RESUMO
OBJECTIVE: To determine the association between maternal mobile phone use and adverse outcomes in infants, children, and mothers. METHOD: In March 202, we conducted a search on the MEDLINE, Embase, and Scopus databases. Data extraction and an assessment of the quality of the studies were performed by two authors. The quality of the studies was assessed using the checklist of the Newcastle-Ottawa scale. RESULTS: Studies assessing behavioral problems in infants aged 6 to 18 months reported null findings. However, an increased risk of emotional and behavioral disorders was observed in children aged between 7 and 11 years whose mothers had been exposed to cell phones. The findings regarding the association between maternal cell phone exposure and adverse outcomes in children aged 3 to 5 are controversial. A study found a significant association between the call time (p = 0.002) or the history of mobile phone use (in months) and speech disorders in the children (p = 0.003). However, another study found that maternal cell phone use during pregnancy was not significantly associated with child psychomotor and mental developments. Inconclusive results were observed about the adverse outcomes in fetuses, such as fetal growth restriction or t scores for birth weight in cell phone users as opposed to non-users. On the contrary, the children of mothers who were cell phone users had a lower risk of scoring low on motor skills. Similar results were observed regarding the adverse outcomes of cell phone use in infants, such as fetal growth restriction or low birth weight, and the risk of preeclampsia was lower among subjects with medium and high cell phone exposure, as opposed to those with low exposure. CONCLUSION: Studies on behavioral problems have reported different postnatal results, such as null findings among infants and a positive association in children.
OBJETIVO: Determinar a associação entre o uso de telefone celular pela mãe e os resultados adversos em recém-nascidos crianças e mães. MéTODO: Em março de 2020 realizou-se uma pesquisa nas bases de dados MEDLINE, Embase e Scopus. A extração de dados e avaliação da qualidade dos estudos foram realizadas por dois autores. A qualidade dos estudos foi avaliada por meio da lista de verificação da escala Newcastle-Ottawa. RESULTADOS: Estudos que avaliavam problemas comportamentais em recém-nascidos de 6 a 18 meses relataram resultados nulos. No entanto um risco aumentado de transtornos emocionais e comportamentais foi observado em crianças de 7 a 11 anos de idade cujas mães foram expostas a telefones celulares. Os resultados relacionados à associação entre a exposição materna a celulares e resultados adversos em crianças de 3 a 5 anos são controversos. Um estudo encontrou associação significativa entre o tempo de ligação (p = 0.002) ou o histórico de uso de celular (em meses) e distúrbios de fala nas crianças (p = 0.003). No entanto outro estudo descobriu que o uso de telefone celular pela mãe durante a gravidez não estava significativamente associado ao desenvolvimento psicomotor e mental da criança. Resultados inconclusivos foram observados com relação aos resultados adversos de fetos como restrição de crescimento intrauterino ou valores de t para peso ao nascer em usuárias de telefone celular em oposição a não usuárias. Pelo contrário os filhos de mães usuárias de telefone celular apresentaram menor risco de pontuação baixa em habilidades motoras. Resultados semelhantes foram observados com relação a resultados adversos em recém-nascidos como restrição de crescimento intrauterino ou valores de peso ao nascere o risco de pré-eclâmpsia foi menor em indivíduos com exposição média e alta a celulares em oposição àqueles com baixa exposição. CONCLUSãO: Estudos sobre problemas comportamentais relataram resultados diferentes no pós-natal como achados nulos em recém-nascidos e associação positiva em crianças.
Assuntos
Uso do Telefone Celular , Telefone Celular , Efeitos Tardios da Exposição Pré-Natal , Criança , Feminino , Humanos , Lactente , Exposição Materna , Mães , GravidezRESUMO
Abstract Objective To determine the association between maternal mobile phone use and adverse outcomes in infants, children, and mothers. Method In March 202, we conducted a search on the MEDLINE, Embase, and Scopus databases. Data extraction and an assessment of the quality of the studies were performed by two authors. The quality of the studies was assessed using the checklist of the Newcastle-Ottawa scale. Results Studies assessing behavioral problems in infants aged 6 to 18 months reported null findings. However, an increased risk of emotional and behavioral disorders was observed in children aged between 7 and 11 years whose mothers had been exposed to cell phones. The findings regarding the association between maternal cell phone exposure and adverse outcomes in children aged 3 to 5 are controversial. A study found a significant association between the call time (p=0.002) or the history of mobile phone use (in months) and speech disorders in the children (p=0.003). However, another study found that maternal cell phone use during pregnancy was not significantly associated with child psychomotor and mental developments. Inconclusive results were observed about the adverse outcomes in fetuses, such as fetal growth restriction or t scores for birth weight in cell phone users as opposed to non-users. On the contrary, the children ofmothers who were cell phone users had a lower risk of scoring low on motor skills. Similar results were observed regarding the adverse outcomes of cell phone use in infants, such as fetal growth restriction or low birth weight, and the risk of preeclampsia was lower among subjects with medium and high cell phone exposure, as opposed to those with low exposure. Conclusion Studies on behavioral problems have reported different postnatal results, such as null findings among infants and a positive association in children.
