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The Aging Process of the Heart: Obesity Is the Main Risk Factor for Left Atrial Enlargement During Aging The MONICA/KORA (Monitoring of Trends and Determinations in Cardiovascular Disease/Cooperative Research in the Region of Augsburg) Study

STRITZKE, Jan; MARKUS, Marcello Ricardo Paulista; DUDERSTADT, Stefanie; LIEB, Wolfgang; LUCHNER, Andreas; DOERING, Angela; KEIL, Ulrich; HENSE, Hans-Werner; SCHUNKERT, Heribert; MONICA KORA Investigators
Fonte: ELSEVIER SCIENCE INC Publicador: ELSEVIER SCIENCE INC
Tipo: Artigo de Revista Científica
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Objectives This prospective study evaluated the association of obesity and hypertension with left atrial (LA) volume over 10 years. Background Although left atrial enlargement (LAE) is an independent risk factor for atrial fibrillation, stroke, and death, little information is available about determinants of LA size in the general population. Methods Participants (1,212 men and women, age 25 to 74 years) originated from a sex-and age-stratified random sample of German residents of the Augsburg area (MONICA S3). Left atrial volume was determined by standardized echocardiography at baseline and again after 10 years. Left atrial volume was indexed to body height (iLA). Left atrial enlargement was defined as iLA >= 35.7 and >= 33.7 ml/m in men and women, respectively. Results At baseline, the prevalence of LAE was 9.8%. Both obesity and hypertension were independent predictors of LAE, obesity (odds ratio [OR]: 2.4; p < 0.001) being numerically stronger than hypertension (OR: 2.2; p < 0.001). Adjusted mean values for iLA were significantly lower in normal-weight hypertensive patients (25.4 ml/m) than in obese normotensive individuals (27.3 ml/m; p = 0.016). The highest iLA was found in the obese hypertensive subgroup (30.0 ml/m; p < 0.001 vs. all other groups). This group also presented with the highest increase in iLA (+6.0 ml/m) and the highest incidence (31.6%) of LAE upon follow-up. Conclusions In the general population...

Screening for acromegaly in adult patients not reporting enlargement of the extremities, but with arterial hypertension associated with another comorbidity of the disease

Rosario,Pedro Weslley; Calsolari,Maria Regina
Fonte: Sociedade Brasileira de Endocrinologia e Metabologia Publicador: Sociedade Brasileira de Endocrinologia e Metabologia
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/11/2014 Português
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Objective To determine the value of acromegaly screening in adult patients not reporting enlargement of the extremities, but who present arterial hypertension associated with at least one other comorbidity of the disease. Subjects and methods Patients seen by general practitioners at primary health care units were evaluated. Among the patients without extremity enlargement, those with recently diagnosed arterial hypertension associated with at least one other comorbidity were selected. Results A total of 1,209 patients were submitted to laboratory investigation. Elevated IGF‐1 was observed in 22 patients. Eighteen patients had adequate suppression of growth hormone (GH). No GH suppression was observed in four women with confirmed elevated IGF‐1. In the latter, IGF‐1 and nadir GH were only slightly elevated, magnetic resonance showed a normal pituitary, and chest and abdominal computed tomography revealed no tumor, and no intervention was performed. Conclusion In patients with arterial hypertension without known pituitary disease, acromegaly is unlikely in the absence of enlargement of the extremities.

Clinical and morphological study of calf enlargement following S-1 radiculopathy

Nascimento,Osvaldo J. M.; Freitas,Marcos R. G. de; Hahn,Myrian D.; Araújo,Abelardo Q. C.
Fonte: Academia Brasileira de Neurologia - ABNEURO Publicador: Academia Brasileira de Neurologia - ABNEURO
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/09/1992 Português
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Calf enlargement following sciatica is a rare condition. It is reported the case of a 28-year-old woman who complained of repeated episodes of lower back pain radiating into the left buttock and foot. One year after the beginning of her symptoms, she noticed enlargement of her left calf. X-ray studies disclosed L5-S1 disk degeneration. EMG showed muscle denervation with normal motor conduction velocity. Open biopsies of the gastrocnemius muscles were performed. The left gastrocnemius muscle showed hypertrophic type 2 fibers in comparison with the right gastrocnemius. Electron microscopy showed mildly increased number of mitochondria in these fibers. A satisfactory explanation for denervation hypertrophy has yet to be provided.

