Literatura científica selecionada sobre o tema "320/.082"

Abstract BACKGROUND: In ruptured cerebral aneurysms (RCAs), identification of the rupture point of a cerebral aneurysm is useful for treatment planning. In unruptured cerebral aneurysms (URCAs), detection of the risk of aneurysmal rupture is also useful for patient management. OBJECTIVE: Electrocardiographic (ECG)-gated 3D-CT angiography was performed for patients with RCAs and URCAs using 320-row area detector CT (ADCT) to detect pulsation of the cerebral aneurysms. The clinical usefulness of this method was then evaluated. METHODS: Twelve patients had 12 RCAs, and 39 patients had 53 URCAs. A 320-row ADCT system was used to scan. ECG-gated reconstruction was then performed with the R-R interval divided into 20 phases. RESULTS: Pulsation was observed in 10 of the 12 RCAs. The bleeding site was considered to correspond to the area of pulsation. Pulsation was observed in 14 of 53 URCAs. Thirteen patients with 18 URCAs were followed. Of the 11 URCAs in which pulsation was not observed, 1 showed a change in shape. Of the 7 URCAs in which pulsation was observed, 3 showed a change in shape. URCAs in which pulsation was observed were more likely to show a change in shape (P = .082). CONCLUSION: The area of pulsation was found to correspond to the bleeding site in many RCAs. This information would be extremely useful for treatment planning. The detection of pulsation in an URCA is therefore considered to provide useful information for patient management.

Background:Exposure to severe or chronic life stressors may alter immune function and high levels of subsequent distress have been implicated in autoimmune disease pathogenesis. Post-traumatic stress disorder (PTSD) is a debilitating psychiatric condition affecting 1-12% of the general population1, occurring in response to traumatic events. Growing evidence supports an association between trauma exposure and PTSD with systemic lupus erythematosus (SLE) onset2.Objectives:To cross-sectionally assess PTSD prevalence in a cohort of patients with SLE and to examine its correlation with quality of life.Methods:A 189-item anonymous questionnaire including demographics, disease features, the 9-domain Trauma and Loss Spectrum – Self Report (TALS-SR) and the 8-domain Lupus Quality of Life (Lupus QoL) was administered via web to a cohort of patients with SLE. Patients were classified as PTSD cases based on TALS-SR items corresponding to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for PTSD.Results:Ninety-nine (95% female and 5% male) patients with a median follow-up of 16.5 years completed the questionnaire. Self-reported fatigue prevalence was 75%. Fifteen patients (15%) reportedly were on psychological and/or psychiatric support. Thirty-one patients (31%) met the DSM-5 criteria for PTSD. The average LupusQoL interdomain score was 80/100. PTSD cases reported significantly lower scores compared to non-cases in three LupusQoL domains: planning (83 vs. 100, p=0.035), body image (85 vs. 95, p=0.031), and fatigue (67 vs. 92, p=0.001). An inverse correlation between TALS-SR scores and Lupus QoL subscales was found (Table1). In particular, the degree of stress secondary to losses or upsetting events was strongly correlated to fatigue intensity (rho= -0.458, p<0.001).Conclusion:PTSD prevalence might be higher in SLE than in the general population and have a detrimental influence on quality of life. Fatigue perception might be more significantly affected by PTSD. Intervention studies are needed to assess the therapeutical effects of psychological support in patients with SLE.References:[1]Shalev A et al. Post-Traumatic Stress Disorder. New England Journal of Medicine, June 2017.[2]Roberts AL et al. Association of Trauma and Posttraumatic Stress Disorder With Incident Systemic Lupus Erythematosus in a Longitudinal Cohort of Women. Arthritis & Rheumatology, November 2017.Table 1.Spearman rho coefficients outlining correlation across Lupus QoL and TALS-SR domains. The highest negative correlation has been found between fatigue and reaction to traumatic events. Significant correlations boxes are coloured in yellow (weak, rho 0.20-0.39) and red (moderate, rho 0.40-0.59). * p<0.05, ** p<0.01.LupusQoL DomainsLupus QoL Total ScorePhysical healthPainPlanningIntimate relationshipsBurden to othersEmotional healthBody imageFatigueTALS-SR DomainsLoss events-.217-.217-.096-.031.047-.022.076-.009-.061Grief reactions-.145-.104-.041-.018-.124-.172-.192-.149-.107Potentially traumatic events.039-.082-.169-.167-.207-.185-.046-.229-.096Reaction to losses or upsetting events-.221-.256*-.289*-.218-.290*-.369**-.371**-.458**-.341**Re-experiencing-.139-.215-.245*-.228-.320**-.275*-.287*-.342**-.274*Avoidance and numbing-.176-.246*-.279*-.257*-.337**-.405**-.413**-.406**-.338**Maladaptive coping-.190-.238-.294*-.282*-.324**-.340**-.358**-.405**-.327**Arousal-.134-.177-.263*-.320**-.283*-.279*-.321**-.397**-.282*Personal characteristics / risk factors-.044-.115-.266*-.189-.409**-.231-.197-.253*-.199Disclosure of Interests:Luca Moroni: None declared, Martina Mazzetti: None declared, Giuseppe Alvise Ramirez: None declared, Simone Zuffada: None declared, Nicola Farina: None declared, Enrica Bozzolo: None declared, Valentina Di Mattei: None declared, Lorenzo Dagna Consultant of: Abbvie, Amgen, Biogen, BristolMyers Squibb, Celltrion, Galapagos, GlaxoSmithKline, Novartis, Pfizer, Roche, Sanofi-Genzyme, and SOBI, Grant/research support from: The Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR) received unresctricted research/educational grants from Abbvie, Bristol-Myers Squibb, Celgene, GlaxoSmithKline,Janssen, Merk Sharp & Dohme, Mundipharma Pharmaceuticals, Novartis, Pfizer, Roche, Sanofi Genzyme, and SOBI