Resumo Objetivo Determinar a associação entre o uso de telefone celular pela mãe e os resultados adversos em recém-nascidos crianças e mães. Método Em março de 2020 realizou-se uma pesquisa nas bases de dados MEDLINE, Embase e Scopus. A extração de dados e avaliação da qualidade dos estudos foram realizadas por dois autores. A qualidade dos estudos foi avaliada por meio da lista de verificação da escala Newcastle-Ottawa. Resultados Estudos que avaliavam problemas comportamentais em recém-nascidos de 6 a 18 meses relataram resultados nulos. No entanto um risco aumentado de transtornos emocionais e comportamentais foi observado em crianças de 7 a 11 anos de idade cujas mães foram expostas a telefones celulares. Os resultados relacionados à associação entre a exposição materna a celulares e resultados adversos em crianças de 3 a 5 anos são controversos. Um estudo encontrou associação significativa entre o tempo de ligação (p=0.002) ou o histórico de uso de celular (emmeses) e distúrbios de fala nas crianças (p=0.003). No entanto outro estudo descobriu que o uso de telefone celular pela mãe durante a gravidez não estava significativamente associado ao desenvolvimento psicomotor e mental da criança. Resultados inconclusivos foram observados com relação aos resultados adversos de fetos como restrição de crescimento intrauterino ou valores de t para peso ao nascer em usuárias de telefone celular em oposição a não usuárias. Pelo contrário os filhos de mães usuárias de telefone celular apresentaram menor risco de pontuação baixa em habilidades motoras. Resultados semelhantes foram observados com relação a resultados adversos em recém-nascidos como restrição de crescimento intrauterino ou valores de peso ao nascere o risco de pré-eclâmpsia foimenor em indivíduos comexposição média e alta a celulares em oposição àqueles com baixa exposição. Conclusão Estudos sobre problemas comportamentais relataram resultados diferentes no pós-natal como achados nulos em recém-nascidos e associação positiva emcrianças.
Assuntos
Humanos , Feminino , Recém-Nascido , Criança , Efeitos Tardios da Exposição Pré-Natal , Telefone Celular , Uso do Telefone Celular , Exposição Materna , MãesRESUMO
Systemic symptoms such as fever and fatigue are non-specific manifestations spanning from inflammation to neoplasia. Here we report the case of a 34 year-old man who presented with systemic symptoms for four months. CT-scan and MRI revealed a 3.4 cm arterialized hepatic lesion and a 7 cm paraduodenal mass. Surgical resection of both lesions and histological examination revealed an inflammatory hepatocellular adenoma and a unicentric plasma cell type of Castleman disease. Moreover, a diffuse AA amyloid deposition in the liver was observed. Resection of both lesions was associated with an improvement of the symptoms. To our knowledge, this is the first report of a synchronous presentation of a unicentric plasma cell type of Castleman disease, inflammatory hepatocellular adenoma and AA amyloidosis.