Drug-induced gingival enlargement - Part II. Antiepileptic drugs: not only phenytoin is involved

Lin,Katia; Guilhoto,Laura M. F. F.; Yacubian,Elza Márcia Targas
Fonte: Liga Brasileira de Epilepsia (LBE) Publicador: Liga Brasileira de Epilepsia (LBE)
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/2007 Português
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INTRODUCTION: Gingival enlargement is the term now used to describe medication-related gingival overgrowth or gingival hyperplasia, a common reactionary phenomenon that occurs with the use of several types of therapeutic agents, including antiepileptic drugs. This disorder has been recognized since 1939, shortly after the introduction of phenytoin. METHODS: Review of literature concerning etiology, pathogenesis and management of antiepileptic drug induced gingival enlargement. CONCLUSIONS: It is important that neurologists become aware of the potential etiologic agents of antiepileptic drug induced gingival enlargement and its characteristic features in order to be able to prevent, diagnose and successfully manage it.

EU enlargement: meeting the challenges of the global security and trade environment

Downer, Alexander
Fonte: Universidade Nacional da Austrália Publicador: Universidade Nacional da Austrália
Tipo: Working/Technical Paper Formato: 26531 bytes; 351 bytes; application/pdf; application/octet-stream
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Introduction:...European integration has been an extraordinary and visionary enterprise, built on practical steps towards unity. The European Union is not only a complex work in progress, harmonising the internal policies of its members, but a force in world politics. This sixth wave of enlargement is one of the great moments in its evolution. This conference has an ambitious agenda and brings together a body of experts intimately concerned with the engineering of this grand design. And the conference is timely and relevant for Australia, because it is important to our relationship that Australians comprehend the dynamics and changing nature of the EU. My theme today is the opportunity that the imminent expansion of the EU offers for tackling global security and trade challenges. I want to expand particularly on areas where Australia’s interests are strongly engaged.; Speech at the National Europe Centre Conference on EU enlargement, Canberra, Australia; no

Conditions and consequences of EU enlargement: a Polish perspective

Pusz, Sylwia
Fonte: Universidade Nacional da Austrália Publicador: Universidade Nacional da Austrália
Tipo: Working/Technical Paper Formato: 99340 bytes; 351 bytes; application/pdf; application/octet-stream
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Conclusion: By 30 April 2002 Poland has temporarily closed negotiations with the European Union in 23 negotiation chapters. At present negotiations are conducted in the following 7 chapters: Competition policy, Fisheries, Transport policy, Justice and home affairs, Regional policy and co-ordination of structural instruments, Agriculture, Financial and budgetary provisions. The difficulties that arise in the negotiation process result from the fact that the integration with the EU is constantly developing, and the Community law is changing. Every year there are new common arrangements, which amend and supplement present principles and rules. Of course, this creates additional challenges and difficulties for the negotiating teams. The longer the negotiations the more probable the change of the common rules and the necessity to adapt them to a moving target. In addition, negotiations are complicated by several other issues, which were irrelevant during previous enlargements of the European Union. The basic one issue that accession negotiations coincided with deep changes in the Union itself, relating to the implementation of the third stage of the Economic and Monetary Union. The Member States of the EU lost their monetary sovereignty and the possibility to use exchange rates. These competencies have been vested in the supranational financial authority - European Central Bank. It is understood that a simultaneous implementation of two very ambitious tasks...

The impact of EU enlargement on external relations, notably with the US and Russia

Noe, Willem
Fonte: Universidade Nacional da Austrália Publicador: Universidade Nacional da Austrália
Tipo: Working/Technical Paper Formato: 47616 bytes; 348 bytes; application/pdf; application/octet-stream
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Conclusion: In summary, enlargement will prove a positive for bilateral relations between the US and the EU but will also make them more complicated. The US supports enlargement as next big step toward European integration and securing the gains of the post Cold War. There are also considerable economic opportunities. On the other hand, the possibility of a larger, more competitive and more assertive EU may threaten US interests. Deepening EU relations with Russia will herald an opportunity for the US to secure a more prosperous, stable Russia. Russia appears to consider enlargement an opportunity to drive a wedge between the EU and the US. All the more reason, then, for collaboration between the European Union and America to avert this possibility.; no

