucocorticoid replacement or treatment. Our experience demonstrates that: (i) early cortisol < 5 to 7 µg/dl, (ii) a period of glucocorticoid dependence > 6 mo, (iii) absence of response of cortisol/ACTH to CRH or DDAVP, (iv) return of dexamethasone suppression, and circadian rhythm of cortisol are appropriate indices of remission of CD. In patients with undetectable cortisol levels early after surgery, recurrence seems to be low. Finally, although certain biochemical patterns are more suggestive of remission or surgical failure, none has been proven to be completely accurate...

‣ Sustained rheumatoid arthritis remission is uncommon in clinical practice

Prince, Femke HM; Bykerk, Vivian P; Frits, Michelle; Iannaccone, Christine K; Shadick, Nancy Ann; Lu, Bing; Cui, Jing; Weinblatt, Michael Elliott; Solomon, Daniel Hal
Fonte: BioMed Central Publicador: BioMed Central
Tipo: Artigo de Revista Científica
Português
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27.01598%
Introduction: Remission is an important goal of therapy in rheumatoid arthritis (RA), but data on duration of remission are lacking. Our objective was to describe the duration of remission in RA, assessed by different criteria. Methods: We evaluated patients from the Brigham and Women's Rheumatoid Arthritis Sequential Study (BRASS) not in remission at baseline with at least 2 years of follow-up. Remission was assessed according to the Disease Activity Score 28-C-reactive protein (DAS28-CRP4), Simplified Disease Activity Index (SDAI), and Clinical Disease Activity Index (CDAI) scores, and the recently proposed American College of Rheumatology (ACR)/European League against Rheumatism (EULAR) criteria for remission. Analyses were performed by using Kaplan-Meier survival curves. Results: We identified 871 subjects with ≥2 years of follow-up. Of these subjects, 394 were in remission at one or more time-points and not in remission at baseline, according to at least one of the following criteria: DAS28-CRP < 2.6 (n = 309), DAS28-CRP < 2.3 (n = 275), SDAI (n = 168), CDAI (n = 170), and 2010 ACR/EULAR (n = 158). The median age for the 394 subjects at entrance to BRASS was 56 years; median disease duration was 8 years; 81% were female patients; and 72% were seropositive. Survival analysis performed separately for each remission criterion demonstrated that < 50% of subjects remained in remission 1 year later. Median remission survival time was 1 year. Kaplan-Meier curves of the various remission criteria did not significantly differ (P = 0.29 according to the log-rank test). Conclusions: This study shows that in clinical practice...

‣ Biologic-free remission by orthopaedic surgery in non-responder to infliximab for rheumatoid arthritis

Kanbe, Katsuaki; Chiba, Junji; Inoue, Yasuo; Taguchi, Masashi; Yabuki, Akiko
Fonte: Springer International Publishing Publicador: Springer International Publishing
Tipo: Artigo de Revista Científica
Publicado em 13/10/2015 Português
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The aim of this study was to investigate remission and biologic-free remission after orthopaedic surgery and related clinical factors in non-responder to infliximab for rheumatoid arthritis (RA). We analyzed 74 patients who were treated with 3 mg/kg infliximab and methotrexate and underwent orthopaedic surgery after non-responder to infliximab with disease activity score (DAS) 28 (CRP) of ≥3.2. The rates of remission and biologic-free remission at 52 weeks after orthopaedic surgery were investigated and the clinical factors related to remission and biologic-free remission were analyzed by logistic regression and receiver-operating characteristic analyses. The rates of total remission and biologic-free remission were 37/74 (50 %) and 9/74 (12.2 %), respectively. Regarding orthopaedic surgery, the rates of remission and biologic-free remission were 25/38 (65.8 %) and 7/38 (18.4 %) for synovectomy, 7/20 (35 %) and 0/20 (0 %) for arthroplasty, and 5/16 (31.3 %) and 2/16 12.5) for others including spine surgery and foot surgery. DAS28(CRP) at baseline was significantly related to both remission and biologic-free remission. Prednisolone was negatively associated with remission, and DAS28(CRP) was related to biologic-free remission by logistic regression analyses. DAS28(CRP) below 3.7 was cutoff point for acquiring biologic-free remission of non-responder to infliximab after orthopaedic surgery. Therefore orthopaedic surgery may be effective to obtain remission or biologic-free remission in RA patients treated with biologics.