Assuntos
Adenoma de Células Hepáticas/complicações , Hiperplasia do Linfonodo Gigante/complicações , Neoplasias Hepáticas/complicações , Adenoma de Células Hepáticas/diagnóstico , Adenoma de Células Hepáticas/cirurgia , Adulto , Biópsia com Agulha de Grande Calibre , Hiperplasia do Linfonodo Gigante/diagnóstico , Diagnóstico Diferencial , Hepatectomia , Humanos , Neoplasias Hepáticas/diagnóstico , Neoplasias Hepáticas/cirurgia , Imageamento por Ressonância Magnética , Masculino , Tomografia Computadorizada por Raios XRESUMO
OBJECTIVES: This study sought to evaluate the outcomes of the early experience of transcatheter mitral valve replacement (TMVR) with balloon-expandable valves in patients with severe mitral annular calcification (MAC) and reports the first large series from a multicenter global registry. BACKGROUND: The risk of surgical mitral valve replacement in patients with severe MAC is high. There are isolated reports of successful TMVR with balloon-expandable valves in this patient population. METHODS: We performed a multicenter retrospective review of clinical outcomes of patients with severe MAC undergoing TMVR. RESULTS: From September 2012 to July of 2015, 64 patients in 32 centers underwent TMVR with compassionate use of balloon-expandable valves. Mean age was 73 ± 13 years, 66% were female, and mean Society of Thoracic Surgeons score was 14.4 ± 9.5%. The mean mitral gradient was 11.45 ± 4.4 mm Hg and the mean mitral area was 1.18 ± 0.5 cm(2). SAPIEN valves (Edwards Lifesciences, Irvine, California) were used in 7.8%, SAPIEN XT in 59.4%, SAPIEN 3 in 28.1%, and Inovare (Braile Biomedica, Brazil) in 4.7%. Access was transatrial in 15.6%, transapical in 43.8%, and transseptal in 40.6%. Technical success according to Mitral Valve Academic Research Consortium criteria was achieved in 46 (72%) patients, primarily limited by the need for a second valve in 11 (17.2%). Six (9.3%) had left ventricular tract obstruction with hemodynamic compromise. Mean mitral gradient post-procedure was 4 ± 2.2 mm Hg, paravalvular regurgitation was mild or absent in all. Thirty-day all-cause mortality was 29.7% (cardiovascular = 12.5% and noncardiac = 17.2%); 84% of the survivors with follow-up data available were in New York Heart Association functional class I or II at 30 days (n = 25). CONCLUSIONS: TMVR with balloon-expandable valves in patients with severe MAC is feasible but may be associated with significant adverse events. This strategy might be an alternative for selected high-risk patients with limited treatment options.
Assuntos
Calcinose/cirurgia , Cateterismo Cardíaco/métodos , Doenças das Valvas Cardíacas/cirurgia , Implante de Prótese de Valva Cardíaca/métodos , Valva Mitral/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Valvuloplastia com Balão , Calcinose/diagnóstico por imagem , Calcinose/mortalidade , Calcinose/fisiopatologia , Cateterismo Cardíaco/efeitos adversos , Cateterismo Cardíaco/instrumentação , Cateterismo Cardíaco/mortalidade , Europa (Continente) , Feminino , Doenças das Valvas Cardíacas/diagnóstico por imagem , Doenças das Valvas Cardíacas/mortalidade , Doenças das Valvas Cardíacas/fisiopatologia , Próteses Valvulares Cardíacas , Implante de Prótese de Valva Cardíaca/efeitos adversos , Implante de Prótese de Valva Cardíaca/instrumentação , Implante de Prótese de Valva Cardíaca/mortalidade , Humanos , Masculino , Pessoa de Meia-Idade , Valva Mitral/diagnóstico por imagem , Valva Mitral/fisiopatologia , América do Norte , Seleção de Pacientes , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/mortalidade , Desenho de Prótese , Sistema de Registros , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Índice de Gravidade de Doença , América do Sul , Fatores de Tempo , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
Background: Carcinosarcoma of the breast (metaplastic, biphasic metaplastic, metaplastic sarcomatoid carcinoma, sarcomatoid carcinoma) is an aggressive, rare neoplasm that has been reported to account for 0.08-0.2% of all breast malignancies. Mammary carcinosarcoma is rare in rabbits. Carcinosarcoma is a neoplasia composed of cells morphologically resembling malignant epithelial components and cells resembling malignant connective tissue elements. In spite of the rarity in rabbits, carcinosarcoma should always be considered in the different diagnoses of the mammary neoplasias, especially those of undifferentiated neoplasias. Case: An eight-month-old, female New Zealand white rabbit (Oryctolagus cuniculus) weighing 1.9 kg was referred to Tabriz university veterinary hospital for acute swelling on the abdomen and history of mammary mass. The complete blood count was within the reference ranges. The rabbit had been slightly depressed and anorectic. At clinical examination, the patient presented a huge lobulated mass in the mammary gland area. Clinical signs were included: emaciation and hardness in moving. Due to unfavorable prognosis the rabbit was euthanized and afterward complete mastectomy was performed. At necropsy, a non-infiltrative