Histological and immunohistochemical features of gingival enlargement in a patient with AML

Sonoi, N.; Soga, Y.; Maeda, H.; Ichimura, K.; Yoshino, T.; Aoyama, K.; Fujii, N.; Maeda, Y.; Tanimoto, M.; Logan, R.; Raber-Durlacher, J.; Takashiba, S.
Fonte: Springer Japan KK Publicador: Springer Japan KK
Tipo: Artigo de Revista Científica
Publicado em //2012 Português
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Here, we discuss the pathophysiology of leukemia-associated gingival enlargement based on a case of acute myelomonocytic leukemia (AML-M4) with typical gingival enlargement. Uniquely, this patient was well enough to allow full periodontal examination and incisional gingival biopsy to be performed both before and after chemotherapy. The patient was a 39-year-old Japanese woman with AML-M4 showing gingival enlargement. Histological and immunohistochemical features of gingiva and bacterial counts in the periodontal pockets were examined before and after chemotherapy. The results were as follows: (1) infiltration of myelomonocytic blasts in enlarged gingiva; (2) resolution of gingival enlargement with complete remission of AML by anticancer chemotherapy; and (3) the numbers of bacteria in the periodontal pockets were not high and were not altered before or after chemotherapy. In patients with AML-M4, remarkable mucosal enlargement is not generally observed in the body except in the gingiva. We hypothesized that antigens derived from periodontal bacteria, even if they are not present in large numbers, could act as chemoattractants for myelomonocytic leukemic cells.; Norihiro Sonoi, Yoshihiko Soga, Hiroshi Maeda, Koichi Ichimura, Tadashi Yoshino...

Regionenabhängige Vergrößerungsfaktoren von Panoramaschichtaufnahme in Abhängigkeit von der Patientenpositionierung und ihre Bedeutung für die Implantologie; Area-dependent enlargement ratios of panoramic tomography depending on incorrect patient positioning and its significance for implant dentistry

Gómez Román, Germán; Lukas, Dieter; Beniashvili, Roman; Windisch, Simone; Schulte, Willi
Fonte: Universidade de Tubinga Publicador: Universidade de Tubinga
Tipo: ResearchPaper
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Dokument 1: Teil 1: Orthograde Patientenpositionierung Dokument 2: Teil 2: Asymmetric patient positioning - Englische Version Dokument 3: Teil 2: Unsymetrische Fehlpositionierung - Deutsche Version Dokument 4: Teil 3: Symmetric patient positioning - Englische Version Dokument 5: Teil 3: Symetrische Fehlpositionierung - Deutsche Version Dokument 6: Anhang: Horizontale Vergrößerung an der apikalen Implantatstufe - Deutsche Version Dokument 7: Appendix: Horizontal magnification factors at the apical implant step - Englische Version *************************************************** In der vorliegenden Arbeit wurde das Verhalten der vertikalen und horizon-talen Vergrößerungsfaktoren auf der Panoramaschichtaufnahme in den ver-schiedenen Implantatregionen des Ober- und Unterkiefers untersucht. Ein Verfahren wird vorgestellt, das die Bestimmung der regionalen Vergrößerungsfaktoren in Abhängigkeit von der Implantatregion und der Fehlpositionierung des Patienten zuläßt. Dabei werden gut definierte Merkmale am Implantatkörper (Frialit 2- Implantat) als Referenzpunkte herangezogen. Da in der horizontalen Dimension die Patientenpositionierung einen großen Einfluß auf die Vergrößerungs-faktoren vor allem in der Interforaminalregion nimmt...

