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1.
Medicine (Baltimore) ; 101(39): e30518, 2022 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-36181121

RESUMO

INTRODUCTION: Myotonic dystrophy type 1 is a rare genetic disorder that mainly affects the musculoskeletal system; However, it may cause several complications in other body systems representing challenges for health care providers. PATIENT CONCERNS: We present the case of a patient with a history of previously diagnosed type 1 myotonic dystrophy who presented to the emergency department with cough dyspnea, and thoracic pain. DIAGNOSIS: Differential diagnoses included pulmonary embolism with a moderate probability according to the Wells score, acute coronary syndrome, acute heart failure, and pneumonia. Diagnostic workup involved chest radiography, EKG, and a CTPA which revealed pneumonia, posteriorly the patient presented de novo atrial fibrillation. INTERVENTIONS: The patient was successfully treated with empiric antibiotic therapy and amiodarone, respiratory and physical therapy. OUTCOMES: The patient was discharged on day 34, however oxygen weaning was not possible. CONCLUSION: Treatment of MD1 patients is challenging due to the various mechanisms of the disease; patients with new-onset deterioration should be screened for the most common complications such as cardio-respiratory events.The authors suggest pneumonia as a risk factor for basal respiratory function deterioration and a contributing factor for triggering cardiac events for further research in prospective studies.


Assuntos
Amiodarona , Fibrilação Atrial , Distrofia Miotônica , Pneumonia , Antibacterianos , Fibrilação Atrial/complicações , Fibrilação Atrial/diagnóstico , Humanos , Oxigênio , Pneumonia/complicações , Estudos Prospectivos
2.
Artigo em Inglês | MEDLINE | ID: mdl-32765628

RESUMO

OBJECTIVE: Colorectal cancer represents a heavy burden for health systems worldwide, being the third most common cancer worldwide. Despite the breakthroughs in medicine, current chemotherapeutic options continue to have important side effects and may not be effective in preventing disease progression. Cannabinoids might be substances with possible therapeutic potential for cancer because they can attenuate the side effects of chemotherapy and have antiproliferative and antimetastatic effects. We aim to determine, through a systematic review of experimental studies performed on animal CRC models, if cannabinoids can reduce the formation of preneoplastic lesions (aberrant crypt foci), number, and volume of neoplastic lesions. MATERIALS AND METHODS: A systematic, qualitative review of the literature was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, Embase, and Scopus databases were searched. We use the following Medical Subject Headings (MESH) terms in PubMed: "colorectal neoplasms," "colonic neoplasms," "colorectal cancer," "polyps," "rimonabant," "cannabidiol," "cannabinoids," "azoxymethane," "xenograft," and "mice." Only studies that met the eligibility criteria were included. RESULTS: Eight in vivo experimental studies were included in the analysis after the full-text evaluation. Seven studies were azoxymethane (AOM) colorectal cancer models, and four studies were xenograft models. Cannabidiol botanical substance (CBD BS) and rimonabant achieved high aberrant crypt foci (ACF) reduction (86% and 75.4%, respectively). Cannabigerol, O-1602, and URB-602 demonstrated a high capacity for tumor volume reduction. Induction of apoptosis, interaction with cell survival, growth pathways, and angiogenesis inhibition were the mechanisms extracted from the studies that explain cannabinoids' actions on CRC. CONCLUSIONS: Cannabinoids have incredible potential as antineoplastic agents as experimental models demonstrate that they can reduce tumor volume and ACF formation. It is crucial to conduct more experimental studies to understand the pharmacology of cannabinoids in CRC better.

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