multilobulated mass were observed in the chirurgic area. The mass didn't infiltrate into the skin, subcutaneously and adjacent to the musculature and it was moved easily. The neoplasia was solid, firm, and yellowbrownish. Tissue samples of the tumor were fixed in 10% neutral buffered formalin, embedded in paraffin, cut at 5 µm, and stained with hematoxylin and eosin and masson trichrome. Microscopically, the neoplasm had a solid pattern and was composed of a heterogeneous cell population, mainly pleomorphics. Polyhedral cells showing ovoid or vesicular nuclei with prominent nucleoli and abundant lightly acidophilic cytoplasm resembling epithelial cells were observed. Cells with scant cytoplasm and elongated or oval nuclei containing inconspicuous nucleoli resembling mesenchymal cell were also observed. There were also neoplastic areas with a myxoide matrix. Some young cartilage pieces were observed in the tumor. In some parts of the tumor a very dense fibrous connective tissue was observed. Based on the histological findings, the diagnosis of mammary carcinosarcoma was confirmed. Other organs showed normal histological characteristics. Discussion: The carcinosarcoma is a neoplasia characterized as containing a mixed cell population with malignant proliferation of both mesenchymal and epithelial-like cells. Although the carcinosarcoma is rare in the domestic species, their origin has been discussed in two theories: 1) multiclonal theory suggests that the epithelial and the mesenchymal components originated from two or more stem cells; 2) the monoclonal theory suggests that the epithelial and the mesenchymal components originated from totipotential neoplastic cells play multiple potential pathways of terminal differentiation. Abnormal level of growth and Prolactin hormones is one cause to breast tumors. Recent evidence supports the speculation that prolonged hyperprolactinemia leads to malignancy, given the case of ductal carcinoma in one woman who, after incomplete pituitary adenomectomy, was hyperprolactinemic for 15 years. This physiologic relationship and disease progression are important to consider in clinical diagnosis and management of these cases in rabbits. Although some studies were not showed any difference in level of mentioned hormones. In spite of being rare in rabbit, the carcinosarcoma should always be considered in the different diagnoses of the mammary neoplasias, mainly of those undifferentiated neoplasias.
Assuntos
Animais , Feminino , Carcinossarcoma/diagnóstico , Carcinossarcoma/veterinária , Neoplasias Mamárias Animais/diagnóstico , CoelhosRESUMO
Background: 3-Methyl indole (Skatole, 3-MI) is produced by microfloral fermentation of tryptophan in rumen and production of that has relation with the onset of respiratory problems in cattle. The aim of this study was to compare complications of 3-MI dissolved in two solvents, Cremophor and Propylene Glycol on BALB/c mice by histopathologic and stereologic studies. Materials, Methods & Results: Female Balb/C mice 56 days of age (23 - 27 g) were divided into 13 groups of eight and had access to food and water ad libitum. Mice were housed in plastic cages (4 per cage) with wire bar lids on bedding of sawdust in an air-conditioned room with 12 h light: dark cycles. After a 7-day acclimation period, for 5 groups, Mice were injected with 400, 500, 600, 700 and 800 mg/kg from solution of 3-MI in propylene glycol and similarly for 5 other groups with Cremophor. As well as 2 groups were injected with Propylene glycol and Cremophor with the dosage that is necessary for solving the highest dose of 3-MI. One group received normal saline with the volume equal with Cremophor (drug vehicle) group. Briefly, 125 mg of 3-MI was dissolved per mL of sterile filtered Propylene glycol and 30 mg of 3-MI was dissolved per mL of sterile filtered Cremophor. Once injected intra peritoneally, mice were monitored 3-4 h for external reaction signs from the injection. LD50 was determined 610.16 mg/kg 3-Methylindole and 687.5 mg/kg 3-Methylindole dissolved in Propylene glycol and Cremophor respectively with linear regression. Increase in respiration rate, tachypnea and shallow respiration was observed in clinical examination. In necropsy, alveolar and bronchial hyperemia was significant in lungs. Some superficial wounds were observed in upper respiratory airways. Trachea and Hungarian airways were severely hyperemic. There were some debriss in airways canals. We couldnt find any lesion in other organs. Histopathology showed noticeable alveolar edema and emphysema, type I pneumocytes necrosis, Slight endothelial lesions, rare degeneration of type II pneumocytes and raised nutrophil infiltration around vessels were observed in higher dosages of both groups. Moderate interstitial edema, hyperemia and increase of alveolar macrophages were observed too. Increase of lymphocytes was noticed after the dose 600 mg/kg moderately on a dose dependent manner. There was a Hyaline membrane in the wall of air sacs. Endothelial capillary damage in Cremophor