Enlargement and Legitimacy: A passage from Europe of the Elites to Europe of the Electorates

TAMVAKI, Dionysia D.
Fonte: Instituto Universitário Europeu Publicador: Instituto Universitário Europeu
Tipo: Tese de Doutorado Formato: 1526707 bytes; application/pdf; digital
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This project focuses on the interrelations between the micro-level of popular attitudes to European integration and the macro-level of elite justifications for pursuing membership. Drawing on extant research on Eastern Enlargement this study develops an approach of ‘theoretical differentiation’ and distinguishes between rationally oriented ‘Utility Maximizing’ entrants (UM) and constructively driven ‘Value Maximizing’ countries (VM). ‘Theoretical differentiation’ in elite attitudes then, becomes the default drive in empirically investigating public support for the EU. First, explaining the dynamics of utilitarian public attitudes, this study ‘differentiates’ the short- term, economic factors from the long-term, elite-driven stimuli that render the UM group of countries more eurosceptic than the VM group. The regression analysis shows that while in both groups short-term support fluctuates with the business cycle, the intensity of long-run support is determined by the set of structural characteristics that identify them as either UM or VM. Similarly, ‘differentiation’ in affective support shows that the latter is a mixture of the longterm disposition towards EU, determined by historical elite attitudes, and the current socialization factors that govern short-run variations. Yet...

Eastward Enlargement By the European Union and Transnational Parties

DELSOLDATO, Giorgia
Fonte: Sage Publications Ltd Publicador: Sage Publications Ltd
Tipo: Artigo de Revista Científica
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In this article, the Ostpolitik of European transnational parties is examined as a process within the process of the eastward enlargement of the European Union. First, the Eastern politics of major European transnational parties is analyzed within the framework of their development and institutionalization processes. Then, the European transnational party-level dimension is examined as part of the development of party systems and party politics in the postcommunist candidate countries, with specific references to the EU enlargement policy and a focus on Central Europe.

The second wave of NATO enlargement: a key contributor to the transatlantic link?

Murariu, Adriana
Fonte: Monterey California. Naval Postgraduate School Publicador: Monterey California. Naval Postgraduate School
Tipo: Tese de Doutorado Formato: xiv, 79 p. : col. map
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Approved for public release, distribution is unlimited; The purpose of this study is to determine how post-Cold War NATO allies have contributed to transatlantic relations, both in times of crisis and in times of harmony. Their contribution, although less significant when compared to long-time members' military capabilities, takes various forms. Their support in times of disagreement among allies over the Iraq 2002-2003 issue proved to be more valuable than was anticipated. Therefore, my research is an introspective look at the events that marked NATO's evolution during the last fifteen years and their implications for NATO members as units and for traditional transatlantic relations as a whole. Successive NATO enlargements proved that each decision to add new members reflected NATO's priorities at that particular moment. Whether it was a pre-Cold War enlargement or a post-Cold War enlargement, the decision reflected NATO's interests. Some of the decisions were predominantly military; some were in accordance with the international order established after World War II. The post-Cold War enhancements had two major characteristics: the first enlargement was more symbolic than the second because it erased the artificial lines set by Yalta...

Democracy and security in Central Europe: a comparison of the Czech Republic and Slovakia in NATO Enlargement

Vlach, Miroslav
Fonte: Monterey, California. Naval Postgraduate School Publicador: Monterey, California. Naval Postgraduate School
Tipo: Tese de Doutorado Formato: xvi, 164 p.
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Approved for public release; distribution is unlimited; This thesis compares two cases of European democracy and security to explain why the Czech Republic was invited to join NATO and why Slovakia was excluded from the Euro-Atlantic integration. This thesis further discusses the political and economic character of Slovakia and the proposed reforms of Slovak policy to join NATO and the European Union in the near future. When Czechoslovakia split into two independent states, the Czech Republic and Slovakia, on January 1, 1993, both were believed to have a good chance of integrating into the West's political and military organizations at the earliest opportunity. While the Czech Republic forged ahead with democratic and free market reforms and successfully completed NATO accession talks, Slovakia failed to achieve these important objectives. Because of Slovak Prime Minister Vladimfr Meciar's anti-democratic statecraft, Slovakia has lately been excluded from the enlargement process. This policy led Slovakia slowly and non-democratically toward an authoritarian regime and dictatorship. However, the 1998 September Parliamentary elections have changed the political face of Slovakia and the new Prime Minister, Mikulas Dzurinda's government...