‣ Salvaged single-unit cord blood transplantation for 26 patients with hematologic malignancies not in remission

Yao,W.; Zheng,C.C.; Liu,H.L.; Geng,L.Q.; Tang,B.L.; Tong,J.; Zhu,X.Y.; Song,K.D.; Qiang,P.; Sun,Z.M.
Fonte: Associação Brasileira de Divulgação Científica Publicador: Associação Brasileira de Divulgação Científica
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2015 Português
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Treatments for patients with hematologic malignancies not in remission are limited, but a few clinical studies have investigated the effects of salvaged unrelated cord blood transplantation (CBT). We retrospectively studied 19 patients with acute leukemia, 5 with myelodysplastic syndrome (MDS with refractory anemia with excess blasts [RAEB]), and 2 with non-Hodgkin's lymphoma who received 1 CBT unit ≤2 loci human leukocyte antigen (HLA)-mismatched after undergoing myeloablative conditioning regimens between July 2005 and July 2014. All of them were in non-remission before transplantation. The infused total nucleated cell (TNC) dose was 4.07 (range 2.76-6.02)×107/kg and that of CD34+ stem cells was 2.08 (range 0.99-8.65)×105/kg. All patients were engrafted with neutrophils that exceeded 0.5×109/L on median day +17 (range 14-37 days) and had platelet counts of >20×109/L on median day +35 (range 17-70 days). Sixteen patients (61.5%) experienced pre-engraftment syndrome (PES), and six (23.1%) patients progressed to acute graft-versus-host disease (GVHD). The cumulative incidence rates of II-IV acute GVHD and chronic GVHD were 50% and 26.9%, respectively. After a median follow-up of 27 months (range 5-74), 14 patients survived and 3 relapsed. The estimated 2-year overall survival (OS)...

‣ Avaliação do eixo hipotálamohipófise adrenal no diagnóstico e na remissão da doença de Cushing; Assessment of the hypothalamic-pituitary-adrenal axis in Cushing's disease diagnosis and remission

Costenaro, Fabiola; Rodrigues, Ticiana da Costa; Rollin, Guilherme Alcides Flores Soares; Czepielewski, Mauro Antonio
Fonte: Universidade Federal do Rio Grande do Sul Publicador: Universidade Federal do Rio Grande do Sul
Tipo: Artigo de Revista Científica Formato: application/pdf
Português
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A doença de Cushing (DC) permanece um desafio médico com muitas questões ainda não respondidas. O sucesso terapêutico dos pacientes com DC está ligado à correta investigação do diagnóstico síndrômico e etiológico, além da experiência e talento do neurocirurgião. A adenomectomia hipofisária transesfenoidal constitui-se no tratamento de escolha para a DC. A avaliação da remissão da doença no pós-operatório e da recorrência em longo prazo constitui um desafio ainda maior. Especial destaque deve ser dado para o cortisol sérico no pós-operatório como marcador de remissão. Adicionalmente, o uso de corticoide exógeno no pós-operatório apenas em vigência de insuficiência adrenal tem sido sugerido por alguns autores como requisito essencial para permitir a correta interpretação do cortisol sérico nesse cenário. Neste artigo, revisamos as formas de avaliação da atividade da DC e os marcadores de remissão e recidiva da DC após a realização da cirurgia transesfenoidal.; Cushing’s disease (CD) remains a medical challenge, with many questions still unanswered. Successful treatment of CD patients is closely related to correct approach to syndromic and etiological diagnosis, besides the experience and talent of the neurosurgeon. Pituitary transsphenoidal adenomectomy is the treatment of choice for DC. Assessment of remission after surgery and recurrence in the long term is an even greater challenge. In this regard...