dissolved 3-MI groups were slightly lower. Although damage to the vessels was not that much progressed in both groups. Stereologic study of type II pneumocytes showed a significant increase in the percentage of them in alveoli of treatment groups in a dose dependent manner compare to control and drug vehicle groups. At the highest dose (800 mg/kg) the group with Propylene glycol as solvent had significant difference with Cremophor dissolved 3-Methyl indole group and epithelialization was more severe in that. Bronchiole injuries raised in a dose dependent manner in both treatment groups. Discussion: The results of this research indicate that intraperitoneal infusion of 3-MI dissolved in Propylene glycol and Cremophor cause noticeable changes in the respiratory systems of mice. Effects of 3-MI in Propylene glycol is more severe than 3-MI dissolved in Cremophor but type of the lesions is not different. Bronchiolar lesions were moderate compare to the effects of 3-MI in some other animals. Severity of vascular lesions in Propylene glycol dissolved 3-MI was greater than groups that received the Cremophor dissolved 3-MI. Although the vascular injuries were not that much noticeable at all.(AU)
Assuntos
Animais , Feminino , Camundongos , Escatol/efeitos adversos , Doenças Respiratórias/induzido quimicamente , Enfisema Pulmonar/veterinária , Edema Pulmonar/veterinária , Propilenoglicol/farmacocinéticaRESUMO
Background: 3-Methyl indole (Skatole, 3-MI) is produced by microfloral fermentation of tryptophan in rumen and production of that has relation with the onset of respiratory problems in cattle. The aim of this study was to compare complications of 3-MI dissolved in two solvents, Cremophor and Propylene Glycol on BALB/c mice by histopathologic and stereologic studies. Materials, Methods & Results: Female Balb/C mice 56 days of age (23 - 27 g) were divided into 13 groups of eight and had access to food and water ad libitum. Mice were housed in plastic cages (4 per cage) with wire bar lids on bedding of sawdust in an air-conditioned room with 12 h light: dark cycles. After a 7-day acclimation period, for 5 groups, Mice were injected with 400, 500, 600, 700 and 800 mg/kg from solution of 3-MI in propylene glycol and similarly for 5 other groups with Cremophor. As well as 2 groups were injected with Propylene glycol and Cremophor with the dosage that is necessary for solving the highest dose of 3-MI. One group received normal saline with the volume equal with Cremophor (drug vehicle) group. Briefly, 125 mg of 3-MI was dissolved per mL of sterile filtered Propylene glycol and 30 mg of 3-MI was dissolved per mL of sterile filtered Cremophor. Once injected intra peritoneally, mice were monitored 3-4 h for external reaction signs from the injection. LD50 was determined 610.16 mg/kg 3-Methylindole and 687.5 mg/kg 3-Methylindole dissolved in Propylene glycol and Cremophor respectively with linear regression. Increase in respiration rate, tachypnea and shallow respiration was observed in clinical examination. In necropsy, alveolar and bronchial hyperemia was significant in lungs. Some superficial wounds were observed in upper respiratory airways. Trachea and Hungarian airways were severely hyperemic. There were some debriss in airways canals. We couldnt find any lesion in other organs. Histopathology showed noticeable alveolar edema and emphysema, type I pneumocytes necrosis, Slight endothelial lesions, rare degeneration of type II pneumocytes and raised nutrophil infiltration around vessels were observed in higher dosages of both groups. Moderate interstitial edema, hyperemia and increase of alveolar macrophages were observed too. Increase of lymphocytes was noticed after the dose 600 mg/kg moderately on a dose dependent manner. There was a Hyaline membrane in the wall of air sacs. Endothelial capillary damage in Cremophor dissolved 3-MI groups were slightly lower. Although damage to the vessels was not that much progressed in both groups. Stereologic study of type II pneumocytes showed a significant increase in the percentage of them in alveoli of treatment groups in a dose dependent manner compare to control and drug vehicle groups. At the highest dose (800 mg/kg) the group with Propylene glycol as solvent had significant difference with Cremophor dissolved 3-Methyl indole group and epithelialization was more severe in that. Bronchiole injuries raised in a dose dependent manner in both treatment groups. Discussion: The results of this research indicate that intraperitoneal infusion of 3-MI dissolved in Propylene glycol and Cremophor cause noticeable changes in the respiratory systems of mice. Effects of 3-MI in Propylene glycol is more severe than 3-MI dissolved in Cremophor but type of the lesions is not different. Bronchiolar lesions were moderate compare to the effects of 3-MI in some other animals. Severity of vascular lesions in Propylene glycol dissolved 3-MI was greater than groups that received the Cremophor dissolved 3-MI. Although the vascular injuries were not that much noticeable at all.