Resting skin blood flow (RF) and the venoarteriolar response (VAR = the vasoconstrictor response on standing) have been studied in 100 patients with diabetic neuropathy, in 100 diabetics without neuropathy, and in 100 normal subjects by laser Doppler flowmetry. Capillary filtration was also studied with strain gauge plethysmography. The authors followed up these patients by evaluating their microcirculation again after three years. At the beginning of the study in patients with neuropathy, RF and capillary filtration were increased. The VAR and the microangiopathy index (MI = VAR/RF) were reduced in all diabetics, to a greater extent to those with neuropathy. After three years the authors observed an increase in capillary filtration associated with a further impairment in VAR and MI, suggesting progression of microangiopathy in both groups of diabetics. These results suggest that the postural control of blood flow in the skin of the foot is impaired in diabetic microangiopathy, particularly in neuropathics. Increased skin blood flow and capillary filtration and the impaired venoarteriolar response cause edema and may contribute to the thickening of capillary basement membranes and the progressive evolution of diabetic microangiopathy.
Oral poster abstracts S-BOT (p = 0.05). M-BOT had echogenic fluid more than S-BOT, but this difference did not reach statistical significance. Only in 5/11 tumors (45%) a significant blood flow was documented. 11/23 (47%) tumors were correctly triaged for oncology-related surgery procedure based on clinical and sonographic evaluation. Conclusions: Echogenic fluid, multilocularity and a larger diameter is more typical to M-BOT. Papillary projections are more often associated with S-BOT. Correct triage for an oncology-related surgery, based on these factors, seem less successful than expected. Objective: The purpose of this study was to evaluate the intraobserver and interobserver agreement for identifying adnexal malignancy using color flow location in indeterminate masses after a gray-scale transvaginal sonography. Methods: Digitally stored color Doppler sonographic images, from a consecutive series of 130 women with an adnexal mass submitted to surgery after transvaginal sonography were evaluated by 6 different examiners with different degree of experience. Only consecutive cystic mass in which the gray-scale echo architecture was not suggestive of benign histology was included in the study. Solid excrescences or solid portions of the tumor were evaluated for vascular flow with color Doppler sonography. A mass was graded malignant if flow was shown within the excrescences or solid areas (central flow) and benign if there was no flow or only peripheral. Intraobserver and interobserver agreement according with the level of experience were assessed by calculating the kappa index. Results: Of the 130 consecutive cases with indeterminate findings at gray-scale evaluation, definitive histologic diagnoses were as follows: 80 (61.5%) benign and 50 (38.5%) malignant masses. Intraobserver agreement was good or very good for all examiners with different degree of experience (kappa ranging from 0.721 to 0.888). Interobserver agreement was good to moderate for all operators (kappa ranging from 0.478 to 0.714), irrespective of degree of experience. A correct classification was obtained by all assessors in 52% of malignant masses. Only ten masses (7.7%) were incorrectly classified by all the assessors. Conclusions: The use of color Doppler in the evaluation of flow location for the detection of adnexal malignancy seems to be reproducible method even in moderate experienced examiners.
OP24.08
OP24.09Transrectal ultrasound in the evaluation of locally advanced cervical cancer after neoadjuvant chemotherapy Objective: We compared accuracy of transrectal ultrasound (TRUS) and magnetic resonance (MRI) in evaluation of locally advanced cervical cancer after neoadjuvant chemotherapy (NACT) in this study. Total 36 women with histologically verified cervical cancer stage IB2, incipient IIB and deep stromal invasion with response to NACT were included in this study. All patients were treated with ifosfamide/cisplatin chemotherapy followed by radical hysterectomy at our department in years [2004][2005][2006][2007][2008]. The histologica...
The prevalence of BRCA1 and BRCA2 mutations among breast cancer patients in Peru has not yet been explored. We enrolled 266 women with breast cancer from a National cancer hospital in Lima, Peru, unselected for age or family history. DNA was screened with a panel of 114 recurrent Hispanic BRCA mutations (HISPANEL). Among the 266 cases, thirteen deleterious mutations were identified (eleven in BRCA1 and two in BRCA2), representing 5% of the total. The average age of breast cancer in the mutation-positive cases was 44 years. BRCA1 185delAG represented seven of the eleven mutations in BRCA1. Other mutations detected in BRCA1 included: two 2080delA, one 943ins10, and one 3878delTA. The BRCA2 3036del4 mutation was seen in two patients. Given the relatively low cost of the HISPANEL test, one should consider offering this test to all Peruvian women with breast or ovarian cancer.
BackgroundDespite therapeutic hypothermia 30-70% of newborns with moderate or severe hypoxic ischemic encephalopathy will die or survive with significant long-term impairments. Magnetic resonance imaging (MRI) in the first days of life is being used for early identification of these infants and end of life decisions are relying more and more on it. The purpose of this study was to evaluate how MRI performed around day 4 of life correlates with the ones obtained in the second week of life in infants with hypoxic-ischemic encephalopathy (HIE) treated with hypothermia.MethodsProspective observational cohort study between April 2009 and July 2011. Consecutive newborns with HIE evaluated for therapeutic hypothermia were included. Two sequential MR studies were performed: an •early’ study around the 4th day of life and a •late’ study during the second week of life. MRI were assessed and scored by two neuroradiologists who were blinded to the clinical condition of the infants.ResultsForty-eight MRI scans were obtained in the 40 newborns. Fifteen infants underwent two sequential MR scans. The localization, extension and severity of hypoxic-ischemic injury in early and late scans were highly correlated. Hypoxic-ischemic injury scores from conventional sequences (T1/T2) in the early MRI correlated with the scores of the late MRI (Spearman ρ = 0.940; p < .001) as did the scores between diffusion-weighted images in early scans and conventional images in late MR studies (Spearman ρ = 0.866; p < .001). There were no significant differences in MR images between the two sequential scans.ConclusionsMRI in the first days of life may be a useful prognostic tool for clinicians and can help parents and neonatologist in medical decisions, as it highly depicts hypoxic-ischemic brain injury seen in scans performed around the second week of life.
Venous microangiopathy was improved by the treatment with Venoruton. The comparison with Daflon indicates that HR is comparatively more effective both on microcirculatory parameters and on signs and symptoms.
The aim of this study was to systematically review the literature available about the benefit of health education by a training nurse in patients with axial and/or peripheral psoriatic arthritis in the framework of the drawing up of the axial spondyloarthritis and psoriatic arthritis guidelines of the "Spanish Society of Rheumatology". Electronic databases (Cochrane Central Register of Controlled Trials, EMBASE, Medline/PubMed, CINAHL) were systematically searched from inception to 2014 using medical subject headings and keywords. Only articles in English, Spanish and French were included. The patients studied had to be diagnosed of psoriatic arthritis (all ages, both sexes) with axial involvement and/or peripheral arthritis who had received health education by a specialized nurse. We included in the search randomized clinical trials, cohort observational studies, descriptive studies and case series and qualitative research studies. Measured outcomes were those related to the education provided in a nursing consultation such as increased adherence to biological therapy, conducting exercises, smoking cessation and patient satisfaction. Eight studies were included, five randomized clinical trials with moderate level of quality and three intervention studies with no control group with low level of quality. Meta-analyses were not undertaken due to clinical heterogeneity. According to our results, it can be concluded that although there is little evidence on the role of a trained nurse in patients with psoriatic arthritis, this role can be beneficial to the patients because it can increase the rate of adherence to treatment prescribed by a rheumatologist, promotes patient self-management of their disease and increases patient satisfaction.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.