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Tamsulosin and Dementia in Old Age: is There Any Relationship? 坦索罗辛与老年痴呆:有关系吗?
Pub Date : 2019-09-23 DOI: 10.24018/ejmed.2019.1.4.77
Rebecca Renata Lapenda do Monte, Karina de Andrade Vidal Costa, Arnaldo Santiago Nunes Junior, A. Rêgo, I. Filho
Tamsulosin is used to treat Benign Prostatic Hyperplasia (BPH), prescribed annually to about 12.6 million patients worldwide. It is an alpha-adrenergic antagonist that reduces the tone of the prostate smooth muscle involved in the pathophysiology of BPH. By acting on alpha 1A receptors, predominant in the prostate, tamsulosin also acts on receptors present in the brain. This study consisted of a literature review aimed at disseminating scientific knowledge about the relationship between the use of tamsulosin and the onset of dementia. Pubmed, Scopus, Scielo, Embase, and Web of Science studies involving dementia in patients using tamsulosin in the last five years were selected. The review showed a risk correlation and a higher incidence of dementia in treated patients. The risk ratio, when compared to other medicines, approached 1.20. In conclusion, it was identified the need for clinical trials with higher sampling power to increase relational significance due to the high prevalence of BPH and the extensive use of tamsulosin in elderly patients with the disease.
坦索罗辛用于治疗良性前列腺增生症(BPH),每年为全球约1260万患者开具处方。它是一种α-肾上腺素能拮抗剂,可降低前列腺增生病理生理学中涉及的前列腺平滑肌张力。坦洛新通过作用于前列腺中占主导地位的α1A受体,也作用于大脑中的受体。这项研究包括一篇文献综述,旨在传播关于坦索罗辛的使用与痴呆症发作之间关系的科学知识。选择了过去五年中使用坦索罗辛的痴呆患者的Pubmed、Scopus、Scielo、Embase和Web of Science研究。该综述显示,在接受治疗的患者中,痴呆症的风险相关性较高。与其他药物相比,风险比接近1.20。总之,由于前列腺增生的高患病率和坦索罗辛在老年患者中的广泛使用,确定了需要具有更高抽样能力的临床试验来增加相关性意义。
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引用次数: 0
Impulse Control Disorder in a Patient with Invasive Prolactinoma on Dopamine agonist Therapy: A Case Report 多巴胺激动剂治疗侵袭性泌乳素瘤患者的冲动控制障碍:一例报告
Pub Date : 2019-04-02 DOI: 10.31579/2640-1045/038
P. Dutt
Prolactinomas constitutes a major bulk of pituitary adenomas. All symptomatic prolactinomas require dopamine agonist (DA) therapy. Impulse control disorders (ICD) or pathological behaviours are rare adverse events described with use of DA. Herein we are describing a male patient with pathological gambling and doctor shopping following use of bromocriptine and higher dose of cabergoline.The pathological behaviour disappeard after debulking surgery, reduction in cabergoline dose and several sessions of counselling. Physicians prescribing DA should be aware of this potential adverse event.This should be emphasized to the patient and family members before starting DA and physician should be inquisitive for eliciting pathological behaviour on follow up.
催乳素瘤是垂体腺瘤的主要组成部分。所有有症状的泌乳素瘤都需要多巴胺激动剂(DA)治疗。冲动控制障碍(ICD)或病理行为是使用DA描述的罕见不良事件。在此,我们描述了一名男性患者在使用溴隐亭和更高剂量卡麦角林后进行病理性赌博和医生购物。在拆散手术、减少卡麦角林剂量和几次咨询后,病理行为消失了。开DA处方的医生应该意识到这种潜在的不良事件。在开始DA之前,应向患者和家属强调这一点,医生应在随访中好奇是否会引发病理行为。
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引用次数: 0
MiR-302: The Multifunctional MicroRNA MiR-302:多功能MicroRNA
Pub Date : 2019-01-01 DOI: 10.31579/2640-1045/040
S. Ying
MicroRNAs (miRNAs) are short single-stranded noncoding RNAs (20- to 25-nucleotide (nt) long) representing a class of small regulatory RNAs. By inhibiting the translation of target mRNAs, miRNAs regulate gene expression posttranscriptionally and thus play an important role in a wide range of cellular processes. Currently, there are two known types of miRNAs: intergenic and intronic miRNAs. Biogenesis of an intergenic miRNA starts with the synthesis of a primary miRNA transcript (pri-miRNA) catalyzed by types-II or -III RNA polymerase (Pol-II/III). Pri-miRNAs are processed in the nucleus by the ribonuclease Drosha into a miRNA precursor (pre-miRNA) approximately 60-nt in length. After being transported into the cytoplasm, these pre-miRNAs are further processed into mature and functional miRNAs by the cytoplasmic ribonuclease Dicer. Mature miRNAs then associate with a number of proteins to form the RNA-induced silencing complex (RISC) that bind with target mRNAs having total or partial complementary sequences to the miRNAs and initiate the inhibition of subsequent protein translation via RNA interference (RNAi).