NATO enlargement and democratic control of the Armed Forces: the experience of Poland and implications for neighboring "Partnership for Peace" countries

Svirdenko, Valery
Fonte: Monterey, California. Naval Postgraduate School Publicador: Monterey, California. Naval Postgraduate School
Tipo: Tese de Doutorado Formato: xiii, 110 p.
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Approved for public release; distribution is unlimited; The collapse of the Warsaw Pact, the end of global confrontation and the subsequent disintegration of the Soviet Union brought about a real opportunity for European unification and transatlantic security. Thus there is a unique chance for the states of Central and Eastern Europe to build an improved security architecture in the whole Euro-Atlantic area after half a century of division. That is why Central and East European countries are seeking to join NATO and in that way provide increased stability, peace and security for all without creating new dividing lines. To join NATO all Central and East European countries need to accomplish democratic transformation especially in the system of civil-military relations. Democratic civilian control of the military is one of the main prerequisites for Central and East European states to qualify for inclusion in NATO. Thus, NATO enlargement can promote democratic transformations of the East European countries, especially in civil-military relation realm, and integration of the Central and East European countries into the North Atlantic Treaty Organization. By admitting new members NATO will make itself better able to address Europe's new security challenges. Such a broad concept of security embracing political...

On the perceived obstacles to NATO enlargement

Rózsa, Andrea
Fonte: Monterey, California. Naval Postgraduate School Publicador: Monterey, California. Naval Postgraduate School
Tipo: Tese de Doutorado Formato: 127 p.
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Approved for public release; distribution is unlimited; All too often when the issue of NATO enlargement is raised some of the current members object to it due to one of several preconceptions. The more common objections include the potential members' perceived domestic and economic problems, the various disputes betwem these countries themselves, and the adverse position Russia has taken regarding the question. The author intends to show that present requirements, as set forth in the September 1995 'Study on NATO Enlargement,' were not applied to previous enlargements, a fact that raises the question of fairness in present members' expectations. Furthermore, by exarnining three alternative scenarios for Russia in the fliture, it will be shown that none of these suggests that the issue of enlargement should be dropped. Finally, the study of Hungary, a country representing a 'middle ground' among the so-called 'Visegrad four,' will demonstrate that Hungary is closer today to complying with the strict expectations set forth in the document than previously added members were, although their task was much less demanding. This implies that stereotypes are involved in resistance to NATO enlargement, which should be set aside if only to secure a more stable regional environment in Europe.; http://archive.org/details/onperceivedobsta00rozs; First Lieutenant...

The European Union's enlargement process

Bastarreche, Carlos
Fonte: Universidade Nacional da Austrália Publicador: Universidade Nacional da Austrália
Tipo: Working/Technical Paper Formato: 41408 bytes; 356 bytes; application/pdf; application/octet-stream
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[Conclusion]: .....one must bear in mind that enlargement is an open process. Its obvious complexity is commensurate with the historical impact that it carries with it, as determining factor for the future of our Continent and for the role that the EU has to play in the international sphere. Turkey is already enjoying the recognized statute of candidate country and the benefits of pre-accession facilities. Furthermore, the latest invitations to participate in the European Conference, which is a forum of political dialogue, provide an indicative list of potential and foreseeable candidates. Together with the traditional ones, which are part of the European Free Trade Association, the European Council of Nice included the Balkan countries that is to say, Croatia, Macedonia, Bosnia Herzegovina, Federal Republic of Yugoslavia and Albania. More recently, in Gottemburg, Moldavia and the Ukraine were also invited. The process of integration and extension and, ultimately, of strengthening of the EU against the background of globalization, does not seem to end with the fifth enlargement. Other countries of Europe may follow the road of the current 13 candidates, engaging in a process that will one day culminate in the reunion of the Continent as a whole...

Germany and the enlargement of the European Union

Klaiber, Klaus-Peter
Fonte: Universidade Nacional da Austrália Publicador: Universidade Nacional da Austrália
Tipo: Working/Technical Paper Formato: 95973 bytes; 359 bytes; application/pdf; application/octet-stream
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Let me begin by expressing my thanks to the National Europe Centre for giving me the opportunity to share with you some reflections on the enlargement of the European Union as seen from Germany. I believe it is legitimate for Australian academics, business people and politicians to retain an awareness of the changing realities in Europe because they impact on Australia: - the EU has been the largest economic partner of Australia for the past 12 years - the two-way trade between the EU and Australia totalled 47.2 bn A$ in 2003, that is 19 % of all transactions of Australia - Euroland (12 EU countries with a single currency) is the second largest financial market after the US. 45 % of Australia's reserves are held in Euro. These are just a few figures to demonstrate to you the significance of EU-Australian relations.; no