‣ Criteria of cure and remission in cushing's disease : an update; Critérios de cura e remissão na doença de cushing : uma atualização

Czepielewski, Mauro Antonio; Rollin, Guilherme Alcides Flores Soares; Casagrande, Alessandra; Ferreira, Nelson Pires
Fonte: Universidade Federal do Rio Grande do Sul Publicador: Universidade Federal do Rio Grande do Sul
Tipo: Artigo de Revista Científica Formato: application/pdf
Português
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Neste artigo, são revisados os principais critérios clínicos e hormonais utilizados para avaliação do tratamento cirúrgico da Doença de Cushing (DC). Inicialmente são comentados aspectos fisiopatológicos que orientam a avaliação hormonal e os principais fatores clínicos, laboratoriais, cirúrgicos e histológicos associados com melhores resultados, observados nas principais séries da literatura e em pacientes acompanhados prospectivamente pelos autores. Foram revisados, também, critérios adotados nas principais séries da literatura, nos últimos 25 anos, chamando-se atenção para as dosagens hormonais, o momento em que foram realizadas, a possibilidade de interferência de tratamentos prévios e da reposição glicocorticóide. À seguir, essas dosagens são discutidas salientando-se a importância do cortisol obtido seqüencialmente no pós-operatório e sem a interferência de reposição glicocorticóide. A experiência prospectiva dos autores, recentemente referendada na literatura, demonstra que valores de cortisol < 5 a 7 μg/dl associados com um período de dependência aos glicocorticóides > 6 meses, ausência de resposta do ACTH/cortisol ao DDAVP e/ou CRH, retorno da supressão à dexametasona e do ritmo circadiano...

‣ Anti-heat shock protein 90β antibodies are detected in patients with multiple sclerosis during remission

Cid, Cristina; Regidor, I.; Alcázar, Alberto
Fonte: Elsevier Publicador: Elsevier
Tipo: Artículo Formato: 259768 bytes; application/pdf
Português
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4 pages, 2 figures.-- Available online 11 Dec. 2006.; Antibodies against heat shock protein 90β (Hsp90β) recognize the antigen on the surface of oligodendrocyte precursor cells and induce a decrease in the oligodendrocyte population of cell cultures. This study investigated the presence of anti-Hsp90β antibodies in patients with multiple sclerosis (MS) during remission. Anti-Hsp90β antibodies were detected in the cerebrospinal fluid (CSF) of patients with a specific and sensitive western blot procedure using Hsp90β from cell membrane fraction. The number of patients with anti-Hsp90β antibodies detected in the CSF was significantly greater in MS patients than in control patients with other neurological diseases, which included patients with other inflammatory neurological diseases. CSF anti-Hsp90β antibody levels were significantly higher in MS patients than in control patients. The presence of anti-Hsp90β antibodies in the CSF of MS patients during remission could suggest a potential pathogenic role for these autoantibodies in MS.; This work was supported by Spanish Grant 05/1099.; Peer reviewed

‣ A remissão em esquizofrenia é possível?; Is remission in schizophrenia possible?

Elkis, Hélio
Fonte: Universidade de São Paulo. Faculdade de Medicina. Instituto de Psiquiatria Publicador: Universidade de São Paulo. Faculdade de Medicina. Instituto de Psiquiatria
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; ; ; ; ; ; Formato: application/pdf
Publicado em 01/01/2007 Português
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CONTEXTO: O conceito de remissão já está bem definido em algumas patologias psiquiátricas, como é o caso do transtorno depressivo, porém só recentemente foi proposto um critério para esquizofrenia. OBJETIVO: Revisar o novo conceito de remissão em esquizofrenia. MÉTODO: Revisão da literatura usando o PubMed. RESULTADOS: Os conceitos de resposta, remissão, estabilidade e recuperação são amplamente discutidos neste artigo, bem como os itens das escalas utilizados para definição. CONCLUSÃO: O conceito de remissão caracteriza-se pela presença nos últimos 6 meses de sintomas que atingem um nível máximo de gravidade (nível 3 da Panss) mas que permitem um certo funcionamento social. As dimensões do conceito e seus respectivos sintomas psicopatológicos são: Positiva: alucinações, delírios, conteúdo incomum do pensamento. Desorganização: desorganização conceitual, maneirismos e postura. Negativa: afeto embotado, afastamento social passivo/apático, falta de espontaneidade no fluxo da conversação.; BACKGROUND: The concept of remission is well established in some psychiatric disorders such as depression, but only recently it has been proposed for schizophrenia. OBJECTIVE: The aim of the present paper is to review the new proposed criteria for remission in schizophrenia. METHOD: PubMed search. RESULTS: The concept of remission...