MicroRNAs (miRNAs)是短单链非编码rna(20- 25个核苷酸(nt)长),代表了一类小的调控rna。通过抑制靶mrna的翻译,miRNAs通过转录后调控基因表达,从而在广泛的细胞过程中发挥重要作用。目前,已知的mirna有两种类型:基因间mirna和内含子mirna。基因间miRNA的生物发生始于由ii型或III型RNA聚合酶(Pol-II/III)催化的初级miRNA转录物(pri-miRNA)的合成。pri -miRNA在细胞核内被核糖核酸酶Drosha加工成长度约为60 nt的miRNA前体(pre-miRNA)。这些pre- mirna被转运到细胞质中后,通过细胞质核糖核酸酶Dicer进一步加工成成熟的、有功能的mirna。成熟的mirna随后与许多蛋白质结合形成RNA诱导沉默复合体(RISC),该复合体与与mirna具有全部或部分互补序列的靶mrna结合,并通过RNA干扰(RNAi)抑制随后的蛋白质翻译。
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引用次数: 0
ErbB2 and EphA3 as a novel prognostic and therapeutic target of Recurrent Non-functioning Pituitary Adenomas: A pilot study ErbB2和EphA3作为复发性无功能垂体腺瘤新的预后和治疗靶点:一项初步研究
Pub Date : 2019-01-01 DOI: 10.31579/2640-1045/039
P. Dutta
Non-functioning pituitary adenomas (NFPA) are 30% of all pituitary adenomas. Although benign in nature but they may be invasive and recurrent. Markers of recurrence are needed to guide patient management. Recteptor Tyrosine Kinases (RTK) may sereve as therapeutic marker for recurrence as they can targeted by already available tyrosine kinase inhibitors. To examine differential RTK phosphorylation pattern of recurrent NFPAs, we recruited 20 patients and grouped them as non-recurrent (n=10), and recurrent (n=10). Recurrence was determined by follow-up of 15 years. We then performed a membrane-based antibody array (ARY001B) for the determination of the relative phosphorylation of 49 tyrosine kinases in recurrent NFPAs. As the experiment was replicated on two set of membranes, each tyrosine kinase was represented in quadruples. Student’s t-test was performed to compare the means between two groups. We found ErbB2, PDGFR beta, SCFR, Trk, VEGFR1, VEGFR2, EphA3, and Alk significantly hyperphosphorylated in recurrent NFPAs. Out of these eight hyperphosphorylated tyrosine kinases ErbB2 and EphA3 were 1.6 (p=0.01) and 1.9 (p=0.002) times hyperphosphorylated in recurrent NFPAs. This result indicates that EphA3 may be an effective therapeutic target in recurrent NFPAs.