Association between gingivitis and anterior gingival enlargement in subjects undergoing fixed orthodontic treatment

Zanatta,Fabricio Batistin; Ardenghi,Thiago Machado; Antoniazzi,Raquel Pippi; Pinto,Tatiana Militz Perrone; Rösing,Cassiano Kuchenbecker
Fonte: Dental Press International Publicador: Dental Press International
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/2014 Português
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OBJECTIVE: The aim of this study was to investigate the association among gingival enlargement (GE), periodontal conditions and socio-demographic characteristics in subjects undergoing fixed orthodontic treatment. METHODS: A sample of 330 patients undergoing fixed orthodontic treatment for at least 6 months were examined by a single calibrated examiner for plaque and gingival indexes, probing pocket depth, clinical attachment loss and gingival enlargement. Socio-economic background, orthodontic treatment duration and use of dental floss were assessed by oral interviews. Associations were assessed by means of unadjusted and adjusted Poisson's regression models. RESULTS: The presence of gingival bleeding (RR 1.01; 95% CI 1.00-1.01) and excess resin around brackets (RR 1.02; 95% CI 1.02-1.03) were associated with an increase in GE. No associations were found between socio-demographic characteristics and GE. CONCLUSION: Proximal anterior gingival bleeding and excess resin around brackets are associated with higher levels of anterior gingival enlargement in subjects under orthodontic treatment.

Antiplatelet therapies are associated with hematoma enlargement and increased mortality in intracranial hemorrhage

Gea-García,J.H. de; Fernández-Vivas,M.; Núñez-Ruiz,R.; Rubio-Alonso,M.; Villegas,I.; Martínez-Fresneda,M.
Fonte: Medicina Intensiva Publicador: Medicina Intensiva
Tipo: info:eu-repo/semantics/article; journal article; info:eu-repo/semantics/publishedVersion Formato: text/html; application/pdf
Publicado em 01/11/2012 Português
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Objective: Antiplatelet therapy (AT) is increasingly used for treating or preventing vascular diseases, especially as a consequence of population aging. However, the risks may sometimes outweigh the benefits, mostly in relation to intracranial hemorrhage (ICH). Our aim was to determine whether AT is associated with hematoma enlargement and increased mortality in ICH. Design: A prospective, observational cohort study. Setting: The Intensive Care Unit (ICU) of Arrixaca University Hospital (Murcia, Spain). Patients: We studied 156 patients admitted with non-traumatic ICH between January 2006 and August 2008. Interventions: None. Main variables: Demographic data, medical history and clinical and laboratory parameters were recorded, along with hematoma volume upon admission and after 24h, and mortality. Results: A total of 37 patients (24%) received AT. These subjects were older (69±11 vs. 60±15 years, p=0.001) and more frequently diabetic (38% vs. 15%, p=0.003) than those without AT. We detected no difference in hematoma volume upon admission between the two groups, though the volume was significantly greater after 24h in the AT group (66.7 [IQR 42-110] vs. 27 [4.4-64.6]cm³, p=0.03), irrespective of surgical intervention. Moreover, hematoma volume increased by more than a third in AT-users (69% vs. 33%...

HIV-associated salivary gland enlargement: a clinical review

Ebrahim,S; Singh,B; Ramklass,SS
Fonte: South African Dental Journal Publicador: South African Dental Journal
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/10/2014 Português
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Salivary gland disease is well established as an important HIV associated oral lesion. It manifests as salivary gland swelling involving one or both parotid glands with or without xerostomia. In the context of HIV, the swelling may be due to a wide spectrum of pathological conditions that include reactive or inflammatory disorders, acute and chronic infections, and neoplasms. This paper reviews the epidemiology, pathogenesis, clinical presentation, aspects of diagnosis and management of HIV associated salivary gland enlargement, in particular parotid gland enlargement, due to benign lymphoepithelial cysts (BLEC). Parotid gland enlargement is typically an early manifestation in the HIV-positive patient and should alert healthcare professionals to the likelihood of HIV infection. FNAC of the parotid gland is required to confirm the diagnosis and instituting HAART forms an important part of the management. There is a shift away from surgery in the treatment of this essentially ‘benign’ condition.