‣ Neurocognitive changes in patients with schizophrenia during relapse and early remission

Balogh,Nóra; Égerházi,Anikó; Berecz,Roland
Fonte: The European Journal of Psychiatry Publicador: The European Journal of Psychiatry
Tipo: info:eu-repo/semantics/article; journal article; info:eu-repo/semantics/publishedVersion Formato: text/html; application/pdf
Publicado em 01/09/2015 Português
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Background and Objectives: Several studies have demonstrated that patients with schizophrenia have impaired cognitive functioning. In the literature there have been controversial results about the cognitive deficits occurring in the different states of the illness. Furthermore, there have been relatively few studies to investigate the associations between neurocognitive deficits and clinical status over time. In order to follow the changes of neurocognitive subfunctions during relapse and early remission (clinically stable state), in the present study patients with schizophrenia were tested in the acute phase and in clinically stable state, and then the results were correlated with clinical symptoms. Methods: Forty-two patients diagnosed with schizophrenia based on diagnostic interviews by clinicians and 43 normal controls were studied. Neurocognitive skills were evaluated with six subtests of the Cambridge Neuropsychological Test Automated Battery (CANTAB). Among patients with schizophrenia, symptom severity was assessed with the Positive and Negative Syndrome Scale (PANSS). Results: Patients with schizophrenia performed significantly worse in all neurocognitive subtests compared to healthy controls at both relapse and clinically stable state. At follow-up these cognitive changes improved...

‣ Health related quality of life in patients with Cohn's disease in remission

Iglesias,M.; Vázquez,I.; Barreiro de Acosta,M.; Figueiras,A.; Nieto,L.; Piñeiro,M.; Gómez,R.; Lorenzo,A.; Domínguez Muñoz,J. E.
Fonte: Revista Española de Enfermedades Digestivas Publicador: Revista Española de Enfermedades Digestivas
Tipo: info:eu-repo/semantics/article; journal article; info:eu-repo/semantics/publishedVersion Formato: text/html; application/pdf
Publicado em 01/11/2010 Português
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Background: Crohn's disease (CD) affects Health Related Quality of Life (HRQoL) especially in patients with clinical activity but their impact over the disease during periods of remission has not been sufficiently studied. Objective: To evaluate HRQoL in CD patients in remission and to identify socio-demographic and clinical factors related. Methods: We included patients with CD in remission for at least 6 months, defined as a CDAI < 150 and a CRP < 5 mg/L. Socio-demographic and clinical parameters were recorded. HRQoL was evaluated with Short Form 36 Questionnaire (SF-36) and the Inflammatory Bowel Disease Questionnaire (IBDQ). Results were analyzed using multiple regressions with a confidence interval of 95%. Results: Nine two patients (X = 37 ± 11.4 years, 52.2% men) were consecutively included. Two patients failed to fill correctly the questionnaire and were excluded. Scores on the SF-36 were lower than in the general population of similar age and sex. The most affected dimension in the SF-36 was General Health (47.98 ± 19.58) and the IBDQ Systemic Symptoms (5.15 ± 1.27). Age, colonic location and previous surgery was related with worse HRQoL, while higher educational status, more time since diagnosis, steroid-resistance and inflammatory behavior...