无功能垂体腺瘤(NFPA)占所有垂体腺瘤的30%。虽然本质上是良性的,但它们可能是侵袭性和复发性的。需要复发标记物来指导患者的治疗。受体酪氨酸激酶(RTK)可以作为治疗复发的标记物,因为它们可以被现有的酪氨酸激酶抑制剂靶向。为了研究复发性nfpa的RTK磷酸化模式差异,我们招募了20例患者,并将其分为非复发性(n=10)和复发性(n=10)。随访15年确定复发率。然后,我们使用基于膜的抗体阵列(ARY001B)来测定复发性nfpa中49种酪氨酸激酶的相对磷酸化。由于实验在两组膜上重复,每个酪氨酸激酶以四倍数表示。采用学生t检验比较两组间的均值。我们发现ErbB2、PDGFR β、SCFR、Trk、VEGFR1、VEGFR2、EphA3和Alk在复发性nfpa中显著过度磷酸化。在这8种高磷酸化酪氨酸激酶中,ErbB2和EphA3在复发性nfpa中分别高磷酸化1.6倍(p=0.01)和1.9倍(p=0.002)。这一结果提示EphA3可能是复发性nfpa的有效治疗靶点。
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引用次数: 0
A Case Report of Cortisol-Secreating Adrenal Adenoma Causing Cushing Syndrome 肾上腺皮质醇分泌腺瘤致库欣综合征1例报告
Pub Date : 2019-01-01 DOI: 10.31579/2640-1045/044
H. Radhi
Cushing syndrome is a state of prolonged exposure to excess cortisol production. Causes can be varied ranging from exogenous intake or endogenous production from a pituitary source due to overproduction of adrenocorticotropic hormone (ACTH) or due to over secretion from unilateral or bilateral adrenal glands. Cushing syndrome in an adult can present with proximal muscle weakness, facial plethora, wasting of the extremities with increased fat in the abdomen and face, wide purplish striae, bruising with no obvious trauma, and supraclavicular fat pads. Here, we report a 38 year old male who presented with suspicion of having Cushing syndrome due to his clinical manifestations and high cortisol levels. He presented to the clinic with new onset diabetes, severe hypertension, chronic abdominal pain and distension which was being investigating by different specialties. The patient underwent CT scan of the abdomen which show right adrenal adenoma and on examination, he was found to have proximal weakness and purple striae. Laboratory data showed high morning cortisol, 24 urine free cortisol and ACTH levels which were strongly suggestive of ACTH independent Cushing syndrome.
库欣综合征是一种长期暴露于过量皮质醇产生的状态。原因可以是多种多样的,从外源性摄入或内源性产生的垂体源由于过量生产促肾上腺皮质激素(ACTH)或由于过度分泌从单侧或双侧肾上腺。成人库欣综合征可表现为近端肌肉无力,面部过多,四肢消瘦,腹部和面部脂肪增加,宽紫色条纹,无明显创伤的瘀伤,锁骨上脂肪垫。在此,我们报告一位38岁男性,因其临床表现和高皮质醇水平而怀疑患有库欣综合征。他以新发糖尿病、严重高血压、慢性腹痛和腹胀就诊,正在接受不同专科的调查。患者行腹部CT扫描,显示右侧肾上腺腺瘤,检查时发现近端无力及紫色条纹。实验室数据显示早晨皮质醇、24尿游离皮质醇和ACTH水平高,强烈提示ACTH非依赖性库欣综合征。
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引用次数: 0
Education and Exercise on the Quality of Life among Adults with Chronic Renal Disease 成人慢性肾脏病患者生活质量的教育与锻炼
Pub Date : 2018-11-12 DOI: 10.31579/2640-1045/037
M. D’Souza, Eilean Victoria Lazarus Rathinasamy
Objective: Evaluate the effectiveness of education and exercise on the quality of life among adults with chronic renal disease (CRD) on hemodialysis post-intervention (4 and 8 weeks). Methods: An evaluative true intervention approach was used. An ethical approval was obtained from the institutional ethics committee. A random sample of 150 patients (75 in intervention and 75 in control group) with CRD receiving dialysis was selected based on the inclusion criteria. The intervention group received interactive education and supervised exercises. RAND health-related kidney disease QOL (KDQOL) questionnaire was used. Results: Mean scores for the Kidney Disease and general QOL sub-scales among the intervention group were higher and statistically significant (p<0.01) compared to the control group. Conclusion: Education and exercise was shown to have a positive effect on the physical and mental health among the adults.
