Background-Endoscopic diagnosis of short segments of Barrett's epithelium (SSBE) is diYcult and its meaning in terms of the presence of specialised columnar epithelium (SCE) has not been prospectively evaluated. Aims-To evaluate the prevalence of SCE in patients with an endoscopic diagnosis of SSBE and in individuals with normal appearing oesophagogastric junctions, and to compare the clinical characteristics of these two groups. Patients-Thirty one patients with an endoscopic diagnosis of short Barrett's oesophagus, less than 3 cm in length (group A), and 44 consecutive patients with normal appearing oesophagogastric junctions (group B). Methods-Multiple biopsies were performed in suspicious epithelium and at the oesophagogastric junction in groups A and B, respectively. Results-Age and sex distribution were similar in both groups. Reflux symptoms were more frequent in group A (p<0.001), as were endoscopic and histological signs of oesophagitis (p<0.0001 and p=0.001, respectively). SCE was found in 61.3% of group A patients compared with 25% in group B (p<0.002), with men predominating in group A while women were more frequent in group B (p=0.02). The diVerences in reflux symptoms and endoscopic/ histological oesophagitis remained significant. Conclusions-These results show that endoscopic diagnosis of SSBE is associated with a high prevalence of SCE, significantly higher than that found in normal appearing oesophagogastric junctions. DiVerences between patients with SCE in the two groups suggest they may represent two diVerent entities. (Gut 1998;42:659-662)
Diabetes Mellitus is one of the most common causes of neuropathies, which can be caused by molecular imbalances that impair metabolic pathways. Studies in rats showed the importance of sirtuins (SIRT), deacetylases that use NAD + as a cofactor, which have a widespread function in metabolism, and their relation when food deprived or calorie restricted. Additionally, diabetic neuropathy presents different structural biomarkers that cause morphological alterations in fibers that can be partially treated. SIRT1 is the principal sirtuin, which acts on hypothalamus, liver, kidney, among other organs, up regulating or down regulating the expression of some genes or enzymes crucial in the process of glucose absorption.
Abstract:The aim of the study was to characterize the heart rate variability in a patient with no comorbidities, submitted to buccomaxillofacial surgery under total venous anesthesia using the linear frequency and nonlinear methods in the chaos domain (Poincaré plot). Data collection was performed before, during and after the surgical procedure using a Polar V800 cardiofrequencymeter and subsequently analyzed and filtered using the Kumbios HRV 3.0 software. During propofol infusion, elevations in LF, HF, SD1 and SD2 were observed. The LF/HF ratio showed obvious changes, which were found to be maximal during extubation and submaximal during awakening under greater influence of the sympathetic nervous system. The moment of the incision has parameters similar to those of rest. Final surgery maintenance showed the lowest values of LH/HF and SD1/SD2, with lower LF and SD2 values compared to rest. During the awakening, there was a decrease in SD1 and HF, representing the moment of greatest fragility during the total venous anesthesia, being of fundamental importance future studies about their repercussions.
Major depression is the most common psychiatric disorder described, being a highly disabling disorder with a high prevalence in ocident and has a huge social and economic impact. With several effective treatments to combat depression, whether with drugs, with evidencebased psychotherapy or its association, most of these depressed patients or not outweigh the disease or reach partial improvement. This group is classified as depression resistant to treatment (TRD). Transcranial magnetic stimulation (TMS) is effective alternatives for nonresponsive cases. It is a brain intervention that modulates the activity of cortical areas and neural circuits associated with induction of non-invasive intracerebral current and its most common use is high frequency stimulation in the dorsal region of the left lateral prefrontal cortex (DLPFC). Several single-center, controlled studies TMS studies were made and in most cases, been proven antidepressant properties of TMS, despite certain recommendations for greater safety and efficacy in the treatment of depression.
Objective: evaluate the current evidence regarding different aspects (epidemiological, histological, physiological and genetic) of male infertility caused by Y-chromosome microdeletion. Material and Methods:A systematic review of articles from January 1 st , 1996 and February 28 th , 2014 present in two databases: MeDLINe and ScieLO. The search was performed with the MeSH descriptors "Y Chromosome", "Infertility" and Keyword "microdeletion". results:The literature indicates that deletion of AZF, especially AZFc, is related to azoospermia, oligozoospermia or even infertility. The absence of other loci is also underlined by the evidence: AZFa, AZFb and AZFd, even though the prevalence rates are not equidistant. Surveys also show changes in the male hormone physiology varying the levels of testosterone/LH/FSH as well as modifying the gonadal morphology in individuals affected by Y-chromosome microdeletion. Conclusion:More research is needed focusing on possible deletions that the Y-chromosome may suffer, giving emphasis on their clinical outcomes and correlations with infertility.
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