目的:评价成人慢性肾脏病(CRD)血液透析干预后(4周和8周)生活质量教育和锻炼的有效性。方法:采用评价性真实干预方法。获得了机构伦理委员会的伦理批准。根据纳入标准,随机抽取150名接受透析的CRD患者(干预组75名,对照组75名)。干预组接受互动教育和监督演习。采用RAND健康相关肾病生活质量(KDQOL)问卷。结果:与对照组相比,干预组肾脏疾病和一般生活质量子量表的平均得分更高,具有统计学意义(p<0.01)。结论:教育和锻炼对成年人的身心健康有积极影响。
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引用次数: 1
Thyroid Storm: Emergency Care for Thyrotoxicosis 甲状腺风暴:甲状腺毒症的紧急护理
Pub Date : 2018-09-16 DOI: 10.31579/2640-1045/030
Sam Hamseley
Thyroid hormones affect all organ systems and, in excess, can cause increased metabolic rate, heart rate, ventricle contractility, and gastrointestinal motility as well as muscle and central nervous system excitability. Thyroid storm is the extreme manifestation of thyrotoxicosis with an estimated incidence of 0.20 per 100,000 per year among hospitalized patients in Japan. The mortality of thyroid storm without treatment ranges from 80% to 100%; but with treatment, the mortality rate is between 10% and 50%. The diagnostic strategy for thyroid storm may take into consideration Burch–Wartofsky scoring or Akamizu's diagnostic criteria. Multiple treatment aims need to be addressed in managing thyroid storm effectively. This paper puts together all aspects to be considered for the management of hyperthyroidism and thyroid storm during the acute and emergency phase as well as consideration of special populations.
甲状腺激素影响所有器官系统,过量会导致代谢率、心率、心室收缩性、胃肠道运动性以及肌肉和中枢神经系统兴奋性增加。甲状腺风暴是甲状腺毒症的极端表现,在日本住院患者中,估计每年的发病率为0.20/10万。甲状腺风暴未经治疗的死亡率在80%至100%之间;但经过治疗,死亡率在10%到50%之间。甲状腺风暴的诊断策略可能会考虑Burch–Wartofsky评分或Akamizu的诊断标准。在有效管理甲状腺风暴方面,需要解决多种治疗目标。本文总结了甲状腺功能亢进症和甲状腺风暴在急性期和急诊期以及特殊人群的管理需要考虑的各个方面。
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引用次数: 0
Anti-Diabetic Agent: Involvement in Hepatic Fat Metabolism In Pioglitazone-Treated Type 2 Diabetic Patients 抗糖尿病药物:参与吡格列酮治疗的2型糖尿病患者肝脏脂肪代谢
Pub Date : 2018-09-16 DOI: 10.31579/2640-1045/028
David Spacey
Pioglitazone (brand name Actos) is a prescription drug of the thiazolidinedione (TZD) class with hypoglycemic (antihyperglycemic, antidiabetic) action to treat diabetes. Pioglitazone is one of the antidiuretic agents used in the management of type 2 diabetes mellitus (DM). The effect of pioglitazone on blood glucose, lipid profile, liver enzymes and weight has been shown with conflicting results. In this study we aim to evaluate the effect of pioglitazone on the weight, lipid profile and liver enzymes in patients with DM. Pioglitazone is used to lower blood glucose levels in the treatment of diabetes mellitus type 2 (T2DM) either alone or in combination with a sulfonylurea, metformin, or insulin.
吡格列酮(品牌名Actos)是一种噻唑烷二酮(TZD)类处方药,具有降血糖(抗高血糖、抗糖尿病)作用,可治疗糖尿病。吡格列酮是用于治疗2型糖尿病(DM)的抗利尿药之一。吡格列酮对血糖、血脂、肝酶和体重的影响已被证明是相互矛盾的结果。在本研究中,我们旨在评估吡格列酮对糖尿病患者体重、血脂和肝酶的影响。吡格列酮用于单独或与磺酰脲、二甲双胍或胰岛素联合治疗2型糖尿病(T2DM),以降低血糖水平。
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引用次数: 0
Epidemiological Study of Proliferative Diabetic Retinopathy Treatments for the Vision-Threatening Complications of Diabetic Macular Edema 增殖性糖尿病视网膜病变的流行病学研究糖尿病黄斑水肿危及视力并发症的治疗
Pub Date : 2018-09-16 DOI: 10.31579/2640-1045/029
A. Petrovich
Diabetic retinopathy (DR) is a leading cause of vision-loss globally. Of an estimated 285 million people with diabetes mellitus worldwide, approximately one third have signs of DR and of these, a further one third of DR is vision-threatening DR, including diabetic macular edema (DME). The identification of established modifiable risk factors for DR such as hyperglycemia and hypertension has provided the basis for risk factor control in preventing onset and progression of DR. Additional research investigating novel risk factors has improved our understanding of multiple biological pathways involved in the pathogenesis of DR and DME, especially those involved in inflammation and oxidative stress. Variations in DR prevalence between populations have also sparked interest in genetic studies to identify loci associated with disease susceptibility. Diabetic retinopathy (DR) is a leading cause of vision-loss globally. Of an estimated 285 million people with diabetes mellitus worldwide, approximately one third have signs of DR and of these, a further one third of DR is vision-threatening DR, including diabetic macular edema (DME). The identification of established modifiable risk factors for DR such as hyperglycemia and hypertension has provided the basis for risk factor control in preventing onset and progression of DR. Additional research investigating novel risk factors has improved our understanding of multiple biological pathways involved in the pathogenesis of DR and DME, especially those involved in inflammation and oxidative stress. Variations in DR prevalence between populations have also sparked interest in genetic studies to identify loci associated with disease susceptibility. In this review, major trends in the prevalence, incidence, progression and regression of DR and DME are explored, and gaps in literature identified. Established and novel risk factors are also extensively reviewed with a focus on landmark studies and updates from the recent literature.
糖尿病视网膜病变(DR)是全球视力下降的主要原因。据估计,在全世界2.85亿糖尿病患者中,约有三分之一的人有DR的症状,其中,还有三分之一是威胁视力的DR,包括糖尿病黄斑水肿(DME)。已确定的DR可改变风险因素的识别,如高血糖和高血压,为控制风险因素预防DR的发作和进展提供了基础。对新风险因素的额外研究提高了我们对DR和DME发病机制中涉及的多种生物学途径的理解,尤其是那些参与炎症和氧化应激的人。不同人群DR患病率的差异也引发了人们对基因研究的兴趣,以确定与疾病易感性相关的基因座。糖尿病视网膜病变(DR)是全球视力下降的主要原因。据估计,在全世界2.85亿糖尿病患者中,约有三分之一的人有DR的症状,其中,还有三分之一是威胁视力的DR,包括糖尿病黄斑水肿(DME)。已确定的DR可改变风险因素的识别,如高血糖和高血压,为控制风险因素预防DR的发作和进展提供了基础。对新风险因素的额外研究提高了我们对DR和DME发病机制中涉及的多种生物学途径的理解,尤其是那些参与炎症和氧化应激的人。不同人群DR患病率的差异也引发了人们对基因研究的兴趣,以确定与疾病易感性相关的基因座。在这篇综述中,探讨了DR和DME的患病率、发病率、进展和回归的主要趋势,并确定了文献中的空白。对已有的和新的风险因素也进行了广泛的综述,重点是里程碑式的研究和最近文献的更新。
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引用次数: 0
Reproductive Endocrinology: Pregnancy and Postpartum Thyroid Disorders in Women 生殖内分泌学:妇女妊娠和产后甲状腺疾病
Pub Date : 2018-09-16 DOI: 10.31579/2640-1045/031
E. Rogers
Reproductive Endocrinology is a medical specialty for infertility, menopause, and other issues with reproductive hormones. Reproductive endocrinologists are OB/GYN (obstetrics and gynecology) doctors with special training to help both men and women with problems related to reproductive hormones. Sometimes, this specialty is called reproductive endocrinology and infertility because much of their work focuses on helping women to become pregnant and carry a baby to term.
生殖内分泌学是一门治疗不孕症、更年期和其他生殖激素问题的医学专业。生殖内分泌学家是受过特殊训练的妇产科医生,他们可以帮助男性和女性解决与生殖激素有关的问题。有时,这个专业被称为生殖内分泌学和不孕症,因为他们的大部分工作都集中在帮助女性怀孕和分娩。
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引用次数: 0
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Endocrinology and disorders : open access
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